ISSUE 2 | 2025 THE OFFICIAL JOURNAL OF THE UTAH ACADEMY OF FAMILY PHYSICIANS You Help Shape Who They Become Finding Your FUTURE in Family Medicine
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A PARTNER IN MENTAL HEALTH FOR YOUR PRACTICE The CALL-UP program was developed by the Huntsman Mental Health Institute at University of Utah Health as a free statewide resource to support you and your team in caring for patients with mental health needs. Through CALL-UP, you can access timely consultations with experienced psychiatrists for help with: • Diagnostic clarification • Medication guidance • Treatment planning • Local mental health resources and more Our dedicated care coordinator works directly with your office to help patients connect with social services and other local supports—so you can feel confident they’re getting the care they need beyond the exam room. We also offer free CME-accredited webinars through our Project ECHO series so you can stay current on evidencebased approaches in mental health care with practical tools, real-time learning, and peer support networks. We’re here for you Monday–Friday, 9 a.m.–5 p.m. (excluding holidays). Request a consultation online at uofuhealth.org/call-up or call 801.587.3636. Questions? Email us at Callup@hsc.utah.edu. LET US BE YOUR PARTNER IN PROVIDING COMPREHENSIVE, COMPASSIONATE CARE.
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Table of CONTENTS ISSUE 2 2025 12 9 28 On the cover: UAFP staff and board meet for their annual board retreat, held this year at Snowbird, to exchange ideas and plan for the coming year. PRESIDENT’S MESSAGE 6 Where We Go Next CEO’S MESSAGE 7 Finding Focus Amidst Chaos 8 2025/2026 Utah Academy of Family Physicians Board of Directors 9 Finding Your FUTURE in Family Medicine 12 2025 AAFP Congress of Delegates Recap SAVE THE DATE 16 CME & SKI 2026 17 “You Help Shape Who They Become” A Call for Family Physicians To Meet Utah’s Urgent Need for Clinical Preceptors 20 The Final Act of Care A Conversation With Utah’s Chief Medical Examiner MEMBER SPOTLIGHT 23 Frank Powers, MD RESIDENT SPOTLIGHT 26 Saar Yaniuta, MD, PhD, MHA STUDENT SPOTLIGHT 28 Kate Bercaw PROGNOSIS NEGATIVE 30 Epic To Require Five Levels of Encryption to Log in to the EMR, Repeated Every Three Minutes 5
I’m honored to serve as your UAFP Board president this year. Like many of you, I juggle multiple roles: family physician, medical educator, healthcare leader and parent to four great kids. I understand how valuable your time is, and I approach this role with a deep respect for the limited capacity all of us have outside our day jobs. As a board, our responsibility is not to take on more but to focus on what matters and follow through. We are aligning around goals that are realistic, measurable and supported by our CEO and staff so that our volunteer board can stay strategic and impactful. We are currently exploring how to better support rural engagement. Family physicians practicing in rural Utah face distinct challenges that often go unheard. Earlier this year, UAFP surveyed rural members to gather direct feedback for the state’s Rural Health Transformation Grant planning. That input is now helping shape Utah’s strategy to improve access in underserved areas. We are asking what more we can do to support rural members not just through advocacy, but through visibility, connection and partnership. We are also focused on encouraging knowledge sharing across our membership. There is a strong interest among members in learning from each other, whether it is clinical expertise, leadership skills or systems innovation. UAFP staff are exploring ways to support that through tools and platforms. As a board, we are looking at avenues to foster connection in ways that are useful, relevant and do not overwhelm already-busy physicians. UAFP continues to represent Utah in the AAFP House of Delegates, ensuring our state’s voice contributes to national discussions that shape the future of family medicine. Through our participation in this process, we help advocate for policies that reflect the needs, challenges and strengths of family physicians across Utah. If you have ideas, feedback or interest in getting involved, I invite you to reach out. Whether you are in a rural clinic or an urban residency, in solo practice or a health system, your voice helps guide where we go next. I am grateful to serve in this role and look forward to what we can accomplish together. PRESIDENT’S MESSAGE Where We Go Next Lynsey Drew, DO, MBA, FAAFP, President, UAFP 6
Finding Focus Amidst Chaos I’ve started this message multiple times, struggling to capture exactly what I want to convey. After some reflection, I realized that my difficulty is a metaphor for the state of our country right now — a time filled with chaos, distractions and a lack of focus. Open a newspaper or scroll through social media, and we’re bombarded with a mix of memes, rhetoric and often discouraging news. This constant flood can feel overwhelming, only adding to our internal stress and confusion. It’s safe to say that none of us has witnessed this level of turmoil in our lifetimes. Inflation is rising, impacting housing, food, transportation and healthcare. With cuts to healthcare coverage, egregious misinformation and soaring insurance premiums, healthcare, in particular, feels under siege. So, what do we do in the face of all this? How do we find the positives, if any? I recall taking a philosophy class in college, where I first encountered the concept of the “dichotomy of control.” This idea suggests that by recognizing what we can control versus what is beyond our influence, we can reduce stress and live a more tranquil life. In reality, the scope of our control is narrower than we might like, but it’s still significant. We can control our thoughts, judgments and the actions we choose to take. However, we cannot control others’ behaviors, external events or outcomes beyond our reach. Maryann Martindale CEO, UAFP CEO’S MESSAGE In times when it feels like the world is spinning out of control, it’s tough to maintain this perspective. But I’m trying, and I hope you are too. Focus on what you can control, particularly the positive impact you have on your patients. People come to you in times of need, and they leave better for having seen you. You offer calm and relief when others are sick and struggling. I don’t claim to have all the answers, but I know I’m trying to focus on what I can control — areas where I can make a real difference. Sometimes, amidst uncertainty, the best we can do is find our own peace. Maryann’s happy place. 7
2025/2026 Utah Academy of Family Physicians BOARD OF DIRECTORS THANK YOU FOR YOUR SERVICE TO THE UAFP BOARD! Executive Committee Lynsey Drew, DO, MBA, FAAFP President Tyson Schwab, MD, MS, FAAFP President-Elect Tiffany Ho, MD, MPH, FAAFP Immediate Past President Daniel Payne, MD Treasurer At-Large Board Members Shannon Baker, MD Craig Batty, DO Colten Bracken, MD Emily Chin, DO, MBA Marlin Christianson, MD Katharine Caldwell, MD, MPH Brandon Hall, MD, FAAFP Katherine Hastings, MD Jessica Jones, MD, MSPH Bernadette Kiraly, MD, FAAFP Collin Lash, MD Matthew McIff, MD David Miner, MD Jaime Montes, DO Heather Sojourner, MD, FAAFP Kirsten Stoesser, MD, FAAFP Sally Tran, MD Sara Walker, MD, MS, FAAFP AAFP Delegates and Alternates Thea Sakata, MD AAFP Delegate Saphu Pradhan, MD, FAAFP AAFP Alternate Delegate Chad Spain, MD, FAAFP AAFP Delegate Nick Duncan, MD AAFP Alternate Delegate Family Medicine Residency Representatives Andrew Sorenson, DO CHC Family Medicine Residency Representative Claire Baumgartner, MD McKay-Dee Family Medicine Residency Representative Ellie Zurbuchen, MD St. Mark’s Family Medicine Residency Representative Hendrik Stegall, MD University of Utah Family Medicine Residency Representative Clayton Watts, MD Utah Valley Family Medicine Residency Representative Medical Student Representatives Desiree Gonzalez Noorda College of Osteopathic Medicine Maria Kothari Rocky Vista University — Southern Utah Izak Walker University of Utah School of Medicine 8
Utah Medical Students Reflect on the AAFP FUTURE Conference DISCOVERING WHAT WE’D BEEN MISSING By Jaxon Savage, OMS-IV, Rocky Vista University, FUTURE Alternate Delegate Attending this conference for the first time made me realize how much I had missed by not going in previous years. For any medical student interested in family medicine, it truly is one of the most valuable experiences available. From lectures on the specialty and residency application process to an expo hall filled with residency programs, the opportunities are unparalleled. The environment allows you to connect with current residents and program directors in a relaxed, conversational way, making it easy to ask questions and gain insight into their programs. The connections made here can shape not only your understanding of family medicine but also your future in the field. Finding Your FUTURE in Family Medicine The AAFP National Conference for Students and Residents is now called FUTURE, reflecting the exciting path ahead for medical students who will shape the next generation of family physicians. Held every July in Kansas City, FUTURE is the nation’s largest residency fair, featuring representatives from nearly every family medicine residency program in the country, along with the U.S. Armed Services. The conference also includes educational sessions, inspiring keynote speakers, poster presentations and hands-on workshops. This year, more than 25 students from Utah’s three medical schools attended. Thanks to the generous support of the UAFP Foundation, many were able to receive stipends to help cover the cost of travel and lodging. By Maryann Martindale, CEO, UAFP Community Health Center Residency 9
A VOICE IN THE PROFESSION’S FUTURE By Serin Baker, OMS-III, Noorda College of Osteopathic Medicine, FUTURE Student Delegate Attending the FUTURE Conference as a medical student and serving as a student delegate was an inspiring experience. I had the opportunity to participate in the Student Delegate Congress and vote on student-written resolutions intended to advance the family medicine profession, such as furthering behavioral health integration in medical school and residency training, improving clerkship curriculum standards surrounding reproductive care and potential topics for CME. I was also able to engage with program directors and residents who were genuinely excited about family medicine and created a welcoming space for students who share that passion. One of the highlights was hearing directly from residents about their specific experiences during residency, including their first delivery as interns, interactions with co-residents and hobbies they enjoy outside of residency. Conversations at the conference reminded me of the vast range of settings, patient populations and specialized tracks available within family medicine, reaffirming my commitment to pursuing a career that is community-driven, adaptable and grounded in continuity of care. I highly encourage any students interested in family medicine to attend this conference. CRAFTING A LIFE I LOVE IN FAMILY MEDICINE By Shahem Attallah, OMS-III, MBA, Noorda College of Osteopathic Medicine I came to FUTURE to decide, not to be dazzled. Programs are not only choosing me; I am choosing them, and I wanted a clear sense of which residencies match my style, my goals and the physician I am becoming. Walking into a hall with roughly 70% of programs felt like opening a living catalog of how family medicine can be trained and practiced differently. Arriving as a third-year osteopathic student turned out to be an advantage because curiosity outpaced anxiety. Exposure beat assumption every time I asked a real question and listened to how people talked about their work. Very quickly, I built a filter I could carry from booth to booth: Will this place grow my courage, my craft and my capacity to serve, or will it only fill my calendar? That single question changed the conversations I was having. St. Mark’s Residency Above and Below: Utah & Arizona Student & Resident FUTURE Social University of Utah Residency 10
time used for reflection and growth? Where do graduates land, and how much of what you train do they truly use? Range clarified what I want. Some programs leaned into robust obstetrics, procedures and point-of-care ultrasound, while others focused on addiction medicine, refugee health, geriatrics, tribal and frontier care or LGBTQ+ health. The variety did not scatter me; it sharpened my outline. I realized I am energized by clinics that utilize time as a form of treatment and teams that treat learning as real work. “Become so skilled, so flat out fantastic, that your talent cannot be dismissed” is a sentence I am taking seriously, which means doubling down on sleep, movement, mentorship and Spanish so I can serve more patients effectively. I also kept a few lines that feel like anchors for the years ahead. “Family medicine is the pluripotent stem cell of medicine” captured what I sensed on the floor; our training allows us to differentiate into what communities need, then re-differentiate as those needs change. “There are only 24 hours in a day” sounded simple at first, yet it keeps pointing me back to boundaries that protect attention, presence and joy. My mission is to help patients reach their highest potential medically, mentally, emotionally and generationally, and the only way to live that mission is to train where time, teams and teaching are designed to make it possible. Not every program felt right, and that contrast was valuable. Some spaces felt like instant oxygen, while others felt like heroics with a smile. Saying out loud what I need drew the right mentors and gently repelled the wrong fit. I arrived wondering if it was too early to attend as an OMS-III and left convinced I was right on time, because seeing so many programs in one place did not make my decision easy; it made my decision informed. This was not just a recruiting fair; it was a rehearsal for the career I want. The AAFP FUTURE conference floor taught me range, the sessions taught me design and the hallway conversations taught me culture. I am leaving with a compass instead of a script, and that is enough to choose with conviction. Next comes the work of excellence, curiosity and service, one ordinary Tuesday at a time. Looking Ahead Across sessions, expo halls and chance encounters, Utah’s medical students found more than career guidance; they found clarity, community and confidence in the path ahead. FUTURE offered a living portrait of what family medicine is and what it can become. The next generation of family doctors is ready, curious, grounded and determined to build their future one ordinary Tuesday at a time. McKay-Dee Residency Above: Utah Valley Residency Below: Utah Medical School FUTURE Attendees I asked about a typical Tuesday, rather than the glossy highlight reel, and paid attention to how people described the parts of training that never make it into a brochure. “Knowing who you are is the first step to finding where you belong” became a refrain I wrote at the top of my notes, a reminder to match culture with mission, not marketing with hopes. The most useful intel arrived in elevators, coffee lines and lobbies. Staying in the conference hotel meant I kept bumping into program directors and residents, which led to unscripted five-minute chats about night float, precepting rooms and how feedback actually happens. Those moments were disarming in the best way and felt more honest than any slide deck. Serendipity pays compound interest when you are prepared, and I arrived ready with questions that cut to fit: Who coaches residents here, not just supervises them? How is protected 11
2025 AAFP Congress of Delegates Recap It was another great year at the annual AAFP Congress of Delegates (COD). UAFP members are always well-represented by their elected representatives, and this year’s delegates were no exception. This year’s congress was held Oct. 4-6 in Anaheim, California. UAFP presented two resolutions, both of which were passed by the delegates. Resolution 1: Addressing Health Misinformation in Primary Care to Support Clinician Well-Being and Patient Trust This resolution instructs AAFP to develop and disseminate evidence-based training modules and communication resources to assist family physicians in effectively and efficiently addressing health misinformation during clinical encounters, with the goal of preserving trust, improving patient outcomes, delivering evidence-based care and reducing clinician stress and burnout. Resolution 2: HIPAA Protection for Immigration Status This resolution directs AAFP to advocate for the recognition of immigration status as PHI, not to be disclosed without the expressed consent of patients. For those wishing to get involved, delegate elections are held each year in the spring, and delegates are elected for a two-year term. The 2026 Congress will be held in Nashville, and the 2027 Congress will be held in San Diego. Please scan the QR code to view the complete list of resolutions, UAFP positions and final results. https://docs.google.com/spreadsheets/ d/1I56ow5PpVkhqzIQI2L1Jn7zm_OJ_affN/ed it?gid=1028351924#gid=1028351924 Perspectives from Utah’s Delegates NICK DUNCAN, MD, UAFP ALTERNATE DELEGATE “I am tired of being educated about fire safety by arsonists!” The metaphorical phrase spoken by AAFP CEO Shawn Martin capitalized on the momentum building throughout his address to the 2025 COD. It was the phrase that captured my attention the most as I attended the Congress a few weeks ago. (I’ll let you guess as to what he was referring to.) We are living through turbulent times, to say the least, in the healthcare landscape. Systems we have relied on — and that much of the world has also relied on — for decades are being dismantled or attacked. Uncertainty is felt everywhere, especially by our patients. Outgoing AAFP President Dr. Steven Furr addresses the Congress. 12
And yet, despite the turbulence, throughout this Congress, there was a clear sense that we are uniquely positioned to continue educating our patients individually with evidence-based guidance and fight collectively on a larger scale to push back against the misinformation flooding the country. Dozens of resolutions were debated, reworded and reorganized, and many eventually passed, providing clear direction for the Academy to stand strong for our profession and our patients in this difficult landscape. As a delegation, it was heartening to see the two resolutions we put forth pass, again with strong emphasis on supporting us as we care for our patients. While I did not write down quotes from others who spoke during the Congress, I walked away with great confidence in our national leaders. The newly sworn-in president, Dr. Sarah Nosal, and the newly elected president-elect, Dr. Kisha Davis, both bring extensive experience and drive to lead us through the turmoil. I wholeheartedly support them as they stand firm for us and our patients on a national level, clearly proud to be family physicians. I, too, am proud to be a family physician. Thank you for the opportunity I have been given over the last two years to represent Utah at the AAFP COD. It has been an honor and a privilege. CHAD SPAIN, MD, FAAFP, UAFP DELEGATE I’ve yet to come away from an AAFP event without feeling rejuvenated, and this year’s COD was no different. With a clearly unprecedented year of combating science against the current leadership of HHS, Shawn Martin (CEO of AAFP) let it be known that the Academy will continue to fight for the health of our patients and our rights to practice as physicians. Incoming president Sarah Nosal, MD, FAAFP, and new president-elect Kisha Davis, MD, MPH, FAAFP, gave passionate speeches as well, ensuring the leadership of the academy is in great hands for years to come. Our delegation was able to pass both resolutions we submitted this year, including one to help physicians combat medical misinformation. For those of you who may feel isolated, helpless or defeated in your quest to deliver healthcare in an effective model for both you and your patients, know that you’re not alone. After speaking with our colleagues across the nation, it’s clear that we all face similar barriers from external forces. The AAFP hears your voice and is working diligently to improve your life and our healthcare system. It’s been an honor to serve in Utah’s delegation; we trust that the work at COD will establish a framework to improve your clinical practice and lives in the immediate future. THEA SAKATA, MD, UAFP DELEGATE Today is a great day to be a family physician! At first, this may seem like a strange thing to say. Avedis Donabedian, the grandfather of health services research, theorized that Dr. Chad Spain speaks in favor of the UAFP resolution on the need to address misinformation. 13
structures underpin processes that beget outcomes. As we see many structural foundations of science and medicine dismantled around us, the future looks grim for many processes and outcomes to which our profession has become accustomed. But out of crisis rises opportunity, and if we family docs want things to change, now is a tantalizing moment to engineer it. That work was well displayed at this year’s AAFP COD in Anaheim, California. Two reflections on this year’s Congress come to mind. First, the energy in the room was different than when I was a delegate for our state two years ago. While there was always a sense that the work of the COD was important, this year it held more gravity and urgency than before. As part of the usual opening rounds of business, Speaker Russell Kohl of Missouri called for any late resolutions to be presented. Because they have not undergone the procedural scrutiny of the regular resolution submission process, late resolutions can be an eclectic mix of urgencies and imperfectly reasoned desires. This year was different. There was only one late resolution brought before the congress: an ask by Dr. Steven Furr, past AAFP president and family doc from Alabama, to include healthcare work as an independent risk factor for infectious diseases due to repeated pathogen exposures, thus allowing healthcare personnel without other conditions to have access to any available immunizations, personal protective equipment and pre/post exposure prophylaxis. In a year when writing prescriptions for COVID shots took up greater than zero hours of physician time, I not only appreciated the spirit of Dr. Furr’s resolution, but also how it highlighted that organizations matter. When healthcare workers are facing barriers to their own safety, a policy statement from a major national physicians’ organization, such as the AAFP, can help them push back. The second reflection that made an impression is that if we physicians want the healthcare system to change in a way that supports our patients’ health and our role therein, using our professional societies to get there makes good sense. Management strategist and Harvard Business School professor John Kotter famously outlined an eight-step model for episodic change management. (See Miles et al., 2023, PMID 36817526, for an accessible description of the model and how a GME program utilized it for candidate recruitment.) I’ve listed the first four steps below, along with how current events and the AAFP’s existing infrastructure already put us halfway to major change. The First Four Steps of Kotter’s Model for Change Management 1. Create a Sense of Urgency: Current events have already done this. 2. Build a Guiding Coalition: The AAFP’s leadership and influential groups. 3. Form a Strategic Vision: The work of the AAFP COD. 4. Enlist a Volunteer Army: All of us as the membership of the AAFP. The remaining four steps — enable action by removing barriers, generate short-term wins, sustain acceleration and institute change — are still works in progress. However, if we want a future healthcare system that works for us rather than against us, family physicians are well-positioned to drive that change. Newly sworn-in AAFP President, Dr. Sarah Nosal, gives her president’s address. 14
I can’t wait to see what next year’s COD brings. What a great time to be a family physician! SAPHU PRADHAN, MD, FAAFP, UAFP ALTERNATE DELEGATE Throughout my years of involvement with the AAFP in various roles, I have considered it a privilege to be among the most passionate family physicians in the country, discussing important issues facing our profession, our patients and the communities we serve. I have trusted the AAFP to stand behind science, defend our scope of practice and take an objective approach on charged issues to accomplish our shared goal of providing holistic care. In past years, the camaraderie between diverse-minded colleagues and our ability to reach an agreement on various issues were matters of conversation and mutual understanding. However, this year, I was skeptical of finding common ground as topics that were previously taken for granted have now become controversial. I was anticipating a COD meeting with vaguely worded speeches that would tread lightly on those issues, and expected that the delegates and alternate delegates would assume divisive positions. Surprisingly, the speeches were quite open and direct, recognizing that we are living in a dynamic era and our ability to care for patients has been overshadowed by fears that were previously not a threat. The progress we have made over decades of hard work to serve all populations in this vast nation is being reversed, further limiting access to healthcare and our ability to provide it. Family medicine relies on our ability to establish trust and build relationships with the human beings we serve; to develop an understanding of their values and beliefs; to take into consideration the issues they face in daily life that may interfere with their ability to access appropriate and adequate care; to take into account their mental health as a significant part of their overall state of health and wellbeing; and to guide them through the scientific basis of their diagnosis and management of their conditions. Our practices are now limited regarding which human beings we may serve, who may receive our services, what kind of services we may provide, which services are unavailable, who can afford care and the extent of the care we may provide within these boundaries. The obstacles we are facing seem vast and insurmountable. Once again, the assembly of national leaders and state representatives that participated in the COD meeting brought reassurance, reinforcing that we are not alone and we are not helpless. State chapters, including ours, remain united with a common purpose. National leaders are working with other healthcare organizations to address each challenge and develop creative strategies to provide evidence-based, high-quality care to the human beings we call patients. I hope all Utah family physicians can find support and understanding in this organization. Thank you for the opportunity to serve as your alternate delegate. UAFP Delegation, L to R: Dr. Chad Spain, Dr. Thea Sakata, UAFP CEO Maryann Martindale, Dr. Nick Duncan, and Dr. Saphu Pradhan 15
The first time a medical student sits beside a seasoned physician in the exam room, something transformative happens. In that ordinary moment of listening to a patient’s story and deciding on a course of care, the student begins to see what medicine truly means. For many, that moment, guided by a preceptor, becomes the compass that defines the kind of doctor they will become. “Preceptors profoundly shape the trajectory of medical students,” says Dr. Lynsey Drew, dean of Noorda College of Osteopathic Medicine in Provo. “The time a physician spends teaching in the clinic or hospital often becomes the moment a student discovers who they are, what kind of physician they want to become and why the calling to medicine matters.” That calling has never been more urgent. Across the United States, and even more acutely here in Utah, medical schools are expanding faster than clinical teaching opportunities. Class sizes are growing and new campuses are opening, yet the number of available preceptors has not kept pace. Each year, thousands of clinical weeks must be filled to meet accreditation and graduation requirements. Without more physicians willing to teach, students face delays or limited access to the very experiences that make them competent, compassionate clinicians. The Growing Strain In 2025, Veritas Health Solutions published “Bridging the Gap,” a report commissioned by Utah’s Health Workforce Advisory Council. The findings were sobering: The state faces a “significant and growing deficit in clinical preceptor capacity,” particularly in “You Help Shape Who They Become” A Call for Family Physicians To Meet Utah’s Urgent Need for Clinical Preceptors family medicine. Its companion report, “Development Process and Supporting Research,” outlines how that shortage emerged alongside Utah’s rapidly expanding medical education landscape, including new osteopathic and allopathic programs and regional campuses designed to keep students in-state. Research shows that most medical students who attend school and complete residency training in a state will stay to practice there. That means Utah’s preceptors aren’t just teaching students, they are shaping the future healthcare workforce of their own communities. Dr. Drew calls this a “tremendous opportunity.” She notes that nearly 80% of healthcare happens not in large academic centers, but in community-based clinics. “Those community physicians are uniquely positioned to teach the skills, judgment and values students need most,” she says. “The investment of preceptors strengthens our profession in ways that extend far beyond any single rotation.” A Preceptor’s Perspective In Provo, Dr. Erik Gulbrandsen, a family physician, has been precepting medical students since finishing his residency. 17
Teaching has always brought him joy, but it took a single continuing medical education session to change his perspective on it. “At a UAFP CME event, a physician from the Society of Teachers of Family Medicine (STFM) explained how medical students can actually speed you up, instead of slowing you down,” Gulbrandsen recalls. “That idea changed everything.” He began giving students meaningful responsibilities. Every morning, his students review the previous day’s lab and imaging results and propose treatment plans for each patient. Gulbrandsen then discusses and refines those plans with them before having the students communicate the plan to the patient and document the conversation. The result, he says, is greater efficiency and deeper learning. “They remind me why we ordered certain tests, they handle documentation and they help me keep the clinic flowing,” he says. He also adopted a modified-wave scheduling system that allows both him and the student to see patients in tandem, cutting down on perceived wait times and increasing the number of patients seen. For Gulbrandsen, the rewards go far beyond productivity. “If you give students responsibility, instead of just shadowing, the growth you see in them is phenomenal,” he says. “It’s incredibly rewarding. Years from now, you’ll have a coaching tree filled with students who remember you for what you did to help them grow. You end up helping more patients than you ever could on your own.” A System Under Pressure Dr. Michelle Hofmann, interim senior associate dean for the University of Utah’s new Southern Utah Regional Medical Campus, says the demand for preceptors has reached a critical point. “Utah’s healthcare landscape is evolving rapidly,” she explains. “With explosive growth in MD, DO, PA and advanced practice nursing programs, the demand for clinical preceptors, especially in family medicine, is greater than ever.” According to the Veritas reports, financial constraints remain one of the largest barriers. While some schools offer stipends, many physicians either cannot accept payment or choose to volunteer. Regardless of compensation, Hofmann points out that the American Medical Association’s Principles of Medical Ethics affirm a physician’s duty to support medical education. “Family physicians are the cornerstone of community health,” Hofmann says. “They’re uniquely positioned to give students broad, high-impact clinical experiences. And students bring fresh perspectives and current knowledge that can enrich a practice.” Teaching, she adds, is also one of the most effective ways to recruit and retain young physicians in underserved areas. “When students learn in community settings,” Hofmann says, “they see themselves building a future there.” Turning Policy Into Action The “Bridging the Gap” report didn’t just diagnose the problem — it also proposed solutions, chief among them being a statewide Clinical Preceptor Stipend Program, endorsed by the Health Workforce Advisory Council in 2025. The program aims to ease financial barriers by compensating physicians who dedicate time to teaching, a long-overdue recognition. But the reports make clear that funding alone won’t close the gap. Many clinicians hesitate to precept because they fear it will slow their clinics or add to administrative burdens. Others doubt they have the temperament or skills to teach effectively. As Dr. Gulbrandsen’s experience shows, however, structured delegation and intentional scheduling can make precepting not only feasible but energizing. Moreover, the act of teaching itself can serve as a counterbalance to burnout, a way to reconnect with the purpose that drew so many into medicine in the first place. “The experiences with our students often lead to reinvigoration of the why in medicine,” says Dr. Drew. “Precepting reminds physicians of the meaning and purpose that first called them to the profession.” A Call to Family Physicians Utah’s physician community now stands at a pivotal moment. As the state expands its medical training infrastructure, the need for community-based preceptors has never been greater. The policy groundwork is being laid; the funding mechanisms are on the horizon. What remains is the profession’s response. Becoming a preceptor is more than an educational service; it’s an act of stewardship. Every physician who chooses to teach invests in the next generation of clinicians, ensures the vitality of the workforce and strengthens the fabric of community health. As Dr. Hofmann puts it: “By serving as a clinical preceptor, you play a vital role in shaping the future of medicine in Utah and beyond.” To those already teaching, thank you. To those considering it, now is the time. Reach out to a medical school, open your clinic door to a student and remember what first inspired you to practice medicine. The future of healthcare in Utah depends on it. 18
Acknowledgments This article was developed with input and contributions from: • Lynsey Drew, DO, MBA, FAAFP, Dean, Noorda College of Osteopathic Medicine • Erik Gulbrandsen, DO, Family Physician and Clinical Preceptor, Provo, Utah • Michelle Hofmann, MD, MPH, MHCDS, Senior Associate Dean (Interim), Southern Utah Regional Medical Campus, Spencer Fox Eccles School of Medicine at the University of Utah Special thanks to Veritas Health Solutions for its “Bridging the Gap” and “Development Process and Supporting Research” reports, which informed much of the policy context for this article. Why I Precept: Perspectives from Preceptors in Utah “It’s an honor to care for the men and women who have given so much in service to our country. As a reservist, I feel responsible to help create the next generation of physicians who are called to serve. I especially value working with students who are military-bound or on VA scholarships, as they share a commitment to caring for my brothers and sisters in arms. Precepting is one way I can give back and ensure our veterans continue to receive the high-quality, compassionate care they deserve.” Zachary Farnworth, DO Family Practice Physician, U.S. Department of Veterans Affairs “I have been precepting now for the past two years, and the experiences with students have made my job more enjoyable and fulfilling. I love being able to show students the depth and breadth of family medicine and all that we are trained to do. Many students come in with the misconception that we only treat blood pressure and diabetes, so it is always fun to hear, ‘I didn’t know that family docs did that too!’ Precepting is not only needed for students to learn directly from practicing physicians, but it is also needed to advance the profession. I believe and have seen that a well-rounded experience during the family medicine rotation is a crucial driver in students choosing to match to our specialty. Several students of mine have commented at the end of the rotation that they are now seriously considering a career in family medicine. I have benefited from excellent preceptors during my training and am happy to pay it forward.” Cameron Smith, DO Mountainlands Community Health Center “Many of us in family medicine feel overwhelmed every day, and it is hard to imagine taking on one more thing. Teaching medical students is something that I never hesitate to do, even with all the other stressors around me. I know that the future of our profession is fragile right now, and it is more important than ever to help train and mentor future family physicians. Teaching medical students in my clinic is one thing that actually fills my cup instead of emptying it. I love the energy and enthusiasm the students have for learning. Asking them to call a patient or a pharmacy to check on something or present to me about a topic the next day we are together really keeps me stimulated and takes the burden off me or my staff in the office. I will always make time for teaching as it was good teaching that got me to where I am today, and I want the future family physicians to be just as strong, compassionate and knowledgeable as we are!” Shannon Baker, MD Intermountain West Jordan Clinic “The road to becoming a physician is a long one, and along the way, students learn from a wide variety of physician-mentors. I recently completed my training at McKay-Dee Family Medicine Residency, and I’m deeply grateful to the many physicians who took the time to teach and guide me. Teaching learners often requires extra time, energy and patience, which is something I didn’t fully appreciate until I entered practice myself. But now, working with students has given me a renewed appreciation for those who helped me along my own path. I love witnessing their ‘aha’ moments and seeing their growth firsthand. They also help keep me sharp by bringing fresh perspectives, current research and questions that challenge me to reflect on my own practice and stay current with the latest evidence. I plan to continue working with students throughout my career. It’s one of the most meaningful ways I can give back to the profession and help shape the future of medicine.” Andrew Steinicke, MD Syracuse Tanner Clinic 19
When Deirdre Amaro, MD, walked into her first autopsy as a medical student, she didn’t expect to feel wonder. The case was messy, quite literally. A bowel perforation during evisceration and holding a human brain for the first time did not inspire revulsion as it might in some. “This is so freaking cool,” she remembers thinking then, and still thinks now as Utah’s chief medical examiner. Amaro didn’t set out to become a forensic pathologist. She began medical school with a vision of pediatrics as a career, but the pace of outpatient visits, the brief time she had to meet with them and the sorrow of inpatient pediatrics nudged her toward pathology. She completed a forensic pathology fellowship in New Mexico, followed by a neuropathology fellowship (“I’m prepared for the zombie apocalypse,” she jokes). She spent the next leg of her career as a sole practitioner for a sheriff’s office in far Northern California. Eventually, she decided she missed academia and took a position in Missouri, initially as an assistant medical examiner and later as the chief medical examiner. While there, she also joined the faculty at the University of Missouri in the pathology department. When asked what brought her to Utah to work as the chief medical examiner for the Department of Health and Human Services (DHHS), she, like many, mentions the beauty of the mountains, The Final Act of Care A Conversation With Utah’s Chief Medical Examiner By Barbara Muñoz, MPP, Associate Director, UAFP Dr. Deirdre Amaro and UAFP CEO Maryann Martindale outside of the Office of the Medical Examiner after a tour of the facility. 20
as well as the relative lack of ticks and summer humidity prevalent in Missouri. Another benefit of working in this capacity in Utah is the Office of the Medical Examiner’s (OME) statewide structure. Much of the U.S. is a patchwork of death investigation systems; most jurisdictions are county-based, and many are led by elected coroners with varying levels of training. In some places, the qualifications to be a coroner amount to age, residency and winning an election. Autopsies may be performed by “any willing physician” in many jurisdictions. Utah, by contrast, runs a statewide medical examiner system within the DHHS, which establishes uniform standards and ensures consistent data collection. It also, crucially, provides a direct link between death investigation and public health. “People think a death certificate is just paperwork,” Amaro says. “But the cause and manner we assign are coded into ICD. That becomes mortality data. It’s how we know what’s really killing people — and how we decide what to do about it.” She can point to the benefit of this data for public health, both contemporary and historic. In the present, Utah’s clarity about fentanyl-related deaths through robust and accurate data has underpinned a multi-stakeholder response, including the governor’s Fentanyl Task Force. A historical example involves an autopsy technician on the East Coast who noticed an alarming pattern: infants dying in car crashes at far higher rates than others. Once validated with national mortality data, that observation helped drive a change in car-seat requirements, which led to a decrease in the number of infant deaths in car accidents. Cases like these illustrate the profound impact that the quiet, meticulous work of death investigation and data analysis can have on the lives of the living. For family physicians, the most immediate intersection with Amaro’s office is the death certificate. Most deaths in Utah are natural deaths under physician care and never become ME jurisdiction. That’s where clinicians often feel a pang of uncertainty. The patient died at home over the weekend. Police arrived first. The funeral home is calling. What now? First, Amaro reassures, it is typically unnecessary to complete a certificate outside business hours. While issuing the death certificate promptly is critical for the family of the deceased, it’s normal for physicians to take time, gather the information they need to complete the certificate and ask for help from the ME if needed. “There are several steps that happen before your signature is needed,” she says. Law enforcement often makes the initial scene assessment in unattended deaths; the funeral home usually coordinates the next steps and outreach to the treating physician. If the scene investigation has ruled out trauma, overdose or suspicious circumstances, and the patient’s clinical history supports a natural process, it may be reasonable to certify a natural death even without an autopsy. “Uncertainty is part of medicine,” she notes. “An autopsy isn’t a magic box that always yields a single, definitive answer. We make clinical judgments in life; we also make them at the end of life.” If families ask about an autopsy outside the ME jurisdiction, the pathway is a hospital or private autopsy. Both require consent from the legal next of kin. Utah has an additional safeguard that clinicians should be aware of and explain to families: The ME’s office reviews every case slated for cremation or removal from the state. Most reviews are straightforward, but they occasionally surface concerns that warrant a deeper look. “Sometimes the body is the evidence,” Amaro says. When that evidence would otherwise be destroyed or leave the state, the office may intervene — a necessary step, though it may be inconvenient for families. Behind these processes lies Amaro’s larger appeal to family physicians: collaboration. Physicians receive little formal training in death certification. It can be stressful when a patient dies and the “final diagnosis” falls to a clinician who wasn’t present at the time of death and, in some cases, has not seen the patient in some time. Her message is simple: Call us. “If one of your patients dies and it’s not our jurisdiction, but you have questions about how to structure the certificate, we’re happy to help. We know how important this is for the family, and for understanding the health of our community.” That collaboration begins with a shared ethos. To Amaro, signing a death certificate is an act of care, not a bureaucratic chore. It honors the patient’s story with a clear, defensible conclusion that reflects what we know about their health and the circumstances of death. When uncertainty creeps in, consider the information you, as the physician, Dr. Deirdre Amaro 21
obtain because of a competent scene investigation: no evidence of trauma; medications accounted for; no red flags for overdose; no indicators of foul play. If those things are ruled out, a natural death grounded in known disease is the likely culprit. And if you’re still uneasy, pick up the phone. The point, Amaro stresses, is not to impose decisions on busy clinicians, but to stand alongside them. Utah’s system isn’t perfect, she admits. No system is. Even here, late course corrections occur: a cremation review triggers a deeper inquiry; a case that should have come in earlier is retrieved; plans are disrupted. But the redundancies are purposeful, designed to protect families and the public’s trust. In her view, the difference lies in a culture that prioritizes accuracy and cooperation over speed or convenience. Chief Medical Examiner Deirdre Amaro (left) and Chief Medical Examiner Investigator Cory Russo (right) on a media tour of the Utah Office of the Medical Examiner on Nov. 14, 2024 (published with permission from Alixel Cabrera/Utah News Dispatch). Dr. Amaro presents to a group of UAFP members, including residents and attendings, on how to properly fill out death certificates. Ultimately, the work proves surprisingly humane. Families arrive at the ME’s doorstep, stunned by loss and overwhelmed by the logistics of death, including the funeral home arrangements, the paperwork and the toll of grief. “The business of death adds an extra layer of trauma,” Amaro says. “If we [the ME’s office and clinicians] can minimize that through education, partnership and timely certification, everybody is better served.” ADVERTISE HERE! RESERVE YOUR SPOT TODAY! 801 676 9722 sales@thenewslinkgroup.com RESEARCH SHOWS: • The average ROI for print advertising is around 130%. – Electro IQ • 56% of consumers trust print marketing more than any other advertising method. – AllBusiness.com • Print media has a 90% brand recall rate, the highest among all advertising channels. – Sonder & Tell Don’t just take our word for it! PRINT ADVERTISING isvital for success. 22
MEMBER SPOTLIGHT Roots and Early Inspiration I grew up in New Baltimore, Michigan, on Lake St. Clair, in a family of five children living in the house our mom grew up in. Our family has always been very close, including several generations of extended family, friends and neighbors. Back then, New Baltimore was transitioning from a very rural to a suburban area as the Detroit Metro area expanded north, and to this day, it maintains a small-town feel. People know each other, and no matter how far I have traveled or what I have accomplished, I will always be “Frankie Powers” when I return home. The Road to Medicine Both of my parents are healthcare workers: my father, a dentist who built enduring relationships in our town over 40 years, and my mother, a nurse on labor and delivery known for her empathy and clinical expertise. I witnessed firsthand the dedication, purpose and humility inherent in the healthcare profession. While I was encouraged to take any career path, I was inspired to pursue a career in medicine. I attended De La Salle Collegiate, a high school with a strong foundation in education and service to others. During the summers, I worked in landscape construction alongside Mexican-American men working 70-hour weeks to support their families. I went to Kalamazoo College, a liberal arts college in Michigan, where I majored in biology, ran cross-country, lived in Ecuador for a study abroad, performed research in biochemistry on cytochrome P450 metabolism, created a Spanish interpreter service for the pediatric hematology-oncology clinic and worked at Bell’s Brewery with some eclectic characters. I considered various career paths in science. Ultimately, my upbringing, my high school education encompassing service to others and my experiences at Kalamazoo College regarding human rights, social justice and diversity solidified my desire to practice medicine. It’s as a way to contribute to community, engage in people’s lives and impact health while treating all people with dignity, respect and compassion. Frank Powers, MD 23
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