Rolland Barrett, MD - Alumni Spotlight

Rolland Barrett, MD

January/February 2016

Rolland Barrett, MD was awarded a Graduate Certificate in Bioethics from Wake Forest University in December 2014.

Trained as a gynecologic oncologist, Rolland began his practice in Winston-Salem in 1985. Early on he became aware of the limitations of standard cancer treatments. Rolland shares “it was apparent that we spent the majority of our time working to palliate both the symptoms caused by cancer as well as by our treatments.” Rolland noted that breakthroughs in cancer treatment, whether they be new drugs or new surgical innovations, created problems in terms of cost as well as appropriate allocation stating “as new treatments for cancer emerged, the science as well as the business of oncology were forging ahead without clear consideration of the ethical problems that followed.” Rolland remembers reading a quote by Willard Gaylin of the Hastings Center back in the late 1980’s – “We are now on the threshold of a giant success in medicine. And while most people may not realize it, it is always our successes that get us into trouble. What causes expensive medicine is our successes. Good medicine increases morbidity. Our successes keep sick people alive. There is no such thing as preventive medicine ultimately, in that we’re all going to die. It means that you prevent a child from dying of a childhood diseases, which has a humanitarian purpose, but not an economic purpose because he will then live to be very expensive old man.”

An increasing interest in palliative care as an important part of good (as well as cost-effective) oncologic care led Rolland to consider issues such as patient autonomy in clinical decision making, futile care, surrogate decision makers, advance directives and other end-of-life care issues, which of course are also core issues in clinical ethics. In addition to palliative care, another fundamental issue in medicine that led Rolland to enroll in the bioethics program was the evolving nature of physician professionalism and the physician–patient interaction. Many studies show that burnout among physicians is increasing. This in turn impacts how we relate to our patients, our colleagues and our families. Many of the leading writers addressing this issue, such as Edmund Pellegrino, were doing so in the bioethics literature.

Rolland became aware of Wake Forest University’s graduate programs in Bioethics while attending a conference on palliative care at Forsyth Medical Center. Dr. Diane Meier, a world-renowned expert in palliative care, was the keynote speaker on the program, and Dr. John Moskop from Wake Forest University spoke as well.

The most memorable experience about the Bioethics Graduate Program was the collegiality among faculty and students. Since finishing his graduate certificate, Rolland has had the good fortune of working with Deb Love, corporate director for bioethics at Novant Health and fellow alum of Wake Forest University’s Bioethics Graduate Program. Rolland serves as co-chair of the of the ethics committee at Forsyth Hospital. Additionally, he is participating with a multidisciplinary group assisting Deb in developing a new program for the medical staff, “Mastering Conversations That Matter,” designed to improve communication, support patients, and reduce physician and provider stress. Rolland states “the education I received in the core curriculum in the Bioethics program from Professors King, Iltis and Moskop has prepared me well to participate in these roles”.

In addition to these activities, Rolland continues to see patients in the outpatient department of Novant Health Oncology Specialists, Gynecologic Oncology. Away from the hospital, he enjoys reading, listening to jazz, and chasing after his English setter and German shorthair where they lead him.