What are the positives?
“The greatest strength to the rotation at SOBRAMFA was the opportunity to experience Family Medicine in Brazil in so many different contexts ranging from ambulatory care, to in-patients, long-term care facilities, palliative care, and home visits. This in both the private and public system providing a wide range of disease presentation and patient socioeconomic profiles. It was also very exciting to be part of a group of doctors which truly believe and promote the whole-person care and humanistic philosophy of Family Medicine. As such, SOBRAMFA are currently innovators in Brazil, a country that is slowing embracing and re-discovering the value of having a Family Doctor able to see the patient as whole and not only the part, which specialty-based medicine tends to focus.”
What are the negatives?
“Given the clinical exposure was very varied, there were often different teaching sites that were far to get to. São Paulo is a city burdened with high traffic on the streets and a transportation system that despite being well maintained, safe, and organized could often be quite tiring and crowded. Otherwise, it was a great rotation and there is not much SOBRAMFA could have done to change traffic in the city afterall. “
What you learned?
“Management of geriatric patients in terms of centralizing their care, managing their medications, and debulking the complexity of having to many specialists managing conditions that are easily taken care of by a family doctor.“
What is your big surprise?
“My biggest surprise was the very comfortable and well managed SOBRAMFA headquarters where the whole team would meet every Monday afternoon for their “marcapasso”. It was such a pleasant place and every Monday different clinical journals were presented be it on humanistic or clinical updates. It was a great experience to foster a team environment, stay up to date on recent data, discuss patients amongst the team, and nurture the philosophy from which SOBRAMFA bases its practice from.”
Tell a story concerning your period with us
“This is the story of Mrs. M, a palliative care patient who as diagnosed with end-stage pancreatic cancer. It was a great and humbling experience to have met her at a time where the physicians were trying not only to treat her physical pain which she certainly suffered from, but also the emotional pain which if left unattended would have completely halted any relief of the patient’s distress. Her pain was such that IV opiates no longer could manage her pain and indeed the team arranged for a celiac nerve block, which seemed to magically reliever her pain….but only for a day. Her pain quickly resumed, with further complications of Deep Vein Thrombosis, further biliary stasis, and hepatic failure. The team never let her feel as “there was nothing else to do”. There were lots to do to help her, while making it clear that no further interventions did not mean they would leave her alone. She trusted the team as did her family, and it was beautiful to see the team’s continued devotion to Mrs. M till her eventual passing away.”[/vc_column_text]