The Hero Next Door: ‘Stubborn’ DO puts patient care before all else
Anthony H. Dekker, DO, gives a presentation on addiction medicine at OMED 2012. Dr. Dekker currently treats U.S. military members for addiction. (Photo by Patrick Sinco)
This article is part of a series, The Hero Next Door, on osteopathic physicians who are quietly transforming health care in their communities and beyond.
Anthony H. Dekker, DO, was new to the Indian Health Service and unaccustomed to the scorching desert heat of Phoenix. On one 117-degree day in 1998, a 12-pack of Diet Coke exploded in his truck. After cleaning it out, he was walking back to his office at the Phoenix Indian Medical Center when he heard a loud tearing sound. He discovered its source: A 15-year-old hospital volunteer was manually shredding a huge stack of paper.
Sensing untapped potential, Dr. Dekker chatted with the volunteer, an American Indian girl, and learned that she came to the hospital because she wanted to shadow nurses. However, the hospital’s age requirements for shadowing meant she was tasked with paper shredding instead.
Dr. Dekker then introduced the girl to a few nurses, and he persuaded the administration to waive the 18-and-older rule for shadowing.
“The first week, we found four other girls who also wanted to follow nurses,” he says. “And now the Phoenix Indian Medical Center has more American Indian nurses than anywhere else in Arizona.”
Helping these students inspired Dr. Dekker to start a chapter of the Hoop of Learning educational program in the Indian Health Service. The program encourages native students to graduate from high school and earn college credit in the summer. Some 1 out of 2 American Indian students in Maricopa County graduated, but among the hundreds of kids who went through the program over 12 years, almost all earned their high school diploma, Dr. Dekker says.
“The ‘lines’ are not my friend. I’m not going to stay within the boundaries. I can prescribe yoga and Reiki and Tai Chi in addition to all the other standard treatments.”
Everywhere he has worked, Dr. Dekker has similar tales of going out of his way to help others, often by establishing community-enriching programs—from Chicago’s South Side to the Indian reservations of the Southwest, from Kansas City to Virginia, where he currently treats the military’s active-duty service members for addiction. Dr. Dekker says he doesn’t consider himself a hero. His patients—the men and women willing to sacrifice their lives for our country—are the real heroes, he says. But early in life, Dr. Dekker made a commitment to improving public health, and he has not wavered.
“There’s always an opportunity to make a lot of money if that’s all you want to do,” he says. “But if you want to take challenging situations and see if you can make a difference, that to me was more of a career choice.”
Eager to improve every community he worked in, Dr. Dekker’s projects often didn’t add to his organization’s bottom line, running him afoul of the administrators he worked for. When they tried to shut down his programs, Dr. Dekker would take his skills elsewhere.
“I tend to stir up dust wherever I am to try to facilitate change,” he says. “I’m a stubborn, stubborn person, and if I can’t serve the mission of improving people’s health, I don’t want to stay.”
Community medicine in Chicago
The son of Midwestern blueberry farmers, Dr. Dekker grew up in western Michigan and graduated in 1978 from the Michigan State University College of Osteopathic Medicine in East Lansing. He completed his residency at the former Chicago Osteopathic Hospital, then joined its staff. He established a division of community medicine, and his team created the first osteopathic adolescent medicine fellowship, he says.
Chicago’s South Side, where the hospital was located, was rough, and Dr. Dekker demonstrated unshakable commitment to working with impoverished populations, says former colleague Joseph Banasiak, who was the director of psychological services with Dr. Dekker’s community medicine program.
“Tony had a dream, and he is one of the hardest working and most altruistic people I know,” he says. “We developed a staff that consisted of not only physicians but also a psychological services section, which included social workers; developmental specialists; a neonatal specialist; and psychoeducational tutors. Children combined therapy with doing their homework.”
In Chicago, Dr. Dekker also established a program to provide health care to the homeless in 1982.
“There were so many homeless people and so many shelters throughout the Near South Side near the hospital,” Banasiak recalls. “Tony and his residents started visiting these shelters after completing a full clinic. He’d gather up all the sample medicines that we got from drug reps, and he’d go to shelters and treat people there.”
As word of the program spread, pharmaceutical companies began donating medications to the program, as did other osteopathic physicians, Banasiak says.
While the homeless program was a great success, Dr. Dekker says his most significant accomplishment in Chicago was ingraining community medicine in 12 classes of graduates from what was then the Chicago College of Osteopathic Medicine.
“We emphasized community service,” he says. “We developed great relationships with our graduates, and they continued this commitment to working with the underserved and working with high-risk populations.”
Then in the mid-’90s, Chicago Osteopathic Hospital was bought by a for-profit hospital chain.
More stories about unsung heroes
Read the other articles in our series, The Hero Next Door, to learn what DOs are doing across the nation and around the world to improve health care.
The new administration was unsupportive of the homeless program because it wasn’t making money, Dr. Dekker says. He found other DOs to run the program independently before he left.
“I had vowed to never work for a for-profit company,” Dr. Dekker says.
Dr. Dekker headed to Kansas City in 1994, where he worked just as hard on establishing new and innovative training methods and community-enriching programs. As the chair of family medicine at the Kansas City (Mo.) University of Medicine and Biosciences’ College of Osteopathic Medicine (KCUMB-COM), Dr. Dekker established a family medicine residency and a sports medicine fellowship as well as homeless intervention programs similar to the one he created in Chicago.
Also a faculty member at the University of Missouri-Kansas City, Dr. Dekker created an exchange between its theater department and KCUMB-COM to help medical students bolster their patient interviewing skills.
“We put all our students through videotaped interviews to make sure that they could address issues of patients trying to get inappropriate medications from them, patients who were sexually provocative or suicidal, and patients who had high-risk HIV infections and didn’t know it,” Dr. Dekker says. “The theater students would play different scenarios, and they did amazing theatric work challenging our students.”
Another innovative project Dr. Dekker spearheaded was the first student chapter of DOCARE International, his former student David D. Dyck Jr., DO, recalls.
“Dr. Dekker helped put together trips to Mexico and later to Guatemala, and the chapter has continued to blossom,” he says. “There’s so much more involvement from all of the osteopathic schools now, but I remember him as being instrumental in putting the first one together.”
One standout memory from their time together, Dr. Dyck says, happened on a DOCARE trip to Mexico. It was obvious that Dr. Dekker wasn’t feeling well on the plane, but he didn’t mention it to anyone, Dr. Dyck says. When they landed in Mexico, his condition worsened and he spent several days in bed, but then worked the rest of the trip. After returning to the U.S., Dr. Dekker learned that he had a bleeding ulcer.
“That’s just the kind of guy he was,” Dr. Dyck says. “He was always there, and nothing was going to stop him from doing the right thing or making the hard choices and doing the things that he felt were most important.”
Indian Health Service
Dr. Dekker loved Kansas City, but resigned from his job following an administration change at KCUMB-COM because he didn’t share the new leaders’ vision for the school. In 1998, propelled by a continued desire to serve those in need, he joined the Indian Health Service, a federal health program for American Indians. He helped lead the Phoenix Indian Medical Center and served as the service’s national consultant for addiction medicine and chronic pain management.
“I absolutely loved the mission of the Indian Health Service,” he says. “It was great to work with people who were so dedicated to a mission, who put themselves second and put the mission first. There are still problems in Indian Health, there’s no doubt about that. But the reality was, there was a lot more good than there was bad.”
“Nothing was going to stop [Dr. Dekker] from doing the right thing or making the hard choices and doing the things that he felt were most important.”
In Phoenix, Dr. Dekker’s Hoop of Learning chapter helped 19 students get into medical school and more than 50 gain admission into nursing programs. Through the program, students also took tuition-free classes from a nearby community college in the summer.
Dr. Dekker treated many patients for diabetes, alcohol and substance abuse, and chronic illness paired with chronic pain—all conditions prevalent in Southwestern American Indians. He is especially proud of his work treating the American Indian transgender population, he says. Many members of the large American Indian transgender community were resorting to prostitution, crossing the border for hormone therapy treatments, and abusing drugs and alcohol.
Dr. Dekker talked with the tribal community about treating these patients, and he began seeing them. He gave them hormone treatments so they wouldn’t have to go to Mexico to get them, and he counseled them on addiction and emotional issues.
“I said, ‘Listen, we can give you the medication that you feel is necessary to help you be the person you are,’ ” he says. ” ‘But as long as you continue to prostitute, you’re going to be in the presence of HIV, you’re going to continue to abuse drugs and alcohol, and the emotional issues that you have are not being addressed. Let’s supply you with the things that you need to feel human again. And we accept you as you are, we’re not trying to change you.’ “
Word spread in the community, and soon Dr. Dekker had 55 transgender patients.
“They started taking care of themselves, and they were highly invested in remaining sober,” he says. “They stopped working the streets and started getting jobs. It was just amazing.”
Dr. Dekker was surprised when a professor at the University of New Mexico called him and wanted to know how he came to be the doctor for so many transgender patients.
“The professor said that the transgenders were going to Albuquerque and saying, ‘There’s a doc in Phoenix who takes care of us,’ ” Dr. Dekker recalls. “And he also said, ‘You’re taking care of more transgender American Indians than anyone else in the country.’ “
Once again, administration changes cut Dr. Dekker’s time with the IHS short. He was promoted to a plum administrative position, but when told he could no longer see patients, he considered leaving. Then, when an administrator wanted to stop the Hoop of Learning program because it didn’t make money, Dr. Dekker realized that he had to go.
“I couldn’t watch all these programs that we created with the community just get randomly destroyed,” he says. “It was a sad moment because I’d only worked in Chicago, Kansas City and for the Indian Health Service to that point, and every time I left it was always because of administration.”
Addiction in the military
In 2011, Dr. Dekker started his current position as director of addiction medicine for Fort Belvoir (Va.) Community Hospital, a new military hospital.
Dr. Dekker is developing the hospital’s addiction medicine department. Of his patients, 90% are military members.
When treating these patients for addiction, Dr. Dekker notes, it’s necessary to take a holistic and multidisciplinary approach and consider the patient’s other possible conditions such as posttraumatic stress disorder, traumatic brain injury and physical injuries.
Many of his current patients, Dr. Dekker says, have a genetic predisposition to addiction that surfaces following a traumatic event.
“If your best friend that you have been with for the past 12 months is blown up in the Humvee in front of you, and you’re taking fire, and you can’t help him, and you hear him screaming for 20 minutes before he burns to death, is that going to have an effect on you?” he asks. “Are you going to try to numb yourself so you don’t feel those feelings all the time?”
Working with this population requires engaging them in their own treatment and personalizing the treatment, Dr. Dekker says.
“The beauty of being an osteopathic physician is there’s no limit,” he says. “The ‘lines’ are not my friend. I’m not going to stay within the boundaries. I can prescribe yoga and Reiki and Tai Chi in addition to all the other standard treatments.”
Dr. Dekker is always willing to go above and beyond to help patients, says Donald Berghman, MD, an addiction psychiatrist at Fort Belvoir. As an example, he cites Dr. Dekker’s diligence in working with one high-ranking Navy officer who was using extremely high levels of narcotics.
“Dr. Dekker has been following this Navy officer for well over a year, making sure that she does what she needs to do, making sure that when she needs to be hospitalized for detox that she gets in, sometimes in the face of opposition within our own hospital,” Dr. Berghman says. “Despite the resistance that he gets, he plows forward. And he does this with all the patients. He never says no to any patient who wants to come back and see him repeatedly.”
While Dr. Dekker’s commitments to his patients, public health and community service meant he had to make hard choices and leave places he loved, he consistently left inspired colleagues and bettered communities in his wake.
“I have the utmost respect for him as a physician and a personal friend,” says Dr. Dyck. “He has always been a hero for me throughout medical school and throughout my residency.”
Dr. Dekker represents the spirit of osteopathic medicine, says Banasiak, who has spent his career working with DOs.
“A.T. Still, wherever he may be, is smiling when he thinks of Tony Dekker,” he says. “Because when you talk about holistic medicine and treating the whole person, he exemplifies that. That’s how Tony approaches medicine.”