Year 3. January 3. Looking Ahead for 2024.
Happy New Year! I am pleased to welcome you back to the department after what I hope was a joyous and restful holiday with friends and family. 2024 is going to be another banner year for the department of medicine as we begin to implement our strategic plan which will help us achieve our goals and vision of being a department that leads in innovation, transforms care, and advances health for all. I recorded a few remarks reflecting on the year past and providing an overview of our strategic plan that will frame many of our initiatives in 2024.
I hope that you are feeling as excited and optimistic about this upcoming year as I am. We will no doubt face challenges, but I am confident that we will continue to excel across our missions because of your enthusiasm, drive, and commitment to the department of medicine, our patients, and community.
Now let’s celebrate some recent achievements.
DoM Postdoctoral Fellow Receives Travel Award to Speak on Dementia, Caregiving, and COVID-19
Deborah Oyeyemi Walton, MD, is an internal medicine-trained postdoctoral fellow in the UCLA National Clinician Scholars Program (NCSP). Previously known as the Robert Wood Johnson Clinical Scholars, the NCSP is designed to immerse clinician scholars in a rigorous program of research, policy, and leadership training with partner sites. UCLA is one of the oldest partner sites, and having grown up in Northern California, Dr. Oyeyemi Walton felt that returning to California was a homecoming after completing medical school at Duke and residency at Yale.
At UCLA, she is supported by the divisions of geriatric medicine and general internal medicine and health services research. Through their support and the NCSP, Dr. Oyeyemi Walton is balancing her clinical work with her research pursuits, all of which center around older adults with dementia.
Dr. Oyeyemi Walton’s work was published in the November 2023 issue of the Journal of the American Geriatrics Society. In recognition of her impactful research, The Clinician-Scientists Transdisciplinary Aging Research (Clin-STAR) Program awarded Dr. Oyeyemi Walton a national travel award the same month to attend and present at the Clin-Star meeting in Santa Ana Pueblo, New Mexico. The Clin-STAR meeting supports the mission of the National Institute on Aging (NIA) by fostering the development of clinician-scientists in aging, and by providing a platform for exchanging and disseminating information about aging, geriatrics, and advances in aging research to the scientific community.
At the meeting, Dr. Oyeyemi Walton presented her research on caregiving and assistance network changes for older adults during the COVID-19 pandemic. The talk highlighted evidence that older people with dementia were not only more likely to suffer worse medical complications from COVID-19, but also more likely to struggle with other challenging aspects of the pandemic such as disruption of care and isolation. She shared that addressing these specific needs drives her commitment to the field of geriatrics, geriatric research and seeking solutions developed for aging populations that are applicable across a range of communities, especially marginalized communities in healthcare:
"I know that what we can make work for the dementia community, could honestly benefit everyone," she states, "Improved communication, improved caregiver support, and making sure that no one's lost in the health system."
Congratulations Deborah on your award-winning work!
Medicine Trainees in the National Clinician Scholars Program
As we celebrate Dr. Oyeyemi Walton along with all the trainees in the National Clinician Scholars Program, let me welcome the new class of incoming scholars and acknowledge the spectacular leadership of Dr. Joann Elmore. Eleven NCSP scholars will be joining the program this year. They join a talented and driven group of NCSP trainees who have participated in over 50 talks at scientific meetings, panel sessions, and grand rounds throughout the country; published more than 40 scientific reports or editorials in peer‐reviewed publications and earned 7 pilot research awards over the past year.
I would like to highlight the two current NCSP scholars who are supported by the department of medicine. Like Dr. Oyeyemi Walton, these scholars are obtaining rigorous research training in policy and leadership. Below are introductions to the two medicine trainees as shared in the 2023 NCSP Narrative Report.
"Dr. Jocelyn Lo, a primary care internist, is interested in delivery of high‐quality primary care in underserved communities. Her research has focused on community‐based, culturally‐tailored patient education materials and evaluation of appropriateness of preventive services in primary care.
As a first year NCSP scholar, Dr. Lo has partnered with mentors Dr. Arleen Brown (UCLA) and Dr. Soma Wali (Olive View Medical Center) on the DECIPHeR cluster randomized trial called “Multi‐ethnic multilevel strategies and behavioral economics to eliminate hypertension disparities in Los Angeles County.”
Her research project is one intervention in the trial that centers on creating community‐based, culturally‐tailored patient education materials on hypertension. She and the team use qualitative and quantitative assessment of community and stakeholder evaluation of existing patient education materials. The findings are being applied to design culturally tailored hypertension education materials informed by 5 community action boards, including patients, safety net health system partners, and a behavioral sciences team. Additionally, Dr. Lo is working with Dr. Yusuke Tsugawa (UCLA) on a secondary data analysis evaluating appropriateness of preventive services used in primary care.
Dr. Lo is completing her Master of Science in Health Policy and Management at the UCLA Fielding School of Public Health and is co‐precepting UCLA internal medicine residents weekly at Venice Family Clinic.
"Dr. Maria Patanwala is a primary care physician interested in improving social and health outcomes for people experiencing homelessness (PEH) through compassionate clinical care, effective program development and evaluation, and building partnerships between local institutions and agencies to collaboratively serve vulnerable populations.
She is co-funded by the department of medicine and the Department of Veterans Affairs. Dr. Patanwala completed her Master of Science in Health Policy and Management at the UCLA Fielding School of Public Health and is participating in a PCORI‐funded project led by Dr. Lillian Gelberg (VA/UCLA) and Dr. Benjamin Henwood (University of Southern California). Dr. Patanwala’s mentorship team also included Dr. Roya Ijadi‐Maghsoodi (VA/UCLA).
Her primary project is titled “Is supportive housing supportive enough? Qualitative results from the Patient Centered Housing Options, Outcomes, Services, and Environment Study,” which she presented at the Society of General Internal Medicine (SGIM) and will be submitting for publication.
Dr. Patanwala has been practicing clinically in primary care at the Greater Los Angeles Veterans Administration Hospital and with the UCLA Homeless Healthcare Collaborative. During year two of the program, Dr. Patanwala assisted with the Work in Progress (WIP) and Anti‐Racism Curriculum. She collaborated with program leadership to organize bimonthly Work in Progress meetings for fellows to receive feedback and collectively problem‐solve and learn from each other’s projects. She also co‐created and organized the anti‐racism curriculum with program leadership, for health services research fellows to have a better foundation on issues of systemic racism to consider in health equity research."
Program for Reducing Obesity (PRO) Experiences Significant Growth
Obesity continues to sharply increase across the US, with the prevalence exceeding 40% in 2023. However, obesity doesn't impact all communities equally. Obesity prevalence is notably highest among Black and Latino adults, people living in rural communities, and low-income communities. Given these staggering and growing levels of obesity, along with inequitable impacts of obesity likely due in part to barriers such as distance and cost that can make it difficult for some patients to access treatment and preventive care, programs designed to manage patients with obesity in ways that are accessible and do not amplify stigma or negative stereotyping are essential.
In response to this growing need, one of our endocrinology faculty, Na Shen, MD, founded the Program for Reducing Obesity (PRO) in 2019 at the UCLA Thousand Oaks clinic, with the goal of providing education and treatment to patients who may be at highest risk of having obesity related complications and yet may face the greatest barriers in accessing treatment. To help mitigate those hurdles, Dr. Shen structured the program to be as accessible as possible, through an insurance-supported design that offers both individual visits and shared medical appointments. Services include personalized medical and nutritional weight management, comprehensive diagnosis and management of related hormonal and metabolic disorders, body fat assessment, and group nutrition classes on weight loss.
The innovative program is unique in its built-in support for patients -- many of whom were in want of obesity treatment but could not access it due to insurance barriers and lack of local weight management programs. As a result, the success and impact of the program has been resounding and has led to significant program expansion in just the past year. In 2022, PRO consisted of just four obesity medicine certified endocrinologists at three sites (Thousand Oaks, Westlake Village, and Downtown); today, PRO consists of nine obesity medicine certified endocrinologists and primary care physicians (Medical Director Dr. Na Shen, Dr. Susan Ahern, Dr. Deepashree Gupta, Dr. Laura Sue, Dr. Sonya Heitmann, Dr. Jeffrey Wei, Dr. Nazanin Gunn, Dr. Melissa Chung, Dr. Vanessa Schmidt) and newly appointed Nutrition Director Lara Al-Dandachi, RD, across six sites in Thousand Oaks, Westlake Village, Ventura, Burbank, Downtown and Santa Monica. Shared medical appointments are also conducted remotely to promote broader access.
The expansion of PRO represents an innovative approach to address an unmet clinical need in our communities at scale. The project underscores the value of high quality obesity treatment, and why more providers and PCPs should be trained in obesity treatment, which is complex and requires ample time and holistic approaches.
"For a lot of people," Dr. Shen shares, "even those on new life changing weight loss medications, it takes a combination of intensive lifestyle intervention, anti-obesity medications and even surgical interventions to optimally treat obesity — reflecting that obesity treatment should really be collaborative and multi-modal. It’s not either/or anymore."
Dr. Shen also emphasized that to make any strides in combatting the obesity epidemic, stigma must be stamped out.
"There is no place for patient shaming. There are so many factors including hormones, genetics and environment involved, and so many myths and barriers that we’re trying to work through. Obesity is a chronic condition and should be treated just like any other chronic disease without the stigma - which only worsens the issue."
It's clear that PRO is not only mindful of this dynamic, but is setting the precedent for discourse and treatment models as field leaders not just at UCLA, but globally. Thanks for your leadership, Na.
I know that you have many New Year traditions. One of mine, when possible, is catching the sunrise. This does not happen every year, but I have over the years experienced some good ones.
Here is one from a small island in the Caribbean, that I took 6 years ago.