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January 6, 2012

Table of contents

Message from Paul Ramsey

Paul G. Ramsey

UW Medicine ready to build on 2011 gains in advancing healthcare

Dear Colleagues:

In a recent address, Donald Berwick, former administrator of the Centers for Medicare & Medicaid Services, said, “I have never seen, nor had I dared hope to see, an era in American healthcare when there is more possible than this very moment. The signs are everywhere.” I could not agree more. We are in a period of intensive focus on achieving top-quality healthcare that is safe, effective and efficient. We are also in an era in which scientific research is producing extraordinary results. New treatments are turning terminal diseases into chronic conditions. As a result, people will live better lives.

UW Medicine faculty, staff and trainees have led a number of these accomplishments that advance healthcare. I would like to focus for a moment on how we can build and expand upon these gains in 2012.

In 2011, UW Medicine strategic planning resulted in substantial progress in multiple priority areas: delivering high-quality, safe and cost-effective care, building networks and affiliations, building key clinical programs, and enhancing support for research, teaching and patient care.

In clinical care, this work focused on putting our patients first as we continued to improve our services to the community. Valley Medical Center, part of UW Medicine since July 2011, has added an outstanding team of healthcare professionals to our system. The UW Neighborhood Ravenna Clinic, which opened in September 2011, is already a vibrant and vital part of the community. Our orthopedic joint replacement and midwife programs moved to Northwest Hospital and plans to move the multiple sclerosis program to Northwest in 2012 progressed smoothly. The UW Medicine Board Patient Safety and Quality Committee is fully operational. These are a few examples of the many gains made over the past year and areas for further progress in 2012.

These achievements are the result of sustained effort and efficient, collaborative teamwork. It will be important to continue to work efficiently and effectively together in 2012 and to lead healthcare improvements under the Affordable Care Act. With the assistance of the Chartis Group and under Johnese Spisso’s excellent leadership, a large team is preparing UW Medicine as an Accountable Care Organization, with reimbursement tied to quality, safety, efficiency and effectiveness. As the largest health system in our service area, UW Medicine should continue to model and lead the changes that improve health for our community.

Thoughtful strategic planning and effective teamwork will also be critical for the ongoing excellence of our teaching and research activities. While UW Medicine is financially stable, challenges remain. In 2012, we will face further state funding reductions that will further challenge our educational programs. The completion of American Recovery and Reinvestment Act (ARRA) grants requires identification of new research funding for some outstanding programs. New areas of strategic planning in 2012 will focus on enhancing the quality and impact of UW Medicine teaching and research activities despite budget challenges. I look forward to involving many of you in these efforts over the coming months.

In 2011, our clinical programs focused on putting our patients first, our educational programs emphasized improving active learning for our students and trainees, and our research programs developed new approaches to improving diagnosis, treatment and prevention of human diseases. The excellence of these academic activities contributes substantially to improving health for all people.

Thank you for your outstanding work and commitment. I look forward to working with you in 2012 and continuing the remarkable progress made in 2011.


PGRamsey Signature2


Paul G. Ramsey, M.D.
CEO, UW Medicine
Executive Vice President for Medical Affairs and
Dean of the School of Medicine,
University of Washington




UW study reports evidence of structural brain changes in diet-induced obesity

Michael SchwartzMichael W. Schwartz, UW professor of medicine, is senior author of a paper reporting the first evidence of structural change in the brain in both animal models and humans that may help to explain one of the most vexing problems of body weight control in humans.

The paper entitled “Obesity Is Associated with Hypothalmic Injury in Rodents and Humans” was published in the Jan. 3 issue of the Journal of Clinical Investigation.

The well-established tendency to regain weight lost through dieting and exercise is the single largest obstacle to successful obesity treatment. Body weight is controlled by complex interactions between hormones and neurons in a brain area known as the hypothalamus that influence appetite and food intake and that, in most obese people, conspire to prevent permanent weight loss.

“Obese individuals,” said Schwartz, “are biologically defending their elevated body weight.” The mechanism for this phenomenon is the object of intense investigation by neuroendocrinologists.

Schwartz said, “To explain a biologically elevated body weight ‘set-point,’ investigators in the field have speculated about the existence of fundamental changes to brain neurocircuits that control energy balance. Our findings are the first to offer direct evidence of such a structural change, and they include evidence in humans as well as in mice and rats.”

His group studied the results of a high-fat diet in the brains of mice and rats that were bred to become obese on this diet. They found evidence of very early and lasting injury to a specific part of the hypothalamus in these animals. Using brain imaging, they also found signs of similar damage in the same area of the brain in obese humans.

Schwartz holds the Robert H. Williams Endowed Chair in Medicine in the Division of Metabolism, Endocrinology and Nutrition. He is head of the Section of Clinical Nutrition and founding director of the UW Medicine Diabetes and Obesity Center of Excellence.

Read more in UW Today.


Study finds superior drug combo for difficult-to-control epilepsy

Nicholas PoolosA combination of two common drugs, lamotrigine and valproate, is more effective in treating difficult-to control epilepsy than other anti-epileptic regimens, according to a University of Washington study published Jan. 3 in Neurology, the journal of the American Academy of Neurology.

In a large-scale, retrospective study of a population of patients with very difficult-to-control epilepsy, researchers discovered that only the lamotrigine/valproate treatment regimen, out of 32 drug combinations studied, significantly decreased seizure frequency in this group.

This specific combination reduced seizure frequency by about half, on average, compared to other regimens. Although it rarely produced complete freedom from seizures, the combination was superior to others in reducing the number of convulsive seizures patients experienced.

Nicholas Poolos, neurologist at the UW Medicine Regional Epilepsy Center and associate professor of neurology, led a retrospective study to find drug combinations that reduce seizure frequency in hard-to-treat epilepsy. Poolos led the project team of pharmacists and a neurobiologist.

Poolos explained that most people with epilepsy have good control of seizures, which means that they have been seizure-free for at least 12 consecutive months. About one third of people with epilepsy are "medically refractory." They continue to have seizures, despite trying several drug combinations prescribed by their physicians.

Physicians have had little evidence to guide them on which drugs or drug combinations, from a multitude of possibilities, might be of most help for patients with difficult-to-treat epilepsy. This long-standing clinical challenge was the impetus for Poolos and his team to conduct a major study, the first of its size and kind to look retrospectively at patients treated for refractory epilepsy.

The researchers determined that out of 32 most frequently used combinations of anti-epileptic drugs, only the lamotrigine and valproate combination had superior efficacy, compared to an aggregate measure of other drug regimens to which the patients had been exposed, as well as comparisons with other anti-epileptic drug combinations. The researchers looked at both older and newer generation drugs.

"The study results dispel the dogma that all drug treatments are equally ineffective for this patient population," Poolos said, "and provide evidence for future, prospective drug trials."

Read more in UW Today.


Clinical Care

Valley Medical Center trustee board now complete

In the strategic alliance between Valley Medical Center and UW Medicine, the appointment of the final three trustees to oversee the operations of Valley Medical and its clinics has been completed.

The newly appointed trustees are two former commissioners for Public Hospital District No. 1, Don Jacobson and Gary Kohlwes, both of Renton, and Barbara Fletcher of Newcastle, a retired executive of the Weyerhaeuser Co. The three will join Julia Patterson of SeaTac, a member of the King County Council, and Bernadene Dochnahl of Renton as the five trustees who represent the district service area.

“The three final appointees to the Valley Medical Center Board bring a great depth of knowledge and passion for improving the health of the community,” said Paul Ramsey, chief executive officer, UW Medicine, in a press release.

“All have served the south King County community through their volunteer efforts and we all look forward to having them join the newly configured Valley Medical Center Board,” said Ramsey, who made the appointments.

Read more about the announcement at Renton Reporter.com


Education and Training

Paul Lange receives Society of Urologic Oncology Huggins Medal

Paul LangePaul Lange, UW professor and chair emeritus of the Department of Urology, has received the Huggins Medal, the highest award bestowed by the Society of Urologic Oncology. The award was presented at the society’s annual meeting in Bethesda, Md., Nov. 30 – Dec. 2.

The Huggins Medal recognizes outstanding contributions in furthering the science of urological oncology and advancing patient care for individuals with genitourinary cancer. Lange’s career in surgery and translational research spans four decades. He is an internationally recognized clinical expert in genitourinary oncology, tumor markers, reconstructive urologic surgery and medical ethics. He is a renowned surgeon and a leader in research on urological malignancies, including prostate cancer.

Lange is director of the Institute for Prostate Cancer Research (IPCR), a partnership of scientists and physicians at UW Medicine and Fred Hutchinson Cancer Research Center. The IPCR’s mission is to understand the causes of prostate cancer and its progression, develop new prevention strategies, devise innovative diagnostics and improve survival and quality of life.

The Society of Urologic Oncology (SUO) was created in 1984 as a place where physicians interested in the care of patients with malignant genitourinary diseases could meet to discuss, develop and implement ideas to improve care.

The Huggins Medal is named after Charles B. Huggins, who was awarded the Nobel Prize for Physiology or Medicine in 1966 in recognition of his work on the hormonal treatment of prostate cancer.


School of Medicine announces new holders of 11 endowed faculty positions

The School of Medicine recently announced the appointment of several new holders of 11 endowed faculty positions. They are:

Satoshi MinoshimaSatoshi Minoshima (photo, right), UW professor and vice chair for research in the Department of Radiology, first holder of the Wil B. Nelp, M.D. Endowed Professorship in Nuclear Medicine

Jane C. Ballantyne, UW professor of anesthesiology and pain medicine, first holder of the Medical Education and Research Endowed Professorship

John M. Harlan, UW professor of medicine in the Division of Hematology, first holder of the Elo Giblett Endowed Professorship in Hematology

Kristin R. Swanson, UW research associate professor of pathology, first holder of the James D. Murray Chair of Applied Mathematics in Neuropathology

Michael L. Linenberger, UW professor of medicine in the Division of Hematology, first holder of the Robert and Phyllis Henigson Endowed Professorship in Hematology

David H. Avery, UW professor of psychiatry and behavioral sciences, first holder of the Depression Therapy Research Endowed Professorship

Debra SchwinnDebra A. Schwinn (photo, left), UW professor and chair of anesthesiology and pain medicine, first holder of the Allan J. Treuer Endowed Professorship in Anesthesiology

William C. Parks, UW professor of medicine in the Division of Pulmonary and Critical Care Medicine, second holder of the Endowed Chair in Pulmonary Disease Research

Timothy C. Cox, UW research associate professor of pediatrics, first holder of the Laurel Foundation Endowed Chair in Pediatric Craniofacial Medicine at Seattle Children’s

Gabrielle Kane, UW associate professor of radiation oncology, second holder of the Alexander Rodney Muir Professorship in Radiation Oncology

Paul Nghiem, UW associate professor of medicine in the Division of Dermatology, first holder of the Michael W. Piepkorn Endowed Chair in Dermatologic Research

For more information about these appointments, please contact UW Medicine Advancement at 206.543.5686.


Cyrus Rubin, UW Medicine gastroenterology pioneer, dies

Cyrus RubinCyrus E. Rubin, UW emeritus professor of medicine, passed away Dec. 19 at the age of 90. He was a member of the faculty for 57 years.

Rubin, a pioneer in gastroenterology, “was a brilliant scientist and innovative engineer; a passionate, caring clinician; a dedicated teacher and mentor; a deeply valued colleague; and a true Renaissance man,” said William Bremner, UW professor and chair of the Department of Medicine.

Rubin was born in Philadelphia on July 20, 1921. He received his bachelor’s degree at Brooklyn College in 1943 and his medical degree at Harvard Medical School. Following internship at Beth Israel Hospital in Boston, he served as an officer in the U. S. Army Medical Corps. He completed residencies in medicine, at the VA Hospital in Framingham, Mass., and in radiology at Beth Israel. He then went to the University of Chicago for fellowships in gastroenterology.

Rubin joined the UW Department of Medicine faculty in 1954. In the late 1950s and the 1960s he made engineering advances in gastric and intestinal biopsy that led to the accurate diagnosis of celiac disease. Uses of the Rubin Tube demonstrated that celiac sprue in children and in adults were identical disorders, and his classic 1960 paper established the diagnostic criteria for the disease. Over the years he continued to refine endoscopic technology and its applications to diagnosis, treatment, and research on gastrointestinal disorders, meanwhile becoming an international authority on celiac disease.

Officially retired since 1992, Rubin remained an active teacher, investigator, and clinician for many years after. In recent years, he studied the long-term effects of partial gastrectomy on the gastric mucosa, the genetics of ulcerative colitis and of GI malignancies, gastric health in elderly Japanese Americans, and disease associated with Helicobacter pylori. He produced an online lecture series for physicians on celiac sprue and many of the classic texts in the field.

Rubin received international recognition for his accomplishments, including the Distinguished Achievement Award and the Friedenwald Medal from the American Gastroenterology Association; the Rudolph Schindler Award from the American Society of Gastrointestinal Endoscopy; and the Clinical Research Award from the American College of Gastroenterology. The Cyrus E. Rubin Endowed Chair in Medicine was created in 1997 in his honor.

His funeral was held Wednesday, December 21, at Congregation Beth Shalom in Seattle.

WWAMI Regional News

WWAMI Idaho mourns physician-educator Michael Baker

Michael BakerMichael Baker of Pocatello, Idaho passed away November 22, 2011. Baker was a gifted and award-winning physician and teacher who served on the medical school faculty of the University of Washington and the University of Utah and participated as a family medicine clerkship preceptor for thirty years. At Idaho State University, he taught in the College of Pharmacy and was instrumental in building the Family Medicine Residency Program. Baker was the recipient of many teaching awards. He received the Preceptor of the Year Award from the Pocatello family medicine residents in 1996, 2006 and 2007 and the Outpatient Teaching Award in 2000 and 2011.

Baker graduated from the University of Florida in 1964 and earned his medical degree from the University of Miami in 1969. He entered the United States Army as a physician, serving in Vietnam and earning a Bronze Star and a Medal of Commendation. In 1974, Baker moved to Pocatello, Idaho to raise his family and founded the Family Practice Group, which became known as the InterMountain Medical Clinic.

“Dr. Baker was truly one of the finest and brightest doctors I have ever met,” said Earl Stoddard, physician and a graduate of the UW School of Medicine. “He was inspiring. Pocatello is a better community because of him.”

Baker loved practicing and teaching medicine and over the years provided integrated and comprehensive care for generations of Pocatello families. He worked in advanced cardiac life support, wound care and hyperbaric medicine and was highly respected for his work with diabetic patients.

“As we go through the journey that is life, we encounter people whose influence forever changes us and we realize that we are a better person for having known them. For me this is a very short list and Mike is at the top of it,” said colleague Jill Gronholz.

InterMountain Medical Clinic continues to be active as a UW School of Medicine family medicine third year required clerkship site and with the Family Medicine Residency Program in Pocatello. Several of the partners at the InterMountain Medical Clinic trained at the Idaho State University Family Medicine Residency program and benefited from their interactions with Dr. Baker.  

Assistant clinical dean position for WWAMI now open

The University of Washington School of Medicine WWAMI program has a position open for assistant clinical dean. The assistant clinical dean will have responsibilities for developing, coordinating, and maintaining clinical medical education activities in western Washington with an emphasis outside the greater Seattle Area. A search committee has been appointed to conduct the search for the position. Visit the Academic Human Resources webpage for the position announcement.



Upcoming Events

The following are events that may be of interest to the UW Medicine community.

Party beCause: Benefit for Country Doctor Youth Clinic, Jan. 20

The UW School of Medicine Medical Student Association (MSA) will host a benefit auction for the Country Doctor Youth Clinic, 6 p.m., Friday, Jan. 20, at UW Medicine South Lake Union. The auction will benefit the Country Doctor Free Teen Youth Clinic run by the Adolescent Medicine Section in the UW Department of Pediatrics. The clinic provides medical and social services to homeless youth in Seattle. Auction items include a winemaker’s dinner for up to six people, dinner at Canlis Restaurant, horseback ride in Yellowstone National Park, and more. The evening will include music and refreshments. For more information, visit the Party beCause website. Tickets are available at Brown Paper Tickets

Faculty Development Workshop, Jan. 24

Demystifying the Teaching Portfolio, 8:30 a.m. to noon, Tuesday, Jan. 24, South Campus Center, Room 316. The workshop will help clinician-educators develop a framework for their teaching portfolios. Participants will leave with a portfolio template and enhanced skills in composing and assembling this important part of merit documentation and faculty promotion. Presenters include Helen Emery, UW professor of pediatrics and division chief of rheumatology, Seattle Children’s; Andrew Luks, UW assistant professor of medicine in the Division of Pulmonary and Critical Care Medicine; Mark Whipple, UW associate professor of otolaryngology -- head and neck surgery; and other select members of the 2006-07 UW Teaching Scholars program cohort. The workshop is sponsored by the Department of Medical Education and Biomedical Informatics in partnership with the Office of Faculty Development. Contact Rachael Hogan at 206.616.9875 or rhogan@u.washington.edu  for more information.

Paul Ramsey annual address to the UW Medicine community, Feb. 9

Paul G. Ramsey, CEO of UW Medicine, executive vice president for medical affairs and dean of the School of Medicine, University of Washington, will give his annual address to the UW Medicine community at 4 p.m., Thursday, Feb. 9, in Hogness Auditorium at the UW Health Sciences Building. The title of the talk is UW Medicine 2012: Progress and Plans. The talk is open to all faculty, staff, students, trainees and others. A reception will follow the address in the Health Sciences Lobby. For more information, contact Julie Monteith at 206.543.7718 or jspiro@uw.edu.

20th anniversary of UW Medicine Salutes Harborview, Feb. 25

The 20th anniversary of UW Medicine Salutes Harborview Gala, the premier fundraising event for Harborview Medical Center, will take place at 6 p.m., Saturday, Feb. 25, at the Sheraton Seattle Hotel. The Gala’s net proceeds benefit Harborview’s Mission of Caring Fund, which helps Harborview serve vulnerable populations and provide world-class care to patients from throughout the region. The event is presented by the Western Washington Toyota Dealers Association. Register to attend the 20th UW Medicine Salutes Harborview Gala. Follow the event on Facebook and Twitter.

Continuing Medical Education

Visit Continuing Medical Education for more information on upcoming classes.