How this oncology leader is increasing care access for rural patients

Joseph Rosales, MD, was considering a few different specialties during training, but what drew him to oncology was the ability to have "very close and intense relationships with patients."

"I've had so many patients teach me a lot over the last couple of decades," he told Becker's. "They've contributed a lot to my growth and my current philosophy about medicine. That connection with patients still really fuels me."

Dr. Rosales has been with Seattle-based Virginia Mason Franciscan Health for 12 years and was appointed executive medical director for cancer services in July.

Here, he talks about his focus within cancer care.

Editor's note: Responses have been lightly edited for clarity and length. 

Question: What cancer study, technology or innovation are you most excited about right now?

Dr. Joseph Rosales: I focus on thoracic oncology and lung cancer, and they have had a lot of innovation and growth in personalized medicine, next generation sequencing, immunotherapy and the molecular signatures of patients' tumors. All that allows us to tailor treatments based on what the patient has. Lung cancer is probably on the forefront of that, but it has really expanded into a lot of oncology over the last ten years. When somebody has a cancer diagnosis, we know what mutations and abnormalities to exploit while still maintaining quality of life. Personalization of medicine and the molecular aspect has been one of the most exciting things to happen in the last five to ten years and continues to be moving forward.

Q: What aspect of your work or the field keeps you up at night?

JR: Cancer is still not cured. With all of the innovations that we've had, there's still a lot more to go. It's frustrating. I hope that we can continue to move forward with regard to our technology and what treatments are available for patients. 

The other thing is making sure all treatments remain available. Healthcare has become increasingly more complicated, increasingly more expensive, and depending on the situation, more difficult to access for a lot of our patients. A lot of times, physicians know what they want to do, but it takes a bit of planning and logistics to make sure the patient can get that treatment and receive it in an appropriate amount of time. It's not just one thing making this hard. It's a combination of insurance coverage, logistical problems, issues with a patient's education, and even access to staff. 

Q: What's one thing your hospital/system is doing in cancer care that you're most proud of?

JR: We're really most proud of expanding our availability to areas where they weren't necessarily available before. I work predominantly in Seattle, but we're really expanding oncology to ensure that services are available to the patients where they're at. That includes diagnostics, therapeutics and infusion centers. For things like specialty surgery that cannot be done at smaller clinics or hospitals, we want to make sure that we have a community to identify those patients. They need more care than what is available locally, then that means that we need to make sure that they get to where they need to go. Navigators are a big part of that. We've also hired new physicians in these other areas to make sure that the patients can be seen without having to travel.

Q: What's the best leadership advice you've received?

JR: Making sure that you understand your team and they understand you and the vision remains intact and clear, because a team and leader really need to be going in the right direction. Especially in healthcare, I think everybody knows what direction we need to go even if there are some differences in how to get there. We need to make sure we deliver high-quality, low-cost care to the patients as quickly as possible and as definitively as possible. Everybody knows that and nobody wants to not do that, but a lot of times it's difficult because you don't have the resources. So making sure that everybody on the team knows what direction we're going and you have buy-in from the team.

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