Advancing the Science

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April 4, 2019

The lowdown with Dr. Bharucha: Gastroenterology researcher and clinical trials guru

By Caitlin Doran

Adil Bharucha, M.B.B.S., M.D.

For Adil Bharucha, M.B.B.S., M.D., research is a passion nurtured over time. A passion, he says, that came to him, not in a dazzling “a-ha moment,” but slowly, through the encouragement of mentors, the exhilarating feeling of discovery, and the compassion he felt for his patients—“through osmosis,” he says.

He began his medical studies at University of Bombay, in India and then came to the United States, where he accepted a residency, then a fellowship, in gastroenterology at Mayo Clinic, and later joined the staff.

Now, 27 years and more than 200 research papers later, he is director of the Office of Clinical Trials, in the Mayo Clinic Center for Clinical and Translational Science.  Under his leadership, the Office of Clinical Trials works with study teams and sponsors to facilitate clinical trials that accelerate the translation of medical discoveries into patient care.

Dr. Bharucha looks back on his career, the opportunities he has been given and the good work he has accomplished, and feels incredibly fortunate. “I did not dream I would have the opportunities I do today,” he says. “I’ve worked hard, but a lot of it feels like serendipity to me. I was at the right place at the right time.”

He was also interested in an area of research—having to do with the digestive system, the intestines, the bowels—which, at the time, wasn’t popular with other scientists. “There was urgent patient need but, frankly, not a lot of enthusiasm from researchers,” he says.  “I saw that as an opportunity to make a difference.”

Mayo Clinic Public Affairs recently sat down with Dr. Bharucha to learn more about his zeal for gastroenterology research and to find out what drives his keen interest in optimizing the conduct of clinical trials

A portable device, invented by Dr. Bharucha and a Mayo colleague, for evaluating patients with constipation or fecal insentience. In the past, these tests were usually performed in specialized laboratories. With this device, the tests can be performed at the bedside, enhancing efficiency and patient satisfaction. The product has been licensed to Medspira, Inc.

How did you become interested in researching gastroenterology?

I became interested in gastroenterology, in part, because of an early interest in neurons. Did you know that the gastrointestinal tract has more neurons than the spinal cord?

When I came to Mayo Clinic as a resident, my advisor, Dr. Gores, saw my passion and my desire to conduct mechanistically-based clinical research studies and suggested I work with Dr. Camilleri, an expert in gastrointestinal motility disorders, such as dyspepsia (indigestion), gastroparesis, irritable bowel syndrome, chronic constipation, and fecal incontinence.

"Doing research has made me a better doctor."
— Adil Bharucha, M.B.B.S., M.D.

These are some of the most common health conditions, but they’re poorly understood and treatment options are limited.  There’s a lot of patient need in this area, but unfortunately, at the time, there were not a lot of researchers who wanted to pursue these topics. That piqued my interest. I knew I had an opportunity to contribute to finding solutions for patients.

Why do you think it’s important for a doctor to be involved in both patient care and research?

Doing research has made me a better doctor. 

A lot of patients come to Mayo Clinic because they know that doctors, like me, are also involved in researching their conditions. Patients are relieved to hear their symptoms can be explained and that I’m engaged in the search for answers.

In addition, my involvement in research trains my brain to think about problems from many different angles. It often helps me identify out-of-the-box solutions for patients.

Left to right: Gregory Gores, M.D., Kinney Executive Dean for Research; Gianrico Farrugia, M.D., president and CEO; Henry Schultz, , M.D.; Sidney Phillips, M.D. (left); Michael Camilleri, M.D. (right), accepting a teacher of the year award; Rolf Hubmayr, M.D.; Joseph Szurszewski, M.D.

What role have mentors played in your career?

Mentors have played key roles at almost every turning point in my career.

  • I interviewed for my second year residency at Mayo with Dr. Schultz, who embodies the very best of Mayo. I was start-struck and I was convinced I wanted to come here to work.
  • Early on in my career at Mayo, Dr. Camilleri, Dr. Phillips, and Dr. Hubmayr encouraged me to pursue research and helped guide my choices since I didn’t have a formal plan.
  • I received considerable support from mentors when I applied for and received my first National Institutes of Health grants. Receiving those grants provided critical strategic direction for my career, giving me opportunities to focus on epidemiology and the mechanisms of pelvic floor disorders.
  • It was a mentor who convinced me to focus my research on anorectal dysfunctions. I recall vividly the day Dr. Phillips took me aside at a formal dinner to talk me into it. He could be very persuasive.
  • More recently, under Dr. Szurszewski’s and Dr. Farrugia’s leadership, I have been involved in an NIH sponsored study of how diabetes mellitus affects the gastrointestinal tract.

All along the way, mentors have helped guide my choices and have helped make me a better doctor and researcher. They’ve also prepared me for my current leadership position as director of the Office of Clinical Trials.

What is the role of the Office of Clinical Trials in research at Mayo Clinic?

The Office of Clinical Trials supports the Mayo Clinic research priority of strengthening clinical trials by helping Mayo Clinic attract and conduct high-impact trials that bring hope and solutions to patients.

Researchers often encounter unanticipated challenges and roadblocks as they try to get clinical trials activated and off the ground. The office provides resources and support to blast through those roadblocks, as well as expert guidance to keep issues from arising in the first place.  It’s the support I remember getting from my research mentors, but on a much larger scale. We’ve created a whole office focused on this specialized support that is set up to assist researchers across Mayo Clinic.

Why do you think optimizing clinical trials is so important?

Patients are waiting and clinicians are eager to do more amidst their hectic schedules. That’s what motivates me in my leadership of the Office of Clinical Trials. Clinical trials bridge the gap between research and patient care. If the office can help optimize this process, we’ll be able help more patients.

At Mayo Clinic, the research of today is the clinical practice of tomorrow. Many patients come to Mayo because of the opportunity to receive cutting-edge therapy afforded by clinical trials. They come here looking for help they can’t get anywhere else.

Optimizing clinical trials is also good for physicians and scientists. They’re able to partake in research that not only satisfies their intellectual curiosity, but that also is more likely to have an impact for patients.

Can you provide an example of an important challenge that the Office of Clinical Trials has helped to resolve?

When I began this assignment as director of the Office of Clinical Trials, one of our first priorities was to reduce the amount of time required to activate clinical trials. At the time, the average time required to activate at trial was 220 days. We made it our goal to shorten this time frame.

Thanks to the remarkable collaboration of the various Mayo business units involved, we’ve shaved that 220 day activation time down to just 65 days. Four years and nearly 700 clinical trials later, this process has saved Mayo Clinic over 300 years in valuable research time.

Adil Bharucha, M.B.B.S., M.D.

What’s next for the Office of Clinical Trials?

Here are four things that are top-of-mind for me:

  1. We need to make it easier to bring clinical trials to all patients who may benefit from them. This means finding better ways to identify and connect with potentially-eligible patients.
  2. We should continue to take advantage of technology to gather data more effectively and efficiently, and to use that data to inform our work. This could help us make important decisions, such as selecting which trials should be activated at Mayo Clinic.
  3. We need to shorten the amount of time between when a research protocol is first submitted and when a funding proposal is subsequently submitted. Anything we can do to remove “waiting time” from clinical trials processes will help in our mission to transform scientific discoveries into solutions for patients.
  4. I’d like to see us develop an integrated protocol management system for clinical trials. This would make it easier for study teams to navigate the process of conducting trials.

There is so much to do.  If the office can accomplish these goals, we’ll be able to provide better help to study teams and, through them, better help for the patients who need us.

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Tags: Adil Bharucha, Center for Clinical and Translational Science, clinical trials, gastroenterology, medical research, News, People

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