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Oregon Governor's Newsletter November 2020
In this Issue:
- Fostering Excellence In Internal Medicine 2020
- NO PLACE LIKE HOME: HEALTHCARE AND THE HOMELESS
- OREGON ACP ADVOCACY DAY 2021
- THIEVES’ MARKET
- COMPETITION 2020 – VIRTUAL
- CHAPTER SOCIAL MEDIA – TWITTER and FACEBOOK
- VACCINES - Virtual Event
- FUNDRAISER FOR BOOST OREGON
- My Kind of Medicine: Real Lives of Practicing Internists:
- A Unique Perspective On Treating Patients With Chronic Diseases
- My Kind of Medicine: IM Family:
Marianne C. Parshley, MD, MACP, ACP Governor
Fostering Excellence In Internal Medicine 2020
ANNUAL SCIENTIFIC MEETING
November 6-7, 2020 / “VIRTUAL” – Two Half Day Mornings
EARN 7.25 CME & MOC
The Oregon Chapter ACP Annual Meeting is a rich source of knowledge content. Target audience includes general internists, subspecialty internists, hospitalists, family practitioners, residents,
medical students, and other professional health care professionals.
HIGHLIGHTS INCLUDE EDUCATIONAL TOPICS and STORY SLAM
Leveraging Diversity & Inclusion To Improve Outcomes – Eileen Barrett, MD, MPH, FACP, SFHM
Women's Health-VT & Anticoagulation – Bethany Samuelson-Bannow, MD
Modern Day Medicine-Meets Modern Day Learning: Smartphone Resource – R. Logan Jones, MD
Approach To Behavioral Disturbance In Dementia – Marian Hodges, MD, MPH, FACP
Things We Do For No Reason – Adam Obley, MD, FACP
Outpatient Medicine Updates – Leonard Mankin, MD, FACP
Current Challenges In Diabetes & Case-Based Discussion – Elizabeth Stephens, MD, FACP
Updates In Hospital Medicine 2020 – Kevin Breger, MD, PhD, FACP, SFHM
You Are Pretty Resilient-You Deserve A Workplace That Supports - Eileen Barrett, MD, MPH, FACP, SFHM
Reg Fee: $150.00. Students, Residents, & Fellows: $0.
PLEASE REGISTER BY MIDNIGHT, TUES, NOV 3rd.
Participants will be able to – Apply updated knowledge of IM to clinical practice. Understand recent advances in IM. Develop knowledge and skills in spotlighting best practices in inclusion and equity. Understand the significance of behavioral disturbance in persons with dementia. Discover electronic resources for asynchronous learning & clinical practice. Review management of estrogen-associated venous thromboembolism. Describe patient experiences with diabetes management: technology, refill issues, monitoring reality, insulins.
Friday-Post Meeting: Thieves Market / Saturday-Pre Meeting: Women's Networking Session (no cme) - (separate registration will be sent for these two events)
NO PLACE LIKE HOME: HEALTHCARE AND THE HOMELESS
This virtual event was held Wednesday – October 7, 2020
VIEW THIS PRESENTATION RECORDING AND EARN 1.5 CME.
Much thanks to our special speakers:
Lori Kelley, MPH-Health Manager Social Determinants – Oregon Health Authority
Sharon Meieran, MD, JD-Emergency Medicine Physicians/Multnomah Cty Commissioner, District 1 – OR
Rachel Solotaroff, MD-Internal Medicine Physician/President/CEO – Central City Concern
Michael Bower, MD, FACP-Internal Medicine Physician/Retired/ Member-Portland Street Medicine.
VIEW – EVALUATE - CLAIM CME:
The ACP designates this other activity (live component and enduring component) for a maximum 1.5 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. The American College of Physicians (ACP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Go to the News & Meeting section on the Oregon Chapter webpage and follow the prompts.
View the presentation. Complete the Evaluation. Claim 1.5 hours CME:
MORE INFORMATION TOPICS AND MORE:
For more information about topics covered at our meeting, and more, please visit
ACP's Online Learning Center: www.acponline.org/cme-moc/online-learning-center
OREGON ACP ADVOCACY DAY 2021
SAVE THE DATE
During February 2021, Oregon Chapter ACP will hold its 2nd Annual State Legislative Advocacy Day (either in Salem, or virtual). “Oregon ACP Advocacy Day 2020” drew more than 60 members, including more than 40 resident and student members, for a day of advocacy skills training and legislative action. The Oregon ACP Health and Public Policy (HPP) Committee sponsored the event.
Join more than 15,000 colleagues in the Advocates for Internal Medicine Network (AIMn) in advocating for the interests of internal medicine in Washington, D.C. The AIMn program is for ACP members interested in participating in federal advocacy. It is designed to help members engage with their federal lawmakers on policy issues important to ACP and internal medicine.
Follow @AdvocatesIM https://www.acponline.org/advocacy/advocates-for-internal-medicine-network
Will You Be The First To Make The Diagnosis???
Please join Oregon Chapter ACP on Friday, November 6, 2020, 12:15pm–1:45pm,
Just following the Chapter Meeting
Education and FUN!! Cases presented in fun and interactive session.
This is a separate event from the Chapter Meeting (separate registration for both)
Our Hosts Will Be:
ALEXANDER SCHAFIR, MD, FACP – Oregon Chapter
DAVID SCRASE, MD, MACP – New Mexico Chapter
REGISTER HERE – THIEVES’ MARKET - NO COST:
You are invited to a Zoom meeting. When: November 6, 2020 12:00 PM Pacific Time (US and Canada)
Register in advance for this meeting:
After registering for Thieves' Market, you'll receive confirmation with information to join the meeting.
Poll Everywhere Will Be Used In This Session - Choose 1 of 3 ways to participate:
- Web Browser: Go To www.pollev.com Enter: davidscrasem571.
- Text: To: 22333 / davidscrasem571.
- Download App: From iTunes and Google Play.
COMPETITION 2020 – VIRTUAL
Showcasing Oregon's Resident & Medical Student Scholarly Activities
NOVEMBER 19, 2020
6:45pm – 9:00pm
Mark your calendar – watch for our official invite – join Chapter Members, Friends, Colleagues – for our evening of oral presentations from Resident Members.
Poster Winners from all categories, for both Residents & Medical Students will be announced. We'll send a formal Zoom Invite to all Chapter members.
Abstracts include categories: Clinical Vignette / Quality Improvement-Patient Safety / High Value Cost Conscious Care / Research-Basic / Research-Clinical.
Oral Presentations include category of Clinical Vignette.
POSTER JUDGING: Judging will be performed entirely online! Poster presenters have prepared “Voice-Over PPT”, to view and judge. We'll provide instructions to access online, your assigned number of posters to judge–approx 8-12 posters–each approx 3-5 minutes—approx 1.5–2 hours time committment. Judging will take place between November 9-13.
ORAL PRESENTATIONS COMPETITION: Judging will take place on November 19th, evening event, live, online. Presenters are giving their oral presentations—live. You will tune in and judge—live.
THINGS TO CONSIDER: **Normally–we do NOT allow faculty associated with any Residency Program to judge any Resident Posters—–however—in these virtual times—-we need a ton of Judges—so PLEASE even if associated with a residency training program—we encourage you to be a Judge this year. **Judging Chapter posters/orals—-is a great thing to add to your CV!!
Oregon Chapter American College of Physicians
Endorses Measures 108 & 110
The Oregon Chapter American College of Physicians is pleased to announce our official endorsement of health-related Oregon ballot measures 108 and 110, which will appear on the ballot in November.
In spite of the progress that has been made in the last few decades, tobacco use remains the leading preventable cause of death in the United States and the harms of electronic inhalant delivery systems have become increasingly apparent. In addition to the human costs, the financial impact of tobacco-related illness and death in the United States is enormous—over $300 billion each year according to the Centers for Disease Control and Prevention. Because of this, we support Measure 108 which would increase the cost of tobacco and vaping products in Oregon. ACP policy has long supported the use of tobacco excise taxes as an effective tool for reducing tobacco and vaping related harms, and this approach is particularly effective in preventing young people from starting to smoke or vape. In addition, the revenues generated through Measure 108 would be used to help shore up the funding for state health care programs like Medicaid. Because of its combined public health and health care financing benefits, we encourage a YES vote on Measure 108.
As internists, we have the privilege and duty to treat people with a wide variety of illnesses, including patients with substance use disorders. We see first-hand the consequences of our fraying social safety net and broken legal system on our patients, families, and communities. Measure 110 offers a path forward toward evidence-based, treatment-focused, and compassionate care of people with substance use disorder in our state, and we are proud to join hundreds of other clinicians and health care organizations in supporting this initiative.
Measure 110 contains two major components that are essential to bringing about a new era of addiction treatment in Oregon. First, it decriminalizes individual possession of small amounts of Schedule I drugs (sale, distribution, or possession of large amounts would remain illegal), thus sparing many people with substance use disorder the added harms of incarceration. People who are jailed for drug use experience higher rates of Hepatitis C and HIV, greater discrimination in the housing and job sectors, and increased risk for fatal overdose and return to high-risk substance use upon release. Second, Measure 110 uses existing Marijuana Tax Revenue to establish 24/7 access to multidisciplinary addiction care in each coordinated care service area in Oregon. With current projections, this will triple the amount of state funds allocated to fighting the substance use disorder epidemic that plagues our state. These funds will be allocated through an oversight committee and will include addiction resources, housing, medical treatment, counseling services, and peer support.
Oregon, its physicians, and ACP have a long history of tackling the tough issues on behalf of our patients and our communities. Oregon ACP encourages a YES vote Measure 110 to show our state and our nation that there exists a more humane, evidence-based, and effective way to treat addiction.
CHAPTER SOCIAL MEDIA – TWITTER and FACEBOOK
TWITTER: @OregonACP (http://twitter.com/OregonACP)
Twitter for chapter related news, including highlights of policy and advocacy work at the National ACP level, as well as photos of chapter activities and news about chapter members.
VACCINES - Virtual Event
Raising Vaccination Rates
In A Climate Of Vaccine-Hesitancy
Presented by Gretchen LaSalle, MD, FAAFP
Author of “Let's Talk Vaccines”
January 13, 2021 - VIRTUAL
Earn 1.0 CME
The American College of Physicians is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The American College of Physicians designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This Event Is Open To ACP Members and Non-Members
Watch for Formal ZOOM Invite!!
FUNDRAISER FOR BOOST OREGON
Our evening event will feature a fundraiser for BOOST OREGON!!!
UPCOMING EVENTS / MEETINGS / CONFERENCES
All Events, Meetings, & Conferences - Subject to Last-Minute Adjustments.
ACP - Oregon ACP – Chapter Annual Scientific Meeting
November 6-7, 2020. VIRTUAL. https://www.acponline.org/node/290333
ACP – Oregon ACP – Thieves' Market
November 6, 2020. VIRTUAL. 12:15pm (just following Chapter Meeting).
ACP – Oregon ACP – Competition – Showcase Residents & Medical Students Scholarly Work
November 19, 2020. VIRTUAL.
OHSU - Managing Autism And Other Developmental Disabilities: An Update For Primary Care
December 11, 2020. VIRTUAL. www.ohsu.edu/cme
ACP – Oregon ACP – Vaccines Event – With Gretchen LaSalle.
January 13, 2021. VIRTUAL.
OHSU – 52nd Annual Primary Care Review
February 8-12, 2021. VIRTUAL. www.ohsu.edu/cme
ACP – Oregon ACP - Advocacy 2021 Training Day
February 2021 (exact date TBD) – VIRTUAL.
OHSU – 5th Annual Mental Health Update: Strategies For Primary Care
March 5, 2021. VIRTUAL. www.ohsu.edu/cme
OHSU – 4th Annual Pediatric Mental Health Update
March 12, 2021. VIRTUAL. www.ohsu.edu/cme
ACP – Oregon ACP – Chapter Awards Celebration
March 2021 (exact date TBD). VIRTUAL.
ACP – National ACP – Internal Medicine Meeting
April 29-May 1, 2021. VIRTUAL. www.acponline.org
OHSU – Sommer Memorial Lectures / OHSU SOM Alumni Scientific Session
May 6-7, 2021. Multnomah Athletic Club – Portland, OR. www.ohsu.edu/cme
NATIONAL INTERNAL MEDICINE DAY!
October 28, 2020RS.
We apologize for sending this two days late—but please know that Oregon Chapter ACP values your membership in the College and we are proud that YOU represent internal medicine specialists and sub-specialists who are united by a commitment to excellence and who make a difference in the lives of their patients – every day!!
The National ACP designates the last Wednesday of every October as
NAITONAL INTERNAL MEDICINE DAY
Use the official hashtags in social media posts to spread the word about internal medicine pride, recognize a colleague, thank a mentor, or tell your story.
IN HONOR OF A FEW OF OUR CHAPTER MEMBERS – PLEASE READ ON FOR STORIES THAT WERE FEATURED IN THE NATIONAL ACP PUBLICATIONS.
My Kind of Medicine: Real Lives of Practicing Internists:
Sima S. Desai, MD, FACP
Growing up in a small town in New Mexico, Dr. Sima Desai remembers a local surgeon who had a remarkable impact on his patients and the community. Seeing how the surgeon gave back to the community exposed Dr. Desai to the giving nature of the medical profession. “When I first thought about being a physician I thought it would be a profession about doing things, rather than giving back, and it was the giving part of being a physician that really struck a chord with me and became my road to medicine.”
When entering medical school at the University of New Mexico, Dr. Desai was torn between choosing pediatrics and internal medicine. She was drawn towards internal medicine because of the mentors she had in medical school. “Often the mentors that you find and the kinds of people that you think you would be happiest sharing your professional life with play a major role in choosing your career path in medicine.” Medical school was a pivotal time in Dr. Desai's life. “I grew in a way that I had never grown before and I attribute that to my mentors and colleagues as well as my interactions with patients,” said Dr. Desai. She believes that students are in a very privileged place to interact with their patients. “It is those experiences as a student that allows you to say ‘Wow, I have the privilege to be part of this person's life and his or her health care.’”
Dr. Desai had many important mentors in medical school that helped her to evolve as a student. She was drawn to the idea of treating adults and the opportunity to have families involved in patient care. She found various similarities between other residents in internal medicine and herself and was excited at the thought that her peers would become her professional family. By her fourth year of medical school, she realized that her mentors had become her role models and she wanted to give back to the medical community in the same way that her mentors had done.
Leaving New Mexico was a hard decision for Dr. Desai but one she does not regret. Her mentor suggested that she interview for residency outside of New Mexico to gain a different perspective and suggested interviewing for an internal medicine residency program at the Oregon Health & Science University (OHSU) in Portland, Oregon.
During her interview, Dr. Desai had the opportunity to meet Dr. Tom Cooney, Program Director of the Internal Medicine Residency Program and a future mentor. After completing 14 different residency interviews Dr. Desai matched with the OHSU Internal Medicine Residency Program. “As I tell students now, you may think it is hard to imagine making a decision about the next three years of your life based on visiting a school for one day, but there is something to be said about trusting your intuition.” During medical school and residency, Dr. Desai had never seen herself as a teacher. Even now in her role as Program Director of the Internal Medicine Residency Program she feels that she has much to learn.
When Dr. Desai was a second-year resident, she was the leader of her residency team and enjoyed the aspects of teaching and working together in a team dynamic. Several of her mentors at OHSU encouraged Dr. Desai to apply for the chief resident position. After receiving the position, she began to develop an appreciation for being in a teaching environment that was both exciting and challenging.
After finishing her chief residency position, Dr. Desai and two of her colleagues were approached by Dr. Alan Hunter, a faculty member at OHSU, and asked to begin a program for hospitalists at OHSU. Dr. Hunter asked if Dr. Desai and her colleagues would like to be the inaugural faculty in the hospitalist program. “It was the opportunity of a lifetime, to be given salary support to be both a clinician and an educator.”
Several years later, Dr. Cooney approached her and asked if she would be interested in the position of Associate Program Director at OHSU. By this time Dr. Desai realized that the two things that she loved the most were taking care of patients and teaching and accepted Dr. Cooney's offer. “They continually challenge me to become better than I am,” said Dr. Desai of the students and residents she teaches.
Dr. Desai laughs that she could never see herself as the Program Director of the Internal Medicine Residency Program at OHSU but now has the unique privilege of sitting in the same office where her mentor Dr. Cooney once sat.
Dr. Desai took over the position of Internal Medicine Program Director after Dr. Cooney's 26-year tenure in the position. Dr. Desai faced the challenge of stepping into Dr. Cooney's shoes and making sure the legacy that he created at OHSU continues. Dr. Desai looks forward to leaving her own mark on the Internal Medicine Residency Program and believes she is in a position to improve the educational environment of internal medicine residency programs for residents. The experience for Dr. Desai has been both exciting and challenging; “In the end as an educator, what you really to strive for is to ensure that the residents that graduate from your program can be the very best at what they do because that's what patients and the public deserve.”
Dr. Desai balances her role as Internal Medicine Program Director and mother to her six-year-old son. “Maintaining life-work balance is a scale that tips back and forth for me. When I find I am spending more time at work, then I try to be conscious and actively self-reflect on what I should do to maintain as much equality in my life as possible.” She spends her free time participating in activities with her son such as basketball, baseball and Tae kwon do. In addition to spending time with her partner of 16 years and her son, Dr. Desai enjoys biking to work, hiking and cross-country skiing.
She credits her membership with ACP as another huge pivotal part of her life. As a young faculty member, Dr. Desai received the Walter J. McDonald Award for Young Physicians from ACP. As a result of receiving this award, she was given a chance to be part of ACP's Council of Young Physicians. “Being a part of ACP allowed me to evolve in my thinking and offered me a chance to meet extraordinary people who have made me a better leader and educator. If a position paper came through or policy went into effect, being part of the Council of Young Physicians gave me an opportunity for my voice to be heard.”
Throughout her leadership roles with ACP, Dr. Desai served as the Vice Chair and Chair of the Council of Young Physicians and was also an ex officio member of the Board of Regents. “ It was such a privilege to watch how a large group of physicians who can have very different opinions can come to a middle place and have an organized thought about our values and what we care about as internists.”
Dr. Desai continues her involvement with ACP at the local level with the ACP Oregon chapter and remains in contact with several of her mentors.
A Unique Perspective On Treating Patients With Chronic Diseases
Dr. Elizabeth Stephens, MD, FACP
Getting through residency is hard enough. It gets even more difficult when you're trying to manage your own chronic disease. Dr. Elizabeth Stephens developed Type 1 diabetes in her third year of medical school. “Residency was really difficult with the long hours, the intense patient interactions, the stress, and then also trying to stay well with diabetes. That was a really challenging time in my life, but when I came out of that I felt very proud that I didn't veer off course. I stayed, I finished on time and I went on straight ahead and did a fellowship. I felt pretty resilient that I made it through that,” she says.
She recalls an incident as a second-year resident when she was in the call room when two more residents entered the room. “They were talking about someone who'd been admitted and they were talking in a sort of an annoyed way about ‘that’ diabetic. They said things like, ‘if he would just stop, if he would just check his blood sugar, I wouldn't be admitting him at 2 in the morning.’ There was a lot of blame and a lot of shame and at the time I was just really shocked. “They just didn't get how hard it is and how much time it takes and how smart you have to be with all these components that go into managing chronic disease. It was that moment that I thought I might have something to offer in terms of perspective for people living with chronic disease. It was at that point that I committed to doing endocrinology,” says Dr. Stephens.
Solving Problems - I just really liked the problem solving of internal medicine. And I also really like the relationships that came with internal medicine. Dr. Stephens initially chose internal medicine because it appealed to her strengths in communication, working with people, and collaborating. “I just really liked the problem solving of internal medicine. And I also really like the relationships that came with internal medicine. In medical school, I thought I was going to do a thousand different things. But then internal medicine really just seemed like the most interesting thing in medical school. And then as I moved to residency, I decided to specialize.” Her internal medicine training has been invaluable in her endocrinology career. “Honestly, as an endocrinologist, I feel like I still use a lot of my internal medicine skills. A lot of specialties are procedural and very specialized. In endocrinology, you still do a lot of the same things that you do in internal medicine, thinking through people's medical issues. There's a lot of diagnostics and problem solving. Endocrinology is full of all these really unusual diagnoses and mysterious things. It's a really interesting specialty. It's a lot of the same ideas that were similar in internal medicine. Endocrinology was just kind of an extension of that interest.”
I'm proud to be a member because ACP gives support to everyone, not only people who are out of training. It's a really robust community. She first joined ACP as a resident where she was encouraged to take part in the poster presentations at regional meetings. She moved to Colorado for a fellowship and got involved again with the Oregon Chapter when she moved back to Portland. “It's a really good, inclusive community that's very proactive,” she says of the Oregon Chapter. “It's still a lot of the same people that I trained with, a lot of good friends. So it's just been a great community to be a part of. I'm actually a Fellow of ACP, and I really appreciate the advocacy they do. There are a lot of great reasons to be a part of ACP, even more so than some of the specialty organizations, quite honestly.
“I'm proud to be a member because ACP gives support to everyone, not only people who are out of training. It's a really robust community. There's a lot of engagement from med students on up. It's a great chance to meet people, to stay connected with people who are further along in their path, to get mentorship, and to be involved in committees,” says Dr. Stephens, who served as co-chair of the Oregon ACP Chapter's Council for Women Physicians from 2011 to 2014.
Meditation on Wheels - Her busy schedule can make it difficult to get time to herself, which is why Dr. Stephens rides her bike to work each day, weather permitting. “It's about six miles each way and if the weather isn't too bad it takes about 25 minutes. Biking really gives me a chance to have quiet time, where I can meditate on my work, and process that on the way home.” Portland averages more than 150 rainy days a year, but she has commuted through it for more than 15 years. “I'm pretty well outfitted for rain, with the right pants and jacket. I've got so many lights that need to get turned on before I go in the morning. I have seven sets of lights on my bike because it gets so dark here in the wintertime.”
The thing that I really enjoy about what I get to do is journeying through life with people.
Dr. Stephens is also an accomplished singer. She performed in a female acapella group (The BioRhythms) during medical school and was part of a band during her fellowship in Colorado. “It was a pretty interesting band called Dogs in the Yard. It was composed of my fellowship director, a cardiologist, an internist on drums, a physical therapist doing percussion, a pharmacologist playing bass, and I was a vocalist. We were a medical band and we recorded a CD of original songs. We performed at holiday parties, and we opened for some bands.” Music runs in her family. “My son plays drums. He's 14 and he plays in a number of bands and plays in School of Rock. And then my other son, he's 12, plays trumpet. And my husband plays guitar. A couple of years ago we did a Battle of the Doctor bands. They had a competition here in Portland and our family band, Pink Hubcaps, performed. We didn't win, but it was super fun.”
As much as she enjoys performing, practicing medicine and helping people is what drives her. “The thing that I really enjoy about what I get to do is journeying through life with people. Even as a specialist, I've known many of my patients for years. Just the experience of knowing people, caring for them, knowing their families, helping them through challenging times. It's so rewarding. I am so grateful that, despite all the challenges and changes in medicine, seeing people is the thing that I still really, really like to do.”
My Kind of Medicine: IM Family:
The Chadaga Family
In honor of ACP's Centennial, My Kind of Medicine: IM Family is a new series of physician profiles featuring multi-generational internists. The stories will appear in several issues throughout 2015 to showcase how a tradition of caring and a passion for internal medicine are passed from one generation to the next.
ACP Fellow: Rajagopal V. Chadaga, MD, FACP
Current Occupation: Academic Hospitalist, John Cochran Veterans Medical Center, St. Louis, MO
Residency: St. Elizabeth Medical Center, Youngstown, OH
Medical School: Kasturba Medical College, Mangalore, India
ACP Fellow: Smitha R. Chadaga, MD, FHM, FACP
Current Occupation: Academic Hospitalist, Legacy Emanuel Medical Center, Portland, OR
Chief Residency: Veterans Administration Hospital, and Presbyterian/St. Luke's Hospital, Denver, CO
Residency: University of Colorado, Aurora, CO
Medical School: University of Missouri-Kansas City School of Medicine, Kansas City, MO
ACP Fellow: Amar R. Chadaga, MD, FACP
Current Occupation: Associate Program Director, University of Illinois Chicago - Advocate Christ Internal Medicine Residency Program, Oak Lawn, IL
Chief Residency: McGaw Medical Center of Northwestern University (Evanston) Internal Medicine Residency Program, Chicago, IL
Residency: McGaw Medical Center of Northwestern University (Evanston) Internal Medicine Residency Program, Chicago, IL
Medical School: Southern Illinois University School of Medicine, Springfield, IL
In true sibling fashion, Smitha Chadaga, MD, FACP and Amar Chadaga, MD, FACP found their way to internal medicine by different paths, but they both say that their father, Rajagopal Chadaga, MD, FACP, has had a profound impact on their respective careers as internal medicine physicians. They also credit their success as physicians to their family-focused upbringing and their parents for allowing them every opportunity growing up.
Dr. Rajagopal Chadaga: The Patriarch
Dr. Rajagopal Chadaga made such an impact on his two children, Smitha and Amar, both internal medicine physicians, and he is still inspiring medical students today. One medical student recently wrote on an evaluation that he planned to pursue a career in internal medicine because of Dr. Chadaga's influence.
He remembers the moment he knew that he wanted to become a doctor. It was during an exhibition put on by the local medical school in his hometown of Mangalore, India. The exhibition took place when Dr. Chadaga was in the ninth grade, and he remembers that he was fascinated by the event and from that moment he knew that he wanted to become a physician. “I couldn't sleep for a couple of days after,” he recalls.
As a child, Dr. Chadaga was mechanically-minded, interested in science, and curious about how things worked. He would often disassemble things but did not always put them back together, which annoyed his mother. “I was not successful at putting them back together, but I did try,” he says, laughing.
Dr. Chadaga's eldest brother, Lakshminarayana, helped put him through medical school at Kasturba Medical School in Mangalore, India. He was Dr. Chadaga's biggest fan until his recent death. After completing medical school, Dr. Chadaga came to the United States, which he describes as a life-changing experience. Initially, he thought that he wanted to go into pediatrics or possibly pathology, but after completing an internship with rotations in surgery, and obstetrics and gynecology, he questioned whether he was cut out to be a clinical physician. Eventually, Dr. Chadaga settled on internal medicine because he felt that subspecialists are fragmented and focus only on their one part of the puzzle.
Today, he is an academic hospitalist at John Cochran Veterans Medical Center in St. Louis, MO. He recently went to a part-time schedule which allows him to work every other month, seeing patients with his team of residents and medical students both from Washington University and St. Louis University.
After morning rounds, Dr. Chadaga makes a point to go around to each of his patients later in the day on his own. “It's remarkable the way the patients open up to you, when earlier in the day they were hesitant with five or six people towering over them,” he says.
Dr. Chadaga has always had a strong desire to ask questions and keep learning. If a patients' diagnosis is not resolved by the time they were discharged, Dr. Chadaga will write down their name and will look it up later to ‘close the loop’. He says that he is always curious, and he tries to instill that sense of curiosity in his students.
As a mentor, Dr. Chadaga tries to make a difference in the way his team treats patients. One observation that he has made about medical students is that “they don't think outside the box.” For example, he reminds them that “there are 101 things that can cause chest pain” and that each reason should be looked into thoroughly. Internists treat the whole person, not just their symptoms and look at every aspect of the situation, and as an internal medicine physician Dr. Chadaga has a sense of professional satisfaction because he is not only focusing on one aspect of the patient's care. A lot of physician burnout is due to doctors not enjoying medicine because they are busy calling attending physicians for consults, writing notes, and seeing patients. Sometimes doctors have no inclination to learn from their patients, he says. “There is no patient that is not interesting, and it is up to you to make them interesting. If you stop enjoying medicine, then you get burnt out.”
Dr. Chadaga has been a member of ACP since he came to the U.S. 43 years ago, and was named a Fellow of ACP (FACP) in 1991. He depends on the College to continue to help him learn. He finds the “Updates in Internal Medicine” articles in Annals of Internal Medicine to be insightful, and says that ACP keeps him current with everything that is happening in medicine.
His favorite part of practicing medicine is the patient interaction. Dr. Chadaga has been in the VA hospital setting for his entire career. “It's a pleasure and a privilege to take care of the veterans. Whenever a veteran tries to thank me, I make it a point to tell them that they have truly earned it.”
Dr. Smitha Chadaga: A Daughter Follows Her Father
Dr. Smitha Chadaga, the older of Dr. Rajagopal Chadaga's children, loved to read so much that her mother used to have to kick her out of her room and tell her to go outside and play. And while her parents encouraged her to forge her own path in life, and from age five, Dr. Chadaga knew she wanted to be a doctor.
Dr. Chadaga remembers her father talking about “doing rounds” when she was a little girl. She envisioned a giant auditorium where all of the patients would be in their hospital beds arranged in a big circle. She wondered if her dad jumped over the beds or climbed into the middle of the circle to examine the patients. When she went to work with her dad, she was disappointed that the patients stayed in their rooms during her dad's rounds, but she was thrilled when the nurses gave her a stethoscope of her own during one of her visits.
During her high school years, Dr. Chadaga volunteered at the Veterans Affairs (VA) Medical Center in Marion, IL, where her father worked. As a volunteer she moved patients via wheelchair to the clinic or to get x-rays, and brought documents elsewhere in the hospital. The volunteers she worked with were often veterans and both working with and for veterans was a special honor.
After high school, she entered a six-year program BA/MD program. When she joined medical school Dr. Chadaga imagined returning to her hometown to be a family physician. But during her third year of her schooling Dr. Chadaga took a questionnaire designed to help her choose a specialty and path that would best suit her. The questionnaire helped her realize that she wanted to be in an academic setting, and that she wanted to care for adults and impact them in a meaningful way. “I felt like internal medicine gave me the best chance at doing that,” she said.
While Dr. Chadaga was determined to make her own path as a physician she drew inspiration from her father. “It was a huge inspiration to me as a kid, watching my dad makes an impact on people's lives,” Dr. Chadaga said. “I still find inspiration in him, as an adult, and as a physician, I'm always asking for his advice about handling different things,” she says, adding, “If I can do half of what he's done, I will be somewhat successful as a physician.”
Today, Dr. Smitha Chadaga is an academic hospitalist in Portland, OR. She makes rounds with residents about 60% of the time and the other 40% of the time she does rounds by herself. Like her father, Dr. Chadaga enjoys the patient interaction that comes with the job. On average, she sees 12-15 patients each day. “I think the advantage to being a hospitalist is that I get to take care of these people through a set process and provide them with care, and impact their life in what, I hope, is a meaningful way,” she says.
She views medicine on an individual level and in a global sense. Since there are a finite number of patients that she as an individual physician can help, she relies of educating medical students and residents to have a greater impact. Dr. Chadaga believes that educating medical students and residents, and impacting how they practice medicine, hopefully for the better, can have an exponential impact on patient care. Educating students and residents sustains her in a different way than patient contact.
In 1998, while in medical school, Dr. Chadaga became a member of ACP. She found and continues to find value in her ACP membership because it provides her with guidance on how to be a good learner and a good professional. When Dr. Chadaga was in medical school and completing her residency, there was a certain pathway set out for her, but she said that when she was done with schooling, there was no fixed pathway. ACP was a helpful guide for Dr. Chagada as she navigated her career by helping expand her knowledge and providing advice to her. She was named a Fellow of ACP (FACP) in 2013.
Medicine is an ever-evolving science, which Dr. Chadaga says proves to be a challenge for her, but working at an academic institution helps her provide her patients with evidence-based care. The residents help her stay current on the latest medical information. “While I'm teaching the residents, the residents are teaching me,” she says. “They're in a position to learn in a different way.”
Her advice for today's medical students who are choosing their residency is to not just imagine the best-case scenario for their desired career. She suggests that students “think about the most challenging situation in that specialty, and imagine yourself doing that every day. If you can say ‘I'll be happy dealing with that challenging situation every day’, then it's the right specialty for you.”
Dr. Amar Chadaga: A Son Also Walks in His Father's Footsteps
Dr. Amar Chadaga is the younger of two children in the Chadaga family. Growing up, he remembers that his parents made a point for the family to eat dinner together each night. The conversations around the dinner table included world news and events that took place during the school day. He continues to enjoy talking and debating politics and current events with his parents, who he FaceTimes with every day.
When he was seven years old, his mother taped a notecard to his bedroom door. In her beautiful cursive writing, she wrote “The 3 D's to success are desire, dedication and determination.” That notecard stayed on his bedroom door until he went to college, and although he does not know what happened to the notecard, Dr. Chadaga thinks about the 3 D's every day.
While his sister immediately knew that she wanted to study medicine in college, Dr. Chadaga was undecided when he entered his first year at the University of Illinois. His mother encouraged him to keep an open mind when he went to college. He and his mother developed a strong bond from very early in his life. Dr. Chadaga was born with a cleft lip and palate and was not able to speak or hear very well until age five. His mother would drive him around in the car and would point to a stop sign and say “that's an octagon.” She continued to teach him even though he was slow to warm up to learning, and he calls her his biggest fan.
His mother suggested that he study engineering in college, and although he considered it, he knew that he wanted to interact more with people in his job. Dr. Chadaga was involved with student government and thought that he might want to become a lawyer but kept going back to his desire to find out what was wrong with people when they say “I'm not feeling well.” Dr. Chadaga cannot pinpoint whether that mentality was ingrained in him by his father or his sister, but he says that his family has always been charity-oriented and had a desire to help people.
Like his sister, he also volunteered during his high school years at the hospital where his dad worked. Medicine became especially appealing to Dr. Chadaga because “at the end of the day, you can be social while helping people heal and learning constantly.”
He studied medicine at Southern Illinois University School of Medicine. It was during his second year of residency that he fell in love with teaching. “You have to know the material so well to be able to teach it, and I finally started figuring out the material better,” he said, noting that his year as an intern was tough for him.
During that same year in residency, he was a member of the winning Doctor's Dilemma team from the ACP Illinois Northern Chapter. The team participated in the competition at the Internal Medicine Meeting in San Diego, and while the squad exited early in national competition, he says that his first exposure to the ACP Internal Medicine Meeting was a pivotal moment in his career. He was named a Fellow of ACP (FACP) in 2013.
Today, he is an associate program director in the internal medicine residency at the University Of Illinois College of Medicine at Chicago Advocate Christ Medical Center Program. “I love my job,” he says. Roughly 50% of the time Dr. Chadaga is administrative and didactic teaching while the rest of the time is spent interacting with patients on the inpatient teaching service. On non-clinical days, he moderates morning report, researches various topics in graduate medical education, mentors students and residents, and attends meetings related to the internal medicine residency. He likes that the days vary and that he his schedule is flexible.
Dr. Chadaga is also in charge of recruitment. Each year he conducts between 200 and 300 interviews to secure the upcoming intern classes. In 2013, after this first full year of teaching at Advocate Christ Medical Center, he was awarded the General Medicine Teacher of the Year Award. The internal medicine residents vote on who embodies the best internist in terms of evidence-based medicine, patient care, and teaching.
He tells his students to pay close attention to detail and strive to be the best. “You don't have to be the best,” but Dr. Chadaga asks that they bring their “A” game every single day. Combining his love of teaching with patient care, Dr. Chadaga created a boot camp program for new interns to help learn essentials of inpatient medicine. It received positive feedback both before and after program took place.
Avoiding physician burnout is a challenge that Dr. Chadaga is working to overcome. Caring for inpatient patients can be busy and finding a work-life balance can be tricky. In order to combat physician burnout, Dr. Chadaga serves on a physician wellness committee at the hospital with colleagues from various departments. “Because there is always work to do and always ways to improve, you could stay at work all day, in any job,” he says, adding that it is a little harder in medicine because the clock does not stop at 5 p.m.
Dr. Chadaga is also interested in researching bullying in hospital settings, in particular amongst residents and fellows. He says that bullying is the big elephant in the room that no one wants to talk about and that at times the hospital can be toxic and hierarchical.
Dr. Chadaga says that his father has had a profound effect on his career. He describes his dad as calm and cool under pressure. His father's approach to medicine is second nature, which he compares to Michael Jordan playing basketball. “If I could literally be half of the physician that he is, then I think I'd be an amazing physician.” Dr. Chadaga adds that his father has a strong work ethic and that “his fire hasn't gone down at all. I definitely want to emulate him.”