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Practice Updates: Funding, Budgets, & Mergers
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Released: July 29, 2024

Expiration: July 28, 2025

John Marshall
John Marshall, MD

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John Marshall, MD: Hey everybody, this is, believe it or not, episode four of Oncology Update, where we're really trying to get to, God should we say it, the truth in oncology. There's so much going on out there. It's a complex business. There's a lot of really cool science. There's a lot of progress going on. We're affecting a lot of people's lives, including our own.

So, let's jump right in and see what's going on out there this week.

Remembering the Father of Tamoxifen
[00:00:31] I don't know if you saw this, but a guy named V. Craig Jordan, PhD died. If you don't know who Craig Jordan is, he actually worked here at Georgetown briefly. He invented tamoxifen. You think about the impact of understanding the estrogen receptor and being able to intervene on it and have an impact on people. Talk about somebody who's had an impact on a whole lot of lives. That is Craig Jordan, and his impact will always be felt. But as a human, we will miss having him around.

DOD Gives Colon Cancer Research Thumbs Down
[00:00:58] Up here on Capitol Hill, kind of a bad day for colon cancer. We've been lobbying to try and get colon cancer as a set aside in the DOD budget. Remember that breast cancer stuff that's in there? A couple of other cancers are in the DOD budget as a set aside, but colon is not. A set aside. It's in the pot. You can do colon research with DOD funding, but we didn't get our set aside. Even though we are among the top five in terms of common and seriousness and cost and all of that. We think we should be in the DOD budget, but we didn't make it.

NCI Budget Challenges
[00:01:33] Dr. Kim Rathmell, new director of the NCI, she's got a lot of work in front of her. Budget being slashed up there on the hill. But there's this ARPA-H thing, which is this new kind of designated money for more, I don't know, inspirational research might be the right way to put it. Whereas NIH is kind of incremental research that gets funded, ARPA-H is looking for that leap of research.

Time to Unionize Oncology Practices?
[00:01:59] And then, I don't know if you saw this. This is kind of interesting. We'll have a little bit of a theme on this today is that out in California, there are 400 residents who work for a Kaiser organization there, and they actually formally filed to unionize, and I want to think a little bit about unionization and practice and the like.

Merging Oncology Practices: More Guidelines, Fewer Choices
And let's talk a little bit about the business of oncology. So there was a recent paper by Mike Milligan, it was actually one of the ASCO pubs, and it was looking at U.S. oncology practice patterns. And, just very briefly, what they showed is that there was an increase in number of oncologists by 14 percent over, say, 2015 to 2022, but a decrease in number of practices by 18%. Well, you can do the math on that one. What it means is, is that more and more practices are getting bigger and bigger. And in fact, here in Washington, D.C. I work for a 7000-physician practice here in Washington, D.C. And our oncology team is all 1 big team, if you will, and work together. So, we're working more and more for someone and we're working in larger and larger groups. And what it sort of suggests to me is. Maybe we need to start thinking about unionizing.

[00:03:28] Now, I'm not trying to be some socialist, although I was in England when the Labour won their vote over there. Now, they know how to have an election. That was way cool. We should take a tune from them. They know how to have an election, but we still don't. But, you know, we are being asked more and more to follow guidelines, to basically be on the assembly line doing what we're expected to do and less and less freedom. And I think the way that we will regain some of that independence is through collaborative sort of bargaining, if you will. And so, I do think I see that trend increasing, as more and more of us work for one individual. Or one company, if you will.

Dr. Ferris Heads to Lineberger After UPMC Layoffs
[00:04:10] Other news on the headlines is that a guy named Robert L. Ferris, MD, PhD, a very prominent runner of the UPMC Cancer Center has just moved down to, a great cancer center as well, down at UNC and North Carolina at Lineberger Cancer Center. He's a great guy and, and he's going to do very, very well wherever he is. But then it made me sort of think, well, what's happening up at UPMC? Because I think about that as being a great place. They turned out to have lost over the last year, 200 million bucks in, unbalanced budget, if you will. And they had to let go 1000 people. And so, we understand that our business is indeed fragile. Makes me wonder if Dr. Ferris made the trip out of there knowing that things weren't going to be very good at UPMC for the while, but we do need to take care of each other, in our business of oncology.