Family Medicine Is Largely Focused on Relationships

This essay was written for the Michigan State University College of Human Medicine's Integrated Medical School and Family Medicine Residency Program (TIP), a transitional fourth year medical school experience that continues into residency.


by Stephanie Rutterbush

 Family medicine, The Integrated Program, and the Marquette community all encompass the aspects of medicine that initially drew me into seeking a career within the field. The idea of continuity of care and the relationships that result forms a large part of the foundation behind family medicine and is an idea that resonates well with The Integrated Program. Gaining the ability to begin forging relationships within the medical and local communities of Marquette will be of great benefit given my desires to eventually practice nearby. The Integrated Program will enhance my ability to accomplish this goal as I move forward in my education. I have already had the opportunity to work with a variety of providers who have been not only knowledgeable but also helpful and incredibly inspiring.

 During the first month of my third year clerkships, I was exposed to a wide variety of experiences in the family medicine office to which I was assigned. While there, I met a woman who presented for her annual well woman exam. She was very kind, talkative, and conversation between us flowed easily. We spent a good deal of time chatting about the beautiful UP weather and sharing tidbits about ourselves. She asked me about mammograms -- she was slightly overdue and not particularly excited about the prospects of getting one again this year. After our discussion and a brief exam, I excused myself and reported to my attending making sure to note her questions regarding mammography. I then re-entered the room with my attending and was able to witness an extraordinary patient relationship come to life; my attending was greeted by this vibrant woman with a hug and long discussion on how each was faring in life since their last visit. It was as though their patient-physician relationship was that of old friends seeing each other again after many months. The exam progressed as the conversation between the two carried on; however, on her breast exam, we found a lump. The energy in the room immediately changed to a tone heavy with concern; my attending calmly discussed the next steps, comforted the patient, and assured her that she would be there to help guide the way. Later that week, the pathology report arrived and indicated that this patient had invasive ductal cell carcinoma; I was fortunate enough to be present for the conversation during which my attending revealed the diagnosis. It was a touching and difficult discussion; however, it was a necessary and an important stage in my medical training. I finished my short four weeks on family medicine a few days later and was never able to follow this patient despite my desire to do so. It would have been an honor and a privilege to help my attending guide her through the challenges that certainly lie ahead.

Family medicine encompasses a wide variety of clinical scenarios from the diabetic patient presenting for a regular check-up to the 3 year old with an infected bug bite. It is a specialty that allows one the opportunity to share that special moment with a mom as she hears her infant's heartbeat for the first time. Family medicine enables one to follow and guide a family as they grow and experience the joys and hardships of life -- through times of injury and those spent in health, the growth of family, the pain of loss, and even dying itself. A family care physician has the unique opportunity to follow a child to adulthood, and when lucky, there is the opportunity to see that child start their own family and have their own children. It is these characteristics that have always drawn me toward a career in this particular specialty, and it is experiences and memories, like the patient with the breast lump, that push me toward a life and career in family medicine.

Based on my experiences thus far, family medicine is largely focused on relationships one is able to build, grow, and sustain over time. It is for this reason that I first became interested in the Integrated Program. I would very much enjoy having the ability to begin to form bonds with the patients that I would have the pleasure of seeing and assisting in the clinical setting. The shear ability to begin such a crucial component of family medicine in advance of my residency training is an amazing opportunity. I ideally plan on applying for the Integrated Program through the Marquette campus, where I am currently working on my required third year clerkships. This will not only afford me the ability to remain in the Upper Peninsula, a place I have come to call home over the past several years, but I will also have the opportunity to continue building and strengthening relationships with the attendings, residents, and other members of the health care team at Marquette General and the surrounding medical facilities. I hope that my presence in the Marquette community will not only benefit the patients that I see, but that will also bring personal growth and allow the development of lasting connections and relationships with the people I meet.

I have long considered the option of completing my residency in Marquette. The UP has been my home since my undergraduate years at Michigan Technological University. There I made many lasting memories, met some of my closest friends, and fell in love my with husband. My husband and I intend to continue building our life together in UP, specifically in the Houghton/Hancock area where Michigan Tech and my husband are located. My husband is currently an employee of the university there, and he is quickly building a niche for himself and advancing his own career goals. Being able to establish myself in the Marquette area would be a great advantage and a wonderful treat; my husband and I would continue to live near one another while being able to work toward our respective career goals and enjoy the beautiful Upper Peninsula that we now call home.

Relationships are such an important component of any branch of medicine, and I thoroughly enjoy the opportunity to form such important and special relationships with every person I meet in the clinical setting and beyond. There are those that may simply be just another patient -- easy to forget, but there are individuals that make a more profound and lasting impact. These are the types of relationships I hope to harbor with my future patients; I hope to make a positive impact on their health and their life. It is through the specialty of family medicine, the Integrated Program, and the healthcare community in Marquette that I feel most able to begin this process.


(May 2014)