By Dan Murphy
Meet Dr. Elizabeth Natal, the new director at the Family Health Center at St. Joseph’s Medical Center. Natal joined St. Joseph’s 10 months ago, succeeding Dr. Craig Orvieto. She brings eight years of experience working as a full-time clinician at H&H Health Center at Tremont in the Bronx, which was the ambulatory clinic of the North Central Bronx Hospital/Jacobi Medical Center.
In addition to serving in the clinic’s leadership team, Natal hosted medical students for clinical training and utilized an interdisciplinary approach to effect positive systematic changes within the clinic to help serve the needs of patients and residents in the low-income, west Bronx neighborhood.
Natal recalled that as far back as medical school, she had an interest in administrative work and teaching. During medical school at New York Medical College, she revised a summer program held for students from underrepresented backgrounds. The changes were meant to be a “stepping stone” for students as they integrated through the medical school curriculum.
As she neared graduation, Natal knew that academia and administrative work were going to be a part of her vocation. She applied to a residency program that offered a faculty developing fellowship in teaching at the Montefiore Medical Center’s Residency Program in Social Medicine.
Her work at Montefiore included administration in the educational-curriculum-clinical committees. During this time, Natal became the director for Montifiore Medical Center’s Summer Health profession internship, known as Monte-HOP (Health Opportunities Program).
This program was tailored towards high school senior and college students from underrepresented groups with an interest in medicine. Initially, the program’s focus was an obstetrics summer program, but under Natal’s guidance, the program was expanded to include exposure to a multitude of health professions and experience. Natal implemented a similar program for first-year medical students at Albert Einstein’s College of Medicine who were interested in early exposure to primary care.
During residency, Natal became involved in the Bronx-Westchester academy of Family Physicians and continued with the academy beyond residency, eventually transitioning into the role of BWAFP president for three years. During her time at BWAFP, she met Dr. Sonia Velez, St. Joseph’s Medical Center’s residency program director, who was instrumental in recruiting Natal to St. Joseph’s.
Following the completion of her fellowship, Natal continued her work at Montifiore, Albert Einstein and renewed her relationship with her “alma mater” New York Medical College, holding positions at all three health care institutions.
Natal said her professional experiences, most recently at H&H Health Center, have taught her valuable lessons of great effort and teamwork that are required for effective change. Natal’s ability to communicate her passion, and her enthusiasm to treat patients, enables her to be a motivator and teacher. Her prior experiences in health care have prepared her well for her new job at St. Joseph’s.
Ten months into her role, Natal continues to absorb and digest and learn. “It’s best to experience the practice and then work with administration and clinical staff to utilize a disciplinary team approach and create well thought out changes,” she said.
Natal has a wide ran of ages of patients to think about and she accepts the challenge with a bundle of personality and self-assurance. With new renovations coming to St. Joseph’s, Natal said she is interested in creating a Chronic Disease Group, consisting of a dietician, social worker and physician to serve patients, with the ultimate goal of creating different treatment groups to treat various chronic diseases.
She successfully ran an English/Spanish diabetic group at the Bronx Clinic.
The other challenge Natal, and every doctor, faces is: How do you ensure that patients properly take their prescribed medications? “How do you know if they can afford them?” she posed. “How do you know if they understand what the medication is? Other issues may take priority over taking their medications, like food and housing. We need to take this into account each time we see a patient and prescribe a medication, where non-adherence can lead to poorer health outcomes.
“The main focus of the Family Health Center is to make sure our physicians care for the family unit. It could be one person or a multi-generational unit. We at St. Joseph’s Family Health Center want everyone to have a dedicated family doctor of their choice, and to have continuity of care, with the ultimate goal to partner with our patients to help them take charge of their health,” said Natal.
Diabetes is one form of chronic care that Natal has a focus on, and not only in treating the disease, but in its causes in patients. “The problems may not just be diet and exercise, they may be cultural, as well,” she said. “For many in higher-risk populations, there can be a genetic component in the development of this disease.
“Cultural practices can play a significant role in the development of various medical diseases. Exposure to unhealthy food choices and practices may start early in some cultures. We need to have the discussion about how to move people who are used to certain foods to healthier choices, and share recipes, give them pedometers to count their steps, and encourage exercise.
“You have to try and see everything through that prism and work to treat diabetes, which when uncontrolled can lead to a multitude of problems and significantly impact your quality of life,” continued Natal. “Prevention, diagnosis, treatment, administration, education, training all are key.”
Patient follow-ups are important, too. “Once patients are seen and you have a baseline, you can then see what their needs are, and try to follow up with a specified time frame for treatment,” she said. “We provide care to a variety of patients, who can walk into the center to schedule an appointment. Some come through the ER and some are referred here. Some have insurance and some do not. We also provide geriatric day care in this building, which includes physical therapy, occupational therapy and speech therapy.”
St. Joe’s is unique because it remains an independent hospital. While it has medical affiliations with Montifiore, it is not owned by NY Presbyterian or Northwell. Natal sees that independence as “good because it gives you an advantage of being independent, but it also has its challenges.”
St. Joseph’s Medical Center is a non-profit hospital whose motto is to treat everyone, regardless of their ability to pay. A charity fund for those who are indigent after submission of an application provides significant discounted rates for those without insurance. Sometimes the state or federal government helps pay for the treatment of those who cannot afford the bill, but at St. Joe’s, everyone is treated.
And that is the mission of Dr. Elizabeth Natal – to teach the next generation to become doctors, and to treat those in her community that need care.
Natal was raised in the Bronx and just recently moved to Yonkers. The patients she now sees in the Family Health Center are similar to the population in the Bronx, but more diverse and multicultural. She is fluent in Spanish. In addition to serving as director of the Family Health Center, Natal is a faculty member of the residency program, giving her direct contact as an advisor and teacher to resident physicians learning at St. Joseph’s.
We hope Dr. Natal stays in Yonkers, and at St. Joseph’s Medical Center, for many years to come. Yonkers is lucky to have her.
The Family Health Center at St. Joseph’s is open six day a week, from 9 a.m. to 8 p.m. Monday through Thursday, 9 a.m. to 5 p.m. Friday, and 9 a.m. to 3 p.m. Saturday. It ais located at 81 S. Broadway.
