December 2015 Newsletter

Department of Medicine eNewsletter
December 2015
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Welcome to the Department of Medicine Agre Society
department interview
Carla Harwell, MD, Medical Director of the Douglas J. Moore Clinic at University Hospitals Case Medical Center and UH Otis Moss Jr. Health Center and Associate Director of the Internal Medicine Residency Program at Case Western Reserve University School of Medicine, talks about the importance of engaging with patients, discusses persistent health care disparities and shares her vision on making a lasting impact in health care.

Can you tell us more about UH Otis Moss Jr. Health Center and its unique mission? How have the needs of patients evolved over the past few years?

UH Otis Moss Jr. Health Center seeks to provide excellence in patient care in a spiritually supportive environment. We believe there is more to the healing process than just traditional medicine. We provide care to our patients through engaging their spiritual or supportive foundation with the help of the Olivet Institutional Baptist Church. Religion and church play a very significant role in the African-American community. So the idea of bringing a private-practice-based model to the community and incorporating it with a support system the community heavily relies upon was truly unique. Because it is a primary-care-based model, and I serve as the primary health care provider, patients have developed a new level of trust with the system and health care as a whole. I think University Hospitals' commitment to put a health care center in that neighborhood was truly meaningful, and patients have significantly benefited from it.

The center offers primary care, pediatrics, obstetrics and gynecology as well as podiatry services. One of the goals of UH Otis Moss Jr. Health Center was to reduce the unnecessary visits to the emergency rooms locally. We have been successful in educating our patients and changing their behavior to properly utilize primary care physicians. I think the health center has made a difference in the community, as it has been successful in improving ER usage as well as educating the patient population about preventive screenings.

You have participated in a number of health care campaigns. Why do you think it is important for physicians to get involved at this level?

Anything that brings real awareness to a health issue plays a significant role to me because as physicians we have to find ways to connect with our patients. Though patients are more informed nowadays, not all of them are engaged in their health care. The involvement in health care campaigns allows me to talk to patients on a different level and ask them to take action steps toward making better health choices. At the health center in the past we have offered gospel line dancing and my patients would see me participating in the class with them. I think it is important to be a visible advocate for health, rather than preach it from the four corners of an exam room. When my patients see me, for example, in a Go Red For Women campaign, it not only excites them, but also makes them understand that I stand behind the recommendations for preventive heart disease. I am able to persuade patients to take better care of their health on a completely new level.

You have been an Associate Director for Internal Medicine Residency program since 2006. How have the skills of trainees evolved over the years?

Over the years I have seen residents become more culturally sensitive and learn to take into account the social determinants that influence a patient's behavior. For example, residents may have an African-American female patient who has high blood pressure and uncontrolled diabetes. Residents would notice that even though they keep advising the patient to take steps to manage her health better, after a third visit her behavior has not changed and her health has still not improved. While the majority of residents in other programs know to ask general questions and are aware of financial and transportation issues, our residents look beyond the most obvious determinants and identify the social dynamics, including the role the older African-American woman may play in her household. The role of a matriarch often leads to older African-American females compromising their own health needs to ensure the younger generation is cared and provided for. In addition, our residents are aware of cultural lifestyles that influence the health of our patients. I have seen our residents rise to the occasion when such issues as health care disparities, cultural competencies and health equity care became hot topics in modern medicine.

What are some of the common health care issues that you witness among the patient population that are still unresolved?

The most prominent one is mistrust with the health care system among African-American patients. There are studies that show that when there is doctor and patient racial concordance, it results in better patient satisfaction and outcomes. When I take care of the African-American population, my racial background helps me overcome that mistrust because my patients can identify with me. The core of the problem unfortunately lies in the health care disparities where patients receive different quality of care because of their race.

What would you say is your role in addressing this issue in your practice?

I try to reassure my patients that they will get equitable care wherever they go. I work hard to create trusting doctor-patient relationships at UH Otis Moss Jr. Health Center. I want my patients to know that I will do the absolute best for them. If I have to send my patients to see a specialist, I make sure to explain the referral process and educate them about their onset condition. I take that opportunity to truly connect and educate my patients about their health. I also try to bridge the gap and instill a sense of security with the health care system.

Can you discuss some of the issues of professional development of minorities in medicine? How do you think these issues influence patient care at large?

I have always felt that I had to put more effort into seeking opportunities for professional development than the opportunities being offered to me along the way. I was lucky to have Edgar B. Jackson Jr., MD, as my mentor as he was most instrumental in helping me shape my career.

Nationally it has been projected that by 2050 the growing majority of the population will be Hispanics and Latinos. As we have discussed, doctor and patient racial concordance bring better results. In order to serve this population, we have to be able to offer patients physicians who come from the same background to increase patient satisfaction and improve patient outcomes. I think University Hospitals has put in place a lot of great initiatives and Mr. Zenty has done a wonderful job at addressing the sensitive issues of inclusion and health equity. At the same time, I would like to see more minorities in upper management positions throughout the country.

What energizes you in this challenging field of medicine? What motivates you every morning?

At the end of the day I would like to be remembered for trying to make a difference, as corny as it may sound. I am a daughter of two high school educated parents from the south, who moved north in order to make a better life for their family. They were working multiple jobs to provide the best they could for my sister and me. My parents have always told me: "Make a difference!" I consider it a success if I can persuade a 60-year-old woman who has never had a mammogram before to get one. I consider it a difference if I can get patients to take their blood pressure medicine, understand the importance of it and ways it improves their health. Success is written in many different languages and communicated in many different ways; what is true success to me is that I have a patient base that knows that I genuinely care for them.

department news report
Division of Cardiovascular Medicine

Daniel Simon, MD, became President of University Hospitals Case Medical Center. In his new role, Dr. Simon will focus on recruiting top faculty physicians and scientists to deliver quality patient care and advance the institution in reaching its strategic goals. Dr. Simon will also lead initiatives to further UH Case Medical Center's national reputation for excellence and attract the best and brightest residents and fellows into the training programs.




Division of Gastroenterology & Liver Disease

Fabio Cominelli, MD Fabio Cominelli, MD, PhD, became the Associate Dean of Program Development in the Case Western Reserve University School of Medicine. In his new role, Dr. Cominelli will help develop and implement new programs to promote connectivity and cooperation throughout the School of Medicine.




Keyur Parikh, MD, and Matthew Cohn, MD, became the inaugural recipients of the Lansing C. Hoskins Education and Research Fund. The award provides assistance to inspired fellows and junior faculty to pursue and develop innovative ideas promising to advance the knowledge, treatment and prevention of digestive diseases. The $5,000 awards will help fund Dr. Parikh's project entitled "L-Methol Injection as a Novel Technique during Colonoscopy" and Dr. Cohn's project entitled "The Application of Machine-Learning and Fecal Calprotectin Levels in SAMP/YitFc Mice."




Division of Hematology & Oncology
Richard Lee, MD, joined the Division of Hematology & Oncology as the inaugural Parker Hannifin-Helen Moss Cancer Research Foundation Professor of Integrative Oncology. Dr. Lee will serve as Director of Supportive and Integrative Oncology at University Hospitals Seidman Cancer Center, and as Director of the Case Center for Integrative Oncology. In these roles, he will develop and oversee the clinical, research and educational programs related to supportive and integrative approaches to cancer. As a hematologist and medical oncologist, Dr. Lee will provide routine oncologic care in addition to broad consultative services regarding complementary treatment methods. He will be joining the Gastrointestinal Cancer Disease Team, with a special interest in liver tumors.




Division of Rheumatology

Charles Malemud, PhD, and his colleagues published an article entitled "Blockade of Recombinant Human IL-6 by Tocilizumab Suppresses Matrix Metalloproteinase-9 Production in the C28/I2 Immortalized Human Chondrocyte Cell Line" in the Journal of Integrative Molecular Medicine.

Edward Medof, MD, PhD, was appointed as the inaugural Dr. and Mrs. Paul J. Vignos, Jr. Professor of Rheumatology and Immunology.

department conferences & events
Department of Medicine Clinical Retreat
Date: Saturday, January 23
Time: 8:00 a.m. - 1:00 p.m.
Location: Wolstein Research Building
Topics: The Accountable Care Organization; Shared Team Responsibilities; Models of Chronic Disease Management; Telemedicine; Patient Engagement; Transitions of Care; EMR; ICD-10; Future Measurable Outcomes and Quality Metrics; Referral Practices.
Click here for a full schedule of the event



Full-Time Faculty Meeting with the Chairman
Date: Wednesday, January 20
Time: 5:00 - 6:00 p.m.
Location: Wolstein Research Building

Grand Rounds
Time: 12:00 - 1:00 p.m.
Location: Kulas Auditorium
January 12
"Sarcoidosis" by Thomas Daniel, MD
January 19
"#Obesity, #Diet, #Social Media and More" by Joumana Chaiban, MD
January 26
"CAM and the Academy" by Michael Devereau, MD



AGRE Society
Date: Wednesday, January 6
Time: 5:30 - 6:00 p.m.
Location: Carpenter Room, Lakeside, 3rd Floor
Speaker: Derek Abbot, MD, PhD
development & diversity events
The Good, the Bad and the Ugly: True Stories and Practical Advice for Women Entrepreneurs
Date: Thursday, January 14
Time: 9:00 - 11:30 a.m.
Location: FSM Center for Women, Tinkham Veale University Center, Suite 248
Sponsor: FSM Center for Women
Audience: Women faculty interested in improving their business/operational expertise

Faculty Grant Writing Program
Date: Friday, January 15
Time: 12:30 - 2:00 p.m.
Location: Hitchcock Hall, Thwing Center
Speakers: Coordinated by Amanda Schaffer, MA, ACC, GPCC, Director, Office of Faculty Development
Sponsor: Case Western Reserve University Office of Faculty Development
Audience: Case Western Reserve University faculty interested in improving their grant writing skills while working on an actual grant
RSVP: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Keeping the Family Healthy This Winter
Date: Friday, January 15
Time: 12:00 - 1:30 p.m.
Location: FSM Center for Women, Tinkham Veale University Center, Suite 248
Speaker: Claudia Hoyen, MD, Associate Professor of Pediatrics
Sponsor: FSM Center for Women
Audience: Faculty interested in improving self and family care

Mather Salon Series
Date: Friday, January 22
Time: 9:30 - 11:00 a.m.
Location: FSM Center for Women, Tinkham Veale University Center, Suite 248
Speaker: Agata Exner, MD, Professor of Radiology
Sponsor: FSM Center for Women
Audience: Faculty interested in learning about high-profile research performed by women faculty at Case Western Reserve University

Empowerment for All Women, Conversations on Building Inclusivity
Date: Tuesday, January 26
Time: 12:00 - 1:00 p.m.
Location: FSM Center for Women, Tinkham Veale University Center, Suite 248
Speakers: FSM Women of Color Series
Sponsor: FSM Center for Women
Audience: Women faculty interested in enhancing a professional culture of diversity

Annual Faculty Wine Tasting ($10 per person)
Date: Friday, January 29
Time: 5:30 p.m.
Location: Hitchcock Hall, Thwing Center
Speakers: Coordinated by Amanda Schaffer, MA, ACC, GPCC, Director, Office of Faculty Development
Sponsor: Case Western Reserve University Office of Faculty Development
Audience: Case Western Reserve University faculty interested in networking with faculty colleagues from around the campus
RSVP: This e-mail address is being protected from spambots. You need JavaScript enabled to view it