{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/gt5fb4xz8q/manifest","type":"Manifest","label":{"en":["Dr. Stacey Bartell"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}},{"label":{"en":["Date"]},"value":{"en":["2021-12-03 (created)"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}},{"label":{"en":["Format"]},"value":{"en":["video"]}},{"label":{"en":["Subject"]},"value":{"en":["Covid-19 (topical term)"]}},{"label":{"en":["Keyword"]},"value":{"en":["family medicine","MIchigan","pandemic","elderly","South Lyon"]}}],"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/204/686/small/StaceyBartell%2812-3-21%29.mp4_1691690511.jpg?1691690512","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/104643/file/204686","type":"Canvas","label":{"en":["Media File 1 of 1 - Stacey_Bartell_(12-3-21).mp4"]},"duration":1984.28,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/204/686/small/StaceyBartell%2812-3-21%29.mp4_1691690511.jpg?1691690512","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/104643/file/204686/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/104643/file/204686/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/204/686/original/Stacey_Bartell_%2812-3-21%29.mp4?1691690510","type":"Video","format":"video/mp4","duration":1984.28,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/104643/file/204686","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/104643/file/204686/transcript/48794","type":"AnnotationPage","label":{"en":["Transcript of Dr. Stacey Bartell interview [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/104643/file/204686/transcript/48794/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Crystal Bauer: Good afternoon. Today is December 3rd, 2021. My name is Crystal Bauer and we are conducting an oral history interview with Dr. Stacey Bartell on her experiences as a family doctor during the COVID-19 pandemic. Stacey, what is your present title?\n\nStacey Bartell: So my present title is I'm a faculty in family medicine at Ascension Providence Family Medicine in Southfield, Michigan. I'm also the medical director of our South Lyon site. We're a two site practice, or two site residency program. So I am the medical director of the smaller site, it's a little more rural.\n\nCrystal Bauer: Where did you go to medical school, Stacey?\n\nStacey Bartell: I went to medical school at Wayne State University in Detroit, so not too far from here.\n\nCrystal Bauer: Okay. And where did you complete your residency?\n\nStacey Bartell: So I completed my residency in the same program. I was at Ascension Providence Family Medicine, Southfield at my same location in South Lyon, Michigan.\n\nCrystal Bauer: And you, after residency decided to stay around in this area?\n\nStacey Bartell: Yeah. So I'm from Michigan, not too far from where I grew up. So I did a couple of other things for a few years, and then I went back to South Lyon where I did my residency site. And I practiced there for a couple of years, became the medical director probably about eight years ago now. I've been there over 20 years, so I've been there a while.\n\nCrystal Bauer: So could you speak to your many hats and what you do on a daily basis? Or a weekly basis, if that would be easier.\n\nStacey Bartell: Yeah, so patient care takes up a little bit more than half my time. So I've been there 20 years, I've quite a longstanding patient base. I supervise residents, so I help precept residents one or two times day per week. And then the rest of my time is spent admin, which is the medical director duties. So I'm responsible for clinical operations in the office, all things quality, population health, and just overall the resident experience, why they go through their training. Making sure they're getting the best possible resident office experience we can provide.\n\nCrystal Bauer: Could you tell me a little bit about the types of patients who treat your program, what their background is, where they come from?\n\nStacey Bartell: Yeah, so we are in a smaller, more rural suburb of Detroit. We are considered to be the rural equivalent of our other site, which is in Southfield. So Southfield, Michigan is a little bit more urban setting and we're a little bit more rural. Although really more of a small town suburb now, we're not really rural anymore. We do have approximately a 30% Medicare base, there's several retirement communities in our area. We have 15 to 20% Medicaid, wide spectrum of patients. We're 90% Caucasian. We have patients everywhere from business owners to people who have no transportation and can't leave our small town, they struggle with that. To a few homeless patients, a lot of mental health in our small town. Just a wide variety of patients, it's a great place for family residents to train.\n\nCrystal Bauer: Because just the variety of experience they're going to run into?\n\nStacey Bartell: Yeah. We have onsite x-ray, onsite procedures. We have a lot of things on site because we're a little more smaller and distance from the hospital, which is nice. It just is a wide variety of experiences we provide.\n\nCrystal Bauer: thinking back to the onset of COVID, could you describe how it first impacted your area and your faculty? \n\nStacey Bartell: So Michigan was unfortunately hit very early. Our first case was documented in Michigan in March 10th of 2020. Within two weeks, Governor Whitmer had issued a lockdown order. Which in Michigan, you weren't supposed to be on the roads unless you were a healthcare worker or a first line worker or someone who really needed to be out in the community. So the world locked down and we kept coming to work. I remember those lonely days where we were driving to work and we were the only ones on the road. I remember some early calls we had from patients, as COVID was hitting we probably had a couple strong cases that were our patients. But at that time there was no testing or anything. So if we had a possible exposure and the story made sense, we called the Oakland county health department with every case to see if they needed to be tested, and they took them from there. In our practice, we quickly stopped letting people in who had respiratory symptoms.\n\nStacey Bartell: I laugh and reflect on it now because we know that a fair amount of COVID patients also have GI symptoms, but we didn't know that back then. So we let every GI illness in the door, but we weren't letting respiratory patients in. During the time when we locked down, we started to lock down, we would buzz patients in the side door. So we'd screen them and let them in the side door. We're a small town practice and we're right on Main Street. So it's not uncommon for our patients just to walk in on part of their daily routine and pop in and ask something from our office. So I think that was a little bit difficult for our patients when we locked down. I think for a while they even thought we were closed. We had fortunately just switched our virtual platform, probably January before that March. We had offered virtual visits in the office for at least a year before that, but we had very limited success in patients taking them. We probably had done more than 20 virtual visits in the whole year leading up to the pandemic.\n\nStacey Bartell: But the good news is we were really all trained and we had just trained on the new platform. So the staff were trained, the faculty were trained. So that actually put us in a really good starting place when we started. And Ascension in the beginning, which is our employer, was really focused on the hospitals because they had to be because the hospitals just ballooned so fast with cases. And so in the outpatient space, we were just left with figuring it out. I had vague memories of the day that I looked at all of our staff and we said, \"Hey, if you don't need to be here, you shouldn't be here,\" And we sent everyone home. So our biller went home to work, our referral coordinator went home to work, our behavior health provider sent home, our care manager. We literally looked one day and just half the people had to leave our office and they left. So they all worked from home, but it was a little bit scary at the time.\n\nStacey Bartell: We had staff who were high risk that went on medical leaves who never came back, they never came back from the health system and they haven't come back to work. A lot of those staff from then are still remote. I don't think I've seen our biller in person in a year and a half, she's just still working remote.  Our sister site in Southfield at that time, which is a little bit closer to Detroit, which is where the outbreak was much worse than in our area, they had a COVID outbreak in the office. So despite the fact that we're one residency program and everyone commingles a lot, we quickly quarantined from that office because we realized we couldn't risk our office getting infected. So we separated the offices a little bit. The medical schools pulled all the students from our practice one day, just all of a sudden one day they all had to leave also.\n\nStacey Bartell: So there was a lot of rapid change during those first two weeks. Because our local hospitals were hit pretty hard and we have a strong faculty led inpatient service, our faculty were recruited to work the shifts in the hospital. They had very limited supplies at the time, so two residents and two faculty were assigned an entire floor of COVID patients and suspected COVID patients. They worked 12 hour shifts, three days on, three days off for two cycles. It was very scary at the time. A lot of uncertainty. We were asked to pack up all of our office supplies, gloves, masks, and swabs, and those were all shipped off to the hospitals because as they were so shorthanded.\n\nStacey Bartell: Our staff were drafted to work in the hospital. So they literally got the call one day and were told to show up at the hospital the next day for a two week shift. That was hard. It was hard because they were scared, it was hard because we felt helpless, like we didn't know what to tell them or help support them. Fortunately they all came back healthy, everyone was okay. It was just a lot of change at the time. I hadn't rounded in 15 years in the hospital, so I did not go into the hospital. So I stayed in the ambulatory space with another one of my faculty providers. And we converted quickly to almost 90% virtual visits within a week or two. Like I said, we were at least well set up to do that, so was fairly easy for us to do. It was a lot of work for our front staff though, they had to teach people how to use their cell phones and teach people how to log into a virtual visit. And they became tech experts overnight. So that's what we looked like early on.\n\nCrystal Bauer: That's quite a bit. Quite a bit of change in a short amount of time for you and your staff. Definitely. What are some of the unique challenges that you and your program faced with COVID 19 and how have they changed from last year to this year?\n\nStacey Bartell: It's funny, I'm not sure any of our challenges are unique, in that when you talked or practices across the country and the state, that I feel like we're all facing the same challenges, maybe just at different times as the pandemic rises and falls in different areas. For us in particular, the hardest thing is that we were a super high-functioning team before all this started. We were advanced primary care practice, we were in all the quality programs, we just really had our stuff together and everyone knew their role and we function so well. And I feel like that's personally where I feel the loss the most, I think, is that we've had so many staff turnover, we've been unable to replace a lot of them. And so it changes the patient experience, it changes the resident experience, and certainly the provider's stress load and the provider's experience.\n\nStacey Bartell: That's been our hardest shift right now. Our biggest challenge last year was to take care of all of our patients through such crazy times. I remember a lot of the specialist offices shut because they just didn't know how to do virtual visits quite yet and didn't know what to do. So a lot of patients were just left hanging with, how do I even get medical care? I remember the pharmacists were all given the permission to just refill scripts without even talking to providers. So sometimes patients just would call their pharmacy and get refills and wouldn't even have to reach out to their providers. And a lot of them just didn't know we were open, so that was where we struggled a little bit. I think once we got up and running, patients were more comfortable with it. I remember sitting in... We did a lot of one-on-one visits with our residents because they still had to be really supervised for virtual visits.\n\nStacey Bartell: And so we would just sit in our nice, quiet at office every day and we'd see virtual patients all day. But it was fascinating for them too, because we learned how to manage things that we didn't traditionally manage in the outpatient space. We would bring people in for daily IM injections for cellulitis. Or we had a patient who had gone to the ER and maybe had a kidney stone, but didn't want to go back to the ER, because it was too scary to go to the ER. I remember a patient who was diagnosed with cancer in the middle of this and we had to somehow find him a way to start cancer treatment, which was just super hard to do, but we were able to do it. So I remember the positive things that we had through that time too. How challenging it was, but we still managed to provide care, which was our goal, is how do we keep providing care for these patients during this time?\n\nCrystal Bauer: And do you feel like your training as a family physician has really helped really help the successes as opposed to being more specialized?\n\nStacey Bartell: Yeah. I think that we were used to being a little bit of everything. We're pretty much trained in how to cover all of that. And so we also just realized that it was our job and our role. If no one else was available, it was up to us to figure out how to do it. So we just did what we needed to do. I think the resident recruitment thing, as we recruited new residents too, I think that was challenging. I think graduating a group of residents last year was challenging. We said goodbye in the middle of it pandemic and that was hard. Bringing a new class of residents in last year during the pandemic, that was interesting too.\n\nStacey Bartell: Because they had just been medical students not many months before and had seen the start of the pandemic and then they came to us and they were overwhelmed I think their first year when COVID... We've ridden this wave in Michigan four times now. So the second wave, the faculty were all used to it by then, the new resident class wasn't used to it at all. So we watched them quickly get burned out, and had to bring them through the occasion too and teach them how to manage it and how to deal with it and what it was like. So it's just been a long, 18 months, year and a half, almost two years now.\n\nCrystal Bauer: Absolutely. Thinking about COVID right now, how is it impacting the current work?\n\nStacey Bartell: Well, I think it impacts everything we do. I think we still have a large number of virtual visits. I think we've completely changed how we provide a lot of care. I'm not sure patients are still riding this journey with us in the same way. I think a lot of patients, especially in our small town, want it to be over. We've had a few patients who just get mad that they have to put a mask on at the front door, and so they leave, because we have mandatory masking obviously in all medical offices.\n\nStacey Bartell: I think we're on this journey of trying to explain to patients that this is just what a pandemic looks like in public health, and this is what public health crisis looks like. And how do we ride the wave and keep riding the wave and still provide care? So the good news is a lot of patients have started to come back in for physicals and do their preventative care, and I think that part's up and running still pretty good. I think there's still a handful of patients that are still out there not seeking care because of either fear or frustration, like they don't want to wear a mask or they don't want to get a vaccine. Or there's still, unfortunately, I think a lot of patients that have not returned to care, which concerns me a lot.\n\nCrystal Bauer: You mentioned the impact on your residents, but could you talk more about how COVID-19 has impacted the learning of your residents in family medicine and what changes you think might be permanent?\n\nStacey Bartell: All the things they learned in this last year and a half. They learned a completely different thing in their residency than I learned in mine. They learned how to live through a pandemic and how to practice medicine through a pandemic. So as much as they did lose some rotational experience last year, they also got an amazing... They all went to work at the inpatient floors, they all managed COVID patients, they all learned how to give COVID vaccines, they all managed virtual visits. They learned a bunch of new things, which was great too. And they were on the cutting edge of medicine. Everything going on in medicine, they were exposed to in the minute and they became experts in quickly and rapidly. So I do think they lost some of rotational experiences and some of the stuff that would be helpful in family medicine, but I think at the same time they got some new unique experiences.\n\nStacey Bartell: I think the transition to virtual care, they were well suited. For this generation of residents we have now, their technology and their ability to do virtual visits is much quicker and faster than I've ever learned them. So they're ready to go with that in the future and I think that will be a good thing. I think learning to deal with the burnout that we're all experiencing right now as we're riding our fourth wave of COVID in Michigan is challenging for all of us. I think that's something that they're also learning is how to be adaptable, how to be resilient, how to be grateful. All of those things we're all still working on. So hopefully those changes are permanent, learning how to ride the waves, but hopefully the waves will be less impactful in the future of our day to day experience.\n\nCrystal Bauer: Can you just describe the vaccine rollout in [inaudible] area and your staff and your staff reception?\n\nStacey Bartell: Yeah. So we were very blessed and lucky. Our hospital system was able to start vaccinating all the healthcare workers in December of last year. So I got my first vaccine just before Christmas, I got my second vaccine in January. We all remember sitting in this big room at the hospital, the national guard had come in to give our vaccine. And we all just got our vaccine and then we went and stood into a room and all just quietly stared at each other while we waited our 15 minutes to make sure we were okay, and then we all went back to work. So I think we were a little nervous in the beginning, at least healthcare workers. Our office staff were in that second round, so they were all vaccinated by January and February. And then I think our hospital system was able to shore up large vaccination centers, maybe started February, March is when we started to really do that around here. So that was a little bit challenging because our hospital system is spread out across a large chunk of Southeastern Michigan.\n\nStacey Bartell: So their large mass vaccination center they were able to set up was at a local community college, but at that community college was a good 45 minutes from our office. And we started vaccinating, obviously the older population first. And so it was a little bit challenging to get appointments over there for our patients and then to get our patients to drive 45 minutes to get the vaccine. So we have a lot of fond memories that time. We literally printed a list of all of our patients starting from a hundred years old down. And literally, there was three or four of us in the office and we just started calling those patients every day as the vaccine appointments opened up and we had access to them. We called every single patient and we tried to convince them to go get a vaccine. We had carpools from South Lyon, some of our 80 year olds drove our 90 year olds to go to the vaccine.\n\nStacey Bartell: We would call a parent who was 90 years old, and they'd be like, \"Can you call my son?\" So we'd hang up, call their 70 year old child and say, \"Hey, can you take your elderly parent to go get their vaccine tomorrow?\" And they're like, \"Sure.\" So we were doing everything we could to facilitate patients to get the vaccine. And everyone wanted it, they were on waiting lists everywhere. I think patients quickly learned that they were probably going to have to drive 45 minutes to get the vaccine. There just wasn't a lot availability in the beginning. If they weren't able to get there, our office also signed them all up on whatever county health department they lived in. We signed them up on the health department list, because a lot of them don't have electronic access or computers at home or knew how to do that. So while we had them on the phone, we would put them on the county department's waiting list for vaccines, with the hope that if we didn't get to them first, the health department would be able to call them and get them in.\n\nStacey Bartell: So that was good. It's funny how everyone was so grateful for a vaccine back then. And then we went through the time of, \"Okay, so now who needs a vaccine and who wants a vaccine and how are we going to convince them to have a vaccine?\" So I was a very early advocate for primary care being able to give vaccine in our area. I fought very, very hard for it in the beginning because I truly believe that we are still the vaccinators and we are still the right people to get the vaccine from because of the information we provide. And patients comfort level with us and their trust in us. And so we fought very hard to be one of the first facilities in our area to offer the vaccine. So we've had the vaccine, oh gosh, I think early summer, sometime in the summer we started vaccinating in our office. And so a lot of it's been challenging. The health department had to give the vaccine to the hospital, the hospital has to store the vaccine and dispense the vaccine to us.\n\nStacey Bartell: But we're actually pretty proud because of our 81 practices in our health system, we are the top vaccinating site by far. Our patients have taken up, I think 20% of all the health system's ambulatory space vaccines so far. So we have a lot of patients who we then had to call and reach out to and to convince to come in and get the vaccine. And now we've completely transition to be just like any other vaccine you get when you come in the door. So if you come for your appointment and you're due for your booster vaccine, we offer your COVID booster today, which I think has been very great for patients. As they've opened up the booster vaccines locally, we now have another shortage of vaccine access in our area, which means all the pharmacists are all busy giving vaccines and you can't get a vaccine appointment. So now we're back to nonstop calls on, \"How do I get a vaccine? How do I get a vaccine?\" And we're struggling with, \"How do we have enough staff to give vaccines all day, every day, as often as we can to people who need them?\"\n\nStacey Bartell: And we're having a lot of breakthrough cases right now in Michigan, meaning that the boosters are needed. So we're trying to get everyone their booster shot as quick and as fast as we can. So we're working on that right now, too. So it's challenging now because there's still those stragglers who haven't been vaccinated. And I think I chuckle because I think my patients are tired of my 20 minute discussion at the start of every visit about how and why they need a vaccine and how important it is, and how I really want them to get it. And my biggest fear, frankly, is if I didn't convince them to get it and they get sick and they go in the hospital and they die, did I do enough to convince them to get the vaccine? So that's been hard. But that's where we're at right now. We're doing pretty good in the state of Michigan, I think, from a vaccination standpoint. I think our numbers nationally maybe don't look that good, but we feel locally like we're doing a good job.\n\nCrystal Bauer: Thinking about what skills family doctors need to fight this pandemic, what do you think family doctors name?\n\nStacey Bartell: Well, I think one of the things that's become apparent is we're going to need to learn how to deal with the misinformation that we're dealing with right now, which is really hard for us every day. We're all going to need to get a little bit better at community health. It overlaps everything that we do. And as we've been through this pandemic, we've really had to look at our practice from a population health perspective. How do we vaccinate everybody? How do we get everybody boostered? How do we get flu shots to everybody? So that's been great from a population health perspective that we learn how to do that better. I think we're learning how to practice resilience. So how do we lean to each other for support? We're really the only ones that understand which each other are going through and other health providers are going through right now.\n\nStacey Bartell: We obviously need to learn how to embrace technology. And the next generation is obviously way far ahead of us on this. But as we talk about things like remote patient monitoring and some other things we're working on trying to get going, that's been great. I think leadership. One of our biggest things we've tried to promote on this is sending a strong message on masking. We do not write waivers for mask, we do not write waivers for vaccine waivers. We don't endorse off label use of alternative therapies for COVID. We're really trying to set a good example of masking all the time in our offices. We're just trying to be leaders on this and what it should look like and how we should all be on the same page and work together in our community for this. And I think that's been important for us to do.\n\nCrystal Bauer: What have you learned through this pandemic?\n\nStacey Bartell: Well, I think I've learned how to be grateful every day, or you won't last the long haul through this. So I'm grateful my family made it through intact. We lost my father-in-law early this year and we early on started weekly Zoom calls with my husband's parents. And so we're so grateful we had that time with them and that we made that effort. I think I've learned that family medicine are the best advocates for our patients in the community, and that we have to continue to ride the waves of the pandemic. I've learned that pandemics are tough. Practicing medicine was pretty easy before this, and it's a little bit more difficult now. So we're still riding the waves every day and learning how to do this well.\n\nCrystal Bauer: What do you think your residents have learned?\n\nStacey Bartell: Hopefully resilience. I think I look at the crew that came in last year, the new first year residents, and I think to myself what a different experience they've had from any other class we've had before. So I think they're learning, again, good leadership from us. I think they're learning how to practice medicine in a time of uncertainty. I think they're learning good conversational skills, redirecting of misinformation. I think they're learning how to advocate for their patients. I think they're learning to change how you practice medicine rapidly. So I remember when they first went to the hospitals last year, they literally said when they walked in the door, they were handed a list of preferred treatments for COVID for the day.\n\nStacey Bartell: And then they'd walk in the door two days later and they'd be handed a different list of preferred treatments for COVID every day, because they were learning as they go what the best treatments were. So I think the residents learn a lot in that short time. They also learned to be a big part of the team. Our hospitals wouldn't have survived without our residents during this time. So they learned how valuable they were. They learned how much they knew, which was tested really early on. So I think that was a great experience for them too. Hopefully they're learning... A lot of our residents are traveling right now. I laugh because we have a few residents who like to go out to Mexico on a regular basis. So I think they're also learning the balance, their private life with the stress of practicing medicine right now, which I think is good for them.\n\nCrystal Bauer: If you could go back to the start of the pandemic and start it over again and do things differently regarding COVID-9 care, what would you change?\n\nStacey Bartell: I'm not quite sure. We did the best we could every day, every moment, and every step of the way. I wish as a community we were more out there with information every day, early on. I wish somehow family medicine was out there just projecting the information rather than letting the politicians lead the information or leading whoever we have out there as our messengers. Family medicine should be right by their side projecting the same information. Why do we need to vaccinate? Why do we need to wear masks? All of those types of things. I wish we had shared best practices on outpatient COVID care. What we do in our office is we keep a list of our patients in our practice who have COVID, and we call them every one or two days to check in on them and see how they're doing.\n\nStacey Bartell: We get them on a list right now for monoclonal antibody as soon as we can, we manage them by the phone. We want to make sure they feel supported and they know what to do if the symptoms are worse. And so I don't think all providers in our area are doing that at same thing. A lot of patients I think right now reach out to their providers and their providers are saying, \"Well, there's not really any treatment for COVID. So it's just a virus, if you get sick, go to the emergency room.\" And we're trying to support our patients a little bit differently, because I think we find if the patients don't feel supported, they're trying all sorts of alternative, crazy treatments they find in the community. In the last couple weeks, I've had two patients who somehow are inhaling colloidal silver to treat their COVID.\n\nStacey Bartell: And so some days I just hang up the phone and I'm like, \"What just happened and how did that happen and how did we let that happen?\" So I worry about how, did we not do a good enough job in getting information out? Did we not do any good enough job in explaining how viruses work? COVID is a weird virus, and so it has a lot of crazy symptoms. And I think unfortunately patients are seeking information on the internet as opposed to from us providers, and I'm not all sure all providers are giving the same information. So I think somehow we need to be more cohesive as a group and all on the same page in how we're treating our patients with COVID and how we're giving them information through COVID.\n\nCrystal Bauer: How has the pandemic changed you as a physician?\n\nStacey Bartell: So I'm not really sure. I think I'm still processing this, as you can tell. I'm exhausted and angry a lot these days, which is not fun. I struggle with letting people down every day as a leader. At times, I'm just frustrated. I'm frustrated with how many barriers in our way and getting back to some level of normalcy, so whatever that is. So staffing is real tough right now in our office. We want to make sure we're providing the best care that we can for our patients. And like I said, we don't look like we looked like two years ago as a practice, we look completely different and we don't want to let our patients down. So what does that look like when you're down probably three quarters of the staff or half the staff that we had before? And I'm not quite sure that I figured that out. So I'm working at it every day, I'm working on resilience, I'm working on being grateful, and that's all I can work on right now.\n\nCrystal Bauer: Who are the people you've worked with most closely during the pandemic who impressed you during these times? Are these established professional relationships or new relationships?\n\nStacey Bartell: So definitely the faculty group in my office. They've been amazing. I think we all stood by each other, every crazy minute. And certainly our staff. I'm grateful for those who stayed with us and those that have joined us in the middle of the pandemic and stayed, because we certainly haven't always shown our best every day through this pandemic. It's a crazy time to work in healthcare. It makes me sad that we don't have more people going into healthcare right now, and I hope that changes. So I'm grateful for all of them. And that's been our closest group to work with through this pandemic.\n\nCrystal Bauer: What's your sense of where family medicine is going in the future?\n\nStacey Bartell: I think we're going to rebound. I'm hopeful we're going to get back to the high functioning practice we once were. Rather than right now, I feel like we're just trying to survive every day. So I think that's going to take a little bit of time. I think we're going to need to do some recruitment in our practices in different ways. I think we're going to have to bring medical assistants in a different way, staffing in a different way. We're just going to have to look at supporting practices in a different way.\n\nStacey Bartell: So I think family medicine is going to be just fine. I think we're such a strong specialty and the core of what everything medicine does every day is medicine, and certainly the future of medicine is family medicine and primary care. So I'm not worried about the specialty, I'm worried about the physicians and the rebound of physicians. We have a lot of core group of just physicians I've worked with for over 20 years who have retired during this pandemic. So I think that's been just different. But I think we're all going to be okay, I think it's just going to take time to get there.\n\nCrystal Bauer: Are there any [inaudible] important issues in the specialty related to COVID-19 that we have not addressed here that you'd like to share with us?\n\nStacey Bartell: Nope, I think we've covered everything. I think one of the things, the other thing that brought me joy during this pandemic is I chaired a conference this year for society of teachers of family medicine and practice improvement. And one of the most amazing things that came out of this conference this year, which also refreshed me for family medicine, is I was amazed at the way that practices across the country found ways to do process improvement in the middle of this pandemic. Whether it was popping up vaccination clinics or learning how to swab or treat COVID patients in the ambulatory space safely, or how to practice a different type of medicine or virtual visits. And so that cheers me up, because the fact that we're already learning how to do practice improvement and we are starting to do that again, despite all of the challenges right now that we're facing, I think that is important for us as a specialty and that will keep us going.\n\nCrystal Bauer: I think that speaks to your real resiliency as family medicine as a whole.\n\nStacey Bartell: I hope so.\n\nCrystal Bauer: Yeah. Yeah.\n\nStacey Bartell: I hope that's what we're trying to teach and I hope that's where we're going, and I think that we're going to be fine, I think it's just going to take some time.\n\nCrystal Bauer: Well, Stacey, thanks so much for doing much for doing this interview. If you have nothing else add [inaudible] interview. And I'd like to thank you so much for all much for all your hard work.\n\nStacey Bartell: Thanks so much for having me.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/104643/file/204686#t=0.0,1984.28"}]}]}]}