Dr. Joane G. Baumer's 32 years in family medicine have included sports medicine, women's care, and global health initiatives. Dr. Baumer is chair of the department of family medicine at JPS Health Network Family Health Center in Fort Worth, Texas, a teaching clinic for the family medicine residency and geriatric residency that also serves as the international health clinic for the Immigration and Naturalization Service. Located in an urban community that serves a diverse population, the department provides clinical services to multiple sites in the county through a centrally located hospital, a surgicenter, a sports and pain clinic, four family health practices, two residency practices, and 19 school-based clinics in neighborhoods.
Q: What led you into the practice of family medicine?
Dr. Baumer: Family medicine engaged me early in my life. My family was privileged to have a wonderful family physician who encouraged me to go to medical school. The pivotal point, however, occurred for me during medical school in my second year when I was seeing patients with a local family physician in his office. His engagement with his patients and love of his discipline was inspiring. As I began to plan my clerkships, I realized that I could not give up on my desire to care for all patients across the lifespan. Dr. Gabriel Smilkstein was one of the faculty at the University of California, Davis, at the time who supported me in this decision when I was being heavily recruited into other disciplines. His mentorship was invaluable. As students, we were encouraged to develop a migrant farm workers clinic to gain more experience and insight into our own interests. It provided us with another view of health care outside of the academic health center. It still exists today.
Q: What is a typical day for you?
Dr. Baumer: Today, my practice of medicine is an engaging blend of direct patient care with my own patients about 20 percent of my time, teaching about 30 percent of my time, and administrative duties as a department chair about 50 percent of the time.
Q: How have things changed since you entered the field?
Dr. Baumer: The level of responsibility for a physicain has always been high, but today there is less emphasis on the individual physician as there was 30 years ago. Today, a physician is more likely to function in a team setting as a trusted advisor with a group. I feel a much greater level of partnership with my patients today because we both have access to the internet, electronic records, and wonderful educational tools as we research and learn what solutions may be best for them. It is an exciting time.
Q: What surprised you most as a new physician?
Dr. Baumer: The level of complexity of patients' needs was probably the thing I was least prepared to address as a new physician. At that time, patients were very dependent on the family physician for many resources other than just health care. Being aware of the tools in the community was critical for me as a physician so that they could adhere to treatment decisions, such as getting to office visits and referrals and obtaining medications. While this is still true today in many settings, the acknowledgment of other determinants of health is allowing physicians to refer patients for support for medications in pharmacy assistance programs, to be compensated for managing behavioral and mental health disorders, and to refer simple acute care disorder and stable chronic disorder management to mid-level clinicans when available. Today some social services are available that were rare 30 years ago, and I feel that as a physician I can truly share the burden of care with a community around a patient.
Q: What do you love about your work?
Dr. Baumer: The level of engagement that I experience in my work is a great privilege. Never is a day the same as the one before. The constant education and rewards that come in the relationships between myself, my pateints, my students, residents, and colleagues is joy that prevents any need to look at my watch.
Q: What community service activities are you involved in, and what motivates you to do this work?
Dr. Baumer: My passion to help colleagues is what guides most of my service activities. For some time I have felt that physicians need to reach out to one another to stay healthy and engaged in their careers. This has been especially evident with the shortage of physicians and health care clinicians that we are experiencing and will continue to address. With the help of my health network we started a re-entry program for practicing physicians who had not been using their clinical skills due to an interruption in thier careers. This has been engaging and rewarding as we send them out to care for patients once again. I actively participate in the Texas Medical Association Committee on Physician Helath and Rehabilitation as well as my county medical association rehabilitation committee and our network physician health committee. I also am a volunteer physician to Project Access, a local nonprofit coordinator for care to indigent patients. At home, I support my physician husband of 40 years whenever I can, play with my grandchildren, work in my gardens, and entertain as a vocalist with or without an audience.
Q: What do you wish you knew when you were in medical school?
Dr. Baumer: I would have liked to know how to structure my lifelong learning a little better. My own advice to myself would have been to take time to meet with my colleagues in small groups to discuss cases every month.
Q: What has been the greatest challenge you have faced as a family physician?
Dr. Baumer: My greatest challenge has been to combat the negativity toward family medicine from other colleagues both within and outside the discipline. Because my younger colleagues are still reporting this experience in medical schools today, I realize that we have not been too successful in changing this view from our specialty colleagues. In addition, we are often as a group made to feel that less well-trained and experienced clinicians should replace us for cost and safety concerns, when there is evidence to the contrary. Recently, the Centers for Medicare & Medicaid Services (CMS) and Association of American Medical Colleges (AAMC) has provided mixed messages to us as a discipline despite the Affordable Care Act (ACA) and our strong work as an organization to gain that support. If we are to change this we must be united. The AAFP and our local organizations must remain in lockstep and we all must participate — as I continue to do so — even if it takes a long time. OK, off the soapbox.
Q: What do you tell medical students who are considering family medicine?
Dr. Baumer: If you never want to look at your watch, if you are curious about what is behind each door, if you love the challenge of ambiguity and undertaintly, and, most importantly, want to work with others to change their lives, there is simply nothing that competes with family medicine.
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Medical School & Residency
In Their Own Words: Family Physician Q&As
Dr. Joane Baumer