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Celebrating

at the University of Michigan

Spring 2011

Leaders in PCMH

In This Issue From the Chair 2 Development 3 Education Mission 9 Alumni News 11 Clinical Mission 12 Research Mission 16 Faculty Activity 20

Efforts by the Department and University partners were key to the state of Michigan being selected as one of eight states participating in the Centers for Medicare and Medicaid Services (CMS) MultiPayer Advanced Primary Care Practice demonstration project. The goals of this project are to improve the efficiency and effectiveness of health care, strengthen the patient and primary care physician relationship, and reduce health care costs. “This demonstration project is a very exciting opportunity for the state of Michigan,” noted Jean M. Malouin, M.D., M.P.H., assistant professor, associate chair for clinical programs. “We will have the largest multi-payer patient-centered medical home pilot in the nation with almost 500 practices, 1,800 physicians, and 17 payer groups invited to participate.” Dr. Malouin is co-leading the project with Carol Callaghan, M.P.H., chronic disease and injury control director for the Michigan Department of Community Health, and Susan Moran, director of Medicaid Program Operations and Quality Assurance at the Michigan Department of Community Health. Applying for the project involved the collective efforts of U-M, the Center for Healthcare Research and Transformation, the Michigan Department of Community Health, Blue Cross Blue Shield of Michigan, and other physician organization and health plan representatives from around the state. The project, announced as part of a new CMS Innovation Center, will also evaluate “health home” and “patient-

centered medical home” concepts in Maine, Ve r m o n t , Rhode Island, N e w Yo r k , Pennsylvania, North Carolina and Minnesota. The eight states that will participate in the CMS Multi-Payer Advanced Primary Care Practice Demonstration will be providing care via 1,200 medical homes -- of which about 40 percent are in Michigan. “This is a chance to highlight and build on the outstanding work that is going on in primary care practices throughout the state in partnership with CMS and leading Michigan health plans,” Dr. Malouin said. “Although UMHS practices are not participating in this project due to ongoing work in another CMS demonstration project, we are very supportive of this effort. The University of Michigan will also be developing the demonstration’s data repository and analysis through the Michigan Data Collaborative.” During the three-year demonstration project, participating physician organizations, physician hospital organizations and practices will receive additional funding to build on existing PCMH attributes to attain additional depth in PCMH transformation. This funding will cover care management support, practice transformation and performance improvement rewards, and administrative expenses. Continued on page 20

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Reflections from the Chair

Thomas L. Schwenk, M.D. The George A. Dean, M.D. Chair of Family Medicine

This column is one I never thought I would write. I am leaving the University of Michigan. On July 1, I will assume the position of Dean of the University of Nevada School of Medicine and Vice President for Health Sciences at the University of Nevada, Reno. However, the University of Michigan is not leaving me. I will, in fact, not be resigning but retiring, and will hold a Professor Emeritus appointment, which I will treasure no matter where my career takes me from here. As a student and then faculty member, I have been part of the U-M culture for well more than half of my total life and nearly all of my adult life — 35 years. My wife, Jane, and I have watched U-M football since 1967 when football tickets were given away free just to fill the stadium. We were there for the 1969 upset of Ohio State. I am sorry we will not be here in the fall for the start of the Hoke era! More

importantly, I have certain regrets about leaving the Department of Family Medicine that has been my home for the past 27 years. My office is more or less packed — books, papers, plaques and mementos — and loaded on the truck that will take our household goods to Nevada; this office, and its predecessors, is where I have lived for much of that 27 years. Many people have asked why I would leave the Department at a time of such success and stability to become a medical school dean. There are, of course, many answers to this question, ranging from vanity to hubris to poor career counseling, but the best answer is that I so strongly believe in the vision and the value system of Family Medicine as a fundamental guiding force in academic medicine that I want to see if the same value system can guide a medical school and a division of health sciences. By this I do not mean a medical school that is particularly primary care oriented, or focuses specifically on the clinical and academic roles of family physicians. Rather, I want to explore the deeper meaning of family medicine as a guiding force in how academic medicine is led and managed. Does what we believe in Family Medicine have value beyond our specialty-specific objectives? I believe we have created something truly special in Family Medicine at U-M. And I am not using the royal “we” (as I sometimes do). I really mean “we.” The Department’s growth and development has been more of a crusade than a job, a crusade that was fueled by the

commitment and energy of every single member of the Department. We have established Family Medicine as a major contributor to and source of pride by the University of Michigan Health System, something many people said could not be done in our early years. But Family Medicine is more than a medical discipline, more than the principles specific to the care of patients — continuous, comprehensive, compassionate, accessible, and accountable care. While it is, or should be, a countercultural force in patient care, as Gayle Stephens described more than 30 years ago, it also is, or should be, a countercultural force in how medical schools and health care organizations function. The Department has been successful because of several key values — how it includes the contributions of all its members, supports their career aspirations, is inclusive of the many health care and organizational disciplines that make up the future health care team, is truly patientcentered and learner-centered, values outreach and community partnerships, and cultivates diversity in all of its definitions while emphasizing a common purpose. We have tried to make decisions in an accountable and transparent way, reward citizenship and civility, minimize purposeless conflict and drama, and remember that the really hard work lies in advancing our mutual objectives, not in squabbling amongst ourselves. That focus does not mean that disagreement is not valuable. Some of the strongest memories for me are the times when Continued on page 20

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Spring 2011


Development

T

2011 Student Scholarships and Awards Presented The University of Michigan Department of Family Medicine presented its annual Scholarships and Awards on May 11, 2011. The nine scholarships, including the new Robert J. Fisher, M.D. Family Medicine Scholarship, were presented by Thomas L. Schwenk, M.D., the George A. Dean, M.D. Chair of Family Medicine. There was also a special tribute to Thomas R. Berglund, M.D., (M.D. 1959) long-time friend and supporter of the Department, who passed away in January. (Read more about Dr. Berglund’s legacy on page 8.) Ken and Judy Betz Family Medicine Scholarship recipient: Jennifer M. Brewer

Jennifer Brewer (center) celebrates with Judy and Ken Betz (right) along with Thomas L. Schwenk, M.D., and Anne L. Kittendorf, M.D. (left).

A graduate of University of California, Berkeley with a B.A. in neurobiology and English literature (dual degree with honors), Jennie did her M3 clerkship at Ypsilanti and her M4 elective in the Indian Health Service. She volunteered at both the Delonis Free Clinic and Medpals and

raised money to enable chronically and terminally ill children to attend local events. She participates in Medmarathoners, the U-M Triathalon Team and the Victor Vaughn S o c i e t y, d e v o t e d t o history and philosophy of medicine. Her dual passion for psychiatry and family medicine led her to research with Annelie Ott is congratulated on winning the Chelsea the U-M Molecular and Community Family Medicine Scholarship by Thomas L. Behavioral Neuroscience Schwenk, M.D., and James F. Peggs, M.D., (right) who worked Institute. Jennie matched with her during her clerkship in Chelsea. at University of Conference for Family Medicine California, San Diego. “It is an honor to stand here and Residents and Medical Students, present this scholarship,” noted Ken organized shadowing experiences in Betz. “We did this because of our family medicine for medical students daughter, Anne’s (Kittendorf, M.D.), and participated in Clinical Simulation excellent experience at Michigan; it was Lab activities. She spent her third year the least we could do to say thank you.” family medicine clerkship working Anne completed her B.S. and her closely with, James F. Peggs, M.D., medical school training (M.D. 2001) professor, and demonstrated impressive at U-M and her residency (2004) with patient and clinical skills. We are the Department of Family Medicine thrilled that Annelie will begin her and is currently an assistant professor. residency with us in Chelsea. “Receiving this award made me C h e l s e a C o m m u n i t y F a m i l y feel welcomed and I very much look Medicine Scholarship recipient: forward to joining this wonderful community of people. Thank you Annelie Ott everyone,” shared an enthusiastic Growing up in a small East German Annelie. town, Annelie was drawn to her local Unfortunately, Arlene Howe, a family doctor, who often made house dedicated friend and founder of this calls, and the world of medicine in scholarship, was recovering from general. A U-M graduate with a B.A. surgery and unable to attend the in psychology, Annelie was very ceremony. We wish her a speedy active in the Family Medicine Interest recovery. Group. She attended the 2010 National Continued on page 4

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Spring 2011


Development Scholarships Dale L. Williams, M.D. Family

…continued from page 3

Medicine Scholarship recipient and AEI Sorority Family Medicine Scholarship recipient: Allison Wessel

honored to present their scholarship to Allison Wessel (center). Christel and Dale Williams, M.D., were

outstanding students in family medicine. Here she congratulates winner, Allison Wessel. A graduate of Johns Hopkins University with a B.A. in cognitive science (with honors), Allison worked in research in the Department of Psychology at University of Pennsylvania and the Laboratory for Child Development at Johns Peg Shearer, M.D., (right) is proud to honor

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Hopkins prior to starting medical for the AEI Sorority Fund, noted, “It school. She co-founded Domestic was very pertinent that the scholarship Reach, exposing medical students remained in the Department of Family to underserved communities and Medicine – especially since the old healthcare challenges in the U.S.; AEI Sorority house is now home to the participated in MedArt, providing Department’s research and education art therapy sessions for pediatric faculty and staff.” patients; and volunteered at Project H, a free clinic. Allison was a member of the Medical School Admissions Committee and co-authored a children’s book centered on characters with disabilities. We are pleased she will begin her residency with us in Chelsea. “Receiving both the AEI Sorority and Dale Williams Scholarships Dr. Berglund’s family including wife, Jill, children Tracy and Tom has been an unexpected Jr., daughter-in-law, Nancy, and seven grandchildren attended the honor and privilege. It ceremony and memorial tribute. The family was proud to carry was wonderful meeting on Dr. Berglund’s legacy and congratulate winner, Kristine Smith. the donors of both Jill and Thomas R. Berglund, scholarships - they are amazing role models and true pioneers M.D. Family Medicine Scholarship in family medicine. The strong bonds recipient: Kristine E. Smith and generosity of the U-M alumni With a B.S. in biology from Gonzaga community are something I have University, Tina did her M3 clerkship appreciated and admired, and I hope to with Kristina M. Gallagher, M.D., be in a position to assist aspiring family assistant professor. Dr. Gallagher noted physicians as they so graciously have,” her enthusiasm for medicine, ability Allison said. to reach out and connect with patients Dr. Dale Williams, a retired family from all backgrounds and impressive physician from Muskegon, and his clinical skills. Tina completed a wife, Christel, enjoyed the day’s research project in Ghana, becoming celebration. “Every time we meet an undergraduate mentor for students a student we are impressed with traveling there. She participated in how bright and smart they are. We Galens Medical Society and helped appreciate being here and it’s an honor raise money for children in Washtenaw to present our scholarship today,” County through Tag Days.  Tina will commented Dr. Williams. begin her residency at Memorial Marguerite (Peg) Shearer, M.D. Hospital, South Bend, Ind. (M.D. 1960), the designated trustee “It was truly an honor to receive the

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Development Berglund Scholarship. Learning of Dr. Berglund’s legacy and commitment to family medicine was inspiring. It also is rewarding financially and emotionally to know there are role models who support my ambitions to become a family physician,” noted Tina. “My father made a commitment to give back to the medical field and when he retired, he wanted to give back to family medicine because he loved the specialty. We wish all the scholarship recipients the best and, as my dad would say, ‘Go Blue!’” said Tom Berglund Jr. during a warm and meaningful tribute to his father. Vincent P. and Genevieve L. Burns Family Medicine Scholarship recipient: Katherine Christensen Belsky

the support of both the Department of Family Medicine and alumni. I am very grateful to the Burns family,” noted Katie. Robert J. Fisher, M.D. Family Medicine Scholarship recipient: Matthew R. Schlough

Robert Fisher, M.D., (right) is proud to give

back to his alma mater by establishing a

“I am very grateful to the Department of Family Medicine and, in particular, Dr. Fisher for his generosity. It was great to meet him and hear interesting stories about medical school and residency training from years past,” Matt said. “I’m really excited to be heading to Seattle for residency and this scholarship will help ease my transition to the Northwest and offset some of the significant cost of medical school.” Dr. Fisher (M.D. 1960) commented, “I really appreciate what the U-M did for me and am pleased to present this scholarship to Matt.” Family Medicine Senior Scholarship and Terence C. Davies, M.D. Award recipient: Christina W. Li

scholarship. He celebrates with the first

Graduating from the University of California, Berkeley with a B.A. in molecular and cellular biology in 2006, Katie was an Alumni Scholar and Schwab-Rosenhouse Scholar. She received the U-M Medical School Dean’s Annual Scholarship, as well as the Dean’s Commendation for Excellence in Clinical Skills and the Art of Medicine, and was recognized for her final project in Advanced Medical Therapeutics earning the N. Cary Engleberg Award. Katie volunteered at MedBuddies and participated in both the Galens Medical Society and Medical School Admissions Committee. Katie will begin her residency at Sutter Health in Sacramento, Calif. “It is truly an honor to receive the Burns Family Medicine Scholarship. I am excited to be entering the field of family medicine, especially with

Matt graduated from Dartmouth, summa cum laude, with a B.A in economics. Prior to imagining a career in medicine, Matt worked as an investment analyst for a private equity firm in New York City. Lack of satisfaction led him to join the Peace Corps in Mali, which sparked his interest in medicine and led him to medical school. Matt volunteered at Arbor Hospice; co-coordinated and volunteered with MedBuddies, where he supported, encouraged, and provided comfort to pediatric patients hospitalized for extended periods of time; taught sixth-graders about heart healthy lifestyles with Project Health Schools; and served on the Medical School Admissions Committee.  Matt will begin his residency at Swedish First Hill, Seattle, Wash.

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recipient of his scholarship, Matthew Schlough.

Winner of the Family Medicine Senior Scholarship and Terence C. Davies, M.D. Award, Christina Li is congratulated by Thomas L. Schwenk, M.D.

Christina graduated from U-M with a B.S. in biology (with honors) and academic minor in Asian languages and culture and was an Angell Scholar, Continued on page 11

Spring 2011


Development Gorenflo and Kessler Awards Presented

Daniel W. Gorenflo, Ph.D., donor, and his daughter, Caroline Gorenflo (center), with winners of the William Clippert Gorenflo Research Award, Lindsay Davis (left) and Sara Bowling (right).

Last November, the William Clippert Gorenflo Research award and the Harold Kessler, M.D. Scholarship in Family Medicine were presented. The 5th annual Gorenflo award was presented to co-recipients: Lindsay Davis, a third-year medical student, and Sara Bowling, a fourth-year medical student. Both Daniel W. Gorenflo, Ph.D., a former faculty member who established the award in honor and memory of his father, and his daughter, Caroline, attended the ceremony and the luncheon immediately following. Sara Bowling was drawn to integrative medicine research with Suzanna M. Zick, N.D., M.P.H., assistant professor, to investigate the role of diet in the incidence and severity of primary insomnia. In particular, the total intake of bioflavonoids in the diet of healthy patients as compared

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students as they pursue their dreams.” Since 2009, Lindsay Davis has been working with Thomas L. Schwenk, M.D., the George A. Dean, M.D. Chair of Family Medicine, and Leslie A. Wimsatt, Ph.D., educational planning and development administrator, on the “Depression, stigma and suicidal ideation in medical students” project. Upon completion in 2010, the project was published in the Journal of the American Medical Association, resulting in enormous publicity and recognition. Her contributions and commitment to the project were instrumental. “I am extremely honored by the Gorenflo family’s award for our study of the stigma of depression in medical

to those with primary insomnia. Sara presented the th research findings at the 6 International Congress on Complementary Medicine in May 2011 in China. Honored to receive the award, Bowling shared, “During my training at the University of Michigan Medical School, I have found that there is opportunity, support and inspiration at every turn if you look to the Thomas L. Schwenk, M.D., the George A. Dean, M.D. right mentors and find the Chair of Family Medicine, presents award certificates to right path. I am lucky to have Sara Bowling (center) and Lindsay Davis (right). found great mentors and students. I was lucky to work with honored to have received this award. both Dr. Schwenk and Dr. Wimsatt I want to thank the generosity of the on a project that has uncovered Gorenflo family for contributing to an integral part of the culture of the Michigan tradition of providing medical school. I am excited by the support and enriching opportunities to

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Development increased awareness to depression in medical students that this study has generated,” commented Davis. Noted Dr. Gorenflo, “I was so impressed by Lindsay and Sara — both a perfect fit for the award, and very deserving.” The Gorenflo Award is intended to reward passion and enthusiasm for research. Jennifer J. Knoester is the seventh recipient of the Harold Kessler, M.D. Scholarship in Family Medicine. Jenny’s experiences already show a distinguished career of service. She stands out by not only “thinking globally and acting locally,” but also by “acting globally.” Jenny’s experiences include her international HIV work in Cape Town, South Africa, and she was also a Policy and Advocacy Intern at the International AIDS Society in Geneva, Switzerland. In 2007 she became the Quito Project Director, a non-profit multidisciplinary, student-run organization at U-M, and orchestrated all project activities relative to the goal of providing comprehensive care, education and social services to the underserved communities in Quito, Ecuador. Yet, well before arriving in Quito for the first time, she had become dedicated to promoting social justice and resolving health disparities between populations. “Although medicine is inherently personal, human lives and livelihoods are always contextualized within families, communities and nations. Primary care physicians — naturally oriented towards equity, work each day to treat their patients while keeping one eye on the conditions that made them sick in the first place. It is

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Thomas L. Schwenk, M.D., the George A. Dean, M.D. Chair of Family Medicine, with Barbara Kessler, donor, Jennifer Knoester (center), winner of the Harold Kessler, M.D. Scholarship, and Dick Soble, Barbara’s husband.

Award winner, Jennifer Knoester (left), and donor, Barbara Kessler (right), share a hug during the awards ceremony.

incredibly reassuring to know that we have allies such as the Kesslers in

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the pursuit of social justice. I am grateful for their support each day.” Barbara Kessler, who, with her two siblings, established the award in memory and honor of their father, attended the event with her husband, Dick Soble, and noted, “Each year, meeting with the scholarship recipient is an important milestone and memory point for our family, and we are very pleased to be a part of the life path of future family physicians.” The Harold Kessler, M.D. Scholarship in Family Medicine is awarded annually and based on outstanding academic achievement, demonstrated financial need, interest and dedication in helping the underserved populations and a demonstrated interest in family medicine. ■

Spring 2011


Development Dr. Berglund’s Legacy This year, the practice of family medicine lost a visionary, supporter and advocate when Tom Berglund passed away in a tragic skiing accident. He is survived by his wife, Jill, daughter, Tracy Curran, of Grand Rapids, son, Tom Berglund Jr., of Kalamazoo and nine grandchildren. Both of his children are U-M graduates; and two of his grandchildren are continuing the tradition as students in Michigan’s College of Engineering. “Tom [Berglund] was a force of nature with an optimistic view of the world,” shared Thomas L. Schwenk, M.D., the George A. Dean, M.D. Chair of Family Medicine. “He loved learning, medicine and the breadth and continuity of family medicine.” Tom Berglund lived an active and adventurous life, which he shared generously with his family. They thoroughly enjoyed downhill skiing. They also were biking enthusiasts and have pedaled through the countrysides of France, Ireland, Italy, Thailand and Vietnam. “Thank you to the Department of Family Medicine for giving our family the opportunity to celebrate my father,” said Tom Berglund Jr. at the May scholarship ceremony. “My father took his calling – which is what it was to him – very seriously. He enjoyed sharing his knowledge with medical students and family medicine was my father’s love.” The Berglund family is proud to honor their father by contributing to the future of family medicine through the annual Berglund Scholarship that is presented each year to a graduating

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2010 Annual Giving Results Although the total dollar amount raised from the 2010 annual giving initiative did not surpass last year’s record-setting amount, the number of friends making donations rose 15% from last year. The top area in amount of support was the Terence C. Davies, M.D. Collegiate Professorhip Fund in Medical Student education with over $10,000 in gifts.

Jill and Tom Berglund, M.D., on one of their many adventures.

medical student who matches to a family practice residency. ■

Thanks to our friends, colleagues, fellow family physicians and Medical School alumni, who continue to support the Department and its missions. ■

To make a contribution to the Berglund Scholarship please contact Amy St. Amour at astamour@umich.edu or 734.645.0423.

Save the Date

The Departm ent of Famil y Medicine in physicians retu vites all fam rning for the ily U-M Alumni (all classes wh R eu ose graduation nion Weekend year ends in ei well as all emer ther “1” or “6 itus ” as to join us for an alumni who graduated in 19 61 or earlier) informal cock tail reception 2011, from 4: on September 30 p.m. – 6:00 9, p.m. at the An at Eagle Crest n Arbor Marriot Resort in Ypsil t anti, Mich. Please stop by to meet some faculty and re we welcome yo sident membe u back to Ann rs as Arbor for your Formal invita reunion weeke tions coming nd! soon.

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Spring 2011


Education Mission Residency Program Expansion

As part of a U.S. Health and Human Services initiative to address the anticipated increase in demand for primary care physicians, the Department secured a grant of nearly $1 million to expand the residency program, one of only two across the state to secure such funding. The Department will welcome it’s first 11-member resident class this July. “This is the first significant residency expansion in over a decade and will allow five additional family physicians to graduate from the program over the next seven years,” says James M. Cooke, M.D., assistant professor and residency program director. “There is a huge need in the primary care workforce nationwide. Family medicine and other primary care residency programs need to anticipate the nation’s health care needs as more patients receive health care coverage. We hope this increase will help meet the needs of our communities.” The program was also able to secure

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a separate grant sponsored by the U-M Center for Research on Learning and Teaching to develop and implement a leadership curriculum for the residents. Faculty members from the U-M Ross School of Business and the U-M School of Public Health participated in the development of a groundbreaking project for curriculum development, which utilized didactics, exercises and innovative on-line simulations to teach leadership skills to residents. The grant also allows for the development of residency curriculum tracks that integrate the core leadership skills into individualized areas of interest to help residents develop a foundation for leadership early in their career. Current tracks include: advocacy and public policy; behavioral science; clinical practice; education; global health; healthcare administration; integrative medicine; obstetrics; research; and sports medicine. Additional tracks in the care of the underserved, geriatric medicine, and hospice and palliative medicine are under development. The residency program is currently evaluating its success for recent graduates through annual one- and five-year alumni surveys that query for leadership preparedness as well as defined leadership positions held by recent graduates. ■

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Co-Chief Residents Announced

Nell Burger Kirst, M.D., and Michael T. Kopec, M.D., have been named co-chief residents. The Department wishes to thank Marisyl de la Cruz, M.D., and Thomas A. O’Neil, M.D., for their extraordinary leadership over the past year. ■

3 Correction

Amanda J. Kaufman, M.D., assistant professor, was inadvertently omitted as an instructor with the Family Centered Experience as published in the Fall 2010 issue of the newsletter. We regret the error. ■

Spring 2011


Education Mission Congratulations, Class of 2011

Marisyl de la Cruz, M.D.

Elizabeth K. Jones, M.D.

Jeffrey L. Kim, M.D. Loma Linda University Medical Center Loma Linda, Calif.

Department of Family Medicine, Mie University Tsu City, Japan

Adaku Onyeji, M.D.

Suzanne V. Ross, M.D.

Jamie A. Szelagowski, M.D.

Huong Tran, M.D.

Women’s Health Fellowship University of Michigan

Private Practice Greensboro, N.C.

Academic Fellowship University of Michigan

Undecided

Private Practice Wapakoneta, Ohio

Kei Miyazaki, M.D.

Resident Earns AAFP Grant Michael E. Johansen, M.D., h o u s e o f f i c e r, was awarded a $2,000 American Academy of Family Physicians Foundation resident research grant entitled, “Specialty Differences in the Use of Statins in Primary Prevention.” Dr. Johansen will conduct a survey of family physicians, internal medicine primary care physicians and cardiologists to assess the differences in the use of statins in primary prevention, or people without known coronary artery disease. The survey will also question practitioners

about the intended benefits of the drug for this specific patient group. Dr. Johansen is honored to receive this grant. “It is important for me to participate in this type of research because it will help further expand our knowledge about the use of statins in primary prevention. As one of the most prescribed medications, surprisingly, very little is known about physicians beliefs regarding how and when the medications are used in primary prevention,” he said. Following the completion of his research, Dr. Johansen will present his findings at the National Conference for Family Medicine Residents and Medical Students this July. ■

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Private Practice Boston, Mass.

Thomas A. O’Neil, M.D.

Hospice and Palliative Medicine Fellowship University of Michigan

Alisa P. Young, M.D.

Briarwood Family Medicine University of Michigan

Upcoming CME Events Update on Common Clinical Concerns in Primary Care: Northern Michigan Summer Conference June 20-24, 2011 Bellaire, Mich.

Internal Medicine Update July 29-31, 2011 Mackinac Island, Mich.

Cardiology Update August 12-14, 2011 Mackinac Island, Mich.

Northern Michigan DDW Wrap-Up August 19-21, 2011 Mackinac Island, Mich.

For more information, visit www.cme.med.umich.edu or call 800-800-0666. Spring 2011


Education Mission Residency program alumnae, Tammy Chang, M.D., M.P.H., has been accepted to the prestigious Robert Wood Johnson Foundation Clinical Scholars program, a fellowship that provides advanced education in research and academic scholarship. U-M is one of four sponsoring institutions for the fellowship. “My exceptional experiences as a resident have developed a strong interest in using research to improve the health of individuals and communities. I am honored to be selected, and will use my skills to develop innovative programs to improve the health of women and children,” Dr. Chang

commented. Residency director, James M. Cooke, M.D., assistant professor, says, “Dr. Chang has demonstrated dedication to providing comprehensive, culturally sensitive and sustainable primary care for her patients. We are happy that she will be returning to Ann Arbor.” The two-year fellowship begins in July. Dr. Chang will be examining the delivery, impact and organization of health care. ■

Scholarships

as well as a Branstrom Freshman Prize winner. A leader of the Family Medicine Interest Group, she organized family medicine shadowing experiences for medical students. Christina volunteered in MedArt and the Cuban Medical Experience and is a member of the Galans Medical Society. A talented musician, she is a percussionist in the U-M Pops Orchestra and is involved in playing the carillons in the U-M bell towers. Christina will begin her residency with the Department in Ypsilanti. The Family Medicine Senior Scholarship was established with

the support of faculty, staff, alumni and friends of the Department. The Terence C. Davies, M.D. Award was named in honor of the Department’s founding chair and enduring friend of the Department. “Both of these recognitions were entirely unexpected, and I am extremely grateful. It is such an honor to join the ranks of TCD Award recipients, as they are all physicians whom I look up to and deeply respect. The Family Medicine Senior Scholarship is a solid rock to stand on while bracing myself against the oncoming storm of student loan repayment,” said Christina. “Christina Li joins a long line of outstanding recipients of the these awards. She has a passion for Family

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…continued from page 5

Alumni News Karen Reiter, M.D. (Residency 2003), was voted “Favorite Area Doctor” by the readers of her local newspaper, The Crescent-News. Dr. Reiter noted, “I was very honored. Of course this couldn’t have happened however without the help and support of my nurse practitioner and our office staff! There is no I in team! We treat our patients like our family — and I think that is the difference.” Dr. Reiter is part of Defiance Regional Medical Center in Defiance, Ohio. Keep in touch with your classmates and keep the Department up-to-date on your career, connect with us on Facebook, Twitter and LinkedIn. Links can be found on our homepage: www.med.umich.edu/fammed. ■

Medicine and is dedicated to the principles set out by the Department and by Dr. Davies when the awards were established. We are proud of her achievements and pleased she is staying in the Department for her residency training,” commented Dr. Schwenk. Dr. Schwenk eloquently summarized the day, “There is a certain passion for what we, as family physicians, do and a passion to support students who chose this specialty. Today we saw this commitment by the family physicians, donors and alumni who support these scholarships. This is a very special place with very special people.” ■

Spring 2011

Alumni News

Robert Wood Johnson Foundation Clinical Scholar


Clinical Mission Health Center Receives Coveted Award The Ypsilanti Health Center (YHC) has earned the prestigious title of University of Michigan Health System Clinical Program of the Year. “Being named the recipient of the UMHS Program of the Year award represents an amazing achievement for the Ypsilanti Health Center. I feel truly blessed to work with such a dedicated group of individuals” said Stefani A. Hudson, M.D., medical director. The YHC serves thousands of patients each year — including a high percentage of underrepresented, lowincome and non-English-speaking individuals. In addition to excellent primary care from both the Family Medicine and Pediatrics teams, the YHC offers a full range of social support programs to enhance the health and well-being of its many patients. Its innovative programs such as group visits for expecting mothers or children with asthma and their parents have helped hundreds of patients.

“The Program of the Year award to the YHC is an acknowledgement of their extraordinary commitment to excellence in clinical care, student and resident education, community outreach, and culturally competent care. The Department of Family Medicine is so proud of the staff and faculty members at the YHC whose work is recognized by this award,” said Thomas L. Schwenk, M.D., the George A. Dean, M.D. Chair of Family Medicine. YHC was chosen by senior University of Michigan Hospitals and Health Centers leadership from many nominated because of their overall excellence in such areas as innovation, serving patient needs, improving quality and value, social responsibility

Paperless Prescriptions Electronic prescribing, or ePrescribe, is a way for physicians and other healthcare providers to order medications online. It allows for instant reviews of drug interactions, dose levels, and patient-specific factors including prior adverse reactions. It is secure: patient information is kept private. And, prescriptions are sent directly to the pharmacy, meaning that it is often ready for the patient when they arrive. Under the leadership of Philip Zazove, M.D., professor, the paperless ePrescribe system has already been launched at the Briarwood, Chelsea and Dexter Family Medicine health centers, with remarkable success, thanks in considerable part to the training and support of medical assistants. Dr. Zazove talks about the transition to electronic prescribing: “Overall, the pilot testing and first of seven waves has gone well. I am enthusiastic about the benefits of ePrescribe, and look forward to its use throughout the health system.” Other clinical sites in Family Medicine, as well as throughout the University, will begin using the system within the coming year. ■

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Tricia Campbell, health center manager, and Stefani A. Hudson, M.D., medical director (center), accept the award from U-M Hospitals and Health Centers Executive Director and Chief Operating Officer, Tony Denton.

and teamwork. Leadership also honored the Cancer AnswerLine as Support Program of the year. ■

New Clinical Scheduling Software

The Department has adopted new clinical scheduling software called Physician Scheduler. It is expected to save faculty, residents and staff time by improving efficiency and reducing errors. It will be able to communicate with the new email system that the UMHS is adopting later this year, as well as communicate with the electronic medical records system being implemented over the next two years throughout the health system. The new system, which will be transparent to patients, will help faculty, residents and staff better serve patients and their families. ■

Spring 2011


Clinical Mission Men’s Health Expert Announces New Developments Since 2007, Joel J. Heidelbaugh, M.D., F.A.A.F.P., F.A.C.G., associate professor of family medicine and urology, has been very active in the global men’s health field. He is now a leader within the International Society of Men’s Health (ISMH), the premier organization dedicated to the rapidly growing field of men’s health. The ISMH utilizes a comprehensive scope of men’s health to bring together multiple disciplines including urology, primary care, cardiology, endocrinology, oncology, gerontology, psychology, sexual and reproductive medicine, and public health and advocacy. “The ISMH brings everyone together in an international arena to get a better understanding of what we as physicians need to do improve research, patient care and advocacy,” said Dr. Heidelbaugh, who serves as the editorin-chief of the ISMH Web site and the section editor of academic medicine for the Journal of Men’s Health. The ISMH seeks to improve outcomes in men’s health worldwide and to overcome the disparities between men’s and women’s health. Through a partnership with the Collins Center for Public Policy, experts including Dr. Heidelbaugh convened in the first-ever Men’s Health Maintenance Consensus Conference in April 2010 for a comprehensive examination of the myriad of health risks that men face and the ways in which the medical community can better address their needs. This panel has devised a universal set of guidelines for men’s

overall health maintenance and disease prevention entitled “How Should Clinicians Address Men’s Health? Consensus Recommendations from the International Society of Men’s Health” that is scheduled for publication in the Mayo Clinic Proceedings this fall. “This landmark document will set the standard for how we approach preventive men’s health on the worldwide level,” Dr. Heidelbaugh said. Dr. Heidelbaugh also notes that the ISMH is enhancing the academic men’s health portal on its website to provide healthcare providers and researchers across the globe with the latest abstracts and publications via a Scientific Spotlight section. This portal highlights key elements of men’s health including aging, testicular hypogonadism, complementary and alternative medicine, and many topics. For more information about the International Society of Men’s Health and to follow these exciting trends in men’s health, please visit: www.ismh.org/en/. Additionally, Dr. Heidelbaugh serves on the Commission on Paternal Involvement in Pregnancy Outcomes (CPIPO), an advocacy group that has identified the most important social barriers to paternal involvement during pregnancy and has outlined a set of key policy priorities aimed at fostering paternal involvement.

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Recent publications from the CPIPO include: • Bond MJ, Heidelbaugh JJ, Robertson A, Alio PA, Parker WJ. Improving research, policy and practice to promote paternal involvement in pregnancy outcomes: the roles of obstetricians gynecologists. Curr Opin Obstet Gynecol 2010;22:525-529. • Alio AP, Bond MJ, Padilla YC, Heidelbaugh JJ, Lu M, Parker WJ. Addressing policy barriers to paternal involvement during pregnancy. Matern Child Health J 2011; published online 7 April 2011; DOI 10.1007/s10995-011 0781-1. ■

Spring 2011


Clinical Mission Family Medicine Plays A Role in New UMHS Observation Unit When William G. Barson, M.D.,

Chair of Emergency Medicine, developed his idea for an Adult Medical Observation Unit (AMOU) within the health system, he knew he would need internal support and he turned to the Department of Family Medicine. The AMOU allows for active observation of patients who are too sick to go home, but may not need to be admitted. Dr. Barson felt that family medicine would be a good fit to provide the type of care needed in this unique setting. William E. Chavey II, M.D., associate professor, became one of many family physicians who staffed the AMOU. Dr. Chavey feels that this unit is very interesting from a family medicine perspective. He enjoys working with patients whom he normally would not have the chance to see.

“Family Medicine was a natural choice for the AMOU. In the unit we see a wide variety of patients, including a full spectrum of adult medical cases as well as gynecology and occasionally obstetrics,” said Dr. Chavey. “It is a hybrid between the inpatient and the outpatient settings so, we feel well-equipped for this type of work.” While family medicine was a good fit for the unit, it does not come without challenges. Dr. Chavey noted that the loss of continuity of care can be difficult for a family physician. However, he has attempted to overcome this by maintaining contact with his patients’ primary care providers. He has even gained former AMOU patients to his practice. “There is a difference in the way we approach patients in the AMOU versus

Faculty Featured in Prominent Book

Dr. Chavey (left) gives a tour of a patient room in the Adult Medical Observation Unit.

our office. Still, we are used to primary care and we manage our patients in this unit with that in mind,” said Dr. Chavey. Additional Department faculty who work with the AMOU include Masahito Jimbo, M.D., Ph.D., M.P.H., associate professor, Scott A. Kelley, M.D., lecturer, Vijay Singh, M.D., lecturer, and Philip Zazove, M.D., professor. ■

ISSVD World Congress

The third edition of the textbook that is considered the standard for teaching programs in primary care residencies, “Pfenninger and Fowler’s Procedures in Primary Care” (Elsevier 2011), was recently released. Several faculty members are contributors: Lee A. Green, M.D., M.P.H., professor and associate chair for information management; John M. O’Brien, M.D., associate professor; Eric P. Skye,

M.D., assistant professor and associate chair for education programs; and Gary Yen, M.D., assistant professor. Dr. Yen comments, “It is our honor to be included in the book that is essential for any primary care provider.” ■

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Barbara D. Reed, M.D., M.S.P.H., professor, has been named co-chair of the Pathophysiology o f Vu l v o d y n i a breakout session at the International Society for the Study of Vulvovaginal Disease (ISSVD) World Congress in Paris, France, in September. Additionally, she has been invited to speak at the postgraduate course following the World Congress about the causes of vulvodynia. ■

Spring 2011


Clinical Mission Primary Care Following Disaster in Japan Sahoko H. Little, M.D., Ph.D., lecturer, and Etsuko Inohara, medical assistant, who both practice at the Department’s Japanese Family Health Program (JFHP) traveled to Japan for one week in April with the Tokushaukai Medical Aid Team to provide emergency medical care and conduct disaster relief. Dr. Little and Ms. Inohara, who is licensed as an RN in Japan, traveled to the devastated Minami-Sanriuk areas where they saw more than 500 patients in a large shelter housed in a sports facility.  They also participated in a moving clinic designed to bring medical care to patients where they are staying so they are not required to travel for medical care.

The Department has strong t i e s t o J a p a n a n d t h a n k s D r. Little and Ms. Inohara for their services throughout this crisis. Michael D. Fetters, M.D., M.P.H., M.A., associate professor and director of the JFHP, also stressed the important role primary care plays following a disaster noting that the largest medical challenge was not treating patients with traumatic injuries. Providing routine care for people with a host of issues from chronic diabetes to imminent childbirth proved more challenging Two of Dr. Fetters’ colleagues from the U-M-affiliated Shizuoka Family Medicine program, visited the disaster zone to provide this much needed care: Shinji Tsunawaki, M.D.,

Dr. Little (left) and Ms. Inohara preparing to join a moving clinic in the tsunamidevastated Minami-Sanriuk area of Japan.

who is just finishing his first year of family medicine training, and Yosuke Fujioka, M.D., a former physician at the JFHP. ■

Service Chief Appointments The Department is pleased to announce t h a t Wi l l i a m E . Chavey II, M.D., M.S., associate professor, has been appointed to the role of Chief of Service. He is a graduate of the Department’s residency program (1995), has been a faculty member since 1997, and has served as the inpatient service chief since the program’s inception in 1999. As Chief of Service, Dr. Chavey is responsible for all aspects of the Department’s three inpatient services, and will work closely with the service directors on clinical

program development, inpatient educational issues, staffing, patient safety and resource utilization, risk management, as well as liaison to the Office of Clinical Affairs. “Dr. Chavey brings a wealth of inpatient experience and expertise to this role and I am very excited about his willingness to take on this important task,” says Dr. Schwenk.

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Masahito Jimbo, M.D., Ph.D., M.P.H., associate professor of family medicine and urology, takes over as director of the

inpatient service. He has been a major contributor to the inpatient teaching and clinical programs, and has been a faculty member since 2004. Additionally, John M. O’Brien, M.D., associate professor, assumes leadership of the newborn service from David C. Serlin, M.D., assistant professor and medical director Briarwood Family Medicine. Both Drs. O’Brien and Serlin are graduates of the Department’s residency program, 1982 and 2003, respectively. ■

Spring 2011


Research Mission Original Projects — Resident Research In May 2011, the Department’s graduating residents presented their Original Projects, continuing a long tradition of original scholarly investigation and research within the residency program. In the last 20 years, 161 residents have participated in this program and have created an independent scholarly project either alone or with their peers. In the last seven years when the Department began tracking, 2 grants and 6 manuscripts were either published or accepted for publication that directly resulted from the Original Project research. Randall T. Forsch, M.D., M.P.H., assistant professor, and Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, currently guide the program. Over the last decade, 31 current faculty members have served as Original Project mentors to the residents, which is a testament to the widespread faculty

support of the program as well as the need for a diverse set of mentors for the varied topics chosen by the residents. This year the topics include evaluation of cervical cancer screening, study of clinical reminders for childhood vaccinations, development of curriculums for nutrition education and for inpatient teaching, a study on resident peer evaluation, and a pilot intervention to influence resident billing patterns. Recent changes to the program include a component of evaluation or research for each project, presentation of preliminary ideas to the faculty in the HOII year to allow early feedback, development of a more formal curriculum on research and project development, and encouragement for all residents to present their projects at the statewide Family Medicine Research Day held each year in May. ■

Depression in Primary Care In the 15 minutes a primary care doctor typically has with a patient, they are expected to diagnose the current ailment, help manage ongoing health issues and provide preventive care. In this setting, confronting all but the most obvious and immediate mental health needs of patients is an ongoing challenge. A study published in Annals of Family Medicine by Michael S. Klinkman, M.D., M.S., professor, however, points to an encouraging strategy for improving and sustaining mental health results in chronically depressed patients by

providing small amounts of flexible, targeted follow-up care — without overburdening busy doctors’ offices. Dr. Klinkman demonstrates that patients who received interventions that included self-monitoring tools and follow-up phone calls from a care manager were more likely a year and a half later to have symptoms that were in remission and to have fewer reduced-function days than those receiving usual primary care treatment. “They key is to keep patients engaged in treatment. What it’s not is telephone therapy. Patients have a

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Publications Resulting from Original Projects, 2004-2011 Mirabelli M, Shehab R, Gorenflo D, Fetters MD. Pre-exercise stretching and sports related injuries: Knowledge, attitudes and practices. Clin J Sport Med, 16(3):228-31, 2006. Gold KJ, Gorenflo DW, Schwenk TL, Bratton SL. Physician experience with family presence during cardiopulmonary resuscitation in children. Pediatric Critical Care Medicine. 2006;7(5):1-6. Phillips JP, Weismantel DP, Gold KJ, Schwenk TL. Medical student debt and primary care specialty intentions. Fam Med 2010;42(9):616-22. Khodaee M, Fetters MD. Soccer safety equipment use and parental attitudes toward safety equipment in a community youth sports program. Res Sports Med, 2011 (accepted, in press). Phillips JP, Weismantel DP, Gold KJ, Schwenk TL. How Do Medical Students View the Work Life of Primary Care and Specialty Physicians? Fam Med 2011 (accepted, in press). Riley MA, Galang Bettcher S, Green LA. The Impact of Clinical Prompt on Prenatal Care. Fam Med 2011 (accepted, in press).

Continued on page 17

Spring 2011


Research Mission Family Medicine in Ghana In October, Pamela G. Rockwell,

D.O., assistant professor, and Katherine J. Gold, M.D., M.S.W., M.S., assistant professor, traveled to Ghana in order to support the family medicine specialty. Eric P. Skye, M.D., assistant professor, and Caroline R. Richardson, M.D.,

Dr. Richardson attended collaborative

integrated into the medical school.” Additionally, Dr. Gold began work on a three-year, Global Reach funded, project where she will study the prevalence of postpartum depression among mothers presenting with a sick infant for care at an urban teaching hospital. The Department values their commitment to family medicine and looks forward to our growing partnership with Ghana. ■

research meetings on diabetes and also attended research meetings with senior residents at Korle-Bu Polyclinic in Accra.

Dr. Skye observes family medicine at work and learns about routine training activities in Kumasi.

training capacity and increase the number of Ghanaian-trained family physicians.  The faculty members lectured on U-M’s family medicine clerkship and residency programs and many other topics. The group also evaluated the university’s membership exam and lead Journal Club meetings.  Dr. Rockwell said, “All in all, it was a wonderful experience and I feel I can contribute so much more to help the people I met become more

In Kumasi at the Komfo Anokye Teaching Hospital Dr. Gold shadowed residents in inpatient and outpatient settings and spent time both in the mother-baby NICU and on

At the University of Accra Dr. Rockwell had

labor and delivery.

the opportunity to participate in teaching

associate professor followed in April. A partnership between the Department and Ghana developed in order to build their family physician

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rounds with the family medicine residency program, as well as precept a group of residents in an outpatient clinic and run the residents’ journal club meetings. 

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Depression human contact, somebody who can help

…continued from page 16

them become more actively involved in their own care. It’s hard to do that if you’re just spoon feeding information to ‘educate’ a patient or telling them to go to a website.” says Dr. Klinkman. For the study, a care manager worked in collaboration with doctors’ practices, rather than on the side or independently, Klinkman says. That helps the family practice office to act as a home base for all of a patient’s medical needs. The approach can also serve as a model for treating other types of chronic conditions, he adds. While some patients did become less engaged when their symptoms started getting better, many got back in touch with their care manager when things started to slip again. “We helped get people back into care who otherwise might not have returned to treatment,” Klinkman says. Several of the tools developed for the study were integrated into the U-M Depression Center Toolkit (www.depressiontoolkit.org). ■

Spring 2011


Research Mission Big Changes for Cielo MedSolutions In November, Cielo MedSolutions™

was awarded a $1.3 million grant from the National Cancer Institute. The company, in a teaming arrangement with the Department, utilized the funding to develop the next generation of ambulatory clinical quality improvement system, based on Cielo Clinic, which was developed within the Department. Donald E. Nease Jr., M.D., former associate professor, Cielo’s chief medical officer, noted, “This STTR grant is particularly exciting because it bolsters our ongoing exploration of the best way to support ambulatory

care quality improvement initiatives in a manner that fits into a practice workflow.” In February, Cielo MedSolutions was sold to The Advisory Board, a company that provides a wide range of services to health care companies and other industries. “This acquisition represents a potential huge leap forward for the software that we use everyday in our clinics to improve the quality and efficiently of our care. All of us involved are very excited about this development,” said Dr. Nease. “It’s extremely gratifying to see how the Cielo approach to

helping primary care practices improve their care has been embraced by the Advisory Board. It really does validate our approach of using a data model that makes sense for outpatient care combined with the concepts of giving doctors and their staff the key information they need to deliver quality preventive and chronic disease care. As a part of this transition Dr. Nease accepted a Senior Director position with The Advisory Board and regrettably left the Department in April. Read more about Dr. Nease on page 20. ■

Delegation to Improve Family Medicine in Japan

delegation of mayors and hospital administrators from Shizuoka Prefecture, Japan. The visit was part of a $1.4 million grant the Department’s Japanese Family Health Program received from the Shizuoka Prefectural Government to establish a family medicine residency training program and

help Japanese doctors revamp the way family medicine is practiced in Japan. “The partnership is really a culmination for me of almost 20 years of working to promote family medicine in Japan along with my colleagues who share a similar vision,” says Michael D. Fetters, M.D., M.P.H., M.A., associate professor. “After years of making the sales pitch for family medicine in Japan, we found three mayors and three hospital CEOs who were willing to support it.” Family medicine is just getting a foothold in Japan and the delegation observed various aspects of patient care while exploring how family physicians might be better integrated into their health care system. The Department is lending its expertise to a country that finds its medical system in crisis, Dr. Fetters

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Dr. Fetters gives the group a tour of the Department’s Japanese Family Health Program located at Domino’s Farms.

Last fall the Department hosted a

The Japanese Delegation stands outside University Hospital.

says, and the four-year grant is part of a larger $8 million effort undertaken by the Japanese government to improve medical care in rural areas. Like in the United States, Japanese physicians tend to practice in metropolitan centers at the expense of rural areas. The delegation had a full schedule during their five-day stay in Ann Arbor visiting mayors, hospitals and health clinics in Ann Arbor, Chelsea and Dexter, along with meeting leaders at both the University Health System and Chelsea Community Hospital. ■

Spring 2011


Research Mission Social Tools and Online Health Programs In an era when social networking sites and blogs are visited by three quarters of online users, it’s only natural that the medical profession would also tap into the power of social media tools. Caroline R. Richardson, M.D., a s s o c i a t e p r o f e s s o r, a n d h e r colleagues found that adding an interactive online community to an Internet-based walking program significantly decreased the number of participants who dropped out. Seventy-nine percent of participants who used online forums to motivate each other stuck with the 16-week program. Only 66 percent of those who used a version of the site without the social components completed the program. Still, both groups saw equal improvements in how

much they walked while using the program’s web interface to track their progress — about a mile per day. The findings, published in the Journal of Medical Internet Research, show that adding community features to online health programs can be a powerful tool for reducing attrition, says Richardson, the study’s lead author. The approach also has the potential to produce significant savings compared to traditional interventions, such as face-to-face coaching, which are expensive to do on a large scale. “Brick by brick we have been building a model of how to change health behaviors using online tools,” Dr. Richardson says. “We can see that social components can help to mitigate the big downside that

Department Launches Health Seminar Series April 16th kicked off the first bi-annual

Department of Family Medicine Health Seminar, “Taking Care of You: Women’s Health Seminar”. Over 30 guests listened to Barbara D. Reed, M.D., professor, talk about vulvodynia, treatment options and how to address the distress associated with painful sex. Caroline R. Richardson, M.D., associate Mack T. Ruffin IV, M.D., M.P.H., professor, professor, discussed diet and exercise Caroline R. Richardson, M.D., associate and provided details on new initiatives to professor, Barbara D. Reed, M.D., help women move more and eat less to improve their daily lives. Both physicians professor, and R. Dale Lefever, Ph.D., answered questions and provided valuable emeritus faculty, greet guests at the information and resources for the attendees. Department’s inaugural health seminar. The Health Seminars are open to the public and free of charge. The next seminar will focus on Healthy Aging and be held in Fall 2011. ■

If you would like further information on the seminars, please contact Amy St. Amour at astamour@umich.edu or 734.645.0423.

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Internet-mediated programs have had in the past, namely attrition.” F or health programs w ith a national or international scope, even small reductions in attrition could lead to positive health outcomes Continued on page 21

GRIN Update

The Great Lakes Research Into Practice Network (GRIN) has been very busy over the past six months. The Network redesigned it’s website providing more current information and a more user– friendly format. GRIN is in the process of updating it’s extensive database of information on individual members and member practices to improve network value and efficiency in assisting study PI’s and project managers. GRIN is also working to improve collaborations with physician organizations and insurers such as the Michigan Primary Care Association, Michigan Association of Family Physicians and Blue Cross Blue Shield of Michigan. In addition, GRIN is actively involved in a number of large studies totaling over $8 million in grant funds. ■

Spring 2011


Faculty Activity Departing Faculty Kristy K. Brown, D.O., lecturer and assistant residency director, is leaving the University for New England at the end of July. Dr. Brown has been dedicated to outpatient and obstetric teaching, residency leadership, and support of residents, and through her many contributions to the curriculum and recruitment efforts. Donald E. Nease Jr., M.D., associate professor, left the University to be a Senior Director for The Advisory Board

Reflections we had to make tough decisions about …continued from page 2

which there was not unanimity. The ability of the Department faculty members to speak their minds honestly and forcefully and then endorse and support the decisions that were made is truly remarkable. What I will take with me, more important by far than the mementos in my office, is 27 years of these memories and many others, of the victories, defeats, successes, failures, of opportunities realized and lost, of the greatest joy and the greatest

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Company, a research, consulting and technology services firm focused on the health care and higher education industries, which recently acquired Cielo MedSolutions™, an Ann Arborbased company that consults on health care improvement. Additionally, he has accepted a position with the University of Colorado–Denver where he will be working with the Distributed Ambulatory Research in Therapeutics Network, a clinical practice network that performs large-scale comparative effectiveness research studies. The Department offers its many thanks to both faculty members for their years of service, and wishes them well in their new endeavors. ■

sadness. What I most value from this long run is the fact that the Department, i t s f a c u l t y, residents and staff, gave me the opportunity to be as good as I could be, to grow and learn with them as they grew and learned with me. For that opportunity I will forever be grateful. Go Blue! ■

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PCMH “In my role as co-lead of this project, …continued from page 1

I will be working with state experts on the development and implementation of the demonstration’s clinical interventions, with a focus on care management and care coordination. This work will help prepare primary care practices improve the health of our state’s population and also build a strong foundation for successful Accountable Care Organization models throughout the state,” said Dr. Malouin. Patient-centered medical homes are primary health care practices that provide comprehensive whole-person care to those they serve: children, adults, seniors and families, including recommended preventive care and chronic disease management. Medical homes assure coordinated care across the health care system, including specialists, hospitals, nursing homes, and the patient’s community. Quality and safety are hallmarks of the medical home, as is enhanced access through expanded hours and new options for communication between patients and their medical teams. Dr. Malouin, along with Lee A. Green, M.D., M.P.H., professor, associate chair for information management, have led efforts to implement PCMH practices in all of the Department’s clinics over the past six years. ■ For more information please visit the Michigan Primary Care Consortium online at www.mipcc.org.

Spring 2011


Faculty Activity Social Tools …continued from page 19

for large numbers of people and significant system-wide cost savings. While one-on-one interventions can cost hundreds or thousands of dollars, the web-based approach has the potential to deliver similar results at a much lower cost. The pedometers used in Richardson’s program cost $34 each. A website like the one they used is somewhat expensive to set up, but becomes cheaper on a per-person basis over time and as the size of the program increases. Plus, much of the content is provided for free by participants as they share tips and encouragement. “There is already a huge demand for change that we are not meeting in the health system,” Richardson says. “There are people who know what they want — help losing weight, sleeping through the night, improving their diet - but they don’t have guidance. They do not have the necessary behavioral skills or support that will allow them to be successful. That is where these types of programs fit in.” Moreover, as social media networks become even more integrated into the fabric of American life, there will be additional opportunities to harness their power, encouraging participation and disseminating information at a low cost by piggybacking on that existing infrastructure. “For many people, if you give them a path that’s likely to be successful and it’s not too painful, they’ll do it,” Richardson says. ■

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Publications and Presentations PUBLICATIONS • Adhikari A, Sen A, Brumbaugh RC, Schwartz J. Altered growth patterns of a mountain population of Papua New Guinea over 25 years of change. Am J Hum Biol Dec 22, 2010. • Asai H, Fetters MD. インターネットを利用 した学習モジュール作成とe-learningの可能 性: 避妊法モジュールの経験から (Design of a study module using the internet and the potential of e-learning: Experience based on a contraception module.) JIM 20(10):798-800, 2010. • Asai H, Jimbo M. Electronic health record to realize error-free medicine: Difference in American and Japanese clinic set-up and a possibility for a computerized clinician support system. Jpn Med J 4481:93-97, 2010. • Brown VA, Patel KR, Viskaduraki M, Crowell JA, Perloff M, Booth TD, Vasilinin G, Sen A, Schinas A, Piccirilli G, Brown K, Steward W, Gescher AJ, Brenner DE. Repeat dose study of the cancer chemopreventive agent Resveratrol in healthy volunteers: Safety, pharmacokinetics and effect on the Insulin-like growth factor axis. Cancer Res 70(22):9003-11, 2010. • Carlos RC, Dempsey AF, Ruffin MT IV, Patel DA, Straus CM, Kure A, Dalton VK. Feasibility of using maternal cancer screening visits to identify adolescent girls eligible for HPV vaccination. J Wom Hlth (Larchmt) 19(12):2271-5, 2010. • Cigolle CT, Lee PG, Langa KM, Lee YY, Tian Z, Blaum CS. Geriatric conditions develop in middleaged adults with diabetes. J Gen Intern Med 26(3):272-9, 2011. • Dempsey A, Cohn L, Dalton V, Ruffin MT IV. Worsening disparities in HPV vaccine utilization among 19-26-year old women. Vaccine 29(3):52834, 2011. • Djuric Z, Ellsworth JS, Ren J, Sen A, Ruffin MT IV. Implementation intentions for increasing fruit and vegetable intakes. Prev Med 50:265-271, 2010. • Inada H, Mitsunami K, Motohara S, Fetters MD. 参加型臨床実習は医学生のモチベーシ ョンを高める―浸透学習」からの脱却のた めの事例報告 (Increasing motivation of medical students through a participatory style of learning: A case study demonstrating how to get away from “osmotic learning”). Med Ed 41(5):347-52, 2010. • Gallagher KM, Nutting PA, Nease DE Jr, Graham DG, Bonham AJ, Dickinson WP, Main DS. It takes two: Using co-leaders to champion improvements in small primary care practices. J Am Board Fam Med 23(5):632-9, Sept-Oct 2010. • Ganesan S, Faris AN, Comstock AT, Chattoraj SS, Chattoraj A, Burgess JR, Curtis JL, Martinez

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FJ, Zick SM, Hershenson MB, Sajjan US. Quercetin prevents progression of disease in elastase/ LPS-exposed mice by negatively regulating MMP expression. Resp Res 11:131, 2011. • Hawkins MS, Sevick MA, Richardson CR, Fried LF, Arena VC, Kriska AM. The association between physical activity and kidney function: NHANES. Med Sci Sports Exerc Dec 21, 2010. • Klinkman MS, Bauroth SA, Fedewa S, Kerber K, Kuebler J, Adman T, Sen A. A long-term clinical outcomes of care management for chronically depressed primary care patients: A reports from the depression in primary care project. Ann Fam Med 8(5):387-96, Sept-Oct 2010. • Lin Z, Simeone D, Anderson MA, Brand R, Xie X, Shedden K, Ruffin MT IV, Lubman DM. A mass spectrometric assay for analysis of haptoglobin fucosylation in pancreatic cancer. J Proteome Res Mar 19, 2011. • McAlearney AS, Song PH, Rhoda DA, Tatum C, Lemeshow S, Ruffin MT IV, Harrop JP, Paskett ED. Ohio Appalachian women’s perceptions of the cost of cervical cancer screening. Cancer 116(20):472734, 2010. • Nease DE Jr, Nutting PA, Graham D, Dickinson WP, Gallagher KM, Jeffcott-Pera M. Sustainability of depression care improvements: Success of a practice change improvement collaborative. J Am Board Fam Med 23(5):598-605, Sept-Oct 2010. • Nelson RK, Horowitz JF, Holleman RG, Strath SJ, Kriska AM, Swartz AM, Richardson CR. Physical activity is a better predictor of insulin resistance than cardiorespiratory fitness (abstract). Med Sci Sports Exerc 42(10):53-4, 2010. • Olin JW, Allie DE, Belkin M, Bonow RO, Casey DE Jr, Creager MA, Gerber TC, Hirsch AT, Jaff MR, Kaufman JA, Lewis CA, Martin ET, Martin LG, Sheehan P, Stewart KJ, Treat-Jacobson D, White CJ, Zheng ZJ, Masoudi FA, Bonow RO, DeLong E, Erwin JP 3rd, Goff DC Jr, Grady K, Green LA, Heidenreich PA, Jenkins KJ, Loth AR, Peterson ED, Shahian DM. 2010 performance measures for adults with peripheral artery disease: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures. J Am Coll Cardiol 14;56(25):2147-81, 2010; Vasc Med 15(6):481-512, 2010; J Vasc Nurs 29(1):23-60, 2011. • Patel DA, Unger ER, Walline H, Opipari AW, Lee DR, Flowers LC, Ruffin MT IV. Lack of HPV 16 and 18 detection in serum of colposcopy clinic patients. J Clin Virol Feb 7, 2011. • Phillips JP, Weismantel DP, Gold KJ, Schwenk TL. Medical student debt and primary care specialty intentions. Fam Med 42(9):616-22, 2010.

Spring 2011


Faculty Activity Publications and Presentations • Potworowski GA, Green LA. Assessing the uptake of evidence-based management: A systems approach. Industrial and Org Psych 4;54-56, 2011. • Resnick PJ, Janney AW, Buis LR, Richardson CR. Adding an online community to an internetmediated walking program: Part 2: Strategies for encouraging community participation. J Med Internet Res 12(4):e72, 2010. • Richardson CR. Objective monitoring and automated coaching: A powerful combination in physical activity interventions. Phys Ther Rev 15(3):154-62, 2010. • Richardson CR, Buis LR, Janney AW, Goodrich DE, Sen A, Hess ML, Fortlage LA, Resnick PJ, Zikmund-Fisher BJ, Strecher VJ, Piette JD. An online community improves adherence in an internet-mediated walking program. Part 1: Results of a randomized controlled trial. J Med Internet Res 12(4):e71, 2010. • Rubinstein WS, O’Neill SM, Rothrock N, Starzyk EJ, Beaumont JL, Acheson LS, Wang C, Gramling R, Galliher JM, Ruffin MT IV. Components of family history associated with women’s disease perceptions for cancer: A report from the Family Healthware™ Impact Trial. Genet Med 13(1):52-62, 2011. • Ruffin MT IV, Nease DE Jr, Sen A, Pace WD, Wang C, Acheson LS, Rubinstein WS, O’Neill S, Gramling R. Family History Impact Trial Group. Effect of preventive messages tailored to family history on health behaviors: The family healthware impact trial. Ann Fam Med. 9(1):3-11, Jan-Feb 2011. • Wooldridge AN, Arato N, Sen A, Amenomori M, Fetters MD. Truth or Fallacy? Three hour wait for three minutes with the doctor: Findings from a private clinic in rural Japan. Asia Pac Fam Med 9:11, 2010. • Zick SM, Al Rawi S, Merel G, Burris B, Sen A, Litzinger A, Harris RE. Relaxation acupressure reduces persistent cancer related fatigue. Evid Based Compl Alternat Med Vol Art ID 142913, 2011. • Zick SM, Ruffin MT IV, Djuric Z, Normolle D, Brenner DE. Quantitation of 6-, 8- and 10-gingerols and 6-shogaol in plasma by high-performance liquid chromatography with electrochemical detection. Int J Biomed Sci 6:233-240, 2010. • Zulman DM, Sussman JB, Chen X, Cigolle CT, Blaum CS, Hayward RA. Examining the evidence: A systematic review of the inclusion and analysis of older adults in randomized controlled trials. J Gen Intern Med Feb 1, 2011.

www.med.umich.edu/fammed

PRESENTATIONS

…continued from page 21

• Chang T, Llanes MT, Gold KT, Fetters MD. Physicians’ and nurse midwives’ approach to weight gain during pregnancy. North American Primary Care Research Group (NAPCRG). Seattle, Wash., November 2010. • Djuric Z, Ren J, Turgeon DK, Ruffin MT IV, Cornellier M, Rapai M, Sen A, Brenner DE. Effects of a Mediterranean diet intervention on eicosanoid levels in colon biopsies. Chemistry in Cancer Research Meeting on Inflammation and Cancer. San Diego, Calif., January 30-February 2, 2011. • Fetters MD. Medical Marvels Interactive Translational Research Experience (MITRE): Use of a community forum to teach about informed consent for research. Center for Bioethics and Social Sciences in Medicine Seminar. Ann Arbor, Mich., October 2010. • Fetters MD. Public opinions on participating in medical research and about medical researchers: Findings from the Medical Marvels Interactive Translational Research Experience (MITRE) project baseline survey in The Detroit Science Center. North American Primary Care Research Group (NAPCRG). Seattle, Wash., November 2010. • Fetters MD, Pluye P. Mixed methods workshop. North American Primary Care Research Group (NAPCRG). Seattle, Wash., November 2010. • Jimbo M, Fetters MD. How do community practices view technological implementation to improve CRC screening. North American Primary Care Research Group (NAPCRG). Seattle, Wash., November 2010. • Gold KT. Bereaved mothers using internet peer-support message boards for pregnancy loss: An internet survey of user characteristics and depressive symptoms. Joint Conference of the International Stillbirth Alliance/International Society for the Study and Prevention of Perinatal and Infant Death. Sydney, Australia, October 8, 2010. • Gold KT. The impact of pregnancy loss on the bereaved couple: Estimating the Risk. International Conference for Perinatal Bereavement and Infant Death. Washington, D.C., Nov. 5, 2010. • Gold KT. New research: Bereavement care after pregnancy and infant loss. Keynote Speaker, International Conference for Perinatal Bereavement and Infant Death. Washington, D.C., Nov. 4, 2010. February 2011. • Jimbo M, Nease DE Jr, Fetters MD. Powers D. Community practice views of implementation of information technology to improve colorectal

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cancer screening. North American Primary Care Research Group (NAPCRG). Seattle, Wash., November 2010. • N e a s e D E J r. E m p o w e r i n g p a t i e n t s ’ transformations: An exploration with and through the balint method. 16th WONCA Europe Conference. Malaga, Spain, October 2010. • Nease DE Jr, Arroll B. Developing a research framework for transforming medical encounters: Exploring themes of transformation. North American Primary Care Research Group (NAPCRG). Seattle, Wash., November 2010. • Nease DE Jr, Campbell-Scherer D, Green LA, Klinkman MS, Sen A. Are coronary heart disease and depression independently associated? A primary care population-based analysis. North American Primary Care Research Group (NAPCRG). Seattle, Wash., November 2010. • Neilson AP, Reuven SL, Djuric Z, Ren J, Hong YH, Smith WL, Brenner DE. Modulation of eicosanoid formation by COX genotype and fish oil diets in mouse colon. The Colon Cancer in Murine Models and Humans III meeting. Bar Harbor, Maine, October 18-22, 2010.  • Reed BD, Sen A, Harlow SD, Legocki LJ, Haefner HK. Vulvodynia prevalence in a population-based sample of women in Southeast Michigan. North American Chapter of the ISSVD Meeting. Chicago, Ill., October 3, 2010. • Richardson CR. An online community reduces attrition in an internet-mediated walking program. 138 th APHA Annual Meeting. Denver, Colo., November 8, 2010. • Ruffin MT IV. Bayesian modeling of recurrent events with dependent censoring. 25th International Biometric Conference. Florianopolis, Brazil, December 5-10, 2010. • Wooldridge A, Arato N, Sen A, Fetters MD. Truth or fallacy? Three hour wait for three minutes with the doctor: Findings from a private clinic in rural Japan. North American Primary Care Research Group (NAPCRG). Seattle, Wash., November 2010. ■

Spring 2011


Faculty Activity Department Faculty The George A. Dean, M.D. Chair of Family Medicine, Professor Thomas L. Schwenk, M.D.

Professor

Barbara S. Apgar, M.D. Zora Djuric, Ph.D. Lee A. Green, M.D., M.P.H. Michael S. Klinkman, M.D., M.S. James F. Peggs, M.D. Barbara D. Reed, M.D., M.S.P.H. Mack T. Ruffin IV, M.D., M.P.H. Kent J. Sheets, Ph.D. Philip Zazove, M.D.

Associate Professor

James E. Aikens, Ph.D. William E. Chavey II, M.D., M.S. Michael D. Fetters, M.D., M.P.H., M.A. Joel J. Heidelbaugh, M.D. Masahito Jimbo, M.D., Ph.D., M.P.H. Robert B. Kiningham, M.D., M.A. John M. O’Brien, M.D. Caroline R. Richardson, M.D. Ananda Sen, Ph.D. Sara L. Warber, M.D.

Assistant Professor

David J. Alvarez, D.O. Ricardo R. Bartelme, M.D. Catherine M. Bettcher, M.D. Christine T. Cigolle, M.D. James M. Cooke, 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. Grant M. Greenberg, M.D., M.H.S.A., M.A. Joyce E. Kaferle, M.D. Amanda J. Kaufman, M.D. Anne L. Kittendorf, M.D. Amy B. Locke, M.D. Jean M. Malouin, M.D., M.P.H. Tarannum A. Master-Hunter, M.D.

www.med.umich.edu/fammed

Amy C. Miller, M.D. Karen L. Musolf, M.D. Pamela G. Rockwell, D.O. Phillip E. Rodgers, M.D. David C. Serlin, M.D. Eric P. Skye, M.D. Lourdes Velez, M.D. Stephen M. Wampler, M.D. Joy C. Williams, M.D. Gary Yen, M.D. Suzanna M. Zick, N.D., M.P.H.

The Regents of the University Julia Donovan Darlow Laurence B. Deitch Denise Ilitch Olivia P. Maynard Andrea Fischer Newman Andrew C. Richner S. Martin Taylor

Instructor

Christine W. Krause, M.D. Theresa R. Peters, M.D. Michelle L. Rabideau, M.D. Karl T. Rew, M.D.

Katherine E. White Mary Sue Coleman (ex officio)

Lecturer

Kathryn M. Harmes, M.D. Heather L. Holmstrom, M.D. Stefani A. Hudson, M.D. Scott A. Kelley, M.D. Sahoko H. Little, M.D., Ph.D. Ebony C. Parker-Featherstone, M.D. Elisa B. Picken, M.D. Margaret A. Riley, M.D. Cheryl E. Strzoda, M.D.

Psychologist

Samuel E. Romano, Ph.D.

Emeritus Faculty

R. Dale Lefever, Ph.D.

Editor-in-Chief Thomas L. Schwenk, M.D.

Editorial Consultants Blythe A. Bieber Diana S. Dascola Katie M. Grode Amy C. St. Amour Kent J. Sheets, Ph.D.

Managing Editor Kristen A. Ochomogo If you would prefer to receive an electronic copy of the newsletter in the future, please e-mail sgenske@umich.edu. Printed on pcw Forest Stewardship Council Certified stock, manufactured using wind generated electricity.

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Spring 2011


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Student Scholarships and Awards

Residency Program Grows Ypsilanti Health Center Named Program of the Year Social Media Tools and Exercise Programs

Family Medicine Support Staff

Support Staff Member of the Year The Department is pleased to announce that Blythe A. Bieber, executive assistant, received the 2010 Support Staff Member of the Year award. “I would like to thank Dean Woolliscroft and the Medical School for selecting me for this award. I am truly honored and humbled because having been at the University of Michigan for over thirty years, I know how many wonderful staff support people there are here at the health system,” Ms. Bieber comments. “Her dedication is apparent every day she has worked at U-M,” says

Thomas L. Schwenk, M.D., the George A. Dean, M.D. Chair of Family Medicine and professor. Ms. Bieber has performed many roles over the years, and she says that her career has grown along with the Department. She joined as the receptionist when the Department was just two years old, and has since worked on faculty appointments and promotions, support for the Advisory Committee on Promotions and Tenure, and annual career development meetings with the chair for more than 60 faculty members. ■

James O. Woolliscroft, M.D., dean, congratulates Blythe A. Bieber, executive assistant, on her accomplishments at the Staff Awards Banquet held in November 2010.

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U-M Family Medicine Newsletter Spring 2011