Alexa Namba, DO, HS'19, is currently a physician at Duke Primary Care Oxford and a medical instructor in the Department of Family Medicine and Community Health. She graduated from the Duke Family Medicine Residency in 2019 and held a continuity clinic at Duke Primary Care Oxford as a second- and third-year resident.
Tell us about your experience in your continuity clinic at Duke Primary Care Oxford as a 2nd and 3rd year resident.
The time I spent with my continuity clinic in Oxford was the most formative experience of my residency training. I was able to practice true continuity of care—this included seeing patients repetitively throughout my two years, and also working with the same preceptor, Dr. Koinis, as well as the same medical assistants and nurses each week. This consistency allowed for specific, real time learning and feedback, allowing me to grow my professional identity and formulate how I wanted to practice outpatient primary care. I was also able to be more hands on with patient care, performing more outpatient procedures, learning how to use microscopy to diagnose patients in the office, and speaking with specialists in the community. Lastly, I found that DPC Oxford was truly a family practice and I was welcomed Day 1 into this close knit, supportive community.
Describe the mentorship relationship between you and your attending physicians when you were a resident at DPC Oxford.
I feel very fortunate to have found a remarkable group of mentors in the attendings at DPC Oxford. From my first day, I could tell that they not only were interested in sharing their breadth of knowledge, but they also were invested in my success as a family doctor. As a resident, they would find me in clinic if there was a patient with a unique physical exam finding or a procedure, even if they were not the acting preceptor. Additionally, they were open to any questions I might have about patient care or professional development. Some of my favorite memories were the lunches we were able to have pre-COVID-19, sitting at the picnic tables outside our office, hearing about their journeys through medicine. As a recent graduate, I feel very well supported and can ask any of my colleagues for a second opinion or management advice. This is truly a team based approach to primary care.
What drew you to join DPC Oxford after finishing residency?
Joining DPC Oxford was a natural fit after residency. When I was looking for a job, I knew I wanted to join a practice that was supportive and fostered an environment of learning as I would be a fresh graduate with questions. I also wanted to apply my public health training and join a practice that was invested in the community they serve. Oxford presented an incredible opportunity where I could join a close knit team of providers who care for medically complex, multigenerational families in a rural community.
Can you describe the types of patients that you see in Oxford? How do those patients differ from those you saw in Durham at Duke Family Medicine Center?
We see a variety of patients in Oxford. Some are very healthy and need an occasional check-in to ensure they are maintaining their healthy habits. Others are very medically complex and require close monitoring. One key difference from the patient population served by Duke Family Medicine in Durham is our access to specialty and emergency care. There are a few, superb specialists that are local in Oxford, but many of our patients prefer to have their complex medical issues managed by us as their PCPs. This has provided me the opportunity to take a more active role in managing these comorbidities and as a young provider, this has greatly enhanced my medical knowledge. Additionally, our patients often present to our clinic for initial evaluations when they are sick. As a resident, I saw patients coming in with burns sustained at home, a developing anaphylactic reaction to a bee sting or even a patient having a heart attack in our office. In Durham, these patients most likely would have presented directly to the Emergency Department, but here in Oxford, they can walk in our front door.
What do you like best about working and living in a small rural town?
I love the close-knit nature of the Oxford community. I have the privilege of caring for several generations of family members and most commonly get new patients by word of mouth referrals. This has allowed me the opportunity to get to know my patients much more deeply than the notes we capture in the medical record and build trusting relationships. This trust and understanding allows me to make more personalized recommendations to my patients that will lead to more sustainable healthy changes.
Describe the advantages of working in a small town clinic that is part of a large academic health system.
Being a part of a large academic health system like Duke dramatically expands the resources available to our patients. From a subspeciality standpoint, we can refer patients to Duke specialists that are not available locally. Additionally, we are able to offer nonclinical support services like care coordinators who can help patients find pharmacy assistance to better afford their medicines or have health educators provide teaching to tailor specific lifestyle recommendations to help patients. We can also transition patients to and from the hospital with ease as we share a medical record and can exchange message directly with the inpatient providers caring for our patients. Lastly, this past year has truly highlighted the benefits being part of a large academic health system. When the pandemic struck, our office was able to transition rapidly to telemedicine, get COVID-19 testing to our rural community, and even offer experimental treatments like monoclonal antibody infusions and COVID-19 vaccines to our patients.
In addition to training at Duke Regional and Duke Family Care in Oxford, how do you feel that future residents in the program will benefit from training at Maria Parham Health, which is a rural hospital with 205 licensed beds?
I am very excited our residents will have the opportunity to train at Maria Parham as well as Duke Regional and Duke University Hospitals. They will be able to experience the differences between more specialty supported care in Durham, to more generalized hospital medicine at Maria Parham. Residents will have more autonomy to direct the full spectrum of management for their patients and take a more active role in transitioning patients home from the hospital and back to our office in Oxford.