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ANNUAL REPORT 2001-2002
Summary
Teaching Programs
Administration
Research
Clinical Activity
Faculty Recruitment and Retention
Problems Areas and
Challenges/Opportunities for the Future
I. SUMMARY
This has been a year of continued development within the Division of
General Medicine. There has been ongoing recruitment activity, with
the recruitment of both research and clinically oriented general internists,
and the further development of the Division's academic programs. Each
of these areas will be elaborated upon in the following paragraphs.
Members of our faculty have assumed or have continued in major leadership
roles in the Department and Medical School, overseeing the clinical
and educational transformation of the academic medical center.
Members of the Division have an increasing visibility nationally and
locally, as evidenced by the number of published manuscripts, abstracts
presented at national meetings, a number of invited lectureships, visiting
professorships, and career development and research awards as well as
endowed chairs and medical school and departmental teaching awards.
Collaborative arrangements with faculty at the School of Public Health,
Schools of Education and Literature, Science and Art, as well as other
faculty in the Medical School, also have been very rewarding. Our plans
for the upcoming year will focus on filling out our existing health
services research base with complementary areas such as medical education,
medical decision-making, ethics, patient safety and health services
for underserved populations; as well as enhancing the skills and practice
context of our primary care physicians to promote quality and efficiency
in our clinical practice.
In summary, there has been a substantial increase in clinical care
activity and increased visibility of the research and educational activities
of the Division of General Medicine over the past year. As our research,
practice, and teaching environment becomes increasingly cost-competitive,
there will be new urgency to develop efficient and effective methods
to deliver care and educate health professionals in a changing environment.
It is anticipated that the Division of General Medicine will continue
to provide strong leadership in each of these areas to the Department
and Medical School in the upcoming year.
II. TEACHING PROGRAMS
A. Medical School Teaching: The Division has a number
of individuals who have continued major leadership roles in the Medical
School's undergraduate medical education programs.
Dr. Paul Fine is the Director of the Medical School's Clinical Refresher
Program, a tutorial for medical students who are returning to their
third-year clinical activities after an absence of one year or more.
Drs. Susan Goold and Joel Howell have been actively involved in teaching
Medical Ethics at the Medical School.
B. Postgraduate Training: A number of faculty in the
Division have substantial roles in postgraduate training in Internal
Medicine.
Dr. Joel Howell has continued his major educational role in the Medical
Center as the Director of the Program in Society and Medicine.
Dr. Rodney Hayward serves as the
Coordinator/Lecturer in the M-2 curriculum of critical appraisal of the
medical literature and medical decision making.
Dr. Peter Ubel is the Co-Principal Investigator of an Agency for Health
Care Policy and Research Funded Fellowship Program in health services
research.
Drs. Laurence McMahon and Joel Howell are Co-Directors and Dr. Hayward
is Associate Director of the Robert Wood Johnson Clinical Scholars Program
at Michigan.
C. Teaching Awards: A number of faculty have been recognized
in the past year for excellence in teaching. Those faculty include:
Dr. Robert Ernst received Special Recognition for contributions to
House Officer Teaching Program, Department of Internal Medicine, 2001.
Dr. Paul Fine was awarded the Kaiser-Permanente Award for Excellence
in Clinical Education.
Dr. Sean Kesterson received Special Recognition for contributions
to the Medical Student Teaching Program, Department of Internal Medicine,
2001.
Dr. Sanjay Saint was the recipient of the Silver Shovel Award, University
of Michigan Medical School, April 2002. He was also the recipient of
the Senior Award, University of Michigan Medical School, June 2002 as
well as the Token of Appreciation from Medical Students, June 2002.
Dr. Danielle Turgeon received Special Recognition for contributions
to the Medical Student Teaching Program 2001-2002, Department of Internal
Medicine Annual Dinner, 6/14/02.
Endowed Chairs:
Dr. James Woolliscroft, MD was awarded the Lyle C. Roll Endowed Professorship.
Dr. Joel Howell, MD, PhD, was awarded the Victor Vaughen Collegiate
Professor of the History of Medicine.
III. ADMINISTRATION
A. Administrative Positions: A number of faculty in the Division
of General Medicine have key administrative positions at the University
Medical Center and the affiliated VA Medical Center including:
William Barrie, MD, assumed the role as the Acting Associate Chief
of Staff (ACOS) for Ambulatory Care at our affiliated VA Medical Center.
Steven Bernstein is Director of the Health System's Guidelines Utilization
Implementation Development and Evaluation Studies (GUIDES).
John E. Billi, MD, continues as Associate Vice President for Medical
Affairs and Associate Dean for Clinical Affairs in the Medical School.
John Brinley, MD assumed the role of Medical Director of the Canton
Health Center.
John Crump, MD, continues as Medical Director of the Saline Health
Center.
Robert Ernst, MD, continues as the Associate Residency Program Director
in the Department of Internal Medicine.
Susan Dorr Goold, MD, MHSA, MA, is the Director of the Medical School
Bioethics Program.
Rodney Hayward, MD, continues to direct the VA Health Services Research
and Development Field Program.
Sean Kesterson, MD, continues as Medical Director of the Brighton
Health Center.
Sonya Krafcik, MD, assumed the role of Medical Director of Internal
Medicine Specialists in Chelsea, MI.
Sonia Mitrovich, MD, continues as Medical Director of East Ann Arbor
Health Center.
Thomas O'Connor, MD, continues as Medical Director of the Briarwood
Health Group and as Associate Division Chief for Ambulatory Care.
David Spahlinger, MD, continues his role as the Executive Medical
Director of the Faculty Group Practice, and Associate Dean for Clinical
Affairs in the Medical School.
Connie Standiford, MD, continues as the Associate Medical Director
for the Central Region in Ambulatory Care.
Paul Tichenor, MD is the Medical Director of the General Medicine
Faculty Practice and Primary Care Outpatient Practice. He oversees and
runs the outpatient clinical operations for the Division.
Peter A. Ubel, MD serves as the Director of the Program for Improving
Health Care Decisions.
James O. Woolliscroft, MD, Lyle C. Roll Professor of Medicine, is
the Executive Associate Dean and Associate Dean for Graduate Medical
Education.
IV. RESEARCH
- Major Scientific Accomplishments:
Steven J. Bernstein, MD, MPH continues his research on the
impact of cardiovascular procedures on patient's quality of life.
He also is involved in the measurement and implementation of clinical
practice guidelines. This work has focused on studying the accuracy
of medical records and systems to assess quality of care. He has applied
his research knowledge to the University of Michigan Health System.
This year he founded and Chairs the "Improving Care with Appropriate,
Responsible, Cost-Effective Pharmaceutical Prescribing (iCARE)"
Program and is the Director of the measurement and implementation
section of the Guidelines Utilization, Implementation, Development
and Evaluation Studies (GUIDES) program'. In addition, he continued
his work on the Board of Directors of the International Society for
Technology Assessment in Health Care.
John E. Billi, MD, leads the UM effort to develop an innovative
health plan (Partnership Health) in a partnership with the Ford
Motor Company, and leads the efforts to develop a similar program
(ActiveCare) with General Motors. He is responsible for the University
of Michigan's efforts in fostering new approaches to population-based
medical management, complex case management, and disease management
programs. He chairs the Michigan State Medical Society's Advisory
Committee on Medical Economics. He also represents UM at the Ford
Health Care Quality Consortium, a quality improvement initiative
that supports health services research using Ford Motor Company's
health data warehouse. Dr. Billi co-chairs the Southeast Michigan
Health Care Quality Forum, a regional quality improvement consortium
that includes representatives from the three autos, labor, payers
and the major health system of Southeast Michigan. Dr. Billi also
co-chairs the Michigan Quality Improvement Consortium, which develops
consensus on evidence-based guidelines, quality measures and coordinated
approach to quality improvement across all major health plans in
Southeast Michigan. Dr Billi also leads the University Oversight
Committee for the new pharmacy benefit management program at UM,
and chairs the Health System's Ambulatory Formulary Committee, coordinating
drug choices across all major health plans in Southeast Michigan.
Matthew Davis, MD, MAPP, has focused his research on the
financing and delivery of preventive services for children and their
families. Specifically, he is the principal investigator on a grant
from the Centers for Disease Control and Prevention to examine how
increases in costs of vaccines are likely to affect performance
of state immunization programs. He is also examining how recent
national shortages of vaccines developed, and how they have influenced
physician administration of vaccines to patients. In addition, Dr.
Davis investigates the impact of health insurance coverage on receipt
of health care services, and has been named a Robert Wood Johnson
Generalist Physician Faculty Scholar to examine the phenomenon of
underinsurance among privately insured families. He also has conducted
economic analyses of potential smallpox vaccination programs, and
was awarded the Milton Hamolsky Junior Faculty Research Award from
the Society of General Internal Medicine in 2002 for this work.
Dr. Davis has also received an outstanding educator award from the
Division of General Pediatrics, serves as a mentor for multiple
resident and fellow research projects, and teaches at the Gerald
R. Ford School of Public Policy.
A. Mark Fendrick, MD, continued a broad research agenda
to evaluate the clinical, economic and health system impact of medical
innovation. Dr. Fendrick continued his research on Helicobacter
pylori infection, focussing recently on the role of this infection
in the development of adverse events associated with nosteroidal
antiinflammatory drugs (NSAIDs). Published analyses addressed the
impact of innovative diagnostic tests for coronary artery disease,
homocyst(e)ine and electronic beam computed tomography (Archives
of Internal Medicine), and novel management approaches for individuals
with acid related disorders (American Journal of Gastroenterology).
Over the past year his work examining the effects of technological
innovation expanded to include clinical areas such as diabetes,
cancer, respiratory tract infections, and stroke. From a health
care system perspective, award-winning studies evaluating the increased
use of prescription drugs were published, as were analyses examining
the role of pharmaceuticals in specific clinical conditions. He
continues to mentor several residents, fellows and junior faculty
in economic evaluation, technology diffusion and outcomes research
methods. In his role as co-director of the Consortium for Health
Outcomes, Innovation, and Cost-Effectiveness Studies (CHOICES),
Dr. Fendrick has collaborated with investigators from several departments,
other academic units, health care payers, and industry. He serves
on the Cost-effectiveness Subcommittee in the NIH funded trial of
Lung Volume Reduction Surgery. He is a member of the Board of Directors
of the International Society for Pharmacoeconomics and Outcomes
Research (ISPOR) and serves on the editorial board of 4 peer-reviewed
publications.
Susan Dorr Goold, MD, MHSA, MA, continues her study of
the allocation of scarce healthcare resources, espeically the perspectives
of patients and citizens, in the Robert Wood Johnson Generalist
Faculty Scholars project, "Consumer Values and Preferences
for Managed Care." Results from projects using the CHAT (Choosing
Healthplans All Together) game have been published and presented
in national and international venues. A number of private and public
entities have licensed the technology, now available on CD-ROM,
in order to obtain input on health benefit priorities. She also
directs the Graduate Medical Education in Ethics program, an innovative
cross-departmental initiative to design and implement an ethics
curriculum for resident physicians. Recent publications from CHAT
projects and on the topic of trust in healthcare contexts have appeared
in JGIM, the Hastings Center Report and Social Science and Medicine.
Dr. Goold is Director of the Medical School Bioethics Program.
Rodney A. Hayward, MD, during the past year has been extremely
productive with regard to his personal work (especially presentations,
publications and initiation of new work regarding diabetes care),
and as Director of the VA Center for Practice Management & Outcomes
Research. He continues to serve as the Director of the Outcomes
Evaluation Core of the NIH-funded Michigan Diabetes Research &
Training Center and as an Associate Director of the RWJF Clinical
Scholars Program. In the past year he has had over 10 papers published
or accepted for publication and continues work as a Principal Investigator
of 3 VA Merit grants and is a co-investigator on several other projects.
Timothy P. Hofer, MD, MSc, continues to focus on methodological
and practical issues in profiling the quality of health care providers.
Currently he is the principle investigator and director of an AHRQ
sponsored Developmental Center for Education and Research on Patient
Safety. He has completed projects assessing the reliability and
validity of indicators of health care quality and resource use in
the areas of screening and preventive health services, hospital
care and currently diabetes care. These projects have focused on
the adequacy of risk adjustment, precision of measurement and ways
of establishing the degree to which indicators actually measure
processes of care that result in important health care outcomes.
Joel D. Howell, MD, PhD, continues his research on the
history of medical technology, with increasing focus on the policy
implications of his findings. He is presently writing a book on
the use of medical technology from 1925 to the present, as well
as one on the English use of medical technology for an earlier period,
and continues to publish widely in the scholarly literature. He
is also starting to explore the interesting, old, and persistent
connection of technology with privacy concerns in the United States.
Joel is a member of the University of Michigan Society of Fellows,
and continues to serve on the Executive Committee of the University
of Michigan Press. Nationally, he is on the editorial board of the
Journal of the History of Medicine. Joel continues to play an active
role in the educational mission, teaching extensively at all levels
of the curriculum. This includes lectures in the required sequences,
M1 electives in the first year, as well as continuing an innovative
law and medicine class to medical and law students jointly with
a law professor, and serving as co-director of the Clinical Scholars
Program and Director of the Program in Society and Medicine. He
is also active as a mentor for PhD students in the College of Literature,
Science, and the Arts. Joel was honored this year by being named
the first Victor Vaughan Professor in the History of Medicine.
Steven J. Katz, MD, MPH, has had a number of major accomplishments
over the past year. He is developing a vigorous research agenda
of the study of the process and outcomes of patient-provider communication
and decision-making with a special focus on early detection and
treatment context in cancer. He continues to lead an ambitious study
funded by NIH to examine the quality of treatment decisions for
breast cancer in population-based samples of women in three cities
in the United States. He received a new grant from the Michigan
Department of Community Medicine to examine ways to improve screening
for colorectal cancer in primary care. He has completed two randomized
controlled trials at the University of Michigan to evaluate the
cost and outcome consequences of electronic patient-provider communication
through both e-mail and web-based technologies. He is the Co-Director
of the Medical School-wide program - Consortium for Health Outcomes,
Innovations, and Cost-Effectiveness Studies (CHOICES).
Eve A. Kerr, MD, MPH, has continued her work on methodological
issues surrounding the measurement of quality of care in ambulatory
settings, on the influence of organization of care on quality, and
on the challenges of providing care to patients with multiple chronic
conditions. Dr. Kerr is recipient of a VA HSR&D Advanced Research
Career Development Award to pursue these areas of research. Dr.
Kerr is PI and co-PI on three VA research grants to study quality
of care issues. The first examines the validity of alternate quality
assessment tools, the second examines how using different data sources
to measure quality of care for diabetes affects the quality assessments,
and the third, a joint project with the CDC, studies the quality
of diabetes care for patients in 6 geographical locations. She is
also PI on three University of Michigan subcontracts from RAND to
examine quality of care in the community and in managed care organizations
and is co-investigator of the Quality Enhancement Research Initiative
for Diabetes in the VA. Dr. Kerr serves on the editorial board of
Medical Care Research and Review, continues to be on the core faculty
of the University of Michigan Robert Wood Johnson Clinical Scholars,
and has presented her research findings at the annual meetings of
the VA Health Services Research and Development Service and the
Society of General Internal Medicine.
Catherine Kim, MD, MPH, holds a joint appointment in the
Department of Obstetrics and Gynecology. She has focused her research
on the screening and management of cardiovascular risk factors in
women. Her research has focused on gender-specific exposures such
as contraception and pregnancy and association with cardiovascular
risk factors, as well as on the management of women at high-risk
for cardiovascular disease. During the past year, she has published
several articles examining the relationship between contraception
and diabetes in Diabetes Care and the Archives of Internal Medicine
and on the management of women with coronary disease in Circulation.
She is currently examining how structural characteristics of the
healthcare system affect women's screening and treatment of cardiovascular
risk factors in a multi-center cohort of diabetic patients. She
has reviewed the association between diabetes during pregnancy and
future diabetes in the mother (also accepted in Diabetes Care) and
was awarded the Society of General Internal Medicine Research and
Mentorship Award to examine cardiovascular screening and treatment
practices in high-risk pregnant patients. She has also developed
written materials for a new women's health curriculum for internal
medicine residents and coordinates a primary care gynecologic rotation
through her clinic.
Kenneth M. Langa, MD, PhD, completed his third year on
the faculty at the University of Michigan. Dr. Langa's research
focuses on the societal costs of chronic diseases in the elderly,
with an emphasis on Alzheimer's Disease. Dr. Langa is the recipient
of a Career Development Award (K08) from the National Institutes
of Health and a New Investigator Award from the Alzheimer's Association.
He is a collaborator on the National Institute on Aging (NIA) Health
and Retirement Study, a large-scale longitudinal survey of US adults.
Dr. Langa is Co-Director of the health system's Patient Safety Enhancement
Program. During the past year, Dr. Langa's research was published
in Medical Care, Journal of General Internal Medicine, and the Journal
of Clinical Oncology, and presented at national and international
research meetings, including the Society of General Internal Medicine,
the Gerontological Society of America, and the International Society
for Pharmacoeconomic Research.
Monica Lypson, MD, throughout her career, Dr. Lypson has
focused on medical education. She has worked with the National Board
of Medical Examiners and the Accreditation Council on Graduate Medical
Education and has served on numerous committees that have allowed
her to explore medical education at local, regional and national
levels. Dr. Lypson's research interests include historical and contemporary
trends in medical education, academic leadership and the under representation
of minorities in academic medicine. Her work this year focused on
the evaluation of medical student career choice in academic medicine
as it is stratified by race. In addition, she has begun work on
the implications and implementation of the core competencies in
residency education.
Rajesh Mangrulkar, MD, continues to establish a research
agenda studying the design and evaluation of digital technology
in medical education and clinical practice. He has focused his efforts
in three realms within this broad field. First, he and Dr. Richard
D. Judge have received grants from the Culpepper Foundation and
the Medical School to develop and implement the Professional Skill
Builder, a web-based multimedia teaching tool using case simulations
to promote history-taking, physical examination, and technology-management
skills. Using a unique partnership model between the University
and a private Internet start-up company, the pilot phase for this
project is nearing completion and will be undergoing testing in
the summer of 2002. He will then study the impact of this web-based
program on medical students and residents as part of his Master's
thesis work in Health Professions Education at the University of
Illinois-Chicago. Second, in the field of patient safety, he has
helped to implement two projects: one studying the impact of a computer-based
signout tool on adverse patient events, and a second developing
case portfolios of preventable adverse events to integrate into
medical school and residency curricula. Finally, he has expanded
his role in the teaching of evidence-based medicine (EBM) and the
evaluation of impact of these curricula on physician knowledge and
behaviors. He continues to serve on the Steering Committee for the
Society for General Internal Medicine's EBM Task Force (funded by
the Merck Foundation), leading the evaluation of its distance learning
interventions. He directs the Medical Decision-Making sequence in
the medical school and the Medical Informatics course for internal
medicine residents, and is actively involved in the integration
of EBM skills in the newly-revised medical school curriculum. He
also serves on the Comprehensive Clinical Assessment Committee for
the medical school. Finally, he has recently been appointed as Associate
Residency Program Director for the Department of Internal Medicine,
a position he will assume on July 1, 2002.
Laurence F. McMahon, Jr, MD, MPH, was the Co-Principal
Investigator with Van Harrison, PhD in Postgraduate Medicine, in
a recently completed study that demonstrated the use of administrative
data and a direct mail approach to improve mammography screening
in the Medicare population. He has continued to develop systems
to analyze and manage clinical processes with a recent paper with
Sanjay Saint, MD, MPH, illustrating the problem of cost shifting
among groups of hospitalized patients. He has taken the lessons
learned in the study of mammography in the Medicare population and
developed a new grant exploring the dynamics of colon cancer screening
among Medicare beneficiaries. He is also the Chair of the Health
Services Research Leadership Search Committee through the Medical
School under Dr. Gilbert Omenn. Finally, he along with Phillip Schoenfeld,
MD in Gastroenterology have applied for an Epidemiology Training
Program in Gastrointestinal Disease.
John Piette, Ph.D., is an Associate Professor in the Division
of General Medicine and a Research Scientist at the VA Center for
Practice Management and Outcomes Research. He holds a Sc.M. in Health
Policy and Management from the Harvard School of Public Health and
a doctorate in chronic disease epidemiology from Brown University.
Before coming to the University of Michigan last fall, Dr. Piette
was on the faculty at Stanford University and a researcher at the
VA Palo Alto Health Care System. Dr. Piette's research focuses on
the design and evaluation of chronic disease management services.
Much of his work has emphasized improvements in diabetes care and
the use of information technology such as automated telephone calls
and the internet to improve chronic illness management. He is a
Deputy Editor for the journal Medical Care and recently joined the
Research Policy Committee of the American Diabetes Association.
His research has been supported by grants from the VA, Agency for
Healthcare Research and Quality, and foundations. In recognition
of his contribution to the field of diabetes health services research,
Dr. Piette has been awarded the VA Under Secretary for Health's
Innovations Award and the Society for Behavioral Medicine's Diabetes
Research Award. Dr. Piette's research has been published in health
services research, general medicine, and medical specialty journals;
and he is frequently an invited speaker at conferences focused on
managing chronic health problems. In addition to his research, Dr.
Piette teaches courses in Evidence Based Medicine to Internal Medicine
residents and medical students.
Sanjay Saint, MD, MPH, has focused his research on enhancing
the safety of hospitalized patients. Specifically, as a hospitalist,
he is seeking to determine the best methods of delivering high-quality,
cost-effective care to patients admitted to the hospital. His research
interests include prevention of hospital-acquired complications
(eg, catheter-related urinary tract infection), meta-analysis, cost-effectiveness
analysis, and evaluation of guidelines, protocols, and critical
pathways. He has published articles in many peer-reviewed journals,
including the Archives of Internal Medicine and the American Journal
of Medicine. Additionally, he co-authored a clinical problem-solving
article in the New England Journal of Medicine. He continues to
serve as section editor of "Current Methodological Concepts,"
a new section of the American Journal of Infection Control. He was
presented with both the Silver Shovel Award and The Senior Award
from the University of Michigan Medical School, and the Token of
Appreciation from Medical Students. His research has been supported
by grants from the Agency for Healthcare Research and Quality, the
Department of Veterans Affairs, the Research Foundation for the
Prevention of Complications associated with Health Care, Blue Cross
Blue Shield of Michigan Foundation and the AETNA Quality Care Research
Fund. He also is editor of the Saint-Frances Guide series of clinical
manuals published by Lippincott Williams & Williams and has
co-authored the popular Saint-Frances Guide to Inpatient Medicine
and the Saint-Frances Guide to Outpatient Medicine. He also co-authored
Essentials of Diagnosis and Treatment (2/E), a pocket handbook published
by McGraw-Hill. He serves as Chair of the National Association of
Inpatient Physician's Research Committee and Chaired their most
recent Scientific Abstract Review Committee. He also Co-Chairs the
Adverse Events Committee at the Ann Arbor VA Medical Center and
is a member of the University of Michigan's Patient Safety Committee.
Finally, he directs the University of Michigan Health System's Patient
Safety Enhancement Program.
Maria J. Silveira MD, MA, MPH, is an internist, health
services researcher, and ethicist examining issues surrounding the
end of life. She recently joined the faculty of the Division of
General Medicine at the University of Michigan as a lecturer in
the Bioethics Program. She has published research regarding public
and physician knowledge about laws governing end of life (e.g. the
Oregon Death with Dignity Act), the geography of death, and how
elderly women make decisions about end-of-life care. Currently,
she is conducting several studies to reveal the determinants of
and improve quality in end-of-life care.
David Stern, MD, PhD, continues his research in medical
education, with a special focus on the teaching, learning, and evaluation
of professionalism in medical students and residents. He is also
involved in research on the use of standardized patients, cardiac
exam teaching using computers, and the effect of teaching skill
on student performance. Having completed a two-year research project
on when, where, and how professional values are taught, Dr. Stern
has had eight papers published or submitted on this topic. He has
recently completed research on predictors of professionalism with
a grant from the Greenwall Foundation. He has been working with
the Institute for International Medical Education (www.iime.org)
to establish international minimum standards for the MD degree,
and is assisting in the assessment efforts of this multinational
organization to ensure that all medical schools graduate physicians
with a minimum level of competency. The initial trial of this program
is ongoing in eight leading medical schools in China. As the director
of the new Global REACH program (Research, Education, And Collaboration
in Health) for the medical school, Dr. Stern is actively facilitating
research and educational collaborations between University of Michigan
faculty, and faculty from outstanding medical schools worldwide.
Peter Ubel, MD, research focuses on the intersection between
decision-making, health policy, and bioethics. He is currently director
of the Program for Improving Health-Care Decisions (PIHCD), a multidisciplinary
research group aimed at studying health-care decisions from the
bedside to the boardroom. In the past year, Peter has contributed
over a dozen articles to the peer review literature. In addition
he is principal investigator on three grants from the National Institutes
of Health. He is currently completing the third of five years of
support as a recipient of a Presidential Early Career Award for
Scientists and Engineers.
Sandeep Vijan, MD, MS, has been primarily focused on studying
methods of optimizing treatment and prevention of chronic diseases.
He is interested in understanding better the nature of individual
variation in risk of adverse outcomes, and also in how patient attitudes
and preferences affect these risks. He also is actively involved
in trying to understand the best means to improve care through a
combination of methods including understanding patient preferences,
the effectiveness of targeted care management, and of novel means
of dissemination of information - such as the impact of celebrities
on adoption of effective treatments and the use of electronic communications
and interventions to improve knowledge and use of preventive services.
Using information from these and other studies, he hopes to improve
our ability to understand how to optimize care for chronic diseases
from a broad perspective that includes patients, physicians, systems,
and society.
Brent C. Williams, MD, MPH, focuses his research and teaching
activities in graduate medical education. Teaching activities include
seminars in geriatrics, medical interviewing, psychosocial aspects
of clinical medicine, evidence based medicine, and managed care.
During this year, Dr. Williams began directing a Reynolds Foundation
Project to develop geriatrics curricula in multiple residency and
fellowship programs in medical and surgical specialties and subspecialties
(e.g., Emergency Medicine, Gynecology). He played a central role
in the development and implementation of a curriculum to teach interdisciplinary
geriatric care in managed care systems, and completed a project
to create national standards for measuring resident competence in
"new" curricular domains such as managed care, quality
improvement, and medical informatics. Publications included articles
relating to the measurement of faculty teaching performance, faculty
development for teaching, and the symptom detection among outpatients.
In addition to maintaining an active clinical practice, Dr. Williams
served on the Steering Committee of the Shelter Association Health
Clinics of Washtenaw County, and served on the Governing Council
of the Midwest Society of General Internal Medicine. He also received
the Community Service Award from the Washtenaw County Medical Society.
James O. Woolliscroft, MD, is the Executive Associate Dean
for the University of Michigan Medical School and Associate Dean
and Director of Graduate Medical Education for the University of
Michigan Health System. Internationally, Dr. Woolliscroft was invited
to present at the Forum of Presidents on the occasion of the 50th
anniversary of the founding of Tianjin Medical University, Tianjin,
China. He has also been named to the Board of Trustees of the new
Shanghai Jao Tung Medical School in Shanghai, China. Nationally,
he was elected to the office of President-elect of the Association
of American Medical Colleges, Group on Educational Affairs. Locally,
Dr. Woolliscroft was honored to be named the initial recipient of
the Lyle C. Roll Professor of Medicine endowed chair. The third
edition of the Handbook of Current Diagnosis and Treatment. A Quick
Reference for the General Practitioner, of which Dr. Woolliscroft
is the editor, was published. In addition, he is the principal investigator
on a grant received from the Ford Motor Company titled "Global
Health Policy Advisor". This grant will assist in the development
of global health care workforce competencies and educational programs
to meet the competencies for Ford physicians' worldwide.
B. Funding and Major New Programs: The overall research program
in the Division of General Medicine has continued to flourish. In
the past fiscal year, the funded research in the division has increased
from a yearly average of 5.4 million to 7.8 million dollars per
year. In addition, this past fiscal year, faculty applied for over
44 million dollars in total grant funding. There are a number of
faculty with substantial external funding, which includes the following:
Steve Bernstein
U.S. Department of Veterans Affairs, "Quality Enhancement
Research Initiative - Diabetes Mellitus (QUERI-DM)," Co-Investigator,
7/1/01-6/30/02, annual direct cost budget $300,000.
University of Michigan Hospital, "Guidelines Utilization, Implementation,
Development and Evaluation Studies (GUIDES)," Clinical Lead,
Guidelines Implementation and Evaluation, 7/1/01-6/30/02, annual direct
cost budget $336,451.
University of Michigan Hospital, "Improving Care with Appropriate,
Responsible, cost-Effective pharmaceutical prescribing (iCARE),"
Director, 12/1/01-6/30/02, annual direct cost budget $252,983.
Mark Fendrick
Consortium for Health Outcomes, Innovation and Cost Effectiveness
Studies (CHOICES), Co-Principal Investigator with Katz, 7/1/01-6/30/02.
University of Michigan Medical Center, "Health Services Core
Lab," Principal Investigator, 1/1/02-6/30/02, annual direct cost
budget $267,521.
AHRQ, "Targeting Interventions to Reduce Errors," Co-Investigator,
9/1/01-6/30/02, annual direct cost budget $132,450.
VA HSR&D, "Economic Impact of Guidelines for Gastroesophageal
Reflux Disease," Investigator, 7/1/01-6/30/02, annual direct
cost budget $132,600.
Aetna Quality Care Research Fund, "The Clinical and Economic
Effects of Antibiotic Therapy in Acute Exacerbation of Chronic Bronchitis,
Co-Principal Investigator, 7/1/01-10/31/01, annual direct cost budget
$39,869.
National Institute of Aging, "Computerized Calendar Methods
- Health and Economic Measures," Co-Investigator, 7/1/01-6/30/02,
annual direct cost budget $280,418.
Ortho Biotech, "UM/Ortho Biotech Outcomes Research Fellowship."
Co-Director, 7/1/01-6/30/02, annual direct cost budget $73,394.
AETNA Quality Care Research Fund, "The Discharge Navigator:
Facilitating the Transition from Hospital to Outpatient Care Via New
Web Infrastructure," Investigator, 7/1/01-10/31/01, annual direct
cost budget $17,372.
Glaxo Wellcome PLC, "CEA of Prophylactic Pacemaker - Implantation
to Allow Beta Blocker Use in Heart Failure," Co-Investigator,
9/1/01-6/30/02, annual direct cost budget $23,004.
Ford Motor Company, "Understanding Prescription Medication Cost
Growth," Collaborator, 7/1/01-7/31/01, annual direct cost budget
$36,000.
Robert Wood Johnson (RWJ) Foundation, "Clinical scholars program,"
Core Faculty, 7/1/01-6/30/02, annual direct cost budget $401,780.
Ortho Biotech, "Out-of-Pocket Costs for the Elderly with Cancer,
Principal Investigator, 8/20/01-6/30/02, annual direct cost budget
$57,692.
Ortho Biotech, "The Cost of Family Caregiving for the Elderly
with Cancer," Co- Investigator, 7/1/01-10/31/01, annual direct
cost budget $128,205.
Susan Goold
FGP Academic Venture Fund, "Graduate Medical Education in
Ethics," Principal Investigator, 7/1/01-6/30/02, annual direct
cost budget $156,197.
Robert Wood Johnson (RWJ) Foundation, "Clinical scholars program,"
Core Faculty, 7/1/01-6/30/02, annual direct cost budget $401,780.
Robert Wood Johnson (RWJ) Foundation, "Generalist physician
faculty scholar," Principal Investigator, 7/1/01-6/30/02, annual
direct cost budget $87,893.
University of Michigan Center for Clinical Investigation and Therapeutics,
"Human Subjects and Training Cores," Program Director, 7/1/01-6/30/02,
annual direct cost budget $50,000.
University of Michigan Medical School, "Bioethics Program,"
Program Director, 7/1/01-6/30/02, annual direct cost budget $171,175.
Rodney Hayward
Veterans Administration Medical Center, "Quality Enhancement
Research Initiative for the Care of Diabetes Mellitus (QUERI-DM),"
Principal Investigator/Director, 7/1/01-6/30/02, annual direct cost
budget $300,000.
Veterans Administration Medical Center, Merit Review, "Proactive
Diabetes Case Management," Principal Investigator, 7/1/01-6/30/02,
annual direct cost budget $188,323.
Veterans Administration Medical Center, "Health Services Research
& Development Field Program, " Principal Investigator/Director,
7/1/01-6/30/02, annual direct cost budget $600,000.
Robert Wood Johnson (RWJ) Foundation, "Clinical Scholars Program,"
Associate Director, 1/1/01-12/31/01, annual direct cost budget $401,780.
National Institute of Health-NIDDK, "Michigan Diabetes Research
and Training Center, Outcomes evaluation core, " Core Director
and Investigator, 7/1/01-6/30/02, annual cost budget $56,067.
Veterans Administration Medical Center, VA Service Directed Research,
"Survey of VA Researchers," Principal Investigator, 7/1/01-9/30/01,
annual direct cost budget $72,650.
Robert Wood Johnson (RWJ) Foundation, "Scholars in Heath Policy,"
Core Faculty, 7/1/01-6/30/02, annual direct cost budget $9,702.
Veterans Administration Medical Center, "Evaluating the Performance
of Explicit Quality Monitoring Systems in the VHA," Co-Investigator,
7/1/01-6/30/02, annual direct cost budget $252,498.
Veterans Administration Medical Center, "Evaluation of VISTA
Performance Profiles and Non-VISTA Measures." Co-Investigator,
7/1/01-11/30/01, annual direct cost budget $59,890.
Clinical Scholar Program #465, "Glycemic and Complications in
Diabetes Mellitus Type 2," Investigator, 7/1/01-06/30/01, annual
direct cost budget $15,883.
Veterans Administration Medical Center, "TRIAD," Principal
Investigator, 7/1/01-6/30/02, annual direct cost budget $275,076.
Veterans Administration Medical Center, "Economic Impact of
Guidelines for Gastroesophageal Reflux Disease," Co-Investigator,
7/1/01-6/30/02, annual direct cost budget $132,600.
Veterans Administration Medical Center Advanced Career Development
Award, Associated Level II, HSR&D, Mentor (Hofer), 7/1/01-6/30/01,
annual direct cost budget $174,335.
Veterans Administration Medical Center Career Development Award,
HSR&D, Mentor (Kerr), 7/1/01-6/30/02, annual direct cost budget
$151,681.
Timothy Hofer
Veterans Administration Medical Center Advanced Career Development
Award, Associated Level II, HSR&D, Principal Investigator, 7/1/01-6/30/02,
annual direct cost budget $174,335.
AHRQ, "Targeting Interventions to Reduce Errors," Principal
Investigator, 9/1/01-6/30/02, annual direct cost budget $132,450.
Veterans Administration Medical Center, "Quality Enhancement
Research Initiative for the Care of Diabetes Mellitus (QUERI-DM),"
Analytic Consultant, 7/1/01-6/30/02, annual direct cost budget $300,000.
Veterans Administration Medical Center, "Health Services Research
& Development Field Program, " Core Faculty, 7/1/01-6/30/02,
annual direct cost budget $600,000.
Veterans Administration Medical Center, "Evaluating the Performance
of Explicit Quality Monitoring Systems in the VHA," Investigator,
7/1/01-6/30/02, annual direct cost budget $252,498.
Veterans Administration Medical Center, "Quality Enhancement
Research Initiative for the Care of Diabetes Mellitus (QUERI-DM),"
Analytic Consultant, 1/1/01-12/31/01, annual direct cost budget $300,000.
Veterans Administration Medical Center, "Automatic ICU Risk
Adjustment Performance," Co-Investigator, 7/1/01-6/30/02, annual
direct cost budget $48,200.
Robert Wood Johnson Foundation, "Trends in Breast and Cervical
Cancer Screening in the United States and Canada," Co-Investigator,
7/1/01-4/30/02, annual direct cost $45,871.
Robert Wood Johnson (RWJ) Foundation, "Clinical scholars program,"
Core Faculty, 7/1/01-6/30/02, annual direct cost budget $401,780.
National Institute of Health-NIDDK, "Michigan Diabetes Research
and Training Center, Modeling Core, " Associate Director, 7/1/01-6/30/02,
annual direct cost budget $41,125.
Veterans Administration Medical Center, "Patient Preferences
and the Care of Diabetes" Co- Investigator, 7/1/01-6/30/0, annual
direct cost budget $42,565.
Joel Howell
Robert Wood Johnson (RWJ) Foundation, "Clinical scholars
program," Co-Director with McMahon, 7/1/01-6/30/02, annual direct
cost budget $401,780.
Robert Wood Johnson (RWJ) Foundation, "Clinical scholars program
Cohort 7," Co-Principal Investigator with McMahon, 7/1/01-6/30/02,
annual direct cost budget $342,312.
Robert Wood Johnson (RWJ) Foundation, "Clinical scholars program
Cohort 6," Co-Principal Investigator with McMahon, 7/1/01-6/30/02,
annual direct cost budget $157,258.
Robert Wood Johnson (RWJ) Foundation, "Health and Society Scholars
Program," Senior Investigator, 1/1/02-6/30/02, annual direct
cost budget $9,207.
Steven Katz
Consortium for Health Outcomes, Innovation and Cost Effectiveness
Studies (CHOICES), Co-Principal Investigator with Fendrick, 1/1/01-12/31/01,
see Fendrick.
Michigan Department of Community Health (Oakwood Healthcare System),
"Evaluating a Web-based Tailored Information & Feedback Program,"
Principal Investigator, 1/1/02-6/30/02, annual direct cost budget
$46,970.
Michigan Department of Community Health "Developing Electronic
Communication-Based Interventions Between Patients and Providers to
Improve Cancer Control in the Primary Care Setting," Principal
Investigator, 7/1/01-9/30/01, annual direct cost budget $53,167.
National Institute of Health, "Determinants and Outcomes of
Surgical Treatment for Women with Early Stage Breast Cancer: Is DCIS
Different than Invasive Disease?," Principal Investigator, 7/1/01-6/30/02,
annual direct cost budget $549,493.
Robert Wood Johnson Foundation, "Trends in Breast and Cervical
Cancer Screening in the United States and Canada," Principal
Investigator, 7/1/01-4/30/02, annual direct cost $45,871.
The European Community 5th Program, "Patterns and Correlates
of Mental Health Services Use in Selected European Countries,"
Principal Investigator, 1/1/01-12/31/01, annual direct cost budget
$16,295.
University of Michigan Medical School, Munn Research, "Early
Stage Breast Cancer," Principal Investigator, 1/1/02-6/30/02,
annual direct cost budget $15,000.
National Institute of Health, "Use of Radiation in Stage IV
Nonsmall Cell Lung Cancer," Co-Investigator, 4/1/02-6/30/02,
annual direct cost budget $151,000.
Eve Kerr
Veterans Administration Medical Center Career Development Award,
HSR&D, Principal Investigator, 7/1/01-6/30/02, annual direct cost
budget $151,681.
California Health Care Foundation, "Comparing Quality in California
Medical Groups," Robert Wood Johnson Foundation, "Variations
and Trends in the Quality of Care in the U.S.A Community Tracking
Study," Subcontract, Principal Investigator, 7/1/00-6/30/01,
annual direct cost budget $50,690.
Agency for Health Care Policy and Research, "Adult Global Quality
Assessment Tool," Co-Principal Investigator, 7/1/01-9/30/01,
annual direct cost budget $21,500.
Robert Wood Johnson Foundation, "Community Quality Index Part
II," Subcontract, Principal Investigator, 7/1/01-6/30/02, annual
direct cost budget $55,045.
Robert Wood Johnson (RWJ) Foundation, "Clinical Scholars Program,"
Core Faculty, 7/1/01-6/30/02, annual direct cost budget $401,780.
Veterans Administration Medical Center, "Evaluating the Performance
of Explicit Quality Monitoring Systems in the VHA," Principal
Investigator, 7/1/01-6/30/02, annual direct cost budget $284,865.
Veterans Administration Medical Center, "Evaluation of VISTA
Performance Profiles and Non-VISTA Measures," Principal Investigator,
7/1/01-11/30/01, annual direct cost budget $79,853.
Veterans Administration Medical Center, "TRIAD," Co-Principal
Investigator, 7/1/01-6/30/02, annual direct cost budget $275,076.
Veterans Administration Medical Center, "Quality Enhancement
Research Initiative for the Care of Diabetes Mellitus (QUERI-DM),"
Co-Investigator, 7/1/01-6/31/02, annual direct cost budget $300,000.
Catherine Kim
CDC National Center for Chronic Disease Prevention & Health
Promotion., "Translating Research into Action for Diabetes (TRIAD),"
Co-Investigator, 11/16/01-6/30/02, annual direct cost budget $592,664.
Kenneth Langa
National Institute of Health, K08 Award, "Identifying Cases
and Costs of Dementia in the United States," Principal Investigator,
7/1/01-6/30/02, annual direct cost budget $117,500.
Alzheimer's Association, "Identifying the Costs and Consequences
of Dementia in the United States," Principal Investigator, 9/1/01-6/30/02,
annual direct cost budget $44,618.
SGIM, "Identifying the Costs of Dementia Using Populatin-Based
Studies," Principal Investigator, 7/1/01-6/30/02, annual direct
cost budget $3,500.
Michigan Center on the Demography of Aging, "Using the Survey
Research Center Statistical Data Enclave to Explore Medicare Home
Care Use inthe Health and Retirement Study," Principal Investigator,
7/01/01-6/30/02, annual direct cost budget $15,000.
Michigan Center on the Demography of Aging, "Using HRS Restricted
Data to Examine Health System Effects on Formal and Informal Caregiving
for the Disabled Elderly," Principal Investigator, 7/01/01-8/31/01,
annual direct cost budget $15,000.
National Institute of Aging, "Health and Retirement Study,"
Collaborator, 7/1/01-6/30/02, annual direct cost budget $25,000.
Social Security Administration, "Implications of Chronic Health
Conditions on Work-Force Participation: Disability, Retirement, Caregiving,
and Lost Productivity, " Co-Principal Investigator, 7/1/01-9/30/01,
annual direct cost budget $51,021.
Social Security Administration, "Implications of High Risk Health
Behaviors on Work-Force Participation: Disability, Retirement, and
Lost Productivity," Co-Principal Investigator, 10/1/01-6/30/02,
annual direct cost budget $33,113.
National Institute on Aging, "Health and Retirement Study-Dementia
Supplement," Co-Investigator, 7/1/01-6/30/02, annual direct cost
budget $20,000.
Ortho Biotech, "Out-of-Pocket Costs for the Elderly with Cancer,
Co-Principal Investigator, 8/20/01-6/30/02, annual direct cost budget
$57,692.
Ortho Biotech, "The Cost of Family Caregiving for the Elderly
with Cancer," Principal Investigator, 7/1/01-10/31/01, annual
direct cost budget $128,205.
Laurence McMahon
Robert Wood Johnson (RWJ) Foundation, "Clinical Scholars
Program," Co-Director with Howell, 7/1/01-6/30/02, see Howell.
Robert Wood Johnson (RWJ) Foundation, "Clinical scholars program
Cohort 7," Co-Principal Investigator with Howell, 7/1/01-6/30/02,
annual direct cost budget $339,908.
Robert Wood Johnson (RWJ) Foundation, "Clinical scholars program
Cohort 6," Co-Principal Investigator with Howell, 7/1/01-6/30/02,
annual direct cost budget $157,258.
Blue Cross Blue Shield Foundation, "Analyses of Variation in
Health Care Use in Michigan," Collaborator, 7/1/01-9/30/01, annual
direct cost budget $44,863.
AHRQ, "Targeting Interventions to Reduce Errors," Chair,
Planning Committee, 9/1/01-6/30/02, annual direct cost budget $132,450.
Rajesh Mangrulkar
AHRQ, "Targeting Interventions to Reduce Errors," Co-Investigator,
9/1/01-6/30/02, annual direct cost budget $132,450.
Rockefeller Brothers Fund, "The University of Michigan Clinical
Skills Builder," Co-Investigator, 7/1/01-6/30/02, annual direct
cost budget $150,000.
John Piette
AHRQ, "Automated Assessments and the Quality of Diabetes
Care," Principal Investigator, 9/30/01-6/30/02, annual direct
cost budget $349,895.
Veterans Administration Medical Center, "Quality Enhancement
Research Initiative, Automated Telephone Assessment and Patient Education
to Improve the Quality of Diabetes Care," Principal Investigator,
7/1/01-6/31/02, annual direct cost budget $58,864.
Veterans Administration Medical Center, "TRIAD," Co-Investigator,
7/1/01-6/30/02, annual direct cost budget $275,076.
Health Services Research and Development Service, Department of Veterans
Affairs, Duke University, " Co-Investigator, annual direct cost
budget $175,148.
Sanjay Saint
VA HSR&D, Career Development Award, "Enhancing Patient
Safety by Reducing Catheter-Related Infections," Principal Investigator,
annual direct cost budget $159,683.
AHRQ, "Targeting Interventions to Reduce Errors," Co-Principal
Investigator, 9/1/01-6/30/02, annual direct cost budget $132,450.
Research Foundation for Prevention of Complications Associated with
Health Care, "Suprapubic verus Urethral Catherterization: A meta-analysis,"
Principal Investigator, 1/1/02-6/30/02, annual direct cost budget
$9,890
Blue Cross Blue Shield, "Enhancing Patient Safety by Reducing
Inappropriate Urinary Catheterization," Principal Investigator,
7/1/01-6/30/02, annual direct cost budget $57,731.
Aetna Quality Care Research Fund, "The Clinical and Economic
Effects of Antibiotic Therapy in Acute Exacerbation of Chronic Bronchitis,
Principal Investigator, 7/1/01-6/30/02, annual direct cost budget
$39,869.
Aetna Quality Care Research Fund, "The Discharge Navigator:
Facilitating the Transition from Hospital to Outpatient Care Via New
Web Infrastructure," Investigator, 1/1/01-10/31/01, annual direct
cost budget $17,372.
California Healthcare Foundation, "Quality Grand Rounds,"
Site PI, 11/16/01-6/30/02, annual direct cost budget $20,082.
Blue Cross Blue Shield of Michigan, "Improving Patient Safety
in Hospitals: Implementing Change at Ground Zero," annual direct
cost budget $114,119.
Maria Silveira
University of Michigan Life, Society and Values Program Pilot
Grant, "No Place Like Home: the Relationship between Place of
Birth and Death," Principal Investigator, 12/1/01-6/30/02, annual
direct cost budget $20,000.
David Stern
FGP Academic Venture Fund, "Graduate Medical Education in
Ethics," Co-Principal Investigator, 7/1/01-6/30/02, annual direct
cost budget $156,197.
Institute for International Medical Education, "International
Educational Assessment," Principal Investigator, 7/1/0-6/30/02,
annual direct cost budget $24,000.
Arnold P Gold Foundation, "Practice: Professionalism Research
Assessing Choices by Trainees in Clinical Education," Principal
Investigator, 7/1/01-10/31/01, annual direct cost budget 3,200.
China Medical Board of New York, Inc., "International Perspectives
on Human Clinical Trials," Principal Investigator, 7/1/01-6/30/02,
annual direct cost budget $102,000.
Danielle Turgeon
National Institute of Health, "Great Lakes-New England Clinical
Epidemiology Center," Co-Investigator, 7/1/01-6/30/02, annual
direct cost budget $1,297,689.
Advisory Council of Clinical Research, Medical School, "Effect
of NSAID's Upon Colonic Surrogate Endpoint Biomarkers," Principal
Investigator, 7/1/01-6/30/02, annual direct cost budget $24,285.
Merck and Company, Inc., "A Multi-center, Randomized, Parallel
Group Placebo Controlled, Double Blind Study with In house Blinding
to Determine the Effect of 156 Weeks of Treatment with MK-0966 on
the Recurrence of Neoplastic Polyps of the Large Bowel in Patients
with a History of Colorectal," Principal Investigator, 7/1/01-6/30/02,
annual direct cost budget $35,010.
Ubel, Peter
Veterans Administration Medical Center Career Development Award,
HSR&D, Principal Investigator, 7/1/01-12/31/01, annual direct
cost budget $141,237.
Veterans Administration Medical Center, "Presidential Scholar
Award," Principal Investigator, 7/1/01-6/30/02, annual direct
cost budget $25,000.
National Institute of Health, "Improving Value Measurement in
Cost-effectiveness to be Fair to Elderly and People with Disabilities,"
Principal Investigator, 7/1/01-6/30/02, annual direct cost budget
$254,196.
National Institute of Health, "Exploring Discrepancies Between
Patient and Public Utility Ratings," Principal Investigator,
7/1/01-6/30/02, annual direct cost budget $304,610.
National Institute of Health, "Identifying & Reducing Cognitive
Biases Created by Decision Aids," Principal Investigator, 1/1/02-6/30/02,
annual direct cost budget $283,656.
AHCPR, "Health Services Research Training," Co-program
Director, 7/1/01-6/30/02, annual direct cost budget $57,697.
AHRQ, "Targeting Interventions to Reduce Errors," Co-Investigator,
9/1/01-6/30/02, annual direct cost budget $132,450.
Sandeep Vijan
Veterans Administration Medical Center, Merit Review, "Patient
Preferences and the Care of Diabetes," Principal Investigator,
7/1/00-6/30/01, annual direct cost budget $42,565.
Veterans Administration Medical Center, Merit Review, "Proactive
Diabetes Case Management," Collaborating Investigator, 7/1/00-6/30/01,
annual direct cost budget $75,903.
Veterans Administration Medical Center, "A Custom Approach to
Implementation of Diabetes Hypertension Guidelines," Principal
Investigator, 7/1/01-6/30/02, annual direct cost budget $188,323.
Michigan Department of Community Health (Oakwood Healthcare System),
"Evaluating a Web-based Tailored Information & Feedback Program,"
Co- Investigator, 1/1/02-6/30/02, annual direct cost budget $46,970.
University of Michigan FGP Academic Venture Investment Fund, "Proactive
Identification of Patients At-Risk for High Utilization: Using the
MCDR Telephone Interview," Collaborating Investigator, 7/1/01-6/30/02,
annual direct cost budget $89,459.
Social Security Administration, "Implications of Chronic Health
Conditions on Work-Force Participation: Disability, Retirement, Caregiving,
and Lost Productivity, " Co-Principal Investigator, 7/1/01-9/30/01,
annual direct cost budget $51,021.
Social Security Administration, "Implications of High Risk Health
Behaviors on Work-Force Participation: Disability, Retirement, and
Lost Productivity," Co-Principal Investigator, 10/1/01-6/30/02,
annual direct cost budget $33,113.
Veterans Administration Medical Center, Mentored Career Development
Award, "Diabetes Care: Optimizing Quality, Minimizing Risk,"
Principal Investigator, 7/1/01-6/30/02, annual direct cost budget
$148,222.
Veterans Administration Medical Center, "Quality Enhancement
Research Initiative for the Care of Diabetes Mellitus (QUERI-DM),"
Co-Investigator, 7/1/01-6/30/02, annual direct cost budget $300,000.
Clinical Scholar Program #465, "Glycemic and Complications in
Diabetes Mellitus Type 2," Investigator, 7/1/01-06/30/01, annual
direct cost budget $15,883.
Brent Williams
Robert Wood Johnson/Partnerships for Quality Education, "The
Collaborative Interprofessional Team Education (CITE) Initiative,
Co-Investigator, 7/1/01-6/30/02, annual cost budget $17,014.
Partnerships in Quality Education, Ford Motor Co., General Motors,
and Michigan Department of Community Health, "Invitational Conference
on Managed Care Evaluation," Project Director, 7/1/01-6/30/02,
annual direct costs $25,000.
Donald W. Reynolds Foundation, "Comprehensive Programs to Strengthen
Physicians' Training in Geriatrics," Principal Investigator,
Faculty Development Core, 7/1/0-6/30/02, annual direct cost budget
$80,107.
Yarows, Steven
Astra Zeneca, "A Randomized, Double-Blind, Placebo-controlled,
Multicenter, Long-Term Trial of Preventing Hypertension using Candesartan
Cilexetil 16mg in Patients with High Normal Blood Pressure (TROPHY),
Principal Investigator, 7/1/01-6/30/02, annual direct cost budget
$3,475.
Merck & Co., Inc., "Life Study, Losartan Protocol 133/COZ
368," Principal Investigator, 7/1/01-1/31/02, annual direct cost
budget $29,853.
Omnicare Astra Zeneca plc, "Antihypertensive Efficacy of Adding
Candesartan citiexetil to Lisinopril in Comparison to Up-Titration
of Lisinopril," Principal Investigator, 12/1/01-6/30/02, annual
direct cost budget $9,400.
PPD Pharmaco/Bristol-Myers Squibb, Omapatrilat Cardiovascular Treatment
Assessment Versus Enalapril (OCTAVE)," Principal Investigator,
7/1/01-11/15/01, annual direct cost budget $2,000.
V. CLINICAL
ACTIVITY
The Division of General Medicine has a number of clinical responsibilities,
reviewed below by clinical area.
Primary Care Clinical Activity*
2001-2002
| Site |
Visits
2001 |
Visits
2002 |
Percent
increase/
(decrease) |
| General Medicine Primary Care Practice (Taubman) |
11,140
|
12,278 |
10.22% |
| General Medicine Faculty Practice (Taubman) |
13,861 |
14,155 |
2.12% |
| Briarwood Primary Care |
23,553 |
25,248 |
7.20% |
| East Ann Arbor Health Center |
18,780 |
17,075 |
-9.08% |
| East Ann Arbor Medicine/Pediatrics |
10,653 |
10,634 |
-0.18% |
| Saline Health Center |
5,289 |
6,016 |
13.75% |
| West Ann Arbor Health Center |
10,080 |
10.062 |
3.78% |
| Brighton Health Center |
22,553 |
23,500 |
4.20% |
| Howell Internal Medicine(1) |
4,776 |
0 |
|
| Chelsea Internal Medicine |
9,710 |
7,368 |
-24.12% |
| Internal Medicine Specialists |
9,538 |
9,044 |
-5.18% |
| Livonia Internal Medicine |
9,188 |
7,080 |
-22.94% |
| Novi Health Center(2) |
286 |
0 |
|
| Canton Health Center |
19,113 |
21,941 |
14.80% |
| Canton Medicine/Pediatrics |
8,366 |
9,214 |
10.14% |
| Monroe Health Center(3) |
751 |
0 |
|
| Ann Arbor VA Medical Center |
32,625 |
39,035 |
19.65% |
| TOTAL |
210,262 |
212,650 |
1.14% |
*Data source ACAR June 2002
- Howell site closed May 25, 2001
- Novi
Health Center closed as of July 31, 2000.
3.Monroe site closed
September 30, 2001
In summary, the clinical care activity provided by
the Division of General Medicine is an important component of our overall
mission. It is expected, given the importance of primary care, as well
as the shift of patient care activity and medical education from an
inpatient to an ambulatory care setting, that there will be growth in
all areas of General Medicine delivered primary care.
The Division of General Medicine has also been tracking its productivity
by using Relative Value Units (RVU's) assigned to each CPT code. These
RVU charts are attached.
VI.
Faculty Recruitment and Retention
A. Faculty - the following individuals were actively involved
in Divisional
activities during the past year:
University Hospital
Rodney Hayward, Professor
Joel Howell, Professor
Laurence McMahon, Professor
James Woolliscroft, Professor
Steven Bernstein, Associate Professor
John Billi Associate, Professor
Mark Fendrick, Associate Professor
Susan D. Goold, Associate Professor
Steven Katz, Associate Professor
Sanjay Saint, Associate Professor
David Stern, Associate Professor
Peter Ubel, Associate Professor
Brent Williams, Associate Professor
Kenneth Langa, Assistant Professor
Catherine Kim, Lecturer
Monica Lypson, Lecturer
Rajesh Mangrulkar, Lecturer
Maria Silveira, Lecturer
Paul Fine, Clinical Associate Professor
Mark McQuillan, Clinical Associate Professor
Susan Blitz, Clinical Assistant Professor
Jane McCort, Clinical Assistant Professor
Paul Tichenor, Clinical Assistant Professor
Jeffery Smith, Clinical Instructor
Veterans Administration Hospital
Timothy Hofer, Associate Professor
Eve Kerr, Assistant Professor
Sandeep Vijan, Assistant Professor
Angela Fagerlin, Research Investigator
John Piette, Research Investigator
William Barrie, Clinical Assistant Professor
Pamela Reeves, Clinical Assistant Professor
Caroline Taylor, Clinical Assistant Professor
Hester Choi, Clinical Instructor
Bobbi Lynn Jorkos, Clinical Instructor
Renu Chunduri, Lecturer
Primary Care
Thomas O'Connor, Clinical Associate Professor
David Spahlinger, Clinical Associate Professor
Connie Standiford, Clinical Associate Professor
Steven Yarows, Clinical Associate Professor
Robert Anderson, Clinical Assistant Professor
Linda Balogh, Clinical Assistant Professor
Sharon Berkowitz, Clinical Assistant Professor
F. John Brinley, Clinical Assistant Professor
David Cooke, Clinical Assistant Professor
John Crump, Clinical Assistant Professor
Monica DiMagno, Clinical Assistant Professor
Arvin Gill, Clinical Assistant Professor
Steven Gradwohl, Clinical Assistant Professor
Jenny Hsu, Clinical Assistant Professor
Mary Johnson, Clinical Assistant Professor
Sean Kesterson, Clinical Assistant Professor
Anita Kirsch, Clinical Assistant Professor
Mary Kleveland, Clinical Assistant Professor
Sonja Krafcik, Clinical Assistant Professor
Kristen Krieger, Clinical Assistant Professor
Yeong Kwok, Clinical Assistant Professor
Thuy LeDesai, Clinical Assistant Professor
Lawrence McMaster, Clinical Assistant Professor
Sonya Mitrovich, Clinical Assistant Professor
Jennifer Nastelin, Clinical Assistant Professor
Elisa Ostafin, Clinical Assistant Professor
Rajesh Patel, Clinical Assistant Professor
Rebecca Patrias, Clinical Assistant Professor
Namita Sachdev, Clinical Assistant Professor
Amy Saunders, Clinical Assistant Professor
Mark Skalski, Clinical Assistant Professor
Barbara Soyster, Clinical Assistant Professor
Eleanor Sun, Clinical Assistant Professor
Jeffrey Sweet, Clinical Assistant Professor
Linda Terrell, Clinical Assistant Professor
D. Kim Turgeon, Clinical Assistant Professor
Denege Ward, Clinical Assistant Professor
Rodney Dewyer, Clinical Instructor
Rochelle Eubanks-Daniel, Clinical Instructor
Charisse Gencyuz, Clinical Instructor
Clara Kim, Clinical Instructor
Julie Morelock, Clinical Instructor
Janice Stephenson, Clinical Instructor
Debaroti Borschel, Lecturer
Michael Kramer, Lecturer
B. Fellows
Peter Cram
Eric Stecker
C. Personnel Changes
There have been a number of personnel changes during this year and
these will be described by location.
University Hospital
1. Additions to the faculty
Catherin Kim, Lecturer
Monica Lypson, Lecturer
Maria Silveira, Lecturer
2. Departures from the faculty
None
Ann Arbor Veterans Administration Hospital
1. Additions to the faculty
Renu Chundrui, Lecturer
John Piette, Research Investigator
2. Departures from the faculty
Veda Giri, Lecturer
Richard Horenstein, Clinical Instructor
Primary Care
1. Additions to the faculty
Debaroti Borschel, Lecturer
Yeong Kwok, Clinical Assistant Professor
Michael Kramer, Lecturer
Julie Morelock, Clinical Instructor
2. Departures from the faculty
Sheila Bee, Clinical Instructor
Ching Chen, Clinical Assistant Professor
Gerald Dreslinski, Clinical Assistant Professor
Daniel Dubay, Clinical Assistant Professor
Breton Weintraub, Clinical Assistant Professor
Fellows
1. Additions to the fellowship
Eric Stecker
2. Departures from the fellowship
Keoki Williams
D. Promotions
Sanjay Saint, Associate Professor with tenure
David Stern, Associate Professor with tenure
Linda Balogh, Clinical Assistant Professor
David Cooke, Clinical Assistant Professor
Monica DiMagno, Clinical Assistant Professor
Jenny Hsu, Clinical Assistant Professor
Eleanor Sun, Clinical Assistant Professor
Jeffery Sweet, Clinical Assistant Professor
VII.
Problems Areas and Challenges/Opportunities for the Future
A. Health Centers: Expanded research and clinical activities
have placed new urgency on defining the role and cost structure of the
Primary Care practices in the supporting the basic missions of the Medical
Center. Although there is agreement that the primary care practices
spearhead the delivery of services and referral for subspecialty care
to patients for the Medical Center, there is less consensus on how costs,
revenues, and administrative resources should be allocated among the
hospital, Departments, and Medical School to achieve these objectives.
In addition, the balance and interdependence of our clinical programs
with our research and education missions will need to be addressed at
the Health System level.
B. VA Medical Center: Recent continued growth in the demands
for clinical services have place substantial stress on the human and
physical resources currently available at the VA Medical Center. A central
goal for the upcoming year will be to continue to meet the service demands
at the VA while developing or protecting the resources necessary to
pursue our education and academic missions. To accomplish this, we will
be working with the VA to improve existing administrative and incentive
structures, and allocate adequate financial resources to enhance the
educational and clinical programs of the Division.
C. Research: As the Division continues to expand the depth and
breadth of our research activities. We look forward to rounding out
our existing research faculty, with its major focus in traditional health
services research, to include focused, complementary areas such as medical
education, medical decision-making, patient safety, ethics, and health
services to underserved populations.
UM
Health System Department
of Internal Medicine
Division of GENERAL MEDICINE
300
North Ingalls, Suite 7C27
Ann Arbor, MI 48109-0429
Phone: (734) 936-5216 Fax: (734) 936-8944
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