Change-induced anhedonia

So, the Singing Pen has been struggling to get motivated lately.  Despite Larry Bauer's excellent guest post nearly two weeks ago, I just can't seem to get a post beyond a few sentences these days.  I am beginning to see that my disinterest with academic and family medicine topics is due to an overriding issue that, until now, it has not been appropriate for me to broadly share.

I have announced my resignation at my current position, as my husband and I will be moving out-of-state in September.  The decision to leave - and choosing new jobs - has been an agonizing process for us.

I've always been an efficient and energetic worker, but lately I am finding myself distractable and fidgety.  Keeping my focus to precept or teach is a chore.  I have little interest in following Twitter.  I've barely posted on Facebook and am isolating myself from my friends.

I am experiencing both grief and anxiety.  Grief for what will be lost, anxiety for what is to come.  I am already mourning the loss of day-to-day interactions with colleagues, learners, and staff here.  I worry if I will I fit in at this new place.  I don't want to start over again building relationships.

To be fair, I am also excited about our future.  I genuinely enjoyed meeting my future colleagues, who are an amazing and inspiring group.  It'll be fun to house hunt again.  The city is beautiful and the right size - with the right amount to do - for us.  We will be much closer to our families, whom we've both been feeling the pull to be closer to lately.  I am confident that the decision to relocate is the right one for us.

But this place, where I survived residency, conquered fellowship, and took my first fledgling attending steps, feels like home to me.  With the perspective of the interview trail behind me, I see now that my identity has been too tightly enmeshed with my current position.  My self-view is dominated by this program and the work that I do here.  Perhaps I have cared too much, been too invested in this place.  Regardless, the time has clearly come for me to leave the nest.

I just wish that I wasn't afraid to fly.

GUEST POST: The Founders of Family Medicine

Larry Bauer, the CEO of the Family Medicine Education Consortium, distributed this essay to the FMEC Board (full disclosure: I am a member-at-large on the board) and others in his network earlier in the week.  The founders of Family Medicine dreamed big; more than just creating another specialty, they wanted to fundamentally change how medicine is practiced.

He has graciously granted me permission to share his essay here.  I'll share my thoughts in a follow-up post.

Courtesy of Larry Bauer, MSW, MEd:

The Dreams of the Founders of Family Medicine

As Family Practice emerged from the field of General Practice, it is important to realize that many in and out of medicine told the founders they would not succeed. The cynics believed that the dominant forces in medicine were too entrenched and there were too many societal forces working against the idea of a generalist renaissance in medicine. “Real” medicine of the future aspired to something more worthy. Real medicine involved care of hospitalized patients and was informed by the scientific and technological advances associated with sub-specialty medicine. Anyone could care for the people “out there”. But the founders dreamed big, bold dreams; they were a determined and visionary group.

They dreamed of a cadre of talented and competent Family Physicians that would serve the people in all the communities of our nation. The rich, the poor and all in between in rural, urban and suburban communities; all needed access to a Family Physician. They believed that the practitioners in this specialty would focus on the needs of their patients and communities and would protect people from the medical industrial complex as much as possible

They dreamed that a new academic specialty would emerge whose core would focus on issues surrounding patient management and the care of the whole person in their community.  They believed that medical education was moribund and harmful and in need of a compassionate and thoughtful revitalization.

For the founders, the biomedical model was inadequate. They believed that it is not possible to be effective as a physician without understanding the contextual issues that influence a person’s life. The biopsychosocial model, the power inherent in relationships and the abilities and skills involved in creating facilitative relationships needed to be integrated into medical education, practice and scholarship.

They believed that medicine was a profession that involved more than a technical set of skills and a high income. They accepted the responsibility of caring for the whole person; mind, body and soul.

They believed that the practice of medicine required team work among the medical and helping professionals and that the patient was to be an active partner in the care process. In fact, it is the patient’s goals and agendas that drive the healing process. 

They believed that lifelong learning and the need to continuously upgrade one’s knowledge and skills was critical to the practice of medicine.

They dreamed of generations of leaders who would rise to take their places and extend their efforts.

They believed that Family Medicine was more than another group of medical practitioners. Family Medicine should serve a transformative agenda that changed the academic medical centers and health systems so that they would better serve the people and communities.

They were willing to bring other generalist colleagues to their ranks. They respected the pediatricians especially who wanted to contribute to Family Medicine’s early development. They sought a relationship with psychiatry and mental health professionals. They had a comfortable relationship with the general surgeons and all their colleagues who respected the value of a generalist practitioner.

Shout out to my "tweeps"

So, the Singing Pen is returned from my trip to the Society of Teachers of Family Medicine annual meeting in New Orleans last week. 

This particular STFM meeting felt very different to me than the others I've attended in the past, and I have to credit Twitter.  The social media "tweeps" there live-tweeted a lot of the conference, which as a relative newbie on Twitter I had never experienced before.

It was just incredibly cool!  By following the #STFM hashtag, I picked up all kinds of great ideas from sessions I didn't even attend.  I also got a kick out of contributing live tweets from the sessions I was attending; in one session, someone tweeted me a question in response.  I approached the presenter at the end of the session to find out the answer for him.

After introducing myself, I stated that I had been live-tweeting her session and that someone had tweeted me a question to ask.  The presenter very kindly provided an answer (which I tweeted back out) and then said, "that's a new one for me!"  She had never been asked a question about her presentation by someone not physically in the audience before.

Now, lest you cry out in horror "how did you ever pay attention and tweet at the same time?," let me reassure you.  Tweeting during the sessions was basically like taking notes, except that I was sending out my notes, real time, to people not at the session (and even not at the conference).  I can access everything I typed out easily, and so I have a record of all of the ideas - and my responses to them - from every session I attended.  Plus I have the ideas - and responses - of every other session live-tweeted there by others.

Conferences will never be the same for me again.  When I was responsible for sharing the content I was hearing about, I became much more mentally engaged with the presentations I was attending.  The constant Twitter hum of dialogue about goings-on made me feel much more connected to the conference as a whole.

And, last but far from least, this introvert also crept out of her shell and met some of the folks I follow on Twitter who were there.  They are an amazing, thoughtful, and fun group that I am now privileged to know both in person and in the Twitterverse.

Looking for a way to get more plugged into your next conference?  Tweet away!

(For a great wrap-up of the STFM Annual Meeting, check out Dr. Mike Sevilla's Family Medicine Rocks blog: http://www.familymedicinerocks.com/family-medicine-rocks-blog/).

Making the most out of conferences

Last week, I ranted a bit about the imperfect conditions of most conference settings.  Today, I'd like to suggest ways around some of those issues; I'll also throw in some general tips about how to have a great conference experience.

1. Dress for success
Presenting at your conference?  Pack a suit or other professional clothing.  You want to look like a pro, so be sure to bring along that suit or outfit that makes you feel like a presenting rock star.

For the non-presenting times, typically business casual will do.  Conferences are networking opportunities, and I wouldn't want to meet a potential future employer or colleague while looking super-casual.  Remember, first impressions are powerful!

In addition, indoor conference sites are usually super-air-conditioned, so be sure to dress in layers, especially if your conference venue is in a warm place.

2. Ask for a low floor
When reserving your hotel room, ask for a low floor.  In my experience, you will typically get the floor or two right above the conference center, which will make moving back and forth between conference and your room an elevator-less experience.  In a bigger hotel, you may still need the elevator, but you'll be the first off and the last on, leading to a much shorter ride.

3. Get creative with space
Empty/unused conference rooms make great, quiet workspaces.  If there's nothing going on in the evening or early morning in the smaller conference rooms, I will sometimes hunker down in one and get a little work done.

4. Bring your business cards - and keep 'em on you at all times.  Make sure that they have your e-mail, Twitter name, Facebook page, Linked In profile, and/or whatever else you want on them.

5. Pack with organization
Packing cubes, collapsible shelves - there are all kinds of nifty packing systems out there that help to keep your things organized and relatively unwrinkled.

6. Plan each day the night before
Which sessions will you attend?  If you're presenting, when will you head over to set up?  When might be a good time to take a break (and you'll probably need one at some point)?  Tap into your experienced colleagues, too, about which presenters are a "don't miss."

7. Don't ask, don't get
I learned this phrase at the conference I was just at, and it will stick with me.  Don't be afraid to ask for free internet or fitness center access - if you ask nicely, you may be surprised how often you will get it!  One of the attendees that I met last week asked for free internet at this hotel, was initially told "no," asked again nicely, and then they capitulated.

Please feel free to comment on your own experiences, and happy conference-ing!