December 20, 1996

List of VUMC’s top storiesof 1996 a long, varied one

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The VUMC team that studied BRCA1's cancer-fighting properties. Front: Patty Obermiller, Kim Newsom, Marilyn Thompson, Ph.D. Back: Dr. Roy Jensen, Dr. Jeffrey Holt, Tom Jetton, Ph.D., Cheryl Robinson-Benion, Dr. David Page, Trena Brown and Riet Van Der Meer.

List of VUMC's top storiesof 1996 a long, varied one

In May, Dr. Robert Maciunas (left) and Dr. David Charles implanted a thalamic stimulator in patient Homer Edwards.  The breakthrough device helps patients suffering from Parkinson's disease dramatically increase control of muscular tremors.

In May, Dr. Robert Maciunas (left) and Dr. David Charles implanted a thalamic stimulator in patient Homer Edwards. The breakthrough device helps patients suffering from Parkinson's disease dramatically increase control of muscular tremors.

Graduation '96 was a family affair for Medical School Founder's Medalist Nova Ryder (right), who drew inspiration from her sister Vicky.

Graduation '96 was a family affair for Medical School Founder's Medalist Nova Ryder (right), who drew inspiration from her sister Vicky.

In November, Dr. Roscoe R. Robinson and his wife, Ann, greeted President Clinton.

In November, Dr. Roscoe R. Robinson and his wife, Ann, greeted President Clinton.

A report by VUMC's Office of Financial Management pegged the medical center's impact on the Middle Tennessee economy at $1.2 billion.

The bulk of this – $983 million – came from salaries and wages paid to VUMC faculty and staff. Using the U.S. Department of Commerce's analysis of health care services and their impact on local economies, 40 jobs are created for every $1 million of direct salaries paid. Based on this model, VUMC created 17,307 jobs for the local economy, in addition to employing more than 9,000 faculty and staff.

VUMC continues to provide millions of dollars in uncompensated care to Middle Tennesseans. According to the report, VUMC provided $29 million in uncompensated care during fiscal year 1996.

VUMC's Lung Transplant Program gained approval for Medicare coverage, the final link in making all of the medical center's Transplant Center programs Medicare-approved.

Single-lung, double-lung and heart-lung transplants are all now covered under the federal program. Only nine other lung transplant centers in the United States have Medicare approval, with the VUMC program being the largest and most active in Tennessee.

Also this year, the liver transplant program signed a $5.3 million contract with the Veteran's Administration to perform 36 liver transplants over the next three years.

Nursing school additions.

Roxane Spitzer, R.N., B.S.N., joined the School of Nursing as associate dean of Practice Management and professor of the Practice of Nursing.

In addition to her nursing degrees, Spitzer has an M.B.A. and a Ph.D. in management, a background which serves her well in her new position.

Also, Gail L. Ingersoll, Ed.D., R.N., was named Julia Eleanor Chenault Professor of Nursing and associate dean for Research, completing the School of Nursing's management structure.

In her position, Ingersoll will be responsible for overseeing the research mission of the school.

VUMC teamed with the state of Tennessee's long-term care division to offer the state's TennCare-eligible elderly and disabled a Home- and Community-based service program as an alternative to nursing home placement in Davidson County.

The program is administered by Vanderbilt Home Care Services in cooperation with the state and Nashville's Senior Citizens Inc. The program received a three-year federal- and state-funded grant to offer the program to persons eligible for TennCare and who also meet the criteria for level-one nursing home admission.

Strong genes:

VUMC landed a four-year, $2.4 million grant from the Howard Hughes Medical Institute to strengthen the institution's programs in genetics.

The funds are being used to recruit several new faculty members in the field of mammalian genetics and to establish or reinforce core resources for researchers working in genetics, said Joel G. Hardman, Ph.D., associate vice chancellor for Health Affairs.

"The grant from the Howard Hughes Medical Institute is an important component of a broader initiative in mammalian genetics being undertaken by this institution."

In a move aimed at keeping up with the rapidly changing health care environment and the trend toward treating more patients outside of the hospital setting, VUMC began requiring all fourth-year medical students to complete a Primary Care Ambulatory Medicine Clerkship.

The rotation, optional before this year, allows students to choose between pediatrics or internal medicine, where they spend time working one-on-one with both full-time faculty and community physicians.

Stahlman honored:

Dr. Mildred T. Stahlman, professor of Pediatrics and Pathology, received the 1996 John Howland Award from the American Pediatric Society, the society's highest award.

Stahlman, who has spent her entire academic and professional career at Vanderbilt, is best known for beginning the first newborn intensive care unit in the country to use respiratory therapy on infants with damaged lungs. She also initiated the Angel transport program, Vanderbilt's mobile intensive care unit.


The Vanderbilt Breast Center began a new service to assist women who believe they are at high risk for developing breast cancer.

The program, the Breast Cancer Risk Consultation Service, helps put cancer risk in general – and inherited risk in particular – in perspective through counseling and education, including the use of genetic testing when warranted.

BRCA 1 breakthrough

National attention focused on VUMC after investigators uncovered the first direct evidence suggesting that the gene known to cause hereditary forms of breast and ovarian cancers can also halt and – in some cases – reverse these deadly diseases.

Two separate but related studies demonstrated that the normal forms of the cancer-causing gene BRCA1 may be as effective at suppression development of breast and ovarian cancer as its mutant form is at causing it.

"We now have an obvious approach to treating these cancers," said Dr. Jeffrey T. Holt, associate professor of Cell Biology and senior author of one of the studies. "We can see the light at the end of the tunnel."

VUSM ranks high:

Nine physicians at Vanderbilt University Medical Center were named among the best doctors in America by two separate national magazines.

Good Housekeeping and American Health conducted two separate surveys where physicians across the country were asked to review their peers. More than 3,000 physicians contributed to the comprehensive and objective surveys. One VUMC doctor was named in both surveys.

The Vanderbilt specialists were the only physicians in the region named in the surveys. They are: Drs. Harvey W. Bender Jr., Gottlieb C. Friesinger II, Donald M. Gass, Thomas P. Graham Jr., Neil E. Green, David H. Johnson, John N. Lukens Jr., James A. O'Neill Jr. and Robert H. Ossoff.

Vanderbilt University School of Medicine was ranked among the nation's elite programs in medicine by U.S. News & World Report.

The School of Medicine ranked 14th out of the nation's 125 medical schools.


VUMC became the only medical center in the Southeast to offer an ambulatory detoxification center in The Vanderbilt Clinic for Pharmacological Treatment for Addiction.

The clinic offers screening, assessment and treatment of individuals who have developed substance dependence and who are at risk for significant withdrawal symptoms.

Strategic plan for academic enterprise:

Vanderbilt University Medical Center officials began the process of creating a strategic plan in support of the academic enterprise of the School of Medicine.

The initiative – related in spirit to the institution's strategic vision plan addressing the changing environment in health care delivery – will better position VUMC to take advantage of future advances in the generation and acquisition of new knowledge, officials say.

The institution-based strategic plan for academic enterprise will play an important role in supporting VUMC's primary goals of research, education and patient care, and during the coming years will serve as a road map of where the institution will go and how it will get there, said Dr. John E. Chapman, Dean of the School of Medicine.

"As we enter an era of special emphasis on change in clinical service, the academic enterprise must not only enhance our service capability, it must explain it, make it optimally functional and develop it through special initiative and enterprise."

Inigami honored:

Tadashi Inagami, Ph.D., Stanford Moore Professor of Biochemistry, received one of eight annual awards given by the Japan Academy, that nation's equivalent of the United States National Academy of Sciences.

The Japan Academy award recognized Inagami's work on renin and angiotensin, key components in hypertension and remodeling of cardiac and vascular tissues and major targets in hypertension therapy. The enzyme renin is the key enzyme that regulates the generation of the peptide hormone angiotensin, which has many effects on the cardiovascular system, working toward the retention of salt, elevation of blood pressure and the degeneration of the kidneys, blood vessels and the heart.

Inagami discovered the biochemical mechanism by which renin works and cloned receptors for angiotensin.


In May VUMC debuted 11 new labor/delivery/recovery suites that feature numerous amenities.

The stylish suites, which provide the safety of a hospital-based birth in a home-like environment, are located in four-Soth, previously occupied of the postpartum unit, and bring the total number of LDR units to 14.


More than 300 of the world's leaders in the study of embryonic development – the process in which the egg divides into a multicellular embryo and cells become specialized – gathered at VUMC for the 1996 national meeting of the Society for Developmental Biology.

They discussed the latest knowledge of embryo research, the evolution of developmental mechanisms, signaling and patterning mechanisms of genes and gene products and other topics concerning the genetic control of development.

New imaging technology:

VUMC unveiled its new imaging technology. Coincidence imaging and Single Photon Emission Computed Tomography (SPECT) on a non-PET camera using positron emitting isotopes was designed by VUMC researchers in collaboration with an Israel-based nuclear imaging company.

The technology produces images that rival the quality of those created by Positron Emission Tomography (PET) alone – but at a fraction of the price.

"We've had a PET camera since 1988, and even though the information is useful, it is very expensive," said Dr. Martin P. Sandler, professor and vice-chairman of Radiology and Radiological Sciences.

"Now, with SPECT/PET, we have created comparable technology on a much more versatile system."

Hospitals' integration halted:

Vanderbilt and Saint Thomas hospitals agreed not to pursue a full integration of their hospitals, but the two remain active partners, along with Baptist Hospital, in the Middle Tennessee Healthcare Group, a regional networking alliance.

The hospitals share many faculty, and Vanderbilt residents continue to train and see patients at Saint Thomas. That will not change. Saint Thomas and Veterans Administration Medical Center will continue as affiliated teaching hospitals of the Vanderbilt University School of Medicine.

Primary caring:

In August, VUMC opened Primary Care Services at Madison, the second community-based nurse-practitioner clinic of the Vanderbilt School of Nursing.

The new clinic was designed as a way for those who look to the Veterans Administration system for routine care to get that care closer to home. The clinic will also provide primary care services to all Madison residents. The new clinic joins the other Nursing School primary care site in the Vine Hill Community.


Vanderbilt University Medical Center strengthened its commitment to providing high quality health care throughout the region by affiliating with Nashville-based Midsouth Independent Practice Association Inc.

The agreement gives VUMC a partnership with Midsouth's 254 primary care and specialist physicians in counties surrounding Nashville, said Dr. James K. Geraughty, associate vice chancellor for Health Affairs.

"It ensures that patients and physicians in these communities will continue to have access to Vanderbilt's broad range of health care services."

Vanderbilt University Medical Center acquired MedCore Medical Group, an 11-member physician group practice located in Franklin, Tenn.

The move increases Williamson County residents' access to VUMC's broad range of health care services and allows VUMC to expand its geographic coverage and augment its network of primary care physicians. VUMC and MedCore had been affiliated since December, 1994.


Vanderbilt University Medical Center chose Birmingham, Ala.-based Lewis Advertising to aid the institution in its plan to enhance its regional marketing and advertising.

The agency's task will be to help devise strategies to market the Vanderbilt Medical Group to the Middle Tennessee region, said Dr. John S. Sergent, professor of Medicine and Chief Medical Officer of Vanderbilt Medical Group. The VMG is the state's largest multi-specialty group practice located at one health care institution, and is one of the largest in the Southeast.

Primary care gets new home:

Vanderbilt's new Adult Primary Care Center opened in September on the seventh floor of Medical Center East.

The new center will be staffed by 22 physicians from VUMC's division of General Internal Medicine and the Wilson Medical Group. As part of the relocation from space at The Vanderbilt Clinic, the Division of General Internal Medicine will change its clinical practice name to Vanderbilt Internal Medicine Associates.

The new Adult Primary Care Center at Vanderbilt will dramatically increase VUMC's primary care efforts while at the same time benefiting patients with improved service capabilities, said Dr. James P. Wilson, associate professor of Medicine and Director of Adult Primary Care.

Finding the path:

Vanderbilt University Medical Center faculty and staff got a glimpse of the future at a series of meetings in October outlining the institution's strategic direction.

The meetings marked the kickoff of "The Year of the Pathfinder," a year's worth of activities designed to highlight VUMC's strategies for leading the way through the rough terrain of today's health care environment.

The key goals of VUMC's strategy are to maintain and strengthen the three core areas of research, education and patient care while at the same time working to be recognized as a market leader in delivering quality health care and responding to managed care, Robinson said.

To accomplish these goals and steer the institution down the proper path, VUMC has taken, or is planning to take, several steps.

€ A new advertising and marketing campaign will get under way during the first quarter of 1997; the campaign will drive home the message that Vanderbilt, through the Vanderbilt Medical Group, is a source for quality health care in the Middle Tennessee region.

€ Since February, 13 contracts have been signed with managed care organizations to provide health care for their patients.

€ Culture change continues and several teams are currently involved in the reorganization of The Vanderbilt Clinic.

€ The rate at which research grant applications by VUMC scientists are being awarded has remained constant, which runs against current national trends. Currently, one out of every three grant applications leads to an award, which puts VUMC among the top 25 institutions receiving National Institutes of Health funds.

€ Cost control measures at Vanderbilt University Hospital have produced dramatic results.

€ The School of Medicine is making changes in its curriculum to reflect the prominence of managed care and the need for more primary care physicians. These changes include a family practice rotation. The goal is to produce health care professionals that blend the finest health care education with the business practices that exist in today's health care marketplace.

€ The Vanderbilt University School of Nursing's strategies for the future also reflect the realities of the health care marketplace; its production of advanced nurse practitioners has facilitated the opening of two primary care sites in the Nashville area during the last year, and will continue to develop partnerships with physicians to facilitate the school's mission.

€ Networking will continue to be a major focus of VUMC; the task will be to package the medical center and market it to today's buyers of health care services. Primary care services will be expanded to make VUMC more attractive to the managed care organizations in the area.

€ Even amid the atmosphere of cost-containment, VUMC will continue to invest in its infrastructure to keep the institution at the forefront of research and patient care. Currently, work is under way to expand the Capers Avenue garage, which will include an addition of space for family medicine.

Students at Vanderbilt University School of Medicine are more pleased with their medical education than are students at the other 124 medical schools across the United States, according to a recent national survey.

This information comes from the Association of American Medical Colleges' 1995 Graduation Questionnaire – known as the GQ – given to all graduating medical students in the country.

The question asked was "Overall, how satisfied are you with the quality of your medical education?"

And 83.2 percent of the 1995 VUSM graduates reported they were "very satisfied" with their medical education.

William W. (Bill) Franklin, 52, executive director of Development for Vanderbilt University Medical Center, died Oct. 11 from injuries sustained in a car accident. He had been visiting a physician in LaGrange, Ga., on business for VUMC, and was returning to the airport when the car he was driving collided with another on U.S. Hwy. 29.

Dr. Roscoe R. Robinson, Vice-Chancellor for Health Affairs at VUMC, said Franklin will be missed as both a colleague and a friend.

"Bill's unexpected departure is a great personal and professional loss for me and leaves a major void at Vanderbilt University Medical Center," Robinson said. "As executive director of Medical Center Development he did so much more than raise funds for medical research and medical education. No one associated with Vanderbilt University Medical Center, past or present, has had a greater commitment to its success than Bill Franklin."

Franklin came to VUMC in December 1989 from Millsaps College in Jackson, Miss., where he had served as vice president for development for the previous 10 years.

Franklin is survived by his wife, Madge, and stepchildren, Michael Columbus of Louisville, Ky., and Daniel Columbus of Memphis.

Business operations consolidated:

Vanderbilt University Medical Center bolstered its commitment to networking and business development with the formation of Vanderbilt Health Services (VHS).

The new operating unit brings together several different networking and business functions currently housed in various locations across the medical center and centralizes them in one office on the 17th floor of the Palmer Plaza office building on West End Avenue.

"There was a need to consolidate these business activities and house them in one location. We are bringing a number of diverse elements together," said Dr. James K. Geraughty, associate vice chancellor for Health Affairs.

The mission of VHS will encompass such activities as managed care operations and contracting, physician practice development and affiliations, strategic alliances with other non-profit health care entities, primary care networking, business development, sales and customer service.

Presidential visit:

President Clinton and Vice President Gore visited VUMC in early November to honor the medical center's WorkStart Program. This initiative provides job training to people on welfare and helps match them with positions throughout the medical center.