Maggie McKay: This is Meet the Provider, presented by Beebe Healthcare. I'm your host, Maggie McKay. And today, we're getting to know Dr. Ryan Arias, the core faculty member of the Family Medicine Residency Program at Beebe Healthcare and Doctor of Osteopathic Manipulative Medicine.

When it comes to the Family Residency Program at Beebe Healthcare, the educators behind the scenes are as important as the residents they teach. We have the pleasure of getting to know Dr. Arias and find out what he does, what he loves and more.

Dr. Arias, thank you so much for making the time to be here today. To begin with, will you please introduce yourself?

Ryan Arias, DO: Hello, I'm Dr. Arias. I'm one of the core faculty members for Beebe's newly established Family Medicine Residency Program. I did all of my medical training down in North Carolina. My alma mater is CUSOM or Campbell University School of Osteopathic Medicine and did my residency there as well down in a smaller rural program called Harnett Health. And then, we moved on closer up to family here in Delaware.

Maggie McKay: And what got you interested in being a faculty member?

Ryan Arias, DO: I knew pretty early on in my residency career that I liked teaching. I would always find myself just a little bit more bored when medical students weren't around. So as a resident, you have some ability to teach medical students. And when they weren't there or they're off rotation or they had a break, when we didn't have a break, I always just felt a little bit more bored. So, that was a signal to me that teaching and being a part of graduate medical education needed to be something that I did when I was done.

Maggie McKay: Was there any life event that inspired your career choice?

Ryan Arias, DO: Funny you asked that. So, there was this one time, so before I started any of this, I was an urgent care center manager in Maryland. And I distinctly remember this one gentleman, I don't remember his name, and I won't divulge any of that even if I did. But it was a very busy day. And our urgent care only had, I think at that time, it was just 10 rooms. But it was such a busy urgent care center. We had four providers in the morning. And so, from 7:00 AM until 12:00 PM, we'd see probably around 48 to 60 patients between all those providers. And I was going around in the front trying to make sure that everything was getting up to speed and we weren't falling behind.

And this gentleman had come in and he looks at me and I look at him, I say, "Can I help you, sir?" And he goes, "Well..." And then, he slaps his hand on top of the desk, right, these really, really tall desks. He just puts his hand up there and he goes, "Do you think this needs to be looked at by a doc?" And on his hand, his finger as a matter of fact was generously swollen. And there was a ton of just purulence pouring out of it. And I said, "Well, sir, in my non-medical professional opinion, I think that should be looked at by one of our doctors, yeah, one of our providers." And he goes, "All right. Well, here's the deal..." And I said, "Well, what's the deal?" And he goes, "Well, I did this building a rocking chair for my young niece, and it's her baptism today. And it starts at one and the party doesn't end until four. Can I come back later?" And I said, "I mean, yeah, sure. I really need to tell you, since you stepped inside this office, that I need to have a provider at least eyeball you and make sure that everything looks okay for you to leave and get their opinion." So, I went to the back, I got a provider out. She came out pretty quickly because I told her what was going on. And she looked at him and said, "Sir, you really need to get that looked at right away." And he goes, "Well, I think I'm going to have to go to the baptism first and I feel fine. So, I'll come back at four." And so, I had to have him sign a bunch of paperwork and whatnot because he was leaving the institution against provider's advice. And then, I hoped he came back.

So, four o'clock rolls around and he showed up. And it was worse than it looked that morning, of course. And the provider who actually saw him in the morning, who eyeballed him was there in the afternoon. She was a phenomenal provider. She was doing a double that day and she goes, "Oh yeah, I'll take him back." And so, I distinctly remember her coming out going, "Hey, I need the other provider." And so, I got the other provider. We only had two at that time now. We weren't quite busy because it was a Sunday at 4:00 PM. So, the other provider goes in, comes out, looks at me and goes, "I need you to contact our orthopedics surgeons that we're associated with." And I said, "Oh, is everything okay?" He goes, "I think this guy's got a nail head stuck in his finger." I said, "No way." And he goes, "Oh yeah, I think there's a nail head in there."

So then, I contacted the orthopedic surgeon. They said, "Okay. X-ray. Let's see if it's hitting the bone. If it's in the bone, you got to send him out. If not, you can try and take it out." So, we had what's called a C-arm, and it's a portable kind of x-ray. You can do everything in extremities, but nothing in the core of the body. And we all go back there. My job was just to hold the C-arm on and adjust the angle. And the two providers were diligently working, trying to see if the nail head that this man had gotten stuck with a nail gun was into his bone or not. And it was really at that point where I thought to myself, "I really want to be one of these providers and not just the guy standing off to the side holding the C-arm on." So truly, about two weeks later, I put in my two weeks' resignation and thought, "I need to go back to schooling to become a doctor."

Maggie McKay: That's so cool. Dr. Arias, what does osteopathic medicine include? What does it entail?

Ryan Arias, DO: So osteopathic medicine, so there's DO and there's MD, okay? And MD is allopathic and a DO is osteopathic. And the difference arises in the training that we get. So, the classic MD allopathic school doesn't have what's called osteopathic manipulation training or OMT built into its curriculum, whereas DOs have it built into the curriculum. And varying schools have varying hours, amounts that are required in order to graduate with that degree. But at its core, a DO learns osteopathic manipulative training and we're also geared more towards primary care as a subset of physicians. We're trained more for holistic management, preventative medicine, and more of our rotations are done and encouraged to be done with primary care.

Maggie McKay: And what percentage of your patients are athletes?

Ryan Arias, DO: Athletes, I guess it depends how you classify athletes. So if we are talking a high schooler who is playing sports or somebody in college who's D1 or D3, that's probably a smaller percentage of the population. But if you include the people who are working out five, six days a week, who run marathons, who are going to the gym, who are even retired population here keeping fit, biking 13 miles a day, then that's a pretty good percentage of my population.

Maggie McKay: You seem to have the best of both worlds. You get to teach and treat.

Ryan Arias, DO: I absolutely love both of that. I love the teaching portion, I love the treating portion and then mixing the two and seeing the culmination of what that arises after a resident steps in brand new, their first year and then seeing them progress. Even with my fellow residents during residency training, seeing new interns become second years, then step into the role of a third year and senior, that was phenomenal. And then, the contact with the patients is just great. You get to know people, you get to know families, you get to know likes and dislikes. I think today I probably had about 12 different conversations about what everybody did for the holidays. So, it's not just all business with family medicine.

Maggie McKay: And Dr. Arias, what's the most rewarding aspect of what you do and what's the most challenging?

Ryan Arias, DO: The most rewarding is certainly the people. It's the contact. It is being there when people are having a hard time and helping them see through it and helping them guide their way through the hard time. And then, I love seeing the end result after they've had a great time. The hardest aspect is, you know, I think we all say it and know it and hear it all the time, it's just insurance, just trying to deal with the weirdness of insurance companies.

Maggie McKay: So true. So, if you have any free time, it sounds like you're pretty booked up, what are your outside interests or passions? How do you spend your free time?

Ryan Arias, DO: Yeah. I love lifting the things up and putting them back down. That's my thing. I like lifting weights. I enjoy running. I do some athletic kinds of things, I guess you would call them. Also, joining gyms, reading, I enjoy reading, watching football. Sunday football is always big in my house, always has been.

Maggie McKay: And how do you advise young people coming up in medicine? What do you tell them when they ask you for advise?

Ryan Arias, DO: When they ask me for advice, I guess, I force them to narrow it down a little bit and I say, "Why do you want to do medicine?" And make sure that there is nothing else they want to do. Because it is a lifelong commitment. It is a big dedication of time. It's strenuous for you as a person. It's strenuous for your family as a person, as you're going through the training. There were countless amounts of birthdays and holidays and stuff that I had missed through my various years of training, and it required that time. So, I had set the expectation, you know, that this is going to be a big commitment. So if that's something you're looking for and ready and able to handle, then go for it.

And then, I also tell them to spend some time with a provider. Whether you want to be a PA or an NP or a physician, spend some time with them. See what they do, see what they like, see what would work for you maybe, or if the lifestyle wouldn't work for you and spend some time with both medicine and surgery, because those are two very different fields and very different time commitments.

Maggie McKay: And speaking of all that commitment, how do you balance work and personal life through the years?

Ryan Arias, DO: Through the years, I have to say my wife was the rock of the relationship for sure, especially during medical training and medical residency. She would pull me back, "Hey, hey, you're spending too much time. Come on back to the real world here for a little bit and take a step out and try and relax and enjoy what's going on around you." I think right now I have got good times as an attending, the work-life balance is there. Beebe does a good job of giving me that. So, pretty exciting.

Maggie McKay: And what do you think med students today are up against that you didn't have to deal with and vice versa? How did you have it easier and vice versa?

Ryan Arias, DO: I think the toughest thing they have to do right now is virtual interviewing. Before COVID hit, it was almost standard. You would get an interview offer for residency, for a residency program, and you would go visit the institution. And the night before, you would meet all the residents or some of the residents at a dinner. And that institution who's bringing you in would pay for the dinner and potentially pay for some housing or some sort of combination of both. And you would get to see residents outside of the hospital. Because, you know, when we step into work, then everybody steps into work. But being outside how they are, where they appear disgruntled, where 'they're overly tired. So, that was a very good thing to see because if they came out and they had bags dripping all the way down like this, and they go, "Oh man, my attending told me I had to be there and I just made it out to here" when they're a part of an institution, they know where they have to do these things. That's kind of red flags.

Now with virtual interviewing, you don't get that. That is a part that is missing. Seeing it in-person and feeling the emotions of a place, I think that is very difficult to deal with. I do feel very much badly for them. But conversely, now they get to see more institutions with virtual interviewing. The social inequities that were there because it costs money to go to places. I remember I had to take out extra loans to visit places. So, that social inequity, that social disparity is gone with a virtual interviewing. So, that is a nice added bonus. You get to interview at big places and small places alike. Whether they extended you and interview or not would be different, but you could at least apply and it would still be feasible for you to do.

Maggie McKay: And at the end of our conversation, we like to ask some quick questions if you're up for it. Do you have kids?

Ryan Arias, DO: I do. I got a little one. His name's Easton. He's four years old. And he's cute and he knows it.

Maggie McKay: Oh, that's not a bad thing. Do you have any pets?

Ryan Arias, DO: I do, I got two dogs. One is named Rocky. He's a husky and Golden Retriever mix, and the other one is Chloe and she's pure golden.

Maggie McKay: Nice. And who got to name them?

Ryan Arias, DO: My wife and I actually. The SPCA is where we got Rocky from, and they named him Rocky there. And we kept the name, we thought it was very fitting. And then, my wife and I named Chloe.

Maggie McKay: That's what we did too. Our dog was already named Hercules, so we just went with it.

Ryan Arias, DO: What a great name.

Maggie McKay: Yeah. He lives up to it, trust me. What's a favorite city you've ever lived in and why?

Ryan Arias, DO: Favorite city I've ever lived in and why? We just moved from Holly Springs, North Carolina up to here in Lewis. Holly Springs is a new home. It was a new place for me and my wife. We were just engaged at the time we moved down and then had Easton there. So, there's some of the fondest memories down there in Holly Springs, so that's why I would go with that.

Maggie McKay: Nice. So, is there any fun thing that you bought that you had to save up for, you know, when you were coming up, like a car or, I don't know, like a treat for yourself?

Ryan Arias, DO: Oh, let's see. My parents were nice to me. They gave me a lot of things. I wanted my dad's old 1998 Jeep Grand Cherokee. And it was there, it had already been paid off. But they looked at me and they said, "If you want that Jeep, you have to pay the car insurance, all the gas and all the repairs." but it was old, so it needed a lot of repairs. So, I went to work. I was working on the beach as a ticket collector. I saved all that money. And then, the summer was over, so I kept that in the bank. So, it took me a couple of summers and then, I was able to start affording the Jeep and it's gas and all its repairs.

Maggie McKay: I love it. Do you still have it?

Ryan Arias, DO: Oh, no. Her name was Gladys. I named her Gladys. But she's gone now. Gladys got turned in. She had this quirkiness to her. She had some exposed wires underneath the manifold. So every time it rained, she would stall out. So, I would've to pull off to the side if it was raining, if it was a flash downpour and wait for the wires underneath to dry.

Maggie McKay: Gladys had to retire.

Ryan Arias, DO: She had to retire, yeah.

Maggie McKay: Dr. Arias, do you have a mantra? And if so, what is it?

Ryan Arias, DO: A mantra, I'm a big fan of "Let's get it done." So, that's usually how I attack things that need to get done, we just sort of get done and get it over.

Maggie McKay: And in your life every day, do you have a philosophy in a sentence or two?

Ryan Arias, DO: Oh, everyday kind of philosophy. Wake up, work hard, have fun.

Maggie McKay: Good one. It's been so much fun getting to know you, Dr. Arias. Thank you for being here and teaching us a little bit about yourself and what you do at Beebe Healthcare. If someone would like to get in touch with you or find out more, where would they go?

Ryan Arias, DO: They would go to rarias@beebehealthcare.org. That's my email.

Maggie McKay: Awesome. And again, to find out more, you can go to beebehealthcare.org. That's B-E-E-B-E healthcare.org. Thanks for joining us.

Ryan Arias, DO: Thank you so much.