Q & A With Dr. Michael A. Friedman

Last May, Dr. Michael A. Friedman took the helm of City of Hope as its CEO. A federally designated Comprehensive Cancer Center, the 112-acre biomedical research and treatment center in Duarte got its start in 1914 when members of the Jewish Consumptive Relief Association set up two tents as a haven for those stricken with

tuberculosis.

Friedman, an oncologist and clinical researcher, also has experience in public policy and commercial drug development. He served as the acting commissioner of the Food and Drug Administration under President Bill Clinton and as associate director of the National Cancer Institute (NCI). He got his start as a clinical oncologist and professor at UC San Francisco Medical Center and most recently worked in the pharmaceutical industry.

The Jewish Journal spoke with Friedman as City of Hope celebrates its 90th anniversary, Friedman marks his first year with the institution and a state-of-the-art Helford Clinical Research Hospital, scheduled to open this fall, nears completion:

The Jewish Journal: What attracted you to this position?

Dr. Michael A. Friedman: If you look for the intersection between wonderfully creative research and dedicated, effective and compassionate care in an environment where all the best humanistic values are evidenced, I don’t think there’s another institution that captures all of that confluence quite so well as City of Hope. It’s an institution that has a splendid history, but more than that, is poised to have some wonderful scientific and clinical accomplishments over the next decade.

JJ: What were some of the challenges you faced as you began your tenure as CEO?

MF: The general challenges are that the health care environment in Southern California is very challenging, dynamic and unpredictable. Support for research from federal and local agencies is finite and hotly competed for. The economic environment in Southern California and the nation has been struggling, and that has affected development opportunities and fund raising.

The unique challenges here, I think, are to examine how a modest-sized institution that has aspirations of the highest quality activities can function effectively. We’ve decided there are a limited number of clinical areas that we want to focus on and do them extremely well.

JJ: Does that mean there some areas that you’ve had to let go or de-emphasize?

MF: Not so much de-emphasize as not emphasize. There’s a difference. We feel confident and capable of giving superb care for all kinds of malignancies, but from a research perspective, we’re going to focus on certain of these malignancies … where we can make a world-class difference.

JJ: With medical costs rising dramatically, how does City of Hope meet the financial challenges of health care delivery?

MF: Providing the highest quality care and research can’t be done without great expense. Our research is partly underwritten by grants … our patient revenues are higher than ever before … our past successes translating basic science into clinical science has generated substantial royalty income, but even these are not enough to cover costs. If we didn’t have donations, this would not be possible. We recognize that public generosity makes our quality of care and quality of research possible. We could spend less money and have things more self-sustaining, but we would lose the greatness of the institution.

JJ: How is City of Hope poised to make a difference in cancer research?

MF: The unique aspect of what we do here is taking basic science knowledge and translating it into clinically meaningful treatments. We’ve had this very pragmatic perspective since the institution was founded of trying to make a practical difference in people’s lives.

On this campus, a scientist in one building gets an idea, makes a small molecule — or monoclonal antibody or gene therapy or whatever it is — gets FDA approval to use that molecule in patients and walks across campus where the substance can be made under the most rigorous standards. And then the clinicians can administer that treatment here. That’s making that loop [from idea to reality] as short as possible without compromising a moment of patient safety or concern.

JJ: What was it like working at the FDA?

MF: It was hugely interesting and overall very enjoyable — especially looking back on it. When I was sitting in the House or the Senate testifying, I enjoyed looking around at the formal organs of government and knowing that it’s a privilege to participate in a democracy.

JJ: What do you think the founders who pitched those tents 90 years ago would think of today’s institution?

MF: While they would be confused by the complexity … and frightened by the number of choices and possibilities for the future … I think they would be struck by the humanness and the heart and good intentions of the institution that have remained remarkably intact over the years.

JJ: Are you willing to be a soothsayer and predict when cancer will be conquered?

MF: I don’t know the answer to that. I can tell you that there will be selective cancers that will be cured within the next decade. There are others that will be difficult and less tractable. This is the most complicated problem because each person is different and each person’s tumor is different. To come up with general answers to such unique situations is challenging.

There’s a pioneering spirit that was true when this place was first started and remains today: No problem is too hard. Today, it’s easy to look back and minimize the challenge of tuberculosis, but TB was miserable. There was no treatment and it was the No. 1 killer for many years. But nobody said, “That’s too hard.”

As TB became highly treatable, this institution could have easily folded its tents. But they said, “OK. We’ve dealt with one impossible problem. Let’s take on another impossible problem — this time it’ll be cancer. Or diabetes.” That speaks volumes about what this place is about: Hope. Hatikvah resonates in a lot of different ways. It’s a powerful idea that is right at the heart of this institution.