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In 1984, Ronald Reagan’s reelection campaign introduced the theme “Morning in America," promoting an image of the U.S. as a hopeful nation moving toward a better future. As one campaign advertisement asserted, “It’s morning again in America, and under the leadership of President Reagan, our country is prouder and stronger and better.” Fast forward to 2016. “Hopeful” or making the country “prouder" aren't descriptors most Americans would apply to either this presidential campaign or the contenders. One day post-election, what do experts think will be the “better future” under our new President and Congress? And how might the new President’s health care agenda be felt in the Commonwealth of Virginia?
A John F. Anderson Memorial Lecture
Musicologist April Greenan outlines use of music in western medicine as an agent of both healing and prevention, reviewing data documenting music's beneficial effects on patients, and suggests ways that health professionals might purposefully employ music in patient care. How might doctors guide patients to use music on their own in managing pain, anxiety, depression, the side-effects of chemotherapy? Given the ubiquity and affordability of recorded music today, might it represent a cost-effective way to help improve health care and health?
A John F. Anderson Memorial Lecture
Dr. Aaron Vinik recounts his journey through the golden years of biomedical and clinical research as he has studied and tested regeneration of pancreatic islet cells and nerve fibers. There are lessons here for coming generations of physician-scientists--about discovery, about collaboration, about being mentored, about, as Ralph Waldo Emerson suggests, venturing where there is no path and leaving a trail.
The Alpha Omega Alpha Lecture of the School of Medicine
The year 2018 marks the centennial of the "Spanish" influenza pandemic, the world's deadliest event, killing at least 50 million persons worldwide. This pandemic's sudden emergence and high fatality are stark reminders of the threat influenza has posed to human health and society for more than a millennium. Unusual features of the 1918-1919 outbreak, such as the age-specific mortality pattern and unexpectedly high frequency of severe and fatal pneumonias, are still not fully understood. But the recent sequencing and reconstruction of the 1918 virus—work accomplished by NIH scientist Jeffery Taubenberger and colleagues—have yielded answers to crucial questions about the virus's origin and pathogenicity. In this Hayden-Farr Lecture at Medical Center Hour, Dr. Taubenberger summarizes key findings, considers yet-to-be answered questions about the 1918 influenza, and looks ahead to 21st century public health preparedness and the need to optimize preventive vaccines and vaccination strategies.
The Hayden-Farr Lecture in Epidemiology and Virology/Medical Grand Rounds/History of the Health Sciences Lecture
Co-presented with the Department of Medicine, Historical Collections in the Health Sciences Library, and Influenza! 1918-2018
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
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
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
Hospitals and clinics and safety-net organizations across the U.S. are increasingly challenged to provide medically appropriate care to undocumented and uninsured immigrants. These "patients without passports" do not qualify for public benefits that finance health care for low income persons and often lack other means to secure care for themselves and their families. In this Medical Center Hour, Nancy Berlinger, co-director of The Hastings Center’s Undocumented Patients project, explores the ethical and practical dimensions of health care access for this cohort of immigrants, drawing on data from Virginia and other states and on her work with New York City policymakers to improve health care access for vulnerable populations. UVA emergency medicine physician David Burt offers a local perspective.
A John F. Anderson Memorial Lecture
Co-presented with Institute for Practical Ethics and Public Life
Have you ever received an unsolicited email from a publisher you’ve never heard of inviting you to submit a paper to a journal with a generic-but-believable-sounding name or a conference abroad or at an airport hotel? These publishers may advertise their journals as “open access” and promise to make your work visible to well-known indices; they may claim “impact factors” and editorial board members who are leaders in their field. All that’s required of you is a modest fee—an "author’s processing charge"—and these publishers can deliver the lifeblood of any academic career: a peer-reviewed publication. There’s just one catch: the journals are fake.
These journals are labeled "predatory," and they are sometimes associated with the broader open-access movement. This Medical Center Hour tours the strange world of predatory publishing and describes some of its more outrageous excesses. But, as Brandon Butler will argue, the fake journals are just a distraction. The academy today faces more serious challenges as it wrestles with how best to share research and knowledge. How should academia confront the predatory moves of its most well-established publishing partners and take better advantage of open access?
A John F. Anderson Memorial Lecture