Achieving Excellent Healthcare for All: A Candid Conversation with MSK’s New President & CEO, Dr. Selwyn Vickers

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Dr. Selwyn Vickers was named President and CEO of Memorial Sloan Kettering Cancer Center in September 2022. His vision of a future with equal access and better outcomes for all has inspired the faculty and staff at MSK. In this episode, Dr. Diane Reidy-Lagunes gets to know Dr. Vickers’ philosophy on achieving health equity, from restoring trust in the system, to overcoming racial bias in the clinic, to improving people’s access to top hospitals like MSK.



Learn more about MSK’s Office of Health Equity.
Learn more about MSK’s Immigrant Health and Cancer Disparities Service.

Episode Highlights

Dr. Diane Reidy-Lagunes: 

Dr. Selwyn Vickers was named president and CEO of Memorial Sloan Kettering Cancer Center in September 2022. He’s one of our nation’s top healthcare leaders and an esteemed surgeon and researcher. He has a vision for the future – an equitable, compassionate future – that’s centered on making healthcare accessible for all. Dr. Vickers, can you share with us a little of your journey and why you chose to become a surgeon?

Dr. Selwyn Vickers:

I had an uncle in the 1970s, as an African American medical student at the University of Cincinnati, who allowed me to observe his practice and see what it meant to be a physician, and that was pretty unusual. There were only four African Americans in his class, which was routinely about the number across the country. I learned I wanted to be involved with the profession that interacted on a daily basis with people. I had the fortune to go to Johns Hopkins for 16 years, though it was hard to decide on surgery because I liked almost everything from pediatrics to psychiatry to medicine. Surgery ended up being the thing that I realized at the end of the day, I would be miserable if I didn’t do it.

Dr. Diane Reidy-Lagunes:

What is your proudest accomplishment, and what lessons did you learn along the way?

Dr. Selwyn Vickers:

My greatest accomplishment is my partner who I married, my wife. I say to people, particularly in academia, who you choose as your partner is not necessarily a prediction of your trajectory, but it really can be a determination of your ceiling. It’s the single most important decision I’ve ever made.

Dr. Diane Reidy-Lagunes:

What is one thing our healthcare industry can do better?

Dr. Selwyn Vickers:

As we saw during the pandemic, we took a vaccine from concept to completing clinical trials in eight to nine months, which is phenomenal. But when we look at the delivery and the engagement as it relates to trust, we’re still in the dark ages. We’ve found ourselves grasping for why people wouldn’t believe this was good for them. We’ve lost the understanding that our business is not only about delivering a product, but it’s also about being purveyors of trust and conveyors of truth.

Dr. Diane Reidy-Lagunes:

Can we talk about race as it relates to trust in the healthcare system? How can healthcare professionals improve upon that trust?

Dr. Selwyn Vickers:

The incomplete narrative we all grow up with in America is typically centered around our community, our race, and our family. One of the ways we can begin to change is by completing that narrative to understand that we are all humans living in this country and on this earth. The completion of that narrative begins by getting to know and understand the life of someone who is very different than you – in experience, skin color, activities, and professions ­– and see that excellence has many shades. I think reshaping the mindset of what’s excellent, beyond what we’ve grown up with, is going to be huge.

We have to realize that the greatness of a place like MSK lies in our ability to treat people from every spectrum of life. We must understand that if we do the hard work for those who are disparate, inherently we will improve the outcomes of those who’ve had the most. There’s data to show that when you improve access for those who historically can’t get in, you improve the quality of care for everyone else as well. In fact, you make it better.

I think the large burden for American healthcare is to deal with health equity. It costs our country billions of dollars because we don’t proactively deal with disease and cancer and screening in the lives of those who don’t have access. We pay it on the back end because we didn’t deal with it upfront.

Dr. Diane Reidy-Lagunes:

What advice would you give to the patient who may feel racial bias or misunderstood by their healthcare provider?

Dr. Selwyn Vickers:

Don’t assume that the intent was to do harm or disrespect. The person is probably operating on an incomplete narrative, based on their background and what they’ve seen, which is unfortunate. Use the experience as a chance to reframe that person’s narrative and complete it by sharing what you thought didn’t go right and what you would’ve liked to see happen. That can be a powerful lesson for everyone involved in your care.

Dr. Diane Reidy-Lagunes:

Where do you think healthcare is going in the next decade?

Dr. Selwyn Vickers:

I think we’re approaching an age where the process of turning ideas into reality– from the lab to the clinical trial to the patient’s bedside – will be on a level of rapidity we haven’t seen before. I think the understanding of the genome and how we target it, combined with our relatively new ability to mobilize our own immune systems to fight cancer cells, is marshaling in an age where we’ll have stronger treatments, cures, and sustainable forces for keeping cancers away. And all of that’s coming from the lab, which is why I think MSK is uniquely positioned to do all of this.

Dr. Diane Reidy-Lagunes:

What’s the message you would want to send anyone who’s facing a diagnosis of cancer, whether it’s the patient or their loved one?

Dr. Selwyn Vickers:

There’s probably nothing more challenging than being told you have cancer, and we want to maximize your chance to beat it. And although there is great care around the world and even around our own neighborhood, I would want you to consider being at a place where our sole mission is curing your cancer. Everything we do is not tangential to your problem; it’s directly related to your problem. It’s not an afterthought; it is our primary thought. So if you have that diagnosis, there’s no better place in the world to be than at MSK. It’s our job to make sure you can get here and get out of here, surviving your cancer.

 

Show transcript

Dr. Diane Reidy-Lagunes:

What makes a good leader? Is it knowledge, humility, the courage to push boundaries, or the conviction to help those whom society does not often see? One might say it's a combination of all these things. And here at Memorial Sloan Kettering, I am so proud to say we found it in our new leader and he's here with us today. From small town Alabama to the president's office of MSK, let's get to know the man whose life and philosophy is nothing short of inspirational.

Hello, I'm Dr. Diane Reidy-Lagunes from Memorial Sloan Kettering Cancer Center, and welcome to Cancer Straight Talk. We're bringing together national experts and patients fighting these diseases to have evidence-based conversations. Our mission is to educate, empower you and your family members to make the right decisions and live happier, healthier lives. For more information on the topics discussed here, or to send us your questions, please visit us at mskcc.org/podcasts.

Dr. Selwyn Vickers was named president and CEO of Memorial Sloan Kettering Cancer Center this past September. He's one of our nation's top healthcare leaders and an esteemed surgeon and researcher. He has a vision for the future – an equitable, compassionate future – and that's something we can all get behind. Dr. Vickers served as Senior Vice President for Medicine and the Dean of the Heersink School of Medicine at UAB. And while he leaves giant shoes to fill there, we couldn’t be happier to have him here with us. So let's get into it. Dr. Vickers, welcome to the show and welcome to New York City.

Dr. Selwyn Vickers:

Thank you, Diane. I’m excited to be here and really looking forward to having this conversation with you.

Dr. Diane Reidy-Lagunes:

Oh, we're so thrilled to have you. I'd like start off with a quote I often heard you say, which is there is often a distance traveled to get people where they are. Can you share with us a little of your journey and why you chose to become a surgeon?

Dr. Selwyn Vickers:

That comment is really driven by the fact that when you look at where individuals have landed, it's often understanding what they've had to go through to get there. For me, I had a couple of influences. I had an uncle in the 1970s, as an African American medical student at the University of Cincinnati, who allowed me to have exposure for what it meant to be a physician, and that was pretty unusual. There were only four African Americans in his class, which was routinely about the number across the country. And then I had a chance to observe an early part of his practice. Those things really gave me some insights that I wanted to be involved with the profession that really interacted on a daily basis with people. I had the fortune to go to Johns Hopkins and stayed there for 16 years. It was a hard thing to decide on surgery. I liked almost everything – I rotated from pediatrics, from psychiatry, from medicine – and surgery ended up being the thing that I realized at the end of the day, I would be miserable if I didn't do it.

Dr. Diane Reidy-Lagunes:

What is your greatest success or proudest accomplishment, and what lessons did you learn along the way?

Dr. Selwyn Vickers:
When I look at the foundation of what I have accomplished, it's really about teams and partners, legitimately. I don't use that just as soft language, but in reality, I believe that. So probably my greatest accomplishment is my partner who I married, my wife. She's legitimately been a partner for my success and our success. I say to people, particularly in academia, who you choose as your partner is not necessarily a prediction of your trajectory, but it really can be a determination of your ceiling. Who you marry is probably one of the biggest deals for me as I've gone through my professional career.

Dr. Diane Reidy-Lagunes:

Amen. For no matter what you do in life, right? That is by far the most important partner, I couldn't agree more. Speaking about our own industry – because I think that advice is great no matter what industry you're in – what do you think is the one thing our healthcare industry can do better? And we know there are many.

Dr. Selwyn Vickers:

I think we have to work very hard to reinvent ourselves. We're in a business where, by virtue of what we do, it is a constant demand. So one of the things that I think we have to do better is both thinking much more cogently and thoughtful about how we deliver the care. I think that's fundamental because if you look at the excellence in care, the opportunities we have, it's pronounced from where we've gone from the days of penicillin. And yet those who can access it in many ways hasn't changed. I think we also are evidenced by the pandemic: we took a vaccine from concept to actually completing clinical trials in almost eight to nine months. And that's phenomenal. But when we look at the delivery and the engagement as it relates to trust, we're still in the dark ages. We've found ourselves grasping for why people wouldn't believe this was good for them. And we lost the understanding that our business is not only about delivering a product, but it's also about being purveyors of trust and bargainers and in many ways, conveyors of truth. And so that part we need much more work on.

Dr. Diane Reidy-Lagunes:

Absolutely. Can we talk about race, particularly as it relates to that trust in our healthcare system?

Dr. Selwyn Vickers:

Yeah. I think America has a significant and challenged history as it relates to race. And in many ways, as it relates to our minority populations, the pandemic took a set of smoldering embers and poured gasoline on it. And those were the individuals who were affected greatly and most harmed by our ongoing system of disparities and inequity. And so we saw that play out as sort of a storm within a storm in their own world of disparities, now exacerbated and really in many ways harmed in some way significantly by the pandemic.

Dr. Diane Reidy-Lagunes:

Absolutely. How can we learn from that and what solutions might there be from such a crisis? How do we as a healthcare profession improve upon that trust, and specifically as it relates to race? I have heard you talk about, for example, cultural competence. But what can we do better?

Dr. Selwyn Vickers:

For many ways, no fault of our own, our lives as individuals, particularly Americans, are developed and formed, if you would, in incomplete narratives. The narrative that we know is typically our community, our race, our family. And one of the ways I think we can begin to change is by completing the narrative of our lives as humans living in this country and on earth. And the completion of that narrative begins by getting to know and understand the life of someone who is very different than you, both in experience, both in skin color, both in activities and even professions. But getting to know those individuals and understanding that number one, excellence has many shades. Number two, the value proposition we've often put on communities that have often seen less opportunity don't define their ability to achieve or provide a contribution of excellence to an environment or a community. It also, as you've heard me say, it's transitioning the ideas around diversity to be an aspiration to be excellent, not just to achieve equity. And so I think reshaping the mindset of what's great and excellent beyond what we've grown up in our own limited narrative and expanding that, is going to be huge. We have to realize that the greatness of a place like MSK is to treat people from every spectrum of life and be proud of the outcomes of excellence in each of those spectrums, and understand that if we do the hard work of getting the outcomes for those who are disparate, inherently we will improve the outcomes of those who've had the most. There's data to show that when you improve access for those who can't get in, guess what, for those who know the double secret handshake, they can get in easier as well! In fact, you make it better. I think the large burden for American healthcare is to deal with health equity. It costs our country billions of dollars because we don't proactively deal with disease and cancer and screening in the lives of those who don't have access. We pay it on the back end for those who suffer because we didn't choose to deal with it upfront.

Dr. Diane Reidy-Lagunes:

That’s right. And what advice would you give to the patient that may feel, for example, racial bias or just didn't feel understood, that their healthcare provider just didn't get who they are or, or what they believe?

Dr. Selwyn Vickers:

You know, Diane, I would say both for the patient and the provider don't make the assumption that the intent was to either do harm or to disrespect. Make the understanding that this person, as I said, is probably operating on an incomplete narrative. Their understanding from their background and what they've seen often has led them to give a perception and a bias regarding who you are, which is unfortunate. But don't lose that opportunity to change that narrative and to actually reframe it by taking the time to both share how you felt and share what you would like to have been done. One of the most powerful messages around narratives, about Desmond Tutu's experience of getting on a Kenyan Airways plane and seeing two black pilots and realized that every narrative he had ever been taught said that was wrong and in fact dangerous. And it's not only the power of that narrative on a majority population that may convey it, but it's an even more powerful impact on the minority population who's taught to believe it, which then puts a ceiling on what they think they can be or achieve and creates a level of acceptance of what's done to them because that's what we deserve. And so I would say to the patient, use it as a chance to reframe the narrative and complete it, both by sharing what you thought didn't go right and sharing what you would've liked to see happen, which can be a powerful lesson for all of those who would be involved in their care.

Dr. Diane Reidy-Lagunes:
Yeah, I couldn't agree more. And we often try to have those conversations. I mean, clinics can be so busy sometimes, but spend two minutes to say, “Tell me something about yourself.” You know, we're taking care of the patient and not just the illness. In terms of our own vision and where we're going in healthcare, where do you think the next decade is going, specifically the role of basic science – what we're doing in the lab – and then importantly how we may translate that into helping our patients of tomorrow?

Dr. Selwyn Vickers:

I think we have a tremendous both history and future. I think now we're approaching an age where the ideas that we're producing, we more than ever can take our discoveries to impact our patients and a level of rapidity that we hadn't seen before. I think the pandemic itself pushed us to say it doesn't take four years to have a vaccine work, otherwise we're gonna lose half of our world. I think that carries over to the concepts of precision cancer care or personalized cancer care. I think the understanding of both the genome, and how we target that therapy with safety, create not only cures but functional individuals after their cures so that their lives still have productive years. Now juxtaposed to how we now create a new army from the immune system that now goes into parts of our bodies and our organs that have often been off limits for drugs – and even when they were on limits for drugs, they weren't effective – and now marshaling that to actually be both a treatment, a cure, and a sustainable force for durability of keeping cancers away is really powerful of where we might go. And all of that's coming from the lab. It's coming from that translational space of both the basic to the preclinical to the actual clinical trial to really impact our patients in real time. I think MSK is uniquely positioned to do that and it's uniquely gifted in all of those attributes being tremendously strong.

Dr. Diane Reidy-Lagunes:

What's the message you would want to send to anyone who's been facing a diagnosis of cancer, whether it's the individual patient or their loved one?

Dr. Selwyn Vickers:

I would say, there's probably nothing more challenging and we shouldn't minimize being told that your pathology report has come back and it says you have cancer. And we don't want to minimize it, but what we do want to maximize is your chance to beat and win the battle against cancer. And I think, although there is great care around the world and even around our own neighborhood, I would want you to consider to be at a place where their sole mission is curing your cancer. Everything we do is not tangential to your problem; it's directly related to your problem. It's not an afterthought; it is our primary thought. So if you have that diagnosis, there's no better place in the world to be than at MSK. It's our job to make sure you can get here and get out of here, surviving your cancer.

Dr. Diane Reidy-Lagunes:

Dr. Vickers, thank you so much for being our leader and for all you represent.

Dr. Selwyn Vickers:

Diane, thank you for the opportunity. In my limited observation, you are a phenomenal caregiver and clinician, and thank you for what you do not only in that role, but you're also an outstanding leader.

Dr. Diane Reidy-Lagunes:

Thank you so much. Thank you for listening to Cancer Straight Talk from Memorial Sloan Kettering Cancer Center. For more information, or to send us any questions you may have, please visit us at mskcc.org/podcast. Help others find this helpful resource by rating and reviewing this podcast at Apple Podcasts or wherever you listen to your podcasts. Any products mentioned on this podcast are not official endorsements by Memorial Sloan Kettering. These episodes are for you but are not intended to be a medical substitute. Please remember to consult your doctor with any questions you have regarding medical conditions. I'm Dr. Diane Reidy-Lagunes. Onward and upward.