Ethics, Evidence and Outcomes — Practicing skepticism in medical research to improve patient care
Honoring an ethical practitioner, a talented researcher and outstanding teacher
Dr. Storrs passion and devotion to dermatology and to the education and mentorship of others is matched only by her dedication to a life of learning. The Storrs Lectureship focuses on areas important to Dr. Storrs: medical dermatology, controversies in medicine and ethics in medicine.
The Storrs Lectureship seeks to encourage interaction and dialogue among attendees by focusing on provocative topics that impact the practice of medicine in general and dermatology in particular. The specialty of dermatology is spotlighted, controversial topics are discussed, fiction is separated from fact and myths are busted in a town hall like setting usually featuring a keynote speaker and an interactive session between panel members and the audience.
More on Frances J. Storrs
Lasting Legacy — Frances J. Storrs, M.D. '68
By Harry Lenhard
Frances J. Storrs, MD, or Fran,as she is known to everyone, has spent more than 40 years blazing trails. "My professional career has been incredibly satisfying to me. Things aren't always perfect in life, but I don't know of any major thing I would have done differently. I'm more pleased than anything that I've been able to have a professional life that worked well with my private life. It's given me a chance to put my family first, and my family remains central to my life."
She was the first woman to complete a residency in the medical school's dermatology department and is a path-breaking physician, researcher and mentor. Her skills in the classroom have earned her many teaching and service awards. She is known nationally and internationally for her work in contact dermatitis and discovering new workplace allergens. She has received virtually every honor her specialty can bestow, among them the Gold Medal of the American Academy of Dermatology (AAD), its highest award, as well as its Master in Dermatology Award. She won the Rose Hirschler Award of the Women's Dermatologic Society.
And along the way – through example and activism – she's fought to change the culture of academic medicine. Her notoriety began after a pivotal 1971 event. "The Arlington Club experience totally changed my life," she said.
1971: The Arlington Club epiphany
"It made me more active in terms of making sure things were going to be okay for women. It made me a feminist and I wasn't a feminist before that."
It happened a few years after Dr. Storrs had joined the OHSU faculty. She had been invited by a local dermatologist to a dinner at the Arlington Club honoring Dr. Harvey Blank, who was in town to participate in the annual School of Medicine Sommer Memorial Lectures. Dr. Storrs was mingling with colleagues at dinner when she was informed that the club was a men-only establishment and she would have to leave.
The descent down the club's wide staircase to the street below was a "totally life changing experience," she said. "It was a window going up, a true epiphany. It was really the first time in my life where I saw that my being a woman made a huge difference in terms of what my professional life might be."
The effect on Dr. Storrs was profound. "It made me more active in terms of making sure things were going to be okay for women. It made me a feminist and I wasn't a feminist before that."
Within months she had joined the board of the Oregon chapter of the American Civil Liberties Union and taken over as chair of the medical school's affirmative action committee. She helped the medical school adapt to Title IX of the Civil Rights Act which outlawed discrimination on the basis of sex at any educational institution receiving federal assistance.
"Title IX changed totally the way women were treated; we were able to use it very effectively in getting women into areas where they could never have been otherwise. At the time, some surgeons, for example, wouldn't let women medical students do hernia exams on men, so I would call up the head of the department and say, 'Are you aware of what Title IX is?' After hemming and hawing, he would say, 'Well, I think we can arrange for women to do hernia exams on men.'"
Dr. Storrs went on to become a dedicated community activist. She chaired a Citizens Task Force that probed the internal affairs policies of the Portland Police Bureau. She served as president of the Portland City Club, and in 2001 was honored as Portland City Club's Citizen of the Year.
Planning from a young age to balance work and family
"I saw the impact of my parents' professional life on our family life and I was fearful that if I became a doctor, I would marry a doctor and I thought that would be very difficult."
Dr. Storrs hadn't encountered many barriers growing up in a prosperous household in Spokane. "I grew up with the emphasis on my life that I would certainly work and that I could do whatever I liked."
Her mother and father both were family doctors with large practices. Both were graduates of the University of Oregon Medical School (precursor to OHSU School of Medicine) and of Whitman College where they had met. When her mother went on house calls and hospital rounds young Fran often went with her. Her mother, in particular, was always accessible. She might be in the middle of a physical exam but would immediately interrupt it whenever Fran called. "That kind of appreciation of the importance of family in the lives of working women and men was very unusual. It made that kind of attitude towards family a big part of my life as I was growing up as a physician."
Her parents were involved in church and civic organizations, not just medical societies. "My mother had a great sense of obligation to serve the community," Dr. Storrs recalled. She worked with the Salvation Army and the White Shield home for unwed mothers and was active in the PTA. Fran's father, the son of missionaries, enjoyed gardening and even developed a number of new species of iris.
The daily demands on family doctors that Dr. Storrs witnessed growing up, however, initially soured her on the idea of following in her parents' footsteps. "I saw the impact of my parents' professional life on our family life and I was fearful that if I became a doctor, I would marry a doctor and I thought that would be very difficult." Her love of science ultimately moved her to change her mind. But she set out from the beginning to tailor her career to fit around the needs of the full family life she was determined to have.
She chose Cornell University Medical College, now the Weill Medical College, partly because it was in New York City. She went there to learn, of course, and did well enough to keep going, but concedes, "I mostly enjoyed New York." She did a stint in Scotland on a cardiology rotation in Edinburgh and worked with a family practitioner in South Africa.
She ultimately settled on dermatology after posing a question to an endocrinologist that she met on a rotation: If his wife were a doctor, she asked, what specialty did he think would be ideal for her. Dermatology, he said. It was a perfect field for a woman who wanted to have a family and a controlled professional life. That is exactly what Dr. Storrs' goal was then. Discovering how interesting dermatology was and how much she loved it would come later as frosting on the cake.
Being true to herself, and recognizing the importance of mentors
She was drawn back to the Pacific Northwest after medical school by her love of the region's beauty. "I didn't want to live in Spokane, where my parents were, because I knew that would be too potent an influence." So she came to Portland where her brother lived, interned at Good Samaritan Hospital and worked with Dr. Ted Kingery, the leading dermatologist in Portland. Dr. Kingery introduced her to Dr. Walter C. Lobitz Jr., chairman of the dermatology department at what then was still the University of Oregon Medical School.
Dr. Storrs applied for a residency in the dermatology department and after a round of interviews, she was invited to become a resident. Dr. Lobitz would become Fran's lifelong mentor. He was "absolutely charismatic. His mind sparkled with ideas and interesting concepts. He saw to it that I did what you needed to do in order to advance in academics. He would bring articles to me and tell me I had to read this article, read this journal, have this be my special interest. And then he would set up places for me to travel in different parts of the world to go study with somebody and learn a particular thing. He'd put me on committees, put me in charge of lectureships. I would not have had any of the academic success in the measure I had if it hadn't been for Dr. Lobitz." It was through him that she met her future husband, John Storrs, a prominent Northwest architect. Storrs was a patient of Dr. Lobitz's.
Twenty-five years of sleep deprivation
"I was working every night until two and three in the morning and my buddies in private practice were fast asleep."
Her union with John Storrs came with three teenage stepchildren from his first marriage. Three years later they had a son, Leather. "In the evening I would be with my family for dinner and then be with all of them until they were all in bed, and then I just stayed up and worked most of the night to prepare a talk or do all the things an academic person has to do to advance. I wanted to tailor my life so that I could manage my family and private life. But when I look back at all the things I was doing, it was way too much. I was probably sleep deprived for 25 years. I was working every night until two and three in the morning and my buddies in private practice were fast asleep."
While balancing work and family in academic life was harder than she expected, academic medicine did prove to be suited for family life in one sense. Dr. Storrs, her husband and Leather traveled the world during the three sabbaticals she took as well as when she went to speaking engagements, which she accepted only if her husband and Leather could accompany her. "That allowed me to spend tons of time with my family during the time my son was growing up and it was very important as well to my marriage." It also meant that Leather missed about nine months of school, all told, while he was in grade school, but he got a rich exposure to foreign cultures.
Success in academic medicine – or any profession – is easier with the right life partner, Dr. Storrs said. "Probably the most important thing you can do going into any profession is choosing someone who understands what you're doing and is willing to assist." John Storrs, who died in 2003, reshaped himself into the helpmate Dr. Storrs needed. "He took on lots and lots of responsibility in our family, he was very involved."
Full circle: now giving back, as a mentor
"Get involved in community and civic activities. It helps keep you grounded."
Dr. Lobitz's impact on her career inspired in Dr. Storrs her great interest in promoting mentorship opportunities for others. She remembers not knowing when starting out that she needed a mentor. "It wasn't something I thought about. I wasn't searching for one. There were no women around to mentor me. But Dr. Lobitz knew what I needed and directed me."
Now, she's giving back. She takes pride in the mentorship program of the Women's Dermatology Society that she initiated. It pairs young men and women with senior women dermatologists. Almost 400 young dermatologists have participated in the program and most other dermatology sub-specialty societies have since copied it.
Lessons learned, lessons shared: Advice from Dr. Storrs
Dr. Storrs's advice to young women in academic medicine?
- If you want to achieve excellence, work hard.
- Select a good mentor after reaching the understanding in your own mind that that kind of guidance is what you need. Mentoring lasts awhile and is different from a role model. The relationship usually lasts about five years. The person you choose should be someone far enough along in their own career that he or she won't feel the need to compete with you. They don't necessarily have to be in the same field or specialty. They do have to be someone who can put up a mirror in front of you that can help you identify the things you need to do to succeed.
- If you want to be a leader in your specialty, join the organizations that can teach the skills you need. If you want to be a department chair, which I never did, or a dean, check out ELAM – the Executive Leadership in Academic Medicine Program for Women.
- Choose a life partner who understands what you're doing and is willing to help you and, maybe most crucial, has a sense of humor.
- Get involved in community and civic activities. It helps keep you grounded.
Article written by Harry Lenhart
Unconscious Bias in Medicine: Frequently Wrong, But Never in Doubt
Keynote: Patrick G. Croskerry, M.D., Ph.D.
Director, Critical Thinking Program; Dalhousie University
Blake Lesselroth, M.D., M.B.I., F.A.C.P.
Acting Director, Clinical Informatics, VA Portland HCS
Arthur Papier, M.D.
Associate Professor in Dermatology and Medical Informatics; University of Rochester Medical Center
Crystal Roberts, J.D.
Program Manager, Unconscious Bias Campus-Wide Initiative; OHSU
Robert A. Swerlick, M.D.
Professor and Alicia Leizman Stonecipher Chair of Dermatology; Emory University.
Promises and Pitfalls of High Tech Medicine
Stephen Friend, M.D., Ph.D.
Founder, President of Sage Bionetworks
Daniel Webster, Ph.D.
Lead Developer of Mole Mapper App
James Taylor, M.D.
David Adelson, M.D.
Troy Bundy, J.D.
Hart Wagner, LLD
Michelle O'Neill, R.N., Ph.D.
Risk Control Consultant, CNA
Screening for Melanoma: Current State of the Evidence
Keynote: Martin A Weinstock, M.D., Ph.D.
Professor of Dermatology, Brown University
Watch presentation Screening for Melanoma: Current State of the Evidence
Robert Swerlick, M.D.
Professor and Alivia Leizman Stonecipher Chair of Dermatology, Emory University
Watch presentation Screening for Melanoma: Notes from a contrarian
Jeffrey North, M.D.
Assistant Professor of Dermatology and Pathology, UC-SF
Watch presentation Molecular Diagnostics in Melanoma: How and When to Use Them
Heidi Nelson, M.D., M.P.H
Research Professor and Vice Chair of Medical Informatics and Clinical Epidemiology, OHSU
Watch presentation Applying Evidence to Practice: Current Standards for Screening Guidelines in the U.S.
Nikola L. Jones, J.D.
Partner, Lindsay, Hart, Neil & Weigler, LLP
Watch presentation Legal Aspects & Implications for MDs
ACOs, CCOs, Medical Homes and the Future of Medical Care – Is there a seat for dermatology at the table?
Oregon is in the nation’s spotlight for its effort to reform the state’s Medicaid program with Coordinated Care Organizations (CCOs). Do you understand this new model of care? Are you familiar with how specialty practice fits into this new paradigm of community based care? If you have questions and concerns regarding the potential impact that Accountable Care Organizations (ACOs) and CCOs may have on your practice, or how these models may expand in the future, join us for lectures and panel discussions with three of the state’s foremost authorities leading the effort to improve health outcomes for Oregonians.
Bruce Goldberg, M.D.
Director, Oregon Health Authority
David Labby, M.D., Ph.D.
Chief Medical Officer, Health Share of Oregon (a CCO)
Ron Stock, M.D., M.A.,
John Kitzhaber, M.D., Fellow in Health Policy, The Foundation for Medical Excellence; and Director of Clinical Innovation, Oregon Health Authority Transformation Center
Does empathy pay? Our relationship with patients in the era of outcome based medicine.
Designed to encourage interaction and dialogue by focusing on provocative topics that impact the practice of medicine and dermatology, this townhall event will turn a spotlight on provider-patient communication and potential impacts of the medical field’s new focus on outcomes.
Featuring Neil Prose, M.D. Dr. Prose is director of pediatric dermatology at Duke University Medical Center and Professor of Dermatology and Pediatrics. He is the author or co-author of more than 60 publications, co-author of the Color Atlas of Pediatric Dermatology, and co-editor of the two volume Textbook of Pediatric Dermatology. He runs an active clinical pediatric dermatology service at Duke, and lectures nationally and internationally on topics of interest to both dermatologists and pediatricians. Fluent in Spanish, Dr. Prose has delivered lectures on numerous occasions in many of the countries in Latin America. Additionally, he has developed expertise and interest in two special areas: the care of skin disease in developing countries and communication between doctors and patients.
Variations in health care practice: opportunities for improving care?
David C. Goodman, MD, MS
Professor of Pediatrics and Health Policy, Dartmouth Institute
Key Note Address
Beneath the skin of variation in health care practice:
Insights from the Dartmouth Atlas of Health Care
1. Oregon health care reform: moving in the right
2. How variations in clinical decision making aff ect
individual health; will your decisions aff ect local
and national policy?
Joining Dr. Goodman for a panel discussion of the special topics will be Robert Dannenhoff er, M.D., pediatrician from Roseburg and former president of the Oregon Medical Association, and Edward Keenan, Ph.D., president of the Foundation for Medical Excellence, both of whom have been deeply involved with health care policies and reform in Oregon.
The cost of health care: Whose fault is it anyway?
Jack Resneck, Jr., M.D.
Associate Professor of Dermatology and Health Policy, University of California San Francisco School of Medicine
Designed to encourage interaction and dialogue by focusing on topics that raise controversy, this town-hall event will turn a spotlight on health care reform and how it affects the specialty of dermatology by delivering facts, busting myths and providing a platform for discussion.
Are dermatologists paid the right amount for the procedures we perform?
Panel participants: Jack Resneck Jr., M.D., and Scott Collins, M.D.
Medications: Do dermatologists know how much they cost, and are the latest and greatest truly better?
Panel participants: Jack Resneck Jr., M.D., and Julianne Mann, M.D.
“The future of dermatology practice – top issues facing us in the next five years”
Alexa Boer Kimball, M.D., M.P.H.
Associate Professor and Vice Chair of Dermatology, Massachusetts General Hospital
Panel #1 “Generation and gender – positive and negative effects?”
(Drs. Brooke Sikora, Al Solomon, Michael Adler, Rebecca Bremner, Margaret Hewitt)*
Panel #2 “Evolving relationships with industry – are we throwing the baby out with the bathwater?”
(Drs. Andrew Blauvelt, Eric Simpson, Phoebe Rich, Bert Tavelli)*
Panel #3 “Dermatology’s scope of practice – are there too many surgeons, cosmetics and non-physician clinicians?”
(Drs. Diane Baker, Bert Tavelli, Anna Bar, Karen Vigeland, Mrs. Lakshi Aldridge)*