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A Catalyst to Innovation

Medical Fellowships reward brave thinkers in research and health care value.

Dr. William Curry is intimately familiar with taking risks, with seeking answers to seldom-asked questions, with the substantial medical rewards earned only by pushing back against resistance to revolutionary thought.

Which is why in 2006, as a young, mentored researcher with big, bold ideas in the world of immunotherapy, he was a perfect match for the Rappaport Foundation and its insistence on convention-challenging innovation.

He was in just his second year on the full-time neurosurgery staff at Massachusetts General Hospital, and Dr. Curry was in the early stages of work, under Dr. Robert Martuza, to effectively generate an immune response against a brain tumor. And though he was not the only one who believed in this use of immunotherapy, he was certainly in the minority.

He found an ally in the Rappaport Foundation.

The 2006 Fellowship provided Dr. Curry’s first independent, non-mentored award, and it helped to catalyze a path that has since taken him to his role as co-director of Mass General Neuroscience, Director of Neurosurgical Oncology, and the primary principal investigator of a clinical trial that will test the efficacy of a herpes virus-based immunotherapy in fighting brain tumors.

“No one ever achieved anything great or novel without a little bit of risk,” Curry said. “The Rappaport Foundation supports true, real-time innovation.”

It has been supportive of that sort of envelope-pushing work for decades, in support of its mission to cure neurologic and mental health diseases, as well as a focus on increased health care value.

The Rappaport Foundation has provided one-year research fellowships at Mass General Hospital since 2000 and began funding five-year general research scholars there in 2012; has funded research fellows at McLean Hospital since 2000; and has for decades supported psychiatric researchers at Brigham & Women’s Hospital, where the Foundation also offers awards for clinical innovation.

“A lot of times there’s no precedent. They’re working on things that will appear in textbooks in the future.”

Bill Carlezon, Ph.D.

“The Rappaports are funding people who are operating at the cutting edge,” said Bill Carlezon, Ph.D., who heads the Center of Excellence in Basic Neuroscience at McLean Hospital. “A lot of times there’s no precedent. They’re working on things that will appear in textbooks in the future.”

Dr. Carlezon has been on the committee to choose the Rappaport Fellows at McLean since 2005. It’s become one of the hospital’s most coveted and competitive awards, he said, based not only on the relatively substantial financial component, but on the flexibility it provides.

In contrast with a typical National Institutes of Health federal grant, he said, the Rappaport Award offers the opportunity for a young researcher to create his or her own dynamic path. In a field chronically short of training funds, NIH grants are often narrowly approved based on a predetermined potential for research success, “and that can work against people who are really innovative thinkers,” Dr. Carlezon said.

On the other hand, Rappaport Awards are more likely earned by those willing to play it less safe while on a path to greater future successes, championing research that dares to reexamine previous conceptions about the causes and treatment of psychiatric illness.

The Rappaport Fellowships also provide critical leverage, arming young awardees confidence and results to apply to government and private organizations for additional financial support toward a goal of becoming an independent investigator.

“It’s a means to NIH grants,” Dr. Carlezon said. “The researchers now have this pilot data, they’ve made their mistakes and they now know how to address them, and it was all made possible because of the money provided by the Rappaports.”

In addition to the research dollars, the Foundation offers substantial funding toward improving value in health care through the Rappaport Award in Clinical Innovation at Brigham and Women’s Hospital. The program was established in 2013 and provides support for internal medicine residents to spearhead innovative projects.

“We have a fantastic health care system in the United States, but it’s not affordable,” said Joel Katz, Ph.D., the Internal Medicine Residency Director and Vice Chair of Education at Brigham and Women’s, who has served on the selection committee since the program was founded. “If we can’t reduce the costs of health care or get more out of the health care dollar that we’re inputting, the weight of the expense is going to crush its impact.”

In the simplest terms, the Award in Clinical Innovation is designed to do just that: improve value by either increasing a system’s effectiveness or decreasing its cost.

The beauty of the program is that it rewards the very people who are least likely to have access to typical grants, who are at a particularly vulnerable period in their careers, and yet who know the most about waste in health care: the internal medicine residents.

Drs. Jose Figueroa and Bram Geller, for example, were the inaugural, 2013 recipients of the award for their project, “Educating and Incentivizing Housestaff on Early Discharges: An Intervention at Cost Containment.”

Recognizing that health care team goals and incentives were not always aligned, sometimes leading to delays in care and discharge, the Figueroa-Geller initiative worked to ensure that teams and their patients were co-localized to a single unit, not spread out throughout the hospital, thus improving care and teamwork while saving money.

Award recipients have taken on social justice issues in the past as well. In 2018-19, Drs. Anne Beckett, Aaron Richterman and Lauren Eberly were funded for “Reducing Inequities in Heart Failure Management,” which questioned whether or not race or gender played a role in the quality of care, and follow-up care, of congestive heart failure patients.

The answer, as it turned out, was yes. White heart failure patients were more likely to receive specialty care and follow-up with a cardiologist than were Black or Hispanic patients, and likewise men received higher quality care and after-care than did women.

The important part of the project, then, was to reverse the trend, a process that has been ongoing since the results were determined.

“This was an incredible project,” Dr. Katz said. “I was very proud of that one.”

In general, Dr. Katz said, the Rappaport Award has been game-changing for the department. “It has extended the influence of the residency,” he said, “but more importantly it has helped shape and sculpt leaders who are going to make the health care system more affordable and more effective.

“We are just so grateful for the Foundation support.”

Gratitude for the Rappaport Foundation has been a common theme for decades in the world of Boston Health care. From value and quality of care to neurologic and mental health solutions, the Rappaports have relentlessly pursued and promoted excellence in innovation across the spectrum, and the subsequent advancements will no doubt manifest in better health outcomes for untold numbers of end-users.

“Right now, we are literally working on funding a clinical trial for patients with recurrent brain cancer, using a version of the approach that I wrote about my proposal for the 2006 Rappaport Award,” Dr. Curry said. “One of the holy grails for an investigator that does translational research is to conceive of an idea in the laboratory, see it come to fruition in a clinical trial, and hopefully cures, or at least impact in patients.

“This is one of those rare times that we have the momentum to accomplish that, and it’s very gratifying.”