David B. Allen, MD (PG '84, '88), and Brittany J. Allen, MD '09, take turns with this reference

Two generations of Allens— David B. Allen, MD (PG ’84, ’88) (left), and Brittany J. Allen, MD ’09— are on the Department of Pediatrics faculty.

A father and daughter pair of pediatricians are making an impact at the University of Wisconsin School of Medicine and Public Health (SMPH) and American Family Children’s Hospital, where they trained and practice. Their personal stories meld and diverge, and they honor each other’s differences—all for the love of their patients and their family.

Rewind to the growing-up years for Brittany J. Allen, MD ’09, and the family was frequently discussing an “issue of the day” over dinner, says her dad, David B. Allen, MD (PG ’84, ’88). Now a professor and head of the Division of Endocrinology and Diabetes in the SMPH Department of Pediatrics, David Allen’s early research focused on the effectiveness and ethics of treating children with human growth hormone (hGH). He often came home and described—de-identified, of course—a challenging patient he saw at work or read about in the literature. Or Brittany Allen’s mom, Sally Allen, might return from teaching students with learning disabilities and share a helpful approach she’d discovered. Today, the grown siblings remember those discussions as formative.

“Our parents see each of us as individuals who bring our own qualities to the table,” says Brittany Allen, who joined the Department of Pediatrics faculty in 2013. “About our personal and professional lives, they say ‘You are driving this bus, and we are excited to see where it’s going!’”

Brittany Allen’s passion and talent for teaching is apparent, says her father, who adds with a laugh, “The tables have turned from her to me being ‘The Other Dr. Allen.’”

Watching his daughter—a specialist in the care of transgender, non-binary and gender-diverse (TNG) youth—advise residents or develop innovative modules for medical students reminds him of his 15 years as the program director of the Pediatrics Residency Program.

“We both strive to help people develop ways of thinking rather than memorizing knowledge,” says David Allen.

He and Brittany Allen each hold awards that recognize their efforts. She has twice earned the Top 25 Pediatric Teachers Award based on evaluations from SMPH students and residents. And David Allen has received numerous teaching honors, including the Parker Palmer Courage to Teach Award and the UW Health Clinician Educator Award.

Other parallels exist for David and Brittany Allen. They both left Midwestern homes for college on the coasts—he to Stanford University in California, and she to Wesleyan University in Connecticut—and were eager to become anything other than a doctor like their fathers. They earned undergraduate degrees in the humanities while quietly satisfying pre-med requirements. While David Allen attended medical school at Duke University in North Carolina before coming to UW-Madison for his pediatrics residency, chief residency and fellowship, Brittany Allen chose the SMPH for medical school. And now, they both embrace Madison as home.

A generation back

For David Allen—whose father, Richard Allen, MD, was a highly respected pediatrician in the Chicago suburbs—it was a challenge to navigate a career path that was similar yet different. While sharing his father’s love for medicine, and specifically pediatrics, he recalls, “I see how choices in life reflect a balance between accepting inherited professional attractions while taking paths that separate us from our parents.”

Thankfully, he says, “My parents were always excited to see how my story was turning out.”

Attracted to an academic pediatric specialist career, David Allen joined the SMPH faculty in 1988. His early research improved newborn screening for endocrine disorders and described how recombinant hGH could reverse growth failure in glucocorticoiddependent children, and—with colleague Aaron Carrel, MD (PG ’98)—improve physical function and body composition in children with Prader-Willi syndrome. David Allen is lauded equally for his work on the growth-suppressing effects of inhaled corticosteroids in children with asthma, for which his growth study design is regarded by the U.S. Food and Drug Administration as the gold standard for analysis of the systemic effects of these medications in children.

Today, David Allen leads the Department of Pediatrics’ Endocrinology and Diabetes Fellowship Program. Over the past decade, he and his colleagues have focused on improving the prevention and treatment of childhood obesity, insulin resistance and Type 2 diabetes. And in 2010, Nan Peterson, RN, MS, and David Allen co-founded the Dane County Healthy Kids Collaborative to advocate for and create healthy physical activity and nutritional environments for children.

Referring to his longtime teamwork with Norman Fost, MD, MPH, an SMPH professor emeritus and pediatric bioethicist, David Allen shares, “From the get-go, my most recognized work was collaborating with Norm to look at the ethical challenges of growth hormone treatment.”

Since then, David Allen has continued to analyze and write about prescribing hGH and other endocrinology treatments in ethical and cost-effective ways. He credits his strong interest in the “social conscience” aspect of medicine to his mom, Joyce Allen, RN.

“It made sense to her that pre-med studies should interface with humanities in college,” says David Allen, adding that his daughter shares his concern with medicine’s ethical and philosophical underpinnings.

The next generation

Having completed a pediatrics residency at the Ann and Robert H. Lurie Children’s Hospital of Chicago, where she also served for a year as chief resident, Brittany Allen’s career calls upon her expertise in the burgeoning field of health and wellness for TNG children and adolescents. She also is committed to improving health care access and care for lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ+) youth.

Noting that her undergraduate education piqued her interest in health and sexual education, she was thrilled when the opportunity to co-direct—with Jennifer L. Rehm, MD—the groundbreaking Pediatric and Adolescent Transgender Health (PATH) Clinic at American Family Children’s Hospital materialized.

PATH is the first clinic of its kind in Wisconsin to provide gender-affirming transition care for TNG children and adolescents, and services for their families, using the most up-to-date knowledge. As of April 2020, the clinic has provided care for 350 youth from Wisconsin and Illinois; Brittany Allen has seen more than half of these patients. Since 2017, the clinic’s frequency has doubled, and it’s expected to grow an equal amount within the next year.

While PATH’s clinical work is recognized as a national model, Brittany Allen notes the equal importance of the faculty and staff’s work toward enacting systemic change. She engages with health care, academic and community organizations as an expert and an advocate. At UW Health, with the goal of helping practitioners know how to best address their patients, she founded the LGBTQ+ Patient Care Task Force, which has initiated the use of a “preferred name” field and the Sexual Orientation and Gender Identity SmartForm in the organization’s medical-record system.

But “just inputting that information is not enough,” Brittany Allen says. “You also have to teach people to create a truly safe and affirming environment and to understand the data that’s being captured.”

To ensure ongoing cultural integration, the task force advocated for the creation of the UW Health position of chief diversity officer, a role now held by Shiva Bidar-Sielaff, a member of that group.

“We realized that we needed to hear the voices of people reflected in our policies,” shares Brittany Allen, who used this inspiration to found the Transgender Youth Resource Network, and serve as the principal investigator of a statewide survey by the multidisciplinary Wisconsin Transgender Health Coalition Data Team.

A report by that team described significant gaps in the medical and mental health care of TNG youth and provided guidelines for future improvements.

In just the few years since those findings, UW Health’s policies on access to bathrooms and changing rooms ensure that all patients have access to facilities they consider safe.

“It’s a good start,” she says. “But we have a lot more work to do in terms of thinking about how we honor a person’s gender identity and experience in different types of care.”

“Although I’d like to think we’ve moved beyond the 101-level of information about these issues, patients often describe interactions that are riddled with mistakes or assumptions, such as calling patients by the wrong name, ignoring their gender identity, or creating undue attention to it in a clinically inappropriate setting, such as when a person has a sinus infection or a sprained ankle.”

Stage left, stage right

David Allen says, “As I begin to ‘exit stage left’ in my career, I am excited about Brittany’s contributions to our colleagues, patients and students. She’s asking, ‘How do we think about this new thing we’re doing?’ ‘How are we going to do this responsibly and effectively?’ ‘How do we help families navigate difficult decisions in doing the best thing for their kids?’ And that’s where I see parallels between my era of growthhormone treatment and her era of caring for transgender individuals.”

Brittany Allen chimes in, “I appreciate that both of my parents are open to learning from their kids. It’s been great to work with my dad and to be able to teach him about my field.”

A growing family tree

David and Sally Allen have thrived on watching Brittany Allen and her siblings grow and change, and they are celebrating yet another generation, as Brittany Allen and her partner, Peter Witucki, have had children.

The elder Allens admit to being preoccupied with “spoiling the heck” out of their grandchildren, now ages 7 and 4.

“I’m fascinated by how generations both follow in and separate from one another’s footsteps, and how much less complicated it can be to emulate grandparents rather than parents,” observes David Allen, who adds with a laugh, “In our grandkids’ eyes, we can do no wrong!”

As for whether he hopes one of the grandchildren chooses the path of medicine, he concludes, “While there are some things I miss about the profession I entered 40 years ago, medicine keeps reinventing itself and always will present wonderful opportunities to serve and discover.”