Barbara L. McAneny, MD
Since the founding of the American Medical Association (AMA) in 1847, Barbara L. McAneny, MD, is the fourth woman and first oncologist to be elected President of the venerable medical association. “I’m a generic Midwesterner. I was born in Missouri and raised in Madison County, Illinois, and went to school in Minnesota and Iowa. My mother was a mathematician, and my father was a physicist; they both turn green when I talk about the things I’ve done in health care,” said Dr. McAneny.
In high school, Dr. McAneny said she thought about becoming a psychiatrist, but her guidance counselor told her girls didn’t go to medical school, putting a blunt end to that early aspiration. She had planned on following in her father’s footsteps to a career in physics, but when she found out her brain didn’t “work that way,” she decided on becoming a mathematician. And in 1969, she entered Grinnell College in Iowa as a math major.
“However, soon thereafter, I figured out that if I were a mathematician I’d likely end up working as an actuary or a professor, neither of which particularly appealed to me. By then I’d moved and was pursuing my bachelor’s degree at the University of Minnesota,” said Dr. McAneny.
Falling in Love With Cancer Patients
At the University of Minnesota, Dr. McAneny did some soul searching, wondering what else someone who’d spent most of her education taking science courses could do. “I thought about medicine, actually for the first time. So I applied to lots of medical schools and was glad to be accepted in 1973 to the University of Iowa College of Medicine, as it was my first choice out of the schools I’d been accepted to.”
“I decided to spend my career doing exactly what I loved: taking care of cancer patients in private practice.”— Barbara L. McAneny, MD
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As a third-year medical student, Dr. McAneny was assigned to the acute leukemia ward, which was a career-shaping event. “I fell in love with the leukemia patients; I was amazed by their grace under pressure and their courage. I also realized that when you’re working with cancer patients, you can develop a close relationship without having to know them for 20 years first. You cut to the chase about what’s important in life and getting a glimpse into people’s souls was an amazing privilege—one I never saw in any of my other rotations. That’s when I decided on a career in oncology,” said Dr. McAneny.
Appeal of Private Practice
Dr. McAneny became aware of the unspoken rule of thumb: The best doctors practice in academia. “But during my residency, when I had to write a paper, I’d suddenly realize there was just one more thing I had to do back on the ward. I’d avoid writing the paper so I could spend more time with my patients. So why was I forcing myself to do something I didn’t like instead of spending time in the clinic? I decided to spend my career doing exactly what I loved: taking care of cancer patients in private practice,” said Dr. McAneny.
One of Dr. McAneny’s attendings told her that most doctors who go into private practice tend to locate their practices close to where they did their fellowship. “I began thinking seriously about where in the country I wanted to live. I loved Minnesota and Iowa, all the upper Midwest, but I knew I wasn’t tough enough anymore to deal with those long, incredibly cold winters so decided to look South and Southwest. I came to New Mexico, and it was love at first sight. It spoke to me; it still does, with the 300 days of brilliant sunshine and the beautiful desert landscape. I also love the diversity in New Mexico. You get to learn about the world through the eyes of so many different cultures,” said Dr. McAneny.
Dr. McAneny also saw New Mexico as a place where she could make a difference. “This is a very underserved state; in fact, all but one of our counties is considered medically underserved, and we are statistically well below the number of physicians a state of this size should have. And we have 19 different American Indian tribes that live on reservations,” said Dr. McAneny.
Creating Cancer Center to Address Patients’ Needs
In 1980, Dr. McAneny began her hematology-oncology fellowship at the University of New Mexico. After she completed her fellowship, she opened the New Mexico Oncology Hematology Consultants Ltd, with a friend from the University of New Mexico.
“We were a two-doctor medical oncology practice for a long time, and as we got busier, I began learning more about health policy. I became deeply involved with organized medicine in county and state societies,” she explained.
“We cannot accomplish our career goals without valuable input from other specialists, pathologists, radiologists, endocrinologists, and primary care doctors.”— Barbara L. McAneny, MD
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It occurred to Dr. McAneny that to fully serve cancer patients in her area, her practice would need to expand from just medical oncology to a multidisciplinary care model. “At that time in New Mexico, the hospitals and academic centers were using outdated linear accelerators, and I saw the need for an independent practice to offer radiation and imaging services as well as medical oncology—sort of a one-stop shopping for patients. Being a cancer patient is exhausting, and I wanted to create a facility that addressed the needs of our patients and make it so they just have to show up and we’d take it from there,” she revealed.
Dr. McAneny and her associates tried to partner with the local hospital, but their efforts were rebuffed, as were their attempts to bring surgical oncology into their cancer care model. “After several years of unsuccessfully trying to partner with the hospital, we broke ground for the New Mexico Cancer Center in 2001 and opened our doors for patients in 2002. We’ve been growing ever since,” commented Dr. McAneny.
Along with running her expanding practice, Dr. McAneny also increased her activities in local and state medical societies; she’d been an active ASCO member since her first days as an oncologist. “It became very clear to me that we cannot accomplish our career goals without valuable input from other specialists, pathologists, radiologists, endocrinologists, and primary care doctors. Understanding that delivering medicine is a team effort led me to the AMA [American Medical Association],” said Dr. McAneny. “And when I served as a state medical society president, I saw firsthand the ability that different specialists working together would result in better patient care throughout our health-care system.”
Benefit of Cross-Specialty Collaboration
Dr. McAneny noted an incident that illustrated the benefit of cross-specialty collaboration. When serving as a state medical society president, she advocated for an obstetrician who was embroiled in a difficult and costly malpractice suit.
“The baby was born with cerebral palsy, and the plaintiffs were blaming it on the delivery procedure. So I worked with local obstetricians, and as an oncologist who wasn’t professionally invested in the case, I had a lot of credibility. But as documented in the literature, cerebral palsy develops in the first trimester, so after a lot of work, we turned it around into a lack-of-prenatal care issue in the state and created a prenatal care task force, which actually improved prenatal care in the state. That experience taught me that when doctors across all specialties work together as a team, we are unstoppable,” said Dr. McAneny.
Oncology Medical Home Programs
In 2012, Dr. McAneny wrote her first grant application and was awarded a $19.8 million Health Care Innovation Award from the Centers for Medicare & Medicaid Services (CMS) to test how private practices could provide better care at a lower cost and create the Oncology Medical Home. “The early intervention processes we had put in place in the New Mexico Cancer Center were keeping patients healthier and consequently out of the hospital. The grant was given to see if our success could be replicated elsewhere across the country. So we expanded it to seven practices from New Mexico to Maine and showed it was generalizable. Based on our success, it was woven into the National Oncology Home Care Model,” she reported.
The processes that Dr. McAneny and her colleagues created will be helpful for physicians under the Medicare Access and CHIP Reauthorization Act (MACRA). “As we move forward trying to help practices across the country deal with MACRA, I’ve partnered with ASCO in a pilot project called ASCO COME HOME. This is an oncology medical home program designed to transition community oncology practices from volume-based to value-based care by structuring reimbursement around the full range of services needed by patients with cancer,” said Dr. McAneny.
Asked about being AMA President, Dr. McAneny said: “It is a deep honor and privilege to be elected a leader of an organization that is committed to serving as a strong physician voice and a dedicated patient advocate. The AMA will play a pivotal role in the changing health-care environment as our nation confronts pressing health-care issues. With vision and perseverance, I look forward to creating a brighter future for patients and the medical profession.”
Despite political change and an ever-evolving health-care system, Dr. McAneny plans to use her position in the AMA to advocate for full access to equitable health care across the system. “I’m anxious to read the new health-care provisions that will be coming out of Congress, because I am committed to providing access to health care for everyone. I believe if you develop a system that provides care for our poor, the rich ones will be easy.” ■
DISCLOSURE: Dr. McAneny reported no conflicts of interest.