On their way: Alicia Agnoli focuses on community health issues

In 2009 Alicia Agnoli spent a summer in Varanasi, India, working in an urban clinic and studying their community health infrastructure. Here, she rows the Ganges River. — Courtesy Francine Agnoli

On Their Way is an occasional series in which The Times introduces people who grew up on Martha’s Vineyard and have moved on to establish themselves in careers on or off Island. We are looking for young people who have distinguished themselves by their accomplishments in the arts, business, in social services, in the military, in academics, in fact in any meaningful way. We welcome your suggestions.

Alicia Agnoli of Edgartown is in her second year of a three-year medical residency in an innovative family practice clinic in Malden where she works with a caseload of about 500 patients of all ages, ethnicities, and walks of life. The 30-year-old works about 80 hours a week and loves her work. She plans to eventually add a public health component to her work as a physician.

“I pretty much always knew I wanted to be a doctor from my days growing up on the Vineyard,” she told The Times in a recent telephone conversation.

Alicia attended the Edgartown School and graduated from the Martha’s Vineyard Regional High School (MVRHS) in 2001. Her father, Jeffrey Agnoli, a former English teacher, retired last year as guidance counselor at MVRHS. Her mother, Francine Agnoli, works in real estate in Edgartown. Her brother, Micah, is a senior in college, and her sister, Jona, a mother of three and a nurse, has finished training to become a nurse practitioner.

Alicia has always managed to maintain a balance between sports and academics. She played soccer, basketball, and tennis in high school. Now even with her busy work schedule she finds time to play tennis when the weather permits, but she considers herself primarily a cyclist, riding both her city cruiser around town and her road bike on longer rides.

The Malden clinic, part of the Cambridge Health Alliance, is developing a new model for primary care called a patient centered medical home (PCMH). “We consolidate care for patients in one place,” she said, “where the care is very carefully coordinated across disciplines with an emphasis on prevention, which reduces the need for sick care. Prevention is a lot cheaper.”

An important component of the PCMH model is team-based care, which utilizes an interdisciplinary team of doctors in consultation with clinical pharmacists, dietitians, administrative staff, and nurses, Alicia said.

She is one of 24 residents and 12 attending physicians in what she said is one of the last public health care clinics in the state. Some of her time is spent covering in the community hospital where her patients are admitted. She sometimes works on the labor and delivery floor of the hospital.

A resident’s workweek is limited by regulation to 80 hours a week. Alicia said that she usually doesn’t have a problem staying under that limit. Her work varies from week to week.

Her plans for a future as a physician, her desire to work in public health, and her interest in social justice began to coalesce at Princeton University where she studied a little bit of everything. She took on a broad liberal arts course of study and finished necessary pre-med courses while earning a degree in anthropology in 2005.

“I loved the anthropology department,” she said. She wrote her senior thesis on the role of community in a children’s hospital.

She moved to Boston after college and worked for three years before entering medical school. Her jobs involved clinical research in epidemiological at the Harvard School of Public Health and studying ways to optimize treatment in clinical trials in cardiology at Brigham and Women’s Hospital in Boston.

In 2008, she enrolled in the Tufts University School of Medicine combined MD and Masters in public health program, which she found to be a natural complement to her interests.

“I found the public health work to be a necessary context in which to do the medical training,” she said. “It is very grounding when you are up to your eyeballs in basic sciences, the pre-clinical medical training, to have that broader public health context in which to appreciate things.”

During her time at Tufts she spent a summer in India working with an urban clinic and studying their community health infrastructure. She also found time to play basketball on a medical school intramural, co-ed team. Her independent research focused on addiction medicine and treating dependence in the primary care setting.

“I would love to see universal health care in my lifetime, Alicia said. “In time, I’ll settle for a better model that gives better quality care for a cheaper bottom line,” she said. “It’s really exciting. We have a lot of enthusiasm and excitement.

Alicia is considering a fellowship in health policy in primary care research after her residency.

“I would ultimately like to have a career that combines public health research and public policy advocacy work as well as clinical care,” she said. “Perhaps in health care administration, running a community health center, or working with a public health department, doing more community health research and advocating public policy on a community level.

“It is a pretty exciting time to be analyzing the things we are trying out and finding ways to make them better and making it happen. That’s definitely where my passion is.”