Freelancer Looking For Opportunities

My quest to become a freelancer is challenging. Presently I’m still working on the resume.

You see, while I have great training and I am a MD, I never had a title besides “Doctor”. Titles are very important in the business world, as they imply leadership skills. Most titles are shared by a few wearing several hats; you will see them at various meetings and be amazed they can juggle so many hats, until you see the hats falling to the floor with each throw.

When I practiced, my priorities were my family and patients. While I had opportunities to get a title I was uninterested. And in some cases left those jobs, not wanting to spread myself too thinly.

Sadly, I feel the need to explain my not acquiring a title during my career as a single mom physician, whose husband also happened to have committed suicide.

Now I could easily create a few companies and make myself CEO. Wait, I am the CEO of the companies I created (Engaged Environments, LLC and Angela Crane Associates, LLC).

Recently, a fellow physician complained about a MPH consultant who never practiced medicine, teaching doctors how to practice medicine. A job I would not be considered for because I did not complete the MPH degree at Harvard, despite my 20+ years in practice and the last 4 years as a patient. Interesting how short sighted businesses can be.

Yes the world of freelancing is not easy.   Not having a title, as well as my location and race, all work against me.

Over the weekend I will rethink my strategy to include patient advocacy and malpractice as possible freelance work. I will either get there or die trying.

If you need an expert (which I am!) to review your medical care and make suggestions, or want to know your care was appropriate, then please send me an email to arrange a free 15 minute consultation at AngelaRMCrane@outlook.com

Finding Work Using Social Media

Farewell to Exclusivity and Tokenism

Krish_healthcropped

It is no measure of health to be well adjusted to a profoundly sick society.

~Krisnamurti

Yesterday, I was un-invited to an ACA event that day–apparently, Issued too many invitations and my presence irrelevant–Invitation one month ago and a second confirmation of attendance over 1 week ago….

I am disappointed!   This event attended and presented by the same people (and their protégés) is the biggest problem in medicine affecting medical care for everyone– perpetuating  vicious cycles of failed programs and ideas– The problem of  Exclusivity.  Exclusivity and diversity do not complement or work well with each other.   This mutually unique opportunity for  networking and leadership was  denied.    The problem with exclusivity is ACCESS.  Yesterday, I was denied access….unfortunately, this occurs often to people of color.  #POC

Harvard School of Public Health  did not practice what it preached.  I was prepared to teach  them:  Impart wisdom to the decision makers with formal authority.  Did they  not know physicians are important stakeholders?

Did they forgot my contributions to HSPH   during my first 4 months?

Did they  understand  how physically and emotionally ill I felt on returning to HSPH   following a 17 hour nightmare of cruelty and denigration  at Tufts Medical Center Emergency Department?

This culture says, who cares?  Diversity is paramount to appreciation and comprehension of   health.  Diversity begins with acceptance and comprehension of language.  Language is the means we use to communicate  thoughts, experiences and ideas –our cultures.  It is no measure of health when everyone has to adjust to a society that is profundly sick.

assimiliate-party12

The mindset of  medicine and public health is not diverse but rather stifling and very biased.  The  same voices in different roles. Essentially, the same actors and a few selected actresses wear different hats and hold all key positions of FORMAL authority.    This is called change and leadership.

Medicine does not value diversity and that is reflected in its culture and Continued Failure to Listen….resulting in lack of diversity along with increased morbidity and mortality of excluded groups.

***

Below is a letter that marks the end of my affiliation with medical care.

I will not attend this conference or any other claiming to care for patients when real patients are not represented and ….

Will there be People of Color presenting? The images do not show anyone like me. Last year I attended and enjoyed the conference but felt frustrated and disappointed by the lack of depth and diversity.

As I suspect the same, I will pass my ticket onto a colleague who is more your target. It is shameful medicine ( I will not say healthcare because there is nothing healthy or caring about our current system) remains exclusive even to the point of patient advocates.

I can’t be part of this atmosphere of exclusivity and tokenism.

It is no measure of health to be well adjusted to a profoundly sick society.

~Krisnamurti

Krish_no-health123

Krish_understand

When we talk about understanding, surely it takes place only when the mind listens completely – the mind being your heart, your nerves, your ears- when you give your whole attention to it. ~ Jiddu Krishnamurti

#quotes

A Story From The Balcony: Group Dynamics

fromthebalcony_AGimage2_-1000x749

A Story From the Balcony: Group Dynamics | Part 3

The Ideal

Based on the Drexler/Sibbet Model, we went from stage one—orientation—to completing the task without entering the intervening stages. I believe this is usually the case where groups form around short-term projects. The stages required to build trust take time and respect for all ideas.

Drexler/Sibbet Model
Drexler/Sibbet Model

We did not clearly identify  problems,   and most importantly, communicate a common vision for the group. An  consensual agreed-upon structure would have defined the group further and helped develop group norms. Limited time and the need for creativity make different approaches that, in essence, bond people.

A common vision is paramount to jump starting any process of building a relationship or starting any project. The other paramount ingredient is the respect for all ideas. The notion of respect for all ideas is essential to keep all stakeholders at the table lest the table become singular. The above two elements, along with feelings of connectedness, bring transformation with multi-perspectives–the essence of innovation. This encompasses the IDEO model and more. An idea that may sound weird, when flushed out a bit, usually spurs other ideas; suddenly, we are adaptive, thinking of outside-the-box, real, creative ideas.

I disagree with the Drexler/Sibbet model, which notes that trust comes before goal clarification, because people need solid reasons to gather and take time out of their schedule — making framing of goals or intentions very important for getting stakeholder buy-ins. That allows for interactions that, if positive, will lead to trust and relationship building. This strengthens stakeholders’ commitment. A clear vision lends itself to prioritizing goals and aligning them with resources.

When all ideas are acknowledged and discussed, the end result can be creative and innovative. This is facilitated by focusing on common visions whilst anticipating conflict. If a conflict is handled with respect and inquiry, the result will be high-performing teams (or communities) with innovative ideas.

Given the pressure and discomfort with the topic at hand, our class overlooked the above. In my opinion, we went from the task to the solution without understanding the problems. My attempts to understand the problems and the right questions were met with fierce resistance. In my mind, how could we begin to tackle an adaptive problem without understanding the perspective of the afflicted communities and their families? There were basic questions that were never answered. These include:

a) What were some explanations for the large disparity in infection rates between black females and black males?

b) Why was the ratio of sexually active black teenagers similar to white teenagers, while Chlamydia infection rates between the two groups were disproportionately out of whack against black teens? (Sexual activity rate is similar between black and white teens while chlamydia infection rates are much higher in black teenagers than white teenagers. Why? How was chlamydia reduced in white teens?) Those questions were basic research questions that suggested other factors were at play, and that Prof Wang’s lecture did have relevance beyond due mention of subject matter.

Other questions best answered by communities follow. The process of discovering the many narratives behind those questions often lead to trust, better partnerships and collaborative efforts:

a) What were the trusted communication sources within this population? How was information transferred?

b) What were the demographics and cultural dynamics of these communities?

c) What were the access issues to treatment?

d) If the stigma of STD was the sole factor for not seeking care, why did many other cities seek onsite testing?

e) What was the standard of care when sexually active teens presented for a physical? What was it when they presented for screening or an STD? How did those standards compare to non-disadvantaged communities?

f) Were their other medical problems with such racial disparity? These were important questions; unfortunately, I was ineffective in articulating them. Soon, many of my classmates stopped listening the moment my mouth opened.

The Conclusion

Were my actions adaptive? Did I exercise adaptive leadership? Was I a team player? My actions were adaptive; I asked the difficult questions and made people feel uncomfortable. I discovered the power of writing; my use of the Wiki was more  therapy than a way to be heard. It surprised me to discover that my classmates were reading my blog. They were paying more attention to my blog than my spoken words. I used that opportunity to make inroads by providing a narrative for those communities, with some success.

Part of leadership is orchestrating the process of change. While I did turn up the heat and increased the awareness of some of my classmates, many were unprepared for the discomfort. I worried my last blog would undermine the project. I am glad it did not. It will take practice to develop the art of orchestrating conflict, especially with younger ones. 🙂

In conclusion, group dynamics inevitably leads to conflict. It is important to  anticipate conflicts; never ignore them.Conflicts represent opportunities for greater understanding and bonding within  groups.  Never ignore conflicts lest they become future minefields.

Part 1:  A Story From The Balcony    https://failuretolisten.com/2013/09/30/a-story-from-the-balcony/

Part 2:  A Story From The Balcony: The Disconnect https://failuretolisten.com/2013/10/03/a-story-from-the-balcony-the-disconnect/

fromthebalcony_AGimage_effect-660x600

Things seems so different now...
Things seems so different now…

A Story From The Balcony: The Disconnect

The Disconnect
The disconnect

A Story From The Balcony: The Disconnect

The Team

The stage was set perfectly for controversy. We were given an impossible challenge where our competitive nature and need to shine in front of important people were at risk if we did not complete the task. Each of us had our own agenda and needed to be a leader. The problem was the same beliefs and actions that contributed to health inequities or disparities were cherished values, foundational beliefs of the teams–that was the culture of our group dynamic. The ground rules were quietly cast aside, despite our tense discussion and agreement on those rules on day one.

We divided into six stakeholder groups in an effort to gather information, but we never identified the problems or set clear goals. There was no shared vision, only a sense that certain members were the decision makers. Their ideas, good or bad, received attention and recognition. My ideas were not received in the same manner. I felt people heard but did not listen, because they already knew where I was coming from.

The rate of gathering information varied, resulting in decisions without an adequate understanding of the issues. This led to the right answers to the wrong questions. Our stakeholder group did not make contact with a youth group until the last moment. We did a focus group with a wonderful group of lively, non-sexually active, honor students, trained to educate their peers who were sexually active, non-honor students. {One immediately appreciates the lack of thought and evidence that go into designing these programs. Money WASTED in the name of good.} While they were not the ideal target, they offered a unique, non-stereotypical view. Given the discussion in class, I was excited to let my teammates know such Afro-American teenagers exist. This information was not given the deserved respect or attention by the team–I guess they didn’t believe.

While we were conducting the focus group, I noted an older black lady quietly sitting with her head bowed, but eyes peering carefully at us, making sure no harm came to her teenagers. In engaging her, I realized she could provide a wealth of information, and she did. Her alias is Ruby. We had a great conversation about her community, STDs, and the healthcare delivery system in her community. Her suggested solutions were brilliant in their simplicity; however, the class rejected this information. She was over 50–how could she possibly know what teens are up to working in a teen center?

My teammates did not believe that a black woman – a parent, a grandmother, living and working in the target community – is reliable or resourceful. Her story was not what they expected. I was even accused of falsifying data by one of my teammates while the professors watched on. {Also her truth did not align with the DATA.}

The real problem was time; to my teammates, this woman’s story shattered theirs, believing her meant re-thinking our solutions: Chlamdyia bracelets, T-shirts bragging, “I am Chlamdyia free”, and Readers Digest. On that day, I felt the class had gone too far in disrespecting Ruby, the target community, and me.

The Disconnected
The Disconnected

The Disconnect

Here on the balcony, it was inevitable. It was inevitable that my outrage would lead to lack of understanding and the inability to communicate my concerns clearly. My classmates had a task and the clock was ticking, but for me, this was not just a project. I desired deeply to correct some of the misconceptions about Afro-Americans, and to share with the class how well intentioned programs can be just as harmful as doing nothing. This was “the disconnect” between my classmates and I.

The Chlamydia articles left me with many unanswered questions. The interchangeable use of cases and rates per 100,000 was very confusing. I got the impression that over 95% of Afro-American teenagers and young adults were infected. It was difficult to find the actual percentage. These articles seemed to imply that black teenagers’ early and frequent sexual encounters were the root cause of the problem. Yet Prof. XYZ articles implied that this racial disparity in Chlamydia infection rates was symptomatic of the various forms of discrimination: systemic, internalized, interpersonal, and structural. Here was the sine qua non of the problem; our opportunity to dig deep and understand the problem from another perspective. Instead, however, we glossed over it, creating a huge disconnect. We identified the problem as adaptive but thought only of technical solutions.

As the story continues…

A Story From The Balcony Introduction Part 1

A Story From The Balcony: Group Dynamics  Part 3

The Disconnect limits views and creates myths...
The Disconnect limits views, creates myths…and is harsh.

A Story From The Balcony

from the balcony...
from the balcony…

A Story From The Balcony

Introduction

Leadership! My actions left me questioning my ability. The rationale behind those actions was similar to those of the Colonials in the American Revolution, standing their ground and creating their own rules of engagement with the British. Could they have read, “The Art of War” by Sun Tzu? I don’t know, but on that infamous Thursday when I was ambushed and bludgeoned, the lessons from that book raced through my mind, giving me the strength to strike back. So, now, I stand on the balcony, in control and with new appreciation and understanding for my teammates. Continue reading “A Story From The Balcony”