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Opiate abuse and addiction in the U.S. population have reached epidemic proportions, with one result being that primary care practices increasingly see patients for whom addiction is the presenting, or exacerbating, problem. But are primary care practitioners actively engaged in treating addiction? Unfortunately, no, says Dr. Hughes Melton, a primary care physician and Virginia's Chief Deputy Commissioner of Public Health and Preparedness. They lack the practical training and helpful mindset to approach addiction, but, also, addiction is more than a medical problem, with multiple stakeholders beyond patient and family, doctor, and clinic.
In this Medical Center Hour, Dr. Melton and two Generalist Scholars--students preparing for careers in primary care--consider what primary care practitioners need in order to care effectively for this urgent population health problem: practical skills and informed attitudes, to be sure, but also the will and nuanced capabilities to be robust social leaders in the community.
A John F. Anderson Memorial Lecture
Co-presented with the Generalist Scholars Program and the Department of Public Health Sciences in observance of Primary Care Week at UVA
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
Randall Griffin was born and raised in 1967 in Chattanooga, Tennessee, and spent time as a young child in Lanett, Alabama, where his mother’s family worked as sharecroppers. Griffin discusses his Cherokee roots in Standing Rock, Alabama, and his early memories of growing up in public housing in Tennessee. His father was a musician in Tennessee with a band called the Fabulous Battalions. Griffin joined the Navy and was stationed in Norfolk in 1986. Following his time in service, Griffin worked as a manager at a Fertilizer plant in Chesapeake when he lost his left hand in a workplace accident, which disabled him permanently. He later went on to work for the Parks and Recreation Departments in Virginia Beach, Norfolk, Chesapeake, and Portsmouth. In this oral history interview, Griffin discusses his experience often being the first Black person in these departments and his experience with workplace discrimination. He discusses the importance of rec centers in young people’s lives. This interview was conducted in the Cavalier Manor Recreation Center in Portsmouth, Virginia, where Griffin serves as the Recreation Program Specialist.
Ray Smith was born in Douglas Park, Portsmouth, Virginia, in 1954. His father worked in the Norfolk Naval Shipyard, and when the city of Portsmouth built the interstate in Douglas Park, his family and other residents were forced to relocate to the Mount Hermon neighborhood. When the city of Portsmouth announced the closure of I.C. Norcom, a historically Black high school in 1972, Smith and others organized a walkout in protest. I.C. Norcom was saved and eventually rebuilt in 1999, when Smith served on the school board. Smith became involved in city politics working for governor and presidential campaigns and served as the President of the Civic League, a community organization dedicated to improving conditions for the Portsmouth community of Cavalier Manor, of which he was a resident for 45 years. In this interview, Smith discusses the ways that recent tolls in Portsmouth have impacted Portsmouth residents and how the city dealt with Hurricane Isabel.
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
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
