#MiFamMed Member of the Month

August 2022

Sahoko Little MD, PhD

Which practice settings/types have you experienced throughout your career?

I was trained as a plastic surgeon in Japan before moving to the United States in 2003. Since graduating from Oakwood Annapolis Family Medicine Residency (now known as Beaumont Health-Wayne Family Medicine Residency) in 2008, I have been working for the Department of Family Medicine at University of Michigan.

I started at Domino’s Farm Family Medicine clinic, one of the department's five clinical sites that housed the Japanese Family Health Program (JFHP). This program, established in 1994, provides linguistically and culturally competent healthcare for the Japanese-speaking population with limited English proficiency who live in Southeast Michigan. JFHP expanded to Livonia Health Center in 2014, where I have practiced since then in a group practice setting; 85% of my patients are Japanese speaking. JFHP currently is at two clinical sites with six Japanese speaking physicians and Japanese speaking staff including nurses, medical assistants, and clerks to serve patients’ needs. I took on the role of the Clinical Director of JFHP in 2020. I also precept residents at one of the resident clinics once a week, and I practice inpatient obstetrics, where I serve as director of Family Medicine Newborn Service.

During residency, I started on the inpatient wound care consult service run by family medicine faculty and a resident, and I continued to provide wound care at the plastic surgery clinic since joining University of Michigan. The comprehensive Wound Care Clinic was launched in 2014 at University of Michigan, where I continue to provide care of patients with chronic skin ulcers; here, I teach residents and students regularly. I also teach procedures to residents at the procedure clinic as well as using simulation tools I created. I enjoy teaching very much.

What led you to this career, and was your path inspired by anyone?

I did not understand medicine when I was admitted into medical school at 18 years old. I was born with a cleft lip and I had multiple surgeries between 3 months and 6 years of age. Even then, I still had significant deformity and my parents opted for no more surgeries until I was grown and could make the decision myself later in life. I refused to think about more surgeries and tried to deny my inferiority complex throughout childhood. Plastic surgery was the last specialty I wanted to go into. During my last year of medical school, I was thinking of going into a surgical subspecialty, and I thought it might be my last chance to get any surgery as surgical residents get no time off in Japan. I had two revision surgeries before graduation. It made me feel much more confident and I also met many patients who became much happier after their surgeries. It led me to choose plastic surgery as my profession in Japan.

During plastic surgery residency, I did 2-year rotations with general surgery and ENT, which gave me a breadth of clinical skills and knowledge. When I moved to the United States and decided to practice medicine here, I thought about the most important factor in medicine for me. I missed the aspect of personal connections with patients from my clinical experience in Japan more than the satisfaction I got from doing great procedures. In Japan, ENT and surgeons follow cancer patients after surgery for many years, administer chemotherapy, and provide comfort care when they die. Plastic surgeons follow children with facial deformity for many years and provide comprehensive support as a team and perform necessary surgeries. This aspect was what I really enjoyed, and it was meaningful to me. Family medicine was the perfect specialty to choose in the United States to meet my interests, and I can also use my skills I learned previously. When I started residency at Oakwood, I was very surprised at how nice faculty members are and that they took time to teach residents in clinical settings as well as by lectures. This was not something I learned in Japan, and I have been trying to do the same and model myself after them.

What has been the most unique aspect/experience of your practice of medicine thus far?

My uniqueness comes from my background of being a plastic surgeon in Japan with experiences in practicing general surgery, ENT, and plastic surgery. The skills and knowledge from this background led to caring for Japanese-speaking patients at Japanese Family Health Program, teaching procedures to learners, and clinical care at the Wound Care Clinic. I also write articles on health topics in Japanese language for a local newspaper to promote important knowledge about health and healthcare. Examples of topics include, “Folic acid for all women," “How to live in COVID pandemic," and the series “How to use the American medical system.”

What is one professional skill you're currently working on?

I am one of the current cohort of AAFP Leading Physician Well-Being scholars and learning how to implement the Personal Health Improvement Program (PHIP) and System Wide Improvement Project (WHIP), to promote physician well-being. I started a wellness project at the clinic where I work. Physician well-being is very important to all healthcare providers including AAFP members and MAFP members. Physician burnout is a serious issue. To achieve the triple aim of enhancing patient experience, improving population health, and reducing costs, improving the work life of health care providers is essential (Quadruple aim).

Why is it important for you to be a member of Michigan Academy of Family Physicians and American Academy of Family Physicians?

AAFP advocates for all family physicians and MAFP gives me an opportunity to serve and connect with the fellow family physicians in the state of Michigan. 

How do you achieve work-life balance and maintain your own wellness?

I don’t take up a large project unless it is very important to me. When I feel like I can do a little more, I only accept small projects. I run marathons and I schedule meetings and other events around my running schedule. I also love cooking and sharing the meal. I share food with friends every weekend and cook a large amount, almost like a caterer. For that reason, I don’t work on the weekend.

What book/podcast/Netflix series are you currently enjoying?

As English is my second language, I did not read a lot of books until I discovered that audio book works like magic, for listening while driving, cooking, and even running. Recently I read “Empire of Pain” by Patrick Radden Keefe, “Vaccine” by Joe Miller, “The Art of Gathering” by Priya Parker, and “Fallout” by Lesley Blume.

If you could choose one superpower, what would it be?

Teleportation. I spend so much time going to different groceries stores, and I hate using shopping services. I also travel back to Japan to see my family, which takes 15 hour each way.

Is there anything else you would like everyone to know about you?

I run marathons and I run in many races. Improving my time or placing compared to my past is very encouraging and makes me want to work harder. Although it is just a hobby, seeing improvement in results gives me motivation and joy.