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Articles / 2009

The Art of Medicine
Hospital promotes careers as community doctors

Ventura County Star
Wednesday, 07/27/2009

She saw life, death and pretty much everything in between.

As part of a program designed to show medical students what it means to be a community doctor, Susan Slater watched a mother give birth in a room crowded with family members. She stood with a physician who told a family their loved one was dying, presenting the news matter of factly but knowing when to offer comfort.

After four weeks, the 37-year-old former insurance agent came away thinking that in a day when medicine can seem sterile and impersonal, when healthcare faces pressures never seen before, her goal is still reachable.

She can be a doctor who knows when to be a medical interpreter for her patients and when to empathize. She can be there when miracles happen and when they don’t.

“It makes me feel very privileged,” Slater said. “As a doctor you get to the people at the best and at the worst.”

Seeing the personal side of medicine

The students learning how to be doctors included a poker player, a drum major and a woman from Vassar. There were six of them, just out of their first and most difficult year at USC’s Keck School of Medicine

They spent four weeks shadowing doctors as Community Memorial Hospital in Ventura in a program that ended Friday. They learned about bedside manner, developing relationships with patients and the difference between the science of medicine and the art of being a doctor

“Medicine is personal,” said Dr. Jim Hornstein, the Ventura family practice doctor who started the training program last year. “At the end of the day, you want to treat patients like you want your mother treated, or your sister or your best friend

The Importance of five minute

Jorge Flores grew up in South Central Los Angeles. As an undergraduate at UCLA, he helped cover his personal expenses through winnings from Texas Hold ‘em. Like other students, his first year at medical school made him feel like a sponge trying to soak up seas of knowledge

“You begin to really feel the pressure,” he said

As Community Memorial, the students rotated through the maternity ward, the emergency room and rooms of patients whose health conditions are still unsolved mysteries, like the woman with the infection that may or may not have involved her pacemaker.

Flores talks most about a family practice doctor who has known some of his patients all their lives. The doctor spent five extra minutes with each one, swapping stories, asking about their families and learning about things that affect their health.

That’s who Flores wants to be.

“It’s amazing what you can do in five minutes,” he said. “I want to be the guy the patients turn to because they trust you.”

Dealing with everything

In some programs, medical school students spend all their time shadowing one doctor. The Ventura County Medical Center has a nationally known family practice residency program for doctors who have just graduated from medical school. The hospital also has training programs for student sin their third and fourth year of medical school.

The Community Memorial program focuses on students who have just begun medical school and don’t know whether they want to be family doctors or heart surgeons. The students work with 60 different doctors over four weeks and also listen to lectures on everything from medical malpractice to the ethical hot buttons of abortion and physician-assisted suicide.

One of the goals is for students to think about becoming primary care doctors, where shortages jeopardize patient care, said Erin Quinn, associate deal for admissions and educational affairs at the Keck School of Medicine.

The program’s concept emerged a year ago when medical school student Josh Hornstein asked his father if there was a way he and a few of his friends could spend the summer learning about medicine at Community Memorial. Jim Hornstein, a longtime family physician, saw a chance to start a program that focused on being a doctor, not just practicing medicine.

He wants the students to see what their lives will be like as doctors, working not in university-based hospitals that focus on transplants and exotic diseases but in community hospitals that deal with a little bit of everything. He wants them to consider careers not just as primary care doctors but as specialists and surgeons.

He wants the students to think about more than medicine. They met with doctors who volunteer in everything from protests over the war in Iraq to local theater groups.

“We’re part of this community and that’s what we’re trying to teach the students,” Hornstein said.

A flat line

The heart stopped beating, the monitor showing a little line as flat as a tabletop as surgeons replaced the mitral valve. A bypass machine kept the blood bumping and the patient alive as the doctors worked.

Michelle Munoz watched it all, her eyes wide.

“I was in awe,” she said. “Sometimes you can’t just wrap your head about it. It’s amazing what we can do to save people’s lives.”

Munoz is 24 and grew up in Oxnard, the first in her family to go to college. Now she’s in medical school and wants to be a family practice doctor, maybe returning to Ventura County to care for poor people.

The students talk about being able to see their future, watching doctors care for patients and envisioning doing the same thing. Slater may have taken the longest route to get there.

A native of Ventura, she worked in an HIV prevention program and then spent six years selling insurance with her mother. She went back to school and became a 30-something student, pursuing medicine because of the challenge and the chance to be part of her patients’ lives.

She met with doctors who did a little bit of everything, from delivering babies to treating flu symptoms to assisting surgeons in the operating room. That, she thinks, is her path.

She wants to be an old-time family doctor who will go anywhere she’s needed with only one caveat:

That “there is a Nordstrom’s within driving distance.”

By Tom Kisken