Transcript
Speaker: Hello and welcome to Optum's Off the Chart podcast, where we introduce you to Optum's nationwide family of dedicated clinicians by highlighting their human side.
Speaker: I'm your host, Dr. Kenny Poole.
Speaker: I'm a healthcare experience champion, and I'm also a general internal medicine physician.
Speaker: Today's guest is Morgan Brescia, a nurse practitioner from Reliant Medical Group in Massachusetts.
Speaker: Morgan Brescia went to college at Smith College and subsequently worked in Alzheimer's research and as a registered nurse.
Speaker: She did her graduate work at the UMass Worcester Graduate School of Nursing.
Speaker: She currently practices family medicine as part of the Optum family at Reliant.
Speaker: Morgan, it's a pleasure to meet you and thank you for joining.
Speaker: Yeah, thanks for having me.
Speaker: Great, great.
Speaker: I want to jump right in to your upbringing.
Speaker: Tell me about how you grew up and where you grew up and what led you to Smith.
Speaker: Sure.
Speaker: Yeah, no, of course.
Speaker: So I grew up in a small town right outside of Providence, Rhode Island, a town called Seacock, Massachusetts.
Speaker: I grew up in the same house that my grandfather was born in, actually.
Speaker: Oh, wow.
Speaker: So, yeah.
Speaker: Yeah.
Speaker: Grew up on an old farm, no longer a working farm, but my mom remembered growing up there and picking asparagus and working with livestock.
Speaker: So I grew up with two parents, my mom and my dad, and a younger sister who was actually adopted from China.
Speaker: So h ad a great upbringing, really enjoyed spending time outdoors and exploring New England with my family.
Speaker: I went to high school in Providence, Rhode Island, and went to Smith College in Northampton, Massachusetts.
Speaker: After that, I wasn't exactly sure what I wanted to study, so I knew I wanted to go to a liberal arts college, and Smith gave me the opportunity to do that.
Speaker: Interestingly, Smith doesn't have any core requirements that a lot of colleges do have, and so that was one of the things that really appealed to me.
Speaker: going to Smith and ultimately studied sociology, but always kind of had the idea of doing something with medicine in the back of my mind.
Speaker: So where did that piece come from then?
Speaker: Like where did that appetite for medicine and health care come?
Speaker: And when did it come?
Speaker: Yeah, no, great question.
Speaker: Probably came as soon as I could remember.
Speaker: My mom is a internist.
Speaker: And so as a result, family dinners with friends and other family members were usually focused on medical stuff.
Speaker: Got two uncles who are physicians as well.
Speaker: and a lot of my mom's friends, physicians, family practitioners, internists, but also nurse practitioners and physician assistants.
Speaker: So I definitely think that pushed me in the direction into medicine.
Speaker: I saw what they did.
Speaker: and really enjoyed hearing their stories of caring for patients, but wasn't really sure I wanted to take the leap into medical school.
Speaker: So I went a bit of a different route.
Speaker: At Smith, I studied sociology.
Speaker: I liked my science classes, but I love sociology because you get to learn so much about human behavior and the dynamics people have with one another, regardless of where they are in life.
Speaker: Once I graduated, I really wasn't sure what I wanted to do.
Speaker: And doing some Alzheimer's research at a psychiatric hospital led me into determining I really wanted to stick to medicine.
Speaker: So tell me about the decision that went into moving from an RN to a nurse practitioner.
Speaker: And then the second part, so this is a two part.
Speaker: So RN to nurse practitioner.
Speaker: The second piece is why family medicine as a specialty as opposed to some other field.
Speaker: Sure.
Speaker: So I'm a little bit unique as a nurse practitioner.
Speaker: The program that I did through UMass is actually a graduate entry pathway program.
Speaker: So what that means is the students who start there already have a bachelor's degree in something other than nursing.
Speaker: So a bit of a different path.
Speaker: So for an intensive 12 months, I became an RN.
Speaker: Subsequently, I worked as a registered nurse for three years and continued to go to school and get my master's.
Speaker: So I wasn't exactly sure if I wanted to continue with the master's because I really liked being a bedside nurse.
Speaker: I worked on a medical surgical floor, learned so much, but I knew that ultimately I wanted to be part of these patients' lives outside of the hospital.
Speaker: wanted to be somebody that they could look to to make decisions throughout their entire life.
Speaker: So that continuity of care and treating that whole patient in an outpatient setting really is what drove me to family medicine and just the scope of practice, being able to see infants, newborns, all the way up to 100 plus years old.
Speaker: It's great being able to take care of five generations of patients, which is really unique to family practice.
Speaker: That's interesting.
Speaker: That's an interesting model.
Speaker: Is that a popular model for nurse practitioner programs or are most nurse practitioners RNs that then go back later on and do their graduate work?
Speaker: It's really mixed based on my experience.
Speaker: In my practice, we have five practitioners.
Speaker: advanced practitioners.
Speaker: And one, actually two of us did the program that I did.
Speaker: And the two others, they were nurses before.
Speaker: So I'd say it's 50-50.
Speaker: My guess is it's probably geographic, you know, depending on where those programs are offered.
Speaker: But in my experience, I've seen both.
Speaker: Got it.
Speaker: So talk to me a little bit outside of work.
Speaker: What does your family or source of support look like outside of work?
Speaker: Sure, so I'm recently married.
Speaker: I got married in September.
Speaker: Oh, well, congrats.
Speaker: Thank you, thank you.
Speaker: Planning a wedding in a global pandemic was lots of fun, but a good distraction.
Speaker: So I live about 30 minutes from where I work with my husband, Brad.
Speaker: He is a mechanical engineer.
Speaker: He is not medical, but always has lots of medical questions, which I'm happy to answer.
Speaker: Both of us are really close with our families.
Speaker: We live about an hour away from our parents and we've got siblings that live close by, nieces who we love spending time with.
Speaker: So that's a little bit about home life.
Speaker: The pandemic has made me...
Speaker: kind of rethink what I really love to do in my free time, which is riding horses.
Speaker: So growing up, I had horses, I enjoyed riding horses and with school and life, everything got busy.
Speaker: So took a break for the past eight years and recently I've started riding again.
Speaker: And it's a, it's a wonderful, wonderful break from the, the daily craziness of life.
Speaker: Sure.
Speaker: So what, what, what other, um,
Speaker: you know, special interests or hobbies do you have outside of work besides horse riding?
Speaker: Sure.
Speaker: I love to travel.
Speaker: I haven't been doing too much of that lately, but going back to just the change in the world as a result of the pandemic, it's kind of allowed me to explore local stuff.
Speaker: So we're trying new restaurants, we're exploring New England.
Speaker: Also love to ski in the wintertime and New England is a perfect place to do that.
Speaker: We were in Vermont last weekend,
Speaker: So spending time outdoors.
Speaker: And then in the summertime, I can't get enough of the beach.
Speaker: I love spending time down with friends in Rhode Island at the beach.
Speaker: So, you know, we're now going back to to work a little bit as we close things out.
Speaker: Tell me the best part of of your work.
Speaker: What's the best part of what you do?
Speaker: The patients.
Speaker: I absolutely adore the patients that I take care of.
Speaker: I work really hard to make sure that we are carefully making sure that they are living the healthiest, happiest lives that they can be, and if they're not,
Speaker: I'm there as a support system.
Speaker: So they're the reason I enjoy work so much.
Speaker: Another aspect is I'm partnered with a very experienced and extremely knowledgeable physician who has really helped me along in my career.
Speaker: And it's the patients and him that keep me going.
Speaker: Do you guys use that team model across all of your programs?
Speaker: primary care within your group there at Reliant?
Speaker: Sure.
Speaker: So, so there's actually a few different models.
Speaker: So if, if an advanced practitioner has more than five years, and if they choose to, they can actually be a paneled AP, so they can have their own panel.
Speaker: But the more popular model is to have a physician partnered with an advanced practitioner.
Speaker: For me, six years ago, when I was a new grad, it was great, because it was essentially, you know, a mini residency,
Speaker: with this physician who I'm now partnered with, which is great.
Speaker: So we share a panel.
Speaker: Got it.
Speaker: Can you, and just keeping with that, because I think it's a really interesting model.
Speaker: Can you speak to the reception of the patients to that, you know, to like you and your partner, if you will?
Speaker: Yeah.
Speaker: So initially it was, it was a little bit difficult for me.
Speaker: My, my physician colleague, Dr. Smith has had, you know, 25 years of experience.
Speaker: He's been with Reliant that entire time.
Speaker: So it was a change for the patients to say, well, wait a second.
Speaker: I can't see Dr. Smith every time I've got to see this new person.
Speaker: Her name's Morgan.
Speaker: She's a nurse practitioner.
Speaker: So it took about a few years to work all of that out and to get patients comfortable with seeing me.
Speaker: But there's actually a good amount of patients now who would prefer to see me, which is fine.
Speaker: A lot of the young females prefer to see me.
Speaker: Some of the older women prefer to see me, which I totally understand and respect that.
Speaker: And then there are patients who prefer to see him.
Speaker: But really, the model is every other visit, which is what we aim to do.
Speaker: So that way they get to know both of us.
Speaker: So if I'm out, yeah, go ahead.
Speaker: I was going to say, and you guys are probably viewed as an extension of one another, correct?
Speaker: Yeah.
Speaker: So, so we try to avoid using the language of, you know, my, my advanced practitioner, right?
Speaker: Morgan, it's more of my teammate, Morgan, my, my teammate, Dr. Smith.
Speaker: And together we work as a team.
Speaker: So the patients realize that there's a whole team that takes care of us.
Speaker: We have two nurses on our team who are the ones who are getting the live calls.
Speaker: We have a receptionist.
Speaker: and two medical assistants.
Speaker: So it's really essentially a mini office within a bigger office in a large organization.
Speaker: Got it.
Speaker: Love it.
Speaker: So, you know, as we close it out, I'd love for you to tell me what you would change about healthcare and the practice of medicine overall to make it work better if you were to have a magic wand.
Speaker: If I had a magic wand, I would want to change a lot of things.
Speaker: But I think that the biggest thing right now is allowing new physicians the opportunity to go into primary care because primary care is the core of medicine.
Speaker: Patients who have problems, their immediate...
Speaker: responses, let me go to my primary care provider and talk it out.
Speaker: And there's simply just not enough primary care providers in the United States.
Speaker: So by using a model similar to what we use at Reliant elsewhere, I would hope that we'd be able to care for more and more patients.
Speaker: But at the same time, the nation needs to accept nurse practitioners, physician assistants as being somebody who can be a primary care provider or be a teammate and
Speaker: that would be my biggest ask.
Speaker: More primary care providers.
Speaker: Got it.
Speaker: Got it.
Speaker: Well, you know, I think that's a perfect way to end our discussion, particularly as a former primary care provider.
Speaker: So I hear you with that.
Speaker: Morgan, thank you so much for being a part of the podcast.
Speaker: I really enjoyed talking to you.
Speaker: You're most welcome.
Speaker: Thank you so much for having me.
Speaker: Great.
Speaker: So that's it for this episode of Optum's Off the Chart.
Speaker: I want to thank everybody for listening.
