International Medical Graduate Richel Avery, MD, has been based in San Antonio since completing her residency at the UTHSCSA Family and Community Medicine Residency program. She now practices full-spectrum family medicine and serves as the medical director at the UT Health Kyle Seale Parkway Primary Care Clinic, as well as oversees 10 specialties as the Associate Chief Medical Officer of the UT Health Outpatient and Surgery Center. After earning her diplomate in obesity medicine in 2017, Avery started the Medical Weight Management Program. Last year she helped TAFP’s Council on Health of the Public launch the Task Force on Obesity, which quickly created and held the first obesity CME workshop at Annual Session and Primary Care Summit last fall.
Who or what inspired you to become a family physician?
I completed medical school in the Philippines where my clinical rotations illustrated the importance of primary preventive care. During my exposure with the rolling clinics, a medical outreach initiative providing care to the remote and mountainous areas of southern Philippines, I discovered firsthand that a lack of care could equal higher morbidity and preventable death. I witnessed a parallel between health care disparities and socioeconomic inequalities that compelled me to prioritize caring for the underserved, focusing on primary care. My experience working at the community hospital in the Philippines taught me about what a doctor should be and introduced me to family medicine. I learned that treating a patient involves not only the patient, but the family and the community. Such a holistic approach is what distinguishes family medicine from other specialties, and I find it a more rewarding experience.
Through your work on TAFP’s Council on Health of the Public you helped create the Task Force on Obesity, which is a practice passion of yours. Tell us more about your interest in obesity medicine.
My interest in obesity medicine began as a scholarly activity as a resident where I developed a children’s obesity program that involved the whole family. We discovered that the prevalence rate of obesity in children ages 2-12 years was higher in our patient population at the Family Health Center than the national average. Additionally, this correlated with a higher BMI in their parents. If we wanted to make an impact on children’s health, it would have to be an intervention that addressed the entire family.
With the help of my mentors, I submitted a TAFP grant proposal using family group visits to improve children’s eating habits and activities, thereby improving their BMIs. As a new physician working at the UT Health Primary Care Center, I became board certified in obesity medicine and started a weight management program. I continue to develop and grow the program, initially treating my own patients and now currently receiving referrals from PCPs and specialists for medical weight management. I believe that family physicians are uniquely poised in addressing obesity and overweight in their patients due to several key factors.
- Continuity of care. Family physicians often have long-term relationships with their patients, which facilitates ongoing monitoring and support for weight management. This continuity of care increases the likelihood of acknowledging obesity and providing a treatment plan.
- Comprehensive approach. Family physicians are well-positioned to integrate lifestyle interventions, dietary changes, physical activity, behavioral therapy, pharmacotherapy, and referrals for bariatric surgery into a cohesive treatment plan. They can provide personalized care that considers the patient's overall health, comorbid conditions, and preferences.
- Accessibility. Most medical care for adults with obesity is delivered in primary care settings, making family doctors the first point of contact for many patients. This accessibility allows for early identification and intervention, which is crucial for effective obesity management.
- Chronic disease management. The American College of Cardiology, American Heart Association, and The Obesity Society recommend using a chronic disease management model for obesity, which includes comprehensive lifestyle interventions and, when necessary, pharmacotherapy and surgical options. This is a model of care which family physicians are well-trained at and adept at doing.
- Patient-physician relationship. The established trust and rapport between patients and their family physicians can enhance the effectiveness of obesity treatment. Patients are more likely to adhere to treatment plans and engage in open discussions about their weight and related health issues.
- Team-based care. Family physicians can coordinate with dietitians, psychologists, and other specialists to provide a multidisciplinary approach to obesity management, which has been shown to be more effective than isolated interventions.
Why do you choose to be a TAFP member?
I have been a member of TAFP since I was a resident. The meetings and conferences have given me invaluable training and resources to improve myself as a leader, a researcher, a clinician, a teacher, and as a person. As a resident, I was granted scholarships to conduct, travel, and present research. As an early clinician, I was part of the 2019 cohort for the FMLE, which helped me grow as a leader, learning to step out of my comfort zone and have the courage to start a Walk with a Doc program within my institution. Being part of the Council on Health of the Public has allowed me the opportunity to be able to contribute and share my knowledge and experience which enabled me to step up to lead the Task Force on Obesity.
The litany is long on how my TAFP membership has benefited me. However, I can say that the biggest value given to me by TAFP is that it provided an avenue for me to connect with my colleagues outside of the clinical space. We share ideas and resources, network, and simply chat. In addition, it is a space which is welcoming to my family, and I can perform scholarly activities and be with my family at the same time.
What do you enjoy doing outside of medicine?
Outside of work, I spend as much time as possible with my two boys and my husband. We like to spend time outdoors, camping, and traveling to new places. Because of my kids, I learned how to ski, play golf, and stand-up paddle board.
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 tafp@tafp.org or by phone at (512) 329-8666.