Clin-STAR Journey Story

Mentorship, Multidisciplinarity, and Momentum: The Research Journey of Dr. Scott Bauer

Dr. Scott Bauer, MD, MS, is a general internist with a primary care practice at the San Francisco Veterans Affairs Medical Center. He is also a translational epidemiologist and clinical investigator. He serves as a member at the Bakar Aging Research Institute, the Kidney Health Research Collective, and the Women’s Health Clinical Research Center. His expertise and experience focus on primary care for older adults and geriatric urology. He has investigated how diet, exercise, frailty, mood, and cognition intersect with the aging urinary system.

Dr. Bauer’s initial research in graduate school focused on identifying lifestyle risk factors and interventions for prostate cancer survivors. During his training to become a general internist, he saw many older patients in the clinic suffering from the same symptoms that were driving cancer treatment decisions, and he recognized that their needs were not being met by the organ-focused approach used by most urologic surgeons. But it was Dr. Louise Walter who truly drew him into the field of aging research through their interactions via the University of California, San Francisco K Scholars Program. In addition to providing scientific and clinical feedback, Dr. Walter introduced Dr. Bauer to AFAR and other organizations that provide research resources, from mentorship to funding, to deep expertise in a multitude of aging topics.

As Dr. Bauer thinks back on his progress to date, he remains most proud of the work that he completed with support from the Claude D. Pepper Older Americans Independence Center’s Research and Education Component (2019) and GEMSSTAR (2020). The feedback and support he received during those initial projects gave him the confidence to fully commit to his geriatrics-informed research program. The projects were rooted in anecdotal and personal experiences from his lifestyle research and primary care clinic, and they allowed him to apply his epidemiological expertise using cohort data to produce a strong foundational understanding of how frailty and lower urinary tract symptoms interact at a population level. This initial work continues to inform the field of urology studies in older adults, as other investigators pick up where he left off and explore causal mechanisms and novel interventions.

Dr. Bauer’s Beeson project was a direct extension of his earlier work, as it explored specific mechanisms of how age-related changes in skeletal muscle and mobility lead to urinary symptoms. The work focused on the identification of novel biological mechanisms and led to multiple publications that have provided the preliminary data needed to move from epidemiological studies, based on previously collected data, to clinical trials. “When I started this research program, I was connecting dots from data that already existed. As I pushed forward, I needed to collect primary data, and quickly found that measures of urologic, physical and cognitive function required personnel and equipment that were very siloed. Participation by older adults required them to walk across a large campus for different tests and measures. That was extremely difficult or impossible.” Thus, Dr. Bauer worked to identify ways to create multidisciplinary teams and stakeholders to improve the experience of participants in the PROUD (PRescription Exercise for Older Men with Urinary Disease) Pilot Study funded by the National Institute of Diabetes and Digestive and Kidney Diseases.

Mentoring is a key component of Dr. Bauer’s success. In addition to Dr. Walter, who introduced him to the Clin-STAR community, he credits Dr. Ken Covinsky, Dr. Anne Suskind, and Dr. John Newman, who all helped Dr. Bauer expand his research into other areas of aging research. Overall, Dr. Bauer underscored the importance of building a strong team of colleagues in different specialties and with diverse experiences. He thinks that Clin-STAR-affiliated events, initiatives, and interest groups are the perfect place to meet like-minded colleagues and future mentors. The first step in an aging research career is attending events and networking He also recommends the Clin-STAR Distinguished Professorship to help bring an inspirational aging researcher to your own subspecialty meetings. Dr. Bauer recently sponsored Dr. George Kuchel to join a urology annual meeting, and it led to the formation of a new uro-aging interest group.

While Dr. Bauer remains very optimistic about the field and future, he acknowledges that there are many challenges. The common issue is establishing “buy-in.” When attempting to introduce new concepts, there is always resistance, and primary care and urology were no different. By building and sharing a strong case for why older adults need holistic and patient-centered care for their urinary symptoms, adoption of the latest guidance increases, and multidisciplinary team efforts that combine geriatrics and urology expertise along with allied health professionals will become more common.

When asked what advice he would give to those interested in working in the aging research space, Dr. Bauer was very encouraging. He said, “There is so much to learn. There is an immense need, and now is the time. I have touched a lot of different fields and spaces as a generalist. There is no field as warm and welcoming as aging research. This is one of the most collaborative and supportive clinical research communities.” He went on to say that the field of aging research is at a position in time where the need has never been higher. He said, “The aging of our population means that more patients will require geriatric expertise, and advancements will require those in all subspecialties to truly embrace and prepare for the nuanced needs of older adults. The medical and research systems are generally very unfriendly and not prepared for older adults’ needs.” He hopes that more geriatrics enthusiasts join the effort. “Finding a niche where you are the only aging person can be intimidating at first, but it can be really impactful. It requires a lot of learning and failing, but there will be rewards. And those lasting results are worth all the effort.”