Shall we have geckos in the exam room?

As I told some of you in the beginning of the meeting, I have heard Lara tell of her inspiration from her encounters with her patients. I really enjoyed hearing the stories you shared last night. You shared your love for her, what she has meant to you, and I felt gratitude because when she "goes to work" she is sometimes met with people like you, people who care for her. What else could a spouse ask for? I suppose I only ask that you please tell the friends who are like you about the clinic!

Some of my favorite moments from the night include:

Someone making a comparison with the way standard doctor interactions feature  doctors who don't look at you when they come in the door and just start flipping through charts. Or the phenomenon in "team-based care" of multiple "health care providers" asking you the same questions over and over and over again, to the point where you feel like little more than a data spewer... We were discussing some of the elements of dehumanized care when one gentleman came up with this analogy:

It's like when you go to your public defender and you're in court and he tells you, "Just say no, no, no, to everything." And you're like, "But what about my case? What about my file?" And he's like, "You think I have time to read that stuff? I don't have time to read anything."

As brainstorm fodder I wrote words and questions on the white board. One of them was "animals?" One guy asked me, "What did you mean by animals?" I told him how in some clinics cats, dogs, fish, and even goats have been known to grace the interiors. He smiled and looked relieved, "Well then I would say geckos. We have a gecko and he is really cool and I would love to bring him."

We met for about one and a half hours. People didn't share everything they wrote on their sheets so when we got home and read the comments and ideas it was really like Christmas as a kid (or your wrapped gift childhood memory of choice). People were already brainstorming about ways they could help.

For instance, one person brought up a concern about how the Happy Doc Neighbors' Clinic might be inundated with people who want to get in on this very personal, human-scaled model of care. We confirmed that at some point we would have to slow down accepting new patients. We talked about how we look forward to putting up on our website, "Sorry, but we are not accepting new patients until our current ones get healthier. Keep checking back though!" And one guy in the back, the same guy who talked about his public defender's lack of personal attention, said, "You know? This is all new to me, but if I read something like that, and I was a patient, it would make me feel accountable to other patients. Knowing that other people won't get to be in this clinic because I am still sick would actually motivate me to take better care of myself."

Amazing! When Lara and I thought of our version of, "This doctor's panel is closed," we hadn't even thought about how that particular message would effect the current patients. But his observation goes right to the heart of our hope of making a clinic space that fosters accountability and caring about the other patients associated with the clinic. Pamela Wible always says, "Patients will sink to the level of dysfunction at a clinic or rise to its highest standard." And that guy blew us away with his immediate understanding of what we were trying to accomplish. He saw it before we did.

Oh yes. And will we have geckos in the exam room? Well, we were told they are great for eating mosquitoes, so if we ever have a bug problem we will definitely hire the geckos. Otherwise, one never knows.

Lara will share some of her thoughts later on. Thanks again to all friends, family, and patients who attended. --Chris