Through its outreach program, Brigham Health physicians are able to partner with clinical colleagues in the Indian Health Service (IHS) to improve the health status of American Indian/Alaskan Natives. Outreach opportunities include volunteering for on-site clinical care, on-site teaching or shadowing and remote clinical care or teaching. Recently, Brigham and Women’s Faulkner Hospital’s Chief of Psychiatry Dr. John Fromson volunteered his expertise through a remote Continuing Medical Education (CME) course.
Recognizing that the IHS has limited access to specialty services and a chronic understaffing of physicians, Brigham Health encourages its physicians to volunteer. For Dr. Fromson, volunteering to conduct a CME course is just one small way he can support his colleagues. He says, “I have such admiration and respect for the clinicians who work in that environment. They just don’t have the infrastructure and the peer support that we have here.”
Dr. Fromson was first exposed to the outreach program when he offered a talk on physician burnout. When he was asked to do another, he was happy to participate. The CME course, titled “Management of the Violent Patient,” addressed all too common struggles providers face within the IHS. “On the reservations, they are exposed to a lot of substance abuse, particularly binge drinking and the unstable behavior that can be associated with that, such as domestic violence, antisocial behavior and violence in general,” explains Dr. Fromson. “Our colleagues practicing there are really like first responders. Their patients come to their offices or ED intoxicated or psychotic and they really don’t have the structures and the resources that we do to deal with this patient population.”
In his talk, Dr. Fromson began by addressing patient and provider safety. “My presentation then looked at the historical psycho/social aspects that they should be on the lookout for,” he says. “Then we talked about management, from medication management to physical restraints and how to assess a patient to determine if they can be released from restraints.”
For Dr. Fromson, who delivered his talk remotely via video conferencing, it was thrilling to see how engaged his audience was. “A lot of the questions centered around psychopharmacological management. They wanted to know what drugs to use in different situations. There were also questions about dealing with family members and cultural sensitivity. They were very open and honest about the issues they come across,” he says.
Dr. Fromson encourages his colleagues to volunteer with the IHS outreach program. “It was a wonderful experience,” he says.
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