Careers in medicine and health care were all around AMA member Nariman Heshmati, MD, when he was growing up. His father, uncles and brother were all physicians, and his mom was a psychologist. Dr. Heshmati would play with toys sitting in his father’s medical practice and, when he was 10, he even set up his dad’s electronic billing for claims submissions.
While he was surrounded by doctors, what made the biggest impact on his future career in medicine was seeing the work his father did as a public health director in Florida. It is why Dr. Heshmati is where he is today as a physician, leader and public health professional.
“My father always believed that health care was a fundamental right and he designed programs around that concept. He ensured vaccinations for children and maternity care for mothers regardless of ability to pay or insurance status well before programs like those became mainstream,” said Dr. Heshmati, an ob-gyn at the Everett Clinic and president of the Washington State Medical Association (WSMA). He is also executive medical director for Optum Washington and represents WSMA in the AMA House of Delegates and is executive
“Growing up, I would constantly encounter people who, when I said my last name, would tell me a positive experience or outcome as a result of those programs. And that ability to help others and improve care really stuck with me,” he said. “When my father retired, they named the health department building after him. So now when I visit Florida, I take my kids there and show them the building and talk to them about the importance of making a difference in the community.”
In this exclusive Q&A with the AMA, Dr. Heshmati shared more about his journey, work in public health and dedication to helping patients however he can—including as a YouTuber.
AMA: How did you get involved in the AMA?
Dr. Heshmati: Similar to many AMA members, I got my start as a medical student. I grew up in Florida and did my undergraduate and medical training there. The first week I was in medical school, several of my professors highlighted the importance of being involved in both the state medical association and the American Medical Association.
At its core, we want to keep our communities healthy and provide health care to our patients. In order to be able to do that, we need the system around us to support us, not interfere or place barriers. State medical associations help ensure that at the local level and the AMA helps ensure that nationally.
I ended up serving as a medical student on the Florida Medical Association [FMA] Political Action Committee Board of Directors and a member of the FMA Strategic Planning Committee. I also spent a month embedded with the FMA lobbying team as a Gerald Schiebler Legislative Intern. They encouraged me to attend AMA meetings and get involved nationally, so I served on the American Medical Political Action Committee Student Advisory Board and never looked back. I made so many great friends at those first few meetings and saw how much of a difference involvement could make. I stayed involved as a resident and fellow delegate and now as a state delegate.
As a delegate for the Washington State Medical Association to the American Medical Association, I get the opportunity to partner with a team entrusted with the voice of Washington physicians. We bring our ideas, concerns and initiatives to the AMA to bring visibility to them and get support to take action. When you combine our voices with those of all of the other state and specialty delegations, we truly become a unifying voice of the house of medicine.
Twenty-two years later, I’m still in awe of the lifelong friends and colleagues I still see attend every meeting. Ultimately, my involvement—and that of everyone else—impacts my career by helping support my ability to see patients and provide care the way we would want to receive it ourselves.
AMA: How does your “DrNari” YouTube channel help educate patients on various ob-gyn topics?
Dr. Heshmati: Pregnancy can be a scary time. You just want everything to be perfect and go well. Sometimes things come up and those things can cause anxiety and it helps to be able to refer to a resource that explains the medicine in easy-to-understand terms.
I found, early in my career, key topics kept coming up that stressed out my patients like an echogenic intracardiac focus on the baby’s ultrasound—something that can commonly be seen on an ultrasound and is likely a normal variant but is also a “soft marker” for chromosomal abnormalities. The same topics and questions came up so much that I wrote out explanations I could give patients. I ended up making videos based on that information.
Since I live in Washington state, which has such a variety of beautiful geographic locations, I decided to pick a new site for each video. Once I almost fell into a deep hole of fresh snow trying to get set up for a video at Lake Wenatchee during the winter.
My videos have been watched over 400,000 times since I started the channel and I still get messages from families all over the world thanking me for the information. A few even sent me pictures of their kids growing up, which is so fulfilling.
AMA: How does getting involved in legislative and regulatory advocacy efforts help patients?
Dr. Heshmati: There are very few physicians in our state legislatures or in Congress, but those groups create the rules by which health care is delivered.
As physicians, we know what is working in health care and what is not. We need to help bring that perspective—and the voice of our patients—to our elected officials to facilitate things improving and not developing burdensome regulations that make things worse. Plus, if we are not there to give a voice to the realities of health care, others who do not have our patients as their priority will be there to fill that void and advocate for special interests that aren’t what we need.
In my roles with the medical association and as a medical leader overseeing advocacy efforts in my medical group, I focus on any issues that impact the delivery of care whether that is regulatory rules, scope of practice, cost of care or access initiatives. It comes back to helping create a health care system we want to be a part of and receive care in ourselves.
AMA: Why are you involved in so many medical organizations, and how does it help patients?
Dr. Heshmati: I stay active in all of these organizations because each of them has an important mission that has meaning to me. For instance, the March of Dimes has a mission “to create a world where every family, mom and baby are healthy and strong, regardless of wealth, race, gender or geography.” This is important to me not only as an ob-gyn but as a father to a son who was born preterm and spent 10 days in the neonatal intensive care unit.
I also have found that there are parallel missions with all of these organizations, and I try to bring them together to help magnify the impact that we can make. At the end of it all, the more involved we all are, the more we can help create communities we can be proud of and that take care of everyone.
AMA: Do you have any advice for other physicians?
Dr. Heshmati: Get involved. Whether it’s at your county medical society, state medical society, specialty society or the AMA—or all of them. Health care is one of the most heavily regulated areas, and we need to ensure that our patients are taken care of.
Physicians have consistently been one of the few groups who have advocated for patients—many of which aren’t in a position to advocate themselves—and we need to continue to do that to ensure we have a health care system we want to be a part of and one day receive care in.
I often hear from new physicians that they don’t have time to get involved or think it can’t make a difference. I’ll be the first to admit that this does take up time, but it also helps keep me feeling excited and energetic about the future of health care—a future we get to help create. And it is important to know that everyone can make a difference.
Every major initiative began as an idea in one person’s mind. Don’t let that idea float away and be forgotten. Get involved and let that idea go further than you could ever imagine.
