Olivia Pope on a Budget

Week 4

July 28th – Aug 3rd, 2014

Another week of life in and out of medical school + in and outside of Cleveland.

MONDAY: Communication Workshops are hard!

When I heard that there were workshops here detailing how to talk to patients, me in my hubris kind of scoffed. We have to learn how to talk to people for 2 hours? Is this necessary?

I consider(ed) myself somewhat personable and friendly…a descent listener. At least that is what I am told…but dang, I am beginning to realize that this whole talking to patients thing is very different from talking to my friend Joe Schmo. First of all, it is a systematic and organized conversation. I can’t converse just to talk. Also there are these strange occupational power dynamics going on.  Taking a history of present illness and patient history involves several questions and acronyms so you collect the right amount of memorization. Until these questions become second nature, and I gain an artful medical interviewing style, I cannot help but be apprehensive that I will forget an important question, or in the process of remembering, appear distant or bizarre!

I hope I am not overthinking this…

TUESDAY: Neuro stuff but histopathology slides are starting to make more sense. 

OMG the spinal chord and stuff…need to learn about that. But, those histopath slides of different tissues are starting to make more sense now. I can identify different types of epithelial cells (squamous v simple, cuboidal, columnar etc) and different types of tissues like (loose connective, dense regular, dense irregular) and different types of muscle (smooth, skeletal, cardiac)! Woo!

ALL DAY ERRDAY: Need to dress for the job I want

If anyone has any advice for where I can buy AFFORDABLE and STYLISH professional clothing (think Olivia Pope on a budget) please holla at me. Please and thank you.

THURSDAY: Neighborhood Family Practice

Exciting bit of the week!

I ventured to Neighborhood Family Practice’s main campus on Ridge Road. At first, I thought we were in the Detriot-Shoreway neighborhood I read about earlier in New to Cleveland (as designated in the field placement document), but later discovered that the NFP location I visited today was the main campus located elsewhere. Unsure of where we were exactly, my preconceived notions of the community and the people they serve dissipated, and I observed my surroundings with curiosity and an open mind.

When fellow M1, Len, pulled into the shopping complex where NFP was located, I noticed how it was situated right next to a Dave’s “Mercado.” The Spanish spelling of market told me that the community NFP serves would include a Latino population, but when we all stepped inside we all learned much more.

NFP is an extremely busy federally qualified health center (FQHC). In 2012, they saw 14,000 patients and had over 50,000 visits. Half of their patients are on Medicaid and about half of their patients are also below the poverty line. Since NFP is a FQHC, they have received a significant amount of funds through federal grants in order to serve their patients. If qualified, a smoking patient with high cholesterol may have access to expensive top of the line drugs like Crestor or  smoking cessation drugs like Chantix, which usually aren’t covered by insurance for sometimes only $10. Their location next to Dave’s Mercado allows NFP to refer patients to their pharmacy and fresh produce.

NFP is filled with family physicians, family nurse practicioners, social workers, nurses, and “patient advocates.” They all work in close proximity to one another with their desks side by side. The role of the patient advocate was especially interesting to me because it reminded me of my old Health Leads position back in Chicago where I had a similar role. Patients are referred to advocates in order to gain access to resources like housing or to even be enrolled in an insurance plan. The roll of a patient advocate has gotten even busier of late because the ACA allows many individuals who formally were uninsured to gain access to insurance. Patient advocates could be any individual trained to do the position—even college students, and I think it is such a great way to provide integrated and personal care for patients. And, an excellent way to provide process and system improvement.

NFP works in tandem with the community. Before employing a new physician or transferring them to a new site, a decision must be made by a committee of individuals reflective of the medical providers as well as the community. This integration allows the clinicians to hear directly from their patients and to be more attuned to the needs of the community.

An innovative idea that came from this partnership was the “Rest, Breast, Refresh” stations at the Taste of Tremont two weeks ago. Community members wanted places to breastfeed on hot summer days, and the NFP set up stations during the busy event. I thought their response and action was creative and thoughtful!

NFP also works closely with refugees that come into the Cleveland area. The physician who gave us the tour told us that cultural competency goes a long way. She said that a simple, “Namaste” greeting and put a smile on the face of a patient.

Family medicine is really special, and I was really honored to see a bit of what can be done for patients when doctors have a long-lasting relationship with them.

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THURSDAY: Hearing from Patients

Case has this lovely thing where we get to hear from special patients every week. It really is really rewarding to hear their stories and the impacts their physicians have had on them. I have a great story for the next post! Stay tuned!

SUNDAY: Witnessing the Marriage of Kindred Spirits

On Saturday I took a Lyft (the driver was slightly more creepy than previous Lyft drivers. Creepiness is of note) to the Cleveland airport and flew out to Chicago for a whirlwind trip. I had the privilege of witnessing one of my close friends from college get married. She looked lovely (pretty much like a princess), and she and her new husband look perfect together and seem to have very compatible temperaments. She is a dancer and had probably the best first dance with her new hubby I’ve ever seen! Ballet slippers and all!!

At Winterfest, an InterVarsity Christian Fellowship conference, one year, I remember playing Mendelssohn’s wedding march on my computer, and talked about it. I asked her what song she’d walk down the aisle to, and she told me it would probably be something from a ballet, and when I saw my dear friend walk down the aisle to Waltz of the Flowers from the Nutcracker, I thought to myself how much time flies and how dreams really do come true.

You never know how life may change.

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