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0d19354b3a8f88747a3f6877b5123bab-huge-joshua-st.-louis.jpgThis time of year, many fourth-year medical students are thinking about residency. This family medicine resident shares why he chose his residency program, and he offers tips and great advice to residency applicants.

By Joshua St. Louis, M.D.

During my first week of family medicine residency, I was surprised to find myself at the local public housing office picking up a housing application. Although we were supposed to be undercover, my adviser Jenny and I didn’t look like typical residents of Lawrence, Massachusetts. After asking a few pointed questions, the receptionist finally asked, “Are you doctors from Greater Lawrence Family Health Center? They always come around this time of year pretending to need housing applications.” Realizing that the jig was up, we came clean and the receptionist pulled us through a side door to have an impromptu meeting with the director of public housing. Upon returning to the clinic, all the interns and our advisers shared what we learned at the public housing center and a number of other affordable-housing related stops on our community medicine scavenger hunt. 

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Posted by Sonya Collins on Jan 29, 2015 11:37 AM EST
183e6cbaf51bb2e4035cdd8bd4dd5b69-huge-aimee-english.jpgThis family doc learned from her teacher husband that patients, like students, need the confidence to ask questions and security to learn from mistakes in order to achieve their goals. 

By Aimee English, M.D.

My mother is a very smart woman.  I see it in the way she solves problems, creates complex crafts, and navigates hard conversations. She can't, however, add fractions. She was never very good at math, she says.
 
"I was never very good at math" is a dirty phrase that garners much attention in my household.  My husband, a sixth grade math intervention teacher spends just over 170 days each year attempting to undo that misconception among low-performing public middle school students.  When I ask him what the most important factor is to help students improve, he says it all comes down to having the confidence to ask questions and the willingness to make and learn from mistakes.

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Posted by Sonya Collins on Jan 27, 2015 11:21 AM EST
"We cannot afford to perpetuate a system that pressures clinicians to chase outcomes for problems that originate far beyond their reach. We must pursue transformation that aligns public health and primary care," says public health professional Brian C. Castrucci in a blog post in which he urges primary care and public health to work together to not only increase supply of primary care physicians but also to lower demand. 

By Brian C. Castrucci

Everyone from US Senators to major media outlets (USA Today, The New York Times, The Wall Street Journal) and advocacy outlets is talking about the primary care physician shortage. This shortage could grow as the number of insured Americans increases thanks to the Affordable Care Act (ACA). Estimates of how many physicians would fill the gap range from just over 20,000, according to HRSA, to 45,000, according to the AAMC. Half a century ago, 50 percent of our nation’s physicians practiced primary care. How did we end up here?

First, medical students are taking a long, hard look at the job and deciding that the costs outweigh the benefits. Those who do pursue careers in primary care have some of the lowest salaries in the profession and face the greatest risk of burnout. In 2013, three of the five lowest paid physician groups were primary care physicians – internal medicine, $178,000; family medicine, $175,000; and pediatrics, $173,000. Compare that to orthopedics, $405,000, and cardiology, $357,000. The median debt for medical graduates in 2014 was $180,000.

Even more worrying, nearly a third of primary care physicians ages 35-49 – doctors in the prime of their career, able to bring expertise and experience to their patients and to the workforce – plan to discontinue their practice within the next five years. That rate climbs to 50% for primary care physicians who are fifty and older

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Posted by Sonya Collins on Jan 22, 2015 10:40 AM EST
This family physician has had a unique and exciting career in primary care, and she's debt free! She encourages medical students who love primary care, but worry about their future earning potential, to reasearch the many unique career options and debt-forgiveness opportunities available to physicians in this field.

By Charmaine Chan, D.O.

A medical student asked to speak to me about a month ago at the Philadelphia College of Osteopathic Medicine, where I am an instructor of family medicine. He has been very active in our school’s Primary Care Scholars Program and community health outreach activities. “Dr. Chan,” he said, “I am so torn. I really love primary care, but I am so worried that I won’t be able to get my loans paid off.” 

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Posted by Sonya Collins on Jan 20, 2015 9:18 AM EST
This medical student spent most of his life resisting the pressure to follow in his parents' footsteps, until they showed him that baseball isn't the only career that lets you be part of a team.

By Nathaniel Pedley

Many medical students can recall the moment they first felt the pull to become a doctor, yet much of my life was defined by a push against medicine. My parents are both neurologists, and while their medical conversations often interested me when I was growing up, I had no intention of following in their footsteps. I wanted to carve out my own niche.

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Posted by Sonya Collins on Jan 15, 2015 11:34 AM EST
At 12 years old, Tom Atwood thought "diabetes" sounded like a death sentence, but the diagnosis ended up setting the course for a whole new life.

By Tom Atwood

When I was 12 years old, I was diagnosed with type 1 diabetes. It was the first day of summer vacation, and I had gorged myself on cupcakes at our end-of-the-year party the day before. After months of feeling off, low energy and frequent trips to the bathroom, this sugar splurge led to a dozen such trips that evening. My mom decided it was time to see a doctor, so she took me to the Connecticut Children’s Medical Center. Now, twelve years later, many of the details of that day are foggy to me, but three stand out as clearly as ever: the toys, the rainbow, and Dr. Ratzan.

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Posted by Sonya Collins on Jan 13, 2015 11:43 AM EST
A family physician encourages health care providers to start the year off by pledging not to discriminate when it comes to patient care. 

By Jack Westfall, M.D.

The Colorado HealthOP started with the value and belief that there is no place for discrimination in health care. We mean it. And that’s why we are encouraging health care providers in Colorado and around the country to take the pledge. It’s simple.
 
“I pledge to be a friendly provider for LGBTQQI patients. I pledge to make my office a friendly place for LGBTQQI patients.”
 
That’s it. 
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Posted by Sonya Collins on Jan 7, 2015 10:00 PM EST
In our first post of the new year, an oncology patient navigator explains the responsibility of specialists and non-physician health care professionals in care coordination in the primary care clinic. 

By Ming Lin

“Mike” sat, shoulders slumped, on top of the exam room table, his legs swinging back and forth in an agitated rhythm. A baseball hat covered his alopecia. A baggy sweater obscured his severely misaligned shoulders. A young man in his mid-20s, he had a troubled, lost look beyond his years. He had survived a rare childhood cancer that left him with glandular problems, kidney problems and increased risk of cardiac damage and skin cancer, which meant a lifetime of visits to numerous specialists. Given this complex brew of health concerns, his follow-up care was a lifelong unwanted burden. And as Mike sat in the exam room that day, the burden was visible.

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Posted by Sonya Collins on Jan 5, 2015 8:26 PM EST
In our final blog post of the year, PCP's co-founder and president offers an end-of-year message to PCP chapter members and the community of primary care advocates at large. 

By Andrew Morris-Singer

2014 has provided only a glimpse of what is possible for us. That’s right: you, me, all of us. We are the leaders who will transform and save primary care.
 
We’ve petitioned schools to revamp their primary care curriculum, and we’ve produced real changes that better align training and practice. We’ve launched new student run clinics and increased access for communities that have gone for years without care. We’ve developed new interprofessional student-run teams to “hotspot” and support some of the most complex and vulnerable patients, improving health and lifting spirits (both theirs and ours) at the same time that we’ve driven down costs.
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Posted by Sonya Collins on Dec 23, 2014 11:32 AM EST
In one of our final posts of the year, Tom Bodenheimer -- primary care physician, professor, author and member of our National Advisory Board - offers an end-of-year message to our community. 

By Tom Bodenheimer, M.D. 

In 1990, an organizer with Save the Children went to Vietnam to help fight malnutrition. The government told him, “You have six months to make a difference,” according to Chip and Dan Heath’s account of the story in their book How to Change Things When Change is Hard. Make a difference in malnutrition in six months? An impossible task. Undaunted, the organizer went to rural villages and asked local mothers to help him weigh every child in the village. He visited poor families with well-nourished kids and learned what those successful mothers were doing. Then he worked with the high-performing mothers to spread their practices to families with malnourished children. 

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Posted by Sonya Collins on Dec 23, 2014 11:02 AM EST
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Josh - great post, and I'm so excited that you and your colleagues get to be a part of such a special program. The fact of...
Relational leadership is crucial for moving all of us to create change. People are not moved by data alone, but by val...
Thanks, Aimee! Great piece. This one definitely strikes a chord with me. I'm pretty shy in most group dynamics, so it...
I'm so glad this article emphasizes that a large proportion of health is created outside of clinics and hospitals. T...
Thank you Dr. Chan for taking the time to share your story! It is so important that medical students know that choosin...

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