Division Dialogue

Division Dialogue

September 2009

A Message from Vice President John A. McDonald, M.D., Ph.D.

Health Care Reform: Caveat Lector, Caveat Emptor

John A. McDonald, M.D., Ph.D.

Two intertwined themes dominate today’s headlines—The economy and health care reform. Both are in trouble and both are related. Let’s explore what the core issues are in health care reform and relegate the economy to wistful memories of 401(k)s' performance in the past.

First we should remind ourselves that all developed nations enjoy a level of health care incomprehensible to those living in third world and developing countries. Millions suffer and die from preventable infectious and parasitic diseases—tuberculosis, pneumonia, malaria or treatable conditions amenable to medical or surgical intervention routine in the U.S. So while our system certainly isn't optimal, it is a far cry better than those enjoyed by others who simply lack the good fortune to be born in a first-world country.

Many things work well in the current system—we enjoy access to the fruits of a vibrant biomedical revolution: extraordinary drugs, advanced imaging and minimally invasive surgery, and highly trained and skilled health care professionals who provide excellent care. Despite this, as a nation, our public health is poor compared with other developed countries, and despite much higher health care costs. We lag other developed countries in most aggregate measures of public health, including longevity, infant mortality, and maternal death rates. There are significant inequities in the U.S. that contribute to this lag. Statistically speaking, a poorer individual in this country is less likely to enjoy good health than one with higher income. But this does not mean that there is a strong correlation between spending and health. Annual expenditures above $1,000 in per capita for health care does not correlate with increasing longevity.

Why should we care about the cost of health care if we, as do most consumers, believe that we have access to good health care? From the global perspective, it makes us less competitive. The cost of health care for retirees and current workers for General Motors exceeds the cost of the steel in the automobiles they build. When competing with manufacturers with lower health care costs here and abroad, there is an economic disadvantage. As a consumer, medical expenses are the leading cause of personal bankruptcy. Finally, there is the social inequity when many Americans lack access to high quality health care, which also drives up cost for everyone.

So what should we as informed consumers and educators of future health care professionals look for in a health care plan? I believe any successful health care reform has to focus on outcome and quality. We must focus on measures that deliver the best outcome in a cost effective way. In other words, deliver prevention, diagnosis, and treatment based on by objective data analyzed impartially by unbiased experts. This implies profound changes in the funding, organization, and delivery of health care as we know it today. For example, the Institute of Medicine of the National Academy of Sciences estimates that approximately 40 percent of national health care expenditures result from system inefficiencies.

Moreover, while we have a good system for intervening in acute illness, we are less prepared to manage chronic disease. Twenty common diseases (cardiovascular disease, diabetes, arthritis, kidney disease, etc.) are responsible for between 40 to 70 percent of the total annual health care expenditures. To cut cost, we must measuring outcomes and introduce evidence based medicine aligned with economic incentives. It is our responsibility to educate health sciences graduates, irrespective of their discipline, to this reality.

How health reform occurs, and what shape the final system takes is consuming all oxygen in the current debate. Some solutions that are palatable in other countries are for historical and sociological reasons less likely to succeed in the U.S., even though we have elements of these systems already. But when you hear the rhetoric and sophistry dominating today’s debate, think about the end game—maintaining and improving outcomes while driving down cost. Moreover, while we do have 47 million under and uninsured Americans today, everyone has some access to health care. That care is often too little or too late, and it is expensive and is passed on to your and my health care costs. To drive down the cost, a proven strategy is to provide access to health care to everyone. The keynote speaker at our recent assembly, Dr. Margot Kushel ,from the University of California, San Francisco and San Francisco General Hospital, shared how innovative and somewhat controversial approaches to provide health care access to the rapidly growing homeless population can save costs to our communities. We may consider health care a right or a privilege, but to withhold it, even from individuals who exhibit unhealthy or even illegal or self-destructive behaviors, it is simply bad economics. While we may distain these behaviors personally, we ignore their cost to society at our peril. For an extreme example of this from our own community, I highly recommend reading Million-Dollar Murray.

As an integrative division of health sciences, we are uniquely positioned to educate our students in the current realities of the health care system, and to prepare them for what I believe will be a more integrative and holistic approach to care in the future. That is the major goal of our division.

The opinions expressed herein are solely of the author.

News from Division of Health Sciences Units

CEHSO Participates in Kid’s University Program

In response to the increasing shortage of health professionals in Nevada, the School of Medicine’s Center for Education and Health Services Outreach (CEHSO) has established a departmental commitment to health professions education and recruitment for middle and high school students. In response to this initiative, CEHSO Program Specialist Jennifer Bennett, M.P.H., taught “Health Care Heroes”, July 13-17, as part of the Extended Studies Kids University summer program for school-age kids.

With collaboration from all Division of Health Sciences units, the course focused on introducing seventh and eighth grade students to a wide-range of health professions, including medicine, nursing, public health, social work, oral health, dietetics, emergency medical services, speech pathology and audiology, physical therapy and sports medicine.

Special thanks to the following faculty and staff for their participation: Gina Sella (Medical Education), Teri Jones-Rodrigues (Extended Studies), Bill Oberding (Medicine), Jolyn Wirshing (Medical Nutrition), Enid Jennings (Student Health Center), Jill Manit (Social Work), Kim Baxter (Nursing), Terrence Horan (Medicine), Dan Cook (Community Health Sciences), Leslie Golberg (Speech Pathology and Audiology), Shelly Germann (Sports Medicine), Jamie Crumbaker (Sports Medicine), Mark Lamoreaux (Athletics), and Caroline Ford (CEHSO). Many thanks as well to the following UNR students for all of their work and energy: Wilfredo Torres (MS IV), Anna Delgadillo, and Kelsey Heslington; and a big thanks to our community partners: Ryan Ramsdell (REMSA), Mark Dougan (Washoe County District Health Department), Laurie Nickles and Kathy Burns (Nevada State Health Division), Andrea Gibbins (High Sierra AHEC), and Brian Fearnly (Nevada Physical Therapy).

Student evaluations proved the program successful and it is anticipated that Health Care Heroes will be offered again during Kids University next summer.

DHS Launches “Walk Your Talk” Tuesdays

The Division of Health Sciences is about learning and working together to improve health and wellness. Staying true to this mission we have created a new year-long wellness program for faculty and staff, “Walk Your Talk Tuesdays.”

Each month you are encouraged to participate in a variety of activities, from informational and educational presentations, fitness, nutrition and stress reduction classes and utilizing the resources we have available at the university. Plus, it is a great way to meet and network with other DHS colleagues and do something positive for you! Join us for our first event:

"Managing Your Weight and Health in an Unsupportive Environment. How Wellness Resources on Campus Can Help You Prioritize Living a Healthy Lifestyle"

Tuesday, Sept. 15, 4 p.m.-5:30 p.m.

Center for Nutrition and Metabolism, Room 249

University of Nevada School of Medicine, Reno

Join Maureen Molini, M.P.H., R.D. as she presents a brief overview of weight loss and wellness programs available at the Center for Nutrition and Metabolism, with the opportunity for participants to schedule their first appointment once the presentation is over.

English Professor Seeks Health Care Professionals for Student Interviews

Susan Palwick, Ph.D., associate professor in the University of Nevada, Reno Department of English, is teaching a section of English 102, the research-based second semester of freshman composition, with a theme of narrative medicine. One of the papers requires students to interview a health care professional.

The interview will take no longer than an hour and will not be recorded. It will be used as material for a five to seven page provider profile essay, a class assignment in which the students will describe how you became involved in your field, what you find both rewarding and challenging about it, and what experience if any you've had with narrative medicine. Essays will not be published, although five or six of them will be read and critiqued by the entire class. The student who interviews you will be responsible for contacting you to set up a convenient time and place.

This paper is due Sept. 30, which means that students would probably be contacting you the week of Sept. 14 or Sept. 21. If you're willing to be interviewed by the students, many of whom are interested in health care professions themselves, please send your name, specialty and contact information to Susan Palwick or call (775) 682-6389 ext. 246.

Division of Health Sciences Grand Rounds Events

DHS faculty, staff and students are encouraged to attend a series of grand rounds educational presentations that have been planned and co-sponsored with the Department of Psychiatry, School of Medicine. These events take place on the third Wednesday of every month from 4:00 p.m. to 5:30 pm in Room 16 of the Penning ton Medical Education Building, as well as, pictel to Las Vegas at the 2040 Building in the dean’s conference room.

CME credits are available. The 2009-10 schedule includes:

  • Oct. 21: "PTSD in Vets Returning With Head Injury" by Thuy Boardman, Ph.D. M.P.H., VAMC
  • Nov. 18: "Grief" by Tony Papa, Ph.D., Department of Psychology, University of Nevada, Reno
  • Jan. 20: "Geriatric Suicide" Prevention by Jerry Reed, Ph.D.
  • Feb. 17: "Universal Health Care" by Ole Thienhaus, M.D., MBA, Dean, University of Nevada School of Medicine
  • June 16: "Moderators of Cognitive Aging" by John Morris, M.D.

Upcoming Events

Social Work Professors to Talk on Cross-Cultural Dying, Death and Bereavement

Division faculty are invited to attend the lecture "Dying, Death and Bereavement: A Cultural Comparison of Celebration and Mourning in Ghana and the U.S." by Alice Boateng, Ph.D., assistant professor, and Linda Anngela-Cole, assistant professor, at the School of Social Work, on Sept. 16, 12:00 p.m. to 1:30 p.m. in the Schulich Lecture Hall 001.

School of Medicine 40th Anniversary: Multi-Specialty Updates Offers CME

Plan to attend the University of Nevada School of Medicine’s 40th Anniversary Multispecialty Update. This continuing medical education opportunity is scheduled for Friday, Sept. 25 in Manville Auditorium and will offer a full day of clinical updates, presented by several of the school’s distinguished faculty. Register or view the complete agenda or contact the Office of Continuing Medical Education and Professional Development at (775) 784-4782.

More Professional Development Opportunities at the School of Medicine

The Office of Continuing Medical Education announces several opportunities this fall. The 2009 Annual Diabetes Conference will be held Friday, Oct. 2 at the Peppermill Hotel Convention Center in Reno. "Networking for HIV Care: Tenth Annual Autumn Update" is planned for Oct. 17 and 18 at Northstar-at-Tahoe in Truckee, Ca. To register or for additional information, call (775) 784-4782.

Nevada Public Health Annual Conference on Sept. 21-22

The Nevada Public Health Association will hold its annual conference at the Joe Crowley Student Union at the University of Nevada, Reno on Sept. 21 and 22. "The State of Public Health in Nevada: Taking Stock on the Eve of Healthy People 2010" will be the theme this year as practitioners, researchers and students explore different perspectives on what it takes to achieve a healthier Nevada. To register and for more information call (775) 784-1983.

Women in Health Sciences Workshops, Dec. 7 in Reno, Dec. 8 in Las Vegas

Faculty and students are invited to attend the first Women in Health Sciences professional development event. The program will be held in Reno on Dec. 7 and Las Vegas on Dec. 8 and will feature workshops and presentations from 8:00 a.m. to 1:00 p.m. The guest speaker, Elizabeth Travis, Ph.D. will speak on "Achieving Work/Life Balance." Box lunches will be provided. RSVP by calling (775) 784-6777. This event is co-sponsored by the University of Nevada School of Medicine Office of Faculty Affairs and Development, Division of Health Sciences, Orvis School of Nursing, UNLV School of Dental Medicine and UNLV School of Nursing.

Our People

CASAT Group shot

Center for the Application of Substance Abuse Technologies

Julie Hogan, Ph.D., Eric Albers, Ph.D. and Joshua Phillip presented with Carol McHale, Ph.D., senior social scientist analyst, CSAP, other SAMHSA officials, and prevention specialists from Palau, Guam, and the Commonwealth of the Northern Mariana Islands on contract work done in the pacific jurisdiction of the U.S. Department of Health and Human Services SAMHSA CSAP Asian Pacific American Heritage Month.

The event was "Celebrating Service to Science with the Pacific Jurisdictions: Working with Community Programs to Tell Their Stories of Success." The presentation was held on May 28 in Rockville, Md. Brief descriptions of the CSAP Service to Science Initiative were presented along with information on the importance of building cultural and collaborative foundations with prevention program partners. The jurisdictions talked about their programs and demonstrated how the work provided by this project helped them advance their initiatives.

Hoskins Named to Renown Pregnancy Center Advisory Board

Melinda Hoskins, M.S., R.N., C.N.M., assistant professor at the Orvis School of Nursing, was appointed to serve on the advisory board for the Renown Pregnancy Center as they implement the centering pregnancy model for prenatal care. The program is funded through a March of Dimes grant to sponsor training for staff and fund materials for patient education.

Barsky Named Chair of Pathology Department

Sanford H. Barsky, M.D., joined the University of Nevada School of Medicine as professor and chair of the Department of Pathology. Barsky is a highly-regarded and entrepreneurial cancer researcher who will serve as chief of pathology at Nevada Cancer Institute in Las Vegas and associate director for the institute in Reno. He will lead the research and clinical missions of the Department of Pathology in Nevada, in addition to maintaining its outstanding teaching missions. He is a pioneer in digital pathology and will initiate a virtual slide microscopy diagnostic consultative service in the state.

Grants, Publications and Research Activities

Christine Aramburu Alegria, Ph.D., R.N., FNP-BC, assistant professor at the Orvis School of Nursing, received a junior faculty research grant for a study to examine changes in the activities and identity of heterosexual couple members in which the female partner has had weight loss surgery.

Melissa Piasecki, M.D., associate dean for faculty affairs and development at the University of Nevada School of Medicine, presented "Competency Standards for Immigration Hearings" to federal immigration judges last month at the U.S. Department of Justice in Washington, D.C.

Daniel Cook, Ph.D., assistant professor at the School of Community Health Sciences, recently published Pharmacy Policy: Medication Therapy Management Favors Large Pharmacy Chains and Creates Potential Conflicts of Interest; Tobacco control: The Politics of Smoking in Federal Buildings: An Executive Order Case Study; and Conflicts of Interest in Science: Journalists and Conflicts of Interest in Science: Beliefs and Practices.

Bernadette Longo, Ph.D., R.N., assistant professor at the Orvis School of Nursing, presented "Acute Respiratory Effects Associated with Volcanic Air Pollution from Kilauea Volcano" at the 20th Sigma Theta Tau International Nursing Research Congress in Vancouver. She was featured on a TV news special on KHNL Channel 8 NBC Honolulu about health effects and the volcanic air pollution while doing research this summer at Kilauea.

Student News

Know Your Associated Students of the University of Nevada Senators

The ASUN Student Senators representing the division are Geramye Teeter and Kimberly Anichowski. You are encouraged to contact them with issues or ideas related to student government and campus activities.

New Computers in Lab and Refurbished Lounge for Division Students

If you are on the south end of campus and need a quiet place to study or eat lunch, stop by the refurbished Sandra Neese Lounge, located on the first floor of the Sarah Fleischmann Building. Comfortable furniture, work tables and lap top accessible tables are now available during times that it is not being used for classes.

The Division of Health Sciences Student Center has 15 new computers in the computer lab (SFB 204C) and four new computers in the student center office (SFB 204B) available for student use. A new printer is also available in the student center office. Students should bring a ream of paper to share each semester. The division office will cover the cost of ink.

Get Involved: Join a Club

Division of Health Sciences students have a variety of opportunities to join organizations affiliated with their major. Now is the time to join and meet fellow students with similar interests. A brief description and contact person is provided below:

Orvis School of Nursing

Orvis Student Nurses' Association (OSNA)

The objectives and aims of the Orvis Student Nurses' Association are to unite student nurses, pre-nursing students, faculty and nurses in the community for the purpose of giving support, providing networking opportunities and offering leadership enhancement to candidates of the bachelors of science degree. OSNA is a professional nursing student service organization representing Orvis School of Nursing (OSN) students and the nursing profession. Club Leader: Derek Drake

School of Community Health Sciences

Physical Therapy Club

The mission is to prepare students of the University of Nevada for professional school of physical therapy by providing information about schools, scheduling guest speakers, announcing continuing education classes, as well as, giving every opportunity to experience all areas of physical therapy. Club Leader: Ashley Young, (775) 741-7395

Pre-Dental Society

The mission of our club is to educate and familiarize interested students in the field of dentistry while helping them prepare for entrance into dental school. We also aim to build strong relationships with the local dental community as well as with neighboring dental schools. Club Leader: David Beistline

School of Social Work

Undergraduate Student Social Work Association (USSWA)

The USSWA is the University of Nevada, Reno's official organization for all undergraduate social work students. All University of Nevada, Reno students are welcome. Funds assist the students of the University and members of the communities of Reno, Sparks and outlying areas. Club Leader: Ruben Risi Garcia, (775) 636-1111

University of Nevada School of Medicine Department of Speech Pathology and Audiology

National Student Speech Language and Hearing Association (NSSLHA)

NSSLHA is a pre-professional association for undergraduate students interested in the study of communication science and disorders. We do fundraisers throughout the year, go to national conventions, and bring in professionals from our field to talk about experiences in the work place. Club Leader: Cassandra Foust

Other Health Sciences

Gerontology Club

In serving the local elderly population, the gerontology club offers opportunities for scholarships, career and educational development, leadership, personal interaction, and community service. Our aim is to develop a greater understanding of and connection with local senior citizens by participating in fun and helpful activities. Club Leader: Casie Weaver, (775) 784-1324

Student Organization for Providers of Addiction Services (SOPAS)

Our mission statement is "promoting activities which strengthen and unify the addiction services professions while striving to positively impact campus and community life." Faculty Advisor: Meri L. Shadley, Ph.D., (775) 784-6265

Copyright © 2009 Health Sciences.