By Susan Abram
Kaiser Health News
The University of Southern California veered sharply and deliberately from tradition in naming the first woman — and the first geriatrician — to lead its 133-year-old medical school.
Dr. Laura Mosqueda, who took over the position on May 1, says she’ll work hard to steer more young doctors toward elderly care to treat the country’s aging population. At the same time, she will face a stiff challenge trying to help rehabilitate the image of USC as it grapples with the growing fallout from recent drug and sexual misconduct scandals.
Mosqueda’s appointment is partly the result of USC’s #MeToo moment. It sends an unmistakable message that campus officials want to open a new chapter after the sobering revelations that toppled Mosqueda’s two immediate predecessors and the university’s president — all men.
“I think it signals a sea of change at USC,” Mosqueda, 58, said in an interview. “I think as a woman I’m probably more likely to bring a less competitive and more collaborative, more nurturing approach. I think we women are tough in different ways.”
She added that the decision to put her in charge of the university’s Keck School of Medicine was “a really odd choice at this university. It’s an obvious action that says we’re doing things differently.”
Mosqueda’s ascent also signals that Keck is ready to embrace a new perspective reflecting the nation’s changing demographics. It shows that the field of geriatrics “is coming of age,” said Dr. Sharon Brangman, chief of geriatrics at the State University of New York’s Upstate Medical University.
Care for the elderly is a “crucial” part of training health care professionals, Brangman said. “Every doctor-to-be, nurse-, physical therapist- and pharmacist-to-be should have some training in caring for older adults, because that population is growing.”
Close to 50 million people living in the United States, or about 15 percent of the population, are 65 and older, according to the U.S. Census Bureau. That number is expected to rise to about 98 million, or nearly 25 percent, by 2060. Of those, about 20 million will be over the age of 85.
Geriatrics is “not about curing,” Mosqueda said. “We’re about caring. It’s not a heroic specialty. It takes a bit more of an understanding to appreciate it as a specialty. Yet it’s tremendously rewarding. We need to get it into the curriculum.”
As dean, Mosqueda will oversee more than 4,150 full-time and voluntary faculty members who educate 800 medical students and 1,000 others pursuing graduate and postgraduate degrees. The school also trains more than 900 resident physicians in more than 50 specialties or sub-specialties.
Mosqueda comes to the job with Trojan pride deep in her blood. Both her parents graduated from the USC medical school when “there was a quota of six women per class,” Mosqueda said. Mosqueda herself is also a USC medical school graduate, and she later returned as a professor and chair of the family medicine department before being named interim dean last October.
Mosqueda’s mother, a radiologist specializing in mammography, and her father, a gastroenterologist, had successful careers at Kaiser Permanente in Los Angeles. But they never pressured their daughter to become a physician, Mosqueda recalled. (Kaiser Health News, which produces California Healthline, is not affiliated with Kaiser Permanente.)
She took an initial interest in veterinary medicine and marine biology — she’s still an avid scuba diver — but later found her path in primary care, family medicine and geriatrics, as well as the detection and treatment of elder abuse.
In a memo announcing Mosqueda’s appointment to the USC community, provost Michael Quick said support for her among faculty, staff and students had been overwhelming.
“It was clear to us, and to the vast majority of the Keck community, that we had identified the right dean,” Quick said.
The institution Mosqueda now heads was forced late last year to acknowledge alleged misconduct by two former deans, Dr. Carmen Puliafito and Dr. Rohit Varma.
Puliafito, a renowned eye surgeon, led the medical school from 2007 until March 2016, when he abruptly resigned as dean, saying he wanted to pursue other opportunities, though he remained on the faculty. The Los Angeles Times later reported that three weeks before his resignation, he had been in a Pasadena hotel room with a young woman who overdosed in his presence and had to be rushed to the hospital.
Puliafito was later fired from the school after the Times reported he had associated with criminals and drug abusers. In September, the state suspended his license to practice medicine. Varma, who succeeded Puliafito as dean, resigned last fall after reports surfaced he had once sexually harassed and then retaliated against a female fellow.
More recently, the university has been embroiled in a controversy over allegations of sexual abuse spanning decades by USC gynecologist George Tyndall. The allegations have landed the university in a heap of legal trouble, drawing numerous lawsuits and a federal investigation.
Late last month, USC president Max Nikias agreed to step down under pressure from students and faculty. And earlier this month, students marched on campus to protest how the university has handled the Tyndall case.
“Students are feeling largely unheard, neglected and misled,” said Nivedita Kar, a doctoral student in biostatistics at Keck. “At places like Keck, where men hold a tremendous amount of privilege and therefore institutional power, the new dean must completely change the medical school culture to hear the voices of the underrepresented, restore trust and actually protect its students.”
Mosqueda knows she’s got her work cut out for her.
“We’ve been through a bad series here and we have to accept responsibility for the part of this that is our own doing,” she said. “I don’t want to be distracted. I want to own up to what was wrong and make it right.”
Making it right includes addressing the ongoing concerns of students, she said, and changing the way women’s health is discussed.
Mosqueda recalled sexist comments by male physicians when she was a medical student at USC in the 1980s. “I would hear things like ‘You’re a good girl,’ in the operating room,” she said. “In my time, it wasn’t okay to make those comments, but [there was] just acceptance of the fact that it was going to happen.”
Mosqueda is respected by her peers nationwide as a researcher and expert in geriatrics and family medicine. She directs the National Center on Elder Abuse, a federally funded initiative, and she co-founded the nation’s first Elder Abuse Forensic Center.
“Physicians like Dr. Mosqueda, who was one of the first wave of doctors specializing in geriatrics, have had to innovate and revamp programs and teach medical schools about the value of geriatrics,” said Brangman, the Upstate Medical University geriatrics chief. “All of these things created the leadership skills that have come to fruition.”
One of the challenges in improving elder care will be to make geriatrics an attractive field for new doctors, Brangman and Mosqueda said. Older adults have complicated health care issues but the specialty doesn’t pay well.
In addition, the stigma attached to aging persists even now. “We live in an ageist society,” Mosqueda said.
Mosqueda said she is eager to tackle the challenges facing USC head-on. Honesty and humility are the two elements that make a good doctor, and that’s what is needed to heal the university and move beyond its current troubles, she said.
“I don’t view myself as a token,” Mosqueda said of being the medical school’s first female dean. “I want to do the right things for the right reasons.”