Alexander Diaz de Villalvilla, MD, FACP
Primary Care Physician, Medical Associates of Rhode Island, Bristol, RI
Clinical Assistant Professor of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI
1. What is your current professional position?
Bobbing between my med–peds background, primary care, teaching, and a fellowship attempt, I am currently a primary care doctor for adults at a multispecialty practice in Bristol, Rhode Island. I teach bedside manner, physical exam, and clinical thinking in a second-year Doctoring course at the Alpert Medical School of Brown University.
2. Why did you choose internal medicine?
I actually chose med–peds for the breadth and the depth of the training. My original love was global health. I wanted to be as broadly able to help as I could, across outpatient, inpatient, and intensive care settings, with a depth of knowledge of physiology, applied pathophysiology, and psychology across the developmental spectrum. It’s gratifying to think outside, or at the edges, of the box!
3. What trends are you seeing in your day-to-day practice (with patients, the health care system, or otherwise)?
In primary care, patients want time—to be known for who they are and what influences their health behaviors and difficulty with change. They wish for doctors who can provide mental health support through the tumult of life and struggles with illness, who are attentive to their psychosocial health and actual well-being. They want a sleuth who will work hard to find diagnostic answers for them, not just refer them out. They dislike the impersonal revolving doors of urgent cares and ERs. Our medical system does not recognize or reward cognitive ability, the effort involved in disease prevention, or amelioration of those at high risk for bad outcomes—the pressures are antithetical to what being an internal medicine physician really is.
4. What do you want to accomplish professionally within the next five years?
I’d love to find professional stability; I’ve had a very tough early career. I wish to return to a healthy balance of clinical practice and teaching, with time to mentor and write. I’m no coach or pro, but I’m sensitive to the struggles and suffering of our path; we are not alone.
5. Can you share a brief (and anonymous) patient encounter or professional situation that made you proud to be an Internal Medicine physician?
I diagnosed a gent with antisynthetase syndrome recently. The symptoms immiserated him with pain so he stopped working, which was his identity. Now, he is back, up and moving, doing side jobs again. I’m proud of taking care of the person, supporting his mental and emotional well-being, and being a sharp diagnostician for a rare condition, returning him to himself.