How Lived Experience Drives One's Clinical Practice Leadership - Patrick Makarewich, UTSouthwestern

Patrick Makarewich, clinical practice manager for ENT and head and neck surgery at UT Southwestern in Dallas, brings an unusual credential to his administrative role: he is a head and neck cancer survivor. Diagnosed in 2017 with an HPV-related head and neck cancer while he was leading the cancer center at JPS Health Network in Fort Worth, Makarewich found himself navigating the healthcare system from the patient side at the same time he was managing it from the inside. That intersection has shaped how he leads clinical teams, engages with patients on the floor, and thinks about the operational challenges facing practice administrators today.

What a cancer diagnosis teaches an administrator

Makarewich's symptoms were easy to dismiss at first. A swollen lymph node along the neck, a history of allergies, and life in North Texas, where seasonal irritants are a constant, made it simple to rationalize. But a second node near his collarbone changed the calculus. His primary care physician confirmed the concern immediately, and imaging led to a diagnosis of HPV-related head and neck cancer, a type that has grown increasingly prevalent among men in their forties and fifties, distinct from the historically older, smoking-related patient population.

He chose to receive his treatment at UT Southwestern's Moffitt Creek Cancer Center in Fort Worth rather than at JPS, a deliberate decision to separate his identity as a patient from his role as the facility's administrator. Seven weeks of weekly chemotherapy and 35 radiation therapy sessions followed. The experience was serious, at times physically grueling, and occasionally absurd. His colleagues at JPS noticed he looked pale as a ghost on chemotherapy days even as he insisted he felt fine. "They said you were one of our worst patients," he recalled with some amusement.

The clinical reality was harder. Radiation targeting the head and neck region progressively compromises a patient's ability to eat and swallow. Makarewich avoided a feeding tube by consuming five or six high-calorie supplements a day, but the threat was a constant motivator. Nine years later, he describes that period as a turning point: "I firmly believe God put you in certain positions in your life," he said, reflecting on having been diagnosed while running a comprehensive cancer program. "I don't know why I'm in this spot." The experience did not simply give him empathy in the abstract. It gave him a specific, practical lens for rounding on patients.

Operational priorities: access, staffing, and generational leadership

Makarewich's undergraduate background in industrial and operations engineering, a discipline he describes as lean Six Sigma thinking before that framework became widely adopted in healthcare, informs how he approaches the day-to-day pressures of clinic management. He identifies access to care and workforce stability as the two most significant stressors facing practice administrators right now, regardless of specialty. In a high-acuity program like head and neck cancer surgery, scheduling delays carry clinical consequences that go beyond inconvenience. A single open position among five surgery schedulers means the team is operating at 80 percent capacity, and that gap has real effects on how quickly patients reach the operating room.

On workforce retention, Makarewich takes a direct view: recruiting never stops, even when no seats are open. "The most important recruiting we do is with the people that are here Monday through Friday," he said. That means one-on-ones focused on individual circumstances, schedule flexibility where operationally possible, and attention to the whole person, including employees managing young families, pursuing degrees, or caring for aging parents. He is also attentive to generational differences within his teams, noting that earlier-career staff today show a stronger preoccupation with workplace safety and security than he recalls from his own early years, a shift he attributes to the media environment they grew up in and the events they have witnessed.

AI adoption and the human element

UT Southwestern recently appointed a chief AI officer, a move Makarewich sees as consistent with the institution's broader identity as an innovation leader. At the clinic level, the most immediate application is in AI-assisted note-taking, helping providers document patient encounters more efficiently without sacrificing the accuracy the medical record requires. Makarewich is measured in his assessment of where things stand, drawing a parallel to early internet adoption: the technology will do things no one anticipates and fall short in areas where expectations run high. What he is confident about is that provider work-life balance, particularly the burden of chart closure and documentation, is a real and solvable problem, and AI offers a credible path toward easing it. The work of integrating it responsibly, he suggests, is exactly why a named human leader for AI strategy makes sense.