As I continue my trek across Missouri this year, I stayed ‘home for the holidays’ by visiting my own District 3 when Kanika Turner, MD, MPH, former resident delegate to the MAFP Board of Directors, accepted my invitation to meet over lunch.  I listened to holiday music as I made the shortest drive of these journeys thus far to south St. Louis City to meet Dr. Turner near Family Care Health Center, the federally qualified health center where she practices.

Having been impressed with Dr. Turner’s energy and passion since she was a medical student, I looked forward to hearing about her work now that she was an attending.  As it turns out, her work now is more than just her clinic.  While her practice includes full-spectrum Family Medicine, including maternity care and hospital care, Dr. Turner also makes time for teaching, public health, health policy and community outreach.  Case in point: Dr. Turner joined me after leaving clinic early to attend Governor Parsons’ ribbon-cutting ceremony for the St. Louis Veteran’s Home and before meeting with a local attorney to explore ways of promoting treatment for substance use for people charged with drug-related crime. 

Over lunch, Dr. Turner demonstrated all the enthusiasm of a doctor in her first couple years of practice.  She acknowledged she’s just as busy now as she was in residency but that it’s a “different kind of busy and one that keeps me passionate.”  When asked about the challenges of providing family care for patients, she added her voice to the universal chorus decrying the current state of electronic health records as a burden.  She noted that, in response, her clinic had recently discussed the feasibility of ending appointment times an hour earlier in the day to allow time to tackle the administrative load still remaining after patient hours end (ie, finishing chart notes, reviewing records, returning patient messages).  I then asked if she had experienced unexpected challenges in the transition to being a new physician and she laughed, stating the hardest part was learning to earn and track CME hours on her own without the miasma of academia that surrounds a resident in training. 

Finally, I asked her, as a former member of the Board of Directors, in what direction she would like to see family physicians in MO go.  She first noted it’s simply important for her to know there is a professional community of family physicians in her city and her state that are looking out for the interests of the patients for whom she cares.  But in terms of specific directions in which to go, she stated, “Family physicians need to take the lead on opioid use disorders (OUD).” 

Dr. Turner encouraged MAFP to promote a primary care model of treating OUD.  After all, she observed, a treatment center can’t ensure its clients are up to date with colon cancer screening or that their lipids are appropriately managed or that they’re using family planning methods appropriately.  BUT, a family physician can do all those things AND prescribe treatment for OUD.  Dr. Turner herself has her buprenorphine waiver and has incorporated medication assisted therapy (MAT) for OUD into her practice.  She is currently researching the intersection between maternity care and MAT for women who are pregnant and recovering from OUD.  She states the level of trust that develops between a physician and patient when the physician can also treat substance use is awe-inspiring.  She urged family physicians to be unafraid of doing so.  “If it’s relapse that worries you as a primary care doctor providing MAT,” she said, “you just get your patients back on track after it happens.”  She likened it to uncontrolled diabetes, stating family doctors don’t stop treating a diabetic patient just because his or her hemoglobin A1C went from 6.5 to 9.  On the contrary, they explore why that happened and double down efforts at control.  For Dr. Turner, MAT for OUD is no different.

This is a time of year filled with festive gatherings between colleagues, friends and family and I enjoyed gathering with Dr. Turner.  Many thanks to her for making time!  If you celebrate Hanukkah, Bodhi Day, Christmas, Kwanzaa or other holy days this month, then I wish you a very safe and blessed holiday season and a very happy new year!

As always, any errors, opinions or offenses in this blog have been committed by me alone.  The above does not necessarily reflect the position, mission or work of the Missouri or American Academies of Family Physicians or their respective staffs!

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