Year 4. November 17. Rockstars, Royalty and the Safety Net
One of the things I have learned from living in LA is that members of our department impact lives across the entire socioeconomic spectrum. Our work is also recognized by grateful patients, some with the means to generously support our institution and others who are simply grateful for the positive impact that we have had on their lives and health. This week I share stories that span the spectrum of recognition, embodying our commitment to be leaders in innovation who transform care and advance health for all.
Mina Sedrak, MD Honored with King Hussein Cancer Research Award
I am proud to share (and am impressed) that Mina S. Sedrak, MD, MS, director of cancer and aging research in the UCLA Department of Medicine (DoM) and co-leader of the UCLA Jonsson Comprehensive Cancer Center Cancer Control and Survivorship Research Program, was recently honored for his groundbreaking work in cancer research with the King Hussein Cancer Research Award’s Young Investigator Award. This recognition celebrates early-career scientists who are making significant progress in research around cancer prevention, detection, diagnosis, treatment and survivorship. Mina traveled to Jordan to receive the award from members of the Jordanian Royal Family during a special ceremony on Nov. 14.
“I’m truly humbled by this honor," Dr. Sedrak said. “It belongs as much to the mentors who guide me, the colleagues and mentees who inspire me, and the patients with cancer who give my work purpose.”
Dr. Sedrak received the award for his research on the biological basis for accelerated aging in people with cancer and potential strategies to ameliorate them. His team at UCLA examines how chemotherapy, radiation and precision medicine therapies alter cells in a way that leads to frailty, chronic health conditions and functional decline. They aim to develop therapies that protect cancer patients from these effects.
“By studying the connection between cancer and aging, we can uncover universal pathways that contribute to chronic disease,” Dr. Sedrak said in a UCLA Health press release about the award. “The ultimate goal is to translate this science into actionable solutions that help people live longer, healthier and more fulfilling lives.”
Congratulations, Mina, on this tremendous honor!
Daniel M. Kozman, MD, MPH and Team Steer Successful Safety Net Partnerships
Our highest calling as a public institution is to serve the needs of our community. One way we do this is through partnerships with safety net hospitals, which are medical centers that guarantee care regardless of a patient’s ability to pay. Our work with these institutions is central to our goals under the community engagement and investment pillar of the UCLA DoM Strategic Plan.
DGSOM Assistant Dean for Inclusive Excellence and the inaugural DoM Director of Health Equity Partnerships Daniel M. Kozman, MD, MPH, who served as a member of the strategic planning community design team, dug deep into how to further our progress on this front during a two-year fellowship with the California Health Care Foundation (CHCF) Health Care Leadership Program, from which he graduated on Sept. 25. For his required California Health Improvement Project, or CHIP, Dr. Kozman analyzed the factors that make safety net partnerships successful and ways to encourage investment from health systems and state-run health insurance programs.
“Before the program, there were a few key healthcare ecosystem players that were less familiar to me in terms of how they function,” Dr. Kozman said. “Our group would bounce ideas off each other and help each other make stronger proposals.”
Dr. Kozman’s matriculation into the CHCF Health Care Leadership Program coincided with his appointment to the role of director of health equity partnerships in the DoM. He leveraged the program’s resources to study how to boost the workforce of and improve retention in safety net hospitals. Dr. Kozman noted that his approach has greatly benefited from the program’s seminars and ideas of other health leaders in his cohort.
In a presentation on his CHIP that he gave as part of his graduation from the program, Dr. Kozman described the efficacy of our safety net partnership model, which is structured as follows:
- Compensation rates for UCLA clinical services are negotiated based on what is the typical safety net rate, rather than private market rate
- The safety net partner keeps any revenue generated by UCLA faculty services
- The UCLA DoM covers the difference between the safety net partner compensation rate and the amount needed to keep the faculty member’s compensation whole compared to their peers
The goal with this model is to bolster our faculty’s presence at safety net health centers and to improve retention, both of which are crucial to expanding safety net capacity, addressing patient needs earlier, and preventing avoidable use of UCLA emergency departments and hospitals, which are frequently used by patients who are underinsured and could be served by safety net institutions. Workforce turnover historically has challenged our safety net partners, making it difficult for them to meet patient needs.
“Our model removes the disincentive to work at safety net health centers, and by doing that, we are increasing the safety net workforce and access to care within these partner organizations, which are amazing organizations,” Dr. Kozman said. “This leverages their strength and supports with providing consistent staffing.”
Our progress so far includes the placement of 25 faculty from 10 specialties across five partner organizations; a departmental award from the dean’s office recognizing our community engagement; and $900,000 in donor funding to departmentally expand and also replicate our model in other departments. Survey data shows that the model works for clinicians, too: Among the 31 UCLA DoM faculty with safety net-based positions who responded to the survey, 90% said that their work at these sites improved alignment with their values, 87% said it made their job more meaningful and 87% said it boosted the likelihood that they would stay in their roles.
Dr. Kozman noted in his presentation that this investment also has impressive returns for our department and the health system more broadly. Research on the business case for physician well-being shows that it costs 2 to 3 times a physician’s salary to replace them; if just one extra faculty member is retained annually above baseline thanks to this model, the program would pay for itself.
Dr. Kozman pointed out that our safety net model has benefits for payers, too. The fellowship put him in contact with a large Medi-Cal managed care plan that has an initiative to increase the capacity of safety net institutions. He and his team are now in discussion with the plan to see if they may be willing to fund some of our safety net partnerships.
“It’s in their interest to make sure that if they assign a patient to a safety net medical group, that the safety net organization truly has the capacity on the ground to address the patient's needs,” Dr. Kozman said. “We’re working within a deeply fractured health ecosystem where patients fall through the cracks, so we’re thinking about this work in a way that shores up the safety net and helps position our faculty and department to step in the gap.”
Studies on the impact of our safety net model are ongoing, including on the wellness of our faculty and partner organizations' staff, the impact of adding endocrinology services on diabetes care outcomes, and an assessment of Federally Qualified Health Center-empaneled patients' utilization of emergency department for ambulatory care-sensitive conditions. Looking ahead, there are plans to expand incentive programs for safety net faculty, identify new recruitment opportunities and grow philanthropic support. Dr. Kozman also hopes to engage the UCLA hospital and clinic system for strategic co-investment.
The success of our safety net model hinges on partner trust. Our partner organizations care for many patients from under-resourced or historically marginalized communities who may be wary of institutions.
“You build trust by rolling up your sleeves and doing work alongside people,” Dr. Kozman noted. “When we do that intentionally by sustainably placing deeply committed people in these positions, our faculty as well as our safety net partners all thrive and better serve our communities.”
Dr. Kozman is grateful to Alice A. Kuo, MD, chief of the med-peds division, and Keith C. Norris, MD, PhD, executive vice chair of the DoM and director of the office of community engagement and inclusive excellence, for supporting him in applying to the CHCF Health Care Leadership Program and for their many years of mentorship. He also acknowledged the immense contributions of the team behind the DoM’s safety net partnerships, including Amy Chen, Camila DeLeon, Albert Haro and Tisha S. Wang, MD. This team in turn extends its deepest thanks to all of the safety net faculty and division leaders who have answered the call to serve, as these impactful community partnerships would not be possible without their critical dedication and service.
Introducing "A Day in the Life": Evan Michael Shannon, MD, MPH
I am excited to share the first installment of the DoM’s new “A Day in the Life” series, a collection of multimedia profiles that offer a look into the day-to-day lives of some of our phenomenal clinical faculty. I hope you will all be motivated to connect with them after you learn more about their work!
Our first clinician is Evan Michael Shannon, MD, MPH, a hospitalist who divides his time between the Greater Los Angeles Veterans Affairs Healthcare System and the UCLA Homeless Healthcare Collaborative (HHC). Dr. Shannon is also a clinician investigator who conducts research on the impact of health-related social factors and race and ethnicity on outcomes for underserved populations. His high-impact work during the COVID-19 pandemic even caught the attention of the Real Heroes Project and earned him a shoutout from professional wrestler John Cena.
“I've always gravitated toward caring for patients who don't have the resources or the means of accessing the state-of-the-art care that UCLA provides,” Dr. Shannon said. "I think it's rewarding to be able to treat people who otherwise wouldn't be able to receive medical care and hopefully improve the trajectory of their health conditions.”
Dr. Shannon's clinical work is divided into four to five two-week blocks at the VA throughout the year, plus one or two shifts a month at the HHC. His days at the VA begin with a review of all the inpatients who will discharge that day, followed by one of his favorite things: learning.
“We have amazing morning conferences at the VA. My colleagues in the hospital medicine group are some of the best educators I’ve ever encountered, the chief residents are excellent educators too, and our residents are superb,” Dr. Shannon said. During the meeting, a resident will present a case, and the chief residents and attendings will chime in to integrate clinical pearls.
“I won’t call it the highlight of my day — I love my job, so a lot of the day is highlights — but it’s a really nice way to get the educational juices flowing,” he said. He spends the rest of the morning rounding with his clinical team, then uses the early afternoon to catch up on research work. The rest of his day is spent checking back in on patients before heading home.
While his work at the VA is highly rewarding, Dr. Shannon sometimes finds it difficult to balance his dual roles as a clinician and a researcher.
“It’s hard to go back and forth, especially when I’m on inpatient time, because I really want to focus fully on patient care and education,” he said. “If I have conflicting deadlines or duties on the research side, they can really stack up on each other, so that can be challenging.”
Additionally, some Veteran patients that Dr. Shannon cares for at the VA do not have the means to participate in their care. They may be unstably housed, experiencing homelessness, or socioeconomically vulnerable, with comorbid substance abuse and mental health issues. That requires a holistic and realistic discharge plan when it’s time for them to leave the hospital, possibly including finding housing options.
“We’re very fortunate to have excellent case managers and social workers at the VA who really know the ins and outs of the system and can help with that,” Dr. Shannon said.
Dr. Shannon’s days with the HHC look a bit different. Those mornings begin with a trip to the organization’s Santa Monica headquarters, where he meets with HHC social workers, nurses, community health workers and mental health professionals to come up with a game plan for the day. They all hop into a van, sometimes accompanied by a resident, and head out to find patients who need help — or who they hope to follow up with. Often, that isn’t possible.
“Sometimes we try to call them, and their phone isn’t on, or they don’t have minutes left. Sometimes we just sort of know what a patient looks like, what clothes they might be wearing or where they usually hang out, and we just have to sort of ask other people, ‘Have you seen this person?’” Dr. Shannon said. While some blood tests can be done on the spot, there are many more that cannot. It is also difficult to coordinate imaging tests.
“It’s not as easy as writing an order in Epic and having a patient get it done,” Dr. Shannon said. “The challenges can be emotional, too."
“You see patients who are in a really tough spot,” he said. “There’s a lot more that I wish we could do, but we’re working within the limitations of the resources we have.”
Though the HHC's work can be difficult, Dr. Shannon loves working with its patient population and is grateful for his team.
“It’s always just such a great atmosphere of really amazing, mission-driven people,” Dr. Shannon said. Thank you, Dr. Shannon, for giving the DoM a peek into your day-to-day work. Be on the lookout in December for our next profile!
Diana Márquez-Garbán, MD Receives Teaching Excellence Award
Back in July I shared the happy news that Diana Márquez-Garbán, MD, a physician-scientist in the hematology-oncology division and prolific mentor to undergraduate students from underrepresented backgrounds, was to be honored with UCLA Distinguished Teaching Award. Dr. Márquez-Garbán officially received her award during the Andrea L. Rich Night to Honor Teaching, which took place on Oct. 23 at the Luskin Center.
“I feel so deeply honored that among so many brilliant professors and colleagues at UCLA, I was selected to receive this award,” she said. “Being surrounded by passionate educators who are deeply committed to their students was truly inspiring.”
In her acceptance speech, Dr. Márquez-Garbán spoke of her experience helping first-generation college students navigate the challenges of balancing school and family needs. As an immigrant physician-scientist herself, she is familiar with many of their struggles.
Senior Executive Academic Vice Chair of the Department of Medicine Gregory Brent, MD attended the event to support Dr. Márquez-Garbán.
“It is a special and rare distinction for school of medicine faculty to be recognized with this very competitive UCLA campus-wide teaching award,” Dr. Brent said. “Dr. Márquez-Garbán has been a highly impactful teacher and mentor for undergraduate students working with her in the laboratory, with many crediting her impact on their academic and professional success in graduate and professional school.”
Dr. Márquez-Garbán has seen the power of her work firsthand. The award validates that others see it too.
“Receiving this award reaffirmed my belief that mentoring is a powerful form of advocacy. I strongly believe that representation and equity are integral to excellence in science and medicine,” she said. “As I continue to teach and mentor, I am committed to creating environments where every student, regardless of background, feels valued, challenged, and empowered to reach their full potential.”
She added that helping students see themselves as capable scholars and future leaders has been one of the most meaningful aspects of her teaching.
“Over the years, I have learned that small acts, such as creating inclusive spaces or connecting students with opportunities, can have a lasting impact,” she said. Watch the video that was made and presented of Dr. Márquez-Garbán sharing her story here.
NIH Awards Funding to Collaborative New Center for Aging Research
I am thrilled to share that UCLA DoM faculty will be part of a groundbreaking collaborative new center to study aging that recently received significant funding from the National Institutes of Health (NIH) and the National Institute on Aging (NIA). UCLA, Cedars-Sinai, and the University of Southern California (USC) were awarded an NIH and NIA grant of $6.5 million to establish the Los Angeles Claude D. Pepper Older Americans Independence Center. The VA Greater Los Angeles Healthcare System is also a partner in the research conducted there.
UCLA geriatrician and scientist Jonathan Wanagat, MD, PhD will serve as co-director of the Pepper Center. He called its funding “incredibly gratifying.”
“This award recognizes years of collaborative work across UCLA, the VA, Cedars-Sinai, and USC to build a regional hub for aging research,” Dr. Wanagat said. “More importantly, it affirms that our teams are doing the kind of rigorous, translational science that can truly improve the lives of older adults.”
The center will be part of a 15-center national consortium on aging that will serve the goal of extending the health span of older adults. UCLA faculty will lead studies on a wide range of topics, including exercise and nutrition interventions, molecular biomarkers to predict resilience and recovery, and much more. Dr. Wanagat is especially excited about a project that assesses how cancer survivors regain strength and function after chemotherapy by integrating skeletal muscle biology, frailty assessments and mitochondrial genetics. He also looks forward to another project that will identify blood-based biomarkers for biological aging, which could guide individualized interventions.
“I’m most excited about what this means for our trainees and early-career investigators,” Dr. Wanagat added. “The Pepper Center creates a research home for them, a place where they can connect basic discovery to clinical practice and patient outcomes. Building that next generation of geroscience researchers is the most important part of this work.”
The center is timely because the population is aging more quickly than the healthcare system can adapt. It will serve as a hub for scientists and clinicians who want to develop practical, evidence-based strategies to extend healthspan, not just lifespan — and, in Dr. Wanagat’s view, is a model for how major L.A. institutions can work together to tackle shared challenges.
“This center exists because of a shared commitment, from our faculty, institutional partners, and philanthropic supporters, to transform how we study and treat aging,” Dr. Wanagat said. “It’s a chance for Los Angeles to lead nationally in advancing not just longer lives, but better ones.”
Digestive Diseases LEADERS Make Trip to Olive View-UCLA to Celebrate Collaboration
Finally, I will share some updates from Olive View-UCLA Medical Center in Sylmar, where our presence continues to expand in the form of educational opportunities, patient care initiatives and research endeavors. Department and UCLA Division of Digestive Diseases leaders paid a special visit to Olive View on Sept. 23, where they learned about the remarkable growth of the Olive View-UCLA Division of Gastroenterology and discussed exciting future plans that will make our partnership even stronger.
“I was thrilled to learn about the expansion of UCLA-Olive View’s clinical care capacity. This development was critical to meet the needs of a growing community,” Eric Esrailian, MD, MPH, chief of the UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, said. “The quality is excellent, and our GI fellows have loved their educational experiences over the years. By partnering with our expanding faculty and programs in UCLA Division of Digestive Diseases, the opportunities for clinical research will also grow with time.”
Dr. Esrailian was joined by division Vice Chief and UCLA Digestive Diseases Fellowship Program Director Lin Chang, MD and Senior Executive Academic Vice Chair Gregory Brent, MD. They were hosted by Olive View-UCLA Department of Medicine Chair and Vice Chair for Affiliates Soma Wali, MD, FACP and Olive View-UCLA Division of Gastroenterology Chief Simon W. Beavan, MD, PhD, who gave a presentation about the division’s immense growth in clinical volume and procedures offered.
“I am so grateful for the leadership and vision of Dr. Wali and Dr. Beaven, and they have truly built an amazing gastroenterology and hepatology program with their colleagues at UCLA-Olive View in a few short years,” Dr. Esrailian added. Dr. Beavan has recruited exceptional faculty in interventional gastroenterology and hepatology and provides important expertise for patients in the county health system.
Others involved in the day’s discussions included Olive View-UCLA CMO Benjamin Waterman, MD; Olive View-UCLA Department of Medicine Vice Chair and Pulmonary/Critical Care Division Chief Nader Kamangar, MD; Olive View-UCLA Vice Chief of GIM Services Richard Tennant, MD, FACP; and Laxmi Suthar, MD, FACP, program director of the UCLA-Olive View Categorical & Preliminary Internal Medicine Residency program and Olive View-UCLA designated institutional official. A meeting was also held with the Olive View-UCLA Department of Medicine division chiefs, who discussed opportunities for further collaborations in clinical care, training programs and research, including building out the infrastructure for clinical trials. Their conversation also included sharing resources that are being developed as part the strategic plan with Olive View-UCLA faculty and trainees, including mentorship programs, faculty development and expanded research resources. Thank you to our digestive diseases and gastroenterology LEADERS at Olive View and UCLA for your dedication to advancing our missions!
Dale
P.S.
There is one more rockstar to give a shout out to. Last weekend, we had the opportunity to celebrate with Ali Nsair, MD (wearing the #1 t-shirt), who was honored on field at the LA Chargers football game against the Pittsburgh Steelers. Dr. Nsair is the director of the Heart Transplantation and Mechanical Circulatory Support Program at UCLA and associate professor in the division of cardiology. I am sure Ali’s presence contributed to the Chargers’ resounding victory.
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