“Sometimes chance and destiny meet together when you’re paying attention.”
Dr. Viviana Martinez-Bianchi is a family physician and a Fellow of the American Academy of Family Physicians. She serves as an Associate Professor and the Director for Community Engagement at Duke University’s Department of Family Medicine and Community Health. In October 2023, she was elected President-Elect of the World Organization of Family Doctors (WONCA) and assumed the presidency on September 20, 2025 until November 2027.
Viviana qualified in medicine from the Universidad Nacional de Rosario, Argentina and completed her Family Medicine residency at the University of Iowa, where she was chief resident, and later served as faculty. She was previously a WONCA Executive Member-at-Large and liaison to the World Health Organization from 2016 to 2021. She is the Co-founder and Chair of the Board of LATIN-19, a coalition dedicated to advancing health equity for Latinx communities. She is the Principal Investigator of NC-FIEL at Duke FMCH, a project expanding health insurance enrollment among Hispanic/Latino communities in North Carolina. She was awarded 2021 NC Family Doctor of the Year, the Society of Teachers of Family Medicine’s F. Marian Bishop Leadership Award, the Duke Presidential Award, and recognition by WTVD ABC-11, Durham Magazine, and The News & Observer.
In 2020, she was featured in a mini documentary video by Univision highlighting her work in the pandemic. The documentary, “The Heroes of the Pandemic”, can be seen in the LATIN-19 website http://latin19.org/who-we-are/
” I’ve been an activist, I think, all my life”
The start of journey of a lifetime…
Welcome to MedicsVoices.com where we talk to the key opinion leaders in health and medicine around the world. Today we’re in the United States, and I’m talking to Viviana Martinez-Bianchi.
You were brought up in Argentina where you were greatly influenced by your father…
Viviana Martinez-Bianchi: My dad was a vascular surgeon, and even though he was, one could say, in a narrow focused speciality, I learned from him. I think he was, in many ways, my first role model as a family doctor. He was a surgeon who would often speak about smoking cessation, who would talk about prevention, who would always carry a black doctor’s bag in the trunk of his car. My family grew up sailing on the Parana River, one of the largest rivers in Latin America and when we would go sailing he would always take his doctor bag in our sailboat. Sailing among the different islands in the river, fishermen in little boats with an outboard motor would come up to us and he would take care of them. He would bring prescriptions for high blood pressure, for diabetes, he look after wounds, he would take care of different things. He knew them. They knew him. Every now and then we will have to carry somebody back to the city from the islands because that person was so ill, they needed access to emergency care. And so I learned from him that caring for the community is part of the work that we do. I always saw myself as a primary care doctor with a very strong community engaged portion of my practice. And that’s one way that he influenced me. Another one was that I was 14 years old when the Alma Ata declaration was made in 1978. This was a difficult time in Argentina during the dictatorship but the Alma Ata declaration was in all the newspapers and magazines and he was certain that this was going to change the course of the world, because there was an emphasis on health as a human right and on primary health care. He felt this was going to be something that would make a tremendous difference around the world and he was so excited. I started thinking about this and I told him that I was going to be a primary care doctor with a world emphasis and that I wanted to work with the United Nations and the World Health Organization.
“He definitely made a huge impact on me. But, he died too young to even see me beyond the first year after finishing medical school. He is always in my mind and, in a way, he is the compass that shows me the route to follow.”
A newspaper article from 1968 highlighting the surgical skill of Vivianas father, Dr Carlos Martinez
DMacA: He was clearly an inspiration, and he was very active in his own way. But you were also an activist…
V M-B: I’ve been an activist, I think, all my life. I grew up during the dictatorship and one of the things we noticed as I went to medical school was that entering medical school was restricted to very few. Even people who passed the entry exams, wouldn’t get in. In my first year of medical school, still during the dictatorship in 1983, we marched as students. We decided to go on a hunger strike to request the Chancellor’s office to change the rules for admission to medical school so that more people coming from the community would enter medical school and that it shouldn’t just be that the children of doctors and high ranking officers. I was the daughter of a doctor, of course, but I didn’t go to the same university as my father because I didn’t want to be known as my dad’s daughter, even though I admired him. I wanted to be able to create my own path. And we marched to the chancellor’s office, about 100 medical students. In those times it was very rare for medical students to be activists. That was more common with students in the school of philosophy or psychology or other liberal arts but not medicine, so it was remarkable. Once we arrived are the Chancellor’s office, we were surrounded by police with their arms drawn at us. It was pretty scary at the time. The student leaders started talking to police officers and we explained to the chief of police that our dream was that the children of police officers could attend medical school if they were interested and passed the exams, and that we felt the rules needed to be more equitable. Then, he said, they were going to protect us. We didn’t know at the time that the police officers had also gone on strike against the military dictatorship because they had not been paid for four months- otherwise I wouldn’t be telling you this story! The military police arrived and surrounded the entire area, but the police officers turned to them and said that everything was under control, and that they were there to protect us and calm the situation. And so they left.
The hunger strike lasted in nine days and I woke up on the ninth day in the emergency room as I had passed out. It began at our school at the University of Rosario and then what happened was that the University of Cordoba followed, and then La Plata, and then Buenos Aires, and all the medical schools started going on strike. What also happened in our city of Rosario of a million and a half people was that people started supporting us, singers started doing concerts and it became this big awakening, in some ways, after years of dictatorship. Not only did the University Chancellor resign but the Minister of Education and the Minister of Health also resigned. It became much bigger than we had anticipated and subsequently allowed the entry of thousands of medical students that had been left behind for several years. So I’ve been that type of person that looks at issues and wants to do something about it. This was a fast entry into politics that I had not expected. My parents were terrified, as you can imagine. My father sent my mom and my grandma to get me out of there but I wasn’t going to leave.
In 1978, when I was 14, he explained to me the World Health Organization’s Alma-Ata Declaration, which affirmed that health is a fundamental human right. Reading the declaration and watching footage of the event, I knew I wanted to become a doctor — one whose career would join primary care with public policy. In that moment, I began to dream of the path I am privileged to walk today. My father’s example continues to guide me as a family doctor and now as WONCA President, in spite of his untimely death 34 years ago.
DMacA: Like many graduates from Argentina, you went to the United States.
V M-B: Several things happened. I left Argentina because I had learned about family medicine. I also left Argentina because in 1991 when I graduated, there was a lot of anti-women sentiment in medical education. For the first time, historically, 60% of the graduates in 1990 were women and that had never happened before in Argentina or, at least, in our medical school. The University of Rosario is a national university. The professors were very mean and anti- women, and in the US, I was being recruited because I was a woman. So it was not so hard for me to say that I was treated differently in medical education in my country because I was a woman and in the U.S, I was being recruited to the US because I was a woman, and there were not that many women doctors and definitely not enough people who spoke Spanish. So I left, but I didn’t leave with the intention of leaving Argentina for good. I left to train in family medicine which was only just starting in Argentina and I didn’t know any family doctors in Argentina. I came to the US to train in family medicine and I spent two years in a program that had an emphasis on mental health in family medicine. And then spent the next two years at the University of Iowa, where I was chief resident there. Following that I was a rural doctor, and I married, my husband, Greg Warren, who is a US citizen from Chicago. We never went back. I also realized that I had a big role in this country with my knowledge of immigrant health, my knowledge of Spanish, and my understanding of the immigrant experience. And so I’ve been 30 years in practice in the US as a clinician, first as a rural doctor and then in an academic medical centre where half of my time is clinical. Not all of my patients have been immigrants or members of the comunidad Latina, the Spanish speaking people, but I’ve been a big part of that community in making sure that we’re improving health for everybody and that we are inclusive and that we are creating health systems where those voices are heard.
DMacA: I read that, after a while, you found that it was too cold in Iowa…
V M-B: We lived in Iowa for 11 winters. And after 11 winters, where there are some days where you wish for snow because its much warmer when there is snow, I was done. I just needed to move south and I begged my husband to see if we can find jobs in the southern part of the US. I was looking for an academic medical centre, my husband is a urologist, and we came to work at Duke University.
I loved the people of Iowa, I enjoyed it, I loved their teamwork mentality. It was about getting together with everybody working together for a common good, which is very much the rural way. If something happens to a community member. If for example, a tornado takes a house down, the community would come together. I was very fortunate to have started my career as a rural family doctor, even in the winters of Iowa.
“Another thing that I learned from my parents was that you don’t need to be directly involved in politics in a political party but you can be involved in organizational politics and I could do it in a medical organization.”
DMacA: You’ve brought all this experience of family medicine in both rural and urban to Duke University. Tell us about your work in Duke.
V M-B: At present, I’m Director for Health Equity with an emphasis on health for all in the Department of Family Medicine and Community Health. And 50% of my time is dedicated to doing clinical work where I do, what we call in the US, a full spectrum outpatient family medicine. I also do a newborn nursery round so, for the last two weeks I was on call as a team member in the newborn nursery, taking care of all the babies rooming with their mom and not needing special care nursery care. The other part of my time is related to health equity. I have a team that does research on trying to increase the number of members of the Latino community that have health insurance. A lot of people are eligible for health insurance in the US but do not have the health insurance. So we’re doing an educational intervention on this together with community health workers. The emphasis on the equity which allows me the time to work with WONCA
DMacA: You’ve brought us very nicely to talk about your work with WONCA. Tell us how you got involved.
V M-B: As I said, ever since I was 14 years old, I thought I would like to do global work. When I first arrived to the United States, I first needed to cement my knowledge of the US healthcare system, which is very complex and complicated. I also became an activist.
Another thing that I learned from my parents was that you don’t need to be directly involved in politics in a political party but you can be involved in organizational politics and I could do it in a medical organization. My parents were very involved with their organizations, my dad as a vascular surgeon and my mom as a biochemist. So I learned that you can actually impact what happens with health through membership of your medical organizations. The American Academy of Family Physicians was very important to me and the Iowa Academy of Family Physicians. I became a member of the board of directors of the Iowa Academy and then, after living in Iowa for 11 years, we moved to North Carolina. I was about to become President of the Iowa Academy when we moved to North Carolina. I wanted to continue my activism through impacting in our specialty society, family medicine. I spoke to a mentor, Kathryn Andolsek https://fmch.duke.edu/profile/kathryn-marijoan-andolsek who looked at me and said, ‘Viviana, why the North Carolina Academy? Why not WONCA? You speak several languages, you are binational, and you understand different cultures.” At the same time Rich Roberts was President Elect of WONCA and Rich had been my mentor through the American Academy of Family Physicians. I had been a delegate to the AFP Congress of Delegates when Rich was a president elect of the American College of Family Physicians. I called him up, talked to him, and said, I want to be involved. He said, this is a great time and he explained what WONCA was doing.
Something very interesting was about to happen as the United Nations had called the first high level meeting on Non Communicable Diseases (NCDs). It was, I believe, in 2011. And Rich told me that WONCA was trying to impact the statements at the NCD meeting, but they had not been able to get in.
Sometimes chance and destiny meet together when you’re paying attention. I had met with a friend that I had not seen for 17 years who was an Argentinian diplomat, the ambassador to the United Nations. He told me that he was one of the organizers of the NCD meeting and that they needed a representative of civil society of Argentina to attend. So, not only did I end up attending the meetings as part of their Argentinian delegation, but because he was one of the writers of the document, Rich Roberts and I were able to meet with him on Skype and help with the wording of that NCD declaration, which was very important.
It got me going, and then Richard asked me if I could go with him to the meeting of the Ibero-American Summit on Family Medicine which WONCA holds every two years. They hold a high level summit, a ‘Cumbre’ together with the Pan American Health Organisation (PAHO) , Ministers of Health and academic bodies get together to discuss important issues from a policy perspective for family medicine. And so I attended the Paraguay ‘Cumbre’ at the request of Rich Roberts because he wanted me to help with the translation. He wanted very specific: ‘ I don’t want to miss anything that happens. And I want you to be there to translate both the wording and the sense of what’s going on.’ I became involved and continued to go to all of the regional meetings. And then I ended up attending Prague conference in 2013 and I was elected to the OEC, the organizational equity committee. And then I started dreaming of the possibility of running for office as a member at large. And then, 12 years later, I’m President Elect and so honoured to be able to represent family doctors from around the world.
“I feel a great responsibility to try to understand family medicine in all of its complexity: family medicine, general practice, community medicine. It’s a little bit different in each country and the needs are different in each country, and the impact can be different. But I’m very hopeful for my next two years ahead as President.”
Taking the chain of office of President of WONCA at the 2025 World Congress
DMacA: The obvious question now is to ask you as incoming President, is what are your aims and objectives for your time as President?
V M-B: There are certain things that are very important to me; health for all, comprehensive primary care, and to improve health for people through comprehensive primary care we need more family doctors and we need the insertion of family doctors in health systems around the world and we need them in academic medical centres. In some countries it is well recognized but in other countries it is not part of the academic offerings for medical students. So many of them just happen to run into family medicine, they don’t have a real, knowledge of it through their academic education at medical school. I would love to see that strengthening. As I go to all the regional conferences. I also think we have a missed opportunity. I see abstracts showing amazing work, but they die in that conference and I would love to see a WONCA journal that brings the perspectives from those regional conferences into papers that are published especially from low and middle income countries. A lot of our colleagues do amazing work that doesn’t make it into the known journals that are dominated by the English language. I would love to highlight these amazing experiences from around the world; more South-South collaboration, North-South collaboration. I have seen amazing things happening in the global South that we don’t get to learn about in the global North and I would like to see that highlighted. And, I want us to work more in advocacy and policy looking at what it is that we need to do to strengthen primary care in every country in the world through family medicine and their teams.
DMacA: As a final question…Thinking back to that 14 year old girl following her dad around with his medical bag, how do you think that 14 year old girl has done with her life?
V M-B: I think she has done more than she ever thought possible. I wish it was possible to get together with my dad and talk. I’m not able to do but I think he would be very proud of that career that he saw was possible. And that the dreams that he had as a father for a daughter growing up in a difficult country, in a difficult situation, did come true. And that I was able to achieve more than he or I ever imagined at that time.
But I think the other thing that he would be very proud of is that the achievement is not just mine but is for the people, and that I hope to be able to elevate the voices of so many family doctors and so many communities that we care for. So, I think the 14 year old would be surprised and happy to know what had happened in the next 50 years.
DMacA: Thank you very much for sharing so much of your life, your inspiration, your family, and may I wish you every success as President of WONCA. Muchas gracias.
