Beth Horenkamp, M.D., serves as Chief of the Division of Hematology & Oncology at Lancaster General Hospital. We asked the busy mom of four about her division’s priorities and challenges, why she chose oncology and how she makes time to de-stress every morning.
What is your background?
I’m originally from New Jersey. My mother is a retired geriatric nurse practitioner, and she was a big inspiration for me to get into medicine. I met my husband, Dave, at Franklin & Marshall College. We went to medical school at Penn and joined the Air Force together. I did my residency and fellowship at Lackland Air Force Base in Texas, and we served as staff physicians at Scott AFB in Illinois for three years. Dave, a urologist, served an additional two years at the Air Force Academy in Colorado Springs.
When did you join Lancaster General Health?
We moved from Colorado to Lancaster in 2003. With four children and two jobs, we needed more family support. My parents moved down the street from us, and Dave’s parents also recently moved to a local retirement community. Having all four grandparents here made life a lot smoother for us. I joined what is now LG Health Physicians Hematology & Medical Oncology and worked part time. I gradually increased to four days a week and became managing physician and division chief around 2009. I currently work 2.5 clinical days and 1.5 administrative days. I also sit on the ABBCI operational oversight committee, which I enjoy. I like things to run smoothly. With four kids and a career, I know all about efficiency.
How did you decide to specialize in oncology?
I initially wanted to specialize in anything but oncology. Then during my residency, I saw a really sick patient with congestive heart failure. He was in the hospital all the time, and he had so many doctors. He asked me to be his quarterback. For the next 18 months, he was only in the hospital once. When he died, his wife brought me a bottle of bourbon that he had set aside for me. I thought I had actually done something useful. The way I frame it now is that I help people who really need help. I feel like I’m needed.
How has the practice changed since 2003?
We have grown from five physicians to 10 physicians and three APPs. Each of us now has an area of specialty. Oncology is so complex today that you can’t keep up with it all alone. Each physician leads a “disease team,” which focuses on standards for testing, therapy and pathways, and leads the tumor board for their disease site. I lead the head and neck disease team. Younger people are getting these cancers now, due to HPV, and in many cases, they need a lot of support to get through treatment successfully.
Tell us about the Oncology Care Model
Dr. Beth Horenkamp with her family
ABBCI is part of this CMS pilot that focuses on improving patient engagement, creating evidence-based pathways for patient care and managing patients in the lowest-cost setting. We have made a lot of changes to our practice, especially around the consent process, shared decision-making and advance care planning. We have all had Lean training and engage our entire care team with regular huddles. We are really focusing on working as a team – both with each other and our patients.
What are some of your division’s other current projects?
Shared decision-making will continue to be an area of focus for us. We’re also looking at our processes involving immunotherapy patients. All of our pods now have a “worry board” with the names of patients who seem to be at risk for hospitalization. We talk about these patients at our huddles and contact them once a week. Now that we know who is at risk, we are figuring out how we can help them, and provide support and guidance to their caregivers.
How do you work with your oncology colleagues throughout Penn Medicine?
We have a longstanding relationship with our colleagues throughout the Penn system. Overall, it’s gotten increasingly easier to collaborate on cases. Our specific relationships vary by disease team. Some Penn physicians see patients here in the clinic. We also get together for tumor board meetings or lectures via Skype. Our nurse navigators and concierge help to facilitate appointments and coordinate logistics for patients who must travel to Philadelphia for consults or treatment.
What do you like to do when you’re not at work?
Carving out time for our families and ourselves is important. We have four children: Adam, 23, a software engineer outside of Philadelphia; Sarah, 21, a senior at Haverford College who is applying to medical school; Jack, 18, a freshman at Northeastern University who is spending his first semester in Montreal; and Lucy, 17, a senior in high school who will play lacrosse at Penn next fall. Spending time with them is our favorite activity. I’m a big proponent of exercise for my patients, and it’s how I manage my stress too. I have to do some kind of exercise every morning – swim, bike or run – or I wouldn’t be bearable. I also like to participate in local story-telling competitions.