Having recently transitioned from private practice in rural Oklahoma to a full-time faculty position at the Univeristy of Oklahoma School of Community Medicine, Russell Kohl, MD, FAAFP, brings a full-scope expertise with him to the academic community. Dr. Kohl has been practicing full-scope family medicine for seven years, including surgical obstetrics and endoscopy, with a strong focus on community involvement and public health. His new role brings him to Oklahoma's second largest city, Tulsa, where he strives to prepare medical students to address the health disparities and social determinants of health they will need to treat in their careers. Dr. Kohl served on the AAFP Board of Directors as its new physician member in 2010-11.
Q: What led you to family medicine?
Dr. Kohl: I was a firefighter/EMT (emergency medical technician) before going to medical school and expected to go into emergency medicine. However, when working in a family physician's office in college, I discovered the satisfaction of relationships that come from knowing my patients on a personal level. In emergency medicine, I took action and got immediate feedback, but never knew what happened to the patients. Family medicine gave me the emotional fulfillment of knowing the rest of the story.
Q: What is a typical day for you?
Dr. Kohl: I'm currently transitioning from private practice into academics, so every day is a new and different one. My time is split between practicing medicine and teaching residents and medical students. Due to a strong interest in health care policy and clinic-based research, a moderate amount of time is spent meeting with other organizations and people trying to improve the health care process in our community.
Q: What do you tell undecided medical students who are considering family medicine?
Dr. Kohl: Follow your heart. The money will work out, the loans will get paid off and your family life will be what you make it — regardless of your specialty of choice. The thing that determines your happiness is whether you wake up each morning and think you are making a difference in the world. You can make that difference every day as a family physician.
Q: What surprised you most as a new physician?
Dr. Kohl: How little oversight there was. After years of having things double checked by upper levels and attendings, it was very odd to find that I was now my own quality control. It forced me to develop matricies to give myself ongoing feedback about the quality of care I was providing, and encouraged a strong focus on continuing to learn and develop as a physician.
Q: What do you love about your work?
Dr. Kohl: To this point, it has been delivering babies. It's not like medical school, where you don't know them and will likely never see them again. To deliver a baby that you have already cared for in utero and then to watch them grow and succeed has been the most rewarding part of my practice. I have also enjoyed working with medical students as a rural preceptor and watching them develop into thoughtful, confident physicians. As I move into academic medicine, I expect this to be an even more rewarding part of my career.
Q: What motivates you to be involved in community service?
Dr. Kohl: The same thing that moves me to family medicine — I want to make a difference. Not everything that improves someone's life is medical. Sometimes the friendship and fun of cub scouts, the fitness and teamwork of sports, or the camaraderie and sense of community from Rotary are the things that make the difference our patients need to succeed.
Q: What is your most vivid memory from medical school?
Dr. Kohl: Watching each of us change over the four years as we attempted to master information, balance lives, learn healing and jump through the hoops of academic has given me profound respect for them. Among my best friends from medical school are family physicians, radiologists, ER docs and even a pediatric neurologist. However, the passion of that first day medical student can still be seen in each.
Q: How have things changed since you entered the field?
Dr. Kohl: I was one of the last groups to train before the work hour restrictions earnestly went into effect. I think that shaped my expectations of what practice is like. My first seven years were as a rural, full-spectrum family physician, with the last three in solo practice. It was very fulfilling, but it has become increasingly obvious that students and residents are scared of the demands and uncertainty in that career path. It is my goal to help build that passion for helping the underserved, and the confidence it takes to do it well, to a new generation of family physicians, and to get them excited about the challenges and rewards of rural practice.
Q: What advice would you give your medical student self?
Dr. Kohl: You're going to pass the USMLE tests, so don't worry about them. Instead, take every minute to understand the physiology of the human body. There are still unnamed diseases and zebra cases that you could miss. They won't be on the test, but they'll be in your office someday. If you understand how the body works, you can figure out what's going wrong, even if you don't know the name of the syndrome.
Q: What has been the greatest challenge you have faced as a family physician?
Dr. Kohl: The need exceeds my ability to fulfill it. There are simply too few doctors to fill all the needs in our community, state and nation. I've been very active in developing telemedicine projects, supporting physician recruitment programs and expanding residencies to increase the volume of physicians available. I've worked with many excellend mid-levels and have been able to see physician-led teams improving patients' lives when a single physician would never have been able to accomplish it all.
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Medical School & Residency
In Their Own Words: Family Physician Q&As
Dr. Russell Kohl