PNA Spotlight: Dr. Lewis Z. Leng


lengThis month the PNA Spotlight focuses on Dr. Lewis Z. Leng, a board-certified neurosurgeon at Sutter Health/California Pacific Medical Center. He also serves as Department Head of Neurosurgery for Sutter West Bay Medical Group and as a Clinical Assistant Professor of Neurology at Geisel School of Medicine at Dartmouth. In addition he is Co-Director of Endoscopic Skull Base and Pituitary Surgery, and Chair of the Neurosciences Quality Improvement Committee at CPMC.

Dr. Leng received his B.A. from University of California at Berkeley. He earned his medical degree from Perelman School of Medicine at the University of Pennsylvania during which time he was a 21st Century Scholar and received a Howard Hughes Medical Institute Fellowship. Dr. Leng completed his residency in neurosurgery at New York Presbyterian Hospital-Weill Cornell Medical Center and Memorial Sloan-Kettering Cancer Center. He was kind enough to answer a series of questions from the PNA. His answers follow.

What inspired you to choose your career path?

I became interested in pituitary and skull base surgery because of my mentor, Dr. Theodore Schwartz. I was fortunate to be a young resident when Dr. Schwartz started his work as a pioneer in endoscopic pituitary and skull base surgery. I was inspired by Dr. Schwartz’s insightful approach to these challenging pathologies and cases. I was excited by the innovative nature of this emerging field and the constant drive to improve our techniques and disease management strategies.

What is the primary focus of your work/research?

I practice at Sutter Health, a large, not-for-profit healthcare network that is spread across Northern California. Despite the riches of our state and number of well-known healthcare institutions and networks, there are still quite dramatic disparities in the quality of care in different regions of the state. I strive with subspecialist physicians and surgeons throughout our healthcare network to deliver high quality, consistent, uniform care across Northern California.

What do you consider to be the future of your field?

I strongly believe that integrated healthcare systems will be the key to improving the quality and accessibility of delivered care. I believe this applies to not just common primary care diseases such as hypertension and diabetes but also to subspecialty diseases such as pituitary tumors and disorders. One of the silver linings of the COVID-19 pandemic crisis is that it has helped accelerate the modernization of healthcare delivery systems. With the development of better electronic health record (EHR) systems, telehealth platforms and integrated healthcare networks, a patient with a newly diagnosed pituitary tumor will be able to readily access high-quality care, whether in the far northern reaches of California or in the San Francisco Bay Area. I am working closely with the Sutter research institutes to bring to fruition the promise of “big data” in medicine. The primary issue with EHR data in the past has been the non-discrete nature of the inputted data. As EHR systems and disease databases are refined, we will be able to shift the paradigm of retrospective review and research to one that is more prospective, and proactive. Research and quality improvement for management of pituitary disorders would be a more intertwined, continuous process as we monitor the pituitary health of millions of patients throughout a healthcare network.

What should patients know about your field/what deserves more recognition/awareness?

The management of pituitary diseases is team effort that starts before the operating room, continues in the OR, and goes on well after discharge from the hospital. I have been fortunate to work with Dr. Aditi Mandpe, my fantastic otorhinolaryngology co-surgeon, since I started practicing. I work with a wonderful network of primary care providers, endocrinologists, ophthalmologists, hospitalists, intensivists, anesthesiologists, neuroradiologists, neurointerventional surgeons, and radiation oncologists.

What would you like to convey about yourself to your patients?

I tell all my pituitary patients that their relationship with me is a long-term relationship. Most pituitary tumors and disorders require long-term treatment and/or surveillance. Because of this, I offer my continued input and guidance as my patients navigate follow-up appointments, imaging, and lab studies in the years following the index surgery.

Why did you get involved with the PNA and what is the extent of your involvement?

I joined PNA because I believe patient education is the key for improving patient outcomes and well-being. I believe an important duty of a clinician is to explain to the patient his/her pituitary condition in an understandable and clear manner. PNA is a fantastic partner because of the abundant PNA resources that help supplement my one-on-one discussions with patients. I believe PNA is doing vital work by helping to disseminate accessible information on pituitary diagnoses, treatments, and providers to patients and families.