In the weeks leading up to Opening Day, general managers (GMs) for Major League Baseball’s 30 teams are in full assessment and acquisition mode. They analyze where they’ve been and where they need to go in order to place their team among the elite.
Key to the GM’s role is assessing the current roster, looking at strengths, areas for improvement and how to acquire additional talent to make their team better than the competition.
Queens native and life-long New York Mets fan Richard Barakat, MD, smiles at the analogy that likens his dual role as director and physician-in-chief of the Northwell Health Cancer Institute and the health system’s senior vice president of cancer services to a baseball GM. “It’s very much like that,” he said. “We want people in the right positions to make us the very best we can be. My job is to put them there.”
Just as some baseball teams are identifiable by their pitching, ability to hit home runs or solid defense, Dr. Barakat says the Northwell Cancer Institute’s identity will be formed by the expertise of the players on its roster.
“We’re standardizing cancer care and integrating it across the system,” Dr. Barakat said. He is clear on what the cancer center’s identity will be: “comprehensive medical care as the standard for cancer care.”
Cancer Institute leadership is located in a single location, at Northwell’s Center for Advanced Medicine in Lake Success, where deputy physicians-in-chief and directors of radiation, surgical and medical oncology oversee their programs across the health system, Dr. Barakat said. He added that the Cancer Institute is also developing system-wide programs for colorectal, pancreatic, breast and thoracic cancer. Most notably, it launched a Center for Cancer, Pregnancy and Reproduction last fall.
“Nobody else can do what we can do,” Dr. Barakat said. “We see more than 16,000 cancer patients annually, but we also offer quaternary services – highly complex care – that specialty cancer centers can’t. If you combine that with cutting-edge cancer clinical trials, the Feinstein Institute and our partnership with Cold Spring Harbor Laboratory, we are in the enviable position of being able to bring all the pieces and talent together for comprehensive cancer care in a way nobody else can.”
He cited two examples of what distinguishes Northwell’s cancer care from all others. The first involves a patient who, at 24 weeks pregnant, had a cancerous mass on her ovary.
“She went to the gynecologist oncologist for surgical removal of the ovary, which is extremely difficult during pregnancy,” Dr. Barakat said. “Post procedure, she remained high risk and came back to our Maternal-Fetal Medicine Program. She then received chemotherapy treatments while still pregnant – again, no easy task – which was managed in conjunction with our Pharmacy Division to limit the toxicity for the fetus.”
He marvels in the telling of just how many medical touchpoints this one patient experienced, but he’s not even half way through her story: “The patient developed a blood clot and needed to be treated by hematology with anticoagulants and then went back to ob-gyn for a C section. After the baby was born, neonatology was involved because the baby was exposed to chemotherapy in-utero.” The patient received completion surgery, a reoperation to remove any residual traces of ovarian cancer, which was followed by more chemo.
“And all of that happened right here at Northwell,” he said. The result? “Baby is healthy. Mom is healthy. Do you know how amazing that is?
“This is what we do. We bring together an entire team to care for the patient, no matter what comorbidities may arise."
The second story is equally illuminating. Richard Lazzaro, MD, chief of thoracic surgery at Lenox Hill Hospital, had a patient with a large lung tumor who wanted to go to a cancer specialty center for surgery. The tumor grew through the man’s interior pulmonary vein into the left atrium.
“They told him they couldn’t do it because they don’t have cardiac surgeons,” Dr. Barakat said. “So he went back to Lenox Hill.” There, Dr. Lazzaro collaborated with S. Jacob Scheinerman, MD, Lenox Hill’s chair of cardiothoracic surgery, and Nirav Patel, MD, vice chair cardiothoracic surgery at the hospital, to review the case and present it to the tumor board.
Drs. Lazzaro and Patel surgically removed the lung tumor and performed a partial atrial resection. “The reason it was done at Lenox Hill is because we have the expertise to handle that kind of complex case requiring cardiac bypass,” Dr. Barakat said. “The other hospital doesn’t perform bypass surgeries because they don’t have cardiac surgeons.
“That’s why I say comprehensive medical care is our standard for cancer care. The complexity of this is just unbelievable. And we do it regularly. We have a great deal of talent,” Dr. Barakat said. “And we’re recruiting additional top-tier talent so that we’re a world-class program that’s close to home for patients.”
And how does Dr. Barakat attract that coveted free-agent physician to round out his cancer care roster?
"I explain that we have an incredible opportunity to build on the existing talent within the Northwell system to improve the outcome of tens of thousands of patients by changing cancer care on Long Island and throughout the metropolitan area,” he said.