- 1. Congratulations on your position as the new SOHM listserv moderator! What do you see as the role of the listserv in PHM? Do you have any plans for changes or upgrades during your term?
Thank you! It is an honor and privilege to assume this role. The listserv, in my view, serves three important purposes. First, it allows for the rapid exchange of clinical expertise. Second, it provides a safe space for pediatric hospitalists to support each other in the midst of challenges unique to our specialty or more generally in the practice of medicine. Third, it provides a forum for strategizing over the direction we want the specialty to go as well as how to respond to a wide range of factors that impact child health. The listserv has fulfilled these roles very well in recent years and I have no plans to fix what isn't broken. I would like to continue to enhance the ability of our membership to search and retrieve the wealth of information contained in past posts. And I have a deep desire to keep the conversation going around diversity and equity in medicine--without creating any sort of "agenda" for the listserv. I eagerly solicit input into how to best support the listserv community in those goals.
2. You have your Master’s Degree in Epidemiology from Michigan State University and then did a Post-Doctoral Fellowship in Perinatal Epidemiology—how do those degrees help you in your work as a pediatric hospitalist?
My degree in epidemiology has proven very helpful in parsing the literature as I strive to be ever more evidence based in my practice, and I hope it has been of some help to my colleagues as we work together in that regard. Both my master's training and my post-doctoral fellowship serve as a constant reminder that what I see in the hospital is the end result of factors at work in the community and, often, factors at work before birth. While I work inside the relatively controlled environment of our hospital, I hope this background keeps me grounded in the importance of advocacy for families in our community and across the globe.
3. As both a clinician and researcher, how do you balance your time? And what research project(s) are you working on right now?
For many of us, getting "protected" time for research is a constant struggle. I consider myself to be very fortunate to have the generous support of the DeVos Cardiovascular Research Program that allows me to devote time to research. In addition, my section and departmental leadership are very supportive and recognize the importance of research for our patients as well as the development of our specialty. My research right now focuses on the gene transcriptional events that are required for normal heart development as well as regeneration after injury. The goal is to repurpose existing therapies and even dietary habits to promote heart development and regeneration.
4. You completed your Pediatric Residency at Helen DeVos Children’s Hospital and now are a Pediatric Hospitalist there. What made you want to stay at the same hospital where you did your training? How do you counsel pediatric residents in regards to staying at the same institution versus changing location during training?
Well, what more could one ask for than HDVCH? A quaternary referral center and teaching hospital treating every pathology you can imagine, tucked into a fantastic little big city with all the cultural offerings you could want combined with a family friendly atmosphere. Having said that, I have so much enjoyed gaining the perspectives of my partners that have trained elsewhere. There is a lot to be said for training at one location and practicing elsewhere. I just couldn't help myself.
5. You were the owner of Exsilico Consulting LLC from 2007 to 2012; can you tell us more about this business? How did it play a role in your career path?
Wow. You really did read my CV. I have always been fascinated with computers and my research has always focused on bioinformatics and computational biology. I leveraged those skills to do consulting with biotech start up companies in the past. Not only is working with biotech startups fun, but also gives insights into how the business aspects of developing new diagnostics and therapeutics works. I find this helpful in thinking about how to bring new ideas all the way to the bedside.
6. As co-author of “Archived unfrozen neonatal blood spots are amendable to quantitative gene expression analysis” in Neonatology, you discuss the feasibility of using blood spots from the newborn screen for microarray and qPCR assays as a resource for perinatal determinants of disease development. What are the ethical implications of this work? What would your response be to parents that want to refuse the Newborn State Screen in the newborn nursery?
There continues to be a lot of confusion in the general public about genomics--which is perfectly understandable given how rapidly the field is developing. The work we did was totally anonymized, and all work on blood spots where informed consent was not possible (for example, using archived blood spots) would be similarly anonymized. I think some have the perception that employers or insurers or others would use genetic profiling of blood spots with nefarious intent. But that is just not possible in our current regulatory environment. I would tell parents that the newborn screen offers them a chance to identify devastating illnesses and intervene before it is too late, and that those samples would never be used in a way that could be detrimental to them or their infants. In general, I have found that the overwhelming majority of parents are eager to do all they can to maximize their children's health and, even beyond that, to do what they can to help other children. In my research I have encountered very little resistance on the part of families even for genomics work.
7. Jack Percelay often ends his list-serve commentary with the phrase “that’s just my 2 pennies.” What are your two cents?
Keep the great dialogue going! On the listserv, keep it brief if you can, make it witty if you want, and always always keep it cordial.