Dr. Cassey Koid ’11 Pursues Equity in Pediatrics

For Dr. Cassandra (Cassey) Koid ’11, the social determinants of health are just as important as the quantitative methods of health analysis. Growing up in developing countries, Koid was always interested in the intersection of poverty and health. In her Sociology of Health and Illness course at Grinnell, she “realized there are inequities and disparities in the U.S as well." Koid says that the emphasis on teaching inquiry in the sciences at Grinnell gave her an edge in research and in medical school. “Grinnell was the place that trained me to think outside of the box,” she says.

After graduating in 2011 with a degree in biology, Koid took a gap year in Canada before entering medical school at the School of Medicine at Trinity College Dublin. She then went onto a pediatric residency at a county hospital in Queens, New York. Training in both Ireland and the U.S. allowed her to see the contrast between socialized medicine and the "business of healthcare" here in the states, Koid says. “I find that in the U.S., we tend to over-test or we are pushed by parents to do lab testing that is not always necessary."

Dr. Koid is now finishing up her master of public health and pediatric emergency medicine fellowship at the University of Washington. There, her fellowship project focused on the health disparities arising from race, ethnicity and language. “My research found that in the ED [emergency department], white patients are the most likely to get admitted to the hospital, and black patients are the least likely to get admitted. And there are also differences in specific diagnoses,” Koid says. She continues, “If you look at asthma and bronchiolitis, the rates of imaging, IV fluids, meds, and antibiotics are all different depending on your race, ethnicity, and language for care.” Koid sees a physician’s role as looking beyond the analytics and thinking, “What does this feel like to the patient and family? What does a longer wait time mean for future care?” As she spoke about her work, the power of her words told me she would be a catalyst for change.

I asked Koid how it feels to be a physician who is a woman of color.

“Most people think I’m a nurse because I’m Asian, or they think I’m a medical student,” Koid says. “You need to have support from your department, and my department has been very supportive with grants for my research. However, if you are presenting your results to a group that doesn’t look like you — and our group is very white — there are people who will ask, ‘Is that what the data is showing or are people using the ED for their primary care and that is why we are seeing these patterns?’ Being a woman, being anyone who’s of color, and then also, for me, me having that international flag has always sucked. You know, I feel like you just must push yourself a little bit more than others sometimes.”

Koid explains how her team in the ED uses an equity dashboard, where physicians can pull a patient census and view the metrics every day. This dashboard allows them to track how long every patient waited, what tests were ordered, and final diagnoses. She has also helped lead trainings on Diversity, Equity, and Inclusion initiatives and hopes to continue this work in her next position as an attending pediatric ED physician in New Orleans. The destination was driven not only by the position but by her need to work where a visa is available, given her Malaysian citizen status. In New Orleans, her position will contain both academic and clinical components. Her facility there was just approved to start a pediatric emergency medicine fellowship, and Koid “wants a piece of the pie” in the education and training of the fellows.

As we finish our conversation, catching up about our families and her latest “best eats” and travels, I remember my first class teaching Koid — she’s always been Cassey to me. She was my student, then became my co-researcher, then my dog-walker, friend, and family. I am not at all surprised that her positive impact is already spreading around the world.