The Mini-Internship Program

The mini-internship program provides an excellent way to introduce legislators to the practice of orthopaedic medicine. The program encourages elected officials to spend clinical time with an orthopaedic surgeon. As with traditional medical training, the "intern" is allowed to directly observe and learn first hand from the interaction among physicians, patients, family members, and other medical personnel. The goal is to create a better understanding of the realities and challenges of the practice of orthopaedics, while building strong, working relationships with elected officials.

It also provides elected officials with first hand exposure to the impact of the laws they write on patients and the medical community. Legislators leave the program with contacts and resources within the medical profession which they can call upon for advice when making critical legislative decisions involving health care.

Who will participate

Orthopaedic surgeons who participate in the mini-internship program should be knowledgeable and conversant with legislative and regulatory issues of importance to the orthopaedic community. They should be able to discuss issues in a thoughtful, non-confrontational manner. They should be able and willing to use patient interactions to demonstrate important points to the intern. If hospital visits are involved, permission should first be obtained from the hospital administrator.

Who to invite

Careful thought should be given to which elected officials you want to invite. Those who should be considered for an invitation include state and federal representatives, in particular, legislators who hold leadership positions or key committee assignments. It is usually best to have one intern per orthopaedic surgeon.

Know what "segments" you want to include in the mini-internship, - office visits, hospital visits, surgery, etc.

Letter of invitation

Letters of invitation should be sent from a leader in the local orthopaedic community, the legislator's constituent, or an orthopaedic surgeon who has an established relationship with the elected official. Keep the letter to the point, and if possible, on one page. Try to offer at least three dates for the program. If possible, offer dates during a time when the legislature is in recess.

Find out from the legislator at this time if they are comfortable with the internship segments you are offering.

Include a response form, and a confidentiality agreement with each letter.

Briefing (optional)

It may be helpful to hold a briefing for all participants prior to the internship. This can be done the morning of the event, or at a dinner the evening before. A dinner the night before allows for greater socializing and relationship building.

During the briefing, be sure to provide participants with detailed information about what will happen during the program, and let them know a bit about the types of situations they may encounter.

The internship

Provide the intern and the orthopaedic surgeon with detailed instructions of when and where to meet. Phone numbers should also be provided should there be an emergency which causes a cancellation or delay. Provide the intern with a white lab coat and a name badge. If it is appropriate, you may also want to have a photographer present to record the event.

The physician should introduce the intern to each patient, and ask the patient's permission for the intern to observe. As always, the patient's care and comfort are of primary consideration. The intern should be prepared to leave the room if :

  • The patient objects to their presence.
  • If the examination may be embarrassing to the patient.
  • If the intern is acquainted with the patient.
  • If the intern is uncomfortable with the situation.
Explain as much as possible to the intern before and after each patient session.

Interns should not be allowed to inspect patient records, but may be shown forms, etc. which need to be completed. Allow interns to listen to conversations with patients, medical staff, other physicians, and family members. Explain the significance of these conversations.

You might want to have the intern make a call to the patient's experience could provide valuable insight on the difficulties and delay in receiving authorization.

After the visit

Consider scheduling a de-briefing session. This will give participants an opportunity to discuss the issues and encourage questions form them as well.

Thank you notes should be sent to participants, along with an evaluation form asking for their impressions of the program.

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