May News

Message from Dean Richardson: Aligning to meet strategic goals

Earlier this month, the Dean's office staff participated in a day-long retreat. One purpose of our offsite gathering was to dig into a core question: are we optimally organized to meet the strategic goals of the School of Medicine and the broader OHSU Vision 2020?

To some extent, our initial discussion tended to circle back to the current budget situation facing OHSU and the School of Medicine, linking this to the urgency to reorganize. While this is undoubtedly a factor, a broader strategic context on this topic proved more constructive.

One goal of our strategic plans is to integrate our mission areas, moving from traditional "silos" to a model in which we can take full advantage of the opportunities and strengths inherent in the overlap between education, research and clinical care. I believe that by focusing aggressively on this strategic goal, we are likely to simultaneously alleviate our fiscal constraints.

The reorganization of the OHSU Cancer Institute is emblematic of an integrated model that breaks down unneeded boundaries between our missions. Under Dr. Brian Druker's leadership and vision, the OHSU Cancer Institute will take the lead on consolidating and expanding cancer research, coordinating cancer care, and directing new efforts throughout the state on screening and prevention. I anticipate that this model, with the appropriate centralized administration, will also help make us more cost-efficient.

While our financial picture is not the main motivating factor to integrate, partner and prioritize, realism in this regard reinforces the necessity and inevitability of such fundamental change. Most of us understand the implications of the temporary "gap" between cash outlay and revenue generation from the university's three new buildings and how this has affected the School of Medicine, however, other factors are also in play.

In the coming years, we will experience a financial impact from changes to the Oregon Tort Claims Act (OCTA). Since 1967, the OCTA has limited the dollar amount that an individual can win in a lawsuit against any Oregon public entity, including OHSU. The constitutionality of the cap is under review by the Oregon Supreme Court and the legislature is debating changes to the OCTA.

We don't know the outcome of these deliberations yet but we do know that the cap, under any scenario, will be increased. The historical cap of $200,000 per individual no longer meets a reasonable standard by anyone's definition, including our own.

While we anticipate and appreciate a modest increase in state funding this year, the state's allocation to OHSU and the School of Medicine has been steadily declining for a decade. In response, the School of Medicine has accumulated deferred maintenance needs that can no longer be ignored.

Evaluating the status quo in this strategic and fiscal context was a goal of the Dean's office retreat. We made progress on envisioning our future organization, and acknowledged that change was inevitable. An outcome of our discussion was articulating anew our core function: service – to learners, to faculty and to alumni. Going forward, we agreed to develop a plan to ensure that our form optimally meets this function.

Over the course of the next 12 months, I encourage every unit within the School of Medicine to also take the time to consider the core question: are you optimally organized to meet the strategic goals of the School of Medicine and the broader OHSU Vision 2020?

Best regards,

Mark Richardson

Faculty Feedback

The Office of the Dean regularly receives questions and comments from faculty on a variety of topics. We will use the newsletter to periodically respond to some of these questions, particularly those of widespread interest or concern or those that have relevance to faculty satisfaction. Our goal is to continually improve communications in the School of Medicine. Your questions and comments are welcome and appreciated. (These questions are a compilation of multiple inquiries on the same topics.)

Q: I am a relatively new faculty member and have not been evaluated. Setting out goals and objectives for my future in an evaluation seems essential to timely promotion. What can I do about this?

Dean Richardson has recently implemented a requirement that all faculty members receive annual performance evaluations by their Chairs. Over time, Chairs will be assisted in this with a standardized evaluation tool, now under development. (This was identified as a goal in the School's strategic plan.) Next year, each department will be asked to provide statistics to the Office of the Dean about faculty evaluations. To encourage this process, Dean Richardson has added the completion of annual faculty evaluations as a performance indicator for Chairs. In turn, this will be considered as part of the Chair's annual evaluation conducted by the Dean. For more information, or if this issue persists in your department, please contact: Tracey Parsons, Human Resources Director, parsonst@ohsu.edu.

Q: What is being done to ensure that we recruit more women and support a culturally diverse faculty?

Developing and supporting a diverse faculty and student body is a central goal of the School's strategic plan and the OHSU 2020 Vision. There are multiple initiatives underway, but realistically, the process will take time. Most immediately, Dr. Ella Booth, Associate Dean for Diversity, is reaching out to chairs and search committees to provide training on how to expand recruitment efforts in ways that identify more women and diverse candidates. President Robertson recently charged a Diversity Advisory Council to make recommendations regarding strategies for increasing diversity of students, faculty and staff. Dr. Booth represents the School on this Council. For additional information, please contact Dr. Booth at boothe@ohsu.edu.

Submit your question or comment to: Kathleen McFall, Communications Director, SOM, mcfallka@ohsu.edu.

Meet the Deans: Molly L. Osborne, MD, PhD, Associate Dean for Student Affairs

In her position of Associate Dean for Student Affairs, Molly L. Osborne, MD, PhD, coordinates and guides medical school students – from the first day of orientation all the way through Hooding and Commencement. Dr. Osborne provides guidance and insight on a range of issues such as family emergencies, academic or personal concerns, and career advice. She supports students seeking experiences in community outreach, research and leadership. "I enjoy helping students with advising and preparing for their future careers. I really enjoy meeting with students and discussing their concerns."

Dr. Osborne is Director for the Pulmonary Section of the second year Circulation course. She serves on multiple committees and has ongoing meetings maintaining continuity with the Student Health Services, Minority Affairs, Financial Aid and Admissions. She chairs the Honors & Awards and Residency Advisory Committees and serves as Chair of the Ethics and Conflict of Interest in the American Thoracic Society and as Co-Chair of the American Board of Internal Medicine Pulmonary SEP program. In addition, Dr. Osborne is Principal Investigator for the new OHSU School of Medicine Palliative Care Education Project. OHSU is one of six sites funded by the Robert Wood Johnson Foundation to host this project.

Beginning in November 2006, Dr. Osborne assumed a national leadership role in the Group on Student Affairs (GSA), one of 13 professional development groups within the Association of American Medical Colleges (AAMC). She will serve a four-year term in leading the AAMC group as Vice Chair, Chair-elect, Chair and Past Chair.

Dr. Osborne earned her MD and PhD from Colorado University/Health Sciences Center in Boulder. She holds a joint appointment as Professor of Medicine, Division of General Internal Medicine and Geriatrics, and she is a senior Scholar in the OHSU Center for Ethics in Health Care. Dr. Osborne spends about one third of her time attending at the Veteran Affairs Medical Center in the Medical Intensive Care Unit and on the Pulmonary Consult Services.

For an overview of the Dean's office organization: click here.

Dr. Brandon Hayes-Lattin advocates on Capitol Hill with Lance Armstrong Foundation

Brandon Hayes-Lattin, MD, Assistant Professor of Medicine, was part of the Lance Armstrong Foundation (LAF) delegation visiting Washington, DC/Capitol Hill on May 16 to advocate for more aggressive national investment in resources, treatment and services for people affected by cancer.

The LAF selected Dr. Hayes-Lattin as one of 200 advocates to participate in LIVESTRONG Day, a grassroots advocacy initiative to unite people affected by cancer and to raise awareness about cancer issues.

Dr. Hayes-Lattin, a cancer survivor himself, is medical director of the OHSU Cancer Institute's Adolescent and Young Adult (AYA) oncology program, which has been funded by the LAF. Dr. Hayes-Lattin is a member of the organizing committee of the Lance Armstrong Foundation's Young Adult Alliance.

"I was honored to join the Lance Armstrong Foundation for LIVESTRONG Day, and I was glad to have the opportunity to talk to Oregon's congressional leaders about my personal and professional passion to make cancer a national priority," said Dr. Hayes-Lattin.

In the photo: Dr. Hayes-Lattin in Washington DC with the 200 strong delegation and Lance Armstrong.

OHSU Representation of Women Report

Since 2000, the Women in Academic Medicine (WAM) Committee and the TALENT Program of the School of Medicine have collected information describing the status of women faculty at OHSU. The 2005-2006 report was recently issued, including data on trends in faculty recruitment, promotion, rank and other indicators for the School of Medicine.

"The new data show that some progress has been made in the last seven years; however, much remains to be done. I am committed to supporting a diverse faculty in all respects," said Dean Mark Richardson. "I am particularly concerned by the finding that women are not applying for promotion at the same rate as men. It is important to understand why this is happening, and I will look to all faculty to help us identify and mitigate these factors."

"The data show that women faculty members are increasingly involved in the school's Standing Committees. This is very heartening and we hope this trend continues," said Dr. Ella Booth, Associate Dean for Diversity.

For the School of Medicine, the report showed that there are there are 56 women who hold the rank of Professor compared to 277 men at that rank. Fifty-five percent of men are at the rank of Professor or Associate Professor whereas 31 percent of women are at either of these ranks (MD or PhD faculty only).

In terms of hiring trends, since 2000, the School of Medicine has hired seven new female Professors compared to 39 male Professors and have hired 13 female Associate Professors compared to 33 male Associate Professors. The percentage of women at the rank of Professor has increased from 10 percent to 12 percent in the past 7 years.

Although women faculty are promoted at a rate similar to men, the proportion of women at the Assistant and Associate Professor ranks who apply for promotion is less than the proportion of men who apply.

Women hold 6 of the 19 leadership positions in the SOM (Dean, Associate Deans and Assistant Deans). At the department level, 2 of 25 chairs are women and 4 of 51 division chiefs are women.

In the past 5 years, the percentage of women on SOM Standing Committees has increased from 32 to 50 percent. The proportion of total residents who are women exceeds the national average in 8 of the 16 residency programs with at least 9 residents total in the program. The 2006 entering medical school class is 53 percent women (national average = 48.4 percent, and women comprise 67 percent of graduate students.

A Town Hall to discuss the results of this report will to be held in the near future.

Report: Clinical Research Forum meeting

Lynne Shinto, ND, MPH, attended this year's annual Clinical Research Forum meeting in Washington, DC, April 26 and attended the Forum's Young Investigators Workshop on Clinical Advocacy on April 25. Dr. Shinto is an Assistant Professor in the Department of Neurology and the Center for Women's Health Integrative Medicine Division. Here is her first-hand report from these events:

"The biggest impact message during the day I attended this meeting was that the NIH ‘doubling' days are over and probably will not return. 2008 government funding for research was outlined as the follows:

1. Decrease in NIH by 1.7%
2. Decrease in CDC by 4.4%
3. Increase in AHRQ by 3.9%

The good news is that with the increase in AHRQ funding there may be a little more money for health services and outcomes research, the bad news is obvious.

Elias Zerhouni, MD, Director of NIH, gave a 45 minute talk outlining NIH emphasis areas and funding priorities (listed on NIH roadmap).

Emphasis Areas: Microbiome; Inflammation; Phenotyping; Proteome; Epigenetics.

Funding Priorities: Training for Young Investigators; Retaining Promising New Investigators; Translational Research; Clinical Outcomes Research.

Dr. Zerhouni's overriding message was quite clear - for Academic Health Centers to continue growth in research they cannot continue to rely on NIH as their major support. This includes maintaining promising New Investigators.

NIH has identified two ‘vulnerable' points for young investigators. The first is the transition from postdoc to training as an independent researcher for which the K23 and K99/R00 awards were created. The second is the transition from mentored independent research (K23) to the first independent award (R01). For this second transition phase the NIH has developed two new awards: 1) the New Innovator Award will support new investigators that have not yet attained an RO1 and will fund up to $1.5 million in direct costs over 5 yrs; 2) NIH Director's Bridge Award which will support new investigators that have submitted their first R01 but have just missed the payline.

As these awards are limited and highly competitive, Dr. Zerhouni strongly encouraged Academic Health Centers to find non-NIH resources to help support promising new investigators. The hope is that with NIH and non-NIH support, new investigators can flourish and direct the next generation of clinical research.

One such funding source for new investigators, The Burroughs Wellcome Fund, www.bwfund.org, has two awards:

1.Clinical Scientist Award in Translational Research which would be a post-K23 award; funds up to $750,000 over 5 years.

2. Career Award for Medical Scientists (modeled after NIH K99/R00); funds up to $700,000 over 5 years.

As a new investigator (starting year 4 of my K23 award) I found these talks very sobering. I can't help being concerned about a future career in clinical research with such limited resources available. I am wondering if we could create some type of forum at OHSU to discuss and find solutions to some of the issues summarized above.

Young Investigator's Workshop on Clinical Research Advocacy, April 25th

This workshop had two aims:

1. To inform young clinical investigators about the importance of research advocacy.

Lesson learned: research dollars do not fall from trees, especially NIH funding. To continue innovative and high level research, investigators need to be actively engaged in promoting the importance of research to the public.

2.To impart tools to help young investigators become better advocates.

- Communication: the ‘one minute' message, clear and concise communication.
- Media: know local media, know media support at institution.
- Write Editorials/Op Eds.
- Know local and state legislators.

Comment: Many of the tools that were presented at the workshop are not ‘intuitive' to clinical researchers. It may be worthwhile to invite Research!America to OHSU to present a similar type workshop to both medical students and researchers.

In closing, I would like to add that OHSU received a lot of positive feedback from other members of the CRF on OHSU's receiving the CTSA. Although I had no part putting the CTSA application together, it was nice basking in the ‘glow' by association."

***

The Clinical Research Forum is an organization comprised of 55 of the nation's academic health centers whose goal is to sustain and expand a cadre of talented, well-trained clinical investigators at all stages of career development. The mission of the Forum is to provide leadership to the national clinical and translational research enterprise and promote understanding and support for clinical research and its impact on health and health care. OHSU is a member of the Forum.

Dr. Shinto can be contacted at shintol@ohsu.edu.

Burroughs Wellcome Fund opportunity: June 15 deadline

The Burroughs Wellcome Fund announced a funding opportunity for clinical scientists with an MD or MD/PhD focused on translational research. This program supports established independent physician-scientists who are dedicated to translational research. The program helps protect award recipients' time to pursue the vital link between basic and clinical research.

The program aims to identify and reward proven mentors and to increase their capacity to train the next generation of investigators skilled in translational research. While BWF accepts applications from a wide range of departments, they particularly encourage applications in the area of reproductive science and those from women and traditionally under represented groups.

This opportunity requires internal coordination since the university may only submit a limited number of applications. If you intend to apply, complete a limited submission form before the internal deadline of June 15.

For more information: click here.

"1887 Society" honors donors

The 1887 Society, a School of Medicine's prestigious donor group, recently held its annual Donor Recognition Event on the OHSU campus. Guests were invited on coach tours and student-led walking tours of the campus and tram rides, finishing the day with a reception to celebrate the School of Medicine in the Old Library Great Hall.

The 1887 Society recognizes donors to the School of Medicine of unrestricted gifts of $1,000 or more, made on an annual basis. These gifts provide the Dean with the flexibility to address to most pressing needs of the School or to take advantage of unique, often time-sensitive, opportunities to enhance the education programs.

Dean Richardson took the opportunity of the annual event to thank the members for their tremendous support, and announced that their gifts were being used to purchase computer equipment for the students' study center as well as other projects that directly support the medical and graduate students.

For more information on the 1887 Society, please see the School's website or contact Jill Smith, Director of Annual Giving, at (503) 494-0748 or smithjil@ohsu.edu.

"Social Medicine" curriculum receives award

The four individuals primarily responsible for creating the innovative Social Medicine Curriculum were honored with the Northwest Regional Primary Care Association's (NWRPCA) 2007 Award of Excellence. The award honors a demonstrated excellence and commitment to community and migrant health.

The Social Medicine Curriculum is a collaboration between Central City Concern (CCC) and the Division of General Internal Medicine and Geriatrics in the Department of Medicine. Established in 1979, CCC is a nonprofit agency working to end homelessness in the Portland metro area.

The curriculum rotates residents through CCC's Old Town Clinic – a primary care clinic serving mostly homeless and low income patients. Residents learn how to better recognize and accommodate the unique social factors that can impact the health of homeless individuals. Simultaneously, the model expands clinical capacity at the Clinic by bringing in new providers.

The four individuals singled out for recognition are: Ted Amann, MPH, RN, Director of Health Care and Improvement, CCC; Judith Bowen, MD, Professor of Medicine, and Division Head; Jessica Gregg, MD, PhD, Assistant Professor of Medicine; and, Rachel Solotaroff, MD, Medical Director, CCC, Instructor.

The awards were presented in conjunction with the Spring Primary Care Conference in Portland at the Membership Luncheon May 22.

Emergency medicine research attracts media

Faculty members from the Department of Emergency Medicine presented research at the Society of Academic Emergency Medicine (SAEM) annual meeting in Chicago in May. OHSU tied with Massachusetts General Hospital and the University of Ottawa for the most scientific presentations at SAEM.

One study, presented by Craig Newgard, MD, Assistant Professor, analyzed crash data for more than 65,000 front-seat occupants and found that airbags, while effective for people of medium stature (5'3" to 5'11") were harmful to people smaller than 4'11" and taller than 6'3". The study received international media attention including a Reuters article that ran in multiple newspapers across the nation (e.g., the Atlanta Journal Constitution and the New York Post), a Scientific American podcast, an article on WebMD.com and one on WashingtonPost.com, among others.

Another study prompted the Portland Tribune, KLCC-radio, KEX-radio and the Depoe Bay Beacon to interview Rob Hendrickson, MD, Assistant Professor, about the first prospective analysis of the burden of methamphetamines on emergency departments. The study analyzed data from all ED visits during a 20-week time period last spring. These visits accounted for an average of $133,212 in weekly hospital charges, or an estimated annual cost of $6.9 million.

In an another study, Dan Handel, MD, MPH, found that use of the emergency department by Oregon Medicaid enrollees is much less than suspected. Anecdotal evidence had suggested use of the ED to be a substantial driver of Medicaid costs; however, Handel's study found ED usage accounted for only 6.8 percent of Medicaid spending. A study presented by Robert Lowe, MD, MPH, Associate Professor and Director of the OHSU Center for Policy Research in Emergency Medicine, analyzed whether the previously-developed tool called the "Emergency Department Algorithm" could accurately detect changes in ED usage following cutbacks to the Oregon Health Plan. This research was covered by American Medical News, the Portland Tribune and Business Journal, among others.

Information provided by OHSU News and Publications.

Associate Dean Sharon Anderson, MD, appointed Chief of Medicine, PVAMC

Sharon Anderson, MD, has accepted an appointment as Chief of Medicine at the Portland VA Medical Center effective June 24. Dr. Anderson is currently Associate Dean of Faculty Development and Faculty Affairs in the School of Medicine. Dr. Anderson is also Professor of Medicine (Nephrology and Hypertension) and Vice Chair for Clinical Affairs in the Department of Medicine.

"I congratulate Dr. Anderson in her new appointment. We will miss the enthusiasm and energy Dr. Anderson brings to her position in faculty development in the School of Medicine but I have no doubt about the great leadership and vision she will now bring to this new position," said Mark Richardson, MD, MBA, dean of the School of Medicine.

Dr. Anderson will remain affiliated with the Office of the Dean.

Hooding and Commencement

The School of Medicine Hooding Ceremony will be held on June 8, 9:30 a.m. at the Arlene Schnitzer Concert Hall in downtown Portland. A reception for graduates, family and faculty will immediately follow the ceremony at the Performing Arts Center (across from the Schnitzer Concert Hall).

The OHSU Commencement Exercises will be held on June 8 at 5:00 p.m. at the Arlene Schnitzer Concert Hall.

OHSU to become Tobacco-Free Environment on Sept. 17

The proposed Tobacco-Free Environment policy will become effective on Sept. 17, 2007. The policy will apply to everyone while they are at any Portland-area OHSU facility or on OHSU grounds. There will no longer be designated smoking area for employees, patients or visitors. The policy covers all Portland-area property owned or leased and occupied by OHSU.

Central to this initiative is a commitment to support employees, students, patients and visitors in quitting tobacco, if they choose, or in managing their cravings during the time they spend at OHSU. In preparation for moving to a tobacco-free environment, OHSU has expanded benefits for employees and students who use tobacco.

For information about the new policy, please go to: www.ohsu.edu/tobaccofree

Upcoming events

Career Series - Work-family Interface in Academic Medicine: Challenges and Strategies for Succeeding, June 1

"Balance" between children, work, household chores and family time is hard enough when parents have stable, predictable work schedules. But what happens when mom is also a doctor or scientist?

Please come to a panel discussion with several distinguished OHSU faculty who are also mothers maintaining active family lives. Learn how these women have struggled and succeeded with their choices combining work and raising children. As faculty productivity and vitality depend on institutional commitment to well-being, the goal is to explore what practical resources exist at OHSU and discuss what OHSU can do to build more support for individuals striving for more work-family balance.

Date: Friday June 1st, at 12-1:30 p.m. in Mackenzie Hall, Room 1162.
LUNCH PROVIDED!
RSVP: Brian Secrest; secrestb@ohsu.edu, 4-6055.

Doernbecher Children's Miracle Network Telethon – June 2, 3

The Doernbecher Children's Miracle Network Telethon is a live broadcast that raises funds and awareness for Doernbecher. The national segment, airing Saturday, June 2, includes appearances by celebrities and entertainment. The local portion of the broadcast, airing Sunday, June 3, recognizes Doernbecher patients' families, doctors, nurses, fund-raising groups and donors.

This year's telethon airs on KGW Northwest NewsChannel 8. Each year the Telethon raises significant funds and awareness for the children at Doernbecher. More than 100 volunteers donate their time and energy to make the Telethon a success. Over $5.5 million was raised from our generous viewers, sponsors and volunteers during the 2006 Telethon.

Saturday, June 2 & Sunday, June 3
1-5 p.m.

School of Medicine, Cancer Institute members at upcoming Oregon Cancer Summit – June 8

The Oregon Cancer Summit on June 8, sponsored by the Oregon Partnership for Cancer Control, is a one day conference entitled "Moving Upstream: Collaborating to Enhance Cancer Prevention, Early Detection & Survivorship." The intended audience is providers (especially primary care physicians), public and private organizations and survivors.
Four OHSU speakers are participating:

Brandon Hayes-Lattin, MD, Assistant Professor of Medicine, School of Medicine, OHSU Cancer Institute member

Elizabeth Steiner, MD, Associate Director, Breast Health Education Program, OHSU Cancer Institute member

Kerri Winters-Stone, PhD, Assistant Professor and Associate Scientist, School of Nursing, OHSU Cancer Institute member

Lawrence Wolff, MD, Professor of Pediatrics, School of Medicine

For agenda, RSVP and Exhibitor form: click here.

Dr. Fields elected president of the Society of Teachers of Family Medicine

Scott A. Fields, MD, Professor and Vice Chair of Family Medicine, was elected as President of the Society of Teachers of Family Medicine at their annual national conference held in Chicago. This Society represents over 5,000 Family Medicine educators from the US and Canada. Dr Fields will serve a three-year term on the Board of Directors, initially as President-elect, then as President. STFM is engaged in improving the educational experience throughout the continuum, including premedical, medical, residency, and continuing medical education.

Jennifer Redig receives OHSU Global Service Award

The OHSU Student Council presented second-year PhD student Jennifer Redig with the Global Service Award recognizing exceptional work in education, public or clinical service at an international level. The award honors Jennifer's work with Ana's Children, which she co-founded. Ana's Children is a nonprofit organization that helps street children in Bucharest, Romania. The program emphasizes education as a way to break the poverty cycle and works to provide positive role models.

CeDMA honors faculty and students

The Center for Diversity & Multicultural Affairs (CeDMA) annually recognizes the leadership and contributions of people who help advance the diversity and multiculturalism of the OHSU community. Now in its 8th year, this year's School of Medicine recipients are:

Outstanding Program Award to Charles Thomas, Jr., MD, Professor and Chair, Department of Radiation Medicine. This award recognizes a department and chair that have gone "above and beyond the call of duty" by providing significant leadership and by performing services to advocate for diversity and multiculturalism.

Faculty Award to Grover Bagby, MD, director OHSU Cancer Institute. Dr. Bagby was honored for his work with the CURE program, a partnership between the Institute and CeDMA that places diverse students in research labs. The program goal is to increase participation of underserved and minority students in biomedical research and other health-related programs.

Student Leadership awards to Safa Magid, Brian Coackley, and Jason Huckleberry. This award recognizes graduating students who have made outstanding contributions to the promotion of diversity within the OHSU community.

New Faculty

A warm welcome to new faculty joining the School in March and April (in order of effective date).

John Heffner, MD, Adjunct Professor, Medicine

Joan Kruse, Instructor, Ophthalmology

Micheal Beckstead, PhD, Research Assistant Professor, Behavioral Neuroscience

Allison Lindauer, MSN, Instructor, Medicine

Gunny Hagelberg-Cherrytree, MSN, Instructor, Anesthesiology & Peri-Operative Medicine

Carol Sherbenou, MSW, Instructor, Family Medicine

Roger Garvin, MD, Assistant Professor, Family Medicine

Vaishall Phalke, MD, Assistant Professor, Diagnostic Radiology

Tawna Pangborn, MSN, NP, Instructor, Medicine