Internal medicine physician has learned the power of little moments in patient care

Elizabeth Cruse, MD, is a board-certified internist and member of the CMS Board of Directors representing the Employed Physician Section. Though she will soon relocate to Glenwood Springs, Dr. Cruse most recently served as medical director for Ambulatory Quality Improvement and Population health for Boulder Community Health and Boulder Valley Care Network. She is proficient in Spanish and has a special interest in women’s health.

Before her position with Boulder Community Health, Dr. Cruse practiced internal medicine at Memorial City Hospital in Houston. While in Texas, she also served as an assistant professor for the University of Texas Health Science Center, where she received a Dean’s Award for teaching.

Who or what inspired you to pursue medicine?

Elizabeth Cruse (EC): This is such a great question. I suppose it was my maternal grandmother, though I never knew her; she died before I was born. However, I heard many stories about her and how hard she worked, but also how rewarding her career was. She was one of only four women to graduate from UTMB in Galveston in her year, and the only one who went on to practice. She ran her own allergy and immunology practice in Houston until she died. Along the way there were many others who continued to inspire me with their caring, knowledge and work ethic – people who supported me and encouraged me, as is likely true for many of us.

You are a member of the CMS Board of Directors, representing employed physicians - what have you learned since joining the board?

EC: I have to admit that joining the board was my first foray into CMS, other than attending a few meetings. I feel like I kind of came in through the back door, and I really appreciate the opportunity. I have been impressed with how closely CMS members work with our legislative members, and how respected and appreciated our physicians’ opinions are by our legislature and other elected representatives. I have been impressed at how involved physicians are from outside the Denver metro area, and how altruistic the organization is – CMS is truly dedicated to making sure we provide the best patient care in Colorado, not just making sure that physicians are protected (though often that goes together).

You also have your MBA; did you get your master’s before or after your medical degree, and how does it complement your MD?

EC: I didn’t go for my MBA until I was 50! Getting a dual degree wasn’t as common back when I went to medical school, but as I moved through my career, I really wanted to understand more about the health care system and the business of health care. Getting my MBA seemed like a logical step when I moved into a more administrative position and was contemplating a change to physician leadership. There are other pathways, but CU’s executive healthcare MBA is an excellent local program and very accessible for full-time working physicians. I did receive a scholarship and I had some money saved for the tuition, which helped too! Though I have since decided to go back into full-time patient care, I do not regret exploring this avenue and the experience I gained was invaluable.

Can you share a story of a patient that has really stuck with you?

EC: The stories that stick with me are the ones in which we have been able to wrap care around a person and prevent them from falling through cracks in our system that they otherwise would have in the past. Many of our primary care practices have benefitted from federal programs like the Patient-Centered Medical Home and Comprehensive Primary Care, and which allowed us to build out teams – including RN care managers, behavioral health and pharmacists – that enable us as physicians to focus on the medical care, but also address those social determinants of health that often prevented patients from “complying” with our recommendations in the past. Plus, these team members provide needed expertise without making patients travel to a different office or be referred for needed care.

As I am preparing to leave my current practice for a new opportunity in Glenwood Springs, I am saying goodbye to patients that I have known for more than 15 years. Though I just felt like I was doing my job, this leave-taking has made me realize everything I have been through with some of my patients, and how what was a little thing to me – often just listening and being there for them as they faced challenges that we all do in life – meant everything to them. It is truly a privilege to be allowed to care for people.

What advice do you have for physicians-in-training?

EC: This is a great profession. We are lucky to be able use our knowledge to provide comfort to people, even if the diagnosis we are making is dire. Listening is your most important tool, and meeting patients where they are and partnering with them is the best way to build those long-term relationships that can help them make changes. Don’t let your natural perfectionism (we’re all a little Type A) lead to burnout; focus on the relationships you build with your patients, colleagues and in your personal life as a measure of success. That’s what is going to keep you going, not the money or anything else.

What do you enjoy doing outside of medicine?

EC: We love to cook, hike, ski and travel. I am also a science fiction nerd, and love reading for fun. Let me know if you have any book recommendations!