As part of our “Meet Yale Internal Medicine” series, today’s feature is on Janelle Duah, MD, Assistant Professor of Medicine (General Medicine).
Janelle Duah, MD, has known that she wanted to be a primary care physician since she was very young. Born with a congenital heart disease, she had to see a cardiologist at least once or twice a year. “I’d have to be getting echoes for an hour, and as just a little kid who didn’t really understand what was going on, seeing them treat me with compassion and explaining medicine to my parents was very helpful.”
She contrasts that experience with that of her own parents. Growing up in an underserved neighborhood in Brooklyn called Crown Heights that didn’t have many doctors forced patients to drive far out of the neighborhood to get medical care. She remembers the quick, five to ten minute appointments with her parents where the physician would prescribe a new medication each time. “We had a stack of unfilled prescriptions in my living room that my parents wouldn’t be able to fill because they’re expensive and they honestly didn’t understand what most of them were for. When it came down to, are we going to fill this drug, buy groceries, or purchase clothes for the upcoming school year, they would often not pick the prescriptions.”
Remembering the vagueness of the prescription and lack of education or discussion about her parents’ health problems in the doctors’ offices incited Duah’s interest in primary care. The importance of explaining to her parents what the medications did and why they were necessary could have massively improved their health long-term. As a primary care physician, she serves as their advocates - both for teaching them ways to improve their own health, as well as being their voice for specialty care and keeping their treatment on track. “Being able to take that time to educate patients, talk to them, get to know them, and advocate for them is really why I wanted to get into medicine and primary care specifically.”
Though her appointments with her own primary care patients last much longer than the five minute appointments in her youth, Duah still finds herself wishing she had more time to speak with her patients. For instance, the 40-minute appointment for a new patient is also wrapped up in getting roomed, running vitals, and other administrative activities besides the one-on-one care. And outside of seeing her patients’ faces, the background work also takes up a lot of time, from keeping prescriptions updated to messaging over MyChart and coordinating with specialists.
While she mostly does primary care, Duah and another provider, Jorge Moreno, MD, run a weight loss clinic within their primary care clinic, Yale Internal Medicine Associates. On average, she sees approximately fifteen patients for weight loss per week, both new and long-term patients. The process of weight loss is extraordinarily difficult. She cites patients’ stories about their doctors telling them that they need to lose weight, but never telling them how. In helping patients to lose weight, she delves deep into their diet and exercise habits, stress levels, sleep patterns, underlying medical conditions that might be contributing to their weight management, and if they want to use an FDA-approved medication for assistance.
What Duah loves about her work is the diversity of patients that she sees. With her youngest patient at 17 and her eldest at 99, she sees a wide range of people. “It’s great because we’re learning how to take care of a wide variety of people. We’re learning a lot too as we take care of them and it helps us keep that broad knowledge base we need to have in primary care.”
The Section of General Internal Medicine is committed to the core missions of patient care, research, education, and community health from the “generalist” perspective and is one of the 11 sections within the Department of Internal Medicine. To learn more about their mission and work, visit General Internal Medicine.