Guest post courtesy of J. Carson Rounds, MD: President of the North Carolina Academy of Family Physicians Foundation
It can be hard to teach messy real-world issues, but practitioners need to understand how these issues affect their patients and how to interact with, and ultimately improve, an exceedingly complex and fragmented system to provide good patient care.1
Guanajuato, Mexico is roughly 2000 miles from Wake Forest, NC. Modern aviation can get you from Guanajuato to Wake Forest in about 7 hours, if all goes well. If it doesn’t, it might take 16 hours, like it did for Will Martin. The original class of Family Medicine Scholars was selected late enough in 2010 that many, including Will, already had summer plans. We had to work around that schedule to fit in his time at my office. Will’s first day in our office was the day after he returned from Mexico.
A clearly tired Will was on time and ready to learn. I was struck by his dedication and enthusiasm despite his arduous journey the day before. He quickly assimilated into our team and spent the next four weeks learning from me and my patients. He also challenged and taught us. My work day became longer, but my patient care benefitted. I work hard to ensure my patients understand their diagnosis, what I believe we should do about it, and why it is important to do something. The addition of probing questions from a medical student forces me to maintain a diagnostic and therapeutic rigor that is threatened by the “messy real-world issues” I face every day.
Will’s time with us that summer went by quickly. The enthusiasm, dedication, and curiosity Will brought with him renewed those same feelings in me. Will built an easy rapport with our patients and prompted many of them to become prophets, predicting Will’s future success as a physician. When he returned last fall, he picked up where he’d left off, often getting to see people he’d met during the first rotation.
Teaching and mentoring are acts of hope. I teach because I believe in the future of Family Medicine and our ability to make a difference in the world. I teach because I am taught by my students every time. I teach because Will reminded me that even when my ‘journey’ in the fragmented and complex world of medicine doesn’t go as planned, I can choose to be a cheerful, curious, and enthusiastic partner with my patients as we build a 21st century medical home.
Learn more about the relationship between physician and student by watching the Inspired story “Welcome to the Family.”
1Molly Cooke, David M. Irby, William Sullivan, and Kenneth M. Ludmerer. “American Medical Education 100 Years after the Flexner Report.” New England Journal of Medicine 355.13 (2006): 1339-344
Guest post courtesy of Debra Horton, executive director, North Carolina PTA Learn more about the impact of PTA by watching this Inspired story.
When it comes to being champions, Margie Butts, volunteer, and Kevin Ulmer, president of Codington Elementary PTA (both pictured here with other members of the Codington family), have mastered one thing for sure – they know how to play! We awarded their PTA with a Champions of Play grant in November 2011, and they’ve been off and running ever since – literally!
With a focus on finding fun ways to increase activity levels and improve healthy choices, Codington PTA selected Healthy Child – Healthy World as their school year theme and expanded on the concept by creating the Codington Healthy Family Challenge, which helps participants track their physical activity minutes and their fruit and vegetable intake over six months.
Getting Families On Track
To help everyone get a running start and stay motivated, Codington PTA provides families with fitness tips, training plans, healthy recipes and reminders about fun activities around the county. They have even launched a weekly group run/walk on Sundays at the school.
Going the Distance To celebrate everyone’s steps to healthier choices, all participants are encouraged to join students who are already enrolled in Girls on the Run or STRIDE programs for a fun and challenging 5k in May. Plus, families who log the most hours of physical activity are eligible to win gym memberships, fitness equipment and other prizes to encourage continued physical activity.
Planning for Extra Mileage Teaming up with educators and school wellness committee members, Codington PTA built their family challenge as a model for other school communities. They openly share their fun, integrated approach and were recently selected to present at the Emerging Leaders Conference at UNC Wilmington.
At the end of the day, it comes down to building a healthy school team, and PTAs are a great avenue for this collaboration.
Want to learn more? Parents and educators who are interested in stepping up to create healthy experiences for students (and families) can join statewide leaders for a special Just ASK Health Coalition workshop at the NCPTA Parent Education Conference Saturday, April 28 in Raleigh. Plus, volunteers can choose to participate in a special Health Track June 2 in Raleigh at the NCPTA Summer Leadership Training. Visit www.ncpta.org for more information.
Guest post courtesy of Christopher Walker, Volunteer Coordinator, NCMOM; UNC School of Dentistry 2016
Support the work of NCMOM and other efforts to deliver dental care to the underserved by watching and sharing this Inspired story.
At every North Carolina Missions of Mercy clinic, I notice the long line of patients who waited outside through the night, no matter the weather. These patients are from all walks of life. Most did not choose to avoid dental care; it was simply never a choice they could make. They come hoping for a chance to smile again, and so we come, bringing an army of volunteers, dental professionals and equipment, hoping to rebuild those smiles and change lives.
The North Carolina Missions of Mercy (NCMOM) is a mobile dental clinic that offers free dental care to those in financial need who have few other treatment options. NCMOM operates under the N.C. Dental Society and N.C. Dental Health Fund with the goal of providing care to as many under served North Carolinians as is possible and involving as much of the state’s dental community in treating those patients as is possible. Estimates place the number of under served in our state at more than one million, and access to dental care in many areas of North Carolina can be physically and financially out of reach to many residents.
My first experience with NCMOM in 2009 motivated me to be a part of this mission. Before visiting a clinic, I was unaware of the numbers of people in need of dental treatment and access to care. I was also unaware of the dental community’s united effort to help those in need and address this problem through projects like NCMOM. Their coordinated efforts and dedication to serve have inspired my own path to dentistry, which begins this fall as I start my first year of dental school at the UNC School of Dentistry.
NCMOM holds 12 clinics annually, serving patients from the mountains to the sea. Patients’ reasons for putting off dental care varies, but they always take the time to remind us that our event is a blessing—a gift that helps them smile again. Each year as we return to certain areas, local volunteers notice the growth in the event. We bring more equipment, more dentists, more volunteers, all in an attempt to help more patients. As the need continues to grow, so does NCMOM.
One dynamic factor in growth of the clinics’ success came from the mobile X-ray unit provided by a BCBSNC Foundation grant. The X-Ray bus allows NCMOM to perform a digital panoramic X-Ray on each patient for use in the clinic’s dental triage and treatment areas. With this advancement, volunteer dentists are able to efficiently and safely address patients’ immediate needs. Having this equipment also allows dentists to better treat previously undiagnosed issues of which patients may not even be aware.
With the help of hundreds of dentists, hygienists, assistants, dental students and community volunteers, NCMOM was able to treat more than 8200 patients in 2011. We hope to inspire more members of the dental community to help us provide services and continue to spread smiles throughout the state in the coming year.
Inspired to lend a hand at an NCMOM event? Please visit ncdental.org/ncds/NCMOM.asp
My faith journey began at an early age and in a somewhat nontraditional way. I fondly remember attending weekly prayer meetings and Bible studies at my grandmother’s house in rural North Carolina. Community members would come from all around to worship together in a small, weather-beaten house at the end of a long dirt path. They would read scriptures, sing songs and tell stories of how they were able to overcome various obstacles throughout the week. At the time, I didn’t fully understand how folks who had just lost their jobs, received less than encouraging doctors’ reports or were in the midst of marital or other familial turmoil could still come together in praise and worship – not as victims, but as victors…. It was quite a remarkable thing to witness; one that has stayed with me throughout my adult life.
I now recognize the source of hope, inspiration and strength that so many who worshipped at my grandmother’s house were drawing from – their faith. It is this same source that I draw from on a daily basis as Program Coordinator of the North Carolina Council of Churches’ faith-based health initiative, Partners in Health and Wholeness (PHW). The mission of PHW is to promote health as a practice of faith and to improve the health of clergy and congregants through increased physical activity, healthy eating and tobacco use prevention and cessation.
My interest in faith-based health stems from my previous employment at the NC Division of Public Health, academic training at the UNC Gillings School of Global Public Health, and many years of watching loved ones suffer or die prematurely from poor health. My own beloved mother, who will celebrate her 56th birthday later this month, is now wheelchair-bound after breaking both of her hips, after more than a decade of undergoing dialysis, following years of uncontrolled hypertension. I know first-hand the financial and emotional toll that is placed on a family when what starts out as a minor – or better yet, preventable – problem becomes a significant one requiring costly medical intervention. Thankfully, my family’s strong foundation in the faith and large support network has helped us to manage quite well in the face of adversity.
Not all families in North Carolina and across the U.S. are so fortunate, however. For that reason, the North Carolina Council of Churches has made it our charge to emphasize the connection between faith and health – demonstrating that our faith is not only there to draw on after we receive a bad doctor’s report, but to help people of faith make healthier choices in the first place…. To facilitate congregations to serve as health promotion centers in the community, touching the lives of countless North Carolinians without a medical home.
How are we doing? More than 7,000 individuals now attend a congregation in North Carolina that has made the health of its members a top priority by participating in the Council’s PHW Certification Program and other health-related activities. And we are working hard to expand this reach. To learn more about these efforts and how you can get involved, please visit www.healthandwholeness.org .
Guest post courtesy of Rob Doherty, DDS, MPH, Dental Director of Greene County Health Care, Inc. Originally appeared online at DentistryIQ.
Support the work of Dr. Doherty and others committed to bringing dental care to the underserved by watching and sharing this Inspired story.
Like most of us in the dental profession, I went to school expecting to associate and then eventually open a private practice in my hometown of Long Beach, Calif. During my years in dental school, “public health dentistry” was basically the health department, and many times it seemed to be what someone considered when there was no other place to go.
My career with the U.S. Public Health Service greatly changed that outlook, and I had the opportunity to witness oral health care delivery throughout the country as well as in industrialized and third world countries. As a result, I have spent the last 22 years working full-time clinically in North Carolina’s Community Health Centers (CHCs), treating almost exclusively those who are at or below 200% of the federal poverty guidelines. Our patients pay a reduced fee, and we are helped by grants and donations that cover about 30% of our budget.
Over the past few years, many of the country’s CHC dental programs have evolved into modern, efficient, high-tech, comprehensive oral health care programs working hard to meet the area’s many needs for adults and children. Dentists in the centers are well paid with good benefits, including extensive continuing education. In our center in eastern North Carolina, we have more than 15,000 patients, and we are in a constant learning environment. Young dentists join us and are exposed to complex oral surgery, endodontics, removable and fixed prosthetics, implants, orthodontics, and pediatric dentistry. Our private practice colleagues are supportive of our efforts, and we work closely with the two schools of dentistry in North Carolina.
At the National Network of Oral Health Access (NNOHA) Conference last October in Washington, D.C., the courses were packed with young and mid-career CHC dentists from throughout the country learning about practice management, leadership, grant writing, community programs, IT, and all phases of clinical dentistry. There was one CHC dental program there from Gaston County, N.C., whose ambitious school program was honored for achieving the goal of making all the children at one of the county’s elementary schools virtually caries free.
At this time, only 66 of North Carolina’s nearly 4,200 dentists work in these settings. Yet the need is overwhelming, here and in many communities across the country. We have a “call-in day” each month to accept 50 new comprehensive treatment patients, and we normally get 400 calls in the first two hours. We can use more centers like ours, and we can use more dentists like the ones working with us. While it might take a while for the image of “public health dentistry” to change, it’s grown into a viable and substantive option for many dentists, whether for a few years or as a career.
Personally, I cannot imagine a more challenging, vital, satisfying, and enjoyable career choice than working with a Community Health Center. To many of us, this is the most appealing part of the work — if these patients did not get this work done, in this setting, at these reduced fees, they would not get the work done. They have no other place to go.
The vision and goals of these programs naturally work toward making a difference in thousands of lives. For those of us who work with these programs, that vision helps to make us better oral health professionals and, at the same time, better people.
Guest post courtesy of Carolyn Ward, CEO, Blue Ridge Parkway Foundation
When I grew up, I spent most of my time outside – as did all the other kids in the neighborhood. I don’t remember many “rules” about being outside or many restrictions about what we could or could not do. We just “played” and mom and dad were happy that we were not inside and underfoot. You could drive through any neighborhood in my hometown and most were filled with the sounds of laughter and children playing. And then something changed…I grew up. I guess I had stopped paying attention to things like children outside and by the time I had a child myself and began to notice such things again…the neighborhoods seemed empty. I no longer saw the swing sets and tree houses of my youth.
This stark realization became even more troublesome when my young daughter began playing with other kids her age. It took no time for me to realize that these kids did not go outside to “play”. Many had never walked barefoot on the grass or sat on the ground without a blanket to “protect” them from the ground. This was the beginning of the inspiration for the Kids in Parks program, and I was Inspired.
I left my career as a professor to see if I could help make a difference. With childhood obesity rates rising and children’s connection to parks and places decreasing, I was excited to see if a program linking children’s health and the health of our parks and public lands could really work. With the support and partnership of the Blue Cross and Blue Shield of North Carolina Foundation, The Blue Ridge Parkway and the Blue Ridge Parkway Foundation, we launched the Kids in Parks program and opened our first TRACK trail in 2009. Now, with 11 trails in the ground in three states, linking over 40 partners, we have distributed over 30,000 brochures, and had over 12,000 kids and families unplugging and going outside.
From studies that show increased brain activity and higher SAT scores when children play in natural settings to research that links lower incidences of bullying, ADHD and depression in kids that play outside, there is clear evidence that children benefit from time in nature. We know that it is through a personal meaningful connection with natural and cultural resources that lasting positive impacts can be achieved both for the children and for the place. Getting kids and families outdoors and moving helps develop healthy stewards who are connected meaningfully to their heritage and their home.
Our vision is to create a TRACK trail near every citizen in North Carolina and then spread the program across the country. Together we form the partnership for health: children’s health, the health of our parks, and the health of our communities. My daughter plays outside…
Watch and share the Inspired story on Kids in Parks to support getting more kids outside.
Post courtesy of Jason Baisden, Executive Director, North Carolina Association of Free Clinics
In North Carolina and throughout the United States, free medical clinics often have to fight the false perception that the quality of care they provide is somehow sub-standard. As the old saying goes, “You get what you pay for,” and many believe that since the care is provided for free, it must be of a lower quality than the care provided to paying consumers.
North Carolina’s free clinics are not only shattering that perception, they are also demonstrating that the care they provide is on par with the care provided by the private sector, particularly in helping to stabilize the health of individuals with chronic conditions
In 2009, North Carolina’s free clinics embarked upon an initiative to prove that many North Carolinians who receive their care from a free clinic have health outcomes rivaling those receiving care through private providers.
Statewide Impact:
In 2010, North Carolina free clinics directly provided $162,000,000+ in free health care services to 86,893 uninsured and underinsured patients, totaling more than 205,000 patient encounters. These services were made possible through the efforts of 9,600+ volunteer health care professionals and other community volunteers donating close to 400,000 hours of service.
North Carolina’s free clinics also arranged for $20,400,000+ of free health care services provided by other health care entities within local communities. Free clinics provide outstanding value for the contributions they receive. A $282 contribution will, on average, sponsor a patient for an entire year at a free clinic.
Improving Health:
In 2010, North Carolina’s free clinics reported that:
71% of free clinic hypertensive patients achieved Blood Pressure Control of <140/90 compared to: Commercial Insurance (HMO 63.4%, PPO 56.7%), Medicare (HMO 61.9%, PPO 55.7%), Medicaid (HMO 55.6%)
BP Control of <140/90 is the recommended goal (Joint National Committee (JNC 7) Guidelines on the Prevention, Detection and Treatment of High Blood Pressure). HMO = Health Maintenance Organization, PPO = Preferred Provider Organization
44% of free clinic diabetic patients achieved an A1C level < 7 % compared to: Commercial Insurance (HMO 42.5%, PPO 28.2%), Medicare (HMO N/A, PPO N/A), Medicaid (HMO 34.7%)
Lowering A1C to below or around 7% has been shown to reduce microvascular and neuropathic complications of diabetes and, if implemented soon after the diagnosis of diabetes, is associated with long-term reduction in macrovascular disease. Therefore, a reasonable A1C goal for many nonpregnant adults is <7%. (American Diabetes Association Guidelines)
62% of surveyed patients indicated a decrease in emergency room utilization since becoming a patient at the free clinic
58% of surveyed patients indicated a decrease in hospital admissions, and
77% of surveyed patients feel their health has improved since becoming a patient at the free clinic
North Carolina’s free clinics are able to demonstrate this level of value and statewide impact because they remain committed to patient-centered medical care. And they are altering perceptions by providing tremendous value through compassionate service.
Check out www.ncfreeclinics.org to learn more and to find the free clinic nearest you. Whether you need health care services or are able to volunteer your time, free clinics are an important part of local communities throughout North Carolina and we invite you to get involved.
Support the work of free clinics simply by viewing and sharing their Inspired story.
Guest post courtesy of family physician to be, Brian Moore
My earliest memory of medicine is my family doctor making a house call at 10:00 PM on a Sunday night to treat my ear infection. I remember waking up with intense pain, but knowing that everything would be okay after the doctor arrived (and after the brief discomfort of the otoscopic exam). Only years later did I realize what a rarity house calls were, and appreciate my family doctor’s amazing dedication to patient care. Having now performed such exams on many children, I also realize that not every child has such insight.
As I grew older, my family doctor was always available both as a physician and a friend, answering all my questions and making me feel as if I were his only patient. My inquiries eventually turned from my symptoms to the medical field itself. He told me that each day brought new challenges and opportunities for learning. With each passing year, my desire to pursue a career in medicine intensified.
As a result, when I first came to medical school at the University of North Carolina, I was already strongly considering a career in family medicine. This commitment grew as I became a part of the school’s Family Medicine Interest Group, had the opportunity to attend the NC Academy of Family Physician’s (NCAFP) Annual meeting, and later discovered the Family Medicine Interest & Scholars Program supported by the BCBSNC Foundation and the NCAFP Foundation.
This program has truly been a blessing. It has allowed me to become deeply involved in family medicine through clinical work with my master preceptor and attendance at national and statewide convenings. The time which I spent with my master preceptor, observing her and practicing diagnostic reasoning and physical exams, has helped me to become a better medical student and will make me a better physician in the future. As a result of this program, I have also attended the AAFP National Conference of Family Medicine Residents and Medical Students, the AAFP Scientific Assembly and Congress of Delegates, and additional NCAFP Annual Meetings. With each of these opportunities, I have learned from expert clinicians, and connected with other students enthusiastic about family medicine, including my now-fiancée.
Family medicine is my passion, with its breadth, commitment to patients, and necessity for constant learning. I am proud to follow the footsteps of my family doctor into this field. And, hopefully I too will inspire my patients to pursue careers in the field of family medicine.
Inspired to learn more about family medicine, click here.
Guest post courtesy of the Appalachian Sustainable Agriculture Project
ASAP is inspired. We’re inspired by the efforts of the many great organizations featured here, and by all of you who have shown support for our work. We’re also deeply inspired by our partners. This campaign has given us the opportunity to reflect back on the pilot portion of our Farm to School Education Project in Jackson County, which is discussed in our video and was funded through the generous support of the Blue Cross and Blue Shield of North Carolina Foundation. The Inspired campaign led us to ask, “Where would our project be now without the BCBSNC Foundation and without the partners who jumped on board with us—no questions asked (well, hardly any!)—right from the start?”
There is no road map when it comes to integrating Farm to School into education and health science courses of study. Yet professors, teachers, faculty, and students at Western Carolina University and Jackson County Public Schools embraced our idea of working “upstream,” training pre-service students and nutritionists in Farm to School programming so they could incorporate the methods from day one of their careers. These partners have offered vital assistance, support, insight, and guidance along the way. They have embraced this approach and are now fully engaged in spreading the benefits of Farm to School. Their enthusiasm is affirming, and they certainly deserve a big thanks from us.
Sarah Malcolm, who participated in the pilot as a Western Carolina University student and who is interviewed for our Inspired story, recently shared with us that she feels the Farm to School portfolio she created helped her secure her first teaching job.
Again, this is wonderfully affirming. What’s more, the success means we get to continue this exciting work! We get to continue working with Western Carolina University and Jackson County Public Schools, to continue learning from them. And, we get to begin another project—one which has grown from the seed of our pilot project to a full-fledged new approach. Currently, schools throughout our region are submitting their proposals to receive funding to become Growing Minds Schools—schools just like those in Jackson County, where Farm to School is front-and-center in the classroom and cafeteria. We can’t wait!
If you’ve not watched our Inspired video, we hope you will, and that you’ll share our story with others. To learn more about this work and our new project, visit www.growing-minds.org, and follow ASAP on Facebook (Appalachian Sustainable Agriculture Project) and Twitter (asapconnections).
Not quite a Hollywood soundstage, inspiration was captured at make-shift sets across the state. Here, the Kids in Parks story shines under the bright lights as Blue Ridge Parkway Foundation CEO, Carolyn Ward tells of their great work.
Guest post courtesy of J. Carson Rounds, MD: President of the North Carolina Academy of Family Physicians Foundation 
