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Health care information can confuse doctors and patients alike. What are the risks and benefits of mammograms, of aggressive blood pressure control, of EKGs, of lung cancer screening, of heart stents? When patients can’t accurately answer these questions, they find it difficult to have sensible conversations about their health care with their doctors. And lack of comprehensible medical information not only interferes with shared decision-making between physician and patient but can also lead to over-screening and over-treatment, with deleterious consequences for patients as well as for the health care delivery system and medical reform.
In this Medical Center Hour, internist Andy Lazris and scientist Erik Rifkin assess this challenging situation and then present, as one solution, a novel decision aid called a Benefit Risk Characterization Theater (BRCT). When health care information is conveyed simply, factually, and in a non-numerical format, true shared decisions become possible. They offer BRCTs to explain the risks/benefits of some common medical interventions and demonstrate how this approach can improve health care delivery, lead to greater patient satisfaction, and result in less over-treatment, one of the main drivers of low-value health care cost.
Co-presented with the Department of Medicine
Renee Hoyos is the former Environmental Justice director for Virginia’s Department of Environmental Quality (DEQ), where she worked for 18 months between 2021-2022. This interview discusses her time with the agency, the limitations of the DEQ, and why she left her position.
In September 1925, while the family of English composer, Herbert Howells, was on vacation in the English countryside, their son, nine-yer-old Michael Howells fell ill with polio and died in London three days later. Howells channeled his grief into the composition of the "Requiem," which drew heavily on an earlier, unpublished work. In this Medical Center Hour, fourth-year medical student and musician Rondy Michael Lazaro explores the historical context of polio in the 1930s and how the loss of Howells's young son played out in the composer's music. Mr. Lazaro conducts a chamber chorus in the performance of two movements from Howell's "Requiem."
Co-presented with the History of the Health Sciences Lecture Series
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
Since its creation in 1999, the same year the Institute of Medicine issued its landmark report, To err is human, the Richardson Memorial Lecture has sparked and sustained conversation at the University of Virginia on the sensitive subject of medical error. The annual lectures ever since have brought to UVA noted experts on medical mistakes, communication about error, and the importance of clinicians' attending carefully to patients as persons. Collectively, the Richardson Lectures have provided opportunities for students, clinicians, educators, and administrators to learn better how to prevent medical errors, communicate about them when they do happen, improve quality of care in complex clinical systems, and assure patients and families of the best possible care and outcomes. The 2013 Richardson Lecturer is internationally known patient-safety expert Dr. Peter J. Pronovost, whose scientifically validated checklist protocol, developed at the Johns Hopkins University, is improving patient safety in health care institutions across the US and the world.
Co-presented with the Patient Safety Committee, UVA Health System
Part one. Law professor Jack Greenberg's class discusses executive governmental determination of states of emergencies, such as in South Africa during Apartheid and in the United States during Japanese-American internment in World War II. In 1987 states of emergency are called regularly in South Africa to detain people without reason in the name of public safety, to maintain the status quo, and to suppress the majority. Part two. What happens to democracy when the government alone has the power to declare a state of emergency? The class discusses the use of states of emergency as a way to suppress people and deny rights, preventative detention as an abuse of human rights, and using the courts in South Africa to fight the injustices of the states of emergency. Part three. How much does a democratically elected government insure adherence to human rights? The class also talks about the rights of the white minority in a future democratic South Africa. Part four. Examples of transitions to democracy.
