The Scope and Variety of Military Family Medicine

Last week, the USUHS FMIG hosted a lunch with the student clerkship coordinators from most of the military's family medicine residency training sites.  The coordinators were in town for a clerkship planning retreat held by LtCol Jessica Servey and the USUHS Department of Family Medicine, and were enthusiastic about meeting with the students.

I find it really inspirational to hear what is happening at each of our training sites.  For instance, Madigan AMC at Fort Lewis is bringing an endoscopy fellowship on line for Army family physicians, Nellis AFB is continuing to grow the military's newest family medicine residency program, and our Navy colleagues continue to prepare physicians for garrison and operational billets alike.

Even more inspirational are the students coming up the ranks and ready to stand in the gap.  During the meet, we discussed the "ecology" of healthcare in the United States.  If you look at a map of the US, you'll notice that the majority of counties in the US interior (i.e. non-coastal, non-urban areas) are designated as a Primary Care Health Professional Shortage Area.  If you remove family physicians from the mix, close to 70% of the US falls into this category.  [See the article at http://fmignet.aafp.org/online/fmig/index/family-medicine/questions-about-fm.html for details]

Health reform is underway, but for some, it perhaps will not, or cannot, come soon enough.  There simply are not enough primary care physicians in the right places.  Whether we have a shortage of physicians is debatable.  What is not debatable is the fact that we do not have the right geographic distribution of current physicians.  Family physicians tend to be more likely to serve in interior and rural areas that have a hard time recruiting health professionals.  Fortunately, I think that our students are increasingly drawn to what we have to offer—procedurally competent, operational-savvy, professionals able to serve in the acute, chronic, urgent, emergent and trauma settings—and I think we’ll all be the better off for their service.