By Ishani Ganguli, M.D.


This series, by the former editor of Progress Notes, originally appeared on her blog, Short White Coat, for the Boston Globe. Admitting she had little exposure to the other members of the allied health professions in medical school, Ishani explores here the roles of the diverse members of the health care team at the Ambulatory Practice of the Future in order to better understand the team players we will increasingly rely on to deliver primary care.  

See the first piece in the series here on Progress Notes, and find the rest on Short White Coat.


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By Chelsea Slade

I was standing outside of the exam room door, palms sweaty, my voice suddenly feeling very gone. My mentoring physician had just poked his head into the patient’s room to say that he was going to have his medical student ask some questions first, if that would be all right. “It is not all right!” the patient had shouted. “This is my first time here and I need to see the doctor!”  But my mentor had closed the door and handed me the patient’s chart anyway. This was the first time I would be seeing a patient by myself as a medical student, ever.
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By Joe Tobias

Earlier this year I heard Jack Geiger deliver Grand Rounds in the Social Medicine Department of Montefiore Medical Center. A physician well into his 80s, Geiger still travels the country promoting medicine as social rehabilitation—a model he has championed for the past fifty years. In the Mississippi Delta, in the racially divided South of the 1960s, Geiger started the nation’s first community health center. Not only did the center treat North Bolivar County residents’ acute medical problems, it also empowered them to lead better lives: to learn the skills they needed to stay healthy, to obtain the education that poverty had unjustly denied them and to realize their potential.
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By Kevin Bernstein, MD, MMS

First, we want to congratulate all students who matched in family medicine! (Editor's note: This article refers to data from the  2011 match.) Welcome to the Family Medicine Revolution  (#FMRevolution)! We also want to congratulate all students who matched in primary care residencies AND who plan to stay in primary care!  We all need to work together to provide increased access to quality primary care to our future patients. Over the past few weeks, I have had the pleasure to read summaries of match results from various schools and various national organizations.  Trust us, we are excited about the 11% increase in Family Medicine and the 94% fill rate - the most all time - for Family Medicine!  However, there are many misleading reports flying around from various sources touting their production of primary care.
 
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By Matthew Mintz, M.D.

Most articles about why medical students don’t choose primary care will say that a career in primary care simply won’t pay off the enormous debt accrued in medical school. Indeed, the average 2010 graduate came away $157,944 in debt. And primary care salaries are in fact far lower than those of other specialties, a disparity that is increasing. However, I repeatedly ask medical students if they would choose a career in primary care if it would completely erase their student loan debt. A few hands go up, but not many. In fact, for a while now, the federal government has dedicated millions of dollars to repaying loans for students who choose primary care. Yet residency match numbers show that the percentage of students choosing primary care is not increasing.  Though loan forgiveness is a step in the right direction, medical students realize that by choosing a more lucrative specialty, they can pay off their loans just fine.
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By Diana Tucci

“There – there’s a space between those two layers that you have to fold that edge into, do you see that?” I said to the older woman sitting next to me. I had never met anyone worse at following directions. It was a Lunar New Year celebration and she wanted to learn how to make origami paper cranes. It had been a long and tiring day, and I was in a bad mood for most of that time. My friends had left without me and I was waiting for someone, anyone, to drive me home so I wouldn’t have to walk back in the cold of a Pittsburgh winter. She sat there, bent over her work, apparently ignoring the things I was showing her. I was really starting to get frustrated.

“No, I can’t see anything,” she replied. It wasn’t until then that I realized she was blind.

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By Mark Ryan, M.D.

When I entered medical school in Richmond, Virginia, I was certain I wanted to be in primary care but I was not yet sure what specialty.  Once I had decided to work in a medically underserved community I chose family medicine because in a rural site, where resources are limited, there is added value in the breadth and scope of family medicine training. I would be able to see all patients, regardless of age, gender, or initial symptoms. This training served me well when I took my first job after residency, in the small town of Keysville, Virginia.  In Keysville, I worked for four years providing care to patients in town and in the surrounding counties.
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By Annie Mooser

The training requirements for Peruvian physicians are an exceptional experience which link doctors to the culture and circumstances of the country’s impoverished residents.  Through that country’s mandatory rural service year, a requirement for anyone who wants to practice in a public Peruvian hospital, there is potential for the physician to develop clinical skills in the most dire of circumstances while forming an intimate relationship with an isolated community.  There, it is easy to appreciate and admire the talents of Peruvian physicians and their understanding of their patients’ realities.
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An Interview with Lucy Hornstein, M.D.
By Sonya Collins

Video by Joanna Hornstein

Family physician Lucy Hornstein has been in practice in Pennsylvania for more than 22 years.  In this three-minute mini-documentary produced by her daughter, Pennsylvania College of Art & Design student Joanna Hornstein, Dr. Hornstein shares what it means to be a family physician. 
 
On her blog, Musings of a Dinosaur, Dr. Hornstein describes herself as, “A family doctor in solo private practice, I may be going the way of the dinosaur, but I’m not dead yet.” The blog inspired the material for her 2009 book Declarations of a Dinosaur: 10 Laws I’ve Learned as a Family Doctor.

Watch the video here, then see what Dr. Hornstein told us about caring for families in all stages of life and writing about her work.
 

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