Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Jame Abraham, Chair of Hematology and Medical Oncology at Cleveland Clinic

Transcript

Dr. Jame Abraham, Chair of Hematology and Medical Oncology at Cleveland Clinic · Becker’s Healthcare - Clinical Leadership Podcast

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  - This is Laura Dedo with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Dr. James Abraham, chair
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  of hematology and medical oncology at Cleveland Clinic.
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  Dr. Abraham, it's a pleasure
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  to have you on the podcast today.
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  - Uh, thank you, Laura. It's, uh, an honor for me
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  to be part of this podcast.
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  - Well, fantastic. And you know, I'm looking excited
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  to our conversation because there's
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  so much happening in cancer care today and,
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  and really, I know Cleveland Clinic is on the forefront
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  of a lot of the different innovations and, and treatments.
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  So I'm looking forward to learning more
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  about what you have in store.
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  But before we dive into my questions,
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  can you tell us a little bit more
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  about yourself and your background?
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  - Uh, sure. Um, so I'm the department chair, uh,
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  for the hematology and oncology at, uh, Cleveland Clinic.
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  Um, I'm a breast cancer doctor.
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  Uh, so I've been doing breast cancer, uh,
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  for the last 20 years or so.
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  Um, uh, that's my patient care focus.
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  Um, and then of course, um, clinical trials
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  through N-S-A-B-P and N Energy
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  and many different large clinical trials group.
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  Uh, from an administrative perspective, for the last, um,
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  uh, four or almost five years, uh, I've been running one
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  of the largest, um, uh, hemo departments in the country.
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  And as you know, we have presence here in Ohio.
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  Uh, we have more than a hundred hematology oncology doctors
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  here in Ohio, and we have, uh, presence in Florida,
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  and we have presence in, uh, uh, in Abu Dhabi.
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  Um, so it's a global, uh, uh, organization, um,
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  delivering cancer care.
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  - Absolutely. Well, fantastic. Um, you know, and,
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  and I'm wondering from your vantage point leading such a
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  great institution at Cleveland Clinic, um, for cancer care,
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  what are some of the biggest issues
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  that you're following in 2024?
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  - So, um, so let me kind of say, you know, some
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  of the external issues and some of the internal issues.
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  Um, so external when we watch
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  and see what's happening, um,
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  and I'm talking about outside, purely outside
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  of the four walls of the hospital,
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  and we are looking at, um, um, um, uh,
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  the cost of care delivery.
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  Um, again, that's not unique for healthcare,
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  and it's not just unique for oncology, uh, space,
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  but, you know, overall care delivery, uh,
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  the cost has increased exponentially in the past,
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  let's just say five years or so.
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  That's something which, and, um, uh, as, as a, if I can say
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  as a cancer doctor, as a leader in this space, uh,
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  we continue to pay attention.
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  Um, if I look at, um,
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  and then of course, uh, everything else is happening outside
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  and, uh, like, um, uh, a huge explosion of, uh,
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  information, especially in the
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  artificial intelligence space.
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  And then the genomic space, uh, is really,
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  and we are looking at internally, uh, similar.
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  Um, uh, the, some of the really fascinating thing, uh,
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  developments are, uh, in the genomic space, crispr, um,
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  and then, uh, how, uh, artificial intelligence is going
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  to help us, um, uh, in making some of this care delivery,
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  uh, easier, uh, for our patients.
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  Uh, and then, um, the drug shortage is something on top
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  of our mind, and overall things are more
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  manageable now.
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  Uh, but that's something which we continue to keep a tab on,
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  um, how we continue to provide the right drug
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  for the right patients, uh, when we are in an environment
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  of a drug shortage.
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  - I can imagine that's something, you know,
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  that really is a challenge for providers
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  because they wanna provide the best care possible
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  and really make sure their patients are, um, taken care of.
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  You know, when you look at what you're doing today as well
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  as, um, you know, what's on tap for the future,
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  what really are, are you thinking through long term
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  and short term when you look at drug shortages?
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  How are you approaching that from the, I guess, department,
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  um, perspective at Cleveland Clinic?
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  - So, um, uh, so what we are doing several things.
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  One, we have a constant communication between our
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  pharmacy leadership and our, if I can say,
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  our deceased leaders.
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  So the pharmacy is kind of keeping a tab on
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  what's happening in the market, uh, what, uh,
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  what drugs are in the shortage list, uh,
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  what we can expect in the next kind of 30 days.
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  So then, so there's a constant communication between
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  the pharmacy leadership and us, uh, and the clinicians.
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  And then, um, we optimize,
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  let's just say in a particular disease,
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  there is a specific drug shortage.
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  Our clinical leaders, um, get together
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  and decide what's the next best thing we can, you know,
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  provide, you know,
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  and optimally treat our patients without
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  compromising outcome.
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  But so far, um, without really proactive approach
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  and proactive, um, uh, engagement with, uh, the purchasing,
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  uh, overall our Cleveland Clinic network, and in Ohio
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  and Florida, uh,
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  we are doing fairly well in making sure our patients
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  get the right drug.
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  - That's great to hear, and,
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  and certainly so helpful to know
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  and understand how that communication is happening within
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  your divisions now.
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  What are some of the things you're
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  most excited about right now?
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  What makes you nervous?
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  - So, I'm really excited about, uh, the, uh,
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  really rapid evolution of, you know, this technology.
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  You know, so you, when I talk about, you know,
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  I briefly mentioned about crispr, um,
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  and then, uh, um, the,
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  I'm sure you are really watching the synthetic biology space
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  where, um, you know, it's a, it's a, it's a working together
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  of the engineering technology
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  and, um, um, our understanding of, uh, how
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  a target, you know,
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  and identifying an optimal target to developing targets
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  specifically for that.
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  Um, and, and then in addition, bringing
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  artificial intelligence to that space.
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  So I think, um, so some of these novel technologies
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  that are in synthetic biology
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  or crispr um, CAR T
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  that always continues to make kind of change
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  how we treat our patients in oncology space.
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  Uh, it's, it's gonna be fascinating to watch, um,
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  how new targets are identified, how new drugs are developed,
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  and how fast we can bring them to our patients.
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  I think that's going to be drastically
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  different five years from now.
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  Uh, i, I think we will do this things in a completely
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  different way in the next step in the five, 10 years.
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  And, and, and the exciting thing is a lot of, if I can say
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  big players and, uh, not just the pharma, um, including
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  Google and other people are investing billions
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  of dollars in this space to make it easier
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  or faster for all patients.
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  What makes me nervous?
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  So, um, the price tag come with this, uh, you know,
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  um, I'm, and of course I'm from India and I'm sitting here.
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  Um, we are privileged to, uh, make these drugs available,
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  uh, for a, uh, a large segment
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  of population here in the us.
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  Uh, but when we look at global incidence of many diseases,
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  especially cancer, uh, 70% of cancers will happen,
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  uh, in low and middle income countries.
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  So how we can make sure some
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  of this technology like crispr, which cost three
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  to $4 million per patient a CAR T, which may cost
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  500,000 to a million dollar per patient,
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  how do we make sure this is accessible
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  for, uh, majority of population in the US
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  and rest of the world?
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  I think that's what make me nervous.
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  - Got it. I, I think that's just fascinating
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  and certainly, you know, so helpful
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  to understand from your perspective as a clinician as well
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  as a leader in this space
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  and someone who, you know, is really focused on trying to,
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  um, do the best you can with patients
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  and really help them, um, in a significant way.
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  Now, as we talked about, healthcare is changing quite a bit
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  and, um, will continue to evolve, I'm sure,
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  in the next three to five years, significantly.
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  So, what do you see as being important
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  for most effective leaders in healthcare
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  to be successful in the next few years or so?
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  - Um, so I, I think we really need to,
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  um, and the leader need to be agile.
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  Um, I think agility is going to be an important
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  quality for the future leader.
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  So, so why do I say that?
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  Um, the agility or being agile is important
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  because as a leader, you need to really
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  pay attention to what's happening internally means within
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  our teams, within our patient population,
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  and what's happening within the society,
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  and what's happening in the innovation space,
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  which is surrounding us.
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  And it can be in, in pharma world,
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  it could be in the government, it could be in the IT world.
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  So the innovation which is rapidly happening around us,
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  what's happening in the society
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  and what's happening with our patient population,
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  what's happening with our own team.
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  So if you look at oncology,
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  if you look at our own team,
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  and again, our team is the most important part
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  of the whole care delivery.
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  There is a concern about now burnout,
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  and then there's a concern about, uh, the impact
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  of all this novel technology on the pro caregivers.
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  And, and, and so I think it's really important for
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  the leader to be sensitive about those issues.
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  Um, at the same time, um, try to manage, uh,
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  our patient's expectation with this novel, um,
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  therapeutic options.
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  So you have to be really agile in making sure,
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  and this, you know, balancing the, uh,
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  the patient's expectation,
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  the workload from our providers at the same time,
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  this onslaught of new things coming at you,
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  uh, from an outside, um, uh, system.
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  Uh, but it's a really, really an exciting time
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  and I'm really, really privileged to be in oncology.
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  I'm really privileged to be in Cleveland Clinic, um, uh,
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  which, and we really tried to deliver care, uh,
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  across our enterprise, uh, here in Ohio
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  or Florida, uh, and then in Abu Dhabi and London.
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  So it's a really, an exciting time to be in healthcare.
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  - Dr. Abraham, thank you so much
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  for joining us on the podcast today.
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  This has been such a fun conversation
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  and really fascinating
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  to hear about all the different things you're doing at
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  Cleveland Clinic, um, to provide great care
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  for cancer patients
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  and certainly lead the way in, uh,
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  technology and development in the future.
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  - Thank you, Laura. It's, uh,
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  really a pleasure to talk to you.
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  Um, thank you so much.