Morning Rounds: Why some doctors plan to quit their jobs

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Good morning folks, we’re almost there! The shortest day of the year is this week. It’s also our last week of Morning Rounds before a break for the holidays, and the last Monday from me for 2023. See you next year!

Who were the best biopharma CEOs of 2023?

It’s that time of year again: reindeers are preparing to hear the starting line-up on the sleigh next week, while biopharma executives are anxiously waiting to hear who STAT’s Adam Feuerstein will anoint as the year’s best CEO in the industry. Adam said this decision was easy: David Ricks of Eli Lilly is “the runaway, rock star, who-else-could-it-be Best Biopharma CEO of 2023.”

​​Lilly’s market capitalization surpassed $500 billion for the first time, making it worth more than Johnson & Johnson, AbbVie, Merck, or Pfizer. There’s even been credible discussion about Lilly possibly becoming the first trillion-dollar pharma company. This success is due to the exploding demand for GLP-1-based medicines to treat diabetes and obesity. (Lilly has one drug with a different name for each: Mounjaro and Zepbound, respectively.)

Read more from Adam on Ricks and the other top CEOs of the year. And you can look back on our colleague Matt Herper’s piece from earlier this year about the “dynamic duo” of Ricks and Eli Lilly Chief Scientific Officer Dan Skovronsky.

Disfiguring disease gets long-awaited WHO designation

The World Health Organization officially recognized noma as a “neglected tropical disease” (NTD) on Friday. The decision comes almost a year after the Nigerian government submitted a request to WHO on behalf of 32 member states to add noma to the list of 20 other NTDs.

Noma is a severe, gangrenous disease of the mouth and face that most often affects young, malnourished children in areas with extreme poverty. Within weeks, the disease can kill enough bone and soft tissue around the face to make eating, breathing, speaking, even seeing difficult, as wrote STAT contributor Joanne Silberner last month. Silberner also noted that the incidence numbers for the disease are “squishy” — WHO estimates 140,000 people in Asia and Africa suffer from noma.

But in a new First Opinion essay about the designation, STAT contributor John Button noted that WHO’s estimate is from way back in 1998, which was the last time they updated the disease’s incidence. For Button, the decision only signals how much more work is needed to prevent noma: “Formal adoption onto this list alone does not spell a solution,” he wrote. “We can stop this disease before it progresses to disfigurement. We can prevent this disease from even taking hold.”

Why some doctors plan to quit their jobs

One of the most iconic First Opinion essays that STAT has published is by Uché Blackstock, a physician who left her job at an academic medical center due to “a toxic and oppressive work environment that instilled in [her] fear of retaliation for being vocal about racism and sexism within the institution.” Almost four years later, a new study in JAMA Network Open builds on the testimonials by those like Blackstock to identify how many physicians intend to leave their current institution, and what factors lead them to making that decision.

The researchers collected survey data from doctors at 15 academic medical institutions from October 2019 to July 2021. They found that more than 32% of respondents indicated a “moderate or higher intention to leave” their job within two years. Burnout and a lack of professional fulfillment were strongly associated with greater intentions to leave, along with depression and the negative impact of work on one’s personal relationships. Factors that were associated with less of an intention to leave? Supportive leadership, organizational support regarding Covid, organizational alignment with one’s personal values, and helpfulness with electronic health records.

Life science postdocs need a raise, says NIH group

And speaking of people leaving their jobs: A National Institutes of Health working group on Friday recommended a sizable increase in salaries of postdoctoral researchers and a cap on the length of the position in an effort to secure the future of academia’s research workforce amid an unprecedented exodus of young life scientists to industry.

The group called for raising minimum postdoc salaries to $70,000 beginning next year — an increase of more than 20% — and adjusting wages for annual inflation, as well as limiting postdoctoral work to no more than five years in most cases. “We acknowledge upfront that some of our recommended changes may lead to fewer postdocs, not more, but we believe will lead to a healthier system and thus bolster the academic biomedical research enterprise,” Shelley Berger, an epigenetics researcher at the University of Pennsylvania and one of the group’s co-chairs, said to STAT’s Jonathan Wosen. Read more.

New Jersey’s telehealth restrictions cut off access to life-saving care, lawsuit argues

Since states started rolling back pandemic-inspired flexibilities that allowed physicians to easily practice telehealth across state lines, virtual health care providers have criticized the United States’ state-based medical licensure system as unnecessarily burdensome, expensive, and detrimental to patient care. Now, doctors and patients are arguing in a lawsuit that licensure requirements can also be unconstitutional. 

On Wednesday, a neurosurgeon, an oncologist, and two New Jersey-based patients sued the state’s medical board, alleging that the state’s licensure requirements for doctors practicing via telemedicine restrict live-saving access to specialty care. The case marks a newly aggressive strategy as health care systems and regulators continue to debate the role of state medical licensing in an increasingly virtual health care system. “I think we live in a different era now than when those laws were made,” plaintiff Shannon MacDonald, an oncologist at Massachusetts General Hospital, told STAT’s Katie Palmer. Read more.

The biggest health care deals of 2023

Looking back is often a good way to gauge what’s next, so my colleagues Bob Herman and Tara Bannow took a look at 2023’s biggest deals in health care. As they write, there are a few clear trends: Vertical consolidation is still the name of the game, as the CVS-Oak Street deal showed us back in February. And as Kaiser’s new Risant Health moves show, we’re seeing different kinds of hospital takeovers nowadays.

Sometimes, they write, it’s the local transactions that matter just as much, if not more, than the national ones — even though those local deals often fly under the radar. Here’s their full rundown.

What we’re reading

• An Alzheimer’s patient wandered from her assisted-living home and died from exposure. It’s shockingly common, Washington Post
• STAT readers on teaching medical students about intellectual disabilities, sobering centers, and annual wellness visits, STAT
• I was a doctor in Iraq. I am seeing a nightmare play out again, New York Times
• ‘We’ve exhausted all avenues’: A small biotech may give up on its ultra-rare disease drug over frustration with the FDA, STAT
• COVID testing company CareCube was vast fraud, feds say, New York Magazine