This Women’s History Month, the Office of Healthcare Equity spotlighted Dr. Judith Tsui, an innovative leader in Substance Use Disorder Research, transforming how we support those undergoing treatment along with their communities.
Dr. Judith Tsui zipped across the country numerous times early in her career, from completing medical school in New York, moving to the other coast for residency in Oregon, then making stops in Atlanta and San Francisco to complete a Master’s in Public Health before diving into research. When she landed her position at the University of Washington, she made her last cross-country move from Boston to Seattle, and is currently a Professor of Medicine at UW Medicine, based at Harborview Medical Center, and the founder and former Director of the Substance Use Research and Education (SURE) Unit within the Division of General Internal Medicine and current Director of the UW Medical Student Addiction Research (MedStAR) program. She could be considered more than bi-coastal at this stage in her life; “I think, in hindsight, I maybe would like to have one or two fewer moves,” joked Dr. Tsui. She began her training as a primary physician before specializing in addiction early in her career. Once, a career as a doctor was her plan B, initially attending music school before pivoting into a flourishing career navigating substance use disorder with patients, their loved ones, and support systems.
Her interest in the substance use disorder space began initially with an interest in supporting vulnerable patients in safety net hospitals and clinics. “My first faculty job after residency was working for Emory University at Grady Memorial Hospital. I helped to start a primary care-based program to treat hepatitis C—a disease that in the U.S. is primarily spread through injecting drugs. This, and other experiences, opened my eyes to how we were overlooking substance use and addictions as the root cause of many of our patients’ conditions,” she shared. She discussed the difficulty of helping these patients heal during her time working with a highly prevalent population confronting substance use disorder and the lack of emphasis during medical school training. On combating the stigma of the disorder in the medical community and medical school, she shared, “It seemed like it was the ‘elephant in the room’ in clinical care and medical education— how can we help our patients if we are not addressing the root cause of their illness?”
In the early 2000s, Dr. Tsui became trained to provide office-based treatment for opioid use disorders with buprenorphine and developed a clinical and research focus around hepatitis C and opioid use disorder, which she maintains today. Her overarching goal is to improve care delivery and health outcomes for persons who use drugs. “Addiction medicine is somewhat of a new field: we need more of a solid research base to help guide treatment and policy. I also appreciate how substance use disorders are complex and- like many medical conditions–impacted by structural barriers and social drivers of health,” she shared. Supporting these patients challenges doctors to think more broadly about how they can best address the condition while also encouraging new ways to encourage the integration of care.
Navigating a treatment plan in a decentralized healthcare system while managing insurance coverage and cultivating a support system leads patients to hit various roadblocks on their road to recovery. Rather than addiction treatment being seen as a separate issue addressed with a different provider, Dr. Tsui recommends that primary care physicians be equipped with the knowledge and skills to provide these services. At Harborview Medical Center, this integrated model has been implemented and allows patients to receive addiction/substance use disorder treatment screenings in one location. “Primary care is really good for offering care for chronic medical conditions and longitudinal care. The idea is we have a medical home for patients, and I think that’s incredibly valuable for patients with substance use disorders, to have that sort of long-standing relationship with their clinician and a medical team,” she shared.
While patients receiving treatment is one component of the complex network of navigating substance use disorder, support systems serve as a literal lifeline for those undergoing recovery plans, and the emotional toll it takes on loved ones, family, and friends is a crucial factor and consideration to maintaining wellbeing for caregivers. There are resources for caregivers or concerned significant others (CSOs), including family and community support groups, to offer connection in times of stress. According to Dr. Tsui, having a CSO is a major asset for a patient and is associated with better outcomes. Harborview’s office-based opioid treatment clinics recently conducted research to try to learn how to implement programs to support and grow the skills of CSOs.
Dr. Tsui witnesses the positive transformations of patients’ lives in her role and offers insight into the brighter side of her work, challenging misconceptions— “I think probably the main misconception is more about the work of being an addiction medicine-focused physician; I feel like people think, oh, that must be so hard, or it must be very depressing. I actually love my work. I think it’s meaningful and I feel fortunate to be able to talk to patients and that they are willing to share with me their experiences.” Dr. Tsui still nourishes her musical side outside of the clinic, playing the cello in an orchestra called the “Seattle Collaborative Orchestra”, a multi-generational orchestra that strives to promote historically underrepresented composers. Her 15-year-old daughter inherited the music bug and plays the viola alongside her— “Driving to rehearsals is a great way to ensure that she has an extended conversation with me once a week,” shared Dr. Tsui.
