Choosing Family Medicine: What Was Your ‘Lightbulb Moment?’

A couple of weeks later, I found myself in a homey waiting room on an overstuffed couch. Any open wall space had been filled with bookshelves. When a nurse called me to meet with Dr. Jonas, I felt at ease seeing even more bookcases teeming with well-loved books. More were perched precariously on side tables or filling the corners of his desk as we made our way to his office. As a fellow bookworm, I had a feeling I had finally found a mentor. 

We spent that Friday afternoon going from room to room and I saw rashes, high blood pressure, anxiety, diabetes, pre-surgical exams, sports physicals and grief. Was there any illness Dr. J. didn’t treat or any service he didn’t provide? I was surprised by the range and depth of his knowledge. 

What impressed me most, however, was the care with which he personalized his treatments, recalling the names of siblings, parents, hobbies, pets. This was what I had imagined when I decided to become a doctor, attending personally and knowledgeably to every person who walked through the door. 

I asked to come back, and to my surprise, week after week, he kept saying yes. When we finished at his clinic on Tuesdays, we would go to the free clinic he ran. There I saw:

The girl with a sore throat. 

The older gentleman with chronic knee pain.

The widow who cared for five children and couldn’t sleep at night. 

Dr. Jonas cared for them all. And I knew one day, I would, too. 

I had decided to become a family doctor. 

Lilian White, M.D., is a 2023 graduate of the family medicine residency program at Cleveland Clinic. She opened a direct primary care practice, Empowered Health, this fall in Cleveland. 

Seeing Is Believing

I attended a medical school without a family medicine department, which unfortunately resulted in limited exposure to our specialty. I had always been drawn to the idea of family medicine due to its foundational role in primary care and its capacity to adapt to any medical complaint, patient age, or community need. However, it wasn’t until my fourth-year visiting rotation that I finally had the chance to experience the specialty.

During a month at an urban community health center in Seattle one of my preceptors, Chris Yee, M.D., offered to take me to hospital rounds for a few of his admitted patients. At my medical school, inpatient and outpatient services never overlapped, so the concept of a primary care physician managing both was foreign to me. 

Our first patient was an elderly woman hospitalized for electrolyte management. Although her sodium levels were corrected, she was uncooperative with physical therapy, and the inpatient team had numerous concerns about a safe discharge plan. As we examined her together, I observed that my preceptor not only focused on her symptoms but also engaged in conversation about her home life. He mentioned her daily walks with her granddaughter and asked if there were new vegetables sprouting in her garden. In her native language, he validated her desire to return home and encouraged her to work with physical therapy. 

We moved on to see other patients, but later, during the conclusion of rounds, I spotted our first patient at the end of the hall. She was up and out-of-bed, walking with the physical therapist. When she saw my preceptor in the distance, she began waving and doing jumping jacks. We all shared a laugh at the sight!

I often reflect on how that moment solidified my aspirations to become a family physician. My preceptor not only treated his patient in multiple settings but also approached her holistically, considering her health, personal goals and family. To this day, these values guide my own clinical practice.

Emmeline Ha, M.D., is an assistant professor in the Family Medicine Section of the Department of Emergency Medicine at the George Washington University School of Medicine and Health Sciences in Washington, D.C.

A Series of Fortunate Events

I’ve always been a family doctor at heart, I just didn’t have a name for it during most of my medical school training. 

The first time I even thought about family medicine was at the end of my third year of med school when I was having a discussion with my advisor, who is a child psychiatrist. I told him how much I loved all my rotations and felt like whatever service I was on at that moment was the type of medicine I could envision myself practicing.  

“Maybe you should consider family medicine,” he said.  

At that point I was pretty invested in pediatrics, so I didn’t think much of it.

However, another important moment occurred during my primary care rotation early in my fourth year while I was meeting a patient who was new to the practice. The patient asked for three or four different referrals, but the attending doctor said, “Nope, I can do that.” 

That made me think about the tremendous value of comprehensive primary care, saving time and money for everybody. 

My final pivotal moment was during a sports medicine rotation when an attending asked me how I envisioned my future in sports medicine. Without knowing it, I explained family sports medicine to him. I talked about how I wanted to take care of all ages and stages of athletes and be able to diagnose or start the treatment for almost any condition. He looked at me and said, “Sounds like you should go into family medicine.”  

I was always a family doctor at heart, I just needed a few people to show me the way.

Alex McDonald, M.D., FAAFP, is a family and sports medicine physician with Southern California Permanente Medical Group, core faculty of the Fontana Family Medicine Residency and an assistant professor at the Kaiser Permanente School of Medicine.

From Volunteer to Mentor 

My interest in family medicine started while volunteering at our medical school’s annual health fair during my pre-clinical years. Several of the people I met while helping screen for diabetes already had a diagnosis of diabetes but were attending the health fair to follow up on their A1c screenings. 

The questions I received ranged from nutrition advice to medication dosing clarification to medication side effects and even questions regarding additional referrals to specialists. Though the conversations were short, the value of that time to people was evident in the way these patients’ expressions changed, in how they took notes or asked family members to jot down things to follow up on. 

I did not have a lot of direct patient care or clinical care experience at that time, but I knew that these were the conversations that I wanted to have with future patients. 

Later, I took on a leadership role in that annual health fair and also took on a volunteer position as a clinic manager in one of our student-run free clinics. In these roles, I worked closely with Nora Gimpel, M.D., a family medicine faculty member who served as the medical director for both events. The more I worked with her, the more I learned about family medicine, and the greater my desire became to join the specialty! It had everything that I was hoping for when I volunteered in the diabetes booth: the variety, flexibility and, most importantly, the trusted relationships that are built over time.

My lightbulb moment started from a short volunteer opportunity. From there, it was nurtured by mentors, family and friends, and supported through additional volunteer opportunities and clinical encounters that helped fuel my continued passion for family medicine.

Astrud Villareal, M.D., FAAFP, is an associate program director and assistant professor in the Department of Family and Community Medicine at the University of Texas Southwestern Medical Center.