January 2017 Member of the Month
Suzan Goodman, MD, MPH
Suzan Goodman, MD, MPH serves as fellowship and curriculum director of the TEACH Program, an Associate Clinical Professor at UCSF, and a Co-investigator at the UCSF Bixby Center for Global Reproductive Health with the Beyond the Pill Initiative. Her research interests include contraceptive access and equity, highly effective contraceptive methods, systems-based innovation, miscarriage management, and abortion training in primary care specialties. A graduate of Stanford University School of Medicine, Dr. Goodman has a strong interest in policy and is active through her work with Physicians for Reproductive Health, the Society of Family Planning, the Association of Reproductive Health Professionals, and California Academy of Family Physicians.
Why did you choose family medicine, and what’s your favorite aspect of it?
After studying applied medical anthropology among immigrant and migrant women during college, I initially thought of family medicine as the most far-reaching passport for doing meaningful work in underserved and international settings. Faced with competing interests in OB/Gyn where I spent two years, I was ultimately drawn by our strong community of peers with complementary values.
Although I continue to tap the variety of our field, my work focuses on contraception and abortion as parts of primary health care. Given the relatively high rates of unintended pregnancy, early pregnancy loss, and abortion in our country, all family physicians will see patients facing these issues. We are particularly well-suited to incorporate prevention and care into our practices since we work in diverse and underserved communities, are procedurally-trained, and see women throughout the life cycle. After a decade as director, I now serve as the fellowship and curriculum director for TEACH Program, which is an academic-community partnership aimed at expanding reproductive health access by assisting family medicine residencies to integrate comprehensive reproductive health, including abortion, into their curricula and practice. And I have expanded my role as National Training Director at UCSF Bixby Center’s Beyond the Pill Initiative, which promotes contraceptive access, equity and women’s reproductive autonomy, including access to highly effective contraceptives. I also find time to provide emergency medicine and participate in international projects.
Were you inspired by anyone to pursue family medicine?
Two early mentors come to mind. Dr. David Jones was our family physician and close family friend who masterfully tended to my mother’s integrative cancer care, and whose passion for underlying causes and healing relationships led him to become a pioneer and leader in the Institute of Functional Medicine. Dr. Maureen Paul is a visionary leader and collaborator within Planned Parenthood and the academic reproductive health community whose long history of building training programs in contraception and abortion showed me how to harness personal conviction, integrity and the efforts of great teams.
What is the most interesting/memorable experience you have had when dealing with a patient?
Most women spend a few of their reproductive years trying to get pregnant, and almost 20 years trying NOT to get pregnant, so it has often been the stories of women overcoming common challenges that move me. An adolescent who has sorted out myth from fact and now wants to help teach her friends. A student who is the first in her family to go to college and won’t let a pregnancy derail her from that path. A woman who has traveled far and was further delayed because of an inappropriate or ideology-driven referral. Or a new mother who was unable to get her postpartum contraception and is struggling with an unintended pregnancy. As an abortion provider, there are few aspects of care that I provide that have a greater impact on the trajectories of the patients I see, or for which they are more grateful. Much work will be needed to assure access to reproductive health services under the upcoming administration. Common to my involvement in both reproductive and emergency care is the opportunity to transform a potentially traumatic experience into a supportive and empowering one for a patient.
What one word or phrase characterizes your style of family medicine?
Encouraging the individual to reach his or her higher and deeper potential.
What is the best experience you have had during your career as a family physician so far?
In my career, the most fruitful work has been richly collaborative. I am really proud to have helped to build and sustain a regional coalition of TEACH Program faculty who have worked together across many residency programs to train more than 50 residents annually, create curricula used internationally, offer mentoring, advocacy, and leadership training for residents and fellows, and help graduates incorporate reproductive health services into practice.
What has been your best experience as a CAFP member? Why?
Through CAFP I have been involved in state advocacy and helped effect policy change at a national level. I have worked on co-authoring a number of reproductive health resolutions, and strategized, caucused, and supported their passage through AAFP. But what has been most powerful has been mentoring many residents to do the same. The most important resource I find CAFP offers me is a watershed of like-minded physicians within which to do innovative advocacy work to be brought to a national forum.
How do you make a difference in family medicine and in your community?
Over a decade ago, I spearheaded changes to improve access to highly effective and convenient contraceptive methods, including IUDs and implants. I had hypothesized that health care barriers were central to their low utilization, so I helped our Planned Parenthood clinics embark on efforts to minimize barriers to access, including staff training, simplified screening criteria and same-day IUD insertions. The evidence no longer supported the prevailing practice of advanced screening, so we changed our protocols and studied it. Our results showed a multifold increase in utilization and a dramatic decrease in unintended pregnancies among women receiving immediate vs. delayed insertions. Presenting the work to PPFA’s National Medical Committee led to joining the Committee and also to serving as co-investigator of a national cluster randomized trial in 40 U.S. family planning clinics which were evaluating a reproducible half-day intervention providing patient-centered contraceptive counseling, skills and streamlining for improved LARC method access. In the intervention sites, half as many patients experienced unintended pregnancies while maintaining their decision-making autonomy. We have now adapted this model to scale, and reached more than 700 clinics, public health departments and hospitals around the county.
The experience profoundly reinforced my thinking about the impact of individual ideas, collective process and teamwork in proactive systems change. It taught me to use a natural ability to galvanize support, to contribute through a collaborative style of leadership and to follow through on an idea to fruitful completion far beyond my initial vision.
Tell us about a project in which you are involved and why it is important to you:
Last spring, our Beyond the Pill initiative joined the Zika Contraception Access Network (Z-CAN), an initiative launched to address the Zika public health emergency in Puerto Rico. Partnering with the CDC, ProGyn and health care providers in Puerto Rico, we adapted our evidence-based training intervention to train nearly 400 physicians and clinic staff from a variety of health settings, including community health clinics, private practices and universities, to provide patient-centered counseling and the full range of contraceptive methods. Over many trips to Puerto Rico, it was personally gratifying to work adaptively and teach in another language. The stark reality, though, is that the virus is spreading faster than efforts to spread resources and awareness, and the effects are devastating to individuals and families. While no means a cure, contraception serves to significantly reduce the chances of infected men and women creating unintended pregnancies that can result in infants born with microcephaly and other birth defects. It is critically important to put contraception into the hands of women in affected areas. We are also working with southern states that face a clustered threats, including temperate zones at risk for Zika, high rates of uninsured and unintended pregnancy, and restricted access to both contraception and abortion.
What are good qualities a family physician should have?
To be an astute listener, respectful, responsive, engaged, innovative and a team-player.
What is one sentence of advice would you give to medical students interested in family medicine?
Distinguish between other people’s paths which may inspire you, and the work that actually brings you the most pleasure.
How do you spend your free time?
Cycling, mountain bike touring, skiing, and mountaineering (see the image above of Mount Shasta from Mount Ashland, both frequent sites of exploration near home). Also gardening succulents, practicing yoga, going to farmers’ markets, and cooking with friends and family.
If you weren’t a doctor what would you be doing with your career?
Leading people on one of two types of journeys: physically demanding wilderness adventures, or equally demanding journeys of self-discovery and realization.
What would your best friend say about you?
I like to challenge people to go beyond their comfort zones.
Tell us briefly about your family:
My parents were pre-Beat Generation New Yorkers who moved west in 1960 to settle in the mountains above Ashland, Oregon. My brother and I were raised in a creative and intellectual environment, in a mountain cabin far off the grid, without conveniences of electricity or indoor plumbing. In addition to a strong love of the wilderness, my parents impressed me deeply with their commitment to right livelihood, which kept them both fully engaged in their work through the end of their lives.
My husband Louis is a neonatologist who has artfully integrated his enthusiasm for international health and Aikido (the martial art of conflict resolution) with two ongoing projects in Ethiopia. We are grateful to share two bonus kids in their 30s, two god kids under age ten, and an extensive chosen family of dear friends.
Each month, CAFP highlights one outstanding California family physician member who lends their voice, time, talent and resources to strengthen the specialty of family medicine and his or her community. The Member of the Month interviews are conducted by CAFP staff. If you choose to share this article, feel free, but give appropriate source and author information. If you would like to share your story or know a family physician colleague who deserves to be recognized for his or her impact or leadership, contact us at (415) 345-8667 or email.