As a young diabetes specialist in England’s West Midlands, Dr Stephen Gough was drawn to an important – if low-status – challenge: healing and preventing new wounds in diabetic feet.
"Diabetic foot disease can be a neglected area of care even in the UK. Many consider feet to be smelly and dirty, and best avoided! No one really wanted to look after them,” he recalls.
At the time, the local health service was spending a lot of money on expensive, clunky, bespoke footwear that nobody wanted to wear. So when a podiatrist showed Dr Gough how to turn Nike training shoes into protective footwear by adapting the insoles, he proposed a change of policy to the hospital management.
“The new training shoes were much more attractive and prevented further foot problems, people liked wearing them – it paid for the service, including the podiatrists’ time in clinic, within months, and provided a greater access to much-needed foot care,” he says.
The memory of the decision, which took place in the 1990s, still makes him smile. “I dislike suffering, and I am troubled by people not getting access to things I take for granted,” he says.
Dr Gough joined the World Diabetes Foundation Board on 1 January – the latest addition to a distinguished career spanning clinical care, academia and the pharmaceutical industry. He was Head of the Oxford Centre for Diabetes Endocrinology and Metabolism in the UK and served as Professor of Diabetes to the University of Oxford and Consultant Physician at the Oxford University of Hospitals NHS Trust before joining Novo Nordisk A/S in 2015.
WDF spoke with Dr Gough about his current role as Chief Medical Officer (CMO) for Novo Nordisk, what he brings to the WDF, and what he hopes to achieve as its newest Board member.
What are a Chief Medical Officer’s responsibilities?
My function has three key areas. First, I’m the patient voice within Novo Nordisk. So when R&D comes with a great new molecule, I say, ‘Why do we need this? What is the benefit to the patient, what is the unmet medical need?’
The second role is to be the senior medical voice externally - one of my main activities in this respect is coordinating public/private partnerships. My third key role is to provide strategic medical guidance.
Why are you joining the WDF Board – and why now?
I see a connection between who I am and the World Diabetes Foundation. The CMO is the patient voice with a social and societal responsibility – that’s who you are as a doctor and as CMO. So for me it is perfect that the CMO has a role with a foundation that sees diabetes in the wider sense, sees the people who lack access not only to drugs but also to routine clinical care. 50% of people in the world with diabetes are not getting any treatment at all – what can we do for these people?
If, at this stage in my career, I can use my experience to do something about diabetes care in parts of the world where it is not happening, this is highly attractive - this is why I was so keen to be a part of the WDF.
Did your three decades in UK clinics and universities influence you and your work?
Massively. As a medical consultant, my first 15 years as a specialist were in Birmingham in the West Midlands, where there were very socially and ethnically diverse groups of people. Some of the initiatives I led as a specialist were focused in this area.
For example, I moved some of my diabetes clinics in inner city Birmingham from hospitals into the community. I felt you had to bring care to where the patient was rather than bringing the patient to you. I also created a series of new initiatives in terms of diabetic foot care, setting up and redesigning those that existed, so that more people benefited from the services that they needed. Those two things, from a clinical point of view, really interested me.
I’ve also been a university academic working with bright people in my research group, and that has really helped me from an R&D perspective. But it is my clinical experience inside and outside diabetes that helps me understand what is important to patients, and how often little things can make a big difference to their lives and the lives of their family and friends.
What do you hope to gain from working with WDF?
I hope to continue to make a difference and give something back. I believe health and education should be freely accessible to everyone, and unfortunately that’s not always the case. If I can do something through WDF to help address that, to bring diabetes care to those who don’t have it or improve it where it is suboptimal, that would give me an additional reason to get up in the morning - I would feel it was really worthwhile.