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Focus on Daniel Mullady, MD

Daniel Mullady, MD, is an assistant professor in the division of gastroenterology. His areas of clinical interest include advanced therapeutic endoscopy, endoscopic ultrasound, diagnosis and treatment of billiary and pancreatic disorders.

Dr. Mulllady sees patients at the Center for Advanced Medicine, 4921 Parkview Place, 8th floor , and Barnes-Jewish West County Hospital, Medical Office Building Two, 10 Barnes West Drive, 200.

FOR AN APPOINTMENT, PLEASE CALL 314 747-1277.

How did you choose your specialty?

During my third year of medical school at the University of Connecticut, I was unsure of what I wanted to specialize in – surgery or medicine. Rather than starting my fourth year, I did a one-year fellowship in anatomic pathology – a program unique to my medical school. During that year, I was able to perform autopsies, dissections of surgical specimens and review histology slides with the pathologists.

The year in clinical pathology was instrumental in my decision to pursue internal medicine and gastroenterology. During my fellowship, an interest in endoscopy and the therapeutic aspect of the field motivated me to pursue advanced interventional endoscopy training.

What brought you to Washington University?

Because I have no personal connections to St. Louis, many people were surprised I ended up here. I knew I wanted to stay in academic medicine and live in a smaller city. From that standpoint, and because Washington University is a leader in virtually every area of medicine, coming here was a natural choice. Fortunately, the interventional endoscopy division was looking to expand. I felt very comfortable here from my first interview -- it is an excellent match for me.

Dr. Mullady and family


Which aspect of your practice is most interesting?

I definitely enjoy the procedural aspect of my practice. Most of my focus is on endoscopic ultrasound and ERCP (endoscopic retrograde cholangiopancreatography). One of the conditions that I diagnose is pancreatic cancer. I also treat some of the side-effects, such as jaundice and intestinal blockage.

 It is certainly a challenge to tell someone that they have cancer, and I feel that it is important to take the time to sit down and talk to them about their diagnosis. I’ve heard people say “you know my doctor came in, told me I had cancer and then left”. I don’t want to practice that way I want to be the one who spends a little extra time with patients to answer their questions. I think doing that can really have a positive impact on their initial journey into battling cancer.

The procedural aspect that I enjoy the most is removing bile duct stones. A person can be very sick when he or she initially comes in, and then because of the procedure, gets better -- dramatically and very quickly. It is instant gratification as opposed to so many other outcomes in gastroenterology that require patience – sometimes weeks, months and even years.

I also enjoy the educational component in diagnosing and treating patients. Many people do not know much about their pancreas and/or bile ducts. I find that communicating to the patient in terms he or she can understand is very rewarding.

What new developments in your field are you most excited about?

Outcomes for pancreatic cancer have not changed substantially over the last 30 years. Unfortunately, pancreatic cancer often becomes symptomatic at too late a stage for a cure. Even if detected early, there is still a very small chance of long-term survival. We have learned, however, that early diagnosis does make a difference. I am most excited about new developments and technology that will allow us to detect pancreatic cancer at a very early and completely curable stage – perhaps even before patients develop cancer.

Is pancreatic cancer usually diagnosed through imaging?

When patients present with pancreatic cancer symptoms – either pain or jaundice from when the cancer blocks the bile duct --that’s usually a very advanced stage. The cancer is initially diagnosed when a CT scan picks up a mass in the pancreas. I then do additional testing to obtain a tissue diagnosis.

We do know that there are certain risk factors for pancreatic cancer. There’s been research among patients who have had two or more first-degree relatives with pancreatic cancer. There are certain genetic syndromes that predispose patients to pancreatic cancer. We know that there are specific precursors in these patients that lead to cancer.

Most of pancreatic cancer is what we call ‘sporadic’ -- which means it just happens. Two things that may indicate somebody has pancreatic cancer could be new-onset diabetes or acute pancreatitis. But usually there is no reason to suspect cancer, and that’s why early diagnosis is such a challenge.

Is there a particular award or achievement that is most gratifying to you?

I would have to say that getting accepted into medical school is my most gratifying achievement. I worked very hard for that opportunity, and it has provided me with the foundation for my professional life. I am very grateful for that and it’s very humbling.

Where are you from originally?

I grew up in Barkhamsted, Connecticut, a small town (population 3,000) in the northwestern part of the state that is near the border of Massachusetts and New York. Many people do not think of Connecticut as being a rural place, but I am from a small, rural town. It was a great place to grow up. My parents still live there, and my mother is the town clerk, so I still have a strong connection to my hometown.

What do you do when you’re not working?

I enjoy spending time with my wife and daughter. We are exploring St. Louis and getting settled in our new hometown. I’m also an avid sports fan – but it’s not too popular around here to say that I’m a Red Sox and Patriots fan. But hopefully my daughter will be a Cardinals and Rams fan.

What is the best advice you have ever received?

Whenever things have been stressful and I’ve looked to my father for advice, he’s always told me: “Just do your best. Nobody can ask more of you than that.” It’s simple advice, but I’ve taken it to heart and try to apply it both professionally and personally. Also, there were a few mentors throughout my training who stressed the importance of talking to patients and spending a little extra time with them when they’ve just been given bad news. I try to put myself in their place -- in the hospital bed as opposed to standing next to the bed.

If you weren’t a doctor, what you like to be doing?

I enjoy educating patients about their diagnoses, so I think a natural second choice would be for me to be a teacher if I weren’t in medicine. I’d like to be a high school teacher since that’s a pivotal time to have a positive impact in someone’s life, and I’d also like the opportunity to coach sports.
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Copyright 2009 Washington University School of Medicine
Copyright 2009 Washington University School of Medicine