Cedars-Sinai

Medical Staff Pulse Newsletter

Medical Staff Meeting Reflects on Impressive Year

The annual meeting of the medical staff saw an audience of more than 200 fill Harvey Morse Auditorium on Monday, Oct. 14, to reflect on achievements and challenges over the past year. During the two-hour luncheon, presenters recapped an impressive year during which teamwork and problem solving helped to make significant progress against some of the medical center's top challenges, such as capacity and its effects on patient experience and flow.

» Read more

Richard V. Riggs, MD, Appointed Chief Medical Officer

By Thomas M. Priselac, President and CEO

Following a comprehensive national search, I am very pleased to announce the appointment of Richard V. Riggs, MD, as senior vice president of Medical Affairs and chief medical officer. Riggs, who currently serves as vice president, chief medical information officer and as chair of Physical Medicine and Rehabilitation, has an extraordinary track record leading multidisciplinary teams focusing on clinical quality, safety and efficiency. 

» Read more

Cedars-Sinai Leadership Series: People

Watch the next video in a series featuring executive leaders talking about the institution's most important goals and initiatives. This week, Andy Ortiz, senior vice president of Human Resources, talks about one of the four organizational strategic pillars: people.  

» Read more

Letter From Chief of Staff: New Incident Reporting System Coming in December

By Clement C. Yang, MD, Chief of Staff

Transparency is key to promoting a positive and engaged safety culture. One of the ways we are promoting both transparency and engagement is through the rollout of a new incident reporting system, CS-Safe. CS-Safe will more effectively catalogue near misses, good catches and safety events that affect patients, staff and visitors. It is expected to rollout in December. Information on HealthStream training will be available in the coming weeks.

» Read more

Letter From Chief of Staff: Register With Doximity

By Clement C. Yang, MD, Chief of Staff

Reputation plays a major role in Cedars-Sinai's quest to become the leading destination for healthcare in California and the nation. Achieving this designation depends in part on how actively we network online with our peers and promote the innovative, lifesaving care at Cedars-Sinai.That's where Doximity—the online professional network—can help. Every year, U.S. News & World Report partners with Doximity to conduct its online survey as part of rankings for the nation's top hospitals. If you have not yet joined Doximity, I urge you to become a registered member by visiting Doximity.com by Nov. 1, 2019. 

» Read more

'Since You Asked': Parking Rates

In this issue's Since You Asked, Jeff Smith, MD, JD, executive vice president of Hospital Operations and chief operating officer for Cedars-Sinai Medical Center, and Andy Ortiz, senior vice president of Human Resources, discuss the upcoming changes in parking rates. Got a question? Email us at sinceyouasked@cshs.org.

» Read more

Moshe Arditi, MD, Wins Pioneer in Medicine Award

A physician-scientist who has devoted much of his career to investigating a coronary disease mainly afflicting children and often leaving them with lifelong heart problems has received the Pioneer in Medicine Award for 2019. The award winner, Moshe Arditi, MD, is a leading international expert in Kawasaki Disease, an ailment that is the nation’s No. 1 cause of acquired heart disease among children.

» Read more

Mark J. Ault, MD, Receives Master Clinician Award

Mark J. Ault, MD, a 41-year Cedars-Sinai veteran was presented with the institution’s inaugural Master Clinician Award on Oct. 14. The new award was created to recognize a candidate who has made “a substantive contribution to patient care at Cedars-Sinai,” as well as contributions “recognized at a national level by specialty societies or specialty boards.” 

» Read more

Panel Discussion Celebrates Women in Medicine

In 1849, Elizabeth Blackwell became the first woman in the U.S. to receive her MD. Today, about half of medical students, and 36% of all physicians, are women. While acknowledging those advances, particularly over the last half-century, participants in a panel discussion at Cedars-Sinai's "Celebrating Women in Medicine" program on Oct. 2 offered mixed assessments of the current status of female physicians.

» Read more

Four Young Women in Medicine Talk About Their Careers

Four young women in medicine at Cedars-Sinai recently sat down to talk about their work, career challenges and major influences. They are: Katelyn Atkins, MD, PhD, a radiation oncologist; Carol Lin, MD, an orthopaedic surgeon; Tiffany G. Perry, MD, a neurosurgeon; and, Janet Wei, MD, a cardiologist.

» Read more

Reminders for Protecting Patient Privacy

Have you ever said or done something you wish you could take back? Take the example of squeezing too much toothpaste onto your toothbrush—once it's out you can't push the paste back in. When it comes to patient privacy, the same concept applies. When a patient's personal or health information is inappropriately disclosed—whether oral, written or electronic—to the wrong party, this is considered a privacy breach.

» Read more

CS-Link: Plan for Unavailable Workflow Tasks

To ensure a smooth transition in the upcoming Nov. 3 update, there will be restrictions on certain tasks in CS-Link™ that may affect you. One week prior to update, you will be unable to create new dashboards or create new or edit existing QuickActions and SmartPhrases.

» Read more

Medical Staff Meeting Reflects on Impressive Year

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Mark J. Ault, MD, receives a standing ovation as he receives the inaugural Master Clinician Award.

The annual meeting of the medical staff saw an audience of more than 200 fill Harvey Morse Auditorium on Monday, Oct. 14, to reflect on achievements and challenges over the past year.

During the two-hour luncheon, presenters recapped an impressive year during which teamwork and problem solving helped to make significant progress against some of the medical center's top challenges, such as capacity and its effects on patient experience and flow.

“We have attacked this as a cultural transformation rather than just as a process improvement project," said Jeff Smith, MD, JD, MMM, chief operating officer and executive vice president of Hospital Operations. "That's involved building teams of teams by breaking down silos, holding teams accountable, empowering our frontline staff to take action and developing a network so we can react more quickly."

Smith went on to say that the use of real-time data, bed huddles, early discharges and the Departure Lounge, among other initiatives, have helped to improve both patient flow and patient satisfaction, even as capacity continues to prove challenging and Emergency Department volume increases year over year.

President and CEO Thomas M. Priselac took a step back to highlight the impacts the health system as a whole has had on the medical center. He said that the expansion of the health system has enabled the medical center to develop relationships that help to grow its programs, as well as improve its own care delivery capabilities—such as the role of new urgent care clinics in supporting the medical center's Emergency Department.

Following the reports by Priselac and Smith, Chief of Staff Clement C. Yang, MD, whose tenure concludes this year, delivered his final staff meeting report, noting that among the many efforts to make headway in affordability, two significant success stories were the launch of the Physician Best Practices Team and the sharing of procedure cost reports with surgeons and proceduralists to identify savings opportunities.

"We're having valuable conversations about why we do things differently and how we can all do things better," Yang said of the new initiatives' impacts. "We're talking to each other."

Turning his focus to burnout, Yang told the audience that physician wellness "is now stated as an organizational goal and a top priority of medical center leadership," adding that new physician events, career growth opportunities, and counseling and support services have helped to foster a culture of wellness over the last year.

"As our practice of medicine has evolved, so too must our medical staff structure," Yang said in closing, citing the introduction of two new departments—Cardiac Surgery and Cardiology, along with the Infection Prevention and Control Committee—as examples of necessary evolution within the medical staff that will help to improve quality and advance the stature of the medical center.

The event closed by honoring three award-winning physicians: Moshe Arditi, MD, received the Pioneer in Medicine Award; Mark J. Ault, MD, received the inaugural Master Clinician Award; and Shaun Miller, MD, received the Chief of Staff Award.

The chief of staff position will be filled in the new year by Marc A. Edelstein, MD, with Monique Araya, MD, serving as vice chief of staff.

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Pictured at the annual meeting of the medical staff: (from left) Chief of Staff Clement C. Yang, MD; Pioneer in Medicine Award winner Moshe Arditi, MD; Vice Chief of Staff Monique Araya, MD.

Richard V. Riggs, MD, Appointed Chief Medical Officer

By Thomas M. Priselac, President and CEO

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Richard V. Riggs, MD

Following a comprehensive national search, I am very pleased to announce the appointment of Richard V. Riggs, MD, as Cedars-Sinai's senior vice president of Medical Affairs and chief medical officer. 

Riggs, who currently serves as vice president, chief medical information officer and as chair of Physical Medicine and Rehabilitation, has an extraordinary track record leading multidisciplinary teams focusing on clinical quality, safety and efficiency. His executive leadership skills have also been demonstrated during the planning, development and operation of the California Rehabilitation Institute.

As chief medical information officer since 2015, he has worked closely with our clinical staff to ensure that our information technology strengthens their ability to care for our patients. Throughout his 25-year career at Cedars-Sinai, Riggs has demonstrated his ability to work collegially and effectively throughout the institution, earning a well-deserved reputation for listening and leading. He has led numerous departmental and institutional quality and safety initiatives that have improved the care of our patients.

In his role as chief medical strategy officer and chief of staff of the California Rehabilitation Institute since 2015, Riggs has led the development of the physician staff and, along with the other members of the institute, has been instrumental in the very rapid and very successful growth of the organization, helping to bring its vision to fruition.

As senior vice president of Medical Affairs and chief medical officer, Riggs will oversee clinical quality and medical standards to ensure the effective use of clinical resources in the provision of high-quality care to the patients at Cedars-Sinai Medical Center and Cedars-Sinai Marina del Rey Hospital. He will also work with John Jenrette, MD, and the medical leadership of the Cedars-Sinai Medical Network to ensure appropriate standards throughout the organization. Finally, he will collaborate with the medical leadership of the other organizations which comprise the Cedars-Sinai health system in the development of the vision and systems to assure the provision of high-quality, effective care. Riggs will report to me for policy-related matters and to Executive Vice President and Chief Operating Officer Jeff Smith, MD, for operational matters.

I would like to thank Rekha Murthy, MD, vice president of Medical Affairs and associate chief medical officer, for her outstanding work as acting chief medical officer since Michael Langberg's retirement in May 2018.

Please join me in congratulating Riggs on his appointment and promotion. Cedars-Sinai is very fortunate to have his leadership and collegiality in the years ahead.

 

 

Cedars-Sinai Leadership Series: People

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Watch the next video in a series featuring executive leaders talking about the institution's most important goals and initiatives. This week, Andy Ortiz, senior vice president of Human Resources, talks about one of the four organizational strategic pillars: people.  

Letter From Chief of Staff: New Incident Reporting System Coming in December

By Clement C. Yang, MD, Chief of Staff

Transparency is key to promoting a positive and engaged safety culture. One of the ways we are promoting both transparency and engagement is through the rollout of a new incident reporting system, CS-Safe.

CS-Safe will more effectively catalogue near misses, good catches and safety events that affect  patients, staff and visitors. It is expected to rollout in December. Information on HealthStream training will be available in the coming weeks.

The platform will also provide status updates in real-time, allowing staff to better monitor their entry and be informed of its follow-up. Our hope is that CS-Safe provides an avenue for shared accountability, ease-of-use and an ongoing dialogue with staff that entered the event.

As you may  know, each year, thousands of issues ranging from patient safety to environment of care  are reported by staff to assess for improvement opportunities.

To enhance the culture of safety, we are making a strong push to encourage all employees and physicians to document any event or unsafe condition that could affect patients, staff and visitors. As such, all employees, clinical and non-clinical, will be encouraged to use the CS-Safe platform.

CS-Safe is also designed to better track patient safety events and to provide feedback to operational and nursing leadership, as well as to the employee who submitted the initial incident report.

It will also be utilized within the Cedars-Sinai Medical Network, allowing for synergy and consistency in reporting and an ability to look at risk through transitions of care.

Thank you for helping us transform Cedars-Sinai’s safety culture into a feedback-based, positive, data-driven system.

Letter From Chief of Staff: Register With Doximity

By Clement C. Yang, MD, Chief of Staff

Reputation plays a major role in Cedars-Sinai’s quest to become the leading destination for healthcare in California and the nation. Achieving this designation depends in part on how actively we network online with our peers and promote the innovative, life-saving care at Cedars-Sinai.

 

That’s where Doximity—the online professional network—can help. Every year, U.S. News & World Report partners with Doximity to conduct its online survey as part of rankings for the nation's top hospitals. Physician votes in the survey are the basis of reputational scores used in the U.S. News rankings. Your participation in Doximity—and voting only for your specialty at Cedars-Sinai—is critical to our continued success in rankings for the medical center and for specialty areas.

If you have not yet joined Doximity, I urge you to become a registered member by visiting Doximity.com by Nov. 1, 2019.

The next survey period is expected to open in February. If you are board-certified and register for Doximity before Nov. 1, you will automatically receive an email asking you to log into your Doximity account to submit your specialty recommendations next year. Remember to vote only for your specialty at Cedars-Sinai, and not other institutions.

If you register with Doximity after Nov. 1, you will not be able to vote until 2021.

Doximity also allows you to stay connected with peers, communicate with colleagues, promote your services, and gain information about trending topics and new treatments in your specialties.

I hope you will become more actively engaged in Doximity and help us further elevate Cedars-Sinai’s national visibility and reputation. We have maintained No. 8 on the Honor Roll for the past two years. With your continued support, we can propel Cedars-Sinai’s standing among the country’s most influential and respected medical centers to become the top-ranked institution on the West Coast.

Thank you.

'Since You Asked': Parking Rates

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Since You Asked has gone digital, and Pulse is now publishing answers to employee questions as a regular feature. Please email questions to sinceyouasked@cshs.org. This issue's questions deal with the upcoming parking rate changes.

Parking Rate Changes

Question: [From the editors of Since You Asked] We have received a number of questions and comments about the upcoming changes in employee parking rates. Employee comments have ranged from questioning the need for the increase, to the criteria used for the rate change and the perceived inequities in parking rates for long-term employees, per diem employees, and full-time versus part-time employees. We have asked Jeff Smith, MD, JD, executive vice president of Hospital Operations and chief operating officer for Cedars-Sinai Medical Center, and Andy Ortiz, senior vice president of Human Resources, to respond to these concerns.

Answer: Thank you for taking the time to share your concerns about our decision to raise parking rates. We appreciate your feedback as well as the chance to further explain our decision.

We did not take the decision to raise parking rates lightly. We knew it would not be popular with employees, but we also know that stewardship of Cedars-Sinai's resources is an important part of leadership as we work to ensure our organization's future.

Let us share some of our thinking as well as the research behind the decision. We looked into policies on employee parking at other academic medical centers before determining rates. The rates we decided upon are in alignment with other institutions and are reasonable. In some cases, the rates are less than what employees at other institutions are asked to pay. We should also note that our rates have held steady for almost two decades.

We were determined not to cause financial hardship to any employee. That's why we developed the "tiered" approach to employee contributions, similar to what we use with our health benefits. Many of our lower-paid employees will actually pay less than they have previously paid. We have also greatly increased our ride-sharing incentive to help our employees offset the cost of parking.

While we regret any distress or concern this decision may cause, we are firm in our belief that we have taken the right path. We value our employees and the tremendous contributions they make, but we also have an obligation to our community and the patients we serve to be careful stewards of our resources.

Thank you again for your feedback. And, thank you for all you do not only to make Cedars-Sinai the remarkable institution that it is today, but also to help ensure that we have a bright future for our employees, our patients and our communities. 

Moshe Arditi, MD, Wins Pioneer in Medicine Award

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Moshe Arditi, MD

A physician-scientist who has devoted much of his career to investigating a coronary disease mainly afflicting children and often leaving them with lifelong heart problems has received the Pioneer in Medicine Award for 2019.

The award winner, Moshe Arditi, MD, is a leading international expert in Kawasaki disease, an ailment that is the nation's No. 1 cause of acquired heart disease among children.

Arditi, who immigrated to the U.S. after attending medical school in his native Turkey, said his interest in the affliction was spurred three decades ago while he was being trained as a pediatric infectious diseases specialist. During that time, he treated hundreds of young Kawasaki disease patients at the medical center now called Lurie Children's Hospital of Chicago, an affiliate of Northwestern University. Arditi said he also was inspired by meeting the Japanese pediatrician, Tomisaku Kawasaki, who identified the disease in the 1960s and who Arditi continues to meet with every year.

The work of his research lab at Cedars-Sinai, Arditi said, is conducted with an eye toward helping "hundreds of thousands of kids with Kawasaki disease" and preventing them from developing cardiac disease as adolescents and adults.

As George Liu, MD, PhD, formerly a professor of pediatric and biomedical sciences at Cedars-Sinai and now a professor at the University of California, San Diego, medical school, noted in his letter nominating Arditi for the Pioneer in Medicine Award, a treatment based on Arditi's research currently is in clinical trials. If the outcome is successful, Liu wrote, "this novel therapeutic approach will be widely used to prevent potentially fatal heart disease in children with KD [Kawasaki disease], and allow them to live healthy, productive lives."

Another major focus of Arditi's research is cardiac disease in adults. His research lab at Cedars-Sinai has explored the role that infections and their resulting inflammation can play in worsening atherosclerosis, a buildup of plaques including fats and cholesterol in the arteries, which can restrict blood flow and lead to heart attacks.

Among other roles at Cedars-Sinai, Arditi is executive vice chair for research in the Department of Pediatrics and director of the division of pediatric infectious disease and immunology. He also is a professor both at Cedars-Sinai and UCLA.

He is the latest in the string of Pioneer in Medicine Award winners dating back to when the annual honor began in 1982. Among other things, recipients are required to be or to have been involved in research, published in national or international peer-reviewed journals, a teacher and a positive role model, an innovator or someone who has changed the medical world around him or her, and a physician at the medical center during a major part of their career.

Liu, in his nomination letter, said he has known Arditi since 2006 and agrees with "the consensus among his peers: Dr. Arditi unquestionably epitomizes the excellence in research, academics, teaching/mentoring and devotion to medicine that the Pioneer in Medicine Award has long honored."

Arditi has been a prolific academic author as well. He has published more than 151 peer-reviewed papers, many of them in some of the top-ranked journals in the world, along with 12 book chapters and 123 scientific abstracts.

Arditi, a jazz aficionado who draws parallels between the musical form and science, aimed some of his final remarks in the speech he prepared for the presentation of the award on Oct. 14 at "young investigators and physician scientists." One piece of advice was that, "There is nothing like the thrill of discovery. That is being something bigger than yourself, that is one of the greatest motivations for a scientist."

Arditi also cautioned that science "is a marathon and not a sprint, you have to be in it for a long haul. There is a lot of pounding you have to take, it is a lot like boxing. You are going to get knocked down several times, the question is, can you get back up, and if you can, you will still be in the game."

 

 

 

 

 

 

 

 

 

Mark J. Ault, MD, Receives Master Clinician Award

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Mark J. Ault, MD

Mark J. Ault, MD, recalls a day in 1990, while he was director of Cedars-Sinai's Ambulatory Care Center, when his chief of medicine asked him and a colleague if they could start putting PICC lines in patients.

Their reply: "OK. What’s a PICC line?"

PICC lines—long, thin tubes, or catheters, inserted into a vein in the arm to do such things as provide chemotherapy or antibiotics over extended periods—still were new then. But Ault and his colleague figured out what to do, and put four into patients that first year.

That marked the beginning of Cedars-Sinai's Procedure Center, which now handles thousands of cases a year, involving PICC lines as well as other diagnostic and therapeutic procedures for patients from all over the medical center.

It also marked an important professional turn for Ault, a 41-year Cedars-Sinai veteran who on Oct. 14 was presented with the institution's inaugural Master Clinician Award.

The new award was created to recognize a candidate who has made "a substantive contribution to patient care at Cedars-Sinai," as well as contributions "recognized at a national level by specialty societies or specialty boards." It also calls for candidates to have demonstrated "community activism and educational efforts that advanced healthcare and the wellbeing of the Cedars-Sinai community."

In her letter nominating Ault for the award, Teryl Nuckols, MD, MSHS, director of the Division of General Internal Medicine, said "physicians have come to count on the fact that they can order a procedure and have it performed within only a few hours in most cases. Truly, without Dr. Ault and the others on the team, the flow of patients through Cedars-Sinai would practically come to a halt."

Nuckols' letter mentioned that the center "started small as an approach to avoiding complications including injuries due to misplaced lines, infections, perforations of the bowel, bleeding, etc." The result of the Procedure Center's performance, Nuckols said in comments prepared for the award presentation, is that complications at Cedars-Sinai have been reduced "to only a tiny level" compared to rates documented elsewhere.

"Patients adore him, and as an educator he is revered," she wrote. Nuckols noted that Ault has won the Circle of Friends Recognition award seven times, a Standing Ovation for Quality Service eight times and the Golden Apple Teaching Award twice.

In the nomination letter, Ault also was cited for being "instrumental" in opening a pioneering AIDS unit at Cedars-Sinai in the early 1980s.

Ault, who grew up in small-town Sewickley, Pennsylvania, near Pittsburgh, came to Cedars-Sinai as an intern in 1978 and has remained with the institution ever since. Over the years he has held an array of leadership roles, including director of the Procedure Center and of General Internal Medicine, where he remains a staff physician and proceduralist.

These days, he is spending more time in direct patient care. In the most recent fiscal year, Ault performed 6,564 procedures—more than half of the Procedure Center's total of 11,745.

"The Procedure Center really is my pride and joy,"Ault said.

He said he was inspired in that direction while a student at the Mount Sinai School of Medicine in New York in the 1970s. He witnessed the deft way a physician performed a paracentesis, a removal of fluid from an abdominal cavity, on a patient badly suffering from liver disease.

"It just struck me at the time how an experienced doctor and a decisive procedure can make such a huge difference in a quick way. And that sort of stuck with me forever," Ault said.

From there, Ault said, he continued "to migrate toward things that allowed me to do procedures—for instance, the ICU and the emergency department. And then when the opportunity came to develop a procedure center, that was the icing on the cake."

And what's kept him at Cedars-Sinai for so long?

"Two things," Ault said. "One is the role models. Everything I've done—whether it's been critical care, emergency medicine, ambulatory care—I've had good role models to lead the way. The science of medicine, you can learn by reading, but the art of medicine, you've got to learn by watching your role models and adopting the nuggets that they can show you."

The second factor, he said, "was opportunity. I almost couldn't think of another place where I could do the things that I've done over time to get to my role at the Procedure Center. And so, somehow or another, I've lasted for 41 years."

 

 

Panel Discussion Celebrates Women in Medicine

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Virginia Apgar, MD, introduced the first standardized method for evaluating a newborn's transition to life outside the womb.

In 1849, Elizabeth Blackwell became the first woman in the U.S. to receive her MD. Today, about half of medical students, and 36% of all physicians, are women.

While acknowledging those advances, particularly over the last half-century, participants in a panel discussion at Cedars-Sinai's "Celebrating Women in Medicine" program on Oct. 2 offered mixed assessments of the current status of female physicians.

Nancy L. Sicotte, MD, who this year was named chair of the Department of Neurology, offered perhaps the most upbeat view. "Medicine is now open to everyone who has the willingness and the grit to get through the training and wants to be in this profession. And I think that makes us all stronger," she said.

But Sarah J. Kilpatrick, MD, PhD, chair of the Department of Obstetrics and Gynecology and moderator of the discussion, emphasized, "We still have a lot to do." Kilpatrick, while noting that women are now about 50% of U.S. medical students, said "we're nowhere near that in terms of fulltime working women and in terms of academics," where female department chairs remain a distinct minority.

Kilpatrick, who became Cedar-Sinai's first female chair when she was named to her current position in 2010, and Sicotte were joined on the panel by Joanna Chikwe, chair of the Department of Cardiac Surgery at the Smidt Heart Institute, and Selma Calmes, MD, a retired clinical professor of anesthesiology at UCLA and a past chair of anesthesiology at Olive View-UCLA Medical Center, who has written about the history of her field.

Chikwe, speaking before the standing-room-only audience of faculty, fellows, residents and students at Harvey Morse Auditorium, noted that evidence shows that "what hampers women and minorities, or people that come from a different culture or other organizations, it's that you tend to not be given the benefit of the doubt when your boss has incomplete or inaccurate information because you don't have a relationship—you don't have a network." She said that also leads to "less access to opportunities, both within your organization and outside of it."

Her advice was to be "extremely intentional" in building relationships with potential mentors. She said that should be done not through making "superficial connections" at networking events but by "trying to build it around interests in common, projects in common."

Calmes gave a talk before the panel discussion highlighting the challenges that women doctors have faced over the years by telling the story of Virginia Apgar. A pioneering female anesthesiologist, Apgar in the early 1950s introduced what is known as the Apgar score for evaluating a newborn's general condition moments after delivery.

Calmes explained that Apgar found herself in the subfield of obstetric anesthesia only after being prevented, because of her gender, both from becoming a surgeon and, later, from being appointed chair of Columbia University's anesthesia department. Her success in medicine "just goes to show that even when there's an obstacle, there's always something better that will come and that you'll find, and I hope that's true for all of you. It's certainly been true for me in my career as a physician."

Four Young Women in Medicine Talk About Their Careers

Four young women in medicine at Cedars-Sinai recently sat down to talk about their work, career challenges and major influences.

Katie Atkins, MD, PhD, radiation oncologist

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Katie Atkins, MD, PhD

How has your personal background influenced your career?

I grew up in a small town in Oregon called Lorane and, until college, I always was in very small schools. I've always really liked the feeling of having a community. I even had that same sense of community in college because I played basketball and the team was my community. As I moved forward academically, it was always really important to me that I enjoyed my team and my community. In radiation oncology, with the multidisciplinary team that you have, it feels similar. This specialty really illustrates a team approach to medicine.

What are the chief challenges you have faced in your career?

Early on, the idea of just even getting into medical school was a daunting task. Part of it was that I came from small schools. I felt like I had a lot of catching up to do. So I had insecurities about whether I had the right academic background to do this and to be successful in medicine. It took time for me to feel comfortable and feel that I belonged.

A year ago, while I was a chief resident, I had a baby, and I think that having a baby as a resident, a trainee, comes with a host of challenges.

Could you say more about how you chose your area of specialization?

When I started medical school, I actually had no idea what radiation oncology was and I really didn't have a set idea of what specialty I wanted to go into. I did a combined MD-PhD program. When I was working on my PhD, which was in a basic science cell biology lab, I had a meeting with radiation oncology researchers and the radiation medicine department chair at Oregon Health and Science University (OHSU). And the department chair asked me, "Are you interested in radiation oncology?" At that time, I had been starting to get interested in oncology from the research side and thought I wanted to look into it clinically. But after that meeting, I started working with the radiation oncology department while doing my research and kept up those ties. Then I did a clinical rotation in that field when I went back into medical school. And as soon as I worked there, I felt like, "These are my people, these are the people I want to work with."

Who has deeply influenced your career?

I don't think I would have discovered radiation oncology at the right time had it not been for Dr. Charles Thomas Jr., the chair of radiation medicine at OHSU. He is someone who recruits like a coach. And I mean that in all the positive ways. He's a mentor. On the personal side, I would say my husband, Bobby Caldwell. We've been together almost 16 years, and through the whole time, he has been unwavering in his support of my career trajectory. 


Carol A. Lin, MD, MA, orthopaedic surgeon

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Carol A. Lin, MD, MA

How has your personal background influenced your career?

My parents immigrated from Taiwan in the late 1970s as graduate students. My mother is an engineer and my father is a radiologist, which influenced me. In college, I actually tried not to do medicine because I was trying to find my own thing. But I kept coming back to it. It just felt like the most natural course for me.

What are the chief challenges you have faced in your career?

I think most women, when they go into surgical specialties, are asked, "Are you tough enough?" In orthopaedics, there's the additional stereotype, "Is she strong enough?" But it's rarely malicious, just uninformed. I try to turn it into something lighthearted.  It's more about brains than biceps.

Nationally, only 7% of orthopaedic surgeons are women, while more than 50%  of incoming medical students are women. We're lucky Cedars-Sinai is one of the more diverse and supportive places to work but, even so, I'm the only woman on the orthopaedic faculty.

How did you choose your area of specialization?

I thought I was going to be a pediatric or a cardiac surgeon. And then I spent a year in Malawi, working on a nutrition project. On field visits we sometimes functioned as medical transport for villagers. One child had a leg bent 90 degrees from an old infection. We would shuttle her back and forth so that an orthopaedic surgeon could release all of her scar tissue until she could walk again. I thought that was miraculous. When I came back, I made sure that I did some orthopaedic rotations. I saw people who were in terrible pain, who couldn't really walk or walked with a cane, and then received a hip replacement. They'd feel a difference the next morning and leave the hospital already better. At their post-op, they were just ecstatic. That immediate change in quality of life really appealed to me.

Who has deeply influenced your career?

From my residency, Serena Hu, now chief of spine at Stanford, and Lisa Lattanza, now chair of Yale's Department of Orthopaedics and Rehabilitation. I saw how they led people and was very struck by how subtle it was. Dr. Hu is the quietest speaker in the room, but when she speaks, everybody stops and listens because what she says is so well-reasoned. Dr. Lattanza had a way of correcting behavior directly and indirectly, but never disrespectfully. They became orthopaedic surgeons in a much less favorable environment than now. I love that they managed to still be very gracious and fair. Also, Dr. Donald Wiss, who was my fellowship director here, who was my model for patient care. He's an elegant, thoughtful surgeon and a compassionate physician, very different from the "ortho bro" stereotype. 


Tiffany G. Perry, MD, neurosurgeon

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Tiffany G. Perry, MD

How has your personal background influenced your career?

Going to a small school, Elon University, I received a lot of individual attention and had the ability to pursue my own interests. While I was an undergrad, I studied art, theater and music, and taught at my own piano studio. I realized that, although I was good at piano, I was not good enough to make music my career. At that point, I spoke with my biology mentor who asked if I ever had thought about medicine, a path that I probably never would have taken if I had been at a larger university and gotten lost in the system. 

What are the chief challenges you have faced in your career? 

Neurosurgery is a male-dominated field. As a female in spine surgery, I'm even more in the minority and that is a challenge. It still is a boys club. My hope is that one day, we will all look at each other as human beings, and treat each other with respect no matter the gender or race or cultural background. When I encounter these challenges of being in the minority, I remind myself to stay focused on my patients and my work.  This mindset helps me keep the focus off of myself and on taking care of others, which is ultimately why I went into medicine. 

How did you choose  your area of specialization?

I had an excellent mentor, Ann M. Ritter, MD, a pediatric neurosurgeon and the first neurosurgeon I shadowed. I remember my first day in the operating room with her after my first year of medical school at the University of North Carolina at Chapel Hill (UNC). I knew immediately I wanted to go into neurosurgery. 

Who else has had a strong influence in your career? 

On a personal level, my parents. They were supportive every step of the way. Professionally, there were probably four key people. Matthew Ewend, chair at UNC, was a constant reminder of professionalism in neurosurgery and focusing on patient outcomes. Eldad Hadar, our residency director there, taught me balance. You're never going to achieve perfect balance in your family life, but you have to try every day. Edward Benzel of the Cleveland Clinic is the father of spine neurosurgery internationally—a phenomenal human being, surgeon and mentor.  Currently, Keith Black, MD, chair of the Department of Neurosurgery, is my chairman. I could not ask for a more supportive, even-keeled and talented person, who teaches that leading is not always by spoken word but rather by action.

The one thing I would add is that I've experienced cancer affecting both of my parents and four other close family members. Going through these illnesses helped me recognize the personal side of medicine. I think that bringing humanity into your practice can come from being on the other side of it. That has definitely changed my practice and who I am as a neurosurgeon. 


Janet Wei, MD, cardiologist

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Janet Wei, MD

How has your personal background influenced your career?

As I was growing up, my parents were always supportive of volunteerism so that my brother and I could get a perspective of what life is like for different people and realize the challenges that people go through. We volunteered, for example, in a nursing home, in a hospital and in a facility for children with developmental disabilities. Having that exposure at a young age helped me appreciate that there are different health challenges that people face. I think that experience shaped my interest in medicine. I was able to understand, to a limited degree even as a young adult, that we need to have empathy and to also realize that there are knowledge gaps in medicine.

What are the chief challenges you have faced in your career?

When I expressed my interest in a career in cardiology, there were a few people who questioned this choice due to my desire to have children, given the busy lifestyle and radiation exposure. Fortunately, because of the amazing female and male mentors that I had during my residency and cardiology fellowship here at Cedars-Sinai, that challenge didn't prevent me from pursuing my dream.  A current challenge for me is finding an optimal work and life balance—time for research, time for writing, time for clinical care, time for family and time for myself.

How did you choose your area of specialization?

I am a preventive cardiologist specializing in heart disease in women. I became interested in this field in the first month of my internal medicine residency, when I took care of a woman who had persistent chest pain but no obstructive coronary disease and was very frustrated with not having a diagnosis. In the Cedars-Sinai cath lab, I observed her invasive coronary reactivity testing procedure, which ultimately diagnosed her condition as coronary microvascular dysfunction. She burst into tears at the end of the procedure, not because she was upset about the diagnosis, but because she finally had a diagnosis and that her symptoms weren't just all in her head. That left a very strong impression on me. Prior to working with the Barbra Streisand Women’s Heart Center, I had never learned about coronary microvascular dysfunction which predominantly affects women, and I wanted to know more.

Who has deeply influenced your career?

My mentors here at Cedars-Sinai not only take great clinical care of their patients, but also take the extra time to investigate the pathophysiology, presentation, treatment and ultimately the prevention of their patients' diseases. I am fortunate to be surrounded by physician-scientists. One in particular is my mentor, C. Noel Bairey Merz, MD, director of the Barbra Streisand Women’s Heart Center, who has focused her career on investigating heart disease in women and has greatly influenced my academic and clinical cardiology career.

 

 

Reminders for Protecting Patient Privacy

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Have you ever said or done something you wish you could take back? Take the example of squeezing too much toothpaste onto your toothbrush—once it's out you can't push the paste back in.

When it comes to patient privacy, the same concept applies. When a patient's personal or health information is inappropriately disclosed—whether oral, written or electronic—to the wrong party, this is considered a privacy breach.

Common Privacy Violations

  • Providing a different patient's AVS/Discharge paperwork to a patient
  • Inadvertently emailing patient information to an individual with a similar name as the intended recipient
  • Discussing patients in a public area
  • Not verifying the correct patient is selected when processing a request
  • Mailing patient information to the wrong address

All Cedars-Sinai Workforce Members are Responsible for Protecting Patient Privacy

Federal (Health Insurance Portability and Accountability Act or HIPAA) and state (Confidentiality of Medical Information Act or CMIA) healthcare privacy laws dictate how we may use and disclose confidential patient information. As a member of Cedars-Sinai's workforce, you are responsible for utilizing appropriate safeguards and complying with federal and state privacy rules to uphold the confidentiality of Personal Health Information (PHI).

How Can We Protect Patients' Information?

  • Do not discuss a patient in public places (e.g., elevators, hallways or cafeteria)
  • Always double-check phone numbers, fax numbers and email addresses before disclosing or sending information
  • Do not leave PHI unattended
  • Discard documents containing PHI in secure shred bins
  • Do not share passwords and log off/lock your computer screen

Reporting Privacy Concerns, Breaches or Questions
Cedars-Sinai workforce members are required to promptly report any suspected privacy violation(s) to the Cedars-Sinai Privacy Program.

Privacy Program Contact Information
310-423-7972, option 5 or submit a privacy incident report.

CS-Link: Plan for Unavailable Workflow Tasks

To ensure a smooth transition in the upcoming Nov. 3 update, there will be restrictions on certain tasks in CS-Link™ that may affect you. One week prior to update, you will be unable to create new dashboards or create new or edit existing QuickActions and SmartPhrases.

In addition, creating, editing or sharing NoteWriter macros will also be disabled, along with applying filters to Chart Review and customization of Hyperspace. Note your current filters, QuickActions, SmartPhrases and Notewriter macros will remain accessible and operational through this time and after the update.

The restrictions will begin Monday, Oct. 28, at 5 a.m. and last until the update is completd on Sunday, Nov. 3. Please make any changes you might need prior to Oct. 28.

For more details, please visit the CS Service Center page on the November 2019 update.

If you have questions, feel free to contact groupeisphysicians@cshs.org.