A Social Perspective on Family Medicine

Friday, December 14, 2018

Emma Richardson knew she wanted to study medicine soon after earning a bachelor’s degree in sociology. Her undergraduate background, though, has remained a big influence as she refines her approach to patient care.

Richardson, a fourth-year Rush Medical College student, is mindful of how patient health is impacted by social institutions. That outlook has helped her become a Pisacano Scholar — just the third Rush student to be honored since the program started in 1993 — for her leadership in family medicine.

She recently talked to us about her sociology roots, work in the community and desire to become a family physician.

Tell us a little bit about your background prior to starting at Rush.

Emma Richardson: I grew up in a small town in Illinois called Manhattan, and I’ve continued to bounce around the Midwest ever since. As an undergraduate, I went to the University of Notre Dame and studied sociology and preprofessional science. While I was there, I developed a strong interest in community service, both locally and overseas in Uganda.

After I graduated, I was interested in pursuing medical school but wanted to take time off first. I ended up working in Madison, Wisconsin, at Epic, which is a medical record software company. I did project management and electronic medical record implementation work for two years before starting medical school.

Why did you decide to pursue a career as a physician?

ER: One of the biggest things I learned studying sociology is the impact of policies and systems on people’s lives. Health care provides a unique opportunity to not just address people’s medical needs, which obviously influences their health and quality of life, but also to connect people with other resources to address social determinants of health. I love direct patient care, but I also like to think about the bigger picture of how health outcomes and disparities are created and perpetuated.

As a sociology major, I learned that all of these different things we often think about as separate factors — like education level and employment — are closely intertwined with health. I felt like a career as a primary care physician would allow me to address health from a broad perspective, reduce disparities and promote greater health equity.

What drew you to Rush?

ER: A couple of things: the people and the opportunity for community service. I felt like Rush had a much closer-knit family type of feel than any of the other places I applied to. People seem to genuinely love the work they’re doing. And faculty are accessible to students, which isn’t always the case at other institutions.

There’s also the community service part. During the interview process, I remember Sharon Gates, senior director of community engagement, speaking about the importance of service and addressing health from a holistic perspective. It’s been great working with her on some of the service work I’ve done.

What are some of the community initiatives you’ve been involved in at Rush?

ER: In my first year, I sort of stumbled into an interest in correctional health. Dr. David Ansell hosts dinners with guests speakers for students, and one of the speakers was Dr. Jack Raba, who is a former medical director of the Cook County Jail. With my background in sociology, I had done some reading about the criminal justice system, but he opened my eyes to it from a health care perspective.

I was connected with Dr. Raba’s successor, Dr. Elizabeth Feldman, and we started a health education program at the Cook County Jail. Since my first year of medical school, we’ve been leading health education sessions at the women’s housing units in the jail every Saturday. We not only developed a curriculum to provide written health-related information for the women who are coming in and out of the jail, but also helped those who are leaving make connections with community resources that help with housing, legal issues, mental health services and domestic violence.

What have you enjoyed most about your time at Rush?

ER: One is the initiative at the Cook County Jail. To me it’s an example of Rush’s efforts to really meet people where they are.

And the other big thing has been Rush’s Family Medicine Leadership Program. Since my first week of medical school, I’ve had the opportunity to work with family physicians on a pretty consistent basis, and that’s been really big in building my understanding of health care and the need for high quality family medicine clinicians. I work with Dr. Donald Childs at Rush Oak Park Hospital one afternoon every week.

One of the other things that’s great about that experience is it shows us what continuity of care really looks like. We’re often seeing patients again after several months or even years have passed since the last time we saw them, and we’re able to approach care with that continuity in mind — with an understanding of what those relationships look like over time.

Sometimes people aren’t ready to talk about a sensitive topic on the first visit. Sometimes that trust and understanding develops over time. The ability to be there with your patients over a period of months and years and really get to know them is really fun. It’s an experience that’s really unique to get in medical school.

Why did you decide to focus on family medicine?

ER: There’s so much that you can do within family medicine. Having the ability, all in one day, to, say, see a kid for a well child visit and manage chronic diseases with an older adult and maybe then do prenatal counseling for a pregnant woman — that’s really amazing and isn’t really replicated by any other specialty.

You were named a Pisacano Scholar this year in recognition of your dedication to family medicine. What does that honor mean to you?

ER: It’s really humbling. I read the bios of a lot of the other people who were awarded in my class, and they have all done some really astounding work. Technically, it’s an individual award, but it’s really a reflection of the people who have been supportive of me and provided opportunities for mentorship and leadership during my time at Rush. I am so grateful to all of the wonderful mentors I’ve had, especially Dr. Cynthia Waickus, who has provided me with so much guidance along the way.

Now that you’re close to graduating, what advice would you give to students considering medical school or to med students who are in the beginning stages of their training?

ER: It’s really important for med students to have the ability and freedom to feel like they can explore their passions. There’s often a lot of pressure in medical school to check all the boxes, but it’s also really important to follow your heart. It’s really easy to get caught up in a whirlwind of stress, so the ability to ground yourself in something that you care about provides a sense of meaning when things do get challenging.

Also, be kind to yourself. And find people who are supportive along the way.