It’s in Dr. Lucy Guerra’s genes to be completely drawn in to the team-based patient care offered at USF Health. Her own Latino heritage includes a close-knit family that is involved in nearly every aspect of life, including each other’s health.
Knowing she is living true to who she is, she practices team-based medicine every day, putting her patients first, reinforcing the concept to medical students and residents she teaches, and watching the students, in turn, practice it as they provide free care to the local underserved community at the BRIDGE Clinic.
Dr. Guerra wears multiple hats in her career as a physician. She is associate professor, director of the Division of General Internal Medicine in the USF Health Morsani College of Medicine, co-faculty mentor for the BRIDGE Clinic, and associate director of the Internal Medicine Residency Program.
She doesn’t see them as multiple roles, but as one job, she said, a testament to her preference for working at an academic medical center.
“We all need to change our concept of what medical care is and to think of it as having evolved to a very patient-centric model,” Dr. Guerra said. “It’s more about working as a team to provide the best care and realizing the patient is part of that team. It’s a trend we call value-based care. When patients come to a place like USF Health, they’re going to always meet with the physician and other health care providers – a nurse practitioner, social worker, pharmacist or physician assistant – and it’s always going to include medical students and residents because we are an academic teaching institution.”
But an academic medical center is more than patient care and Dr. Guerra is emphatic in her efforts to incorporate USF Health’s other missions into her world.
“Our other missions – research and teaching—are equally important to patient care because you really can’t do one well without the other,” she said. “If we don’t have the research component then we can’t find better drug therapies and better behavioral therapies to treat patients. And sometimes I think this needs to be emphasized more because patients don’t necessarily realize that. The research part is very ethereal – you just don’t see it in action. Patients think of research as being done in the lab. But when you’re coming here, to an academic institution, you have the opportunity to participate in research studies and get involved. If patients realize they can participate in some kind of research study that will make a difference for the next generation of patients that come after them then wow, what a contribution they’ve made to medicine, as well to the future of their own grandchildren.”
For the teaching mission, Dr. Guerra said that, beyond the science of medicine, she tries to remind her students and residents why they chose medicine as a career.
“People who are learning and in a learning environment sometimes get caught up, just like I did, in studying or trying to get good grades or trying to pass, and you have to keep reminding them why they chose this profession,” she said. “For a physician, a nurse or anyone working in health care, it really needs to be a commitment. You’re making a commitment to somebody else – the patient. If you can ground a student in that, then they’re going to be the better health care provider for it.”
HARRY VAN LOVEREN, MD
Over and over again, Harry van Loveren, MD, walks through a surgery in his mind before actually cutting open the brain of his patient, perfecting every step and accounting for everything he will encounter, the expected and the unexpected.
Dr. van Loveren is chair of the Department of Neurosurgery in the USF Health Morsani College of Medicine, senior associate dean for Surgical Subspecialties at USF Health, and chief medical officer of the USF Physicians Group. Along with a brilliant mind and capable hands, his visualization technique has made him an accomplished and much sought after neurosurgeon.
“To prepare for the kind of operations I do you have to mentally do the operations a number of times before you walk into the operating room,” he said. “And you have to understand it all – the anatomy, the surgical instruments, the surgical techniques – so your mental experiments are valid, that what you see in your mind is what you will see in the patient’s head. That these things you see in your mind are true and that if it works in your mind it had better work in the operating room. And if I can’t see that in my mind’s eye, I go back to the (training) lab, go back to text books, and review videos and figure it out until I can create a paradigm in my mind where I complete the surgery successfully.”
How does someone decide to become a neurosurgeon? For Dr. van Loveren, it was because it’s considered the most difficult area of medicine and requires the longest amount of training.
“To be honest, I don’t know why other people go into neurosurgery but I know why a lot of us do – because we’re so egotistical and because we want to be the best,” he said. “As we’re going through medical school we look around and ask what would be the hardest thing I could do? What would be the biggest challenge? But I don’t think we’re the only ones who do that. For instance, look at people who go into the police force and say ‘I want to be on the SWAT team’ or go into the military and say ‘I want to be a Navy SEAL.’ There’s an element of that to becoming a neurosurgeon. We’re looking for the greatest challenge.”
In fact, when he joined USF Health about 10 years ago, he set a goal for his Department to become the go-to neurosurgery department in Florida. Starting with only six neurosurgeons, he has built the Department to about 30 surgeons and nine PhDs, becoming a hub for the most complicated cases.
“My practice is a little bit unique,” he said. “It’s called complex cranial so I do the more complex side of brain operations and a lot of my practice is taking care of patients for other neurosurgeons in the state either for those things they don’t want to do or don’t feel they ought to be doing. That can be a bit of a lonely and frightening position to be in. But nobody wants to see any lack of confidence in us and we don’t really want to feel that lack of confidence.”
His other reason for choosing neurosurgery is because he saw it as the one specialty in which he would never stop learning.
“I chose it because it looked like my learning curve would go on forever,” he said. “When I looked at neurosurgery, I saw older neurosurgeons still making great contributions and the acquisition of experience is so valuable to neurosurgery. So the finish line is, wonderfully, always just beyond our reach.”
He admits, though, that the real reason he chose neurosurgery might truly be because he thinks “the brain is cool.”
“The brain is who we are, it’s what we think, it’s what we believe,” he said. “The ability to affect a person’s life by manipulating that organ is profound and extremely interesting. And we really get some insight into brain function when we’re operating on someone while they’re awake and speaking to you. And with certain stimulation you can bring back very specific old memories for the patient, you can play music, you can run videos. It’s all stored in the brain and you can recall it and make it come out for the patient.”
With a laugh, he added “It’s just a really satisfying career. You should try it sometime.”