New Chapter

Daniel Chan, M.D. (MED ’11, I ’14, GI ’17), spent 10 years training at Mayo Clinic — medical school, residency and fellowship. He and his wife had a baby son when they arrived in Rochester, Minnesota, and had three more sons during Dr. Chan’s training. When training was done, quality of life was uppermost on his mind. He wanted to pay back his family for a decade’s worth of sacrifices. Off to Hawaii the family went — to live, not just visit. While practicing medicine in Hawaii is not without challenges, Dr. Chan says it’s well worth it. His sons know him as more than a dad who works all the time. And Dr. Chan says he’s lucky to be surrounded by Mayo Clinic alumni in his practice.

“’The needs of the patient come first’ was ingrained in me. In a busy practice, stresses such as finances and the pandemic can cause you to lose focus of that message. But Mayo Clinic instilled it in me, and it helps in my practice and serves as a reminder to take care and address the needs of the patient. … Mayo taught me to stand true to those values. Everything else is secondary.”

How did you become interested in medicine?

My sister, who is eight years older than I am, went to medical school and served as an inspiration to me.

In college, I was an electrical engineering major. I had a passion for science but realized that my personality was more social. I craved interactions with people that engineering didn’t offer. Midway through college I became more introspective and my sister’s path gave me the idea to explore medicine. She stopped medicine after medical school to stay home with her children. I finished what she started.

How did you discover Mayo Clinic Alix School of Medicine?

I was looking for medical school opportunities that were affordable, highly ranked and prestigious. Mayo fit the bill and offered many opportunities beyond medical school — residency and fellowship. I have to admit I couldn’t pick out Minnesota on a map before visiting Mayo. I flew into the Twin Cities and drove to Rochester for my interview. As I began to see corn and soybean fields, I wondered what I had gotten into. However, bar none, Mayo exceeded my expectations compared to everywhere else I interviewed.

I had great teachers and mentors in medical school, residency and fellowship that made all the difference in my career. It was fortuitous chance that I applied to Mayo and a stroke of luck to have had that opportunity.

What were your initial impressions of Mayo Clinic?

I was awestruck and dumbfounded that such a highly regarded, comprehensive medical institution could exist in the middle of nowhere. I was amazed at Mayo’s efficiency and organization, including the physician governance. I continue to be amazed at how Mayo maintains such strong physician leadership that steers the organization in clinical practice, research and education.

Who was your mentor at Mayo Clinic?

I completed the clinician-investigator pathway at Mayo — two years of research in an integrated residency and fellowship program. Dr. Kenneth Wang (I ’85, GI ’88, Division of Gastroenterology and Hepatology), helped focus my research in Barrett’s esophagus. With him, I looked at innovative ways to diagnose GI diseases. I used my background in electrical engineering for unconventional research to detect smells emitted by breath — the electronic nose device concept to detect gases from patients’ breath. I hope this will become part of GI practice one day. Other fellows in Dr. Wang’s lab have continued this research.

What valuable lesson did you learn at Mayo Clinic?

“The needs of the patient come first” was ingrained in me. In a busy practice, stresses such as finances and the pandemic can cause you to lose focus of that message. But Mayo Clinic instilled it in me, and it helps in my practice and serves as a reminder to take care and address the needs of the patient. It’s why I went into medicine — the social aspect of talking to and listening to patients. Mayo taught me to stand true to those values. Everything else is secondary.

What led you to practice in Hawaii?

I spent 10 winters in Rochester — I needed to thaw out in a warmer climate!

Actually, a Mayo colleague recruited me to our hospital in Hawaii. Joseph Chang, M.D. (I ’08, GI ’11), was a GI fellow when I was a fourth-year medical student and we kept in touch throughout the years. Our GI group at our medical center also has Mayo Clinic alumni including Scott Kuwada, M.D. (I ’91, GI ’94), who is our GI division chair; and Larissa Fujii-Lau, M.D. (I ’11, GI ’14), who I had trained with during fellowship. Almost half of the GI physicians in our group are Mayo Clinic alumni. We are united by a common standard of practice and level of care.  Additionally, I frequently interact with Mayo Clinic alumnus Heath Chung, M.D. (INFD ’10), in Infectious Diseases at our hospital, and when I first arrived in Hawaii and looked for a primary care provider, I found Andrew Dang, M.D. (I ’91), another Mayo Clinic alumnus who is my internist. Despite being so far from Minnesota, I seem to be surrounded by Mayo Clinic alumni everywhere here in Hawaii.

Practicing medicine in Hawaii can be challenging. We don’t always have the subspecialists or expertise, which can make it difficult to get diagnoses and care. I’ve used my connection to Mayo Clinic to refer patients to help in management of complex diseases and make elusive diagnoses.

The cost of living in Hawaii is high, which makes it challenging to recruit and retain physicians. That said, who can pass up Hawaii? The last three years have equaled a lifetime of vacations. I can hop to a beach on weekends to relax and unwind.  I cannot imagine a more fun place to practice medicine.

Tell us about your practice.

I have a general GI practice and spend half my time in the clinic and half performing endoscopy. I tell my kids that endoscopy is like playing video games — using a controller and monitor to look for polyps ;  the prize is removing them to reduce the risk of colon cancer.

A regional difference in our practice in Hawaii is a higher prevalence of stomach cancer as our population more closely resembles that of Asia and requires us to individualize our practice of medicine based on ethnic and racial differences.  Also being the only state in the tropics, we see more infectious diseases such a H. pylori and GI bleeding associated with ulcerations from it.  Further, I have made a novel observation of eosinophilic granules during colonoscopy which are associated with schistosomiasis and strongyloidiasis – parasites related to tropical disease.  Dr. Chung and I are collecting these mutual patients into a case series for publication.  I enjoy seeing differences in medicine that are due to these unique regional and geographic differences.

How is Hawaii faring in the pandemic?

We’re among the states that have weathered the pandemic the best. We’ve controlled the flow of COVID-19 coming into the state. Our resources are scarce — we couldn’t sustain a large surge in disease. Our Department of Health is leading the effort to conduct contact tracing to isolate hot spots and to monitor those returning from exposed areas. We’ve almost returned to pre-COVID operational capacity. A large percentage of my outpatient practice has transitioned to telehealth to protect at-risk patients.

What advice do you have for trainees?

I can’t fathom being a trainee again. The climate has changed so much. I’m impressed by today’s trainees and amazed at the unchartered waters they’re navigating.

I tell them to work hard and find joy in the journey. The journey to independent practice is arduous. We tend to focus on the destination rather than the journey itself. Finding friends, support and mentors helped me find enjoyment during training. The day-to-day things make the experience so valuable.

You trained at Mayo Clinic for 10 years. How is life after training?

Very enjoyable — the destination was worth it! Three of my children were born during my training, and they knew nothing but dad being on call and spending a lot of hours at the hospital. After life after training, I was focused on quality of life for our family. I wanted to balance work and life. I want to participate in the kids’ activities and interests, and give back to my family for the years they invested in my training. I have found that balance in Hawaii.

What do you do in your free time?

I have been happily married for 16 years, and my wife and I have sons ages 14, 12, 10 and 6. We enjoy exploring Hawaii and all it offers — hiking, water sports, beaches and culinary opportunities. I like being a dad not fully consumed by work.

What would people be surprised to know about you?

I like landscape photography, which I started pursuing in medical school. I’ve had some of my photos published and featured on the walls of my hospital.

See past New Chapter stories here.