Strengthening the Doctor-Patient Relationship: A Spotlight on DCMS Member Dr. Linda Edwards
Friday, April 5, 2019
Posted by: DCMS
A self-described “country girl,” Dr. Linda Edwards grew up in a small town in North Carolina called Rural Hall with a population of about 2,000. It was during those formative years that she learned the importance of family, specifically during Sunday afternoons at her grandparent’s home.
“My grandmother, with the help of her daughters and daughters-in-law, would put on a big spread for Sunday lunch after church,” she recalled. “After those Sunday lunches, my cousins and I would play flag football or softball. I am thankful for my family and the love that we shared. My mom and dad enjoyed sports as well and would play with my cousins and me. Mom was a great left-handed basketball player and would challenge us to a game of HORSE. Dad loved volleyball and softball so those Sunday afternoon games usually had an adult sneak in to play!”
Now serving as the Senior Associate Dean for Educational Affairs and an Associate Professor for the Department of Medicine at the University of Florida College of Medicine in Jacksonville, you might be surprised to learn Dr. Edwards didn’t always plan to be a physician.
While she always had a strong interest in science (her undergraduate degree from UNC-Greensboro was in biology), she didn’t decide to pursue medicine until she was a junior in college. At that time, she was taking graduate level courses in microbiology and virology in anticipation of a career in the microbiology lab. Her advisor saw strong promise and suggested that she consider medical school.
“He shared with me that he thought that I would be more fulfilled interacting with patients than sitting in the lab “behind a microscope!” Dr. Edwards remembered. “So, I took his advice and took the MCAT and applied to medical schools.”
Turns out it was the right decision. Dr. Edwards was in the first class to graduate from the four-year medical school at East Carolina University in 1981. Her class at ECU was small, only 28 students.
“In one respect we were ‘in a fishbowl’ being scrutinized by many since we were the first class of a new school,” Dr. Edwards recalled. “However, because we were the first class and because many of the residency training programs that are part of medical schools were just beginning to recruit, we had a tremendous clinical experience.”
She remembers a fantastic learning environment with faculty and residents who were very involved in her training. As a student on surgical rotations, she was scrubbed in for numerous cases and given the opportunity to participate at the level a surgery resident would be allowed to participate.
“It was great! So, you might think that I would have pursued surgery as a career. But internal medicine was a better fit for me,” she said. “I certainly did not enter medical school with a pre-determined idea of what discipline I would pursue. I can honestly say that I enjoyed all of my clinical rotations as a third- and fourth-year student! When I look back, I think my choice was the right one for me and I would do it again!”
Upon graduation from medical school, Dr. Edwards moved to Jacksonville to complete an internal medicine residency and also served as chief medical resident from 1984-1985. The UF College of Medicine training programs in Jacksonville at that time were JHEP, Jacksonville Health Education Programs. Dr. Edwards completed her residency and chief residency and joined the faculty of the Department of Medicine at what was then JHEP. For many years, she served as program director for the internal medicine residency. In the 90s, she was appointed Chief of the Division of General Internal Medicine and she still continues in that role today! In 2013, she was also appointed Senior Associate Dean for Educational Affairs.
Medicine has changed a lot over the years, and technology, particularly the electronic health record, is one of the biggest changes. Dr. Edwards notes that it’s had both a positive and negative impact, particularly with the doctor-patient relationship, which is critical to patient care.
“The relationship develops trust between the provider and the patient and is critical to their care. This trust that develops impacts the patient comfort in providing necessary information to their provider and impacts patient compliance,” she said. “The introduction of the EHR has, in many instances, eroded that relationship. Physicians are so focused on checking the right box and picking the right “smart phrase” that they forget there is a patient in the room!”
“On the positive side is that information is literally at your fingertips. Providers have dashboards that allow them to compare their practice to others and against national quality metrics. They receive reminders to ensure that preventive measures are taken and immunizations are given. Nothing new here, but the EHR has contributed to physician burnout and frustration. We need to figure out how to make the EHR work for us!”
While it was not part of her medical or residency training, Dr. Edwards is thrilled about the use of simulation that now prepares students and residents for clinical scenarios they will encounter. Interprofessional team care has also become a critical component of the practice of medicine.
“Physicians are learning to not only be the leaders of teams but to be a member of the team when another professional is the more appropriate leader,” she stated.
In her role as Senior Associate Dean for Educational Affairs, Dr. Edwards is responsible for graduate medical education at UFCOM. The College of Medicine has 35 ACGME (Accreditation Council for Graduate Medical Education) accredited programs and two CODA (Council on Dental Accreditation) accredited programs. There are approximately 350 residents and fellows completing their graduate medical education at UF in Jacksonville.
“It is a privilege to be involved in the training of the future physician workforce,” Dr. Edwards said. “But it is daunting as well, because of the evolving technology and the need to prepare our young physicians for their future practice. And as physician educators we must not only graduate competent and caring physicians but we must also ensure that the physician workforce is a healthy one as well, addressing physician wellbeing and burnout. Burnout and wellbeing were not issues that were addressed when I trained, although very likely an issue, just not one discussed or addressed.”
Dr. Edwards acknowledges that a variety of people influenced her medical career and still continue to inspire her today. Professionally, Dr. Malcolm Foster was Associate Chair of Medicine when she began her training in Jacksonville. Dr. Foster served as both a mentor and advocate throughout the years.
“Dr. Foster shared with me early on that it was important to give back to your community and to your family,” she said. “His insight has proven valuable over the years and I thank him for his counsel.”
Dr. Yank Coble also served as an advocate and mentor, particularly encouraging her to become involved in the Florida Society of Internal Medicine and the American Society of Internal Medicine, organizations that merged with the American College of Physicians several years ago. Dr. Coble was also instrumental in her appointment to the Residency Review Committee for Internal Medicine of the ACGME. More recently, Dr. Arsahg Mooradian has become a valuable mentor, fostering her growth as a leader and providing encouragement and support in her various roles at UFCOM-Jacksonville.
Personally, Dr. Edwards’ brother has been a tremendous influence and role model.
“Although younger, I have always looked up to him,” she noted. “He is a humble servant leader.”
Perhaps most importantly, she is thankful for her husband who serves as a sounding board and a great source of strength and comfort.
“He is the levelheaded one in the family and offers great wisdom,” she said.
Although the majority of her work time is spent as Senior Associate Dean for Educational Affairs, Dr. Edwards also still has a limited practice. In 2005, she worked with pediatrician Dr. David Wood to establish a transition clinic for adolescents and young adults with chronic medical conditions, including intellectual and developmental disabilities. Out of that program, JaxHATS (Jacksonville Health and Transition Services), came a new program, Program for Adults with Intellectual and Developmental Disabilities (PAIDD). This is a primary care home for adults with ID and DD.
“This is an underserved patient population in our community, as well as nationally,” Dr. Edwards noted. “It is a very gratifying experience and I am humbled and honored to care for this group of adults. Since this is such a unique clinical experience, medical students form UFCOM Gainesville, as well as internal Medicine residents from our internal medicine residency spend time with me in this clinic. They too find the clinical experience to be a rewarding one and quite different from their usual primary care experience.”
Over the years, Dr. Edwards has been involved with a variety of organizations in the Jacksonville community. She has previously served on the board of Hubbard House and currently serves on the Pine Castle Board of Directors. The organization provides services for adults with intellectual and developmental differences and Dr. Edwards has found it very rewarding to advocate for these individuals.
No matter who your patient might be, Dr. Edwards lives by the notion that the doctor-patient relationship is key.
“That aspect of medicine is what keeps me going,” she said. “I have patients that I have taken care of for 35 plus years! As these patients and I say, ‘we’ve been taking care of one another for a long time!’”
When she’s not working, you’ll typically find Dr. Edwards enjoying the outdoors. She enjoys jogging, the opportunity to clear her head and stay in shape. She also describes herself as a beach person, a title she realized after moving to Atlantic Beach just nine months after she first arrived in Jacksonville in 1981. Being near and on the water brings great joy.
“When I met my husband, one of our first dates was on his sailboat, a 31-foot Beneteau, named Cabernet,” she recalled. “We love to sail and have had several sailboats over the years. We currently have a Bavaria monohull that we keep in town on the river. Sailing on the Lizzie Marie, named after our mothers, is another way we decompress and enjoy the outdoors. We love getting friends together on the boat for Saturday or Sunday afternoon sails. And sunsets on the river are pretty spectacular!”
Drawing on her childhood, Dr. Edwards still loves being around her family. Her brother lives in Boone with his wife and she has a niece and two nephews. While her husband and her do not have any children, she loves being an Aunt and considers her residents and fellows as family, as well.
“I laugh and say that I have about 350 children from work,” she jokes. “I am pretty sure that they would not find this amusing!”
Loving your career is one of the best dreams you can have and Dr. Edwards is fortunate to be in that position. She plans to continue her involvement in graduate medical education, as well as continuing to serve adults with ID/DD.
“Being involved in training and preparing the next generation of physicians is so important and staying involved keeps me young!”