Barbara L. Sheline, MD, MPH, has made private practice, academics, global health, clinical innovation and service to the underserved all part of her career. She practices the full scope of care, including obstetrics, through her position as assistant dean for primary care and associate professor of family medicine at Duke University School of Medicine. Dr. Sheline teaches at the university and sees patients in Duke's clinic, which incorporates elements of the Patient-Centered Medical Home model. Dr. Sheline joined the Duke faculty in 1990, after completing a fellowship in social medicine at the University of New Mexico.
Q: What led you into the practice of family medicine?
Dr. Sheline: I discovered family medicine while I was completing my MPH after my third year of medical school. I recognized it as my specialty based on the focus on individual and population prevention and community outreach.
Q: What surprised you most as a new physician?
Dr. Sheline: I thought I had to know all the answers by the end of medical school, or at least residency. No one told me that practicing doctors look up information or seek help nearly every day. That is the first thing I tell my new students. Especially now in the computer age, it is easy to say, "I don't know, but I will look it up!"
Q: What do you love about your work?
Dr. Sheline: I love the relationships I have developed with my patients, my students and my teaching faculty. My greatest reward is when I see empowered patients and students taking the lead in their lives. I have learned to let go of my expectations and let my patients and students guide me more.
Q: What do you tell undecided medical students who are considering careers in family medicine?
Dr. Sheline: Family medicine is at the forefront of the new paradigm in health care. It is reinventing itself and we are not sure exactly what it will look like in the future. I anticipate more coordination with community resources, more team care, inclusion of electronic visits, improved communication when the doctor is needed, and creative use of information technology. Family medicine is the field for people who say, "It is not about the diagnosis, but about the person who has the diagnosis. Who is that person? I am curious. How do I serve them?"
Q: What community service are you involved in, and what motivates you to do this work?
Dr. Sheline: I work to link students to community health work. I serve as the faculty advisor for the North Carolina Student Rural Health Coalition, Duke chapter, which runs a free clinic with the community of Freemont, NC. I also serve as the liaison for the Schweitzer Fellowship program at Duke. These groups give direct service to our underserved communities, and it is that need which motivates me to participate.
Q: What is a typical day for you?
Dr. Sheline: I usually start my day early in my garden. I have a beautiful garden of edible fruits as well as lovely flowers. I ride my bicycle to work on many days. My work week is split 50-50 patient care and teaching. I direct the practice course, which teaches doctor-patient communication and clinical skills to all Duke medical students. I also direct the brand new Primary Care Leadership Track at the med school. I also see patients on three different days. I have had some patients for almost 20 years. I am caring for the children of patients I knew as children. I really love my patients. I feel so lucky to both teach the next generation of doctors and to have a robust medical practice.
Q: What is the Duke Primary Care Leadership Track?
Dr. Sheline: This work is extremely rewarding as I work with wonderful staff, faculty and students to create change agents for the future of primary care. We are creating a four-year program that allows students to follow patients over a year or more, work with a community team caring for the underserved, and be trained in leadership skills and community-engaged research.
Q: What is your most vivid memory from medical school?
Dr. Sheline: Meeting the man that would become my husband in the lab the first day of medical school, and getting married a year-and-a-half later, just before our clinical rotations.
Q: How have things changed since you entered the field?
Dr. Sheline: We carefully created a fantastic team approach to patient care in our clinic. Our patients are better served. The providers and staff support each other as team members. I still have my wonderful relationships with my individual patients.
Q: What has been the greatest challenge you have faced as a family physician?
Dr. Sheline: My greatest challenge was balancing being a mother, a wife and a family doctor. I worked part-time for a number of years. We always hoped to work overseas, so when our children were 13 and 10 we moved to San Ramon, Nicaragua, for nine months. There we served during the crisis of Hurricane Mitch, gave free medical consultations in remote rural villages, home schooled our children and improved our Spanish!
Q: What advice would you give your medical school self?
Dr. Sheline: Take time to get to know faculty who may have similar interests. I was careful to keep balance in my life all through medical school. I was determined not to let it diminish who I was as an artist, a dancer, a gardner and a partner.
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Medical School & Residency
In Their Own Words: Family Physician Q&As
Dr. Barbara Sheline