September 2012 Newsletter

Department of Medicine eNewsletter
September 2012
:: Interview
:: Department News
:: Department Events
:: Leadership Council Minutes
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The Department of Medicine's website was visited by more than 14,000 people over the summer
Most recent addition to the website has been the section on the Residency Program

Most popular division is Cardiology
Most searched for Division Chief is
Dr. Fabio Cominelli
Most searched for faculty member is Dr. Jonathan Stamler
Readers come from such far-away locations as Egypt, Thailand, Bahrain, Trinidad and Tobago

Leadership Council
September, 2012

Chair ::

R. Walsh


Present ::

K. Armitage

A. Askari

R. Chandra

F. Creighton

C. Hoppel

G. Isenberg

M. Jain

A. Krikorian

N. Meropol

R. Salata

K. Strohl

R. Walsh
J. Wright


Recorded by ::
A. Staruch
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department interview
Dr. Fabio Cominelli, Division Chief of Gastroenterology, shares his thoughts on philanthropy, industry-based research and factors that helped his division advance to 14th place in U.S.News & World Report.

There are a number of new research projects in the division, including the Barrett's network and the inflammatory bowel disease PPG. What is the impact of these awards on new faculty and spin-off grants?

Both of the research projects mentioned are multi-disciplinary grants that not only support individual research projects, but also help the mentoring infrastructure that allows young researchers to pursue education and training in the division. For example, the program project in inflammatory bowel disease supports a number of international fellows and post-doctoral trainees that come from Japan, Italy, Greece and other countries. Some fellows emerged as junior faculty members after working on individual research projects (for example, Dr. Linda Cummings and Dr. Katarina Greer).


Individual grants are also generated through multi-disciplinary grants to pursue new directions within a program project. One of the individual spin-off grants currently taking place in the Division of Gastroenterology and Liver Disease is a GI Cancer grant led by Dr. Linda Cummings. We anticipate new spin-off grants to be generated from recent research projects within the next 3-5 years. 



What role does industry-based research play in the division? Do you see it as a viable, long-term means of support for faculty effort?


Because of the economy's decline and recent increase in regulations, pharmaceutical companies are more careful about financial investments in research. However, industry funding plays a very important role in the Division of Gastroenterology and Liver Disease. We currently have multiple industry-sponsored multi-centered studies that not only support the development of new therapies for gastrointestinal disorders, but are also essential in attracting new patients. These state-of-the-art services are essential in differentiating us from other competitors in Cleveland area.


The division is currently concentrating on developing investigator-initiated industry grants. We are breaking away from the classical approach of solely relying on NIH funding and concentrating on diversifying our funding portfolio by increasing support from industry grants, foundation grants and philanthropy.



Strong philanthropic relationships are becoming critical as a means to subvent shrinking extramural and clinical funding. What are you plans for identifying new philanthropic support for the division?


Philanthropy has become an important component in the current economic environment. The plan of the division is to work closely with the School of Medicine and University Hospitals to identify new opportunities for growth. The most giving donor is a grateful patient; therefore, GI faculty's top priority is to provide the highest quality of care possible to patients. The first step in cultivating philanthropy is to provide great clinical service and educate patients on how they can help support new discoveries.


The Division of Gastroenterology and Liver Disease currently has one endowed professorship, The Menges Professorship in Internal Medicine; we are planning to develop two more: one in inflammatory bowel disease and one in GI cancer. In addition, we are looking for philanthropic support of start-up projects that are premature for a full grant application but have the potential to generate future spin-off grants. We are also working on a philanthropic gift that will allow us to support the inflammatory bowel disease clinical database that holds clinical demographic, tissue banking, and DNA data.


Could you share your insights on how leading-edge technological advancements are shaping the clinical procedures performed in GI?

There are a number of interesting new technologies that have been pioneered by our faculty in advanced and therapeutic endoscopy. These include endoscopic ultrasound, cryotherapy, radiofrequency ablation, and endoscopic submucusal resection. These new techniques allow us to not only perform state-of-the art imaging of the gastrointestinal track, but also execute therapeutic interventions, including stopping bleeding and removing lesions. In addition, we do not only integrate the latest technological advancements into the procedures the division offers, but also invest time into further advancing them using our experimental laboratory and actively collaborating with the Department of Surgery.



The rankings of the Division of Gastroenterology in U.S.News & World Report have dramatically improved, raising from #25th to #14th in just one year. What were the key data from the recent survey that contributed to the higher ranking?


The division is very happy to continue this track record of success - over the past few years we went from 47th to 14th place in the rankings. The key data contributing to the improved rankings is related to the quality of service we provide in our division. For example, we have a low mortality index, serve high volume of patients, and offer advanced technological procedures. A unique synergistic relationship between the division, other departmental chiefs, and educational programs led by Dr. Armitage and Dr. Bonomo has resulted in a new inpatient service that opened last year. This ultimately allowed us to increase the number of patients we admit and the quality of care we provide to them. Our reputation index has also increased due to new key recruitments which was another significant factor that contributed to our success.


Our plan over the next five years is to continue to improve our place in the rankings, breaking into the top 10 by concentrating on strong research and education, providing excellent health care to patients, and further improving our reputation. This will allow us to continue to establish ourselves as one of the premier gastroenterology programs in the world.

department news report

Division of Cardiology

Dr. Richard Josephson received Distinguished Service Award from the American Association of Cardiovascular and Pulmonary Rehabilitation. This honor is presented to AACVPR members who have provided considerable leadership, intellectual resources and commitment to the organization. AACVPR is a multi-disciplinary professional association comprised of health professionals who serve in the field of cardiac and pulmonary rehabilitation.




Dr. Tom Lassar made a presentation at International Academy of Cardiology 17th World Congress on Heart Disease. In his talk Dr. Lassar concentrated on outcomes of anti-platelet therapy directed by post-PCI platelet function testing in a real world setting. Among Dr. Lassar's latest publications is an article entitled "Use of Clopidogrel and Pathways of Platelet Function Testing at University Hospitals of Cleveland" published in Cath Lab Digest.



Dr. Daniel Simon is principal investigator of a study to determine the safety and effectiveness of a new stent device for adult patients with coronary artery disease. The investigational stent, which utilizes a fully bioabsorbable drug-eluting polymer that is coated on the exterior surface only, will be compared to a previously approved stent that uses a permanent, non-absorbable polymer that releases the drug on both the exterior and interior aspects of the stent.



Under Dr. Daniel Simon's leadership UH Harrington Heart and Vascular Institute has made great improvements in delivering fast high quality care to patients who experienced heart attack.

Patients who have critical heart attacks often receive angioplasty, a technique used to mechanically widen narrowed or obscured arteries using an empty or collapsed balloon and opening the blood vessel by inflating the balloon to a fixed size. As the mortality rate is linked to how quickly the procedure can be executed, guidelines have been developed for hospitals to meet 90-minute or less time standard for the execution of angioplasty (starting from the time a patient is admitted to a hospital to the time blood flow is normalized).

In order to consistently reach the 90-minute mark, Harrington Heart and Vascular Institute has donated a wireless transmission system and training worth over $50,000 to a large EMS system it works with. This contributed to significant time-saving as ambulances equipped with portable machines transmit ECG results prior to patients' arrival. The initiative culminated in a dramatic improvement in health care results: the 90-minute standard is met 100% of the time (a considerable increase compared to less than 60% in 2010). Dr. Dan Simon also states that median door-to-balloon time is only 47 minutes for patients arriving to ER on foot or by ambulance. These improvements are especially important for the excellence-oriented Division of Cardiology as researchers who analyzed Medicare data concluded that best-performing hospitals consistently achieved 60-minute mark.


Harrington Heart & Vascular Institute and Case Cardiovascular Research Institute went on a medical mission to Uganda. Drs. Daniel Simon, Marco Costa, and Chris Longenecker performed first peripheral angioplasty, mitral valvulopasty, and chronic total occlusion coronary artery procedures in the country's first cardiac catheterization laboratory that opened recently. Dr Robert Salata, leveraging his role as the International Liaison of the Ugandan Joint Clinical Research Centre, has been instrumental in establishing the new cardiovascular medicine program.


Division of Gastroenterology and Liver Disease

Dr. Stanley Cohen accepted a position in the division to further develop the Liver Center of Excellence and Liver Transplant programs in the Digestive Health Institute and Transplant Institute. With his appointment, the division will boast four hepatologists, which will facilitate the growth of the Hepatology and Transplant programs to new levels. Dr. Cohen's expertise includes Hepatitis C and Liver Transplantation. Dr. Cohen is also well known for his publication entitled The Downstream Financial Effect of Hepatology (Hepatology, 2005), which studied the economic impact of Hepatology services in an Academic Medical Center environment.



Dr. Anil Mishra joined the division as Professor of Medicine and
will be starting an independent and well-funded research program focused on gastrointestinal inflammation and inflammatory diseases of the esophagus. Dr. Mishra has an outstanding record in research and boasts an international reputation in the field of eosinophilic esophagitis and gastrointestinal inflammation. He is the author and co-author of 52 peer review original manuscripts, four review articles, and two book chapters. In addition, he is the principle investigator on two newly funded R01 grants dealing with the mechanisms of IL-15 actions in the pathogenesis of eosinophilic esophagitis.  He is also a co-investigator on another R01 grant funded by NIDDK. This is a very significant achievement considering the challenging NIH funding situation.




Division of General Internal Medicine and Geriatrics

Drs. Brook Watts, Amy Hirsch, and Yngve Falck-Ytter were awarded a $93,114 grant from the VA Office of Public Health, HIV/Hepatitis C Pathogens division, for their project entitled "Implementation and Evaluation of a Hepatocellular Cancer Tracking Tool". This project aims to enhance the care for patients with hepatocellular cancer through the use of an informatics system that facilitates timely tracking and measurement of clinical care benchmarks.



Division of Hematology and Oncology

Dr. Nathan Berger was honored at the UH Seidman Cancer Center with naming of a new medical inpatient service as the "Berger Service." Dr. Neal Meropol, Division Chief, presented Dr. Berger with a paperweight that was inscribed: "Mentor, Role Model, Leader, Friend."






Dr. Marcos de Lima joined the division as Professor of Medicine; he will hold several leadership position at University Hospitals Case Medical Center and CWRU. Within the Division of Hematology and Oncology he will serve as Section Chief for Hematologic Malignancies and Stem Cell Transplantation. In the Seidman Cancer Center, he will serve as Medical Director of the Stem Cell Transplant Program. Dr. de Lima will also be a member of the Case Comprehensive Cancer Center Hematopoietic Disorders Program.

Dr. de Lima has an international reputation as leader in field of BMT for hematologic malignancies. He is an invited lecturer worldwide and has published more than 200 scientific manuscripts, chapters and review articles. Dr. de Lima's research focuses on the use of stem cell transplantation for treatment of acute and chronic leukemias. He has developed and published novel conditioning regimens for unrelated donor transplants, and post-transplant maintenance approaches. He has studied ex vivo expansion of cord blood stem cells to improve engraftment and led phase I studies of new combinations as well as subsequent phase II trials.

In addition, Dr. de Lima has a variety of national and international roles. He is a member of the NCI Leukemia Steering Committee; elected member of the Center for the International Bone Marrow Transplant Registry Advisory Committee; elected president of National Marrow Donor Program Council; member of the National Marrow Donor Program board of directors; Chair, Committee on Foreign Medical Graduates of the American Society of Bone Marrow Transplantation. He also currently serves on the National Cancer Institute-Sponsored International Workshop on Relapse after Allogeneic Hematopoietic Stem Cell Transplantation.


Dr. Clark Distelhorst was appointed Deputy Chief for Laboratory Research within the Division of Hematology and Oncology. The overall goal of the new position is to foster the development of basic and translational science within the division.






Stephen Fink, PhD received a CTSC Core Utilization Award from CWRU. The

grant in the amount of $8,000 will support his work on "Mechanisms of Vitamin D Resistance in Colon Cancer."


Stan Gerson, MDDr. Stanton Gerson received the Case Western Reserve Medal for Excellence in Health Science Innovation. This award is the highest honor bestowed by the School of Medicine and is presented to medical leaders whose contributions are advancing research, education and health care. Dr. Gerson has distinguished himself in each of the three realms. Dr. Gerson has exemplified successful leadership of pioneering research and clinical entities, including the Case Comprehensive Cancer Center, National Center for Regenerative Medicine, both based at Case Western Reserve University, and the Seidman Cancer Center at UH Case Medical Center. In addition, Dr. Gerson's research in DNA repair and stem cell therapy has resulted in numerous publications and patents. Dr. Gerson has also been an outstanding mentor and educator for the next generation of compassionate clinicians in the Division of Hematology and Oncology.


Dr. Rami Manochakian joined the division as Assistant Professor of Medicine. During his fellowship in the division, Dr. Manochakian concentrated his clinical and research efforts in the area of gastrointestinal cancer under the mentorship of Dr. Smitha Krishnamurthi, Dr. Nate Berger and Dr. Joseph Bokar. Dr. Manochakian will be a member of the Hematology/Oncology section at the LSCVAMC where he will serve as the Medical Director of the Multidisciplinary Lung Cancer Program and medical oncologist for gastrointestinal malignancies within the Specialty Care Center of Excellence. He will continue his clinical research pursuits examining the effects of metformin in pancreatic cancer. Dr. Manochakian will also continue his educational efforts at the CWRU School of Medicine and within the Department of Medicine residency program.


Drs. Gayathri Ravi, Srinivasa Sanikommu, and Novejot Sekhon joined the division as Assistant Professors; each will focus on the clinical care of hematology and oncology inpatients in UH Seidman Cancer Center. This expansion of the Seidman Hospitalist service will accomplish two key initiatives: open a third unit for medical inpatients as well as increase the capacity to admit more patients and provide daily in-house attending-level coverage until midnight on weekdays. This will facilitate afternoon and evening admissions and improve the continuity of care.

Dr. Neelesh Sharma was presented with the 2012 Linda Arena Endowed Scholarship Award for Lung Cancer Education at University Hospitals. The Linda Arena Fund provides an annual scholarship to staff and/or students at University Hospitals to obtain advanced training or to further their education in lung cancer prevention and treatment. The fund was established by the children of Linda Arena who succumbed to lung cancer.




Dr. Basem William joined the division as Assistant Professor of Medicine in the section of Stem Cell Transplantation and Hematologic Malignancies. Dr. William will focus his efforts on patient care and clinical investigation for patients undergoing transplantation. He will provide outpatient and inpatient care at UH Seidman Cancer Center on main campus.







Division of Infectious Diseases and HIV Medicine

Yong Gao, PhD, was awarded a one year U.S.- China Biomedical Collaborative Research grant from NIH. Yong Gao will be collaborating with Tongji Medical College, Huazhong University of Science and Technology, in China. The project will explore efficient screening for hybridoma expressing anti-HIV-1 broadly neutralizing antibodies.






Dr. Barbara Gripshover, received funding to support patient care in the Special Immunology Unit. The grant in the amount of $350,000 will provide comprehensive HIV care to a growing population of underserved HIV-infected youth and women, engage and retain them in care to preserve their health and, in so doing, hopefully abate new infections as well. In particular, this program will support primary HIV care in the SIU for uninsured and underinsured women and youth, obstetrics and gynecologic care, mental health counseling, a dedicated nurse care coordinator for women and youth, and a youth social worker.


Dr. John Johnson's work on tuberculosis was featured in many articles. Among his recent publications are Effect of HIV Infection on Tolerability and Bacteriologic  Outcomes of Tuberculosis Treatment in International Journal of Tuberculosis and Lung Disease; Reasons for Non-Participation in an International Multicenter Trial of a New Drug for Tuberculosis Treatment in International Journal of Tuberculosis and Lung Disease; Antiphospholipid Antibody Levels as Biomarkers for Monitoring Tuberculosis Treatment Response in Tuberculosis; Substitution of Rifapentine for Rifampin During Intensive Phase Treatment of Pulmonary Tuberculosis in Journal of Infectious Diseases; Approaches to Clinical Trials of New Anti-TB Drugs in Clinical Investigation; Time Until Relapse in Tuberculosis Treatment Trials: Implication for Phase 3  Trial Design in American Journal of Respiratory and Critical Care Medicine.



Krisztina Papp-Wallace, PhD, received a Steris Corporation Grant award in the amount of $37,500. Her work will explore the role of penicillin-binding protein 3 in beta-lactam resistance in Acinetobacter baumannii.







Dr. Roxana Rojas received a one year CFAR grant in the amount of $157,000. Dr. Rojas's research will concentrate on the mechanisms that control the survival of M. tuberculosis, the bacteria that causes TB, in cells of the immune system. Also, this project will interrogate whether these cellular mechanisms are modified by HIV infection. Dr. Rojas's work may explain how HIV infection favors the development of TB disease.




Dr. Robert Salata received $1.7 million from Clinical Research Management/NIH to begin a study entitled "A Two-Part Phase I Study to Establish and Compare the Safety and Local Tolerability of Two Nasal Formulations of XF-73 for Decolonization of Staphylococcus Aureus: A Previously Investigated 0.5 mg/g Viscosified Gel Formulation Versus A Modified Formulation."

In addition, Dr. Salata's work appeared in multiple journals. Among his recent publications are Risk Factors for Chronic Kidney Disease in a Large Cohort of HIV-1 Infected Individuals Initiating Antiretroviral Therapy in Routine Care in AIDS; Current Concepts on the Virulence Mechanisms of Methicillin-Resistant Staphylococcus Aureus in Journal of Medical Microbiology; Measuring HIV Self-Management in Women Living with HIV/AIDS: A Psychometric Evaluation Study of the HIV Self-Management Scale in Journal of Acquired Immune Deficiency Syndromes.

Under Dr. Robert Salata's leadership the Infectious Disease Alliance had its first summer training program for Peer Educators in the Glenville neighborhood of Cleveland, who were comprised of nine high school students from across Cleveland. They received formalized training in sexual health and sexually transmitted infection prevention and will adapt what they have learned for their peers by participating in ongoing service learning opportunities during the school year, including developing a Peer Educator-led public health campaign, shadowing at local health clinics, and facilitating presentations for other youth organizations. In addition, the ID Alliance has partnered with Glenville High School and this fall will begin teaching a cadre of 10th graders about sexual health and STI prevention once weekly as part of the standard Healthcare I curriculum.


Marion S. Skalweit, PhD, MD

Dr. Marion Skalweit was awarded a 2012 VA VISN 10 Research Council grant in the amount of $10,000 for her project entitled "Mutations in Acinetobacter Beta-Lactamases That Enhance Susceptibility to Sulfone Inhibitors."

In addition, Dr. Skaweit has been actively publishing articles on beta-lactamases and antibiotic resistance. Her latest publications include: The Importance of the Trans-Enamine Intermediate as a Beta-Lactamase Inhibition Strategy Probed in Inhibitor Resistant SHV Beta-Lactamase Variants in ChemMedChem; Substitutions at the 105 Position Cause Inhibitor Resistance in SHV Family Beta-Lactamase in Antimicrobial Agents and Chemotherapeutics.

Dr. Usha Stiefel's proposal entitled "Role of Microbial Eradication in Preventing Recurrent MRSA Infection" was selected for a 2012 ASPIRE Award. The ASPIRE Awards in Antibacterial Research are competitive, externally reviewed grant awards sponsored by Pfizer, Inc. Dr. Stiefel's project will evaluate the hypothesis that antimicrobials displaying superior rates of microbial eradication and superior rates of intestinal pathogen eradication will be associated with decreased rates of recurrent infection with methicillin-resistant Staphylococcus aureus (MRSA) in veteran patients.

Dr. Stiefel also received a $37,500 grant from Steris Corporation for her work entitled "Comparative Efficacies of Commonly Used Antibiotics in a Murine Model of Intestinal Colonization with MRSA."




Division of Pulmonary, Critical Care and Sleep Medicine

Dr. Reena Mehra received Women Faculty Of the School of Medicine Mid-Career Development Award and T. Franklin Williams Scholar (TFWS) Alumni Executive Leadership Award. Dr. Mehra has also been awarded the REACH for Commercialization Fellowship, funded by the National Science Foundation ADVANCE Grant which introduces female professionals to the multiple pathways toward entrepreneurship with the goal of extending the reach of their research. In addition, Dr. Mehra chaired a session on Arrythmogenesis and Cancer Disease in Sleep Disordered Breathing in San Francisco, CA and served as a Co-Chair at American Thoracic Society Scientific Symposium Poster Discussion on sleep disordered breathing and cardiovascular disease.


Dr. Robert Schilz became the Chair of the Education Committee for the Pulmonary Hypertension Association. PHA provides information to the public about the illness and acts as a support group for those with the disease.










Division of Rheumatology

Dr. Ali Askari has been named a Master of the American College of Rheumatology. This honor is bestowed upon a select few rheumatologists every year for their contributions in education, research and well-being of patients with rheumatic diseases.



department conferences & events

Medicine Grand Rounds

Location: Kulas Auditorium

Time: 12:00 - 1:00 p.m.

  • September 25 - "TB and Immunology: Why Should Clinicians Care?" by Henry Boom, MD
  • October 2 - "The History of the Department of Medicine" by Thomas Daniel, MD
  • October 9 - "Biomarkers for Coronary Heart Disease: Which One to Order, Why and When?" by Carl Orringer, MD
  • October 16 - "New Approaches in Surgical Treatment of the Spine" by David Hart, MD
  • October 23 - "Atril Fibrillation" by Albert Waldo, MD

Medicine Quality Summit: Moving Forward

Location: Corporate College East, 4400 Richmond Rd, Warrensville Heights

Date: Saturday, October 27, 2012

Time: 8:00 a.m. - 12:30 p.m.

To register click here or contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it



7:15 - 8:00 - Registration and Breakfast

8:00 - 8:10 - Introductions by Dr. Robert Salata

8:10 - 9:00 - Healthcare Reform: Improving the Healthcare World in Cleveland and Beyond by Dr. Barry Straube

9:00 - 9:20 - Family Centered Relationship Based Communication Guide by Jeffrey Beers RN, BSN, MA

9:30 - 10:30 & 10:45 - 11:45 -  Breakout Session (Physician Accountability: In the Public Eye; Pain: Healing it Without Feeling it; Communication and Miscommunication: Say What You Mean and Mean What You Say; The Patient Experience: The Good, the Bad and the Ugly)

12:00 - 12:30 - Wrap-up Plenary Summaries and Action Plans


CWRU School of Medicine designates this live activity for a maximum of 4.0 AMA PRA Category 1 Credits.

department leadership council minutes

Leadership Council

Dr. Walsh announced to the Council that his State of the Department Address will be Thursday, September 13, 2012 at 5:00 p.m. in the Wolstein Auditorium with a wine and cheese reception to follow.


Leadership Council

Dr. Walsh reviewed the current UHCMC hospital policies on faculty conflict of commitment.


Leadership Council

Dr. Walsh gave an update on the Harrington Project as well as the Harrington Award which is through the American Society of Clinical Investigation and will be an annual award.

Leadership Council

Dr. Walsh also updated the Council on the search for a Director of the Respiratory Health Institute. Two top candidates will be visiting in October. An advertisement has been placed for a Nephrology Section Chief at the Louis Stokes VAMC. In Geriatrics, Dr. Stefan Gravenstein will be starting in his role as the Associate Chief of the Geriatric Center for Academic Affairs in December.


Dr. Walsh distributed an example of a salary supplement plan for CWRU faculty salaries. The sample plan provides a supplement to a faculty member's salary when a certain level of external salary support is achieved. Additional discussion on a salary supplement plan will be an agenda item at the next Council meeting.

Leadership Council

Dr. Walsh announced that Dr. Debra Leizman has been appointed as the Director of Undergraduate Medical Education for the Department of Medicine. More information on Dr. Leizman and her new appointment will be available on the departmental web site in the near future.

Leadership Council

Dr. Armitage reviewed Basic Core 1 Rotation Evaluations (7/2011 - 6/2012) with the Council. Dr. Armitage also discussed changes in the Intern and Fellowship Recruitment processes.

Leadership CouncilDr. Walsh outlined the American Hospital Association's (AHA) Lifelong Learning program on Physician Competency Development. Improving healthcare delivery in the U.S. requires focusing on three areas: improving the patient experience of care; improving the health of the U.S. population and reducing per captia costs of healthcare. The AHA researched the following core competency areas for physicians: medical knowledge, patient care, practice-based learning, systems-based practice, professionalism, interpersonal and communications skills and use of informatics.

Leadership CouncilDr. Walsh presented information to the Council on "The Information-Driven Medical Enterprise: Maximizing Dashboard Utility to Elevate the Total Value of Care" documented by The Advisory Board Company. This information will be discussed in greater detail at the next Leadership Council meeting.

Leadership CouncilDr. Salata announced that the Department of Medicine Quality Summit will be held on Saturday, October 27th from 8:00 a.m. - 12:00 p.m. Four Risk Management Credits may be obtained by attending this summit and also CME credits will be available.