Member of the Month: Evelyn Sbar, MD
Amarillo physician spearheads area COVID clinic and headache care
By Kate Alfano
TAFP Member of the Month Evelyn Sbar, MD, is passionate about quality health care and medical education. She is a graduate of Texas Tech Health Science Center School of Medicine and the TTUHSC Amarillo Family and Community Medicine Residency Program. After completing residency, she traveled to Germany with her husband, Alan, and worked for the Department of the Army both as a fulltime family physician providing obstetrical care and a clinic director, until obtaining the role of deputy commander of outlying health clinics for the USMEDDAC Bavarian Region. After leaving the Army, she spent eight years in Manitowoc, Wis. as a family physician, bringing up their patient-centered medical home and serving as the associate chief medical officer of quality and health care transformation for the Holy Family Memorial Hospital System.
In 2014, she found her way back to Texas and returned to teach in the residency program in Amarillo. She has served as clinic director, curriculum director, and is the current vice-chair of the family medicine department, COVID clinic medical director, and assistant dean of clinical quality and healthcare transformation. Besides achieving her fellow from the American Academy of Family Physicians, she completed her CAQ in Headache Medicine. The TTUHSC Amarillo Headache Clinic opened March 1, 2020, with Sbar at the helm, and is the first of its kind in the Texas Panhandle. Her interests include headache medicine, both as a provider to a patient base and as an education model for primary care providers.
Who inspired you to become a physician?
I was one of those kids who always wanted to be a physician. I grew up in Edinburg, Texas, and we saw a general practitioner, Dr. Jetta Brown. She was a strong-minded female physician who did everything in her office. I was inspired by her and idolized her. She not only treated me as a patient, but when she found out I was interested in medicine, she let me work with her in high school and college shadowing her and doing phlebotomy. She was a great educator and a great role model who showed me how to be an excellent physician and juggle a career with being a wife, mom and active member of the community.
You did your medical training in Amarillo, then practiced in Germany and Wisconsin. What brought you back to Amarillo?
It was kind of serendipity that brought us back to Amarillo. Alan was interested in a breast cancer fellowship in Amarillo. I had lunch with Dr. [Rodney] Young and many other colleagues I knew from my previous time there. They told Alan he shouldn’t do the fellowship but instead that Amarillo needed a hometown general surgeon. I started working in the family medicine department as director of clinical operations. Over time I’ve become assistant dean of quality and health care transformation and helped bring up Texas Panhandle Clinical Partners, one of the accountable care organizations in town.
What is your main focus now?
Three years ago, I went back for additional training in headache medicine. As a chronic headache patient myself, my neurologist encouraged me to consider providing this service to the region; there just aren’t enough neurologists around to take care of the 39 million migraine patients in the United States. We started down this path as a joint adventure. Unfortunately, he passed away in May 2020.
We opened the headache clinic at TTUHSC Amarillo on March 1, 2020. Everything shut down with COVID a few short weeks later in mid-March and I was pulled as the head of outpatient COVID clinic. My fantastic nurse practitioner, Nichole Campbell, kept the headache clinic not only running but growing. I am finally back to seeing patients more frequently on the headache side as we hope to close the COVID clinic in June 2021.
What do you like about headache medicine?
Headaches are one of the most common complaints seen in primary care and, when treated early in their course, they’re not that hard to treat. But there is so little education given to medical students, residents and doctors in general about headaches or other chronic pain disorders that often when a patient comes in complaining of something in this category (i.e. migraines or fibromyalgia), they shut down — it’s not something they want to deal with. Some of my patients have dealt with chronic headaches for well over 30 years; some even longer! It is such an awesome feeling when we have success with only one or two visits. So often it just takes being able to listen to them. In the insurance-based system where doctors are pushed to see as many patients as possible for 20-minute visits, this isn’t feasible for most primary care physicians. Headache visits aren’t 20-minute visits. You have to be able to listen to them and provide extensive education about what they need to do as a patient and what I can do as a physician.
How did the pandemic affect your patients and community?
We split our family medicine faculty and residents down the middle. Half went to the hospital and half stayed in the clinic. We split the clinic group again to either staff the COVID clinic or the regular clinic, and tried to keep them from associating to minimize exposure. We saw as many healthy patients as we could in the regular clinic and we all learned telemedicine on the fly. It didn’t matter that insurance was slow to pick up on the telehealth piece, we were just doing our best to care for patients.
The family medicine clinic lives on the fifth floor. With a very tight turnaround, we took over space on the first floor for the COVID clinic and named a dedicated team of myself, three residents who had volunteered, two nurses and two front desk staff. That’s what we did for four months. We felt we could control the situation, follow safety protocols and quarantine rules, and we understood PPE and performed vigorous housekeeping and touch-sterilization around the clock. Amarillo made the national news twice with our COVID numbers, taxing all members of the medical and service communities here. I think we are still trying to recover. Most of us feel like 2020 was a blur.
When vaccinations started to come out, Texas Tech helped manage the distribution of vaccinations for physician personnel and distributed 7,000 vaccines to the high-risk community as soon as they were available in January.
How did you manage during that time?
We had a tight knit vaccine team with an unparalleled work effort. We lived on caffeine, stale donuts, and pizza. Admittedly, there’s a little bit of burnout. You’re just constantly moving, and under constant stress. The phone calls and texts don’t stop — 24/7 questions about quarantine, test results, refrigeration temperatures, weather delays, etc. Often, we administered vaccines from 6 a.m. to 10 p.m. without a break and did whatever it took to not waste a single dose. We still have the COVID clinic open and we’re still seeing patients, but thankfully hospitalizations are down to 3% and the emergently sick COVID patient is a rarity instead of an hourly dilemma.
How do you feel about the future?
I feel hopeful, though ambivalent. We went through a period of tremendous change over the past year: The education of our children, how we shop, the real estate boom. This pandemic has changed forever how we think and act, and how we treat people. It was fascinating watching the explosion of technology that has set us on a new course of health. With many new medical schools opening in Texas, I wonder what medical education will look like five years from now. I don’t think we’ll go back to the status quo, which is a good thing.
I do think we’ll see fallout from the pandemic as patients delayed care for the past 18 months. We’re already seeing an increased number of heart attacks, strokes, and secondary things that happen when you don’t manage diabetes, or cancers that weren’t detected. When the next pandemic happens, we’re going to have to do a better job of not letting those things fall off.
What do you enjoy doing outside of medicine?
I love to play tennis; I play with a United States Tennis Association league that travels across Texas to play. I also love the outdoors — hiking, gardening, just the feel of the wind and the sun on my face. My husband and I own an Airstream trailer and our favorite activity is traveling. Having been pretty locked down the last 18 months, we are anxious to get out and explore the U.S.!
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.