{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/mg7fq9rk7r/manifest","type":"Manifest","label":{"en":["Dr. Emily Soni"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}},{"label":{"en":["Date"]},"value":{"en":["2021-11-08 (created)"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}},{"label":{"en":["Format"]},"value":{"en":["video"]}},{"label":{"en":["Subject"]},"value":{"en":["Covid-19 (topical term)"]}},{"label":{"en":["Keyword"]},"value":{"en":["MIchigan","family medicine","osteopath"]}}],"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/202/298/small/EmilySoni%2811-8-21%29.mp4_1690906662.jpg?1690906664","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102691/file/202298","type":"Canvas","label":{"en":["Media File 1 of 1 - Emily_Soni_(11-8-21).mp4"]},"duration":2438.64,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/202/298/small/EmilySoni%2811-8-21%29.mp4_1690906662.jpg?1690906664","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102691/file/202298/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102691/file/202298/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/202/298/original/Emily_Soni_%2811-8-21%29.mp4?1690906662","type":"Video","format":"video/mp4","duration":2438.64,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102691/file/202298","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102691/file/202298/transcript/47168","type":"AnnotationPage","label":{"en":["Transcript of Dr. Emily Soni interview [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102691/file/202298/transcript/47168/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Crystal Bauer: Good evening. Today is November 8th, 2021. My name is Crystal Bauer and we are conducting an oral history interview today with Dr. Soni on her experiences as a family doctor during the COVID-19 pandemic. Could you please give your... Confirm for the record that you are aware that this is being recorded and that you are giving your permission to do the interview. All right. Could you please give your name in full.\n\nEmily  Soni: I'm Emily Block Soni.\n\nCrystal Bauer: And what is your present title?\n\nEmily  Soni: I'm the Director of Osteopathic Education and faculty at Ascension Providence Family Medicine Residency.\n\nCrystal Bauer: And where is that located?\n\nEmily  Soni: It is in Southeast Michigan in the Southfield and South Lyon area.\n\nCrystal Bauer: All right. Back to your education, where did you complete medical school?\n\nEmily  Soni: I went to Michigan State University College of Osteopathic Medicine.\n\nCrystal Bauer: And where did you complete your residency?\n\nEmily  Soni: At University Hospitals Case Western Reserve University in Cleveland.\n\nCrystal Bauer: That's a mouthful.\n\nEmily  Soni: Yes.\n\nCrystal Bauer: So then you went back to Michigan to work after residency? Are you from there?\n\nEmily  Soni: I actually did a fellowship after residency at Maine Dartmouth. At the middle of Maine, I did an osteopathic manipulation fellowship.\n\nCrystal Bauer: Oh wow. Okay. Well, could you kind of give a little bit of an overview of your current position and what you do on a daily basis?\n\nEmily  Soni: Yeah. I'm faculty in a residency that has 27 residents, so nine each year. I'm also the director of osteopathic education. I work mostly in the outpatient setting, but I do still deliver babies, so I get to have that joy in my life. And then I also work a few weeks out of the year in inpatient medicine. I run didactics for the residents. I can do didactics in anything, but specifically I'm most interested in teaching them osteopathic manipulation and practices and principles.\n\nCrystal Bauer: Wow. That's a lot. Well, could you tell us a little bit about the types of patients you treat in your program, who they are and kind of the buildup of the geographic location that you're at?\n\nEmily  Soni: Sure. We're located in Southeast Michigan. We have two clinic sites. Our larger clinic site is in Southfield, Michigan. That is primarily an urban setting, very underserved area, mostly black African-American patients. I am only there about one day every week or every other week doing just osteopathic manipulation, but that's the population that I serve when I do inpatient medicine. And then my clinic site is out in South Lyon, Michigan, which is about 45 minutes west of Southfield. We're more of a suburban setting now but it was a very rural clinic when we started 60 years ago here. I wasn't there 60 years ago but I'm told it was very rural. It's been moving more towards a suburban. Our clinic population here in South Lyon is very elderly. We have a lot of 90 year olds, 80 year olds, 70 year olds, and they've been greatly impacted by just the isolation of COVID and then just losing a lot of friends through this pandemic. So yeah, that's about it for our practice.\n\nCrystal Bauer: That's actually really interesting because it sounds like the clinics have such a different population. In general, you're kind of exposed to two very different populations.\n\nEmily  Soni: Our population here is mostly Caucasian, I should say that too. More elderly, more Caucasian here, and then generally more middle aged in Southfield.\n\nCrystal Bauer: Okay. Thinking back to the onset of COVID-19 in 2020, could you describe how it first impacted your area and your locations?\n\nEmily  Soni: Yes. I have a lot to say here, so bear with me. Southeast Michigan was one of the first hotspots. The Detroit area was hit really hard back in March and April of 2020. Around March 1st, we had one COVID positive patient. Granted, we weren't testing everybody. But within a couple weeks, at our two main hospital sites, so we have Southfield and Novi, we had over 350 COVID positive patients or what we called people under investigation. It was taking about 10 days for the tests to come back. So when somebody came in with a disease that looked like COVID, they got called a PUI and placed in the COVID units. So that was very strongly hit. So I'm going to talk a lot about that.\n\nEmily  Soni: But then on the office side of things, we had actually just started to implement, about December of 2019 we put into place the ability for us to do virtual visits. We had done a couple and we were like, okay, we can kind of start to do this. And then March of 2020 came and we were like, okay, everything is virtual. So we pretty much switched to completely virtual care and we were able to do that pretty seamlessly because we had already like trained in it and tried it out a couple of times. So that was pretty swift.\n\nEmily  Soni: In the hospital, when we got hit initially with all of this, we, like everyone else, was very short supply in our PPE. The COVID test, like I said, were taking sometimes two weeks to come back. So the hospital administration really acted very quickly to put emergency plans into place. What they did at our hospital was cohorted the floors. So they said you are the physician for this floor. I had a colleague that did half the floor, I did the other half, and we had two senior residents that were with us during that time. So that was about 10 to 15 patients per day that I would cover. Our unit, our family medicine department, we volunteered to be deployed to these cohort units. And so I was there from March 30th to April 8th or 9th and that was really the peak of our involvement in that first COVID wave.\n\nEmily  Soni: We worked in 12 hour shifts. We did three days on, three days off, three days on, and then we stopped. So I was really only there for six total days. During that time we had one N-95 mask that we would use per shift, which from what I was hearing from the other hospitals was a lot better. Like we got one for the whole day, we didn't have to use it for a week. But you would put that on in the morning and really not take it off the whole day unless you were eating. We rounded up all the patients in the morning. We would put on our gloves, our shoes, our gowns, our Bouffant caps, our face shield, we would put on double gloves. And then we would start with the people that were the least likely. They were still PUIs. They were the least likely to have COVID, so that we wouldn't spread it from room to room. We'd remove just our outer layer of gloves because we didn't have enough of everything else to change, put on clean gloves and go to the next room.\n\nEmily  Soni: Usually when we would round in the morning, it would involve stabilizing one to three patients that were on the verge of intubation or are very ill. I would do ABGs because we were limited in our phlebotomists and our ability to do ABGs. Respiratory therapists couldn't do them because they were elsewhere. I titrated up the oxygen levels because the nurses were really trying to also limit their time in the rooms. We would then go write our notes, eat lunch, and then round up the patients again in the evening. If we consulted any specialists because of a cardiac side effect of the COVID or something else going on, they would stay outside of the room and call the patient and rely really on our physical exam and our ability to talk to the patient so that they wouldn't have to waste the PPE to go in the room.\n\nEmily  Soni: And then there was the nurses that they were really the ones that risked exposure the most and they were absolutely incredible. But I did try to coordinate with them if I was going in the room to help the patients to the bathroom or whatever they needed so the nurses wouldn't have to make another trip. Thankfully we have not had to go back to that cohorted level of care again. Michigan has been very strong in its response to COVID. Our governor really has had mask mandates early, has really tried hard to get the word on the vaccine out. And so we haven't had to go back to that and I really hope we never have to again.\n\nEmily  Soni: On the floor where I served, of the patients I cared for with my partner, we lost 11 patients in those six days, which is really more death than I have ever seen. I have not seen a disease sweep through communities like this one. The patients I cared for, I had one patient that lost two cousins, an aunt and three friends to COVID before getting hospitalized. And then while she was there, her mother and her aunt were also on a vent in the ICU. One day I had a hospital employee, because no one was really allowed in the rooms, but there was a hospital employee who worked downstairs in the kitchens. He came up because his mother-in-law was there and she had gotten off of the vent. So she had been intubated and now she was on my floor. She had lost, while she was vented, her mother and sister.\n\nEmily  Soni: And so he came up to help me tell her that this had happened while she was intubated. We put up her family on FaceTime to deliver the news. Her grief was like so sudden and she was just alone in this room where she couldn't get the support that you would normally get in that situation. It was heartbreaking. During my second set of three days I was there, more time had passed since we knew that this had happened in our community. And so many of the people I was taking care of during the second three days that I was there were healthcare workers or people that had been cleaning the hospital, nurses, just anyone that had been exposed either at my hospital or another one.\n\nEmily  Soni: At that time we had two of our own infectious disease doctors and an internal medicine doctor that were intubated in the ICU. The day before... There's another caller that came in. I don't know. Okay. The day before I started my second shift there, a resident that was my age had died in a nearby hospital. So it was a really terrifying time as I was taking care of these patients, though they were unbelievably grateful even though we knew so very little and we really only had guesses at what might be helpful for them.\n\nEmily  Soni: We were using steroids at that time, really not knowing if they'd be helpful or not. And then that was when we were still using like Plaquenil and azithromycin and just like crossing our fingers that that would be helpful. And then as an osteopath, I offered all of my patients that were well enough and were fit enough to consent, I offered them osteopathic manipulation. During the flu epidemic in 1918, the osteopathic hospitals would have all of the physicians go around and do OMT rounds on their patients and they reported a lower morbidity and mortality rate in their hospitals.\n\nEmily  Soni: And so I was like, well, it is my time to do this. There's really only one technique that I did on all of my patients and that was the pedal pump. Most of the other techniques we do really require a lot of prolonged close exposure. And so I was too scared to do that. But with the pedal pump, I'm able to stand at the foot of the bed, six feet away from the patient and put my hands on their... Not from the patient, but from the patient's mouth from where the COVID is coming from. So I stood at their feet and I would push on their feet in this rhythmic pattern. It kind of makes their whole body move. This has been shown to increase lymphatic flow throughout the body and promotes the body's natural immune response.\n\nEmily  Soni: My patients really looked forward to this. When I walked in the room, they got ready in the bed. They put their feet out. They're like, okay, where's my daily jiggle, some of them called it. After that movement, because many of them were so sick, they were just laying in bed motionless. Just that motion, that movement of me doing that for about two minutes really helped them feel better. They told me they felt better and they could breathe better. There was one nurse that I had that was teetering on the edge of needing intubation for a few days. Her ABG was showing oxygen levels in the 50s and low 60s. And so I used this technique and a few others on her.\n\nEmily  Soni: I told her to lay prone, which was not something that we were doing. We didn't know to lay prone. I remember arguing with a respiratory therapist who we were trying to intubate this patient but we didn't have the stuff that we needed. We were out of propofol. We were out of any sedating thing. So I was like, \"From that patient, I heard some news from somewhere that that would be helpful.\" And they're like, \"What are you talking about?\" They didn't really argue with me, but it was just this new thing that nobody was doing at the time. So told this patient to lay prone. And anyway, after I finished my three days with her, my colleague came on and she said, \"I really appreciate Dr. Soni because I think that's the only reason I didn't get intubated.\" So I appreciated that and hopefully made a difference for her.\n\nEmily  Soni: The days were really long. At lunch, local restaurants brought food. So we would go and the three other doctors I was with, we'd have our lunch break, mask break. So only 15 minutes we took off our masks. And then at 5pm  every day, my team would do what I call wellness rounds. The halls were eerily quiet because the doors were closed. We were on a unit where there were no windows out, so we couldn't see into the patient's rooms. They couldn't see out. And there were no visitors at all allowed in the hospital.\n\nEmily  Soni: So my team would go down and do lunges and squats and yoga and just have about 10 minutes of wellness near the end of the day. And then we would stay until 7pm, go home. At home I took off my shoes in the garage, threw my clothes immediately in a bag and showered, put on a mask and then put my two and five year old to bed and got up in the morning before they were awake and just hoped every day that I would not expose them or my immunocompromised husband. Thankfully we got out of it without any COVID so far. So masking and PPE does work. That's my very long answer to that.\n\nCrystal Bauer: No, that's wonderful. Thank you so much for sharing and having so much detail from last year. That's very powerful. Thinking in terms of the present, what unique challenges do you feel like your program faces now with COVID 19 and kind of how has that changed from the challenges you had last year?\n\nEmily  Soni: Ongoing challenges from COVID-19 mean we may have to completely change our curriculum from being an in-person to a virtual depending on the COVID numbers in the area and the positivity rates. And so we've gone from, hey, we were actually going to meet in person this week and then finding out later that we can't. And so it means changing our teaching style on a dime and trying to get these residents the teaching that they need without always being able to do it the way that we feel comfortable doing it. So we've done a lot of on the dime changes and I'm sure that's not unique to my program at all. We now are starting to do more things in person which has been very good for morale and for teaching, I think.\n\nEmily  Soni: We've also struggled with how do we teach and promote resiliency in our residents as they go through this really residency without COVID is a hard thing. It's not like going to war but it feels like you're going through this really hard thing that you struggle with and there's this cohort that you go through it with. And now with COVID on top of that, our residents are really seeing a lot of really hard things and experiencing it on a daily basis. So focusing on wellness, we've really tried hard to do that throughout this pandemic. Initially that meant that our behavioral health director would personally reach out to each of us, faculty and residents, to check in. Now we're able to gather and be in the same place and have more conversations about what we've all gone through as a program and a country through this whole thing.\n\nCrystal Bauer: You mentioned this cohort of residents has really been hit with a lot. Would you say their inability to be in person all the time has impacted their ability to bond with one another? Has it impacted like that togetherness at all, would you say, or?\n\nEmily  Soni: I think some ways they've bonded more because when you go through hard things together, you bond really well. But they've been limited in their social interactions the way that I was able to do when I went to residency. And so that kind of, and maybe I'm wrong, maybe they're all getting together much more than I expect, but at least initially in spring of 2020 they were really feeling the stress of not being able to be with one another, I think much less so now.\n\nCrystal Bauer: Could you describe the vaccine rollout initially in your area and kind of your staff and patients reception to the vaccine?\n\nEmily  Soni: Oh, yes. Okay. Our hospital started vaccinating employees December 16th, 2020. I got to be on the first day of vaccination, so that was pretty neat. We kind of sat in this room full of respiratory therapists and doctors and nurses as we waited to see if we'd have a reaction and just kind of had this great conversation about like what does this mean. So this brings us so much hope and so much relief from the year that we had had. By late January, we had set up a clinic site, a vaccine clinic site, which was very far from my patients here in South Lyon. So it was about an hour drive for my population here.\n\nEmily  Soni: It was much closer for Southfield, but our Southfield population has a lot of transportation issues. That was not a place that public transportation went easily. And so they were very limited in their ability to get the vaccine. Our folks here were calling up a 90 year old and saying, \"Can you drive an hour to get this vaccine and then drive back?\" It was really very challenging. But what my clinic did is every day at the end of the day they would say these are the vaccine slots that did not get filled and my staff, mostly my nurse practitioner and my medical director and a couple others would be on the phone every night until 10 O'clock just like, \"Hey, we do have a slot. Can you go tomorrow?\" And we would do everything that we could to get all of the slots filled so we wouldn't be wasting any doses.\n\nEmily  Soni: I had done that a couple of times. It was a very, very strange experience to call someone at 9:30 at night and say, \"Hey, what you doing tomorrow? Do you want to go get this vaccine?\" And many times it was met with, \"Yes, I've been trying so hard to get it.\" So there was that. Our medical director, Dr. Stacey Bartell, lobbied from very early on to get these clinic sites closer to our spot. She's been an advocate for pushing vaccines at primary care locations because we as family doctors are uniquely qualified to kind of get this vaccine out. So she was able to get the vaccine kind of here before it was anywhere else, which was nice because a lot of our patients that couldn't drive out there were also having trouble finding vaccine appointments through the health department or through the pharmacies when it was early on. So they came here initially very eager. So we got that population that was excited to have this vaccine, knew what it meant, rolled up their sleeves and did their part.\n\nEmily  Soni: We still have around 20% of our population now that is not vaccinated and they're not willing to get vaccinated. This has been for many different reasons. Most of the time it's because of some misinformation or conspiracy theory that they've heard of. I've had some conversations turn pretty ugly as I try to convince them to get the shot. Our staff here, they mostly also jumped on board and got vaccinated. Our vaccine mandate came into effect for Ascension, which is the bigger organization I work with, earlier this month. I think it was like the second, you had to be vaccinated by the second. We did lose, I think, two staff members at my clinic that did not want to get vaccinated and their medical or their religious exception was not accepted. So we are very short staffed now because... We were short staffed before, but we are now extremely short staffed.\n\nCrystal Bauer: Sure. I'm assuming since the vaccine rollout for the younger age group, the five to 11, has that had any impact? Do you see clients of that age?\n\nEmily  Soni: We definitely have a patient population that's that age. It's probably 5%. We have like a 5% pediatric population. We have asked for, ordered the vaccine, but we do not yet have it. I mean, last Monday it was approved or Tuesday. So right now in our area vaccines are pretty readily available, not at the local pharmacies. So the eager parents that are really wanting to get their kid vaccinated now we're able to direct them and they can get a vaccine appointment. The most I've had someone have to wait is two weeks at this point. So that's been pretty effective rollout, I think.\n\nCrystal Bauer: Oh yeah. For sure. What skills do you feel like family doctors need to continue to fight this pandemic and how do you see medical and residency programs adapting to help their students and residents meet these demands?\n\nEmily  Soni: Being a family doctor over the last 20 months has meant really changing and learning medicine on the fly and learning a lot about public health that I certainly didn't learn as a resident. I mean, I learned about public health as a resident, but this is like a crash course in public health. With the science changing so rapidly, it's really important to promote that lifelong learning skills. Something that I learned last month about COVID is probably not true anymore. And so every time I round at the hospital, I'm like, \"Hey guys, what have you learned from the infectious disease doctors that's new? This is what I'm reading, what are we doing in the hospital?\" And really learning how fast medicine can change.\n\nEmily  Soni: I was doing some reading about an old cardiologist who's still alive who was like the first to give someone a beta blocker who had heart failure and like first to describe hypertrophic cardiomyopathy. Unfortunately, I can't think of his name right now. But I was reflecting on the time where he was practicing 40, 50 years ago and they didn't know what beta blockers were. There was so much about medicine that was unknown and there's so much now about medicine that feels very known and solid and not changing. This pandemic has taught my residents and me that that's not true, that we are learning and changing so much with medicine in general every day.\n\nEmily  Soni: The other thing about this pandemic is the education piece, really trying to... We're mounting an anti-misinformation campaign in the middle of all of this while we're dealing with very sick patients in the hospital and they're coming to the clinic where people are like, \"COVID is not real. What do you mean there's people dying? That's not a real thing.\" And we're like, \"No, we saw it. Like yesterday, we were there. It's happening.\" And so teaching our residents effective communication skills, how to educate, motivate, motivational interviewing their patients to get these vaccines. So having a strong behavioral health program to foster those skills and also foster the skills of self-care and resilience as you're going through this trauma every day and all the things that we're facing.\n\nEmily  Soni: And then the other thing that we really need to focus on teaching our family doctor residents is how to advocate for their patients and communities at a government level, at a community health level. So we're trying to get our residents involved in the hospital system. So, why don't you join a committee at the hospital so you can see how these decisions are made. But we're also, every year we go lobby at the Michigan State Capitol for healthcare related issues. So we're trying to foster those skills so that we can have a bigger voice in the surrounding government and area.\n\nCrystal Bauer: That's great. What have you learned through this pandemic?\n\nEmily  Soni: Yeah. I don't think I can fully grasp how much this pandemic has yet taught me and changed me. I had respect for all doctors and nurses before, but I have learned a new respect for the ER and ICU doctors and the nurses and the respiratory therapists and everybody else who's really in this every day in the hospital. I can run away to my clinic which is a nice reprieve from the hospital. I've learned a lot about humanity and how at the beginning it was just really amazing how humanity pulled together and really did the things that they needed to do to protect and support each other.\n\nEmily  Soni: And then I've seen really this misinformation campaign and how when that takes root in the community is so easy to sway people to believe what you are selling, the snake oil you're selling, when they're afraid. People have been afraid for a long time. And how that misinformation can end a life and it's really, really sad. And then I've really learned a lot about public health and the public health measures that can be taken by law. I'm learning all about the laws and the power of the government and really how much society has to sacrifice for the public health. That's something I'd read about but not experienced until this.\n\nCrystal Bauer: You've mentioned this briefly before, but what do you feel like your residents have learned through this?\n\nEmily  Soni: I think they've also seen that misinformation and how people can be in denial about reality and how frustrating that is. I've seen them learn things very quickly, learn how to keep up with changing medicine. I've seen them adapt very quickly to we've never done virtual and telephone medicine before, let's learn that really quick. And the residents are like, sure, that seems like a challenge I can do. Many of them are very computer savvy and it's no big deal and they're FaceTiming and doing virtual visit, not virtual visits but hanging out with their friends virtually all the time. So it's pretty easy for them to adapt to those things. Yeah. It's hard.\n\nCrystal Bauer: It is, yeah. You've mentioned your respect for ER staff, but who are the people you've worked with most closely during the pandemic that have impressed you and were some of these established professional relationships or did you form new relationships through this that really impacted you?\n\nEmily  Soni: Initially there was an infectious disease doctor, Dr. Wysocki. He was the one that was at Southfield with us and he would round on every floor because every floor was COVID. Every day he was there for 15, 16, 17, 18 hours a day. I don't know how that man was still standing. His colleagues were literally intubated in the ICU, so there was no one else, like it was crazy. He would come every day and I'd sit down with him and I'd chat with him and I was just, he was very knowledgeable and he would just reflect like, \"I don't know. I don't know if steroids are going to be helpful. I don't know if Plaquenil is going to be helpful.\" He was very real and obviously cared very much about everything that was going on and was willing to sit and educate me, so I appreciated that so much.\n\nEmily  Soni: Our medical director. I hadn't really had a relationship with him before, but now every time I see him in the hallway, I'm like, \"Hey, do you know [inaudible].\" Another really person that impressed me early on was Dr. Sorser who's a gastroenterologist and he volunteered to be cohorted to the floors because he's like, \"I can't do scopes. I basically can't do anything outpatient. I'm a trained internal medicine doctor. I'm here.\" And he also put in like crazy hours. That was really impressive.\n\nEmily  Soni: Our medical director, who I had a very good relationship with before and just professionally I'm very impressed by her, Dr. Bartell. She's just been such a strong advocate for our patients and for our clinic throughout this whole thing. I mentioned that she was really the one that got our site to get the vaccine early on. She's been really instrumental in all of that. We are currently still vaccinating a higher percentage of people. Of the vaccines that Providence Hospital is giving out, our clinic is giving out most of them, like higher percentage than any other clinic. That's definitely because of her.\n\nCrystal Bauer: That's wonderful.\n\nEmily  Soni: Yeah. She's also been really good at changing protocols as like, \"Hey, now we're doing vaccine boosters. Let's get a protocol in place immediately to get that rolling.\" She's been really a great innovator and effective leader throughout this whole thing.\n\nCrystal Bauer: That's important. Looking to the future, what is your sense of where family medicine is going? Big question.\n\nEmily  Soni: Yeah. I know, big question. I'm about 10 years into my career and I think I'm still very much in the weeds. I remember feeling as a resident like I'm never going to understand the bigger picture, like I'm focused on this potassium right now and now I'm like, oh, the big picture. I feel like there's going to be a moment in the future where I look down and I'm like, oh yeah, this is the big picture of family medicine and where we were and where we're going. I certainly I'm looking forward to having that bird's eye view.\n\nEmily  Soni: I have a grasp now of like all these changes that are happening close to family medicine in the payment model and like quality improvement measures and performance and value based care. We're part of CPC+ and all these things. I'm sure I'm forgetting something. But anyway, what we need to do as family docs is really advocate for ourselves so that in the future, family medicine will be better reimbursed for what we do. Right now we certainly have... I mean, maybe not pandemic now but 2019 now we had some of the highest burnout rates in medicine. So we have less time with our patients to do more work for them. As a doctor mom, I rush home every day at the end of work so that I can have time with my family, put my kids to bed and then I'm chatting and responding to messages and things on the portal.\n\nEmily  Soni: Personally, I'm concerned about the scope of family medicine getting narrower. I see it happening. I see less pediatric patients coming in. I see less pregnant patients coming in. And so as a family doc that still does obstetrics, I'm really like, please, we need to keep this as part of our scope. My residents, they're not very interested in obstetrics and I try and make them interested and they're just not. And so they're not learning it because they're not interested and then they go out and they don't practice it. And so I'm worried about family medicine kind of losing these skills that we've had for so long. I know this is different in Maine where I did my one year fellowship. They were an unopposed program. They were very involved in their obstetric program. They saw a lot of their OB patients. So I'm hoping that there's other areas that are in more rural, not my urban areas, that have more OB numbers and they can keep it going. So, cheers to that.\n\nCrystal Bauer: Are there any views on important issues in the specialty related to COVID-19 that we've not addressed that you want to share with us? Anything we're leaving out?\n\nEmily  Soni: We've addressed everything. I think I've said all the things.\n\nCrystal Bauer: You've said a lot in great detail, which is wonderful. It's great to have those thoughts. Any thoughts overall that you would like to add that we haven't covered? This is your chance to be a part of history. So anything left you'd like to share related to family medicine?\n\nEmily  Soni: I really appreciate. I'm just so grateful for this opportunity. I'm really glad you guys are doing this. One of my favorite things was oral history thing like this that my great uncle was in Pearl Harbor and he, before he passed away, was able to do one of these and listening to that audio recording was really neat. And so I was thinking about him as I was preparing for this. I'm just really glad you guys are doing this. I feel a lot of pride about being a family doc. At the beginning of this when my family was very nervous about everything, I was very nervous about everything, I said, \"But as a family medicine person, I can do this. I know how to take care of these patients, the scope of my practice. I'm uniquely qualified to deal with these patients, inpatient and outpatient. So I'm the one. I didn't necessarily sign up for this, but I'm the one.\" And it's been a journey for sure.\n\nCrystal Bauer: Well, Emily, thank you for all your amazing work as a doctor and thank you so much for doing this interview. We really appreciate all of this.\n\nEmily  Soni: Thank you so much. I really appreciate you.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/102691/file/202298#t=0.0,2438.64"}]}]}]}