As a physician and scientist, Elena Fuentes-Afflick, MD, MPH, has long combined her research and clinical interests to improve the lives of her patients and their families. On July 16, he joins the AAMC as chief scientific officer, a role in which he will lead the organization’s research and science policy efforts, as well as oversee the direction of the Center for Health Justice, which developing and promoting health equity research and policy.
A pediatrician by training, Fuentes-Afflick comes to AAMC from the University of California, San Francisco (UCSF), where he was a professor of pediatrics and assistant professor at the UCSF School of Medicine Zuckerberg San Francisco General Hospital. He has held national leadership positions as a board member and president of the American Pediatric Society and the Association for Pediatric Research. Fuentes-Afflick is an elected member of the American Academy of Arts and Sciences and the National Academy of Medicine (NAM). Currently, he serves as the Home Secretary of NAM. Her academic work has focused on gender issues, including Latino health, immigrant health, health disparities, and various forms of academic medicine.
«I am empowered to apply my lifelong passion for — and commitment to — academic medicine at the AAMC, and lead efforts to educate the public about the importance of science and research,» he says.
Fuentes-Afflick spoke with him recently AAMCNews about the challenges facing scientists in a post-pandemic world, and the opportunities for researchers and academics.
This discussion has been edited for brevity and clarity.
You are a pediatrician by training. What made you choose that option?
I am a very happy pediatrician. I considered a few other specialties, but I’m so glad I chose pediatrics. I believe that children represent our future, and it is an honor to contribute to the growth and development of children, youth, and young adults. I think we have the opportunity to make a very important contribution to society through our work.
Pediatricians aren’t for everyone, obviously. Many people will say, «But you can’t talk to your patients,» or «It’s hard to see sick children or to see children die,» and that’s true, but many children they are healthy, and most of them are true. grow up and have a chance to be the next generation of our community.
Most of your research focuses on gender issues, both in the patient population but also in health care workers. Why is equality in the health professions so important?
What we all understand very clearly is that we live in a society and work in jobs that have a long history of injustice. And as our organizations become more diverse, as our workforce gradually changes, issues of equality and opportunity have emerged as very powerful topics that challenge us, all the time at work, to understand and to deal with them. My first priority is to make sure that, as health professionals, we provide opportunities to all who are interested in working in our profession. On a personal, departmental, and organizational level, we must ensure that equality is central to our values ​​as well as our practices. We have to speak the language. We also have to walk. And by that, I mean that we want individuals to succeed and contribute uniquely, so gender needs to be addressed across the board and at the highest levels of leadership.
You’ve been studying health balance for most of your career. What’s the biggest change you’ve noticed?
I have always been interested in what we would now call health equity, mainly because of my experience as well as my clinical experiences working in community hospitals in San Francisco, where diversity issues are important to what we do. In the early days at UCSF, we were a group of researchers from different fields, but we all had a commitment to what we initially called minority health. So we met as a group under the leadership of Dr. Gene Washington and Dr. Eliseo Pérez-Stable, both of whom have had remarkable careers in advancing social equality. And we created a structure, an institutional structure, of a university that we called the Medical Success Research Center for a Diverse Population. [now called the Multiethnic Health Equity Research Center]. It gave us an organization and helped us to create our research agenda and research community focusing on different topics, depending on our skills or our behavior. Over time, our community grew, the nation grew, now we find ourselves in a situation where there is no difference in life, when we use that word, we understand how what do you mean. We have a common understanding of why it is important, and we understand that it is important for clinical care, education, research, policy. So for 30 years, it’s been amazing to see how complicated we are now and how it seems to be a shared priority.
During the COVID-19 pandemic, we learned how important basic financial science is – as research on mRNA vaccines over the past 20 years has helped develop a vaccine in record time. However we also know that there are differences in who receives funding. What are your thoughts on improving equity in NIH funding?
As you know, there is a perception among the research community, supported by a growing literature, that there is a disparity between the topics covered or the topics funded and the people funded. So because the National Institutes of Health is our country’s leading sponsor of research and academic medicine, I think what the NIH is doing sets an example for others. I believe it is very important in this role that I work with the NIH to support their efforts to ensure equity in funding, to the extent that they can change their existing structures or review their practices. and to identify areas where they need to improve. Almost all of the major health issues in our country have different dimensions in terms of who is affected or who dies, etc. and so the lens of disparity applies almost entirely. and every topic, and I hope to work with the NIH to solve these problems. .
The COVID-19 pandemic has created a great deal of mistrust in science and the scientific community. What do you think can be done to improve the way science and scientists are perceived in the public eye?
I am very worried and sometimes disappointed about this change in the attitude of the importance of science and research, as well as the attitude of people who do science and research, because we have serious issues that need to be solved, they can be solved it is our community.
As we recover from this pandemic, it is disheartening that people are questioning the quality of vaccines, our approach to COVID, the intersection between medicine and public health, and the impact of climate change on health. We need to bring good science to these important questions. But then, do we make sure that we convey the message in a way that is understandable and believable? We always focused on understanding, thinking that we don’t want to use too many words, we don’t want to say the wrong way. But we had an irrational feeling that we were trustworthy people, we were trusted advisors, now that we understand that this is not a shared issue, we have to rethink how we deal with how these issues and how we really approach them, I believe. from the point of view of how we can build trust? What is mutual trust? How do we convey it? How do we resolve mistrust? I look forward to working with other members of the AAMC community who have experience in this area, because we have great expertise, and we have the promise of great work, but the last part of getting it out into the community and transfer it to. funders and making them accept the value of what we share, is an area that needs urgent action.
I believe you are following the outbreak of avian flu in dairy cows and several farm workers. How concerned are you about the possibility of this becoming the next epidemic?
I am worried about bird flu. What we have learned so far already shows the fact that information changes almost daily, so what you knew yesterday may not be correct today, and that show the challenge of keeping up to date with research and science. It requires active investment in knowledge and knowledge acquisition and integration. So this is a subject that changes very quickly. I believe it is important for the research and scientific community to have close communication, so that the top leaders as well as the everyday researchers and scientists, and health care providers, can have accurate, up-to-date information. But based on what we’ve just learned from the COVID-19 epidemic, we have to integrate public health and medicine, research and science, and that requires, of course, relationships and organizational collaboration. And I think we have some work to do to make sure that those kinds of relationships and connections are strong enough to be accurate and educate our people, because none of us want learning more about the COVID-19 pandemic, especially while it’s still happening. it’s basically over.
We talked about some of the biggest challenges facing science and scientists. Are there others?
There are certainly challenges that medical researchers face today. There are also many exciting opportunities. Sometimes I think we focus too much on the challenges and ignore the opportunities we have, but I think both are exciting, because now, we know that it takes a lot to prepare and maintain a successful career of biomedical research. . Many possibilities. Most of the research is extensive, and the challenges are very strong, but we know that we ask a lot of people when they are training and when they are ready to start their career.
We also know that people who train for these jobs have opportunities that were not so common 10 or 20 years ago. I think a lot about industry and biotech. There are many new job opportunities, but each one requires slightly different skills, so we have to make sure we prepare people for the jobs they will choose.
You have been in academic medicine for many years. Is academic medicine a viable career choice for physician researchers today?
What I love about academic medicine is the variety. Every day is different. Sometimes you are surprised by what you do on a given day. It doesn’t always match your expectations. But every day you have the opportunity to do something important and impactful. And what I love about medicine as a career is that if you’re passionate about academic medicine, that could be your path. If you like medical care, there are many opportunities. If you like medical education, then we understand that it is the right way to work as a doctor, including physician researchers. So there are so many opportunities in academic medicine that I find it not only a good thing for me, but, I hope, to accept and force future generations.
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