Shehzad K. Niazi, M.D.
- Consultant, Department of Psychiatry and Psychology
- Assistant Professor of Psychiatry, Mayo Clinic College of Medicine and Science
What moment or experience in your life influenced your decision to be a clinician?
Rather than a singular "aha" moment, it was a confluence of factors. The nobility of the profession, the opportunity to help others and the intellectual challenge of lifelong learning prompted me to pursue medical education.
I loved the skill, precision and rigors of surgery and the intellectual challenges of various medical specialties, yet kept noticing the same problem: We often knew a lot about Mr. Smith's diabetes or cirrhotic liver, but knew little about Mr. Smith himself. What motivated him? What internal or external factors impeded his ability to better care for himself? What aspirations did he have? What barriers resulted in suboptimal care?
These were all behavioral and psycho-social factors that seemed to strongly impact long-term outcomes. These questions became more and more intriguing to me and motivated an interest in mental health. The suffering of often-marginalized patients was not being taken seriously, and it was too difficult for me to ignore.
Psychiatry won out for me. I am now a consultation and liaison psychiatrist and work with patients who have considerable medical and surgical needs and have comorbid psychiatric conditions.
What motivated you to become a Kern Health Care Delivery Scholar?
The ways in which health care is delivered, monitored and reimbursed have tremendous implications for patients, providers, payers and society at large. Numerous methodologies exist for measuring these factors, yet most focus only on process measures that assess efficacy or value of care. As a clinician on the front lines, I find several of those measures to be frustrating at best and pointless at worst.
I started looking for a better way of measuring health care delivery. Once I started to focus on ways of incorporating clinically relevant, patient-reported outcome measures in routine clinical care, I became increasingly aware of the need to learn new skills to conduct effective health services research.
The Kern Health Care Delivery Scholars Program is an ideal way of acquiring these needed skills in a structured fashion, under the guidance and mentorship of experienced and accomplished leaders in the field, while having protected time to do so.
What is your focus as a scholar within the Mayo Clinic Kern Center for the Science of Health Care Delivery?
I am studying the impact of patient, disease and caregiver factors, assessed at baseline, on the outcomes of people receiving liver transplant and their caregivers. Clinical observations suggest that resilience, coping skills, different types of patient-caregiver dyads and psycho-social factors all impact care utilization, patient well-being, perceived value of care and caregiver burden.
My team studies these phenomena longitudinally, using a mixture of qualitative and quantitative methodologies to first assess economic, clinical and humanistic outcomes among people receiving liver transplants and their caregivers, and to then identify potential intervention targets to develop mitigation strategies.
Tell us about your mentoring team.
Reflecting the diverse nature of my project goals, I have the privilege of working with a multidisciplinary team of experienced and accomplished mentors, including:
- C. Burcin Taner, M.D., is a transplant surgeon and chair of the Department of Transplantation at Mayo Clinic's campus in Jacksonville, Florida. Working with Dr. Taner improves my understanding of medical and surgical aspects of transplantation.
- Teresa A. Rummans, M.D., in the Department of Psychiatry and Psychology, has been my mentor since 2014 and continues to be my mentor as I study the impact of psychiatric and social factors on outcomes after transplant.
- James M. Naessens, Sc.D., is my mentor for health services research-related activities, such as studying economic outcomes, research methodology and protocol development. I am also improving my grant writing skills under his mentorship.
- Joan M. Griffin, Ph.D., is my mentor for caregiver burden research and related matters.
- Matthew M. Clark, Ph.D., L.P., is my mentor for studying quality of life and program development.
- Additionally, I am working with Aaron C. Spaulding, Ph.D., in Mayo Clinic's Department of Health Sciences Research, to learn qualitative research methodology and with Lauren R. Bangerter, Ph.D., for caregiver burden.
How will your research improve patient care or impact public health?
Survival after transplantation has steadily improved. There is now increasing emphasis on not only whether patients survive transplant but also on how well they are living. If we can identify factors that prevent patients from achieving their desired outcomes at a reasonable cost — in other words, obstacles to high-value care — then we can come up with strategies to address those factors.
Why did you choose Mayo Clinic to pursue your career?
First, an interesting tidbit: I trained at Mayo Hospital in Lahore, Pakistan, long before I joined Mayo Clinic. It is a 3,000-bed hospital that was founded in 1871, named after the Viceroy of India, Sixth Earl of Mayo. There is no affiliation between Mayo Hospital in Lahore and Mayo Clinic here in the U.S. But even as a medical student in Pakistan, I was aware of the "World Famous Mayo Clinic."
After completing my residency training in the U.S., I worked at a large multidisciplinary group practice in Wisconsin for seven years. It was a tremendous experience, but once I started to become more interested in larger scale systems issues in health care delivery, I felt the need to develop additional skills and access resources not available in my posting at that time.
In 2011, after meeting my wonderfully talented and dedicated future colleagues at Mayo Clinic's campus in Jacksonville, Florida, and learning about various potential clinical, academic and educational opportunities at Mayo Clinic, my decision to join Mayo became an obvious one! Anytime I am struggling to find an answer to a research or clinical question, I can always find colleagues with tremendous expertise who are invariably generous with their time and in sharing their knowledge.