Alumni Profile: Alfred F. Tallia, MD’78, MPH
After more than 42 years at Rutgers Robert Wood Johnson Medical School, family medicine physician Alfred F. Tallia, MD’78, MPH, has treated three generations of patients—and taught three generations of medical students. Although the Department of Family Medicine and Community Health chair didn’t pursue his dream of becoming an architect, Dr. Tallia has been a builder just the same.
“Architecture was something I was thinking about early in my life. I liked to build things,” he explained. “My dad said, ‘No matter what you do, surround yourself with intelligent, happy people and then help them succeed.’ And that’s kind of what I did. Our department has made a huge impact in New Jersey and around the country.”
In September, Dr. Tallia was recognized by the city of Paterson for his outstanding accomplishments in the medical field and for serving as an ambassador of the city. He also was recently honored by Rutgers Health with the Lifetime Distinguished Achievement Award for a sustained and distinguished lifetime record of achievement.
Under Dr. Tallia’s leadership as chair over the last 18 years, the department has grown from 15 faculty members to more than 85 and serves more than 100,000 patients and learners annually. It has added sports medicine, community health, geriatrics, and hospital medicine divisions. The hospitalist program cares for the largest number of inpatients at Robert Wood Johnson University Hospital. Dr. Tallia, who also holds academic appointments in the Rutgers School of Public Health and the Rutgers Ernest Mario School of Pharmacy, has worked to expand access to care through programs for home visits, reproductive health, and adults with developmental disabilities.
National Roles, New Jersey Roots
Dr. Tallia was recruited to the medical school to lead the school’s family medicine residency when he and his wife, a nurse, were practicing in Philadelphia. Once here, he oversaw the burgeoning residency program for 10 years and was instrumental in launching Family Medicine’s research efforts to improve the quality of care. In fact, Dr. Tallia has authored more than 100 published abstracts, chapters, and scientific publications.
His efforts to elevate the practice of medicine locally led to national roles, including elected terms with the 100-year-old National Board of Medical Examiners (NBME), the international nonprofit organization responsible for developing competency assessments of physicians and other health
professionals in the United States and abroad. He is the immediate past chair and current director of the NBME and is the past chair of the governing committee of the United States Medical Licensing Examination (USMLE) program. He conducted the first comprehensive review of the exam in decades, transforming the test from multiple choice to one that requires critical thinking and clinical knowledge instead of primarily memorization.
Growing up in Paterson, N.J., Dr. Tallia attended the same grammar school as his father in a community he describes as multiethnic, multireligious, and multiracial. He attended Seton Hall Preparatory School in South Orange before earning a bachelor of science degree from Fordham University, Bronx, N.Y. When he moved to Piscataway for medical school, he was stunned by the rural scenery.
“Going from New York City to this place called Rutgers Medical School was a bit of a shock,” he said with a laugh. “There were literally cornfields around the campus.”
While it may seem difficult to imagine him doing anything else, medicine wasn’t Dr. Tallia’s first career choice. With interests in architecture, urban design, and the sciences, he also yearned to be a public servant.
“I grew up in a family where public service was really important,” he explained. “I thought about how I could help people and determined that being a physician was probably the highest calling that would allow me to do that.”
However, his decision to focus on family medicine was an easier choice.
“Family medicine is the foundation of every Westernized, industrialized health care system,” he said. “It is all about the relationship between the physician and his or her patients, their families, and the communities in which they live. Although the faculty wanted me to choose a subspeciality, I knew that wasn’t for me. I like people and their stories and being able to help them accomplish what they want in life.”
The Evolution of Family Medicine—and the Medical School
Dr. Tallia, a university-designated Master Educator and fellow in the Rutgers Center for Organizational Leadership, has seen the field of family medicine advance significantly over the last four decades. Class sizes are larger now, more women are choosing medicine, and the number of residency programs has grown exponentially, for example. Unfortunately, in the aftermath of the COVID-19 pandemic, many family medicine physicians developed post-traumatic stress disorder. The silver lining of that experience is that the field is now getting its due recognition.
“There is a newfound understanding that what family physicians deliver is not just important but essential,” he explained. “Ours is one of the few disciplines that, from an epidemiological standpoint, has been shown to reduce mortality, morbidity, and health care disparities. That’s due to the longitudinal relationships we have with our patients.”
Another key change in medicine is the nature of the patient-doctor relationship: “When I was a kid and even in medical school, the doctor was the boss. It was a very paternalistic model, where the doctor told the patient what to do. What’s exciting now is that it’s more of a partnership between family physicians and their patients. Patients are now in the driver’s seat in many respects, and that all starts with the family physician.”
Perhaps Dr. Tallia’s greatest hope is that reimbursement for family medicine physicians will soon match the value the specialty brings to the healthcare system.
“The financial underpinning still hasn’t shifted, so family physicians are still at the bottom of the food chain,” he said. “We work with patients and families to set realistic goals and solve problems to promote physical and emotional well-being. Our goal is to keep them out of the hospital. Unfortunately, our system is designed to put people in the hospital. I’ve been waiting 42 years for this to shift. It’s changing slowly, but I’m optimistic.”
Improving access and affordability of care also is of interest to Dr. Tallia. Medical debt is one of the most common causes of personal bankruptcy in the United States. To help make getting care easier and more affordable, Dr. Tallia worked with the Washington, D.C.-based Primary Care Collaborative, a not-for-profit organization focused on advancing the effectiveness and efficiency of the American healthcare system via primary care and the patient-centered medical home. The group advocated for the Affordable Care Act, which reduced the number of uninsured from more than 60 million to under 20 million.
“That’s still a significant number of uninsured, but now millions don’t have to choose between getting medications or having shelter and food,” Dr. Tallia said.
Pearls of Wisdom for Future Family Physicians
Dr. Tallia still sees patients at Family Medicine at Monument Square in New Brunswick.
“I have some families where there are three generations of patients that I’ve taken care of, and that is such a privilege,” he said. “There are very few other disciplines where that’s possible, but in family medicine, you see the entire spectrum of life. It is a joy and privilege, and I don’t think I’d ever want to give that up.”
His advice for the next generation of physicians is simple: Put the patient first.
“There’s too much emphasis on providers and organizations and not enough on the patient. We need to ask what patients want and, more importantly, what they need, and we need to ask in a respectful way,” Dr. Tallia said. “Being an advocate for patients in a sometimes-dysfunctional industry is a great role and opportunity for family medicine. I’m enough of a child of the ‘60s to love being a bit counterculture. I tell students, ‘It’s not about you, and it’s not about me. It’s about the patient.’”
When he’s not working, you can find Dr. Tallia on the racquetball court or his bicycle. He also likes to read about the progression of ancient civilizations and play classical music on the piano. When asked which of his many accolades means the most, he said, “They all mean a great deal, but ultimately, the biggest reward is to have done something positive for a colleague, the school, or my family. The reward of seeing the people around me succeed helps me sleep well at night. It’s just been a terrific ride.”