Aug 30, 2022
Editor’s note, November 10, 2022: ASCO is deeply saddened by the news that Dr. Jeff Ward passed away on November 3, 2022. We are grateful to have had the opportunity to recognize his commitment to exceptional patient care and public advocacy. Our thoughts are with his family, friends, colleagues, patients, and all who knew him.
By Aaron Tallent
Greatness in medicine, or any field, often starts with unlikely beginnings. For Jeff Ward, MD, his career in oncology began with an English paper that he had to write during his senior year at Ephrata High School in eastern Washington state.
“I knew that if I was going to get an A on my senior thesis, then I needed to write about something that my teacher had never heard about before. So, I went to my advanced biology teacher to get ideas and he said, ‘Have you ever heard about chimeric DNA?’,” Dr. Ward said.
That question led to a career in oncology that has helped improve the lives of thousands of patients with cancer and their families. Dr. Ward’s English teacher had never heard of chimeric DNA, but neither had Dr. Ward himself, because molecular biology was an emerging and controversial field in the 1970s. In fact, there was a moratorium during that period on research in chimeric DNA, while ethics were established on this science of combining DNA from different species. To get the A, Dr. Ward learned everything he could to fully understand it as he wrote the paper.
“My teacher wrote at the top, ‘This is the most fascinating paper. I've never heard anything about this before,’ and that got me interested in science,” said Dr. Ward.
In the decades that followed, Dr. Ward has forged a career in oncology helping improve the quality of life for patients with cancer in both Washington state and nationally, both through his clinical care and through his advocacy and consensus-building on complex and controversial issues. This commitment to fully understanding every aspect of care and developing solutions has been the guiding focus of his service both in his work as a medical hematologist and oncologist with the Swedish Cancer Institute and his role as a former president and current board member of the Washington State Medical Oncology Society (WSMOS).
“His ability to understand the whole oncology care system and how health care works is really just amazing. When we come to together as a state society to discuss our approach to a given piece of legislation, we all kind of wait for what Jeff does because he’s always so insightful,” said Blair Irwin, MD, WSMOS president and medical director of MultiCare Regional Cancer Center in Tacoma, WA.
Dr. Ward has also provided countless hours of service to ASCO. He served for 10 years as an associate editor of JCO Oncology Practice and for decades on numerous committees, including as chair of ASCO’s Clinical Practice and Government Relations Committees.
“I love working with him because in his heart he's very passionate about what he does, but intellectually he also takes a very tempered approach on issues where not everyone agrees. He is also just a fantastic, dedicated oncologist, an amazing mentor to so many oncologists, and the ultimate patient advocate,” said Ray Page, DO, PhD, FACOI, FASCO, president of The Center for Cancer and Blood Disorders in Fort Worth, TX, who served with Dr. Ward on numerous ASCO committees.
This determined but even-keeled approach has been critical in helping ASCO formulate its position and advocate on a wide range of issues. Most notably, Dr. Ward has been at the center as the Society developed payment models and weighed in on others proposed by the Centers for Medicare and Medicaid Service (CMS).
“Jeff is able to take an objective view of the situation and lay out both sides without saying one is morally wrong and opening up the possibility for another solution that everyone can agree on,” said Deborah Kamin, RN, PhD, ASCO’s vice president of policy and advocacy.
Two Ways to Beat Cancer: A Life in Oncology
When it came time for Dr. Ward to pick a major at Brigham Young University, he chose microbiology. By his third year, he was fully fascinated with medicine and decided to pursue it, enrolling at the University of Washington School of Medicine.
“When we hit the patient wards, I realized that although I really enjoyed science, I loved taking care of patients. At that point, my emphasis switched from research more towards patient care,” he said.
A number of significant events led Dr. Ward to oncology. One in particular occurred when he was an intern at the University of Minnesota Medical Center on October 25, 1987. During his service rounds, Dr. Ward took the time to sit with a patient, a fourth-year medical student struggling with terminal testicular cancer, and watch the Minnesota Twins beat the St. Louis Cardinals in Game 7 of the World Series.
“His room had a view of the Metrodome, and we could faintly hear the screams of the crowds. That moment, along with additional rotations in oncology and BMT, cemented in my mind the idea that there were two ways to beat cancer. One way was to be cured. The other was to live a life such that if one died, they could say they were proud of the life they chose to live and had not been beaten by the cancer,” said Dr. Ward.
After staying in Minnesota for his fellowship, Dr. Ward and his family moved back to Washington, where he joined a small private oncology practice in Edmonds. A few years later, the practice merged with another group and joined what is now U.S. Oncology. They stayed with U.S. Oncology for roughly 10 years before becoming a foundation practice supported by Swedish Medical Center and then a division of the Swedish Cancer Institute. Not long after, Swedish merged with Providence Healthcare. This experience has given Dr. Ward a firsthand view of the challenges faced in a variety of practice settings: private practice, a large national oncology practice, a community hospital, and a large nonprofit health care consortium.
In addition, Dr. Ward has helped patients live life the way they wish by serving as the medical director of Providence Hospice and Home Care of Snohomish County for the past 28 years. Founded in 1978, it provides comprehensive medical care in patients’ homes, helping them and their families work towards medical rehabilitation or a peaceful and dignified death.
The Ultimate Advocate
Dr. Ward’s generosity and commitment to his work does not just apply to his own practice. Dr. Irwin, who is at a competing practice in Washington state, has often reached out to Dr. Ward for advice on a wide range of issues. She also spoke of an instance where he helped avert a push in Washington state to cap payments for high-cost drugs by working with lawmakers to adjust the language so it would not hit private oncology practices as hard.
“He didn't have to do that. He works for a health system, but he did it anyway. That’s just Jeff,” she said.
Dr. Ward’s work with ASCO began when he agreed to serve as the Washington state Medicare Carrier Advisory Committee (CAC) oncology representative and regularly attended the ASCO/American Society of Hematology Annual CAC Meeting. His experience and willingness to ask questions to fully understand issues practices were facing ultimately led to him being asked to serve as president of the Washington State Medical Oncology Society and on multiple ASCO committees and workgroups.
“Washington state is often an incubator for cutting-edge state health laws, so he's been on the forefront of both identifying and developing legislation and regulations at the state level,” said Shelagh Foster, JD, currently an attorney with Polsinelli in Washington, DC. Ms. Foster is a former ASCO senior director of government relations and worked closely with Dr. Ward in his volunteer roles during her ASCO tenure.
One of Dr. Ward’s most monumental efforts started with the Congressional Joint Select Committee on Deficit Reduction’s failed efforts in 2011 to avoid the sequestration that ultimately decreased chemotherapy reimbursement to average sales price (ASP)+4.3%. The Supercommittee’s staff considered deeper cuts to as low as ASP+2% but approached ASCO for alternatives. Dr Ward considered this experience a failed opportunity and, as Clinical Practice Committee chair, led the formation of the ASCO Payment Reform Workgroup. For the next two years, Dr. Ward attended in-person meetings and biweekly phone calls, the latter of which had to be held at 5:00 AM PT.
“That is above and beyond. Jeff’s willingness to get on a call at 5:00 AM every two weeks for two years demonstrates how driven he was to try and find an answer to a problem that had been plaguing oncology for many years,” said Ms. Foster.
Dr. Ward noted that the committee acknowledged that it was not going to be able to “fix” payment reform by tweaking the current system, and instead took the approach of designing a reimbursement scheme from the ground up. “Our rule of thumb was to throw out everything we thought we knew and ask ourselves, ‘What would a reimbursement scheme that would optimize the odds of giving the right cancer drugs to the right cancer patient at the right time, fairly and appropriately pay oncology clinics for their services, and avoid perverse economic incentives look like?’” he said.
The work produced CPOC (Consolidated Payments for Oncology) and a comprehensive alternative payment plan, PCOP (Patient-Centered Oncology Payments), marrying CPOC with value-based clinical pathways and an oncology medical home. While the concepts were controversial at the time, they are now squarely in the mainstream of alternative payment discussions.
As an ASCO volunteer, Dr. Ward has also played a critical role in educating policymakers. Dr. Kamin discussed an instance where he spoke before the Medicare Payment Advisory Committee, a congressional advisory committee whose members were either former senior-level staff of previous presidential administrations or health care systems, along with economist actuaries.
“I saw a lot of people go in front of that group and come out torn to pieces, but Jeff laid his argument out in a very dispassionate way, clearly having done his homework, and they listened respectfully. He did a masterful job,” she said.
Living Life the Way He Chooses
Sadly, Dr. Ward was diagnosed with mucosal melanoma 10 months ago. This is the second time his family has faced cancer, as his daughter was diagnosed with breast cancer at age 27. After going through all treatment options, Dr. Ward has chosen not to participate in a distant clinical trial to spend his remaining time with his family.
“Cancer has been such a big part of my career, but now it has become an even bigger part of my life. I’ve given this consideration and have decided not to pursue a treatment that likely would have me spend much of the rest of my life in hotels and hospitals away from my home,” he said.
Dr. Ward has said that he is in as good a spot as he can be and is grateful for the support during this journey. He can also know that his positive impact in cancer care will be felt for decades to come—by the patients he has cared for directly, as well as their loved ones, by the colleagues he has supported and mentored, and by everyone who will benefit from the health care policies that he advocated for and helped bring to fruition.
“Jeff has been an amazing mentor to me, and we’ve all come away better people because of our interactions with him,” said Dr. Irwin.