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News
Former Medical Student HonoredBingham Scholar Student wins poster contest
Faculty PresentationsMembers of the Family Medicine Residency Program faculty give many regional and national presentations at STFM (Society of Teachers of Family Medicine) meetings. This is a snapshot of the presentations for the 2007-2008 academic year.October, 2007 AAFP Annual Scientific Assembly ~ Chicago, IL #1 - 100 Shades of Gray: The Art and Science of Clinical Decision Making – Presented by Donald R. Woolever MD Abstract: Decision making in the clinical setting is a very complex and dynamic process that requires the application of a wide spectrum of skills. Some will approach the clinical question like an equation, while others will view it as a free-flowing exchange, and still others will apply research concepts. These varied approaches point back to the perennial conflict between the art and the science of medicine. The process is further complicated by the role of the patient. The patient’s educational level, adherence, skills and home support all impact on the practical application of the clinical decision. Emotional issues elicited by the patient encounter will also often influence a provider’s approach to the clinical question. Whether utilizing algorithms, applying the scientific process or consulting colleagues, clinical decision making can be facilitated by considering probabilities, establishing a treatment/intervention threshold and being consistent. As advocated by the “Future of Family Medicine” project, a formalization of clinical decision making processes has the potential to improve the quality and safety of patient care. Northeast STFM Annual Meeting ~ Pittsburgh, PA # 1 The Wide World of Contraception: A Workshop to Assess Evidence, Expand Knowledge, and Develop Skills. Presented by: Bethany Picker MD, Donald R. Woolever MD, Denise Cogle DO, Carlos Martinez MD and Terry Ann Scriven MD Abstract: With nearly 15 million couples using some form of contraception, family physicians are often sought out to counsel on pregnancy planning. Emerging technologies and an increased focus on women’s health have brought the risks, benefits and controversies of contraception to the forefront. The number of methods available has increased dramatically, and the family physician must be knowledgeable about all options in order to effectively advise patients. The family physician is ideally suited to work with couples to develop contraception plans that best suit their lifestyle, beliefs and goals for having children. This workshop will review available methods in a skill station model of learning. #2 – What is Health? Presented by: Donald R. Woolever, MD Abstract: What is health? In the rush to implement evidence-based practices and measure outcomes, have we lost sight of what health really is? A normal blood pressure and up to date screening tests do not ensure well-being. Health is much more than medications and procedures. The foundation of the health hierarchy is made up of the most basic of elements: food, air, water, shelter, sleep, love, spirituality. Our current model of care often fails to consider the importance of these building blocks. Implementing healthcare in context and utilizing alternative performance measures, such as self-rated health, may help to refocus our efforts. Working with our patients to find common ground and develop personal health mission statements may lead to the realization of a desired level of “health”. #3 – The Perfect Match: Strengthening the Power of Your Residency Application Presented by: Deborah Taylor, PhD (and Sara Karp, MD from Tufts FMR) Who says “You can’t always get what you want...”? Medical students (I through IV) are welcomed to attend this workshop and: - learn about the Residency Match process (AOA or NRMP), - learn more about the diversity in Family Medicine Residency education, - take inventory of the strengths of your educational and life experiences; - prepare for the residency application process; - add strategies to help increase the power of your application; and - increase your appeal before/during/after the interview day. You will complete a Residency Application Strengths Inventory, receive direct instruction about preparing for the match in MS Years I, II and III, be given tips on producing an effective personal statement, and develop an effective strategy for the interview season including the actual interview day. November, 2007 The Conference on Practice Improvement: Health Information and Patient Education (co-sponsored by the American Academy of Family Physicians and the Society of Teachers of Family Medicine) ~ Newport Beach, CA #1 Contextual Care: A New Model to Improve Adherence, Outcomes and Satisfaction. Presented by: Raj Woolever MD and Reggie Albert Abstract: Contextual Care is the process of incorporating context within the ongoing patient-physician relationship to maximize patient-centered care, facilitate shared decision-making and optimize health outcomes and well being. Contextual Care draws from many well-established care models, but it also incorporates logistical concerns, financial constraints and community resources. Despite its theoretical basis, Contextual Care is pragmatic, intuitive, and highly personal in its application. It was observed in the forward to the Future of Family Medicine project that “patients value an individual relationship with a physician who knows them as a person and who understands the social context of their lives.” Family physicians adjust their approach and recommendations to patients according to many elements which comprise a “health context”. This skill, while often modeled, is rarely taught explicitly. #2 A Comprehensive Approach to Caring for Refugee Populations. Presented by: Raj Woolever MD and Reggie Albert Abstract: With over 20 million refugees in the world and 170,000 new refugees and asylum seekers arriving in the US in 2006 alone, this is a growing population with a unique context and health history. While many refugees primary re-settlement site may be a large US city, increasingly, secondary re-settlement sites are in middle-sized and small cities and towns. Refugees are required to have a full medical exam within one year of their arrival and often arrive with complex medical histories further complicated by language and cultural barriers. Tropical infectious diseases and significant physical and psychological trauma are common. The implementation of strategies and services to facilitate a positive introduction into the health system can result in rewarding relationships and improved health for these families. #3 What is Health? – Presented by Raj Woolever,MD Abstract: (see NESTFM description in prior section) February, 2008 Conference on Families and Health ~ New Orleans, LA #1 – From P4 to C3: The Development of a “Contextual Care” Family Medicine Residency Competency-based Curriculum. Presenter: Deborah Taylor PhD Abstract: While Family Medicine is founded on and the FFM is steeped in language about the care of patients in "context", this session will focus on a community FMRP's attempt to name "context" and to develop a curriculum (including EHR resources) for teaching and assuring competency by residents and medical students in this vital area. Our P4 application, while not accepted, motivated us to persevere with C3 (Contextual Care Curriculum) and I2 (Intentional Interaction). A CD with relevant materials will be handed out to all participants. April 2008 Annual STFM Conference ~ Baltimore, MD #1 - Resuscitating "Seasoned" Behavioral Scientists: A Sharing of Ideas to Rehydrate Our Work and Our Passion. Presenters: Deborah Taylor PhD, Tim Spruill EdD (from Florida Hospital Orlando) and Robert Zylstra EdD (U. Tennessee Chattanooga) Astract: The intention of this gathering is for the current three co-chairs of the Group on Behavioral Science to bring together seasoned (defined as >10 years of experience) Behavioral Scientists for a discussion of current FMRP or FM Department behavioral science curricula, creative teaching methods and competency based evaluation strategies. If you are feeling in need of some new ideas (re-hydration) or need your passion reignited (resuscitation), we hope you will join us.
Wilderness Medicine ConferenceScheduled for April 22The Central Maine Medical Center Family Medicine Residency Program willpresent the 3rd Annual Wilderness Medicine Conference on April 22. Sponsored by the residency’s Wilderness and International Medicine Program, the event will feature presentations by experts on a variety of topics. The conference is being offered free of charge and is open to anyone with an interest in wilderness medicine. The day’s agenda will feature the following: “Medical Decision-Making in Medicine, Mountaineering and Daily Life” with Paul Hoehner, M.D., an anesthesiologist who practices with Central Maine Heart Associates in Lewiston. Hoehner is also a theology doctorate candidate. “The North East Ridge of Everest” with Bill Yeo of Durham. Yeo, a professional guide and mountaineer, will discuss his May 2006 Everest expedition. “Frostbite” with Bina Maharjan, M.D., and Michael Gravatt, M.D., physicians with the CMMC Family Medicine Residency, and trauma surgeon David Sooriash, M.D., “Snake Bites in Central America” with Kirk Silver, M.D., 2007 graduate of CMMC Family Medicine Residency Program “Environmental Stewardship: Bells of Everest Project” with Jeff Clapp, founder of Bells of Everest. “Wilderness Medicine Aspects of Mt. Katahdin Summit Attempt March 2008” with the University of New England College of Osteopathic Medicine Wilderness Medicine Club. A wilderness medicine mock code scenario will also be explored as part of the day’s events. A light lunch will provided. The event will begin at 11:45 a.m. and will be presented in the Chairmen’s Rooms, 12 High Street Medical Office Building, lower level. For more information or to register, email fredaji@cmhc.org or call 795-2803.
Wilderness & International MedicineSpring 2008 Conference
National Physicians AllianceBethany Picker is an active member of the National Physicians Alliance. Through her work with the NPA she has become very involved with healthcare reform and developing support for a Public Health Option. Working with Healthcare for America Now, Bethany created a television ad that has been airing in Maine http://www.youtube.com/watch?v=00V6A8MCLxg. This ad has caught the attention of the media including the New York Times http://www.nytimes.com/2009/05/28/health/policy/28health.html?_r=2
Christina Vietor, Bingham ScholarSpending Summer at Residency Program
Dinner Celebration of Recent Graduates
Graduation Ceremony
Skills Workshop during Week 4 of Orientation
Range Pond Retreat
Recent Events Related to the CMMC FMRDr. Woolever presented at the AAFP Global Health Workshop in Denver, CO. The topic of the presentation was on linking his community-based, rurally focused family residency to a similar program in India.CMMC hosted the OMM Update - all presentations were done by our faculty and osteopathic residents - attendance and evaluation of the event was high. Ten faculty and residents from our FMR worked the medical tent on 10/4 at the 1st Annual Dempsey Challenge - a biking and running event fundraiser for CMMC's Dempsey Center for Cancer Hope and Healing - the event raised $1,000,000! A group of four faculty and four residents attended the NESTFM Conference in Rye, NY presented a medical student/resident experiential workshop about Integrative Medicine as well as a workshop on finding the perfect residency match. Drs. Lovett and Ganta will have their article "Advising Patients about Herbs and Nutraceuticals: Tips for Primary Care Providers" published soon in the Journal Primary Care: Clinics in Office Practice Two senior residents have now launched the new Sports Medicine Selective - with rave reviews!
Upcoming EventsDr. Picker will be presenting on Health Care Reform at the upcoming Practice Management Noontime Conference.Dr. Kenney will be kicking off the first of two half-day conferences on Wilderness and International Medicine (WIMP) with one in October focused on International Health. A group of four faculty and four residents will be heading to the NESTFM Conference in Rye, NY to present a medical student/resident experiential workshop about Integrative Medicine as well as a workshop on finding the perfect residency match. Drs. Lovett and Ganta will have their article "Advising Patients about Herbs and Nutraceuticals: Tips for Primary Care Providers" published soon in the Journal Primary Care: Clinics in Office Practice
Faculty Roast Faculty
November Residency NewsPer the expected timelines, Dr. Woolever transitioned to the role of Program Director in early November. Dr. Claxton, the former program director, assumed a faculty role with primary responsibility for the Care of the Elder curriculum and helping bring the Patient Centered Medical Home philosophy to the outpatient primary care practices.Faculty completed Day 1 of an annual two days of long range planning retreat time. The retreat was attended by all faculty, the chief residents and our administrative leadership including the practice manager and our nursing supervisor. Day 2 is scheduled for 12/10/2009. RHEDI clinic is launched within our Family Medicine Center. Drs. Taylor and Woolever have submissions to the 2010 Annual Society of Teachers of Family Medicine in Vancouver accepted for presentation. Dr. Ned Claxton will be working as an advisor/consultant with 4 practices in our system in the redesign of how care is delivered. Each of the groups is enrolled in a Maine project to study how practices can grow into Family and Patient Centered Medical Homes of excellence. The FMR staff, residents and faculty - led by Kim Theriault from the nursing staff - donated enough food and $$ to create two Thanksgiving baskets including turkeys for two needy families in our practice.
December Residency News
A pot luck lunch to celebrate the holidays was held on 12/15 - Secret Santas were revealed and team games were enjoyed. The Central Maine Medical Group (a division that encompasses all outpatient practices) also enjoyed a great 2 hour holiday lunch at the Kora Shrine Temple across the street from CMMC on 12/11. Several of our FMR employees won door prizes. Dr. Patrick Pine graduated from the residency this month. We wish him well in his family medicine career. Dr. Hatzenbuehler and his wife, Stephanie, celebrated the birth of their son Miles on Christmas day. He tells that his wife, "the trooper", was discharged 14 hours after delivery and they were home by Christmas night to open presents! Dr. Geoffrey Carden has become a reviewer of the American Family Practice journal - congratulations Geoffrey! Drs. Taylor and Wooelver have had submissions accepted to the 2010 Annual STFM Conference in Vancouver, BC in April. Faculty Drs. Lovett, Picker, Woolever were joined by residents, Adams, Koteles, Long and Nguyen for a invited trip to Boston University to present an Integrative Medicine workshop to medical students. This event was co-sponsored by the BU FMIG and the BU Integrative Medicine Club. Over thirty students attended and the evening was enjoyed by all. The FMR's community service project for January is being spearheaded by Betty Ostrander, our CPC/Biller in the FMR. Donations are being accepted for our local Androscoggin Humane Society and will be delivered at the end of January - this is a time of year when donations often are low due to expenses people have over the holidays. There is a lot of enthusiasm for this project in our work family. Thanks Betty!
January Residency News
Drs. Rivard and Taylor found themselves in Jacksonville, Florida over the same weekend in January - Gary was attending the STFM Predoctoral Education Conference and Deborah was attending the winter STFM Board of Directors' mtg. They both enjoyed their meetings and a short break from winter. The Resident Research and Scholarly Activity Committee, chaired by Dr. Geoffrey Carden, has developed a timeline for all first year residents to follow in order to successfully complete their scholarly activity project. The scholarly activity can be research, a QI initiative or a Community Orientated Primary Care (COPD) project. <a href="pdf/scholarly_project_timeline.pdf">Download the document timeline</a>.
February Residency News
Med-Psyc Clinic returns to the FMC (to the delight of patients and providers alike) - Dr. Christine Gray will be returning to our Family Medicine Center starting 3/8 for a Monday weekly Med-Psyc clinic. Residents and students will benefit from Dr. Gray's expertise with diagnosing and treating psychiatric conditions, and patients will receive this psychiatric evaluation and intervention as part of the Patient Centered Medical Home and integrated model of healthcare. Dr. Don McCrann will start precepting two days a month - he is an OB-Gyn who will be precepting patients who present for women's health visits. He will also be completing some chart audits and educating all providers about optimal healthcare for women. New Group Medical Visit (GMV) set to begin soon - Patient with CHF will be asked to attend GMVs as a way of increasing their education about this chronic disease as well as how to best manage the condition and symptoms. Our Diabetes GMV has been so well received that we are branching out! We had a "perfect" Osteopathic Match result - 3 for 3! Drs. Adam Duquette and Christopher "Todd" Kitchens (from UNECOM) along with Dr. Shayna Lemke (from PCOM) will be joining our first year class on 6/28/2010. We await our NRMP Match Results - due to us in mid March. Dr. Geoffrey Carden is now officially an ALSO instructor - congrats Geoffrey. UNECOM clerkship class for 2010-2011 has been announced. We are so excited to welcome Robert Caron, Adriana Chavez, Jamie Gellock, Kate Harmoney, Viki Johnson, Rob Parker, Tom Sheelsey and Aaron Slaiby to CMMC for their third year Core Clerkship year. We hope that the 10-11 class is as fabulous as our 09-10 class has been!
March Residency News
Aden Ahmed joined the Family Medicine Residency on March 22, 2010. He speaks three languages: English, Somali and Swahili and is available to interpret for patients both in the Residency as well as other CMMG practices! New Community Preceptors The CMMC Family Medicine Center is pleased to welcome two new preceptors as supervisors and educators of our residents. Dr. Christine Gray is returning one day a week to precept a MedPsyc clinic - providers can refer into this clinic for psychiatric diagnostic clarity or help with medication management - residents and medical students will rotate through the clinic to enhance psychopharmacologic knowlege base. Dr. Don McCrann is a board certified OB-GYN and will be precepting women's health cases and teaching procedures. Kathy Morin, RN, Nurse Supervisor has recently been appointed to the board of the FMRNA (Family Medicine Residency Nurse Association) and will be attending a fall session with the board which is being held in Dallas Texas. Congratulations Kathy.
April-May Residency News1. Dr. Carden has been accepted into the Faculty Development Fellowship at University of North Carolina - he will spend 6 weeks in Chapel Hill over the course of the 2010-2011 academic year - Congrats Geoffrey!2. Drs. Woolever and Taylor attended and presented at the 2010 Annual STFM Conference in Vancouver, BC in late April. Both came back to the residency jazzed up with lots of innovative ideas and much energy and enthusiasm for their work as faculty and administrators in the residency. 3. CMMC was a co-sponsor of a recent ALSO (Advanced Life Support in Obstetrics) Course in Portland. Drs. Carden and Woolever were on the teaching faculty; Drs. Gummadi (1st year resident) and Picker (faculty) took the course. Dr. Picker plans to take the instructor course in the fall of 2010 which would give us three certified ALSO instructors! 4. Dr. Rivard just received news that he passed his boards - hoorah for you Gary! 5. The residency has new chief residents. Drs. Jennifer Dressel (rural track), Bina Maharjan and Laurel Schwingel (2009-2010 chiefs) passed the torch to Drs. Lisa McAllisetr (rural track), Alicia Koteles and Stephanie Youd. Alicia, Lisa and Stephanie attended the AAFP Chief Resident Leadership Course in KC, MO in mid May. Like Raj and Deborah, they returned with lots of innovative ideas and energy for their leadership roles within the residency. 6. Several CMMC FMR faculty and residents along with medical students from our clerkship class from UNECOM recently attended the Maine Academy of Family Physicians Annual Mtg in Freeport. Drs. McElrath, Focht, Rothe and Picker were presenters. Dr. Lisa McAllister, the rural track chief resident, was elected to the MAFP board of directors as a resident alternate. 7. Dr. Lisa McAllister who is a resident in the rural track in Rumford was honored at the MAFP for her work with the AAFP Tar Wars program - Three of the four top rated posters, including the top rated one for the state, came from a class that Dr. McAllister taught to about the benefits of not smoking and the hazards of doing so. Congratulations Lisa!
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