Medical students finish Sonoma County residency program with unexpected versatility forged in the pandemic

THE NORTH BAY BUSINESS JOURNAL

July 28, 2021

Meet three local family residency graduates

Dr. Lauren T. Glaser

Glaser, who was born at Kaiser Permanente Santa Clara, will practice medicine within the health care system when this fall she becomes a full-time attending physician in outpatient family medicine.

After graduating with a human biology degree from the University of California, San Diego, Glaser joined Stanford University’s pediatric endocrinology clinical research team. She then went on to graduate school at Case Western Reserve University in Cleveland.

Glaser attended medical school at Creighton University School of Medicine, spending her first two years in Omaha, before moving to Phoenix to complete her final two clinical rotation years.

Glaser says she has a particular interest in geriatrics.

Dr. Julet Baltonado

Baltonado will continue her career as a family medicine physician at Kaiser Permanente, where she will care for patients of all ages.

Baltonado earned her medical degree from the University of New England College of Osteopathic Medicine. Baltonado states she chose to train, and ultimately join, the Kaiser Permanente health care system to practice as a family physician and create long-term relationships with patients and their families.

Baltonado grew up in the Philippines and is a native speaker of English, Bisaya (Cebuano) and Tagalog.

Dr. Daniel Ayala-Ortiz

Ortiz states his philosophy on health care is a whole-person approach, where optimal health is achieved when the mind, body and soul are in sync. He plans to help his patients achieve their goals through healthy lifestyle choices and preventive care.

Ortiz graduated from the University of California, Davis, with a bachelor’s degree in exercise biology and Chicano studies. He then attended the UC Davis School of Medicine and participated in the Rural PRIME curriculum, which gives students specific knowledge and skills they need to practice in rural communities.

Ortiz says he is passionate about advocacy work, especially within the Latinx community.

How has COVID-19 changed not only our lives, but those of medical students who have been on the front lines — especially those whose careers are just getting underway?

Three newly minted graduates of Kaiser Permanente’s inaugural three-year family medicine residency program shared their personal experiences during the Business Journal’s 22nd annual Health Care Conference, held virtually on July 20.

Dr. Patricia Hiserote, director of the program whose inaugural class had six students, led her portion of the presentation by discussing the early days of COVID-19.

“It was really scary because we didn't know who had COVID and who didn't,” said Hiserote, who also is family medicine physician at Kaiser. “We were learning a lot about the virus, and it really caused an additional layer of anxiety during a time of medical training that would be pretty anxiety-provoking to begin with.”

Dr. Julet Baltonado, one of the graduates of the family medicine program, said the pandemic and its impact brought the need to be flexible to a whole new level.

“We were in a unique situation … that we've never experienced before and it was affecting our daily life in the sense that … we had to get moved to different places in terms of our medical rotations,” Baltonado said. “That was very unexpected, so (there were) a lot of scheduling changes.”

She also recounted the period of time during the pandemic when the hospital was trying to conserve personal protective equipment.

“The residents at Kaiser Santa Rosa weren't allowed to see COVID-positive patients initially,” she said, adding that changed once more PPE was available. “I also think initially there was a shift in (that) we were kind of uprooted from our regular rotations … and were no longer seeing patients in the clinic.”

That meant the residents had to see their patients virtually, on a scale beyond what they already were doing in their training.

“(That) was a new challenge,” Baltonado said, “and a new skill set that I feel like we had to learn, and I'm really grateful that I got that training.”

Hiserote asked Dr. Daniel Ayala-Ortiz to describe his experience with COVID-19’s impact on the delivery of health care. He expanded on what Baltonado said about the switch to virtual care.

“It just kind of shifted everything and made us think from a different perspective, and medicine was something that we had to really figure out,” he said. “How do we assess patients over video, over telephone … and who do we bring into the office?”

Ayala-Ortiz said the shift in delivery of care sometimes required quick thinking, such as determining which patients were sick enough to come into the office.

He also discovered additional patient care issues to be addressed.

“I think it kind of uncovered a couple of different inequities in terms of who has access to video and who doesn't,” he said. “Most people do have a phone, but there are some that don't. So, that definitely brought up a bunch of different situations that weren’t 100% clear.”

From the program director perspective, Hiserote noted the residents are taught how to do virtual care through video visits, telephone visits and through email — just not routinely.

“When COVID hit, we were doing about 80% in person and about 20% telemedicine, and that just flipped on a dime,” she said. “And I was grateful that we had that curriculum for (the students), but also overwhelmed as a career physician doing that much telemedicine because it is a different kind of medicine.”

Hiserote asked Dr. Lauren Glaser to talk about some of her patient experiences during her residency.

Glaser recalled a number of patients who wanted to help her save time by offering to wait for care if their condition wasn’t urgent, which she said she appreciated but wasn’t about to do. And there were others who, when the vaccines were first rolled out, wanted to wait so others could get their shots first.

“We wanted people to get (the vaccine) when it was their chance to get it, but it was just so much kindness,” she said. “(People) have been sacrificing so much during the last year and a half. It was really profound.”

Cheryl Sarfaty covers tourism, hospitality, health care and education. She previously worked for a Gannett daily newspaper in New Jersey and NJBIZ, the state’s business journal. Cheryl has freelanced for business journals in Sacramento, Silicon Valley, San Francisco and Lehigh Valley, Pennsylvania. She has a bachelor’s degree in journalism from California State University, Northridge. Reach her at cheryl.sarfaty@busjrnl.com or 707-521-4259.