Dear Colleagues, I am pleased to share with you the first Division of General Internal Medicine Annual Report, 2020. We ended 2020 the same way it began; with anticipation, hope, and optimism. Though 2020 did not go as some of us would have desired, each of you continued each day to endorse our mission. Our clinicians, researchers, educators and staff navigated through challenges of how to handle the unknowns with poise, resilience, and grace. Inside this year’s report, you will find examples of some of the admirable work being done by our distinguished faculty, awards received by members of the division, and details on educational, clinical, and research programs. While this report features news highlights from calendar year 2020, it has been full of unexpected challenges, and Duke GIM has proudly risen to the moment in every way! Thank you all for your hard work, dedication, and devotion to Duke GIM. Your efforts to improve health and the lives of patients and their families has been truly unparalleled. I hope you enjoy the report. Sincerely, L. Ebony Boulware, MD MPH FACP Eleanor Easley Distinguished Professor of Medicine Chief, Division of General Internal Medicine
Leadership Message Awards & Honors Clinical Activities Research Activities Education Activities Community Engagement Philanthropy
Division of General Internal Medicine‒ Annual Report ‒ 2020
Pg 2 Pg 3 Pg 10 Pg 13 Pg 19 Pg 24 Pg 27
Neil Stafford, MD
Noel Ivey, MD
Jeannette Stein, MD
Faculty Promotions 2020
Karen Goldstein, MD
“Academic promotions mark faculty members' scholarly achievements and are a hallmark of professional accomplishment in our school.” L. Ebony Boulware, MD Chief, Division of General Internal Medicine
Jennifer VanKirk, MD
Gerardo Alcazar, MD
Emily Ko, MD
Associate Professor:
Jason Webb, MD
Full Professor:
James Davis, MD
Assistant Professor:
Jonathan Bae, MD
Rowena Dolor, MD
Andrea Archibald, MD
Notable Publications
Notable Recognitions
2020 DGIM EXCELLENCE AWARD RECIPIENTS
Clare Il'Giovine Staff Excellence Award
Emily Ko, MD Early Career Research Award
Noel Ivey, MD Practice Excellence Award
Aubrey Jolly Graham, MD Quality Improvement Award
Duke Annual Service Awards
Bruce Peyser, MD Clinical Mentoring Award
Joel Boggan, MD Research Mentoring Award
Awards, New Positions
Suchita Shah Sata, MD Educational Excellence Award
30+ Years Jeannette Stein, MD; L. Thomas Barber, MD; Douglas McCrory, MD: Eugene Oddone, MD; David Matchar, MD; Janet Vasey, MD; Veronica Ray, MD; Kathleen Waite, MD; Faye Banks, MD; David Simel, MD; Roy Williams, MA; Eric Westman, MD; Martha Adams, MD 25 Years Thomas Owens, MD; David Edelman, MD; Lawrence Greenblatt, MD 20 Years Kevin Waters, MD; Patricia Bunn; Clay Musser, MD; Wendy Henderson, MD; Will Yancy, MD; Leslie Clayton; Carol Hammond, PhD; Maria Fakadej, MD PhD 15 Years William Knaack, MD; Catherine Stanwyck; Daniel Kaplan, MD; Brian Griffith, MD; Bruce Peyser, MD; Saumil Chudgar, MD; Corrine Voils, PhD; Cara O'Brien, MD; Jane Kim, MD; Jonathan Bae, MD; Jerome Ecker, MD; Susanne Haga, PhD 10 Years Ryan Schulties, MD; Cecily Peterson, MD; Deborah Morris, MD; Brian Wolf, MD; Jonathan Lovins, MD; David Halpern, MD; Joanna Kipnes, MD; Eric Chu, MD; Katherine Neal, MD; Lisa Vann, MD; Nilesh Patel, MD; Amber Walters, RN 5 Years Brian Hayes, MD; J. Trig Brown, MD; Neil Stafford, MD; Audrey Metz, MD; Kambiz Soheili, MD PhD; Eric Poon, MD; Jenny Vann Kirk, MD; Patrick Hemming, MD; Lynn Keplinger, MD; Clarissa Diamantidis, MD; Aparna Kamath, MD; Suchita Shah Sata, MD; Faye Farber, MD; Jacquelyn Bolewell, MD; Elizabeth Hankollari, MD; James Kelly, MD; Caroline Sloan, MD; Clare Il'Giovine; Oliver Glass, PhD; Jeffrey Clough, MD; Laura Caputo, MD; Kimberly Lim, MD; Sonal Patel, MD; Robin Byrd REACH Equity Award Keisha Bentley-Edwards, PhD; Assistant Professor of Medicine PCORI Advisory Panelist Rowena Dolor, MD; Professor of Medicine National VHA HeRO Awards: App for Screening VA Entry and a novel COVID-19 Education Curriculum Kenneth Goldberg, MD; Associate Professor of Medicine Chad Kessler, MD; Assistant Professor of Medicine Associate Program Director, Internal Medicine Residency (Research and Scholarship) Nia S. Mitchell, MD; Assistant Professor of Medicine Chair, Program for Women in Medicine (PWIM) Daniella Zipkin, MD; Associate Professor of Medicine Associate Director, Primary Care Leadership Track Fatima Syed, MD; Assistant Professor of Medicine Chief Medical Officer, Duke Population Health Management Office John Yeatts, MD; Assistant Professor of Medicine Ambulatory Medicine Teaching Award Anne Phelps, MD; Assistant Professor of Medicine Duke Regional Teaching Award Adam Wachter, MD; Assistant Professor of Medicine VA Faculty Teaching Award Amber Bowman, MD; Assistant Professof of Medicine Excellence in Education, Department of Medicine Fatima Syed, MD; Assistant Professor of Medicine Strategic Academic Advisory Council in the Department of Veterans Affairs Kenneth Goldberg, MD; Associate Professor of Medicine Career Research Mentoring Award in Clinical/Population Health, Department of Medicine David Edelman, MD; Professor or Medicine Black in America (Blog in Springer Nature) Keisha Bentley-Edwards, PhD; Assistant Professor of Medicine Improving Hospital Rating Systems (first author of JAMA Viewpoint article) Jonathan Bae, MD; Associate Professor of Medicine A piece of my mind article, becomes a 'Favorite' (JAMA) Marie Carlson, MD; Assistant Professor of Medicine Graphic Medicine work (LA Times, N&O, Medium.com, Annals of IM) Nathan Gray, MD; Assistant Professor of Medicine Mask Study, became wildly popular Eric Westman, MD; Professor of Medicine Clinician-Educator Training & it's Impact on Career Success: a Mixed Methods Study (JGIM Paper, first author) Daniella Zipkin, MD; Associate Professor of Medicine School of Medicine Research Speaker (only invited speaker from Department of Medicine) Ranee Chatterjee, MD; Associate Professor of Medicine 2020 DIHI Innovation Awards: 8 GIM Faculty L. Ebony Boulware, MD MPH; Professor of Medicine J. Trig Brown, MD; Assistant Professor of Medicine Anisha Chandiramani, MD; Assistant Professor of Medicine Brian Griffith, MD; Assistant Professor of Medicine Aparna Kamath, MD; Assistant Professor of Medicine Cara O'Brien, MD; Assistant Professor of Medicine Adia Ross, MD; Assistant Professor of Medicine Kevin Shah, MD; Assistant Professor of Medicine Lauded by NIH Duke Hospital Medicine Fresh Produce Project with Med Students Duke Outpatient Clinic 2020 Department of Medicine SHEROes Caroline Avery, MD; Assistant Professor of Medicine & Pediatrics Kathleen Batley, MD; Medical Instructor, Medicine Satasuk (Joy) Bhosai, MD; Medical Instructor, Medicine Jacquelyn Bolwell, MD; Medical Instructor, Medicine Megan Brooks, MD; Assistant Professor of Medicine Marie Carlson, MD; Assistant Professor of Medicine Anisha Chandiramani, MD; Medical Instructor, Medicine Dana Clifton, MD; Assistant Professor of Medicine & Pediatrics Tatyana Der, MD; Medical Instructor, Medicine Clarissa Diamantidis, MD; Associate Professor of Medicine Colby Feeney, MD; Assistant Professor of Medicine & Pediatrics Preeshini Fernando, MD; Medical Instructor, Medicine Aubrey Jolly Graham, MD; Assistant Professor of Medicine Elizabeth Hankollari, MD; Assistant Professor of Medicine Noel Ivey, MD; Associate Professor of Medicine Feerozeh Jahanshahi, MD; Medical Instructor, Medicine Swapna Joseph, MD; Medical Instructor, Medicine Aparna Kamath, MD; Assistant Professor of Medicine Rania Kazan, MD; Assistant Professor of Medicine Joanna Kipnes, MD; Associate Professor of Medicine Emily Ko, MD; Assistant Professor of Medicine Alexandra Lee, MD; Medical Instructor, Medicine Rebecca Lumsden, MD; Medical Instructor, Medicine Diana Mehedint, MD; Medical Instructor, Medicine Neha Mehta, MD; Medical Instructor, Medicine Nia S. Mitchell, MD; Assistant Professor of Medicine Dinushika Mohottge, MD; Medical Instructor, Medicine Nilima Mosaly, MD; Medical Instructor, Medicine Katherine Neal, MD; Assistant Professor of Medicine Cara O'Brien, MD; Assistant Professor of Medicine Nadia Pasha, MD; Medical Instructor, Medicine Sonya Patel-Nguyen, MD; Medical Instructor, Medicine & Pediatrics Cecily Peterson, MD; Assistant Professor, Medicine Danielle Richardson, MD; Medical Instructor, Medicine Adia Ross, MD; Assistant Professor of Medicine Sharon Rubin, MD; Associate Professor of Medicine Mary-Nel Saarloos, MD; Medical Instructor, Medicine Suchita Sata, MD; Assistant Professor of Medicine Poonam Sharma, MD; Associate Professor of Medicine Sheila Sherzoy, MD; Medical Instructor, Medicine Tara Spector, MD; Assistant Professor of Medicine Jenny Van Kirk, MD; Assistant Professor of Medicine Lisa Vann, MD; Assistant Professor of Medicine Lana Wahid, MD; Medical Instructor, Medicine Kathleen Waite, MD; Associate Professor of Medicine Marie Witte, MD; Medical Instructor, Medicine Daphne Xiao, MD; Medical Instructor, Medicine Yiran Yang, MD; Assistant Professor of Medicine Betty Zhao, MD; Medical Instructor, Medicine Daniella Zipkin, MD; Associate Professor of Medicine
Sunday, December 19, 2020 What a Career! Many across the medical center acknowledge the privilege of working with Dr. Oddone. It is our honor to help celebrate. His accomplishments are formidable: Over 220 peer-reviewed publications 44 research training and career grants Countless number of mentees Over the past 35 years Dr. Oddone filled a number of leadership roles within Duke University School of Medicine and the Durham VA. Oddone was a dedicated division chief for twenty years (1997-2007) followed by an interlude as vice dean for research in the school of medicine, before returning as the interim division chief (2012-2013). As a researcher, among many prominent positions, Dr. Oddone was the director for the Center for Health Services Research in Primary Care in the Durham VA and director of Duke's renowned Clinical Research Training Program. We thank Dr. Oddone for his inspiration and wish him the very best in the future. We know that much of what we have built these past many years is a direct result of his leadership, vision, and civility. We are confident retirement will offer many new opportunities. Luckily we won't be leaving us completely and he will be staying on as Professor Emeritus of Medicine to assist with the APT process as well as mentor junior faculty and National Clinician Scholar fellows. Thanks for everything, Dr. Oddone, and enjoy your well-deserved retirement!
Dr. Oddone's Emeritus Tribute
Clinic Locations
Duke Outpatient Clinic Executive Health Duke Signature Care Duke Primary Care Clinics VA Ambulatory Medicine Integrative Medicine Diet & Fitness Center Brain Tumor Center
Clinic Volumes: FY18-FY20
Clinical Activities
* FY20 Numbers are lower due to COVID-19
35 New Faculty 16 Promotions Submitted 12 Promotions Effective
2020 in Numbers
COVID-19 Updates: Hospital Medicine
Friday, January 22, 2021 The Duke hospital medicine team continues to play a key role in helping treat patients with COVID-19 infection and develop hospital-based processes and policies to keep staff safe. By January 2021, the hospital medicine services (and emergency departments and intensive care units) are all experiencing greater numbers of patients with active COVID-19 infections since Fall 2020. The number of community infections and hospitalizations are rising in tandem with the holiday season (see graph from Performance services). We have been seeing approximately 9% weekly increase in COVID hospitalizations over the last few weeks and we have had to implement COVID surge planning. The Department of Medicine has done a great job in floating some available attending physicians to assume general medicine teaching responsibilities, thereby freeing up hospitalists to work in our COVID units. At Duke Hospital, we now have 6 adult COVID-19 isolation units: 2 ICUs and 4 intermediate step down units. DRH and DRAH each have large intermediate step down COVID isolation units as well. Residents on general medicine teaching services are also rotating in the COVID units. Dr. Cara O’Brien is leading efforts for hospital medicine and Department of Medicine to create an enhanced home care support for patients with COVID infection to avoid need for acute hospitalization. Hospital workflows & processes Hospital workflows and processes remain similar from Spring 2020. Visitation restrictions remain in effect with limited visitation for non-COVID patients and very restricted visitation for COVID patients. PPE is in good supply because of the fantastic efforts of our procurement and materials teams and donning & doffing of PPE is second nature to many of our providers now. Hospitalists have signed up enthusiastically for the COVID-19 vaccine and we are now finishing second dose for most of our providers. Research Our hospitalists continue to help support many of the ongoing research trials involving COVID treatments. Participating hospitalists include Dr. Thomas Holland, Dr. Noel Ivey, Dr. John Franzone, Dr. Lana Wahid, Dr. Emily Ko, and Dr. Tatyana Der. Resilience Resiliency work during this pandemic is crucial for everyone including hospitalists. We still try to connect socially via Zoom, Webex, etc., but we miss the in-person collegial interactions and hope and pray this changes by summer! Hospital medicine is also so grateful for the overwhelming support of all of our colleagues at Duke Health and our communities – this support is what keeps us focused during these challenging times.
Has the new intern ever seen you without a mask?
Sunday, October 4, 2020 When we asked Dr. Lynn Bowlby, medical director of the Duke Outpatient Clinic, whether the new interns had seen her without a mask, she told us that “it actually took us a few weeks to realize we had never seen the interns without a mask on, nor they us!“ We then inquired how things are going for DOC clinic given the challenges of the coronavirus pandemic and arrival of new interns in July. She was quick to say that “it really takes a team – from our social work staff to our nursing staff, all contributing to a virtual orientation and then a short, on-site orientation.” This was a first, a complete rework of orientation this year. Yet now, three months later, Bowlby reports “In testimony to the interns it is as if they have been at DOC for years. They have embraced our very complex patients, going above and beyond to provide care for their medical problems, help them with housing and cost of medications, and provide support through their worries about COVID. We have come to know each other through our eyes, and have figured out that a smile is in our eyes as well as our actual mouths!” "One thing for certain is change." COVID-19 continues to transform the DOC, pushing all to be innovative, creative and vigilant over months of a changed clinic. For example, "telephone visits where the complaint is abdominal pain, push us to new ways to figure out how best to help our patients. We continue to be ready for additional changes that will be happening!"
“We have come to know each other through our eyes, and have figured out that a smile is in our eyes as well as our actual mouths!” Lynn Bowlby, MD Medical Director, Duke Outpatient Clinic Associate Professor of Medicine
•Commercial: $3,853,756 •Federal: $9,116,466 •Non-Profit: $5,756,025 •Educational Institution: $1,158,503
GIM-Owned Active Awards
VA Faculty: •3 Faculty: 3- IPAs- Total: $250,875
Proposals Submitted by GIM Faculty: •13 Faculty: 25 Proposals- Total: $31,010,295
Total in Active Grants $19,884,750
“The pandemic has challenged us to think differently about how we engage research participants and patients in the community. At the same time, it has pushed us to think more creatively about ways we can engage as many people as possible in the work we are doing. Dr. Mitchell’s work is incredibly important. This next phase of her study will undoubtedly not only shed light on how to treat obesity but also how to do this under the changing circumstances of our new world.” L. Ebony Boulware, MD MPH Chief, Division of General Internal Medicine
Impact of COVID-19 on the clinical research of one GIM investigator November 8, 2020
An interview with Dr. Nia Mitchell We last interviewed Dr. Mitchell about her research in February 2019, as we celebrated news of her first R01 funding from the NIH National Institute on Aging. Dr. Mitchell’s clinical trial aims to address an area of health care disparity – an intervention for older African-American women with obesity and frailty in need of weight loss and physical exercise. But, here’s what happened at Duke and with the study population On March 13, 2020, Duke University suspended all in-person study activities for non-essential studies until further notice. In mid-March the housing communities where the team planned to conduct the study were forced to close to public visitation by local officials due to the risks associated to COVID-19 and have yet to reopen. Mitchell and team were unable to move forward with plans for in-person recruitment, weekly intervention group meetings, and quarterly study visits to collect outcomes data. A daunting task “Initially, although it was a daunting task” says Dr. Mitchell, “we thought we would transition to virtual recruitment, group meetings, and data collection visits. While this would be challenging in most studies, it was going to be more challenging for us because our population was older African American women living in public housing. We thought we would have to provide computers, internet access, and training…in addition to trying to figure out how to collect blood samples and perform physical function tests with minimal in-person contact.” “We started to worry.” Mitchell goes on to say that “we contacted a couple of TOPS chapters [TOPS is Take Off pounds Sensibly, a national nonprofit, community based, peer-led weight loss program] whose members were older African American women – one in Durham and one in Denver, CO. Neither one of these chapters, which had been operating for years, chose to go online during the pandemic. We started to worry that we would put in a lot of work setting up our as-yet-to-be-formed chapters with the internet and computers, and they might not want to participate.” Would the participants themselves accept computer technology? We decided that it would best to ask potential participants if they would be interested in a virtual intervention where we provided the internet and computers. We also decided to ask about their previous experience with virtual interactions with family, church, and healthcare visits. We will also ask them about any changes in their eating and physical activity habits during the shelter-in-place orders during the pandemic. Transforming to a virtual intervention We realized that we needed to get more information from the population we are trying to serve before we plan an intervention in which they may not be able or willing to participate. We plan to conduct a telephone feasibility survey with our population to understand their interest in and barriers to receiving a virtual intervention. The surveys will also tell us how residents are currently coping with the impacts of COVID19. We feel COVID-19 may have been detrimental to older individuals who may rely on others for food, transportation, and social support. Continuing clinical trials ensuring patient and investigator safety, and also maintaining quality data, are of utmost importance. No doubt work such as Mitchell’s will re-envision the future of clinical trials. Sunday, September 27, 2020 A team of Duke Health clinicians that include faculty from the Department of Medicine are working diligently in a collaborative effort to enroll patients in a randomized, controlled trial, testing a novel antibody treatment for COVID-19. The Duke team’s early success in the ACTIV-3 trial has been recognized by Francis Collins, MD, PhD, director of the National Institutes of Health, and Janet Woodcock, MD, a leader in the federal government's Operation Warp Speed. The trial is being run out of the Cardiothoracic Surgical Trials Network at Duke.Peter Smith, MD, professor of surgery, is the primary investigator. Medicine faculty who are part of the trial include Christina Barkauskas, MD, assistant professor of medicine (Pulmonary, Allergy, and Critical Care Medicine); Thomas Holland, MD, associate professor of medicine (Infectious Diseases); Emily Ko, MD, assistant professor of medicine (GIM); Noel Ivey, MD, medical instructor (GIM); John Franzone, MD, medical instructor (GIM); and Tatyana Der, MD, medical instructor (GIM). Friday, August 14, 2020 Finally, research about Clinician-Educators! A new study published Monday as an online first in the Journal of General Internal Medicine examined whether advanced education training is associated with productivity and success. GIM Associate Professor of Medicine, Dr. Daniella Zipkin, was the first author on this paper entitled,Clinician-Educator Training and Its Impact on Career Success: a Mixed Methods Study. The authors were members of the SGIM Education Committee. Using survey data and focus groups the team explored the role of advanced training for clinician-educators and academic success. "We wanted to look at whether training actually makes a difference," says Zipkin. Key finding They found that "high-intensity” training, defined as fellowships or degree bearing programs in medical education, was associated with greater career satisfaction, higher academic productivity and lower gender disparity in the publication domain. Expected impact Zipkin says she hopes this research will elevate the conversation about defining clinician-educator paths. She also believes this research will: help trainees and junior faculty make decisions on what opportunities to pursue to get ready for a clinician-educator path; help mentors and leaders who need educators among their faculty to better support individuals who pursue the educator pathway; and help the promotions process by making the contributions of educators more mainstream "I'd like to support the movement to a more holistic review of educators based on their multiple contributions that are not manuscripts," says Zipkin. “Duke is doing well in this area, but the process varies greatly across institutions.” Zipkin adds that as we better define the expectations placed on educators, we need to put in place more opportunities for their training. So, what now? Zipkin hopes more research will be done in these areas, especially as it pertains to race and gender. Ultimately, she hopes to see more Clinician-Educator Fellowships in GIM. Zipkin, an academic clinician educator Dr. Daniella Zipkin is an Associate Program Director for the Duke Internal Medicine Residency Program, the Director for the Advocacy in Clinical Leadership Track (ACLT) for residents, and also is a physician and mentor at The Duke Outpatient Clinic. Zipkin tells us that being a clinician-educator is a "dream job" but she knows not everyone who wants to be in academic medicine are as fortunate as she. Was it her fellowship training that got her this job or just being in the right place at the right time? We may never know. "Now is the time to shine a spotlight on career development for educators and making the criteria and expectations more clear and unified across institutions," says Zipkin. "It is time to give educators more structure along their path, on par with clinical and research careers”.
Nia S. Mitchell, MD; Assistant Professor of Medicine
"Now is the time to shine a spotlight on career development for educators and making the criteria and expectations more clear and unified across institutions." - Daniella Zipkin MD Associate Professor of Medicine
Medicine faculty part of ACTIV-3 trial team lauded by NIH
"It is wonderful that we have been able to bring COVID-19 clinical trials to Duke Regional and offer our patient's access to cutting-edge therapies," Dr. Ko says. "Thanks to our COVID-19 nurses, pharmacy, laboratory, and phlebotomy teams for quickly learning new processes and making trials successful at Duke Regional Hospital." Emily Ko, MD Assistant Professor of Medicine
Zipkin leads study on Clinician-Educator roles
Thursday, August 27, 2020 The transition between pre-clinical and clinical education is often challenging for medical students. This is the ninth straight year Dr. Saumil Chudgar and Dr. Aubrey Jolly Graham have led the Clinical Skills Intensive (CSI), a 3-week full-time course that helps to prepare new second-year medical students for their clinical education. "The course lays the foundation for students' clinical rotations by teaching essential clinical skills including ECG and lab interpretation, procedures, patient safety, differential diagnosis, diagnostic testing, clinical reasoning, evidence-based medicine, and diagnosis-based physical examination," explains Chudgar. 2020 - the year of going virtual yet interactive Due to the COVID-19 pandemic, most of what this course usually teaches in-person switched to an online format. "Admittedly, the transition to the virtual year presented a new challenge for us," said Chudgar. "Most of the sessions were transitioned to Zoom." The instructors presented large group lectures live via Zoom. Special functionality of Zoom easily facilitates breakout rooms, polling, and a chat feature to make the lectures more interactive. Special permission for in-person sessions The course obtained special permission from the School of Medicine and the University to have one set of sessions in-person. These were sessions where the students practiced procedures such as arterial blood gases, nasogastric tubes, and intravenous lines on task trainers. "Because these were tactile skills and the students needed to use the equipment and learn the techniques, these had to be done in person," says Chudgar. To help keep everyone safe, the group was sure to take special precautions including strict hand hygiene, universal masking, and social distancing. There were also limits placed on the number of people in a given room based on the size of the room. Students rotated in small groups at different times throughout the day. Benefits of year-long small groups Approximately 120 students participate annually in the CSI course. Besides these 3 weeks at the start of the clinical year, small groups continue for two hours every other week. In this manner the students can apply the skills they are learning to more challenging problems gained with ongoing clinical experience. Each group has an assigned faculty instructor and a third-year medical student as a co-leader. The third-year students benefit from faculty mentoring as future clinican-educators. "One of the exciting things over the last 9 years is the caliber of our students," says Chudgar. "All the faculty are blown away each year at how much they know and how eager they are to learn." Faculty Involved in Course: Saumil Chudgar, MD - Course Director (GIM/DUH Hospital Medicine) Aubrey Jolly Graham, MD - Course Associate Director (GIM/DUH Hospital Medicine) Small Group Leaders: Mitchell Black, MD , Joel Boggan, MD, Aimee Chung, MD, Alison Clay, MD, James Fox, MD, Jane Gagliardi, MD, David Gordon, MD, Elizabeth Hankollari, MD Brian Kincaid, MD, Nancy Knudsen, MD, Cara O’Brien, MD, Cecily Peterson, MD, Jenny Van Kirk, MD, Nancy Weigle, MD
Chudgar + Jolly Graham lead Clinical Skills Intensive for 9th year
Saumil Chudgar, MD; Aubrey Jolly Graham, MD
Edelman + Mitchell at Southern SGIM
Sunday, February 16, 2020 The Southern Regional Meeting of the Society of General Internal Medicine (SSGIM) took place February 13 to February 15, 2020, in New Orleans, LA. Our own Drs. David Edelman and Nia S. Mitchell attended and engaged in academic mentoring. The southern region includes Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Texas, and West Virginia. Edelman and Mitchell were active participants They were part of a workshop entitled, “Is GIM Fellowship Right for You?” where they presented with colleagues from the University of Alabama at Birmingham and Medical University of South Carolina. They provided feedback to two researchers at a "Works in Progress" session. Dr. Edelman, during an individual mentoring session, counseled a junior faculty member who is a full-time clinician-educator interested in a research career. Dr. Mitchell co-moderated one of the oral abstract sessions. This small regional meeting provided a unique opportunity Sessions at the regional meeting are similar to those at the national meeting. These included clinical updates, clinical vignettes, poster sessions, and workshops. The medical Jeopardy competition held over lunch was a popular event. Resident teams from 10 schools participated. UT Southwestern was the ultimate winner. Because the meeting is smaller than the national meeting, there is an opportunity for more individualized contact. For example, there are "Works in Progress" sessions where researchers have the opportunity to obtain input from scholars at other institutions to improve their manuscripts and research projects. This does not happen at the national meeting. Dr. Edelman observes, “It is important to participate in these meetings because we can connect with colleagues in the region and may have the opportunity to recruit people to our division.”
ACLT Virtual Advocacy Experience
Thursday, May 21, 2020 Over recent weeks participants in the Advocacy in Clinical Leadership Track (ACLT) led by Duke GIM Associate Professor,Dr. Daniella Zipkin, basically became video conferencing pros. Once the residents learned their long-planned trip to Washington, DC, was canceled, this virtual solution demonstrated for the residents just how powerful their voice as physician advocates still can be. Altogether, there have been four virtual meetings, each with individuals or organizations with considerable societal and health care influence. The first day’s event we reported previously, included the office staff of Senator Tillis and the staff from AAMC. Next, the residents spoke about health disparities and vulnerable communities with Dr. Kirsten Bibbins-Domingo, the inaugural Vice Dean for Population Health and Health Equity in the UCSF School of Medicine. A seminar followed with Duke physician and behavioral scientist, Dr. Peter Ubel, who discussed writing, academic medicine, mentorship, advocacy, and the value of “following your passions”. Between meetings, the residents divided and conquered to review the impact of COVID-19 on vulnerable populations and develop a platform to share. This was the fastest one-pager turnaround time in ACLT history, and all done virtually! The ending to this pinnacle experience concluded with a conversation with health policy staff for Senator Richard Burr of North Carolina, Angela Wiles and Rachel Portman. “I honestly wasn’t sure how this would all come together since the context was so rapidly changing. This amazing group of residents pulled off a thoughtful and impactful presentation and learned a lot along the way," said Zipkin. his year's ACLT residents: Senior Assistant Residents- Drs. Keva Garg, Alie Mara, Katie Pollard, Tamara Saint-Surin, Anmol Singh, Alex Sullivan, Nancy Yang Med Psych Residents-Drs. Nicole Helmke, Johnny Komisar, Colin Smith, Alyssa Stavig Junior Assistant Residents- Drs. Marius Chukwurah, John Davy, Nathaniel Harris, Cassie Lautredou, Soo Lim, Ahmad Mourad, Cindy Pabon, Bhavik Patel, Maggie Salinger
Greenblatt + Westman "cover the triangle"
Community Engagement
Larry Greenblatt, MD & Eric Westman, MD
Thursday, April 16, 2020 It all started with a couple of concerned doctors. Two Duke General Internal Medicine faculty members, Dr. Eric Westman and Dr. Lawrence Greenblatt, put their heads together to protect those in the Triangle most at risk because of where they live or work, and came up with a plan to quickly mobilize large numbers of face masks. "This tidal wave was coming and we were not doing enough to protect those who are most at-risk," said Greenblatt. The two physicians are purchasing masks from businesses and individuals affected by the COVID-19 pandemic, and are donating their time to organize and distribute them. The main two sources of masks are fromThe Original Mattress Factoryand independent seamstresses who were sewing forThe Carolina Ballet. Teaming Up Duke Medical School Students, Durham City Government, and Durham County have all joined in collaboration on this effort to help identify the highest risk individuals and help disseminate the masks to them.They have already successfully handed-out over 10,000 masks! "I think the research, although it is not as rigorous as we'd like it to be," Greenblatt explains, "it's pretty clear that when people broadly wear masks when out in public you see a steep decline in the transmission of the virus." Dr. Greenblatt recommends anyone who is out in public to wear a mask. He also encourages those who don't have a mask to make their own by using an old t-shirt or bandana. Learn more about making your own face mask on the Covering The Triangle website. Sunday, November 22, 2020 For most in health care this would be a major stress – an outbreak of COVID-19 at a homeless shelter. This is the story of just such an event in Durham, NC, an outbreak that called for a major multidisciplinary response. Julia Gamble was prepared. Julia is a nurse practitioner with the Duke Outpatient Clinic (DOC) where she participates with a multidisciplinary team serving patients who are frequent visitors to the ED. Apart from DOC clinic Gamble is a director of Durham Homeless Care Transitions which is a transitional care management service for homeless persons with ongoing medical issues post hospital admission. Her skill set was instrumental in this positive outcome of a community homeless shelter impacted by the coronavirus pandemic. The COVID outbreak as told by Julia Gamble, NP Managing COVID-19 is tough for anyone but crowded conditions in homeless shelters and a population that is poor and in ill health creates a situation ripe for an outbreak. In March 2020, preparing for such an outbreak, a team of community leaders from Lincoln, DOC, mental health (Alliance Health), the county and the city came together to develop a plan. 17 positive COVID results in 2 days In October the community's hard work came in handy. A COVID outbreak was discovered at Urban Ministries of Durham. The staff learned on Monday, October 26, of a positive COVID test. This followed an October 16 positive test of a resident who happened to have a job working at a nursing home. By Wednesday, October 28, testing results were identified positive for 17 residents. Altogether 45 residents were tested that night at a site on the campus of Urban Ministries, testing led by Dr. Jacob Feigal and his team from the Healthcare for the Homeless Clinic of Lincoln Community Health Center. These testing events are continuing every Wednesday with the support of resident and faculty volunteers from the internal medicine, medicine-psychiatry, and family medicine programs. Dr. Feigal’s expertise has been invaluable to the Durham Homeless COVID Response team. Feigal completed residency at Duke in the combined internal medicine and psychiatry program, and primary care training at the DOC clinic. He is now a faculty member in the Department of Psychiatry and Department of Medicine. Testing and hand-off to isolation Next, Dr. Nick Turner, with his expertise as a specialist in Infectious Diseases, stepped in to advise the group on COVID testing in the homeless population. He contributed his experience with high risk populations as a faculty member from the Duke Division of Infectious Diseases. In a previous response to a positive case at Durham Rescue Mission, Dr. Turner led surveillance testing events, and later, in coordination with Dr. Jacob Feigal, held testing events at Urban Ministries. Managing isolation Julia, through her work with Durham Homeless Care Transitions, a service supported by the city and county, supervised the isolation process for the residents. Daily check-ins included management of medical and mental health needs, including coordination with outpatient psychiatry and substance abuse treatment programs and the Department of Public Health. The rapid isolation of shelter residents resulted in control of the outbreak, as follow-up testing revealed only 1 case in the following 2 weeks. Sunday, February 16, 2020 GIM Assistant Professor of Medicine, Dr. Fatima Syed, practicing at Duke Primary Care Pickett Road, has a desire to provide innovative care for her patients with diabetes. She started a monthly group diabetes class that's available to all patients with type 2 diabetes and an elevated hemoglobin A1C greater than 8. "We have a structured curriculum, but I also like to follow the lead of the group," says Syed. Her main goal is for patients to achieve better A1C targets. The group often discusses diet, one of the most challenging components of diabetes care. Other popular topics include physiology about normal body functions and about medications and how meds work. Dr. Syed hopes these classes will better inform her patients and their families. The class meets for an hour every second Friday of the month at 10 am. (Note: this coming March the class moves to the third Friday). For more information, contact Pickett Road Clinic at (919) 490-9800.
"The main benefit of mask-wearing is reducing spread from asymptomatic carriers to others."
GIM Fellowship
VA Quality Scholars Aimed to train interdisciplinary healthcare professionals in quality improvement scholarship. As a new VAQS site, Durham brings a wide array of expertise related to quality improvement and implementation science, including clinical experience in the fields of geriatrics, mental health, musculoskeletal disorders and women’s health. They will be recruiting from the fields of physical therapy, psychology, nursing and medicine. Health Outcomes and Policy Offering training for clinicians who want to drive policy-relevant research and partnerships to improve health and health care. The goal of the program is to advance the scientific knowledge necessary to promote population health, improve healthcare outcomes, and develop sound public policies to achieve higher quality health care at a lower cost. Health Services Research and Delivery This 2-3 year fellowship is for physician scholars with an interest in training in health services research. The primary goal of this post-doctoral fellowship is to perform high-quality health services research with expert mentorship from members of our 30+ core faculty. Population-Based Translational Science This two-year fellowship for physician scholars with an interest in training in clinical or translational research. The primary goal of the fellowship is for trainees to perform high-quality health services research with expert mentorship from any of the hundreds of outstanding Duke faculty members with expertise in clinical or translational research. Genomic Medicine This two-year program will provide didactic training in the methods of clinical research and knowledge relevant to genomic medicine research and a co-mentored research experience emphasizing interdisciplinary research in genomic medicine. Clinical Informatics This two-year fellowship focuses on academic development and scholarly work aimed at enabling the fellow for a future position as a leader in academic hospital medicine. Throughout the two-year fellowship, project work relevant to hospital medicine will be performed in the areas of quality and safety, as well as education. Palliative Care Centered on efforts to improve palliative care for all populations. Projects and opportunities include spiritual care, counseling, mobile health platforms, communication and advance care planning, and data-intensive approaches to defining quality of care.
Duke General Internal Medicine offers a variety of fellowship opportunities. The programs are two or three years in length and are categorized in three specifically designed tracks: Quality, Health Services & Outcomes Research, and Precision Medicine & Data.
"We have a structured curriculum, but I also like to follow the lead of the group." Fatima Syed, MD Assistant Professor of Medicine
Dr. Syed leads group diabetes class at Pickett Road Clinic
"Homeless people are socially complex because of homelessness but also can be ill medically, psychiatrically, and cognitively and really require engagement from all those areas." - Julia Gamble, NP
A COVID-19 outbreak at a homeless shelter
Wednesday, February 17, 2021 There is a significant connection between housing stability and food access. Families experiencing financial hardship may have little money left for food after paying their rent or mortgage, or they may live in disinvested neighborhoods where access to healthy, affordable food is less likely. The current economic crisis caused by the pandemic has led to devastating consequences for those who were already struggling. Duke Alum, Jason Goldblatt, recognizes the importance for both affordable housing and access to healthy food. Goldblatt is the Chairman and CEO of Foundation Housing, a non-profit whose mission is to preserve affordable housing around the country to ensure there are affordable options for people who are unable to afford the high cost of housing. “When the pandemic hit, one of the things we really started to see was not only were people struggling with their rent, but they were struggling with other housing costs, most significantly the cost of food,” says Goldblatt. Goldblatt reached out to the Duke development office who presented him a number of different options that were aligned with his desire to help out with food insecurity within the region. “The one that jumped out to me was Root Causes,” recalls Goldblatt. Root Causes is an organization founded by a group of Duke Medical Students that is focused on healing the food system through education and outreach, community service, and advocacy. They partner with the hospitals, clinics, and the community to help improve the Duke Health food environment. One of their key projects includes the Fresh Produce Program, which delivers bags of produce and other household items to local families in need. “The Durham community holds a very dear place in my heart,” says Goldblatt. “I wanted to make sure that any money we gave was going to address the issue of food insecurity in the region.” Due to the gracious donation received on behalf of Jason and his company, the Root Causes organization was able to expand to help more families in the area gain access to healthier food and other household staples. “I was really pleased to be able to support Root Causes because it’s supporting an issue that is critical.” _____________________________________ Learn more about Root Causes on their website: www.rootcauseshealth.org If you are interested in making a contribution of your own, please visit the Duke Development website: www.gifts.duke.edu/dukehealth
Jason Goldblatt, Duke Alum CEO, Foundation Housing
Duke alum helps address the root cause of poor health in the region
Philanthropy
9 Donors in 2020 $36,100 Total Gifts Received
3 Areas benefited: Executive Health: $21,000 Duke Outpatient Clinic: $6,000 Palliative Care: $9,100