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John Noseworthy, M.D., discusses need for medical research and more in Bloomberg interview

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John Noseworthy, M.D.

John Noseworthy, M.D. (N ’90), Mayo Clinic’s president and CEO, sat down in early July with Bloomberg’s David Gura at the Allen & Company Media Conference in Sun Valley, Idaho, to discuss health care legislation then before the U.S. Congress, Mayo’s strategic objectives and its advocacy efforts, and the state of the health care industry. Gura is the host of “Bloomberg Markets: The Trump Economy” on Bloomberg Television.

The media conference gave Dr. Noseworthy the opportunity to represent Mayo Clinic among other leaders of the most well-known, influential companies in the world. Dr. Noseworthy talked about Mayo’s perspective on patient-centered and high-value care, and exchanged ideas with leaders representing the full range of industry — from business and energy to health care and finance.

In his interview with Gura, Dr. Noseworthy stressed the essential need for research funding to counter the societal burden of diseases and their related costs. The time to find a cure for diseases such as Alzheimer’s is now, he said, because without a cure, the cost of treating these diseases could consume a quarter of the U.S. economy by 2050.

You can read the transcript of the interview and watch the video below. This is reprinted with permission from Bloomberg.

GURA: How are you following [the health care bill] and processing it and determining what it might mean for your business?

DR. NOSEWORTHY:  We watch it very closely. We’re really focused on what we can control — which is the agenda of advancing high value health care, better quality care at lower cost, investing in research, and then regulatory reform — the things that are really the responsibility of the medical profession. We hope to see a bipartisan response that provides good, solid care for our citizens. But on our side of the fence, it’s really ‘How do we provide better care, deliver care?’ This bill is really not about health care reform. It’s about Medicaid and who’s paying for it. And the nitty gritty of how health care is delivered is really in our bailiwick.

GURA: Why is it such a difficult conversation for politicians and policymakers in Washington to have? Do you think that they focus enough on policy and what could make things easier when it comes to advancing medicine?

DR. NOSEWORTHY: There’s been unprecedented bipartisan support for moving from fee for service to a value agenda, to extracting high quality care at lower cost, and that’s what they’re focused on with us. There’s a lot more to do there. It’s in its infancy. There was strong bipartisan support for finding cures for patients, investing in Alzheimer’s disease, in research, and science and innovation. Now, there’s pretty strong support for looking at the regulatory burden in health care as they are across other sectors.

The agreement between the parties is rather strong on those fundamental issues — not so much on policy and on the role of government in the lives of our citizens.

GURA: Is the role of government changing when it comes to research and innovation? You look at the latest budget from the president — reduction in the amount of money that would go to the National Institutes of Health (NIH), for instance. Do you accept that as the way things are going and if that were to be the case, does the burden then fall more greatly on private companies?

DR. NOSEWORTHY: I don’t think the president’s budget will be accepted as is. In fact, we were told it’s probably dead on arrival because it’s a very draconian budget cut. We have strong bipartisan support in Congress for continuing to invest in science and research. There are two reasons for that.

There’s a huge societal need. The societal burden of these diseases is enormous. Also, from a macroeconomics standpoint, health care is one-sixth of the economy. The U.S. needs to be the leader in growing our global competitiveness through this fastest-growing part of the sectors of our society.

I think we’ll get a strong budget from Congress. This is not a time to pull back on that.

GURA: Whenever I talk to the health care executives — the men and women who run hospitals or insurance companies — they all talk about costs and escalating costs and the burden that that places on them. How do you navigate that at Mayo Clinic?

DR. NOSEWORTHY: For 153 years, we’ve had a single culture to be patient centered and to advance high quality care while reducing the cost of it. One of our secrets is, for a hundred years, we’ve had engineers embedded in our processes. And with the physicians, nurses, engineers and so on, we look at what adds value and increase that and remove what takes away value. That model has helped us focus on what we do best — which is care for patients with serious and complex illness — and that’s really where we need to remain focused.

These patients that we see — that others either are having trouble diagnosing or managing because they’re so complex — have highly unusual diseases or very advanced diseases. The care of them is complex because you have multiple folks working together on them. It’s our responsibility to make sure that happens efficiently, safely, with the highest quality possible, bringing in technology where we can, and getting them back to work. So that’s what we do.

GURA: How do you see growth in health care, growth for Mayo? You’ve expanded a network. That’s a different approach than many others have taken. How do you see growth going here into 2017-18?

DR. NOSEWORTHY: We’ve seen so many mergers and acquisitions in health care, and you’ve covered that. We chose a different path for a couple of reasons.

For Mayo Clinic to acquire hospitals and put our name on it, those hospitals really wouldn’t be the Mayo Clinic. They’d just be a name on a hospital.

Secondly, we felt we could do it much better, much more efficiently, much better for the patient if we shared our knowledge. So we’ve taken Mayo’s knowledge and built a network that’s based on our knowledge with over 40 major medical centers nationally and internationally, subscribing to Mayo knowledge. The nice thing about that is those physicians connect with us and say, ‘I need help with this patient.’ And 80 percent of the time those patients can stay in their home community — Singapore, Pikeville, Kentucky — it doesn’t matter. And it doesn’t cost the patients anything to get the advantage of our input. When they do have serious or complex illnesses that require us to see them face to face, then they travel, but four times out of five they don’t need to travel.

Our growth has been through extending our knowledge to get right at the bedside.

GURA: We’ve heard from this president that when it comes to innovation in medicine — particularly that things happen too glacially. It takes too long for a drug to be approved or for tests to take place. Do you agree with that? When you talk about the regulatory burden on health care, is that a component that you’re worried about?

DR. NOSEWORTHY: The part that we’re more concerned about is the regulations that get in the way of physicians providing care to patients, and scientists getting innovations into the practice.

In the U.S., we spend almost a half a trillion dollars administering health care. That’s way out of line with other developed nations. We require 12 administrators for every physician to run the practice. Physicians are spending twice the amount of time that they spend with patients managing the regulatory burden that is imposed on them individually. Twenty hours a week, a physician is on the phone or using a fax machine to get permission to do a test on a patient. It’s gotten way out of control. That reduces the quality of care, slows the speed of innovation, and crushes the profession.

Physicians, nurses, other health care professionals go into our field because they have a need to serve others. And when they’re spending twice as much time doing clerical work, they lose that sense of purpose and joy in their work.

The FDA’s approval of drugs has to be done extraordinarily carefully. We need to make sure that drugs work and that they’re safe.

These are complex illnesses. We’re spending $230 billion this year caring for patients with Alzheimer’s disease. That’s going to grow, and it’ll be a quarter of our economy by 2050. It’ll basically devour the American economy if we don’t find a cure for Alzheimer’s disease. This is the time to invest in that.

Watch Dr. Noseworthy’s interview with David Gura.

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