NC Family Physician - Winter, 2021

Volume 17 Issue 1 • Winter 2021

The North Carolina

Family Physician Quarterly News in North Carolina Family Medicine

Dr. Jessica Triche 2020-21 NCAFP President P. 4

SAVE THESE DATES FOR TERRIFIC NCAFP CME IN 2021 One-Day Saturday CME Opportunity Saturday, Aug. 7, 2021

2021 Winter Family Physicians Weekend Thursday, Dec. 2 to Sunday, Dec. 5, 2021

Learn more at www.ncafp.com/continuing-education Planning is already underway for these two fantastic CME opportunities.

We will keep you well-informed of the in-person and/or virtual plans for both opportunities.

Contact Kathryn Atkinson, CMP, Manager of Meetings & Events at Katkinson@ncafp.com.

Inside Winter 2021

Debunking the Myths & Misconceptions of Family Medicine P. 22

PRESIDENT’S MESSAGE

PROFESSIONAL DEVELOPMENT

4

2020 Winter Weekend Recap & 2021 CME Opportunities

The Awesome Power of Mentorship in Family Medicine

RESIDENTS & NEW PHYSICIANS

CHAPTER AFFAIRS

10

Fighting for Family Medicine and The COVID-19 Vaccine

MEMBERSHIP & MEMBER SERVICES

14

18

Dr. Thomas White, 2020 NC Family Physician of the Year

20

Holistic Care is at the Core of Continuity in Family Medicine

PRACTICE MANAGEMENT

26

Funding Available to Improve Childhood Vaccination Rates

DEPARTMENTS

PUBLISHED BY

President’s Message 4 Chapter Affairs 10 Membership 14 Professional Development 18 t 919.833.2110 •

fax

Residents & New Physicians 20 Medical Student Programs 22 Practice Management 26

919.833.1801 • ncafp.com

Managing Editor, Design & Production Peter T. Graber, NCAFP Communications

Have a news item we missed? NCAFP members may send news items to the NCAFP Communications Department for publishing consideration. Please email items to pgraber@ncafp.com.

PRESIDENT’S MESSAGE to Members

By Dr. Jessica Triche 2020–2021 NCAFP President

~ 2020 INAUGURAL ADDRESS ~

The Awesome Power of Mentorship in Family Medicine Well...this was not the speech I imagined giving a year ago! Thanks 2020! Thanks to COVID, I couldn’t hang out with my friends and colleagues for our yearly misadventures at Grove Park Inn! I truly missed trying to sneak in my cell phone and contraband alcohol into the spa this year. But I’m sure we can still make the upcoming year fun. It has to be better than 2020!

2020 was tough. We, as family physicians, have been on the COVID frontlines, putting our lives at risk in order to care for our patients. We’ve had to explain that science is real and that we practice evidence-based medicine. As family physicians, we must weed out the crap. We owe it to our patients to speak the truth. We are all still in this fight together. We have learned a lot so far. We learned how to wear a mask all day, every day and have adjusted to not being able to hug our patients. We’ve become tech savvy and navigated virtual visits, enjoying seeing our patients relaxing at home (sometimes too relaxed). Most importantly, we learned that you should probably not wear PJ pants during virtual visits, just in case you need to attend to your kids burning toast! Trust me...I know.

If we thought COVID was enough “badness” for 2020, we were wrong. George Floyd was killed by police who knelt on his neck while he cried out for his

4

mother. This is nothing new. It’s a continuation of how our society functions on implicit bias. But this year Black Lives Matter became a movement and protests erupted across the country. Family physicians and students/residents have spoken up and became involved in this movement, marching side by side with our patients and community members to protest systemic racism. The AAFP asked the White House to declare racism a public health emergency, stating that it impacts mental health, chronic illnesses, maternal and infant mortality rates, overall health outcomes, and life expectancy. The NCAFP echoed this in a statement of our own. I know all of us can think of patients who are victims of this systemic racism. These are our patients, and it is our job to take action!

We can talk about racism and inequities as it relates to medicine, but we also need to talk about how it

The North Carolina Family Physician

2020-2021

NCAFP Board of Directors

Executive Officers President

Jessica Triche, MD Dimitrios “Takie” P. Hondros, MD

President-Elect Secretary/Treasurer

Shauna Guthrie, MD, MPH

Immediate Past President Executive Vice President

David R. Rinehart, MD Gregory K. Griggs, MPA, CAE

At-Large Directors Talia M. Aron, MD Elizabeth B. Baltaro, MD Jewell P. Carr, MD Garett R. Franklin, MD Nicole Johnson, MD, MPH Brian McCollough, MD Mark McNeill, MD Ying Vang, MD

Academic Position Mark L. Higdon, DO (Novant FMR)

Resident Director Clayton Cooper, MD, MBA (Duke)

Resident Director-Elect Ryan Paulus, DO (UNC)

relates to improving our communities and our future. Our students and residents ARE the future! They are family! We need to teach our family to break down barriers for our patients to ensure they receive excellent care, regardless of race/color/gender/sexual orientation. This is how we mentor!

Mentor: A wise and trusted counselor or teacher. Mentoring: the process for informal transmission of knowledge, social capital, and psychosocial support as relevant to work, career, or professional development.

Note this definition does not just mean knowledge....it includes social and cultural teachings. Mentoring is not just teaching a student about diseases. It encompasses sharing life experiences outside the walls of our clinics as well as what occurs inside. We all come from different backgrounds and experiences and should use this to educate our students about the complexities, compassion, knowledge, and culture of Family Medicine.

Student Director Hannah Smith (ECU)

Student Director-Elect Morgan Carnes (Wake Forest)

AAFP Delegates & Alternates AAFP Delegate

Karen L. Smith, MD

AAFP Delegate

Robert L. Rich, Jr., MD

AAFP Alternate

Richard W. Lord, Jr., MD, MA

AAFP Alternate

Tamieka Howell, MD

My mentors have taught me a lot over the years. I ask us all to continue to learn how to be better mentors. For example: How do we pass on 2501 Blue Ridge Road, Suite 120, Raleigh, North Carolina 27607

Winter 2021

www.ncafp.com

medical, psychosocial, and cultural knowledge? How do we teach our students/residents to be compassionate physicians engaged within the community? How do we teach them to be comfortable with patients from all backgrounds? And, most importantly, how do we teach them how to be mentors themselves? Here are important pearls I’ve learned from my mentors: BE A LEADER: You don’t have to be a CMO to be a leader. We, as physicians, lead by advocating for our patients as well as ourselves, whether through prior authorizations, or giving input on how to relieve administrative burden. Physician voices must be heard.

My own physician career would have turned out differently if I had not rotated with Dr. Michelle Jones. It seems like yesterday that she drove me, as a second year medical student, to the NCAFP Advocacy Committee meeting. I knew I wanted to be a family physician but had no idea about the leadership aspect of medicine. I did not realize that physicians can make an impact in the legislative world. I sat in that room, much younger than others (no offense to others who were there) and as one of the few women at the table. I encourage all of us to bring students/residents to leadership meetings and invite them to conferences and talks just as Dr. Jones did.

Show them that family physicians are more than just clinicians. Introduce them to officials at the local, state, and national levels. Engage them in current legislative healthcare issues. I remember watching in awe that day, as physicians like Dr. Jones and Dr. Karen Smith spoke up about their concerns as everyone listened. They were true leaders in that room. Our input is key to influencing important decisions that affect our patients. Party lines don’t matter -- being a family physician is what matters. It was a few years later that Michelle was elected as NCAFP President and I was privileged to be in the audience. Thank you, Dr. Jones for being the spark that lit my leadership fire.

BE REAL: As family physicians, we realize our lives are similar to, influenced by, and sometimes intertwined with our patients. We may have that wonderful moment when your patient shows up to your son’s musical debut. But, we may also have that crappy moment when a patient gets mad about not getting an antibiotic for a

6

cold. Medicine, in general, is not perfect and Family Medicine isn’t exempt. We need to be honest about our jobs and careers. Let’s talk about administrative burden. Let’s show students and residents what to expect. They need to be prepared. And they need to be aware that physician leaders are working to improve these burdens. Let’s talk about how we may not have the income of a dermatologist, but we have great income and much better stories! Let’s discuss physician well-being and show them how we care for ourselves.

Get personal. Invite them to lunch or dinner. Take them with you to make a major life purchase! Invite them into your home. Discuss work/life balance.

The relationships we develop with our students may impact their future. Who knows...you may even become friends and have your whole family invited to their wedding. A mentor who kept it real for me, (and introduced me to good bourbon) was Dr.

The North Carolina Family Physician

Shannon Dowler. Shannon convinced me that I COULD be a leader. I remember sitting next to her, as a new physician and listening to her speak about her experience as NCAFP President. I knew she had two young kids and worked full time. I observed how she handled things so calmly and with a great sense of humor and lots of rapping about STDs. At this point in my career, I was being asked to take a bigger role with the Academy and I was scared I could not do it. Dr. Dowler encouraged me to make that jump.

Shannon continues to speak with me about work / family balance and how, we may miss some family dinners, but we can make it up with quality time with our kids (in her case, hot tub conversations; in my case, boat conversations). Shannon is an example of how physician leaders can be fun, relatable, and approachable, leaving a lasting mark on those who come behind them. Dr. Dowler continues to inspire me.

Winter 2021

HAVE UNCOMFORTABLE CONVERSATIONS: Earlier I spoke about how, in our society, we have issues with institutional racism and disparities. We can’t fix these issues unless we have difficult conversations with ourselves, our colleagues and those who come behind us in order to make them aware these disparities exist. We should have these difficult conversations just as we do within our own families. Being uncomfortable is what helps us all grow. This is more important now than ever. In response to deaths of people of color by the police, White Coats for Black Lives was started in 2015 by medical students in order to help eliminate racial bias and recognize racism as a threat to health. In the past year, our students and residents have organized marches. It is our job to support these efforts. We must advocate for our patients and community. As family physicians, we are role models for Continues on next page

7

the community. Let’s participate in marches and vigils and community led events with our students and patients. Point out examples of discrimination and racism in healthcare when it affects our patients. Teach them that some of what we have learned, in regard to race and health, may have an implicit racist background, for example GFR calculation.

Remember that when we ask a patient to exercise, that they may not live in a safe neighborhood. Or, maybe, they live in a “safe” neighborhood, but may still fear they could wind up like Ahmaud Arbery, who was murdered jogging in his own neighborhood.

Having uncomfortable conversations doesn’t always mean race…. we need to talk about gender and sexual orientation. Teach our students to be open minded when obtaining a sexual history.

This may be a portal to a trusting relationship. I am a person of white privilege and struggle with how to make things better. But I am lucky enough to have an excellent mentor who is willing to have frank, and sometimes uncomfortable, conversations with me.

My good friend, Dr. Tamieka Howell, is a phenomenal mentor. Many of you know her as a recent Past President who encouraged us to be unapologetic about who we are and the things we feel strongly about. Although we knew each other prior to NCAFP work, our friendship grew as we texted funny and sarcastic comments to each other, somewhat discreetly, during our Board meetings (sorry Greg). And some of our best ideas on how to fix healthcare occurred after a few bourbons! Dr. Howell is inspiring for many reasons. She is a smart, successful, mother of three. She has overcome poverty and racism to excel in her field.

8

Currently she sits on an AAFP Commission and I hope to see her as a future AAFP President. Dr. Howell has encountered patients who see and treat her differently because of the color of her skin. Some may treat her poorly or not trust her at all. But, for many, she is an inspiration and source of care they can trust. Dr. Howell is who I aspire to be, and I think I can say that many others feel the same way.

You know, we have all been through a lot over the past year. Hopefully, 2021 will bring mass vaccinations and a treatment for COVID and continued progress in social justice issues. We can all work together to improve the future of Family Medicine and the health of our patients. I am a white, female physician urging all of us to think about our brown, black, LatinX, and LGBTQ patients and students/residents and how we can make positive changes. We can shape a future family physician’s life, just as mine has been shaped by family physicians before me. I do have one big ask as NCAFP President. I want us all to commit to working with at least one student this year. Be a mentor. Remember-not every medical student we teach will become a family physician. But EVERY medical student we teach will respect a family physician. It is never too early to mentor. Help shape our future! To Shannon, Tamieka, Michelle, Maureen, Karen, and every physician who helped shape my life and career and to those out there who will shape the lives of future physicians...CHEERS.

The North Carolina Family Physician

FAMPAC

Empowering Family Medicine

JOIN THE FIGHT FOR FAMILY MEDICINE IN RALEIGH Participating is easy -•

Get to know your elected officials and become their trusted healthcare advisor.

•

Contribute so we can support candidates that support Family Medicine.

•

Participate in NCAFP’s ongoing advocacy events and efforts.

To learn more about FAMPAC and donate, visit www.ncafp.com/fampac

CHAPTER AFFAIRS

By Gregory K. Griggs, MPA, CAE NCAFP Executive Vice President

~ FIGHTING FOR YOU ~

Fighting for Family Medicine and The COVID-19 Vaccine AAFP coined the phrase “Fighting for Family Medicine” and I especially like it in the age of COVID. It seems we have had to fight for your rightful place in every step of this pandemic: in PPE distribution, in financial assistance, in testing, and now in vaccine distribution.

But that has made me, and your entire NCAFP staff, even more determined to fight for our members. So, let me take the opportunity to outline some of the ways we have advocated for your role in both receiving and disseminating the COVID-19 vaccine.

On December 18th, your incoming and outgoing President (Dr. Jessica Triche and Dr. David Rinehart, respectively), wrote a letter to North Carolina State Health Director Dr. Betsey Tilson and NC Department of Health and Human Services Secretary Mandy Cohen, MD. The key messages in the letter included: Family physicians are exposed to COVID-19 in their office daily, whether through known positive patients or unknowingly when a patient is there for another visit but subsequently tests positive. As a result, it is imperative that family physicians and their staff receive the vaccine as quickly as possible. I hope that by

10

the time you receive this magazine, we will be beyond vaccinating family physicians.

Family physicians should receive the vaccine quickly whether they work in a health system or a private community clinic. Secretary Cohen ultimately sent several strongly-worded directives to our state’s health systems stating that they also bore responsibility for helping vaccinate community physicians, not just their own employees. We subsequently worked with many of our private practices to connect them to health systems or health departments to receive the vaccine.

Family physicians are ideally suited to vaccinate their own patients. They know who in their office fits into which risk stratification phase and are equipped at dealing with vaccine hesitancy due to the trusting relationship they have with their patients.

Also, in December, AAFP sent similarly-worded letters to federal health officials and the National Governor’s Association.

Through late December and early January, we remained in touch with North Carolina health officials, constantly bringing their attention to problems that family physicians were having. This included numerous phone calls and e-mails, even on Christmas Eve. In early January, the Department shifted some resources to begin unclogging the bottlenecks in order to move vaccines into the hands of primary care practices for your patients. As of writing this column in mid-January, quantities of vaccine were still not available for distribution beyond centralized locations (such as health departments and health systems), but much work was under way to prepare for more distribution sites as supplies became more available. Just as an example, in the week ending January 9, the state of North Carolina had only received about 200,000 doses of COVID-19 vaccine (Pfizer Continues on next page

The North Carolina Family Physician

URGENT Now’s the Time to Help Your Patients Quit Tobacco and Improve Their Lung Health This Standard of Care can Triple Your Patients’ Quitting Success!

1) Medication: 12 weeks of EITHER Varenicline OR Combination Nicotine – Patch AND Gum OR Lozenge 2) Counseling: Refer to QuitlineNC.

QuitlineNC can help! 1.800.QUIT.NOW www.quitlinenc.com/health-professionals/tobacco-treatment-standard-of-care.html

NC Department of Health and Human Services • Division of Public Health • Tobacco Prevention & Control Branch • www.tobaccopreventionandcontrol.ncdhhs.gov • NCDHHS is an equal opportunity employer and provider.

and Moderna product combined). Over 85,000 of the Pfizer doses were scheduled for booster immunizations, meaning the state received less than 120,000 first doses that week. Remember, North Carolina has a population of 10.5 million.

information.

By mid-January, as I write this article, our focus has turned on getting primary care practices into the COVID-19 Vaccine Management System (CVMS), that is required to distribute vaccines. While the state was updating the system in hopes of making it easier, the NC-AHEC Program, Community Care of North Carolina, and specialty associations like the NCAFP, were redeploying staff to help practices onboard to CVMS. Two NCAFP staff members took extensive training about the system so that they could answer your questions and hopefully expedite the process. The absolute first step in private practices being able to vaccinate their own patients is onboarding onto CVMS.

• Slides from numerous webinars COVID-19 vaccine distribution

We also continue to message about the need to simplify every step of vaccine distribution in North Carolina.

While we agree that vaccine should first be distributed to priority populations, we also expressed to the state that an additional guiding principle should be getting our state’s residents vaccinated in a timely, efficient, and effective manner. And family physicians can help do just that.

Given that we write these columns approximately three-to-four weeks before the magazine lands in your mailbox, I am not sure what the situation will be when you are reading the article. But you can rest assured that we are fighting to make it as simple as possible for you to vaccinate your own patients. We have heard your concerns and have expressed them loudly to state officials. And we will continue to do so.

Another part of our advocacy efforts centered around education. We have worked with other associations, NC AHEC, CCNC and NC DHHS to bring you continuous webinars about COVID-19 and the COVID-19 vaccination process. Many of these webinars are occurring on an as-needed basis, so we can’t promote them in this magazine. So be sure to watch for our e-newsletter, NCAFPNotes, for the latest

12

Finally, we continue to add updated information to the COVID-19 resource page on our website (www. ncafp.com). Some of the information includes: on the process.

• Details on the phases of the COVID-19 vaccine distribution plan.

• A COVID-19 Vaccination Guide for Medical Practices developed by the NC AHEC Program.

• A copy of the letter we sent the State Health Director, and a copy of the letter AAFP sent the National Governor’s Association.

So please keep using our website as a resource for you and your practice.

If you are continuing to have issues, please do not hesitate to reach out to me or another member of our staff. We continue to try to problem solve on the behalf of individual practices. Just remember, getting our state’s residents vaccinated for COVID-19 is a marathon, not a sprint. Vaccine supplies are likely to remain in short supply. Once supplies do get to private practices, they are likely to be limited. There are hoops, for better or worse, that you will have to jump through to vaccinate your own patients. And as of this writing, the state is still working on the details on how your practice will ultimately receive quantities of vaccine for your patients. It very well may be through your Local Health Department, so if you have not already established a strong relationship with your Local Health Department, now would be a good time to do so.

I am hopeful that by the time you are reading this article (likely mid-February) that you may have some vaccine in hand and the drip drop of vaccines will at least become a trickle. However, I doubt that the hose pipe will be open all the way, so remain patient, and keep us informed.

The North Carolina Family Physician

jobs.ncafp.com

Employers:

Family Physicians:

• PLACE your job in front of our highly qualified members • SEARCH our resume database of qualified candidates • MANAGE jobs and applicant activity right on our site • LIMIT applicants only to those who are qualified • FILL your jobs more quickly with great talent

• POST multiple resumes and cover letters or choose an anonymous career profile that leads employers to you • SEARCH and apply to hundreds of fresh jobs on the spot with robust filters • SET UP efficient job alerts to deliver the latest jobs right to your inbox • ASK the experts advice, get resume writing tips, utilize career assessment test services, and more

powered by

jobs.ncafp.com

MEMBERSHIP & MEMBER SERVICES

By Peter Graber NCAFP Communications Services

~ AWARDS ~

Dr. Thomas White Named 2020 NC Family Physician of the Year Dr. Thomas R. White, a ‘hometown’ and ‘Main Street’ family physician, has been named North Carolina's 2020 Family Physician of the Year, the most prestigious award from the NCAFP. Dr. White was formally presented with the award during a ceremony early last November in Cherryville.

Dr. White currently practices at Hometown Direct Care in Cherryville, NC, a direct primary care practice he founded in 2015. Dr. White’s practice has had a tremendous impact on the health of the community. And while his practice setting and style have changed during his 32 years serving the people of Cherryville, Dr. White’s commitment has never wavered.

Dr. White’s interest in medicine began just prior to him entering undergraduate study Duke University. With a badly burned arm from an accident, he was treated over the course of several months by Dr. Marshal Anger, a well-known family physician from Cherryville. This experience inspired him greatly.

“I just remember the respect he commanded and deserved, and the dedication he clearly had,’ noted Dr. White in recalling the experience. “On the other hand, I was intimidated by the sheer number of patients he saw daily, and how little time he had to listen and deal with multiple complex issues. So I was inspired to be a community small town physician, but hesitant based on the demands,’ Dr. White explained.

Dr. White went on to graduate from Duke University, earning both his undergraduate and medical degrees.

14

He completed his Family Medicine residency training at Charlotte Memorial Hospital and returned to Cherryville 1988 to found Cherryville Primary Care.

Dr. White’s practice would later be acquired by Carolinas Health Care System, which operated it until its 2015 closure. Dr. White subsequently founded Hometown Direct Care in Cherryville, the area’s first direct primary care practice and an ongoing success. Since opening, Dr. White has established a satellite office in Shelby and added another family physician, Dr. Joshua Carpenter, with plans to add another family physician in the summer of 2021.

White’s change in his care model has enabled him to once again deliver personalized, accessible, and comprehensive care, and leverage much-longer visit times to provide holistic care for his patients.

“When a patient tells me I listened and understood them, that is when I most appreciate the privilege of doing what I am doing,” Dr. White explained. He also thinks the change has extended his career, too. “More than that, I think it has made me better appreciate being a doctor,” said White.

Outside of his practice, Dr. White is very involved in his community and is a huge giver of his time, resources and energy to several causes. He has sponsored numerous athletic teams, quietly assisted community members with

The North Carolina Family Physician

college tuition, and sponsored the Cherryville High School Male and Female Scholar-Athlete of the Year Awards. In Cherryville, he was also an early member of the town’s Main Street Program, as the committee applied for and won a National Historic District designation. Dr. White has also served on multiple local boards, including the YMCA, the local Education Foundation, the Citizen Against Drugs Program and the local Rotary Club. Within organized medicine, he has also been a key contributor, serving as the NCAFP President in 2015, and also helping lead the Southeast Lipid Association, serving as President in 2020, and the National Lipid Association, in his current role a national board member.

Most recently, Dr. White has served as a leader in the community’s response to the COVID-19 pandemic. He developed a local call-in radio program to answer questions and problem solve about coronavirus concerns, teaming up with City Manager Jeff Cash on the weekly show. In addition, he recruited local seamstresses to make cloth masks and has provided those for his patients and neighbors. Finally, he has given out well over 100 “support your local business” gift cards to his patients to help local shops survive.

Dr. White credits several physicians as inspirations and role models for success throughout his career, including previous recipients Drs. Lee Beatty, Melvin Penn, Allen Dobson, Tommy Newton, Charlie Rhodes, Ophelia Garmon-Brown, and the late Bobby Jones, as well as Dr Thomas Barringer of Charlotte.

After all of his success and a wonderfully rewarding career, White’s recipe continues to be simple: “Just follow your heart.” He feels this is especially critical to medical students finding their way in a rapidly changing world.

“If you experience Family Medicine, and it resonates with your heart and reasons for choosing medicine, then stay the course,” notes Dr. White.

“Do not be distracted by poorly-defined terms like “prestige” or the financial rewards. The latter will come if you are wise and patient. And think about what your community, your state, and the public needs. Family medicine is so needed. What a great opportunity to meet the needs of society.”

Winter 2021

MEMBERS IN THE NEWS...

Duke Family Medicine Residency Director Featured in AAFP Q&A about Virtual Interviews The pandemic has forced the unprecedented step of moving all residency match interviews online. In this Q&A from the AAFP, four Family Medicine residency program directors share their insights regarding virtual interviews.

Duke Family Medicine Residency Director Dr. Will Bynum is one of the four program directors featured. You can read the article at www.ncafp.com/ virtual-interviews.

Family Medicine Represented on New Health Care Coverage Access Group NCAFP Past President J. Thomas Newton, MD, is representing our organization on a high-level, bi-partisan group examining how to expand access to healthcare coverage in North Carolina. Governor Roy Cooper recently formed the NC Council for Health Care Coverage, which is being convened by the Duke-Margolis Center for Health Policy.

Council members include bipartisan members of the General Assembly and representatives from a variety of sectors including business, nonprofit and healthcare.

The group held several strategy meetings to develop principles on how to improve affordable health coverage in our state. NCAFP is pleased to be represented on this important group. The Council is charged with reviewing the state of health care coverage in North Carolina, exploring how other states have increased health care coverage, and developing principles to guide policymakers in increasing coverage in the state. As of 2019, 17% of adults were uninsured in North Carolina, the 6th highest rate in the U.S. This number continues to grow as a result of the COVID-19 pandemic.

MEMBERSHIP NEWS

Thank You for Your Continued Membership, Participation, and Support of Our Chapter First, thank you to members who paid 2021 membership dues by the 12/31/20 deadline. You should have received an email from the AAFP with a redemption code for your renewal gift*. Please note that this code cannot be used for NCAFP meetings. This code is specifically for an AAFP CME Livestream course. Check the AAFP CME calendar page for 2021 Livestream course dates and topics at www.aafp.org/cme/browse/ by-month.html. If you have questions or cannot locate your code, please contact the AAFP at aafp@aafp.org or 1-800-274-2237.

As we begin a new membership year, we would like to share a few important details that may help in your planning: 2021 Membership Dues for Active, Inactive, Supporting & the 2021 Class of Life Members If you missed the January 1, 2021 payment deadline for 2021 membership dues, please enroll in the installment plan or pay your balance to maintain your membership via one of the following options: • Phone: Call the AAFP at 1-800-274-2237 x 0 (M-F between 9:00 a.m. – 6:30 p.m.)

• Online: www.aafp.org/quickpay (username is your email address on file with AAFP) • AAFP Mobile App: Press More > My Account • Make checks payable to AAFP and mail to: AAFP, 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2680.

• If your practice status has changed (fellowship, interrupted practice, retired), please contact the AAFP at 1-800-2742237 x 0 to determine status transfer eligibility.

• If you have moved out of NC, please vis-

16

it www.aafp.org/relocation or contact the AAFP at 1-800-274-2237 x 0 for a required state chapter relocation transfer to avoid cancellation. Please note that AAFP membership is contingent upon active state chapter membership as memberships are unified according to AAFP bylaws.

• If you need a copy of your invoice or a receipt of payment, please call the AAFP or log on to your AAFP account at aafp.org for a paper copy.

2020-2021 Resident Dues $65 Most Resident dues invoices are sent directly to your residency program for payment (billing cycle July-June)—another perk of Resident membership!

If you happen to receive a mailed invoice to your primary address, please submit to your program coordinator promptly.

If your invoice goes to your program, your program coordinator may ask your permission to submit your dues from your allocation as uninterrupted membership is required for a 50% discount on first-year Active member dues following graduation. Please reply to that request promptly to avoid membership interruption.

Current Resident membership is also required for scholarship eligibility, Resident meeting rates, and receiving discounts on clinical courses and self-study CME as a New Physician.

2020 CME Re-Election Candidates Members whose CME re-election cycle ended on Dec. 31, 2020 and who have not yet met the CME requirement will have an additional year to do so. This means you have until Dec. 31, 2021 to earn your CME required for 2020 Re-election.

Please note that the ABFM does not report your credits earned to the AAFP. It is best to report everything to the AAFP, and they will report to the ABFM on your behalf.

If you have any questions about this extension or CME in general, please contact the AAFP at 1-800-274-2237 or visit aafp.org/cme.

The North Carolina Family Physician

Updating Contact Information If any of your contact information has changed (mailing address, phone, fax or email address), you may update anytime at aafp.org via your profile under your account. Remember your email address on file with the AAFP is your username. You may also email your changes to aafp@aafp.org or call the AAFP at 1-800-274-2237.

Updating Credit Card for Dues Installments or Auto Pay If you are enrolled in installments or auto pay for membership dues and need to update or check your credit card on file, please visit www.aafp.org/ quickpay or call the AAFP at 1-800-274-2237. It is important to update the credit card associated with your account to make sure installment payments go through successfully.

We are always happy to help you navigate through your membership. In addition to the AAFP resources, please also feel free to contact Tara Hinkle, Manager, NCAFP Member Services, at thinkle@ncafp. com, with any membership related questions you have.

Thank you again for all you do for your patients and communities. We sincerely appreciate your membership and commitment to family medicine.

Here’s to a healthy and hopeful 2021. *The renewal gift of 50% off each session in one AAFP CME Livestream course must be redeemed by or before 11:59 p.m. CT May 31, 2021. The code is good for one use, cannot be combined with any other AAFP offer, is not redeemable for cash or a refund, and cannot be applied to prior purchases.

This offer does not apply to other membership categories (resident, student, transitional, life, international, supporting, and inactive), or any excluded courses listed below. Please contact the Member Resource Center at aafp@aafp.org or (800) 274-2237 if you have questions about this gift.

Winter 2021

A Family Medicine Community Podcast

www.ncafp.com/ncfmtoday

JANUARY - COVID-19 Vaccination In this edition of NC Family Medicine Today, we speak to Dr. Alexa Mieses-Malchuk, a faculty member in the Department of Family Medicine at the University of North Carolina about why all North Carolinians should receive a COVID-19 vaccine, especially historically marginalized populations. She also discusses her advocacy role in family medicine and how she was recently interviewed for Oprah Magazine.

DECEMBER - Mentoring in Family Medicine Meet the new president of the NC Academy of Family Physicians, Dr. Jessica Triche, who practices at Vidant Chocowinity Family Medicine and lives in Bath, NC. Dr. Triche discusses three lessons she has learned from her mentors and why mentoring is so important in developing the future healthcare workforce. Dr. Triche also discusses her own journey into leadership positions in medicine.

NOVEMBER - Medicaid Transformation In this episode of NC Family Medicine Today, Dr. Tom Wroth, President and CEO of Community Care of North Carolina (CCNC), discusses the future of family medicine and primary care in light of the COVID-19 pandemic, Medicaid Transformation in North Carolina, the move to value-based healthcare and the results of the recent election. He discusses how CCNC specifically and primary care practices in general have pivoted to deal with all the changes 2020 has thrown at the practice of medicine.

17

PROFESSIONAL DEVELOPMENT

By Kathryn Atkinson, CMP Manager, NCAFP Meetings & Events

2020 Winter Weekend Highlights and Upcoming 2021 CME Opportunities

Martin, JD, also joined the webcast for informative discussions centered around the role of Family Medicine and the accelerated move to value-based care post-COVID-19.

You can catch these recordings, along with your outgoing president, Dr. David Rinehart’s State of the Academy Address, current president, Dr. Jessica Triche’s inspiring installation speech, and Dr. Thomas White’s Family Physician of the Year acceptance speech at www.ncafp.com/wfpwrecordings.

The virtual weekend also included the annual Research Poster Contest, which drew over a dozen entries. In the medical student category, Ms. Hannah Conley (ECU, MS4) claimed the top prize with her submission: Promoting Reproductive Health Education in Pitt County (PREP): An Educational Program to Address High STI and Adolescent Pregnancy Rates and Ms. Willa Joe Jen (UNC, MS3) claimed the runner up prize for her submission: Incorporating Medical Students into Telemedicine Visits in the Ambulatory Set-

Thank you to everyone who joined us for the NCAFP’s first-ever Virtual Winter Family Physicians Weekend.

While we will always prefer seeing you in-person, the 2020 virtual weekend proved to be a successful alternative for the ever-popular annual tradition of top-notch CME and priceless camaraderie. With over 450 registered attendees and lots of terrific feedView these videos at www.ncafp.com/wfpwrecordings back, your NCAFP CME Team was Covid-19 Response, Medicaid Transformation, State of the Academy Address thrilled to provide and Other Updates from NC DHHS David Rinehart, MD - Immediate Past President essential CME and Dr. Mandy Cohen, Secretary NC DHHS unique networking Presidential Installation Ceremony Family Medicine’s Role in Post COVID & Inaugural Address opportunities in a Healthcare: A Fireside Chat Jessica Triche, MD - 2021 President safe, convenient, Von Nguyen, MD, MPH, Senior Vice President and Chief Medical Officer for Blue Cross & Blue Shield of and fun cyber forFamily Physician of the Year Ceremony NC; Shawn Martin, JD, Executive Vice President and Thomas White, MD mat.

CEO of the AAFP

In addition to our ting. In the resident category, Michael Colfax, MD trademark of timely clinical CME topics, the two-day (SRAHEC, PGY-2) claimed the top prize with his webcast also featured important updates and lively dissubmission: Improving HPV Immunizations in Adocussions with three of today’s top healthcare thought lescents in a Family Medicine Residency Program, and leaders. Dr. Mandy Cohen, Secretary of the NC DeJordan Shirley, DO (Cone FMR, PGY-3) took the partment of Health and Human Services, provided runner-up prize with her submission: Expedited Parta COVID-19 update, in addition to comments on ner Therapy: Implementing Treatment at the Point of the state’s ongoing response to the pandemic and its Care in a Family Medicine Residency. Please join us preparation for Medicaid Transformation. Senior Vice in congratulating the winners and thanking everyone President and Chief Medical Officer for Blue Cross & who participated by submitting quality and relative Blue Shield of NC, Von Nguyen, MD, MPH, and ExFamily Medicine research. ecutive Vice President and CEO of the AAFP, Shawn See 'Recap' on Back Cover

18

The North Carolina Family Physician

Get Inspired.

Make Connections.

2021 Virtual Family Medicine Day SATURDAY, MARCH 27, 2021 ATTENDANCE IS FREE FOR ALL MEDICAL STUDENTS!

www.ncafp.com/famday

W

e are excited to announce that the NCAFP and the North Carolina Area Health Education Centers (AHEC) program will present this year’s 14th Annual Family Medicine Day via a convenient and fun virtual format on Saturday, March 27, 2021. Family Medicine Day, considered North Carolina’s premier Family Medicine residency recruitment conference, is also a fantastic opportunity for medical students to explore the breadth and scope of Family Medicine and the many rewards that come from being a trusted family doctor. All current medical students are encouraged to participate.

Carefully designed so that medical school students can engage with many of NC’s fantastic and diverse Family Medicine residency programs, the half-day agenda is packed with helpful information and phenomenal networking opportunities for everyone. The day will kick off with an inspiring keynote address by NCAFP President, Dr. Jessica Triche. Attendees will then be entertained, informed, and delighted by a series of concurrent 10-minute “TED Talk inspired” presentations led by several of NC’s top-notch residency programs.

Winter 2021

Current presentation topics include obstetrics, rural and underserved medicine, osteopathic manipulation, nutrition and culinary medicine, preparing to apply to residency, residency interviewing skills, staying sharp and well during residency and many more. Small breakouts will occur during the program to promote purposeful connections between medical students and residency programs. The day will end with a lively virtual residency fair where all participants will have a unique opportunity to connect and learn even more in a safe, fun, and convenient virtual setting.

Because of AHEC’s generous sponsorship, registration for this must-do and highly anticipated educational and networking opportunity is free for all current medical students. Do not miss this remarkable opportunity to be inspired by family medicine and become acquainted with NC’s finest family medicine residency programs this March. Online registration and complete program details are available at www.ncafp.com/famday. Please contact Kathryn Atkinson, CMP, Manager of NCAFP Meetings and Events, with any questions you may have at Katkinson@ncafp.com.

19

RESIDENTS & NEW PHYSICIANS

By Ryan Paulus, DO, PGY-2 UNC Family Medicine Residency, NCAFP Board Resident Director-Elect

~ FULL SPECTRUM~

Holistic Care is at the Core of Continuity in Family Medicine “Thank you for taking care of my grandma, she was my best friend,” said a tearful young girl in the hospital lobby. Her grandma was one of my first patients in residency. I was taking care of her in the hospital and was going to meet with her family after we decided to pursue comfort care. As I was approaching the family, I thought about the first time I met her and everything she has taught me as a young resident physician. The son, who accompanied her at clinic visits, emerged from the group in tears and met me with a big hug.

The rest of the family proceeded with thanking me for taking care of their loved one. It was a moment I will never forget.

I grew up in a rural community where continuity of care was practiced and valued. Family physicians cared for their patients in the office, hospital, labor and delivery, nursing home, and even the emergency department. By doing so, they practiced traditional full spectrum Family Medicine. When it came time for choosing a residency, it was important for me to choose a program that focused on a full spectrum of training. During residency, I have been trained to provide the traditional full spectrum of care, but I have also been able to expand the outpatient scope to meet the changing needs of our patient population.

20

Point of care ultrasound, telemedicine, population management, addiction medicine, hepatitis C treatment as well as more advanced therapies for patients living longer with chronic diseases, are some examples of this extended scope.

The AAFP states that, “continuity of care is a hallmark and primary objective of Family Medicine.” By providing continuity of care, we form trusting bonds with our patients that leads to lower healthcare costs, reduced ED visits and hospitalization rates, shorter hospital stays, and an improved physician-patient experience.1-3 As I interviewed applicants this year for our residency program, I listened to medical students express their interest in our program because they too want to practice full spectrum Family Medicine. However, I was surprised by the diversity of responses describing full spectrum care and it has caused me to reflect on my definition of the term. I started to look at the data and found that it is apparent that our traditional scope is changing. Only 7% of family physicians practice obstetrics and only 46% of recent Family Medicine graduates practice inpatient medicine, a decline from 78% prior to 2010.4,5 Ironically, this is occurring despite residents’ intention to have a broader scope of care than the actual care provided by current practicing family physicians.6 Constraints imposed by employers, insurers, and market forces, as well as individual lifestyle and general changes in medicine, have contributed to this change in scope.

While the settings where we provide care maybe narrowing, the comprehensiveness of care we provide is expanding. With the expansion of medical education and access to readily available information, family physicians are more equipped to care for and treat conditions than they were in the past. We may not be caring for our patients as much in the hospital, but

The North Carolina Family Physician

we are now placing an ultrasound probe on their chest in clinic looking for a pneumonia or providing more complex services to keep our patients out of the hospital. Advances in telemedicine will lead to more co-management with specialist rather than absorption of the patient by the specialist.

As I continued to reflect on the definition of full spectrum and what it actually means to practice full spectrum care, I continued to think about the quote from the AAFP stating, “continuity of care is a hallmark and primary objective of Family Medicine.”

I came to realize full spectrum care can be practiced in many forms but what lies at its core is continuity of care and the ability to provide holistic care for our patients. Therefore, I would like to end with a question to create conversation and thought. As the scope of the family physician continues to change, how do we continue to ensure that continuity of care remains at the heart of our profession?

REFERENCES: Bazemore A, Petterson S, Peterson LE, Bruno R, Chung Y, Phillips RL Jr. Higher Primary Care Physician Continuity is Associated With Lower Costs and Hospitalizations. Ann Fam Med. 2018 Nov;16(6):492-497. doi: 10.1370/afm.2308. PMID: 30420363; PMCID: PMC6231930.

Irwin KA, Agius M. How does continuity of care affect quality of care in primary healthcare? Psychiatr Danub. 2017 Sep;29(Suppl 3):452-456. PMID: 28953807.

Pandhi N, Saultz JW. Patients’ perceptions of interpersonal continuity of care. J Am Board Fam Med. 2006 JulAug;19(4):390-7. doi: 10.3122/jabfm.19.4.390. PMID: 16809654.

Helping physicians in medicine, business, and life.

Curious to know more? Visit curi.com

CORPORATE SPONSOR OF THE NORTH CAROLINA ACADEMY OF FAMILY PHYSICIANS

Tyler W. Barreto, Aimee R. Eden, Stephen Petterson, Andrew W. Bazemore and Lars E. Peterson. Intention Versus Reality: Family Medicine Residency Graduates’ Intention to Practice Obstetrics.

J Am Board Fam Med. July 2017, 30 (4) 405-406; DOI: Weidner AKH, Chen FM. Changes in Preparation and Practice Patterns Among New Family Physicians. Ann Fam Med. 2019 Jan;17(1):46-48. doi: 10.1370/afm.2337. PMID: 30670395; PMCID: PMC6342592.

Coutinho AJ, Cochrane A, Stelter K, Phillips RL Jr., Peterson LE. Comparison of intended scope of practice for family medicine residents with reported scope of practice among practicing family physicians. JAMA. 2015; 314(22): 2364–2372.

ADVERTISE! Reach many types of Family Medicine professionals in North Carolina.

Contact Peter Graber with the NCAFP at pgraber@ncafp.com

Winter 2021

STUDENT INTEREST & INITIATIVES By:

Chamara Dharmasri Julia Draper Bronwyn Fadem Zachary Fisher Allison Hollowell Lucas John

Ben Kaplan Andres Lopez Kate Miller Jessica Stevens Greeshma Somashekar Em Trambert-Kylstra

anything and everything and part of a specialty that empowers us to do more for our patients than just diagnose and treat.

“When I first came into medical school and was asked at orientation to imagine the doctor I wanted to be, I pictured the type of physician that the field of Family Medicine offers to patients.” –MS4

Debunking the Myths and Misconceptions of Family Medicine

Throughout medical school, we worked with FMtrained medical directors and academicians on local, state & nationwide initiatives like the N-648 Refugee Clinic, the Farmworker Health Project, Planned Parenthood, Formerly Incarcerated Transition program, Orange Co. Health Departments, Medicare for All, and innovative models of healthcare delivery.

Printed below is an open letter by the authors that has been distributed to all UNC medical students.

All authors are 4th-year medical students planning to MATCH into Family Medicine.

“In one morning, my FM preceptor had a newborn exam, an IUD insertion, follow-up on A-fib, an injection for arthritis, a wellness visit for a man there with his wife (also a patient at that clinic), and a vasectomy.”- MS4

Greetings Fellow Students!

These are just some examples of the practices you can build for yourself in Family Medicine, and there are countless other fellowship opportunities following residency that allow for subspecialties in a variety of inpatient and outpatient settings, including geriatrics, EM/ critical care, behavioral health, and women’s health.

We are writing as some of the future Family Medicine Physicians in the Class of 2021 to share our experiences and encourage you to consider Family Medicine as your future specialty! Our state and country need more primary care physicians and we are honored and excited to take this path.

We hope this letter will address some misconceptions about Family Medicine and reinforce the endless potential of the specialty. Collectively, we came to recognize the unrivaled breadth and versatility of FM, the ability to practice holistic medical care, the platform to advocate for changes that promote equity in medicine and society, and the consistently kind-hearted, justice-oriented, and compassionate physicians and culture of the specialty.

Throughout medical school, we were socially minded and considered almost every specialty—OBGYN, Internal Med, Pediatrics, Psychiatry, General Surgery, Emergency Med, Med-Peds, and PM&R. In the end, we chose Family Medicine so that we can be physicians trained for

22

Deep, longitudinal relationship building and addressing disparities & barriers to care are critical to Family Medicine and are some of our most commonly shared motivations for entering FM. “Patients trusted and confided in their family doctors more than [other preceptors I had], leading to more important conversations around safety, health education, mental wellbeing, food insecurity, access barriers, finance, and legal status.” – MS4 Family medicine not only recognizes the limitations of medicine, but also instills a duty to act to address these limitations and expand our impact beyond clinic

The North Carolina Family Physician

walls. It is one of the specialties best suited to address social determinants of health using a health equity lens and population health principles, and it does so by prioritizing prevention, multi-disciplinary guidelines, and clinician advocacy both inside and outside of clinical settings. In residency and beyond, Family Medicine is dedicated to community needs, especially the underserved, and allows the space to be as flexible and multifaceted or as focused as you would like.

Do not hesitate to reach out to any of us or the faculty advisors, Dawn Morriston and Kelly Brossenbroek Fedoriw, if you need guidance on pursuing Family Medicine.

We would genuinely love to connect and support you through your time in medical school and beyond!

2021 Virtual Family Medicine Day Saturday, March 27, 2021 Family Medicine Day, considered North Carolina’s premier family medicine residency recruitment conference, is also a fantastic opportunity for medical students to explore the breadth and scope of Family Medicine and the many rewards that come from being a trusted family doctor.

All current medical students are encouraged to participate in this fun, free, and unique opportunity.

What to Expect

MYTH #1: Those going into FM have low STEP 1 scores and don’t qualify for other specialties.

11 out of 12 of us said that our STEP 1 score had no bearing on choosing Family Medicine, in other words, we did not feel pressured or like our options were limited to FM because of our score—it is NOT a catch all for those with lower scores and attracts both above and below average scores. Members of our cohort are in student government leadership roles, have Master’s degrees, are inductees in the Gold Humanism Honors Society, have been published in national journals, and have been recognized with statewide awards from the NCAFP.

• Prepare to be entertained, informed, and delighted by a series of concurrent 10-minute “TED Talk inspired” presentations led by NC’s top-notch residency programs • Learn more about family medicine and ask questions during interactive breakout sessions • Make purposeful and lasting connections during the lively virtual Residency Recruiting Fair Registration is Free!

Simply visit www.ncafp.com/famday

MYTH #2: If you have a lot of debt, don’t even think about FM because you could never pay it back!

We are graduating with various amounts of debt—some with $0 and some with over $150,000. Therefore, debt is not necessariContinues on next page.

Winter 2021

Please join us in thanking AHEC for their generous sponsorship. This fantastic program would not be possible without their support.

Contact Kathryn Atkinson, CMP, Manager of Meetings & Events at Katkinson@ncafp.com.

ly a determining factor and should not scare you away from the specialty. In reality, the average Family Medicine physician earns over $230,000 a year, and thus, still receives ample compensation to pay off debt. Additionally, one of us specifically said, “I will be graduating without debt because and only because I got so many scholarships for my commitment to rural primary care and am guaranteed extra financial support in the future for continuing with this passion.” If debt feels limiting to you, we want you to know there are tons of ways to get scholarships, stipends, loan repayment programs, and work placement that specifically help primary care doctors pay off debt.

Importantly, we were competitive in every single one of our rotations and could have chosen other specialties. In past and present classes, we have consistently received honors in hospital and surgical rotations, been eligible for or inducted into AOA, and were never forced into Family Medicine because of academic or clinical inferiority.

MYTH #3: Family Medicine is unexciting because you do the same thing over and over (colds, wellness exams).

MYTH #6: You cannot go into academic medicine or research as a Family Medicine doctor

Family medicine has the broadest scope of practice of any other specialty. You are prepared to take care of individuals at the beginning of life, the end, and for all the chaos in between. It is prevention, acute care, wellness, multi-morbidity management, and more. It is immersive, and allows us room for adaptation to a community’s needs. In addition, Family Medicine is the only specialty where you can go on to care for and develop expertise in ANY population through Fellowships and other training programs including geriatrics, pediatrics, maternal and child health, adolescent medicine, addiction, palliative care, sports medicine, emergency and critical care, procedures and some surgeries. There is very little we cannot do with our breadth of training, especially with all the new fellowship opportunities available to develop expertise in specific areas.

Again, this is simply not the case and is shown by the fact that Family Medicine specialists fill many faculty and leadership positions at the UNC School of Medicine. However, UNC SOM is certainly not the only medical school program that employs FM on its faculty and leadership teams. Like other specialties, some FM doctors do research and/or obtain Master’s degrees to bolster their credentials before becoming an academician physician. Not to mention all of the opportunities that exist to teach at the 500+ FM residencies across the country.

MYTH #4: You can only do outpatient medicine and most of it is wellness exams.

This is simply not the case and as mentioned before, Family Med docs end up in just about every setting— from hospitalist work to emergency/critical care to labor and delivery; other settings also include the health department/public health, prisons, free clinics, urgent care, and policy/leadership roles.

24

MYTH #5: People in FM probably are not very competitive applicants and do not match up to other classmates in clinical performance

MYTH #7: The scope of practice in Family Medicine is just too challenging, there is no way I could know EVERYTHING While the scope of practice is broad and FM is not for the faint of heart, the challenge this presents is actually one of the main things that attracts us! We want to be life-long learners, want to push our professional and interpersonal limits, and want the flexibility that a full-spectrum specialty allows. In the end, you can continue to be a full-spectrum generalist out of residency or you can subspecialize with fellowship and other training programs.

The North Carolina Family Physician

Thank You to Our Sponsors The NCAFP would like to thank the many terrific sponsors of the 2020 Virtual Winter Family Physicians Weekend.

This successful program would not have been possible without the support of these fantastic sponsors and their dedication to Family Medicine. Thank you!

PLATINUM SPONSORS

GOLD SPONSORS

Diabetes Division

SILVER SPONSORS

Obesity Division

PRACTICE MANAGEMENT

By Brent Hazelett, MPA, CAE NCAFP Vice President & Chief Operating Officer

Funding Available to Improve Childhood Vaccination Rates Independent primary care practices are now eligible for a $5,000 grant to support efforts to improve rates of childhood vaccinations. As you know, rates of childhood vaccinations have fallen sharply during the pandemic, leaving children and the adults around them vulnerable to preventable diseases. These grants are intended to provide additional resources to independent primary care practices working to address

the problem. The North Carolina Division of Public Health, in partnership with NC Area Health Education Centers and Community Care of North Carolina, are providing these grants to pediatric and Family Medicine practices to support interventions aimed at boosting compliance with scheduled immunizations and wellchild care. FQHCs and rural health centers are also encouraged to apply.

To apply for the DPH Keeping Kids Well Fund Initiative or to learn more, see www.ncafp.com/ immunization-grant-funding.

PUBLIC HEALTH

State Releases Comprehensive Cancer Control Action Plan The NC Department of Health and Human Services released the NC Comprehensive Cancer Control Action Plan 2020-2025 late last year. The plan includes strategic actions to address disparities among historically marginalized and rural communities who experience a disproportionate burden of cancer disease, disability, and death.

“The NC Cancer Action Plan is a statewide blueprint for everyone working to reduce the burden of cancer on North Carolinians,” said Dr. Susan Kansagra, NCDHHS Chronic Disease and Injury Section Chief.

The action plan lists strategies to increase screening rates and prevention measures for priority cancers that are preventable through screening and/or vaccination. The six priority cancers include lung, female breast, colorectal and prostate cancers, which are the four most deadly cancers in North Carolina, as well as cervical and skin cancers.

26

Each cancer section looks at risk factors, prevention, early detection, treatment, and strategic actions to reduce mortality and incidence rates. The goals are: • Reduce cancer risks by supporting health behavior change in North Carolinians.

• Increase cancer screening and early detection of cancer.

• Improve access to cancer care, enhanced care coordination and quality treatment.

• Improve the knowledge and understanding of cancer, cancer care and the relationship between cancer and other chronic diseases among health care professionals and the general public.

Dr. Vickie A. Fowler currently serves as the NCAFP representative on the NC Advisory Committee on Cancer Coordination and Control, which approved the plan.

The North Carolina Family Physician

MEMBER PERSPECTIVE

A Family Physician's Humorous Take on 2020

By William A. Dennis, MD

My whole family posed for a picture late in 2019. We sent it out as a Christmas card in 2020.

Dr. Dennis graduated from medical school at East Carolina University School of Medicine in 1999 and completed his residency in 2002 at Anderson Area Medical Center in Anderson, SC. Prior to his medical career, he graduated from the University of North Carolina in Chapel Hill with a B.A. in Journalism, and spent 20 years as an editor, reporter, and columnist at the Henderson Daily Dispatch newspaper in Henderson, NC. During medical school, Dr. Dennis was inducted into the Alpha Omega Alpha medical honor society, was a 1996 Rural Health Scholar, received the Merck Award for Academic Excellence in 1998, and was awarded the American Society of Clinical Pathologists’ Award for Academic Excellence and Achievement in 1999. He served as president of the NCAFP in 2014.

It has turned out to be a more accurate view of the future than any offered by pollsters in the November election. (OK, so that doesn’t set the bar very high.)

With the majority of our family now living in Asheville, those of us who are still low-landers went up the mountain last year to gather for a great Christmas. The picture was taken at the “Funkatorium,” a brewery best known for its unique sour beers. Who knew it would be the last time we’d all be together for, well, that remains TBA?! And who knew just how sour and full of funk the coming year would be?!! Not to mention how often we’d be in need of strong drink.

Truly, it has been a year. I think the Grinch may actually have gotten away with it this time. But we’ll be back. There is hope on the horizon.

Despite working in a respiratory clinic since July, I have managed to dodge the viral bullet. So far. In fact, just before writing this column (just before Christmas), I got the initial dose of the coronavirus vaccine. Duke put me in the first wave since I met both main qualifications: 1.) Old. 2.)

Pollyanna-ish enough to work all day with covid-19 patients.

For those debating whether to get the shot, I can report I haven’t noticed any side effects. Other than occasionally seeing microchips in my urine. Also, when I close my eyes, Winter 2021

I hear Bill Gates whispering, “Microsoft good. Apple bad.”

As some may know, I decided to retire from Henderson Family Medicine in June and take a position with a Duke Urgent Care pilot project called “Walk-In Wellness.” As soon as I started, however, my clinic was converted into a respiratory care center dealing with patients who have symptoms or complications of covid-19. We had the option of moving to a different site if we were “skeered,” but I elected to stay. I actually have enjoyed the work, and have learned a new Life Lesson: “’Tis far better to swab, than to BE swabbed.”

You can quote me on that.

I don’t want to make light of the pandemic. It truly has been horrible - rapidly getting worse, in fact - but we all should strive to seek light in the darkness. I have found a few sunny rays, not the least of which is being able to “go to church” in my pajamas while sipping a mimosa and eating sausage. This is an option they should discuss continuing when this is all over. Maybe set up an early service, or perhaps a separate lounge. Just putting that out there.

In addition, with more free time on my hands, I have worked to become more handy around the house. Cases in point: my lawnmower, which refused to keep going in the rare instances when it actually started, and my bike, which locked in on one gear and stuck to it. Why pay big bucks to the repair shops, I thought? There’s a YouTube video for fixing ANYTHING these days.

So, I met with Mr. Google (masks in place, of course) and found the appropriate videos. The obvious problem with my mower was the carburetor. I ordered new parts, followed the YouTube expert, and in under two hours had the fresh parts in place. Not a single piece was left over, which is my metric for a job well done. The bike was clearly in need of new shifter cables. Again, I got the proper replacements.

Again, the work was deeply gratifying. Left me pumped up and feeling downright Tim the Tool-Mannish.

There was the minor annoyance that neither mower nor bike came close to working properly after my labors - another reminder of the recurrent need for strong drink See '2020' on Back Cover

27

RECAP continued from page 18

but now that I’ve taken each to its respective repair shop, they’re both functioning perfectly.

So, I invite you to just bask in the inspiration.

You never know what you can (or can’t) do until you try!

Our most hopeful wish for 2021 is similar, I expect, to many of yours: Simply that we’ll get to see - and hug - our family all together again very soon.

This time, for the sake of prognosticating, I think we should skip Funkatorium and meet at French Broad Chocolate Factory.

Sweet things surely must follow. Come go with us.

We’ll try our best not to wind up at Wicked Weed down the street… who KNOWS what kind of year would follow that!! So to all, here’s to a happy and hopeful 2021.

Non-Profit Org. US Postage

NOTE: A version of this column first appeared in the Henderson Daily Dispatch over the holidays.

PAID

Come on by if you want - just be sure to soak your whole body in hand sanitizer, plus wear

your N-95, face shield, double gloves, and gown. And don’t breathe while inside. Visits are limited to 3 minutes. Enjoy!

Pontiac, Illinois Permit No. 592

In other news, the family is doing great overall.

My wife has suffered the covid troubles common to most. She is not so happy that we introverts now command the universe. At last. She really misses family. And she feels she’s taking her life into her own hands every time she enters the grocery store. (Hey, some of us felt that way BEFORE covid!!) But I think she’s handled it all very well. Apparently, starting Hallmark Christmas movies in May is actually better medicine than hydroxychloroquine or injecting Clorox. She had our house looking festive and sparkly for the holidays, even though nobody got to see it but us.

2501 Blue Ridge Road, Suite 120, Raleigh, North Carolina 27607

2020 continued from page 27

As we look ahead to brighter days in the new year, we are excited to announce two exciting CME opportunities in 2021.

Mark your summer calendars for Saturday, August 7, 2021, for a terrific OneDay Saturday CME Opportunity. Also, be sure to save the dates for the 2021 Winter Family Physicians Weekend, scheduled for Thursday, December 2, Sunday, December 5, 2021. We will keep you well-informed of the in-person and/ or virtual plans for both opportunities.

On behalf of the NCAFP, thank you for what you continue to do every day within your communities. Please continue to be safe and stay healthy. We appreciate you, we are so proud of you, and we cannot wait to see you again. If you have any questions regarding the NCAFP’s terrific CME opportunities, please contact Kathryn Atkinson, CMP, Manager of NCAFP Meetings & Events at Katkinson@ncafp. com.

www.ncafp.com

I would be remiss if I did not give a big heartfelt thank you to our dedicated and hard-working Winter Weekend meeting chairs. When they committed to chairing the NCAFP’s biggest and most popular annual conference in early 2020, a virtual format was never part of the discussions. Please join us in thanking program chair, Dr. Victoria Kaprielian, and program vice-chair, Dr. Jay Patel, for their commitment, flexibility, and enthusiasm for a fantastic event, regardless of the format. The hugely successful cyber event would not have been possible without their continued dedication and support from start to finish. The Meetings Department would also like to thank the many terrific guest speakers and faculty for helping make the virtual weekend a tremendous success. Our tradition of providing incredible content and memorable conference experiences would not be possible without fantastic folks like them who are willing to share their expertise and knowledge with our attendees. Thank you!