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Bottles Helps Predict Prevent
GRAND RAPIDS — About a quarter century ago, a cancer research administrator — the late Lewis Thomas — predicted science would invent something akin to vaccines to conquer the great suffering and huge expense of cancer.
Well, Kent Bottles, M.D., says we’re at the threshold of such a future right now and he believes this community can show the rest of the country how to deal with it, literally.
Bottles is what the British call a man of many parts. He is a pathologist and cytologist (a student of cell structure) and has practiced and taught in both disciplines in medical schools. In a field notable for clipped speech, Bottles is as contagiously effervescent as champagne.
He has been a for-profit genomics company executive. Since moving here in May, he has straddled the line between public and private sectors, serving as a community assistant dean for Michigan State University, vice-provost for health at Grand Valley State University, a professor with both institutions — all the while holding down his day job as the president and CEO of the Grand Rapids Medical Education and Research Center for Health Professionals (MERC).
MERC is a creation of a consortium of GVSU, MSU, Mercy Hospital and Spectrum Health. Bottles calls MERC a unique model. And what it’s setting forth to do, he said, will help the rest of the world adapt to what he calls the new paradigm in health care.
“This is the best job in the country,” he said of his post with MERC. “We’ve got four competitors all on the same page to create new models of education because of disruptive technologies.”
By “disruptive technologies” he said he’s referring to genomics, the emergence of nanotechnology, inventions such as artificial blood and vaccines for certain cancers. “These are all coming down the pike. They’ll change professional life, they’ll change all the rules, and they’ll have ripple effects which make it hard to predict how it’s all going to work out.”
He said that when he was a medical student and resident, the overall paradigm was “diagnose and treat,” with appropriate medicines or surgery or both. But thanks to the unfolding science of genomics, he said the new paradigm is becoming “predict and prevent.”
“Now you conduct a susceptibility test. Based on that test, you predict what diseases the patient is genetically disposed to, and you can prevent those diseases by changing lifestyle, by changing diet, perhaps even giving drugs to stop the disease from ever occurring.
“Under the old paradigm,” he said, “health was defined as the absence of disease. Now we’re moving from that to the mind-body approach to things.
“The point is that we kind of get stuck in the way we’re trained,” he said. “We really have to be open to change the way we do things because genomics is starting to turn medicine upside down. It’s changing the way we diagnose, classify and treat human disease.
“I think Grand Rapids medicine is really strong — it’s as strong as any large regional medical system I’ve ever seen in the country. But because of the changes coming out of research at the Van Andel Institute and other places like it, we have to change the way we’re going to practice medicine and we’re going to take Grand Rapids medicine to the next level.”
He said the changes occurring in medicine are as fundamental as those influencing manufacturing, financial services or any other sector of industry, and that has a personal impact.
“Diagnosing somebody with a biopsy or a blood test is one thing,” he said. “But it’s kind of different if you can tell a patient, ‘You don’t have this disease yet, but you’re at a higher risk to develop this disease because of your genetic inheritance.’ What does that mean to the patient? ‘Do I have it? Do I get the disease for sure?’ Suddenly you’re going to have to change the way doctors talk to patients, so that patients understand.”
He said a national movement has begun to reassess the training of physicians and other health care workers to give them the tools they need.
As VAI produces more and more results, he proposes an annual or semi-annual program for primary care physicians, nurse practitioners and other health care professionals. “These would be 1½-day sessions with people coming to Grand Rapids from all over the country on ‘How do you use all these new breakthroughs that are coming out? How do you treat that patient?’ It’s pretty exciting stuff.”
Though he has been in health care since receiving his M.D. from Case Western in 1980, Bottles says his biggest career break came only three years ago when Michael Wall, a genomics entrepreneur, invited him to join a New York firm named Genomics Collaborative.
“I was able to jump over to become a biotech executive in a business where they are linking up specific genes with specific diseases to develop new tests and drug therapies.
“It allowed me to learn the whole new culture of the for-profit world. It’s a little bit better at action and making things happen, a little bit more concerned with being economical — that sometimes is lost in the academic world.
“So now I get to be entrepreneurial in terms of education programs. It’s neat to have both perspectives.”
It also is exciting from the standpoint that Grand Rapids soon will have the Renaissance Zone site in which to incubate new genomics-oriented businesses.
And he’s convinced the opportunities for such businesses are open.
“This is not in the future,” he said. “It’s now. Today we have 700 to 800 genomics tests. Some of them deal with some kinds of breast cancer.
“Well, there are 34,000 genes and what’s in the future is predict and prevent: linking genes not just with breast cancer, but diabetes, heart disease, other cancers — and developing new drugs specifically for those diseases.”