Frederick Chen, MD, MPH, joined the faculty of the University of Washington, Seattle, in 2004, after completing the Robert Wood Johnson Clinical Scholars Program, a two-year fellowship in health services research. "During that time I developed my interest in combining research with health policy, which led me to work in Washington, D.C., for the federal government," Chen said. Chen was the Kerr White Visiting Scholar in the Center for Primary Care Research at the U.S. Agency for Healthcare Research and Quality (AHRQ), and also examined primary care research policy in the National Health Service as an Atlantic Fellow at the Public Health Policy Unit of the University College London. In addition to his position as associate professor of family medicine, Chen has a clinical practice at Seattle's Harborview Family Medicine Clinic. The county hospital serves an urban underserved population in which half of its patients are uninsured, and one-third are non-English speaking, Chen said. His practice provides prenatal and pediatric care, as well as addresses mental health and social needs.
Q: What led you to practice familiy medicine?
Dr. Chen: I have always been motivated by the community, family, and patient-based perspective of family medicine. No other specialty embraces the systems-based approach to patient care. Plus, the nicest people I met in medical school were invariably family physicians. I think of two pivotal moments – first was my sub-internship in Santa Rosa's family medicine program when I really experienced the excitement and fulfillment of community-based family medicine. The second was an elective at the CDC working on infections disease outbreaks. Although I was interested in infectious disease, it became clear that being a clinical generalist was a real asset; I could feel comfortable talking about everything from HIV/AIDS to maternal child health to chronic disease care.
Q: What is a typical day for you?
Dr. Chen: I really enjoy the flexibility of an academic career. Every day is different. I see patients 1-2 days a week, teach medical students and residents, work on research projects, and contribute to national health policy discussions about primary care and workforce needs.
Q: How have things changed since you entered the field?
Dr. Chen: There is currently a great deal of excitement and expectation for primary care. Policymakers and politicians understand and encourage primary care growth. There is a lot of hope that a health care system based on primary care can deliver better health for populations, and at a lower cost. At the same time, there is a greater emphasis on data and measurement, which is a new reality that physicians will have to embrace. Also, the focus on health care costs means that our health care environments are going to be constrained at a level that we haven't seen before.
Q: What motivates you to be involved in community service activities?
Dr. Chen: I have and always will enjoy seeing individual patients and building vital personal relationships. But so many problems that contribute to illness are social and societal in nature. I feel like community and public service is an extension of my clinic, and an opportunity to inform and intervene at a level that affects all patients, including the one sitting in front of me. I am currently working with the fedral government to implement primary care programs from the Affordable Care Act, such as Teaching Health Centers, which creates new primary care residency programs in Community Health Centers.
Q: What is your most vivid memory from medical school?
Dr. Chen: It was wonderful to be around so many smart, motivated, passionate people with a great diversity of interest and experience. Medical school was a unique time of growth for me and a place where I could really pursue my own interests and begin to build a professional life that resonated with my values and interests.
Q: What has been the greatest challenge you've faced as a family physician?
Dr. Chen: The greatest challenge is to provide high quality primary care to patients who are inexorably affected by their environment, social structure, and health policies. In many cases, these factors are detrimental to their health. I've chosen to address this challenge by becoming more active in health policy.
Q: What do you tell undecided medical students who are considering family medicine?
Dr. Chen: Family medicine has so much breadth and diversity in careers for all kinds of people. I would especially consider it if you are a generalist, want meaningful relationships with your patients, are interested in public health, teaching, or policy, or want to be part of the solution to American health care.
Q: What surprised you most as a new physician?
Dr. Chen: I came to appreciate how important it was to have good partners and colleagues. Clinical practice can be a lonely experience if you don't have good partners to discuss your cases with, share information, and work together.
Q: What do you love about your work?
Dr. Chen: I love being a generalist and being able to speak with experience about a wide range of clinical topics. I also appreciate the ability to bring clinical experience to research and health policy discussions. Importantly, I appreciate being part of a discipline that embraces not just the diversity of clinical care but also diverse career paths. There are family physicians in all levels of government, industry, and academia.
Q: What advice would you give your medical school self?
Dr. Chen: There was no way to know back then, but I'm reassured now that my choices and experiences would shape my career in a very positive way. I probably could have learned more about the way our health care system works but I don't know if I would have been ready to understand it.
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Medical School & Residency
In Their Own Words: Family Physician Q&As
Dr. Frederick Chen