Jason Keiner, MD
Please tell us a little bit about yourself.
Currently I'm a third year Family Medicine resident at Crozer Keystone Health System right outside of Philadelphia. I'll be graduating in June and look forward to starting my new Job as a Complex Health and Social Needs Fellow - a unique partnership between Crozer and the Camden Coalition of Healthcare Providers in NJ. This fellowship focuses on providing high quality care for our health system's most complex patients and preventing hospital readmissions. It also combines two of my passions, innovation in healthcare and commuting to the great state of New Jersey.
Throughout residency I've focused on linking the services we provide in our office with the broader social context of medicine. Trauma informed care, medication assisted treatment for addiction and community collaboration have increased our ability to care for patients. During this time I developed an advocacy curriculum for our program, ensuring that every resident has training on how to engage with their local community through political action, professional leadership within our field or community service.
Outside of medicine I am obsessed with travel. An ideal day off would probably revolve around recreational coffee and reading comic books.
When and how did you decide to practice medicine?
Primary care services are in short supply and badly needed and I wanted to be a part of a movement to improve the care of people with the most complex needs. During medical school I was drawn to the stories of patients that fell through our medical system's cracks resulting in frequent hospitalizations or bad clinical outcomes. Providing care for those patients often requires the health system to re-engineer its processes to be more person centered and flexible. Trauma or adverse childhood events often effect patterns of behavior and worsen medical morbidity in ways we are only beginning to understand. To work with these patients you need a trusting relationship as a foundation and I saw the best route to that relationship through family medicine. It helped that after reflecting on my clinical experiences during medical school I realized that I loved components of Internal Medicine, Pediatrics and Obstetrics.
How did you come to choose family medicine as a specialty?
Frankly no other specialty ever really had a chance.
is your favorite part about practicing family medicine?
Before medical school I served as a Peace Corps Volunteer in a small community in Southern Africa and saw the cycle of poverty and health play out in some extreme circumstances. That link between social systems and health determinants has been an ongoing area of interest. An amazing lens through which to view these challenges is through the stories of families; caring for multiple generations is one of the incredible privileges of the field. Seeing how a grandparent's aspirations or a parent's struggles effect a child as they grow and develop helps guide your care and understanding of each patient. It helps me appreciate the bigger picture of the day to day work we do.
More broadly speaking, working in healthcare has given me a better understanding of the need for medicine to fit more closely into the social context of our society. Factors like poverty, the criminal justice system and racial disparities impact a person's health and trajectory in life in far greater ways than we can address from our offices. As a field we need to be outspoken advocates for our patients, working to improve our communities through engagement and action.
is the biggest challenge facing family medicine today?
We are confronting enormous changes to healthcare. The fee for service system is already giving way to value based models and these changes are only going to accelerate. We really do not have a clear understanding of what we mean when we discuss quality in healthcare. Is quality based on outcomes? Is it a process metric? Is it rooted in an obscure calculus, opaque and inaccessible to the average person?
One thing that is clear is the unique relationship between primary care providers and their patients is the cornerstone of our health system. An authentic healing relationship is the key to providing cost effective, high quality care. We may not know exactly what the future of healthcare will look like, but every model I have seen places primary care in the center. If we advocate consistently for our perspective to be heard we can help frame the conversation.
encouragement would you give medical students to choose family medicine?
Join us! You'll never have a boring day.