We spoke to European Respiratory Society (ERS) President Professor Mina Gaga at the start of 2018 about her work, her vision for the society, the role of the patient voice within healthcare, and some of the key trends and challenges ahead.
Could you start by giving us an overview of your work?
I specialised as a pulmonologist and started my medical career working on lung conditions in general. I then went to the UK and did 2 years of clinical work and research into the underlying immunological mechanisms of asthma – I learned in depth about asthma and really enjoyed myself! After that, I came back to Greece and worked mostly on asthma. Ten years ago, I took on a hospital department that looks after lots of people with lung cancer, and so my work has now shifted more in this direction.
What is the situation for lung health like in Greece?
Greece has a problem with smoking, which is unfortunately still seen as socially acceptable, and is causing a lot of lung cancer and chronic obstructive pulmonary disease (COPD). We still see asthma, but at lower rates than what I saw when working in the UK, and are also seeing more interstitial lung disease.
Most places around the world are experiencing financial problems in terms of healthcare, and the cost of some new treatments is extremely high. This puts a strain on healthcare systems worldwide but it feels more pronounced in Greece, because of the financial crisis. Other important problems in Greece are the absence of both home care and chronic care facilities, as well as access to some tests and facilities such as radiotherapy, which can cause delays or mean that more patients will need to pay for their treatment. However, we are trying to keep things as well-organised as possible.
What motivated you to run for, and become, the President of ERS?
I have been involved with ERS for a long time, serving as a national delegate, as the organisation’s learning resources director, (where I was responsible for online education materials), and more recently as Secretary General.
ERS is still quite a young but active society – it feels good to be a part of. Having known the society for quite a while, I thought I could do a good job as President. It is a very positive environment to work in, and I am impressed with the dedication of its officers and staff.
I also really enjoy interacting with patients through both ERS and ELF, and seeing how we, as healthcare professionals, can get involved with, listen to and learn from our patients and how best to support them.
What is your vision for ERS during your presidency?
My vision is better respiratory health. And I think we can do this by working together. I want to encourage more involvement from our members and I want to facilitate effective communications and interactions with all key stakeholders in respiratory health: patients, doctors, nurses and all healthcare professionals, policy makers, industry, the public and the media. Together, we can better define the problems and work toward their solution. We are currently in the process of defining our strategy for the next 5-7 years, responding to the changing needs of our members and anticipating the changes in our society. ERS is a member-based society; everyone can help to shape our activities, whether they are part of the leadership structure or not. Our strategy is really about getting all of the members involved, so that we can work together to reach our ultimate goal of better care for people with lung conditions.
In my opinion, ERS already does many things extremely well. I think that the gamification of education, helping research, and working with other stakeholders, such as industry and politicians, to prioritise and solve issues are really important to push for. But many more ideas and trends are being collected through a survey and we consult with the different assemblies (groups of ERS members that focus on specific topics), so that ideas and decisions come from as many people as possible. The ERS presidency is about knowing our society and helping our members and our patients evolve, it is working with all the ERS officers together as a team, so that there is continuity and consensus. And this is important because, as a large society, I think we can influence the world around us.
How important is the patient voice within healthcare, and how do you see the role of patients within ERS activities growing?
I think the patient voice is very important – patients are who we work for, after all. As healthcare professionals, we need to understand what our patients need from us. Our role is both to explain the scientific side of things and to take our patients’ specific needs and choices into consideration. Carers should also be involved in the conversation. When a person is ill, it often affects their partner and family, so we need to be there to support them and offer advice in terms of caring for their family member. And we need to listen; often this will make our view much clearer.
I think that ERS, through ELF, is doing a great job in terms of involving patients and carers in our work. For example, people with lung conditions and carers are involved in ERS Task Forces (groups of experts that produce new guidelines for healthcare professionals on a particular topic), helping us to make sure that the information we produce is useful for other patients, as well as scientifically accurate. In addition, listening to the perspective of patient speakers at high-level events like the ERS International Congress really helps us as healthcare professionals to understand more about their needs and how we can provide better care.
I think that ELF’s Healthy Lungs for Life campaign, which targets the general public with themes like ‘Breathe clean air’ and ‘Take the active option’ are very important and can make a huge difference. While issues like air pollution require high-level action to reduce the impact on our lung health, it is also crucial that people know about the different ways they can protect themselves on an individual basis. That is why I think that ELF’s information on exercise and air quality is so useful.
What do you think are the biggest challenges and trends in healthcare at the moment – and what role can ERS and ELF play?
I think that one challenge is the need for information, both in terms of preventing and caring better for lung conditions. In this regard, ERS and ELF are providing high quality, clear and relevant information – both to patients and doctors. Moreover, the information is available on the web so it is easy to reach.
Another important trend is the increase in people with multiple health issues, which is accentuated by the ageing population. Many people that I treat have at least one chronic health problem and often two or three alongside their lung condition, and are taking different types of medications. This is a key example of where working in a multidisciplinary team to look after a person can be really beneficial. Digital health and technology advances may be particularly important here by helping easy communication between patient and healthcare providers and allowing for personalised care.
The rising cost of care in a time where budgets are constrained is another thing to address. We need new medications, therapies and tests, but they often come at a high price. Therefore, we need to establish how we can afford this in every country, for every patient and still ensure that health systems will be viable.
Finally, I think that prevention is another important topic – we know that public health measures are usually very cost-effective. If we can help people to understand how to preserve their lung health – through not smoking or quitting smoking, a healthy diet, regular exercise and breathing clean air at home, at work and outdoors – we can reduce the number of people who get lung conditions and help to improve the quality of life of the people who have them.
What are you looking forward to most about your presidency?
I hope that the ERS Presidential Summit, which will take place in Athens, Greece in June, will be a successful event. This will be about responding to patient needs.
To structure the event, we ran a survey that went out to patients and patient organisations about what they feel are the main issues and future challenges in the field of lung health. Isabel Saraiva, the ELF Chair, will present the findings to everyone involved in patient care – doctors, nurses, physiotherapists, insurers, policymakers, regulatory bodies and we will get everyone’s input and comments. Many patients will also give testimony of what they feel and what they need. I hope that this will spark discussions with all stakeholders so that we can work together on strategies and solutions for better care. It will be an ambitious agenda, but we need to bear in mind that everyone’s health is affected by a range of factors, so the big picture is important.
Moreover, this summit will be important because its key points and proposals will be incorporated into the 2018-2025 ERS strategy on which we are currently working.
I believe in team work and fertile conversations, I believe that all voices should be heard and I hope working together we will define a successful 2018-2025 strategy – a strategy that will indeed help better care for our patients, and build a better environment for our members and an even stronger ERS.
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