Dr. Bobby Mukkamala has been an otolaryngologist—ear, nose, and throat surgeon—in Flint, Michigan, for 25 years and was sworn in as the 180th president of the American Medical Association in June. He was diagnosed with a brain tumor in November 2024 and continues to be treated for cancer.
From your perspective as a physician and a patient, what is the state of medical innovation today?
We live in a world of increasing threats to public health, such as we all experienced during the COVID-19 pandemic, in large part because our world is more interconnected now than it has ever been.
So our challenge is to maintain a sense of urgency—and innovative thinking—to respond to health threats. At the same time, we can be hopeful about the state of medical innovation today. I am—especially when I consider the host of new science that has been involved with my cancer treatment. The pathology on my brain tumor wasn’t finalized in 24 hours like a typical pathology; it took several weeks of testing to discover that it was a grade 2 astrocytoma with an IDH mutation. This information dramatically changed my treatment options from typical radiation and chemotherapy to a cutting-edge pill that was FDA-approved just weeks before I needed it—after more than a decade of research. We will live longer with previously quickly fatal disease because of such innovative research.
What innovations excite you the most?
My own treatment for brain cancer is a testament to innovative approaches to science and medicine. If we abandon this progress by cutting research funding, we will reverse the enormous progress we’ve made, and people will suffer needlessly.
As a head and neck surgeon myself, I love the innovations that help me to help my patients have less bleeding, faster healing, and better cure rates.
I also have an excitement and a concern about the amazing pharmaceutical developments we’ve seen. To be able to treat cancer in a way that is specific to the genetics of a patient is amazing. I don’t mind at all that the cellular nature of my brain tumor took a few extra weeks to figure out, because this specificity improves my prognosis immensely.
The concern comes from the cost of being cutting-edge. My daily treatment adds up to more than $200,000 a year. I appreciate this medication, but the impact of treatment like this on the overall cost of health care in our country worries me.
For all the optimism about innovation, what challenges continue in medical care?
Access to care is too variable in our country. Between where I live in Flint and more affluent cities around me, access is dramatically different. If a neighbor had the same brain tumor as me, they would suffer for several more months, if not longer, waiting to have it removed—and that delay in care could significantly affect their chances of survival. The life expectancy of my ZIP code in the city of Flint is more than 10 years shorter than the life expectancy in the suburbs.
Another big challenge patients experience right now is a severe—and worsening— physician shortage across the U.S. in high-demand specialties. This is especially true in rural and underserved communities like mine. It’s imperative that we address the underlying factors contributing to this shortage—which is projected to get much worse over the next decade. This includes addressing the administrative hassles and busywork that contribute to burnout, expanding residency opportunities, and increasing opportunities for foreign-born physicians practicing in the U.S.
And we need to fix the broken financial model that has decreased physician reimbursement through Medicare by more than 33% since 2000, which is exerting enormous financial pressure on physicians, like me, in private practice and forcing some to reduce their hours, lay off support staff, or close altogether—further reducing patient access to care. I want my focus to be on the health of my patients, not the finances of my office. I think there has been a generational change for this issue. My mom, a retired pediatrician in Flint, loved taking care of her kids. She worked hard for decades and never burned out. There is no way she could have lasted that long if faced with today’s challenges.
What is the role of physicians and health care workers in relaying innovations to patients?
Patients have a lot of questions, and it’s important that physicians answer them to the best of our ability or help them get the answers they need. However, our ability as individuals to accelerate the evolution of the science behind better health is pretty limited. Thus, organizations like the American Medical Association are critical to improving health care by including the contributions of practicing physicians and other health care workers in the development of new tools. When new options become available—whether they’re simple, like communicating health information between doctors through electronic health records, or a new medical instrument or drug, like my recently approved brain cancer pill—physician involvement is critical to making these useful to all of us.
Nowadays, commercials on TV show the bright, happy faces of people on new medications. But viewers seem to miss the quick list of side effects and danger from the new medication. That’s where doctors come in. We have a critical role in sharing the science behind these new treatments so our patients get better care.
For all the attention to innovation, what is the role of prevention?
If we want to live healthier lives, have a healthier country, and have more efficient health care expenses, disease prevention and preventing disease progression are critical. This requires counseling on disease prevention, routine screening for disease, and consultation with physicians if you’re at elevated risk.
As it happens, I took my boards to become certified to practice lifestyle medicine one week after my brain tumor diagnosis. Thankfully I passed, because I think prevention is important if we are going to live longer and healthier.
Mindfulness is also important. While cutting-edge development will always be important to living better lives, the basic function of our mind also has a critical impact on our well-being. In Flint, where children suffer from poverty, struggling families, and risks to their lives, taking a moment at the beginning of every school day to be guided through a mindful moment orients them to the classroom and what will happen that day—which, fortunately, is happening in our classrooms thanks to the Crim Fitness Foundation. When people suffer from diseases like cancers and strokes, their physical health is supplemented by their mental health. Making the connection between physical health and mental health may be one of the greatest innovations in recent medical thinking.
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