A P U B L I CAT I O N O F N O R T H E A S T O H I O M E D I CA L U N I V E R S I T Y â€¢ V O L 2 0 .2 FA L L 2 019
LIVING IN POVERTY
he impact of poverty on health outcomes is real. And it happens in many ways — generational, residential and institutional. Any of us may fall victim to it. All of us can make it better for the least of us. I was born in the Bronx, a city of immigrants, in the year following the end of World War II. I have spent more than 40 years playing a small part in advancing medical education, health care and research, particularly to help those who are underserved. Reading this issue of Ignite in the last month before I retire, I remain as excited as ever about the work by our students, faculty, researchers and staff. Our medical, educational, public, civic and private partnerships have grown; our understanding of and relationships with the people in our communities have become even stronger. The advocacy, collaboration and empathic concern that you’ll witness in this issue show NEOMED as an exemplar of medical pedagogy and practice; and it shows Rootstown is the ideal hub and convener for the region that is Northeast Ohio. To have been a servant leader of a University that is patient-centered and world class is humbling. In this issue, you can read about how our students gain real experience by caring for the underserved. In “The High Cost of Sugar,” we get a taste of their work with NEOMED’s SOAR Student-Run Free Clinic. Their patient interactions are complemented by our humanities curriculum, which you’ll hear more about in “When I Realized.” The work of free clinics bridges the gap between managing one’s own health and having access to health insurance. “Making a Home on South Street” tells the wonderful stories of the Faithful Servants Urgent Care Center, where alumna Susan Tucker, M.D., helps those with financial needs maintain their dignity, and those in recovery restore theirs. “Taking a Family Approach to Schizophrenia” focuses on the importance of family support, and “When Refugee Health Matters” highlights the lack of understanding about refugees, revealing that they are often disrespected, misdiagnosed and mistreated. No one, especially babies, should be dying due to poverty or the social determinants of health (see “Finding the Goo-google Algorithm”). Caring empathetically for patients from diverse groups is critically needed, but so is medical education — which is why we at NEOMED also focus on public health. As I leave NEOMED now, after a decade of service, I look forward to reading about the new ways the University is combating economic barriers and helping make better health possible for all.
Jay A. Gershen
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VOL 20.2 FALL 2019 Northeast Ohio Medical University is a communitybased, public medical university with a mission to improve the health, economy and quality of life in Northeast Ohio through the medicine, pharmacy and health science interprofessional education of students and practitioners at all levels. The University embraces diversity, equity and inclusion and fosters a working and learning environment that celebrates differences and prepares students for patient-centered, teamand population-based care. Ignite magazine (Fall 2019, Volume 20, No. 2) is published twice a year by the Office of Marketing and Communications, 4209 St. Rt. 44, P.O. Box 95, Rootstown, OH 44272-0095 Email: firstname.lastname@example.org Jay A. Gershen, D.D.S., Ph.D., President NEOMED Board of Trustees Robert J. Klonk, Chair Paul R. Bishop, J.D., Vice Chair E. Douglas Beach, Ph.D. Sharlene Ramos Chesnes Joseph R. Halter Jr. Chander M. Kohli, M.D. Richard B. McQueen Phillip L. Trueblood Susan Tave Zelman, Ph.D. Student Trustees David Johnson Jonathan Seok
Editor: Elaine Guregian Contributing Editors: Samantha Hickey, Roderick L. Ingram Sr., Jared F. Slanina Publication Design: Scott J. Rutan Illustrations: Cover: Dave Szalay, associate professor at University of Akron Myers School of Art; page 4, Emily Wolchko, University of Akron Myers School of Art; page 8, Caitlin Kane, University of Akron Myers School of Art; page 12, Elise Radzialowski, University of Akron Myers School of Art. Photography: Lew Stamp, Chris Smanto As a health sciences university, we constantly seek ways to improve the health, economy and quality of life in Northeast Ohio. The Accent Opaque paper used for this magazine has earned a Forest Stewardship Council (FSC) and a Sustainable Forestry Initiative (SFI) certification. Strict guidelines have been followed so that forests are renewed, natural resources are preserved and wildlife is protected. Ignite was printed by Printing Concepts in Stow, Ohio, using soy inks. No part of this publication may be reproduced without prior permission of the editors. Copyright 2019 by Northeast Ohio Medical University, Rootstown, Ohio 44272.
DEPARTMENTS 24 HUMANITIES IN MEDICINE
34 DONOR SPOTLIGHT
28 IN THE REDIZONE
36 CLASS NOTES
31 WHALE WATCHING
38 WHALE WATCHING
32 TASTES LIKE HOME
39 FINAL LOOK
FEATURES 04 THE HIGH COST OF SUGAR
Just affording the medication and supplies for diabetes can be overwhelming for patients with no budget for health care.
08 TAKING A FAMILY APPROACH TO SCHIZOPHRENIA How to pull together to help a financially struggling patient manage schizophrenia.
12 CARING FOR OUR REFUGEES Health care is one of the basic human rights missing from daily life for many refugees.
18 MAKING A HOME ON SOUTH STREET Being the medical director of a free clinic could make a person jaded. One physician works to keep those feelings at bay.
About the cover: Artist Dave Szalay is an associate professor at the Myers School of Art of the University of Akron, a NEOMED partner school.
Ignite magazine was named Best Trade Publication in Ohio at the 2019 All-Ohio Excellence in Journalism Awards by the Press Club of Cleveland. It also won two awards for cover designs by artist Dave Szalay; two for headline writing; and writing awards for “The United Silence of America,” “Women in Surgery: A Rising Tide,” and “Finding Time for Reflection.”
20 FINDING THE GOO-GOOGLE ALGORITHM FOR BABIES TO REACH THEIR FIRST BIRTHDAYS Best practices that everyone can use.
For web extras, visit neomed.edu/ignite
The Society of Professional Journalists recognized Ignite with three awards in the Trade Publications category of the 2019 Ohio’s Best Journalism Contest. “Food for Thought” won first place (Best Department); “Women in Surgery: A Rising Tide” won second place (Best Trade Report) and “The United Silence of America” won second place (Best General Story).
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THE HIGH COST OF SUGAR BY ELAINE GUREGIAN
nsulin is ridiculously expensive,” says Bhavika Patel. “And a lot of people don’t know how to navigate the health care system to get it.” With diabetes being one of the most common chronic diseases in the U.S., Americans are paying a high price for this condition — in more ways than one. With low economic status linked to poor health outcomes in general, the prospects are grim for those trying to manage diabetes on a shoestring. So, when this second-year NEOMED College of Pharmacy student volunteers at the University’s SOAR Student-Run Free Clinic, she looks for every way she can to help clinic patients, who come there because they have limited resources. Diabetes weaves its own net of complications. “A lot of costs go along with
Illustration: Emily Wolchko
being diagnosed with diabetes. Even food — a lot of our patients can’t afford the food you need,” Patel says. In rural settings like NEOMED’s campus in Rootstown, food choices are limited — and so are transportation options to reach other food sources. And in a world where some people can access health care information quickly by going online, other people don’t have access to the Internet. They may lack the education or expertise to determine which websites are reliable (like the American Diabetes Association) and which ones may lead them astray with erroneous information or cures that are come-ons. “My sugar” is what people with low health literacy skills commonly call what a physician would refer to as their blood sugar level or blood glucose level. The term “sugar” itself reflects a common mis-
conception; a person’s blood sugar level isn’t elevated simply from eating foods with lots of sugar, but also from foods like white potatoes or white rice, which have what’s called a high glycemic index. Another huge gap for lower-income patients is that they don’t have a support system of people who can help them with any and all of the tasks needed to manage a complicated chronic disease like diabetes. Denial and pushback are common reactions from people who can’t afford the many associated costs of managing diabetes.
SMALL CHANGES Patel works with Harshitha (Hershey, as she’s known) Dudipala, a NEOMED College of Medicine student, on an interprofessional team of medicine and pharmacy students who see patients at
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Diabetes doesn’t travel solo. It usually arrives hand in hand with obesity, often carrying the added baggage of hypertension (high blood pressure). In Portage County, Ohio, where Dr. Awad teaches and practices, of those adults diagnosed with diabetes, 84% were also
obese or overweight, 80% had been diagnosed with high blood cholesterol and 62% had been diagnosed with high blood pressure. (Source: Portage County Community Health Status Assessment, 2016)
the free clinic, which operates under the guidance of NEOMED faculty and staff. “With a lot of patients, when we say it’s time to start on insulin, they’ll say, ‘I have a cousin on insulin. I don’t want it,’” says Patel. People may be overwhelmed by the news that they have diabetes, especially if they have in mind a dire outcome like a family member who lost a leg to the disease, says Patel. “As future doctors we’re trying to eliminate the negative connotations of insulin,” Dudipala adds. But reality is daunting. Start with insulin, add the high cost of glucose test strips and a glucose meter, and you’ve got a lot of ongoing expenses to go along with all the high maintenance of diabetes. Student volunteers at the free clinic are working on ways to present educational materials, remembering that they need to meet the patients halfway. (See some of their suggestions in the Resources list at the end of this article.) For a patient who eats too much fast food, that may mean rec-
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“WITH A LOT OF PATIENTS, WHEN WE SAY IT’S TIME TO START ON INSULIN, THEY’LL SAY, ‘I HAVE A COUSIN ON INSULIN. I DON’T
– Bhavika Patel ommending that they add some fruits and vegetables, instead of ordering them to eliminate all fast food — advice that’s pretty much doomed to fail. The students can’t change the circumstances of their patients’ lives — the social determinants of health. But they keep
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poking at the boundaries, helping to encourage incremental improvements, says Dudipala: If you’re talking with someone who doesn’t like to exercise, then you ask them, “Would you consider making a small change?”
MEETING THE PATIENT’S NEEDS As the pharmacy director of AxessPointe Community Health Centers, a group of Federally Qualified Health Centers (FQHCs) in Northeast Ohio, Magdi Awad, Pharm.D., encounters many people struggling to manage diabetes on a limited budget. And when Dr. Awad, an associate professor of pharmacy practice at NEOMED, teaches first-year College of Pharmacy students, he passes along his insights about working with patients who have low health literacy, which is often a byproduct of living in poverty. “I use the teach-back mechanism, where you have the patient repeat back to you the highlights of what you told
them, using open-ended questions. You try to get information from the patient to see what they learned,” he explains. Instead of overwhelming people with complex medical explanations, the health provider gives patients written materials in simple language — often with fewer words and more pictures. Handouts in pharmacy patient exam rooms at AxessPointe are heavy on visual cues, says Dr. Awad. For diabetic patients, for example, a care schedule uses visuals to remind patients what they need to do every three months, every six months and every year. Samantha Hickey contributed to this story.
RESOURCES Administering Insulin: diabeteseducator.org/living-with-diabetes/ tip-sheets-and-handouts/insulin-injectionresources American Diabetes Association 1.800.342.2383 or diabetes.org Blood Glucose Monitoring: diabeteseducator.org/living-with-diabetes/ tip-sheets-and-handouts/blood-glucosemonitoring Healthy Recipes: diabetes.org/food-and-fitness/food/ what-can-i-eat/food-tips/quick-meal-ideas/
A NATIONAL COMMISSION WORKING TO PREVENT AND REDUCE DIABETES John Boltri, M.D., a professor and the chair of the Department of Family and Community Medicine, oversees NEOMED’s SOAR Student-Run Free Clinic, which provides care to underserved patients — including anyone in need among the 20% of people over age 65 diagnosed with diabetes in Portage County, Ohio, where NEOMED is located. (Source: Portage County Community Health Status Assessment, 2016.) Dr. Boltri also serves on the National Clinical Care Commission (NCCC), established in 2018 by an Act of Congress to help improve the prevention and treatment of diabetes in the United States. Dr. Boltri is the co-chair of a NCCC subcommittee called Prevention: Targeted Population, which focuses on people at the highest risk for developing diabetes, such as those with pre-diabetes, obesity, high blood pressure, low HDL cholesterol levels and high triglycerides. It is Dr. Boltri’s hope that the National Clinical Care Commission’s recommendations to prevent and reduce diabetes and its complications will help lighten the heavy burden of diabetes in the United States — especially for those who can afford it the least.
Ohio Senior Health Insurance Information Program provides extra help for Medicare Part D prescription drug costs. 1.800.686.1578 or insurance.ohio.gov Social Security Administration Extra Help program (national website) for Medicare prescription drug costs: ssa.gov/benefits/ medicare/prescriptionhelp/ For web extras, visit neomed.edu/ignite
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TAKING A FAMILY APPROACH TO SCHIZOPHRENIA BY ELAINE GUREGIAN
hronic illness. Never going to get better. Dangerous. Going to be hospitalized. Those are typical generalizations people make about a schizophrenia diagnosis, but people with schizophrenia can and do get well and live normal lives. They can be productive members of society and be happy and fulfilled, says Mark Munetz, M.D., The Margaret Clark Morgan Endowed Chair of Psychiatry at NEOMED. “There is so much misinformation about schizophrenia. This lack of knowledge and how to access care is a barrier to people getting the help they need to recover,” says Dr. Munetz. A person who is financially secure will probably be able to identify and obtain many treatment options for schizophrenia. But people with limited financial resources are likely to be sidelined by any number of roadblocks, says Danelle Hupp, Ph.D., a clinical psychologist and clinical assistant professor in the Department of Psychiatry at NEOMED. Illustration: Caitlin Kane
Think of it this way: Schizophrenia touches people from every income level. Having less money doesn’t put you at higher risk, says Dr. Hupp, senior consultant and trainer at NEOMED’s Best Practices in Schizophrenia Treatment (BeST) Center, who trains staff at community agencies and hospitals to disseminate best practices to families of patients with schizophrenia. “But if your family struggles financially, you may not be connected to the resources or information to know there can be help — that this person could be living a much different life.”
THE HIGH HURDLE OF HOMELESSNESS Through the BeST Center, Beckie Kenney, LPCC, has worked with Dr. Hupp in a program called Building on Family Strengths: Supports, Education and Advocacy, which trains people to help families dealing with serious mental health issues — notably, schizophrenia. Kenney understands the hurdles, and how stub-
bornly they pop up for people in poverty. Homelessness tops the list, says Kenney, who is the director of quality improvement at Murtis Taylor Human Services System, a social services agency that helps an underserved urban population in Cleveland, Ohio. With the shortage of long-term facilities to provide mental health treatment, it’s easy for a cycle of homelessness to be set in motion, says Kenney: “A lot of times, patients are in and out of the criminal justice system. As counselors, we try to get them into subsidized housing, but a criminal background can mean that they’re not qualified for it. They may also be locked out of jobs, because of a criminal background. That creates a lot of the chronic homelessness and lack of employment and stability.” Kenney remembers a client she previously counseled for whom homelessness seemed like an insurmountable hurdle. “One patient (I’ll call him DeShawn), an African-American male, age 42 and single, was receiving Social Security but NORTHEAST OHIO MEDIC AL UNIVERSITY
– DID YOU KNOW?
The National Alliance on Mental Illness (NAMI) says that what may look to the rest of us like denial might be a lack of awareness of the disease, a condition called anosognosia. “With schizophrenia you might feel distressed but might only attribute it to external factors as opposed to having insight into that it might be something happening within your own person,” says Dr. Hupp. Such a lack of insight into the illness puts people with schizophrenia at higher risk for dangerous situations.
LOOK FOR THE EARLY WARNING SIGNS OF PSYCHOSIS Typically, a person will show changes in his or her behaviors before psychosis develops. The list below includes several warning signs of psychosis. • Worrisome drop in grades or job performance • New trouble thinking clearly or concentrating • Suspiciousness, paranoid ideas or uneasiness with others • Withdrawing socially, spending a lot more time alone than usual • Unusual, overly intense new ideas, strange feelings or having no feelings at all • Decline in self-care or personal hygiene • Difﬁculty telling reality from fantasy • Confused speech or trouble communicating
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the amount was very small — about $750 a month — and when you have a single male, they don’t qualify for the amount of food stamps that they used to. “DeShawn worked with his team at Murtis Taylor to learn to consistently take the medications that stabilized his symptoms. Medication compliance had been a major challenge for him and had led to his initial homelessness, so this was a significant achievement. But DeShawn was so concerned he wouldn’t be able to pay for all of his bills, his medication, his transportation, and so on, that he continued to live in the homeless shelter. Over time, DeShawn did move into his own apartment. He was able to maintain his housing through his ongoing medication compliance and the support of his case manager.”
A NEED FOR FAMILY ADVOCATES Fear of being labeled as a person with schizophrenia, with all the baggage that carries, often deters people from seeking help. “Often what you’ll hear is, ‘My son, my brother, doesn’t have schizophrenia: He wouldn’t shoot up a school. He would never hurt anybody like that, so he can’t have that disease.,’” says Dr. Hupp. Yet most people with mental health issues, including schizophrenia, are not violent, Kenney notes: They’re actually much more likely to be victims of crime. It helps to understand such common misconceptions — and the stigma around schizophrenia. At the same time, it’s often true that people with mental health problems really are treated differently from people hospitalized for other health concerns, says Dr. Hupp. For example, patients who undergo a routine colonoscopy are required to arrange transportation home, ideally with a family member or friend taking them, because they are con-
sidered to be functioning at less than 100%. But when a patient is discharged from psychiatric hospitalization, no one is required to accompany them, and the patient is the only one listening to the discharge instructions. “They’re given two weeks of medications and told, ‘Pick up your medication refill and go to these two appointments you have scheduled, and here’s bus fare home — or to the homeless shelter,” says Dr. Hupp. So, the stigma and the practical barriers make it especially important for people with a serious mental illness who are living in poverty to have family and friends who are knowledgeable about how to advocate for them. Often it takes a crisis for someone to be connected with a mental health service. The number of those crisis situations could be reduced if more family and friends were taught to recognize common early warning signs that a person with schizophrenia needs help. Another reason to include families? The mental health system in our country often treats the individual in a vacuum, rather than as a person who interacts with others. A holistic approach makes sense for all patients, regardless of economic status, says Patrice M. Fetzer, LISW-S, director of the BeST Center. “For people living in poverty, coordinating supports like housing, transportation and legal needs — and making their families aware of those supports — can make a profound difference,” she adds. More education about the disease and tools to help their loved one manage it can help families to relax, knowing they are doing the best they can. “When clients have family and friends who are supportive and knowledgeable, you will see much better outcomes including improved treatment adherence, reduced relapse and hospitalization rates, and improved overall family well-being,” says Dr. Hupp. “Everyone just does better.”
Family members with loved ones affected by schizophrenia developed a list of tips in consultation with the BeST Center at NEOMED (neomed.edu/bestcenter). For more details on each tip, visit email@example.com. 1
Take care of yourself
Learn as much as you can about schizophrenia
Participate in FIRST Family Psychoeducation
Listen to how your loved one is feeling
Be part of a support network
Try to create daily routines and to minimize stress for your loved one
Set realistic expectations
Be prepared for a relapse or crisis
Know the laws in your state
Never stop loving your family member or friend
DID YOU TAKE YOUR MEDS? Families can easily fall into the trap of saying, “Did you take your meds today?” “Just because now you’re aware that this individual has a diagnosis of schizophrenia, every time they cry doesn’t mean it’s a crisis. Every time they cry means they’re human and maybe they’re distressed by something. When you say, ‘Have you taken your meds today,’ you strip the humanness from them,” says Danelle Hupp, Ph.D. “You’ve immediately shut that person down, because now you’ve created a barrier between them and you.” What’s a better way to say it? “Maybe they didn't take their medication. Or maybe they're having a bad day. Try starting with, ‘I see you’re feeling really frustrated. What can I do to help you in this moment?’ That softens the person and lets them know that you’re there, and as the conversation goes along, you can gather information,” Dr. Hupp says. “Family and friends need to understand that it’s not just a matter of missing one pill. It’s a matter of ‘What are the events that led up to this?’”
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CARING FOR OUR REFUGEES BY JULIE AULTMAN, Ph.D.
’ve heard the personal stories of women who have fled the Northern Triangle in Central America (El Salvador, Guatemala and Honduras) with nothing but the clothes on their backs, and whose children were violently murdered by members of drug cartels. Bhutanese families have told me horrific tales about living in overcrowded, unsanitary refugee camps for over a decade with little food and water and losing loved ones to illness and malnourishment. I have observed Syrian refugees, who were rescued through humanitarian efforts, struggle to attain freedom from the discrimination and violence some experience living in the United States. From hearing dozens of these stories in clinical and research settings, I have come to see the challenges our U.S. com-
Illustration: Elise Radzialowski
munities have in providing appropriate aid and sense of security for these individuals and families who were not afforded basic human rights. Among the fundamental needs missing from daily life has been health care — a need presenting extraordinary challenges that begin, but don’t end, with the poverty in which many refugees first live when they come to the U.S.
LITTLE UNDERSTANDING Large numbers of us live in areas of the U.S. with resettlement programs designated to house, educate and provide support to refugees and asylum seekers who have been vetted through our federal government. Yet, we understand very little about the plight of our new community members prior to and during
their resettlement. We fail to recognize the humanitarian efforts that are needed to care for the most vulnerable of our global community. Many refugees and asylum seekers have a wealth of prior education, trade or farming experiences from which American society could greatly benefit. Before becoming a refugee, many individuals were lawyers, mathematicians, scientists, health care professionals, engineers and other professionals making a difference in their own communities. And they can continue to contribute. One success story I’ve encountered is that of Officer Damber Subba of the Akron Police Department — a Bhutanese refugee who was the first person of his ethnicity to become a police officer in Ohio. But because of a difference of appear-
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ance, language or living environment, our resettled neighbors are too often ignored, isolated and perceived as ignorant or incapable of contributing. Sometimes they are denied employment and educational opportunities; frequently, they are mistreated by business owners. Tandn (not her real name) told me that when she would go to a local convenience store, the employees would suspiciously follow her, make comments about her mismatched clothing, and inquire whether she could pay for the items in her basket. It wasn’t until more resettled Bhutanese entered the community that business owners became familiar with their culture and were less suspicious.
ELENA’S STORY A woman from El Salvador (I’ll call her Elena) sought asylum in the U.S. due to the extreme violence in her hometown, where she was repeatedly raped, beaten and held captive by a gang. Elena told me that before she learned English, her neighbors called U.S. Immigration and Customs Enforcement (ICE) to deport her to Mexico. They claimed that Elena had escaped Mexico, crossing a border into the U.S. The reality was that Elena had not even set foot in Mexico. She had been helped by a group of Americans and Europeans who had created a type of underground railroad to provide assistance, including support in seeking asylum in the U.S. Elena’s neighbors never bothered to introduce themselves or understand her story; they simply made assumptions. – Julie Aultman, Ph.D.
SOMEONE ELSE’S PROBLEM Within the health care sector, our refugees are often disrespected, misdiagnosed and mistreated, because providers do not want to take the time to work with a translator, or because the health issues are deemed too numerous and complex to fully address. Some health care professionals have told me they should not be responsible for learning about and examining more closely the physical and psychological impact of resettlement and its effect on refugee health. They believe the complex financial, social and health problems of resettled refugees should be someone else’s responsibility — namely, the federal government’s. It should be said that other health care professionals do have a desire to improve their local communities, and they do so by tackling the social determinants of health. For example, Susan Tucker, M.D., and Magdi Awad, Pharm. D., (the medical director and pharmacy director, respectively, of clinics for underserved patients in Northeast Ohio) manage the important but unpredictable need for interpreters at health care appointments by using a translator app to
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communicate with patients whose first language is not English.
HOW MUCH AND HOW MANY Are we doing enough? The United States has been a leader in refugee resettlement since the 1970s, offering care and hope to the most vulnerable, including survivors of violence and torture. However, due to reduced refugee admission caps by the current U.S. government, the number of refugees and asylum seekers being admitted for resettlement in the U.S. is now at the lowest rate since the Refugee Act of 1980 (immigrationforum.org). All refugees and asylum seekers who resettle to the U.S. are vetted through several federal agencies and go through extensive security checks and comprehensive medical screening, which can take up to two years. Once a community accepts a resettled person or family, local and state resources are provided for housing, health and nutrition, legal ser-
vices, education and employment opportunities. For example, in Ohio, the Refugee Services Program provides cash and medical assistance upon entry to the U.S., and offers social services (e.g., English language training, employment training, citizenship classes) for up to five years. Translation and interpreter services, referrals and citizenship and naturalization services are offered beyond the five years. These resources may appear to be generous, but the reality is that many resettled persons live in poverty, are socially isolated, and are unable to access many resources – including health care – due to lack of transportation, extensive mental and physical health issues, or the need to take care of family. It takes an understanding community of health care professionals, legal experts, educators, employers and business owners to work with local refugee agencies to provide access to these resources without bias or discrimination. Opposition to such community efforts is often generated by fear of “the other,” or the belief that
LESSONS LEARNED IN BOGATA Maryam Audu, M.D. (’19), worked as an operating room nurse before matriculating at NEOMED. Now an internal medicine resident at Summa Health System in Akron, Ohio, Dr. Audu volunteered in a clinic for underserved patients in Lisboa, Bogata, Colombia, for a global health certificate course that she completed through the NEOMED College of Graduate Studies, as well as to fulfill her final rotation at the College of Medicine. Dr. Audu was a fourth-year medicine student working on a team with a newly minted physician, a family medicine attending and two other family medicine residents when she met Maria (not her real name). Following is her reflection:
aria was just 24, a year younger than my younger sister, but her face belied her age; she looked older than me. I first caught a glimpse of her when I walked into Consultation Room 5. She was lying on the exam table, surrounded by medical students who were taking her vitals and measuring her abdomen. Her fiancé (a man at least 10 years her senior) watched from a chair in the corner. Maria was here for a prenatal consultation, 15 weeks pregnant with her first child, She had not seen a physician since the previous fall in Venezuela. She was the third Venezuelan refugee we had seen that morning. Many of them had not had medical care in months (some of them, not in years), and quite a few had run out of their medications weeks before their appointment. We were doing all that we could at the clinic, but because it was an underserved and under-resourced clinic, we could only provide preventative care and give discount vouchers for medications, lab tests and imaging studies. A lot of the people we saw couldn't even afford to return for their follow-up visits, see the specialists we recommended, or get the labs and images they required. This story stood out to me the most because not only was Maria pregnant; she also had a gastric tumor that had been diagnosed the previous fall in Venezuela. She needed to get endoscopies and would most likely require surgery, followed up by chemotherapy and radiation – meaning she would have to terminate the pregnancy or suffer the consequences of her malignancy. As a former operating room nurse, I had seen a lot of cases of malignancies that had become metastatic. I had held a lot of hands as people went under anesthesia. Now, watching Maria, I had nothing to give her but my hand and presence while we discussed her options.
Something that I have learned over the years is that patients need to be educated, so that they can be the leaders of their own health and advocates for themselves. Maria was not aware of the severity or implications of her gastric tumor. She had continued to smoke, had not gotten the required imaging studies and tests, had not followed up with her physician (because of finances, the country’s situation, and more), and she was now faced with a decision of choosing between her life and her baby’s. Dr. Camilo, my attending physician (family medicine), was a man whose intellect was astounding to me. His passion for educating his students and the patients never ceased to amaze me. He went above and beyond, to the point of giving his own personal dollars to some patients for medications. He talked at length with Maria about what she would need to do and reassured her that we would be there for her, no matter what — although ultimately, it was her decision to make alone. While I was growing up in Nigeria, I saw a lot of paternalistic approaches to medicine, and I expected a similar thing in Colombia, so I was amazed at how Dr. Camilo instead chose to arm his patients with information and let them partner in on their health care decisions. As a new physician, lessons I took from this experience (and previous ones) included continuing to listen to my patients – after all, in the words of our Human Values in Medicine director, Joseph Zarconi, M.D. (’81), they are the reason we are here; to continue having the heart of a nurse (to be there and hold someone’s hand, even in silence); and most important, to educate them so that they may advocate for themselves. Whether I practice in the U.S., or another country, these universal lessons will serve me well.
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A few years of assistance cannot quickly alleviate a lifetime of
persecution, sexual violence, physical and mental abuse, the loss of friends and family to war, or separation from loved ones through resettlement. Delivering health care that takes into account these pervasive issues — all in the context of ﬁnancial struggle — is no small challenge.
“American citizens must be taken care of first before outsiders,” especially given that so many citizens are already living in poverty.
HARD CHOICES Th e arduous process of acquiring asylum and refugee status, along with the resettlement process and cultural adjustment, can be as emotionally traumatic for individuals and families as their past experiences fleeing from persecution, conflict and violence – or having to live in an impoverished and overcrowded refugee camp where access to food and health care is considered a luxury. If offered the opportunity for resettlement, many refugees living in camps now refuse to leave. For example, some of the individuals within Northeast Ohio’s Bhutanese and Nepalese resettled community have described to me the difficulty of convincing family to resettle in a foreign land such as the U.S., where they can be exposed to even great16 I G N I T I N G
er risks than they faced in the camps. Suicide among our resettled refugee populations is now higher than the national average, due to alcohol and drug abuse, isolation, unemployment, depression, PTSD and loss of family. A few years of assistance cannot quickly alleviate a lifetime of persecution, sexual violence, physical and mental abuse, the loss of friends and family to war, or separation from loved ones through resettlement. Delivering health care that takes into account these pervasive issues — all in the context of financial struggle — is no small challenge. I’ve seen enough to know that when resources and community support are ample, refugees thrive and teach their diverse communities about their cultures, at the same time they assimilate into U.S. culture. I have been gratified to see how my own community has come together in meaningful ways to provide a safe and nurturing home for our resettled refugees, while giving them the opportunity to
share their stories through such advocacy agencies as ASIA, Inc., in Akron, Ohio. But when we don’t take the time to learn from our resettled neighbors and address their unique needs (health or otherwise), we contribute to the ill-health and poverty of our whole community. For the sake of everyone involved, we need to do better. Julie Aultman, Ph.D., is a professor of family and community medicine and the director of the Master of Arts in Medical Ethics and Humanities program and the Medical Ethics and Humanities Certificate program in NEOMED’s College of Graduate Studies. Her article “How Should Health Care Professionals Address Social Determinants of Refugee Health?” was published in the American Medical Association Journal of Ethics in March 2019. Resources: United Nations High Commission on Refugees, unhcr.org/5630f24c6.html
SIX ALUMNI FIND A NOVEL WAY TO GIVE They utilized a life insurance policy to maximize their giving potential
David Mallamaci, M.D. (’97)
Vimal Patel, M.D. (’96)
Albert Kim, M.D. (’97)
“We received a great medical education at NEOMED; our planned gift will help others do the same.” – Seilesh Babu, M.D. (’97)
Michael Huang, M.D. (’97)
Gagandeep Mangat, M.D. (’98)
In the company of friends, the conversation began as it often does — during a round of golf. But this time the friends — former classmates and fellow physicians — were simply spectators at the 2017 WGC-Bridgestone Invitational. The six friends share a love of the game, the medical profession and their alma mater — Northeast Ohio Medical University. Despite their busy lives and varied geographies, they get together for leisure activities and leisurely talks. So, when Seilesh Babu, M.D. (’97), a specialist in the treatment of ear and skull base disorders, started discussing a group gift in support of NEOMED, the conversation got really interesting. Drs. Seilesh Babu, Michael Huang, Albert Kim, David Mallamaci, Gagandeep Mangat and Vimal Patel decided to do what no group of NEOMED alumni had ever done — they decided to personally fund and donate a whole life insurance policy to beneﬁt the medical university they love.
How was this possible? And whose life would they insure? Here’s how it works: Seilesh volunteered to have his life insured, and all six friends would make tax-deductible gifts to the NEOMED Foundation totaling the policy’s annual premium cost. The NEOMED Foundation pays the premium cost, owns the policy and accumulates the policy beneﬁt over the next 10 years from the group’s annual gifts. The policy would pay up to a $150,000 beneﬁt to NEOMED on the death of the insured. Assuming there is no claim, the NEOMED Foundation can utilize the accumulated gifts. It’s as simple as that. By donating as a team, these classmates and friends chose to make a greater philanthropic impact on NEOMED than by giving separately. Although they were all on board, ﬁrst things ﬁrst: The guys had to ask their wives. No problem — they received full spousal support (it didn’t hurt that two spouses are also proud graduates of NEOMED). The group can nurture this long-term gift for the purpose of their choosing — scholarships, research funding, etc. It’s up to them.
Maybe you have thought about a future gift to Northeast Ohio Medical University through your estate plans or a seamless transfer of property. If you’ve already included NEOMED in your plans, THANK YOU! But please let us know so we can ensure that your legacy wishes come true.
A conversation that begins with you and your loved ones can move forward with a call to us. For assistance in accomplishing your planned giving goals, please contact: Michael A. Wolff, J.D. | 330.325.6667 | firstname.lastname@example.org
MAKING A HOME ON SOUTH STREET BY ELAINE GUREGIAN
Not many people are out and about on the street at 5 p.m. on a weeknight in the tired South Akron, Ohio neighborhood where Faithful Servants Urgent Care Center set up shop three years ago. The clinic sits across the street from a funeral home, not far from a county jail and a Salvation Army office. Most of the patients coming to the clinic live in halfway houses nearby. In a state that was second in the nation in 2017 for drug overdose deaths involving opioids, addiction is a familiar topic. Susan Tucker, M.D., an internist who graduated from the College of Medicine in 2012, started this free clinic location three years ago with her husband, Joe Tucker, the executive director of South Street Ministries — a nonprofit that does community development work. She’s here every Wednesday night, assisted by volunteers like Caitlin Morgan, Pharm.D., a 2016 graduate of the College of Pharmacy, and Jan Green, a former nurse who on one spring evening has brought in a homemade quinoa taco salad to share with patients — her way of making the experience homier. In between seeing patients behind the screens that serve as simple exam rooms and recording patient notes on her laptop, Dr. Tucker talked about what health care is like for her patients at the clinic. Many of the people we see in the clinic are in recovery, living in recovery housing in the neighborhood. They are in a system where they are often stripped of their identity and their humanity. They’re given a number; they are treated very anonymously, like just one more in a line.
Photo courtesy of Elaine Guregian
I think the bulk of the good that is done in this clinic is probably done by my front desk volunteers. We intentionally have a setup where our front desk is right in the waiting room with our patients, not separate. Their job is much more than just entering data. It’s to look the patients in the eye and talk with them. My favorite nights are the nights when I’m sitting here and I’m afraid that I have a hundred patients waiting, because I hear so much noise in the waiting room, but it’s because my front desk is engaging with them in a way that reminds them who they are — that they are much more than just, ‘Ok, next in line.’ Those conversations with our volunteers are what can empower people to continue and can motivate them to change. Our primary goal is to provide health care in a way that shows dignity and compassion. I work three days a week at a family practice and one night here. That gives me balance. Through the course of med school and training, it’s easy to focus on the medicines and the numbers and writing all the labs down and to lose sight of that goal of providing care with compassion. If people aren’t careful, they will lose sight of the humanity of the person in front of us — no doubt about it. If you don’t guard yourself against callousness, if you’re not proactive, you can get jaded in residency. So, you need the intentional discipline of sitting with patients, looking them in the eye and asking their stories. My own background is so different from our patients’. I want to hear their stories. I feel like it allows me to be compassionate when I’m frustrated. When I’m wondering why they’re here four weeks in a row for silly things, or when I know
they’re abusing the system and I’m frustrated with it, it does remind me that they still have a story, and they still have a reason for why they’re there today. Even if it’s not a medical reason that warrants my
THEY ARE IN A SYSTEM WHERE THEY ARE OFTEN
pertension, medication effects and kidney — in 10 minutes. We are trying our best to collaborate with others in the community and in the re-entry and recovery communities to minimize barriers for patients to get quality care and limit overutilization of hospital emergency departments. Tell us about a patient who especially needed your help because of their financial need. A woman in her 40's — I’ll call her Rose — was in one of the halfway houses and was sent to see us initially about six months ago. She has a significant medical history of blood clots due to a hypercoagulable state and she is on coumadin, which requires close monitoring. When Rose saw us at our South Akron location, we were limited in what we could offer on site, but given her known hypercoagulable state, her health would have been at significant risk had she stopped the blood thinner or gone a prolonged period without monitoring. We were able to get Rose connected at our Tallmadge clinic for monitoring on her blood thinners, so she's been able to continue with her program and is now four years sober. Just last month, she spent a lot of time talking with one of our volunteer physicians on how impactful the re-entry and recovery programs at the Front Porch Cafe [another arm of South Street Ministries] and through our clinic have been, and how grateful she was to have been connected with us during this hard period. Rose just started a new job and will have insurance within the next couple of months, so we were able to support her and encourage her in this challenging time.
STRIPPED OF THEIR IDENTITY AND THEIR HUMANITY.
THEY’RE GIVEN A NUMBER; THEY ARE TREATED VERY ANONYMOUSLY, LIKE JUST ONE MORE IN A LINE. doctor time, it warrants my human time. Transportation is often an issue for low-income patients. How have you seen that factor into care for the people at your clinic? Many of our patients in the city of Akron have a tremendous barrier to transportation, because they rely on a relatively sparse busing system. Our primary clinic location is in the Akron suburb of Tallmadge, about five miles away, which is difficult for patients to reach with just one bus going that far. Traveling to the lab work location can be a two-hour trek by bus and walking for many of our patients, who live in the halfway houses in South Akron near our smaller clinic. We were able to reduce that barrier when we were generously given a grant for an on-site EKG machine and for a Piccolo machine, which allows us to get an accurate comprehensive metabolic panel — a test that’s used frequently to monitor diabetes, hy-
NORTHEAST OHIO MEDIC AL UNIVERSITY
FINDING THE GOOGLE ALGORITHM FOR BABIES TO REACH THEIR FIRST BIRTHDAYS BY RODERICK L. INGRAM SR.
t any given moment, millions of people depend upon data to prescribe what they should do in a certain situation. Data optimizes traffic lights and driving patterns. It guides business decisions. When we search for information on the web, Google's algorithms crunch the data and delivers the best possible results. Data can also be used to disseminate information for best practices in health care. A nonprofit called Better Health Partnership collects data from health care providers and other stakeholders as a way “to share best practices and to accelerate data-informed improvements,” says Rita Horwitz, President & CEO of the Northeast Ohio organization, which was established in 2007 with support from the Robert Wood Johnson Foundation. One focus? Learning what issues are contributing to premature births.
PUBLIC AWARENESS Many people are aware of deaths from violence in the U.S. – there were nearly 20 I G N I T I N G
20,000 victims of homicide in 2017 – and recognize the impact that public policy strategies can have in addressing prevention at a population-based level. Yet the rate of infant mortality is not nearly as well known. According to the Centers for Disease Control and Prevention (CDC), in the year 2017 alone, 22,335 babies died before their first birthday. We don’t receive news notifications on our phones about these babies and the stories are rarely shared via social media. It is as if these deaths had not even occurred. Yet many of those 20,000 infant deaths could have been prevented, had the families been aware of some simple practices. Those practices might have enabled their babies to live and utter those first “googoo, ga-ga” sounds that we take for granted until they go silent. “Maternal and Child Health” is among the 33 health concerns listed on the American Public Health Association (APHA) website, which provides great resources and education – including a focus on end-
ing preventable deaths among all women, children and adolescents. But since the rate of infant mortality is not well known by the general public, it could be argued that the Infant Mortality Rate (IMR) should also be listed and highlighted separately, as it is highly preventable and needs more public education and awareness than it receives.
THOUSANDS OF BABIES DYING BEFORE THEIR FIRST BIRTHDAY SHOULD NOT BE “A THING” Yet, available preventative and healing strategies are not being used, and thousands of babies are dying not long after they are born. Infant mortality is defined as the death of a live-born baby before their first birthday. The IMR is the number of infant deaths per 1,000 live births. In 2017, the IMR in the United States was 5.8 deaths per 1,000 live births, meeting the Healthy People 2020 target of 6.0 infant deaths per 1,000 live births. Healthy People provides science-based, 10-year
national objectives for improving the health of all Americans. If the IMR goal is being met and the infant mortality rate is supposed to serve as an important marker of the overall health of a society, something’s amiss in this formula. The 2019 edition of the Bloomberg Healthiest Country Index, which ranks 169 economies according to factors that contribute to overall health, lists the U.S. as number 35. Thirty-fifth! We can’t be doing too well.
PROGESTERONE PREVENTS SOME PREMATURE BIRTHS “Twenty years ago, two-thirds of infant deaths before age one was due to prematurity. Now, it’s at about 35%,” notes Elena M. Rossi, M.D, FAAP, associate medical director for special projects at Akron Children's Hospital’s Boardman, Ohio location. “That’s thanks to neonatology, obstetric care and the use of progesterone.” Progesterone is a hormone that helps the uterus grow during pregnancy and keeps it from having contractions. Treatment with progesterone may reduce the risk for premature births; it also prevents premature birth recurrence, says Dr. Rossi, a neonatologist who also serves as clinical professor of pediatrics at Northeast Ohio Medical University. “If a woman who has a premature birth becomes pregnant again, by taking progesterone she has a 40% chance of carrying the pregnancy further.” But locally, for example, only half the women who are eligible receive it, Dr. Rossi notes. A pregnant woman can qualify for progesterone in one of two ways: She must have had a previous premature birth or she must have a short cervix. Ohio’s Go When You Know campaign stresses the importance for a woman to seek prenatal care as soon as she knows she is pregnant and to talk to her provider about progesterone.This allows them to be evaluated
for progesterone and get a cervical length ultrasound, which lets them know that they have a short cervix. Even if the pregnant woman hasn’t had a premature birth before, this would let them know that they could still benefit from progesterone, which they might be eligible to receive once a week, starting at 16 weeks. If they don’t get the cervical length ultrasound when they see their prenatal care provider, then they won’t be offered the progesterone to potentially prevent a premature birth. But prematurity is just one of many contributors to infant mortality. And progesterone is just one of several best practices that would prevent thousands of these deaths from occurring.
A BEFORE AND AFTER CHECKLIST With Ohio's infant mortality rate (in 2011) nearly 30 percent higher than the national average, the Ohio Equity Institute was formed in 2013. The data-driven and evidence-based initiative consists of nine Ohio communities and the Ohio Department of Health partnering to focus on improving birth outcomes and reducing racial disparities in infant mortality. Th e nine communities are Butler County, Canton-Stark County, Lucas County/Toledo, Cincinnati, Mahoning County/Youngstown, Columbus, Montgomery County/Dayton, Cuyahoga County/Cleveland, and Summit County. There are some things that are known to increase the likelihood of having a healthier baby and to reduce the infant mortality rate. And “we have a checklist,” says Dr. Rossi. Safe sleep. Birth-spacing. Tobacco. Progesterone eligibility. “In Mahoning County/Youngstown they already had the MY Babies First Infant Mortality Coalition,” says Dr. Rossi. “And they were ahead of some of the other communities — already thinking about safe sleep; breastfeeding (they found they
couldn’t impact that change); birth spacing; and progesterone. But in 2016, they added tobacco – a huge, potentially preventable factor for infant mortality. “They did a huge awareness campaign to educate people. Although they reached their overall goal in Mahoning County with IMR of less than six per thousand, the impact of poverty, stress and lack of prenatal care remained. The IMR is still three times higher for blacks, with black women having higher risks – even when educated — of IMR, low birth rate and their own maternal death. “This is devastating to parents. And so, many choose to get pregnant again quickly. We’re all in this together, we all want healthier outcomes; but we need to educate the entire family,” adds Dr. Rossi. According to the passionate physician, many don’t want to hear advice. When she expressed her concern about a TV show storyline in which a character on “The Big Bang Theory” was sleeping in the crib with her baby, the backlash was huge. [See the interview at youtube.com/ watch?v=28DwAnRa5YA.] Evidence-based practices on Dr. Rossi’s checklist: For safe sleep, mothers shouldn’t fall asleep with their babies while breast-feeding. And babies must sleep on their back for a least a year in an empty crib. Everyone can get a cribette and car seat for free. Promote the ABCs — Alone, Back, Crib — of safe sleeping. [See sidebar.] For birth spacing, if you get pregnant within 12 months of a previous delivery, low birth weight and prematurity goes way up. The recommendation is to wait at least 18 months before becoming pregnant again. Regarding progesterone, six years ago,
NORTHEAST OHIO MEDIC AL UNIVERSITY
SAFE SLEEP TIPS FOR YOUR BABY
Put babies to sleep:
Alone. On their Backs. In an empty Crib. Bedtime. Naptime. Anytime. Babies are safest sleeping on their backs. • Use a ﬁrm sleep surface and ﬁtted sheet. • No blankets, bumper pads or toys. • Do not allow baby to sleep with an adult or child in a bed, couch or chair. • You may offer a dry paciﬁer, with no strings or clips. • No smoking near baby. • Provide tummy time for baby to play while awake to assist development. Every week in Ohio, 3 babies die in unsafe sleep environments. Share these safe sleep tips with everyone who cares for your baby. For more information, call 330.543.8942 Source: Akron Children's Hospital
agencies didn’t know much about it — only obstetricians did, but they were seeing patients too late in their pregnancies to help. And tobacco? In 2017, 33% of mothers with babies in the NICU used tobacco. The number was 25% in the ’90s. “Recent data says that people want to stop but they just don’t have a lot of success.
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Unfortunately, no one thinks there’s harm in e-cigarettes, so many of Ohio’s cities are working on age 21 and over laws to buy them,” says Dr. Rossi. [Gov. Mike DeWine recently signed a bill which states that all Ohioans must be at least age 21 to legally buy cigarettes, cigars, vape pens and other tobacco products. The law takes effect October 1, 2019.] So, the coalition changed its education
from “Do you smoke”? to “Are you interested in stopping?” and “Here are the effects that smoking has on your baby … secondhand and thirdhand.” Free resources, such as 26 weeks of nicotine replacement products, are available, too.
FOLLOW THE LEADERS By 2017, Ohio had the ninth-highest IMR in the country, at 7.2. But, while the state’s infant mortality rate for Hispanic and white infants was lower in 2017 than in 2016, the rate for black infants — at 15.6 in 2017 — increased, with black infants dying at three times the rate as white infants. That’s bad news, but it’s worth noting that best practices are making a difference in counties such as Butler, Franklin, Stark and Summit, which saw fewer black infant deaths in 2017. Local groups within all nine counties in the Ohio Equity Institute are pursuing evidence-based strategies and promising practices to reduce infant mortality and address racial disparities in birth outcomes. State and federal funding is supporting these efforts. During the past eight years, Ohio has invested more than $137 million to help more babies reach their first birthdays. One new strategy that began last year involves the use of “neighborhood navigators” to identify pregnant women in their community who may be at risk for a poor birth outcome and connect them with needed health care, social and other services. In Cuyahoga County, where significant disparities in birth outcomes exist based on race, ethnicity and location, First Year Cleveland is working on a unified strategy centered on reducing racial disparities, addressing extreme prematurity and eliminating sleep-related deaths. “In 2018, the infant mortality rate in Cuyahoga County was 8.5 — reduced by 20% from 2015’s 10.5. The goal is to get
to 6.0 by 2020. We’ve impacted sleep-related deaths — reducing them from 27 in 2015 to 19 in 2018 through increasing public awareness, education and addressing cultural practices related to safe sleep,” says Horwitz. “But the leading contributing factor to infant deaths in our region has been prematurity which we have only reduced from 14.9% in 2015 to 11.9% in 2018. Our goal is reduce prematurity as a factor to less than 10% by 2020.”
A COMMUNITY RESPONDS In December 2015, First Year Cleveland (FYC) was formed by the CEOs of health systems in Cuyahoga County and other leaders in the city of Cleveland, Cuyahoga County and the state of Ohio who came together to call for an effort to help save “our babies and make sure that they celebrate their first birthdays.” They also needed an organization like Better Health Partnership, which could respond quickly to the issue, given their well-established infrastructure and process for leading collaboration, getting and collecting data and getting consensus around modifiable interventions that could have the greatest impact on reducing extreme premature birth. By taking an overall systems view, First Year Cleveland assembled 11 action teams to take part on different issues. For example, the racial disparities team works with employees in workplaces to look for any potential biases that might be negatively impacting maternal and child health outcomes. The families team focuses on those who have experienced a loss, helping them to gain perspective on losses that occur in the prenatal period, in the hospital or after the mother has gone home following giving birth. Then there’s the extreme prematurity team. This group aims to get at the root causes of prematurity by working with hospital systems and researchers. Called
INFANT MORTALITY IN CUYAHOGA COUNTY
Babies are dying due to poor or no prenatal care.
Cuyahoga County has the highest rate of prenatal care in the state and the worst Infant Mortality Rate.
Poor Black babies are dying, so poverty must be key.
In 2015, 50% of African American babies who died from prematurity and birth defects were on Medicaid and 50% on private insurance.
Babies who are dying are born to teen moms and/or moms who abuse drugs and alcohol.
In the past 10 years, less than 4% of all infant deaths were to teen moms and/or moms with addiction or mental health issues.
Action Team No. 4, Better Health Partnership works with four major health systems — MetroHealth, Cleveland Clinic, University Hospitals, and Southwest General — to collect 2018-2019 data to identify and replicate best practices of modifiable interventions that can prevent or delay premature births and optimize outcomes of periviable births. Better Health Partnership is looking at zip codes and their related demographics in Cuyahoga County, where infant mortality and preterm birth rates are the highest. Of those with the highest rates, most families are living below the poverty level and most are African American.
AS SIMPLE AS IT MAY SEEM There’s a tendency by some to make assumptions about the demographic makeup of the grieving families. While poverty is a factor, many misconceptions have come to light. [See “Misconception vs. Reality” sidebar.] The work continues. Better Health is connecting its clinical and demographic
data with other First Year Cleveland Action Teams, which are working on research to better understand the roles that race and maternal stress play in infant deaths. They will also look for things that may beg a question or two, such as, “When there’s appropriate access to care, is there some unconscious bias in the plan of care that may be impacting outcomes?” How to help more babies live past their first birthday? “There’s no silver bullet to the issue of infant mortality. It’s multi-layered and complex. Whereas public health concerns like opioids may touch everyone, infant mortality may not,” says Horwitz. “We need to keep raising awareness and to educate the entire community on the causes of infant mortality and interventions that can help save our babies and ensure they celebrate their first birthdays. And we need to continue to look for best practices through the data supplied by the participating health systems; conduct learning circles; and disseminate what works with all providers of care.”
NORTHEAST OHIO MEDIC AL UNIVERSITY
HUMANITIES IN MEDICINE
LIVING IN POVERTY — WHEN I REALIZED BY ELAINE GUREGIAN
EOMED students come from a variety of backgrounds, including economic. Some know from experience what it’s like when your family has to choose between food and medicine. Others had a chance, by role-playing the parts of family members in a poverty simulation last spring, to feel the stress of trying to make a small monthly budget stretch beyond its limits. Think about it: How would you manage getting to businesses that are only open during hours when you’re supposed to be at work? Or getting
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your kids to school, if your boss didn’t allow for any flexibility, and you had only limited funds for public transportation, which wasn’t close to your apartment and ran infrequently? This year, all fourth-year College of Medicine students participated in the Community Action Poverty Simulation Program, developed by the Missouri Community Action Network, as part of their Clinical Epilogue and Capstone Course — a conclusion to the four years of humanities studies that are required of all College of Medicine students.
Photos: Lew Stamp
After the simulation, Olivia Roy, M.D. ( ’19) reﬂected: As an aspiring obstetrician/gynecologist, I have had the opportunity to work with women in underserved areas throughout my clinical years at NEOMED. I was able to help them during their medical appointments but very seldom was involved in the other social aspects of their visit. The poverty simulation at NEOMED showed me that there are so many factors that play into a patient’s life that can then affect their ability to access health care. My character in the simulation was a woman whose husband had left her two weeks prior. In my character’s attempt to obtain Social Security, the secretary asked me several very personal questions. including when was the last time I had engaged in sexual relations with my estranged husband. These kinds of stressors can wear a person down and lead to the downfall of their health despite the efforts of the caregiver. Therefore, as physicians it is important to recognize and address factors outside of just medicine that can affect our patients’ health.
Olivia Roy, M.D. (’19) The simulation program isn’t the only way students gain life experience, of course. Here, they reﬂect on other moments when insight struck. I was doing an OB-GYN rotation at St. Vincent’s Hospital in Toledo. A lot of family medicine clinics are located by bus stops, because transportation is an issue for the patients. The first time it hit me was on a day when the temperature was five below zero and an attending offered to drive a pregnant woman home because she had walked two miles to a clinic for her prenatal care.
Lillian Hetson, M.D. (’19)
Sophia Kunkle, M.D. (’19) The first time I realized what accessing health care while living in poverty was like came during my first year of medical school while I was serving as a health coach for Alliance Community Hospital. I remember discussing with the patient I was meeting with about how important it is for her to take her medications for her diabetes regularly, to eat low carb foods and to visit her doctor every 3 months. She looked at me and told me she’s doing her best, that her medications are out of reach, she eats whatever she can get at the pantry, and she gets to her doctor as often as she can but regularly had difficulty with transportation. It really made me realize how out of reach a lot of what we recommend for our patients can be.
NORTHEAST OHIO MEDIC AL UNIVERSITY
HUMANITIES IN MEDICINE
While I was working at a community clinic in Bogota, Colombia, over the winter break of my second year of medical school, I encountered many patients like the one I will call Rosa — a woman who was coming in for prenatal care. Due to lack of access to health care, this was Rosa’s first prenatal visit, although she was far along in her pregnancy. She also had scabies, which is common in Colombia because of that same lack of availability. Rosa came to the visit carrying every piece of her medical record, which consisted of maybe three or four papers total. That wasn’t unusual. Many people in Rosa’s community cannot afford medical care and do not see doctors more than a handful of times throughout their lives. Health literacy rates are also commonly low amongst this South American population, due to the limited interaction with the medical community. Despite these barriers, Rosa was able to receive excellent care because of the structure of this community clinic. It never turns anyone away because they’re unable to pay. And its health care providers take as long as is necessary for each patient to fully understand the scope of the reasons for the medical visit. Because Rosa didn’t understand health and health care very well, the attendings took the time to ensure that she understood what was wrong, primarily using the teachback method — asking her to restate in her own words what had just been explained. The attendings allowed Rosa to ask all of her questions and get detailed answers. The process took over an hour. Spending that much time with one patient would not always be practical in a medical setting like in the U.S., where 15 minutes per patient is often stated as the norm. However, I saw there a lesson to be learned: It’s worth it to take the time to ensure that your patients understand what is wrong with them, in order to help them heal.
Photo courtesy of Lydia Du
Madison Ordonez College oƒ Pharmacy CLASS OF 2022
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Lydia Du College oƒ Medicine CLASS OF 2021
One day when I was working my job at a community pharmacy, a patient came in with a prescription for penicillin from the emergency department. He said he had an infection in his mouth and needed the prescription filled but didn't have insurance. We ran it through our in-house discount program and it came to be about $18 for the 40 pills he needed. He hesitated, asking if he could do a partial fill until he got paid Friday. We determined that it would end up costing more to do a partial and he said he would think about it and walked away. This was one of the first experiences I had with someone in poverty. $18 does not seem like a lot of money but it really is for some people. This opened my eyes to the harsh world and the high costs of healthcare, without our discount card, this prescription would have been $52. We were able to work with him to get him this prescription, but not everyone would have done that.
HUMANITIES IN MEDICINE
THE POVERTY PRACTITIONER BY RODERICK L. INGRAM SR.
We began as friends in health, no wealth of parental provenance; Raised to care for ourselves, don’t trust the wellness governance; From a place of survival, we dwell; pain that poverty can’t portend, Of miasma our systems smell, aﬀordable care’s not an option. Before long we changed our roles, our days with privileges anew; The dampness that infested our souls; was hardly in our purview; What ailments bespeak these pros, who say our behaviors we’d rue? We didn’t start — don’t they know? — with the lives that others do. And so you return, my friend; no longer with signs of tatter. The way we meet again, is what mom would always chatter. “Remember your ways of old”; “Money is not all that matters.” Of docs, common sense and self-control, we still must learn the latter. To rid our social determinants, pros would not trade their incomes; But giving the best of medicines, sure would aid in our outcomes.
NORTHEAST OHIO MEDIC AL UNIVERSITY
IN THE REDIZONE
Blake Bruce, left; Stephen Charles, center;Youngstown State University MBA student Matthew O’Dell, right
LEARNING TO THINK LIKE AN ENTREPRENEUR BY ELAINE GUREGIAN
ntellectual property. Patent offices. Market sizing. Or the most daunting of all: Venture capitalists. If you want to take an invention into the marketplace, you need to understand these topics. And in the summer of 2019, an interprofessional group of law, business, medicine and pharmacy students dug into them, one by one. The group of eight was brought together as the first cohort of the Burton D. Morgan Future MedTech Entrepreneur Internship program, offered by the Research, Entrepreneurship, Discovery and Innovation Zone (REDIzone®) at NEOMED. Each intern received a $3,000 stipend and the chance to spend six weeks
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learning from experts, not to mention rolling up their sleeves to simulate the process. The program was funded by the Burton D. Morgan Foundation through a grant to the NEOMED Foundation. Blake Bruce, a third-year College of Pharmacy student who works in the corporate office of an Ohio-based retail pharmacy chain, is an intern in the program. When entrepreneur-in-residence Elliot Reed, J.D., M.B.A., visited Blake’s pharmacy class last year to seek out students interested in entrepreneurship, Bruce was intrigued. He thought, “Here's business, finance and analytics, all kind of jammed into one.”
HANDS-ON When Bruce joined the other seven interns to begin the program, he found the experience to be even better than he had imagined. Interactions with guest speakers like Stephen Charles, Ph.D., the founder and CEO of SATOR Therapeutics, filled the first two weeks of daily sessions, giving the interns insights into topics from intellectual property and technology licensing to investment presentation and pitch development. On one early day of the program, the cohort was gathered in a classroom, chairs circled as they listened to Dr. Charles speak from his own experience about the regu-
Photos: Lew Stamp
latory environment for drugs and devices, as well as for clinical trials. The entrepreneur encouraged them to ask him about the nuts and bolts of this complex world, where the steps to success aren’t always easy to determine. “Sometimes people in the patent office don’t understand the technology,” said one student. “They don’t,” agreed Dr. Charles. “You are the expert.” And with that heady thought, they delved further into questions and discussions. Scott Schmuki, a second-year College of Medicine student, asked how to identify patients for clinical trials. Here, Reed, the executive director of the Institute for Innovation, Commercialization, and Economic Development at NEOMED, chimed in to caution the group: “You may have a scientist who says, ‘We can do the study at my hospital,’ … but if they only see two patients a year [in the area you’re studying] that’s a very costly enrollment.”
THINKING LIKE THE JUDGES The interns spent the second two weeks of the program learning to think like the professionals who would judge their presentations and products if they pursue an entrepreneurial path. They were given copies of actual pitches that have been submitted to the regional funder, then
they split into groups. Each was assigned different perspectives (marketing, finance, intellectual property, reimbursement and regulations) from which to evaluate each pitch, as if they were the funder. On the big day, the whole group visited Lorain Community College, near Cleveland, to hear the actual companies or inventors pitch their ideas to a real-live organization called Innovation Fund Northeast Ohio. “The idea here was that if the interns can learn (by doing) the process of due diligence to identify weaknesses in someone else’s proposal, they’ll also learn what makes a strong proposal,” said Reed. Of course, you can’t have a new product without a pitch, so for the final two weeks, after getting tips from seasoned pros, the students developed their own Shark Tank-style messages. The day of reckoning was slated for July 25, but really, the work had been done by then. With or without a winning product that day, these students had experience in their pockets. “The guest speakers have been amazing,” said Bruce. “You don't have opportunities like this every day to sit down and have face-to-face conversations with these brilliant minds. I have a desire for knowledge and I've learned so much in a short amount of time.”
Venture capital, private equity and $100 million used to be concepts that seemed too big to wrap my brain around. But after talking to people from the Cleveland Clinic Venture group, University Hospitals Ventures, and the North Coast Angel Fund, they didn’t seem too far out of reach,” says Stephanie Wolff, a second-year College of Medicine student who participated in the internship. “And the cooperation I saw between these groups to form a pipeline of innovation was unreal. For example, we learned how a venture funded by University Hospitals allowed for computer algorithms to drill down into medical records and alert the physician to trends that could lead to improved patient outcomes in labor and delivery. “Seeing successful venture groups — including a physician who continues to work in both capacities — has inspired me to pursue a similar future. Being involved in the cutting edge of medical technology has opened my eyes to what the future of medical practice may become.”
NORTHEAST OHIO MEDIC AL UNIVERSITY
One of Many Reasons to Reconnect … Alumna Maria Rubinstein, M.D. (’13), has been named as the 2019 Young Investigators Award recipient by Gateway for Cancer Research and the Conquer Cancer Foundation of the American Society of Clinical Oncologists. The award will provide Dr. Rubinstein a one-year, $50,000 grant to conduct research in clinical oncology. Dr. Rubinstein’s research will focus on improving outcomes for patients with gynecological malignancies, especially endometrial cancer. The trial will be a ﬁrst in human study that will evaluate the safety, tolerability and preliminary efﬁcacy of copanlisib ( an FDA approved PI3K inhibitor ) in combination with a ketogenic diet. Currently serving as a medical oncology fellow at Memorial Sloan Kettering Cancer Center in New York City, Dr. Rubinstein is yet another example of …
MORE NEOMED GRADUATES WHO ARE DOING AMAZING THINGS. Maria Rubinstein, M.D.
NEOMED has 4,616 alumni representing all 50 states plus Canada and the U.S.Virgin Islands. Alumni hail from over 300 undergraduate universities, are employed by nearly 200 clinical institutions and pharmacies, and practice in more than 50 ﬁelds of health care.
Reconnect with a Who’s Who of Fellow Health Professionals
SAVE THE DATE! SATURDAY, SEPTEMBER 28, 2019 A LUMNI ASSOCIATION REUNI ON A N D AWA R D S D I N N E R – PLUS –
A MICROBREWERY TOUR IN CANTON
Wine and Dine with NEOMED Alumni and Colleagues
& SALUTE THE EVENING’S HONOREES
Dr. John Docherty
But before you do, take our shuttle tour to three of Canton’s most popular brewing companies.
Dr. Mona Mangat
Dr. Albert Cook
BRINGING THE WORLD CLOSER
A map of the world covered in thumb tacks sat outside the 2019 Multicultural Festival — each pin representing a student’s culture. Aromas of samosas, pizelles and orange chicken floated through the air as each person passed by. From Peking opera variations to Bollywood dance, each performance transported the audience to a different part of the world. The Latino Medical Student Association brought their best moves, while students representing Sri Lanka, Puerto Rico, Pakistan, Cuba and more channeled their inner fashion models while walking the runway. – Samantha Hickey
Photos: Chris Smanto
TASTES LIKE HOME
NO FRESH VEGGIES? NO PROBLEM BY ANNA CHERIAN
n my days as a high-school intern with the Childrenâ€™s Defense Fund of Ohio, I learned that nutrition is one of the many factors that impact health. I chose medical dietetics as my major in college and worked as a registered dietitian before pursuing a career in medicine. The recipe shown here, which I found on The Real Food Dietitians, was a hit in the cookbook I created during my time working as a registered dietitian at a Cleveland recreation center. I thoroughly enjoyed helping community members find easy and cost-friendly ways to eat healthier and develop a balanced lifestyle.
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Creating small, realistic, timely goals can help people make lifestyle changes. During the 2018-19 year, as a first-year medicine student in the Northeast Ohio Medical University-Cleveland State University Partnership for Urban Health, I spent time at the Bishop Cosgrove Center, a homeless shelter in Cleveland, for a community experience class. There I had a patient who was in her mid-20s with Type 2 diabetes. She expressed to me that no one had ever spoken to her about managing her disease with diet and was unaware that carbohydrates contributed to increasing her blood sugar levels. We made a small goal of switching from fruit juice, which is
Photos: Lew Stamp
loaded with sugar, to Crystal Light — a no-calorie powder that she could mix into tap water so she felt like she was having a treat without getting a lot of empty calories.
FRESH OR FROZEN? Patients are often surprised that frozen vegetables (without any sauce) are flash-frozen at their nutritional peak and contain the same nutritional value as fresh vegetables. So, if you are economically disadvantaged — or just live in a place where you don’t have access to a lot of farmer’s markets or grocery stores with fresh vegetables — you can still eat healthfully with frozen vegetables. One-Pan Balsamic Chicken Veggie Bake can be made with just a few ingredients that are low-cost and can be found at any grocery store. I usually marinate the chicken the night before. After I come back from class, I put the chicken and vegetables onto a sheet pan and throw it into the oven, and it is ready within 35 minutes. Students always appreciate a meal that’s low-cost and easy to prepare, so Anna invited Jubilee Winer and Jamee Colucci — who during the 2018-19 year were second-year College of Pharmacy students and co-presidents of NEOMED’s Walking Whales Cooking Club — to see how it’s made.
ONE-PAN BALSAMIC CHICKEN VEGGIE BAKE *Adapted from The Real Food Dietitians Serves 4 people Ingredients: 1 ¼ pounds boneless, skinless chicken (breast, tenders or thighs) 2 packets of frozen vegetable medley of choice ¼ cup balsamic vinegar ¼ cup olive oil 2 tablespoons of garlic, minced ½ teaspoon dried thyme ½ teaspoon salt ½ teaspoon pepper Feel free to add other vegetables or spices of your choice. Instructions: 1. Pre-heat oven to 400 degrees. Line a baking sheet with parchment paper. 2. Combine balsamic vinegar, oil, garlic, thyme, salt and pepper. Whisk to make sauce. 3. Place chicken in zip-close bag with half of the balsamic sauce. Toss and move chicken breast around to coat. Set in fridge. 4. Place vegetables on the sheet pan. Pour remaining balsamic sauce over veggies and toss veggies to coat. Make sure all pieces are coated. 5. Remove chicken from zip-close bag and move veggies around to make space for chicken. Place chicken on pan.
6. Transfer pan to oven and bake at 400 degrees for 30-35 minutes, or until chicken is cooked through. This will depend on the thickness of the chicken. 7. Serve and enjoy! NORTHEAST OHIO MEDIC AL UNIVERSITY
GIVING WITH PASSION — AND PRAGMATISM BY ELAINE GUREGIAN
an Oppenheim and Marta Williger wouldn’t have to search far to get advice on leaving a bequest to NEOMED. She’s a nationally certified elder law attorney who specializes in estate planning. A certified elder law attorney before retirement, he now serves as a director on the NEOMED Foundation Board. But you don’t have to be an attorney or a financial wizard to make a planned gift, says Oppenheim, whose speech carries a trace of his Boston roots when he states,
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“It’s so simple!” He believes in NEOMED’s mission, and Williger, who grew up in Cuyahoga Falls, has enjoyed seeing him blossom in his role on the Foundation Board since moving to Northeast Ohio to be with her. It was through a friendship with Oppenheim’s new physician in Northeast Ohio, internist Erwin Maseelall, M.D., that Oppenheim became involved with NEOMED. For the first seven years after he and Williger were married twelve
years ago, he had commuted to Boston to work. “I didn’t know anyone except Marta and her family,” explains Oppenheim. When Oppenheim retired and was looking for a way to actively contribute to the community in Northeast Ohio, Dr. Maseelall invited him to join him on the Foundation Board. Oppenheim dived in. Currently, as the chair of NEOMED Foundation’s Planned Giving Committee, he helps to organize continuing education events that intro-
Photo: Lew Stamp
duce attorneys and financial planning professionals to the NEOMED mission. He also takes pleasure in bringing visitors to see NEOMED in person, to share his enthusiasm for the University. Oppenheim works to connect people who might be interested in supporting NEOMED — as he and Williger have so willingly done — through various planned giving strategies facilitated by professionals who can help them accomplish their goals.
WHY NEOMED? Logical and pragmatic, as befits an attorney, Oppenheim lays out three main reasons for his passion for NEOMED. First is the University’s mission of serving the underserved in Northeast Ohio. Williger notes how much the couple admires the NEOMED-Cleveland State University Partnership for Urban Health, with its goal of including non-traditional students. “We met with some students when the CSU program began and they were so bright, so receptive, so driven,” Oppenheim says. Another highlight for the couple is the REDIzone® program. In dedicated space at the University, researchers whom Oppenheim describes as “fascinating, exceptional people” work on public-private collaborations to take the most promising translational research ideas to the marketplace. The potential impact resonates with this couple: “As elder law attorneys, we want to find cures for diseases like Parkinson’s and Alzheimer’s, or ways to reverse hearing loss,” says Oppenheim. Finally, there’s the leadership at the top — faculty and staff whom Oppenheim praises as outstanding and committed. All of these factors motivated the couple to make a financial contribution in addition to Oppenheim’s vigorous advocacy. Using planned giving to make a tax-exempt gift has significant advantages, notes the couple. Not only does it effec-
tively result in a larger gift to the University. It also results in the donor saving on income taxes and reducing or avoiding capital gains taxes.
ANYONE CAN DO IT “The way we have chosen is to designate the University as a beneficiary of several IRAs,” explains Williger. After an IRA holder turns 70 and a half, required minimum distributions (RMDs) must be taken annually. In Oppenheim’s case, that means gifts to NEOMED from his RMD payments have begun already – and the donations are not taxed, because of the NEOMED Foundation’s status as a public, charitable organization. After Oppenheim’s death, the University will receive gifts from the remaining balances of the IRAs. There are other easy options, says Williger. As an elder law attorney, she consults clients about planning for many aspects of their lives, including charitable donations. Some people make a specific dollar amount bequest in their will or distribution from their trusts. Others stipulate a percentage will go to the charitable orga-
nization(s) of their choice. Another option is to designate a certain savings account or life insurance policy that names the charity as the direct beneficiary after the donor dies, notes Williger. Yet another option is to name the charity in a transfer on death deed. The idea of including NEOMED in your estate planning is anything but remote when you’ve just come from a visit to the University. Oppenheim tells the story of a group of NEOMED retirees who had toured the campus. After meeting with students, faculty and staff, one woman in the group told a development officer that she had just decided to designate a $50,000 life insurance policy to go to her former employer. “The people I meet at NEOMED are very caring and very dedicated to NEOMED’s mission,” says Oppenheim. “You can’t help but want to support them.” For more information on planned giving, contact senior development officer Michael Wolff, email@example.com or 330.325.6667.
The people I meet at NEOMED are very caring and very dedicated to NEOMED’s mission. You can’t
help but want to support them.” – Ian Oppenheim
NORTHEAST OHIO MEDIC AL UNIVERSITY
Dinah Fedyna, M.D., has retired from academic and clinical practice, due to Bulbar Motor Neuron Disease, a form of ALS. She most recently served as a clinical professor of family and community medicine. After her retirement, NEOMED introduced the Dinah Fedyna Family Medicine Award. In honor of the clinical professor of family and community medicine, the scholarship will be awarded annually to a third-year NEOMED College of Medicine student studying primary care. Dr. Fedyna continues to keep busy in Austintown, Ohio, with her husband, Joe, daughter, Natalie and two Jack Russell terriers.
Elizabeth Baum, M.D., and husband, John Baum, celebrated the NEOMED graduation of their son, Joseph Baum, M.D. (’19), at a special hooding ceremony.
Kevin Dieter, M.D., was the recipient of the 2019 Josefina B. Magno Distinguished Hospice Physician Award from the American Academy of Hospice and Palliative Medicine. Dr. Dieter serves as the associate medical director at Hospice of the Western Reserve in Cleveland, Ohio. He also oversees medical care at the David Simpson Hospice House, a non-profit inpatient care unit in Cleveland.
John Bastulli, M.D., was appointed to the Ohio State Medical Association Focused Task Force on State Legislation and elected as councilor-at-large to the OSMA Council. In addition, Dr. Bastulli will continue to serve as the vice president of legislation affairs for the Academy of Medicine of Cleveland and Northern Ohio.
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Pradeep Manudhane, M.D., celebrated the NEOMED graduation of his sons, Anthony Manudhane, M.D. (’19), (photo, left) and Albert Manudhane, M.D. (’19), (photo, right) at a special hooding ceremony.
Stephen Noffsinger, M.D., became director of the Forensic Psychiatry Fellowship at Case Western Reserve University/University Hospitals Cleveland Medical Center, located in Cleveland, Ohio, in July 2018.
Arvind Malik, M.D., and his wife, Michelle Malik, celebrated the NEOMED graduation of their son, Alexander Malik, M.D. (’19), at a special hooding ceremony.
Dean Elisabeth Young, M.D. (‘85), (photo, left) joined parents Lori Hess, M.D. (’91), and Jeffrey Hess, M.D. (’91), to celebrate the NEOMED graduation of their son, Jonathan Hess, M.D. (’19), at a special hooding ceremony.
Michael Tan, M.D., was elected to the Board of Regents of the American College of Physicians at Internal Medicine Meeting 2019, ACP’s annual scientific meeting.
2003 Angela Rouse, M.D., has been accepted into the two-year Arizona Center for Integrative Medical Fellowship, under the direction of Andrew Weil, M.D. Dr. Rouse currently practices in Westerville and Sunbury, Ohio as a board-certified OB-GYN with North American Menopause Society certification.
Christopher Stiff, M.D., and Angela Doty, M.D., (‘91), celebrated the NEOMED graduation of their daughter, Katherine Stiff, M.D. (’19), at a special hooding ceremony.
Nabil Fahmy, M.D., and Manal Assaad, M.D. (’94), celebrated the NEOMED graduation of their son, Joseph Fahmy, M.D. (’19), at a special hooding ceremony.
2004 Tina Smith, M.D., has moved to Ohio to join Memorial Health System’s pediatrics department, located in Marietta.
Brady Steineck, M.D., graduated from Walsh University in December 2018 with a Master of Business Administration in Healthcare Management degree.
2013 Samantha Woods, Pharm.D., accepted a staff position with Hopewell Health Centers, Inc., in Logan, Ohio. The mission of the organization is to provide access to affordable, high-quality, integrated health care for all. Prior to joining Hopewell Health Centers, Inc., Dr. Woods spent four and a half years as staff pharmacist and pharmacy manager with The Medicine Shoppe.
Sonali Vora Raman, M.D., a female pelvic medicine and reconstructive surgeon at St. Elizabeth Healthcare in Cincinnati, was named a Top Doctor for Greater Cincinnati and Northern Kentucky in 2018. Dr. Vora Raman married Sathya Raman in 2012. The couple has two children, Shriva, 5, and Shvam, 3.
Taylor Engelhart, Pharm.D., was selected as a presentation merit award semifinalist at the recent APhA annual meeting for her poster titled “Implementation of a pharmacy-based telehealth protocol for medication assisted treatment in opioid addiction at a federally qualified health center.” Dr. Engelhart is currently a PGY-1 resident at AxessPointe.
NORTHEAST OHIO MEDIC AL UNIVERSITY
STUDENT ORGANIZATIONS BY SAMANTHA HICKEY
Northeast Ohio Medical University is home to more than 80 student organizations. Here's a sampling of groups whose efforts have helped people who struggle ﬁnancially.
PHYSICIANS FOR HUMAN RIGHTS
From Ohio to Syria, Physicians for Human Rights helps those in need across the globe. The student group organizes food drives; sends clothing donations abroad; and educates the NEOMED community about homelessness, domestic violence and other struggles their future patients may face. The organization’s mission is to mobilize health professionals to advance health, dignity, and justice — promoting the right to health for all.
SIKH STUDENT ASSOCIATION
In collaboration with the Project Kaur Foundation, an organization started by two Northeast Ohio Medical University students, the Sikh Student Association is dedicated to lending a hand to those in need. In its ﬁrst year, members made care kits, served meals at homeless shelters and organized a winter clothing drive at local Gurdwaras (Sikh places of worship) to donate to a Northeast Ohio homeless shelter. The goal of the Sikh Student Association is to spread awareness of the Sikh faith and practice one of its most important principles: selﬂess service.
Partnering with Northeast Ohio Medical University’s SOAR Student-run Free Clinic, student members care for underinsured and uninsured patients in nearby communities. OutReach members provide quality information and health care services to Northeast Ohio residents through educational classes, discussions, preventative services, health services and social support. Together, students focus on holistic care for their communities.
STUDENTS FOR SIGHT
As part of Sight for All United, NEOMED’s Students for Sight chapter joins a strong network of optometrists and ophthalmologists who examine and treat patients. To help bring awareness to the organization, Students for Sight uses the acronym HEAL: Help every person reach his/her visual potential, Educate the community on impact of poor eyesight, build Awareness of eye health and vision issues, and Lift barriers to access care. The group participates in and hosts annual events, such as the Eye Ball, Golf Fore Sight and A Night in Their Shoes dinner.
For more information on student groups, contact Student Affairs at 330.325.6735 or visit neomed.presence.io. 38 I G N I T I N G
If youâ€™re a student starting your ďŹ rst year, events like White Coat, the Aesculapius Ball and Match Day may seem mysterious, and the acronyms swarming all around you might sound like a foreign language. Just wait four years. You'll see how fast it went and how many acronyms you know!!
Photos: Chris Smanto and Lew Stamp
4209 ST. RT. 44, PO BOX 95 ROOTSTOWN, OHIO 44272
HIGH QUALITY. ZERO CO$T. Primary care services beneﬁting the entire community.
SOAR STUDENT-RUN FREE CLINIC
WHO WE SERVE • PATIENT INSURANCE STATUS
315 Medicine and Pharmacy students and 29 health care professionals
LOCATED IN THE NEOMED EDUCATION AND WELLNESS CENTER Learn more about us at outreachneo.org/student-run-free-clinic
Ignite is a biannual publication designed to showcase and celebrate the advancement of students, innovation and research, and community heal...
Published on Aug 29, 2019
Ignite is a biannual publication designed to showcase and celebrate the advancement of students, innovation and research, and community heal...