Now a third-year resident at the UT Health San Antonio Family Medicine Residency Program, Carmella DeSerto, MD, previously received undergraduate degrees in Spanish and kinesiology/sports medicine at Rice University in Houston. After completing medical school at UT Health San Antonio Medical School, she decided to stick around South Texas. She is now focused on the largely underserved patient population that the residency program serves, especially the LGBTQ+ community. DeSerto’s interest in the community developed during medical school, and is now the focus of her project through the TAFP Foundation’s Texas Family Medicine Scholars Program, which supports Texas family medicine resident leaders interested in giving back to their community and the specialty. Learn more about her project below.
Who or what inspired you to become a family physician?
I had a really wonderful family medicine physician growing up who was part of my inspiration to pursue medicine. I grew up in the middle of nowhere in a small town in Wisconsin, so the types of medical professionals I saw were very limited. My perception of a physician has always been a family physician. Someone well versed in everything, who sees everyone regardless of illness or age, and who advocates for them no matter what. During medical school, I explored the other areas of medicine that intrigued me, but I always found myself drawn back towards family medicine. The mentorship through the faculty of our program was excellent through my clinical rotations, and most of the physicians who lectured and taught were primary care physicians. I love seeing all different types of medical problems, helping people navigate through the social aspects of medicine and life, seeing people of all ages, and being a lifelong learner and teacher. There is nothing more rewarding than giving someone an answer to what their symptoms mean and seeing treatment and resolution. The smile on the face of one of my continuity patients when they feel better or have control over their medical problems is something that keeps me coming back every day.
What unique challenges are represented in your patient community?
Our patient community here in San Antonio, especially the patients we serve through the University Health system, are some of the most underserved patients in the country. Our patients deal with so many social factors that make it near impossible to engage with health care, and when they do, they often feel disenfranchised by the system. We see patients who are from low SES or are unfunded, deal with homelessness, get diagnosed late in their disease’s course, don't have social support, experience drug use, have adverse childhood events and trauma, are ethnic minorities or refugees, and the list goes on. But we treat each and every person with the dignity they deserve, and we try to connect them to as many resources as possible.
Our Family Health Program utilizes Promotores, community health workers who connect our patients with social and medical support. They are also community members, so they know the struggles our patients face and how to overcome them. UT Health San Antonio also has Carelink, a unique payment plan resource for patients in Bexar County who need to seek medical care but are unfunded. San Antonio is also the major metropolitan area for South Texas and much of Mexico and Central America, so we are often the last stop when people are referred to specialists, which means we have the unique experience of seeing interesting patient presentations that you might normally only read in a textbook. These challenges create a really rich environment to learn both medicine and the human and social aspects of treating patients.
You were chosen as one of the TAFP Foundation’s 2022 Texas Family Medicine Scholars. Tell us a little about the project you’re doing with that program.
Through the Texas Family Medicine Scholars program, I am working on a project to help create more resources for our LGBTQ+ patients here in San Antonio. I have always been interested in LGBTQ+ social issues, and as a queer person myself, I have seen firsthand the dynamic social, political, and medical changes we have experienced in our community over the last decade. When I was in college, I used to give Safe Space presentations to college students about the most basic of LGBTQ+ terminology. It's amazing to see how far we've come as a society, but there's still so much progress that needs to be done.
Now, I'm in the unique position of seeing a huge gap in health care centered for LGBTQ+ patients. My project focuses on increasing the clinical knowledge training that our residents and staff receive and creating spaces within our clinic where LGBTQ+ patients can feel safe and engage in health care. When I was in medical school at UT Health San Antonio, I had the honor of working with the PRIDE Clinic, a free clinic for LGBTQ+ adults, a large portion of whom are transgender. Through that clinic, which is run by student volunteers and faculty, unfunded patients can get access to hormone therapy and other health needs. Now, as a resident, I see a huge gap in the care we offer for patients who would be able to qualify for things like Medicaid, Carelink, or who have other insurance and are seeking care through the University system. There isn't a good resource like PRIDE clinic for them. My hope is to increase the comfort that our providers have in LGBTQ+ health topics and to create a dedicated clinic space for our LGBTQ+ patients to seek out any and all health care needs in a place they feel safe and heard.
Why do you choose to be a TAFP member?
TAFP membership is so valuable to me for many reasons. I think it's crucial to stay well-connected with colleagues who are doing great work in advocacy and clinical learning. TAFP allows for an organized and central way to connect with other medical professionals and community leaders, to enact and present research, and to advocate at the highest levels for what we need to give our patients excellent, evidence-based care. Access to TAFP and AAFP gives me the resources I need to stay well-informed, make good clinical decisions, advocate for my patients, and have excellent interprofessional development and collegiality.
What do you enjoy doing outside of medicine?
Outside of medicine, I'm a huge nerd. My biggest hobby is playing Dungeons and Dragons weekly with my friends. I've been playing D&D since college and it's something that brings me so much joy, laughter, creativity, problem solving, and sometimes drama. It's a fantastic creative outlet for me to write stories and an excuse to gather around a table together with friends over good food every week. I am also a big lover of the outdoors and of traveling. I've been to 20 of our 63 U.S. National Parks, and my bucket list is to go to all of them someday! I love camping, hiking, and exploring places off the beaten path. This year, I also became a parent, which has been a huge part of my time outside of medicine! My daughter is 7 months old now and she loves trying new foods, giggling at everything, and going for walks. My husband and I are very proud of her, and we love to watch her become her own little person.
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.