Former ASH president honored for dedication to improving care of underserved populations
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Alexis Thompson, MD, MPH, is an optimist.
Her positivity over the past 30 years has made a difference with her patients, with up-and-coming doctors and with communities that do not always have supporters in their corner.
The American Society of Hematology recognized that and awarded Thompson, its former president, with its 2023 Award for Leadership in Promoting Diversity at ASH Annual Meeting and Exposition.
“You have to dare to be optimistic sometimes when things are uncertain,” Thompson, chief of the division of hematology at Children’s Hospital of Philadelphia, told Healio. “So, am I going to make this one work? I don’t know, but I’m going to design this experiment, I’m going to approach this next child who comes in with a diagnosis as being that one child who’s going to have a great outcome. It’s not to say it’s blind optimism, it really is having tremendous faith in science and in the work of my colleagues.”
Thompson took some time to speak with Healio about what the award means, her efforts to help underserved populations and what more needs to be done.
Healio: What does this award mean to you?
Thompson: It’s an extraordinary honor. When you’re nominated by your peers, in particular for work that they see as important, certainly it is very meaningful to me, but I appreciate that it is things that are being recognized more broadly. For that, I’m really, deeply honored.
Healio: Why is tackling the needs of underserved populations so meaningful to you?
Thompson: There are many areas in which having diversity in person and place makes us all better. The kinds of science we pursue and the ways we frame questions can be impacted by the people in the room. Seeing that there are needs within the underserved community is quite easy. It’s almost impossible to ignore at almost every stage of medical education. It’s been very satisfying to find ways to contribute to providing not only direct support for trainees from underserved or underrepresented groups, but also to understand how the work that many of us want to do can have an important impact on communities that historically have been underserved. There’s so many examples of where we’ve fallen short in terms of the ultimate benefit of certain scientific discoveries because certain groups were not represented. Whether it was women not represented in cardiovascular studies or treatment trials that continue to not have diverse enrollees, it means that the impact or the significance or findings of that research are limited.
Healio: How has your advocacy for patients from historically underserved populations in clinical trials improved their care?
Thompson: Clinical trials are a fundamental part of determining the benefits and the safety of new agents; however, when these trials take place and they do not involve the broadest population possible, it isn’t surprising that there are differential benefits to that research. Yet, it’s easier said than done to think that communities that have historically been disenfranchised — not only in health care but in other aspects of our society — that they may not necessarily be first in line to think about themselves in a potential contribution to their own health and to the health of their community by participating in clinical trials. It means educating not only those communities, but researchers and research funders about the importance of inclusion of diverse patient populations for us to see the maximum benefits.
Healio: What steps have you taken to mentor trainees from underrepresented communities in hematology?
Thompson: To have some individuals who do not necessarily have other members of their family that are in healthcare to dare think about becoming not only a physician but hopefully a leader in this field, is daunting. It is also challenging when they choose to engage in medical education yet there are no mentors or professors that look like them or that seem to have their perspective. My approach is to encourage students that they themselves can be that voice, that they can be that leader, be that professor or that clinic lead or that direct patient care provider for a population, and that their unique contribution matters.
Healio: How much progress has been made in bridging disparity gap for patient care over the length of your career?
Thompson: By nature, I am an optimist, but I am also a pragmatist. I cannot deny that there have been some extraordinary advances in science. It is not to say, however, that we are at a point where we’ve achieved equity in healthcare, let alone other parts of our current society. I remain hopeful and I believe that there will continue to be opportunities to see more people benefit from some of the improvements we already have. For instance, sickle cell disease. My career began with the adoption of newborn screening broadly in the United States such that every baby in this country, regardless of their race or ethnicity, if they were born in a hospital, then they were tested, and this allowed us to begin to think about evidenced-based intervention for them that we know now saves lives. It’s allowed us to begin to look at how we can utilize new medications for that population, although we need more medications for them, and it’s particularly exciting that sickle cell disease became the very first disease in this country to be approved for gene therapy, where the person’s own cells are used to treat their genetic disease. So, there’s this remarkable arc in the country, but there still are more people who need to benefit from this. I think the next horizon clearly needs to be in the global south. Some of the things that American children benefit from, Africa’s children are still waiting for.
Healio: How much more needs to be done? What actionable steps can be taken?
Thompson: In the United States, there still are opportunities. There are still individuals who see themselves outside of the health care system. They don’t perceive that the system was built for them or provides for their needs. Being able to make the case and identify where we can provide the best possible care to the largest number of people is still an aspiration in the United States. So, being able to increase the number of knowledgeable providers, and thereby increase the number of people who are trained to provide evidenced-based care is still something we are striving for. We need to continue to find ways to reach people where they are, as opposed to them always needing to seek out care at academic medical centers. In Africa, it may require more partnerships between high-resourced countries, between funding agencies or between providers and experts in the global north who can partner with our colleagues across Africa. Providing some basic public health measures, whether it’s newborn screening, the assurance of children having immunizations, treatment for malaria, or basic medications to ensure their survival are things that are within our grasp.
Healio: What is your advice to colleagues to further the cause?
Thompson: This is an extraordinary time to be involved in health care. At times, when I see many people expressing frustration or disappointment with this field, the number of tools that we have available, whether they are virtual with artificial intelligence, with electronic tools with the ability to provide care to a broad group of people ... I think that this is still a time for discovery. There are still tremendous opportunities to have an impact, and I look forward to seeing many of my mentees find their lane, find what inspires them and to have at it. Their voices are valued, their input is needed, and I have every expectation that they will have as great of an impact or more.
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