marry_me_tina_b

Hey David, thank you for sharing your experience and for doing this AMA. I work in healthcare, specifically in the world of substance use. Obviously, the opioid crisis is a major focus of what I do. Do you have any tips so I can be a better advocate? We tend to view a lot of what we do through the lens of problematic substance use and substance use disorders which is one portion of the population and I think we can easily miss the forest for the trees sometimes. For instance - how many people wind up accessing the illicit drug supply because they are not treated properly for things like chronic pain conditions?

I mean, OP didn't list a single healthcare or medical organizations or service provider partner. They shared some places they donate and that's it. I would ask about how this service engages with a mom's existing providers and healthcare team when they are planning support as it looks like this service is completely separate. Continuity of care and a collaborative approach between the patient and all the team members involved in their care is really important for health outcomes and stability for the patient - where they don't have to manage all the communication from multiple service providers in the midst of receiving care and planning goals for themselves.

Thanks for the more direct response to my comment - I can appreciate that you're new and my be working on establishing those partnerships, that doesn't sound unusual at all. I read the original response and didn't see a direct answer but appreciate you clarifying here.

I really like the way you describe the community of support you are building - my wife is pregnant and we observe that currently with the pandemic it has been hard to find others to talk to as mommy groups and other support groups are not running. I work in healthcare in Canada and it sounds like you're in the USA so my direct experience with establishing partnerships might not be that meaningful as I am not familiar with the USA healthcare system in the same way I know and understand mine. I'd just highlight that building in continuity and communication with a person's existing healthcare providers and teams is vital. If your program is providing some healthcare services then I'd say it's really important that the broader team is informed and able to share information for the benefit of mom. Forgive my ignorance as well, as I do not know how doula's practice in the USA, but engaging with physicians and specialists can be a bit of an art form.I have consistently found you really do want that partnership with providers involved in the care instead of butting heads with a service they view as competing or dismissing their work (speaking from personal experience there)

Thanks for the response! Where I work, GPs are prescribing opioids but they do very much worry about auditing and, because of the previous opioid epidemic as well as the current one, are quite shy to use the medications in their toolkit that have the potential to be addictive.

What I struggle with is avoiding tokenism in terms of meaningful engagement with patients and people with lived experience. I find in many instances we share things with these stakeholders too late in the process - after decisions have been made about programs - and then ask for their feedback. Or, we have one person on a committee outnumbered by healthcare staff and it seems unfair to expect one person to speak for all people with lived and living experience. It’s incremental progress but I think we could do a lot better and that’s why I asked about being a better ally. I view things from a clinical and organizational lens because that’s my role and my training.