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Jeff Sharman Profile
Jeff Sharman

@jeff_sharman

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Harvard/Stanford trained community practice Heme/Onc - Director of Hematology Research US Oncology - challenging white collar traditions with blue collar moxie

Eugene, OR
Joined June 2013
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@jeff_sharman
Jeff Sharman
2 years
BTK inhibitors have transformed the lives of many patients with Chronic Lymphocytic Leukemia and other lymphomas. These drugs "exploded" onto the scene in 2013-2014 and have fundamentally changed the way we treat the disease. What many people don't know is how it all happened..
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@jeff_sharman
Jeff Sharman
1 year
1/x True story that highlights the loss of autonomy and agency by physicians - the force that results in more burnout than any other: A physician colleague of mine in a different practice that was recently acquired by a major financial firm was on back-up call…..
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@jeff_sharman
Jeff Sharman
1 year
Conclusions: Washington post writing that physicians are overpaid is incredibly oblivious to the reality on the ground - we can’t find enough doctors to hire - and my practice is one of the good ones. Sounds like the market is broken.
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Jeff Sharman
1 year
Conclusion #3 : financial investors who are consolidating ownership of medical practices is one of the worst developments in healthcare and will leave irreparable damage. Avoid such jobs!
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@jeff_sharman
Jeff Sharman
1 year
Conclusion #6 : a wise friend told me, “if you are not sitting at the table, you are likely on the menu.” Docs need to take back control of the practice of medicine or we will be eaten up by our financial masters.
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Jeff Sharman
1 year
Conclusion #2 : autonomy is a value you don’t appreciate until you lose it. Working for an “overlord” that controls your time and effort and doesn’t appreciate your reality is a fast track for burnout
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Jeff Sharman
1 year
Conclusion #5 : if you are “managed” by someone with far less education and experience than yourself and lacks a medical background - watch out - I’ve heard many stories over the years that are equally ridiculous.
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Jeff Sharman
1 year
Conclusion #4 : physicians have delegated business decisions to others for so long that many are now just small pawns in the large machine: find a job where you are closer to the business decisions and you can affect your fate. You will be happier in the long run
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@jeff_sharman
Jeff Sharman
1 year
5/x After 36 hours without sleeping- getting all of his work done early - he let his clinic know he was headed home early to get some sleep before his drive. His “manager” told him he would need to use his allocated “vacation time/pto” if he planned to leave clinic early
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@jeff_sharman
Jeff Sharman
1 year
You may not intend for us to do this on vacation but the reason the tweet went viral is that most of us have to do it that way. Our lives don’t give us big chunks of time to do this. This is our reality and why we reacted so strongly #ENDmoc
@ABIMcert
American Board of Internal Medicine (ABIM)
1 year
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@jeff_sharman
Jeff Sharman
5 years
@RexChapman Dogs love snow
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@jeff_sharman
Jeff Sharman
1 year
@IranRevolut2018 Due to ongoing fallout- I don’t want to say publicly what happened - but you highlight the consequences appropriately. Physicians are viewed as “replaceable widgets” by corporate medicine. They believe the work will get done and frankly are ok with “cost reduction”
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@jeff_sharman
Jeff Sharman
4 years
Came across this photo from residency ⁦ @MGHMedicine ⁩ - year 2 - almost 20 years ago. #etherdome
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@jeff_sharman
Jeff Sharman
1 year
4/x he therefore adjusted his afternoon clinic. He had afternoon patients come in early and worked through lunch in order to finish early. Only two patients had visits cancelled. By working efficiently and through lunch he was able to be done 2.5 hr early
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@jeff_sharman
Jeff Sharman
1 year
He was in a surgical discipline and got called to help in a challenging case that kept him in the or from midnight until 5am. The medical emergency resulted in major trauma to young woman but saved her life
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@jeff_sharman
Jeff Sharman
1 year
Since clinic started only a few hours later he stayed at the hospital and then began seeing patients at 8am as though it was a regular day. He was planning on driving to Portland after work for a family event but was concerned about sleep deprivation and a long drive
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@jeff_sharman
Jeff Sharman
1 year
Now accepting nominations for “dad of year award” T-Swift in Nashville (props to my wife Anne for making it happen) - thinking of using the shirt during next ASH conference presentation
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@jeff_sharman
Jeff Sharman
1 year
Conclusion #7 : physician income has been squeezed for decades. blaming docs for cost of healthcare is a fundamental misdiagnosis. If Washington and the profiteers keep extracting concessions from md’s - insurance will not be the barrier to care but provider supply will be
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@jeff_sharman
Jeff Sharman
4 years
Phase 3 study results leading to fda approval of #acalabrutinib for untreated cll. Good evidence of safety and efficacy. Grateful for the team that brought this to fruition
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@jeff_sharman
Jeff Sharman
4 years
Re: #COVID19 / #Hydroxychloroquine - single arm phase 2 data is the scientific equivalent of a hypothesis - don’t confuse larger number of uncontrolled patients as evidence - it is only the volume with which you are yelling. Proof requires randomized studies @VPrasadMDMPH
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@jeff_sharman
Jeff Sharman
2 years
What happened next was beyond anything I could ever imagine and has been turned into a novel that was published this week.
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@jeff_sharman
Jeff Sharman
5 years
Ash abstracts are online! Here you go cll world. Think about this for a few minutes!
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@jeff_sharman
Jeff Sharman
1 year
3rd year oncology fellows: We're hiring for our Eugene practice. Join a top 10% MGMA practice with incredible clinical research and sub-specialization opportunities. 4d clinic schedule with pretty light hospital responsibilities. Group includes rad onc / Gyn onc and 25 docs!
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@jeff_sharman
Jeff Sharman
2 years
Like many in the book - I never made a penny off of the original idea, but I am very proud that an idea I brought forward has resulted in so much good for so many patients
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@jeff_sharman
Jeff Sharman
1 year
Genuine question to spark discussion on behalf of hematology-oncology fellows: What are the benefits of staying in an academic institution versus community practice? Thoughtful replies only please
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@jeff_sharman
Jeff Sharman
4 years
Oregon in summer: beautiful
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@jeff_sharman
Jeff Sharman
1 year
For hematology-oncology fellows wondering how to continue clinical research in their careers, the newly combined US Oncology / Sarah Cannon Research Institute is the biggest platform in the world. 20% US patients treated in our network. @VPrasadMDMPH
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@jeff_sharman
Jeff Sharman
10 months
Multiple myeloma - frontline quad therapy validated in high quality Ph3 study: HR = 0.42 ASH - late breaking abstract!
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@jeff_sharman
Jeff Sharman
2 years
Who’s with me? Epic is a giant cash register beloved by hospital administrators powered by the non-rechargeable batteries of physician souls
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@jeff_sharman
Jeff Sharman
1 year
Lots of graduating Heme-onc fellows prioritize geography over job characteristics because they don’t know what is out there. Important “personal finance question” to ask yourself - “what does my geographic preference cost in the long term?”
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@jeff_sharman
Jeff Sharman
1 year
Trying to hire a medical oncologist for Florence Oregon (Beautiful Oregon coast) position. Incredible work/life balance position. 2-3d work week, no hospital coverage, competitive pay / negotiable. DM me
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@jeff_sharman
Jeff Sharman
1 year
@AaronGoodman33 This is professionally indefensible. In an era where physician shortages are already limiting access to care, and burnout threatens to drive many others from the field - "hey, why don't you just work through your vacation" seems uniquely tone deaf. #MOCery
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@jeff_sharman
Jeff Sharman
4 years
#IGotTheShot #CovidVaccine Glad that vaccinations in my community outpace new infections. Thrilled to get myself vaccinated #backtonormal life
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@jeff_sharman
Jeff Sharman
3 years
At our hospital 4% of patients admitted for COVID were fully vaccinated. The remaining 96% were either unvaccinated or partially vaccinated. I am having trouble getting some procedures scheduled for my cancer patients who need care. Please be kind to your neighbors - vaccinate
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@jeff_sharman
Jeff Sharman
10 months
A lot of implications from this MCL late breaking abstract! 1) Ibrutinib approval previously withdrawn in MCL? Time to revisit? 2) Does this combo data impact choice of BTK in r/r MCL? 3) New SOC in eligible patients? 4) Are age related toxicities the same in CLL/MCL?
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@jeff_sharman
Jeff Sharman
1 year
I've been working on this molecule for a decade. A long journey but finally across the finish line. Huge props to Calvin Lee, Jamie Hirata and Wayne Chu, who carried it a long way FDA Approves Polatuzumab Vedotin Plus R-CHP for Treatment-Naïve DLBCL ()
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@jeff_sharman
Jeff Sharman
4 years
Year 5 of “daddy / daughter” backpacking trip in the books!
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@jeff_sharman
Jeff Sharman
1 year
Attn: 3rd Yr Onc fellows: Do you know what a "puppy mill" job is? Watch out for private practice jobs where there is no chance you will ever make partner! Ask about every doc in practice that has left and why. Don't get "used" for 3-5 years then leave unhappy!
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@jeff_sharman
Jeff Sharman
1 year
3rd year onc fellows: the “highly desirable” urban locations to work are often the most expensive - but also associated with lowest earning potential. This is due to contracting strength and independence from dominant health systems ⁦ @HemOncFellows
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@jeff_sharman
Jeff Sharman
3 years
I was in a high school jazz band with #taylorhawkins who went on to become iconic rock drummer with #FooFighter . Sad to learn of his death. He was a lot of fun to be around although he gave our conductor heartburn.
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@jeff_sharman
Jeff Sharman
1 year
Recent questions on "specialization" in community practice. I call it "regionalization." This week I see: CLL =28 pts Indolent NHL = 8 Aggressive lymphoma = 5 Myeloma = 8 Myeloid / benign heme = 10 Solid Tumor = 11 4d work week about 70 pts. I love the mix / diversity
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@jeff_sharman
Jeff Sharman
1 year
@AaronGoodman33 Information - interpretation = anxiety
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@jeff_sharman
Jeff Sharman
1 year
Summer fun in Oregon! We have the best outdoor opportunities
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@jeff_sharman
Jeff Sharman
2 years
It took a year for the first cohort to enroll which is a disaster for a small biotech so Pharmacyclics reached out to my new group to see if we could assist enrolling patients into the study. Shortly thereafter I treated the first CLL patients in the world with ibrutinib
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@jeff_sharman
Jeff Sharman
1 year
Very cool when world renowned leaders in oncology begin to grasp what we have built and decide that the grass can be greener on our side of the fence. @VPrasadMDMPH @HemOncFellows @TheFellowOnCall @OncBrothers @JCO_ASCO @ASH_hematology
@VivekSubbiah
Vivek Subbiah, MD
1 year
1/2 📣IT’S OFFICIAL📣 Honored to join the @SarahCannonDocs #SCRI as the Chief, Early Phase Drug Development. The next generation of #personalizedmedicine is here and now more than ever, we call for rapid & efficient access to #precisiononcology #clinicaltrials for our patients
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@jeff_sharman
Jeff Sharman
1 year
@DGlaucomflecken This provides an obvious satirical glimpse into the reality of modern healthcare - but the satire and the reality are far too close for comfort. This direction will be the end of quality in medicine (what is left of it)
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@jeff_sharman
Jeff Sharman
5 years
Lugano!
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@jeff_sharman
Jeff Sharman
2 years
I love being a doctor and I would never trade that experience for the fortune I may have made had I followed the idea into industry... a choice that would have fundamentally re-routed the course of my life
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@jeff_sharman
Jeff Sharman
2 years
In 2004 I became convinced that turning off B-cell receptor signaling would cause cancerous b-cells to stop growing. This theory came into focus based upon an understanding of epstein barr virus protein LMP2A, EBV relationship to Hodgkin lymphoma, and other breadcrumbs
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@jeff_sharman
Jeff Sharman
1 year
When your daughter has been gone for a month in Taiwan - the proper way to welcome her back….
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@jeff_sharman
Jeff Sharman
1 year
@chadinabhan @ilanayurkiewicz Physician work force is collapsing. Efficiency of employed docs is 30% less that physician owned practices (and more expensive). Add in impact of baby boomer retirement, decreased work intensity in rising generations….
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@jeff_sharman
Jeff Sharman
2 years
As the physician scientist who first proposed inhibiting bcr signaling and a bit character in the book - I wish I had taken this “crash course” before becoming a clinical trialist #imbruvica #calquence
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@jeff_sharman
Jeff Sharman
4 years
Oregon cascades + family = good living
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@jeff_sharman
Jeff Sharman
5 years
Getting ready for an exciting ash! FDA Approves Acalabrutinib for CLL via @onclive
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@jeff_sharman
Jeff Sharman
5 years
This made me laugh hard. Just watched the movie with my kids recently. Now it is a cll research meme! Thanks to whoever created this!
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@jeff_sharman
Jeff Sharman
2 years
So much progress in CML and CLL - saw two patients in clinic today who together had combined WBC count of 1400 (two separate patients with WBC > 700K) within the last month. Both doing remarkably well! #physiology
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@jeff_sharman
Jeff Sharman
1 year
Didn’t see this coming- ibrutinib accelerated approval going away in mcl and mzl…. Wow!
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@jeff_sharman
Jeff Sharman
11 months
Excited for the next installment in the history of BTK inhibitors - this time from the perspective of a drug developer. Coming out this summer - preorder now! @nathanvardi
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@jeff_sharman
Jeff Sharman
11 months
To any doctor practicing medicine: This video gives us a 45 second call to action with concrete step to take. It is a moral imperative to do so. Lose this battle and we sacrifice our dignity and our profession
@DGlaucomflecken
Dr. Glaucomflecken
11 months
🚨PRIOR AUTHORIZATION REFORM🚨
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@jeff_sharman
Jeff Sharman
4 years
The Pacific Northwest is magical. Just discovered this gem 30 min from home. Looking forward to our new summer swimming hole!
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@jeff_sharman
Jeff Sharman
3 years
One of the biggest questions in cll right now is what drug to partner with venetoclax. Btk or cd20? Lots to answer here
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@jeff_sharman
Jeff Sharman
4 years
@adamcifu When will we stop criticizing hypothesis generating studies because they don't meet the "randomized placebo controlled phase 3 trial" standard. These are important studies because they are building blocks in our understanding. They are not proof, but they are a start.
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@jeff_sharman
Jeff Sharman
5 years
Mato: important new btk options when resistance develops
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@jeff_sharman
Jeff Sharman
5 years
When you build a hospital on top of a hill and have worst roads for access anywhere... one cool solution is a spectacular tram ride with views of the cascades
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@jeff_sharman
Jeff Sharman
11 months
@AaronGoodman33 He was my chief resident along with Levi garaway (Genentech) and sek katheresian (verve)… id say we had a kick ass group
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@jeff_sharman
Jeff Sharman
2 years
I decided the best way to turn off the receptor would be to use drugs which shut off the signaling pathways emanating from the B cell receptor - notably SYK. Fortunately Ron Levy M.D. of Stanford was willing to let me test the hypothesis in the laboratory
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@jeff_sharman
Jeff Sharman
1 year
@IshwariaMD a lot of room for confounding variables here? @VPrasadMDMPH
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@jeff_sharman
Jeff Sharman
6 years
Median age of frontline fcr in cll from landmark md Anderson study = 57 years. In the rest of world that cannot travel / afford mda - average age =74 at 1st rx. Many died from therapy because data didn’t export to “real world” well
@chadinabhan
chadi nabhan MD, MBA, FACP
6 years
We manage 95% of US adult cancer pts based on data generated from the 5% that are treated on clinical trials;& trial pts R younger, less co-morbidities, able 2 travel 2 trial sites, more caucasians, & have better psychosocial support. That’s the “real-world” I keep talking about.
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@jeff_sharman
Jeff Sharman
2 years
Looking forward to the main event! My kiddo throwing at oregon relay!
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@jeff_sharman
Jeff Sharman
2 years
He had PCI-32765, a molecule that inhibited the next enzyme in the BCR signaling pathway - BTK. Based upon our experience with fostamatinib, we set up a consulting agreement and I helped design a study to test ibrutinib in patients with NHL/CLL
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@jeff_sharman
Jeff Sharman
1 year
I think they are not expecting anyone to challenge their “evidence” but it is circumstantial at best and insulting when you get to #5 . They clearly don’t regard this effort seriously - labeling them “myths” #ENDmoc
@VPrasadMDMPH
Vinay Prasad MD MPH
1 year
ABIM is sending out these talking points. Look at #1 You have to have a concussion to think these absolutely TRASH papers prove MOC has value. ABIM needs CME in evidence appraisal. For 20 million a year, I offer to teach them @doctorwes @AaronGoodman33
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@jeff_sharman
Jeff Sharman
2 years
I am also very grateful for the incredible hard work put forward by so many others without which the drug would have never made it so far.
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@jeff_sharman
Jeff Sharman
4 years
Found an even older class photo - was this intern year? Why the older residents in the photo ⁦ @MGHMedicine ⁩ ⁦ @DrRoderickTung ⁩ ⁦ @RickLee6 ⁩ ⁦ @ekgpdx
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@jeff_sharman
Jeff Sharman
4 years
I love watching as “big evil corporations” and “greedy pharmaceutical companies” scramble to save our asses while the government inept dawdling flounders. Yet some would have us believe more government is the solution??? #COVID19
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@jeff_sharman
Jeff Sharman
2 years
I acquired #fostamatinib from #RigelTherapeutics and set to work - quickly learning that I didn't belong in the lab at all (not my skill set) Fortunately, others came to the similar idea and shortly thereafter we began testing the compound in patients with lymphoma
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@jeff_sharman
Jeff Sharman
2 years
At the time #pharmacyclics was a zombie company almost left for dead but Richard Miller MD was at the helm and saw my patients with me at Stanford receiving fostamatinib. I explained to him the hypothesis of BCR signaling inhibition which turned into a critical moment
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@jeff_sharman
Jeff Sharman
1 year
@AaronGoodman33 Nice work if you can get it.... Glad to know our MOC dollars are hard at work
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@jeff_sharman
Jeff Sharman
1 year
Dr Rajkumar - I totally agree and find their silence thus far disappointing. This will be an interesting litmus test of their loyalties
@VincentRK
Vincent Rajkumar
1 year
I urge our professional societies including @ASH_hematology @ASCO to advocate for us on ABIM MOC. We support our societies with our dues and participation. By 99:1 membership opposes ABIM MOC. We need your advocacy. #MedTwitter
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@jeff_sharman
Jeff Sharman
1 year
@TheRealDoctorT The difference is profound and yet easy to understand. Private practice is incentivized to do good work to build a business. In academia, working harder doesn't necessarily yield material benefit. It accrues to the institution - so the motivation is to do the least necessary.
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@jeff_sharman
Jeff Sharman
1 year
I'm going to keep adding pictures of Florence periodically until we get someone interested joining our group with elite MGMA performance, incredible research opportunities. This is perfect job for anyone wanting to balance quality of life and favorable work!
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@jeff_sharman
Jeff Sharman
4 years
Sad to me that most people's opinion about mask is informed more by politics than by science. Thought this summary article was fascinating about volume of cough cloud with and without different masks
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@jeff_sharman
Jeff Sharman
4 years
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@jeff_sharman
Jeff Sharman
1 year
@calliecoombsmd Enormously important study for the field. Thank goodness for German CLL research! They school us in large CLL studies. Now we need data for optimal doublet BTK/Ven vs CD20/Ven - MAJIC anyone?
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@jeff_sharman
Jeff Sharman
6 years
Post 1d of #ash18 #cll meetings I believe: 1) ibrutinib beats chemo immunotherapy 2) cit contraindicated in 17p and unmutated frontline CLL 3) in r/r disease targeted regimens are superior to chemo
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@jeff_sharman
Jeff Sharman
5 years
Matt Davids - one of the best in our field with clear take home points! Thanks Matt
@Lymphoma_Doc
Jason Westin, MD FACP
5 years
Excellent summary of #ASCO19 CLL oral abstracts by @DrMDavids with key takeaways below: #lymsm
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@jeff_sharman
Jeff Sharman
1 year
@AaronGoodman33 @msf33178 There are three values you get to chose from in a career in medicine: Geography (city/family/school/etc) Ratio of compensation to effort (are you paid well for your effort) Existential (job has meaning, autonomy) 2/3 is pretty good job 1/3 is common
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@jeff_sharman
Jeff Sharman
1 year
@chadinabhan @VPrasadMDMPH @VincentRK @DrMatasar @DrMDavids @mshadman @PamelaKunzMD @dapattmd The scorn I got for leaving academics was significant and uncomfortable - it was clear that I was violating their sense of professionalism - yet I feel like I've done more in community medicine than I ever could have in academia
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@jeff_sharman
Jeff Sharman
5 years
2014 CLL11: Clb vs G-Clb vs R-Clb 2015: RESONATE-2 Ibrutinib vs Clb 2015: Complement-1 Ofa-Clb vs Clb 2019: Illuminate Ibr-Gzv vs Gzv-Clb 2019: CLL14 Gzv-Ven vs Gzv-Clb 2019/20: Elevate-TN, Unity-CLL - both Gzv-Clb #venetoclax #ibrutinib #gazyva #acalabrutinb #umbralisib
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@jeff_sharman
Jeff Sharman
6 years
@anthonymatomd @sloan_kettering @PennCancer Anthony Mato leading the way. Unquestioned leader of #CLL -2.0 - from breakthrough to knockout!
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@jeff_sharman
Jeff Sharman
2 years
@Gabby_Brauner27 Can’t find a primary care doc because….???? A: most can’t afford to go into primary care due to accumulated debt relative to income expectations
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@jeff_sharman
Jeff Sharman
4 years
@toddstarnes 4/20,000 patients treated with the vaccine. Thanks- happy to take my chances with the vaccine over my chances with the virus any day. Hospitalization and death are not the only measures of harm caused by covid.
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@jeff_sharman
Jeff Sharman
5 years
If hospital administrators take bonuses after staff have died for lack of #COVID19 ppe - the rage will be like none we have seen before
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