Family Medicine and Family

A very inspiring psot.

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Bridgid Wilson Medical Student Bridgid Wilson
Medical Student

This is a finalist in the 2015 STFM Blog Competition

Our first indication that my pregnancy may not be quite as smooth as we originally thought came around 6 weeks when I experienced some spotting. It was days before Christmas, and knowing that our ability to get care may be limited in the coming days, my husband, a family medicine doctor, reached out to his colleague, Dr Justin Edwards, in hopes we might get a quantitative hCG before the holiday. Not only did Dr Edwards order the tests and let us know the results as soon as they were available, but he also offered the kindest support during a time that would have been otherwise unbearably nerve-wracking. We had a good Christmas because of Dr Edwards.

A few weeks later, just when I started to feel less anxious about my pregnancy following our first little scare…

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Happy 2016

Aside

This has been an unsettling year.  We have the elections with the cast of clowns. Really, they all just need a red nose and a clown car.  The news media is no better. Then there is the cast of characters who are in charge of our government. It is truly not the statesmen we grew up admiring even when we disagreed with them.  There is no eloquence in the speeches or great land mark legislation passed.

We have seen what racism has produced in our over the top policing that has led to a record number of shooting deaths of unarmed black males.  The shoot to kill approach rather just arrest.  I watched a video of the London Police take down the subway attacker and there was no gunfire even though he had a knife.  There have been so many revealing and brilliant  NYT Op-eds written and I have posted them all on my Facebook page.

I don’t make New Year’s resolutions.  I am preparing to take a new position by returning to graduate medical education. This has allowed me the opportunity to review my career by putting together a credentialing application. I had to provide licenses, education history, documentation of competency regarding specific procedures and get letters of support from former colleagues.  I am reviewing evidence-based guidelines for the treatment of acute and chronic diseases.  Another requirement is completing modules and reviewing corporate compliance and learning about the culture of the organization I am joining. There is a review of the vision, mission, and values of the organization.

When I see the widespread use of deadly force by our police, I  can only ask if this is the culture and part of the training.  Is there any review of skills and competency documentation? Does it go beyond the firing range?  Is there any cultural awareness training? What is the vision, mission and values statement of the police force? Is it written and reviewed?

This also can be applied to our politicians.  Their vision, mission and values are not clearly stated and they have not shared their plan of including all Americans. The issues of gun violence especially looking at not only police shooting, but acts of terror and black-on-black murders.  Women’s reproductive rights are under attack and we cannot forget the wage gap. The issue of racism is real and as one of my colleagues has stated, must be addressed.  Racism is leading to a wealth and education gap. In the medical community, racism affects patient care, medical school admission and matriculation, and the number of medical educators that are from underrepresented minorities (URM). The definition of URM is African Americans, Mexican-Americans, Native Americans (American Indians, Alaska Natives, and Native Hawaiians), Pacific Islanders, and mainland Puerto Ricans. This is very important because of the cost of medical education and the issue of work-force diversity.

I am looking forward to 2016. I am energized by all that I (we) have to accomplish.   Happy New Year!!!

Gratitude: 50 things I am Grateful for

My friend Lisa Winkler  invited me to join in this “blog party,” where we write what we’re grateful for. The rules required we set a timer for 10 minutes and then write.  I  cheated a bit because I could not set the timer  and just write for 10 minutes. I did this in between patients.  They are in no particular order. I am grateful for :

  1. My Husband of 30 years, Leroy
  2. My children whom I am not allowed to name
  3. My mother who is the rock of our family
  4. My three sisters
  5. My handsome nephews
  6. My dear friend since medical school who taught me to be brave and keep myself open to the Universe.
  7. My wonderful colleagues
  8. For my mentors
  9. All my mentees
  10. My teachers there are too many of you to list
  11. All my patients who have allowed me the privilege to participate in your health care
  12. Meharry Medical College for admitting me into medical school
  13. All my friends who have have supported me
  14. My Yoga teachers
  15. Yoga,  for teaching me discipline and  showing me how far I can go if I try
  16. Learning to be fearless and just allowing life to happen
  17. Farmers Markets.  I love the fresh food.
  18. Meditation because  taught me to be calm and focused
  19. Being a US Citizen even though our politics is messed up
  20. Being an African American.  It has taught me resilience and how to make it against all odds
  21. Adele, who gives me goose bumps every time I hear her sing- Reminds me of listening to Phyllis Hyman, Roberta Flack and Randi Crawford
  22. Oprah and Deepak teaming up for the Meditation Challenge
  23. For PBS for giving us Downtown Abbey, Nova, Grantchester, Dr. Blake and Miss Fisher just to name a few.
  24. Star Wars
  25. Lupita Nyonga who is just beautiful in every way
  26. Viola Davis who is just amazing to watch
  27. The Obama Family for just being here
  28. President Obama who is just trying to keep it real.
  29. Donald Trump who is making us all get riled up and hopefully we will go to the polls and vote
  30. Desserts
  31. Vacations
  32. Family Reunions-All my aunts, uncles and cousins
  33. My faith
  34. Reading books
  35. Harper Lee for writing “Go Set a Watchman”
  36. Black Lives Matter – I know but it is important
  37. Shopping
  38. Movies- thank you TCM channel
  39. The Society of Teachers for Family Medcine
  40. All my residents past and present.
  41. Planned Parenthood for being there
  42. Trips to ceans
  43. sunsets
  44. Neil Degrasse Tyson who has reminded me to look up
  45. My new book group
  46. My NJIT family
  47. Learning to enjoy each moment
  48. BBQ chicken wings
  49. Chocolate
  50. Natural Hair and my new hair stylist

December 1, 2015

December 1 was my husband’s 72nd birthday. It marked 332 birthdays that we have celebrated together. That is hard to believe. December 1 is his birthday but it is also World Aids Day. The first World Aids Day was Dec 1, 1988 which was 27 years ago. I witnessed the first documented case in our hospital in 1983 when I was a resident. Five years later during my Family Medicine residency, we would diagnose many cases in men, women and children. My residency and pediatrics rotation provided an opportunity to unfortunately hospitalize several children who had AIDS. I provided care to many patients and watched too many of them die over a period of 12 years.

It is difficult for new physicians to understand how we all become so involved in the care of patients who had AIDS.  I was the only provider who was willing or trained  to care for my patients until I was joined by another colleague who shared my passion.

Now,  despite all the new information that we have to prevent infection, there are a rising number of new HIV infections in young African American and Hispanic males. This can also lead to an increase in infections in women. The irony is that we relaxed the push to get information out there to this group. According to the Centers for Disease Control (CDC), African Americans represent approximately 12% of the U.S. population, but accounted for an estimated 44% of new HIV infections in 2010. Also, Hispanics/Latinos represented 16% of the population but accounted for 21% of new HIV infections in 2010. Of those living with HIV in 2009, Hispanics/Latinos accounted for 19% and Blacks accounted for 44%. Sadly in 2010, the greatest number of new HIV infections (4,800) among MSM (men who have sex with men) occurred in young black/African American MSM aged 13–24. Young black MSM accounted for 45% of new HIV infections among black MSM and 55% of new HIV infections among young MSM overall. http://www.cdc.gov/hiv/basics/statistics.html

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I now only provide primary care to patients who have HIV/AIDS but I do know that I will be diagnosing and referring new patients for treatment. I am recommitted by these statistics to get the news out to a new generation. Safe sex through use of condoms is essential to prevention. However, the sad truth is that 1 in 6 people with HIV do not know they have been infected. Getting tested is important. Let’s get the information out there. For more information http://www.itsyoursexlife.com/gyt/hiv-aids/

Reaching Potential Teachers Like Me

One way your giving can help.

stfmguestblogger's avatarSTFM Blog

Sonya Shipley, MD, Sonya Shipley, MD,

One day I received an email from STFM about a task force that seemed awesome, but I did not want to apply. My initial thought was, “That seems great, but I am not qualified for that.” You see, I had only been back on faculty for a little over a year, and I wondered, “What do I have to contribute?” Well, in comes my work mother, also known as my department chair, who says, “Apply! You have lots to offer.” Fast forward to today. Guess who is serving on the Faculty for Tomorrow Taskforce—Moi!

The mission of the task force is to prepare faculty today for family medicine tomorrow—to reach those excellent clinical teachers from residency or community practice who have what it takes to shape the next generation of family medicine clinicians. Fantabulous mission, right?

And—the icing on the cake—4 years ago, I was exactly…

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July Recap: Surgeries And Sutures!

They are at it again.

therealtinlizzy's avatarTheLadder

Medical scholars at July’s session of the Ladder had the opportunity to try their hands at surgery and suturing!

Our youngest scholars focused on learning the finer points of tying off sutures using needle drivers without needles (safety first!) in model biceps. Older scholars had the opportunity to (carefully) suture on model arms with needles.

Scholars then practiced various types of virtual surgery: appendectomy, adenoidectomy and knee replacement.

Tell the young scholars in your life, family, school, class and neighborhood about the Ladder – where they can not only develop academic and career goals for their future, but have a whole lot of fun in the process. They will also be actively supported and challenged to pursue their goals by mentors and resources from the University of Minnesota Academic Health Sciences schools & colleges, the North Memorial Family Medicine Residency Program, and Broadway Family Medicine. In addition…

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Caring for Patients: Betraying the Hippocratic Oath

The Hippocratic Oath is the read to all medical Students in a White Coat Ceremony in the first few days of Medical School. It is also recited at graduation.  I have had the privilege of having worked with some really great physicians who are honest and ethical. They are talented not just in their chosen specialties but are accomplished athletes, musicians, writers, poets, and singers. They all have in common the ability to make patients feel safe. I have had a rare one or two that I chose not to refer patients to because I was not comfortable with a treatment plan but that did not include any of the talented well-rounded ones. Continue reading

Caring for our Girls: Women are the Foundation of our Society

Women are the foundation of our society.  From the moment  girls are born, the love and support from family helps them evolve into strong, confident and caring women.

Yet, fear and suffocating religious customs and cultural beliefs prevents this from happening in many parts of the world.  Across the world these precious members of our society are being raped, killed, sold into slavery, struggling on minimum wages and being victimized by their male partners. They are trapped in poverty and held captive.

Over the years, my female patients have revealed the pain of sexual assault, incest and intimate partner violence.  Women in the military who are serving our country and looking for a better life are being victimized. Even on college campuses where women are supposed to be safe, sexual assault is happening and being mishandled.

Women have worked and completed their education while raising their children alone.  Many are caring for aging parents. While we debate minimum wage, crippling student loan debts, and abortion; we are losing sight of the importance of these issues to the number of women who are struggling to get out of poverty.

Studies show that girls raised by working are confident, have higher levels of education, earn more money and are more likely to be in supervisory roles. There are daily assaults on our confidence from bullying by peers and even adults.  I am really against Facebook shaming.  This latest incident proved me right. Fathers play a critical role, if they are present,  in  the development of a girl’s self-esteem. A betrayal can have devastating and even deadly consequences.

My uncles took the place of my father who did not have the stability to provide support emotionally or financially.  Each of my mother’s brothers made it a point of always letting me know they cared.  One uncle took me to my first concert.  Another taught me to fold sheets and make a bed with military style corners. He made sure we cleaned the house to perfection before he left for his night shift.  My mother, worked days and had a long bus ride home.  We felt pride when she came home to a clean house. When I came home from college and later medical school for visits, their faces were all I needed to see.  They beamed with pride.  My uncle still to this day wants to know how I am doing and loves to hear stories about my patients.  It was my way of letting him know how I was progressing.  I would tell him about a difficult case and how I made the diagnosis.

Teachers are critical to the creation of a supportive environment in the classroom for all students.  My teachers taught well and expected us to do well.  I never heard that I could not go to medical school. My minister and my church was supportive. In my church,  I was praised for making the honor roll and graduating with honors. No one ever said that I could not afford to go to college or medical school. They all acted as if that was what I was destined to do. They just said, I would make a good doctor.  I was in the class of 1983 from Meharry. Our class had, at that time, the highest number of females to ever graduate from the school.

The joint win of the Nobel Peace Prize by Malala Yousafzai and Kailash Satyarthi  highlights the importance of the need to support the education of girls and prevent the exploitation of children world-wide.

Women can be scientists, make important contributions to science and win a Nobel Prize without being a distraction in the lab.  We can be a CEO of a major company and bounce back with grace after a tragic loss and be an inspiration to us all. We can produce and direct movies and as an actor redefine beauty and body-image by not falling victim to all the hype. Let’s not forget launching a television network.

As we struggle through this 2016 presidential campaign and have the opportunity to elect a woman as President, it is disheartening to hear the petty issues that are being discussed. As women, we should demand discussion of the issues that are important and not whether a woman has the ability to be President.  The answer is yes we do have what it takes to lead a country: yes, she does. It is important for our girls to hear that. message. The global issues affecting women are education, unemployment, poverty, war, physical and sexual violence, abortion, and family planning.

Memorial Day

I first wrote this on May 26, 2014. I wanted it to pay tribute to all the Veteran’s I had the privilege of having been their physician. I am surprised we just started talking about the crisis with the VA Health System. Over the years my I have had many veterans come to me for care.  They felt it a privilege to have the VA there for them. They went to the VA to get their medications and major tests such as colonoscopies, cardiac catherizations , etc.  If they needed operative procedures, they wanted me to find them a local provider for a second opinion so they would not have to travel out-of-town. They all had Medicare or private insurance and were not solely reliant on the VA.

In 1990, when I was starting my practice, I had an influx of new patients.  I was surprised they chose to come to my office.  We need to realize that the VA has always had a shortage of doctors.  Now with two wars and a surge in numbers of soldiers with mental and physical injuries, they are overwhelmed.  Also many of these soldiers are unemployed and solely reliant on the VA system for care. Many of these new patients are women.  These are the first wars where we have had women serving at the front lines.  The VA system is more prepared for the male veteran.

I remember a patient with recurrent chest pain due to heart disease in need of a cardiac catherization.  He went to the VA and had it done.  I asked him the results.  It was difficult to get any reports at that time.  It is better now due to the conversion to an Electronic Health Record.  The VA has a very sophisticated system.  He said the doctor just said “You have a bad heart.”  He needed to have his procedure performed but he had several admissions for angina before it finally happened.  He had to wait.  Many are calling for investigations and hearings.  The VA needs providers.  Psychologists, psychiatrists, primary care providers (doctors, nurse practitioners) and they need to have an increase in female providers.

We do not need to privatize the system.  That is not the solution.  We just need to continue to recruit the best and the brightest healthcare providers. We need lots of them.  The VA does a tremendous job with the resources it has.  We need congress to do more.  The unemployment rate for veterans who have served since 9/11 was reported at 10 % in 2013.  That is a large influx of patients relying solely on the VA for care.  Each year, the number of discharged service men is reported to be as many as 360,000.

We need to honor their service by increasing funding. We need to speak up and use our power as voters in this next election.

Here are a few of my family members who served. We have a long history of service by both male and female family members.

 

Joe_giddens

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Happy Mother’s Day

john1994a

Watching the video,  A Conversation About Growing Up Black,  brought tears to my eyes.  This one of  the difficult truths that comes with growing up for African-American  males in the US.

I left a General Surgery Residency, Continue reading