As a part of my series on The Future of Healthcare, I’ve had the pleasure of interviewing Dr. Brian Caveney. Dr. Caveney, currently enterprise-wide chief medical officer at LabCorp, holds an MD from the West Virginia University School of Medicine, a JD from the West Virginia University College of Law and an MPH in health policy and administration from the University of North Carolina at Chapel Hill. Dr. Caveney came to LabCorp after serving as chief medical officer of Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Dr. Caveney also served as chief clinical officer of Mosaic Health Solutions, a wholly owned subsidiary of Blue Cross NC for strategic investments in diversified health solutions businesses. Prior to joining Blue Cross NC, Dr. Caveney was a practicing physician and assistant professor at Duke University Medical Center and also provided consulting services for several companies in the Research Triangle Park region.
Q&A with Brian Caveney MD, JD, MPH. Enterprise-Wide Chief Medical Officer of LabCorp
What are you most excited about regarding the future of healthcare?
Laboratory testing is often forgotten in healthcare discussions, and only accounts for a tiny portion of the money we spend on healthcare, but it is extremely impactful on diagnoses and outcomes. Lab test data are specific, objective, and quantitative.
In all the discussion of big data and bridging the gap between claims and clinical information in EMRs, lab data is the one area of healthcare that is already structured and built for analytics and data mining without much curation or natural language processing needed.
Lab data is important, and often underappreciated, in our ability to measure quality and improve health care. A huge opportunity in the future, and one area we are excited about at LabCorp, is the idea that we can move from one size fits all population medicine, to precision medicine, where we can provide individualized, customized interventions for each patient. Making precision medicine a reality will depend on better, more accurate biomarkers and genetic testing to help physicians make more specific diagnoses and better decisions about which medications they should and could use at the right dose.
For example, the media and policy experts are focused right now on the cost of medications. Lab testing can help manage pharmacy costs. Companion and complementary diagnostics can help a physician determine whether a patient’s condition is likely to respond to a certain medication. Pharmacogenomic profiles can suggest whether a patient will metabolize a medication normally at the recommended dosage. Therapeutic drug monitoring can help determine whether the drug is circulating at an adequate concentration to be effective, and whether the patient has developed anti-drug antibodies to the medication. All of these can help optimize medication usage to achieve the desired clinical outcomes, getting us one step closer to the idea of truly precision medicine.
LabCorp’s diagnostics and drug development businesses work together to realize those goals for patients, ordering physicians, and the pharmaceutical companies and biotech companies we serve. We see incredible opportunity to improve healthcare and perhaps lower cost in the future by using smarter laboratory testing to improve medication usage.
Q&A with Brian Caveney
What brought you to this career path?
I come from a health care family. When I was in diapers, my family did not ask “what is this kid going to do with his life,” but rather “what kind of doctor is he going to be?” Ever since I was very young, I assumed that I was going to be a physician. But I’ve also always been interested in the business and policy side of health care.
I was in college in the early nineties when the country was in its last healthcare reform era, including the Clinton plan, the rise of HMOs, and other changes. I became very interested in health policy. Around this time, I was applying to medical school, and became interested in either a combined MD/MBA or a MD/JD.
Another event was one of those serendipitous things that happen to you in life that leads you down a certain path. When I was a faculty physician at Duke and active in the North Carolina Medical Society, I attended a committee meeting and just happened to be sitting next to a medical director from Blue Cross NC. As we were chatting, and she said “We need someone like you at Blue Cross because the Affordable Care Act just passed. Our employer groups with health insurance do not understand its implications and how it applies to them. We need a physician who is able to explain the health care side and the policy side of the ACA.”
I saw this as a great opportunity to apply my full background in a meaningful way and that’s how I left clinical medicine and moved into a corporate environment. Everything that I’ve done since then can be traced back to that one fortuitous conversation, including the amazing opportunity that I had to move back to the provider side at LabCorp.
How can we “future proof” our career?
No matter how expert you are in your niche within health care, realize that there is so much more to the fabric of the healthcare ecosystem than you can ever know. You have to be incredibly open minded to how the system works, how the different players within the system interact, how the money flows and how the regulatory framework impacts the behavior of everyone in it.
Stay curious, you must follow industry news in order to stay relevant, and never stop learning about where you and your organization fit into the overall health care ecosystem. Medicine is now more complex than the human mind can process without help from machines, but it will be a long time before AI could replicate our empathy and contextual thinking.
Finally, pressure test your own ideas. You will often come at a decision from the viewpoint of an expert in your niche, but it’s important to also consider the perspectives of other stakeholders. When we are able to view any given topic within health care from multiple perspectives, we understand why it’s so difficult to change the system, and why there often is no one “right” answer. Almost every proposed solution has trade-offs.
What do you believe in?
I’ve always been fascinated with learning, and often get made fun of for having three graduate degrees. I am a voracious reader, and I like to think about policy questions that impact health care. There may not ever be a silver bullet that will magically “fix” health care, but if we can be honest about some of the overarching ethical and political questions, use data to make sound decisions, and make steady incremental progress, we can achieve greater financial stability and clinical improvements for patients.