Reflecting on my own training at the age of 34, I’m finding that I’m in the middle of two very distinct generations of physicians: the traditional, paternalistic one-finger typers and the democratized technologists with carpal tunnel syndrome. My training started with barely readable paper charts and finder needles (we systematically and blindly stuck a patient’s neck quickly and repeatedly until we drew blood to figure out where to place the central line). It ended with fancy electronic medical records, emailing and texting patients, and ultrasounds as the standard of care for central lines.
In that time, I’ve seen medicine fall from the Golden Age into crisis. Physicians and patients alike are unhappy with patient-doctor relationships, and everyone else is panicked that we spend one-fifth of our nation’s budget on healthcare. I’ve watched trainees transition from understanding the secret code of medicine – advocating is essentially equivalent to labeling your forehead with “blackball me” – to successfully stepping up and creating change. A few weeks ago, I worked in the ER with NYTimes columnist and author Dr. Pauline Chen, and we reflected on this phenomenon between seeing patients. She told me that she sees this generation of doctors as the activist generation.
At first I wasn’t sure if I believed Pauline. Then I watched a new medical documentary, Code Black, at the Museum of Fine Arts last week. While following residents through training and showcasing their disillusionment with healthcare, the documentary was a surprising call to action. It was a call for this generation of medical students and residents to define themselves and to define medicine, asking how we will practice the kind of medicine most doctors imagine before they enter residency. I was fascinated, because this type of movie would never have been given a green light during my training years, yet director Ryan McGarry filmed the documentary while he was a resident.
I think it might surprise many one-finger typers to learn about the depth to which most medical students (like McGarry) think about the American healthcare crisis. Ramin Lalezari, a medical student from Washington University in St. Louis, an American Resident Project Writing Fellow and a Celebrity Judge for Medstro’s Primary Care Challenge, is as much of an activist as he is a medical student. He believes that primary care is a space where innovation is desperately needed.
“Primary care is currently undergoing a period of rapid change,” Lalezari says. “With the ushering of provisions of the Affordable Care Act, along with the push towards Accountable Care Organizations, the primary care provider has become more important than ever in coordinating cost efficient care. As with all transformations, that changes in primary care will open gaps. Medicine needs innovators to find ways to fill these gaps and improve medicine at its very foundation.”
For this reason (and many others), I’m excited to be working with The American Resident Project, a platform for empowering future physician leaders – medical students, residents, and physicians newly in practice. And I’m excited that we’re bringing together several organizations to look for answers to what I believe is the largest problem in American healthcare: the delivery of primary care. In an unprecedented move of collaboration, The American College of Physicians, The Harvard Medical School Center for Primary Care, the Society of Teachers of Family Medicine, the Patient-Centered Primary Care Collaborative, Primary Care Progress, in-Training, and a number of State Academies of Family Medicine have come together to co-host The Primary Care Challenge (#PCC14). This is an open call for any medical student or physician to tell us what they’re doing to innovate in primary care.
“The Primary Care Challenge is evidence that moves are being made right now to make medicine better,” Lalezari says. “It is commonly thought that medicine lags behind new technology, but I firmly believe that this generation of innovators will transcend that thought.”
My passion is healthcare optimization, whether that is with innovation, making scientific discoveries, or improving delivery. I love bringing people and ideas together and making projects work. With this, medicine exists to improve lives, and I will strive to always help patients and those around me.
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