Kā pirmais 2016.gada 7.martā "Starmeša gaismā" nostājās DR. Andrejs Avots-Avotiņš no Templas, Teksasa, ASV
1. When and where did you do your medical studies?
After completing my Bachelor of Arts degree in Biology at the University of Texas in Austin, Texas, I continued my studies at the University of Texas Medical Branch in Galveston, Texas. I received my Ph.D. in Microbiology in 1980, and my M.D. in 1984. My post graduate training was obtained at the University of Utah in Salt Lake City, Utah. I completed a three year residency in Internal Medicine in 1987, and a two year fellowship in Gastroenterology in 1989. I received an additional year of training in advanced gastroenterology procedures at Scott & White Clinic in Temple, Texas, and joined the full time faculty of the Scott and White Clinic in 1990.
My clinical practice has diminished significantly over the last 8 years as I have taken on administrative and leadership positions within the institution. I served on the Scott & White Clinic Board of Directors from 2001 to 2013, and served as the Chairman of the Board of Directors from 2008 through 2013, having the responsibility of overseeing a group practice of 1100 physicians. In late 2013, the Scott & White Healthcare system merged with the Baylor Healthcare System to form Baylor Scott & White Health, the largest integrated delivery network in the State of Texas, and one of the largest healthcare systems in the United States. I currently serve as the Sr. Vice President of Medical Affairs in the Central Texas Division of Baylor Scott & White Health. My clinical duties are limited to one day a week, and focus on colorectal cancer screening, and colon cancer prevention. As an administrator I focus on enhancing both the physician and patient experience, engaging our physicians in a culture of service to our patients and communities, and help encourage models of high quality care focused on reducing costs by eliminating redundancy and waste.
2. Presuming that you were born in USA - did you have any challenges being a "Latvian" or may be there were advantages - when you were studying in college and in University?
Personally, I do not feel that I faced many challenges growing up in a Latvian family in the United States. I was born in South Dakota, where my father, Karlis Vitauts Avots-Avotins, was a general practitioner and general surgeon, and my mother Alma served as his nurse and administrator. When I was three years old my father moved the family to Texas, where for 30 years he served as a general surgeon in the Veterans Administration Hospitals in both Marlin and Temple, Texas, retiring in 1987. I was fortunate to grow up in an extended family which included my father’s mother, her sister and her sister’s husband. My brother Peter and I grew up in a household where Latvian was the primary language, and English was secondary. In my earliest years of public school, I vaguely recall having some struggles with the English language, but it wasn’t long however before my brother and I became proficient in English, and it became the preferred language in our home. Although I can speak some Latvian today, I regret that I never learned to read or write Latvian. Other than my name, which was quite unusual for Texas, I do not recall any specific challenges other than having to constantly pronounce it, spell it, and explain where Latvia is located. As I got older, my name became an advantage. My patients and my colleagues were always interested to learn about my name, and always asked where it originated. Quite a few were familiar with Latvia when I would mention my family originated from the region around Riga.
3. Any advice that you may have to students and residents from Latvia as they are looking for observership and other study opportunities abroad?
There is no doubt in my mind that study abroad for students, residents, and even well established physicians, is an incredibly valuable experience. Unfortunately there are not enough of these programs to meet the overall demand. Additionally, international learners may be challenged by: travel, language, living expenses, visas and passports, licensing and health insurance coverage. None the less, if the opportunity exists, I would encourage individuals to participate in international exchange programs. Learning is a two way street. International students and physicians may learn new techniques, procedures, practice patterns and models of care, but the international student can also act as educator, and provide alternative approaches and models of care. The opportunities to improve overall care for our patients is a common goal for all of us in health care, and observerships help foster these learning efforts.
4. Are you aware of any differences between medicine practiced in Latvia and in USA (in case you have had exposure to medicine in Latvia)?
My knowledge of medicine and how it is practiced in Latvia is very limited. It has been 15 years since I last visited Latvia. I attended two World Congresses in Latvia, the first in 1997, and the second in 2001. It was a tremendous honor to be invited both times by Professor Nikolajs Skuja. I was introduced to many colleagues and had great discussions about the current state of Medicine in Latvia. In particular, I fondly recall my interactions with Ivars Tolmanis, Ph.D., and Marcis Leja, M.D., Ph.D., both of whom served as my interpretors and guides through meetings, presentations, and tours of various facilities. Our dialogue and conversations were stimulating. The care that I saw delivered to patients was excellent despite an infrastructure that lacked many of the amenities and equipment that I had taken for granted in the United States. I appreciated the many innovative ideas and thoughts expressed by my Latvian colleagues, which helped them provide the best possible care to their patients. I have remained in contact with Professor Leja and have occasionally seen him at Digestive Diseases Week in the United States. It would be a great pleasure to return to Latvia and see what changes have occurred in thepractice of medicine over these last 15 years.
5. What could be improved in medicine in Latvia so that people would like to return to Latvia?
(I cannot answer this question specifically but I do have some thoughts.)
Information technology (IT) has advanced to the point that with computers and telecommunications equipment, the exchange of information and knowledge has become relatively easy. I believe international collaborations between academic institutions utilizing IT, may be one way to engage physicians on a global scale through unique educational opportunities, second opinion services, and affiliation agreements which could enhance and improve the care that can be delivered to patients locally. The opportunity to provide the highest quality care that is safe, effective, and efficient, is very satisfying to the vast majority of physicians in the US, and is a significant factor in physician satisfaction and engagement. I believe the same would be true for physicians throughout the world, and overall satisfaction would be increased with the opportunity to participate and engage in international collaborations.
6. Any suggestions what LĀZA can do better?
I have enjoyed receiving information from LAZA. As I have already mentioned, I am unable to read or write Latvian. Previously my father and I would review information that was sent to us, but with his and my mother’s passing, I have no one to turn to for translation. I know that some information is presented in English, but a complete translation would be most helpful to me, and would allow me to better understand issues and accomplishments of my medical colleagues in Latvia. I do not know how many other Latvian physicians are in the US or other countries who do not read or write Latvian, but I suspect many of them would be very interested and willing to join LAZA and perhaps engage in international exchange programs and observerships if English translations of all materials were made available to us.
Andrejs E. Avots-Avotins