Final Reflections

Ten weeks ago I began my journey into the world of health administration under the tutelage of the professors at the University of Washington, MHA program. I arrived at the MHA program with an undergraduate degree in business management and four years of experience working for a nonprofit organization that provides support services to the mentally ill population of Josephine County, Oregon. I knew virtually nil in regards to medical clinical care. The MHA program required that I explore the topic further and I have since begun to understand that clinical care encompasses a variety of issues, processes, ideas, procedures, beliefs, theories and practices. One topic that I found particularly interesting was that of the role of the “provider” in the provider-patient relationship. Exploration of this relationship taught me how to ask questions. The answers of which will provide me with the information that I need to be an effective administrator.

One of the first clinical care topics that I was invited to explore in the MHA program was that of disease, illness and sickness. The question was simple, what is/is not a disease? I thought it interesting that during a discussion, my class and I tried to avoid attaching unattractive labels like “disease” to things that we considered “normal”. Prior to this exercise, I didn’t realize that negative connotations are almost always attached to words like sickness, illness and disease. Nor did I realize that as a result, many patients experience feelings of powerlessness, depression or loneliness. As an administrator, whose job it is to support my providers, the question becomes whether or not the role of the provider includes provision of services outside of the assessment of symptoms, diagnosis of illnesses and treatment planning for said illnesses.

Two more exercises in my clinical care class required that I watch a video. One video explored whether or not medicine is a calling or a business. Certainly, the video leaned toward medicine as a “calling” but, does that mean that in order to be a good provider one must forego the business end of medical care? The second video was about a woman who pours blessed water on people and prays in order to heal them. I was asked to evaluate whether or not hiring this woman was a good idea. At first, I thought the idea ridiculous. I then explored cultural relativism and realized that the term “provider” can mean different things to different people at different times.

Further investigation into the role of the provider in the patient-provider relationship was an exploration of error disclosure. This topic brought up some important issues. Should a physician reveal error? If so, how much information should be shared? How should the information be shared? Is the physician responsible for sharing errors with the patient? I also explored how the culture of medical school influences physician behavior. I discovered the importance of a good role model for young physicians to develop the bedside manner they need to work with patients. My question, after watching that video was how I might change the culture of medical school to, as Kurt O’Brien would say, “Humanize” patients for doctors.

The end result of my investigation thus far is that I now understand some of the aspects of the role of the provider in the provider-patient relationship, I also have a few opinions and ideas regarding the subject. More important, I am learning to ask the questions that I need to ask as an administrator to get the information I need to do my job.