- Date:
- 2016-11-28
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Health information technology (health IT), including electronic health records (but much, much more), enables health care providers--from individual clinicians to widely networked health care organizations--to better manage patient care through streamlined sharing of health information. Since 2004, the Office of the National Coordinator for Health Information Technology has led U.S. efforts to deploy advanced health IT in order to improve clinical service delivery and support patient engagement. As a result, nearly every hospitalization and most doctor visits now have a digital footprint, and an extraordinary amount of health data exists that simply didn't a decade ago. The health IT goal now is to foster seamless and secure data sharing to improve the health and care of individuals and populations alike. In this special Medical Center Hour, Dr. Vindell Washington, National Coordinator for Health Information Technology, introduces this key national initiative and cites the promise and chief challenges for this increasingly central component of our nation's health care system. A John F. Anderson Memorial Lecture
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- Date:
- 2017-01-25
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- The stethoscope, an extension of the clinician's ear, is perhaps modern medicine's most characteristic symbol. Through it, doctors listen for the body to disclose its secrets. Doctors must also listen to their patients' stories. In fact, as Oliver Sacks said, "The first act of medicine is listening to a personal story." But hasn't the clinician's ear lost much of its importance now that procedures and machines can give us more direct access to pathology? In this Richardson Lecture, physician and poet John Coulehan affirms the importance of the clinician's aural attention in the clinical encounter and considers three aspects of the metaphorical clinical ear. First, listening to patients, an active process with vertical (deep listening) and horizontal (narrative) dimensions. Second, listening to the heart, the reflective core of clinical practice. And, finally, hearing the resonance of our own healing words. In medicine, the word can be an instrument of healing. Co-presented with the Office of Quality and Performance Improvement, UVA Health System
- Date:
- 2018-02-14
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In the summer of 1816, an eighteen-year-old English girl on a lark in Switzerland with a married man and her stepsister began writing a story that would outlive her by centuries. Mary Shelley's novel, Frankenstein, published in 1818, still fascinates and confounds us today, told and retold in so many genres that even those who have never read the original know the story. This Medical Center Hour marks Frankenstein's 200th anniversary by exploring two of the many reasons for its apparent immortality. First, this novel probes the central quest of medicine and biology: What is life? Second, it asks—but leaves for us to answer—the essential ethical question: Should we as human beings manipulate the spark of life? Co-presented with the History of the Health Sciences Lecture Series, Historical Collections, Claude Moore Health Sciences Library
- Date:
- 2015-09-30
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In this Medical Center Hour, award-winning journalist Meera Subramanian explores the human and global health implications of India’s ravaged environmental landscape. Her new book, A River Runs Again: India's Natural World in Crisis, investigates five environmental crises by profiling ordinary people and micro-enterprises determined to guide India and its burgeoning population into a healthier future. An organic farmer revives dead land; villagers resuscitate a river run dry; cook-stove designers seek a smokeless fire; biologists bring vultures back from the brink of extinction; and, in one of India’s poorest states, a bold young woman teaches adolescent girls the fundamentals of sexual health. In these individual stories resides hope for a nation and its people and the potential for a sustainable and more prosperous world. A John F. Anderson Memorial Lecture/Exploring the Global South Co-presented with the Center for Global Health, Institute for the Humanities and Global Cultures (Global South Initiative), Department of Public Health Sciences, and Virginia Quarterly Review
- Date:
- 2012-11-07
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- RN-MD collaboration in health care (or the lack thereof) is one of the more vexed issues facing our struggling health care system. Yet it rarely gets addressed in a substantive and purposeful way. The problem begins with the training of nurses and doctors. Nursing schools have seldom taught the nuts and bolts of working with physicians. Medical schools have taught future doctors almost nothing about working with nurses. Often the result in clinical practice is that each group finds the other difficult. Even so, nurse-physician collaboration is what makes health care possible, and good collaboration makes high quality care much more likely. In this Medical center hour, nurse and author Theresa Brown considers new, potentially revolutionary initiatives in health professional education, including at UVA, that bring nursing and medical students together as learners. Will interprofessional education lead to better RN-MD collaboration in practice and, as a result, to better patient care? The Zula Mae Baber Bice Memorial Lecture Co-presented with the School of Nursing
- Date:
- 2015-11-11
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Over the last half-century, pain medicine has been defined by controversy: when is pain real? Does too-liberal, overly compassionate relief create addiction? Is chronic pain a legitimate basis for disability claims and long-term benefits? What should we do when end-of-life pain care resembles physician-assisted suicide or euthanasia? Professor Keith Wailoo explores the political and cultural history of these complex medical and social debates, examining how pain medicine emerged as a legitimate yet controversial field; how physicians, patients, politicians, and the courts have shaped ideas about pain and its relief; and how the question “who is in pain and how much relief do they deserve?” has become a microcosm of broader debates over disability, citizenship, liberalism, and conservatism in American society. Co-presented with History of the Health Sciences Lecture Series and the Institute for Practical Ethics and Public Life, UVA History of the Health Sciences Lecture
- Date:
- 2017-03-01
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Where you live in a particular U.S. city determines your predicted life expectancy. Neighborhood is destiny, in a way. For example, in New Orleans, there is a twenty-five-year difference in life expectancy from one parish to another only three miles away. This pattern of great gaps in health status, even over short distances, repeats itself in New York, Chicago, the Bay Area, and many other American cities, with harsh consequences. In 2005, Tulsa, Oklahoma was one of the first cities to recognize such dramatic neighborhood variations in life expectancy, with a fourteen-year difference in life expectancy between north Tulsa and midtown—and to take action. In this presentation, Dr. Gerard Clancy describes specific initiatives and lessons learned on the ten-year journey, from 2005 to 2015, to reverse these health disparities and improve the health of the people in north Tulsa. The successes of the past decade have inspired a new ten-year initiative in Tulsa focused on mental health system improvements. Co-presented with the Brodie Medical Education Award Committee, the Academy of Distinguished Educators, and the Department of Medicine
- Date:
- 2017-11-15
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Our society is aging, and, thanks partly to the science and success of advanced health care, the journey into one’s last years is often long and richly rewarding. But our medicalization of aging also means that older adults are longtime patients entangled in complex, costly, fragmented, and sometimes ad-libbed “systems” of individualized care that are challenging for them and their caregivers to navigate. When elders’ health and functional status changes, ways of managing their care may come undone, just when robust attention is most needed to effect transitions in their care—and the goals of care. In this Medical Center Hour, distinguished gerontologist Mary Naylor offers her pioneering approach to the design, evaluation, and dissemination of health care innovations that has at once improved outcomes for chronically ill older adults and their caregivers and lowered health care costs. Her collaborative work with an interprofessional team has yielded the Transitional Care Model, a cost-effective model led by an advanced-practice nurse that improves the transitions of frail elders as they move through both their final years and our fractured health care system. The Zula Mae Baber Bice Memorial Lecture, School of Nursing The Koppaka Family Foundation Lecture in Medical Humanities, School of Medicine Co-presented with the School of Nursing and the Center for Biomedical Ethics and Humanities, School of Medicine
- Date:
- 2015-02-11
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Fifty years ago President Lyndon B. Johnson envisioned a Great Society, an America free from poverty and racial injustice and full of equality of opportunity and social mobility for all. Many legislative planks of his Great society platform--civil and voting rights, educational opportunity, fair housing practices, urban planning, mass transit, and health care --represent what we today consider "social determinants of health." This Medical center hour with bioethicist Erika Blacksher reviews how Americans are faring today in relation to key aspirations of LBJ's Great Society, especially those that bear on health. Americans generally live shorter, less healthy lives than their counterparts in peer nations, and within the U.S. health varies dramatically among social and economic groups and from region to region. What ethical concerns are raised by significant health disparities? Are such disparities unjust, as many in public health assume? If so, what are our responsibilites, and what ethical limits might constrain our pursuit of a more equitable distribution of health? Co-presented with the History of the Health Sciences Lecture Series and the Institute for Practical Ethics and Public Life
- Date:
- 2014-02-26
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- The Diagnostic and statistical manual of mental disorders (DSM) is perhaps the most contested document in American medicine, vital for the organization and funding of psychiatric research and mental health care, yet perennially criticized both from within and behond the mental health community. Heated debate accompanied the 2013 publication of the manual's fifth edition, DSM-5. Critics charged that the new edition masks political interests (e.g. interests of psychiatrists and pharmaceutical companies) under the guise of science at patients' expense. DSM-5 defenders championed the inclusiveness and transparency of the review process and evidence-base behind the manual's diagnostic decisions. In this Medical center hour, psychiatrist and theologian Warren Kinghorn argues for a mediating alternative: that the DSM may be best understood as neither an apolitical "encyclopedia" of psychopathology nor a political cloak for psychatric power, but rather as a working document of a living moral tradition. In this case the tradition-constituted discourse allows for appreciation of the DSM as a useful scientific document that reflects the moral assumptions and convictions of the communities that created and continue to sustain it. Co-presented with the History of the Health Sciences Lecture Series
- Date:
- 2012-09-12
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In 1990, University of Pittsburgh Public Health Professor John C. Cutler delivered to the university's archives thousands of pages of documents and photographs about an unpublished research project that he ran in Guatemala for the U.S. and Guatemalan governments between 1946 and 1948. Duly cataloged, the files then sat in the library until the mid 2000s, when historian Susan Reverby began to read them as part of her book project on the Tuskegee syphilis studies. Who knew that the infamous U.S. Public Health Service Study of Untreated Syphilis in Tuskegee, Alabama, had an off shore successor? Unlike Tuskegee, the Guatemala studies led by Dr. Cutler involved actual inoculation of sexually transmitted diseases and the paying of sex workers to transmit disease. Unsuspecting and unconsenting prisoners, soldiers, mental patients, and sex workers participated; only some were treated if and when they became infected. In 2009, Professor Reverby returned to the Pittsburgh archive, and in 2010 she wrote up her findings on the Guatemala project. She shared her unpublished article with the late David Sencer, former director of the Centers for Disease Conrol (CDC), who gave the article to the current CDC leadership. The CDC prepared its own report and sent it, along with the Reverby article, up the chain of command to the White House. On Oct. 1, 2010, Health and Human Services Secretary Kathleen Sebelius and Secretary of State Hilary Rodham Clinton apologized to the Guatemalan government and President Obama telephoned then President Colom in Guatemala to explain. In the spotlight of worldwide media attention, presidential commissions in both countries undertook investigations, and survivors of the study filed suit against the U.S. government. The Guatemala study and its aftermath have urgently renewed debate about the ethics of clinical research involving human participants, especially research carried out with vulnerable populations and in the global arena. In this Medical Center Hour, Susan Reverby discusses how her discovery of the Guatemala study files set in motion international investigative and diplomatic processes and what we can learn from this ethically immoral use of medical science. Bioethicist John Arras, a member of the Presidential Commission for the Study of Bioethical Issues, will comment on the commission's investigation and its 2011 report, Ethically impossible: STD research in Guatemala from 1946 to 1948.
- Date:
- 2017-10-25
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- A diverse population of caregivers working in clients' homes constitutes a vital link in our health care “system,” their services filling a gap between institutional care and what families are able to manage on their own. Who are these caregivers, what is their work, and what does their work mean—to them, to the clients and families they serve, to our larger society? Prompted by the recent documentary film, CARE, by Deirdre Fishel, which profiles five caregivers and their elderly clients, this Medical Center Hour inquires into the nature and lived experience of home-based caregiving for elders. What role will such home care play as our society ages and people seek to stay at home with complex, care-intensive medical conditions? How can we better value and compensate care workers and better support families who need their services? What about the sustainability of the home health caregiving economy and its workforce? A John F. Anderson Memorial Lecture Co-presented with the Department of Chaplaincy Services, UVA Health System
- Date:
- 2014-11-12
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- At a time when lesbian, gay, bisexual, and transgender (LGBT) individuals enjoy ever greater social acceptance and legal protection, transgender teens and young adults still face challenges on many fronts. Simply negotiating adolescence isn't easy, and gender identity issues can complicate matters. Health care for transgender youth is in transition, as the population becomes better understood. In this Medical Center Hour, a panel of pediatricians makes the case for increased cultural competency in medicine and society alike to help give transgender teens a safe medical home and help them to lead satisfying, successful lives.
- Date:
- 2018-02-21
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Tuberculosis continues to be one of the world's most deadly infectious diseases, killing almost two million people each year. In this Medical Center Hour, historian Christian McMillen explores TB's stubborn staying power by examining key aspects of the disease—including the rise of drug resistance and TB's resurgence with the HIV/AIDS epidemic—and detailing global efforts to control it since 1900. Co-presented with the History of the Health Sciences Lecture Series, Historical Collections, Claude Moore Health Sciences Library
- Date:
- 2018-01-24
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Neurologist Oliver Sacks (1933-2016) was a legend in his own time—as a physician but also as a writer whose work probed medicine, science, and the arts and as a tireless explorer of both the natural world and the human condition. His clinical tales, published in the medical literature and mass media alike, found a wide audience across medicine and society. Behind these tales, which stretched the case history to illuminate and celebrate the person who was marked, and often rendered remarkable, by neuropsychological illness, flared Sacks's own curiosity, an insatiable urge to question and a generous capacity for paying meticulous attention. In this inaugural Hook Lecture in Medicine and the Arts, writer and photographer Bill Hayes, who was Sacks's late-life partner, offers insights into Oliver Sacks as a person and a physician whose creative nature and prodigious output enriched medicine and culture across a long and productive life. A writer and photographic artist in his own right, Hayes addresses the place of curiosity and creativity in Sacks's practice and his own, especially how, for both, interest in and radical openness to a fellow human being are paramount. The Edward W. Hook Lecture in Medicine and the Arts / Medical Grand Rounds Co-presented with the Department of Medicine, with which the Medical Center Hour shares a fund established by the late Edward W. Hook MD MACP whereby the arts can generously enrich medical education and training.
- Date:
- 2014-04-02
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Despite their reliance on technical knowledge that requires mastery, medicine, law, and business are all deeply human professions. Medicine is more than body repair, law more than legal systems, business more than the physics of money. While professional education necessarily must be at the cutting edge of technical expertise, it must remember too the human nature—including the values, emotions, and richly complicated lives—of professionals and professional organizations. In this Medical Center Hour, Professor Ed Freeman from UVA's Darden School of Business demonstrates how the creative arts and humanities can be embedded in professional education to address and actively teach ethical conduct in professional life and leadership of complex professional organizations. What lessons in course design, student engagement, and classroom outcomes might medical educators draw from Professor Freeman's courses, "Business Ethics through Literature" and "Leadership, Ethics, and Theater"? A John F. Anderson Memorial Lecture Co-presented with the Institute for Practical Ethics and Public Life, UVA
- Date:
- 2012-09-19
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- With the aging of our nation's practicing physicians and the recent, steep decline in medical graduates choosing careers in primary care for adults, U.S. patients today are hard pressed to find a primary care doctor. And the already impressive gap between supply and demand of primary care physicians will likely widen once more than 30 million people gain access to health insurance under the Affordable Care Act. The urgent shortage of primary care physicians compounds this country's already significant health care challenges regarding access, delivery, and cost of care. In an era when all of health care is undergoing potentially transformative change, what will be the role of primary care doctors? For patients, what will be the "value added" of having a primary care M.D.? What roles will other primary providers (physician assistants, nurse practitioners) play? Is the primary care physician an endangered species, or a key participant in a newly configured primary care team? How can we devise, model, deploy, and teach new ways of delivering primary care that are team based, interprofessionally collaborative, effective, and satisfying to patients and practitioners alike? In this Medical Center Hour, family doctor and medical journalist Susan Okie draws on her recent Perspective article in the New England Journal of Medicine to explore the prospects ahead for the primary care physician. Two of UVA's primary care physicians: one a mid career family medicine physician and teacher, the other a medical student planning a primary care career offer their perspectives as well. Co-presented with the Generalist Scholars Program in observance at UVA of Primary Care Week
- Date:
- 2017-09-13
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- On 13 September 2017, the University of Virginia proudly dedicates as Pinn Hall the medical education and research building formerly known as Jordan Hall. The building’s new name recognizes UVA medical graduate Vivian W. Pinn MD, Class of 1967, founding director of the Office of Research on Women’s Health at the National Institutes of Health. Dr. Pinn was the second African American woman to graduate from the School of Medicine and went on to a distinguished career in pathology and in medical leadership. One of the medical school’s four colleges bears Dr. Pinn’s name, and she is an active presence in Pinn College student life. This Medical Center Hour celebrates Dr. Pinn and her accomplishments and calls attention to critical current issues of fair and full access for underrepresented minorities, especially African American women, as students, practitioners, and leaders in medicine but also as beneficiaries of health care. Individually and institutionally, what can we learn from Dr. Pinn to ensure that her legacy matters? Co-presented with the Department of Medicine and the Generalist Scholars Program, in conjunction with UVA's dedication of Pinn Hall and the UVA medical students' celebration of Primary Care Week
- Date:
- 2015-11-18
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Early in her own training in psychology a decade ago, Casey Schwartz discovered that contemporary neuroscience and psychoanalysis are entangled in a conflict almost as old as the disciplines themselves. Many neuroscientists, if they think about psychoanalysis at all, view it as outdated, arbitrary, and subjective, while many psychoanalysts decry neuroscience as lacking the true texture of human experience. Yet some are now fighting passionately to bring the two fields together, including Mark Solms, a South African psychoanalyst, neuropsychologist, dream researcher, and towering presence in the effort to grow the hybrid discipline that he himself calls neuropsychoanalysis. Ms. Schwartz has written this story in her new book, In the Mind Fields: Exploring the New Science of Neuropsychoanalysis. In this Medical Center Hour, she tracks and interprets the ongoing struggle to define what we mean by the mind, the brain, and everything in between. History of the Health Sciences Lecture Co-presented with History of the Health Sciences Lecture Series and the Department of Psychiatry and Neurobehavioral Sciences
- Date:
- 2018-03-14
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Whether we are students, educators, or clinicians (learners all!), our stated assumptions and principles are sometimes at odds with our actual practices. In this Brodie Medical Education Award Lecture, learners of all stripes will practice foundational skills such as cultivating beginner’s eyes and more accurate data collection in order to uncover and examine habits and thought patterns that may no longer serve us. Understanding our own assumptions and the values they reflect will allow us to be more intentional in designing educational programs and clinical learning/practice environments that are principle-driven and meet the needs of patients, learners, and caregivers. The Brodie Medical Education Award Lecture/Medicine Grand Rounds