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| Cassandra Foens, M.D. |
Alumni Interviews:
Cassandra Foens, M.D.
What is your hometown?
Waterloo, IA
How/when did you become interested in science and medicine?
I guess I don't ever remember a time when I wasn't interested in
science.
What interested you to pursue a career in medicine and specifically,
radiation oncology?
I was originally trained as an x-ray technologist, and got my first
full time job doing radiation therapy treatments at the hospital
in Burlington, IA. As I worked closely with that oncologist, I
became more interested in going back to school in order to become
a radiation oncologist.
Is there a teacher, mentor or Carver College of Medicine faculty
member who has helped shape your education?
There have been several who have been very helpful to me over the
years. Dr. David Hussey, former chairman of the Radiation Oncology
division, was an excellent teacher and always encouraged my outside
activities in organized medicine. He saw to it that I had the time
to pursue those interests, even as a resident. Dr. Gerald Clamon,
in Medical Oncology, let me do 3 rotations with him - as a 3rd
year medical student, as a 4th year medical student, and as a resident
- and I still hear his voice in my head, particularly when I take
care of lung cancer patients. And Dr. Barrie Anderson, in Gynecologic
Oncology, was a great friend and mentor as I went through my education.
Iowa has always had a number of women in leadership roles, and
that mentoring has a wonderful effect.
How or why did you choose the UI for your education and
medical training?
Iowa is my home – I never really
considered any place else once I made up my mind to try and go
to medical school.
What kind of professional opportunities or advantages has your
UI medical training provided?
I never realized how well respected the UI College of Medicine
was until I started to interview at other institutions for residencies.
Every one always commented what a great school Iowa was. Many of
the faculty in Radiology and Radiation Oncology are active in the
national organizations that serve our specialties, and there was
always a colleague around to encourage me to continue my professional
interest, particularly in the American College of Radiology (ACR).
Please describe your professional interests?
I am in general community cancer practice, so I treat all kinds
of cancers. I have been president of the medical staff here at
Covenant Medical Center, and currently serve as the Covenant
Foundation Chairman as well as on the Covenant Health System
Board of Directors. I have an interest in hospice care, and serve
as a board member of our local non-profit hospice. I also have
an interest in medical politics and government relations, which
has been one of my areas of focus at the ACR.
What are some of your outside interests?
Despite living in Iowa, I am a scuba diver. We take every opportunity
possible to go down to South Florida or the Caribbean to dive.
I'm a fond fan of Iowa Men's Basketball. I have done work with
Columbus High School here in Waterloo to update their science
classrooms, and I have my 2nd Presidential Scholarship student
now at the University, studying pre-med. At home it's me and
my 3 cats – Honey, Muffin, and Shy.
Do you have an insight or philosophy that guides you in your professional
work?
I have always believed that medicine was more than a job – it's
not just a vocation, but it is an avocation. We have the privilege
of becoming involved in our patient's lives, and that creates a
responsibility for us to put our patients' interests ahead of anything
else. Getting patients the right care at the right time is more
than just me as doctor seeing them – it means advocating
for them with government policymakers such as Congress and Medicare.
It means opening up educational opportunities to the community
so that all people can become more savvy health care consumers.
It means understanding sometimes that more care isn't necessarily
the right care – that sometimes the right thing to do is
nothing. Too many physicians think that "somebody else" can
do this advocating for us – that we are too busy to do it.
We can't be too busy to be advocates – there are too many
vested interests in medical care right now, and not all of them
put the patients' best interests first.
If you could change one thing about the practice or business of
medicine, what would it be?
I would like more decisions between patients/families and physicians
to be a 2-way dialogue. Patients need to tell us what they want
and what they don't want, particularly as the end of life nears.
I don't want to tell patients "what to do" but I want
to give them choices and learn what they want to do. I want to
give patients the right treatment, not just the fastest treatment
or the most expensive treatment, or the cheapest treatment. Too
many patients just "want everything" without really understanding
what that means. Too many families don't know what their loved
ones really want and that makes medicine even harder than it has
to be.
What is the biggest change you've experienced in your field since
you were a student?
My specialty has been revolutionized by the advances made in computer
technology. These more powerful computers have allowed us to diagnose
cancer faster and more accurately, through the use of CT, MRI,
and now PET scanning. They have allowed us to do much more accurate
radiation therapy treatment planning, which has given us the opportunity
to use more individualized treatment fields and higher radiation
doses. Hopefully this will result in better outcomes and fewer
side effects for patients.
What one piece of advice you would give to today's medical
students?
Choose an area that you truly love – don't
pick a specialty only on lifestyle or reimbursements. Those things
change with time
and may ultimately be controlled by others, not you. If you are
doing what you really enjoy, all the rest of it will work out.
What do you see as "the future" of the medicine?
Physicians are going to have to make more time to be advocates,
not less. Just seeing patients isn't going to be enough. I think
government's role in healthcare will be more, not less, making
it more important than ever that physicians be politically active
with organizations like the AMA or specialty societies like the
ACR. We need to help control the debate on how to use the finite
resources we have in medicine. As the population ages but technology
pushes forward, more patients are going to want more care. We
will not have unlimited money or resources to provide all the
care these patients desire but we don't want only legislators
and insurance companies making these decisions. We have to be
willing to put ourselves on the front line.
You have recently been elected to the Board of Chancellors of
the American College of Radiology and will be the first radiation
oncologist and first woman from Iowa to ever serve in this capacity.
What do this role and honor mean to you?
The Board of Chancellors serves as the governing body of the ACR.
The ACR represents over 30,000 radiologists, radiation oncologists,
and medical physicists across the United States. We are active
in areas such as continuing medical education, socioeconomic issues,
and political lobbying on behalf of our members. All of us in the
leadership of the ACR are physician volunteers, taking time away
from our practices to participate. I think what my election proves
is that any physician, even those like me in small private practices,
can make the time to participate at the state or national level
in medical organizations. Most physicians are still in non-academic
practice, and our contributions are valuable to these national
medical societies. Women represent half of most medical school
classes now, and need to push themselves forward to be active at
the highest levels. I think it speaks volumes for the ACR Council,
that they are willing to support with their votes, a woman and
a radiation oncologist from a small-town Midwestern practice as
one of their elected leaders.
In what ways are you engaged with the greater Iowa public?
I am very active with an organization called Speaking of Women's
Health. This is a national organization that puts on educational
events for women in about 30 cities across the country. Waterloo
has been part of that elite group for 2 years now, and we have
had tremendous feedback from the women who have attended our
sessions. I have helped to chair our local steering committee
and have lectured at the breakout sessions. I have a scholarship
student at Iowa, and have another scholarship with Dollars for
Scholars for an x-ray technology student to attend the training
program at Covenant Medical Center where I practice.
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