As part of our “Meet Yale Internal Medicine” series, today’s Q&A is with Anita Arora, MD, MBA, MHS, assistant professor of medicine (general internal medicine) and associate director of Population Health for Yale Medicine.
Q: What sparked your interest in medicine? ![]()
A: Both my parents are physicians, so I had a chance to see how wonderful this career can be. I remember an older gentleman coming up to my family once in a restaurant and telling me, "Your Dad saved my life.” That was powerful to hear as a kid. My father is a hepatologist, and my mother is a primary care provider. My parents are both in academics as well, and really love that balance of being able to teach and have a number of other roles, in addition to their clinical work. So that always attracted me.
I had been considering medical school, and in college worked in a federally-qualified health center to help patients enroll in Medicaid. I also started a “Reach Out and Read” program there, which helps to encourage parents to read to and with their children. My experiences at this clinic made me excited about medicine, and also specifically, caring for underserved populations. In addition to a medical degree, I decided to pursue an MBA so that I could really understand the healthcare system and be involved in changing it to provide better care for our patients.
Q: What brought you to Yale School of Medicine (YSM)?
A: I moved here for my residency in 2012 and never left. [laugh] After high school in New Mexico, I went to college in California. I wanted to go to a medical school where I could get a joint MD and MBA, so that took me to Dartmouth in New Hampshire. I applied pretty widely for my residency. When I came to YSM, I just felt the people, the residents, and the faculty were very special.
I was very impressed with Dr. Mark Siegel, the Traditional Internal Medicine Residency program director. I could tell he cares deeply for his residents and is constantly trying to improve their well-being. I also felt that he supports candidates who have diverse interests. My goal was always to do medicine and clinical work, but also have a role where I could make some system-level change. So that's how I ended up here. It was one of the best decisions I ever made. As a resident, I decided to apply for the Robert Wood Johnson Clinical Scholars Program (now called the National Clinician Scholars Program) because I wanted to get more background in health policy and research methods, and to prepare myself as a leader.
Q: Where do you split your time?
A: I serve as an attending both in the York Street Primary Care Center and on the inpatient Generalist service. The faculty, residents, and medical students at Yale are truly amazing and I feel that I learn so much from all of them. It is a privilege to work alongside such compassionate and brilliant providers.
I also serve as the Associate Director of Population Health at Yale Medicine. In this role, I have helped to establish programs that improve access, quality, and coordination of care for our patients.
One of our big initiatives is the Enhanced Referral and Electronic Consults (eConsults) program.
Through this program, referring providers serving in a primary care role are able to electronically send questions to specialists for patients who do not need to be seen face-to-face by that specialty. By sending an eConsult, providers receive timely guidance and patients avoid unnecessary visits to specialist providers. The program is payer-agnostic, so providers are able to request eConsults for patients whether or not they have insurance. For many of our patients who face barriers to receiving specialty care due to transportation or financial constraints, this has been an important way to move their care forward. As one Yale primary care provider put it, we are able to provide the right care more quickly. In the last two years, 27 adult and pediatric specialties have joined the program and more than 900 eConsults have been completed. We have also added condition-specific templates to referral orders for face-to-face visits, which guide primary care providers to write a clear question and help staff to more appropriately schedule patients with the correct specialist. During the COVID pandemic, at the time when face-to-face visits were very limited, eConsults served as an important way for us to continue caring for our patients. For that reason, we are currently engaging with the Association of American Medical Colleges and other academic medical centers across the nation to study the utilization of eConsults during the COVID pandemic.
Our population health team has also helped to establish a Mental Health Collaborative Care and Team-Based Care program at Yale Internal Medicine Associates. Through this program, patients who screen positive for depression are evaluated and treated by a health psychologist embedded in the clinic. This program addresses a key barrier that many patients face: poor access to behavioral health. In addition, through the work of care coordinators and a social worker, patients are assisted through transitions of care and their social needs are addressed.
Other efforts have included educating providers and staff about value-based payment programs and engaging them in the improvement of quality measures. At the moment, we are trying to systematically improve rates of flu vaccination and tobacco use screening and cessation counseling.
I also enjoy the ability to teach and mentor students and residents in my role. I have led an 18-month workshop in Epidemiology and Public Health for first-year medical students and I teach third-year medical students about population health during their primary care clerkship. Finally, I am privileged to serve as a Mentor/Advisor/Coach (MAC) for the Yale Internal Medicine residency program.
Q: What are your future goals in this line of work? What would you like to change, or see changed, or help change?
A: I would love to keep expanding our Enhanced Referral and eConsult program to additional clinicians. We have started including OB/Gyns as referring providers, and plan to add oncologists to this group as well. I would also like to help coordinate behavioral health integration efforts across the health system, and establish a taskforce that would help guide the development of technology and the investment in resources that support these efforts. I am very interested in understanding ways to improve quality without putting additional burden on individual providers. For example, we are trying to find ways to systematically provide cessation counseling to all patients who use tobacco through standardized workflows and the use of online educational tools. Ultimately, I would like to help create systems that reduce health disparities and make it easier for clinicians to provide high quality and coordinated care.