University of Michigan Family Medicine Fall 2016

Celebrating

at the University of Michigan

Fall 2016

Family Medicine in Pennsylvania Goes Maize and Blue

In This Issue From the Chair 2 Clinical Mission 3 Education Mission 6 Research Mission 9 Development 13 Faculty Activity 15

Mack T. Ruffin IV,

Grant M. Greenberg,

M.D., M.P.H.

M.D., M.H.S.A., M.A.

Two Department leaders have been selected as department chairs at two different institutions in Pennsylvania.

Mack T. Ruffin IV, M.D., M.P.H., the former Dr. Max and Buena Research Professor of Family Medicine, is the Chair of the Department of Family and Community Medicine at Penn State Hershey Medical Center.

And, Grant M. Greenberg, M.D., M.H.S.A., M.A., former assistant professor and associate chair for information management and quality, has just started as chair of the Department of Family Medicine at Lehigh Valley Health Network in Allentown, Penn.

During his 27 years with the Department, Dr. Ruffin, a talented researcher, helped to develop the Department into one of the top family medicine research programs in the country. For the past 12 years, he led the research team as the associate chair for research programs. He was named the Dr. Max and Buena Lichter Research Professor in 2011. Under his leadership the Department has remained in the top ten of NIH funding within family medicine.

“When I joined the 12 academic faculty of our Department in 1989, I never imagined how much we would accomplish.

From these humble beginnings, we have grown from a neglected unit to an essential department to UMHS and a nationally recognized leader in our discipline. The experiences provided by the Department’s leaders and all of my colleagues have been amazing. I am well prepared to take on this new leadership position,” noted Dr. Ruffin.

Dr. Ruffin’s research focuses on cancer prevention, chemoprevention and cancer screening. He is dedicated to changing patient and physician practices to promote cancer prevention. A well-respected academic family physician, Dr. Ruffin has published more than 150 articles in peerreviewed journals, 13 book chapters, 20 commentaries, and one book.

Dr. Greenberg also has had a tremendous impact on the Department during his 16 years as a faculty member. For the past four years, he has managed the Department’s IT efforts and directed all quality projects. Beyond the Department, he held prominent roles with the University of Michigan Medical Group. Through multiple roles focused on quality, he evolved into a quality and lean thinking expert. His leadership in these medical school positions kept the Department at the forefront of quality improvement.

Passionate about technology and change management, he led the Department through the transition from an internal

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Reflections from the Chair

Philip Zazove, M.D., Professor and the George A. Dean, M.D. Chair of Family Medicine

The University of Michigan Health System recently decided to double its primary care network from 200,000 to 400,000 patients by 2025 as part of its strategic plan. Family Medicine is being asked to help lead this expansion.

I find this exciting. It demonstrates that our world renown quaternary medical center understands the value we bring. And, it will allow our faculty to meet our missions in a way that helps patients, the populations we care for, and our learners at all levels.

Of course, any time one takes on an endeavor of this size, there will be challenges. We will need to continue to recruit 7-10 quality faculty every year, plus add advanced practice providers.

Clinic space for these clinicians will be needed, as well as hospital beds for the resulting increased admissions on our inpatient services. An expansion of our educational offerings will give new faculty opportunities to teach. And, we’ll need to help faculty develop their areas of interest, leading

to scholarly work as well as enhancing their teaching.

This will take time and hard work, and there will surely be bumps in the road. Still, I know we can do this. Our faculty have shown again and again their ability to meet every challenge.

Just look at the number of innovative, high-quality activities they lead. Here are some examples.

We have helped lead the move to a population-based clinical paradigm.

This has included piloting and implementing a ‘medical scribe’ program in our offices, standardizing medical assistant duties, optimizing the use of our electronic medical record system, integrating site-based behavioral health, leading a statewide CMS (Medicare) innovation project, establishing a weekend walk-in clinic to reduce use of the Emergency Department and, as described in this newsletter, piloting pre-visit planning.

We have been just as busy in our educational mission. The medical school has a new, innovative medical school curriculum, and Family Medicine faculty provide leadership in all four years. Our residency has a record number of applicants, and is focusing on a “clinic first” (versus the traditional hospital first) model which should improve both the training we provide and the care we give. A family physician leads U-M’s clinical simulation unit, we continue to build fellowships offerings in diverse areas, and for those past their formal training years, our Faculty Development Institute and CME programs remain robust.

This newsletter highlights examples of our research and scholarly work. Six superb junior investigators joined our ranks in the last three years along with,

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a world renowned mixed-methods expert, and two post-doctoral fellows.

The breadth and depth of our scholarly work - performed by both research and clinical track faculty - is amazing.

In the last year the team earned more than $7M in grant funding, served on numerous national committees, and published in major journals on a broad range of disciplines.

Last but not least, we remain actively involved in the community – both locally and globally. We volunteer at local organizations providing care for underserved populations, and have well-established relationships with colleagues in countries ranging from Japan to Ghana. This work both inspires us and extends our impact far beyond our borders.

And so, I remain “bullish” for Family Medicine at Michigan despite the tremendous health care changes taking place. As the sign in my office says, “Do not be afraid of change. Be afraid of not changing.” Our teams of faculty and staff clearly have the skill and emotional intelligence to respond to the challenges, and to do best by our patients and learners. They exemplify what it means to be Leaders and Best and I look forward to watching them succeed. Go Blue! n

~ Philip

Fall 2016

Clinical Mission Partnership with Community Pharmacists Benefits Family Medicine Patients Local Meijer Pharmacies to provide hypertension management services for adult patients and expand our efforts in the patient-centered medical home.

U-M patients can now visit participating Meijer pharmacy locations to receive a blood pressure check and assessment. If the patient’s blood pressure is elevated, the clinically trained Meijer pharmacist will communicate directly with the patient’s U-M Health System provider. The patient will also receive appropriate follow-up and education about disease, clinical goals, medications and lifestyle.

“We are excited to partner with Meijer to augment the care we provide for our patients. This collaboration will help improve the health of our communities by providing more convenient options for our patients to receive hypertension evaluation and management. It builds on earlier efforts, as we work to expand the patient-centered medical home into the community, further expanding partnerships that we have previously established with CVS Pharmacy, Chelsea and Dexter Area Wellness Foundations and others to provide diabetes and prediabetes support,” noted David C. Serlin, M.D., assistant professor and associate chair for clinical programs.

In addition, documentation of the patient’s visit to their Meijer pharmacy will be recorded in their electronic medical record so the patient can easily discuss the reading and assessment with their U-M Health System provider at their next medical visit.

Patients at Briarwood Family

Medicine and Ypsilanti Family Medicine are now able to utilize this exciting new service at two local Meijer Pharmacies on Ann ArborSaline Road and Carpenter Road.

“This partnership is allowing us to provide our patients with clinical pharmacist services in the community,” says Hae Mi Choe, director and associate dean of pharmacy innovations and partnerships at U-M. “Our patients will have more access to an effective and safe hypertension treatment and monitoring program right in their neighborhood.”

Nearly 90 percent of Americans live within five miles of a pharmacy and a community pharmacist is one of the most accessible health care professionals in the U.S., according to the National Association of Chain Drug Stores.

“Improving blood pressure control is one of the U-M Health System’s goals,” Choe says. “We are hoping this partnership will allow patients another convenient access point to high-quality care and improved management of their condition.”

U-M Health System patients with elevated blood pressure will be identified at clinic visits and given the option to visit the Meijer pharmacy for their follow-up care. There will also be outreach to patients with elevated blood pressure who live in close proximity to the participating Meijer locations inviting them to visit

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their local Meijer pharmacy, or return David C. Serlin, M.D. to their physician’s office, for their follow-up care. n

Family Medicine

…continued from page 1

electronic medical record to the UMHS-wide MiChart system.

“I have been privileged to work with wonderful leaders, mentors, and colleagues, to whom I am forever grateful and plan to continue work with in the future. All of my UMHS experiences have helped me grow as a person and leader, and have led to this opportunity to take on a very exciting leadership role at Lehigh Valley, said Dr. Greenberg. “Transitions are challenging, I will be saying farewell to many patients, friends, and colleagues.

However, I will continue to collaborate with my family medicine and UMHS colleagues and will continue to be a regular attendee at the Society of Teachers of Family Medicine conferences. While my address is changing, I remain loyal to U-M.” Dr. Greenberg took on many administrative roles throughout his career at U-M, but patients are always his top priority. He saw patients at the Chelsea Health Center, where he was the medical director from 2005-2013 and served on the Department’s FamilyContinued on page 17

Fall 2016

Clinical Mission Dr. Holmstrom to Lead PCMH and Information Management Heather L. Holmstrom, M.D., assistant p r o f e s s o r, Heather L. Holmstrom, M.D. has been named to two Department leadership positions. She will lead all patientcentered medical home (PCMH) efforts as PCMH director and she will act as interim associate chair for information management and quality.

Dr. Holmstrom has been active in the PCMH since its inception within the Department. She worked with previous director, Kathryn M. Harmes, M.D., assistant professor, as the PCMH assistant director. Through this role, she led the Department’s development

of a walk-in clinic designed to improve patient access and reduce utilization of the Emergency Department.

Additionally, her project to determine the effectiveness of medical scribes expanded into a UMHS medical scribe program that she currently leads.

Her experience and drive make the Department well poised to advance this effort tremendously. The PCMH team will also be led by new assistant director, Anna R. Laurie, M.D., lecturer.

While a search is underway to permanently fill the role of associate chair for information management and quality that was left open following Dr. Greenberg’s departure, Dr. Holmstrom will lead this effort as

well. Dr. Holmstrom is a member of several committees that have given her the experience needed to succeed in this role including Faculty Practice Improvement Group, Quality Improvement, Population and Health Management. She was also a member of the MiChart Implementation team and is currently a UMHS physician builder for the EPIC electronic medical health record. And, she is a medical school instructor for Population Management, LEAN Concepts and MiChart Efficiency.

The Department is thrilled to have Dr. Holmstrom serve as a leader in these positions and is looking forward to her successes. n

Improving Patient Visits by Planning Ahead The Department of Family Medicine led a pilot of pre-visit planning. The practice improvement initiative took place at Domino’s Farms Family Medicine and was led by Heather L. Holmstrom, M.D., assistant professor, medical director of the patient-centered medical home (PCMH) and interim associate chair for information management; Pamela G. Rockwell, D.O., medical director of Domino’s Farms Family Medicine; and Devon Kinney, project manager.

Because the number of expected clinical performance measures to address within each office visit has

increased, yet office visit work time has remained constant, patients, faculty and staff often experience frustration at the “bottleneck” experienced during a visit. The team developed five goals for the pilot project.

1. Identify and define the current process and its constraints within the electronic medical record (EMR).

2. Improve process flow by redesigning work flow and creating EMR improvements with creation of a pre-visit appointment.

3. Increase value to patients

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and physicians with improved quality metrics and satisfaction.

4. Document faster medical assistant (MA) rooming times for health maintenance evaluations and Medicare wellness visits.

5. Reduce the need for follow-up visits.

The new process developed by the team included physician and MA teams performing chart reviews and visit planning followed by patients being contacted 2-4 weeks prior to their appointment. During this pre-visit

Fall 2016

Clinical Mission Multimedia Medicine Micheleen Hashikawa, M.D., lecturer, recently created and produced a video, “University of Michigan Parent Survival Guide,” that features discharge instructions for new parents.

The goal of the video was to improve maternal satisfaction and sense of preparedness prior to leaving the hospital. The video, which can be viewed at bit.ly/parentsurvivalguide, has been well received by both patients and physicians. A resident original research project by Jane E. Chargot, M.D., now a lecturer, and Kristine L. Cece, M.D., Ph.D., now an academic fellow, found that mothers who received discharge instructions from the video had a higher satisfaction rates than those who received face-to-face instructions. Anecdotally, the video has been very helpful to physicians when doing rounds, especially when

the service is very busy.

Additionally, the video received national acclaim and was selected to be shown at the American Public Health Association’s Global Public Health Film Festival.

Dr. Hashikawa, who had no previous video experience, enjoyed the challenge of doing something new and exciting.

As an “artsy, hands-on person,” it allowed her to combine her passions of art and science.

Following the successful new parent project, she worked with Philip Zazove, M.D., the George A. Dean, M.D. Chair of Family Medicine, on his grant project entitled “Early Audiology Referral in Primary Care.” You can read more about this grant on page 12.

She is currently working on a Japanese language version of the survival guide video and if time allows,

she hopes to work on more video projects in the future.

“My goals are to help f e l l o w Micheleen Hashikawa, M.D. colleagues enrich their teaching and research projects by producing and training others to create multimedia productions without the cost of external, professional companies. I believe, in the near future, students and patients will demand more things in a digital format in this ever increasing digital world,” she noted. n

appointment patients are advised to complete lab work, cancer screening tests and other items before their office visit.

Preliminary results show an increase in both quality metrics and patient satisfaction and a decrease in rooming time. The team is currently working with leaders at other sites to expand the program.

This PCMH pilot project was funded by the Family Medicine Educational Scholars Programs, a Department program designed with many aims, one of which is clinical development and process improvement. n

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Fall 2016

Education Mission Welcome Residency Class of 2019!

YPSILANTI FAMILY MEDICINE

Julie A. Blaszczak, M.D. Laura M. Crespo Albiac, M.D. University of Michigan Medical School

Rush Medical College

Camila Diaz, M.D. University of Florida College of Medicine

Andrea Lui, M.D.

Case Western Reserve University School of Medicine

Daniel S. Oram, M.D. Michigan State College of Human Medicine

CHELSEA FAMILY MEDICINE

Elizabeth M. Marshall, M.D. University of Michigan Medical School

Hope E. Meyer, M.D.

University of Iowa Carver College of Medicine

Kristin L. Pacl, M.D.

M. Abbey Moon, M.D.

Saint Louis University School of Medicine

Medical University of South Carolina

Anthony C. Tam, M.D. George R. Wasylyshyn, M.D. Northeast Ohio Medical University

University of Michigan Medical School

Summer Preceptorship Inspires Future Family Physician

Emily Geerlings

It was another great year for the Kenneth and Judy Betz M1 Preceptorship Program with one medical student engaging in a monthlong preceptorship experience with a community-based physician.

Kurt Lindberg, M.D. (MD 1996) in Holland, Mich., hosted Emily Geerlings. She precepted with him and his team of ten other family physicians.

Although this was not Emily’s first exposure to family medicine. Emily’s grandfather, Dr. Harry Holwerda,

graduated from U-M Medical School in 1965 and practiced family medicine in Grand Rapids, Mich., where he also retired and lives today.

“In short, the past month was a wonderful experience to grow my fledgling clinical knowledge, and to explore the field of family medicine.

I was impressed by the variety I saw in just a month, and I cannot wait for the rest of my training,” said Emily.

During the month, Emily learned about the variety and scope of the clinical challenges a family physician encounters, was able to experience continuity of care and gained a sense for the professional and personal lives of a family physician.

“It was a rewarding experience in which I shadowed, interviewed patients, practiced physical exam

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skills (and learned a few new ones), attended a physicians’ educational meeting, observed a population health management meeting, presented cases to physicians (and learned their preferences for medical student presentations), removed staples and sutures, learned from physicians about their experiences in family medicine, and received many tips from them on patient care. Of these, two specific instances stand out — watching a delivery and observing a visit with a patient with a personality disorder, shared Emily when asked about the Betz Preceptorship experience.

A special thank you to Dr. Lindberg for hosting Emily and sharing a glimpse of what it means to be a family physician. n

Fall 2016

Education Mission Family Medicine Fellowships 2016-17 Kristine L. Cece, M.D., Ph.D.

Claire K. Ankuda, M.D., Ph.D.

Academic Medicine

National Clinician Scholar

Lydia U. Lee, M.D.

Cornelius D. Jamison, M.D., M.S.P.H.

Medical School: Virginal Commonwealth University School of Medicine Residency: Family Medicine, University of Michigan

Medical School: East Carolina School of Medicine Residency: Family Medicine, Duke University/ Southern Regional AHEC

Medical School: University of Michigan Medical School Residency: Family Medicine, University of Michigan

Medical School: University of Vermont College of Medicine Residency: Family Medicine, University of Washington

Mental and Behavioral Health

National Clinician Scholar (VA Scholar)

Fareeha Khan, M.D., M.P.H.

Hassen Berri, D.O.

Medical School: Jinnah Sindh Medical University, Karachi, Pakistan Residency: Family Medicine, St. Mary Mercy Hospital, Livonia, Mich.

Medical School: Michigan State University College of Osteopathic Medicine Residency: Physical Medicine & Rehabilitation, University of Michigan

Sports Medicine (Physical Medicine & Rehabilitation)

Geriatric Care

Lyle S. Walton, M.D.

Kent P. Scheff, M.D.

Medical School: University of South Carolina School of Medicine Residency: Family Medicine, St. Joseph Mercy Health, Ypsilanti, Mich.

Medical School: University of Minnesota Medical School Residency: Family Medicine, St. Joseph’s Hospital, St. Paul, Minn.

Sports Medicine (Family Medicine)

Hospice and Palliative Medicine

Gwendolyn M. Fitz-Gerald, M.D.

Cheryl E. LaMore, M.D.

Integrative Medicine, Faculty Fellow

Women’s Health

Gregory D. Shumer, M.D.

Niyati Shah, M.D.

Medical School: Georgetown University School of Medicine Residency: Family Medicine, University of Michigan

Medical School: Yale University School of Medicine Residency: Family Medicine, University of Michigan

Medical School: University of Vermont College of Medicine Residency: Family Medicine, University of Colorado-Denver

Medical School: University of Illinois College of Medicine Residency: Family Medicine, University of Michigan

Women’s Health

Integrative Medicine

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Fall 2016

Education Mission Supporting Wellness in Memory of Susan Guynn Susan Guynn was the assistant r e s i d e n c y coordinator at Chelsea Family Medicine from 2009-2012, when she was diagnosed Susan Guynn with breast cancer.

Although her time as the assistant residency coordinator may have only been four years, her impact on the residents was beyond measure.

Susan went above and beyond her role to help the residents at work and paid attention to small details. From baking cookies and washing — and ironing — lab coats, to bringing in pigs’ knuckles for suture practice, Susan loved her job and the residents she served. Susan died on December 26, 2015, at age 57, from breast cancer.

The Susan Guynn Family Medicine Residency Wellness Fund was established by anonymous donors who greatly appreciated the genuine care that she showed the residents.

The Fund will support and promote wellness initiatives for the family medicine residents, such as support of the resident retreat; wellness activities; initiatives to address stress management, and the resident wellness and well-being curriculum.

This Fund honors Susan’s dedication to the family medicine residents. n To make a gift in memory of Susan, please contact Amy St. Amour at 734-645-0423 or astamour@umich.edu.

Chelsea Scholarship Completed!

A special thank you to Arlene Howe (U-M Nursing 1943 and a member of the Family Medicine DevelopArlene Howe m e n t Advisory Committee) who, along with supporters of the Chelsea Community, was able to complete the Chelsea Community Family Medicine

Scholarship Fund by reaching the endowment goal of $100,000.

Since 2009, the Chelsea Scholarship has been awarded annually to a deserving and talented fourth-year medical student at the University of Michigan who enters a family medicine residency program and has a demonstrated financial need.

Thank you Arlene! n

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Philip Zazove, M.D., Earl Zazove, M.D. and Alon Avidan, M.D., M.P.H.

2016 Zazove Lectureship The Drs. Earl and Louise Zazove Lectureship in Family Medicine sponsored Alon Avidan, M.D., M.P.H., director, UCLA Sleep Disorders Center and UCLA Neurology Clinic, to speak at Grand Rounds on July 13th.

A captivated audience, including Dr. Earl Zazove, age 95, enjoyed the informative presentation on “Sleep Disturbances in Older Age: What Lies Beneath?” Dr. Avidan addressed “what every family physician needs to know” including information on sleep apnea, insomnia, movement disorders, REM sleep disorder and more. Following Grand Rounds. Dr. Avidan spent time with the family medicine residents, as well as various faculty members before returning to California.

The Zazove Lectureship in Family Medicine supports an annual lectureship in family medicine and an education program focused on aging that features a prominent speaker and family medicine educator. n

Fall 2016

Research Mission Dr. Chang Links Hydration and Obesity People who are obese and have a higher body mass index (BMI) are more likely to be inadequately hydrated and vice versa, Tammy Chang, M.D., suggests new M.P.H., M.S. research led

by Tammy Chang, M.D., M.P.H., M.S., assistant professor.

“The link between hydration and weight is not clear. Our study further explains this relationship on a population level using an objective measure of hydration,” said Dr. Chang.

Researchers analyzed a nationally representative sample of 9,528 adults from the Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey (NHANES). Roughly a third of the adults, who spanned ages 18 to 64, were inadequately hydrated. And overall, they found that a lack of proper hydration was associated with higher body mass index. The odds of being obese were 1.59 times higher for people who were not well-hydrated.

The study also suggests that people with higher BMIs - who are expected to have higher water needs - might also demonstrate behaviors that lead to inadequate hydration, such as not drinking enough water and eating

foods that have lower water content.

The authors note that because the data is cross-sectional, they cannot say that inadequate hydration causes obesity or the other way around. But their findings highlight an important relationship between the two.

“Hydration may be overlooked in adult weight management strategies,” says Dr. Chang. “Our findings suggest that hydration may deserve more attention when thinking about addressing obesity on a population level.” The study was published in the Annals of Family Medicine.

Melissa A. Pegue, M.A., statistician, was a co-author on this study. n

Study Finds Inconsistencies in National Dataset A new study led by Christine T. Cigolle, M.D., M.P.H., assistant professor, reveals patterns of human error behind a seminal dataset, used in more than 3,000 publications on health and aging.

For more than 20 years, the Health and Retirement Study (HRS) has surveyed adults ages 51 and over on their health and economic well-being, including the diagnosis and treatment of their chronic diseases.

Dr. Cigolle’s study, recently published in the Journals of Gerontology: Social Sciences, examined patterns of inconsistencies in how more than 24,000 respondents self-reported their disease status in the biannual survey, from 1995 to 2010. Inconsistencies were classified as instances where people noted that they

were diagnosed with a chronic disease and later, in subsequent survey waves, noted that they did not have the disease.

These inconsistencies are problematic and “clinically implausible,” as chronic diseases, by definition, persist throughout the lifespan.

Researchers found that nearly 30% of respondents had inconsistencies in their self-report of chronic diseases over time.

Of the seven chronic diseases studied, arthritis and hypertension had the most frequently inconsistent responses, while stroke and cancer had the fewest.

The study also identified demographic factors that predicted the likelihood for inconsistencies. Respondents with cognitive impairments or who used proxies, such as a spouse, to respond to the health interview were more likely

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to misreport their disease status. Other key predictors included: age, Hispanic ethnicity and wealth.

The researchers also Christine T. Cigolle, M.D., established a M.P.H. new method of adjudicating and resolving data inconsistencies. Their multi-step method resolved 60-75% of inconsistent responses and revealed, in some cases, substantial differences in disease prevalence, including increases in the relative prevalence of heart disease, lung disease, cancer and stroke. n

Fall 2016

Research Mission Acupressure Reduces Fatigue in Breast Cancer Survivors Acupressure helped reduce persistent fatigue in women who had been treated for breast cancer, according to a new study led by Suzanna M. Zick, N.D., M.P.H., associate professor.

The study, published in JAMA Oncology, found acupressure reduced fatigue by 27 percent to 34 percent over six weeks. Two-thirds of women who did relaxing acupressure achieved normal fatigue levels.

Acupressure is derived from traditional Chinese medicine. It involves applying pressure with fingers, thumbs or a device to specific points on the body. Researchers tested two types of acupressure: relaxing acupressure, which is traditionally used to treat insomnia, and stimulating acupressure,

which is used to increase energy.

The research team recruited 424 breast cancer survivors from the Michigan Tumor Registry. Participants were randomized to relaxing acupressure, stimulating acupressure or usual care.

The women were taught how to find and stimulate the acupressure points and were then asked to do the acupressure once per day for six weeks.

Both acupressure treatments resulted in significant, sustained improvements in fatigue. But only relaxing acupressure also improved sleep quality, such as disrupted sleep, and overall quality of life.

“Fatigue is an underappreciated symptom across a lot of chronic diseases, especially cancer. It has a significant

impact on quality of life.

Acupressure is easy to learn and patients can do it themselves,” says Dr. Zick.

The researchers are developing a mobile app- Suzanna M. Zick, N.D., lication to teach M.P.H. acupressure. They will also investigate why acupressure impacts fatigue and whether it is also effective for patients in active treatment and with cancers other than breast.

Ananda Sen, Ph.D., professor, was a co-author on this study. n

Stigma & Sanctions Prevent Doctors From Revealing Mental Health Concerns Wary of the stigma of a mental health diagnosis and its toll on their careers, physicians often avoid getting help for depression and other mental illnesses, a new Katherine J. Gold, study suggests.

M.D., M.S.W., M.S. The study, led

by Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, surveyed over 2,100 female physicians from February to April 2016. One in three respondents said they had been given a formal mental health diagnosis since medical school. And nearly half believed they had met the definition for a mental illness at least sometime during

their career, but had not sought treatment.

Many doctors said getting diagnosed would be embarrassing or shameful, or they believed they would be judged by others, deemed incompetent, or have their privacy and autonomy violated. Two-thirds reported that fear of stigma drove them to keep their worries quiet.

“I have definitely suspected a lot of people were feeling the stigma, but I was really astonished by how high the numbers really were,” says Dr. Gold.

The study appears in General Hospital Psychiatry and is the first of its kind to ask doctors about mental health questions that appear on most state medical licensing applications.

Only six percent of those who had ever been diagnosed had reported it to their state licensing board, as most felt their

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condition did not affect the care they gave.

While studies have shown that substance use issues can have an impact on physicians’ ability to practice, few studies have looked at whether and how non-substance-related mental health issues impair physician performance.

Dr. Gold and her colleagues hope to do further research on broader populations of physicians, including looking at the relationship of physician burnout or resilience to depression. She also hopes to study state management of self-reported physician mental health issues. “More research is needed on this issue, to reduce stigma among physicians and to help physicians feel safe seeking care.”

Thomas L. Schwenk, M.D., professor emeritus, was a co-author on this study. n

Fall 2016

Research Mission Exceptional Research Mentorship Caroline R. Richardson, M.D., the Dr. Max and Buena Lichter Research Professor of Family Medicine, is a 2016 recipient of the Michigan Institute for Clinical & Health Research Distinguished Clinical and Translational Research Mentor Award.

The award honors U-M faculty who have demonstrated consistently highquality research and career mentoring in areas of clinical and translational research. Dr. Richardson was nominated by an impressive band of mentees and colleagues, from doctoral students to senior investigators, across many areas of medicine. Their testimonies highlight Dr. Richardson’s genuine and steadfast commitment to

mentorship and the deep impact her advocacy has had in the lives and the communities she has supported.

“Dr. Richardson always goes above and beyond to make herself available to her mentees - even when it is very inconvenient for her,” noted Michelle Segar, Ph.D., M.P.H., director of the Sport, Health, and Activity Research and Policy Center at U-M. “At the last minute, there was a need to review the statistics prior to submission, on the day that Dr. Richardson was moving into a new home. Despite a hectic day, Dr. Richardson sat with me for two hours, amidst the chaos of many people transporting furniture.”

“Without a doubt, Dr. Richardson is one of our department’s most outstanding teachers, mentors and educators. Dr. Richardson is known

Post-Doc Research Fellow DeJonckheere, M.D., N.P., Ph.D. is a qualitative and mixed methodologist working with Michael D. Fetters, M.D., M.P.H., M.A., professor, and the Michigan Mixed Methods Research & Scholarship Program. She recently completed her Ph.D. in Educational Studies at the University of Cincinnati. Her primary methodological interest is the integration of community-based participatory research and mixed methods designs. To date, her research has focused on the social determinants of health, including chronic stress in childhood and adolescence. During her fellowship, she will be responsible for supporting the development, analysis and dissemination of mixed methods projects. n

Achieving Perfection Two junior research investigators

Melissa

for her patient yet persistent attention to detail, her dedication to one-on-one mentoring and her love of teaching,” said Philip Zazove, M.D.,the George A. Dean, M.D. Chair of Family Medicine. “She holds an unwavering vision for each junior colleague’s greatness and works to help them attain this. She reminds many faculty of the importance of our mentoring duties, and the positive downstream implications for our mentees when we help them be successful.”

Dr. Richardson was presented with the award in a ceremony on October 14th. She is the first member of the Department to receive this prestigious award. n

To read more mentee stories, go to: bit.ly/michraward

Justine P. Wu, M.D.,

Tammy Chang, M.D.,

M.P.H.

M.P.H.

rece ived perfect scores on their recent NIH five-year career development K Grants. Justine P. Wu, M.D., M.P.H., assistant professor, and Tammy Chang, M.D., M.P.H., assistant professor, have outstanding projects that should lead to impactful research.

• Improving Contraceptive Care for Women with Chronic Conditions: A Novel, Web-Based Decision Aid in Primary Care by Dr. Wu • Speaking Their Language: Using Social Media and Texting to Create an Adolescent-Centered Approach to Healthy Weight Gain During Pregnancy by Dr. Chang “We are thrilled to have such talented junior faculty on our Family Medicine research team. Drs. Chang and Wu are already making an impact with their innovative work,” said Caroline R. Richardson, M.D., associate chair for research programs and the Dr. Max and Buena Lichter Research Professor of Family Medicine. n

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Fall 2016

Research Mission Innovation Through Inquiry – Current Research Projects Researchers in the Department seek novel approaches to primary health care.

Learn more about a few of the Department’s currently funded projects.

Health Check-Up for Expectant Moms: Computer Intervention for HIV/STI Risk and Drug Use During Pregnancy Golfo K. Tzilos, Ph.D., Assistant Professor $405,932 Eunice Kennedy Shriver National Institute of Child Health and Human Development HIV and other sexually transmitted infections (STIs) risk and alcohol/drug use during pregnancy are interconnected problems — both are associated with numerous negative consequences for the woman and the developing fetus. Yet, virtually no interventions have been developed or tested to target both of these serious health concerns during pregnancy.

This study will: • Design and develop Health Check-up for Expectant Moms (HCEM), a computer-delivered brief intervention that targets both the risk for HIV/STIs and alcohol/drug use among low income pregnant women • Determine the effect of HCEM in two-group randomized control trial • Inform the development of integrated HIV/STI and substance use interventions that are cost effective, high-reaching, and widely disseminable within prenatal care.

Telemonitoring Enhanced Support for Depression Self Management James E. Aikens, Ph.D., Professor $3,385,700 National Institutes of Health, National Institute of Mental Health

Dr. Aikens is co-principal investigator of this R01 study, which seeks to improve depression outcomes by implementing a low-cost, automated telephone-based intervention that activates depressed patients’ existing social networks to enhance their self-management support.

The intervention links patients with a non-household family member or close friend who is trained to support the patient, in coordination with the clinician and any existing in-home caregiver.

This project has three aims: • Compare the effectiveness of telemonitoring-supported care partners-depression versus usual care (control) on depression severity, in a one-year randomized controlled trial.

• Examine key secondary outcomes (response and remission, impairment, well-being, caregiving burden, health care costs) and potential moderators.

• Use a mixed-methods approach to enrich interpretation of the statistical associations, and to discover strategies to enhance the intervention’s acceptability, effectiveness, and sustainability.

Early Audiology Referral in Primary Care (EAR-PC): Improving Detection of Hearing Loss Philip Zazove, M.D., Professor and the George A. Dean, M.D. Chair of Family Medicine $1,624,469 National Institutes of Health, National Institute on Deafness and Other Communication Disorders, Department of Health and Human Services

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Dr. Zazove is lead investigator of this R21/R33 study, which seeks to increase hearing loss screenings for patients 55 and older by utilizing electronic clinical management tools in the primary care setting and multimedia. The MiChart research team has designed a Best Practice Alert (BPA), which notifies primary care providers (PCPs) of hearing loss assessment opportunities and allows clinicians to refer directly and efficiently to audiology specialists. The multimedia project, guided by Micheleen Hashikawa, M.D., lecturer, features a video to address physicians’ mental models of hearing loss.

The investigation has expanded to look at patients’ decision-making around hearing testing and adoption of hearing aids.

The EAR-PC study has partnered with the Beaumont Family Medicine network and Elie Mulhem, M.D., of Oakland University’s William Beaumont School of Medicine, to successfully include 5,500 patients in the pilot study. Dr. Zazove anticipates more than 20,000 patients in the R33 phase.

The research is guided by three aims, to: • Evaluate whether the EAR-PC program increases PCP identification of patients with mild to moderate hearing loss compared to baseline data.

• Evaluate whether the EAR-PC program increases appropriate PCP referral of patients with mild to moderate hearing loss to audiology specialists.

• Utilize both qualitative and quantitative inquiry to investigate how successful PCPs implement the intervention, identifying processes and tools that will allow this project to successfully scale. n

Fall 2016

Development Family Physicians Return to U-M The Department of Family Medicine hosted a reception for returning Medical School Alumni family physicians during Reunion Weekend on September 30th.

With more than 25 guests in attendance from as far as Montana and Florida, the evening was a nice opportunity to reconnect fellow family physicians.

“It is always wonderful to bring family physicians together from across the country and across the years to share stories from the past and thoughts on the future of the specialty,” noted Philip Zazove, M.D., the George A. Dean, M.D. Chair of Family Medicine. n

John Edleman, D.O.(left), of Bellaire, Mich. is the longest running attendee of our annual Northern Michigan Family Medicine Update CME course having attended all 52 courses.

He was very happy to reconnect with former course director, James F. Peggs, M.D., emeritus professor. Dr. Edleman will be hosting a gathering for Northern Michigan family physicians during the 2017 course.

Todd Wampler, M.D. (MD 1996), and Heidi Wampler, DVM, kept Kent J. John O’Brien, M.D. (MD 1979, RES 1982) associate

Sheets, Ph.D., professor, entertained

professor, had an enjoyable time catching up

with tales from Helena, Mont. Dr.

with Lynn Swan, M.D. (MD 1984, RES 1987) who

Wampler was also happy to run into

was a resident early in his career. Dr. Swan, a

classmate, Todd Sheperd, M.D. (MD

former chief resident, currently serves on our

1995) who lives in Petoskey, Mich.

Development Advisory Committee.

Ruffin Award Supports Resident Research The Department has a robust research program for family medicine residents and a new fund supports this outstanding program. Each resident works with a faculty advisor to conduct their own original project. During their final year of residency, they present their research to the full faculty for review.

In honor of Mack T. Ruffin IV, M.D., M.P.H., professor emeritus,who retired from the Department and is now chair of the Department of Family and Community Medicine at Penn State Hershey Medical Center as you read about on the cover of this newsletter, the Department has created a fund to

support resident original research. The Mack T. Ruffin IV, M.D. Resident Original Project Award Fund, with a goal of $100,000, will support an annual monetary award to the top resident original research project.

As Dr. Ruffin was an adviser to dozens of these residents over the years in the development of their projects, it is fitting an award has been created in his name.

“The discipline of Family Medicine has a critical shortage of residents with the passion for research. Without these great minds addressing issues relevant to our patients, we will be limited in

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our ability to advance the discipline.

This award will reward the best resident scholarly projects as voted by their peers and faculty. The goal is to nurture their passion for research,” noted Dr. Ruffin.

Dr. Ruffin is passionate about research and this Fund honors his career with the Department and will carry on his dedication to encouraging outstanding research in the specialty of family medicine. n To make a gift to support this award, please contact Amy St. Amour at 734-645-0423 or astamour@umich.edu.

Fall 2016

Development Department of Family Medicine – 38 Years of Success

Department Characteristics Revenue

2015 – 2016

93 Faculty/290 Staff 33 Residents/14 Fellows

$ 14.6 M

Clinical Grants/Contracts (Directs)

$ 2.6 M

Institutional Support

$ 2.4 M

Philanthropy

$ .40 M

Other

$ 2.2 M

Total

$ 21.15 M

Total Revenue 1978 – 2016 > $ 449.55 M

Department Mission

Increase the availability of quality primary health care to residents of the United States through the advancement and demonstration of the principles of family medicine as an academic discipline.

Clinical Mission Outpatient Volume

2015 – 2016

1978 – 2016

Briarwood (1986)

35,315

> 840,000

Chelsea (1978)

33,561

> 1,036,000

Dexter (1995)

18,924

> 278,000

Domino’s (1993)

22,884

> 361,000

Livonia (2014)

11,133

Ypsilanti (1993) Total

Inpatient Volume

>16,000

18,757

>536,000

140,578

> 3,077,000

2015 – 2016

1978 – 2016

CFM

1,145

> 29,000

UFM

1,337

> 19,000

FMB

461

> 10,400

FMN

578

> 10,900

Total

3,521

> 70,000

Total Outpatient Visits 1978 – 2016 Approximately 3.07 M

DFM Clinical Focus Metrics (FGP Performance/DFM Performance)

Controlled Substance – Opiods Only – Comp Urine Drug Screen

64.7% / 80% (90th %tile)

Controlled Substance – Opiods Only – Controlled Substance Agreement Controlled Substance – Opiods Only – Michigan Automated Prescription System Pediatric Preventive Care – Well Child Visits 0–15 mo.

Hypertension – BP Control – Most Recent BP Post-Partum Visits – 21 to 56 Days After Delivery Adults Preventive Care – Breast Cancer Screening Age 50 to 74

77.1% / 88.3% (90th %tile) 77.2% / 84.4% 91.4% / 86.3% (75th %tile) 73.4% / 73.4% (75th %tile) 86.8% / 80.8% 80.7% / 79.8% (75th %tile)

Total Inpatient Visits 1978 – 2016 Approximately 70,000

Education Mission Predoctoral

Residency

2015 – 2016

1978 – 2016

178

5,103

Students Taught M3 M4 (Elective/Sub I)

30

M3 Clerkship Ratings

1st for 18 out of 20 years!

Students Matching in FM

10.9% (17 out of 156)

Continuing Medical Education 2015 – 2016 Registrants Revenue Average Rating

1978 – 2016

451

> 24,500

$229,657

> $23 M

Exceeded/Met Expectations > 95%

2015 – 2016

1978 – 2016

11 1 2 1 1 3 2 1 1

280 12 28 10 5 3 33 10 1

Graduates Residency Academic Geriatric Integrative Med Palliative Care Sleep Medicine Sports Med Women’s Health Individualized

ABFM Board Examination Pass Rate Our Residency (100%) National Pass Rate (95.6%)

Total Educational RVUs for 2015 – 2016 17,192

Research Mission 2015 – 2016

1978 – 2016

Research Grant Funding (Directs/Indirects)

$ 3,391,118

> $ 57 M

Grant Submissions

67

Percentage Capture of Family Medicine NIH Budget

3.45%

2.66%

Approximate NIH Ranking

5

6th

Publications and Major Presentations

Hundreds!

Thousands!

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Fall 2016

Faculty Activity Welcoming New Faculty

Best Wishes Drs. Velez and Warber

• Julie K. Prussack, M.D., Lecturer Domino’s Farms Family Medicine Medical School: University of Michigan Medical School, 2012 Residency: University of Michigan, 2015 Fellowship: Women’s Health, University of Michigan, 2016

Lourdes Velez, M.D. joined the Department in 1998 and retired this year.

Dr. Velez, a talented clinician, had a special interest in cognitive disorders, diabetes, stroke and geriatric medicine. Fluent in Spanish and English, she provided compassion, continuity and quality health care for her patients in Ypsilanti, Mich.

Dr. Velez received her medical degree at the San Juan Bautista School of Medicine in San Juan, Puerto Rico.

After her family practice residency at North Oakland Medical Center in Pontiac, Mich., she completed additional fellowship training in primary care faculty development and a geriatrics medicine fellowship.

Now, as an emeritus faculty member, Dr. Velez is committed to establishing a Latino Health Patient Assistance Fund that will continue to support many of her patients and others in perpetuity. She also plans to work to improve health care in Puerto Rico.

Sara L. Warber, M.D. joined the Department in 1997 and retired this fall. Her work focused on incorporating integrative healthcare content into the medical school curriculum and across U-M. She established the Integrative Family Medicine Clinic in 2006, where she and others serve the holistic health needs of patients wishing to blend the best of alternative and conventional medicine.

Her later research focused on healing, natural products, multi-modal retreats, and the health effects of time spent in nature. In 2013-14, she received a Fulbright Scholarship Award to study ‘nature-deficit disorder’ at the European Centre for Environment & Human Health, University of Exeter Medical School, Truro, UK. As an emeritus professor, Dr. Warber will work to support the Sara L. Warber, M.D. Health and Well-Being Education Fund that will support integrative medicine initiatives. n

• Stephen J. Warnick Jr., M.D., Assistant Professor Livonia Health Center Medical School: University of Michigan, 2007 Residency: University of Cincinnati, 2012

To make a gift to either of these funds, please contact Amy St. Amour at 734-645-0423 or astamour@umich.edu.

• Jane E. Chargot, M.D., Lecturer Briarwood Family Medicine Medical School: Rush Medical College, 2013 Residency: University of Michigan, 2016 • Timothy C. Guetterman, Ph.D., M.A., Assistant Professor Doctoral Program: Psychology, University of Nebraska, 2015 Advanced Degree: M.A., University of Iowa, 2003 • Laura E.A. Heinrich, M.D., Lecturer Dexter Health Center Medical School: Loyola University of Chicago – Stritch School of Medicine, 2013 Residency: University of Michigan, 2016 • Katherine E. Hughey, M.D., Lecturer Ypsilanti Health Center Medical School: University of Chicago Pritzker School of Medicine, 2012 Residency: University of Michigan, 2015 Fellowship: Community Medicine, University of Michigan, 2016 • Ayano Kiyota, M.D., Ph.D., Assistant Professor Livonia Health Center Medical School: St. Marianna University of Medicine, 1998 Residency: University of Pittsburg Medical Center, 2009 Fellowships: Hospice and Palliative Medicine, Wayne State University, 2010 and Geriatric Medicine, University of Hawaii, 2012 • Angela L. Kuznia, M.D., M.P.H., Lecturer Chelsea Health Center Medical School: Michigan State University College of Human Medicine, 2012 Residency: Georgetown University, 2015 Advanced Degree: M.P.H., University of Michigan, 2008 • Anna R. Laurie, M.D., Lecturer Briarwood Family Medicine Medical School: Pennsylvania State University College of Medicine, 2012 Residency: University of Michigan, 2015

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Fall 2016

Faculty Activity Faculty Publications • Chang T, Ravi N, Plegue MA, Sonneville KR, Davis MM. Inadequate Hydration, BMI, and Obesity Among US Adults: NHANES 2009-2012. Annals of Family Medicine. 2016 Jul;14(4):320-4.

• Whitson HE, Johnson KS, Sloane R, Cigolle CT, Pieper CF, Landerman L et al. Identifying Patterns of Multimorbidity in Older Americans: Application of Latent Class Analysis. Journal of the American Geriatrics Society. 2016 Aug 1;64(8):1668-1673.

• Wimsatt LA, Cooke JM, Biggs WS, Heidelbaugh JJ. Institution-Specific Factors Associated With Family Medicine Residency Match Rates. Teaching and Learning in Medicine. 2016 Jul 2;28(3):269-278.

• Bashan I, Cooke JM, Rooney DM. Using SimulationBased Education to Improve Residents’ Clinical Decision Making Skills in Developing Countries.

Turkish Journal of Family Medicine and Primary Care.

2016 Jun 10(2):96-104.

• Zhao SG, Alexander NB, Djuric Z, Zhou J, Tao Y, Schipper M et al. Maintaining physical activity during head and neck cancer treatment: Results of a pilot controlled trial. Head and Neck. 2016 Apr 1;38:E1086-E1096.

• Arthur AE, Bellile EL, Rozek LS, Peterson KE, Ren J, Harris E, Djuric Z et al. Pretreatment serum xanthophyll concentrations as predictors of head and neck cancer recurrence and survival. Head and Neck. 2016 Apr 1;38:E1591-E1597.

• Frantzen KK, Lauritsen MB, Jørgensen M, Tanggaard L, Fetters MD, Aikens JE et al. Parental Self-perception in the Autism Spectrum Disorder Literature: a Systematic Mixed Studies Review.

Review Journal of Autism and Developmental Disorders. 2016 Mar 1;3(1):18-36.

• Teo AR, Andrea SB, Sakakibara R, Motohara S, Matthieu MM, Fetters MD. Brief gatekeeper training for suicide prevention in an ethnic minority population: A controlled intervention. BMC Psychiatry. 2016 Jul 7;16(1). 211.

• Frantzen KK, Fetters MD. Meta-integration for synthesizing data in a systematic mixed studies review: insights from research on autism spectrum disorder. Quality and Quantity. 2016 Sep 1;50(5):22512277.

• Fetters MD, Molina-Azorin JF. The Future of Mixed Methods Task Force Report: A Call for Commentary.

Journal of Mixed Methods Research. 2016 Jul 1;10(3):220.

• Gossa W, Wondimagegn D, Mekonnen D, Eshetu W, Abebe Z, Fetters MD. Key informants’ perspectives on development of Family Medicine training programs in Ethiopia. Adv Med Educ Pract. 2016;6:1-9.

• Molina-Azorin JF, Fetters MD. Mixed Methods Research Prevalence Studies: Field-Specific Studies on the State of the Art of Mixed Methods Research.

JMMR. 2016;10(2):123-8.

• Gold KJ, Normandin MM, Boggs ME. Are participants in face-to-face and internet support groups the same? Comparison of demographics and depression levels among women bereaved by stillbirth. Archives of Women’s Mental Health. 2016 Aug 25;1-6.

• Spangenberg K, Wobil P, Betts CL, Wiesner TF, Gold KJ. Intimate Partner Violence Among Mothers of Sick Newborns in Ghana. Health Care for Women International. 2016 May 3;37(5):583-594.

• Petrites AD, Mullan P, Spangenberg K, Gold KJ. You have no Choice but to go on: How Physicians and

Midwives in Ghana Cope with High Rates of Perinatal Death. Maternal and Child Health Journal. 2016 Jul 1;20(7):1448-1455.

• Opoku C, Kolbilla D, Borwne ENL, Spangenberg CA, Gold KJ. Perception and risk factors for cervical cancer among women in Northern Ghana. Ghana Medical Journal. 2016 Jun;50(2):84-89.

• Gold KJ, Andrew LB, Goldman EG, Schwenk TL. I would never want to have a mental health diagnosis on my record: a survey of female physicians on mental health diagnosis, treat, and reporting. Gen Hosp Psych. 2016;43:51-7.

• Holtrop JS, Potworowski G, Fitzpatrick L, Kowalk A, Green LA. Effect of care management program structure on implementation: A normalization process theory analysis. BMC Health Serv Res. 2016;16(1).

• Heran BS, Allan GM, Green LA, Korownyk C, Kolber M, Olivier N, et al. Effect of medication timing on anticoagulation stability in users of warfarin (the INRange RCT): Study protocol for a randomized controlled trial. Trials. 2016;17(1).

• Potworowski G, Green LA. Training change agents in CTA to bring health care transformation to scale: the case of primary care practice facilitators. Journal of Cognitive Engineering and Decision Making. 2016 Jul;1-22.

• Meurer WJ, Legocki L, Mawocha S, Frederiksen SM, Guetterman TC, Barsan W, Fetters MD et al.

Attitudes and opinions regarding confirmatory adaptive clinical trials: A mixed methods analysis from the Adaptive Designs Accelerating Promising Trials into Treatments (ADAPT-IT) project. Trials. 2016 Jul 29;17(1). 373.

• Guetterman TC, Mitchell N. The role of leadership and culture in creating meaningful assessment: A mixed methods case study. Innovative Higher Education. 2016;41(1), 43-57.

• Guetterman TC. What distinguishes a novice from an expert mixed methods researcher? Quality & Quantity. 2016;1-22.

• Bush EJ, Hux K, Guetterman TC, McKelvey M. The diverse vocational experiences of five individuals returning to work after severe brain injury: A qualitative inquiry. Brain Injury. 2016;30(4), 422-436.

• Jonson JL, Thompson Jr RJ, Guetterman TC, Mitchell N. The Effect of Informational Characteristics and Faculty Knowledge and Beliefs on the Use of Assessment. Innovative Higher Education. 2016;1-15.

• Guetterman TC. Writing Reviews of Books and Other Media for the Journal of Mixed Methods Research. Journal of Mixed Methods Research.

2016;10, 315-318.

• Meurer WJ, Legocki L, Mawocha S, Frederiksen SM, Guetterman TC, Barsan W, Fetters MD et al.

Attitudes and opinions regarding confirmatory adaptive clinical trials: a mixed methods analysis from the Adaptive Designs Accelerating Promising Trials into Treatments (ADAPT-IT) project. Trials.

2016;17(1), 373.

• Bashshur RL, Howell JD, Krupinski EA, Harmes KM, Bashshur N, Doarn CR. The Empirical Foundations of Telemedicine Interventions in Primary Care. Telemed J E Health. 2016 May;22(5):342-75.

• Heidelbaugh JJ. Just Eat Less and Exercise More?

Primary Care - Clinics in Office Practice. 2016 Mar 1;43(1):xiii-xiv.

• Heidelbaugh JJ. Objectivity and Compassion.

Primary Care - Clinics in Office Practice. 2016 Jun

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1;43(2):xiii-xiv.

• Heidelbaugh JJ, Kaplan SA. The affordable care act: How it has impacted men’s health. Urology Times.

2016 May 1;44(5).

• Lopez WD, Kruger DJ, Delva J, Llanes M, Ledón C, Waller A et al. Health Implications of an Immigration Raid: Findings from a Latino Community in the Midwestern United States. Journal of Immigrant and Minority Health. 2016 Apr 4;1-7.

• McKee MM, Case B, Fausone M, Zazove P, Ouellette A, Fetters MD. Medical schools’ willingness to accommodate medical students with sensory and physical disabilities: ethical foundations of a functional challenge to “organic” technical standards. AMA Journal of Ethics. 2016;18(10):9931002 • Bornstein J, Goldstein AT, Stockdale CK, Bergeron S, Pukall C, Zolnoun D, Coady D; consensus vulvar pain terminology committee of the International Society for the Study of Vulvovaginal Disease (ISSVD) including Reed BD. 2015 ISSVD, ISSWSH, and IPPS Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia. Obstetrics and Gynecology. 2016 Apr;127(4):745-751.

• Bornstein J, Goldstein AT, Stockdale CK, Bergeron S, Pukall C, Zolnoun D, Coady D; consensus vulvar pain terminology committee of the International Society for the Study of Vulvovaginal Disease (ISSVD); International Society for the Study of Women’s Sexual Health (ISSWSH); International Pelvic Pain Society (IPPS) including Reed BD. 2015 ISSVD, ISSWSH, and IPPS Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia. The Journal of Sexual Medicine. 2016 Apr;13(4):607-612.

• Bornstein J, Goldstein AT, Stockdale CK, Bergeron S, Pukall C, Zolnoun D, Coady D; consensus vulvar pain terminology committee of the International Society for the Study of Vulvovaginal Disease (ISSVD), the International Society for the Study of Women’s Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS) including Reed BD. 2015 ISSVD, ISSWSH, and IPPS Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia. Journal of Lower Genital Tract Disease.

2016 Jul;20(2):126-130.

• Papoutsis D, Haefner HK, Crum CP, Opipari Jr AW, Reed BD. Vestibular mast cell density in vulvodynia: a case-controlled study. Journal of Lower Genital Track Disease. 2016 Jul;20(3):275-279.

• Rew KT. Care of Patients With HIV Infection: Foreword. FP essentials. 2016 Apr 1;443:2.

• Rew KT. Eye Conditions in Older Adults: Foreword.

FP essentials. 2016 Jun 1;445:2.

• Rew KT. Respiratory Conditions Update: Foreword.

FP essentials. 2016 Sep;448:2.

• Johansen ME, Richardson CR. Estimation of potential savings through therapeutic substitution.

JAMA Internal Medicine. 2016 Jun 1;176(6):769-775.

• Janney CA, Kilbourne AM, Germain A, Lai Z, Hoerster KD, Goodrich DE Richardson CR et al. The influence of sleep disordered breathing on weight loss in a national weight management program.

Sleep. 2016;39(1):59-65.

• Damschroder LJ, Goodrich DE, Kim HM, Holleman R, Gillon L, Kirsh S, Richardson CR, Lutes LD. Development and validation of the ASPIRE-VA coaching fidelity checklist (ACFC): a tool to help ensure delivery of high-quality weight management

Fall 2016

Faculty Activity Family Medicine

Publications

…continued from page 3

…continued from page 16

interventions. Translational Behavioral Medicine.

2016 Sep;6(3):369-385.

• Moy ML, Martinez CH, Kadri R, Roman P, Holleman RG, Kim HM, Nguyen HQ, Cohen MD, Goodrich DE, Giardino ND, Richardson CR. Long-term effects of an internet-mediated pedometer-based walking program for chronic obstructive pulmonary disease: randomized controlled trial. Journal of Medical Internet Research. 2016 Aug 8;18(8):e215.

• Krein SL, Bohnert A, Kim HM, Harris ME, Richardson CR. Opioid use and walking among patients with chronic low back pain. Journal of Rehabilitation Research and Development. 2016;53(1):107-116.

• Valenstein M, Dalack GW, Simoncic T, Metzger K, Deneke DE, Richardson CR, Hopper JA, Rion R, Williams BC, Miller A, Ryan P, Cuson S et al.

Implementing the Collaborative Care Model as Part of a Countywide Initiative. Psychiatric Services. 2016 May 1;67(5):476-478.

• Riley MA, Ahmed S, Lane J, Reed BD, Locke AB. Using Maintenance of Certification (MOC) as a Tool to Improve the Delivery of Confidential Care for Adolescent Patients Journal of Pediatric and Adolescent Gynecology. J Pediatr Adolesc Gynecol.

2016 Aug 16. pii: S1083-3188(16)30138-3.

• Riley MA, Laurie AR, Plegue MA, Richardson CR. The Adolescent “Expanded Medical Home:” SchoolBased Health Centers Partner with a Primary Care Clinic to Improve Population Health and Mitigate Social Determinants of Health. Journal of the American Board of Family Medicine. 2016 May 1;29(3):339-347.

• Umoh FI, Kato I, Ren J, Wachowiak PL, Ruffin MT IV, Turgeon DK, Sen A, Djuric Z, et al. Markers of systemic exposures to products of intestinal bacteria in a dietary intervention study. European Journal of Nutrition. 2016 Mar 1;55(2):793-798.

• Baxter NT, Ruffin MT IV, Rogers MA, Schloss PD. Microbiota-based model improves the sensitivity of fecal immunochemical test for detecting colonic lesions. Genome Medicine. 2016 Apr 6;8(1):37.

• van der Wouden CH, Carere DA, Maitland-van der Zee AH, Ruffin MT IV, Roberts JS, Green RC. Impact of Personal Genomics Study Group.

Consumer perceptions of interactions with primary care providers after direct-to-consumer personal genomic testing. Annals of Internal Medicine. 2016 Apr 19;164(8):513-522.

• Schwenk TL. Integrated behavioral and primary care. What is the real cost? (invited editorial). JAMA. 2016 Aug 23/30;316:822-23.

• Satagopan JM, Sen A, Zhou Q, Lan Q, Rothman N, Langseth H et al. Bayes and empirical Bayes methods for reduced rank regression models in matched casecontrol studies. Biometrics. 2016 Jun 1;72(2):584-595.

• Sidahmed EK, Sen A, Ren J, Patel A, Turgeon DK, Ruffin MT IV, Brenner DE, Djuric Z. Colonic Saturated Fatty Acid Concentrations and Expression of COX-1, but not Diet, Predict Prostaglandin E2 in Normal Human Colon Tissue. Nutrition and Cancer. 2016 Oct 2;68(7):1192-1201.

• Tzilos GK, Reddy MK, Caviness CM, Anderson BJ, Stein MD. Mostly Smokers: Identifying Subtypes of Emerging Adult Substance Users. Substance Use and Misuse. 2016 Oct 14;51(12):1587-1592.

• Tzilos GK, Caviness CM, Anderson BJ, Stein MD. Stimulant Use and Associated Health Risks Among Student and Non-Student Emerging Adults. Emerging

Adulthood. 2016 Aug 1;4(4):298-302.

• Braciszewski JM, Stout RL, Tzilos GK, Moore RS, Bock BC, Chamberlain P. Testing a Dynamic Automated Substance Use Intervention Model for Youths Exiting Foster Care. Journal of Child and Adolescent Substance Abuse. 2016 May 3;25(3):181187.

• Husk K, Blockley K, Lovell R, Bethel A, Bloomfield D, Warber SL, et al. What approaches to social prescribing work, for whom, and in what circumstances? A protocol for a realist review. Syst Rev. 2016;5(1).

• Rahtz E, Bonnell S, Goldingay S, Warber SL, Dieppe P. Healing Moments in Healthcare: A Thematic Analysis of Practitioners’’ Experiences. Journal of Alternative and Complementary Medicine. 2016 June; 22(6): A1-A142.

• Rahtz E, Bonnell S, Farias M, Goldingay S, Warber SL, Dieppe P. Drawing Healing: Using Visual Ethnography to Explore Healing in Natural Environments. Journal of Alternative and Complementary Medicine. 2016 June;22(6): A1-A142.

• Warber SL, Reddy D, Irvine K. Promoting LongTerm Holistic Wellbeing Through a Multi-Modal Retreat Program in a Natural Setting: A 3-Month Observational Study. Journal of Alternative and Complementary Medicine. 2016 June;22(6): A1-A142.

• Scott JG, Warber SL, Dieppe P, Jones DS, Stange KC. The Healing Journey. Journal of Alternative and Complementary Medicine. 2016 June;22(6): A1-A142.

• Wu JP, Gundersen DA, Pickle S. Are the contraceptive recommendations of family medicine educators evidence-based?: A CERA survey. Family Medicine. 2016 May 1;48(5):345-352.

• Wu JP, Kusunoki Y, Ela EJ, Barber JS. Patterns of Contraceptive Consistency among Young Adult Women in Southeastern Michigan: Longitudinal Findings Based on Journal Data. Women’s Health Issues. 2016 May 1;26(3):305-312.

• Sarmiento C, Miller SR, Chang E, Zazove P, Kumagai AK. From impairment to empowerment: A longitudinal medical school curriculum on disabilities. Academic Medicine. 2016 Jul 1;91(7):954-957.

• Zazove P, Case B, Moreland C, Plegue MA, Hoekstra A, Ouellette A, Sen A, Fetters MD. U.S. medical schools’ Compliance with the Americans with disabilities act: Findings from a national study.

Academic Medicine. 2016 Jul 1;91(7):979-986.

• Zick SM, Sen A, Wyatt GK, Murphy SL, Arnedt JT, Harris RE. Investigation of 2 Types of Selfadministered Acupressure for Persistent CancerRelated Fatigue in Breast Cancer Survivors: A Randomized Clinical Trial. JAMA Oncol. 2016 Jul 7. doi: 10.1001/jamaoncol.2016.1867.

Due to the rapid growth of the Department and the increasing number of scholarly publications and presentations completed by the faculty each and every year, the list of presentations has grown too large for print. Please visit the Department online to see a complete list of presentations given by faculty members throughout the past six months. n

Mother-Baby service delivering babies for 13 years.

“It is a testament to the outstanding work we do in the Department that two of our leaders have been selected to chair family medicine programs. We are so excited for both Mack and Grant and their phenomenal opportunities.

They both have the skills to take on a job of this high magnitude,” said Philip Zazove, M.D., the George A. Dean, M.D. Chair of Family Medicine. “We will miss them and their expertise very much, but look forward to watching their departments grow and succeed.”

Though the departure of these two physicians leaves a void in the Department, family medicine is sure to thrive and grow under their considered care.

Drs. Ruffin and Greenberg are the fourth and fifth member of the Department’s faculty to transition to a prominent leadership role in recent history. Thomas L. Schwenk, M.D., professor emeritus, is the V.P. of health sciences and dean at the University of Nevada School of Medicine. Lee A. Green, M.D., M.P.H., professor emeritus, is the chair of the University of Alberta Department of Family Medicine. And, our own Dr. Zazove was a prominent member of the Department’s faculty prior to being selected as chair of our Department following a national search. n

Find the list at: bit.ly/UMFamilyMedPresentations.

http://medicine.umich.edu/dept/family-medicine

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Fall 2016

Faculty Activity Faculty Accolades Lorraine R. Buis, Ph.D., assistant professor, was named Associate Editor for the journal Smart Health.

James M. Cooke, M.D., assistant professor and executive director of U-M’s Clinical Simulation Center, directed the opening of the new Independent Simulation space. The new space features 24-hour access to on-demand simulation-based training for retinal exam, adult and pediatric heart and lung exam, lumbar puncture, pediatric airway management and pediatric central line placement.

Michael D. Fetters, M . D . , M . P. H . , M.A., professor, is currently in China as a 2016 Fulbright Distinguished Chair in Social Sciences.

He is the first U-M Medical School faculty member in recent memory to receive a Distinguished Chair honor, Fulbright’s rarest and most coveted award. Dr. Fetters’ research focuses on Chinese physicians’ attitudes regarding cancer communication in both the diagnosis and treatment stages. Find more information on the exciting work Dr. Fetters is doing in the next issue of the Family Medicine newsletter.

Katherine J. Gold, M.D., M.S.W., M.S., assistant professor was invited to the University of Texas Health Science Center at San Antonio as the Holly-Belue Endowed Visiting Professor. The engagement was arranged by their Department of Family and Community Medicine and coincided with Primary Care Week (October 4-7). Dr. Gold gave Grand Rounds and several other talks and panel discussions.

• Named the American Academy of Family Physicians representative of the Advisory Committee on Immunization Practices’ working group on RSV through the Centers for Disease Control.

Joel J. Heidelbaugh, M.D., professor, was named the liaison for graduate medical education between the American Academy of Family Physicians and the Society of Teachers of Family Medicine.

Justine P. Wu, M.D., M.P.H., assistant professor, was selected as an NIH Mixed Methods Research Training Program Scholar. The program provides comprehensive training in mixed methods through a fully-funded educational and mentoring program in the health sciences. Program scholars benefit from working closely with a team of nationally recognized mixed methods mentors and consultants, and have the opportunity to enhance their skills in study design, measurement, and data collection and analysis procedures, among other areas.

Dr. Wu also won Best Oral Research Presentation at the 2016 Michigan Family Medicine Research Day. Her talk was titled “Contraceptive Use Among Women With Vision and Hearing Loss: A Secondary Analysis of the National Survey of Family Growth, 2011–2013.” n

Pamela G. Rockwell, D.O., associate professor, was selected as a journal reviewer of Vaccine.

Her additional achievements include: • Named co-chair of the UMHS Immunization Committee.

• Named chair of the Society of Teachers of Family Medicine’s Immunization Education group.

• Elected as a member-at-large to the Michigan Academy of Family Physicians.

http://medicine.umich.edu/dept/family-medicine

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Sara L. Warber, M.D., emeritus professor, was named a review editor of the Environmental Psychology section o f F ro n t i e r s i n Psychology.

Fall 2016

Faculty Activity Department Faculty Professor and Chair Philip Zazove, M.D.

Professor

James E. Aikens, Ph.D. Barbara S. Apgar, M.D. Zora Djuric, Ph.D. Michael D. Fetters, M.D., M.P.H., M.A. Joel J. Heidelbaugh, M.D. Masahito Jimbo, M.D., Ph.D., M.P.H. Michael S. Klinkman, M.D., M.S. Barbara D. Reed, M.D., M.S.P.H. Caroline R. Richardson, M.D. Ananda Sen, Ph.D. Kent J. Sheets, Ph.D.

Associate Professor

William E. Chavey II, M.D., M.S. Robert B. Kiningham, M.D., M.A. John M. O’Brien, M.D. Pamela G. Rockwell, D.O. Phillip E. Rodgers, M.D. Eric P. Skye, M.D. Suzanna M. Zick, N.D., M.P.H.

Assistant Professor

Ricardo R. Bartelme, M.D. Catherine M. Bettcher, M.D. Lorraine R. Buis, Ph.D. Tammy Chang, M.D., M.P.H., M.S. Christine T. Cigolle, M.D., M.P.H. James M. Cooke, M.D. Keri L. Denay, M.D. Margaret L. Dobson, M.D. Jill N. Fenske, M.D. Randall T. Forsch, M.D., M.P.H. Kristina M. Gallagher, M.D. Uche D. George-Nwogu, M.D. Katherine J. Gold, M.D., M.S.W., M.S. Timothy C. Guetterman, Ph.D. Kathryn M. Harmes, M.D. Heather L. Holmstrom, M.D. Elizabeth K. Jones, M.D. Anne L. Kittendorf, M.D. Ayano Kiyota, M.D., Ph.D. Christine W. Krause, M.D. Cheryl E. LaMore, M.D. Sahoko H. Little, M.D., Ph.D. Mikel Llanes, M.D. Jean M. Malouin, M.D., M.P.H. Tarannum A. Master-Hunter, M.D. Michael M. McKee, M.D., M.P.H. Amy C. Miller, M.D. Karen L. Musolf, M.D. Thomas A. O’Neil, M.D. Ebony C. Parker-Featherstone, M.D. Elisa B. Picken, M.D.

Karl T. Rew, M.D. Margaret A. Riley, M.D. David C. Serlin, M.D. Elizabeth R. Shih, M.D. Ghazwan Toma, M.D., M.P.H. Golfo K. Tzilos, Ph.D. Stephen M. Wampler, M.D. Stephen J. Warnick, Jr., M.D. Joy C. Williams, M.D. Justine P. Wu, M.D., M.P.H. Gary Yen, M.D. Alisa P. Young, M.D.

Instructor

Scott A. Kelley, M.D. Theresa R. Peters, M.D. Michelle L. Rabideau, M.D. Jill R. Schneiderhan, M.D.

Lecturer/Investigator

Jane E. Chargot, M.D. Christina L. Chiang, M.D. Jenna B. Greenberg, M.D. Micheleen Hashikawa, M.D. Laura E.A. Heinrich, M.D. Anita K. Hernandez, M.D. Katherine E. Hughey, M.D. Nell B. Kirst, M.D. Angela L. Kuznia, M.D., M.P.H. Anna R. Laurie, M.D. Christine J. Medaugh, M.D. Christina A. Murphy, M.D. Carissa A. Orizondo, M.D. Amal Othman, M.D. Ketti S. Petersen, M.D. Julie K. Prussack, M.D. Keturah P. Schacht, M.D. Allison N. Ursu, M.D. Christa B. Williams, M.D. Jean H. Wong, M.D.

Psychologist

The Regents of the University of Michigan Michael J. Behm Mark J. Bernstein Laurence B. Deitch Shauna Ryder Diggs Denise Ilitch Andrea Fischer Newman Andrew C. Richner Katherine E. White Mark S. Schlissel (ex officio)

Editor-in-Chief Philip Zazove, M.D.

Managing Editor Kristen A. Ochomogo

Editorial Consultants

Samuel E. Romano, Ph.D.

Blythe A. Bieber

Emeritus Faculty

Christina M. Czuhajewski

Lee A. Green, M.D., M.P.H. R. Dale Lefever, Ph.D. James F. Peggs, M.D. Mack T. Ruffin IV, M.D., M.P.H. Thomas L. Schwenk, M.D. Lourdes Velez, M.D. Sara L. Warber, M.D.

Adjunct Professor George A. Dean, M.D.

http://medicine.umich.edu/dept/family-medicine

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Devon R. Kinney Amy C. St. Amour If you would prefer to receive an electronic copy of the newsletter in the future, please e-mail sgenske@umich.edu.

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Fall 2016

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Acupressure Relieves Cancer Fatigue

New Dr. Mack Ruffin Endowment

Family Medicine Fonde Fund Starts to Make an Impact

Versell Smith, Development Director, Kathryn Bondy Fessler, M.D., Ph.D. Medical Director, Joel Thurtell, Nicole Adelman, M.P.H., Executive Director.

On a sunny June day, the first gift of support from the Karen R. Fonde, M.D. Family Medicine Underserved Populations Fund was presented to The Corner Health Center in Ypsilanti, Mich.

Joel Thurtell, Dr. Fonde’s husband, and Amy St. Amour, associate director

of development for the University of Michigan Department of Family Medicine, met with members of the team at The Corner to present the gift. They were pleasantly surprised to receive a tour of the entire facility and meet with physicians who worked with Dr. Fonde during her time there.

Sharing memories and retelling stories of Dr. Fonde’s impressive career made the gift very meaningful.

The Corner’s mission is to provide j u d g e m e n t - f r e e , h i g h - q u a l i t y, affordable health services to young people aged 12 through 25, regardless of their insurance status or ability to pay. The Fonde gift will help

cover unreimbursed costs for flu shots, immunizations, vitamins, lead testing and fluoride varnish for 31 uninsured or underinsured patients.

Dr. Fonde helped open the U-M Family Medicine Health Center in Ypsilanti, where she practiced and taught students and residents from 1993 until 2009. She also practiced and taught at the Corner. n

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