By Merin C. MacDonald
In this month’s Chair’s Spotlight, we highlight the work of Doreen Brettler, MD, a physician and professor of medicine in the Division of Hematology/Oncology. Dr. Brettler has spent her career caring for benign and malignant hematology patients, with primary concentrations in hemostasis and thrombosis. She currently sees a broad spectrum of patients at the University campus for bleeding and clotting disorders, genetic blood disorders, and low blood cell conditions, as well as other chronic diseases and low-grade hematological malignancies. In October, we sat down with Dr. Brettler to learn more about her work.
Dr. Brettler has been practicing at UMass Memorial Health since the beginning of the 1980s. Early in her career, much of her focus was helping to develop a program at UMass that concentrated on bleeding disorders–mainly hemophilia. She eventually became director of that program which continued to grow during the late 1980s and early 1990s. During that time, a majority of her work transitioned to caring for patients who had contracted HIV, hepatitis C (HCV), or other transfusion-transmitted diseases, because the blood supply had become infected. She and her colleagues were able to obtain federal funding from the Centers for Disease Control (CDC) and others, to help with the care of this very specific group of patients.
Dr. Brettler’s focus has since shifted to include clotting disorders. There has been increased interest in thrombosis (clots in the veins and in the lungs) as well as in familial genetic issues with thrombosis in her practice over the years. She collaborates with the anticoagulation clinic in Cardiovascular Medicine to care for patients who are on blood thinners because in some cases, primary care physicians are not comfortable with prescribing newer therapeutic agents to their patients. She and her colleagues see these patients on matters such as how to handle their blood thinners and if or when to stop them. They also actively help patients transition from the pediatric to the adult hematology clinic. Sickle cell patients, for example, are a population that she and her team are specifically working with to help bridge care across both clinics so that patients who have been well-cared for as children and adolescents can continue their care as adults.
In addition to her work on bleeding and clotting disorders, Dr. Brettler cares for patients who have chronic diseases and are co-infected with HIV and/or HCV. She said that in the past, many of these individuals believed that they would not survive, but with the advancement of medication and therapeutics, have gone on to live long lives. They often need support with keeping up with regular preventive exams and procedures such as colonoscopies. “We believe it is important to get them better plugged into regular medical care, and help them coordinate with primary care physicians and other groups such as Gastroenterology and Cardiovascular Medicine,” she said. She also sees a variety of patients with other hematological disorders including low platelets, anemia, and low white blood cell counts, as well as lymphoma or other low-grade hematological malignancies.
Dr. Brettler emphasized her gratitude for her team, including Jennifer Feldman, RN, who works on bleeding and clotting disorders, and Megan Belanger, RN, who works exclusively in hematology. She is also grateful for the nurse practitioners, social workers, and administrative support that she receives. “[Having a supportive team] has been really helpful and I think it's been a really good team effort,” said Dr. Brettler. “It is very hard work and they deserve a lot of the credit.”
Dr. Brettler is hopeful that although many in the Hematology/Oncology fellowship lean toward training in solid tumors (e.g., lung and breast cancer), with continued support from Dr. Jonathan Gerber, chief of Hematology/Oncology, and support from national organizations such as the American Society of Hematology, interest will increase in this important field of work.
Dr. Brettler earned her medical degree from Stanford University School of Medicine in Palo Alto, CA. She completed residency programs at Santa Clara Valley Medical Center and Stanford Health Care - University Medical Center, both in California, and her fellowship at Brigham and Women’s Hospital in Boston, MA. Dr. Brettler joined the faculty at UMass Chan Medical School/UMass Memorial Health in 1981.
We are grateful for Dr. Brettler’s contributions to the Department of Medicine and for her ongoing commitment to excellence in patient care.