Family Medicine on a Mission Part 4: ABFM Interviews Dr. Ian Solari

By Aaron Burch

Lt. Col. Ian Solari is an ABFM Diplomate deployed to St. Vincent and the Grenadines for two weeks as part of the LAMAT humanitarian mission. He provided nearly two weeks of patient care, largely at Kingstown’s Milton Cato Memorial Hospital

There, Dr. Solari worked alongside local physicians in the emergency department for eight days before moving to the Air Force’s two-day health fair to conclude the mission.

On the last day of his clinical care in St. Vincent, Dr. Solari sat down with ABFM’s Aaron Burch to discuss how family medicine and military service coexist. This is that conversation, edited for clarity. You may also listen to their discussion on The ABFM Podcast’s newest episode, out today. (link)

ABFM: Dr. Solari, thanks so much for doing this. To start, can you explain how your relationship with the Air Force Reserves began?

Dr. Ian Solari: I joined around 2019. It was a decision that had been in the works for a while. I was introduced to the Air Force at the University of Virginia where I did my residency. There were a number of providers there, one of [whom] was Col. Brian Neese (LAMAT strategist and now Command Surgeon of SOUTHCOM). He and Col. [Scott] Strayer [retired Air Force Colonel and ABFM Diplomate] were my mentors, and they introduced me to the military.

In 2019, I joined the reserve. I got assigned to Travis Air Force Base. Travis specializes in mobility. They move things. There, I was assigned to ASTS – an Aeromedical Staging Squadron. Our mission was to set up small medical tents when we’re deployed in a military or combat environment. We can transport wounded from this point of care on the battlefield to a higher level of care.

In the reserve, commitments are one weekend a month, and two weeks of the year. It’s been a great experience. I became a flight surgeon specializing in aerospace medicine. They do a lot of really cool things. The camaraderie has been a big draw for me. I like the people I work with. I’m proud of what I do.

It gets me out of a civilian type of practice and into variable situations like this. You get to stress yourself a little bit and put yourself in positions where you are a little uncomfortable. I like that. I think it makes me a better doctor back at home.

Working with limited resources, you learn tricks of the trade you wouldn’t think of when you have everything at your fingertips. And the doctors here know stuff you’ve never thought of too. They work in this type of environment all the time, so it’s a collaborative effort that I appreciate.

ABFM: We’re a week and a half into the mission. How are you feeling about your experience so far?

Dr. Solari: I really enjoy it. To me, these things come down to building relationships: meeting people, learning their culture and learning how they live. How do they get to work? How do they interact with their government? Those are all interesting things. Overall, it’s been a really good experience.

You’re away from your family, which is always difficult, but it’s a short time frame where you can get a lot done. Every day is pretty full.

ABFM: What hurdles of patient care have you overcome in your time here?

Dr. Solari: Several things. There are different language barriers sometimes, different dialects. Medications are different. Orders processing in the hospital, all different.

Also, the nurses interact with their providers a little different here. So, learning their nuances and how they work together can be a challenge. You’re trying to help, learn, and work together, and when you’re in a busy environment, you have to pick up things pretty quick. It’s a juggling act.

ABFM: In the emergency department this morning, we saw a UTI, we saw constipation. These are very common ailments. What did you see this afternoon?

Dr. Solari: I really didn’t see too many unusual [cases] on this trip. There’s a lady who came back from the neurosurgeon with a brain cyst. She had been there a number of times. We tried to figure out the process without having a very robust specialty system and being unable to communicate through electronic medical records.

It was a process of trying to work out ‘what’s the best situation for the patient?’ Should we admit her or have her go home? Unfortunately, she was still getting worked up when I left. Those types of situations are different and challenging. You have to hope they work out.

ABFM: What is your relationship with continuing education and certification, in civilian life and in the Air Force?

Dr. Solari: The Air Force has continuing medical education [requirements] called the Comprehensive Medical Readiness Program (CMRP). Those include acute minor procedures, outpatient care, a certain number of patients, a certain number of hours, pediatrics, and women’s health. Throughout our time here, we’re all working on that.

We all work to help each other out. There’s a lot of training and lectures we can offer. Yesterday I gave a lecture on traumatic brain injury. We help each other progress through those CMRPs. It’s a similar thing to CME for board certification.

At the end of the day, it comes down to seeing the patient and working things out. I find teaching to be even more valuable. You get a lot out of it. Those opportunities translate to my practice seeing patients.

ABFM: What will you remember from this experience?

Dr. Solari: I did my medical school at St. George’s [in Grenada]. A short portion of it was spent here, and I did have to go to [Milton Cato] hospital as a medical student. I remember walking in some of those hallways 20 years ago. For me, it just brings that back. It’s full circle in a way.

It’s hard to believe it’s been 20 years. It’s a good feeling because at that time I was in a different stage of my life. To know I’ve made it to the point I am now makes me proud, and it continues to make me want to do more. That’s what I’ll remember the most. That’s why I wanted to do this mission.

ABFM: Could you tell me more about your time as a medical student?

Dr. Solari: It’s a similar type of thing to [LAMAT]. It was all about overcoming hurdles and figuring out how to make things work when you don’t have what you’re used to. Meeting new people, making new friends, figuring out how to get through medical school. There are a lot of challenges.

Medical school was tough, but I did it, and it makes me really proud. St. George’s was a good school, and it put me in a position where I could succeed.

ABFM: Thank you so much again for speaking with me. Do you have any final thoughts?

Dr. Solari: The reason I do what I do is because I love my country, and I’m proud to serve. The types of things I’ve gotten to do have been amazing, so I’m looking forward to what comes next.

Aaron Burch serves as Editorial Content Manager for the American Board of Family Medicine. He has been writing professionally in the health care field since 2014.