Q&A with Dr. Mimie Tran: “It’s time to get creative”

Dr. Mimie Tran cares about her patients deeply. “I’ve had days where I’ve driven home in tears,” she said, as she talked about the impact some of her patients have had on her. She joined Venice Family Clinic in September 2019 after completing a family medicine residency program at Harbor-UCLA Medical Center focused on providing quality care for patients with fewer resources, as well as understanding how our environments affect our health. She now works in our Rose Avenue clinic with some of our most vulnerable patients. Tran spoke with us about her experience working at the Clinic and how the current global pandemic has changed how she thinks about health care.

Venice Family Clinic: What do you like about practicing medicine at Venice Family Clinic?

Mimie Tran: I was initially interested in coming to Venice Family Clinic because I had done a rotation with Dr. Coley King during my residency. I liked how everyone was really warm and welcoming, and meeting patients where they were at, no matter where that might be. I also like how the Clinic provides a lot of support services, not just in physical health but also in overall well-being. Mental health is readily available, and we can give out food vouchers or help with transportation. Those types of services and resources are often dispersed among different agencies, and that makes access more difficult for patients. But not here. All the staff, from the front to the back, is on the same page and has the same mission to serve patients. That is something that really stands out to me.

VFC: How does working at a clinic such as ours, where we provide comprehensive care, make a difference in how you are able to provide care as a physician? How does that translate to making a difference in your patients’ lives?

MT: We can provide better quality care for patients because we can work with the whole team, including mental health, health education and case managers, in a more patient-centered approach. I’m grateful for the large team at Venice Family Clinic who work to promote all facets of health for our patients, regardless of their life situation or background. Taking a whole-person approach makes more of a difference than just responding to a lab test or a physical.

VFC: Do you have any examples of how this team approach has worked for your patients?

MT: I have a patient experiencing chronic homelessness who initially came in for a sore throat. After diagnosing a lump on her throat, I referred her to a specialist for a biopsy. I also noticed that her labs showed she had type 2 diabetes, which was completely unknown to her as a thin woman, so she was surprised. We talked about her need to take insulin, as well as where she might keep her syringes so they wouldn’t be stolen from her.

Diabetes is one of the more common issues in the United States and something that should have been straightforward to treat, but it’s not so simple when you’re not sure what your next meal is going to be. So we got her a food voucher and some food from the food closet. That made it so much less traumatic for me as a provider in providing care. Just sending someone off without tools, resources or support feels horrible. Just allowing her to feel like the Clinic was a safe space was important for both of us.

VFC: How have you adjusted your practice amid the COVID-19 pandemic?

MT: It’s been hard for patients and providers to not be able to have more personal face-to-face interaction, but we’re able to bridge some of those gaps by following up more often with patients over the phone. I’m seeing a lot more adjustment disorder with anxiety among my patients. So I’m linking 60-70% of my patients to behavioral health, and when I follow up. They thank me for referring them to someone to talk through those things and helping them develop coping strategies because things are becoming overwhelming. During phone visits we talk about the stressors that come with our new circumstances, and I can affirm that it’s OK to feel stressed because it’s something we are all going through. In a lot of ways, I can understand where they’re coming from because this huge change has impacted me, too.

VFC: Do your patients have any unique needs or challenges because of the novel coronavirus?

MT: I’m working with a good number of patients experiencing homelessness. I now feel the gravity of their situation so much more. That’s why it’s so critical that we do whatever we can to step up. I’m glad we have the ability to test these vulnerable neighbors for COVID, and connect them directly to quarantine through Project Roomkey [a collaborative effort between the state and county to secure hotel and motel rooms for vulnerable people experiencing homelessness]. Being a part of that project with the county is an amazing thing that Venice Family Clinic is doing, and I’m really proud of that. I love that the Clinic understands the lack of access to healthy food and that we distribute food to them at our weekly free food markets.

VFC: How are you addressing their needs now?

MT: We’re being careful and creative to protect patients, and staff, so no one falls through the cracks. For many patients, we can advise them over the phone about what they can do at home to keep themselves safe. But , we’re also still seeing patients in person, with proper precautions. For example, patients with open wounds have to come in for us to tend their wounds – we can’t do that work over the phone. We’re also making adjustments for patients who have substance use disorder and need medication-assisted treatment, connecting them by phone and calling just to check in to see how they’re doing. We’re also getting first-time patients by phone who have lost their insurance, and we’re trying to navigate continuity of care for them, often with filling prescriptions, even though we often don’t have their medical history. If someone has been taking blood pressure medication for years, for example, and they need a refill but no longer have insurance, we’ll help them. Anecdotally, I’d say about 20% of my patients have never been seen here, but had heard of us.

VFC: What have you learned as a physician during this pandemic that you might be able to use in the future?

MT: Something I’m talking to patients about is giving yourself time and space to process. As a physician who is early in her career, I’m also putting that into practice and trying to give myself space to adjust. Everything is changing so quickly, I have to remind myself to be open-minded and stay positive, so I can adapt and be as creative as possible. This is unchartered territory for everyone, and people’s lives are on the line.