[00:00:05] Speaker A: The Michael Hatfield ReMax team presents real Estate and more. Bay Area real estate is different than all of America and why? What's up with home buyers? What's on sellers minds? How is the market? And much, much more.
[00:00:22] Speaker B: Now here's your host, Michael Hatfield.
[00:00:25] Speaker A: Isaiah, welcome back to the Real Estate and More show where we explore the exciting world of real estate and take deep div into fascinating topics beyond the home market. We talk about people, we talk about topics, we talk about anything that can be of interest. But today we truly have an extraordinary guest who works on the front lines of healthcare, making a difference every single day. She's a brilliant urgent care physician at the renowned John Muir Health system with a career that has taken her across the globe from Pakistan to Great Britain and now into the United States. She's been here a while, I've seen her, she's taking care of me and my family at urgent care and just has been a wonderful, wonderful friend. So today with that in mind, let's welcome Dr. Rukaya Fatima.
[00:01:20] Speaker C: Hi Michael. Thank you for having me.
[00:01:23] Speaker A: Oh, it's wonderful to see you and to have you on the show. So your journey, let's start right out of this. Your journey as a physician has taken you across continents, exposed you to a wealth of different medical experiences. What does it take for someone to follow in your footsteps to become a highly respected doctor like yourself?
[00:01:48] Speaker C: You know, Michael, I think I would probably attest for a lot of physicians that are currently practicing and that are training, it takes a lot of grit and compassion and passion and persistence and hard work.
For me personally, I was just always in awe of the, you know, the human body, just from the cellular level to the multi organ systems and they work, you know, so beautifully in sync. So I just was always, always gravitated towards human physiology. And then, you know, I realized early on that I like talking to people and learning from them. So medicine just seemed to be the natural progression of my career and that's how it happened.
[00:02:37] Speaker A: So if somebody was really interested in following in your footsteps, you would suggest having that incredible interest in health in people, in their bodies.
[00:02:47] Speaker C: I agree. You know, I think just the science of the human body, but also, you know, being a people's person where you actually genuinely care about people and their and you know, once you realize that medicine is and very early on I realized medicine is not just about, you know, disease. It is for most part it's disease processes and the morbidity and mortality of disease. But it's so multifactorial, it's so Much, so much to consider when you're treating a patient.
[00:03:23] Speaker A: You know, I thought about it at one time, becoming a physician back in many, many, many decades ago. But the lure of the skies and the airplanes were what drew me away from that at the time. But it would just be a fascinating career because you can never dive deep enough into what is challenging you as a person. I would think.
[00:03:44] Speaker C: Yeah, that's true. You know, and I feel like as all professions, and I'm sure flying was amazing and so exciting. Exciting.
You help people, you're serving people. Medicine is just like you're doing it at a very intimate level.
And there are people that make huge differences in people's lives. But with physicians it's like patient, you know, it's cell by cell, patient, you know, it's person by person. So that's how you make a difference.
[00:04:13] Speaker A: I think you gotta care. You gotta care. So your path to working at one of the nation's premier medical institutions is undoubtedly an inspiring one. You know, could you take us personal journey? You know, where did you start with this medical career and your life and how did you end up here in the San Francisco Bay area? The wonderful San Francisco Bay area.
[00:04:35] Speaker C: Oh, I love this place. It's so diverse. I grew up in the Middle east, in Abu Dhabi. It was back in the day, it was, you know, it was a bubble. We had a, you know, it was a resource. It was a first world country per se. And there were no, there was absolutely not one issue that we encountered what I encountered growing up, because you're just a bunch of young expatriates, you know, that were working and you know, our tax free income, everything was paid by my dad's work. And you went to best schools and you know, there was no, you know, there was no, it was, it was, it was, it was heaven. It was just a bubble.
Pakistan was where I actually was born. That was where I was originally from. So when I finished high school and in those days, well, even now you are supposed to pick your career when you are done with high school, which was, which was kind of hard because I was, I was leaning towards medicine, but I was not quite convinced that was the right path for me. But you know, there's some people in your life that just that change the course of your trajectory. And I feel teachers are so important.
I had a professor that was from a chemistry professor. He was a, he was a really fine guy, a PhD and I, and he said to me and my parents, like, no, she's meant to be a doctor. I'm not sure what he saw in me, but I was a little taken aback. I'm like. He's like, nope, you're not doing anything else. You are, and you need. And I. You will eventually give me a free doctor's visit when you're done.
I don't know where he is right now. This is way back. And then. So that's when I applied to medical school. I was like, maybe it is meant to happen. And, you know, one of my teachers thinks I need, you know, that's what I'm meant for. And then I went to medical school and one of the underserved third world countries in the world, and I was just blown away with the disease processes. I saw, you know, coming from that environment where I was in a bubble to where I saw people not having access to, forget health care, to clean water or food or, you know, they had to walk, like, days to get to a health care facility. And they had diseases like none other, like, you know, cancer. I was just. And they would camp outside in the courtyard of the hospitals to be seen by one, you know, healthcare professional. That. And we had. We had limited resources.
So I was.
I was, you know, I did have an emotional, you know, initially, it was an emotional meltdown. I was. I couldn't believe how blessed I was.
It was. It was a moment of reflection and growth. But I was just so, so happy I could be there to make their lives, you know, help them in whatever capacity. And that's when I realized, and there's so many stories Michael can go on about, but that's when I realized, you know, I will probably not be able to change the morbidity of their disease or the mortality. But what I can do is try my best in that capacity. I am there in that moment, and that changed.
[00:07:58] Speaker A: You know, what's amazing is that that teacher was pivotal in your life. And in my life, I find that I had the same things happen.
All of a sudden. I was going to be an airline pilot. And everyone said, well, you know, there's a fuel crisis on and you cannot get there. You need to be a military pilot. They will not hire you if you're not military. And everyone had the reasons why not. But yet there's the shining star that stands out there and says, you know, Dr. Fatima, you're doctor in waiting. This is what you're going to do. And you're going to be a really good one, too. And then suddenly inside yourself, you say, I like it because it's helping people. And with you, it's loud and clear.
[00:08:44] Speaker C: Oh, you're too sweet, Michael.
[00:08:45] Speaker A: It's only true. It's only true. So you ended up in Pakistan and then what happened from there?
[00:08:51] Speaker C: And then what happened was I finished medical school and then I got married to my husband, met him through a friend. We got to know each other and he was already working in the U.S. and that's how I came to the U.S.
i started to study for my boards here. I did take a little bit of a back seat in terms of my profession because I had, you know, I had a I gave birth to my daughter and I wanted to spend some time with her. But when she was three years old, I went back into training and residency at Michigan, which was amazing, Michigan, except for the weather, of course. There was a lot of the patient population there was very different from what I see in the Bay Area.
There was a lot of comorbidity and a lot of healthcare issues. And I worked, I trained as family medicine.
And again, it was a growth moment for me. I realized preventative care is so important, striking at the root of disease before it takes cause and effect is so important. And again, you try to save patients day by day, bit by bit. And it, it's a multifactorial process. We're going to take a short break.
[00:10:20] Speaker A: We'll be right back. REMAX.
[00:10:25] Speaker D: The Real Estate Minute with RE Max expert Michael Hatfield Bay Area housing markets are always changing. What should we think of that, Michael?
[00:10:33] Speaker B: You know, Mark Twain said, I seldom saw an opportunity until it ceased to be one. We live in the greatest housing market in the nation. But careful thoughts should should be given each time one buys or sells a home. A good agent can help you grasp a great opportunity.
[00:10:48] Speaker D: Tell us about discount agents, Michael.
[00:10:50] Speaker B: Discount agents can list your home, but without telling my secrets, they're unlikely to do all we do for clients. It's an unnecessary risk to save a few thousand by hiring a junior agent and lose tens of thousands through a poorly done transaction. You don't know what you don't know. It's wise to hire someone who does.
[00:11:08] Speaker D: If you or someone you know is interested in buying or selling a home, call the Michael Hatfield RE max team at 925-322-7775 or go to michaelhatfieldhomes.com when your real estate needs are beyond the standard and you demand more than the status quo, look no further than the Michael Hatfield REMAX Accord team with offices in Danville and nine more Bay Area locations. Here's Michael Hatfield to tell us more.
[00:11:35] Speaker B: Do you have A housing problem such as you live in a three bedroom home with three children and need one, one more bedroom, you want better schools or your kids grown up, moved out and your home is just too large. Our team is a five star agent who serves our clients. Housing needs is our number one priority. Call us for a free buyer consultation to start working on your housing problem. Now let us help you to solve your housing issue, whatever your need may be.
[00:11:59] Speaker D: Call 925-322-7775 to partner buyer or seller needs with the Michael Hatfield ReMax a court team. That's 9253-2277-7592-5322-7775. Come discover a new level of excellence in real estate with the Michael Hatfield RE Max Accord team.
[00:12:22] Speaker C: Now back to our show and over time, it takes a long time.
[00:12:27] Speaker A: Yeah, I know you work so many hours and so much with your, your work. Now I got a question. The term urgent care, you know, it's bannered around a lot these days and obviously it has a very good purpose in the medical system. Can you explain a little bit about that?
[00:12:44] Speaker C: Sure. So I think urgent care came in, it's relatively new healthcare facility. The concept is I think to take burden off from ER and also a lot of primary care.
We see a lot of acute care issues.
So anything, you know, we can have anything walk through the door potentially. But anything from you know, colds to, you know, musculoskeletal injuries to, you know, minor trauma, to, you know, to, you know, we do see stroke and heart attacks too. But we are there to stabilize them and you know, direct them to the ER.
If you, this is not a PCP's office in that we're not preventative. We don't do, we don't, it's not preventative care. So if you have, you're worried about your cholesterol that if you had for years, you wouldn't want to walk into urgent care. It's for just anything that's acute care. So it is. So if you feel like something that's recently come on, you need to visit the urgent care. But anything that you're following through with your primary care doctor, you need to follow up through, you know, just make, you know, those follow up appointments.
[00:14:02] Speaker A: So in other words, you put your finger in the dike, you know, to keep the water from flowing out of the dam.
[00:14:08] Speaker C: Exactly.
[00:14:09] Speaker A: And then, then you go to your own, you know, primary care physician.
[00:14:13] Speaker C: Exactly.
[00:14:14] Speaker A: Why, why did you choose urgent care over primary care like that?
[00:14:18] Speaker C: So, you know, that's A very interesting question, Michael. So, you know, even the ER is a relatively newer board. 50 years ago it was the regular, you know, internists that would man, you know, emergency rooms. In fact, even in smaller towns, I think there's just internists that man the, or, you know, primary care doctors that man the er. So we didn't, back in Pakistan, where I trained, we didn't have an official ER training. We were just either hospitals or clinic. That was the concept. So when I trained in Michigan, when I trained through the er, I loved it. I guess maybe it's just a personality. I just loved the fact, I think that maybe the adrenaline rush, you don't know what can walk through the door and it's fast paced. So when I, you know, at that point I was, it was, I was already in training, so I was like, oh, I wish I had known this before. But then urgent care for me, once I graduated was the closest thing to being in the er. And in hindsight it worked out better because there's no overnight, so, so better lifestyle.
[00:15:21] Speaker A: It's a lot the same though, I would think, you know, can you walk us through a day that you see some different types of cases that come in the door? We touched on it earlier, but I know that you might get somebody come in with a bee sting. But that bee sting could be a lot more serious than what people would actually like to think about.
[00:15:40] Speaker C: Yes. So, you know, a bee sting, for example, could, you know, there's, it's usually an allergic reaction when they come in. First we need to make sure their vitals are stable, they're not having a life threatening allergic reaction. Now the signs of a life threatening allergic reaction could be is usually swelling of your tongue or your throat or dizziness or nausea, you're just feeling worse. But for most, typically people have a family history or they have a previous history of anaphylaxis. Most people, it is usually a mild case of an allergic reaction. And there are medications out there. It's usually antihistamines and steroids.
Sometimes if there's a secondary infection, again that's a clinical judgment call. We give them antibiotics too.
There are certain disadvantage to overusing antibiotics in terms of resistance. And that's all that's discussed in that 10 minute visit, 15 minute visit that we have with patients. But yeah, anything from chest pain to stroke to abdominal pain to UTIs to allergic reactions, you name it, Michael, we see everything. We also do procedures like abscesses, we drain inds, we do laceration repairs, toenail removal, foreign body Removal. So you know, it is very interesting and it's so diverse in terms of what we see.
[00:17:07] Speaker A: Do you have a really interesting case that came to you that you recall at obviously de identify, but I mean one that came to you that you just keep thinking about how could that have ever have happened or boy, that was unusual or something of that nature.
[00:17:24] Speaker C: You know, on a general note, I think in the urgent care what I personally feel is a little challenging is mental health because we have like that 10 minute slot and we have to make, we have to connect with the patient and we have to have them trust us.
And a lot of, you know, that's very challenging. So that is a general mental health and to make. Because a lot of these patients that have mental health disease don't want to go to the doctors or you're generally not following through. So it is a process where we are that turning point sometimes where we make sure that they are, we are, you know, they're, they are, they, they're, you know, the trajectory is in the right direction. Like I once had this patient and I didn't realize that she was, she was about, she, she was clearly going to end her life. And I had that 10 minutes and then, you know, I, I had. And obviously I took more than 15 minutes with her. But then she sent me, you know, I've saved those notes for when I after retire. But she's like, Dr. Fatma, you know, you, you know, you changed the trajectory of my life. So you know, those things I remember. And then, you know, of course medically there are certain things you see, for example, I saw a rash that seemed like regular rash. But you know, when you send them to the dermatologist and you realize this is a tumor, you know, neurofibromatosis, which is like a tumor of the skin of the nervous system that presents as lesions on the skin. So that's like mind blowing. You're like when you look back, you know, so you can see a lot of diverse disease processes and you know, and then learn and look back. What has also been challenging, I feel like is, you know, giving bad news in the urgent care. Sometimes we're put in that spot when we don't know the patient. We have, you know, end stage cancer which is, you know, so we have to sit them down and really talk things through. And you know, that has, you know, that's always, always left a mark, I'm sure for, you know, for the patient. But for, and I'll always go back and reflect on that too.
[00:19:39] Speaker A: Now when Dr. Fatima came in, she says, why? Why me? Why not talk to some other doctors or whatever? But ladies and gentlemen and everybody, you can see what a wonderful lady this one is. You can see the compassion. You can feel it. And you can see her applying the tools that she has learned over practicing in several different countries around the globe. And it's just really heartwarming to see people that actually care. So this is why I like to see you. Because you've got that million dollar smile that everybody likes to see no matter where you go, even if it's the urgent care.
[00:20:19] Speaker C: You're too sweet, Michael.
[00:20:20] Speaker A: It's only true. If you could have chosen a different career, why not ophthalmology?
Why not go er? But you liked urgent care, apparently.
[00:20:31] Speaker C: And I think that's what I love about urgent care.
I feel like, Michael, I'm practicing in the most diverse places on earth.
And if I must say so, I feel like it's amazing to see the different languages and cultures. And I feel like in that room of mine I have actually traveled the world and I am just so blessed.
I have learned so much from my patients, just not just from the medical, you know, from the science part of it. It's just the culture and the diversity. And you know, I actually feel like now I can pick up on languages when I hear them and say, oh, this is Cantonese, this is Mandarin. So that's, you know, that's like, that's pretty amazing. You know, you can, you can recognize a language. So. And I never realized, and I don't think if I practice anywhere, like, just because we have such a high turnover of patients, primary care is different, or even specialists, they have patient panel, they don't. But we wrote, we see probably 30 new faces every day. So it's just, I learned so, so much. I feel like I get a three hundred and sixty degrees view of the world. I just love it.
[00:21:48] Speaker A: With the complexity of medicine, do you ever concern yourself, and I don't like to use the word worry, but do you ever concern yourself that in the time allotted that you could miss something because there's so much complexity? I mean, take a look, for example, we just saw the accident in Washington D.C. and in my position before as a check pilot with a company, we would be involved in accidents so that we could learn from it and improve it. Do you feel that when you go into the urgent care rooms and you meet these people that you gotta kind of use your intuition to say, what is, what is the, what's going on here?
[00:22:32] Speaker C: Absolutely, Michael. And you Know one thing I realized, it is a very high stress job. Just the way it's paced. You have 15 minutes and you know your decision can make or break a patient. And you know, sometimes you have, and you have to kind of make, make that call and say, is this patient safe to go home? We're going to take a short break. We'll be right back.
[00:22:59] Speaker B: There's a shortage of Bay Area homes for sale. And you've been watching home prices rise year after year and now your home is worth a great deal more. And you're thinking, time for something new. Why not sell before interest rates and market conditions change everything? You'd like experts who can help you get the best deal possible, negotiate on your behalf and work hard to ensure a smooth transition. List your home with us. If you're buying or selling a home, call us now.
[00:23:26] Speaker E: Working with Michael and Nancy. I was a first time home buyer and I was very nervous about the process. I didn't really know what to expect. Michael and Nancy were able to take that fear away from me and answered all of my questions. They were right by my side the entire time and they really helped me find the perfect home for me. And I'm so thankful for excellence in real estate.
[00:23:46] Speaker D: Call the Michael Hatfield ReMax team at 925-322-7775 or go to michaelhatfieldhomes.com now back to our show.
[00:24:00] Speaker C: And that's why it's, you know, I guess that's what probably MD stands for make decision all the time. So it's intense and that's why it is very stressful because we are. Because if you spend a lot of time with one patient, you're also backed up. You have to see one patient every 15 minutes. But yes, you do the best of your ability and you try to do what's safe for the patients. And a lot of patients that I sent to the ER and I do tell them, I make, obviously, you know, I understand where the patients are coming from. Not everybody wants to go to the er And I do explain to them that, you know, this is not because I think there's something wrong. We just need to make sure nothing life threatening is going on because we're limited in terms of testing at the urgent care.
[00:24:47] Speaker A: Yes, yes. And so my other question was, do you ever feel that, you know, with the complexity of the human body that you could miss something? And that is a very stressful thought all unto itself because knowing you, it would eat you up to miss something that you wish that you had not. And they give you so little time to do it that I have to have a lot of sympathy for urgent care doctors as well as ER doctors, because there's a lot of pressure to treat as many people as you can effectively and efficiently. But yet, with our airspace system as another correlation, you know, you've got a lot of airplanes. There's 8,000 airplanes in the sky above the United States all the time. You're going to have things happen from time to time. So when a patient comes in with an acute illness, how do you know that, okay, this is something that needs to go to ER now. I mean, you've got that decision to make as well as well. Can I do anything to put my finger in the dike to help it get there? But, I mean, you have a lot of things to think about right there.
[00:25:56] Speaker C: Of course. And so, you know, first things first, we need to look at their vitals.
Anybody I. Before sending anybody home. You know, we, all of us physicians, want to make sure their vitals are stable because, you know, that is a big indicator sometimes. Like, for example, I've sent patients to the ER with normal vitals and normal ekg, and they stood still, had blockage, and they came back and said, you saved our lives. You know, so sometimes it is. You have to, you know, again, it's a. You have to take. It's a clinical judgment call. You have to go through your textbook case, you know, checklist again. And sometimes it's just an intuition thing. You're like, something's not right.
But, yes, you know, you have to risk stratify the patient.
The good thing is, and we try to get patients into the specialist's office also, if we can do that for a lot of patients and we can save them from going to the er, so it's multifactorial. If we can get them to see the specialist. If not, then we have to send them to the er, but if they're unstable, they have to go to the er.
[00:27:12] Speaker A: You know, one thing I noticed that I thought was really incredibly interesting. This has been a number of years. Nancy had a surgery, and I'm in this little room. She's getting ready to be wheeled in. She's under the care of a nurse at the time, and in came the team to take her to surgery. They came in and they said, okay, this is patient, and these are our vitals. This is the. It was a handoff. And incredibly. And there's not too many people will argue with me about this. But they learned that from the airline business. The handoff of the patient from that room to the team, taking them to the. The surgery, so to speak. And I imagine you have those type of systems also in place that will protect the citizens that come in there and absolutely are lucky enough to have you.
[00:28:01] Speaker C: Oh, that's sweet, Michael. But yes, absolutely. We always give handoffs, sometimes physician to physicians, sometimes it's RN to the rn, depending the complexity of the patient. When we are sending patients over to the ER or when we are sending patients over to the specialist just to get us, you know, just to make sure that the transition is safe.
Some patients we have to send by ambulance, too, and we have to give report, you know, to the medics, paramedics, and they. And they take the patients over. So, yes, that, you know, transition of care is very important.
And, you know, the more we communicate, the better it is interpersonal, you know, between doctors and specialists. I think it makes a difference.
[00:28:49] Speaker A: Wow. Dr. Rukaya Fatima, you happen to see her in urgent care.
She's really a lovely person to have in charge of your care at that time. So what words would you like to leave? Health advice. Would you like to leave with our audience today? Good doctor.
[00:29:09] Speaker C: You know, I just want to tell people out there that we are right now in the midst of a flu breakout. And then I would recommend that everybody wash their hands frequently, don't touch their face if they're having fever, stay home and get your flu vaccines and cover your cough and.
And the more diligent you are, the more likely you will not get infected with the flu.
[00:29:40] Speaker A: Well, what an insightful conversation we've had today with, with the good doctor. So thank you for being on the show.
[00:29:47] Speaker C: Thank you, Michael.
[00:29:48] Speaker A: You're an amazing lady and we're just so blessed to have you.
[00:29:51] Speaker C: Thank you, Michael.
[00:29:52] Speaker A: So until next week, stay safe, try to stay out of the urgent care. But if you do, go to John Muir C Dr. Fatima, she'll fix you right up. And we'll see you on our next episode of Real Estate and more and have a blessed week.
[00:30:08] Speaker B: Please remember to go to our new YouTube handle, my real talk show. That's my real talk
[email protected] and touch that subscribe button. You can also find past air shows at our handle myrealtalkshow on YouTube.com.
[00:30:28] Speaker A: Sa.
[00:30:54] Speaker C: It.
