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Wednesday May 13, 2015

Here's Why New Physicians Should Care About Global Health

For generations, the United States has proudly labeled itself a melting pot of cultures from around the globe. Not only has the influx of people continued -- it has accelerated. According to population projections released by the Census Bureau last year, 43.3 million documented and undocumented immigrants(www.census.gov) live in our country. Immigrants account for more than 13 percent of the U.S. population, the highest percentage in nearly a century.

With our patient populations becoming ever more culturally and ethnically diverse, it is important for us to be aware of how this cultural interplay affects our clinical encounters, treatment options and medical outcomes. Understanding and learning about my patients' cultures has improved clinical rapport, patient compliance and satisfaction. Hand-in-hand with this has come a boost in follow-up rates.

Here I am discussing international exchange opportunities available through Polaris. I spoke recently at Iberoamerican Congress of Family and Community Medicine in Montevideo, Uruguay.

As our world becomes more interconnected, both the interest in and need for global health has risen. Not surprisingly, those who have completed an international clinical rotation(www.stfm.org) tend to report an improved ability to recognize disease presentations in addition to more comprehensive physical exam skills with less reliance on expensive radiographic imaging. This is important because the United States has one of the most expensive health care systems in the world, yet our outcomes lag behind(www.commonwealthfund.org) those of other developed nations.

Global health initiatives allow us to interact with our international peers to learn about their medical systems, share best practices and strengthen our cultural intelligence. These opportunities are not only valuable for medical students and residents, but also for new physicians who are still solidifying their specific style and preferences for medical practice. With experiences through exchange programs such as FM360 (as described by family physician Aaron George, D.O.), who would not want to participate?

The majority of our newest physicians have grown up as part of Generation Y -- a.k.a., millennials -- and share a unique set of experiences and characteristics. Our entire lives have been inundated with modern technology, including cell phones, computers and the Internet. Notably, we are also more likely to speak a foreign language, engaging with both our local and global communities through face-to-face clinical encounters, online messaging and social media.

Although time and money can be limitations, physicians and medical students still may participate in the global health community through one of many organizations, including the AAFP or Polaris (our North American New and Future Family Doctor Movement) or via initiatives like our Balint 2.0 group(www.globalfamilydoctor.com) and the Polaris international journal club, the AAFP Center for Global Health Initiatives, the #1WordforFamilyMedicine(sites.google.com) social media project, the FM Changemakers(twitter.com) group and many more. Most of these novel approaches are discussed in the following section, and you can learn more by following @WoncaPolaris(twitter.com) on Twitter or joining the Wonca Polaris group(www2.facebook.com) on Facebook.

Recent Events
Maria del C Colon-Gonzalez, M.D., and I recently represented the Wonca Polaris group in Montevideo, Uruguay, at both the Iberoamerican Congress of Family and Community Medicine and the Young Doctors' Movement (YDM) preconference. We served on the preconference organizing committee and as speakers and moderators for small-group discussions that took place during the preconference. Later, at the congress, we participated in the rural medical education panel, made four oral presentations, including one regarding improving research methods for residents and new physicians and presented two posters. The presentations resulted from collaboration with family doctors from countries around the region, including Peru, Uruguay, Colombia, the Dominican Republic, Portugal and Spain.

Undoubtedly, evidence of Polaris' positive effect in the Latin American region went far beyond posters and presentations. One such example was a Polaris initiative -- the Balint 2.0 Ambassadors -- which has united all seven Wonca YDMs in the first-ever multi-international online Balint group. Of the 14 international participants, five were present in Montevideo.  

Additionally, the social media project #1WordforFamilyMedicine, which launched eight months ago during the AAFP Global Health Workshop, has gone viral in Iberoamerica. The project asks family physicians and residents to describe their favorite part of our profession in a single word on Facebook or Twitter. Responses are then collected and the lists are turned into "word cloud" images that represent the specific participating region/country. Of the 50 countries that have participated, almost half are in the Iberoamerican region.

Evidence of the project was abundant during the conference in the form of T-shirts, photos, mugs, posters and more. This ongoing project has helped unite young family physicians from different parts of the world and has improved our specialty's image around the world.  

World Family Doctor Day
May 19th marks a special day for family physicians: World Family Doctor Day. The AAFP and family medicine organizations around the world will be celebrating in different ways. Family physicians are asked to display the #1WordforFamilyMedicine image on our social media profiles. An online interactive map(bit.ly) shows the countries that have provided images to date. Go to the map, and click on the image over your country. Right click, save and display on your profile.

Also on May 19, I will be speaking with medical students about the intersection of family medicine and global health through the live social media series Family Medicine On Air(www.youtube.com) hosted by the AAFP's Family Medicine Interest Group Network.

Lastly, the Polaris-led ASPIRE Global Leader Program will launch on World Family Doctor Day. We welcome medical students, residents and new physicians who want solidify their leadership skills and become more involved in global health to participate.

Looking Ahead
Polaris is focusing its efforts on organizing Wonca North America's first international preconference, which will take place on Oct. 1 in Denver before the AAFP Global Health Workshop. Both of those events are being held in conjunction with the AAFP's 2015 Family Medicine Experience (formerly Assembly).

In addition to our Canadian and Caribbean colleagues, the preconference's organizing committee is delighted to have assistance from other regions' YDMs. The preconference and the Global Health Workshop will give medical students, residents and new physicians opportunities to develop in the areas of research and scholarly activities, as well as in leadership and mentorship.

Kyle Hoedebecke, M.D. is a 2013 graduate of the Womack Family Medicine Residency in Fort Bragg, N.C.  He is a clinician in the U.S. Army, an assistant professor at the Uniformed Services University and serves as the chair of Polaris. Speaking Spanish, Portuguese and Guarani, his passions include global health, traveling and spending time with his family.

Posted at 03:43PM May 13, 2015 by Kyle Hoedebecke, M.D.

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