Tuesday, August 17, 2010

A Pause, And A (Somewhat) New Beginning

As might have become amply evident at this point, this blog is not following the path its name implied.  When I started writing here, way back when, I was hoping to discuss issues surrounding health care in underserved and marginalized communities.  However, with health care reform last year and early this year, as well as many opportunities to comment on issues of the day, my plans have been diverted.

I still hope to discuss issues surrounding underserved communities and health care, but it will evidently be through a broader, health care reform perspective.  I think this is still relevant, considering that health care reform will change the landscape for health care in and for marginalized parts of the US, but I wanted to bring this out in the open in case the blog name/title deceives.

Meanwhile, my professional situation has changed somewhat.  Rather than working full-time in Southside Richmond,  I am now splitting time between that community practice and the family medicine faculty practice at the medical center.  This change will hopefully be a positive move: I'll be more involved in teaching, can start thinking more about research ideas, and can be a resource to students who might have interest in family medicine as a career.  The kicker, though, is that I will not be working as often with underserved or uninsured patients.  The faculty practice usually does not work with the hospital's patient assistance program.  The department has been very generous, and has made it such that any patient I was already seeing who has coverage through the patient assistance program will be able to continue seeing me, but I won't be taking new patients covered through that program.  As a balance, I will be helping staff a medical and pharmacy student teaching clinic at a free clinic on Southside. 

Although I am excited about this, I feel a little conflicted: I have talked the talk about the need for docs to work with patients who lack access to care that I feel self-conscious about walking the walk to a different practice site.  I believe that working with the free clinic and with the largely Spanish-speaking, mostly Medicaid-covered community on Southside will continue to drive me as my mission.  But it will take time to adjust.

This family medicine department is my home department: this is the medical school from which I graduated, and the department is the one with which my residency was affiliated.  I feel very welcome here, and have found many kindred spirits.  So I move on, sort of, but I also settle in.  But I will always keep working to do what I think is right for patients: both those I directly care for, and for what I perceive as the greater good.


DrSnit said...

We NEED TEACHERS TOO. When the students are ready, the teacher comes. When the teacher is ready, the students come.

:) It is like that. I shifted more and more from PRACTICE to teaching in my career and still do primarily.

It is ok to make changes. YOU ARE NEEDED. YOUR VOICE IS NECESSARY. You must get through to the younger docs in training... they need to hear YOUR VOICE helping them see the other sides.

They have hero hearts - but YOU MUST BRING IT OUT. They NEED YOU. Do not be conflicted over making the RIGHT CHOICE. Teaching is a POWERFUL AND NOBLE thing.

I adore you. I am proud of you. You are doing a good thing. Just don't get into bed with any drug reps.

mark said...

Thanks, Melissa. That's how I'm looking at it, too, but it's a significant refocus after 7 years in practice.

Thus far, I've sort of stumbled in to jobs: practice in a small town of 900, working in an outpatient clinic of a university hospital system, and now the faculty practice/teaching. I trust that I'll end up where I'm needed. Doesn't make the transition much easier, though.

DrSnit said...

Transitions are never easy. They are part of the process. Thanks for sharing yours!

DoctorKJ said...

Welcome to the wild and rewarding world of Family Medicine education. As Melissa mentioned, the nurturing of your residents with not only your knowledge but also your mission will have an impact on far more lives than you could have ever touched as a physician by yourself. Train them well and your reward will be seeing your vision of service multiplied many, many fold.