It’s true. What you give to the world, the world gives back to you. It’s a lesson that has practical application in areas of life that go way beyond attracting the “right” friends and acquaintances. It’s also a lesson that has rescued me time and time again, and it’s one that is rooted in authenticity, transparency, and a willingness to put yourself “out there.” What’s funny is that in my case, I kind of went about it completely backwards. A few years into my endeavor with Pediatric Housecalls, I found myself surrounded by a tribe of vibrant, loyal, hard-working, brilliant, and caring providers and families, and only after much introspection and careful analysis (INTJ anyone?), have I realized that it hasn’t been by accident. That whether we realize it or not, the little every-day choices we make, the “vibes” we give off even in the simplest of interactions, add up to what our life’s journey ultimately becomes.
What’s that other saying? You gotta to know what you don’t know? For me, there was a heck of a lot I didn’t know about running a business, when I first opened Pediatric Housecalls. When it became clear to me that owning and operating a medical practice required far more than just clinical knowledge, experience, compassion, and a desire to help, I’ll admit that I felt the wind let out of my idealist sails a little bit. Naive or not, the idea that I had to consider the economics of the patient-doctor relationship left me feeling sad, confused, and overwhelmed. Let’s be real. I am so uncomfortable talking about the exchange of money when it comes to running a medical practice, that I don’t even like to use the word money. I just used the word economics instead. (Exact quote 4 lines above: “the economics of the patient-doctor relationship.”) Bless. The obvious point that I discovered pretty quickly into my journey with Pediatric Housecalls (that I had zero training in medical school about how to run a business) precluded the second point (that I had zero desire to deal with that part of it.) So much so, that after returning from a medical mission trip to Guatemala, I secretly wondered if mission work was the direction that I was supposed to go in, instead. The simplicity of serving, without insurance red tape or exchange of money, and the dire needs met with the simplest expressions of care, certainly fills a certain selfish need to feel like a helper, with no strings attached. But as the weeks, months, and years progressed, and Pediatric Housecalls continued to grow and thrive, another new question seemed to repeatedly work its way into my mind, almost like a toddler on a mission to get your attention in the checkout line of the grocery store. And that question was: “Why?” To be sure, this was not a “Why am I called to do this?” question. It was not, “Why do I want to take this on?” Or even “Why does it have to be so complicated?” But it was rather, “Why is Pediatric Housecalls…actually…working?” (Pillar of confidence, huh?!) As Pediatric Housecalls continued to gain traction and serve more and more families, I honestly found myself asking, almost incredulously, “Why is this thing actually working?!” Part of that comes from a place of self-doubt, and let me tell you, nothing on earth prepares you for the kind of self-doubt you face when deciding to challenge the status quo, especially the kind of status quo that can creep into the medical establishment. Part of the “Why is it working?” question, though, also stemmed from the fact that despite all conventional business wisdom, we were succeeding. Surely we weren’t the most skilled in insurance contract negotiations, the most experienced in hiring and managing people, and we certainly didn’t have the backing of either of the two major healthcare systems in our area. We had no advertised hours, I let every team member decide for themselves on a daily basis, if they wanted to work, when they wanted to work, and how often they wanted to work. I rationalized that if I was craving freedom and flexibility as a working doctor-mom, then I was bound and determined to offer that same freedom and flexibility to anyone who was interested in jumping on board with me. Sounds like a stellar business plan, no? Pediatric Housecalls, as it began to grow, was in essence, a practice made up entirely of part-time working mothers, with no set hours, no brick-and-mortar presence, and absolutely zero precedent to pave the way for what we were doing. And yet…It was working. Parents continued to seek us out, and we continued to grow. So, as the weeks turned into years, that little bit of self-doubt continued to constantly chirp in my ear, “Seriously. Why is this working? It’s got to be a fluke. I’m not a business person. How can I possibly grow this practice and make it survive?” If you haven’t read much about the idea of “imposter syndrome”, I encourage you to do so. It’s a fascinating concept, and one that I could certainly be a poster child for. Which, after reading much about it, I wear that badge proudly, as many of the world’s most accomplished persons (statistically, more often women than men), have suffered from this syndrome at some point in their careers. The bigger issue at hand, though, I felt, was not figuring out why that nagging question kept creeping back into my mind. The bigger issue, for me, was figuring out what the heck the answer to that question actually was. Seriously, guys. I needed to understand why Pediatric Housecalls was succeeding as well as it was, despite our unconventional approach to just about every aspect of the business side of running the practice. After thousands of interactions in the homes of thousands of families, I’ve come to believe our success boils down to two very simple things. Neither of which are business concepts. And that delights me. Because simplicity is one of my love languages. And business is not.
The first concept: Accessibility. I don’t mean accessibility in a starch, sterile sense. Any business can be accessible. Any practice can add hours, or weekends, or providers to increase their accessibility. And actually, if we had a drawback as a practice, is was our lack of availability from time to time in the traditional sense, given that we had built a team of all part-time working moms. What I mean, is garden-variety human accessibility: Being accessible during patient visits to listen as long as necessary, to dissect and review every one of the parent’s concerns, being emotionally accessible to see what is driving that parent’s fears, and therefore, their behavior. Of course, removing the barrier of parents having to drive to an office, sit in a waiting room, and figure out what to do with healthy siblings, certainly makes us more accessible to parents than the typical healthcare encounter, so that’s part of it. But it’s not the whole story. What’s more, is that so much of pediatrics is the diagnosis and caring for illnesses that are viral…things that we can’t prescribe medicines for. I agonized over this a bit, when I first started, worrying that parents might perceive my house call as “useless” or a “waste” if I didn’t prescribe anything. What I quickly realized, is that more than anything, parents want to know what to expect. I never used to spend more than a sentence or two on this. I now spend the better portion of most visits talking about this. Taking care of a sick child is scary for a lot of parents. But what is even scarier for them, is taking care of a sick child and having no idea when they are sick enough to have them seen again, or when it has gone on long enough that it might mean something else is wrong, or how long they might have a fever, or what to do if they see x, y, or z. Knowledge is power. And most parents can handle a fever of 104 in their child, even if it is due to a virus, and you’ve just told them it’s going to have to “run its course”, as long as you give them a life-line. That life-line sounds like this: I know this is stressful. I know you hate to see your child so miserable. I am going to give you a clear list of things you can do, in the short-term, to make them a little more comfortable. I’m going to make sure you know what to watch for, that would signal it’s time to have them seen again. I’m also going to make sure that you don’t have any lingering worries in your head about your child’s illness that I haven’t thought to go over yet. Even if they seem outlandish, I want to hear the things that you are worried about. I’m not finished with the visit, until all of these things are done. That is true accessibility.
The second concept: Kindness. This is inextricably tied to the first, because no one…no one…can possibly be emotionally accessible to another human being, without being kind. This means a lot of things. It means listening without judgement. It means being patient. (Lest I remind you that fear and worry – two of the most common emotions that parents experience when their child is sick – do not speak the language of efficiency or logic.) It means empathizing. It means naming their concerns out loud. It means reassuring them out loud. It means reassuring them that they are capable, and doing a great job, and going to get through this. It means having a sense of humor. It means not taking their words or actions personally. It means maintaining a sense of gratitude for even being allowed into the sacred space of caring for another human being. It means showing love. What is another way of looking at this? Our values. Our style. Our priorities. Our mission. These were all of the little small choices we were making, day after day, month after month, year after year, without really even being aware of it, that have ultimately all added up to our “vibe.” And it continues to surprise me and bring me joy, in the roads that it leads us down. So, what does this mean for everyone else out there who is pursuing a goal, or starting a small business, or raising a family, or doing anything, quite frankly, that makes them occasionally wonder why it is all actually…working? It means that you shouldn’t discount those intangible things you bring to the table. The parts of you that someone else might say are a liability may turn out to be your greatest strengths. Remember the misfit gang of part-time working moms who decided to band together to slay the world of pediatric sickness one house at a time. Success is often illogical. Stay true to who you are, be yourself in every single interaction, big or small, and you might just find that you attract those things right back. Sometimes it might even surprise you, how well it all works out…