I write each of you today with a heart filled with joy and pride. You, the graduates of our Tinsley Harrison Internal Medicine Residency Program, are absolutely fabulous physicians and colleagues. I have loved coming to know many of you and to learning so much from working with you.
In this issue of Letters to Tinsley, I draw your attention to a beautiful and heartfelt story, “The Fell Clutch,” by Malcolm Chapman, a current PGY-2. Malcolm implores us to visit the Legacy Museum and the National Memorial for Peace and Justice in Montgomery, where he recently journeyed with fellow residents in our program’s Health Disparities Track.
Malcolm tells of what he learned about the roots of structural racism in America in the domestic slave trade and the acts of racial terrorism that followed emancipation. I can feel the weight he felt as he descended into the National Memorial between the brown, rusting masses that commemorate those who were murdered by racial terror lynching. Thank you, Malcolm, for sharing your introspection and inspiration.
As I complete my 12th year as Chair, I prepare to step away from the department and the work I have so loved. As I have said from Day One, our Tinsley Harrison Residency Program is the heart and soul of our department. It attracts all of us as physicians. It pulls us together in our shared mission of caring and learning. It sustains us with good work and collegiality.
Our motto, Excellence without Ego, describes our aspiration. E = hH2 articulates our commitment to both head and heart. “Contagious fire” is how we light the world. I am more grateful than you know to have learned this way of medicine at UAB. I hope each of you will carry the UAB way with you through your career.
I will soon turn to a challenge that I believe contributes to declines in the health and life expectancy of Americans despite incredible advances in medical science. That challenge is what I call the crisis in primary care, the lack of comprehensive, relationship-based care. Today, primary care is not accessible to many Americans. Primary care spending has decreased 25 percent in less than a decade, and the number of U.S. primary care physicians has plummeted. In Alabama, whole counties have no physician; friends and colleagues cannot find a doctor. Across America, every medical center and even Kaiser now have difficulty hiring primary care physicians. “Concierge medicine” is the only primary care that is readily available, for a high fee. Loss of primary care affects disproportionately those who have fewer socioeconomic resources, worsening inequities in health care.
In September, I will address this challenge as a fellow at the Center for Advanced Study in the Behavioral Sciences at Stanford. As the only physician in my cohort, I will learn from sociologists, economists, anthropologists, and other “real” scholars – I have a bit of imposter syndrome and hope I will bring something new to a big problem in health care. I will certainly take this on with the wisdom I have gained while learning the UAB way!
I am happy that I leave the department in excellent hands. Mark Dransfield, M.D., has been named Interim Chair, and he will have a stellar group of department leaders to support him during the transition. Many of you know Mark as Director of our Division of Pulmonary, Allergy, and Critical Care Medicine, and a national leader in COPD research and care. His quiet calmness, quick wit, great acumen, and deep knowledge of UAB will prove invaluable during his service as Interim Chair. And you all know Lisa Willett, M.D., who will become Executive Vice Chair, effective July 1. Mark, Lisa, and I will work together through the coming months to assure we pass the baton well.
Thank you to Malcolm for writing eloquently in this issue, and thank you to each of you for all you do for medicine and our patients, and for all you have done for UAB.
Best regards,
Seth