1998 Annual Report
Gordon Ray, M.D.
Gordon Ray has spent the better part of his life fighting cancer. As head of the PAMF's Department of Radiation Oncology, Dr. Ray has pioneered in innovative, humanistic approaches to cancer care. He has participated in ground breaking studies on the treatment of breast cancer and the use of hyperthermia. He has obtained private funding to support new technology and developed corporate partnerships to facilitate improved patient care.
Often described as a visionary and a catalyst for change, Dr. Ray is quick to give credit to his mentors Victor Fish (his predecessor as head of Radiation Oncology), Malcolm Bagshaw and Henry Kaplan (his professors during a post-doctoral radiology fellowship at Stanford), PAMF colleague Hewlett Lee, and PAMF physician/administrators Robert W. Jamplis and David Druker, who he says are the true visionaries.
"I've always enjoyed creating something new and helping to implement it," Dr. Ray says. "Some people are adverse to change. To me, coming up with new ideas to do things differently and putting diverse groups together to develop new approaches is very exciting.
"I've been lucky to be surrounded by some very talented and dedicated people. Together, we've had an abiding vision of innovative patient care. This vision has taken some different turns over the years as the milieu around medicine has changed, but at the core of this vision has been a commitment to integrated, state-of-the-art therapy in a very caring environment."
The seeds of Dr. Ray's interest in new ideas were planted early. He grew up in New York, where he played on the high school football team and was active in politics. He persuaded a local business to fund his science club project on data management and did a study on the effects of radiation on lettuce seeds.
"I had these interesting experiences with very different groups of people," Dr. Ray recalls. "I'd be working on science projects, participating in political-science discussion groups, and playing football. One afternoon I might be sitting with a group of people talking about implications of the Cold War, then run by a lab to radiate something, then go to football practice for three hours."
He majored in biological sciences at Adelphi University, where he also served as president of the student Judicial Board and established new dress and honor codes. He went on to medical school at the University of Miami. "I was going to go into space medicine or maybe become an astronaut, but I found I was much more interested in taking care of patients than in dealing with things like space and laboratory mice," he says.
The basic-science research aspects of medicine continued to attract him, however. After an internship at the University of Southern California, he accepted a post-doctoral fellowship in radiation at Stanford University, which led to a faculty appointment in 1971.
"I was really torn between research and patient care," Dr. Ray says. "It was a hard choice for me. I remember having a talk with Dr. Kaplan, who told me, 'Gordon, you can't do everything you're trying to do. You're going to have to make a choice.' I began to realize more and more that patient care was what I wanted to do, but it was important for me to do something innovative."
An opportunity at the Palo Alto Medical Clinic provided Dr. Ray with the flexibility he wanted--the ability to concentrate on patient care, apply technology and conduct clinical research. He joined the Clinic in 1975 and--with Drs. Fish, Lee and Jamplis--created a cancer center that integrated radiation oncologists, surgeons, and medical oncologists Paula Kushlan and William Rogaway.
This integrated approach has produced many dividends. During the 1980s, Dr. Ray collaborated with Dr. Fish on an important study showing the benefits of pre-operative radiation in breast cancer patients. He then joined with Dr. Lee to demonstrate the effectiveness of lumpectomy and radiation as an alternative to mastectomy. In 1992, supported by a donation from one of his patients, Michael Kilbane, Dr. Ray established one of the early hyperthermia units on the West Coast. Another major gift from a patient will fund the Paul C. Petersen Family Radiation Oncology Center in the new PAMF campus.
"I look at our vision here as unfolding in three stages," Dr. Ray says. "The first phase was to create the integrated, state-of-the-art cancer treatment center. The second was to provide innovative treatment of breast cancer and bring in new technology. The non-profit Palo Alto Medical Foundation model (in 1980-81) gave us the vehicle we needed to do that. Philanthropy has made it possible for us to do things we normally couldn't afford to do, for the benefit of the community and patients.
"Now we're working on the third phase of our vision, and I think it's a positive result of the recent changes in medicine. The cutbacks in reimbursements and government funding have stimulated us to find new, world-class solutions to providing value for patients, payers and providers. The bottom line is, how are we going to continue to provide quality care given the economic situation, societal changes and reimbursement patterns?"
One of the answers, Dr. Ray says, is to partner with a private commercial venture to put more effective systems in place. The Foundation is collaborating with Varian, a high-tech company based in Palo Alto, on an ambitious "process mapping" program to increase cost-effectiveness and improve the quality of patient care. The Foundation has been designated as a "learning center" where every step of a patient's diagnosis and treatment is tracked to determine how quality and value can be enhanced, how time can be saved and how resources can be utilized more efficiently.
"The practice of medicine is really a contract between two persons--the patient who's seeking help and the physician who's offering help," Dr. Ray says.
"Our goal is to look at how we're handling that patient/physician encounter. We need to look at how we provide care, how we can maintain a sense of humanity, and how we can spend less time on paperwork and more time with our patients."