Integrating Primary Care and Biomedical Research
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University of Massachusetts Medical School eScholarship@UMMS History of UMass Worcester Office of Medical History and Archives 2012 The University of Massachusetts Medical School, A History: Integrating Primary Care and Biomedical Research Ellen S. More University of Massachusetts Medical School Let us know how access to this document benefits ou.y Follow this and additional works at: https://escholarship.umassmed.edu/umms_history Part of the Health and Medical Administration Commons, and the History of Science, Technology, and Medicine Commons Repository Citation More ES. (2012). The University of Massachusetts Medical School, A History: Integrating Primary Care and Biomedical Research. History of UMass Worcester. https://doi.org/10.13028/e2m6-hs02. Retrieved from https://escholarship.umassmed.edu/umms_history/1 Creative Commons License This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License. This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in History of UMass Worcester by an authorized administrator of eScholarship@UMMS. For more information, please contact [email protected]. The University of Massachusetts Medical School, A History: Integrating Primary Care and Biomedical Research Ellen S. More The Lamar Soutter Library University of Massachusetts Medical School The University of Massachusetts Medical School, A History: Integrating Primary Care and Biomedical Research Ellen S. More Lamar Soutter Library University of Massachusetts Medical School 2012 http://escholarship.umassmed.edu/umms_history/1/ This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License. Table of Contents Introduction …………………………………………………………………………………….......... 1 Part 1 (1962-1970) Chapter 1—Does Massachusetts Really Need Another Medical School?......... 6 American Medical Education at a Crossroads: the 1950s and Sixties ....... 6 The “New” Generation of Medical Schools ................................................. 11 Politics, Medical Education and the Commonwealth................................. 17 Politics, Medical Education, and the University of Massachusetts............ 27 Chapter 2—Lamar Soutter…………………………………………………………………... 48 Chapter 3—Why Worcester?........................................................................... 80 Anywhere but Boston ................................................................................. 81 Strange Bedfellows: Staking a Claim for Worcester................................... 83 Organized Labor.......................................................................................... 87 Politics, As Usual......................................................................................... 93 “You can’t learn to play the piano, unless you have a piano”.................... 98 The Vote and its Aftermath........................................................................ 109 Chapter 4— A “Sort of Schizophrenia”: What Makes a Medical School ‘First Class’?.................................................................................................. 133 Scandalous Designs.................................................................................... 138 “Progress and Problems”............................................................................ 142 “A Long, Hard Look”................................................................................... 151 Part 2 (1970-2015) Chapter 5—University Hospital, 1976-1998………………………………………….. 172 Background................................................................................................. 172 Construction Budget Battles: 1967-1972.................................................... 174 Dean Soutter vs. President Wood............................................................... 177 The Deal: A Tertiary Care Hospital for a Primary Care School................. 185 Opening the Hospital.................................................................................. 193 Staff and Program Development................................................................ 201 Nursing....................................................................................................... 213 Solidifying the Hospital’s Position: 1976-1986.......................................... 216 The Challenges of Cost Containment, 1987-1992...................................... 227 A Divorce or a Merger? Privatization from 1993-1998.............................. 235 Chapter 6—Integrating Primary Care into the Curriculum: Community Medicine vs. Family Medicine………………………………………………………….... 272 Great Expectations, Unclear Goals............................................................. 273 Community Medicine and Medicine for the Community.......................... 275 Family Medicine Comes to Massachusetts................................................ 283 From General Practice to Family Practice................................................. 285 Dick Walton’s Umbrella: Founding Family Medicine at UMass............... 292 Shaping a new Residency........................................................................... 300 Family Medicine Secedes from the Union................................................. 307 Chapter 7—Primary Care Education Hits its Stride……………………………..... 327 Reuniting Family Medicine and Community Medicine............................ 328 In from the Margins: Primary Care in Internal Medicine and Pediatrics............................................................................................. 337 Primary Care at UMass Med: Beyond Family Practice............................. 343 Primary Care in the Undergraduate Medical Curriculum........................ 350 The Generalist Physician Initiative........................................................... 354 Chapter 8—Becoming a Research University, Part 1: 1970-1990…………….. 372 Research on a Shoestring........................................................................... 372 Growing Pains: the 1980s.......................................................................... 383 A Fork in the Road..................................................................................... 393 James Dalen and the Clinicians’ Perspective: the Road not Taken.......... 401 The Stress Reduction Clinic and the Birth of Mindfulness in Health Care................................................................................................ 404 A Painful Transition................................................................................... 412 Chapter 9—Becoming a Research University, Part 2: 1990-2012………….... 436 Aaron Lazare: Finding a Balance among Stakeholders............................ 436 Research of “National Distinction”........................................................... 442 AIDS Research and Therapy, 1987-present.............................................. 443 The Program in Molecular Medicine......................................................... 453 The Worcester Foundation for Biomedical Research, 1944; 1997-.......... 467 MassBiologics, 1895; 1997-........................................................................ 471 Commonwealth Medicine, 1999-............................................................... 473 Chapter 10—Education: Students, Faculty, Curriculum………………………... 496 Medical Education in the United States: Flexner and Beyond................. 497 The Shaw Building Years, 1970-1974, Early Curriculum.......................... 500 Students..................................................................................................... 504 Faculty........................................................................................................ 523 The Integration of Preclinical and Clinical Education, 1978-1990........... 532 Thoroughgoing Curriculum Reform, 1990-2005...................................... 536 Medical Education since 2005: LInC, Global Health, and Learning Communities....................................................................... 543 From Affirmative Action to Diversity and Equal Opportunity................. 551 Underrepresented Minorities............................................................... 551 Gender Equity....................................................................................... 558 The Graduate School of Nursing.............................................................. 567 Founding the Graduate School of Nursing, 1965-1985........................ 567 Growing the GSN—1985-2010.............................................................. 569 The Graduate School of Biomedical Sciences............................................ 575 Lamar Soutter Library.............................................................................. 584 Chapter 11—Conclusion: An Academic Health Science Center, Honoring the Past, Looking to the Future…………………………………………... 618 Appendix A……………………………………………………………………………………... 636 Appendix B…………………………………………………………………………………….... 641 Acknowledgments…………………………………………………………………………... 642 Index…………………………………………………………………………………………….... 644 Introduction IN 2009, The New York Times ran the following headline: “Doctor Shortage Proves Obstacle to Obama Goals. Primary Care Lacking.” The story ran as the lead on page one. In Massachusetts, according to the Worcester Telegram and Gazette, new patients wait an average of 43 days to be seen by a primary care physician. To anyone in America old enough to remember the 1950s and ’60s the situation will seem familiar, as