Healthcare reform is about lives, not just politics
The Sacramento Bee

It’s hard to say which of the things transpiring in a Sacramento Charter High School classroom last week was more unusual: teenagers taking a sonogram of Dr. Charlene Hauser’s unborn child or family medicine doctors getting a chance to be the stars of the medical profession.

The session was part of Future Faces of Family Medicine, a program started last school year by family medicine residents at UC Davis and Sutter Health, along with the California Academy of Family Physicians, to recruit more youths – especially those from low-income and ethnic minority backgrounds – into their often-unsung profession.

California and the United States face a shortage of primary care doctors that threatens to get worse. The CAFP expects as many as 30 percent of California family physicians to retire within the next few years, and for the state’s deficit to reach 17,000 doctors by 2015.

As more people become insured – a change California has pledged to make even if the U.S. Supreme Court strikes down the federal health care law – those dwindling ranks of doctors will become only more strained.

“A lot of people don’t even understand what primary care is and don’t understand the value of it,” said Randi Sokol, a UC Davis resident and co-founder of the program. “By the time people get into medical school, a lot of their minds are already made up.”

Yet recruitment efforts rarely start as young as high school.

Last Thursday’s class began with a graphic video of childbirth (which the kids uniformly declared the best possible form of birth control). Then Sokol demonstrated delivering a baby using a peach-colored plastic infant and a model of a woman’s midsection.

Louis Macklin, a junior, crinkled his nose and looked away when Sokol demonstrated inserting her fingers into the plastic vagina to check the cervix. But his classmate Aurea Colston, a sophomore, sprang up to try a delivery herself.
Next, Hauser, a UC Davis resident more than eight months pregnant, told students the elements of a routine prenatal checkup. Then she gamely laid down on a classroom table, hiked her shirt above her belly, and invited the teens to press and feel her baby’s foot. Even Macklin dared.

Macklin squirted medical gel onto Hauser’s belly and moved a plastic wand across it to find the fetus’s heartbeat. The muffled thump-thump came out over a small, crackly speaker, a rapid 156 beats per minute, like club music carrying across the classroom.

When the bell rang at the end of the school day, no one in the Future Faces class rushed to leave.

The four-month program includes eight sessions, where its 20 students learn to perform a physical exam and gain CPR certification. At the end of the program, they are matched with family doctors who serve as long-term mentors.
It costs very little to run the program. Residents volunteer their time. Hospitals have given space. The CAFP Foundation covers the $2,000 or so in direct costs per semester.

The Sacramento High staff helped identify students who are likely to benefit from the program. While just 25 teens applied for the 20 slots in the first year, this year the applications jumped to 40.

“It’s been pretty fun,” said Zemeka Ware-Smith, a junior from Meadowview, who now sees the difficulty of practicing family medicine and is considering psychology instead.

“You have to deal with people being sick and angry and irritable, to their life being in your hands,” she said. “That’s crazy, it having to be your decision and what you know determining if someone lives or dies.”

Taylor Mitchell, a junior from Natomas, said she still wants to be a plastic surgeon or neurologist, as she has since third grade, but the program has made a big impact on her.

“Our CPR training was the biggest thing,” she said, “because I’ve never really thought that I, being a 17-year-old kid from Sacramento, could be in a position to save somebody’s life.”

CAFP plans to follow Future Faces graduates for years, to see which careers they choose.

“There’s a lot of work that needs to be done” to make up the gaps in family medicine, said Callie Langton, executive director of the CAFP Foundation.

“But programs like that can go a long way to helping students who are interested in helping others to say, ‘I can go to medical school, I can be the first in my family to go to college, and then I can come back and help my community.’ These initiatives are really about helping the community to grow their own.”