From the Chairman - School of Medicine

March & April 2015
IN THIS ISSUE
INSIDE:
Pellegrino Center for
Clinical Bioethics
Jane Hickman Teaching
Award Winner
Volunteer trip to Tanzania
Students Present at SHM
Conference
Congress to Repeal SGR
PREVIOUS ISSUES
Tips from Department of
Medicine Computing
Bystanders: Our Nation’s
Immediate Responders
Contacting Department of
Medicine Computing
Lockette takes on role as
SOM diversity dean
Safer drug combination
found for patients
2015-2016 Department of
Medicine Interns
Quality Matters
STAFF SPOTLIGHT
Scholarly Works
Announcements
UPCOMING
EVENTS:
5/16—School of
Medicine Commencement
6/11—Department of
Medicine Graduation
Banquet
Fro m t h e C h a i r m a n
Spring is here…finally!...and there is a lot of coming going
around campus, as usual. We had an historic resident match
this year in both our Categorical Medicine and Med-Peds
programs and we will be welcome our incoming residents this
June for orientation prior to the start of the training year July
1st. Congratulations to our program directors, Dr. Turi
McNamee and Dr. Abby Emmerson, and the whole
Education team for a job very well done! Please make our new
residents feel at home. At the same time we are saying a bittersweet farewell to
our senior residents and fellows who will be moving on but certainly never
forgotten. Happily, several will be staying with us on faculty or as fellows. Having
several of our own “stay home” with us each year helps me realize that we are
doing something right as an academic department of medicine. Each year I also
look forward to watching the trajectory of our students and trainees as they cross
the threshold in becoming physicians. This year a total of 24 seniors out of a
graduating class of 95 chose Internal Medicine—more than any other residency
selection at MU and an all-time high for our department these recent years.
Several are also staying at MU (Med-Peds, Categorical, and Preliminary Programs),
so kudos to all of you for the wonderful teaching and mentoring you are doing!
Please don’t forget that we are celebrating the accomplishments of our residents
and fellows at the 2014-2015 Department of Medicine Graduation Banquet
on Thursday, June 11, 2015 at the Reynolds Alumni Center.
One year ago at this time I was thanking you for your support and encouragement
as I began my Presidency of the American College of Physicians (ACP). Here we
are, a year later, and I am once again thanking you for supporting me this past
year while I completed my Presidential duties. On May 2nd, at close of the
business meeting at Internal Medicine 2015 in Boston, I officially handed the
baton off to Dr. Wayne Riley, the 2015-16 President of ACP. Dr. Riley will be
here this fall as a visiting professor and will do Grand Rounds for us September
24th – this is one you don’t want to miss. Needless to say, it has been an amazing
year. There has been (as you know) extensive travel; the opportunity to meet,
teach, write, and collaborate with colleagues and learners at many levels, both
nationally and globally; and opportunities to be involved in policy discussions
having an immense impact on health care of our country. It has been a once in a
life time experience and I will miss the excitement and energy but I am also happy
to be “coming home” to a more normal and settled life (if being a chair can ever
be either normal or settled). As Immediate Past President I still have a bit of travel
to do in in May for ACP but after that I will look much less travel weary.
I’d also like to recognize and congratulate many in the department who continue
to excel. A very special congratulations goes to Dr. Carla Dyer who received this
year’s Jane Hickman Teaching Award last month, which recognizes excellence in
medical student education and teaching. Dr. Warren Lockette was recently
FROM THE CHAIRMAN CONTINUED
featured on the front page of the Missourian for his integral role as the newly-appointed Senior Associate
Dean for Diversity and Inclusion. Several of our students presented at the Society of Hospital Medicine
(SHM) Conference: Nila Manandhar presented her poster, “The Effect of Medication Prophylaxis on
the Incidence of Delirium in Elderly Patients Undergoing Orthopedic Surgery: A Meta-Analysis;”
Courtney Champagne presented her poster, “Predictors of Recurrent Hospital Admission for Patients
Presenting with Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State;” and David Hayes
presented his poster, “Delaying the Inevitable? A Case Series on Lower-Extremity MRSA Osteomyelitis”.
Well done to all of you.
Let me end my message this month with a bit of food for thought. We have and always will have many
challenges but also many blessings, much to be proud of, and much to be thankful for. Our challenges
may be many but there is joy to be found – let it be those nuggets of joy that we take with us. They will
sustain us in lean times and make the good times even better.
Take care and please remember to join us for the annual Department of Medicine BBQ on Tuesday, May
19 at 11:30am!
- DAF
PELLEGRINO CENTER FOR CLINICAL BIOETHICS
David Fleming, MD, MA, MACP, was recently invited to give the Twelfth Annual John Collins Harvey
Lecture, “Advocating for the Patient’s Good: Meeting Obligations and Ensuring Trust Through
Organized Medicine,” at the Pellegrino Center for Clinical Bioethics at Georgetown University Medical
Center in Washington DC. The Pellegrino Center provides
university-based ethics resources for individuals that shape and
give health care. They seek to promote serious ethical
reflection and discourse in pursuit of a just society and health
care that affirms the dignity and social nature of all persons.
2
JANE HICKMAN TEACHING AWARD WINNER
Congratulations to Carla Dyer, MD on being
awarded the Jane Hickman Teaching Award at
the School of Medicine Education Day April 9!
The Jane Hickman Teaching Award is
historically the highest recognition of excellence
in medical student teaching at the University of
Missouri-Columbia School of Medicine. The
goal of this award is to reward faculty members
who have made sustained, outstanding
contributions to medical student education at
MU over a period of three or more years.
Here is an excerpt from the nomination letter
Department of Medicine Chair Dr. David
Fleming wrote for Dr. Dyer:
“Her teaching commitments are time
consuming and require a true passion. As any educator knows, teaching new generations of
learners can be challenging. One must also keep in mind that each student differs in their learning
style. Dr. Dyer has risen to this challenge by integrating more simulation center time into teaching
sessions utilizing the Objective Structured Clinical Examination (OSCE). She has increased the
number of faculty using turning point audience response system for learner participation in many
of the didactic lectures. Further, she has been actively involved in the scholarly research area of
medical education and effectiveness tools and has presented her research in a number of venues.
Dr. Dyer’s efforts have been recognized with teaching awards at the School (Curriculum Board
Curriculum Innovation Award in 2012), campus (Intercampus Collaboration Award in 2014), and
International levels (Academy for Healthcare Improvement Duncan Neuhauser Award
recognizing Innovation in Quality Improvement and Patient Safety Education in 2011). These
recent awards are true testaments to the professional commitment, dedication, and passion Dr.
Dyer has for medical education.”
3
VOLUNTEER TRIP TO TANZANIA
Third year fellow and Dr. Michael
C. Perry Fellow for 2014-2015,
Uladzislau (Vlad) Naidzionak,
MD, traveled to Tanzania. Below
are some details of his trip.
“Here is what I'd like to share
about my time in Tanzania. I
worked at Muhimbili National
Hospital at Dar es Salaam in
November. I was the first fellow
ever in my volunteering program.
First of all I would like to point out that people in Tanzania are much less fortunate having very little
available in the medical field. At the same time they have some of the highest rates of aplastic anemia and
leukemia in the world. Their medical officers suffer from insufficient training but they try their best to
deliver best care possible. Therefore I am proud to be part of their education process. We hope to
improve quality of care in Africa through better education and we had eager students. Overall I am very
grateful to American Society of Hematology and our department for the rare opportunity to volunteer in
Tanzania. I encourage everyone who cares about less fortunate adults and children to offer their help to
volunteering organizations. Because disadvantaged but great people of Africa deserve better medicine.”
4
STUDENTS PRESENT AT SHM CONFERENCE
University of Missouri School of Medicine students, Nila Manandhar, Nicole Champagne and David
Hayes presented posters at the Society of Hospital Medicine Annual Conference in Washington DC
March 29—April 1.
Nila Manandhar with her poster, “The Effect of
Medication Prophylaxis on the Incidence of
Delirium in Elderly Patients Undergoing
Orthopedic Surgery: A Meta-Analysis”
Courtney Champagne with her poster,
“Predictors of Recurrent Hospital Admission for
Patients Presenting with Diabetic Ketoacidosis
and Hyperglycemic Hyperosmolar State”
David Hayes with his poster, “Delaying the
Inevitable? A Case Series on Lower-Extremity
MRSA Osteomyelitis”
5
CONGRESS TO REPEAL SGR by David A. Fleming, MD, MA, MACP
Senate Joins House to Repeal Sustainable Growth Rate (SGR) Averting Future Deep
Cuts or Additional Reimbursement Patches
April 14, 2015
We all witnessed something quite extraordinary and historic today when the Senate followed the House in
passing comprehensive legislation to repeal Medicare’s Sustainable Growth Rate (SGR) formula (H.R. 2)
and transition us to a new value-based system. After consideration of a series of amendments, the Senate
passed the measure. This comes on the heels of an overwhelming show of support in the House, where
both Republicans and Democrats voted in favor of H.R. 2 on March 26.
President Obama is expected to sign the bill immediately, which will avert a 21 percent physician payment
cut from taking effect.
ACP applauds the efforts of so many in Congress who worked in a bipartisan fashion, over many years,
to develop this legislation. Repeal of the SGR has been a priority of ACP’s, and nearly all of medicine, for
more than a decade. Physicians and their patients no longer will have to be concerned with impending
yearly payment cuts as a result of the flawed SGR formula and no longer will this burden of uncertainty
be hanging over physician practices. Equally important, the legislation provides strong incentives for
physicians to engage in activities to improve quality; streamlines existing quality reporting programs; and
provides additional support to physicians who participate in Patient-Centered Medical Homes, and other
alternative payment models, shown to improve outcomes and the effectiveness of care provided.
The SGR repeal is finally finished but it did not come about easily. On behalf of all of us at ACP, we say
thank you to Congress for seeing the wisdom of repealing this flawed formula and to our 141,000
members for their tenacious advocacy over this long journey to SGR-repeal. ACP’s advocacy efforts will
continue, but now with a renewed focus on other key priorities that include: extension of Medicare’s
Primary Care Incentive Program beyond 2015, reinstatement of the Medicaid Primary Care Pay Parity
program, and support of important physician workforce issues like Graduate Medical Education (GME)
financing reform.
On this day, we can and should pause for a long-awaited celebration. The exhausting effort to repeal the
SGR has finally crossed the finish line.
Highlights of the H.R. 2 legislation include:





The SGR is permanently repealed, effective immediately; reversing the 21 percent SGR cut that went
into effect on April 1.
Positive payment updates of 0.5 percent are provided for four-and-a-half years, through 2019.
Current quality incentive and payment programs are consolidated and streamlined into a new Meritbased Incentive Payment Program (MIPS), and the aggregate level of financial risk to practices from
penalties has been mitigated in comparison to current law.
Physicians in alternative payment models (APMs) receive a 5 percent bonus from 2019-2024.
Strong incentives are created for physicians to participate in a qualified Patient Centered Medical
6
CONGRESS TO REPEAL SGR by David A. Fleming, MD, MA, MACP
Homes (PCMHs), an innovative model of care that has been shown to improve outcomes, patient
experience, and reduced costs. Physicians in qualified PCMHs will get the highest possible score
for the practice improvement category in the new MIPS program. PCMHs that have
demonstrated to HHS the capability to improve quality without increasing costs, or lower costs
without harming quality, can also qualify as an APM without having to accept direct financial risk.
 Technical support is provided for smaller practices, funded at $20 million per year from 2016 to
2020, to help them participate in APMs or the new MIPS program.
 Funding is provided for quality measure development, at $15 million per year from 2015 to 2019.
Physicians retain their preeminent role in developing quality standards.
In addition, H.R. 2 provides continued funding of the National Health Services Corps, Community
Health Centers, Teaching Health Centers, and the Children’s Health Insurance Program, programs
that are especially important to ensuring patient access to primary care.
TIPS FROM DEPARTMENT OF MEDICINE COMPUTING
How many times have you travelled and worried how you might find your phone if you lost it. Or, what
if you were in an accident and unable to let emergency personnel know whom to contact for you. If you
use a PIN to lock the screen from prying eyes, no one will have access to your contact information.
Fortunately, there are some easy options that could help your phone be safely returned to you or to
assist someone getting in touch with your emergency contact if needed.
Most simply, if not the prettiest, you can enter the contact
information you want to provide into the Notes app found on
most phones. Do a screen capture, and then select that image to
be your lock screen photo. (Be certain to use a phone number
other than your phone.)
Android has a way to add “owner info” to the Security settings on
the phone.
Additionally, there are several apps that allow you to add text over
any photo you have on your phone. These go beyond just creating
contact cards and could be a lot of fun!
Lastly, here are a couple apps with Emergency Contacts in mind
(some may cost).
Android
Acadian I.C.E. app
ICE: In Case of Emergency
iOS
Acadian I.C.E. app
Contact Lockscreen Info
7
BYSTANDERS: OUR NATION’S IMMEDIATE RESPONDERS
On February 10, 2015 physician leaders of major medical organizations, including Dr. David Fleming,
along with key federal personnel and National Security Council (NSC) staff participated in a Physicians
Roundtable on a national initiative, Bystanders: Our Nation’s Immediate Responders. This medical
preparedness initiative is a direct response to Presidential Policy Directive 8 (National Preparedness).
The meeting was held at the Eisenhower Executive Office Building at the White House. The goal of the
initiative is to build national resilience by better preparing the general public to save lives by raising
public awareness of techniques that can save lives by taking such basic actions as stopping life
threatening bleeding. Our national preparedness is the shared responsibility of all levels of government,
the private and nonprofit sectors, and individual citizens. As we have seen in such recent tragic incidents
as the Boston Marathon bombings, anyone can contribute to safeguarding the Nation from harm. At the
meeting, convened by NSC staff, participants in the federal interagency Bystander Workgroup reviewed
progress on the initiative and received valuable input from physician leaders. There was unanimous
broad support for the Bystander initiative from heads of major national physicians’ organizations.
CONTACTING DEPARTMENT OF MEDICINE COMPUTING
The Department of Medicine Computing Office no longer has a pager. Due to the fact that it very rarely
received pages, and the cost saving initiatives throughout the department, they have canceled the
service. The phone is covered the vast majority of the time, however, if no one answers please leave a
voicemail and someone will get respond as soon as possible.
8
LOCKETTE TAKES ON ROLE AS SOM DIVERSITY DEAN
Lockette takes on
complicated role as School
of Medicine diversity dean
Warren Lockette, the MU School of
Medicine's new senior associate
dean for diversity and inclusion, is
faced with the task of improving
the often-criticized lack of diversity
within the School of Medicine.
Lockette said he takes a panoramic
view of diversity that includes
women, veterans, people with
disabilities and any other
marginalized populations that are
underrepresented in medical fields, as well as people of different races and ethnicities.
See full article from the Missourian here.
SAFER DRUG COMBINATION FOUND FOR PATIENTS
Safer drug combination found for patients with high-risk atrial
fibrillation
Patients with high-risk atrial fibrillation, or AFib, often require
one drug to regulate heart rhythm and a second drug to thin
their blood and reduce the risk of stroke. A recent study led by
Greg Flaker, MD, the Wes and Simone Sorenson Chair in
Cardiovascular Research at the MU School of Medicine, found
that use of a newer blood thinner significantly decreased the risk
of strokes for patients with AFib who require both types of
medication. Read more about the study here.
9
2015-2016 DEPARTMENT OF MEDICINE INTERNS
Congratulations to all of the University of Missouri students on their internship placements! The
University of Missouri students that will be starting with the Department of Medicine in July are
included below.
Grace Carlson
Medicine
Lucas Blount
Preliminary
Anesthesiology
Merryl Terry
Preliminary
Ophthalmology
Troy Loethen
Medicine
Ravinder Mankoo
Medicine
Mark Reed
Medicine
Emily Cole
Preliminary
Dermatology
Mohammed Khan
Preliminary
PM&R
Kathleen Long
Preliminary
Dermatology
Kara Mohr
Med-Peds
10
Jonathan Shirshekan
Med-Peds
QUALITY MATTERS
By Barbara Boshard, RN, BSN, MS, QI Coordinator
Effective Management of Patients Leaving AMA – Against Medical Advice
The April 2015 Quality Matters revisits a previous quality improvement project conducted in 2007 and 2008 by the
Department of Medicine to manage patients who choose to leave against medical advice (AMA). Since this project
created a safe protocol and standardization of the process for the Department of Medicine yet this issue continues
to be a problem, we wanted to share this with you to see if it still meets the needs of our providers and patients.
Several key stakeholders were involved in this project including Hospitalists, a Chief Resident, medicine residents,
the Medicine QI Office, Psychiatry, UMHC General Counsel, Nursing, the Office of Clinical Effectiveness, Risk
Management, Office of Compliance, Social Services, Regulatory Affairs, Reimbursement Coordination, and a
representative from the Patient Rights Committee. Please look this over to ascertain whether you think these are
still effective methods by which to manage patients who leave against medical advice and send any
recommendations to boshardb@health.missouri.edu.
Department of Medicine AMA Guidelines April 2008
Problem Statement: The Department of Internal Medicine needs a standardized process for internal medicine
residents to effectively manage patients who want to leave the hospital against medical advice (AMA). This can
impact on the quality of care delivered, the legal and ethical ramifications for the provider, and the processes that
are used for documentation and management by IM residents. This is particularly difficult when it occurs during
the middle of the night. Standardization is important in order to protect both the safety and health care needs of
the patient and the effectiveness, skills, legal protection, and documentation needs of the resident physicians.
Recommendations from QI AMA Team:
Protocols Recommended
1) Assessing and documenting decision-making capacity (Four standards identified by Dr. Drew Resnick, Department
of Psychiatry, UMHC, to determine capacity in decision making includes, 1) Ability to communicate (verbal or non-verbal); 2)
ability to understand information provided; 3) appreciation of options available; and, 4) rational decision making),
2) follow-up arrangements determined including signs and symptoms that should prompt an immediate return
to the emergency department, planned telephone follow-up, home care needs or arrangements as indicated,
planned out-patient follow-up (within 7 days), prescriptions or dispensing of medications, and documentation
of these components, and;
3) communication with patient and documentation of the summary with the patient of diagnoses, treatments,
medications, follow-up plans, communication with primary medical team and primary care providers,
communication with family with patient approval and documentation of each of these discussions. i
Documentation Recommended
The decision-making capacity of the patient,
physician assessment,
3) the patient is able to verbalize his/her understanding of the diagnosis, proposed treatment,
alternative treatments, risks of leaving, benefits of staying, plan for follow-up, contact information,
scheduled appointments,
4) the patient is informed of his/her welcome to return for admission,
5) potential impact on payment for this visit and return hospitalization if necessary
6) signed AMA and HINN forms or attempt to obtain,
7) prescriptions ordered or provided,
8) home care arranged, and;
9) valuables and prescription/OTC medications returned or arrangements for pick up.
11
QUALITY MATTERS
By Barbara Boshard, RN, BSN, MS, QI Coordinator
Algorithm: Safe Discharge of Patients
Wanting to Leave AMA
Wednesday, April 16, 2008
Patient wants to
leave AMA
On-call/Primary Intern Called
Patient Elopes
Intern will:
1. Reason for AMA
2. Plan for bedside evaluation
ASAP
3. Inform nurse about time of
evaluation within app. 30-60 min.
4. Nurse will inform patient about
expected time
Intern will review chart
1. Reason for admission
2. Current status/issues
3. Why was he not discharged?
4. Medical condition stable/unstable?
5. Clear and present danger to self or
others?
6. Capacity to make decision?
Document
thoroughly
Intern at Patient’s
bedside
Explain potential
impact on
reimbursement
Intern asks patient
what (s)he can do
to keep patient in
hospital
Patient has social
needs
Patient dissatisfied
with service
Offer info and
assistance to
patient to submit
complaint
Contact Social
Services
Reassurance &
Encourage to Stay
Call Nurse Mgr if
applicable (ex:
delayed
procedures,
nursing concern
Social Services can
usually assess within 15
min
(8a-12p)
(Not available after
midnight.)
Communicate
issues between
teams
Call Attending if
applicable
Pt. requests Meds
No
Is it medically necessary?
(*pain control
*withdrawal
*Short term psych meds)
Yes
Can you give one time dose
until primary team arrives in
a.m. and no medical
contraindication
Yes
Give one time
dose
Priority during
a.m. rounds
Still wants to
leave AMA?
No
Yes
Unable to give 1X
dose –
Explain reasons to
patient
No
Obtain Pt.
consent to call
family, DPOA
a
12
Document
assessment,
intervention, plan,
outcome
QUALITY MATTERS
By Barbara Boshard, RN, BSN, MS, QI Coordinator
Determining Safety of Discharge
Revised 04/16/08
Public Health
Concern
a
Determine
Capacity
&
Medical Stability
Check http://www.dhss.mo.gov/
CommunicableDisease/
reportablediseaselist2.pdf
Capacity:
AAO x 3
No Hallucinations
No Delusions
Able to communicate
Understands & reports back info
provided regarding Dx,
prognosis, current mgmt and
options
Contact
Attending if:
Yes
Medically Stable
No capacity
Yes
Medically Unstable
Capacity
Medically Unstable
No Capacity
Medically stable
Capacity
yes
Are there current
medical reasons for
poor decision making
capacity?
Are there current
psych issues?
yes
Yes
No
Consult Psychiatry
to help for
confirmation/
assistance
Implement IM
AMA Protocols
Retain until
medically stable
Questions about
capacity, safety, or
retaining?
No
Yes
Contact Risk Management
(Telephone #
882-1181)
Or seek Hospital legal
advice through House
Manager
B
13
Immediately Reportable
Reportable within 1 day
Reportable within 3 days
Contact UMHC
Infection Control
882-2264
QUALITY MATTERS
By Barbara Boshard, RN, BSN, MS, QI Coordinator
AMA Process
B
Patient chooses to
leave AMA and
has capacity to
decide
Implement IM
AMA Protocols
Discharge
Document Assessment
Attempt to get patient signature on AMA Form
Attempt to get signature on HINN Form
Offer prescriptions as possible
Discuss follow-up arrangements
Document attempt to set follow-up appointments in
Resident Clinic within 1 week
Inform pt. that resident will contact patient in a.m.
Offer home care assistance if needed
Document this discussion
Return prescribed/OTC home meds and valuables if
accessible or schedule return time for pick up with
House Manager
Communication:
Ask pt to repeat back understanding, Communicate
with primary care team
Communicate with family/DPOA if patient consent
Discuss S&S that indicate need for stat return
Make sure patient knows they are welcome to return
Document conversations
Obtain best patient contact number
Provide information that leaving AMA may impact on
payment for this admission or readmission
Resources:
Some additional resources provided to us from UMHC and from Ms. Diane Johnson, medical librarian at the J. Otto Lottes
Library include:
1. AlfandreD, “I’m Going Home”: Discharges Against Medical Advice, Mayo Clin Proc., March 2009; 84(3):255-260.
www.mayoclinicproceedings.com.
2. Bristow DP and Herrick CA. Emergency department case management: the dyad team of nurse case manager and social
worker improve discharge planning and patient and staff satisfaction while decreasing inappropriate admissions and costs: a
literature review. Lippincott’s case management 7(3):121 – 128, 2002.
3. List of reportable diseases: http://wwwn.cdc.gov/nndss/script/conditionlist.aspx?type=0&yr=2013
4. MooreM, EkmanE, & ShumwayM, Understanding the critical role of the social work in safety net medical settings:
framework for research and practice in the Emergency Department, Social Work in Health Care, 51:2, 140-148. http://
dx.doi.org/10.1080/00981389.20011.610872.
5. Social workers cut nonemergent visits 45%, Emergency Department Management, AHC Media LLC, 7/1/2007.
6. TawkR, FreelsS, MullnerR, Associations of Mental, and Medical Illnesses with Against Medical Advice discharges: The
National Hospital Discharge Survey, 1988-2006, Adm Policy Ment Health (2013) 40:124-132.
UMHC, RI-3 Patient Acceptance and Refusal of Medical Care (AMA), revised 8/7/2014, edited 1/12/15, https://
docushare.umh.edu/dsweb/ApplySimpleSearch
14
SCHOLARLY WORKS
AWARDS + HONORS
Congratulations to Dr. Sameer Siddique, an American Society for
Gastrointestinal Endoscopy (ASGE) trainee and winner of an ASGE
Community Outreach Award! This year, ASGE asked trainees to develop an
infographic, included here, to create awareness about colon cancer.
Dr. Stephen Keithahn has been named to the Board of the Boone County
Medical Society for 2015. Congratulations Dr. Keithahn!
Congratulations to Dr. William Salzer for being elected Investiture Marshall
for Graduation!
GRANTS
Richard Webel, MD, is Principal Investigator for an Amgen sponsored
clinical trial titled, “OLE: Supplemental GLAGOV study for Evolocumab”
for $49,868.
Akwi Asombang, MD, is Principal Investigator for an American College of
Gastroenterology grant titled, “North American International Training
Grant” for 6,000.
PUBLICATIONS & PRESENTATIONS
Shahzad Raza, Mahadi Ali Baigc, Christopher Changa, Ridhima Dabasa,
Mallika Akhtara, Areej Khana, Krishna Nemania, Rahima Alania, Omran
Majumdera, Natalya Gazizovaa, Shaluk Biswasa, Priyeshkumar Patela, Jaffar
A. Al-Hillia, Yasar Shada, Barbara J. Bergera, Mohammad Zamana. A
Prospective Study on Red Blood Cell Transfusion Related Hyperkalemia in
Critically Ill Patients. J Clin Med Res. 2015;7(6):417-421.
Shadi Barakata, Jamie Odemb, Jacqueline R. Bataniane, Shahzad Raza,
Uzma Z. Khand. Papillary Thyroid Cancer in Struma Testis with Malignant
Transformation in the Lung Associated with Trisomy 17 Successfully Treated
with Total Thyroidectomy and Radioiodine Ablation. Case Rep Oncol
2014;7:751–757.
Centor RM, Fleming DA, Moyer DV. Maintenance of Certification: Beauty
Is in the Eyes of the Beholder. Ann Intern Med. 2014;161:226-227.
doi:10.7326/M14-1014
Bosch FH, Fleming DA. Moving to High-Value Care: More Thoughtful Use
of Cardiopulmonary Resuscitation. Ann Intern Med. [Epub ahead of print 7
April 2015] doi:10.7326/M15-0492
15
ANNOUNCEMENTS
CODE OF CONDUCT MANUAL
This link will connect you to the most updated Code of
Conduct manual provided by the University of Missouri.
MU Health System Code of Conduct
• We act with integrity and treat everyone we encounter
with dignity and respect as we strive to provide high
quality patient and family-centered care.
• We abide by laws and regulations that govern our
organization.
• We are trustworthy and maintain the confidentiality of
patient and proprietary information.
• We maintain right relationships and avoid conflicts of interest.
• We are good stewards of resources entrusted to us — people, money, supplies, equipment and the
health system’s reputation.
• We demonstrate the highest ethical standards in achieving innovation and discovery.
DR. JORDAN METZL VISITS MIZZOU
Mizzou alumnus Dr. Jordan Metzl spoke at Department of
Medicine Grand Rounds, held a book signing and led his
Ironstrength Workout on Thursday, April 30. Dr. Metzl is a
sports medicine physician at the Hospital for Special Surgery in
New York City. For Grand Rounds, Jordan Metzl, BA ’88, MD
’93, gave a talk entitled “Should Doctors Prescribe Exercise?
Trends in Preventative Wellness Through Activity.”
Metzl’s exercise philosophy began while in medical school at
MU, where he noticed his brain worked better after a run,
allowing him to sit and study better. His book "The Exercise
Cure" recommends fitness programs to address health issues.
Metzl has completed 31 marathons and 11 triathlons. In a
country that spends more than $325 billion annually on
prescription drugs, “We need to make sure people exercise
every day of their lives,” he says.
16
Congratulations to
Dr. Joshua Mongler and
his wife on the birth of
their son, Frederick Eugene
"Fritz," on March 5, 2015