21st National Conference – Reports from Tuesday Breakout Sessions – April 13, 2010

The 21st National Conference on Primary Health Care Access met in six breakout sessions on Tuesday, April 13, 2010. The following question was posed to each of six teams:

You are developing an Internet-based program designed to interest medical and pre-medical students in family medicine and community-based primary care. What kinds of information would you bring to their attention to encourage them to consider primary care and family medicine as a career choice? What would you like students to know about what family doctors do and how they interact with their patients?

Team 1. Hines (Lead), Bejinez-Eastman, L. Burnett, Erickson, Ross, Wilke

[Ross] Promotion of lifestyle of FM-“Do what you want to do” the wide variety of choice in career paths..

Target areas which historically produce FP’s-Community focused (target rural and local communities)

Reaching out to rural areas:

  • 4H (careers in health-special interest groups)
  • Scouts-School outreach
  • FFA Career counselor
  • Grass roots
  • Make sure residency programs have FM docs/residents at career days at school, offer in –residency experiences
  • Booth at residency program meetings in KC-including AFMRD and Annual Conference of students and residents-all PD’s are worried about FM and want something to improve our applicant pool.
  • Local “SON” (?) group need a champion at each location to be successful
  • Package pre-selected materials for community outreach activities, and address immediate as well as long-term needs
  • Show people what a career in FM looks like: daily activity journal, international medicine, many and any others. Show them exciting aspects of the career,  including packaged on-line content (through Studentdoctor.net)
  • Coordinate with the State chapters and State/local orgs and Chapters

“The closer you get to the kids/local level, the better the response”

[Other particpants]
What and how to implement (ideas):

1. Have a doctor keep an online journal that gives a glimpse of being a family doctor

2. Create YouTube clips, perhaps of interactions with a few patients, like a mini-reality TV show. Could subsstitute for shadowing for those students who do not have good opportunities to shadow a doctor.

3. Connect students with local physicians. Lunch with a family doctor program, outreach to high schoolers, local mentoring. Maybe send local residents to do community outreach (schools, junior colleges), possibly partner with community-based nonprofits and campus groups for undergrads.

4. Arrange shadowing experiences at community health centers.

5. Keep things local if possible; encourage personal contact

6. Provide advising for students without resources at their schools

7. Invite family physicans to submit articles, ideas to www.studentdoctor.net (existing forum users)

8. Feature medical mission work.

10. Feature global health partnerships.

11. Physician’s personal and inspiring stories – their own.

12. Tell why we went into family medicine.

13.Talk about choice of procedures and flexibility in designing your own practice (USIM?)

14. What FP docs do that students might find exciting and interesting.

15. Information to bring to students’ attention:

Focus on long term relationships with patients.

“Brand” family medicine and address the fit with student interests.

Show that FM docs see a variety of patients with t a variety of disease states = not just the same procedures over and over.

Feature FP docs working in global health or in high level positions, in order to inspire and show that these opportunityes do exist.

Highlight patient stories about their FP doc and show the value and benefit from the relationships.

Ask community health center residents to write about their experiences.

Show us having FUN at work.

Relationships, fun, trust, and community leadership.

Basic exposure to role models, practice content, mentoring

International work feature

Health policy issues and food policy

How FPs can influence policy development.

Team 2. Babitz (Lead), Clover, Fowkes, Frey, Hara

What  impact of teaching students:

* Not necessarily the content of the message is important, but how teaching is delivered and relating to the new pedagogy for the millenial student, i.e. group teaching, podcasts. Family medicine can be leaders in this.

Fowkes, session scribe.

Team 3. Herman (Lead), Baird, Fernandez, Kimball, Lee, Maudlin

[Below: Team Three discusses Internet Web-based Student Interest; from left front, clockwise are James Herman, MD, MSPH; Betsy Kimball; Macaran Baird, MD; Enrique Fernandez, MD; Jay Lee, MD and Robert Maudlin, Pharm. D.]

Tuesday April 13, 2010 Team 3 Breakout Sessions

Media: Mayo/ABC News Primary care spot

Politics: Workon on institutional level (Buy-in)

Medical Student interviews Clips

Emergy  <—> New physicians/residents

Blog feeder. Social justice

PCMH/LEAN

Wihi

Personal statement by your besdie

Idealistic/optimistic/courageous vs cynical

Fuzzy logic vs concrete-operational

Negotiation techniques

CAQs: geriatrics, sports, adolescents

“Family physician of the month”

Facebook fan page

Technology

Longitudianl experiences

How do I become the doctor that I want to be

Public Policy Education.

Team 4. Freeman (Lead), Casey, Flinders, Fort, Osborn, Troy

Look at your patient with both eyes (science and mystery/art; biology and spirituality)

Do it like a dating service to do intake of the student and match them to FPs for shadowing/networking

Find out why students don’t come and address it: (Salary and benefits; mission and values)

Is this the wrong question? Shouldn’t we be asking how to get students into medical school that are prone to be in primary care?

Make it relational! It’s about the Love.

Tell them we’re nicer and happier.

What if the medical school admissions committee has to reflect workforce needs? (50% primary care/generalist physicians)

Tell students that their loans will be forgive if they practice in a Health Professions Shortage Area for three years (go, hope! go!)

Address the myths

FAQ; put in positive way. If you love seeing a variety, and are not afraid to get out of bed at night to watch a miracle happen.

As Jamie Osborn for her poem “I am a Family Physician” and put it on YouTube.

Team 5. North (Lead) Coleman, Hixon, Peck, Vega, Webster

Team 6. Pugno (Lead), W. H. Burnett, Hansen, Kasovac, Palafox

[Below: Team Six discusses Internet student interest websites at Dondero’s; from left, clockwise, Perry A. Pugno, MD, MPH; Thomas J. Hansen, MD, Mitchell Kasovac, DO; William H. Burnett, MA; and Neal Palafox, MD.]

Tuesday April 13, 2010 Team 6 Breakout Sessions

This already exists through the virtual family medicine interest group, through the unprotected PowerPoint presentation “Your Future In Family Medicine”. The traffic is enormous, usually looking for CME. The newest area of contact is premed students.

There is a national organization of pre-health guidance counselors. There is a guide for all of the health sciences.

A concern expressed by the American Academy of Family Physicians: many people in rural areas don’t consider a career in medicine. The AAFP has products down to the seventh grade.

AAFP links with Facebook, twittering, tweeting, and readily built connections and relationships.

On www.studentdoctor.net, there are online discussions of career paths. There is sharing of information among the two websites www.studentdoctor.net and www.coastalresearch.org. All of the articles that appeared on studentdoctor.net that are relevant to coastalresearch.org exist on this website also.

Vision for Hawai’i. IMIHOLA: Seekers of health; socially disadvantaged. Allows those in the neighboring Hawai’ian islands that there is a career in medicine in Hawai’i for them, leading to them returning to their home islands. Native Hawai’ians constitute 20% of the population of the state, but have only 3% of the physicians.)

How to dialogue and connect on curricula.

Regular leadership: those trying to get with medical schools, residency programs.

The University of Hawai’i has to Maui campuses. There are many private colleges, mostly doing things on-line.

Success of mini-clinics: they have immediate results and reflect desires of consumers.

AHEC  (area health education center networks).

Schools of osteopathic medicine have a heavier emphasis on primary care. The basic science faculty are socialized to primary care, and have been involved in admissions paired with primary care physicians.

The underlying philosophy of osteopathic medicine includes touching and the emphasis on body, mind and spirit, and the body’s ability to heal itself. There is great role modeling in DO schools on patient/physician relationships.

The American Association of Medical Centers appear committed to preserving the status quo, whereas AAFP promotes a heavy push into primary care. The AAFP sponsors forums and groups to address bigger questions. The AMA is not really representatative of physicians (only 11% of physicians belong to the organization).

We need to determine how many medical students actually go into primary care five years post-graduation, to eliminate the counting of those going into sub-specialties and hospitalist positions.

New legislation will be available to train physicians and nurses in the community health center system.

OB/GYN has shifted from arguing it is a primary care specialty to positioning itself as a surgical specialty, due to the latter’s greater reimbursement rates.

COMMENTS

This was an amazing meeting.  Thank you for the invitation.  Ilook forward to next year!

Thomas J. Hansen, MD, Creighton University