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The Knock

Posted By Lisa Tyndall, PhD, Tuesday, March 27, 2012
The sound is a familiar one. I have heard it at my primary care physician’s office, my gynecologist’s office, my pediatrician, the mammographer, and the ultra sound tech room, two quick knocks and then an entrance. Whoever follows that knock brings with them several things. Among those items is usually a sense of respect, knowledge, authority, news, caring, sometimes curing, and always a sense of privilege. They belong there, it is their space and I wait for them to share with me what they know.

So who am I to be on the other side of the door? Could I be a "knocker"?

These are two of the questions that I battled with as I entered into my first integrated care internship. I was told to check the sheets for patient information, go into the room, and introduce myself and my services. But this would require me, very quickly, to become confident in not only my role in the healthcare agency, but also in myself. I would have to be the one on the other side of the door. You know, the one with the "respect, knowledge, authority, news, caring…etc.” Who? Me?
Lisa Tyndall

"So go ahead, knock. Knock respectfully, kindly, and firmly, but knock.

You’ll be amazed at the doors that open."

 As medical family therapists, we have battled for acceptance as a valid and worthy and reimbursable service. Our western culture has long appreciated the seemingly solid science of medicine, but it has shied away from fully endorsing the impact of the psychological, social, and spiritual impact on our physical health. This disparity can leave the burgeoning medical family therapist feeling somewhat timid as he/she enters into a medical context. But this disparity must be overcome and must be overcome within the provider him/herself.

If medical family therapists are going to be successful in a medical context, we must grow in our confidence in ourselves and in the services we offer. While this probably comes naturally to those who have been practicing for longer, in students it may show itself in two ways. It may manifest in an intern with an overly-confident demeanor or an intern who is so hesitant that they think their services are an intrusion into the patient’s "normal visit.” We must learn to strike a balance between confidence in our services and place in the medical setting, while remembering one of the core components of family therapy, humility in what our patients and their families can teach us.

The balance is rooted not only in our belief in what our profession and services have to offer, but also a belief in ourselves. As individual providers, we must work to be as self aware as possible in who we are and any issues that might be hindering our ability to gently assume our place within the medical system. We must believe in ourselves that we can carry out what our mentors and professors have taught us about our profession and role in the healthcare industry. And as is true for so many things in the therapy world, this is isomorphic to the patients and families we work with. As we embrace the value in our work and in ourselves, we will likely impart that belief to our clients and the other providers with whom we collaborate. Perhaps they will learn that they too are valuable.

So go ahead, knock. Knock respectfully, kindly, and firmly, but knock. You’ll be amazed at the doors that open.


Lisa Tyndall is employed as the Clinic Director for the East Carolina University (ECU)Family Therapy Clinic in Greenville, NC. She has her license in Marriage and Family Therapy, and received her doctorate in Medical Family Therapy where herdissertation research focused on developing a consensus definition of MedFT. She is the beaming mother of two fantastic young boys and adoring wife to her husband, Richard, of almost 13 years.

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