Nafisseh S. Warner, M.D.
Assistant Professor of Anesthesiology
Senior Associate Consultant, Division of Pain Medicine
What moment or experience in your life influenced your decision to be a clinician?
My interest in medicine developed somewhat serendipitously as a young girl, when I found myself frequently serving as an unofficial interpreter for my parents and other Iranian immigrants as they worked to establish medical care in the United States.
As I grew older, I began to develop a love for the sciences, yet this was incomplete without a central component of human interaction. After several formative volunteer experiences both at home and abroad, I realized that a career as a physician would allow me to balance my love for science with my desire to interact with patients to alleviate pain and suffering.
What motivated you to become a Kern Health Care Delivery Scholar?
From the start of my medical training, I was determined to integrate scientific discovery into my career as a physician. Though I had taken extra time to pursue clinical research training during medical school and remained involved in clinical research since that time, I was always looking for an opportunity to broaden my ability to conduct meaningful research and to positively impact the way in which clinicians care for patients.
The Kern Health Care Delivery Scholar program was a perfect fit, as it provides extraordinary opportunities to strengthen my training in clinical research. I'm able to build my skills in implementation science to facilitate the translation of research findings into system-wide changes in clinical practice. I have the chance to collaborate with leading researchers to share knowledge, resources and experiences both for the enhancement of my own training goals and for the dissemination of research findings to others.
What is your focus as a scholar within the Mayo Clinic Kern Center for the Science of Health Care Delivery?
My research focuses on opioid prescribing after major surgery. Despite increased attention to the widespread problems associated with inappropriate opioid therapy, little is known regarding patterns of opioid use in patients with chronic pain undergoing common surgical procedures, especially the characteristics, attitudes and beliefs of the providers who prescribe them.
My research aims to describe opioid prescribing patterns after major spine surgery, a population deeply connected to chronic opioid therapy, with a focus on the transition of prescribing from surgical to primary care providers. This will facilitate the development of a procedure to better manage opioid prescription transitions in clinical practice, with a focus on prevention of overprescribing and successful opioid tapering.
Tell us about your mentoring team.
I have a fantastic group of mentors who provide tremendous professional and personal support. My primary mentors are David O. Warner, M.D., and Elizabeth B. Habermann, Ph.D. Both have vast experience in epidemiologic studies focused on postoperative outcomes, as well as specific expertise in opioids.
Dr. Warner is a professor of anesthesiology, co-director of the Mayo Clinic Office of Health Disparities Research. He also serves as the associate director, co-principal investigator, and director of education resources for the Mayo Clinic Center for Clinical and Translational Science.
Dr. Habermann is a professor of health services research, the Robert D. and Patricia E. Kern Scientific Director for Surgical Outcomes, and a leader in institutional and national opioid-related research, as evidenced by her appointment to the National Quality Forum's National Quality Partners Opioid Stewardship Action Team.
How will your research improve patient care or impact public health?
Perhaps no issue is more pressing or prominent in the national health care mindset than that of opioid misuse and abuse. One of the fundamental gaps in the opioid crisis is at the prescriber level, which presents us with remarkable opportunities to not only understand how variations in opioid prescribing practices relate to opioid misuse and dependence, but also develop methods to modify prescribing behaviors.
While my proposed research focuses on the improvement of opioid prescribing in those undergoing spine surgery, the research approach is likely applicable to other patient populations. Thus, the ultimate goal of my research is to improve the use of opioids after a wide variety of surgical procedures, thereby mitigating the risk of prolonged postoperative opioid use and its downstream consequences.
Why did you choose Mayo Clinic to pursue your career?
When I interviewed for medical school at Mayo Clinic, it became clear that this was a place where the needs of the patient truly do come first. Mayo is unique, and I wanted to be a part of it.
Though I wasn't particularly enamored by the geographical location (that is, winter), I knew that a career at Mayo Clinic would provide me with the incredible opportunity to impact the lives of others and to be part of something far greater than any individual effort.