Community Health

What was the natural choice for a resident who would rather be seeing her continuity patients or volunteering at the free clinic than performing a stat c-section or putting in a central line? Yes, I was that resident, but I didn't have the answer - so I sought advice from two faculty members who knew me quite well... Dr. Flori and Ms. Bloomgarden. Their answer - community health. And then it became so obvious.

I work at New Horizon Family Health Services in Greenville, South Carolina. We are a community health center that seeks to provide a medical home to the underserved members of our community. The training I received at GPFM has equipped me with the knowledge and skills necessary for this type of medicine. I am able to see my patients within the context of their past experiences, social situations, and belief systems, which I believe makes me able to care for my diverse patient population. I credit my residency experience for shaping me personally and professionally for this type of work; however, the lessons I learned are not specific to underserved medicine.

Allow me to illustrate: I have had numerous patients bring me a list of medications that they were taking prior to losing their jobs, thus losing their insurance. As I glance over the list I hear Dr. Clemenson saying, "Find comparable drugs on the $4 list. What's the point of writing scripts for drugs you know they can't afford?"

I see a depressed, passive lady and I hear Ms. Bloomgarden, "Have you asked her if anyone is making her feel unsafe?"

When facing a diagnostic challenge I'm tempted to check off every lab on the order sheet. But then I hear Dr. Truong, "If you're going to order a lab, know what you are going to do with the results. If the results won't change your management, is there a reason to order them?"

"Look it up, Bostrom!" "Don't say anything you wouldn't write down." "If you know how to describe something, you can usually come up with the diagnostic terminology." That is Dr. Owens' advice I remember on a daily basis.

"Have you assessed his readiness to change?" Dr. Flori is coming in loud and clear. I know this is the first question I must answer before launching into one of my lectures regarding unhealthy behaviors.

In those circumstances that leave me wondering if I'm making the right decision, it's Dr. Palmer's voice I hear, "Did you call his cardiologist? Did you get her on the phone and ask her what she would advise? Call her now!" And that gives me the courage to dial a number and admit that I'm unsure of the next step.

You get the picture. Oh, I have at least one time per clinic session when I'd love to run into the precepting room and have someone else more experienced help me work through a confusing situation. Yes, most of the time, I can map out my argument (I mean, plan) and justify my decision with sound evidence.

Residency was intellectually challenging and physically exhausting. There were days when it seemed, at the time, my faculty was only trying to make my life harder! If I had only known then that they were preparing me for NOW.

Great Plains became a family of individuals who shaped me as a doctor. That is a gift I can pass on, but never repay.