Total Care, Not Just Cancer Care

George Raptis, MD
George Raptis, MD

George Raptis, MD, has spent his career pursuing solutions for cancer patients. As the North Shore-LIJ Cancer Institute’s acting executive director he emphasizes unified care for patients--not only by providing cancer treatments under one roof, but also by fostering collaboration among clinical specialists.

He explains the significance of total patient care for this new installment in our Leadership Series.

Question from interviewer: As the leader of a service line with more than 200 physicians, what are your goals?

Dr. Raptis: The Cancer Institute continues to evolve. I hope it will become a greater force in the communities we serve, changing the way we deliver cancer care and conduct cancer research. That is how we designed and how we are implementing the Cancer Institute. As we continue to develop the physical plant, the infrastructure and our relationship with Cold Spring Harbor Laboratory, we will be able to achieve that in very short order.

Q: What are the core strengths of the Cancer Institute?

Dr. Raptis: We are exceptionally good at delivering very high quality cancer care in a personable way. When it comes to what the patient needs at any one time, we can deliver and we are able to integrate the delivery of their care into their community.

We have a very large hub at Center for Advanced Medicine in Lake Success, where we have put together all the services necessary to care for our patients, including medical oncology, surgical oncology, radiation oncology, urologic oncology and diagnostic radiology. Having everyone together under the Cancer Institute umbrella, on one site, facilitates patient-centered care and provides better coordination of care. Physicians and researchers get to bump into each other, talk with each other, and meet with each other regularly.

For patients who live in different [geographical areas] of our health system, we have cancer programs in Huntington, Staten Island University Hospital and Lenox Hill Hospital, and still othersites in development. We want to offer patients access to high-quality care and clinical research in all the communities we serve. The goal is to deliver subspecialized, disease-focused, interdisciplinary care at each site.

Q: Why is clinical research important?

Dr. Raptis: There are many standard [cancer] treatments that are effective and in many cases curative...but we do not cure everyone. Every time we sit with a patient, we have to be thinking of two patients at the same time:  that patient in front of us and the one who comes afterwards. We have a responsibility to care for that individual and we have a responsibility for making it better for those that come after. We take that seriously. That is why research is an important part of our mission.

Q: The health system invested about $175 million to open and expand these cancer treatment centers throughout the metropolitan area. Talk about the primary focus of this dramatic growth.

Dr. Raptis: There are many reasons we are seeing growth of comprehensive cancer care, not just here but in other health systems around the country. There is a huge consolidation of cancer care delivery as there are in other aspects of medical care. There are many technologies that have to come together to be able to pull information in data sets that allow us to make the best decision about how to treat an individual. While many of those tests and much of that technology may be available in smaller practices, it is not as comprehensive as when it comes together under one umbrella, one health system, where [clinicians] share that information and can communicate and plan the best care for that one patient.

It is getting increasingly more challenging to deliver comprehensive, exceptional care outside an integrated organization like ours. What patients require and what is essential for great care delivery and outcomes is not just having physicians that specialize in a disease, but also a team built around caring for the whole person and their loved ones..

Finding Cancer's Achilles Heel

Q: Talk about how technology and life sciences will evolve in the next three to five years.

Dr. Raptis: In 1988, when I applied for a fellowship in oncology, I was asked to put together an essay. I chose to talk about one of the major reasons I was interested in oncology--the concept of [Paul] Ehrlich’s Magic Bullet, the concept that there would be some type of bullet that could target a particular locus of disease while leaving behind all normal tissues.

Ehrlich was not necessarily speaking about cancer, but the concept applies to cancer. That was very appealing to me, as it is to many physicians. That was the Holy Grail that we were looking for. How do we get away from chemotherapies that indiscriminately destroy or damage cells?

We never [previously] had the ability to individualize or personalize our treatments and to rationally develop therapeutics that go after the Achilles heel of a particular cancer. Over the last few years, those tools have become available. Molecular and genomic tools will be increasingly used to better identify what is wrong with that cancer. It will enable us to give specific therapies that target that mechanism.

Q: The North Shore-LIJ Cancer Institute participates in almost 200 clinical trials. How does this research distinguish the Cancer Institute from other [health care] providers?

Dr. Raptis: In the region and the communities we serve, we are among the most active in terms of offering clinical research studies. The breadth of it across multiple diseases is important, because we serve a very broad community. It is really important to give patients access to that research and clinical trials.

What is important is taking care of the patient and offering the best research opportunities. Often, we can find them here. But we are committed to making sure that patients get the best research care, even if that means referring a patient elsewhere.

Integrated Care, Better Results

Q: As a patient, I have a lot of options for cancer care. Why should I choose North Shore-LIJ?

Dr. Raptis: If I were a patient, I would be very selective of where I would go to get my cancer care. I would want to know that the focus of cancer care would be personalized around my needs and that there will be a team of individuals that bring together multi-specialties along with subspecialty knowledge and supportive services to deliver that care. I would also want to have access to innovative clinical research studies. These are the things that we bring together at North Shore-LIJ.

Beyond that, integrated care is important. Many patients go where they may get very good cancer care, but the physician who treats their other health issues and other diseases are in another part of the city or state, and consequently [patients] are treated by very disparate physicians that cannot communicate. Unfortunately, when patients get fragmented care, they only get partial care. Here, as part of a large health system, we provide integrated care--total care--and that leads to better outcomes.

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