leaders say residents experience first-hand the unique challenges physicians and patients face in a rural setting. “There are different barriers to health that patients experience when they are geographically isolated from care and that becomes their barrier for maximizing their own health, and their physicians need to be aware of those barriers and help them figure out how to navigate those things,” said Hollander-Rodriguez. Faculty members say residents at Cascades East learn to navigate dual roles as care providers and as very visible members of the community. Residents often find themselves connecting with patients at the grocery store or in social settings. Students learn a unique set of professional ethics that takes into account the context of where they are and what role they’re playing. “It’s nice to be able to have the community at your fingertips from that standpoint. It allows me to connect with my patients—say a patient who’s successfully stopped smoking—and I can ask them to volunteer to be a mentor for someone else. Knowing those resources closely and being able to connect people is important,” said third year resident Larissa Thomas, MD. The program is highly selective, with over 1,000 medical school graduates typically applying for eight slots each year. “We’re really looking for people who show that commitment to rural family medicine. We want people that are interested in taking care of underserved populations and have demonstrated that in their past. They are those students that have that spark for doing this type of work. They’ve been involved in family medicine interest groups and rural medicine interest groups and done great service work,” said Hollander-Rodriguez. Hollander-Rodriguez credits the program’s success with the strong partnerships they’ve built with Oregon Health and Science University (OHSU) and the local hospital. (OHSU administers and co-sponsors the program, which is also supported by Sky Lakes Medical Center and Oregon Area Health Education Centers.) She says OHSU and the Department of Family Medicine provide the strong educational foundation that keeps their program oriented on teaching ideals while also providing critical faculty development support. “We’ve also been really fortunate to work with Sky Lakes Medical Center because it’s a hospital that thinks a lot about the health of the community and population-based health and has invested in the residency program and the primary care base of this community and ways of improving the health of this community,” added Hollander- Rodriguez. Cascades East has earned patient-centered medical home status, and faculty and students are committed to using data from the clinic’s electronic health record to better manage population health. Residents use the data to track and care for patients with chronic medical conditions, like diabetes, ensuring these patients get into the clinic for regular testing. “We want to make sure what we’re doing and discussing and recommending for patients is the most valuable, and to evaluate that you have to have concrete measures and qualitative and quantitative data to demonstrate that effectively. That’s been the driver of EHR development to make ourselves accountable; particularly in the care of chronic disease,” said Thomas. “There are different barriers to health that patients experience when they are geographically isolated from care and that becomes their barrier for maximizing their own health, and their physicians need to be aware of those barriers and help them figure out how to navigate those things.” —Joyce Hollander-Rodriguez, MD, Program Director Cascades East Family Medicine Residency and Assistant Professor at OHSU Students also complete rotations with different community organizations and take care of patients in different settings such as hospice, homecare, homeless shelters, mobile clinics, and in remote communities such as Burns and Lakeview. “It’s all about exposure and knowing what I’m getting my patients into. The relationships are really the central aspect of it. It’s one of the things that draws and keeps people in rural areas because the relationships are so strong,” added Thomas. Cascades East Family Medical Clinic w ww.TheOMA.org Spring 2015 13
OMA Spring 2015 Magazine
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