The Insiders Scoop – Family Medicine

Name: Valerie Chan Teng, MD

Specialty/Interests: Family Medicine

Education: University of California, Irvine (MD), Stanford University O’Connor Hospital (Residency in Family Medicine),

Current Position: Clinical Assistant Professor, Stanford Family Medicine Clinic

1 | What drew you to family medicine?

The breadth and versatility of family medicine excited me the most. I wanted to do just about everything within its realm- perform minor surgical procedures, deliver babies, and grow relationships with patients from infancy until beyond retirement age. I absolutely love that, in one clinic session, I can perform a knee injection to bring immediate relief to the woman with arthritis, follow up on the high school athlete’s concussion, see the adorable 5-year-old for her check-up, and optimize medications for the diabetic patient with heart disease. Being able to address any concern someone walks through the door with was also important to me, especially for the times I had spent and plan to spend in local or international free clinics.

2 | What do you like the most about family medicine? The least?

One of the best things about being a family physician is the relationships that I form with whole families. When my patient has their spouse establish care with me and then their children establish care with me, I have the rare and invaluable opportunity to walk alongside them through all of life’s stages. I look forward to when I can say I have been the physician for a family for three or four generations!

One thing I wish was different is that family medicine or primary care physicians would be valued higher by the reimbursement system. Generally speaking, a specialist can have an hour to speak with a patient in the clinic about a single specific issue, such as their gastroesophageal reflux disease. In contrast, primary care physicians commonly have half that time and less reimbursement to discuss multiple issues, including, for example, gastroesophageal reflux, weight management, mood concerns, and chronic back pain.

3 | There is a shortage of primary care physicians in the USA. How can we encourage more medical students to pursue primary care?

Increasing the compensation and prestige of primary care physicians may not occur in a timely manner so as to address the current shortage of primary care physicians.  Feasible ways to encourage more medical students to pursue primary care revolve around giving medical students more time with primary care physicians. This includes having primary care physicians teach lectures and lead standardized patient encounters, which allows medical students to see how primary care physicians are well-trained in such topics as chronic kidney disease, hypothyroidism, and heart disease. We would also do well to partner medical students with primary care physicians who perform office-based procedures. In being a part of the Minor Procedure Service at Stanford Family Medicine, I have learned that many students are not aware of the variety of procedures primary care physicians perform. Some of them become more open to considering primary care as their career choice after seeing primary care physicians in action.

4 | What advice would you give to students interested in family medicine?

Identify someone you admire and ask them to be your mentor. Family medicine is a broad field, and many physicians have specific interests or skills. Some may be fellowship-trained in sports medicine or obstetrics; others may be very involved in specific communities; and still others may focus on medical education. Even if you ultimately do not adopt the same interests, you will learn how to achieve your ideal career goals and how you can shape the field of family medicine. You might consider going a step further and asking how you can aid your mentor with quality improvement initiatives or other meaningful tasks. This will give you greater insight into their work and provide an unparalleled experience to bring with you into your own training and medical practice.

5 | How much sleep do you get every night? How many hours do you work per week? How many vacation days do you take per year?

I get an average of 7 hours of sleep every night. I work part-time. Two-thirds of my time (16 hours per week) is spent with patients in the clinic or on the phone. I enjoy the telephone call appointments I have with patients, as this allows me to work remotely. The remaining one-third of my time is devoted to my administrative role as the associate director of the Stanford Medical Scribe Fellowship, also known as COMET. I spend several more hours throughout the week reviewing lab results, completing charts, and communicating with patients via our online portal. My vacation days allow me to be away from work for a total of 3 to 4 weeks. I make a point to take at least two one-week long hiatuses from work each year. Sometimes one of these hiatuses will be 2 weeks long (something I highly recommend).

6 | How do you maintain your work-life balance?

It’s much harder to maintain work-life balance with the convenience of technology, which allows us to access work while away from the workplace. While this brought about some very positive changes, including the ability to make telephone calls remotely and to not stay late in the office completing charts, I’m challenged in how to keep my time away from work a true time of rest and leisure. I’ve found that the best balance involves: 1) setting specific times for myself to complete work, and staying within those limits as much as possible; and 2) being mindful of what I am doing when I am enjoying non-work related activities by focusing on what’s at hand rather than dwelling on the number of tasks I still have to complete when I return to my work.

7 | Are you satisfied with your financial compensation, such that you can manage your student loan debt (if any)?

While financial compensation for primary care physicians is certainly not among the highest rated, I am quite satisfied with my compensation.  A large part of this is due to living below my means. While I still live comfortably, I have been able to manage my relatively small student loan debt, give generously, and work towards larger purchases.