Dr. David Henkin '16 on Outpatient Palliative Care at Henry Ford in MI

Dr. David Henkin, a 2016 graduate of UMHS, will deliver the keynote speech at the upcoming UMHS White Coat Ceremony in May in St. Kitts. Dr. Henkin is currently working as the Medical Director for Outpatient Palliative Care at Henry Ford Health in Detroit, MI. He completed his internal medicine residency in 2020 and a fellowship in hospice and palliative medicine at the University of Texas Health Science Center in San Antonio. Dr. Henkin's typical work day includes a combination of direct patient care, administrative work and teaching students, residents and fellows.

Dr. Henkin chose UMHS for its smaller class sizes and the personalized attention from professors. He credits UMHS for providing him with the platform to achieve his career goals. He also discusses his experience in UMHS admissions (both in the Michigan and New York offices) and teaching while at UMHS and how it influenced his interest in the administrative side of medicine. Dr. Henkin stresses the need for more primary care physicians to address the shortage in the field and encourages prospective students to consider primary care as a rewarding specialty. He also mentions the opportunities available in rural areas and underserved communities. Dr. Henkin encourages UMHS alumni to stay connected and network with each other through the UMHS Alumni Association.

UMHS spoke to Dr. Henkin on a winter day when he had a rare spare half hour to talk about his career.

Palliative care in Detroit

UMHS Endeavour: Dr. Henkin, I want to welcome you today for taking the time to speak with us, and can you just fill us in a little bit about where you're working now?

Dr. David Henkin: Thank you, Scott. Right now, I am working downtown in Detroit at Henry Ford Health. I am the Medical Director for Outpatient Palliative Care. I completed my three years of internal medicine residency. I finished that in 2020. I did a fellowship in hospice and palliative medicine at University of Texas in San Antonio. And then I moved back to Detroit and I've been at Henry Ford Health since.

You've done a mixture of a bit of everything. You’ve done internal medicine; you've done hospice and palliative care. And for what you're doing right now, Dr. Henkin, what is a typical work day like for you?

I get up early. I still like to prioritize my own health and wellness. I do some exercising in the morning. I get up at five. Get downtown, work, chart review for about 45 minutes to an hour, look at all the patients for the day. And then I usually, on an average day, I see about eight patients a day, four in the morning, four in the afternoon. Some days I have more of an administrative day where I work on projects, policies, take meetings. And I like to come home at five o'clock. I hopefully will leave and spend the rest of the day with my kids and my wife.

Dr. Henkin, could you just fill us in a little bit why you chose UMHS over other med schools?

Absolutely. At the time when I was applying to medical school, I was looking at a few different Caribbean medical schools and the draw to UMHS. At the time, I liked the smaller class sizes. I talked to [VP of Alumni Affairs] Michelle Peres and I had talked to another few students who were attending at the time. And they had shared with me that not only the smaller class sizes, all the professors knew you by name. It was more of a smaller feel, something that I felt confident that would allow me to get done everything I needed to with perhaps a closer eye on the importance of my education through the professors and the teachers, everyone that was there. And it did. It was exactly what I wanted.

I remember while you were still a UMHS student, you were actually in the New York office for a while and you wrote a guest blog post for me for the UMHS Endeavour. It's a few years ago, and it was about how you didn't originally do well on the MCAT. But you excelled in med school anyway by improving your study candidates and you managed to get, at the time, what was one of the highest Step One scores at the time at UMHS. Can you just tell us a little bit about that experience?

Coming from undergrad, studying for the MCAT, I really didn't at the time have the best study technique I would say. I thought I could study well, I put the time and the hours in. But I didn't really study as well as I could have.

When I started medical school, I started studying in a new way where I would sit down after each class and just read through the notes, take notes by hand, reread my notes again. Trying to really learn the material as opposed to just rote memorization of facts and material. Every semester I would do the same thing and every semester it would be more reinforced and I studied really well. I learned how to really put in the time and maximize the amount of time spent, studied efficiently. I ended up doing really well on my boards. I haven't for a few years, but I was tutoring for both step one and step two for a few years after I had taken the boards. Yeah, I really learned how to study in medical school. That was for me the time where it really made sense.

You also worked as a teaching assistant while at UMHS. And you worked for a while in the New York office with Michelle Peres while you were in Michigan. What were these experiences like for you working as a TA and also working for admissions?

The teaching assistant [job] was one of my favorites. Whatever course, whatever class you excelled in, they would ask you or offer you the opportunity to be a teaching assistant. I was able to do that for a few of the classes, just to be able to spend time teaching the material that I already took, going over with colleagues and friends, just teaching them how to understand the new material for the exam. I love teaching so for me that was a great opportunity. Currently, I teach now in my role as an attending physician. I'm an associate professor for Michigan State University so I have the opportunity to teach students, residents, and fellows. So, I think that was, for me, a good introduction to how to teach as a TA.

And then after I finished in 2016 going into 2017, I had the opportunity to work with Michelle, like you said, both in the Michigan and the New York office. I was able to do some recruitment. I was fortunate that I was able to do some interviewing as well of prospective students. That was a very great opportunity. And then it showed me—I refer to it as almost like the administrative side of medical school—to be part of that. And then that taught me that I do have a liking for the administrative side. So, as I've been in my three years of attending, I've had the opportunity to do more of the administrative, to be the medical director. Just because I had known that working in those offices, being able to be part of that, it was rewarding for me.

Dr. Henkin, is there anything that you'd like to say to current and prospective students, UMHS students, either thinking about going into internal medicine or any other specialty or just thinking about if they're prospective students, thinking about why they should go to UMHS over other schools?

For anybody that's a prospective student, debating going to school anywhere, I say do it. If this is something you want to do, it can be done. UMHS, for me, was the platform that allowed me to accomplish my career goals. I'd say if you're on the fence about it and if you don't know if you want to go to school, reach out to anybody and just hear their experiences, too. But this school, UMHS, was, for me, the opportunity, the foothold to push me into my career.

Is there anything else that you would like to add to current or prospective students or even alumni out there or anything that you'd like to add that we haven't covered?

Just the opportunities that UMHS had. The rotations we did as students across the state, across the country rather, there were so many resources, so much opportunity. That was another driver for me to pursue my medical education at UMHS. It really is a great opportunity. The school was incredible and it allowed me to be where I am right now and meet all of my goals for my own

Dr. David Henkin with his wife & two kids at home. Photo: Courtesy of Dr. Henkin.

Growing up in Metro Detroit

Where did you grow up and did you always want to be a doctor?

I grew up in Metro Detroit, so in Michigan. For as long as I can remember, I had wanted to be a doctor. It was my grandfather [who inspired me]; he passed away. He was a doctor; he was an internal medicine specialist. And I remember spending a night at my grandparents' house and a bird had flown into the window and we went outside together and he picked it up and it was injured. He put in the garage and made a little bed for it, I guess. I don't really remember exactly. The next day it was flying around the garage and we opened the garage and I left. And I just remember thinking he [helped heal] an animal. My grandfather fixed the bird with his bare hands. And I knew he was a doctor and I knew he wasn't a veterinarian. But to me was the coolest thing to just see that in action, to see him fix something. And from then on, all I ever wanted to do was be a doctor, just like my grandpa.

So you wanted to help human beings and fix people who are injured or sick, right?

Correct.

That's a great story. You attended Michigan State University as an undergrad and you originally majored in psychology. What made you want to study psychology, just out of curiosity?

I knew I was going to do pre-med and I knew that was all of the sciences and the biologies. So, to me, I had a meeting with someone from the major department, I don't remember what it's called. Just looking at all the different opportunities to major in. And I loved psychology already. I had a fascination with it. I used to read books about the brain and how people thought. And then I realized I could do a bachelor's of science in psychology and still get the sciences but with fewer biology courses and more of the psychology science courses. I always found the brain fascinating. I still do. And I think it complements what I currently do now. Part of what I learned in psychology is one of the classes, social psychology, why people react the way they do. Why people say things or why saying certain things would prompt a certain reaction. But to me it's the communication part and how the psychology of communication that I find really important in my field now, how to meaningfully communicate with patients.

Did you ever consider possibly going into psychiatry or neurology or anything that's brain oriented or?

Yeah, I liked everything when I did all my rotations. I thought about psychiatry for a little bit. As I was doing the rotation, I missed the peer medicine. There wasn't enough labs and medicine for me. And that was the driver for me to realize that I did appreciate internal medicine the most.

While you were at Michigan State, you worked on research project to improve medical competencies in the area of doctor-patient and peer-to-peer communication with the goal of enhancing medical school curriculums. Can you tell us a little more about this?

It was a really cool opportunity with a communications professor at Michigan State. He had gone and communicated with a dean of a medical school. And the purpose of the project was to enhance communications, interpersonal communications, peer-to-peer, doctor-patient, through creating this project that took all of the core clinical medical competencies, problem-based learning, professionalism, system-based practice for example, and then figuring out all of the best resources at the time that would help with communication for those competencies. And the learner, the medical student learner, would then take a test, if you will, on each of those competencies and they'd see where they were lacking if they were. And then it would push them to read more or watch different modules for those communication techniques to enhance communication in each of those competencies.

Communication is really important to me in medicine. But in what I do in my field, I take care of a lot of seriously ill patients who deserve a clear understanding of exactly what's going on with them and their health. And to sugarcoat it wouldn't do them the justice of having a meaningful interaction. So clear communication, meaningful communication with empathy, is so important. That project was something that really showed me the importance of communication. And then now I'm part of a few communications projects at Henry Ford. One of them is early introduction to communication at the level of the medical student. So, taking what I learned in my undergrad and then full circle, bringing that back in as a staff physician now and teaching enhanced communication techniques at the medical school level again.

It's interesting that you mentioned communication and telling people exactly what's going on.  I have friends who have had doctors who didn't communicate bad news well. Someone I know had a cancer diagnosis and she had a very inexperienced young doctor that didn't know how to break bad news and didn't say it properly and my friend was really shocked and upset with how unprofessional the doctor was. I think that's so important—communicating with compassion and truth. Especially when somebody's very sick and you have to tell them something is life-threatening or critical or God forbid, even terminal.

Tell us a little bit about your experience in hospice and palliative care. And could you also maybe explain the difference between hospice and palliative care?

Palliative care is a field of medicine that treats patients with serious illness to help support them and their families. And it's a concurrent care with their primary doctor, with their gastroenterologist, with their cancer specialist. And the palliative doctor is an extra layer of support helping with side effects or symptoms, pain being a big one that we manage, working in conjunction with their doctor. Palliation is to fix a symptom to make something better. It does not mean end of life care. It does not mean that someone is actively dying. It just means they have something that they need extra support with.

Hospice is, by definition, when someone has a prognosis of six months or less. It is a benefit through insurance that they can pursue a hospice level of care where the focus is purely on comfort and quality of life in their own home, in a hospital, in a hospice facility.

Hospice and palliative are all palliative care. Palliative care is not hospice, if that makes sense.

That makes total sense.

The focus is treating symptoms, the whole spectrum. But palliative care doesn't mean that you have an end-of-life diagnosis or terminal diagnosis.

It could just be you've had an accident and you're in extreme pain and you need a lot of pain management or rehab or whatever. And it's like we're going to be really intense but it's not necessarily mean that you have terminal. And I know that hospice usually means it's making somebody comfortable who is likely not going to get better.

I'll give you an example. I had a patient I just took care of. He had head and neck cancer. It was in the jaw and the treatment was chemo and radiation and surgery. And this is a big ask for anybody. The surgery removed part of his jaw so he can't communicate very well. The radiation is painful. The chemotherapy caused nerve pain and severe symptoms. I treated him for, he was my patient for a little over a year. Pain management and just helping understand what's going on with his disease. He was cured. He doesn't have cancer anymore. He has surgery and scars to show that he went through a lot. But he's cancer-free now and we've weaned him off of all of his pain medicines and he's a productive member of society.

Wow, that's amazing.

So, it was an opportunity to help somebody in their most vulnerable time with side effects and symptoms and fear related to cancer. But we got him through it. And now it's just the memory of we did that once and now we're not there anymore.

That's really promising and good news I'm sure for somebody to actually be cancer-free, even though, like you said, he went through a lot and maybe has a little bit of disfigurement or whatever, but he's alive. That's awesome.

Yeah.

Now you originally started out in internal medicine as a medical specialty. What are some of the most rewarding things about internal medicine as a specialty?

To me, I love medicine just because of the puzzle.

Of course.

To try to understand what someone's complaining their complaint is or their concern. And then asking the right questions, digging a little bit deeper, looking through the labs, looking at the images and synthesizing a diagnosis and then treating it. That to me was the best part. It is the best part. Just playing detective, if you will. That to me just has always been my favorite part of medicine.

What do you think that current and prospective students should know about the primary care shortage and how specialties like internal medicine can help fill the void that's present in the country?

You're right. Unfortunately, there is a shortage of primary care. So many doctors are retiring and not everyone's jumping to pursue primary medicine or primary care medicine. It’s arguably one of the most important roles as a physician to have. Preventative care, preventing people from going to the hospital, preventing people from needing to see a heart doctor early on in life by treating and getting involved to prevent something from even happening. One of the big reasons to not just jump into primary care is that everyone has these extravagant amount of medical student loans.

Of course.

And people are opting to pursue a surgical role or a dermatology position because they know they're going to get paid more and then they could really focus on their loans. So, there are a few medical schools that I've been told that are waiving a medical school fee. If you matriculate into this medical school, there's no loans; there's no cost.

Wow.

And the push is to get more people to pursue primary care because there isn't a driver to make as much money as possible to pay off these loans. Not realistic for everyone everywhere. But it is so important, primary care. And in my training, we did a day a week every single week in the same continuity clinic, treating patients, managing diabetes, high blood pressure, heart disease without having to send them to cardiologists or endocrinologists. It's very rewarding to see your work, to see your treatment plan become successful and prevent disease or to slow down disease, if you will. So, anyone that's going to read this, just really considering the importance of primary care and giving it an opportunity to try. I think it is a rewarding field.

Definitely. This is something that I've done some research on. I researched rural medicine by interviewing academics across America in the field and wrote a UMHS guide to rural medicine a couple years ago. It's primary care specifically for rural areas and not just—when I say rural areas, not just small towns—but places like Oklahoma or Nebraska or Wyoming where many would not consider going. But what they don't realize is that they're in such dire need for primary care in these areas and they pay very well. I've actually spoken to some UMHS alumni who've talked about that are practicing now in Oklahoma, whereas they thought if they were in a big city, they’d be making more money. But because the cost of living is much cheaper and they pay a lot more, I think a lot of people, I just know from one of the years I worked in admissions at UMHS that I'd get so many prospective students like, "Oh, I want to work at a big city hospital like Cedars Sinai in LA or New York-Presbyterian/Columbia University Irving Medical Center in New York City." While some people might be lucky enough to eventually work at one of the big prestige hospitals, they overlook the fact that there's so many other places that one can be working.

You're right. I saw that, too. Not to make everything about money, but going somewhere more rural, underprivileged, underserved.

From my understanding, a lot of these hospitals, and not only rural areas, but just smaller cities or medium-sized cities. By that I mean not on the coasts, in between somewhere. A lot of them will help out with student loans if you sign a contract for so many years. I think a lot of people don't realize that. Especially if they do some primary care in a smaller city, and maybe it's not where they ultimately want to be but they do two or three years there. They can make a really good salary, pay off their loans.

Absolutely.

Is there anything that you would like to say to the UMHS alumni out there?

I think that it's growing every year. There are more and more alumni. It's probably smaller than other medical schools. This is our opportunity to stay close and to network and to stay connected with everyone that we went to school with or went to the same school together. So, I say use these opportunities to just stay in the loop with everyone and network.

(Top photo): Dr. David Henkin. Photo: Courtesy of Dr. Henkin.

Email Dr. Henkin at henkinda@gmail.com