From the Dean

From the Dean thoughts on innovation

we all worry about our health. And increasingly we worry about the health of our nation. This issue’s cover reinforces that national perspective and serves to remind us that we have access to a wealth of medical information that can be plumbed, decoded, and applied to those national concerns.

To give a perspective on where progress is being made— and what work remains to be done—we turn our focus to two conditions, pregnancy and cardiovascular disease, both very much a part of our nation’s fabric. We also look at the practitioners who are most likely to deliver first-line care.

Every day we are reminded how commonplace pregnancy is, as we work or walk beside women who are expecting, or, as physicians, stand at their side as they give birth. Here at HMS, the latter keeps many of us busy: approximately 21,000 babies are born at our Harvard-affiliated teaching hospitals each year. And while our article on obstetrics shows that it remains a profession filled with joy, it is also a specialty with its share of challenges as technology and social changes push the boundaries of who can become pregnant and when.

Cardiovascular disease may not be visible, but it, too, is prevalent. Our ability to recognize and treat some of its leading risk factors has meant improvements in mortality rates and in disease prevalence. As you will read, however, the challenges now faced by physician researchers include understanding the effects that biology and social constructs bring to the exam table.

Any discussion of the health of our country’s diverse populations should also touch upon the role of those who deliver their care. And in this issue, we do just that: We highlight the dynamic work of our new HMS Center for Primary Care; peer into one alumnus’s efforts to transform his primary care practice; and present portraits of family medicine practitioners. Each account reminds us that the depth and intensity of the doctor–patient relationship continues to be a powerful factor in the practice, and evolution, of medicine.

As you read the stories of work by colleagues near and far, I hope you will join me in celebrating their successes in bringing about change. HMS continues to be an innovation leader, and its physicians and researchers continually find solutions to seemingly intractable problems. And that’s a good thing, because addressing the issues that face our nation’s health will require the efforts of all of us, working together.

Jeffrey S. Flier Dean of the Faculty of Medicine Harvard University

Editor

Ann Marie Menting

Design Director

Paul DiMattia

Assistant Editor

Susan Karcz

Contributing Writers

Angela Alberti, Ellen Barlow, Alexander Blount, David Cameron, Jessica Cerretani, Shraddha Chakradhar, Elizabeth Cooney, Laura DeCoste, Katie DuBoff, Mary Leach, R. Alan Leo, Sue McGreevey, Jake Miller, Keri Stedman

Editorial Board

JudyAnn Bigby ’78; Emery Brown ’87; Rafael Campo ’92; Michael Chernew, PhD; Nicholas Christakis ’88; Elissa Ely ’88; Daniel D. Federman ’53; Timothy G. Ferris ’92; Alice Flaherty ’94; Atul Gawande ’94; Jerome Groopman, MD; John Halamka, MD; Donald Ingber, MD, PhD; Sachin H. Jain ’06; Perri Klass ’86; Jeffrey Macklis ’84; Victoria McEvoy ’75; Barbara McNeil ’66; Lee Nadler ’73; James J. O’Connell ’82; Nancy E. Oriol ’79; Anthony S. Patton ’58; Mitchell T. Rabkin ’55; Eleanor Shore ’55; Rachel Wilson, PhD

Dean of the Faculty of Medicine

Jeffrey S. Flier, MD

Executive Dean for Administration

Richard G. Mills, JD

Associate Dean for Communications and External Relations Chief Communications Officer

Gina Vild

Director of Editorial Services

Maria Fleming Buckley

Harvard Medical Alumni Association

Nancy Rigotti ’78, president Laurie R. Green ’76, president-elect Barbara McNeil ’66, president-elect Beth Karlan ’82, vice president Lynt B. Johnson ’85, secretary L.D. Britt ’77, treasurer Matthew M. Davis ’94; Phyllis I. Gardner ’76; Chi-Cheng Huang ’97; Lucian Leape ’59; Stephen Martin ’01; Mary Mullen ’87; James J. O’Connell ’82; Eleanor Shore ’55; Herman Taylor ’80; Nancy Wei ’06

Chair of Alumni Relations

A.W. Karchmer ’64

Harvard Medicine is published three times a year at 25 Shattuck Street, Boston, MA 02115. Publishers: Harvard Medical School and Harvard Medical Alumni Association © President and Fellows of Harvard College Phone: 617-432-7878 • Fax: 617-432-0446 Email: harvardmedicine@hms.harvard.edu Web: hms.harvard.edu/harvard-medicine Third-class postage paid at Boston, Massachusetts. Postmaster, send form 3579 to 107 Ave. Louis Pasteur, Boston, MA 02115. ISSN 2152-9957 • Printed in the U.S.A.