“Mom, what if you had to go be a doctor in California?’ he blurted out as he stretched his right arm all the way out, as though pointing to the ends of the earth.
“I wouldn’t take that job,” Kate Embry said, then added with a smile, “I bet I can find a job here.”
The state of Georgia is trying to make sure there are plenty of opportunities for Embry and other graduating physicians as a way of addressing its doctor shortage.
Embry will graduate Friday from the Medical College of Georgia at Georgia Health Sciences University and this summer will start her residency in family medicine there. She is one of only 32 of the 184 entering a first-year residency program who will stay in Georgia and one of only 70 to choose primary care.
It makes a big difference who ends up practicing in the state, according to the Georgia Board for Physician Workforce.
Of those who went to medical school and did their residency in Georgia, nearly 72 percent were practicing in Georgia, compared with 46 percent of all graduates of Georgia medical schools.
The state Legislature and Gov. Nathan Deal took steps to address that this year by adding funding for 400 more slots, which will probably not add more positions in Augusta because those are aimed at attracting health systems not yet participating in residency programs, said Dr. Walter Moore, GHSU’s senior associate dean for graduate medical education and VA affairs.
When Georgia residency programs get medical school graduates from other states, nearly half remain to practice in Georgia, data show.
Residency programs are often where young physicians start to mature, begin families and make connections with a community as they go through the three- to five-year program, Moore said.
“That’s really laying down roots” that often stick, he said.
GHSU hopes to give students more of that community feel with its use of regional campuses in Savannah, Albany and soon in Rome as part of its “distributed” system, which will give students contact with different areas of Georgia.
That could help address a limiting factor in that only 36 percent of MCG students put a Georgia program among their top three choices for residency, the second-lowest among Georgia’s five medical schools.
It was never a question for Embry, who has been raising Benjamin and Maggie, now 9, as a single mother since 2006. She applied to medical school in 1996 but was turned down, so she went on to a career as a computer programmer for the Federal Reserve Bank in Atlanta. After having Benjamin, she found herself drawn back to her old college biology book.
The medical school dream was slowly reawakened, With two young kids, however, people tried to convince her she could not do both, which only made her more determined.
“I had always vowed that I would not do this if I couldn’t still be a really good mom,” she said. “That’s been a really, really big part of this.”
Instead of a hindrance, the children are part of her formula for success.
“I honestly don’t know how I could have done this without Maggie and Benjamin,” Embry said. “They keep me focused. I know I can’t procrastinate because I’ve got to come home and cook dinner. I have to get people to gymnastics and art classes and all of the extracurricular activities that they do.”
She has to make sure her homework and studying are done – even if it means getting up at 4 a.m. – before picking Maggie and Benjamin up in the afternoon from St. Mary on the Hill Catholic School.
On one afternoon, the children, still in their uniforms, fan out around one end of the dining room table and spread out their worksheets. Maggie is studying suffixes, and Benjamin is reading about how the Chinese kept the secret of making silk for 3,000 years.
Even their boisterous Labrador, Sam, is quiet – for a few minutes, anyway.
“We have our routine,” Embry said. “We come in and get our homework done.”
Talk the talk
Often, her parents drive from Panama City, Fla., to help out. When she starts her residency in July, there will be a nanny to pitch in. But it will still be the three of them together, and it seems only natural that she would want to go into family medicine.
“I like to talk, ask a lot of questions,” Embry said. “I want to know about your family. I like to see my patients come back. I like getting to know you.”
It stems from her belief that all aspects of a person’s life – emotional well-being, work, family life – truly influence health.
“As a family physician, I have the opportunity to sit down and talk to you and discover all of those things about you, to be able to take into account all of those different aspects into the medical management for that patient,” Embry said.
That kind of relationship is the “foundation of family medicine,” said Dr. Joseph Hobbs, the chairman of the Department of Family Medicine at GHSU.
“Because they are able to follow patients over the life cycle, in a sense the discipline had to take a holistic approach to the management of patients with an emphasis on wellness and prevention while at the same time having special skills in dealing with the chronic diseases that we all have to deal with as well,” he said.
It is an old concept that has most recently been championed in the patient-centered medical home, where GHSU was one of the first academic family medicine programs to achieve a high-level status, Hobbs said. It is now being recognized by payers, who say it provides better care, not only in quality of life and health but also in savings, Hobbs said.
It will take more doctors like Embry and a better system to support them, Hobbs said. She is ready to step in.
“I’m definitely going into this because I want to take care of people, and I think there is a huge need out there,” Embry said.
She, Maggie and Benjamin say they aren’t going anywhere.
“I love the school Maggie and Benjamin are at,” Embry said.
“I love it, too,” Maggie chimed in.
“We’ve all made close friends here and feel like we’ve established ourselves here,” Embry said. “We feel like this is home now.”