Caitlin Whyte (Host): Ladies and gentlemen, welcome back to another episode of In Their Words. Today we have the privilege of introducing you to our guest, Pediatric Surgeon, Dr. Safford. He's about to take us on a journey through the moments that matter most to him and provide us with insightful perspectives on the incredible range of pediatric care at UPMC Central PA and beyond. So join us as we step into the world of Pediatric Surgery, witness the moments that define the profession, and gain insights into the vast world of pediatric care.

Shawn Safford, MD, MBA, MAS: What made me go into pediatric surgery and pediatric subspecialties is because when I'm taking care of a child, you're not just taking care of the actual disease of the child or what's going on specifically, but the thing that made me want to take care of children is you're actually taking care of an entire family.

And that is not just the child, the parents, but it's also the siblings, and the grandparents, and the aunts, and the uncles. So, my passion for taking care of children is the fact that you're taking care of an entire family when you're taking care of a specific thing. UPMC Children's in Harrisburg really envelops that entire concept for the children.

And so, when your child's being taken care of here, it's not just the disease that's being taken care of, it's actually the kid. It's the mom and the dad and the siblings, and we have all of the resources here to make sure that we can approach a child from many different facets. And so that might be, what's the right antibiotic? What's the expert antibiotic to have? We might need subspecialty expertise in the area, at which point we're connected to Pittsburgh. And can incorporate the care for your child here too. So that's the reason I went into pediatrics and it's my passion for it as well.

Host: In the world of pediatric care, excellence knows no bounds. It extends not only across UPMC Central PA, but also beyond to institutions like UPMC Children's Pittsburgh. Together, these sister institutions form the foundation of world-class pediatric care, shaping the landscape of healthcare today.

Shawn Safford, MD, MBA, MAS: You can't forget that you're taking care of the kids in your community. So a funny story was my daughter and I, I'm a rec ball softball coach for my daughter's softball team and they were taking us around the Hummelstown community on the back of the fire engine, and out came from one of the houses, one of my very special patients that I've taken care of for years, with a very significant problem, and he was running down the street yelling, there's my doctor, there's my doctor, and he went in to get his mom and she texted me and said, you weren't on a fire truck going down the street, were you? Because our little buddy saw you running down the street. And so, I mean, talk about being able to be part of your community. I mean, as I said, sometimes there's a disconnect between hospitals and the patients.

And all of my families have my cell phone. And all of them are incorporated with social media with myself. And that I always say, once I've taken care of your child from a surgical standpoint, your point, you're part of the surgical family. And as my own kids say, daddy, you have four kids, but you really have thousands of kids you take care of that are yours.

 So, I've been at large children's hospitals, medium sized children's hospitals, and kind of a hybrid adult and children's hospital. Some of the biggest problems or concerns you have is that even being in large, in children's hospitals, you don't necessarily have a top 10 children's hospital as your backup.

And when you have UPMC Children's in Harrisburg, we can take care of your kid at the best place, best time and optimal care. And you have UPMC Children's here in your community with the top 10 resources. So in my world, I'm a pediatric surgeon, if your child has something that's so complex that in this region, it shouldn't be taken care of because we don't have the expertise regionally; we can take you to Pittsburgh and have the surgery there, or I can have a consultation if I have something complex occurring here from a medical standpoint. I can call my colleagues in Pittsburgh and say, this is what we've got going on. What do you think about this? And we can do that integration of Pittsburgh.

I mean, I consider them one big slippery slope back and forth between the two of them that if we need to be in the right place, we can provide that care. We go all the way up to Williamsport where we provide probably 80% of children's surgical care. In Harrisburg, we provide probably 95%, and then that 5% allows you to know that despite you living in a region without a Children's Hospital in our region, you can be taken care of in a top 10 Children's Hospital and then come back to your community for your follow on care.

Well, and if you think about kids' problems are rare, just in general. I always say our specialty, pediatrics, there's a lot of adults because most kids are healthy. When a child is unhealthy, you frequently need an expert to be engaged. We have most experts in the region, but then you have those sub specialty experts, those who deal with something that happens 500 times in the world each year.

We have those people on telephone consultation to give us guidance, or if we need to provide the patient's care in Pittsburgh, we can do that. As a physician, as a surgeon, that really takes a lot of the stress off me because I'm not finding myself taking care of kids where I don't feel like I have a backup.

I don't have someone who specializes in little fingers. You know, you have these people who specialize in these very focused things that aren't in this region. They're just not going to be in Central Pennsylvania. They're going to be at the large children's hospital. And with the Children's Hospital in Pittsburgh, you have a top 10 children's hospital. And that's pretty incredible. That's such a great resource to our community.

Host: The connection between UPMC Central Pennsylvania and UPMC Children's Pittsburgh, serves as a vital bridge, often facilitating access to specialized care for unique and complex cases.

Shawn Safford, MD, MBA, MAS: Well, without being too specific, because unfortunately with rare things, you can kind of tell who people are. With keeping that in mind, you know we've had some rare congenital conditions that I'll be honest, if you look it up in a book, it's one in 5 million. And this is a great example of a mom and dad who had a child who had a very rare condition.

It was an emergency. It didn't need to be taken care of today, but I was able to consult my pediatric urology colleague. She gave some advice. It went beyond what her capabilities were. So we talked to Pittsburgh. They rarely had seen it, but they had an expert there in specifically this. So guess what?

That child's getting the appropriate, the perfect study to be doing to evaluate the problem. And now they're going to be seen in three months. And boy, does that family feel great because they've had the world's experts looking at their child to give them the best management possible. And that family is ecstatic because they could have been trying to, if they were born in another hospital, someone who would just quote unquote, try to figure it out is going to look at their child.

They don't have this absolute massive network of experts that can come through and give you the optimal management for your child. And again, as a dad, I'm excited by it.

So, I grew up in this area. I grew up in Anvil. My wife is from Lancaster. I grew up kind of a farmer's kid. And I went to medical school from college because I was interested in fetal development. I was interested in how the fetus develops, how it becomes, how the organs develop. How do we become who we are?

And so that had been my focus of research and my interest. I did my medical school at University of Pennsylvania in Philly. And then my residency at Duke. Now for pediatric surgery, it's very competitive. It's a very challenging subspecialty. There's only 950 of us in the whole country. And yet we have two here in Harrisburg that are actually three in Harrisburg that we have that are taking care of your children. Then I did my fellowship at Children's Hospital Philadelphia after residency, and then spent some time in the Navy where I was active in humanitarian missions. And developed a fetal surgery program and at Children's National Medical Center in D.C. So that, and from there I kind of had some additional leadership roles at various institutions and then had the opportunity to come back to our community and lead the pediatric service line. And that's all of the pediatric services and build them up and identify where our needs are for the community.

Host: Dr. Safford's connection to his work and passion runs deep, further amplified by the presence of his own family and children. This unique perspective, bridges his professional and personal life; creating a profound connection that fuels his dedication.

Shawn Safford, MD, MBA, MAS: I have four. I have four. They span the ages. They're getting older now. So I have a 22 year old and then two 18s and then a 13 year old as well.

It's funny, when you're a general surgery trainee or resident, they call them you're trying to figure out what the heck do I want to do with my career? What do I want to do for the rest of my life. And you see a lot of subspecialties that you think, Oh, that's a really interesting specialty. And technically it's very challenging and you enjoy the patients.

But I can tell you that one of the, one of the defining moments was I was on call and I had to hurry up and get to the hospital because there's an emergency and now my now 22 year old was five years old. And I always take my belt off when I got home from work and laid it down and never could find my belt when I needed to find it, of course.

And my 22 year old's yelling at her mom going, find daddy's belt. He's got to go save a baby. You really come down to those moments where you're just like, you know what, my kids know and love and respect what I do. When I leave my house in the middle of the night to go help a baby, there's never a qualm of where's my dad?

My dad, you know, I've missed a lot of events. I've missed a lot of kids walking, a lot of kids talking in my family, event, graduations. All these things that you've had to do because my first child is my patient. And my kids always know they've had to take a second seat to that.

But they love and respect the kids, too, and know that, and support me, in what I do. I always tell the story that when I was a fellow, we would be on every other night call. So that means you'd spend 36 to 40 hours in the hospital and then off for 8 to 12. And my wife, God love her, would come in every weekend and bring all of the children into my office, lay out a blanket, and they'd spend the day with me, while I was on call so I could see the kids. That's the kind of family commitment that most of the surgeons that you'll see, and most of these subspecialists that you'll see, they've had to do. Their entire families have become vested into what we do.

Host: When it comes to clinical trials, UPMC Central PA stands at the forefront of innovation and excellence. Clinical trials are a cornerstone of medical advancement, offering the opportunity to test new treatments and therapies; pushing the boundaries of what's possible in healthcare. UPMC Central Pennsylvania's commitment to participating in and leading clinical trials signifies their dedication to providing the latest and most effective treatments to their patients.

Shawn Safford, MD, MBA, MAS: So that's where it's so critical to be part of the Children's Hospital Pittsburgh group. So we are an extension from there, so we can integrate our patients into those trials. And that might be the patient goes to Pittsburgh to get incorporated into that trial, but then is able to come back into the community to be followed on and some of that care being performed.

So that there's no question we, you have absolutely every resource and every trial available to you out of Pittsburgh, and then we have that pipeline between Harrisburg to there to be able to do the follow on cares.

Host: When asked about the significance of the Infant Development Program, Dr. Safford offered a compelling perspective that underlines its importance in pediatric care.

Shawn Safford, MD, MBA, MAS: I can't overemphasize how important the Child Development Program is. If you think about as we grow and as we mature, and our brains develop, and our bodies grow into the, to being adults, we always talk about that, the trajectory of our development. We always talk about the trajectory of our development as that curve that occurs, that developmental program can help push it to a higher level than if it was left by itself.

And so that's such an important role. We all maintain the same trajectory, the same line of development, but how do we increase it to have a better, more developed, higher functioning, more integrated approach to that. And without that child development, without those resources, without that, frankly, commitment by UPMC, I mean, what an amazing impact we're having on kids across our region.

I mean, it makes a massive difference in how these kids end up behaving. Because if you figure example, all babies look alike. It's easy to be a baby is one of the funny sayings we have. They're sitting there smiling, they're eating, they're drinking. And then you think about the two year old. Well, where are they at in their milestones? Some are higher, some are lower. How can we push that milestone to a higher level? How can we continue to support the families, the child, to increase that, to reduce the change, the variations as we go along. I mean, life is tough enough for all of us and we, there's different components, but if we can medically intervene to improve that, what an amazing resource.

Host: The Infant Development Program serves as a vital resource for a diverse range of patients offering support and guidance to numerous families and children who can benefit from its services.

Shawn Safford, MD, MBA, MAS: So those are children who have been identified as having a potential loss in that curve. So children who aren't necessarily optimizing their continuation of how they're thinking, their intelligence, their motor skills. And so they can identify those kids early on to help push that curve to improve development and meeting those milestones that are needed.

That's where we have the things like physical therapy, nutrition counseling, speech, and occupational therapies. Those are the kinds of things that those resources that we have that continue that infant development into the next step. And so with having those resources here, we really can kind of continue that management of the baby as they get out of that two to three years of age and they're continuing on that need assistance. Those are the kind of things that we have available that are here. But in addition to that, we have resources in Pittsburgh that we can kind of continue at a higher level and bring back to the Harrisburg area.

Host: When we take a closer look at UPMC in Central Pennsylvania, the expansion of resources available to patients throughout the system is nothing short of astonishing.

Shawn Safford, MD, MBA, MAS: Well, as I said, I grew up in the area so I always had my impression of the UPMC system and Harrisburg, frankly, 25 years ago, 20 years ago before it was UPMC. And it is amazing. It's almost like light year.

I actually call it the Big Bang. The Big Bang of pediatric care. Because it went from having these small resources, small things, in the course of two years, this massive expansion of all the resources and all the capabilities. I mean it's shocking to just see how meteoric our rise has been. And it really, having been away from the area, grew up in the area with a certain vision of what it was like, to then coming back home and seeing what it's become, it's just been amazing.

Well, and I think the other part of this is comprehensive care. Like, the UPMC Children's and Harrisburg subspecialty care, let's face it, thank God most of us don't need those services of that subspecialty, rare case issues. Most of our kids, we need pediatricians. We need to have ability to see patients after hours.

We have that here. We have that ability, which was frankly lacking in the area. And we've just continued to expand these services in the Hummelstown area, in Hershey, in, in Le Moyne. I mean, it's just amazing how much, for just regular care, just making sure our children are growing and healthy and safe. That is such a resource to me.

Host: In the world of healthcare, listening to one's intuition can often lead to the best possible outcome. Our inner compass, when coupled with medical expertise and guidance, can play a pivotal role in making the right decisions for our health and wellbeing.

Shawn Safford, MD, MBA, MAS: I will tell you just to take a step back more globally, which is I always say moms are always right. So my job is to either prove the mom wrong, but my assumption starts with the mom, you're right. Now let me figure it out to make sure that it's really right. If I don't agree with you, I have to prove you're wrong because no one knows their baby like their mama.

I mean, I always joke that my wife would always feel our daughter and say, Oh, she's got a fever. And I'd feel her and like, no, she's fine. And within like 10 minutes, of course, she had a horrible fever. Moms know that slight temperature difference in their kid. Moms know their kids just aren't right. They're not their normal.

So I take that very seriously. It's the reason all my moms for surgery have my cell phone number because I always tell them it's one of two things. It's either nothing and takes 10 seconds of my time, or it's something, and I need to see your child. Either way, it's 10 seconds of my time and it's probably a valuable phone call.

And I will tell you, I've been doing this for 20 years, I've never felt bad about a mom calling me. Because it really does make a difference and it makes them feel better about it. But to that point, to talk to the moms, go with your gut. I mean, the realities are we've got great providers. We've got great, from pediatricians to the nurse practitioners to physician's assistants.

We've got amazing providers that are there for you. And they're available after hours. And so, we've got our UPMC Children's Express Care. That's available after hours so that you can be seen. And let's face it, we all have jobs and it's tough. We're here for them, and we're here to hear, we're here to hear their concerns.

Host: When asked about the future evolution of pediatric care at UPMC Central Pennsylvania, Dr. Safford provided a glimpse into his vision of what lies ahead.

Shawn Safford, MD, MBA, MAS: I think we continue to have greater subspecialty care presence. We're going to continue to build out where there are needs in the area. And so, where do we see that need? Where do we see the community engagement? We do, to the point of we serve an underrepresented group, and it's one of the reasons I'm here is, we are in Harrisburg, there's definitely some differences of income status, and we want to be able to provide the services to those families.

And I think you're going to see a continuation of also outreach into those communities and engagement with those communities. So I think it's funny, it really represents the full spectrum of primary care, preventative medicine, all the way to very advanced surgical care and potentially some very high end things just to bring up the Fetal Care Center that we're on the precipice of beginning.

So in late 2023, the Center for Advanced Fetal Care will be starting and for central PA. And super excited about having this capability. Like I told you, for pediatric subspecialties and pediatric medicine, we take care of an entire family. Take that a step further is that you have a mom with the child. So with a fetus, that now involves all of the different specialties. And I can tell you frequently when you have a mom with a child, with a the congenital need; one that needs to be taken care of early after delivery, medical care is frequently provided in a siloed, differential fashion. That means you see your gynecologist and you see your MFM doctor. Then you may see a surgical specialist. Then you may see a NICU doctor. Oh, and then I need to get tests. And then, and no one's coordinating and thinking about you as a unit of a mom and a baby together.

We're developing and we're putting together the Center for Advanced Fetal Care,where all of those specialists are under one roof. We'll have the MFM doctor, your obstetrician, who'd be your primary obstetrician, the surgeon, the NICU, the pediatric subspecialist, all under one roof where you'd come in, be seen by the specialists, have your tests done, we'll discuss your tests as a group, and then come up with a delivery plan.

You want to talk about, it's already such a stress and anxiety for a mom with a child with a congenital problem without having to navigate the system of health care. We're making it easier and we're making it seamless and we're making it with very good communication. It's funny you say that, because I always tell the mom, let me take on your worry. Let me have your worry. I need you to take care of you because, it's only going to make your baby not be healthier and happier. I just saw a fetal consult this week where we're talking to the mom and again, it's a first time mom. She has a child with a bad problem. And you can see that it's just every second of the day, you just want to know it's going to be okay. And I try to take that stress off of them. And it's so critical to have that holistic approach because we're not just bodies. We're spirits, minds, bodies and families that are all together.

And if we don't actually approach it as such, we're not taking care of, we're not taking best care of our community.

Host: When parents contemplate where to entrust the health and safety of their children; the decision they make holds profound significance. The confidence in knowing that their little ones are in capable hands, receiving the best possible care, brings peace and reassurance to parents.

Shawn Safford, MD, MBA, MAS: Well, and I think it's so important that one of the things they always say is, well, my surgeon's not very nice, but he's a good surgeon. Well, what we're pulling together here is good surgeons who are also nice. You know, there's a certain bit of haughtiness that frankly physicians have. This is a reality. That's not the culture here. The culture here is we are an integrated team and we're working together. I can tell you the nurses on the pediatric floor and I, we meet weekly to talk about integration. How can we do things better? Because I don't know my blind spots. And if we don't know our blind spots and we don't know how to make this thing better, how to create a good mission, how do we have that focused mission on the child and the family; you're going to lose out. And so some of these places, and again, I don't want to name any specific places, but they get siloed and they're just worried about their own specialty. And what am I doing? And where, we're focused on the families here. I mean, every meeting I start with, which is, it always starts with what's best for the kid.

So as we develop a system, I always say what's best for the baby. Then what's best for the mom and the family, what's best for the nurses and staff and what's best for our community. And that has to kind of be the approach we take. Because if we don't, we're not providing the best care for everyone.

To me, one of my mission statements for our group, which is we take care of children from cradle to college. And that really has to be your perspective is that our one time touch point with children in medical care can't be the only time. We actually have to think about that child and their progression to being adults, and how do we get them there as healthy as possible.

And as you mentioned before, that's our mental health, that's our physical well being, that's our spiritual well being, that's how we provide kind of connections amongst each other, and that's what you get at UPMC Children's in Harrisburg.

I believe in what we're doing. You know that has to be part of it, right? Is I can't sell you something if I don't believe in it, and I really believe in what we're doing,

Host: And so we draw this enlightening episode of In Their Words to a close featuring the dedicated insights and stories from Dr. Safford, a Pediatric Surgeon. We ventured into the world of pediatric care, exploring the moments that matter most and the remarkable resources available at UPMC Central PA and beyond. Stay tuned for more empowering episodes of In Their Words, where we'll continue to explore the stories and insights of those who are dedicated to transforming the world of healthcare. Until next time, remember that every story, every voice and every moment matter.

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