Brian Kavanagh

Q&A with Brian Kavanagh ASTRO president

September 19, 2017
by Sean Ruck, Contributing Editor
ASTRO’s annual meeting is scheduled for Sept. 24-27 at the San Diego Convention Center. In advance of the show, HealthCare Business News spoke with ASTRO President Dr. Brian Kavanagh.

HCB News: What inspired you to get involved in health care?
Brian Kavanagh: My dad was my role model. He was a surgeon and served in a real-life MASH unit in Korea before starting a civilian practice in the days of house calls and endless workdays. But he never complained and was always grateful for the chance to help others who were less fortunate.

HCB News: What attracted you to ASTRO?
BK: Paul Starr’s book, "The Social Transformation of American Medicine" was an eye-opener to the continuing evolution of medicine as a sovereign profession. By getting involved with my specialty’s society, I thought that in some small way I might feel engaged in that process.

I am grateful to my many mentors: Mike Steinberg, Najeeb Mohideen and others taught me a lot about health policy. Tim Williams and Colleen Lawton, among others, set outstanding examples with their integrity and character.

HCB News: What initiatives are you championing as president?
BK: The ASTRO Accreditation Program for Excellence (APEx), which promotes high-quality care by implementing a number of clinical standards, is gaining momentum. We hope eventually to enroll more than 1,000 practices, and we already have about 200 in the pipeline.

I am also excited about ASTRO’s radiosurgery registry project in partnership with the American Association of Neurological Surgeons. We have already collected data prospectively on more than 2,200 patients, with about 200 more added each month, so we will have a large treasure trove of clinical observations that can reveal the key components of quality radiosurgical care.

HCB News: What are the biggest challenges facing your members today?
BK: As for other medical specialties, there is uncertainty in how we can continue to provide the best possible patient care given the economic stressors impacting health care. Physicians need to sustain full-throated advocacy for our patients with policymakers. There have been many improvements in outcomes for cancer patients over the last few decades that depend on resource availability. To keep up the pace of progress, we need continued support for research that will advance the frontiers of what clinicians can accomplish.

HCB News: What are the biggest opportunities?
BK: The emerging developments in health policy, which include changes in the federal and private insurance programs, give us a chance to modernize our way of thinking and morph our field into a leader in value-driven practices. Over the past several years, we have been closely engaged with federal agencies to help design an alternative payment model that will move us forward beyond the antiquated fee-for-service construct.

HCB News: In what positive and negative ways has the rise in technology impacted oncologists?
BK: The broadest-reaching development in health-related technology is the widespread implementation of electronic medical records, and most agree it has produced both good effects and unintended consequences. Improving the legibility of charts and prescriptions clearly benefits patient safety, but we haven’t yet figured out how electronics can adequately improve workflow efficiency. The current level of required documentation for patient care is quite burdensome, and that is a parallel problem to fix.

HCB News: Do you have any concerns about the repeal of the ACA?
BK: Our concerns are simple and echo the concerns raised by the entire house of medicine. ASTRO wants all cancer patients to have access to proper care. We oppose the use of pre-existing conditions to deny insurance coverage. We support screening and prevention programs. At the same time, we recognize a need to find efficiencies where possible, and we want to be at the table to help find that compromise.

HCB News: What are you most excited about seeing at this year’s ASTRO annual meeting?
BK: Everything! First, the keynote speakers are outstanding. On Monday, Dr. Richard Zane, chief innovation officer for University of Colorado Health, discusses how new technology is restructuring patient-doctor interactions. Tuesday’s plenary is a fireside chat between Dr. Heather Wakelee and Dr. Lucy Kalanithi, co-author of “When Breath Becomes Air,” a best-selling memoir about a young neurosurgeon’s reflections during treatment for lung cancer. Finally, on Wednesday, we hear from Dr. Vinay Prasad of OHSU, one of the most outspoken and insightful leaders of the coming generation.

Sunday’s presidential symposium will feature innovative science, the challenge of quantifying quality and the art of caring for patients in [the] late stages of their disease. Additionally, thousands of scientific presentations are accompanied by dozens of expert panel discussions on topics including the immunogenic effects of radiation, the physician’s role in the current opioid crisis and potential uses of artificial intelligence in radiation oncology, among many others.

HCB News: How will radiation oncology change in the next 10 years?
BK: I think that the field will continue to transform itself scientifically and that the great science in the lab right now will translate into meaningful, value-enhancing clinical benefits. Combined with novel agents and informed by genetic data, radiation therapy will become even more individualized. I am optimistic that innovation will foster improved patient outcomes all around.