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Rounds to Residency (from MedSchoolCoach)

Feb 6, 2020

Josh Umbehr is the CEO of Atlas MD and a family physician in direct primary care. With over ten years of clinical education experience, he has many useful pearls on how to approach primary care education. He also covers a lot of business negotiating and business of medicine education material in their clinical rotations. Healthcare revolves around money and physicians should be well educated in many of the business aspects that they may be involved in.

In primary care, there are standard inpatient costs and times associated with them. However, with a non-insurance-based practice, physicians and students may have more time for patient discussion and forming stronger connections. There are often richer experiences available to students by running many of their own labs and procedures in comparison to insurance-based primary care clinics. The model allows for more flexibility, according to practitioners.

Strong preceptors are talented at phrasing their questions in the right. They take the time to educate their medical students and avoid “read my mind” questions. They help guide the learner past the textbook and how to find answers on their own. Clinical preceptors must also avoid using their learners as work-horses in order to maintain their busy schedules. There are many potential learning experiences that can occur each day and knowing which ones will benefit the student the most comes from experience. Although medical students must learn proper filling out and filing paperwork, this is not always a great learning opportunity.

Josh also states that an added benefit to learners and patients in the direct care model is that of time for decision making. There is much more time to decide if a patient should be referred out or if this is something that can be handled in-house and potentially lead to substantial savings. The other end of this is that it can be anxiety-provoking at times when patients are in a gray area. However, the decision options can be discussed more thoroughly in a DPC setting than in many insurance-based settings.

Dr. Umbehr recommends that students focus on a few key principles when they are on clinical rotations in primary care.

  • Professionalism and leading by example is not only the ethical thing to do but also builds trust and helps to lead patients to be more honest with healthcare professionals.

  • Keeping an open mind can greatly benefit learners. This can allow them to find answers that may not be top of the list or solutions outside the box. This can also allow them to listen and not simply “wait for their turn to talk.”

  • Developing technology skills and communications also greatly impact the efficiency of our clinical training and should be a top consideration.