My Kind of Medicine: Real Lives of Practicing Internists: Lori Minasian, MD, FACP
“No one goes into medical school thinking ‘I’m going to work for the federal government,’” says Dr. Lori Minasian, Chief of the Community Oncology and Prevention Trials Research Group Program at the National Cancer Institute (NCI) of the National Institutes of Health (NIH). Yet as improbable as the idea seemed to her at the time and later as a practicing oncologist in Augusta, Georgia, all it would take to change her mind would be an innocent conversation with a friend from Washington, DC. The friend worked for NCI and wanted to know if Dr. Minasian would be interested in a position there that had opened up. “I remember asking him ‘what exactly do you do?’” she recalls. She liked what she heard and decided to give it a go. “I took a leap of faith,” she says; one year later she was running the program.
Sharing the Limelight
NIH is the primary agency of the United States Department of Health and Human Services, responsible for biomedical and health-related research. There are 27 Institutes and Centers within NIH, NCI being one of them. The majority of NIH’s $27.8 billion dollar budget goes to investigators in academic centers for peer-reviewed projects. To put this in perspective, the agency is responsible for approximately 28 percent of the total biomedical research funding spent annually in the U.S. NIH focuses on facilitating the kinds of important medical discoveries that improve people’s health and save lives through the work of their scientists, or “investigators,” who investigate ways to prevent disease as well as the causes, treatments and cures for common and rare diseases. NCI funds basic and clinical research in cancer, and sponsors a national network of academic and community physicians to participate in clinical trials. Dr. Minasian manages and oversees the Community Clinical Oncology Program, a community-based trials network that is nested into NCI’s overall clinical trials program. ”
NIH is a high profile organization, yet much of the work takes place behind the scenes. Managing research, unlike patient care, as Dr. Minasian explains, can be hard to define. “It’s difficult to show what you’ve done because all of the real work is executed by the funded investigators,” she says. “You have to be able to step back and let someone else take the limelight.” The real star of the show is the community physician, who Dr. Minasian says is the focus of the program’s efforts. The relationship is mutually beneficial—NIH can evaluate treatment regimens and prevention strategies in real settings, and the community physicians who participate gain access to state of the art cancer care through clinical trials. “I really feel like what we do is a wonderful approach to translating science into medical care on the level of the community physician,” she says. “I like to think that we create fluidity between academia and community.”
Dr. Minasian has received a lot of positive feedback about her commitment and passion for her job, which she says was not always a natural fit. She had growing pains during the first two years and cites the time as one of her most taxing. Realizing how much she missed clinical work, despite spending one day a week as a volunteer at NCI’s cancer clinic, she left and returned to the world of academics and clinical care. But instead of confirmation that she was not cut out for government work, returning to the clinical world accomplished exactly the opposite—it made her want to go back. “In an odd way I came to realize the value and importance of what I had been doing,” she says. “It was as if I needed to go back and get my bearings again to realize that my role at NCI could have value in a way that I hadn’t seen before.”
She adds that working for the government entails a desire to work in science for the public interest. “There is a significant need to have people within the government understand science and medicine in order to move the research into a framework that has a public health benefit.”
As a girl growing up in southern California, Dr. Minasian read a lot of books, one of her favorites of which was “Florence Nightingale.” She liked the combination of the romantic story and the theme of helping people, so much so that it shaped her choice to pursue medicine for a career. “After I finished the book I told my father that I wanted to be a nurse. He said that if I wanted to do medicine, I should become a doctor, instead. ”
In medical school, she considered both internal medicine and surgery, but by her third year she realized she felt most comfortable with internal medicine. Her choice was more intuitive than anything else. “It comes down to where you feel most comfortable,” she explains, “and by that I mean, where is it that your thinking most closely matches those around you? I think different groups have different mindsets. If you like to problem solve, internal medicine is perfect for you.”
Her decision to pursue oncology was deeply personal. When Dr. Minasian was a second year medical student, her father died of cancer. In the 1980s colorectal cancer screening had yet to exist, so when her father was diagnosed, the family was told he had less than three weeks to live. “It was a roller coaster ride,” she remembers, “everyone dealt with it differently. I know for me personally, it really changed how I approached my last year of medical school. I had a different appreciation for what families go through.”
The experience touched her professionally as well. During her residency, she realized that her own personal experience with cancer had left her with a keen sensitivity for patient-family dynamics, and she found herself helping the family members as well as patients cope with having cancer. To her surprise, she discovered she was not alone. “If you take a close look you’ll find that many oncologists have had some kind of personal experience with cancer,” she says. “Many of my oncology fellowship group had personal experience with cancer. It became clear to me that I was not unique.”
A Perfect Marriage
When it comes to job satisfaction, Dr. Minasian does not suffer. “I get to work with some of the best people in the country—wonderfully committed physicians in both academia and the community,” she says. “It’s a combination of bright, interesting people.” Her happiness on a professional level is mirrored in her personal life. When she’s not working, she and her husband enjoy spending time outdoors with their son and daughter. They frequent state parks and often travel together, which she refers to as some of the best times she has ever had.
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