A family medicine physician on patient empowerment, health equity, and getting better care.
Tema Fodje, MD is a family medicine physician and patient advocate whose work sits at the intersection of medical expertise and community trust. Through her social media platform, she translates complex health information into content that actually makes sense to the people who need it most. She is passionate about health equity, increasing Black representation in healthcare, and reframing the doctor-patient relationship as a partnership rather than a power dynamic. She joined Rolling Out Health IQ to talk about how patients can get more out of every appointment, when telehealth actually works, and what she wants Black communities to understand about the healthcare system.
(The views expressed are those of Dr. Fodje and do not constitute endorsement by the Department of Defense, Defense Health Agency, Department of the Navy, or the U.S. Government.)
What is the biggest mistake patients make when they go to a doctor’s appointment?
One of the biggest mistakes is just not understanding how the healthcare system works and how to use it to your advantage. I do not blame patients for that at all. The healthcare system is complicated, so I try to have conversations with my patients about how to navigate
How should someone prioritize their concerns when they only have a short amount of time with their doctor?
Unfortunately, especially when coming to a family physician/primary care doctor, you often only get 20 to 30 minutes to address a concern. Some offices can get up to 40 minutes, especially for an established care visit or an annual. The big thing I often tell patients is to try to make multiple appointments. I know that can be difficult, but that is part of using different types of appointments to your advantage.
During a primary care annual visit, a lot of patients do not realize that is not necessarily the time to get all your acute issues addressed. Your annual visit is really for check-ins on medications, preventative medicine screenings, and making sure all of that gets done comprehensively. I recommend patients have their annual visits but also schedule separate acute visits, and try to schedule them as soon as an issue starts, or before it comes up if it is something recurring.
When does telehealth actually make sense, and when should someone come in person?
I personally love telehealth visits. One of the few good things that came out of COVID was the big boom in telehealth, where patients do not have to come in for everything. Telehealth works really well for things like getting a referral, or a medication refill for something you have been on chronically for years. For example, if you are renewing a longstanding medication like Zoloft or a Prozac that has been working great, you should not have to drive in for that.
If you do not know whether something should be a telehealth visit or in person, you can always send a message. Either the physician or the staff will be able to tell you whether it works as a telehealth visit or whether you should come in.
How can patients prepare before an appointment to get the most out of their visit?
Definitely try to write down a list of your concerns. If it is an acute care visit, write things down as they are happening. For example, if you are coming in for headaches, start writing down the triggers you have noticed, what other symptoms show up, how long they last. When you are able to bring that
information, it gives your doctor a much clearer picture. Sometimes when patients go in without having thought through those details, the provider ends up asking them to create a symptom journal. If you come with a symptom journal already done, it can actually help speed up your care.
Should people bring someone with them to a doctor’s appointment?
I always recommend bringing somebody who knows about your history, because everyone has a different level of comfort when it comes to navigating healthcare. Sometimes you can leave the doctor’s office and not remember what just happened. Having another person there means they can advocate for you if you have trouble speaking up, or they can help jog your memory if you forget something you wanted to bring up.
If you cannot bring someone with you, there is no harm in taking notes during the visit. A lot of offices will also send an after-visit summary, and many physicians will hand-write the key points from the appointment for patients to take home. Taking notes shows that you are being active in your care, and none of my colleagues have any issue with it.
How do you want patients to think about their relationship with their doctors?
The reason I went into family medicine is because I love the community aspect and the relationship building. I want patients to realize that doctors are here to be partners in your care. Medicine has shifted from a model where the doctor just tells you what to do, to one that is much more about shared decision-making. I can give you as much advice as I can, but I want it to work in the context of your life. I want to know what your goals are and how to help you reach them in the healthiest, safest way.
What does health equity mean to you personally, and why does it matter in Black communities?
Health equity means the world to me. I am the child of immigrants and I am a Black woman, so I have seen firsthand how inequities in healthcare have
affected different communities, especially the Black community in the United States.
A lot of people are starting to understand that equity does not mean giving the same resource to everybody. Equity means that there are communities that have not gotten any resources, so we may need to give them more to get closer to a point of equality. For me, that sometimes means taking 10 extra minutes with one patient because there are things they do not know that, for a variety of reasons, they need to be caught up on.
A lot of Black physicians, whether medical students, nurses, or doctors, have also been working to increase the pipeline into medicine and healthcare, because the more we have physicians who look like the patients they serve, the better the health outcomes. Studies have shown that.
Why did you choose family medicine, and what do you want people to understand about primary care?
I had a winding road to family medicine. I initially thought I wanted to be a plastic surgeon. As an undergraduate, I worked with a mobile health clinic that went into underserved communities in Boston to provide community-based care, and that shifted things for me. I briefly considered OBGYN, but mentors kept pointing out that I seemed to love treating older men and children just as much as any other population, and encouraged me to look at family medicine.
When I got to medical school and did my family medicine rotation, it was that relationship with communities that solidified it for me. Most people do not know how wide the scope of family medicine actually is. It is kind of a choose-your- own-adventure specialty. Family medicine doctors do outpatient care, inpatient care, and can deliver babies. In some settings they can even perform certain surgeries.
I absolutely love being able to take care of somebody from the time they are born until they leave this plane. Primary care as a whole is a very underappreciated field in this country, and it honestly does not have as many physicians as it should. I want patients to know that you can go to your family physician for way more than you think.
What is your message to Black communities who feel distrustful of the healthcare system?
If anybody is trying to fault you for feeling distrustful, they should not, because we can look at history and see a million and one reasons why that distrust exists. But know that there are physicians and people in healthcare who are trying to right the wrongs that have historically happened. Find those people.
A lot of physicians are on social media now, breaking down the healthcare system in accessible ways. Use word of mouth. If you know somebody who has a great physician, go to that physician. And if that physician does not have availability, they will likely know another doctor they trust and can give recommendations. Just know that there are a lot of us out here trying to help our communities.
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