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Monday Jun 19, 2017

Who Will Mentor the Next Generation of Family Doctors?

We all have had great teachers in our lives; one of mine lived and worked in rural southern Georgia. Dr. B. was a wise family physician who introduced me to his practice of medicine, which included a busy office and working in the hospital when his patients landed there. He taught me not only about medicine but also about his community. He knew more about his patients, I thought, than I would ever know about mine.  

Today, as the associate dean of the Medical College of Georgia, I am constantly looking for preceptors who will engage with students, as well as with patients, and energize both to want to know more.

I'm not alone. The Society of Teachers of Family Medicine (STFM) held a summit last summer to address a shortage of high-quality family medicine community preceptors. According to STFM, nearly half of allopathic family medicine clerkship directors report difficulty finding clinical preceptor sites(www.stfm.org).

Finding preceptors is especially tough in this era of transition from fee-for-service to quality metrics and value-based care. We physicians can feel at times that we are in service to our electronic health records and have only limited time for students. After all, teaching takes time, and time is money.

But if we don't make time for students, where will that leave us? Who will be the next generation's Dr. B.?

A 2015 survey of fourth-year medical students who were AAFP members revealed that 93 percent of respondents who matched into family medicine residency programs said strong family medicine mentors influenced their specialty choice. Conversely, of those who didn't match in family medicine, only 60 percent said they had a strong mentor in the specialty.

Other factors play a role in student choice, but clearly, students are less likely to choose family medicine without strong mentoring and role modeling.

We know what's at stake, but you still might be asking, "What's in it for the practicing physician?"

Before taking my current position, I was in practice in a small community, and later became faculty with the family medicine residency program in my hometown. The experience was as rewarding for me as seeing patients. Students keep you on your toes, challenge you to stretch your knowledge base and compel you to stay up-to-date. I recall one young man from Germany, for example, who was doing a rotation in the States. I learned as much about health care in another country from him as he did about family medicine from me. 

Today, it is my privilege to teach third-year medical students. At our campus, we connect students with patients and have them follow those patients during their third year. What we see are young people getting in touch with the real reason they went to medical school in the first place. 

Students have stresses of their own -- competition for residency positions and concerns about school loan debt, to name just a couple. It takes a special person to mentor or precept them. Students need to see the best among us, and we need them to see the joy of family medicine.

If you've lost that joy, having a student in your office might just help you rediscover it. I have seen this become a new mission in physicians' lives -- giving back to the profession and the field we love. 

Think about it, we need to train the next generation of family physicians, family physicians who will one day take care of us. What better way to ensure our future health care than to have helped trained those who come along the path behind us? 

Family medicine is about teaching. We teach our patients about the concerns they have about their health, and it naturally follows that we can teach students about our job on a day-to-day basis. But it also is about relationships. The relationship between physician and patient, between physician and community, between physician and student. 

For me, family medicine is like visiting with friends every day. I know each patient personally. We talk about their health issues, but also about their families. Establishing those relationships is what makes it worthwhile. As a new physician, I soon came to realize I knew more about my patients than I ever thought I would, just like Dr. B. 

Leonard Reeves, M.D., is a member of the AAFP Board of Directors.

Posted at 03:10PM Jun 19, 2017 by Leonard Reeves, M.D.

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