ASTRO 2021 elections results
Congratulations to the following newly elected members of ASTRO’s Board of Directors and Nominating Committee. The new officers' terms will begin on October 26, 2021, during the 2021 ASTRO Annual Meeting.
Radiation oncology is an established equal partner in cancer care. Our peers in other oncology specialties recognize our unique expertise and essential contributions to a multidisciplinary care team—but we have room to improve. Radiation oncologists have led many essential and innovative clinical research advances that enhance patient outcomes and extend survival. We can be proud of our specialty’s clinical and scientific accomplishments. Nevertheless, there remain opportunities to generate a better public profile amongst our patients and their communities and have a stronger voice in the future of multidisciplinary oncology.
The current ASTRO Strategic Plan was approved by the Board in 2017—more than 4 years ago. Today we are in a position to reflect on where that plan has brought us and whether or not it reflects our Society’s sustained vision. I believe the Board hit the mark on stating our specialty’s core values of Excellent patient care, Improved outcomes, Innovation, Integrity, and Diversity and Inclusion. We have made significant strides within most of these values, although we can do much better addressing Diversity and Inclusion. Much of our strategic plan remains relevant today.
Although we still attract exceptional medical students, we are now struggling to routinely fill our training slots with the strongest candidates. Over this past decade, we went from being the most competitive medical specialty to one where we are openly criticized by the next generation of physicians. This is partly due to oversupply, both real and perceived. Another concern is whether we are preparing our trainees for real-world challenges. Whether it be clinical practice, the board exams, or careers in academia, we need to prepare future radiation oncologists to meet the challenges of a dynamic workforce and competitive funding and reimbursement. ASTRO needs to understand the reasons for these changes and recapture our pre-eminent position amongst the bright young minds who seek a fulfilling career.
ASTRO has been the leader in advocating for our specialty to protect our patients’ access to the lifesaving care we offer. Our influence amongst policy-makers has been strong, despite the relatively small size of our specialty. Nonetheless, opportunities exist to address the ever-growing challenges of constrained reimbursement, third-party denials of care, pre-authorizations, and the concomitant administrative burden and burnout to which these barriers contribute.
Finally, this past year has been unlike any other in our lifetimes. Both COVID-19 and the global demonstrations highlighting social inequality have revealed much about our human character. ASTRO must ensure that our membership more closely represents the communities in which we practice. Achieving this will require a cogent, creative plan, hard work and long-term dedication, but we must start now. It is imperative that we build a pipeline of diverse students, trainees, and practicing oncologists. Only then can we enjoy the status of being truly equal amongst our peers, cement our future as opinion-leaders in oncology, and maintain access to all for the critical and cost-effective therapies that we provide.
Jeff Michalski, MD, MBA, FASTRO, is the Carlos Perez Distinguished Professor and vice-chairman of the Department of Radiation Oncology at Washington University Medical School. He earned a BS in biochemistry from the University of Wisconsin in 1982 and an MD from the Medical College of Wisconsin in 1986. After starting residency in radiation oncology at Columbia Presbyterian Medical Center in New York, he completed his residency training and fellowship at the Mallinckrodt Institute of Radiology and the Washington University School of Medicine in 1991. He earned an MBA from the Washington University Olin School of Business in 2001.
Dr. Michalski served as Vice-chair of the RTOG, leading its Advanced Technology Integration Committee. He is Co-chair of the Radiation Oncology Committee of the NRG. He was Chair of the Radiation Oncology Quality Assurance Committee of the Pediatric and Childrens Oncology Groups. He is Co-chair of the NCI Genitourinary Steering Committee and member of the bladder cancer panel of the NCCN. He is a member of the Siteman Cancer Center and is Medical Director of the center’s Clinical Trials Core and Siteman Cancer Network.
Dr. Michalski’s research interests include radiation dose escalation in prostate cancer; conformal therapy to reduce toxicity and neuro-cognitive effects in children; assessment of quality of life in survivors of adult and childhood malignancies. He is the principal investigator of the Advanced Technology QA Center (ATC). He was co-principal investigator for the Veterans Administration Radiation Oncology Practice Assessment program, reviewing quality of care at forty VA radiation oncology centers.
ASTRO’s Strategic Plan outlines the goal to remain not only an equal partner in oncologic care, but also to emerge as leaders in innovation, value, equality and comprehensive patient care.
ASTRO’s plan for increased national visibility is a sound strategy. I would encourage members to highlight the value of partnership with radiation oncology in oncologic research and clinical practice. Members should collaborate with other societies in tumor boards, scientific research, meetings and publications. Inviting other disciplines to our scientific meetings, to submit publications to our journals as primary or co-authors and to contribute to our podcasts can foster increased familiarity with our specialty. Likewise, we should embrace closer collaboration with other specialty societies.
Future innovations cannot be limited to technological advances. ASTRO member research evaluating how tumor biology affects radiation-tumor-normal tissue interactions is important, as the same molecular knowledge that drives innovative systemic therapies may have a profound influence on radiation therapy. Innovations in efficiency and safety combined with objective metrics should be encouraged and successes publicized. Educational opportunities that combine educational lectures with brainstorming sessions for interested members (and across disciplines) may also stimulate new ideas.
Radiation oncology has attracted the best minds and a concerted effort to showcase the advantages of our specialty and foster relationships with medical students and residents will maintain a strong specialty and society. Working to reflect the populations we treat is a goal that takes active effort and includes hiring decisions, mentorship and sponsorship. We need to be united in contributing to the positive narrative, while maintaining transparency and integrity.
As an active participant in health policy, it is apparent that involvement in value-based incentive models is imminent. ASTRO advocacy must continue to protect guideline concordant care, resist unnecessary practice burdens, avoid the inadvertent fostering of unfair competition, reverse payment cuts disguised as value and insist on the freedom to pursue innovation. ASTRO efforts in highlighting these issues and driving true value-based care will allow members to thrive in the future health care environment. Member engagement in health policy has been disappointing and there exists a need for emphasizing to members the direct impact the committee work has currently and for future practice. The health policy committee needs to stress that active engagement drives results, and I would like to see short informational podcasts on relevant topics.
Current health care paradigms place an emphasis on patient outcomes and satisfaction. Continuing work to increase or maintain tumor control while decreasing toxicity is a long-term goal and fostering an environment to do so will take continued research and advocacy for the freedom to seek new solutions. ASTRO should continue to support pathways, provide educational opportunities to fill physician, community and patient knowledge gaps and promote technology that helps provide consistent, high quality care. Methods to increase patient understanding and supporting decision algorithms to aid physicians, payers and patients on appropriate care is another step toward equalized, informed and compassionate care.
The ASTRO Strategic Plan recognizes impactful science is both a core value and an essential component of the future of radiation oncology. Science advances the public perception of radiation oncology and leads to critical improvement of clinical outcomes through translational science. The importance of basic radiation biology, medical physics and clinical research within our field cannot be overstated. The uniqueness of our field is in integrating biologic, physical, mathematical, engineering and clinical cancer care. This distinguishes us and furthermore positions our discipline as the potential glue for interdisciplinary cancer care among other oncology disciplines. Training the next generation of scientific leaders that is increased in diversity is vital for our future and will improve the quality of our research. We cannot advance without this investment in the next generation of leaders. In this role the opportunity to positively impact the resources and approaches needed from both internal and external sources is critical to attain success for our field. Working with policy and advocacy and fellow board members to enhance our scientific impact would be a committed privilege and inspire my leadership goals to benefit our ASTRO membership.
Dr. Buatti is Professor and the Chair of the Department of Radiation Oncology, a position that he has held with distinction since 2001, when he established an independent department at the University of Iowa Hospitals and Clinics. In 2005, he opened Iowa’s first Center of Excellence in Image Guided Radiation Therapy, which was innovative for its use of advanced 3D imaging including a 3T MR scanner and 40 slice respiratory-gated PET/CT scanner to better locate and treat tumors. As a clinician, he is a leading authority on the treatment of cranial malignancies. He is a prolific scholar having authored or co-authored more than 250 peer-reviewed publications. He has published 22 book chapters.
With a life-long commitment to improve the quality of cancer imaging in therapy he served as the first chair of the Steering Committee for the Quantitative Imaging Network (QIN) and Chair of the Clinical Trials Design and Development Working Group and was a member of the Coordinating Committee for QIN. He has served on the ASTRO Education Committee, as Co-Chair of the ASTRO IHE-RO (Integrating Health Enterprise-Radiation Oncology) and served on the ASTRO Science Council Steering Committee. He chairs the ASTRO task force on Theranostics.
He is and advocate for diversity in the workplace and encourages the development of scientist-investigators through summer internships and the active recruitment of minorities. He supports an active Holman Pathway program for residents as well as a graduate program in Free Radical and Radiation Biology within his department.
If elected as a member of the ASTRO Nominating Committee, I aspire to promote members of our community who can best represent us as leaders in society committed to advancing quality and accessible healthcare. I fully support ASTRO’s Strategic Plan and those priorities that most resonate with me are as follows:
Multidisciplinary cancer care. Only radiation oncologists have the foundation in training and longitudinal relationship with medical physics and dosimetry to truly understand our technological capacity and clinical implications, the radiobiologic consequences of radiation treatments, and the potentials in integration with other therapies. It is our responsibility as clinicians to engage in the forefront of multidisciplinary clinical care with our non-radiation oncology colleagues. Increasingly, with combined treatments with novel drugs such as targeted therapies and immunotherapies, the clinical advancements in disease response has sometimes come with humbling toxicities. There is an imperative need for the radiation oncologist to provide leadership in investigations to understand the merging of radiation biology with immunology and rest of clinical oncology. Similarly, our position as clinicians first enables us to best guide medical physics and our other technical colleagues towards advancements with greatest clinical utility.
Health care cost and access. The remarkable technological advancements in our field has come with a significant price to deliver this care. As a field, we are socially responsible for advancing healthcare that is accessible throughout the world and not just to communities of greater wealth. I seek to attract persons with expertise and interest in healthcare economics, health policy, social determinants of health, global health, healthcare disparities, among other multidisciplinary interests that are critical to providing affordable access to best cancer care. ASTRO’s leadership in proactively defining a longitudinal view is instrumental in advancing cancer care and the role of radiation therapy.
Quality of care. Quality begins with attracting tomorrow’s leaders and ensuring the highest quality clinical training with forefront research opportunities. In addition, shared values in education, diversity and social responsibility must be instilled early. The delivery of radiation therapy is only one small part of our responsibility. Excellence in comprehensive care requires an environment of implicit universal respect for each other. It mandates that there is diversity in our staff to reflect the populations we serve. It requires education to understand bridging the gaps of equity for healthcare workers and patients alike.
Communication and advocacy. I seek leaders for ASTRO who will represent us well as articulate communicators who in themselves have achieved national respect as outstanding professionals with the highest integrity. These ASTRO representatives will be responsible for defining radiation oncology to other interest groups and for engaging and educating the broader public.
In summary, the tasks of ASTRO and each of us as members is significant. If chosen as an Academic Physician of the Nominating Committee, I will endeavor to promote diverse talents to lead us with the common goal of quality, innovation, and the best clinical care.
It would be an honor to serve as your community practice radiation oncologist on ASTRO’s Nominating Committee. If elected, I would seek out a diverse slate of candidates for ASTRO positions who can elevate radiation oncology’s profile, foster innovative research, promote sound health policy, promote quality and safety in our field, and demonstrate the unique role radiation oncologists have in being physicians with technical expertise, practicing the art and humanity of medicine.
The Core Purpose, Core Values, and Vision of ASTRO's Strategic Plan resonated with me, but I really enjoyed reading "Vivid Description If Strategic Goals Are Achieved." Nevertheless, it should not take us 10+ years to get there. Most Americans have a positive perception of radiation oncology, but it could be better. Not only should we be quoted in mainstream media, radiation oncologists should, for a change, be the protagonist in medical dramas in the entertainment industry—that would surely increase positive public perception! Because in real life, we really do save the day--for inoperable patients, those too frail to tolerate systemic therapy, those needing acute symptom relief, and all those patients getting curative treatment.
As more patients survive their cancers with opportunities to develop new ones, it is the community radiation oncologist who is the steward of a woman's breast, uterine, and skin cancer, or a man's lymphoma, prostate, and tonsillar cancer. No other medical specialty can do this comfortably, making us natural leaders of oncology teams.
Surviving the oral boards equipped us with the ability to discuss plans of care and cite the literature during tumor boards. Recent years have brought a record number of radiation oncology specific papers published in mainstream high-impact journals. We have demonstrated the ability to deliver high value, cost effective care (and yet still got targeted for an alternative payment model). Through ASTRO's Advocacy Day, we actively engage with lawmakers to improve health policies.
A lot in ASTRO’s Strategic Plan is already happening. But reading this inspires me to think of where we can do better. More radiation oncologists need to take on leadership roles in organized medicine outside our field. More of us should be at the helm of NCI Comprehensive Cancer Centers. More of us should be the heads of medical schools, hospitals, hospital systems, biotech firms, think tanks, and county/state medical societies. Having a radiation oncologist chairing or co-chairing a NCCN Guidelines panel should be the expectation, not the exception. No longer will we be confined to the basement, as we lead and inspire our multidisciplinary colleagues to provide extraordinary, personalized care.
Dr. Join Luh is a radiation oncologist in rural private independent practice at St. Joseph Hospital in Eureka, CA, serving patients as far north as southern Oregon, and many rural outlying areas in northwest California. He is the clinical lead for the Providence St. Joseph Health System's Radiation Oncology Focus Group and represents Humboldt County to the Providence St. Joseph system's Cancer Leadership Committee.
His areas of interest include quality improvement, quality metrics, payment reform, clinical documentation, artificial intelligence, 3-D printing in medical technology, and augmented reality in radiation oncology. He has firsthand experience with the Merit Based Incentive Payment System (MIPS) in MACRA's Quality Payment Program (QPP). He is a bit uneasy about being mandated to participate in the Radiation Oncology Alternative Payment Model (RO-APM) but is grateful to have the support of ASTRO’s health policy and advocacy team. During his spare time, he enjoys mountain biking, surfing (on a paddle board), golf, catching fresh seafood from the Pacific coast, craft beers, Wisconsin cheeses and playing music.
I am honored to be selected as a Physicist Candidate for the ASTRO Nominating Committee. My policy statement for this committee position focuses on diversity, equity and inclusion. I strongly believe that having a diverse cohort of candidates for all positions is critical for the continued development and success of the field. There are many aspects to diversity, including race, ethnicity, and gender, as well as career rank, geographic location, size of primary institution and practice setting. There are many reasons that diversity is important, first it is the moral and ethical way for the society to act. Second, data shows that when leadership is diverse, it creates an authentic and inclusive society. Third, scientific data demonstrates that diversity in scientific teams leads to more innovation and improved performance. These three components are critical to the continued and expanding success of ASTRO. It will be my mission, if elected to the position of Physicist on the ASTRO Nominating Committee, to ensure equity and inclusion in the society through the nomination of a diverse slate of candidates for all positions.
I strongly agree with the core values of the ASTRO strategic plan: excellence in patient care, improved outcomes, innovation, integrity and diversity and inclusion. One of the strategic objectives of ASTRO is to have the radiation oncology field reflect the diversity of the patients served. This is precisely aligned with my policy statement above. For the radiation oncology field to achieve its full potential, students, trainees and scientists interested in joining the field of radiation must be able to self-identify with the diversity in membership, especially in leadership positions. They must feel empowered to fully engage in the society at all levels. The Nominating Committee of ASTRO must ensure that this strategic objective is met. A second strategic objective of the field is to establish radiation oncology as an equal partner in the cancer field. This objective is also synergistic with my vision of characteristics of future ASTRO leaders. The Nominating Committee must ensure that the slate of candidates represents ASTRO’s commitment to excellence in patient care and improved outcomes in their clinical practice and through their professional conduct within ASTRO and all professional societies. Finally, ASTRO’s strategic goal to retain and foster the intellectual research talent currently entering the field of radiation oncology is a purpose that drives the Promoting Science through Research and Training Committee of ASTRO, where I currently serve as Chair. This is a critical mission for ASTRO and I believe that future ASTRO leaders must have a strong commitment to foster and develop innovation and scientific discovery within the ASTRO community.
Kristy K. Brock received her PhD in Nuclear Engineering and Radiological Sciences from the University of Michigan. After receiving her PhD, she held faculty positions at the University of Toronto and the University of Michigan. She is currently a Professor with tenure in the Department of Imaging Physics, University of Texas MD Anderson Cancer Center, where she is the Director for the Image-Guided Cancer Therapy Research Program. Her research focuses on image guided cancer therapy, where she has developed a biomechanical model-based deformable image registration algorithm to integrate imaging into treatment planning, delivery, and response assessment as well as to understand and validate imaging signals through correlative pathology.
She is board certified by the American Board of Radiology in Therapeutic Medical Physics and holds a joint appointment with the Department of Radiation Physics at MD Anderson. Dr. Brock has published over 100 papers in peer-reviewed journals, is the Editor of the book ‘Image Processing in Radiation Therapy’ and has been the PI/co-PI on 21 peer-reviewed, industry and institutional grants. Her clinical activities focus on the clinical validation and streamlined integration of deformable image registration into radiation therapy planning, dose accumulation and adaptation.
She has a strong interest and commitment to education and training programs and diversity, equity and inclusion. She currently serves on both the Admissions Committee and Steering Committee of the Medical Physics Program of the Graduate School for Biomedical Sciences at the University of Texas. She also serves on the MD Anderson Faculty Diversity, Equity and Inclusion Council.