For Rebecca Smith ’03, a certified nurse midwife at a rural community health center, prioritization is the name of the game.
“My perspective is, what is the work that needs to be done? What are the resources we have? How are we going to figure out prioritizing it per resource and then moving on down the priority chain?” she says.
That explanation may sound more granular than the work of a typical midwife — that’s because, in addition to her daily duties of pregnancy care, family planning, and reproductive and sexual health care, Smith takes on an operational role at Open Door Community Health Center in Eureka, Calif. Succinctly, she helps the center run smoothly for both providers and patients.
Most clinicians get into operations work because they see a repeated problem, and they travel down a rabbit hole trying to fix it, Smith explains. Those problems can be anything from poor documentation practices to outdated scheduling systems, which make life difficult for both the pregnant person trying to get prenatal care and the veteran doctor running out of time during an appointment because patient files are disorganized. Overall, optimizing healthcare operations involves taking a step back and looking at the bigger picture so solutions can be created. “Seeing the big picture helps me rearrange how processes go in clinics, so that we can spend more of that one-on-one time with patients,” Smith explains.
Currently, Smith and two medical assistants are creating a staff guide for her clinic, which details every type of patient visit, as well as what happens at each of those visits from both operational and clinical standpoints. If staff members follow the guide, her hope is that the overall visit experience will be positive for everyone involved.
One of Smith’s motivations for optimizing patient care is personal: Those patients are her neighbors. “One of the drivers for me moving here was living and working within the same community,” explains Smith, who last practiced in Los Angeles. “I didn’t want to commute 45 minutes and serve a community and then drive home.”
Rural health care often requires clinicians to wear many hats, and Smith is no exception. In addition to her operations and patient care roles, she is also a diabetes care and education specialist. Additionally, she acts as a preceptor to family medicine residents in her clinic and in the nearby hospital, Providence St. Joseph.
Through her newest venture, The Thoughtful Clinician, Smith plans to give new clinicians mentorship and continuing education opportunities. She will also consult on trauma- informed clinical operations. “I’m excited to help other people gently enter into their practice and feel supported.”
Smith says it’s common to misconstrue the work of certified nurse midwives. “People think of midwives as being the hippie grandma who catches babies in the woods,” jokes Smith, who delivers babies in a hospital setting. To set the record straight: The main difference between midwives and OB-GYNs is the surgical aspect of the latter’s role.