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In June 2018, Gov. Ralph Northam signed a budget bill that gives 400,000 low-income Virginians access to government health insurance through Medicaid. This action marked an upbeat, bipartisan close to a bitter, four-year battle in the General Assembly. An Affordable Care Act option, Medicaid expansion makes additional low-income persons in participating states eligible for care that is funded chiefly with federal dollars. Virginia’s decision to join 32 other participating states hinged on a legislative compromise with Republicans that imposes work requirements on Medicaid recipients. While a few other states have taken similar positions, debate about work requirements continues in government, policy circles, and the courts. This Medical Center Hour looks at Medicaid expansion in Virginia—to be implemented in January 2019—from policy, political, and health care perspectives, with a focus on what it means locally, in Charlottesville and Central Virginia.
A John F. Anderson Memorial Lecture
Martina Scholtens worked as a physician at Bridge Refugee Clinic in Vancouver for ten years, caring for patients from around the world. Her book about this work, Your Heart is the Size of Your Fist, is a creative nonfiction account of one Iraqi family’s first year in Canada from her perspective as their doctor. In this Medical Center Hour, Dr. Scholtens explores the physician writer’s obligation to patient, profession, and society and inquires into the legitimization of patient suffering, the concept of medical maternalism, and the challenges of advocacy.
The Moore Lecture of the School of Medicine/Medical Grand Rounds
Co-presented with the Generalist Scholars Program and the Department of Medicine, and offered in conjunction with Primary Care Week at UVA
The influenza pandemic of 1918 was the most powerful pandemic disease in human history, emerging out of the worst-case scenario of an airborne virus mutating to an extremely lethal form amid crowded conditions of military training camps and battlefields. This deadly influenza exploded from the Western Front of World War I to circle the globe and kill at least 50 million people worldwide within 18 months. To open UVA’s centennial commemoration of the 1918 pandemic, historian Carol Byerly highlights the U.S. Army’s experience with influenza at home and abroad in the context of the historic relation between disease and war. What can we learn from 1918 even as we anticipate and fear future pandemics?
A History of the Health Sciences Lecture
Co-presented with the Bjoring Center for Nursing Historical Inquiry, School of Nursing; Historical Collections in the Claude Moore Health Sciences Library; and Influenza! 1918-2018
We hear much these days about the widening gap in America between the rich and the poor, the haves and the have-nots. Inequality is all around us, and it exacts a serious toll on health. The poor die sooner. Blacks die sooner. And poor urban blacks die sooner than almost all other Americans. Indeed, there is a 35-year difference in life expectancy between America's wealthiest (and healthiest) and poorest (and sickest) neighborhoods.
Internist David Ansell MD has worked for four decades in hospitals serving Chicago's poorest communities. While he's witnessed first-hand the structural violence—racism, economic exploitation, and discrimination—responsible for the "death gap," he argues that geography need not be destiny. In this Medical Center Hour, Dr. Ansell outlines how we can address this national health crisis and act to remedy the circumstances that rob many Americans of their dignity and their lives.
Co-presented with Alpha Omega Alpha National Medical Honor Society, UVA chapter
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
In 1759, London’s British Museum opened its doors for the first time, the first free national public museum in the world. In this Phi Beta Kappa Lecture at Medical Center Hour, historian James Delbourgo explores the role of slavery and imperialism in making this now venerable institution possible by exploring the career of its founder, Anglo-Irish physician Sir Hans Sloane. Sloane worked in Jamaica as a plantation doctor, used money from sugar plantations in the caribbean and from the Atlantic slave trade to support his collecting, and created his own personal imperial network to assemble one of the greatest cabinets of curiosities in the world—and one of the key institutional legacies of the Enlightenment.
Co-presented with Phi Beta Kappa (Beta of Virginia), President's Commission on Slavery and the University, Department of History, and History of the Health Sciences Lecture Series, Historical Collections, Claude Moore Health Sciences Library
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
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
In recent years in the US, increasing workforce diversity has become a priority in health care and other industries. Many companies, including Fortune 500s, now recognize that having a diverse workforce improves both business and the bottom line—indeed, diversity is key to organizational excellence. In this Medical Center Hour, a panel of physicians explores whether UVA Health System's growing diversity can add value in a very different way: can our organization's greater diversity be a lever to mitigate bias in these increasingly fraught times?
A John F. Anderson Memorial Lecture
In the spotlight for years now, health care that is truly equitable and patient-centered and delivered by a diverse, well-integrated team remains a goal—in most sites, it's not yet everyday reality. Individuals and institutions—including health professional schools as well as centers of clinical practice—continue to work toward this goal. But this effort cannot depend just on recruiting more diverse learners, reorganizing clinical environments, or deploying didactics aimed at eliminating biased attitudes and behaviors. Rather, it’s a matter of redesigning health professional education—curriculum, assessment strategies, learning environments—to prepare a thoroughly diverse workforce ready to counter health disparities. To actually realize diversity’s benefits, we must eschew a colorblind philosophy and embrace principles of equity pedagogy.
In this Medical Center Hour, Dr. Catherine Lucey explores equity pedagogy and how it may help to counter the structural racism and inequitable learning environments of traditional medical school. Such a fundamental change in our pedagogy may be necessary to improve health outcomes for patients of all cultures, colors, creeds, and means and, along the way, establish work environments where clinicians, teachers, and scientists of many backgrounds and professional preparations can all flourish.
A John F. Anderson Memorial Lecture / Medical Education Grand Rounds
Co-presented with the Office of Medical Education