In early 2022, the ADFM membership began a robust listserv discussion about the incredible and varied ways that departments of family medicine responded during earlier stages of the COVID-19 pandemic. These stories were powerful, poignant, and highlighted the incredible resourcefulness of our members, as well as their commitment to their patients and communities.
“Unsurprisingly, well-resourced communities and health care systems are experiencing better outcomes than under-resourced ones during the pandemic,” says Erik Brodt, MD, center director and assistant professor of family medicine, Oregon Health & Science University School of Medicine. “The Indian Health Service operates with funding of approximately $4,000 per capita, while the national average is approximately $10,000 per capita. The burden of COVID-19 on Indian Country will likely be grave.”
In a broken system of care delivery and with a lacking public health infrastructure, family medicine departments and residency programs stepped in. They provided front line care without appropriate personal protective equipment (PPE); they stood up testing tents, sometimes the only one in town; worked in makeshift intensive care units in parking garages; and went into the community to provide vaccinations to hard-to-reach populations, all while continuing their educational mission, teaching students in new and creative ways,1 and researching the impacts of the virus and its long-term consequences.
“With the onset of COVID a lot of schools were going virtual, and places for students to get hours were closing,” noted Joe Crozier, executive director of North Alabama AHEC. “At the same time, we were setting up COVID testing sites in our rural areas and decided to offer the opportunity to our scholars in North Alabama.”
Working primarily in precepting with the McLaren Flint Family Medicine Residency Program in Flint, Michigan, Dr Paul Lazar felt the initial surge at the nursing home where his residents would normally come in for 5 mornings a week. That ended with COVID. He explains, “We had a major outbreak…plum scary…more than 10 of my patients either died or were hospitalized…many came back with serious problems…couldn’t send the patients out to specialists… taking care of problems we had never faced before.” He acknowledges that COVID accelerated the critical care knowledge and skill of the residency program. Many of the residents volunteered to attend in the critical care units at the hospital.
We were inspired by these stories and the examples of wide ranging and critical roles departments have in caring for patients and communities. These stories are crucial to the bigger story of the role of family medicine and primary care in the early days of the COVID-19 pandemic, and we believe that future generations need to have access to these stories to remember the bravery, fortitude, and resourcefulness of our colleagues.
“The family medicine residents worked hard, harder than any of us could possibly imagine. They were assigned (and even volunteered) for extra hospital shifts and a few helped staff the ICU. Initially, there was a lot of fear about seeing hospitalized COVID patients, but one of our chief residents rallied the team by drawing parallels to the beginning of the HIV epidemic. We refused to be those doctors who turned their backs on people in need. This wasn’t just part of the job, it’s who we are … it’s our mission and our values.” - (Dr Elisabeth Wilson, Maine Medical Center Family Medicine Pandemic Contributions)
In order to capture and save these stories so they can be shared, referenced, and remembered, ADFM partnered with the Center for the History of Family Medicine (CHFM) to create an archive. The Center for the History of Family Medicine understood the importance of capturing this time in family medicine’s history. The Center then set up an exhibit page on its website with all of the submitted stories to share the archive. Access these stories to learn more here: Family Medicine Departments and Residencies Response to COVID-19 (aafpfoundation.org).
This archive is open for continued contributions; it is a gift to the discipline to have a robust account of the work you all did and the difference it made, particularly in the early days of the COVID pandemic! If you already have something written that you could share, if you would like to provide an oral interview, or if you would like some writing prompts to help you write your or your department’s story, please submit at this form: https://aafp.secure-platform.com/a/solicitations/261/home.
- © 2023 Annals of Family Medicine, Inc.
REFERENCES
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