Making the Rounds with Boston’s Top Docs
Photograph by Christopher Churchill
R. LEORA FISHMAN
Family Medicine
Practice: Somerville Family Practice
Hospital affiliation: Mount Auburn Hospital/Cambridge Health Alliance
Board certification: Family medicine
Education: SUNY–Stony Brook School of Medicine
Years in practice: 27
What made you choose primary care? Even before going into medicine, I was very curious about what makes us tick—our backgrounds, ethnicity, religion, socioeconomic status, family history—how that all affects our beliefs about health and illness. Primary care gives you a big opportunity to interact with people, to talk with them and get to know them. And in family practice, specifically, you work with people in the entire lifespan, from birth to death. It just made sense for me.
What does a typical day look like for you? I might see a newborn, to make sure he’s gaining weight and Mom’s not having problems breastfeeding; maybe three or four middle-aged people with chronic conditions like diabetes or asthma; frail elderly patients dealing with a multitude of illnesses, who come in with some family members; a healthy 23-year-old who needs a pelvic exam—all this, and more. I’m changing the channels in my brain constantly.
How has Massachusetts’ universal healthcare law—and the ensuing demand for primary-care doctors—played out at your practice? Well, it’s gotten more people to come in who haven’t been seen by a doctor in years, so we’re very thankful for that. But we often hear from new patients that we may be the third practice they’ve called, and nobody’s taking new patients. And that’s scary, and it’s frustrating.
What can be done to recruit more med students into family medicine? Government incentives would help. So would reforming how insurers reimburse primary-care physicians. Finally, it has to start in medical school. Some schools in our area don’t even have a department of family medicine! If you’re not exposed to it, you don’t have the chance to be excited by it.
What’s your best health advice? Keep your weight down, get regular exercise, don’t smoke—those come up over and over again. I also advise people to learn their family medical history. Sometimes it’s a little scary, but knowledge is valuable, and my role is to help you negotiate what all of it means.
What would your patients be surprised to learn about you? I love to sing. I started singing in a chorus when I was in third grade, and have been singing most of my life. For the past 10 years I’ve been singing in the Brookline Chorus.