RHODE ISLAND M EDICAL J OURNAL FEEDING OVERVIEW OF HYPERBARIC CHILDREN IN MEDICINE CENTER AT KENT HONDURAS PAGE 13 PAGE 19 BUTLER CREATES ARONSON CHAIR PAGE 44 GOOGLE GLASS MAGAZINER: IN RIH ED FIXING HEALTH CARE PAGE 47 PAGE 45 APRIL 2014 VOLUME 97• NUMBER 4 ISSN 2327-2228 Some things have changed in 25 years. Some things have not. Since 1988, physicians have trusted us to understand their professional liability, property, and personal insurance needs. Working with multiple insurers allows us to offer you choice and the convenience of one-stop shopping. Call us. 800-559-6711 rims I B C RIMS-INSURANCE BROKERAGE CORPORATION Medical/Professional Liability Property/Casualty Life/Health/Disability RHODE ISLAND M EDICAL J OURNAL 7 COMMENTARY An Up-Front Guide to Getting Promoted: Slow and Steady JOSEPH H. FRIEDMAN, MD By the Sweat of Your Brow STANLEY M. ARONSON, MD 41 RIMS NEWS CME: Eleventh Hour Education Event RIMS at the AMA National Advocacy Conference Why You Should Join RIMS 54 SPOTLIGHT Jordan Sack, MD’14: His early struggles with deafness and those who inspired him to help others 61 Physician’s LEXICON The Manifold Directions of Medicine STANLEY M. ARONSON, MD 63 HERITAGE Timeless Advice to Doctors: You Must Relax MARY KORR RHODE ISLAND M EDICAL J OURNAL IN THE NEWS BUTLER HOSPITAL 44 51 JAMES F. PADBURY, MD creates Aronson Chair for receives March of Dimes Neurodegenerative research grant Disorders 52 BRENNA ANDERSON, MD IRA MAGAZINER 45 studies Group A strep on how to fix health care in pregnancy LIFESPAN 47 creates Clinical 52 SAMUEL C. DUDLEY, MD, PhD Research Center investigates cancer drug RI HOSPITAL 47 52 BRADLEY HOSPITAL testing Google Glass in ED receives $3.4M grant SECURE DIRECT 48 53 DWIGHT J. ROUSE, MD messaging hits million milestone co-authors Obstetric Care Consensus PEOPLE DINO MESSINA, MD, PhD 57 58 REBECCA L. BURKE, RN, MS joins Memorial as named Kent Sr. V-P, chief assoc. program director nursing officer MELISSA M. MURPHY, MD, MPH 57 58 BRIAN K. REED, MD joins Kent Hospital joins Kent Hospital GEORGE VALENTIN 57 CRISTESCU, MD joins Kent Hospital APRIL 2014 VOLUME 97 • NUMBER 4 RHODE ISLAND Rhode Island Medical Society R I Med J (2013) 2327-2228 M EDICAL OURNAL PUBLISHER J 97 RHODE ISLAND MEDICAL SOCIETY 4 WITH SUPPORT FROM RI DEPT. OF HEALTH 2014 PRESIDENT April ELAINE C. JONES, MD 1 PRESIDENT-ELECT PETER KARCZMAR, MD VICE PRESIDENT CONTRIBUTIONS RUSSELL A. SETTIpaNE, MD 13 The Kent Hospital Wound Recovery and Hyperbaric Medicine SECRETARY ELIZABETH B. LANGE, MD Center: A Brief Overview, 1998–2013 LISA J. GOULD, MD, PhD; CATHERINE DECIANTIS, RN, CHRN; TREASURER JOSE R. POLANCO, MD RONALD P. ZINNO, MD; GEORGE A. PERDRIZET, MD, PhD IMMEDIATE PAST PRESIDENT ALYN L. ADRAIN, MD 19 Successes and Challenges to Implementing an Early Childhood EXECUTIVE DIRECTOR Supplemental Feeding Program in Rural Honduras: NEWELL E. waRDE, PhD A Qualitative Study EDITOR-IN-CHIEF HARAN MENNILLO; FADya EL RayESS, MD, MPH JOSEPH H. FRIEDMAN, MD ASSOCIATE EDITOR 24 Post-Traumatic Raynaud’s Phenomenon Following Volar Plate Injury SUN HO AHN, MD YOSEF G. CHODAKIEWITZ, BA, MD’15; AlAN H. DANIELS, MD; EDITOR EMERITUS ROBIN N. KAMAL, MD; ARNOLD-PETER C. WEISS, MD STANLEY M. ARONSON, MD PUBLICATION STAFF 27 Parents’ Vaccine Beliefs: A Study of Experiences and Attitudes among MANAGING EDITOR MARY KORR Parents of Children in Private Pre-Schools [email protected] CATHERINE ROGERS GRAPHIC DESIGNER MARIANNE MIGLIORI 31 Quality of Internet Health Information on Thumb Carpometacarpal ADVERTISING Joint Arthritis STEVEN DETOY SARAH STEVENS ROBIN N. KAMAL, MD; GABRIELLE M. PACI, MD; ALAN H. DANIELS, MD; MICHELLE [email protected] GOSSELIN, MD; MICHAEL J. RAINBOW, PhD; ARNOLD-PETER C. WEISS, MD EDITORIAL BOARD STANLEY M. ARONSON, MD, MPH JOHN J. CRONAN, MD PUBLIC HEALTH JAMES P. CROWLEY, MD EDwaRD R. FELLER, MD 36 Health Risk Profile of Rhode Island’s Working Poor JOHN P. FULTON, PhD TaRA COOPER, MPH; YONGWEN JIANG, PhD; BRUCE CRyaN, MBA, MS; PETER A. HOLLMANN, MD KENNETH S. KORR, MD SAMARA VINER-BROWN, MS MARGUERITE A. NEILL, MD FRANK J. SCHABERG, JR., MD 40 LawRENCE W. VERNAGLIA, JD, MPH Vital Statistics NEWELL E. WARDE, PhD COLLEEN A. FONTANA, STATE REGISTRAR RHODE ISLAND MEDICAL JOURNAL (USPS 464-820), a monthly publication, is owned and published by the Rhode Island Medical Society, 235 Promenade Street, Suite 500, Providence RI 02908, 401-331-3207. All rights reserved. ISSN 2327-2228. Published articles represent opinions of the authors and do not necessarily reflect the official policy of the Rhode Island Medical Society, unless clearly specified. Advertisements do not im- ply sponsorship or endorsement by the Rhode Island Medical Society. Advertisers contact: Sarah Stevens, RI Medical Society, 401-331-3207, fax 401-751-8050, [email protected]. Maybe It’s Time For A Second Opinion? You protect your patients - We’ll cover you. he Rhode Island Medical Society and Butler & Messier Insurance are offering an exclusive CONCIERGE PROGRAM for all your insuranceT needs. Everyone in the Rhode Island medical community is eligible for the best rates for your home and auto insurance, as well as your office policies. For a no obligation second opinion call 401.728.3200 or visit ButlerandMessier.com/rims. Exclusive Insurance Partners www.ButlerandMessier.com COMMENTARY An Up-Front Guide to Getting Promoted: Slow and Steady JOSEPH H. FRIEDMAN, MD [email protected] 7 8 EN The following is a report Keywords: initial protocol called for photos at the presented at the annu- seating arrangements, beginning or the end of the presenta- al American Academy academic promotions, tion but that captured only half the of Medical Faculties’ aging, junior faculty maximum audience and was modified meeting held recently shortly after the project began. Faculty in Boston. Aim who sat halfway or more towards the To determine if promo- rear were then randomly assigned to Abstract tions among academic either maintain their current seat or to For many years there faculty at a medical school move to a row in the front quarter of has been a debate about were influenced by seat- the room. No other intervention was the explanation for the ing arrangements at de- made. Faculty were then tracked for common observation that partmental grand rounds. promotion. The data-analysis commit- faculty who sit nearer the front of the tee was kept blinded to assignment. A conference room at departmental grand Methods sample-sized calculation revealed that rounds are more likely to have higher The deans of every medical school in 4,356 subjects would be required with an academic rank. There is an obvious cor- the U.S. were informed of this study attendance record of 50% over 10 years relation between rank and age, so that and asked to submit a letter indicating to achieve a p value under .05 if standard the natural tendency of older faculty to interest in participating. Of the 141 statistical analyses were performed. be closer to the front in order to hear accredited medical schools and 30 ap- Therefore, a dichotomous, minimalist, and see better poses one confounding proved schools of osteopathy, 55 chose forced-choice regression analysis using variable. But the underlying questions to participate. All were asked to submit Friedman’s parametric Manichean-fold – whether faculty who sit closer to the attendance records for the preceding six distortion-free universal constants was front get promoted because they sit months. To qualify, fulltime faculty had chosen, reducing the number required closer or choose to sit closer in order to to have maintained a 50% attendance to 86. In addition to this analysis, bar get promoted or sit closer because they record in each department. Using this graphs were also employed. feel more engaged and want to partic- criterion, only 3 universities qualified. ipate rather than be more passive, or Attendance requirements were reduced Outcome nap – has never been addressed. It is akin to 30% in each department and then to 880 subjects were enrolled, of whom 640 to a nature/nurture question, but the 25% in half the departments. At this were still participating by the end of the truth of the observation has never been level of attendance, 14 programs met study. There were 324 faculty who sat supported by data. The following study, criteria. However, only 10 were able to in the back of the room and remained financed by the Academy, was intended obtain IRB approval (See* below). in the back of the room. The remaining to answer this contentious question and In each department photos were 316 were asked to move to the front. Of provide a path forward. taken of the conference room halfway note was the difference in the percent- Fifteen years ago the Academy funded through a baseline presentation. The ages of junior faculty who, before the a large study to investigate this question via a long-term, multi-center trial. The *IRB approval was not obtained within the 18-month limit at 4 universities due to the following is an analysis of the results. need for approval from multiple different hospital IRBs. WWW.RIMED.ORG | RIMJ ARCHIVES | APRIL WEbpagE APRIL 2014 RHODE ISLAND MEDICAL JOURNAL 7 COMMENTARY study, sat in the front versus the back in The odds ratio for promotion to assistant of the room. A decision on how to move the different departments (e.g., 90% of professor was far less skewed. forward will be rigorously discussed at general surgery junior faculty sat in the the next CoPOut meeting, to be held first two rows whereas 90% of pediatri- Discussion this summer. cians sat in the last two rows). Of those These results indicate that junior faculty who moved to the front, 123 ended up who sit in the back of the grand rounds Respectfully submitted, moving to the back of the room.