This week’s faculty spotlight shines on adult and pediatric rheumatologist Stephen Balevic, MD. Balevic talks to us about how he became interested in the subspecialty of rheumatology, his interests in precision medicine and drug development, and his reflections on completing a fellowship in adult and pediatric rheumatology here at Duke.
How long have you been at Duke? How did you decide to come here?
I came to Duke in 2014 to start a combined adult and pediatric rheumatology fellowship. I knew Duke was a leading institution for patient care and research; after meeting the outstanding clinician educators and learning about research training opportunities at the Duke Clinical Research Institute (DCRI), I knew Duke was a perfect fit!
What are your responsibilities in the Division of Rheumatology? What does a typical day for you look like?
I spend most of my time conducting clinical research in pharmacology and clinical trials at the DCRI. When I am not engaged in research, I alternate seeing patients in both the adult and pediatric rheumatology clinics, and in the hospital. A typical day can take me from Duke North to Duke South, to downtown Durham
How did you first get interested in medicine? What made you decide to become an adult and pediatric rheumatologist in particular?
Rheumatology was the perfect subspecialty for me; I enjoyed the continuity and rapport of taking care of patients over a long period. At the same time, I enjoyed the complexity and diagnostic challenges of rheumatic diseases and was fascinated that so many different organ systems can be involved from the same disease. Because most rheumatic diseases also occur in both adults and children, it was also an ideal way for me to care for patients of all ages.
What’s one thing you wished more of your patients knew about pediatric rheumatology or medicine in general?
Rheumatology is often viewed as an obscure subspecialty given the rarity of most diseases. As a result, many patients have never heard of a rheumatologist, and do not know what to expect when they arrive in clinic. We therefore always try to counsel families on who rheumatologists are- pediatricians (or internists) specially trained to evaluate and manage autoimmune and inflammatory disorders.
What are your specific interests in the fields of adult and pediatric rheumatology?
While many specialists focus on very specific diseases, my clinical (and research) interests are in the field of therapeutics and pharmacology. As a result, I have the opportunity to see patients with a wide variety of rheumatic diseases, all being treated with the same classes of medications.
Is there any research or other special projects you are doing or plan on doing?
I am particularly interested in precision medicine and drug development. We are becoming increasingly aware that there is not a “one size fits all” approach to dosing in adults and children. The goal of precision medicine is to be able to identify the right drug, at the right time, and at the right dose, for each patient. The aims of some of my current projects are to measure blood levels of medications in understudied populations (pregnancy, children) to determine optimal dosing.
You completed your fellowship in adult and pediatric rheumatology here at Duke. How did that experience help prepare you for your current position? Can you name one or two memorable moments or aspects of the program that stand out?
I was fortunate to have a very comprehensive training program at Duke that included clinical rheumatology, a research fellowship at the DCRI, and a clinical pharmacology fellowship. This unique training positioned me to be able to care for patients while also transitioning to a junior faculty researcher. It also opened the doors for additional training opportunities at the FDA. With the guidance of my mentors, I was able to obtain several research foundation grants and present our results at several conferences. The most memorable aspect of my training was the dedication of my mentors; they were truly interested in my development both personally and professionally.
What passions or hobbies do you have outside of work?
I am lucky to be a husband and dad to two wonderful kids- we love to spend time outside in the Durham/Hillsborough area!