
15 minute read
Dr. Viviana Martinez-Bianchi Honored by Foundation for Health Leadership & Innovation
NCAFP Dr. Rebecca Hayes Receives Golden Stethoscope Award from NC Medical Society
The NC Medical Society recently honored four physicians with Golden Stethoscope Awards at its Gala Banquet held in conjunction with their LEAD Conference in mid-October. NCAFP Member Rebecca Hayes, MD, MBA-HM, was one of the four physicians honored. Dr. Hayes is Vice Chair of Clinical and Community Operations
Past President Dr. R.W. (Chip) Watkins Appointed to CLIA Workgroups
NCAFP Past President Dr. R.W. (Chip) Watkins has been appointed to the Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver and Provider-performed Microscopy Procedures (PPMP) Workgroup. In this workgroup, Dr. Watkins will share his experiences and challenges observed in Certificate of Waiver and Certificate for PPM Procedures testing sites. This is part of his continuing work with CDC as a member of the CLIAC (Clinical Laboratory Improvement Advisory Committee). Dr. Watkins currently serves as CCNC Regional Medical Director.

Family Physician Dr. Devdutta "Dev" Sangvai has been appointed interim president of Duke Regional Hospital. He begins this leadership role in in the Department of Family Medicine and the Assistant Specialty Medical Director of the community clinics in the Emerging Care Model Division at Atrium Health. In her 15 years at Atrium, she has also served as medical director and core faculty at Elizabeth Family Medicine, and associate program director for the Cabarrus Family Medicine Residency Program.
mid-August. Dr. Sangvai has served on the Durham County Hospital Corporation Board of Trustees, which is the board for Duke Regional Hospital. At Duke, Dr. Sangvai is vice chair for strategy in the Department of Family Medicine and Community Health, as well as vice president for Population Health Management. He is also the executive director of Duke Connected Care, Duke's accountable care organization.
Dr. Art Apolinario Installed as NC Medical Society President
Dr. Art Apolinario, a family physician and NCAFP member, was installed as the latest President of the NC Medical Society (NCMS) this past October during a gala as part of the NCMS LEAD Conference. Dr. Apolinario completed his medical degree at Tulane University and completed his Family Medicine Residency at Saint Vincent Health System in Erie, PA. He has practiced at Clinton Medical Clinic for well over 20 years. Congratulations to Dr. Apolinario, and the entire NC Medical Society team for a great LEAD Conference.
STUDENT PROGRAMS & INITIATIVES
FAMILY MEDICINE ON CAMPUS
Wake Forest Introduces Innovative Effort to Attract Students into FM
“Having grown up in the middle east, it is well known that barriers to communication are often removed when food is in a room - allowing us to see the human side of those we respect and recognize the innate needs we all have. Coupling that psycho-social thrombolytic with a room full of welcoming potential mentors was one of the pivotal components allowing me to see the field of Family Medicine as one that I could be welcomed into. Once barriers came down, it was much easier to feel comfortable asking questions, hear about opportunities available, and see our mutual ambitions.” - Joshua Pontier, MD Candidate – Class of 2024
“There are so many avenues to explore in the field of Family Medicine! I came into this rotation with limited exposure to how broad this specialty is and how a physician can tailor their practice towards their personal and professional strengths and interests. The planned lunches and Meet and Greet event crafted by Danielle and Arleen allowed for these intentional opportunities to talk candidly with residents and attendings outside the clinic. After the combination of clinical exposure and hearing from physicians in various stages of training discuss why they chose this specialty, what others were considered during medical school, and how they currently structure their workday, Family Medicine is now in my top choices of specialties. I am really excited to come to clinic every day and continue to learn more. “ - Megan Alsaeedi, MD Candidate – Class of 2024
“Our departmental “Meet and Greet” activities have been a big hit. These unique, themed gatherings allow for a relaxed exchange between our staff, faculty and residents in family medicine with potential future family medicine physicians (i.e 3rd year clerkship students). Whether it was our clerkship director, Scott Harper, as Uncle Sam or our recent representation of “Dr. McDreamy” by our departmental chair, these gatherings bring lighthearted fun and a platform for the students to get more insight into what makes family medicine such an awesome specialty. Arleen and Danielle do a fantastic job of welcoming the students and encouraging dialogue beyond the standard didactic and clinical teaching. This has been a great addition to our curriculum.” - Chris Miles, MD
Increasing the workforce pipeline into Family Medicine is a core tenant of the NCAFP Foundation, but how do we encourage those pre-dispositioned to Family Medicine to choose medical school, and then ensure those students do in fact find their home in Family Medicine? The answer is certainly multi-faceted, and the strategies numerous, but it’s especially exciting when a new endeavor is successful.
At Wake Forest University School of Medicine, Arleen Settles, Administrative Support, and Danielle Averitt, Clerkship Coordinator for Family Medicine, saw an opportunity for greater engagement with the medical students coming through their doors and took a chance on a new idea – and it’s working!
Each month as a new group of M3s begin their Family Medicine Outpatient Clinic they are invited to attend a Meet-and-Greet event held on-site and given a chance to mingle with their classmates and faculty in a casual setting. The real draw however – the themes! From Alice in Wonderland to Grey’s Anatomy, the imaginative events serve as a unique way to disarm the students (and faculty!) and create a setting where all can socialize and build a foundation for budding relationships. By getting to know the students a bit more personally, the faculty and staff in the Family Medicine Department are better suited to pinpoint students who are interested in pursuing Family Medicine or those who they see potential in…something they might have missed before. The students and faculty have great things to say too: It’s easy to overlook these simple opportunities but bringing a bit of levity has opened the doors for building community and relationships within the Family Medicine Department at Wake Forest School of Medicine!


CAREers in FOCUS
MOMS in Family Medicine

Navigating a Fulfilling Career and Family: Part 1
By Perry Price NCAFP Workforce Initiatives Manager
In 2020, roughly 42% of practicing Family Physicians were women -- up almost 8% from 2010. While the increase is promising and expected to continue (more than 50% of US medical students are women), it also clearly shows the need for employers and decision makers to formulate workplace policies and strategies that promote professional growth alongside parental responsibility for female physicians. Balancing practice and motherhood should be a celebrated feat, not a tolerated one. While parenthood is not unique to female physicians, there are unique burdens and pressures that regularly fall on mothers.
We interviewed a few of our members to get their perspectives on being Moms in Family Medicine, and to hear their stories about starting and raising families at different times and across a variety of practice settings. This edition of The North Carolina Family Physician features Part 1, an introduction of our interviewees and an acknowledgement of some of the policies that supported and challenged them. Make sure to read Part 2 in our February 2023 edition where our interviewees will share their strategies and advice, and the benefits of being a Mom in Family Medicine!

Share your story - At what stage of your career did you have children? What type of practice setting were you in? What stage of your career are you currently in?
Jessica Triche, MD: I had my first child, Kevin, during my 3rd year of residency. My program frontloaded call so this was planned. I was able to take extra call earlier in my training, so it balanced out with my classmates, and I did not feel bad. Currently, I have two kids and am practicing in an academic clinic.
Vickie Fowler, MD: As it so happened, my journey into motherhood began in the fall of 1999 just after I returned to my hometown of Ashe County, NC joining my own family physician to provide full spectrum rural Family Medicine. I found out I was pregnant halfway through my obstetrical fellowship, which was particularly challenging with the frequent call and long hours. I had three children in my 30s and I joke that I spent my entire 30s either pregnant or breastfeeding or BOTH! Currently I am mid-career with children ages 16 to 23 and I practice in Raleigh, NC in a hospital owned outpatient-only practice.
Kelley Lawrence, MD: I had my first child about a month after taking Step 1, so after my MS2 summer. My second child came at the beginning of PGY2 year of residency, my third child came after residency graduation (and after taking the Family Medicine boards), and my fourth child came as I left my first clinic to pursue the academic portion of my medical career. I am currently Associate Program Director of our Family Medicine Residency (have been with this organization for 7.5 years) and also the Assistant Dean for a regional campus of the UNC School of Medicine (in this role for 2 years).
Jackée Clement, MD: My husband and I decided to have a child during my second year of FM residency. It has been almost a year, so I am currently a third-year resident.
Liz Baltaro, MD: I was shocked to be pregnant with twins in my 2nd year of residency. They were born at the start of 3rd year. My 3rd child was born during my PGY7 year working as an employed family physician for a rural health system. I’m now entering PGY11 about a decade into my medical career-- mom of three, employed medical director and family physician.
What workplace policies have been in place that allowed you to succeed as a mother? Or policies in place that made it difficult?
JT: In residency, I took the minimum time off for maternity leave. I did not want to miss training and I did not want to crap on my classmates. I was not pressured by my program. When I had my 2nd kid, I made sure to take the full 12 weeks. Some of it was unpaid but I didn’t care. I actually got a paper check for “zero dollars”. My organization was supportive during my
full 12 weeks of maternity leave. I have not had any more kids since then. As for policies that have allowed me to succeed, not many. I have winged it! Most of the time everyone has been understanding of time off for kids related issues/sports, etc. My current practice manager is very supportive of me making it to kids sporting events or things like Math Team competition.
VF: Practicing in my own practice in rural NC and providing full spectrum care in a critical access hospital, I cannot really acknowledge any formal workplace policies that existed. What allowed me to succeed as a mother was the concept that, “It takes a village to raise a child” and my incredibly supportive family and colleagues. There were times when my male colleagues in the practice told me to not come into the office or the hospital on my day off when they could see the demands of my job weighing on me. It was more me learning to accept others help and being willing to acknowledge the importance of that day off with my children. The ability to have a complete day off during the week from the office (if not the hospital) was absolutely critical for my ability to be a Mom. Every physician or APP had a day off from the office each week. My greatest challenge was finding an opportunity and a location to pump breastmilk while working. In spite of all odds against me in terms of my schedule and work demands, I was able to breastfeed all three of my children successfully for years.
KL: While I don’t know of many policies that helped me with my own pregnancies or breastfeeding efforts, I benefitted greatly from the support of other understanding physicians, who gave good advice and encouraged me to follow my parental instincts and spend that early time with my children. Dr. Georgette Dent at the UNC SOM gave me the advice to take a year between MS2 and MS3 to pursue my “MOM” degree and I regret not one moment of that time. In residency, I wish I had asked to see the parental leave policy during interviews. It is also important to know how supportive and flexible your supervisors/employers can be with parental leave and pumping breaks to adequately plan mentally and physically to be a physician mother.
JC: One of the reasons I chose the Novant Health Family Medicine Residency program is because they were finalizing a strong maternal health policy. In fact, I met my future mentor, Dr Kelley Lawrence, during my interview day there. During my interview with her, I asked if they had maternity leave for residents interested in having children during training. This was a risky question to ask during an interview; however, I knew it was important to me and my then fiancé. I didn’t want to go to a residency that would look down on a medical school student for asking anyway. And fortunately, Dr. Lawrence was a woman with a plan. She was so open and passionate about the policy she was working on. Essentially, we get 3 months of parental leave. One month is fully dedicated to being with baby as a maternal health elective. The other two months, we return gradually to patient care. And over those three months, we are expected to come up with a maternal health project, such as a presentation on breastfeeding medicine, that encompasses some of what we learned from our first-hand experience taking care of a newborn.
LB: I feel fortunate to work in the post-1993 era where FMLA is in place, but believe that parental leave policies could be better. I experienced unexpected pregnancy complications, and hospitalizations prior to my premature delivery. It was physically demanding to work while pregnant with twins, especially night shifts. My residency program was supportive, yet it was painful to leave babies in the NICU, and to have only 5 weeks at home with my twins once they were discharged. If I had taken more time, I may have had to repeat a year of residency.
“I benefitted greatly from the support of other understanding physicians, who gave good advice and encouraged me to follow my parental instincts and spend that early time with my children.” — Kelley Lawrence, MD
Policies which felt challenging included inability to train or work part-time, rotations/ hospital call/ evening meetings that prevented me from being with my children during their waking hours for over 2 full days in a row. I was required to work the same number of weekend/ call weeks per year when I took parental leave, making my time back at work even more challenging than usual.
What workplace policies would you advocate for?
JT: I would advocate for some sort of “childcare issue” time. Like CME... when your kids are sick or have snow days you can take a day and not be penalized. Maybe work from home, virtually. Would need documentation of child illness or school closure. I am making this up...just thought of it with this question but would have been helpful during my career!
VF: Maternity leave for 12 weeks all fully paid if possible. A 30-minute break to pump breast milk as often as every 4 hours if needed in an appropriately private and comfortable location. Ability to return to work part time following the birth of a child for up to the first year. Not a policy but a culture that is supportive for pregnancy/motherhood, ex, ability to leave or decrease participation in the call schedule readily during parts of pregnancy or post-partum time as needed (without guilt.)
KL: I believe that we as a profession (and as a nation) need to honor the important work of bearing and, when possible, naturally-feeding children. At the residency level, I have worked with colleagues to build and share on state and national levels our family learning plan—for residents building family, we couple 6 weeks off as now required by the ABFM with 6 additional weeks of at-home learning (there’s plenty of that with a new child and it can be practice-defining!) with a small amount of “transition-back” to residency time to give the new parent one session per week for a few weeks to practice some time away and troubleshoot rather than coming back all at once. Workplaces, especially healthcare workplaces, need to have policies in place that support and protect lactating mothers who are employees—not just those who are patients/clients of the healthcare facilities. The USBC is a great advocacy organization that gives guidance to workplaces who want to improve their lactation policies. Also, the North Carolina Breastfeeding Coalition gives guidance as to how to be a breastfeeding-friendly business or clinic (similar to how hospitals can work to become Baby Friendly).
JC: I was happy with my experience. So I would advocate for polices that emulate that. So women need a minimum of 3 months just to recover from delivery, so policies should not stop shy of this time requirement. Obviously, men should be able to stay at home and provide support for their family as well. Not only should there be at least 3 months off, but it should be paid leave.
LB: Policies that promote flexibility in residency training and beyond-- allowing parents to feel supported to take more time off if needed, or work part-time or different hours (such as starting/ ending earlier in order to pick up kids). I would especially like to see these policies support both partners. I would advocate for subsidized child care, and on site daycares, and support in securing childcare. I would like to see all parents, and especially parents of multiples allowed longer parental leave.
Be sure to read Part 2 of Moms in Family Medicine in our February 2023 edition, where our interviewees will give their advice for navigating these challenges, reveal who they look to for guidance, and share how being a mom has shaped them into the successful Family Physicians they are!