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- Healthcare Nation Podcast discusses healthcare innovation and technology with guest Dr. Michael Ivan, a renowned neurosurgeon.
- Dr. Ivan specializes in complex brain tumor and skull-based surgery and is an associate professor at the University of Miami.
- His research focuses on minimally invasive brain tumor management using endoscopic approaches and robotic keyhole surgery.
- The podcast covers new Alzheimer's drugs and the use of technology such as artificial intelligence in healthcare.
- Dr. Ivan's work at the University of Miami Brain Tumor Initiative has been a source of hope for many patients.
- In his practice, Dr. Ivan aims to integrate various data points across a patient's treatment to improve patient outcomes.
- He is developing an augmented reality and artificial intelligence system to better estimate tumor locations and update algorithms during surgery.
- The goal is to use this detailed information to create more precise, personalized treatment plans for patients, such as targeted radiation therapy.
You can reach out to him through the University of Miami's website and also on social media @michaelivanmd
Creators & Guests
Host
Producer
What is Healthcare Nation?
Welcome to Healthcare Nation, the podcast for enthusiasts passionate about the healthcare sector and eager to explore its current state and future trajectory. Join us as we delve into the heart of the healthcare, biotech, and MedTech industries with the help of top thought leaders.
I'm your host, Rick Gannotta, with over four decades of experience in healthcare, spanning from the hospital bedside to the boardroom, C-Suite roles in renowned health systems, advising game-changing startups and established companies, and educating the next generation of healthcare leaders.
In each episode, we'll bring you conversations with distinguished guests, including innovators, scholars, practitioners, and influencers shaping the healthcare landscape. Gain valuable insights from their perspectives and stay updated on the latest developments, trends, and noteworthy news.
Join us on this exciting journey and become a part of the Healthcare Nation community. Subscribe now on Apple Podcasts, Spotify, or your favorite podcast platform to stay in the loop.
[00:00:00] healthcare-nation_joe_joe-yu4jmnky9_cfr-synced_2023-may-04-1407pm-utc-riverside: Welcome to the Healthcare Nation Podcast, Rick Janata, your host here, and I'm with Joe Woolworth, our producer.
[00:00:06] Joe, what's happening? How you doing there in the control room? I'm doing good. I'm doing good. Hey, this is, this is next chapter that we're on, or the current chapter that we're on. We're talking about healthcare innovation and technology and the guest today had a lot of, lot of cool stuff to say.
[00:00:20] Yeah, I will. I will tell you first of all, Quick introduction, Dr. Michael. Ivan is just a renowned and incredibly gifted neurosurgeon. we had an opportunity to discuss so much from the advances in technology, surgical techniques, what's promising in the world of everything from immunology and biomarkers, including.
[00:00:42] The leveraging technology from an artificial intelligence side what'd you think, Joe? Yeah, I mean, definitely some exciting stuff to talk about and I really enjoyed the episode specifically. We talked about a new Alzheimer's drug as well as you know how to. You know, use the new technologies that are coming out.
[00:00:59] Mostly when I hear about stuff like chat, G P T and stuff like that, it's like how to save yourself time and how kids are using it to cheat in school. But it's really awesome to see some of these benefits that are applying to real world lifesaving. Kind of practices. The stakes are so high.
[00:01:14] It, it becomes such a loaded proposition and the promises are, are all in there. But let me, let me do the intro. You know our guest, Dr. Michael Ivan, currently associate professor at the University of Miami, where he focuses on complex brain tumor and skull-based surgery. He also acts as the site disease leader for neuro-oncology at the Sylvester Comprehensive Cancer Center as chief of cranial neurosurgery in neuro-oncology.
[00:01:38] At Jackson South Medical Center at Jackson Memorial Hospital he's also the director of the Brain Tumor Fellowship at the University of of Miami. He has one of the busiest clinical cranial neurosurgery practices in all of Florida, radiosurgery, gamma knife, skull-based tumors, primary brain tumors, secondary brain tumors, you know, mens pituitary tumors, and even dealing with epilepsy through surgical approaches. So an incredible practice, I want to make sure that our listeners understand the level of expertise that's available at, at some of the institutions.
[00:02:11] And we're so happy to have Them represented on the show. Dr. Ivan, his work in research at the University of Miami brain Tumor Initiative, where he's the director, has been a real hope of promise for a lot of what's happening he graduated from Cornell with a degree in chemical engineering.
[00:02:30] He got his doctorate medicine from Rutgers University. His personal research has been on minimally invasive brain tumor management and using endoscopic approaches. This is the robotic keyhole surgery you could find Dr. Ivan, obviously through University of Miami's website, also on social media at at Michael Ivan md. I really encourage folks who are, who are interested in understanding more about what he does, his practice, what's happening at the program at University of Miami, to reach out to Dr.
[00:03:01] Ivan. And with that, Joe, let's welcome Dr. Michael Ivan.
[00:03:06] Before we get jumping into this episode, this is a professional man who was so kind to give us some of his time before he had to jump into a big surgery. So you're gonna hear like some buzzes and some bings and some things from his devices that he can turn off cuz he's at work and he's doing important things.
[00:03:23] Joe, thanks for calling that out. You know, we are fortunate to have busy. Professionals and in some cases very busy neurosurgeons on our show. And in, in those cases we don't mind a little bit of interruption and hope our audience can understand that. So with that, let's welcome Dr. Michael Ivan.
[00:03:42] Welcome to the Healthcare Nation Podcast. I'm your host, Rick Janata, and we're committed to bringing you thought leaders in the field to discuss what's new and noteworthy in the health sector.
[00:03:56] This is the Healthcare Nation Podcast.
[00:03:59] Rick: Dr. Michael Ivan. Michael. So glad to have you on the show. I've been looking forward to this for, for a while now. When I originally conceived the podcast and thinking about. The health sector really in general and in, in the aggregate. I knew that the provider piece was going to have center stage on a few of the episodes, really focusing on innovation, patient care, delivery, research.
[00:04:24] Really the next generation who are gonna bring that and tee it up for us. And you were always top of mind in those conversations. So I'm so happy to have you here.
[00:04:35] Michael Ivan: Oh, thank you so much. It's really my honor to be here. And especially those key words. I mean, they're really a passion of mine, you know, improving our, our patient's healthcare and their treatment with the use of innovation technology. And just looking at the future you know, makes me excited and and just excited to kind of get through some of these questions today.
[00:04:55] Rick: Oh, fantastic. Well, listen, let's just start with this. Tell me and, and get our listeners up to speed. What have you been up to lately? All things what have you been focused on in both your clinical practice and your research? If you can just give us an overview.
[00:05:10] Michael Ivan: Yeah, for sure. You know, I'm a brain tumor and skull-based surgeon here at the University of Miami, and so, you know, a majority of my time is. Spend in the operating room with my patients. And you know, we're always, every time we do a surgery, we're always trying to think of new ways. And for each part of the case, each part of the, you know, whether it's the opening, the removal, the closure ways that we could kind of make things more efficient, make things more advanced, learn from it, and so that we could kind of make the next case or all future patients better.
[00:05:41] And so one of the major things that I've really been looking at with technology is, is this idea of instead of having these silos, Yeah, of, you know, we, we get a lot of information about our patients before they go into the operating room with imaging and labs and exams. And then, you know, we use that to make decisions of what we're gonna do.
[00:05:58] But then once we get into the operating room, we kind of are just focused on the surgery. We get more information about, you know, things about pathology and what the anatomy looks like. And again, you know, that's useful. But then after surgery, you know, we really don't kind of, other than knowing what it, what it was and what we did, we don't really use a lot of that information.
[00:06:17] Across the stream of the entire treatment of the patient. And so I'm we're developing kind of a, a system that we can kind of now start to integrate all of these data points that we collect through the patient's care, to kind of use them together and, and then learn from them in a better way that we haven't before.
[00:06:35] So, for instance, so we are developing kind of this augmented reality and artificial intelligence. To use pre-operative imaging to try to estimate with, with artificial intelligence better where the tumor may be. But that's just an estimation. But then when we get into the operating room, we have a novel pathology system that gives us almost immediate results on the pathology.
[00:06:59] So now, instead of just taking one piece and letting us know, we get pieces from all over the tumor. In this complex 3D three dimensionality, and you could now combine that information with the pre-operative imaging to kind of now enhance the estimation as you're operating. So, you know, you can say, okay, well I thought this part of the, the brain was gonna be tumor, but now when we're in the operation, we've learned this is actually what real tumor is and this is what actually not real tumor is.
[00:07:26] Let's, let's update the algorithm and actually update this estimation as we're operating. And and then after we're done operating, Now we have all this data about exactly what was left behind, if there was anything left behind. You know, many times we don't leave anything behind, but sometimes we have to.
[00:07:44] And so if we do, you know, let's, let's not only just tell somebody that, oh, we left a little bit behind. Like, you have to treat it. Let's tell them a little bit like. About what exactly that geometric shape looks like. What exactly the volume of that? What is the cell density? Where was the highest cell density?
[00:07:59] Where is the heart part of the most proliferation? So that when we look at these images and we see these patients, as we follow them closely, we have actually more kind of precise and detailed information to make details of, okay, well this part needs a little bit higher dose radiation because, We know from the operating room, this was the part of most concern, or this part is, looks a little bit questionable on the next mri, but you know what?
[00:08:24] That correlates to what the pathology was showing in that exact 3D location in the operating room. And so, Rather than say, well, we don't know, I'm gonna be more likely to call that as this is something that's changing. And so by connecting with, with technology kind of the, the entire experience, I think it will kind of really improve better, better care, make better decisions at each step and kind of shorten these decisions that sometimes we're kind of like, let's wait three months and see what's gonna happen.
[00:08:52] Let's wait four months and see what happens. Cuz it's just so too hard to tell.
[00:08:55] Rick: Yeah, the level of precision that I hear in, in what you're saying, the descriptions, it's really, it's absolutely fascinating, but also I think brings a level of hope and confidence that. You're more than on to something. This is actionable right now, and you're using it in real time. And correct me if I'm wrong, it looks like you're taking the aggregate experience longitudinally, right?
[00:09:20] And you're kind of skating to the puck and again, leveraging the data in real time, even in the or. And after the fact, you're able to prognostically kind of give perhaps a more precise trajectory for an individual. Is, am I right on that?
[00:09:37] Michael Ivan: Yeah, I mean, with some of these more difficult and more aggressive tumors, you know, what we're learning is that. There's so many variables. There's, you know, you can't just tell somebody that you know their age, their sex, and what kind of tumor they have and say, this is your treatment for you. Right?
[00:09:54] There's so many variables on every level. Their diet, their environment, their ethnicity, the genetic makeup of the tumor, the genetic makeup within the three dimensions of the tumor that it's very hard to kind of plan sometimes. A trial or a clinical trial with is 30 or 40 patients to capture all these variables and expect it to work on everybody.
[00:10:16] So unless we start gathering all of this really, really specific, like you're saying, specific details on every step of the process and looking at those trends, you know, it's gonna be hard to make these improvements as we move forward in the future of medicine.
[00:10:31] Rick: All right. Let me bookend two things that I know you have a, a specific focus on. One is we'll call it the novel use of biomarkers, and I'm thinking there predictively and on the other end innovative techniques for drug delivery in, in particularly, I know how, how difficult that could be crossing the blood-brain barrier, et cetera.
[00:10:54] Can you comment on, on both those areas,
[00:10:57] Michael Ivan: Yeah, I mean, I mean, again, Ma having our information to make decisions earlier or to treat somebody when, when these diseases are in a, in a earlier stage just makes the treatment more effective and the outcomes better. And so I think there's really some novel. Ideas with, you know, looking at the blood, looking at the csf, looking at new novel imaging that are coming to about, and what we're finding is that for each different kind of tumor, perhaps there's different biomarkers that are the best ones.
[00:11:30] And so, you know, again, it brings on a whole nother complexity into the problem. But yeah, for, for brain tumor specifically, I mean, you know, we, we've, we're moving well beyond just getting an MRI now, right? I mean, we have. These advanced MRIs. So MRI spectroscopy is one that we're working with where we could actually look at the metabolites.
[00:11:48] In the brain, but not just in one spot, which has been around now for like 30 years. We can actually look at the metabolites in every spot, every part of the brain. It's called three-dimensional spectroscopy, and so you're getting, you know, 7,000 data points per brain. On, you know, all these different metabolites and you could kind of see now, okay, well this brain, this person's brain metabolites at baseline is this, and how are these changing?
[00:12:12] It's not comparing patient A to patient B, it's comparing themself to how they they would B in a couple weeks from now. And I think that's really exciting.
[00:12:19] Rick: Yeah. That's fantastic. How do you think these treatments, these, I would say advanced in probably you know, With respect to access only found at the institutions that have the type of program that you're at, how does it impact the patient? Clinical outcomes, quality of life compared to, let's just say the historical treatment of, in this case, brain tumors.
[00:12:45] Michael Ivan: You know, access is, is always key and it, it is a, a major problem across, you know, not only the United States, but even beyond. Right. And The, I think with technology we're starting to see a lot, some of those barriers be broken down because some of this technology is becoming faster, cheaper, smaller, more accessible, and and I think that is one of the major kind of pillars when we look at these new technologies that we're trying to bring into brain tumors specifically is, okay, is this something that we can, you know, diffuse across.
[00:13:21] You know, everywhere beyond the United States. And, and so if you come up with the next 10 million, you know, scanner, that's great. Maybe it does help. But in the real life, you know, how many people are gonna have access to that? You know, and so if we could now kind of take some of the technology that we have already and make it more useful, and I think that's what we're seeing a lot with this augmented reality systems in the future, is its ability to kind of see this 3D anatomy.
[00:13:45] And see you know, the structure is very carefully and, and put information into augment reality to make your decision making. Okay? And these systems are, are, you know, are looking to replace kind of these, these prior systems that are out there that cost more than most people's houses. And now they're, they're just a fraction of the cost and they're small mobile.
[00:14:05] You put 'em in your suitcase, you could travel to an OR and bring it with you. And I see those are the kind of things we're gonna see in the future.
[00:14:11] Rick: Yeah. And, and along those lines, I think robotics, you're talking about AI here. Would you say they're now routinely being deployed in neurosurgery across the board, or is it still select institutions that are really again, having access to that type of technology? Or perhaps it's the practitioner or even training
[00:14:34] Michael Ivan: Exactly. Yeah. I mean, it's, it's. The great thing about the field of medicine and especially neurosurgery, is that technology is always kind of, you know, on a, in this major slope. And so you know, many of the things that I do now are not even things I learned when I was a resident. They're just things that we, we kind of continue.
[00:14:53] We go to these conferences and courses and now with webinars like this, we learn about all these techniques that everybody you're doing around the world and we could kind of assign value to them and, and bring them in. And so Yeah, I, I think that there's still, it's still kind of on the, the learning curve the beginning of the learning curve or the use of robotics and, and artificial intelligence.
[00:15:13] But you know, you could either be a part of the development and optimizing these, these devices and technology to make it more efficient and, and make it really useful. Or you could wait for it to be done and then just try to, you lose it then, and, and, you know, Here and, and, and even my partners here in Miami, we, we are kind of really taking the approach that we'd rather jump on the technology and really take a part in the development and learning it and, and making it sure that it's really useful for our patients and not just something that's just a new technology that you have to do more than the latter.
[00:15:48] Rick: Yeah, and influencing the process and, and having a place at the table with I would say in, in this case, the private sector and health tech. I think that really gives you an advantage as well, not only to be able to utilize it and have access, but to give your feedback so that it could be incorporated into next generation version.
[00:16:09] Michael Ivan: You. Yeah. You know, I mean it's, it's this cross specialization of working with the tech companies and the engineers and the marketing team and. Sometimes, you know, when you get so involved and it's, you know, these products are very cool. I mean, I'm not gonna dumb it down, but they're, they're just really impressive to watch and to look at.
[00:16:26] And the keywords are there, but you have to always remember that it's patient-centered. Right? And so the physicians were, and the physician's input. Really needs to be the most critical part of it because we need to make sure that we're not just moving the bar a tiny bit, but costing 10 times as much, right?
[00:16:42] We're, we're really making a significant difference, or that there's a potential for the future to make a significant difference.
[00:16:47] Rick: Yeah. And, and on the line of innovation, something I've been following for a while has really been immunotherapy in the treatment for brain tumors. Are, are you working in that arena as well? And what do you see as as upsides or, or the latest news in, in that area of neurosurgery?
[00:17:06] Michael Ivan: Yeah, that's a great question. So we just we just have a new partner, Ash, Dr. Ashish Shaw, who's, who's come in that's really started our immun immunology and oncolytic virus kind of section of brain tumors here at our university. And it's because we see such promise in this area. You know, just like any other therapeutic, you know, the past, we've had a lot of failures.
[00:17:28] It's been, I think a lot of the deployment of this has been kind of blanket, you know, we we're gonna, we come up with a vaccine, we try it on everybody, and then, and then it fails at 90, 95% of the patients and it, we are just unclear of who that 5% is working for. And if. If we could figure out that 5% that it worked for in every trial that we've done and for instance, glioblastoma has had now like 1200 clinical trials that have failed.
[00:17:51] You know, you could, you could then make a difference. And so I think now what's happening is that people are kind of backtracking and trying to really, we have better tools to kind of understand. Who is gonna have their immune system revved up? Who's gonna have their immune? How do we prime the immune system if it's not primed to kind of get it to give the best response once we give these medications?
[00:18:11] And I think that's where the promise is gonna come.
[00:18:14] Rick: Yeah, and I, I'm really pleased to hear that you intentionally recruit. For areas or gaps in the program with a level of content expertise that will round it out, that is laudable obviously, and in, in that regard. And I would say in the context of, of not only treatment, but also research. Is the community, the scientific community, the neurosurgical community, and I would say even the private sector, when we talk about tech and even startups, is there enough communication you know, cross collaboration in those areas, including outside of your field where you could really get that X factor going?
[00:18:54] Where you have that level of innovation that you feel like, yeah, we're really making strides versus other specialties or other areas. How do you feel about that as it relates to neurosurgery and, and, and your practice specifically? I know that's a loaded question.
[00:19:08] Michael Ivan: Yeah, there's a, there's a lot in that question, but I would say that yeah, we are very organized in neurosurgery. You know, there's multiple committees and, and multiple you know, conferences that we are very specifically focused where we all get together. I mean, it's not a large community. If you talk about the number of neurosurgeons, then you talk about the number of, of, of kind of brain tumor neurosurgeons specifically.
[00:19:30] You know, it's not a lot and especially in the US and so we all know each other very well. We, we all talk to each other very frequently about patients and we all share patients. And when we go to these conferences, we're all, you know, it's a, it's a very collegial kind of group that we're all trying to.
[00:19:45] You know, it's us against the disease, right? It doesn't feel like it's us against each other. And and so in that regards, we're all trying to help each other push those different technologies because, you know, as long as somebody figures it out, what the next big thing is, we'd be all be happy.
[00:20:00] Rick: Yeah, and along those lines, thinking about the next generation and the generation after, any comments on education or the programmatic. Commitment of academic medical centers or programs across the country, you see that as something that's positive needs more focus. What's your, what's your thoughts on that?
[00:20:21] Michael Ivan: Yeah, I mean, I think that what we're seeing now is this, you know, big push in technology, which is, you know, includes things like you know, artificial intelligence, machine learning, programming and python and coding you know, high level statistics that are, you know, really multi-dimensional and multi-variate.
[00:20:43] And, and, As we start seeing more and more patient papers that talk about these, these big data sets, you know, this isn't really something that's taught very well in medical school. And so what I'm worried about is, you know, you're gonna come out with data that says, oh, well this, this, and, you know convolution neural network told us to do this.
[00:21:02] And, and there's not gonna be enough people that are gonna be able to dissect that paper and say, you know what, like the variables that you put into that network just aren't capturing everything. And so for that reason, I don't trust it. And, you know, we should really kind of, you know, validate that with X, Y, and Z.
[00:21:18] And so, you know, before it was very simple like, I operate on 10 patients, this is what I found. Here's the statistics and this is what I recommend. And you could, it's very clear, kind of for somebody to dissect that kind of you know analysis and results. But as things become more complicated, and they should, because as I said, this disease is extremely complex and you can't.
[00:21:38] You know, there's too many variables just to do it so simply. But I think the amount of people that could really kind of dissect things and, and ask the right questions and validate it and make sure that all those decisions are correct are becoming less because of just the training that we're getting.
[00:21:53] So I think that the medical school and resident training needs to start kind of including this higher you know, level of, of kind of analysis into the educational process.
[00:22:02] Rick: Yeah. Yeah, and what I heard in your response also was when it came to data was, was, let's say a neurosurgeon's, you know, real world experience with their own cases. Now in the future being augmented by perhaps enormous data sets from other neurosurgeons, which are going to contextually, you know, inform something that every aspiring neurosurgeon's gonna have to understand how to ask it, how, how to query it, and how to get the kind of information out of it where you can make a decision.
[00:22:37] That has the, the kind of specificity and fidelity that's going to be, you know, hopefully advancing the field. I think it's fascinating and there's probably not many specialties that have the number of data points that neurosurgery has.
[00:22:52] Michael Ivan: I mean, there's, there's many specialties that have many complex problems, but I, I do I am excited when I see neurosurgeons kind of adapting you know, this technology and the use of artificial intelligence in spine and brain and functional and all these different areas. When I go to the conferences, it's really exciting to see that we've really taken in, cuz we all believe it, it is gonna help the process, right?
[00:23:15] I mean, it's so hard to do a large. You know, randomized clinical trial to get the final gold standard answer for every question that comes up. And the questions come up faster and faster it seems every day. And so if we keep waiting for these, you know, these clinical trials to get done you know, it's, we're gonna miss things along the way.
[00:23:34] And so what can we do to kind of get to some of these answers faster? And then to kind of really hone in on what clinical trials we need to focus on. And I think that with the use of big data and with with artificial intelligence, that will help.
[00:23:47] Rick: Yeah, lemme stay on the, on the treatment side with that. We, we just heard some promising news from Lilly and the Alzheimer's drug. Looks like it's, it's got some real promise there with respect to the efficacy. One thing I wanted to ask you was, The role of neural interfaces and brain computer interfaces in the, in the future of, of neurosurgery, how might these technologies, you know, impact, improve the lives of patients and the folks who're treating it?
[00:24:14] And, and what does that look like with respect to the patient profile?
[00:24:20] Michael Ivan: Yeah, I mean, man, that's, that's, you could talk for days on, on, on that topic. It's super exciting and there's so many ways that you could use you know, brain inferior interfaces. I, I think for me as a brain tumor surgeon, you know, what could be exciting is that. You know, many times these patients, they present with tumors, they present with symptoms.
[00:24:41] They don't know they've had this until they already have a deficit. And you know, right now the best I could do is I could remove the tumor and try to prevent that from, from getting worse. But I, I think with this ability to kind of augment or improve or rehabilitate, The brain with the use of, of these brain computer interfaces that you could foresee somebody, you know, removing a tumor or removing something in the brain.
[00:25:06] And then at the same time implanting one of these devices to kind of automatically restart the rehabilitation and the kind of the modulation of their brain so that they could kind of have improvement rather than just stabilize.
[00:25:18] Rick: Wow. Really Like jumpstarting it literally.
[00:25:21] Michael Ivan: Yeah, exactly.
[00:25:22] Rick: that's again just fascinating.
[00:25:25] Michael Ivan: Yeah, and we, we've, we've, we worked with that here at Miami. You know, we've done some of this for spinal cord injuries with these patients who are so unfortunate and in a, they live function of their arms and legs. And we had a clinical trial just a few years ago. We were able to implant and actually restore the movement of somebody's hand with, you know, multiple devices working together just by using the patient's thoughts.
[00:25:49] To kind of, you know, mobilize and, and whatnot. What we found is not only can you just kind of, you know, use their thoughts to kind of reprogram their hand movement, but that same device could be kind of connected to multiple devices. It could be connected to a walking device, it could be connected to a car, it could be connected to a computer.
[00:26:04] And so this ability to have one kind of brain computer interface and one spot the brain, then being able to communicate with multiple devices in multiple ways, using the same part of the brain just tells you, you know, that we, we just scratched on the surface of where we could go with this.
[00:26:18] Rick: Yeah, the, I think the impact on on so many lives, so many Opportunities for application. It's just tremendous and I trust that with folks like you and the research that's behind there, we'll get further, faster down the road towards those discoveries. Along those lines, I wanted to ask you and, and look, I'd be remiss my background and, and healthcare administration and certainly on the policy side.
[00:26:46] Do you feel that healthcare systems are keeping pace with the rapid advancements? Do you and I'm, I'm not putting you on the spot, but in general, do you feel like your colleagues are getting the kind of support programmatically so they could meet not only the, the demands from your patient, but really meet the future?
[00:27:04] Michael Ivan: Yeah, it's, it's tough. I mean, I think that, you know, a lot of the technology and a lot of the science we're doing, you know, we don't know what's gonna play out in the end, right. I mean, that's why we're, that's the exciting part of some of this research we're doing is we, we all believe in it. We all think it's gonna make a difference, but, you know, it's hard to predict what one is gonna be the next.
[00:27:24] Game changer in medicine or in neurosurgery. And so, you know, a lot of times we ask, you know, our administration here understands that they've, they've done a great job with trying to invest and, and, and kind of help us with development and, and push pushing the limit and pushing the line forward. But in the end, you know, some of the times this technology is outdated, you know, by the time you get it installed and updated and, and you're using it, and then all of a sudden you find out.
[00:27:48] Oh, you know, the, the version two has come out and it's already much better. And so I think that is challenging for hospital administrations to kind of look at and understand and really put an ROI on and, and, and kind of look at what that's gonna get. But you know, we have, we have systems in place to deal with that.
[00:28:06] And I think As long as we're open with what the, with the, what the, you know, what the patient component would be and the financial costs and what, you know, what the future looks like with everybody, then, then everybody could understand what the risks are.
[00:28:18] Rick: That's good to hear. That really is. Listen, any exciting research collaborations, or are you working with folks on the horizon that you'd want to share with our listeners?
[00:28:28] Michael Ivan: Yeah, I mean, I see. So, so part of my research is, is on the technology side, but then, you know, we know that that technology can only take us so far. It's also the biology that kind of, we, we need to understand. And I think there is technology going on with that as well. So the other part of my research is looking at is that brain invasion.
[00:28:47] And this idea of why do tumors kind of cause this destruction of the surrounding tissue and, and, and surrounding brain. And it's this, it's a interesting question because it's very hard to. Recapitulate, this idea of cell movement and mortality in the lab. And so, you know, one of the other areas of technology that we're trying to, to kind of invest in is this idea of, of looking at organoids or mini brains to kind of recapitulate not just a cellular level.
[00:29:15] But these three dimensional shapes that are kind of, could recap, appreciate all of the different cell types that a tumor may interact with to try to really create better models to understand you know, potential treatments and therapeutics of brain tumors. And then, and then try to correlate that to, you know, the technology and the, and what we're finding in the operating room.
[00:29:35] And to bring those two together is a whole nother set of technology, I think is really exciting. So the use of. Organize and 3D imaging and you know, novel ways to kind of interpret what is going on with these cells is, is is kind of happening at the same rapid pace as I would say the technology in the operating room is as well.
[00:29:53] Rick: I wanted to ask you this, just with respect to your practice specifically. When you think about giving a, a, a description of, of your practice for, for our listeners out there, for folks who are there, what would you say? What's the, the the elevator pitch? When you say, look, there are patients, neurosurgical patients who are out there who should come see you.
[00:30:16] I think this is really an important one for folks to hear.
[00:30:19] Michael Ivan: Yeah, I, I think that. You know, obviously the brain is a very kind of complex area, and so for me, I deal with brain tumors, complex squa complex skull-based tumors. And, and you know, these tumors that are just, many times people would go somewhere else and they say, we can't operate on this. It's just too complex.
[00:30:40] And I think that's where kind of, I, I kind of come in with these very complex cases with the ability of understanding and using ability to use the technology in the lab and, and kind of some of the advanced equipment that we have to kind of. Do smaller openings, more minimal invasive, understand kind of the connections of the brain and and how we could kind of get in and get out safely and, and make a, an important impact into those patients.
[00:31:03] Rick: And I think for, for our listeners who, who maybe aren't familiar with Skull Base, it's really, it's the, it's the location. Shin in, in the brain, in the head that historically has been the most difficult to access. Am I, am I accurate on that?
[00:31:18] Michael Ivan: Yeah, it's this area of the bottom of the brain where you know everything that's in the brain is kind of leaving, and all the information is going through these very small wires that go to your face and to your ears, into your body. And when the tumors occur in this location, you have the communication between the brain going through these small wires that are typically wrapped around the tumors.
[00:31:41] And you know, it becomes quite delicate to kind of remove those in those deep locations without. You know, injuring any of the wires and also without disrupting the brain. And so we have some, some novel kind of techniques and approaches that we do here that are, that, you know, very few places do that we're able to get to those areas and, and remove those, those tumors without disrupting.
[00:32:02] Rick: Hmm. I know you've got a busy day in the or. I've got one last question for you. What advice would you give to aspiring clinicians, researchers? I would, I would even say others who are interested in neurosciences, neurosurgery, pursuing a career in, in research and treatment. It is a long road, and I, I, it, I know that it encompasses an entire life.
[00:32:28] But us the, the, you know your, your words of advice and your perspective.
[00:32:35] Michael Ivan: Yeah. I mean, we have a lot of students that come through here, so, you know, looking through their eyes I would just say, you know, keep that, you know, you have to keep that fire going and the only way to keep the fire going is to constantly, you know, be in touch with what you want to end up doing, you know?
[00:32:51] So there's a lot of. Sidetracks that you have to go along the way, courses and, and schooling and whatnot, that sometimes take you away and you wonder, you know, this is not very fun. But if you're always involved in an area of neuroscience or neurosurgery with a mentor, with a partner or whatnot, that could kind of bring you back to say, this is the real, this is the why, this is why we're doing this.
[00:33:14] This is the exciting part of it. You know, the brain is, is a mystery. It's a black box and, and, Every day we're making exciting new findings about it. And and that's what really motivates me to kind of every day to kind of do all the reading, look at the research, do the teaching, because I know that you know, the, the next discoveries around, around the road or the next person that I kind of inspire could be that person that's gonna be gonna find that next kind of thing that's gonna be critical to pushing the, the, the limit forward in our specialty.
[00:33:45] Rick: The good work you've done already for so many and the work you continue to do even today as we, as we speak after this show it is inspiring and I look forward to having you back on the show and looking at. The accomplishments you have yet to come. Ivan, thank you so much for being on the Healthcare Nation Podcast.
[00:34:05] It's been great.
[00:34:06] Michael Ivan: Thank you. Really appreciate it.