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Julie Freed, MD, PhD, splits her professional time between cardiac anesthesiology and vascular biology, with a couple other high-profile roles thrown in the mix. In this Member Spotlight, she tells ASA Community about her practice, her research, and her thoughts on why the physician-scientist pipeline can be a bit "leaky" - especially for women.

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We understand that you’re a cardiac anesthesiologist and translational scientist who is advancing our knowledge of how dysfunction of small blood vessels leads to cardiovascular disease. Can you tell us a bit about your work?

Absolutely. I like to tell people I have a somewhat unique workweek. On Mondays I’m a cardiac anesthesiologist who unfortunately has to see the end result of cardiovascular disease. I take care of patients who need coronary artery bypass grafting or, in worse cases, require mechanical devices to support or replace their native heart function. The rest of the week I am a vascular biologist trying to understand the beginning stages of cardiovascular disease which, as the evidence is showing, really begins in the small resistance arterioles, or microvasculature.

My lab studies mechanisms of microvascular dysfunction using human arterioles. We’re able to do this by collecting otherwise discarded surgical specimens from the operating room. We collect both atrial tissue (from right atrial appendage clippings for cardiopulmonary bypass) as well as adipose tissue to dissect and study peripheral microvessels. We also have clinical studies underway that utilize special imaging devices to assess whether an individual has microvascular dysfunction by examining the arterioles in the mouth. The hope is to detect microvascular dysfunction early before the development of atherosclerosis or heart failure.

You’ve been busy! Within the past year you were elected to serve as an editorial board member for the prestigious AHA journal Circulation Research and also named Chair of the Cardiovascular Center's Human Tissue Bank. How do you manage the whole balancing act?

You left out managing my toddlers too! I think trying to stay as organized as possible helps in juggling everything. When I’m in the operating room it’s pretty clear what I need to focus on however the rest of the week I really need to prepare when I’m doing what. I often schedule specific work time on my calendar, e.g. from 1 pm to 5 pm I need to work on this manuscript, or when the kids go to bed I need to review this journal article. While I do wish there were more hours in the day we have to work with what we have. It also helps to have an amazing and supportive spouse!

You also received the Rising Pioneer Award at the Medical College of Wisconsin (congratulations!). Being a woman physician and a research scientist is a subset of a subset. Are you seeing more women take this career path now than when you were first starting out?

 Actually, I do feel as if there are more women pursuing this career - which I am so happy to see. I’m less worried that women won’t initially choose this career than I am that they will not continue along this path. The physician-scientist pipeline is already quite leaky, but the plumbing problem is often worse among women. I do train aspiring physician-scientists in my lab and have noticed most of them are women.

There is data that shows women are more likely to continue in academia if they are mentored by a woman. The problem, however, is the lack of women mentors!

What do you think are the challenges and opportunities in training the next generation of physician scientists in anesthesiology?

I think there is a combination of old and new challenges that we are going to face as we look into the future. Physicians drive medical innovation and anesthesiologists have to contribute to the advancement of medicine. Past challenges remain; how to balance research and medicine, getting the protective time needed to be successful in research, and the never-ending battle of obtaining funding to name a few.

And now we are seeing unique hurdles with the next generation: increased cost of medical school debt, increased research regulatory requirements, and providing more higher acuity care on a day-to-day basis resulting in fatigue and burnout. I believe anesthesiologists are best suited to lead medical innovation in many areas but without the proper training and investment this dream will not become a reality. The opportunities are endless, and we need to think bigger and more broadly when it comes to how our specialty will advance medicine.

 
Is there anything you’d like to add that we haven’t yet touched on?

I often get asked by medical students if knowing what I know now would I chose a different specialty. The answer is always “absolutely not.” I love being an anesthesiologist and I belong in academia. I was hoping to get through this without bringing up the pandemic, but the truth is the last year has caused some damage to all specialties, all physicians who conduct research, and the advancement of medicine.

My dream is that within the next five years we’re allowed to engage with each other more, support one another, and it does not matter whether you are in private practice or academia, we all chose to be physicians in Anesthesiology.

Julie K. Freed MD, PhD, is an Assistant Professor and Director of Clinical Research for the Department of Anesthesiology at the Medical College of Wisconsin. She has a secondary appointment in Physiology and subspecializes in adult Cardiothoracic Anesthesiology.