Meera Sheffrin, MD, practically gushes, in a good way, when discussing her current focus — the Stanford Home-Based Senior Care clinic where she is the medical director. When I first met her, she had just moved into her own office, an exciting transition for an up-and-coming academic physician.
We chatted about her start in science, her interest in geriatrics, her love of gardening and more.
How did you get interested in science and medicine?
I attended an after-school science class for girls in elementary school, which I really enjoyed. I pretty much wanted to be a doctor since the third grade. In college, I volunteered in a community clinic and I really found this was my passion.
How long have you been at Stanford?
I've been a faculty member for two-and-a-half years. I'm originally from northern California and when I joined the faculty it felt like coming home.
What are you working on today?
At Stanford, we have a relatively new home-based senior care program. We wanted to figure out how to provide health care for patients who had a lot of trouble getting into the clinic or had cognitive difficulties. The VA has a well established home-based primary care program and we modeled ours after theirs.
Our clinic has a nurse practitioner, doctor and full-time social workers as well, because patients' social needs are just as important as they get older. We are working on educating people about our program and hope to show it's sustainable.
There's so much demand, patients are so grateful this service is offered; I really want to use it to make a difference.
What is most fulfilling about your work?
I love working with older adults and my days are really varied. I can be in someone's home giving them a flu shot while their grandchildren are running around. And then spend the next morning in my office working on the administration of the program.
Geriatrics includes medical problems, but also the complexity of people's social environment.
What is the biggest challenge in geriatrics?
A lot of parts of aging are not really 'health care' so it is hard to find money to solve problems — such as where is someone going to live, or how are they going to have more caregivers — so we have to develop creative solutions.
As a geriatrician, what are your thoughts on aging?
If you take three patients above the age of 80, they'll all be in different states of health. Age means nothing about someone's health and life.
I never automatically attribute something to aging, I always do a thorough exam for any new symptom or problem. At the same time, there are things we cannot fix. There are ways the body fails us that we cannot control.
There are a lot of misconceptions about older adults, including that they don't embrace technology. On our online program (MyHealth), for example, plenty of 80-year-olds message me.
And there are a lot of differences in how families approach end-of-life conversations. In some families it is strictly taboo and they pretend like they are never going to get old, and others welcome and are eager for end-of-life conversation if brought up in a gentle manner.
I often joke that there are very few things I can help my patients and their families cure, but there are many things I can do to help them.
How do you unwind?
I love to garden. And I really enjoy walking and hiking in nature.
What are you reading?
Jane Eyre. I never read it in high school, but recently one of my patient's spouses made a reference to it and I realized I wanted to improve my knowledge of literature.
What is your favorite food?
Definitely pizza. I make pizza at home once a week, often with tomatoes and basil from the garden.
What advice would you have for someone hoping to pursue a career like yours?
The world is your oyster in geriatrics. The field is looking for leadership. You can be a leader in a small clinic and you can be a leader in the national field shaping policy. People turn to geriatricians for advice.
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Photo by Becky Bach