February 2002 • Volume 8 • Number 2 |
R-E-S-P-E-C-T. To paraphrase singer Aretha Franklin, that's what it's all about. And increasingly on campuses around the country, that's exactly what family practice is getting. As the specialty comes into its own, more and more FPs are ascending the heights of academe.
Not an easy road, to be sure. Time -- and timing -- have played a role. As has devotion to the precepts that define family medicine. But family physicians have proved themselves equal to the task.
"Family practice is a young specialty," says Richard Homan, M.D., dean of the Texas Tech University School of Medicine and the Graduate School of Biomedical Sciences, Lubbock. "We're now at the point where we're well enough developed in our careers to assume these positions of responsibility."
Homan sees FPs as well-suited to academic leadership. "We have a broad area of expertise, and we communicate well," he says. "We're able to bring a global perspective to our work."
As the former chair of the family and community medicine department at Texas Tech University Health Sciences Center, Homan was able to "build bridges and forge connections" with other departments, he says.
 Richard Homan, M.D. |
 Joseph Scherger, M.D. |
 Nancy Dickey, M.D. |
 Ann Jobe, M.D., M.S.N. |
 Michael Lewis, M.D., Ph.D. |
CREATING NEW LEADERS
That sort of broad-based support mimics the breadth of the specialty, according to Joseph Scherger, M.D., M.P.H., founding dean of the Florida State University College of Medicine, Tallahassee. "The generalist physician is an ideal leader," says Scherger. "We understand a broad dimension of medicine."
The progenitors of the discipline likewise understood that leadership required attentive nurturing. Nancy Dickey, M.D., of College Station, Texas, president of the Texas A&M University Health Science Center, points to AAFP's role in cultivating FP leaders.
"The Academy has spent a great deal of time and energy doing formal leadership training," says Dickey. She also cites the Society of Teachers of Family Medicine Foundation's Marion Bishop leadership training program as one recent example. "Growing" new leaders takes pairing family medicine's brightest and best with those who have already demonstrated their leadership skills. This active mentoring is then passed on to yet another generation of rising stars.
ROLE MODELS FOR FAMILY MEDICINE
"I think having visible role models who enjoy what they do is a critical element of increasing interest in family medicine," says Ann Jobe, M.D., M.S.N., dean of the Mercer University School of Medicine, Macon, Ga. "Although I have to be careful about promoting family practice over other specialties, that doesn't mean that I can't speak out about the contributions family physicians make and how much they are needed."
Dickey says she, too, recognizes the need for sensitivity to alternative career paths. "There's no doubt that as a dean of a medical school or as president of a university, you have to be a leader for all. But simply having family physicians in the extraordinarily visible position of dean or president says to people, 'Wow! These aren't just country bumpkins who treat splinters. These are real people with potential for real impact.'"
For Scherger, it's not so much about promoting the specialty as it is about promoting what the specialty does. "I'm not here to promote one specialty. I tell students, 'The purpose of this medical school is that you'll go out and meet unmet needs, that you'll serve society.' It's caring about communities and people in those communities that leads people to family practice."
SERVING PATIENTS, FAMILIES AND COMMUNITIES
In that sense, medical educators can best serve their students -- and their patients -- by modeling the values they wish to impart, says Michael Lewis, M.D., Ph.D., of Charleston, W.Va., vice chancellor for health sciences for the state of West Virginia.
"It's important for the medical education system to be able to respond to the needs of individuals, families and communities," says Lewis. "While the explosion of medical information will continue to drive the development of marvelous new treatments, we must remember that there is a person receiving the treatment and there is a concern to the family involved. Medical educators must continue to make vigorous efforts to preserve sensitivity and compassion toward the individual and the individual's family."
"Medical education needs to instill in the new generation of physicians the critical skills of caring, communication, collaboration, commitment to professionalism and continuous improvement," Jobe notes. "Academic medicine must be open to change -- not resistant to it. The curriculum in medical schools needs to be responsive to the changing health care environment so that we can educate future physicians to practice in new ways."
RE-ENGINEERING MEDICAL PRACTICE
Scherger takes pains to instill this attitude at Florida State. He advocates taking advantage of the tools that are out there to better serve patients. "I don't believe that patient-centered care for an aging population with more and more chronic illnesses can be done well in 10-minute office visits," says Scherger.
"The visit is the most precious thing we do," he says. "We need to use the office visit far more selectively so we can devote more time to it. The way we do that is to tend to the more routine needs in a more efficient way. That's where the Internet and e-mail and resource-sharing come into play."
Don't discount the value of relying on other health care professionals to expand the services your practice can provide, Scherger says. Nurse practitioners, physician assistants and other professionals have a valid place in health care.
"This is not a case of either/or; the beauty of these professionals is that they work with family physicians," he says. "Right now, the percentage of family docs working with NPs or PAs is very, very high. What the midlevel providers do is let doctors prioritize their time, focusing on more complex problems. This is what makes family medicine fun."
FP Report is published by the
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Copyright © 2002 by
American Academy of Family Physicians.