This is a reprint of a post originally published in May 2015. 

I have been asked by my esteemed colleagues at CFHA to submit a blog post explaining why I feel that being an extrovert is beneficial when working in integrated care. They have asked me to go first because they are still trying to convince my introverted counterpart to participate. I will do my best to represent my fellow extroverts, but if I get something wrong please let me know. I would love to talk about it! 

(Side Note: How do you know if you are an extrovert? You have to ration how many exclamation marks you use in written communication!!)

As a behavioral health consultant, I am well aware of the need to initiate interactions in order to work as a team in primary care. It’s not that primary care providers don’t want to work together; they just don’t always have time to stop long enough to bring me in. Occasionally they forget I’m available unless I remind them. These dynamics of primary care have helped me to develop some of my potentially dysfunctional character traits in order to further the cause of integrated care.

In my opinion, the best personality type for integrated care is an extrovert who is mildly hypomanic, somewhat inattentive, and has a touch of OCD. My hope is to convince you to develop some of these traits in yourself in order to better work together as a team. In preparation for this blog entry I talked to everyone I know… not about what to write, but because I’m an extrovert and like to talk to people. Now it is getting late so I should probably start writing something.

Anyway, back to my formula. In order to establish a new integrated care function you have to be willing and able to talk to anyone and by that I mean, anyone! No shrinking violet when it comes to talking to the grumpy provider, the resistant patient, or the reluctant administrator. Sometimes you have to just keep talking to them until they agree with you, right? It also helps if you do not mind looking ridiculous from time to time. Communication can get a bit muddled sometimes and you may end up going into the wrong exam room – turn that into an introduction to the service and move on!

Because of the pace at which we work it’s helpful to keep your energy up. You can do that by developing a nasty caffeine habit or regularly raiding the candy drawer (admit it; we all have one – or 5 – somewhere in the clinic). I have found it is easier to just nurture my hypomanic tendencies. It keeps things light and really helps to burn off the extra calories from the coffee and candy. Just make sure you are not experiencing distress or impairment and you are free and clear. It’s not just the artists that can benefit from hypomania anymore!

The next component, inattentiveness, is a bit blurry in that it is a fine line between hypomania and hyperactivity but just humor me on this; a formula with only two components is not as interesting. Integrated care, especially in the early days of forming a new service requires a person to wear many hats. Because of this, you have to be able to switch sets at the drop of a hat. You think you are going to lunch but then you are doing a crisis intervention because a patient might be suicidal. Of course, the down side is that you can sometimes find yourself getting ready to go to lunch and trying to remember what you were going to do a couple hours ago…then you remember that you were headed to the bathroom.

 

I have found it is easier to just nurture my hypomanic tendencies

Lastly, it helps to have a little OCD. When you are going from patient to patient you need to be able to keep track of all those little details like what you saw them for the last time and what interventions you have already tried. Being able to find handouts on the fly is important (you need to move on to talk to more people!) so a good filing system comes in handy. Of course, at the end of the day when you are trying to remember what happened after you set your coffee down that morning, being a bit anal retentive about paperwork is really helpful. For those who need some help developing these tendencies I recommend putting tape outlines for everything on your desk…then just for fun put the objects outside of the lines and see who squirms! Another fun strategy is to start making super complex spreadsheets for everything. Once you have created a spreadsheet to manage your spreadsheets, you have made it!

Now I think it is time to stop as I may be drifting into more introverted pastimes. I certainly do not want my readers of the introverted variety to be uncomfortable…though I suppose it is too late for that at this point. You know the saying: “We’re here, we’re uncomfortable, we want to go home” but alas one of you must speak out. Do not panic! We are here to support you and if you will only speak up to the rest of the group…wait, that can’t be right. For all of my teasing, I will concede that an introvert can function in integrated care but I suspect it would require a lot of naps. We will all have to tune in to hear what the next post will be about…

 

Juliette Cutts is a licensed clinical psychologist and Behavioral Health Consultant at Salud Medical Center in Woodburn, Oregon.  She is a native Californian and got her PsyD from John F. Kennedy University in Pleasant Hill, California in 2010.  After graduation she completed a post-doctoral fellowship in Health Psychology at the University of Wisconsin in Madison.  After post-doc, she stayed on at Access Community Health Centers as a Behavioral Health Consultant to provide services to underserved patients in the Madison area.  In 2012 she moved back to the West Coast to join Yakima Valley Farm Workers Clinic as the Behavioral Health Consultant at Salud Medical Center.  At Salud she works with predominantly migrant workers who are not well served by traditional mental health.