The Impact of Family Medicine
Spring 2011 Issue | By William M. Woodhouse, MD
Imagine yourself, or one of your family members, in one of the following situations:
- You are new to this country. Your husband works in the potato fields outside of Aberdeen. The home pregnancy test is positive. You are terrified - you only speak Spanish, all your relatives are in Guatemala and your first pregnancy, delivered in a village back home, resulted in a dead infant and you nearly bled to death.
- You go in to your doctor's office near your summer home in the mountains to have the prescription for your blood pressure and diabetes medications refilled. Your doctor tells you that the latest research on hypertension and diabetes indicates that your medications should be changed.
- There is no denying the results of the test. You just thought you would do your civic duty by donating blood. Now you discover that you're HIV- infected and living in small town Idaho, where everybody knows everybody.
- You are 24 years old, back home in rural Southeast Idaho while looking for work after college. The health department calls to let you know that your pap smear is abnormal, maybe early cancer. The nurse tells you that the only way to know is to have a special test and biopsies on your cervix. The procedures could cost more than $1,000. You just don't have the money.
- You are driving your car on an icy, windblown interstate out east of Rupert. The jack-knifed truck comes out of nowhere.
The lives of these individuals are about to be significantly impacted by Idaho State University's Department of Family Medicine and the ISU Family Medicine Residency. Each of these scenarios exemplifies a group of underserved Idahoans who have been deliberately targeted by federally-funded service, education and research projects in the Department. Ongoing support from the State of Idaho, Idaho State University and Portneuf Medical Center places the Department in a position to successfully pursue and qualify for this funding. Over the past decade family medicine researchers and grant writers have been responsible for bringing over $8 million in federal dollars back to Idaho to improve the health care of Idahoans.
With the Rural Perinatal Clinic Project, Title VII funds from the Bureau of Health Professions have paid to train family medicine residents to provide culturally-appropriate maternity care to pregnant women in rural Eastern Idaho. This population tends to be poor, uninsured and culturally diverse. The Department actively recruits Spanish-speaking family medicine residents who travel on a weekly basis to Health West's clinics in Aberdeen and American Falls to provide prenatal care. This care helps prevent complications and associated increased medical costs. When the women are ready, they come into Portneuf Medical Center to be delivered by a doctor with a familiar face who knows their language and their unique needs.
The Department's Family Medicine Clinical Research Center is actively engaged in cutting-edge clinical research. They have taken part in several landmark National Institute of Health trials that have significantly influenced how doctors treat high blood pressure, diabetes and congestive heart failure. Their ongoing research studies will evaluate how best to prevent heart attacks and stroke. So when the doctor in the mountain village recommends the medication change, that doctor is using the latest clinical research from studies done at Idaho State University.
The Department of Family Medicine has been caring for patients with HIV infection and related diseases for well over a decade. The ISU HIV Clinic, which is supported by federal Ryan White III funds, is integrated into the day to day function of Pocatello Family Medicine. HIV-positive patients seen in the clinic are provided with convenient access to confidential, state-of-the-art, multi-disciplinary care for their illness. The ISU HIV Clinic saves these patients from preventable costs, complications, disability and death caused by HIV infection.
The Department identified a need among its graduates for increased training in procedures that are used to diagnose, prevent and treat early cancers of the uterus and cervix. An application to the Health Resources and Services Administration resulted in funding to start the ISU GYN Clinic. This clinic is open to any woman in Idaho who has an abnormal pap smear but cannot afford to have the more expensive follow-up diagnostic and therapeutic procedures. Referrals for these procedures come from health care providers and health departments all over Eastern Idaho. Not only do the women get the care they need, but also the much greater costs of an untreated cancer are prevented, and our resident physicians are better trained to care for the women in their communities when they go out into practice.
Idaho ranks dead last in the United States for physicians per capita, but Idaho's family medicine residencies rank eighth in the nation in retaining graduates in the State after training. The biggest need in Idaho's rural areas is for more family doctors who are trained to deliver the babies, staff the emergency rooms, care for patients in the office and comfort the sick and dying. Having a doctor available who is able to handle everything from a c-section to a multiple trauma motor vehicle crash requires that they receive intensive training in the full spectrum of family medicine. That training is the mission of the ISU Family Medicine Residency. Recently, the chances have increased that a well-trained family doctor will be available to you after your car crash. The Department of Family Medicine, has applied and been approved for federal Primary Care Residency Expansion funds that were passed as part of the Patient Protection and Affordable Care Act. With the help of these funds the Residency will be able to expand the number of family medicine residents that are trained for practice in underserved areas of Idaho.
This is just a sampling of the many ways that federal grant funds, brought into the State by the ISU Department of Family Medicine, have improved the health care of Idahoans. More recent applications are directed toward receiving funding from the Bureau of Primary Care to establish a Community Health Center, from Medicare to increase the funding of family medicine resident education and from the National Institute of Health for new research projects. When your turn comes to benefit from these efforts you probably won't know it. But, hopefully, you will experience a competent, compassionate family physician who uses the latest in medical knowledge to give you the best possible care.