Friday, October 21, 2011

The Power of One

I've put this real story on my blog to help you, my reader understand how even 1 person, yourself can go out and change your world for the better.  You can change your circumstances, your lifestyle, you can indeed become a better person, a stronger patient advocate, let nothing get in your way!  Become empowered!

Sandy, had been a PA for 18 years and was working in an academic medical center in the department of medicine, where she ran several out-patient clinics as well as taught at the medical school, precepted NP and PA students, and did clinical research.  Her research results had been presented several times at national physician meetings.  Her writing skills were such that she had been involved in writing NIH funded training grants as well as other grants.  She was also the author of more than 50 published articles in the commercial and medical journal arena. 

Over the years of working in the department of medicine she had come up against numerous MDs who didn’t like the idea that the institution employed mid-levels.  She was aware that this attitude came from the very top down, it even included the CEO, who had expressed adamant beliefs that mid-levels didn’t belong within the institution.  This belief even extended to the daughter of the CEO (a MD) who had worked with Sandy and had told her mother that she wanted to go to school to become a PA.  Upon hearing this, the CEO told her daughter that she wouldn’t pay for her schooling unless she went to college with the intention of going to medical school. 

The second in command under the CEO (just prior to being promoted to his current  position) had been head of the community health clinics (10 of them).  His mission (we shall call him Dr. P ) for the past 4 years had been to get rid of mid-levels within the community clinics.  He had been partially successful, he had gotten rid of 8 of them, and replaced all of them with MDs.  

The mid-levels (NPs and PAs) ‘ran scared’ of him.  They dared not cross him, he was biased, preferring to believe the mid-levels didn’t know what they were doing, and choosing not to listen to their concerns. 

Then came the time for the leadership retreat, all department heads and higher executives were told to attend.  During the retreat the CEO told everyone in attendance that she was going to implement group patient clinic appts, much like what Kaiser Permanente was doing.  Sandy had already begun to initiate a similar idea in her clinics, especially when her RN had to show patients how to do their injections. 

Then it came time for the Department of Medicine head (Sandy’s boss’ boss) as well as the Division of Orthopedics to do their presentation on the usage of mid-levels within their respective areas.  There were 5 ortho PAs and the surgeon told the audience that they were very useful as surgical first assistants.  He went on to show how financially his division couldn’t handle all of the multiple trauma cases they had without the PAs on board. 

Then the Department of Medicine Chief got up and did his presentation.  Sandy was the only mid-level within his department.  He explained to the audience (which included the CEO and Dr. P) that he had been so impressed with what Sandy had accomplished that he was hiring three other mid-levels in his department within the next 3 months.  He went on to explain how financially she had brought in payer sources as well as had the highest rate of remission (compared to the national levels) in the patients she treated. 

He raved so much about what Sandy had accomplished that two MDs the following Monday caught Sandy in the hallways and told her that they had heard about her work and that there had been quite a bit of talk about her.  Having no knowledge of what they referring to, she just said ‘thank you’ and went on about her work.  Little did she know that both of these MDs had been at the leadership retreat and heard her boss’ boss speak just the prior week. 

But, what was most important was that both MD presentations on mid-levels and their usage, turned the heart of the CEO.  At the end of the leadership retreat, she told everyone in attendance (including Dr. P) that the attitude and emphasis in this academic medical center would henceforth not only be friendly towards mid-levels but that they were to be hired and kept.  Not only were they needed for financial reasons but two of them could be hired for every MD on board.  Therefore twice the amount of patients could be seen for every MD hired. 

With this change of heart, the mid-levels in the community health clinics could breath again, relax and go about doing what they did best.  So not only did Sandy’s work affect her immediate division within the department of medicine, but it also affected patients having access to healthcare out in the community.  Mid-levels would once more be hired to fill the empty clinical positions in the clinics. 

So if any of you ever think that you don’t have an impact on others, or on what is going on around you, think again.  You, as an individual can indeed bring about change, change in how you communicate with your physicians, change in how you deal with life issues. 

The Power of One is a significant force.  Go make that change, you’ll be glad you did!

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