The Q&A: Gail Eckhardt

With each issue, Trib+Health brings you an interview with experts on issues related to health care. Here is this week's subject:

Dr. Gail Eckhardt is an oncologist and pioneering cancer researcher. She was recently appointed to be the inaugural director of the LIVESTRONG Cancer Institutes at UT Austin’s Dell Medical School. We spoke with her recently about this appointment and her vision for the institute.

Editor's note: This interview has been edited for length and clarity.

Trib+Health: What drew you to oncology?

Gail Eckhardt: I did my medical training in Texas at the University of Texas medical school in Galveston. And then I went all over country doing my residency and my fellowship. I really got interested in oncology during my internal medicine internship and residency at University of Virginia in Charlottesville, Virginia. I was assigned to the oncology ward as an intern, and really got interested in oncology at that time.

I think the things that really appealed to me was not only the exciting research that was going on in oncology, even back then, but also the fact that you had really profound relationships and interactions with patients and their family. After that, I could tailor a lot of my elective experiences around training in oncology.

I did something sort of atypical post residency — instead of going to a clinical fellowship, I was really interested in the lab, so I went from residency to two-year postdoc fellowship in the lab at Scripps Research Institute in La Jolla, California. When I was there, I wasn't directly working in oncology, but I was working on molecular virology of hepatitis B.

After those two years of solid lab experience, then I went into my clinical fellowship at UCSD in La Jolla. And then did another year of virology, but working on the AIDS virus in relationship to cancer. That was really my training background.

But then my husband, he's a scientist, was recruited to the UT San Antonio Institute for Biotechnology. And what I did is, I spoke with a doctor there, Dan Van Hoff, who some would consider the father of phase I drug development in oncology. When I met with him, I was very much interested in that. So we sort of made a deal where he said you know, if you come and get a lab set up here, and get some funding, then I can teach you the field.

That was 1992 — and that really launched my career.

Trib+Health: What are your main goals as director of the LIVESTRONG institute?

Eckhardt: First of all, the reason I was very interested in this position is I’m at a time in life where I really wanted to take on a position that would have the greatest impact. The overall vision is to build a vigorous cancer research and cancer care program that really takes into account patient values and value-based care models.

As you know, Dell medical is very interested in providing new ways of value-based care, so I’m very interested in that. But along with that, the plan is to really integrate and incorporate a lot of the values that have been built with LIVESTRONG Cancer Foundation. That is, really trying to provide care within a patient care environment. Layered on that, because I’m also a researcher, the idea is to have seamless integration both of patient care and research in a way that really allows the patient values to be considered.

To me, this position really is able to hopefully accommodate and incorporate all those things because we're building from the ground up. I think many times it is difficult to build a better patient-centered environment or integrate research with care in places where there's already an environment of one thing or the other. I think what's really appealing here, is that everyone is very motivated towards having this all be integrated from the ground up. So I think that's the really exciting part.

Trib+Health: What is the importance of patient-centered care for cancer treatment?

Eckhardt: As an oncologist, having practiced in academic medical centers for the past 20-plus years, one of the frustrating things is having not just the care part of the medical care, but having other things available, such as survivorship, palliative care, symptom management, exercise programs, and psychosocial, nutritional, and financial support.

And clearly we often have that at academic medical centers, but we refer the patient to place X, Y, Z, and it becomes very fragmented. I think patients feel as if they're just being referred all over the place without someone really looking at, in a more holistic way, the things they need to provide the best care.

Right now, you’ll find at medical centers, if you’re dealing with a particular disease, like colorectal cancer, they have these things called multidisciplinary clinics. They are made up of surgeons, radiation oncologists, medical oncologists, pathologists, radiologists, and a lot of other people that will come to hear about the patient and help make a decision.

What I envision is similar to the patient-centered multidisciplinary model, so that when a patient comes in, we would have a similar meeting. But have that then involve not just medical care components, but things such as symptom management, palliative care, exercise, physical therapy, all of the various things that are really outside of medical care, and doing that in the same comprehensive manner that we do with disease multidisciplinary clinics.

So that really, from the time the patient comes in, we can discuss what the needs are, and really build a program around not just the medical care of that patient, and not just the research component, but around the other components that are required for the best medical care.

Trib+Health: How is LIVESTRONG hoping to change cancer treatment with this new institute at UT Austin Dell Med School?

Eckhardt: The name of the center is the LIVESTRONG cancer institute, but the subtitle is the Center for Cancer Innovation. What we would like to be thought of in some regards is an incubator for innovative care delivery. And that encompasses everything from research to delivery itself.