Dean's Weekly Message

September 21, 2020

Dear colleague:

Students of the School of Medicine are participating in VotER, a nationwide, non-partisan effort that is encouraging voter registration among patients. I would like to thank our affiliate partners at Denver Health, the VA, and Children’s Hospital Colorado for being supportive of voter registration efforts. I think it is important to recognize that two key factors have shaped the current state of our health care system – first is the advance of scientific knowledge and its translation into patient care, and second is the increasing role of government and public policy in our health system. In clinical trials, we know that a representative sample of the population yields the best results. Similarly, our country’s system of governance derives its legitimacy from the consent of the governed. To achieve the results that best take into account the needs of all, we should promote broad participation.

From my perspective, participating in the processes that elect and select those who formulate laws and policies that profoundly affect the structure of our health care system is every bit as important as encouraging participation in clinical trials that advance our knowledge of medical science. I encourage our students to continue their engagement in efforts that promote best possible care for the most people. The effort is especially important when public health during a pandemic is a primary concern. The need for safe voting is described in this CNN opinion column by Alister Martin, MD, founder of VotER and an emergency medicine physician and former chief resident at the Massachusetts General Hospital, and Halea Meese, MD, who graduated from our School of Medicine this year and who is now a family medicine resident in New Mexico. Thanks to Suzanne Brandenburg, MD, professor of medicine and director of the CU Center for Interprofessional Practice and Education, for coordinating this important curricular endeavor and for presenting it to the School of Medicine Faculty Senate last Tuesday. Thanks also to Steve Lowenstein, MD, MPH, professor of emergency medicine and associate dean for faculty affairs, for serving as faculty liaison with the medical students on this endeavor.

The CU Medicine board of directors voted unanimously last week to provide $1 million in scholarship funding for students in the School of Medicine’s MD, physician assistant, physical therapy, and anesthesiology assistant programs. The support of our faculty is essential to the success of our students, and the commitment of scholarship funding is an important way that we demonstrate leadership. In recent years, we have seen an increase in support from private donors who are giving to scholarship programs and we are grateful. In difficult times, it is especially important to find tangible ways to support one another. I would like to thank our faculty whose professionalism gives strength and value to CU Medicine, our faculty practice plan. Thanks also to the CU Medicine board and leadership for translating that value into an investment in our future.

The Centers for Medicare & Medicaid Services (CMS) announced last week that it is withdrawing the proposed Medicaid Fiscal Accountability Rule, which would have made substantial changes to Medicaid’s financing structure and supplemental payments. The proposed regulation, announced in November 2019, was supposed to be finalized this fall. It called for capping funding mechanisms that provided flexibility for delivering services to Medicaid populations. For Colorado, the impact could have been devastating for many people who depend on our services. Our School, in coordination with the state Medicaid agency, has been able to expand services to residents throughout the state. In the past three years, the School has established more than 60 projects that expand access in rural communities and bring some specialty care services to patients closer to home. The spring issue of CU Medicine Today magazine included an article highlighting some of those projects. Thanks to Kent Springfield, CU’s associate vice president for federal policy, for his work raising awareness among lawmakers and our peers in the Association of American Medical Colleges of the potential adverse impacts of this proposed rule.

The CU Anschutz Medical Campus is one of 12 health systems participating in a consortium called Reliable Response Data Discovery (R2D2), which last week launched The consortium, led by UC San Diego Health’s Department of Biomedical Informatics, will allow users to submit questions about adults hospitalized with COVID-19. Here’s how the site works: Users submit questions about adults hospitalized with COVID-19. Consortium team members evaluate the submissions for clinical utility and likelihood that available data can provide answers. Questions are then translated into a computer code that queries a variety of electronic medical records in a way that will deliver reproducible results. This project shows the critical importance of data analytics to the future of medical science. Thanks to Lisa Schilling, MD, professor of medicine, who is the principal investigator from our campus, and the others here who are working on this effort.

The CU Anschutz | Denver Postdoc Association  and the CU Postdoctoral Office this week are celebrating National Postdoc Appreciation Week, which recognizes postdoctoral fellows for their contributions to improving human health and moving science forward. The National Postdoctoral Association is hosting a series of virtual events throughout the week and the local association has its own events. The postdocs on our campus are valued members of our community who make significant academic contributions. Be sure to thank them for their work.

On Tuesday, September 15, the Fitzsimons Building was glowing red along with many other buildings and iconic landmarks around the world as part of the Light it Red campaign for World Lymphoma Awareness Day. The event is intended to raise awareness of the disease and to provide hope to those affected by lymphoma. This lighting ceremony is one of several Blood Cancer Awareness Month activites occurring in September.

Nee-Kofi Mould-Millman, MD, associate professor of emergency medicine and principal investigator of the C3 Global Trauma Network, and his team have been awarded $7 million by the U.S. Department of Defense to study prehospital trauma care and military-relevant clinical outcomes. This five-year, multi-center study builds on a long-standing research relationship with collaborators in South Africa. The study aims to answer high-priority civilian- and military-relevant questions regarding the influence of time and early resuscitative interventions on clinical outcomes in critically injured trauma patients. The Department of Emergency Medicine, CU Anschutz Center for Combat Medicine and Battlefield (COMBAT) Research, co-principal investigator Adit Ginde, MD, professor of emergency medicine, and collaborators at CU and in South Africa supported this transformational award.

Marsha Anderson, MD, professor of pediatrics and associate director of the Pediatric Residency Program and assistant dean of the longitudinal curriculum, is co-author of a report, “Climate Change and the Practice of Medicine,” published this month in Academic Medicine.  The authors note that health risks include heat-related illness, infections, asthma, mental health disorders, poor perinatal outcomes, adverse experiences from trauma and displacement, and other harms. They add that more numerous and increasingly dangerous natural disasters likely will impair delivery of care by disrupting supply chains and compromising power supplies. With such health consequences and the need to deliver care amid disruptions, there’s a need for curricula that addresses the concerns. The article offers a framework of content, with recommendations for learning objectives and assessment strategies.

Lorna Grindlay Moore, PhD, professor of obstetrics and gynecology, was featured a Physiologist Magazine article for her work studying pregnancy at high altitudes. In Peru, Tibet, and Bolivia, Lorna has explored why native highlanders gave birth to babies who weighed more than babies born to lowland women who were living at high altitude. She has identified a mutation to AMPK, a metabolic signaling enzyme, and  is now studying potential targets for drug therapies to help women whose placental blood flow is compromised by pregnancy complications of preeclampsia or fetal growth restriction. While directly addressing issues of maternal and newborn mortality, her work also could yield a better understanding of causes of cardiovascular and other diseases that manifest in adulthood. Lorna explains, “High altitudes therefore constitute a natural environment for understanding fundamental questions of life itself.”

In a posting on Neurology Blogs last week, Hunter Greer, a member of our MD Class of 2021, describes his experience dealing with a patient’s homophobia. It happened on the first day of Hunter’s neurology clerkship. Hunter went to see a patient with upper extremity numbness and weakness, and like any good medical student, Hunter’s mind was racing through the symptoms and potential diagnoses. While conducting the exam in the patient’s hospital room, the television was on and commentators were discussing presidential candidate Pete Buttigieg, the first openly gay man running for the office. The patient said, “I have nothing against gay people, but do they have to kiss on TV? It’s disgusting.” In the column, Hunter described how he, as a young man, had coped with homophobia throughout his life and how the patient’s comment affected his ability to conduct the exam. “Despite my efforts to provide the best care I can, he was disgusted by a part of my identity—the part I often hide to avoid encounters like this one—the part that makes being a learner even more challenging,” Hunter wrote. “As students, we are taught to treat patients with the utmost respect. But are they the only humans in the room? Everyone deserves respect and compassion, but people are often shamed for their sexuality. Instances like this make me wish I only had to struggle with the discrimination of upper vs. lower motor neuron diseases, not with patients’ and colleagues’ discrimination of me.” The column is worth your time and I encourage you to read it.

And finally, a shout out to Pearce Korb, MD, associate professor of neurology, who was featured last week in a Q&A article in Neurology Today, where he talked about his day job as a neurologist and his occasional ventures into stand-up comedy and the importance of a good laugh.

Have a good week,

John J. Reilly, Jr., MD
Richard D. Krugman Endowed Chair
Vice Chancellor for Health Affairs and
Dean, School of Medicine

The Dean’s weekly message is an email news bulletin from John J. Reilly, Jr., MD, Dean of the CU School of Medicine, that is distributed to inform University of Colorado School of Medicine faculty members, staff, students and others about issues pertaining to the School’s mission of education, research, clinical care and community service.  For clinical news and patient stories from UCHealth, please visit UCHealth Today

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