Program Offers Chance to Learn from Field's Best

Abstract

DR. KAISER is a fellow in the Harvard/Beth Israel Deaconess Medical Center geriatrics program. He interviewed fellow Futures participants for this article. With topics ranging from the utterly optimistic (“It's ALL Possible”) through the more practical (“Risk Management”) to straight nuts and bolts (“A Day in the Life of a Medical Director”), the 2009 AMDA Futures Program showcased the real-world practice of medicine in long-term care. The recipients of all that information and more were geriatric medicine fellows and residents from around the country. Several participants said the Futures Program introduced important concepts that they had not been exposed to in their geriatrics training. For instance, Joshua Uy, MD, a geriatric fellow at the Robert Wood Johnson Medical School, Piscataway, N.J., said the program revealed a perspective from faculty members that was “passionate not just about medical knowledge but also its real-world application.” Dr. Uy explained, “What makes [the Futures Program] different than the fellowship is that, while others might teach medical knowledge and tolerate having to deal with the regulations and organizational issues, the physicians at AMDA seem to see it all as an opportunity to improve patient care and make big changes.” For Romin Shah, MD, of the University of Miami geriatrics fellowship program, the experience gave him an appreciation for the scope of responsibilities of a medical director. “With each session, I gained a whole new level of respect for what it means to be a medical director and for all of the responsibilities it entails,” he said. Impressed by the “many hats” the medical director must wear, Dr. Shah said that he learned that taking on that responsibility “could enhance my career, bringing interesting problems and exciting challenges to a day's work.” Dr. Shah and other participants commended the faculty for bringing a personal perspective to their presentations, distinguishing the content from something they might read on a Web site. Dr. Uy said he learned that today's medical directors are “thinking of the bigger picture but not afraid to dive in and get their hands dirty.” He explained, “Whether it means working with the administrators, developing protocols, educating the staff, playing detective … helping our long-term care patients means having a ‘whatever-it-takes’ attitude.” For many of the participants, the Futures Program served as a welcome introduction to AMDA as a professional organization. The consensus among the group was clear: Involvement in this organization would be essential for physicians focused on caring for patients along the long-term care continuum. For Kathleen Unroe, MD, a geriatrics fellow at Duke University, Durham, N.C., the program went a long way toward addressing concerns she had about a career in long-term care. “I am dedicated to working with long-term care patients, but the regulatory environment and risk of litigation seem intimidating. The program offered practical approaches to managing these issues and provided role models who are enjoying rewarding careers in this field.” Other participants echoed these sentiments, commenting that the Futures presenters addressed challenges of long-term care while remaining enthusiastic. Many in the Futures class said they intend to become more involved in AMDA, and they applauded the course for providing the framework to do so. As the program adjourned, TV monitors tuned to coverage of the March 5 “White House Forum on Health Reform” served to remind everyone of the challenges facing physicians dedicated to caring for vulnerable patients. This year's Futures participants arrived knowing the uncertainty of embarking upon a career in a health care system on the threshold of change during tough economic times. Nevertheless, the program revealed the virtues of a career in long-term care, the exciting challenges inherent in the role of the medical director, and the strengths of AMDA. Said Dr. Shah, “One of many great aspects of the AMDA Futures Program was the opportunity to meet colleagues and mentors from all over the country.” Reflecting on opportunities to meet AMDA leaders and other long-term care experts, he added, “Sitting face to face with the leaders of today—true innovators and pioneers—I looked around the room and felt inspired by what we, the leaders of future, might bring to the table.”