OMS Success

Innovation Through Collaboration

by

By Advaith Bongu, MD

Surgical lore details stories of the most unlikely of collaborators. The idea that a pioneering aviator, vascular surgeon, and a master glassblower worked together at an NYC lab in the 1930s reads more like a superhero origin story than reality.1 For something more recent, consider how the field of minimally invasive surgery advanced.

In 1987, Phillipe Mouret had the revolutionary idea to simply turn the laparoscope upward and perform the first laparoscopic cholecystectomy. As it was not published at the time, the unsung heroine was his nurse who spread word to her new employer of this amazing new application. What followed was an exchange of ideas between two surgeons that burgeoned through their contact list and turned into a movement.2

Is it possible for us to innovate within our current constructs? Some suggest that traditional departmental structures are to blame.3 Your own unconscious bias of why a transplant surgeon is lecturing about innovation to a group of oral and maxillofacial surgeons is a testament to that fact.

There are six so-called “forces” that can stifle innovation: funding, policy, technology, consumers, accountability, and involved players.4 Additionally, in a competitive private practice setting, there also is the simple matter of time.

I offer you another superhero story: in 2015, a patient in the Houston area presented with organ failure and osteoradionecrosis of the calvaria after tumor treatment.

A multidisciplinary plan was developed, and an extremely talented group of craniofacial and transplant surgeons together performed the first simultaneous scalp, skull, kidney, and pancreas transplant, all from a single donor.5

What remains undeniable is that collaboration is our key to innovation. To that end, we must keep our eyes open for a need.

If there is a need that brings forth an idea, those same antagonistic forces can provide a roadmap for how best to position ourselves for success. It is about turning those impediments into opportunities. For example, if I were academically inclined and had some research question in mind, I would first ask, who are the involved players? Interestingly, in a survey of translational researchers, nearly half of basic scientists collaborated with a clinical investigator.6 

How, then, do I go about finding those colleagues? Funding is always a challenge, but are there local and departmental grants available with minimal effort? Policy/accountability would in this case be interpreted as IRB requirements and human subjects protections which have to be addressed.

What technology (lab equipment or software) would I need to help answer this research question? How does this affect the consumers (patients) or standard of care? To be clear, these ideas do not have to be academic or clinical: they can even be administrative or public health-oriented.

For example, the state of Louisiana opted for an innovative approach to eliminating hepatitis C. Dubbed the “Netflix Model,” the LA-MATCH project involves the Department of Health, Medicaid, Department of Corrections, and industry sponsors to help ensure a fixed subscription cost for antiviral therapy for 5 years.7

If these ideas require collaborative partners, how do we find them? It’s really about putting ourselves out there and leaving our collective clinical bubbles. This may mean attending sub-speciality grand rounds, being more active at local and national meetings, participating in multidisciplinary rounds, or emailing a colleague in a different department.

Never has there been more capital invested in medical technology, informatics, or biotechnology. Perhaps it’s time to take that call from an industry rep. Chances are, you will find someone doing amazing work close to home. All you need to do is ask.

References

  1. Sade, R.M., A Surprising Alliance: Two Giants of the 20th Century. Ann Thorac Surg, 2017. 103(6): p. 2015-2019.
  2. Litynski, G.S., Endoscopic surgery: the history, the pioneers. World J Surg, 1999. 23(8): p. 745-53.
  3. Pryor, A.D., Surgical evolution: collaboration is the key. Arch Surg, 2005. 140(3): p. 237-40.
  4. Herzlinger, R.E., Why innovation in health care is so hard. Harv Bus Rev, 2006. 84(5): p. 58-66, 156.
  5. Selber, J.C., et al., Simultaneous Scalp, Skull, Kidney, and Pancreas Transplant from a Single Donor. Plast Reconstr Surg, 2016. 137(6): p. 1851-1861.
  6. Weston, C.M., et al., Faculty involvement in translational research and interdisciplinary collaboration at a US academic medical center. J Investig Med, 2010. 58(6): p. 770-6.
  7. Afaneh, H., et al., Louisiana Medicaid access for treatment and care for hepatitis C virus (LA-MATCH) project: A cross-sectional study protocol. PLoS One, 2021. 16(10): p. e0257437.

 

Advaith Bongu, MD

Robert Wood Johnson University Hospital

Dr. Bongu specializes in transplant surgery at Robert Wood Johnson University Hospital in New Brunswick, NJ. He also serves as the director of surgical simulation at Columbia University Irving Medical Center in New York, NY.