For over a decade, Amherst College has hosted an annual bioscience symposium for students to have the opportunity to hear from and connect with highly experienced Amherst alumni. This year, this event was named the Hughes Symposium as a tribute to the late Dr. Edward Hughes ‘62, P’95, ‘01, an Amherst alumnus whose prestigious career had a deeply profound impact on the healthcare industry. After beginning his journey at Amherst as a philosophy major, Dr. Hughes came to attend Harvard Medical School with a newfound interest in health policy and health equity. He then earned his Masters in Public Health at Columbia University, inspiring him towards his career as a professor of healthcare policy at Northwestern University. According to various testimonials from friends and family, Dr. Hughes was known not only as an accomplished scientist, but also as a compassionate “bright light for the family.” In fact, Sue Hughes, Dr. Hughes’ wife, shared her fond memories of her truly authentic and eccentric husband, highlighting his many achievements and contributions to the world, one of which would be this symposium.
This year, the Hughes Symposium invited four major figures within the health industry: Dr. David Kessler, a professor of Pediatrics at the University of California, San Francisco and the former Commissioner of the US Food and Drug Administration; Dr. David Lawrence, the CEO and Chairman of the Kaiser Foundation Health Plan and Hospitals (1991-2002); Dr. Julie Segre, the chief and senior investigator at the National Human Genome Research Institute; and Dr. Mryon “Mike” Weisfeldt, a professor of Medicine and Chair of Medicine at Johns Hopkins School of Medicine.
Universal Healthcare
The symposium kicked off with the government’s role in providing healthcare throughout the United States. All the panelists shared a common concern for the United States’ lack of universal health care despite it being a fully developed country. For instance, Dr. Lawrence highlighted specific consequences, such as the increased difficulty for people to live fulfilling lives, the decreased productivity of the country’s workforce and economy, and the creation of an unsustainable environment of inequality prone to exploitation for political gain. These effects, Dr. Lawrence argued, contribute to a significantly weaker, unstable society.
Dr. Segre expanded upon this sentiment, proposing a new direction for American healthcare that combines “American individualism and…[the] sense of providing for society and community benefits.” How is this intersection possible? Dr. Kessler’s and Dr. Weisfeldt’s take on this issue touched upon the need for new perspectives in the medical industry that entail broader social awareness. As the chair of Hopkins’ Department of Medicine, Dr. Weisfeldt shared his experience creating the Johns Hopkins Urban Health residency located within East Baltimore. He emphasized how he recruited interns and residents to specifically provide primary care which includes first-contact general health management, rather than more advanced specialty care such as radiology, for inhabitants of one of the poorest neighborhoods in Baltimore. Coupled with this shift in focus, the hospital provided free treatments for patients within near proximity. Following this structure for over 15 years, these implementations lowered not only the total cost of care expenses but the overall number of heart failure and heart attack cases within East Baltimore. Dr. Weisfeldt credited this significant improvement to the healthcare professionals who adopted a more communitarian approach to healthcare by connecting with the people in the neighborhoods that they were serving; as a result, they were able to truly understand the root of certain issues and strengthen efforts towards prevention.
Regarding health economics, Dr. Segre touched on the concern of healthcare expenses through her perspective as a genomics expert. She explained the issue of antibiotic resistance and its subsequent effect on healthcare expenses. Patients who come to harbor resistant bacteria cannot be discharged into nursing homes or be released from hospitals, prolonging their stay and raising the price of care. These are factors that people must consider when talking about providing universal health care, as these expenses can add up. However, both Dr. Segre and Dr. Lawrence also point out how these expenses can be decreased if proper attention is given to prevention of illness and quality of care. In fact, Dr. Lawrence mentioned his own experience with Kaiser Permanente, one of the largest healthcare providing organizations within the United States, and how he invested huge amounts of money into prevention practices, quality improvements, and patient safety, investments that paid off in the long-term. Therefore, another goal to consider is not simply to provide more services but also to be more prudent and foresighted with healthcare decisions, especially before illnesses become serious.
Pandemic Preparation
On the topic of investments, the discussion then shifted towards the Covid-19 vaccine, which has been regarded as one of the greatest medical investments in recent times. Dr. Kessler, who was the chief science officer for Operation Warp Speed under President Biden, shared his experience providing 680 million Covid vaccines at an incredible pace. He credited not only the government’s ability to financially support clinical projects but also the strong foundation in biomedical research that contributed to the rapid understanding of the necessary products. Both Dr. Weisfeldt and Dr. Kessler emphasized how this crowning achievement of American technology was made possible through the country’s investment into cutting-edge research.
With the conversation focused on the handling of the Coronavirus, the next question was obvious: is the nation more or less prepared for a future pandemic? Dr. Segre felt uncertain, as she mentioned how we were, in a way, lucky with the Coronavirus. With previous research done on past viruses, such as SARS, scientists knew to target the spike protein, making the solution somewhat easier to construct. Additionally, Dr. Kessler mentioned how previous research on methods of vaccine implementation made the handling process much more efficient, as it was easier to understand which methods would be most effective. Overall, the main issue lies in the fact that more research must be conducted to truly ensure the nation’s safety. Further, Dr. Lawrence brought up another interesting aspect affecting the nation’s ability to survive a future pandemic: decaying public trust in the government. Dr. Lawrence declared the United States to be in a worse position than five years ago to endure and survive another nationwide pandemic, as “there is a political movement that basically does not believe in government and is promoting chaos…” Following up on this remark, Kristen raised the question of how the nation can face this “crisis of trust,” and Dr. Lawrence brought attention to medical professionals trained in community health and organization. Since these professionals acutely understand the true help that certain communities would need and be drawn to, he believed their contributions are key to unifying our nation.
Following the conversation about Covid-19, Dr. Kessler was asked to briefly touch upon the Bird Flu, a newly arising concern. Having written an op-ed on this outbreak, Dr. Kessler warned of the uncertainty of viruses with various mutations and transmission methods, cautioning the nation to be prepared because “this is potentially…very real.”
Acclimating to AI
With the growing integration of AI into various fields and workplaces, the final major topic of the symposium covered the effects of AI on the future of medicine and healthcare. Dr. Weisfeldt commented on the implementation of AI with a generally optimistic view. For instance, AI can help gather and decipher more information about patients’ medical histories and issues, emphasizing areas of attention for doctors and physicians. Dr. Weisfeldt provided a specific example of AI improving medical practices through Elliott Fishman, a pancreatic cancer specialist at Hopkins who can now diagnose pancreatic cancer six months earlier on average with AI.
Although these AI advances seem promising for the future of medicine, many are worried about the stability of their careers and future in the industry with AI adopting more integral roles. Dr. Lawrence confirmed that this is a very real possibility, as AI is an excellent resource for pattern matching, one of the distinguishing skills of a clinician. Not only can AI go well beyond the limits of the human brain for interpretation, but it also has access to larger information pools. In light of these concerns, Dr. Lawrence assured prospective medical professionals that while AI may reinvent their workflow, it will not completely erase the job from the market. Dr. Lawrence believes that doctors will now have to take on different forms of training that focus on new criteria, such as patients’ sociocultural development and environmental context. This means that doctors could be selected more for their aptitude in humanistic contexts, allowing them to work in conjunction with AI. This point ties back to Dr. Weisfeldt’s urge for budding medical professionals to be more broadly trained with community-focused experiences and perspectives.
Finally, Dr. Segre further reassured students by mentioning a potential limitation of AI regarding interpreting medical records. She mentioned her own experiences of struggling with medical records, as there seems to be an overall lack of care for their organization. She recalled how she still walks into the healthcare office, and they do not really know her. Additionally, she mentioned how medical records cannot be leveraged to diagnose health issues because diagnoses are not standardized across different institutes. Therefore, a compilation of medical records from numerous sources will be hard for AI to interpret.
To end the evening, the panelists were asked to share important takeaways for students to consider. The general message seems to be that there is no singular pathway into the health industry. For example, Dr. Segre chased her dreams of working in medicine even though she started as a math major without many of the prerequisites for medical school. Even after she was accepted, she found herself within an environment where everyone was a top-tier scientist with vast amounts of scientific wisdom and knowledge, making her uncomfortable. However, she learned to become comfortable with being uncomfortable and realized she could still make an impact despite these initial setbacks. Dr. Lawrence shared a similar story, as he spent a majority of his undergraduate career focused on playing sports, leaving him with very little time for academics. Despite facing challenges, such as receiving a 10% on his first organic chemistry test, Dr. Lawrence continued with his academic journey, crediting his pure stubbornness and determination. In fact, he also shared how he barely got into medical school and was unable to attend a prestigious institution because he did not have enough money; however, this allowed him to meet his mentor who introduced him to community medicine and led him down the path to become the person he is today. Finally, Dr. Weisfeldt directed attention towards admissions and shared a secret insider’s tip, as he revealed that many admission committees nowadays are searching for qualities beyond the textbook. In fact, admission officers take very detailed notice of students who invest time and energy into a genuine interest that is connected with their future career.
Even esteemed scientists, such as the panelists, were once unsure of their direction in life; however, what matters is that they found their own, unique paths. In the context of confronting current healthcare issues, just as important as academic preparation is a humanistic perspective. Unafraid of traversing new grounds, the panelists left with a final message to the audience: “be comfortable with being uncomfortable.”