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Mavens of Medicine: Q&A With Dr. Yaron Tomer

Yaron Tomer, M.D., is professor and chair of medicine and the Anita and Jack Saltz Chair in Diabetes Research at Einstein and Montefiore. He was recruited from the Icahn School of Medicine at Mount Sinai, where he served as division chief of endocrinology, diabetes, and bone disease. Dr. Tomer is an active researcher, with a focus on finding the genetic and environmental factors that trigger autoimmune thyroid disease and type 1 diabetes.

Why did you choose endocrinology?
I wanted a specialty that requires analytical problem solving. In endocrinology, nearly every clinical scenario is a puzzle that you need to solve. In addition, when you’re seeing a patient with an endocrine condition, solving the puzzle requires considering not only the clinical symptoms but also the molecular mechanisms that could explain the problem.

What influenced you to come to Einstein in 2015?
Of the many reasons, there were three unique attractions. First was Einstein’s and Montefiore’s commitment to social justice and to the Bronx community. Second was my ability as chair of medicine to have a much broader impact on patient care at a time when the U.S. healthcare system is undergoing a historic transformation from fee-for-service to value-based care. Finally, the merger between Einstein and Montefiore had just been announced, and leading the department of medicine during the unification presented an exciting opportunity to me, as well as a great privilege.

Do you have plans for promoting even closer ties between Einstein and Montefiore?
One of my goals is to create more bench-to-bedside collaborations, bridging basic research at Einstein with Montefiore’s clinical capabilities. The new Fleischer Institute for Diabetes and Metabolism exemplifies what we aspire to achieve. The institute includes a new clinic we opened at 1180 Morris Park Avenue for treating patients and enrolling them in translational research and clinical trials.

Any initiatives to improve patient care?
Improving patient care is my highest priority. Drs. Sharon Rikin and Sarah Baron direct ambulatory quality improvement and inpatient quality, respectively, and are leading numerous projects.

A year ago Dr. Rikin launched a very successful program called eConsult, a unique way to improve primary-care patients’ access to specialty expertise. A physician submits a request in the patient’s electronic medical record for a specialist’s help; a dedicated specialist then determines whether a face-to-face consultation is needed or if the specialist can give advice remotely. This initiative has reduced the number of face-to-face consults by 55 percent, meaning that the majority of patients no longer have to wait weeks to see a specialist. We plan to expand eConsult throughout the medical center.

What about on the inpatient side?
Dr. Baron and members of the infectious diseases division are leading a highly successful effort to reduce the number of hospital-acquired C. diff infections, a serious and costly complication. In addition, Dr. Baron just launched a new task force to improve glucose management among inpatients with diabetes and other conditions.

What are some Bronx health problems that you’re addressing?
First and foremost is the opioid epidemic, which has hit the Bronx harder than many other communities. We recently established an addiction center at Montefiore, under the leadership of Dr. Chinazo Cunningham, to better care for patients with addiction disorder. Other examples include programs to meet the huge need for early detection of cancer and to care for patients with asthma, chronic obstructive pulmonary disease, and chronic kidney disease. We’re also involved in a large project that screens people for hepatitis C and treats those found to be infected. So far, several hundred hepatitis C patients have been cured through this initiative.

Could you discuss an aspect of your own research?
My research focuses on two autoimmune endocrine diseases—autoimmune thyroiditis and type 1 (autoimmune) diabetes. Our goal is to block the T cells that attack the thyroid in thyroiditis and the pancreatic islets in type 1 diabetes. We’ve discovered a compound, which we’ve patented, that shows promise for treating autoimmune thyroiditis by blocking antigen presentation and T-cell activation. We’re now developing other compounds for treating type 1 diabetes in the same way. I’m excited and hopeful about attempting to translate our mechanistic research findings from the past 20 years into new potential therapies for autoimmune thyroiditis and diabetes.

Have you read any good books lately?
The last book I read—The Martian, about survival against all odds—made a great impression on me. It’s better than the movie, and I highly recommend it.

What do you miss about Israel, your native country?
Most of my family lives there, and I miss seeing them more frequently, especially during the holidays. And I miss being able to go to the beach almost every weekend. It’s like Florida weather there.

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