{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/kk94748465/manifest","type":"Manifest","label":{"en":["Dr. Andrew Slattengren"]},"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":["2020-10-09 (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":["Minneapolis","redlining","family medicine","Black","African American","structural racism","George Floyd","systemic racism","Medicaid","protests","Hawthorne neighborhood"]}}],"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/000/198/940/small/AndrewSlattengren%2810-29-2020%29.mp4_1689789740.jpg?1689789742","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100603/file/198940","type":"Canvas","label":{"en":["Media File 1 of 1 - Andrew_Slattengren_(10-29-2020).mp4"]},"duration":2258.8,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/198/940/small/AndrewSlattengren%2810-29-2020%29.mp4_1689789740.jpg?1689789742","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100603/file/198940/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100603/file/198940/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/198/940/original/Andrew_Slattengren_%2810-29-2020%29.mp4?1689789740","type":"Video","format":"video/mp4","duration":2258.8,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100603/file/198940","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100603/file/198940/transcript/46424","type":"AnnotationPage","label":{"en":["Transcript of Dr. Andrews Slattengren interview [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100603/file/198940/transcript/46424/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Crystal Bauer: Good morning, Dr. Slattengren. Today is October 29th, 2020. Please confirm for the record that you were aware that this is being recorded and that you are giving your permission to do the interview.\n\nDr. Andrew Slattengren: I am.\n\nCrystal Bauer: Would you please give your name in full?\n\nDr. Andrew Slattengren: I'm Andrew Heslin Slattengren.\n\nCrystal Bauer: And what is your present title?\n\nDr. Andrew Slattengren: I am an Assistant Professor in the Department of Family Medicine and Community Health at the University of Minnesota Medical School. I'm also the Associate Program Director and Director of Osteopathic Education at the North Memorial Family Medicine Residency Program.\n\nCrystal Bauer: Where did you go to medical school?\n\nDr. Andrew Slattengren: I went to Lake Erie College of Osteopathic Medicine.\n\nCrystal Bauer: And where did you complete your residency?\n\nDr. Andrew Slattengren: University of Wisconsin, Madison Family Medicine Residency Program.\n\nCrystal Bauer: So can you speak a little bit about your current positions and what you do on a daily basis?\n\nDr. Andrew Slattengren: So I do full scope family medicine with an academic twist, which means I see patients in clinic and supervise residents and students in that setting. I also work in a level one trauma hospital. And I work on the family medicine service, but I also take medicine call and obstetrics call in that setting. On top of that, two afternoons a week I teach future physicians courses at the University of Minnesota for undergraduate students who are planning on going into medicine. And then on top of all that, I have some academic time where I can work on my duties as the Associate Program Director, where I set up the educational offerings from my clinic and our hospital for medical students and residents.\n\nCrystal Bauer: So you're not busy at all.\n\nDr. Andrew Slattengren: No. And yesterday was a classic day. I supervised residents in this clinic in the morning. In the afternoon, I had a two hour webinar on family medicine reinvestment, and then I went and taught my undergrad class for an hour and a half. I was able to come home and have dinner with my family. And then I went back to the hospital, took medicine call. And on top of that, took obstetrics call and came home this morning around eight o'clock just in time to see my daughter off to school.\n\nCrystal Bauer: Wow.\n\nDr. Andrew Slattengren: Yeah.\n\nCrystal Bauer: Busy 24 hours.\n\nDr. Andrew Slattengren: That happens.\n\nCrystal Bauer: So could you tell us a little bit about the types of patients you treat in your program and who they are and where they come from?\n\nDr. Andrew Slattengren: Yeah. So we provide full spectrum care to patients of the Hawthorne neighborhood from North Minneapolis. North Minneapolis neighborhoods have experienced systemic and structural racism, and really disinvestment from the city and those in power since the early 1900s. And that's come through defunding of social services and safety nets, over policing, red lining, school neglect, excessive pollution, environmental, water, air, and predatory lending and slum leasing. Yet, somehow our patients in our neighborhood continue to be this vibrant, amazing, thriving community, primarily of African Americans, native Americans, African immigrants, including Somali patients. And the strength of those people is just amazing. And we've had a presence our clinic for 40 years in that community.\n\nCrystal Bauer: Wow.\n\nDr. Andrew Slattengren: Yeah. Yeah, the majority of our patients are Medicaid or Medicare recipients. And our patients come to us for routine family medicine care, but also prenatal care, office based medication assistance for opioid treatment, sexual and gender minorities looking for inclusive primary care. And really anything else you can imagine, needing to see a physician for our clinic has been there for them for 40 years.\n\nCrystal Bauer: So what unique challenges do you and your program face with COVID-19? What are those barriers and obstacles that you've come across?\n\nDr. Andrew Slattengren: Yeah. So I think taking care of our population, what puts us in a unique situation is we already knew the health disparities that existed in the United States. But the COVID-19 pandemic has really disproportionately impacted the communities of color in America. And it's shined a light on the fact that black, indigenous, and people of color have suffered from generations of systemic racism. Those patients are more likely to work in frontline jobs, less likely to have a position where they have appropriate paid sick time when they are ill or when they're exposed to people that are ill.\n\nDr. Andrew Slattengren: Also, they're more likely to suffer from underlying health conditions like hypertension, diabetes, and obesity that elevate the risk of complications from COVID-19. And in that setting, as we moved through the pandemic and we created this social isolation and had these communities that really rely upon one another to make it through every day, that feel that pressure. Just a couple of months into the pandemic on May 25th, George Floyd was murdered in the streets of Minneapolis.\n\nAnd for three days the communities in Minneapolis and surrounding Metro experienced fires and really a righteous rage in response to decades of oppression and racism and violence against both communities. On May 28th, our clinic and the surrounding Broadway Avenue Corridor had similar violence. And the internal structure of our clinic was broken into and looted and destroyed. And so we were forced to close our doors to provide care to those people who really needed it. Our physical space was shut down, luckily, only for two and a half weeks. We've continued to provide uninterrupted virtual care to our patients.\n\nAnd the other things that happened is after that community violence, the public transportation was stopped leaving our patients without mobility. Most of our patients do not have their own vehicles. The grocery stores and convenience stores in our area that were within walking distance were all closed. So our patients were left without food or toiletries. The pharmacies were closed, leaving our patients without access to medications that they use to control their chronic conditions. And so that, like I said, with our clinic being closed to visits while the physical structure is being repaired, we were only able to see our patients through video or phone visits.\n\nAnd even that exposes a level of institutionalized racism in medicine, as the reimbursement rates are dramatically higher for video visits. And our patients don't have access to the technology needed to complete those visits. In response to our clinic being closed and our patients having all those needs are, our shared parking lot that we shared with a couple of other businesses turned into a distribution center for food, diapers, baby formula, toiletries.\n\nAnd people from around the twin cities, thousands of people dropped off supplies in almost a constant flow in that first week. And this was all set up by community organizers. So myself and other physicians and med students, former residents from our program volunteered their time out there to distribute whatever the people of our community needed. So, that was our unique challenge through the days of COVID.\n\nCrystal Bauer: Very unique, very powerful. So much going on, even non-COVID related for your city. Can you describe a little bit and you have already, but how COVID-19 has impacted your current work?\n\nDr. Andrew Slattengren: Yeah. Our clinic is now open at our previous capacity. Yet, due to that revenue decline from early in the pandemic, when hospital systems shut down elective procedures, and we had decreased patient volume early in the pandemic. We have lost significant number of our clinic staff due to furloughs and layoffs, which has led directly to increase work duties for those who remain in the clinic. We've had to adjust every single aspect of our standard work and usually those types of things take weeks and subcommittees, and then it gets okayed, and we just have to change them on a daily basis.\n\nDr. Andrew Slattengren: It's that constant change along with the increased work and ever present stress of virus transmission from patients has had a detrimental effect on our staff satisfaction, add on the pay cuts that occurred to them. And our staff is not only having decreased satisfaction, but they're burning out and they're really tired. For physicians, we're also working harder than ever at lower compensation rates. Similar, we've had our pay cut dramatically. Over the last two months though, I've seen more patients per shift in clinic than I have in the previous nine years that I've been at Broadway Family Medicine. 80% of those patients are in person and 20% are virtual visits. And so that has put a whole new change on the flow of clinic.\n\nDr. Andrew Slattengren: How do you communicate with people? How do you get people what they need? It's interesting. Some of the sickest patients who should be coming to clinic choose to do virtual visits because it's so hard for them to come into clinic and that care delivery can be very complicated. Some of that increased work is not just due to that patient volume. Some of that increased work is due to our interprofessional teams being broken up, our behavioral health providers, our pharmacists, our dietician, and social worker, and care coordinators are working many of their shifts virtually because our physical space doesn't allow for us to have the number of bodies together like we used to do and still stay socially distance appropriately.\n\nDr. Andrew Slattengren: They're available via video chat or phone, but it doesn't match up to the previous experience of having them right next to you where you can pop a question at them or having them join you in a visit. We often did shared visits at my clinic with the other health professionals or even tandem visits so the pharmacists or the dietician could take care of one aspect of care. And the physician could come in, in more of an advisory role on top of that. And so our patients are really not getting expertise from those other professionals that they deserve, or honestly, that they really need.\n\nDr. Andrew Slattengren: In the hospital, everything also has changed dramatically. Early in the pandemic, we were lucky in Minnesota to not have the surge of patients that other places in the country did. So we had time to learn from the patient's experience and build our clinical pathways in the hospital setting. We did have inadequate PPE though at that time. And most of us were honestly working scared. We didn't know how safe it was for us to be at home. I, myself, after working hospital shifts would isolate in my basement and made sure I stayed a good distance from my family. And that was difficult. And then most of my colleagues were doing the same thing.\n\nDr. Andrew Slattengren: At 7:00 PM daily, early in a pandemic, we would get calls nightly from our hospital for COVID updates, where we would talk about bed status, COVID numbers in the state and in our hospital, supply updates where we would each hear about how many paper mass, PPE, other PPE, including N95 masks, how many swabs we had to use. All these things that you don't normally have to worry about in the richest country in the world. And then they give us highlights on the changes being made that day to structures and processes, which were happening on a daily basis.\n\nDr. Andrew Slattengren: One of the changes made early on was we went to strict geographic rounding, where physicians or a small team of physicians such as me and my resident team would only stay on one floor and only take care of patients on that floor. And because we took care of obstetrical patients as well, those of us who were on the family medicine team, we were given a general medicine floor. And what that meant was I no longer rounded on patients in the ICU or in the step-down high acuity units. I couldn't follow my patients in those settings, or I couldn't follow my patients in the post-operative units.\n\nDr. Andrew Slattengren: And we also couldn't go down to the emergency department to admit patients or to even do consults for our community patients, which was something that would happen routinely in the past. If a patient just needed a resource and the emergency department felt that we would be the best ones to do that, they'd call family medicine. But because of geographic rounding, we'd have to wait until patients were admitted to the hospital and then came up to our floor for us to provide care.\n\nDr. Andrew Slattengren: It's left many of the physicians in the hospital feeling isolated because we are siloed away from one another. And that's decreased the comradery with peers that we previously had. There is a huge benefit to that. Our team, our medicine team, working with the same nurses on a daily basis has really strengthened our communication skills. And it honestly has decreased our transmission, possibly a virus from patient-to-patient within the hospital. We're now in a position where we have adequate PPE. And we know that our time to obtain COVID tests is down dramatically from where it was early in the pandemic.\n\nDr. Andrew Slattengren: Yet, we're starting to build up at this point in late October with another surge and our hospital again is starting to look like we're filling up beyond where we were previously. The difference now is that even with this new surge occurring is, I don't think we're working scared at all. But the constant, emotional stresses and mental gymnastics of having new policies and procedures on a daily basis come down, has us exhausted.\n\nCrystal Bauer: How do you see COVID-19 impacting the learning of students and residents in family medicine and what changes will be permanent?\n\nDr. Andrew Slattengren: Yeah. So our residents, in response to COVID-19, have had a decreased ability to participate in away rotations. So historically, our residents would go to a rural sites and many of them would end up working in those places in the future. Those have been shut off. And subspecialty clinics, even to kind of learn a little bit deeper on certain issues. Those have been shut down. And even the international travel, of course, are shut down. So people that really had a flavor for global health aren't able to really explore that option at this point.\n\nDr. Andrew Slattengren: In the hospital, because of our geographic rounding, they have not been caring for a full spectrum of inpatients. Being on a general medicine floor and not being able to take care of post-surgical people and not being in the ICU or step down, there are just conditions that they haven't been able to see. We're fortunate that our hospital now has opened up the ICU for our residents to do rotations there. So they, again, now are experiencing those rotations. And our hospital leadership decided early on that they would not shut the residents out of labor and delivery or the emergency department. So that has been a huge benefit for our residents, but I know around the country that has not been the same experience.\n\nDr. Andrew Slattengren: In the clinic, our residents took a huge hit early in the pandemic. Their numbers are down dramatically. Patient care numbers, overall, are down dramatically compared to residents in previous years. One of the biggest changes for the residents though, has really been how we deliver our didactic education along with other educational offerings, such as grand rounds, morbidity and mortality, everything's moved to Zoom format. After initial growing pains, our faculty have adjusted and we're now providing offers that seem to both meet the needs of the educational requirements of the residents and are highly valued by the learners.\n\nDr. Andrew Slattengren: These virtual sessions might meet those needs, but they're missing out on the social aspect of being together. And they're feeling a high amount of burnout and a big part of it is the loss of those peer interactions. So we're working to try to build in some other more social Zoom options where they can stay safe, but still interact with one another. I feel that some aspects of that geographic rounding will be permanent. The huge benefits of communication, the improved efficiency by not having to run around the hospital are aspects that I see continuing.\n\nDr. Andrew Slattengren: Also, we'll likely have some percentage of our educational sessions continue to be virtual, with the understanding that our learners really would benefit from social interaction. And we need to build that onto those things. For our students, man, they did virtual rotations for months. So if you ask them how to answer some of these task questions that are routine on boards, they're great at that. They're well behind in their clinical skills and communication skills compared to where we usually see students in the fall, but they are so resilient and adaptable. The skillset that we have had coming through our rotations have just been like, \"I just want to take care of people.\"\n\nDr. Andrew Slattengren: And it's really great to see that, that hasn't been lost on them. The reason why they went into medicine, it's to take care of people and to help people through these difficult times. I think some of the rotations, so we historically, at my center had four week family medicine rotations were required. And because of the sheer number of students that have to get through in the shorter time, we've decreased that to two. And in response, we have created a number of sub-internships at our clinic and at our hospital so that these students can have four or six weeks of family medicine instead of the two weeks that are mandatory.\n\nDr. Andrew Slattengren: And so the students now are sharing. Instead of having two to four students at our site, we are having six to eight at all times. And I honestly think that having a larger number of students has allowed them to have their own social network. And it's allowed us to create some educational offerings for them that we haven't in the past. So I see that as a benefit that we feel that we can continue to provide a higher number of educational opportunities for our students, and subsidize those with a lot of the virtual learning that has been developed in the last year.\n\nCrystal Bauer: What have you learned through this pandemic?\n\nDr. Andrew Slattengren: First of all, that the ACGME was right when they said resilience and adaptability and lifelong learning were important competencies. And that it's amazing how well most of us family medicine docs are at those things. Some of that is the reasons why we went into family medicine. We like the barrage of different things coming at us. We like taking care of people at every different aspect of their lives and adjusting our responses. And so I've learned that they were right when they did that.\n\nDr. Andrew Slattengren: I've learned that a community focus is really where it's beyond just saying the words or having a little rotation where you learn about a couple of the community outreach things around your clinic. We need to adjust the care that we deliver to meet our patients' needs. And we can do that. Sometimes it takes physically having your home taken away to understand that, but you can do that. I did clinic from the hospital library one day, calling patients and getting on the phones because there was no other wifi access around. And on top of that, if we're going to be taking care of our patients and meeting their needs, it's really important that we become advocates. Advocacy for our patients and for our profession is so important.\n\nDr. Andrew Slattengren: I've been lucky because I have a position in the Minnesota Academy of Family Physicians as their president currently (and I was president elect when the pandemic started), that I've been able to really help formulate some responses to things that are going on and also because of my ties to a large land grant institution, and have had the support of our university to be able to speak out on those issues because our university feels that we need to respond to the needs of our patients. And that's why we're here.\n\nCrystal Bauer: What do you think your students have learned?\n\nDr. Andrew Slattengren: So I think that they've seen that physicians can and will step up and that community really matters. And that family docs can and should care for patients outside the walls of their clinics and treat patients and understand patient settings, where they live, learn, work, and play because that's where health occurs. It doesn't occur in the hospital setting or in the clinic setting. Health is in their everyday lives and students and our residents are starting to learn that, that's where we need to take care of them.\n\nCrystal Bauer: If you could start this year over again and do things differently regarding COVID-19 care, what would you change?\n\nDr. Andrew Slattengren: First of all, I would use my positions within the academy to push for a more unified plan from the national and federal level. We have had patchwork planning and care, and it felt like each of our individual states and even hospital systems has been left up to their own to make those decisions. \n\nI would have focused more, in my clinic leadership, on setting up processes to care for our patients with chronic conditions in the outpatient setting. We spent all of that lead time when people were getting really sick in New York and other parts of the country, focusing on our inpatient care and our processes there. Looking back, can now see that we left a higher number of our patients high and dry by not paying attention to how we were going to continue to take care of them and how we were going to deal with the disruptions in their care. \n\nWe adopted pretty quickly to the virtual platforms, but I think if I could go back, we would've helped set some of those up earlier with our patients.\n\nCrystal Bauer: During the pandemic, what do you feel you've done right and why?\n\nDr. Andrew Slattengren: I think I've been able to communicate with the patients and the public about what's really going on and to give them a realistic status update. I've been able to talk to schools. I've worked through social media. I've also been on TV news because patients and the community really need to have facts and not just rhetoric. I've been able to keep my team safe. We had early adoption of a lot of infection control measures before they were recommended both in our... We were just adopting them in our clinic and our hospital setting, even before either our health systems were recommending some of those.\n\nDr. Andrew Slattengren: And then I think I've continued to stay curious and that's important. I'm always learning. And from early on in the pandemic, trying to stay a step ahead of what's going on here and being able to judge the information that's coming out and how to put that altogether, that's been important. But above all, I think the biggest thing is I've been able to spend a lot more time with my family because anytime we're away from work and you're stuck at home in quarantine. And more than anything, I feel like I've worked really hard on the relationships in my life, both in my family, but also reaching out to colleagues to make sure we all have each other's back.\n\nCrystal Bauer: What do you feel you've done wrong and why?\n\nDr. Andrew Slattengren: Yeah, I think we didn't reach out to our patients earlier in the pandemic to ask them what's going on? How could we provide you care? We did have a team of medical students come along in May at the University of Minnesota. And they eventually reached out to all the patients who we hadn't seen in a month or two. And there was so many cases of social isolation, of food insecurity, of rationing medications that came out of those brief intervention conversations. That I really feel like we could have reached out sooner to our patients.\n\nDr. Andrew Slattengren: I think we were so focused on who we were taking care of in front of us and putting up new processes, that we didn't take care of those who weren't reaching out to us. And again, we had a lack of a unified front. Everything seems to have become political. I mean, even mask wearing has become political and to not have that unified front has been devastating.\n\nCrystal Bauer: Who are the people you have worked with most closely during this pandemic? Who impressed you during this time and why? And were these established professional relationships or new relationships?\n\nDr. Andrew Slattengren: Yeah, I think the first group that's really impressed me is our resident physicians. They didn't even hesitate when barriers were put in front of them. They just said, \"No, we're going to go out and engage with the community. We're going to do these things. We're going to take the lead on that.\" Many of them have started their own advocacy journey. Since that time they become more active in a lot of the policy development, and many of them are trying to figure out, \"How can I get more involved with our state legislature to get things changed.\n\nDr. Andrew Slattengren: Next is my faculty colleagues. Many of us have families. I have one colleague who's been out of work five times because she has a child who's at daycare age. And of course they get fever and they whole families out. And we've all just picked each other up when we need time off. When the pandemic was really rolling, there were days where somebody was scheduled on a weekend, but since we're all socially isolated, some of us would go in and pick up shifts for each other. And just to see how much we all have really demonstrated that caring for one another through our work has been amazing.\n\nDr. Andrew Slattengren: And then our clinic leadership team, as the educational leader, I get to work with our medical director and our program director and our nursing supervisor and our clinic supervisor and our front desk supervisor. And just that group's communication skills is amazing. The ability for them to complete duties while facing their own life challenges at home, away from work, has been a testament to the endless passion, what they do for their patients, and why we work where we work. So all of those were really established professional relationships. Those are the people who have impressed me the most.\n\nCrystal Bauer: What is your sense of where family medicine is going in the future?\n\nDr. Andrew Slattengren: I hope that family medicine will now ask the communities what they need, and that we will adjust our care to meet the needs of that society. Things like on demand virtual visits should be there. I mean, otherwise people are going to keep jumping in to the CVSs and the Walmarts. But there is a role for personal relationships and having that continuity of care and being able to take care of people throughout the spectrum of their life, but also in different settings.\n\nDr. Andrew Slattengren: And that's why we need to continue to have family medicine and to have those face-to-face interactions. Further, I think we will be the voice of our communities within the healthcare system as we work to dismantle those structures that have really been built out of racism and continue to reinforce care that increases health inequities.\n\nCrystal Bauer: Any views on important issues in this specialty related to COVID-19 that we have not addressed here that you would like to share with us?\n\nDr. Andrew Slattengren: No, I'm okay with that one.\n\nCrystal Bauer: Okay. Well, are there any last thoughts you would like to add? This is your opportunity to share your thoughts with future generations listening to this recording, or to set the record straight on anything you feel might be important to address.\n\nDr. Andrew Slattengren: Yeah. I think when you look back a 100 years, I've had the time, a couple of times to look back at what happened in the 1918 pandemic. And it's such a broad view that it's really hard to feel what happened to individual families, to individual people, to individual communities. I just would like to stress the sacrifices that so much of our community and our country have made. Our teachers are doing double work, they're teaching children at school, while at the same time teaching kids online. Older kids haven't been in school. My daughter went back to her first day of school today since March, in person.\n\nCrystal Bauer: Wow.\n\nDr. Andrew Slattengren: So all of a sudden children were learning on a totally new platform. Parents had to adjust work and life, many people working from home so that they could help be tutors to their kids. So many aspects of our business world have been demolished financially and are in ruin. There are so many restaurants and local shops that aren't going to be able to survive this, and we're going to have a new face. I think that those are the things that get missed when you just look at the sheer numbers. And if you were just to look at how well our economy seemed to have been doing throughout this pandemic, you'd say, \"Oh, those things weren't affecting normal people.\"\n\nDr. Andrew Slattengren: Everything has changed. Our social interactions, how we discuss, even social outings with people is completely different. And I don't know how to put that into words, other than to have people go back and read the individual journals of what this looks like throughout the time. And thank you.\n\nCrystal Bauer: Thank you so much. If you have nothing else to add, this will conclude our interview. And I'd like to thank you for taking the time to do this interview.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100603/file/198940#t=0.0,2258.8"}]}]}]}