Selling Alaska

I wear many hats in my day job. Working in healthcare has stretched me in ways I didn’t expect. Some of my tasks are straightforward…arranging meetings, trainings, working with electronic records, learning the work flow of clinic front office processes. Others allow for more creativity, more flexibility, require attention to details of individual need and style.

Recruiting for open provider positions falls into this second category. Selling a vision of professional satisfaction, personal choices, family stability in a new environment, all while keeping yourself and your message honest about the pros and cons of the opportunity you offer…it’s a challenge from the start.

You find yourself trying to read the people you talk with, imagining them in the setting you know well, wondering if they’ll be successful, weathering the difficulties of life in rural Alaska, and celebrating the triumphs.

Rob calls practicing in the small clinics of remote fishing villages “earning the stethoscope.”

I call it brave, sometimes foolhardy, not a choice for the faint of heart.

When you have to ferry out to the nearest hospital, or on a good weather day, take a float plane, advanced care options are not easy to come by. Actual medevacs cost a fortune, most of which we pay for via tax dollars.

I’m always amazed at the folks who live in the middle of nowhere, on tiny islands, and who regularly appear in the local clinic for any and every need under the sun. They travel out of town, going to regional hospitals for specialty consults, surgeries, treatments. They come back home to recover, to live out their days….some to overcome and thrive, others to give up and resign themselves to dying at home, in their own space.

The people who come to work in these clinics are often wide-eyed idealists, imagining they’ll have an Alaskan adventure, experience a frontier with all the romance and excitement the travel brochures promise. The folks who are transplants to Alaska mix with the local staff, people who understand the land, the life, and the limitations of practice here.

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The beauty is here, for sure, and the adventure too. But you have to really want it to get much of it…too often the hiking, fishing, exploring, and traveling charms that lure people to work here are elusive…too much of life is consumed with work, and traveling out to visit family, to tend to other life needs…it can be surprisingly difficult to work in Alaska and have much time to really enjoy leisure here, in my experience.

A lot of people come to pay off school debt, to put aside some nest egg money, work in under-served communities to fulfill a service obligation of some sort.

The health care shortage the whole country experiences seems amplified here, where people can’t easily drive to the next community over, likely have one clinic and maybe one or two providers to choose from for their primary care.

Every clinic in this region is recruiting, looking for a few good men and women who’ll be clinical super-heroes, serving patients and trying to keep from burn-out.

If I sound dramatic, I don’t mean to. It’s just the reality of doing a hard job in a beautiful but challenging environment. You never know what you’ll have to deal with, and you may have to deal quite a while before you can send your emergency patient on to a hospital.

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We’re interviewing a candidate this week, hoping to connect with a person who’s up to the challenge…someone who will be able to weather the weather, the annual 13 feet of rain that falls in this rainforest, and the small town setting that feels like a fishbowl at times.

The bait…the beauty of the land, the ocean, the trees…it’s amazing when you see it, green and blue and so big you can’t believe it. But it takes a special sort to take the relative isolation, the limited options of restaurants and stores and amenities. The other major resource is the people that live here: resilient, often self-reliant, taking life as it comes.

To be honest…and I am honest with these people…it’s a mistake to be anything but honest…I can only take it so long myself. Working part-time here works because it’s part-time. I love the beauty, but I’m more into eating salmon than catching it. And while I don’t need mega malls or big cities, I’ll admit I miss the road system I so took for granted when it was always just outside my door in the lower 48. And a few other conveniences that can be hard to come by in fishing villages.

But some people wear it like a glove, snuggling into the small town settings, finding joy in the community and the fishing and the boats and the water. That’s the person we hope to find. Helps to find a couple…this is a hard place to look for a significant other. And great medical skills are a must.

Here’s hoping for a good fit! The only thing worse than not persuading a candidate to take your open position is persuading the wrong candidate to take your open position. Trust me, a bad fit is never a good thing.

So we’re honest, but we’re also selling…selling a lifestyle, a place, professional opportunity, financial security.

Know anyone who would be a good fit? Send them my way! I have an adventure to share!

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Primary Care

Two weeks. For two weeks this month I worked in the local primary care clinic, seeing the daily parade of patients and problems: the good, the bad, the ugly.

The clinic was short-handed with some staff out for spring break, and I was able to help out at the front desk. I went through training last year to be a super-user for the clinic’s electronic record, and it helps me to stay current to go in and work in the live setting when I have opportunity. And it’s good to catch up with staff I used to see on a daily basis when I worked full-time in the admin department. Plus, the clinic is in Ketchikan, so I got to be in my own home while I fulfilled this commitment. So all good.

I’ve blogged about this before. Most of my work in the world of healthcare has been on the administrative side. I came into healthcare through the back door of grant writing and office work. I’ve expanded to policy writing, recruiting, project coordination…all tasks that are familiar and comfortable. But patients…now that’s different.

Patients are the reality check to all the work I do.

I usually work in quiet offices, with much of my day consumed with writing, or researching, or interacting with other staff: problem solving, planning, coordinating efforts, meetings, interviews. All valuable, and part of the mechanism that keeps staff in house and programs operating.

But in that world I’m shielded from the nitty, and the gritty. Two weeks of primary care changes that focus.

The other staff I worked with are great: patient, helpful, appreciative of the support I offer, even when it’s imperfectly delivered. In a busy clinic, you need all hands to juggle clinic hours (the clinic offers extended hours; some days the schedule begins at 7:00 AM, and others it ends at 7:00 PM), patient demands, and keep up with the minute-to-minute of busy days. Navigating the electronic system for patient registration,  scheduling appointments, fielding a million questions a day…ok, maybe a thousand, but it seems like more…well, I’m reminded again: I’m grateful to be healthy; humbled to recognize that my complaints of life are “first world” in nature; and I alternate between admiration of people who are cheerful and upbeat in the face of difficulty, and amazement at patients who abuse the very staff who are trying to help them.

Patients are thoughtful, kind, appreciative, attentive. Some are dainty little old ladies, or stately elderly men, in for blood pressure checks and routine appointments that make them regulars. The staff know them by heart. They’re the ones that give you a sense of purpose and satisfaction.

Others are also known, but not for their good traits. They’re rude, demanding, careless, dysfunctional. They’re the ones with an attitude and a knack for saying the wrong thing. They no-show for appointments, then complain when they can’t be worked in; they “lose” prescriptions; they’re quick to criticize and expect more. You see one of those names on the schedule for the day and you hope you don’t have to encounter them. They make you glad with their absence. And yet, even as you put on the smile and ignore the attitude that’s so inappropriate, you wonder: what happened to this person to turn them into a (take your pick) bitter/manipulative/ungrateful/difficult human being?

Work in a clinic setting, and it’s inevitable: you begin to have better understanding of the issues. The headlines about healthcare and insurance and regulations have a real-life meaning that you see through forms, and requirements, and layers of bureaucracy created to manage patients, and the business of paying for care.

The patients make it real too. Some of them can barely walk. Some of them smell. Some of them are dying, slowly but surely. Some of them are living, but miserably. I see the way the staff work with the needs, the challenges, the drama. I’m impressed that these people make a life of touching, healing, processing, listening, advocating, arranging, soothing. The list could go on, and does: the work is never-ending, and the reward is more of the same.

Sometimes it’s funny. When people become patients, you can expect the unexpected, and just when you think you’ve seen it all, it’s another day, and you’ve haven’t seen anything yet.

Sometimes it’s heartbreaking. Patients die, and every week there are two or three sympathy cards laid out on a back shelf, ready to mail “to the family of…”

I say it often: working in healthcare is not a job for the faint of heart.

The job of professionals is to make hard work look easy, and the team I just worked with does that on a regular basis. They find the grace to rise to the challenge every day.

I never had any aspiration to become a nurse, or a physician, or a hands-on healer of any sort. And I’ll admit I’m more than a little relieved that now I’ll go back to my role as a sometimes-recruiter, sometimes-project coordinator, juggling many balls and enjoying the variety of my world. But I have to acknowledge, a little time in the hot seat, interacting with patients is a good thing. It reminds me that there are people at the heart of the work I do from my safe and sanitized desk.