Logo for University of Iowa Health Care This logo represents the University of Iowa Health Care

Cassandra Foens, MD

88MD, 92R-Radiology
Radiation Oncologist
Covenant Cancer Treatment Center
Waterloo, Iowa

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.

Monday, May 15, 2017