Category Archives: Family Medicine

Becoming a Doctor One Step at a Time – University of Colorado Anschutz Medical Campus

Its amazing the things you can learn on YouTube.

Because she was taking big steps on an unknown and sometimes difficult path the first in her family to pursue a medical career Brissa Mundo-Santacruz often turned to YouTube for guidance on things like preparing for the MCAT and applying to medical school.

I didnt know anybody who was in medical school or who was a doctor, so I had to do a lot of research and seek out information wherever I could find it, she says. I didnt really know what I was doing, but the one thing I did know is that I wanted to be a doctor.

Now, as Mundo-Santacruz prepares for Match Day March 17, when shell learn where she matched for her family medicine residency, shes envisioning a career that not only allows her to build long-term relationships with patients and to treat the whole person, but that also includes space for mentorship.

I do feel a sense of wanting to be someone who represents people from my community and who inspires them to pursue their passion, she says. If health care is something that they want to go into and they dont have anyone in their family whos in the medical field or who has gone to college, I want them to be able to look to folks like me and be like, She was able to do it. If shes a doctor, then I can be a doctor, too.

Even before she dreamed of becoming a doctor, Mundo-Santacruz saw first-hand how health inequities can impact underserved communities. She was born in Mexico and, before moving to Loveland, Colorado, with her mother, she saw her family struggle with chronic conditions.

For example, my dad has always struggled with not wanting to go to the doctor theres a lot of mistrust there, she says. He has diabetes and hypertension, and for the longest time he never went to be screened or anything because he just didnt trust it. He often said, If I dont go, they cant tell me something is wrong. That was really eye-opening and I slowly started to put the pieces together of why these things were happening.

With all the adjustments of life in a new place, though, Mundo-Santacruz had to devote more energy to finding her footing than to planning for her future. She wasnt the best student in high school, she admits, and for a while didnt even think shed graduate.

I just wasnt really interested in what came after, she recalls. But I had a really great, amazing counselor, Mr. Cain, who I still keep in touch with, and he supported me in a lot of the things I was going through. He was like, You should just sign up for some college classes and he helped me enroll in community college. When I graduated high school, I was like, I already signed up for these classes, I might as well go.

Mundo-Santacruzs time as a student at Front Range Community College was something of a revelation. She was suddenly able to tailor her education and study things she loved, discovering her passions for science and for helping people. However, she also was soon confronting the challenges that many first-generation students experience.

Looking back, Im recognizing how difficult it was to actually learn about what a pre-med path was, learning that I needed to transfer to a four-year university and all the prerequisites, she says. I remember a couple of counselors being like, Is that really what you want to do?

Her mother, while unfailingly supportive, had no frame of reference for what Mundo-Santacruz was trying to do. My mom was a housekeeper at the time and my step-dad worked as a plumber, so they just didnt have familiarity with the process, she says. Studying in college is really different than just doing homework, so I was explaining to my mom why I needed to study for so long. But she was always so supportive even when it wasnt something she knew about.

Mundo-Santacruz completed her undergraduate degree in biology at Colorado State University, knowing that she wanted to go on to medical school. She turned to YouTube to learn how to do that and began blind-calling doctor's offices, asking if she could come talk with someone there about pursuing a career in medicine.

She learned about the American Association of Medical Colleges Fee Assistance Program, which offers support with MCAT and medical school application fees, and submitted about 15 applications. Her first choice was always the University of Colorado School of Medicine, in part because she didnt want to be too far from her family, and was thrilled when she was accepted.

Brissa Mundo-Santacruz with her husband, William Mundo, MD, and their daughter, Yaretzi.

Medical school was yet another new world and once again, Mundo-Santacruz pivoted to YouTube for insight on traversing her first year.

It definitely is like drinking out of a fire hose, she recalls with a laugh. And it was very humbling. I think for a lot of medical students, youre used to being either the top of your class or just the person who has it the most together, but suddenly youre in this group where everyones the best of the best. I remember just not doing great on my first few exams and I was like, What!? Im so used to getting As and thought I did so well on the exam, and then I got a C and was just very sad.

Mundo-Santacruz did struggle with imposter syndrome a feeling of not belonging and fear of being discovered as a fraud despite being qualified to be there. Most of these feelings stemmed from the lack of representation in medicine, she says, so it was imperative for her to find community in her class, because many of us feel this way at some point or another. Eventually I was able to get to a point where I was like, I think this is OK, I think Ive got this.

She cites enriching experiences with patients, including real-life health care simulations through the Center for Advancing Professional Excellence, for helping her realize that she did belong in medical school and the medical field, and could make a significant difference in her patients quality of care. She knew the best thing she could do, once again, was work hard and persevere.

And then the COVID-19 pandemic hit. After finally having her feet underneath her and becoming comfortable with very dense subjects, Mundo-Santacruz then learned to adapt to a new paradigm of online learning. Fortunately, some of the experiences from which she learned the most she was able to complete in-person, including rotations through various medical specialties. In the midst of those rotations, she knew shed found her place in family medicine.

Now, as she awaits her match, Mundo-Santacruz is thinking a lot about the career she wants to have. During one of her rotations, she practiced at Salud Family Health Centers, which serves many underinsured and non-insured patients, as well as many Spanish speakers.

I loved the very broad scope of care thats offered there, she says. As a provider, youre doing all that you can to help a patient because a lot of these patients just cant be referred to a specialist as easily, so you try to do as much as you can. I was also seeing how powerful it is to be a provider who speaks Spanish, just seeing how much peoples eyes light up when theyre like, Oh, my gosh, are you my doctor?!

Mundo-Santacruz is aiming to build a career that helps to address longstanding health inequities and that also supports women in medicine. She and her husband, William Mundo, MD, an emergency medicine resident at Denver Health, had their daughter, Yaretzi Mundo, less than a year ago, so Mundo-Santacruz experienced not only being a woman in medicine, but an underrepresented pregnant woman in medicine.

I think its really important for people to see that this can be done, and to be someone that people feel like they can come to for tips or support, Mundo-Santacruz says. I know how difficult it is to do all this work on your own, when you dont necessarily have someone you can look up to or feel comfortable asking questions, so I want to be that person for others like me.

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Becoming a Doctor One Step at a Time - University of Colorado Anschutz Medical Campus

Do genes tell all? How UAB is using genomics to treat patients – University of Alabama at Birmingham

AGHI is partnering with the UAB Department of Family and Community Medicine to aid research, patient care and insight on using the genomic sciences in primary care.

AGHI is partnering with the UAB Department of Family and Community Medicine to aid research, patient care and insight on using the genomic sciences in primary care.Patients at three University of Alabama at Birmingham Department of Family and Community Medicine clinics can discover predicted high risks for diseases such as cancer and heart disease and receive personalized medication information thanks to the departments partnership with the Alabama Genomic Health Initiative.

The departments primary care clinics, UAB Hospital-Highlands, UAB Medicine Hoover Primary and Specialty Care, and UAB Selma Family Medicine Center, all offer enrollment into an AGHI study that uses the genomic sciences to try to discover health and medication information about a patient based on the patients genetic makeup.

AGHI does this by identifying whether the patient has any gene variants associated with a high risk of certain diseases, like certain kinds of heart disease and cancer.They also use pharmacogenetics to see how medication is metabolized and interacts in patients. This can help inform selection and dosing of medications to minimize side-effects and maximize efficacy.

The departments partnership with AGHI will allow UAB primary care providers to offer personalized patient recommendations and learn how primary care clinics can best provide genomic science-based care, says UAB Hospital-Highlands Medical Director Erin DeLaney, M.D. DeLaney was one of the first primary care doctors at UAB to offer enrollment into the study.

One of the goals of this partnership is to understand better how genomics can be part of a primary care practice and how it may impact patient care, disease prevention strategies, precision drug therapies and treatment, DeLaney said. This partnership will help bring cutting-edge, precision medicine to patients where they are, help doctors provide more precise treatment recommendations, and help us all understand what genetic variants and pharmacogenetic findings may or may not mean in the real world and how they can affect patients.

Research is also an important factor in this partnership, which helps collect more genomic information on diverse populations. AGHI Program Director Renie Moss says this information has been lacking previously.

This study has a real-world impact on communities that have been left out or missing from genetic research in the past, Moss said. Historically, genetic databanks have predominantly consisted of data from persons of European ancestry, which leaves out a significant part of our diverse population in Alabama. AGHI is helping to fill in those gaps to not only improve health outcomes for these historically underrepresented communities but understand how genetics factors into these communities health outcomes.

AGHI does this by putting the genomic information of patients who agree to this into a biobank and data repository that AGHI-approved researchers for Institutional Review Board-approved studies at UAB can use. Although this is a completely optional part of enrollment, this information could help researchers better understand genomics. More than four of every five people who are enrolled have opted in.

As of Nov. 4, 2022, more than 800 primary care patients have enrolled with the AGHI from the three clinics. Nearly two-thirds of enrolled patients are African American, and over 1.5 percent are from other minority populations, as of Jan. 20, 2023.

To get tested, patients can choose to enroll after AGHI research team members completely explain the study to potential participants and answer their questions. They then take a blood test often the blood draw is done at the same time as other routine blood tests that are ordered by their primary care provider. Both the primary care provider and the patient then receive the results, which are included in the patients digital medical records for reference throughout the patients life.

If the patients results indicate a positive disease risk, an AGHI genetic counselor contacts the primary care provider and the patient to educate them on the results and next steps, and then the primary care provider ensures any needed steps are implemented. If the results include pharmacogenetic information that could inform a current medication decision, the primary care provider and an AGHI pharmacist will discuss the results.

A community board also advises AGHI. This diverse board helps to continually improve how AGHI implements its study.

Clinicians, community members, faith leaders and community organization leaders who are a part of the AGHI community advisory board come together quarterly to provide guidance and community input to the study team, Moss said. Valuable revisions to the study, including recruitment, educational materials and return of results procedures, have been made as a result of the ongoing guidance received from the AGHI advisory board members.

Patients in participating clinics who are at least 18 can enroll by talking with their primary care team. From there, the team will connect them with AGHI to enroll, which can often happen at the end of a scheduled clinical appointment.

Find a provider at UAB Hospital-Highlands or UAB Medicine Hoover Primary and Specialty Care, or call 334-875-4184 to make an appointment at UAB Selma Family Medicine Center.

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Do genes tell all? How UAB is using genomics to treat patients - University of Alabama at Birmingham

PeaceHealth names new chief medical officer for its communities in … – PeaceHealth

BELLINGHAM, Wash. Lorna Gober, MD, has joined PeaceHealths Northwest network as chief medical officer (CMO).

As CMO, Dr. Gober will work closely with the PeaceHealth Northwest executive team as well as medical staff and medical group physician leadership. Dr. Gober will also be an important addition to the PeaceHealth senior physician leadership team made up of other PeaceHealth hospital and medical group CMOs.

Dr. Gober most recently served as the Medical Director of Sound Physicians at PeaceHealth facilities in Bellingham, Sedro-Woolley and Vancouver, an expanded leadership role within Sound after leading the hospitalists at PeaceHealth St. Joseph. Prior to Sound, Dr. Gober was with Family Care Network in Bellingham for more than a decade, during which time she held a variety of executive leadership roles. Earlier in her career, Dr. Gober worked at Western Washington University Student Health Center, and briefly as a fill-in physician at Sea Mar Community Health Clinic and Nooksack Tribal Health.

Dr. Gobers well-rounded experience makes her ideally suited for the CMO role, says Charles Prosper, chief executive of PeaceHealths Northwest network. We believe that she will be an excellent leadership partner and mentor.

Dr. Gober received her Bachelor of Arts from the University of Oregon Honors College, where she graduated magna cum laude. She received her Doctor of Medicine from the University of Washington and completed her residency training at the Tacoma Family Medicine Residency Program.

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PeaceHealth names new chief medical officer for its communities in ... - PeaceHealth

St. Luke’s official: Change is needed in Idaho’s abortion laws before … – Yahoo News

To those who witnessed the fall of Roe v. Wade and the implementation of Idahos total abortion ban, the medical community accepts that broad access to abortion is no longer an option in Idaho.

Dr. John M. Werdel is the womens service line medical director at St. Lukes Health System.

What most do not realize is the dramatic impact criminalizing medical care is having on recruitment and retention of physicians who care for Idahos pregnant women. We need the citizens and legislators to fully understand and appreciate what is at stake now and act before it is too late.

As the medical director of womens health care at St. Lukes Health System, I am witnessing first-hand the impact of these laws on all physicians who give advice and care to pregnant women. These providers are terrified and constantly second-guessing their decisions. Not because of the restrictions on broad access to abortion, but because they can no longer safely manage and advise their patients who have pregnancy complications.

Complicated pregnancies are not rare; the average is 30 per week for the St. Lukes Health System alone. These complications may require the termination of the pregnancy to protect the health of the mother or end a fatal fetal defect. But physicians dealing with these complications could be facing felony charges from such care and have no choice but to defend these medical decisions in court.

What reasonable physician wants to take that chance? Many are deciding it is not worth the risk.

A recent survey shows that more than 45% of obstetrical-gynecological physicians are currently considering or exploring relocation out of Idaho.

In the last six months, three of the maternal fetal medicine physicians (high-risk pregnancy specialists) in our state have decided to leave Idaho. Family medicine and generalist OB-GYN physicians, who manage the vast majority of pregnant patients in our state, are also signaling a desire to limit their practice, retire early or leave Idaho.

Recruitment of new physicians to Idaho has been virtually impossible since late summer 2022, which should be setting off alarm bells throughout Idaho.

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Again, it is not the restrictions on elective abortion that are driving this unfolding nightmare. Physicians do not want to practice in Idaho; they do not want to live and raise a family in a state that criminalizes care that is both medically appropriate and necessary.

It is not too late.

Legislators in this session could make simple changes in the laws and allow for appropriate and medically necessary exceptions in the cases of terminations. This would allow the doctor and the patient to make these often heart-wrenching decisions, without the fear of prosecution hanging over their heads.

Obstetrical care is complex, and a nuanced approach is required. If we do not rewrite these laws during this legislative session, we will lose more physicians. Recruitment will remain difficult if not impossible. This will lead to provider shortages, increased access issues, substandard and unsafe care.

Please contact your representatives and ask them to prioritize this issue.

Dr. John M. Werdel is the womens service line medical director at St. Lukes Health System.

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St. Luke's official: Change is needed in Idaho's abortion laws before ... - Yahoo News