Did you know that nearly 90% of diabetic patients never see an endocrinologist? Or that nearly 500 babies are delivered to Michigan Medicine each year by physicians other than obstetricians?
Indeed, most of these patients are seen and treated by faculty members of the Department of Family Medicine, a one-stop shop for health services throughout the lifespan, from birth to death.
In honor of National Primary Care Week, here’s a look at one of the departments providing primary care in Michigan Medicine – and why the team is so important.
Eyes on the mission
When most people think of family medicine, they often think of the clinical aspect of the department’s work. But that’s far from everything this team offers.
“Our department covers all aspects of the organization’s mission, from patient care to education and research,” said Phillip Zazove, MD, George A. Dean, MD, president of family medicine. “And I am proud of the work we do and the collaborations we have forged with specialists from all areas of Michigan medicine.”
The department is large – with over 100 professors and countless support staff – and has members who help patients in hospitals, outpatient clinics, and community clinics; work as fellows or residents; carry out continuing education courses; or participate in innovative research.
A central point of contact
As mentioned earlier, clinical care is the most visible aspect of family medicine. But what type of care does this team provide exactly?
“We try to care for patients throughout their lives, from cradle to grave,” said David Serlin, MD, who heads outpatient operations for the department. “This means we serve as a central point of contact with patients to meet all of their healthcare needs. “
Doctors help patients manage chronic illnesses such as birth defects and other disabilities, heartburn, diabetes, depression, anxiety and heart disease, as well as acute illness and injury. The team also offers geriatric and palliative care.
“A lot of these chronic conditions have aspects that patients face every day, and our team can help them with that,” said Serlin. Often times, this means discussing diet, exercise, and lifestyle changes that can help prevent poor health outcomes.
“If more serious issues do arise, we can refer them to a specialist here at Michigan Medicine,” Serlin added. “By using this model, we keep specialists available to treat the most serious conditions and better support our patients. “
Family physicians also treat pregnant women and provide prenatal and postnatal care and delivery.
“Think about how transparent this can be for our patients,” Serlin said. “They are seen by a family doctor for antenatal care, who can then give birth. After birth, this same doctor will watch the mother and provide care for the baby and the whole family as they grow older.
When family medicine patients are admitted to hospital for a number of reasons, they may also be seen on the side of hospital patients by their physicians.
“We have two inpatient departments, one at St. Joseph Mercy Chelsea and the other at the University Hospital,” said William Chavey, MD, MS, inpatient leader of family medicine . “The inpatients we see on an outpatient basis who do not need to be in an intensive care unit or being treated by a subspecialist will be seen by family physicians. “
Reach out to the community
For family medicine, it is about meeting patients where they are, both in a hospital setting and on an outpatient basis. Ambulatory family medicine services are offered at six clinical sites in the region, two in Ann Arbor and one each in Chelsea, Livonia, Dexter and Ypsilanti.
In addition, certain clinics reach certain populations.
“We have a Japanese family health program that takes care of the Japanese population and a Latin health clinic, Programa de Salud Familiar, which serves this specific community,” said Serlin. “At Dexter, we also have the Deaf Health Clinic so people who are deaf or hard of hearing can receive the care they need. “
Family medicine also created the first pantry in Michigan Medicine to help patients for whom food insecurity is a barrier to health and well-being. for underserved patients who volunteer at Corner Health Center and Hope Clinic.
Indeed, the department is committed to advancing Diversity, Equity and Inclusion (DCI) for patients, learners, faculty, staff and the community. This vision is part of the ministry’s strategic plan.
“In the clinical area, we employ staff from the Luke Clinic in Detroit, providing pregnancy care, including childbirth on our Family-Mother-Baby department, and newborn care for at-risk mothers and babies. their children, ”said Ebony Parker-Featherstone, MD, director of diversity, equity and inclusion for family medicine. “We are also active in education by hosting a quality health equity conference that provides a comprehensive patient review and we have faculty who help lead the institution’s efforts in this area. inclusive education on the principles of health equity and justice. “
Finally, the team conducted a department-wide anti-racism training in 2020, and the research areas are part of the Population Health Assessment Engine (PHATE) pilot project which seeks to incorporate data into clinical practice to inform care, launched the anti-racism and health equity program. (AREP) which seeks to promote health equity through anti-racism research and research practices, and leads efforts towards inclusion in accessibility through the MDisability program.
Train current and future generations
In addition to DEI’s educational efforts, members of the family medicine team impact both the current and next generation of healthcare professionals in a multitude of ways. For example, medical students rotate in the department, and there is a strong residency program, scholarships, and continuing medical education courses.
“What is unique about our residency program is that our residents become primary care physicians for specific patients throughout their three years at Michigan Medicine,” said Eric Skye, MD, associate president for education. “They will be assigned to one patient in the first year and will follow them every three years. “
The program is open to 13 residents per year who are divided into two sites, one at the Chelsea Health Center and the other at the Ypsilanti Health Center. Twelve of the residents follow a traditional course, while another follows a course in Spanish to help develop culturally competent doctors. The department also manages one sports medicine scholarship and five post-graduate medical scholarships, while three other scholarships at Michigan Medicine may involve family physicians, but are hosted in other fields.
Finally, three major CME programs are offered by family medicine, two in Ann Arbor and one in northern Michigan, and the team offers faculty development courses.
“Whether you go through our residences, scholarships, CME training, or even our faculty development courses, we pride ourselves on producing highly skilled primary care physicians,” Skye said. “They can use the skills they have learned here and bring them back with them to communities across the country. “
Putting research into practice
Nearly two dozen professors are focusing their efforts more on research than on patient care. This research often takes the form of surveys of the most effective ways to treat common conditions.
“For example, we know that diet and exercise can help reduce the risks and dangers of heart disease,” said Caroline Richardson, MD, who heads the research portion of the department. “But what are the most effective ways to get patients to actually embrace these changes? This is the type of research that we do.
The team is also examining best practices in clinical care and how clinicians can better forge alliances with patients to ensure change is happening.
“Often, strategies exist, but we are looking for ways to implement those strategies at scale,” said Richardson.
The research side of the department is now the industry leader. Richardson, for example, is the editor of the Annals of Family Medicine, the world’s leading primary care research journal.
“The work we do here at Michigan Medicine can impact all of our patients here at home, but also millions of others around the world,” said Richardson. “And whatever role you play in our department, it’s incredibly exciting.”
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