We need more clinicians leading research innovation

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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

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to build their own research program, whether or not they have a mentor.

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As clinicians, we spend a decade or more as trainees learning to take care of patients.

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When we finally start our careers, we want to build research programs, but then we find

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that our years of clinical training did not adequately prepare us to lead our research

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program.

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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

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However, clinicians hold the keys to the greatest research breakthroughs.

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For this reason, the Clinician Researcher podcast exists to give academic clinicians

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the tools to build their own research program, whether or not they have a mentor.

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Now introducing your host, Toyosi Onwuemene.

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Welcome to the Clinician Researcher podcast.

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I'm your host, Toyosi Onwuemene, and it is an absolute pleasure to be talking with you

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today.

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Thank you so much for tuning in.

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Today, I want to talk about why physicians lose from not being involved in research,

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and I'm not sure if that will be the final title, but we are going to be talking about

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the real importance of clinicians and research.

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So I start because, and I'm sharing this because last week I was at the Bio International Convention

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in San Diego, California.

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And so this is the, BIO stands for Biotechnology Innovation Organization, and they have an

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international convention, which is done annually.

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This was my first attendance, and it was so awesome.

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And I was in attendance as part of the Bio Entrepreneurship Capstone program hosted by

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NIH, co-sponsored by the NIH Seed Office and also UNCF.

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And so I was one of 15 teams, I was a member of 15 teams that were invited to pitch and

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to pitch our startup companies at the Bio International Convention.

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And so do I have a startup company that's in progress?

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Just to say what I realize is that a lot of the research that we do, we develop innovations

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that are actually potentially commercializable.

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And so that's what the Bio Seed group wants to do at NIH, the NIH Seed group wants to

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do is to encourage researchers to commercialize their innovations and to give them the tools

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to be able to think about how to do it.

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And so I have a digital innovation that I went to present at the conference and it was

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well received and we had coaches who worked with us for months.

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We had meetings where we learned about the importance of customer discovery.

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We had several customer discovery meetings.

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It was a really great experience.

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And the experience culminated with pitching at the Bio Conference, at the Bio International

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Convention.

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And so I had a couple of observations I made at this convention that I'm here to share

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about on the podcast today, because I thought it was really important to bring it to clinicians.

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Clinicians who are really at the forefront of patient care and those who are involved

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in research, because this is a clinician research or podcast, hello, and the importance of your

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clinical insight in research and where it goes beyond just writing grants and writing

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and submitting manuscripts.

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So one of the things I noticed was that it was a gathering of healthcare innovators and

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these were from the biotech industry.

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These are from pharma.

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These were people from academia, though academia was a really small portion of this group,

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but really a lot of biotechnology companies, startups and pharma.

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And it was just companies coming together to say, these are the innovations that we

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are creating in healthcare.

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And there were so many, so many companies.

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It was really awesome.

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You could feel the energy.

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You could see that something big was happening at this conference.

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And I was excited to be part of it.

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I'm a physician, right?

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I've never been part of this conference.

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And I have to tell you that I looked around and I thought, where are all the other physicians?

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And I really didn't find too many.

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I actually didn't find any, honestly.

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I'm sure they were there, but not obviously.

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It was clearly not a physician conference.

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This was different from my annual meeting.

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We've had my annual meeting at the Ash, at the Ash is my annual meeting.

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We've had it at the San Diego Convention Center before.

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And this was on a much, much, much larger scale.

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Anyway, so the first thing I want to share is that healthcare needs transformation.

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Now, no surprise to you, you know that a lot of great things have happened in healthcare

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over the years.

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And really people get amazing care in the United States where we practice.

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And it's just a great place to practice.

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And we know that there are opportunities for better healthcare.

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And that's why a lot of us are involved in research because we know there are opportunities

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for patients to live better, to live longer, to do better overall.

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And the way we're serving them is good and there are opportunities to do better.

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So we know that healthcare needs transformation.

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And I think no one is more aware of that than the physicians who practice within the healthcare

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space.

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We know innovation is needed, reform is needed, transformation is needed.

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We know that so much is needed.

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But here's the thing, we are used to doing things the way we've always done them.

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It's like, well, you know, this is how we practice as physicians.

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This is how I go to clinic.

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These are the patients I see.

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This is how I make my RVUs.

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Then I go to my research program and then I publish papers and then I do my research.

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I submit my grants.

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I give talks.

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This is just the way I've always done it.

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And the way you've always done it is good.

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I'm not here to judge the way you've done it.

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I'm just saying that the way we've done it leads us to the way we have, what we have

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now.

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And if we're going to do something different, where if we're going to have a different experience,

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right, we're going to need to do something different.

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Okay.

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That brings me to point number two, that we not only need to imagine a different future,

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and I believe we all do.

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We know that we could support patients better.

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We know that we could help patients live longer.

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We know that there are opportunities to do that, right?

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If we knew how to do that right now, we would already be doing it.

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But we know that things can be better.

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And that's why so many of us are involved in research, trying to open the next, you

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know, the doors to the next frontier.

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Like we're making ways, we're making inroads into our research because we know that there

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is a better future.

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But not only do we need to reimagine, imagine a different future than the one we currently

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have or the one we're currently leading towards, but we actually do need to go out and create

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it.

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And honestly, we're doing that in our research programs.

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We're doing that because we're creating new knowledge.

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We are democratizing knowledge as we're sharing our information through talks or through submitted

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manuscripts and when they get published.

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So we are going out and doing work and sharing our work.

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But we've got to be able to begin to work towards creating the future we imagine.

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And so it's not enough to just keep doing the things we've always done, but it's to

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say, what do I need to do differently to create a new future?

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And the reason I say that is that, you know, this is number three.

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When I was at Bio, what I realized is that there were not many physicians.

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There were just not physicians there.

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And I wondered about that.

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I said, well, why aren't physicians here?

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Why are people innovating in healthcare, developing all these new inventions, and there are not

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physicians here?

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However, when it's time for these interventions to be unleashed in healthcare, physicians

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are kind of the first group to be approached to say, hey, how will you champion this change

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at your institution?

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And whether that's a digital innovation or it's a new medication innovation, physicians

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are at the front lines of delivering these innovations, right, or delivering these new

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therapies.

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So if they're to be involved in delivery, why are they not involved in the creation?

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And so the observation I made when I went to Bio is that, well, I think what's happening

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is that all these people are going out and they're inventing the future and they're recreating

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what things are supposed to...the way things are supposed to be.

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And then they're going to come back and they're going to give it to physicians and they're

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going to say, here, go execute.

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Go execute a future we've already created.

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And to be honest, it's happening right now.

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I'm not even making this up, right?

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It's that, yes, all these new therapies do need to go through clinical trials and they

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do.

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Physicians are part of the group of investigators that are recruited to do the clinical trials.

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And then once these drugs are approved, then there is a dependence on physician partners

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to encourage their colleagues, whether they're giving talks or giving testimonials about

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the medications, to encourage their colleagues to use these therapies and actually drive

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them into mainstream use.

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So physicians are part of this process.

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However, I feel the physicians should not be at the end of the process.

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We should really be at the beginning where people are innovating and they're thinking

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what is needed in the healthcare space?

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What are the innovations that are needed?

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We need physicians to be out front and center, but we're not there.

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Where are we?

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I think this has to do with many things as far as policies and the separation of physicians

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from industry and the need to declare conflicts.

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I do think that there is a structural issue in terms of these collaborations.

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However, I do know that culturally as physicians, we tend to spur an industry and we're like,

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yeah, you guys are interested in big money, big business.

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We're here to take care of patients.

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Do not interfere with my care of patients.

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So sometimes there is that bias by physicians or from physicians against companies, especially

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big pharma.

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Don't come here and take my prescription patterns.

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And this is not an innocent relationship.

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Physicians are out to make a profit and physicians are out to care for patients.

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And it doesn't always seem as if there should be overlap.

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But I do know and I did see at Bio and the center when it comes to the center of innovation,

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there is a need for physicians to be part of these innovations because from the very

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beginning we need to be creating innovations that actually serve patients, that actually

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will make a difference.

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And we don't want to wait until implementation to find out that, yeah, this is not going

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to work.

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And people talk about companies starting and failing all the time, but how many companies

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would succeed if they had the right resource, the right expertise from the beginning?

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If they had everything they needed right at the time that they needed it, would they do

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better?

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And so I just think it's an opportunity.

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So while others, researchers and a lot of PhD scientists and industry people are going

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out and testing on a new future, I think what's happening is that physicians are staying behind

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and we're plugging the holes in a leaky system that's not quite working the way it's supposed

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to.

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And so the fourth observation I want to share is that research is a path to creating new

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things.

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Research is a path to innovation because you're asking questions and you're probing the present.

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When you do research, you're saying, I'm not satisfied with the current reality.

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I believe that there is another reality.

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And in research, we're uncovering new realities.

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We're not making up anything new as much as we are discovering things.

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And we use what we discover to innovate.

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So we are creating new things, but what we're really doing is uncovering knowledge that

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was previously unknown to us so that we can innovate or create something different.

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And so research is so powerful and so important because it is that path to innovation.

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And it's not just the path to innovation in terms of discovering new therapies, which

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is the way we think about it a lot, but it's also innovation in the path to innovation

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in the path to helping patients take their medications better.

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Like what is the...

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Bless you, Joelle.

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What is the path to helping patients take their medicines more?

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Like what is the path to adherence?

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Sometimes we stand and we judge patients who are like, you are not adherent to your medications.

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But there is a research path that allows us to innovate around how do we help people adhere

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to drugs better?

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And so research is about creating new things.

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And whenever physicians create new things, it really is a pathway to innovation.

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It's a pathway to commercialization.

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It's a pathway to new companies.

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It's the pathway that many PhD scientists take, engineers take as they, because of their

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research are able to create new innovations that spur biotechnology, new technology, new

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opportunities, new ways of thinking about healthcare and thinking about how to deliver

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healthcare, right?

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So research is a path.

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So that's why observation number five is that any system that systematically blocks physicians

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from participating in research is actually working against the pipeline to physicians

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being part of innovation.

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Because if physicians are just out there doing what we've always done, right?

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Just doing the status quo, this is the way we've always done medicine, we're just going

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to do it this way again.

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If we are not in the space of actually creating the new knowledge, then we're not there to

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create new innovations.

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And so any system that says, hey, we're not going to support physicians to lead research

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is a system that says we're going to systematically block physicians from being part of innovation.

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Innovation in healthcare.

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And so if we're going to innovate in healthcare and if we're going to create innovations that

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actually support patients, we need physicians involved from the beginning.

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And it's not just at the point of creating a new commercial entity, but at the point

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of doing the research that underlies the creation of a new commercial entity.

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For that reason, observation number six is that we really do need institutions to invest

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in physicians as researchers.

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We need more investments.

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And I'm not saying institutions should invest in physicians as researchers so that they

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can go on and transform the biotech industry.

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That's not what I'm saying though.

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That's not a bad idea.

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But I'm saying that research is a path to innovation.

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And if physicians are not supported to do research, we don't get the kind of healthcare

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innovations that we need and we systematically debar physicians from being part of those

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innovations that are critical to patient care.

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Imagine a system where pharma worked with physicians, worked with industry partners,

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worked with engineering, worked with all the resources, all the resource people resources

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needed to create new technology.

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Imagine the kind of technology that would be created if we had so many partnerships

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where people at the forefront of patient care are also part of the innovations that are

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being birthed.

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And that would be really, really awesome.

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And so institutions do need to create more avenues for physicians to succeed in research.

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And the seventh thing I wanted to say is that, you know what, if people are not going to

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create the pathways for you, then I think we should strongly consider creating these

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pathways for ourselves.

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We strongly consider creating these pathways for ourselves.

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Yeah.

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So those are seven observations from the biotechnology conference, Biotechnology Innovation Organization

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Conference, Bio, Bio 2024, as I went there, was there last week.

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And I just want to recap, healthcare needs transformation.

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We need to imagine a different future, but we also need to go out and create it.

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And we're seeing that there are people out there who are testing out a new future and

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meanwhile as physicians, what we're doing is we're kind of being left behind trying

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to plug holes in a leaky present.

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Research is a path for us as physicians to create something new.

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And we really do need to push against systems that block physicians from leading in research.

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I'm encouraging institutions to invest in physicians as research leaders and physicians,

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if institutions will not invest in you, how can you invest in yourself?

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It has been such a pleasure talking with you today.

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Thank you so much for listening.

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I'm so excited to bring you reports live from, well, it's not live anymore, but from the

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Bio International Convention.

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And I hope that you will consider attending as a physician if for no other reason other

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than to go and have your mind blown at the way people are thinking about technological

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innovation in healthcare.

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These are the things that are going to affect your practice of medicine that are going to

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affect the research that you do as they come and change the landscape of care.

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You want to know about it.

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And I hope you'll think about attending next year.

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All right.

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It's been a pleasure talking with you today.

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Thank you so much for listening.

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I look forward to talking with you again next time on the Clinician Researcher Podcast.

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Have a great day.

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Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

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clinicians learn the skills to build their own research program, whether or not they

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have a mentor.

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If you found the information in this episode to be helpful, don't keep it all to yourself.

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Someone else needs to hear it.

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So take a minute right now and share it.

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As you share this episode, you become part of our mission to help launch a new generation

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of clinician researchers who make transformative discoveries that change the way we do healthcare.