At the ASCO Annual Meeting last month, I was privileged to receive the ASCO-American Cancer Society Award for cancer control. This mainly was due to my founding and developing QOPI with an amazing group of other volunteers and ASCO staffers. We began in late 2002 assembling the pilot practice groups that hammered out the first quality measures and the processes. In 2007 QOPI was opened to any ASCO member's practice. QOPI has grown dramatically since then, with more than 500 practices now registered and more than 20,000 charts reviewed twice a year. (See news article on page 34 of this issue.)
In the past year, QOPI has developed a voluntary certification program which, unlike basic QOPI, gives each practice a performance score, audits their charts, and makes random site visits to practice sites. Also, practices must pay a fee to go through the certification process, while basic QOPI is a free service to ASCO members.
Gradually, as with every growing venture, the “mom and pop” nature of QOPI administration has become more complex and ASCO has gradually invested substantially in staff and funds. ASCO has installed committee structures, formal oversight, and administrative management to handle the increasingly sophisticated program. QOPI has become one of the most important ASCO programs.
As with any transition from a small founding group to a larger “corporate” team, there are gains and losses. We now have a much better staffed, more flexible system that has the capacity to grow and implement more uses and applications for participants. We inevitably lose the intimacy of a small group—those who “marched with Mao,” so to speak.
For me a better example of this phenomenon is my experience at St. Jude Children's Research Hospital. When I went there in 1967, St. Jude was only five years old and had only a handful of scientists and physicians. We all knew each other—the electricians and plumbers, the cafeteria workers, and many others at all levels. We could fit everyone in a small auditorium for our annual Christmas skit/party. It had a family atmosphere.
But during my 24 years there, the staff and physical plant grew steadily. And by the time I left in 1992, it was no longer a mom and pop operation but an internationally influential force in oncology and science. The same is becoming true of QOPI. I am confident in QOPI's future because the ASCO leadership continues to provide strong support.
Closeness & Sheer Fun
However, an indication of the closeness and sheer fun enjoyed by the 23 initial physician volunteers and small ASCO staff is depicted in the artwork that accompanies this column. These images were dreamed up by one of the original seven QOPI members, Dr. Mike Neuss.
The first is a photo of a metal medallion with the body of Obi-Wan Kenobi from Star Wars. Mike's son, also a Michael, did the Photoshop job of transferring my head onto the body of Obi-Wan, thus creating QOPI-Wan. It shows me cutting a dashing figure, impossible in real life. We wore these medallions at the ASCO Annual Meeting that year and they became a hot item…fortunately we had plenty.
The next picture morphs Yoda, the wise Jedi Knight and teacher, into Joda, the old bald guy trying to make a go of the QOPI project. This is the favorite of my former secretary who wanted to keep it when I left the University of Florida. I think she likes it because it does such a good job of identifying the 10 or so lonely hairs left on the top of my head. Note the Italian flag (my roots) and the pediatric text in the background. This and subsequent pictures were painted by Mike's neighbor, Chris Payne, a professional artist.
The third painting channels the famous Norman Rockwell painting, putting my head on the doctor. This is my favorite because I love Norman Rockwell's paintings and I am, after all, a physician and pediatrician. The child in the Rockwell painting is a girl who was replaced in this picture by a boy; he is the son of Kristen McNiff, MPH, the ASCO staffer who did a magnificent job getting QOPI going and managing a bunch of volunteer doctors.
The fourth picture is the only one I actually posed for. I was visiting Cincinnati and had dinner with Mike Neuss and his family at his home, along with the artist, Chris Payne. Chris brought a hat shaped like Uncle Sam's, which I put on, and then I made the finger-pointing pose. He took a few photos and did the painting from them. We had opened QOPI to all ASCO members that year, so a recruiting poster seemed apt.
The final picture is, in some ways, my favorite. It shows the Wizard of Oz characters embarking on the yellow brick road, a future with hope and optimism. The Tin Man is Mike Neuss, the Cowardly Lion is Peter Eisenberg, I am the Wizard, Kris McNiff is Dorothy, Joe Jacobsen is the Scarecrow, and another ASCO staff stalwart, Pam Kadlubek, MPH, is the Good Witch of the North.
All of us who worked on QOPI are proud of its development and importance and remain very optimistic about its future. I have fond memories of those early days, but it is time for QOPI to move on to bigger and better things.