Category: Clinician Corner

Iris clinicians are at the heart of what makes our organization such a special place to work. That’s why we’re turning the spotlight on the amazing work they’re doing every day. This month, we’re sitting down to talk with Dr. Mark Miceli.

Q: How did you find Iris and decide you wanted to be an Iris provider?

A: Before I joined Iris, I was working at an inpatient hospital in New Jersey as the medical director of my unit and the interim chairperson of the division of psychiatry. I was doing a lot, and it was really hectic. I wasn’t happy at the job.

I was working with another clinician who told me I should look into Iris, and I ended up applying. I went through the interview process, and it went from there.

Q: What does a typical day as an Iris Telehealth provider look like for you?

A: I work for a health system in Minnesota. I’m credentialed at 10 or 12 different hospitals and partial hospital units across that health system and I fill in when they need people. That includes when people are on maternity leave, when organizations are in-between hiring a new psychiatrist, or if someone is taking an extended leave.

Q: What do you love about being a telepsychiatry provider?

A: In my previous job, I was in a little office with no windows and a cold air vent blowing on me – it wasn’t comfortable by any stretch of the imagination. With Iris, I love that I’m in my own environment. I love that I can work with people in different geographical areas. My patients are all in Minnesota, so I get to know the culture that exists there. There’s also a separation where I’m not going to run into patients at the grocery store.

Another thing I love is the flexibility to work from different places. At the height of the COVID-19 pandemic, my family and I were able to rent a beach house in Cape Cod. The beach house had Wi-Fi so that I could work there and my son could enjoy the outdoors and fresh air.

With inpatient, we usually see people early in the day, and then we do documentation. Once I see my patients, I can move my computer anywhere where there’s Wi-Fi. I can take a break to get my son and eat good, hot food at home instead of spending money at a restaurant. I also love that I don’t have to commute 45-minutes or an hour every day. There are a million great things.

Q: How do you foster connection with patients virtually?

A: In my home office, I have things behind me like a guitar or a yoga mat – having these things related to my interests in the background gives my patients and I something to talk about. Another thing I always do is look into the camera, smile, and try to make eye contact. I try to send them really good, positive energy over the internet.

One helpful thing is having the on-site staff really trust and work with me. They’re a major factor for inpatient care, and their extra help makes a significant difference. They help reassure the patient and let them know what I’m doing and that I care about them. One of the most satisfying parts of the job is the people I work with. The teamwork is fantastic.

I work at four or five places steadily where I rotate through, and I look forward to seeing the people, and they look forward to seeing me. It’s a nice thing, and it doesn’t get old after six years of being in the same place. It stays refreshing and diminishes the grind. When you work in an inpatient unit, you’re going to the same place every day and seeing the same people. The specific job I have with Iris is amazing.

Q: As a healthcare professional, how do you manage work-life balance?

A: I don’t have a commute, so I can drop off my son in the morning, go for a walk in Central Park, do my yoga exercises, then work. I can take time to relax, have lunch, then go back to work. I can still get my son in the afternoon. I don’t know if there’s any secret to it. We can travel and have a life outside of being stuck in an apartment.

I have much more time in my life now that I’m a telepsychiatrist. It’s liberating. You’re not trapped in a certain place for that many hours.

Q: What are your biggest learnings from your time at Iris?

A: I learned a lot of new technology that I wasn’t really aware of – like Epic. Getting to know Epic was a great skill to learn, and I love that platform. It’s one thing that I didn’t use before. It’s amazing, and I’m so happy that all my jobs are using it now. It’s powerful, and you can easily learn about the patients.

Q: What is the most rewarding part of your job?

A: Working for Iris has been the most rewarding out of all the jobs I’ve worked since my residency. The people I work with are super positive. I always feel supported and proud to work for Iris.

I also love working in Minnesota. I love the culture and the people. I like making connections with the support staff and the patients there. It’s been gratifying. I live in New York City, and I work on the East Coast, so it’s just a different approach to life. I have more connection with my son, and I’m able to be a big part of his life even though I’m working full time. If I were commuting an hour back and forth every day, that would be two fewer hours to be a part of my son’s life.

Q: Why do you think telepsychiatry is important to the future of mental healthcare?

A: It brings psychiatry to places where it’s not easily accessible for people. Especially where I’m working in some of the smaller towns in Minnesota, it’s hard for people to get quality psychiatry. I know that primary care is doing a lot of medication management. However, that’s not their specialty, it’s one more thing to learn, and they may not be comfortable with it.

I think we can bring more quality, specialty care to people who don’t have access. Even though COVID-19 made it unsafe for people to go out, they can still get their medications refilled, have a connection, have someone check in on them, support them, and help treat their conditions.

Even in Minnesota, they were canceling outpatient programs in the bad snow and cold, but we could still see people in their homes. This type of access varies by state, and some states don’t allow the patient to be at their home. However, Minnesota is really progressive. In the partial hospitals where I’m working, people talk from their own homes instead of having to come into a clinic.

Q: What do you love about working with Iris?

A: Iris makes you feel like you’re part of the team, and they really validate you. I’ve worked so many places where you’re just there, and they expect you to be there and do your job, but you don’t get any appreciation.

After four years, Iris gave me a plaque, and I was employee of the month. Ted Bryant, the Senior Manager of Clinical Operations, is amazing. He’s always positive and is always saying, “You’re a great doctor!” It makes a difference to feel like you’re not just a cog in the machine, but you’re a person. I don’t know what it would be like to work for another telehealth company, but I can’t imagine anything better than working for Iris.

At Iris, we believe our providers should be respected, valued, and applauded for the work they do, and we couldn’t be more proud to say, “thank you” to our very own Dr. Mark Miceli. If you’d like to learn more about working for Iris Telehealth, contact us today.

Iris clinicians are at the heart of what makes our organization such a special place to work. That’s why we’re turning the spotlight on the amazing work they’re doing every day. This week we’re sitting down to talk with Dr. Isabel Norian.

Q: How did you find Iris and decide you wanted to be an Iris provider?

A: At the time, I was working in outpatient psychiatry at a community mental health center. It was a very fulfilling job, but I had a growing family with four kids, a husband, and pets. I was dissatisfied with the back and forth between the clinic and the really late nights. There were times I felt my work-life balance was out of kilter. That’s when I decided I wanted to look into telepsychiatry.

I started researching different telepsychiatry companies and was quickly impressed with Iris. I had other leads, but I found Iris to be the most responsive, welcoming, and clear in its mission. As soon as I had my first meet and greet, I felt like I belonged. I wouldn’t dream of working with any other company than Iris.

Q: What does a typical day as an Iris Telehealth provider look like for you?

A: I work at a community mental health center with patients affected by intellectual and developmental disabilities and patients on the autism spectrum. My typical day includes protected time for administrative work, seeing patients, and collaboration with the clinical staff. I often see them for consultations, and they call me if they have a question or a complex issue.

I’m also a big fan of our protected time for staff meetings. While the meetings don’t happen often, they’re a huge part of my job satisfaction. We talk about cases, bounce things off each other, and connect. It’s really therapeutic. Even though I’m not on-site, it gives me a real sense of community and that I’m a part of the clinical team. Our clinic works really well with Iris, so that’s a great feeling. I really lucked out in a lot of ways.

Q: What do you love about being a telepsychiatry provider?

A: Everything. I feel like I got my personal and family life back. My family and I love that I’m not commuting. Without all the transitions, I can end work one moment and be out the door to pick up my kids the next. Transitions can be quicker, and for a working mom, that’s priceless.

By working in my home, I can look at the screen and be present for the moments when my patients need me. I’m able to tune out the rest of the world, and that’s serene. It’s almost meditative at times, and it really helps me focus.

I also feel less tethered to a system I am frustrated with, which is my experience in previous jobs. Now, I’m partnered with a company that I chose and who chose me. I pursued them voluntarily and intentionally because they presented synchronous values.

Then, I was matched with a clinic that I feel very fulfilled by and that is very receptive to my needs and aspirations. It is a great balance. I feel more in control than I have in any other work situation. I think that’s empowering.

Q: How do you foster connection with patients virtually?

A: Creating connections has come naturally. I act as if I’m in the room with the patient, which informs how I ask questions, make eye contact, present myself physically, and relate to them through the screen. My job is to make patients feel comfortable and with a little bit of practice, you quickly forget the screen is there.

However, when my patients seem unsure, I try to provide education and reassurance. I also remind families that they have options. Where I work, we have one or two on-site providers at any given time. I let patients know that if telepsychiatry isn’t something they’re ready for or if it isn’t something that’s a good fit, there are other ways they can be seen.

I’ve found that if I’m providing education, reassurance, and reminding people of their options, it’s enough to dissolve the uncertainty. When people feel they have choices, they typically navigate towards something that works.

Sometimes I’ll check in at the end and ask, “How is this for you?” I’ll ask them, “What might I do differently?” “I welcome you to always tell me what I can do differently to help make this work better.”

Q: As a healthcare professional, how do you manage work-life balance?

A: Boundaries are important when you work from home. I’ve learned that I have to close the door, even when I’m home alone, to provide a sense that I’m at the office. When the workday is done, I close the door and say, “Now the office is closed.” I even have a little sign on my door that says, “out of office” and “in a meeting.”

It’s also important to take advantage of the flexibility that telehealth provides. I would recommend using that flexibility to build in movement breaks throughout the day and stretch. Along with this, I’d say do something different or something that you enjoy. For me, it’s dance. When I’m not dancing, I’m not taking care of myself.

I’ve also found it’s helpful to spend time with my family without devices. Since devices have become such a significant part of my work, I’ve found that it’s imperative not to be staring at a screen when I’m not working.

Q: What are your biggest learnings from your time at Iris?

A: I’ve learned that it’s not only okay but also good and healthy to delegate. There’s an impulse to fix things when working in broken systems, and I’m a fixer. When systems weren’t working, I tried to fix things independently. Whether it was the computer, EHR, staff support, or the lack of resources for people with mental illness — I would work harder, not smarter, to compensate for breaks in the system. That’s why I was relieved when I found Iris. Iris is so well-resourced and well-prepared to address all the hiccups and challenges that come with the daily work in mental health.

I have many experts to lean on, whether it’s IT, HR, or my clinic liaison. This support gives me the freedom to focus on patient care. I have the structure to succeed, and I’m learning to let experienced, talented, dedicated people help me be more effective.

Q: Why do you think telepsychiatry is important to the future of mental healthcare?

A: I think access to care is one of the biggest mental health crises that exists. It’s not that there aren’t talented providers or a lack of students ready to become psychiatrists — it’s that there’s a disconnect between resources and people who need those resources.

Telepsychiatry provides access to care that is unparalleled. As a telepsychiatrist, you get to see people from their home, group home, or foster care system. So for me, telepsychiatry is the connection, and it is the future of mental healthcare.

At Iris, our providers help create a better world through healthy minds. Thank you, Dr. Norian for helping us further our mission through your incredible work. If you’d like to learn more about working for Iris Telehealth, contact us today.

Iris clinicians are at the heart of what makes our organization such a special place to work. That’s why we’re turning the spotlight on the amazing work they’re doing every day — starting with our very own Dr. Marialba Romero Medina.

Q: How did you find Iris and decide you wanted to be an Iris provider?

A: I found Iris at a time in my life where I needed a change. I wanted to expand my horizons in terms of what I was doing and what I could do considering the circumstances. I’m Latina, and I’m based in Puerto Rico. As the world knows, we went through a natural disaster a couple of years ago, Hurricane Maria. After that time, a lot of services changed here, and a lot of things that doctors could or could not do sort of modified. To put it simply, there were a lot of clinic closures.

I had to adapt to the times. As clinics were closing, I started to consider what I could do to continue working and hopefully continue living close to my family. Telehealth was the option. I did an overall search of companies and found Iris. My friend had already interviewed with the company and was in the process of onboarding. So, I interviewed with Iris, and it seemed like a good opportunity. I took a leap of faith, and here I am three years later.

Q: What does a typical day as an Iris Telehealth provider look like for you?

A: I do outpatient child and adolescent psychiatry at a community mental health clinic in Monroe, Michigan, with a population very much far removed from my own experience in terms of Puerto Rico. Even though I trained in Philadelphia, it’s still a sort of cultural adjustment.

A typical day is fairly standard and generally includes following up on patients and doing initial patient appointments. In times of COVID-19 and other things specifically going on in Michigan, there are many difficult circumstances that people have been going through. These challenges can complicate their daily lives and affect their kids.

I provide people with whatever resources we have, but I don’t do it alone, and I’m happy to have a great team. It’s refreshing because we have nurses, which is not something that I used to have in outpatient treatment. And, we have therapists and case managers, so it’s a team effort. I’m one tiny piece in a gigantic clinic offering a bunch of services.

Q: What do you love about being a telepsychiatry provider?

A: On the professional side, I love the idea that we can reach more people. And, more recently, things are moving more towards collaborative care. There’s an opportunity for physicians to work together remotely, and telepsychiatry opens up the scope of what we can do with very limited hours.

Personally, it’s been nice. Despite the significant loss and pain brought on by the pandemic, it has allowed me to be home. It’s a change in pace and expectation. Instead of driving an hour and a half to work, I can get up early to exercise, play with my dog, or if it’s sunny, I can look at the sun and prepare myself for the day. Considering the nature of the job and the stories we hear every day, being able to take care of yourself is a plus. Telehealth has allowed me to take better care of myself.

Additionally, if I have a no-show, I can go outside and take a walk or throw a ball with my dog, or even do some laundry. All around, I think it’s an improvement in quality of life.

Q: How do you foster connection with patients virtually?

A: I keep my video background very interesting, and even though it’s a view into my private life (or my human cave) it shows a little bit of who I am. I think this comforts patients by giving them something to look at, and it shows them that their doctor is also a human being with interests, likes, and random Christmas lights in the background. This atmosphere helps kids engage, ask questions, and opens up the conversation. It helps them feel more at ease, versus my experience at previous clinics where it’s hard to provide a personal touch or give a glimpse of who you are as an individual.

I try to be as genuine as possible with the way I talk and dress — I’m very colorful, and I have found that this helps.

Q: As a healthcare professional, how do you manage work-life balance?

A: Working from home can be isolating, which many people have experienced in the last two years. For me, I’ve been fortunate that I’ve made connections with people I studied with in medical school. We communicate, almost obsessively, daily. Connection is a good thing that technology has provided. But, maintaining those connections takes work. You have to make an effort to connect with someone, send them a text, or give them a call.

I’ve also been very lucky that the chart system we use at work is very responsive, and everyone uses the same one. If there’s a question about a patient, we can all talk to each other. I adore my nurses. We understand one another and can acknowledge that some days are harder than others.

Q: What’s the most rewarding part of your job?

A: I always hope I won’t have a patient long-term and that they can be discharged and go on. Sadly, especially in community settings, things are a little more complicated. Individuals can stay in a community mental health center for many years, so it’s nice to see them grow. It’s nice to see the change in their faces and how they see and interpret things compared to when they were younger. And, hopefully, they change for the better. It’s nice to see them realize that you can overcome even when things seem insurmountable.

Q: What are your biggest learnings from your time at Iris?

A: I’ve learned that there are positive and nice working environments. It has been healing to be with a company that is so supportive and so kind. Because not every work environment is that way. I think that Dr. Shaheen managed to grow a company that values genuine kindness, connection, and being nice to each other — even when things are overwhelming. We’re all overwhelmed at times, but I’ve always been treated in the most kind and respectful way. Every time I reach out, somebody answers and is paying attention. They’re making sure we’re okay.

Q: Why do you think telepsychiatry is important to the future of mental healthcare?

A: I think as the world continues to accept the reality that we’re all connected in one way, shape, or form, they’ll realize that we can’t do this on our own. The importance of being able to see and talk to each other even when we’re not in the same space or in the same area is vital. Whether it’s psychiatry or another type of healthcare, the idea that we can see and talk to each other, regardless of where we are, will be important.

Additionally, when it comes to healthcare, there are only so many doctors, and having somebody who can provide services in different areas is going to be positive. When it comes to what we need as individuals, many people need to be close to their families or to an area where they feel comfortable and where they enjoy living. And, that’s not always where a patient is going to be. Having the ability to meet with a patient where they’re comfortable and where the provider is comfortable, too — is a plus. There’s also no commute, and if they have to commute, it’s to a clinic in their area. It’s a win-win. Read this post to learn more.

If you’d like to learn more about working for Iris Telehealth, contact us today.