Newsletter Summer 2014

This e-mail address is being protected from spambots. You need JavaScript enabled to view it >
Department of Medicine eNewsletter
Summer 2014
:: Interview
:: Department News
:: Department Events
:: Leadership Council Minutes
U.S. News & World Report Rankings

The Department of Medicine is proud that seven of its divisions are ranked among 50 top hospitals in the nation. We thank our faculty who are committed to providing the highest quality of care to all patients.

#14 Gastroenterology
#18 Cancer
#22 Cardiology
#28 Geriatrics
#29 Nephrology
#36 Pulmonology
#38 Endocrinology
Leadership Council
July 2014
Richard Walsh

B. Arafah

K. Armitage

A. Askari

R. Chandra

F. Cominelli

S. Gravenstein

D. Hricik

M. Jain

N. Meropol

R. Salata

R. Schilz

D. Simon

U. Stiefel

R. Walsh


Recorded by:
A. Staruch
Stay connected
and up-to-date
with department
conferences and events
by signing up for the following tools:

Department of Medicine YouTubeDepartment of Medicine LinkedinDepartment of Medicine Facebook
Welcome to the Department of Medicine Agre Society
department interview
Ali Askari, MD, Division Chief of Rheumatology, talks about the division's strategic goals, discusses the influence of high-tech biologics on rheumatoid arthritis and projects the future of rheumatology as a specialty and its appeal to graduating residents.



What are the strategic plans of the Division of Rheumatology?


Over the past few years we have established a prominent name and reputation for treating clinical arthritis in the community. Right now we have such a high demand for rheumatologic care, that we must create very heavy patient schedules as it obviously takes such an effort for our faculty to fulfill the demand. In order to meet the mission of the hospital and department, we need to hire more rheumatologists to cover our clinical practice. In addition, we would like to have our research centralized and enhanced in the areas of immunology, inflammation and rheumatology.


You have largely concentrated your personal research on Sjögren's syndrome. Where does your research stand now and how do you see it advancing further?


In 2002, we found the pathologic basis of this disease represented in every organ system of the human body. In the past, we have also reported on Sjögren's syndrome mimicking lymphoma and malignancy. In general there has not been much development in terms of treatment of this disease. We have come up with the system of care to decrease the dryness and treat the complications of the syndrome, but we have yet to identify the mechanism that underpins the disease.


As for the present time, we are developing a considerable database and just received an IRB to report on different aspects of a large cohort of patients with Sjögren's syndrome. With the help of this database, we are looking to identify the extent of lymphoma and malignancy as well as major causes of death in patients with Sjögren's syndrome. The goal is to narrow down the underlying causes before the disease evolves into cancer and develop an effective treatment for it.


Has your collaboration with the School of Dental Medicine been successful?


Our collaboration with the School of Dental Medicine ended up being a truly pioneer work because we discovered that people with rheumatoid arthritis have a worsening of the disease due to periodontitis. We have proven that the treatment for rheumatoid would help periodontitis and, conversely, when periodontitis is treated, rheumatoid arthritis gets better. One of the treatments for rheumatoid arthritis, i.e., anti-tumor necrosis factor, appeared to be helpful for the treatment of periodontitis as well. One of our former students, who is now located in Houston, TX, and participated in this research project, is actively trying to get the molecular substances to use locally in periodontitis.

As for the relationship between dental medicine and Sjögren's syndrome, it has been already proven the association of gum disease and periodontitis. Sjögren's syndrome causes cavities mainly because of the mouth's dryness.


How have high-tech biologics influenced the treatment of rheumatoid arthritis?


They have revolutionized the treatment of rheumatoid arthritis. So many biologics, each for a specific target, are currently being developed. Since 1991, when first specific anti-tumor necrosis factor was available for treatment, we are seeing less deforming rheumatoid arthritis and happier patients with less pain and misery.


There seems to be a concern developing over the shortage of rheumatologists in the country with the majority of residents pursuing fellowships in cardiology, oncology or gastroenterology. How do you see rheumatology developing as a specialty over the next few years?


The country needs at least 10,000 rheumatologists to serve the population. Currently we have a little over 5,000 rheumatologists. Here, in the Department of Medicine, we have been very lucky to grow the rheumatology fellowship program; we are currently training six fellows with three graduating every year. Our program is also one of the top programs nationally; just this past year we received over 80 applications for four fellowship positions we had available. If you look at the country as a whole though, we are only graduating 100-120 rheumatologists a year.


Indeed, we are not answering the population's demand, as more people will be insured and want to be taken care of over the next few years. In fact, it is estimated that by 2025 there will be a shortage of at least 2,000-3,000 rheumatologists.


What will be the hot topics of rheumatology over the next 10 - 15 years? What developments are you envisioning for the specialty?


We are moving toward developing more target treatments. In the old days, we just gave a blanket treatment for everything; we have now embraced a new way of thinking and I believe this trend will continue. According to CDC, one of every three individuals has some kind of rheumatic disease, so nationally there is a great need to provide targeted therapies. Though the generation of baby boomers is aging, we should also note that rheumatoid arthritis, lupus, and Sjögren's syndrome are the diseases of young generations as well as older generations.

department interview
Robert Jenkins, Division Manager of Cardiovascular Medicine, is retiring this summer. Before leaving, Mr. Jenkins looks back on his work with the division, highlights his most proud accomplishments and shares his thoughts on future plans.


What separates the Division of Cardiovascular Medicine from other divisions in the Department of Medicine? What are the unique aspects of managing it?


First and foremost, the Division of Cardiovascular Medicine has a high degree of complexity when it comes to managing all the relationships among University Hospitals and its system hospitals, the School of Medicine and Case Western Reserve University and the Louis Stokes Cleveland VA Medical Center. When I first joined the division in January 2000, it was called the Division of Cardiology and it was primarily clinically focused. The division still had the educational component and prominent fellowship programs, but it was nowhere near the size of the programs we have in place today; in addition, we had a far less robust research platform. When Daniel Simon, MD, came in 2006 and brought 16 clinicians and researchers from Boston, we became the Division of Cardiovascular Medicine. At that point, the division included all phases of cardiology and vascular medicine. A new service line was established including cardiovascular medicine, cardiac surgery and vascular surgery. This service line integrates all medical and surgical divisions under one service line model and provides us the opportunity to offer a broader range of services utilizing our diverse faculty appropriately. The level of complexity grew even more with the inception of University Hospitals Harrington Heart & Vascular Institute in 2007. Under the direction of Dr. Simon, the institute delivers services in 25 locations in Northeast Ohio. This new institute model has added an unprecedented level of responsibility to meet the needs of systemwide hospitals in addition to the academic medical center activities. Finally, the large number of faculty separates us from other divisions of the department. When I first came here, we had 28 faculty members; we now have 55.


How did you start your career in the medical setting?


I have a master's degree in hospital administration from the University of Minnesota. I first worked in small- and medium-size community hospitals for eight years. I relocated to Northeast Ohio in 1989 and was working for a contract organization to manage a mental health program, which facilitated my transition toward practice management. I started my UH career as a business manager for University Hospitals primary care practices in 1998. Subsequently, in January 2000, I had the opportunity to become the Division Manager of Cardiology. I have been with University Hospitals for over 16 years.


What were your most notable accomplishments during your work with the Cardiovascular Medicine Division?


I have always viewed my job as a business manager for all faculty members of the division. Part of that foundation includes working with faculty members to support them as effective individual business units. When I first came onboard, there were a lot of things that needed to be streamlined and updated in the infrastructure. Some faculty were more involved in research and needed to have grant funding, while others were more involved in clinical practice and required different support mechanisms. We put together a formal model to provide the proper foundation and support for each faculty member to be successful in his or her respective line of endeavor. This basic model is still in place. It has served us well in the growth of our division. It is very gratifying to be able to create collaborative relationships with people in the workplace.


Did the decision to retire come easy to you?


I was originally planning to retire at the age of 62. My wife and I are retiring together and we find that we do not have the same stamina and energy level that we used to. We decided it was best to retire at the top of our game while our health is good and we still have enough energy to enjoy life and spend more time with each other.


What are your plans for the retirement?


My wife and I have some travel plans set up. We are taking a Road Scholar trip to central Europe at the end of September to visit Krakow, Poland; Budapest, Hungary; Vienna, Austria; and Prague, Czech Republic. This program is primarily focused on exploring the art and architecture of each city. During our first full week of retirement, Linda and I will be going to the Shakespeare seminar in Stratford, Ontario, to see eight plays in five days, five of the productions are Shakespeare plays. Finally, both of our sons are getting married soon, so we are planning to spend some time together as a family. I also like the thought that I will have flexible time to relax a bit.

What do you think you will miss most about working in the Division of Cardiovascular Medicine?


I will definitely miss the people. It is extremely stimulating to work in an environment that consists of people making leading-edge discoveries and implementing novel treatment techniques. I also plan on continuing my association with UH through volunteer opportunities after I get some initial rest. I still would like to do some community service that will help me engage with people in a fun and constructive way while maintaining my long-term relationship with the organization.


The Division of Cardiovascular Medicine's new Manager is Dick Ingersoll. Click here to view Mr. Ingersoll's profile.
The department news report

Division of General Internal Medicine & Geriatrics

Hiloni Bhavsar, MD, joined the Internal Medicine Residency program as a new Associate Director.










Karen Horowitz, MD, became the editor of the Society of General Internal Medicine Forum.










Attila Nemeth, MD, became the Chair of the Innovation Review Committee for the 2014 Society of General Internal Medicine Midwest Conference.





Division of Hematology & Oncology


Michael Gibson, MD, received 2014 NCI Cancer Clinical Investigator Team Leadership award from the National Cancer Institute. This award recognizes clinical investigators at cancer centers who serve many critical roles in support of development, activation, monitoring, accrual, and analysis for institutional and multicenter clinical trials.



Neal Meropol, MD,
was honored as a Fellow during the opening session of the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago. Dr. Meropol's designation of a Fellow is a recognition of his extraordinary service, dedication and commitment to ASCO.

Evi Stavrou, MD,
was recognized as the top educator by the fellows of the Division of Hematology & Oncology. The award is a tribute to Dr. Stavrou's depth of commitment to teaching excellence.

Schedule a clinical appointment with Hematology & Oncology physicians


department conferences & events

Grand Rounds

When: Tuesdays, 12:00 - 1:00 p.m.

Where: Kulas Auditorium, Lakeside, 5th Floor


September 9

"APOL1 Gene and African American Susceptibility to CKDF" by John Sedor, MD


September 16

"What Superutilizers Teach Us About Care Transitions" by Stefan Gravenstein, MD


September 23

"Landmark 21st Century Clinical Trials in the Treatment of Atrial Fibriallation: Lessons Learned" by Albert Waldo, MD


September 30

"Multidrug Resistant Bacterial Infections: A Global and Local Scourge" by Robert Bonomo, MD




Morbidity and Mortality Conferences

When: Fridays, 12:00 - 1:00 p.m.

Where: Kulas Auditorium, Lakeside, 5th Floor

August 29
A 45-year-old man with non-ischemic cardiomyopathy underwent an ICD lead revision complicated by right ventricular perforation.

September 5
A 30-year-old woman with a history of chronic abdominal pain presents with multiple admissions for pain management.

September 12
A 57-year-old woman with complex cardiac history is admitted for shortness of breath and found to have an aggressive leukemia with a complex hospital course.

Intern Welcome Dinner 2014
This year, our intern class spent a great night at Shoreby Club, enjoying food and drinks, taking in the scenic Lake Erie view, laughing and bonding.

department leadership council minutes

Leadership Council

Dr. Walsh announced that there will be a second UH Leadership Academy beginning this fall. From the Department of Medicine, Dr. Matthew Cooney, Division of Hematology & Oncology, has been selected to attend. The hospital is also in the process of forming a CEO Advisory Group which will include faculty who have been through the UH Leadership Academy.


Leadership Council

Dr. Walsh updated the council members on the following chair searches: Department of Family Medicine, Search Committee chaired by Dr. Michael Konstan; Department of Urology, Search Committee chaired by Dr. Cliff Megerian; and Department of Surgery, Search Committee chaired by Dr. Warren Selman. Dr. Walsh also updated the council on the search for the position of Director of the Respiratory Health Institute and Division Chief of Pulmonary, Critical Care and Sleep Medicine.



Leadership Council

Dr. Walsh reminded the council members to encourage their faculty to attend a meeting of the full-time faculty of the Department of Medicine regarding the Physician Engagement Survey.


Leadership Council

Dr. Walsh distributed and reviewed information from the University Hospitals 2014 Press Ganey Physician Survey.



Dr. Walsh thanked all leadership members for their participation in the External Review of the Department of Medicine. Dr. Walsh will share the External Review report with the Leadership Council after he receives it.



Leadership Council

Dr. Jain reviewed the process for ASCI nominations. Dr. Walsh encouraged the Division Chiefs to nominate faculty who meet the criteria for ASCI membership.



Leadership Council

Dr. Walsh updated the council members on issues at the Louis Stokes Cleveland VA Medical Center.


Leadership Council

Dr. Armitage discussed delivery of and feedback on attending teaching evaluations.


Leadership Council There will not be an August Leadership Council meeting. The next Leadership Council meeting will be held Monday, September 8.


Among the nation's leading academic medical centers, University Hospitals Case Medical Center is the primary affiliate of Case Western Reserve University School of Medicine, a nationally recognized leader in medical research and education.