Tuesday, September 30, 2008

Register for the Primary Care Mixer


Register Here!

When: Friday, Oct. 10th, 2008 from 5:30-8:00pm
Where:
Boston Medical Center, East Newton Pavilion,
2nd floor, Conference Room C & D
Click Here for Maps



Are you...
  • a Medical Student interested in Primary Care?
  • a Resident in a Primary Care specialty?
  • a Faculty member in a Primary Care dept ?
  • an Alumnus practicing Primary Care?

You are invited to join us for the final celebration of a series of events for National Primary Care Week (Oct. 5-11th). This is an event for medical students, residents, faculty and alumni to network for and promote recruitment and retention in Primary Care medical practice. Casual attire recommended. Hors d'oeuvres, including a chocolate fountain, will be served (budgets are tight). Live music provided by generous and talented medical students.

Sunday, September 28, 2008

National Primary Care Week @ BUSM

Mon Oct 6 @ 5:30: "Crisis in Primary Care"
Speaker: Dr. John Abramson, family doctor & author of "Overdo$ed America"
Location: Hiebert
The two speakers will examine the critical shortage of primary care physicians and implications on health policy and patient health. Dr. John Abramson is an award-winning family physician, on the clinical faculty at Harvard Medical School. His publications include "Overdosed America." He will discuss the growing waste and comercialism in American medicine and identify health policy solutions.

Tue Oct 7 @ 12:00 Solutions- Patient-Centered Medical Home

Speaker: Dr. Charles Williams, Family Medicine
Location: R-109
The Patient-Centered Medical Home (PC-MH) is an approach to providing comprehensive primary care established by the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, and American Osteopathic Association.

These groups, representing about 333,000 physicians, created a set of 7 principles for the PC-MH:

1. Each patient is entitled to a personal physician
2. The physician is the leader of a team of individual practitioners
3. Whole person orientation
4. Care is coordinated and/or integrated using the latest and most appropriate technology
5. Quality & safety
6. Enhanced access to physicians
7. Payment schemes that reflect the value of the PC-MH for patients' health.

Register here


Wed Oct 8 @ lunch: Primary Care Tables, Lobby
We will be selling fruits with chocolate fondue. Information sheets will be provided about primary care highlighting statistics, critical issues and ways to get involved. There will also be a membership sign-up for the American Academy of Family Physicians (FREE) for those interested. Membership includes subscription to American Family Physician, a twice-monthly journal, scholarships to conferences, and other discounts and benefits.

Fri Oct 10 @ 12: Global Health and Primary Care

Speaker: Dr. Thea James, Emergency Medicine
Location: L-112
Dr. Thea James is an Assistant Professor of Emergency Medicine at the Boston Medical Center. She graduated with an MD degree from Georgetown University School of Medicine in 1991, and finished her residency in Emergency Medicine right here at the Boston Medical Center. She has gone to Haitian hospitals to provide care with more modern technology, and is also the Co-Director of a BMC based Haitian Health Institute.

Fri Oct 10 @ 5:30: Primary Care Mixer
Location: BMC East Newton Pavilion, 2nd floor, Conference Room C/D
Come meet and talk with primary care residents, faculty, medical students and alumni.
Register here

Tue Oct 14 @ 5:30: Geriatrics Workshop
Hosted by Boston University Chapter of the American Geriatrics Society
Speaker: Dr. Won Lee
Location: L-414
How well will you function when you are 85?

Join Dr. Lee and the BU Chapter of the American Geriatrics Society as they host an Interactive Aging Workshop to explore and experience the aging process. The workshop will be a hands on experience based on Xtreme Aging programs found at other medical schools.


Wed Oct 15 @ 6:00: Medical Activism Panel
Speakers: Dr. Michael Grodin (BUSPH), Dr. Felton Earls (Social Medicine, HMS), Dr. Joia Mukhergee (PIH, HMS), Dr. Jay Bhatt (PGY1 Cambridge Health Alliance, past AMSA president)
Location: Bakst
A multi-generational panel of physicians will reflect on the role activism plays in their medical careers and discuss the important of activism in medicine today.

Saturday, September 27, 2008

Patient-Centered Medical Home

The Patient-Centered Medical Home (PC-MH) is an approach to providing comprehensive primary care established by the...
  • American Academy of Family Physicians (AAFP)
  • American Academy of Pediatrics (AAP)
  • American College of Physicians (ACP)
  • American Osteopathic Association (AOA)
These groups, representing about 333,000 physicians, created a set of 7 principles for the PC-MH:
  1. Each patient is entitled to a personal physician
  2. The physician is the leader of a team of individual practitioners
  3. Whole person orientation
  4. Care is coordinated and/or integrated using the latest and most appropriate technology
  5. Quality & safety
  6. Enhanced access to physicians
  7. Payment schemes that reflect the value of the PC-MH for patients' health.
Indeed, since the development of this model, it has been touted as a potential solution to the challenges of providing quality health care for the entire US population. According to the Commonwealth Fund,
The Commonwealth Fund 2006 Health Care Quality Survey finds that when adults have health insurance coverage and a medical home—defined as a health care setting that provides patients with timely, well-organized care, and enhanced access to providers—racial and ethnic disparities in access and quality are reduced or even eliminated.
Find out more about this New Model for primary care at the following events at Boston University Medical School.

Upcoming Events

Tuesday, Sept. 29th, 2008 @ 12:00pm
BMC Family Medicine Grand Rounds
The Medical Home, physician reimbursement plans, and other solutions to the crisis Primary Care
Dr. Charles Williams
Dowling 1 Conference Auditorium
Free Food

Tuesday, Oct. 7th, 2008 @ 12:00pm
--National Primary Care Week--
Solutions: The Patient-Centered Medical Home
Sponsored by FMIG
Dr. Charles Williams (BMC Family Medicine) will facilitate a lunchtime discussion on the Patient Centered Medical Home as a potential solution to the crisis in primary care. Participants are encouraged to attend Dr. Williams' talk at the Family Medicine Grand Rounds.

Dr. Williams' Bio


References

Monday, September 22, 2008

Mass Crisis: Is This The Future of Health Care?

The recent Massachusetts legislation to mandate health insurance has been touted by many as a victory in health care reform. Implementation of this experiment in solving to US health problems, however, still presents many challenges.

Mandatory Health Insurance...plenty of patients but where are the doctors
?

A recent article in the Boston Globe (Sept. 22, 2008) highlights a few of the upcoming challenges that Massachusetts will face as a result of the upcoming implementation of the MA health insurance mandate. The most immediate of these is the lengthy wait times for receiving an appt. with a primary care physcician (PCP). The average wait time to see an Internist was 52 days and 46 days to see an OB/GYN.

These long wait times are the result of a shortage of PCPs, lack of focus on preventive health care, administrative burdon, and misdirected physician compensation schemes. According to MMS President Dr. Bruce S. Auerbach, who recently addressed a session of the National Congress on Health Reform in Wasington, D.C., there are severe labor shortages in:
  • Internal Medicine
  • Family Medicine
  • Vascular Surgery
  • Neurosurgery
  • Cardiology
  • Anesthesiology
  • Psychiatry
  • Gastroenterology
  • Urology

How to Increase PCP Supply?

In an attempt to increase the availability of PCPs, the federal and state government have funded a number of programs, including:

  • loan forgiveness programs
  • advanced medical home pilot projects
  • expanded primary care training
Medical school for free?!?!?!

From the Boston Globe article...
The Massachusetts law includes $1.5 million this year to help the University of Massachusetts Medical School expand its class size - from 103 students to as many as 125 - and to waive tuition and fees for students who agree to work as primary care doctors in Massachusetts for four years after they finish training.
This is indeed a crisis situation. If the state is moving towards free education for medical students interested in primay care, it is a clear sign of the dire circumstances facing the population of Massachusetts, and the rest of the United States.

So what can be done about this?

There are several proposed solutions. Together with AMSA, FMIG has planned a series of events for National Primary Care Week (Oct. 5-11) to highlight the challenges and potential solutions facing health care in the United States of America. Come and find out for yourself what we can do as future health professionals to best prepare for the difficult sitations waiting for us upon graduation.

References
Resources

Wednesday, September 17, 2008

Study showing fewer medical students intending to become primary-care physicians

Check out this new report and the corresponding JAMA article.
http://jama.ama-assn.org/cgi/content/full/300/10/1154

NBC Nightly News (9/9, story 10, 0:30, Williams) reported that a new study shows that few medical school students plan to become primary-care physicians. Most "are going into specialized fields instead."

USA Today (9/10, Rubin) reports that "medical students are shying away from careers in general internal medicine, which could exacerbate the U.S. doctor shortage expected by the time the youngest baby boomers head into their senior years," according to a study published in the Sept. 10 issue of the Journal of the American Medical Association.

In fact, "only two percent of graduating medical students say they" were considering practicing as primary-care physicians, the AP (9/10, Johnson) adds. By comparison, a similar survey conducted in 1990 showed that nine percent of medical students were interested in primary care. The data showed that "paperwork, the demands of the chronically sick, and the need to bring work home are among the factors pushing young doctors away from careers in primary care." Lead author Karen Hauer, M.D., of the University of California-San Francisco, pointed out that "it's hard work taking care of the chronically ill, the elderly, and people with complex diseases -- 'especially when...doing it with time pressures and inadequate resources.'"

For the study, researchers surveyed "1,177 medical students last year, found just 24 wanted to practice primary care, while 23 percent were interested in internal medicine, whose subspecialties include cardiology and cancer care," New York's Newsday /Bloomberg News (9/10) notes.

Salaries in primary care dissuade medical students from the field. The Columbus Dispatch (9/10, Hoholik) reports that "fewer U.S. medical students are choosing careers in family medicine because of long work hours and low pay," according to a research letter published in the Sept. 10 issue of the Journal of the American Medical Association.

Mark H. Ebell, M.D., of the University of Georgia, "examined whether there is an association between specialty selection and anticipated incomes using current data," MedPage Today (9/9, Groch) added. He used "residency information...from the National Residency Match Program," and "mean annual salary in 2007 came from the annual American Medical Group Association survey of physician salaries."

Dr. Ebell found that "family medicine had the lowest average salary ($185,740), and the lowest percentage of filled residency positions (42.1 percent)," Modern Healthcare (9/9, Robeznieks) noted. And, "internists, with the third-lowest salary of $193,162, had the third-lowest residency fill rate: 55.9 percent." In contrast, "radiologists -- whose average salary was $414,875 -- had a residency fill rate of 88.7 percent; and orthopedic surgeons -- whose average salary was $436,481 -- had a fill rate of 93.8 percent." Dr. Ebell wrote that "the correlation between salary and primary-care physician shortages -- which, in turn, may be tied to higher all-cause cardiovascular, cancer-specific, and infant mortality rates -- has persisted since his original research on this issue was published" in 1989.

Researchers say racially diverse medical schools may better prepare students. HealthDay (9/9, Preidt) reported that "attending medical schools with high levels of racial and ethnic diversity may better prepare white medical students to care for minority patients," according to a study published in the Sept. 10 issue of the Journal of the American Medical Association. Somnath Saha, M.D., of the Portland VA Medical Center, and colleagues, "analyzed data from a Web-based survey of 20,112 graduating medical students from 118 medical schools." The researchers "found that white students at medical schools with the highest quintile (one-fifth) for student body racial and ethnic diversity, measured by the proportion of underrepresented minority (URM) students, were 33 percent more likely to rate themselves as highly prepared to care for minority patients than white students at medical schools in the lowest diversity quintile -- 61.1 percent vs. 53.9 percent, respectively." Notably, "this association was strongest in schools in which there was positive interracial interaction."

The study also showed that "students from under-represented minorities were significantly more likely (at P<0.001) than either white or non-white/non-URM students to plan to work with the underserved, at 48.7 percent, versus 18.8 percent, versus 16.2 percent, respectively," MedPage Today (9/9, Smith) added. The authors of an accompanying editorial argued that these findings "might persuade medical schools to do more to encourage diversity." The St. Louis Post-Dispatch (9/10, Bernhard) also covers the story. This week's JAMA Report video features the study.

Monday, September 8, 2008

Sports Medicine Series

Dear all,

The Family Medicine Interest Group is presenting a year-long workshop series in Sports Medicine, featuring Dr. Alysia Green, a Sports Medicine doctor at BMC.

Dr. Green will be giving an Introduction to Sports Medicine talk on Wednesday, September 10th from 11:30-12:30 in room L-110. Lunch will be provided!

Each month, Dr. Green will be presenting on a different aspect of her practice as a Sports Medicine physician. Students will be able to learn about these exams and practice interactively on each other with assistance from Dr. Green. Workshops and seminars include:
-boarding
-joint exams
-taping
-concussions

If you are interested in going to any of the workshops this year, you MUST attend this Wednesday's talk! Each workshop will be open to sign-up on a first-come, first-serve basis after that.

Thursday, September 4, 2008

FM Scholars program

Dear FMIG members,

Marcel suggested I post here to be sure you all know about our Family Medicine Scholars program. You can learn about it at:

http://www.bu.edu/familymed/medstudenteducation/scholars.html

We currently have 4 active scholars, and more joining shortly. If you are interested in learning more about this program, which is unique to our department, please contact me. My email is: John.Wiecha@bmc.org


John Wiecha, MD, MPH

Director of eLearning / Director of Predoctoral Education
Department of Family Medicine, Boston U. School of Medicine
eLearning website: www.bu.edu/familymed/distance/index.htm
Second Life: http://slurl.com/secondlife/Teaching%209/21/132/23