August 2017 Member of the Month
Member of the Month: Alyssa Molina, MD, MPH
Eagle Lake FP thrives on giving compassion and comfort to her community of patients
By Perdita Henry
It’s been almost seven years since Alyssa Molina, MD, MPH, transitioned from family medicine resident to family physician. Her journey toward family medicine is somewhat unique. No one in her family is a family doctor. She saw a pediatrician as an adolescent, and nurse practitioners during her time at university. As she moved through medical school and into residency, she enjoyed her rotations and many of them made lasting impressions on her. However, her curiosity about the patients she treated and would likely not see again left her with an internal wonder. What happened to the older man who was receiving cancer treatment? How is his family doing? Looking down at the wiggly infants she treated, she wondered what they would be like months and years from now. How were their moms doing? It wasn’t until her family medicine rotation that things clicked into place. Molina found joy in all her rotations but she found a home in family medicine.
Since then, she has settled in to the small town of Eagle Lake — population 3,710 — and practices full-spectrum family medicine. She knows the mothers of the wiggly infants, empowers patients with knowledge about their conditions, follows up with families of patients, remembers compassion in all her interactions, and brings medical students participating in the Texas Family Medicine Preceptorship Program along for the ride.
“I love the way family medicine looks at the whole patient — not just their physical state, but their social, emotional, and mental state as well.”
Why did you choose family medicine? What’s your favorite aspect of it? Were you inspired by anyone?
As I went through clerkships I did in my first two years, I liked psych, and OB, and kidney. Then in my third year, I really enjoyed pediatrics, pediatric surgery, and then pediatric burns. I loved delivering babies, but I always wanted to know where the baby went. In pediatrics, we had newborns but I was interested in the moms too. However, the weirdest thing happened when I started my family medicine rotation. I felt like I was home. I realized I love this, I love the variety of patients, I love the way family medicine looks at the whole patient — not just their physical state, but their social, emotional, and mental state as well.
I remember a patient on my internal medicine rotation, an older man, who had recurrent prostate cancer. He was there with his wife and his son. After we talked about what was going on with him physically, his son happened to mention he was adopted and all this stuff about his own family and it was so fascinating to watch the whole interaction. I felt privileged to be in on something so personal and intimate. My patient ended up returning but this time to hospice and I just felt attached to him. There was something about him and watching his whole family that made me want to take care of his wife, and his son, and his granddaughter. I wanted to know how all of them were. That was what made me excited and interested in family medicine. It was the idea of following a patient and their whole family longitudinally.
There was a family medicine doctor at UTMB who I didn’t know very well. Her name was Dr. Romero and she was in the process of retiring. I watched as she said goodbye to her patients and noticed the relationships she had built with them. They were clearly moved at the idea of her retiring. I thought that was so special as a physician to be so important in someone’s life that they cared if you left. For me, it was more about the interactions with patients that made me want to do this all the time.
How does your Master’s in Public Health complement your medical training?
I studied disease control and that looks at the way disease move through a population rather than one person. I think in that aspect, I have more understanding about how diseases are spread. Even though we all learn that in medical school, you learn a little bit more in public health. Because in epidemiology and in public health school in general, you talk a lot about sensitivity, specificity, screening, primary prevention versus secondary prevention, and that’s an area I understand well when it comes to screening tests.
“Sharing my passion with the next generation of physicians and having them share their passion with me is an almost symbiotic thing.”
What are the benefits for physicians participating in the Texas Family Medicine Preceptorship program?
Having a student with you makes you examine your practice and makes you think hard about why you do things. Because you’re trying to teach a doctor-to-be why we do certain things, it makes you ask yourself a series of questions: “Why do I do this? Is this really the right thing to do? Do I do this because it’s easy or do I do it because it’s right?”
It helps keep you up to date on what you are doing and how you are treating your patients. Medical students learn so much more than what I learned and I was only in medical school 15 years ago. Having them talk about the things they’re learning, helps me refresh my very rusty basic sciences, and they teach me sometimes, too.
Another benefit is the contagious energy and passion a first-year and second-year medical student brings to the table. Whereas I might feel blasé about putting in stiches or taking care of a newborn — though I never get that way about delivering babies; that’s always exciting and terrifying — to see it all again through these brand-new eyes is exciting. Sharing my passion with the next generation of physicians and having them share their passion with me is an almost symbiotic thing.
Another reason is because I’ll need a doctor when I get older. I already have a doctor but he’s older than me and at some point, he’ll retire and I’ll need another doctor. So it behooves me to invest in the future primary care system because I will need a smart, efficient, compassionate family doctor for myself when I get older and for my kids as they get older. I think of it as helping myself, my family, and my community when I help up-and-coming physicians.
Why is it important for you to be involved with TAFP?
I think TAFP has excellent CME. I really appreciate the CME I have received, in fact it was a lecture led by Dr. Hart on hormone therapy that made me realize I was practicing based on assumptions I had about incomplete information. It’s also important to understand what’s going on in the world of policy and how it will affect me, my patients, and my practice. I really appreciate the work [the TAFP advocacy team] does, receiving legislative updates, and meeting other physicians — especially as a rural family doctor. Through TAFP, I have met all these colleagues who are all very helpful and very nice. I enjoy the fellowship and community aspect of TAFP meetings. It’s really exciting to be around other physicians who are more than happy to share with me their passions, stories, and resources.
How do you make a difference in family medicine and in your community?
I’m on the Perinatal Advisory Council, I speak about the neonatal maternal levels of care, and I have some say in how policies will be created and how the legislation will be enacted. However, I see my main role as making a difference in the lives of my patients. My patients often tell me I am good listener and that I explain things well. I try to help my patients understand what is going on with them as much as possible. I can’t always devote as much time to explain everything as in depth sometimes, but I try very hard to make sure my patients understand why it’s important to, for example, manage their diabetes or take care of their blood pressure.
What words or phrases characterize your style of family medicine?
Compassion and comfort. I don’t wear a white coat. I don’t put on airs. Our office is modest. I try always to be compassionate and think about how I would want to be treated in any situation. Our CEO once told us to think about what it might feel like if you had never been in a courtroom and how terrifying that would be. For many people who don’t work in the medical field, that’s what it feels like to go to the doctor. Remember even though you’re comfortable because this is something you do every day, this can be anxiety-provoking to other people.
“I am most effective in caring for my patients when I can establish a trusting relationship where we have mutual confidence in each other.”
What is the most important quality a family physician should have?
Compassion. I think when your patients feel like you care about them, it goes a long way. You’re more likely to feel fulfillment in your work when you’ve made someone’s day better. The way to accomplish that is to treat them as you would want to be treated. It is easy to label a person and treat them as a non-compliant diabetic rather than a person who has diabetes, is taking care of her dying sister, lives on a disability check and food stamps, and barely has enough money to pay her light bill. It’s easier to have compassion about why she doesn’t take as good care of her diabetes when you think about all the things she is facing.
How do you spend your free time?
When I’m not working, I am hanging out with my kids. I like to bake. I like to make muffins and cookies, though sometimes I will make pies. I make a good pecan and lemon meringue pies. I use baking to help me unwind. This is kind of weird but I really like to hand-mix things and watch the batter come together. If I’m stressed out, I will be in the kitchen making some cookies or muffins so I can mix the batter together. There’s something about everything being disorganized and then watching it come together into one organized batter that helps me.
I also really like to sing. I used to sing on the praise team at my previous church but we’re currently in-between churches. I love “The Golden Girls” and “I Love Lucy.” In fact, I have seen every episode of both of those. My husband got me the entire “I Love Lucy” collection and then he put it on a hard drive so I could take it anywhere. I am also a “Star Wars” fan. I used to watch “Return of the Jedi” every day while I did my homework in high school.
TAFP’s Member of the Month program highlights Texas family physicians in TAFP News Now and on the TAFP website. We feature a biography and a Q&A with a different TAFP member each month and his or her unique approach to family medicine. If you know an outstanding family physician colleague who you think should be featured as a Member of the Month or if you’d like to tell your own story, nominate yourself or your colleague by contacting TAFP by email at firstname.lastname@example.org or by phone at (512) 329-8666. View past Members of the Month here.