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Wednesday Apr 30, 2014

Medical Student Advocates Make Big Impression on Legislators at FMCC

When I sat down at my state's table at the Family Medicine Congressional Conference (FMCC) earlier this month, I was quite surprised to find two of my Quillen College of Medicine students already sitting there.

Melissa Robertson, left, and Jessica White, right, seniors at East Tennessee State University's James H. Quillen College of Medicine, met with legislators from their state -- including Rep. Marsha Blackburn, center -- during the Family Medicine Congressional Conference in Washington.

The AAFP provides two scholarships for students and two for residents to attend this annual advocacy event in Washington, which trains family physicians (and future FPs) to advocate for their patients and for family medicine. The AAFP Foundation also awards a student scholarship, so I thought perhaps these students -- Jessica White and Melissa Robertson -- had earned scholarships to attend. But as it turns out, they decided to make the trip from Tennessee at their own expense because they thought it was an important learning opportunity.

In fact, 55 students and residents from around the country attended FMCC this year. Their spirit and efforts give me great hope for our future.

FMCC provides a remarkable blend of advocacy education and skills development along with the chance to immediately put those learnings into action. On the first day of the conference, we heard from advocacy experts, representatives of federal health agencies, congressional staff and two legislators.

On the second day of the event, more than 200 students, residents and practicing physicians took what they had learned on day one to Capitol Hill to talk with legislators and staff about issues such as physician payment, education and workforce. One of the best parts of this conference is the opportunity to share personal stories with our legislators. There is no question these conversations have a big impact and are one of the reasons face-to-face meetings have such potential to make a difference in promoting our interests.

Legislators and congressional staff hear from the AAFP Board several times a year, but stories from members can be so important because they speak directly to legislators who are elected to represent their state and district and tell them how constituents are being affected by the various challenges family physicians face.

For example, Jessica and Melissa, two seniors who have matched into family medicine residency programs, were able to talk about important education issues during our visits. As we reviewed the key points from the previous day's advocacy training sessions, we realized their presence was especially serendipitous given their paths to family medicine.

Jessica matched in Asheville, N.C., just across the mountains from Quillen. She will join the family medicine residency at the Mountain Area Health Education Center(MAHEC), which is a teaching health center. These centers provide creative approaches to training family medicine residents based in the communities that most need them.

Under the Teaching Health Center Graduate Medical Education (THCGME) program established as part of the Patient Protection and Affordable Care Act, GME funds go directly to the centers. However, the THCGME program, which started in 2011, is only funded through 2015.

The program is now completing its third academic year, graduating its first cycle of residents and sending almost 300 primary care physicians into the workforce. It should come as no surprise, then, that extending funding for the teaching health centers program is one of the Academy's top legislative priorities during this congressional session.

Without such an extension, Jessica's residency program cannot guarantee her salary for all three years of her training. Accepting this offer represents a remarkable leap of faith on her part. It also provided a great example to the people we talked with about the importance of extending funding for these programs.

Melissa is a nontraditional medical student and former elementary school teacher, so she brings a critical, real-world perspective to both medicine and medical education. She came to the AAFP's National Conference of Family Medicine Residents and Medical Students two years ago and got the advocacy bug there. During that conference, she was elected to the Society of Teachers of Family Medicine's Board of Directors and now is serving her second term.

Melissa, who matched to our East Tennessee State University residency program in Bristol, has a real knack for asking common-sense questions that help cut through administrative layers. Her particular path has made advocacy issues such as student debt and the primary care salary gap extremely important in her world.

Together, the three of us considered the day's congressional visits and how to tell these stories in meaningful ways. First up was Tennessee Tuesday, which is a weekly breakfast during which Sens. Lamar Alexander, R-Tenn., and Bob Corker, R-Tenn., welcome everyone visiting from our home state to Washington. They are always excited to meet their constituents and were especially eager to meet these medical students.

Next, we met with Rep. Marsha Blackburn, R-Tenn. Jessica's family lives in Blackburn's district, so this connection immediately lent relevance to our advocacy stories in a way that had not happened in my previous conversations with the congresswoman. Our legislators certainly pay attention to their constituents, and we were able to get some unscheduled time and a photo opportunity with Blackburn.

Moreover, during a subsequent meeting with Blackburn's health aide, we were able to talk about topics in a totally different light because of the students' circumstances. This latter meeting also showed Jessica and Melissa the critical role legislative aides play in setting agendas for elected members of Congress.

We then met with Rep. Phil Roe, M.D., R-Tenn., who represents Quillen's district. Originally, we had been scheduled to meet his legislative aide, but when he heard there were two medical students from his district present, he immediately made time to meet with them. In fact, their stories were so compelling that he asked if we would walk to the Capitol with him because he had to vote, but he did not want to cut short his discussion with Jessica and Melissa.

Jessica’s story about her uncertain financial situation at the residency program in North Carolina grabbed Roe’s attention in a way my previous discussions with him could not, in part, because Christ Community Health Services in Memphis is one of more than a dozen residencies that are expected to start receiving THCGME funds beginning in the 2014-15 academic year.

As a nontraditional student who made a huge financial sacrifice to become a physician later in life, Melissa's story also sparked his interest immensely. He specifically asked her about her medical school debt and how that influenced her and other classmates in their specialty choice.

Roe also took notice when Melissa addressed another of our advocacy points -- the need to renew and increase commitments to GME, such as through Title VII funding, and to consider how we can increase the number of students choosing primary care specialties.

As he prepared to walk to the Capitol, Roe asked Melissa and Jessica whether they would come back to his office after he returned from the vote because he wanted to talk more with them.

After we finished talking with Roe, I left for a media interview and then headed out of town for the Minnesota AFP meeting. By this point, Melissa and Jessica were seasoned advocates, and I knew our messages were in good hands and would be heard in powerful ways. They went on the next visit on their own and later went back to Roe's office.

The three of us texted about the overall experience later, and we made plans to improve how we present the need for advocacy to students and our residents. In fact, Melissa is meeting with the Quillen Family Medicine Interest Group this week to talk about how to prepare for the Academy's resident/student conference scheduled for Aug. 7-9 in Kansas City, Mo. That is the "pay it forward" concept in action.

So, what can you do to pay it forward? In addition to the scholarship opportunities mentioned above, the Association of Family Medicine Residency Directors sponsors 10 scholarships for residents to attend FMCC. But we could do more. Family medicine residencies, departments of family medicine, state chapters and even individual practices can help send students and residents to FMCC. Exposing students and residents to advocacy, a critical part of how we can improve the care of our patients, can pay huge dividends for those FPs-in-training and for our specialty.

Reid Blackwelder, M.D., is president of the AAFP.

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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.