The Blue Ribbon Physician Workforce Committee has launched a campaign to educate state and federal policymakers on the projected physician shortage. The committee commissioned New York State University 's Albany Center for Health Workforce Studies to perform a state-specific study of physician supply and demand. Denise Holmes, assistant dean for government relations for the Michigan State University College of Human Medicine, recently presented preliminary results of the Michigan study.

Preliminary Results of the Michigan Physician Workforce Analysis
•  Michigan currently has 30,000 active patient-care physicians and will need 38,000 physicians by 2020.
•  Michigan will be 900 physicians short by 2010; 2,400 short by 2015; and 4,500 doctors short by 2020.
•  Michigan is going to experience a more severe shortage of doctors than the nation as a whole. The United States will be 7.9 percent short, and Michigan will be 11.9 percent short.
•  On the basis of population alone, Michigan should experience a shortfall of 2,814 physicians by 2020; this study projects a Michigan shortfall at 4,500 physicians by 2020.
•  Michigan is losing physicians after graduation at much the same rate as are many of the northern states. New York has a very similar problem, despite being the largest producer and trainer of physicians in the United States.

•  While Michigan 's primary care physician projections indicate physician supply will be adequate for demand until 2018, the specialist projections indicate that a shortage will begin in 2006.

The Blue Ribbon Committee convened about a year ago to create a comprehensive strategy that is supported by the four Michigan medical schools (University of Michigan School of Medicine, Wayne State University School of Medicine, Michigan State University College of Osteopathic Medicine, and Michigan State University College of Human Medicine); the State of Michigan, as represented by the Michigan Department of Community Health; the Council on Graduate Medical Education; and statewide associations and organizations impacted by physician supply concerns. Michigan's four medical school deans attended the briefing and each presented one component of the Committee's plan to meet the challenges related to increasing the number of physicians trained in Michigan .

•  Robert Frank, M.D. – Wayne State University School of Medicine
Allow Michigan's teaching hospitals to train more physicians in Michigan by raising the cap on the number of residents and fellows eligible for Medicare reimbursement by 10 percent.

•  Allen Lichter, M.D. – University of Michigan Medical School
Maintain commitment to Medicare indirect medical education financial assistance to support the nation's teaching hospitals.

•  William Strampel , D.O. – Michigan State University College of Osteopathic Medicine
Maintain federal commitment to the Medicaid program to prevent further cost shifting to already overburdened states.

•  Marsha Rappley , M.D. – Michigan State University College of Human Medicine
Adopt the Senate version of Title VII funding allocations to support programs that encourage distribution and diversity of our nation's health care workforce.

Michael Sandler, M.D., chair of the Michigan State Medical Society, offered summary comments and indicated the support of organized medicine. According to Blue Ribbon Physician Workforce Committee members, advanced briefing is the first step in their combined efforts to prepare an appropriate health-care workforce for Michigan. For more information or to participate in this effort, please contact Carol Parker Lee, MSU Institute for Health Care Studies, at (517) 432-8385.

Blue Ribbon Physician Workforce Committee Members
College of Human Medicine – Michigan State University
College of Osteopathic Medicine – Michigan State University
The University of Michigan Medical School
School of Medicine - Wayne State University
Council on Graduate Medical Education – rep: Henry Ford Hospital
Council on Graduate Medical Education – rep: Ingham Regional Medical Center
Michigan Department of Community Health
Michigan Department of Labor and Economic Growth
Michigan Association of Health Plans
Michigan Health Council
Michigan Health and Hospital Association
Michigan Osteopathic Association
Michigan Primary Care Association
Michigan State Medical Society
Michigan State Area Health Education Center
MSU Institute for Health Care Studies

 

 

Noreen Rossi, M.D., has been named assistant dean for clinical research at the Wayne State University School of Medicine. She will assist the associate dean for research in facilitating translational research collaborations, developing an infrastructure for investigators to get maximum support, and re-engineering the school's clinical research enterprise, per the National Institutes of Health Roadmap for Medical Research.

A tenured professor of internal medicine, noted nephrologist and well-funded researcher, Dr. Rossi has experience and expertise in designing and conducting clinical trials. With joint appointments at Wayne State University and the John D. Dingell Veterans Administration Medical Center , Dr. Rossi continues to see patients, conduct critical research, and educate medical students and graduate students in biomedical studies.

Dr. Rossi earned a bachelor's degree in chemistry from the University of Detroit and a medical degree from Yale. She completed an internship and residency at Venderbilt and did nephrology fellowships at the University of Colorado. She joined WSU as an instructor in 1985 and has risen through the ranks to be named a tenured professor in 2001.

She has won numerous research, teaching and service awards including the Distinguished Service Award for Research from the National Kidney Foundation of Michigan and she was named a fellow of the American College of Physicians in 1997. She has directed the theses of 10 graduate students and has personally mentored and advised more than 40 others. Dr. Rossi has to her credit 88 original publications and more than 100 invited presentations.

 

WSU President Irvin D. Reid recently announced that Bonnie Sloane, Ph.D., and Charles R. Schuster, Ph.D., are among the seven WSU faculty members selected to be distinguished professors. Dr. Sloane is professor and chair of the WSU Department of Pharmacology, and Dr. Schuster is a professor of psychiatry & behavioral neurosciences.

"The Distinguished Professor appointment denotes the highest of academic achievements, and each of the individuals chosen is recognized as an academic leader in his or her chosen field," President Reid wrote in a letter announcing the appointments.

With this year's appointments, the university now has honored 27 faculty members with this title.

Dr. Sloane joined the WSU School of Medicine in 1980 and has built a distinguished career during her 25 years at the university. Her research grant support includes four current grants from the National Institutes of Health and the Department of Defense.

She is an inaugural Host Awardee of the Avon Foundation/American Association for Cancer Research International Scholar in Breast Cancer Research, a national competition awarded to only four people in 2004. Dr. Sloane has published 112 peer-reviewed articles, and has served on national planning committees, including the National Cancer Institute Think Tank on Inflammation and Cancer.

After joining the WSU School of Medicine in 1995, Dr. Schuster became the founding director of the Substance Abuse Research Division and the director of the Addiction Research Institute. Formerly, Dr. Schuster served as the director of the National Institute on Drug Abuse and accompanied the U.S. attorney general on presidential trips to Asia and Europe to curtail drug abuse and illegal smuggling of opiates.

Dr. Schuster has received a number of NIDA/NIH grants, including one to establish the Great Lakes Regional Node of the NIDA Clinical Trials Network. This program seeks to determine efficacy of treatment interventions.

He is a mentor for the Robert Wood Johnson Project for Leadership Development in the area of substance abuse and is a founding member of the International Network for Drug Policy Analysis. Dr. Schuster is co-author of three books, 19 journal articles, including American Journal on Addications, Drug and Alcohol Dependence and the Journal of Psychoactive Drugs.

 

 

What if a bomb went off in a downtown building simultaneously injuring hundreds of people? What if a group of government employees reported to the emergency department with suspected anthrax exposure?

When disaster strikes, the public health system shifts into emergency mode. Wayne State University faculty members are making sure future doctors and other health professions students are prepared for such emergencies and follow a planned response. A multidisciplinary team from WSU has been awarded a $300,000 grant from the Department of Health and Human Services to develop a terrorism, disaster and public health emergency curriculum.

When faced with the threat of bioterrorism or a public health scare, there are three things doctors need to know immediately, said Suzanne White, M.D., project director and professor of emergency medicine and pediatrics:

• Is it contagious and can it harm me?
• Where do I call for reliable information?
• What bigger response will go on around me and what's my involvement with law enforcement and public health officials?

“Detroit is high risk for terrorism with a density of vulnerable populations,” Dr. White said. “How many students in pharmacy, nursing and medicine go untrained? Yet we look to health care professionals to take the lead when a disaster happens. Recognizing that WSU has a history of expertise in developing competencies for emergency and disaster medicine, we are filling a training gap with a five-module training program.”

The undergraduate curriculum focuses on recognition of possible terrorist or public health threats. It emphasizes: basic principles of disaster medicine; bioterrorism and biological agents; mental health and risk communication; nuclear and explosive threats; and chemical agents. These themes are taught throughout the undergraduate medical curriculum by microbiologists, pharmacists, crisis communication experts, radiation researchers, and rescue operations teams.

“Preparation will never be wasted,” said Dr. Matt Jackson, project co-director and assistant dean for basic science education. “It's not a matter of if something happens. It's a matter of when. There was heightened awareness of disaster readiness after 9/11, but this applies to non-terrorist issues too: the power outage in Detroit a couple summers ago, tornadoes and floods, large-scale fires, chemical spills, SARS, avian flu, infant abductions and security threats. All of these events fit into a larger public health structure. The recent tsunami, earthquakes and hurricanes in the world provide tremendous examples of the health care system being overrun. Physicians need to be trained to respond.”

“The core pieces of information health care workers need are recognition, reporting and response,” said Dr. Sharon Popp, assistant director of clinical curriculum development. “We want students to understand the importance of working together with the local health department, law enforcement agencies and emergency management teams, so they are not treating affected patients in isolation.”

The curriculum, to be integrated into the curriculum for medicine, and shared with the colleges of nursing, allied health and social work, highlights the importance of the field of public health. “That specialty alone has added 25 years to our life expectancy, through advances in polio, vaccinations, and simple reporting of trends,” Dr. White said. “Physician educators need to know that this specialty is critical and the role they play in disaster medicine is critical.”

While other schools and hospitals offer sporadic training seminars and disaster drills, this is the most comprehensive, curriculum-based training of its kind. WSU was one of two medical schools to receive funding this round from the U.S. Health Resources and Services Administration for disaster medicine training. The other was Duke. WSU modules are being developed and will be implemented into the curriculum beginning in January.

For the first time, researchers have identified genes in the human brain that could be responsible for most forms of pediatric epilepsy.

The findings, reported in the Annals of Neurology, the official journal of the American Neurological Association, may lead to new methods of diagnosing and treating the disease which affects an estimated 2 million Americans – about one out of every 100 people.

Epilepsy occurs in both children and adults. The disorder is marked by excessive electrical signals in the brain causing sudden, involuntary seizures that can mimic anything the brain does normally.  Seizures range from changes in emotions and senses, such as taste, smell, vision, and hearing, to violent whole-body convulsions.

In the study, investigators monitored the brain activity of 17 patients, ages 6 months to 15 years, during seizures. Using electroencephalography, they identified the seizure's epicenter and compared it with adjacent, nonepileptic regions exhibiting more normal activities.

Because the patients had not responded previously to antiepileptic drugs, each required surgery to remove epileptic brain tissue and adjacent regions – standard practice to curing the seizures.

To determine differences between the epileptic and nonepileptic brain tissue, the researchers compared the genetic information of both. Of thousands of possible genes, only 11 consistently characterized the epileptic brain.

These included four genes, EGR-1, EGR-2, c-fos and MKP-3, associated with heightened levels of learning and memory in animals. This finding suggests that epileptic brain regions are “too smart” – that they perform normal brain functions, but to an extreme degree.

Because the study compared seizure location and changes in gene expression within each patient, the results ignore confounding effects of biological and genetic differences among patients and likely apply to most forms of the disease.

“One of the major limitations in developing effective treatments for patients with epilepsy is the lack of specific targets to prevent or stop the disease,” says Jeffrey Loeb, M.D., Ph.D., associate professor of neurology and the Center for Molecular Medicine and Genetics at Wayne State University School of Medicine and senior author on the study.

“We've only opened the door,” he says, “but the results are clearly relevant in developing new diagnostic and treatment approaches. These genes can help us define more precisely the specific area of the brain requiring surgery and guide us toward developing new, highly-effective, targeted drug therapies.”

While epilepsy is more common than Parkinson's disease and multiple sclerosis, it receives less public attention. For its victims, however, seizures can occur hundreds of times a day, last several minutes at a time, and can result in a lifelong disorder often beginning in childhood.

For some 70 percent of its victims, the cause is unknown. Rare forms of epilepsy run in families though, because most result from brain insults including even minor sports-related head injuries, anyone can develop the debilitating disease.;

In others, seizures are caused by brain scarring, infections such as meningitis, tumors, surgery, stroke, and Alzheimer's and related diseases. They can be triggered by stress, lack of sleep, infection, alcohol, certain medications and, in children, fevers.

Dr. Loeb notes that, as with most illnesses, prevention is key. Children and their parents should wear seatbelts in automobiles and helmets when riding bicycles, skiing and engaging in other physical activities.

Most of the patients who participated in this research study improved significantly following surgery at the Comprehensive Epilepsy Program at Children's Hospital of Michigan .

The work involved researchers from Wayne State University School of Medicine departments of neurology, pediatrics, computer science, radiology and neurosurgery, its Center for Molecular Medicine and Genetics, and the Michigan Center for Biological Information.

It was supported financially by the Ralph Wilson Medical Research Foundation, the National Institute of Neurological Disorders and Stroke, and the Epilepsy Foundation of America.

 

Two Wayne State University alumni were named to the Institute of Medicine of the National Academy of Sciences. Michael Fleming, M.D., '74, and Gerald Shulman, M.D., Ph.D., '79, have been elected to an elite group of fewer than 1,500 scholars and scientists who are recognized as among the most distinguished in the country. Drs. Fleming and Shulman are two of 64 new members this year.

Dr. Fleming is professor and director of research in family medicine at the University of Wisconsin Medical School. His research and advocacy relate to substance abuse screening and treatment in the primary care office. He has built a substantial federally funded clinical research program in primary care and has distinguished himself in the field of alcohol and addiction. He has consulted on research projects with WSU's own Dr. Robert Sokol, distinguished professor of obstetrics and gynecology and director of the C.S. Mott Center for Human Growth and Development , who said of Dr. Fleming, “He's first rate and has made seminal contributions in the field of brief intervention for behavioral modification. His work is creative and has now been replicated by others. He more than deserves this honor.”

Dr. Fleming recalls his training days at Detroit General Hospital that were “filled with wonder and awe.” He said, “I mostly remember the chaos on a busy night with so many sick patients and so much going on at the same time, but also the sense that patients were getting good care and the residents and staff were inspiring. It was really an amazing place to be medical student. Wayne State taught me to be curious, to ask questions, to base my patient decisions on the evidence, to be skeptical of new treatments until the science was strong. This curiosity and the need to know is what led me to my career as a physician scientist and led me to the Insititute of Medicine.”

Dr. Gerald Shulman, who earned both his medical and doctoral degrees at WSU, is now a Howard Hughes Medical Institute Investigator and also a professor of medicine and cellular and molecular physiology at Yale. He has distinguished himself in the field of diabetes and obesity and in particular has utilized nuclear magnetic resonance spectroscopy (NMR) to demonstrate molecular predictors of insulin resistance and to examine molecular effects of a variety of therapeutic approaches to diabetes.

For example, his research indicates that a decreased ability to burn sugars and fats efficiently is an early and central part of the diabetes problem, and that elderly people may develop insulin resistance because "power plants" in their muscle cells decline or fail with age. Because diabetes and obesity are major problems in our country, Dr. Shulman's line of work has huge implications for public health.

Membership in the Institute of Medicine is both an honor and an obligation to work on a broad range of studies related to health policy issues. Members contribute their knowledge and professional judgment to the formulation of public policy recommendations.

Drs. Fleming and Shulman now join WSU faculty members Blaine White, M.D., and Charles Schuster, Ph.D., who are also members of the Institute of Medicine .

Established in 1970 as a unit of the National Academy of Sciences, the Institute of Medicine is concerned with the protection and advancement of the health professions and sciences, the promotion of research and development pertinent to health, and the improvement of health care. The National Academies are comprised of: the National Academy of Sciences, National Academy of Engineering, Institute of Medicine , and National Research Council.