A Conversation with Paul J. Pockros, MD

Issue: April 2015

In this issue, HCV Next asks five questions of Paul J. Pockros, MD, director of the Liver Disease Center of the division of gastroenterology/hepatology at Scripps Clinic and clinical director of research at the Scripps Clinic Liver Translational Science Institute.

Paul J. Pockros

Pockros received his medical degree and completed his residency in internal medicine at University of Southern California School of Medicine, followed by a fellowship in hepatology at Rancho Los Amigos Medical School and a fellowship in gastroenterology at Scripps Clinic.

Today, Pockros treats the full spectrum of digestive diseases, but his areas of expertise are hepatology, including the treatment of chronic hepatitis B and C virus, transplant hepatology and gastroenterology. He has served as a principal investigator on many studies and has contributed more than 300 published abstracts and 130 PubMed-indexed manuscripts on topics that include viral hepatitis, liver transplantation, cirrhosis and diagnostic tests for liver disease.

What area of hepatology research interests you most right now?

I continue to have an interest in clinical investigation and have broadened my area of trials to cholestatic disorders (primary biliary cirrhosis and primary sclerosing cholangitis), nonalcoholic steatohepatitis, as well as continuing studies on new HCV agents. I am certain that HCV will remain a study area until we have multiple regimens that are all-oral, well tolerated and probably shorter in duration than we now have. This will likely take another 2 to 3 years. I also feel that we need to next tackle hepatitis B virus and develop an immune-modulator that will effectively clear cccDNA. We have more work to do and I want to be part of these discoveries, as this is the most rewarding part of my career.

What advice would you offer a medical student today?

Find an area in medicine that stimulates you, one where you seem to really have a gift or a passion, and pursue it as far as it takes you. The exact specialty is irrelevant. You shouldn’t spend too much time worrying about paying back your debt or how much money you will make. Medicine in our country has been a rewarding field and will continue to be, one way or another. If you are good at what you do and enjoy it, you will make enough money eventually. Physicians will always have a certain level of autonomy. No matter what griping you hear from older docs, remember that.

Have you ever been part of medical history?

I feel that I was blessed in my career to be an integral part of medical history, as I have been an HCV investigator since my first study on Roferon (interferon alfa-2a, Roche Pharmaceuticals) almost 25 years ago. Our sustained virologic response rate — although we had no measurement of HCV RNA and no confirmation of HCV infection — was 2% to 3%! I have participated in more than 100 HCV trials over the years and have watched in astonishment as we reached the simple and well-tolerated cure for almost everyone that we now have.

What are your hobbies outside of practicing medicine?

I enjoy outdoor activities and make the most of living in a wonderful place. I swim laps, play tennis and do Pilates on a regular basis and have for more than 25 years. I also enjoy skiing in Utah and sailing on a 44-foot schooner that I have been a minor partner on since 1989, although I don’t have time to do these as often as I would like. My wife and I enjoy travel and love to stay in classic European hotels in out-of-the-way places.

Who has had the greatest influence on your career?

Telfer Reynolds, MD, trained 100 liver fellows at the USC Liver Unit during his career and I was one of them. He definitely led me down the road to be a hepatologist, although I really didn’t know what my career would be like. I started with an interest in ascites and portal hypertension, long before therapies for viral hepatitis and before the era of liver transplantation. I have actually still kept my original interest honed by Reynolds, even though I have spent most of my career in hepatitis and transplant.