The Beam: Introducing our new medical director, an in-depth look at our patient access team, and meet our new dosimetrist

Introducing new medical director, Dr. Annemarie Shepherd

Fred Hutch Cancer Center is excited to introduce Annemarie Shepherd, MD, the new medical director for Fred Hutch Cancer Center - Proton Therapy. Shepherd will start on September 1 and has extensive experience in proton therapy. Prior to coming on board, she worked and treated patients in three different proton therapy centers on the east coast.  She has had a special interest in protons and their potential since she was in medical school.

“I did a research year at University of Pennsylvania while they were building their proton therapy facility,” Shepherd explained. “It was incredible to witness the technology evolve. After I finished my residency at Penn several years later, the proton therapy center and technology had advanced so much.”

As a young student, Shepherd gravitated toward math and science. In college she worked on research to determine what makes cancer cells sensitive to radiation. Her mentor at the time encouraged her to see what the clinical side of medicine looked like.

“It was a formative moment. I saw how physicians can make a difference in a patient’s life, how a conversation with a specialist could decrease anxiety,” said Shepherd. “I wanted to be part of that.”

Helping patients through something as stressful and life-altering as cancer made oncology very appealing to Shepherd. She felt it was a perfect fit for her nurturing personality. She especially liked the high-tech aspect of radiation oncology with its constant changes and advancements, and the ability to limit toxicities while treating cancer. She has a particular interest in thymic malignancies, which are rare but uniquely benefit from the heart-sparing capabilities of proton therapy. Shepherd serves on multiple committees in the International Thymic Malignancy Interest Group and chairs the ITMIG International Tumor Board. 

After her residency at Penn, Shepherd moved to Memorial Sloan Kettering Cancer Center in New Jersey. She worked as a radiation oncologist with a specialty in thoracic cancers (which occur in the area of the torso protected by the rib cage). She was eager to treat patients using protons and further her research on proton therapy and thoracic malignancies. Later, when the New York Proton Center opened in 2019, she treated thoracic patients there. With her strong interest in protons and her leadership skills, she was very excited when the position for proton therapy medical director opened up at Fred Hutch.

“It was particularly enticing because I would be able to work with one of my greatest mentors from my residency at Penn — Dr. Ramesh Rengan,” said Shepherd. “He has helped me so much during my career. In fact, I know many of the physicians in the department already, which makes the prospect of working with them so great. I know they are genuinely caring individuals. Working in a culture where people take care of each other is very important, especially if you are going to move across the country for the job.”

Shepherd understands the challenges to running a proton therapy facility and is looking forward to helping mitigate issues such as insurance coverage.

“With more and more advancements, it’s really amazing to think of what the future potential is for protons,” she said.

Shepherd will continue to see patients with thoracic cancers while she serves as medical director. Her approach is to learn her patients’ background and their understanding of what they are going through; help to dispel any erroneous preconceived notions about treatment or cancer they may have; and help them understand what the oncology is today and what they can expect. 

“Just being able to relieve their anxieties — besides offering the best treatment plan, of course — that is my first priority,” she said.

Having lived all her life on the East Coast, Shepherd and her family are excited to explore all the West Coast has to offer. Her family of five loves traveling and spending time outdoors, which makes the Pacific Northwest all the more attractive to them. Please join Fred Hutch in welcoming Shepherd to the proton facility and be sure to share some of your favorite local places for her to explore.  

An in-depth look at the patient access team

The patient access team at Fred Hutch’s proton therapy facility is made up of a variety of roles, including team coordinators, patient care coordinators, health information management specialists, a revenue integrity analyst and an appeals coordinator.  

Patient care coordinators, or PCCs, are crucial members of the patient support system. From a patient’s first consultation to the start of treatment and subsequent follow-up care visits, PCCs are there every step of the way. They have a wide range of duties, including patient registration; obtaining relevant medical records such as imaging, pathology reports, radiation records and implant records; providing financial guidance and handling incoming phone calls. 

The team thrives on supporting patients during their most challenging moments. Team members often serve as the initial point of contact for patients, shaping their care experience and becoming their trusted guides through treatment. The ongoing interaction with patients allows the patient access team to build strong, personal connections with patients and their families. Every patient is paired with a PCC who provides one-on-one support throughout their proton therapy treatment, fostering relationships that significantly enhance their overall experience at Fred Hutch. 

There are three PCC teams, each tasked with managing specific disease areas.  

“We have a strong work family that collaborates well, creating a safe and comfortable workspace for us to thrive in,” said Matt Garcia, who leads the PCCs. “It really is our cast of characters and personalities that makes coming to work fun.” 

There are challenges, of course, including obtaining insurance approvals for proton therapy. 

“Some insurance providers continue to categorize proton therapy as investigational, underscoring the importance for our PCCs to write compelling prior authorization submissions that emphasize the medical necessity of proton treatment,” Garcia said. “We have developed expertise in navigating the complex authorization process, mastering each insurance's unique coverage criteria and the array of portals and forms needed for submission. The satisfaction of successfully advocating for the necessary care our patients need keeps us going.” 

Becoming a PCC at the proton therapy facility does not require any specific degree. However, it does involve a significant time commitment due to the many responsibilities and the challenging learning process, particularly in financial matters. It can take approximately six months to a year to fully grasp the nuances of the role.  

“To ensure thorough preparation, a minimum of one month of on-site training and shadowing with leaders and different departments is mandatory,” said Garcia. “We have a detailed competency checklist in place to ensure all skills are mastered.” 

The patient access team prides itself on its close relationships with one another. They enjoy getting together outside of work for seasonal and celebratory gatherings. Some of their favorite team-building activities include miniature golf, arcade games and bowling.  

Meet proton therapy dosimetrist Blake Webb 

“Helping and doing things for other people makes me happy,” said Blake Webb, the newest member of Fred Hutch’s proton therapy dosimetry team. “I feel like most of us in the medical field are this way in some fashion and working with the team at Fred Hutch Cancer Center - Proton Therapy has given me the ability to fill this bucket on a daily basis.” 

Webb works with physicians, physicists, radiation therapists and others to design and implement high-quality radiation plans that are customized to every patient’s needs.  

“I was always interested in math, science, using data to hypothesize an outcome, then attempting to achieve the desired outcome,” said Webb. “I like the team effort necessary to create radiation plans that are best suited and customized to help cure a patient’s cancer. I especially like using all the information possible — from assessing a patient’s anatomy to knowing our capabilities — to develop a plan designed to achieve a set of results.” 

Webb joined the team after having worked in dosimetry at Swedish Medical Center and then the Seattle VA Medical Center. He wanted to challenge himself and proton therapy planning was one of the only aspects of dosimetry that he hadn’t worked on.  

“I wanted to try something leading edge,” he said. “So far it has been an interesting experience and having to learn a new skill has been exciting!” 

Outside of work, Webb likes working with his hands, tinkering or building things. He will be celebrating his 14^th wedding anniversary with his wife this summer and they have two children ages 5 and 9 who keep them busy. He also enjoys creating delicious meals for his family. 

 “I especially love to cook,” he said. “I worked for years in the food and beverage industry and learned many cooking styles. My favorites are Indian, Thai, Vietnamese, Mexican and, of course, Pacific Northwest seafood.” 

 Say “hi” to Webb when you see him at the proton therapy facility.  

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