From CT Surgery in the U.K to Studying Business at Wharton — A Conversation with Dr. James Buxton (Episode #47)
On this episode of Penn HealthX’s Podcast, co-president Ryan O’Keefe spoke with Dr. James Buxton, a fellow Wharton MBA, and physician from the UK, from his residence across the pond. Dr. Buxton shares his unorthodox career path, sheds light on US vs. U.K. healthcare systems, and touches on how his life has been impacted by COVID-19.
Pathway to Medicine: A Life of CT Surgery in the U.K.
Dr. Buxton reminisces about the inciting forces that enticed his entry into the medical field, recalling two events, in particular, that stand out in his mind. A brutal jaw injury mid-rugby game turned into a career-piquing opportunity when he dialogued with his care team prior to surgery. However, prior to his injury, he was no stranger to the wonders of surgical medicine, as his younger brother was the third successful recipient of an arterial switch operation for congenital transposition of the great arteries. The two experiences helped propel him into medical school, which in the UK is combined with an “undergraduate” degree. His early exposure to bypass surgery further enhanced his interest in cardiothoracic surgery; it’s remarkable to “kill someone and bring them back to life,” he remarks. He completed a one-year clinical fellowship followed by a two-year core surgical training program.
Exposure to the Entrepreneurial Spirit
During his clinical fellowship, Dr. Buxton describes his involvement with an online platform-based healthcare start-up called Locum’s Nest that he managed to squeeze in between seeing patients (which to me is on-level with the medical miracle of arterial switch surgery). The experience engendered a genuine passion for improving healthcare inefficiencies he experienced in the clinic. He describes his frustrations with the practice of charging administrative executives to make clinical decisions without formal clinical training and the converse practice of tasking senior physicians with the job of making managerial decisions without business training. As a result, he decided to pursue an MBA. Seeking to expand his world experience and to capitalize on the unique training programs for MD/MBAs in the United States, Dr. Buxton enrolled at Wharton. His resolve centered around wanting “to try to break out of the narrow stereotype of doctors here in the U.K.”
Healthcare: U.S. vs. U.K.
Dr. Buxton’s unique experience in healthcare and healthcare business spans both countries, which provides him with a unique perspective and the ability to adroitly compare and contrast each system’s strengths and weaknesses.
· Pros in UK:
o centralized system for data collection (perfect interoperability)
o more coherent screening programs and health strategies across the country,
o provisions and access more ubiquitous than across heterogenous U.S. states
o $12,000 pounds for all of medical school to U.K. citizens
· Cons in UK:
o Inefficient about using collected data (sitting on untapped treasure trove)
o 50–60% of students completing foundational medical training leave the country or do not pursue higher-level medical training in the U.K.
Though progress in data analytics in the U.K. has been slow, Novartis, the NHS (National Health Service), and Oxford University recently announced a collaboration in a large-scale cohort study of aPCSK9 inhibitor siRNA targeted therapy for LDL reduction. Dr. Buxton hopes that this will be the first of many partnerships aimed at using collected health data for public benefit.
The Future: COVID-19 and Beyond
After possibly contracting and successfully recovering from COVID on his way back to the U.K., Dr. Buxton describes the country’s recent call for physicians past, present, and future to the front lines of the crisis. He plans on reentering the hospital as a practitioner in July or sooner, as his licensure will not expire in the U.K. for another five years. Graduating medical students’ practical exams were suspended across the country, and a number were given early registration to practice on the front lines. Even upon retirement, physicians in the U.K. retain a general medical license number, which facilitates the rapid contact of physicians if the need arises. He will likely practice in an emergency setting, especially aiding ventilator patients requiring tracheostomies. Though Ryan and Dr. Buxton joke about him “being a bit rusty” at first, their sentiment has been proactively addressed by the government, which has put together online learning modules for COVID care (ventilator, biomarker, and treatment algorithms). “Much like pre-lecture reading,” Ryan ruefully jokes.
Beyond COVID, Dr. Buxton’s future plans are ambitious and impactful:
1. To get involved in biopharmaceuticals and biotechnology industries
2. To become a healthcare public policy advisor or political figure in the U.K.
This summer he’ll be spending time at a big bank in the U.K. learning the ins and outs of hedge fund management. One thing is for sure in this uncertain time: Dr. Buxton has an incredibly bright future ahead of him, and we’re excited to see where his passions take him.
