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Choosing a Career in Family Medicine

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Title: Choosing a Career in Family Medicine


1
Choosing a Career in Family Medicine
  • What medical students need to know
  • The Federation of Georgia Family Medicine
    Residency Programs

2
What is Family Medicine?
  • Family practice is the medical specialty which
    provides continuing and comprehensive health care
    for the individual and the family. It is the
    specialty in breadth which integrates the
    biological, clinical and behavioral sciences. The
    scope of family practice encompasses all ages,
    both sexes, each organ system and every disease
    entity.

Definition of the American Academy of Family
Physicians _at_ www.aafp.org
3
What is Family Medicine?
  • Family practice is the medical specialty which
    provides continuing and comprehensive health care
    for the individual and the family. It is the
    specialty in breadth which integrates the
    biological, clinical and behavioral sciences. The
    scope of family practice encompasses all ages,
    both sexes, each organ system and every disease
    entity.

Definition of the American Academy of Family
Physicians _at_ www.aafp.org
4
Family Medicine The Specialty
  • What things are you most proud of personally and
    professionally? ... Personally, I am most proud
    of my new daughter, Coral. Professionally, I am
    excited at the prospect of becoming a part of the
    community in which I will raise my family and
    care for those around me.
  • What do you like most about family medicine?
    ... Family medicine is unique in that it allows
    us to develop relationships and friendships with
    the families and communities we care for that you
    just cant obtain in other specialties.
  • Please describe one of your favorite patients.
    ... My favorite patient taught me, humbled me and
    befriended me. He is an older gentleman with
    severe COPD, which limits him and his daily
    activities. One of his favorite pastimes is
    fishing, which has become increasingly difficult
    for him. Despite this and with his familys
    support, he continues to have big tales to tell.
    Through our relationship he has included me in
    his adventures and as a close friend of his
    entire family.
  • Describe one of your favorite memories about
    training to become a family physician. ... The
    residency program at the Medical College of
    Georgia provided me with a great number of
    wonderful memories. This program places its
    residents in a broad range of learning
    environments, ranging from Fort Stewart to
    tri-county clinics in Warrenton, Salvation Army
    clinics and on high school football fields
    learning sports medicine. Its too difficult to
    pick just one, but in retrospect the opportunity
    MCG FM gave me made me understand that its more
    than just medicine were doing. Its caring about
    the people around us.

5
Family Medicine The Specialty Crucial to the US
Healthcare System
  • The nation's nearly 70,000 practicing family
    physicians are key providers of primary care in
    the United States with nearly one in four of all
    office visits made to general and family
    physicians annually. 
  • In 2001, office visits to general and family
    physicians numbered more than 210 million - 76
    million more than to any other specialty.

6
Child with several fractures Look at the sclera
7
Sclera are somewhat blue …
Osteogenesis Imperfecta
8
Large olecranon bursitis with…
9
Incredible pitting edema of the hands
Chronic Gout
10
Severe olecranon bursitis
Removed 250cc fluid on aspiration
11
Family Physicians find out where babies come from…
12
Right here, right?!!
13
Anyone recognize these silvery scales?
14
Psoriasis
15
Family Medicine The Specialty
  • In the increasingly fragmented world of health
    care, one thing remains constant Family
    physicians are dedicated to treating the whole
    person.  Family medicine's cornerstone is an
    ongoing, personal patient-physician relationship
    focusing on integrated care.

16
Family Medicine The Specialty
  • Unlike other specialties that are limited to a
    particular organ, disease, age or sex, family
    medicine integrates care for patients of both
    genders across the full spectrum of ages within
    the context of community and advocates for the
    patient in an increasingly complex health care
    system.
  • We care for the whole person body, soul, and
    spirit.

17
Family Medicine The History of the Specialty
  • The specialty of family medicine was created in
    1969 to fulfill the generalist function in
    medicine, which suffered with the growth of
    subspecialization after World War II.
  • Since its creation, the specialty has delivered
    on its promise to reverse the decline of general
    medicine and provide personal, front-line medical
    care to people of all socioeconomic strata and in
    all regions of the United States.

18
Family Medicine The Specialty
  • Today, family physicians provide the majority of
    care for America's underserved rural and urban
    populations.
  • In fact, more than a third of all U.S. counties,
    with a combined population exceeding 40 million
    Americans, depend on family physicians to avoid
    designation as primary care health profession
    shortage areas.

19
Family Medicine The Specialty
  • Family physicians complete a three-year residency
    program after graduating from medical school.
  • Internal medicine and pediatrics are three years.
  • OB/GYN is four years.
  • General Surgery is five years.

20
Family Medicine The Specialty
  • As part of their residency, residents participate
    in integrated inpatient and outpatient learning
    and receive training in six major medical areas
  • Pediatrics
  • Obstetrics and Gynecology
  • Internal medicine
  • Psychiatry and Neurology
  • Surgery
  • Community medicine.

21
Family Medicine The Specialty
  • They also receive instruction in many other areas
    including
  • Geriatrics
  • Emergency medicine
  • Ophthalmology
  • Radiology
  • Orthopedics
  • Otolaryngology
  • Urology

22
Family Medicine The Specialty
  • Because of their extensive training, family
    physicians are the only specialists qualified to
    treat most ailments and provide comprehensive
    health care for people of all ages - from
    newborns to seniors.

23
Family Medicine The Specialty
  • Providing patients with a personal medical home,
    family physicians deliver a range of acute,
    chronic and preventive medical care services.
  • In addition to diagnosing and treating illness,
    they also provide preventive care, including
    routine check ups, health-risk assessments,
    immunization and screening tests, and
    personalized counseling on maintaining a healthy
    lifestyle.

24
Family Medicine The Specialty
  • Family physicians also manage chronic illness,
    often coordinating care provided by other
    subspecialists.  From heart disease, stroke and
    hypertension, to diabetes, cancer and asthma,
    family physicians provide primary care for the
    nation's most serious health problems.
  • For example, how would a specialist deal with a
    older gentleman with hypertension and
    uncontrolled diabetes who might not be taking his
    medications appropriately because of depression
    issues?

25
Truths
  • We take care of more than just colds and act as
    more than just gatekeepers to specialists, caring
    for 90 of our patients issues.
  • Family Medicine is a challenge and will utilize
    all of your talents.
  • Family Physicians have a good track record for
    picking up unusual diagnoses by having an ongoing
    relationship with patients and recognizing
    change.
  • Family Physicians can acquire training to use
    technology in hospitals and in private practice
    to perform procedures with efficiency and safety.

26
Although we do see some very interesting lumps
and bumps to keep things exciting…
27
Doc, I gotta bump in my neck
28
Large thyroid goiter
29
8 yo girl with a large cyst
30
Family physicians stop and smell the roses, or
lilies in this case.
31
But sometimes, there are critters in the bushes!
32
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33
Doctor, My Babys feet are crooked
34
But you see, Maam, we can straighten the feet
so your young one is fine!
Metatarsus Adductus
35
Why Choose Family Medicine?
  • After entering practice, a family physician often
    becomes an important part of the community, often
    serving as
  • High school sports physician
  • Member on hospital board
  • Member of local community associations
  • (Insert other options)
  • (Free clinic Good Samaritan in Atlanta)
  • (Missions experience)

36
Why Choose Family Medicine?
  • During clinical rotations, you might hear someone
    comment that no one can manage a specific
    disease better than a specialist.
  • Not all problems need to be managed by
    specialists and their expertise is better used
    for consultation on more complex disorders.
  • Many conditions may not need continued
    subspecialty care after an initial consultation
    /or diagnosis confirmation.
  • Some patients will especially need the help of a
    Family Physician to balance multiple concurrent
    conditions.

37
Why Choose Family Medicine?
  • Family physicians may decide to focus on one
    particular aspect of their practice and complete
    fellowships in
  • Adolescent medicine
  • Rural medicine
  • Geriatrics
  • Faculty Development
  • Obstetrics
  • Preventive medicine
  • Sports medicine

38
Why Choose Family Medicine?
  • Family physicians can also combine family
    medicine with other specialties such as
  • Preventive medicine
  • Psychiatry
  • Internal medicine

39
Family Medicine vs. Med/Peds (both provide full
scope of care to adults children)
  • Family Medicine
  • Has more training in behavioral health and
    outpatient specialties
  • More procedurally oriented with training on
    office-based procedures
  • Obstetric training
  • Med/Peds
  • Has more focus on inpatient care
  • Good for students who are certain they want a
    significant number of inpatients as part of their
    practice

40
Why Choose Family Medicine?
  • Incomes for family physicians compare favorably
    to those of other primary care specialties as
    well as other professional careers that require
    advanced education and training.
  • While income may vary by region, years in
    practice and type of practice the average net
    income of family physicians allows them to
    effectively pay off student loans and comfortably
    support their families.
  • The average annual incomes for family physicians
    range from approximately 140,000 to 163,000

41
Why Choose Family Medicine?
  • The lifestyle is quite conducive to normalcy,
    should you so choose.
  • You can work 80 hours a week.
  • Or, perhaps a bit less and have more time with
    family, more time to train for that triathlon,
    etc...

42
Making the Decision
  • What brings you personal satisfaction?
  • What brings you professional satisfaction?

43
Why did I choose Family Medicine?
  • (Insert your personal answer)
  • The breadth of medicine is simply too attractive
    to resist. You go from a child with a skin rash
    to an adult with heart failure to a geriatric
    patient with diabesotension (diabetes, obesity,
    and hypertension). No other specialty does this.
  • Procedures abound!
  • I have a reasonable answer for almost any medical
    condition.

44
13 year old boy with itchy skin
45
As Bugs Bunny says, Whats up, Doc.
Dermatographism in acute urticaria
46
35 year old female with grouped vesicles on her
chest
Shingles
47
What do you see?
48
Truly a Big Catch… An Aortic Aneurysm
49
Dont ask yourself what the world needs. Ask
yourself what makes you come alive, and go do
that, because what the world needs is people who
have come alive. Gil Bailie
50
(Insert different experiences)
  • Procedural medicine
  • Missions Medicine
  • Cruise/travel medicine
  • Research
  • Academic medicine
  • Military medicine
  • Locum tenans

51
We can work anywhere !
… providing relief to suffering while gaining
grateful patients.
52
Missions Work as a Family Physician
  • Family physicians can see all patients of all
    ages.
  • We are comfortable with uncertainty and a lack of
    resources.
  • We are able to improvise and provide
    compassionate care how to make someone smile
    without knowing their language
  • We are procedurally capable.

53
The place where God calls you is the place where
your deep gladness and the worlds deep hunger
meet. Frederick Buechner
54
Procedural medicine
  • Just do it!

55
Outpatient Procedures Flexible Sigmoidoscopy
with biopsy Colposcopy Endometrial
biopsy Cryosurgery of the cervix IUD
insertion/removal Norplant Removal (Insertion no
longer available) Vasectomy Treadmill Stress
Testing Nasopharyngolaryngoscopy (NPL) Punch
biopsy Shave biopsy Radiofrequency
ablation Excisional biopsy Lipoma, EIC,
etc… Joint injections Knee, Shoulder, etc… And
much, much more.
56
Inpatient Procedures Central Lines Arterial
Lines Thoracentesis Paracentesis Lumbar
Puncture Run codes Full Spectrum Obstetrics
57
Bigger Procedures
  • Cesarean Section
  • Cholecystectomy (Gallbladder)
  • Appendectomy
  • Orthopedic surgery
  • These can potentially all be done by FPs who have
    obtained sufficient training.

58
Why Choose Family Medicine in Georgia?
  • Atlanta Medical Center Family Medicine Residency
  • Columbus Family Medicine Residency
  • Emory Family Medicine Residency
  • Floyd Family Medicine Residency
  • Medical College of Georgia Family Medicine
    Residency
  • Mercer University School of Medicine / Medical
    Center of Central Georgia Family Medicine
    Residency
  • Morehouse Family Medicine Residency
  • Satilla Regional Family Practice Residency
  • Savannah Family Medicine Residency
  • Southwest Georgia Family Medicine Residency

59
Southwest Georgia Family Medicine Residency
  • Southwest Georgia Family Medicine Residency is
    located in Albany, Georgia and has the first
    accredited Sports Medicine Fellowship in the
    state. Phoebe Putney is a large community-based
    hospital that acts as a tertiary referral center
    for the SW corner of GA. This combination allows
    for increased 1-on-1 contact with attendings and
    exposure to pathology comparable to large
    academic centers. Our faculty are committed to
    resident education and implementing the FFM
    recommendations now.

60
Southwest Georgia Family Medicine Residency
61
Southwest Georgia Family Medicine Residency
62
Southwest Georgia Family Medicine Residency
63
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64
Albany, GA
65
Southwest Georgia
66
Southwest Georgia Family Medicine Residency
67
Emory Family Medicine Residency
  • The Emory Family Medicine Residency Program is
    university based and housed in an unopposed
    community hospital in Atlanta, Georgia. We serve
    a broad multi-cultural population in the heart of
    a thriving and vibrant city. Educational
    experiences abound at the renowned Emory Clinic.
    Our residents care for their patients' physical,
    psychological, and family concerns as they
    prepare for their future practice.

68
Atlanta Medical Center Family Medicine Residency
  • The Atlanta Medical Center program teaches the
    principles of Community Oriented Primary Care to
    produce community responsive physicians. We also
    have a special emphasis on behavioral medicine.
    The principles of managed care will be stressed
    in order to produce physicians that are cost
    effective while providing the highest quality of
    care.

69
Atlanta Medical Center Family Medicine Residency
70
Atlanta Medical Center Family Medicine Residency
71
Atlanta Medical Center Family Medicine Residency
72
Atlanta Medical Center Family Medicine Residency
73
Atlanta Medical Center Family Medicine Residency
74
Atlanta Medical Center Family Medicine Residency
75
Morehouse Family Medicine Residency
  • The Morehouse Family Practice Residency
    Program was established in 1981 as the first
    residency training program at Morehouse School of
    Medicine. Our residency training program is
    designed to equip family practice residents with
    knowledge and skills to competently care for the
    health and well being of the family. Our faculty
    is a full complement of highly trained, dedicated
    and enthusiastic teachers who are committed to
    maintaining excellence in education, and training
    physicians to practice and serve in our
    communities.

76
Medical College of Georgia Family Medicine
Residency
  • The Medical College of Georgia program provides
    clinical experience in a strong academic
    institution where Family Practitioners are
    respected and function independently. Residents
    are supported by 18 full time clinical faculty.
    Procedural skills, including sigmoidoscopy,
    vasectomy, colposcopy, dermatologic surgery are
    part of our comprehensive training along with
    electives in practice management and laboratory.
    Augusta is the second largest metropolitan market
    in Georgia.

77
Medical College of Georgia
78
MCG Family Medicine Center
79
MCG Childrens Medical Center
80
MCG Sports Medicine Center
81
Dr. Paul Forney, MCG Residency Director Presents
at Morning Report
82
Minor Surgery MCG
83
MCG Osteopathic Manipulation Therapy Clinic
84
MCG Osteopathic Manipulation Therapy Clinic
85
MCG Procedures
86
MCG Newborn Nursery
87
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88
Riverwalk Augusta on the Savannah River
89
Augusta National Golf Club Masters Golf Tournament
90
Columbus Family Medicine Residency
  • Columbus is the only residency program in a
    well-supported medical education program, our
    residents have many opportunities for a broad
    range of clinical and procedural experiences. We
    have successfully implemented an EHR for our
    Family Medicine Center. The program has also
    developed an FP Critical Care/Hospital Medicine
    Fellowship..

91
Columbus Family Medicine Residency
92
Columbus Family Medicine Residency
93
Columbus Family Medicine Residency
94
Columbus Family Medicine Residency
95
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Columbus Family Medicine Residency
97
Columbus Family Medicine Residency
98
Columbus Family Medicine Residency
99
Columbus Family Medicine Residency
100
Columbus Family Medicine Residency
101
Columbus Family Medicine Residency
102
Mercer University School of Medicine / Medical
Center of Central Georgia Family Medicine
Residency
  • The Medical Center of Central Georgia Family
    Practice Residency Program offers first-rate
    outpatient experiences, including nursing home
    and home visits and many procedures (treadmills,
    colposcopy, Holter monitoring, noninvasive
    arterial studies). 630 bed community hospital
    with excellent inpatient training. 10 full time
    faculty, special expertise in geriatrics, womens
    health, practice management and alternative
    medicine.

103
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Floyd Family Medicine Residency
  • Floyd Medical Centers Family Practice Residency
    is a 7-7-7 community based, unopposed program.
    Nestled in the picturesque hills of northwest
    Georgia, we are located approximately 70 miles
    north of Atlanta and 70 miles south of
    Chattanooga. Our Family Practice Center is
    conveniently located to our hospital, where
    attendings eat breakfast with residents instead
    of eating them for breakfast.

113
Floyd Family Medicine Residency
114
Floyd Family Medicine Residency
115
Floyd Family Medicine Residency
116
Floyd Family Medicine Residency
117
Floyd Family Medicine Residency
118
Floyd Family Medicine Residency
119
Savannah Family Medicine Residency
The Savannah Family Medicine Residency Program,
located in Savannah, Georgia, provides excellent
clinical, academic, and practice opportunities
for physicians seeking residency training in
family medicine.
120
Savannah Family Medicine Residency
  • Features of the program include
  • State-of-art Family Medicine Center with the full
    range of equipment and facilities
  • Medical University affiliation with Mercer
    University School of Medicine
  • Individually assigned resident work stations
  • Wireless access throughout the medical center
  • Excellent healthcare benefits
  • Resident Lounge newly renovated
  • Daily Didactic sessions with food provided
  • Walking distance to the hospital
  • Free parking and access to physician parking as a
    senior resident
  • Four weeks time off
  • Reimbursement and time off for continuing medical
    education
  • Salary range 40,600 44,600
  • Historic city with convenient beach access
  • Food Allowance Housing Allowance Book
    Allowance Moving Allowance

121
Satilla Regional Family Medicine Residency
  • Our program is based at Satilla Regional Medical
    Center in Waycross, Georgia, and is affiliated
    with the Medical College of Georgia in Augusta,
    Georgia. Aspiring physicians complete the first
    year of their three-year residency at MCG, and
    the second and third years at Satilla Regional
    and the private outpatient offices of Blackshear
    Family Practice. BFP is comprised of eight family
    practice physicians and one internist.
  • We offer a special program designed to help
    medical school graduates interested in rural
    family practice medicine gain practical
    experience. Residents are given an abundance of
    hands-on learning experience, low
    faculty-to-resident ratio, and opportunities to
    develop a significant patient panel of their own.
  • We also provide placement for students who want
    to do elective rotations and clerkships. Students
    are offered the opportunity to attend regular
    noon-day conferences with the residents, as well
    as daily Morning Report meetings.

122
Satilla Regional Family Medicine Residency
123
Satilla Regional Family Medicine Residency
124
Satilla Regional Family Medicine Residency
125
Satilla Regional Family Medicine Residency
126
Satilla Regional Family Medicine Residency
127
Satilla Regional Family Medicine Residency
128
Waycross, GA
  • There are more alligators in this area than there
    are people!
  • Waycross is home to Rice Yard, the largest CSX
    computerized rail yard on the East Coast.
  • Red Lobster owners got their start in the
    restaurant business here with the Green Frog
    Restaurant, which was opened in the 1930s by the
    Darden brothers.
  • Waycross has one of the biggest high school
    football stadiums in the State.
  • Waycross is approximately 1.5 hours from Amelia
    Island and the Florida coast as well as a
    national league football team, the Jacksonville
    Jaguars.
  • Visit the local museum where youll see a
    naturally mummified dog wedged in a hollow tree
    trunk while hunting its prey!

129
Satilla Regional Family Medicine Residency
130
Why Choose Family Medicine in Georgia?
  • Many advantages to doing a family medicine
    residency in the same state where you plan to
    practice. It is easier to
  • Preview practice sites
  • Make professional contacts
  • Research has shown that graduates tend to
    establish practice within a 50-mile radius of
    where they completed residency training

131
Learn More About Family Medicine in Georgia
  • (Describe specific opportunities for M1,M2,M3,
    M4s in Ga.)
  • Resources to learn more about family medicine
  • Faculty and Advisors
  • Your Family Medicine Interest Group
  • Georgia Academy of Family Physicians
  • www.gafp.org
  • American Academy of Family Physicians
  • www.aafp.org which has a special section for
    students

132
Increasing Demand for FPs in Georgia
  • Georgia ranks 38th in its ratio of physicians to
    population, according to the American Medical
    Association.
  • Georgias population is growing rapidly, yet the
    states physicians supply remains stagnant.
  • Physician distribution remains more favorable in
    urban areas than rural parts of the state.

133
Choosing a Career in Family Medicine
  • Testimonial from Ga. Doc, just out of Ga.
    Residency
  • (Well ask a recent graduate two-three years out
    to give us an Amen ?)

134
Choosing a Career in Family Medicine
  • Closing argument ???
  • Ultimately, you have to like what you do.
  • Family medicine gives a physician the ability to
    practice in almost any environment with tertiary
    to backwoods medicine support.
  • Family medicine uses evidence-based medicine
    while practicing within the parameters of
    reality.
  • The breadth of our specialty guarantees that a
    physician will not get bored.

135
Choosing a Career in Family Medicine
  • I love procedures and I do them several days a
    week.
  • I find great joy in teaching and family medicine
    is a field of mountain flowers, with each petal
    being a different clinical teaching point, both
    for me as well and my residents and students.
  • The hope and life in family medicine is like a
    sparkling river the water is new every time you
    look into its crystal surface.

136
Family Medicine A Specialty of Expertise and
Adventure
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