Final family practice residency class bids long goodbye to patients at Andrews AFB

Published June 23, 2009
By Benjamin Newell
AFDW Public Affairs

AIR FORCE DISTRICT OF WASHINGTON -- Robert Decent, a 15-year Navy civil servant with 21-years of active military service, could go to any number of hospitals between his Annapolis, Md., home and Andrews Air Force Base. But he drives out to the 779th Medical Operations Squadron to visit a doctor assigned to the Family Practice Residency Program because, he said, "In my 36 years with the Navy, this is flat-out the best care I've ever received."

The retired Senior Chief Petty Officer drove past at least 12 medical facilities when his shoulder began aching on the job to get a cortisone shot from Capt. (Dr.) Michelle Jurkonie, a resident with the program.

Mr. Decent in part owes the care he's received to Col. (Dr.) Robert Manaker, director of the Family Practice Medical Center. When he took over the residency program in June 2005, Colonel Manaker began slowly paring down the program, which took a hit under BRAC -- Base Realignment and Closure.

Colonel Manaker could have simply announced a closure date on the program and moved all the patients to alternate care providers. Instead, he kept the doors open for an extra three years, allowing this graduating class of residents to receive most of their training on Andrews at Malcolm Grow Medical Center.

"I wanted them to get an educational experience here on base, with this excellent staff and with this set of patients," said Colonel Manaker. "It would be hard to top that experience, so it was important to maintain the program."

On June 12, the class held a formal graduation at The Club on Andrews. In August, the program will be taken over by the Family Health Clinic at Malcolm Grow, a move most patients and doctors view as bittersweet. The program has trained 315 residents in a psychiatric and family medicine program. This year's graduating class of six family practice physicians and three family practice/psychiatry residents will be the last.
"We'll be losing some great care givers," said Senior Master Sgt. Annette Wingo of the 113th Wing, whose daughter was in for a minor procedure on her foot. "However, we know a lot of the doctors who are coming in and it's going to be okay."

Fresh out of college, most new residents don't get a chance to develop a relationship with their patients while in school. That changes during a residency program, where patients often take a paternalistic stance with their doctors, doing their best to work with them on bedside manner and the importance behind explaining steps being taken during a seemingly routine procedure. Though their caseload often exceeds 400, many residents have become close with their patients. Some will be leaving the clinic with their hearts still in one of the supply closets.

"I'm getting deployed to Korea after this," said Capt. (Dr.) Miriam Dinatale, one of the residents, "but many of my patients want to know when I'm coming back so they can come to my clinic. It's quite a special place."

Colonel Manaker has witnessed something special between the residents themselves. "I really believe these residents have a relationship similar to what you see in Airmen who have been on deployment together," said Colonel Manaker. "The fact that this clinic was closing and that they were the last class helped glue them together in a great way."

The nursing staff, which stays in the clinic as the residents filter in and out, expressed a universal fondness for this class. "We're just blown away by how hands-on this class is," said Leslie Struble, a Licensed Practical Nurse. While all but one of the LPN's and RN's will be staying at Malcolm Grow, all residents and most of the staff of doctors will be moving on due to deployment, or retiring. When June 30 arrives, the entire program will be absorbed by the Family Health Clinic. "Come June 30, this hospital loses it's ability to teach family practice residents," said Colonel Manaker.

In addition to the family practice residents, the clinic has a history of teaching psychiatry students who get the unique opportunity to deal with service veterans and the issues confronted by families. Some psychiatric residency programs within the hospital will remain after the Family Practice Residency Program is closed. The three Family Psychiatry Residents, who work in conjunction with Family Practice Residents will also be the last to receive residency training at Malcolm Grow Medical Center.

For now, the clinic is busying itself with packing slowly, probably a symptom of their demonstrated affection for the time they spent working alongside patients and experienced staff physicians.

Thirty minutes after the cortisone shot, with his shoulder loosening up, Mr. Decent begins to pack up his things. "I'll be coming here until they lock the doors," he said as he walked out holding a bag in his right hand, a chore that was too painful to complete when he initially walked in.