As a part of my interview series with prominent medical professionals about “How To Grow Your Private Practice” I had the pleasure of interviewing Lee Schwartzberg, MD: Board Member of OneOncology and Executive Director of West Cancer Center, a founding practice of OneOncology.
Dr. Schwartzberg was the founding editor-in-chief of the journal Community Oncology and currently serves as the editor-in-chief of the Practice Update Oncology website and is on the editorial board of both the Journal of Supportive Oncology and The ASCO Post.
Besides serving as a reviewer for many prominent medical journals, including the New England Journal of Medicine and the Journal of Clinical Oncology, Lee is also a member of the board of directors for the National Comprehensive Cancer Network where his major research interests are new therapeutic approaches to breast cancer, targeted therapy and supportive care.
I became interested in oncology early in my medical training. I did my fellowship in oncology and hematology at Memorial Sloan Kettering and was prepared to practice in an academic setting where I could also focus on research.
I had personal relationships with the physicians who turned out to be my founding partners at West in Memphis. We all shared a vision to conduct research in the community setting. That original vision is what we’ve accomplished over the last thirty years: replicating the best of academia in the community setting to give patients access to the highest quality care while also conducting research so patients also have access to clinical trials in their community.
Making the shift to the community setting was a major turning point in my career. It was also a huge leap for me personally moving from my home in New York City to Memphis, Tennessee — a state and city I had never visited up until that time.
I was always interested in “higher-stakes” medicine. When I entered medicine, oncology was the highest stakes of all specialties. Early in my career, patients just didn’t survive, but there was a glimmer of hope in understanding the biology of cancer. Back then, we were only at the dawn of being able to take all the science and figure out ways to deliver it to patients. That’s what excited me then and is what still excites me today: delivering scientific discovery to improve lives.
Another important impetus for my partners and I when we started our own practice was the ability to identify new trends early on. We’ve been early adopters and made relatively wise choices that have benefited patients. We did that early on in the life of our practice, and it’s paid off in the form of better patient care.
As one example, we were the first group practice to invest in a CT machine outside of the hospital setting. At that point, for a group practice, it was unheard of to invest significant resources into technology but putting the CT machine on site in our center improved care in just about every case. It changed how we read images for patients and enhanced our care. Today, CT is ubiquitous in every group practice, large or small. I’m proud of the decision we made, the risk we took, and the value the CT technology afforded us to deliver to our patients.
Another example is in precision medicine. Four to five years ago at the beginning of precision medicine, we recognized the value of knowing the genetic alterations in cancer so we could get our patients into the right clinical trial. We established our involvement early in precision medicine, and now it’s being used in academic centers.
The bottom line: being an early adopter has been invaluable as we started and grew our practice.
I agree!! It’s exhausting!!!!! Being a business owner and managing a business is challenging. They do not teach business management in medical school or fellowship training. I learned from making mistakes. The competitive environment of managing a business today is dramatically more complex than it was 30 years ago. We wouldn’t be successful today if we used the same approach as we did back then. We felt our way along. There was room to make mistakes as a business owner. And we made plenty of them — and we tried as best we could to learn from each.
Generally, now my business advice to physicians is: don’t try this at home. Get the expertise you need. It’s rare for a physician to have business skills or a desire to learn them. Physicians need to know there is help, and that they should learn from those of who’ve gone through it. My fellow OneOncology physician executives, Drs. Jeff Patton and Jeff Vacirca, and I try to put our teams in successful positions by serving as the interface between the business and the clinical worlds. In these two vastly separate worlds, it’s important to have someone who speaks both languages and understands both sides. I’ve learned how to navigate this over the years.
Physicians in general, and me specifically, tend to be perfectionists. We are wired to do as much of the job as possible. This is especially true of my generation of physicians who were trained with this perspective in mind.
As I’ve grown, I’ve had to learn it is more efficient to get the job done by delegating and managing the tasks. Not doing so leads to burnout. It’s been a difficult lesson to learn. I’m better at it now than I was when we began West, which has been humbling. You have to delegate and manage to succeed. For me, that’s translated to cutting down on my patient obligations. That’s difficult, especially when you’ve been practicing for a long time and love the patient interaction. As I’ve cut down on my patient load, we’ve worked as a team to ensure the patients I do see have access to me and my staff just as they would if I was practicing full time.
There is a specific failure that sticks out to me that has helped build resilience. Through personal relationships, we had an opportunity to open a clinic in Singapore — half way around the world. The principle was sound then and remains correct today: Bring expertise and use it in an emerging market where people need access to care. We were a group of people proactively running oncology practices 12 hours apart, meaning we had to run operations 24 hours a day — which stretched us. What I learned from that experience is that not every opportunity — even those built on sound principle — should be executed. And if the opportunity is pursued, it must be pursued in a way that doesn’t compromise your core mission.
If we make sure we do what’s best for the patient, it should be best for physicians as well. Aligning patient and physician outcomes is best for everyone.
I sometimes have trouble completing tasks, and I used to have trouble saying no. I really get excited about new things! But those projects are only worthwhile if they get completed. My to-do list can be overwhelming; it often has more “to dos” than “completed” tasks. But, at the same time, I do perform well under pressure, and I use high-pressure situations to become very efficient. I constantly walk a fine line between balancing taking on too much and stimulating my professional curiosity with new projects.
The most important mentor to me has been Dr. Bill West, the founder of our practice. What I learned from Bill was having a vision and bringing it to life. Of all the people I’ve known (and I’ve known some brilliant people), Bill remains the person with the best vision and clearest path for achieving it. The other thing I’ve learned from Bill and my other co-founder, Dr. Kurt Tauer, is respect for everyone. I attribute much of our success to our focus on valuing everyone’s contribution to the practice. A physician is no better than anyone else. We are all part of a team to take care of very sick individuals. We treat them like family because that’s the way we would like to be treated if we were in the same situation.
It was such a long time ago, it feels like a different world. The most important resource I had was leveraging personal relationships to engage individuals with expertise I wanted to better understand. Today, while expertise is more democratized and available in infinite forms, I still believe personal relationships with individuals, who have an expertise and have been through similar situations, are extremely valuable. Today, I still learn by talking to other practices and physicians to learn how they addressed and solved problems.
I’ve received some bad financial investment advice. It seems to me doctors tend to be susceptible to bad financial advice. I’m no exception.
I don’t read a lot of business books, but Good to Great by Jim Collins had a lot of value and changed my thinking.
I am not a huge social media person, but you can find me on Twitter @oncSTATdoc. You can also get updates from OneOncology on Twitter @OneOncology and on LinkedIn.
For other incredible interviews, please check out our podcast: Healthcare Heroes.
A special thanks to Dr. Schwartzberg again! The purpose of this interview series is to highlight the entrepreneurs, innovators, advocates, and providers inside Healthcare. Our hope is to inspire future healthcare providers on the incredible careers that are possible!