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Boston internist is reaching out to Iraq's physicians

From the October ACP Observer, copyright © 2006 by the American College of Physicians.

By Bonnie Darves

One physician from Boston is getting a chance to help physicians in war-torn Iraq do what conditions there have made impossible before: develop professional societies, and medical certification and continuing medical education (CME) programs.

As part of an independent alliance of United States and United Kingdom physicians, called the Medical Alliance for Iraq, Larry Ronan, MACP, 52, is using his experience in and dedication to disaster relief to make a difference in Iraq.

“After the initial war in 2003, there was a realization that the health care of Iraq needed to be rebuilt as well,” said Dr. Ronan, a staff physician at Massachusetts General Hospital and the internal medicine representative to the alliance. “Because medicine had been controlled by the government ... there really has been no formal way for Iraqi doctors to access CME or be brought up to date—and inter-professional collegiality just doesn’t exist there,” he said.

The alliance that was formed in late 2003 and now includes 40 physicians, may change that. One goal is to work with internists in Iraq to develop an internal medicine society. "We know that the internists are extremely interested in looking at ACP as a model,” Dr. Ronan, said.

Colleagues in other specialties are engaged in similar efforts to help physicians there bolster and “reconstitute” their profession as well as serve as mentors or “buddies” to their Iraqi colleagues.

“This really has to do with the nuts and bolts of how [members of] a profession, in a free society, would govern, police and educate themselves,” he said.

Dr. Ronan and other alliance members made their first visit to Iraq in 2004 but postponed a planned second visit last year because of security issues. He acknowledged that the instability there may hamper the alliance’s progress. “If you don’t have safety, you’re not going to worry about whether your credentials are up-to-date,” he said.

But the alliance isn't giving up. Dr. Ronan and other members plan to visit Irbil in December to help the country’s health ministry and physicians move forward with identified activities, such as discussing potential models for professional societies and certification processes.

'What it's all about'

This is not the first time Dr. Ronan—who also has served as family physician for the Boston Red Sox for the past two years—has made time in his schedule to volunteer his services overseas or at home to help disaster victims.

He assisted in the aftermath of the Sept. 11, 2001, terrorist attacks. He later joined Project HOPE’s humanitarian aid mission to Asia after the devastating December 2004 tsunami. And last year, he headed to New Orleans after hurricane Katrina.

The experiences, he said, have taught him a lot about the medical profession—and about himself.

“The [tsunami and hurricane Katrina] disasters offered two opportunities for the medical profession to shine—or not. Frankly, we could have done better," he said.

On a personal level, Dr. Ronan found volunteering during those difficult times to be life-changing. "What I realized during both disasters was that to be a doctor and to be able to help in times like that is what it’s all about,” he said.

Making a difference

Dr. Ronan’s interest in disaster relief was fueled by his personal mentor, the late Thomas Durant, MD. The Dorchester, Mass., obstetrician-gynecologist spent a good deal of his life following catastrophe in war-torn, often forsaken corners of the world: Bosnia, Rwanda, Croatia, and earlier, Cambodia, Northern Ireland and Viet Nam.

“He was an extraordinary person, and in many ways, he was the U.S. medical world’s representative to those refugee camps and disaster areas—and he became very knowledgeable early on about [disaster-area health] issues we’re just starting to understand,” Dr. Ronan said.

“The gift of Dr. Durant was that he truly believed that individuals make a difference in the world and for the individual patients they treat. It’s a very internal medicine perspective on the world.”

Dr. Ronan gained an intimate perspective on Dr. Durant’s world view when he became his personal physician and cared for him until his death in 2001. Dr. Ronan now directs the Thomas S. Durant Fellowship in Refugee Medicine (for more information, see the fellowship’s Web site.)

Even without Dr. Durant's considerable influence, Dr. Ronan became interested in civilian-military relationships while he was studying at Harvard Medical School. That interest continues even though he has not served in the armed forces.

“It’s that interaction of the civilian sector and the military in times of crisis that interests me most,” he said. “And hurricane Katrina was a textbook example of just how poorly that [interaction] can go.”

For more information about the Medical Alliance for Iraq, contact Dr. Ronan at LRONAN@partners.org.

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