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My Kind of Medicine: Real Lives of Practicing Internists
Name: Caroline Lubick Goldzweig, MD, MSHS, FACP
Current Occupation: Medical Director for Quality and Clinical Performance, Cedars-Sinai Medical Care Foundation, Beverly Hills, CA
Residency: University of Pittsburgh Medical Center, Pittsburgh, PA
Medical School: State University of New York at Buffalo School of Medicine, Buffalo, NY
Dr. Caroline Goldzweig spent years searching for her niche as a physician with an interest in business and economics. Now, she’s able to incorporate all of her experiences in her role as Medical Director for Quality and Clinical Performance at Cedars-Sinai Medical Care Foundation in Beverly Hills, California.
Q: Where did you grow up?
A: I was born in Washington, D.C., but my family moved back to my parent’s hometown of Buffalo when I was young, so my early life was in Buffalo, New York. When I was about 13, we moved back to the Washington, D.C. area and I spent my high school years there.
Q: What were your interests as a child?
A: I was quite interested in languages—I studied French, German and Latin, and I liked English. Interestingly, when I was a relatively young child I thought I wanted to be a doctor, but over the course of my elementary education, I forgot about that.
By the time I was in high school, I really was not thinking at all about being a doctor. I was moved more by the area of social sciences, I think. When I got to Cornell, I decided to major in economics. It’s not that much of a surprise, because I think that even my career in medicine has always had a bit of a social-science bent, so it all seemed to come full circle.
Q: After you obtained that degree, what made you decide to switch back into medicine?
A: When I was in college at Cornell, one of the requirements was that you had to take biology. I enrolled in a biology course for non-majors, and when it got to human biology, I was fascinated. At the time, I was surrounded by a bunch of people, friends, who were pre-med. I sort of felt like I’d missed out by not studying some of this—it was super interesting, and I hadn’t really done much of it in high school.
My mother really encouraged me to figure out what it took to go to medical school. I did a little research, and I discovered that in fact, I didn’t have to be a science major to go to medical school, but I did have to take a certain number of courses. I started going to school in the summer, and over the course of the rest of my college career I made sure that I took the requisites for medical school, and eventually took the MCAT as a senior. I was hoping that I’d get into medical school—I had a year between college and med school where I went abroad, and I worked at a lab at NIH, but I applied to medical school during that year and then luckily, I got in!
Q: Once you began studying in medical school, what prompted you to go into internal medicine?
A: When I got into my clinical rotations in my 3rd year, the first one was surgery. It was really exciting and fun, so I thought that I needed to find a surgical subspecialty that I can do. Then my next rotation was medicine, and I think from the first day it dawned on me that this was the career path for me—just the breadth of diseases that you had to consider, the thought process, the analytic side of it, coming up with differential diagnoses, taking care of the whole patient—just everything about medicine fit with me and my personality. I really didn’t look back after that.
I really like to take care of the whole patient, and I like to think about the interactions of all the different diseases that a patient has—there was never sort of one organ that really floated my boat. I toyed with cardiology, endocrinology, but I couldn’t give up the other stuff. The idea of making a lasting impact on the patient and having the continuity relationship, those were other things that I really, really enjoyed. That’s why I wasn’t that into the idea of emergency medicine, or specialty areas where you have a more transitory relationship with the patient.
Q: How did you become involved with ACP?
A: I’ve been a member of ACP probably since I was a resident in internal medicine, and I’ve maintained my association with ACP since. My mentor was a governor who was really engaged in the ACP and was our regional leader here in southern California for a while—it was really because of her that I ended up becoming a fellow.
The ACP represents the interests of the internal medicine providers in a really effective way. I think the ACP seems to always bring reason and a rational way of thinking to discussions, so I’ve been a big fan of ACP and its approach to medicine in the United States and to representing the needs of internists, particularly primary care internists.
Q: Could you describe the work that you do now?
A: I’m in a brand new position right now that I’ve been in since October, where my title is ‘Medical Director for Quality and Clinical Performance’ at Cedars-Sinai, a large health care institution in Los Angeles. I work for the Medical Care Foundation which is the umbrella organization associated with Cedars. There’s a large medical group, there’s an independent practice association, there are a number of specialty practices, oncology, cardiology, orthopedics, GI, that are under this Foundation. It’s expanding its reach to create a broader geographic span for primary care and specialty care. In this position, my job is to create and implement a vision for quality across the entire Foundation—not just quality measures but also safety, efficiency, all of those things.
Q: Can you tell me about your work with information technology?
A: After completing my fellowship, I took a job at the department of Veteran’s Affairs (VA), and that’s where my career was for 21 years. At the VA, which was at the forefront of electronic medical record adoption back in the late 90s, I became really interested in using electronic health records (EHR) to improve quality of care. I started doing a lot more for our institution with designing how we would use the decision support systems, and eventually I oversaw our informatics department which included the EHR and the analytics around clinical care improvement.
My strength has been in identifying how computerized technology may be able to help make care more efficient and how to implement computer technology into the care environment. It’s always been just a vehicle to improve care, improve processes and make things better. Having computerized data in health gives us so much power to impact so many lives because without it, we wouldn’t be able to aggregate over populations, look at whole panels of patients and do all the things we can do related to population health management. I think that’s one of the great strengths of having access to electronic information about patients.
Q: Have you always been drawn to leadership roles?
A: I think that’s a part of my personality. I was a chief medical resident at the end of my training, and that was a great job in terms of getting a taste for what it’s like to lead and guide people, and so I think I’ve gravitated to that.
Now that I’m further along in my career, I can say that I really enjoy it—I like to mentor and help people. I’ve tried to hone my skills, listening and moderating responses to help move things forward while enlisting the support of multiple different people—that’s a big part of what my job is now. There are a lot of players out there, and trying to get them to move toward common goals is a big part of what I do.
Q: Do you currently have a family of your own?
A: I’ve been married for over 21 years, and I have three daughters, two of them are in college and one is in high school.
Q: Are they studying medicine?
A: My oldest definitely isn’t—she has never been able to step into a hospital from the time she was a kid. My second one, I personally think she would be a great doctor, and she hasn’t picked a major yet, but she’s making a plan to take the prerequisites for medical school like I did—she might gravitate towards a public health career, community health and potentially medicine. She’s a hope.
None of my children has expressed an interest in being a doctor from the time they were babies—this is going to be a process over time with them, if anyone ends up actually doing it. I was the first doctor in my family, so it’s not like we come from a long line of physicians.
Q: Do you have any interests or hobbies outside of your work?
A: I’ve always been a bit of a jock, so I still try to stay pretty active—I played lacrosse in college, and I have been really involved in bringing girls lacrosse to the Los Angeles area. I help to run a girls lacrosse league in our neighborhood, two of my kids are into that sport. I love to play tennis and to ski, and those are some of my favorite things to do.
Q: What’s your favorite thing about practicing medicine?
A: I’m so glad that I went into medicine—there are just so many opportunities in medicine, there’s almost no limit to what you can do. The most amazing thing is that you can feel like you’ve made an impact on someone’s life virtually every day, whether it was one patient at a time, or moving a whole system at a time, there are just so many different ways that you can have an impact. There are very few careers that can be satisfying in that way.
When people have an interest in medicine and they talk to me, I always encourage them because you just never know where your career is going to lead. Anyone can find an area or a niche in medicine. Mine happened to be more public health and organization-based—I could have gotten an MBA given what I do now, but I kind of organically grew some of those skills. There are just so many ways that you can contribute.