Category Archives: Physician Faculty Scholars

Nov 13 2014
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RWJF Scholars in the News: EpiPens in schools, suicide prevention, financial incentives for wellness, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

A study by RWJF Physician Faculty Scholars alumna Ruchi Gupta, MD, MPH, shows that keeping supplies of epinephrine, commonly known as EpiPens, in schools saves lives, Health Day reports. Epinephrine injections are given in response to life-threatening allergic reactions to food or to insect stings. Gupta’s study found that epinephrine was administered to 35 children and three adults in Chicago public schools during the 2012-13 school year. “We were surprised to see that of those who received the epinephrine, more than half of the reactions were first-time incidents,” Gupta said. “Many children are trying foods for the first time at school, and therefore it is critical that schools are prepared for a possible anaphylactic reaction.”  Forty-one states have laws recommending schools stock epinephrine, according to the article.

Matt Wray, PhD, MA, an RWJF Health & Society Scholars program alumnus, writes in Medical Xpress that when it comes to preventing suicides, it’s important to focus some attention on how a person seeks to end his or her life. According to the article, suicide-prevention research has shown that when people who have begun to act on suicidal impulses find that access to their chosen method is blocked, many do not seek out other means. “Most people don’t have a backup plan,” Wray writes. “So when their initial attempt is stalled, the destructive impulse often passes. Moreover, contrary to what many believe, people who attempt suicide more than once are rare. Less than 10 percent of those who survive an attempt ever end up dying by suicide.”

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Nov 11 2014
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Let’s Put Veterans in Charge of Their Pain Care

Erin Krebs, MD, MPH, is the women’s health medical director at the Minneapolis VA Health Care System and associate professor of medicine at the University of Minnesota Medical School. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Physician Faculty Scholars program and the RWJF Clinical Scholars program.

Erin Krebs (Veterans Day)

How can we create a Culture of Health that effectively serves veterans? We can put veterans in charge of their pain care.

Chronic pain is an enormous public health problem and a leading cause of disability in the United States. Although 2000-2010 was the “decade of pain control and research” in the United States, plenty of evidence suggests that our usual approaches to managing chronic pain aren’t working. Veterans and other people with chronic pain see many health care providers, yet often describe feeling unheard, poorly understood, and disempowered by their interactions with the health care system.

Evidence supports the effectiveness of a variety of “low tech-high touch” non-pharmacological approaches to pain management, but these approaches are not well aligned with the structure of the U.S. health care system and are often too difficult for people with pain to access. Studies demonstrate that patients with chronic pain are subjected to too many unnecessary diagnostic tests, too many ineffective procedures, and too many high-risk medications.

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Oct 31 2014
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RWJF Milestones, October 2014

The following are among the many honors received recently by Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, grantees and alumni:

Linda Aiken, PhD, FAAN, FRCN, RN, has won the Institute of Medicine’s Leinhard Award in recognition of her “rigorous research demonstrating the importance of nursing care and work environments in achieving safe, effective, patient-centered, and affordable health care.” The director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing, Aiken serves on the National Advisory Committee of the RWJF Interdisciplinary Nursing Quality Research Initiative and is a research manager for the Future of Nursing National Research Agenda.

A number of RWJF Scholars and Fellows were recently elected to membership in the Institute of Medicine:

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Oct 9 2014
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RWJF Scholars in the News: The nurse faculty shortage, teaching empathy, a link between overtime and diabetes, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

ABC News explores the nation’s nursing workforce shortage, focusing specifically on the faculty shortage at nursing schools. “Suddenly, we turned around and realized we’re not attracting enough nurses to go into teaching,” said Kimberly Glassman, PhD, RN, chief nursing officer at NYU Langone Medical Center. “The fear is we will have to shrink the number of nurses we can prepare for the future at a time when we need to prepare more.” Glassman is an RWJF Executive Nurse Fellow. The article was republished by Yahoo News and ABC News Radio.

RWJF Health & Society Scholars program alumnus Allison Aiello, PhD, MS, is interviewed for an NBC News story on Enterovirus D-68. She recommends that parents consider getting flu shots for their children, noting that preventing children from getting the flu should help make Enterovirus less complicated to diagnose and treat. The video is available here.

RWJF Harold Amos Medical Faculty Development Program scholar Paloma Toledo, MD, co-authors a Huffington Post blog entry on the need for medical schools to teach students to be empathetic. Over the course of their training, they become less empathetic, as opposed to more empathetic, and the reasons for this are unclear,” Toledo writes, recommending lectures on active listening and communication skills, among other measures. 

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Sep 25 2014
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RWJF Scholars in the News: Unintended consequences of shorter ER wait times, Ebola response, vaccinations and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

Policies aimed at shortening emergency departments waiting times may have unintended consequences, including unnecessary admission of patients who might be better off being discharged, RWJF Physician Faculty Scholars alumna Renee Hsia, MD, MSc, tells Health Day. Hsia published two research letters in JAMA Internal Medicine on emergency wait times at urban and rural hospitals. RWJF Clinical Scholar alumnus Jeremiah Schuur, MD, MHS, author of an accompanying editorial, seconds Hsia’s concerns. “Medicare started advertising waiting times at ERs about a year ago. And that will be a strong incentive for hospitals to work on and improve their waiting times...[h]owever, some of the hospitals with longer waiting times, like teaching hospitals, care for the most complex patients who often don’t have access to regular care. And these places are, by nature and necessity, going to have longer waiting times,” he warned. The article was republished by U.S. News & World Report and Health.com, among other outlets.

CBS Detroit interviews Howard Markel, MD, PhD, FAAP, recipient of an RWJF Investigator Award in Health Policy Research, for a story on President Obama’s decision to send American troops and medical and logistical support to Africa to stop Ebola from spreading. “It is a humanitarian gesture,” Markel said. “I applaud the president for doing it. Do I wish as a physician and an epidemiologist it was done earlier? Yes, of course.” Markel says he does not expect the virus to spread to the United States. He is also quoted in the New Republic and Politico.

In an op-ed for the New York Times, Jason Karlawish, MD, explores the balance between risk-avoidance and enjoying life as we age. Noting that 3.6 percent of the population is 80 or older, he writes that as Americans age, “life is heavily prescribed not only with the behaviors we should avoid, but the medications we ought to take.” Aging in the 21st century is all about risk reduction, but “[w]e desire not simply to pursue life, but happiness” and “medicine is important, but it’s not the only means to this happiness,” Karlawish writes. National investment in communities and services that improve the quality of our aging may be one answer, he adds. Karlawish is a recipient of an RWJF Investigator Award in Health Policy Research.

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Sep 18 2014
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RWJF Scholars in the News: Antibiotic overuse, sexual assault nurse examiners, diaper banks, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

RWJF Investigator Award in Health Policy Research recipient Anthony So, MD, MPA, co-authors a piece in the News & Observer (Raleigh, North Carolina) about the need to reduce the overuse of antibiotics, in both humans and animals. Overuse accelerates the development of antibiotic-resistant bacteria. The Centers for Disease Control and Prevention estimates that half of human antibiotic use and much animal antibiotic use is unnecessary, the article says. So calls for public policies that create incentives for farmers to decrease use of antibiotics and that limit antibiotic use in animals to disease treatment, rather than growth-promotion or as a substitute for hygiene and infection-control.

In Chicago, most children with asthma or food allergies do not have a health management form on file at school, leaving their schools without information they might need in emergencies, according to a study by RWJF Physician Faculty Scholars alumna Ruchi Gupta, MD, MPH that was covered by Reuters Health. Researchers analyzed 2012-13 school year data on more than 400,000 Chicago schoolchildren, including 18,287 with asthma and 4,250 with a food allergy. Only a quarter of the asthmatic students and half of those with a food allergy had a health management plan on file. The study was also covered by The Chicago Tribune, Fox News, The Baltimore Sun, and Red Orbit, among other outlets.

RWJF Nurse Faculty Scholars alumna Angela Frederick Amar, PhD, RN, FAAN, publishes an op-ed on Talking Points Memo about the report from the White House Task Force to Protect Students from Sexual Assault, Not Alone. Amar notes that effective response to campus sexual assault should include medical care for survivors, and that Sexual Assault Nurse Examiners (SANEs) are trained to tend to the medical and emotional needs of survivors and collect forensic evidence. In other institutions with high rates of sexual violence, such as the military, SANEs are considered an essential part of treatment for victims of sexual violence, Amar writes.

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Sep 4 2014
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RWJF Scholars in the News: The nursing shortage, ADHD, meaningful online communications and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

NBC 2 (Buffalo, New York) interviewed Carol S. Brewer, PhD, RN, FAAN, co-director of RWJF’s RN Work Project, for a story about the nursing shortage and job prospects for nurses early in their careers. “We are not seeing as much demand for brand new graduates,” Brewer said. However, the anticipated retirement of many older nurses and the increasing demand for health care as a result of the Affordable Care Act could combine to create a 19-percent increase in demand for nurses in the near future, Brewer said. In the meantime, she suggests that new nurses be willing to relocate and look for nursing jobs in rural communities, where demand is greater.

It is important to keep media and public focus on the Affordable Care Act, Jake Haselswerdt, PhD, an RWJF Scholar in Health Policy Research, tells the Independent Voters Network website, because some states are still blocking full implementation of the law. “In order for the more stubborn states to move forward with implementation and expanding care, there may need to be some continued pressure,” he said. “That’s going to require the media to pay attention to the big disparities that are emerging between states that tried to implement the law and those that resisted.”

Tina Bloom, PhD, RN, an RWJF Nurse Faculty Scholar, led training for nurses in Columbia, Missouri, aimed at helping them identify the risk factors and symptoms of domestic violence, and then to support victims, ABC17 News reports. The training is consistent with preventive care provisions in the Affordable Care Act, the article says. Among other things, Bloom teaches nurses to look for certain types of injuries and for issues in patients’ medical histories that do not make sense.

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Aug 21 2014
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RWJF Scholars in the News: Costs for blood tests, dentists testing for hypertension and HIV, fudging medical history, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

A new study uncovers vast variation in pricing for common blood tests by California hospitals, reports the Washington Post. Renee Hsia, MD, MSc, an RWJF Physician Faculty Scholars program alumna, says she was “very surprised” to see such variation among more than 160 hospitals studied. Hsia’s research found that during 2011, some hospitals charged as little as $10 and others as much as $10,169 for a basic cholesterol test. The study found no clear explanation for the price differences for what Hsia categorized as ten “simple and standard” tests in which blood samples are inserted into a machine that performs the analysis. Time magazine, the Boston Globe and Kaiser Health News also cover Hsia’s research.

Dentists could offer a variety of medical tests in the future, including diagnostic tests for health problems such as diabetes, hypertension and HIV, Harold Pollack, PhD, tells Ozy.com. The mouth, Pollack says, “is the gateway to the human body.” He is an RWJF Investigator Award in Health Policy Research recipient.  

“There’s an overabundance of evidence that shows hospitals that have better staffing have better outcomes when we look at things like mortality,” Matthew McHugh, PhD, JD, MPH, FAAN, tells the Santa Fe New Mexican. In an article about nurse staffing ratios, McHugh, an RWJF Nurse Faculty Scholars program alumnus, says hospital readmissions, failure to rescue patients in distress, and patient satisfaction also correlate with increased staffing. “If you compare any two hospitals—one that’s good at staffing and one that has not as good staffing, but are similar in other factors—the hospital with better staffing is much less likely to be penalized” for bad patient outcomes by Medicare and Medicaid, McHugh notes. 

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Aug 14 2014
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RWJF Scholars in the News: Ebola fears, ER closures and mortality, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Bringing two American medical volunteers infected with the Ebola virus back to the United States for treatment triggered some criticism, particularly on social media. But Susan Mitchell Grant, MS, RN, CNAA-BC, who is treating the two patients at Emory Healthcare in Atlanta, writes that the criticism is “unfounded and reflect[s] a lack of knowledge about Ebola and our ability to safely manage and contain it.... We are caring for these patients because it is the right thing to do,” she says in a Washington Post op-ed. “Ebola won’t become a threat to the general public from their presence in our facility.” Grant, an RWJF Executive Nurse Fellows alumna, goes on to explain that “the insight we gain by caring for them will prepare us to better treat emergent diseases that may confront the United States in the future.”

Some hospice providers may not be serving patients in the way the end-of-life care should, according to research covered by the Washington Post. Joan Teno, MD, MS, recipient of an RWJF Investigator Award in Health Policy Research, is lead author of a study that analyzed more than 1 million records of Medicare patients across the country. Her research team found that some hospices, particularly those that are new and for-profit, have discharge rates of 30 percent or higher. That is double the standard discharge rate. Historically, some patients are discharged from hospice because their health unexpectedly improves. But Teno and colleagues say the higher discharge rates suggest two types of improper hospice practices: admitting patients who are not dying; and releasing patients when their care becomes expensive. She suggests that both practices may be driven more by “profit margins than compassionate care.”   

Chronic stress during adolescence can lead to adverse health outcomes later in life, says Keely Muscatell, PhD, an RWJF Health & Society Scholar, in an interview with NPR member station KALW (San Francisco). Based on her study, “How Stress Makes Us Sick,” Muscatell suggests that ongoing psychological stress during childhood triggers physiological inflammation throughout the body and could be a primary link to such conditions as major depression, cardiovascular disease, and rheumatoid arthritis. Muscatell explains that chronic stress can even change patterns of gene expression that lead to poor health later in life.

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Aug 7 2014
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RWJF Scholars in the News: The ACA and mental health treatment, HIV training for nurses, the rise of superbugs, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

An Affordable Care Act (ACA) provision that allows parents to keep adult children on their health insurance plans under they reach age 26 has resulted in millions more young people with mental-health and substance-abuse problems getting treatment, according to a study led by Brendan Saloner, PhD. Time reports that over two years, young adults ages 18 to 25 who had screened positive for mental health or substance abuse disorders increased their use of mental-health treatment by 5.3 percent compared to a similar group who were not eligible for their parents’ coverage. Vox and HealthDay were among the outlets to report on the study. Saloner is an RWJF Health & Society Scholar.

Infection Control Today quotes Jason Farley, PhD, MPH, CRNP, on the growing need to train nurses to provide HIV care. An RWJF Nurse Faculty Scholar, Farley developed new HIV curriculum for the John Hopkins School of Nursing, where he is an associate professor. “For many years these specialty training programs in HIV have been available for physicians,” he says. “This is the first time we’re offering them to non-physician providers. It’s quite an important development. When you look at data comparing patient outcomes with physician care and with nurse practitioner care in HIV, whether in the United States or in sub-Saharan Africa, those outcomes are the same.”

Magda Cerdá, PhD, MPH, an RWJF Health & Society Scholars program alumna, explores the stressors that lead to high numbers of returning National Guard soldiers abusing alcohol, reports Science Codex. Cerda is the lead investigator of the study, which examined 1,095 Ohio National Guard soldiers who served primarily in Iraq or Afghanistan in 2008 and 2009, and found that having just one civilian stressor such as job loss, or legal or financial problems, raised the odds of alcohol use disorders. Medical Daily and Medical Xpress also cover Cerda’s work.

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