Department of Pediatrics, UW Madison
From his arrival at the Department of Pediatrics in 1990 and for the next 30-plus years, David Wargowski, MD, professor in the Division of Genetics and Metabolism, has served tirelessly, addressing genetically based diseases and health conditions of the region’s children. He will step away from his clinical work at the Waisman Center in June and continue monthly outreach clinics in Green Bay through November before retiring on December 1.
“Three to five percent of children are born with a major congenital anomaly, and about that many are born with some significant developmental problem,” Wargowski explained. “That’s roughly one child per classroom in the schools. There are a lot of families dealing with these issues. The American Family Children’s Hospital and the Waisman Center afford us an opportunity to do things for families that’s unique. The field is constantly changing, with new technologies being developed all the time. It’s really rewarding.”
Biological sciences hooked Wargowski’s interest early on. When he took human genetics during his time at the University of Wisconsin–Stevens Point, he knew he’d found his subject. Genetics engaged and challenged his intellect and fed his imagination. It revealed to him so many conditions with obvious biological bases that most people were not aware of. A friend suggested that medicine was a profession that could include genetics. Wargowski took the suggestion to heart, though no one in his family had ever considered medical school.
“It was intriguing to me to consider how to help people disadvantaged with those conditions to have better lives,” Wargowski said. He and other students, including his wife, Lori, formed a pre-med group with a faculty physiology professor as a mentor. (Wargowski still maintains a connection with that professor.) He knew he wanted genetics to be a focus of his life. Medicine was the way: he stepped forward, followed the path on, and never looked back.
When Wargowski joined the department of pediatrics faculty in 1990, his position was originally created to expand outreach services of the division. He became the director of the Clinical Genetics Outreach Services of the (then) University of Wisconsin Clinical Genetics Center, located in the Waisman Center. The position was also partially supported by the state’s newborn genetics screening program. His outreach genetics work took him throughout the state, including Eau Claire and LaCrosse, Ashland and Rhinelander, and the Fox Valley. He also worked with hospitals in Wausau, Rockford, and Green Bay. His relationship with Green Bay’s St. Vincent Hospital as medical director of clinical genetics services has lasted to the present day.
“Doing outreach allowed me early on to nearly merge two areas I was interested in — rural pediatrics and medical genetics,” Wargowski said. “Those seem almost opposing areas, but through outreach I could combine them. It is tremendously gratifying to meet people where they are emotionally, intellectually, and geographically, and provide service to them.”
Over the years, outreach funding was slowly lost as state support went to other priorities. More of his effort became focused on services at the Waisman Center and its emphasis on developmental disabilities and neurodegenerative diseases. Evolution of the field and the applicability of genetics to an increasingly broad range of medical specialties has changed the division focus — as well as the nature of its patient population.
Wargowski was chief of the Division of Genetics and Metabolism from 2008 to 2020. His has also served as medical director for a project addressing fetal alcohol spectrum disorder identification and treatment, plus related treatment outreach and outcomes projects between 2003 and 2017. He has been the past program director for the division’s residency and fellowships, in addition to director of the clinical molecular genetics fellowship training program (today’s Laboratory Genetics and Genomics Fellowship).
Wargowski has taught genetics topics to all levels: undergraduate, graduate, medical school, and professional education, as well as public and hospital presentations, both state and regional. He has published 20 refereed papers as part of research teams, three non-refereed articles, plus 20 abstracts and posters for conferences. His work has brought in years of grant support. One might be inclined to think that there is not one Dr. David Wargowski, but rather a team of Dr. David Wargowskis always at work!
In the positions he has held and in the health care organizations he has served, Wargowski has impressed colleagues and patients’ families alike with his extensive knowledge, astute diagnostic skills, and deep compassion.
Maria Stanley, MD, professor and chief, Division of Developmental Pediatric and Rehabilitation Medicine, expanded her role in July 2023 to become interim chief of the Division of Genetics and Metabolism. She recently nominated Wargowski for a UW Health Physician Excellence Award in Regional Services.
“Dr. Wargowski has been a champion of regional care since 1990,” Stanley recounted. “He has established significant relationships with local teams and cared for patients traveling from as far as the Upper Peninsula of Michigan to receive care. Dr. Wargowski’s clinical and leadership expertise has been invaluable, particularly in the development of genetic services in northeastern Wisconsin. Without his efforts, these services would not exist.”
A family wrote in a grateful letter:
“Dr. Wargowski came into our lives at a time of uncertainty. We were searching for answers for our medically complex child who was stumping everyone. He and his staff immediately put all of us at ease. He is incredible at asking questions to dig deep into getting closer to answers! His reassurances and support of our entire family has been incredible. His strong advocacy for our daughter’s quality of life has led to continued interventions so she can be in the hospital and clinic setting less and just be a kid as much as possible. We are very grateful for Dr. Wargowski!”
Five Questions for Dr. David Wargowski
How has your career surprised you, compared to how you had expected it to develop when you began?
What has surprised me, and perhaps shouldn’t have, is that genetics became as important and “the future of medicine” that people said it would be 30-35 years ago. We get a lot of referrals from other specialists now that we didn’t used to get because a condition that they’ve always taken care of is now known to have a genetic cause. That is part of our division’s “demand” problem: we can’t find enough people going into genetics now. It surprised me that those predictions of genetics “taking off” came true.
What do you consider to be your biggest achievement?
Shepherding the division through some tough periods while I was division head is at the top of that list.
What has been your largest obstacle to overcome?
The biggest issues by far have been the recruitment issues and continuously struggling to integrate what we do clinically into the health care system. Our technology advances so quickly that it outruns the process of building an evidence base for clinical utility, and we are continuously negotiating with insurance providers and Medicaid to justify the value of what we do.
What advice would you offer to new physicians just starting out?
First, remain curious. I think curiosity has been a driving force in my life and one of the main reasons I pursued this career – curiosity about what is really going on inside cells of the human organism, especially during prenatal and child development, processes we too often take for granted but which we well know are unimaginably complex and vulnerable. Second, consider a career in medical genetics! For those in genetics, I think I’d offer the advice that I was given — and pretty much ignored — which is to find a niche and develop it.
Do you have specific plans for your retirement?
My wife and I like to travel. We’re hoping to do more cycling tours and to spend more time enjoying what Madison and Wisconsin have to offer — the things I haven’t taken enough advantage of during my career.
Photo by Bob Gordon/Department of Pediatrics
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