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Keeping the Clinic Open - brainstorming

Hi everybody.

I'm starting this as a separate thread in order to focus on the single issue of keeping the clinic open during breaks. I'm hoping to have some good, open communication and hear some different perspectives and ideas for the mutual benefit of both the students and the administration.

The recent policy change to require students to make up missed clinic shifts during the break has been met with less than an enthusiastic response from students. What I'm hearing from students is that you feel this is a "punitive" decision and that you don't like being 'punished' for getting sick. I'm concerned about hearing people say that this policy will lead them to choose to work their clinic shifts even when they are ill. So for me, this is two issues; keeping the clinic open during breaks and encouraging interns to take the day off when they are sick.

Let's look at this from a professional perspective. You don't want to treat patients when you are sick; it isn't good for business. Patients don't want to sit in a small room with a person who is contagious. It's very bad for your business to pass your illnesses on to patients. You don't look good when you're sick. Patients do not want to be treated by someone that looks ill. It does not inspire confidence. You want your patients to feel safe when they come to see you. If they are worrying about what cooties you're spreading, they don't feel safe. This may mean that they don't come back to see you again. When you're paying for your clinic hours, maybe that's not such a big deal, but when you're paying rent on a space, you really care about how many people return to see you again.

I want you to feel like staying home when you're sick is the very best choice you can make. For yourself, for your patient, for your practice, for the community at AIMC. So, to that end, how can AIMC encourage you to make that wise choice?

Now about the other issue. The fact of the matter is, we need to keep the clinic open during breaks. Closing the clinic (as has been the practice for many years) causes a significant lull in the schedule for the first few weeks of every trimester. Our patients get out of the habit of coming every week and find other uses for the money they spend at AIMC. We need to figure out how to reverse that trend. It is a benefit to both the school and the interns that we maintain a steady flow of patients and income. So, how do we do it?

The short answer is, interns need to work over break. Obviously it isn't helpful to the professional setting if those interns are insolent and angry that they are here. We need you to want to be here.

What incentives can AIMC offer you? What sorts of things can you think of that would make intersession clinic an attractive option for you? What do you need to inspire you to "take one for the team'" as it were, and do intersession clinic?

Brainstorming is a process where we open our minds and consider all the ideas that come into it. They will not all be good ideas. They will not all be viable or sustainable ideas. Throw them out there anyway, please. From an unsustainable idea may come a sustainable one, you never know. I also think it is really important to develop our communicative skills and practice communicating with each other in a warm, respectful, professional manner. With that, I open the floor. I'm very excited to hear your ideas.

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Replies to This Discussion

Permalink Reply by Jason Yerger on October 2, 2009 at 2:58pm: Well, I'm only a T2 student, so I've not entered clinic yet and have only vague knowledge of the issues facing the clinic. But I do have an idea about how to manage to keep the clinic open during intercession: allow students to defer a certain amount of their clinic hours to intercession. This would obviously require some modification of clinic scheduling procedures. However, by allowing students to schedule in advance to defer their hours, they could lighten their load during the term and help lower the intern-to-patient ratio (at least some of the time). I can imagine this being implemented in a variety of ways: offering a "late-start" clinic schedule that begins and ends three weeks later than the standard schedule; a "light" clinic schedule taken concomitantly with a heavier "intercession" shift, or a flexible "hour by hour" deferment program. What does everyone else think?; ▶ Reply to This

Permalink Reply by Donna Chang on October 2, 2009 at 7:58pm: Valerie,

Thanks for starting this discussion. I think it is important that we try to create a positive vision together rather than just complaining what's not working.

Jason, those are good suggestions. I wonder if we can send out a poll/ survey:

1)
If at the time of registration, students given the option to schedule part of their clinic during intercession, would they do it?

2)
How many weeks/ days/hours of intercession clinic shifts would they want to take on at most?

We then also need to figure out how many clinic shifts per week we need during intercession in order to keep the clinic open.

I am going into clinic next term (yeah, finally!) and like many students here, I don't usually go away for the whole break. I think if taking on clinic shifts during the break would lighten my load during the term slightly, and if it means there will be more patients to treat, I will do it.
Personally, I wouldn't want to do more than 1-1.5 week of intercession clinic shifts so I still can have a break.

-Donna; ▶ Reply to This

Permalink Reply by Valerie on October 2, 2009 at 9:38pm: Thanks for your responses.

I think there's a great advantage to doing clinic during the break - especially if you are struggling at all with the coursework. Doing less clinic during the term leaves you with more time to devote to studying. Or if you're working, doing a more consistent clinic schedule allows for working during the term and a slightly more steady income, which is also nice.; ▶ Reply to This

Permalink Reply by kd on October 3, 2009 at 8:37pm: Perhaps shortening the hours the clinic is open during break from 9-3 instead of 5 would make the day less drawn out and insure students get to see patients during each slot. It would also feel like a break because the day would be shorter.

I am wondering if the front desk calls regular patients, or emails all existing patients one week before school begins to remind them the term is beginning and to ask if they would like to be scheduled. If it were an email it could explain the benefits of acupuncture for that particular season...

I think a community and ear shift should remain during intercession. Many students wanted these shifts during the term but the slots were full. Some students would come in just for that.

I think that the lull would be less if there was also more marketing done for the school in general. Many times I tell people where I go to school and they've never heard of it. I think that the initial lull has some more factors other then intercession. We are on week 4 now with many open slots!

K; ▶ Reply to This

Permalink Reply by Valerie on October 3, 2009 at 9:14pm: Wow, Kristin! Seasonal emails to the patients, that's an awesome idea! Maybe some of you folks who are good at that sort of thing could contribute a healthy seasonal recipe or something. In fact, if we had an email tree for our patients, we could send out regular emails with interesting information, recipes, maps to farmer's markets, monthly clinic specials, things to keep AIMC in their minds.

I agree that the community and ear clinics should remain open. They are very popular clinics. It might also be an opportunity for someone who isn't quite sure Community style is for them to try it out - community-lite, as it were. Good idea!; ▶ Reply to This

Permalink Reply by Falena Enders on October 3, 2009 at 11:08pm: I agree an email tree is a wonderful way to help increase patient education and increase the likelyhood that they will want to continue regular acupuncture treatments. There should be more marketing for the clinic in general. Maybe students could convert some class time to time out in the community helping to get new patients. I personally learned more about marketing actually doing it, than sitting in a class for it. Students could also be given the option to make up clinic time by participating in a marketing event, instead of making it up during the break.

I also like the idea of keeping the Community and Ear clinics open during the break. I do think students need a break though and that clinic on the break should be optional. For the students that want a lighter clinic load, then they can be given the option to having shifts during the break.; ▶ Reply to This

Permalink Reply by Dawn on October 7, 2009 at 10:11pm: I am so happy to see discussion about this. There are great ideas here! Thanks Valerie for getting it started. My question is, how do we get more people in on this discussion and how do we present these ideas to staff and admin? Many people don't check the AIMC channel often or at all.

I really love the idea of an email tree. Also, including students in the process of marketing will provide great hands-on experience. I agree with Falena, hands on is a great way to learn about marketing.; ▶ Reply to This

Permalink Reply by Chris Kresser on October 8, 2009 at 6:39pm: Valerie,

Thanks for initiating the discussion. Actually, I had the opposite problem during the last intercession. I needed to make up some hours but when I went to schedule some shifts during the break many of the shifts were full. I suspect that this will be an increasingly large problem now that students who miss clinic shifts during the regular trimester can only make them up during intercession. I wonder what will happen when students who need to make up clinic hours aren't able to do so during the intercession because all of the shifts are full.

Chris; ▶ Reply to This

Permalink Reply by Deb Gorman on October 9, 2009 at 9:50am: Hi Valerie and all...

I am so glad to find this thread today. I went to the meeting with Terri, Benjamin and Beau yesterday and want to continue and expand the conversation about the marketing of the clinic, facilitating communication between students, faculty and admin., fostering good will and enhancing our educational experience at AIMC.

I am T4 and just starting to get my feet wet in the clinic. It is interesting to feel how the new policies are landing. I think the two main issues are 1) scheduling the clinic and 2) marketing the clinic. I think there have been some wonderful ideas presented already about both.

I would like to focus on the marketing idea and will start another thread that is dedicated to that. I come from a background in bodywork and have had varying degrees of success in private practice over the past 20 years. I have learned a thing or two about marketing and want to get really efficient and effective at it.

We have an amazing community of folks here at the school and I am wondering how we can pool our collective wisdom in a way to support the school in developing an awesome marketing plan. A plan that students can participate in at whatever level they like or are able to.

I am also interested in how to bridge the communication about all this between students and admin. I know we have a student council and maybe that is the route that needs to be followed. But they seem to be overwhelmed by everything that is going on and our cohort doesn't have a representative right now so maybe I am acting as a bit of a maverick here. I am also interested in how to bridge the communication between students. I hardly check "the channel". But I like the idea of developing a poll as a way to gather ideas and opinions from as many people as possible. Meetings don't work for everyone for various reasons like scheduling and personality styles. I want people to feel comfortable and supported in giving input.

I love kd's idea about seasonal emails, and agree that hands on marketing experience is invaluable. I too would love to see this as an option for some credit, either in the clinic or for one of the classes around practice building. I tossed out a few ideas at the meeting and Beau was delighted at the input. I think we have a huge opportunity right now to craft a program that really works for everyone.

I plan on calling Beau this morning to see what we can do to get the ball rolling. I bet we might be able to use the school's email list as a way to open the communication to everyone. Then we will need a few folks to focus the process, maybe craft a poll and figure out a way to compile and communicate the results. A lot of this can be done online. Benjamin knows how to put it together and is willing to help. So, lets start thinking about a list of questions that would best extract the feedback we are looking for.

I am willing to spearhead the beginning of this process around the MARKETING of the clinic. But the process of communicating about all the issues of the clinic is bigger than just the marketing. Maybe it can all be included in one poll, maybe not.

If I have stepped on anybody's toes, or overstepped any boundaries, I apologize in advance.
I look forward to your feedback.
Deb; ▶ Reply to This

Permalink Reply by Valerie on October 9, 2009 at 5:21pm: Thanks you guys for these great contributions. I've pointed Benjamin and Teri in this direction so they can see your thoughts.

The number of people in the clinic is always a balancing act. The state has a maximum supervisor:intern ratio of 1:4 so they have to know in advance who is planning to work every shift in order to not be in violation of that rule. They carefully plan clinic shifts for the term to meet that ratio, which can complicate things when someone wants to make up an extra shift. In that regard, doing make-up during intersession really makes sense, but the balancing act is still there.

Thanks, Deb, for volunteering to be a point person on this project. You've got years of experience and a great attitude! I'm excited to have you involved!; ▶ Reply to This

Permalink Reply by Deb Gorman on October 10, 2009 at 6:05am: Well, I spoke to Beau and I have an appt to meet with her on Tuesday sometime between 5 and 7pm. I want to take a look at the marketing plan and see where we as students might have some input to the parameters and practice of marketing the clinic. I spoke to Benjamin and he can help us put together a questionnaire/poll. We need to come up with questions we want answered by our fellow students so we can feel well represented on this subject. I am in the process of compiling the info in this tread into a powerpoint presentation. I have included all your feedback and suggestions.

The main points I have identified are
Logistics - polices and procedures, scheduling, communication, supplies
Education - supervisor availability and consistency, credit for marketing efforts
Marketing - marketing plan (getting new people in the door)
Patient retention - different than marketing (keeping the ones we have)
Feng Shui - climate control, art and decor,

I think this information needs to be organized put into a presentation so that we don't have to keep reinventing the wheel every time we start this conversation with a new group. I have been to too many meetings going over the same old material again and again with no real movement forward. Keeping up with threads can be tedious for people.

I am posting this in the Keep the Clinic Open thread because I think this presentation will include some of that conversation that is NOT marketing. Plus, I want to have my meeting with Beau before I start a new thread dedicated to marketing.; ▶ Reply to This