DEPARTMENT OF MEDICINE 2018 Annual Report DIVISIONS AND INSTITUTES The Divisions » Cardiology James Udelson, MD » Clinical Care Research Harry Selker, MD » Clinical Decision Making John Wong, MD » Clinical Nutrition Edward Saltzman, MD » Endocrinology, Diabetes and Metabolism Ron Lechan, MD » Gastroenterology Joel Weinstock, MD » Geographic Medicine and Infectious Diseases David Snydman, MD » Hematology/Oncology Rachel Buchsbaum, MD » Internal Medicine and Adult Primary Care Deborah Blazey-Martin, MD » Nephrology Andrew Levey, MD » Palliative Care Tamara Vesel, MD » Pulmonary, Critical Care and Sleep Medicine Nicholas Hill, MD » Rheumatology, Allergy and Immunology Timothy McAlindon, MD The Institutes » Institute for Clinical Research and Health Policy Studies Harry Selker, MD » Molecular Cardiology Research Institute Iris Jaffe, MD, PhD TABLE OF CONTENTS The Department of Medicine Chairman’s Message 4 Diversity and Inclusion Efforts 6 Departmental Leadership 8 Departmental Organization Chart 9 Clinical Activity 13 Research Activity 15 Internal Medicine Training Program 17 The Divisions Cardiology 20 Clinical Care Research 36 Clinical Decision Making 38 Clinical Nutrition 42 Endocrinology, Diabetes and Metabolism 46 Gastroenterology 54 Geographic Medicine and Infectious Diseases 60 Hematology/Oncology 70 Internal Medicine and Adult Primary Care 84 Geriatrics 92 William B. Schwartz Division of Nephrology 94 Palliative Care 104 Pulmonary, Critical Care and Sleep Medicine 108 Rheumatology, Allergy and Immunology 118 The Institutes Institute for Clinical Research and Health Policy Studies 130 Molecular Cardiology Research Institute (MCRI) 142 Publications 152 3 CHAIRMAN’S MESSAGE 2018 saw a major leadership change at Tufts Medical Center. The longtime CEO, Michael Wagner, MD, transitioned to the Chief Physician Executive and eventually Interim » CHAIRMANS CEO role at our parent corporation, Wellforce, which has grown recently with the addition of several new hospitals. During the national (and, as it turned out, MESSAGE international) search for a new CEO, I was asked to serve as interim co-CEO of the Deeb N. Salem, MD, FACP, FACC, FACCP— The Sheldon M. Wolff Professor and medical center for several months. It was a truly gratifying experience, but I was Chairman, Department of Medicine also very happy to return to my regular role in the department of medicine. In November, Dr. Michael Apkon, an accomplished physician and leader who was CEO of the Toronto Children’s Hospital, was named CEO of Tufts Medical Center. In the Department of Cardiology and the affiliated Center for Cardiovascular Research, there was continued high volume and outstanding outcomes in cardiac transplantation and ventricular assist devices. Tufts Medical Center also enjoyed the highest volume in the world of new patient referrals for hypertrophic cardiomyopathy, as well as a growing volume of myomectomies and surgical ablations. The transcatheter aortic valve replacement program grew and the Watchman left atrial occlusion device program was initiated. The expertise of the Division of Clinical Decision-Making was recognized by the membership of its Chief, Dr. John Wong, on multiple prestigious panels to evaluate the utility of various disease-preventive measures, cardiac imaging procedures and liver disease. The Division of Endocrinology, Diabetes and Metabolism continued its landmark NIH-supported studies of the effects of vitamin D supplementation on the risk of diabetes, cancer and cardiovascular disease and on muscle performance in older adults. Under the leadership of the Division of Geographic Medicine and Infectious Diseases, the Antimicrobial Stewardship Program was initiated and was one of 20 institutions given an Antimicrobial Stewardship Center of Excellence Award by the CDC. For her leadership in this effort, Dr. Gabriela Andujar was recognized by an award from the IDSA and CDC. Tufts University School of Medicine and Tufts Medical Center jointly founded the Center for the integrated Management of Antimicrobial Resistance under the leadership of Helen Boucher, MD and Ralph Isberg, PhD. Dr. Rachel Buchsbaum was named the Dr. Jane DesForges Chair in Hematology/ Oncology and became the new chief of the division. TUFTS MEDICAL CENTER DEPARTMENT OF MEDICINE — ANNUAL REPORT 2018 The Division of Internal Medicine and Adult Primary Care added a new primary care physician, 3 new Physician’s Assistants, 2 community health workers, and 2 case managers to the academic medical center practice. Members of the William B. Schwartz Division of Nephrology received teaching awards from the National Kidney Foundation, the Massachusetts Medical Society, Tufts Medical Center house staff and fellows and from the medical school. A new faculty member joined the Division of Palliative Care, expanding its ability to care for patients with serious illnesses. In the Division of Pulmonary, Critical Care and Sleep Medicine, Dr. Nick Hill chaired the search committee for a new Executive Director of the American Thoracic Society. Eric Garpestad was appointed Associate Chief Medical Officer in addition to his role as Associate Chief of the division. Several clinical faculty joined the division. In the Division of Rheumatology, Allergy and Immunology, five members received the Boston Magazine’s ‘Top Doctors” award. Dr. Timothy McAlindon received a prestigious Distinguished Clinical Research Award from the Clinical Research Foundation. Dr. Chenchen Wang received the 2020 Innovative Research Award from the American College of Rheumatology. Dr. Michelle Park received the Outstanding Young Investigator Award at the 2018 NIH International Congress on Integrative Medicine. Although the two institutes are not formally a part of Tufts Medical Center, there is great overlap between members of the institutes and members of clinical divisions, fostering useful collaborations between current clinical needs and basic research. The Molecular Cardiology Research Institute (MCRI) celebrated its twentieth anniversary and its chief, Iris Jaffe, was elected to the Association of University Cardiologists. The Institute for Clinical Research and Health Policy Studies (ICRHPS) received over $7 million in new funding for research projects and currently is overseeing 80 research projects; Its CTSA Award from the NIH was renewed with grant awards of $56 million. I am grateful to these clinician, teachers, administrators, and investigators, who, once more, have demonstrated their commitment and talent to further the missions of Tufts Medical Center. Sincerely yours, Deeb Salem 5 DIVERSITY AND INCLUSION EFFORTS WITHIN THE DEPARTMENT OF MEDICINE–2018-19 The Department through its administrative activities and the faculty within the Department are involved in a number of activities in promote diversity and inclusion efforts within the Department. 1. Efforts to change the culture of inclusion active in the new PO Diversity Committee and their The Department’s annual review form asks each efforts to increase and retain a diverse faculty. » DIVERSITY AND faculty member to reflect on his or her contribution to 5. Expansion of research on health disparities a culture of inclusion and diversity. This addition to The Program on Equity in Science and Health, led by the annual review form was intended to emphasize Dr. Freund, currently has two NIH research grants and diversity and inclusion as a core value within the several training grants addressing health disparities Department. Faculty reflect upon their role in the care INCLUSION research. These activities have attracted a number of of an increasingly diverse patient population. Many new URM trainees, and resulted in new collaborations are in a position to expand on the training efforts with URM faculty from other Tufts Institutes and across the spectrum of trainees. Schools. 2. Efforts at the Student level 6. Faculty Training Faculty report a number of activities to increase and The Department of Medicine will embark in this year support diversity in our students and trainees, on a R25 funded faculty development program, including participation on the TUSM admissions entitled BRIM – Bias Reduction in Internal Medicine. committee, and serving as mentors to URM medical This program is part of an educational trial to students and high school students as part of pipeline understand the impact of two different models of programs. faculty training on reduction bias, and its impact on 3. Efforts at the resident/fellowship level both attitudes and actions toward inclusion behavior. Our residency program and fellowship programs are The Department has in addition worked to offer this developing specific outreach activities in conjunction training across all TUSM faculty on the Boston with the Dean for Multicultural Affairs to increase the campus, both at Tufts Medical Center, and in the diversity of their applicant pool. We are tracking our TUSM employed faculty in the basic science divisions recruitment efforts including the number of URM and community medicine and public health to benefit trainees invited for interviews, those we rank to join from this training opportunity. Dr. Freund was us , and those who rank us sufficiently highly to match awarded a TUSM IDEAS innovation grant to with our programs. implement this training. 4. Efforts at the faculty level Women in Medicine Committee – The Department provided the initial support to the formation of this committee, which is now a TMC-wide committee, to promote the career advancement of women within the Department