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The State of Yale Cancer Center and Smilow Cancer Hospital

April 22, 2024

April 19, 2024

Presented by: Dr. Eric Winer

ID
11599

Transcript

  • 00:00What I would like to do this morning is talk a little
  • 00:04bit about where the Cancer Center
  • 00:08and Smilow are at the moment,
  • 00:11give you a little update.
  • 00:12For those who are more on the clinical side,
  • 00:14you'll hear a little overview of what
  • 00:18happened in terms of our overview of
  • 00:21the Cancer Center and of our recent
  • 00:24CCSG Cancer Center Support Grant.
  • 00:27For those of you more on the research side,
  • 00:29I'm going to talk a little bit about
  • 00:32where we are clinically.
  • 00:34There might be like a little bit of
  • 00:37vision sprinkled in here and there.
  • 00:39I'm gonna try not to offend large
  • 00:41groups of people or individuals.
  • 00:43I can assure you that there are
  • 00:45individuals who I have not mentioned in
  • 00:47the slides who I probably should have.
  • 00:49And I apologize to you up front and you know,
  • 00:54just doing my best.
  • 00:57So let's talk about the the state
  • 01:00of the Cancer Center and actually,
  • 01:03Smilow, I tend to think of it
  • 01:06all as one big entity.
  • 01:08So
  • 01:11this is our mission to reduce the
  • 01:13burden of cancer in Connecticut
  • 01:15and beyond through transformative
  • 01:17science and community partnership,
  • 01:19ensuring Health Equity and
  • 01:21exceptional care for all.
  • 01:23So there's not too much to argue with that.
  • 01:27And to go a little further, in my mind,
  • 01:32we strive to provide truly outstanding
  • 01:35multidisciplinary care across the
  • 01:38state through our network to all
  • 01:42residents to conduct clinical trials
  • 01:44to develop better cancer therapy,
  • 01:45since where we are today is simply
  • 01:49not good enough to integrate our
  • 01:51care and clinical trials with basic
  • 01:54translational and population science
  • 01:56research to enhance population health.
  • 01:58And by that I'm really referring
  • 02:00to the fact that I think that
  • 02:02in addition to treating cancer,
  • 02:03we should be paying attention
  • 02:05to the population,
  • 02:06particularly the population of Connecticut,
  • 02:08which for the cancer centers,
  • 02:09our catchment area in terms
  • 02:12of issues like prevention.
  • 02:14We should be educating people about cancer.
  • 02:17We should just be paying attention
  • 02:19to those who are not necessarily
  • 02:22our patients yet or perhaps ever.
  • 02:25And of course,
  • 02:26we want to educate and train the next
  • 02:29generation of researchers and clinicians.
  • 02:31I can't say how important that is.
  • 02:34I don't speak a great deal in this
  • 02:37talk about our fellowship program
  • 02:40or other fellowship programs and
  • 02:44residencies within the institution,
  • 02:46but the training of people
  • 02:49is really critical.
  • 02:51So the Cancer Center has 309 members,
  • 02:55it contains 6 research programs shown here.
  • 02:59There are actually 7 shared resources.
  • 03:02There's now 8 because we had one
  • 03:05that was just newly approved or well,
  • 03:08not officially yet.
  • 03:11We have $95.7 million in Cancer
  • 03:16Research funding annually.
  • 03:19We'd like that number to go up and
  • 03:21something in excess of 100 would
  • 03:24be nice within the next year.
  • 03:26And we have a lot of publications,
  • 03:30including a lot of publications
  • 03:32in high impact journals.
  • 03:34I'll just mention that this year we
  • 03:37took a much more stringent view of how
  • 03:40we defined cancer related publications.
  • 03:43The total number actually fell compared
  • 03:45to past years because we were very,
  • 03:48very specific about what counted
  • 03:49as a Cancer Research publication
  • 03:56after I arrived here and in preparation
  • 03:59for the Cancer Center for grant,
  • 04:01but sort of for general purposes beyond that,
  • 04:05we did convene a a fairly large group
  • 04:09of people to develop a strategic plan.
  • 04:12And the themes of that plan
  • 04:14are shown on this slide.
  • 04:16Research, discovery and innovation,
  • 04:19access and care, cancer burden
  • 04:22and disparities, our own culture,
  • 04:25equity and inclusion and education,
  • 04:29training and career development.
  • 04:30And we'll, we'll touch on
  • 04:32some of these later.
  • 04:34We also as part of the Cancer Center
  • 04:38Core grant and beyond that for our own
  • 04:41purposes had to identify priority cancers.
  • 04:44This doesn't mean the cancers not
  • 04:47included on this list are that
  • 04:49that we don't care about or that
  • 04:51we won't do research there or that
  • 04:54we'll turn patients away never.
  • 04:58But these four were the cancers that
  • 05:01we identified as priority cancers.
  • 05:03And they were identified as
  • 05:05priority cancers either because,
  • 05:07number one, they're very common,
  • 05:10which is true for three of these
  • 05:13#2 there are problems in terms
  • 05:17of disparities in the state.
  • 05:20And that is true of each of these.
  • 05:23It's probably true for all cancer,
  • 05:25but it's particularly true for each of these.
  • 05:27And finally,
  • 05:28we also wanted to focus on
  • 05:31cancers where we had expertise or
  • 05:33wanted to build the expertise.
  • 05:35So this was quite carefully thought through.
  • 05:39We also did something that
  • 05:42is a little bit unusual,
  • 05:44I think in in these Cancer Center
  • 05:47core grants is that we also
  • 05:49identified 4 cross cutting themes.
  • 05:51And those themes were early onset cancer,
  • 05:55meaning early age of onset defined
  • 05:58practically as people who are diagnosed
  • 06:01with cancer under the age of 50.
  • 06:04In my mind,
  • 06:0550s getting a little old
  • 06:06for early age of onset.
  • 06:07But in many tumor types,
  • 06:10that's the definition that is used.
  • 06:13And as people probably know,
  • 06:15there has been a great deal in
  • 06:17the press as a result of what has
  • 06:20happened clinically in terms of the
  • 06:22increasing incidence of certain
  • 06:23cancers in young individuals,
  • 06:25most notably colon cancer.
  • 06:26I will tell you for that,
  • 06:28for the past 25 years,
  • 06:30everyone has said to me yearly there's
  • 06:32so much breast cancer in young women.
  • 06:34It's increasing, it's increasing.
  • 06:36The truth is it has increased
  • 06:38a very tiny amount.
  • 06:40But it, you know,
  • 06:41it's very different from
  • 06:42the colon cancer story,
  • 06:44where in fact incidence of colon
  • 06:47cancer in people under the age of 50
  • 06:50has really gone up very substantially
  • 06:53over the course of the past 20 years.
  • 06:56So we also are focusing on brain metastases,
  • 07:00which I think are an increasing
  • 07:03problem as our treatments get better
  • 07:05for disease outside of the brain.
  • 07:07And often times disease from the
  • 07:09brain seems to be more resistant
  • 07:12for lots of different reasons,
  • 07:15obesity and metabolism.
  • 07:16And as people probably know,
  • 07:19being overweight or obese is associated
  • 07:21with an increase of incidence and in
  • 07:24some cases an increase in mortality
  • 07:27for 13 different tumor types.
  • 07:29And finally,
  • 07:29of course,
  • 07:30the ubiquitous problem of tobacco use,
  • 07:32which has gotten a little bit better
  • 07:34throughout our country and in Connecticut
  • 07:36over the past couple of decades.
  • 07:38But it's still a major problem and
  • 07:41a problem that is particularly
  • 07:43relevant to underrepresented groups.
  • 07:49And while we're touching on disparities,
  • 07:52I'll just embarrass Tracy for a minute,
  • 07:55who's sitting here in the the 3rd row.
  • 08:00We have launched an initiative focused
  • 08:02on on cancer disparities, particularly
  • 08:05cancer disparities in Connecticut.
  • 08:08As many of you may know,
  • 08:11the the statistics are really quite alarming.
  • 08:14If you're a 20 year old woman in the
  • 08:16United States who happens to be black,
  • 08:17you have twice the chance of being dead
  • 08:20from breast cancer by the time you're 50.
  • 08:23That's the most dramatic of
  • 08:24the statistics that I know,
  • 08:26but it's true really across the
  • 08:29board and in all cancer types.
  • 08:33Race is is a major issue.
  • 08:38It's interesting that in many cancer types,
  • 08:41being Hispanic or Latinay may make the
  • 08:44course of treatment more challenging
  • 08:46because people have trouble coming in,
  • 08:49accessing treatment.
  • 08:50But in some cases in breast
  • 08:52cancer is one of them.
  • 08:53Mortality is actually not compromised at
  • 08:56all for reasons we don't fully understand.
  • 09:00But we recruited Tracy Battaglia,
  • 09:03who had a long career, well,
  • 09:06not that long because she's still
  • 09:08in the middle of her career,
  • 09:10but Tracy who had been at Boston
  • 09:14Medical Center at Boston University
  • 09:16for an extended period of time,
  • 09:18lots of experience focusing on
  • 09:22ways to diminish disparities,
  • 09:25largely through patient navigation.
  • 09:28Tracy joined us on February 26th and we're
  • 09:33all really happy that that happened.
  • 09:36We also gave out some internal grants
  • 09:39this past year totaling $500,000.
  • 09:41That money came from a donor who
  • 09:43specifically wanted to focus on this
  • 09:45area and some of the topics are
  • 09:47shown here and you're going to hear
  • 09:49more and more about this over the
  • 09:51course of the next couple of years.
  • 09:54We also have a new initiative focused
  • 09:57on early onset cancers and that's just
  • 10:01getting off the ground and Beta Giri
  • 10:04and Nancy Borselman are Co leading this.
  • 10:07The idea is that we really want a
  • 10:11statewide program across our entire
  • 10:14network that focuses on younger
  • 10:17individuals both to optimize care
  • 10:20and perhaps even more importantly to
  • 10:23try to understand what it is that
  • 10:26these younger individuals face in
  • 10:28terms of getting treatment and why
  • 10:31some of them are developing cancer.
  • 10:33So there will be a large research
  • 10:35cohort that is established and then an
  • 10:39opportunity to ask hypothesis driven
  • 10:41questions within the within that context.
  • 10:45And and we're excited about that.
  • 10:50And I think that in many ways it's
  • 10:53good for everything because we will
  • 10:57help these younger individuals,
  • 10:58we will learn from them for the health,
  • 11:01for the for the for the health system.
  • 11:05We will probably bring more
  • 11:07younger individuals into
  • 11:11the the system and it's
  • 11:13just the right thing to do.
  • 11:18Our research programs in the
  • 11:20Cancer Center are shown here as
  • 11:23well as the various leaders.
  • 11:25It's, there's no particular reason why
  • 11:27some have 3 leaders and some have two.
  • 11:30It's, it's, it's not that we felt that
  • 11:33the ones that have three that the people
  • 11:36are somehow insufficient or inadequate,
  • 11:38but it has just evolved this way in general.
  • 11:41And most programs across the country,
  • 11:44they're anywhere from 2 to 3 leaders.
  • 11:46And it's possible than the programs
  • 11:48that have two that we will add people.
  • 11:51In my mind leading a,
  • 11:53one of the research programs in
  • 11:55the Cancer Center is, is,
  • 11:56is something like a 10 year job.
  • 11:58And I think it's important to remember
  • 12:00that all of these positions are positions
  • 12:02where we should have some turnover.
  • 12:04And we've had some turnover
  • 12:06over the past few years.
  • 12:07And I think it's really important
  • 12:09in terms of keeping the intellectual
  • 12:12activity within the program very fresh.
  • 12:17I want to talk for a couple of minutes about
  • 12:21what I would call the transformation of the
  • 12:24clinical research operation in early 22,
  • 12:27which actually coincided with my arrival.
  • 12:31The clinical trials office was not in great
  • 12:34shape and I think we don't need to say a
  • 12:37lot more other than accrual had fallen,
  • 12:40protocol activation time was high.
  • 12:42Lots of people had had had left the
  • 12:47system partially because of the great
  • 12:51resignation associated with COVID and and
  • 12:55for other reasons before I was even here.
  • 12:57I recruited Ian Krop,
  • 12:59who joined us a month after I arrived,
  • 13:03who then promptly recruited Alyssa
  • 13:05Gateman as the Executive Director.
  • 13:08And under their leadership,
  • 13:10the CTO was totally reorganized,
  • 13:12staffing was stabilized.
  • 13:14Protocol activation times
  • 13:16have dramatically declined.
  • 13:18So more work to do for sure.
  • 13:21Many more protocols were open,
  • 13:23investigator initiated trials were
  • 13:25prioritized and accrual has increased,
  • 13:28not as much as we would like,
  • 13:30but it's going up.
  • 13:31And this is the accrual on
  • 13:34interventional treatment trials.
  • 13:36And what you can see is that it Nader
  • 13:40in 2022 at just over 500 and the
  • 13:44projected number for fiscal year 24
  • 13:47which ends on June 30th is just over 700.
  • 13:51But we really should be at 1000
  • 13:54within a year or two.
  • 13:56And this shows the proportion of patients
  • 14:00who are recruited to interventional
  • 14:03trials in New Haven versus at our
  • 14:07external sites throughout the state.
  • 14:10And I think we have room
  • 14:12for improvement in both.
  • 14:13As people know,
  • 14:14one of the major changes that we have
  • 14:17instituted in the network is that we're
  • 14:20really focusing on sub specialized care.
  • 14:22And the more sub specialized we get,
  • 14:24I think naturally the more people will go on,
  • 14:27on trials at sites around the state
  • 14:31because it's really specialists who
  • 14:34ultimately know the disease well and,
  • 14:37and tend to be that much more committed
  • 14:40to enrolling people in trials.
  • 14:42And, you know,
  • 14:43we appreciate all the efforts
  • 14:45that have been put into this by
  • 14:48people throughout the network.
  • 14:49And we're also, I should add,
  • 14:51trying to make sure that that,
  • 14:53that doctors throughout the network
  • 14:56have the necessary time both to
  • 14:59be specialists and attend tumor
  • 15:01boards and and do all of that,
  • 15:03but then also to enroll people in trials,
  • 15:06which takes longer than just
  • 15:08doing standard care.
  • 15:09We have done reasonably well from
  • 15:11the standpoint of recruiting
  • 15:13under represented groups.
  • 15:14We want to do better.
  • 15:16We are the proportion of patients
  • 15:19who are largely Black and and Latin
  • 15:22A who are recruited to trials in our
  • 15:26system actually is sort of on par
  • 15:29with the state population as a whole.
  • 15:34But again, we can do much, much better.
  • 15:40I want to touch on DEI.
  • 15:42We recruited a new DEI leader in
  • 15:46the Cancer Center, Faye Rogers,
  • 15:48after a national search.
  • 15:50And that national search LED us back home.
  • 15:53And Faye, of course,
  • 15:54is an associate professor
  • 15:56in radiation oncology,
  • 15:57has done a great deal related to
  • 15:59DEI throughout the the School of
  • 16:02Medicine and has just really done
  • 16:05a great job over the past year.
  • 16:08And she has recruited an assistant director,
  • 16:12Iris Selfie,
  • 16:13who actually also is the DEI
  • 16:17representative for hematology and oncology
  • 16:20within within the Department of Medicine.
  • 16:24There are ongoing monthly
  • 16:25meetings of the DEI Council.
  • 16:27I'm sure if there's anyone here
  • 16:29who's interested in the DEI council,
  • 16:31please contact Faye.
  • 16:33And in the fall,
  • 16:35we had about 60 people together for a
  • 16:39whole day for anti racism training.
  • 16:43And it was remarkably both interesting
  • 16:46and I think effective and eye opening.
  • 16:51And it's gonna be repeated at least once,
  • 16:55probably more than once
  • 16:56with a broader audience.
  • 17:00Community outreach and engagement
  • 17:02is critically important.
  • 17:04It's critically important for
  • 17:05the Cancer Center Core Grant,
  • 17:07but it's important for all of us.
  • 17:10Our community outreach and engagement
  • 17:12component of the of the grant
  • 17:15is led by Marcella Nunes Smith.
  • 17:17But let me just sort of take
  • 17:20a step beyond the grant.
  • 17:22We really need to embrace the community.
  • 17:27And by the community,
  • 17:28I mean not just the New Haven community,
  • 17:31but the statewide community.
  • 17:33It is remarkable to me that we live in a
  • 17:38city that is a majority minority city,
  • 17:41that there's inadequate care that is,
  • 17:44that is available to people in our own city.
  • 17:48And some of that is about lack of knowledge.
  • 17:51Some of it is about being
  • 17:53uncomfortable with all of us.
  • 17:55And I truly believe we can make that better
  • 17:57by reaching out and spending time in,
  • 18:00in the community.
  • 18:01And there are many opportunities to do that.
  • 18:05And we're going to be tapping more
  • 18:07and more of you to, to get involved.
  • 18:11And finally, we're,
  • 18:12we're coming to the end about
  • 18:14the issues related to the,
  • 18:16to the Cancer Center and,
  • 18:18and the recent grant we put in.
  • 18:20But of course, Cancer Research,
  • 18:21education, training and coordination,
  • 18:23which in the world of CCS
  • 18:27GS is called Surtek,
  • 18:28which is led by Harriet,
  • 18:32has the has the oversight over education
  • 18:36and training essentially for everyone.
  • 18:39And they've done really a great job.
  • 18:42But the goal is,
  • 18:43is to start with students in high
  • 18:46school and college and to continue
  • 18:49efforts to support training all the
  • 18:51way through post doctoral fellows and,
  • 18:53and, and actually faculty.
  • 18:56So thank goodness the CCSG is done.
  • 18:59I thought it might kill me.
  • 19:01It didn't, thankfully.
  • 19:03And we did reasonably well,
  • 19:06actually quite well.
  • 19:07And it's because we have
  • 19:10a truly amazing team.
  • 19:12We have a great team of deputy directors and
  • 19:15associate directors and countless others,
  • 19:18all the program leaders and,
  • 19:20you know,
  • 19:21all of the people who work in administration.
  • 19:23And it was really a huge team
  • 19:26effort that I think really paid off.
  • 19:28And it paid off not only because
  • 19:31ultimately we'll get a adequate
  • 19:33or much better than adequate,
  • 19:35so we're going to get a good score,
  • 19:37I believe.
  • 19:38But it paid off because it really
  • 19:42brought us all together and helped
  • 19:44us all learn much more about
  • 19:47what everybody else is doing,
  • 19:49which is really critical.
  • 19:51And with that in mind,
  • 19:52I just want to put in a little
  • 19:53plug for membership. In the YCC.
  • 19:56There are a variety of criteria
  • 19:59for membership.
  • 20:00And in truth,
  • 20:02if anyone doesn't meet those criteria,
  • 20:04there are there are clinical
  • 20:06memberships as well.
  • 20:07And so we really want to
  • 20:09get everyone involved.
  • 20:13And finally, before leaving this whole area,
  • 20:16we, we did have our conclave,
  • 20:20which I guess for the past 10 or 12
  • 20:22years has been the annual meeting where,
  • 20:25or meeting event where,
  • 20:28where awards are given.
  • 20:30I will confess that I
  • 20:32personally hate the name.
  • 20:34You know, we're not trying to
  • 20:37run a papal selection in secrecy.
  • 20:39And if you, if you actually look up conclave,
  • 20:42it talks about choosing the Pope.
  • 20:44It also talks about meetings in general that
  • 20:47are basically held in private dark rooms.
  • 20:50And that's not really what Conclave is about.
  • 20:54And so next year look for a new name.
  • 20:57But I, I just want to congratulate all
  • 21:00of these people who who received awards.
  • 21:05So let's talk about sort of the
  • 21:08clinical end of the world.
  • 21:11And 1st, I think it's important for
  • 21:15everyone to realize that there's been a
  • 21:19real change over the past couple of years.
  • 21:22And this is not a change
  • 21:24because of my arrival.
  • 21:25It's something that's been bubbling up
  • 21:28through the organizations for a lot longer.
  • 21:32And that is that there is a real
  • 21:35integration and desire for alignment
  • 21:37between Yale New Haven Health
  • 21:40System and Yale School of Medicine.
  • 21:43And at the risk of sharing too much,
  • 21:46I will say that I think there were
  • 21:49problems for many years in the past.
  • 21:51And in my own view,
  • 21:54there's plenty of guilt to go
  • 21:56around or blame to go around,
  • 21:58I think on the health system
  • 22:00side for many years.
  • 22:01And, and I'm,
  • 22:03I'm,
  • 22:03I'm actually remembering back to when I
  • 22:07was a resident just a decade or two ago,
  • 22:10but certainly at that time,
  • 22:13and I think more recently,
  • 22:14the health system didn't necessarily
  • 22:17appreciate that having Yale physicians,
  • 22:20having an academic Medical Center
  • 22:23feeding into a health system
  • 22:26was particularly valuable.
  • 22:28And it was hard for people to
  • 22:31distinguish a community Dr.
  • 22:33not that not that they didn't
  • 22:35practice great medicine and not
  • 22:37that they weren't valuable,
  • 22:38but it was they didn't really see any
  • 22:42benefit from having academic physicians.
  • 22:45And in truth,
  • 22:46on the school side,
  • 22:47which I think endlessly frustrated
  • 22:50the healthcare system for years,
  • 22:52there were plenty of clinicians who
  • 22:54thought that being a clinician was
  • 22:57seeing two patients every three days.
  • 22:59And you know, in many, many ways,
  • 23:01and this this actually now dates
  • 23:04back to when I was a resident,
  • 23:06clinical medicine wasn't part of an
  • 23:10integral and it wasn't a critical
  • 23:13element in the School of Medicine for many,
  • 23:15many years.
  • 23:16And, and all of these things have changed.
  • 23:19And what has led to this view that
  • 23:22alignment is so critical is that I
  • 23:25think everybody realizes that we can
  • 23:27just be so much better if we work together.
  • 23:30So that's what's going on.
  • 23:32In truth, as Lori Pickens
  • 23:34points out repeatedly in Smilo,
  • 23:37in the Cancer Center,
  • 23:39we've been much more aligned for a long time.
  • 23:41And I think that's true,
  • 23:42but it's gone further.
  • 23:45So as part of this alignment,
  • 23:48I was appointed as president of Smilo.
  • 23:51Lori continued in her very critical
  • 23:53role in Smilo and was appointed the
  • 23:57Chief Administrative Officer for YCC.
  • 24:00So both of us have roles on both
  • 24:03sides of the street and I somehow
  • 24:06managed to convince Lori to move
  • 24:08to the office across from me,
  • 24:10which actually enhances communication hugely.
  • 24:17We have an increasing number of
  • 24:20administrative positions where
  • 24:22people work at the moment still
  • 24:24for either the healthcare system
  • 24:25or the School of Medicine,
  • 24:26but their responsibilities on what
  • 24:28I will continue to refer to as both
  • 24:32sides of the street for the moment,
  • 24:34probably not the best way of doing it in.
  • 24:37In terms of philanthropy,
  • 24:38we have a new assistant vice president
  • 24:41for cancer philanthropy who was hired
  • 24:43by the school but who now overseas
  • 24:46fundraising in both YCC and Smilo.
  • 24:48And in my own view,
  • 24:50we have left millions of dollars
  • 24:52on the table from generous donors
  • 24:54because we just didn't do it right
  • 24:57and in a coordinated fashion.
  • 24:59And Sue, for those of you who
  • 25:02have not met her is great and it's
  • 25:06somebody I worked with in from 2000,
  • 25:104 to 2009 or 10 at Dana Farber.
  • 25:14And totally by luck,
  • 25:15she called me up and was just wanted to
  • 25:19chat the day we opened up this position.
  • 25:23And it turned out she had just
  • 25:25left the job and it was great.
  • 25:27And the overall goals are to eliminate
  • 25:30duplicative processes and to have
  • 25:32seamless interactions and we have to do that.
  • 25:35So where are we in terms of clinical trends?
  • 25:38And you know this looks at all sorts of
  • 25:42different types of of events of care,
  • 25:47infusion surgery cases,
  • 25:48radiation oncology treatments,
  • 25:50what have you.
  • 25:51And what you can see is that overall there
  • 25:55is growth in terms of Medonc and hematology,
  • 25:58new visits up 6% last year,
  • 26:037% this year, surgery is up,
  • 26:06radiation oncology is up.
  • 26:09This is all good.
  • 26:11And you know,
  • 26:12this is the kind of growth that
  • 26:15one would like to see in a,
  • 26:17in a healthy organization,
  • 26:19double digit growth is pretty hard
  • 26:21to deal with.
  • 26:22So you know, this,
  • 26:24this kind of growth is something
  • 26:26that we can deal with focusing
  • 26:29down on Med onc and and hematology.
  • 26:34In terms of hematology,
  • 26:37you can see that there's a mix
  • 26:40of both classical heme,
  • 26:42which all of us for a while were perplexed.
  • 26:45But the truth is this is an
  • 26:47area that is growing hugely.
  • 26:49Alfred has done a great job as the the
  • 26:52chief of classical hematology And it's,
  • 26:55it's, it's a huge growth area.
  • 26:58I used to think that it was because
  • 27:01in primary care nobody knew anything
  • 27:03about how to work up anemia any longer,
  • 27:05and that the world has just
  • 27:07changed in the minute someone sees
  • 27:09a value with the Red Star,
  • 27:10they say call hematologist.
  • 27:12But I think that it's also very
  • 27:15much part of the fact that with our
  • 27:17more complicated medical treatments,
  • 27:20there are just way more hematologic
  • 27:23problems and acute hematologic problems
  • 27:26than was the case many years ago.
  • 27:29And they are really busy and you can see
  • 27:34the very large solid tumor volume we have.
  • 27:39And in terms of this just shows a
  • 27:42little snapshot of new patient visits
  • 27:45across a variety of of different areas.
  • 27:48These are the four sort of biggest solid
  • 27:51tumor areas and you can see
  • 27:53that there is continued growth.
  • 27:58I want to point out that we're all
  • 28:00over Connecticut for the most part.
  • 28:02I mean we're, we don't have a huge
  • 28:05presence up in the northeast corner
  • 28:08in Windham County and Tolland County,
  • 28:12but we, we are obviously distributed very
  • 28:16well across the shoreline and up towards
  • 28:20Waterbury and increasingly towards Hartford.
  • 28:23And assuming that everything moves
  • 28:26forward with the Prospect acquisition,
  • 28:29we we will be that have that much of A
  • 28:34stronger presence in Waterbury as well as
  • 28:37in Manchester right outside of of Hartford.
  • 28:40And at the moment we see about 50%
  • 28:43of patients who were diagnosed
  • 28:45with cancer in Connecticut.
  • 28:47I think that in truth that percentage
  • 28:50should be much higher and it's
  • 28:52going to be higher by continuing to
  • 28:55raise the profile of care here and
  • 28:57its sites around the state.
  • 29:00And again,
  • 29:02having having disease specialized care at
  • 29:04each and every one of our sites is really
  • 29:08something that's going to be critical.
  • 29:11So in my mind,
  • 29:12what we're doing is developing A
  • 29:14statewide academic oncology program
  • 29:16that provides sub specialized
  • 29:19state-of-the-art multidisciplinary
  • 29:20care enhanced by the most important
  • 29:23and forward-looking trials.
  • 29:25Do you want to take this moment
  • 29:28to emphasize that cancer is a
  • 29:30team sport and that it in this?
  • 29:34It's not so much true in leukemia and
  • 29:37lymphoma where medical oncologists
  • 29:38do most of the work,
  • 29:41but in all of the solid tumors,
  • 29:45it is a partnership between the
  • 29:47surgeon and the radiation oncologist
  • 29:50and the medical oncologist.
  • 29:52And although there's this tendency,
  • 29:54I think for structural reasons
  • 29:56to think of the Cancer Center
  • 29:58as more about medical oncology,
  • 30:00because in truth,
  • 30:01the medical oncology and
  • 30:03hematology actually sit
  • 30:06in the Cancer Center. From a,
  • 30:08from a financial standpoint, I am.
  • 30:13And the Cancer Center as a whole is
  • 30:17every bit as much focused on the
  • 30:19surgeons and radiation oncologists as
  • 30:21we are on the medical oncologists.
  • 30:23And I can add to that,
  • 30:24you know, pathologists and,
  • 30:26and imaging people and everybody else.
  • 30:32I will confess that I have gone back
  • 30:34and forth about how we name the, the,
  • 30:37the each of the individual programs and
  • 30:39what's the center of excellence and what's
  • 30:42a clinical research team and what have you.
  • 30:45And I've gone back and forth on this,
  • 30:47but I think this is pretty final and I,
  • 30:52I guess I'm presenting it here.
  • 30:54And if you have any major problems,
  • 30:56you can tell me later.
  • 30:58But I think within each and
  • 31:00every one of our diseases,
  • 31:01we have essentially a large center of
  • 31:05excellence with a director or several code,
  • 31:08one or two or three Co directors.
  • 31:11I think within that we have a clinical
  • 31:13program that focuses on clinical growth,
  • 31:15clinical performance,
  • 31:16clinical pathways,
  • 31:17everything you can imagine.
  • 31:19There's a translational research team with
  • 31:22a lead that's trying to bring together
  • 31:25the translational researchers and then
  • 31:27a very critical clinical research team.
  • 31:31And in some cases,
  • 31:33leadership may be in multiple places
  • 31:36the same person, and in others,
  • 31:38it may be a different name in every place.
  • 31:40And I think what's important is to make
  • 31:44sure that we have leaders who are,
  • 31:47who both have the time and the
  • 31:50interest to tackle each of these areas.
  • 31:52And of course,
  • 31:53the centers of excellence are not
  • 31:55the the academic home of the faculty.
  • 31:57The academic home for the faculty
  • 32:00continues to to remain in the departments.
  • 32:03Oh
  • 32:06yeah, oh, that's right.
  • 32:07There was nothing written on the errors.
  • 32:09This was my animation to remember
  • 32:11to say how important radiation
  • 32:13oncology and surgery are.
  • 32:18So as you know we have divided up
  • 32:22into divisions based on disease.
  • 32:25And I just want to point
  • 32:27out that in hematology,
  • 32:29I'm residing is now the chief
  • 32:32of malignant hematology or he
  • 32:34malignancies as I usually call it.
  • 32:36And Alfred for for now over a
  • 32:38year has been the chief in,
  • 32:41in hematology and they are working very,
  • 32:45very closely together and I think very,
  • 32:48very well. And I just want to point
  • 32:52out that this picture of Alfred
  • 32:54must be at least 15 years old.
  • 32:58He's not here.
  • 32:59So it's it,
  • 33:00it doesn't have the same effect.
  • 33:02Oh, he is
  • 33:09so Alfred, I, you know,
  • 33:10I just couldn't resist. He does look.
  • 33:13He he, he, he looks good.
  • 33:15But I saw that picture and
  • 33:16I said like, you know,
  • 33:17is that his bar mitzvah picture?
  • 33:22No.
  • 33:24So, and these are the faculty
  • 33:27and before I was talking about
  • 33:29the faculty in the Cancer Center.
  • 33:31These there are 151 faculty in
  • 33:33the Cancer Center and you can
  • 33:35see how they're distributed.
  • 33:39I hate to talk about funds flow,
  • 33:43but I, I think there are people
  • 33:45who remain very interested in this.
  • 33:47And so I'm just going to
  • 33:50briefly say a few words.
  • 33:52So in the Cancer Center,
  • 33:54the the this applies to the
  • 33:58medical oncologist, hematologist,
  • 33:59neuro oncologist and palliative
  • 34:01care physicians.
  • 34:02In the old days,
  • 34:04meaning more than a year ago,
  • 34:05the hospital backed the salaries
  • 34:07of all clinicians.
  • 34:08Anybody who did more than 20% clinical
  • 34:10work had their salary essentially
  • 34:12covered by the hospital if they
  • 34:15didn't have other sorts of funding.
  • 34:17In the new era,
  • 34:19your Cancer Center director is
  • 34:22provided with funds based on RVUS,
  • 34:24and I have to make it all work.
  • 34:26The model provides for some protected
  • 34:29time for some people who are actively
  • 34:31engaged in unfunded research,
  • 34:33particularly clinical trials.
  • 34:35It's a model that I dare say is a little
  • 34:40more generous than some people have.
  • 34:42And it is because everyone in the system,
  • 34:45in both the school and in
  • 34:47the healthcare system,
  • 34:48recognize that it takes time to develop
  • 34:51clinical trials and that cancer care
  • 34:54can't be done without clinical trials.
  • 34:57And I think the most important
  • 35:00message is don't worry,
  • 35:01'cause I'm worrying for all of you and I'm
  • 35:05not trying to be paternalistic about that.
  • 35:07But I really,
  • 35:08I will tell you,
  • 35:09there are departments where people
  • 35:11are really panicked about this.
  • 35:14There is no reason to panic and
  • 35:17I do want everyone to who who is
  • 35:20within these areas to pay attention
  • 35:23to RV us and to do their best to
  • 35:25maximize their generation of RV us.
  • 35:27But I don't want anyone to feel tortured
  • 35:29that they're supposed to, you know,
  • 35:31suddenly as a result of funds flow,
  • 35:33see 10 extra patients a week.
  • 35:35Just just make sure that you're
  • 35:36that we're getting paid for what you
  • 35:38do and take good care of people.
  • 35:40Yes, yes,
  • 35:42I just want
  • 35:47to make sure folks grow up.
  • 35:49Oh the oh, absolutely.
  • 35:49The pay, you know,
  • 35:50the where all of the fund,
  • 35:52you know, so it used to be that,
  • 35:54that that the system, the healthcare
  • 35:56system used to just fund the salaries.
  • 35:58Now they fund the payments that come
  • 36:01that that support the and the whole idea
  • 36:05here is a much tighter collaboration.
  • 36:08We've had a lot of recruits in 2023 and 2024.
  • 36:16What happened?
  • 36:17Oh, I hit the wrong one.
  • 36:19And we have more recruits coming.
  • 36:21We have two recruits to the to CMCO,
  • 36:24the Center for Molecular and Cellular
  • 36:27Oncology and that's Sarah and
  • 36:29Corleen on either end of the top.
  • 36:31We have recruits in the solid
  • 36:34tumors and in he malignancies.
  • 36:37And I'll just point out someone who
  • 36:40none of you know who's Raghav Sundar,
  • 36:43who's who's actually coming
  • 36:45from Singapore that Pam *****
  • 36:48recruited and will be here in
  • 36:50the next couple of months.
  • 36:55So my my friend for many years,
  • 36:59Hal Burstein used to always talk
  • 37:00about the lightning rounds where he
  • 37:02went through things very quickly.
  • 37:03So these are my lightning announcements
  • 37:07that we have an ongoing search
  • 37:09for chief of Neuro oncology.
  • 37:11We're looking for many classical
  • 37:14hematologists and Alfred's
  • 37:15taking the lead on that because
  • 37:18they are hugely understaffed.
  • 37:20We have a soon to be launched search
  • 37:22for a senior clinician scientist to lead
  • 37:25cellular therapies as soon to be launched,
  • 37:27search for a lymphoma leader
  • 37:29that Amar is going to champion.
  • 37:33We're going to expand the development office.
  • 37:35We have an ongoing recruitment
  • 37:38of a new biostatistical leader.
  • 37:41Our present leader has been great,
  • 37:42but hasn't had the time to be full
  • 37:45time in the Cancer Center and we we
  • 37:49have the search ongoing for that.
  • 37:53We're going to be hiring at least
  • 37:55two to three physician scientists,
  • 37:56probably one in the area of breast cancer.
  • 37:59There are three spores that are
  • 38:02in planning stages.
  • 38:03We have an ongoing search for an SVP
  • 38:06of patient care services and much more.
  • 38:12I want to call out some people for
  • 38:16special thanks and, or some groups.
  • 38:19You know, none of us could do everything
  • 38:22we do on the clinical side without
  • 38:24the nurses and both the nurses that
  • 38:27staff the clinics and the nurses
  • 38:30that staff the infusion rooms and the
  • 38:33inpatient units and of course the APPS.
  • 38:36And we have a lot of APPS and we need them.
  • 38:44We couldn't do what we do without the
  • 38:47administrative professionals of all types,
  • 38:48from the most senior people
  • 38:51to the most junior people,
  • 38:53both in Smilo and the YCC.
  • 38:54We couldn't do it without the social
  • 38:57workers and the pharmacists and of course
  • 39:00our patients and their families and the
  • 39:03clinical trials staff and the clinical
  • 39:05trials participants and the students,
  • 39:07residents,
  • 39:07fellows and postdocs and many others.
  • 39:10And let me just mention that we
  • 39:13couldn't do this with a the,
  • 39:15the team of people who take care
  • 39:18of the OR oversee the operations
  • 39:21in Smilo like Kevin and Sarah and,
  • 39:24and at the moment Tracy and so many others.
  • 39:31We are in the news.
  • 39:32Just want to point this out.
  • 39:34Many of you may have seen the billboards and,
  • 39:37and if you haven't,
  • 39:38I thought I would show you this
  • 39:42slide and this is my last slide.
  • 39:45And you know,
  • 39:46it's often said that culture
  • 39:48eats strategy for breakfast.
  • 39:50And the question is what?
  • 39:51What's culture about?
  • 39:52So I actually did a little Google
  • 39:55search last night and I found many,
  • 39:58many different definitions of what
  • 40:01constitutes a positive culture.
  • 40:03And I picked out the.
  • 40:08Adjectives,
  • 40:08the characteristics that I thought
  • 40:11were most important and I decided
  • 40:13not to try to rank them or to
  • 40:16try to pick the top five,
  • 40:18although I probably could pick the top five,
  • 40:20but just list them.
  • 40:21So trust, transparency, equity,
  • 40:25emotional intelligence, respect.
  • 40:28Next one I think is actually pretty
  • 40:30important support for and confidence
  • 40:32in risk taking and innovation,
  • 40:34a sense of purpose and then
  • 40:36the three CS cooperation,
  • 40:37caring and competence.
  • 40:39And you know,
  • 40:40this is really what I hope we can all
  • 40:43strive for because it really is true
  • 40:45that it is having the right culture
  • 40:47that allows us to do so much better work,
  • 40:51whether it's work in the laboratory,
  • 40:53work in in the wet laboratory,
  • 40:57dry laboratory, clinical trials,
  • 40:59and of course in the care of
  • 41:02the people who need our care.
  • 41:05So, you know,
  • 41:06it's something we should all
  • 41:09really think about.
  • 41:10And thanks.
  • 41:11I deliberately left 1520 minutes so
  • 41:14that there would be time for questions.
  • 41:17Thanks.
  • 41:27There are questions.
  • 41:27You just have to eat bagels.
  • 41:36Yes, I know like many of us,
  • 41:39you were spending a lot of time
  • 41:40thinking about Wellness for our
  • 41:44clinicians and teams. It's an ongoing
  • 41:49addition to funds flow.
  • 41:51It's another worry on your mind. Maybe
  • 41:55you could share some of your
  • 41:57thoughts. We're all here
  • 42:01to help. So I think funds flow actually
  • 42:04helps with it in the sense that I think,
  • 42:08you know, it's important to be in
  • 42:11control of our own destiny and we can
  • 42:14be very clear about expectations with
  • 42:16funds flow and we have the ability
  • 42:18to protect time for some people.
  • 42:22But you know, it it of course
  • 42:25goes way beyond that.
  • 42:26And you know, the one thing that has
  • 42:30been shown repeatedly in efforts
  • 42:32to enhance clinician well-being,
  • 42:34and I don't think we should focus
  • 42:36just on physicians here.
  • 42:40What doesn't work are things like massages.
  • 42:44And you can give a gift certificate
  • 42:46for a massage and I think somebody
  • 42:49feels better for about 15 minutes.
  • 42:52And, and that this has been,
  • 42:54this has been shown across the country,
  • 42:56but we have to focus on on ways that on,
  • 43:01on all of the things that
  • 43:04make clinicians frustrated.
  • 43:06And so the systems in that presently
  • 43:12exist that just drive everyone mad,
  • 43:16like some of which we have control over,
  • 43:19some of which we don't insurance
  • 43:22approvals and writing notes
  • 43:24and endless clicks and this,
  • 43:26that and the other.
  • 43:29And you know, it's, it's a slow process,
  • 43:31but we can get there.
  • 43:33I will tell people and you should
  • 43:34feel good about this.
  • 43:35Although I had a conversation with
  • 43:37Sarah about this and she's not
  • 43:39convinced that she's going to buy in,
  • 43:40But I am absolutely convinced
  • 43:42that within the next two years,
  • 43:44you're going to be able to walk
  • 43:45into a room and talk to a patient
  • 43:47and a note will be generated.
  • 43:49And personally,
  • 43:50Sarah thinks that she she that
  • 43:52it won't be as good as her note.
  • 43:55But sorry to embarrass you,
  • 44:00but but I think that that's a
  • 44:03huge step forward for a lot of
  • 44:05us and we'll make things better.
  • 44:07And we just have to keep focusing on this.
  • 44:09And I, you know,
  • 44:10I think the other thing though,
  • 44:11is it really helps, you know,
  • 44:14to have the right culture.
  • 44:16And you know, as you all know,
  • 44:20I also believe that having the
  • 44:24right kinds of relationships
  • 44:26with for the clinicians,
  • 44:29with the people we take care of,
  • 44:30and I will extend this
  • 44:32now to the researchers,
  • 44:33having the right kind of relationship with
  • 44:36the people you work with every day and,
  • 44:39you know,
  • 44:40with everyone around us really
  • 44:42makes our lives better.
  • 44:45So,
  • 44:47Roy,
  • 44:47do
  • 44:49you like your picture?
  • 44:51I do, you know, I've yet to see it,
  • 44:52but I, I need a picture from
  • 44:54my mother so you can send.
  • 44:56Would you want me?
  • 44:57Do you want me to e-mail her this slide?
  • 44:58That would be great. It's Passover.
  • 45:00Well, Eric, that was a great talk.
  • 45:01So I wanted to ask, you know,
  • 45:03a question forward thinking the future of
  • 45:05oncology and how we're going to cure cancer.
  • 45:06So I'm struck by, you know,
  • 45:08we're at Yale and I think our advantage is,
  • 45:10you know, an amazing university.
  • 45:12We're actually #4 right
  • 45:13now in Blue Ridge funding,
  • 45:14which is looking at all the medical schools.
  • 45:16We've got so much going on in every area.
  • 45:19So finishing up your ASCO presidency
  • 45:21with everything you've seen,
  • 45:22what are a couple of areas where we
  • 45:24could take the science of Yale and
  • 45:25really be the leaders, you know,
  • 45:27something new and an exciting technology and,
  • 45:29and how can we all get together and,
  • 45:31and, and make that happen?
  • 45:33Well, you know, I think it's,
  • 45:35it is a challenging problem, but I,
  • 45:38you know, I really believe that by,
  • 45:41you know, sometimes
  • 45:45form helps function.
  • 45:47And I think that by setting up
  • 45:50programs such that clinicians and
  • 45:54scientists are talking to each other,
  • 45:57you can take it that, you know,
  • 46:00you can take a step forward.
  • 46:01And, you know, the Cancer Center is meant
  • 46:04to be a highly translational entity.
  • 46:08So, you know, there's a lot of
  • 46:12great science at Yale and we
  • 46:15need to start or we need to.
  • 46:17We don't need to start.
  • 46:18It's well started. As you know,
  • 46:20we need to increase what's going on.
  • 46:23And of course,
  • 46:24we all know that there are certain
  • 46:27cancers that are a particular
  • 46:29challenge where we really
  • 46:30haven't made that much progress.
  • 46:36And I'm going to take one where
  • 46:37it's not like that, you know,
  • 46:39breast cancer, you know,
  • 46:41we'll probably be at the point in 10 years
  • 46:43with breast cancer where we can say,
  • 46:45you know, the vast, vast, vast, you know,
  • 46:4898% of people will will be cured or will
  • 46:51not have to die from the disease if
  • 46:53they have treatment available to them.
  • 46:55We're nowhere nearly there in terms of
  • 46:58pancreatic cancer and glioblastoma.
  • 47:01And, you know, we have to sort of
  • 47:04redouble our efforts there. Thanks.
  • 47:16There's somehow I miss the fact
  • 47:18that Yang was had like taken
  • 47:19on this role of passing around
  • 47:21the microphone. Thanks so much.
  • 47:24Yeah, no, I know. I know. It's good.
  • 47:27Hi. Thank you. Eric, I was curious,
  • 47:31I know within your the first slides
  • 47:34that the patient experience was
  • 47:37really embedded in your priorities.
  • 47:39And I just wondered if you could
  • 47:41speak a little more specifically
  • 47:43to that and what you think are the,
  • 47:45the priorities that we should be
  • 47:48expecting and focusing on for the whole
  • 47:50enterprise should be in that area.
  • 47:55You know, I don't, I, I, I will say,
  • 47:58I don't think we do badly in general
  • 48:01from a patient experience standpoint.
  • 48:04I think when people come,
  • 48:06they do feel that they're cared for.
  • 48:09But, you know, in my mind,
  • 48:12we need to make it from the minute somebody
  • 48:14calls until they no longer need us.
  • 48:16And so people from day one
  • 48:18need to feel like they get,
  • 48:20you know, they need two things.
  • 48:22They need great care,
  • 48:24great care in terms of technical expertise,
  • 48:28but they also need people
  • 48:30who care about them.
  • 48:31And, you know, in my mind,
  • 48:35that's having the right
  • 48:36partnerships between clinicians and,
  • 48:38and, and patients.
  • 48:43I think it's something that is
  • 48:46comes out of both the right kind
  • 48:50of systems and the right culture.
  • 48:53And, you know, there are a number of
  • 48:56cancer centers where there are great
  • 48:59doctors and I think pretty bad culture.
  • 49:02And you can tell because of what patients
  • 49:05say about their experience there.
  • 49:07And then there are places where
  • 49:10the culture is right or better and
  • 49:13where there's a real focus on making
  • 49:16sure that the patient is cared for.
  • 49:19And that's what we have to just
  • 49:21keep striving for.
  • 49:22I will tell you that, you know,
  • 49:23we're not there yet as a whole system,
  • 49:26and we're not there even in the
  • 49:28Cancer Center by any means.
  • 49:30But
  • 49:34we need to fix our access
  • 49:36problem across the whole system.
  • 49:39You know, when you call up and
  • 49:41you need an appointment with
  • 49:42a rheumatologist and you get,
  • 49:44you know, an appointment,
  • 49:46you call in March and you get
  • 49:48an appointment in September.
  • 49:49Like that doesn't work.
  • 49:52So, you know, we need to be available,
  • 49:54we need to care, we need to have expert care.
  • 49:58And finally, we,
  • 49:59we all need to take care of each other,
  • 50:06which is a part of, you know,
  • 50:08like Roy's pushed for this,
  • 50:09I've pushed for this.
  • 50:10Part of the reason we want more
  • 50:13and more people back at work,
  • 50:14not 100% of the time, but most of the time.
  • 50:17And, and working a little less from
  • 50:20home is it's really hard to do the
  • 50:23culture thing from a distance.
  • 50:25You know, I, I think that and that
  • 50:27now I'm just sort of going off,
  • 50:29but I think that, you know,
  • 50:31it's much easier to have sort
  • 50:34of contentious on the one hand,
  • 50:36contentious, on the other hand,
  • 50:38unproductive interactions by Zoom and,
  • 50:40and in person it works better.
  • 50:49And the follow up question is,
  • 50:52oh, change gears.
  • 50:53But thank you for the, the other answer.
  • 50:56And I agree, I think access is,
  • 50:59is really critical.
  • 51:00But changing gears, I,
  • 51:02you referred a couple minutes ago
  • 51:05to the AI revolution that's coming.
  • 51:09And I've been hearing a little bit
  • 51:12about bridge and this technology of,
  • 51:15you know, forming our notes
  • 51:16while we're in the room.
  • 51:18I wondered if you could speak to that
  • 51:20and what we know might be coming there.
  • 51:23But should we anticipate
  • 51:25there's a pilot coming?
  • 51:26I've seen a demonstration of it.
  • 51:28It's really quite remarkable,
  • 51:30at least based on the demonstration.
  • 51:33I, I, I saw and I think it'll be great.
  • 51:37And you know, there is,
  • 51:38I have been to three retreats in
  • 51:40the past three months that focused
  • 51:43entirely on AI and how AI is going
  • 51:45to affect everything that we do,
  • 51:48I think is still an unknown.
  • 51:50I think from an administrative standpoint,
  • 51:53like with notes,
  • 51:54it can be very, very helpful.
  • 51:56I think there are a lot of people who
  • 52:00have many concerns by patients calling
  • 52:02up and interacting with a, you know,
  • 52:05chat box and not even realizing that
  • 52:09that's what they're interacting with.
  • 52:12And I think there are feelings
  • 52:14that in those situations,
  • 52:15patients need to be informed
  • 52:17what they're dealing with.
  • 52:20You know, the other of course,
  • 52:21big areas are how can,
  • 52:24how can AI help us with decision making?
  • 52:27You know, in my mind,
  • 52:29really good clinicians,
  • 52:31you know,
  • 52:32can bring together lots of different
  • 52:36data from many different sources
  • 52:38to make a decision with a patient.
  • 52:40But the truth is there's so
  • 52:42much information out there that
  • 52:44none of us can do it as well as
  • 52:46we can with some assistance.
  • 52:51OK who? Amar? OK,
  • 52:54Yeah, yeah. Thanks, Eric.
  • 52:55Sorry I couldn't be in, in person.
  • 52:57And so great vision.
  • 52:59I I think I would.
  • 53:00I was wondering whether you could
  • 53:02speak more to your thoughts about how
  • 53:04the efforts in clinical research with
  • 53:06the new model will be incorporated
  • 53:09without transactional components.
  • 53:11I'm particularly worried about the
  • 53:13junior faculty who are hoping to be
  • 53:15clinical trialists and all the like
  • 53:17huge amount of work that goes into
  • 53:20Iits and early phase clinical trials.
  • 53:22And as you know,
  • 53:23getting grant funding for this
  • 53:26generally has not been easy.
  • 53:28So how,
  • 53:28how do we maintain that academic
  • 53:31interest in clinical trials without
  • 53:33having these junior faculty shift
  • 53:36to RVU generation and without
  • 53:38compromising the academic mission?
  • 53:40I
  • 53:41think it's a great question, Amir.
  • 53:43So in much the same way that
  • 53:45for somebody in who's going
  • 53:47to have a laboratory career,
  • 53:50you can't say, well,
  • 53:52initially you're supposed to see,
  • 53:55you know, three days,
  • 53:56three days a week you're in clinic
  • 53:59and then if you get a grant,
  • 54:01you can have protected time in the
  • 54:03laboratory that doesn't work on the
  • 54:05clinical research and either and
  • 54:07particularly early in people's careers,
  • 54:10they need protected time.
  • 54:11I mean, we recognize that
  • 54:14for laboratory investigators,
  • 54:15it is true for clinical
  • 54:18investigators as well.
  • 54:19And through a variety of
  • 54:21mechanisms and funds flow,
  • 54:23we have the flexibility to do that.
  • 54:27That doesn't mean that people
  • 54:29can work one day a week and
  • 54:31spend the rest of the time,
  • 54:32you know,
  • 54:33doing whatever they want to be doing.
  • 54:35And they have to ultimately
  • 54:37demonstrate productivity because
  • 54:39we all have to be accountable.
  • 54:41But we will be able to protect people's time.
  • 54:44And if we can't,
  • 54:46we will lose a generation of people.
  • 54:50So I'm certainly committed to that.
  • 54:53You're going to be part of the
  • 54:55conversation about how exactly
  • 54:56we're going to implement that.
  • 55:00Last question, Adriana,
  • 55:11Hi. I just wanted to ask a question going on
  • 55:13that, but not related to the clinician,
  • 55:15but more related to the timing
  • 55:17from when you have an IIT presented
  • 55:19to the time it indeed opens.
  • 55:21It takes about a year
  • 55:22or so or more sometimes.
  • 55:23So and also for activation of clinical
  • 55:26trials, you have seen that that's
  • 55:27also something that takes a while.
  • 55:29So how are we going to think ahead
  • 55:30to try to make that a little shorter?
  • 55:32So it's not that like lengthy.
  • 55:34Well, thankfully I have two great
  • 55:37colleagues in Ian and Alyssa,
  • 55:39and I let them think about that
  • 55:42whole activation piece because I
  • 55:43know that they're thinking about
  • 55:45it far better than I ever could.
  • 55:47And they have, they have really
  • 55:50made significant strides there.
  • 55:52There's more work to be done,
  • 55:55and some of it has to do with
  • 55:57working in a large matrix system and
  • 56:00not having full control over this,
  • 56:02but they're slowly chiseling away at that.
  • 56:06In terms of the IIT, you know,
  • 56:09a lot of the time is really
  • 56:11spent perfecting the idea.
  • 56:13And I think with the right mentorship,
  • 56:17I think we can, you know, for junior people,
  • 56:20we can do that more quickly.
  • 56:22You know, a year seems sort of OK to me.
  • 56:27Six months would be better.
  • 56:29And I think 6 months is about as good as
  • 56:32you can get in terms of having an idea,
  • 56:34putting it all together and
  • 56:36then getting it through.
  • 56:37But I think that's ultimately the goal.
  • 56:40So I want to thank everyone.
  • 56:43I will try to do this again
  • 56:46in about another year.
  • 56:48I, I just want to say that, you know,
  • 56:51we really want to make this place great.
  • 56:54It's it is great,
  • 56:55but we want to make it greater.
  • 56:58And, and I think that we're
  • 57:00sort of on the cusp of,
  • 57:03of really a very different way of,
  • 57:10of working together.
  • 57:12And I think that we are going to be
  • 57:15far more productive both research wise
  • 57:18and clinically than we ever have been.
  • 57:21And that's sort of an arrogant thing to say
  • 57:23for somebody who's been here for two years.
  • 57:25But I, I,
  • 57:26I really do believe there's just such
  • 57:29unbelievable potential here that and,
  • 57:32and, and such a spirit of wanting it to
  • 57:35be better and working together that I,
  • 57:39you know, just gonna keep our,
  • 57:42keep our, our, our eyes focused on,
  • 57:46on what's really important.
  • 57:47So come talk anytime.