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In Conversation With Lipi Roy

Ranjani Saigal

Dr. Lipi Roy is an internal medicine physician at the Boston Health Care for the Homeless Program, where she helps provide comprehensive care to an often overlooked and underserved population.  She sees patients at our respite facility, a homeless shelter clinic (St. Francis House) and the Massachusetts General Hospital.

She completed her training in internal medicine at Duke University Medical Center, Durham, NC. Prior to residency, she obtained dual degrees in medicine and public health (i.e. a combined MD/MPH) at Tulane in New Orleans. She has great interest in preventive medicine — focusing on primary care, nutrition and exercise — and global health. Thus far, she has performed clinical and public health work in New Orleans, Nicaragua, India and Haiti, where she provided medical relief to earthquake victims. She loves to cook. In addition to the recipes she has researched the history and health benefits of many spices.   

She was recently won the Primary Care Fellowship Award from the Massachusetts General Hospital.  She talked to Lokvani about the award and the joys of being a Primary Care Physician. 

Congratulations on winning the Primary Care Fellowship Award.  Could you describe the award for us?

Thank you! To receive such an award from a leading academic medical center like the Massachusetts General Hospital is a tremendous honor. I have been awarded a fellowship award that will help support primary care in the community. In my case, I plan to use the award to bring attention to the homeless men and women of Boston.

You have an unusual photo essay - Healthcare for the Homeless - Capturing Humanity in the Homeless: A Photographic Essay.  Could you tell us about the essay? What motivated you to work on that project ?

I have had the good fortune to be a physician at Boston Health Care for the Homeless Program. I was hired exactly one year ago, and this position has reminded me why I became a physician. Being a doctor, I believe, is a privilege; and to be able to provide medical care to an otherwise neglected and underserved population is both a necessity and a privilege. I wanted to combine my passion for patient care with my passion for photography. By taking photographs of our patients accompanied by a few lines of writing, I wanted to convey their struggles and heroic triumphs. I think the general public will be quite surprised - and moved - at the stories they'll read and the expressions on the faces of the patients.

What motivates you to be a Primary Care Physician?

Primary Care Physicians, in my opinion, wear many hats. We need to be good listeners, we need to understand *many* different types of problems presented by the patient, we have to create a good treatment plan, and we have to coordinate care with other clinicians/specialists. And there are many other roles! Primary Care Physicians at BHCHP have a unique role in that we not only address a patient's medical problems, but also their complex psychosocial circumstances. For, without addressing the latter, the former is a moot point. In other words, if my patient is worried about where he's going to sleep tonight or how she's going to get her next meal, then it really doesn't matter if I prescribe 9 different medications.

Why do people shy away from Primary care?

Many reasons, I believe. I think there is a misunderstanding of the role of primary care physicians. Many people do not understand both the challenges AND rewards of primary care. I also believe that governing bodies need to restructure compensation such that procedure-driven specialties aren't necessarily paid the most. Listening to patients' multiple, complex issues and coordinating their care should not be deemed as less important and thus should be rewarded accordingly. Improving these issues will hopefully encourage more medical students to view primary care as a rewarding career.

There is a raging debate in the country over Obamacare. As a physician do you have an opinion?

I think that health care reform is a highly complex issue. I also believe that every human being deserves access to good quality health care. Health care should absolutely be a right and not a privilege. I also think that the U.S. can learn from nations such Sweden, U.K., Canada and a multitude of others. It will be difficult to please 100% of a population, but I think the President and his Administration have spent a great deal of time and effort to provide health care to the people of this country.

How important is it to have a focus on preventative health?

It is vitally important! I am incredibly passionate about preventive health. And my passions are consistent with the mission set forth by the Administration, particularly that of the First Lady Michelle Obama. Her "Let's Move" program is a brilliant way of combating childhood obesity. Obesity is absolutely an epidemic that will eventually cripple this otherwise successful, high-achieving society. Healthy eating and fitness are so important to me that I created a healthy spices website and blog, www.SpicesforLifeMD.com,  where I discuss the evidence-based health benefits of spices (e.g. turmeric, cumin, coriander, cinnamon), share a recipe with that spice, and discuss a health condition that would benefit from a healthier diet (e.g. high blood pressure, colon cancer, diabetes). I also plan on discussing meditation, yoga, pilates and other beneficial activities.

Can you tell us three important issues that Indians need to be aware of in the area of preventative health?

There are many, but the Indian community should focus on: controlling blood pressure; preventing diabetes; preventing heart attacks. The risk of the latter can be minimized by addressing the 1st. And all three can be managed by a healthy diet and exercise!

Any advice for medical students considering a career in Primary care?

Primary care can be highly rewarding. There are *many* career options: community health, academic medicine, leadership roles, public service/government, ...the list goes on. I would also strongly advise medical students to contact primary care physicians directly (or through hospitals or medical schools) and ask to have a meeting and/or shadow doctors in their clinics.

What is the greatest joy in being a doctor? What is the greatest challenge?

There are many joys, but probably the greatest is the opportunity to hear the extraordinary stories of my patients; and to be able to help them solve their problems. It is also a joy to work as a team - with nurses, nurse practitioners, social workers, case managers - to care for a patient. Challenges include lack of time, abundance of paperwork, but the pros of being a doctor far far outweigh the cons.

Any message for our readers?

Appreciate all the small things in life. No matter how stressful life can get, always try to take a step back, take a deep breath and realize how lucky you are. And cherish your health - physical, mental, emotional and spiritual. Without it, nothing else matters!

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