Before Saint Francis Hospital and Medical Center family medicine specialist Abigail Tillman, M.D. ever considered becoming a doctor, she worked at a research lab in Boston, where one of her responsibilities was managing a mouse colony. Dr. Tillman had done animal research on multiple sclerosis and Parkinson’s disease as an undergraduate neuroscience major at Colgate University in New York. She continued on a similar track after graduation, doing the kind of bench (or basic science) research that eventually leads to clinical studies, but found that, to her dismay, she was spending most of her time with mice.
“I decided I liked people better than mice,” she says, explaining why she ultimately chose to pursue a medical – instead of a research – career. She finished her pre-med requirements while working at the lab. As soon as she completed her medical school applications, she quit her research job and headed to Colorado to work as a ski instructor while awaiting an admissions decision.
Moving from the snow-covered Rockies to the sunbaked Caribbean island of Grenada, where she eventually attended St. George’s University School of Medicine, was a big adjustment, she says. “But it was a beautiful place; I loved it down there.”
Still, transitioning from living in America to living in a developing country was “very humbling,” she says. “I learned a lot of patience, because it’s a much slower pace of life down there. And you really are a guest in the country, learning to interact in a meaningful way with the people, but also learning how to navigate this new place.” Though it was hard work, she says, the young doctor enjoyed having the opportunity to explore another part of the world.
Family Medicine: Wilderness and City
Dr. Tillman was born in New Milford but grew up in Greenwich, where she became an avid athlete early on, swimming and playing lacrosse competitively, and skiing in her spare time. She continued to play lacrosse for Colgate, and picked up scuba diving while studying medicine in Grenada.
She chose to focus on family medicine because, as she puts it, “it was a little bit of everything that I liked in medical school – pediatrics, surgery, gynecology and sports medicine.” But she also wanted to combine family medicine with her interests outside of medicine, which at that time were primarily skiing, scuba diving, hiking and other outside activities. That’s what led her, while receiving her residency training, to choose a personalized track of study in wilderness medicine, an evolving field focused on providing urgent medical care in remote settings.
“Wilderness medicine addresses the question of, ‘How do you practice medicine in an austere environment where you don’t have the resources you have in the hospital, or even the office?’ ” Dr. Tillman explains. “For me, that translated to caring for people who have ski or scuba accidents – and other medical complications of the outdoors.” While she concedes that Hartford is not a remote setting, she says her wilderness medicine training has taught her to more effectively utilize the resources available. “Do I order a chest X-ray, or can I use my clinical expertise to figure out if I need to use antibiotics?” she says.
Dr. Tillman was first introduced to wilderness medicine while doing a medical school rotation on the slopes of Stratton Mountain in Vermont, where she treated ski injuries and provided skiers with urgent care. As part of her wilderness medicine track during her residency training, she and a fellow resident developed a curriculum for the simulation lab designed to teach family medicine residents how to manage pediatric, obstetric, and other adult emergencies in the community – whether in the hospital or on the street. The 34-year-old family doctor joined the Trinity Health Of New England Medical Group at Saint Francis Hospital and Medical Center in August 2017, but is continuing her specialty training via a virtual fellowship through the Wilderness Medicine Society in her spare time.
A Push Toward Preventive Care
Trinity Health Of New England Medical Group appealed to Dr. Tillman for many reasons. “The scope of medicine is getting more refined, and family physicians are able to do less and less in an urban setting – but at Saint Francis Hospital, family doctors practice the full scope of medicine,” says Dr. Tillman, who relishes the variety in patients and problems that she gets to treat in Hartford. In addition, she says, her more seasoned partners, Drs. Paul Sullivan and Alberto Rodriguez, “are great mentors for me.”
Dr. Tillman also notes that Trinity Health Of New England Medical Group’s mission is very much aligned with her own thinking. “I loved that during my residency training, we were encouraged to invest in the patient population and give back to the community. When I went through the interview process with Trinity Health Of New England Medical Group at Saint Francis Hospital, I got the same feeling of a shared vision,” she says.
Dr. Tillman says her own mission – and a national trend in family medicine – is to convey to patients the importance of preventive care. “Because of everything that is happening with health care and insurance, there’s a big push toward preventive care,” she explains.
The United States spends the majority of its health care dollars on treating chronic diseases at the end of life, as opposed to many other industrialized nations, which invest in preventive medicine. “But over the last couple of years,” says Dr. Tillman, “the primary emphasis in family medicine here has been more on preventive medicine and diet and exercise.”
According to Dr. Tillman, pediatrics is primarily preventive in nature, but adults tend to have the mindset that they only need to see a doctor when they are sick. “We do well with preventive medicine in the pediatric population because we see them so often when they are little, but the idea of prevention starts to fall off when you get to teenagers and 20-year-olds – and that perpetuates into adulthood,” she says. “The biggest thing that adults can do to help prevent chronic disease, is to focus on diet and exercise and living a healthy lifestyle.”
The most rewarding part of her job, Dr. Tillman says, is “when you are able to form a connection with somebody and help them with either a big change they want to make (something preventive, for example, like losing weight), or through a devastating and life-changing diagnosis.”
She adds that the variety in patients and breadth of pathology that makes family medicine so exciting is also the most challenging part of the specialty: “You never know what you are going to get in family medicine – there are always new diagnoses and new problems coming up that test your font of knowledge.”
Dr. Tillman, who works with University of Connecticut family medicine residents at the hospital, says the most important lesson she tries to pass on to her students is that their education does not end with their residency.
“You are never going to know everything and that’s OK,” she says. “Be humble, and you can always learn something new from your peers and your patients.”
Lori Miller Kase is a freelance writer living in Simsbury.
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