Category Archives: Family Medicine Stories

The Joy In Family Medicine

TamAnthony

Anthony Tam, MD
University of Michigan FMR

When I look back and think about who I thought a doctor was when I was a kid, I imagined that person taking care of kids, adults, and even pregnant mothers. I saw them as a primary responder for minor injuries and illnesses or even for acute processes. And I looked up to these role models and hoped that, some day, I could be that doctor and role model for others. It wasn’t until medical school that I figured out the role model I looked up to was a family medicine physician.

After doing my clerkship rotation in family medicine, I knew this was the field I wanted to enter. A specific patient I had talked to at the clinic was “Mary”.  Mary had come in for a follow-up on her thyroid medication. Routinely, I went in before the resident I was working with to talk to “Mary” and discuss any issues she had. She suddenly burst into tears about how she has been feeling sad and giving up on life. However, after a long discussion about how much good she had done for her family, kids, and community, she came to the conclusion that she deserved to be alive and should continue helping others.  When my resident came in to review what we had discussed, the first thing “Mary” said was, “Will this be the doctor that will replace you when you are gone?  I felt so comfortable talking to him about my troubles in life and really hope that I can continue seeing him in the future for my care.”  It was this moment when I knew that family medicine was the career path for me. I wanted to be that doctor that builds trust in relationships and provides the care that any person needs, regardless of their economic or social situation.

Family physicians present themselves with great confidence, leadership, and sincerity.  They exude confidence by helping patients make informed decisions on preventive care.  They show true leadership in working with not only other doctors, but also the staff that helps run the clinic. And most importantly, they show true sincerity in making sure each patient feels as though they are being seen by a doctor that cares about them.

How do I know that I chose the right profession?  Fast forward now to my second year in a family medicine residency where I am looking forward to the days I have clinic so I can see the patients I started seeing as an intern. The staff I work with make me smile every day I’m here and I enjoy the time I spend in clinic.  I exit each room with my patients laughing and catching up with their lives as I walk them out to checkout.

The great, long-lasting relationships and trust developed with a patient and the continuity of care are priceless. I am so happy to have matched into an amazing family medicine residency that helps me become the doctor whose hand patients can hold in a time of sorrow, the one who encourages them to make the right lifestyle choices, or maybe even the one who takes care of an injured athlete on the field. I am more than eager to continue my time here with Michigan Medicine.

It Is Time to Serve as a Primary Care Physician

By Sumi Dey, MD and Harland Holman, MD

It’s time to serve as a primary care physician.

This is what we tell our students. Why? Because the US Department of Health and Human Services estimates that by 2025 the United States will be short 35,000 to 44,000 adult care primary care physicians. We believe this is a crucial time for medical students to become interested in serving as primary care physicians. If future students will not prepare to care for our nation’s needs, who will?

If a student asks why they should be primary care physicians, this is our answer.

Americans who regularly visit their primary care physician have a 33% lower health care cost and 19% lower odds of dying than patients who visit only specialists. According to the Report on Financing the New Model of Family Medicine, if every American had an established relationship with their primary care physician, it would reduce national health care costs by $67 billion per year.

Primary care access is correlated with more equitable distribution of health within a population and can mitigate the adverse effects of income inequality. This is especially important in the United States, where minorities and economically challenged people are struggling to access regular primary care.

Countries where patients have established relationships with primary care physicians have lower depression and suicide rates. Mental health problems including depression and anxiety are part of patients’ everyday life experience, and often primary care physicians address mental health at almost every visit. According to the National Alliance on Mental Illness, more than 70% of visits to primary care physicians are associated with psychological issues.

Establishing a long-term, strong relationship with a primary care physician plays a crucial role in early disease diagnosis and prevention. The Centers for Disease Control show that disease prevention is important in creating healthier communities and productive lives, and in reducing overall health care costs.

Primary care physicians provide continuity and preventive care for a wide range of medical conditions and undiagnosed health concerns. They also serve as the framework for building a strong health care system that ensures positive, cost-effective health outcomes and health equity for the nation, especially in underserved populations.

Students, it’s time to serve as a primary care physician.

From Journalism to Medicine: Not Such a Huge Leap After All

Ranit Mishori, MD, MHS

Ranit Mishori, MD, MHS

Now that I have stacked up a good number of years in medical practice, I am one of those doctors who gets asked from time to time to talk about my career with medical students and junior physicians, answering questions about how I chose my specialty, how I like life in academia, and how I balance being a doctor, a spouse, and a mother.

Part of my answer always includes my late start in the field. I was nearly 30 when I decided to give up on a life in journalism and go back to school and become a doctor.  For a decade before that, I was a newswoman, a radio producer, and then a TV producer and editor, and I worked in Jerusalem, New York, and London. I covered wars, natural disasters, politics, terror attacks, international affairs, and some fluff stories as well. Yes, I must confess: skateboarding squirrels, surfing dogs, and high-heel races are some of the memorable news stories I shared with the world.

And when I share this, the most common comment I get is some variation of, “Wow, journalism to medicine sounds like 180 degrees!”

I thought so too at the time I started making the switch. But eventually I found it not to be a radical change at all. To the contrary, my decade in news prepared me well—better than any of the required organic chemistry or physics courses—for a life as a medical doctor.

Here’s why:

It’s all about storytelling.

One of the things that many students feel most nervous (and excited) about in the first 1 to 2 years of medical school is interviewing patients. This is what we call in medicine taking a history: a process that is at least as important as doing a physical examination. Indeed, I would argue that its impact is often greater than diagnostic testing or lab results in reaching a diagnosis and creating management plans.

For me, history taking felt like being back out on a story, behind the camera, getting the facts and making them make sense. Doing this well, in either context, is an art in itself: knowing when to press, when to let go, asking open ended questions, letting silences linger, paying attention to what’s not being said. These are crucial skills that we, as medical educators, try to teach medical students from year one to the end of their training and beyond. And they were skills I acquired in journalism.

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