Jada Bussey-Jones, MD (Host): Hello. This is Jada Bussey-Jones, the current president of the Society of General Internal Medicine and the host of SGIM's President's podcast. We engage SGIM's former presidents who are leaders across healthcare, public health policy, and academia. As we lead up to the organization's 50th anniversary, we aim to capture insights from our nation's thought leaders so that our organization, our members, and healthcare broadly, are in a stronger position to grow, innovate, and meet the challenges of our time. To our listeners, thank you so much for joining us.

Today, I'm excited to talk to Dr. Barbara Turner. Dr. Turner is a Professor of Clinical Medicine at Keck School of Medicine in the University of Southern California where she practices General Internal Medicine and mentors researchers in Implementation Science and Health Disparities Research. She's a Senior Advisor for the Gehr Center of Health System Science and Co-Director of the Healthcare Delivery Science Center of Southern California CTSI.

Dr. Turner also serves as the American College of Physicians Deputy Editor for a collaboration with DynaMed, an online clinical resource that's used worldwide. She has held tenured positions in medicine at Jefferson University, University of Pennsylvania, and the University of Texas Health Science Center in San Antonio. She has previously served, of course, as the president of SGIM and a region of the American College of Physicians for a decade. She was the Associate Editor and then the Senior Executive Deputy Editor of the Annals of Internal Medicine. In San Antonio, she established the Center for Research and Community Health to improve the health of South Texas Latino population.

She has over 200 peer-reviewed publications. And for all of her wonderful work, she has received a Woman in Medicine award for her role as a mentor from the Perelman School of Medicine. So again, Dr. Turner, Barbara, thank you so much for joining us today. I always get so inspired by reading and hearing about your bios. And so, I'd like to just start off with a general question, if you can tell me about how you started in your career in General Medicine.

Barbara Turner, MD: Great. Well, first of all, I am really impressed with your initiative in taking this on. And it's emblematic of the creative leadership that we've had over the years of SGIM. So, congratulations to you, and you have a wonderful speaking voice too, I might add. So, I wanted to back up a little bit before getting into General Internal Medicine, because I had a weird path getting into Medicine.

Host: Yeah.

Barbara Turner, MD: I was a Humanities major. I took Geology and Astronomy in college. And then, I was starting on a career in Art History. I was in a graduate program, and I felt like I was losing touch with the world. It was more a feat world that I was entering, not that it's not an important career, but I looked at my friends and my former boyfriend who were all going into Medicine. And I felt like they could make a difference in everyday lives. And I looked at people on a bus and I thought, "They don't care that I'm in Art History, but they might care if I'm a physician." So, I called my parents and I said, "I'd like to switch." And they went, "Huh?" So, we made a bet that I could go through pre-med if I did well academically. And I was really fortunate to get into Penn very early on, and it was a fascinating class with a lot of diversity. So, I felt quite comfortable.

I had a wonderful time in my career at Penn and I had role models. One was Anna Marie Chirico, who was a clinician educator there, and delivered longitudinal primary care as a woman in those days. It was really eye-opening to me. And then, I had the original leaders, if you will, of academic General Internal Medicine, John Eisenberg, Sankey Williams, and Sandy Schwartz, all as role models who combined clinical practice with research.

So, General Medicine team, to me, perfect, because I could get to know people, have a longitudinal experience, taking care of them and getting to know them. And I also could do research. So, what's not to like? I did two fellowships after that.

Host: Wow. That's awesome. And I'm curious this pathway from Humanities and Art history to moving to pre-med, first I'm wondering how and whether you use any of those skills or what you learned in your world today, personally or professionally? And then, I want to come back to this question about your model for practicing and engaging as a professional, as a woman. But maybe either of those questions you can take and sort respond to.

Barbara Turner, MD: One of the things that, having been a Humanities major is I know how to write, and I know how to edit. And that has served me very well through my academic career. It helps me as an editor too, and I really love editing. So, I actually feel, not to put down the science majors, but they don't really get that skillset. And actually, the other part of Art History is it's been, I think, a theme of my family that we love art, we love museums, we love traveling. My middle daughter is a professional artist. It binds us all together. So, art has been something that kept me grounded through days when I wasn't sure I loved the hectic life of being a physician. So, I think it was, for me, a great combination.

Host: I love it. And, you know, I've gone to a lot of the regional meetings this year and they have special sessions about Humanities and Medicine, so people are drawing or writing about and reflecting on experiences that they've had in the medical space. And so, I think that there's a tremendous connection. What about your thoughts about practicing and leading and being a woman in the space of academia?

Barbara Turner, MD: Well, I mean, it's evolved obviously over the years. My class was still almost 25% women. So, it wasn't like we were a rarity even in the early '70 at Penn, but I hit my bumps. I had real experiences of people who weren't so happy that I was going into Medicine. Actually, there was a book written about my class by a guy who was a reporter for the Enquirer, and I recently ran across one of the chapters, which is largely about me, and it says, sexism is still alive in medicine.

Host: Wow.

Barbara Turner, MD: It was more sexism in terms of the patients didn't want to deal with me. But I had lots of it from both sides. I feel like it makes you more resilient. And you may ask me why SGIM, well, part of it is that I had a core group of friends who were actually in Philadelphia with me, and we got together and we talked through those challenges and how to make work-life balance work. I mean, we were able to say-- well, one person said, "Well, I cook on weekends with my husband so I don't have to deal with it during week." What a great idea, or different options for childcare. I mean, it helped with that balance because I actually have the notoriety of being the first resident in Internal Medicine at the University of Pennsylvania to get pregnant.

Host: Wow.

Barbara Turner, MD: And I was on the floors within three weeks. So, it was quite an experience and nobody knew what to do. The chair of medicine said, when I mentioned to him that Tony Fauci, of all people, had asked me how I was managing it-- I was pregnant at the time and his wife was interested in it-- so I told him, and I told the chair, because I ran across him. He said, "You mean you people actually plan these things?"

Host: Oh my goodness. Yeah, I mean, and we have come a long way because I do remember I got pregnant at the very end of my residency, so it didn't impact, but it was definitely frowned upon, even as I was training. And it's something that was not just about you, but about the work that your colleagues might have to do.

Barbara Turner, MD: Yeah. We don't have flexibility to cover. And so, I think that's one of the fascinating issues. I have a medical student right now who's working with me on a literature review of support for home life for women in Medicine. I think it's still a thriving question, but we have now the workforce that people really care about. There's enough women in Medicine that we really have to address these issues.

Host: Absolutely. And men and women are both parents. And so, I think this idea of parenting, parental leave, that there are universal concepts. But again, we have made tremendous progress. That said, I saw that in 2005, I think was your year as president, that you were only the fifth woman to be president of the organization. So, that sort of speaks to your resilience that you got to, that you were speaking about before. So, maybe you can just tell me a little bit more. You started to talk about why you chose SGIM and you've clearly found a group of people.

Barbara Turner, MD: Yep. So, it's an easy question actually. The leaders of establishing SGIM were my mentors at Penn, some of them. So, it was obvious and I started when I was a fellow. I think the interesting question is why was it so special? And in my early research years, I was mostly doing HIV work, actually a lot of work on women with HIV, which when I went to the HIV meeting, there were people who said, "But women don't get HIV." So, the HIV meeting was massive, and health services research was in the far corner, the D corner. And I felt ostracized. I went to APHA, it's a monster. I went to the ACP, it was mostly clinical. So, it's sort of like Goldilocks. I think SGIM was perfect. It offered the clinical expertise. It offered fabulous research opportunities to learn and also present your own research. Education was also a focus. And you got to know people.

One of the things I like to tell my friends is that when you're at SGIM, don't sit with your team, with people you know from your institution. Go sit down with somebody you don't know. And it's the kind of place where you have such opportunities to connect with people from all over the United States who have fascinating work and background. So, I think it's just a phenomenal organization.

Host: I couldn't agree more. Obviously, we stuck around long enough to lead the organization. But sort of that Goldilocks just right kind of thing, I had the same experience. Maybe I can ask a little bit about your tenure in leadership or perhaps really any of your time in SGIM. Is there something, an experience, that you reflect on that you're particularly proud of?

Barbara Turner, MD: It's hard to pick one. So, I thought about that, and I can sort of reflect on a couple of things. One is the growth from being a regional leader, which is not that hard to become to then joining council. I'm sure you've had this trajectory, but it's a natural growth and it doesn't seem like you have to be a politician to get yourself to be president. You just work your way getting to know people in wonderful opportunities. Council meetings were inspiring, and helped me feel like I was contributing to this organization that I cared so much about.

So, being president was a happy opportunity for me. It came in a challenging time. We were really having to protect longitudinal, comprehensive General internal Medicine from additional certifications because the hospitalists were getting that. So, that was a time when I had to work with a lot of other organizations. But that's a real opportunity too. I'm very proud of having established the funding for the Founders Award, which is a junior faculty pilot grant award. And I'm pleased that my team decided to hire CRD. We had the ACP as our advocacy group and CRD has been awesome over the years. I think advocacy has been one of the highlights of our organization's s skillsets, if you will.

And I also really loved speaking of advocacy, going to the Hill as an SGIM member. I actually ran into a senator who is Republican from Pennsylvania. And he said, "Oh, you are a physician." I go, "Yes." And then, I went off on my particular interest at the time. And I felt like I made a difference, I couldn't believe with that interaction. So, I think what we do on the Hill and the advocacy and John Goodson's leadership has been incredible. We're a small but influential.

And the last thing is I led a working group that decided we should probably give up on having non-physician chief executive officers. And we thought we should hire a physician. And Eric Bass, I think proves the point beautifully. He's been awesome. So, I don't know, I felt very proud of that and him.

Host: Oh my goodness. I honestly didn't know that you were a part of many of those things. So, I can say that having CRD, having Eric on the team as both a physician and, you know, a member of the administrative team, the executive administrative team for the organization, has been incredible. And so, thank you for your leadership in that space. That has had a lasting legacy, especially now, I think, when we're thinking about continuing to sort of state our values and do advocacy in that space, it's been particularly important.

So, maybe this is a good time to ask about, again, from my own personal benefit as the current leader, but even for future leaders as we are approaching our 50th anniversary, if you could offer any advice for SGIM, the organization or its current or future leaders? What would that be?

Barbara Turner, MD: If you'd asked me that question two months ago, it would've been a much more, rah-rah, we need to keep up with supporting General Internal Medicine and trying to argue for the role in our institutions. But I feel like we're in an existential crisis right now. And that's why I think it's important we're talking about advocacy, because I feel like we have to figure out a way to, without being burdensome, help engage all of our members to be agents of change. We just can't sit back right now with a lot of the things we value being threatened in a really significant way: patient care, research, the environment. I mean, you name it.

We are having to show our medal. So whether we, reach out more with social media to our individual members with opportunities, I also feel like we have to be agents of change in our own institutions. I mean, I am, I guess, a squeaky wheel about things that I think need to be improved at my institutions-- plural-- in terms of the support of General Internal Medicine. I'm a less of a vocal advocate or even a prepared advocate for hospitalist medicine, but I think that has to be the case too. But for longitudinal clinical medicine, I feel like we have to embrace not just team-based care, but technology to make our job easier for all of those rote things we do, so we have more time to really talk to patients and help them understand the rationale of what we're doing.

And I have to say, my experience with being the so-called usual source of care has been incredibly rewarding. And how do we tell our trainees or help them learn what it's like to know people? I mean, I agree, we're not super buddy-buddy, but last Tuesday, I had a patient who I've been treating for a while, has a movement disorder and mood issues, but he told me that last month he lost his house to the fire just before his son's first birthday party, and showed me videos of his house and his neighbor's house going up in flames. His father, just diagnosed with a terrible neurologic disease and we hugged each other on the way out. I mean, these are relationships that we're so fortunate to have. And when I was in West Philly, I had lots of wonderful patients who I treasured and I took my kids to the Baptist Church in West Philly. These are things that you just don't get in any other venue, so it's something we have to transmit to the trainees. How we do that I think requires creative people like you.

Host: Yeah, I agree with you 100%. I think that, especially when things are under threat, how we leverage our voice collectively and individually, it's a really important time. And we, as an organization, have been thinking a lot about how to amplify that. But also, the way that we are engaged still and always with our individual patients for longitudinal primary care. I think that's such a great part of what we do. So, thank you so much for that. Offering that advice, I think it's incredibly important.

Maybe I'll shift a little bit and talk about how you juggle multiple commitments. You clearly have had longstanding leadership roles, editor, mentor, research, clinician, and leader. And so, how have you been able to do all those things and still, you know...?

Barbara Turner, MD: Everybody tell you there's no downside. There's always a downside. But I think that it's really been having the support of people who are inspiring and that includes my mentees. Often, they're really inspiring. Often, they're women. But I've had great mentors over my career and they've helped me through the ups and downs. Actually, my first NIH grant, the study section was led by Martin Shapiro.

Host: Oh wow.

Barbara Turner, MD: I don't know. Anyway, so I think how do you balance it? There's no question you have to figure out efficiencies, but I'd work on nights and weekends, but I really asked my peers how to do things in a way that met my needs and met my kids' needs and met my work needs. And I got a lot of wonderful insights. So, I think using that social network and learning from people's successes really helps you wend your way. There are times when you want to throw it all in. I actually kept going because of guilt. You know, I mean, I had two fellowships after I finished my residency. How could I possibly not continue on? But then, I had all the rewards of doing my research and the leadership that made it worthwhile. I have a supportive husband and three amazing daughters who put up with me not being there at every single sports event. But we do stuff together and we have done things together a lot.

I love gardening, so we go to gardens. I love museums. We go to museums. My husband loves photography. We do, you know... So, I think sharing all of those wonderful interests, with the kids and valuing what a marvelous thing kids are. I know I have grandchildren who I'm absolutely over the moon with. You know, I think it's just that's the richness that you can have, but without a cost. I had to write AIDS grants over Christmas, so...

Host: Well, I mean, it sounds like, you know, you started getting that advice very early on through your SGIM network as well that has paid dividends. But, you know, you have clearly found a way to balance it and to have a wonderful family. I'm so jealous of you having grandkids. My adult sons have not yet started on that journey. I'm looking forward to it.

Barbara Turner, MD: How old is he?

Host: Twenty-seven and twenty-three.

Barbara Turner, MD: Give a break. I didn't have a grandchild until, you know, my daughter was like 35.

Host: Okay. All right. So, there's hope. Yeah. So, I'll wrap up by just offering an opportunity for you to offer any final reflections or thoughts for the listeners, either about anything really, your career, SGIM, or really just what's next.

Barbara Turner, MD: I have to actually end with a really funny story. So when I was a fellow at St. Thomas' in London, right after I finished my residency at Penn in Community Medicine, it was really wonderful. But we had a place up in Highgate, and John Eisenberg got ahold of me and said, "I'm coming to London." And I went, "Oh my goodness. Well, how do I entertain him?" So, I heard that he really loved ballet, so I got tickets to Covent Garden, and not knowing-- All I know is Romeo and Juliet, which I thought would be pretty cool. So, we get out of the subway at Covent Garden and the world has descended on it, plus Bobbies, police all over the place and we show our tickets and they go, "Oh, all right. Well, I guess you can go in." So, we go in sort of the front door and all these people are standing around, so why don't we stand around too? Who should come in about four minutes after us, but Charles and Diana, and it was the Royal Ballet that day. So, here I am in my plain clothes and they're all dripping with jewels. And of course, Diana swings by looking unbelievable. And Charles turns around to us. And said, "Oh, are you waiting for us?" John and the rest of us go, "Yeah." Anyway...

Host: That's amazing. You really did entertain John then...

Barbara Turner, MD: He was pretty impressed.

Host: An amazing visit, it sounds like. That's awesome. Thank you so much for sharing that. And I want to thank our listeners as well. Thank you for joining us today. I want to thank the SGIM staff and Roz Boggle, our executive producer and our production team overall. Also, I want to thank our listeners. You have been listening to SGIM's President's podcast. If you like what you have heard, please rate us and leave a comment wherever you listen to podcasts. It helps others to find us and also look for us on the SGIM website, sgim.org and follow us on X.