Living Like a Leader: A day in the life of Dr. Gerold Bepler, CEO of Karmanos Cancer Institute

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"There are two key things to be a successful leader: No. 1, stay focused on a long-term task and No. 2, trust your reports and delegate work. Do not micromanage, and give them space to be creative. Those items will result in having an engaged leadership team which permeates across the hospital."

Between driving growth, meeting clinical objectives and navigating the COVID-19 pandemic, there don't seem to be enough hours in the day for healthcare executive

Leaders succeed despite these challenges, each with their own habits, hacks, styles and methods — and Gerold Bepler, MD, PhD, president and CEO of Karmanos Cancer Institute in Detroit, is no exception. 

Since Dr. Bepler took the helm in February 2010, Karmanos has become Michigan's largest cancer care and research network. Under his leadership, the cancer institute struck a partnership with Detroit-based McLaren Health Care, grew from three sites of care to 16 and more than doubled the number of new cancer patients seen annually.

The cancer institute has one of the largest clinical trials programs in the U.S. , with more than 400 trials offered to patients at a single point in time.

Dr. Bepler is also a world-renowned thoracic oncologist and researcher. While most of his time is spent in administration, he continues to conduct research and do inpatient consultations. 

For this installment of Becker's Hospital Review's "Living Like a Leader" series, Dr. Bepler offers a glimpse of how he manages his energy, teams and time.

Editor's Note: Responses have been lightly edited for length and clarity.

Question: What's the first thing you do when you wake up? 

Dr. Gerold Bepler: I tend to wake up without setting an alarm, between 4 a.m. and 5 a.m. Right away, I will get up and get ready for work. I am energized, and I look forward to seeing the people I work closely with. We have a fabulous leadership team, which makes me excited to get into the office. 

My commute into the office is about 15 miles. I will stop at a bakery to get a bagel and coffee. I also listen to news on my drive in and soak up what is going on across the U.S. I tend not to watch TV, so I really get that through conversations and listening to NPR.

Q: What's the first thing you do when you arrive at work?

GP: I typically arrive around 6 a.m. I will walk through the main entrance and see the staff providing patient care. The first thing I do when I arrive in my specific office is check my emails. Our CFO is also typically in the office early, so I will talk to him, touch base to see what is on his mind.  

Q: Is there anything that makes your physical office setup unique? 

GP: In my office I have a lot of memorabilia from my medical training. I did my residency and fellowship at Duke University and have pictures from that. I also have pictures of my family. I have a wife and four kids, age 16, 20, 23 and 28. There are three boys and one girl. I also have old pictures that my kids drew when they were younger as well as coffee mugs from events they had.

Q: How much of your time is spent with your direct reports?

GP: I have six direct reports that I interact with frequently. If you exclude the time I am by myself in the office completing a task, I would estimate 75 percent of my time is spent with them.

Q: How often do you meet with clinical staff/perform rounds?

GP: About two years ago we established what is called senior leadership safety rounds. Senior leaders at the cancer institute are assigned two areas that they round at once per month. This means that at least twice a month, I round in different areas, such as the inpatient unit, outpatient infusion center, registration, accounting, IT or radiology.  We all get them assigned and do this for a six-month period, and then we rotate.

Aside from the safety rounding, I meet with physician leadership on a regular basis about once per week, most often spontaneously. Additionally, I meet with nursing leaders once per week.  

Q: How do you think your routine differs from that of other healthcare leaders?

GP: I think it differs because I am a physician, and I do inpatient rotations and consultations. The second aspect is that we do a lot of research and clinical trials, so I am involved in this all of the time. We have a pretty large clinical trial office with 130 staff members. Since my area of expertise is medical oncology and thorac oncology, I meet with that team once per week and clinical trials team at least twice a month. I also meet four times a month with scientific leadership of the cancer center, including biostatistics, community outreach, population sciences. I think those are things that are quite different from other hospital CEOs.

Q: How did your daily routine change amid the pandemic?

GP: It changed enormously. It started initially with incredible uncertainty of how severe the virus would be. We immediately established a crisis center and had meetings twice daily to report on what was going on. We struggled to find protective gear at first, and needed to figure out how to staff inpatient units  —  if we would allow visitors and what we would do with the residents, fellows, nursing students and volunteers. It took us about six to eight weeks to establish a totally new routine. Which has now, in a sense, become the norm. We do social distancing in the waiting areas; do check-ins at the front door rather than a desk; call patients in when it is their appointment time. We are doing a lot more telemedicine. As a result, there has been a lot less traffic in the hospital. The biggest downfall of the pandemic is that, particularly with cancer patients, you always want family members with you on the journey. However, because of the infection risk, we stopped allowing them in for a while. These visits had to be done via a phone call or a Facetime. But hospitalized patients or end-of-life patients not having family members with them is a real tragedy. 

In terms of the administrative team, they continued to go into the office daily. But a lot of the meetings we have are now conducted via Zoom, Teams or Web Ex. 

Q: What is the hardest part of your day? 

BP: The hardest part is seeing the engagement of family members fall off amid the pandemic. It is really heartbreaking to see cancer patients be in the room and go through treatment alone due to restrictions. I'd also say having students excluded from hands-on learning opportunities. Right now medical students, nursing nursing students and high school students in our summer program are missing out on hands-on learning and instead are forced to do much of the learning virtually. I hope this doesn't go on much longer because this really impacts the experience of our future healthcare providers. 

Q: What is the most rewarding part of your day?

BP: Unequivocally, the pace at which new treatments are being developed and coming to the forefront. It is so stunning to see how long patients with advanced stage cancers live now and that they have a pretty good quality of life. It is so rewarding to see the hard work of researchers translate to a positive change in cancer patient outcomes. 

Q: What's the last thing you do before you leave your office?

BP: I'll check my emails to make sure everything I need to get done for the day is done. Then I start thinking and planning for what I need to do the following day. I leave the office anywhere between 3 p.m. and 7 p.m., depending on if I have meetings outside of my office.  

Q: Do you work at home?

BP: I do a lot of work at home. Typically, I do this in the evening after I get home or in the morning prior to coming to work. I work on the things I know I need a dedicated block of time without disruptions to complete. This tends to be working on reports, reviewing articles and strategic planning, where I need at least 45 minutes to an hour uninterrupted. I also ensure I have completely wrapped up the day, analyzing what are the major tasks and what can I do the following day to have the biggest impact. 

Q: How do you unwind at the end of the day?

BP: I love to have dinner with my wife and kids if they are around. We talk about nonhospital-related things. I also like to do handiwork in the house and work in the garden. Gardening is taking care of the shrubs, flowers, lawn and trees.

Q: Anything else?

BP: There are two key things to be a successful leader: No. 1, stay focused on a long-term task and No. 2, trust your reports and delegate work. Do not micromanage, and give them space to be creative. Those items will result in having an engaged leadership team which permeates across the hospital.

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