Family Medicine Activist: Using Internet Radio

Internet radio is a dynamic social media tool for activists.  One can promote a cause to people worldwide if needed or to a small local group of like-minded persons.  To demonstrate the use of internet radio, I will use my Dr Synonymous Show broadcast on April 10 to promote #HAWMC, The Health Activist Writer's Month Challenge.  Yes, I'll be reviewing and commenting on blogs, blogs and blogs.

This will be followed by more blog reviews and then MY Family Medicine Activist blogs written for #HAWMC.

A couple other medical announcements or "factoids" will be included in this special show on Blog Talk Radio.

Tune in to The Dr Synonymous Show live from 8-9 PM ET on Tuesday April 10 ( or anytime thereafter for the podcast at www.BlogTalkRadio.com/DrSynonymous).

Internet radio is great for activists.  Try it a few times.  Youll like it.

Family Medicine Activist: Therapeutic Presence

I'm reading, Don't Sing Songs to a Heavy Heart by Kenneth C. Haugk, PhD, a book that discusses "how to relate to those who are suffering" from a Christian perspective.  Family Physicians are exposed to suffering daily.  How do we relate to those persons who are experience loss, grief, trauma, shock, etc.?

There is no formula or "right answer" about what to say.  Haugk writes, " The truth is, in most situations of significant struggle or suffering, nothing you can say or do can make the pain go away."
What to do is easier initially- Be Present.  A caring presence is a good start.
A caring touch or hug may be appreciated as the individual is allowed to uniquely experience and process their situation.
Efficiency and good time management may be wisely displaced temporarily, since, as Haugk points out," sudden breakthroughs do occur in caring relationships, but they are few and far between- and they are not the result of careful strategizing."

Being Present- over time becomes Therapeutic Presence, a basic skill for Family Physicians.  Patience helps Patients.

Family Medicine Activist: Patient, Doctor and Prescription Tension Mounts

Changes continue in the wrong direction in healthcare and health care.  Confusion increases about how to get continuing medications for patients at the start of each new year.  New insurances, new rules.  New deductibles, new co-pays.  High deductible HSA's lead to more frustration for persons who aren't used to paying more than $20 dollars for health care encounters.  More unemployed patients without insurance (who pay nothing when seen and have little chance of ever paying) are showing up.  Tension mounts.

I take ER call for unattached patients for follow-up.  Someone accidentally started faxing me the ER record for ALL unattached patients in the ER on my on call days showing me that about 20 uninsured, unattached patients hit our small county hospital daily.  I know that another Family Physician is retiring at the end of May near the hospital, exposing another 2000 patients to a scramble for a Family Physician.  Tension mounts.

It took me fifteen minutes to figure out one chronic med for a senior citizen who got a brand Rx from a specialist but we immediately had the POA (daughter) calling us about the excessive cost (first drug) then the denial of second Rx for unspecified reasons. Six phone calls later to and from my office yielded brand name Rx three.  The third Rx was affordable, but caused a significant side effect in this patient.  The Pharmacy Benefits Manager of her insurance company  said she had to again take the medication that caused the most intense negative reaction because they have no record that the patient was prescribed the medication (since it was sample pills given by another specialist).  This type of bureaucratic response is dangerous and worrisome.  We need more flexibility in the persons making decisions about medication formularies and how those decisions are communicated to patients and physicians.  Help!  Tension Mounts.

Tension mounts.  Tension is everywhere.  Even in poetry.  Here's an interesting piece about tension in poetry that I found meaningful when thinking about tension. It's from a local blogger (with poetic understandings)-Grace Curtis. N2Poetry: Tension in Poetry by Grace Curtis

Family Medicine Activist: Med Student Training in Family Medicine

"The AAFP recommends that the curriculum of every medical school have adequate preclinical and clinical student exposure to family medicine with the further directive that, where such is lacking, every possible means of correcting the deficiency be exercised. The AAFP is committed to making every effort to ensure that family medicine in the undergraduate curriculum with appropriate exposure to role models on the faculty be instituted in all medical schools.

The AAFP recommends that all medical schools provide mandatory family medicine clerkships completed by the end of the third year, and elective preceptorships and clerkships to their students.
(1973) (2008)"  From the American Academy of Family Physicians

During their clinical training, medical students get exposure to Family Physicians via their clinical clerkships,  learning from Family Physicians in a Family Medicine practice location such as a private practice-like my office-an academic setting, a community health center, etc.).  They interact with patients every day during this four to eight week patient care rotation, getting first hand experience with their clinical knowledge and skills and their mentors who are Family Physicians (and residents training to be Family Physicians) and support staff.  The clinical learning is usually enjoyable for the medical students who start to realize that they know something useful to real live patients.

The students usually get exposed to a broad range of conditions and diseases  as well as a "womb to tomb" age distribution of patients.  This also heightens their career and specialty selection planning skills as they start to realize what they like and don't like to do.  They may feel very comfortable both in the office and in the hospital with Family Medicine patients (under the supervision of their Family Medicine Faculty).

It may challenge them to care for newborns (or learn to circumcise the baby boys) or prescribe medications and treatments for 90 year-old patients with multiple organ problems such as kidney or heart failure.  They may be especially satisfied with the rapid improvement of the patient with pneumonia.  They may notice the need to help relatives to better understand some aspects of the end of life planning for their in office or hospitalized relative with  dementia.  Well child exams in the Family Medicine office may appeal to the student as another aspect of their future chosen specialty.  Variety is the daily fare in Family Medicine.

They also expand their learning and understanding of the role of a family physician in the medical community and in patient lives.  Once the medical student knows that there isn't always a "right answer" to the patients problem they start to allow the patient to be their unique self, not so much the person the medical student (or their family of origin dogma) wants them to be.  This can be fun for those who have more comfort with uncertainty and think like a relationship-based, family oriented generalist.

Self understanding is a part of every experience in medical school, hopefully enabling the student to understand which specialty best suits them so they may best serve patients.  The Family Medicine experiences are required for students, so all get the exposure to various aspects of the specialty and many different faculty.  Less than 9% choose the specialty for their own, but all get some understanding of the content of the specialty and the type of relationships one may have as a Family Physician.

Family Medicine Activist: Residency Training in Family Medicine

Someone's Dream- Not Mine What do Medical Students expect when they decide on a career in Family Medicine?  A satisfying specialty with a wide variety of clinical experiences and procedures, enriched by meaningful relationships with thousands of patients.  Relationships with individuals and families are a core element of the continuing care of patients in Family Medicine.

Each Family Medicine Resident experiences three years of training, including some mandatory clinical experiences and some elective experiences. Guidelines for each of the possible experiences can be found via the link below:

Residency Curriculum guidelines for each experience during three years of training.

The Family Medicine Model Practice unit becomes the clinical home for each trainee during their three years of training and growth.  They have continuity clinics in the Practice unit even while rotating through the many elective and required rotations or experiences.  This prepares them for similar, concurrent outpatient and inpatient patient care contingencies after graduation.  They are comfortable with the sick, well and injured after their Family Medicine Residency training.