National Conference Keynote Speakers Illuminate Promising Future
Aug. 8, 2024, Scott Wilson (Kansas City, Mo.) — “Make sure people know you were there,” said the first of the two Main Stage speakers at the 2024 National Conference of Family Medicine Residents and Medical Students, held here Aug. 1-3. One way to do that, the second speaker said the next day, is to embrace accountability.
J. Nwando Olayiwola, M.D., M.P.H., FAAFP, shares a few of the many career paths available in family medicine.
The two talks, each witty and emotionally direct and each touching on family, service and leadership, illustrated in complementary ways the power of choice. Taken together at the 50th anniversary of this gathering, they offered students and residents powerful advice on shaping their careers, and a look at how varied and rewarding family medicine’s pathways can be.
‘What Are You Excited About?’
“My career makes absolutely no sense,” J. Nwando Olayiwola, M.D., M.P.H., FAAFP, said late in her presentation Thursday afternoon.
Her talk, “Lead, but Lead Towards Something: My Journey Into Primary Care Leadership,” traced that career across an impressive atlas of family medicine’s many available destinations — including her current roles as the incoming president of the Advocate Health National Center for Health Equity, the founder and CEO of Inspire Health Solutions LLC and an adjunct professor at the Ohio State University College of Medicine and College of Public Health — and made a convincing case for young family physicians to embrace the possible.
For Olayiwola, one such exploration began when, new to the maternity ward, she started asking her laboring patients, “What are you excited about?”
“No matter what their race, religion, socioeconomic status, ethnicity, they all said a few similar things. They said, ‘I want a healthy baby, and I want this baby to have more than I did.’ And I realized we all fundamentally want the same things. We want the people we love to reach their full potential.”
Olayiwola, who has advocated for health equity across her career, eventually brought this insight to “A Tale of 4 Babies: Health Equity at the Center of the Quadruple Aim,” a paper she published in 2022. It also informed a paper she wrote about the health opportunity index, a tool to analyze how the social determinants of health are intermingled. Another paper, on racism in medicine, drew thousands of emails from people who were moved to share, she said, “heavy stories of what they’d actually gone through, individual stories, people pouring out their hearts.”
“Your gift is that you can use family medicine to tell those stories,” she told her audience, through what she called the family medicine “leadership essentials” of service, stethoscope, pen and platform.
“I want to emphasize that to students and residents here,” Olayiwola said. “You might think you have to be a boss to lead, but there are so many ways to lead. Servant leadership, for instance. I want my team to commit to service. It might be that your career in family medicine is about serving, volunteering, working on the streets, at domestic-violence shelters.”
The stethoscope signifies influence in the clinical environment.
“Patients are counting on you. They believe we are trained, prepared, knowledgeable. So you can lead from a position of clinical work. You have lots of opportunities to make a difference with patients. It’s really important for me to stay grounded in what the patient is experiencing.”
Which leaves the pen (besides her academic writing, she has published four books), the platform (reaching people with a strong message) — and, behind all four essentials, passion.
Showing Up
Olayiwola’s audience left with a concrete way to put that pen to use: stationery for completing letters to their future selves (which the AAFP will eventually send). The next day’s crowd took away a different tool for self-examination from Alex Sheen, Friday’s Main Stage speaker: a rubber-banded set of his virally popular promise cards.
Sheen founded the nonprofit known as “because I said I would,” which has distributed almost 10 million such cards around the world. The work has channeled his personal values into a professional passion that, like Olayiwola’s, is influenced by a concern for health equity.
When his father died of cancer in 2012, Sheen centered his eulogy on, he said, “the importance of promise,” recalling that his father “was a man of his word.”
“If he said he was going to be there for you, he showed up,” Sheen told the audience. “He was far from a perfect person, but he kept his promises. And people don’t seem to do that anymore.”
He titled the eulogy “Because I Said I Would,” and he passed out preprinted cards for people to use as personal markers against their word.
“You give it to a person and you say, ‘This card is my property and I’m coming back for it.’ You honor your promise and you come back for it.”
After the funeral, Sheen impulsively promised on social media to mail promise cards to “anybody, anywhere in the world, at no cost.”
“This was the dumbest financial decision I’d ever made in my life,” he said. “It should go without saying: Don’t offer free stuff to people on the internet.”
Thalia Vega, M.D., stops for a photo with Main Stage speaker Alex Sheen at the 2024 National Conference of Family Medicine Residents and Medical Students.
Of course, Sheen (who was a recent guest on the Academy’s Inside Family Medicine podcast) continues to do just that via his nonprofit, which has mushroomed into what he calls a “social movement.”
He said committing to a promise creates the simplicity of “one path forward, one way, something I can control.” It also focuses the three elements of his habits of resiliency.
Cognitive reframing: “Every time you hear yourself saying, I have to, I have to, reframe it. I don’t have to. I get to.” Doing that, Sheen said, is his “No. 1 motivation tactic.”
Improving diet, sleep and exercise habits: “As you become physicians, and for those who already are, your patients are looking for a silver bullet, but we can’t leave out this foundation. We can’t forget this. Give your biology a chance to work.”
Remembering the bell curve: “Averages play out in a curve. But in the concept of resiliency skills and mental health, what is going to work for you is simply not known. The truth is, you have no idea where you are in effectiveness with any tactic, so you have to be your own experiment. No other way to find out. You have to give yourself a sample size of attempts as you go on a journey to work on your resiliency, your mental health.”
He asked his listeners to reflect on their own path of personal development, their resiliency skills and mental health, one step at a time to become stronger versions of themselves for the world around them and the families they’ll take care of.
“As you take, as students and residents, the Hippocratic oath, I hope you remember the true strength you possess,” Sheen said. “Doubt has uses, but it can overwhelm you.” Quoting a colleague who counseled him in the wake of a fire that devastated his nonprofit’s headquarters, he added, “It’s OK to think you can’t do it — but that doesn’t mean you’re right.”
A Heart on Fire
Olayiwola had primed the students and residents at National Conference for Sheen in her talk the previous day.
“As you write that letter to yourself, you might ask yourself what you want to lead toward,” she said.
It’s a powerful question, one that inspired Olayiwola to change the topic of a TED Talk that she had already put months of work into developing.
“The woman running the program asked: ‘What’s the one thing you want the world to know when they think about you? What do you stand for?’ I thought I had an idea, but it dawned on me that I wanted to talk about something that set my heart on fire. What would I be willing to stand up and let people all over the world know I care about?”
For her, this turned out to be combating racism and place-ism in medicine. For her National Conference audience, she said, it could be anything.
“If you are thinking you have something to say, I would encourage you to do that, especially if the work you’re doing sets your heart on fire and you can stand by it and use your skills and training. We are the quintessential Jacks and Jills of all trades. As you figure your journeys, don’t let anyone put you in a box.”
She held up the many curves of her own path as proof.
“If anybody tells you your career in family medicine needs to be linear, just remember me. I’ve been enormously blessed by the career I’ve had. It hasn’t been linear, but it’s been wonderful.”