What attracted you to a career in radiation oncology? A couple of things: The spectrum of patients — you see men, women, kids, people of all ages with interesting and significant medical problems that challenge me as a physician. I learned early on that these are the best patients, the most heroic patients. Then there’s the use of the technology and the fascination with the biology of cancer. But by and large, for me, it’s about the patients, who they are and the challenge of caring for them and possibly saving their life.

In addition to serving as current president of ASTRO, you’re also a professor and chairman of radiation oncology at the David GeffenSchool of Medicine at UCLA and director of clinical affairs for UCLA’s Jonsson Comprehensive Cancer Center. How does your work there play a direct role in what you bring to ASTRO? Certainly the notion of integration of multidisciplinary practice is one of the things that I do in my roles as chair and director of clinical affairs for the cancer center here at UCLA. And UCLA being a cutting edge academic institution, we are challenged with many similar policy issues that affect ASTRO members and ultimately my patients at UCLA, so I think they dovetail quite nicely.

Can you share some of the goals you have accomplished as president of ASTRO? When I ran, I had a set of goals and one of the goals was to put in a process that we call best practices—a way of evaluating how we take care of patients, kind of beyond what guidelines do, but what are the best ways to do things. We were able to establish a best practice process and are now developing the first best practice for GYN cancers and the second group will be GI cancers. Another issue that I brought up a few years ago when I ran for the office had to do with radiation oncology research funding at NIH being bundled inappropriately with radiology for historical reasons. If we are going to ask for more research funding from NIH, which we want to do, we need to know the baseline funding for radiation oncology research at NIH, which is not yet knowable. I am pleased that we are getting that information and will bring it to the board and membership. In the broader sense, it prompted us to establish a basic science task force to look at that benchmarking issue with funding, but also to look at issues around education for both residents and practicing physicians for new and developing cancer biology, as well as to set a translational research agenda that will serve the specialty long into the future. Those are two things I think we’ve accomplished so far and there is more coming.

What will you be speaking about at ASTRO’s annual conference? In the presidential symposium, which is themed “transforming care through innovation,” ten speakers will address issues of advancing innovation in radiation oncology in terms of redesigning and restructuring, and not only the issues of innovations and technology, but how we deliver care as well. I’ll be speaking about health reform and changing dynamics associated with health reform and the title of that talk is “The Patient Not Treated.”

What are some of the challenges radiation therapy will face in the coming year? In the coming year, what looms largest for us right now are proposed draconian cuts in the Medicare Physician Fee Schedule, which we think are not well-founded and could dramatically impact many smaller practices, particularly rural practices and those that serve the medically underserved. We’ll know in November what the final Medicare rule says. The other challenge has to do with ongoing health care reform. Regardless of what the Supreme Court did a few months ago, or if a new administration comes in and wants to repeal the law, the health care reform train has left the station and radiation oncology, like all specialties in medicine, has to respond to this notion of accountable care and address the value proposition in health care.

How do you think radiation therapy will continue to advance? I think through innovation—through evolving and innovating the way we take care of patients, the way we do treatment delivery, and embracing the value proposition in health care. One of our keynoters [at the Annual Meeting] is one of the leaders of putting that notion out there: Michael Porter will talk about value in health care and how one redesigns and redefines health care in this new milieu. That’s how we’ll continue to advance in terms of how we take care of patients. The other part is we’ll continue to advance on the technical side—innovation on the technical side is our middle name, and then the biology behind why radiation works is becoming more and more sophisticated and better understood.