As a patient-focused, technology-driven specialty, interventional radiology has always valued the role that innovation and business acumen play in improving patient care.
In this series, IRQ speaks with physicians who hold corporate leadership positions to learn more about their career paths and why they felt pulled from the IR suite to the C-suite.
Michael R. Jaff, DO
Name: Michael R. Jaff, DO
Position: Chief Medical Officer and Vice President of Clinical Affairs, Technology and Innovation, Peripheral Interventions at Boston Scientific Corporation
Can you tell us a little about your background and current position?
Michael R. Jaff, DO: I’m a vascular medicine specialist and was trained at the Cleveland Clinic in Ohio. I practiced in various private practice environments for about 10 years before I was recruited by Massachusetts General Hospital (MGH) to run their noninvasive vascular lab and then ultimately be the first medical director of a multispecialty, horizontally integrated vascular center within MGH.
In the late 1990s, I established a clinical trials research unit for peripheral vascular devices and ended up running that core laboratory for about 20 years. The lab became very prolific, running over 200 multicenter clinical trials in 66 countries. It participated in the research of many of the vascular products that IRs use every day.
After working at MGH for about a dozen years I was asked to become president and CEO of the largest community hospital within the Mass General Brigham health system, Newton Wellesley Hospital. I worked there for about 3 ½ years. In January 2020 I began my current position as part-time chief medical officer for peripheral interventions at Boston Scientific.
What initially drew you to industry and clinical trials?
MJ: I was very interested in the evolution of surgical-based treatment for peripheral vascular diseases to minimally invasive treatments. It was such an incredible shift in thought, and the impact potential was so massive that it struck me as an amazing moment in medical history. I figured two components had to be successful for that strategy to evolve: doctors had to want to innovate, and industry had to want to put the muscle and engine behind those innovations. My initial involvement with industry was in the clinical trials unit I established and ran, where industry reached out to my lab and said, “Hey, we want to do a trial of this device. Can you help us do that?” That’s essentially how the vast majority of my interaction with industry started—and was maintained—through my career until I joined BSC.
What about Boston Scientific appealed to you?
MJ: During my career, I’ve had the privilege to work with every medical device manufacturer that was interested in the peripheral vascular medical device arena. It was interesting because these are bright, highly motivated groups that have an amazing ability to take a concept and make it real. I got to watch how everyone worked and participated in clinical research, and one thing that impressed me about Boston Scientific was the level of clinical trials that they performed. As opposed to performing clinical trials solely for device approval, where the lowest common denominator was often used, they were willing to put their devices to the test against competitive technologies. In the coronary space, that was commonplace, but in the peripheral vascular space no one did clinical head-to-head trials of one technology vs. another. Boston Scientific really set that bar, so I was impressed by their commitment to testing their technologies to help doctors make decisions to best care for their patients.
As a vascular medicine specialist, you work closely with IR, but what drew you to being interested?
MJ: Early on in my training at the Cleveland Clinic, at the time, IRs were the ones. They generated the best angiographic images, and they could answer the questions that I as a clinician needed to best care for my patients. They had the ability to think differently about options to treat those patients, so from my earliest experience as a trainee in vascular medicine I knew right away that IRs would be key to the successful care of my patients—and therefore to my success. In each subsequent job, my success hinged on the ability to collaborate closely with IR. When you add the technology explosion—the ability for IRs to hold something in their hands and make it something new and transformative—it was an amazing lights-on moment for me. So that’s how I cut my teeth with IR.
What do you see as some challenges or opportunities facing IR in the coming years?
MJ: I’ll put aside the massive challenges that face U.S. health care, and focus solely on the issues specifically for IR.
I think IRs have slowly evolved from being viewed as procedural experts to clinical experts, and that evolution needs to continue. IRs have unbelievable experience taking care of patients, often beyond the procedural suite. For patients with both vascular disease and cancer, the ability for the IR to stand up as a leading voice on that team is really important. Patients count on it. For patients to get the best outcome, each department—be it interventional radiology or oncology or surgery or cardiology—needs to bring their expertise equally and loudly to the table. I believe that’s the challenge for IRs who practice in both the vascular and oncology spaces. They’ve earned their seat at that table and for their voice to be just as loud as those of other specialists, and they need to trust that.
It sounds like collaboration is very important to you.
MJ: Patients count on it. You hear stories about large cancer centers having tumor boards where everyone sits at the table and the case is presented and everyone gives their opinion. Then a team-based strategy is put together. That team-based approach really does matter for a patient with cancer. I believe the same thing happens in vascular disease, particularly for the more complex patients.
Do you have any advice for other physicians who would like to become involved with industry, regardless of specialty?
MJ: There is a line in organized medicine that doctors say to each other. “Don’t go to the dark side. Don’t leave organized clinical medicine for industry.” Having now been in this role for almost 2 1/2 years, I’d argue that organized health care is in the dark ages and industry actually has an enlightened view on health care. So don’t let bias stop you from investigating the opportunity.
Secondly, if you’re interested in pursuing clinical research or innovating technology, I think you should reach out to industry boldly while being very transparent about that relationship. Don’t hide it, don’t be embarrassed by it. Be open. Tell them you work with Boston Scientific and are being paid for it, or that you’re getting royalties. If you hide it, people will think you’re doing something wrong, even though there’s nothing wrong with collaborating with industry. Every great technology you use originated from the hands of a doctor, and physicians collaborated with industry to bring it forward. So be proud and honest about the collaboration.
The last thing is to remember that industry needs physicians. They don’t have the experience that IRs have sitting with patients and families, talking about potential risks of a procedure, managing outcomes, navigating complications that may occur, and celebrating the victories. They don’t have that perspective, and without it industry can’t decide in which direction to go. So, industry needs physicians as much as if not more than physicians need industry.
