I Believe That Behavioral Science Faculty Face an Uphill Battle

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This is the third in a series of collaborative blog posts between the Collaborative Family Healthcare Association and the Society of Teachers of Family Medicine.

Molly Clark, PhD

Molly Clark, PhD

I believe that although behavioral science faculty can have years of training, experience, and add to the improvement of our patients, we continue to have an uphill battle in proving our value within medical settings. As I recruit people to our program, I make the statement that family medicine is like working with family for me and feels as comfortable as home. I am fortunate to work with some of the best people I know personally and professionally. In addition, I have met some great people from around the United States who work in family medicine and share similar attributes as my colleagues. However, my experiences have not always been happy and easy.

Although I came into a program with prior experience within family medicine and there had been an established behavioral medicine program, I was faced with the challenge of having to prove my expertise and value to our residents. My strategy was to set boundaries and stick with them at all costs. In my first year, I received evaluations from the residents that ranged from “She is extremely helpful” to “She is not welcome here.” In my second year, I was met with slightly more challenges. While providing feedback during resident check outs, some residents would sit so that I was completely to their backs as they presented a case. My evaluations included comments such as, “You’re not a real doctor” or “You’re not welcome in the physician lounge because you are not a physician…in fact you should not be considered faculty.” While those are not pleasant experiences, I think one of the worst experiences was when I sat down for lunch in the physician lounge, and residents either left or the ones coming in sat in a different area. There were times I would go to my office, sit down, and feel completely ineffective. I hate to admit it, but there were times I cried. All the while, my physician faculty stood beside me, supported me, and told me that this would get better. They asked for my input, consulted me when the residents would not, and gave me more responsibilities.

In subsequent years, things began to change. I started to receive pages from residents and curbside consults to ask me my thoughts about their patients. I was even asked by a resident if they could do a rotation with me. My evaluations began to include comments of “Excellent,” “Extremely helpful,” and “Wished I could see her more in clinic, but I know she has other duties.” In one of my more recent experiences, a resident asked me what they should do for a patient’s joint pain. When I responded that I was a psychologist and not a physician, the resident laughed and said “Oh, yeah, I forgot.” I’ve grown to have relationships at the medical center across physician specialties and seemingly have a positive reputation. So, as I am feeling confident that I have overcome bias and have proven my worth as a member of the interdisciplinary team, I walk proudly to another medicine department to give a lecture on physician wellness. As I am completing the lecture, I recognize an old familiar feeling, stare into the audience, and realize that I might as well be promoting the sell of snake oil as a cure for various medical ailments. I sigh and go back to the Department of Family Medicine, where I feel at home and am satisfied with my accomplishments. I’ll leave the job of establishing the value of interdisciplinary care in that discipline to another individual and hope they will one day be as valued there as I am in family medicine.

3 responses to “I Believe That Behavioral Science Faculty Face an Uphill Battle

  1. Ken Grauer, MD

    THANK YOU for writing Molly! So glad that things have turned around for you at your institution. I believe the situation you describe is common (in various degrees) at many sites. Fortunately with time – most (not all) residents finally realize the tremendous assistance Behavioral Science Faculty can provide – and how essential developing skills in this area is not only for their professional success, but also for their peace of mind as family medicine practitioners. Having regular Balint Group sessions (co-presented by MD with B.S. facuty) – I believe facilitated acceptance by most (not all) residents.

  2. Sandra Burge, Ph.D.

    We old timers have observed that some residents will bristle about any significant change in the program – including (but not limited to) the addition of a not-physician on the faculty. Stick to it for 2 years, graduate the bristlers. And, suddenly, with a full complement of “your” residents, you become part of the program culture and curricular expectations. The most important element for a happy work environment for behavioral science faculty is the support of the physician faculty – they are the people who will stay in the program and validate your work.

  3. Thanks, Molly! Reading your very prescient comments felt like I was reading one my old journal entries. The journey to acceptance and connection and a feeling of making a contribution to FM can be a long one. It was for me. One of my mentors once commented that “Bill you’re just as bright as the residents and faculty; they just don’t know it yet.”

    Warm regards, Bill Mygdal, Ed.D.

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