September 2002 • Volume 8 • Number 9 |
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• Resident & Student News •
Providing the best possible health care is all about making the right connections. And it's not always in medical school that you learn to do that.
 America Bracho, M.D., M.P.H. |
So said America Bracho, M.D., M.P.H., Aug. 2 at the National Conference of Family Practice Residents and Medical Students here. Bracho delivered this year's Stephen J. Jackson, M.D., Memorial Lecture.
"Medical schools train us only to use this brain," Bracho said, pointing to where one would normally expect to find said organ. But if that's as far as you take it, she added, "You are blocking your ability to connect, because you don't connect with your brain. You need to connect inside -- you need to connect with the patient and you need to connect with the community."
It's only by using your emotional brain -- your heart -- said Bracho, that you come to understand that there's more to practicing medicine than simply treating patients' health problems. "For you, it might be just that medical condition," she said, "but not for them."
The trick, Bracho said, is interacting with patients in the context of their families and their communities. And to do that, she added, "You have to step out of your box. Go into the neighborhood to see what's going on." Once you have a handle on that part of the picture, you open yourself up to ways to engage patients in their own care.
Bracho has had ample opportunity to practice what she preaches. After years of rural practice in her native Venezuela, she earned her master's degree in public health from the University of Michigan, Detroit, specializing in health education and health behavior. Those experiences formed the backdrop for her founding Latino Health Access, an award-winning, nonprofit community health organization, in 1996.
Santa Ana, Calif.-based LHA uses a "client-driven" approach emphasizing collaboration among physicians, other public health profes- sionals and trained community health workers, or "promotores," who act as catalysts and role models. It's up to the clients to identify community-wide health problems -- alcohol and drug abuse, teenage pregnancy or other issues -- and follow through with meaningful, results-oriented projects often centered on making lifestyle changes.
In this setting, the physician's role is that of coach, team partner and advocate. While this approach may not reflect the proverbial wisdom you learned in medical school, said Bracho, it's what gets the job done. And it only happens when you make the decision to work with patients rather than on them.
"The only reason we don't make that connection is because we feel like we don't have control -- and if there's one thing they teach you in medical school, it's that you have to control," she said. "Let me bring you this truth today: You are not in control."
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Copyright © 2002 by
American Academy of Family Physicians.