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I Believe That Behavioral Science Faculty Face an Uphill Battle

Posted By Molly Clark, Thursday, June 20, 2013

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The "I Believe" series is a month-long co-blog on behavioral science education in partnership with the Society of Teachers of Family Medicine (STFM). Please check back each week.


I believe that although behavioral science faculty can have years of training, experience, and can add so much to the improvement of our patients, we continue to have an uphill battle in proving our value within medical settings. As I recruit people to our program, I make the statement that Family Medicine is like working with family for me and feels as comfortable as home. I am fortunate to work with some of the best people I know personally and professionally. In addition, I have met some great people from around the United States who work in Family Medicine and share similar attributes as my colleagues. However, my experiences have not always been a happy and easy.

Although I came into a program with prior experience within Family Medicine and there had been an established behavioral medicine program, I was faced with the challenge of having to prove my expertise and value to our residents. My strategy was to set boundaries and stick with them at all costs. In my first year, I received evaluations from the residents that ranged from "she is extremely helpful” to "she is not welcome here.” In my second year, I was met with slightly more challenges. While providing feedback during resident check outs, some residents would sit to where I was completely to their backs as they presented a case. My evaluations included comments such as, "you’re not a real doctor” or "you’re not welcome in the physician lounge because you are not a fact you should not be considered faculty.”

While those are not pleasant experiences, I think one of the worst experiences was when I sat down for lunch in the physician lounge and residents either left or the ones coming in sat in a different area. There were times I would go to my office, sit down and feel completely ineffective. I hate to admit it, but there were times I cried. All the while, my physician faculty stood beside me, supported me and told me that this would get better. They asked for my input, consulted me when the residents would not, and gave me more responsibilities.

As I am completing the lecture,
I recognize an old familiar
feeling, stare into the audience
and realize that I might as well be promoting the sell of snake oil.

In subsequent years, things began to change. I started to receive pages from residents and curbside consults to ask me my thoughts about their patients. I was even asked by a resident if they could do a rotation with me. My evaluations began to include comments of "excellent,” "extremely helpful,” and "wished I could see her more in clinic but I know she has other duties.” In one of my more recent experiences, a resident asked me what they should do for a patient’s joint pain. When I responded that I was a psychologist and not a physician, the resident laughed and said "oh, yeah, I forgot.”

I’ve grown to have relationships at the medical center across physician specialties and seemingly have a positive reputation. So, as I am feeling confident that I have overcome bias and have proven my worth as a member of the interdisciplinary team, I walk proudly to another medicine department to give a lecture on physician wellness. As I am completing the lecture, I recognize an old familiar feeling, stare into the audience and realize that I might as well be promoting the sell of snake oil as a cure for various medical ailments. I sigh and go back to the Department of Family Medicine, where I feel at home and am satisfied with my accomplishments. I’ll leave the job of establishing the value of interdisciplinary care in that discipline to another individual and hope they will one day be as valued there as I am in Family Medicine.

Molly Clark

Molly Clark is currently an Assistant Professor and Fellowship Director in the Department of Family Medicine at the University of Mississippi Medical Center (UMMC). She received her doctoral training in Counseling Psychology at the University of Southern Mississippi, completed her residency at the University of Missouri-Columbia, and fellowship in Health Psychology at the University of Mississippi Medical Center. She also holds an appointment in the Department of Human Behavior and Psychiatry at the UMMC. Dr. Clark’s area of specialty is in behavioral medicine with particular interests in obesity, sleep, and mood disorders in primary care. She also has an interest in teaching and training medical students and residents. She has a number of publications and national presentations in these areas of interest.

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Michael Redd says...
Posted Sunday, June 23, 2013
As a student it is good for me to read and get a realistic view of how things are likely to be if I took a position like this somewhere down the road. On the other hand, it is a bit depressing and defeating to read of the uphill battle that behavioral health professionals often face in medical settings. From what I have heard, read, and experienced, I don't think that this phenomenon just applies to teaching as a faculty member in a family medicine program, but occurs much more broadly.

I do believe that it makes a lot of sense that as professionals part of an interdisciplinary team, we would need to prove our value to the team. It makes sense to me that we would need to develop relationships, show where we had expertise, let other professionals see the results and positive outcomes of being able to consult with us and have their patients be seen by us. It makes sense that we need to prove ourselves reliable and competent.

However, it also makes sense that there needs to be some kind of basic acceptance, openness, and valuing of collaboration and others' expertise for this information to actually penetrate and inform others' opinions of us (if people prejudge us they may not actually notice what we do that is positive). Even though the optimistic side of me says that the initial bias and prejudice against behavioral/mental health by some is evidence that we can do a lot of re-education and good by getting into this field, the realistic side of me takes a big sigh of frustration at the amount of work needed now to change hearts and minds.
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