December 2003
Volume 27 • No. 10

Doctor without 'white coat' offers political reality check

Medical board clarifies policies for conflicts of interests, human subjects

Overzealous spam blockers zap key E-mail

Sorensen, hematologist, medical board member is advocate for community colleagues

Otolaryngology becomes department

BMT numbers grow past landmark number

Music program serves patients

Bylaws committee formed, begins work

Faculty women honored in NLM exhibit

Sue Sorensen, hematologist and medical board member

Sue Sorensen, hematologist, medical board member is advocate for community colleagues -- and Stanford Hospital's well-being

Hematolgist Sue Sorensen's second stint on the Stanford Hospital Medical Board may have started when she and some 200 other physicians and health care professionals walked into a Palo Alto City Council to save their practices in July 2000.

Wrapping up her first term on the board three years ago, Sorensen and many of her health professional colleagues on Welch Road picked up a local paper to find that the city was studying whether to rezone the doctors' office spaces for housing. Facing possible eviction with no alternatives near their hospital of choice, some 200 health professionals formed the Welch Road Tenants Association and elected Sorensen vice president. (Orthodontist Richard Ridgley was - and remains - president).

Sorensen and many of the Welch Road professionals attended a tumultuous city council meeting held a few days after the article on July 10, 2000. Then with the support of many faculty members and other Stanford backers, the rezoning was taken off the table and much sought after zoning for housing was explored elsewhere in Palo Alto.

"But that political moment created cohesion in the private practice community. It made us realize we needed to pay attention to events around us.

"In order to take care of our patients we need to take care of our practices," Sorensen commented in a recent interview.

Last September, Sorensen began a second stint on the Stanford Medical Board. Faced with a busy general hematology and internal medicine practice, Sorensen asked rhetorically:

"Why did I come back? Over the last few years the community doctors have realized that they need a voice on the medical staff - not to be divisive but to maintain an awareness of our presence and our needs because we truly want to work effectively in the hospital with our patients and with all of our colleagues - faculty, community, and hospital staff.

"I believe the medical board as a whole certainly has an influence on how the hospital is run. I think we set the tone for how the medical staff works in a hospital environment. And I think it's important that the private community is recognized as part of the medical staff.

"As a whole, the board's role is to support the success of the hospital, and that means the well being of patients, fiscal responsibility and the opportunity for a diverse medical staff to practice optimally. I do think the medical board needs to understand what is needed to make the hospital a successful business, and individual doctors need to be aware of what's necessary to practice cost-effective medicine," she said.

Sorensen noted that doctors and the medical board have been instrumental in supporting key changes that weren't always popular when they were initiated.

"For example, a number of years ago, everyone was kicking and screaming when the hospital established a drug formulary. Now, I don't think there is anyone who has a problem with the reasonable way that is being run. If you really do need an off-formulary drug, you get it, but you really do need to understand that you have to make a thoughtful decision and not simply ask for the drug that you like because you're accustomed to using it. I think the Medical Board as a whole played a reasonable leadership role in this and other changes.

"While I think all Stanford physicians share a common bond in wanting to foster best medical practices, I do think some of our interests as community physicians are different from the faculty."

Some of these interests, Sorensen said, may be relatively mundane, such as the availability of parking. Other issues are more complex and crucial, including the durability of physician office leases on Stanford-owned land along Welch Road.

And Sorensen notes the "2008 issue" is fast approaching, the end of the nearly half-century contract which ensured community physician access to the university-owned hospital.

"We don't have any sense one way or another about what the hospital plans to do about that [access]. We don't want to go, we like it here, but we need to plan, and we need to make certain that community physicians remain on the planning radar screen."

While many of independent practitioners lease office space on Welch Road and have a common interest, Sorensen said that the Medical Board should advocate for all staff members - faculty, independent, community and group practitioners.

Sorensen is quick to point out that her own practice, like many of her independent practitioner colleagues, is intimately tied to the teaching hospital across the street.

"I like practicing in a teaching hospital. The residents and medical students certainly keep you on your toes, and the proximity to a facility like Stanford Medical School has really enabled the private physicians here to be on the cutting edge of practice.

"I think we offer the faculty something as well. Not everything we see is esoteric. I think it's helpful for the housestaff to see bread and butter cases and also get a sense of what it's like to take care of patients long-term," said Sorensen who maintains teaching ties as an adjunct clinical assistant professor of medicine in hematology.

Sorensen's practice includes general medicine patients ranging in age from 15 ("I just started seeing a couple of teenage girls; one was the product of a pregnancy that I diagnosed") to 92.

"I enjoy the interaction of healthy people, assessing their health, their risk factors for disease, and helping them strategize how they are going to optimize their health in the future, but there is always a need for the hospital.

"When my patients do need to be admitted, I admit them myself. Usually I work with the housestaff; the university attending doesn't need to get involved. And I use a variety of hospital services. As a hematologist with a large outpatient practice component, I use the ambulatory treatment unit quite extensively, and I send a lot of lab work to the Stanford labs across the street. It's great for me to know that if I need a specialized service, I don't have to start checking around to find where it might be available and my patients are grateful that I don't need to send them out of town for subspecialty treatment."

Sorensen's own practice took a turn in 1996 "when I left a five-person group because I decided at that point to sever my relationship with HMOs and PPOs. I do think it was a good decision for me, but when I first did it, I couldn't decide whether I was a dinosaur or on the cutting edge."

Today, Sorensen says she's still not sure, but without citing statistics, she believes that consolidation of physicians into large groups, at least locally, is starting to reverse. Meanwhile, she and her colleagues are doing what is needed to keep their independent practices viable.

"If every patient is paying the cost of taking care of themselves, then the cost per patient is lower. By eliminating extensive management costs, Sorensen said she can keep her fees lower.

"And at this time when people are losing their jobs and losing their insurance, we can help them out. And I have time to do pro bono work," including volunteer activities at the Stanford-sponsored Arbor Free Clinic in Menlo Park.

Sorensen also volunteers in the community at Foothills Congregational Church, where she became involved when she felt her children, now aged 22 and 18, "needed that sort of community.

"Now my activities are more adult oriented, and I really enjoy being able to relate to people without that 'doctor/patient' thing in the middle." She also said that through activities, such as the women's choir and chaperoning a group youth trip to Mexico, she can learn to empathize with the wants, needs and aspirations of non-medical lay people more comfortably.

Sorensen began her Stanford career as an undergraduate, receiving a BA in 1973. She then decided against a career in medicine after she noted her father's busy OB/GYN practiced "sent him to the hospital almost every day at 3 a.m."

She received a master's degree in education, traveled and taught for several years before deciding to return to medical school at the University of Hawaii, where her father had joined the faculty and her family lived. She was torn between a career in medicine and pathology and said she chose the former because of the people contact. Then she found a residency in hematology in part because of its lab orientation which matched many of the interests that had led her to pathology.

After a residency at Kaiser Santa Clara, she returned to Stanford as a hematology fellow from 1986 to 1988 before crossing the street and joining a Welch Road practice. Her current independent practice is at 900 Welch Road, across the street from the Clinical Cancer Center, where construction three years ago launched her political interests and her trip with colleagues to the Palo Alto City Council.