A Passion for Human-Centered Care: Negeen Farsio, Graduate Student at Brunel University of London

Dr. Parsa Mohri

Hello, I'm Parsa Mohri, welcoming you to the Raise the Line with Osmosis from Elsevier, our ongoing exploration of how to improve health and healthcare.

Today, we're continuing our NextGen Journeys series, highlighting learners and early career healthcare professionals around the world and their fresh perspectives on education, medicine, and the future of care.

I'm thrilled to welcome Negeen Farsio, a diagnostician at Cognitive Diagnostic Associates

in Newport Beach, California. Negeen holds a BA in anthropology from UC Berkeley and is beginning her master's in medical anthropology at Brunel University, London. Her path includes medical training experiences in London, Cyprus, and Curacao, and her lived experience as both a patient and a caregiver shape her commitment to mental health, patient advocacy, and ethical human-centered care.

Many in the Osmosis community knew Negeen from her work as a medical editor and as a fellow in the Osmosis Medical Education Fellowship Program, supporting healthcare learners worldwide. She's also curious about how neuropharmacology and AI can advance diagnostic practice.

Without further ado, Negeen, thank you so much for joining us.

Negeen Farsio

Thank you so much for having me. I'm excited to be a part of this.

Dr. Mohri

Likewise. So Negeen, if someone were to ask, what do you do, how would you introduce yourself today?

Negeen Farsio

Yeah, that is a very complex question that I do get asked. So my most recent position was as an educational diagnostician and I was working in that job for just over two years and to be honest I did not know what that job entails before I started.

Really my role was to administer different types of testing to students of all ages. So as young as five years old to 26 or 27 -- basically anybody in an academic setting. It was usually kids who were having either behavioral problems or social or academic struggles in school. My job was to administer different types of tests such as IQ tests, ADHD testing, and autism testing to get an idea of where the student struggles in their work.

There was a multi-professional team of psychologists, therapists, speech language pathologists, occupational therapists, and I was the first point of contact. So the kids would come to me, I would do a one-on-one testing session with them and then we pass on the results and then the rest of the team would figure out what's the best way to support this child in the classroom. Yeah, that's it in a nutshell.

Dr. Mohri

Sounds like quite a holistic care I would say, especially this is the sort of area that is not given that much of a focus unfortunately in hospital or healthcare settings but this sounds very wonderful. In terms of medical anthropology, it overlaps with public health if I'm not mistaken, or I'm curious as to how they meaningfully differ.

Negeen Farsio

Yeah, definitely. So it's been just about a month and a half now that I started a medical anthropology master's program. The reason I chose this route is I did my undergrad in anthropology, but I also did some medical training and decided it wasn't really working out for me the way I wanted. It wasn't exactly the right path for me. But medical anthropology is a field that looks at healthcare systems around the world and how human culture shapes the way we view different illnesses, different diseases, and also treatments. So you're right to say that there is a bit of an overlap with public health.

I guess the difference is that public health looks at how to look at a society and see where are some highs and lows in terms of getting the right care for people and it implements different strategies or different governmental tasks that go on to address different issues that affect the health of the public. Whereas medical anthropology is more, I would say, focused on the culture of a specific group, or groups of people within that society, and addresses why they may or may not be benefiting from certain public health policies.

Dr. Mohri

So, it includes as well the tailored approach towards a population taking into account their culture, if I'm not mistaken.

Negeen Farsio

Yeah, exactly, because in essence anthropology is the study of humankind and human culture. If you would ask any anthropologist, they would probably agree that the health setting is definitely one place where you do need a holistic approach. You definitely do need to take into account culture and social factors, political factors, and how those can actually shape the way that not only do people view illness, but also how they respond to different treatments and also take into account that there's not always a cookie cutter type treatment for every person. Everybody has a unique background and medical anthropology definitely aims to see the full picture of each patient.

Dr. Mohri

What first drew you to anthropology and how has that sort of perspective or lens that you've got changed the way you diagnosis and care for a patient.

Negeen Farsio

It's actually interesting. Initially wanted to major in psychology for undergrad because when I did do medicine, my end goal was always psychiatry. So when I was taking the required courses for psychology, I had to take a few anthropology courses and I had no idea what anthropology was.

Dr. Mohri

Hahaha

Negeen Farsio

I was not too excited, but it was a requirement. So, I took my first intro to social and cultural anthropology course, like in my second year of undergrad, and -- I know it sounds really corny -- but I instantly fell in love with it. I felt really conflicted at first because this is something I definitely enjoy, it feels like a passion, and I'm not sure what to do now. So I ended up majoring in anthropology and kept it on the table where I thought, down the line maybe I can do something with it and that's what I'm doing now.

Dr. Mohri

Yeah, see where it got you now. I love those sorts of introductions towards a topic or a concept that at first it's like your blank, like a canvas, but then eventually it becomes like a very lovely artwork.

Negeen Farsio

Yeah, I like that. It's a nice way of putting it, yeah.

Dr. Mohri

And so especially with your experience and training in London, Cyprus and Curacao, I wonder how did each setting teach you about healthcare culture and patient expectations?

Negeen Farsio

So I did my medical training at a British university in Cyprus. So I was exposed to two cultures at once because I was following like the British system of medicine -- which is a little bit different than it is in the US, which is where I'm from -- and also getting to know the Cypriot culture and the Cypriot views on health and like just their own, you know, traditional ways of viewing health.

So, it was interesting because that was the time where I felt my background in anthropology helped me the most actually because I was trained to view each patient holistically and see, you know, how each background affects the patient and affects their own compliance with what the doctors may like. You know, they may prescribe them certain treatment and they may or may not follow it. And you do have to look at what are their reasons to follow or not follow? Why do they have hesitations to follow or not follow what the doctor says, for example? Yeah, so it just reinforced the idea that location, culture, and society has a huge, huge impact on how patients perceive their own health and also how they will respond to what they're being told to do by the healthcare industry.

Dr. Mohri

That's definitely something that should be given a bit more focus, especially with treatment compliance, or that trust that the patient has towards the healthcare policies. Especially during COVID times, we've seen how the public has reacted quite differently towards new healthcare policies being introduced or how different governments -- though they were introducing similar policies with their neighboring country -- the population's reaction or just how they introduced it made such a big difference towards whether it's accepted or it would be protested.

Negeen Farsio

Yeah, exactly. COVID really shook things up. And I think it did a great job of showing us how there are some flaws in every health system around the world. The doctor-patient rapport is an area we can always improve, because it's not only it's not only treating the patient, but it's treating, I guess, everybody that that patient knows and looking again, from a cultural perspective, at how one interaction between patient and doctor can affect several other patients and doctors.

Dr. Mohri

Absolutely. I was wondering if you'd like to share a moment from your own patient or caregiver experience that helped reshape your path or ethics in practice or perspective.

Negeen Farsio

Yeah, for sure. So right about the time that I transferred out of Cyprus to come back to the States, I transferred to Avalon University School of Medicine. I only did a bridge semester to do like exam prep. That was right around the time that COVID was just starting off.

Unfortunately, my father was diagnosed with stage 4 lung cancer, and it was like the height of the pandemic when he was hospitalized for a few weeks. That experience really turns everything upside down for me, looking at health care in general, especially since I was a medical student at the time and having these experiences where, you know, the health care professionals are not doing what I've been taught to do, or it wasn't as I expected.

There were a lot of unfortunate experiences where we felt like we weren't being heard or not taken seriously. This was March of 2020, so it was like right at the height of the pandemic, when things were already chaotic. And unfortunately, my father did pass away a few months after that, but before he passed, I turned into an overnight caregiver, like literally just as soon as we brought my dad back home. It was like me and the rest of my family doing our best to take care of him. Because of COVID, we couldn't really have in-home nurses or the contact was really minimal, so we became his nurses and I learned a lot about cancer care and patient care and just how tough it really is to be like a full-time caregiver.

It definitely opened my eyes to different types of treatments and different attitudes from different types of healthcare professionals. Ethics was definitely one of them where there were some instances where I didn't feel like what was going on was super ethical or I had questions and I felt like they were being disregarded. So it, I would say, that whole experience piqued my interest in patient advocacy.

Dr. Mohri

Thank you so much for sharing that story. I’m very sorry and express my condolences for your father.

Negeen Farsio

Thank you, I appreciate it.

Dr. Mohri

It definitely, I think, gave a bit of a perspective towards how the vulnerable populations are affected by public policies. When it comes to the more vulnerable population, they're unfortunately forgotten and the patient is left with their own family members to take care of them.

Negeen Farsio

Yeah, it is very true.

Dr. Mohri

So we did touch base upon a bit of mental health, and a bit of holistic health, and I was wondering if you have noticed some big gaps within this field and whether you have a practical proposal to sort of address this that clinicians could be able to adopt tomorrow.

Negeen Farsio

That's something I'm very passionate about is mental health. I've had my own personal mental health struggles. I'm pretty comfortable talking about it at this point, but yeah, I've had obsessive-compulsive disorder since I was a little kid, also known as OCD. And it is, unfortunately, a very misrepresented and very misunderstood illness and that causes a lot of issues not just for the patient, because it is a difficult illness to deal with, but it also makes diagnosis harder and treatment even harder.

I think the average is like ten to fifteen years for someone with OCD to get it an actual diagnosis.

In the past couple years, my OCD has flared up, especially dealing with grief from the passing of my father. Last year was a really difficult year for me in particular, and I really had to face what it really means to encounter trauma and how to deal with mental health struggles when it's not so understood by those around you.

It took a lot of trial and error to find the right therapist, the right doctors, the right medications, the support that you need. And that was a whole other journey into patient advocacy because like you were talking about with vulnerable populations, it really opened my eyes to people who do struggle with mental health issues.

I am fortunate enough that I have family and I have safety nets backing me up. Like, I could take time off work if I needed to. But there are many people that can't do that and it becomes a ripple effect where, you know, a lot of people lose their homes, they lose their families, and it's just like a vicious cycle where they just keep suffering. So again, patient advocacy is not just about raising awareness. It's also about being able to give a voice to those who are voiceless within not just mental health, but any health issues.

Dr. Mohri

Very beautifully said. You've probably seen it in your medical training or through your own personal experience how some overlapping symptoms, whether it's mental health initially one would think it's something probably organic and I should probably see a doctor for this, but it would never be caught and it would usually just be shrugged off as if there's nothing wrong with you.

Negeen Farsio

Right, yeah.

Dr. Mohri

And I've especially seen it with patients who go to gastroenterology who are told in quite a harsh way, “You need to see a psychiatrist.”

Negeen Farsio

Hmm, yeah, that's a common thread. I've heard that too, unfortunately.

Dr. Mohri

Yeah, instead of, you know, bringing the patient on board with what's going on, it's just sending them off like, “This is no longer my problem.” So that's definitely very relatable across the whole globe. The way different cultures even approach the topic of mental health could be quite holistic in some places and maybe in some other parts quite unaddressed.

Negeen Farsio

Yeah, for sure. And unfortunately, there's a lot of stigma surrounding mental illness, which just makes it a lot harder for patients to get the support they need. I would say on the opposite end, it also makes it hard for the healthcare professionals to do the outreach that they need to reach the clients that need them the most.

Dr. Mohri

Absolutely. You mentioned earlier about being interested in psychiatry, psychology as well. Are there any developments within the field that you're looking forward to?

Negeen Farsio

Yeah, psychiatry and neurology in general are super interesting. The brain is fascinating, so there's just constant news about what's going on and what people are discovering. Something that's really caught my attention this past year is I've noticed there's been a bit of a movement, I would say, in psychiatry towards different theories on how to taper off medications, antidepressants, for example. I've seen a few startups growing where there's new research that shows if you're on a certain medication for a long period of time, it really alters your brain chemistry.

Usually, if you're trying to come off of a psychiatric medication, you'll be guided to taper off within like a couple of weeks to a month. But now there's like new research showing that it takes much longer, like maybe years. Otherwise you might end up with withdrawal like months later or a relapse. I personally had that experience where I was on a certain medication and I tried to come off of it and I was fine for the first month or so and then I had really serious symptoms a few months later. So that really caught my interest because it is interesting to see that maybe we're approaching it a little too quickly. Maybe it needs some time.

Dr. Mohri

That makes sense because some people are definitely on it for years and to be told yeah, you could taper out of it in just a matter of a few weeks and you'll be fine definitely makes sense why that sort of relapse would happen.

Negeen Farsio

Right. Exactly.

Dr. Mohri

And with the topic that we cannot escape nowadays, the rapid advancements of AI within healthcare, you've probably heard in the news, some people have been using it as their own personal therapist since they don't know who to turn to unfortunately, or maybe they just don't have that resource to be able to seek treatment. I was wondering if there's any use cases that you're optimistic about or anything you'd like to just touch upon about that at the moment?

Negeen Farsio

Yeah, for sure. I think with any new technology, there's going to be pros and cons, and I think it really depends on how we as humans use the technology. But I do see a lot of good potential with AI. And something that I've seen recently as more of a positive is getting a diagnosis.

Of course, you have to take AI with a grain of salt. But, you know, thinking back to my own dad, when he first had some symptoms, his main and really the only symptom he had for a long time was shoulder pain. It took, I don't know, a very long time, months, maybe over a year, to get the diagnosis that it was lung cancer. He went to different physical therapists, orthopedics, and it took a long time to put together that it was referred pain. It wasn't actually shoulder pain, it was his nerves.

So I feel like sometimes there probably will be a lot of cases where you can just put in a few symptoms into ChatGPT or something and just be like, “What are all the possible differential diagnosis that I could have?” Because I know that if he had been diagnosed sooner, we may have had more time with him.

So yeah, in terms of diagnosis, we've got a long way to go, I think, but I think we're getting there, and I think AI could definitely be helpful in providing the right guidance of where you should go if you have certain symptoms and who you should see.

And the same with mental health as well. Like you said, a lot of people use it as a personal therapist. I think if anything, it's just unfortunate because it shows how people don't have access to the mental health support that they actually need. But again, you have to be careful with how we use technology because on one hand it could be great. If it helps people reduce their anxiety, for example, great. Sometimes though it might steer you in the wrong direction.

It really depends on what exactly you are struggling with. I guess the case for someone with schizophrenia would be a little bit different if they go to AI for guidance versus someone who just needs like a little bit of help with calming down their anxiety.

Dr. Mohri

Absolutely. So, as you've had experience with being part of the production of the content on Osmosis, I was wondering if there's some content gaps that you see in our offerings, or which topics you would love us to cover a bit more next?

Negeen Farsio

I'm pretty biased because I've loved Osmosis from the start. I was a huge fan when it first came out. It helped me so much in medical school. It's not like a typical, I would say, medical education platform because it is very holistic and it covers a lot of areas that a lot of other websites don't go into. They just do content, but Osmosis goes beyond academic content.

I think it would be great, and I think Osmosis already does this, where they talk a bit about different types of professions. I think it would be great to have a series of maybe lesser known healthcare professions or different fields where you can apply medicine once you get that education. For example, I'm again going to be a little biased here, but like medical anthropology, because most people don't know what it is, but I think it is something that could definitely be applied within the healthcare setting because it would help not only patients, but also the healthcare professionals come to more common ground.

Dr. Mohri

Absolutely, I agree on that. We've discussed, I think, a lot of very relevant, very important topics and I was wondering what's one thing you would want our listeners to take away from this episode?

Negeen Farsio

Boy, one thing, you know, follow your passion, whatever it is. It may take you exactly where you want it to go, but you just didn't know. So, you know, if you like one thing and you end up doing something else and then you get rerouted, you know, it's a journey. Things change. I never saw this plan for myself. My end goal was always psychiatry. I never saw anything beyond that. And I am still interested in mental health, but I feel like now I have a more diverse background and a better background to approach mental health.

So, keep an open mind when you are deciding what it is that you want to do. And you don't have to stick to just one thing, especially nowadays. I feel like different fields are being so beautifully integrated that you can always create your own path, and can create your own career even.

Dr. Mohri

I wish I was told that a long time ago. That's very well said, and thank you very much, Negeen, for being with us today.

Negeen Farsio

Yes. Of course. Thank you.

Dr. Mohri

I'm Parsa Mohri. Thanks for checking out today's show. Remember to do your part to raise the line and strengthen the healthcare system. We're all in this together.