Doctor, Advocate, Educator

After four years of medical school and three of residency at Brigham and Women’s Hospital in Boston, Alexandra Bachorik decided it was time to go back to school once more — this time as a master’s candidate in the Specialized Studies Program at HGSE. And Bachorik is dedicating her year at HGSE to a specific purpose: women’s health advocacy.

Even as an undergraduate, Bachorik was interested in the way gender influences health outcomes. As a medical student, she cared for women from different backgrounds, communities, and socioeconomic statuses. Yet she noticed a commonality: When women did not have proper access to contraception or adequate information about women’s health in general, it could have devastating effects.

“When these [basic healthcare] needs weren’t addressed, it really had an impact on my patients’ physical, emotional, and financial stability,” Bachorik says. “So when women didn’t have contraception or experienced early complications of pregnancy, I saw how access to reproductive health care could drive a patient’s health outcomes.”

While the American Board of Internal Medicine does identify certain core competencies for women’s healthcare, like breast exams, medical literature shows that primary care physicians don’t provide counseling about contraception as frequently as is medically indicated. Studies suggest that this is due, among other things, to inadequate knowledge or comfort with the subject matter on the part of the physician. As a result, physicians will often refer patients to a specialist, such as an OB/GYN, instead of providing these services themselves. Bachorik points out that these referrals take time and any kind of delay could result in an unplanned pregnancy. Additionally, not all patients have the same kind of access to a knowledgeable OB/GYN.

“As an internist with training in women’s health, I could identify and meet a need for contraception in one visit, instead of sending a patient to an OB/GYN,” Bachorik says.

After graduating from medical school and entering residency, Bachorik worked to develop her clinical skills and knowledge so that she could reduce barriers to access to reproductive healthcare for her own patients. However, while she developed these clinical skills, she also developed an interest in education.  

“I realized I loved teaching and mentoring — and that working to improve education around reproductive health was a way that I could improve access for not only the patients that I saw, but the patients of the learners I work with,” says Bachorik.

As a student at HGSE, Bachorik hopes to develop her skills in curriculum design to create effective educational programs in women’s health for internists. She is particularly enthusiastic about the Specialized Studies Program because it has allowed her to select classes that she feels will allow her to refine her toolkit as an educator and as an advocate. She plans to investigate different learning styles to build curricula that can allow all kinds of learners to develop facility with methods of evaluating educational interventions, so she can ensure the curricula she builds are effective. She also hopes to build skills in negotiation to persuade other doctors about the importance of women’s health and contraception in primary care.

“It’s important to me that internists feel empowered and comfortable talking with patients about their reproductive health,” Bachorik says. When asked about advocacy work on campus, she says, “Right now, I’m really just trying to work on absorbing everything I can from my classes and juggling this with my work as a relatively new primary care doctor. But if you see me on campus and want to talk about reproductive and women's health — I'd be happy to talk to you about what I know!”