As some of you may know, one of my go-to day dreams for self-care is thinking about building a small farm/homestead, growing my own food, and living a simpler life.
Well I have a new one I’ve been ruminating on as an escape and it entails the fantasy outpatient clinic I would have. Now this is definitely never going to happen because I want to be a hospitalist and never own my own clinic but this is what it would entail:
The building would have my OBGYN clinic and a pediatrics office sharing the same space. There would also be an on-site day care to provide child care for all of the employees and patients would be able to drop off their kids or their non-sick kids and go to their appointment whether that’s on the OBGYN side or the peds side so they can be present without having to wrangle their kids during the appointment or figure out child care. Kids will be able to play PG video games, play with play-doh, do arts and crafts, play board games, or watch movies.
There would be three social workers within the building and at least one clinical psychologist, but likely more than just one. There would be a victim’s advocate nutritionist, and a lactation consultant available. There would be a small pharmacy stocked with common medications that can be challenging to get filled elsewhere (abortion medications, suboxone for pregnant patients prescribed by MFM etc.) and lactation rooms with little fridge lockers so people can store it during the day and know it’s secure. There would be two conference rooms where breastfeeding, birthing, diabetes education, and other classes would be provided on Wednesday evenings and Saturdays.
On the OBGYN side every employee would be female, there would be at least two large, full-service procedure rooms where we can do MVAs, LEEPs, cones, endometrial biopsies, colposcopies, etc. The gowns would be kept in towel warmers so they’ll be warm when patients put them on. The jelly for the speculums will be warmed. In the bathrooms there will be different colored pens so if someone is being abused or needs help they can write their names on pee specimen cups in a different color. There will be mammograms offered on site and they will use the special heated panels that are more comfortable and less painful for patients and there will be a full ultrasound suite for GYN and OB ultrasounds. An MFM doctor will be in the office as well as a genetics counselor and we’ll be accredited to do all OB ultrasounds except fetal echo. We will also have gyn-oncologists working in this office for patients with cancer, who will have a separate waiting room for safety/protecting the immune-compromised. There would be a separate waiting room for patients who have experienced a pregnancy loss or are in need of a hysterectomy so they won’t need to see or hear children in the waiting room of the pediatrics office. The office will offer LGBT friendly services and support.
There will be phlebotomy services for both clinics so patients can have their blood drawn at the clinic instead of needing to go elsewhere. There will be an XRay machine for the pediatrics office.
The pediatrics office will require (and the OBGYN office with regards to covid, flu, shingles, and pneumovax for older people) patients to be fully vaccinated, the OB office will not take on patients who do not intend to vaccinate themselves or their unborn children. There will be a fun children’s play area and after each visit, instead of stickers or candy, the kids can pick out an age-appropriate book to take home with them that we will buy from library sales, dollar stores, or thrift stores or receive as donations from the community.
As for how the employees will be taken care of, they will receive full benefits and fair salaries based on their experience level. Everyone will only work three days a week but we’ll be open on Saturdays and until 8pm on Wednesdays. One day a week, lunch will be provided for all employees who are working that day and dinner will be provided for those working late on Wednesday. The meals will be chosen by the nutritionist to promote wellness There will be an area with free snacks (again chosen by the nutritionist) that are for all employees or for patients who may need them (low blood sugar, etc.) and there will be a small food pantry for patients or employees who are food-insecure.
The day care will provide free or low cost childcare to all the employees and lactating employees will have time to pump or go breastfeed their child at the day care center throughout the day as needed. Employees will be provided with free or discounted gym memberships to a gym in the local community to promote wellness. Therapy will be fully covered under whichever insurance plan we offer. Employees will also be invested in the company and receive profit shares quarterly if the clinics are doing well, this way the employees are invested in providing excellent service and will want to ensure staff are properly trained and being professional and are willing to go above and beyond to serve our patients and community. All employees will be required to complete trauma-informed care training and be fully vaccinated. Employees will have 12 weeks of paid parental leave and one month of PTO for sick time or vacation. Employees will be encouraged to take sick time if they are sick as it’s rude to come infect their colleagues or patients, employees will be encouraged to take mental health days.
There will be hospitalist OB providers and office providers who work in the hospital to do OB care and deliver patients. Office providers (depending on how many we have) are expected to do at least 21 call days a year 8 of which must be weekends (pediatricians will be expected to take more call because there are no hospitalist pediatricians in this clinic), holidays will be covered by either the hospitalists or locum providers or anyone who wishes to cover, they will receive generous bonuses if they volunteer to work holidays.
Each provider would have their own office so they can do telehealth appointments or give bad news privately and just to have their own space. All employees would have the same professional looking scrub uniform but be designated by color (black scrubs for the doctors, blue for nurses, forest green for front desk and office support staff, etc.). It will have the clinic logo on it and be embroidered with everyone’s names. Each staff member will be given 5 free uniforms, and free replacements when they turn in a damaged set. Patients who are pregnant will be given free upsized shirts or pants as they grow. Shoes need to be tennis shoes but can be whatever the employee wants.
Obviously this would never be attainable in the US especially under our current system but it’s a fantasy day dream for a reason. Right now this is what is helping me get through the days.
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