This episode of Busine$$ of the V highlights inequities in clinical research due to a lack of both diversity and nuance within the industry. To understand the “why” behind this persistent problem, Dr. Dweck and Rachel welcome Dr. Ru-fong Joanne Cheng, Senior Medical Director in charge of women’s health projects in the Office of the Chief Medical Officer at Johnson & Johnson. It’s an overwhelmingly tall order, but this conversation breaks down many of the stubborn barriers to inclusive medicine one by one.

You’ll learn about the $100 million dollar commitment that J&J has made to correcting inequities in women’s health care over the next five years. Dr. Cheng and her team are sponsoring research that is taking a cutting-edge prism to everything from the astronomical (and disparate) rates of death in childbirth among Black women in the U.S. to the FDA’s acknowledgement that clinical research must incorporate and reflect the reality of gender variability. Topics covered also include research processes that Dr. Cheng believes warrant reconsideration, strategies for harnessing data-driven insights, key factors impacting access and quality of care among different female demographics and how a physician in private practice might go about pursuing alternative careers in the medical space, including within industry.

The bottom-line focus is all about diversity – diversity of study subjects, diversity among clinical researchers. Dr. Cheng contextualizes gender, racism and implicit bias –  and how acknowledging variability is elemental to determining the course, accessibility and equity of ongoing medical research that so deeply impacts the ability of women to thrive now and into the future.

HOT FLASH: Duke Health conducted a survey in early 2019 that revealed more than half of all women (compared with one-third of men) believe gender discrimination in patient care is a serious problem.

Watch the Interview with Dr. Ru-fong Joanne Cheng

About Dr. Ru-fong Joanne Cheng

Dr. Cheng was inspired at a young age to make a difference in the world, which led her to become a physician in Obstetrics and Gynecology. While working in academic medicine, she discovered clinical research, which provides an opportunity to make a difference on a larger scale. For the past 12 years, she has worked in the pharmaceutical industry in clinical development for drugs and medical devices, taking positions of increasing leadership. In her roles, she blends science and medicine with the business of pharma and delivers treatments to patients with unmet needs. She is energized by the variety of work and leading cross-functional teams across different therapeutic. She has experience across all phases of drug development, regulatory submissions and approvals with global health authorities, post-marketing activities and lifecycle management.

FURTHER RESOURCES:

Website: J&J Office of the Chief Medical Officer

Dr. Cheng @LinkedIn

Topics Covered in Dr. Cheng’s Interview

  • Why Dr. Cheng felt the need to advocate for women, address marginalization and promote research that focuses exclusively on women.
  • The FDA has recognized that gender is a clinical variable that influences how people interact with the health care system and vice versa. Dr. Cheng believes race is also a clinical variable.
  • Dr. Cheng shares historical perspective on how women’s health and clinical research has been impacted by false categorization and blind spots.
  • It’s groundbreaking that gender has at last been designated as a clinical variable because, Dr. Cheng believes, it has previously gone unreported and untracked.
  • Clinical research is only just beginning to reflect an evolution in understanding about sex and gender diversity, examining data through a sex-differentiated lens.
  • Specific aspects of the research process that warrant consideration:
    • Frameworks must incorporate and evaluate based on differentiations.
    • Researchers must be diverse to ensure diverse perspectives.
    • Funders can be made more aware of their power to influence change.
    • Journals and research publications can require data and research based on sex-desegregated and gender variable context.
  • The data about health-related issues that women are able to collect through various apps can be harnessed for collective knowledge (but could be skewed by self-selected participation).
  • Dr. Cheng’s “aha” moment about women was cumulative and based on her observations about the way in which women soldier on even under challenging (if not life-threatening) conditions.
  • Quality of life health issues don’t generate urgency in terms of medical research because the data aren’t framed in a context that resonates – like loss of productivity.
  • Where Dr. Cheng and her team are focused:
    • Women-centered science with a data-driven approach.
    • Addressing maternal racial health inequity and disparities of treatment and the comparative likelihood of death in childbirth among Black women.
  • Key factors that could be exacerbating inequitable health care among women:
    • Limited access
    • Cost
    • Physiological differences
    • Institutional racism and implicit bias
    • Inherent dangers of childbirth
  • About Johnson & Johnson’s collaboration with local researchers and studies based in nearby geographies that can be extended as data warrant.
  • Dr. Cheng misses aspects of direct-patient care, which she gave up some years back, but she is fueled by a desire to make a broader impact with her industry work.
  • Advice for clinicians interested in transitioning from patient care to research/industry:
    • Define exactly what it is you want to get out of the move.
    • Explore the myriad non-traditional opportunities available to people with medical degrees.
    • Network with people who have taken alternative paths.
    • Sign up for classes that provide the nuts-and-bolts of clinical research.
  • If working on the medical industry side feels like a fit, then go for it! Dr. Cheng has found it very exciting, cool and fulfilling!

About Dr. Ru-fong Joanne Cheng

Dr. Cheng was inspired at a young age to make a difference in the world, which led her to become a physician in Obstetrics and Gynecology. While working in academic medicine, she discovered clinical research, which provides an opportunity to make a difference on a larger scale. For the past 12 years, she has worked in the pharmaceutical industry in clinical development for drugs and medical devices, taking positions of increasing leadership. In her roles, she blends science and medicine with the business of pharma and delivers treatments to patients with unmet needs. She is energized by the variety of work and leading cross-functional teams across different therapeutic. She has experience across all phases of drug development, regulatory submissions and approvals with global health authorities, post-marketing activities and lifecycle management.

FURTHER RESOURCES:

Website: J&J Office of the Chief Medical Officer

Dr. Cheng @LinkedIn

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