Viviana Martinez-Bianchi, M.D.: The Complex Art of Family Medicine

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Family Medicine residents with Dr. Martinez-Bianchi

Duke Family Medicine residents Jonathan Jimenez, Kenetra Hix and Everlyn Perez with Viviana Martinez-Bianchi at the Moral March on Raleigh.

By Viviana Martinez-Bianchi, M.D., FAAFP

Residency training at Duke Family Medicine is in full swing. Busy lives, achieving knowledge, competencies and skills and new Family Medicine Milestones are reached each day.

Every week, I look at where the residents are spending each day. I review what rotations they are doing or about to do, and I grow excited thinking of all the places where our outstanding young colleagues are learning the complex art of family medicine.

There are the typical intern year rotations, mostly in the hospital setting, there are many ambulatory options in a diversity of health systems and community sites, and then there are the ones that take them far away.

Several residents choose to become involved with leadership activities done in a longitudinal fashion, working in advocacy, organizational leadership, education and addressing upstream reasons for poor health.

Checking in with the Interns

Our interns — already eight months into their first year of training — are spread across different rotations at Duke.   

  • Alexa Namba is in the full-term nursery at Duke University Hospital learning to provide comprehensive care to newborn babies.
  • Jessica Lapinski is spending this month at the Duke Children’s hospital,  where she is busy managing a diverse number of conditions affecting children and adolescents needing hospitalization. 
  • Mansi Shah is doing her cardiology rotation, working in the Duke Division of Cardiology.
  • Anna Afonso is in population management at the Duke Family Medicine Center, where she is working with our medical director on a quality improvement project for the practice, teaching smoking cessation at TROSA, caring for her patients in her Centering Obstetrics group, and providing comprehensive care in the Duke Family Medicine Center.
  • Alexa Mieses, now doing her obstetrics rotation at Duke, just returned from serving as a resident representative in the American Academy of Family Physicians (AAFP) Commission on Health of the Public and Science. The scope of work of the commission includes generation of new knowledge, providing recommendations to the AAFP board on areas such as incorporating evidence-based medicine into clinical practice guidelines and developing projects to help address major health national health concerns.

Our Second- and Third-Year Residents

Second- and third-year residents have the opportunity to spread their wings into “away rotations” at a variety of sites and communities that enrich their knowledge. 

Brian Blank is doing preoperative assessments at Duke, Vanessa Solomon is in population Health management, Jonathan Jimenez is treating patients in the Duke emergency room alongside the ED residents , and Kenetra Hix is in outpatient pediatrics at Wake Med in Raleigh.

Samantha Eksir is attending to the needs of patients in the neurology inpatient consult service at Duke, while Jonathan Hedrick and Everlyn Perez are doing the family medicine Inpatient Service in the UNC Hospitals system.

Expanding Our Horizons

I am always looking for opportunities that will enhance our residents’ learning and exposure to a diversity of realities and cultures on how to practice Family Medicine.

Samuel Fam is in Ecuador in the Andean community of Cacha. He spends half of the day taking Spanish-as-a-Second-Language classes at Cacha Medical Spanish Institute, and the other half of the day doing clinical rotations serving indigenous communities. Sam already speaks Arabic and French, and I look forward to seeing the result of his time in Ecuador mastering yet another language, and the ability to communicate with our members of the Latino community here in Durham.

Tiffany Covas, our chief resident, is our first resident to experience a new rural family medicine rotation at Granville Health System. I practiced in rural Iowa for five years and fell in love with the pace, culture and personality of my rural hospital. I have worked with Granville Hospital leadership and attendings for two years to create a rotation that will provide our residents all that life in a rural hospital has to offer. Granville Hospital announced this new rotation in a press release.

Preyanka Makadia will soon be heading to the Northern Navajo Medical Center in Shiprock, New Mexico, located in the Four Corners area of the United States where New Mexico, Arizona, Colorado and Utah meet. The Shiprock Service Unit is the largest service unit of the Navajo Nation, serving approximately 80,837 Native Americans. This is also a new rotation offered to our residents.

Marching for Improved Health

Moral March on Raleigh

Sometimes, our role as family physicians may bring us to the streets. A few Saturdays ago, I was honored to represent the "white coats" with a speech at the Moral March on Raleigh. I will never forget the experience of speaking from my heart to a crowd this size about the health and health care needs of our communities.

 

Duke med students

I was excited to see the presence of so many health professionals and health professions students, and more importantly inspired by the diverse humanity who attended the march. Duke medical students in the Family Medicine Interest Group, the Student National Medical Association and Primary Care Leadership Track, and various other students organizations, carpooled to Raleigh, and showed up with great signs, and well-prepared chants. 

My sister took video of my speech. At my sixth line, I choked up thinking about the estimated 80,000 people I could see from the stage, the Raleigh mall filled with people all the way from the Old Capitol to the Center for Performing Arts.

State and National Work

The Duke Family Medicine Residency Program’s presence in state and national activities is strong. In the next three months we will be participating in the North Carolina Family Medicine Day; the I3 Collaborative; the Starfield 2: Health Equity Summit, which I co-chair as part of my work with Family Medicine for America’s Health), the AAFP Program Directors Workshop, and the annual meeting of the Society of Teachers of Family Medicine

Donations from our alumni are making some of the dreams of residents’ attendance to these meetings and away and global rotations a reality! Thank you so much for your cooperation!

Our program is dedicated to training family physicians who are excellent clinicians, leaders, and advocates of health care within the community. We partner with a variety of local health care and community teams to meet the needs of  individuals, families, and populations, with the core goal of reducing health care disparities and improving health.


Viviana Martinez-Bianchi is program director of the Duke Family Medicine Residency Program. Email viviana.martinezbianchi@dm.duke.edu with questions.
 
Editor’s note: A member of the Duke Family Medicine Residency Program leadership team guest blogs every month. Blogs represent the opinion of the author, not the Duke Family Medicine Residency Program, the Department of Community and Family Medicine or Duke University.


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