By: Ron DiGiaimo, MBA, FACHE, Dr. Catheryn Yashar, MD, FACRO, FABS, FACR, FASTRO, Ben Adams, Bri Driggers
Cancer growth and cancer care have never stopped in the world of oncology and the COVID-19 global pandemic. Hospitals and cancer centers faced unique challenges and were forced to adapt quickly to ensure the safety of cancer patients, at increased risk for COVID-19. Across the nation, we saw oncologists, healthcare workers, and patients overcome challenges and produce incredible solutions that may be with us for years post-pandemic.
We sat down to obtain lessons learned and information that can be shared from Dr. Catheryn Yashar, MD, FACRO, FABS, FACR, FASTRO, professor, and vice-chair of the Department of Radiation Medicine at the University of California San Diego School of Medicine. Dr. Yashar provides her perspective on cancer care operations, obstacles that faced her team, and the emergence of key takeaways from the global pandemic as we begin to emerge into a post-pandemic world.
Combatting Cancer-Related Complications with Proactivity
“I cannot over-emphasize how proud I am of my team at UCSD” Dr. Yashar began, “with being proactive and helping us be among the first in our region to provide testing and vaccines for our staff and our community.” The University of California’s San Diego School of Medicine led the area in COVID-19 testing, then the following year, became the first supercenter in Southern California for vaccination. Leading the front lines during both the beginning of the pandemic and vaccine rollout is truly impressive, and Dr. Yashar credits the exceptional UCSD team with pushing forward and leading the way.
Additionally, during the worst of the pandemic, initiating screenings at the door for every employee and cancer patient were essential in protecting the facility. Maintaining safety helped ensure peace of mind in the community, as the permeated fear of high-volume hospitals and clinics impacted everyone, especially increased risk patients with cancer. Keeping these measures in place and being proactive from the beginning were the key to success for UCSD.
This proactivity was far from easy for the entire staff to maintain, as adding COVID-19 testing to elective and nonelective surgeries, emergency testing, and countless other procedures took a physical and mental toll. Extended hours impacted doctors, staff, and cancer patients, as we have seen in numerous cases around the nation. Patient fear of doctor visits and follow-up appointments were eased in part by telemedicine; implementation was quick and effective, thanks to the extra time and effort was put in by the UCSD’s team, and teams across the nation.
One of the key technological advancements outside of oncology and healthcare that greatly impacted COVID-19’s spread was Apple’s contact tracing alert system, which let phones know when they were in close contact with a user at risk. UCSD worked in conjunction with Apple to develop this application, which Dr. Yashar highlighted as a point of pride for the entire organization. Slowing the spread of COVID-19 at the beginning of the pandemic was made possible due to partnerships across industries, and cooperation across the nation. As we continue to advance, roll out vaccinations nationwide, and combat the pandemic, remembering the steps taken to get here is important in outlining our path forward.
Getting to Know Dr. Catheryn Yashar
Dr. Yashar operates as both professor and provider at the UC San Diego School of Medicine, with touchpoints in care, research, and leadership in her role. When we asked her of the initial interest that drove her to healthcare, and oncology specifically, she described herself as a restless spirit throughout her career, with cancer care offering a fast and ever-changing challenge. Not one to stay still for too long, Dr. Yashar reflects on her pivot from being an OBGYN to entering radiation oncology, taking every opportunity to volunteer for committees, and entering the academic side of research to further expand her horizons beyond just the oncology practice.
“Medical and radiation oncology always fascinated me because we have so much to learn. The research opportunities are vast, and there are no signs of it slowing down in the future,” Dr. Yashar stated, “and every patient has a different story, support system, and cultural background that affects how the cancer impacts them.” The “care” in cancer care is incredibly important to Dr. Yashar, as combining medical expertise with empathy and understanding of each individual patient’s situation goes beyond diagnosis and standard care.
“Crafting a treatment plan and guiding them through diagnosis, therapy, and hopefully recovery can be difficult, but it is interesting and rewarding.”
When a cancer patient has a family or support system, tailoring these treatment plans requires asking about their abilities and needs for cooking, cleaning, transportation, and everyday household operations, discovering what changes are necessary in order to provide the best situation. “I have had more than one conversation with family members where the patient has talked about being exhausted from going home every day and cooking dinner, and my response would be to ask who else can contribute in the house, adults, older children, or otherwise, in reducing stressors and exhaustion?” Dr. Yashar said, “and looking at the total picture, I think that is imperative in oncology.”
While patient care is at the center of every oncologist’s drive to provide, research provides another interesting avenue for medical professionals to pursue. Intersecting with academics, Dr. Yashar’s work as a professor at the University of California creates meaningful touchpoints with the future of both cancer care technology and providers. To this point, Dr. Yashar notes that seeing medical students struggle to sit on the sidelines during the pandemic was difficult, as their role had to be postponed at the beginning of the pandemic. She described the feelings of her students, saying “They were training to be doctors, and yet during one of the biggest global health crises we have ever faced, they were excluded.”
Furthermore, Yashar’s ascent to leadership positions came through prioritizing her work values and principles, which she believed guided her and so many of her colleagues through the ranks in health care. Her mantra? “Say yes, do a good job, and do it well and expeditiously! So the next time someone needs something done, they know to reach out to you.”
Dr. Yashar went on to speak highly of the volunteering and fellowship opportunities that led to leadership opportunities at the American College of Radiation Oncology (ACRO), the American Society of Radiation Oncology (ASTRO), and the American Brachytherapy Society (ABS). Getting to know the people and operations behind great care was the step she needed to implement ideas and solutions to her many roles. Intellectual curiosity would lead to asking why certain practices and operations were done, and the committees and people she surrounded herself with provided the knowledge and ability to implement them. Now, as vice-chair of Clinical Affairs, one of the UCSD Health System’s associate Chief Medical Officers, and a leader of the Breast Cancer and Gynecologic Cancer Treatment Sections, there are thousands of touchpoints in operations and care that her restless spirit can continue to drive and improve.
4 Takeaways from the Pandemic: The Future for Oncology and Healthcare
1. Proactive Solutions Made the Difference
Every system, facility, oncology practice, and team faced unique challenges during the pandemic, to ensure safety, efficiency, and the best possible care under stressful circumstances. However, during this time, progress towards these goals was swift, and results were overall positive. The nation as a whole continues to recognize the sacrifices healthcare workers made, and in the realm of medical and radiation oncology, the effect on every increased risk cancer patient was felt.
As we look to the future, in a post-pandemic America, increased safety measures and innovations in health care will remain fixtures. The “new normal” is not just an overused phrase. Years down the line, the early 2020’s will undoubtedly be the starting point of a widespread shift toward more cautious and mindful operations in healthcare and otherwise, all off the back of swift, impactful, and proactive work to provide the best care when it was needed most.
2. Students and Residents Need to be Active and Involved
Dr. Yashar viewed the stress and discontent of medial students, residents, and all learners during the pandemic through her roles in education and operations. For many, “being forced to stay home was difficult” and there were so many opportunities for socialization, hands-on learning, and idea-exchange that were unfortunately lost. Moving forward, these next few years will be incredibly interesting to see how they recover, and how our education and training adapts along with them.
3. Telehealth is Here to Stay and Evolve
The rise of telehealth in its applicability held enormous benefit for physicians and the legal precedent for technology and innovations in healthcare. With physicians across all of healthcare continuing to uncover the true value of telehealth in everyday operations, we could see certain specialties adopt permanent practices quicker than others, depending on usefulness. Radiation oncologists will probably prefer to do treatment visits in person, for example, but follow-ups and visits with patients could see successful integration. Alternatively, as technology is explored, and knowledge is advanced, individualized treatment plans for other specializations are seeing more and more implementation.
4. People from All Organizations, Industries, and Backgrounds Stepped Up
Mid-pandemic, at the Mexican border, there were many overwhelmed facilities and providers facing instability. This was not a unique case, of course, as around the world, everyone was facing stretched hours, breakdowns of communication, and difficulties providing acceptable, much less exceptional care that patients needed. However, despite their own struggles, teams of physicians from the University of California stepped up to partner with and help defend against the virus’ surge, providing support where needed.
A simple story, and thankfully not a unique one, as across the world, cooperation and comradery shined brightly. There is no doubt that division lines were drawn in certain areas, but when it came to helping each other pull through the worst of the pandemic, people and organizations stepped up. Establishing and holding onto that cooperation drives progress and goodwill for everyone and may be a key to emerging from the pandemic stronger and better than ever before.