Q&A with Dr. Meredith Doherty, MSW ’10

Meredith Doherty headshotAfter she earned her MSW from NYU Silver in 2010, Dr. Meredith Doherty gained four years of clinical experience in the context of chronic and serious illness before pursuing her PhD in Social Welfare from the CUNY Graduate Center/Hunter College Silberman School of Social Work. 

Her first post-MSW position was on an Assertive Community Treatment (ACT) team at NYC Health + Hospitals’ Coney Island Hospital working with people with severe mental illness. She then joined an outpatient mental health clinic that served people with HIV and AIDS and later returned to Coney Island Hospital as a palliative care supervisor. 

During her doctoral studies, Dr. Doherty was an American Cancer Society doctoral scholar at Silberman Aging, a Hartford Center of Excellence in Diverse Aging at CUNY, where she was the project director of Dr. Daniel Gardner’s NIH-funded study Access to Supportive Care in the Community. Separately, she was a project team member on NYU Silver Professor Dr. Victoria Stanhope’s NIH-funded study, Person-Centered Care Planning and Service Engagement. In recent years, she has served as an teacher and mentor in NYU Silver’s Zelda Foster Studies Program in Palliative and End-of-Life Care.

Dr. Doherty earned her PhD in 2019 and in 2021 she completed a Postdoctoral Research Fellowship in Psycho-Oncology at Memorial Sloan Kettering Cancer Center, where she was Co-Chief Research Fellow in Psycho-Oncology. Dr. Doherty is now an Assistant Professor at the University of Pennsylvania School of Social Policy and Practice (SP2) and a member of the faculty of SP2’s Center for Guaranteed Income Research.

NYU Silver’s Communications Department recently spoke with Dr. Doherty about her research interests, the influence of her Silver education, and her continued connection to the School after all these years.

At the Center for Guaranteed Income Research, you are the lead investigator of the Guaranteed Income and Financial Treatment Trial (GIFTT), the first randomized control trial of guaranteed income in the U.S. to focus on alleviating financial hardship in families facing cancer. Could you tell us more about your research?

I am a health services researcher interested in reducing cancer disparities. I’m really focused on medical financial hardship, which we in the cancer world call ‘financial toxicity.’ That’s a combination of high out of pocket costs from being under-covered by health insurance as well as lost income from work when people with cancer don’t have adequate employment or income protections. The latter tends to be more of a struggle for lower income people, those who work in the gig economy, and the working poor. 

Income protections is a particular interest of mine, and that’s where my research is focused now. For the GIFTT study, we are recruiting 2,500 low-income cancer patients from three cancer centers in Philadelphia. They will be randomized to either receive the control condition of treatment as usual, which is a financial resource navigation program, plus a one time payment of $500 to $1,000, or to receive the intervention condition of the same financial resource navigation program plus $500 to $1,000 per month on a debit card for 12 months. 

The main outcomes that we are looking at are quality of life; anxiety and depression; financial toxicity, for which there’s a distinct measure; and also mortality. We will be using administrative data to look at mortality outcomes to see if the increased income and reduced income volatility for these patients actually leads to improved treatment adherence and completion and increases survival. That’s the hope because there has been at least one landmark study that did find an association between financial hardship and cancer survivorship. 

We know that there are negative impacts for patients who encounter financial strain and these effects are seen to a greater extent, and with greater severity, in women, younger patients, and, of course, low-income patients and people of color. So it really is an equity issue around the cost of care.

Was your interest in financial toxicity something that was sparked during your post-MSW work at Coney Island Hospital?

At Coney Island Hospital, I saw a lot of financial hardship and a lot of patients with advanced cancer and other serious illnesses that needed palliative care. As a safety net hospital, Coney Island, like all NYC Health + Hospitals facilities, provides treatment to anyone, regardless of their insurance status, immigration status, or ability to pay. So access and cost were not barriers to care in that setting. What we did see were the ambient financial effects that are not directly related to the cost of care, so the income loss from not being able to work, which has direct implications for housing and food security. In studies done by my colleagues and at the center I worked at at Memorial Sloan Kettering, we found that food insecurity and housing insecurity are widespread among low income cancer patients.

Did you take medical social work classes when you were at Silver?

I actually didn't. At Silver I trained as a psychotherapist. I thought I would go into a psychoanalytic training program and then a private practice. I didn’t end up where I thought I was headed at all. The ACT team position at Coney Island Hospital was the first job that was offered to me. The pay was a big draw and I could gain clinical hours towards my LCSW. Then, in the course of my early years in practice, I came face to face with all of these issues of equity. I realized that is really where my heart is and it is the avenue that I wanted to pursue developing and testing solutions for.

Although you didn’t specialize in medical social work, did the skills you learned at Silver help you in those early years of your career?

Absolutely! The skills that I learned at Silver ‒ the skills of engagement and particularly engagement across cultural difference, and recognizing my privilege in those connections and interactions  ‒ were hugely important. I also came out of Silver with amazing training in group dynamics and an intuition about people’s interpersonal needs, their relational needs, and their intersubjectivities. That was really welcome on an interdisciplinary medical team. 

Was there a course or faculty member at Silver that was particularly influential?

I took Dr. Stanhope’s Advanced Social Policy ‒ Mental Health course and for my last paper of the semester, I wrote on therapeutic jurisprudence and psychiatric advance directives. I was looking at autonomy, bioethics, sovereignty, competence, and capability to make healthcare decisions when people suffer with chronic mental illness that is episodic in nature. I got an A and Dr. Stanhope wrote “you would be an amazing PhD student, I think you should consider applying to a PhD program.” I also built a relationship with Dr. Gary Holden, whom I had for Research II. Those are the two faculty members that I have really stayed in touch with. In terms of my pathway to a PhD program, every year while I was still in practice, I would check in with them and ask what they thought of different options. I got very different perspectives from each of them. They are both intellectual powerhouses and really important mentors for me. 

How did you come to be part of Dr. Stanhope’s Person-Centered Care Planning study team while you were pursuing your PhD at Hunter?

At Hunter, we were doing a lot of Community Based Participatory Research, which is a very valuable skill set for me to have but very niche. I wanted to complement that with experience on a Randomized Control Trial within the traditional medical model of research. Victoria had just started her NIH-funded study and she was looking for staff. Because I had stayed connected, I was able to join and learn about implementation science and the translation of knowledge into practice, cluster randomized clinical trials, and mixed methods.

What was your path to involvement with our Zelda Foster Studies Program?

When I first started the program at Hunter, I came in with an interest in palliative care and particularly disparities in palliative care. My mentor was Dr. Daniel Gardner, who had just received NIH funding for a study on disparities and access to palliative care among Black and Hispanic elders in New York City. He had previously been at NYU and was a faculty member in the Zelda Foster Studies program. The first paper I wrote as a PhD student was a collaboration with Dr. Gardner and Dr. Susan Gerbino, the Director of Zelda Foster Studies Program, on mentoring palliative and end-of-life-care social workers. Four years later, I began teaching in the Zelda Foster Studies Program’s Leadership Fellowship and I have also been a mentor for master’s students in the MSW Fellowship. 

Now that I’m on the faculty at SP2, I’m not sure if I will be able to continue to be involved in the Zelda Foster Studies Program but if I can, I’d love to. It’s an amazing program!