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GUEST POST: Palpable, pediatric, public health

Tuesday, June 3, 2014

Pal….pal-puh-bul. That means that you can touch it. Is that right?”

I slowly smiled, and said “yes.”

Across from me, was a second year law student whose furrowed eyebrows had suddenly faded. A room full of public health, law, and medical students looked back at me—some who nodded in agreement, some who still retained wrinkled foreheads, but earnestly leaned in to listen.

This is an ordinary snapshot at one of the many meetings at Roundtable of American Health Delivery (RAHD), one of Drexel’s first graduate student organizations for interdisciplinary healthcare collaboration. I have co-founded this with MPH student Alexander Krengel, and founded a similar seminar series, Recharting the Borders, during my time in medical school.

My impetus to initiate collaborative efforts began early in my third year pediatric rotations at our home site’s GROW Clinic for patients with “failure to thrive.” After seeing a patient with the pediatrician, I was surprised to walk to a table with the staff nurse, nutritionist, psychologist, and social worker actively working to create the final treatment plan. Although each provider had different perspectives and opinions, each maintained a mutual respect for one another.

I was taken aback.

I had been long accustomed to drafting H&Ps and SOAP notes by myself in medical school.  This was truly my first glimpse at the working world, where one person did not drive patient-centered decisions—a team did. The reality is that my educational training is not much different than that of most medical students in the United States. Health care provider curricula focus on creating the “optimal physician” or the “optimal nurse,” which essentially creates educational silos and areas of functional specialization.

The Institute of Medicine (IOM) identifies lack of coordination and communication as the leading culprits to hampering our healthcare system today. Fragmented care and disjointed responsibility lead to readmissions, duplicative diagnostic testing, and poor center-to-center patient transitioning. This drives to upwards of $130 billion dollars in what the IOM considers “waste” due to coordination problems alone. Their solution? Improve transition and coordination processes across organizations to ensure seamless patient care.

For us medical students, the transition to 3rd and 4th year clinical team care is inherently bumpy because a lot is simply foreign. But one area that doesn’t have to be unfamiliar is experience in team-based and coordinated decision-making. The “optimal physicians” are not islands. They work effectively with pharmacists, nurses, physician assistants, physical therapists, lawyers, and public health partners.  The idea behind interdisciplinary collaboration in classrooms is to provide a safe learning setting for correcting mistakes and building confidence. Earlier introduction of this concept in educational training not only helps medical students develop further as professionals, but also provides grassroots solutions to some of our health system’s biggest challenges.

As I get ready to attend another roundtable meeting of RAHD today, I make sure to highlight the medical jargon in our reading that might need explaining. But for every pink highlight I make for medicine, comes a blue highlight for law, and green for public health. I know this slow, but valuable process in learning different disciplines will translate into my clinical practice as a future pediatrician. From it, I hope to see better patient outcomes, or in pediatric terms—a lot more kids smiling. And this itself, will be the most tangible…most palpable success of all.

ABOUT OUR GUEST POST CONTRIBUTOR: Ashley Landicho graduated from Drexel University with a B.S. in Biological Science and is completing her M.B.A. from Drexel Lebow College of Business. She will soon be a fourth-year medical student at Drexel University and plans to pursue a career in pediatrics. She has a strong interest in healthcare policy, child advocacy, and community outreach.


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