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20 Questions: Julie Hersch, MD

Created October 26, 2011 by Juliet Farmer
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Dr. Julie Hersch, an oncologist with Kaiser Permanente Medical Center in Roseville, Calif., attended University of California, Davis, (UCD) before heading to Albert Einstein College of Medicine in New York. After, Dr. Hersch returned to California, serving her internship with UCD’s department of internal medicine, then a residency with UCD’s department of internal medicine, and finishing with a fellowship with UCD’s division of hematology/oncology.

Dr. Hersch started her career at Kaiser as an associate physician in Sacramento, then as a physician in Roseville, where she worked for seven years. Dr. Hersch went on to serve as medical director of the Hospice Caring Project and as a hematologist/oncologist in private practice in Santa Cruz, Calif., before rejoining Kaiser in 2003 as an oncologist. Dr. Hersch is certified by the Board of Medical Quality Assurance, American Board of Internal Medicine and Medical Oncology, and American Board of Hospice and Palliative Medicine, and is a member of the American College of Physicians, National Organization of Hospice and Palliative Medicine, and American Academy of Hospice and Palliative Medicine.

When did you first decide to become a physician? Why?
I was always interested in science. I went to UCD to consider veterinary school, but I volunteered at the veterinary hospital and also at UCD Medical Center during my freshman year of college, and I decided I liked medicine–you can’t really talk to sick animals.

How/why did you choose the medical school you went to?
I just chose the school that I thought was best.

What surprised you the most about medical school?
In college, I could always master my classes if I worked hard, and I did work very hard in college. In medical school, there was so much information given in such a short period of time, it was, for me, impossible to feel like I could learn absolutely everything. It was a bit of an adjustment to be in classes with so many really, really smart people who also had a multitude of other talents and accomplishments.

Why did you decide to focus on oncology, particularly breast-cancer treatment?
I actually did not choose to focus on breast cancer and I do take care of all cancers. However, I see more breast cancer patients, because a lot of women really prefer to see a woman.

It may sound strange, but I got into oncology partially because I was moved to help people transition to death. I had been very influenced by a hospice doctor’s lecture in college. I also found it very interesting and knew that it would be a field that would always be moving forward. I found the hematology interesting and loved looking at bone marrow and blood smear slides and making diagnoses.

Lastly, I found during my residency that the relationship with cancer patients can be very different. They are not superficial, and really important things matter since they may be facing a life-threatening illness. The relationships with my patients remain one of the best things about my job.

If you had it to do all over again, would you still become an oncologist?
I think I would have done training in palliative medicine/hospice instead, but those fellowships did not exist then.

Has being an oncologist met your expectations? Why?
Yes, in terms of the progression of better treatments and satisfaction with my interactions with patients. In some ways no, because I did not realize how stressful it would be and how much energy it would take and time it would take away from my family. I don’t think there were good female role models at the time who discussed balancing a hard job with having a family.

What do you like most and least about being an oncologist?
What I like most: The relationships forged between me and my patients, and the feeling that I have made a positive difference in some of their lives or their deaths (an easier transition to dying – sort of like a midwife to the dying).

What I like the least: Stress from the amount of work, the huge decisions, the giving of bad news, and the difficulty keeping up with the field.

Describe a typical day at work.
I usually arrive at 7:30 a.m. to go over the charts of the patients I will be seeing that day so that I know what is going on with them before I see them. I see about 15+ patients a day, which includes some hour-long appointments for new patients.

At lunch or before, I start seeing patients or after I finish seeing patients, I go see my patients in the hospital. In between that, I respond to emails and telephone messages from patients. I usually work through lunch finishing notes and calling patients.

I am often here until between 6 p.m. and 7:30 p.m. finishing notes and calling patients back. I often do more work at home on the computer if I feel I need to leave and have not finished. I work 60 percent time, so on the days I don’t come to work, I get on the computer to make sure there is nothing essential that needs to be taken care of when I am not there and to avoid a big pile up of messages when I get back.

How much of your work is research and/or teaching? Do you like the amount of each you currently participate in? If not, why?
I do not do research — I do put patients on clinical trials. Research is not my thing. I would love to do more teaching, but we do not have residents or med students at our facility. I have started having students from the local high school job shadow.

On average: How many hours a week do you work? How many hours do you sleep per night? How many weeks of vacation do you take?
I work 30 to 40 hours at 60% of full time, if you include the work I do at home. I sleep about 7 hours. I do take about 5 weeks vacation.

Are you satisfied with your income?
Yes, and I do not have a need for big toys!

If you took out educational loans, is/was paying them back a financial strain?
I was very lucky when I went through medical school and had only a small low-interest loan that was not hard to pay back and a grandfather who helped fund my education — I was very lucky. I had classmates who took many years to pay off their loans.

In your position now, knowing what you do – what would you say to yourself 10 years from now?
Sorry to say, it would be: “Thank goodness I am retired,” but I would also say that I was happy that I was able to make a difference in some people’s lives

What information/advice do you wish you had known when you were pre medical school?
I wish I had women mentors that were not in academics to help me find a career in medicine that was conducive to balancing a career and family life.

From your perspective, what is the biggest problem in healthcare today?
Overall, skyrocketing costs. Pharmaceutical companies charging too much money for new drugs and claiming that it is due to research and development. The lack of human connection and physical exam because it seems easier and faster to order a test. Patients not really being educated about their condition and wanting unrealistic and futile treatments. Not talking about death. Lack of healthcare for everyone.

Where do you see oncology in 10 years?
More drugs that are targeted to the cancer cells or DNA. Hopefully an understanding of the environmental factors contributing to cancer.

What types of outreach/volunteer work do you do, if any?
I used to work in my children’s classrooms when they were younger.

What’s your favorite TV show?
Hard to believe I do not watch much, if any, TV. If my kids are watching, the only things I would watch are The Office and 30 Rock.

How do you spend your free time? Any hobbies?
I love reading novels. I exercise a lot — it is my great stress reliever. I run, cycle, horseback ride, walk my dog with my kids. Anything outside makes me happy.

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