Bringing CNS Members Together to Make Children’s Lives Better

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Councilor for the West

Meghan Candee, MD, MSc

My journey to child neurology began during the summer after my first year of medical school, when I worked in a metabolic lab at Massachusetts General Hospital and had the chance to join my mentors on a few afternoons in neurometabolic and genetics clinic. Having earned a master’s degree in the biochemical bases of nutrition after college, I was amazed by the ways in which dietary therapies, co-factors, and supplements could be utilized to treat and, in some cases, cure disease. I became fascinated by the myriad ways in which developing brains could be affected – by lack of an enzyme, abnormal cell migration or chromosomal aberrations. My eyes were opened onto a field which continues to sustain my desire for lifelong learning and clinic days that vary widely in terms of the patients I meet and diagnoses we aim to treat. I am a fellow of the American Headache Society, who also takes great pride in being a general neurologist. I am continuously astounded by the breadth of pathology we see as our understanding of newer subspecialties, such as neuro-immunology and neonatal neurology, rapidly progresses.

With eight years of experience as a child neurology residency program director, I have cultivated a deep understanding of the educational and professional needs of our trainees and junior faculty. I have benefited greatly from working alongside other program directors to navigate the latest changes in recruiting methods and ABPN board eligibility. My roles on the CNS Ethics and Awards Committees and the United Council for Neurologic Subspecialties (UCNS) Accreditation Council have further enriched my perspective on the ethical and evaluative processes that are crucial for maintaining the highest standards in our specialty. I am acutely aware of the need for increased diversity within our society and am committed to fostering an inclusive environment that welcomes and supports all members.

In my local role as Associate Medical Director for Ambulatory Pediatrics at the University of Utah, I have spearheaded numerous quality improvement projects aimed at enhancing patient experience and optimizing clinical operations to promote provider efficiency and deliver patient-centered care across the Intermountain West Region (which serves Utah and five surrounding states). I would welcome the opportunity to engage with other councilors regarding issues and initiatives that arise, fostering collaboration and shared problem-solving within our leadership team.

My goal of further increasing my involvement within the CNS is fueled by the collaborative relationships I have built over many years with colleagues across the country through research in the areas of headache, genetic epilepsy, and multiple sclerosis. These partnerships have not only advanced our understanding of these complex conditions but also highlighted the importance of interdisciplinary collaboration. As Councilor for the West, I aim to leverage these relationships to foster greater engagement within our community. I am passionate about enhancing resident and junior faculty education and advocacy, ensuring that the next generation of child neurologists is excited and well-prepared to meet the challenges of our evolving field.

What key experiences within the CNS or other professional organizations have been most impactful or rewarding for you, and how have these experiences influenced your vision for advancing the strategic goals and direction of the CNS?

My journey working with professional organizations like the Child Neurology Society (CNS), American Academy of Pediatrics (AAP), and American Headache Society (AHS) has been profoundly rewarding. Through my connections with other residency program directors via the CNS, I have learned about issues and practice parameters that may be specific to one geographic region or population. I have also been better able to advocate for residents by hearing about how other programs address similar challenges. Through the AAP, I have had the chance, on the local and national level, to empower primary care physicians and advanced practice providers on how to evaluate first-time seizures, headaches, and developmental delay. Being selected as an AHS Emerging Leader gave me the opportunity to collaborate with peers from around the world who were at similar stages in their careers. We learned how to create, present, and enact impactful initiatives, many of which needed to begin with the AHS to garner momentum. As a state representative to Headache on the Hill, I was able to hone my public speaking skills in order to better advocate for headache-related research funding to speak out against the stigma of migraine, one of many invisible neurological diseases.

Some of the most impactful experiences I have had have resulted from attending a variety of conferences for the families of children with various genetic syndromes. Through my own good fortune of working with Dr. John Carey, a world-renowned geneticist at the University of Utah, I have worked on projects and papers establishing the seizure characteristics in Pallister Killian Syndrome (12p tetrasomy) and Trisomy 18. This led to my attending multiple annual family meetings for patients with PKS. More recently, earlier this month, I attended the Support Organization for Trisomy annual meeting in Minneapolis and had the distinct privilege of representing our specialty as the sole pediatric neurologist, meeting with families and speaking on panels about the various neurological complications specific to Trisomy 13 & 18. These interactions were enlightening. I gained invaluable insights from the experiences shared by families and other specialists dedicated to caring for these unique patient populations. The experience underscored the importance of listening and learning from those we aim to support, deepening my commitment to advocacy and patient-centered care.

My goals for working with the CNS leadership board align with the organization’s established values of advocacy, inclusivity, and transparency. Locally, as the associate medical director for the Pediatric Clinical Enterprise, I am already involved in streamlining financial processes to ensure the availability of funds necessary to implement best practices. I am eager to bring this experience to the Society level, addressing systemic and operational challenges to further the CNS’s mission and enhance our collective impact.

What are the most challenging issues facing child neurologists today, and how would the CNS, under your leadership, help its members meet those challenges?

Child neurologists today face numerous challenges that impact their ability to provide optimal care. One significant issue is ensuring equitable access for all children to pediatric specialists, both in-person and via telehealth, regardless of geographic location. Many families in rural or underserved areas struggle to obtain specialized care, creating and perpetuating disparities in health outcomes. Additionally, insurance oversight poses a substantial hurdle, particularly when it comes to accessing medications that are not yet FDA-approved for children and may not be for some time. This can leave young patients without the most effective treatments, putting their health at risk. The demands of clinical practice, combined with limited time and funding, make it difficult for providers to advocate for their patients. This lack of resources hinders efforts to address systemic issues and advocate for necessary policy changes. Integrating emerging technologies like artificial intelligence (AI) into clinical practice, patient education, and policy change remains an underexplored yet promising avenue. Harnessing AI could revolutionize our field but requires thoughtful implementation and robust support.

Under my leadership, the Child Neurology Society (CNS) could play a pivotal role in helping its members tackle the above challenges. To promote equitable access, we could advocate for policies that support telehealth infrastructure and reimbursement parity, ensuring that all children can receive specialized care regardless of their location. Addressing insurance barriers would involve lobbying for legislation that allows for broader use of pediatric medications and streamlining approval processes. To empower providers, the CNS could establish dedicated advocacy training programs and secure funding for initiatives that enable neurologists to champion their patients’ needs effectively. We could explore integrating AI into clinical practice, offering workshops and resources to help members leverage these technologies effectively. Ensuring that AI tools are accessible and user-friendly will be crucial in enhancing diagnostic accuracy and treatment personalization in the future. Furthermore, the CNS should include its youngest members earlier on in fun and accessible ways, fostering engagement and nurturing the next generation of child neurologists. Initiatives such as interactive educational programs, mentorship opportunities, and hands-on experiences can inspire and prepare young members for future leadership roles. By focusing on these strategic areas, the CNS can foster a supportive environment where child neurologists are equipped with the tools, resources, and backing necessary to overcome the obstacles they face and deliver the highest standard of care.