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Can We Bring the Joy Back into Medicine with Community Engagement?

Dr. Renee Kinman says she came to medicine in a backwards way. After college, she took a year off and started a PhD program, later deciding that she wanted to go to medical school, too. Today she’s a pediatric endocrinologist at Valley Children’s Hospital in Fresno, California. She’s also deeply passionate about education, community involvement and advocacy, which led her to submit an idea to Geneia’s Joy of Medicine competition.

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Dr. Kinman skates at Central Park. Photo provided.

But we were curious: does Kinman truly believe that working in the community is the silver bullet for bringing joy back into the practice of medicine? Why? And what does this actually look like?

We caught up with her this week to talk about the inspiration behind her submission and the ways she puts these ideas into practice every day in her own life.

Q: In your submission to Geneia’s Joy of Medicine contest you mentioned that physicians might feel better about their work if they became more involved in their local community. What was the inspiration behind that idea?

The idea for my posting came from my current situation. I work at a huge children’s hospital in Fresno that serves people from a 45,000 square mile radius. My patients can come from up to four hours away, and the community in the San Joaquin Valley is impoverished. The people who do the growing in the agriculture community tend to be very poor.

When I came here, I knew I wanted to work with the residents. I’m really passionate about education – I’m working on a masters in education right now, actually – and I believe that being a teacher is deeply intertwined with being a doctor. You can’t separate the two. So one of my colleagues – who has a masters in public health – had the idea of working with the residents and managing the community, too. The whole idea was to help the residents recognize that the patient isn’t just the person in the exam room – they’re part of a larger community, too. Health depends on what happens in the exam room, but also what happens beyond it. Can you get to the pharmacy? Why aren’t diabetes patients managing their health? There’s so much psychosocial stuff.

Since then, we’ve gotten grants to help change our community pediatrics programs with the goal of teaching residents that their patients are not just kids on the physicians’ turfs, they’re kids viewed as part of the larger community.

Q: What does that kind of community engagement look like in Fresno?

We’re working within school systems right now. We started with a group of girls at the public high school in a program called AVID. It’s an elective program that senior girls can choose to take. What we realized was that adolescents don’t like listening to parents or doctors; they want to work with each other. So this group of girls has started to teach their peers about health during lunchtime presentations. Residents have helped them plan presentations around teenage pregnancy, exercise, sugars and bullying. They trust us – we’re their doctors – but I feel like they’ve adopted us. We also work in local clinics, too.

Q: How does going into the community bring the joy back into medicine? Why does it benefit the individual?

Here’s an example: Last Friday I went down to the high school and I met with the patients and students. And I was just happy. It’s all about the interactions, the teaching, the love of doing something and seeing it happen. They’re like ‘When do we get to see you again?’ I felt so good afterward. Then I came home and I saw the Geneia contest – I deeply believe in advocacy – so I was like ‘I feel happy about this, let me write about it.’ Bottom line: doctors like to help people. That’s why we got into this career.

You know – it’s tough out there right now. We just went to an EMR a year and a half ago in my office. It’s not about benefits anymore, it’s about the business. The people in charge are not doctors, they’re administrators. It’s about seeing as many patients as you can. We’re taking laptops into exam rooms and checking off little boxes. I have 20 minutes to see a complex patient and I spend half of my time checking off little boxes that don’t make a difference, just to fulfill a stupid requirement. It’s hard to give patient satisfaction when you’re not talking to the patient. So being in the community helps me get back to what I love about this job.

Q: What would you say to the physicians who are burned out and considering leaving medicine?

I actually know a physician who’s thinking about leaving medicine and I’m trying to get him involved with teaching residents. I’d say that being in the community helps – it really does. And there are many ways to be in the community. It also helps to do stuff that makes you feel how you felt when you went into medicine. It’s hard to change administration and bureaucracy, but let’s find what makes you happy. What do you like to do? Sports, reading, skating, teaching… that’s what you have to do.

I also think it’s important to be an advocate and teacher – for your patients, for others. It doesn’t have to be political, either. It can be reaching out within the local community and making your own community better. And if you can’t do that within your own confines, try outside. So many people in U.S. are impoverished.

Do you have ideas about what it means to bring joy back into medicine? Submit your thoughts to Geneia’s Joy of Medicine competition and join the conversation about what needs to change.

Jenni Whalen

Jenni Whalen

    Jenni Whalen is the Executive Assistant of Editorial at Upworthy. She was previously MedTech Boston's Managing Editor and has an MS in Journalism from Boston University, as well as a BA in Psychology from Bucknell University. Whalen has written for Greatist, Boston magazine, AZ Central Healthy Living and the New England Journal of Medicine, among other places. She has also worked as a conference planner, ghost writer, researcher and content developer.

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