Dr. Erika Penz: From individuals to the system, perspectives for improving care

Throughout her career, Dr. Erika Penz SM, MD, MSc, FRCPC, Respirologist and Assistant Professor, Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan has been interested in exploring the whole scope of health care, at all levels:

“After completing my studies in health policy and management, I wanted to pursue a career in medicine to deepen my understanding of health and health care; to treat patients at an individual level while having the tools to also think broadly.”

Her ambitions have taken her from the University of Saskatchewan (B.Comm) to Harvard University (MSc), McMaster University (MD), University of Calgary (Residency and Respirology Fellowship), and University of York in the UK (Health Economics Fellowship), eventually bringing her back to where she started, where she is currently investigating the “science of burden” in health care.

“Studying burden as a topic - from the burden individual patients and families encounter to macro-level burdens at a health care system level – is my niche. I want to understand what we as a health care system do well and also learn from the misinformed decisions that have already been made in health care.”

Dr. Penz’s work focuses on burden as it pertains to lung cancer. According to the Saskatchewan Cancer Agency, there were an estimated 790 new cases of lung cancer in 2017, accounting for 14% of all new cancer diagnoses from that year in Saskatchewan. It is also the leading cause of death from cancer nationally.

Dr. Penz has been able to describe the way the health care system responds to lung cancer patients through the use of longitudinal administrative data, outlining individual patient and health care system resource usage. The picture the data is painting vividly captures one particular short-coming of the clinical pathway of lung cancer patients in Saskatchewan:

“Although cancer patients are among the most likely to get adequate end-of-life care, most Saskatchewan lung cancer patients die in-hospital, often in four-person rooms, where we aren’t set-up to deliver adequate end-of-life services. How we design our health system for people with end-stage disease matters.”

It is her hope that her creative use of administrative data will further unearth hidden burdens that will allow for deeper investigation of issues:

“Working on a research team with a varied skillset allows me to pass-off what I detect in the administrative data to a qualitative researcher who can explore the nuances of the problem. For example, what does the last year of life look like for patients? Who is offered palliative care and why? This collective approach provides a much richer understanding of an issue as important as end-of-life care in order to improve the way we design services.”

It is her unique multi-level perspective that has propelled her research career forward, answering meaningful research questions by using a blend of clinical skills and health economics methodologies. With a cross-provincial study in her sights that will compare lung cancer patient outcomes between Saskatchewan and Ontario, Dr. Penz is excited about the prospect of the RRC also growing across borders:

“The better the work RRC and the members do, the higher our standards will become. From there it is only a matter of time until we improve our talent and ideas, broaden our scope and demonstrate world-class research innovation from here in Saskatchewan.

This will take meaningful interaction from across campus; to create a whole that is better than the sum of our parts.”

Photo by Rawpix on Unsplash