Shadow Physicians, #7 of the "How to Get Your Foot in the Door of Hospital Practice" Series

keywords:  hospital practice, prospective hospital-practice integrative health practitioners, students of East Asian Medicine (acupuncture), integrative health students, shadowing health care practitioners, clinical observation, preparing for hospital practice, shadowing in hospital practice setting, shadowing hospital-based providers, what to do before you start clinical work, biomedical clinical care, biomedicine, shadowing physicians, biomedical clinical observation, Project ECHO™


This is the seventh in the blogpost series answering the question:

"How do I get my foot in the door of hospital practice?"

Want to pre-order a pdf of this entire blogpost series?  Order here.

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Quick overview

• First, make sure you have the basic requirements covered
• Then, preparation.  
• You must enrich your foundation, pack a trail bag, and find your trail guides.
• Your first expeditions are to develop the basic stepping stones into successful hospital practice, shadowing and volunteering.  
• These stepping stones are used throughout your hospital practice career to learn and grow.  So, become familiar with these stones and do not neglect how much easier they make crossing streams or rivers vs. wading in without a trail guide or path to follow.

Acronyms and Definitions
Shadow = a unique and very old tradition of clinical observation, often short-term.  Not the same as an internship.
EAM = East Asian Medicine.  Broad term that includes Traditional Chinese Medicine (TCM) and related disciplines.
EAMP, and L.Ac. = terms for a practitioner who has completed an ACAOM-accredited master's or doctorate program and has a current state license.  EAMP = East Asian Medicine Practitioner.  L.Ac. = Licensed Acupuncturist.  L.Ac. is the most common state license title in the U.S.
MD = medical doctor, physician
PCMH = patient-centered medical home
PCM = primary care manager, depending on state scope of practice, may be an MD, DO, ND, ARNP, PA, or DC.
DO = osteopathic physician
ND = naturopathic physician
ARNP = advanced practice nurse practitioner
PA = physician assistant
DC = chiropractic physician

I began shadowing physicians as an undergraduate student and recommend every practitioner do this from time to time. 

Shadow a physician who is in a discipline you are interested in learning more about or an area you specialize in. 

If you are studying pediatric acupuncture, spend time shadowing a pediatrician or family practice physician.  This helps you understand their process and lets you see the pediatric physical exam done by an expert.  Also, shadowing someone who specializes in a specific physical exam set is a great time to fine-tune some of your physical exam skills.  

Remember, you don’t know what you don’t know. 

Remember, you don't know what you don't know. --Trail Pack toolkit item #5 = humility 

www.thehospitalhandbook.com

Shadowing like this also helps you develop contacts and communication.   If you are respectful and it
turns out you get along well with the provider you shadow, it could also be a good source of referrals for your work.  This kind of referral is great because you have first-hand experience understanding this provider’s process and, for the provider, you are a real face, not just a name.

Shadowing improves your biomedicine language communication skills and can help you create positive connections.

Consider shadowing providers that are referring to you.  For example, if you work at a pain specialty clinic and notice that a large number of your referrals are coming from neurology, make a point to contact that provider or provider's office, at least to say thank you.  If shadowing doesn't work with either of your schedules, maybe you can attend the next presentation or grand rounds that provider is giving in-house. Or invite him/her to the next workshop or presentation you are doing.

How often do you shadow? 

This varies by the practitioner you are shadowing.  You learn more if you can shadow on a consistent basis.  However, some practitioners are only able to accommodate one shadow a week or one shadow a month. 

You must work out with your practitioner what works best for both of you.  If the shadow time is extra awkward, it is probably time to stop and look for another practitioner or another facility to do your shadow.

www.thehospitalhandbook.com

Travelling for a Special Opportunity to Shadow

If you have traveled out of town for a special shadowing trip, you are likely doing an intense shadow already planned by you and the provider.  

For example, you traveled 100 miles to Seattle Big Hospital and Outpatient Clinic to shadow Provider Ann.  You will be in town for two days.  Ann would like you to shadow her at the outpatient clinic 0700-1100, an ECHO® call with your sack lunch, and then to inpatient rounds until 1500.  On day 2, Ann wants you to shadow her 0700-1500, a full out-patient clinic day.

For more about Shadowing, please Review these in this Series

• Benefits of shadowing health care practitioners
• What to Expect on Your Shadow Day
• As a New Employee, Shadow Your Clinical Team

Stay tuned for the next post, The Volunteering Adventure.

copyright Megan Kingsley Gale.  all rights reserved.

Do not reproduce without author's written permission

Review the other posts in this series

• Basic education and licensing requirements before applying for hospital-practice work
• Pack Your Trail Bag--tools you need for the journey and how to develop stepping stones
• Find Your Trail Guide--the importance of having hospital-based practice mentors and an introduction to the stepping stones of shadowing/clinical observation and hospital-based volunteer work

Want to pre-order a pdf of this entire blogpost series?  Order here.

Today's resource recommendations

• Review the previous posts in this series (see the list in above paragraphs)
• Project ECHO®, goes beyond the basic telehealth consult model and connects PCMHs and local rural champions to specialists at specialty hubs while providing CEUs and training for PCMs. Learn more in our blogpost about this resource. 

  

  https://echo.unm.edu/

• The ECHO® model breaks down barriers between primary care and specialty care.
• The specialty hubs are often interdisciplinary teams which include professionals from surgeons to dietitians, health psychologists, chiropractors, OTs, PTs, and L.Ac.s/EAMPs, and more.
• This model, from the University of  New Mexico, is catching on quickly in the U.S. To learn more, check out this short video.  
• Project ECHO® is a "force-multiplier" 
• If you are a program manager or a rural primary care provider, you can join one of the Project ECHO® programs.  Learn more about how to connect to the ECHO® programs here and find one near you here.
• Recommendations for learning more about integrative medicine/health in hospital practice, team work, and related topics on your lunch break.  
• Want to learn more about the movement of integrative medicine into mainstream medicine?
• Sign up for the Hospital-practice Handbook Project email newsletter

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