1 00:00:00,205 --> 00:00:01,765 - Welcome everyone to the Becker's 2 00:00:01,765 --> 00:00:02,885 Healthcare podcast series. 3 00:00:03,045 --> 00:00:04,485 I am Maria Mohammed, writer 4 00:00:04,545 --> 00:00:06,125 and moderator with Becker's Healthcare, 5 00:00:06,465 --> 00:00:08,325 and I'm thrilled to have with me today Dr. 6 00:00:08,495 --> 00:00:11,085 Sagar Patel, radiation oncologist at Cape 7 00:00:11,085 --> 00:00:12,165 Radiation Oncology. 8 00:00:12,505 --> 00:00:13,925 Doctor, it's very nice to have you 9 00:00:13,925 --> 00:00:15,045 back on the podcast today. 10 00:00:15,045 --> 00:00:17,525 It's always a pleasure to speak with you to get us started 11 00:00:17,525 --> 00:00:19,445 with you, may please introducing yourself 12 00:00:19,465 --> 00:00:21,045 and telling us a bit about your background. 13 00:00:22,555 --> 00:00:24,575 - Hey Mariah, thanks again for having me. 14 00:00:24,715 --> 00:00:28,495 I'm very appreciative always of having the opportunity 15 00:00:28,495 --> 00:00:30,295 to be on the Becker's Healthcare Podcast. 16 00:00:30,795 --> 00:00:34,415 Uh, so as you mentioned, uh, my name is Sagar Patel 17 00:00:34,795 --> 00:00:37,975 and a little bit about me guess from a training perspective. 18 00:00:38,695 --> 00:00:42,735 I completed an undergraduate degree in classics, um, 19 00:00:42,755 --> 00:00:45,335 at Brown, completed my medical school there as well. 20 00:00:45,835 --> 00:00:48,575 And then I completed my specialty radiation oncology 21 00:00:48,935 --> 00:00:52,095 training at the University of Iowa hospitals and clinics. 22 00:00:53,085 --> 00:00:56,775 From a practice perspective, I'm a radiation oncologist, 23 00:00:56,995 --> 00:00:59,095 as you mentioned, at St. 24 00:00:59,095 --> 00:01:02,415 Francis Healthcare System in, uh, southeast Missouri. 25 00:01:02,995 --> 00:01:04,895 And I'm one of the radiation oncologists 26 00:01:04,895 --> 00:01:05,935 with my colleague Dr. 27 00:01:06,035 --> 00:01:09,895 Ben Goodman there. And thankfully I have the opportunity 28 00:01:09,985 --> 00:01:12,855 there to also be the medical administrative officer 29 00:01:13,475 --> 00:01:17,575 for the oncology service line as well as the vice president 30 00:01:17,635 --> 00:01:19,855 for the medical staff executive committee. 31 00:01:21,065 --> 00:01:23,605 And from a leadership standpoint, uh, 32 00:01:23,655 --> 00:01:27,045 where I've focused on primarily is trying to develop 33 00:01:27,145 --> 00:01:28,925 and integrate meaningful access 34 00:01:28,985 --> 00:01:31,885 and care pathways across primary care 35 00:01:32,225 --> 00:01:33,525 and multiple specialties 36 00:01:33,995 --> 00:01:36,485 with my colleagues in our care teams there. 37 00:01:39,595 --> 00:01:40,605 - Wonderful, wonderful. 38 00:01:40,605 --> 00:01:42,565 Thank you so much for giving us that background. 39 00:01:43,185 --> 00:01:45,285 Um, so with your title 40 00:01:45,505 --> 00:01:48,165 and everything that you are currently doing, what are some 41 00:01:48,165 --> 00:01:49,645 of the biggest issues you're following 42 00:01:49,645 --> 00:01:50,765 in healthcare in this year? 43 00:01:52,735 --> 00:01:56,065 - Yeah, sure. So Mariah, as you know, what we see 44 00:01:56,125 --> 00:01:59,065 and experience daily is that care delivery 45 00:01:59,765 --> 00:02:04,225 across the health ecosystem today, I'd say is very complex 46 00:02:04,735 --> 00:02:06,785 ever changing and quite demanding. 47 00:02:07,975 --> 00:02:10,825 When I kind of break this down, I think that globally 48 00:02:11,365 --> 00:02:12,825 we see patients in need 49 00:02:13,415 --> 00:02:16,985 accessing health services at differing points of care 50 00:02:17,535 --> 00:02:19,505 with unclear direction, navigation, 51 00:02:19,565 --> 00:02:22,585 and various outcomes while their personal costs 52 00:02:22,605 --> 00:02:24,145 of healthcare market entry 53 00:02:24,145 --> 00:02:28,025 and exit for these patients continue to rise and accumulate. 54 00:02:28,415 --> 00:02:29,625 When you look at the hospital 55 00:02:29,645 --> 00:02:31,985 and health systems side, they're, 56 00:02:31,985 --> 00:02:35,465 they're collectively continuing to face mounting pressures 57 00:02:35,545 --> 00:02:37,185 of closures, mergers 58 00:02:37,185 --> 00:02:39,905 and acquisitions from these rising costs of delivery, 59 00:02:40,555 --> 00:02:42,505 while they're also trying to attempt 60 00:02:42,525 --> 00:02:44,825 to secure favorable operating margins, 61 00:02:45,135 --> 00:02:47,025 competitive payer contracts. 62 00:02:47,565 --> 00:02:49,065 And they're ultimately grappling 63 00:02:49,065 --> 00:02:51,985 with maintaining these critical health services amidst, 64 00:02:52,245 --> 00:02:55,905 as we know the pervasive, uh, workforce shortages. 65 00:02:56,405 --> 00:03:00,165 And then when you look from the provider side, I'd say from 66 00:03:00,745 --> 00:03:04,205 the physicians and other healthcare provider's viewpoint, 67 00:03:04,915 --> 00:03:06,245 they're confronted with 68 00:03:07,075 --> 00:03:10,995 high increasing administrative burdens, increasing barriers 69 00:03:11,175 --> 00:03:12,715 to practice meaningful medicine, 70 00:03:13,055 --> 00:03:15,435 and this daily perennial pressure to produce, 71 00:03:16,045 --> 00:03:18,835 which I think are ultimately contributing 72 00:03:18,835 --> 00:03:20,915 and leading to increasing rates of burnout, 73 00:03:21,465 --> 00:03:23,235 disengagement and moral injury. 74 00:03:23,255 --> 00:03:26,975 As we know, when we look at this from a global perspective 75 00:03:27,635 --> 00:03:28,935 and a societal perspective, 76 00:03:29,595 --> 00:03:31,855 I'd say from a macroeconomic perspective, we know 77 00:03:31,855 --> 00:03:35,815 that healthcare spending is about 20% of the GDP. 78 00:03:36,315 --> 00:03:39,415 And you look, you see this stark discordance in the level 79 00:03:39,435 --> 00:03:42,855 of quality and outcomes achieved across the data 80 00:03:42,855 --> 00:03:44,055 and literature that we see. 81 00:03:44,795 --> 00:03:48,655 And so when I internalize this, I see with the high spending 82 00:03:48,715 --> 00:03:51,895 and suboptimal outcomes, there's clear opportunity 83 00:03:52,115 --> 00:03:55,895 for accruing benefit from entry within the healthcare 84 00:03:55,895 --> 00:03:57,015 sector of the economy. 85 00:03:57,995 --> 00:04:00,005 What do I mean by that? Specifically? 86 00:04:00,025 --> 00:04:03,565 We see that the traditional healthcare stakeholders are now 87 00:04:03,585 --> 00:04:04,805 met with new entrants 88 00:04:04,805 --> 00:04:08,205 and investors seeking opportunities to influ influence, 89 00:04:08,275 --> 00:04:11,925 control and capitalize from the healthcare ecosystem. 90 00:04:13,215 --> 00:04:15,875 And what I think is specifically happening, 91 00:04:16,365 --> 00:04:19,395 these new entrants within the healthcare ecosystem 92 00:04:20,065 --> 00:04:22,995 have identified particular niches in areas 93 00:04:23,215 --> 00:04:25,315 to implement innovations technologies 94 00:04:26,015 --> 00:04:28,795 and ultimately secure strategic product placement. 95 00:04:30,015 --> 00:04:32,675 In addition, I think they've been very smart. 96 00:04:33,215 --> 00:04:35,675 Uh, they've made sure that their marketing focuses 97 00:04:35,975 --> 00:04:38,515 and depicts that they will increase access 98 00:04:39,015 --> 00:04:41,595 and availability, address care gaps 99 00:04:41,655 --> 00:04:45,435 and efficiencies contain overall cost, as well 100 00:04:45,435 --> 00:04:48,955 as provide the particular technology in resources 101 00:04:48,955 --> 00:04:53,115 to enhance data retrieval to make quick strategic decisions, 102 00:04:53,115 --> 00:04:57,075 which we really need while optimizing overall system health, 103 00:04:57,075 --> 00:04:58,835 system security and patient privacy. 104 00:04:59,855 --> 00:05:03,075 So why, you know, summarize that I think we 105 00:05:03,345 --> 00:05:05,035 therefore clearly see 106 00:05:05,635 --> 00:05:08,075 a seismic shift in the healthcare landscape 107 00:05:08,075 --> 00:05:10,275 and eco ecosystem accordingly. 108 00:05:11,835 --> 00:05:14,095 So to go back to your question, your initial question, 109 00:05:15,085 --> 00:05:16,255 when I put all this together 110 00:05:16,355 --> 00:05:19,495 and I see all this manifest, I'd say the prime issue 111 00:05:20,115 --> 00:05:21,735 or question that I'm following 112 00:05:22,315 --> 00:05:25,655 in in healthcare trends right now is whether the motivation 113 00:05:25,715 --> 00:05:26,855 of and market forces 114 00:05:27,875 --> 00:05:30,135 of transforming the healthcare industry. 115 00:05:30,795 --> 00:05:33,535 Is it truly to deliver high quality, low ca, 116 00:05:33,715 --> 00:05:35,815 low cost patient-centered health? 117 00:05:36,355 --> 00:05:39,015 Or is it once again simply a monetization 118 00:05:39,635 --> 00:05:42,735 of certain market segments within the health ecosystem, 119 00:05:43,305 --> 00:05:46,255 which ultimately may lead to an acceleration 120 00:05:46,275 --> 00:05:50,095 of these health inequities that we see And ultimately, 121 00:05:50,095 --> 00:05:51,695 unfortunately deriving value 122 00:05:51,795 --> 00:05:53,615 for every entity aside from the 123 00:05:53,615 --> 00:05:55,295 patient who's the most important. 124 00:05:56,485 --> 00:05:58,185 So I'd summarize by saying, 125 00:05:58,655 --> 00:06:02,025 will these transformative elements within the healthcare 126 00:06:02,095 --> 00:06:04,025 landscape, secure population health, 127 00:06:04,445 --> 00:06:06,865 or ultimately simply be one more 128 00:06:08,175 --> 00:06:11,585 evidentiary process of driving profit margins? 129 00:06:13,515 --> 00:06:14,925 - Yeah, wonderful. Thank you so much 130 00:06:14,925 --> 00:06:16,245 for giving us that detail. 131 00:06:16,595 --> 00:06:18,205 Very, very interesting. 132 00:06:18,945 --> 00:06:22,645 And moving on to anything that you're seeing 133 00:06:23,035 --> 00:06:24,485 that is making you excited 134 00:06:24,585 --> 00:06:25,685 or is making you nervous, 135 00:06:25,685 --> 00:06:28,285 whether it's something you're working on personally, um, 136 00:06:28,285 --> 00:06:30,285 or something that you're seeing constantly come up. 137 00:06:32,055 --> 00:06:33,665 - Yeah, absolutely. I think there's a lot 138 00:06:33,665 --> 00:06:36,865 to be excited about and equally nervous about. 139 00:06:37,145 --> 00:06:39,145 I tried to, you know, think about 140 00:06:40,015 --> 00:06:42,185 what specifically impacts me 141 00:06:42,245 --> 00:06:44,905 as an oncologist and also globally. 142 00:06:45,245 --> 00:06:49,385 So, you know, I tried to think about framing this, uh, 143 00:06:49,385 --> 00:06:52,465 from my own perspective and you know, building on that. 144 00:06:52,525 --> 00:06:56,825 So I'd say as a radiation oncologist, I truly enjoy 145 00:06:57,605 --> 00:07:00,385 the daily privilege and opportunity of defining 146 00:07:00,525 --> 00:07:03,265 and depicting the diagnosis stage 147 00:07:03,285 --> 00:07:05,625 and overall treatment paradigm with my colleagues 148 00:07:06,125 --> 00:07:08,065 and care team for my cancer patients 149 00:07:08,445 --> 00:07:09,665 and ultimately being a part 150 00:07:09,725 --> 00:07:12,625 of our patient's care in a multidisciplinary fashion 151 00:07:13,365 --> 00:07:14,985 and evidence-based approach. 152 00:07:15,225 --> 00:07:17,305 I think this is very, this is very important. 153 00:07:18,885 --> 00:07:20,945 In turn, I recognize and seek 154 00:07:21,325 --> 00:07:23,465 and enjoy this daily responsibility 155 00:07:23,885 --> 00:07:27,225 and challenge of being informed as possible, as prepared 156 00:07:27,225 --> 00:07:28,785 as possible, and most importantly, 157 00:07:28,785 --> 00:07:32,665 being the most present possible for each individual moment 158 00:07:33,325 --> 00:07:37,465 and the summative longitudinal journeys our cancer patients, 159 00:07:37,685 --> 00:07:41,835 our cancer patients face the particular opportunity 160 00:07:42,215 --> 00:07:46,075 to in impact or influence our patient's overall outcome 161 00:07:46,095 --> 00:07:49,155 and quality of life with our care team is endlessly 162 00:07:49,155 --> 00:07:51,595 rewarding and unequivocally why I'm here. 163 00:07:54,745 --> 00:07:58,595 However, at the same time every day I wish we 164 00:07:58,595 --> 00:08:01,555 as a team could further drive the best outcomes 165 00:08:02,295 --> 00:08:03,675 for each individual patient 166 00:08:04,535 --> 00:08:08,155 and at the same time limit our collective administrative 167 00:08:08,185 --> 00:08:09,835 burdens accordingly along the way. 168 00:08:10,855 --> 00:08:14,535 So I would say building on this idea 169 00:08:14,715 --> 00:08:18,215 and experience this very sentiment is 170 00:08:18,215 --> 00:08:21,135 what drives my excitement in the current 171 00:08:21,235 --> 00:08:24,375 and future applications of both predictive 172 00:08:24,555 --> 00:08:26,255 and generative AI 173 00:08:26,795 --> 00:08:30,295 and its potential to ultimately transform the level 174 00:08:30,435 --> 00:08:33,695 and ability to deliver either personalized 175 00:08:33,695 --> 00:08:34,815 or precision medicine. 176 00:08:35,315 --> 00:08:39,695 In oncology, I would say the ability 177 00:08:39,795 --> 00:08:42,575 to I identify and diagnose cancer early 178 00:08:43,115 --> 00:08:46,815 and tailor cancer therapies to the specific characteristics 179 00:08:46,815 --> 00:08:50,415 of each individual utilizing genomic profiling 180 00:08:50,435 --> 00:08:54,695 and molecular diagnostics is no longer un unimaginable, 181 00:08:54,695 --> 00:08:55,720 which is super cool. 182 00:08:56,855 --> 00:08:58,595 And it's also the only outcome 183 00:08:58,665 --> 00:09:01,595 that which we would expect and accept. 184 00:09:02,645 --> 00:09:03,865 So as an oncologist, 185 00:09:04,895 --> 00:09:08,345 imagining the potential high reaching scale pace 186 00:09:08,405 --> 00:09:12,705 and magnitude to which artificial intelligence may deliver 187 00:09:13,295 --> 00:09:16,785 precision medicine to cancer patients is not only amazing, 188 00:09:16,965 --> 00:09:19,385 but also reinvigorating as a physician. 189 00:09:21,505 --> 00:09:24,445 The same time you asked about being nervous. 190 00:09:24,665 --> 00:09:26,205 So I would summarize by saying, 191 00:09:26,775 --> 00:09:29,165 while the transformative potential impacts 192 00:09:29,305 --> 00:09:33,165 of artificial intelligence is what I'm most excited about, 193 00:09:33,825 --> 00:09:38,545 it also makes me most nervous as well, why 194 00:09:39,365 --> 00:09:41,905 we know that the adoption, implementation 195 00:09:41,925 --> 00:09:45,185 and regulation of artificial intelligence in healthcare 196 00:09:45,585 --> 00:09:48,665 decision make in healthcare decision making would certainly 197 00:09:48,755 --> 00:09:52,225 bring forth immense challenges with respect 198 00:09:52,225 --> 00:09:55,465 to ensuring no bias, true patient representation, 199 00:09:56,105 --> 00:09:59,865 transparency, privacy, trust, accountability, 200 00:10:00,445 --> 00:10:02,065 and most importantly explainability. 201 00:10:03,645 --> 00:10:05,225 So when I think about this, 202 00:10:05,905 --> 00:10:09,225 I truly wonder whether the transformative elements 203 00:10:09,225 --> 00:10:13,945 of generative AI will lead to true care augmentation 204 00:10:14,655 --> 00:10:17,465 patient empowerment as a consumer of healthcare 205 00:10:18,285 --> 00:10:20,985 and administrative burden simplification, 206 00:10:21,685 --> 00:10:26,265 or will it once again ultimately accelerate the exclusivity 207 00:10:26,565 --> 00:10:29,785 and healthcare delivery further disempower the patient 208 00:10:30,565 --> 00:10:33,945 and limit the opportunity to deliver healthcare to 209 00:10:34,465 --> 00:10:38,305 a select few entities who hold and control the data. 210 00:10:39,965 --> 00:10:41,455 - Yeah. Thank you so much for giving us 211 00:10:41,455 --> 00:10:42,575 that insight, doctor. 212 00:10:42,765 --> 00:10:44,775 That is definitely so important. 213 00:10:44,995 --> 00:10:46,535 And the last thing I wanted to ask you 214 00:10:46,535 --> 00:10:48,935 before letting you go is what would the most effective 215 00:10:48,935 --> 00:10:51,775 healthcare leaders need, uh, need in order 216 00:10:51,775 --> 00:10:53,015 to be successful in the next two 217 00:10:53,015 --> 00:10:54,095 to three years, do you think? 218 00:10:55,855 --> 00:10:59,305 - Yeah, so just going back earlier, we already emphasized 219 00:10:59,305 --> 00:11:03,145 that healthcare delivery is very complex, always evolving, 220 00:11:03,845 --> 00:11:06,545 and the pressures and demands on health systems globally are 221 00:11:06,545 --> 00:11:09,145 quite high and only increasing. 222 00:11:09,925 --> 00:11:12,905 So I'd begin by saying that the ability to adapt 223 00:11:12,965 --> 00:11:16,185 and be resilient when addressing rising costs, 224 00:11:16,185 --> 00:11:17,545 implementing technology 225 00:11:18,205 --> 00:11:21,185 and innovation to optimize health services offered 226 00:11:21,725 --> 00:11:23,305 and maintaining data security 227 00:11:23,365 --> 00:11:26,705 and patient privacy are essential for healthcare leaders. 228 00:11:26,885 --> 00:11:30,985 Now more than ever, I ultimately think health systems will 229 00:11:31,075 --> 00:11:33,945 adopt and implement diverse strategies 230 00:11:34,005 --> 00:11:36,785 to address these challenges and meet market 231 00:11:37,405 --> 00:11:40,305 and meet market forces likely resulting in both progress 232 00:11:40,885 --> 00:11:42,065 and additional struggles. 233 00:11:43,475 --> 00:11:45,855 But amidst these challenges and uncertainty, 234 00:11:46,325 --> 00:11:50,095 however, I think what I know is still important 235 00:11:51,625 --> 00:11:55,125 is always primarily focusing on who the healthcare 236 00:11:55,955 --> 00:11:57,125 ecosystem serves. 237 00:11:57,425 --> 00:12:00,205 And that's the patient no matter what, 238 00:12:00,225 --> 00:12:02,125 we must keep the patient at the forefront 239 00:12:02,665 --> 00:12:05,205 and that overlying sentiment must permeate 240 00:12:05,665 --> 00:12:07,285 and be embodied within the culture 241 00:12:07,905 --> 00:12:09,365 and vision of the health system. 242 00:12:09,865 --> 00:12:13,965 Its providers and particular stakeholders, both individually 243 00:12:14,185 --> 00:12:18,125 and collectively with patients in mind. 244 00:12:18,125 --> 00:12:21,245 Health systems must clear, have a clear strategy, 245 00:12:21,305 --> 00:12:24,765 and establish the right partnerships to drive care together. 246 00:12:25,735 --> 00:12:28,615 I think certainly there may be a few vertically integrated 247 00:12:28,615 --> 00:12:30,335 health networks and 248 00:12:30,355 --> 00:12:33,775 or a few health systems that may arguably have potential 249 00:12:34,315 --> 00:12:36,695 to provide comprehensive patient-centered care 250 00:12:36,755 --> 00:12:40,175 as one entity, but even then they certainly will need 251 00:12:40,575 --> 00:12:43,015 strategic collaborative partnerships as well. 252 00:12:45,625 --> 00:12:48,995 Thus, I think partnerships and collaborations are central 253 00:12:49,095 --> 00:12:51,955 and critical across health systems in order 254 00:12:52,015 --> 00:12:54,355 to achieve scale, meet, demand, 255 00:12:54,815 --> 00:12:57,915 and share costs, both to secure health services 256 00:12:58,575 --> 00:13:00,995 and to ensure safety, security, 257 00:13:01,055 --> 00:13:02,515 and privacy for our patients. 258 00:13:04,275 --> 00:13:06,535 And I think along with strategic partnerships, 259 00:13:07,495 --> 00:13:10,165 leadership must engage governance structure 260 00:13:10,465 --> 00:13:13,445 and boards to look beyond the financials 261 00:13:14,335 --> 00:13:18,195 and to determine appropriate physical footprint, scope, 262 00:13:18,735 --> 00:13:22,275 and infrastructure and to integrate appropriate technology 263 00:13:22,295 --> 00:13:24,715 and innovation to augment care 264 00:13:24,935 --> 00:13:27,995 for the particular communities and regions it serves. 265 00:13:29,245 --> 00:13:31,205 Ultimately, I would say healthcare is not easy. 266 00:13:31,305 --> 00:13:33,525 We know this, but it's the most rewarding 267 00:13:33,905 --> 00:13:35,205 and like no other sector 268 00:13:35,275 --> 00:13:38,525 because of the consumers we serve, which is our patients. 269 00:13:39,365 --> 00:13:42,185 So I think healthcare leaders along with their internal 270 00:13:42,185 --> 00:13:44,865 and external networks must continue 271 00:13:44,865 --> 00:13:45,985 to embrace these opportunities 272 00:13:46,605 --> 00:13:50,665 and must all always hold on to the why of what we do 273 00:13:51,285 --> 00:13:52,625 as they meet these challenges. 274 00:13:54,625 --> 00:13:56,155 - Yeah, wonderful. Thank you so much 275 00:13:56,175 --> 00:13:57,435 for those final thoughts, doctor. 276 00:13:57,585 --> 00:14:00,315 This has definitely been an amazing, informative discussion. 277 00:14:00,615 --> 00:14:01,915 So again, I wanna thank you so much 278 00:14:01,915 --> 00:14:03,355 for coming back on Becker's Healthcare. 279 00:14:03,455 --> 00:14:04,555 We really do appreciate it 280 00:14:04,735 --> 00:14:06,355 and I look forward to connecting with you again soon. 281 00:14:07,935 --> 00:14:09,805 - Thank you very much, Mariah. Have a good day. 282 00:14:10,105 --> 00:14:10,445 - You too.