By Ron DiGiaimo, MBA, FACHE, Dr. Barbara McAneny, MD, Marc Gelinas, and Ben Adams
Cancer growth and cancer care have never stopped in the world of Oncology and the COVID-19 pandemic. Hospitals and cancer centers faced unique challenges and were forced to adapt quickly to ensure the safety of cancer patients, at heightened risk. Across the nation, oncologists, healthcare workers, and patients came together to overcome the challenges and produce incredible solutions that may be with us for years post-pandemic.
We sat down with Dr. Barbara McAneny, MD, 173rd President of the American Medical Association (AMA) and current CEO of the New Mexico Cancer Center, the largest privately-held oncology practice in the state to get her very interesting perspective on the last few years, including how her center’s work with Navajo Nation of New Mexico highlighted disparities of care, the struggles of cancer patients coming in with advanced diagnoses, and how to better evolve health care using what we as a nation have learned and her worldwide exposure as AMA President.
Cancer Does Not Wait for Pandemics
Dr. McAneny and the New Mexico Cancer Center had one guiding principle throughout the pandemic: “Cancer does not wait for COVID.” Constantly adapting to evolving safety measures and redoubling efforts to keep patients out of emergency departments and hospitals kept cancer patients safer and hospitals focused on COVID.
The New Mexico Cancer Center always had a robust program to take care of cancer survivors and patients in a clinic with expanded services, providing the option to be treated as an outpatient clinic treatment, rather than in a hospital. This was really appreciated during a time of great stress and frustration. “A lot of patients were understandably frustrated and angry,” McAneny remembered, “Not directed at us, but directed at how the pandemic got in the way of their cancer care.”
Checkups were postponed by patients and elective procedures were postponed by hospitals, which contributed to increased volumes of advanced stage cancers and general angst in patients. Recognizing this uptick in stressors for cancer patients, the NMCC added a psychologist specifically to boost psychosocial programs for patients and give as much care to mental health as physical health. The complications and frustrations related to COVID-19 on the average cancer patient were difficult, and Dr. McAneny recognized how these hardships were magnified for disadvantaged families and individuals. New Mexico is home to a uniquely affected population fighting cancer and COVID-19 while lacking consistent availability of running water, phone and internet access, and the infrastructure to handle the pandemic; the Navajo Nation.
Impacts on the Navajo Nation
“COVID-19 had an incredibly negative impact on the Navajo Nation. Every family we saw lost someone.” The New Mexico Cancer Center Foundation and the Gallup clinic, which is in the medical heart for the Navajo Nation, provides support to families and communities that do not have the means to travel, much less use services like telemedicine to take care of COVID-19 and cancer. Areas of the reservation were without running water and did not provide the adequate ability to social distance as well, allowing COVID-19 to spread dramatically.
The NMCC team were providing cancer diagnoses and treatment, giving bags of food and supplies. When the authorities closed the town, they handed people letters so they could get to the clinic across the road barriers. McAneny and the New Mexico Cancer Center Foundation realized that their responsibility went beyond the walls of delivering cancer care, and in the worst of the pandemic, the foundation, community, and government all played their part in reducing the impact on the Navajo Nation. Transportation and availability struggles were felt around the country and globe, including in Hawaii, where the blocking of inter-island travel created issues for patients of The Queens Medical Center as discussed by QMC VP Darlena Chadwick.
Evolving Telemedicine and Health Care
McAneny’s work with the Navajo Nation revealed the strengths and the limits of telemedicine. For the NMCC, telemedicine tremendously helped day-to-day operations during the pandemic. Physicians across many specialties such as urology, internal medicine, and oncology offering telemedicine as an alternative to patients who do not require hospitalization positively affects all sides and will likely remain a fixture in most clinics for the foreseeable future. If coverage and opportunity expanded to disadvantaged groups that currently cannot take advantage of this resource, like the Navajo, telemedicine could cut materially down on transportation time and make a real difference in the health of that community.
McAneny stressed that there are clear limits with the current implementation, and as we see telemedicine evolve, assessing its inherent value while pointing out opportunities for growth are pertinent. McAneny is particularly passionate about the Navajo because they are in her home state of New Mexico, but she is quick to point out that they are one of many diverse communities that contain disparate care.
McAneny urged the entire United States health care system to assess its value and evolve to provide affordable and appropriate care to patients everywhere, especially in light of the economic crisis due to the pandemic. “There are a lot of places where I think we need to learn what it costs to deliver optimal care and stop paying exorbitant prices for the same level of care.” With the entire health care world facing drastic change as we exit the pandemic, now is the time to assess the value of these health care dollars. Additionally, McAneny states, we should create a system that allows the patient to succeed in making smart financial and health-related decisions. McAneny’s time as President of the AMA has given her a worldwide perspective on health care and highlighted the exacerbation of health disparities for disadvantaged groups due to the pandemic in the United States and across the world. “I am very proud with what the AMA is working on,” McAneny stated, as the group leads the charge on these issues, but she foresees a long and difficult journey to ensure a healthy nation.
With health care being in a state of flux, assessing value and accepting evolution will be key in coming out of the pandemic on the path towards better care.
From the Perspective of Dr. Barbara McAneny
With multiple leadership roles for nation-leading organizations, experiencing the major changes within health care over the years, and building global connections and reach, Dr. McAneny began her journey in health care simply. As a young girl, she excelled in math and science at school and aspired to work within those interests. While she initially wanted to be a mathematician, health care appeared to be the perfect combination of her particular skill set.
Beginning her career in oncology, McAneny’s goal was similar to many other oncologists–the wish to take care of as many patients and cancer survivors as she could and provide that service in her adopted home state of New Mexico. However, while working as an oncologist, McAneny began looking critically at the functionality of healthcare systems and practices. “I realized that you have to think about how you take care of patients when there are recurring problems, and I’m being asked the same questions every time.”
That recognition of a need and trend is where her involvement in the AMA began, as she took advantage of the numerous educational opportunities regarding insurance companies, Medicare, liability issues, etc. She took her experience as an oncologist to influence her work at the AMA, and her work at the AMA to influence her work as a medical oncologist. The connections to other practices across the country offered incredible benefits to McAneny’s professional growth, experience, and understanding, as she brought back new procedures to her practice.
After working her way up to running the largest privately-held oncology practice in the state, McAneny took on the role of President at the AMA, holding the positions simultaneously. Both are incredible leadership opportunities individually, and her experience maintaining them at the same time positively influenced the other immensely. Leadership in the healthcare industry requires incredible amounts of foresight and critical decision-making. Today, Dr McAneny’s work for the New Mexico Cancer Center is just as rewarding and allows for a direct impact on the great, diverse community of New Mexico.