AAMC News and Leadership Announcements, 2013 April 12

The current issue of AAMC News and Leadership Announcements is now available:

President Obama on Wednesday released his fiscal year 2014 budget proposal. Full details on accounts and programs of interest to academic medicine will be published in Friday afternoon’s edition of AAMC Washington Highlights (subscription details below). The President is proposing additional significant cuts in the Medicare program. The NIH program level for FY 2014 is $31.331 billion, an increase of $471 million (1.5 percent) over the FY 2012 program level. NIH estimates that it will support a total of 36,610 research project grants (RPGs) in FY 2014, an increase of $382 million and 351 grants over FY 2012. Within this total, NIH estimates it will support 10,269 new and competing renewal RPGs, an increase of 1,283 grants over FY 2012. For research training, the NIH FY 2014 budget request proposes an increase in the stipend for entry level postdocs to $42,000 (an increase of about 7 percent) and a 4 percent increase for subsequent years of experience. The stipend increase for predocs would be 2 percent. The total number of positions would decline by 108. All comparisons are to the FY 2012 level due to delay in the FY 2013 appropriations bills and sequestration.

AAMC President and CEO Darrell G. Kirch, M.D., issued a statement on Wednesday on the Obama administration’s FY 2014 budget proposal. He said, “America’s medical schools and teaching hospitals see good news and bad news in President Obama’s proposed budget. We are encouraged by the president’s continued support for medical research as reflected in the modest increase in funding for the National Institutes of Health (NIH). However, we are deeply concerned that the cuts to Medicare in the president’s proposal will have serious consequences on the health of the nation.” Dr. Kirch’s full statement is available on-line.

As part of the budget release, NIH on Wednesday issued the annual report on the Biomedical Research and Development Price Index (BRDPI). The estimated growth in the BRDPI for FY 2012 is 1.4 percent. The updated estimate for FY 2011 remains at 2.8 percent, the same value as the preliminary estimate posted last year. The following pattern of growth in the BRDPI is projected: 2.5 percent for FY 2013; 2.7 percent for FY 2014; 2.9 percent for FY 2015; and 3.0 percent each year from FY 2016 through FY 2018, respectively. According to the report, “The modest BRDPI growth rate of 1.4 percent for FY 2012 reflects the effect of the reduction of the NIH extramural investigator salary limitation (‘cap’) from $199,700 to $179,700 for that year and the continued freeze on salaries of Federal civilian employees.” The report also provides an estimate of the impact of the salary cap change: “Our best estimate is that over the past year, for NIH awards to academic institutions: 12.9% of requested salaries are subject to the original cap of $199,700; 14.4% of requested salaries are subject to the lower cap of $179,700; -10.7% is the average reduction due to lowering the cap (from $199,700 to $179,700) for the 14.4% of salaries subject to the lower cap.”

The Minneapolis Star Tribune reported on Thursday, “The high-stakes maneuvering over ownership of Fairview Health Services ended abruptly Wednesday, with Sanford Health and the University of Minnesota halting discussions about a merger or acquisition. The CEO of South Dakota-based Sanford, whose merger effort came under intense scrutiny the past two weeks, said Wednesday afternoon that he was ending discussions because Sanford has a policy of ‘only going where we are invited.'” The article further reported that “Shortly thereafter, [University of Minnesota] President Eric Kaler said Fairview’s board won’t consider a proposal he made in January for the U to take over the hospital system. Instead, the two sides will talk about strengthening the existing arrangement in which Fairview has run the U’s medical center since 1997.”

The New England Journal of Medicine on Thursday posted on-line a perspective essay by Robert Witzburg, M.D., of Boston University, and Henry Sondheimer, M.D., of the AAMC staff. Titled, “Holistic Review – Shaping the Medical Profession One Applicant at a Time,” the essay reviews the holistic review rubric in medical school admissions (“a flexible, individualized way of assessing an applicant’s capabilities by which balanced consideration is given to experiences, attributes, and academic metrics . . . and, when considered in combination, how the individual might contribute value as a medical student and future physician.”). Its use at Boston University is reviewed.

JAMA has posted a viewpoint essay by Ezekiel J. Emanuel, MD, Ph.D., of the Perelman School of Medicine and Wharton School, University of Pennsylvania, on “The Future of Biomedical Research.” Dr. Emanuel offered four factors that “contribute to the erosion of support for the NIH.” He also offered three factors “for improving the NIH funding environment…only some of which are in the control of the biomedical research community.” He concluded, “Focusing research on cost-lowering, quality-improving interventions has not been an NIH priority. This change in focus is vital to the future of both the country and the NIH.”

Several leading national physician education and assessment organizations announced on Wednesday their partnership to launch the Data Commons, LLC, an information-sharing company and its new system that will allow them to make selected information from their individual databases available via a data hub. The new system, which is expected to be operational during the third quarter of 2013, will save significant time and expense for researchers, policy makers, analysts and others who seek data about the nation’s physicians – while facilitating new ways of combining and analyzing data-sets. The six organizations include the American Board of Family Medicine, the American Board of Pediatrics, the Association of American Medical Colleges, the Educational Commission for Foreign Medical Graduates, the Federation of State Medical Boards and the National Board of Medical Examiners.

The Patient-Centered Outcomes Research Institute (PCORI) will hold a roundtable discussion on Tuesday concerning, “Building a National Data Infrastructure to Advance Patient-Centered Comparative Effectiveness Research.” The event will be held on April 23, from 9:00-11:00 a.m. ET, at the National Press Club in Washington, D.C. The focus of the roundtable is how to create a national data infrastructure to support high-quality patient-centered comparative effectiveness research (CER). Dr. Ann Bonham, Chief Scientific Officer at the AAMC, will participate in the roundtable discussion. The event is free and open to the public, but registration is required by Friday, April 19, at 5:00 p.m. ET, and may close early depending on when capacity is reached. A webcast will be available for those who can’t attend in person.

The Baltimore Sun reported on Friday that “A large section of brick facade fell off a National Institutes of Health research facility on the Southeast Baltimore campus of Johns Hopkins Bayview Medical Center, reviving concerns about a building that opened two years late because of other problems.” The building houses researchers that are part of the National Institute on Aging and the National Institute on Drug Abuse intramural programs and earlier had serious and well-publicized vibration issues. No one was injured in the Thursday incident.

The Wall Street Journal has an on-line feature titled, “The Experts,” which poses policy questions to individuals with background in the topic under discussion. The current issue is “What role should government play in combating obesity?” Dr. Atul Grover, AAMC Chief Public Policy Officer, is one of the respondents. Dr. Grover highlighted the important impact NIH-funded medical research has made, and will continue to make — if adequately funded — in addressing the obesity crisis.

Friday’s Montreal Gazette features an article about curriculum changes at McGill to promote the training of more primary care physicians. The article reported that there is some faculty opposition to the changes. The article discussed the dwindling number of clinician scientists being trained at Canadian medical schools.

More than 50 Nobel laureates have written to members of Congress urging them to support research funding. The group wrote, “We urge you, even in these financially troubled times, to keep the budgets of the agencies that support science at a level that will keep the pipelines full of the younger generation upon whom our economic vitality will rest in future years.”

On March 7th the HHS Office of Human Research Protections issued a determination letter concerning the Surfactant, Positive Pressure, and Oxygenation Randomized Trial (SUPPORT). OHRP noted in its letter that the randomized multi-site study was conducted at approximately 22 sites and reviewed by at least 23 IRBs. About 1,300 infants were enrolled in this study from 2004 to 2009. OHRP determined “that the informed consent document for this trial failed to adequately inform parents of the reasonably foreseeable risks and discomforts of research participation.” The letter, while available on the OHRP web page for over a month, was page-one news in Thursday’s New York Times and Washington Post, following a publicity effort by the group Public Citizen.
http://tinyurl.com/d4o7lcu (NY Times)
http://tinyurl.com/c6f5eyq (Wash. Post)
http://tinyurl.com/ctcu9ns (Public Citizen)

The Centers for Medicare and Medicaid Services has posted “The Official Website for National Physician Payment Transparency Program: OPEN PAYMENTS (Section 6002 of the Affordable Care Act),” also known as the Sunshine Act. CMS says the web site and the Act create “greater transparency around the financial relationships of manufacturers, physicians, and teaching hospitals.” No individual data has yet been posted on the site.

According to various media reports, Dr. Carol Folt, the interim president of Dartmouth College, will be named the next chancellor at the University of North Carolina at Chapel Hill. The announcement is expected on Friday. Dr. Folt, an environmental scientist, will succeed Holden Thorp.

In remarks Tuesday to the National Press Club, Mayo Clinic President and CEO John Noseworthy, M.D., outlined three steps health care providers and policymakers should take to create high-quality, patient-centered care at lower costs: deliver knowledge, create value, and fund excellence. Congressional Quarterly reported that Dr. Noseworthy also disclosed that across-the-board cuts in Medicare provider payments are costing the Clinic $47 million a year…” He said that, “Half of that comes out of patient care, half of that comes out of research.”

The University of Arizona reported its “Faculty Senate has implemented new promotion and tenure criteria for faculty that creates a more inclusive view of scholarship by taking into account translational research, technology commercialization and industry and community-based collaborations.”

NIH has issued a reminder of its “Policy for Handling Electronic System Issues that Threaten On-Time Grant Application Submission.” The notice “serves as a reminder of NIH policies regarding the submission of late applications if a system issue beyond an applicant’s control is suspected as the cause of the late application.” The notice appeared shortly after reports that the System for Award Management (SAM.gov) was unavailable for an extended period.

The AAMC’s Diversity Policy and Programs unit has collaborated with Cook Ross to develop a 3-day workshop which examines how unconscious biases develop, how they influence perceptions and decision making, and their impact on institutional diversity and inclusion efforts. After a successful launch of this program in January 2013, this opportunity is being extended to additional participants. The Learning Lab will be held April 29-May 1, 2013 at Cook Ross Inc Headquarters just outside Washington, DC in Silver Spring, Maryland.

Michael J. Dandorph has joined Rush University Medical Center as executive vice president and executive director of Rush University Hospitals. Mr. Dandorph joins Rush from the University of Pennsylvania Health System where he served as the senior vice president of strategy and business development.

Dr. Eli Adashi of Brown has posted an interesting essay on the JAMA Forum on the ethical debate on human Embryonic Stem Cell (hESC) research. Dr. Adashi noted, “The issues at hand in bioethical debates typically aren’t static. Instead, such debates have frequently been shown to evolve to a point of resolution. Although the nature of this self-sorting and conciliatory property of the public discourse remains enigmatic, against all odds, seemingly irreconcilable ethical quandaries ultimately have found clarity, even in the thorny arena of reproductive ethics.” Dr. Adashi’s essay is particularly salient in light of the media reports recounting the work of Nobel laureate and IVF pioneer Professor Sir Robert Edwards, whose death was announced on Wednesday.

Georgetown Lombardi Comprehensive Cancer Center and the John Theurer Cancer Center, part of Hackensack University Medical Center, have announced the establishment of an oncology affiliation agreement to foster collaboration among clinicians and researchers from both institutions. According to Georgetown, the agreement “is a significant step towards the future goal of developing a clinical, translational and basic science cancer research consortium.”

The American College of Physicians and the Federation of State Medical Boards on Thursday issued a new policy paper, “Online Medical Professionalism: Patient and Public Relationships.” Among the recommendations, “Physicians should keep their professional and personal personas separate. Physicians should not ‘friend’ or contact patients through personal social media” and “Physicians should not use text messaging for medical interactions even with an established patient except with extreme caution and consent by the patient.”

Dr. Bruce Orkin has joined the Department of General Surgery at Rush University Medical Center as professor and vice chair for academic affairs in the department. He had been at Tufts. Also at Rush, Dr. Michael J. Liptay has been appointed as chairperson of the Department of Cardiovascular-Thoracic Surgery at Rush University Medical Center. He has been at Rush since 2006. Lastly, Dr. Ajay Nehra has been appointed as chairperson in the Department of Urology at Rush University Medical Center. He joined Rush as vice chairperson and professor in May 2012. He previously served as professor of urology at the Mayo Clinic in Rochester, Minn.

Benjamin A. Alman, M.D., has been named chairman of the Department of Orthopaedic Surgery at the Duke University School of Medicine. He most recently was the chairman of orthopaedics at the University of Toronto. David Attarian, M.D., FACS, is serving as interim chair at Duke pending Dr. Alman’s arrival later this year.

Michael F. Rotondo, MD, FACS, chairman of the department of surgery at the Brody School of Medicine at East Carolina University and chief of surgery at Vidant Medical Center, Greenville, NC, has been named chief executive officer of the University of Rochester Medical Faculty Group. Dr. Rotondo will also serve as senior associate dean of clinical affairs, professor of surgery, and vice-president for administration at Strong Memorial Hospital.

The Indiana University School of Medicine has announced the publication of a new book, “Enhancing the Professional Culture of Academic Health Science Centers” that “explores how faculty at academic health centers — home to many medical schools in the United States and abroad — pursue and achieve success in doing research. A unique contribution of this volume is its focus on relationships; how they form, are sustained and mature in a highly competitive research environment.” The new book is edited by Thomas S. Inui, M.D., and Richard M. Frankel, Ph.D.

Tony Mazzaschi

PS: Feel free to email <cas@aamc.org> if you have a problem accessing any article or resource mentioned in this summary. Also, have colleagues email <cas@aamc.org> if they would like to receive these news postings. We also welcome news tips and corrections.

PPS: Other news, policy, and innovation products from AAMC may be of particular interest to subscribers:
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+AAMC STAT (Short, Topical and Timely), a weekly news email highlights news related to academic medicine
http://www.aamc.org/newsroom/aamcstat/aamcnews.htm (note subscription box on right)
+AAMC Washington Highlights, a weekly summary of legislative & regulatory developments affecting academic medicine
+AAMC Second Opinion, news and perspectives from AAMC’s Chief Public Policy Officer
Subscribe by emailing: SecondOpinion@aamc.org
+Wing of Zock, a blog about innovation and change in medical schools and teaching hospitals
http://wingofzock.org/ and its Twitter feed @wingofzock
+AM Express, the journal Academic Medicine’s free monthly issue announcement service
Subscribe by emailing: acadmed_online@aamc.org
+AM Rounds, the journal Academic Medicine’s official blog


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