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In love with a health department?
So, today was my big adherence presentation at my new clinic. Things began inauspiciously, but wound up going really really well. This part of my job is going to be wonderful.
Yesterday afternoon, I checked out the Institute's laptop and projector and practiced putting them together and loading the presentation. (Was I nervous? Why, yes, I was nervous. Why do you ask?) I made 20 copies of my handouts. I removed the superfluous equipment from the laptop bag (zip drive, extra Li battery, external mouse in an oddly heavy case, assorted cables) so that it would be light enough to lift. (For some reason, the Institute has a tiny, adorable little projector with just a whisper of weight to it, and a 50-pound laptop-and-case.) I checked the train schedule once. I checked it again. I packed an extra electronic copy of my presentation, just in case.
I got on the train at my stop, and got off at College Park. It was only then, as the commuter rail pulled away, that it became clear that there must be two College Park commuter rail stops. I was near the Metro station, which I had been told was about a mile from the clinic. A nice young graduate student in English directed me as best she could (toward Rte 1, that being the only navigational landmark she mentioned that I recognized), and I started walking. And walking. It was probably half a mile to Rte 1. Did I mention that I was wearing heels?
By Rte 1, sweat was pouring off me and my feet were starting to hurt. Mercifully, it was not as hot as it had been the day before. Unfortunately, that's not saying much. I went into a laundromat to ask directions, and the look of dismay on the people's face when I said I was walking was enough for me. I went across the street to an Exxon station, called a cab, and started sponging myself off as best I could with paper towels. The neckline and chest of my shirt were visibly soaked with sweat, and there wasn't much I could do about it, but I at least dried off a bit.
The cab took me right past the Riverdale rail stop. The clinic was a block and a half away, just as advertised. The very nice nurse I'd met on my previous visit took me immediately into a heavily air conditioned back office and suggested that I rest and compose myself for a few minutes. One glance in the bathroom mirror explained why: I was lividly red, and damp, and in disarray. I'm surprised she didn't want to check me for heatstroke.
Lydia wasn't there yet, but around 10:15 (when they'd finally managed to assemble everyone) I launched into my presentation anyway. She showed up about 10:30, I think - I was a little busy at the time. The presentation went very well indeed - every five minutes or less someone would have a question, or a comment, or they'd want to check my clinical experience against theirs. I can't remember the last time I had such an engaged audience. A lot of the questions focused on secondary prevention - something I don't think anyone ever mentioned at the EJC. (Certainly not directly.) People were so eager, so receptive, so friendly to our ideas and our approach.
After the presentation, Lydia and I got mobbed by the prevention-counseling team. We ended up staying an extra hour to meet with them - they wanted to tell us about their program, and find out what we thought we could add. It hit me, partway through that second meeting, what the difference must be between this clinic and the EJC. I had been thinking in terms of size, of overcrowding, of staffing. That's not it. The EJC was an Infectious Disease clinic, an outpatient clinic of a traditional medical center. The clinic was run on the medical model, and things like psych and social work were seen as ancillary services. (And, of course, psychology was subordinate to psychiatry, because psychiatry is a medical specialty.) So patients' social and behavioral needs were never a priority - because they weren't viewed as primary functions of the clinic.
This new place is a Health Department clinic. It's not run according to the medical model, it's run according to a public health model. Their philosophy places prevention, health education, counseling, health promotion at the core of the clinic's purpose. So the kind of work that we do fits right in. It's wonderful! It's so exciting to think about what we can do with Behavioral Medicine services in a clinic that's actually designed to support and encourage the kind of work we do. They're so pleased about having us come, and so excited about working with us - it's almost hard to believe. They almost seem unnaturally nondefensive and open to suggestions. More than one person has actually said to us, "As you get to know our system, let us know if there's anything you think we should change. We're open to almost anything."
And it doesn't seem like there are going to be turf wars. Both the psychiatric nurse who currently does most of the psychotherapy, and the person running the prevention counseling program, seemed genuinely delighted to have someone to share the work and bring in new ideas and new areas of expertise.
Is it too good to be true? Or am I just too accustomed to the dysfunctional, after a year at the EJC? I don't even care. I just want to get started there. Please, let them have signed the contract. I want to start right away...
Yesterday afternoon, I checked out the Institute's laptop and projector and practiced putting them together and loading the presentation. (Was I nervous? Why, yes, I was nervous. Why do you ask?) I made 20 copies of my handouts. I removed the superfluous equipment from the laptop bag (zip drive, extra Li battery, external mouse in an oddly heavy case, assorted cables) so that it would be light enough to lift. (For some reason, the Institute has a tiny, adorable little projector with just a whisper of weight to it, and a 50-pound laptop-and-case.) I checked the train schedule once. I checked it again. I packed an extra electronic copy of my presentation, just in case.
I got on the train at my stop, and got off at College Park. It was only then, as the commuter rail pulled away, that it became clear that there must be two College Park commuter rail stops. I was near the Metro station, which I had been told was about a mile from the clinic. A nice young graduate student in English directed me as best she could (toward Rte 1, that being the only navigational landmark she mentioned that I recognized), and I started walking. And walking. It was probably half a mile to Rte 1. Did I mention that I was wearing heels?
By Rte 1, sweat was pouring off me and my feet were starting to hurt. Mercifully, it was not as hot as it had been the day before. Unfortunately, that's not saying much. I went into a laundromat to ask directions, and the look of dismay on the people's face when I said I was walking was enough for me. I went across the street to an Exxon station, called a cab, and started sponging myself off as best I could with paper towels. The neckline and chest of my shirt were visibly soaked with sweat, and there wasn't much I could do about it, but I at least dried off a bit.
The cab took me right past the Riverdale rail stop. The clinic was a block and a half away, just as advertised. The very nice nurse I'd met on my previous visit took me immediately into a heavily air conditioned back office and suggested that I rest and compose myself for a few minutes. One glance in the bathroom mirror explained why: I was lividly red, and damp, and in disarray. I'm surprised she didn't want to check me for heatstroke.
Lydia wasn't there yet, but around 10:15 (when they'd finally managed to assemble everyone) I launched into my presentation anyway. She showed up about 10:30, I think - I was a little busy at the time. The presentation went very well indeed - every five minutes or less someone would have a question, or a comment, or they'd want to check my clinical experience against theirs. I can't remember the last time I had such an engaged audience. A lot of the questions focused on secondary prevention - something I don't think anyone ever mentioned at the EJC. (Certainly not directly.) People were so eager, so receptive, so friendly to our ideas and our approach.
After the presentation, Lydia and I got mobbed by the prevention-counseling team. We ended up staying an extra hour to meet with them - they wanted to tell us about their program, and find out what we thought we could add. It hit me, partway through that second meeting, what the difference must be between this clinic and the EJC. I had been thinking in terms of size, of overcrowding, of staffing. That's not it. The EJC was an Infectious Disease clinic, an outpatient clinic of a traditional medical center. The clinic was run on the medical model, and things like psych and social work were seen as ancillary services. (And, of course, psychology was subordinate to psychiatry, because psychiatry is a medical specialty.) So patients' social and behavioral needs were never a priority - because they weren't viewed as primary functions of the clinic.
This new place is a Health Department clinic. It's not run according to the medical model, it's run according to a public health model. Their philosophy places prevention, health education, counseling, health promotion at the core of the clinic's purpose. So the kind of work that we do fits right in. It's wonderful! It's so exciting to think about what we can do with Behavioral Medicine services in a clinic that's actually designed to support and encourage the kind of work we do. They're so pleased about having us come, and so excited about working with us - it's almost hard to believe. They almost seem unnaturally nondefensive and open to suggestions. More than one person has actually said to us, "As you get to know our system, let us know if there's anything you think we should change. We're open to almost anything."
And it doesn't seem like there are going to be turf wars. Both the psychiatric nurse who currently does most of the psychotherapy, and the person running the prevention counseling program, seemed genuinely delighted to have someone to share the work and bring in new ideas and new areas of expertise.
Is it too good to be true? Or am I just too accustomed to the dysfunctional, after a year at the EJC? I don't even care. I just want to get started there. Please, let them have signed the contract. I want to start right away...