By Jennifer Jang, ASTRO Communications
Attendees of yesterday’s Presidential Address heard a heartfelt appreciation and exhortation from Jeff Michalski, MD, MBA, FASTRO. Clifford Robinson, MD, his colleague at the Washington University School of Medicine, noted Dr. Michalski’s many roles that showcase his unwavering commitment to the field, including the Carlos Perez Distinguished Professor and vice-chairman of the Department of Radiation Oncology, and vice-chair of the RTOG.
Dr. Michalski devised this year’s meeting theme, “Pay it Forward: Partnering with Our Patients,” an outgrowth of his consistent passion for clinical trials and ensuring that patients receive high quality care through rigorous quality assurance.
Dr. Michalski acknowledged four leading mentors on his path: Jim Cox, MD, FASTRO, Larry Kun, MD, FASTRO, Theresa Vietti, MD, and Carlos A. Perez, MD, FASTRO. They impacted his career choices, including his commitment to clinical trials and involvement in the RTOG and to children’s cancer groups. He advised early career physicians in the audience to listen to sound advice. He encouraged more seasoned physicians to be generous with their experience, to mentor, to pay it forward.
Dr. Michalski’s next personal encouragement was to be humble. With humility and transparency, he shared an early difficult experience, when he had to tell parents of a five-year-old patient that he had devised an incorrect treatment plan. Furthermore, he shared the incident to Dr. Kun, noting that as much as he was disclosing a protocol deviation, it was also a confession.
In response to Dr. Kun’s encouragement, Dr. Michalski took the lesson to spur his interest in quality and safety. He adopted the mission to ensure that radiotherapy delivered on pediatric trials was the highest quality, and such was his third charge, be accountable. Among the new trials he oversaw, one had a typo in a protocol that resulted in an overdose of magnesium sulfate to one patient. He quickly sized up the ramifications, drafted an amendment to be distributed quickly, calling all participating centers personally.
Dr. Michalski then discussed challenges clinical trials face, and how having grit is needed to pursue critical findings, whether breaking down barriers to enrollment or introducing technology amendments. Being curious is also an important motivator to continue discoveries to improve patient outcomes.
Then came the exhortation to have courage, to conduct studies that randomize new technologies against existing standards of care. Many centers market new technology as superior to more common approaches, which might do more harm to patients who then seek treatments far from their homes, potentially leading to physical and emotional distress. The role of trial sponsors and insurance companies cannot be downplayed. Important trials are suffering from dropout, jeopardizing completion and helpful study findings.
Dr. Michalski closed his talk with numerous thanks to those who helped in his practice, at ASTRO and his family, yet the appreciation is returned manifold. Favorite quotes were sprinkled throughout, from Moliere to Thomas Edison, but attendees likely jotted down the following as their takeaway: “Mentor. Be humble. Be accountable. Have grit. Be curious. Have courage.” – Dr. Jeff Michalski
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