Melissa Li-Ng, MD

Podcast Transcript

Cara King, DO:
Hello, everyone. Welcome back to Inspirations and Insights. This is Dr. Cara King here, and thank you all so much for joining us. We are excited to have Dr. Melissa Li-Ng on our episode today. Melissa joined the endocrinology department here in Cleveland, Ohio back in 2009.

Since this time, she has had many incredible leadership roles. Including starting the endocrinology department in Abu Dhabi back in 2014. Most recently, she was appointed the medical director in international operations since 2019. She initially oversaw the collaboration with the Luye Medical Group in Shanghai.

Her role has now expanded to overseeing the clinic's growth in the entire Asia Pacific region. On today's episode, she discusses her childhood in lower Manhattan and New York City, the importance of meeting patients where they are. Her experiences in both Abu Dhabi, as well as Shanghai. We hope you enjoy.

Mary Rensel, MD:
We are very excited today here at the WPSA podcast to welcome Dr. Melissa Li-Ng. Welcome, Melissa.

Melissa Li-Ng, MD:
Thank you so much, Mary. Thank you, Cara. Happy to be here.

Mary Rensel, MD:
Dr. Li-Ng is the medical director of international operations here at Cleveland Clinic. Tell us about that role. What does that entail?

Melissa Li-Ng, MD:
Well, I have been a Medical Director in International Operations for about two years now. Initially, overseeing our Shanghai hospital project with Luye Medical. That role has expanded to overseeing the (Cleveland) Clinic's growth in the Asia Pacific region.

Mary Rensel, MD:
Is that all, just the whole Asia Pacific region. Is that all? Tell us more. What's happening?

Melissa Li-Ng, MD:
Just about 60% of the world's population!

Mary Rensel, MD:
Do you have everyone cared for in that population, Melissa?

Melissa Li-Ng, MD:
Well, I really believe in the (Cleveland) Clinic's model of care and our patient-centered quality and care. Really, seeing opportunities to expand our care delivery to Asia Pacific is really important to me. I think that patients there really want and would appreciate the level of care that we provide here locally in Ohio to be available to them in Asia.

Mary Rensel, MD:
I love it. I want to take you way back. I have read that in your home growing up, there was a few different languages spoken. You likely were the translator when you went to the doctor or the school. Is that true as a child? Did you help your parents understand what the doctor or the nurse was saying, or understand what the teacher was saying?

Melissa Li-Ng, MD:
Yes. I was the translator for my parents at the doctor's office, at school, in court, in various situations. I grew up in lower Manhattan in New York City in Chinatown. My first language is Chinese. My dad actually grew up in Cuba. He is a Chino Cubano. His side of the family spoke Spanish. We grew up hearing Chinese, Spanish, and English.

Mary Rensel, MD:
I love it. Go back to that time of your life, what do you wish the doctors knew about your family?

Melissa Li-Ng, MD:
I wish the doctors knew that my parents worked every day. From morning until 11:00 PM at night. My dad only had Mondays off and he would basically sleep in. My mom was a stay at home mom until my father passed away at the age of nine.

Mary Rensel, MD:
I'm sorry.

Melissa Li-Ng, MD:
Then, she went back to the garment factories to work. As a single parent and raising three young kids, she had to work from early morning until late at night in order to make enough for us to survive. Me and my sisters basically were very independent.

Melissa Li-Ng, MD:
We really had to band together to take care of ourselves, whether it was going to the doctor, and not having a parent around. Saying to the doctors or nurses that, "Oops, mom's busy, but we're here to get our vaccinations."

Melissa Li-Ng, MD:
Even when I went to get my glasses. I had to pay out of my own earnings for my glasses. I basically forged a letter from my mom saying that I have permission to get glasses.

Mary Rensel, MD:
Wow. Do you think you see that same pattern in some of the patients you currently treat?

Melissa Li-Ng, MD:
Well, I certainly see patterns particularly at the diabetes center, where I practice at main campus. In terms of patients having difficulty accessing good health care, as well as healthy foods because of their work needs or their childcare needs, or the needs that their elderly parents may have.

Melissa Li-Ng, MD:
That just makes it really difficult for them to be able to come to appointments. This held true for my family. Also, we think of people who don't show up to appointments as noncompliant, when actually they just can't get there because putting food on the tables important for the family. I lived that every day of my life.

Mary Rensel, MD:
How do you bring that to some of the residents or medical students who may not know that life? They may have always had a parent home with them. I've seen that you've said in other interviews, that groups of people get labeled in medical care, that they're non-compliant, or they're like you said, lazy.

Mary Rensel, MD:
That's not the truth. The labels aren't fair or accurate. How do you bring that to light for the young doctors that are in training, and seeing patterns that they assume the issue is laziness or not working, when indeed, the reality is something very different.

Melissa Li-Ng, MD:
One of the questions that I ask my patients when they come in is, "How can I help you?" It's really seeing, meeting the patients where they're at. I think as physicians, we have an agenda. We have a certain criteria that we want the patient to meet. As an endocrinologist, I want everyone's hemoglobin A1C to be less than 7%.

Melissa Li-Ng, MD:
I want their blood pressure to be less than 130 over 80. That's what I want. I think that's what the patient wants. Actually, they may not be able to get there without meeting certain needs. In approaching the patient and asking them, "How can I help you? Why do you want to get better? What are your goals for your health?"

Melissa Li-Ng, MD:
We may get unexpected answers. For my mom, her goal, in terms of her health, was to be healthy enough to be able to make enough money to feed her three children. For some of my other patients at the diabetes center, their goals in their health is to be able to take care of their grandchildren.

Melissa Li-Ng, MD:
I think for medical students and other trainees who are going through their journey of becoming a provider, I think it's really important to be able to step into the patient's shoes. To get out of our own agenda, and to really imagine being in that patient's setting. In that patient's life, in order for them to meet their own needs.

Melissa Li-Ng, MD:
I tell my patients, I say, "I'm here to equip you with what you need. If you can't afford the $800 vial of insulin, I shouldn't prescribe it for you. Where can we start? How can I help you? What do you need? Is it healthy food? Is it bus passes to get to your appointment? Is it time off from work?"

Melissa Li-Ng, MD:
That's where I start the conversation. Not that I throw out all of the guidelines for care, but I do put those aside in my visits with the patient, and really talk to them about what they can do, and what they need.

Mary Rensel, MD:
That is a beautiful partnership. I love it.

Cara King, DO:
Yes, Melissa, your words are striking me. Really incredibly deeply, because I'm thinking about just even my own clinic schedule. We're on this really tight schedule where I need to see 25 patients in this day and my patient shows up 15 minutes late to her 20-minute appointment and sometimes, I'm going to be honest with you, my lens is like, "Why are you late? Now I'm really late for my next patient."

Cara King, DO:
Just having that insight is how hard it may have been for that patient to get to my office that day. Really shifting your lens and understanding that they have an entire life out there that they're trying to deal with. Maybe kids and working, and trying to get their kid to school on time, and packing their diaper bag to get their baby here, and all the things. Really keeping that perspective. That's really powerful.

Melissa Li-Ng, MD:
I had a patient who came with her two foster children. I really just praise her for being a hero in terms of taking on two foster kids. Bringing them to the diabetes center to see me, but also telling her like, "If you need to stay home and you can't come in, I can just give you a call and see how you're doing. You bringing an infant and a two-year-old foster child, it's just a lot of work to come and see me."

Melissa Li-Ng, MD:
I told her, I appreciate her coming in, but there are ways that I can help to meet her needs without having her to go through so much trouble to come into the center. I really take to heart some of the things that our patients have to go through. I was seeing another new patient for uncontrolled diabetes, but what really bothered him was constipation.

Melissa Li-Ng, MD:
Of course, that bothers everyone. He actually didn't want to talk about his diabetes. All he talked about was his constipation. When I asked him, "How can I help you?" He goes, "Doc, I know my sugars are really bad, but man, I am so constipated. I don't know why."

Melissa Li-Ng, MD:
I said, "Well, it could be because your sugars are really high and you're dehydrated. Why don't we talk about your constipation? Figure out what you can eat and I could give you some medications to help with that. I'm going to bring you back to really talk about the diabetes. Again, improving your sugars is going to help improve your constipation."

Melissa Li-Ng, MD:
He was a happy camper because I took care of the thing that he was most concerned about. He really wasn't ready to hear about all the things that he needed to do for his diabetes.

Cara King, DO:
You nailed it. The patient's not ready to tackle what maybe your agenda is, it's not going to work. I've heard, you mentioned as well, it's not just your patient, it's their entire environment at home and their family at home, and everything else that's going on.

Cara King, DO:
You inadvertently tackled some of his sugar issues by helping him poop. By changing his diet and doing those things. You secretly were helping his sugars but you were also helping with what he came in to talk to you about. That's a ninja move. That's a professional ninja move. I like that.

Melissa Li-Ng, MD:
That's right. You can do it all in five minutes. That's the nice part of it. I used to have this whole, I think 10 minutes spiel. I once timed myself, a 10 should be spiel on diabetes. 30 to 60 minutes of physical activity every day. You need to do 150 minutes of exercise every week.

Melissa Li-Ng, MD:
I went into the whole diet thing and then I thought, "Man, that spiel doesn't work." You really just need to get at why people are motivated to be healthy and some people aren't. Sometimes you just have to be very prescriptive. When people are motivated and you understand the why.

Melissa Li-Ng, MD:
You use that to motivate them and encourage them to develop healthy habits, it's very powerful. They see it and they become so encouraged and they start believing that this is going to work, and the trust is built. That part's just a lot of fun. I think that's the most rewarding part about being a physician. That is very impactful.

Cara King, DO:
It's so true. Again, you're making my brain work. The reason a lot of us go into medicine is because we like connecting with people. We like that connection. What I found though, is when I first got out into practice, my brain was so filled with a bandwidth of what tests do I need to order?

Cara King, DO:
Should I be getting a biopsy here? All those things, that sometimes I lose that connection with a patient and I'd be counseling them and I'd be very scripted and I'm like, "This isn't me." What I've really found is the more comfortable I am with my field, the more connection I can have again because I'm actually present and listening to the patient.

Cara King, DO:
It's funny, I myself have done a 360 there and gotten back to connecting, which is why I went into the field to begin with.

Melissa Li-Ng, MD:
That's great. I'm glad to hear that. I do remember coming out of fellowship and ordering all these labs for everyone. Every patient I saw had a CBC, CMP, TFTs, A1C, lipid panel, vitamin D level. Then I was like, "What am I doing? Is this even the right thing for the patient?"

Melissa Li-Ng, MD:
I think as I developed my practice and developed these connections with patients, and then understanding which patients need what, you can't put the patients through the same process. I think that's the art of medicine.

Melissa Li-Ng, MD:
There's the science and then there's the art of delivering care and practicing medicine. I hope we don't lose that art of practicing medicine.

Cara King, DO:
I couldn't agree more. All right, Melissa, I want to shift a bit here to your move to Abu Dhabi back in 2014. Is that when you made the move over to Abu Dhabi?

Melissa Li-Ng, MD:
Yes, I did.

Cara King, DO:
To help establish their endocrinology department. When I'm thinking about this, the coordination to move a family is absolutely incredible. Sometimes the logistics of that can be overwhelming. Do you have kids, Melissa?

Melissa Li-Ng, MD:
I do. I have three kids.

Cara King, DO:
That's what I thought. I thought I saw that. My recent move here from Madison to here to Cleveland, there's obviously the logistics part of it, but there's also this part of wanting to make sure everyone else in your family is doing okay. My partner and my kids. I had this huge weight on my shoulders to make sure everyone else was happy during that move because I felt really responsible for uprooting my entire family. I'm just curious, did you feel those type of pressures when you made the decision to move? How did your kids react to that decision?

Melissa Li-Ng, MD:
Well, I don't know if this is part of my Chinese mentality, but I really didn't take into consideration my children's feelings. Their happiness is secondary.

Cara King, DO:
I love this.

Melissa Li-Ng, MD:
Both my husband and I are Chinese. We made this decision as a family, of course, considering our children's well-being. Their happiness really isn't a priority. Their health and their safety is as well as the opportunities afforded to them. Their actual feelings really don't matter too much to us.

Melissa Li-Ng, MD:
They do matter more now because they're older and they were younger when we moved, they were seven, four, and one years old. Their opinion didn't matter. We did have an amazing time in Abu Dhabi. I am so grateful that we have this opportunity to live abroad.

Melissa Li-Ng, MD:
To live in a different culture. To be around just a diverse group of people. I know that certainly my seven-year-old and my four-year-old, when we moved there are very appreciative of that. They talk about their time and Abu Dhabi just as a fun adventure. They just really, really enjoyed it. Again, I'm glad I had that opportunity to give that to them.

Cara King, DO:
Yeah, those memories will stick with them for the rest of their lives. That's incredible. We talk a lot about work-life integration and how our priorities ebb and flow at home and at work and how we oftentimes have to be flexible when things shift in both of those places.

Cara King, DO:
When you make that big move, oftentimes, especially when you have such an incredible leadership position, you're very much needed in your new role. As your family transitions, you're oftentimes needed at home as well. How did you balance that potentially highly demanding time on both ends of that integration?

Melissa Li-Ng, MD:
I must preface this by telling you that I have an amazing husband. We've been married for almost 21 years now. I know I look young. You can't see how I look on the podcast.

Cara King, DO:
She looks 23, just so you know.

Melissa Li-Ng, MD:
We've been married for over two decades. Through that, what has kept our marriage strong and both of our careers afloat, is a tremendous amount of respect. I respect my husband deeply and his career means as much to me as my career. He is a real estate entrepreneur actually.

Melissa Li-Ng, MD:
It was a sacrifice for him to move to Abu Dhabi, to really let go of his business here and move over there. He respected the opportunities that the move to Abu Dhabi would give to me. We made an agreement going over there that we knew that demands on my time to build this hospital would be high.

Melissa Li-Ng, MD:
That he would be there for the kids. He would be the class parents. He would be at all the activities. With that, I felt very confident that we would settle there and that we would thrive there. He loved being in Abu Dhabi. As a family, again, it was such a fun place.

Melissa Li-Ng, MD:
As a workplace for me, I learned so much that I was able to bring back to Cleveland and apply that knowledge here. In terms of the work and the life demands, I think it's really important to have a supportive partner, and to call on help when we need it. We had his family come visit us from Hong Kong. We had my family visit from the States.

Melissa Li-Ng, MD:
We just were able to make it work. I could not have made it work by myself. There's no way. The whole Superwoman thing or Wonder Woman thing, that Wonder Woman is backed up by a lot of people. I was supported by a lot of people.

Cara King, DO:
I absolutely agree. My husband also is amazing. He has stayed home for the past two years since we moved here to also help with all those things. I also have three young kids. I absolutely agree, things ebb and flow. My husband will be going back to work shortly as well.

Cara King, DO:
Having that understanding that priorities shift and having that support around you is really crucial. That's great to hear. Thank you for that insight.

Mary Rensel, MD:
Melissa, how did you get into medicine? What brought the Melissa from the Bronx to medical school?

Melissa Li-Ng, MD:
Well, my mom assigned it to me at birth.

Mary Rensel, MD:
Chinese Mothers. Is that the Chinese mother?

Melissa Li-Ng, MD:
I'm not kidding. I used to tell this joke. Do you remember there was that there was this book by Amy Chua. What was it?

Mary Rensel, MD:
The Tiger Mom?

Melissa Li-Ng, MD:
Yes, The Tiger Mom, about the tiger mom. I used to make a joke that my mom made The Tiger Mom looked like a panda. You talk about a tiger mom, my mom was ferocious. I have two sisters, there are three girls, and I'm in the middle. She told my older sister that she would be an accountant.

Melissa Li-Ng, MD:
Guess what? She's an accountant. She told me that I would be a doctor because I like to read books and I care about people and she's like, "Yeah, this one will be a doctor." Then, I became a doctor. Then the third one, my younger sister, she said, "She's going to be a lawyer because she talks back and she's got attitude."

Melissa Li-Ng, MD:
Now the thing is, my younger sister is not a lawyer. She does work for the federal government though. She does use her skills of talking back and attitude for our country's benefit. My mom had always wanted me to be a physician. I think given my interests and my ability to empathize, it fit well with my personality, and with my skills.

Mary Rensel, MD:
I love it. I did read that Tiger Mom book. I remember one of the stories is the kids made a birthday card and the mom thought it was unacceptable. They didn't put enough time into it. She returned it. I was like, "I really need to step up the game."

Melissa Li-Ng, MD:
One time I remember I called my mom. It was the afternoon, it was her birthday. She got upset because I should have called her early in the morning. It should have been the first thing on my mind. I remember there was a passage in the Tiger Mom book about practicing piano every day, and I did play piano.

Melissa Li-Ng, MD:
I played several instruments. The way that we practice piano is the way that my mom made me practice typing. I would actually have to practice typing on a Smith Corona typewriter for an hour. I would type out books. Literally, pages at a time. I type 150 words a minute.

Cara King, DO:
Oh my gosh.

Mary Rensel, MD:
Oh my gosh. Wow. God bless your mother. Speaking of your mother's power and demands, when COVID hit here in Cleveland and around the world around the globe, looks like you were part of a team that's called the Cleveland Clinic Community Health and Partnership team. There's actually a publication of all that you guys did throughout COVID to support our local community here. Tell me about being part of that team, because that was a very impressive list. All that you did, there were calls every week to the local community leaders. I was very impressed. Tell me more.

Melissa Li-Ng, MD:
Well, certainly the work done by Cleveland Clinic Community Health and Partnerships has been incredible. The service to the community, the resources given to the community. Absolutely phenomenal. I was fortunate enough to get involved with this.

Melissa Li-Ng, MD:
Well, one because I was going to move to China, actually with the Shanghai hospital and didn't get to move because of the pandemic. Got tasked to help with COVID efforts in the community. Got to work with incredibly talented people in community health and partnerships like Dr. Nazleen Bharmal and just the whole team there.

Melissa Li-Ng, MD:
Really, rolling out COVID testing to the communities and then rolling out COVID vaccinations. That was just a blessing to see our work being able to impact thousands and thousands of Clevelanders and folks in Northeast Ohio.

Mary Rensel, MD:
Well done. What's happening with the China move?

Melissa Li-Ng, MD:
Well, there's a new surge Asia going on right now. In Taiwan and Singapore, China's borders are still quite tight. They do require a 14-day quarantine. Our team has not been able to get to China. We are going to see how this pandemic plays out for the rest of the year.

Melissa Li-Ng, MD:
Plans for the Shanghai hospitals still continue. We did have to delay the opening for a year. We are planning to open it 2025.

Mary Rensel, MD:
2025, we look forward to it.

Cara King, DO:
One last question for you, Melissa, as time always goes by so fast. Within your career, you have always had this upward trajectory and from the outside, it's looked like you've just gone straight up with your accomplishments, and all that you've done.

Cara King, DO:
I'm wondering, have you ever had a time in your career where you felt like things were a bit stagnant, or you felt like things were a little stuck? How did you notice that? How did you shift your focus to change that?

Melissa Li-Ng, MD:
I know that I have been very blessed with all the opportunities that I've had. Sometimes they come out of left field like, "Oh, wow, didn't even know that was an option." That actually happened when I was in Abu Dhabi. I think when the hospital opened in Abu Dhabi was incredibly busy and it was successful.

Melissa Li-Ng, MD:
They asked me, "Would you like to be the chief of medical informatics?" I was like, "What? I never knew there was such a position, but I don't have an IT background or anything close to that.”

Cara King, DO:
You can type fast.

Melissa Li-Ng, MD:
I type really fast, but other than that, nothing much. I don't click very well. I think that was an opportunity afforded to me because I've always been very enthusiastic about continuous improvement. Making systems work better and helping people to do their jobs better.

Melissa Li-Ng, MD:
I was the chief of medical informatics for a year in Cleveland Clinic Abu Dhabi and that was super fun. I learned a lot. I got to work with a whole army of IT people. They're fantastic, brilliant people, who understand how meld the medicine with the tech. I felt like I became one of those super cool medical tech people.

Melissa Li-Ng, MD:
I think my coolness, it's almost like owning a Tesla. My coolness ramp up just being a part of that group. Anyway, I don't know if I was stagnant at the time beforehand. Super busy with the endocrinology practice. Again, it was an opportunity that I had to say yes to, because it was such a great learning opportunity.

Cara King, DO:
I love that. I envision you walking into the cafeteria with like this group of tech people and being in the cool crowd of this new tech group. I envision this whole extra level of coolness once you were part of that.

Melissa Li-Ng, MD:
It was beyond that. It was beyond cafeteria cool. I don't know how to describe it. It's like Tesla cool.

Cara King, DO:
No, you're right.

Mary Rensel, MD:
Levels ahead.

Cara King, DO:
God bless it. These are life goals right here, Mary. Life goals.

Melissa Li-Ng, MD:
Someone asked me like, "What's your dream car? People were saying, "I want a Porsche or whatever it is." I was like, "I want a Tesla. I want something green and environmentally responsible."

Cara King, DO:
Can I ask you, what do you drive?

Melissa Li-Ng, MD:
I drive a Toyota Sienna, a hybrid Toyota Sienna. I'm really bad at parking. When I park at main campus, I park on the top floor so that I don't bump or scratch into anybody. I've done that before at the Target parking lot. I'm really bad at parking because I have no sense of depth perception.

Mary Rensel, MD:
You don't want to make eye contact as you bump up to Beri Ridgeway's white Tesla!

Melissa Li-Ng, MD:
I was driving a physician over to the diabetes center and he said, "There's this big scratch on your car." I was like, "Really? That must've been from yesterday." I didn't even notice it because it's so common that scratches and bumps all over my car. I'm just really bad at parking.

Cara King, DO:
If that's the one thing that you're bad at you, you seem to be excelling at every other aspect of your life. I think that's a good trade off. Get some air bags. It's all good. Melissa, with that, I think that's all the time we have.

Cara King, DO:
Are there any closing comments that you want to make for the listeners of our Insights and Inspirations podcast?

Melissa Li-Ng, MD:
Hopefully, as this pandemic draws to a close, I just want to recognize all the heroic and incredible things that my colleagues have done. The physicians, the nurses, the cool IT people that have enabled us to take care of the sickest of the sick.

Melissa Li-Ng, MD:
To try to keep well the people who are healthy. My last message would be that when we get to a safe place, that we become trusted providers and effective providers, so that we can provide high quality and accessible care to everyone, and anyone who needs it.

Cara King, MD:
I have nothing else to add to that. That is a mic drop. I love that message. Melissa, we are eternally grateful for your leadership. Thank you so much for your time today. We hope to have you back on Insight sometime soon. Thank you so much.

Melissa Li-Ng, MD:
Thanks, guys.

Cara King, MD:
Thank you for listening today. Join us again as we draw inspirations and insights from women doctors past, present, and future. You can follow us on Facebook, Twitter, and Instagram @WPSA1. That's at W-P-S-A and the number one. This podcast is supported by Cleveland Clinics Women's Professional Staff Association, as part of the Cleveland Clinic Centennial celebration.