Washington People: Jane Garbutt

Improving patient care in private practices

Jane Garbutt, MBChB (center, right), goes over data with (from left) Randall Sterkel, MD, assistant professor of clinical pediatrics; Kathy Mandrell, research patient coordinator; and Robert Strunk, MD, the Donald Strominger Professor of Pediatrics; at a Washington University Pediatric and Adolescent Ambulatory Research Consortium planning committee meeting. Strunk calls Garbutt an “incredible jewel” for the medical school. “Her background helps us all understand how we might be able to approach treatment more effectively,” he says. “She has been able to get a large number of private pediatricians engaged in research, most recently focused on asthma care. One of my greatest accomplishments at the School of Medicine has been getting her involved in asthma research.” (Credit: Robert Boston)

Training in England gives Jane Garbutt, MBChB, a unique perspective on medical issues in the United States and how care can be provided differently.

Her hometown of Southport, England, about 20 miles from Liverpool, also offered Garbutt another advantage — an early glimpse of The Beatles.

“My dad said they wouldn’t last, but I thought they were fantastic,” says Garbutt, research associate professor of medicine at Washington University School of Medicine in St. Louis, who first saw the iconic rock group on TV when she was 10 years old.

The Beatles quickly won over the rest of the world, but Garbutt still endeavors to convince doctors to take a new look at patient care.

Medical stints in England and Canada convinced her that less treatment is sometimes better. Doctors in these two countries often question the need for immediate medical intervention and whether modern technology is necessary, Garbutt says.

Bradley Evanoff, MD, chief of the Division of General Medical Sciences, describes Garbutt as a pioneer in outpatient clinical research.

She has been successful, her colleagues say, because of her tremendous energy and intellectual curiosity.

Garbutt strives to help pediatricians in private practice find the most effective treatments for everyday medical problems. When children visit their pediatricians with common problems such as pinkeye and sinus infections, the treatments can vary greatly from doctor to doctor and from office to office.

Garbutt’s interest in solving the conundrums faced by private-practice pediatricians led her to establish a research network. The Washington University Pediatric and Adolescent Ambulatory Research Consortium (WUPAARC) now boasts 66 pediatricians and five nurse practitioners from 35 practices in the St. Louis area. WUPAARC pediatricians suggest the study questions.

“It’s not feasible to have a research assistant in every office,” Garbutt says. “It’s much more efficient if we can enroll a few patients from lots of different practices so we can share the burden of conducting research. This approach also makes our findings more applicable generally.”

In 2008, Garbutt began using her research expertise to study asthma. She is leading a large trial to evaluate if weekly calls from asthma coaches to mothers of children with the disease will help children gain better control of their disease. The coaches monitor how families are treating the symptoms and make recommendations to enhance asthma care and improve self-management.

“Jane’s expertise in the methods and logistics needed to perform research in outpatient settings is very helpful to other investigators,” says Evanoff, also the Richard A. and Elizabeth Henby Sutter Professor of Occupational, Industrial and Environmental Medicine in Medicine. “In order to move toward more evidence-based practice of medicine, it’s important to develop more practice-based evidence.”

Robert Strunk, MD, the Donald Strominger Professor of Pediatrics, calls Garbutt an “incredible jewel” for the medical school.

“Her background helps us all understand how we might be able to approach treatment more effectively,” he says. “She has been able to get a large number of private pediatricians engaged in research, most recently focused on asthma care. One of my greatest accomplishments at the School of Medicine has been getting her involved in asthma research.”

Garbutt also has investigated common medical problems in adults. A large study she and her colleagues published in February in the Journal of the American Medical Association determined that adults with sinusitis don’t recover faster or have fewer symptoms when they take antibiotics.

From barmaid to family practice physician

Garbutt has four brothers and is the oldest child. Her mother, who taught high school typing and shorthand, loved to throw parties. Her father, a scientist, redesigned workplaces and renovated properties in his second and third careers.

In her teens, Garbutt decided to become a physician and attend the University of Bristol. In England, students go straight from high school into a five-year medical training program that has more of a clinical emphasis than medical school in the United States. Garbutt chose to specialize in family practice because she enjoyed getting to know whole families. She also welcomed the challenge of using the breadth of her medical knowledge.

Throughout medical school she worked as a barmaid in a Bristol pub, giving her a crash course on interacting with the public.

“I discovered that people are basically good, and everyone has an interesting story,” she says, adding that she met her future husband, Jerry, when she served him a beer.

After a year of training similar to a residency in the United States, Garbutt and her husband moved to Toronto, where he had accepted a job in accounting at Coopers & Lybrand. Garbutt completed two years of family practice residency training in Toronto before practicing family medicine for five years.

But she always had been interested in academics and decided to return to school when her second child, Jeremy, was 18 months old. She completed a community health and epidemiology fellowship at the University of Toronto.

Trading watercolors for research methods

The couple moved again for her husband’s job, this time to St. Louis. For four years, Garbutt stayed home with their children and focused on painting with watercolors. But a stint as a community member on the School of Medicine Institutional Review Board (IRB) led to her current position.

From left: husband, Jerry; daughter, Kate; Jane Garbutt; and son, Jeremy. (Credit: Courtesy photo)

On the IRB, she got to know then-chairman William Powderly, MD, adjunct professor of medicine, who introduced her to Ben Littenberg, MD, who was forming the medical school’s Division of General Medical Sciences. She was hired as a part-time fellow in research methods.

During her fellowship, she started working with local pediatricians in a study that tested antibiotics in children with acute sinusitis. She joined the full-time faculty as a research assistant professor in medicine in 2003.

In addition to her clinical research and WUPAARC responsibilities, Garbutt directs the mentor training program in clinical investigation.

Stephanie Fritz, MD, assistant professor of pediatrics, says Garbutt has been an inspiring mentor who has made her research on staph infections possible.

“Dr. Garbutt and WUPAARC have been essential to me in the development and progress of my own research program,” Fritz says.

St. Louis pediatrician Randall Sterkel, MD, who has worked with Garbutt through WUPAARC and other research projects for about eight years, says she has championed the children in St. Louis and their pediatricians through research and advocacy.

“She is a good friend and colleague, from whom I have learned a great deal,” he says. “And because she does all of this while using the Queen’s English, she always sounds more erudite than those around her.”

Fast facts about Jane Garbutt

Born: Southport, England
University position: research associate professor of medicine and pediatrics
Most recent books read: The Cookbook Collector by Allegra Goodman and The Emperor of All Maladies by Siddhartha Mukherjee
Hobbies: Reading, painting with watercolors, bridge, growing wild roses, visiting her children, spending time at cottage in Canada
Family: Husband, Jerry Garbutt, owner of Global Surgical Corp., a local company that manufactures microscopes; daughter, Kate, 29, a financial researcher in San Francisco; son, Jeremy, 26, IT sales representative in Phoenix