E-DMN - January 14, 2008

January 14, 2008

Editor's Column: Surveys Of Physicians' Attitudes: Are The Results Worth Reading?
WCMSSM Member Gambles On Urgent Care
HFHS Wins $12 Million Hypertension Grant
Oakwood Heritage Receives National Kudos
Event Honors WCMSSM Member
Dean Mentzer Delivers 2008 Message

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Editor's Column: Surveys Of Physicians' Attitudes: Are The Results Worth Reading?

By JOSEPH WEISS, MD
The Dec. 4 issue of the Annals of Internal Medicine surveyed the medical professionalism of physicians by a series of questions to a randomly selected group of 1,600 physicians. The investigators stated that the answers provided evidence that physicians are working at a high ethical level in their relations with patients. The study found that the profession felt that medical resources should be used wisely; a physician should see a patient regardless of the patient's ability to pay and that a physician should keep up his or her board certification.

However, the authors expressed dismay with aspects of the survey's findings. Their upset came from physicians' answers to (1) questions concerning reluctance in reporting colleagues suspected of committing medical error and (2) ordering an MRI because a patient insisted on it.

Difference in practice is characteristic of the medical community. If a physician gives Augmentin when you would prescribe Zithromax, is that colleague committing medical error? Is that person impaired or incompetent?

The same air of the hypothetical hangs over the ordering of tests one patient. Responding to the patient's need may be the best response. The questionnaire gives the physician no place to express his or her criteria of what constitutes medical error. Nor was there a place to explain that a physician will not usually blame another physician for errant behavior that might be his own. Using the questionnaires, with their short sentences and one-line choices won't allow a physician the space for a reasoned reply.

We ask the editors of medical publications such as the Annals of Internal Medicine to act with consideration to those of us in medical practice. We have no chance to participate in the peer review of these articles that concern us, but we must be given a chance for rejoinder.

Allowing practicing physicians a few lines in the next issue's letter-to-the-editor section will not do. Let us speak on the page that follows the article that criticizes us.

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WCMSSM Member Gambles On Urgent Care

Mohammed Arsiwala, MD, was recently the subject of a feature in a local publication. The story details the business and patient care gamble he took when Providence Hospital closed its Livonia facility 10 years ago. Rather than leave patients in the lurch and simply take another job, Dr. Arsiwala sold his house and opened an urgent care clinic.

The initial site of the new practice is still open at 37595 Seven Mile Road, the same location that housed the old Providence facility. After two years, the business achieved success and now the new entity has a nine locations, including Livonia Urgent Care – the inaugural clinic.

Arsiwala says he has about 80,000 patients at the nine centers, including 27,000 at the Livonia location alone. Business has been so good, Arsiwala is planning on opening 18 more facilities over the next three years in Michigan, Ohio and Indiana.

The facilities, which employ board certified doctors, offer a wide range of medical services for both children and adults, including diagnosing and treating illnesses and accidents. They also have a full service lab, offer chest pain evaluation with EKG, can treat broken bones, sprained joints, and fix cuts with staples or stitches, as well as offer flu and tetanus vaccinations.

The Urgent Care facilities, which accept most insurance providers including HAP and Blue Care Network, are open 8 a.m. to 10 p.m., seven days a week, every day of the year (including holidays). For more information, visit www.michiganurgentcare.com.

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HFHS Wins $12 Million Hypertension Grant

Oscar A. Carretero, MD, a hypertension researcher at Henry Ford Hospital, has been awarded a $12 million, five year grant from the National Institutes of Health to study the role of the kidney in blood pressure regulation, as well as how chronic high blood pressure damages the kidney, heart and vasculature.

Hypertension, or high blood pressure, is one of the nation’s most common cardiovascular diseases. Hypertension affects approximately 50 million Americans and is one of the main risk factors for cardiovascular diseases. When left untreated, hypertension leads to heart attacks, heart failure, vascular disease, kidney failure and stroke. Cardiovascular disease and stroke are responsible for nearly 50 percent of the total mortality rate in the United States.

In this Program Project Grant, five inter-related projects use a model of hypertension in rodents to study the factors that promote and prevent high blood pressure. Three of the projects focus on target organ damage in the heart, while two projects focus on control of the filtration of blood by the kidney and the mechanisms that control salt and water balance by the kidney. Dr. Carretero hopes to show that it is possible to derive therapeutic effects by altering the balance of pro- and antihypertensive systems.

Dr. Carretero is division head of Hypertension and Vascular Research at Henry Ford Hospital. He has published more than 300 papers in peer-reviewed journals and 35 book chapters. Dr. Carretero has received the Novartis Award for Hypertension Research from the Council for High Blood Pressure Research, the Lifetime Achievement Award in Hypertension Research from the Inter-American Society of Hypertension and the Distinguished Scientist Award by the Henry Ford Medical Group.

“Ultimately, we believe our studies will greatly increase our knowledge about the origin and development of both hypertension and end organ damage,” Dr. Carretero said.

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Oakwood Heritage Receives National Kudos

The Oakwood Heritage Hospital (OHH) laboratory has been recently recognized by the Commission on Laboratory Accreditation of the College of American Pathologists (CAP) with an award of accreditation for excellence. This national recognition is based on a thorough inspection process ensuring the highest standard of care for patients.

“Oakwood Heritage Hospital strives for excellence in everything we do, and our laboratories are no exception,” said Eric W. Widner, chief operating officer, OHH. “While patients may never see the lab directly, it’s a key component of the care we provide and this recognition validates what we’ve been striving for all along.”

During the CAP accreditation process, inspectors examine the laboratory’s records and quality control of procedures for the preceding two years. In addition, inspectors also examine staff qualifications, lab equipment, facilities, safety protocols and records and the overall management of the area.

The CAP Laboratory Accreditation Program is recognized by the federal government as one of the most stringent programs in the country.

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Event Honors WCMSSM Member

St. John North Shores Hospital (SJNSH) will host its 20th Annual Spring Dinner Dance, Rhythms of the Caribbean, at Mac & Ray's Banquet Center, 30675 North River Road in Harrison Township on Saturday, March 8, 2008 at 6 p.m. Proceeds from this year's dinner dance will be used toward the St. John North Shores Hospital HOPE Fund (Helping Our Patients in Emergencies).

The HOPE Fund helps provide resources for St. John North Shores Hospital patients, such as medications, walkers, hospital beds, home modifications, and other items that improve the daily lives of the disabled who are in need. The HOPE Fund also provides funds to encourage those with disabilities to gain more physical independence by opening doors to more recreational activities.

The event will honor Patrick Michael Verb, MD, a dedicated physician and long-standing member of our medical staff, and Donald Gooley, President of Don Gooley Cadillac, Inc. a longtime resident of Harrison Township and a supporter of SJNSH's many fundraising efforts. Their continued support and commitment are what make SJNSH so very special.

SJNSH is a 96-bed specialty hospital that provides comprehensive physical medicine and rehabilitation, along with a wide range of medical and surgical services. It also provides emergency, extensive outpatient rehabilitation services and many ancillary diagnostic services.

For more information on the 2008 SJNSH Dinner Dance, please contact Lorraine Owczarek at (586) 582-7509.

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Dean Mentzer Delivers 2008 Message

Editor's Note: The following is a New Year's message from Wayne State University School of Medicine Dean Robert Mentzer, MD.

To the School of Medicine Community:

The Year 2008 meets us as does any year -- with challenges, opportunities and the responsibility to honor the rich history of the Wayne State University School of Medicine. As we settle back into our classrooms, laboratories and clinics and prepare to resume our responsibilities as medical educators and researchers, it is important that we pause to reflect upon our achievements of 2007, and how those milestones will be a foundation for our 2008 agenda.

The Year 2007 was characterized by challenges and changes consistent with the shifting paradigms in medical education, research and healthcare throughout the United States. As the region’s acknowledged early responder to national physician manpower planning, the School of Medicine -- after careful analysis of southeast Michigan clinical resources -- increased its entering class size to ensure future healthcare for Detroit and its surrounding communities. From the subsequent rush by numerous private and state institutions to enter the medical education "market," it became evident that to fulfill our responsibilities to our students and to the community that we have served for 140 years, our School of Medicine must be the catalyst for wider collaboration and interdependence among the many medical education, research and healthcare delivery institutions of Detroit and its surrounding communities. And we have done just that: In 2007, the School formally launched a forward-thinking strategic plan that will ensure the stability and growth of our medical education, research and clinical care programs.

The work of our extraordinary faculty earned us full accreditation by the Liaison Committee for Medical Education of our M.D. programs, and full accreditation by the Accreditation Council for Graduate Medical Education (ACGME) of our jointly sponsored WSU-DMC residency training programs. To diversify its graduate medical mission, Wayne became a sole sponsor of four new ACGME-accredited residency training programs (dermatology, family medicine, otolaryngology and urology) with multiple hospital partners, and began planning for programs in cardiothoracic surgery and orthopaedic surgery.

The School’s two-year planning efforts for a Center for Clinical Translational Science were validated by the National Institutes of Health’s award to WSU of a Clinical Translational Science Award (CTSA) planning grant. This grant has enabled an active cadre of Wayne and Henry Ford Health System researchers to design and refine a community-wide vision to facilitate collaborative bench-to-bedside research -- and expedite the benefits to patients. To this end, the School of Medicine created an Office of Clinical Trials that will facilitate work of the CTSA.

The creation in 2007 of a Cardiovascular Research Institute (CVRI) will become a reality this February when its new director, Karin Przyklenk, Ph.D., joins the School of Medicine. The CVRI, much like our existing strengths of cancer, maternal-child health, neurosciences and healthcare disparities, embodies the interdisciplinary research paradigm of the CTSA and will be a "pacesetter" program of both the 2007 strategic plan and the CTSA.

The excellence of the Wayne State University Physician Group was acknowledged by 81 of our physicians being cited by their national peers as "Best Doctors" and "Top Doctors."

Chief among our accomplishments in 2007 was the groundbreaking for the Richard J. Mazurek, M.D. Medical Educational Commons. This state-of-the-science facility will consolidate educational and technology resources for undergraduate and graduate students, and for physicians continuing their education. The new Commons will advance and enrich our education mission while standing as a daily reminder of our commitment to the City of Detroit. The Commons, named for 1961 School of Medicine graduate Richard James Mazurek, M.D., was made possible in large part by Dr. Mazurek’s business partner, Nick Labedz, whose transformational $10.2 million gift helped make this vision a reality. The School’s Alumni Board of Governors and Board of Visitors, assisted by a targeted executive fundraising committee, guided the School’s development staff in identifying and securing more than $26 million of targeted philanthropy to construct the Commons. These gifts to the School of Medicine are solid investments in the future of medicine in Michigan. While construction of the Richard J. Mazurek Medical Educational Commons is under way, we will leverage the opportunity to secure a $3 million Kresge Foundation Challenge Grant by concluding fundraising by July 2008 for the project’s final $4 million.

The Wayne State University School of Medicine continues to reach out to new and diverse regional partners to enhance our mission and the broad community that we serve -- just as our substantive affiliations with Oakwood Healthcare Inc. and Crittenton Hospital Medical Center have already begun to integrate Wayne academic and research resources with the unique clinical resources and supportive hospital environments of these fine southeast Michigan institutions. This strategy will ensure our continued ability to deliver excellence in medical education, and expand the scope of our research enterprise to include a strong program in clinical and translational science that spans Detroit and its surrounding communities.

As we enter 2008, the Wayne State University School of Medicine stands prepared to move forward with implementation of its strategic plan, toward achievement of "Vision 2011." As your Dean, I remain committed to protecting and nurturing our School of Medicine as the standard bearer for medical education in southeast Michigan, and as an innovator in inter- and multidisciplinary research and clinical care. Together, we will discover and implement innovative approaches and strategic partnerships that will galvanize and grow our tripartite mission of education, research and clinical care.

In summary, we achieved important milestones in 2007. Exciting new programs and healthcare system partnerships have evolved, and a bright constellation of partners has emerged, each with unique points of light that will illuminate our mission, and ensure WSU as an unwavering anchor in the City of Detroit.

On behalf of the School of Medicine, I extend to you and your loved ones my best wishes for a prosperous and productive 2008.

Robert M. Mentzer Jr., M.D.
Dean, School of Medicine
Senior Advisor to the President for Medical Affairs
Wayne State University

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