Dr. David Beyer

Q&A with Dr. David Beyer, president and incoming chair of ASTRO

September 27, 2016
by Sean Ruck, Contributing Editor
HealthCare Business News recently caught up with Dr. David Beyer, president and incoming chair of the American Society for Radiation Oncology (ASTRO), to learn about his career, the latest news from the association and what to expect at the ASTRO annual meeting being held in Boston from Sept. 25-28.

HCB News: What inspired you to get involved in health care?
I started my career as an electrical engineer and was involved in bioelectrical engineering. Through creating the devices used to care for patients (back in the 1970s when things were less sophisticated), I realized that I enjoyed not just the technology, but its application with people. From there, I decided to pursue a career in medicine. With radiation oncology, there’s significant use of technology, but it’s brought to bear on an individual. It allowed me to have a very close relationship with the people I was treating.

HCB News: What attracted you to ASTRO?
ASTRO is the largest organization for radiation oncologists, and most board-certified radiation oncologists in the U.S. are members. ASTRO is the biggest source of education for our field, from its scientific journals to the annual meeting.

HCB News: How long have you been with the society?
I’ve been a member for 31 years and was a member-in-training for a year or two prior to that. Since the late 1990s, I’ve had some type of active involvement or leadership position.

HCB News: What is ASTRO’s involvement in the “moonshot” initiative toward curing cancer announced by Vice President Joe Biden and President Barack Obama?
We certainly were excited to hear about the initiative and have embraced the effort. ASTRO itself has issued several statements of support, such as when the president’s proposed 2017 budget included nearly a billion dollars in increased funding for the National Cancer Institute. We’ve also taken steps to generate research ideas from our members, including a tweet-up where some of our doctors joined a national online conversation about ways to make progress.

I can say ASTRO is disappointed that there’s not a stronger radiation oncology presence on the advisory panel overseeing this initiative, because radiation therapy is an essential component in the fight against cancer. Take, for example, using immune modulation to fight cancer — an approach that is gaining attention from the news media, but yet something that we’ve been doing for a number of years. We know that you can stimulate an immune response with radiation, but there is much more we need to understand. Why does it work? How do you make it work better? How do you harness it? We’ve submitted a number of ideas for funding, but are in a bit of a holding pattern.

HCB News: As chair, what kind of initiatives will you move forward?
I happen to be sitting on ASTRO’s board right at the moment when I think there is a radical change in how health care is delivered in this country. We call it payment reform and we’re involved in innovations in how we provide care, so we can take care of both the patient and payor. A lot of the programs we’re presenting this year are discussing how we integrate ourselves into the overall process and how we go about breaking down barriers between radiation oncologists and other specialists that also take care of the patient. How can we work together to keep the patient healthy and out of the hospital?

HCB News: Does ASTRO lobby for health care?
Yes. ASTRO fights for several issues to help physicians and researchers do the best job we can for people with cancer. The health care system and the way we get health care are rapidly changing. ASTRO is a part of that process. We meet with the Centers for Medicare & Medicaid Services (CMS), Congress, various committee members and other policymakers, all to help guide decisions that we think are beneficial for our patients. Once a year, we have Advocacy Day, where more than 100 members volunteer to give up two days at their practice to sit down with members of Congress and explain what the issues are.

This year our focus was on sustained cancer funding to improve cancer care. When you get funds as a one-off without a sustained arc year over year, it’s very hard to build a cancer program. There are other important issues, too. Funding for graduate medical education. Stability in the physician payment process — because the changing fee schedules that CMS issues each year can be very disruptive for practicing physicians. I practice in a small market, and I don’t have the resources to handle substantial changes year after year. The whole health care realm is in upheaval, and we want to know what we can count on so we can plan staffing, equipment updates and more.

HCB News: What’s new for this year’s annual meeting?
Thematically, we’re talking about enhancing value and improving outcomes. Our presidential symposium, for example, focuses on prostate cancer issues such as how and when different treatment approaches are appropriate. It’s important to define value and deliver it to the various stakeholders in the room, including the patient. It’s important to give some guidance so we can go home and do a better job.

Kathleen Sebelius, who was Secretary of Health and Human Services, will be one of our keynotes and will talk about health policy and defining value. Another keynote speaker, Jason Ragogna, is a safety executive for Delta Airlines. He will talk about safety and quality. Our third keynote, Tom Lynch, is CEO of the Massachusetts General Physicians Organization, and he offers a lot of experience in personalized medicine.

We’re also excited to be back in Boston. ASTRO loves Boston. I have every reason to expect we’re going to set records for attendance this year. We have a record number of abstracts, more than 350 oral abstract presentations, almost 2,000 posters, nearly 75 educational sessions and scientific panels and more than 200 exhibitors showing off the latest technology. We also will have eight e-contouring sessions. This is one of those skills you need as a radiation oncologist — taking information from a patient’s scan and creating a radiation treatment plan from it.

We’ve created a process for hands-on training. It’s not just note-taking. You do it, and you get it reviewed by experts in the room. We’re also doing a second year of a prostate brachytherapy workshop to allow people to get a very hands-on experience with phantoms. The workshop allows you to practice everything you need to do when you’re going to care for such a patient.

HCB News: What will radiation oncology look like 10 years from now?
It’s hard to know what it’s going to look like. The way radiation interacts with matter and its ability to kill cancer cells is something that we’ve known works for more than 100 years, but it’s just within the past 30 years or so that we’ve come to understand how and why it works. In 10 years, we’ll know even more. We’ll combine that knowledge with certain drug therapies to make certain areas more sensitive or protected. In the same way that you want your surgeon to have the sharpest scalpel possible, you want your radiation therapist to have the sharpest tools possible. You need to make choices. Sometimes complicated is better, sometimes it’s not. With ASTRO’s participation in Choosing Wisely, we emphasized the importance of careful consideration when making treatment decisions.