Monday, November 30, 2015

Guest Post: Primary care lifeline

- Sarah E. Stumbar, MD, MPH

In March, the Association of American Medical Colleges (AAMC) released a report estimating that there would be a shortage of between 12,500 and 31,100 primary care physicians by 2025. These projections are not news to anyone in medicine, but in the uproar following Columbia University/New York-Presbyterian’s unilateral decision to close its family medicine residency program (and the subsequent quick reversal of that decision), it became obvious that most people still do not understand the complex and integral roles that primary care physicians play in their patients’ lives.

During my Family Medicine residency, I provided prenatal care, delivered babies, provided postpartum contraception, performed options counseling and abortions, and saw the infants I delivered grow into toddlers. I went on home visits to provide emotional support and end-of-life care to a magnificent woman dying of esophageal cancer. I followed my patients from the clinic to the inpatient setting and back to the clinic again. I worked to forge relationships that would hopefully keep my patients out of the hospital. I gave out my cell phone number and my e-mail address, and I welcomed phone calls and clinic walk-ins whenever there was a question or concern. I made countless calls to specialists, begging them to see my patients sooner than the next available appointment in six months. Once, for a patient with possible lung cancer on a CT scan, I made twelve phone calls to a pulmonologist before I was able to get her an appointment within an acceptable amount of time. In the Bronx community where I trained, I made certain that I was the strongest advocate for my patients, many of whom had never had anyone advocate for them before.

Now seeing uninsured patients in a mobile health clinic in Miami-Dade County, I am the safety net that wouldn’t otherwise exist. My new patients are quickly learning that I believe in their right to health care, and I will do anything to help them navigate our struggling medical system. The Washington Heights Community served by Columbia’s deeply invested residents—and this nation as a whole—needs more family physicians, not more medical administrators who have forgotten the daily realities of our patients.

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Dr. Stumbar is a 2015 graduate of Montefiore Medical Center’s Residency Program in Social and Family Medicine. She is now an Assistant Professor of Family Medicine at Florida International University in Miami.

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