Growing up in a small town, the daughter of homemaker and a sometimes self-employed laborer, we never had health insurance. There was always worry. Would there be heat? Would there be food? Would someone encounter an illness or injury that would financially, catastrophically wipe out the family home?
I remember feeling that there was one place I felt safe and never judged—my family doctor’s office. At school, I did not have the right hair or clothes. Certainly, all kids grow up with some form of feeling inadequate, but when one is poor, external locus of control augments any feeling of inadequacy. When one is poor and comes from an underrepresented minority, multiply that by 1000. But my doctor was the consummate professional. I never felt judged. I felt safe and cared for.
These life experiences led me to hold the long view of family medicine—as a solution for social ills and our healthcare spending crisis. Early in my career, I entered academics to pass the professionalism and professional identity that I saw in my family doctor. It was easy for me to emulate him, even in my homeless care work, because I often see my younger self had the unthinkable happened. Those are not just homeless people. Those are my people and I would have been one of them had the circumstances been different.
But how does one pass on the sensation of empathy for someone in poverty or in different circumstances? I worry about what I am seeing more and more: cynicism and labeling in how we approach each patient. Even as I embark on an exciting, new journey to create an accelerated program in family medicine, I worry that the students who approach these challenges come in warped by our geo-political polarization. One way or the other. Right or Left. Conservative or Liberal.
Yet, I continue to have hope in the resilience and kindness of the human spirit, and I am hopeful as I interview new amazing students seeking a place in our transformative care continuum. This new accelerated 3-year program will include early longitudinal clinical care with a continuity panel and a focus on health systems, quality improvement, population health, and leadership.
One of the things I hope we instill in this new program is an ability to be truly reflective. I hope each student will learn to really listen and reflect on one’s skills. Professional identity occurs in meeting each patient without cynicism but with empathy by this process. I hope that each of these students grows into the family doctor I had when I was a child: the family doctor that made me feel safe and never judged.