A tale of two operating rooms

OHSU-trained surgeon splits time between urban academic health center and community hospital

October 2, 2017

Dr. Lori CardwellLori Cardwell, M.D. R '17, is just a few weeks into her career as a faculty member, but she's a familiar face at OHSU. An honors graduate in the M.D. Class of 2012, Dr. Cardwell stayed at OHSU for graduate medical education and completed her residency in June, receiving a chief resident of the year award at graduation. Now, she's assistant professor of surgery in the OHSU School of Medicine and an example of a faculty member who's bringing to life the partnership between OHSU and Tuality Healthcare that was announced nearly two years ago.

No two days are exactly alike for Dr. Cardwell. She practices two days a week at the Tuality Digestive Health and General Surgery Clinic, and three days a week at OHSU, either in clinic or the operating room. The arrangement makes sense for her logistically – she lives between the two locations – and it's giving her experience in two professionally diverse environments.

"It's nice to have the variety," Dr. Cardwell said. "I like the broad scope of surgical practice as well as the potential for team-building and fostering close relationships across disciplines in a smaller community hospital. Then coming to OHSU, I see a wide assortment of challenging cases and have access to numerous specialists for consultations and advice."

She's also on call at Tuality, and has already been able to leverage her relationships at OHSU to help a patient who came to the Tuality emergency department. Upon evaluation, Dr. Cardwell and her Tuality colleagues concluded the patient urgently needed specialized care. She knew the surgeon on call at OHSU and was able to quickly relay the information needed for a transfer to OHSU Hospital. "The transfer and subsequent management was efficient; the patient was evaluated by the appropriate surgical specialty, taken to the operating room that evening and underwent a successful minimally invasive surgery," she said. "It was a good team effort and I know the patient benefited from the timely care."

Efficient, acuity-appropriate transfers are essential to any hospital's operations, and a particular focus at OHSU Hospital right now. Throughout the past year, inpatient occupancy has reached a tipping point, resulting in a significant increase in transfer denials and emergency department ambulance diversion. In order to ensure the right patient receives the right care at the right time by the right staff, OHSU launched a Mission Control Governance Council to oversee both the strategic and operational aspects of capacity and transfer management. Early results are promising – and Dr. Cardwell's example is one that the people involved in the transfer center aim to replicate.

Dr. Cardwell will focus primarily on clinical care but said she looks forward to teaching when the opportunity arises. Robert Martindale, M.D., Ph.D., professor of surgery and head of the Division of Gastrointestinal and General Surgery, OHSU School of Medicine, was a big influence on her decision as a third-year medical student to pursue general surgery. "He was so enthusiastic and it was clear that he loved what he was doing. I was so impressed with his ability to motivate and inspire his teams, his breadth of knowledge and technical skill, his commitment to teaching and his genuine character… all which contributed to the excellent care of his patients." She hopes to instill in learners that same sense of privilege and camaraderie, as well as the importance of being an active learner – something she sets as a perennial goal for herself, too.

Meanwhile, Dr. Cardwell is enthusiastic about the future and building stronger ties between colleagues at OHSU and Tuality. "I hope I can help bridge good relationships and communication between specialists at OHSU and the physicians at Tuality," she said.

Dr. Cardwell has earned numerous honors in her time at OHSU. As a student, she was selected as a member of the Alpha Omega Alpha National Medical Honor Society and received one of the school's highest medical student honors at graduation – the Edward S. Hayes Gold-Headed Cane Award. She was also named the William Krippaehne, M.D. awardee as a graduating student. In addition to being chief resident, she was awarded Outstanding Resident in Cardiothoracic Surgery by the Portland Veterans Affairs Health Care System, and was co-recipient of the "Intern of the Year" award from the Department of Surgery.