May Newsletter 2018
What are we training new physicians to do? What were you trained to do as nurse, medical assistance, or IT? I can pretty much guarantee what you are doing now is different from what you were trained to do. Yes, there are some similarities, but the jobs we perform in health care are quite different.
25 years ago we were training family medicine residents to write in paper charts, look up information in the library, and in the really sophisticated systems, like our training clinic, use dictation devices with little cassette tapes. (Google if or see Guardians of the Galaxy if you’re not sure what a cassette tape is).
Residents saw patients one on one, mental health care was done with a psychologist who saw patients by appointment for 45 minutes.
Yet we changed. We developed teams, used an EMR back in the early 2000’s, and stopped using transcription services. Our residents looked up information on the World Wide Web and we taught them how to use the novel ‘on-line’ resources. We still had a library that took up the wall space of a typical exam room, and had just hired a guy named Kirk Strosahl with innovative ideas about integrated behavioral health.
Currently all the residents are in teams, we are doing group visits, the EMR continues to evolve, and we have over 3 FTE behaviorists at our site. Graduates are taking jobs with ‘Innovative Downtown Seattle’ clinics that are completely rewriting the way care is delivered. Some are in direct primary care practices that bypass most of the traditional system. And some still do full spectrum family medicine delivering babies and practicing in the hospital. At a time when drugstores have clinics, Uber is looking at delivering healthcare, and no one handwrites in a clinic chart, how can we possibly train for the future that changes so quickly?
Fortunately, it’s pretty simple. Do what has worked for decades. In family medicine we train the true generalist, the pluripotent stem cell physician. This physician can go into any system and thrive. Just like a stem cell can go anyplace in the body and function as needed, our graduates can fill any niche, even those rapidly changing niches.
Who knows, those residents you all help train may someday work for Apple delivering low cost health care to all their patients when and where they need it direct to the patient’s iphone!
Russell Maier, MD