ALUMNI BULLETIN
J E F F E R S O N M E D I CA L C O L L E G E • T H O M A S J E F F E R S O N U N I V E R S I T Y • FA L L 2 013
Delivery Debate: Do Physicians in America Perform Too Many C-Sections?
Meet the New President and CEO of Thomas Jefferson University and TJUH System
Stephen K. Klasko, MD, MBA Wednesday, November 20, 2013 6 to 8 p.m. Reception and Buffet
Sub-Zero & Wolf Showroom Philadelphia Navy Yard 4050 South 26th Street Philadelphia, PA 19112 Use the 26th Street Entrance
RSVP to events@jefferson.edu or register online at: connect.jefferson.edu/catchklasko Join fellow alumni at an exclusive event welcoming Dr. Klasko to Jefferson. Hear firsthand about his plans to transform Jefferson into the health sciences university of the future.
Self parking available on site Questions, call Jefferson events at 215-955 -9100
Contents FEATURES
6 Pushing the Limit: Cesarean Rate Breeds Concern 10 OB/Gyn Pilots Safety Program Used in Aviation
DEPARTMENTS 2 DEAN’S COLUMN 4 FINDINGS Meditation Combined with Art Therapy Can Change Your Brain and Lower Anxiety
14 FACULTY PROFILE
Nicole L. Simone, MD: Counting Calories to Curb Cancer
15 SPOTLIGHT Phil Marone, MD ’57: A Life of Service at Jefferson
16 ALUMNUS PROFILE
10 Questions with . . . Peter C. Amadio, MD ’73, 2013 Alumni Achievement Award Recipient
18 SCHOLARSHIP UPDATE
Remembering the Past, Investing in the Future: One Alumnus Honors Another with New Scholarship Fund
20 CLASS NOTES 21 ALUMNI ASSOCIATION PRESIDENT’S MESSAGE 23 IN MEMORIAM 25 BY THE NUMBERS
Jefferson Alumni Bulletin Fall 2013 Volume 62, Number 4 Senior Vice President, Jefferson Foundation: Frederick Ruccius Vice President for Development and COO, Jefferson Foundation: Stephen T. Smith Editor: Gail Luciani Associate Editor: Karen L. Brooks Design: JeffGraphics Bulletin Committee William V. Harrer, MD ’62 Chair James Harrop, MD ’95 Cynthia Hill, MD ’87 Larry Kim, MD ’91 Phillip J. Marone, MD ’57, MS ’07 Joseph Sokolowski, MD ’62
Quarterly magazine published continuously since 1922. Address correspondence to: Editor, Alumni Bulletin Jefferson Medical College of Thomas Jefferson University 925 Chestnut Street, Suite 110 Philadelphia, PA 19107-4216 215-955-7920 Fax: 215-503-5084 connect.jefferson.edu Alumni Relations: 215-955-7751 The Jefferson community and supporters are welcome to receive the Alumni Bulletin on a regular basis; please contact the address above. Postmaster: send address changes to the address above. ISSN-0021-5821 Copyright© Thomas Jefferson University. All Rights Reserved. JG 14-0426
THOMAS JEFFERSON UNIVERSITY
On the Cover: Illustration by Graham Roumieu.
2 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN
The Dean’s Column Quality and safety are now front and center in the national discourse on health care — big time. Regardless of where the healthcare reform train heads over the next few years, one can be sure that a laser focus on quality of care and patient safety is here to stay. The payers have keyed in on it, and so too caregivers and patients. The medical academy must now follow suit. At Jefferson, we have been ahead of the curve. The spotlight on quality and safety has come from the top down, from the health system level. Setting minimum quality standards is at the heart of Jefferson Health System’s directive. For more than three years, I have chaired the JHS Quality Committee, a board-level committee ably guided by the system’s chief medical officer, Stanton Smullens, MD ’61. Beyond ensuring that minimum quality standards are met, this committee oversees an elaborate incentive program that holds senior management, at both Thomas Jefferson University and Main Line Health hospitals, accountable for performance in the quality and safety spheres. The efforts of the JHS Quality Committee, along with its subsidiary quality committees within the member hospitals, have started to pay off. In 2012, JHS was named by Thomson Reuters (now Truven Health Analytics) one of 15 of the highest performing health systems in the nation. This award was particularly noteworthy since it emphasized quality and patient perception of care and efficiency. For the first time in its history, TJUH was named this year to U.S.News & World Report’s prestigious Best Hospitals Honor Roll, as one of the top 18 hospitals (out of nearly 5,000) in the nation. Here too, quality and safety metrics loomed large. These early TJUH successes reflect the work of many, with special recognition to Rachel Sorokin, MD, TJUH’s chief patient safety and quality officer. Effective partnering between hospital and practice leadership, alongside an engaged care delivery team, has been key for our progress so far. Some joint initiatives span
departments in creative ways. A notable one is the LifeWings/Crew Resource Management program (featured in this issue, p. 10), which adapts best practices of high reliability organizations (such as commercial aviation, U.S. Navy aircraft carriers and nuclear power) for high-risk healthcare settings, such as labor and delivery. Our university group practice has itself, as an entity, been sharply focused on quality. The financial incentive is there, and soon this will be a matter of do-or-die. Contracts with payers have increasingly incorporated incentives linked to quality and safety metrics, for example, pay-forperformance. The upside incentives will increasingly be complemented by downside penalties. Patients too will weigh in, as they are empowered by the internet to access the quality and safety track records of the caregivers they choose. David McQuaid, president of TJUH, who has championed the hospital’s charge on quality and safety, has been proactive on this front — Jefferson’s performance will be at the fingertips of patients, publicly available on the hospital’s website. As a medical school, we now have to take the ball and run with it. Our public trust is to make sure the next generation of physicians is facile with quality and safety concepts and tools. Increasingly, the regulators will mandate this. Training physicians in quality and safety is no longer optional. LCME and ACGME competency requirements have now brought training in quality and safety into the limelight for undergraduate and graduate medical education alike. JMC is already on the bandwagon, with a suite of events and seminars laced through its curriculum, such as a showcase InterClerkship Day program focused on patient safety. The Rector Simulation Center at Jefferson provides opportunities for scenario and situational training, and through drilling on precision and conciseness of communication, students develop a far deeper understanding of quality processes.
We will need to teach the teachers. The AAMC recently released an Expert Panel Report titled Teaching for Quality: Integrating Quality Improvement and Patient Safety Across the Continuum of Medical Education. It calls for a “national, collaborative faculty development initiative to ensure the proficiency of all clinical faculty members in Quality Improvement/Patient Safety.” At Jefferson, we are especially well positioned to accomplish this task. David Nash, MD, the founding dean of our School of Population Health, is a national authority on quality and safety in healthcare delivery, and he has put training in this subject high on Jefferson’s radar screen. His team has rolled out one of the nation’s first master of science in health care quality and safety. In a new interschool program being launched under his guidance, key faculty from all of JMC’s departments will be engaged in this intense course of study. So armed, they will serve as catalysts for quality and safety training back in their home departments. As we pursue this new future, a word of caution may be in order. The discourse around quality and safety is still but in its infancy. The very words ‘quality’ and ‘safety’ will need to be more clearly and contextually defined. As buzzwords like ‘value-based purchasing’ enter the lexicon, finances are being brought into the quality equation. While quality and cost will often be in synch, especially as we move from ‘doing more’ to ‘doing better,’ challenging trade-offs between quality and cost will nonetheless emerge. In the face of such trade-offs, society may start to dial the rheostat on the level of ‘value’ and ‘quality’ it is willing to purchase. In teaching our students, and teaching our teachers, we will have to titrate in a heavy dose of medical ethics so that they can grapple with these minefields of the 21st century medical landscape. Mark L. Tykocinski, MD Anthony F. and Gertrude M. DePalma Dean Jefferson Medical College
FALL 2013 3
Our public trust is to make sure the next generation of physicians is facile with quality and safety concepts and tools. Increasingly, the regulators will mandate this.
4 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN
FALL 2013 5
Findings Meditation Combined with Art Therapy Can Change Your Brain and Lower Anxiety A cancer diagnosis inevitably causes stress — and high stress is tied to poorer health outcomes in cancer patients. Research out of the Jefferson-Myrna Brind Center of Integrative Medicine has shown that an eight-week program combining creative art therapy and mindfulness-based stress reduction, or MBSR, can lead to changes in brain activity associated with lower stress for women with breast cancer. Daniel Monti, MD, director of the Brind Center and lead author on the study, and his colleagues have previously demonstrated the success of mindfulness-based art therapy, or MBAT, in helping cancer patients reduce stress and improve quality of life. “Our goal was to observe possible mechanisms for the observed psychosocial effects of MBAT by evaluating the cerebral blood flow changes associated with an MBAT intervention in comparison with a control of equal time and attention,” he says. “This type of expressive art and meditation program has never before been studied for physiological impact and the correlation of that impact to improvements in stress and anxiety.” Eighteen patients were randomly assigned to the MBAT program or an education program control group. All had received a breast cancer diagnosis between six months and three years prior to enrollment and were not in active treatment. The MBAT group consisted of the MBSR curriculum (awareness of breathing and emotion; mindful yoga; walking; eating; and listening) paired with expressive art tasks to provide opportunities for self-expression, facilitate coping strategies, improve self-regulation and allow participants to express emotional information in a personally meaningful manner. Response was measured using a 90-item symptom checklist completed by patients before and after the eight-week program. In addition, functional magnetic resonance imaging was used to evaluate cerebral blood flow, corresponding to changes in the brain’s activity. Scans were performed at rest and then during a “neutral task” (control), a meditation task, a stressor task and at rest again in order to provide a thorough analysis of the changes between the pre- and post-program scans. Members of the MBAT group demonstrated significant effects on cerebral blood flow compared with the control group, showing increases in the emotional centers of the brain including the left insula, which helps us to perceive our emotions; the amygdala, which helps us experience stress; the hippocampus, which regulates stress responses; and the caudate nucleus, which is part of the brain’s reward system. These increases correlated with a reduction
Post-training
Pre-training
Caudate
Insula Functional magnetic resonance imaging (fMRI) scans of the subjects before and after their participation in the MBAT program show that there was increased activity in the emotional limbic system and in a structure called the caudate, which is part of the brain’s reward system. There was also increased activity in a structure called the insula, which sits between the limbic system (emotions) and the cortex (thoughts, awareness and decision-making skills). This area of the brain helps us process emotions and communicate them to other parts of the brain. In the study, the increased activity in the insula suggests that creative pursuits allow us to more fully experience our emotions and reflect on them in constructive ways.
in stress and anxiety that was also reflected in the results of the pre- and post-program anxiety scores among the MBAT intervention group. The observed psychological and neuropsychological changes are consistent with current literature that states that MBSR interventions have been shown to reduce anxiety, depression and psychological distress in a variety of populations. These results have been associated with improved immune function, quality of life and coping effectiveness in women with breast cancer. Given the improvements in anxiety levels and changes in cerebral blood flow, these findings suggest that the MBAT program helps mediate emotional responses in women with breast cancer. “With the sample size enlarged, perhaps we can extrapolate these results to other disease populations and gain a fuller understanding of the physiological mechanisms by which mindfulness practices confer psychological benefits,” Monti says.
6 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN
Pushing the Limit: Cesarean Rate Breeds Concern
By Karen L. Brooks
STORY SUMMARY A dramatic rise in cesarean deliveries over several decades has experts worried that the procedure is performed too frequently and without medical need.
Reasons for the rise are complex and include malpractice climates, changes in the population of childbearing women, casual approaches to surgery and sophisticated monitors detecting even the slightest labor complications.
The cesarean rate has stabilized in recent years, suggesting that efforts to decrease unnecessary procedures are working.
FALL 2013 7
pressure ultimately resulted in son Grayson arriving via surgery three weeks earlier than planned and already weighing nearly 12 pounds. “The c-section was 100 times easier than my first delivery. I don’t know what I was so afraid of before,” she says. Vespe’s waning fear of cesarean delivery evokes a national trend. The procedure is now the most common surgery performed in the United States, with one-third of babies entering the world in operating rooms — too many to comprise medically indicated surgeries alone. In 1970, 5 percent of American children were born via cesarean; in 2009, the rate hit a record high of 33 percent. The rise has inspired widespread dialogue about modern obstetrics, with most experts agreeing that c-sections are being performed too frequently for avoidable reasons that sometimes compromise the best interest of both mother and child.
The Myth of the Type-A Mom
Knowing her baby would weigh
more than 9 pounds but dead set against having a c-section, Jessica Vespe prepared herself for a challenging delivery. “Challenging” turned into an understatement at the end of her 30-hour labor, when the doctor was unable to resolve her daughter’s shoulder dystocia — a dangerous condition in which an infant’s shoulder is stuck behind its mother’s pelvis.
“I finally delivered naturally, but they broke her clavicle to get her out,” she says of Emelia, now 4. “And I had so much pain, two months later it still hurt to walk.” Hoping to avoid another “traumatic” experience delivering her second child this past May, Vespe asked about scheduling a cesarean when a 34-week ultrasound revealed that he surpassed the 90th percentile for weight. A spike in her blood
The most dramatic jump in cesarean deliveries occurred between 1996 and 2009, with the rate climbing 60 percent and alarming health officials, particularly because many procedures were performed at 38 weeks of gestation or earlier, when the risk of complications is greater. Popular culture has blamed women themselves for the increase, perpetuating the image of the type-A mom attempting to control her delivery based on convenience rather than medical need — but according to a March 2013 report from the American Congress of Obstetricians and Gynecologists, fewer than 3 percent of cesareans are performed at a patient’s request. “C-sections on maternal request happen occasionally, but out of more than 2,000 deliveries a year, we do under five,” says Vincenzo Berghella, MD ’90, director of maternal-fetal medicine at Jefferson. “If a patient insists, it can be done, but we counsel against it ... The explanation for the rise is much more complex than that.” If control-seeking mothers didn’t cause the increase, what did?
8 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN
Popular culture has blamed women themselves for the increase, perpetuating the image of the type-A mom attempting to control her delivery based on convenience rather than medical need.
1
A Rundown of the Reasons Age and Weight. Today’s average childbearing woman is older and heavier than her predecessors, two traits that can complicate delivery. Older women are more likely to use fertility treatments that can result in challenging multiple births. And pregnant women with body mass indexes of 30 or higher — that’s 36 percent of women over 20 today, compared with 26 percent a decade ago — have bigger babies and more chronic conditions like diabetes and high blood pressure, often leading to c-sections.
2
Malpractice Climate. A common maxim among obstetricians is that “no one gets sued for doing a c-section.” They do get sued, however, for not intervening when there is the slightest indication of a difficult vaginal delivery — meaning surgery is performed as defensive medicine. “Malpractice exposure has a tremendous impact on everything in obstetrics,” says William Schlaff, MD, the Paul A. and Eloise B. Bowers Professor and chair of obstetrics and gynecology at Jefferson. “We have this cultural disconnect between clinicians working extremely hard to take great care of women and a society that is dissatisfied with any less-than-perfect outcome, even if the physician is not responsible or could not prevent it. The financial risks are enormous, and physicians understand that if they don’t do a cesarean and the baby has problems, they are at much greater risk of a lawsuit — so they do the cesarean.”
3
C-Sections ‘No Big Deal.’ Cesarean delivery has become so standard that society fails to recognize it as a major surgery; patients express interest without understanding the inherent risks. The procedure is safe but can spur complications including infections, bleeding and bowel obstructions in the mother and respiratory problems, including asthma, in the baby.
“Making large incisions is a thing of the past — today, there is so much minimally invasive surgery. But for a cesarean, we still have to make this big bikini cut — we have no choice. That comes with risks that some patients think are no big deal, and we must educate them and not perform a cesarean without need,” Berghella says.
4
Technology Trumping Nature. From late-term ultrasounds predicting a baby’s size to machines monitoring its heart rate throughout labor, today’s technology shows physicians even the smallest concerns, causing them to recommend cesareans more quickly than in the past. Some research also suggests that any labor intervention, such as induction with drugs, increases the likelihood of a cesarean delivery. With inductions at an all-time high — at more than 22 percent of births, according to the American College of Obstetricians and Gynecologists, or ACOG — it follows that caesareans have risen, too. “If you look at how many babies die or are sick, trends have gone significantly down, even as c-sections have gone up. This is because with technology, we can better see when c-sections are indicated. We are diagnosing things better — anomalies, placenta problems — and that can drive up the rate,” Berghella says.
5
Coverage and Convenience. Scheduled cesareans allow hospital staff to organize their work and personal lives. “Let’s be honest: It’s sometimes easier for a doctor to schedule a planned cesarean than to stay with the patient for hours and hours during labor — but it’s the obstetrician’s obligation not to do that. This is where ethics come in; cesareans should not be about convenience, but unfortunately, sometimes they are,” says Frank Chervenak, MD ’76, the Given Foundation Professor and Chairman of the Department of Obstetrics and Gynecology at New York Presbyterian Hospital and Weill Cornell Medical College.
FALL 2013 9
6
Pay Scales. Payments are greater for cesarean than vaginal births, making them more profitable for hospitals. A 2013 study out of the University of Minnesota found that private insurers paid an average of $27,866 for a c-section compared with $18,329 for a vaginal delivery in 2010. Medicaid paid less, but costs still varied significantly: $13,590 for a cesarean versus $9,131 for a vaginal delivery. “Physicians are paid the same amount no matter how a baby is born, and delivery decisions are not for administration or insurance companies to enter into. Some hospitals might encourage cesareans with a financial motive, but that’s absolutely wrong,” Chervenak says.
One Leads to Another Compounding all of these reasons is that once a woman has one c-section, any subsequent deliveries are also likely to be via cesarean. The vaginal birth after cesarean, or VBAC, rate plummeted from 28.3 percent in 1996 to 8.5 percent in 2009. “The paradigm for years has been that if you had a cesarean section, you should not be allowed to go into labor again because of a risk of uterine rupture — but there is recent literature suggesting that many patients have a reasonable opportunity for vaginal delivery after a cesarean,” Schlaff says. Repeat c-sections bring their own risks, such as abnormal placenta implantation, injury due to hardened scar tissue, weakened uterine wall and heavy bleeding — making it imperative that initial c-sections are minimized. “Women who have had a low-transverse incision — which is most women who have had a cesarean — are often great candidates for subsequent vaginal delivery. Physicians should be counseling their patients accordingly rather than automatically planning for another cesarean,” Chervenak says.
Reducing Unnecessary Cesareans At Jefferson, a focus on communication ensures an optimal outcome for every labor and delivery case. LifeWings, a teamwork-based safety training program, was introduced on campus last year, with obstetrics and gynecology being the first department to implement its practices. (See story on page 10.) “Cesareans or any procedures are dangerous if you don’t have a streamlined process. Our entire community of providers — neonatologists, obstetricians, anesthesiologists, nurses, pediatricians — has been trained in LifeWings to instill collaboration and a clear understanding of all issues related to every case. Each morning, these groups gather and evaluate what’s in store for the day, and that allows us to manage every delivery to the best of our ability,” Schlaff says. There is no known optimum c-section rate, but ACOG and the Department of Health and Human Services have recommended more judicious use of the procedure, advising that elective c-sections no longer be performed before 39 weeks or on women planning to have more children and aiming to reduce the U.S. c-section rate by 10 percent by 2020. A recent shift signals that this effort might already be working; from 2009 to 2011, the rate leveled off for the first time in 12 years, stabilizing at 31 percent. In that time, the nation also saw a trend toward longer pregnancies, with the rate dropping by 5 percent among women at 38 weeks of gestation and rising by 4 percent among those at 39 weeks. “The overall rate may still be too high, but you cannot get stuck thinking one place is better than another because it has a lower rate. You have to look at outcomes. Some institutions draw more complicated cases, so a higher rate would be indicated,” Berghella says. “Hospitals should be judged by the number of moms and babies who come out alive and healthy regardless of
WHAT’S IN A NAME? The history of the cesarean delivery is murky at best, with references to the procedure dating back thousands of years across countless cultures — from ancient Chinese etchings to the Greek myth about Apollo, the sun god, tearing his son from his dying ex-lover’s womb. Even the story behind the term remains a mystery; many credit the birth of Roman Emperor Julius Caesar as the inspiration, but this theory falls short, as his mother, Aurelia, lived long past his delivery during an era when c-sections were reserved for the dead and dying. Throughout his rule, Caesar dictated that all Roman women who died giving birth must be cut open in an effort to save their babies — a law that possibly inspired the “cesarean” name. The Latin words “caedare,” meaning “to cut,” and “caesones,” applied to children removed from their mothers’ wombs postmortem, also could be related. Ultimately, though, nobody has been able to pinpoint the term’s exact origin.
the c-section rate. We want everyone to be healthy and should do whatever we need to achieve that.” Experts are watching to determine whether the c-section rate remains stable or even begins to drop in the coming years. A slight decrease happened once before, between 1990 and 1996, but then the rate rose again. Whatever happens this time, an absence of ties between an increase in c-sections and improvement in mothers’ or babies’ health makes a strong case for more discerning use of the procedure.
10 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN
OB/Gyn Pilots Safety Program Used in Aviation By Gail Luciani STORY SUMMARY Hospitals across the country have renewed their focus on patient safety. Multidisciplinary teamwork is critical to effective patient care. Jefferson’s obstetrics and gynecology department is piloting a safety program with roots in aviation. Speaking up for patient safety is expected.
Sometimes bringing the right people together at the right time produces extraordinary results in harmony. When the Patient Safety and Quality Office at Jefferson suggested departments take on group safety projects, the Department of Obstetrics and Gynecology volunteered. “It was the right group and right mix of people to work on a special safety project,” says Joseph Montella, MD ’84, associate professor and director of quality and safety in the department. “And we wanted to do a safety project in obstetrics because it’s a high-risk area, which means lots of opportunity for improvement.”
Jefferson, like hospitals across the country, is focused on patient safety and quality of care. And continuous improvement is the name of the game. “We are transforming our culture so that we are the safest place to receive care,” says Rachel Sorokin, MD, chief patient safety and quality officer. “Safety is our number one priority, and this permeates the whole institution.” Teamwork is critical to safety and reliability. Jefferson chose to begin its teamwork training in obstetrics by partnering with LifeWings, a consulting firm with extensive experience in crew
resource management, which is how the aviation industry trains for safety. Aviation safety practices are effective in health care because they share similar root causes for error; approximately 70 percent of airline accidents are related to interpersonal communication while the same percentage of medical mishaps are related to interpersonal interaction. “The complexities of modern medicine have made it a team sport,” says Sorokin. “Our ability to deliver complex and sophisticated care requires enormous reliability and precision in a team function, as well
FALL 2013 11
LEFT: Rebecca Mercier, MD; Anju Suhag, MD; and Stuart Weiner, MD, listen during an OB Report. ABOVE: Third-year resident Shannon Davids, MD (far right), leads the morning OB Report. Listening from left are Zubairul Aghai, MD; Sandeep Sadashiv, MD; Angela Soper, MD ’13; Georgia Cavalli, MD; and fourth-year medical student Megan Savage. Photos by Sabina Pierce.
in a closed space. Residents, anesthesiologists, neonatal and obstetrics attendings, the nurses in labor and delivery and on the ante-natal floor, even senior hospital leadership completed training sessions designed to create tools that would improve patient safety in the department. “The groups in training created projects to work on based on the processes they use every day,” says Claudette Fonshell, patient safety and clinical outcomes coordinator. “They identified opportunities for improvement and created tools to meet their specific concerns.”
1
Obstetrics Safety Tools
as high levels of individual competence and training.” LifeWings is also certified in TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), which was developed by the U.S. Department of Defense’s Patient Safety Program in collaboration with the Agency for Healthcare Research and Quality. TeamSTEPPS is changing the culture of the medical profession by empowering every member of the care team to take ownership for clinical outcomes and patient safety.
Team training began in obstetrics in January 2012, with the implementation of some of the new team-based projects in May. “LifeWings has redefined and reinforced our culture of safety and provides the structure and language to make us better able to put safety at the highest rung of the ladder of all the things we do,” says William Schlaff, MD, the Paul A. and Eloise B. Bowers Professor and chair of the department. Launching a major safety program in obstetrics made sense because it is a closed group, with dedicated physicians, nurses and staff treating specific patients
OB Report. Replacing multiple separate report-out sessions, these twice-daily standardized sessions ensure that everyone starts the shift prepared. Led by the OB resident, the report starts with an introduction of who is on the team, followed by a review of what’s going on in the unit (ante-partum and post-partum), and who has concerns for the day, which range from individual patient care to equipment and staffing. The report ends with a reminder that team members are expected to speak up if there are any patient safety concerns.
2
Post-Partum Report. When a patient goes to the post-partum unit, a standard script of information is communicated to the staff so that everyone on the team has the information needed to provide the best standard of care.
12 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN
Aviation safety practices are effective in health care because they share similar root causes for error.
3 4 5 6
Team Check. Anyone on the team can call for a team check — it is a “safe” word, designed to alert everyone to a patient safety concern. Communication of the concern is followed by the development and documentation of the plan of care. Sometimes, team checks need to go through the chain of command for evaluation. Scheduling Tool. A template to ensure the right information is getting to the right people when a patient comes in for induction. Standardized Neo High 5. A template for documenting the five things neonatal staff need to know: gestational life age, fetal condition, amniotic fluid, maternal condition and why they have been called.
Order of the Day: Safety Check Any physician can champion patient safety by building teamwork. Charge your staff to alert you to any patient safety issues to improve both teamwork and the quality of information flow. • Start each day with a team report. •G o through your schedule. How many patients are you seeing? Are any of the patients known to be problematic? •H ow can team members help each other with problematic patients? •R emind staff that it’s their job to speak up if they have a concern about patient safety.
Neonatal Warmer/Bassinet. Teams developed cards that showed exactly what needs to be placed in a neonatal warmer, and posted those cards with every bassinet. Fully equipped, standardized bassinets are now available in labor and delivery as well as in intensive care, the emergency department and in the Jefferson Hospital for Neuroscience.
Challenging Hierarchy Another aspect of safety training is creating a culture in which there is no retaliation for speaking up about a patient safety concern. “We both expect and demand people to talk about safety and point out to others when what they are doing is unsafe,” says Schlaff. That may be easier said than done, as challenging a physician doesn’t come easily to most team members. “The hard part is to get anybody to challenge anything,” says Montella. “That comes in time, with people working together, and it comes when it is clearly supported by leadership. If everyone is comfortable calling a team check, it will change the way we work together.”
In addition to expecting team members to speak up, a culture of safety requires physicians to relinquish some of their autonomy. “This is difficult because nurses and physicians are all highly competent people who take their individual responsibilities very seriously,” says Sorokin. “But human beings err. And any member of the team may see something others missed.” Those at the top of the hierarchy in aviation set the expectation that team members are required to communicate clearly with each other and do whatever the situation requires in the interest of safety. “Our strategy is to provide safer care for our patients. That’s number one. All the rest will follow from that,” says Montella. Medical students on the obstetrics rotation are encouraged to speak up. “In my operating room a couple of weeks ago, we were doing a time out prior to incision to make sure the correct patient was having the correct surgery, and the anesthesiologists, scrub nurses and surgeons were all on the same page,” says Montella. “The circulator was leading it and said that the patient didn’t have any allergies. But the medical student said ‘No, wait a minute, she said she had an allergy to sulfa.’ So we went back and checked the record, and the patient was indeed allergic to sulfa. I was very proud of that student. Speaking up can be challenging to students because they may go to other locations or departments where there is a different philosophy.” Another safety procedure taken from the aviation manual is cross-checking, a redundancy program in which a second person checks the work of the first person. Anyone who has flown has heard the pilot ask flight attendants to cross check before taking off. “This is not because we think the first person is incompetent, but if you have a two-step process, the second person has the first person’s back,” says Sorokin. “Crosschecking in health care is a method of finding an error and correcting it before
Joseph Montella, MD ’84, follows up with a patient. Photo by Sabina Pierce.
it reaches the patient. It’s just one component of cultural transformation.”
Continuous Improvement and Sustainability Obstetrics has other safety interventions in development, such as an audit system to evaluate c-section procedures. But the goal is a continuum of care, which means that sustainability is key. “Process
Catching Errors Before They Cause an Event
sustainability is a big part of my job,” says Jessica Abrams, perinatal safety nurse. “The early influences of the program can be seen every day in tools like the OB Report. It has helped create a new way of thinking, and I believe that this attention to patient safety is not just a passing fad. With the evolution of the perinatal safety nurse role, there is always someone to stand behind the existing tools and
Each medical specialty has its own unique patient safety challenges. In obstetrics, things happen quickly, there are two patients involved and multiple medical professionals add to the complexity of the equation. That’s why Jefferson’s practice is to verify the date of pregnancy before inducing labor. “I was seeing a woman with a 40-week fetus, so I was reviewing her records,” says Meryl Kahan, MD. “I discovered a report from a first trimester ultrasound from an outside facility that had been scanned into the electronic medical record, but had been overlooked during the patient’s previous visits.” The first trimester ultrasound, which is considered more accurate than later scans, established the patient’s estimated
FALL 2013 13
support the evolution of new ideas, always with the patient and care team’s safety in mind.” Training with LifeWings has started with licensing in spine surgery, and other departments are interested in participating. “A lot of what we do in quality and safety in obstetrics is very translatable to other services, because we see both medicine and surgical problems,” says Montella. “We can apply lessons learned and best practices to other disciplines around the university, but the support for these practices needs to come from all levels — the president, the dean, the chairs, everyone.” Just as the airline industry adapted the principles of teamwork to improve customer safety and minimize risk, hospitals are focused on changing their culture to become more patient centered. “Change is never easy. People rely on patterns of behavior that have served them well, so understanding that a new pattern might be helpful can be challenging,” says Sorokin. “Many of our nurses and physicians are wedded to their feelings of deep personal responsibility for the care that they deliver, and we need that. The challenge is in realizing they can still have those feelings and be a team member, that we are actually improving patient care. It’s a big shift for all of us.”
delivery date as two weeks later than previously thought. Had the induction of labor proceeded, a premature infant might have been delivered. Kahan stopped the scheduled c-section and was awarded the Good Catch Award for the month for saving a baby from being born too early. Her attention to detail ensured that the baby had more time to develop, avoiding the developmental problems that may have occurred had the procedure not been stopped. “The Good Catch Program works to inspire people to recognize and act on anything that they see,” says Sorokin. “An award is given every month to an employee for making a good catch, recognizing, identifying and preventing an error, and inspiring other people to do the same.”
14 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN
Jefferson Faculty Nicole L. Simone, MD Counting Calories to Curb Cancer
A grim funding climate threatens scientific discovery every day across our nation. But among ever-tightening budgets and stiffening competition for grants, Nicole Simone, MD, assistant professor of radiation oncology at Jefferson, continues to thrive. “I’m constantly writing proposals. It’s not fun, but it forces me to plan exactly where I want to go with my science — to develop concrete ideas and ways to implement them as efficiently as possible,” she says. Perhaps the greatest testament to the promise of Simone’s work is her receipt of three prestigious awards in the past year: the Radiation Therapy Oncology Group Simon Kramer New Investigator Award, the American Society for Radiation Oncology Junior Faculty Award and the Ben Franklin-Prostate Cancer Foundation Young Investigator Award. Currently, Simone’s top priority is leading a first-of-its-kind clinical trial evaluating calorie reduction’s impact on radiation therapy for women with breast cancer. Her studies have indicated that cutting calories from these patients’ diets could enhance radiation’s effectiveness, and Simone is excited to translate her lab discoveries to the human population. What inspired you to study caloric intake’s connection to cancer? Radiation stresses cells, so I’ve tested other stressors to see how they affect the body. I found that calorie restriction is a stressor that alters the molecular pathways involved in radiation therapy, so I wondered whether we could use it to get a bigger bang for our radiation buck. And we did — the combination caused greater tumor shrinkage and a decrease in metastases. What does your clinical trial involve? Patients start by keeping a diet log so we can assess their caloric intake. We then work with Dr. Daniel Monti and his team at the
Myrna Brind Center of Integrative Medicine to determine how to safely reduce that by 25 percent. Participants stay on that diet for 10 weeks while they undergo radiation. If we find that reducing calories improves their outcomes, it’s possible that dieting could become a standard, not to mention affordable, part of treatment. Are you conducting any other research? I’m also studying the effect of radiation on microRNA expression. MicroRNAs control translation and proteins, and I’ve been looking at how one in particular, miR-21, operates almost like an oncogene. It’s called an onco-miR and is known to be upregulated in breast cancer. If we could shut it down, maybe we can actually turn off some breast cancer genes. Where do you see your field heading in the next several years? I see a movement to limit toxicity in cancer therapy. Many adjuvant treatments to radiation have toxicity — and if you target different molecules with different drugs, you’re going to multiply that toxicity. But with methods like calorie restriction, we’re learning that we can turn off molecules associated with cancer in a nontoxic way, and I hope we can ultimately use this to enhance treatment safely and with minimal side effects. What is your proudest accomplishment? As proud as I am of my work, I’d have to say my two kids, Christina and Nicholas. They keep me busy but happy. And then as soon as they go to bed, I start writing grants again. — Karen L. Brooks
FALL 2013 15
PHIL MARONE, MD ’57
A Life of Service at Jefferson
P
hil Marone has been a part of life at Jefferson for more than 60 years. From his days as a student in the early 1950s to his current role as associate dean for alumni relations, he has been a resource for patients, faculty and students. Here is a timeline of the life of Dr. Phil Marone, who will celebrate his retirement next month.
1930 Born in 1930. Grew up in a rural area in Pine Grove, New Jersey. An Italian “compound” of his father’s family where everyone knew each other. Grandfather Marone wanted him to become a doctor.
1953
1957–58
1960
Before going to college, worked in a paint factory for a couple of years.
Applied to JMC while still at PCP, and came to Jefferson the same year he graduated.
Wanted to become a doctor but decided to become a pharmacist first. He went to the Philadelphia College of Pharmacy, and graduated in 1953.
Graduated from JMC in 1957. Married Carmela the day after graduation.
Spent the year of 1960 as fellow in NYU at Institute of Physical Medicine and Rehabilitation at the request of his mentor, Dr. Anthony DePalma. “I took the 5 a.m. train out of 30th Street Station every day and I got home about 8:30 p.m. It was a long year, but it gave me something that no other orthopedist had at that time – a background in physical medicine and rehabilitation that was beyond what you would normally get as an orthopedic resident.”
Served as intern and resident at Jefferson, 1957 and 1958.
“ I have nothing but good memories at Jefferson. I have enjoyed every year I was a physician, and I did everything to the best of my ability. I would tell people if I couldn’t help them. God has been good to me.”
1978 Instrumental in launch of the spine center at Jefferson.
1943
Worked on a farm in summers, could drive a tractor before a car. “While I was growing up, I learned what it was to work – my work ethic was instilled in me by my family.”
1961–1966 Worked as an orthopedic resident at Eastern State Penitentiary. “My scrub nurses were inmates. It was the most interesting part of my career.”
Moved to a bigger house in Philadelphia, because family was growing. There were five children. Graduated from high school when he was 16.
1972 Residencies led to a clinical professorship in physical medicine, rehab and orthopedics at Jefferson. “I helped train people in both sides of aisle. Rehab people looked upon me as someone who could help train people so I had both PMR residents as well as orthopedic residents.”
Joined the Philadelphia Phillies as team physician in 1972. “The manager needed quick answers to questions like, ‘How long will this player be out?’”
1992–1998
1999–2000
2007
2013
Received rehabilitation award from Magee in 1992.
Retired from baseball in 1999.
Earned master’s degree in public health in 2007. “It showed me how much I did not know about public health.”
“I came into medicine to help people, which I hope I have done. I have treated everybody the same, whether they paid me or not.”
Presented with portrait in 1998.
Became associate dean of alumni relations in 2000 and has been the face of Jefferson to our alumni for 14 years. He also solicited numerous gifts in support of the medical college.
Dr. Marone retires from Jefferson on December 31, 2013.
16 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN
Alumnus Profile 10 Questions with . . .
Peter C. Amadio, MD ’73 2013 Alumni Achievement Award Recipient
Peter C. Amadio, MD ’73, with his mother, Vilma Amadio. Photo by John Donges.
Peter C. Amadio, MD ’73, was destined to become a physician. “I remember hearing about Jefferson when I was a small child; my dad was a student there, and he said that he turned in an application for me when I was 5 years old,” he says. “My becoming a doctor was always the master plan from my dad’s perspective.” Amadio, currently the Lloyd A. and Barbara A. Amundson Professor of Orthopedics at the Mayo Clinic, is the recipient of the 2013 JMC Alumni Achievement Award, bestowed during reunion weekend festivities in October. “Everything in my early life focused on graduating from Jefferson and becoming a doctor. So it’s a wonderful feeling to have recognition from an institution that means so much to me,” says Amadio. A participant in the Penn State five-year medical degree program, Amadio went on to a residency in orthopedics at Harvard Medical School, followed by a hand fellowship at Jefferson. “I met my wife, Bari, who was a nursing student, while I was at Jefferson,” he says. “We are still married 40
years later.” Amadio graduated 15 years after his father did in 1958, so they shared reunion years during Jefferson’s Alumni Weekend. Amadio spent time in private practice on Long Island before deciding to move north, joining the prestigious Mayo Clinic. “Mayo is a wonderful place to work; everything is collaborative and oriented around teams. It has a family feeling, very similar to what I always felt at Jefferson,” he says. Amadio could claim Philadelphia as his home — he still has family living in the area — but he has lived in Rochester for almost 30 years. “My loyalties are split, but I will say that there is no good junk food in Minnesota. Philly has soft pretzels, Tastykakes and, of course, cheesesteaks,” he says. Amadio became interested in hand surgery and rehabilitation while working at Jefferson with James Hunter, MD ’53, who died in January of this year. “Getting the tendons to move properly after hand surgery is a big problem; they tend to get stuck and the fingers don’t move well. So I became interested in hand lubrication,
which led to partnering with a biomedical engineer at Mayo. For last 20 years, I’ve had an NIH-funded research grant, first on hand tendon lubrication then on tissue engineering, with a goal of building a better lubrication system and possibly artificial tendons. These are all things that started with Dr. Hunter,” he says. As his collaboration with bioengineers increased, so did Amadio’s role; he eventually became a professor of biomedical engineering in addition to orthopedic surgery. He is currently studying how to use stem cells and naturally occurring lubricants to improve tendon healing after an injury. “We’re trying to figure out ways to make them adhere to the surface of a tendon so it slides better and doesn’t get stuck to surrounding tissues,” he explains. Outside of work, Amadio is interested in history and politics. “I used to think those were areas that I’d major in, but now they are hobbies,” he says. “My dad was right — I was meant to be a physician.”
FALL 2013 17
1. When you were a child, what did you want to be when you grew up? One of my earliest memories is playing with my father’s ‘bone box’ — pieces of a human skeleton that medical students took home to study from in the 1950s. So it was pretty much medicine from the get-go. 2. What drew you to your specialty? I remember clearly a conversation on this topic with William Baltzell, MD ’46, a professor of ENT when I was a student. I asked him that question, and he said that the most important part of choosing a specialty was finding people, or even a specific mentor, you liked being around. For him, it was Chevalier Jackson. For me, that’s been hand surgeons. I have had exposure to a number of great role models, both at Jefferson, with Drs. Hunter and Schneider, and elsewhere. Most of my best friends now are other hand surgeons, some of whom I have known for over 30 years.
3. What don’t people know about your field that you wish they did know? It’s a team sport. Nothing happens unless the hand surgeon, hand therapist and patient work together. 4. If you could work for a year in any location in the world, where would you do it? Come winter, as I’m shoveling my roof, I always think Hawaii would be nice. 5. What is your biggest pet peeve? People who spend their lives looking backward instead of forward. You can’t change the past, but you can change the future. 6. What’s on your bucket list (personally or professionally)? I enjoy horse racing and visiting race tracks when I travel. I’ve been to the Kentucky Derby every year since 1989. I would love to attend the royal meet at Ascot, in England, one day.
7. What is the biggest challenge in your field? We have pretty good tools now in hand surgery to fix things, but not enough to replace them, when fixing isn’t possible. Replacements for tendons, nerves, joints — even whole hands — that’s the big challenge today for hand surgeons. 8. What is the best decision you ever made? Marrying Bari. We met in November, married in June, and 40 years later we’re still on our honeymoon. 9. What is the most adventurous thing you have ever done? A friend and I bought a race horse about 10 years ago, and now we also own her babies, several of whom have raced. It’s been a lot of fun. 10. Who is your personal hero? Why? My wife. She has given me the strength to be who I am today.
18 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN
Adnan Bashir, MD ‘13, with Paul C. Brucker, MD, in 2009. Photo by Ed Cunicelli
FALL 2013 19
Remembering the Past, Investing in the Future One Alumnus Honors Another with New Scholarship Fund Iftikhar Chaudhry, MD ’93, remembers his cousin Adnan Bashir, MD ’11, as fiercely ambitious and independent. “He was very aware of how extensive and expensive the process of becoming a doctor is and found every avenue he could to lighten the burden not only on himself but on his family,” says Chaudhry, an ophthalmologist. Bashir’s hard work led to his receipt of a Paul C. Brucker Scholarship in 2009 and 2010. Brucker Scholarship funds benefit students in the accelerated Penn State/ Jefferson BS/MD program — the same program Chaudhry completed years earlier. “Adnan saw how happy I was with my training and wanted to follow in my footsteps, and he was so appreciative that scholarship support helped him do that,” he says. Sadly, Bashir was unable to fulfill his dream, as he passed away suddenly in May 2013 while an anesthesiology resident at the University of Pittsburgh School of Medicine. To honor his memory, Chaudhry recently established the Adnan Bashir, MD, Scholarship Fund to support JMC students. This is the second scholarship fund Chaudhry has endowed at Jefferson — and is also the second one inspired by Bashir. “Adnan’s excitement about going to Jefferson made me want to get more involved,” says Chaudhry, who responded by creating the Chaudhry Family Scholarship Fund, which benefits students in the Penn State/Jefferson program, in 2009. “I named the second scholarship after him to thank him for reminding me of my roots.”
THE MATCH IS BACK Until June 30, 2014, all gifts to establish new endowed scholarship funds will be matched by Jefferson. The University is committed to increasing available scholarships for students in all disciplines to ensure that financial obstacles do not prevent them from pursuing a career in health care. Learn more about the match by visiting connect.jefferson. edu/scholarships.
Scholarship support means an enormous amount to JMC students. To see a video featuring a recent graduate whose life was changed by scholarship funding, go to connect.jefferson.edu/ scholarships.
Both of the scholarships Chaudhry has established qualified for Jefferson’s “match,” through which the University pledges to match funds donated to any new scholarship or professorship, dollar for dollar. By taking advantage of this incentive, Chaudhry has found a way to memorialize a promising young physician whose passing leaves a void but whose legacy will live on by helping countless medical students for years to come. “I did this to recognize an amazing person and also to provide a future benefit for society. Our world needs good doctors, and Jefferson trains good doctors. I encourage all alumni to give as much as they can.”
DONOR HONOR ROLL NOW ONLINE In past years, the fall Bulletin highlighted alumni giving. This year, we have moved all giving lists online. Please visit connect.jefferson.edu/donorhonorroll to see Jefferson’s Donor Honor Roll from last fiscal year.
20 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN
ClassNotes ’48
Lee S. Serfas and his wife, Gerri, live in Nazareth, Pa. Serfas reports that he remains in good health.
’49
Sheldon Rudansky recently retired from Nassau University Hospital in Mineola, N.Y., after 55 years, the last 13 of which he spent as physician adviser to case management. Rudansky lives in Cedarhurst, N.Y.
’59
L. Reed Altemus spends the winter months at Jekyll Island, Ga., but primarily lives in North Yarmouth, Maine.
’64
Stephen C. Kauffman retired from general practice in January and lives in Falls Church, Va. John E. Riffle received the outstanding resident education award from the graduating 2013 ophthalmology residency class of the Medical College of Georgia. Riffle is chief of the Department of Ophthalmology and residency program site director at the Department of Veterans Affairs Medical Center in Augusta, Ga.
’66
W. Royce Hodges III has retired from practicing anesthesiology. He and his wife, Nancy, have moved to a new home in West Virginia. Hodges continues to work on his golf game and says he enjoys reading about things other than medicine “for a change.” Roger D. Raymond reports that he and his wife were honored to celebrate the 50th anniversary of classmate Henri Hood, MD ’66, and his wife, Eleanor, in June. Raymond lives in Barrington, R.I.
’67
Michael Kodroff writes that he has retired to the Outer Banks of North Carolina.
’70
Louis Freeman retired in 2007 and enjoys sailing in Mexico in the winter and working in his wife Marge’s garden in the summer. Freeman says he gets great joy from visiting family in California, Texas and the United Kingdom. Marilyn S. Kershner has welcomed her first grandchildren, a boy and a girl. Kershner is a retired radiologist and tutors once a week at a bilingual school. She hopes to become a docent on whale-watching trips and lives in San Diego, which she says is a great place to retire. Judith Schwartz says she is happy to announce that after three years of planning, she and her husband, Burton Schwartz, MD ’67, are moving to their new home in Brigantine, N.J., and she hopes to see some of her JMC classmates soon.
’72
James E. Fticsar has retired after serving 31 years as a general surgeon in the U.S. Navy. He is enjoying retired life in Chesapeake, Va. Stephanie E. Poellnitz writes that she doesn’t believe 40 years have gone by since graduation. Her children are grown and out of the house, and she and her husband are still working with no plans for retirement. They live in Mays Landing, N.J.
’75
Frank P. Penater has retired from emergency medicine and reports that he is “dabbling” in urgent care. Penater lives in Allentown, Pa.
’79
Terry B. Bachow is pleased that his daughter, Whitney, began medical school at Jefferson in August and will be a member of the JMC Class of 2017. Bachow continues to enjoy practicing radiology with a special
emphasis on neuroradiology and musculoskeletal imaging. He plays drums with various bands at local clubs and says he was excited to have JMC graduates Noah Babins, MD ’79; Gary Cassel, MD ’78; Bruce Goldberg, MD ’79; and Allen Pachtman, MD ’79, at his recent surprise 60th birthday party thrown by his wife, Barbara. His son Spencer is an internal medicine resident at the Hospital of the University of Pennsylvania, and his son Brian is a student at Emory Law School.
Barbara Pittner-Seizert is practicing rehabilitation medicine in Minneapolis, Minn., and reports new challenges resulting from the merging of groups of networks. Sandra A. Willingmyre writes that she is enjoying her work at the VA Medical Center in Tucson, Ariz.
’83
Ellen Blair-Pierce has retired from the U.S. Public Health Service and is a passionate abolitionist with Partners Against Trafficking Humans in North Carolina. She lives in Apex, N.C.
’86
Ignacio Echenique has been married to his wife, Mary Ellen, for 33 years. His son, Ignacio A. Echenique, MD ’09, and daughterin-law, Alicia Sanchez, MD ’09, are both Jefferson graduates. Leonard Tachmes is medical director of the Miami Beach Plastic Surgery Center and Medspa in South Beach, Fla. Tachmes recently was appointed chief of plastic surgery at Larkin Community Hospital in South Miami.
’89
Connie S. Drapcho-Foti is a hospitalist director with Mercy Clinic Hospitalists in Joplin, Mo., and continues to help rebuild programs two years post-tornado.
Andrew Sirotnak has been appointed vice chair for faculty affairs in the Department of Pediatrics at Children’s Hospital Colorado. In this newly created role, he oversees a variety of faculty initiatives including wellness, mentoring, leadership development and workforce issues within the hospital and its network of care. Sirotnak lives in Denver.
’91
John Comber has been a physician with the Abington Emergency Trauma Center for 20 years. He and his wife, Amy Comber, PhD ’92, live with their three sons in Horsham, Pa.
’92
Joseph E. August is the president and CEO of Internal Medicine Physicians of the North Shore in Peabody, Mass. He recently celebrated his 25th anniversary with his wife, Kathleen, and four children.
’99
Louis Giangiulio lives in West Chester, Pa., with his wife, Laura, and their four children. He is now in his third year of his solo pediatric practice, Sugartown Pediatrics, and is “enjoying every minute of it.” Andrew Haas, MD, PhD, is one of six physicians who took part in a first-of-its-kind surgery using human technology to treat a therapy dolphin who was having trouble breathing in May 2013. The surgery on the dolphin at Island Dolphin Care in Key Largo, Fla., was similar to an angioplasty in humans, but in her case, it was her airway that needed to expand instead of a blocked artery. Haas says the 370-pound dolphin is now “doing great.” He lives in Philadelphia and is a pulmonologist at the University of Pennsylvania.
FALL 2013 21
Alumni Association President’s Message
Steven Wagner has been honored for the third year in a row by Philadelphia Magazine as one of “Philadelphia’s Top Doctors” for his vascular and interventional oncology practice at Cancer Treatment Centers of America in Philadelphia. An auto racing enthusiast, Wagner recently earned a competitive auto racing license.
Celebrate the Past and Embrace the Future
’03
Adam Blescia and Jill Shingle Blescia celebrated their 10th wedding anniversary in April 2013 and have four children: Sophia, Sam, Zachary and Audrey. They live in Hollidaysburg, Pa. Leah Muhm Lin recently completed her radiology residency at Kaiser Permanente Los Angeles and started a cardiothoracic radiology fellowship at University of Southern California in July 2013. She and her husband, Kevin, have two children, Lexi and Lucas.
’05
Stephanie M. Moleski has completed her training in gastroenterology and is an assistant professor of medicine in the Division of Gastroenterology and Hepatology at Jefferson. Her research interests include women’s GI and celiac disease.
Send us your personal and professional updates for the Bulletin’s Class Notes! Contact Toni Agnes at 215-955-7751 or antoinette.agnes@jefferson.edu. Mail to: Toni Agnes The Jefferson Foundation 925 Chestnut St., Suite 110 Philadelphia, PA 19107
Tradition. It acts as an anchor, a source of security. As practices are passed down from one generation to the next, we are able to identify with our ancestors from the past. Jefferson is an institution steeped in tradition. As our society continues to evolve, so do our traditions. Some of them fade from the annual calendar, others remain. And some need to be updated. One of my fondest memories as a Jeff student is attending the Black and Blue Ball. For 75 years, students and faculty celebrated the black and blue school colors in style as they hit the dance floor and shared in the “Spirit of Jefferson.” The event was sponsored by the fictitious fraternity Kappa Beta Phi (backwards for Phi Beta Kappa). Several years have passed since the last ball, but I enjoyed it so much that I started working with students last spring to resurrect it. Then, in early summer, a member of the current JMC senior class sustained an injury that rendered him paraplegic. In an instant, this shining star tumbled, and his life changed dramatically, forever. Not long after, I received a call from a fellow Alumni Association officer, our vice president, Dr. Joe Majdan — a tradition himself. A highly respected clinician and well-loved teacher, he has devoted decades of service to students. He suggested that the Alumni Association organize a fundraiser for this injured student. Combining our two ideas led to the 2013 Black and Blue Ball, which became a fundraiser for this dedicated student and loyal classmate as a show of our love and support. The revival of this cherished tradition helps us celebrate the past while lending a hand to a current student facing extreme challenges. Sustaining the “Black and Blue Fund” will also establish an ongoing source of aid to future students who may also encounter hardship. Everyone
from classmates to fraternity brothers and faculty to alumni want to help in the healing process. The enthusiasm is palpable. The current American culture fosters a harried pace enabled by “techno-communication.” Everyone needs to know everything right now! The entire country is “looking down”… texting, Googling and gaming. As the president of the Alumni Association, I have a goal of offering more opportunities for alumni and faculty to “look up” — plan events that bring people together to share a memory, get to know each other outside the hospital and generate good will. One such event is the new annual tradition in its third year, “Jeff at the Beach.” The summer breeze and glowing sunset of Stone Harbor, N.J., set the stage for this beautiful evening of cocktails and conversation, with more than 100 Jeff alumni and friends in attendance. During Alumni Weekend this year, another new tradition was initiated. The first alumnae brunch was held on Sunday, Oct. 6. The program included informal modeling of business clothes, and guests were invited to donate gently used clothing to “Dress for Success,” which helps disadvantaged women transition back into the work force. What a great opportunity for women physicians to mingle, for students to find mentors and for all to share with needy sisters. So come home and spend some time with the “family.” The more people who gather to celebrate the Jefferson Spirit, the more donations will go to help a student in need. We are Jefferson. We bleed black and blue!
Marianne T. Ritchie, MD ’80 President, JMC Alumni Association
22 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN
A LU M N I W E E K E N D 2013
•
O CTO B E R 4 – 6
Graduates reconnected during Alumni Weekend Oct. 4 to 6, 2013, at various events including a “Night in Venice”-themed welcome reception, the annual “Taste of Philadelphia” luncheon and a special Sunday alumnae brunch. Photos by John Donges. To see all photos from this year’s festivities, visit connect.jefferson.edu/alumniweekend2013.
FALL 2013 23
InMemoriam ’44S
Robert H. Hollander III, 93, of Dallas, died May 27, 2013. Hollander was a thoracic surgeon for 34 years. During World War II, he served as a U.S. Navy surgeon in the South Pacific aboard the aircraft carrier USS Essex. He is survived by three sons and a daughter.
preceded in death by his wife of 66 years, Dorothea, and his brother, Stephen. He is survived by three daughters, Dorothea, Bonnie and Amy; a grandson, Andrew; two sisters, Bonnie and Beatrice; and several nieces and nephews.
Emil P. Howanitz, 93, of Kingston, Pa., died April 29, 2013. Howanitz served as a Captain in the U.S. Army at the end of World War II. He served his internship at Jefferson and surgical residency at New York Medical College and practiced general surgery in Wilkes Barre, Pa., for 40 years. He is survived by his wife of 69 years, Florence; three children, Paul Howanitz, MD ’78, Beth Chambliss and Ann Pini; seven grandchildren; and three great-grandchildren.
Joseph A. Lentini, 92, of Jenkins Township, Pa., died June 22, 2013. A veteran of World War II, Lentini served his residency at the Wilkes-Barre General Hospital, where he served on the staff for 40 years as a general practitioner and in the Department of Obstetrics before retiring in 1991. He was a member of the American Medical Association, the Pennsylvania Medical Society and the Luzerne County Medical Society. Throughout his career, he routinely donated his medical services to various community sports teams and other organizations. He is survived by his wife of 22 years, Edith, and seven children.
Milton N. Kitei, 94, of Lafayette Hill, Pa., died May 17, 2013. After an internship at Albert Einstein Medical Center and in the U.S. Navy as a first lieutenant, Kitei began his 64-year career in family medicine. He continued to work until one month before his 90th birthday. Kitei was married for 48 years to Janice Rubin Kitei, who passed away in 1998. He is survived by his daughter, Mindy Rubin; two sons, Robert Kitei, MD ’89, and William Kitei, MD ’75; and four grandchildren, including Paul Kitei, MD ’13.
’45
Edward W. Cubler, 92, of Schuylkill Haven, Pa., died April 25, 2011. Cubler was a World War II veteran and specialized in anesthesiology, serving as head anesthesiologist at the Pottsville Hospital for 30 years. He also served as medical doctor for the Schuylkill County Prison for 15 years and was the physician for Schuylkill Haven Schools for 20 years. He founded and operated the Pottsville Hospital School of Nurse Anesthetists. Cubler was
’51
’52
William Martinez, 90, of Austin, Texas, died July 27, 2013. After serving in World War II, Martinez worked as a cardiac surgeon before spending the last 23 years of his career as medical director of the New Jersey Manufacturing Insurance Co., from which he retired in 1986. Martinez is survived by his wife of 55 years, Marilyn; five sons, William V. Jr., MD ’86; James, David, Paul and Keith; two daughters, Marilyn and Susan; and 22 grandchildren. He was predeceased by four brothers, one sister and two grandchildren.
’54
Christopher K. Hood, 83, of Charlotte, N.C., died March 14, 2013. After completing his residency in obstetrics/gynecology, he served in the U.S. Army Medical Corps before settling into private practice for 40 years. Kennedy is survived by his wife of 62 years,
Ruth, and four children, including son Renwick C. Hood, MD ’81. Nelson F. Moury Jr., 85, of Willow Street, Pa., died March 23, 2013. After his residency, Nelson entered into an internal medicine partnership with Wallace G. McCune, MD, in Germantown, Pa. He was a staff member and teaching fellow at Jefferson, Germantown and Temple University hospitals until 1974 and was also a staff member at Chestnut Hill Hospital. He opened his own internal medicine practice in Broad Axe, Pa., in 1974 and conducted house calls until he retired in 1993. Moury is survived by his wife of 61 years, Jeanne, and three children.
’56
George M. Arnas, 81, of Cherry Hill, N.J., died June 14, 2013. Arnas did his ob/gyn residency at Elizabeth Steele Magee Hospital in Pittsburgh and then worked as an instructor at the University of Pittsburgh before becoming a medical officer at what is now the Naval Health Clinic at Marine Corps Air Station Cherry Point, N.C. From the 1960s into the early 1970s, Arnas was an associate professor and member of the medical staff at Jefferson. He also was in private practice in Philadelphia and later in Cherry Hill until retiring in the late 2000s. He is survived by a daughter, a son and two grandchildren. His wife, Audrey, died in 2011.
’62
John P. Capelli, 77, of Haddonfield, N.J., died at home June 29, 2013, from complications related to pulmonary fibrosis. Capelli was former vice president of medical affairs at Our Lady of Lourdes Medical Center, where he founded the dialysis and transplant center and served as chief of nephrology. In addition to his wife of 51 years, Patricia, Capelli is survived by two sons, David and John; a daughter, Elizabeth; and four grandchildren.
’63
Peter J. Devine Jr., 77, of Holland, Pa., died at home June 28, 2013. Devine served in the U.S. Navy on the USS Sierra for two years. He completed his internship at Nazareth Hospital in Philadelphia. After two years in family practice in Northeast Philadelphia, he joined the medical staff of Bell of Pennsylvania in 1966 and rose to corporate medical director before retiring in 1991. Devine is survived by three children, Michael, Donald and Kristin, and seven grandchildren: Colin, Charlotte, Shelby, Kathryn, Caroline, Caden and Ryan. His wife, Donna, preceded him in death.
’01
Marc R. Criden, 46, died July 30, 2013, in Columbus, Ohio. Criden was a neuro-ophthalmologist at Ohio State University’s Wexner Medical Center and clinical assistant professor at the Ohio State College of Medicine. His clinical interests included ocular and facial trauma, oncology and reconstructive surgery and his research focused on intra-cranial hypertension, giant cell arteritis and orbital tumors. He also was involved in the China Eye Project, an international collaboration developing artificial vision, and previously spent four years at the University of Texas at Houston as division director for both neuro-ophthalmology and oculoplastics and reconstructive surgery. Soon after the 2010 Haitian earthquake, he visited twice to offer medical relief and surgical care to adults and children. Criden is survived by his wife, Natasha; daughter, Scarlett Elizabeth; parents, Helene and Louis Criden, MD ’65; sister, Debbie; father-in-law and mother-in-law, Allan and Julia Steinberg; and sisters-in-law, Shiloh and Tara.
24 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN
FACULTY
C. Paul Bianchi, PhD, 86, of Boothwyn, Pa., died Aug. 13, 2013. Bianchi served in the U.S. Army. He earned a PhD in physiology and with a minor in physical chemistry from Rutgers University in 1956 and was a public health fellow and visiting scientist at the National Institutes of Health from 1956 to 1959 and an assistant member of the Institute for Muscle Disease in New York from 1959 to 1961. Bianchi worked at the University of Pennsylvania School of Medicine from 1961 to 1976, when he came to JMC to become the third chair of the Department of
Pharmacology and a professor of pharmacology, a position he held until 1986. During his tenure, the department grew significantly, and research expanded from an early emphasis on toxicology to include cardiovascular pharmacology and drugs that affect calcium metabolism. Bianchi was active in many local and national scientific societies and served on many editorial boards. In 1987, he and three other local pharmacologists founded the Mid-Atlantic Pharmacology Society, a regional chapter for the American Society for Pharmacology and
Experimental Therapeutics. After stepping down as department chair, he remained a professor of pharmacology, retiring in 1997 as professor emeritus. Bianchi’s research interests centered on electrolyte physiology and pharmacology in excitable tissues such as nerve and muscle. His seminal work formed the basis of our current understanding of the mechanisms of action of local anesthetics and calcium-channel blockers widely used today. Through the use of drugs as tools, his work contributed to our understanding also of the
basic mechanisms of excitationcontraction coupling in muscle. His research extended also to malignant hyperthermia and discovery of the therapeutic efficacy of dantrolene for this condition. His pioneering work on the role of mitochondria in cellular calcium homeostasis predated, by some 40 years, current interest in this topic. Bianchi is survived by his wife, Eleanor; four children, Margaret, Alison, Judith and Joyclyn Agatone; four grandchildren; and one great-grandchild. He was preceded in death by his wife, Judith, and sister, Gloria.
WHAT EVERY
HEALTH CARE PROFESSIONAL SHOULD KNOW:
A GENERAL MEDICAL UPDATE FEBRUARY 2 – 6, 2014
The Ritz-Carlton, Lake Tahoe
Spend a week with Jefferson faculty at the Annual Alumni Winter CME Meeting. Renowned experts from several specialties will present.
SELECTED TOPICS INCLUDE: • Raft Debate: Obesity • Clinical Pathologic Conference • Moving from Bench to Bedside • Healthcare Reform: Evolution or Revolution • International Medicine • Up in the Air: Travel Medicine Emergencies
REGISTRATION FEE: Beginning at $595 (see website for details) includes: • All education sessions and CME Credit • Welcome Reception (Feb. 2) • Breakfast and afternoon snacks (Feb. 3 – 6) • O ne dinner ticket (Feb. 5) Guests welcome with additional ticket purchase • Access to additional area discounts
Questions? Contact the JMC Office of CME at 1-888-JEFF-CME or jeffersoncme@jefferson.edu
The Ritz-Carlton, Lake Tahoe Room rates range from $259 to $489. To reserve a room book online at: ritzcarlton.com/en/Properties/LakeTahoe and use code “JFC.” Make room reservations before December 17 to access special Jefferson rates. Jefferson Medical College of Thomas Jefferson University is accredited by the ACCME to provide continuing medical education for physicians. Jefferson Medical College designates this live activity for a maximum of 14.0 AMA PRA Category 1 Credit(s).™ Physicians should claim only the credit commensurate with the extent of their participation in the activity. (Subject to change)
See the full schedule, including additional topics, and registration information online: jeffline.jefferson.edu/jeffcme/AlumniCME
FALL 2013 25
THE
By Numbers Class of 2017: At a Glance
Students Applied:
Students Accepted:
Students Enrolled:
Alumni:
Post-Graduate Alumni:
Faculty:
10,118 452 11 15
TRI-STATE AREA
32
18
Average GPA:
3.7
28
Including the District of Columbia
Pennsylvania:
New Jersey:
Delaware:
105 23 21
260 14
Women:
Men:
131 129
38
FROM OUTSIDE OF U.S.
U.S. STATES REPRESENTED
AGE
SCORES
Average MCATS:
GENDER
LEGACY STUDENTS
INCOMING CLASS
Sushi chef. Comic book artist. Prison gardener. Radio host. Andean bear tracker. In the past, the 260 members of JMC’s incoming class have held a broad range of roles. In four years, they will all share a new one: physician. The Class of 2017 celebrated its past and future achievements at the annual White Coat Ceremony on Aug. 2, 2013, and students are now well into their first year of medical school. Here is a look at JMC’s current M1 class.
5
Canada | Ghana | South Africa | Greece | Uzbekistan
Hold Master’s Degrees: Enrolled Through the DIMER Program:
(Delaware Institute of Medical Education and Research)
In the Penn State BS/MD Program:
11 22 31
Non-Profit Org. US Postage PAID Permit #276 Philadelphia, PA
925 Chestnut Street, Suite 110 Philadelphia, PA 19107-4216 Change Service Requested
Printed on FSC (Forest Stewardship Council) certified paper, which supports the growth of responsible forest management worldwide through its international standards.
Now it’s easier than ever to stay connected! FOLLOW THESE E ASY STEPS T O G E T S TA R T E D . 1. V isit connect.jefferson.edu and select the MEDICAL COLLEGE community in the top bar. 2. Click “register now” in the upper right-hand corner. 3. Fill in your name to search for your record. 4. E nter your constituent ID. Not sure what it is? It’s right above your name in the mailing label on this page.
Your ID#
******3-DIGIT 19107 500374190 Mr. and Mrs. Thomas Jefferson PO Box 123 Philadelphia, PA 19107-0123
5. Take a few minutes to set up your profile. 6. Simply click “login” every time you visit in the future.
FOLLOW US AND WE’LL FOLLOW YOU!
Keep up-to-date with JMC and the Jefferson community. Follow us @JeffersonAlumni