In This Article
- In high-risk obstetrics, Francine Hughes, MD, appreciates the depth of the relationships a physician can develop with patients and their families as they usher them through a challenging chapter in their lives
- Dr. Hughes received her medical degree from Thomas Jefferson and completed her residency at Saint Barnabas Medical Center
- Her career evolved in a way she didn't anticipate, and she now dedicates time and energy to helping physicians figure out what they're good at within the field of medicine—research, education, administration, and clinical care
Francine Hughes, MD, joined the Massachusetts General Hospital Department of Obstetrics and Gynecology in June as the new chief of Maternal-Fetal Medicine (MFM). Dr. Hughes received her medical degree from Thomas Jefferson University and completed her residency in Obstetrics & Gynecology at Saint Barnabas Medical Center. She completed both a clinical and a research fellowship in MFM at Montefiore/Einstein in New York, where she remained as faculty after graduation. During that time, she worked to lead her own lab, secured sequential NIH funding, served on study sections, and mentored physicians and post-doctoral fellows aspiring to do the same. In mid-career, she shifted focus to education and mentorship to help the next generation find an appreciation for research in reproductive medicine. Dr. Hughes served as an MFM fellowship program director at NYU Langone before being recruited back to Montefiore/Einstein as their fellowship program director and, ultimately, their vice chair of Education.
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Q: What drew you to Mass General?
Hughes: Mass General has a strong national reputation in both research and clinical care, which was part of the initial draw. As I got to know the people that comprise the department and the culture they've created here, I thought it would be a really great place to work.
Q: Clinically, what drives your passion for high-risk obstetrics?
Hughes: I appreciate the depth of the relationships you can develop with patients and their families as you usher them through what can be a challenging chapter in their lives. Women put a lot of trust in you as an expert to steward them through difficult situations, and I take that level of trust very seriously.
I also really enjoy working with women and pregnant people, empowering them with the latest evidence and data we have so they can make the best decision for themselves. While I can provide information about their diagnosis and prognosis, often the best interest of the mother and fetus are in conflict, and, in the end, the woman may have to make very personal decisions. I strive to understand what each person values in each situation and take their priorities into account.
Q: What has been the focus of your research?
Hughes: This has evolved over time—at the start of my career I worked in a lab focused on aging research and I worked in the area of developmental origins of adult disease. Specifically, I wanted to understand more about the role of epigenetic mechanisms, and how changes in DNA cytosine methylation patterns in stem cells associated with abnormal fetal growth might be associated with increased susceptibility for age-related diseases later in life. Today, I am less involved in bench work and concentrate on clinical and some translational research through collaboration.
Q: What advice would you give to early-career academic physicians trying to balance clinical time with research or advocacy work?
Hughes: Being a physician and caring for patients, seeing people at some of the most vulnerable times in their lives is a huge privilege. I still love to deliver babies and being a part of someone else's major life event. On the flip side, I think it is important to acknowledge the cost of being a physician and being entrusted with people's lives. We witness tragedy and other's suffering and over time that leaves a mark. So, you have to take care of yourself. You need some boundaries, so you have the capacity to give to others and focus on their needs. This applies to physicians as teachers, advocates, and researchers. In research, you need space for creativity and clear thinking. Care for yourself too; it will make you better at everything.
Q: How will future research in high-risk obstetrics transform patient care and improve outcomes for both babies and birthing people?
Hughes: There's no doubt research informs care, but research has also lagged behind in women's health care, especially pregnancy-related research, because it has been chronically underfunded on a national level. I think the increased attention and demand for action to decrease maternal morbidity and mortality will lead to change. I don't think we can ignore the reality that social factors contribute to disease burden. Obviously, this is a longstanding, complex problem with no easy solution but I've observed more acknowledgement that the current state is unacceptable and real efforts to make changes.
Q: What's changed in medicine over the course of your career?
Hughes: I'm pleased that physician well-being has become more of a focus. At the start of my career the culture was 'suck it up and solider on,' and that's not sustainable for the duration of a career. We have a better understanding now that doctors provide better care when they have time to invest in their own well-being and come to work centered. There's still work to be done here of course, but I'm pleased more hospitals and health systems are aware of the impact of physician burnout on patient outcomes and the financial implications. I'm hopeful that in the future policy changes will include evaluation of the impact changes will have on the work force.
Q: What gives you hope for the future?
Hughes: Without a doubt it's the next generation of physicians that are coming up. I am continually impressed when I work with trainees, not only about their knowledge and skills but also their dedication to improving the health and lives of women. That gives me hope.
Q: What's on the horizon for research in maternal-fetal medicine?
Hughes: Genetics and genomics are going to be a significant area in the future and have a lot of positive impact on patients and their families. With prenatal genetic testing it is two-fold—patients will appreciate less invasive procedures and we'll better understand variants of unknown significance.
Learn more about Maternal-Fetal Medicine at Mass General
Refer a patient to the Department of Obstetrics & Gynecology