In recognition of the many major accomplishments by women in anesthesia, CSA will be highlighting a variety of women leaders who practice throughout the state, bringing their diverse backgrounds and life perspectives into their work, taking purposeful steps to create pathways for mentorship and sponsorship, and helping support the clinical and research work that is being driven by an increasingly diverse field of anesthesiologists.
Below is one of the series profiles on women making great things happen in anesthesia:
Catherine L. Chen, MD, MPH
Assistant Professor, University of California San Francisco Department of Anesthesia & Perioperative Care
Faculty at Philip R. Lee Institute for Health Policy Studies
What is the focus of your current research?
I am focused on health services research – looking at the delivery of health care on the ground in a real-world environment. So for example, instead of asking, is Drug A versus Drug B better at treating a given disease, we already have existing research that shows that Drug A works more effectively. So then we try to see if physicians are actually prescribing the better drug in their clinical practice. If they’re not prescribing the better drug, why not? Are the barriers financial? Patient-driven? Physician-driven? We are applying this framework to perioperative resource utilization, and one particular area of interest for this is cataract surgery care. Cataract surgery is the most common elective surgical procedure in older adults in the U.S., so decisions on protocols for this can have big impacts on clinical practice and use of resources. Despite clear guidelines stating that routine preoperative medical testing is not needed before cataract surgery, we’ve seen an overuse of routine preoperative testing for cataract patients, which increases costs and creates unnecessary delays in surgical scheduling, without improving patient outcomes. In fact, these delays can actually lead to patient harm. Falls and fall-related injuries are higher among cataract surgery patients being seen by physicians who order more tests versus those who order less, since delaying surgery that improves vision means these patients have a higher chance of falling while waiting for surgery. We are looking into this to understand how to change physician test-ordering behavior to adhere better to guidelines and improve both resource utilization as well as patient health outcomes.
What are some of the unique challenges for women and minorities moving up the ladder in academic medicine?
The higher up the faculty ranks you go, the fewer women there are. There is high attrition of women and underrepresented minorities at the highest levels of academic medicine. What I’ve seen is that navigating the childbearing years, which is often aligned with the Assistant Professor years is hard, so there are fewer women who are able to make the jump from Assistant Professor to Associate Professor. Then there is a smaller pool of Associate Professors, so even fewer make the jump to full Professor. Anesthesia department leadership is generally still male-dominated and there are not as many role models to follow as we navigate those mid-career transition years while raising children. I think that sponsorship can play a really valuable role in addressing some of these challenges. Sponsors advocate for opportunities for their sponsees and help them grow, give them opportunities while they are still “young and unproven,” teach them to think strategically, and help them chart a successful career journey.
What’s your advice for young physicians?
I advise all young physicians to find and connect with mentors and sponsors early in your career, and I advise senior physicians to see the value of this work and provide mentorship/sponsorship support to those coming up the ladder behind them. I also think it’s helpful for young physicians to know what your end goal is and work backwards from there – figure out the steps it will take to get there. For me, I was an English major in college, then worked in investment banking. My dad was also an academic physician, but I didn’t want to jump into that path without being sure it’s what I wanted for myself. After I decided to become a doctor and started medical school, I quickly realized that I loved research. I saw research as a way to impact millions of lives, beyond the lives of my own patients that I would take care of in the course of my clinical career. So I made strategic choices in where I applied for anesthesia residency and have been working to position myself for independent grant funding and independent research.
What do you love about a career in research?
In research, we are always asking new questions, discovering new things, and are never ever bored. I also think the work-life balance is a bit easier in research versus clinical medicine because you have more control over your schedule. Managing three kids, ages 2, 7 and 12, and helping my kids with remote schooling throughout this pandemic has definitely put a spotlight on the value of being able to do my research on a schedule that works for me and my family. I love being in the OR and I get new ideas from that clinical exposure, but I spend about 75 percent of my time on research and I really appreciate that combination of professional roles and responsibilities.