Blog
Power of Diagnosis: Delivering Bad News Is Just the Beginning
I first met TJ when he was newly diagnosed with HIV. Good-looking and soft-spoken, he was an out, young, gay black man who considered himself a leader amongst his peers. TJ had been infected recently, and knowing that patients diagnosed early are thought to enjoy better outcomes if they start medications quickly, I figured he would do well. We agreed to try Triumeq (abacavir, dolutegravir and lamivudine). Although that medication is generally well-tolerated, the difficulty of treating his infection soon became apparent. TJ reported strange...
read moreTry PROBE Tool to Help Stave Off Burnout
When a friend of a friend of mine committed suicide recently, it hit me harder than I would have imagined. I didn’t know the man and knew little about him other than that he was an emergency medicine resident and a member of the gay, lesbian, bisexual and transgender community. When I learned of his tragic passing, I went back and read something he had posted on social media a couple of years ago that stood out as particularly poignant: He wished he could be more proud to be a gay physician and support others who struggle with...
read moreMarie-Elizabeth Ramas, MD … Family Physicians Are Dream Catchers
It helps to remember that we hold the key to the health of our patients, a point that was driven home at this year’s AAFP National Conference of Constituency Leaders. I often hear that this conference is the heartbeat of the Academy, the place where key issues are tackled with an emphasis on change. Each chapter is invited to send representatives from constituencies historically underrepresented in AAFP leadership: women; minorities; new physicians; international medical graduates (IMGs); and gay, lesbian, bisexual and transgender...
read moreAccelerating into Family Medicine
In the summer of 2013 I was sitting in a small humid room in a coastal agricultural town in Ecuador, a young community health Peace Corps volunteer working on his personal statement to get into medical school. A few months later I received good news, acceptance to UC Davis, specifically the new accelerated medical school experience into primary care. I had worked a year in Ecuador, and as I reflected back on the parts of the work that brought me the most joy, it was the long term relationships I had built and trying to promote healthy...
read moreRetiring Physician Reflects on Career in Family Medicine
Many years ago, I brought my new stethoscope up to Community Hospital and the Family Practice Center across the street on Chanate, and spent three wonderful, intense years starting to learn to be a family doctor. And began building relationships with people who came to call me their physician, and with people who came to call me their colleague or co-worker. Or friend. I then took my stethoscope down to Rohnert Park and continued to learn to be a family doctor. A few of my patients came with me from Chanate. I spent a lot of years there,...
read moreFMRevolution: The Evolution Volume 1, Issue 2
When I was a medical student, I was uncertain how to become a leader. What I was certain of, however, was my love of free pizza. So there I was, a first-year medical student chewing on a lot of free pizza to hear what this club or that club might offer me in terms of a leadership opportunity. Well, after eating an ample share of free pizza, I started to get a feel for what interested me and got involved. I went on to become finance chair for the Asian Pacific American Medical Student Association National Conference and later, chair of the...
read morePassing the Family Medicine Torch
An ancient Chinese philosopher said ‘journey of a thousand miles begins with a single step’. But what Lao-Tze failed to mention was that the traveler is often nudged into taking that first step. In my case, it was a fellow resident more than 18 years ago who said to me, “Jack, I’m going to San Francisco with the residents group for the CAFP annual meeting. Do you want to tag along?” And as they say “the rest is history.” During the next dozen or so years, I learned three important lessons as an...
read moreFamily Medicine and Patient Centered Care Are the Best, Most Cost Effective Care for our Patients
I want to share a recent anecdote from my clinic which highlights how patient centered family medicine is cost effective and simply good care for patients. I saw Mr. F, a 75-year-old gentleman. Like many of my patients, he has a history of high blood pressure and obesity. He also had a heart attack in the past as well as two additional stents placed in his coronary arteries. I was seeing him in follow up to his hospitalization. Given the patient centered medical home (PCMH) model that Kaiser Permanente uses, I could easily pull up all the...
read moreMy Experience: Attending Medical School in Cuba
During one of my breaks from medical school in Cuba, I rotated at a US hospital. I was rounding with a third year Family Medicine resident who had a patient with a pleural effusion that needed draining. The resident had not done a thoracentesis before and the attending asked him to locate where he thought we should insert the needle into the patient. He was not comfortable with this and went to get the Ultrasound. While we waited with the patient, I percussed the patient’s back and could hear where the sound went from light to dull,...
read moreFamily Medicine Revolution: The Evolution
Our hashtag #FMRevolution (aka Family Medicine Revolution) was born in 2011. At the time, my aims were two-fold: “Become the physician you wrote about in your personal statement.” That family physicians and other primary care providers realize we are better than what the status quo values us at and we need to ‘revolt’ against the currently fragmented health care delivery machine that exists right now (we’ve been great playing in the sandbox historically, but we must shift the health care system vector permanently away from...
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