CAMPUS CLOSEUPRick Kellerman - Professor, chair of family and community medicine
Submitted/KU School of Medicine-Wichita
Rick Kellerman is a professor and chair of the Department of Family and Community Medicine at the KU School of Medicine-Wichita. He is also president of the American Academy of Family Physicians.
Job duties: I oversee family medicine education, service and research for medical students at KUSM-Wichita, 89 residents at the Smoky Hill-Salina, Via Christi and Wesley family medicine residency programs and continuing medical education and faculty development for practicing family physicians. The department has 36 full-time medical school and residency faculty in addition to hundreds of community volunteer faculty in Wichita and throughout the state of Kansas. The Department of Family and Community Medicine is 207 miles wide and 411 miles long.
You're president of the American Academy of Family Physicians. How did you gain this role, and what is the purpose of the academy? The mission of the American Academy of Family Physicians is to improve the health of patients, families and communities by serving the needs of family physicians. The academy has 94,000 members. The elected officer positions chair of the board of directors, president and president-elect require a three-year commitment.
How did your time as a rural physician in Kansas prepare you for academic medicine? When I was in solo private practice in Plainville, I was a volunteer preceptor for a lot of Kansas City and Wichita medical students on their required rural rotation. Then I was the program director of the Smoky Hill Family Medicine Residency Program in Salina. Now in Wichita, where I have worked in an indigent community health clinic, I have had a relatively unique experience in frontier/rural, mid-size Kansas town and urban health care. Your question begs a follow-up question: "Do academic physicians help prepare students and residents to be rural physicians?" This is a fundamental issue that we don't answer as positively as we might in Kansas.
How does the Department of Family and Community Medicine help encourage young physicians to practice in rural areas? Family medicine is the only medical specialty whose physicians distribute themselves in direct proportion to the population at large. This has been proven nationally and we have demonstrated this phenomenon in Kansas. There are several important things we do in the Department of Family and Community Medicine to support students and resident-physicians who wish to practice in rural communities. First, we let them know it is OK. So often, in academic medicine, students are told they are wasting their careers if they practice in a small town Ð the so-called "hidden curriculum." Nothing could be further from the truth. How do you waste a career by serving people in need? Second, many of our faculty have real-life practice experience in rural communities and can counsel students and residents about the challenges of rural practice and how best to prepare. Third, the department places great value on the education provided to medical students and resident-physicians during required rural rotations. In fact, the rural rotation gets the best evaluations of any medical school rotation.
What are some aspects of your job others might not realize you're involved with? Taking phone calls from physicians, hospital administrators and community board members who are trying to find family physicians.
What do you enjoy most about your profession? I enjoy the opportunity to make a difference.
What, in your opinion, is the biggest challenge in ensuring young physicians practice in rural areas? The biggest challenge is to get policy makers, legislators, medical school administrators and hospital CEOs to understand the importance of family medicine education, particularly for those who wish to practice in rural communities. Resident-physicians must be well-trained for the variety of patient problems they will see in a rural community. One minute the rural physician is taking care of a patient who has suffered from a serious farm accident or oil-field injury or car wreck. The next minute, they are taking care of a child with a high fever. Next is a pregnant woman and her husband looking forward to the birth of their first child. Next is a patient with chest pain and then a patient who is suffering from depression. Next is a discussion with someone who is trying to stop smoking followed by a woman whose screening mammogram has indications of breast cancer. Here is the kicker: There is an extensive research base demonstrating that health care systems whether in rural or urban communities - with a robust primary care base have better outcomes and quality, better mortality and morbidity rates, better access, better patient satisfaction and less cost. The biggest challenge is getting policy makers and decision makers to understand this. It is counterintuitive to the reductionist philosophy that dominates medical education in the United States. In fact, the lack of support for primary care, and family medicine in particular, is one of the two major reasons health care is in such disarray in the United States; the other is the lack of health care coverage for all.
You were also formerly a volunteer preceptor. What is a preceptor, and how important are these individuals to potential rural physicians? Preceptors are the unsung heroes of medical education in Kansas. Preceptor is a word for a volunteer community faculty member. Preceptors teach medical students and residents in both Wichita and throughout rural Kansas. We don't pay them a dime. They take students into their offices and on rounds in their hospitals. They feed the students and house them. When preceptors have a student it adds time to their already busy days and takes time away from their families. Why do preceptors do this? Because they like to teach, they want to give back to the profession, they are concerned about the future of health care in Kansas, for their patients and communities and they are challenged by learners who ask them questions.
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