Mission in Practice: Organizational Culture

Shawnee Christian Health Clinic is primarily organized around values that reflect a commitment to providing equitable care and holistic service to those in need. This past week, as I have begun to serve at Shawnee Christian Health Center, I have seen their mission come alive within the walls of the clinic, which primarily serves local residents of the Shawnee neighborhood. At its core, the organization aims to transform the community by empowering and healing its residents through equitable and accessible healthcare.
In particular, my two weeks of my internship informed and transformed my understanding of the clinic’s commitment to “holistic” healthcare. Contextually and historically, the neighborhood the clinic serves presents a unique array of socioeconomic, demographic, public health, and medical challenges. The Shawnee neighborhood is a predominantly African American neighborhood where a large portion of individuals live below the poverty line. The neighborhood is a food desert without sufficient access to healthy food options. A majority of the individuals smoke cigarettes habitually. Violence and crime rates are extremely high. Mental illness, particularly cases of depression, anxiety, and PTSD, runs rampant and is deeply rooted within the community.
Thus, the clinic’s commitment to providing “holistic” healthcare requires the providers at the clinic not only to treat and diagnose physical and medical problems. To properly and holistically care for a patient, they must examine the behavioral, mental,and physical aspects of an individuals health. Organizationally, this requires the behavioral health, clinical, and administrative teams to work in extremely close proximity to each other. The administrative teams tackles the unique challenge of ensuring the clinicians and behavioral health employees are able to see for a largely underinsured and poor population. Meanwhile, the behavioral health specialists and clinicians constantly consult and collaborate with one another in order to administer tests, select medications, and create treatment plans that best reflects an individual’s medical and mental needs. Because so many individuals in the community suffer with mental health struggles, it is imperative that the teams collaborate in order to care for patients.
In terms of recommendations and evaluations of leadership, the team serving at the clinic has many strengths, but faces several challenges. Overall, the day to day operation of the clinic is highly collaborative. In the area of the center where I work, one head physician oversees the operations of the clinic as a whole. The doctor comes in one day a week to oversee things, meet with staff, and address overarching concerns. However, during the week, physician’s assistants largely serve as the primary providers who see patients and make decisions in the clinic. Instructions and decisions are made primarily by these head providers. However, each provider has either a nurse or a medical assistant that works closely with them one-on-one in a pair to care for the patients. This organization pairs runs well overall. As an intern, I am matched with one of the providers and help assist the team with picking up patients, taking vitals, and assisting in the exam room. I am usually given directions by one of the medical assistants or nurses, who in turn receives directions from the provider. Thus, I communicate more directly with the assistant to the provider than the provider themselves. However, this seems to be the most efficient means. The medical assistants and I run test, take vitals, and print files so the providers are able to spend as much time face-to-face with the patient as possible.
In terms of criticism, the main issue I would identity is that the clinic is largely understaffed. Typically, there are two main providers in the clinic. However, often the front office calls us in the back of the clinic with concerns and reminders about patients in the waiting room. During my first two weeks, I have gained an understanding of how in healthcare operations, one of the most crucial and influential aspects of a visit is wait time. Many individuals have to take off work or take the bus to come to the clinic, and a long wait time only makes these visits less efficient and more irritating for patients. It is a delicate balance between investing time in individual patients and ensuring efficiency across the clinic. Thus, if I were to give a recommendation, I would advise for the clinic to look into ways to manage wait time, either through hiring additional providers or scheduling appointments with more time between each.

One thought on “Mission in Practice: Organizational Culture

  • July 10, 2019 at 11:35 am

    Sounds like a really challenging and exciting place to be interning. Nice to hear that there is a collaborative environment, as often healthcare is talked about in regards to providers NOT working collaboratively with one another (e.g. in terms of prescribing conflicting medications, etc.). I imagine that the limited staff is due to budgetary constraints and to some degree I would imagine that spacing out appointments more could lead to a reduced number of patients served, so it is a sticky situation. As you continue there you’ll likely learn more about both of these and develop further insights about enhancing the patient experience.

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