Blogs

Duke Family Medicine Center is making a concerted effort to reduce the risk of opioid use in our patients. Over the past few years our providers have acknowledged that we all have to change the way we practice in order to reduce harm from opioids.

As my family medicine residency nears completion, I am reflecting on what I did well, what I could have improved and what, if anything, I can influence to change for those who come after. Of these things, I wish to offer a suggestion for the future of graduate medical education, particularly for the family medicine specialty.

All of us who see patients at Duke Family Medicine Center are acutely aware of the incredible complexity of their care, the number of comorbid medical problems our patients have, and the astounding number of medications that many of them take.

The pink of redbuds, the purple of crocuses, the white of Bradford pears, the yellow of daffodils, the “ahh choo” of sneezing. Durham is alive with spring and that means “March Madness.” No, I don’t mean basketball. It is the annual spring ritual of Match Day.

Health is created in the places we live and work — in community. Yet U.S. health care, an industry the size of the French economy, tasked with caring for the nation’s health, remains focused only on the therapies that can improve health for individual patients rather than the for whole communities.

On Feb. 13, a bitter cold Saturday morning in Raleigh, many members of Duke Community and Family Medicine marched on Fayetteville Street, along with an estimated 5,000 people, in the10th Annual Moral March on Raleigh.

Reflecting on my last decade of medical training, I dove deep into understanding the marvels of the human body when it is healthy and diseased, and learning what treatments, whether it be surgical, medical, or lifestyle interventions, might help a patient achieve what we want everyone to achieve: optimal health.

Over the past five years, since the implementation of the Affordable Care Act (ACA), U.S. health care payment systems have changed. In the 1960s and 1970s, we paid for health care on a largely “fee for service” basis, with little regulation of price or utilization of services.

The Duke Family Medicine Residency Program has a tradition known as Winter Orientation. During this time each January, our first-year residents (PGY 1’s) all return from their various rotations and locations to spend two weeks dedicated to the work of the Department of Community and Family Medicine within the Durham community.

Twelve months ago, I interviewed at Duke Family Medicine, a residency program completely out of left field for me. Entering into the interview season, I had initially hoped to match with a large, inner-city program with an inpatient service, located in the northeast.