In this Q&A, CancerAid had the pleasure of speaking to Michael about how cancer care is transforming.
Prof Boyer, Can you give us a brief introduction of yourself and your medical background?
I’ve been a medical oncologist for the past 30 years and continue to enjoy that role and the challenges that it brings. I trained in Sydney, at Royal Prince Alfred and Westmead Hospitals, before travelling to Canada and working at the Princess MargaretHospital/Ontario Cancer Institute as both a researcher and clinician. I now have both a clinical as well as an administrative role at the Chris O’Brien Lifehouse, a stand-alone cancer centre.
Clinically I treat lung cancer as well as head and neck cancer whilst administratively I am responsible for the medical care that is delivered in the facility.
What would you say is the best piece of advice you have ever received?
My father always told me that if I was going to do anything, I had to do it well. That advice has stood me in good stead through my life.
Who inspires you?
My patients are the source of an enormous amount of inspiration. They go through so much yet seem to still have the strength to carry on (and usually in a good natured way!)
Would you like to share what you have learnt recently that just blew you off your feet?
The explosion of knowledge about the molecular composition of cancer, and the way in which cancers interact with our bodies and our immune system is amazing. This understanding has been translated directly into better treatments for cancer, and better outcomes for our patients.
What would you say excites you the most in your industry, having had many years of professional experience?
The most exciting thing about healthcare is the constant change and innovation. This has resulted in us being able to treat, successfully, a whole range of conditions that in the past were felt to be untreatable. Ultimately this translates into better outcomes for patients, and improved health of our community.
Can you tell us about why you wanted to work in medicine?
For as long as I can remember I wanted to be a doctor. Initially, the thing that drew me to it was the science and a fascination with how the body worked. However, soon after starting at medical school, I realised that thing that I really enjoyed and was stimulated by was the ability to help people and make a difference in their lives. This has remained the thing that drives me until today.
For any patients and caregivers reading this, what are your tips on navigating cancer care?
My key tip is to find a team of healthcare providers with whom you feel comfortable, and who will happily and honestly answer your questions and address your issues. Once you have a team that you trust, they can do a lot of the navigating for you.
A positive impact of COVID-19 is the adoption of digital health, can you give us a few examples of your experience around virtual care options?
Using telehealth to conduct consultations has become commonplace during the COVID-19 pandemic. There have been many benefits to this including helping to keep patients safe, as well as the convenience of patients not having to travel to appointments. At the moment, approximately 50% of all consultations I perform occur digitally. However, the rapid adoption of this and other digital approaches have also highlighted some of the limitations, particularly in cancer care. It is challenging to be truly empathic when breaking bad news to a patient remotely. In addition, for initial consultations, it can be difficult to adequately assess a patient without the ability to see them face to face.
“At the moment, approximately 50% of all consultations I perform occur digitally“
Currently, we use the word ‘telehealth’ for everything that is not face-to-face; a normal phone call, a video call, calls made on specific bits of software with waiting rooms and security features, medical record systems with video conferences and health system integrations, everything is called telehealth today.
There are opportunities for companies to be involved by incorporating telehealth into how we [Healthcare Professionals] normally work by seamlessly integrating it into our workflow. This will also lead to an improved experience for the patient.
As for simple calls, these come with much admin for both the clinician and patient and there’s a lot of awkwardness to it. We encounter this as a problem with any telehealth. The patient doesn’t expect a ring, they don’t knowhow long to wait before they should ring and ask their doctor if they’ve forgotten about them, and we on the other side don’t have a way to easily keep the patient up to date as to when they can expect a call back.
But with the current state, we have to remember all this was introduced with very short notice.
In your perspective, what health industry problem is CancerAid well placed to solve?
Because of the way CancerAid’s technology and programs work and the way these are delivered, CancerAid is well placed to optimise the remote delivery of health care, the parts of cancer care where physical presence isn’t absolutely necessary and the patients don’t have to be in the room. On the broader spectrum, CancerAid has solutions, whether in a COVID-19 situation or not.
There is a real benefit to something like CancerAid for the health system, regardless of whether you are talking about cancer care or the overall healthcare space.
The healthcare system is very good at delivering acute care. As an example, we are well equipped to fix a broken leg. We are good at making it not broken again. However, we are less good at what happens afterwards and resolving the immediate problem is only one part of the care a patient needs.
The things that happen in the hospital, the high tech, very expensive bit, is only a very small part of a patient’s journey. The majority of a patient’s time is spent after the acute care is delivered, and the often bigger impact that can be made for the patient is 4-8 weeks after they leave the hospital setting. Sometimes, depending on the situation, this can go on for up to 6 months after treatment when patients need help to get their lives back to how they were before the illness started.
“It actually can work if you do it right, you have a chance to minimise the impact of the disease”
If done right, you are able to help people in getting back on their feet, bring them more confidence, resilience and helping them in getting back to life - and that also includes the workforce. Basically, an intervention, such as CancerAid, that works and can accomplish these things saves money and pays for itself.
Do you see any macro trends in cancer care that CancerAid are well-positioned to address?
Yes, certainly, the first one is the recognition that rehabilitation and recovery are important aspects of care. 20-25 years ago no one really thought about what happens after cancer. The unfortunate truth was that if the majority of patients are dying from cancer, recovery has a less important place. Today, with better and more effective treatments, the spotlight has moved on to recovery and what happens after cancer. Today, we are looking at better outcomes from cancer itself.
Secondly, a trend that we see in all of healthcare is one of managing disease closer to home, with less acute care being delivered in hospital. We manage patients remotely on a much larger scale than before. Again, 25-30 years ago almost all acute care was done in a hospital setting. As of more recently, out of hospital care is becoming more common and patients are being cared for closer to or in their homes. It’s been a huge jump in the last 3 months because of COVID-19, but this change was happening anyway, just at a slower pace.
“We manage patients remotely on a much larger scale than before”
CancerAid, in the way it's set up, can help healthcare players address these two trends well.
If you had one piece of advice to companies endeavouring to address health care’s biggest high-level system changes, what would it be?
It’s about recognising that these changes are happening. These changes represent opportunities for companies working in this space and also for companies that do not yet exist. My advice is to look at these and develop things that can support and accelerate these changes.
“It’s about recognising that these changes are happening.”
Generally, within the health system, most Doctors, Nurses and Healthcare Professionals are interested in making these things happen but are not as good at coming up with the best ideas on how to address these changes. An exception to this is CancerAid, which did arise from founder’s with a background in treating cancer. Of course, the kind of things I’m talking about are not exclusive to cancer and can be done and is being done in other diseases such as heart disease, asthma etc.
People outside of this space are better placed to understand what solutions and changes might be needed and then step into healthcare to support the system. There are a lot of places where these innovative people fit into healthcare, however, when endeavouring in healthcare, people without a medical background or extensive healthcare experience, need to come to us [senior healthcare operators] and talk to us.
How can people like myself and from other companies best engage with Health Care Professionals?
Simply, if people don’t want to listen to you they are not going to. Those that are interested will listen and not see it as a waste of time. Those who are responsible for operations and systems - it’s their job to listen and learn about what’s out there and what can solve efficiency problems, and it’s central to their job. It’s essential for healthcare’s leaders to think about how they want their organisation and service to look 5 years from now
“It’s essential for healthcare’s leaders to think about how they want their organisation and service to look 5 years from now”
If these people don’t want to listen or if you pick the wrong person to speak to, progress stops.
So the key thing to do is to be able to understand the problems facing healthcare organisations, identify the leaders who are responsible for solving these problems, and present them with solutions.
About Prof Michael Boyer AM:
Michael has been a Medical Oncologist for more than 25 years, specialising in the treatment of thoracic and head and neck cancers. He was appointed ChiefClinical Officer at Chris O’Brien Lifehouse in 2011.
Michael was the Director of the Sydney Cancer Centre and former Area Director of Cancer Services for the Sydney South West Area Health Service. He also has an appointment as a Clinical Professor within the Central Clinical School of the University of Sydney. He is theConjoint Chair of Medical Oncology and Thoracic Oncology at Lifehouse.
In 2010, he was made a member of the Order of Australia for his work as an educator, a clinical trials researcher and for his involvement in the development of integrated care facilities for people suffering with cancer.
Michael continues to be actively involved in research, focusing on the testing of new anticancer drugs for the treatment of lung cancer.
Michael has a Bachelor of Medicine and Bachelor of Surgery from the University of Sydney and a PhD in Cell Biology from theUniversity of Toronto.