From left: Alicia, four-year-old Preston, two-year-old Flynn, and husband Tim.
Member of the Month: Alicia Harbison, DO, with special guest Kyle Yen, TCOM third-year student
Early-career family physician enjoys precepting medical students
By Kate Alfano
Alicia Harbison, DO, is new to Texas and in her second year of outpatient practice following residency at Guthrie/Robert Packer Hospital and medical school Lake Erie College of Osteopathic Medicine. She runs a new office in Pantego, Texas, that is affiliated with Transcend Medical Group. In addition to a full medical practice seeing patients from birth to end of life, she enjoys teaching students and currently serves as a preceptor for third- and fourth-year students. On the day of the Member of the Month interview she had one of her students, Kyle Yen, a third-year student at the Texas College of Osteopathic Medicine, with her.
Who or what inspired you to become a physician?
Originally, I didn’t want to be a doctor, I wanted to be a veterinarian. I have always loved caring for animals. I would bring any critter into the house and keep it in a shoebox, much to my mother’s dismay. But I’m allergic to all animals with fur and didn’t want daily allergy shots to be able to work. I briefly considered marine biology: I love turtles and other marine life. Then I shadowed a marine biologist who told me that sometimes you get siloed in a specific area of marine biology; after I considered how much I would dislike the migration patterns of snails, I decided to take a different path.
My mom was a nurse; she encouraged me to get my LNA (Licensed Nursing Assistant certification) to get my foot in the medical door. I worked at a nursing home and liked it. Then in high school I took an anatomy class where we were learning about organ systems and doing dissections and I thought “this is what I want to do, I want to do something with medicine.” From there I went to undergrad in Pennsylvania. I got to study abroad and assist with surgeries in Zambia and Rwanda. It’s a cliché but I really like helping others! I don’t find medical practice to be work. Sure, the paperwork is work but interacting with patients and figuring out what to do with them is play.
Can you briefly describe your career path?
I am a family medicine physician in an outpatient clinic. There are three physicians in our group, Transend Medical Group, and I run a new office in Pantego, Texas, west of Dallas. Today (Nov. 4) is my one-year anniversary at the clinic. I offer pediatrics, prenatal care, all forms of birth control and osteopathic manipulative treatment (OMT). I met my husband six years ago and he’s from the east side of Dallas. The plan when we decided to get married was for me to finish my residency and move to this area; I finished the end of October one year ago — slightly delayed due to getting pregnant with my second child and losing immunity to varicella.
What do you like about your current practice?
I grew up in New Hampshire and did my schooling in Pennsylvania and New York. I’m used to the white demographic. Here I really like the diversity. Half of my patients are Hispanic and native Spanish speakers. I also have a decent amount of Arabic and African patients. I always ask where my patients are from. I love that I get to see all different types of folks. My favorite days are when I can see a pregnant patient, baby, OMT, birth control, and geriatrics. It truly is birth to end of life.
What is the best part of being a preceptor?
I’ve always worked with students. From my first year of residency I always had a third- or fourth-year medical student tagging along with me, and I remember being that student trying to follow the resident and having no clue what was going on! Once I had been at my current clinic for long enough I got permission to precept students. The first three were all second years. They were very fresh and I got to give them lots of information. Then my boss said I could have third- or fourth-year students with me. Kyle is my second third year. I like seeing their knowledge base and what they can teach me. It’s fun — I love teaching. It’s something that I always have been doing in one form or another.
What advice do you give students who complete a preceptorship with you?
I do my best not to steer my students toward a certain specialty. The students in the first group were super young and still had their rotations in front of them. I tell all students to find something they like and pursue that, whatever specialty it is.
I also tell them that it’s okay if you don’t know something; you can still teach yourself. In my six weeks with Kyle, he’s seen me learn on the spot how to do injections on nearly every joint. I watch some videos, quickly do some research, apply the basic techniques I already know and do it. It’s okay to use resources, it’s okay to look things up. Over time things become secondary. I can spout off ACOG recommendations for cervical cancer screenings. I’ve had to tell this to patients day in and day out for the past four years. But it’s okay to try new things and get outside of your comfort zone.
I really enjoy precepting students and hope I can always do it! I love medicine. I think that you have to have the right sort of personality and the right drive but there are lots of different versions of that. I’m the one who had to study my butt off and then I eventually got it. Others hardly studied and pick it up right away. If you’re truly passionate about it and you’re okay being in for a long road, it’s totally worth it.
What is your outlook on the future of medicine? Do you worry about burnout?
I try really hard to stay out of politics. We will always have needs for doctors. We will always have folks who want to study medicine and learn. I know some parts of medicine, especially the financial aspect of it, is very difficult to navigate and I would love to see those areas improve, but I don’t feel qualified to give recommendations on how to fix it. My plan is to keep providing the best care I can and hope that we can work together to create a better future.
As for burnout, I felt that a lot as a resident but after finishing residency, not as much. I do my darndest to not bring my work home with me. Occasionally I’ll have to bring a few charts home but my practice is that when I’m home, I’m with my husband, I’m with my boys. I’m not a doctor at that point, I’m a wife and mom. I’m also religious and find a lot of comfort in scripture and going to church. It’s very important to have some sort of outlet.
What brings you joy in your work? What is the most challenging part of medicine?
I love seeing folks over time. That’s some of my pride and joy of being a family doctor. In residency I got to meet patients in labor and delivery. I took care of the baby, then mom and dad. When mom got pregnant again with her second baby, I delivered and cared for that baby. That family is now pregnant with their third and they were upset that I was no longer in New York to delivery baby three. I have been able to meet many family units and it is incredible to form those bonds by taking care of the mother and father, kids, grandparents. I love seeing that over time.
What is challenging is my schedule. I have no say in it. Occasionally I’ll be double-booked or triple-booked or sometimes I’ll have no one and then a flood. It’s a work in progress. It’s always challenging to lose patients to death; I’ve only had two patients die since starting. One was abruptly, one was somewhat expected. It’s always hard.
How has your practice changed during the COVID-19 pandemic?
I have seen a lot of COVID and done a lot of screening for it. We don’t let sick patients into office unless it’s a child, but we’ve had some COVID cases slip through our doors. Anyone with cough, body aches or who is generally not feeling well will be seen via telemedicine for the sake of keeping our providers and other patients well.
I had no training in telemedicine before March. I thought it was really weird and questioned how we could see our patients through a screen. You can’t do a Pap smear, of course, and I hate seeing rashes because of the video quality but it works for coughs and colds. It has been a learning curve and I’ve gotten a lot better at it, but still find it challenging to switch back and forth between in-office and telemedicine visits.
What do you enjoy doing outside of medicine?
My husband and I are really into board games. Our family will also watch movies together. In the priority list of my life, it’s family, church and then other stuff. All of my husband’s family lives within an hour or two from one another so we see extended family often.
Special guest: Kyle Yen – third-year medical student at the Texas College of Osteopathic Medicine currently precepting with Dr. Harbison
What do you like about family medicine so far?
Like Dr. Harbison said, I like the aspect of seeing patients over and over again and building a relationship with not just them but the entire family. When I was growing up I always got sick. I had asthma, and allergies to dogs and cats, and always went to my family physician for care. My parents immigrated from Taiwan and culturally it can be hard for them to trust people, but they really trusted my family doctor. When I was five I was bitten by fire ants. They didn’t take me to the emergency room but to my family doctor, and everything was fine. I really enjoy that aspect to let patients who trust you with your health and family’s health.
I also enjoy the education aspect of family medicine. Especially in the time of COVID and anti-vaccines you really have to know how to properly educate patients. Whether anti-vax or anti-mask, it’s not about intelligence, it’s about a lack of education. It’s important to educate patients in that regard.
As for my outlook for a career in medicine, I think it’s good. I feel like if you read the internet there is a lot of doom and gloom about midlevel creep, and policies that may negatively impact health care. In the end I’m just trying to find a specialty I truly enjoy. I don’t know when and if that will happen, but I just take it one day at a time.
TAFP’s Member of the Month program highlights Texas family physicians in TAFP News Now and on the TAFP website. We feature a biography and a Q&A with a different TAFP member each month and his or her unique approach to family medicine. If you know an outstanding family physician colleague who you think should be featured as a Member of the Month or if you’d like to tell your own story, nominate yourself or your colleague by contacting TAFP by email at firstname.lastname@example.org or by phone at (512) 329-8666. View past Members of the Month here.