Interviews

The American Medical Association (AMA) had pushed for the CVS–Aetna merger to be blocked because of the increasing body of literature that shows consolidation results in more expensive care with no increase in quality, said Barbara L. McAneny, MD, president of the AMA.

Project ECHO, which helps specialists disseminate knowledge to primary care providers, was created on the idea that patients should not be dying from curable diseases because they don’t have access to the right providers, said Sanjeev Arora, MD, FACG, MACP, director and founder of Project ECHO and a professor of medicine at University of New Mexico.

As a basic scientist, James Allison, PhD, didn’t always meet the patients who benefitted from treatments he discovered, but he did meet 1 woman who participated in one of the early trials of ipilimumab.

Practices that did not meet cost-savings goals in either the first or second performance periods of the Oncology Care Model (OCM) will likely leave the program, said Barbara L. McAneny, MD, president of the American Medical Association.

Major discoveries only happen when there is funding for fundamental science, said James Allison, PhD, chair of the Department of Immunology, the Vivian L. Smith Distinguished Chair in Immunology, director of the Parker Institute for Cancer Research, executive director of the Immunotherapy Platform at MD Anderson Cancer Center, and 2018 Nobel Prize cowinner in Medicine. He explained that he never would have discovered how to use the CTLA-4 protein to treat cancer if he hadn’t been trying to understand the mechanisms of T-cell activation.

Chronic pain is often associated with depression or dysphoria as people can no longer do all the things they want, which may require psychosocial services, said Winston Collins, PhD, program director for substance use services at the John F. Kennedy Behavioral Health Centers.

Healthcare providers must think about the entire home environment their patient lives in when prescribing opioids, said Jeffrey Gudin, MD, director of Pain Management and Palliative Care at Englewood Hospital and Medical Center.

There are a growing number of diabetes therapies, which has led to the need to individualize choices based on patient profile, said Robert A. Gabbay, MD, PhD, FACP, senior vice president and chief medical officer of Joslin Diabetes Center.

Getting more patients access to medication-assisted treatment for their substance use disorder requires reducing the stigma of the disease, said Winston Collins, PhD, program director for substance use services at the John F. Kennedy Behavioral Health Centers.

Assessing a patient’s understanding of his or her own illness is important as cancer treatments become more and more complex, said Denalee O’Malley, PhD, LSW, instructor, Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School.

There are 2 ways prescription drug monitoring programs can improve, said Jeffrey Gudin, MD, Pain Management and Palliative Care at Englewood Hospital and Medical Center.

There are medications, procedures, and techniques that insurers could do a better job covering that would improve quality for women after breast cancer, said Don S. Dizon, MD, FACP, FASCO, director of Women's Cancers at the Lifespan Cancer Institute, director of medical oncology at Rhode Island Hospital, and associate professor of medicine at The Warren Alpert Medical School of Brown University.

Health systems will need to be able to provide multiple services to treat and support people recovering from substance use disorder, which requires interaction and communication, said Winston Collins, PhD, program director for substance use services at the John F. Kennedy Behavioral Health Centers.

Making financial sacrifices during treatment can have long-term effects on survivorship for patients with cancer, said Denalee O’Malley, PhD, LSW, instructor, Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School.

The pendulum has swung so far that even patients with cancer pain may not get the appropriate medications they need, but there are things healthcare providers can keep in mind when caring for patients who need opioids for pain, said Jeffrey Gudin, MD, director of Pain Management and Palliative Care at Englewood Hospital and Medical Center.

Most oncologists aren’t comfortable discussing sexual health needs with their patients, but there are places where sexual health services for patients with cancer are starting to gain foothold, said Don S. Dizon, MD, FACP, FASCO, director of Women's Cancers at the Lifespan Cancer Institute, director of medical oncology at Rhode Island Hospital, and associate professor of medicine at The Warren Alpert Medical School of Brown University.

Younger, premenopausal patients with breast cancer can have unique issues that providers need to keep in mind, said Denalee O’Malley, PhD, LSW, instructor, Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School.

Robert A. Gabbay, MD, PhD, FACP, senior vice president and chief medical officer of Joslin Diabetes Center, explains why the Joslin Diabetes Center and the American Diabetes Association oppose the decision by the American College of Physicians to recommend a higher A1C target across the board.

The Joslin Clinical Guidelines are designed to be streamlined and disseminated as widely as possible, explained Robert A. Gabbay, MD, PhD, FACP, senior vice president and chief medical officer of Joslin Diabetes Center.

The Joslin Diabetes Center published its new Clinical Guidelines in the June issue of Evidence-Based Diabetes Management™. Here, Robert A. Gabbay, MD, PhD, FACP, senior vice president and chief medical officer of Joslin, explains the development of the guidelines and the audience Joslin hopes to reach by publishing in journal.

Tahir Amin, DipLP, co-founder and co-executive director of the Initiative for Medicines, Access, and Knowledge, discusses the organization’s focus on patent opposition for HIV drugs, the results of their work, and what efforts are still needed.

Rick Doubleday, the executive vice president and chief commercial officer at Dexcom, discusses his company's new partnership with Fitbit and what patients with both type 1 and type 2 diabetes will get out of it.

Brenda Schmidt, CEO of Solera Health, discusses how Solera has been getting ready for the launch of the Medicare Diabetes Prevention Program on April 1, 2018.

Care coordination is vital to ensure improved patient outcomes as both CMS and private payers are paying increased attention to it, pointed out Adam Brufsky, MD, PhD, co-director of the Comprehensive Breast Cancer Center at University of Pittsburgh. How is your institution infusing care coordination in its workflow?

There is a lot of energy around educating consumers about their risk for type 2 diabetes, explained Brenda Schmidt, CEO of Solera Health.

Adam M. Brufsky, MD, PhD, co-director of the Comprehensive Breast Cancer Center at University of Pittsburgh, notes important value coordinates of breast cancer care.

Technology is becoming more prevalent in practice, so it's crucial that practices choose the right technology to deliver care, said Robin Shah, vice president of Provider Marketing and Strategy at Flatiron Health.

Nat Turner, co-founder and CEO of Flatiron Health, says that clinical research accessibility is one of the biggest barriers in oncology care that Flatiron Health is working to remove.

There are a number of treatment choices available to treat patients with breast cancer and diagnostic tests can assist in the decision making, according to Adam M. Brufsky, MD, PhD, co-director of the Comprehensive Breast Cancer Center at University of Pittsburgh.

The changing payment and competition landscape in healthcare are the 2 biggest challenges facing community oncologists today, explained Robin Shah, vice president of Provider Marketing and Strategy at Flatiron Health.