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- Date:
- 2014-11-05
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- During the enlightenment, from 1765, the Habsburg Empire capital of Vienna underwent massive transformations in urban design and appearance, from the introduction of sewer systems and streetlights to urbanization of suburbs and construction of public facilities, including parks, all guided by principles we now consider fundamental to creating healthy, green, livable cities. Habsburg Emperor Joseph II (1780-1790), a reformer with almost utopian (and quite Jeffersonian) ideas about architecture and health, extended these massive changes by contructing Vienna's medical district, including the general hospital, the military hospital, an institute for the mentally ill, and the medical-surgical military academy Josephinum. What does it mean to "construct for health" in designing cities and landscapes, public and private spaces, and health care facilities? This Medical center hour examines the Vienna Project as an important design-and-health precedent. How might we in the twenty-first century enlist design professionals and health professionals together in more deliberate, collaborative efforts to improve public and personal health and well being? Co-presented with the History of the Health Sciences Lecture Series, the Center for Design + Health (School of Architecture), the Eleanor Crowder Bjoring Center for Nursing Historical Inquiry (School of Nursing), and the Department of Public Health Sciences and the Center for Biomedical Ethics and Humanities (School of Medicine), as part of the interprofessional symposium “Constructing for Health: A Global Nod to Nightingale,” funded by the Buckner W. Clay Endowment for the Humanities (College and Graduate School of Arts and Sciences)
- Date:
- 2014-01-29
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In 1858, young English surgeons Henry Gray and Henry VanDyke Carter published an illustrated anatomy textbook for medical students. Gray's Anatomy has never since been out of print, but little was known about its author and illustrator until acclaimed science writer Bill Hayes—inspired by a photograph of Henry Gray—pieced together their story in The Anatomist. This Medical Center Hour explores the medical, historical, and artistic significance of Gray's Anatomy and also Hayes's unforgettable year alongside medical students in the anatomy lab. Co-presented with the History of the Health Sciences Lecture Series, Historical Collections, Claude Moore Health Sciences Library
- Date:
- 2014-10-15
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- "Germs have always traveled. the problem now is they can travel with the speed of a jet plane." So said physician and medical historian Howard Markel in recent days, commenting on the spread of Ebola outside West Africa. This Medical center hour takes stock of the rapidly evolving Ebola epidemic and the concomitant rise in global health security concerns. What is known of this unusual virus and the life-threatening hemorrhagic fever it triggers? How are sociopolitical and cultural conditions and healthcare infrastructural inadequacies in West Africia and elsewhere hindering medical and public health response? How are governmental and health care institutions in the U.S. responding as cases erupt outside West Africia? And, looking ahead, what are the prospects for vaccine development and fast-track clinical trials? A John F. Anderson Memorial Lecture Co-presented with the Department of Public Health Sciences and the Center for Global Health
- Date:
- 2014-02-05
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In this Medical Center Hour, Ellen Ficklen, the former editor of "Narrative Matters," takes us behind the scenes at Health Affairs to probe the close working relationship between authors and editors as manuscripts are sculpted and polished into essays that surgeon/author Atul Gawande describes as "some of health care's most stunning writing." A John F. Anderson Memorial Lecture
- Date:
- 2014-10-08
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In this Medical center hour, prize-winning writer Leslie Jamison inquires into the phenomenon of empathy. It may be something more fraught then we often imagine it to be. Empathy isn't just an instinctive reaction but a more complicated blend of intuition and decision. And it's not neccessarily an unequivocal good. It can mislead. It can exhaust. Ms. Jamison draws on her experiences as a standardized patient, working with and observing student doctors getting "trained" in the practice of empathy, as well as her experiences as a journalist, inhabiting a vexed state of empathy for her subjects, to consider a variety of perspectives on what makes for good empathy and what good it can do. A John F. Anderson Memorial Lecture
- Date:
- 2014-09-10
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- At a time of sweeping transitions in health care, medical students and young physicians are eager for guidance as to how best to apply their knowledge and skills in caring for patients. In clinical settings, and especially in primary care, who might be the best role models for young trainees to emulate? What skills and traits do the best clinicians use to create healing relationships with patients? How do clinicians become "healers" -that is, practitioners effective in making the patient-professional relationship itself have active therapeutic potential? Professor Larry Churchill and colleagues at Vanderbilt University School of Medicine have examined these matters, interviewing both clinicians and patients on the vital question of what actually makes for a therapeutic encounter, even in the context of a stressed and changing health care system. In this Medical Center Hour, Professor Churchill will present his studies' findings as a prelude to disscussion of the implications for medical ethics and medical education and for establishing truly "patient-centered" practices.
- Date:
- 2014-10-01
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In summer 2013, UVA landscape architecture graduate students Harriett Jameson and Asa Eslocker travelled to Sardinia, Okinawa, and Loma Linda, California, three landscapes with the highest life expectancy in the world, to explore these places' physical, spatial, and material qualities-topography, plant communitites,urban form-and also the personal attachments that seniors in these sites have to their cultural landscapes. The people in these locales have long been studied for their genetics, diets, and recreation habits. But until Ms. Jameson and Mr. Eslocker arrived, no one had inquired into or demonstrated in these settings the critical role of place in healthy longevity. Through study of these distinctive landscapes and the personal stories of elderly residents, the pair arrived at insights that may help communities rethink and redesign public landscapes to cultivate a culture of health and well being that spans infancy through old age. In this Medical center hour, Ms. Jameson and Mr. Eslocker focus on how place contributes to healthy aging and preview parts of their full-length documentary film, Landscapes of longevity, which will premiere in Charlottesville in November. A John F. Anderson Memorial Lecture Co-presented with the Center for Design + Health, School of Architecture, UVA
- Date:
- 2014-10-22
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Adverse events and poor patient outcomes occur for all doctors, regardless of subspecialty, regardless of educational and training pedigree, and despite best intentions. Such occurrences often exact a significant and sometimes lasting emotional toll on doctors, even apart from any culpability or potential medicolegal ramifications. In this Medical center hour Dr. Farnaz Gazoni demonstrates that adverse events in clinical care and their impact on physicians have substantial, widespread repercussions affecting quality of care and patient safety. But her research and experience show too that, by simply cultivating awareness of this issue, health care institutions and individual practitioners are taking important first steps toward culture change. The Jessie Stewart Richardson Memorial Lecture, School of Medicine In observance of National Quality Week (19-25 October), and co-presented with the Patient Safety Committee, UVA Health System
- Date:
- 2014-03-05
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- American medical education can be proud of its accomplishments. Its graduates populate a sophisticated medical system that often sets global standards in teaching and self-regulation. doctors the world over compete to train and practice in the U.S. There are nearly three applicants for every one place in U.S. medical schools. Things are good. But are they? The U.S. medical system is now by far the world's most expensive, a drag on the economy and a major contributor to accumulating national debt. Physician-writer Atul Gawande notes that the doctor's most expensive instrument is the pen, ordering costly, and sometimes unnecessary, diagnostics and therapeutics. We import a quarter of our doctors, yet major portions of the country are short of physicians. All is not well in medical education. In this Brodie Medical Education Lecture, distinguished physician and health policy expert Dr. Fitzhugh Mullan addresses the technical, cultural, and moral challenges facing American medical education today, and how they go straight to the soul of medicine. Co-presented with the Brodie Medical Education Committee, the Department of Medicine, and the Academy of Distinguished Educators, as part of UVA's Medical Education Week
- Date:
- 2014-03-25
- Main contributors:
- University of Virginia. School of Medicine
- Date:
- 2014-09-24
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Growing enthusiasm in medicine and in the population at large for early diagnosis has engaged many doctors in a systematic search for abnormalitites in persons who are well. While physicians, patients, and the press tend to focus on the potential benefits, Dr. H. Gilbert Welch in his work has exposed the often-ignored harm associated with this practice: overdiagnosis. Diagnoses of a great many conditions, including high blood pressure, osteoporosis, diabetes (and prediabetes), and even cancer, have skyrocketed in recent years, yet many individuals so labeled are destined never to develop symptoms, much less die, from their conditions. They are overdiagnosed. And overdiagnosed patients as Dr. Welch points out in the Medical Center Hour, cannot benefit from treatment since there is nothing to fix. But they can be harmed. Understanding the trade-offs involved is critical, Dr. Welch argues, so that health care systems don't further narrow the definition of "normal" and, ironically, turn more and more well persons into patients. Co-presented with the Department of Public Health Sciences, School of Medicine; the Sadie Lewis Webb Program in Health Law, School of Law; and the Institute for Practical Ethics and Public Life, UVA
- Date:
- 2014-03-12
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Primum non nocere--"first, do no harm"--is a fundamental principle of medical practice, expressing both the hope and humility of physicians. It cautions doctors that even with the best intentions may come unwarranted consequences. One present-day application of this principle has to do with efforts to eliminate hospital-acquired infections. When we define such infections as inevitable if regrettable collateral damage wherever complex care is provided to very sick patients, we create a rationale for paying for them and institutionalize their harm. And we may lose sight of their tragic human and economic costs, and of clinicians' own involvement. The annual Richardson memorial lecture addresses the human toll of medical error and calls for improved patient safety. In this Richardson lecture, Dr. Richard Shannon challenges the academic medical center not only to create safer systems that prevent bloodstream infections but also to invest every frontline worker with the capability and responsibility to see and solve problems before they propagate into error. Importantly, this is about more than safety. It is about culture change, creating a culture of habitual excellence in everything we do. Safety is simply the unassailable starting point. Another foundational medical principle applies: Cura te ipsum--"physician, heal thyself." Co-presented with the Patient Safety Committee, UVA Health System
- Date:
- 2014-10-29
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Over the last decade, the number of reports urging American universities to expose their health professional students to interprofessional education (IPE), so that those who will practice together may learn together, has exceeded the number of actual IPE experiences in most nursing and medical students' entire curricula. In 2013, strong new calls for interprofessional education came from the Institute of Medicine and the Josiah Macy Jr. Foundation. What does this mean for the University of Virginia's Schools of Nursing and Medicine, our students, our health systems, and the patients and families we serve? If we were to push the envelope on IPE, where might we best focus our efforts? How might we lead in preparing the next generation of nurses and physicians for better collaboration and team-based care? The Zula Mae Baber Bice Memorial Lecture, School of Nursing
- Date:
- 2014-02-12
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- At a time when lesbian, gay, bisexual, and transgender (LGBT) individuals enjoy unprecedented social acceptance and legal protection, many LGBT elders face the daily challenges of aging isolated from family, detached from the larger LGBT community, and ignored by mainstream aging initiatives. These elders are more likely to be single, childless, financially insecure, fearful of encountering bias in health care settings, and socially isolated. And the continuing silence surrounding LGBT elders has left many of them underserved and at risk. This Medical Center Hour makes the case that increased cultural competency measures are necessary within medicine and society to help older LGBT persons overcome barriers to successful aging and to ensure that we are all taking good care of our LGBT elders. A John F. Anderson Memorial Lecture co-presented with qMD A John F. Anderson Memorial Lecture co-presented with qMD
- 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:
- 2014-09-17
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- Acclaimed physician-writer Christine Montross (Body of work, 2007; and Falling into the fire, 2013) discusses how diving deeply into her most challenging patient encounters has led her to the ancient concept of "abiding" as a lost tenet of patient care. A psychiatrist and medical educator, Dr. Montross speaks in defense of repugnance, and encourages physicians and doctors-in-training to acknowlege, rather than suppress the discomforts which naturally arise in the practice of medicine. A John F. Anderson Memorial Lecture
- Date:
- 2014-03-19
- Main contributors:
- University of Virginia. School of Medicine
- Summary:
- In its emphasis on instrumentality, on the patient as something to be acted upon, and on the doctor as an abstracted agent of diagnosis and treatment, medicine often neglects the practitioner's involvement in the clinical scene. Recent attempts to direct attention to this aspect of practice have been stymied by medicine's nearly exclusive reliance on a quantitative, positivist disposition, with which humanist scholarship has had difficulty gaining traction. The narrative medicine movement, as articulated by Dr. Rita Charon of Columbia University College of Physicians and Surgeons, has gained widespread attention within the medical academy. But physician and literature scholar Dr. Terrence Holt argues that, for all its positive features (and despite Dr. Charon's efforts to define it otherwise), narrative medicine as applied remains committed to an interventional model that is at odds with the strengths of the humanities. Drawing on readings of texts such as Shakespeare's King Lear, Coleridge's Rime of the Ancient Mariner, Shelley's Frankenstein, and the poetry of John Keats, Dr. Holt contends that the value of the humanities in medical education and practice is not as an intervention but as a diagnostic modality—and that the proper first object of diagnosis may not be the patient, but the physician. The Ellis Moore Lecture of the School of Medicine
- 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:
- 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