Executive Takes: Joseph St. Geme III, M.D.

Joseph St. Geme III, M.D., is Physician-in-Chief at the Children’s Hospital of Philadelphia.
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Time on the job: 13 years

Prior executive roles: Director of Pediatric Infectious Diseases at Washington University in St. Louis; Chair of Pediatrics at Duke University Medical Center and Chief Medical Officer of Duke Children’s Hospital

Ten Takes from Dr. St. Geme

On his father, a towering figure in pediatrics: “My dad continues to be my greatest role model. He was Chair of the Department of Pediatrics at UCLA for 19 years and then Dean of the School of Medicine at the University of Colorado for 20 months. He died at age 55, when I was a third-year resident, which was hard. He was an incredible leader in our family and in pediatrics, and growing up in our household I learned from him about prioritization, organization, preparation, optimism, and how to face challenges by rolling up your sleeves and maintaining a smile.”

On setting a professional example: “It’s really important to be a role model. I‘m a physician and I’m a scientist, making contributions both through direct patient care and through research. I hope I’m setting an example for other faculty and for trainees across the hospital to be academicians and to make contributions as clinicians, as educators, and as scholars.”  

On still running a research lab: “Leading a research lab and generating new knowledge is a source of tremendous satisfaction for me. I don’t do experiments at the bench myself anymore—now I’m largely facilitating the work of graduate students. It’s really gratifying to see my students gain skills, develop as experimentalists, and make discoveries.”  

How his current job differs from his residency at CHOP: “As a resident, I had only a minimal understanding of big-picture things, like healthcare finance, the importance of facility issues, and the relationship between operations leaders and physicians. I gained some of that knowledge as a chief resident, but my understanding was certainly limited compared with where I am now.”

Currently dominating his brain space: “Ensuring that we are operating as a system. We have three different inpatient sites, each in a different geographic location, and each with different patient populations and areas of emphasis. I’m leading work groups to facilitate optimal utilization of these three sites.”  

His solution for making pediatrics popular: “Our pipeline is diminishing. There are economic aspects and probably other factors in pediatrics that are unattractive to medical students. We need to think about how pediatricians function, what their responsibilities are, and what their opportunities are compared with other specialists in medicine. And we need to emphasize the excitement in Pediatrics, now greater than ever, and the joy of a career focused on supporting our future.”

Daily dissonance: “In my mind, the most powerful advance in medicine over the past 50 years has been the development of vaccines against common pediatric diseases. Day in and day out, our pediatricians are talking with parents about vaccination—but it’s one thing to lay out what some of the side effects are in the context of providing vaccines, and it’s another to have to counter the fallacies that many parents have read about or heard about from neighbors and from the broader community. It’s relatively common to find a young child in one of our inpatient units who has not received vaccines, creating the need to have the conversation with the family about the benefits of vaccines—and that’s not always easy. Not all parents are ready for that conversation.”  

Keeps him up at night: “Rates of child obesity, asthma, and mental illness are significantly higher in the U.S. compared with other developed countries. We need to change that. Given that we have the most sophisticated medicine in the world, we should be able to achieve better outcomes than we are.”  

Very excited about: “Translational research—namely, research that builds on work in the laboratory and is translated into care at the bedside or in the clinic. I’ll give you a recent example at CHOP: a boy in our nursery was diagnosed in the first days of his life with a genetic mutation that resulted in accumulation of high levels of ammonia, which is toxic to the brain. Our neonatologists made the clinical diagnosis, and our geneticists established the genetic diagnosis and then developed a novel experimental gene therapy that resulted in correction of the genetic mutation. We’re in the process now of creating an infrastructure that allows us to pursue additional research and ultimately use gene editing routinely to cure genetic diseases.”

What’s next at CHOP: “I want us to develop cures for many pediatric diseases and to improve fundamental clinical outcomes. I want us to be training the strongest pediatric specialists and subspecialists in the country. I want us to have an even broader global impact, facilitating application of discoveries that we make in Philadelphia to other parts of the world. We’re aiming high.”  

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