We need more clinicians leading research innovation

0:00 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. As clinicians, we spend a decade or more as trainees learning to take care of patients. When we finally start our careers, we want to build research programs, but then we find that our years of clinical training did not adequately prepare us to lead our research program. Through no fault of our own, we struggle to find mentors, and when we can't, we quit. However, clinicians hold the keys to the greatest research breakthroughs.

0:40 For this reason, the Clinician Researcher podcast exists to give academic clinicians the tools to build their own research program, whether or not they have a mentor. Now introducing your host, Toyosi Onwuemene. Welcome to the Clinician Researcher podcast. I'm your host, Toyosi Onwuemene, and it is an absolute pleasure to be talking with you today. Thank you so much for tuning in. Today, I want to talk about why physicians lose from not being involved in research, and I'm not sure if that will be the final title, but we are going to be talking about the real importance of clinicians and research.

1:22 So I start because, and I'm sharing this because last week I was at the Bio International Convention in San Diego, California. And so this is the, BIO stands for Biotechnology Innovation Organization, and they have an international convention, which is done annually. This was my first attendance, and it was so awesome. And I was in attendance as part of the Bio Entrepreneurship Capstone program hosted by NIH, co-sponsored by the NIH Seed Office and also UNCF. And so I was one of 15 teams, I was a member of 15 teams that were invited to pitch and to pitch our startup companies at the Bio International Convention.

2:07 And so do I have a startup company that's in progress? Just to say what I realize is that a lot of the research that we do, we develop innovations that are actually potentially commercializable. And so that's what the Bio Seed group wants to do at NIH, the NIH Seed group wants to do is to encourage researchers to commercialize their innovations and to give them the tools to be able to think about how to do it. And so I have a digital innovation that I went to present at the conference and it was well received and we had coaches who worked with us for months. We had meetings where we learned about the importance of customer discovery.

2:48 We had several customer discovery meetings. It was a really great experience. And the experience culminated with pitching at the Bio Conference, at the Bio International Convention. And so I had a couple of observations I made at this convention that I'm here to share about on the podcast today, because I thought it was really important to bring it to clinicians. Clinicians who are really at the forefront of patient care and those who are involved in research, because this is a clinician research or podcast, hello, and the importance of your clinical insight in research and where it goes beyond just writing grants and writing and submitting manuscripts.

3:33 So one of the things I noticed was that it was a gathering of healthcare innovators and these were from the biotech industry. These are from pharma. These were people from academia, though academia was a really small portion of this group, but really a lot of biotechnology companies, startups and pharma. And it was just companies coming together to say, these are the innovations that we are creating in healthcare. And there were so many, so many companies. It was really awesome. You could feel the energy. You could see that something big was happening at this conference. And I was excited to be part of it.

4:14 I'm a physician, right? I've never been part of this conference. And I have to tell you that I looked around and I thought, where are all the other physicians? And I really didn't find too many. I actually didn't find any, honestly. I'm sure they were there, but not obviously. It was clearly not a physician conference. This was different from my annual meeting. We've had my annual meeting at the Ash, at the Ash is my annual meeting. We've had it at the San Diego Convention Center before. And this was on a much, much, much larger scale. Anyway, so the first thing I want to share is that healthcare needs transformation. Now, no surprise to you, you know that a lot of great things have happened in healthcare over the years.

4:58 And really people get amazing care in the United States where we practice. And it's just a great place to practice. And we know that there are opportunities for better healthcare. And that's why a lot of us are involved in research because we know there are opportunities for patients to live better, to live longer, to do better overall. And the way we're serving them is good and there are opportunities to do better. So we know that healthcare needs transformation. And I think no one is more aware of that than the physicians who practice within the healthcare space. We know innovation is needed, reform is needed, transformation is needed. We know that so much is needed.

5:41 But here's the thing, we are used to doing things the way we've always done them. It's like, well, you know, this is how we practice as physicians. This is how I go to clinic. These are the patients I see. This is how I make my RVUs. Then I go to my research program and then I publish papers and then I do my research. I submit my grants. I give talks. This is just the way I've always done it. And the way you've always done it is good. I'm not here to judge the way you've done it. I'm just saying that the way we've done it leads us to the way we have, what we have now. And if we're going to do something different, where if we're going to have a different experience, right, we're going to need to do something different.

6:27 Okay. That brings me to point number two, that we not only need to imagine a different future, and I believe we all do. We know that we could support patients better. We know that we could help patients live longer. We know that there are opportunities to do that, right? If we knew how to do that right now, we would already be doing it. But we know that things can be better. And that's why so many of us are involved in research, trying to open the next, you know, the doors to the next frontier. Like we're making ways, we're making inroads into our research because we know that there is a better future. But not only do we need to reimagine, imagine a different future than the one we currently have or the one we're currently leading towards, but we actually do need to go out and create it.

7:13 And honestly, we're doing that in our research programs. We're doing that because we're creating new knowledge. We are democratizing knowledge as we're sharing our information through talks or through submitted manuscripts and when they get published. So we are going out and doing work and sharing our work. But we've got to be able to begin to work towards creating the future we imagine. And so it's not enough to just keep doing the things we've always done, but it's to say, what do I need to do differently to create a new future? And the reason I say that is that, you know, this is number three.

7:55 When I was at Bio, what I realized is that there were not many physicians. There were just not physicians there. And I wondered about that. I said, well, why aren't physicians here? Why are people innovating in healthcare, developing all these new inventions, and there are not physicians here? However, when it's time for these interventions to be unleashed in healthcare, physicians are kind of the first group to be approached to say, hey, how will you champion this change at your institution? And whether that's a digital innovation or it's a new medication innovation, physicians are at the front lines of delivering these innovations, right, or delivering these new therapies. So if they're to be involved in delivery, why are they not involved in the creation?

8:38 And so the observation I made when I went to Bio is that, well, I think what's happening is that all these people are going out and they're inventing the future and they're recreating what things are supposed to...the way things are supposed to be. And then they're going to come back and they're going to give it to physicians and they're going to say, here, go execute. Go execute a future we've already created. And to be honest, it's happening right now. I'm not even making this up, right? It's that, yes, all these new therapies do need to go through clinical trials and they do. Physicians are part of the group of investigators that are recruited to do the clinical trials. And then once these drugs are approved, then there is a dependence on physician partners to encourage their colleagues, whether they're giving talks or giving testimonials about the medications, to encourage their colleagues to use these therapies and actually drive them into mainstream use.

9:32 So physicians are part of this process. However, I feel the physicians should not be at the end of the process. We should really be at the beginning where people are innovating and they're thinking what is needed in the healthcare space? What are the innovations that are needed? We need physicians to be out front and center, but we're not there. Where are we? I think this has to do with many things as far as policies and the separation of physicians from industry and the need to declare conflicts. I do think that there is a structural issue in terms of these collaborations. However, I do know that culturally as physicians, we tend to spur an industry and we're like, yeah, you guys are interested in big money, big business.

10:15 We're here to take care of patients. Do not interfere with my care of patients. So sometimes there is that bias by physicians or from physicians against companies, especially big pharma. Don't come here and take my prescription patterns. And this is not an innocent relationship. Physicians are out to make a profit and physicians are out to care for patients. And it doesn't always seem as if there should be overlap. But I do know and I did see at Bio and the center when it comes to the center of innovation, there is a need for physicians to be part of these innovations because from the very beginning we need to be creating innovations that actually serve patients, that actually will make a difference.

10:57 And we don't want to wait until implementation to find out that, yeah, this is not going to work. And people talk about companies starting and failing all the time, but how many companies would succeed if they had the right resource, the right expertise from the beginning? If they had everything they needed right at the time that they needed it, would they do better? And so I just think it's an opportunity. So while others, researchers and a lot of PhD scientists and industry people are going out and testing on a new future, I think what's happening is that physicians are staying behind and we're plugging the holes in a leaky system that's not quite working the way it's supposed to.

11:45 And so the fourth observation I want to share is that research is a path to creating new things. Research is a path to innovation because you're asking questions and you're probing the present. When you do research, you're saying, I'm not satisfied with the current reality. I believe that there is another reality. And in research, we're uncovering new realities. We're not making up anything new as much as we are discovering things. And we use what we discover to innovate. So we are creating new things, but what we're really doing is uncovering knowledge that was previously unknown to us so that we can innovate or create something different.

12:30 And so research is so powerful and so important because it is that path to innovation. And it's not just the path to innovation in terms of discovering new therapies, which is the way we think about it a lot, but it's also innovation in the path to innovation in the path to helping patients take their medications better. Like what is the... Bless you, Joelle. What is the path to helping patients take their medicines more? Like what is the path to adherence? Sometimes we stand and we judge patients who are like, you are not adherent to your medications. But there is a research path that allows us to innovate around how do we help people adhere to drugs better?

13:15 And so research is about creating new things. And whenever physicians create new things, it really is a pathway to innovation. It's a pathway to commercialization. It's a pathway to new companies. It's the pathway that many PhD scientists take, engineers take as they, because of their research are able to create new innovations that spur biotechnology, new technology, new opportunities, new ways of thinking about healthcare and thinking about how to deliver healthcare, right? So research is a path. So that's why observation number five is that any system that systematically blocks physicians from participating in research is actually working against the pipeline to physicians being part of innovation.

14:04 Because if physicians are just out there doing what we've always done, right? Just doing the status quo, this is the way we've always done medicine, we're just going to do it this way again. If we are not in the space of actually creating the new knowledge, then we're not there to create new innovations. And so any system that says, hey, we're not going to support physicians to lead research is a system that says we're going to systematically block physicians from being part of innovation. Innovation in healthcare. And so if we're going to innovate in healthcare and if we're going to create innovations that actually support patients, we need physicians involved from the beginning. And it's not just at the point of creating a new commercial entity, but at the point of doing the research that underlies the creation of a new commercial entity.

14:51 For that reason, observation number six is that we really do need institutions to invest in physicians as researchers. We need more investments. And I'm not saying institutions should invest in physicians as researchers so that they can go on and transform the biotech industry. That's not what I'm saying though. That's not a bad idea. But I'm saying that research is a path to innovation. And if physicians are not supported to do research, we don't get the kind of healthcare innovations that we need and we systematically debar physicians from being part of those innovations that are critical to patient care.

15:32 Imagine a system where pharma worked with physicians, worked with industry partners, worked with engineering, worked with all the resources, all the resource people resources needed to create new technology. Imagine the kind of technology that would be created if we had so many partnerships where people at the forefront of patient care are also part of the innovations that are being birthed. And that would be really, really awesome. And so institutions do need to create more avenues for physicians to succeed in research. And the seventh thing I wanted to say is that, you know what, if people are not going to create the pathways for you, then I think we should strongly consider creating these pathways for ourselves.

16:18 We strongly consider creating these pathways for ourselves. Yeah. So those are seven observations from the biotechnology conference, Biotechnology Innovation Organization Conference, Bio, Bio 2024, as I went there, was there last week. And I just want to recap, healthcare needs transformation. We need to imagine a different future, but we also need to go out and create it. And we're seeing that there are people out there who are testing out a new future and meanwhile as physicians, what we're doing is we're kind of being left behind trying to plug holes in a leaky present. Research is a path for us as physicians to create something new.

16:58 And we really do need to push against systems that block physicians from leading in research. I'm encouraging institutions to invest in physicians as research leaders and physicians, if institutions will not invest in you, how can you invest in yourself? It has been such a pleasure talking with you today. Thank you so much for listening. I'm so excited to bring you reports live from, well, it's not live anymore, but from the Bio International Convention. And I hope that you will consider attending as a physician if for no other reason other than to go and have your mind blown at the way people are thinking about technological innovation in healthcare.

17:41 These are the things that are going to affect your practice of medicine that are going to affect the research that you do as they come and change the landscape of care. You want to know about it. And I hope you'll think about attending next year. All right. It's been a pleasure talking with you today. Thank you so much for listening. I look forward to talking with you again next time on the Clinician Researcher Podcast. Have a great day. Thanks for listening to this episode of the Clinician Researcher Podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor.

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