Considering the controversial, emotionally loaded issues tied to the healthcare industry, it's difficult for local industry leaders, decision-makers and influencers to fully understand how the medical system operates - unless they see it firsthand.
With that in mind, the Jefferson County, Kentucky Medical Society, (JCMS), Louisville, has found that a dynamic experience, called a "civic internship," helps facilitate two-way communications and improve negative perceptions of the healthcare community.
This prototype has now become an American Medical Association (AMA), Chicago, standard program in many hospitals and physician groups. And it is, in many ways, the quintessential case study in community relations.
Since it was formally proposed at a Cincinnati hospital 15 years ago by Susan Clarke, communications service manager at the JCMS, more than 200 medical organizations have used the program, including hospitals in Nashville and Dallas. It has proven to be a cost-effective community relations program - running about $2,500 per program.
JCMS invites a small group of people twice a year to take part in a two-day, two-night field trip. The "interns" are paired with doctors in various specialties, where they literally follow the doctors around, so they have the opportunity t view the healthcare trade from an insider's perspective.
Clarke has been hosting the program for about 12 years, four of them in Kentucky. "It has a snowball effect. You impact a small number of people each time you do it, and then those people can influence others," Clarke said.
The ultimate effect of the internship program is to enhance community relations and improve negative perceptions of the healthcare environment. The goal of the program is not to attract media attention.
Those included in the program include doctors, interns and JCMS. "No one takes part in the program for any self-gain; it is not a promotional tool," Clarke stressed. The only warranted media coverage comes from a reporter who participates in the program.
Participating doctors in JCMS's program are all members of the local AMA who help screen the possible interns. The planners, in turn, evaluate which doctors would be good teachers. Just about all want to be involved, said Clarke, and the only ones who shy away do so because of a fear that they will somehow violate patient confidentiality.
JCMS sends out 36 invitations per session about three months in advance, knowing that many will have scheduling conflicts and will not be able to attend. The ideal size group has about 20 people and includes participants such as patient advocacy representatives, clergy, legislators, business and healthcare industry CFOs, insurance executives, malpractice lawyers and media representatives.
Also mailed with the invites is an explanation of why each person was invited; fact sheets; articles written by media interns; and the rules of, and rationale behind, the program.
In the time leading up to the session, JCMS sends out numerous pieces of correspondence to remind interns to come, to get their signature a few times and to better ensure that they won't back out at the last minute.
The actual sessions pair one doctor with one intern, with four different doctors per day, in such settings as surgery, the emergency room, delivery room and the cancer unit. Interns also have the option to use one of the nights to ride with an EMS (Emergency Medical Service) team in an ambulance.
Each night after dinner, JCMS holds roundtable discussions where interns and participating doctors can share ideas, questions and answers about medical practices and the issues facing their communities.
After the session is over, the interns complete a written evaluation, and then a follow-up is sent a few months later by mail. Evaluations identify criticisms of the program, issues addressed or not addressed in the discussions and let JCMS know if its efforts are worthwhile.
"When you see business people, legislators and insurance executives walking in the shoes of a physician for a day, seeing what they have to deal with on a day-to-day basis, you see that it's a great program," said Mark Wolf, senior public information officer at the AMA.
Contact is key for JCMS: every three years it holds a reunion for past interns so that notes can be compared, suggestions can be offered and new industry developments can be discussed.
JCMS also sends its newsletter and monthly magazine to past interns to keep them in touch with news and activities, and asks them to be guest speakers at JCMS healthcare events and conferences or to occasionally write for its publications.
"We are building a network and broadening our contacts in all sorts of organizations. This is an ongoing commitment, we stay in touch with the interns and the new contacts we make through the program," said Clarke.
"To see the relationship between different kinds of doctors and patients in action is the most beneficial part of the program," said Wolf. (American Medical Assoc., 312/464-5382; Jefferson County, Kentucky Medical Society, 502/589-2001)