Fostering children reminds us of the foundational impact of genuine empathy and compassion on the well-being of those we care for.
We’re both physicians and foster parents and have found that this experience has improved our clinical skills in many ways. I (Patrick) am a general internist. I have three biological children and currently foster a five-year-old. I (Lindsay) am a child abuse pediatrician and clinical director of a foster care clinic. I have two biological children and foster two children, ages four months and two years. Here’s what we’ve found:
Interactions with foster families allow us to show a high level of empathy for our patients and their families.
I (Patrick) have become more aware of how challenging it must be for patients and families to access the right care, particularly for behavioral health. We’ve struggled during the pandemic to find proper trauma-informed therapy for our foster children.
I (Lindsay) I have marveled at the challenge of accessing necessary benefits for my medically complex foster (now-adopted) child. Keeping up with medical appointments, prescription refills, and medical supplies, while also trying to be a good mother and pediatrician has been stressful. We’ve struggled to understand food vouchers and what other Medicaid services he’s eligible for. Even when we did find services that he was eligible for, it was often weeks to months before we could get those services in place. I now see the incredible need to lift this weight off of families. We must find ways to proactively step in and help patients and families who have complex needs.
Caring for foster children requires teamwork, just like in healthcare.
Each foster child has a team to help ensure their safety and well-being while they’re in care outside of their biological home. This includes foster parents, social workers, a guardian ad litem charged with helping to advocate for the children’s interest, and routine support from teachers, therapists, mental health providers, medical and dental professionals, lawyers, and judges.
Each team member must communicate and collaborate, as none of us knows the whole story of the child. We have to meet regularly, share notes, solve problems, and apply the expertise that comes from our role. When things don’t go well, negative interactions from one member of the team can seriously complicate others’ interactions and hurt trust. Conversely, when a child is struggling with a challenging behavior, such as regression in toileting or self-care, foster parents have a team they can call on for help. The same applies in healthcare. Success requires appreciation, respect, and inclusion across the team. We need a team to give excellent care to our patients.
Foster parenting helps us practice humility and setting boundaries, which we need to keep giving excellent care.
We reach limits in our role as caregivers. I (Patrick) learned this when a foster child left for a new placement. This child’s needs—after six months together—exceeded the capabilities of my family. Fortunately, we’ve kept a strong connection with the new foster parent. In seeing this child move on, I learned that sometimes children have different needs than what I can give, and that’s not a failure. In medicine, we’re often in an analogous situation, as our patients’ situations and needs change, and we need to be accepting of our limitations and appreciative of what we were able to do along the way.
Taking part in the foster care system gives us a trauma-informed and community-oriented perspective as we seek to give better healthcare for all.
Each child that comes into care–from the infants to teenagers–has experienced trauma. Responding to the needs of our foster children translates into greater sensitivity to the baggage that our patients often silently bring with them to clinic. Adverse events as children are common and can cause poor health outcomes as an adult. To respond, we must hone our skills of listening and observation and become aware and sensitive to needs that aren’t immediately apparent. We gradually find the skills and language to help children name and articulate their needs and begin to own the narrative of their stories.
Foster parents must complete training and licensure, a process which takes several months, and includes between 30 and 40 hours of intensive learning. Stipends paid to foster families generally only cover part of the cost of additional family members, so foster parents are supplying a valuable community service. Many healthcare professionals seek to give back to their communities in similar ways, given the benefits and status of being in the medical profession. The foster system supplies a unique venue for supporting the most vulnerable members of one’s community.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.