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Save Toledo Hospital Family Medicine Residency! #SaveToledoFM

Last week, it was announced that the Toledo Hospital Family Medicine Residency Program is phasing out and will not accept any new residents into their program. The final class of residents will graduate in 2019 (Toledo Blade).

This is tremendously sad news. This program has graduated Family Physicians for more than 40 years. The eventual closure of this program will potentially limit more access to primary care and Family Medicine services for the Toledo community, in a time when the United States needs more access to primary care.

Here are some Fast Facts about national Family Medicine that you may not be aware of:

  • Family Medicine takes are of One in Five office visits, often where no one else takes care of patients
  • We are the only specialty where adding another physician to the community improves the morbidity and mortality, often while lowering costs
  • We are the only specialty that crosses all age groups, genders, and organ systems - The Lifespan. We provide more mental health care than psychiatrists.

I challenge my friends and colleagues in the Family Medicine community - the Family Medicine Revolution, or #FMRevolution, to raise awareness of this story. It's always sad when a training program shuts down, but possibly more tragic when it's a Family Medicine program. Let's raise awareness on this! Use #SaveToledoFM hashtag on Twitter!

Anatomy of Civil War: Summa Health Day Six

It's been six days since New Year's Day when the leadership at Summa Health replaced the Emergency Room physician group. Some physicians are now publicly taking sides, as noted in last night's medical staff meeting as reported by the Akron Beacon Journal

More than 250 voted "no-confidence" in the CEO and leadership team, and called for their resignation. The medical staff totals more than 1000. The vote occurred after a two hour contentious meeting, which at times, possibly sounded like a political convention. Of note, the resident physicians already voted "no-confidence" in the CEO earlier this week.

In addition to the ER physicians being out, it was also announced that the contract for the respiratory and critical care physician group will not be renewed. However, the anesthesia group signed on for another year. What will be the fate of other specialists at Summa? Time will tell.

The best quote from the night came from primary care physician Dr. Rodney Ison. (disclaimer: I worked with Dr. Ison during my Family Medicine residency at Summa Barberton). He called the "no-confidence" vote "ridiculous" and also said this:

"Not once were patients and patient care and what's in the best interest of our patients in the room tonight. We can't have political wars and political battles of 'What's in My best interest and What's in Your best interest' - We're Physicians."

As I stated in my previous post, the Akron community is now seeing this Civil War play out in a very public way. They are seeing the grabbing for profit, the push for power, and the play for politics. But what about patient-centeredness? The longer this drags out, especially in a public way, no one wins, the patient loses, trust in Summa Health plummets, and the closer we'll get to the "End Of An Akron Icon."

Summa Health: End Of An Akron Icon?

As a medical student in the 1990s, I remember one of the first times I walked into Summa Akron City Hospital. I was overwhelmed with the hallways being tremendously busy, and seeing teams of white coats rushing to wherever they were going. I also got a sense that the city and the community trusted this hospital to give them the care that the needed. I even did my Family Medicine Residency training at Summa Barberton Hospital (then known as Barberton Citizens Hospital), and I knew I was going to be receiving the training I needed to be a good doctor.

This past week, Summa Health is mired in controversy and in a public relations nightmare. The summary of the issues are well done by the following two blog posts in the past few days: "The Rape of Emergency Medicine, 2017 Version" by GruntDoc and "What we know about the Summa Health shake-up, and why this goes beyond the ER" from Rubber City Politics. 

What is the big picture meaning for the Akron community? From what I've heard, the hospital across town, Akron General Medical Center (associated/owned by the Cleveland Clinic) is "packed to the gills" with the highest patient census "I've ever seen it." (quotes from a recent e-mail that was shared with me). 

For the most part, the Emergency Room is the doorway into the hospital for patients, and for hospitals, the doorway into generating revenue for the institution. If the Akron community is sensing the uncertainty in Summa Health, with all of its infighting, will the community continue to come to the Summa ER?

No matter how this Summa Health situation ultimately plays out, its reputation has taken a major hit this week. When the fighting finally stops among all of the factions, there has to be some kind of healing of the hospital community, even before it can reach out to Akron to ask for their trust again. If the finger pointing, the negativity & vitriol, and the PR war continues, this may be the beginning of the end of another Akron iconic company...

Suicide: Youngstown's Taboo Topic

Laura Steele, 46, was a local news anchor here in the Youngstown, Ohio area. Last week, it was announced publicly that she passed away. But, on facebook it was discussed that she "took her own life." Her funeral will be later this week.

My curiosity lead be to do a search of "Youngstown Ohio Suicide," and I was surprised what I found. Laura Bowman, 13, passed away on August 13, 2016 after questions of bullying. Cassandra West, 19, and Christopher Ocasio, 21, were found "hanging in their room," in April 2015 in Boardman, Ohio. Colin Hart, 18, and Jamie Serich, 17 had self-inflicted gun shot wounds in December 2009 in Youngstown.

I remember the announcement of the death of Robin Williams in 2014, and this was the first time that I saw actual public discourse about the topic of depression and suicide. But, like all news cycles, the discussion faded. And, in local communities, like Youngstown, Ohio, topics like suicide are hardly brought up publicly or privately.

Know the warning signs of suicide. The American Association of Suicidiology has identified these eight signs to watch out for: Ideation, Substance Abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, and Mood changes. The easier to remember mnemonic: "IS PATH WARM"

Unfortunately, progress raising awareness about suicide prevention occurs following tragedies like this one. I know the stigma is still there, and this topic is very difficult to talk about. But, imagine, if we get the courage to talk about suicide and raise awareness about suicide prevention,  can we prevent one future tragedy from happening? I think we can...

New Year First Step: Visit Your Family Doc

Happy New Year! It's always interesting the first day back in the office for the new year. "Hey, doc! Gimme some advice on how to improve my health!" I told my patients today that they are already taking the best first step: Visit Your Family Doctor.

My number one piece of advice before taking on your aggressive diet and exercise program is this: Visit Your Family Doctor. This is a great opportunity to check in to see where you are at, from a wellness standpoint, with your favorite medical profession.

In addition to a important exam to evaluate your physical health, it's a great opportunity to talk about your family history of medical problems, and what to look out for as we get older. In addition, it's a way to check in on your mental health and well being.

So, as you make your lists for the new year, don't forget to add this very important box to check: Visit Your Family Doctor. Happy New Year!

2016 North Carolina Academy of Family Physicians Meeting

Welcome to those of you who are clicking here from the 2016 Winter Family Physicians Weekend of the North Carolina Academy of Family Physicians at the Omni Grove Park Inn in Asheville, NC. Thanks so much to the NCAFP for the invitation to speak.

You'll see the slides for the presentation above and at this link. Plus, on some of the slides, you'll see links at the bottom which go to various youtube videos which I will share in my presentation. I also hope to record the presentation as well.

My basic message is that I think that Family Medicine needs to utilize social media for purposes of Family Medicine advocacy. What this means to me is that Family Medicine needs to educate everyone from our patients and our communities, to legislators and policy makers, about the difference Family Medicine makes to our nation.

In addition to my website, I invite you to check out my other presence on social media including twitter, facebook, youtube, linked-in, instagram, podcast, and others, Thanks for stopping by my webpage!

Week In Review: What We Learned About Trump & Clinton's Health

I admit that I'm a little bit of a current events and political junkie. It's been interesting for me to see this week's news cycle of the press obsessing over the health of the US Presidential candidates. What was most interesting was watching the doctor's on TV pretend to be political commentators. I mean Dr. Oz had Trump on his show. Sheesh! I admit that I got caught up in the frenzy and wrote a little blog post on my own this week. But, at the end of the week, health of presidential candidates was just the story of the week. I wonder what the political story will be next week?

#FMDoctorPose & #FMRevolution Challenge for AAFP Orlando

In the past few days, you have probably seen the television commercial below from the company Cigna. In the ad, they are using the "TV Doctors of America" to try to get you to a real doctor for a checkup (presuming you're on Cigna insurance - HA!) Will it work? We'll see. I've started reading some marketing websites, and I encourage you to check out this article from Advertising Age, about this commercial.

Close to the end of the commercial, Alan Alda utters the line, "Doctor Poses," to the other tv doctors, and you get the photo above. This really made me think. What would Family Medicine Doctor Poses look like? Sounds like a fun challenge for my friends in the Family Medicine Revolution (#FMRevolution). And, where would be a great place to do this? How about next week at the AAFP National Meeting in Orlando (hashtags #aafpCOD and #aafpFMX). I Challenge #FMRevolution to take your Doctor Pose Selfie at AAFP Orlando and to use the hashtag #FMDoctorPose and let's have fun with this!

For my friends going to the AAFP Orlando conference next week, I also encourage you to download the conference apps (photos below) for the AAFP Congress of Delegates and the AAFP Family Medicine Experience (FMX). And, as you build your profile, make sure to friend me up. For more information, check out the website of the American Academy of Family Physicians. See you soon in Orlando!

The John McCain Medical Records Transparency Strategy

In the past few days, with Hillary Clinton's coughing episode followed by her pneumonia and fainting episode, this has sparked (at least in the press), new questions about her health in being President of the United States. In addition, Donald Trump is rumored to reveal medical records on the Dr. Oz show later this week. What are we to make of this? Do people really care about their health history?

Flashback to 2008, when these same health questions were made to John McCain. At the time, we was 71 years old, and would have been the oldest President of the United States (note, both Trump and Clinton are 68). 

The McCain camp took a step toward transparency, and made available over 1000 pages of medical records (1173 pieces of paper according to the Washington Post). These records were made this available to select press members, like the Associated Press (according to the New York Times). And, without cell phones and internet access, these press members were able to write summaries on their laptops. In addition, the McCain campaign posted summaries of the medical records on their website. And if that wasn't enough, the campaign made available three of McCain's doctors. (See CNN video below)

Did it ultimately work? Uh no. Barack Obama became the 44th President of the United States. But, there is a lot to be learned from this McCain Move from 2008. I think that all of us can agree that more transparency in the political process is a good thing. Will we get this kind of access to the Trump or Clinton medical records? Probably not. But, if there is one thing that you can say about this campaign, is that it is unpredictable...