Karen Scherr, M.D., Ph.D. Karen Scherr, M.D., Ph.D.

In the past few decades, the “patient revolution” has empowered patients to become informed, active participants in their own health care experiences. Strong patient-physician communication is at the heart of this revolution. Unfortunately, physicians may be inadvertently undermining this effort due to our underdeveloped communication skills. As part of my doctoral program in consumer behavior, I read more than 300 transcripts of conversations between patients and physicians to better understand how they communicate with each other.

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Clayton Cooper, M.D., MBA Clayton Cooper, M.D., MBA

In late August, I received an email from Duke Family Medicine Residency Program Director Viviana Martinez-Bianchi, M.D., FAAFP, inviting residents to apply as a World Health Organization (WHO) young leader to attend the WHO/UNICEF Global Conference on Primary Health Care in Astana, Kazakhstan. After reading the application, I knew being accepted out of a global group of young health professionals would be a long shot, but the advice of a long-time mentor popped into my head. He told me to always shoot for 50 percent success in what I apply for, because if I am always successful, I will be missing many incredible opportunities. 

In early October, I was invited to experience one of these incredible opportunities as part of a group of 50 young global primary care health professionals invited to attend the conference, as well as special preconference. During the preconference, I met individuals across the spectrum of health professions to discuss issues facing primary health care in our countries and determine policy priorities to building a future that puts primary care at the center of our health care systems. It was stimulating and inspiring to work with people coming from backgrounds and professions so different than mine and to brainstorm solutions to problems as diverse as reliable power sources for rural African clinics to the need for comprehensive payment reform that better compensates primary and preventive care. While we each had unique challenges, we realized that we shared many of the same struggles to bring primary care to the forefront of our health systems.

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Viviana Martinez-Bianchi Viviana Martinez-Bianchi, M.D., FAAFP

http://www.euro.who.int/__data/assets/pdf_file/0009/113877/E93944.pdfWhile living in Argentina, back in 1978, I was 14 years old when my father, a vascular surgeon, showed me a newspaper article that highlighted the Declaration of Alma Ata. “This,” my father said, citing the call to action to develop primary health care with an emphasis on health equity and health for all, “will make a difference in the health and lives of people of the world.” I read it with attention, and told my dad I wanted “a career that would involve primary care, taking care of babies, children and adults together with teaching and policy making at the world stage.” “What specialty should I go into?” I asked. “That specialty has not been created,” my dad said. “You will find your own path.”

Forty years later, I find myself at the Global Conference on Primary Health Care hosted by the WHO, UNICEF and the Ministry of health of Kazakhstan, an Argentina and U.S.-trained family physician, a clinician and educator representing the World Organization of Family Doctors together with the WONCA Leadership team. Having spent the last year involved in inputs to the Declaration of Astana and collating the collective responses of family doctors from around the world, I have a sense of responsibility to represent, to engage, to collaborate, to listen and to advocate for health for all. In this role, I am making the case for health systems and governments investing in the training of family doctor leaders and members of teams to meet the health care needs of communities worldwide.

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bulletin board Bulletin board of "good things" at the clinic.

Recently, a patient tearfully confided in me her disappointment when a neighbor reneged on a promise to include her when seeing a particular movie. My patient had saved money from her limited disability income in anticipation of the event; it had been years since she had gone to a movie. Even after 40 years of being a social worker, I was struck in this moment by how the simplest pleasures in life often elude our patients, and how often we, ourselves, take for granted these small joys.

Over the years working at Duke Family Medicine Center, I have said that if you work in my job for two days and you cannot write a gratitude list then your life is truly miserable. My patient’s tears on this occasion reminded me again of how lucky most of us are, despite the stresses of our professional and personal lives.

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Cerrone Cohen, M.D. Cerrone Cohen, M.D.

For a group that prides itself on managing the health of others, physicians themselves lead some of the most unhealthy, unbalanced lives you will ever see. In medical school, we’re taught about the association between stress and chronic conditions like heart disease, anxiety and depression but no one ever teaches you how to manage a busy practice and a busy family.

In residency, you’re required to learn strategies to mitigate fatigue, but there were no lectures on how to juggle meetings and still make it to the preschool holiday program. No one ever sat me down during residency and told me how to find time for exercise, church, friends, date nights, reading or travel — all the things I enjoyed outside of my work life.

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