By Kevin Bernstein, MD, MMS

First, we want to congratulate all students who matched in family medicine!  Welcome to the Family Medicine Revolution  (#FMRevolution)! We also want to congratulate all students who matched in primary care residencies AND who plan to stay in primary care!  We all need to work together to provide increased access to quality primary care to our future patients. Over the past few weeks, I have had the pleasure to read summaries of match results from various schools and various national organizations.  Trust us, we are excited about the 11% increase in Family Medicine and the 94% fill rate - the most all time - for Family Medicine!  However, there are many misleading reports flying around from various sources touting their production of primary care.
 
more...

By Matthew Mintz, M.D.

Most articles about why medical students don’t choose primary care will say that a career in primary care simply won’t pay off the enormous debt accrued in medical school. Indeed, the average 2010 graduate came away $157,944 in debt. And primary care salaries are in fact far lower than those of other specialties, a disparity that is increasing. However, I repeatedly ask medical students if they would choose a career in primary care if it would completely erase their student loan debt. A few hands go up, but not many. In fact, for a while now, the federal government has dedicated millions of dollars to repaying loans for students who choose primary care. Yet residency match numbers show that the percentage of students choosing primary care is not increasing.  Though loan forgiveness is a step in the right direction, medical students realize that by choosing a more lucrative specialty, they can pay off their loans just fine.
more...

By Diana Tucci

“There – there’s a space between those two layers that you have to fold that edge into, do you see that?” I said to the older woman sitting next to me. I had never met anyone worse at following directions. It was a Lunar New Year celebration and she wanted to learn how to make origami paper cranes. It had been a long and tiring day, and I was in a bad mood for most of that time. My friends had left without me and I was waiting for someone, anyone, to drive me home so I wouldn’t have to walk back in the cold of a Pittsburgh winter. She sat there, bent over her work, apparently ignoring the things I was showing her. I was really starting to get frustrated.

“No, I can’t see anything,” she replied. It wasn’t until then that I realized she was blind.

more...

By Mark Ryan, M.D.

When I entered medical school in Richmond, Virginia, I was certain I wanted to be in primary care but I was not yet sure what specialty.  Once I had decided to work in a medically underserved community I chose family medicine because in a rural site, where resources are limited, there is added value in the breadth and scope of family medicine training. I would be able to see all patients, regardless of age, gender, or initial symptoms. This training served me well when I took my first job after residency, in the small town of Keysville, Virginia.  In Keysville, I worked for four years providing care to patients in town and in the surrounding counties.
more...

By Annie Mooser

The training requirements for Peruvian physicians are an exceptional experience which link doctors to the culture and circumstances of the country’s impoverished residents.  Through that country’s mandatory rural service year, a requirement for anyone who wants to practice in a public Peruvian hospital, there is potential for the physician to develop clinical skills in the most dire of circumstances while forming an intimate relationship with an isolated community.  There, it is easy to appreciate and admire the talents of Peruvian physicians and their understanding of their patients’ realities.
more...

An Interview with Lucy Hornstein, M.D.
By Sonya Collins

Video by Joanna Hornstein

Family physician Lucy Hornstein has been in practice in Pennsylvania for more than 22 years.  In this three-minute mini-documentary produced by her daughter, Pennsylvania College of Art & Design student Joanna Hornstein, Dr. Hornstein shares what it means to be a family physician. 
 
On her blog, Musings of a Dinosaur, Dr. Hornstein describes herself as, “A family doctor in solo private practice, I may be going the way of the dinosaur, but I’m not dead yet.” The blog inspired the material for her 2009 book Declarations of a Dinosaur: 10 Laws I’ve Learned as a Family Doctor.

Watch the video here, then see what Dr. Hornstein told us about caring for families in all stages of life and writing about her work.
 

more...

By Cody Dashiell-Earp

The first time I read Better by Atul Gawande, I was inspired by his advice: “Count something…it doesn’t really matter what you count. You don’t need a research grant. The only requirement is that what you count should be interesting to you.” Then I went to medical school, and I got scared. I learned about selection bias, recall bias, and the dreaded lead-time bias. Truth, it seemed, came only from a randomized controlled trial or a petri dish, and numbers, which I once understood so well, seemed unrecognizable under a veil of p-values and ROC curves.
more...

An Interview with Rushika Fernandopulle, M.D.
By Sonya Collins

Iora Health is building a new model of primary care from the ground up that changes how patients receive and pay for care.  Dr. Rushika Fernandopulle is the founding director of Iora Health, and he told Progress Notes about this new model.

more...

By Katherine Ellington

Doctors providing primary care deliver definitive care to the undifferentiated patient at the point of first contact taking continuing responsibility for providing the patient's care....Primary care physicians devote the majority of their practice to providing primary care services to a defined population of patients....the personal primary care physician serves as the entry point for substantially all of the patient's medical and health care needs - not limited by problem origin, organ system, or diagnosis. Primary care physicians are advocates for the patient in coordinating the use of the entire health care system to benefit the patient.
—American Academy of Family Physicians
 
The attributes and skills described above are cultivated through years of personal growth and professional development beyond textbooks. Primary care physicians need to share their unique white coat experiences to advance first-hand knowledge of the profession. I’m telling the story of my experience with a doctor who opened office hours for me to learn.

more...

An Interview with Sanjeev Arora, M.D.
By Sonya Collins

In rural New Mexico where hepatitis C is widespread, rural primary care doctors lacked the expertise to treat it while specialists were only found hundreds of miles away at the university. So Dr. Sanjeev Arora, gastroenterologist and hepatologist at the University of New Mexico, founded Project ECHO.
 
Through Project ECHO, rural doctors present their patients’ cases to university specialists via video conferencing in order to learn best practices for the treatment of hepatitis C. The project’s great success with the disease has led Arora to expand the program to other conditions that challenge rural doctors.
 
Watch a clip of our video conference with Dr. Arora where we interacted with him in the same way that rural primary care doctors do. Then read the full interview below. 

more...