When E. Linda Villarreal, MD, tells you, “My passion is medicine,” purer truth is hard to imagine.
The Edinburg internist has pursued medicine – and the betterment of the profession – through every conceivable end and repeated personal trials.
There was a career change – leaving behind a decade-long first career as a pharmacist – before Dr. Villarreal finally pursued the physician career she envisioned when she was a young girl. Along with that, there was a judge forcing her into a snap decision: Choose either medical school or custody of her children.
And there’s been tragedy along the way, too, in the sudden death of her mother and the death of her beloved husband of 25 years from cancer.
Through it all, Dr. Villarreal’s passion for her career – and organized medicine – has never wavered. So when she becomes president of the Texas Medical Association at TexMed 2021, TMA’s 55,000 physicians will have a leader who’s both determined and battle-tested.
What she plans to battle for, first and foremost, is protecting the medical profession – restoring for both patients and physicians the concept of the “medical home,” with warm, personalized, and comprehensive primary care. Reinforcing the soul of medicine is not a new fight for “Dr. V.,” as she’s commonly known; in fact, it became her focus around 30 years ago, when she first went to work in a hospital and began a vocal internal push against corporate influence and its impact on hospital operations.
Now, she says, her priorities for her presidency have come full circle.
“Once you put yourself in that pocket of seeing any profession from the inside out, you start to see things that maybe you’re not too comfortable with, or maybe you don’t like how it’s changing,” she told Texas Medicine. “That was my impetus. I wanted to preserve the profession of medicine, the Dr. [Marcus] Welby kind of style, and make sure that patients had access to health care even when they went to the emergency room and the hospital.”
Crucially for this era of medical practice, Dr. Villarreal will also bring decades of firsthand experience serving the Rio Grande Valley, a region that illustrates many of the reasons for an increasing focus on the social determinants of health.
Trials and tragedy
Dr. Villarreal still remembers what medicine used to be – especially because it’s why she pursued a career in it in the first place. She believes it can become that again.
Growing up in Edinburg as the only girl among seven children, she always wanted to become a physician because of her childhood struggles with asthma – and the personal, patient-first care to which she became accustomed.
“The family doctor sometimes had to make house calls, and my [mental] picture of him is not in his office. The picture I have of him, he’s parking his Cadillac in front of our house, walking up the sidewalk to the house to take care of me,” Dr. Villarreal said. “And that just opened the concept of wanting to be a doctor like he was, and take care of people regardless of where.”
Getting to that point, though – and returning to and settling in Edinburg – involved what she reverently calls a “scenic route.” Her mother provided steadfast financial and emotional support for her drive to become a doctor. But Dr. Villarreal married young, and her first husband wasn’t on board with her going to medical school.
“He said, ‘No, that takes too long. Why don’t you do something else?’” she recalled. “I was 21 years old, so what was I going to say – no? I had family members who were pharmacists, and they encouraged me and said, ‘OK, don’t give up on medicine. Why don’t you go to pharmacy school?’ So that’s what I did.”
She earned her bachelor’s in pharmacy from the University of Texas at Austin in 1970, then began her pharmacy career at Methodist Hospital in San Antonio. Over 10 years, she worked in several different pharmacies, building a working knowledge of pharmacology that escapes the training of most medical students. It was invaluable background for when she decided, at long last, to give medical school a try.
Her mother’s dependable support remained intact. Her husband, however, ended up with the same view he had held a decade earlier.
“He was initially supportive, and then he wasn’t supportive. By that time, I had two little boys, and I felt like I needed his support. Bottom line is, he decided he didn’t want me to do that, and I just made the decision that yes, I was going to do that,” Dr. Villarreal said. “So the marriage failed.”
As a medical school applicant, she was “10 years older than your average bear,” and she found herself short on time and money to apply. She decided to attend Universidad del Noreste in Tampico, Mexico. But as the 1970s became the ’80s, Dr. Villarreal was engaged in a custody battle over her boys, who were 9 and 4 at the time. Her brothers acted as her attorneys.
“My two brothers come into the back room and say, ‘OK, we have some good news and some bad news. The good news is, you can get your kids. The bad news is, you can’t go to medical school.’
“The judge had been told that I would be leaving the country, had no means of support, and therefore, if I chose to leave the country to go to medical school and – the word was ‘abandon’ my children – that … gave him no choice but to award custody to their father.
“I asked my brothers, ‘When do I have to decide?’ And they said, ‘You have five minutes.’ Here I was again trying to get into med school, and again, an obstacle that was making me choose.”
In the hardest decision of her life, Dr. Villarreal chose medical school. She headed to Tampico, driving back across the border every weekend to see her children under visiting custodial rights.
“It’s kind of hard to say I would never do it that way again, because I would miss out on the experience, the culture shock, meeting new people,” she said. “I was able to get my third and fourth-year clinicals done in San Antonio, so it was only two hard years of living in Mexico and trying to adjust to that culture. But I made it through, and I was lucky enough to get my residency and my internship and so forth. At that point, my boys were bigger, older, and they understood my decision.
“There’s a lot of pain involved in that little town where I grew up as far as being the woman with the red letter on her forehead. But I overcame that as well.”
Dr. Villarreal had told herself she wouldn’t leave Texas for her training. So of course, her internship took her to Cleveland, Ohio, where she focused on general adult medicine at Huron Road Hospital. Then came residency at Texas Tech University Health Science Center in El Paso.
The week after she received her medical license, the unthinkable happened on June 3, 1989: Her mother was killed in a head-on collision.
Dr. Villarreal, who had recently landed a job in Dallas, returned to Edinburg and never left. She opened Memorial Medical Clinic and began her private practice in internal medicine in August 1989. The following year, she also joined the staff of Edinburg General Hospital, where she became chief of staff.
“The good thing is, by the time I came back to Edinburg, it was a much different, thriving city, my family was well-known in the community, and suddenly the truth about all of that custody [issue] came out,” she said. “I’ve been in the same building for 30 years. Edinburg has been good to me, and I have been their physician.”
Thus ended the scenic route that took her to her true professional home and her geographic one. While her mother never got to appreciate her service to the community as a physician, Dr. Villarreal has always felt her spiritual presence.
“So many people that knew her said, ‘Well, she got you home one way or the other.’”
The year ahead
She couldn’t have known it at the time, but what Dr. Villarreal observed from her first days back in Edinburg would set the stage for how she’ll lead TMA over the next year. At the time, she had those childhood experiences in mind with her family doctor, who would see his patients wherever they needed to be seen.
“As I started my career as a physician in the community, I saw that that idea really wasn’t popular anymore,” she said. “People were being seen 8 to 5, Monday through Friday. And I keep thinking, ‘Illness does not have a day of the week, or a time of the day.’”
About five years into Dr. Villarreal’s career, the president of the Hidalgo-Starr County Medical Society (HSCMS) drafted her to become part of its executive committee, and her work as a physician advocate begun. It springboarded her into eventual roles as HSCMS president, Texas delegate to the American Medical Association, and a long list of TMA board, council, and committee roles, including chair of the TMA Board of Trustees. (See “Bio Box,” page 19.)
Her biggest platform to date will give her the best chance to advocate for the best parts of the profession she fell in love with.
“We’re losing the sense of the medical home,” she said. “We’re losing the concept of, ‘I am your family physician. If you have questions, then call me. If you have to be seen, I can see you. You don’t have to go to the emergency room. You don’t have to see a specialist for every little thing.’
“I certainly appreciate [specialists] as well. The Rio Grande Valley was held hostage for many, many years because we didn’t have specialists. Now, there’s no shortage of specialists. But I want my patients to know that before we send you to a specialist, that we sit and talk, [have] the dialogue, I’ll examine you. I always like to tell them I’m an internist, and I can examine everything from head to toe, and then together, we plot … how we can fix what you might think is broken.”
While the COVID-19 pandemic will undoubtedly affect the direction of her presidency, Dr. Villarreal hopes vaccine distribution will lead to significantly improved herd immunity, and physicians can continue to use expanded telemedicine where appropriate while regaining “that face-to-face trust” from patients. Preserving physicians’ scope of practice will also be a focus of her leadership.
‘You don’t know the Valley’
Dr. Villarreal also anticipates using her experiences in the Rio Grande Valley to emphasize social determinants of health. She says she sees the importance of those social factors when, for example, she directs a patient to take a medication with food, but the patient needs trust and coaxing to admit that he or she has trouble obtaining food at all.
“Throughout my organized medicine career when I served in different committees, I would always have to stand up and say, ‘You know what? You don’t know the Valley.’ The Valley deals with a million people that are not residents,” she said. “The Valley deals with unemployment and low socioeconomic levels that do not allow a large portion of the population to be able to afford insurance. That was my mantra, so to speak. I said, ‘You may have a little bit of this problem, but physicians along the border and in the Valley are dealing with it all the time.’”
Dr. Villarreal’s second husband, Donald White – whom she considers her first – died from leukemia in 2015. In October 2020, she married Paul Frey. She has seven grandchildren.
“My heart is in the right place. I have been supported by my colleagues. I have been supported by my family,” she said. “I was lucky enough to be married to a person for 25 years that I was his number one job: to support me and what I wanted to do. If I needed to be at a meeting in Austin at 7 am, he would drive starting at three in the morning. So I’ve been very lucky that has allowed me the time and given me the energy to do what I want to do. My passion is medicine. It is who I am, not what I do. My sons understand that. Even my grandchildren now understand that.
“I was lucky and blessed to have another individual find me and ask me to marry him. I’ve continued receiving blessings in an individual who supports me in my passion for medicine. I think as the TMA president, that passion will come through.”
Tex Med. 2021;117(5):16-21
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