My interview with ASTRO president and incoming chair, Dr. Thomas Eichler, took longer than scheduled. The bio he provided before our call offered a lot of interesting background (which we’ll get into), but the mention that he’s an avid reader meant the conversation veered off course at the start. After 10 minutes discussing our favorite works, preferred “Top 100” lists and the authors we revisit time and again, we began our interview, where I learned more about Dr. Eichler's background, what he hopes to achieve as ASTRO Chair and what’s new with the organization ahead of its Annual Meeting this October. Read on to learn more.

HCB News: Who or what inspired you to follow a career in healthcare?
Dr. Thomas Eichler: There wasn’t any single individual that inspired me to go into medicine. It was the love of the work itself. When I graduated from Notre Dame in 1974, I ended up taking a job at a local hospital as an orderly. Very quickly, I became enamored with the potential for a career in medicine. The event while I was working there that stands out most was being able to scrub in for an emergency appendectomy in the middle of the night. I’d never seen an operation before, and it fascinated me. I saw firsthand that medicine could be an exciting and rewarding career. It’s intellectually challenging and stimulating, you’re responsible for the health and well-being of another human being and you have dozens of career options. I quickly settled on medicine as a career path, although I also took a fairly circuitous route to enter medical school.

After a rejection in 1977, I “ran away” and joined a theatre company in Ohio, where I worked as a stage manager and subsequently met my wife. After moving to the D.C. metro area in 1980, our parents met for the first time at our engagement dinner. I excused myself for a minute and came back to find that my future mother-in-law and my father had decided that I was going to be a cardiologist. While I had to say that it wasn’t in the cards right then, I did eventually reconsider my career path. I entered medical school at the Medical College of Virginia in 1983 as one of the oldest first-year medical students in my class.

HCB News: How long have you been a member of ASTRO?
TE: You’re a member-in-training when you are a resident in radiation oncology. When you finish residency, you’re offered the opportunity to join as an active member. For me, that was in 1992.

HCB News: Why did you decide to be chair of the organization?
TE: I grew up in a family where service and politics tended to intersect quite often, and I’ve always been involved in the nuts and bolts of organizations that I belonged to over the years. For instance, I managed campaigns in high school and college, and I served as the president of my medical school class in our third and fourth years. It was a natural continuation of that habit with ASTRO as I became increasingly involved through a variety of committee assignments, with an emphasis on advocacy and health policy reform. When I was elected to join ASTRO's board of directors, I saw up close the potential to serve our field and our patients as chair.

HCB News: What do you see as your key roles as chair?
TE: I think that every person who stands in these shoes sees things differently. I see myself as being responsible for trying to read the tea leaves for the future of the specialty and to be a proactive advocate not only for our members, but for our patients, as well. The last line from the policy statement I wrote in 2018 when I ran for president resonates today: “The path ahead is uncertain, but I promise you I will work tirelessly on your behalf, guided by our strategic plan to preserve the integrity of our specialty and to advance the practice of radiation oncology.”

Quite simply, that’s my goal — to be a good steward of the specialty and to work collaboratively with ASTRO's board of directors, members and staff as we promote, advance and support radiation oncology, and guide the specialty into the future as trusted leaders of the cancer management team.

HCB News: Can you describe any initiatives you’re championing as chair?
TE: A great example is the Annual Meeting, because it’s a different focus than ASTRO meetings in the past. The theme of our Annual Meeting this year is “Global Oncology: Radiation Therapy in a Changing World”; and while this theme was selected two years ago, it could not be more salient today. Sometimes history commands your attention and imposes its will on the moment. More broadly, global health will be a focus, specifically trying to bridge access disparities to radiation therapy services in low- and middle-income countries, as well as tackling similar challenges in medically underserved areas of the U.S., such as rural areas and the inner city. ASTRO will be part of a strategy to coordinate efforts with our sister societies, both at home and abroad, as well with like-minded NGOs. The goal of the Annual Meeting, in that sense, is to not only educate our membership about these issues, but to inspire them to get involved at some level.

Another pressing issue is the lack of diversity in the house of medicine as a whole and in radiation oncology more specifically. I plan to continue efforts initiated this year by our current chair, Theodore DeWeese, M.D., FASTRO, to increase the number of women and Black physicians who choose radiation oncology as a career path. I hope, ultimately, to help our specialty look more like the patients we treat.
These are long-term efforts that will take many years, but the work has begun and I look forward to being able to contribute whatever leadership I can to make positive changes in access and diversity a reality.

HCB News: In your opinion, what are the key reasons someone should join ASTRO?
TE: As the largest radiation oncology specialty society in the world, with 10,000 members from 87 countries, we have a very large footprint and a full portfolio. ASTRO has five councils that act as the pillars of our specialty. Those are Science, Education, Quality and Clinical Affairs, Government Relations, and Health Policy. These five councils are the voice of ASTRO, the voice of our membership. The councils, along with ASTRO staff, provide the goods and services our members have come to expect, ranging from education, to representation before regulatory bodies; from promoting and funding research, to producing guidelines for safe, evidence-based management of cancer patients. Ongoing membership in ASTRO, in my opinion, is one of the best investments a radiation oncologist can make.

HCB News: Besides the annual meeting being virtual-only this year, what other changes or updates are notable for attendees?
TE: In all honesty, the words “virtual only” really don’t do justice to the platform that ASTRO is rolling out. It is extremely impressive. I’ve been part of several virtual meetings since March, and I will tell you that what I’ve seen thus far is superior to anything I imagined. This will not simply be another Zoom call.

In terms of new features, we will offer three Master Classes to attendees. The first one is in “Radiopharmaceutical Therapy.” The second one is “Professional Development, Leadership and Emotionally Intelligent Communication.” The final Class is “Cannabis in Cancer Care.” There will also be storytelling sessions on a range of topics like geographic access and COVID-19, sessions where other leading medical societies will present the latest cancer breakthroughs in their disciplines, and digital posters with live narration from the authors. My Presidential Symposium on Sunday will take a deeper dive on global health issues with “The Global Clinic: Radiation Oncology in the 21st Century.” This session will focus on access disparity to radiation oncology services with a panel of all-star international faculty presenters.

Another upside to the meeting being virtual is that content will be available on-demand for 30 days after the meeting. This means the usual harvest of CMEs jumps from about 35 hours for a regular live meeting to the potential for acquiring more than 200 hours of CME. It’s a wonderful investment and I hope people take the time to register and join us.

HCB News: What are the challenges facing radiation oncology today and has the pandemic exacerbated any of them?
TE: One of the most important issues for radiation oncology, one that we’ve all been trying to navigate for the past several years, is the unnecessary hurdle presented by prior authorization. Prior authorization obstructs the normal process of care for cancer patients and can delay essential treatment, to the detriment of the patient. Delays can range from several hours to weeks. Time is a precious ally for both the doctor and the patient, and prior authorization simply consumes too much of it.

ASTRO currently has a survey in the field to get a better sense of how the COVID-19 pandemic has affected this issue. Preliminary results suggest the problem of prior authorization has been exacerbated by the pandemic. ASTRO will continue working with health insurers, interceding when necessary on behalf of our members, as well as interacting with legislators and regulators to try to fix the problem.