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The Affordable Care Act (ACA) has brought transformational changes to the healthcare system, including, in some ACA programs, movement away from a pay-for-volume system to pay-for-performance or outcome. Three programs exemplify this approach: readmission penalties, no payment for selected hospital-acquired conditions (HACs), and value-based purchasing. To date, the HAC nonpayment program has targeted prevention of central-line-associated bloodstream infections, catheter-associated urinary tract infections, selected surgical site infections, and methicillin-resistant Staphylococcus aureus (MRSA) or Clostridium difficile infections. With better understanding, improved procedural practices, and closer monitoring, more of these infections are proving preventable; infection rates, including for MRSA, have dramatically decreased. In this Medical Center Hour, distinguished medical epidemiologist Dr. William Jarvis discusses these successes, including their financial implications, and how further collaboration between clinicians and infection control programs can prevent even more hospital-acquired conditions.
The Hayden-Farr Lecture in Epidemiology and Virology/Medical Grand Rounds
Co-presented with the Department of Medicine, UVA
Over the past decade, several leading U.S. medical schools have developed courses combining art appreciation and clinical observation skills. Medical students venture from the clinical setting to the art gallery, where they are challenged by gallery educators and medical professors to observe and to articulate what they see in the art before them. Such courses aim to cultivate and deepen students' visual literacy, verbal facility, and tolerance for ambiguity with the expectation that more finely tuned visual observation and communication skills will help them to be better doctors.
Working with a task force in the UVA School of Medicine, Fralin Museum of Art academic curator Jordan Love has created and piloted The Clinician's Eye, an interactive workshop that aims to refine apprentice clinicians' skills through training in visual analysis. This Medical Center Hour invites audience members to participate—hands-on—in a version of this workshop.
A John F. Anderson Memorial Lecture
The history of eugenics is often characterized as a cautionary tale of life in the bad old days, when pseudoscientific assumptions about genetic determinism provided a respectable veneer that enabled barely submerged racism, xenophobia, and blatant discrimination against persons with disabilities to take root in American law. Some argue that, today, our science is sound, our attitudes enlightened; we need not be hobbled by fear of long-expired bad eugenic habits.
In this Medical Center Hour, Paul Lombardo, who has written extensively on eugenics and the law in America, challenges such assumptions, asserting that the same tendencies that led to a century of eugenic law and policy continue to inform our public debate over democratic values and the proper role of science as a tool for solving social problems.
The Joan Echtenkamp Klein Memorial Lecture in the History of the Health Sciences
Co-presented with the History of the Health Sciences Lecture Series, Historical Collections, Claude Moore Health Sciences Library
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
