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Wednesday, October 24, 2012

Clinical Reflections: Tavia Rhoden on the Medical-Legal Partnership for Seniors

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2L Tavia Rhoden, RN, with client at the Medical-Legal Partnership for Seniors clinic.

Black’s Law dictionary defines health as the state of being sound or whole in body, mind, or soul. At the core of healthcare is the concept of early prevention to improve and/or maintain quality of life. Preventive medicine focuses on early interventions to prevent disease processes. However, what I believe diminishes the overall goal of preventive medicine in the United States is our tendency to view a person’s life in sections.

We compartmentalize or group different aspects of person, which may work in an acute critical healthcare setting, but if we are going to promote overall health or ‘state of being whole in body, mind of soul,’ this approach is ineffective. One of the biggest strengths of being in America is all the diversity that is here, but it’s also our biggest weakness. We are so accustomed to placing everyone in a group, whether it's racial, religious or socio-economic, that we often forget to look at each other as individuals with their own life stories, stressors and joys independent of which “group” they belong to. Part of my motivation for coming to law school was to use my life experiences, my faith, my views on life and health, and now my experience in the medical-legal clinic to help with policy changes in delivery of healthcare.

The medical-legal clinic represents a multidisciplinary and holistic approach to providing legal assistance in a medical setting. Consequently the ultimate goal is to improve health outcomes for patients and clients. The terms “multidisciplinary” and “holistic” are important for a variety of reasons. The Oxford American Dictionary defines multidisciplinary as involving several academic disciplinary or professional specializations. Here, in the medical-legal clinic, clients/patients benefit tremendously from having legal and medical professionals (and legal professionals in training) collaborate to improve life and ultimately their health because here, patient/clients have professionals with different skills sets looking at various aspects of their life in a holistic manner. Holistic or holism is defined in the Oxford America Dictionary as the treating of the whole person, taking into account mental and social factors rather than just the symptoms of a disease. Our clients/patients are more than their disease or their legal issues. This then brings me back to my professional/personal goals that I hope to improve or gain through my participation in this clinic.

Prior to attending law school, my work as an emergency room nurse boldly highlighted for me the intersection between law and medicine. In school and at work, the idea of preventive medicine being the ultimate goal was constantly being presented to me, but I realize that what we say or want and what is realistic are two different things. For example during my clinical rotation, I was working with a refugee family that had both the youngest and the oldest member in their family always seeking medical care. I was able to visit their home as a clinical student and realized that there were many underlying issues that I failed to fully understand because my focus was on their medical health, and I just did not really know how to access resources or what the laws were. This family was malnourished not simply because they were not versed in proper nutrition, but because they could not afford it or their living conditions were so deployable. In medicine, we treat the disease, but then these patients go back to the same living condition and the cycle begins again. This made me realize that a multidisciplinary approach is best for patients to improve overall health. “Good health” is viewed from the totality of self. It involves health, emotional, and social wellbeing, and these circumstances extend beyond medical professionals. I want to be part of the solution to help integrate a multidisciplinary approach in healthcare settings. From my work so far in the clinic, I see how effective this model can be, and how it leads to long-term improved health.

I want to be able to use my knowledge of healthcare and law to ultimately benefit my clients on a holistic level. I want to achieve the best possible outcome for my clients. The difficult part in this statement is learning that it is ok if the client does not want the same thing for himself or herself as you want for them. Even though I may think I know the best thing to do, since I can never fully walk in my “clients shoes,” my job is to make recommendations and provide clients with the alternatives for each option available to them and maintain a good rapport with my clients.

At the end of the semester, my goal is to be more aware of issues affecting the aging population. I think about the quality of life I want for my grandparents, my parents and even myself when I am older. Three words are always recurring for me: I want them and eventually myself to have "peace of mind.” I believe that when your finances and long-term plan are in place your stress and anxiety will be less. While nothing is certain in life, at least have a tentative plan in place. Additionally, I would like to help draft some of the policies for our clinic moving forward that indicate to future clinical students how we can resolve certain issues. I see so much potential for this clinic, especially in light of changes in healthcare, and I want to help this clinic grow to its full potential.

My long-term professional goal is to hopefully position myself to be one of the leading experts on medical- legal issues. Additionally I hope that my communication skills continue to improve and that I remain culturally competent and ultimately help to build and maintain the trust of the general population of attorneys. Reaching this goal will not be without its challenges, because I don't consider myself to have the stereotypical attorney persona. I consider myself as being "quietly assertive," meaning that I believe I can achieve what I want in life without compromising my values. I never want to be viewed as abrasive and "cold" or "use people just to get where I want to go." My faith and cultural values play an important part in the person that I am today and I never want to compromise either in pursuit of a career aspiration.

I want to continue working in a multidisciplinary setting and draw on my previous skills, but still remembering to stay in my role as an attorney versus a healthcare worker, and learning to integrate both effectively without compromising either.

by 2L Tavia Rhoden, RN
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