DR FAHMI FARAH
“PIONEER IN MEDICINE”
Why did you want to be a doctor?
I’ve wanted to become a doctor ever since I can remember. I was very intrigued by the way doctors treated their patients and how much hope they were able to bring into people’s lives. I saw doctors as my role models and I wanted to be one of them.
My mother told me I was born really pre-mature and I was very sick during the first 3 years of my life and almost didn’t make it several times.
I will share one particular story that my mother shared with me. When I was 2 months old, I became critically ill in the ICU and everyone had given up on me, including the doctors.
They tried to convince my mom to withdraw care and gave me to her to say her goodbye but my mother was feisty, she chose to defy what was expected of her and she chose to fight instead. She fought for my life that day.
As a person, I am reserved, quiet and shy but internally I’ve always had some amount of fight and defiance in me: fight for my beliefs and defiance against the status quo. I suppose it’s fitting since fight and defiance are the very reasons I’m alive after all and the irony is that these two things had to become a motif in my life, choosing to become a cardiologist as a female.
What was your experience entering medicine?
The field of Cardiology has been male dominant for decades and entering this profession as a female has had its challenges. There are very few female cardiologists in the US and the percentage of female candidates entering into Cardiology fellowship programs are few compared to males. It’s possible this discrepancy is due to not enough females applying. However, the fact that it is difficult for female candidates to enter and complete cardiology training program cannot be ignored.
What was the process involved in the study of Cardiology?
In the US, you have to complete 3 years of internal medicine training before applying for cardiology and then you have to complete 3 years of cardiology fellowship training to become a cardiologist. I completed my cardiology training in June 2017 and it was just 4 years ago when I was applying for a cardiology fellowship position.
Cardiology is one of the most competitive fellowships in the US and everyone is fearful of whether they will match into a program but as a female candidate, I had to be fearful for simply being a female. Having the competitive test scores, highest amount of research on my resume out of my class, publication, excellent staff evaluations, hard work, and dedication, being the first one to arrive and last one to leave, earning a solid reputation in the hospital and residency program compared to my male counterparts weren’t enough to relieve my stress from the burden of being a female when pursuing cardiology.
The fact that I was not on an even ground for being a female was confirmed when I was told that I would not be getting accepted into a program I was considering because I was a female and that it wasn’t my fault, it was because of all the females that came before me. I didn’t know what this meant at the time, it only made me panic even more that all my hard work and the dream of becoming a cardiologist will not be realized. I ultimately went to a different cardiology fellowship program at the University of Oklahoma. I consider it a great program, where I was trained by some of the pioneers of cardiology and I was treated with respect and fairness by the faculty. I believe we will overcome this barrier as more fellowship programs open their doors to female candidates.
What happened next?
Unfortunately, I found from my experience that the struggles of a female don’t end during training years, they continue. A female cardiologist has to earn respect all over again: she has to build her reputation from ground up at every stage, she has to prove herself all over again just to be taken seriously and this becomes an exhausting process that we have to learn to just deal with on a daily basis.
What about women supporting each other?
In my observation, the reason this problem has continued for decades without much improvement is not because females don’t have enough support from males, it’s also because female physicians don’t have enough support from other females and until we become one and tackle this problem together, it will be hard to solve this issue.
What prompted you to go into business for yourself?
Literally everyone asked me why I’d do such a thing, especially when the healthcare industry is so vulnerable.This is also a reason why I chose to break the tide and start my own practice.
I’d do such a thing so that I could provide quality patient care, the very reason I chose this profession and leave everything else behind.
I’d do such a thing so that I don’t have to walk the footsteps of being a victim everyday, no I did not go through 14 years of training to be victimized further for being a female, I did it to be liberated and to liberate.
I’d do such a thing so that when I look into my patient’s eyes, I can tell them that I work for no one else but them and the only thing that matters is what’s best for their health. I did it so my patients see me as their physician and advocate. I see my patients as my passion and hope for improved healthcare and create a place where gender becomes genderless.
How does the insurance system in the US work?
The US essentially has 4 broad categories of healthcare coverage systems.
1. Veterans Affairs (VA) Hospital and clinic: this is for the US veterans. How much coverage they have depends on how service connected they are.
2. Medicare: government funded and this provides coverage for the elderly (65 or older). For majority, this covers 80% of the healthcare cost and 20% is out of pocket for patients. Some patient’s have a secondary form of insurance that covers the 20%.
3. Medicaid: government funded and this provides coverage for low-income population.
4. Commercial health insurance: private insurance companies that people have to subscribe to and pay a premium in order to receive coverage. There are many insurance companies and the premium varies depending on the type of coverage. Usually the better the coverage, the higher the premium one has to pay.
Within commercial insurance coverage, there are 2 types of policies, Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO). HMO has cheaper premium and also has a lot of limitations on the patient. For example, patients with HMO are not allowed to see a specialist on their own. They have to obtain a referral from their primary care physician (PCP).
PPO’s usually have higher premium and allows patients to go directly to specialist without needing a referral from PCP. There may be other limitations for the patients such as which physicians they can see depending on the particular insurance plan they have and all these can add to wait time and travel time for the patients. Despite the several forms of healthcare insurances, a large number of patients in the US continue to be uninsured.
What do you do in the area of Cardiology?
I am an invasive cardiologist and I also specialize in echocardiography, nuclear cardiology and women’s heart disease. I see patients in the office for various types of heart conditions including coronary artery disease, arrhythmia, valvular heart disease, ischemic heart disease, women’s heart disease including complex high risk pregnancy related heart conditions and complications. I perform diagnostic tests including ECG, echocardiogram, stress tests, nuclear stress test, cardiac monitoring for further evaluation on patients who need it. I also perform invasive procedures including coronary angiography, left heart catheterization, right heart catheterization, ventricular angiography among other procedures. I refer patients who will need an open heart surgery to cardiothoracic surgeons.
Tell us some more about your new Cardiology clinic…
The practice is a full service cardiology clinic. It will provide care to adult patients ages 18 and above. The practice will have a full non-invasive lab within the facility including an echocardiography lab, stress lab for bruce protocol and stress echocardiography and a nuclear cardiology lab all within my facility. I am affiliated with all the major hospital in the area and will be using the hospital’s cath lab for the invasive procedures.
Dr Fahmi Farah’s NEW clinic is in Texas
In Texas, the main form of transportation is by private car but my practice is conveniently located near a public bus transportation route. It is within 1 minute of one of the 4 hospitals that I am affiliated with and within 10 minutes of all the other hospitals in the area.