#SaveToledoFM - The Resident Manifesto

In a previous post, I reported the impending closure of the Toledo Hospital Family Medicine Residency Program which will have huge implications in the delivery of primary care and Family Medicine in that community.

As you can imagine, individual residents have been hesitant to speak freely. However, I did receive a message from a resident at the program, and that person wanted me to share their "mission statement," which they hope will shed some light on their thoughts as a group during this difficult time (disclaimer: the photo above is a stock photo, and not of actual residents in the program) Their "mission statement," what I call their "Resident Manifesto" follows below...

We Are Family Medicine

We are Family Medicine resident physicians. Our specialty is people. We treat patients from the moment they enter the world until the day they depart. We practice obstetrics, pediatrics, geriatrics, and more, often in the same day. If we cannot manage a problem, we become the quarterback, directing and coordinating care between specialists, and other health professionals.

We train at the Toledo Hospital Family Medicine Residency Program, also known as W.W. Knight Family Practice. We are a multi-disciplinary team of physicians, nurse practitioners, pharmacists, experts in social work and psychology, registered nurses, medical assistants, and many other wonderful people. Together we take care of more than 5000 patients in the office, hospital, and skilled nursing facilities. Many of our patients have complex medical issues and live below the poverty line. They often find a home at WW Knight when they have no where else to provide their healthcare needs. We take pride in providing excellent care to a complex and underserved population. Our patients are the reason we rise for work each day. We strive to act as their advocates. and to fight for their well being.

According to the Health Resources and Services Administration, there will be a shortage of 20,400 doctors in the United States by the year 2020. Each year, we add six physicians to that shortfall. In Toledo, this gap is felt acutely. It commonly takes three months to schedule with a primary care provider, if a provider is taking new patients at all. For over 40 years, WW Knight has trained high-quality physicians, 65% of whom practice in the local community. Our residents and alumni care for tens of thousands of people in this region, and yet more is still needed.

Unfortunately, it has been decided that WW Knight should be shut down. Our current intern class, scheduled to graduate June of 2019, will be our last. We were told that the program, at this time, does not meet evolving community needs. On paper, our residency does not look profitable. While that loss is significant, we do not believe it captures adequately our value to the community. We provide a safety net for thousands of people who, bluntly, would have difficult time finding another provider in an already overtaxed system. At this time, we do not know what will happen to them.

We empathize that healthcare is a business, and a difficult one at that. We cannot, however, accept termination of our residency as a sustainable solution to this quagmire. Family Medicine is the foundation of American health care. If the base of the pyramid is weak, the entire structure is at risk. Although we face an uncertain future, our present is simple: We will continue to work and fight for our patients. We will continue to provide outstanding and compassionate care.  We will do so until they shut our doors. Our specialty is people. We are Family Medicine.