Sara Schultz, MD, is an infectious disease specialist practicing in Center City Philadelphia. Dr. Schultz provides primary care for people living with HIV at Drexel's Partnership Comprehensive Care Practice. In addition to clinical appointments, Dr. Schultz is an assistant professor at Drexel University College of Medicine and is the Associate Program Director for the Infectious Diseases Fellowship Program.
What made you want to become a doctor?
After taking a seminar on Tuberculosis in college and learning about the interdisciplinary nature of medicine, I knew I wanted specifically to become an infectious disease doctor, so that's why I went to medical school. I loved the idea of discovering infectious agents and trying to be a detective solving clues to understand what made people sick.
You attended Drexel University College of Medicine. What attracted you to the program here?
I'm from Philadelphia and I wanted to stay and train here, and be a doctor in Philly. There are spectacular faculty at Drexel that I learned from, many of whom are still here. There's also Drexel's reputation and its great clinical sites.
What did you like best about the program?
It's a big medical school, so I made wonderful friends and got to rotate through many different hospitals as a medical student, which meant I got to see how medicine is practiced in cities and in rural places as well as in large academic institutions and small community hospitals. Each opportunity presented different areas with different needs. It was a great experience and I loved being a medical student at Drexel.
What do you love about working in infectious disease?
I believe infectious disease is the best field in medicine because it changes every day in ways we can never predict. When you look at the headlines there's always new infectious agents. Zika, Ebola, Pandemic flu, superbugs- these things dominate the news cycle, and we don't know what is going to come next! That's what's so fun about the job – it changes all the time. Not only do new diseases present themselves, but then we have new treatments. For example, Hepatitis C is now an easily curable disease, and we didn't even have a name for it 30 years ago. It's so rewarding watching HIV transition from a devastating life sentence to an easy to control chronic illness now. It's amazing to watch these new infectious agents come, to see treatments develop and to be able to help and reassure patients.
Further, infectious disease is very flexible because you can practice medicine inpatient or outpatient, and you can also take care of patients acutely or over a long course of time like when treating someone with HIV. I also see hospitalized patients in an ID follow up clinic, which is unique because I get to take care of them when they're in the ICU and very sick, and then I can see them when they are home and recovered. ID is a fantastic career option because it is a consultative career. We don't have primary inpatients, so in the hospital we do consultations and we have time where we can do more academic things like research, write grants, and collaborate with other departments like the school of public health.
What services do you provide at Drexel?
I spend some months out of the year on our inpatient ID service doing consults with fellows, residents, medical students, pharmacists, pharmacy residents, and pharmacy students. We have a large interdisciplinary team that rounds together every day to do inpatient consults. Our consults could be for patients in the ICU with pneumonia or septic shock, orthopedic patients, OB patients, medicine patients, and our HIV patients and hepatitis C patients. For outpatient work, I see hospital follow-ups in clinic, and I help to precept our infectious disease fellows in the HIV clinic at Partnership. I also have my own HIV patients at Partnership that I see two days a week. I'm also involved with a lot of research and medical education projects as well.
What do you like most about working at Drexel?
The people, definitely. I knew a lot of them since I was a student here and it's been nice to come home to Drexel and have my relationships progress. To continue to learn from and work together with people that I trained under is really special. I also love the patient population. It's very vulnerable for the most part and I think it's a privilege to take care of these patients. They let us into their lives, which can be chaotic and very fragile, so I appreciate how much they trust us to take care of them. But the Partnership Comprehensive Care Practice (the Partnership) is incredible and probably the best part about working here.
The Partnership seems very collaborative. Can you explain how it works?
The Partnership is a level 2 patient-centered medical home. We have over 20 HIV providers and 70 staff members. We're one of the largest HIV clinics in Philadelphia and we provide a full range of services for our patients—from pharmacy, nutrition, adherence counseling, behavioral health, case management, social work, insurance needs, and help with addiction, along with full medical management of primary care along with HIV and Hepatitis C, as well as offering PrEP for HIV-negative individuals. The Partnership is flexible, so our patients can just walk in if they need us. You can walk into our office with no insurance, no home, no HIV medication, and no linkage to care, and you can leave with a plan- a social worker, insurance, emergency meds, support, follow up, and more. Our patients know that they have a place that will take care of them no matter what- we've been here 25 years!
Can you talk more about PrEP and its use?
PrEP was approved by the FDA in 2012 for HIV-negative individuals who are at high risk for contracting HIV. It took a while to catch on but now we're seeing a large uptick in PrEP usage. PrEP can be prescribed for people that engage in high-risk sex practices, as well as people who are at risk for HIV either because they have a partner with HIV or they have multiple partners which may place them at high risk for HIV. We love to take care of these people because we see each of them as an opportunity to prevent a case of HIV. The whole idea of PrEP is 'treatment as prevention', so you take a pill that is used to treat HIV every day and it can essentially prevent HIV. Last year for the first time in the history of HIV, we saw fewer new infections, which is encouraging and we think it is in large part due to PrEP usage.
What is your area of interest with infectious diseases?
My area of research interest is sexually transmitted diseases (STDs). At the Partnership, we see a lot of STDs, mainly because we have a high-risk patient population and it's challenging to take care of patients with STDs because if their partners are not treated, they get re-infected.
We're about to start a clinical research project here where we're going to look at the use of taking an antibiotic pill to prevent syphilis, similar to how we use PrEP to prevent HIV. We're gearing up to see how well the pill works. Even though there are risks to taking an antibiotic frequently, we think that it is an issue we need to explore to see if we can prevent syphilis this way.
How does doing research fit into your schedule?
Being in academic medicine, it's a privilege that not all of our time every day has to be spent seeing patients. We have time built into our schedule to mentor students, which is a big part of our job; to try to get more people interested in infectious disease because there is a clinical shortage; and to do research. As the Associate Program Director for our Infectious Disease Fellowship Program, I help mentor the fellows with their research. A lot of our fellows are producing case reports or case series and also doing retrospective reviews, answering different questions that come up during their training. Our fellows have been very successful with both getting work published and accepted at big conferences like IDWeek.