1. < Message from the Chair

This week, join me in celebrating LEADERS from our education, patient care, and research missions.

Thank you, Peeps!

The internal medicine chief residents play a critical role in advancing our education mission and in coordinating the activities of our large residency program, which critically supports the health system to provide exceptional health care to all. In their leadership roles, they have guided our residents through a rigorous training experience, they lead critical recruitment activities, and serve as outstanding LEADERS that embody all that is great about the UCLA Department of Medicine (DoM). As they prepare to step down from their year of chief residency, I would like to extend a sincere THANK YOU on behalf of the entire department. Each class of chief residents makes us stronger as an academic medical center and a place of learning. The Peeps have certainly left their mark and I invite you to hear directly from them about their experiences this past year.

Jeanne M. Huchting, NP Receives Daisy Award for Outstanding Nursing Care and Leadership

The Daisy Foundation honors exceptional nurses who go above and beyond to provide patients and their families with excellent clinical care and compassion. Throughout our hospitals, community practices, and teams, nurses who support our faculty’s clinical programs, embody our values as LEADERS and their contributions are invaluable as we partner to provide the highest quality patient care. Please join me in celebrating Jeanne M. Huchting, NP who is the recent recipient of the Daisy Award!

Jeanne’s journey from her graduation from the UCLA School of Nursing to her current role as a vital member of the UCLA TAVR Program exemplify her dedication, compassion, and excellence in nursing. She began her career at UCLA in 2004 at the UCLA-Santa Monica Cardiology practice where she performed cardiac stress tests, managed the Coumadin Clinic, cared for outpatient cardiology patients, and rounded on the Santa Monica Cardiology Consult Service. Six years later, she joined the UCLA Westwood Cardiology Consult team where she led the cardiac preoperative risk stratification program for patients evaluated for liver transplants.

While serving as a leader in the TAVR Program, Jeanne maintains an unwavering compassion and empathy towards her patients. She was nominated for the Daisy Award by a veteran at the West Los Angeles VA Medical Center. “I realized how powerful fear can be,” she states, but in recognizing the greater power of empathy, Jeanne provided this veteran invaluable support and guidance that eased his fears about re-engaging with the healthcare system after he had traumatic experiences both in the military and in the health care system.

Jeanne humbly acknowledges the effort of her team sharing that she “was not the only nurse helping him on his TAVR journey at UCLA. My amazing team is to be credited for his good experience here. Receiving the Daisy Award on behalf of the TAVR team means so much to me… [it] reminds me that no matter how busy our work schedules get, we, as nurses, are appreciated for the simple acts of kindness that we give our patients daily.”

As a nurse and health care leader, Jeanne serves as an inspiration to us all. She credits her mother and father for her nurturing genes and credits her daughters for inspiring her to continue this critical work. She concludes ”I want my daughters to know that they too can have a successful career, a loving and busy family life, and make a difference in the world.”

We congratulate Jeanne on this well-deserved honor and thank her for her continued dedication to excellence in nursing.

Publication Spotlight: “Comparison of Hospital Mortality and Readmission Rates by Physician and Patient Sex,” by Yusuke Tsugawa, MD, PhD

A recent study spearheaded by Yusuke Tsugawa, MD, PhD explores how the sex of physicians impacts the clinical outcomes of their patients, with a focus on differences between male and female patients. In “Comparison of Hospital Mortality and Readmission Rates by Physician and Patient Sex,” Dr. Tsugawa used Medicare claims data between 2016 to 2019 examining approximately 770,000 patients hospitalized for a medical condition and found that patients treated by female physicians generally experienced lower mortality and readmission rates than patients treated by male physicians, and the benefit of receiving the treatment from female physicians was greater for female patients than for male patients.

Dr. Tsugawa and researchers noted that there may be several factors contributing to this. They include male physicians underestimating illness severity among female patients which may result in incomplete or delayed care, leading to poorer health outcomes. A second factor could be associating female physicians with patient-centered and effective communication among female patients. Third, female patients may feel more comfortable discussing health topics with female physicians, that they may be embarrassed to discuss with males, or considered sociocultural taboos.

Dr. Tsugawa notes that there are limitations to the study and that additional research is needed to understand the underlying mechanisms leading to better outcomes for female patients treated by female physicians. The research does raise the importance of increasing the number of female physicians in the health care industry as well as eliminating pay disparities between genders.

This study received widespread press coverage across the world. See here for examples of news coverage.

Congratulations Yusuke for this impactful and study.

Reflecting on this paper, moved me to highlight a critical resource, built by Dr. Tsugawa that not only supports his research, but that of many faculty within the DoM.

DoM Stat Data Core: A Pillar of Research Excellence and Collaboration

Let me now summarize Dr. Tsugawa’s broader contribution to our leadership in research in directing the DoMStat Data Core. An important goal for our research mission in the DoM strategic plan is to accelerate the growth and impact of our research and discoveries. A key objective in this mission is to strengthen research infrastructure. One example of how we are doing this so is illustrated by Dr. Tsugawa’s DoMStat Data Core which celebrates its fourth year of service to investigators.

Since its inception in 2020, the DoMStat Data Core has become a valued resource for the DoM research community and beyond. The Data Core which offers a wide range of support services for investigators, such as managing data use agreements and IRB processes to data analysis, has helped produce successful grant proposals and publications for faculty, post-doctoral fellows, and students. 

I am pleased to share some of the progress that the Data Core has achieved over the past four years and encourage our investigators to explore the resources and identify opportunities for collaboration. Currently, the Data Core houses seven large databases and is actively used by 24 investigators, including seven DoM faculty members, 10 non-DoM faculty members, and seven trainees. The seven databases include:

• National Medicare Fee-for-service Data
• California Medicare Fee-for-service Data
• Merative MarketScan Data
• Healthcare Cost and Utilization Project (HCUP) SID&SEDD (12 states)
• SEER – Medicare Data
• Health Care Access and Information (HCAI) Data
• Hospital and Physician Databases (e.g., AHA Annual Survey Data)

The results of the Data Core’s efforts have generated successful extramural funding totaling $3.3 million. Additionally, eight grant applications using the Data Core databases are currently under review. Finally, a total of 15 papers using the Data Core databases have been published.

I applaud Yusuke and the DoMStat team who have established an important resource and service for our DoM investigators! I look forward to learning more about the Data Core’s partnerships with faculty, trainees, and students, as well as their successes!

In Conversation with… Susanne B. Nicholas, MD, MPH, PhD, Selected for Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program

Last week, we announced that Dr. Susanne B. Nicholas has been selected for the prestigious Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program. Each year, academic medical centers are invited to nominate two faculty members for ELAM’s competitive selection process, resulting in a cohort of 60 fellows. Dr. Nicholas engaged with us in conversation to share what this moment means to her.

What inspired you to apply for the Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program?

I have been interested in pursuing an executive leadership role for many years and have deliberately sought out leadership-training courses that have all been very educational. Unlike other courses, the 2024 Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program uniquely provides a yearlong, leadership development course on topics such as strategic planning and risk-taking, financial budgets, resource distribution and allocation, time management, contract negotiation, strategies for self-growth, and effective communication across all aisles. In addition, ELAM will offer opportunities for networking and career building with like-minded medical faculty at a national level. Importantly, my acceptance as the UCLA DGSOM 2024-2025 ELAM Fellow guarantees individualized mentoring by the UCLA Dean and Vice Dean of the School of Medicine in addition to local and national sponsorship that would otherwise not have been accessible.

How do you envision applying the knowledge and experiences gained from the program to your role and institution?

I envision that the knowledge and experiences gained from the ELAM program will fuel my desire to be a change-maker within my division, department and school. Currently, there are 35.5 million adults in our country with chronic kidney disease; as a translational science investigator and clinician, I would like to create a successful, sustainable outreach program for local communities to improve kidney care and to create a blueprint for equitable kidney health that will extend across, and beyond UCLA.

Can you share a particularly impactful moment or achievement from your career that has shaped your leadership style?

Over the past seven years, my service as a passionate and active member of the Executive Council of Women in Nephrology led to my election to serve a two-year term as president (2023-2024) of this international organization. This has significantly opened new paths to effectively touch the lives and support the academic growth and development of numerous women professionals in the field. This role allows me to solidify the elements of my personal leadership style, which is one of inclusion and teamwork. I believe in providing opportunities for individuality, distinction, open discussion, and active participation. I am really pleased to have the chance to take the organization to a higher level and to increase access to mentorship and leadership training for our members, both within the United States and across more than 20 countries around the world.

What advice would you give to other women aspiring to leadership positions in academic medicine?

There are several pieces of wisdom-inspired advice that I would willingly offer to women aspiring to leadership positions in academic medicine. Some guidance includes -don’t give up, find a mentor(s) early in your career (finding a sponsor is advisable too!), be an active participant, continuously seek out and develop new relevant skills.  

What are your hopes and aspirations for the future of women in leadership roles within academic medicine?

As a strong advocate for advancing women as leaders in the field of medicine, and especially within nephrology, my hope is that women will have equal opportunity to demonstrate their knowledge and expertise without prejudice and without having to continually overcome hurdles that are deliberately placed in their path. To gain full recognition within academia, it is hoped that women will have more occasions to serve as speakers at medical conferences, and grand rounds; to be part of conference organizing committees and steering committees; to receive coveted lectureships and endowed positions; to be offered equitable salaries and that barriers to achieve work/life balance are lowered. 

In Conversation with… Tisha Wang, MD Graduate of the Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program

As we celebrate Dr. Nicholas, join me in also celebrating Dr. Tisha Wang who has just completed the ELAM Program! After a year-long fellowship that includes extensive coaching, networking and mentoring, here is what she had to say about the experience.

How do you feel the ELAM Program has contributed to your personal and professional growth?

Even though I've had multiple leadership positions at UCLA, I haven’t participated in leadership training that extends beyond a few days. The ELAM Program gave me a chance to really focus on both developing and refining a variety of leadership skills that I will apply to all aspects of my career. It's a time intensive year-long program and through professional development, learning communities, 360 evaluations, and professional coaching I discovered ways to both leverage my strengths and actively work on any areas where I need more experience.

What are some key takeaways or insights gained from the program that have influenced your approach to leadership in medicine?

One of my key takeaways was from an exercise we participated in called "power and systems." We role-played for an entire day and felt what it was like to be upper management, middle management, and staff. Everyone was frustrated with everyone else because although everyone was trying their absolute best, the perspectives were so different. Thankfully I've been in all 3 roles in my career, and it reminded me that as upper management, you can only be effective if you never forget what it is to be a staff member. It also reinforced the importance of pro-actively communicating to all groups in a transparent fashion about the mission, plans, goals, and challenges because otherwise the staff don't understand why certain decisions are being made. Being aware of everyone's perspective and better understanding where everyone is coming from allows everyone to be more kind, patient, empathic and we need more of that in our everyday lives. 

Another key takeaway was that I must continue to be a good role model for other women by mentoring them, sponsoring them, connecting them and empowering them. I also have to do my best to continue to take advantage of any opportunities that come my way that would allow me to become even more influential. Most days I think of myself as a small-town kid from Texas who did not have the ambitions to become an academic physician, much less a leader. So sometimes I wake up and realize that I have this amazing academic career and am so grateful to even be working here that I rarely think about the next step. ELAM was largely created so that women leaders would not become complacent in their roles but try to rise if the opportunity presented itself. There are still very few women deans, chairs, chancellors, presidents etc., making it harder for women to sponsor other women at a certain level. That can only change if some of us continue to rise - the idea of rising to eventually sponsor and help support others is a driving force in my career.

How has participating in the program impacted your ability to navigate the challenges commonly faced by leaders in academic medicine?

Much of what I do daily, is solve complex problems, deal with conflict, and make decisions that make the most sense for patients, providers, and our finances – decisions that we as the executive DoM leadership have to take full responsibility for, no matter what the outcome is. It's not always easy and you have to constantly make trade-offs.

One of our first ELAM projects was to save an academic institution that was going under. We had to work together as a team with health system leaders to save the institution while compromising on where to cut programs, budgets, staff. The decisions we had to make really simulated the tough decisions we make on a regular basis, many of which must be negotiated with other stakeholders.

The experience highlighted the fact that academic centers everywhere are all struggling with the same issues - physician and staff retention, burnout, financial cuts to education and research that can only be mitigated by increasing clinical revenue and/or philanthropy, generational differences, clinic access, and overflowing emergency rooms.

The ways in which the program created so much solidarity among the community of women leaders I met, was nothing less than amazing. They are now my sounding board so that I am never alone when navigating difficult challenges - not only do I have the internal DoM executive dream team, but I now also have a new brain trust of women leaders from across the country who can provide insights on the best practices and solutions they have developed at their own institutions. That is a pretty priceless resource, and I made some lifelong friends and connections in the process. 

What do you see as the most significant challenges and opportunities for women aspiring to leadership positions in academic medicine?

The data clearly shows that many women stall at the associate professor level in academia, and it is really such a difficult time in life as many women are trying to raise children and take care of elderly parents. Women still do much more of the caregiving at home and it often coincides with the time that many are trying to climb in their careers. Women also have much higher burnout nationally and certainly at UCLA - this is related to so many known and unknown factors and it is going to take systemic change to even be able to make a dent in these statistics. So, while it is a huge challenge it is also a true opportunity to make a difference. This was actually my institutional action project for ELAM and I plan to continue working on the gender gap in burnout for years to come. 

Another significant challenge is that women leaders are often held to a different standard. People often don't like women leaders who are tough or assertive and expect them instead to be caring, nurturing, and compliant. But when women stick to the nurturing persona, they can be seen as weak. I also think because of certain perceptions, women are less likely to self-promote or pursue a job opportunity if they do not feel that they are fully qualified. 

I think the biggest opportunity is that there is power in numbers. More women are entering medicine and can support one another - to help each other gracefully self-promote and to encourage them to be strong, genuine leaders who can also concurrently be caring and nurturing in certain situations. I've been lucky in that I've always had a coalition of women in my career that I turn to when I need advice, support, or simply need to blow off some steam or just laugh at the ridiculousness of it all. They have unconditionally supported me for so many years and ELAM has created another community that I can truly rely on. And honestly the best part is being able to celebrate your successes with them. Getting an award is great but sharing it and being celebrated by a coalition of women amplifies the joy and pride in every award and accomplishment.  If we continue supporting and mentoring one another and find the many male allies that are out there, we can really help other women rise.

What are your goals and aspirations for your continued leadership journey in academic medicine?

I want to pay it forward to the next generation. Very few women in the country and at UCLA get to participate in a program like ELAM and as we get more and more ELUMs in the DoM (Suzanne Nicholas will be our next one and I'm so excited for her!), I'd like to bring back some of what we have learned and create a faculty development program here at UCLA to help give others an opportunity to learn these helpful skillsets and strategies. I also want to create a more connected women in medicine community in the DoM so that we can celebrate each other's joys and wins, small and big. 

Inaugural Three-Year Annual Conference on Addressing Mental Health Resiliency Using Non-Drug Approaches in the Greater Los Angeles Area and Shanghai

Recognizing the global impact of mental health challenges, it is crucial that we explore innovative and holistic approaches to address this pressing issue. To promote mental health awareness and non-drug approaches in our communities and as part of its 30^th anniversary celebration, the UCLA Center for East-West Medicine hosted a conference: “Addressing Mental Health Resiliency Using Non-Drug Approaches in the Greater Los Angeles Area and Shanghai” at the UCLA Carnesale Commons on May 4, 2024. This conference was the inaugural annual conference as part of a three-year grant funded by the Cyrus Tang Foundation. This conference was also funded by the UCSD Fudan-UC Center on Contemporary China and made possible through the support of collaborators, CSC Health, Shanghai University of Traditional Chinese Medicine, and Fudan University School of Public Health.

Coinciding with Asian American and Pacific Islander Heritage Month, and Mental Health Awareness Month, this conference was dedicated to raising awareness and improving access to culturally appropriate and evidence-based non-drug mental health services in our communities.

The conference, which convened over 110 attendees, received strong support from Cindy Fan, PhD, vice provost for international studies and global engagement at UCLA, who delivered the opening remarks on behalf of UCLA. Afterwards, Peter Ng, CEO of the Chinatown Service Center, also shared opening remarks representing community partners. Weijun Zhang, DrPH, principal investigator of the three-year grant introduced the background of the global health collaboration on developing culturally appropriate non-drug mental health services in local communities. Edward Hui, MD, FACP, clinical chief of UCLA Center for East-West Medicine also welcomed participants on behalf of the Center. 

Min Zhou, PhD and Kenneth Carter, MD, MPH delivered keynote presentations, respectively. Dr. Min Zhou, director of the Asia Pacific Center and Professor of Sociology and Asian American Studies at UCLA, analyzed the characteristics of Asian immigrants in Los Angeles in relation to mental health. While Dr. Kenneth Carter, president of the National Acupuncture Detoxification Association, discussed the embryonic structure of auricular acupuncture and its application in promoting mental health.

The keynote presentations were followed by two expert panel discussions. The first panel discussion focused on building mental health resilience in the Chinese community in Los Angeles County. Two CSC Health behavioral health leaders, Nina Loc and Chun Mei Lam, shared their experiences as licensed counselors in the San Gabriel Valley area and shared insight about appropriate and successful mental health activities for local community members. Yan Ding, MD, director of the Weifang Community Health Center in Shanghai, shared her experiences in tailoring traditional Chinese medicine non-drug mental health therapies to residents of Shanghai communities. Derek Hsieh, PhD, Mental Health Clinical Program Head of the Los Angeles County Department of Mental Health’s Long Beach Asian Pacific Islander Family Mental Health Center, discussed specific strategies that communities can adopt based on Asian Pacific Islander mental-health treatment-seeking behaviors and cultural preferences.

The second expert panel discussion focused on community mental health services projects developed by Tang scholars selected from three collaborating universities (UCLA, Fudan University, and Shanghai University of Traditional Chinese Medicine) in the grant funded by the Cyrus Tang Foundation. Kandace Fung and Anika Ullah, third-year medical students at UCLA David Geffen School of Medicine, respectively shared about non-drug therapies for postpartum depression in women and non-drug therapies for Asians using art and natural therapies. Zheyi Fang, a doctoral student from Fudan University School of Public Health, reported on building the capacity of mental health services for Chinese community health workforce in the post-pandemic era.

During the “Meet the Experts” luncheon, participants met with experts from ten different topics related to clinical, educational and research programs on non-drug approaches. After a healthy Mediterranean-style lunch, the afternoon breakout sessions allowed attendees to experience evidence-based non-drug therapies in four separate workshop rooms, including the National Acupuncture Detoxification Association protocol through ear acupressure, body acupressure, Tai Chi, yoga, lifestyle medicine, and music and art therapy.

I hope you will agree that our LEADERS are having a major impact on our health system, our community and on the practice of medicine around the world!

Dale

P.S.

Hope you all had a restful Memorial Day weekend.

In early May, I spent a few days in Spain. While visiting Seville, and wearing a DoM T-Shirt, I was stopped by a gentleman who asked if I was connected to UCLA. He proceeded to tell me that he was the proud parent of one of our DGSOM’s graduates and PRIME program alum, Dr. Jackelyn Moya (DGSOM MD’2021). As we enter graduation season, this encounter reminded me of the core mission of our school in training graduates who will impact the world, while making their parents very proud.

Me and Mr. Roberto Moya on the river front in Seville, Spain.

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