October, 2009
Donald Lloyd-Jones, MD
- Clinical focus: general and preventive cardiology (primary and secondary prevention)
- Came to Northwestern in 2004 to work with Drs. Greenland and Bonow in Preventive Medicine
- Favorite part of his job: mentoring; helping to develop medical students, residents, fellows and junior faculty in research and academic careers.
- Outside of work: NY Giants Fan
- Chief Medical Resident, Massachusetts General Hospital
What is the role of Preventive Medicine in today’s medicine world?
We actually know much of what we need to know to prevent most chronic diseases and conditions (cardiovascular disease, many cancers, arthritis, obesity, diabetes, hypertension) in the population. But we are terrible at applying this knowledge in clinical practice, and in motivating patients to adhere to treatment plans. We have also done a poor job of motivating local and national agencies and legislative bodies to use the power of public health policy to effect health promoting changes in this country. The Department of Preventive Medicine at Northwestern and the field in general have a lot to add to the armamentarium of prevention for patients and the population as a whole.
One of my favorite papers of recent years was published in the New England Journal of Medicine in 2007 by Earl Ford from the CDC and Simon Capewell from the UK. They explored the reasons for the sharp decline in coronary mortality rates observed in the US from 1980 to 2000. They found that medical/surgical interventions and medical therapies accounted for about half of the improvement, and population changes in behavioral factors and in the environment accounted for the other half. But there were ominous signs that the obesity epidemic was starting to undo these gains.
My must-reads are….
I think to be successful as a clinician and academic researcher you have to read broadly in your field. But you can’t read every journal, so I focus on 5-10 journals and then use websites like theheart.org to keep me up to date. Beyond that, I like to turn off the medicine stuff at bedtime each night and read something for me. I read a lot of non-fiction and some fiction.
Recent favorites of the last few years include “The Shadow of the Wind” by Carlos Ruiz Zafon (love that Barcelona!), “Young Men and Fire” by Norman Maclean, “Shadow Divers” by Robert Kurson, and “The Ghost Map” by Steven Johnson.
How did your MS in Epidemiology help you in your career?
In residency, I became involved in a project that was one of the first to look at quality of care and outcomes in patients hospitalized with unstable angina and obtained practical experience with research design and methods. But it was during fellowship that I was able to get didactic experience through the Program in Clinical Effectiveness at the Harvard School of Public Health. The Program is an intensive 10-week summer course that goes deep into clinical research methods, epidemiology and biostatistics. After two summers of the Program I was ¾ of the way to an MS degree, so I filled out my credits by taking a lot of tools-based courses so I could do my own programming. That gave me a real boost during the early part of my career—I could do some of my own analyses and write papers without having to wait in the queue for statistical analysts to get to my project.
In addition, the extra knowledge I gained, the MS degree really helped me get a better start in the field of cardiovascular epidemiology. I felt like I could have more sophisticated discussions with the biostatisticians and PhD epidemiologists in my chosen field. Although a fair number of people work in cardiovascular epidemiology, relatively few had MD and MS degrees in epidemiology at the time, so it allowed me to bridge the divide between pure epidemiology and clinically relevant applications of epidemiology.
I spend a lot of my time on research projects in observational cohort studies. I am currently interested in refining methods of cardiovascular risk estimation, focusing on lifetime risk estimation and the utility of novel risk markers in clinical risk prediction. Recently I partnered with Drs. Debiao Li and James Carr in Radiology to use MRI to define qualitative and quantitative measures of atherosclerosis development in individuals at different levels of risk for cardiovascular disease. For the future, I hope to continue research in mechanistic epidemiology (understanding basic mechanisms of disease using high-resolution imaging and biomarker methods in population-based studies) and in translational epidemiology (translating observations from epidemiologic work into clinical and public health interventions that prevent cardiovascular disease). My real goal is to survive my children’s childhoods! They are 12, 9 and 5 years old.
