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STFM 38th Annual Conference 2005
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Sunday, May 1
8:15 - 10 am
"Cultural Humility in the Era
of Cultural Competence"
Melanie Tervalon, MD, MPH, NCMHD Center of Excellence
in Nutritional Genomics co-located
at UC Davis and Children’s Hospital Oakland Research Institute
Placing cultural competence and cultural
humility at the center of health education and practice is a requirement for
achieving health equity goals in this 21st century. Our literature, language,
and practice today make frequent use of the terms culture, race, racism, and
ethnicity when talking about social justice, fairness, equality, and health
disparities. What do we mean by racism or any of the other "isms" for that
matter, when we bring this language into our studies, research, and interface
with community as change makers? This talk will highlight the context and principles
of cultural competence in the United States and primarily describe the cultural
humility framework. This session will present this framework as one approach
to regularly and creatively engage with the ever changing dynamic of culture
and difference in thought and action, as we work to end the human misery associated
with health disparities of all kinds.
Melanie Tervalon, MD, MPH, is a pediatrician, consultant, and teacher. In January 2003, Dr Tervalon started her position
as director of education in the Center for Excellence in Nutritional Genomics, co-located at Children’s Hospital of Oakland
Research Institute and the University of California, Davis. This multidisciplinary research program, supported by the NIH-National
Center for Minority Health and Health Disparities, focuses on the relationships between nutrition, genetic research, and health
disparities as a way to make a unique contribution to the urgent national task of eliminating health disparities. In April 1994, the
Multicultural Curriculum Program was created at Children’s Hospital Oakland, under her leadership. This program was grounded
in a teaching partnership that places community scholarship and leadership at the center of health care education and practice.
Dr Tervalon’s work incorporates principles of social justice, fairness, and equity in program practice. She completed her medical
degree at the University of California, San Francisco, pediatric residency training at Children’s Hospital Oakland, masters in
public health at the University of California Berkeley, and a Pew Fellowship in health policy studies at the University of California,
San Francisco. Dr Tervalon serves on several boards and is active in community work.
Monday, May 2
8:30 - 10 am
Blanchard Memorial Lecture -
"The End of the Beginning: The Redesign Imperative
in
Family Medicine "
Joseph Scherger, MD, MPH, University of California, San Diego
While family medicine can celebrate 35
years of success, the time has come for a radical redesign of the processes
of care. Episodic care based on brief office visits is no longer a functional
model of care for an aging population with chronic illnesses and ongoing preventive
care needs. The tools of Health Information Technology and Quality Improvement
methods through Team Practice are beginning to revolutionize health care delivery
toward continuous engagement.
The Future of Family Medicine Report is a starting
point for practice redesign toward a new model of family medicine. To stimulate
a new generation of medical students, and to properly train residents for future
practice, family medicine education programs must lead the redesign efforts.
There are many new opportunities for research in this time of rapid change.
How will relationship-centered care flourish in the age of health information
technology and consumer empowerment? We have a great opportunity to renew the
creative energy in family medicine, or founder as other health
professionals seize the inevitable creation of 21st century health care delivery.
Joseph Scherger, MD, MPH, is clinical professor
in the Department of Family and Preventive Medicine at the University of California,
San Diego School of Medicine. Dr Scherger is director of the San Diego Center
for Patient Safety, and associate director of the Physician Assessment and Clinical
Education program at the University of California, San Diego. From 2001–2003,
Dr Scherger served as founding dean of the Florida State University College of
Medicine. He is a member of the Harvard Kennedy School of Government Health Care
Delivery Policy Project.
Dr Scherger’s main focus is on the redesign
of office practice using the tools of information technology and quality improvement.
From 1981–1992, Dr Scherger divided his
time between private practice and teaching medical students and residents at
University of California, Davis. From 1992–1996,
he was vice president for family practice and primary care education at Sharp
HealthCare in San Diego. From 1996–2001, he
was the chair of the Department of Family Medicine and the associate dean for
Primary Care at the University of California, Irvine.
Dr Scherger has received
numerous awards, including Outstanding Clinical Instructor in the School of Medicine
at the University of California, Davis, in 1984, 1989, and 1990. In 1986, he
served as President of the Society of Teachers of Family Medicine. In 1992, he
was elected to the Institute of Medicine of the National Academy of Sciences.
In 1994, he received the Thomas W. Johnson Award for Family Practice Education
from the American Academy of Family Physicians. He served on the Institute of
Medicine Committee on the Quality of Health Care in America from 1998–2001. He
has served on the Board of Directors of the American Academy of Family Physicians
and the American Board of Family Practice. He has authored more than 300 medical
publications and has given more than 600 invited presentations.
Tuesday, May 3
8:30-10 am
"What Can Findings From Practice-based Research Contribute
to the Training of Physicians? "
Ronald Epstein, MD, University of Rochester
The goals of research, clinical practice,
and medical education are identical—to promote health,
understanding, and high quality care. Practice-based research often focuses on
processes of care, such as communication in clinical settings and systems,
to align the quality and quantity of care with patients’ needs. Yet, there
is limited evidence that research findings have had a significant influence
on medical education at the undergraduate, graduate, or continuing professional
education levels. Practice-based research can and should guide the process
of medical education and assessment of clinician performance— in particular,
research on medical errors; bias in health care; communication among health
professionals,patients, and families; how trainees and seasoned clinicians
learn in practice; and the influence
of commercialization on the provision of health care.
Dr Epstein will link these research agendas to the themes outlined in the
Future of Family Medicine project.
Ron Epstein, MD, is professor of family
medicine and psychiatry, director of research in the Department of Family Medicine,
director of the Rochester Center to Improve Communication in Health Care, the
associate dean for Educational Evaluation and Research at the University of Rochester,
and a practicing family physician. His research explores the impact of patient-physician
relationships on health and health care costs, management of ambiguity in the
clinical practice, and the effect of direct-to-consumer advertising on clinical
care. In medical education, he has developed courses on communication skills
and assessments of professional competence. His influential papers on Mindful
Practice and on Defining and
Assessing Professional Competence have drawn attention to the importance of the
habits of mind of master clinicians.
Dr Epstein has authored more than 90 publications.
He has received funding from the Robert Wood Johnson Foundation Generalist Physician
Faculty Scholars Program, NIMH, AHRQ, DHHS and the Fulbright Foundation. Dr Epstein
was named the first George Engel and John Romano Dean’s Teaching Scholar at the
University of Rochester and is recipient of awards from the Pfizer-AAFP Foundation
and the Koppaka Foundation.
Wednesday, May 4
8:30-10:00 am
"What I Learned About Collaboration, I Learned in
Kindergarten "
Martha Medrano, MD, MPH, University of Texas Health Science Center at San
Antonio
Creating collaborations is a difficult task that requires commitment and sensitivity to the process of
building relationships. Role definition is important in relationship building and revolves around creating
activities that build ownership of the process. Consensus building is another key role of the leader. The
role of the leader is one who facilitates the process, listens, and observes vigilantly to anything that might stifle
the process of relationship building. The leaders predictability and developing
a process infrastructure that fosters clarity of communication and creates an
environment of comfort and safety for group members. The leader needs to be sensitive
to the importance of process and circumvent external forces from disrupting it.
The enthusiasm and energy the leader projects can be and should be contagious.
Having a leader with a good sense of humor also helps. Therefore, the ABC and
D’s of this process will be
discussed during this session.
Martha Medrano, MD, MPH, is currently the dean of continuing medical education and director of the Medical Hispanic
Center of Excellence at the University of Texas Health Science Center at San Antonio. She is a professor of psychiatry,
pediatrics, and family and community medicine. She is also the South Central Regional Director for Redes En Accion, a
multi-site grant funded by the National Cancer Institute, targeting cancer awareness, training and research within Hispanic
communities. She also serves on the Minority Women Panel of Experts for the National Office on Women’s Health, the
National Advisory Board for the National Hispanic Medical Association and the UTHSCSA representative for the National
Association of Hispanic Serving Health Profession Schools. She is also the codirector of professional development for the
newly funded UTHSCSA National Centers of Excellence in Women’s Health.
Dr Medrano has an interest in teaching medical students, and other health professions students about differences in
cultural health beliefs. Dr Medrano has developed the BELIEF model teaching medical students how to ask patients about
their alternative health beliefs and practices. She also has developed the INTERPRET model teaching medical students
about appropriate interpretation methodology with ad hoc interpreters. Though Dr Medrano’s leadership, the MHCOE has
developed a number networking systems and advisory boards. Dr Medrano describes herself as a community psychiatrist
spending most of her career involved in community programs and activities. Because of her interest in health promotion
and prevention, she returned to school and obtained a Masters in Public Health in 1996 from the University of Texas Health
Science Center at Houston, while continuing full-time faculty status.