There are many facets to practicing medicine. A doctor must be a learner, a teacher, a scientist, a diagnostician and a healer at the same time. My ultimate goal as a doctor will be to help my patients maintain their health. I have learned that although knowledge and competence are critical, a doctor's ability to persuade and motivate can also have a significant impact on the health of his or her patients. Bad prognosis is commonly linked to smoking, alcohol or substance abuse. It is also too often linked to poor compliance in taking medication or visiting the doctor. I think that a doctor’s work counseling and teaching a patient can be among the most important factors in determining the health of that patient. I aspire to be a doctor who can convince his patients to take their medication and to confront addiction. This is what first drew me to join the Good Neighbor Clinic in White River Junction, Vermont as a smoking cessation counselor. I learned first hand about the psychological, physical and social challenges involved in combating addiction, as well as the techniques to help empower those patients. This has been a great experience in which I developed skills that will help me make a significant difference to patients suffering from any form of addiction. Through my work at the Good Neighbor Clinic I have also developed a strong desire to continue helping patients suffering from addiction. I am impassioned both by the need to help these patients and by the possibility of doing so. Through the Koop Scholar program I look forward to learning from professionals about academic research and community health projects in this area of medicine, and to applying this knowledge throughout my career.
My interest in addiction medicine began as a family concern—trying to convince my father to quit smoking, and never succeeding. While my understanding of addiction and smoking, as well as the methods one can employ to help a patient quit, have evolved over the course of my medical school training, that family connection taught me about the difficulty of approaching an addiction from an individual perspective. Later in college, while majoring in economics and biology, I learned about the connections between individual or group behavior and economic (dis)incentives. For example, in economic terms, taxing tobacco does indeed lower cigarette consumption. This led me to think more about how to influence an individual’s choice about starting or continuing an addicting behavior from a public policy perspective. As a future physician, I believe that advocating on behalf of my patients on a population-based level will have an impact on their health beyond that of an individual visit in the context of the patient-physician relationship. Through my involvement with the Public Health Policy Advocacy Committee, I have helped to educate and encourage medical students to become active participants in the legislative process, as that is what often determines public health policy, so that they may effectively advocate for patients at all levels of care. I hope that through the Koop Scholar Program I can combine my interests in public health policy, advocacy, and substance use intervention in order to improve patient health on a more comprehensive scale.
The cessation of tobacco use is one of the most important ways a person can increase their survival and long term quality of life. As a medical student, I am just beginning to grasp the critical role that the health care provider plays in promoting healthier tobacco-free lifestyles. Since joining Dartmouth Medical School, I have spent time promoting smoking cessation in the Upper Valley through the Live Free Smoke-Free program run at the Good Neighbor Clinic in White River Junction, Vermont. This is a student run program that provides free weekly counseling sessions to patients motivated to beat their tobacco habits. Through Koop Scholars, I am interested in expanding on my work at Good Neighbor and educating a greater population of Upper Valley about substance abuse and addiction through collaboration with other students and experienced colleagues at DCARE.
For a few years now I have been interested in the area of addiction. While I was majoring in neuroscience as an undergraduate, I took a class titled “Drugs of Abuse” that strengthened that interest and gave a biological background to my previous exposure. Since coming to DMS, I have gained an appreciation for the role of physicians in an individual’s battle with addiction. I was amazed to learn how much speaking with a patient helps their odds. While on campus, I have trained as a counselor at the Live Free Smoke Free smoking cessation program offered through Good Neighbor Health Clinic. In the future I would like to work with other ways to serve the community whether it is expansion of existing programs or creation of new ones.
While at Dartmouth, I have come to realize that caring for patients is not as simple as treating them medically and advocating for the individually. Public policy and attitudes toward unhealthy habits must be the realm of every physician. If a physician does not take an interest in healthcare legislation then he or she is neglecting a very important part of his or her patients' medical care. I am working through the Public Health Policy and Advocacy Committee and the Koop Scholars program to teach more medical students how to advocate for legislation that affects their patients. My personal interests are in advocating for legislation in the New Hampshire Legislature that decreases the negative impact of tobacco on public health.
Hi, I'm Rob Lampman. I'm a third year medical student here at Dartmouth Medical School (Class 2008). My primary interest is in advancing improved public health policy at the governmental level. To that end, I helped established and then run an organization called the Public Health Policy Advocacy Committee, or PHPAC. This is an organization that today boasts to be a somewhat unique medical student group that directly lobbies for policy change with legislators. PHPAC was officially created by a group of students in the DMS student government to be an arm of the student government that could examine and advocate for various bills before the legislature that would impact public health. As an arm of student government, it could also request an endorsement of certain legislation by the full student government on behalf of the student body. Shortly after the group was officially established I ended up as it's leader (I'm still scratching my head as to how that happened). My first order of business was to take this organization that largely existed on paper and turn it into a real substantive body. I believe that's why several people say I "founded" the organization. It took a couple years, but we made it come together. Our greatest efforts have been in the fight against tobacco in NH. To give examples of what our activities are, I've personally given testimony before legislative committees several times, I've contacted the press and legislative offices when our student government has endorsed a bill, and I've called legislators to discuss pending legislation. We've also had discussions with legislators in both NH and VT around various issues involving access to health care.
I came to this current position within the public advocacy world somewhat circuitously. I am from NH and graduated in 1998 from Manchester Central H.S. I then attended the University of Michigan for my undergraduate education. Two things happened while I was in Michigan - I began an ultimately short lived career in biomedical research and I gained a greater appreciation for the social challenges and inequalities that exist in our society. I came to DMS in 2002, initially in the MD/PhD program where I planned to do a PhD in basic science and then have a career as a physician-scientist. I wanted to help cure the world of disease. By 2005 I had discovered a somewhat greater passion for public policy. I realized that through improving governmental health policy I would be better able to tangibly improve the lives and health of people in our communities compared to if I were to continue in the lab. I ended up leaving the PhD portion of my education behind unfinished and have continued on as a regular old medical student. Today, I'm concentrating on learning the most I can to be a good doctor and when I can, to call legislators and discuss important policy issues.
My interest in issues of addiction, and particularly tobacco, began during my undergraduate years where I was part of a team that looked at smoking among incoming freshmen. I was able to further that interest at Dartmouth Medical School where I had the opportunity to be involved with the Public Health Policy Advocacy Committee. I was amazed by the amount of activity taking place at the state level to address these issues and was captured by the amount of opportunity and accessibility that exists for those in the health field to express their views and contribute significantly towards the shaping of eventual policy. This experience helped me realize the importance of medicine participating more in the creation of public policy. Given the complex nature of addiction - the implications it has for the individual, their families, and society as a whole - it is imperative that we, as health professionals, tackle it on both the individual patient level, as well as a larger societal level. In addition to public policy, I am also very interested in the additional burden and adverse effects of addiction in lower socioeconomic and underrepresented groups where support systems are weaker.
I have always felt that improving public health is an important responsibility of doctors. Since smoking and alcohol addiction represent some of the most significant modifiable risk factors contributing to morbidity and mortality, they are extremely important to address. At Dartmouth, I became involved in policy and advocacy work through the Public Health Policy Action Committee. I was amazed at the amount of legislative activity concerning alcohol and tobacco. Seeing the contributions other active medical students have made to policy has encouraged me to effect change. I believe that physicians need to take an active roll in understanding and advocating for medically related legislation because it inevitably has a huge effect on the day-to-day practice of medicine. Recently, I spent a morning in Concord advocating for a bill requiring medicaid to fund smoking cessation medications and therapy. This bill will help provide physicians with the financial resources to help their patients quit tobacco use. I plan to continue to pursue beneficial change to public health policy. I hope in doing so to help people lead happier and healthier lives.
Debraj's interest in the area of addiction has been longstanding. At the start of his first clinical year, while working in an outpatient facility in rural New Hampshire, he noticed that alcohol abuse and addiction to pain medication seemed to be silent epidemics in the region. As a physician-in-training interested in improving health systems, he found that issues surrounding addiction were becoming an increasingly important segment of modern health care. With an interest in vascular and cardiac disease, he has focused his efforts on smoking cessation projects, primarily through his work with the Public Health Policy Action Committee. In the broader realm of public health, he has also worked with fellow students from around the country on developing ImproveHealthCare.org, a website featuring case studies that highlight and discuss current health policy issues in America.
Addiction and substance abuse are fields within mental and physical health that have drawn my interest since high school. As a varsity athlete, I visited numerous elementary schools within the district to educate adolescents on the abuses and consequences of substance addiction. I continued working with students in college as an advisor and student health leader, and learned that addiction poses with many faces. Addictive personalities permeated throughout college, most obviously in the excessive consumption of alcohol, tobacco, and recreational drug use, but also with food and exercise. These addictions to substances, body image, even excessive studying all detracted from a healthy, well-balanced lifestyle. To help counter these pervasive trends, I joined with administrators in several health organizations to develop educational programming targeted at tobacco awareness, eating disorders, and substance abuse. At Dartmouth Medical School, I have continued my public health advocacy against substance use and addiction by joining and leading several organizations focused around the promotion of healthy lifestyle habits, advocating for improved public health policies, and counseling teenagers about the harms of alcohol, tobacco and other drug abuse. Over the past year, I have also volunteered as a certified smoking cessation counselor at a local clinic, and am attempting to apply my experience and knowledge in smoking cessation to related community efforts at Dartmouth and the greater Upper Valley.
I first became involved in the Koop Scholar program after my first year in medical school when a classmate, Dana Carne DMS '09, and I went to Kosovo to help implement a smoking cessation program in Pristina, the capital city. It was incredible to witness the disparity of smoking awareness between Kosovo and the United States. As an example, there was class of first year family residents earnestly requesting a smoking break during a tobacco counseling workshop that Dana and I held. As a former smoker myself, I have a special interest in nicotine addiction, and think that the health care system can do even better in combating this single most preventable cause of death in the United States. I've just completed a project at the Maine-Dartmouth Family Residency Program wherein we integrated smoking as a vital sign in the office and had some encouraging data. I look forward to continuing the ongoing fight against smoking into my career as physician.
With Justin Bennett DMS '08, I traveled to Kosovo and the capital city of Prishtina after my first year of medical school. We witnessed a country in the midst of an economic and political upheaval, where smoking played a very central role in most social occasions. Together we realized that providing smoking cessation directly would only make a small dent in the smoking rate, but perhaps teaching smoking cessation techniques to the medical faculty could provide long lasting results. Thus, we created curriculum based on motivational interviewing skills we learned in our own education as well as many proven techniques in smoking cessation. I hope to continue my advocacy towards smoking cessation during my medical career directly through counseling and teaching, but also to advocate changes in public policy.
From as early as high school, I worked as a Peer Health Educator to educate junior high school students about the facts and effects of cigarettes, alcohol, and drugs. My work with children continued throughout my undergraduate career, both on an individual level as a mentor and a broader level through a child advocacy organization. During my first year at Dartmouth Medical School, I got involved in the Partners In Health program to teach elementary school children about the human body and how to make healthy decisions, including issues of smoking. This year, I continue as the student leader of Partners in Health and am involved in a novel project by Dr. Joyce DeLeo to bring a substance abuse education program to Lebanon Junior High School.
My name is Joan Hier. I am about to start my second year at DMS. Spring term I had the privilege to participate in the Alcohol and Addiction Medicine course which has really sparked an interest in me to work with people struggling with addiction and substance abuse. The underlying motivation for my interest is probably that I have multiple family members dealing with substance use problems. In addition, I have always been interested in the area of psychiatry and substance use becomes such an important co-factor and entity in itself. I have been a participant in the Koop Scholar meetings at Dartmouth and plan to work with two other Koop Scholars in their presentations to and meetings with members of the Greek system at Dartmouth on the topic of substance use. Being a member of the Koop Scholars Group offers an opportunity to open up some incredible resources and contacts, driving my interest in increasing awareness of substance use and ways to stop it.
My interest in addiction stems from time spent in the Utah wilderness, working with teenagers struggling with drug and alcohol addictions in a 12-step based program. There I became fascinated by the interplay of addiction and emotional development, and astounded by the human capacity for change. I've also worked in a psychiatric hospital, which gave me perspective on the intricacies of addiction treatment in the modern mental health-care industry. I think that addiction is a disease that affects us all, in one way or another, so I know that regardless of what I do in medicine, I'll be dealing with it regularly.
I'm a second-year medical student who participated in The Betty Ford Summer Institute for Medical Students. This program was designed to help medical students understand issues with substance abuse that their patients might be facing. This experience, combined with my interest in adolescent development, made me want to learn more about substance use among young people in the Upper Valley community. Currently, I am using my Albert Schweitzer fellowship to design a support group for teenagers who are identified by the Hanover Diversion program as having substance abuse issues.
I first became involved in DCARE and the field of addiction medicine a year ago as a first-year medical student. Due to my experience as an undergraduate here at Dartmouth, I was motivated to address the issue of addiction among college students. Last year I was able to expand my knowledge of addiction medicine through I variety of resources that DCARE made available. I took part in the elective on alcohol and addiction directed by Dr. Gail Nelson, I was given training in addiction and counseling by several medical and counseling professionals in the Dartmouth community, and I participated in the community forum on alcohol and addiction with the Robert Wood Johnson Fellows. This year I plan to serve the undergraduate community through a project that provides education and counseling to members of Dartmouth's fraternity and sorority system. Professionally, I see my future in family medicine and public health. I anticipate that the knowledge and experience I gain working with DCARE will allow me to more capably serve my future patients, and to advocate for effective public policy in the area of addiction treatment and prevention.
I first became interested in working with DCARE when I came to Dartmouth in 2002 to start the MD/PhD program. With another medical student we ran an outreach program for undergraduates in fraternities and sororities who have concerns about drugs and alcohol. At this time i have finished my PhD in neuropathic pain research and am considering specializing in Pain Medicine after a Neurology residency (but who knows?!). I continue to be interested in substance abuse as it relates to abuse of opioid analgesics.
I worked with Kate Coburn for a year and a half on smoking cessation in the Live Free Smoke Free (LFSF) program which was established originally at DHMC and then at Good Neighbor Health Clinic. I didn't take any classes formally for the work that we were doing, but Kate runs a training session on how to be a cessation counselor that I attended. I also attended two conferences on similar topics in 2001, one was the Bacchus and Gammus annual conference and the second was the MSSAMA annual meeting which had some breakout sessions on tobacco control. Based on some of the information learned at these conferences, we made some changes in LFSF and saw an improvement in our relationships with patients. Previously, a student would staff the clinic for one night a month. We revamped the program so that each student got paired up with a patient who wanted to quit smoking and met with that patient each week until he or she quit smoking. This was much more time intensive on the part of the students, but seemed to work better for both the student and the patient. The student was able to establish an ongoing relationship with someone and actually see the results of their counseling over time. The patient had a friendly face to look for each week when they came to the clinic and really felt that they had someone on their side during the quitting process. We haven't performed an analysis to see if our results (success rates for quitting) changed, but my guess would be that our success rates did improve.
I am interested in tobacco addiction and the field of public health. I believe that this is something that crosses into each aspect of medicine. I just started my third year of medical school in June and already I have seen the impact of tobacco and tobacco addiction in the field of pediatrics and obstetrics and gynecology. I am not currently working on any projects due to my schedule, but hope to continue learning more about how to incorporate tobacco cessation into my practice as I go through my clinical years.
After graduating from college, I spent the next three years working in the field of addiction and recovery research at Brown. For a year, I worked on a project which looked at the value of social support in treatment outcomes for alcohol use with motivational interviewing as the treatment. For the following two years, I worked on HIV prevention projects with high-risk substance using adolescents and also with young injection drug users undergoing short-term detoxification. My immersion in the field of addiction medicine within the context of infectious disease prevention led me to desire to pursue these fields in medical school and in my future career.
Last Updated: 3/31/09