CHA Family Medicine Residency

Tufts family medicine residents have "the best of both worlds"


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TUFMR at the Boston Marathon

On Patriot’s Day several of our teaching faculty volunteered for the Boston Marathon with current and former residents. Former resident Nathan Cardoos is currently at UMass doing a sports medicine fellowship and current PGY2 resident Sam Hwu is applying for sports medicine fellowship. Jess Knapp is our new sports medicine faculty member from UConn and this was her second year volunteering at the marathon. Nicole O’Connor recently graduated from our family medicine residency and was scooped up to stay on as faculty. This is Nicole’s 3rd year as a volunteer and she ran the marathon in 2011 as well! Our tent was busier than in years past and at one point we reached max capacity and runners were diverted to other finish line tents. Most of the runners were seen for hypothermia due to the running conditions and improved with warm blankets and warm drink. Overall we had fun listening to the stories told by runners and volunteers while patching up our nations athletes.

Boston Strong!

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Massachusetts Family Medicine Advocacy Day

On Wednesday afternoon, April 15 the Tufts University Family Medicine Residency at Cambridge Health Alliance had a fantastic field trip to the Massachusetts State House for the Annual Massachusetts Academy of Family Physician’s Advocacy Day. We had a group of PGY-2 and 3 residents along with 3 faculty attend the event.

This great annual event that is one of our key activities to get residents training, exposure and practice with direct face-to-face political advocacy with their state legislators, and for many participants, this was their first trip to a state house to interact with legislators and their staff.  In preparation for the day, residents completed the Society of Teachers of Family Medicine on-line advocacy course which gives a great orientation to political advocacy. The afternoon then started with an orientation from the Mass AFP’s lobbying team who gave a legislative Overview, as well as Policy and Advocacy briefing and they also “armed us” with some “one-pagers” describing some of the talking and position points that we could share in our legislative meetings.

After this coaching we broke up into small teams of constituents to go visit the offices of our Senators and Representatives. We had many great conversations with staffers and legislators sharing some of our “real life doctoring stories” to illustrate how policies and the current healthcare climate effect our day to day practice and our patients. Massachusetts (now down to 1.8% of our population being uninsured after passing universal coverage in 2007) is ahead of the rest of the nation in closing the gaps of care. Our state also points to “next step” challenges; once near universal-coverage has been obtained, the primary care shortage gets amplified when patients finally have coverage – they want to use it! We’re also in the throes of figuring out how shifts to “value based payment” models replacing the disincentives of our traditional fee-for-servcies are  requiring us to proactively create teams that can produce health and wellness, not just just respond to disease.

Many of our conversations that day were around Chapter 224, “An Act Improving The Quality Of Health Care And Reducing Costs Through Increased Transparency, Efficiency And Innovation” passed in 2012. Though not yet fully enacted, this act establishes a Health Planning Council and an independent Health Policy Commission that monitor the supply and demand of health resources and supervises and monitor transitions to Accountable Care Organizations. Pipeline and residency funding streams for primary care loan repayment programs and funding for primary care residencies are also part of this legislation. Massachusetts has passed some great legislation that will help move our health system in good directions – but there is clearly much to be figured out in the details.

For those in our program new to political advocacy the Family Medicine Advocacy Day provided a thrill in learning how to make their voices heard, and that we can serve as valuable resources to our legislators who are trying to make difficult decisions to direct our government in responsible ways. Our day at the capitol fell on the heels of a major political win for family medicine nationally when earlier in the week the US Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (HR 2), which repealed SGR and extended several key programs of importance to family medicine. It was a great week for political advocacy at TuftsFMR@CHA!!


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Match Day 2015!

March 20, 2015

MATCH DAY is an exciting day for all residency programs in the US and for thousands of soon-to-be doctors who learn their “match” for which residency program they will be joining.

We are thrilled to welcome Danielle, Faiz, Jennifer, Matthew, Kanthi, Devorah, Ian and Meera into our Tufts FMR @ CHA family!! (see attached Tufts FMR Interns 2015 pdf or the sidebar of our main page in the media section) This is a diverse and dynamic group of individuals that I’m confident will help us continue to grow as a program and discipline and will be leaders in the “primary care revolution” a flame that we are aggressively fanning.

Cambridge Health Alliance is the last public hospital system in Massachusetts and has a deep social justice mission to meet the needs of our diverse underserved patient population. We know that “nonwhite physicians provide a disproportionate share of care to underserved populations. Hence, increasing the racial and ethnic diversity of the physician workforce may be key to meeting national goals to eliminate health disparities.”For this reason, this year our program adopted a new strategic approach to our recruiting and interview season with a goal of recruiting a higher portion minority residents with diverse racial and ethnic origin. Practicing in Malden, a school district with the most diversity in Massachusetts, we hoped to recruit an intern class with broader diversity that better mirrors the populations we serve. We were wildly successful on this front with five of our eight new interns being underrepresented minorities and bringing language skills in 12 . . . yes, I said 12 languages other than English!

Our clinic has undergone a major expansion in the last year as we aim to double our capacity from 13,000 to 26,000 patients that we care for. The success of the “Massachusetts Healthcare Experiment” has shown us that when people get insured (and 98.2% of Massachusetts is now insured!), they want to use it and get seen, so we’re busier than ever (Monday we had 763 phone calls to our clinic – a new record). With our new cohort of additional faculty, PA’s, nurses, front desk, medical assistants, complex care managers, planned care coordinators and integrated mental health team, our team-based care model is maturing and performing better than ever. It’s thrilling to watch a medical assistant light up and take pride in her ownership for proactively increasing our cancer screening rates through outreach and patient engagement. To make primary care sustainable and successful, it HAS to be a team sport and it’s trilling to watch that transformation take place her at the CHA Malden Family Medicine Center.

Congratulations to us, to our new class, and to all newly matched residents and residency program. It’s a very exciting time of year for all of us, and I can’t wait to get to know and work with our new amazing group of young physicians that will be joining our family at TuftsFMR@CHA!

Onward,
~g

Gregory Sawin MD MPH
Program Director
Tufts University Family Medicine Residency
at Cambridge Health Alliance
www.tuftsfmr.org
Assistant Professor of Family Medicine
Tufts University School of Medicine
Clinical Instructor of Population Medicine
Harvard Medical School