Happy Hour with Dr. Rachel Greenup

Between research, teaching, patients, parenting, and running, we caught up with our February Happy Hour special guest, Dr. Rachel Greenup. Dr. Greenup is a leader on the national stage working to create high quality, low cost cancer treatment for all Americans. Her research focuses on creating better outcomes for breast cancer patients, especially those struggling with the quality and cost of their care. In addition to treating patients, pioneering groundbreaking research, and leading teams in this area, Dr. Greenup serves on several national committees dedicated to improving cancer outcomes. Join us from 5:30-6:30 pm to hear Dr. Greenup talk about affecting change in medicine, overcoming the status quo and what keeps her inspired to do more. Tickets are free and drinks are on the house. RSVP to reserve your spot!



About Dr. Rachel Greenup


Dr. Greenup is an Associate Professor of Surgery and Population Health Sciences at the Duke School of Medicine and Duke Cancer Institute. In 2013 she founded the Duke Breast Cancer Outcomes Research Group and serves as the co-director.


In 2016, she received the National Institutes of Health Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) Award to evaluate how financial costs and burden relate to preference-sensitive decisions for breast cancer surgery. More broadly, her research focuses on aligning patient-centered care with high quality, lower cost treatment.


She serves on several national committees, including the Alliance in Clinical Oncology Ethics and Value Committees, the American College of Surgeons Cancer Care Delivery Task Force, the American Society of Breast Surgeons Legislative Committee, and the Editorial Board for the Annals of Surgical Oncology.



Ok Rachel, give us your whole life story. Just kidding—tell us a little bit about where you’re from, what you wanted to be when you were little, and what led you down the path you’re on now. 


The story starts before I do… My parents met their first year at Reed College in Portland, Oregon and went on to be one of the first husband-wife couples to attend medical school at Oregon Health Sciences University. They moved to Milwaukee, Wisconsin for their residencies where I was born.


After my parents divorce, I grew up in a blended family (“his, hers, and ours”), splitting my time between my two states. The Wisconsin household was characterized by six kids, Unitarian church, chores, and composting before it was cool. The Connecticut household was candlelit dinners, culture, and sailing along the New England coast. Four brothers, two sisters, me in the middle. A little more “Modern Family” and a little less “Brady Bunch.” But, I learned so much from my childhood - empathy, kindness, patience, flexibility, the importance of connecting with people who are different than me. My childhood experiences deeply shaped who I have become.


The first day of high school, I sat down next to my biology lab partner. He was the funniest, most magnetic human being I had ever met. Eight years later I married him. We celebrate our 20th wedding anniversary this spring. My husband reminds me there is a big world out there and that I need to enjoy it. He is an incredible example of what it looks like to really live. And what you can do when you are not afraid to fail.





As a child, I always wanted to help people. But, after watching my grandfather and father through their surgical careers, I was 100% sure I did not want to become a surgeon. Early in college it became clear to me that I wanted to apply to medical school. During medical school, it became clear that I wanted to fix people with my hands. Separating people from their disease through surgery is the most amazing privilege. And despite popular beliefs, surgeons and their patients have an incredibly strong bond. I was really drawn to the intensity of that. Apparently, genetics are strong.


To aspiring surgeons I’d say... make sure you love surgery more than the idea of becoming a surgeon. There is a difference. It is not always glamorous. If you can find something you love more, you should probably do that. But, if you love connecting with patients at intense times, working with your hands to remove pathology, sewing them together again, and supporting them as they heal, both physically and emotionally… you should be a surgeon. Then, it is worth it. 



Who are some of your earliest influences? Did you have any mentors or a key piece of advice you received?


My late grandparents were ahead of their time, and believed that women deserved to be educated and could do anything. My parents loved their work as physicians, yet never pressured my siblings or me to go into medicine. However, they instilled in us the importance of making a difference and being passionate about our life’s work, whatever that may be. 


The list of my mentors is long. Some are incredibly well-known and accomplished surgeons, others are peers that provide critical guidance when I am feeling lost. The greatest advice I ever received was to follow my passion.



Where do you find inspiration?


My patients are my greatest inspiration—women and men bravely facing cancer. When I get weary, I channel their strength and courage. And in Durham, there is inspiration around every corner.



What is the most important thing you didn’t learn in school? Who taught you this or how did you learn it?


Be generous with love, time, empathy, and forgiveness. 


So many people in my life demonstrated what generosity could do. My parents and grandparents, my in-laws. My childhood soccer coach. My bosses at the coffee shop I worked at in college. My siblings. My friends, and neighbors.


That quote, “People will forget what you said. People will forget what you did. But people will never forget how you made them feel.” It is true.





Tell us about the Duke Breast Cancer Outcomes Research Group.


In 2013, I founded and now co-direct the Breast Cancer Outcomes Research Group. My goal was to create a collaborative forum for researchers to exchange ideas, learn from each other, and push our science together. With guidance from my mentors, I established a research team that brings together doctors, students, residents, biostatisticians, grant writers and data analysts to solve problems in breast cancer care. We talk about clinical uncertainties and put our heads together to find answers to those questions.



You write a lot about the long term impacts of the financial burden of breast cancer treatment options and how those costs influence patient decisions. And the burden isn’t just financial, it’s emotional too. How have you seen things change over the years?


Healthcare costs have risen steadily over the past 50 years, outpacing national wages and the costs of living. High cancer treatment costs have resulted in cost-sharing, with unaffordable deductibles and out-of-pocket costs falling to patients receiving care. Financial hardship has become a common side effect of cancer treatment. We have a lot to learn about how cost transparency and communication might impact cancer treatment decisions, or how it might affect cost-reducing behaviors. I wish patients and their families knew they could ask about the costs of their medical care, and if need be, for help navigating the financial aspects of their treatment. I wish physicians knew that medical recommendations impacted what patients paid. And, I wish we could improve early conversations about the costs and burden of treatment.



What’s your dream headline in relation to the work/research you’re doing?


High Quality, Affordable Cancer Treatment for All Americans



A parent, a surgeon, associate professor, a researcher, a runner...the list goes on and on! How do you unwind, relax, and care for yourself?


Parenting, surgery, teaching, research, running… one aspect of my life fuels me for another. We should all spend our time focused on the things that really matter to us and let go of the things that do not. Time with my family and friends, quiet, being in nature, laughing with my husband, coming home to my children, weekends at the beach. And sometimes I need to shut the world out for a day or two.





Running is not only an outlet for you, but you have also run competitively and led teams to run in order to raise money for organizations like local non-profit Pretty in Pink Foundation which provides financial assistance for life-saving treatments to breast cancer patients across North Carolina. When did you first start running? What drew you to running and how has that practice impacted you?


I started running at age 12. I love being outside and in my own head. When I moved to Durham, my neighbors (and now some of my best friends) invited me to run with them in the mornings and train for races. Imagine a group of strong, professional, women and their dogs running in the dark with headlamps on before facing the day. Throughout my life, it has been so important for my mental, physical and emotional health.



If someone was visiting you in Durham for the first time, where would you take them? Any best kept secrets or fave places? What’s a not to be missed spot for you?


Always Mateo. Always the trails. DPAC and Duke Chapel. And of course, V&V.



What’s the first thing you do in the morning and the last thing you do at night?


The morning is triple checking my calendar, coffee and gratitude. The night is snuggling on my family and gratitude.



And as it is Happy Hour, what’s your beverage of choice?


Chardonnay in town. Gin and tonic at the beach.