Rationalizing the New Healthcare Paradigm Scientific Agenda vs. Patient Imperatives Scientific Agenda vs. Patient Imperatives

Research Performance Measurement  Are we winning the war against Pca:  How do we know  How do we measure  Black Population:  Disproportionate negative impact  Greatest short term need  What is the “low hanging fruit”:  Education  Access  Early Detection  Comparative funding:  Parity among cancers  Are we winning the war against Pca:  How do we know  How do we measure  Black Population:  Disproportionate negative impact  Greatest short term need  What is the “low hanging fruit”:  Education  Access  Early Detection  Comparative funding:  Parity among cancers

Question #1  Will access to care solve the issue of racial health disparity

Pathways to Cancer  Awareness  Access  Environment  Lifestyle  Culture  Genetics  Every cancer is different  Awareness  Access  Environment  Lifestyle  Culture  Genetics  Every cancer is different

Early Disease Detection  U.S. vs European conflict on screening  No U.S. consensus  Lack of “Risk” determination  Government agency imbalances  Focus:  Promote Wellness  Treat Illness  U.S. vs European conflict on screening  No U.S. consensus  Lack of “Risk” determination  Government agency imbalances  Focus:  Promote Wellness  Treat Illness

Primary Care Impact Decline in doctors entering into Primary Care Medicine Resistance to greater use of nurse practitioners Continuing shortage of nurses Closing of ER’s Resistance to “Convenient Care” clinics Decline in doctors entering into Primary Care Medicine Resistance to greater use of nurse practitioners Continuing shortage of nurses Closing of ER’s Resistance to “Convenient Care” clinics

Complicating the Issue  Women vs. Men  Comparable incidence and mortality  Research funds - 3X for breast cancer  Public health staffing - inconsistent  Government commitment - no agencies  Media focus - inordinately female focus  Men don’t communicate  Women vs. Men  Comparable incidence and mortality  Research funds - 3X for breast cancer  Public health staffing - inconsistent  Government commitment - no agencies  Media focus - inordinately female focus  Men don’t communicate

Question #2  Does your doctor provide you with information on your risk of your cancer progressing  Yes  No  I don’t ask because I fear the answer  I don’t think my doctor can give me the answer  Does your doctor provide you with information on your risk of your cancer progressing  Yes  No  I don’t ask because I fear the answer  I don’t think my doctor can give me the answer

The First Clinical Trial

Question#3  Blacks don’t participate in clinical trials because:  Their insurance won’t pay for it  They don’t have insurance  Their doctors won’t be able to provide care  They don’t want to be “guinea pigs”  Clinical trials don’t work  There is not enough information on trials  Blacks don’t participate in clinical trials because:  Their insurance won’t pay for it  They don’t have insurance  Their doctors won’t be able to provide care  They don’t want to be “guinea pigs”  Clinical trials don’t work  There is not enough information on trials

Why Participate  Health Disparities  Different drug reactions  First Benefit from a New Therapy  Opportunity for treatment years before  Best Standard of Care  Regular health testing  Current approved standard plus new protocol  Protecting the Future  Health Disparities  Different drug reactions  First Benefit from a New Therapy  Opportunity for treatment years before  Best Standard of Care  Regular health testing  Current approved standard plus new protocol  Protecting the Future

Question #4  What would cause you to support more funding for prostate cancer research:  Information from my doctor  Information from TV, newspapers  Results of current research studies  Patient advocacy group information  Change in government policies  Patient success stories  What would cause you to support more funding for prostate cancer research:  Information from my doctor  Information from TV, newspapers  Results of current research studies  Patient advocacy group information  Change in government policies  Patient success stories

Research Accountability  Impact  IMMEDIATE:  What are our Tax Dollars Buying  Communicate:  What does research mean to the patient  Eliminate redundancy:  Support creativity outside of established centers  Building infrastructure and intellectual Capital  Impact  IMMEDIATE:  What are our Tax Dollars Buying  Communicate:  What does research mean to the patient  Eliminate redundancy:  Support creativity outside of established centers  Building infrastructure and intellectual Capital

Expectations  Survivorship:  What is being done to extend my life NOW  Focus:  On the patient, not the system  Results:  Need balance between the future and present  Think Globally:  Utilize data and results from the rest of the world  Survivorship:  What is being done to extend my life NOW  Focus:  On the patient, not the system  Results:  Need balance between the future and present  Think Globally:  Utilize data and results from the rest of the world

Thank You!