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Saturday, December 13, 2008

Recent Residency Interviews

So, I am nearing the last bit of my interview trail for a Family Medicine Residency Program. These last 2 days, I interviewed at 2 programs, Merced and Modesto. They are both broad spectrum family medicine training programs. Broad spectrum meaning that they train resident doctors to do everything from caring for kiddos to elderly, to doing obstetrics and gynecology, and to doing lots of office procedures.

Both of these programs are part of the UC Davis system of family practice residencies. They are both situated in the Central Valley of CA. So, the picture to your left is my summary of the 2 days while I was there. FOGGY! The fog was so thick that I couldn't see more than 50 yrd beyond me.

I've met an attending physicians at each place that really enlightened me with regards to the type of medicine I would like to practice. I'll tell you a little bit about why they are so encouraging. The first one is Dr. K. Dr. K is very passionate about his patients. He made it his career goal to change unhealthy behaviors of the patient. In fact, he says to me that if he does not educate and work with his patients to be healthier, then he has done nothing good for them. He is not satisfied just seeing patients on their visits. He would even go as far as telling them that they would have to find another doctor if they continue to be unwilling to work together toward a better health. He does it so lovingly, that I know he doesn't usually resort to threats. I am sure a large portion of his patients comply. Now, what are the unhealthy behavoirs that he works so hard to change? All these issues are called "Silent diseases," which if can be tightly managed will significantly reduce morbidity as we age and in effect directly increases our Quality of Life!
  1. Smoking cessation
  2. Diabetic disease management: tight control on the blood sugar
  3. Hypertension disease management: tight control on the blood pressure
  4. Asthma disease management: proper treatment combinations for the symptoms
  5. Obesity management: help patients to reduce BMI as way to reduce long term morbidity

These are just a few things. I believe that if we as physicians could impact patient health in these areas, our world would literally be in a much healthier place. Dr. K relentlessly follow up with patients periodically and re-evaluates treatments and lab results to help his patients to keep tighter control. You see, these are diseases that 'slowly disables us WITHOUT US KNOWING!' That's why Dr. K thinks it is imperitive that we as physicians need to be come patient advocates in educating and helping patients.

Dr. B... He is an inspiring physicians who worked many years to make healthcare available to the underserved. His foresight is inspiring. His passion is to train physician leaders to impact health policy of the community in which they serve and eventually policies of this nation. Simple concepts of policies in community developement: where to put schools, health centers, grocery stores, hospitals, community centers, fast food chains, and other businesses has huge impact in the health of the community. Often, railroads split the wealth of the town. Down wind areas are usually poor. Poor areas have fewer grocery stores, lower literacy rates, higher teen pregnancy rates, fewer access to healthcare, higher crime rates... the disparity is tremendous. Mothers who need to buy groceries, bring children to doctors, work, and all that without a car cannot simply do everything if it takes hours to walk to one thing then hours to take a bus ride to another. So, as a way to serve the poor communities, Dr. B and his team worked together with the community organizers to build a community center that consisted of childcare, medical care, and is right in the shopping center of a major grocery store. A one stop shop! Dr. B and his residents also are required to do home visits, many times at a shack of the underserved family or in the park of the homeless person... these 'home' visits developes deeper appreciation for the underserved and also shows the community that 'we' care as physicians. We care and love those who are down and out to visit them where they are. Home visits also give physicians opportunity to talk to their patients are other pertinent social issues, environmental safety issues, disease exposure and risks, and other topics not typically addressed at the 'sterile' doctor's office.

I'm inspired to incorporate these passions into how I approach medicine!


Lake Yosemite in front of UC Merced; Motto of Modesto: water, wealth, contentment, health

So, the last bit of the blog, I want to tell you about the crazy drive I did last night after the interview... I hope I will not have to do this again. So, the interview finished at around 2pm in Modesto, I decided that I should just drive straight back to Sedona, AZ... That's a 11 hour drive! So, I started thinking, ok, I'm gonna take it one step at a time, may be rest in between. So, crazy me... I drove straight through with just one stop to fill up gas. Yup it took me 11 hours :) The last part of the drive was through the mountains in Jerome, AZ (used to be copper mining town). Have you ever seen Tokyo Drift? That was just like the movie. Imagine, at about 1am in the morning, skinny, slithering 2 lane mountain road, laced with 15MPH and 20MPH 'U' turns... The road was clean, washed by rain... kinda like a car commercial. Darkness all around, shear clift on both sides, guard rail on the right, you can see nothing other than the reflective lines on the road. You are it. No one to compete with you, no one to take a piece of the road. You are the road. The road and you are one. Man, it was so good, I was whipping around the turns at twice the prescribed speed, nearly drifting, sliding, skipping... pulling 'G's' All mine... all mine... I felt like driving a go-kart in the mountain... fresh air... a full hour of exhilaration!

Then, as soon as I got back home... I couldn't resist the sweetness of the pillow...

1 comment:

Anonymous said...

AS far as I know, most of doctors sit in the office, wait for patients.
Most of them never make a call for
following up. They don't even talk that much with their patients in the office.
You open my eyes and let me see there
are at least two doctors so different. Where their energy from?
Thank you George!

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