Three WSUPG providers named 2020 Health Care Heroes by Crain’s Detroit Business
June 5, 2020
Congratulations to Gerold Bepler, M.D., Andrew King, M.D., and Latonya Riddle-Jones, M.D., on being named 2020 Health Care Heroes by Crain’s Detroit Business!
Gerold Bepler, M.D.
President and Chief Executive Officer, Barbara Ann Karmanos Cancer Institute
He helped create a Michigan cancer treatment network, sought input on community needs and oversaw research that helped cure the previously incurable.
It’s been a busy decade for Gerold Bepler. Bepler is president and CEO of the Barbara Ann Karmanos Cancer Institute, a post he’s held since 2010.
Making excellent care accessible to diverse populations, at all income levels, has been the overriding goal since joining Karmanos from the Moffitt Cancer Center in Tampa, Bepler said. At Moffitt, he was department chairman of thoracic oncology, which includes lung and other chest cancers.
“I definitely (want) to make sure we continue to be one of the leading cancer institutes in the U.S.,” said Bepler, who has increased Karmanos’ funding from research grants and contracts from $65 million annually to $80 million annually since joining the institute.
The author of more than 200 peer-reviewed articles, Bepler also is chairman of the Department of Oncology at the Wayne State University School of Medicine.
Bepler counts the creation of the Karmanos Cancer Network as one of the institute’s biggest accomplishments during his time at the helm. That happened when Grand Blanc-based McLaren Health Care Corp. acquired Karmanos in 2014, creating a cancer treatment network with 16 locations.
“Us joining McLaren was probably the greatest thing we’ve done,” Bepler said. “We now have the ability to bring advanced cancer treatments to rural populations. The quality of care at those cancer sites has definitely improved.”
McLaren hospitals in Bay City, Port Huron, Mount Pleasant, Petoskey and other locations now have access to many experimental cancer drugs that aren’t available elsewhere, Bepler said.
That’s because Karmanos is one of two National Cancer Institute-designated cancer centers in Michigan. The University of Michigan Rogel Cancer Center in Ann Arbor is the other.
The NCI designation, which requires recertification every five years, gives cancer centers access to new drugs that aren’t approved by the U.S. Food and Drug Administration. The centers then participate in clinical trials to prove efficacy of those drugs.
“Our cancer patients have access to cancer drugs often 10 years ahead of (other hospitals),” Bepler said.
In addition to drug trials, Karmanos is contributing to an immune system therapy that uses patients’ T-cells to fight off previously incurable cancer. After harvesting the cells from a patient’s blood and adding a receptor that will bind to cancer cells, researchers grow large number of the altered cells in a laboratory and then inject them into the body.
Bepler calls therapy using the chimeric antigen receptor cells — called CAR T-cells — the biggest development in which Karmanos has participated in his time there. The treatment, approved by the FDA in 2018, destroys non-Hodgkin lymphoma cells in patients who didn’t respond to other treatments and who may be months from death.
“That has been an absolutely stunning breakthrough,” Bepler said. “We cure two out of three patients. The cancer goes away and it looks like it never comes back.”
The drawback to the treatment is it’s labor-intensive and costly, since cells made from one patient’s blood won’t work on another individual.
Karmanos now is hoping to expand the treatment to other types of cancers.
Research performed at the institute needs to be relevant to the community at large, Bepler said. That’s why Karmanos has formed Cancer Action Councils — focus groups consisting of community leaders, including those from faith-based organizations and social groups.
“We are putting a lot of effort into engaging the communities, so we are not like these ivory towers nobody has access to and nobody listens to,” Bepler said.
Andrew King, M.D.
Attending Physician, Detroit Medical Center
It’s sometimes called “treat ’em and street ’em” — an emergency department strategy to take care of and then quickly discharge patients from the ER.
But it doesn’t serve opioid addicts well, said Dr. Andrew King, an associate professor at Wayne State University and an emergency physician and medical toxicologist for the Detroit Medical Center. King is helping to change the practice by transporting substance abusers directly to outpatient treatment centers.
“(Often) we tell them, ‘Quit heroin — go figure it out and good luck to you,’” King said, adding that patients are put in charge of contacting a hotline for help. “What are the chances of people following up in a day or so? One of the dangerous things you can do with patients with poor health literacy is to discharge them from the hospital. At the same time, you can’t admit everybody.”
King, who works at Detroit Receiving and Sinai Grace hospitals, often encounters patients who are low-income, minority and underinsured. In addition to fighting addiction, they also may have transportation issues, he said.
So, King, in partnership with rehabilitation provider Team Wellness Center, created the Crisis Addiction Response Transportation program for the DMC. The voluntary program gives addicts a ride from the hospital to treatment facilities, where care can begin.
Patients who come in after normal business hours begin their stay with a clean bed.
“A lot of them feel exhausted and need to sleep,” King said.
In the morning, they can meet with a psychiatrist and get started on medicines to help wean them from addiction and to treat other ailments, including high blood pressure. After a stay of a day or two, patients go home with a packet of resources and return to meet with professionals as needed.
“We’ve had some really good retention rates and success rates, even after overdose,” King said. “About half of the people (who) get transported over there will stay in therapy for 20 weeks. One in 10 will stay for a year.”
The DMC also works with substance abuse treatment facility the Faith, Hope & Love Outreach Center.
The CART program is aimed at reducing a disparity in the way opioid addicts are treated, versus people with other serious health conditions.
“After somebody comes in after an overdose, their mortality rate is 5 percent to 8 percent after one year,” said King, who joined Wayne State and the DMC in 2013. “That’s similar to what you see with a heart attack. My idea is we have to treat opioid addiction the same way we would a heart attack.”
But addiction carries a stigma that a heart attack doesn’t.
“Part of the issue I’ve run into is resistance by other (health care) providers to treat this as a disease,” King said. They may believe that, “Nothing we do really matters” or “They’ll get better when they choose to get better,” King said.
“It needs to be thought of as a disease, instead of a moral failing or something wrong with their soul,” he said.
Physicians who push abstinence-only therapy wind up with patients likely to relapse, King said.
“It’s really hard to function when you’re having withdrawal,” he said, adding that drug users often have lost support from friends and family and sometimes have been incarcerated. “A lot of the day is spent trying to obtain the drug.
“There are good medications out there. Instead of having the highs and the lows, we can even (them) out. (Then), they’re not so irritable. They can start taking care of business.”
DMC hopes to spread of the program throughout the state and now is gauging which other health systems are interested, King said.
“We just want to be there to help (those systems),” he said.
Latonya Riddle-Jones, M.D.
Medical Director, Corktown Health Center
It’s not the fear of needles or medical tests that keeps some of Dr. Latonya Riddle-Jones’ patients away from traditional doctors.
They’re more concerned about discrimination and mistreatment. Some have avoided doctor visits for 15 years. Those patients, who are members of the lesbian, gay, bisexual, transgender and queer community, perceive that medical professionals don’t treat them with respect.
“They are coming in with uncontrolled hypertension (and) uncontrolled diabetes,” said Riddle-Jones, an Inkster native who is medical director for Corktown Health Center in Detroit. “They open up to us and we’re able to give them good, quality medical care.”
The nonprofit center, which is open to everyone, is a safe space for LGBTQ people, Riddle-Jones said. Patients, some from Ohio and northern Michigan, are greeted by artwork and magazines featuring same-sex couples, lapel pins with preferred pronouns and medical professionals trained to understand diverse needs.
“One of the reasons I wanted to learn more about this population is because of the disparities,” said Riddle-Jones, a 2008 Wayne State University School of Medicine graduate who is certified in caring for transgender people. “About 50 percent of trans people have attempted suicide at some time in their life.”
Riddle-Jones’ patients tell stories of clinicians — perhaps well-intentioned in learning about an unfamiliar type of patient — treating them like guinea pigs, she said. Others report more offensive behavior.
“They’ve been told they have a disease because they are gay or they were refused treatment because of gender identity,” Riddle-Jones said. “They feel like they have not had their dignity respected.”
The Corktown center contracts with Riddle-Jones’ employer, the Wayne State University Physician Group, for her services. At the center, Riddle-Jones, also an assistant professor at Wayne State, trains some of her students how to care for LGBTQ patients.
“We will talk to the students about how to introduce themselves,” she said. “You may have a legal name, but it may not be the name you prefer. (It’s) just asking people how they prefer to be identified.”
Lessons students learn can be applied beyond the LGBTQ community — things such as requesting permission before performing a physical exam or asking whether diabetes may be linked to lack of access to fresh fruit and vegetables.
The COVID-19 crisis, which has prevented students from working at Corktown and other clinics, has created an unexpected positive outcome. Use of telemedicine to check in on patients is leading to better compliance.
“What we’re finding is just about everybody has a phone and just about everybody is able to text,” Riddle-Jones said. “Patients who are shy about coming into the office or (who are) high-anxiety are a lot more comfortable with telemedicine. We’re thinking we’re going to continue using (it) as a tool.”
In addition to her work at Corktown and Wayne State, Riddle-Jones is associate director for the Barbara Ann Karmanos Cancer Institute’s Tri-County Breast and Cervical Cancer Control Program. Part of a Michigan Department of Health and Human Services effort, the program is aimed at improving health for low-income women.
Besides being uninsured or underinsured, patients may be afraid to go to the doctor because of immigrant status, for example, Riddle-Jones said. Free, mobile mammogram units are welcomed by patients.
Riddle-Jones, who recently earned a master’s degree in public health from Harvard University, also is active in influencing Michigan State Medical Society practices. One initiative she’s involved with is teaching physicians how to talk to patients about safe gun storage in the home.
“I’m trying to change policy,” she said.
Read 2020 Health Care Heroes by Crain’s Detroit Business. Each profile above was written by Doug Henze, Special to Crain’s Detroit Business.