AAMC News and Leadership Announcements, 2013 July 13

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

The Senate Appropriations Committee on July 11 approved an FY 2014 Labor-HHS-Education spending bill that restores funding for medical research and health professions training to pre-sequestration levels. The committee approved the $164.3 billion bill by a 16-14 party-line vote. AAMC Washington Highlights provides details. The Association’s legislative and regulatory affairs newsletter also highlights two new Centers for Medicare and Medicaid Services (CMS) regulatory announcements: the calendar year (CY) 2014 Outpatient Prospective Payment System (OPPS) proposed rule updating payment policies and payment rates for services furnished to Medicare beneficiaries in hospital outpatient departments and ambulatory surgical centers (ASCs) beginning Jan. 1, 2014; and, a proposed rule for changes to the calendar year (CY) 2014 Physician Fee Schedule (PFS).

AAMC hosted a webinar on Monday, July 8 on its recently announced research evaluation initiative and the new report from RAND Europe, “Measuring Research: A Guide to Research Evaluation Frameworks and Tools.” The webinar and related slide sets are now available on-line, as is the new RAND Europe report.

JAMA has posted a report on “The State Of US Health, 1990-2010: Burden of Disease, Injuries and Risk Factors.” Authored by members of the US Burden of Disease Collaboration and the Institute for Health Metrics and Evaluation, the report is an effort, “To measure the burden of diseases, injuries, and leading risk factors in the United States from 1990 to 2010 and to compare these measurements with those of the 34 countries in the Organisation for Economic Co-operation and Development (OECD) countries.” IOM President Dr. Harvey Fineberg authored an accompanying editorial on the study.

The Baltimore Sun on Tuesday reported, “The head of the nation’s medical research agency and leaders of Johns Hopkins hospital and medical school warned Monday that progress in fighting diseases could be slowed, jobs lost and scientists driven overseas unless across-the-board federal funding cuts are reversed. Dr. Francis Collins, director of the National Institutes of Health, joined Sen. Barbara A. Mikulski, Hopkins executives and a stroke survivor at Hopkins’ Children’s Center to appeal for restoration of $1.5 billion in NIH funding cuts as part of the budget ‘sequester’ approved last winter by Congress.” The article and event highlighted the fiscal and job impact of the sequester on Baltimore’s medical schools, as well as the loss of research opportunities.

A new Institute of Medicine report, “Toward Quality Measures for Population Health and the Leading Health Indicators,” examines “the intersection of HHS’s public health quality effort and the Leading Health Indicators in Healthy People 2020, the nation’s 10-year agenda for advancing health in America.” According to the IOM, “The recommendations in the committee’s report are designed to inform and support the development, endorsement, promotion, and use of a unified and coherent set of quality measures useful across a range of settings.”

Clese E. Erikson, director of the AAMC Center for Workforce Studies, has published an article titled, “Will new care delivery solve the primary care physician shortage?: A call for more rigorous evaluation.” The article appeared in the June issue of the new journal Healthcare. Ms. Erikson wrote, “Transformations in care delivery and payment models that make care more efficient are leading some to question whether there will really be a shortage of primary care physicians. While it is encouraging to see numerous federal and state policy levers in place to support greater accountability and coordination of care, it is too early to know whether these efforts will change current and future primary care physician workforce needs. More research is needed to inform whether efforts to reduce cost and improve quality of care and population health will help alleviate or further exacerbate expected primary care physician shortages.”

The AAMC Organization of Resident Representatives (ORR) Community Service Award recognizes those who have made contributions above and beyond the rigors of their residency training to improve the local communities where they live and train. The award recipient will be honored during an award luncheon at the AAMC’s Annual Meeting in Philadelphia, PA on Saturday, November 2, 2013. The 2013 nomination cycle is now open. Nominations must be received by Wednesday, July 31, 2013.

The Pittsburgh Post Gazette on Friday reported, “A faculty committee at the University of Pittsburgh has concluded that researcher Jay Kolls did not commit research misconduct in using work from another scientist’s lab to seek a patent application for a vaccine for pneumocystis lung infections. Dr. Kolls is guilty of research impropriety, though, the committee concluded, because he and fellow researcher Mingquan Zheng did not get clear agreement from Dr. Karen Norris that they could cite her lab’s research in federal grant applications and the patent paperwork…The panel, composed of five senior medical school and biomedical research professors, also chastised Drs. Kolls and Zheng for poor recordkeeping in their lab.”

A front page article in Tuesday’s New York Times, titled, “Unlikely Partners, Freeing Chimps From the Lab,” discussed the actions of Jane Goodall and Dr. Francis Collins that resulted in NIH ending most chimp research it funded. However, the article reported, “Dr. Collins cautioned that there were still areas of disagreement between the N.I.H. and the animal welfare movement. ‘Now obviously if we moved from talking about chimpanzees to talking about mice and rats, we’d be in a different place,’ he said.”

The Aspen Ideas Festival was held in Colorado from June 26 through July 2. Mount Sinai is the first medical center to sponsor the Festival, now in its ninth year. During the Festival, Kenneth L. Davis, MD, President and Chief Executive Officer of The Mount Sinai Medical Center, was interviewed by Richard Besser, MD, Chief Health and Medical Editor at ABC News. Dr. Davis commented on funding cuts to academic medical centers, the recent Supreme Court decision on gene patents, the education of physicians, and various other topics. During the festival, Dr. Davis also spoke on the topic of “What Is Healthcare Going to Look Like in 25 Years.”

Last Saturday’s Arizona Republic reported on the Mayo Clinic’s construction of a 380,000-square-foot cancer center in Phoenix. The article reported, “The Mayo expansion also will consolidate Mayo Clinic departments and services, relocate departments and staff from both the Scottsdale and Phoenix campuses and add space for a new laboratory, endoscopy and radiology services…” In addition, the article reported, “Officials expect the cancer center to anchor the Arizona Biomedical Corridor on the surrounding 1,000 acres of state-owned land. The corridor, a collaboration between the city, Mayo Clinic and Arizona State University, will become the state’s international leader in the biotechnology development and health-care industries, officials said.”

Emory has announced, “In light of financial challenges arising from federal sequestration, the Winship Cancer Institute and Emory School of Medicine have launched a ‘Smart Subsidy’ initiative for researchers who use the Emory Integrated Genomics Core (EIGC). The ‘Smart Subsidy’ initiative is aimed at supporting Winship and Emory researchers’ use of genomics technologies, which have become bread-and-butter laboratory commodities. The EIGC is the result of a partnership between the Winship Cancer Institute and the Emory School of Medicine to consolidate genomic resources on the Emory campus into a single resource.” The subsidy will range between 5 and 15 percent for projects processed by the EIGC only, with larger projects receiving a higher percent subsidy.

The Washington Post on Tuesday featured a lengthy article from Kaiser Health News on the regulation of resident duty hours and explored whether restrictions on duty hours have reduced errors and fatigue. The article also discussed whether training has suffered under the new standards.

The Associated Press reported last weekend on a hospital construction boom in Texas. Many of the new projects involve teaching hospitals. Discussed in the article are the new 17-story, 862-bed Parkland Memorial Hospital; the $800 million, 460-bed William P. Clements Jr. University Hospital; a new teaching hospital at UTMB to complement the current John Sealy Hospital; and, a new teaching hospital in Austin.

A page one article in Monday’s Washington Post discussed alarm fatigue in hospitals. The article reported, “Clinicians and patient-safety advocates have warned of alarm fatigue for years, but the issue is taking on greater urgency as hospitals invest in more-complex, often-noisy devices meant to save lives. Last month, the Joint Commission, which accredits hospitals, directed facilities to make alarm safety a top priority or risk losing their accreditation. The commission is requiring hospitals, starting in January, to identify the alarms that pose the biggest safety risks by unnecessarily adding noise or being ignored. By 2016, hospitals must decide who has the authority to turn off alarms.”

Wednesday’s New York Times reported that the discovery of a rare genetic mutation that appears to result in “dazzlingly low LDL levels has set off one of the greatest medical chases ever. It is a fevered race among three pharmaceutical companies, Amgen, Pfizer and Sanofi, to test and win approval for a drug that mimics the effects of the mutation, drives LDL levels to new lows and prevents heart attacks. All three companies have drugs in clinical trials and report that their results, so far, are exciting.”

An Oakland-Berkeley-area newspaper, the East Bay Express, featured a lengthy story on the approval by the Regents of the University of California of a nonprofit board, called Newco, which “will decide which UC inventions to patent and how to structure licensing deals with private industry.” According to the article, “Newco’s proponents contend that the 501(c)3 entity will bring much-needed private-sector experience to the task of commercializing university inventions. Ultimately, it will generate more patents, and thus bigger revenues for UC through licensing deals and equity stakes in startups, they claim. UC administrators also say they have established sufficient safeguards for Newco and that UCLA’s chancellor and the regents will have oversight over the entity.” Overall, however, the article viewed the new entity with suspicion.

Nature Biotechnology on Wednesday released an article on biotech patents by universities world-wide. The data shows that “Overall, biotech patenting is on the rise” and that “the increase is being driven by US patenting.” (subscription required)

The new issue of the Office of Research Integrity’s newsletter features a lengthy review of Responsible Conduct of Research (RCR) instruction and presents divergent views on its value and effectiveness.

Tuesday’s Pittsburgh Post-Gazette reported, “When Congress approved a drug discount program two decades ago for clinics that serve impoverished and uninsured populations, the pharmaceutical companies didn’t envision that the discounts would be abused by enormous — and, sometimes, enormously profitable — hospitals chains. Yet that’s what’s happening, according to the major drugmakers.” The article further reported, “Hospitals, on the other hand, say the discounts are working precisely as advertised: helping poor patients receive cheaper medication and, as a byproduct, helping medical providers that operate on razor-thin margins to weather years of flat admissions and oncoming overhaul-driven changes that will further squeeze the industry.” The group ‘Safety Net Hospitals for Pharmaceutical Access,’ which represents many of the hospitals in the program, has issued materials to “correct misinformation about the 340B drug discount program and underscore how the program benefits vulnerable patients, including those with little or no ability to pay.”

Last Sunday’s New York Times reported that, “PETA, considered by many to be the highest-profile animal rights group in the country, kills an average of about 2,000 dogs and cats each year at its animal shelter [in Norfolk, Virginia]. And the shelter does few adoptions — 19 cats and dogs in 2012 and 24 in 2011, according to state records.” According to the article, “Even some supporters do not know what to make of it.” PETA reported revenues of $31 million in its most recent filing with the IRS.

The PCORI Improving Healthcare Systems (IHS) program convened a multi-disciplinary workgroup to discuss Transitional Care (from hospital to home) on July 12. The purpose of the meeting was to identify unanswered questions that are important to patients and other stakeholders when deciding to participate in programs of transitional care.

Columbia University has posted a conversation with Filippo Mancia, PhD, concerning the impact of the NIH budget cuts on his research activities and laboratory.

An article in Friday’s Wall Street Journal reported on hospitals and health systems using “big data” to track physician efficiency and productivity.

Friday’s New York Times featured an essay by Dr. Pauline Chen who discussed a recent study concerning “Doctors Badmouthing Other Doctors.”

The Brookings Institution on July 1 released a study on employment in the health care sector and how it impacts metropolitan areas. The study reported, “Over the past decade, the healthcare industry has added 2.6 million jobs nationwide. The industry’s 22.7 percent employment growth rate over that period significantly outstripped the 2.1 percent employment growth rate in all other industries.”

The University of Maryland Medical System has announced that effective later this month, Kernan Orthopaedics and Rehabilitation Hospital will be known as the University of Maryland Rehabilitation & Orthopaedic Institute, “reflecting its growing prominence in innovative and collaborative research to advance patient care, strong ties to the University of Maryland and continued commitment to the highest-quality patient-focused care.”

The National Foundation for American Policy (NFAP), a policy research group, this week released a new report, “The Importance of International Students to America.” The report found that international students account for 70 percent of the full-time graduate students (master’s and Ph.D.s) in electrical engineering, 63 percent in computer science, 60 percent in industrial engineering, and more than 50 percent in economics, chemical engineering, materials engineering and mechanical engineering. The report does not include data on the life sciences.

The Affordable Care Act promotes “shared decision-making (SDM),” which an article by Dr. Lisa Rosenbaum posted by the New Yorker defines as “an approach to medical care in which patients are encouraged to make decisions with their doctors…S.D.M. aims to integrate patients’ preferences and values into the weighing of each choice.” Dr. Rosenbaum, a Fellow at the Philadelphia V.A. Medical Center and a Robert Wood Johnson Foundation Clinical Scholar at the University of Pennsylvania, wrote, “S.D.M. advocates have argued that heeding patient preferences will help improve quality and cut costs. That remains to be determined. For now, we can at least agree that physicians can never fully grasp, nor anticipate, the subjective nature of their patients’ experiences. But whether the answer lies in asking patients to share more in the decision-making process remains a matter for debate. Doctors know all about probabilities and trade-offs, but we don’t know much about how to engage patients in decision-making in a way that actually achieves the most desired long-term outcome.”

The 2013 AAMC Minority Faculty Career Development Seminar will be held September 20-23, 2013 in New Orleans, LA. In addition, the AAMC is sponsoring a one day pre-seminar workshop, the AAMC K-Writers Coaching Group, which is designed for junior faculty who are actively working on an NIH Career Development (K) proposal, and interested in obtaining additional support with developing the proposal. A separate application and registration are required for the workshop and there are a limited number of slots. The application deadline for the K-Writers Workshop is August 9, 2013.
http://tinyurl.com/qyup79e (seminar)
http://tinyurl.com/q6n4usr (workshop)

An op-ed essay in last Saturday’s New York Times by Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, focused on some recent articles on the cost of medicine. He concluded, “Too many of us have passively accepted the situation as being beyond our control. Medical care in America could use a dose of moral outrage. It would be best for all if it was self-administered.”

PLoS One last Thursday posted an article that analyzed the conflict of interest policies of the 17 Canadian medical schools. The article was titled, “Too Few, Too Weak: Conflict of Interest Policies at Canadian Medical Schools.” One dean, quoted by the Toronto Star, said the study’s results, at least in regards to his institution, are “completely flawed and quite erroneous.”

Last Sunday’s New York Times Magazine featured an article about the economic cost of mental illnesses and whether spending more on direct care can reduce the aggregate economic impact. The article also suggested that comparative-effectiveness research is needed to address quality of care issues in the field.

The recent California state budget agreement provides “full and continuous funding of $15 million per year” to the UC Riverside School of Medicine. The School of Medicine will matriculate an inaugural class of 50 students this August.

The Human Rights Campaign this week released its annual Healthcare Equality Index (HEI), “a unique and invaluable resource for healthcare organizations seeking to provide equitable, inclusive care to LGBT Americans -and for LGBT Americans seeking healthcare organizations with a demonstrated commitment to their care.”

Last Sunday’s Minneapolis Star Tribune featured an article on regenerative medicine research at the Mayo Clinic. The article also discussed the Mayo Regenerative Medicine Biotrust, a “massive library of genomic data, cells, tissue, blood and other specimens…”

The New York Times last Sunday reported that an aggressive advertising campaign launched this week by Republicans “to sow doubt about how [the Affordable Care Act] will work.” The largest campaign, being launched by a conservative advocacy group funded by the Koch brothers, targets young women.

Former VA Chief Research and Development Officer Joel Kupersmith, MD; Darrell Kirch, M.D., AAMC President and CEO; Ann Bonham, Ph.D., AAMC Chief Scientific Officer; and others appear in videos posted on-line that reflect upon the nature and goals of VA research, noting its many accomplishments.

The Washington Post last Sunday featured a lengthy article on how health systems are increasingly launching their own health insurance plans.

The Baltimore Sun recently featured a profile of Dr. Carlton Haywood, a sickle-cell disease research, patient and advocate. Dr. Haywood is an assistant professor of hematology and bioethics at Johns Hopkins.

The Houston Chronicle on Thursday reported that the Methodist Health System on July 16 will change its name to Houston Methodist and The Methodist Hospital will become Houston Methodist Hospital. The names of the network’s other hospitals will also be changed. According to the newspaper, “About 80 hospitals in the United States have Methodist in the name…” Methodist is an academic affiliate of New York City’s Weill Cornell Medical College.

The new annual report of the Federal Interagency Forum on Child and Family Statistics, which includes participants from 22 federal agencies as well as partners in several private research organizations, finds that, “The number of children living in the United States declined slightly, as did the percentage of the U.S. population who are children, according to the federal government’s annual statistical report on the well-being of the nation’s children and youth.” Among the reports many findings: a drop for the fifth straight year in the percentage of infants born preterm, from 12.8 percent in 2006 to 11.7 in 2011; a drop in births to adolescents, from 17 per 1,000 girls ages 15 to 17 in 2009 to 15 per 1,000 in 2011 (preliminary data); and, a rise in the percentage of male and female 12th graders who reported binge drinking – consuming five or more alcoholic beverages in a row in the past two weeks – from 22 percent in 2011 to 24 percent in 2012.

A commentary recently posted by the FASEB Journal discusses the increasing trend of co-first authorship in biomedical and clinical journal. A study by the authors found that 25-35% of publications in high profile basic science journal (e.g., Cell, Nature, Science) and up to 15% of publications in clinical journals such as the New England Journal of Medicine now include two or more joint first authors. The authors suggest that journals and bibliographic databases develop means to highlight co-first authors. The article was written by Drs. Marisa Conte, Stacy Maat, and M. Bishr Omary.
http://www.fasebj.org/content/early/2013/07/09/fj.13-235630.full.pdf+html (subscription may be required)

Kevin Cook began serving as chief executive officer of the University of Mississippi Medical Center’s adult hospitals in Jackson July 8. He was formerly CEO of St. Vincent Medical Center in Toledo, as well as president of the Toledo metro market for Mercy Health Partners, part of a large nonprofit health system operating in Ohio and Kentucky. Mr. Cook’s arrival allows Janet Harris, DNP, to return to her full-time role as chief nursing executive officer at UMMC after 18 months as interim CEO.

Dr. R. Bowen Loftin on Friday announced that he will step down as president of Texas A&M University effective January 13, 2014. He will be returning to the faculty and will serve as a tenured professor in the Department of Industrial and Systems Engineering.

The Baton Rouge Advocate on Saturday reported, “Dr. Michael Kaiser will step down from his $350,000-a-year job as chief of the LSU Health Care Services Division effective Aug. 30. Kaiser stepped into the job last fall as the Jindal administration worked toward privatization of six of the seven charity hospitals in south Louisiana under the umbrella of the LSU Health Care Services Division, called HCSD…Kaiser, who is also HCSD’s chief medical officer, declined an interview request.” In an email to colleagues, Dr. Kaiser, a pediatrician, said he was relocating to the San Francisco Bay area.

And finally…Wing of Zock, the innovation web site that highlights transformations in academic medicine, has posted a cartoon depicting the “Functional Anatomy of the Med Student’s Brain.” The artist, Dalya Munves, is a medical student at UT, Houston. She will now be a regular contributor to the blog.

Tony Mazzaschi

PS: Feel free to email <cfas@aamc.org> if you have a problem accessing any article or resource mentioned in this summary. Also, have colleagues email <cfas@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:
+AAMCAction, an iPhone, iPad and Android app featuring AAMC news and advocacy resources
+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
http://academicmedicineblog.org/ and its Twitter feed @AcadMedJournal


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