A Q&A with Justin Lee, the 2018 recipient of the David L. Sackett Graduate Scholarship

Jun 18, 2018, 12:09 PM by Joel Tiller
Like its namesake, the scholarship represents academic excellence and achievement and an unwavering commitment to advance the practice of health education and evidence-based medicine throughout the world.

The David L. Sackett Graduate Scholarship is considered among faculty, staff and students in the Department of Health Research Methods, Evidence, and Impact (HEI) as the highest honour a graduate student can receive. Like its namesake, the scholarship represents academic excellence and achievement and an unwavering commitment to advance the practice of health education and evidence-based medicine throughout the world.

This year’s recipient, Dr. Justin Lee, a PhD candidate in the Health Research Methodology (HRM) Program, sat down with HEI Communications to discuss his research interests, including the clinical epidemiology and management of older adult high cost healthcare users, and the path that led him to where he is today.

Q: Congratulations, Justin. This is a tremendous honour. What does it mean for you personally and academically?

It is very exciting and quite humbling, considering who this award is named after. During my training at McMaster’s medical school, I would always hear about David Sackett and the legacy and impact he left not only here but around the world. For me, to receive an award named after him is great because he is a big reason why I got into research in the first place. It also gives me that extra boost of energy, since research is a long haul, and the added reassurance that I am on the right track and people see value in what I am doing.

Q: You have a broad and extensive background in healthcare, which has undoubtedly contributed to your current success. Describe the path that has led you to where you are today.

I initially trained as a clinical pharmacist, which resulted in me working closely with a number of physicians. I was really interested in what they were doing, so one of my mentors suggested that I consider medicine. Thankfully, the stars aligned and I got into McMaster’s medical school. I trained as a physician here and went through internal medicine training, then I specialized in geriatric medicine.

While working in geriatric medicine I realized that there are many things that we do in practice that is not backed by strong evidence. There was an obvious need to push this field forward, particularly when it comes to addressing the specific needs of our aging society, so near the end of my geriatric residency I enrolled in HEI’s HRM Program. I started in the MSc stream, eventually transferring into the PhD program because I knew research was going to be major part of my career.

Q: Describe your research and the potential impact it will have inside and outside the clinic.

My research focuses on healthcare sustainability and optimizing patients’ use of medications. I concentrate on a particular population of patients – those who tend to be older, sicker and use two thirds of Ontario’s healthcare budget – known as “high cost healthcare users”. Essentially, I am trying to identify what makes this group different, with respect to their healthcare needs, and develop interventions that address these needs. Quite often, healthcare providers throw a lot of stuff at this population not fully understanding their specific needs, and this approach simply does not work. What I believe we need to start doing is offering more targeted and tailored solutions to keep this population healthy and out of the hospital.

Moreover, I am also looking at this population’s use of medications. We have learned that even though these patients are seeing their healthcare providers frequently, it does not necessarily mean they are on the right medications. In some cases, the medications that the system is providing them is, ironically, making them sicker. Therefore, I am looking at ways to identify and better understand whether or not they are on the most appropriate medications, and trying to develop new strategies to improve the quality and cost-effectiveness of the medications that providers are prescribing.

About David L. Sackett

David L. Sackett OC, FRSC, MD, MA, FRCP, was the founding Chair of Canada's first Department of Clinical Epidemiology & Biostatistics (now Health Research Methods, Evidence, and Impact), at McMaster University and led the creation of a graduate studies program, the first of its kind, in Design, Measurement and Evaluation, now called the Health Research Methodology (HRM) Program