BUFFALO, NY - DECEMBER 16, 2009: Judy Smith, Medical Director for the Roswell Park Cancer Institute in Buffalo, NY talks with a staff member on Wednesday December 16, 2009. Dr. Smith is enrolled in a Harvard program to strengthen her business acumen. She says that the demands of healthcare reform will present a new onslaught of challenges on top of the complexities of running a multidisciplinary cancer center. CREDIT: Mark Ovaska for The Wall Street Journal EXECED