Dr. Kari Simonsen Leads The Way In Pediatric Care At Omaha Hospitals

Dr. Kari Simonsen. She and her husband, Alan Horstman, a middle school math teacher, have two children.

Kari Simonsen on graduation day at Glenwood Community High School in 1993.

It takes a special kind of person to be a pediatrician - one who understands and appreciates the family dynamics that often come with the job.

Dr. Kari Simonsen, Chair of the Department of Pediatrics at the University of Nebraska Medical Center (UNMC) and Pediatrician-in-Chief at Children’s Nebraska (Hospital and Medical Center), understands the importance of those dynamics in part because of her upbringing in a family of teachers. Her parents, Jens and Eileen Simonsen, were both educators in the Glenwood Community School District.

“Focusing on pediatrics probably came pretty naturally from growing up in a family of educators,” Dr. Simonsen said during a recent interview from her office at Children’s Nebraska hospital and medical center in Omaha. “There really aren’t any doctors in my extended family, but there are a whole lot of teachers. So, I think working with kids and with families was something that I definitely saw my parents do and it felt a very natural thing for me to do.”

Dr. Simonsen said some of her fellow medical school students were turned off by pediatric medicine because of the required interaction with the patient’s family. She embraces that involvement.

“You know, there are medical students who get into the hospital environment and start seeing kids and families, and they’re like, ‘This is too complex to manage both the patient in the bed but also to manage a family surrounding them,’” she said. “Those of us that get into the environment are like, ‘Yes, of course you’re going to be taking care of everyone.’ We’re the ones that become pediatricians.”

Infectious Diseases Doctor

In addition to her leadership roles in pediatric medicine at both UNMC and Children’s Nebraska, Dr. Simonsen is a Professor of Pediatric Infectious Diseases, another specialized area that’s not for everyone. It was during her undergraduate days at the University of Nebraska-Lincoln, while taking microbiology and parasitology classes, that Dr. Simonsen developed a strong interest in infectious diseases. While many of her classmates were bored by the study of organisms, she found it fascinating.

“I was one of the crazy ones, I guess,” she said. “I thought that class was really fun, so at the end of undergrad, infectious diseases was high on the radar.”

A 1993 Glenwood Community High School graduate, Dr. Simonsen earned her undergraduate degree at UNL and attended medical school at UNMC. She did an internship and her residency in pediatrics at the Indiana School of Medicine and a fellowship in pediatric infectious diseases at Brown Medical School in Rhode Island.

Her first full-time position was at UNMC as an assistant professor of pediatric infectious diseases.

“It was a teaching role but it was mostly seeing patients,” Dr. Simonsen said. “We were a small team and I was seeing patients almost every day. In the hospital, we are a consulting team, so we take care of kids when the pediatrician in charge requests our presence. We see things like complex or unusual infections, kids who are immune compromised and have underlying medical conditions and then are at risk of rare unusual infections. We see some interesting patients for sure.”

As a department chair for UNMC, Dr. Simonsen leads a team of almost 200 other pediatricians and another 100-plus staff members that serve both UNMC and Nebraska Childrens.

“It’s a joy, but everyday is a challenge,” she said. “We are the pediatric workforce really for the state of Nebraska for pediatric care, - everything from oncology, cardiology, infectious disease team, pulmonary and all the different specialties. They all align under the department of pediatrics.”

Nebraska Childrens is the only pediatric-exclusive hospital in Nebraska.

Front Line Of COVID-19 Fight

Dr. Simonsen and her colleagues in infectious diseases found themselves on the front line when COVID-19 surfaced in 2020. UNMC treated some of the very first COVID-19 patients in the United States at the start of the pandemic and was a major player in the testing of vaccines.

It was an interesting time to be an infectious diseases doctor and a pediatrician.

“That whole time dramatically changed the work that I was doing,” Dr. Simonsen said. “It also ended up aligning with my shift in leadership roles and coming into this more administrative role.”

In the early stages of the pandemic, Dr. Simonsen said one of the primary roles of the infectious disease doctors at UNMC was managing the medical center’s workforce and ensuring that people felt safe coming to work.

“For quite a long time, we didn’t have a vaccine at all,” she noted “So, then it was really a matter of making sure that we had teams that were safe to take care of patients – not getting each other sick and not becoming sick to put kids potentially at risk.

“We changed a lot of our usual work flows to be able to more sensitive toward the potential risk of COVID, when we didn’t have an ability to test. Remember, in those beginning days, we didn’t even get tests. We had to really make the assumption that everyone had COVID until we knew they didn’t.”

Policies and procedures at UNMC were being modified regularly as COVID testing and eventually vaccines became available.

Like many hospitals across the country, UNMC saw a surge in adult patients during the initial months of the pandemic. Many hospitals reduced the capacity for pediatric patients to make room for the increase in adult patients.

“It was really interesting working in pediatrics,” Dr. Simonsen said. “We had some organizational challenges around reducing capacity to better match the number of patients that were in the hospital.

“Nationally, this was a trend, too, where the pediatric workforce started to drift away from pediatric centers. Then, as cases started coming to pediatric centers, we didn’t have as ready of a workforce as we needed and ended up kind of going through the same cycle that adult hospitals had.”

To bring the staff numbers up to adequate levels, contract workers were brought in on a temporary basis.

“Now, four years out, I think that we’ve gotten much more sophisticated in how we can manage COVID and smarter in how we can manage our workforce,” Dr. Simonsen said. “Things feel lot more at a steady pace.”

Pediatric Vaccine Clinical Trials

One of the most rewarding experiences for Dr. Simonsen during the pandemic was serving as UNMC’s principal investigator for the Pfizer clinical trials for a pediatric COVID-19 vaccine. There was significant interest from families wanting to participate in the trials.

“Early on, there were many families that were really eager to get their kids vaccinated,” Dr. Simonsen said. “Then, we continued those clinical trials through boosters, managing those booster doses.

“We had 50 kids that were actually part of that study here. That was really rewarding to be able to contribute to that data collection and make sure the vaccine was safe and effective in kids.”

Unfortunately, Dr. Simonsen said, the abundance of misinformation and disinformation about vaccine safety that circulated during and after the pandemic, sometimes for political purposes, has made more Americans skeptical about getting vaccines, not only for COVID-19, but all diseases.

“As the information out there has included more misinformation that’s more readily available to people, it has influenced their overall sense of security in vaccines, which is really disappointing,” she said. “We’re seeing measles this summer, for goodness sake. As pediatricians, we continue to work closely with families around continuing to vaccinate.”

Dr. Simonsen noted that access issues during the pandemic put many children behind in getting their “usual” vaccines.”

Mentors, Role Models

Dr. Simonsen said her parents were definitely the most-influential mentors and role models she had as a child, but is also grateful for the education she received going through the Glenwood school system.

“We had great teachers in the schools in Glenwood,” she said. “I appreciated so many of them over the years, from elementary through high school.”

Dr. Simonsen participated in numerous activities during her high school days, including basketball and tennis, band, where she played the flute and piccolo in concert band, the piano in jazz band and was on the flag corps during marching band season. She was also a participant in individual and large group speech, which was under the direction of Marianne Driml and Mike Schmidt  at that time.

“That was probably my best learning about public speaking because obviously when you go to college and major in science, you don’t get any training in public speaking. “That’s the benefit of being in a smaller school – you can participate in most anything as long as you’re willing to commit to it and put in the work. I really liked that.”

The foundation that was set during her childhood days in Glenwood led Dr. Simonsen to a rewarding career.

“It’s indeed a privilege.” she said, “And I’m really grateful for the work I do.”

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