1 00:00:02,000 --> 00:00:04,419 This is where health care leadership comes together. 2 00:00:04,559 --> 00:00:07,679 Becker's sixteenth annual meeting brings more than 3,500 3 00:00:07,679 --> 00:00:10,880 hospital and health system executives and nearly 800 4 00:00:10,880 --> 00:00:14,259 speakers to Chicago April. 5 00:00:14,615 --> 00:00:17,335 This year's event includes keynote conversations with Dallas 6 00:00:17,335 --> 00:00:20,214 Cowboys legend Troy Aikman and former president George 7 00:00:20,214 --> 00:00:22,934 w Bush. For the agenda and event details, 8 00:00:22,934 --> 00:00:25,175 visit beckershospitalreview.com 9 00:00:25,175 --> 00:00:26,855 and click on the events tab in the 10 00:00:26,855 --> 00:00:29,574 upper right. We're looking forward to hosting you 11 00:00:29,574 --> 00:00:30,314 in Chicago. 12 00:00:31,710 --> 00:00:34,130 Welcome to the Becker's Healthcare podcast. 13 00:00:34,670 --> 00:00:37,649 I'm Elizabeth Gregersen, a reporter here at Becker's, 14 00:00:37,710 --> 00:00:40,590 and I'm thrilled today to interview doctor Robert 15 00:00:40,590 --> 00:00:41,090 Figlin, 16 00:00:41,630 --> 00:00:43,649 interim director of Cedars Sinai 17 00:00:43,995 --> 00:00:47,515 Cancer and interim director of the Samuel Ocean 18 00:00:47,515 --> 00:00:50,954 Comprehensive Cancer Institute on the podcast today. Doctor 19 00:00:50,954 --> 00:00:52,875 Figlin, thank you so much for joining me. 20 00:00:52,875 --> 00:00:54,954 I'm so grateful to share your insights with 21 00:00:54,954 --> 00:00:55,615 our audience. 22 00:00:56,409 --> 00:00:58,090 Thanks so much for the invitation. Happy to 23 00:00:58,090 --> 00:00:58,670 be here. 24 00:00:59,210 --> 00:01:01,530 Great. And before we dive in, could you 25 00:01:01,530 --> 00:01:03,369 introduce yourself and maybe just give a little 26 00:01:03,369 --> 00:01:05,310 bit about your background and your organization? 27 00:01:06,329 --> 00:01:09,209 Certainly. So I'm the Steven Spielberg family chair 28 00:01:09,209 --> 00:01:10,670 in hematology oncology. 29 00:01:11,355 --> 00:01:14,174 I'm a professor of medicine and biomedical sciences 30 00:01:14,795 --> 00:01:17,295 at the Cedars Sinai Health Sciences University. 31 00:01:18,234 --> 00:01:20,715 And I lead the service line and the 32 00:01:20,715 --> 00:01:22,895 cancer efforts across our health system, 33 00:01:23,275 --> 00:01:25,135 which include multiple hospitals, 34 00:01:26,100 --> 00:01:26,920 many practices, 35 00:01:27,540 --> 00:01:30,180 as well as our flagship center in, in 36 00:01:30,180 --> 00:01:32,900 West Hollywood and Beverly Hills, our which is 37 00:01:32,900 --> 00:01:34,439 our academic medical center. 38 00:01:35,299 --> 00:01:37,700 Perfect. Thank you. And I'm grateful to talk 39 00:01:37,700 --> 00:01:39,965 to you. You know, it's not January 1, 40 00:01:39,965 --> 00:01:41,564 but it's still the beginning of the year. 41 00:01:41,564 --> 00:01:43,084 So I'm grateful to kind of get your 42 00:01:43,084 --> 00:01:44,064 insights on, 43 00:01:44,605 --> 00:01:47,084 the landscape of cancer care today and maybe 44 00:01:47,084 --> 00:01:48,605 what we can look forward to in the 45 00:01:48,605 --> 00:01:49,105 future. 46 00:01:49,724 --> 00:01:52,069 But before we get too far ahead of 47 00:01:52,069 --> 00:01:54,810 ourselves, I'd love to know from your vantage 48 00:01:54,869 --> 00:01:55,369 point. 49 00:01:55,989 --> 00:01:58,170 Our audience, you know, they're made up of 50 00:01:58,789 --> 00:02:01,989 health system leaders that maybe aren't completely in 51 00:02:01,989 --> 00:02:03,289 the cancer space, 52 00:02:03,750 --> 00:02:05,369 other specialties, other priorities. 53 00:02:06,295 --> 00:02:08,294 I'd love to know in your experience where 54 00:02:08,294 --> 00:02:09,435 you've seen maybe 55 00:02:10,135 --> 00:02:10,635 misalignment 56 00:02:11,254 --> 00:02:13,915 between a cancer program's growth ambition 57 00:02:14,615 --> 00:02:16,635 and those broader system priorities. 58 00:02:17,254 --> 00:02:19,495 And how can our audience as health care 59 00:02:19,495 --> 00:02:19,995 executives 60 00:02:20,610 --> 00:02:22,789 strategically decide how to balance, 61 00:02:23,330 --> 00:02:24,549 you know, those priorities, 62 00:02:25,169 --> 00:02:26,949 maybe deciding where to invest 63 00:02:27,250 --> 00:02:28,389 or not to invest, 64 00:02:28,769 --> 00:02:31,009 in cancer care over the next three to 65 00:02:31,009 --> 00:02:31,750 five years? 66 00:02:32,544 --> 00:02:34,465 Yeah. That that's a great question. And I 67 00:02:34,465 --> 00:02:36,884 think a question that we all struggle with, 68 00:02:37,424 --> 00:02:39,905 not just today, but we struggle with over 69 00:02:39,905 --> 00:02:40,805 the last decade. 70 00:02:41,264 --> 00:02:42,324 And I think that, 71 00:02:43,344 --> 00:02:46,625 what Cedars Sinai is a horizontally integrated health 72 00:02:46,625 --> 00:02:47,125 system. 73 00:02:47,449 --> 00:02:49,530 And what I mean by that is that 74 00:02:49,530 --> 00:02:52,030 there are always going to be competing priorities 75 00:02:52,090 --> 00:02:52,909 for assets, 76 00:02:53,370 --> 00:02:56,509 whether it's, brick and mortar assets or research 77 00:02:56,569 --> 00:02:57,549 assets or, 78 00:02:58,330 --> 00:02:59,150 or personnel. 79 00:02:59,784 --> 00:03:02,745 And I think that what's clear is that, 80 00:03:03,224 --> 00:03:05,004 we as a service line, 81 00:03:06,104 --> 00:03:06,604 constantly 82 00:03:07,145 --> 00:03:08,764 try to make the case to leadership 83 00:03:09,784 --> 00:03:10,284 that, 84 00:03:10,824 --> 00:03:13,625 the changes that will occur in care for 85 00:03:13,625 --> 00:03:14,525 cancer patients 86 00:03:15,060 --> 00:03:16,280 over the next decade 87 00:03:16,740 --> 00:03:19,060 will dictate the priorities of what we do 88 00:03:19,060 --> 00:03:21,000 today. What do I mean by that? 89 00:03:21,379 --> 00:03:23,879 You just heard from the American Cancer Society 90 00:03:24,260 --> 00:03:26,659 that more than seventy percent of patients survive 91 00:03:26,659 --> 00:03:28,840 more than five years with cancer. 92 00:03:29,365 --> 00:03:31,525 Now what that means is that more and 93 00:03:31,525 --> 00:03:33,925 more cancer patients are going to become part 94 00:03:33,925 --> 00:03:34,985 of our health system 95 00:03:35,365 --> 00:03:37,544 whether it's patients with active cancer, 96 00:03:38,245 --> 00:03:39,784 patients who are in remission, 97 00:03:40,165 --> 00:03:42,104 or patients who are survivors, 98 00:03:42,730 --> 00:03:44,670 or for a place like like Cedars, 99 00:03:45,050 --> 00:03:46,430 people who are at risk 100 00:03:46,730 --> 00:03:48,670 and need, aggressive screening. 101 00:03:49,210 --> 00:03:51,210 So I think it's important for us to 102 00:03:51,210 --> 00:03:52,830 continue to make the case 103 00:03:53,290 --> 00:03:53,790 recognizing 104 00:03:54,170 --> 00:03:55,710 that those competing interests 105 00:03:56,264 --> 00:03:59,405 are also aligned with a horizontally integrated system, 106 00:03:59,864 --> 00:04:03,405 meaning that more cancer patients are developing cardiovascular 107 00:04:03,704 --> 00:04:04,204 disease. 108 00:04:04,664 --> 00:04:08,424 More cancer patients are developing diseases associated with 109 00:04:08,424 --> 00:04:09,324 chronic toxicity 110 00:04:09,625 --> 00:04:10,444 and survivorship, 111 00:04:11,280 --> 00:04:13,139 and these are all gonna be required. 112 00:04:13,599 --> 00:04:15,699 But for the active cancer patient, 113 00:04:16,000 --> 00:04:18,180 the patient with newly diagnosed cancer, 114 00:04:18,720 --> 00:04:20,639 the key for the patient and the key 115 00:04:20,639 --> 00:04:22,419 for the system is access. 116 00:04:23,519 --> 00:04:26,500 Access, access, access. If you're a cancer patient 117 00:04:26,904 --> 00:04:29,404 and you want access to our health system 118 00:04:29,544 --> 00:04:31,564 or any health system across the country, 119 00:04:32,104 --> 00:04:34,024 you wanna know that when you are at 120 00:04:34,024 --> 00:04:35,165 risk for that diagnosis, 121 00:04:35,625 --> 00:04:37,404 that you're going to be able to access 122 00:04:37,544 --> 00:04:38,044 experts, 123 00:04:38,504 --> 00:04:41,464 people people capable of delivering care in an 124 00:04:41,464 --> 00:04:42,604 expedited fashion. 125 00:04:43,199 --> 00:04:44,560 So one of the ways that we've dealt 126 00:04:44,560 --> 00:04:46,899 with that in the Cedars Sinai health system 127 00:04:47,199 --> 00:04:48,879 is in what I would otherwise call a 128 00:04:48,879 --> 00:04:51,779 distributed model. What do I mean by that? 129 00:04:51,920 --> 00:04:53,220 We have other hospitals. 130 00:04:53,680 --> 00:04:56,480 We have other practices that are all under 131 00:04:56,480 --> 00:04:57,139 our domain. 132 00:04:57,724 --> 00:04:59,185 They use our infrastructure, 133 00:05:00,125 --> 00:05:00,625 our, 134 00:05:01,404 --> 00:05:01,904 EHR, 135 00:05:02,685 --> 00:05:03,504 our organizational, 136 00:05:04,764 --> 00:05:05,664 supply lines. 137 00:05:06,125 --> 00:05:08,204 But it's critical because I think one thing 138 00:05:08,204 --> 00:05:11,504 that's also changed about cancer care in 2026 139 00:05:11,805 --> 00:05:12,784 and going forward 140 00:05:13,129 --> 00:05:15,849 is patients would like to receive their care 141 00:05:15,849 --> 00:05:17,870 close to home if at all possible. 142 00:05:18,569 --> 00:05:20,490 And I always like to to give this 143 00:05:20,490 --> 00:05:20,990 anecdote. 144 00:05:21,689 --> 00:05:24,970 Cedars Sinai Health System serves a population of, 145 00:05:25,050 --> 00:05:25,550 approximately 146 00:05:26,009 --> 00:05:28,750 11 plus million people in our catchment area. 147 00:05:29,475 --> 00:05:30,454 We are larger 148 00:05:30,834 --> 00:05:31,814 than some states. 149 00:05:32,354 --> 00:05:34,675 And that's important for those of you that 150 00:05:34,675 --> 00:05:37,975 visited Los Angeles, unlike Manhattan as an example, 151 00:05:38,435 --> 00:05:39,894 as we are a very horizontal, 152 00:05:41,235 --> 00:05:41,735 community. 153 00:05:42,129 --> 00:05:44,370 And sometimes it can take an extended period 154 00:05:44,370 --> 00:05:46,149 of time to travel short distances. 155 00:05:46,850 --> 00:05:49,170 That's why we believe that what people should 156 00:05:49,170 --> 00:05:49,829 be considering 157 00:05:50,610 --> 00:05:51,670 in the health system 158 00:05:52,209 --> 00:05:53,670 is bringing their expertise 159 00:05:54,050 --> 00:05:55,110 to their communities 160 00:05:55,524 --> 00:05:57,604 so that they can have town and gown 161 00:05:57,604 --> 00:05:58,104 delivered 162 00:05:58,644 --> 00:05:59,865 and reserve the, 163 00:06:00,404 --> 00:06:03,204 expertise of the center for those things that 164 00:06:03,204 --> 00:06:05,044 are necessary that can't be delivered in the 165 00:06:05,044 --> 00:06:05,544 community. 166 00:06:06,564 --> 00:06:07,064 Absolutely. 167 00:06:07,919 --> 00:06:09,439 Thank you for laying that all out and 168 00:06:09,439 --> 00:06:11,600 kind of giving, you know, that geographic visual, 169 00:06:11,600 --> 00:06:13,360 but I think it just ties back perfectly 170 00:06:13,360 --> 00:06:15,439 to what you said about access. You know, 171 00:06:15,439 --> 00:06:18,100 when there are all those, you know, survivorship, 172 00:06:19,519 --> 00:06:20,019 considerations 173 00:06:20,639 --> 00:06:21,139 and 174 00:06:21,564 --> 00:06:24,444 this chronic now condition that people are are 175 00:06:24,444 --> 00:06:25,824 saying cancer may be, 176 00:06:26,285 --> 00:06:28,365 none of that care can happen, right, without 177 00:06:28,365 --> 00:06:30,144 access. So, you know, 178 00:06:30,444 --> 00:06:33,084 we need that access first in order for 179 00:06:33,084 --> 00:06:35,185 patients to to receive 180 00:06:35,579 --> 00:06:37,500 all that innovation. And and I I think 181 00:06:37,500 --> 00:06:39,099 that's absolutely true, but it but it can't 182 00:06:39,180 --> 00:06:41,519 has to be more than access only 183 00:06:41,899 --> 00:06:44,240 because it has to be access with deliverables, 184 00:06:44,620 --> 00:06:46,699 in my view. And what I mean by 185 00:06:46,699 --> 00:06:49,274 that is we need we have what I 186 00:06:49,274 --> 00:06:51,675 I think most places would consider a team 187 00:06:51,675 --> 00:06:52,175 approach, 188 00:06:52,555 --> 00:06:54,254 whether it's our multi d clinics, 189 00:06:55,194 --> 00:06:58,314 in pancreas cancer, colorectal cancer, lung cancer, and 190 00:06:58,314 --> 00:06:59,055 breast cancer. 191 00:06:59,610 --> 00:07:01,250 But it's also, as we'll talk about in 192 00:07:01,250 --> 00:07:03,769 a bit, the appropriate use of mid level 193 00:07:03,769 --> 00:07:04,269 providers 194 00:07:04,649 --> 00:07:07,069 to make sure that we are delivering care 195 00:07:07,209 --> 00:07:10,349 in a comprehensive way where everyone is practicing 196 00:07:10,409 --> 00:07:11,709 at the top of their license 197 00:07:12,089 --> 00:07:14,250 and making sure that we bring patients through 198 00:07:14,250 --> 00:07:16,514 the system in a way that's compatible with 199 00:07:16,514 --> 00:07:17,975 what they need for their care. 200 00:07:19,074 --> 00:07:19,574 Perfect. 201 00:07:20,274 --> 00:07:21,254 I'd love to 202 00:07:21,714 --> 00:07:23,814 talk about another operational bridge, 203 00:07:24,995 --> 00:07:27,714 discovery and clinical care. Right? So that's that's 204 00:07:27,714 --> 00:07:29,074 a big one I always hear is the 205 00:07:29,074 --> 00:07:30,214 bench to the bedside. 206 00:07:31,079 --> 00:07:34,439 How at Cedars Sinai and Samuel Ocean have 207 00:07:34,439 --> 00:07:36,839 you approached kind of building that bridge between 208 00:07:36,839 --> 00:07:39,800 discovery and clinical care? And what lessons might 209 00:07:39,800 --> 00:07:41,660 be relevant for other health systems? 210 00:07:42,120 --> 00:07:44,279 I've covered a lot recently that are trying 211 00:07:44,279 --> 00:07:46,220 to kind of scale innovation and research 212 00:07:46,805 --> 00:07:47,305 responsibly? 213 00:07:48,245 --> 00:07:50,425 Yeah. So that's that's a great question, Elizabeth. 214 00:07:50,485 --> 00:07:51,044 And I think, 215 00:07:52,084 --> 00:07:53,305 first, let me say, 216 00:07:53,685 --> 00:07:56,904 in my multiple decades as a cancer investigator 217 00:07:57,524 --> 00:07:59,444 Mhmm. I would just regret 218 00:07:59,925 --> 00:08:01,944 I would I would not I would regret 219 00:08:02,720 --> 00:08:04,979 not being able to say to people 220 00:08:05,600 --> 00:08:07,939 that the care that we deliver today 221 00:08:08,399 --> 00:08:10,399 is on the backs of patients that had 222 00:08:10,399 --> 00:08:12,740 participated in clinical research previously. 223 00:08:13,279 --> 00:08:15,519 Mhmm. So there is no line in my 224 00:08:15,519 --> 00:08:18,259 view between clinical care and research. 225 00:08:18,634 --> 00:08:19,134 Why? 226 00:08:19,514 --> 00:08:22,394 Because I believe when cancer patients want to 227 00:08:22,394 --> 00:08:25,035 receive their care, they wanna know not only 228 00:08:25,035 --> 00:08:27,295 what is best available for them today, 229 00:08:27,754 --> 00:08:30,154 but what might be available to them for 230 00:08:30,154 --> 00:08:32,475 a possible treatment that might be in the 231 00:08:32,475 --> 00:08:32,975 future. 232 00:08:33,379 --> 00:08:35,700 So I think at Cedars Sinai, we fully 233 00:08:35,700 --> 00:08:36,200 embed 234 00:08:36,740 --> 00:08:39,320 our clinical research efforts in our EHR. 235 00:08:39,940 --> 00:08:42,820 We deliver our clinical research across our health 236 00:08:42,820 --> 00:08:43,320 system. 237 00:08:44,100 --> 00:08:46,945 We drive our clinical research and our basic 238 00:08:46,945 --> 00:08:49,205 research through the paradigm of translation. 239 00:08:50,065 --> 00:08:52,884 We expect our cancer programs of cancer biology, 240 00:08:53,264 --> 00:08:54,245 cancer therapeutics, 241 00:08:54,945 --> 00:08:58,065 and and population science to ask and answer 242 00:08:58,065 --> 00:09:00,480 questions that are critical to our catchment area. 243 00:09:01,039 --> 00:09:03,120 And I wanna remind people, Los Angeles is 244 00:09:03,120 --> 00:09:04,179 a unique city, 245 00:09:04,720 --> 00:09:07,360 probably not unlike New York City, but very 246 00:09:07,360 --> 00:09:09,539 different than other populations in the country. 247 00:09:10,079 --> 00:09:13,620 We have a large Latino population, African American, 248 00:09:14,434 --> 00:09:16,855 Asian, especially Korean, LGBTQ, 249 00:09:18,034 --> 00:09:18,514 large, 250 00:09:18,835 --> 00:09:19,735 BRCA population. 251 00:09:20,355 --> 00:09:23,095 So the key for us is to align 252 00:09:23,315 --> 00:09:24,695 our priority cancers 253 00:09:25,154 --> 00:09:27,480 with the people that are seeking our care. 254 00:09:27,799 --> 00:09:30,199 And to do that through a collaborative effort 255 00:09:30,199 --> 00:09:31,899 from the lab to the clinic, 256 00:09:32,440 --> 00:09:34,699 never forgetting that even the laboratory 257 00:09:35,079 --> 00:09:36,459 questions being asked 258 00:09:36,759 --> 00:09:39,339 must in the future have translational applications 259 00:09:40,120 --> 00:09:42,860 and recognizing that the patients that we serve 260 00:09:43,315 --> 00:09:44,995 are critical. One of the ways that we've 261 00:09:44,995 --> 00:09:46,675 done that, and I would encourage many people 262 00:09:46,675 --> 00:09:48,995 to do that, is we have what's called 263 00:09:48,995 --> 00:09:51,254 an active community advisory board. 264 00:09:51,634 --> 00:09:54,134 Our community advisory board is diverse. 265 00:09:54,595 --> 00:09:56,835 It is established through our community outreach and 266 00:09:56,835 --> 00:09:57,975 engagement program. 267 00:09:58,329 --> 00:10:00,970 And what that does is it informs the 268 00:10:00,970 --> 00:10:03,549 science of what's important in the community. 269 00:10:04,089 --> 00:10:07,289 Sometimes as investigators, we might not completely align 270 00:10:07,289 --> 00:10:09,929 with what does the community want. And our 271 00:10:09,929 --> 00:10:13,149 community advisory board has been a strong advocate 272 00:10:13,535 --> 00:10:16,254 for asking the right questions for what's important 273 00:10:16,254 --> 00:10:17,634 for the people that we serve. 274 00:10:18,254 --> 00:10:19,855 Perfect. Yeah. And I feel like, you know, 275 00:10:19,855 --> 00:10:22,514 having that community center too can just inform, 276 00:10:22,735 --> 00:10:25,695 like you said, that connection between discovery and 277 00:10:25,695 --> 00:10:28,440 and the clinical care. It it all matches 278 00:10:28,440 --> 00:10:29,740 up completely together. 279 00:10:30,519 --> 00:10:32,519 On a similar note, we can't really talk 280 00:10:32,519 --> 00:10:35,340 about clinical care without talking about the workforce. 281 00:10:36,279 --> 00:10:37,960 And even, you know, research, we can't talk 282 00:10:37,960 --> 00:10:39,660 about without talking about the workforce. 283 00:10:41,154 --> 00:10:42,914 You know, for our listeners who may be, 284 00:10:42,914 --> 00:10:46,214 you know, leading health systems, not leading just 285 00:10:46,274 --> 00:10:48,434 cancer service lines, but leading, you know, entire 286 00:10:48,434 --> 00:10:51,174 systems that are balancing workforce issues, 287 00:10:51,554 --> 00:10:52,615 what are the oncology 288 00:10:52,995 --> 00:10:53,495 specific 289 00:10:54,179 --> 00:10:56,259 considerations do you feel that they should be 290 00:10:56,259 --> 00:10:58,820 watching more most closely when it comes to 291 00:10:58,820 --> 00:11:00,200 the cancer work workforce? 292 00:11:00,659 --> 00:11:03,159 And maybe how does Cedars Sinai think about 293 00:11:03,379 --> 00:11:05,240 recruitment and retaining talent 294 00:11:05,620 --> 00:11:07,240 in in the environment today? 295 00:11:08,095 --> 00:11:09,695 So I think I think I think it's 296 00:11:09,695 --> 00:11:12,975 a a pertinent question to 2026 297 00:11:12,975 --> 00:11:13,875 and going forward. 298 00:11:14,254 --> 00:11:14,995 The workforce 299 00:11:15,534 --> 00:11:16,034 is, 300 00:11:16,815 --> 00:11:19,235 is a challenge in large part 301 00:11:19,695 --> 00:11:22,115 because we're not training enough cancer experts. 302 00:11:22,720 --> 00:11:25,379 So part of the challenge is the pipeline 303 00:11:25,759 --> 00:11:26,259 for, 304 00:11:26,799 --> 00:11:31,200 physicians is challenged within the oncology workforce. Having 305 00:11:31,200 --> 00:11:31,940 said that, 306 00:11:32,320 --> 00:11:34,320 the way we manage that is through the 307 00:11:34,320 --> 00:11:36,144 lens of we have 308 00:11:36,684 --> 00:11:39,485 experts in diseases in our 13 disease research 309 00:11:39,485 --> 00:11:40,785 groups at the main, 310 00:11:41,325 --> 00:11:44,065 academic medical center, Cedars Sinai Cancer Center. 311 00:11:44,524 --> 00:11:46,865 But we have other types of of physicians 312 00:11:47,325 --> 00:11:49,165 in the cancer workforce that are in our 313 00:11:49,165 --> 00:11:50,144 community practices 314 00:11:50,700 --> 00:11:53,420 where physicians coming out of training programs are 315 00:11:53,420 --> 00:11:56,700 looking more toward a community type practice as 316 00:11:56,700 --> 00:11:59,259 opposed to an academic practice. And then what 317 00:11:59,259 --> 00:12:00,860 we try and do is we are trying 318 00:12:00,860 --> 00:12:02,000 to align incentives 319 00:12:02,585 --> 00:12:05,164 so that they're aligned with where they practice. 320 00:12:05,225 --> 00:12:07,304 So not one size fits all. We don't 321 00:12:07,304 --> 00:12:08,845 expect our community physicians 322 00:12:09,465 --> 00:12:11,945 to, compete for peer reviewed research in high 323 00:12:11,945 --> 00:12:15,065 impact journal publications, but we do expect that 324 00:12:15,065 --> 00:12:16,959 from our from our our faculty. 325 00:12:17,500 --> 00:12:19,579 Having said that, I think the other big 326 00:12:19,579 --> 00:12:22,079 piece that we're thinking about extensively 327 00:12:22,779 --> 00:12:24,860 as we talked about previously is the use 328 00:12:24,860 --> 00:12:25,519 of the, 329 00:12:26,059 --> 00:12:28,940 advanced practice people, whether it's a PA or 330 00:12:28,940 --> 00:12:30,319 an NP. Why? 331 00:12:31,575 --> 00:12:32,715 I I think it's because, 332 00:12:33,495 --> 00:12:36,315 with as our population ages, 333 00:12:37,254 --> 00:12:40,154 unfortunately, there will be more new cancer cases. 334 00:12:40,615 --> 00:12:42,375 And we need to make sure that our 335 00:12:42,375 --> 00:12:43,355 cancer physicians 336 00:12:44,054 --> 00:12:44,955 have the capacity 337 00:12:45,659 --> 00:12:47,679 to take up the new cancer cases 338 00:12:48,059 --> 00:12:50,459 and are not burdened by the more chronic 339 00:12:50,459 --> 00:12:50,959 cases 340 00:12:51,339 --> 00:12:53,820 where they don't allow for the new cases 341 00:12:53,820 --> 00:12:56,799 to enter. And that's where APP is practicing 342 00:12:57,419 --> 00:12:58,639 at the top of their license 343 00:12:59,184 --> 00:13:01,904 can support the care of the patient, the 344 00:13:01,904 --> 00:13:04,065 care of the journey, and the care of 345 00:13:04,065 --> 00:13:06,065 the outcome. And I just for those of 346 00:13:06,065 --> 00:13:07,585 you that might be interested, I did a 347 00:13:07,585 --> 00:13:10,065 podcast with Oncology News Central just a little 348 00:13:10,065 --> 00:13:13,205 bit ago with Sunita Puri from, Irvine. 349 00:13:13,779 --> 00:13:15,539 And it was the title of it was 350 00:13:15,539 --> 00:13:17,559 new reality for terminal cancer. 351 00:13:18,179 --> 00:13:20,820 And what that talked about and much different 352 00:13:20,820 --> 00:13:22,440 than when I started my training 353 00:13:22,820 --> 00:13:25,059 is the number of patients that we have 354 00:13:25,059 --> 00:13:25,960 in our clinics 355 00:13:26,445 --> 00:13:28,785 that have had extended lives 356 00:13:29,245 --> 00:13:31,245 as a result of the treatments that we 357 00:13:31,245 --> 00:13:31,985 can offer. 358 00:13:32,365 --> 00:13:34,465 Those lives are likely not cured 359 00:13:35,085 --> 00:13:37,485 as in some patients, but they can live 360 00:13:37,485 --> 00:13:40,519 for years. And those patients now need to 361 00:13:40,519 --> 00:13:43,160 be managed through a cohort of groups of 362 00:13:43,160 --> 00:13:45,019 pay of of of of caregivers, 363 00:13:45,639 --> 00:13:48,440 including advanced practice to make sure that not 364 00:13:48,440 --> 00:13:50,120 only do they deliver the care they're seeing 365 00:13:50,120 --> 00:13:51,559 and seeing the right person at the right 366 00:13:51,559 --> 00:13:53,500 time, have access to the expert, 367 00:13:53,964 --> 00:13:56,284 but allows the expert to actually access the 368 00:13:56,284 --> 00:13:57,884 new patients that need to see us in 369 00:13:57,884 --> 00:13:58,464 the system. 370 00:13:59,325 --> 00:14:01,485 Thank you for for sharing that. Yeah. And, 371 00:14:01,644 --> 00:14:02,144 if 372 00:14:02,684 --> 00:14:03,184 I'm 373 00:14:03,565 --> 00:14:05,664 taking it incorrectly, it's kind of 374 00:14:06,059 --> 00:14:09,440 the advanced practice providers. They have the space, 375 00:14:09,660 --> 00:14:11,500 and if they're practicing at the top of 376 00:14:11,500 --> 00:14:13,360 their license, they can care for those 377 00:14:13,660 --> 00:14:17,039 patients and then allowing for the new diagnosis 378 00:14:18,174 --> 00:14:21,075 to fuel through to the physician, you know, 379 00:14:21,134 --> 00:14:23,134 no matter the care setting, to kind of 380 00:14:23,134 --> 00:14:25,535 maybe support that survivorship balance that we were 381 00:14:25,535 --> 00:14:27,475 talking about, right at the beginning. 382 00:14:27,855 --> 00:14:29,774 And I think and I think further, Elizabeth, 383 00:14:29,774 --> 00:14:30,434 I think 384 00:14:30,769 --> 00:14:32,370 one of the things that we have not 385 00:14:32,370 --> 00:14:34,389 done a good job in nationally 386 00:14:35,250 --> 00:14:39,009 is allowing our patients and our future patients 387 00:14:39,009 --> 00:14:39,669 to understand 388 00:14:40,290 --> 00:14:43,330 that the team approach to cancer care is 389 00:14:43,330 --> 00:14:44,529 still going to be, 390 00:14:44,850 --> 00:14:45,750 best of class. 391 00:14:46,074 --> 00:14:48,334 And then and then I you know, patients 392 00:14:48,394 --> 00:14:50,654 often become very attached to their physicians. 393 00:14:51,034 --> 00:14:51,934 That's understandable. 394 00:14:52,634 --> 00:14:54,634 But it's best that they we start to 395 00:14:54,634 --> 00:14:57,534 educate them about being attached to their physician 396 00:14:57,674 --> 00:14:58,174 teams 397 00:14:58,634 --> 00:15:00,815 as opposed to just the physician themselves. 398 00:15:01,820 --> 00:15:03,679 Yeah. I love that. I love that mindset. 399 00:15:04,779 --> 00:15:07,419 I guess, speaking of building a team, kind 400 00:15:07,419 --> 00:15:08,480 of looking ahead, 401 00:15:09,100 --> 00:15:11,820 maybe this that team mentality is is one 402 00:15:11,820 --> 00:15:14,379 strategy. But what other kind of strategies have 403 00:15:14,379 --> 00:15:15,039 you seen 404 00:15:15,554 --> 00:15:19,414 succeed or stall cancer care within health systems? 405 00:15:20,115 --> 00:15:23,335 Maybe that's organizational capabilities, you know, government, 406 00:15:23,955 --> 00:15:25,794 position alignment, all sorts of different things. You 407 00:15:25,794 --> 00:15:27,654 could take it at any direction. But 408 00:15:28,115 --> 00:15:30,190 what, you know, two or three have you 409 00:15:30,190 --> 00:15:32,450 seen that really determine whether a health system 410 00:15:32,830 --> 00:15:34,370 cancer strategy succeeds? 411 00:15:35,309 --> 00:15:37,550 So I I think that it is absolutely 412 00:15:37,550 --> 00:15:39,009 critical that we be creative. 413 00:15:39,470 --> 00:15:41,730 Mhmm. And and and we think about 414 00:15:42,190 --> 00:15:44,284 cancer care through the lens 415 00:15:45,144 --> 00:15:48,125 of other technology advances that are taking place 416 00:15:48,184 --> 00:15:50,184 in our in our country and in the 417 00:15:50,184 --> 00:15:53,325 world, whether that's the use of artificial intelligence, 418 00:15:53,945 --> 00:15:56,924 whether that's the use of relationships with commercial 419 00:15:56,985 --> 00:15:57,485 vendors. 420 00:15:58,720 --> 00:16:00,259 And and I think that that, 421 00:16:00,960 --> 00:16:04,100 you know, service lines in my view, especially 422 00:16:04,160 --> 00:16:05,700 cancer care service lines 423 00:16:06,240 --> 00:16:08,980 need to be looked through the lens of, 424 00:16:09,519 --> 00:16:12,160 a bit of a corporate structure. What I 425 00:16:12,160 --> 00:16:13,460 mean by that is 426 00:16:13,855 --> 00:16:15,315 how does one align, 427 00:16:16,014 --> 00:16:16,514 grow, 428 00:16:16,894 --> 00:16:19,794 and deliver care across the cancer continuum? 429 00:16:20,095 --> 00:16:21,695 So I'll give you a good example of 430 00:16:21,695 --> 00:16:23,315 where I think we are succeeding 431 00:16:23,934 --> 00:16:25,875 in an out of the box way. 432 00:16:26,495 --> 00:16:27,315 As you know, 433 00:16:28,264 --> 00:16:30,730 while taking care of cancer patients is is 434 00:16:30,730 --> 00:16:32,590 at the cornerstone of our care, 435 00:16:33,050 --> 00:16:35,790 there are many more million people at risk. 436 00:16:36,649 --> 00:16:37,790 People at risk, 437 00:16:38,410 --> 00:16:41,290 whether they're receiving screening for breast cancer, lung 438 00:16:41,290 --> 00:16:43,930 cancer, prostate cancer, or other cancers in the 439 00:16:43,930 --> 00:16:44,430 future, 440 00:16:44,834 --> 00:16:47,554 wanna receive that, at risk screening at what 441 00:16:47,554 --> 00:16:50,115 we'd otherwise call point of care. They don't 442 00:16:50,115 --> 00:16:52,355 wanna travel to the the main medical center 443 00:16:52,355 --> 00:16:54,615 for their screening. They want something that's convenient. 444 00:16:54,834 --> 00:16:56,774 They don't wanna have to leave their children 445 00:16:57,074 --> 00:16:59,340 and leave their work and leave their jobs 446 00:16:59,340 --> 00:17:01,200 in a way that is gonna make it 447 00:17:01,259 --> 00:17:03,740 in in in insufficient. So one of the 448 00:17:03,740 --> 00:17:04,960 things that we are doing 449 00:17:05,339 --> 00:17:06,240 is we are 450 00:17:06,779 --> 00:17:09,019 a a a joint venturing with a imaging 451 00:17:09,019 --> 00:17:09,519 company, 452 00:17:09,980 --> 00:17:11,500 and we'll just leave the names out of 453 00:17:11,500 --> 00:17:13,575 it for the moment. But the purpose of 454 00:17:13,575 --> 00:17:16,055 which is there are imaging organizations in our 455 00:17:16,055 --> 00:17:18,615 country which are at the point of care 456 00:17:18,615 --> 00:17:20,795 for patients that wanna receive screening. 457 00:17:21,255 --> 00:17:22,934 And then what we've done is we have 458 00:17:22,934 --> 00:17:24,234 established warm handoffs 459 00:17:24,750 --> 00:17:26,289 between the screening evaluation 460 00:17:26,990 --> 00:17:29,730 and the academic cancer center or their affiliates. 461 00:17:30,029 --> 00:17:32,029 And what we have found in breast cancer 462 00:17:32,029 --> 00:17:34,210 and now expanding that to lung and and 463 00:17:34,509 --> 00:17:37,974 and prostate cancer is what patients want is 464 00:17:37,974 --> 00:17:40,694 they want easy access for screening. They wanna 465 00:17:40,694 --> 00:17:42,075 note if there's an abnormality 466 00:17:42,375 --> 00:17:44,214 that they have a warm handoff to an 467 00:17:44,214 --> 00:17:46,294 expert, and they wanna know that that's gonna 468 00:17:46,294 --> 00:17:48,714 be conducive with respect to their own insurance 469 00:17:48,855 --> 00:17:51,380 or their own payer. So we need to 470 00:17:51,380 --> 00:17:53,400 be thinking about innovative models. 471 00:17:53,779 --> 00:17:56,339 Other things that we're doing is we're obviously 472 00:17:56,339 --> 00:17:58,900 thinking about other vendors that are building our 473 00:17:58,900 --> 00:17:59,400 infrastructure. 474 00:17:59,859 --> 00:18:02,900 That's whether that's the infrastructure for molecular testing 475 00:18:02,900 --> 00:18:04,119 and precision medicine, 476 00:18:04,545 --> 00:18:06,965 the infrastructure for clinical trial enrollment. 477 00:18:07,345 --> 00:18:09,365 Those are all things that can be centralized 478 00:18:09,424 --> 00:18:12,244 at the hub and distributed across the system 479 00:18:12,465 --> 00:18:14,625 that I think make the patient and the 480 00:18:14,625 --> 00:18:16,485 system more user friendly. 481 00:18:17,429 --> 00:18:19,269 Right. Yeah. I I love that mindset of 482 00:18:19,269 --> 00:18:21,130 kind of collaboration and care coordination. 483 00:18:22,069 --> 00:18:24,149 It all ties back to access. Right? And 484 00:18:24,149 --> 00:18:26,169 and making those intentional choices 485 00:18:26,470 --> 00:18:28,809 to to help patients receive care. 486 00:18:29,375 --> 00:18:30,975 Yeah. I think I think, you know, as 487 00:18:30,975 --> 00:18:33,154 as we close, Elizabeth, I think that 488 00:18:33,615 --> 00:18:35,455 that, you know, one of the things I 489 00:18:35,455 --> 00:18:38,095 love about Cedars and have for my sixteen 490 00:18:38,095 --> 00:18:40,494 years being here is we are a patient 491 00:18:40,494 --> 00:18:41,475 centric organization. 492 00:18:42,590 --> 00:18:43,890 What what does that mean? 493 00:18:44,190 --> 00:18:46,830 It means that we have to view everything 494 00:18:46,830 --> 00:18:48,509 that we do through the eyes of the 495 00:18:48,509 --> 00:18:50,289 patient, whether that is science, 496 00:18:51,150 --> 00:18:51,650 access, 497 00:18:52,190 --> 00:18:52,690 translation, 498 00:18:53,630 --> 00:18:54,130 discovery. 499 00:18:54,694 --> 00:18:56,535 It has to be viewed through the lens 500 00:18:56,535 --> 00:18:58,535 of the of the patient. And as long 501 00:18:58,535 --> 00:19:00,375 as we keep our so called eye on 502 00:19:00,375 --> 00:19:02,535 the ball, I think that we we will 503 00:19:02,535 --> 00:19:04,154 succeed because the patients, 504 00:19:05,095 --> 00:19:07,255 want to see that they're part of a 505 00:19:07,255 --> 00:19:08,234 larger organizational 506 00:19:08,535 --> 00:19:10,820 structure so that if and when they need 507 00:19:10,820 --> 00:19:12,600 us, we will be there for them. 508 00:19:13,539 --> 00:19:15,940 Amazing. Well, I think that's the perfect spot 509 00:19:15,940 --> 00:19:18,019 to leave it for today. Thank you so 510 00:19:18,019 --> 00:19:20,019 much for joining me, for taking the time 511 00:19:20,019 --> 00:19:22,180 to share your insights. I know that they'll 512 00:19:22,180 --> 00:19:25,294 be so valuable and informative to our listeners. 513 00:19:25,294 --> 00:19:27,294 So thank you for joining me. Thanks for 514 00:19:27,294 --> 00:19:29,534 inviting me, Elizabeth. Have a great day. Thanks. 515 00:19:29,534 --> 00:19:31,134 And I invite our listeners to tune in 516 00:19:31,134 --> 00:19:33,855 to more podcasts from Becker's Healthcare by visiting 517 00:19:33,855 --> 00:19:35,075 our podcast page 518 00:19:35,375 --> 00:19:37,911 at beckershospitalreview.com. 519 00:19:37,911 --> 00:19:38,891 Hope you have a wonderful rest of your 520 00:19:39,351 --> 00:19:39,851 day.