Fall Issue 2025

Volume 21 Issue 4 • Autumn 2025

The North Carolina

Family Physician Quarterly News in North Carolina Family Medicine

Dr. Viviana Martinez-Bianchi Installed as President of World Organization of Family Doctors PG. 8

The NC Family Physician - Autumn 2025 | 1

The 2025 Winter Family Physicians Weekend is back December 4–7 in a dynamic hybrid format! Whether you join us in person at the breathtaking Omni Grove Park Inn in Asheville or online from the comfort of home, you’ll be part of an experience that inspires from start to finish.

Led by Program Chair Dr. Katie Haga and Vice Chair Dr. Amir Barzin, this year’s program features more than 25 expert-led sessions packed with timely updates and practical tools you can use right away. You’ll learn from nationally recognized faculty, connect with colleagues, engage in meaningful discussions, and celebrate the power of Family Medicine together. We hope you will join us in December!

Cardio, Metabolic & Renal Health • • • • • •

Diabetes Management Lipid Management Obesity Care Liver Disease Cardio-Renal- Metabolic Health CGM Advances

Infectious Diseases & Prevention • • •

HIV Care RSV Prevention UTI Management

Women’s Health • • •

Hypertension in Pregnancy Menopause Perinatal Substance Use

Pediatrics • •

Pediatric GI Concerns Urgent & Emergent Pediatric Conditions

Gastroenterology & Pulmonology • •

GERD Lung Cancer

Musculoskeletal Health • •

Concussion Rheumatology

Mental & Behavioral Health • • • •

Mood Disorders: Anxiety & Depression Adult ADHD Chronic Pain Management (non-opioid) Neuromuscular Disorders

Innovations & Emerging Topics • •

Climate Change & Medicine Best FM Studies of 2025

Regulatory & Policy Discussions • • • •

AAFP Update ABFM Update NC DHHS Update NC Healthcare Policy Update

Workshop & Seminars • • • • •

Hands-On Dermatology Workshop Care of Children KSA Women’s Health Seminar Practice Management Seminar Personal Coaching Sessions

Complete conference details, including the schedule of events, registration rates, and more are available now at www.ncafp.com/wfpw. Please contact Kathryn Atkinson, CMP, Director of CME & Events, at Katkinson@ncafp.com with any questions.

Inside Autumn 2025

6 Ways to Get in Trouble with the NC Medical Board (and 4 Ways to Avoid Trouble) PG. 28

PRESIDENT'S MESSAGE

CME OPPORTUNITIES

4

20 High-Impact, High-Energy Hybrid CME —

You Should Stay. Or Not.

CHAPTER AFFAIRS

8

Dr. Viviana Martinez-Bianchi Installed as President of World Organization of Family Doctors

MEMBERSHIP

12 Member Profile: Amanda Steventon, MD

Just for You

RESIDENTS & STUDENTS

24 The Benefits of Summer Programs for Medical

Students Exploring Careers in Family Medicine

PATIENTS & PRACTICE

30 Illuminating the Dark Space Between Visits: One Health’s Journey with Behavioral Health Collaborative Care

PUBLISHED BY

t 919.833.2110 • fax 919.833.1801 • ncafp.com Editor Kevin LaTorre, NCAFP Communications Managing Editor, Design & Production Peter T. Graber, NCAFP Communications

DEPARTMENTS President's Message 4

CME Opportunities 20

Chapter Affairs 8

Residents & Students 24

Membership Services 12

Patients & Practice 28

Have a news item we missed? NCAFP members may send news items to the NCAFP Communications Department for publishing consideration. Please email items to kevin@ncafp.com.

Material in articles and advertisements does not necessarily express the opinion of the NCAFP. Official policy is formulated by the NCAFP Board of Directors.

PRESIDENT'S MESSAGE

You Should Stay. Or Not.

Y

ou may not know that your NCAFP President is kind of a big deal…in Canada. Let me explain.

A few years ago, my wife and I took a summer trip to Montreal. We needed a break from the U.S. and wanted to visit a culturally rich, bikeable city that wasn’t too hard to reach. Montreal fit the bill.

By Mark McNeill, MD

NCAFP 2024-2025 President

During the interview, we talked about how much we loved Montreal. When the news team had gotten what they needed and put down their recording equipment, the reporter came over and asked, “Do you really like Montreal?”

“Indeed, I do,” I replied.

“You should stay,” she immediately responded.

We signed up for their annual evening group bike ride with thousands of other Montrealers as part of the Tour La Nuit cycling festival. The Canadian national news arrived to interview some locals about the festival. They were impressed with the glowing lights on my wife’s biking tutu and came over to speak. When they heard our accents, their eyes widened.

This was a surprising turn in conversation. When visiting other beautiful cities with tons of culture, food, and art, the message that locals frequently give to tourists is “Thank you for your money, now please go home.”

Instead, here was a local who had just met me in one of the most delightful (and surprisingly affordable) cities in North America, trying to recruit me to stick around.

They weren’t expecting to find tourists at this locals’ event.

They were very happy to get our take. We survived the cutting room floor and made the national evening news!

What gives?

Never enjoyed being “Mark McNeill, Tourist” so much in Montreal.

4 | The NC Family Physician - Autumn 2025

Well, during the interview it was revealed that I was a family physician. The reporter explained that Montreal didn’t have enough family physicians and that access to quality primary care was a real struggle. We could easily emigrate there, make a living (and attend more night-time bike rides, dressed up in glow sticks!), and Montreal would be better off for it.

The thing is, I shouldn’t have been surprised. That was not the first time I had been asked to stay as a family physician. My first year out of residency, I took a locum tenens gig in New Zealand. I had a wonderful experience there, and practicing medicine in another country made me a better physician. But it was clear from the start that I would eventually leave. That didn’t stop the physician leaders in the practice there. They tried their best to get me to stay.

2024-2025 NCAFP Board of Directors Executive Officers President

S. Mark McNeill, MD, FAAFP

President-Elect

Benjamin F. Simmons, MD, FAAFP

Secretary/Treasurer

Deanna M. Didiano, DO

Immediate Past President Garett R. Franklin, MD, FAAFP Executive Vice President Gregory K. Griggs, MPA, CAE

At-Large Directors

If ever asked by a colleague in NZ if you want to try shearing sheep, say no.

New Zealand, again, is a wonderful place to be, with some of the most beautiful scenery you have ever seen. There is no shortage of good food, hobbits, and recreational opportunities. But did they have enough family physicians? Nope. They weren’t gonna pass up an opportunity to keep another one around, even if they had a hard time understanding his strong Southern accent.

D. Landon Allen, MD, MPH, MBA, FAAFP Stacey A. Blyth, MD Joshua T. Carpenter, MD Lisa A. Cassidy-Vu, MD, FAAFP Kelley V. Lawrence, MD, IBCLC, FABM, FAAFP Amanda R. Steventon, MD, FAAFP Patrick S. Williams, MD, FAAFP Courtland D. Winborne, MD

Academic Position R. Aaron Lambert, MD, FAAFP

Resident Director Stephanie P. Wilcher, MD, MPH

Resident Director-Elect Irina Balan, MD

Student Director Nicholas Wells

Student Director-Elect Ryan Taylor

AAFP Delegates & Alternates AAFP Delegate AAFP Delegate AAFP Alternate AAFP Alternate

Tamieka Howell, MD, FAAFP Rich Lord, MD, MA, FAAFP Rhett Brown, MD, FAAFP Thomas R. White, MD, FAAFP

NCAFP Committee Chairs

My New Zealand going away party was a Forrest Gump costume affair as my physician colleagues always thought I sounded and looked like him.

My career would take me to rural western NC, then to urban Asheville, and then eventually into my own solo practice. Each time I made a career move, the practice from which I was departing made an attempt to keep me around. As tough as it was to move on from those practices, I never struggled to find plenty of business and meaningful work in my next setting.

Workforce Committee

Jay Patel, MD, MPH

Advocacy Committee

Deanna M. Didiano, DO

Practice Environment & Profesional Development Committee Academic Department Chairs

Nichole Johnson MD, MPH, FAAFP Margaret Helton, MD, FAAFP

NCAFP Foundation President Maureen Murphy, MD. FAAFP

Continues on next page.

2501 Blue Ridge Road, Suite 120, Raleigh, North Carolina 27607

The NC Family Physician - Autumn 2025 | 5

The NC Family Physician - Autumn 2025 | 5 www.ncafp.com

But that’s enough about me. This is a story about you, about Family Medicine. The locale doesn’t really matter, whether it be a rural NC community or an exotic location far across the globe. Family Medicine is in high demand.

Period.

throw you. Remember the value you are bringing to your practice, your patients, your community.

Consider hanging in there. Our Academy’s efforts are constantly underway to improve primary care investment and reduce administrative burden. Technological adTo quote the English poet and playwright, Samuel vances, particularly with AI, may be leading us to a time Johnson: “Praise, like gold and diamonds, where our electronic health records owes its value only to its scarcity.” actually enhance the patient-physician relationship while aiding us Some say the demand is because there in efficiency so we can get home Some say the demand is just aren’t enough of us. That’s part of the earlier. because there just aren’t picture but certainly not close to the full enough of us. That’s part of story.

Our dependence on the flawed fee-for-service system continues to the picture but certainly not We are the highest-value part of the health erode as alternative payment modclose to the full story. care system. We are the ONLY health care els advance and mature. component where an increased supply is associated with better population health Political savvy by both the AAFP and more equitable outcomes. In short, and NCAFP have kept Family when more family physicians are around, Medicine at the table as the voice people live longer and better. Other specialties simply of reason during difficult conversations in Washington, cannot say that. The NCAFP Board, Greg Griggs, our DC and Raleigh. There are many reasons to be hopeful lobbying team, and I can rattle off the mountains of data about the future. In short: you should stay. proving this fact. And we frequently do when speaking with the NC General Assembly, payers, system leaders, However, if you are in a situation where you don’t feel and others. supported or appreciated, knowing your value is even more important. You have options. Every community It is an important time to remember your value because, needs family physicians, and there is a set-up somewhere let’s face it, things are hard right now. For years we have that will treat you better; maybe an independent practice, been underfunded and overloaded with unnecessary a different health system, or another community. Vote administrative burden. It takes constant advocacy with with your feet. If it ain’t feeling right, you should NOT payers and health care systems to make sure you are stay. As a family physician, you are never stuck. Heck, treated like the high-value physicians that you are. it may even be time to start your own practice. (I know a guy who would talk to you more about that if you are And now we are dealing with even more policy challenges interested.) to the vulnerable populations we care about. The hits to Medicaid funding have been tough to absorb. We are havWhile our national news can be tough to absorb, Canada ing to defend vaccine efficacy and safety in ways we never TV did me a solid years ago and reminded me that I’m thought possible. The federal public health infrastructure lucky to be in such a high-value profession. Whether you is being aggressively dismantled by leaders with no medistay or not, know that no matter your location or the cal training. Interference in the patient-physician relationseason of your career, YOU are a big deal. Let your value ship continues. If you are feeling dismayed, overwhelmed as a family physician sustain you during challenging times or both, you aren’t alone. and guide you in your professional decisions.

In those moments, many family physicians understandably have thoughts about moving on and trying a different practice, a different community, or even a different country. Having had a few different chapters to my career in different settings, I can sympathize. If you are in a setting where you feel appreciated, don’t let the national vibe

6 | The NC Family Physician - Autumn 2025

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The NC Family Physician NCFP -- Autumn Summer2025 2025|| 7

CHAPTER AFFAIRS

International LEADERSHIP

Dr. Viviana Martinez-Bianchi Installed as President of World Organization of Family Doctors

D

r. Viviana Martinez-Bianchi, Associate Professor and Director of Community Engagement for the Duke University Department of Family Medicine and Community Health, recently added a new title to her already impressive list of accomplishments. On Friday Sept. 12, she was installed as president of the World Organization of Family Doctors (WONCA) for a two-year term.

By Greg Griggs, MPA, CAE NCAFP Executive Vice President & CEO

States. She succeeds Dr. Karen Flegg of Australia, who has practiced mostly in remote rural areas and is now Associate Professor in the Rural Clinical School of the Australian National University.

NCAFP President Dr. Mark McNeill led a delegation from North Carolina to the 2025 WONCA World Conference to celebrate Dr. Martinez-Bianchi’s installation, which included myself and NCAFP Secretary-Treasurer Dr. Deanna Didiano.

Founded in 1972, WONCA consists of national colleges, academies, and academic associations of Dr. Martinez-Bianchi family physiacknowledged her cians and general chapter roots, first in practitioners Iowa and then in North throughout the Carolina, during her world, including comments at a recepthe American tion held by AAFP in Academy of her honor and in her Family Physicians installation speech.

(AAFP). WON“The North Carolina Dr. Martinez-Bianchi with outgoing WONCA President Dr. Karen Flegg.

CA represents 133 Academy honored me member organizawith the Family Physitions from 111 countries and territories, and the organizacian of the Year award in 2021 as we were coming out of tion advocates for its constituent member organizations at the pandemic,” Martinez-Bianchi said during a reception an international level, where it interacts with international at the conference. “I also want to mention my American bodies such as the World Health Organization.

Academy of Family Physicians, because I grew up as a leader not by chance but by training from the AAFP. It was an Dr. Martinez-Bianchi is the first WONCA president from amazing training ground for people like me who may not North Carolina and only the fourth from the United be the ones who normally make it to leadership positions.”

8 | The NC Family Physician - Autumn 2025

During her Presidential address shortly after being installed as WONCA president, Dr. Martinez-Bianchi compared Family Medicine to the interstitium of our bodies, saying, “We are often part of the interstitium of our society, invisible to the eyes and ears of those who do not understand Family Medicine or can’t understand our value, yet, just like the interstitium is to our bodies and our lives, vital to our patients’ health.”

Furthermore, she noted that we face fragmentation of care, where patients are lost in systems that prioritize procedures over people. Yet, as Family Medicine faces challenges, Dr. Martinez-Bianchi noted that we are prepared. As she travelled across the globe during her term as President-Elect, Dr. Martinez-Bianchi saw hope. “Everywhere I went, I saw family doctors as lifelines for communities,” she said, “a foundation of resilient health systems, and with a moral commitment to equity and justice.”

“The past few years have tested us as never before,” Martinez-Bianchi said. “Family doctors everywhere have carried heavy burdens — caring through pandemics, rebuilding in the aftermath of disasters, navigating conflicts and inequities, too often under-resourced and under-supported.

Many of us have felt exhausted. Many of us have wondered if the world sees our worth.

“But everywhere I traveled, I saw something extraordinary: family doctors never gave up. We kept our doors open.

We stood with our communities. We carried not only the science of medicine, but the spirit of hope. That is who we are. That is Family Medicine.”

Dr. Martinez-Bianchi went on to outline the pillars of the WONCA strategic plan, including: • Equity at the heart of health systems where no patient is excluded because of who they are or where they live • Strengthening the workforce, including fighting for investment in family doctors and the wellbeing of our workforce • Partnerships that amplify impact, both in official meeting rooms and in the lived realities of communities • Innovation and collaboration, breaking down silos to unleash the creativity of family physicians around the world

Dr. Martinez-Bianchi addresses the conference.

my colleagues: I ask you to continue lifting as you climb,” she said. “Mentor a young doctor. Share your innovations across borders. Advocate in your ministries (governments).

Write, speak, teach, and heal. And never underestimate the power of a family doctor’s voice.”

Beyond her role at Duke, Dr. Martinez-Bianchi is the cofounder and Chair of the Board of LATIN-19, a coalition dedicated to advancing health equity for Latinx communities. In 2020, Dr. Martinez-Bianchi was featured in a documentary by Univision which highlighted her work in the pandemic. The documentary, “The Heroes of the Pandemic,” can be seen in the LATIN-19 website (at http:// latin19.org/who-we-are/). She is also a member of the NC Institute of Medicine and a past member of the President’s Council on Sports, Fitness, and Nutrition. She is a past member of both the NCAFP Foundation Board of Trustees and the NCAFP Board.

To conclude her inaugural address, Dr. Martinez-Bianchi reminded the audience that we rise by lifting others. “To

The NC Family Physician - Autumn 2025 | 9

Executive PERSPECTIVE

It Truly is A Small World (in Family Medicine)

By Greg Griggs, MPA, CAE NCAFP Executive Vice President & CEO

4,219 family physicians. 117 countries.

Many of the same issues.

Those are just a few of the facts from the WONCA (World Organization of Family Doctors) World Conference in Portugal, which I attended in September. It was a bit surreal being in a foreign country with so many family physicians from around the world, yet the world seemed so much smaller when attendees began discussing the issues impacting primary care.

During the Opening Session of the conference, attendees heard from the Director General of the World Health Organization (WHO), the President of the Portuguese Medical Association, and the Minister of Health of Portugal, among others. But the real discussions began with Australian family physician Dr. Karen Flegg, the outgoing WONCA President.

Dr. Flegg discussed one of WHO’s goals of achieving universal health coverage throughout the world by 2030.

However, the news on progress toward that goal was not promising: 4.5 billion people — more than half of the world’s population — are not covered by essential health services as of 2021, and over 1 billion people worldwide are at risk of falling into poverty due to out-of-pocket health spending.

To make better progress toward universal health coverage, WHO recommends reorienting health systems toward primary care. Sound familiar? It did to me as well. Here’s one statistic from the WHO: “PRIMARY CARE HAS BEEN SHOWN TO MEET MOST (90%) OF A PERSON’S HEALTH NEEDS THROUGHOUT THEIR LIFE.”

As a result, the WHO is helping countries reorient their health systems toward primary health care as a key way

10 | The NC Family Physician - Autumn 2025

Dr. Martinez-Bianchi with the incoming WONCA Executive Committee.

of moving toward universal health coverage and health security for individuals around the globe. As you might already know, advocating for a system more oriented toward primary care is one of the key goals of our own strategic plan within NCAFP. This was not the only goal I heard during the WONCA conference that aligned with the work of the NCAFP. During that same opening session, Dr. Flegg also noted that we must maintain our workforce and we “can’t keep burning out our doctors.”

To close her session, Dr. Flegg quoted Dr. Margaret Chan, past Director General of WHO, who said, “A health system where PRIMARY CARE is the backbone and FAMILY MEDICINE the bedrock, delivers: the best outcomes, at the lowest cost, and with the greatest user satisfaction.”

This takes me straight to another plenary session I attended and very much recognized, one focused on Artificial Intelligence (another issue both the AAFP and NCAFP are working on). There, Dr. Seyma Handan Akyon, a family physician in Turkey, did not see AI as a threat to Family Medicine because of the need for the human touch. She shared that

outcomes, a better experience for patients, and a better experience for physicians providing the care • Overcoming rural healthcare shortages • The impact that social and economic factors have on health • Improving education of medical students and residents • How doctors and medical students are embracing the role of advocates • Physician burnout One speaker said something that really hit home for me: “Medical training and medical knowledge do NOT give immunity to doctors against fatigue, distress, disease or death.” We’re working to make every environment better for our family physicians, and so are the 4,000+ family physicians where the speaker was presenting.

So, what does all this mean? I took three key lessons from my time with the international Family Medicine community and need to share them with you:

AI is 4x faster in diagnostic accuracy but doesn’t fare as well when it comes to common sense, simple logic, and empathy — the qualities that are especially important in Family Medicine. When there’s a pattern, AI can help. But family physicians deal with so much more than patterns.

Dr. Aykon believes that as AI progresses, primary care is going to be even more important, but there will be fewer referrals for consults to specialists. She expects that consultations will only be needed for rare complex cases, with AI empowering primary care to provide more patient-centered care. She concluded her presentation with a quote from Dr. Eric Topol:

1. We are not alone. Family physicians from all over the world are coming together to bring about change — change that will improve primary care and improve the health of your patients.

2. No one has the perfect health system, but those that perform best are the ones that are grounded in primary care.

3.Culture and language barriers can be overcome. At this conference, English truly was the universal language. And when everyone has the same goal of improving care, culture can melt away, especially if you are simply willing to listen to others tell their stories. You end up finding a lot of commonalities when you just listen.

Other sessions at the meeting focused on subjects such as:

It was a bit intimating for this non-clinical, small-town North Carolina boy to sit in rooms with thousands of highly trained family physicians from all over the world, but it was also an opportunity I would never trade. And when it came right down to it, these family physicians from Australia, Europe, Asia, Africa, South and Central America are really just like the 4,000+ members we serve in NC every day. Their goals are the same as yours: improving the lives of the patients they serve.

• Truly reaching the quadruple aim of lower costs, better

It truly is a small world, especially in Family Medicine.

“The greatest opportunity offered by AI is not reducing errors or workloads, or even curing cancer: it is the opportunity to restore the precious and time-honored connection and trust – the human touch – between patients and doctors.”

To me, that sounds like a good thing for Family Medicine.

The NC Family Physician - Autumn 2025 | 11

MEMBERSHIP

Member SPOTLIGHT

Amanda Steventon, MD

By Kevin LaTorre NCAFP Communications and Membership Manager

W

e are thrilled to feature Dr. Amanda Steventon in the NCAFP Member Spotlight! Dr. Steventon works as a family physician and chief medical officer at Avance Care, PA. In addition, she serves as a member of the NCAFP Board of Directors and the NCAFP Executive Committee.

Dr. Steventon first came to Family Medicine as a patient (and later as a medical jack-of-all-trades).

She grew up on a farm in Maple City, KS. “I grew up in the middle of nowhere,” Dr. Steventon says.

“It’s the cliché where there were more cows than people.”

But even in Maple City, Dr. Steventon enjoyed the care of a local family physician. That care served her well when she faced severe health concerns at age five. “I went for my kindergarten checkup with our doctor, who noticed that I had a very significant heart murmur,” Dr. Steventon says.

“I had to have an open-heart surgery with an atrial septal defect repair. That was how I was introduced to the world of medicine. From that point, I wanted to be a physician.”

Her path to becoming a physician included routes through other health care settings: Dr. Steventon worked as a nursing home assistant during college at the University of Kansas, a medical assistant in a Seattle clinic, and even an emergency medical technician. “All these led me closer toward medicine,” Dr. Steventon says.

12 | The NC Family Physician - Autumn 2025

After she returned to Kansas to enroll at the University of Kansas Medical School, Dr. Steventon seized the chance to become a physician. “I did my med school rotations in Tribune, McPherson, and Chanute,” Dr. Steventon says.

“Those rural sites are where I fell in love with the patient-physician relationship and longitudinal care.” Those were the places that helped her choose Family Medicine.

Ultimately, Dr. Steventon followed that love into a rural Family Medicine clinic in Winfield, KS: Bluestem Family Health. Once there, she wanted to do it all: “I did full-spectrum care there: delivering babies, work in the hospital, work with the health department, and even rounds at a nearby nursing home,” Dr. Steventon says. In addition, she owned the clinic and enjoyed the management responsibilities that her role required.

Still, Dr. Steventon eventually found that better opportunities waited in North Carolina. In 2019, she and her family moved to Benson, NC, where she began working at Benson Health.

When it comes to NC Family Medicine, Dr. Steventon has a “leadership bug.”

After two years in Benson, she began work at Avance Care in Fuquay-Varina. Today, she serves as the clinic’s medical director and chief medical officer for all of Avance Care.

“I have a leadership bug,” Dr. Steventon says, “and Avance drew me in with promises of practice management. I really enjoy that part of medicine.”

Dr. Steventon’s path into medical leadership hit a sharp

ADVISORY CAPITAL

upward curve when she joined the inaugural class of the Leading Physicians Well-being Scholars program in 2020. This American Academy of Family Physicians (AAFP) opportunity coincided with Dr. Steventon’s first engagements with the NCAFP in 2021, when she joined the Advocacy Committee. Both opportunities introduced her to the policy aspects of Family Medicine. “Being able to have a seat at the table where policy decisions are made was important to me,” Dr. Steventon says. “Having input in those decisions became a real interest of mine.”

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In addition, these experiences came at a pivotal time for Dr. Steventon. “Losing my practice and coming here as an employed physician was a significant shift in my identity,” she says. “Those leadership positions helped reset the course of my career.”

Today, Dr. Steventon serves in leadership roles for both NCAFP and Avance Care. The policy and management decisions she leads in her workplace are extensions of her commitment to patient care, Dr. Steventon says: “I do all my administrative work from a clinical perspective: visiting the clinics, interviewing every clinician that comes through our doors, even ordering extra monitors. I’m always trying to answer, How can we move the needle on meaningful changes that make our practices sustainable and provide open access to our patients?” Leading is her best way of helping, she explains.

“I have a unique position: when something doesn’t work, I can lead our brainstorming on how to make it better for all our clinics.”

And of course, Dr. Steventon still continues to care for her patients. “I still see patients on Mondays,” Dr. Steventon says. “I have always planned to see patients. The thing that is most rewarding to me is still the patient connection. Most of my patients followed me from Benson Health, and so they’ve been with me for almost six years now. I’ve gotten to see them grow healthier.”

Everything Dr. Steventon does is thanks to the versatility of Family Medicine.

“I started with one idea of what a physician was, and it is obviously not where I am now in my career,” she says.

“Other specialties can’t afford that style of opportunity.

Family Medicine is versatile. It can grow with you. It can change with you and your trajectory in life.”

CORPORATE SPONSOR OF THE NORTH CAROLINA ACADEMY OF FAMILY PHYSICIANS

We’d like to thank Dr. Steventon for her patient care, her leadership, and her commitment to the Academy!

If you are or your colleague providing unique service to your practice and community, please contact us at kevin@ncafp. com and let us know!

The NC Family Physician - Autumn 2025 | 13

Member NEWS

Andrea Augustine and Hannah Rayala Named 2025 Pisacano Foundation Scholars In September, the Pisacano Foundation (PF) named the recipients of its 2025 scholarship. NCAFP members Andrea Augustine and Hannah Rayala both received this prestigious scholarship!

“Each recipient is noted as an outstanding medical student who has made a commitment to enter the specialty of family medicine,” the announcement states. Only 10 scholars were named this Andrea Augustine year nationwide.

Andrea is a fourth-year medical student at Duke University School of Medicine on the Primary Care Leadership Track.

She serves on the AAFP Foundation Board and completed the NCAFP summer programs in a rural community near Boone. According to the PF release, Andrea moved to Atlanta, Hannah Rayala GA, after being born in Kerala, India.

“Growing up as a low-income, first-generation immigrant, uninsured for much of her life and intimately familiar with the fear of needing medical care, shaped Andrea’s path to medicine,” her bio page states.

Hannah is a fourth-year medical student at East Carolina University Brody School of Medicine and serves on the NCAFP Advocacy Committee. Her PF bio page also shows how her commitment to the specialty began early: “Her commitment to family medicine is deeply personal, rooted in her upbringing as the daughter of two dedicated family physicians,” the page states. “These early experiences instilled in her a deep respect for the specialty and a desire to follow in her parents’ footsteps.”

Congratulations to both Andrea and Hannah!

Dr. Shannon Dowler Reflects on Her Mentor, Dr. Maureen Murphy NCAFP Past President and current AAFP Board member Dr. Shannon Dowler shared a great look at her close friendship with NCAFP Foundation President (and past NCAFP president) Dr. Maureen Murphy, her long-time mentor. “Maureen was my first mentor in medicine,” Dr. Dowler wrote in a short blog for the American Academy of Family Physicians (AAFP). “While I was a medical student she had, unasked, wrapped me in her protective arms, validated me as an emerging woman leader and enthusiastically encouraged me to seek election as resident director. Twenty-five years later, we have remained side by side through a series of professional celebrations.”

Both Dr. Dowler and Dr. Murphy are renowned leaders in NC Family Medicine, and they have each become great mentors to younger family physicians, residents, and medical students coming along behind them. We’re glad for the support they have shown as teachers and mentors!

Greg Griggs (second from right) and the other participants.

Greg Griggs Describes Family Medicine Needs in Business NC Roundtable The August edition of Business NC included a health care roundtable featuring our own Exec. VP and CEO Greg Griggs. Speaking alongside leaders from NC health systems, insurance payers, and other membership associations, Greg discussed the need for primary care investment, the promise of technological advances, and other topics.

“We need more family physicians and primary care

14 | The NC Family Physician - Autumn 2025

physicians to keep people healthy,” Greg said of the NC Family Medicine workforce. “We need more people to go into family medicine, general internal medicine and general pediatrics. Primary care should be a public utility in our state.” Part of that solution is increased primary care investment, Greg said: “It can seem like we have a sick-care system, not a healthcare system. We have the best places in the world to go if you get sick. But prevention deserves more investment. That’s where we’ve missed out.”

To make this point clearer, Greg pointed out the discrepancy between American primary care investment and global health care: “Most industrialized countries invest 12% to 15% of their healthcare dollars in primary care and prevention; the United States invests 5% to 6%.” He also brought the rationale for why that investment is crucial, saying, “We can conquer healthcare costs if we get people into care early and regularly. If they don’t receive primary care, they’ll land in the ER, the most expensive place to receive care.”

The full roundtable article is a great look at the state of North Carolina health care. In addition to Greg, the article included Mysty Blagg, a health care attorney with Poyner Spruill; Josh Dobson, president and CEO of the NC Healthcare Association; Michael Smith, President and CEO of CarolinaEast Health System; and Patrick Poulin, Area Vice President for Gallagher.

Dr. Dahlia Brahmi Co-Writes Article on Contraceptive Expertise in the U.S. NCAFP member Dalia Brahmi, MD, MPH wrote a new article for the AAFP with Dr. Angeline Ti, MD, MPH: “The Loss of Foundational Contraceptive Expertise for the United States”! The article explains how the U.S. Medical Eligibility Criteria (MEC) for contraceptives “provides recommendations on the safe use of contraception for patients with medical conditions.” “To help clinicians use the guidelines in day-to-day practice, the CDC contraception team also distilled their detailed but unwieldy publications into easy to use clinical tools, such as a color-coded chart summarizing the US MEC for contraception use or a simple algorithm.”

The article goes on to state, “To produce these guidelines, the eight-person team at CDC was responsible for monitoring the literature on contraception, conducting rigorous systematic reviews, and convening national experts to synthesize recommendations.”

However, the article also explains how recent reductions to this federal service will negatively impact patients: “This is especially concerning for patients with medical conditions that might have increased health risks for certain contraceptive methods but may also have increased pregnancy risks.”

Read the entire article at https://www.aafp.org/pubs/afp/ afp-community-blog/entry/the-loss-of-foundational-contraceptive-expertise-for-the-united-states.html to learn more.

The NC Family Physician - Autumn 2025 | 15

NCAFP leaders, members, and staff at the AAFP Congress of Delegates.

Dr. Claire Namboodri speaks at the AAFP FUTURE conference.

Dr. Maureen Murphy and Dr. Bradley Propst with students from the NCAFP Concord summer program.

NCAFP Student Director Nicholas Wells and other student members at the AAFP FUTURE conference.

Dr. Mark McNeill and Dr. Tamieka Howell at the Southeast Family Medicine Forum.

Dr. Courtland Winborne with Camille Anderson.

Dr. Michelle Keating and the Wake Forest School of Medicine Family Medicine Interest Group receive their AAFP FMIG Program of Excellence award at FUTURE.

Members of the UNC School of Medicine Family Medicine Interest Gfroup with Dr. Victoria Boggiano and Kayla Bonnell receive their AAFP FMIG Program of Excellence award at FUTURE.

Nikita Patel practices wound care during the NCAFP summer program in Concord.

Dr. Rich Lord and Dr. Tamieka Howell at the 2025 AAFP Congress of Delegates.

Dr. Aaron Lambert, Garrett Wedge, Nikita Patel, Anna Pyne, and Dr. Dawn Caviness.

Greg Griggs celebrates 20 years with the NCAFP.

Medical students with the staff of Seven Peaks Family Medicine during the Western NC Summer Program.

Dr. Tamieka Howell, NCAFP President Dr. Mark McNeill, NCAFP President-Elect Benjamin Simmons, and Dr. Rich Lord.

NCAFP Student Director-Elect Ryan Taylor and Asia-La'Rae Walker.

NCAFP staff at the Association Executives of NC 2025 Summer Meeting: Kevin LaTorre, Jan Rainey, Kathryn Atkinson, Shawn Parker, Greg Griggs, and Perrry Price.

Asia-La'Rae Walker speaks at the AAFP FUTURE conference.

Dr. Mark McNeill, WONCA President Dr. Viviana Martinez-Bianchi, NCAFP Secretary-Treasurer Dr. Deanna Didiano, and Greg Griggs.

Member ROUNDS

Keeping It in the Family (Medicine)

By Erika Steinbacher, MD and Michael Steinbacher, MD

Greetings to our NCAFP colleagues! We were encouraged by NCAFP staff to write a piece about our unique experience as mother and son in the same residency program. We are so grateful to have had this experience and for the opportunity to share it with you. We hope our experience will inspire more family members to do the same!

Steinbacher Squared

By Erika Steinbacher, MD

30 years ago, I walked across the stage at my Family Medicine residency graduation at Group Health Cooperative in Seattle. I was seven months pregnant with my first child, Michael.

Fast-forward to June 2025: that child is now walking across his own graduation stage with Cabarrus Family Medicine Residency, where I have had the pleasure of serving my entire career. How did that happen? A “series of fortunate events” is the only answer I can give.

Michael has always been incredibly curious and loves to think deeply. He loves a challenge and to push and test his own limits. While he ultimately followed his mom and dad to the University of Chapel Hill, he had applied

to the Naval Academy as well. I thought this odd, since we had no military members in our family. When I asked him why, Michael said he wanted to “do something with purpose.” Sound like a family doctor in the making?

While he was in high school, I took him on rounds (back when that was easier to do) to see a mom and her baby, whom I’d delivered the day before. I took him on a home visit with a dear elderly couple. He shadowed me at our Community Free Clinic, where he met the wonderful people who serve and are served by that organization. He was able to join me with my venerable colleagues, Dr. Charlie Rhodes and Dr. Lara Pons, on a trip to provide care to underserved communities in the Dominican Republic. He did a summer internship with a Cabarrus Family Medicine grad, Dr. Lydia Adams, a true servant leader and director of our local Federally Qualified Health Center. He was able to shadow one of the real-life superheroes in Family Medicine, Dr. Ron Pollack.

In other words, Michael saw all the best that Family Medicine can be.

We all know that those wonderful moments punctuate the much-less-inspiring day-to-day work. Michael saw those, too, as I left for call nights and weekend duty and many nights sat in front of my laptop finishing charts (I have the pleasure of being among the generation who endured the infancy of EMRs). I once asked him if my crazy schedule scared him away from ever wanting to think about medicine. He said no, without hesitation. That’s when I knew he had potential!

Dr. Erika Steinbacher with her son Michael.

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When Michael was considering applying to medical school, he asked me what the most fun specialty was.

Without hesitation I said, “Family Medicine, of course.”

While I am most certainly biased, that is an indisputable fact! Many of my specialist colleagues have told me they actively discourage their children from pursuing medicine.

I have never once felt that way, thanks to the nature of Family

Medicine and the servant leaders who populate its ranks.

At UNC School of Medicine, Michael was surrounded by dynamic Family Medicine mentors, including Dr. Beat Steiner, Dr. Vinay Reddy, and Dr. Catherine Coe. The support of the NCAFP and leaders like Dr. Maureen Murphy were also instrumental in cementing his choice of specialty. During his first year, he decided on Family Medicine and, from what I could see, never really looked back.

Then came the question of where to do residency. We started asking whether it could really happen that Michael would train at the residency where I was then the program director. I had to vet this decision. I asked my mentors, Drs. Mark Robinson, Allen Dobson and Charlie Rhodes; I asked other Family Medicine residency program directors and leaders; I asked Atrium Health/Carolinas Medical Center leaders. The main advice I got was to create policies to prevent conflict of interest and ensure fairness. I began plans to transition out of my program director role, partly so that we would be able to minimize potential conflict of interest. A huge thank-you goes to Dr. Aaron Lambert, who helped us to create those policies and take on the daunting role of residency director (in the midst of the pandemic, no less!).

Dr. Erika Steinbacher with Dr. Michael Steinbacher at his graduation.

who made it possible for us to have this precious experience.

The decentralized model we have at Cabarrus meant that we wouldn’t be in the same clinic and that Michael would be able to develop his own identity without Mom around all the time. We did share some call nights and time on our inpatient service. That sure made call more fun! Michael would go do the history and tell the patient, “My supervising physician, also Dr. Steinbacher (and yes, she’s my mom) will be in to see you soon.” We occasionally shared patients on our inpatient service, writing “Steinbacher/ Steinbacher” on the white board as “Resident/Attending.”

As Michael notes below, with a patient we both knew well, Michael converted that notation to Steinbacher2. One of my favorite experiences was when long-time patients of mine encountered Michael. They seemed genuinely proud, since they had kept up with him since he was an infant.

Toward the end of his residency, I had the reverse experience of meeting patients who only knew of Michael as Dr. Steinbacher and were amused to meet his mother!

To complete this amazing circle, Michael decided to stay with Cabarrus Family Medicine Residency as a faculty member, and so I now look forward to at least a few years of us working as colleagues. As I contemplate future retirement, I am gratified to know that the future of Cabarrus Family Medicine and Family Medicine as a specialty will be in the strong and capable hands of doctors like Michael and the other passionate family physicians of his generation.

Michael’s classmates were so gracious and never made an issue of him being the son of one of their bosses. Together, their class weathered the latter half of the COVID-19 pandemic along with the ever-changing world of health care and residency. I know that we could not have made this work without such wonderful colleagues both at the attending and resident level. I am so grateful to all of them

The Other Dr. Steinbacher

One of the key takeaways from our experience is the importance of mentorship. Helping future doctors see the rewards of a career in Family Medicine is a task for all of us. Our situation as a mother and son will likely remain rare, but even if you are not working in medical education, I encourage you to find ways to reach out and support the next generation by exposing them to the wonders of Family Medicine!

By Michael Steinbacher, MD

“Why did you choose to pursue medicine? Why Family Medicine? Who were some of your role models?”

Story continues as "THE OTHER DR. STEINBACHER" on back cover.

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CME OPPORTUNITIES

Upcoming EVENTS

High-Impact, High-Energy Hybrid CME — Just for You

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he countdown is on for North Carolina’s biggest Family Medicine event of the year! In just a few short weeks, 700+ family physicians and other Family Medicine champions from across the state (and beyond!) will gather for what has become the NCAFP’s most anticipated event, the Winter Family Physicians Weekend! Scheduled for Dec. 4-7 at the beautiful Omni Grove Park Inn, this annual Family Medicine Tradition offers the perfect combination of CME, camaraderie, and celebration. And we’re thrilled to once again offer the conference in a convenient hybrid format.

Led by Program Chair Dr. Katie Haga and Vice Chair Dr. Amir Barzin, this year’s conference brings together expert guest faculty to deliver timely updates from across the full spectrum of Family Medicine. From cardiovascular and metabolic health to GI and rheumatology; from infectious disease prevention to cancer; from pediatrics and women’s

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By Kathryn Atkinson, CMP NCAFP Director of CME & Events

health to mental health and concussion care; and from non-opioid chronic pain management to so much more — you’ll walk away with practical pearls you can put into practice immediately. With up to 65.50 AAFP Prescribed Credits up for grabs (our biggest credit offering ever!), it’s also the perfect way to wrap up your yearend CME requirements.

If you’ve ever attended the Winter Weekend, then you already know there’s always

more to enjoy than just the incredible 25+ mainstage physicians pause, reflect, and realign with what matters CME lectures. This year, there is also a pre-conference most to them, both personally and professionally. Space is KSA on the Care of Children (also hybrid!), a Women’s limited and available on a first-come, first-served basis, so Health Seminar (hybrid as well!), a Back-to-Basics Skin be sure to claim your spot early.

Procedures Workshop, a Practice Management Seminar, and an The Winter Family Physicians AI-powered interactive UTI workWeekend is designed by family physhop. On Saturday, join your colsicians, for family physicians. It’s “The Winter Family Physicians leagues for lively casual discussions your chance to sharpen your skills, Weekend is designed by family on timely topics including maternal connect with peers who inspire you, health, teaching and precepting, diand end the year on a high note. physicians, for family physicians. rect primary care, telemedicine, reCan’t make it to Asheville? You It’s your chance to sharpen your ducing administrative burden, and can still be part of the action. Our skills, connect with peers who other subjects during the Optional hybrid format means you can join Health Heroes Networking Lunch. all the mainstage sessions live oninspire you, and end the year Come ready to exchange ideas with line, along with the optional KSA on a high note.” your peers — and leave recharged, and the Women’s Health Seminar. inspired, and equipped with fresh Whether you’re with us in Asheville perspectives to bring back to your or joining online, make plans now practice. to be part of this can’t-miss Family Medicine favorite!

Medical students, residents, and early-career physicians will also find plenty designed with them in mind, from the Visit www.ncafp.com/wfpw research poster contest to the Friday night social for full conference details. to Saturday’s Resident Workshop and Recruitment Fair.

We can’t wait to see you in December! If you’ve already And back by popular demand, members can invest in registered and would like to add any of these incredible themselves through confidential 30-minute coaching sesoptional opportunities to your registration, please reach sions with Dr. Dael Waxman. These private sessions help out to me at katkinson@ncafp.com.

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Physician DELIGHTS

Have You Searched Through Your Career Benchmarks Yet? There’s a Map for Them All

By Kevin LaTorre Communications and Membership Manager

Did you know that the American Academy of Family Physicians (AAFP) has gathered national data on the average compensation of American family physicians? It’s called the Career Benchmark Dashboard. This first-of-itskind tool displays national data on compensation, job satisfaction, benefits, and other topics for any AAFP members who want to search through them Another good word to understand this tool is map. The dashboard maps the way Family Medicine careers happen right now. It can also map how they may exist in the future. By seeing how your fellow family physicians work, you can navigate your own work for today and tomorrow.

You can make your own map from all that the Dashboard offers. It will help you prepare for and during your career with solid data to help support your career decisions.

Here’s how you can start mapping out your next steps: When you visit the Dashboard (at https://www.aafp.org/ family-physician/practice-and-career/managing-your-career/family-medicine-career-benchmark-dashboard/tool. mem.html), you need to explore the data to move through its results. Fortunately, every section of the Dashboard has a clickable button called “Explore.” Once you click to explore, you can customize your results and adjust the map you need to see for your next career step.

Want to understand the demographics of family physicians in the AAFP? Just inside North Carolina? Or how about work satisfaction in North Carolina family physicians compared to that of family physicians around the country?

All you need to do is customize. There are many factors to choose from: clinical settings, years since residency, geographic location, and others. They all help you choose what you find on your map.

I access the Dashboard results whenever I can. Its customization features help me map out what NCAFP members already enjoy in your workplaces and what you still need.

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Here’s a quick look at some of those patterns:* • Male physicians (49.5% of respondents) and female physicians (48.8%) are nearly equally represented • North Carolina respondents reported slightly higher satisfaction with their current roles than the national average (4 out of 5 compared to 3.9 out of 5): 37.3% of NC respondents reported being “very satisfied,” compared to only 32.1% of national respondents • 80% of NC respondents reported that their primary role is “practicing physician,” with 8% reporting “leadership or management” and 7% reporting “faculty”. *Results based on 287 North Carolina survey respondents and over 7,000 national survey respondents.

There are many more results I could’ve shared. But these three give a brief look into three NCAFP priorities: welcoming all family physicians, supporting physician well-being and satisfaction, and supporting family physicians in medical leadership. And a brief look helps us understand what you need to flourish in your workplace and your career.

You can help us understand your needs by participating in the next Dashboard survey.

We just need you to complete a short survey!

If you tell us about your workplace, satisfaction, and compensation, the newest version of the Dashboard will be more accurate and more helpful for your fellow physicians.

It’s an anonymous survey that only takes 10 minutes to complete. It will help the Academy compile data that will provide a robust and accurate picture of how family physicians work — to then help increase their compensation and satisfaction. That’s the end game of the dashboard.

And that’s why we recommend that you complete the survey at https://www.surveymonkey.com/r/2025-AAFPPrimary-Web-Link.

Please complete it as soon as you can: the deadline is the end of November. Help us map out a better opportunity for physicians practicing Family Medicine through this updated Dashboard. That way, you can map out a better future for your career and for your colleagues!

RESIDENTS & STUDENTS

Student PROGRAMS

The Benefits of Summer Programs for Medical Students Exploring Careers in Family Medicine

F

amily Medicine remains central to addressing the health care needs of diverse communities, particularly those in rural and underserved areas. Despite this importance, many medical students have limited exposure to Family Medicine early in their training. The NCAFP’s summer programs provide an invaluable opportunity to bridge this gap! Our programs introduce students to the breadth of the specialty while fostering mentorship, clinical skill development, and community engagement that can shape their long-term career trajectories.

Community immersion is a defining feature of our Family Medicine summer programs. Students are given opportunities to spend time in many settings that highlight the different aspects of navigating life as a family physician: clinic time, hospital service, local hangouts after hours, and popular attractions in the area. Through shadowing and active participation, students gain a deeper appreciation of the rewards and challenges of practicing Family Medicine in various communities.

These experiences underscore the role of health and community resources in shaping patient outcomes. Exposure to underserved communities cultivates a deeper understanding of health equity and may light a fire to serve in shortage areas. For those students who begin the program with the intention of working in rural settings, the opportunity provides additional context for that path and often reaffirms their commitment. One student who participated this summer shared, “While hard to articulate in words, there was a different feeling being in a rural setting that made me feel a stronger sense of duty to the community. I left feeling that no matter what rural community I choose

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By Perry Price NCAFP Workforce Initiatives Manager

to serve in my career, it is imperative that I steward the responsibility and privilege wisely.”

Another major benefit of our summer programs comes through their emphasis on mentorship. Students are paired with family physicians and residents (as well as community partners in each setting) who provide guidance and serve as role models. Through these interactions, students learn about the diverse career pathways available in Family Medicine, from academic and leadership roles to rural and community health leadership. Mentorship also provides practical guidance on navigating medical school, applying for residency, and developing strategies for professional growth. Early access to such networks can be transformative in helping students envision a sustainable and fulfilling career in Family Medicine. Another student commented how grateful they were to see that their preceptor had a network of peers and mentors gathered from his involvement in the NCAFP, and that it not only appeared to help his happiness in practice but also provided avenues to direct insights into what was going on in the greater Family Medicine community.

The NCAFP relies heavily on our physician members who open their clinics for our students to join them. We know that as physicians enter the workforce (or make career changes), having a strong support network of peers makes their transitions more successful. We aren’t alone in our search for strong mentors: our NC medical schools are always looking to increase the opportunities for their students to rotate into Family Medicine practices. Our summer programs offer an avenue for a physician who might be new to precepting to have the experience with-

out the longer-term commitment or stricter structure of a medical school rotation.

Skills development is another defining feature of these programs. Students are introduced to essential clinical skills that extend beyond a pre-clinical classroom setting, including suturing, point-of-care ultrasound, dermatologic procedures, and preventive care techniques. The opportunity to learn in a supportive, low-stakes environment enhances the students’ confidence and competence before they start rotations. Student feedback consistently highlights limited awareness of the full scope and diversity of practice within Family Medicine, particularly around procedures. By reinforcing fundamental skills and introducing new ones, summer programs help to accelerate student readiness for patient care responsibilities and highlight the procedural diversity of Family Medicine!

The combined effects of community immersion, mentorship, and skills development extend well beyond the summer. Students leave these programs with appreciation for the breadth of Family Medicine, a deeper understanding of the communities they may one day serve, greater confidence in their clinical abilities, and a network of mentors and peers to support their journey. Our programs contribute significantly to growing the number of future family physicians prepared to meet workforce needs in both primary care and underserved regions. By fostering early interest and commitment, summer programs help ensure that the next generation of physicians is well equipped to deliver patient-centered, community-oriented care. Our continued support and expansion of such programs are essential to addressing workforce needs and advancing the mission of Family Medicine in improving health outcomes for all communities.

We’d like to offer our sincere gratitude to the MAHEC Boone Family Medicine Residency Program and Dr. Molly Benedum, the Atrium Cabarrus Family Medicine Residency Program and Dr. Aaron Lambert, and our many physician members who served as hosts and preceptors this summer: • Dr. Landon Allen • Dr. Regina Bray Brown • Dr. Rhett Brown • Dr. Lisa Cassidy-Vu • Dr. Megan Easterday • Dr. Jennifer Hill • Dr. Brittany Hipkins • Dr. Travis Howell

• Dr. Gunnar Key • Dr. Toria Knox • Dr. Christian Moretz • Dr. Maureen Murphy • Dr. Macy Osborn • Dr. Caitlin Porter • Dr. Bradly Propst • Dr. Courtland Winborne

We’d also like to offer our sincere gratitude to the medical students who completed the summer programs this year: • Camille Anderson, Wake Forest University School of Medicine • Andrea Augustine, Duke University School of Medicine • Jordan Gentry, Campbell University School of Osteopathic Medicine • Anna Gilbert, Duke University School of Medicine • Rayed Hamid, Wake Forest University School of Medicine • Lauren McMahan, East Carolina University Brody School of Medicine • Joseph Morell, Wake Forest University School of Medicine • Timothy Patron, Campbell University School of Osteopathic Medicine • Nikita Patel, University of North Carolina School of Medicine • Anna Pyne, Wake Forest University School of Medicine • Constance Safley, Wake Forest University School of Medicine • Natalie Tomey, Campbell University School of Osteopathic Medicine • Garrett Wedge, University of North Carolina School of Medicine If you’re interested in learning more or getting involved, please reach out to me at perry@ncafp.com.

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Member ROUNDS

Reflections in My Last Year of Medical School

By Nicholas Wells MS-4 at the University of North Carolina School of Medicine

As I think back over the past three years of medical school, I am stunned by how quickly they have flown by. I’m currently applying to Family Medicine residency programs, and I’m feeling some intense déjà vu from the experience of applying to medical school. I’m at a different stage in training and am vying for a different kind of spot, but I am still the same person. Or am I? A lot happens in medical school – you form close friendships, tackle unique challenges, and gain a whole new world of knowledge. Soon I’ll have two new letters after my name that will change the way the world looks at me, and the way that I look at the world. But what does it mean to get an MD, and perhaps more importantly, how do I decide what to do with it?

At first, it was an information overload (kind of like starting medical school), but after a couple of board meetings, it started to make more sense. I began to understand how much our executive team does behind the scenes. We explore what family physicians in NC need the most and which policies could support them. I’ve learned how important it is to maintain relationships with legislators from across the political spectrum at a time when political differences often seem insurmountable. Even just this year, we had a prior authorization reform bill pass the NC House of Representatives, partly due to our strong advocacy work. As Student Director, I also advocate for the needs of medical students across the state and help figure out how to reach others who might be interested in Family Medicine.

These two years on the NCAFP Board have shown me the impact you can have, even as a student, on medical training and health care across the state.

“At this point, there’s no doubt in my mind that I want to be a family doctor.

But now I have to make the big decision – where to apply to residency?”

For me, the first half of medical school was for learning a mountain of information and connecting with my new community at the UNC School of Medicine.

To accomplish the latter and to learn more about my field of interest, I started going to events hosted by the Family Medicine Interest Group (FMIG). Eventually I became the co-president of FMIG and started organizing workshops, getting to know more family physicians, and engaging with the NCAFP at events like the Winter Conference.

I quickly realized how little I actually knew about the breadth of Family Medicine. I had worked in a rural Family Medicine clinic before medical school through the MedServe Fellowship, but that was only a small window into the vast world of this specialty.

At the NCAFP conferences, I started attending lectures and physician panels where the topics ranged from dermatology to psychiatry to diabetes management. By this point in school, I had enjoyed (almost) every subject,

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and so it was exciting to see a specialty that engaged with pathology in each organ system. I met physicians working in every imaginable setting: private practice, academic centers, direct primary care, community hospitals, or some combination of these options. Some doctors were doing advocacy work, meeting with state legislators, and serving on the NCAFP Board of Directors. When I discovered that students could be on this board, I decided I wanted to be a part of the conversation to help shape the future of Family Medicine in NC. So in 2023, I came on as the new Student Director-Elect for the NCAFP Board.

At this point, there’s no doubt in my mind that I want to be a family doctor. But now I have to make the big decision – where to apply to residency?

Enter FUTURE (formerly the AAFP National Conference), where every July you can explore over 500 residency programs from across the country. Picture this: you walk into a massive expo hall in downtown Kansas City, and the room is buzzing with excited residents and program directors talking to thousands of medical students. You and your North Carolina classmates split up to search for your top programs. It feels like taking a residency road trip across the U.S. You take notes, collect swag, pause for

water breaks (and a much-needed breather), and eventually regroup with everyone to compare programs and grab lunch. By the end, it feels like you’ve just run a marathon, but you somehow feel more energized than exhausted. You walk out knowing that you likely just spoke with someone who will be your colleague for the next several years. FUTURE is where you start to get to know “the vibe” of each of the residency programs you’re interested in.

As I enter interview season and continue to consider which path to take, I’m struck by the amount of nostalgia and gratitude I feel toward my time in medical school. This is a unique phase of life, where my biggest goal truly has been just to learn. Throughout this process, I’ve tried to heed the advice of one mentor, who taught me to “be a humble

sponge,” to take in as much as possible but also realize there’s always more to learn. I will bring this mindset with me into residency as I apply what I’ve learned, pass my knowledge onto others, and continue to soak up as much as I can. If there is one thing that I’ve learned about Family Medicine, it’s that it is a tight-knit community held together by hardworking physicians and groups like the NCAFP. While entering this specialty will be challenging, I know that I won’t be facing it on my own.

Member ROUNDS

NCAFP Members Win Elections at AAFP FUTURE Event

By Kevin LaTorre NCAFP Communications and Membership Manager

At the end of July, NCAFP staff and members made the most of the American Academy of Family Physicians (AAFP) FUTURE Conference!

The medical student and resident members gained new experiences and insights with Family Medicine while also enjoying plenty of fun with their fellow members from around the state and around the U.S. “It was a great weekend for our students and for the NC Family Medicine residency programs,” says NCAFP Exec. VP and CEO Greg Griggs, who attended FUTURE. “Seeing it all happen makes me excited for the next generation of family physicians!”

FUTURE also brought great news for three members of the next generation of family physicians: Dr. Claire Namboodri, Asia-La’Rae Walker, and Andrea Augustine all achieved national leadership roles in Family Medicine! Dr. Namboodri, a second-year resident at the Novant New Hanover Family Medicine Residency, became Resident Delegate-Elect to

Dr. Claire Namboodri, Asia-La'Rae Walker, and Andrea Augustine.

the AAFP Congress of Delegates; Walker, a fourth-year medical student at the Campbell University School of Osteopathic Medicine, became the student representative on the Society of Teachers of Family Medicine Board; and Augustine, a fourth-year medical student at Duke University, was elected to serve a second one-year term on the AAFP Foundation Board.

We were glad to support them during FUTURE, and we look forward to their leadership in the years ahead!

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PATIENTS & PRACTICE

6 Ways to Get in Trouble with the NC Medical Board (and 4 Ways to Avoid Trouble)

By Jean Fisher Brinkley NC Medical Board Communications Director

F

or licensed medical professionals, few consequences are more daunting than public discipline from their regulatory board. However, only a small percentage of physicians and physician assistants licensed by the North Carolina Medical Board (NCMB) are investigated — much less disciplined — in a typical year. For a case to result in adverse public action, NCMB must have evidence of at least one violation of the NC Medical Practice Act (MPA), the state law that governs the practice of medicine and gives NCMB its regulatory authority.

Behaviors may be related to the practice of medicine, or they may involve instances of personal misconduct.

Committing health insurance fraud, failing to appropriately supervise an advanced practice provider, and assaulting a patient or colleague are all examples of unprofessional conduct. In prosecuting a case for unprofessional conduct, NCMB relies on evidence gathered from relevant sources including witness interviews, statements by the licensee, and relevant documentary evidence.

Still, fortune favors the prepared. This article reviews some top causes of adverse public actions taken by NCMB between 2020 and 2024.

In cases involving alcohol or substance use, the licensee involved often comes to NCMB’s attention due to an “event” that brings their alcohol or substance use disorder to light. This could be an arrest for DWI or a report from a hospital that a licensee reported to work under the influence. In nearly all cases involving alcohol or substance use, NCMB refers the licensee for an assessment to determine if they are safe to practice. An assessment typically helps determine if the licensee has an alcohol or substance use disorder and what treatment, if any, is needed. It may also identify other issues that affect the licensee’s ability to practice safely.

1. Quality of Care By a wide margin, the number one source of adverse public actions are matters involving the quality of medical care provided by a licensee. These cases primarily involve instances where the medical or surgical care provided falls below the standard of care. NCMB relies on its internal medical staff and outside specialty experts to determine when the standard of care has not been met.

2. Prescribing Issues Cases that involve prescribing are actually a subset of quality-of-care cases but are numerous enough that NCMB counts them as their own cause of action. To fall into this category, a case must involve issues that arise primarily from the licensee’s prescribing practices. Most, but not all, public cases involve the prescribing of controlled substances.

3. Unprofessional Conduct Unprofessional conduct is a sort of “catch-all” category of misconduct that encompasses a wide range of behaviors.

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4. Licensee Alcohol or Substance Use

5. Professional Sexual Misconduct Professional sexual misconduct cases are a subset of unprofessional conduct cases and can involve a spectrum of behaviors that may lead to public disciplinary action.

These behaviors may include, but are not limited to, inappropriate communications, inappropriate physical contact, sexual relationships with patients, and others. When professional sexual misconduct is alleged, NCMB seeks to protect patients to the greatest extent possible, including offering the services of a victim services coordinator to patients alleging professional sexual misconduct. Professional sexual misconduct violation may result in a various range

of discipline depending on the severity of the misconduct and may include requiring the use of trained chaperones, restricting the licensee from treating male or female patients, or the suspension or revocation of their license.

How to Avoid Problems with the NCMB While it is impossible to predict when or if you may become the subject of a NCMB investigation, there are some practices you can adopt to protect yourself: 1. Always Practice According to Accepted and Prevailing Standards Make evidence-based medicine and standard of care practices the foundation of your medical practice. In reviewing allegations of substandard care, NCMB will look to your peers in the specialty area that you are practicing to determine whether your care was appropriate.

2. Document, Document, Document Thorough, accurate medical records are essential to tell the story of what patient care you provided and the rationale for your decision-making. Review of medical records — both by NCMB medical staff and by independent expert reviewers — helps NCMB determine if care is within minimum accepted standards of care. A licensee’s word that something was done is not enough. Put simply: if you didn’t document it, it didn’t happen.

3. Get Help if You Need It If you or a colleague are struggling with alcohol or substance use or mental health challenges, it is in everyone’s best interest to seek appropriate help — the sooner the better. Licensees may seek assistance from the NC Professionals Health Program (NCPHP) at www.ncphp.org.

NCPHP can recommend appropriate assessments and treatment for licensees who need help, and licensees may participate with NCPHP anonymously.

4. Be Informed There is an abundance of information available to help medical professionals avoid regulatory issues. Many of them can be found on NCMB’s website, www.ncmedboard.org. They include: • Position statements offer guidance on Board expectations for licensee conduct in a wide variety of contexts. Examples include “Guidelines for Avoiding Misunderstandings During Patient Encounters and Physical Examinations” and “Contact with Patients Before Prescribing.” Find the full collection by visiting www.ncmedboard.org/positionstatements.

• NCMB rules spell out the administrative requirements Continues as "MEDICAL BOARD" on back cover.

The NC Family Physician - Autumn 2025 | 29

Practice BOOSTS

Illuminating the Dark Space Between Visits: One Health’s Journey with Behavioral Health Collaborative Care By: Mark Collins, MD, FAAFP, One Health Chief Strategy Officer; Kelly Garrison, MBA, MHA, One Health Chief Transformation Officer; Jessica Reisner, PA-C, MSPAS, One Health Director of Strategic Innovation and Business Development; and Brittnie Sanchez, One Health Director of Transformation and Business Development

In primary care, we continually find ourselves face to face with the weight of behavioral health needs; most overt, many silent. Anxiety behind persistent abdominal pain.

Depression masked by fatigue. Panic hidden in hypertension. We know these patients. We care for them daily. And yet, traditional care models often fall short in addressing the complexity of mental health, especially in the “dark space” between visits, where patients too often struggle alone.

At One Health, we recognized this gap not as a challenge to work around but as a call to transform how we deliver care.

Recognizing the Need In 2022, our primary care teams identified an urgent and growing behavioral health need across our communities.

Primary care providers (PCPs) were overwhelmed and patients faced long waitlists for therapy. Those who needed help the most, often those with coexisting chronic conditions, were falling through the cracks.

We knew we needed a scalable, sustainable solution that did not burden already stretched PCPs. We found that solution in the Behavioral Health Collaborative Care Model (CoCM): a patient-centered, evidence-based framework that connects the primary care provider, a behavioral health care manager, and a psychiatric consultant to form a collaborative team approach.

Figure 1.

30 | The NC Family Physician - Autumn 2025

Partnering for Impact We partnered with MindHealthy PC, powered by C3 Healthcare Rx, an innovative behavioral health organization that aims to broaden access to quality, evidence-based mental health care for all. Together, we launched a virtual CoCM pilot in September 2022, building on a shared mission to close behavioral health gaps and support primary care teams.

Today, nearly three years later, the program has grown into a robust, high-impact initiative woven into the fabric of our modern primary care model.

Program Outcomes at a Glance • 7,450 total referrals since program launch • 95.04% Net Promoter Score, reflecting extraordinary patient satisfaction • 66% month-over-month retention, indicating strong engagement

• 10-day average wait time to Initial Assessment • One clinic with integrated, in-person therapy for expanded access and ongoing modality expansion to meet diverse patient needs (See Figure 2 for the full results.)

A Model That Elevates the Whole Patient The CoCM model has not only improved mental health and quality of life, the model has also enhanced patients’ engagement with their primary care teams. Patients feel heard, supported, and safe, leading to better continuity, trust, and outcomes.

Figure 2.

And we’re just getting started. We are actively exploring the model’s impact on chronic disease management and emergency department utilization. These are areas we believe will show just as much promise as its mental health outcomes.

Moving Forward Together As Family Medicine providers, we sit at the crossroads of physical, emotional, and social health. Collaborative Care does not replace our work; it enhances it. It equips us with the structure and support to treat the whole person in a meaningful and accessible way.

We share our story to inspire action. Whether you are in a solo practice or part of a large system, CoCM is a model worth considering. It is not only good medicine; it is the future of modern primary care.

If you would like to learn more or see how One Health built this model within a large primary care network, we would love to connect.

Together, we can close the gaps and bring light to the spaces where patients need us most.

The NC Family Physician - Autumn 2025 | 31

"THE OTHER DR. STEINBACHER" I must now offer a confession and an apology to some of the interviewers and admissions officers who asked me these questions. While I answered honestly, I committed an assuredly common sin of trying to say what important people wanted to hear. That was because the real answer was too obvious, to the point of being cliché: the answer was my mom. Growing up, I often took the role of a family physician for granted. Entire families would often stop us in public to express their admiration and gratitude for Dr. Steinbacher. This kind of praise seemed only natural to a young son — “of course Mom is great, everyone in my house knows that!”

But my deeper appreciation for what she did as a physician and community leader would come later. I followed in her footsteps often unconsciously and sometimes intentionally. I went to medical school for all the reasons pre-med students say they do: they want to help people, they love science, etc. But at a deeper level, I wanted to be a part of what my mom and her colleagues were building (and what they’re still growing). Cabarrus Family Medicine is an integral part of the growth and success of a now thriving, healthier community. Even more remarkable is their ability to train the next generations of physicians who will continue that mission.

"MEDICAL BOARD" for various processes or activities regulated by NCMB. One example: 21 NCAC 32S .0213 PHYSICIAN SUPERVISION OF PHYSICIAN ASSISTANTS sets out the specific duties required of physicians who supervise physician assistants. Visit the Rules page at the NCMB website.

• The NCMB Communications Department is on Facebook, Instagram, LinkedIn. and X and produces a licensee newsletter (The Forum), a podcast, brochures, videos, and other resources. These things are intended to help licensees stay out of trouble by keeping them informed.

Conclusion A message that often gets lost when licensees contemplate the prospect of patient complaints and disciplinary actions is that NCMB wants the medical professionals it licenses to be successful in their practice. While NCMB cannot

It only took a few weeks into my intern year to dispel any doubts my mom and I may have had about being a rare family team in Family Medicine. I had my own personal preceptor available almost 24/7 and opened a whole new world for our relationship to grow. Who else gets the opportunity to write “Steinbacher2” on a hospital room board to tell patients about their inpatient team? We had several parallel experiences introducing ourselves to patients in the hospital only to be informed, “You don’t look like my Dr. Steinbacher.” Being a family doctor is a unique honor. But it pales in comparison to becoming the other Dr. Steinbacher.

Dr. Erika Steinbacher graduated from UNC School of Medicine in 1992, completed residency at Group Health Cooperative in Seattle, and has been with Cabarrus Family Medicine Residency since 1996.

She has practiced full-scope Family Medicine and served as a faculty member, program director, and now as the Designated Institutional Official, overseeing graduate medical education at Atrium Health Cabarrus. She is married to Steve Steinbacher and has three children and three grandchildren.

Dr. Michael Steinbacher is from Concord and completed medical school at the UNC School of Medicine at Chapel Hill. He trained at Cabarrus Family Medicine Residency and graduated in 2025. He currently practices rural Family Medicine at Cabarrus Family Medicine Mount Pleasant, and he lives with his wife and three children.

give business or legal advice, staff attorneys and other professional staff are always happy to explain policies and rules. When in doubt about the “right” thing to do, don’t hesitate to reach out to the NCMB. Jean Fisher Brinkley is the NCMB Communications Director, a role that involves developing and overseeing strategies needed to enhance public and professional understanding of the Board and its mission. She joined the NCMB in 2008 after an 11year career in newspaper journalism, most of it dedicated to reporting on medicine, health policy, and the business aspects of health care. She lives in Raleigh with her husband and two high school-aged daughters.