08 Jul The Future of Healthcare: “Healthcare is far too reactive” with Dr. Jeff Patton of OneOncology and Christina D. Warner
Health problems are societal challenges and our healthcare is far too reactive. Obesity is an example. Socio-economic issues, inadequate access to high-quality food, lack of regular exercise all contribute to terrible healthcare outcomes. We should be more proactive on the front end to improve outcomes later. Asa part of my interview series with leaders in healthcare, […]
July 5, 2019; As a part of my interview series with leaders in healthcare, I had the pleasure to interview Dr. Jeff Patton, president of physician services at OneOncology, a member of its board of directors and chief executive officer and chairman of the board for Nashville-based Tennessee Oncology, one of the largest community oncology practices in the U.S. Dr. Patton is nationally recognized in the oncology community for his extensive clinical trial research and peer-reviewed publications on advancing cancer treatment and bringing exceptional care to the communities where patients live. Dr. Patton has published eight manuscripts and nearly 20 clinical trial abstracts on cancer treatment research. He specializes in all adult malignancies and holds memberships in the Tennessee Oncology Practice Society and the American Society of Clinical Oncology. Dr. Patton, a graduate of Eastern Virginia Medical School in Norfolk, completed his residency and fellowship at Wake Forest University in Winston-Salem, N.C., where he served as Chief Resident. He is on the board of directors for the Tennessee Chapter of the Leukemia and Lymphoma Society, and Community Oncology Alliance.
Thank you for joining us Dr. Patton! Can you tell us a story about what brought you to this specific career path?
When I was in internal medical training you rotated through every discipline. I liked everything, but I wanted to be a specialist who also had primary care responsibility for patients. And that’s one reason oncology was attractive: in Oncology, you become the point person for your patients. The oncologist develops a primary care relationship with each patient, but you are also their specialist.
When I was in training, cardiology was the “it” specialty. But I knew then, because of the science and opportunity for medical advancement, that oncology was on the ascent as a specialty. Now, there are over 3000 cancer drugs in development globally, and of those 80 percent have the potential to be first-in-class treatments.
I chose the community oncology route as opposed to academia primarily because I wanted to see patients. When I was in my residency at Wake Forest, I was exposed to excellent leadership in the community setting. We saw that cancer care was moving from the hospital to the community setting and I wanted to be a part of charting the future for community oncology.
Can you share the most interesting story that happened to you since you began leading your company?
The thousands of patient stories I’ve heard over 25 years as an oncologist, to me, tell an incredibly interesting story of the value people receive when we deliver world-class cancer care and clinical trials in the community setting — the neighborhoods where our patients, live, work, go to school and church.
To me, knowing that every day 90 physicians in 32 clinics across Tennessee are using the same best-practices to focus on each person’s personal experience; to form relationships with patients and their caregivers all while delivering cutting-edge care and clinical trial access is one of the most gratifying stories in my life.
I am excited to see this commitment to best practices and focus on delivering patients’ personalized experience grow nationally through OneOncology.
I’ve been in leadership in community oncology and at Tennessee Oncology for 25 years. I’m proud to have, throughout my career, dedicated myself to collaborating with colleagues and helping shape and innovate cancer care delivery in the community setting.
Interestingly, in the early 90s, as cancer care moved from hospitals to outpatient, Tennessee Oncology’s reputation grew more on a national scale than locally in the healthcare hub of Nashville due, in part, to my leadership. Somewhat ironically, while world-class care and innovation fueled our strong reputation nationally, our reputation lagged a little locally until our practice grew large enough — with medical oncologists and specialists joining us as owners and leaders — that the strength of our reputation caught up locally.
Can you tell our readers a bit about why you are an authority in the healthcare field?
I’ve been successful at anticipating change and leading innovation in oncology, specifically by advancing clinical research, care and physician best practices. I have had success at examining the available data and being able to — using a hockey metaphor, since I come from hockey town — skate to where the puck is.
Being part of an innovating large community practice that pioneered and developed clinical research gives me a platform for a vision of the future not broadly clear to others. As an example, about 10 years ago when we noted that half of the drugs under development were orally administered, it became clear to me this massive transformation from injectable to oral was about to occur. We realized we had to get in front of the issue and soon thereafter became one of the first practices in the country to open an oral pharmacy.
After analyzing the data at our new oral pharmacy, we noticed the margins we’re thinner than we anticipated, thus we knew we needed the buying power a group purchasing organization (GPO) can deliver. But in the earlier days of oral drugs, I couldn’t get a GPO to make a deal with us. So, we started our own GPO, the first in oncology — Raintree Oncology. Before we started Raintree there were zero orally administered drugs and within two years, 80 percent of our products were purchased through our GPO creating financial efficiencies, and ultimately increased access to the latest cancer therapies.
What makes your company stand out? Can you share a story?
It’s our structure. Tennessee Oncology has been successful being physician led and physician owned. OneOncology takes physician ownership and leadership to a national level with a national network. We’re started with three highly successful practices and we’ll aggregated with the most successful practices in the country.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
Great question. We ask ourselves this every day. I’ll give you three innovative examples that OneOncology is laser-focused on to address specific pain points:
- Increase access to clinical trials. I’m excited to see how OneOncology will bring that level of clinical trial innovation to a network across the country. There are some community practices that are yet to incorporate trials, and they’ll need to soon to survive. We’ve got so many drugs and therapy sequences in development, if we don’t increase access to clinical trials, we will lose momentum to develop new and innovative drugs, which would limit patients’ access to the cutting-edge science and cancer care.
- Improve healthcare technology quickly. Healthcare is a laggard industry with respect to technology. OneOncology is elevating technology using it to be a disruptive force in the market. All our practices and physicians will be on a common platform able to easily and efficiently manage clinical, operational and administrative data and derive insights to improve care. And we are using technology to improve patient communication outside the clinic. As we’ve innovated in Medicare’s Oncology Care Model (OCM), we’ve learned that to improve value to patient and physician, we’ve got to improve how we communicate with patients when they are away from our caregivers.
- Disrupt getting best practices to physicians. One of the issues we face in oncology that is both an advantage and a disadvantage is that knowledge is growing so rapidly it is impossible for one person to keep up (even Dr. Schwartzberg☺). OneOncology is disrupting how best practices get to physicians.
What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)
- I wish someone would have told me that I was going to end up working for the government! Seriously, I didn’t know I’d be a government employee as a physician specialist.
- I wish someone would have told me that information technology in health care would be woefully inadequate.
- I wish that someone would have told me how to convince aforementioned number 1 that HIPPA, Stark laws and other regulatory impediments make it MORE — not less — difficult to share information and use best business practices to improve care.
- I wish someone would have told me how to deal with physician and provider burnout.
- I wish someone would have told me that despite four years of undergraduate studying, four years of medical school, six years of post-graduate work and 25 years of practicing medicine, I still needed an insurance company’s permission to take care of my patients. That would have been a helpful tip.
Let’s jump to the main focus of our interview. According to this studycited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
We have more of a health problem than a healthcare problem in our country. The disparities in our healthcare system are real, including the ability to access high quality, affordable care. Some of these disparities are due to a bureaucratic system, but many are connected to social economic issues that are not part of medicine — even though the healthcare system — from medical professionals to employers to payers — are faced to grapple with their outcomes.
But despite the disparities, it’s important to remember we have the best specialty care in the world. Individuals come to U.S. providers from all over the world for cancer therapies or to have heart surgery. So, while I agree we face — and know that community oncology addresses — care disparities on the extremes, we still deliver the best healthcare in the world.
That said, four reasons why the U.S. healthcare system struggles:
- Health problems are societal challenges and our healthcare is far too reactive. Obesity is an example. Socio-economic issues, inadequate access to high-quality food, lack of regular exercise all contribute to terrible healthcare outcomes. We should be more proactive on the front end to improve outcomes later.
- Healthcare interventions are far too late. Whether its income, education, location, distrust of institutions, we engage medical care or clinical trials later than we should (or not at all).
- We do a poor job preventing — and a worse job of learning from — medial errors, surgical mishaps and misdiagnoses all which lead to bad outcomes — particularly on inpatient side. We must be better at creating a medical culture of safety and transparency in all healthcare settings.
- Horribly misaligned incentives for everyone — especially patients. While we’ve realized in the U.S. healthcare society that rewarding medical professionals based on volume and not value doesn’t make sense and we are moving toward value-based arrangements, the fact is that today the majority of care is still paid for by utilization of services and not based on overall value.
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
- Move toward value-based medicine as fast as possible. One example: It’s well known that providing infusion therapy in the community setting is much less expensive than hospitals. As a business guy, I’d think the low-cost, high-quality, high-value provider would be rewarded. But today, in medical oncology it’s the opposite. That takes value out of patients’ pockets.
- Reward innovation and the quick adoption of new best practices. Both innovation and best practices should lead to better outcomes and the onus is on the physician community to measure and prove that innovations improve outcomes. But aligning incentives so innovations and best practices make it to the point of care as safe and quickly as possible must be our north star.
- Release the chains on information flow and inoperability. Today, if I had a cancer patient admitted to the hospital I may or may not know about it; if my patient receives care or sits in the hospital waiting room, I may or may not know; if my patient is discharged from that hospital, I may or may not now. As an oncologist, siloed information makes guess. That’s illogical, wasteful and harmful to the patient.
- Invest in smart healthcare tools. We must invest in healthcare information technology like we’ve done in other industries. Why do we all use smart phones? Because they provide value. We need healthcare smart tools that bring so much value, we’ll not only use them, we’ll leverage them to improve health outcomes.
- Accelerate the move to consumerism and a free market. I am a capitalist at heart. U.S. healthcare is not a free market. In medical subspecialties that operate more like a free market, the patient experience and outcomes are both better.
Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
First, collaborate. Best practices, aligned incentives, better decision making, interoperable data — all integral parts of solutions to improving health — and healthcare — can only be achieved by building trust and collaborating.
Second, and very specifically, at the end of the day, the government pays for half of the healthcare delivered in this country. Turning to more free market strategies rewards value. Medicare Advantage plans, which are capitated to reward value, are an example. We should do more to use those as incubators of the best ideas and practices to reduce cost and improve outcomes.
Third, scale providers’ direct-to-employer relationships, such as between General Motors and Henry Ford Health System, in southeast Michigan. Aligning incentives between employees, employers and providers improves value.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
Factfulness, by Hans Rosling, a public health physician, changed how I looked at the world. It looks at how our instincts can distort our perspective, and when we base our worldview on facts, we can focus more clearly on what matters. It’s a fascinating book.
I read voraciously and am a self-educated business leader. I bought a book ten years ago synopsizing the 100 best business books of all time. I had read 50 of them. I’ve read the other 50 since.