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A Conversation With Ryan M. Ford, MD

In this issue, HCV Next asks five questions of Ryan M. Ford, MD, assistant professor of medicine at Emory Healthcare.

Ford spent his childhood just outside Atlanta and remained in the area, pursuing his medical studies at Emory University in Atlanta. After realizing his connection to gastroenterology and, later, hepatology, Ford committed his career to treating liver disease in Georgia. Specifically, he focuses on viral hepatitis, alcoholic liver disease, adolescents and liver disease due to congenital heart disease, with an aim to improve practical approaches to the diagnosis and treatment of liver disease.

Ford serves as Medical Director of the Center for Viral Hepatitis Emory University Hospital Midtown and director of Emory Transplant Center Grand Rounds. He is also married to Mandy Ford, PhD, the scientific director of the Emory Transplant Center. Together they are raising two daughters and furthering their careers in Atlanta.

What was the defining moment that led you to your field?

Although I like working with my hands, I knew right away that I did not want to be surgeon — standing in the operating room for hours on end trying to tie sutures around tiny vessels within the right plane did not excite me. I enjoyed many aspects of internal medicine, but after chief residency, I decided to pursue gastroenterology because it is a dynamic subject that is very applicable to the general population (who doesn’t know someone with some type of GI complaint?). The bonus is that you can also do procedures (much shorter cases!) while also using your broad internal medicine training to take care of patients.

During my first year of gastroenterology fellowship, I really started to love hepatology. This grew not only because of the inspirational faculty but the complexity of the sick liver patient and the fact that you can save very ill patients with a liver transplant (the “Lazarus” operation). Furthermore, all aspects of internal medicine training apply when caring for patients with liver disease. It is very gratifying, and I also enjoy working in a multi-disciplinary fashion.

What area of research in hepatology most interests you right now, and why?

We have been very busy treating over 1,000 infected patients with hepatitis C since the advent of DAAs, so I have certainly been interested in evaluating our outcomes with HCV therapy. Our group published our experience with simeprevir (Olysio, Janssen) and sofosbuvir (Sovaldi, Gilead Sciences) in the American Journal of Gastroenterology, and we have had several posters accepted at AASLD and EASL. Joel Wedd, MD, MPH, in our group presented an oral presentation at the American Transplant Congress. We are also trying to figure out better ways to educate, screen and link to care the many patients in Georgia who may have hepatitis C.

My other areas of interest include patients with alcoholic liver disease and liver transplant selection/outcomes, NASH, management of patients with Fontan-associated liver disease and the transition of children/adolescents who underwent liver transplant into the adult clinic and world. I am also interested in improving education and screening for chronic hepatitis B, especially in the immigrant or first generation American population throughout Georgia. Finally, I am the site-primary investigator for the REGENERATE trial looking at obeticholic acid in patients with NASH.

Who has had the greatest influence on your career?

James Spivey, MD, and Samir Parekh, MD, are big reasons why I pursued transplant hepatology and stayed here at Emory for a faculty position. Our transplant surgeons have also been great partners in this field, and I have been very fortunate to work with some very bright and talented surgeons. Finally, my wife Mandy has always been very supportive and has set a good example of how to work hard and achieve amazing goals.

What advice would you offer a student in medical school today?

My advice to any medical student is be true to yourself and decide what you are really passionate about. Decide early if you want to be a surgeon or non-surgeon (it really is a different way of life). Look at the people who practice what you want to do, and ask yourself if you relate to them. If you don’t want to do research or write grants, don’t stress yourself out and set unrealistic expectations — funding is difficult. If you want to be a great clinician and take care of patients, work hard and be courteous; your reputation will grow through the patient population and wherever you may work. If you love to teach, align yourself with an academic center and get involved early on if possible. Finally, show appreciation to those who work with you (ancillary staff, colleagues, mentors, administrators, etc.) because health care is really changing and you need a good teamwork approach in tackling the many issues we face.

Have you ever been fortunate enough to witness or to have been part of medical history in the making? If so, please explain.

I was fortunate enough to have one of my patients be the first in Georgia to have a combined heart-liver-kidney transplant. She is still doing well several years later, but it was not an easy feat to coordinate; it took a great deal of planning from many different people. I also feel that the hepatitis C treatment revolution is history in the making. Practicing hepatology is so enjoyable right now because we are curing disease almost daily. Finally, I have been very proud to be part of the Emory Liver Transplant program. One of my mentors, James Spivey, MD, rebuilt this program about 10 years ago and we are now one of the top programs nationally in terms of patient volume (with approximately 150 adult liver transplants a year) and quality.