VSSL Voices: Beginning a Research Career at VA Puget Sound

In this installment of our “VSSL Voices” series -- which features team members, friends, and supporters of the Lab -- we caught up with Dr. Linnaea Schuttner, general internist, researcher at VA Puget Sound, and member of the Department of Medicine at the University of Washington School of Medicine.

VSSL Voices: Tell us about your current research focus areas and work.

Linnaea Schuttner: I am a physician-investigator at the VA Puget Sound, where I spend 75% of my time focusing on clinical research, and 25% a primary care physician and educator for medical trainees. Within research, my topic areas of interest include primary care delivery systems, quality improvement, low value care, team-based models, and care for complex patients with multiple chronic conditions. I concentrate on creating operationally valuable evidence and relevant solutions for primary care, including working with the Primary Care Analytics Team for the VA’s national evaluation of the patient-centered medical home model.

VV: How did you first get interested in the research topics listed above?

LS: Even from when I was a pre-medical student, I was interested in efficiency and maximizing the population health benefits from systems of care. Throughout my medical training, I found variability in quality of the delivery of care and in patient outcomes frustrating. I spent a year working on a research trial to improve primary care delivery system quality when I was a medical student, then when I was a resident, I started gravitating towards quality improvement projects as the solution to my concerns about the healthcare system, and to complex patient populations as the group that often bore the brunt of medical inequities and suboptimal care. I arrived at my current position through a desire to couple operationally relevant, feasible solutions that could be implemented in the “real-world” with the thoughtful, analytic approach from the research perspective.

VV: What are a few key projects that others might like to know about?

LS: My current main research project is how to define, and then reduce low value care (either wasteful or care with little to no benefit relative to harms) for patients with multiple chronic conditions within the learning health system of the primary care environment. I also am engaged in quality improvement projects outside of research – for example, I am also working with an interdisciplinary team to improve diabetes medication adherence by streamlining the pharmacy refill process.

VV: What are up to 2-3 accomplishments from, or related to, your research that you’re most proud of?

LS: I recently received the Milton W. Hamolsky award for outstanding junior faculty research presentation at the Society of General Internal Medicine Annual Conference for my project on how the patient-centered medical home affects quality of care for patients with multiple chronic conditions.

This past year also felt very successful at a personal level, because I was fortunate enough to receive an institutional K12 grant, finish my fellowship training in Health Services Research, complete my Master in Science degree at the University of Washington School of Public health, and start my faculty position at the VA, all coinciding with the birth of my first child in December.

VV: Over the next 3 years, what do you hope to achieve through your research program?

LS: My next major goal will be to obtain a 5-year career development grant for further training and ongoing development of my career as an independent investigator. I’d like to use that grant to continue to do operationally-relevant research on low value care reduction for high-risk populations within the VA’s primary care learning health system. I would ideally like to develop and spread an intervention that could be used in a clinical visit to help a patient and their physician decide about use of potentially therapies or screenings that may not be of benefit to the patient.