Mark Gibson named Director of the OHSU Center for
Evidence-based Policy, succeeding John Kitzhaber
Dean Mark Richardson has appointed Mark Gibson Director of
the OHSU
Center for Evidence-based Policy. One of the original
founders of the Center, Gibson has served as Deputy Director
since 2003.
John Kitzhaber, MD, Professor Emeritus,
Department of Public Health and Preventive Medicine, will
become Director Emeritus.
"Long before comparative effectiveness research was
popular, the Center was demonstrating how rigorous and timely
research could be used to improve policies affecting the
health of millions of Americans and billions of taxpayer
dollars," said Dr. Kitzhaber. "It has been an honor to be
associated with this Center and I am confident that under the
leadership of Mark Gibson, the Center's important work will
not only move forward but will grow in
significance."
Gibson has a long history of proactive involvement in
health policy issues in Oregon. He was directly involved in
drafting and passage of the Oregon Health Plan. As Policy
Advisor for Health, Human Services and Labor to then-Governor
Kitzhaber, Gibson was active in numerous health initiatives
including Workers' Compensation reform and the creation of the
Oregon Children's Health Insurance Program.
Founded in 2003, the Center grew quickly and has earned a
national and international reputation for excellence in
comparative effectiveness research, particularly with the
groundbreaking work of two large projects linking these
results to policy: the Drug Effectiveness Review Project (DERP) and
the Medicaid Evidence-based Decisions (MED) Project.
These projects, now supported by 16 Medicaid programs, provide
specific research results about the quality and effectiveness
of drugs and interventions to state policy makers.
"Health programs are routinely asked to pay for drugs and
interventions that either do not have evidence documenting
that benefit exceeds harm, or that there are increased
benefits associated with additional costs," said Gibson. "The
information developed by the Center demonstrably improves
patient care and obtains significant savings."
Gibson does not foresee immediate changes to the Center,
however, the Center is poised for growth as the demand for
comparative effectiveness research expands. An important
aspect of that growth will be seeking out new and expanded
internal collaborations within OHSU. "The challenge, and it's
a great challenge to have," said Gibson,"is to find ways to
take advantage of all the relevant activity at OHSU.
Everything we need to be a laboratory of change for health
care is here at OHSU."
"Results from comparative effectiveness research provide
crucial information to patients, clinicians and policy makers.
I am confident Mark will provide strong leadership as this
area continues to grow in importance," said Dean Mark
Richardson. "Please join me in congratulating him on this
appointment."
Associate Dean for
Medical Education Tana Grady-Weliky reflects on the first year
in Oregon
Tana Grady-Weliky, MD, celebrated her
first anniversary as Associate Dean for Medical Education on
January 20. Looking back at a year shaped in part by the
global financial crisis, she confessed, it was unexpectedly
challenging and also immediately clear that it wasn't a time
for "splashy changes." However, she is proud of one early
splash of at least symbolic significance; she rattled a few
chains to get the fountain in front of Mac Hall – one of the
casualties of the financial crisis – turned back on last
summer. "I just thought it represented hope and life –
and it's beautiful; it needed to be on."
This past year, she developed strong working relationships
with OHSU's leadership, including course and clerkship
directors. And she's worked hard to get to know as many of the
students as possible. She has focused on laying the groundwork
for the future. For the coming year, Dean Richardson has
charged her to work with the curriculum committee and other
faculty members to chart "where we need to go and what needs
to be in place so that we can move toward a model of learning
inter-professionally – learning with physician assistants,
nurse practitioners, dentists, and other health care
professionals," she said.
Dr. Grady-Weliky is also focused on the more intangible
aspects of physician education. In a prominent place on a
credenza next to her conference table is a framed copy of two
ancient Chinese proverbs. The first proverb – "kind heart,
kind skills" – represents the ethical code of traditional
Chinese medicine; the second – "knowledgeable hands return
spring" – refers to the skilled hand of a physician restoring
health to a patient. "I love what these stand for and I truly
believe that so much of being a physician is about being
compassionate and caring," she said.
this past year, Dr. Grady-Weliky has been impressed with
the level of commitment School of Medicine students have to
the underserved. She wants to ensure that these values remain
a long-term touchstone for the 500 students she is charged
with shepherding through four years of medical school at OHSU,
as they have been for generations of med students before
them. "Given the enormous pressures current students
face, how do we help them stay connected to the values that
brought them to medicine in the first place?" In the future,
she is also committed to supporting more diversity in the MD
program, not only in ethnicity but also in the economic strata
they are drawn from.
On a personal note, the Teaneck, N.J., native is getting
acquainted with Oregon, although she's not sure she'll ever
get the East Coast out of her system. She's outnumbered
though. Her two and a half year old daughter Maya is a
thoroughly assimilated Oregonian and her husband, a
neuroscientist, born in California, has the West Coast in his
blood.
An expanded version of this article is posted on
theSchool
of Medicine Web site.
January Paper of the
Month: Unraveling the genetic basis for excessive alcohol
consumption
The School of Medicine newsletter spotlights a
recently published faculty research paper in each issue. The
goal s are to highlight the great research happening at OHSU
and to share this information across departments, institutes
and disciplines. A
list of all papers compiled by the OHSU Library and published
by OHSU faculty during the prior month is also provided
here. The monthly paper summary is compiled by Associate
Dean for Basic Science Mary Stenzel-Poore, PhD, and reviewed
by Dean Mark Richardson, MD, MBA, and Vice President/Senior
Associate Dean for Research Dan Dorsa, PhD.
This month's featured paper, published in the journal
Mammalian Genome, is: "A method for mapping
intralocus interactions influencing excessive alcohol
drinking," by Tamara J. Phillips, Cheryl Reed, Sue
Burkhart-Kasch, Na Li, Robert Hitzemann, Chia-Hua Yu, Lauren
L. Brown, Melinda L. Helms, John C. Crabbe and John K.
Belknap.
Tamara Phillips, PhD, s a Professor in the Department of Behavioral Neuroscience and a Senior
Research Career Scientist at the Portland Veterans Affairs
Medical Center (VAMC). The research described in this paper is
a collaborative effort across the laboratories of Drs.
Phillips, Belknap, Crabbe and Hitzemann, all professors in the
Department of Behavioral Neuroscience and also affiliated with
the VAMC.
PAPER SUMMARY: This paper makes an
important step toward understanding the complex genetic
underpinnings of excessive alcohol consumption. The key
finding followed up by the current research was that
combinations of genes inherited from two parents could result
in more excessive alcohol consumption than that seen in either
of the parents. The results described in this paper suggest
specific locations of the genes involved in the excessive
drinking behavior of the hybrid offspring mice. The study
focuses on a unique genetic phenotype – the "hybrid
overdominance effect."
The current study began with an observation made several
years ago by one of paper authors John Crabbe who noted that
F1 hybrid offspring of one mouse strain (C57BL/J) crossed with
another strain (FVB/NJ) exhibited more excessive ethanol
drinking than either of the parental strains. The scientists
then collected and quantified mice behavioral data (ethanol
drinking) with genetic information to map genes that cause
overdominant ethanol drinking in the hybrid
offspring.
Genome-wide quantitative trait locus (QTL) analyses were
performed on this genetic information to identify the
locations of the important genes, and the data were also
analyzed to determine whether there were interactions
occurring between genes (referred to as epistasis) that
manifested as overdrinking behavior.
In the paper, Dr. Phillips described evidence for QTLs
resulting in heightened consumption of ethanol in heterozygous
mice on three different chromosomes (11, 15 and 16).
Importantly, there was no evidence for epistatic interactions
between genes at different locations that could explain the
excessive drinking of the hybrid mice. Instead, intralocus
interactions – interactions between two different forms of the
same gene (one inherited from the mother and one from the
father) at the same locus – are the most likely explanation
for the hybrid overdominance.
The possibility that different forms of the same gene when
inherited from each of the parent strains and expressed
together can cause excessive drinking behavior is an important
finding that will be examined further. Additional work is
focused on identifying the genes. These findings contribute to
research aimed at identifying inherited factors that increase
risk for developing alcoholism. Knowledge of the genes leads
to knowledge of biological mechanisms. This information could
be used to develop new drugs for preventing and treating
alcoholism.
This research was supported by the Department of
Veterans Affairs and by the National Institute on Alcohol
Abuse and Alcoholism (U01 AA016655).
State audit of the "Oregon
Opportunity" concludes that goals were met or
exceeded
According to an audit report issued this month by the
Oregon Secretary of State, the OHSU Oregon
Opportunity research expansion project successfully met
or exceeded its goals and measurable targets. These goals
included job creation, the construction of improved research
facilities and improved technology to increase health
care access throughout rural Oregon. The Oregon Opportunity
program, now in its ninth year, is a public-private
partnership launched to accelerate and expand OHSU research.
In 2001, the state of Oregon approved $200 million in
state bonds for the program to be paid back by tobacco
settlement funds issued to the state of Oregon from
tobacco companies. OHSU promised to raise $300 million
through the OHSU Foundation and successfully raised $378
million in private donations. These contributions came from
78,000 donors representing every Oregon county.
The
OHSU media release is here.
From the Archives: Back
to 1906 and Portland's first internist - Noble Wiley
Jones 
A 1901 graduate of Rush Medical College, Noble Wiley Jones,
MD, settled in Portland in 1906 on the advice of onetime
Portland surgeon and Rush faculty member A.D. Bevan, MD,
becoming the city's first recognized specialist in internal
medicine. Jones joined the University of Oregon Medical School
(the precursor to the OHSU School of Medicine) in 1913 as a
Clinical Associate in Medicine.
He brought to the School of Medicine faculty not only his
advanced training in medicine and pathology, learned in the
great schools of Vienna, Berlin, and Oxford, but also a
commitment to clinical research and academic excellence. With
Frank Menne, MD, and Olof Larsell, PhD, Jones wrote the 1941
report which led to the creation of the Medical Research
Foundation. He wrote or co-authored over 50 publications on
topics from coronary disease to dyspepsia to pyorrhea. Howard
P. Lewis, MD, summed up Jones' contributions by calling him
"one of the most important of the group of men who worked so
hard to advance the fortunes of the University of Oregon
Medical School."
Contributed by Sara Piasecki, Head, OHSU Historical
Collections & Archives.
Suzy Funkhouser: The
view from Salem
As OHSU Director of State and Local Government
Relations, Suzy Funkhouser is responsible for overseeing
OHSU's complex relationships with Salem – the Governor's
office, the state legislature, and state agencies – as well as
with various local government entities from Portland City Hall
to Metro. She has been at the job since April 2009. As a
special session of the legislature gets underway,
Funkhouser reflects on the job, OHSU priorities, health
care reform and more.
Q. What experience do you bring to this
job? I've worked through four regular sessions of the
legislature and several special sessions. My first two
sessions, I was a legislative assistant to then State Sen.
Ryan Deckert, followed by a stint as a policy analyst/lobbyist
for the Oregon Economic and Community Development Department
and the Oregon Innovation Council.
Q. What do you spend most of your time on and what
are the biggest issues you're dealing with? It's my
job to make sure we have a positive working relationship with
Salem and the Governor's office. As far as OHSU's legislative
issues, the state budget is generally our number one priority.
The legislature has the difficult job of prioritizing the
numerous competing public needs, and we work closely with
legislators to help them understand the value of our public
missions. The good news is that we have a positive
relationship with the legislature, and legislators often want
to know how they can help OHSU continue to
succeed.
Q. What's the perspective in Salem on
OHSU? State lawmakers understand the value of OHSU to
Oregon; in fact many would like to increase our funding
support. However, the legislature has to work in a more and
more constricted budgetary environment. Still, as an
institution, we will continue to advocate for our public
missions and work with our legislative supporters to create
additional opportunities. During the last session – which was
generally a time of significant cuts in state programs –
legislators were concerned with the financial challenges
facing the university, and worked to preserve as much of our
budget as possible, as well as passing a new tort cap. The
state has also welcomed our leadership role in health care
reform and will rely on OHSU's expertise as that conversation
continues to unfold.
Q. How do legislators view the School of
Medicine? Legislators recognize that the School of
Medicine is an integral part of OHSU's success. OHSU medical
students are always welcome in Salem. Legislators enjoy
talking to students because they can see right in front of
them the benefits of the funding they vote for. In addition,
some policymakers have been directly touched by clinical care
at OHSU, which can influence their perspective. Many
have had one-on-one experiences that they talk about on the
record and those are invaluable testimonials. Others have a
strong interest in the ground-breaking research that happens
here.
Q. What is the Health Policy Board and what do you
expect to come out of its work? It was set up by the
Legislature in 2009 to develop a comprehensive plan for state
health care reform, including containing health care costs,
addressing quality issues and ensuring access to all
Oregonians. The Governor appointed President Robertson as a
member of the nine-person board. They have had three meetings
so far and will meet regularly throughout 2010. In addition, a
number of our faculty are providing their expertise to
subcommittees, whether it be on evidence based policy, primary
care or research issues. For example, Dean Richardson is on
the Board's workforce subcommittee. The Board's primary aim is
to produce a set of recommendations by the end of the year,
and I envision many of its major proposals will make their way
in some fashion into the legislative process in
2011.
Q. If, as it now appears possible, federal health
care reform does not go forward, what are the
options? The burden will fall back on the states to
try to do something. In many respects, Oregon is already ahead
of most other states. I've heard some anecdotal stories from
legislators who have gone to national conferences and have
heard that Oregon is becoming known during this economic
downturn for how you do it right, in terms of expanding access
and getting more care to more people in need, when so many
states have been forced to cut access.
Why I teach: Carrie Anne
Phillipi
Carrie Anne Phillipi, MD, PhD, Assistant
Professor, Department of Pediatrics, and Medical Director of
the Mother Baby Unit, has been at OHSU since 2004. She came
here as a resident in pediatrics after traversing the
University of California system – earning her undergraduate
degree at UCLA, her PhD at UC-San Diego, and her MD at
UC-Davis. In the course of caring for babies in the newborn
nursery and children of all ages in the inpatient pediatric
ward and outpatient general pediatrics clinic, she always is
working with a learner, either a medical student or resident.
She also does research and works at educating
families.
Why are you here, teaching, when you could be
providing health care outside of an academic setting?
"The thing I most like is the idealism, the hope and the
energy that students and residents bring to the experience.
They keep me on my toes. I'm always required to be a learner
myself with them." One student who challenged her the
most over the past year, she says, was a 16-year-old girl she
had taken under her wing for the summer as part of a
mentorship program for high school students.
"She shadowed me half of each day and we also worked on a
research project together," said Dr. Phillipi, "I felt as if
it was a really important formative experience for her, and
because she was so fresh and so engaged, I think I actually
learned a lot from her. She was even able to turn her research
into an abstract that we submitted for a national meeting and
we're using some of her data to request future funding. She
was one of those amazing students who knows exactly what they
want to do. She wants to be a doctor and I'd be very honored
to have her join our ranks."
Dr. Phillipi was one of five faculty members honored
with the OHSU School of Medicine 2009 Faculty Excellence in
Teaching Awards. We'll hear from the other four in coming
issues. They are: Susan P. Bagby, MD, Department of
Medicine, Matthew J. Thayer, PhD, Department of Biochemistry
& Molecular Biology, Jeffrey W. Karpen, PhD, Department of
Physiology & Pharmacology, Nicole M. DeIorio, MD,
Department of Emergency Medicine.
In the genes: Three
generations of OHSU MD grads equal over a half century of
service to Oregon
When fourth-year med student Thomas Ciesielski steps
forward to receive his hood at the School of Medicine ceremony
in June, he will follow in the footsteps of his grandfather,
Peter Ford, MD, Class of 
1951, and his mother, Paula Ford Ciesielski, MD,
Class of 1978.
Thomas is aiming for a career as a general internist and
academic hospitalist, his mother is an internist with her own
clinic in Eugene, and his grandfather started out as a rural
general practitioner before establishing a succession of
family practice clinics in Portland.
Thomas was fascinated by the family "business" as far back
as he can remember. "Growing up, if we saw an accident
by the side of the road, we'd always be the ones stopping. As
I got older, I'd often find a way to tie a school project back
to medicine and I often went on rounds with my mom." Dr.
Ciesielski also went on rounds with her father as a girl and
the memories are equally vivid. "My father was my first
and best mentor," she recalled.
Dr. Ford, the son of an itinerant Congregational preacher
who had pastorates across Washington state, was torn between
following his father into the ministry and becoming a doctor.
But after graduating from Pacific University in 1945, he was
drafted and pressed into service as an Army medical
technician, an experience he found so engaging that it tipped
the balance. Now 84 and retired, Dr. Ford looks back on his
time as a physician as "the golden years" of medicine. "I
can't think of any profession I would rather have been in."
But he is disappointed with the current state of the health
care system. "When we have over 50 million people without
medical insurance in a nation as wealthy as ours, it's a
travesty." It was a different world in his day. Most people
didn't worry too much about how to pay. If they couldn't
afford it, the bill was paid in barter. Some patients, Thomas
recalled, brought chickens to his grandparents and "my mom
still has furniture traded for my grandfather's
services."
Dr. Ciesielski herself commented on a few other changes in
medicine over the past three generations, including the
increasing role of technology and specialization. "The
expectations of a GP in my father's day were to be the
equivalent of a surgeon, pediatrician, obstetrician and
internist. The breadth of his practice leaves me awestruck."
Another way that medicine has changed over the last there
generations is the number of women entering the profession.
Only five out of the 71 in Dr. Ford's class and 20 out of 120
in her own class were women, while more than half of Thomas's
class are women.
Marquam Hill Lecture on
back pain lecture attracts hundreds to campus
Richard Deyo, MD, MPH, Professor, Department of Family
Medicine, discussed a wide range of treatments for low back
pain at the second Marquam Hill Lecture of the 2009-2010
series, held January 21.The lecture was one of the best
attended in the series 27-year history with over 250
attendees. The audience included students from a number of
regional high schools, members of the public, OHSU faculty and
staff. Marquam Hill Lectures present, in lay terms, the
leading basic science and clinical research being conducted at
OHSU, and are sponsored by the School of Medicine, the OHSU
Foundation, the Oregon Clinical Translational Research
Institute and the Marquam Hill Steering Committee. Series
sponsors for 2009-2010 include Thompson Rubinstein Investment
Management Inc. and Springbrook Hazelnut Farm, Newburg.
Dr. Deyo discussed his findings related to back pain,
recommending that patients avoid imaging in the first month
unless the physician sees clear red flags for diseases such as
a history of cancer, unexplained weight loss, or fever.
His research, and related studies, show that bed rest,
traction and facet joint injections are largely ineffective,
and that non-surgical therapies such as self care, lifestyle
changes, pain relievers and an early return to activity are
frequently as effective as more invasive therapies in reducing
and eliminating the pain.
With colleagues, he has pioneered an interactive video
program in which patients spend up to an hour watching
interviews of prior patients who had similar symptoms.The
video patients discuss their treatments and describe the
results of their decisions – both good and bad. "Back pain has
a generally good prognosis," he said. "Most patients improve
on their own, and treatment should be aimed at reducing your
symptoms while natural healing occurs."
The next Marquam Hill Lecture is March 15 at the
Newmark Theater in the Portland Center for the Performing
Arts. Joel Nigg, PhD, Professor, Department of Psychiatry,
will speak about Attention Deficit Hyperactivity
Disorder. Further
information is available here. Tickets, available at no
charge, are required to attend this lecture. Please contact
the Portland Center for the Performing Arts at (503)
432-2917.
Honors, awards and announcements
Applications for Summer
Equity Program now being accepted – spread the word!
The OHSU Graduate Studies Equity Summer Program is now
accepting applications. The program provides an opportunity
for undergraduate students interested in science to spend 8 to
10 weeks working with faculty and graduate students in a
research setting, learning new skills, and gaining experience.
The program is administered by the OHSU Center for Diversity
and Multicultural Affairs (CeDMA). This is a paid opportunity.
Click
here for more information.
More boots on the ground
Lisa Dodson, MD, Associate Professor, Department of Family
Medicine, shared her perspective on the health care impact of
the growing physician shortage in Oregon, especially in rural
Oregon. As a family physician working in towns such as John
Day and Burns many times a month, often working 48 to 72 hours
straight so physicians in these communities can take a rare
weekend off, she has a unique frontline perspective on the
issue. Read
the full article.
John Saultz is new editor of
Family Medicine journal
John Saultz, MD, Chair and Professor, Department of Family
Medicine, has been named the new editor of Family
Medicine, effective March 1, 2010. Published by the
Society of Teachers of Family Medicine, it is the leading
journal publishing topics related to family medicine
education. The journal has been in print for 41 years and
currently receives some 400 submissions annually. Dr. Saultz
is only the third editor of the journal. "Family Medicine is
already a premier journal in the field of medical education.
As the health reform process moves forward, there is a growing
need for a scholarly forum where information and ideas can be
shared about how to best prepare the workforce of the future
for a transformed primary care system. I'm excited to be a
part of helping our journal to become that forum," said Dr.
Saultz.
OHSU
GME group publishes opinion piece in Journal of Graduate
Medical Education
In late 2008, the Institute of Medicine (IOM) published a
report recommending more restrictive limits on resident work
hours to promote patient safety. Reaction from the graduate
medical education community has focused on concerns about a
lack of evidence supporting the IOM's recommendations. At
OHSU, the GME commuity came together to respond formally to
the new rules with an editorial published in the Journdal of
Graduate Medical Eduation. Titled "The Institute of Medicine
Committee Report on Resident Duty Hours: A View From a
Trench," the editorial was published In the December 2009
edition of the Journal of Graduate Medical Education. The OHSU
authors of the opinion piece were: Andrea S. Cedfeldt, MD,
Clea English, MPH, Raphael El Youssef, MBBS, Joseph Gilhooly,
MD and Donald E. Girard, MD. Read the full piece in the Journal of Graduate
Medical Education.
Ted Ruback assumes Presidency
of PAEA
Ted Ruback, MS, PA-C, Program Director and Associate
Professor, Physician
Assistant (PA) Program, assumed the presidency of the
Physician Assistant Education Association (PAEA) this month,
his second year of a three-year term of service as president
elect, president, and past president. A PA educator for nearly
20 years, Ruback is the founding director of the OHSU PA
Program. He presently also serves as chair of the PA Committee
of the Oregon Medical Board.
Brian Druker featured in
the AAMC Reporter
Brian J. Druker, MD, Director of the OHSU Knight Cancer
Institute and Jeld-Wen Chair of Leukemia Research, is featured
in the January AAMC Reporter – the monthly magazine of the
Association of American Medical Colleges. The internationally
known researcher answers questions about Chronic Myeloid
Leukemia (CML), the cancer-fighting drug Gleevec, and his
reaction to learning he had won the celebrated Lasker-DeBakey
Clinical Medical Research Award. Read the AAMC article here.
Research of Francis Valiyaveetil
noted in prominent academic editorial
A recent paper co-authored by Francis I. Valiyaveetil, PhD,
Assistant Professor, Department of Physiology &
Pharmacology, was noted in an editorial in ACS Chemical
Biology written by Hagan Bayley (Oxford), an
international leader in the study of membrane proteins.
Commenting on the paper: "A modular strategy for the
semi-synthesis of a K_ channel: investigating interactions of
the pore helix," (published in ACS Chem. Biol. 4) (by Komarov,
A. G., Linn, K. M., Devereaux, J. J., and Valiyaveetil, F.
I.), Dr. Bayley wrote: "The work enhances the technology
available for a range of fundamental investigations of
membrane proteins and for applications of membrane channels
and pores in biotechnology."
Dr. Valiyaveetil joined the Department of Physiology &
Pharmacology in 2006 and was selected as a Pew Scholar in the
Biomedical Sciences in 2007. He is a founding member of the
Program in Chemical Biology at OHSU. Read the paper here.
Welcome new faculty!
A warm welcome to new faculty (listed in alphabetical
order):
- Rebecca G. Block, PhD, MSW, Assistant Professor,
Medicine
- Jennifer S. Burmeister, MMSc, PA-C, Instructor,
Medicine,
- Anna M. Hartshorn, BS, ACNP-BC, Instructor, Emergency
Medicine
- Cynthia Melean, MS, PA-C, Instructor, Anesthesiology
& Perioperative Medicine
- Nupur Pande, PhD, MSc, Research Assistant Professor,
Obstetrics & Gynecology
- James A. Peykanu, MD, Assistant Professor,
Psychiatry
- Jessica M. Schemm, MD, Assistant Professor,
Psychiatry
- Elizabeth Super, MD, Assistant Professor,
Pediatrics
- Joseph P. Waldram, MD, Assistant Professor, Emergency
Medicine
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