C E L E B R AT I N G T E N Y E A R S

TEACHERS LUNCHEONLegacy

Recognizing the lessons our patients share

At the University of Missouri School of Medicine, patient-centered care is our

highest priority. To recognize that many of our best and most memorable

teachers are our patients, we created the Legacy Teachers™ Program to

celebrate their contributions to our students’ lifelong learning and development.

What unites this diverse and remarkable group of patients and their families is that

they have all taught important lessons to a physician in training that will last the

physician’s practice lifetime and positively affect countless future patients. We invite

third-year medical students to participate by reflecting on the patients who have

had a particularly powerful impact on their learning and to share their thoughts by

submitting essays, artwork or poetry. Within these pages are selections from this

year’s submissions.

On the front cover from the 2014 Legacy Teachers Luncheon:MU medical Student David Tapscott recognizes his patient, Virginia Ross,acknowledging the important role she played in his education.

On the bottom front cover from the 2014 Legacy Teachers Luncheon (from left):MU medical student Chad Byle recognizes his Legacy Teachers, George and Ruth Pirch, pictured with the Pirch’s physician, Dr. Matthew John, at the 2014 ceremony.

During the 2014 Legacy Teachers Luncheon, MU medical student Elsa Kracke recognizes Dorris Schnelle, and the role she played in Elsa’s education.

MU medical student Jordan Gipson recognizes his Legacy Teachers, James and June Shoemyer, during the 2014 luncheon.

On the back cover at the 2014 Legacy Teachers luncheon (from the left): MU medical student Martin Gregory recognizes his Legacy Teacher, Peter Schauer, at the 2014 ceremony.

MU medical student Krystal Foster recognizes Ashley Rector, for the role her mother played in Krystal’s education.

MU medical students Allek Kelm and Kara Mohr recognize their Legacy Teachers Frankie and Wilda Morris, pictured with their daughters, for the role they played in Allek and Kara’s education.

2015 Legacy Teacher Student Participants

Cecilia Albers

Yazan Alghalith

Kristen Allcorn

Phillip Beck

Derek Benham

Kaitlin Bruegenhemke

Ashley Davidson

Heather Deisher

Erik DeLaney

Brady Fleshman

Joshua Geltman

Jennifer Haslag-Minoff

Jackie Herzberg

Allison Huangs

Kassie Hyde

Elizabeth Koehne

Joseph Lammert

Victoria Levasseur

Sara McElroy

Lauren Miles

Emily Milford

James Rudloff

Kellyn Smith

Alicia Webb

THURSDAY, APRIL 16, 2015University of Missouri Reynolds Alumni Center

WELCOMEPatrice “Patrick” Delafontaine, MD

Dean, University of Missouri School of Medicine

OPENING AND INTRODUCTION OF SPEAKERSBetsy Garrett, MD

Professor of Family and Community Medicine, University of Missouri School of Medicine

T E N T H A N N U A L

TEACHERS LUNCHEONLegacy

Legacy Teacher Lessons – VideoLinda Bailey, Legacy Teacher

Dorothy Ballew, Legacy TeacherKatelyn Bartels, Legacy Teacher, and Steve and Amy, parents

James and Jerrye Bunte, Legacy TeachersPatsy Danner, Legacy Teacher

Judith Ferguson, Legacy TeacherElla Sue Greer, Legacy Teacher, and Allen, spouse

Wilda Morris, Legacy Teacher, and Sandy Drummond, daughterDon Privitt, Legacy TeacherJeffery West, Legacy Teacher

Stacey Haberberger, Medical StudentKathryn Mohr, Medical Student

Legacy Teacher Lessons - Student SpeakerBrady Fleshman, Third-year MU Medical Student

Betsy Garrett, MDProfessor of Family and Community Medicine

University of Missouri School of Medicine

Linda Headrick, MDSenior Associate Dean for Education

University of Missouri School of Medicine

RECOGNIZING OUR LEGACY TEACHER PARTICIPANTS

Case Western Reserve University: Kathy Cole-Kelly

Tufts University: Sarah Rosenberg-Scott

University of Kansas - Wichita: Scott Moser

University of North Carolina: Beat Steiner and Kurt Gilliland

2015 Visiting Medical School Participants

“It was one of those ‘come to life’ moments, where you realize that being patient-centered isn’t just putting the patients first; it is actually listening to their perspective, their knowledge of their own medical issues, and how they would like to manage their medications and chronic conditions. She definitely changed my thought pattern. I realized that managing a patient’s psychosocial stress and not just their biologic issues could have an even greater impact on their life. She made me realize how important it is to engage and truly listen to every patient I come into contact with. She is truly a legacy teacher because she has also allowed me to reflect on my own personal goals as a physician and care provider for thousands of my future patients.”

“She said the top three aspects that go into making a good physician are: personality, ability to listen, and how to admit that you do not know everything. Personality allows physicians to connect to their patient and build trust. The ability to listen allows physicians to understand the current problems the patient is experiencing and to be able to learn from their colleagues. Having the courage to admit that you do not know everything, along with knowing how to properly research the topic and learn more shows that you are committed to continual learning and staying up on topics and guidelines that are always changing and evolving.”

“She taught me to look at aspects and implications of chronic disease that I had not previously considered. She gave me insight into how resilient a young person can be, and the lasting impact interactions with the health care system can have. In future practice, I hope to always remember to consider how living with a chronic disease effects all areas of a patient’s life.”

“I began to realize all the complicating factors that play into one’s health. Every step can be a challenge. This was my first glimpse into chronic pain, and how it can affect every second of every day for those who experience it. Pain is something that no one else can see or feel. We try to describe it and classify it, but someone else’s pain cannot be fully understood. Our training is focused primarily in treating the disease. However, my Legacy Teacher taught me that we must not just treat the disease, but the patient’s experience of the disease. I began to understand that telling patients what to do is such a simple task, but helping them to actually achieve the goals is what sets the excellent physicians apart from the rest. He took time to look out for me as well, and remind me what mattered most to patients. There is much focus on the challenges physicians face due time constraints. However, he taught me that patients have constraints too, and, to treat someone effectively, we must take time to understand their story.”

Listening with an open mind is a crucial component of patient-centered care

“My Legacy Teacher taught me to truly consider a patient’s medical conditions in the context of their whole life. While I expected her chronic medical conditions to impair her life, it was apparent after spending time with her that the issues she struggles with the most every day are the loss of her husband and the failing health of her dog who provides her constant, loving companionship. She is a very spiritual person and feels blessed to have her family close by and caring friends, neighbors, and fellow church members. Because of my Legacy Teacher, I hope to take the extra effort to find out what my patients value the most in their lives so I can help them continue to enjoy those things, like walking the dog every day or going to group water aerobics classes.”

“I no longer saw the medical issue in a vacuum. I was able to appreciate the daily nature of a patient’s experience with medical illness and health care. I saw what went into my patient arriving on time for a 15-minute consultation. I better understood the worry of waiting for test results or the stress of not understanding the physician’s plan. I had the opportunity and time to learn about her life, her struggles and joys, and her questions and grievances. I also learned firsthand the challenges and often slow-won progress in addressing many of the socioeconomic barriers to optimal care. My relationship with my Legacy Teacher is one that I will always treasure and one that I hope will continue to inspire my interactions with all of my patients. To have even a glimpse of a patient’s perspective is to better understand not just the patient’s medical condition but how to best address that illness together.”

“My Legacy Teacher helped me realize the true scope of a disease. The pathophysiology, lab values and statistics are merely cursory. The true effects take root deeply into the lives of an affected person, their family and everyone with whom they interact. Her diagnosis had placed a tremendous emotional and mental toll while she was already dealing with significant stress. Nearly every facet of her life, from her family to her finances, was altered in some way. She helped me come to a powerful realization that it is one thing to know what you have to do, but a different story altogether to put it into practice. With a better understanding of what it truly encompasses, no longer will I make lifestyle changes as a trivial recommendation. I will continue to learn and grow from the lessons learned in our encounter for the rest of my career.”

“A person’s quality of life and how much they enjoy life can impact that person’s physical and mental health. The lessons taught me by my Legacy Teacher have made it very easy to understand how quality of life can be more important than the quantity of life. She reinforced how important it is to involve family members in a person’s health care. She uses her faith and her positive attitude to cope with her diseases. Listening to her and her husband talk about their doctors has shown me what kind of doctor I hope to be in the future and the kind of doctor I do not want to be. They appreciate the doctors that have taken the time to explain their diagnoses and treatments and impressed upon me how important communication with patients and their families is. I am so thankful to them because I now have a much greater appreciation for the scope of the impact of a chronic illness on patients’ lives.”

“My Legacy Teacher and I shared many tears during her hospital stay. I learned a lot about caring for patients and about patients themselves. When I was feeling tired and jaded, she helped me see that my patients remain human beings. They come with their own stories, trials and tribulations from their own unique pasts. Never discredit their sources of strength, as it will be what helps to carry them through the rough times in the hospital and when they get back home. I also learned that we cannot always solve the medical needs of our patients, but we can always try to meet their human needs. I can smile when we talk in the morning. I can hold a hand when someone is crying. When a patient requests that I pray with them I can take a moment to bow my head and to pray.”

Focusing on the person who is the patient is key

“I asked her how she felt her medical diagnoses had affected her life. She responded, ‘I’m not disabled, I’m just differently abled.’ I knew she was right. Each patient I will come across as a physician will be ‘differently abled’ and have adapted or changed at least some part of their life to accommodate the illnesses they face. Perhaps one of the greatest lessons I learned from my Legacy Teacher is that our job as physicians is to care for the person, not the diagnosis. I realized that exploring each of the different aspects of our patients’ lives (and not just the medical ones) is crucial in how we approach the care of their illness and vital for any hope of treatment success. I hope to continually seek the understanding of how illness has ‘differently abled’ each of my patients.”

“My Legacy Teacher gave me insight into a world that, on the surface, seemed so different than my own, yet really was more similar than I realized. What it boils down to is, all people share one thing: we’re all human, and we’re living our human experience the best way we know how. She’s living hers with a positive attitude and a joy for life. In spite of great uncertainty, she appreciates all the little things and small victories of life that most of us take for granted. I can only hope that I have as much zest for life as she does and I hope to have the opportunity during the rest of my career to continue to celebrate lives like hers.”

“I could not be more impressed by how upbeat and positive she is. She doesn’t let any of her multiple chronic conditions affect her. She explains that that’s the way it is and she just has to deal with it. She is bothered most by her need to depend so much on others, but her deep faith sustains her. God is there for her and will take care of her. I admire her strength and am grateful for all she taught me about the importance of faith and family suppport.”

“She taught me that there are two ways that chronic disease can be looked at: as a life sentence or a death sentence. She chose to look at her chronic illness as, ‘A life sentence, but the emphasis is on life.’ It has certainly impacted her in several ways, requiring her and her husband to make adjustments, but she refuses to allow it to diminish her quality of life. Her example has reinforced important goals for me. I will learn to communicate effectively and teach my patients about their diagnoses. I will be upfront and honest about the adjustments they will have to make if they want good control, because they can have a good life. I am not handing them a death sentence. I am handing them a diagnosis while equipping them with the tools to continue on with life.”

“My Legacy Teacher is a woman I feel honored to know and learn from. Her unclenching determination to not just survive but thrive against the starkest of life’s hardships is inspiring. Her voracious passion for the knowledge contained in the written word leaves me in awe. To this woman, I humbly say: Thank you for sharing your story with me.”

“My Legacy Teacher would be the patient who taught me the difference it can make to put my own stressors on the back burner and focus on the patients, their stories, and their concerns. At first, I thought I was specifically reaching out to her, but I soon realized it was her perseverance to heal, optimism about her situation, gratitude for our care, and her ability to laugh and make light of all situations that drew me in. There were few areas of her life that were not deeply affected by her hospitalization. She taught me more about my own strengths and weaknesses, both as an individual and as a future physician. She taught me to be optimistic and enjoy my life, no matter what cards I am dealt. I am thankful that she trusted me with her care, her stories, and her concerns. I will never forget her and her partner and know that my experience with them will motivate me to learn about my patients, respond to their concerns with empathy, and aim to treat them as I would my own family members.”

A positive attitude makes a tremendous difference

“Throughout the first two years of medical school, we are taught that health care is all about being a part of the team. We are required to participate in various scenarios and sessions teaching us the role of each member and how it impacts the patients. However, all of those activities failed to mention that the most important team is the one holding hands with your patient as they’re sitting across the exam room. The importance of a strong support network is one of the life lessons I will never forget thanks to my amazing Legacy Teachers. When a new obstacle arises in their lives, they count on each other, God, family, and friends, old and new, to help them continue forward. I was fortunate to meet this remarkable couple early in my third year, which has allowed me to view my time on the wards with a different mindset. I have noticed that the patients who seem to recover faster are the ones with a positive attitude and a family member by their side. I’ve learned that one of the most important roles I can play as a medical student is that of a listener.”

“I remember dreading the patient encounter, knowing a thorough history and physical exam would be difficult with the patient. It was amazing how my perception of the patient changed as I learned more about her. I began to see her in the light of a beloved friend. I learned several lessons while taking part in her care. I learned the importance of seeking out medical information from loved ones. She taught me the importance of taking the extra step for a patient whether it is finishing a physical exam when I am exhausted or sifting through medical records of a newly admitted patient. The extra steps are what lead to effective patient-centered care and successful treatment plans. Most of all, she taught me that all patients deserve a voice. Reflecting back on my Legacy Teacher, I will always remember the necessity of going the extra mile for each and every patient along the way.”

“My Legacy Teacher and his incredible story have taught me to be more understanding and less judgmental. He showed me how important it is to have compassion and realize that when someone appears healthy you should never make any assumptions before first understanding what they have been through. As a doctor, it is extremely important to remain supportive and to be present even when you might not have any answers. He taught me how important it is to appreciate what we take for granted every day and to find the light within us that will shine even in the darkest of times. Finally, he taught me to have faith and trust in those around us to be there with us, to rise up and battle with us, when we are faced with the unexpected.”

“I’ve experienced and witnessed many different psychological, cultural, social, and economic aspects of illness. Yet, until I met my Legacy Teacher I had never known anyone who was able to adapt to the life changes with such resolve, acceptance, and confidence. I learned that it is important to acknowledge that a chronic disease and aging cause inescapable life alterations, but that with support from your loved ones and trusted health care professionals, it is possible to adapt and accept the situation in order to do what you have to to move forward. He taught me the value of making patients feel comfortable. I am grateful to have known him and gain new perspective on adapting to transitions and transformations.”

Having a strong support system can help overcome great challenges

“My Legacy Teacher and his wife approach each day with gratitude and a deep reliance on each other. They have persevered with grace, kindness, forgiveness, and faith intact through incredible challenges. I realized that my initial confidence in my understanding of their context was drastically misplaced. Even though I may come from the same place as someone else and think we are relatively similar, there are layers upon layers of an individual’s background that are almost never addressed in a normal clinic visit. A brief social history during a 15-minute office visit only scratches the surface, regardless of how simple the patient’s case appears. Each time you ask an extra ‘why’s that’ or ‘tell me more about that,’ you peel back another layer to reveal a deeper understanding of the patient’s perspective on life and on the illness that brought them in to see you. He and his wife have helped teach me lessons that I will keep with me for the rest of my years practicing medicine.”

“I was so appreciative of her inviting me into her life as part of her care team. Despite her progressive illness, she was always inviting me to fully engage in her care. She had high expectations of me for our interactions that I did my best to meet. She did not allow me to sit on the sidelines. It was one of the first times I really gave myself permission to be a caregiver and medical provider. She encouraged me to better understand her as a person. There is no doubt that I was able to provide better care to her after having a better understanding of her experiences. I will always remember to take the time for the ‘little things’ it takes to understand my patients, just as my Legacy Teacher taught me.”

“She taught me the importance of establishing a relationship with all of your patients. Every patient is indeed a unique individual who strives for control of their own health, and the ability to make their health care decisions. I realized that the most important aspects of health care do not occur in the emergency department or in the operating room. Instead, they happen in the daily appointments and interactions through the community. The trust built during these times precedes most other actions and builds the framework of future health care decisions.”

“The strength of my Legacy Teacher’s relationship with his physician has helped me identify the key aspects of the doctor-patient relationship that I will strive to emulate as a future physician. I have learned a great deal from him about what it is like to live with chronic pain, depression, and taking care of a loved one as they go through the most difficult challenge in their life. I have also learned what it means to be a listener, a partner, and a constant supporter with patients. This experience has molded how I view patients and how I interact with them. More than anything else, I hope it makes me a better doctor.”

“I was immediately overwhelmed by the complex health problems of my first patient in my third year, yet this experience and my sweet teacher helped to give me confidence as a student doctor and catapulted me into my clinical years. She helped me see the importance of the human side of medicine. I learned that a little investment of time initially helps to foster a trusting relationship, which makes subsequent interactions much easier. Moreover, this relationship is essential to lasting health improvement and health maintenance. She helped me to remember that patients are more than diagnoses. They are people with feelings, families, and lives outside of the hospital and their present illness. As a physician, it is essential to recognize all these aspects of a patient’s life. I saw firsthand the impact of disease on the physical, mental, emotional, and social health of a patient. I am most grateful for the confidence that she instilled within my spirit through her daily cheerful greetings, referring to me as ‘my doctor,’ and the high level of trust that we developed during her short stay. I will always remember her.”

Trust and empathy developed between a physician and patient is fundamental

Thank you to all who attended the luncheon today. We are so glad you joined us to celebrate the 2015 Legacy Teachers and acknowledge our deep debt to the thousands of women, men and children who seek their health care in sites where future physicians are being trained. The relationship between a patient and their doctor is fundamental to all we do in medicine and, like any important relationship, can be quite complex. Medical students, the newest physicians in training arrive with many ideas and beliefs of what being a physician will involve and require of them, but with little real understanding and no experience. The first two years of their medical education are filled with much they need to know including much about working with patients and hours of practice with role plays, interviews, etc. However, it is in the third year of medical school that they truly enter into deep and important relationships with individuals who have come to us for care. These students experience the full range of human emotions during this time, and learn a tremendous amount about themselves. To be allowed to share some of the most personal and vulnerable times of another human being’s life and to be trusted with deep secrets is a tremendous gift and responsibility for every physician. This Legacy Teachers™ program gives these young physicians in training a chance to reflect on this remarkable year of their life and recognize and thank some of their most important teachers.

Thank you

Visit medicine.missouri.edu/legacy

Deborah Chance, PhD, and Thomas Mawhinney, PhDAnne B. Fitzsimmons, MD

Betsy Garrett, MDLinda Headrick, MD, and David Setzer, PhD

Kimberly Hoffman, PhD, and Timothy J. Hoffman, PhD Kevin Kane, MD, and Cynthia Hayes, MD

James Kerns, MDFrederick Lobati, MD

Jessica Nittler, MDJerry Rogers, MD

Harold A. Williamson, MD, and Mary Todd Williamson, PhDAnonymous Donors

For more information about contributing to the Legacy Teachers Program™, please contact

Carrie Nicholson in the Office of Medical Education,

at 573-884-2472 or nicholsonc@health.missouri.edu .

DONATIONS (payable to University of Missouri)

can also be mailed to:

Office of Medical EducationUniversity of Missouri

One Hospital Drive, MA215 Medical Sciences BuildingColumbia, MO 65212

Supporters of the 2015 Legacy Teachers Program™ Endowment Fund

Patient-centered care reflects a respect for individual patient values, preferences and

expressed needs. This care is grounded in the best available evidence and conserves

limited resources. It depends on shared decision-making and active patient participation.

Our graduates’ care will be marked by compassion, empathy and patient advocacy.

OUR GRADUATES ARE:

• Honest with high ethical standards

• Knowledgeable in biomedical sciences, evidence-based practice and societal and cultural issues

• Critical thinkers and problem solvers

• Able to communicate with patients and others

• Able to collaborate with patients and other health care team members

• Committed to improving quality and safety

• Committed to lifelong learning and professional formation

University of Missouri School of Medicine Commitment to Patient-Centered Care

RESPECTWe nurture free and open discourse, listen to new ideas, and value

diverse perspectives and talents.

SERVICEWe put forth our most diligent efforts on behalf of our patients,

learners, stakeholders and partners.

INTEGRITYWe commit to honesty, truthfulness and authenticity

in our relationships and activities.

RESPONSIBILITYWe exhibit a strong sense of duty, stewardship and accountability

to each other and to the public.

INNOVATIONWe pursue an ongoing, collaborative process of discovery

and translate knowledge for the benefit and service of society.

COMPASSIONWe relate to others in a caring, empathic manner and strive to

prevent and relieve human suffering.

INCLUSIONWe promote diversity and convey a sense of belonging,

respect and value for all persons.

MISSIONTo improve the health of all people, especially Missourians,

through exemplary education, research and patient-centered care

VISIONTo be a transformational leader in improving health

VALUESExcellence: We pursue the highest goals and accept the sacrifices and

responsibilities required to achieve our best possible performance.

MU SCHOOL OF MEDICINE