words by Maryann Brinley / photograph by Pete Byron
his is the perfect job for someone like me who is looking to slow down,” insists Eileen M. Clifford, MD, NJMS ’77. Last year, she became the medical director of care management at St. Joseph’s Health Care System in Paterson, NJ, after 25 years in private practice. “I’m 67 and I feel as if I’ve retired,” she says laughing.
A Catholic Sister of Charity, Clifford laughs because she’s as busy as ever. “I still go to my old office one day a week. I am on call every fifth weekend and two nights a week.” To maintain a clinical edge because it helps with her credibility at the hospital, she also kept all the patients from her old practice who were over age 80, all the nuns and priests, anyone with a cancer diagnosis, several homebound individuals, and a small group in nursing homes. “I have just a few priests and a lot of sisters but,” she adds, as a way of trying to play down her considerable patient load, “I’m not taking any new patients.”
So now she is working two jobs! Yet, “I feel as if a tremendous pressure has been lifted,” she says. In private practice, she used to get up early, go to the hospital, make rounds, drive to the office, see patients all day, and then head back to the hospital if she had admissions. “I also did nights and weekends as a general internist but I loved it. General internists,” she explains, “coordinate the care of patients. You need a lot of help from consultants but you are the primary person coordinating the care of the patient and communicating with the family.”
Her religious affiliation has never been an issue, she reports. “Most people know that I’m a sister and they respond positively to it.” Clifford stopped wearing her nun’s habit years ago. “I don’t try to hide the fact that I’m a sister but it’s never been my entrée,” she explains. Her order, the Sisters of Charity of Saint Elizabeth, based in Convent Station, NJ, actually founded St. Joseph’s in 1867, which opened with 12 beds as part of a mission to service the sick and poor. For 140 years, they have never wavered from this mission. St. Joseph’s is the third largest provider of charity care for the state.
In Clifford’s new position, she reports to the hospital’s vice-president of medical affairs and handles the Medicare, Medicaid and insurance issues. She also does a lot of walking in the hospital hallways. In fact, someone recently joked that it looked as if all she did was walk around all day, waving at people, saying, “Hi there. How are you?”
In truth, “I actually do a little bit more than that,” she says. Her job is to work with the nurse care managers and social workers, reviewing charts to make sure patients are at the appropriate level of care. “Should they be in an acute care setting? in sub-acute? in rehab? or at home? When my colleagues think their patients should stay in the hospital, and in reality they are at a different level of required care, I’m the one they bump up against. We like to call it a recovery plan,” she explains. So what about this reputation for being a presence in hospital hallways? Let’s call her habit of being out and about a communication tool, in fact. “Sitting in a small office handling paperwork for too long would drive me crazy. I’ve been here since 1961. I’m fortunate because almost my entire professional life has been spent here at St. Joseph’s. My colleagues know me. Some knew me when I was a nurse. So they come to me, tell me their concerns and I try to double back and explain why things have to be done a certain way.” What has become clearer to her in this past year are all the rules and regulations hospitals must adhere to in patient care. Most attending physicians are unaware of all the rigmarole.
What she sees in medicine is a breakdown in communication, in spite of cell phones, email, beepers, and faxes. “We used to communicate better,” she says, so she considers one of her tasks as medical director to get doctors talking to one another. Citing the example of a patient she met earlier that day in the hallway — a gentleman who had been operated on for a sub-arachnoid hemorrhage — Clifford explains that he was strolling along while listening to his CD player when she spotted him. After asking his name, she realized he was a patient on her to-be-discharged radar screen. Because of miscommunication, there he was, still walking the halls. “There were so many doctors taking care of him. But right on his chart, you could see that the neurosurgeon had written that he was ready to go.”
Practicing medicine comes so naturally for Clifford that an observer might never know that becoming a doctor wasn’t in her dreams when she first started working in healthcare. For a year after high school, before entering the convent, she was employed in central supply at Holy Name Hospital where a wonderful nurse taught her all the names and uses of the instruments. In the convent, she completed preliminary college studies and was given permission to go into nursing in St. Joe’s diploma program. Later, she earned a BA from Seton Hall University and was thinking of moving on to a master’s degree when “the director of social services pulled me aside one day. She was a little woman who had a bit of ESP. She would read your palms, analyze your handwriting and that sort of stuff. She said to me, ‘You know, I think you should be a doctor.’ As God is my witness, I had never thought of it,” Clifford recalls. She’d been working as a nurse for six years by then.
“I was about 30,” she recalls but she was in a religious community that really believes in educating women so her superior encouraged her to explore the possibility of med school. Initially rejected by NJMS, she remembers a host of reasons why she couldn’t get in. “It wasn’t so much that I was a woman or that I was older.” Her MCAT scores were low. Her science background was limited.
Not to be thwarted in her grand plan, she decided to go to medical school in Mexico and got the okay from her superiors. Grateful for the opportunity to study abroad, she recalls one of her religious directors saying, “Promise me one thing: if you aren’t happy, you’ll come home. I don’t want you to even think about the money or anything else.”
In Mexico, the state forbids the wearing of religious habits on the street but she did just fine. “I never wore my habit again after that.” Back home in New Jersey for Christmas break after just one semester, she reapplied to NJMS for the incoming freshman class. This third time was a charm. “I think I showed them that I really wanted to do this by going to Mexico. And there were new members of the admissions committee. So I started med school over again, completed four years in Newark and then did my residency there, too.” Her class started in 1973, near the end of the Vietnam War, and many of her classmates were older, non-traditional students. “Two were already PhD professors at the medical school — John Sensocovic and Frank Ferrante — so we had a very interesting, great group.” In fact, there were approximately 29 women, probably a record for a generation when men ordinarily outnumbered women in medicine.
As for the feminization of medicine now taking place, there are several young female nurses she passes in her hallways in Paterson who are thinking of applying to medical school. “Absolutely, I tell them. Don’t hesitate. Go for it. Even with all the turmoil because of insurance issues and managed care in medicine, I can’t think of anything better than being a doctor. This is a great privilege. I’ve never regretted one minute.”