The Albion Walter Hewlett Award, developed by the Department of Medicine, is a recurring award honoring an exceptional physician with ties to Stanford. Dr. Hewlett served as head of the Department of Medicine over 100 years ago. He was known as “a physician of rare compassion and extraordinary skills” who made “outstanding contributions to patient care and medical science.” This year’s awardee is professor of obstetrics & gynecology Maurice Druzin, MD.

When Maurice Druzin and his wife, Liz, moved from New York City to Stanford in the early 1990s, they were focused on having their three young sons raised in a more community-oriented environment. “And Palo Alto was a nice college town. That was the draw,” says Druzin. The 27 years since then have constituted an interesting journey whose beneficiaries include high-risk obstetric patients and their babies, Stanford Medicine, and the state of California.

Arriving at Stanford from Cornell University, Druzin came as division chief of maternal fetal medicine and obstetrics. The Division of Maternal Fetal Medicine had only 1.5 faculty members, a small clinical operation, and no meaningful research program. The entire department “was in a bit of a shambles at the time,” says Druzin, “particularly the high-risk obstetrics division. I was recruited to build up the division and establish robust clinical, educational and research programs.”

After Druzin’s many years in administrative roles (division chief, vice chair, associate dean for academic affairs and program director of the residency and maternal-fetal medicine fellowship program), in addition to his clinical work, the division is one of the best in the country. It is now under the leadership of Dr. Yasser El-Sayed, a former resident and fellow at Stanford. Druzin continues to be very active “doing what I enjoy doing most. I take care of patients.”

His roles at Stanford

There are four elements to what he continues to do at Stanford.

His first role is as the maternal fetal attending physician supervising  the high-risk obstetrical service in rotation with other faculty two to three days a week. On service he rounds on complex obstetrical inpatients; does consults on other services for women who are pregnant; and backs up labor & delivery.  “Tuesday afternoon is my own clinic,” he says, “which is all referral high-risk obstetrical patients.”

His second role centers on the perinatal diagnostic centers, which involves obstetrical ultrasounds and consultations. “We have six satellite clinics that we run in the community: Redwood City, Fremont, Santa Cruz, Salinas, Modesto and Mountain View. While four of those clinics have regular faculty, Fremont and Mountain View have rotating faculty, and two days a week I go to one or the other of them.”

The third role is one Druzin especially relishes: “The thing that I enjoy probably more than anything is teaching, and I do that on the job. On service we meet mornings at 7 am, round on high-risk patients with a resident, a fellow, and usually some students tagging along. In my clinic on Tuesdays I have a fellow or a resident and usually a student with me as we see patients with medical, surgical or obstetrical complications.”

There is a fourth role: “The other part of my life that I enjoy is clinical research. My main areas of interest are medical complications of pregnancy, such as autoimmune diseases like systemic lupus erythematosus and hypertensive disorders of pregnancy.”

Service to the State

California has also benefited from Dr. Druzin’s attention over many years. Beginning in 2007, he was appointed to the California Pregnancy Associated Mortality Review (PAMR) to review maternal deaths in the state, and he continues to serve on this committee.. “We meet three or four times a year,” he says, “and review all the deaths of mothers from the beginning of pregnancy up to 42 days postpartum. We also review all the deaths out to one year postpartum, because some women may die from complications of the pregnancy as long as a year after delivery."

This is one of my favorite things to do because we are making a difference: the maternal mortality rate in California is the lowest in the nation.

He continues: The California Maternal Quality Care Collaborative (CMQCC) is the umbrella organization charged with improving health care for pregnant women and, by extension, their fetus and newborn. PAMR operates within CMQCC, which supports the formation of “toolkits,” which are clinical guidelines developed in response to the findings of PAMR.  “From that committee we came up with the leading causes of death and looked at ways to prevent them. We also suggested ways to improve care through the toolkits. When we reviewed a maternal death from, say, preeclampsia, we would look to see if there were any opportunities for improvement in that case. Was the problem recognized quickly enough? Was appropriate treatment given in a timely fashion?”

“Uniquely in California, for each condition leading to a maternal death, we created a task force to take on those findings, produce a toolkit and disseminate this information to all the obstetrical services in California, whether a small community hospital or a large academic medical center. We have published toolkits on hypertensive disorders of pregnancy; on postpartum hemorrhage; on venous thromboembolism; and on cardiac disease in pregnancy. This is one of my favorite things to do because we are making a difference: the maternal mortality rate in California is the lowest in the nation.”

How then did this professor of obstetrics and gynecology, and professor, by courtesy, of pediatrics, learn that he was the Albion Walter Hewlett Award winner for 2018? “I was seeing a patient in the middle of a very busy clinic and I got a call on my phone; when I finished with the patient I looked and it said: ‘Dr. Harrington’s office calling.’ And I thought, ‘Oh jeez, what did I do wrong now?’”

Nothing at all, as it turned out.