Dr. Jen Brull practices family medicine in a Kansas town of only 2,000. Her practice — Prairie Star Family Practice, which she opened in Plainville, Kan., in 2002 — serves residents in the town and across the county. Dr. Brull collaborates with four other family physicians and three midlevel providers in the community, and the scope of her practice is full, "delivering babies to nursing home, ER to hospice, inpatient and outpatient," Brull said. She describes her practice (and family) as, "very closely integrated into the community. It is not uncommon to see my patients in church or the grocery store. They are my Facebook friends and Twitter followers. They are definitely more than just patients." She also has a special interest in health information technology and quality improvement.
Q: What led you into the practice of family medicine?
Dr. Brull: My mentors were family physicians and pediatricians, so I always knew I would do primary care. I actually was drawn to peds, and even led PIG (Pediatrics Interest Group) in med school my second year! My first clinical rotation was in family medicine, though, and I found my "fit" on day one. I didn't expect to love all of the things a family physician does, but with each experience I learned more about family medicine as a specialty and myself as a provider.
Q: What surprised you most as a new physician? In what way(s) was practice not what you expected?
Dr. Brull: I worked as an employed physician for eight months straight out of residency and found out that really wasn't a good fit for me. I opened my own practice a year out of residency and have been there ever since. I found out I am my own best boss!
Q: What do you love about your work? What is the greast reward or benefit you receive as a family physician?
Dr. Brull: I am passionate about quality improvement and using EHRs (Electronic Health Records) to help us improve quality. I love seeing our numbers when it comes to population health. It is very rewarding to know that I am responsible for screening a larger percentage of my patients for breast or colon cancer. My best reward is when I make a personal connection to one of my patients. Getting a card in the mail that says, "you're a great doctor and I'm so glad you're my doctor," really makes my day.
Q: What do you wish you knew when you were in medical school? What advice would you give youself back then?
Dr. Brull: I wish I had been more confident about my role as a member of the medical team and my importance as a person. If I had been more self-assured, I certainly could have resolved some of the conflicts I witnessed! I also would have enjoyed taking the basic science classes a lot more — really absorbed the information instead of cramming it in to get a decent grade.
Q: What is a typical day for you?
Dr. Brull: Today was a pretty typical day for me. I started at 6:00am, getting kids up for school and getting ready for work myself. I had a labor induction at the hospital, started last night, that I knew was waiting for me to come in and rupture her membranes, so I felt a little rushed. But, it was my daughter’s eighth birthday, so having donuts and grape juice for breakfast (a ritual in our family) was a must before leaving! I did get a call from the hospital at 7:30, just as I was walking out the door, that my OB’s membranes had ruptured spontaneously and that she was in active labor — hooray!
I drove to work (about 10 minutes away), dropped off my bag at the office, and headed down the hall to the hospital to check on my labor patient and an observation patient admitted last night for dyspnea and near syncope. I spent the next hour writing hospital notes and planning for discharge of the obs patient. Office hours started at 9:00am with a full slate of patients, but in the middle of my third or fourth appointment, the hospital called to let me know there were complications with the laboring patient.
My awesome staff appeased patients in the office and called patients who hadn’t arrived yet that morning to reschedule them as I jogged over to L&D. The baby was showing some signs of fetal distress but a series of interventions led to an improved strip, and the patient was making change quickly. I stayed with my OB patient since the situation was a little concerning and ultimately she delivered a healthy baby boy shortly after noon.
Next stop was our group’s monthly business meeting to talk to the rest of the providers about financials and practice operations. We managed to finish 5 minutes early and I took the opportunity to take a quick power walk outside (sunshine!) before ducking back to the hospital to check on my mom and baby and make sure the obs patient made it out the door. The afternoon patients started at 2:15pm and several of them required extra time and TLC today — sometimes that happens — so I didn’t finish up until about 6:00pm, late for me!
My message box is pretty full right now, but nothing urgent, so I headed home for dinner and waited to log back in to the EHR later in the evening to clean out the backlog. I will spend an hour or so catching up on “paperwork” (actually, computer work) before tomorrow.
Q: How have things changed since you entered the field of family medicine?
Dr. Brull: When I was in residency, we adopted an EHR and were considerded unique in that way. In my group, we went live with an EHR almost four years ago — now that is very common. More and more, we look at quality measures and how we do in comparison to our peers. That is something I never did in residency or the early years of practice — you just didn't have the data you needed to do so!
Q: What is your most vivid memory from medical school?
Dr. Brull: The thing I remember most vividly is a memory that holds a lot of emotion for me. I was a third-year student on surgery (in the days when students were to be seen and not heard), had a 15-mont-old baby at home, and was post call. It was typical to get up before daylight and get home after dark, and it had been about three days since I had seen my baby awake. It was about 5:30 p.m. and looking good for getting home while my son was still awake — rounds were done, the team was post call so everyone wanted to get out of there — and my chief resident decided rather randomly that everyone could just stick around until 8 p.m. No good reason. No learning opportunity. I remember being so crushed that I was going to miss another day in my child's life to medical school and almost losing it.
I survived, and my son (15 now) still speaks to me, so I guess it wasn't the end of the world. But, it sure felt like it. That memory has been very influential to me as a preceptor. If I have a student on rotation and we are done with work and not doing anything worthwhile, I make sure my student knows it's OK to go home and spend some time with whatever or whomever is important in his or her life.
Q: In what community service activities are you involved, and what motivates you to serve?
Dr. Brull: I am largely involved with community service in the schools. I have three children (one born during medical school, one born during residency and one born during private practice) and enjoy doing things for their schools. We do sports physicials, flu shots, concussion/coach education, sex ed talks — pretty much whatever people ask us to! I am also involved in my church, mostly with music. My family is very musical, so it is an activity we can do together.
Q: What is the greatest challenge you've faced as a family physician?
Dr. Brull: My biggest challenge is just not having enough of me to go around! There are so many things I love doing as a family physician--practicing medicine, teaching students, working on quality improvement projects, motivating other physicians to move toward EHRs, collaborating in my community — and just not enough time to do them all. Doing all of these things means balancing with family life and personal health. I am working ot say "no" when something that isn't within my scope of passion comes up. This is definitely a work in progress!
Q: What would/do you tell an undecided student considering family medicine?
Dr. Brull: I tell undecided students considering family medicine that it is a truly amazing specialty. Family medicine has so many options and allows family physicians to fit their practice to their interests. Family physicians are rural and urban. They are in the hospital, the ER, the ICU, the delivery room, the nursery. Youc an find them in nursing homes, public health centers, research institutions, birth centers, hospice houses, sports medicine centers and outpatient clinics. They provide international medical care, disaster relief services and continuity care in their own communities. They practice medicine across a broad spectrum as a specialty and sometimes a more narrow spectrum as an individual (hospitalists, sports medicine, laborists, hospice directors, emergency medicine). Youc an be anything when you grow up if you choose family medicine!
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Medical School & Residency
In Their Own Words: Family Physician Q&As
Dr. Jen Brull