The Bayview Scholars
They are among the best and brightest scientists and clinicians we have here at Johns Hopkins Bayview. With the support of dedicated philanthropists including the Lowe Family, the Miller-Coulson Family, Mr. and Mrs. Hugh Cosner, Mr. Aristidis Alafouzos, the Amos Family, and Mr. and Mrs. Fred Mirmiran, these scholars are able to spend more time doing what they do best: helping people who are sick. For a list of the Bayview Scholars, see page 25.
The Aliki Initiative
Launched in 2007, this was the nation’s first effort to change medical education by focusing on personal care. Thanks to the generosity of Mrs. Aliki Perroti, our young physicians have learned how to listen better, be more observant. The Aliki Initiative’s key features: Fewer patients for each doctor, so the doctor can spend more time with each one. Doctor-patient relationships that don’t end when the patient is wheeled out of the hospital. Evidence-based medicine, so that medical tests and treatments are appropriate, and based on scientific studies. Patients get to report how well their doctors did, and are asked whether they think their doctors got to know them as individuals. The Impact has been tremendous: 230 residents have been “Aliki-ized,” 320 medical students have been “Aliki-ized,” 24,000 inpatients at Bayview have been on the Aliki service, 200,000 patients have been touched by Aliki graduates, and thousands of patients have received follow-up calls and house visits.
Clinical Excellence Initiative
In 2006, the Miller-Coulson Family funded the DMR project – for “Define, Measure, and Reward” clinical excellence. At its helm were four Miller-Coulson Scholars – Colleen Christmas, Steven Kravet, Samuel C. Durso, and Scott Wright. In academic medicine, the primary rewards seem to come to publishing scientists. The DMR project was a venture into uncharged territory, an attempt to quantify and define the qualities that make an excellent clinician, and to come up with a reward system.
Our Book Clubs
We like summer here at the CIM. Even though an academic medical center never closes, in the summer the structured pace eases up a bit around here. We have fewer meetings, not so many talks and lectures, and these quieter weeks are the perfect time for our CIM Committee members – a group of remarkable people who are willing to think differently – to do some summer reading. It’s hardly ever medical stuff; instead, we look for books outside our field that help us think creatively. We’ve read many great books over the last 10 summers. Some of them include: Thinking Fast and Slow, by Daniel Kahneman; Made to Stick, by Chip Heath and Dan Heath; Team of Rivals, by Doris Kearns Goodwin; Diffusion of Innovations, by Everett Rogers; Meaning in Life and Why it Matters, by Susan Wolf; and Start-Up Nation, by Dan Senor and Saul Singer.
Miller-Coulson Academy of Clinical Excellence
The four Miller-Coulson Scholars had a mission, and it took them two years of painstaking work. First, they defined academic clinical excellence, through meetings with physicians at institutions across the country, empiric research studies, and an exhaustive review of the medical literature. Then they developed the Clinical Portfolio to measure the academic clinician’s performance and contributions. They established an external review Board, identified potential academy members, and in 2009 they elected the first class of Master Clinicians at the first Miller-Coulson Symposium of Clinical Excellence. The Academy, directed by Scott Wright, recently expanded to the Johns Hopkins Hospital campus at the request of Dean and CEO of Johns Hopkins Medicine, Paul Rothman. There are now 30 Miller-Coulson Academy Inductees.
Frank L. Coulson, Jr. Award for Clinical Excellence
In 2012, the Miller-Coulson family and the Miller-Coulson Academy created a new annual award for young doctors who have shown clinical excellence. The Frank L. Coulson, Jr. Award for Clinical Excellence honors the late Frank Coulson’s life, his personal commitment to professional excellence, and his great interest in clinically excellent physicians. Roy Ziegelstein, the Sarah Miller Coulson and Frank L. Coulson, Jr., Professor, told recipients: “an award to people like you who are early in their career is an absolutely fitting tribute to Mr. Coulson. Frank was the leading bond salesman for Goldman Sachs for four decades. But I think the part of his work that he enjoyed the most was mentoring young people. He really would have loved to have met each of you.”
The Miller Lecture
The Miller-Coulson Family has been so generous to the CIM over the years. Our first initiative together was the Miller Lecture, which has become an important and highly anticipated event at Johns Hopkins every year, as we come together to focus on medical excellence.
In our first issue, in 2007, David Hellmann said, “The name of this publication is important. It’s not just scientific breakthroughs…it’s a breakthrough in thinking and in focus.”
In 2007, faculty from Johns Hopkins Bayview’s world-renowned Division of Geriatric Medicine and Gerontology and from Peking Union Medical College, China’s flagship medical institution, joined forces to establish a geriatric medicine program at PUMC. The partnership is “a great example of the CIM’s goals,” says David Hellmann, “focus on the patient, collaboration, and wise use of technology, on an international level.”
A New Model for Academic Medicine
The customary model for academic medicine is a triangle, whose three sides stand for Teaching, Patient Care, and Research. This model worked well for more than a century. But David Hellmann felt that the two-dimensional triangle needed to make more room for patients and the community, to encourage collaboration between scientists and clinicians, and to highlight the critical work of nurses, therapists, and staff. So in 2008 he came up with a better model, a three-dimensional pyramid.
The Carol Ball Medical Floor
Designed with the Pyramid concept – the creative rethinking of the traditional triangle model of academic medicine – in mind, this short-term stay unit was designed to be patient-centered and interdisciplinary, a flagship for innovation. In 2010, a 63-bed ward was transformed into a 38-bed unit where pilot programs are tested, the approach is indisciplinary, and thoughtful measures to make the environment as patient- and family-friendly as possible are encouraged. The Carol Ball Medical Floor is the only unit in any Johns Hopkins Hospital named for a nurse.
Pyramid Fund Grants
This Fund started in 2011, named for our Pyramid model. Grants are deliberately small – from as little as $50 to $1,500 – but that’s the point. Open to all staff and faculty at Johns Hopkins Bayview, the Fund encourages little ideas that have the potential to make a big impact on patients’ lives. “The enthusiasm for this blew me away,” says David Hellmann. Indeed, says Cindy Rand, Deputy Director of Patient-Centered Care, “there are a lot of people around here who really care.”
Center for Behavior and Health
“Unhealthy behaviors account for as much as 60 percent of all medical care costs in the United States,” says David Hellmann, whose efforts were instrumental in getting the new Center started. “Even if someday the human genome project can perfectly predict all diseases, it won’t matter if we cannot also get patients to adopt healthy behaviors.” Unhealthy behaviors include: poor diet, inactivity, and lack of exercise, cigarette smoking, drug addiction, alcohol addiction, and poor sleep.
Healthy Community Partnership at Johns Hopkins Bayview
This program started in 2012, but it’s based on nearly 20 years of collaboration between clinical psychologist Dan Hale and geriatrician Rick Bennett, President of Johns Hopkins Bayview. How do you help patients get more information – sometimes when they don’t even realize they have a disease or medical condition? You go out into the community. Respectfully.
Johns Hopkins Community Health Partnership
If health is the first wealth, says David Hellmann, “Hopkins has not been very attentive in providing that for people in the neighborhood, although that’s what we were founded for. We own the responsibility for trying to make this better.” Hopkins leaders believe J-CHiP, funded by a three-year, $19.9 million innovation grant from the Centers for Medicare and Medicaid Services, is the long overdue opportunity to transform the health of our closest neighbors.
Medicine for the Greater Good *
This innovative program, started in 2013 by one of our Chief Residents, takes our doctors beyond our hospital walls and out into the community, where they hope to help people make lasting changes in their health care.
Medical Education Resources Initiative for Teens (MERIT) was started by three young teachers working in inner-city Baltimore. Two of them have gone on to become Johns Hopkins medical students. MERIT gives disadvantaged students who want to go to medical school a decent shot at actually making their dream come true, and we’re doing all we can to help, with internships, mentoring, and support.
Latino Health Center
Our neighborhood is changing, and Hopkins is changing, too. As the Latino population has skyrocketed in the rowhouses around Bayview and the Broadway campus, Hopkins has opened its arms to welcome them. Centro Sol (“sol” means “sun” in Spanish), which opened in 2013, is focused on brightening the health prospects for the growing Latino community. The result is a multidisciplinary, family-centered approach to caring for Latinos that involves pediatrics, obstetrics-gynecology, internal medicine, and psychiatry.
We value Cores here at the CIM very much, and we have several: The Bayview Lowe Genomics Core, the Biostatistical Core (BEAD), and the Amos Proteomics Core, the Johns Hopkins Food, Body and Mind Core, and cores in histology and cell sorting. Cores allow us to achieve critical mass. When the right people come together, with different skills and areas of expertise that complement each other, we begin to see results that happen much faster.
The Bayview Lowe Genomics Core
In 2004, immunogeneticist Kathleen Barnes was given the chance to build a genetics and genomics program from scratch, with the help of interdisciplinary support and a gift from Mrs. Joan Carl, in memory of her mother, Mary Beryl Patch Turnbull, by supporting research in her name. Soon philanthropist David Lowe, who has also funded much of the autoimmune disease research at Bayview, invested in the Genomics Core, which now bears his name. Barnes has turned the Core into a genetic research powerhouse.
The Amos Family Proteomics Core
Proteomics is the science of reading the ticker tape of protein in our blood. Established with the generosity of the Amos Family, the Bayview Proteomics Center is one of just 10 centers funded by the Hopkins National Heart, Lung and Blood Institute. Our Proteomics Core scientists have made important discoveries that help explain the mechanisms that cause some forms of heart failure, helped identify a newly discovered form of myositis, and provided important insights into the fundamental causes of rheumatoid arthritis.
It started in 2011 with two pilot projects involving patients with rheumatic diseases, but we hope it will have applications throughout medicine. Precision Medicine is highly individualized, focused care in which subsets of patients are identified and their treatments are custom-tailored. “Precision medicine is all about patients,” says Antony Rosen, who is heading this initiative.
Vital Score App
In 2013, clinical psychologist Hillary Hatch, on the faculty of the Center for Behavior and Health, developed an app for the iPad, called Vital Score. It’s a simple tool that she hopes will help doctors do what they really want to do – help the patient become healthier – by shifting the patient’s perspective from changing behavior to improving self-care. It is upbeat and friendly, an arm around the shoulder rather than a kick in the pants. The app is an ice-breaker, something for the doctor and patient to talk about together. “It’s a score, not a judgment,” says Hatch.
Physicians for Responsible Ordering
Started by our medical residents, PRO is poised to save millions of dollars in hospital charges to patients. The key to changing the culture of ordering too many tests: A very focused approach, and well-defined, easily measured goals, says Jeff Trost, Deputy Director of Clinical Practice for the Dept. of Medicine and the group’s faculty leader. In its first year, PRO’s promotion of prudent test-ordering for patients with chest pain reduced the charges of blood tests at Johns Hopkins Bayview by more than one million dollars.
Johns Hopkins Food, Body & Mind Center
Changes in the gut’s microflora can affect the mood, causing depression and anxiety. Our new Johns Hopkins Food, Body & Mind Center, which opened in 2014 thanks to a generous gift provided by Courtney and Paul Amos, is exploring the connections between our two brains – the one in our head, and the smaller, very important one in our gut. The goal is to advance scientific knowledge of the mechanisms by which foods affect our physical and mental health.
The Bayview Scholars
Over the years, they have included:
Felipe Andrade, Lowe Family Scholar
Kathleen Barnes, Mary Beryl Patch Turnbull Scholar
Cynthia Boyd, Bayview Scholar
Colleen Christmas, Miller-Coulson Scholar
Bruce S. Bochner, Cosner Scholar in Translational Research
S. Chris Durso, Miller-Coulson Scholar
Linda Fried, Cosner Scholar in Translational Research
Frank Herlong, Bayview Scholar
Landon King, Bayview Scholar
Steven Kravet, Miller-Coulson Scholar
Stuart M. Levine, Lowe Family Scholar
Constantine G. Lyketsos, Alafouzos Scholar
Parviz Nikoomanesh, Mirmiran Family Scholar
Cynthia Rand, Bayview Scholar
Antony Rosen, Cosner Scholar in Translational Research
Philip Seo, Lowe Family Scholar
Michael T. Smith, Alafouzos Scholar
John H. Stone, Cosner Scholar in Translational Research
Jennifer Van Eyk, Amos Family Scholar
Scott Wright, Miller-Coulson Scholar
Roy C. Ziegelstein, Miller Scholar
* There are two “Medicines for the Greater Good.” One is the actual program begun by our residents, and the other is a philosophy, the way we are implementing our fundamental belief that Medicine is a Public Trust.