NeighborhoodHealthcare:AnExperiencefortheBooks
It’smylastdayatNeighborhoodHealthcare.Partofmysayinggoodbyeinvolves
warmhugsandmanywellwishesfromtheclinicians,sitemanager,andthemedical
assistants.Ithankthemforalltheyhavetaughtme.AsItakeonelastwalkthroughthe
employeesidedoor,Ilookovermyshoulderandnoticeapatientleavingtheclinic,
enthusedaboutanew,low‐costtreatmentoptionforherchronicpain.Inthislastlook
around,Ifeelsheerprideintheworkthisincredibleorganizationdoesonadailybasis.In
justafewmonths,somuchhashappened.
Agoodpartofthosehappeningswasfueledbymyexpectationsforthisinternship,
whichwere:tolearnhowtotreatapatientinamedicallyeffectiveandcosteffective
manner,tolearntoprovidestrongmedicalcarethroughcommunicationwithapatient
withastronglanguagebarrier,andtolearnhowhealthcareprovidersworktogetherto
provideexcellentpatientcare.Myexpectationswerewellmet,asIlearnedmuchmore
abouteachofthesetopics,andmore,andbelievethatwhatIhavelearnedinthisinternship
willallowmetobeastrongerhealthcareprovider(eventually).
Concerningmyfirstexpectation,tolearntoeffectivelytreatapatientwhilekeeping
itlowcost,wasoneofthemostfascinatingaspectsofmedicineIhaveeverlearned.NHC
hasasteadfastcommitmenttoprovidingthebestcaretotheirpatients,withanemphasis
onworkingthroughthefinancestokeepthetreatmentaslow‐costtothepatientsas
possible.Ineachcaseandforeachtreatment,thenursepractitioners,medicalassistants,
andcasemanagersmustworktogethertodeterminethemosteffectivetreatmentfor
patientsgiventheirinsurance,healthconditions,andanextensiveriskassessmentfor
particulartreatments.Sometimesthisteamworktakeshours,days,andsometimesweeks,
toensurethepatientcanaffordthemedication(s)hemostneedstolive,work,andbea
functioningmemberofsociety.Ihaveneverseenasmuchteamworkandcommitmentto
patients,especiallytothosewithfinancialdifficulties,asIhaveatNHC.
Mysecondexpectation,oflearningtoeffectivelyprovidecareforapatientwith
stronglanguagebarriers,wasalsoreasonablymet.IlearnedmuchmoreSpanishasit
appliestothemedicalfieldaswellasproperetiquettewhenseeingpatientsofvarious
culturesandreligions.Forexample,wesawsomepatientswhoareBuddhistmonksfor
whomtreatmentandphysicalexaminationweredifferentthanforthe“average”patient.
Themonkscouldnotremoveanyclothingforphysicalexaminationunlessabsolutely
necessaryandtheyhaveuniquecommunicationcustomsdependingonthesexofthe
provider.
Myfinalexpectation,oflearninghowhealthcareprovidersworktogethertoprovide
excellentpatientcare,wasalsowellmet.Inadditiontotheaforementionedteamworkto
keeptreatmentsatlowcosttothepatients,thehealthcareprovidersatNHCareall
genuinelyinvestedinthewellbeingandtrueimprovementofeachother’spatients.For
example,apatientwellknownaroundthecliniconcecameinwithaninfectedwoundfrom
droppingalargeobjectonherleg.Thewoundlookedparticularlygrisly,andthepatient
wasclearlyindistress,unabletowalklongdistancesduetothepain.Onehealthcare
providersawthepatientandcalledinotherproviderstolookatthewoundandtogether
theyworkedontheperfecttreatmentforthispatientsoshecouldhealandherleg
wouldn’thavetobeamputated.Inafollow‐upappointment,allofthehealthcareproviders
enteredtheexamroominwhichthepatientwaswaitingtoassesstheprogressof
treatmentanddecideonafurthercourseofactionasnecessarytogether.Thisstrongteam
dynamichasresultedinexcellentpatientcare,incrediblepatientoutcomes,and,not
surprisingly,ahealthyworkenvironment.IhavelearnedsomuchfrommytimeatNHC,
morethanIhaveatanyorganizationinmyundergraduatecareer,andhavethoroughly
enjoyedmytimethere.
IbelievemyexpectationswererealisticandrealizedbecauseIwasencouragedto
takeanactiveroleatNHC.BythisImeanIwasallowedtoparticipateinphysical
examinationsofthepatientswiththenursepractitioner,askquestionsofthenurse
practitionerwhenevertheyarose,andinteractwithpatientsbothinandoutoftheexam
room.Icreditmeetingmyexpectationstotakinganactiveroleinmyinternshipthrough
andpickingupasmuchinformationasIpossiblycouldatNHC.Ialsohadanincredibly
supportive,eager,andeducationalsupervisorwhowasableandpleasedtoanswermy
questionsandteachmephysicalexamandpatientinteractiontechniques.
OtherspecificlessonsIhavelearnedatthisinternshipcanbeappliedtoother
settingsaswell.Forexample,inlearningabouteffectivepatient‐providerrelationships,I
gleanedhowtogainapatient’strustasaprovider,andhowtoworkeffectivelyasateam,
asopposedtoworkingone‐sidedlyasahealthcareproviderindependentofthepatient.
ThisappliesmostdirectlytomyworkasanEMT:beingabletoobtainapropermedical
historyandunderstandingoftheemergencythroughgainingapatient’strustintheten
minuteinteractionIhavewiththatpatientwouldgivemeagreatadvantageintreatingthat
patientinthemosteffectivemannerpossible.However,gainingtrustisimportantinmany
situationsthataren’tmedical.Forexample,Iworkatasleepawaysummercamp,and
gainingthetrustofnotonlymycampersbutalsomycoworkersandsuperiorswouldallow
forthebestexperienceforeveryonebynotonlycreatingamorehospitablework
environment,butalsoamorecomfortableenvironmentforchildrenwhoarehundredsof
milesfromhomeforweeks.Additionally,IintendonusingwhatIhavelearnedatNHCin
myinternshipwiththeGiftofLifeinregisteringcollegestudentsforthebonemarrow
registry.Ihavelearnedhowtosensitivelyexplainmedicalprocedureswhilestill
understandingpatients’concernsatNHCandIthinkthisisanincrediblypowerfultoolin
workingwiththeGiftofLifeaswell.Ithinkthisskillwillalsobevaluableinmyworkasan
EMT,particularlywhenexplainingprosandconsofvarioustransportandtreatment
optionstoapatient,whilealsobeinganempatheticandcompassionatehealthcare
provider.
WhileIlovedthesummerIspentatNHC,givenmoretimethere,Iwouldhave
appreciatedlearningmoreaboutcasemanagementandwhatspecificallygoesintoworking
withinsurancecompaniestoaccomplishreferralsandrequestsforpatientsefficientlyand
effectively.Forexample,aparaplegicwhohasbeenapatientatNHCforthepasttenyears
orsoneededanewwheelchair,whichwasrejectedbyherinsurancecompany.Thenurse
practitionerneededtoordermoretestsandimagingtobedonebeforeshecouldsubmita
requestagainforanewwheelchair,whichtheinsurancecompanylaterrejected.Soon
after,casemanagementatNHCcalledtheinsurancecompanywiththepatient’shealthcare
provider,andonlyafteraboutanhourofheateddiscussion,didtherequestgetapproved.I
wouldhavelikedtolearnmoreaboutinsurancecompaniesandwhytheyrejectedthis
requestandwhatcouldbedonetohastenthisseeminglyunnecessarilycircuitousprocess.
Additionally,Iwouldhavealsolikedtolearnaboutworkingasafederallyfundedclinic,
andhowthisdiffersfromaprivatepractice.
KnowingwhatI’dliketoknowisonehelpfulwaytomoveforwardinmyacademic
andprofessionalendeavors.Thisinternshiphasshownmethesignificanceofproviding
healthcareforthepeoplewhoneeditmostinoursociety.OnedayIhopetoworkasa
physicianinaclinicfortheunderservedsurroundingcommunity,similartoNHC,asIhave
astrongdesiretogivebacktomycommunity.Idon’tknowifIwouldhaveevenconsidered
workinginafederallyfundedclinicasacareeroptionuntilIhadtheprivilegeofworkingat
NHC.Ihaveseenfirsthandthenecessityfortheseprovidersandclinics,andIwantto
minimizetheneedforthisasmuchaspossibleandhelpthosearoundmeinanyway
possible.
Becauseofthisinternship’simpactonme,IwouldhighlyrecommendotherHSSP
studentsseekoutsimilarexperiences.Iknowmyexperiencewasparticularlyeye‐opening,
inspiring,andthought‐provoking.Irecommendthistypeofinternshiptoanyoneinterested
inthefieldofmedicine,especiallyHSSPmajors.IhavegreatlyappreciatedmytimeatNHC,
andIhopetoonedayreturntotheclinicasahealthcareprovider.
ForotherHSSPmajorsorundergraduatestudentsinterestedinthissortof
internship,Irecommendkeepinganopenmind.Everydayattheclinicbringsnew
experiences,interactions,challenges,andsuccesses,andtheonlywaytogrowfromthese
experiencesistohaveanopenmindwalkingintothecliniceveryday.Istartedthis
internshipwithanopenmind,andI’mgladIdidbecauseitallowedmetolearnasmuch
fromtheexperienceasIpossiblycouldanddevisecreativesolutionstointricateproblems.
Ialsosuggestaskingasmanyquestionsaspossiblebecausetheprovidersandmedical
assistants(atleastatNHC)lovehelpingpeopleinterestedintheorganizationandbroader
field.Theyareinspiringandknowledgeableteacherswhocaresomuchabouttheir
professionandwanttoinvolveothersasmuchaspossible.
EventhoughIhavelefttheNeighborhood,Iwillalwayscarrywithmethememories,
compassion,andcreativityIgainedfrommycoworkers,patients,andthehealthcare
providers.Iamincrediblygratefulforthisexperience,andcan’twaitforthedayIreturnto
NeighborhoodHealthcareClinicstoserveasahealthcareprovider,andevenhaveanintern
ofmyown.