Pub. 8 2024 Issue 1

Taking the Pressure Off in Sports UAFP 2024 Legislative Recap

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Participation by advertisers does not constitute endorsement by the UAFP. CONTENTSIssue 1 2024 © 2024 Utah Academy of Family Physicians | The newsLINK Group, LLC. All rights reserved. UAFP Journal 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 Journal 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. 16 6 | 4

PRESIDENT’S MESSAGE Why Belonging Matters 6 CEO’S MESSAGE Restoring Confidence in Vaccines 7 UAFP 2024 Legislative Recap 8 2023/2024 Utah Academy of Family Physicians Board of Directors 10 Graduating Residents and New Interns 12 Utah Family Medicine Match Results 14 2024 Student and Resident Awards 15 CME & Ski 2024 16 Member Spotlight: Carissa Monroy, MD, MPH 18 Resident Spotlight: Elise Blaseg, MD 20 Student Spotlight: Kamaehu Mattias 22 Taking the Pressure Off in Sports 24 PROGNOSIS NEGATIVE FDA Approves First Opioid/Benzodiazepine Combo Pill for Life Pain Disorder 26 Your Vote is Your Voice 27 14 8 24 Cover photo: A group of current and former University of Utah family medicine residents with current residency director, Dr. Kirsten Stoesser, attending the UAFP advocacy event at the state capitol. 5 |

In the last magazine, I discussed “What Motivates You?” However, even the most motivated among us can still feel burnt out and suffer from morale injury if we do not have a sense of belonging in our workplace. The Oxford English Dictionary defines belonging as “an affinity for a place or situation.” However, belonging is not just a desire for this connection; it is a fundamental need that expands into every aspect of our lives, including our profession. For family physicians, the significance of belonging extends beyond camaraderie or shared experiences. It directly influences our effectiveness, resilience and overall well-being in the demanding landscape of medicine. Medicine is a collaborative endeavor, requiring physicians to function within intricate networks of patients, colleagues, healthcare systems, insurance companies and legislation. A sense of belonging within this framework fosters cohesion, encourages teamwork and enhances patient care outcomes. When physicians feel connected to their peers and institutions, they are more likely to communicate openly, collaborate effectively and seek support when facing challenges. This collective synergy not only improves clinical decision-making but also cultivates a supportive environment conducive to professional growth and satisfaction. We all know the practice of medicine is inherently stressful, marked by long hours seeing patients and responding to the voluminous messages and phone calls while completing paperwork for patients. In such an environment, the experience of belonging serves as a buffer against burnout and compassion fatigue. When physicians feel valued and supported within their professional communities, they are better equipped to cope with the emotional toll of their work, maintain a sense of purpose and sustain their passion for “helping people,” as all pre-med students say. Belonging provides a vital source of resilience, empowering family physicians to navigate adversity. By fostering a culture of belonging that celebrates diversity and embraces inclusivity, UAFP hopes to cultivate a workforce that reflects the rich tapestry of human experience, amplifying perspectives and advancing health equity for all — to transform health care to achieve optimal health for everyone, the vision of UAFP. We have started on this journey toward our vision by continuing work with our newest committee, the Equity, Diversity, Inclusion and Belonging Committee. We invite you to join a committee or share a big idea for UAFP, where you belong. Join a Committee Submit an Idea for UAFP PRESIDENT’S MESSAGE Michael Chen, MD, FAAFP, President, UAFP Why Belonging Matters | 6

Restoring Confidence in Vaccines CEO’S MESSAGE Maryann Martindale, CEO/Executive Director, UAFP I had an uncle named Dorian. He was just a bit older than my dad and lived close to us. One of his daughters is my age, so we saw them fairly often. When Dorian was in his teens, he contracted polio. This was well before Dr. Jonas Salk developed the polio vaccine, so there was no way he could have been immunized. I watched him go from a man with a stilted and uneasy gait, to a cane, to two canes, to a walker and finally to a wheelchair. His whole life was spent in discomfort and pain and an inability to do the things he wanted to be able to do with his kids and grandkids. When he finally passed, his body was so ravaged that he was a shell of the man I’d known as a little girl. He worked in business and was not a doctor or involved in the medical community, but I recall at every family event, he’d tell us to make sure we got our kids vaccinated — that’s how important it was to him. He never wanted to see anyone suffer as he had. Fast forward to 2024, we’re facing the return of communicable diseases we believed were eradicated. Measles reared its head a few years back, at Disneyland of all places. Measles is highly contagious, airborne, and lives in the air for up to two hours, providing significant opportunity for exposure. According to the CDC, before the measles vaccine was available in 1963, “approximately 500,000 cases and 500 measles deaths were reported annually, with epidemic cycles every two to three years. However, the actual number of cases was estimated at three to four million annually. More than 50% of persons had measles by age six years, and more than 90% by age 15 years.” In addition to measles, the United States has seen an uptick in mumps, whooping cough, hepatitis A and other illnesses that have safe and effective vaccines to aid in preventing kids and adults from contracting them. When did we stop believing in science? We know that vaccines protect people from these serious and often life-threatening diseases, yet people still refuse. We know there are those who are unable to have vaccines due to age, health conditions, or other factors. Those able to be vaccinated provide an extra layer of protection for those more vulnerable among us, ensuring we are not spreading disease unnecessarily. During COVID-19, we heard all kinds of conspiracy theories. We hadn’t dealt with a pandemic since the Spanish Flu in the early 1900s, so few had any experience dealing with something of that magnitude. Did the government make mistakes — most certainly. Did they do their best to try and figure it all out, with information and technology changing rapidly — most definitely. Those in our communities who are stridently anti-vaccine are not likely to change their minds. Still, those who are vaccine-hesitant, who have read an article online, who have a cousin who claims to be an expert or any of the other litany of ways people get their scientific and medical “facts” are still an opportunity for family physicians to educate, and help understand the value, both personally and community-wide, of vaccinations. I remember my Uncle Dorian saying, “Look at me, look at my legs. Don’t let this happen to your kids.” It was heartbreaking but extremely impactful. I think of my Uncle Dorian often, especially when I’m speaking against anti-vaccination rhetoric during legislative sessions. Vaccines work. The science is sound. Let’s work together to proactively restore confidence in vaccines. Maryann Martindale happily receiving her first COVID-19 vaccine in the spring of 2021. 7 |

UAFP 2024 Legislative Recap By Maryann Martindale, CEO/Executive Director, UAFP This year’s legislative session was a lot of things but boring was not one of them. From the very beginning to the closing gavel, things moved fast and furious. We were constantly on our toes, keeping track of important bills. As we’ve seen in previous years, there were numerous bills that grabbed headlines, such as the anti-DEI bill for higher education, social media regulations, the transgender bathroom bill and some attempts at thwarting voter access. UAFP spent the bulk of our time fighting for graduate medical education (GME) funding, protecting the scope of practice and ensuring the safety of medical students, residents, and the general public through bills that impact quarantine options, masking/vaccine requirements and others. The bulk of our efforts were spent fighting against a very short-sided and ill-informed bill, HB463, Medicaid Funding Amendments, by Rep. Brady Brammer (R, Pleasant Grove). This bill would have essentially killed Medicaid expansion. Its far-reaching consequences would have a significant detrimental impact on Medicaid patients — putting all “optional” services on the chopping block. Optional services just so happen to include well-care visits, behavioral health, prescriptions, pre- and postpartum care, to name just a few of the potentially impacted services. While it is likely that we’ll see other attempts to thwart the Medicaid expansion voters passed just a few short years ago, we will be working very closely with supportive legislators to mitigate impact and continue helping those most vulnerable among us. UAFP supports guard rails and fiscal responsibility, but our state is in exceptional financial health, and these critical programs are not the place to make cuts. We have been working hard for the past several years to create collaborative relationships with other healthcare organizations, and it was only through our collective action that HB463 was defeated. It wasn’t all doom and gloom, however. There were many bills passed, including: • Streamlined physicians’ options on prescriptions, death certificates, and fatality reviews. • Gabapentin was added to the Schedule V controlled substance list. • Postpartum Medicaid coverage was funded (passed in 2023 but not funded until this year). • New pathway for internationally trained physicians with significant guardrails to ensure adequate training and patient safety. • Numerous anti-tobacco bills. For a variety of reasons (shortness of the session, time spent on the more “showy” bills), several bills were not passed that UAFP has consistently supported, such as expanding telehealth coverage and increasing payments, requiring insurers to pass through coupons, rebates, or other co-pay type assistance for prescription costs, and a couple really great bills we will push to bring back; one that streamlines the Medicaid application and communication processes, and another to improve the prior authorization process. The legislative process is a marathon, not a sprint, despite our short session, and often bills that cover complex policy changes take several years to educate and gain sufficient support. We could not do this important work without the support of our Advocacy Committee. If you love policy or would just like to get more engaged in our work, please consider joining the committee. Your expertise and experience are essential to this work. | 8

Primary Care Day on the Hill 2024 saw the first annual Primary Care Day on the Hill, organized and sponsored by UAFP, the Association for Utah Community Health (AUCH) and Utah Public Health Association (UPHA). Over 20 different organizations tabled and showcased the incredible work of Utah’s various primary care providers. Groups were able to spend valuable time sharing their messages and policy priorities with legislators and visitors at the Capitol. We look forward to making this an annual event. Advocacy Day Our annual advocacy day looked a bit different this year as we joined the Utah Public Health Association for important updates on legislation, policy issues, healthcare trends in Utah, etc. Our CEO, Maryann Martindale, led a roundtable discussion with legislators, including Reps. Dailey-Provost, Loubet and Stoddard. This was a fun and educational day during the session, and we enjoyed having family physicians join us on the hill. UAFP CEO Maryann Martindale with former Utah Gov. Gary Herbert. Primary care and public health organizations from around the state set up in the capitol rotunda to educate lawmakers about the importance of primary care in Utah. UAFP CEO Maryann Martindale leading a legislative roundtable pictured here with Reps. Anthony Loubet and Dailey-Provost. Family physicians and public health professionals from across the state gathered at the Capitol to learn about the legislative process and how to effectively lobby lawmakers. 9 |

2023/2024 Utah Academy of Family Physicians Board of Directors Thank you for your service to the UAFP Board! Executive Committee Michael Chen, MD, FAAFP President Tiffany Ho, MD, MPH, FAAFP President-elect Saphu Pradhan, MD, FAAFP Immediate Past President Lynsey Drew, DO, MBA, FAAFP Treasurer AAFP Delegates and Alternates Nikki Clark, MD, FAAFP AAFP Delegate Thea Sakata, MD AAFP Delegate Katharine Caldwell, MD, MPH AAFP Alternate Delegate David Cope, MD, FAAFP AAFP Alternate Delegate Family Medicine Residency Representatives Andrew Steinicke, DO McKay-Dee Family Medicine Residency Representative Elise Blaseg, MD St. Mark’s Family Medicine Residency Representative Anita Michelle Albanese, MD University of Utah Family Medicine Residency Representative Spencer Lindsay, MD Utah Valley Family Medicine Residency Representative Medical Student Representatives Jake Roush Rocky Vista University — Southern Utah Annie Galt University of Utah School of Medicine Jessica Pentlarge Noorda College of Osteopathic Medicine Our Mission and Vision 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. The vision of the American Academy of Family Physicians and the Utah Chapter: To transform health care to achieve optimal health for everyone. Interested in becoming a member of the UAFP Board in the future? Contact us at boardchair@utahafp.org for more information. At-Large Board Members Shannon Baker, MD Craig Batty, DO Marlin Christianson, 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 Chad Spain, MD, FAAFP Kirsten Stoesser, MD, FAAFP Sally Tran, MD Mark Wardle, DO, MIH, FAAFP | 10

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Congratulations to the graduating family medicine residents of 2024! We wish you all the best in your career as a family medicine physician. McKay Dee Family Medicine Residency Bo Cates, DO Sports Medicine Fellowship, Reno, NV Kyle Christensen, DO Undecided at time of print Preston Christensen, MD Soda Springs, ID Zack Cowan, MD Manti, UT Austin Dinkel, DO Rawlins, WY Mary Griffin, MD Wells River, VT Andrew Steinicke, DO Tanner Clinic, Syracuse, UT St. Mark’s Family Medicine Residency Soojin Kim, MD Outpatient Family Medicine, Virginia Caleena Longworth, MD Outpatient Family Medicine, Utah Maggie Sheffield, MD Outpatient Family Medicine, Phoenix, AZ Erica Veazey, MD Undecided at time of print Graduating Residents and New Interns University of Utah Family Medicine Residency Anita Albanese, MD Advanced Obstetrics Fellowship, Swedish First Hill, Seattle, WA Aaron Bia, MD Chinle Comprehensive Health Care Facility (HIS), Chinle, AZ Robbie Calvert, DO Addiction Medicine Fellowship, University of Utah Emily Chin, DO Undecided at time of print Jillian Hess, MD Memorial Regional Health, Craig, CO Justine Ly, MD Cottonwood Medical Clinic, Intermountain Health, Murray, UT David Olsen, MD Undecided at time of print Josh Roesener, MD Madsen Health Center, University of Utah, Salt Lake City, UT Joseph Sanchez, MD Huntsman Mental Health Institute Neurobehavioral HOME Clinic, Salt Lake City, UT Utah Valley Family Medicine Residency McKenzie Azevedo, DO Intermountain Healthcare Draper Family Clinic Draper, UT Michael Bishop, MD North Cache Valley Clinic, Hyde Park, UT David Braak, MD Northern Colorado Medical Center, Greeley, CO Samantha Higgins, DO Waimanalo Health Center, Honolulu, HI Spencer Lindsay, MD Intermountain Healthcare Heber Valley Hospital, Heber, UT Patrick Mitchell, DO St. Peters Health, Helena, MT Scott Moberg, DO Revere Health Spanish Fork Family Medicine, Spanish Fork, UT Julia Nelson, MD Banner Health Summit View Medical Center, Greeley, CO | 12

Welcome New Interns! We are also excited to welcome the new class of family medicine interns who will be starting in July 2024! St. Mark’s Family Medicine Residency Morgan Shaver, MD University of Washington School of Medicine Nicholas Kress, MD University of Oklahoma School of Medicine Ali Coffee, DO Rocky Vista University College of Osteopathic Medicine Taylor Schofield, MD Frank H. Netter MD School of Medicine McKay Dee Family Medicine Residency Hannah Flagstad, DO Midwestern University Chicago Aly Floyd, MD University of Louisville Jacob Ivan, MD Texas Tech University Samuel Jacobsen, DO Oklahoma State University Sam Johnson, MD University of Utah Katia Kelty, DO Kansas City University Josh Worley, DO University of North Texas University of Utah Family Medicine Residency Sidney Bryn, MD University of Washington Brandon Christnovich, DO Rocky Vista University Kristin Craig, MD Wright State University Boonshoft Victoria Cook, MD Indiana University Benjamin Finch, DO A.T. Still University of Health Sciences Cruz Gutierrez, MD Western Michigan University Homey Stryker M.D. Tetsuyuki Kawai, MD Texas Tech University Health Sciences Center Paul L. Foster Bernard Nkwocha, MD Imo State University Linsey St. Pierre, MD Louisiana State University Carly Setterberg, MD University of Colorado Utah Valley Family Medicine Residency Bret Andrew, MD University of Washington Harper Christensen, MD University of Utah Katie Ernste, MD Medical College of Wisconsin Boston Gubler, MD University of Colorado Jonathan Nielsen, MD University of Texas Bryce Snow, MD University of Washington Clayton Watts, MD Creighton University Seddrick Weekes, DO Alabama College of Osteopathic Medicine 13 |

Utah Family Medicine Match Results Results from the 2024 National Resident Matching Program® (NMRP) Main Residency Match indicate that this will be the largest class of incoming family medicine residents in history, with 4,595 medical students and graduates matching into family medicine residency programs. This year, family medicine offered 5,231 residency positions,124 more than in 2023! UAFP congratulates all of the Utah med students who matched! Below is a list of all Utah medical school graduates who matched into family medicine. Welcome to the family medicine family! Rocky Vista University College of Osteopathic Medicine Utah Campus Dominic Allan — Central Iowa Health System, Des Moines, IA Keenan Barr — Naval Hospital Camp Pendleton, Oceanside, CA Patrick Barthman — University of Minnesota Medical School, Minneapolis, MN Jessica Chen — Centura Health Corporation Colorado, Westminister, CO Ali Coffee — St. Mark’s Hospital, Salt Lake City, UT Brandon Cox — Idaho State University, Rexburg, ID Alexander Cummock — Eastern Idaho Regional Medical Center, Idaho Falls, ID Daniel Garrish — Center for Family Medicine South Dakota, Sioux Falls, SD Steven Gawrys — University of Florida, Gainsville, FL Sean George — Community Health Care Washington, Tacoma, WA Thomas Gordan — Mercy Medical Center, Redding, CA Tyler Hal — University of Texas Health Science Center, Tyler, TX Clark Hollingshead — Deaconess Hospital, Evansville, IN Andrew Larson — Skagit Regional Health, Mount Vernon, WA Nicholas Longe — Idaho State University, Pocatello, ID Alexander Mattias — Creighton University, Phoenix, AZ Hope Menning — Mayo Clinic School of Graduate Medical Education, Rochester, MN Taylor Nelson — HonorHealth, Scottsdale, AZ Thien Ngo — Texas Tech University, Amarillo, TX Luke Richards — Idaho State University, Pocatello, ID Tanner Roberts — Centura Health Corporation Colorado, Westminister, CO Alexander Seegrist — Spartanburg Regional Healthcare, Spartanburg, SC Nathan Sperry — Martin Army Community Hospital, Fort Moore, GA Evan Starr — Mayo Clinic School of Graduate Medical Education, Rochester, MN Matthew Steffensen — Texas Tech University — Lubbock, TX Lucas Sterr — Halifax Medical Center, Daytona Beach, FL Austin B. White — Dignity East Valley, Gilbert, AZ Steven York — Scott Air Force Base, Belleville, IL University of Utah School of Medicine Kirsi Anselmi-Stith — University of California, Davis, CA Emily Christensen — Utah Valley University, Orem, UT Ryan Johnson — University of Kansas Medical Center (KUMC) in Kansas City, KS Sam Johnson — McKay Dee, Ogden, UT Michaela Kowalewski — Gunderson Lutheran Medical Center, La Crosse, WI Amy Loret — Providence St. Peter Hospital, Olympia, WA | 14

2024 Student and Resident Awards Each year, UAFP recognizes an outstanding graduating medical student from Rocky Vista College of Osteopathic Medicine — Southern Utah and the University of Utah School of Medicine who have matched into family medicine. At the University of Utah, the F. Marian Bishop Award was awarded to Harper Christensen, who will start her residency with Utah Valley Family Medicine Residency in Orem, Utah, later this summer. The Outstanding Senior Award at RVUSU was given to Evan Starr, who has matched into Family Medicine at Mayo Clinic Family Medicine Residency in Rochester, Minnesota. Both of these outstanding future family medicine physicians have shown evidence of active student leadership in family medicine activities and demonstrated evidence of superior scholastic achievement in their medical school studies, particularly in the field of family medicine. UAFP established a Resident Leadership Award in 2021 to recognize the accomplishments of one of our third-year family medicine residents in Utah. Nominations are sent in by residency faculty, peers and other residency staff. Those nominated needed to demonstrate promotion of family medicine, leadership skills and serving as a role model to peers. Additional consideration was given for teaching skills, professionalism, research skills and community service. The UAFP Member Engagement Committee voted on the final winner and chose Erica Veazey from St. Mark’s Family Medicine Residency. The nomination submitted for Dr. Veazey says, “Erica consistently goes above and beyond her duties, willingly taking on additional responsibilities to support her colleagues and improve patient care. Far beyond her role as chief of resident faculty relations, she organized resident wellness events and group brainstorming sessions to highlight residency strengths and address weaknesses. Her proactive approach reflects not only her strong work ethic but also her genuine concern for the well-being of both patients and fellow healthcare professionals. In addition to her leadership and clinical acumen, Erica possesses exceptional interpersonal skills and a natural ability to inspire those around her. Her positive attitude, collaborative spirit and dedication to continuous improvement make her a valuable asset to our residency program and the broader healthcare community.” Congratulations to all of you on your many accomplishments! UAFP Associate Director, Barbara Muñoz presenting Harper Christensen with the F. Marian Bishop Award. Evan Starr with Mark Wardle, DO, MIH, FAAFP, Vice Chair of the Primary Care Medicine Department at Rocky Vista University Utah Campus. 2024 Resident Leadership Award Winner Erica Veazey, MD. 15 |

CME & Ski 2024 February 2024 marked another educational and ski-filled weekend at UAFP’s annual CME & Ski conference in Park City, Utah. We returned to the venue that feels like home this year, the Westgate Resort. We hosted physicians and APCs from 30 different states (including Hawaii and Alaska) and even a group from Canada this year. CME sessions included in-demand topics such as sports med, midlife women’s health, and dermatology for primary care. We are so fortunate to have an abundance of local physicians who are both experts in their fields and happy to present at our conference! And for the first time this year, it snowed several days during the conference, so our guests were able to enjoy fresh powder. Save the Date! We look forward to another year of learning and skiing in 2025 when we return to the Westgate Resort again on Feb. 3-5, 2025. Even though ski season just ended, Epic and Ikon passes are already on sale for the 24/25 season. Get them early for the best prices! Registration for CME & Ski 2025 will open on July 1, 2024, at 8:00 am on our website. Scan the QR code to sign up for email updates and a link to register on July 1. SIGN UP FOR UPDATES We are proud to report that 100% of guests who completed our conference evaluation said they would attend a future CME & Ski conference! We hope you’ll join us next year to see what keeps guests coming back year after year. | 16

Poster Session UAFP hosted its first in-person poster session in several years for students and residents in conjunction with our CME & Ski conference. Eleven groups of residents and students presented their research to our judges and attendees at the conference, and all of them did an outstanding job. Thank you to our judges and to our Poster Session sponsor, Comagine, for providing the prize money for our three winners! FIRST PLACE Implementation of Lifestyle and Evidence-Based Controlled Substance Policy via Multidisciplinary Approach — Presented by Soojin Kim, MD and Caleena Longworth, MD SECOND PLACE Investigating Aspirin Prescribing Rates for Preeclampsia Prophylaxis — Presented by Lauren Pham, DO THIRD PLACE The Immunodulating Effects of Delta-9 Tetrahydrocannabinol (THC) and Cannabinol (CBD) in the Context of Infection — Presented by Rose Goodman and Katherine Rouse 17 |

Member Spotlight: Carissa Monroy, MD, MPH A Bit About Dr. Monroy I grew up a local Sugarhouse, Salt Lake City kid. I like to point out that my daughter will be going to the same high school that I went to and that my dad went to. I am the oldest of four and grew up as a typical firstborn — high achieving, motivated and not much of a risk taker. I attended Stanford University (I joke those were the best four years of my life ... it might still be true) and graduated in Human Biology. I did one semester in Spain with NYU and minored in Spanish, too. I have had many different interests and hobbies over my life. I like to try lots of different things and then get frustrated that I am not very good at them and either quit or just accept my mediocrity. I am currently trying to stay upright skiing and mountain biking. I just started to take up tennis, and we will see how that one goes. I also love to read and try to read 50 books a year — usually, I don’t quite make it, but I get close! The Journey to Becoming a Physician After graduating from college, I took a year off to work at a spa in Santa Barbara, work at a ski resort, and travel solo in Australia for a few months (ok, maybe that was the best year of my life). I went to the University of Utah Medical School where I met my husband, Franz Monroy, who is also a family medicine doctor! We married at the end of our third year, then couples matched into two different programs — Franz at the University of Utah and me at McKay Dee. We had our first child at the beginning of the second year of residency and now have three school-aged kids. Choosing Family Medicine I entered into medical school with an idealistic view of becoming a physician who could provide care to patients who are marginalized and underserved. I obtained my Masters of Public Health (MPH) concurrently with med school and developed a broader view of public health, which fit with family medicine. I also loved every single rotation along with volunteering at the Fourth Street Clinic on Saturdays. I remember asking the medical director of Fourth Street Clinic how I could have that job someday! I also met many amazing family physician mentors, including Cami Collette, Kurt Rifleman, Sarah Woolsey, and Carlos and Paula Guerra, to name only a few, who all helped me to see that family medicine at a community health center could be just what I was looking for! Choosing to Care for Underserved Populations Franz and I came very close to taking jobs in Ventura, California, near where he is from. But we ultimately decided on a better cost of living and full-time babysitters (my parents) in Utah, along with great job offers that fit with what we were both looking for. I took a job with Midtown Community Health Center, which I was familiar with from residency, and joined the small group in Clearfield with a couple of amazing women physicians. Midtown then opened up a new clinic in South Salt Lake, so after six years of commuting up north, I was able to finally work a couple miles from home. I worked part-time (three days a week) for a couple of those years, and I loved that schedule. I really loved Midtown and felt like I was able to use a lot of my family medicine skills in medical care and procedures, along with keeping up on my Spanish. As I hit the 10-year mark in my career, I was starting to want to try something different, and I particularly wanted to be involved in leadership if the opportunity arose. I wasn’t actively looking but would hint at my interests occasionally to different people and it led to an invitation to interview for the Medical Director position at Sacred Circle. I realized that Sacred Circle was just what I was looking for, an organization with a clear mission to serve all groups who are marginalized and underserved, particularly the Native American population and the Goshute tribe. I started out working half-time in inpatient care and half-time in administrative | 18

duties. Our organization has continued to thrive and grow, and after working at Sacred Circle for two years, I moved into the medical officer role. This has meant even more administrative work and less patient time, but I still enjoy seeing patients every week, either in Salt Lake or in Ibapah on the Goshute Reservation. Advice For Those Pursuing a Similar Path I think many students start out with an idealistic view of medicine, and that can get lost over time with the burden of loans, overwork and stress. Working at a community health center or tribal clinic can really help keep a physician connected to some of those goals and ideals that really keep the perspective of why we chose to work in the medical field. These clinics also allow us to practice full-spectrum family medicine that keeps things interesting and challenging. Working with patients from different cultural backgrounds and different life experiences truly is a rewarding and expansive experience. Sacred Circle and Pain Management This is our second year running the Utah Pain Summit. Sacred Circle has a multidisciplinary pain management program, and we sometimes wish we could call it a wellness program because it focuses on so much more than pain. Patients in the pain management program participate in physical therapy, pain management groups, and behavioral health sessions, along with medical management. Our physical therapy director, Lindsay Roper, is very committed to the program and our Pain Summit, which will really talk about stress, sleep and many of the other co-factors that contribute to pain. We are really excited to offer this again! Meeting the Need for More Family Physicians We need to create better pipeline programs that start working with rural and urban underserved students to get them involved and interested in medicine. There needs to be funding for educational and research opportunities from an early age. I have been impressed with the NARI program (Native American Research Internship) at the University of Utah, which is making a big difference. Speaking Up for Family Medicine I am a strong believer in physicians making a difference through organized medicine — meaning participating in groups like the UAFP so that their views can be represented collectively. I have been involved in advocacy off and on over the years; sometimes, it is disheartening, and other times it is effective and fulfilling. I have seen important changes happen that can protect physicians and improve the health of our community. 19 |

Resident Spotlight: Elise Blaseg, MD A Bit About Dr. Blaseg I was born and raised in Kalispell, Montana. I stayed in Montana for college, attending Montana State University in Bozeman where I met my husband, Nate. The two of us went to medical school together in his home state of South Dakota. We moved to Salt Lake City for residency (me in family medicine and Nate in pediatrics) and currently live with our two adventure buddies, our pups Bridger and Harper. We enjoy being outside and spend our free time skiing, camping and hiking. I inherited a sourdough starter from my best friend and have been experimenting with some new baking recipes. I love to read and am always looking for recommendations! The Journey to Family Medicine I have always been excited about teaching and entered college as an education major. After getting my EMT and working more in the medical field, I realized that I could still be a teacher as a doctor, and beyond that, medicine would allow me to create a tangible and lasting difference in my community. I entered medical school with absolutely no concept of where I wanted to end up. I liked all the rotations I did and was trying desperately to decide which specialty was the right fit for me. I think often of the quote “I cannot do all the good the world needs. But the world needs all the good I can do.” Family medicine was the way I felt I could do the most good. The incredible mentors I have had reaffirmed that family medicine is a place for those who want to do good. Over and over, I am amazed at the dedication, compassion and brilliance of family medicine physicians and doctors like our assistant program director, Dr. Melanie Dance. Choosing St. Mark’s Family Medicine Residency My husband and I couples matched in Salt Lake City. I knew I wanted to apply at St. Mark’s months before applications were due. I had read about the Clinic Every Day model and spent hours discussing the logistics of the program with the residents. St. Mark’s Family Medicine Residency (SMFMR) is small enough to allow flexibility in pursuing education and as the only residents at our hospital, we get the undivided attention and enthusiasm of our specialists. While the program has a lot of really great aspects, its best feature has always been the residents. I am so grateful for my co-residents who have transformed residency from a crucible to a camaraderie. We have slowly coerced more and more residents into buying pizza ovens, so now when we have pizza parties, we go all out. We have resident events like Cookie Party, Egg Drop (which is exactly what it sounds like) and Gilmore Girls nights, where we get to focus on being people and not providers. Experience as an AAFP Emerging Leader Institute Scholar Being a Scholar was a lot of fun! You get to meet a bunch of highly motivated and charismatic family medicine trainees and attend leadership training together. Over the course of a year, you create a project with the guidance of leaders in family medicine and the support from the other members of your cohort. I was absolutely blown away by the projects people came up with and the amazing work they are already doing. The future of family medicine is in good hands. I would recommend it to anyone who wants to explore the breadth of what family medicine can become. Plans After Residency I have been fortunate to work through the Lifestyle Medicine Residency Curriculum concurrently during my training. | 20

Wherever I work, I plan to use those lifestyle principles that are so integral to the practice of preventive care. I’d love to move into public health and hope to pursue a Masters of Public Health (MPH) after I graduate from residency. The field of family medicine is ever expanding and changing so I’m sure whatever path I end up on will be dramatically different from whatever hypothetical I envision. I’m excited to see where this career takes me. Hope for the Future of Healthcare In the next 20 years, I hope we see improved access to care for everyone. The data shows that patients have better outcomes when they are cared for by a doctor like them, so I hope we continue to embrace the diversity that makes family medicine so unique. People from different socioeconomic, racial, gender and geographic backgrounds bring valuable perspectives and ideas that help expand access to care for marginalized groups. Even as a resident, I have seen how people suffer when their voices aren’t valued, and I want to be a part of promoting that positive culture of inclusivity that drew me to family medicine in the first place. Advice for Your Younger Self It will be okay. It feels trite to say it but is probably the phrase I rely on most heavily. In medical training, so many things feel out of your control: who your attendings are, where you match for residency, the kinds of patients you get and the frustratingly few hours in a day. Regardless of the outcome, you will learn and improve, and it will be okay. At the same time, the things that become your responsibility as a newlyfledged doctor are overwhelming and, frankly, terrifying. You will do the right thing some days and the wrong thing other days and it will still be okay. The world keeps turning and we take each day as a chance to grow. 21 |

Student Spotlight: Kamaehu Mattias A Bit About Kamaehu My name is Kamaehu Matthias. I would describe myself as a mutt. I grew up in southern New Jersey, my mom is Hawaiian-Japanese from Maui and my dad is from New Jersey. My family moved to Logan when I was in junior high school. The culture shock of that move was pretty fantastic! I met my wife in high school and, despite the fact she knew me in high school, we got married while we both were at Utah State University. Now, we have the most beautiful twoyear-old daughter, Mila, and our border collie poodle, Rey. I’m a beleaguered die-hard fan of Philly sports (Eagles, Sixers, Phillies, Flyers). As a kid, if I wasn’t playing some sport, I was probably doing something related to Star Wars, whether a video game, a book, a movie, etc. I’m happy to say that’s continued into adulthood! The Path to Medicine Neither of my parents completed college, but learning was important to them. They taught my siblings and me early on to always be curious. They loved giving us the resources to pursue anything we wanted to learn about. I remember as a kid my mom always bought yearly memberships to the Franklin Institute in Philadelphia. It’s a beautiful museum of science. One of the iconic exhibits that is still there today is a giant heart model that you can walk through and follow the blood flow through the heart. This is one of my earliest memories of my fascination with how we humans live and thrive. During high school, I got into Health Occupations Students of America (HOSA) and was involved in chapter leadership and the state and national competitions, which further propelled my interests in healthcare. Kamaehu means “strong and firmness of resolution” in Hawaiian. In layman’s terms, you might say “stubborn and pigheaded,” or at least that’s what my parents always said. So, when I was younger, I thought I was going to be a lawyer, but that quickly faded. If there is one thing about medicine that fascinated me most and played a major role in my decision to go to medical school, it was working with people and learning about their culture and background that then influences how they view life and their health. I graduated from Utah State University (go Aggies), and during my undergrad years, I tried to be involved in activities that helped refine my interpersonal skills and helped me learn how to best educate people and be innovative in those interactions. I’ve always loved education and the power education gives to people. I coached high school basketball for several years, did education reform research and did a few other things that really allowed me to experience how best to work with people and influence them to be better versions of themselves. These interests of mine are also a huge reason why I chose family medicine as my specialty. I think family medicine has such a unique and special role in healthcare. I love that so much of family medicine is educating and empowering patients to take control of their health. I truly believe family physicians have a large amount of influence on patients since, oftentimes, this is the strongest doctor-patient relationship an individual has. Choosing Rocky Vista University When it came time to choose a medical school, obviously, location was important. My wife and I wanted to be close to family and reasonably close to Disneyland. Disneyland is very important to us, and we go as often as we can! Other than that, I was very deliberate with finding schools that offered extracurricular activities that fit with my interests and views of healthcare. Like I said before, I love education and innovation and hoped to blend that into my medical education. Rocky Vista offers several elective tracks that you can apply for that offer longitudinal training in various areas outside of the core curriculum. One of the tracks is centered | 22

around digital health and digital medicine. The objectives of the track lined up perfectly with how I envisioned being an innovative future physician. Doctor Impostor “Doctor Impostor” is a podcast that was born out of the classic group study session tangent conversation. My classmate and friend Austin White and I frequently got sidetracked during our study time so at least this one resulted in something fulfilling! We were talking about how before medical school started, all we had heard about medical school was how horrible it was. We hadn’t had too many people tell us anything positive about the experience and how much more anxious it made us at the start of school. This got us thinking about why that was and why so many people who were top students in their undergraduate years then developed so much impostor syndrome during medical school. So, we decided to take our conversation and put it into podcast form to help premed and medical students all over! We hit on the hard parts of school with a helpful and positive outlook. We’ve had so much fun doing it throughout school. At certain points, we’ve not put out much content due to the crazy schedule of rotations, but we fully intend on continuing this into residency. Both of us matched into family medicine in the Phoenix area, so we’re excited to be close to each other to make recording episodes slightly easier! Advice for Premeds and Young Med Students There’s such a huge amount of stress put on your CV and making sure you have the “numbers” of each activity like research, clinical experience, volunteering and so on. It’s very easy to lose yourself in those endeavors to be as well-rounded as you can. Focusing on letting yourself shine through your CV and personal statements rather than the number of lines or words can be a tough undertaking. Be genuine about who you are when you’re doing the things you have to do to get into medical school or match into residency. There’s no rule that everyone has to take the same path and do the same activities to achieve the same goal! You’d be shocked what people on admissions/ interview committees will want to talk about during your interviews. I can’t tell you how many times the majority of the interview I talked about Star Wars and Jordan sneakers because that’s what’s in my background in my office at home or other random things when I was prepared to do a deep dive into the research projects that I was a part of. Do what you love! Remember that you are a human being first and investing time in things that truly interest you will make your experience before and during medical school richer and more fulfilling which, in turn, will make you a better applicant. 23 |

By Sara Walker, MD, MS Most of us can agree athletic participation yields many benefits for youth development, including fine motor skills, spatial awareness, social and leadership skills, as well as improved physical and mental health. The question becomes: How can we encourage this strong skill development without placing undue pressure on student athletes? The National Council of Youth Sports estimates that approximately 81% (60 million) of children in the United States have registered and participated in youth sports in recent years. However, 70% of children leave sports participation by age 13, a sobering statistic. Two related topics that may correlate with this dropout are early sports specialization and burnout. Much has been said about early sports socialization, particularly with the rise of travel and club teams. It is now quite common to see young athletes playing and competing in their sport yearround, increasing their risk for overuse and growth-plate-related injuries. As a sports medicine physician, I often recommend the following guidelines to my patients: • The number of hours spent in their sport per week should not exceed their age (time in sport should reflect the combination of all concurrent teams’ activities). • At least three months of rest from their primary sport each year. • At least one rest day per week. • Just because they are good athletes does not mean their bodies are biomechanically strong — crosstraining and strength training are still recommended. Upon hearing these recommendations, patients/parents often protest that they need to participate in club/travel teams in order to develop the skills needed to progress to the next level. I point to examples like Iowa basketball star Caitlin Clark and tennis professional Roger Federer, who did not specialize down to one sport until their teens. When gymnasts argue that their sport mandates early sports specialization, I mention Olympians Shawn Johnson and Sam Peszek, who have talked about how choosing to continue with gymnastics after trying other sports improved their skill and commitment. Current Women’s National Team member Trinity Thomas competed at state diving championships throughout high school. And Olympic gold medalist Jade Carey didn’t even qualify for elite until she was 17 years old! Burnout is the other massive concern. Talented athletes often feel significant pressure from family members to keep playing in order to earn scholarships or achieve other goals. Yet, according to the NCAA, less than 1 in 14 (8%) of high school athletes play on the varsity team at college, and fewer than 1 in 54 (2%) are awarded athletic scholarships. One question that I like to ask my athletes after sending their parent out of the room is, “If it was only up to you, would you still want to keep playing this sport?” If their answer is no, then upon the parent’s return, I gently start the conversation about the goals of sports participation and the risk of burnout. Kirsten Jones, in her book “Raising Empowered Athletes,” suggests that parents need to examine whether the primary goal is to encourage their child to stay active, learn skills and make Taking the Pressure Off in Sports Placard posted at both ice rink entrances at the Skating Club of Boston, where many elite skaters train. Photo courtesy of Ellen Geminiani, MD. | 24

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