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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.


How did you choose your specialty?

During my third year of medical school, I was torn between surgery and medicine. So, rather than starting my last year of medical school, I entered a one-year fellowship in anatomic pathology, something which is offered at only a few medical schools. During that year, I was able to perform autopsies, dissect and process surgical specimens, and review histology slides with the pathologists. This year in clinical pathology was instrumental in my decision to pursue internal medicine, and ultimately, gastroenterology. Then, during my gastroenterology fellowship, an interest in endoscopy and the therapeutic aspect of the field motivated me to pursue training in interventional endoscopy.

What brought you to Washington University?

I knew I wanted to stay in academic medicine and live in a smaller city. From that standpoint, and because Washington University/Barnes-Jewish Hospital is a leader in virtually every area of medicine, coming here was a natural choice. Fortunately, the interventional endoscopy division was looking to expand. It has been an excellent fit for me.

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.

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 which can take much longer to improve.

I also enjoy the educational component in diagnosing and treating patients. Many people do not know much about the pancreas and bile ducts. It is very rewarding to improve patients’ understanding of their illnesses.

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

Unfortunately, pancreatic cancer often becomes symptomatic at a stage that’s too late for a cure. Although pancreatic cancer has a poor prognosis, we have learned 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.

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 –the cancer is usually already advanced. Usually, pancreatic cancer is initially diagnosed by CT scan. I then perform endoscopic ultrasound with fine needle aspiration to obtain cells to confirm the diagnosis. During this procedure, an endoscope is inserted through the mouth into the stomach. The pancreas is located very close to the stomach and can be imaged well with the ultrasound probe at the end of the scope. Once the tumor is localized, a very small catheter containing a small needle is advanced through the scope and into the tumor to obtain a sample.

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. It has provided me with the foundation for my professional life. I am very grateful for that and it’s very humbling to have been given that opportunity.

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. 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 two young children. I also enjoy reading, doing yard work, and watching sports, especially the Boston Red Sox.

What is the best advice you have ever received?

I think the best advice I’ve received is from my father to: “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, especially when they’ve just been given bad news.

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. 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 2015 Washington University School of Medicine