Career Retrospective: Osman Sanyer Reflects on 40 Years in Family Medicine and Education University of Utah Health Sciences
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Category Archives: Family Medicine
Duke School of Medicine Hosts Navy Medicine Delegation for Collaborative Research Tour – Duke University School of Medicine
Duke University School of Medicine students and faculty met with a delegation of Navy Medicine senior leaders on June 6.
The teamDeputy Surgeon General Rear Admiral (RADM) Rick Freedman, along with Master Chief Petty Officer Hansen LaFoucade, Lieutenant Command Kathleen Dale, Lieutenant Aaron Abreu, and Chief Petty Officer Stephen Todrzak toured School of Medicine facilities and met with several Duke faculty and students to explore collaborative research and scholarship opportunities available within military health care.
Their tour included stops at the School of Nursing, Department of Family Medicine and Community Health, Trent Semans Center for Health Education, Duke Center for Hyperbaric Medicine and Environmental Physiology, Physician Assistant Program, Duke Surgery, and the Human Simulation and Patient Safety Center.
A key focus of the visit was to promote the Navys scholarship programs for health care professionals, including physicians, nurses, dentists, and physician assistants. Scholarships from the Navy cover tuition and offer stipends, which can provide a debt-free path to employment in Navy Medicine after graduation.
Navy Medicine has more than 44,000 highly trained military and civilian health care professionals who provide enduring expeditionary medical support to the warfighter on, below, and above sea, and ashore.
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Cumberland Healthcare announces new family medicine physician – Ashland Daily Press
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Cumberland Healthcare announces new family medicine physician - Ashland Daily Press
Waco Family Medicine to open new headquarters next week, boosting patient care, doctor training – Waco Tribune-Herald
Years of work will come to fruition next week as Waco Family Medicine opens a $65 million flagship facility bringing together medical specialty clinics, community resources and primary care physicians under one roof.
The one-stop shop and headquarters at 1600 Providence Drive will improve care opportunities for patients and provide family practice doctors in residency with access to greater professional development. It represents a decadelong passion project for Dr. Mike Hardin, chief clinical officer of Waco Family Medicine.
WATCH NOW: Waco Family Medicine's $65 million flagship facility on Providence Drive
So many of our patients face transportation insecurity and other challenges to their health like being food-insecure or not living in a neighborhood where they can just go outside to exercise, Hardin said. Now we wont have to send them across town to see certain specialists, and we have community partners on the first floor to offer them housing assistance, nutrition assistance or to help them pay rent and so forth. Having all this in one place will help close gaps in their care and allow them opportunities to improve their lives.
Waco Family Medicine is a Federally Qualified Health Center offering comprehensive health care services. It has more than a dozen locations that served 60,000 patients last year, primarily uninsured or underinsured patients, offering an income-based sliding fee scale.
Fundraising remains underway to pay for the new facility, with less than $13 million left to raise for the $65 million project.
WATCH NOW: Dr. Mike Hardin talks about Waco Family Medicine's new 143,000-square-foot facility, which doubles the clinical space at its Providence Drive campus. (February 2024)
The specialty clinics to be housed in the new headquarters will also give Waco Family Medicine medical residents the chance to rotate with specialists and apply what they learn in the full spectrum of family practice medicine, residency program director Dr. Burritt Hess said.
The organizations residency program already is highly rated and highly competitive, with 700 applicants for 12 positions in a recent group of residents, associate program director Dr. Ryan Laschober said.
Gloria Veracruz Guerra has been a patient at Waco Family Medicine for 42 years. She also has worked there in a variety of roles starting in nursing in 1982, transitioning through billing into patient administration and retiring more than six years ago. She has also been a member of the medical board for the practice the past five years.
Every time I walk into Waco Family Medicine, I observe how other patients are treated, Veracruz Guerra said. I look to see whether they feel heard and whether their needs are addressed.
From the first greeting when patients enter, until they leave, patients receive respect and find their needs addressed and their lives improved, she said.
Now we wont have to send them on another bus ride to another clinic in a different part of the city for specialty care, Veracruz Guerra said. Theyll be able to go to another floor or down the hall to see who they need to see.
The specialty clinics will include minor surgical care; skin care; care for muscles, bones and connective tissues; and care for long-term inflammatory ailments, officials said.
Hess said the practice may reach out to specialists who treat diabetes and glandular conditions as well as those who treat kidney diseases.
Only a portion of health can be addressed in the patient exam room. The rest is social and environmental, Laschober said.
Twenty percent of health is inside the exam room. Eighty percent is community resource, Laschober said. This new facility will provide patients access to care for the whole person. We will have medical, dental and behavioral health here along with addiction medicine.
The facility will also have indoor and outdoor exercise rooms for patients.
For some people, a physician can tell them to exercise more and they know what to do, but not everyone was a high school or college athlete and remembers how to put together an exercise training plan, Laschober said.
We will now give our patients the tools to succeed, he said. We have a fantastic wellness and fitness center, where patients will meet with a fitness specialist who will help them tailor an exercise program specific to their needs. This is not for big biceps. Its for wherever they are on their health journey.
Waco Family Medicine officials, area politicians and celebrities Chip and Joanna Gaines ceremonially broke ground Thursday on a $61 million central facility for the medical services nonprofit that will replace the current one at its existing location in the 1600 block of Colcord Avenue. (October 2022)
There will also be community-partner organizations on-site to help patients address housing challenges, and a variety of programs and resources, including Greater Waco Legal Services and even nutrition, Laschober said.
We have Shepherds Heart who will help with food distribution, but now well also have a culinary test kitchen where local partners will help patients learn to prepare nourishing meals they will eat and enjoy consistent with their culture, he said.
The range of services is aimed at addressing the social drivers of health, Hess said.
Patients will be able to meet with clinicians and community partners, lowering barriers to health and allowing them to flourish in their lives with families and employment as well, Hess said.
The easier access to specialists will also present opportunities for Waco Family Medicines residents training to specialize in family medicine, Hess said.
We have specialists who have graciously volunteered their time to serve patients who are generally uninsured and they will also oversee teams of residents, Hess said.
The specialists and the residents will collaboratively review their patients histories and develop a treatment plan together.
We are thrilled to offer the residents a state-of-the-art medical facility for training that will move training forward in huge ways beyond what the old building allowed, Hess said. And there will be a ripple effect, as these residents complete the program and go out to practice themselves. They will offer top notch care, second to none.
Friday will be the last day providers see patients in the current building next door to the new one, Hardin said. The staff will move their final items and equipment into the new building over the weekend and begin seeing patients there Monday.
Waco Family Medicine offers care from the beginning of life to the end of life, Veracruz Guerra said.
People who may be looking for a new physician should come see us and give us a chance, she said.
Waco Family Medicine plans to have a grand opening after the old building has been demolished and the campus has been put into its final form, likely in the fall, spokesperson Nick Alvarado said.
Even if people do not have a medical need, they should still come get a tour during the grand opening and see what it offers, Veracruz Guerra said.
Fundraising efforts for the new headquarters went public in December 2021, and a groundbreaking ceremony in October 2022 marked the start of construction on the 143,000-square-foot facility, with Dallas-based Beck Group as the main contractor.
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Bryan family medicine office welcomes nurse practitioner – West Bend News
Tara Garza, FNP, MSN, BSN, has joined Parkview Physicians Group (PPG) Family Medicine in Bryan and is welcoming patients at the office, 442 W. High St., second floor.
Tara is an experienced nurse practitioner, and we are very glad shes chosen to serve the Williams County community as part of the Parkview family of providers, noted Sally Taylor, vice president of operations, PPG, Ohio.
Garza returns to Parkview after years serving patients at Community Memorial Hospital. As a registered nurse, she cared for the complex needs of patients in the emergency room, the medical/surgical unit, the intensive care unit (ICU) and the obstetrics (OB) department. As a family nurse practitioner, she has provided comprehensive primary care for patients from newborn to older adult and has served as a preceptor for nurses and nurse practitioners in training.
Garza began her nursing career as a telemetry nurse at Parkview Randallia Hospital, working with patients who had past or ongoing cardiac conditions.
Garza received her masters degree in nursing (Family Nurse Practitioner) from Graceland University in Independence, Missouri. She earned her bachelors degree in nursing from Indiana Wesleyan University in Marion, Indiana, after having received an associate degree from Northwest State Community College (NSCC) in Archbold, Ohio. She has been recognized among NSCCs Distinguished Alumni.
Board certified by the American Association of Nurse Practitioners, Garza is a member of the AMDA The Society for Post-Acute and Long-Term-Care Medicine as well as the Sigma Theta Tau International Honor Society of Nursing.
Drawn to a medical career in childhood, Garza found satisfaction in nursing and has challenged herself to perform at a higher level for the benefit of her patients.
I loved bedside nursing, but I felt I had the skills to help community members even more as a nurse practitioner, so I obtained further education, she said. Being a family medicine nurse practitioner enables me to build a trusting medical relationship with people from birth until their final days. I like that Im able to take the time to get to know my patients not just their medical conditions, but who they are and what they enjoy so I can individualize their plan of care and find what will work best for them. I have experience with the elderly and enjoy the stories my older patients share; helping them live their best lives is very important.
Outside of work, Garza enjoys reading and family time with her spouse, four children and three grandchildren. She finds travel therapeutic, especially the sun and ocean breezes of cruising.
A believer in community support through volunteerism, in recent years, she has served on the Four County Career Center Health Occupations Advisory Board, as a board member of Community Memorial Hospital Rural Health Clinic and as a Gateway Woods mentor to a teen mother.
Garza is welcoming patients of all ages. To schedule an appointment, call 419-636-4517.
Garzas office hours are 8:00 a.m.4:00 p.m. Monday, 8:00 a.m. 6:00 p.m. Tuesday, 8:00 a.m. 1:00 p.m. Wednesday, 8:00 a.m. 4:00 p.m. Thursday, and 8:00 a.m. 4:00 p.m. Friday.
Lab and imaging services are also available at the PPG Family Medicine office. Lab hours are 7:30 a.m. 5:00 p.m. MonFri. Imaging is open 8:00 a.m.5:00 p.m. MonFri.
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Bryan family medicine office welcomes nurse practitioner - West Bend News
CalOptima commits over $500M to increase the rates paid to medical providers – New Santa Ana
ORANGE, Calif. (June 17, 2024) The CalOptima Health Board of Directors has approved an investment of $526.2 million to increase rates paid to hospitals, physicians, community clinics, behavioral health providers and ancillary services providers in Orange County. It is the largest provider rate increase of its kind in CalOptima Healths nearly 30-year history. This investment is intended to support timely access to critical health care services for members and promote longer-term financial stability of the managed care network over a 30-month period from July 2024 to December 2026.
This unprecedented provider rate increase comes at a much-needed time to counteract some of the financial uncertainty due to the California state budget deficit and its likely impact on health programs, including Medi-Cal. The complex nature of the ongoing budget negotiations underscores why CalOptima Healths action to deliver a separate provider rate increase is so significant. Based on prior fiscal prudence and in accordance with its founding ordinance, CalOptima Health is using unallocated reserve funds to expand access and augment provider reimbursement.
CalOptima Health provides health insurance benefits to nearly one in three Orange County residents. It serves more than 928,000 low-income children, adults, seniors and people with disabilities through a managed care delivery model, including health network partners, hospitals, physician groups, community health centers, skilled nursing facilities, behavioral health providers and other ancillary service providers. Together, these organizations are the health care safety net for Orange County.
Historically, Medi-Cal reimbursement has been a barrier to access for patients and their families, said Michael Hunn, CEO of CalOptima Health. We ask a lot of our hospitals, doctors and others who provide life-saving care to our members. During the public health emergency, CalOptima Health supported providers with temporary, short-term supplemental payments. These new rate increases will help ensure member access, provider financial stability, network access and medical care for CalOptima Health members throughout Orange County over the next two and a half years.
A county organized health system, CalOptima Health provides quality health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, California. CalOptima Healths mission is to serve member health with excellence and dignity, respecting the value and needs of each person. CalOptima Health serves more than 928,000 members with a network of 10,900 primary care doctors and specialists and 39 acute and rehab hospitals.
Reactions from health care leaders across Orange County
These rate increases by CalOptima Health put members health care needs first and foremost. All of the hospitals, community clinics, physicians and others who care for CalOptima Health members appreciate the recognition and validation of our important role in supporting the health care safety net in Orange County. We thank CalOptima Health for its historic investment. Robert Braithwaite, President and CEO of Hoag Memorial Hospital Presbyterian and Chair of the Orange County Area for the Hospital Association of Southern California
On behalf of the physician community, the Orange County Medical Association applauds this important action by CalOptima Health in making a substantial investment in the health care delivery system in Orange County. Not only does this help support the providers, but more importantly, it will help to increase access to care in the network that serves one out of every three residents in our community. Jim Peterson, Executive Director, Orange County Medical Association
This landmark decision underscores CalOptima Healths unwavering commitment to enhancing the quality of care for the communities we serve. The increased funding will significantly bolster the ability of the Behavioral Health and Applied Behavior Analysis provider community to attract and retain behavior therapists, and ultimately provide the highest standard of care to our patients. The increase means more comprehensive and accessible mental health services and behavioral interventions. It will allow us to expand our reach to underserved populations, reduce wait times, and deliver individualized, evidence-based care that addresses the unique needs of each patient. We are excited about the opportunities this rate increase brings. Junie Lazo-Pearson, Ph.D., BCBA-D, Chief Clinical Officer, Advanced Behavioral Health
Orange County pediatricians appreciate that CalOptima Healths rate increase is designed to ensure that physicians are adequately reimbursed for the excellent care they deliver. Also, the increase will serve to improve health care disparities for the population served, resulting in better health outcomes and decreased overall costs. We applaud CalOptima Health for understanding and recognizing the importance of the patient-centered medical home as well as assuring continuity of care for our patients. Reshmi Basu, M.D., FAAP, President, American Academy of PediatriciansOrange County Chapter
As a family physician working at a training program within a Federally Qualified Health Center, our goal is to provide high-quality clinical care to our community while training future physicians to dedicate their careers to caring for the underserved. Ultimately, we aim to train physicians who expand their services to meet the needs of the community they serve, including services such as medication-assisted treatment of opioid use disorder, treatment of Hepatitis C, and complex prenatal care. Provider rate increases represent an opportunity for us to be appropriately compensated for the significant impact broadly trained primary care physicians have on the health care system, and for us to continue to focus our efforts on providing our patients timely access to the highest standards of needs-focused care. Matteo Leveroni, M.D., Medical Director of Family Medicine, UCI Family Health CenterSanta Ana
Family Choice Health Services fully supports the provider rate increases being implemented by CalOptima Health, starting July 1, 2024. Family Choice expects that the added upfront monthly capitation provided will be sufficient to pay for the higher provider rates being implemented. With the proper balance in increased funding between physicians, hospitals, health networks, FQHCs and other health care providers, quality patient care and access throughout Orange County will be improved and ensured. Toan Tran, M.D., Chief Executive Officer, Family Choice Health Services
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CalOptima commits over $500M to increase the rates paid to medical providers - New Santa Ana
Discussing Family Health this Father’s Day – Cleveland Clinic Newsroom
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CLEVELAND - Fathers Day is this Sunday, making it the perfect time to check in with your dad about his health and encourage him to see the doctor if hasnt got in a while.
I see people that come into my office and I ask them, Hey, why are you here, Joe? and theyll saymy familys been bugging me about coming in. So, bug them to come in, it works, said John Hanicak, MD, family medicine physician for Cleveland Clinic. And we see the downstream effects of that. So, they do show up and you get things taken care of, catch things early.
Dr. Hanicak said there are all kinds of reasons someone may delay seeing the doctor, like maybe theyve just been really busy, or they didnt think the pain or discomfort theyre experiencing was a big deal.
But, the sooner a person comes in, the better.Then their doctor can help treat the issue before it turns into something serious.
Its also important not to delay screenings or tests.
For example, prostate cancer exams are typically recommended around 50.
They may be needed sooner if theres family history.
Speaking of family history, Dr. Hanicak said parents need to make sure theyre talking to their children about genetic concerns, too.
If you haven't seen your doctor for a long time, don't be afraid to check in with us, he added. We're not going to yell at you because your cholesterol is high. Our job is to help you to be the best person that you can be. But, the first step is coming in for that appointment to catch up and see how things are going.
Dr. Hanicak said talking to men about their mental health is just as important.
He knows it can be a sensitive topic for some, but its worth addressing.
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Discussing Family Health this Father's Day - Cleveland Clinic Newsroom
Bucking the national trend: More Dal med grads opting for careers in family medicine – Dal News
This year, students graduating from Dalhousie Medical School are opting for careers in family medicine in impressive numbers.
Half of the graduating class will begin their residency training in family medicine this summer, marking a significant increase since 2018 when only 25 per cent of the class chose to enter a career path in family medicine.
Dalhousies Family Medicine program has also seen success, once again filling all available residency positions a remarkable feat, especially considering the expansion of its residency seats from 70 in 2022 to 91 in 2024.
While many programs nationwide face challenges in filling positions, this accomplishment is not merely fortuitous but rather the result of systematic changes implemented five years ago.
By intentionally integrating family physicians as educators and role models in the undergraduate curriculum we aimed to shift perceptions, says Dr. Kath Stringer, head of Family Medicine.
In 2018, concern arose when the Faculty of Medicine graduating class witnessed only a 25 per cent match rate to family medicine. Recognizing the pivotal role of family medicine in health care, the Faculty of Medicine identified the need for deliberate and sustained efforts to elevate it as a career choice.
The Family Medicine Project Charter was launched in response later that year, led by Dr. Jennifer Hall, family physician and then associate dean of Dalhousie Medicine New Brunswick. The goal: to achieve a 50 per cent match rate by 2023.
Under the guidance of the charter, initiatives were developed to boost exposure to family medicine across the Dalhousie medicine curriculum. Among them, the longitudinal family medicine clinical exposure experience was introduced for first-year medical students; a two-week rural rotation based largely in family medicine was created; enhanced Longitudinal Integrated Clerkship (LIC) opportunities were offered; and career nights were organized for medical students to explore career options within family medicine.
Efforts were also made to acknowledge and reward the contributions of family medicine residents and faculty. Continuous feedback from students and tracking career choice data has informed subsequent strategies.
The results of the Charters efforts were promising. One year after its implementation in 2018, the match rate had climbed to 41 per cent.
In 2023, the Faculty of Medicine formed a Family Medicine Specialty Committee to further advance this work.
The Family Medicine Specialty Committee led by Dr. Stringer and comprised of various leaders across the Faculty of Medicine, continues to identify and find solutions to the multifactorial barriers students face in choosing family medicine as a desired career.
The Committees work is integral to the Faculty of Medicines strategic plan, Realizing Our Ambition, which affirms the universitys commitment to advancing family medicine education and recognizing family medicine as a specialty of choice.
These efforts are yielding significant results as this years matching numbers illustrate.
The choice to pursue family medicine reflects our learners dedication to the field and embodies their profound understanding of the pivotal role family medicine plays in health care, says Dr. David Anderson, dean of the Faculty of Medicine. I congratulate each of them on making this very important decision and want to express sincere gratitude to the dedicated staff and faculty who helped achieve this impressive accomplishment.
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Bucking the national trend: More Dal med grads opting for careers in family medicine - Dal News
Virginia’s state budget will fund OB-GYN medical residencies amid obstetrics closures – News From The States
Julia Resil is leaving Virginia.
At this stage in her career, the chapter of being a medical resident is naturally coming to a close and she will move on to become an attending physician in Rhode Island. Resil has spent the past three years at Johnston Memorial Hospital in Abingdon, in Southwest Virginia. Shes excited that shell be closer to her family in Boston and nearer to metropolitan areas, though practicing family medicine in a rural area was attractive to her as a medical resident.
Family medicine practice can include obstetrics the delivery of babies and the exodus of doctors like Resil comes at a time where several rural hospitals in Virginia have suspended their obstetrics programs. Within the past year, Sentara Halifax Regional Hospital, Sovah Health in Martinsville and LewisGale Hospital-Montgomery in Blacksburg have stopped offering obstetrics.
President of Sentara Halifax Regional Hospital Dr. Brian Zwoyer said that there was a 33% decrease in births there over the past five years. In a recent email, he attributed this to changing demographics, aging populations and a national declining birth rate.
With hospitals already less accessible in rural areas of the state than urban areas, Resil noted that patients end up traveling further for check-up appointments or to give birth.
And as you get closer to your due date, you have more appointments, Resil said.
About 15% of people in Virginia dont have a birthing hospital within a 30-minute drive, according to a report from the March of Dimes.
Danville-based doula Roshay Richardson works with clients around Virginias South Side and occasionally some from North Carolina. She said that shes seen patients travel to Danville from elsewhere to give birth and wonders how much of a strain that could put on labor and delivery doctors with an uptick in clients. Richardson works with the Virginia Rural Health Association, which advocates to lawmakers about rural healthcare needs.
While doulas arent obstetricians, they provide companionship and patient advocacy to their clients. A U.S. Department of Health study noted doulas role in positive health outcomes and theyve been particularly helpful for Black parents.
Likewise, Resil described a patient traveling about three hours because they wanted to see a doctor of color. Resil is among a diverse cohort of medical residents in a predominantly white part of the state.
They were a little bit scared because they had providers that were white in the past and they felt uncomfortable because they felt like they werent being heard, Resil said of the patient.
As a woman of color with family from Haiti, Resil knows this feeling. She shared that anecdotally, she and members of her family have felt this way when theyve gone to the doctor.
Then seeing that in some of my patients. Theyve been hopping around from doctor to doctor saying something is wrong but I cant figure it out; but no one is listening to me, Resil said. And then we find out, oh yeah, there is. Lets make sure we get you to the high-risk OB-GYN.
OB-GYN care can be deadly at times, with pregnancy-related medical emergencies that can arise suddenly. Such was the case for Wendy Welchs friend.
Welch, director of the Southwest Virginia Graduate Medical Education Consortium, described how a friend developed eclampsia. The pregnancy-related blood pressure disorder is life threatening and her friend had to be flown to a different hospital across the state line and into an urban area. This saved her life, but also resulted in much higher medical bills.
She explained that her friend was unconscious when loaded onto a flight and then woke up about $30,000 in debt.
Money is both an issue and a solution, Welch explained. Her nonprofit organization works to help cover costs of bringing medical residents into Virginia.
Welch said that lower population density and declining birth rates has meant theres not enough people for the hospital system to consider (obstetrics) profitable.
But funding positions could help. Most OB-GYN residencies are in other areas of the state, according to the American College of Obstetricians and Gynecologists. Though family medicine residents can work with pregnant clients, OB-GYN residents are more specialized in obstetrics and gynecology.
(Rural areas) get screwed, Welch said. To catch a unicorn to catch someone whos that valuable and knows theyre that valuable, you need a whole lot of stuff to attract them now. If theyre a kayaker or their mom is in Southwest Virginia, youve got them, but if not, how are you going to get them here?
Lawmakers have secured funding in the state budget that they hope can bolster medical residencies. Del. Chris Obenshain, R-Montgomery and Del. Jason Ballard, R-Giles pressed for one million over the next two years to fund 10 obstetric-gynecological residents. Two positions are specifically earmarked for Johnston Memorial, where Resil has worked in family medicine.
The matter is also personal to Obenshain, whose wife had to travel to give birth to their child recently when the LewisGale hospital near them stopped labor and delivery services.
He felt lucky that there is a cluster of hospitals in his portion of Southwest Virginia, but he noted how other parts of Southwest Virginia and South Side have less options.
Its a much bigger issue when a hospital doesnt provide these services anymore, Obenshain said.
Virginia legislators in both parties worked on a variety of bills this year to improve maternal health outcomes. Some proposals, like a requirement for health insurance coverage of doulas, were signed by Gov. Glenn Youngkin.
Meanwhile, he vetoed a proposal to include unconscious bias and cultural competency training when renewing medical licenses. Black people are more likely to experience negative maternal health outcomes, in part, due to providers racial bias, according to a study. Black women are also more likely to die from pregnancy complications than white women, data from the Centers for Disease Control and Prevention shows.
Women whose skin is darker than my wifes skin have significantly worse outcomes, Sen. Chris Head, R-Botetourt, said during a floor speech while defending the bill in the Senate. Something needs to be examined and done about that.
Head had carried the bill with three Democratic lawmakers who are also Black women: Sens. Lashrecse Aird, D-Petersburg; Mamie Locke, D-Hampton; and Jennifer Carroll Foy, D-Prince William.
Though he ultimately vetoed the bill, Youngkin had first sought amendments that advocates for the bill worried made the training just a checked box.
Youngkin signaled interest in working on more maternal health legislation so the bill could come up again next year.
In the meantime, new cohorts of medical residents will cycle through Virginia and state agencies are set to use the new budget funding to recruit some with OB-GYN specialties.
While Resil has been able to bring her perspective as a practitioner of color to rural Virginia, she has lessons learned from the more hands-on experience that she will take with her when she leaves.
I have made countless house calls to people, and I know thats something I would probably not do in Boston, back home, she said. Being able to see how people are living, you can get a better idea of a family.
She said she plans to be more inquisitive with her patients going forward as a result.
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