Hope

As I sit to write my first STFM President’s Column, the STFM Annual Spring Conference is in full swing. We have been wrestling with some challenging topics, from racism, to disability, to health care reform. Through all the presentations, all the challenges, all the ideas and innovations, and after watching the STFM membership at work, what shines through for me is hope and inspiration.

It has been a rough year. Family medicine has been on the front lines of COVID-19. Our teams have stepped up to learn how to diagnose and treat people with COVID-19, while also figuring out how to safely care for those with other conditions. An important part of our care has been dealing with the emotional aftermath of this stress and grief. Most importantly, we have learned how to keep one another, our families, and our patients safe. The deaths have been intense. Along with this pandemic has come the murder of George Floyd, and so many other Black and Brown lives lost at the hands of police. I have been heartbroken over the continued killings of our community members.

With all of these challenges, why am I hopeful and inspired? As a White, cisgendered male, I know there is much I need to learn, much I need to acknowledge, and much I need to do to help others. In a world where more action is sorely needed, I am inspired by so many role models who are helping to teach me the way. I find hope in the actions and courage of others. There are three specific examples for which I am grateful:

1. The Society of Teachers of Family Medicine and their antiracism and health equity work and focus;
2. The National Academies of Sciences, Engineering, and Medicine report, Implementing High-Quality Primary Care1; and
3. COVID-19 vaccines.

Early in the COVID-19 pandemic, when I was overwhelmed with trying to care for COVID-19 patients, there came a point where I had not slept more than a few hours in days. From the beginning, it was very clear that Black and Brown patients were suffering the brunt of this pandemic, and we were all watching a terrible tragedy unfold. In an exhausted state, I participated in an “STFM Three-Presidents Call” that included STFM Executive Director Stacy Brungardt, CAE; Immediate Past President Frederick Chen, MD, MPH; President Tricia C. Elliot, MD, FAAFP; and me as STFM President-Elect. During that call, the decision was made to present to the STFM Board the idea that STFM would push forward an antiracist agenda. With unanimous support, the STFM Board approved the creation of an antiracism task force. Antiracism resources were rapidly posted on the STFM website alongside the COVID-19 resources, and antiracism and health equity goals were then strengthened in the STFM strategic plan. After that call, my spirits began to lift as STFM was helping to lead some of the changes we need. I am so proud of the leadership of Trish, Stacy, Freddy, the STFM Board of Directors, the STFM Antiracism Task Force, and the STFM membership at this key time in our history. I was so inspired by their powerful leadership that I was immediately filled with hope.

Then, on May 4, 2021, an evidence-based report was released, entitled Implementing High-Quality Primary Care: A Report from the National Academy of Sciences, Engineering and Medicine (NASEM).1 This is a follow-up report from the Institute of Medicine’s (IOM) 2012 report, Primary Care and Public Health: Exploring Integration to Improve Population Health,2 and the IOM’s 1996 report, Primary Care: America’s Health in a New Era.3

This new NASEM report highlighted five strategies to implement high-quality primary care in the United States:

1. Pay for primary care teams to care for people, not doctors, to deliver services.
2. Ensure that high-quality primary care is available to every individual and family in every community.
3. Train primary care teams where people live and work.
4. Design information technology that serves the patient, family, and interprofessional care team.
5. Ensure that high-quality primary care is implemented in the United States.1

Defining this path to better primary care has again inspired me to fight for changes to the US health care system. This pandemic has accentuated the structural and systemic racism that has hurt so many people for too long. It has also highlighted the health care inequities for everyone in the United States, with only 5.4% of all health care expenditures spent on primary care.4 This US system of “sickness care” was not ready when people in the United States became sick from COVID-19. I see the five strategies listed above as critical to ensuring the next pandemic does not take so many lives. We can only accomplish this if we break down the health care inequities that exist for so many people in the United States.

Finally, we have COVID-19 vaccines. It was such an honor to receive my first COVID-19 vaccine dose on December 19, 2020. A nurse I had known for many years, gently inserted the needle into my arm while I, holding back tears, snapped photos of a changed life. Then on May 7, 2021, Jenny Drzewiecki, MPH, a public health professional, who is also my lovely wife, became the last of my family members to become fully vaccinated. Recognizing that so many people have lost so much in this pandemic, Jenny and I are both very fortunate to still have our mothers. This year’s Mother’s Day became the first time in over a year we have hugged and held our family members. It has been a true delight to watch so many of my patients revel in being able to hold grandkids, to attend graduations, weddings, and family gatherings, all thanks to being vaccinated. I am watching my patients relearn how to live engaged and social lives!

This has been a rough year. There is no doubt about that. Yet in the turmoil, I am inspired by those who have given so much to so many. I am inspired by STFM and its members who fight the good fight. There is so much hope in STFM. There is so much hope in family medicine. Together we are strong, resilient, and powerful. Together, let’s push forward the five strategies of NASEM’s report. Together, let’s push toward a society free of racism. And together, vaccinated arm in vaccinated arm, let’s push toward an end to inequities!