Published on July 29, 2020

Gratiot Family Medicine Residents Publish Paper in Medical Journal, Program Graduates Remain in State

The family medicine physicians of the residency training program at MidMichigan Medical Center – Gratiot celebrated two milestones this July. The first is the completion of a research paper that has was published in the July 2020 “Journal of The American Board of Family Medicine.” The second, the program’s 2020 graduating residents will remain in Michigan to continue caring for patients.

“Our family medicine residency at Gratiot crossed a significant threshold this month,” said Michael Stack, M.D., vice president of medical affairs, MidMichigan Medical Center – Gratiot. “Not only did we celebrate the graduation of our second class of residents this month, but to publish a research paper in one of the most prestigious medical journals in their field is truly a milestone to be recognized and applauded.”

The article, “Effects of Implementing a Comprehensive Opioid Reduction Protocol on Overall Opioid Prescribing Among Patients with Chronic, Non-Cancer Pain in a Rural Family Medicine Clinic: A Controlled Cross-over Trial,” zeroes in on the continued opioid crisis. Authors included Matthew Stack, DHA, Vanessa LaRouche, M.D., Yezi Zhang, M.D., Daniel Warden, M.D., Charles Stack, B.S., and Egle A. Klugiene, M.D.

“The opioid crisis presents many challenges for family practice providers in rural communities who treat patients with chronic non-cancer pain (CNCP),” explained Matthew Stack, DHA, physician assistant,  Family Practice Center in Alma. “Unfortunately, evidence for effective opioid reduction strategies is sparse. We evaluated the effects of implementing a comprehensive opioid reduction protocol on overall opioid prescribing among patients with chronic non-cancer pain in our rural family medicine clinics.”

Stack continued, “Like others, we speculate that adverse childhood events and trauma may correlate with adult chronic pain and the use of opioids to anesthetize this physical and psychic pain. If we hope to continue our progress against the opioid crisis, we believe we need to join with community partners in treating psychological trauma in adults and preventing the abuse and neglect of our children.”

The residency program, a joint effort between Michigan State University and MidMichigan Medical Center – Gratiot, was created in 2016 in response to a growing need for primary care physicians in rural Michigan. Its stated mission is “to train high quality compassionate family medicine physicians devoted to serving rural communities, while addressing the health care needs of our diverse population.” The program is filling that role by bringing a dozen additional physicians into the community to care for patients at the Family Practice Center in Alma during their training, while also creating a pipeline of doctors for the long term benefit of the community. The program graduated its first inaugural class in July 2019. Of the two years of graduates thus far, 100 percent have remained in state.

This year the program recognizes three graduates. Graduate Michelle Nelson, M.D., is joining Gratiot’s residency program’s faculty and will remain in the practice to care for patients while helping to train the next generation of providers. Al-Sadek Makki, M.D., and Yezi Zhang, M.D., are joining the hospitalist program at MidMichigan Medical Center – Midland to care for inpatients when they are hospitalized.

“This past year our residents experienced new challenges in taking care of patients in an unprecedented pandemic and they successfully navigated the many changes they faced each day,” said Marita Hattem-Schiffman, president, MidMichigan Medical Centers in Clare, Gratiot and Mt. Pleasant. “We’re fortunuate to have Drs. Nelson, Makki and Zhang as part of our medical community and know they will provide excellent and compassionate care to the Gratiot and Midland communities.”

Those who would like more information about the Family Medicine Residency – Gratiot program may visit