The UMKC School of Medicine has announced that Brian Carter, M.D., will serve as the next William T. and Marjorie Sirridge Professor in Medical Humanities.
Carter joined the School of Medicine and Children’s Mercy Hospital in 2012 as a Professor of Pediatrics and Bioethics. He serves as co-director of the Children’s Mercy Bioethics Center’s Pediatric Bioethics Certificate Course and practices at Children’s Mercy Hospital as a neonatologist.
An internationally-recognized expert in medical bioethics and neonatal palliative care, Dr. Carter is the recipient of numerous NIH grants. He has published extensively in the areas of neonatology, neonatal intensive care, palliative care, and bioethics. Carter is the author of three textbooks on neonatal intensive and palliative care.
Carter is a graduate of the University of Tennessee College of Medicine and is a member of the Alpha Omega Alpha Honor Medical Society. He completed his postgraduate training at Fitzsimons Army Medical Center and the University of Colorado Health Sciences Center.
He is board certified in pediatrics and neonatal-perinatal medicine. Carter served as an active duty U.S. Army Medical Corps officer from 1983 though 1996 and is a decorated Gulf War veteran.
The William T. and Marjorie Sirridge Professorship in Medical Humanities was endowed in 2008 though the generosity of Drs. William and Marjorie Sirridge, two of the UMKC School of Medicine’s Founding Docents.
School of Medicine Dean Steven Kanter, M.D., is pleased to announce that E. Nathan Thomas, previously the chief diversity officer for the University of Kansas, has joined the School of Medicine as the new Associate Dean for Diversity and Inclusion.
A highly successful educator, administrator and entrepreneur, Thomas served as vice provost for diversity and equity at Kansas since July 2014. Before that, he was the first campus diversity director at the University of South Florida Polytechnic, and was founder and a consultant with Invictus Human Capital Management in Florida.
At Kansas, Thomas provided leadership in diversity, equity and inclusion for 21 non-academic and academic units. He expanded the program from a campus-wide to a system-wide model that encompasses four of the university’s campuses, including the medical school. He was responsible for implementing a Diversity Leadership Council work group to execute system-wide diversity efforts and developed work groups to coordinate diversity education and training for all new faculty, staff, and students.
His office at Kansas also partnered with the Office of Faculty Development to fund and implement the National Center for Faculty Development and Diversity (NCFDD), Resources for Inclusive Teaching, and the Diversity Scholars Program
While at South Florida for nine years, Thomas developed the first campus diversity office. His efforts included a mentoring program to enhance the retention of a diverse student body, a diversity advisory group of faculty, staff, students and community members, and a successful multi-university grant proposal designed to increase the number of women and minorities in technology disciplines.
Thomas received his bachelor’s degree in psychology and a master’s in community/clinical psychology from Norfolk State University. He completed his Ph.D. in ecological-community psychology at Michigan State University.
Thomas began his new role at the UMKC School of Medicine on December 18.
“We are excited to have someone with Nate’s broad range of experience and talent to lead our efforts in diversity and inclusion,” Kanter said. “Please join me in welcoming him to the UMKC School of Medicine.”
At the UMKC School of Medicine’s Surgical Innovations Laboratory, Gary Sutkin, M.D., professor of surgery and associate dean for women’s health, is taking a different approach to research.
As director of the lab, Sutkin, who also serves as the Victor and Caroline Shutte Endowed Chair in Women’s Health, has gathered an interdisciplinary team to look at ways to make surgical procedures safer for patients.
Inside the “Surgilab” — his third-floor “think tank” — one can find a pair of large bean bag chairs sitting in a corner on a colorful rug. A portion of one wall is filled with large-screen video monitors. A rectangular conference table in front of the wall is surrounded by different colored chairs. This is all by design, Sutkin explains.
“It’s all about creativity,” he said. “The chairs being different colors represent different ideas that people bring forth. It wasn’t just convenience. The people we work with come from different backgrounds.”
Biomedical engineers, mechanical engineers, and even a theater instructor, gather to discuss surgical procedures and how the operating room team of nurses and technicians can more effectively work together. They do this through studying practitioners’ movements and non-verbal communications.
“We’re one big community here, trying to make surgery safer for patients,” Sutkin said. “We’re trying to make it safer by cutting down on errors and improving communication. The operating room is such a fast-paced, high-risk environment. You have all these people from different backgrounds trying to work together, all with the same goal to have an effective, safe surgery. But they have to communicate well to do that.”
Physicians learn to do better by talking about the mistakes that take place during surgical procedures. One of Sutkin’s projects involves interviewing a number of surgeons to get their perspectives on surgical errors and how to prevent them. It’s a topic that he says surgeons think about often and are quite open to talking about with colleagues.
“I’ve told my mistake stories over and over,” Sutkin said. “It’s only by putting them out in the open and talking about them that we can learn from them and fix our ways.”
The work of the Surgilab is supported by a grant from the University of Missouri Review Board and funding from Sutkin’s endowed chair appointment.
With his research assistant, Fizza Mahmud, and a cohort of interdisciplinary colleagues, Sutkin and company are also exploring the process involved in Midurethral Sling Surgery. The procedure is a minimally invasive approach to treating a common urinary problem of incontinence in women. But it also involves surgical risks.
During a work session, Sutkin grabs a handful of playdoh and begins to form a shape to help describe to the non-medical members of his team the female anatomy and how the surgical instruments are used during the procedure.
“Human error is a part of any high-risk industry,” Sutkin said. “Whether it’s aviation, the railway industry, or surgery, it’s going to happen. You’re never going to get it down to zero, but you’re always trying to make it lower and lower.”
The UMKC School of Medicine has announced that Stephen Jarvis, M.D., will serve as interim academic chair of the UMKC Department of Psychiatry.
Jarvis received his medical degree from University of Missouri-Columbia, and completed residency and fellowship training from the Western Psychiatric Institute and Clinic in Pittsburgh, Pennsylvania.
As a UMKC faculty member, Jarvis has held multiple administrative positions at Truman Medical Centers and at the former Western Missouri Mental Health Center. He serves as the associate chief medical officer and clinical department chair for Psychiatry at Truman Medical Centers.
Jarvis assumed his new role on November 20, 2017.
He replaces Nash Boutros, M.D., who served as chair of the UMKC Department of Psychiatry and medical director for the Center for Behavioral Medicine from 2014 to 2017. Boutros, a professor of psychiatry, holds tenure in the department of Biomedical and Health Informatics. Boutros will remain at UMKC to continue his research program.
In an age of rapidly advancing technology and conflicting economic forces, it is important to guard against overuse of medical treatments and interventions, according to Pieter Cohen, M.D. He was this year’s William Goodson Jr. lecturer.
Cohen, an associate professor of medicine at Harvard Medical School, spoke Nov. 3 about “Slow Medicine,” the approach he and others promote at slowmedupdates.com. Cohen described Slow Medicine as thoughtful practice that involves patients, relies on the best evidence available and is “applied to help decrease excessive and potentially harmful interventions.”
Relatively high use of medical resources and procedures does not produce better results in many areas, Cohen said. For example, research indicates that 30 percent of U.S. knee replacement surgeries are not appropriate. That’s 200,000 major surgeries a year that should have been avoided, he said, resulting in 14,000 people needlessly suffering serious complications and side effects.
Similarly, aggressively ordering lots of CT scans and other tests can result in other overtreatments, not to mention increased anxiety and other side effects, he said, especially when tests produce false positive results.
Cohen cited research in 1973 by John Wennberg, M.D., author of “Tracking Medicine,” who identified the two main drivers of medical overuse. One is supply, so that adding physicians, specialists and hospital beds to an area will increase its use of medicine. The other is the style of medical practice prevalent in an area.
When Wennberg did his research, it was rejected by the Journal of the American Medical Association. But Dartmouth University then financed Wennberg’s work and started the Atlas Project, which examined patterns of medical use and resource intensity in the U.S.
According to Cohen, Wennberg’s conclusions have been proven correct, and Slow Medicine “digs deeper into the style issue to figure out what we can do better.” By involving patients, fully looking at options and not quickly reaching for a specific diagnosis and treatment, he said, Slow Medicine can improve care.
Economic pressures from pharmaceutical companies and medical device makers can promote overuse of some treatments, while cost pressures can curb others than might be beneficial. Slow Medicine tries to put the focus back on what’s best for the patient, which can end up saving money, but for the right reasons. It also keeps physicians from doing things mainly to make themselves feel better, and can prevent extending a treatment that works for some types of patients to others for whom it really wouldn’t be beneficial.
Cohen said Slow Medicine also can take more effort, to fully explain possible risks and rewards of different treatment choices, so that patients have more information and can know that there’s a good case to be made for more than one treatment option. In the end, more thoughtful, appropriate and caring practice can result.
Slow Medicine also is “about letting go of a specific, certain diagnosis” in favor of a more general assessment and then watchful waiting for signs of a particular ailment or for a clearer indication that treatment is needed. The slower approach often provides time for healing without intervention, he said, or provides the data needed to take the best treatment approach possible.
Cohen was the 31st speaker in the William B. Goodson Jr., M.D., Memorial Lectureship, which was established in 1987 by a group of families, patients, colleagues and friends to honor Goodson’s many contributions to medicine.
The challenge of finding the right dosage of medicines for young patients is complex and requires fresh thinking, J. Steven Leeder, Pharm.D., Ph.D., told the audience for the latest installment of the Health Sciences Deans’ Seminar Series.
Leeder, a professor of pediatrics and pharmacology at the UMKC School of Medicine, spoke Oct. 25 in the Health Sciences Building on Hospital Hill on “Exploring Inter-Individual Variability in Drug Response: Moving Beyond the Dose-Exposure Relationship.”
Leeder, who leads the pediatric clinical pharmacology group at Children’s Mercy Hospital, noted that many drugs are initially developed for adults and tested on them, making dosage calculations for children more difficult. On top of that, he said, the typical differences in how people respond to a drug can be magnified in children, given great differences in patient weight and in how rapidly different biological mechanisms in children can change during growth and development.
The maturation of the brain, Leeder said, implies that receptors and transporters affecting drugs’ effectiveness may be changing in children and adolescents, but there’s relatively little research knowledge of these changes.
Given those challenges, he said, it makes sense to invert the usual sequence of “dose-exposure-response”: administering a standard dosage of a drug and then seeing how much of that dosage is present in a patient’s body and how much the patient’s condition responded to the drug. Instead, he favors looking at “response-exposure-dose”: identifying the desired response or therapeutic outcome, and determining the amount of drug that needs to be in the body – the “exposure” — to achieve the desired response. Given that knowledge, he said, then a dosage can be tailored to the patient.
Leader, who practices at Children’s Mercy Hospital, noted that many drugs are initially developed for adults and tested on them, making dosage calculations for children more difficult. On top of that, he said, the typical differences in how people respond to a drug can be magnified in children, given great differences in patient weight and in how rapidly different biological mechanisms in children can change.
The maturation of the brain, Leeder said, means receptors and transporters that affect drugs’ effectiveness must be changing in children and adolescents, but there’s relatively little research knowledge of these changes.
Given those challenges, he said, it makes sense to invert the usual sequence of administering a standard dosage of a drug and then seeing how much of that dosage was used by a patient, and how much the patient’s condition responded to the drug. Instead, he favors looking at the response or outcome that’s desired, and then trying to gauge how well an individual patient’s system will use a drug. Given that knowledge, he said, then a dosage can be tailored to the patient.
Such an approach, he said, might best use the “more information on everyone” being provided by the increase in genomics, bioinformatics and population-wide data from electronic health records.
Leeder holds the Marion Merrell Dow Endowed Chair in Pediatric Clinical Pharmacology and is division director for clinical pharmacology and therapeutic innovations. He earned his pharmacy degree at the University of Minnesota and his doctorate at the University of Toronto. He completed a fellowship in clinical pharmacology at the Hospital for Sick Children in Toronto.
Retirement hasn’t stopped Louise Arnold, Ph.D., from being a major proponent for medical education and research. The School of Medicine’s former associate dean recently joined the list of master reviewers for the Association of American Medical Colleges’ journal, Academic Medicine.
A long-time volunteer peer reviewer for the journal, Arnold has received the publication’s annual Excellence in Reviewing Award three times. The journal’s editor in chief, David Sklar, said that Arnold’s consistently superior reviews have demonstrated her commitment to the peer-review process.
Because of her excellent performance, Arnold has earned the title of “Master Reviewer,” which recognizes the best of the best in Academic Medicine’s reviewer pool, Sklar said.
Arnold will receive special recognition as a master reviewer at the Academic Medicine’s annual MedEdPORTAL Reviewer Reception, as well as in the January issue of the journal and on the journal’s “For Reviewers” web page.
The journal’s editors also offer Master Reviewers the opportunity to become more involved in the review process. As a master reviewer, Arnold will have the opportunity to meet and consult with other master reviewers on needed changes to the review process, participate in peer-review webinars, and serve as a peer review mentor.
Arnold served on the School of Medicine faculty from 1971 through 2012. As director of the Office of Medical Education and Research, she championed on a national stage the school’s docent system and the large role it played as a learning community within the six-year program. She served as founding chair of the Association of American Medical Colleges’ Group on Combined Baccalaureate-MD Programs. The group now represents more than 100 medical schools across the country.
Research studies by UMKC School of Medicine faculty researchers at the Saint Luke’s Mid America Heart Institute have been selected for presentation at the world’s largest educational meeting for interventional cardiovascular medicine.
The researchers are the first or senior authors of 10 original studies and contributing authors of nine other studies selected for presentation at the 2017 Transcatheter Cardiovascular Therapeutics symposium in Denver, running October 30 through November 2.
The presentations includes two major studies selected as Late-Breaking Clinical Trials. Only 12 research breakthroughs highlighting the most innovative treatments for heart disease are selected for the late-breaking presentations.
“It is rare for any institution to have even one late-breaking trial presentation at a major cardiology meeting,” said David Cohen, M.D., professor of medicine and MAHI director of cardiovascular research. “Having two of the 12 come from the Mid America Heart Institute is an incredible honor and a testimony to both the Mid America Heart Institute Clinical Scholars program and the international reputation that our research program has come to enjoy.”
Suzanne Baron, M.D., assistant professor of medicine, is the lead author of a study that describes the long-term quality of life outcomes of nearly 2,000 patients enrolled in a landmark multi-center trial. The research compared everolimus-eluting stents and bypass surgery for the treatment of left main coronary artery disease. Cohen is the lead author of the second study that evaluates the cost effectiveness of transcatheter aortic valve replacement compared with surgical aortic valve replacement in intermediate risk patients.
Four of the MAHI studies to be presented at this year’s meeting are the direct result of a groundbreaking OPEN-Chronic Total Occlusions (CTO) registry. The registry is led by Aaron Grantham, M.D., associate professor of medicine, with assistants from Adam Salisbury, M.D., assistant professor of medicine, and the support of the MAHI Outcomes Research group. The studies define the success, safety, health benefits and cost effectiveness of novel techniques to open blocked coronary arteries that are considered untreatable through minimally invasive techniques.
Domestic violence deeply touched the life of Carol Stanford, M.D. ’79, when one of her colleagues was murdered many years ago.
At a Sept. 28 lecture at the UMKC School of Medicine, Stanford shared the story of that crime while exploring what physicians can do about the problem of intimate partner violence.
Stanford, delivering the 2017 Marjorie Sirridge Outstanding Women in Medicine Lecture, said such violence causes “tremendous emotional, social and economic dislocations” and crosses all demographic lines.
To illustrate that, Stanford told about reading a newspaper report of a “Johnson County soccer mom” who had been killed, and her businessman husband arrested. She found out a few hours later that the victim was her nurse practitioner.
“This is real and touches each of us,” said Stanford, associate professor at the School of Medicine. Most victims are women in heterosexual relationships, she noted, but men also can be victimized. Abuse also occurs in same-sex relationships and ones involving bisexual or transgender partners.
According to Stanford, 2 million women in the United States suffer intimate partner violence annually. Of those, more than 300,000 are pregnant women. One-third of homicides stem from intimate partner violence, Stanford said.
In their lifetimes, one in four women and one in seven men will experience severe intimate partner violence. By one estimate, the costs of care and economic loss from intimate partner violence are more than $8 billion a year. A victim’s health care needs can be increased for 15 years after such abuse, Stanford said.
She went on to say that it’s important for physicians to be aware and look for a wide range of physical symptoms that can indicate abuse, along with psychological problems, including depression, low self esteem, anxiety and substance abuse.
“I’ve started asking routinely, ‘Have you ever been abused?’ or ‘Do you feel safe in your relationship?’ ”
Prenatal care calls for particular vigilance, she said, given women’s vulnerability during that time. The safety of children in an abusive household also must be considered and physicians must report abuse if there are minor children.
In educating future physicians, Stanford said that it’s important to include clinical experience with victims, and suggested integrating more education about intimate partner violence into the curriculum. Students are becoming more aware of the issue through their community involvement, such as volunteering at such places as the Rose Brooks Center for domestic violence victims.
Stanford also said it was important for physicians to do their part because to raise awareness and battle domestic violence. An abused partner’s situation can be difficult and complicated, so a physician may provide a confidential ear, limited by the need to report child endangerment. The criminal justice system, a victim’s employer and other institutions simply can’t address the problem alone, she said.
Stanford also provided several resources to aid physicians in referring victimized patients for help.
“I think it’s important that we empower patients, because they are the expert on their own situation.”
As violent as the world is, Stanford says she is optimistic. “I think the key to solving this, ultimately, is gender equity. We need a multi-disciplinary educational approach.”
Stanford is a longtime faculty member and docent, known for her dedication to students and involvement with their activities. She has served as faculty adviser or sponsor for many students groups and programs, including the Gold Humanism Honor Society, the UMKC chapter of the American Medical Women’s Association and Camp Cardiac.
At the lecture she thanked her husband, James Stanford, M.D. ’80, and son, Ian Stanford, both in attendance. She also thanked the several members of the Sirridge family present and praised the late Drs. William and Marjorie Sirridge as giants in the success of the School of Medicine and its “humanistic approach to interacting with patients.”
The Marjorie S. Sirridge, M.D., Outstanding Women in Medicine Lectureship was established in 1997 to recognize her dedication, compassion and advancement of patient care and medical education in Kansas City.
It had been four years since Monica Lau Katamura, M.D., ’13, last stepped inside the UMKC School of Medicine. So when the school’s newest docent returned in August, she wasted little time in heading to the fourth-floor Gold 1 docent unit.
“One of the first things I did was go back to my old office and take a walk down memory lane,” Katamura said. “It was surreal coming back to the place that had trained me.”
Katamura completed her residency in medicine pediatrics at Tulane University in New Orleans last spring. Now, as the School of Medicine’s Blue 8 docent, she has a new office located on the fifth floor.
As a docent, Katamura said she fees a responsibility to take what she learned as a resident, combined with her time as a student at UMKC, to help the next generation of physicians.
“I want to come back and apply some of what I learned to assess the needs among my individual group of students and make a framework of how to best mentor them, guide them and nurture them through their years three through six,” she said.
Katamura served as chief resident during her final year at Tulane, where she gained administrative experience that she hopes to incorporate into her new role as a docent. She was active in numerous volunteer activities throughout her residency, serving both locally and abroad. She collaborated with pediatrics residency staff and co-residents on the clinical learning environment committee to improve clinical and academic learning environments and provided resident leadership as chair of the medicine-pediatrics ambulatory committee.
Ultimately, Katamura said, she returned to the School of Medicine largely because of the docent program and to be a part of the mentorship that docents provide students.
“Somebody told me that alumni are the most enthusiastic docents,” Katamura said. “I am very enthusiastic about coming back.”
She isn’t alone. Two more recent additions to the School of Medicine’s docent teams are alumni.
Richard Harlow, M.D., ’82, began his role as Green 1 docent this past November.
He was a founder and one of the original owners of HIMS, one of the first and largest hospitalist groups in the Kansas City metro area. After 20 years as a hospitalist, he was ready to return to his roots.
“I have always had medical students with me during my entire time in private practice and have always loved to teach,” Harlow said. “I really feel that the UMKC School of Medicine does a singularly excellent job of preparing students to be doctors on day one and I had always wanted to return one day to give back to what I so enjoyed. I really love working with the students and residents.”
After completing an internal medicine residency at the UMKC School of Medicine and Truman Medical Centers, Harlow entered private practice in Belton, Missouri. He also served as president of the medical staff at Research Belton Hospital and as chairman of the Department of Medicine at St. Joseph Hospital.
David John, M.D., ’77, returned to Kansas City last spring and joined the School of Medicine faculty as docent for Katamura’s old student unit, Gold 1. A board-certified rheumatologist for more than 30 years, John previously practiced at Queen’s Medical Center and at Spark Matsunaga V.A. Medical Center in Honolulu.
He said when the growing demands of electronic medical records began encroaching on his teaching time, he decided to step down from his hospital work and eventually decided to leave his private practice.
“Leaving was the hardest decision I believe I’ve ever made,” John said.
In January, John stepped down as Chair of Pu’ulu Lapa’au, the Hawaii’s Physican’s Health Committee, to return to UMKC.
“It’s been a very good decision,” he said.
While in Hawaii, John served as chair of the Life Foundation, an organization that continues the fight against HIV/AIDS, and participated as a board member of Friends of Youth Outreach, attacking the problem of child homelessness.
He completed his internal medicine residency at the University of Hawaii School of Medicine and his rheumatology fellowship at the University of Michigan. He joined the teaching faculty at the University of Hawaii in the department of medicine in 1984. There, he served on many committees and received the school’s Excellence in Teaching Award.