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Perspective on Family Medicine

Q&A with Pablo Hernandez-Itriago, MD

Dr. Hernandez

Pablo Hernandez-Itriago, MD, is a family medicine physician at Boston Medical Center. He discussed what it means to work in the field of family medicine, including who he cares for, making home visits, and the challenges involved.

Q. How did you end up becoming a family medicine physician at BMC?

A. My path to family medicine was not traditional. I'm originally from Venezuela, and I was following in my father's footsteps to become a surgeon. That all changed when I worked in an underserved area right after medical school. I realized that working with entire families was not only more challenging, but it was also more gratifying. My new calling was to care for and connect with people and their families throughout their entire lives.

Q. What, in your opinion, does it mean to be a family medicine physician?

A. I went to an American Academy of Family Physicians (AAFP) conference in early spring, and one of the phrases that kept coming up was to "have a heart." That's what we in family medicine try to do: have a heart, and be open minded. We're always thinking 'what else is affecting the patient?' Also, what else can work for treatments? When looking into patients' lifestyles, family medicine requires being creative to help patients come up with their own solutions. We're like life coaches, and not being judgmental is a major part of that.

Q. What skills are necessary to succeed in family medicine?

A. I speak "conversational" Portuguese, and I'm fluent in Spanish and English. Being multilingual is a huge comfort to some families whose members speak very little or no English. Patients specifically ask for me simply because they are more comfortable speaking with a doctor in their primary language. It's also necessary to understand the culture of your patients. I see patients from Third World countries, and having an attitude of anything can happen, and anything goes, is helpful.

"My new calling was to care for and connect with people and their families throughout their entire lives."

Q. Who do family medicine doctors care for?

A. Everybody is involved. Parents, kids, grandparents, and often extended family members. Some of my patients live alone, so their neighbors are very much involved in their care. Anyone who falls within a patient's family or circle of care can be seen.

Q. Do family medicine physicians ever make home visits?

A. I still make home visits, in fact, I have one scheduled for next month. I'm not able to make them as often as I'd like to, but it's very humbling to do. People are opening their door for you, to let you into their home. It gives you a different perspective of their reality. Home visits also help to coordinate and manage care if the family is working with a social worker. Residents often do home visits as part of their training.

Q. Do you have any basic tips for those entering family medicine?

A. I've found that the most important thing is to stay quiet and let the patients talk. It's said that we (physicians) interrupt our patients in the first nine seconds or so of an appointment or meeting. In clinics we often need to hurry, but the reality is, let the patients come to the conclusion. Often times they'll point you in the right direction, and it makes them feel more taken care of.

And I always try to make a patient laugh. There's something about healing and laughing that really helps patients. It's a really good thing.