Temple’s Section of Infectious Diseases has evolved greatly since its founding in 1969. Originally staffed by a single physician, the Section has grown to nine faculty members and six fellows. Each is committed to upholding the ideals on which the Section rests – superb teaching, excellent clinical care, and the advancement of science.
In this Q&A, current and former faculty members and fellows share their thoughts on the Section’s 50-year history and the field of Infectious Diseases as a whole:
You are retired now but have the longest history with the Section. What was it like in the early days?
Bennett Lorber, MD, Professor Emeritus and former Section Chief (1983 – 2006):
“The Section was still relatively new when I finished my residency at Temple in 1971. At the time, I asked Bob Swenson, who was the founding Section Chief and a very bright guy, if I could do a fellowship with him. He said yes. There was no match or accreditation back then. The Chair of Medicine approved it and Bob said ‘great.’ In the early days we only covered Temple University Hospital and the consult numbers were very small relative to what the Section handles now, maybe only 25 to 30 consults a month at the time.”
What are the strengths of the Section, historically and today?
Rafik Samuel, MD, Section Chief:
“The cornerstones of the Section have always been education and patient care. I’m proud that we’re often thought of as the best educators in the institution. That’s a reputation we have had for decades, and the many teaching awards our faculty members have won back it up. We’re also known as good clinicians. We’ll often be asked to consult on a patient because the medical team isn’t sure what is going on with that person. For example, the patient has a fever and the team doesn’t know why. We’re great at figuring these things out. It’s also a strength that we have many long-time faculty members. I’ve been here for 20 years and I’m still one of the ‘new guys!”
How has the Section evolved over the years?
Thomas Fekete, MD, MACP, Chair, Department of Medicine, and former Section Chief (2006 – 2017):
“When I interviewed for a position at Temple in 1984, the Section was housed in a modest little office attached to a bunch of labs in the Old Medical School Building. It was hideous, but everyone was very happy and engaged. The Section was extremely student-focused and already had a great reputation for its educational program. It was a friendly, family-like atmosphere but one that had rigorous standards and a very high level of professionalism. Those themes have carried on to this day, even as the Section has added more faculty members and taken on more responsibilities.”
What sets Infectious Disease physicians apart from other specialists?
Heather Clauss, MD, Senior Associate Dean of Faculty Affairs and Director of the Infectious Diseases Fellowship Program:
“We are the ‘doctor’s doctor,’ meaning when another doctor may not be sure if an infection could be contributing to what is happening with their patient, they often call us. Think of us as medical detectives. We do a lot of digging, ask a lot of questions, and dive deeply into a patient’s personal history. Unlike specialties such as surgery, we are not procedure oriented. Our procedure is the chart biopsy along with a detailed medical history and physical exam. We want to know how a patient’s life fits into their medical presentation.”
Talk about the faculty members activities outside the Section.
Dr. Fekete:
“We’re very involved in professional societies, locally, regionally and nationally, as members and leaders. Dr. Lorber served as President of the College of Physicians of Philadelphia and I hold that position today. In addition, I have served on the Board of the Infectious Diseases Society of America and I am currently Chair of the Board of the Foundation of the IDSA. Dr. Lorber was President of the Anaerobe Society of the Americas for several years. Many faculty members have presented their research and led lectures/panels at the national level as well. These presentations have encompassed most of the subspecialties of Infectious Diseases including: General ID, Transplant ID, Antibiotic Stewardship, Infection Control, and HIV medicine.”
Many infectious disease specialists seem to hold leadership positions, why do you think that is?
Dr. Clauss:
“I think there is something about the thought process ID doctors use when caring for patients. It’s the ability to simultaneously see the big picture while focusing on incredible detail that seems to translate into leadership effectiveness. Anecdotally, it appears there is a particularly high percentage of hospital and institutional leaders who are infectious disease specialists nationally. Here at Temple, Dr. Tom Fekete is the Chair of Medicine. Dr. Axelrod is the Chair of the Infection Control Committee. I am the Senior Associate Dean of Faculty Affairs for LKSOM. Most importantly, we are mentoring and sponsoring the next group of upcoming leaders.”
You all mentioned the Section’s emphasis on education. Why is that such a focus?
Dr. Lorber:
“From the beginning, we put a priority on education and went out of our way to make sure we offered an elective that would provide a great experience for students and residents. It is our passion to educate the next generation of physicians. An understanding of the use of antibiotics and the diagnosis and treatment of infections is critical for all doctors in every specialty. Every organ can get infected. A multidisciplinary approach to the management of infections yield the best outcome. I would be remiss if I didn’t mention Dr. Sarah Long, who spent a year doing research with Dr. Swenson here at Temple but was the long-time and well-respected infectious diseases physician at St. Christopher’s Hospital for Children. For many years we sent our fellows to St. Chris to spend time with her, which was a very valuable experience.”
Dr. Samuel:
“Our faculty members love teaching. The list of honors and awards they have received is long and includes Golden Apple Teaching Awards, Temple University Great Teacher Awards, and Lindback Awards for Distinguished Teaching. Dr. Lorber and Dr. Fekete have been honored by receiving the title Master of the American College of Physicians, which is given each year to only a few dozen internists. Dr. Lorber has won the Alexander Fleming Award of the IDSA, the Jane Desforges Teaching award of the American College of Physicians and the Robert J. Glaser award of the medical honor society, Alpha Omega Alpha. Each of these awards is given to just one person per year.”
Dr. Clauss:
“We have had outstanding fellows over the years and have a great track record of placing them in the jobs of their choice, whether it be in academia or private practice. Currently we have one former fellow working for the Centers for Disease Control and Prevention and several on faculty at institutions such as UPMC, Yale and Penn as well as Temple. Part of our Section’s primary mission is to recruit and train the next generation of ID doctors. We are committed to their development as clinicians, as educators, and as researchers. Each year our incoming fellows become a part of the Temple ID family and we couldn’t be prouder of them.”
From a fellow’s perspective, what was the educational experience like in the Section?
Brandi Manning, DO, current second-year fellow:
“Coming here as a trainee to learn about infectious diseases has been a great experience. It’s a very welcoming Section and I’ve learned a lot. I did my residency in Michigan and medical school in Florida, so I was new to Philadelphia. I was instantly welcomed by everyone at Temple. We see very complex patients here and the full depth and breadth of cases and pathology. There is a spirit of cooperation and teamwork in this Section that you don’t see everywhere. Even when we’re busy it’s still fun to come to work. I will be taking a faculty position at another institution after I leave Temple, and I feel very prepared to step into that role.”
Matthew Grant, MD, Assistant Professor of Medicine, Yale School of Medicine, Temple Infectious Diseases fellow (2009 – 2011):
“My experience as an infectious diseases fellow at Temple was terrific. I did my residency at another Philadelphia hospital and made the rounds when it came time to look for a fellowship. I thought Temple had the strongest program in Philadelphia. I have an implanted memory of meeting Dr. Fekete. He looked at me and said, ‘You can stay where you are and get good training, you know how things work there, or you could try something different and come to Temple.’ The way he framed it was like an appealing little apple I wanted to grab. I saw so much during my training at Temple. I went to Cooper and then Yale after Temple, and in both places I rapidly gained the respect of my colleagues based on my training and work. Temple prepared me for anything.”
Not to be overlooked is the clinical knowledge and skill contained within your Section.
Dr. Samuel:
“Absolutely. We have an incredible repository of knowledge within the Section thanks to our veteran faculty members. We also have physicians who are more recent additions and they infuse new ideas and perspectives into the Section. The patient is at the center of everything we do. We spend a lot of time with each patient, delving into sometimes overlooked, but critically important details. The Section prides itself on our collective clinical judgment and our ability to help the teams who consult us give the best care possible to the patients.”
What broad trends have you seen in Infectious Diseases here at Temple since the Section was founded 50 years ago?
Dr. Lorber:
“The extraordinary expansion of transplant medicine at Temple beginning in the 1980s created an increased need for very specialized infectious diseases expertise. In the larger medical field, we also saw the rise in antibiotic resistance. We were early adopters of antibiotic guidelines at Temple in the 1970s. Also, the early years of the HIV/AIDS epidemic became a major part of what we did. Many people were reluctant to care for these patients, but infectious diseases physicians stepped up. We also saw our outpatient practice grow over the years due to the increase in patients living longer with chronic diseases like AIDS. In the past, most infectious diseases were acute illnesses…you treated the patients and they got better. AIDS changed that.”
Dr. Samuel:
“In recent years we have been seeing more infections complicating substance use disorder and have focused some of our practice on harm reduction in these patients. I can’t emphasize enough how much the HIV epidemic influenced our field, in terms of the incorporation of social activism and social justice into our careers. Something that attracts physicians to our field is the knowledge—and fear—that at any time a new infectious disease could evolve and be discovered that will again change the landscape of medicine.”
Dr. Clauss:
“Over the past 10 years, there has been remarkable expansion of solid organ transplantation at Temple. For three consecutive years [2017 – 2019], we have had the highest volume lung transplant program in the U.S. This program has relied on support from Infectious Diseases in the evaluation and management of these patients. Our Section contributes extensively to policies for infection prophylaxis and patient safety for all of our organ transplant programs, including lung, heart, liver, kidney, and pancreas.”