During his three years as Chairman of the Department of Gastroenterology, Hepatology and Nutrition, Miguel Regueiro, MD, initiated several innovative programs in clinical care and education. Now as newly appointed Chair of the Digestive Disease & Surgery Institute (DDSI), he plans to expand these programs throughout the institute’s 34 departments and centers, while putting new emphasis on clinical and translational research and innovation.
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Consult QD sat down with Dr. Regueiro to discuss the specifics of his vision and learn how he plans to carry them out.
Q. Before we begin, I’d like to ask a question: How can a gastroenterologist lead the DDSI?
A. This is a question most often asked of me. In my opinion, the name of my specialty matters less than the interaction with individuals. As a leader, my job is to identify processes that affect positive change and pull everyone together as a team to achieve our goals. I will work together with the chairs of Colorectal Surgery, General Surgery and Regional Operations to institute programs across the DDSI that unite our efforts to provide better patient care. This will require accelerating research efforts, innovating education programs and continuing to recruit and retain the best talent.
It’s very important that every one of our staff members feels valued and understands they are important to our success. We can only make strides if we move forward together. This will mean breaking down clinical and geographic silos to create a culture of “we,” the DDSI.
Q. What does your 5-year vision include?
A. It has several arms. We will develop novel approaches to clinical care, expand innovative educational programs, ensure DDSI develops new technological approaches to surgery and endoscopy, take the lead in clinical and translational research and become a model for a physician staff that feels engaged, happy and productive.
Q. Can you please elaborate on the novel models of clinical care you referenced?
A. In 2018, Cleveland Clinic hired me to reimagine the patient-centered medical home for inflammatory bowel disease (IBD) that I had developed at the University of Pittsburgh Medical Center. The medical home “secret sauce” is diet, nutrition and behavioral health supporting medical and surgical care. Quality and safety are at the core of each program.
The medical home concept has taken off in an exciting way with IBD. We now have the template and are ready to apply it to other diseases. My goal is to add four more medical homes by 2026. Although we talk about digestive diseases, we should be focusing on ways to prevent these diseases or reverse them in their early stages. To this end I am dedicated to partnering with Cleveland Clinic’s Wellness & Preventive Medicine Department to incorporate wellness in our medical homes and community partnerships, and to make sure our staff has access to its programs, as well.
Q. What are the innovative educational programs you referred to?
A. We would like to expand our brand using innovative delivery platforms to deliver education globally. Our live education programs on Consult QD Live have really taken off. Providers find these multidisciplinary, case-based conferences highly attractive, so we plan to double the number of programs we offer from main campus and other Cleveland Clinic locations worldwide.
New educational initiatives under discussion include novel education and training programs for nurse practitioners and physician assistants. There is strong interest in having advanced practice providers (APP) from the community come here for three to six months of advanced training in, say, IBD or another gastroenterology or surgical specialty. We are also discussing a formal one-year training program for APPs in academic or tertiary care centers, who want to enhance their education. Our APP program is one of the strongest in the country, and we are well positioned to formalize a program to train the national APP workforce in DDSI specialties.
Q. We hear you have big plans for research. Will you elaborate on your ideas?
A. My focus will be on evolving the digestive disease culture to be more oriented toward research and innovation. Some of the infrastructure is already in place, but we need to plan for the resources and personnel we need.
I envision a two-pronged approach that includes a translational research unit integrated with the Lerner Research Institute and international Cleveland Clinic sites, and a clinical trials research unit. We should be designing our own trials to test our research discoveries and training and retraining our own physician scientists.
Restructuring our research program will require an infrastructure for investor-initiated studies, as well as working with industry to obtain innovative platforms for novel technologies and endoscopic and surgical approaches.
Ultimately, I envision the DDSI being a global leader in innovation, clinical trials and translational research.
Q. Your plans for promoting physician engagement are intriguing. How do you plan to accomplish this rather “soft” goal?
A. There is no DDSI without our physicians and surgeons. They need to be appreciated, encouraged and energized in order to feel fulfilled and have the incentive to continue striving for excellence and innovating.
I hope to be able to further this by expanding mentoring programs and by establishing career tracks and pathways in clinical care, research and education that enable staff members to realize their dreams.
We are a diverse lot, as are our patients. To this end, I will ensure that diversity and inclusion remain integrated in our culture, that racism is not tolerated and that ongoing education focuses on “us,” meaning “all of us.”
It simply comes down to treating others with respect. As the chair of this institute, it is my job to accept responsibility for any failures or shortfalls that occur, but to acknowledge the team when we are successful. I am a champion for the DDSI and every staff member. I believe that by working together, we can make Cleveland Clinic the best medical center in the world for patient care and the best place in the world for physicians and caregivers to work.