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Monday Nov 25, 2019

AAFP Leaders Give Thanks for Paths to Family Medicine

Editor's note: With Thanksgiving approaching, we asked some members of the AAFP Board of Directors why they're glad they chose family medicine. Here's what they shared.

[happy thanksgiving table concept]

Thankful for Patients

I went to medical school with the dream that I'd be able to do it all. As we plodded through basic sciences, anatomy, pathology and all the other challenges presented during the first two years of medical school, the thing that kept me going was the promise of the extremely bright future at the end of that dark tunnel.

As I endured my clinical rotations, I found myself falling in love with everything.

Internal medicine? Yes, absolutely.

Pediatrics? Yes, I love kids.

Geriatrics? Of course!

End-of-life care? So important and necessary.

In the end, I loved it all. It was natural for me to choose family medicine because I wanted the ability to help anyone and everyone.

More than one attending tried to dissuade me from family medicine. I don't remember any of them. I was so directed, so focused, on achieving my dream of becoming a family physician, that I was an MS4 juggernaut tossing aside the naysayers. And I got my first choice in the Match.

I'm thankful for the opportunity of experiencing it all -- the specialties, systems and diagnostic pathways -- during my clinical years. And I'm thankful for all the inspirational family physicians and primary care pediatricians and internists I've had the privilege of working with (and being cared for by) throughout my life. I'm thankful for my rural training, the advantage of being able to do it all for all, covering two hospitals and our rural clinic.

I'm also thankful for my family physician colleagues because every day you inspire me to be better, to do better and to live better.

Last, and not least, I know our patients are thankful for us. They tell us that through handshakes, hugs, tears, gifts, food, hellos and goodbyes. I want to remember and exclaim that I am so thankful for them!

Andrew Carroll, M.D., Chandler, Ariz.

Relationships Built Over Decades

I have practiced family medicine for 40 years. That's plenty of time to be thankful of my choice, and I always have been.

I chose the field because of its variety, the opportunity for long-term relationships, the fact that patients are embedded in family and community, and because I didn't want to get bored, which I thought might well happen in a subspecialty. And I wanted to make a difference.

Family medicine exceeded my expectations in each of these elements. I never quite know what will be behind the next door. The relationships have been great, especially because I did obstetrics early in practice and I watched those children grow into adults. In fact, a few of the children I cared for later entered medical school and one is a family physician. I'm thankful for that, too. The family aspect was most notable in the intergenerational aspect of my practice, and it was common to discuss relatives, especially kids and grandkids, during office visits.

I can honestly say that during all these years, I never had a day in which I was bored. Tired, sometimes puzzled and running late, but never bored.

I am thankful to be part of a specialty that makes a huge difference in the world around us, both for individuals and communities. Collectively, we are often the glue that holds the health delivery system together, and our brand of comprehensive, integrated, continuous care is needed now more than ever. And that feels good.

Dennis Gingrich, M.D., Hershey, Penn.

Up to the Challenge

My life is a life of service, and I was called to be a family physician. Throughout my training, attendings sought to discourage my career choice. "You're too smart to be a family physician," they said. When I talk to other family medicine leaders today, this experience is shared nearly unanimously.

Twenty years ago, I attended a hearing in the Texas House where all the state's medical school deans were present to argue against a proposed bill that would tie a medical school's funding to the percentage of its graduates practicing primary care five years after graduation. The deans categorically denied that their schools were discouraging students from family medicine, despite 100% of the family physicians present saying they were.

After that meeting, I was invited to a focus group at my medical school's orientation retreat the following fall, where the primary care doctors talked about the need to change the culture. Changing the culture of medical schools is a huge undertaking, but one that still must be done. Tying funding to medical school outcomes would bring about change faster than anything else.

During my clinical rotations, I loved all the disciplines and could not imagine choosing between my pediatric and geriatric patients, giving up longitudinal care and actually knowing outcomes. I love GYN office procedures and skin procedures, including laceration repair. As a family physician, I can do all these things; I bleed family medicine. The best and the brightest students should be encouraged to become family physicians. Here's to the most challenging and rewarding career around.

Erica Swegler, M.D., Austin, Texas

Grateful for Mentors

I am most thankful for having an excellent mentor when I was choosing my specialty. I had gone to medical school with the intention of going into orthopedics and sports medicine. My mentor, David Stevens, M.D., was an orthopedic surgeon. We had many discussions about the paths available to reach my goals, but the more we discussed orthopedics, the more I wondered if that was what I really wanted. Dr. Stevens suggested I think things over and let him know what I wanted to do.

During that time of reflection, I thought about all the things I had enjoyed doing during my clinical rotations. I realized that I enjoyed the comprehensive care found in family medicine. When we met again, I told Dr. Stevens that I had chosen family medicine and explained that this gave me the comprehensive approach to medicine and my patients that I longed for and thought would serve my community well. We talked more about medicine and the changes in health care since he had been in my place as a student. I asked him to write my letter of recommendation for the Match, which he did.

Thinking back on that time, I realize I had a wise mentor who understood me well. He understood what I was seeking and what path would take me there. His help led me to a community where I have practiced comprehensive family medicine, including deliveries in my early career. That choice allowed me to coach a pee wee football team made up largely of boys who I had delivered a decade earlier. This is the type of community story that occurs so frequently in family medicine, and it is the kind of tale that makes me thankful for my mentors, my patients and especially for family medicine.

Windel Stracener, M.D., Richmond, Ind.

A Partner in Health

I am thankful to be a family physician because it gives me the opportunity to provide high-quality, comprehensive care to a diverse and underserved population. I am thankful to be able to promote prevention, develop longstanding relationships, and impact the health and well-being of my community.

Family medicine is simply the best. We are active participants in the lives of our patients at every stage of life, and I am thankful to be a partner in the health and well-being of my patients.

I am thankful to be able to fulfil my commitment to be a caregiver, a promoter of hope, a healer and a guide for patients seeking a path to wellness. Being a family physician is my calling, and it has been a privilege. I can't imagine myself doing anything more fulfilling.

I also am thankful to be part of an organization that cares for patients, the community and our members. Family medicine is one of the more innovative specialties, and we are on the front lines of our nation's health.

AAFP President-elect Ada Stewart, M.D., Columbia, S.C.

Thankful for Family Medicine

I was the first person in my family to attend medical school. Along the way there have been some things I simply didn't know ahead of time. Consequently, when attending physicians asked, "What do you want to specialize in?" I, with great pride and enthusiasm, would respond, "I'm going to be a family doctor."

I had no clue this was a bold medical student move. Who knew there was a right answer, and it was whatever specialty that particular attending had chosen?

I was not prepared for their sometimes rude and off-putting responses, in which they accused me of wasting my time, talent and money in my chosen career path. I'm horrified that medical students continue to experience this reaction.

I'm thankful I didn't know what I was up against. I didn't have the opportunity to have my dream deferred, and I am grateful to now have the opportunity to shape medical culture so we can someday make this narrative obsolete.

As a family physician, I can care for families in our communities, advocate, research, publish, present, lead health systems, explore public health interventions and take on other duties as necessary.

I didn't have to give up of the things they warned me about. In fact, I continue to learn and grow with each year. I am out here living my best life and I'm not an exception. Family physicians are changing lives and making the world better every day and I will be forever thankful to be a part of the family.

Margot Savoy, M.D., M.P.H., Media, Penn.

The Opportunity to Serve

With the arrival of autumn, nature pauses to renew itself for the upcoming year. The chill of an impending winter transforms the lush green forests into a palate of autumn hues inviting children to play in the fallen leaves that once hung far from their reach.

After harvesting the fields that sustain our lives, we pause with nature to give thanks for the many blessings we experienced during another season of growth.

I pause to give thanks each day. Each evening, before I go to sleep, I recite a portion of the Prayer of Jabez: "Bless me indeed and enlarge my territory." This is followed by a request that the same blessing be bestowed upon those individuals I have known in my life, those who remain in my life and those I have yet to meet. I give thanks that our journeys will share a common path. In this moment of silent self-reflection, I am often reminded that as a family physician I have been granted the privilege of living a life many seek but never achieve.

As I was leaving my office late one evening, I walked past one of my students who was sitting at a table hunched over piles of papers and books. I paused to ask him how he was doing. He looked up at me, smiled and said, "I'm living the dream, Dr. LeRoy. I'm living the dream."

Each autumn, I witness hundreds of gifted young people vying to be accepted to medical school. They are drawn to the pursuit of medicine in an effort to serve the world as healers, to make a difference in the lives of others and to enlarge their territory by acquiring a professional skill of great purpose to society.

As a family physician, I am eternally thankful for the opportunity to serve my community, our AAFP members and our nation. Although our profession may suffer through winters of frustrations, it is a cycle of life that prepares us for a joyful season of personal renewal.

Happy Thanksgiving to our family of family physicians. May your territories continue to be enlarged.

AAFP President Gary LeRoy, M.D., Dayton, Ohio

Posted at 04:01PM Nov 25, 2019 by Andrew Carroll, M.D.

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