• Health Equity Fellow Says Family Medicine Is ‘Made’ for Her Work

    A Q&A With 2023 Health Equity Fellow Elizabeth Beiter, M.D.

    March 22, 2023, Michael Devitt — Elizabeth Beiter, M.D., said her journey to becoming a family physician started with two people.

    “My grandparents are from rural America,” said Beiter, an associate program director with the Bethesda Family Medicine residency program (part of the TriHealth Population Health Organization based in Cincinnati, Ohio) and one of this year’s class of AAFP Health Equity Fellows. “Neither one had a high school degree.”

    Beiter’s parents divorced when she was a child. While her mother returned to school and started a new career, her grandparents helped pick up the slack by moving in, cooking meals and driving Elizabeth and her siblings to sporting events and practices at school.

    “But by the time we got to high school, things had changed, and we were driving my grandparents to their doctor’s appointments,” Beiter explained.

     Elizabeth Beiter, M.D.

    Beiter’s grandparents had complications from diabetes and COPD, and they both died shortly after she graduated from high school. While there’s more knowledge of and better treatment options for these conditions today, Beiter has several patients whose health problems are affected by social determinants, such as the inability to afford medications, or lack of access to healthy food or reliable transportation. Those similar types of stories and experiences, occurring decades apart, are part of what fuels Beiter’s passion for health equity.

    “When I see patients who are still having the same outcomes that (my grandparents) did more than 20 years ago, I think addressing health equity really means that a girl in the future might have her grandfather to walk them down the aisle, or her grandmother to share secret recipes with her children,” Beiter said. “It’s very personal for me to give patients those opportunities.”

    Hear Beiter’s story in her own words, including these highlights, in this video interview:

    On her passion for health equity: “I think health care is a basic human right, and that health care should be equitable and of high quality for everyone… As I as it sounds, I went into medicine to help people and I want all of my patients to have happy, fulfilling lives. And I think achieving health equity is the way that we give that opportunity to everyone.”

    On patient experiences: “I was in practice for a few years, and … my practice partner and I built some protocols for our medical assistants to collect information on sexual orientation... I didn’t realize how important it was to patients until I had a gay man who saw me as a patient, and admitted he had not seen a doctor in many years for fear of the stigma of being a gay male, and discrimination he had faced in the past… He had heard about our practice and was willing to take a chance on us, and he knew instantly, when he was being roomed by the medical assistant and she asked about his sexual orientation as part of a routine process, that he was in a safe place.”

    On the AAFP Health Equity Fellowship: “I recognize that I need to expand my knowledge and experience in the health equity field to really speak confidently as a leader in my practice and system, and with my residents. I think the Health Equity Fellowship was a way to bring all of these elements together and take a bigger step forward in addressing it intentionally in practice.”

    On her capstone project, “Improving Health Equity Now and in the Future: Assessing and Addressing Social Determinants of Health and Creating a Longitudinal Residency Curriculum”: “I hope our capstone project … (will) create a playbook for any practice to start addressing social determinants of health in their practice, but then also build the right community partnerships — how to identify the right resources in your community that can help address those for your patients, and how to build those connections.

    On addressing health equity: “When you think about health equity, (implicit bias) can be really dangerous because it’s the result of years of societal learning and things like systemic racism, and we know that that leads to different health outcomes for different groups of people… It can get really overwhelming because there is so much that feeds into health and equity… I think it’s really easy to get overwhelmed and then throw your hands up and say, ‘This is bigger than me. I’m just a small fish in a big ocean. What can I do?’ And to that, I would say that family medicine is made for this… We meet our patients where they are, we start somewhere, and we build and grow together.”

    Learn more on the AAFP Health Equity Fellowship webpage, and check back for more stories from the 2023 class.