Internal Medicine
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internal medicine 2 O 1 1 A N N U A L R E PO RT TABLE O F CO NTENTS Chair’s Report 2 Clinical Programs 4 Faculty Affairs 6 Veterans Affairs 8 Basic & Translational Research 10 Clinical Research 12 Graduate Medical Education 14 Patient Care 20 Research 38 Education 56 Outreach 62 Department Updates 73 Chair’s REPO RT John Carethers, MD Chair CONTINUED RECOGNITION When U.S. News & World Report recently released their rankings of medical schools and medical school specialties, the U-M Department of Internal Medicine was ranked 6th overall nationally, tying our rank for last year, and a repeat of our highest rank in more than 10 years. U-M’s Medical School tied for 10th overall for research medical schools, and 8th overall for primary care medical schools. This recognition by our peers and others is a testament to our efforts to make U-M the best place for education and training, for clinical care, and for research. This past year, 2011, was no exception. Some of our most notable efforts included: MAKING U-M A DESTINATION leadership and extensive research efforts related to Our 2011 annual report’s theme is “Destination Internal metabolic diseases such as obesity (page 40). Medicine.” I wanted to feature our department’s participation in numerous Destination Programs, or RESEARCH GROWTH Centers of Excellence, that are being highlighted by Our research funding and efforts are still going the U-M Health System. These amazing multi- strong. Some of our research groups have moved or disciplinary programs are bringing the best of U-M’s are planning to move to U-M’s North Campus research and clinical care expertise together to create Research Complex to take advantage of NCRC’s the ideal patient experience (page 22). new facilities and their many advantages (page 50). ADDRESSING NATIONAL EPIDEMICS BUILDING A STRONG FOUNDATION Two stories in this year’s report focus on how our Internal Medicine continues to play a vital part in department is contributing to groundbreaking work cultivating the next generation of clinicians and addressing health issues that are contributing to researchers through our extensive role in teaching at major health problems throughout the U.S. the U-M Medical School (page 58) and in our training population. One describes our work with U-M’s Sleep of 280 residents and fellows (page 14). Disorders Center (page 31) and the other details our 2 2011 Internal Medicine Annual Report PIONEERING ACOs HONORING FACULTY The Department of Internal Medicine Two Internal Medicine faculty Caroline Blaum, MD, Our department is pleased to announce that the is healthy, and continues to grow in and David Spahlinger, MD, have been dedicated to Laurence H. Baker Collegiate Professorship in its missions of research, education, exploring how Accountable Care Organizations Cancer Developmental Therapeutics in the Division of and clinical care. Our high national (ACOs) can save money while improving patient care Hematology/Oncology has been established in rankings speak volumes about the through demonstration projects at U-M. Their efforts recognition of Dr. Baker’s impressive contributions to great work that goes on here every have been so successful that U-M has been chosen medical oncology and his leadership in clinical cancer day. As “leaders and best,” our as the site of the Centers for Medicare & Medicaid research, patient care, and education at U-M (page department is setting a national Services Innovation Center’s Pioneer ACO Model 76). After four decades of extraordinary service to U-M trend by being at the forefront of (page 36). and the Division of Gastroenterology, Timothy T. innovation of medicine in everything Nostrant, MD, retired from active practice to join his that we do. Many of the stories in NEW APPOINTMENTS family in South Carolina. The department hosted a this report help illustrate how we’re Raymond Yung, MB, ChB, was appointed as Chief two-day event last fall to celebrate his career, making that possible. of the Division of Geriatric and Palliative Medicine and achievements, and many contributions at U-M (page Co-Director of the Geriatrics Center on Nov. 1, 2011. 77). He succeeds Jeffrey B. Halter, MD, who served as Chief of the Division of Geriatric Medicine since its A FEW FAREWELLS inception in 1984 and remains Director of the U-M Our department sadly lost two outstanding faculty Geriatrics Center (page 74). The Division of members this past year. Giles G. Bole, an emeritus Rheumatology announced the appointment of faculty and former Dean of the U-M Medical School Dinesh Khanna, MD, MS, as Director of the who specialized in arthritis research and rheuma- Scleroderma Program in July 2011. Khanna is tology, passed away on June 8, 2011. Galen B. Associate Professor of Medicine and Marvin and Toews, MD, FACP, a pioneering lung researcher who Betty Danto Research Professor (page 75). led our Division of Pulmonary and Critical Care Medicine for more than 20 years, passed away Oct. 12, 2011. They both contributed significantly to our department and will be dearly missed (page 78). 2011 Internal Medicine Annual Report 3 CLINICAL PRO GRAMS Timothy J. Laing, MD Senior Associate Chair for Clinical Programs fter several years of major growth our clinical programs remained relatively stable in Health System’s newest health center will A 2011. The amount of ambulatory care services provided dropped slightly while our also offer a new musculoskeletal program specialty care services both on- and off-site continued to grow. While our outpatient facilities combining the specialties of rheumatology, in Ann Arbor (Briarwood and Domino’s Farms), Livonia, and Brighton continue to perform orthopedic surgery, and physical medicine; well, there are new efforts to establish facilities in the Northville area. In addition to this, there eye care; radiology services; an infusion for are several other plans underway that will help us meet our patients’ growing needs and cancer and non-cancer treatment; and a improve their care experience. medical procedure unit. NORTHVILLE EXPANSION center in Northville Township, near our TAUBMAN IMPROVEMENTS The U-M Health System is existing Livonia Center for Specialty Care. When the new C.S. Mott Children’s Hospital expanding its primary and and Von Voigtlander Women’s Hospital specialty patient care in The new facility will include 100,000 square opened this past December 2011, outpatient Metro Detroit with the feet of clinical and diagnostic space clinics for women, newborns, and children construction of a new dedicated to caring for adults and children. In moved there—opening up nearly 30,000 $39 million health addition to primary and specialty care, the square feet of space in the Taubman Center. 4 2011 Internal Medicine Annual Report The U-M Health System is investing $20.5 As part of this effort, there are plans to clinical focus areas involve Internal Medicine. higher quality care, while reducing growth in million to renovate, reorganize, and revitalize update and redesign 27,500 square feet on They include transplant, critical care expenditures through enhanced care this space. the third floor where many clinics run by the medicine, digestive diseases, cardiovascular coordination. Caroline Blaum, MD, Professor Department of Internal Medicine will be medicine, and oncology. of Internal Medicine and Geriatrics will serve The south end of the first floor will be renovated to improve the patient experience as the Medical Director of the U-M/IHA converted to a multidisciplinary Transplant and the efficiency of clinic operations. This PIONEER MODEL Pioneer ACO (page 36). Center clinic by the end of summer 2013. includes areas for gastroenterology, general It was also announced in 2011 that U-M will This will provide one-stop access to medicine, pulmonary medicine, nephrology, participate in the Pioneer Accountable Care It is through these many efforts to specialized care for patients who are waiting infectious diseases and overseas travel, Organization (ACO) model, in partnership with grow, improve, collaborate, and for or have received an organ transplant at medical genetics, and rheumatology. IHA Health Services Corporation. The Pioneer innovate that the U-M Department of UMHS. Also new will be an outpatient ACO Model is sponsored by the Centers for Internal Medicine continues to infusion area. This will be the third such clinic STRATEGIC PLAN Medicare & Medicaid Services (CMS) provide some of the best patient opened by UMHS to help meet rising The Health System released the core of the Innovation Center. U-M and IHA will work with care and clinical programs in the demand for such care. UMHS Strategic Plan and five of the seven CMS to provide Medicare beneficiaries with state and the nation. 2011 Internal Medicine Annual Report 5 FACULTY AFFAIRS Richard H. Simon, MD Associate Chair for Faculty Affairs he Department of Internal Medicine has realized phenomenal growth over the past four academic progress and a general T academic years. We continue to increase the size of our clinical faculty while our research Performance Review Committee appraises faculty numbers are stable. The chart at right breaks down that growth by year and by faculty all aspects of their professional activities. To type. In total, the department has added 97 positions during this period. assist the faculty in improving their professional abilities, the Department has ADVANCING DIVERSE through initiatives that develop strategies to been developing leadership training PERSPECTIVES seek out and recruit the best faculty programs that among other areas The diversity of the faculty within the candidates from all demographic groups. emphasizes improving communication skills. Department of Internal Medicine has been We have been strongly supporting the general slowly expanding. The number of women DEVELOPING CAREERS efforts of the Medical School that launched a and under-represented minorities in our The Department continues to utilize peer new faculty career development website this higher academic ranks have been review committees to deliver constructive past year.