Joshua St. Louis, MD, MPH, FAAFP, FASAM, AAHIVS, has been called a “quintessential family doctor.” But that describes only one of his many roles. He is an attending physician in Family Medicine at the Greater Lawrence Family Health Center (GLFHC), where he holds multiple administration leadership positions. He also provides reproductive health and transgender health care at other centers in the Merrimack Valley and in southern New Hampshire. He also teaches for the Lawrence Family Medical Residency, at Tufts University School of Medicine (which he graduated from in 2014) on treating HIV and opioid use disorder, advanced research techniques, health needs of transgender patients, and how to take sexual histories.
Outside of work, he has been a go-to physician for advising leaders and staff at the Massachusetts Medical Society on some of these topics and issues relating to prison health, reproductive health, and care of the medically underserved. He is a strong, frequent advocate and leader within the MMS House of Delegates and at state legislative hearings.
As president of the MMS Essex North District since 2018, he is one of the youngest individuals to hold such a role. He also serves on the Committee on LGBTQ Matters. In June, he begins a term on the MMS Committee on Public Health.
Dr. St. Louis shares with Vital Signs his motivations and the joy he finds in his work.
VS: As the first person in your family to attend college, and a Haverhill native, did you aim to practice medicine just one town away?
Dr. St. Louis: (laughing) Absolutely not! Practice in the Merrimack Valley is not what I intended. I interviewed for residencies all across the country. I wanted an academic environment and a program where social justice was a mission. It turned out that one of the best places for this was three miles from where I grew up! I loved residency and I love the community where I grew up. At work, I encounter people I’m related to, or went to middle school with. I have a shared understanding with many patients and people I work with. This has added meaning and joy to my work.
VS: How did you get involved in the MMS?
Dr. St. Louis: Near the end of medical school, I was named an MMS scholar. That made it possible for me to transition to residency and to pay my rent. My residency was in Lawrence, so I joined the Essex North District. I was interested in advocacy and wanted to be involved.
Essex North had a lot of knowledgeable people, including former MMS presidents and leaders in the American Medical Association. I was the young, opinionated person. But older members were happy to have this young whipper snapper who didn’t even know how the House of Delegates worked. [Former MMS President] Dr. Joseph Heyman was the first person to talk to me at my first district meeting. And he sat next to me at my first HOD meeting, explaining what was happening. I became treasurer as a second-year resident. When I was asked to be president a year later, then-president Dr. Glenn Kimball said, “you can do this.”
Now, I try to make sure that any new HOD delegate from Essex North has an experienced advisor at their first meeting, as Dr. Heyman was to me, so they don’t come away overwhelmed, but instead have a framework for what is happening.
VS: What have you learned through your work in the MMS?
Dr. St. Louis: I’ve learned about advocacy, about how to make changes in an organization, and even how to run a meeting efficiently.
I’ve also learned the importance of putting my faith in others to make good decisions when they have enough relevant information. My perception when I first joined the MMS was that it was a crotchety organization of older cisgender White men who wouldn’t have progressive ideas. But when policies are proposed, and we talk about them, I’ve seen people’s opinions move.
VS: What is an example of this?
Dr. St. Louis: In 2019, some GLFHC coworkers and I wanted to have MMS support for the ROE Act in Massachusetts, relating to abortion. We knew this act addressed issues that were controversial within the MMS and that we were going out on a limb to author this resolution. But the majority of HOD members were receptive to hearing from those of us with experience in the abortion space. The MMS ultimately was instrumental in this becoming law in Massachusetts. And I’ve seen its benefits in my patients.
We saw similar support from the MMS last year for redirecting funding from police to public health, as a way to move away from police vigilante action.
VS: You volunteer in numerous mentoring programs. What role does that play in your life?
Dr. St. Louis: I perceived early on as a Harvard undergraduate that being first in my family to attend college was getting in the way of being a successful student. Classmates could ask their parents for assistance in navigating or finding a summer internship. A few years later, I heard that Harvard undergrads were starting a mentoring program. As a third-year medical student, I became one of seven mentors in the program, with 14 students. This year, 200 mentors support about 400 students.
It’s one of the most fulfilling things I’ve ever done, just to be a friendly person who has experienced what these students are going through. It’s inspiring to watch their trajectories.
VS: As a physician, what fulfills you most?
Dr. St. Louis: I’m a big extrovert. Just talking to patients about their lives and what’s concerning them energizes me. But when you look at my clinical interests, I’m most interested in caring for people who are marginalized and externalized by the health care system: people with HIV, substance use disorders, gender diverse individuals, or people seeking an abortion.
At heart I’m a family medicine doctor, which is about embracing variety. So while I primarily take care of people with substance use disorders or HIV, I also love taking care of their parents and partners and children and grandparents. I want to take care of them all.
Patient care is not an easy job. The medical burden of people in my community is very high. But I maintain joy by focusing on what I do like in medicine.