Passing the Torch: A Mother–Daughter Journey in Family Medicine

Rebecca Lach, MD, MPH | Tammy C. Harris, MD, MPH | Jeffrey Borkan, MD, PhD

Fam Med. 2023;55(7):485-486.

DOI: 10.22454/FamMed.2023.478074

Some say that the pinnacle experience in our discipline is “delivering the babies of the babies we deliver.” Although I have not achieved that joy, I did have the equally transformative experience of training two generations in the same family at either end of my 35 years as a family medicine educator. I had the opportunity to interview one of my first trainees from the 1980s and her daughter, who completed her family medicine residency in 2022, and will be one of my last trainees as I near retirement.

Physician Interviewer [Dr Borkan]: Why did you choose family medicine?

Physician Mother [Dr Harris]: From early childhood I knew I wanted to take care of people. At the age of 8 I got my first microscope and before the age of 20 I started medical school. I had limited exposure to primary care until my fourth year when I rotated with the Indian Health Service in rural Alaska. I was hooked. After a circuitous route that took me first to an Ob-Gyn internship and an MPH, I ended up at UMass Medical School which, in 1985, was the only family medicine residency in Massachusetts. I spent most of my residency time in a community health center in Worcester taking care of the most underserved populations in the city. One of my faculty mentors was Dr Jeff Borkan, who as fate would have it, became my daughter’s teacher and department chair more than 30 years later at Brown.

Physician Daughter [Dr Lach]: My mom tells me I started feeding and caring for my dolls before I could walk or talk. So I guess it was natural for me to want to care for the whole person within the context of their family and community. My decision was cemented at Jefferson Medical School where I also had strong family medicine mentors and a chance to explore a wide variety of interests within the specialty such as women’s health and sports medicine.

Physician Interviewer: Why do you think your daughter followed in your footsteps by pursuing a career in medicine?

Physician Mother: I practiced where I lived and I ran into my patients frequently. At first this bothered me as I felt people could be watching me at any time, but I grew to revel in these chance meetings as it made me feel more connected to my patients. Becca loved it when we encountered my patients in random places. I would try to be discreet to preserve patients’ privacy, but inevitably they would exclaim in the middle of the supermarket aisle, “Your mom is my doctor!” and Becca would beam with pride. It was not a surprise when Becca decided she wanted to pursue medicine as a career.

Physician Interviewer: How did your mother's career influence your choice?

Physician Daughter: Growing up, I was privileged to have a front-row seat to the world of family medicine as I sat at the dinner table across from my mom and listened to her patient stories. It wasn’t necessarily the medicine I was interested in, but rather learning about the diverse lives of her patients with whom she would not have otherwise crossed paths. It was about so much more than treating numbers and prescribing pills. There were countless gratifying moments: caring for three generations of a family, solving a mysterious case of anemia, mentoring medical students. But in later years, there were also struggling times that came with the increasing demands of primary care: constraining to a 15-minute office visit, battling with insurance companies to be able to provide life-saving medications, and charting late into the night. Despite these challenges, I could not imagine a more gratifying career.

Physician Interviewer: What was your practice like?

Physician Mother: I took care of my patients wherever they were, whether it be the office, the hospital floor, or the ICU. I developed my own niches within the practice including obesity medicine, gender-diverse care, and women’s health. I also served on the Board of Health in Framingham, Massachusetts, which enabled me to contribute to making the town a safer and healthier place to live.

Physician Interviewer: What’s next?

Physician Mother: After 32 years in the same practice, I made the bittersweet decision to retire at the end of 2020. I keep my fingers in medicine by precepting residents in their clinic at the local community hospital and by serving on the board of trustees of the hospital. Some of my patients asked me if my daughter could be their next doctor. Many of them remembered when I was pregnant with her. Things are coming full circle. It has been a privilege (and cool!) to be able to serve as a mentor and sounding board for her over the course of both her medical training and her personal life decisions.

Physician Interviewer: What does it mean to be in family medicine today?

Physician Daughter: Family medicine today is part of a broken US health care system. Our days are filled with endless bureaucratic obstacles that seem to dominate health care. How does an individual doctor balance these practice frustrations and still provide excellent care? I believe that establishing rapport with each patient by really listening to the patient’s concerns and goals helps to maintain the humanity in medicine and mitigate the tension of working in our current health care climate. During my sports medicine fellowship, I love teaching residents about sideline medicine during games and precepting in their continuity clinic. Mentorship adds fuel to my sense of purpose and well-being. As my career advances, I hope to achieve the wisdom that comes from years of experience the way my mother role-modeled for me over the years, and in turn, share that with the generation that comes after.

Physician Interviewer: It has been so meaningful to watch both a mother and her daughter develop their family medicine acumen. They are both outstanding exemplars of our discipline. Watching these two generations sprout their family medicine wings has been an incredible honor and gives hope for the future.

Lead Author

Rebecca Lach, MD, MPH

Affiliations: Department of Family Medicine and Sports Medicine, UC San Diego Health System, San Diego, CA


Tammy C. Harris, MD, MPH - Metrowest Medical Center, Framingham, MD

Jeffrey Borkan, MD, PhD - Alpert Medical School, Brown University, Pawtucket, RI

Corresponding Author

Rebecca Lach, MD, MPH

Correspondence: Department of Family Medicine and Sports Medicine, UC San Diego Health System, San Diego, CA


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