November 6, 2025
Member Spotlight: Lucinda (Cindy) Grande, MD, FASAM
Works at: Pioneer Family Practice in Lacey.
How long in practice: 14 years.
Specialties: Family medicine and addiction medicine.
Additional roles: Clinical associate professor in the department of family medicine, UW School of Medicine; current president of the Washington Society of Addiction Medicine.
Why WSMA: The WSMA is a powerful voice for physicians in our state. I learned how influential it could be in 2017 after I presented my first resolution to the House of Delegates. I had hoped to draw attention to an injustice with societal implications, one that had been experienced by my own patients. Denial of life-saving medications to treat opioid use disorder in jails and prisons creates an extremely high risk of overdose death after release. With help from veteran resolution writers at my county medical society, I crafted a proposal to advocate for legislation, standards, policies, and funding to make buprenorphine and methadone available to inmates. The resolution was adopted as a new policy by the WSMA and ultimately by the American Medical Association. WSMA and AMA advocacy helped to catalyze a growing awareness of the problem and led to real changes statewide and nationally.
I have since shepherded about a dozen resolutions through the process, often in collaboration with WSMA staff, family physicians, addiction specialists, and public health groups. Through my participation in the WSMA, I have learned that teamwork is essential to the power of organized medicine. Teamwork requires persistence and compromise, but results in much more attention from policymakers than any of us could hope for alone.
What inspires me about medicine: I love to find solutions for whatever health problems patients bring to me. Often, I can use widely available treatments to address common problems. For example, for the petite white-haired lady who brought in a chart showing wild swings in blood pressure, I tinkered with the doses and timing of losartan and amlodipine. She returned at the next visit with a bright smile because her numbers were now perfectly steady.
But sometimes unconventional solutions are needed. A 38-year-old man, struggling to drop some of his 400-pound heft, yearned to try a GLP-1 agonist. Unfortunately, his insurance wouldn’t pay for it because he didn’t have diabetes. Compounding pharmacies are avoided by many physicians, but I was happy to use one to obtain generic semaglutide for him—enriched with Vitamin B12 for the inevitable fatigue of the overweight—for $200 per month. That man lost 15 pounds in the first 6 weeks. You bet he had a bright smile at the next visit.
A more adventurous area of my work is with patients who—like many millions of Americans—suffer from both chronic pain and psychiatric disorders. A favorite opportunity is to take a depressed and irritable middle-aged man with arthritis who has limped along for years on oxycodone, and initiate buprenorphine for his pain. There is art in luring that man into making the change, and in selecting a suitable starting dose and titration plan. But how thrilling to see the clouds lift and a new brightness in his step!
Through my participation in the WSMA, I have learned that teamwork is essential to the power of organized medicine."
What people may not know about me: My true passion is unlocking the secrets of daily sub-dissociative dose (or “microdose”) ketamine. I have delighted in the frequently favorable and sometimes breathtaking outcomes among 600+ patients with common debilitating conditions from chronic pain, depression, and suicidal ideation to addiction, dementia, and existential distress at end of life. I have several research projects underway with the goal of bringing the rich potential of this treatment strategy into mainstream clinical practice.
Recommended reading: I am immersing myself in the many wonderful books by the cognitive psychologist and psycholinguist Steven Pinker. My favorite is “The Sense of Style: The Thinking Person’s Guide to Writing in the 21st Century.” Next on my list is “The Better Angels of Our Nature,” based on the surprising premise that violence has declined over the course of human history. I am hoping for a refreshing break from the gloom and barbarism of today’s news.
This article was featured in the November/December 2025 issue of WSMA Reports, WSMA's print magazine.