Illinois Medicine

THE ENTREPRENEUR WITHIN Frustrated with spiking prescription prices, dermatologist develops generics to manage patient costs the drug's price spiked for his patients with acne. So when he met an executive at Roche, the maker of the drug, at the A meeting in Switzerland, he asked why there was no generic version. He found out that anyone who wished to produce a generic could purchase the drug's active ingredient and he set on the path to become the first such developer. "What started off as a hobby, within four years became a full-time job," he says. Spear continued to practice while he designed the necessary clinical trials and launched a virtual company. A critical step in the process was identifying individuals with the expertise he lacked, in areas like the U.S. Food and Drug Administration (FDA) process for approving drugs, explained Spear. "I just happened to start this at the right time," he says, noting how such a business would not have been feasible without the emergence of technologies such as laptop computers and email, which have allowed him and his colleagues to efficiently run the company though they are scattered across the country. When Spear Pharmaceuticals eventually won approval for its first generic version of tretinoin in 1998, it was then the smallest company to gain FDA approval for a drug. The company has since gained approval for six more drugs. Spear now employs about a dozen individuals across the country, including manufacturing experts in Florida and Texas, sales professionals in New Jersey, regulatory experts in New York and legal advisors in Washington, D.C. Spear eventually left his practice in 2001. He advises others with the ambition to change careers to hold onto their current jobs until they have established new ones. "Don't take your foot off first [base] until it is on sec- ond," he says. "I'm no business genius, but I read a lot. And I made good partners." Spear says his education as an undergraduate honors biology student K.L. Spear at the University of Illinois in Urbana-Champaign and as a medical student in Rockford helped fuel an appreciation for lifelong learning that has helped him along his unusual career path. To help other College of Medicine students, Spear has established a $25,000 scholarship endowment to help defray the costs of a medical education for students from southern Illinois, where Spear grew up. Spear, who has served on the Generic Pharmaceutical Association's board of directors, notes that during the past nine years, generic drugs have provided $824 billion in savings to the health care system. Spear said he is proud to be a part of that savings. Today 78 percent of all prescriptions dis- pensed are generics, but they account for only 25 percent of the total costs. "Instead of helping patients one at a time, I help every patient who buys a generic we have developed," he says. — Bridget Kuehn CHANCE ENCOUNTER with a pharmaceutical company execu- tive at a 1993 medical meeting in Switzerland radically changed the career course of dermatologist K.L. Spear '75, MD '79, a Rockford campus alum. Spear had become frustrated when tretinoin (brand ) was approved for the treatment of wrinkles, and name Retin-A® COOL UNDER PRESSURE Emergency room director rose at a young age; also chairs nationwide ER physician partnership J AIME RIVAS, MD '92, felt drawn to emergency medicine at an early age, and his passion and talent drove him upward through the ranks. The indefatigable physician was not long out of school when he became emergency department medical director at two prominent hospitals in the San Diego area, Palomar Medical Center (in 1999) and Pomera- do Hospital (in 2003). Last year, he was elected board chairman for CEP America, a physician partnership of more than 1,800 providers in eight states. CEP operates 84 emergency de- partments, 10 hospitalist programs, and more than 25 urgent care and ambulatory care practices. It is the third largest hospital- based physician group by number of patients seen in the U.S. Rivas decided to pursue emergency medicine as an M4. "I could diagnose emergencies quickly, and it felt like I was making a difference," he says. "Although stressful, it was very rewarding. I could help people in a time of need. Sometimes when I went home after a shift, I could say that I saved a person's life." Rivas credits his quick rise to humility, respect for others and work ethic, which he says were instilled by his father, a gardener, and mother, a housekeeper. Jaime Rivas Rivas first gained notice within CEP when he became medical director for a rural hospital whose emergency department was in disarray. Today, Pioneers Memorial Hospital in Brawley is one of CEP's most successful sites. For his work, Rivas earned the CEP San Diego Regional Physician of the Year award in 2000. Rivas' relative youth was no barrier to his quick ascent at CEP because he was "quickly identified by his peers as a person of high integrity and high quality," says mentor and CEP America CEO Wesley Curry, MD. "He's energetic, a team player, listens well and has a great bedside manner." Rivas serves as an executive member of the Palomar Pomerado Health (PPH) Foundation and has a highly visible role in fundraising for what PPH calls the "hospital of the future," which will include an expanded emergency depart- ment that will accommodate thousands more patient visits per year. The new $956 million Palomar Medical Center will feature a green roof; Wi-Fi throughout and online meal ordering; large screens in patient rooms that serve several purposes including radiography review; and alcoves adjoining rooms that allow families to sleep over. "It's very patient-centric," he says, "very futuristic, like a big spaceship." With constant fundraising for the new medical center, administrative duties and frequent business trips, Rivas still finds time to work seven to eight shifts a month in the ER and willingly works holidays, weekends and overnights. "I know it sounds corny, but it's me," he says. A native of San Diego, Rivas, 46, says family pulled him back to warmer climes. Last fall, Rivas returned to Chicago for a fundraiser he helped organize for the Hispanic Center of Excellence (see related story, page 35)—which he cites as an irreplaceable influence on his fast-track career. Named the outstanding medical graduate for 1992 at that fundraiser, Rivas remains in close touch with center director Jorge A. Girotti, PhD, whom he calls "my hero." Girotti recalls Rivas' heavy involvement with the Latino-oriented La Raza Medical Student Association. "He was always willing to lend a hand to those who came behind with the same aspirations of becoming physicians. He understood that being familiar with the cultural and language background of patients could have an impact on quality and outcomes." — Richard Asa ILLINOIS MEDICINE | 39

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