New Executive Director Pursues Medical Entrepreneurism, Growth at DMC Heart Hospital

Kenton Zehr wants DMC Heart Hospital to expand the for-profit health system's cardiovascular service line such as performing more open-heart surgeries.

An accomplished mechanic with an entrepreneurial spirit has his hands on the controls at Detroit Medical Center (DMC) Heart Hospital.

Kenton Zehr, MD, who earned his medical degree at Pennsylvania State University College of Medicine and completed a residency and fellowship in general surgery and cardiothoracic surgery at Johns Hopkins Hospital in Baltimore, was named executive director of DMC Heart Hospital in April.

The board-certified thoracic surgeon says a life-long interest in mechanics drew him to cardiac surgery as his field of interest.

"In sixth grade, we went to the grocery store to buy bottles and things, then I made a heart-lung machine out of bottles that pumped colored water with a syringe-type system. I won the science fair for that," Zehr told HealthLeaders.

"When I hit human anatomy at Penn State that became my favorite class with my mechanical background. My father and my brother and I built our house when I was a teenager. We pounded every nail. So, working in a mechanical healthcare subspecialty makes sense to me."

HealthLeaders recently spoke with Zehr about his vision for DMC Heart Hospital. Zehr wants DMC to perform more open-heart surgeries and expand the health system's cardiovascular service line.

Following is a lightly edited transcript of that conversation.

HL: Why do you find the mechanics of the heart and the vascular system appealing?

Zehr: First off, cardiac surgeons don't treat cancer, we treat something that is fixable. In large part, our patients do well; and once they are fixed, they are fixed with a durable result.

In some ways, it's like opening the hood of the car, fixing the car, and closing the hood. The cardiovascular system is very well circumscribed. You know your limitations—it's the pump and the vessels that come in and out of the pump.

HL: How has your medical background prepared you to lead DMC Heart Hospital?

Zehr: I've worked at several major institutions. I spent nine years training at Hopkins back in the day when we were on call every other night—before the resident work hours limited you to 80 hours a week. I did nine years working 100 to 120 hours per week. We were immersed in it very intensely.

After I finished my training at Hopkins, I went to the Mayo Clinic in Rochester, Minnesota. I spent eight years there. The mechanical portion of using the heart-lung machine started there as a tour de force.

I've worked at pioneering systems. The first successful pump support for heart surgery was done in Detroit in 1952. They made four of those machines. One is in the lobby here. One was given to the Smithsonian. I like to feel connected to the thread of history.

HL: How do you plan to strengthen the cardiovascular service line at DMC?

Zehr: For the past several years, the service line has been heavily oriented toward percutaneous interventions on coronary events, not so oriented to a balanced approach.

There has never been a study that has shown percutaneous interventions such as stenting are superior in terms of durability to open heart surgery. We need a balanced approach to cardiovascular care—more balanced than it has been here.

We need to expand into other areas like valvular work. We're not participating strongly in the surgical solutions for heart failure. We have durable pumps—ventricular assist devices—which are basically artificial hearts that are routinely used across the United States, but not in our program. These are the things I plan to bring to DMC.

HL: What are some of the key steps in that expansion effort?

Zehr: We'll start by expanding the surgical volume. I'm hiring another surgeon from Hopkins who will be starting in September and plan to hire another surgeon. So, I am expanding our surgical staff, and we will expand our internal staff at the Heart Hospital—we just hired two interventionalists for stents and percutaneous procedures.

We have hired an internationally known heart failure expert. With myself and the other surgeons we are recruiting, we will be able to put in artificial heart devices. Several years down the road, we hope to have a heart transplant program. Right now, some of those needs are being met by our competitors, which is fine, but it would be nice to offer that as part of being a comprehensive program.

We will have a full-on marketing strategy to market ourselves as available to our community.

HL: What is your vision for DMC Heart Hospital?

Zehr: I want to see us competitive with Beaumont, with Henry Ford, and with the University of Michigan. I would like to see somewhere between 500 to 1,000 open heart surgeries per year. We occupy a market in downtown Detroit that is not served by others in the area. It's a high-needs community, with high percentages of diabetics and high percentages of people with high blood pressure. The first system to be affected by those disease processes is the cardiovascular system.

One of the advantages we have at the Heart Hospital compared to other institutions is that we are in one building. We see patients in the same building. We drink coffee out of the same coffee pot. We have group meetings, where we have a team approach to discussing cardiac care, and we have cardiologists and cardiac surgeons sitting around the same table.

HL: You have a track record in medical entrepreneurism, including several mechanical device patents. Do you hope to involve DMC Heart Hospital in medical entrepreneurism?

Zehr: Historically in Detroit, there has been a lot of opportunity because we have the car companies here. The machine that did the world's first pump support for a heart operation in 1952 was called the Dodrill-General Motors Research pump. All of the engineers came out of General Motors. There are bioengineers who are still associated with those companies.

In Detroit, we have a history of being part of multi-institutional trials for devices like stents that open up clogged vessels and that will continue—one of our strengths is partnering with industrial companies.