March 1, 2021, 2:05 p.m. David Mitchell — When Mary Nguyen, M.D., was growing up in Texas as a child of Vietnamese refugees, she didn’t have a primary care doctor. Now, as a family physician and advocate, she’s working to ensure that fewer people have the same experience.
“At our office we will see any sick child — insured or not,” said Nguyen, who practices with her husband, Lloyd Van Winkle, M.D., in Castroville, Texas. “It’s very frustrating that in our health system the first question we ask people is, ‘What is your insurance?’ instead of ‘What can I do to help you?’ I want everyone in the United States to have a family physician. I think we give the best care to families from birth to death, cradle to grave.”
Despite not having a doctor, Nguyen knew from an early age that she wanted to be one.
“I really enjoy caring for people,” said Nguyen, who is a clinical associate professor for the University of the Incarnate Word School of Osteopathic Medicine in San Antonio. “It’s hard to explain. It’s something I always wanted to do — that and teach. In medicine, I can do both.”
Nguyen said she chose rural practice because she thought a small community would offer a stronger bond with patients. Castroville, which is about 30 minutes west of San Antonio, has a population of about 3,000.
“It’s about relationships,” she said. “I like talking to people and knowing more than just what is in their charts. I love making connections, and we see generations of families. There are interesting details about families that effect medical care that you don’t know about unless you ask.”
Nguyen is the convener of the AAFP’s Working Group on Rural Health, which discusses issues of concern to rural physicians and elevates them to the appropriate Academy commission.
One of the big issues facing rural communities during the pandemic is the lack of reliable high-speed internet. Nguyen said patients with COVID-19 symptoms drive to her practice and use its Wi-Fi to conduct telemedicine visits with her from the parking lot.
The importance of telemedicine was even more apparent during the recent winter storm that left millions of Texans without power and water. Nguyen was one of those who lost power, so she stayed at her brother’s house — where the power and internet stayed on and she could stay connected to patients.
“There were a lot more phone calls than usual to make sure people were OK,” she said. “There was a lot of hand holding talking through difficult times. It was stressful for everyone.”
Nguyen said that as businesses lost power or ran out of supplies, she played “pharmacy bingo,” trying to connect patients with locations across the region that could fill prescriptions. One patient traveled more than two hours one way to get medication.
“Patients drove wherever we could find something,” she said. “Pharmacies sometimes could fill one prescription but not another.”
A week after the storm, more than a million Texans still were grappling with water issues. Nguyen said telemedicine again filled a critical need because patients were able to conduct visits from home while plumbers worked to repair their damaged pipes.
Nguyen is serving as the president-elect of the Texas AFP this year and will become president next spring. Her goal of making health care more accessible faces a roadblock in the Texas legislature’s longstanding refusal to expand Medicaid. Nearly 30% of Texas adults younger than age 65 lacked insurance coverage last year.
“Everyone should have access to care,” said Nguyen, who has served her state chapter in a variety of committee, commission and board roles dating back to residency.
In addition to state leadership, Nguyen has served in numerous leadership roles for the AAFP. Next month, she will be attending the virtual National Conference of Constituency Leaders, which gives AAFP members from underrepresented constituencies (minorities; women; international medical graduates; new physicians; and lesbian, gay, bisexual and transgender physicians and those who support LGBT issues) opportunities to develop leadership skills and to influence AAFP policy. The virtual event is scheduled for April 17 and April 29-May 1.
Nguyen has been a delegate for her chapter several times at NCCL and has served as co-convener of the minority constituency. She also has served as a constituency delegate at the Congress of Delegates, the AAFP’s policymaking body. This year, she is serving as the Member Constituencies Discussion Leader, which means she is attending NCCL as a representative of the Commission on Membership and Member Services, which has oversight of issues related to the member constituencies.
Nguyen said she would like to see a full delegation from each chapter for NCCL. The AAFP has waived registration fees for NCCL and the Annual Chapter Leader Forum, which are both virtual events this year because of the pandemic.
“It doesn’t matter if it’s your first NCCL or 30th,” Nguyen said. “The camaraderie is amazing. Everyone is inclusive. I’ve never met a stranger at NCCL.”