Page 20 of Anatomy of a Meet Cute
Dr.Franklin snorted and leaned back in his chair, studying Sam. “You’re a community health research fellow, aren’t you? What study did you read that brought this idea on?”
“Okay, yes. You are correct. I’m a community health research fellow.” Sam laughed. She had to hand it to Dr.Franklin: at least he knew his fellows and residents well. “I did my master’s in public health policy, looking at successful mentorship programs for pregnant teens, so I know community programs can work. Why shouldn’t they work for our pregnant population? It’s widely understood that the risk of birth complications for trans people, people with disabilities, lesbians, and people of color is much higher. But the risk of complications decreases when people have access to doulas, which is often the exclusive domain of rich people. If my hypothesis is correct and we design a thoughtful program—and don’t worry; I plan to study this—then we could help improve the experience of and outcomes for marginalized pregnant people tremendously.”
“By using a doula? Why not additional training for staff? A training day is much cheaper than a new program.” Dr.Franklin steepled his fingers and squinted at Sam, his gaze making her nervous all over again.
“I would argue that we could do both. My interest is in community programs. But if we have another fellow on staff who is interested in researching physician education, then let’s include them.” Sam shrugged.
Dr.Franklin shook his head as if he was trying to come up with a nice way to say no. Sam couldn’t let that happen. Jumping in, she added, “Think about it. Only fifty percent of the people who deliver here received care at SF Central prior to having a baby. But our hospital could be a place where people who typically avoid medical care or whose outcomes are poor actually want to come and give birth. Doulas can help bridge the gap between the medical experience and everyday life. Not to mention help provide care for people whose pregnancies may not come to term for whatever reason. Right now, we don’t offer them any real support to speak of, and that is a shame.”
“Dr.Holbrook, I appreciate your enthusiasm, and you certainly make a good point about patient experience affecting the bottom line. However, I know you are new here. Do you have any idea how many of these fly-by-night, fad community health programs have come and gone?”
Sam felt her stomach drop. She should have anticipated this question. Hell, Grant had warned her that this wouldn’t be an easy sell. “Well, no. But that’s the thing—”
“Our midwives do a great job with the postcare checkup after someone has given birth. I fail to see how using a doula for that would be any different. If anything, it is just inviting someone without any formal medical training to do a clinician’s job, despite the fact that we are already paying to have a nurse there.”
Ouch. That was blunt. A small voice in the back of Sam’s head pointed out that although it was harsh, Dr.Franklin had tipped his hand. She was thinking about this the wrong way. Patient centric might be her goal, but it wasn’t his. Money and the old guard were what mattered here. Sam smiled.
“Not everyone who comes here has a baby when they leave. Nurses aren’t much help there, but a doula could be. And for those who do, are we paying nurses to make house calls or scheduling them for more than ten minutes for each patient?” Sam asked, letting her eyes go wide in the hopes that it would sound more naive than judgmental. Dr.Franklin smirked as if he bought her act about as much as he believed in leprechauns, but she continued. “Bringing in a doula allows the nurses to focus on patient care, while someone else handles the aspects that don’t require medical attention so much as managing patient and familial comfort and anxiety. Not to mention the basics of changing and swaddling postbirth and the general reassuring everyone that they are normal.” Sam steadied her breathing as Dr.Franklin shifted his attention away from his watch and back toward her, his focus becoming more intent as she spoke.
“I can see where you have a point.” Dr.Franklin nodded, his expression looking like someone who is trying to decide between a Big Mac and a Quarter Pounder.
“And,” Sam added, pushing her luck just a little further, “if we do this right, the doula will have a relationship with the patient, so they can help with lactation support, finding life balance, and any number of questions that come up in the first few months after the baby is born. It would cut down on calls to the clinic for things that really don’t require a nurse or a doctor’s attention.”
Dr.Franklin’s sigh was heavy, as if Sam’s line of thinking was wearing him out. He leaned back in his chair, letting his eyes flick toward his screen again. “These are all very appealing reasons to consider a community program. But that still doesn’t change the hospital’s financial situation. We just don’t have the cash on hand for something like that.”
“Dr.Gao said as much. But I have done some thinking about this.” Sam refused to let his exhaustion deter her. Not when she was this close to getting her way. “Part of a fellowship is learning how to apply for grants. I know this isn’t likely to get NIH funding, but if I could findus philanthropic support for a pilot program, would you be willing to give my research idea your blessing?”
Standing up, Dr.Franklin looked down at Sam, cueing her to stand without so much as a word. Exhaling so his cheeks puffed out like a bath toy, he said, “Physicians always think their ideas are surefire, easy grant money, and they never are. And doulas? Talk about a tricky sell.” Dr.Franklin snorted as he said the worddoula, and Sam held her breath, refusing to walk toward the door until she had a firm yes or no. He eyed her, waiting for a response.
“I suspect you are right. But what could it hurt to try?”
Dr.Franklin shook his head and walked around the desk, effectively herding her toward the door. “Well, if you are determined to try it. Sure. Go ahead and look for grants. If you can find someone to fund it and a senior physician to advise you since you’re in your first year, then by all means. I’ll let you give it a go.”
“Thank you, Dr.Franklin,” Sam gushed. When she’d envisioned this part of the conversation, she’d thought she’d be chill. It turned out she had zero chill when it came to patient care. “I look forward to updating you as I develop the program.”
The older man walked to the door, the humor returning to his face. Laughing lightly, he said, “Right. Good luck getting doulas in my hospital.”
“I know the idea is unorthodox, but I think it might just work out in everyone’s favor.” Stepping through the door, Sam forced herself to smile. He could underestimate her all he wanted. Sooner or later, Dr.Franklin would eat his words, and then she would be laughing all the way to better patient outcomes and an article published in theAmerican Journal of Medicineor something. “Thank you again for making time to see me. You won’t regret it.”
Sam saw him shaking his head. His expression was the sort of amused look that adults usually reserved for small children telling bizarre stories. She waited until she rounded the corner and heard hisdoor shut before busting out a small happy dance, complete with a shimmy and a few hops.
To think Grant thought it couldn’t be done. Sam grinned as she got in the elevator and pressed the button to the third floor. She wasn’t planning to track down Grant and tell him he was wrong or anything ... but if she happened to see him in the staff lounge, she couldn’t promise she wouldn’t mention it. She could do that without sounding too smug ... or at least she would try.
“How’d it go?” Duke asked as soon as she opened the front door.
For a moment, Sam’s tired mind went empty as she sifted through her shift until it hit on her meeting with Dr.Franklin. “I got the green light.”
“I told you!” Jehan’s voice rushed down the hall, with the sound of her footsteps.
“I see you.” Duke spread out his arms and pulled the two of them into his massive wingspan for a group hug.
“This is the gangliest group hug.” Jehan giggled as she tried to navigate two taller people’s arms. “Seriously. I’m rooming with people who should be in a professional basketball league.”
Sam laughed as the three of them let go. “Maybe it’ll rub off and you won’t need a step stool to reach the kitchen counter.”
Jehan snorted and followed Sam over to the couch, flopping down next to her with the same exhausted sigh. “So what happened? Was Grant right? Details, please.”
“I mean, he was kinda right.” Sam wrinkled her nose. “But also wrong in several ways, which I am choosing to focus on because I’m petty.”
