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

Faculty Focus: Ethan Kuperman, MD

Date: Monday, November 4, 2019

Ethan Kuperman, MDWhat is your hometown?

Iowa City—but I spent 9 years in Hershey, Pennsylvania before moving back to Iowa City in 2013.

How/when did you become interested in science and/or medicine?

I’ve been interested in science for as long as I can remember. Even in elementary school I was interested in computer programming and math. As far as my interest in medicine, I was exposed to medical careers early on—my father is also a physician. I saw how he was able to improve lives on a daily basis. By the time I graduated high school, I saw medicine as the opportunity to take all the different subjects I had learned about—not just math and science but also sociology, psychology, public speaking, language arts—and combine them in a way that could make people’s lives better.

When did you join the University of Iowa faculty?

I joined with my wife in July of 2013—she joined with the Department of Radiation Oncology (where she is now a faculty member)—and I joined as a hospitalist.

How or why did you choose to join the faculty at the University of Iowa?

When I came to University of Iowa Hospitals & Clinics, I had already been a faculty hospitalist at Penn State since 2011. I came back to Iowa City for several reasons: I wanted to live closer to my parents, my wife found an opportunity with radiation oncology, and I joined a large, diverse hospitalist group with an interest in quality improvement that aligned with my personal career goals.

Is there a teacher or mentor who helped shape your career?

Probably too many to list here. Starting locally, I want to acknowledge the contributions of Peter Kaboli and Kevin Glenn, who gave me the time, training, and mentorship to expand my academic portfolio in my early career. Michele Fang (formerly with UI Health Care, but now with University of Pennsylvania) for getting me involved with perioperative medicine as an academic, as well as a clinical, pursuit. Aparna Kamath (formerly UI Health Care, now with Duke), who was an early career mentor for quality improvement. At Penn State, Jenn Kraschnewski for getting me involved in SGIM and being senior author on my first manuscript—as well as Jed Gonzalo for our initial work in medical education and interprofessional care.

How do you see your faculty role impacting medicine and/or science?

My three biggest professional interests are medical education, perioperative medicine, and quality improvement. The achievements I’m proudest of are those that combine those interests—the Virtual Hospitalist service seeks to improve the quality of hospital care at sites beyond UIHC, the merged Presurgical evaluation clinic will combine the anesthesia and internal medicine preoperative evaluations into a single patient visit, decreasing clinical variation and improving continuity between preoperative and postoperative care. As a core faculty member for the internal medicine resident quality improvement curriculum I’ve watched 40 different resident quality improvement projects take shape—many of which have led to lasting changes and improvement in patient care and ALL of which have taught residents valuable lessons in interprofessional collaboration, QI methodology, and presenting scholarly work. Finally, I’m also working with the evidence-based medicine workgroup to standardize and update our Epic Best Practice Advisories. Our goal is to decrease the burden on providers and improve the quality of care delivered to patients throughout UIHC.    

What is the biggest change you've experienced in your field since you were a student?

When I was a resident—and especially when I was a medical student—we did things because that was the way our mentors had done them. Today we might call this “eminence-based medicine.” There was no standardization in things like diabetes management, antibiotic duration, post-discharge follow-up plans, and we had almost no idea how our patients did after they left the hospital. The biggest change that I’ve seen is the widespread growth of evidence-based medicine and the rise of quality metrics and reporting. Patient outcomes are now publicly available and hospitals (and individual physicians) are being held accountable for the care that they deliver. When this is done well, it has greatly accelerated the uptake of new standards of care and improved patient outcomes. Too often, however, standards and guidelines are created haphazardly or before early results can be verified in outside settings. The next challenge for clinicians and leaders in clinical medicine will be to make sure that our interventions and implementations in quality improvement lead not just to better measurement but to better outcomes for our patients.

What one piece of advice would you give to today's students?

Keep investigating and keep probing. When I started my clinical training, everything was overwhelming and the simplest of tasks (correcting a low potassium) seemed overwhelming. Eventually I learned how to replete a potassium, or treat uncomplicated pneumonia, or evaluate for the etiology of acute kidney injury. The piece of advice that I would give my students is this: what to do is no longer sufficient. We have to learn what it feels like to swallow a 20mEq potassium tablet, the taste of the oral solution. We have to learn how it feels to watch a family member suffer from delirium, or why a patient might refuse to drink nectar-thickened liquids. Finally, we need to know why we do things—sometimes it is because of the evidence, sometimes it is still eminence-based medicine, and knowing the difference separates the science of medicine from clinical practice. 

In what ways are you engaged in professional activities outside the University (i.e. population-based research, mentoring high school students, sharing your leadership/ expertise with organizations or causes, speaking engagement off campus, etc.)?

I have presented nationally on quality improvement for the Society of Hospital Medicine, and on perioperative medicine at the Society of General Internal Medicine. I am also a member of the Society for Perioperative Assessment and Quality Improvement—which is an organization of interested hospitalists, anesthesiologists, and other health care professionals looking to improve the care of perioperative patients through education and innovation.

 What are some of your outside (personal) interests?

Right now, most of my outside time is consumed by my toddler, Isaac. His interests are bubbles, animals, and swimming. During naps and after bedtime, I enjoy board games, jogging, and reading the works of Terry Pratchett, Brandon Sanderson, and Jim Butcher.

Learn more about Ethan Kuperman, MD.