Authority on testosterone therapy research delivers Dodge lecture

-PRN, Lectureships, , , ,
Dr. Shalender Bhasin, M.B., B.S., delivered the 39th address in the Mark Dodge, M.D., Lectureship.
Dr. Shalender Bhasin, M.B., B.S., delivered the 39th address in the Mark Dodge, M.D., Lectureship.

This year’s Mark Dodge, M. D., Lectureship speaker represented excellence in patient care and a dedication to learning by sharing research findings on important questions regarding men and aging.

According to Dr. Shalender Bhasin, M.B., B.S., and the 39th annual Dodge lecturer, testosterone prescription sales have grown exponentially in the past decade, but research findings do not support general use in older men with low testosterone.

Testosterone prescription sales have grown exponentially in the past decade, but research findings do not support general use in older men with low testosterone, said Dr. Shalender Bhasin, M.B., B.S., in the 39th annual Mark Dodge, M.D., Lecture.

In his lecture Nov. 2 at the UMKC School of Medicine, “The Benefits and Risks of Testosterone Supplementation in Aging Men,” Bhasin provided an extensive review of recent research including three large random clinical trials.

Testosterone therapy is approved for men whose levels are greatly reduced by disease or ailments, but it appears that much of the recent increase in use has been for men whose testosterone levels are simply declining with age. And in those cases, Bhasin said, the research results are divided on whether, and how much, sexual, physical and cognitive functions can be improved through testosterone therapy.

Unknowns also remain on the long-term risk side of the equation, Bhasin said, including any increased chances for heart trouble or prostate cancer.

As a result, a policy promoting general use in older men with low testosterone does not seem indicated, said Bhasin, who led the Endocrine Society’s expert panel for the development of guidelines for testosterone therapy.

Over time, Bhasin said, more rigorous research could help reduce the unknowns. And in the meantime, physicians can consider prescribing testosterone therapy, case by case, for older patients “with appropriate discussion of the uncertainty of its risks and benefits.”

Bhasin also said societal questions needed to be addressed, involving what it means to be a man and to grow old, often with accompanying decline in sexual activity, vitality and cognitive function. And in his view, testosterone therapy and drugs such as Viagra have “a small but important role” to play as society tries to answer these larger questions.

Besides the Dodge Lecture, Bhasin, a professor of medicine at Harvard University, made presentations at Saint Luke’s Hospital and the University of Kansas Medical Center while he was in Kansas City.

Bhasin is an internationally recognized reproductive endocrinologist with expertise in testosterone biology, reproductive endocrinology and human aging. He is director of the Men’s Health: Aging and Metabolism Research Program and the Claude D. Pepper Older Americans Independence Center for Function-Promoting Therapies at the Brigham and Women’s Hospital in Boston.

The Dodge lecture series began in 1978 to honor Mark Dodge, M.D., a founding director of the Saint Luke’s Hospital Foundation for Medical Education and Research and an authority in internal medicine and endocrinology. Dodge’s insistence on excellence in care and dedication to learning made him an outstanding physician and sought-after adjunct professor. Friends in 1977 raised $130,000 to establish the lectureship. Before his death in 1980, Dodge was able to choose the first two lecturers in the series.

Everyday Ob/Gyn practices face complex ethical issues

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Susan Mou, M.D., delivered the 2006 Marjorie S. Sirridge (left), M.D., Outstanding Women in Medicine Lecture and was recognized afterward by Marilyn M. Pesto, director of the Sirridge Office of Medical Humanities and Bioethics.
Susan Mou, M.D., delivered the 2016 Marjorie S. Sirridge (left), M.D., Outstanding Women in Medicine Lecture and was recognized afterward by Marilyn M. Pesto, director of the Sirridge Office of Medical Humanities and Bioethics.

Physicians in obstetrics and gynecology continually face complex, evolving ethical questions, and they need thoughtful processes and diverse support to make their best decisions.

That was the message of Susan M. Mou, M.D., an associate professor in the School of Medicine’s Department of Obstetrics and Gynecology, who delivered the Marjorie S. Sirridge, M.D., Outstanding Women in Medicine Lecture on Sept. 15 at the school.

Mou started her address, “Ethics in Reproductive Medicine,” by saying she was a general obstetrician/gynecologist and “not a bioethical scholar.” Rather than offering answers, she wanted to share what’s going on “in the trenches” and get students thinking about ever-present ethical issues.

Mou said such issues and questions had existed throughout her career, starting with her residency at the University of Rochester, when steroid use for likely premature deliveries was relatively new. The questions have kept changing, she noted, with advances in many areas, from in vitro fertilization and reproductive endocrinology to HIV treatment.

Such questions often involve weighing possibly competing interests, Mou said, such as fetal health versus maternal health, or a mother’s autonomy and emotional needs versus what appears best for her physical health.

Difficult pregnancies make for difficult questions, such as when a fetal condition makes a live birth unlikely, and interventions to promote live birth might not be in the mother’s long-term health interests. But physicians must consider whether to take those steps, and how far to go with them, Mou said, when the mother has expressed a great desire for the chance to hold her live baby.

sirridgelecture_mo1According to Mou, the models for evaluating such questions also have evolved, so that a woman’s culture and living conditions and communal network can be considered, along with traditional principals such as autonomy, justice and beneficence.

Treatment and care can be more effective, for example, when they account for barriers such as transportation and work schedules, rather than judging a woman for missing neonatal care appointments. Mou also said approaches that see care for pregnant women as the best way to also care for their developing fetuses can overcome past perceptions of conflict between maternal and fetal well-being.

The growth of bioethics studies and decision committees has resulted in practicing physicians getting more help and support in making the toughest calls, Mou said.

“We need to be aware of ethical principles and practices. We need to utilize ethics committees and other resources. It’s so important to have the Sirridge Office of Medical Humanities & Bioethics” at the School of Medicine.

Though Mou claimed no credentials as a bioethicist, she has been a leader in women’s health teaching and treatment for more than three decades.

She is the director of the Breast Clinic and OB Simulation for Truman Medical Centers, and has special interests in general obstetrics and gynecology, pediatric and adolescent gynecology, peri-menopausal issues, vaginitis, and infection disease in obstetrics and gynecology.

Her Sirridge lecture followed more than 90 presentations she has given from coast to coast, including Milestones and STI Lectures at UMKC. Mou’s more than 60 publications include research studies, book chapters and abstracts. She provides peer review for the Journal of Maternal-Fetal & Neonatal Medicine and for abstracts for the American College of Obstetrics and Gynecology.

Mou began teaching at the School of Medicine in 1984. She was director of the school’s residency program in obstetrics and gynecology with Truman Medical Centers and Children’s Mercy Hospital from July 2012 to September 2014. Mou was section chief for gynecology surgery at Children’s Mercy in the 1990s.

Several members of the Sirridge family attended the lecture this year. The Marjorie S. Sirridge, M.D., Outstanding Women in Medicine Lectureship was established in 1997 to recognize Dr. Sirridge’s dedication, compassion and advancement of patient care and medical education in Kansas City.

 

Alumnus to present Sirridge Medical Humanities Lecture

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Daniel Hall-Flavin, M.D. '79
Daniel Hall-Flavin, M.D. ’79

Daniel Hall-Flavin, M.D. ’79, associate professor of psychiatry at the Mayo Clinic College of Medicine, will present the William T. Sirridge Medical Humanities Lecture at the School of Medicine at noon Thursday, March 26.

Reached by phone at the Mayo Clinic, Hall-Flavin said he planned to speak about the search for and meaning of mercy. He titled his lecture The Quality of Mercy, a nod to Shakespeare’s The Merchant of Venice. Hall-Flavin said he vividly recalls being a candidate for the B.A./M.D. program and seeing the famous passage from the play (“The quality of mercy is not strain’d/It droppeth as the gentle rain from heaven”) inscribed above the entrance to General Hospital No. 1.

“I remember at 17 looking at that and just stopping,” he said. “It just grabbed me. It was something that I’ve thought about frequently since then.”

Preserved when the hospital was torn down, the frieze stands outside Truman Medical Center. Hall-Flavin said the marker is more than a vestige to a building that that no longer exists. “I think it’s really kind of a daily reminder to everybody who walks through those portals of what a critical role mercy and all that it carries with it plays in our daily practice,” he says.

After graduating from UMKC, Hall-Flavin interned in internal medicine and trained in adult psychiatry at the Mayo Clinic. He completed a fellowship in chemical dependency at Cornell University. Board-certified in addiction psychiatry, he is involved in research that seeks to identify factors, including genetic factors, which render an individual susceptible to addiction and relapse. He also studies responsivity to antidepressant medication.

Hall-Flavin said he is at a point in his career where he is able to begin to cut back on his duties at the Mayo Clinic. He hopes to use the extra time to pursue his interests in the medical humanities and bioethics. He recently applied to a master’s program in the medical humanities at King’s College in London. A frequent traveler to England, Hall-Flavin has been a visitor at a center for neuroethics at the University of Oxford and is a member of the Oxford Round Table, an American-led educational organization.

Hall-Flavin said his interests in the medical humanities and bioethics are “a natural extension of how I was trained.” His docent was the late Marjorie Sirridge, M.D. Sirridge and her husband, William Sirridge, M.D., who died in 2007, worked to increase the opportunities for UMKC students to study humanities and bioethics and eventually established the Sirridge Office of Medical Humanities and Bioethics. The William T. Sirridge, M.D., Medical Humanities Lectureship was established in 1994.

Hall-Flavin said he met with Marjorie Sirridge in early 2014, a few months before she died. “She asked me to consider doing the lecture,” Hall-Flavin said. “I said it would be an honor.”

Dean’s Lectureship Series

-Events, Lectureships
Alpha Omega Alpha Lectureship

The Alpha Omega Alpha Lectureship replaces noon conference the day after the AOA Annual Induction Dinner in May. The national AOA Honor Medical Society provides guidelines and activity requirements for the speakers each year. For example, the speaker may need to discuss clinical rounds, research discussions, teaching conferences or seminars and lead one or more sessions on leadership and/or medical professionalism. The featured AOA speaker attends the induction dinner, meets with AOA and Gold Humanism Honor Society members the next morning and presents the noon lecture.

The AOA was founded in 1902 and is dedicated to the belief that the profession of medicine will improve patient care by recognizing high educational achievement, honoring gifted teaching, encouraging the development of leaders in academia and the community, supporting the ideals of humanism and promoting service to others.

E. Grey Dimond, M.D., Take Wing Award Lectureship

The award recognizes an alumnus/a who has demonstrated excellence and surpassed the expectations of peers in the practice of medicine, academic medicine or research. Each May, during graduation week, the Take Wing recipient receives an engraved Take Wing statue, presents the annual E. Grey Dimond, M.D., Take Wing Lecture, and makes a brief speech to the graduating class during the commencement ceremonies.

Mark Dodge, M.D. Lectureship

Mark Dodge, M.D., was a respected specialist in internal medicine and endocrinology. During his 29 years at Saint Luke’s Hospital, he was a teacher and clinician held in high esteem by both patients and the medical community. In 1978, two years before his death, the Saint Luke’s Foundation established the Mark Dodge Fund for Medical Education. Each year, this fund sponsors the Dr. Mark Dodge Lectureship, offering the opportunity for area health care professionals to hear a nationally recognized authority in the field of endocrinology.

William H. Goodson, Jr., M.D.,  Lectureship

William Goodson, Jr., M.D., practiced medicine in the Kansas City area for more than 45 years.  Specializing in internal medicine, Dr. Goodson was associated with Trinity Lutheran Hospital for much of his career. His family, patients, colleagues and friends established the William H. Goodson, Jr., M.D., Annual Lectureship to honor him and his many contributions to the field of medicine in the community. The lectureship provides current and future practitioners scholarly perspectives and information related to internal medicine. Dr. Goodson died in 1985, and the first lecturer was in 1987.

He practiced as a consultant in the Arthritis Clinic at the Kansas City General Hospital (later to become TMC) until 1961 and was a member of the Arthritis and Rheumatism section at the University of Kansas for 25 years. He was a docent at the University of Missouri–Kansas City School of Medicine, from 1980 to 1982.

W. Kendall McNabney, M.D., Lectureship

The W. Kendall McNabney, M.D., Lectureship recognizes McNabney, the founder of theDepartment of Emergency Medicine at Truman Medical Center (TMC) and the UMKC School of Medicine. McNabney was the first and longest serving chair of emergency medicine at the School and was the head of Trauma Services for many years.

Robert Schwab, M.D., TMC emergency medicine chair from 2000 to2006, started this lectureship, which began in 2006.

Marjorie S. Sirridge, M.D. Outstanding Women in Medicine Lectureship

The UMKC School of Medicine, in conjunction with the Metropolitan Medical Society board of trustees, established the Marjorie S. Sirridge Outstanding Women in Medicine Lectureship in 1997 to recognize her dedication, compassion and advancement of patient care and medical education in Kansas City. This lectureship attracts high quality lecturers to the School each year to discuss issues affecting women in medicine and women’s health.

Dr. Sirridge was a founding docent and former dean of the School of Medicine. She and her late husband, Dr. William Sirridge, founded the Sirridge Office of Medical Humanities in 1992 to help students mature with both personal wellness and empathy toward their patients. The office coordinates courses that revolve around literature, art, and humanism in healing.

William T. Sirridge, M.D., Medical Humanities Lectureship

At the behest of Dr. William Sirridge, the William T. Sirridge, M.D. Medical Humanities Annual Lectureship endowment was established in July 1994 through an initial gift of $10,300 from the Hospital Hill Health Services Corporation, which was later renamed to the University Physician Association. Dr. Sirridge also forewent his salary in order for the money to go into this endowment. The first William Sirridge Lecture coincided with the Alumni Reunion Weekend that included the Humanities in Medicine Conference in September 1994.

Dr. Sirridge, who passed away in April 2007, and his wife, Marjorie Sirridge, M.D., founded the Sirridge Office of Medical Humanities in 1992 to help students mature with both personal wellness and empathy toward the patients they will be called upon to serve. The office coordinates courses that revolve around literature, art, and humanism in healing.

Dr. Reaner & Mr. Henry Shannon Lectureship in Minority Health

Former Associate Dean for Cultural Enhancement and Diversity Reaner Shannon, Ph.D., has a history of commitment to the School of Medicine and to the community by sponsoring minority health lectureships and coordinating programs for underserved students throughout the Kansas City area. When Dr. Shannon retired from the School in 2006, after more than three decades of service, she and her husband ensured the legacy of serving the minority community by establishing an endowment for the annual Dr. Reaner and Mr. Henry Shannon Lectureship in Minority Health to draw attention to disparities in health and health care. Through this lectureship, held the last Friday in February, medical professionals, students, residents and the local community gain access to information about timely issues that impact the underserved and minority communities.