Tuesday May 17, 2016

Six Lessons From Six Months as Medical Director

Take calculated risks. Lead by example. Be inspirational.

When I became the medical director of our office, I had a smattering of leadership clichés in mind that I thought I should follow. I anticipated that in my new role, I would communicate updates to the team, handle conflicts and set objectives.

But my first six months as medical director of our office involved little of the above. Instead, it's been a whirlwind of navigating teams and strengthening the patient and staff experience. Each day comes with 40 new lessons of you-don't-know-what-you-don't-know moments, personal growth and professional opportunities.

Here are a few of the interesting lessons I've learned.

Culture eats strategy for breakfast. Those who understand organizational psychology embrace this as gospel. It's the key factor in why companies with innovative ideas and solid revenue streams still fail. It's a business philosophy, but I've found it to be even more important in medicine.

An organization's core values need to be woven into decision-making at every level. We don't exist just to prescribe patients' medications. We are not here simply to track labs. Every person in my office is mission-driven (to transform health care). This is evident in both grand insurance battles and small gestures. Our team is diligent about prior authorizations and advocating for care our patients deserve. But we also never hesitate to make tea for a sad or an anxious patient in our waiting room. Our positive culture leads to internal coherence that sees opportunities in challenges. This didn't happen by accident. We invested in defining our culture.

Everyone -- including patients -- should feel ownership of your organization. In medicine, the term "stakeholders" applies broadly to employees, insurance companies, the specialists we refer to, the imaging centers we use and so on. But the most important stakeholders in medicine are the patients, who often feel as though they have little impact on health care. As a result, many medical organizations have started patient advisory groups. It's a good step, but I've learned patient feedback should be continuously integrated into health care organizations in as many ways as possible, not just via a feedback survey or siloed groups. My patients love sharing their experiences -- whether it's about their care, the lab or parking.

The next part is key: Be nimble enough to use feedback as a catalyst for change in your organization. We've expanded our services (we now perform endometrial biopsies, for example) as the result of patient feedback. We've even changed processes, such as instituting an RN consult before placing an intrauterine device. Listening to feedback is a key part of making sure patients feel ownership.

You'll know you are doing it right when patients refer to your office as "we" instead of "you guys."

Infuse your organization with a constant stream of new ideas. People who spend countless hours together start to think like each other. In fact, they start to sound like each other. They even use the same phrases. It's easy to spiral into an echo chamber where no one challenges group consensus. Ways to avoid the prevalence of stagnation include creative hiring and fostering a culture where individuals feel comfortable dismantling the status quo. In fact, 94 percent of senior business leaders said the right people and culture are the most important drivers of innovation, according to global consulting firm McKinsey & Co.

Meetings should be productive, clear and frequent. There are so many meetings. They are in person. They are via video conference. They are on the phone. Some meetings have just two people. Other meetings include hundreds from across our organization. At first, my meeting schedule was exhausting. I took a deep dive into the literature on meetings (this actually exists) and learned meetings require active management, with strict guidelines, attendees, timelines, etc. And it's better to meet frequently, because this contributes to accessibility and responsiveness. As a result, our meeting agenda includes goals and action items for each topic. We have developed a meeting cadence and determined who should be part of each meeting -- and who shouldn't. Our meetings are now more productive and efficient, and we avoid meeting fatigue.

Data without context is dangerous. In this big data era, everyone loves hard numbers. But sifting through those numbers without understanding how they fit an organization's mission is counterproductive. Even worse, sifting through them without realizing any trends or meaning is pointless. Patient volume, patient satisfaction scores, lab reporting times -- these are important, but they don't tell the whole story of an office or patient care. The clinical quality numbers (emergency department visits, blood pressure control, A1cs) can be even more nebulous without understanding your patient population. I'm still figuring this one out.

Invest in professional, leadership and team development. We hire people for potential, not perfection. They generally have core values that align with ours, but they still require structured training, careful mentoring and a path that will challenge them. Even in my short time at my practice, I've been delighted to see admins transition into membership advisers and site stewards become phlebotomists. And we emphasize that one role isn't above another -- it's just a different contribution to the team. It's for good reason: Companies with engaged employees who are inspired, empowered, confident and enthusiastic outperform those without by as much as 202 percent, according to Gallup.

Our team has learned the value of collective leadership. It makes sense that a group, and not just an individual, will have the best solutions to complex issues.

These leadership lessons don't include what I have learned about patient care. Those lessons can't be contained in one blog post. They are more suited for a novel.

This reminds me of another cliché: life-long learning. It's valuable to embrace. I anticipate the next six months (then six years, then six decades) will be rich with lessons.

Natasha Bhuyan, M.D., is a board-certified family physician in Phoenix. You can follow her on Twitter @NatashaBhuyan.

Wednesday Nov 12, 2014

Home Grown: South Carolina Schools Work Together to Address Primary Care Shortage

As a new physician, I sometimes reflect on whether or not primary care was the right choice for me. Over and over, the answer always is yes. Unlike many of my peers, I was a "late bloomer" in choosing family medicine. I started medical school with plans to be an OB/Gyn, and it wasn't until my fourth year that those plans changed.  

That year, I worked in Ecuador for six months, and that's where I finalized my decision to pursue family medicine. I worked on labor and delivery while I was there, but I also taught rural high-school students about sexually transmitted infections and nutrition. And I worked with a rural physician who saw men, women and children in a remote mountainous area called Cacha. Through that experience, I realized that I enjoy caring for all types of people -- from newborns to the elderly -- and that being able to influence mothers meant influencing the entire family.  

Courtesy University of South Carolina School of Medicine

Students at the University of South Carolina School of Medicine listen to a lecture. The school is collaborating with another medical school, a nursing school, and a physician assistant training program to expand the state's primary care workforce.

There are students who are in medical school right now, or even pre-med students still in college, who also might choose family medicine if they had the right experience or exposure to our specialty. How do we reach those students? And how do we keep the interest of those who decided early that primary care was right for them?

According to research by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, the United State is expected to need an additional 52,000 primary care physicians by the year 2025 to care for an aging and growing population, as well as for the rapidly expanding number of patients with health insurance. The situation is particularly grim in my home state of South Carolina, which ranked 40th in the number of primary care physicians per 100,000 people in 2012, according to the Association of American Medical Colleges.

The South Carolina Area Health Education Consortium has responded to this shortcoming by developing the Institute for Primary Care Education and Practice through a grant from the Duke Endowment. The institute is an interprofessional collaboration between two medical schools, a nursing school, and a physician assistant training program designed to increase the number of health professionals practicing primary care in South Carolina.  

The institute recruits first- and second-year medical students, nurse practitioner students, and physician assistant students to become fellows. These health professions students participate in monthly seminars focused on pertinent topics in primary care and an annual retreat with keynote speakers, and they have the opportunity for longitudinal precepting opportunities with primary care physicians, nurse practitioners and physician assistants. The seminars are held via video conference so that students at all the campuses -- which are more than 100 miles apart -- can interact with each other and the seminar speakers.

The institute is in its third year of funding and has experienced success in recruiting dozens of interested students into the fellowship. Many of the nurse practitioner and physician assistant graduates have remained dedicated to primary care as their career choice. This will be the first year of the program that fellows graduate from medical school, so we will have Match data available in the spring to help us gauge our progress.  

It has been an exciting time participating in the institute as a core faculty member and being able to influence so many young health professionals.  

I encourage family physicians to look for ways to foster the next generation of primary care physicians, regardless of whether your primary job function is as an educator. Students need the opportunity to see what we do in our practices across multiple settings, beyond the walls of an academic health center. You may not have a grant to support a project exactly like ours, but you can precept and show the joys we experience in practice as family physicians.

At medical schools, family medicine interest groups can collaborate in a manner similar to the way our South Carolina program works with multiple campus locations, extending limited resources and forming alliances across the state. The AAFP's FMIG Network can help with the tools to build those connections and support your work.

Meshia Waleh, M.D., is an assistant professor of family and preventive medicine at the University of South Carolina School of Medicine in Columbia.

Friday May 09, 2014

Looking for Inspiration, Rejuvenation? NCSC Could Be the Answer

Since graduating from medical school, I've made an effort to return to my alma mater for Match Day and hooding ceremonies every year. There's something about the energy that buzzes through the room at these events. So when frustrations like my electronic health records system or reimbursement issues weigh me down, spending a few hours among bright-eyed, future physicians reminds me of why I went to medical school in the first place.

When I was a student and, later, a resident, I attended the AAFP’s National Conference of Family Medicine Residents and Medical Students. I enjoyed the opportunities to learn, lead and connect with my peers. But as I began my new practice, I shifted away from conferences and focused on being a good family physician. I also had my own growing family to think about.

I testified on behalf of the women’s constituency during the Reference Committee on Advocacy at the National Conference of Special Constituencies in Kansas City, Mo.

Little did I realize how important these conferences, and the opportunities they present, can be when it comes to enjoying what we do. It’s easy to become entrenched in the negatives in the day-to-day grind of practice. More than once, I found myself in conversations at my office about the need to change policies that hinder my ability to do what I love.

Fortunately, one of our state chapter leaders asked if I would be one of our chapter delegates at the Academy’s National Conference of Special Constituencies. I was unaware of this conference, but he explained that it is the Academy’s leadership and policy development event for women, minorities, new physicians, international medical graduates, and physicians who self-identify as gay, lesbian, bisexual or transgender (GLBT) or who support GLBT issues.

Not only would I be able to discuss group-specific issues, it is a forum for change. I would have the ability to participate and learn about policy development and leadership. It sounded like a great opportunity, and I agreed to go as Nevada’s delegate for the women’s constituency.

When we arrived last week in Kansas City, Mo., my initial thoughts were that I would "get my feet wet" and just observe and take things in, but the event had a huge impact on me. I attended a workshop for first-time attendees and learned that I wouldn't be sitting in meeting after meeting or lecture after lecture. I would be participating in sessions where we would brainstorm policies, write resolutions and participate in our own caucus, elections and a business session.

After the opening session and plenary, I went to my constituency meeting. I admit I was intimidated by the fact that I did not know anyone in the room or what to expect. I was awed by the passion the delegates showed when we discussed the many health issues women face.

I watched as delegates volunteered to participate in the research and writing of resolutions that would be debated the next day in reference committee hearings. I felt the desire to make a difference and volunteered to help with a couple of resolutions after listening to the discussion amongst the delegates. The respectful banter in the room was refreshing.

In the afternoon, we had the opportunity to work with the other constituency delegates in writing resolutions. I worked with delegates from the new physician constituency and my own. At one point, I was struck by the fact that I was amongst physicians from a variety of different practice models who had come together from all over the nation to create a better environment not only for ourselves as physicians, but for our patients and communities, as well. At the end of the session, I proudly handed in our resolution feeling satisfied.

During this first day, I learned of opportunities to volunteer for committees and run for leadership positions. I wanted to learn more about the process, so I applied to volunteer and was selected for the teller's committee. With only a few hours of exposure to this conference, I was already feeling rejuvenated and hopeful.

We did more than debate Academy policy. Our keynote speaker, Paula Braveman, M.D., M.P.H., gave an eye-opening presentation on health care disparities. Breakout sessions taught me how to speak with legislators as well as strategies on how to overcome challenges in leadership. Other sessions covered a variety of topics, including the legislative process, social media, giving a keynote speech and the challenges facing new physicians.

Here's another bonus: NCSC runs concurrently with the AAFP's Annual Leadership Forum, which offered even more opportunities to learn.

One of my favorite aspects of these events was the connections I made. The networking opportunities were amazing. I had the pleasure of meeting like-minded but diverse individuals. Some were completely new encounters, and there were also those I previously had interacted with only on social media. An added benefit was the chance to meet AAFP directors and officers, who attended the discussion groups, business and breakout sessions, caucuses and committee hearings.

Another interesting aspect was having a chance to interact with Academy staff, who I found to be organized and efficient. I have never seen a conference run so smoothly.

On day two, the constituencies elected new leaders, and I fulfilled my duties as a teller. Listening to the candidates’ speeches inspired me to take part in the change (rather than standing around discussing it in my office back home). I testified in a reference committee on behalf of my constituency on a resolution that I co-authored. At the end of the day, I felt accomplished and had a sense of purpose -- to improve family medicine and the quality of care in our communities.

The third and final day featured the business session. The process and format are similar to those used at National Conference and, ultimately, the Congress of Delegates, which is the Academy’s policy-making body. Discussion on the various resolutions brought forth left me feeling empowered with new knowledge and a voice to share these ideas.

As I sat on the plane heading back to my family and practice, I felt a sense of renewal. It wasn’t only a feeling that I did indeed choose the right specialty but an inspiration to improve our specialty for future students who choose to practice family medicine.

I'm grateful for a forum where groups with specific concerns have a voice that can be brought to our Academy. I cherish the relationships I made during these past few days. I excitedly look forward to the 25th anniversary of this conference next year when it returns as the rebranded National Conference of Constituency Leaders. It is sure to be another inspiring few days. I hope to see you there.

Helen Gray, M.D., is an employed family physician in Reno, Nev., working in a hospital-based setting. She also is adjunct faculty with the University of Nevada School of Medicine. You can follow her on Twitter @helengraymd.

Thursday Mar 13, 2014

How to Maximize Your AAFP Membership

Did you ever attend the AAFP's National Conference of Family Medicine Residents and Medical Students? Or do you remember your first round of residency interviews?

We all likely had that moment in our experiences as developing physicians when we found "our people." It's the feeling that you have connected with colleagues who have the same passion, people who reinvigorate us with our shared vision of why we became family physicians.

During this, my second year of practice, there have been moments when that feeling of excitement, pride and shared vision got lost in the mounds of paperwork to sign, charts to complete and production numbers to meet.

Here I am (far left) with the new physician and special constituency delegates at the 2013 Congress of Delegates. Attending my first Congress and AAFP Assembly as a new physician was invigorating.

Then, I attended my first AAFP Assembly as a new physician last fall in San Diego. The passion was back! It made me feel energized and hopeful again, just like the Academy's resident and student conference had in the past. I was surrounded by my passionate colleagues, and I felt a little less alone in the challenges we all face in a system that is moving toward a primary care center but is still far from perfect.

The CME, of course, is the traditional draw of Assembly, but for me it's the energy and networking wrapped into it that makes it such a worthwhile trip. I saw so many old friends I didn't expect to see, and I came home with a reinvigorated sense of purpose and a reminder of why what we do on a daily basis is so important.

Important side note: new physicians get a discount on Assembly registration and other CME resources. This year's event is scheduled for Oct. 21-25 in Washington.

But here's one more thing to know about AAFP events: If you want your voice as a new physician to be heard in a powerful way, come to the National Conference of Special Constituencies (NCSC). This conference is held each spring in Kansas City, Mo., for the five designated special constituency groups of the AAFP – new physicians; minorities; gay, lesbian, bisexual and transgender physicians; international medical graduates; and women.

You can contact your state chapter about serving as a delegate for your constituency group, attending leadership development sessions, and writing and voting on resolutions that will influence Academy policy. The new physician delegate from each chapter has his or her airfare to Kansas City paid for by the AAFP.

This is one of the most exciting and energizing conferences -- especially for physicians who are new to practice -- to network with like-minded colleagues and make new connections across the country. This is your chance to build leadership skills to use in your practice and community, voice your opinion, and inspire yourself and others.

NCSC, which is held together with the Annual Leadership Forum, is scheduled for May 1-3 this year. Attendees who register by March 26 save $50.

So what else could you be doing to make the most of that check you write each year for membership dues? There's an AAFP resource for almost anything you encounter each day as a hard-working family physician.

You might be thinking …

"Uh-oh, I don't think I've written down any of the CME lectures I've attended in the past year. I've got to keep better track of this!"

Good thing the AAFP has a great CME tracker online to help you search CME events and keep them logged in one convenient place

"People keep talking about the patient-centered medical home, but I don't know where to begin."

The AAFP has a wealth of resources -- including a checklist and a step-by-step patient-centered medical home (PCMH) planner -- to help get you started in leading your practice in transforming to a PCMH.

"That's it. I'm going to march into the boss' office, remind him about the value I bring as a family physician and demand a better salary!"

Before you head into that important meeting, check out the AAFP's free resources related to contract negotiations. You also can find helpful resources in your free subscription to Family Practice Management

"I'm starting to feel a bit disillusioned with all the chronic narcotic issues I'm dealing with every day. I wish there was a better way."

Whether it's a hot topic or a core clinical issue in primary care, the AAFP has up-to-date resources and recommendations easily accessible for some of our biggest clinical challenges. You also can find CME by topic.

"I should write my senator a letter about this legislation right after I finish charts, sign off on these labs, go home, cook dinner, put the kids to bed, finish a few more charts, and … zzzz."

The AAFP tries to make it easy for us to be advocates for our patients, our practices and our specialty without burning the midnight oil.

There's so much more that could be listed. Think of your immunization question, practice glitch or policy frustration from the past day, week or month, and chances are there is something on the AAFP website to help get you an answer, give you support and give you a voice.

So like your resident and student conferences and residency interview days of the past, come find your people. Online or in-person, the AAFP has so much to keep us connected and inspired.

Amy McIntyre, M.D., M.P.H., is a family physician at the Butte Community Health Center in Butte, Mont., and her practice includes full scope outpatient care, maternity care and long-term care and hospice. She is a co-convener for the women's constituency at the 2014 AAFP National Conference of Special Constituencies and special constituencies delegate to the 2014 AAFP Congress of Delegates.

Tuesday Feb 18, 2014

It's OK to Ask for Help

Completing residency was one of the greatest accomplishments of my life. I had survived the grueling uncertainty of my pre-med years, finding any opportunity to make myself stand out among my peers. I had made it through medical school, with all its classroom endeavors and constant grilling from higher-ups. And now I had endured residency, with all its long hours, seemingly never-ending call and all the lessons those experiences entail.

I could no longer be viewed by others as a "pretend doctor." I now had a real job, and I had made it.

Along with this euphoric accomplishment came a certain confidence that I could do anything. Look what I had been through. I had mastered this, and now it was my turn to use my intelligence and training to heal, without a supervisor continuously looking over my shoulder.

Here I am listening to a patient. After 11 years of education and training, I still wondered if I knew everything I needed to know when I completed residency.

But it also came with the exact opposite feelings.

Did I really know enough to care for my patients?

Would they trust me?

Should they trust me?

What if I didn't know the answer to a diagnosis, what test to order or what treatment route to take? Eleven years was a lot of education and training, but was it enough? I wanted my new colleagues to be confident that they had hired the right person. I knew they didn't expect me to be perfect, but they did expect me to be competent.

In my final weeks of residency, an attending I had always admired offered some advice.

"Hey, I didn't feel fully comfortable with what I was doing until probably three or four years into practice," he said. "If you have any questions, you can always call me, even just for some reassurance. This is something we all go through, but it's not a weakness to ask for help."

I appreciated the sentiment. It came in handy with my patient Roger (not his real name). He was in his 50s and had some intellectual disabilities that would frequently impede our ability to properly communicate. Like many of the developmentally disabled patients I see, constipation was a significant issue for Roger. He had been hospitalized in the past for bowel obstructions, and he faced many social impediments due to this condition. I thought I could handle this problem with Roger and others. How hard could it be?

As it turns out, constipation can be fairly complicated. I tried a few things, stumbling around with treatment options, but I was not quite sure what I was doing. Despite feeling a bit silly for needing some help with this, I asked one of my colleagues who had more experience with this population. He gave me some pointers on which medications to try and how to use them effectively. Based on his advice, we were able to come up with a workable treatment plan for Roger that has kept him out of the hospital.

Not only has the experience not worsened the respect or relationship with my colleagues, it actually enhanced it. I was worried this might undermine my credibility, but it has done nothing of the sort. It seems that the more questions I ask or cases I run by my colleagues, the more they are willing to do the same. We have prevented many potential errors, and we have created better plans than what I otherwise would have come up with on my own.

No matter how many years of experience we have had in medicine, we have all seen different cases. I often ask residents about their experiences with certain cases, which has proven useful. None of us should feel self-conscious or hesitant asking for help, no matter how much or how little experience we have had.

I really appreciated that thought being shared with me as I began practice, and I've since found that it in no way tempers the accomplishment of my many years of medical training. In fact, it seems to more than justify it.

Kyle Jones, M.D., is a faculty member at the University of Utah Family Medicine Residency Program. He is the director of primary care at the Neurobehavior HOME Program, a patient-centered medical home for those with developmental disabilities. You can follow him on Twitter @kbjones11.

Tuesday Feb 04, 2014

Our Specialty, Our Future: Make Your Voice Heard

In 2002, the family of family medicine organizations saw a need to devise a framework for propelling the specialty into the 21st century, so they launched the Future of Family Medicine (FFM) project.

During that project, the Family Medicine Working Party -- the AAFP, AAFP Foundation, American Board of Family Medicine, Association of Departments of Family Medicine, Association of Family Medicine Residency Directors, North American Primary Care Research Group and Society of Teachers of Family Medicine -- came together to create a report that included recommendations to guide the growth of the specialty.

Gerry Tolbert, M.D.

As a medical student at the time, I eagerly applauded the lofty goals of this endeavor, including a patient-centered team approach, elimination of barriers to access, electronic health records, a focus on quality and outcomes, and enhanced practice finances. Laudable goals, all, and focused more on the care of the patient than on economics.

The final report was published in 2004. Fast forward 10 years. Although many of the goals and objectives of the FFM project have become reality, we still have to work to maintain the relevance of family medicine as a specialty. To that end, the Working Party initiated Family Medicine for America's Health: Future of Family Medicine 2.0 (FFM 2.0) last fall as the next step in planning the specialty's course.

The newest goals set forth include defining the role of the 21st-century family physician (both in terms of scope and nature of practice) and ensuring family medicine can deliver the workforce to care for a growing -- and aging -- population.

As new physicians practicing in the current environment with innovation inspired and directly created by the original FFM project, we have a unique perspective that can impact the direction of FFM 2.0.

Choices about scope of practice, location, lifestyle and a whole host of other environmental concerns dictate most of our decisions, not to mention the patient education and patient care decisions we make every day.

Decisions about work/life balance influence our choice of scope, but the mission all family physicians share is superb patient care. This new FFM report will offer us a chance to define our roles as new physicians and practicing family doctors in the much larger scope of a health care system in flux.

The FFM 2.0 project also will serve to direct the efforts of the AAFP and the other family medicine organizations in areas of concern for members and will help dictate where resources will be allocated for things such as workforce research and reform.

Being in the trenches seeing patients each day, as well as on the cutting edge of technology and innovation, new physicians can offer a unique perspective. We have the advantage of growing up with computers and tech that some of our more veteran colleagues have had to adapt to over time. That's not to say we have it all figured out. FFM 2.0 also allows our more experienced colleagues to pass on the wisdom of years of practice, especially if we as new physicians ask the right questions to get the advice we need.

But in order to get the questions answered or the topics addressed, we have to ask and give input. If you think an issue impacts the specialty (or even subgroups of the specialty), or piques your curiosity, now is the time to take those questions to the highest levels of decision-making because the research and planning phase of the project is scheduled to be completed by April.

You can read more about the project, including the questions being addressed, on the AAFP website. I encourage you to share your thoughts on the specialty's future at futurefm@aafp.org.

Gerry Tolbert, M.D., is a board-certified family physician who practices in northern Kentucky. A lifelong technophile, his interests include the intersection of medicine and technology. You can follow him on Twitter @DrTolbert.

Friday Jan 31, 2014

Fresh Perspectives Offers Platform for New-to-Practice Physicians

During my first few weeks in practice after completing residency, it was odd to not have anyone looking over my shoulder. When I wrote a prescription, there was no one to question, "Are you sure that's what you want to do?" When I ordered a test, it was up to me to follow up.

Although the other physicians in my practice were supportive, I had the sense that it really was just me now. I was a real doctor, and I had to make my own decisions. It's a new, different feeling when you don't have to have someone else checking your chart. It was overwhelming and a little bit scary.

 Kisha Davis, M.D., M.P.H., is the new physician member of the AAFP Board of Directors.

On the other hand, I knew I was well trained. And after a few weeks, my confidence started to grow. Each time I saw one of my patients getting better, there was reassurance that I was doing something right. Certainly, there were times when I questioned my judgment -- in fact, I still have those days -- but that keeps me motivated to continue learning and improving my skills to be able to provide the best possible care for my patients.

In residency, I learned that you have to know where to go when you don't know the answers. That could mean asking colleagues for advice or consulting the AAFP's website and journals or other sources.

Starting today, new physicians have one more resource available from the Academy. This new blog -- Fresh Perspectives: News Docs in Practice -- will be written by a group of new physicians who were selected based on recommendations from AAFP leaders and members as well as Academy staff who work directly with our membership segment.

The blog will give new physicians a platform to offer our own fresh perspectives on the challenges and issues we face and also to share our successes. Through the comments field, our new physician peers -- many of whom likely are dealing with similar issues -- also can join the dialogue and offer their own stories and suggestions. We hope that our more experienced family physician colleagues will provide their own knowledge and insights as well.

The new physicians we will be hearing from -- all of whom completed residency in the past three years -- represent different parts of the country and different practice types and have diverse backgrounds and interests. The blog will offer an opportunity for members to find, and talk to, other members who are in similar practice types and also to hear different perspectives on the issues we face.

Here are the new physicians who will be contributing to the blog:

  • Michael Brackman, D.O., Fort Hood, Texas;
  • Helen Gray, M.D., Reno, Nev.;
  • Megan Guffey, M.D., M.P.H., Tacoma, Wash.;
  • Kyle Jones, M.D., Salt Lake City;
  • Margaux Lazarin, D.O., M.P.H., Bronx, N.Y.;
  • Beth Loney Oller, M.D., Stockton, Kan.;
  • Amy McIntyre, M.D., M.P.H., Butte, Mont.;
  • Heidi Meyer, M.D., San Diego;
  • Peter Rippey, M.D., Marshall, Mo.;
  • Gerry Tolbert, M.D., Burlington, Ky.;
  • Jennifer Trieu, M.D., Seattle; and
  • Meshia Waleh, M.D., Columbia, S.C.

You can receive notifications when new blogs are posted by providing your email address under the "sign up" header in the right-hand column of the blog's home page. In the coming weeks, we will address a variety of topics, including the growing percentage of family physicians who are employed, the challenge of starting a new practice, avoiding physician burnout, finding work/life balance and more. What topics would you like to see addressed in this forum?

Kisha Davis, M.D., M.P.H., is the new physician member of the AAFP Board of Directors.

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The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.