Audrey Tran, M.D. Class of 2021
It was a historic day for the Oregon Medical Association (OMA) at their 2018 Annual Conference. First, the OMA was slated to induct Dr. Fred Williams, an accomplished neurosurgeon, as the first African-American president in the history of the organization. Secondly, the medical student attendance, from both COMP-NW School of Osteopathic Medicine and OHSU School of Medicine, was highest in recent memory. Not only were students present, they were presenting speakers as well. This was a novel idea conceived by Dr. Megan Furnari, the conference emcee, director of the Wellness Program for the OHSU School of Medicine, and co-creator of the OHSU Women’s Leadership Development Program. By connecting students to conference issues they cared about, Dr. Furnari reasoned, the conference would embody its own charge to practice physician advocacy now. She was right to advocate for this new model. The combination of seasoned physicians following energetic students was a intergenerational lineup that spoke volumes: the future of medicine is here, and it is in good hands.
To start off the day, the 2017-2018 OMA President, Dr. Kevin Reavis, gave an update on the major legislative victories during the 2018 Legislative Session in Salem, OR. These victories included the successful passage of: House Bill 4133, which formed a maternal mortality and review committee to review individual cases of maternal death in Oregon; House Bill 5201, which funds the creation of the Oregon Psychiatric Access Line, expanding access for mental health care to primary care providers of adult patients; and House Bill 4143, which will establish a peer recovery support mentors program within emergency departments, and will require that providers licensed to prescribe opioids register with Oregon’s prescription drugs monitoring program. This tremendous success was attributed to the work of several physicians and OMA employees who have provided leadership as members of task forces within the OMA.
But advocates for social change must also reflect inward, as the culture of medicine itself is still rife with gender and racial inequities. As the morning keynote speaker Dr. Esther Choo pointed out through countless studies, the gender pay gap between men and women physicians is consistently held at around $20,000, no matter the specialties, experience level, or geographic location. After showing qualitative data about the different gendered adjectives physician-mentors tend towards when describing male and female mentees, or after the observation that there are more mustachioed men in positions of leadership in medicine than women, Dr. Choo charged, “What does it signal when one group is paid less, promoted less, and rarely in charge? Who decided to make that value, and what does that value tell others down the line?” With her powerful insight and fastidious analysis, Dr. Choo compelled conference-goers to reconsider our unconscious biases that hold the field of medicine back from reaching full equity.
Said Kara Konigsfeld, a second-year medical student at OHSU, “The illustrious Esther Choo has given talks on gender equality in medicine before to the Women’s Leadership Development Program and I have heard her speak on the subject two different years. But the way she delivered this content at the OMA conference was the first time I have been present in a mixed-gender audience. She made the problem devastatingly clear with paper after paper, study after study.“
Before Dr. Choo presented, she was introduced by Monique Hedmann, M.P.H., M.D. Class of 2020. Said Monique of Dr. Choo, “She reminded me that the road is long, but will surely lead me to where I need to be. Because of her, I can.” Monique delivered a riveting narrative that demonstrated the importance of representation and mentorship in medicine.
After the keynote presentation, a slew of medical student leaders introduced other equally important topics in subsequent breakout sessions, including discussions on up-to-date opioid prescribing standards, community and legislative solutions for mental health care, the process of implementing for laws that address maternal morbidity in Oregon, and ways to incorporate narrative medicine into clinical practice. Many conference-goers repeatedly mentioned how the student introductions were inspiring and a favorite aspect of the conference.
Dr. Elizabeth Lahti, an internist, director of Narrative Medicine in the School of Medicine, and speaker at the conference remarked, “In the small breakout sessions, students made their introductions come alive by relating the content of the workshops to their experiences as future physicians. In a room filled with seasoned doctors from around the state, OHSU students reminded the audience of the importance of forward, innovative thinking as well as how policy is personal.”
Fellow second-year student Sarah Newhall found the panel discussion on mental health to be her favorite: “I think it brought together powerful people that are working at many levels to break the stigma around mental illness, helping many people who are part of vulnerable populations, and working in communities to create holistic solutions to real issues in the Portland Metro area.”
My personal favorite talk was the afternoon plenary session, where I was thrilled to introduce Dr. Brian Gibbs, as well as Dr. Lisa Reynolds and Dr. Kristen Massimino, fellow members of the OMA Task Force on Firearm Injury Prevention. This task force was established in June 2018 to recommend evidence-based policies that would promote firearm safety and decrease all firearm-related injuries to the OMA. As a fellow task force member, I am pleased to know that our approach to the gun violence epidemic is evidence-based, public health-focused, and committed to bringing diverse perspectives to the table. For example, since the leading cause of firearm injury in Oregon is suicide, there are specific conversations we should entertain, such as gun storage policies and physician gun counseling literature.
In addition to making the deft argument to reframe gun violence as a public health issue, Dr. Gibbs moved everyone deeply with his own personal narrative about how gun violence has affected his family. I was humbled to see how spoke with such grace and poise, even in the face of personal loss, which heightened the power of his words. His remarks reminded me of the power of narrative in advocacy, and the strength of a story authentically told.
After a jam-packed day full of exciting presentations, enthusiastic medical students huddled together to reflect on ideas absorbed at the conference, and how to keep the conversations going in medical school and beyond. I myself feel emboldened to have been included in the conversation, even as a student, for now I feel charged to be an active part of the solution. Many medical students, including first-years, felt similarly. Teva Brender, a first-year medical student, found the conference an inspiring success: “The event was an incredible opportunity to be surrounded by, and connect with fellow students, physicians, and advocates striving to improve the health of all Oregonians.”
Dr. Megan Furnari was in equally high spirits after guiding speakers, students, and attendees in a halo of authentic passion. Upon reflection of the conference, Dr. Furnari remarked, “In a time when feeling rooted is becoming harder and harder, I saw the power in these moments. It is significant when a medical trainee can stand up and speak their truth authentically…I thank the OMA for being open to this new, progressive model of each panel and speaker having student introductions. I hope this continues in the coming years as it bring a light and hope that is needed for us all.”