“Do not go where the path may lead. Go instead where there is no path and leave a trail.” – Ralph Waldo Emerson
The above quote was below my high school yearbook picture in my senior year. A quick Google search now tells me that there is no proof that Ralph Waldo Emerson ever said it and it wasn’t in any of his works. Google was in its infancy when I was in high school, so I’m not sure where I found it. Whomever said it, I like it. Without knowing it, I have followed this advice throughout my career and life.
When I was considering applying for the Primary Care Transformation Fellowship, it sounded like a wonderful opportunity, but no one had done it before. I distinctly remember my husband saying, “What do you have to lose?” I couldn’t think of any good reasons not to and it seemed like a wonderful opportunity, so off I went down this new path.
Not only were we the first cohort of fellows, but I was the only one from urgent care in our group. As we started into the coursework, I had a few moments of thinking the content did not apply to me. As we moved further into learning about population health and social determinants of health, it completely expanded my view and opened my eyes past my narrow urgent care lens. It was amazing to connect with providers outside of urgent care, those working in community health, and even providers outside of the Duke system. The passion that these providers have for what they do is amazing and I am continually inspired by the work they do.
As we start to move more toward a value-based care payment model, it will grow increasingly important to view health care as one connected and fluid entity, not siloed by specialists, hospitals, primary care, or urgent care. My fellowship project fits perfectly into this concept: adding walk-in primary care services embedded in an urgent care setting. Seems simple enough. But that was before COVID.
When COVID hit, I was well into the planning stages of my project, ready to implement it in June or July of 2020. My urgent care clinic was transformed into a COVID respiratory care center (RCC) which meant we could not bring healthy patients in. Seven months into our RCC status, I was incredibly fortunate to have the opportunity to help open and act as the medical director of a brand new clinic where I could implement my project. This alone gave me a whole new set of skills in operations and business management that I would not have otherwise been exposed to without the fellowship (and COVID). A year after our RCC opened, we were able to close down and revert back to our normal urgent care status, which also meant we were able to close down the new location and move my project back to its original location.
Looking back, there were plenty of roadblocks along the way, but I wouldn’t change it for anything. The skills I have gained through the fellowship and the trust and support I have gotten from fellowship staff, my mentor, our network, and my clinic leadership team have been invaluable. I have been able to develop a leadership presence that I am proud of and confident in. I will continue to use these skills to not go where the path leads, but leave my own trail.
Ashley Voss is a fellow with the Primary Care Transformation Fellowship Program. Email ashley.wickliffe@duke.edu with questions.
Editor’s note: Blogs represent the opinion of the author, not the Department of Family Medicine and Community Health, or Duke University.