Kristin D. Pfeifauf MD, JD
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Director of Clinic Development
Dr. Kristin Pfeifauf
Kristin Pfeifauf, MD, JD serves as the Director of Clinic Development at Reza Health, where she leads the organization’s expansion efforts, including the opening of new clinics in South Georgia and Daytona, Florida. In this role, Dr. Kristin combines her expertise in people-centered care and community engagement to improve access to healthcare and raise awareness about critical public health issues, particularly those affecting marginalized populations.
In 2011, Dr. Kristin earned her JD from Washington University School of Law in St. Louis. She subsequently returned to earn her MD from Washington University School of Medicine in 2023. With a background as both a physician and a lawyer, Dr. Kristin is deeply committed to advancing health equity and addressing the healthcare needs of underserved communities. Her prior work at St. Louis Children’s Hospital involved spearheading a successful reorganization of the Cleft & Craniofacial Team to focus on family-centered care, which serves as a model for her approach at Reza Health. In 2022, Dr. Kristin was inducted into the respected Gold Humanism Honor Society, recognizing her dedication to compassionate care, empathy, and service to patients.
Dr. Kristin’s passion for compassionate care is informed by her personal experiences as a patient with craniofacial anomalies, which have shaped her lifelong commitment to supporting vulnerable individuals throughout their healthcare journeys. Her dedication to health advocacy is also reflected in her work as a board member of Friends of the Quilt, an organization that honors the lives lost to HIV/AIDS and works to prevent new infections.
At Reza Health, Dr. Kristin brings a compassionate, multi-disciplinary approach to the organization’s mission of providing people-centered care and addressing the sexual health needs of the community, including HIV/AIDS treatment and prevention. In July, she will begin training in Family Medicine. After residency, she plans to join Reza Health as a Primary Care Provider, with a focus on providing inclusive sexual healthcare for patients of all genders.
Washington University in St. Louis School of Medicine: Saint Louis, MO, US
2018-07-01 to 2019-07-01 | Postdoctoral Research Associate (Post-JD) (Surgery) Employment
Organization identifiers
RINGGOLD: 12275
Washington University in St Louis School of Medicine: St Louis, MO, US
Other organization identifiers provided by RINGGOLD
Washington University in St. Louis School of Medicine: Saint Louis, MO, US
2016 to 2019-06-30 | Postdoctoral Research Associate (Post-JD) (Surgery) Employment
Organization identifiers
RINGGOLD: 12275
Washington University in St Louis School of Medicine: St Louis, MO, US
Other organization identifiers provided by RINGGOLD
Washington University in St. Louis School of Medicine: Saint Louis, MO, US
2019-08-05 to present | MD Education
Organization identifiers
RINGGOLD: 12275
Washington University in St Louis School of Medicine: St Louis, MO, US
Other organization identifiers provided by RINGGOLD
Washington University in St. Louis School of Law: Saint Louis, MO, US
2008-08-01 to 2011-05-01 | JD Education
Organization identifiers
FUNDREF: http://dx.doi.org/10.13039/100007268
Washington University in St. Louis: MO, MO, US
Shared Decision-Making: Process for Design and Implementation of a Decision Aid for Patients With Craniosynostosis
The Cleft Palate Craniofacial Journal
2024-01 | Journal article
DOI: 10.1177/10556656221128413
Contributors: Abdullah M. Said; Ema Zubovic; Kristin D. Pfeifauf; Gary B. Skolnick; Jude Agboada; Penina Acayo-Laker; Sybill D. Naidoo; Mary C. Politi; Matthew Smyth; Kamlesh B. Patel
Contributors
- Abdullah M. Said (Author)
- Ema Zubovic (Author)
- Kristin D. Pfeifauf (Author)
- Gary B. Skolnick (Author)
- Jude Agboada (Author)
- Penina Acayo-Laker (Author)
- Sybill D. Naidoo (Author)
- Mary C. Politi (Author)
- Matthew Smyth (Author)
- Kamlesh B. Patel (Author)
Factors contributing to delay or absence of alveolar bone grafting
American Journal of Orthodontics and Dentofacial Orthopedics
2022-06 | Journal article
DOI: 10.1016/j.ajodo.2021.01.033
Contributors: Kristin D. Pfeifauf; Danielle C. Cooper; Ella Gibson; Gary B. Skolnick; Sybill D. Naidoo; Alison K. Snyder-Warwick; Kamlesh B. Patel
Contributors
- Kristin D. Pfeifauf (Author)
- Danielle C. Cooper (Author)
- Ella Gibson (Author)
- Gary B. Skolnick (Author)
- Sybill D. Naidoo (Author)
- Alison K. Snyder-Warwick (Author)
- Kamlesh B. Patel (Author)
Family-Centered Pediatric Plastic Surgery Care.
Missouri medicine
2021-03-01 | Journal article
PMID: 33840854
PMC: PMC8029619
URL
https://europepmc.org/articles/PMC8029619
Description
Our multidisciplinary cleft palate and craniofacial center was established in 1978 and manages more than 5,000 active patients from birth to skeletal maturity. Over the past four years we have implemented a complex family-centered reorganization, with the goal of improving care and patient retention. Through our implementation of a familycentered approach, we have also decreased treatment burden, need for secondary procedures and cost of care. 1-12.
Presurgical Orthopedic Intervention Prior to Cleft Lip and Palate Repair: Nasoalveolar Molding Versus Passive Molding Appliance Therapy.
The Journal of craniofacial surgery
2021-03-01 | Journal article
DOI: 10.1097/scs.0000000000006929
PMID: 33704966
URL
https://doi.org/10.1097/SCS.0000000000006929
Description
Background
Nasoalveolar molding (NAM) is a widely used presurgical orthopedic device, despite disputes over its effectiveness. This study compares the outcomes after cleft lip and nose repair in patients who received NAM versus those who underwent passive alveolar molding with lip taping.
Methods
A retrospective review of patients with complete unilateral cleft lip and palate who received either NAM (n = 16) or passive molding (n = 10) treatments was conducted. Alveolar gap width was measured on maxillary casts until time of palatoplasty. Nasolabial symmetry was assessed by examining anthropometric ratios on post-operative three-dimensional photographs. Burden of care was evaluated by analyzing the number of patient appointments attended, treatment costs, and caregiver satisfaction surveys.
Results
No statistically significant difference existed in alveolar gap at time of initial appointment or palatoplasty, however the gap was smaller in the NAM cohort at time of lip and nose repair. No statistically significant difference existed in postsurgical heminasal width, nostril width, nostril height, labial height or nasal ala projection asymmetry between the NAM and the passive molding cohort. Patients in the NAM group attended more dental appointments and incurred higher treatment costs compared to the passive molding group. Caregivers reported high satisfaction with treatment outcomes in both cohorts.
Conclusions
There were no differences between NAM and passive molding regarding postsurgical nasolabial appearance and patient satisfaction. Both treatments narrow the alveolar gap. However, NAM places a higher burden of care on families.
Using an Intake Form and Clinic Dashboard to Tailor and Improve the Cleft Team Clinic Visit for Families
The Cleft Palate Craniofacial Journal
2021-01 | Journal article
DOI: 10.1177/1055665620965256
Contributors: Kristin D. Pfeifauf; Alison K. Snyder-Warwick; Sibyl Scheve; Cheryl L. Grellner; Gary B. Skolnick; Sybill D. Naidoo; Kamlesh B. Patel
Contributors
- Kristin D. Pfeifauf (Author)
- Alison K. Snyder-Warwick (Author)
- Sibyl Scheve (Author)
- Cheryl L. Grellner (Author)
- Gary B. Skolnick (Author)
- Sybill D. Naidoo (Author)
- Kamlesh B. Patel (Author)
Using Lorenz Curves to Measure Racial Inequities in COVID-19 Testing.
JAMA network open
2021-01-04 | Journal article
DOI: 10.1001/jamanetworkopen.2020.32696
PMID: 33416882
Understanding Drivers of COVID-19 Racial Disparities: A Population-Level Analysis of COVID-19 Testing among Black and White Populations.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
2020-12-14 | Journal article
DOI: 10.1093/cid/ciaa1848
PMID: 33315066
URL
https://doi.org/10.1097/SCS.0000000000006327
Description
INTRODUCTION:Endoscope-assisted craniectomy and spring-assisted cranioplasty with post-surgical helmet molding are minimally invasive alternatives to the traditional craniosynostosis treatment of open cranial vault remodeling. Families are often faced with deciding between techniques. This study aimed to understand providers’ practice patterns in consulting families about surgical options. METHODS:An online survey was developed and distributed to 31 providers. The response rate was 84% (26/31). RESULTS:Twenty-six (100%) respondents offer a minimally invasive surgical option for sagittal craniosynostosis, 21 (81%) for coronal, 20 (77%) for metopic, 18 (69%) for lambdoid, and 12 (46%) for multi-suture. Social issues considered in determining whether to offer a minimally invasive option include anticipated likelihood of compliance (23 = 88%), distance traveled for care (16 = 62%) and financial considerations (6 = 23%). Common tools to explain options include verbal discussion (25 = 96%), 3D reconstructed CT scans (17 = 65%), handouts (13 = 50%), 3D models (12 = 46%), hand drawings (11 = 42%) and slides (10 = 38%). Some respondents strongly (7 = 27%) or somewhat (3 = 12%) encourage a minimally invasive option over open repair. Others indicate they remain neutral (7 = 27%) or tailor their approach to meet perceived needs (8 = 31%). One (4%) somewhat encourages open repair. Despite this variation, all completely (17 = 65%), strongly (5 = 19%) or somewhat agree (4 = 15%) they use shared decision making in presenting surgical options. CONCLUSION:This survey highlights the range of practice patterns in presenting surgical options to families and reveals possible discrepancies in the extent providers believe they use shared decision making and the extent it is actually used.
Proposed Federal Bill to Mandate Insurance Coverage for Children With Congenital Anomalies
The Cleft Palate Craniofacial Journal
2020-06 | Journal article
DOI: 10.1177/1055665620913024
Contributors: Kristin D. Pfeifauf; Alison K. Snyder-Warwick; Kamlesh B. Patel
Contributors
- Kristin D. Pfeifauf (Author)
- Alison K. Snyder-Warwick (Author)
- Kamlesh B. Patel (Author)
Evaluation of Multidisciplinary Team Clinic for Patients With Isolated Cleft Lip.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
2020-01-21 | Journal article
DOI: 10.1177/1055665619900625
PMID: 31961207
URL
https://doi.org/10.1177/1055665619900625
Description
Objective
To report the incidences of secondary lip and nose operations, otolaryngology procedures, speech-language therapy, neurodevelopmental concerns, and dental and orthodontic issues in children with isolated cleft lip to inform multidisciplinary cleft team protocols.
Setting
An American Cleft Palate-Craniofacial Association-approved team at a tertiary academic children’s hospital.
Design
Retrospective cohort study of patients evaluated through longitudinal clinic visits by a multidisciplinary cleft palate and craniofacial team between January 2000 and June 2018.
Patients, participants
Children with nonsyndromic cleft lip with or without cleft alveolus (n = 92).
Results
Median age at final team visit was 4.9 years (interquartile range: 2.4-8.2 years). Secondary plastic surgery procedures were most common between ages 3 and 5 (135 per 1000 person-years), and the majority of these procedures were minor lip revisions. The rate of tympanostomy tube insertion was highest before age 3 (122 per 1000 person-years). By their final team visit, 88% of patients had normal hearing and 11% had only slight to mild conductive hearing loss. No patients had speech errors attributable to lip abnormalities. Psychological interventions, learning disabilities, and dental or orthodontic concerns were uncommon.
Conclusions
Most patients with isolated cleft lip may not require long-term, longitudinal evaluation by cleft team specialists. Cleft teams should develop limited follow-up protocols for these children to improve resource allocation and promote value-based care in this patient population.
One Multidisciplinary Cleft and Craniofacial Team's Experience in Shifting to Family-Centered Care.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
2020-01-17 | Journal article
DOI: 10.1177/1055665619899518
PMID: 31950854
URL
https://doi.org/10.1177/1055665619899518
Description
Family-centered care is a high-priority focus area in health care and is associated with increased family satisfaction and quality of life, better health outcomes and family follow-up, decreased burden of care, and improved efficiency of resource utilization. Motivated by our aim to improve clinic efficiency and patient retention, our multidisciplinary cleft palate and craniofacial center has been undergoing a complex family-centered reorganization over the past 3 years. We seek to share our experience in hope the information will be a useful starting point to other teams in structuring their own family-centered improvements. We suggest the following stepwise method to achieve a more family-centered process: (1) gathering preintervention data, (2) brainstorming challenges with stakeholders, (3) brainstorming solutions with stakeholders, (4) implementation, (5) follow-up and troubleshooting, (6) further implementation, and (7) gathering postintervention data. Additionally, we found the use of institutional resources added substantial value to our efforts.
Cleft and Craniofacial Multidisciplinary Team Clinic: A Look at Attrition Rates for Patients With Complete Cleft Lip and Palate and Nonsyndromic Single-Suture Craniosynostosis.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
2019-06-13 | Journal article
DOI: 10.1177/1055665619856245
PMID: 31195806
URL
https://doi.org/10.1177/1055665619856245
Description
OBJECTIVE:To evaluate attrition rates prior to expected completion of team care for children with complete cleft lip and palate (cleft) or nonsyndromic single-suture craniosynostosis (synostosis). DESIGN:A single-institution retrospective review of attendance data from 2002 to 2016. SETTING:Single cleft and craniofacial center in the United States. PATIENTS/PARTICIPANTS:A sample of 983 patients with either cleft or synostosis. Patients who were more than 2 to 3 years from their last visit were considered lost to follow-up. Patients with cleft older than 16 years or synostosis over 11 years were considered graduated from team care. RESULTS:Survival analysis shows that in our patients with cleft, 25% leave before age 8 and over 60% are lost from team by age 16. In patients with synostosis, 25% leave before age 6 and 45% are lost by age 11. Cox regression showed underrepresented minorities being 1.7 times more likely to become lost in the cleft group (hazard ratio: 1.66, 95% confidence interval [CI]: 1.01-2.74). CONCLUSIONS:Overall, attrition rates were high at our institution. Many patients are lost to follow-up prior to receiving key medical interventions. Improved family education and personalized care are needed to help ensure continuity of care.
Survey of North American Multidisciplinary Cleft Palate and Craniofacial Team Clinic Administration.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
2018-05-21 | Journal article
DOI: 10.1177/1055665618776069
PMID: 29781722
PMC: PMC6488511
URL
https://europepmc.org/articles/PMC6488511
Description
Objective
This study aims to provide an understanding of the ways cleft palate (CP) and craniofacial teams address billing, administration, communication of clinical recommendations, appointment scheduling, and diagnosis-specific protocols.
Design
An online clinic administration survey was developed using data from an open-ended telephone questionnaire. The online survey was distributed by e-mail to the American Cleft Palate-Craniofacial Association (ACPA) nurse coordinator electronic mailing list, used regularly by the ACPA and its members to communicate with teams. The response was 34.1% (42/123). Two incomplete records were excluded, as were any inconsistent responses of 3 teams submitting duplicate records.
Results
Six (15.8%) of 38 teams do not charge for clinic visits. For all other teams, some or all providers bill individually for services (68.4%) or a single lump sum applies (10.5%). Patients of 34 (89.5%) of 38 teams occasionally or often neglect to schedule or attend follow-up appointments. Twenty-six (66.7%) of 39 team directors were plastic surgeons. Phone is a common method of contacting families for scheduling (60.0%) and appointment reminders (82.5%). Most teams’ providers (90.0%) routinely communicate findings to each other during postclinical conference. Most teams saw patients with isolated cleft lip (43.6%), cleft lip and palate (64.1%), or isolated CP (59.0%) annually.
Conclusions
The breadth of strategies team clinic administration strategies warrants further exploration of the variations and their effects on patient-centered outcomes including the quality of life, satisfaction, cost, and resource utilization.
Assessing calvarial vault constriction associated with helmet therapy in deformational plagiocephaly.
Journal of neurosurgery. Pediatrics
2018-05-11 | Journal article
DOI: 10.3171/2018.2.peds17634
PMID: 29749885
URL
https://doi.org/10.3171/2018.2.PEDS17634
Description
OBJECTIVE Deformational plagiocephaly and/or brachycephaly (DPB) is a cranial flattening frequently treated in pediatric craniofacial centers. The standard of care for DPB involves patient positioning or helmet therapy. Orthotic therapy successfully reduces cranial asymmetry, but there is concern over whether the orthotics have the potential to restrict cranial growth. Previous research addressing helmet safety was limited by lack of volume measurements and serial data. The purpose of this study was to directly compare head growth data in patients with DPB between those who underwent helmet therapy and those who received repositioning therapy. METHODS This retrospective cohort study analyzed pre- and posttherapy 3D photographs of 57 patients with DPB who had helmet therapy and a control group of 57 patients with DPB who underwent repositioning therapy. The authors determined the change in cranial vault volume and cranial circumference between each patient’s photographs using 3D photogrammetry. They also computed a cubic volume calculated by multiplying anterior-posterior diameter, biparietal diameter, and height. Linear regressions were used to quantify effects of age and therapy type on these quantities. RESULTS A comparison of the following variables between the two groups yielded nonsignificant results: age at the beginning (p = 0.861) and end (p = 0.539) of therapy, therapy duration (p = 0.161), and the ratio of males to females (p = 0.689). There was no significant difference between patients who underwent helmeting versus positioning therapy with respect to change in either volume calculation or head circumference z-score (p ≥ 0.545). Pretherapy photograph age was a significant predictor of cranial growth (p ≤ 0.001), but therapy type was not predictive of the change in the study measurements (p ≤ 0.210). CONCLUSIONS The authors found no evidence that helmet therapy was associated with cranial constriction in the study population of patients with DPB. These results strengthen previous research supporting helmet safety and should allow health care providers and families to choose the appropriate therapy without concern for potential negative effects on cranial growth.
Primer on State Statutory Mandates of Third-Party Orthodontic Coverage for Cleft Palate and Craniofacial Care in the United States.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
2017-12-14 | Journal article
DOI: 10.1177/1055665617736765
PMID: 29437499
PMC: PMC6900754
URL
https://europepmc.org/articles/PMC6900754
Description
Provision and timing of orthodontic treatment is a crucial part of comprehensive cleft palate and craniofacial care. Some states statutorily mandate orthodontic coverage for the medically necessary care of cleft palate and craniofacial anomalies. However, application of the medically necessary standard varies broadly. Disputes over medical necessity lead to orthodontic coverage denials and surgical intervention delays. Provider-friendly statutory definitions of medical necessity enable patients and providers to avoid such hurdles. The objective of this study is to evaluate state mandates and highlight language favorable to patients and providers.
Washington University in St. Louis School of Medicine: Saint Louis, MO, US
2018-07-01 to 2019-07-01 | Postdoctoral Research Associate (Post-JD) (Surgery) Employment
Organization identifiers
RINGGOLD: 12275
Washington University in St Louis School of Medicine: St Louis, MO, US
Other organization identifiers provided by RINGGOLD
ISNI: 0000000419369852
OFR: http://dx.doi.org/10.13039/100011912
Washington University in St. Louis School of Medicine: Saint Louis, MO, US
2016 to 2019-06-30 | Postdoctoral Research Associate (Post-JD) (Surgery) Employment
Organization identifiers
RINGGOLD: 12275
Washington University in St Louis School of Medicine: St Louis, MO, US
Other organization identifiers provided by RINGGOLD
ISNI: 0000000419369852
Washington University in St. Louis School of Medicine: Saint Louis, MO, US
Organization identifiers
RINGGOLD: 12275
Washington University in St Louis School of Medicine: St Louis, MO, US
Other organization identifiers provided by RINGGOLD
ISNI: 0000000419369852
OFR: http://dx.doi.org/10.13039/100011912
Washington University in St. Louis School of Law: Saint Louis, MO, US
2008-08-01 to 2011-05-01 | JD Education
Organization identifiers
FUNDREF: http://dx.doi.org/10.13039/100007268
Washington University in St. Louis: MO, MO, US