Family Medicine Clinician Spotlight: Lee Haggenjos, MD

Adjunct Assistant Professor Lee Haggenjos, MD, faculty at the Willmar Rural Family Medicine Residency Program, provides full-spectrum family medicine care with obstetrics. He has worked in Willmar, Minnesota, since 2020 at Lakeland Clinic and Rice Memorial Hospital. He aims to improve the health of historically underserved communities and to meet patients where they are to move toward their health goals. He has particular interests in immigrant health, community health, LGBTQ+ care, addiction medicine, POCUS, emergency and hospital medicine, obstetrics and prenatal care, and medical education.

What brings you joy in practicing your specialty and why?

As a family medicine and obstetrics provider, for me one thing that stands out is the nature of the medicine that we get to practice within family medicine with obstetrics. Certainly, the part of family medicine that's really unique and interesting is the continuity that we have with patients and families over time and the ability to be embedded in the community. We get a sense of what things look like, not just for the interesting conditions and diseases that we care for, but specifically what my patient needs and getting to be involved in their care long term.

My expertise is my patient, and not one specific disease that arises. It's the trust that I build with my patients. I try to leverage that to assist in whatever my patient needs across that domain or spectrum of their life. It includes the uniqueness of obstetrics and birth as well, which is a passion of mine.

The second thing is the ability to advocate for improvement and the changes that we hope to see for health equity as well. A lot of the reasons that I'm practicing where I am is to not only serve the population, but also to work in underserved medicine and to try to shine a light on what we can do as a system to make that piece better.

Because I'm in rural family medicine, I can work in the ICU, I can work in the ED, go to the labor and delivery floor, and I can move between all these different types of care that my patients may need. But at the same time, I also have a lens as their primary care provider to try and work at the system level about the needs of our underserved population. These are the things that speak to me and why I chose family medicine.

Why did you choose family medicine?

Apart from my answer to the first question, the only thing I would add is I had a little bit of a bias coming from rural Indiana. There, family medicine was kind of the only type of medicine—that was the lens I used to see how healthcare was delivered.

When I was looking into what path I would take in medical school, I had the good fortune of having mentors who had similar passions—and they happened to be in family medicine. And so I had this thoroughfare of moving me along that pathway and seeing how I could work through the things that I mentioned within that specialty.

I considered a couple of other specialties, but I always felt that I didn't have the ability to do what that specialty wasn't touching. When I was doing emergency medicine, I felt like I didn't have enough obstetrics. When I was looking at general surgery, I didn't have enough of the continuity or the relationship piece. Family medicine is a great way to allow for all of those things to be there.

What advice would you give to yourself as a physician just starting out?

I think about just starting residency and taking on that position as a physician for the first time—since I'm not terribly far removed from my training. At that time, I was looking to build up my competency as much as I could.

A lot of the pressure that many trainees feel at that step is the idea of how good you are. If you're good enough, you can do this and the immense amount of things it seems that we have to do in order to be good enough. By and large, with more time, the way that medical education is structured and the way that we work amounts to an apprenticeship.

As one of my mentors used to say, “You have to trust the process.” You have to allow for where you are right now, likely not having that expertise, and accept the fact that you're only going to be able to get so much in that step. But the supports around that training process and everything else you've done will move you to the next place. Because the reality is that all of us are good enough to do this. It's just a matter of what skills we have and what our goals are, and things take time.

I left my formal training not having mastered colonoscopy. That was something that I took an extra initiative in following that formal training in order to successfully continue that piece. But there are a lot of other things that change, even as we move through training. The things that we felt we had a comfortable mastery of—they can change too.

There's always something that humbles you in how you approach what we're doing in family medicine. For me, that’s the key: It's not just a one-stop thing. It's a process.

What do you enjoy doing in your spare time?

I do a lot of music. I was a music major as an undergrad. I enjoy listening to music and making music.

I have two kiddos, a four-year-old and a two-year-old. So, most of what I do is just spend time with them. We also very much like to travel. We've traveled more in the past couple of years than we had previously. On a more day-to-day basis, I really enjoy cooking and just kind of being at home in general.

What are your key messages when teaching residents clinical care?

I think there's two sides to that. With trainees, one of the things that I try to start with is assessing where they are and what their goals are, even on a day-to-day basis. This could be what they're hoping for the day or what kind of patients they want to see.

It can be challenging when you're bogged down in day-to-day demands to see how that fits into the long term. So I try to provide focus on that piece for trainees. What goes along with that is trying to communicate that you're here for a reason. You're not expected to know how to do all these things. If you did, you wouldn't be here.

One of my other mentors said, “You're all terrible doctors, and that's what you should be because you're here to learn how to become good doctors.” You do not start out as an excellent clinician; you start out not being good at this and you learn how to become good at this. That's why you're here. I believe taking that to the forefront can be helpful.

Lastly, the training that we have is something that cascades. It's a mentorship process, and a lot of it is informal. So I usually tell trainees to think about what they saw in those who were just a level or two above them. What did they see that made them want to take that next step? Because if you're able to identify that person—maybe it was a fourth year who helped you understand how the ward worked or how to organize a presentation—then when you're a fourth year, you can help to do that for someone in their third year or vice versa as you cascade down.

Because at every level, when you understand what it was that helped you take that next step— that allows you to be that inspiration for someone else.

What are you especially proud of when you consider your clinical career so far?

I think it is a challenging question for those in family medicine. We don't tend to be that ostentatious in our daily accomplishments. For me, the dedication that I have in working with my patients and trying to mobilize our system and our care around their needs. It’s seeing that continuity across the spectrum of their care. Being able to see a patient in the emergency room and get them connected to care, getting them on medication, helping them finally get the coverage that they otherwise hadn't had before, or helping to deliver their child. I know doing these things has made a meaningful difference in several patients' lives.

Aside from that, a lot of the advocacy that we're doing at the local level and above can really help to reframe how we approach this and how we keep the humanity of what we're doing in healthcare for our patients. I think that's probably the biggest thing for me.

What do you hope to achieve in the years to come?

We're starting a residency program here in Willmar, Minnesota. There's been a lot of effort in terms of how we look at what rural training in rural areas looks like. There's a big part of that for me in this next step. Long term, I hope to have the ability to contribute more to teaching.

But in this next phase, I would say that I look forward to helping to define how we look at this phase. Because in the way that we've looked at rural training and rural healthcare, there's been a particular blindness. I think the reality of what rural healthcare and our patient population look like is quite different from what the narratives and many other spheres and political spaces look like. Recognizing the diversity and the equity of what the challenges and the needs of our patients are—and bringing that into how training is done—is what our next trainees are looking for.

In addition, I hope to empower those who are either from a rural background or looking for rural practice or not even sure and just thinking that they really enjoy certain aspects of what I do—like the breadth of the care, the continuity, the ability to have that social bond that's somewhat different than practice in an urban setting or otherwise.

But at the same time, acknowledging that that does not mean that you have to choose between these other considerations of equity or advocacy; these things run hand in hand. There is a diversity of perspective and a need for providers who are able to deeply understand and take on the humility of trying to meet patients where they are and be there for them.

So, one of the biggest things that I'm looking forward to is helping facilitate that process. Because, for a long time, much of how our training has been done has been structured such that you go to the expert. You typically go to those who are most revered and have published the most at the biggest institutions, oftentimes centrally located in a big, urban setting.

A lot of the voices and the perspectives that we look for in the care that is needed in a rural setting—or even in an urban setting removed from that structure of care—is quite different. I look forward to being a teacher who's allowing our trainees to see what that looks like and understand that it's possible to train in that way. It's possible to have a fulfilling practice and have an academic career without necessarily having the barriers to care and access that sometimes come with the more structured and tiered model that has traditionally been part of medicine.

That really excites me. It allows for a lot of ways to bring family medicine into what has sometimes not been as celebrated: the expertise that we bring as rural-based academic physicians and what we bring to the healthcare system.