Jul 05, 2018
By Carson Rolleri, ASCO Communications
Monica M. Bertagnolli, MD, FACS, FASCO, first heard about ASCO when she was a fellow. Although she was training to be a surgeon, many of the faculty members she worked with had a great sense of investment in the organization, inspiring her to get involved. Over 20 years later, Dr. Bertagnolli began her term as the 2018–2019 ASCO President at the Annual Business Meeting on June 4, 2018.
A talented surgical oncologist and longtime ASCO volunteer, Dr. Bertagnolli is chief of the Division of Surgical Oncology at Dana-Farber/Brigham and Women’s Cancer Center, a professor of surgery at Harvard Medical School, and an associate surgeon at Brigham and Women’s Hospital and Dana-Farber Cancer Institute.
Immediate Past President Bruce E. Johnson, MD, FASCO, said that Dr. Bertagnolli’s long history of being an effective advocate for oncology professionals and patients with cancer alike makes her the ideal leader for ASCO.
“Dr. Bertagnolli is an innovator and a positive force in the field of oncology,” Dr. Johnson said. “She is a strong voice in the health care community, a respected clinician, clinical and laboratory scientist, and a committed ASCO volunteer. I can’t think of anyone more dedicated or more capable to be ASCO president in the coming year, and I look forward to seeing the impact of her initiatives.”
Since joining ASCO in 1995, Dr. Bertagnolli has served on the Board of Directors, as well as on numerous committees, including the ASCP/CAP/AMP/ASCO Colorectal Cancer Guidelines Committee, the Cancer Prevention Committee, and the Strategic Planning Committee, among others. The breadth of her volunteer experience gives her a unique perspective on ASCO’s evolution and its future directions.
“It has been tremendous to see how ASCO has grown from a domestic-based venue for scientific exchange of information and education, specific to medical oncology, to a truly global institution,” said Dr. Bertagnolli. “In addition to tackling education, support for oncology providers, and fostering scientific research, it has become an organization that has directly made changes in clinical practice, changes both in the United States and abroad, and changes throughout the cancer care spectrum, from prevention to survivorship. The goal, though, has remained the same: to help the oncology professionals take care of their patients. And I’m so excited to be part of this fantastic organization.”
When she first entered the field of medicine, Dr. Bertagnolli knew exactly what she wanted to pursue.
“I loved surgery as a discipline from the time I first entered the operating room,” she said.
She was also very interested in biology and immunology and was in training when the field of tumor immunology was taking off. This opened the door to meet role models who were both cancer researchers and surgeons, such as Steven Rosenberg, MD, PhD, FASCO, a pioneer in the development of immunotherapy. Ultimately, this mix of interests and opportunities led her to surgical oncology.
Dr. Bertagnolli has always been a trailblazer, both in her field and in the ranks of leadership. She is keenly aware of the challenges that women can face in the medical profession, which is reflected by their representation—only 21.3% of all surgeons in the United States are women,1 and only seven women have been ASCO president before her. Dr. Bertagnolli believes in the importance of creating an equitable environment, eliminating unconscious bias, and supporting talented individuals, regardless of demographics. The responsibility of creating this environment, she stressed, is on both men and women.
“It has been wonderful for me to be a visible presence in surgery, because surgery, like many traditionally male-dominated fields, does have an issue with gender diversity in senior leadership,” she said. “The younger generation of women have a much stronger presence, and we need to ensure that there are no roadblocks based on gender that may prevent these women from reaching their full potential.”
Dr. Bertagnolli received her undergraduate degree from Princeton University and her medical degree from the University of Utah College of Medicine; she performed her residency at Brigham and Women’s Hospital, where she says the institution’s long tradition of surgeons conducting research inspired her to get involved in research early and has led her to the work she does today.
Before becoming a surgical oncologist, Dr. Bertagnolli grew up on a cattle ranch in central Wyoming (which is still in her family), and she notes that her upbringing has shaped her outlook as a physician and her approach to her presidential term.
“I look forward to working with as many ASCO members as I can, and I hope to spend a good portion of my presidential year out in the small communities, because that part of our world and oncology environment is really important to me,” she said. “I understand what it means for a patient to be 100 miles from the nearest hospital, and the kind of burden that it places on patients, caregivers, providers, and the community as a whole.”
Putting Patients First: Changes on the Micro-Level
For the theme that will guide her presidential term, Dr. Bertagnolli has selected “Caring for Every Patient, Learning From Every Patient.” This theme reframes the primary goal of the doctor-patient relationship: oncology providers securing the best care so that their patients have the best chance of conquering cancer.
This, however, is no simple task: barriers such as exclusion from research participation, rising costs of care, and challenges of location (among many other factors) can prevent a patient from getting the best possible care for their disease. Dr. Bertagnolli, as expressed in her theme, refuses to accept these barriers as the status quo and strives to expand the capacities that the cancer care continuum has today. She directly relates ASCO’s vision (a world where cancer is prevented or cured, and every survivor is healthy) and organizational core values (evidence, care, and impact) to her theme as the ultimate measure of success for oncology.
“Our health care systems need to reach all the way to the individual doctor-patient relationships to be truly effective,” she said. “This theme ties ASCO’s lofty goals to individual, measurable results that every patient with cancer can see and benefit from.”
This way of thinking about the doctor-patient relationship considers the whole patient, not only their disease. Dr. Bertagnolli recognizes that many things, like transportation, lack of a support network, or financial strain, can prevent a patient from getting the best care. In these instances, providing cutting-edge therapies isn’t enough; patients need more practical support from the moment they’re diagnosed through treatment and beyond for the best chance of success.
One strategy for tackling these challenges and fulfilling the promises expressed in her theme is expanding clinical research and knowledge gathering to every single patient with cancer. Dr. Bertagnolli points out that it is important for patients to receive not only the best possible care available, but also be offered the chance to participate in research, which will fuel more discoveries and improve care.
“The learning health care system is the only approach for optimizing care for every single patient,” she explained. “If we’re going to give the best care to every patient, we also need to learn from every patient. I can’t see how it can be done otherwise.”
The essence of her theme can be found in many existing ASCO programs and initiatives, including the Society’s work on expanding access to clinical trials, CancerLinQ®, and ASCO International’s portfolio of programs, to name a few. The theme also directly touches ASCO’s Strategic Plan for Increasing Racial and Ethnic Diversity in the Oncology Workforce, which is vital to providing culturally competent, high-quality, compassionate care.
“One aspect of this theme is ensuring a diverse workforce,” Dr. Bertagnolli said. “Our oncology providers, the people who are caring for our patients, should really be representative of our patients, both in gender and ethnicity. And we don’t have that yet.”
The Year Ahead
As part of her term on the Board of Directors, Dr. Bertagnolli has spent considerable time thinking about what lies ahead for ASCO, particularly in terms of its 5-year strategic plan.
“The opportunity to sit with a team of really talented people, both ASCO staff and other volunteers, and think about where we want to be and how we should direct those resources to accomplish our goals, has been incredibly rewarding and exciting,” she said. “I’m looking forward to continuing to have these conversations during my term as ASCO president.”
With her theme in place and a busy term ahead, Dr. Bertagnolli is actively thinking about wellness, and notes that every physician should be too.
“All of us are challenged by the demands of doing research, caring for patients, managing changes in society and health care, and so on, which put more stress on us as providers,” she said. “The best antidote I have for feeling burnt out is to stop and spend time with my patients, to really listen to them and talk about their lives. I feel that this can be one of the best solutions to physician burnout: getting the physicians away from too much time on their computers and other administrative duties, and getting them re-engaged with their patients.”
- American College of Surgeons Health Policy Research Institute. The Surgical Workforce in the United States: Profile and recent trends. April 2010. Available at http://www.acshpri.org/documents/ACSHPRI_Surgical_Workforce_in_US_apr2010.pdf. Accessed May 18, 2018