President’s Message

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 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

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.

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

Executive Officers President Jessica Triche, MD President-Elect Dimitrios “Takie” P. Hondros, MD Secretary/Treasurer Shauna Guthrie, MD, MPH Immediate Past President David R. Rinehart, MD Executive Vice President 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)

Student Director Hannah Smith (ECU)

Student Director-Elect Morgan Carnes (Wake Forest)

AAFP Delegates & Alternates

AAFP Delegate AAFP Delegate AAFP Alternate AAFP Alternate Karen L. Smith, MD Robert L. Rich, Jr., MD Richard W. Lord, Jr., MD, MA Tamieka Howell, MD

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

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 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.

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.

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

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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. 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.