Greeted by a cheer of rousing enthusiasm, Dr. Megan Mahoney, Chair of the UCSF Department of Family & Community Medicine (FCM) opened the 20th Jack Rodnick Colloquium on May 16, 2024, at UCSF Mission Bay Conference Center. She began with a shout-out to Dr. Dahlia Rahmi, the then second-year resident, who launched the idea for the now well-established Colloquium in 2004. This excellent example of creative initiative and vision to build dialogue, set up a strong plenary session on Family and Community Medicine Values Under Threat: Time for Dialogue and Action.
The distinguished panelists represented a range of generations and focus that highlighted core values that empower Primary Care and address the long list of threats. Most importantly the panelists gave excellent examples of demonstrated solutions and plenty of fresh ideas. All emphasized the priority of Family Medicine to engage, educate and build community. They affirmed the purpose of the Rodnick Colloquium to bring people together to grow as a field in this time of complex uncertainty, educating the next generation of physicians, delivering care and expanding the mission of healthcare as social justice. While recognizing challenges, the panel represented the vision and dedication that give strength and purpose to Primary Care, motivation and example to a room full of changemakers. “We are all in this together,” was the fortifying message to leverage the alliance of residency programs.
When Dr. Mahoney asked the audience for the core values of family medicine, many guiding principles were reinforced that motivate the day-to-day work and community building including trust, hope, compassion, love, standing up for those who are struggling, treating the whole person in context of the whole family. These values stood ready to counter the toughest challenges that all panelists agreed needed both systemic and innovative resistance. Threats included legislative dismantling of diversity, equity and inclusion, the aggressive restrictions to abortion, gender-affirming care, the chronic undervaluing of work and contribution of primary care in financial and structural support, the corporatization of medical care, distribution of resources, restrictions to access, divisive political discourse, and freedom to make informed medical choices. While the list is daunting it is also an ongoing positive work in progress led by the examples cited by the passionate and engaged panelists.
Dr. Ivan Gomez, Director of California Statewide Area Health Education Center and Chief of Family and Community Medicine at UCSF Fresno, recounted his experience of arriving in the Central Valley twenty years ago as the only Spanish-speaking doctor for miles around to a clinic full of very sick patients who had little access to preventative care or early detection. His work since has dramatically turned around the principles of who serves and who is served. He pioneered training doctors from the community, connected to the needs and disparities of the valley, public health and civic awareness, advocacy built into the role of training doctors.
Eushavia Bogan, a UCSF medical student, brought her experience as a community organizer around food sovereignty as excellent principles to engage and empower people, from developing gardens to making healthy choices. She represented the vision of mobilizing around solidarity issues for all to be heard with safety and respect.
The issue of silencing was reinforced by Dr. Sen Nguyen, Assistant Professor and gender affirming care provider at UCSF. They spoke powerfully about controlling rage to silence others, a useful message of awareness in divisive contentious times. Dr. Nguyen spoke about training future leaders to be co-conspirators, to be powerful together to resist the political, legal, social attacks on our bodies and bodily autonomy, and how the rhetoric of hate limits the ability to deliver whole person care. They recognized how marginalized people are at the brunt of backlash that mandates patient advocacy in the exam room.
Dr. Sharon Washington, CEO of Sharon Washington Consulting, reinforced this priority with an overview of the attacks on DEI. She articulated the intersectionality of Primary Care as the confluence of individuals, community, education, politics, social and economic forces. Her message to physicians in training was self-love, love for the institution you serve, love for your patients and love for community.
Dr. Michelle Gomez, Co-Founder of the MYA Network, added the power of creativity in crisis, with an example of primary care doctors’ response to the dismantling of abortion access. She reported the history of an abortion care hotline founded by a group of family physicians who thought outside of the box, or the exam room, as restrictions increased the use of oral medications and mailing prescriptions. Patients needed guidance. The hotline has been busy ever since. “Family physicians are creative. We have always been activists,” proclaimed Dr. Gomez, to the deserved applause of the crowd.