Annual Member Meeting Highlights Congress of Delegates STRONG MEDICINE FOR UTAH
Congratulat ons UAFP! To view this year’s winners, please scan the QR code. http://enter.marcomawards.com/ winners/#/platinum/2022 2022 Ma Com Aw rds Winner! Since its inception in 2004, MarCom Awards has evolved into one of the largest, most-respected creative competitions in the world. This year, there were over 6,000 entries from throughout the United States, Canada, and over 43 other countries in the competition. MarCom Awards is an international creative competition that recognizes outstanding achievements by marketing and communication professionals and recognizes the creativity, hard work, and generosity of industry professionals. Being a Platinum Winner is a tremendous achievement symbolized by the intricately detailed MarCom statuette. The MarCom graces the trophy cases of some of the top business and communication firms in the world. MarCom’s Plat num Award is presented to those entries judged to be among the most outstanding entries in the competition. Platinum Winners are recognized for their excellence in terms of quality, creativity, and resourcefulness. We are very pleased to announce that the Utah Academy of family physicians was awarded the MarCom Platinum for print media.
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STRONG MEDICINE FOR UTAH Participation by advertisers does not constitute endorsement by the UAFP. CONTENTSIssue 2 2022 © 2022 Utah Academy of Family Physicians | The newsLINK Group, LLC. All rights reserved. UAFP is published two times each year by The newsLINK Group, LLC for the UAFP, and it is the official publication for this association. The information contained in this publication is intended to provide general information for review and consideration. The contents do not constitute legal advice and should not be relied on as such. If you need legal advice or assistance, it is strongly recommended that you contact an attorney as to your specific circumstances. The statements and opinions expressed in this publication are those of the individual authors and do not necessarily represent the views of UAFP, its board of directors, or the publisher. Likewise, the appearance of advertisements within this publication does not constitute an endorsement or recommendation of any product or service advertised. UAFP is a collective work, and as such, some articles are submitted by authors who are independent of UAFP. While UAFP encourages a first-print policy, in cases where this is not possible, every effort has been made to comply with any known reprint guidelines or restrictions. Content may not be reproduced or reprinted without prior permission. For further information, please contact the publisher at 855.747.4003. The mission of the Utah Academy of Family Physicians: To improve the health of all Utahns by advocating for and serving the professional needs of family physicians. 24 10 UtahAFP.org | 4
22 Executive Director’s Message 6 President’s Message 7 2022/2023 Utah Academy of Family Physicians Board of Directors 9 Connect With Your Fellow Utah Family Physicians: Join a UAFP Committee 10 Annual Member Meeting Highlights 11 Congress of Delegates 2022 12 Member Spotlight: Erik Gulbrandsen, DO 14 Resident Spotlight: Andrew Steinicke, DO 17 Medical Student Spotlight: Mariah Richins 19 UAFP CME & Ski 2023 21 In Support of Ukraine 22 Lessons Learned from Global Travel 24 Population Health Scholars Program to Bring More Primary Care Physicians to Utah 26 On the Cover – Listed clockwise from top: 75th Anniversary – Some of our amazing members, from medical students to semi-retired, gathered at our 2022 Annual Meeting, where we kicked off our 75th anniversary as an organization. CME & Ski – Presenters Rebecca Chavez-Houck, Dr. Danielle Jones, and Dr. Jessica Jones at our 2022 CME & Ski. Southern Utah – Students and faculty at Rocky Vista University-Southern Utah met with local members for a picnic and hike in November 2021. Congress of Delegates – Dr. David Cope, Dr. Thea Sakata, Maryann Martindale, Dr. Jordan Roberts, and Dr. Kirsten Stoesser at AAFP’s Congress of Delegates in Washington D.C. ACLF – UAFP Staff, Maryann Martindale and Barbara Muñoz, and UAFP President, Dr. Saphu Pradhan, attended AAFP’s Annual Chapter Leader Forum, while members Dr. Tiffany Ho and Dr. Thea Sakata attended AAFP’s National Conference of Constituency Leaders in Kansas City, MO. Hogle Zoo – UAFP held an event for members and their families at Utah’s Hogle Zoo in June. 5 |
By UAFP CEO/Executive Director, Maryann Martindale No physician should be at risk of legal or administrative consequences when treating their patients in a legal and evidence-based way. We do not advocate for physicians to break laws but rather for laws that allow physicians to treat patients to the best of their abilities. Unless you’ve been in space for the past few years, you are well aware of the divides we are seeing in this country. I have heard the same question over and over again: “Has it ever been this bad?” I don’t know the answer to that, but I know we are in perilous times. We have reached a division in this country with no end in sight. It would take a concerted effort from all sides to come together, find those things that unite us, and work to overcome this rift, and that doesn’t seem very likely any time soon. We have seen a somewhat successful effort to return to the states the right to make legal determinations about a variety of issues. There are pros and cons to this approach. Allowing states to make laws allows them to be more responsive to their own unique needs. It also creates a patchwork of laws across the country. For physicians who may have patients who travel, have homes in multiple locations, or otherwise need services that may differ from state to state, it can be difficult to navigate. Some of these issues are controversial, and we don’t all hold the same opinion; from reproductive rights to medical cannabis to end-of-life options – medical alternatives that are legal in some states and illegal in others. To be fair, not all issues are controversial – some are based on accessibility, infrastructure, etc. But instead of dividing us, we should allow for different viewpoints and support the rights of both physicians and patients to make the choices they feel are best. The patient-physician relationship is the very foundation of care. Maryann Martindale with UAFP Student Delegate, Stephen Ward, University of Utah School of Medicine Class of 2023 As we have approached our various legislative responsibilities – Congress of Delegates, the UMA House of Delegates, and our work at the Utah State Legislature – one of our guiding principles is protecting the rights of our trusted family physicians. No physician should be at risk of legal or administrative consequences when treating their patients in a legal and evidence-based way. We do not advocate for physicians to break laws but rather for laws that allow physicians to treat patients to the best of their abilities. We wrote and passed resolutions at both the UMA House of Delegates and the AAFP Congress of Delegates to ensure that our governing bodies actively support legislation and policy that protects family physicians and their patients, specifically when state laws differ, from negative repercussions when giving information, helping to secure treatment that may not be available where they reside, and when providing care for patients who may come from neighboring states. We may not all hold the same position on every issue, but our hope is to find common ground. We believe that protecting the rights of physicians to practice without harm is critical to the profession and a position we hope all physicians can support. EXECUTIVE DIRECTOR’S MESSAGE UtahAFP.org | 6
PRESIDENT’S MESSAGE There’s a lot going on in our world right now. The challenges of the COVID pandemic have changed, but the strain it has caused and continues to cause is palpable to all of us in varying degrees. Like many of you, I have spent considerable time reflecting on ways to move forward, focusing on how to provide excellent care for patients and how to thrive personally and professionally. This has been no easy feat. I was recently sitting with a patient of advanced age who had just been discharged from the hospital for injuries sustained from yet another fall. While reviewing her case – vitals, labs, imaging studies, preventative screenings, performing a clinical evaluation, meeting meaningful use and documentation requirements, examining the criteria for ordering further diagnostic testing or prescribing a medication or referral or procedure to treat or manage her medical conditions in a fashion acceptable to the insurer – she asked how I was doing. Unlike my usual answer of “Fine.” I unexpectedly answered, “It ’s been rough,” guiltily followed by, “not as rough as what you’ve been through, though.” She replied, “I feel fine. You look terrible.” I laughed, “How do you know? I’m wearing a mask and safety goggles.” She rolled her eyes and said, “I can tell.” I told her not to worry about me, negotiated whether she would use her walker or let the home health physical therapist into her home this time so she could improve her balance, and gave her a list of proteins she might tolerate so she could recover, all the while weighing the merits of hair dye and cosmetics. My barely middle-aged body ached with fatigue at these thoughts. My next patient was a healthy but worried young woman who needed reassurance that despite what her smartwatch or the internet said, she did not have atrial fibrillation or sleep apnea. I gently and cautiously guided her to consider that she may, possibly, potentially, probably, have some anxiety. She said, “I think I’m just anxious.” As I tried to hide my sigh of relief that my motivational interviewing skills hadn’t fallen flat, and I proceeded to address her anxiety. As my day went on, I dispelled some rumors about microchips in the COVID vaccines to multiple individuals glued to their smartphones while listing the side effects that had actually been reported to the CDC. I thanked a patient for recommending a book of conspiracy theories that he found educational. I delicately asked an adolescent about a bruise on her thigh, holding my breath and hoping the aggressor was her desk or a pet, not a person. I hoped that if it was a person, she trusted me enough to tell me, and if she did, I would be able to help her. Thankfully, she insisted it was her car door, and I believed her. I explained to another patient that we couldn’t check all the vitamin levels or all the hormones or screen for all the cancers but did have screening tools like mammograms, colonoscopies, and pap smears, which were quickly declined. But this was not an exceptional day. It was just another day at the office. Is this what I signed up for? What I spent We care for people and our communities despite the barriers. We all chose this profession, and in the face of obstacles, we find compassion in caring for our patients regardless of what they look like or what they believe. President ’s Message | Continued on page 8 By Saphu Pradhan, MD, FAAFP 7 |
PRESIDENT’S MESSAGE CONT. By Saphu Pradhan, MD, FAAFP my best decade of youth and vigor on? What I sacrificed relationships, passed up adventures, mounted massive debt, and shed tears for? This is not what I expected, but the answer is a resounding YES. I chose all those things, and I hadn’t fully appreciated that my real job is to make each person who enters my clinic feel valued. My job isn’t to impose my beliefs; it is to determine what each patient finds meaningful; how they define good health and well-being, to provide the information they need to make educated decisions to get them to their goals, to build a relationship, so they find my advice relevant and trustworthy, and always to treat each person with compassion. I endure the cumbersome EMR and requirements to “provide quality care for our patients,” because I don’t know of a better way to connect so personally with another human being, to make them feel heard and respected, and guide them through the incredibly confusing maze that is our healthcare system. This work can be exhausting, but as family physicians, this is what we do. We care for people and our communities despite the barriers. We all chose this profession, and in the face of obstacles, we find compassion in caring for our patients regardless of what they look like or what they believe. As family medicine physicians in Utah, we are all facing the challenges of a physician shortage, of a growing and changing population, of deciphering and following new laws instituted by our state and federal governments, all while facing decreasing reimbursement from CMS and private payors and increasing pressure to meet various metrics. We’re all in this together, so let ’s make some changes. This year, my goal as president of the UAFP board of directors is to better connect us as family physicians so we can talk openly about where we are and where we should go from here, what is important to us, and how we can support each other. We take such good care of our patients and advocate for them relentlessly, so let ’s use that compassion to care for each other, to encourage and support future generations of family physicians because even on our worst days, the work we do is really immeasurable and irreplaceable. The UAFP is the largest single specialty organization in Utah, with a membership of 1,200 attendings, residents, and medical students interested in pursuing family medicine. Our members are integrated into local and state health departments, in each of the three medical schools, in each healthcare system, and the state legislature. Our numbers give us clout with our local governments, employers, and payors. Let ’s use this advantage to strengthen our specialty and improve our daily lives. Understanding that time is a precious and limited resource, UAFP provides several ways to connect with your peers throughout the year. Whether you are interested in spending the weekend learning and skiing at CME & Ski, attending a Bees game or going to Hogle Zoo with your family and your fellow family physicians, being a part of Utah’s lawmaking process, participating in a service project, or joining a committee – UAFP has several ways you can engage with your colleagues. We always hope to hear from our rural physicians, currently underrepresented on the board, to present topics of interest to you, and provide suggestions, recommendations, and feedback so we can better serve you and your communities. We are also developing a new committee on Equity, Diversity and Inclusion to connect those interested in this area. We are planning quarterly in-person get-togethers hosted by one of our physician members in their home to provide a safe and confidential space to express our frustrations, look for solutions, and provide camaraderie. Our dedicated CEO/Executive Director, Maryann Martindale, and Associate Director, Barbara Muñoz, are committed to serving our members, our communities and advancing our profession. They represent our views and our voice. Please reach out to them with your ideas. We take such good care of our patients and advocate for them relentlessly, so let’s use that compassion to care for each other, to encourage and support future generations of family physicians because even on our worst days, the work we do is really immeasurable and irreplaceable. President ’s Message | Continued from page 7 UtahAFP.org | 8
Shannon Baker, MD Craig Batty, DO John Berneike, MD Marlin Christianson, MD Amy de la Garza, MD Nicholas Hanson, MD Tiffany Ho, MD Matthew Johnston, MD, FAAFP Bernadette Kiraly, MD Marlana Li, MD, FAAFP David Miner, MD Jamie Montes, DO Isaac Noyes, MD Thea Sakata, MD Tyson Schwab, MD Heather Sojourner, MD, FAAFP Kirsten Stoesser, MD, FAAFP Sally Tran, MD Mark Wardle, DO, FAAFP AAFP Delegates and Alternates AAFP Delegate Jordan Roberts, MD AAFP Delegate Thea Sakata, MD AAFP Alternate Delegate Kirsten Stoesser, MD, FAAFP AAFP Alternate Delegate David Cope, MD, FAAFP Family Medicine Residency Representatives McKay-Dee Family Medicine Residency Representative Andrew Steinicke, DO St. Mark’s Family Medicine Residency Representative Skyler Nguyen, MD University of Utah Family Medicine Residency Representative Laura Yeater, MD Utah Valley Family Medicine Residency Representative Jessica Fullmer, MD Medical Student Representatives Rocky Vista University – Southern Utah Nicholas Longe University of Utah School of Medicine Elliot Nielson Noorda College of Osteopathic Medicine Elizabeth Turner Executive Committee At-Large Mission The mission of the Utah Academy of Family Physicians: To improve the health of all Utahns by advocating for and serving the professional needs of family physicians. Vision The vision of the American Academy of Family Physicians and the Utah Chapter: To transform health care to achieve optimal health for everyone. Thank you for your service to the UAFP Board! Interested in Becoming a Member of the UAFP Board in the Future? Contact us at boardchair@utahafp.org for more information. Michael Chen, MD, FAAFP President-Elect Saphu Pradhan, MD, FAAFP President Chad Spain, MD, FAAFP Immediate Past President Lynsey Drew, DO, FAAFP Treasurer 2022/2023 Utah Academy of Family Physicians Board of Directors 9 |
The Utah Academy of Family Physicians has several committees that help determine the direction of the work of UAFP staff and board. And the more representation we have from across the state, the better we can determine how best to serve family physicians in different geographic locations, places in their careers, types of practices, and times in their lives. Being a committee member does not have to mean a huge time commitment. Almost all meetings are held remotely, and you can determine your level of involvement based on the time you have to give. Current UAFP Committees Legislative & Advocacy This committee is tasked with shaping and developing the legislative and advocacy priorities and activities of the Academy and maintains financial and administrative oversight of the Utah Fam Med PAC, a registered political action committee in the state of Utah. All meetings are virtual and are held weekly during the legislative session, as needed throughout the year and during the electoral cycle. CME & Ski Planning UAFP’s signature continuing education event takes place annually in February in beautiful Park City, Utah. Our dedicated planning committee members are avid skiers committed to providing quality education to family physicians across the country at this event. Committee members must have attended at least one CME & Ski in the past and are asked to provide suggestions for content and invite presenters, mostly local physicians. Most planning and meetings occur in spring and summer before the next event. Equity, Diversity and Inclusion (EDI) This is UAFP’s newest committee. This committee will work to form support networks for physicians, students, and those interested in medicine from underrepresented groups and provide education that will focus both on providing evidence-based education to fellow physicians and patients on medical discrimination, race-based medicine, and social determinants of health. Member Engagement This committee aims to provide high-quality, familymedicine-oriented continuing medical education and social and networking opportunities for all UAFP members in Utah. Members strive to build a sense of camaraderie, ensure members uphold our values as a specialty, provide education and support for future doctors and their patients, and deliver information about evidence-based medicine. Members are committed to providing services and building member engagement in all geographic regions of the state. This committee meets quarterly and ad-hoc when needed. Ready to join? Just fill out the short form on our website to connect with us and learn more! Connect With Your Fellow Utah Family Physicians Join a UAFP Committee https://utahafp.regfox.com/join-a-uafp-committee UtahAFP.org | 10
UAFP’s Annual Meeting was held this year at Thanksgiving Point. We were so glad to host this event in person again and see so many physicians at every stage of their careers, from those early in their medical school journey to those semi-retired. We were also excited to kick off our 75th anniversary as the family physician association in Utah this year! The 2022 Utah Family Medicine Physician of the Year is Dr. Erika Anne Sullivan Dr. Sullivan was nominated not once, not twice, but three times. Her work educating and providing service for the LGBTQ community is groundbreaking. To those she works with and especially her students, she is an incredible mentor and example of the work family physicians provide. The 2022 Utah Family Medicine Champion of the Year is Representative Jennifer Dailey-Provost As a past UAFP Executive Director, Rep. Dailey-Provost is extremely knowledgeable about our issues and is an invaluable resource at the capitol. She continually looks for ways to help the profession, to help our students and residents, and to create good health outcomes for patients. We are incredibly lucky to have her as an ally, and it was an easy decision to give her this award. UAFP also welcomed AAFP President Dr. Sterling Ransone Jr. as our keynote speaker at this year’s event. He spoke about the challenges we all faced during COVID, the resilience of family physicians, and the incredible potential of those in medical school and residency who are pursuing family medicine. He urged family physicians to mentor those who are following in their footsteps. Dr. Ransone also conducted the swearing-in ceremony of UAFP’s new board president for 2022-23, Dr. Saphu Pradhan and conferred three new AAFP Fellows, Dr. Michael Chen, Dr. Saphu Pradhan, and Dr. Heather Sojourner. We hope you can join us next year in the fall of 2023 for this annual celebration of family medicine in Utah! Annual Member Meeting Highlights 1 3 5 4 2 Photos 1 New AAFP Fellows, Dr. Heather Sojourner, Dr. Saphu Pradhan, and Dr. Michael Chen with Dr. Ransone 2 Dr. Sullivan receiving her award from UAFP President-Elect, Dr. Michael Chen 3 Representative Dailey-Provost receiving her award from UAFP Treasurer, Dr. Lynsey Drew 4 Opening remarks from Immediate Past President, Dr. Chad Spain 5 AAFP President Dr. Sterling Ransone Jr. with UAFP President, Dr. Saphu Pradhan
At each Congress of Delegates, resolutions are presented by each state chapter, debated during reference committees, and voted on during general session meetings. Delegates also vote to elect the new leadership of AAFP. 1 And we’re back! After two years of meeting virtually, chapter delegates to the AAFP Congress could finally meet in person. This year’s congress was in Washington, D.C., a fitting location for our own family medicine legislative body. Your 2022 Delegates and Alternates are Jordan Roberts, MD, Thea Sakata, MD, Kirsten Stoesser, MD, FAAFP, and David Cope, MD, FAAFP. This group of dedicated and studious physicians did a fantastic job representing Utah family physicians at this year’s COD. Each delegate and alternate blogged about their experiences at congress. (Scan the QR code to read about the week’s events in more detail.) At each Congress of Delegates, resolutions are presented by each state chapter, debated during reference committees, and voted on during general session meetings. Delegates also vote to elect the new leadership of AAFP. The Utah delegation joined representatives from every state chapter, representatives from Guam, Puerto Rico, the U.S. Virgin Islands, and the U.S. Uniformed Services. As in previous years, after resolutions were submitted, UAFP held a member call to debate and determine whether the Utah delegation would support or oppose each resolution – weighing the implications very carefully before making their decisions. This year, UAFP proposed three resolutions and two resolutions extracted from the 2021 COD for additional discussion. The busy week started with a Town Hall Meeting led by AAFP president Dr. Sterling Ransone and included Dr. Ada Stewart, prior president and current Board Chair, Congress of Delegates 2022 https://utahafp.org/ aafp-congress-ofdelegates-updatesfrom-your-utahrepresentatives UtahAFP.org | 12
3 2 as well as members of the Board of Directors of the AAFP. The AAFP Board of Directors reiterated that AAFP is unequivocally opposed to any legislation that interferes with the physician-patient relationship. In the afternoon, western states’ delegates gathered to present each state’s new resolution proposals and to garner regional support. As this year marks the 75th anniversary of the academy, the Speaker took the opportunity to read some items from previous congress sessions where the issues sounded very similar to those we are still working on and mentioned that we continue to move forward as well as we can. There were several highlights from this year’s congress: • Our delegation played a part in overturning the recommendation not to adopt a resolution that would reinstate the requirement for live Continuing Medical Education (CME) for membership cycle renewal. Smaller chapters, like ours, rely on live CME events as a source of funding. • Due to the pandemic, much of the business of the 2021 Congress was carried forward into this year, including Utah’s resolution to have the AAFP advocate for abolishing the slavery exemption clause in the 13th amendment, which passed successfully. • We joined with the New York delegation to propose a resolution that requires AAFP to protect a patient seeking medical care in other states that may not be available in their home state while also advocating for the protection of both the physician counseling the patient in the home state as well as the physician assuming care for the patient outside of the patient’s state of residence. The resolution passed with strong support • New AAFP leadership was elected, and we are excited to welcome Dr. Tochi Iroku-Malize, MD, MPH, MBA, FAAFP, who was sworn in as the 75th president. Dr. Steven P. Furr, MD, FAAFP, was chosen as president-elect, board positions were filled, and our own Dr. Sarah Woolsey, MD, MPH, FAAFP, was named as chair of the AAFP Commission on Quality and Practice. Delegates fulfill a critical role in shaping the policy and advocacy decisions of AAFP. Elections for delegates are held early each year. If you are interested in being a UAFP delegate, watch our weekly newsletter, The Weekly Beat, for more information. Photos 1 From Left to Right: Dr. David Cope, Dr. Thea Sakata, Maryann Martindale, Dr. Jordan Roberts, Dr. Kirsten Stoesser 2 A thumbs up from Dr. Thea Sakata with Dr. Jordan Roberts 3 Dr. Kirsten Stoesser speaking on behalf of a resolution 13 |
Erik Gulbrandsen, DO I grew up in Provo, attended Timpview High School, was an All-State cross country and track athlete, and trained under Hall of Fame coach Brian Kuhlmann. I turned down scholarship offers at multiple schools and competed at BYU as a preferred walk-on, fulfilling a lifelong dream of wearing the cougar uniform. After a church mission in Brazil, I decided that my racing days were over, and it was time to focus on school. I regularly tell my adolescent patients that my high school GPA was 2.94 and my college GPA was 3.85, hoping to help them gain self-confidence and to recognize their own potential, even though they have failed classes. My wife Annalisa and I met at the BYU bookstore, where I was price-checking economics textbooks for my textbook arbitrage business. I thought she was cute, so I introduced myself and asked for her phone number, and the rest is history. We are the proud parents of seven children. She continues to be the single most important story in my history. I am the high school baseball pitching coach at Karl G. Maeser Preparatory Academy, which is my second parttime job (albeit unpaid). Having never played the sport, I’ve spent way too much time reading textbooks, articles, and medical literature to help me craft my coaching. We finished second in UHSAA 2A this year, and my pitchers had the lowest ERA in the league. I have a special focus on injury prevention for throwing athletes and organized free online training for coaches and athletes. My other part-time job (still, unpaid) is to live broadcast sporting events. This is my favorite hobby, and I consider myself a modern-day one-man band. I do commentary, run the scoreboard overlays, switch the music, and change the camera angles for the six cameras I strategically place around the playing area, all from my lawn chair. The Journey to Become a Physician As I mentioned, I attended BYU as an undergrad and majored in economics. I attended medical school at A.T. Still University in Mesa, Arizona and served as Chief Resident at Southern Illinois University Family Medicine Residency in Carbondale. I come from a family of nurses and physicians, so I had cousins and grandparents I revered as a child. I never really remember a day when I said, “I’m gonna be a doctor.” My greatest mentor in college was my organic chemistry professor, Steven Fleming, who never directly answered my questions, but always guided me to find my own answers. My most influential preceptor in medical school was my OB/GYN preceptor, Douglas Gates, MD, as he showed me superior skills in doctoring by establishing a lasting doctor/patient relationship. My most inspirational leader was my residency program director, Penny Tippy, MD, who gave me the freedom to pursue my educational interests as a resident. Choosing Family Medicine As a fourth-year medical student, I was doing a site visit in Kentucky for a triple board Psych/Peds/CAP residency program, and it seemed perfect for me. The next Monday morning, I started my ER rotation, and while I didn’t enjoy the short-lived relationships in the ER, I was reminded how much I loved diagnostic medicine and changed my plan. My FM preceptors, hearing my interest in psychiatry and pediatrics, counseled me that I could manage a large practice of FM patients with mental health needs, as well as care for pediatric patients. Their guidance was paramount in this decision process. I come from a family of nurses and physicians, so I had cousins and grandparents I revered as a child. Member Spotlight UtahAFP.org | 14
The most attractive aspect of family medicine is the long-lasting doctor-patient relationship and family relationships. While serving the population of Parowan, UT, for three years, I loved caring for entire extended families, mom/dad/cousins. I spend much of my new patient visits taking a social history, as I sincerely want to know about the patient and who they are outside the clinic. Going the Extra Mile for Patients One unique element of my practice is my house call practice. During my residency, the daughter and primary caregiver of one of my chair-bound patients suddenly died. Uncertain about how to get my patient into the clinic, I asked where he lived, trying to work out transportation, and I was made aware that he lived just across the street. From then on, all our visits took place in his living room, and the benefit to him was incredible. I decided to try to do home visits for my homebound patients, if possible. Leading up to the COVID-19 vaccine release, I had many encounters with patients where I spoke of hope for a vaccine, but also, in reality, I didn’t expect one until the next year or later. When the vaccine was approved earlier than expected, I remained positive and encouraging in my communications with my patients. But I was frustrated for many of my senior patients, as they lacked the resources to schedule an appointment online. Most didn’t have a computer, and those who did just weren’t fast enough to get those precious appointments that disappeared faster than a BTS concert ticket. So I decided to schedule the visits for them. As a value-based physician, I had a list of my patients and their annual healthcare expenses. I sorted by cost and started from the top down, using expenses as a surrogate marker for poor health. When I got a “10-minute reservation” to schedule an appointment, I would have my nurse enter the patient ’s information as I quickly dialed their phone number. If they didn’t answer on the first call, we moved on to the next patient. It was a very fast-paced race to get as many scheduled as possible. If the patient answered, I’d say, “this is Erik. I have a vaccine appointment for you next week at 3 PM. Can I book you now for it?” They sensed my urgency, and their response was almost always significant joy that I had thought of them. I told them my nurse would call later with the details, and I hung up and moved on to the next patient. The health department released new vaccine appointments every week at a specific date and time, and if you were lucky, you could schedule one appointment per week. I learned a handful of tricks to improve the odds of getting an appointment slot, and within two weeks of practice, I was an expert at scheduling appointments. It required me to spend an extra one to two hours a night, but I was regularly scheduling 30 vaccine appointments every time the health department released appointments. I made and shared a video online for all to see my tricks so others could also get appointments for their loved ones. After all was done, my staff and I scheduled hundreds of appointments for our patients. And while my practice has been shown, through modeling, to be one of the most complex family medicine practices in the area, I’ve only had two patients end up in the ICU throughout the entire pandemic due to COVID-19. My theory is that this is because of early vaccine acceptance in my practice and good hand hygiene. The Future of Family Medicine As family physicians, we need to be open to precepting medical students. FM doctors, at least in my circles, were never trained to teach medical students in the clinic and improve efficiency. For years I said that medical students added two hours to my day. Now, I see them as valuable members of my team that help care for the patients in their own different ways. I think students should take aptitude tests, and we should encourage these. It will help point medical students to a specialty that will make them happiest. That may not be primary care, but that is all right. My wife Annalisa and I . . . are the proud parents of seven children. She continues to be the single most important story in my history. 15 |
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Resident Spotlight Andrew Steinicke, DO I think I first started considering medicine as a career when I was a sophomore in high school and took a human biology class. I was absolutely amazed while learning about how the body functions. Tell us a little about yourself and your background – where you grew up, went to school, your family, interests, hobbies, etc. I grew up in Kaysville, UT, and graduated from dear old Davis High School. After graduation, I served a two-year mission for The Church of Jesus Christ of Latter-day Saints in the beautiful state of Montana. When I returned home, I started my undergraduate studies at Utah State University and absolutely loved it. Following graduation, I traded the chill of Logan, UT, for the warmth and sunshine of southern Utah as I attended Rocky Vista University – Southern Utah for medical school. I was fortunate to return to my native Kaysville for my third and fourth years of medical school, where I met and married my wife, Abby. Shortly afterward, we started our residency at McKay-Dee, and it has been a wonderful journey so far. We are expecting an addition to our family in February 2023 in the form of a little baby boy, and we couldn’t be more thrilled. Some of my interests and hobbies include basketball, running, guitar, reading, and watercolor painting. Tell us about the journey that took you to medical school and eventually to family medicine. What factors influenced your decision to become a doctor and pursue family medicine? I think I first started considering medicine as a career when I was a sophomore in high school and took a human biology class. I was absolutely amazed while learning about how the body functions. But I wasn’t sure I wanted to commit to all those years of medical school and residency. I had some neat experiences with family members volunteering, and in my undergrad studies, which helped me ultimately decide to become a physician. And I think I always knew deep down that I wanted to practice family medicine. I love the variety and the patient relationships. I also really enjoy sports medicine, and becoming a family physician gives me fun opportunities there. Resident Spotlight | Continued on page 18 I understand you were in the first graduating class from Rocky Vista University-Southern Utah. What was it like being “pioneers” of a sort in a brand-new school? I honestly had a fantastic experience. Sure, there were some bumps in the road with getting a new school up and running, but overall, it went really quite well. We had excellent faculty at our campus as well as our sister campus in Colorado. I especially enjoyed the school ’s location in Ivins, just outside Snow Canyon State Park. I feel fortunate to have been in the first graduating class and for the opportunity of rubbing shoulders with some truly wonderful classmates. What drew you to apply for residency at McKay Dee? How has your experience been there? Growing up in Kaysville, I occasionally visited McKayDee to see family and friends treated there and was just impressed with the hospital in general. As it happens, one of my mentors trained there and had nothing but good things to say about the program, which interested me. I did a sub-internship during my fourth year of medical school and really enjoyed working with the residents and faculty. I was especially drawn to the sports medicine training and opportunities program. It felt like a good fit to me, and I feel so lucky to have wound up here. Residency is tough, and some days are harder than others but knowing I have the friendship and support of my fellow residents makes all the difference. 17 |
Resident Spotlight | Continued from page 17 What kind of practice or additional training are you looking to pursue after you complete your residency? I am hoping to practice general outpatient family medicine. I really enjoy the variety of things that come through the door in family medicine. And I hope to continue seeing a wide range of patients in my future practice. If you could go back in time and give yourself some advice – either as a medical student or new intern – what would you tell your younger self? It ’s okay not to know something. Medical students and residents are under a lot of pressure to get things right. But really, it ’s impossible to remember everything you’ve ever read or learned. Of course, it ’s important to do your best but don’t hold yourself to an unrealistic standard. Approach each day with a willingness to learn, and you’ll be just fine. 801.676.9722 | 855.747.4003 sales@thenewslinkgroup.com ARE YOU READY FOR GROWTH? ADVERTISE IN THIS MAGAZINE AND GET YOUR BRAND IN THE HANDS OF YOUR TARGET MARKET. UtahAFP.org | 18
Mariah Richins Medical Student Spotlight I grew up in West Haven, Utah – a small town west of Ogden. I still have the small-town habit of waving to everyone I see as I walk down the street. I love being outside – which for me includes snowboarding, climbing, canyoneering, and hiking. I also love baking and have taken on a recent task to try and perfect my bagel recipe! My interest in healthcare started as a high school student. I took an anatomy and physiology course and loved it. Shout out to my high school anatomy teacher for supporting my interest in medicine! He encouraged me to join our high school HOSA chapter, and I participated in the National HOSA conference during my last year of high school. I did my undergraduate degree at Utah Tech University in St. George. As I chose my major, I started looking at different healthcare options and was initially signed up for prerequisite respiratory therapy courses. This included a general chemistry class. The professor of the course was a great mentor who encouraged me to start doing research that I did not consider before. She helped me look up different undergraduate research programs and pushed me to take more chemistry classes. I then met more amazing mentors and started doing research with the biochemistry professor at Utah Tech. I realized my love for science extended far beyond my initial introduction to anatomy in high school. My research mentor and the support I received at Utah Tech were crucial to successfully applying to medical school. This special mentoring relationship showed me how important it is to open doors for others. I hope to give back by mentoring those interested in family medicine, particularly those who might be less privileged than I am. Medical Student Spotlight| Continued on page 22 19 |
During the first two years of medical school, I felt open to letting new experiences guide my specialty path. I was equally interested in emergency medicine, obstetrics, pediatrics, and family medicine. My interests shifted often enough that when my family members asked what I would go into, I would tell them a different specialty each time. During my third year, I had an impactful experience working at the Veteran’s Administration Hospital, where one of my preceptors challenged me to talk to each of her patients about smoking cessation. She coached me in my motivational interviewing skills, especially surrounding smoking cessation. I had some of the most rewarding and insightful conversations with her patients. This experience helped me develop a love and appreciation for preventative medicine within primary care. Throughout the rest of my clerkships, I also found that I loved working with pediatric and obstetric populations. Near the end of my third year, I had the opportunity to spend part of my family medicine rotation in a rural area in Utah. I saw what broad-scope rural medicine could look like and thoroughly enjoyed my time there. I am looking forward to a career practicing broad-scope family medicine! My interest in healthcare started as a high school student. I took an anatomy and physiology course and loved it. Shout out to my high school anatomy teacher for supporting my interest in medicine! Medical Student Spotlight| Continued on page 22 UtahAFP.org | 20
*Schedule and CME accreditation info available at utahafp.org/education/cme-ski
On February 23, 2022, very few people in the western world knew what the Ukrainian flag looked like. A request to describe anything about it would be met with blank stares, except for those who envisioned that it may still resemble the flag of the Soviet Union, hammer and sickle over a dark red background. I dare say that even most Polish people, immediate Ukrainian neighbors to the west, would have no idea. But once Russia invaded Ukraine for no legitimate reason outside of Putin’s selfish maniacal narcissism, millions in the western world immediately recognized the depiction of the blue sky over the fields of golden grain representing the country I love. I lived in Ukraine from 2000-2002 as a missionary for The Church of Jesus Christ of Latter-Day Saints. Thus Ukraine feels like my country, and Ukrainians like my people. Given the millions of refugees flooding into Europe, a majority of whom are coming through Poland, and the immense need that creates, I wanted to help in person. As a physician, it was an easy decision on the best way to contribute – offer medical assistance. I spent two weeks in Poland at the end of May and the beginning of June. My first week was with the group International Medical Relief at a former expo center repurposed into a shelter in Warsaw. We staffed a clinic at the center where any refugee could seek care for whatever they needed. The resources were modest, but we helped many people with chronic conditions, acute concerns, and medications. While the center could accommodate many thousands of people, there were only around two thousand during my stay. The influx of displaced Ukrainians had slowed down by this point. Many who had not already gone to another country were planning to return to Ukraine. My second week was supposed to be my return to Ukraine, but it wasn’t to be. The circumstances surrounding the “mission” in Ukraine changed (as is common in war-torn areas, of course), meaning that I was In Support of Ukraine By Kyle Bradford Jones, MD, FAAFP unable to accompany August Mission into the country. Instead, I went to Krakow to assist in clothing donations and other similar activities. However, I wanted to ensure that I was not acting from an arrogant attitude of privilege, where I am the great American coming to fix everything and save everyone, as often exists in such humanitarian efforts. I approached this more as a loving brother and concerned neighbor to help those in need. I intended to come strictly for the Ukrainian people, to meet some of their needs in any small way I could. Not only have they inspired me, but I believe they met many of my needs, as well. The first refugee woman I met arrived at the center just the day before with her daughter-in-law and grandson. Her husband had been killed just days before when Russian shelling destroyed their apartment complex. Despite no previous military training, her son was now fighting in the war. She understandably broke down as she was telling me. I simply held her hand and listened as best I could, conversing with her using my rusty Russian language skills. I saw many similar things throughout my two weeks. I witnessed a large group of Ukrainians outside flinch with a stab of fear on their faces from a plane flying over. I met a medical student displaced from her studies and helped The team from International Medical Relief in Warsaw, Poland. UtahAFP.org | 22
Given the millions of refugees flooding into Europe . . . I wanted to help in person. As a physician, it was an easy decision on the best way to contribute - offer medical assistance. her volunteer at the clinic. I met a young teenager who was in the hospital when the bombing began, and he was separated from his mother for a couple of days. Since reuniting with his mother, he turned his initial terror into being a volunteer interpreter at the clinic. One woman, who misplaced her cell phone, had a severe emotional breakdown because, without her phone, she wouldn’t know if her husband was okay (we found the phone shortly after that). And in response, I saw immense support for these struggling people. The Polish people supported the millions of incoming Ukrainians more than anyone would expect. They provided huge amounts of support in infrastructure, financial relief, and volunteer hours. As of July, nearly eight million Ukrainians had fled the terror of war into other countries, 90% of whom were women and children. Over half of these refugees went to Poland. Another eight million Ukrainians were displaced within their homeland. Countries around the world supported getting visas and other relief for the refugees. Every Ukrainian I spoke with was immensely grateful for the world’s help. One woman, with tears in her eyes, said that she didn’t think anyone in the world knew that Ukraine existed. Ukrainians are among the most resilient people in the world. They have the perfect combination of humility and a willful attitude that has led them to defend their country much more effectively and ferociously than Russia expected. One of the volunteer translators at the center showed me a picture of his eight-year-old niece in Kyiv. She was standing on the charred remains of a burned Russian tank in the middle of the city, flexing her arms with a look of triumph on her face. That is what the Ukrainian spirit truly is and why so many throughout the world now see the Ukrainian flag as such sweet inspiration. Those interested in supporting Ukrainian refugees in Utah, please go to https://utahukrainians.org to donate time, money, or items. Thank you. Kyle Bradford Jones, MD, FAAFP, is an Associate Professor at the Department of Family and Preventive Medicine at the University of Utah and author of Fallible: A Memoir of a Young Physician's Struggle with Mental Illness and Hospital. A line of semi trucks full of donated items in a logjam over a mile long waiting to get into Ukraine. Dr. Jones masked up and ready to help. 23 |
Lessons Learned from Global Travel By Mark Wardle, DO, FAAFP After a two-year hiatus on international travel due to the COVID-19 pandemic, 2022 was a big year for me in Global Medicine: traveling to four countries, navigating several foreign languages, and partnering with seven different international medical organizations. I am lucky to be in a position that allows me to travel internationally for global health outreach, although typically not this often! Because of the greater-than-usual experience this year, UAFP reached out to ask if I had any lessons learned from these experiences to share. As in most aspects of life, lessons are abundant, but I have narrowed it down to just three. People are People I love this quote from Brené Brown, “People, people, people are just people, people, people.” While each culture and subculture has its own nuances and unique characteristics, at our core, people are people. We have hopes and dreams, challenges and disappointments, and we experience love and loss. The laughter of the Maasai children in Kenya matched that of the children of Haitian refugees in the bateyes of the Dominican Republic and that of my own kids. The loving concern of mothers in Honduras, wondering how best to care for their sick babies, mirrors that of the moms I see right here in St. George. While circumstances, environments, and accessible care varies from place to place, the emotions, concerns, and core needs are remarkably similar. Remembering this principle can help foster a closer connection between you and your patient when interacting with others with cultures, beliefs, or practices different from yours. Flexibility is King Anyone who travels, whether for personal or professional purposes, knows flexibility is critical. Flight delays and cancellations, lost luggage, bad directions, etc., are all possible. Planning and preparation help, but you come to expect the unexpected and roll with it. In Kenya, our team lost 11 pieces of luggage and had to push our bus out of a mud hole in the rain. Our flight from Miami to Honduras was delayed, delayed again, and then canceled, costing us two days. Roll with it! But in global medicine, flexibility goes beyond just adjusting travel plans and adapting positively to mishaps; it extends right into the clinic and patient care. Family physicians know all about flexibility – we adjust clinic schedules on the fly when we have a critical patient, a baby to catch, or a colleague to cover. We adjust treatment plans to meet our individual patient needs, and we wear many hats, both in the clinic and in the community. This quality is just as essential in lowPhysician volunteers like Dr. Wardle helped with triage, procedures, teaching, stocking the pharmacy, supervising students, transportation, loading and unloading trucks and vans, and more. UtahAFP.org | 24
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