The Doctor Is In
Welcome to Rochester, Dr. Brophy! Can you tell us a little bit about your background?
Thank you very much for the warm welcome!
It has been such a positive experience moving to Rochester and being able to embrace all the positive energy from the community and the momentum that the Department of Pediatrics and the Golisano Children’s Hospital have!
I am a Pediatric Nephrologist and completed my research (in kidney genetics and development) and clinical fellowship training at the University of Michigan in Ann Arbor. I was a faculty member there for several years and was recruited to the University of Iowa in 2007 to assume the Division Directorship of the Pediatric Nephrology group there.
Over the course of the decade prior to my arrival at the University of Rochester, I was extremely fortunate to have worked with an amazing team of physicians, nurse practitioners, nurses and many other healthcare and research professionals and together we were able to develop a world-class division — with an international presence in the clinical and research areas as well as a strong fellowship and teaching folio — for our students and residents.
In 2013, a team of us graduated from the Tuck Business School at Dartmouth with a Master’s degree in Healthcare Delivery Sciences with a project task of building a Children’s System of Care for Iowa. During this process, we explored a variety of technologies and, with a strong innovations team we were able to build a unique center (The Signal Center for Health Innovation) that allowed us to explore the utilization of unique healthcare delivery techniques as well as a microsystem and lean analytics for changing clinic operations. This also included the securing of several federal grants to help deploy a network of telehealth sites across the state.
What brought you to Golisano Children’s Hospital?
The opportunity to become part of the fabric of the storied University of Rochester Department of Pediatrics and work with an amazing team to build upon the strong legacy of child health was clearly something I could not pass up!
The Department of Pediatrics here has a rich history and has made many vital contributions to children’s health. One example: When I was a first-year resident in Winnipeg, Manitoba, we used to see many children come to the hospital with haemophilus influenza type b (Hib).
It was a terrible disease — often, by the time a child became symptomatic, it was too late for us to help, and I personally saw many children die from these infections. But sometime between my first and second year, the Hib vaccine, which was developed in Rochester, became available. And after that, we just didn’t see that disease anymore; I can’t imagine how many lives have been saved as a result. So it’s wonderful to be in a place that has made contributions like that to children’s health, and I hope we can continue building on that legacy.
Another main factor is the way our hospital is set up. Thanks to all the tremendous efforts of the providers here — including my predecessor Dr. Nina Schor — and the overwhelming support of the community, we now have a wonderful new children’s hospital building. But since that new building is attached to Strong Memorial Hospital, we also benefit from the numerous services that they already have available.
Many of the freestanding children’s hospitals in the country don’t have that benefit; they have to duplicate virtually every service that might already exist in a nearby adult hospital, which can be extremely expensive. But here, we’ve got the best of both worlds: a space designed specifically for children, and support from our adult colleagues who are literally next door.
This not only allows us to share resources, but really supports a continuity of care across the lifespan, and allows us for a more seamless transition for teens and young adults who are graduating from pediatric services. I think that nationally, this type of model is going to be what other health care systems implement going forward.
Continuity of care across the lifespan — that’s something I’ve heard you mention before. Can you expand on that?
Sure. Basically, as a health care system, we want to ensure that all of our care groups are integrated, so that we can provide seamless care through a person’s entire life — starting with maternal fetal medicine all the way through geriatrics.
So one place in pediatrics where this is important is for those patients that I just mentioned: We are seeing more and more teenagers and young adults with complex illnesses graduate to the world of adult care.
This really shows how many advances we’ve made treating some of these diseases, because children with many of these complex illnesses used to die at much younger ages. But it also means we need an integrated system of support to help continue caring for these children as they get older.
So what we already have in place here with the Complex Care Center is wonderful. I’d like to continue to advance our efforts in that area.
How else do you think pediatric care will change in the coming years? Any short- or long-term goals for Rochester that you’d like to share?
I think we, as care providers, need to continue to engage with our community and to understand the needs of our patients. Right now, we ask the patients to do a lot. We ask them to come here — usually during the workday — and park in the garage, and so forth. And then we sometimes get frustrated when they miss their appointments. But as we understand more of the social determinants of health, I think there’s a real opportunity to expand on our programs to meet people where they are.
We already have several great programs here — we’ve done a number of things through telemedicine, through school-based medication programs.
We have to be thoughtful, and we have to be fiscally responsible, but I think we have a chance to be an example, regionally and nationally, of how to do this well.
Anything else you wanted to mention?
The Department of Pediatrics at URMC and Golisano Children’s Hospital provide us with an amazing platform to be innovative, agile and patient-centered. We are duty bound to train the next generation of health care leaders and integrated teams along with our amazing Medical and Dental School, along with our ever-growing collaboration with the School of Nursing and others.
We also must continue to strive for research excellence and continue the strong tradition of seminal discoveries that have shaped child health and impacted so enormously on improving pediatrics across the nation and beyond. Finally, we must also move forward building on our innovative clinical approaches to better serve our most vulnerable patients and their families.