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The History of Hopkins GIM: Thirty-Five Years of Medicine Without Limits

Background

30 Year Celebration PosterHistorically, all internists were generalists who provided comprehensive, continuous care to patients with a variety of health problems. Some also subspecialized in particular areas of interest. The Johns Hopkins Department of Medicine, with its Oslerian tradition of excellence, has long been a leader in providing training for this type of physician. In the latter part of the 20th century, however, with the very rapid growth of physician subspecialization, there emerged a need to reinforce the high quality training of the general internist. Responding to this need, the Department of Medicine, under the leadership of Dr. Victor McKusick, the Chairman of the Department, and Dr. Philip Tumulty, the renowned clinician and model of excellence in general internal medicine, created the Division of General Internal Medicine in 1977. They established the Division to help maintain the tradition of the general internist; to identify that tradition as a specialty in its own right; to strengthen the connections that unified the Department of Medicine; to establish a home for the academic general internist; and to promote excellence in practice, teaching, and research relevant to general internal medicine.
 

Early Years

The Division began as a small cohesive unit under Dr. Tumulty's leadership. Dr. Tumulty was nationally recognized as master clinician and teacher, and was the David P. Carver Professor of Medicine.  He served on the faculty for nearly 50 years, heading the Department of Medicine's inpatient and outpatient services for 17 years.  Known as an unequaled diagnostician and a champion of the humanistic approach to medicine, Dr. Tumulty focused his scholarship on the study of the natural history of disease. The author of many clinical papers on infectious diseases, he also wrote The Effective Clinician, His Methods and Approaches to Diagnosis and Care. In honor of his excellent teaching, research, and patient care, he received many awards and much recognition, including election to the Association of American Physicians. Before his death in 1989, Dr. Tumulty was honored by colleagues and patients who established the Tumulty Endowment Fund for the support of internal medicine, an area Dr. Tumulty felt important in an age of increasing specialization.

Dr. Craig Smith, a former Assistant Chief of Service, who had advocated for creating the Division, was named Associate Director.  Together, Drs. Tumulty and Smith sought to build a division of outstanding general internists on the full-time faculty, who would teach, care for patients, conduct clinical research, and serve as role models for students and housestaff.

Primary faculty recruited to the Division in the early years included Drs. Diane Becker, Laura Mumford, Tom Pearson, Brent Petty, and Lora Wilder. The Division was also the home for the four Assistant Chiefs of Service of the four Firms of the Department of Medicine. To learn more about the close relationship between GIM and the Firm System, watch Chief Rounds, a short film produced by Dr. Brancati.

One of the most important developments in the Division’s first year was the creation of the fellowship training program in internal medicine. Drs. Tumulty and Smith secured funding from the Kaiser Family Foundation for two fellows per year for two years. According to Dr. Smith, this was a seminal event in the history of the Division. It gave the Division money, credibility, and the means to attract young talent. Early post-doctoral fellows recruited to the Division included Drs. Lawrence Klein and Steve McPhee (1978) and Dr. Richard Moore (1980). These individuals established a strong multidisciplinary collegium—a hallmark of the Division to this day.

With Dr. Tumulty's retirement from full-time faculty duties, Dr. McKusick appointed Dr. Smith to the Division Director post. The Division began to grow in number of faculty and staff and to develop its clinical, teaching, and research activities. In addition to its own practice, the Division took responsibility for the University Health Service and the Department’s general medicine consultation service. The Division had also become the home for two important grants: 1) the Robert Wood Johnson Grant to establish a model practice for faculty and house staff practice in general internal medicine and 2) the National Institutes of Health (NIH) Preventive Cardiology Award, under the stewardship of Dr. Thomas Pearson, which brought initial scientific recognition to the Division. Recruitment of new faculty and fellows was underway, and Drs. Smith and David Levine—then a joint faculty member, with a primary appointment in the School of Public Health—recruited Dr. Earl Steinberg to develop and head a program in Health Policy and Technology Assessment. They also recruited GIM fellows to Dr. Levine’s NIH training grant in Behavioral Aspects of Heart and Vascular Diseases, which has been continuously funded since 1976.

The fellowship class of 1982 included four young physician scholars who went on to become nationally recognized leaders: Dr. Richard Allman (now Professor of Geriatrics at UAB), Dr. Linda Fried (now Professor and Director of Geriatrics at Johns Hopkins and a member of the Institute of Medicine), Dr. Michael Klag (now Dean of the Bloomberg School of Public Health), and Dr. Teri Manolio (now Senior Advisor to the Director of Population Genomics at NHGRI/NHLBI).  In 1984, Dr. Smith recruited Dr. David Levine to become a primary faculty member in the Division.

The Levine Years, 1986-1996

Shortly thereafter, having grown the Division to the third largest in the Department of Medicine in research and clinical practice income, Dr. Smith stepped down from the Directorship to start a pharmacoepidemiology program in the Division of Clinical Pharmacology. To replace him, Dr. McKusick appointed Dr. William Hazzard, then Vice Chair of the Department of Medicine.  Dr. Hazzard maintained stewardship of the Division for a year, at which point he was recruited to become Chairman of the Department of Medicine at Wake Forest University’s Bowman Gray School of Medicine. In 1986, the Department of Medicine’s new Chairman, Dr. John Stobo, appointed Dr. Levine, first as Interim Director of the Division, and then as permanent Director, following a national search.

The Division was still small: the faculty, fellows, and staff were all located in close proximity (on the fourth and fifth floors of the Harvey Building, and the third floor of the Carnegie Building in Johns Hopkins Hospital) and would bump into the Division Director daily.  Over the next 15 years, this small cadre of energetic, talented, and committed academicians would evolve into one of the largest and most prominent divisions at Johns Hopkins, renowned nationally for its scholarly work.

During these years, the Division had four main goals: 1) further development of the fellowship in general internal medicine; 2) recruitment of faculty; 3) development of a broad research agenda; and 4) creating a clinician-educator program. Development of the fellowship was given the highest priority. The fellowship was built in collaboration with the Division of General Internal Medicine at the Johns Hopkins Bayview Medical Center, known for its strength in medical education and curriculum development.

Initially, Dr. Levine directed the fellowship himself. In 1988, he asked Dr. Eric Bass to assume the post. Under Dr. Bass’s enlightened leadership, the fellowship matured into a world renowned program, emphasizing state-of-the art multidisciplinary scholarly training, with outstanding mentorship. Dr. Bass not only promoted growth of the fellowship, but instilled innovative curricula, experiences, evaluation mechanisms, and a dedication to professional and career growth that promoted the fellowship into its place of national prestige today. Over 100 fellows have graduated from the program, with 16 current fellows in training. The fellowship has become one of the most competitive in the country, with the vast majority of its graduates becoming leaders in research, medical education, clinical practice, and administration in American medicine and public health. Several of these individuals now hold positions as dean, vice dean, department chair, division director, and endowed professor at various schools of medicine and public health. Many alumni stayed at Hopkins and contributed substantially to its growth and reputation. These include: Drs. Lawrence Appel, Eric Bass, Mary Catherine Beach, Ebony Boulware, Fred Brancati, Geetanjali Chander, Jeanne Clark, Sarah Clever, Joe Cofrancesco Jr., Lisa Cooper, Gail Daumit, Richard Moore, Jodi Segal, Jeremy Sugarman, and J. Hunter Young.

Faculty recruitment was also a high priority for a growing division. The goal was to as to provide breadth and depth of research, teaching, mentoring, and clinical experience.  Two key faculty members were already on staff when Dr. Levine assumed the Director post: Drs. Diane Becker and Richard Moore.

Dr. Diane Becker began her research program with the conduct of her doctoral thesis, which focused on cardiovascular risk in siblings of adults with premature coronary artery disease. Over the next 25 years, this thesis grew into a landmark NIH-funded cohort study. Today, the Sibling Study continues to produce new knowledge regarding biological, genetic, behavioral, and socio-cultural risk factors for cardiovascular disease, as well as effective interventions to lower overall cardiovascular risk profiles in these families. Dr. Becker has also been a pioneer in community-based intervention research, particularly with high risk populations.

Dr. Richard Moore began his research during his fellowship at Hopkins, concentrating on clinical trials, epidemiological methodology, and pharmacoepidemiology. When the HIV epidemic hit, he focused his program on HIV-AIDS, including its epidemiology, treatment, risk profile, outcomes, costs, and policy implications. His pioneering efforts created an internationally recognized model for outcomes research. In 2003, he was asked by the Department of Medicine to lead the Moore Clinic—one of the nation’s busiest and best known programs for the care of patients with HIV-AIDS.

In the late 1980s, The Division also recruited several new key faculty members from outside Hopkins. One new recruit was Dr. Daniel Ford. After completing the Osler Training Program, Dr. Ford undertook a post-doctoral fellowship in clinical epidemiology at the NIMH. At Hopkins, he developed a broad research program on primary care, with a special emphasis on mental health. From 1994 to 2006, he also directed the University Health Service, then a core clinical activity of the Division. In 1998, he obtained a post-doctoral training grant from HRSA to support research in primary care—a grant that continues to be a core source of funding for the GIM Fellowship. Dr. Ford now serves as Vice Dean for Clinical Research in the School of Medicine and was named the David M. Levine Professor of Medicine in 2005.

Another key recruit from the 1980’s was Dr. Neil Powe. Dr. Powe had completed training as a Robert Wood Johnson Clinical Scholar at the University of Pennsylvania, earning an MBA the Wharton School of the University of Pennsylvania. At Hopkins, he joined the Program in Health Technology Assessment and Finance led by Dr. Earl Steinberg, a pre-eminent health services researcher. In his early years on faculty, Dr. Powe focused on evaluation of a range of emerging technologies. In the early 1990s, Dr. Powe’s attention turned more specifically towards the epidemiology and treatment of end-stage renal disease. He joined the Welch Center for Prevention, Epidemiology, and Clinical Research. Founded by Dr. Paul Whelton, a nephrologist-epidemiologist with a joint appointment in GIM, the Welch Center had already gained national recognition for its work on the clinical epidemiology of cardiovascular and renal disease. When Dr. Whelton departed to take the post of Vice Chancellor for Health Sciences at Tulane, Dr. Powe assumed the role of Welch Center Director and Director of the Clinical Epidemiology Concentration in the Department of Epidemiology. The Center is now home to 28 full-time research faculty, most with primary or secondary appointments in GIM, who constitute a unique bridge between the Schools of Medicine and Public Health.

In the 1990s, the Division made a number of important internal recruitments from the GIM Fellowship. Dr. Lawrence Appel built a research program around prevention of cardiovascular and renal disease. Today, he is Professor of Medicine, Epidemiology, and International Health, and the Director of Johns Hopkins ProHealth—an NIH-funded center of excellence for community-based trials of cardiovascular prevention. He is an internationally recognized expert in nutritional aspects of hypertension and on non-pharmacologic approaches to primary prevention.  Dr. Fred Brancati built a research program around the epidemiology and prevention of type 2 diabetes and related conditions. Today, he is Professor of Medicine and Epidemiology and Director of the Division of General Internal Medicine. Dr. Lisa Cooper built a research program around physician-patient communication, with particular emphasis on understanding and eradicating racial and ethnic disparities in health care. She has become an internationally recognized expert in this field and has earned a sterling reputation as a mentor for students, residents, fellows, and junior faculty.

It was also early in the 1990s that Dr. Stobo, in response to an urgent need for educators and internal medicine consultants committed to build a group of general internists who would have focused careers as clinician-educators. With funding from the Johns Hopkins Hospital, the Department formed a financially independent unit based on the 7th floor of the Johns Hopkins Outpatient Center.  In 1991, he recruited Dr. William Aronstein, who had completed his Osler residency and practiced two years in the Indian Health Service in Zuni, New Mexico. 1n 1992, Dr. Aronstein was joined by Dr. Shawn Stinson who had just completed a year as Assistant Chief of Service, and by Dr. John Flynn, who had completed both his tenure as Assistant Chief of Service as well as a rheumatology fellowship. This Group was soon joined by Drs. Lisa Simonson (1994), Patricia Thomas (1995), Stephen Sisson (1995), and Don Martin (1996). In 1995, Dr. Aronstein left Hopkins to lead a collaborative clinical and research effort with Samsung Medical Institutions in Seoul, South Korea. At that point, Dr. Flynn assumed Clinical Directorship of the Division. As a result of Dr. Aronstein’s efforts, Samsung Medical Institutions awarded the University funds for the Samsung Chair which is presently held by Dr. Levine. Dr. D. William Schlott joined the group and was named Tumulty Associate Professor with the funding provided in honor of Dr. Philip Tumulty in 1994. He established clinical operations at Green Spring Station in conjunction with Dr. Amy Gordon and Dr. Paul G. Auwaerter.

The Klag Years, 1996-2004

After a dynamic decade, Dr. Levine stepped down as Division Director in 1996. The Department of Medicine’s then Chairman, Dr. Edward Benz, named Dr. Michael Klag to replace him. Dr. Klag had already built an international reputation in the epidemiology of cardiovascular and renal disease. Under Dr. Klag’s leadership, the Division continued to flourish with enhanced research and clinical programs, along with faculty, fellow, and staff development. The Division underwent important planned growth in faculty, areas of research, training, and interrelationships with other divisions in the Department of Medicine, other departments in the School of Medicine, and the Schools of Public Health and Nursing. During Dr. Klag’s tenure, the Division doubled in size and spread itself across four different sites—a challenging obstacle to unity. Dr. Klag gave high priority to divisional unity and brought all elements—research, clinical, teaching—“back to the table together.” This was critical for the health and future of the Division. Equally important, Dr. Klag championed equity in visibility, promotability, and reward structures for all faculty and staff.

The growth and development of the Clinician Educator Group under the leadership of Dr. Flynn, and with the support of Dr. Benz, was a major accomplishment during these years.   In 1997, the Group size doubled with the additions of Drs. Carol Ann Huff, Redonda Miller, and Kimberly Peairs (who had each just completed a year as Assistant Chief of Service) as well as Drs. Gregory Prokopowicz, Mark Hughes, Jeffrey Magaziner and Joseph Cofrancesco, Jr. who had just completed his GIM fellowship. Dr. Bimal Ashar (1998), who is now the Medical Director of the Executive Health Program, and Dr. Spyridon Marinopoulos (2001), who is now the Director of University Health Services, joined soon thereafter. Subsequent recruitments to this Group have included Dr. Gail Berkenblit (from the Osler Housestaff) in 2002, Dr. Sarah Clever (from the GIM Fellowship) in 2003, and Dr. Rosalyn Stewart (from University of Maryland) in 2004.  On October 16, 2001, the D. William Schlott Professorship in Clinical Medicine was established in honor of clinical and educational excellence provided by Dr. Schlott. Dr. Flynn was the inaugural recipient of this professorship.

By 2005, the Clinician Educator Group had achieved a major influence over the training programs of Johns Hopkins, with one-third of the faculty leading the Clinical Skills course in School of Medicine (three Firm Faculty leaders, and two Associate Program Directors).  That year, both Drs. Flynn and Sisson won national awards from the Society of General Internal Medicine—one for program building, the other for creating a novel internet learning system.

Growth of the GIM research enterprise also continued under Dr. Klag who recruited seven alumni of the GIM Fellowship Program to faculty.  Dr. Jeremy Sugarman, an internationally regarded expert in bioethics, was recruited to the Harvey M. Meyerhoff Chair of Bioethics and Medicine after a successful career at Duke. Dr. Jeanne Clark was recruited to build a program in the clinical epidemiology of fatty liver disease, obesity, and related conditions. Dr. J. Hunter Young, a former Hopkins Assistant Chief of Service mentored by Dr. Klag, joined the faculty with a focus on the genetic and molecular epidemiology of hypertension and related conditions. Dr. Gail Daumit, who originally came to Hopkins as a Robert Wood Johnson Clinical Scholar, was recruited to pursue research in the epidemiology and treatment of medical conditions in adults with severe mental illness. Dr. Ebony Boulware was recruited to build a health services research program in transplantation, with particular emphasis on meta-analysis, cost-effectiveness analysis, and systematic literature synthesis.  Following a Greenwall Foundation Fellowship in Ethics, Dr. Mary Catherine Beach continued her work in the area of physician-patient communication and relationships. And Dr. Geetanjali Chander was recruited to build a research program in the area of substance abuse, HIV, and hepatitis.

In 2000, Dr. Klag assumed the additional responsibility of serving as Acting Chair of the Department of Medicine, a position he held until Dr. Myron Weisfeldt was named Chair in 2001.  Subsequently, Dr. Edward Miller, Dean of the School of Medicine, named Dr. Klag to become the Vice Dean for Clinical Research—a challenging post under any circumstance, but especially so in the aftermath of the sanctions against the School of Medicine levied by the Office of Human Research Protections. While holding down the Division, Dr. Klag also managed to resuscitate the clinical research enterprise of the School and establish an entirely new system for institutional review.

By 2004, the dual role had become too demanding. Dr. Klag stepped down to focus on his role as Vice Dean, only to be named a few months later as Dean of the Bloomberg School of Public Health. From 2004 to 2005, Dr. Levine stepped back in to serve as Acting Division Director.

The Brancati Years: 2005-2012

In 2005, Dr. Fred Brancati was named Director of the Division by Dr. Weisfeldt. He undertook a series of reforms and innovations designed to improve efficiency, productivity, cohesion, equity, and divisional reputation.

Working with Dr. John Flynn and Dr. Dan Brotman, he fully united the research and clinical wings of the Division. Previously, the two wings were treated as distinct entities by the Department of Medicine with separate budgets, leadership, and goals. Unification allowed a series of improvements including: greater access to clinical work for researchers; greater access to research resources for clinician-educators; greater fluidity in roles for junior faculty; more efficient and transparent management; and more leverage in negotiations with the Department and the School.

He overhauled and unified the administrative structure of the Division. Previously, the Division had a core staff of 3 FTEs; most of the budgetary and human resources work was decentralized in the offices of senior faculty. That created problems for supervision, standardization, quality assurance, and cross-coverage. He identified budgetary and human resources work as ‘core’ functions and invested his recruitment dowry in the creation and expansion of core divisional staff--now comprised of 12 FTEs.

He established an Executive Committee for the Division including the Clinical Director, the Hosptialist Director and the Fellowship Director, along with their Associate Directors. By formalizing such Associate roles and connecting them with part B salary, he began to address the gender disparity in leadership opportunities and corresponding salary differentials. To promote salary equity, he instituted a policy of transparency with regards to salary, showing scatterplots of salary at annual state of the division presentations. This approach was later adopted by the DOM.

He launched the Division’s first website. Key goals were to enhance recruitment of fellows and junior faculty, facilitate patient access to GIM physicians, keep faculty informed about each other; allow easy faculty access to policies and paperwork, aid in resident training, support new centers and initiatives, and keep a real time census of GIM faculty and programs. The website rose to national prominence, appearing first or nearly so in Google searches of “general internal medicine” and related topics.

He launched GIM Grand Rounds, held three times a month immediately following DOM Grand Rounds on Friday mornings. The format includes 5 minutes of announcements, a 5-minute introduction of the speaker, a 30-minute presentation, and 10 minutes of question and answer. By assigning faculty unfamiliar with each other as introducer and speaker, the format creates connections between far flung units in a large, diverse division.

With Dr. Jeanne Clark and Dr. Geetanjali Chander, he established the Hopkins GIM Housestaff Research Awards Program. Now in its 6th year, the program is a national competition for house officers who intend careers in academic GIM and who have completed research projects in clinical epidemiology, medical education, bioethics, or other areas of GIM research. The program has increased the Division’s profile nationally and has brought over 20 outstanding young GIM scholars to Hopkins at a formative point in their careers. Two of the winners later came to Hopkins GIM—one as a fellow, another as faculty.

Working with Drs. Eric Bass, Jeanne Clark and Geetanjali Chander, he markedly expanded the budget of the GIM Fellowship, mostly by capturing value created by fellow’s clinical activities. The new funds supported more core faculty effort, two weekly lunch conferences, upgraded computing equipment, and more generous travel allowances.

Working with Dr. Joe Cofrancesco and Dr. Jessica Yeh, he formed GIM’s first Core resources. Founded and led by Dr Cofrancesco, the Clinician-Educator Mentoring and Scholarship Program (CEMSP), provides mentoring and research assistant support to clinically oriented faculty whose scholarly interest lie outside the NIH and AHRQ-funded research infrastructure of the Division. Founded and led by Dr. Yeh, the GIM Methods Core provides broad support to researchers from throughout the Division, ranging from design and biostatistics to data management and analysis. The Core underlies several other research initiatives connected to the Division, including the Osler Housestaff Research Program, the Diabetes Prevention & Control Core, and the Welch Center Methods Core.

With the help of Dr. John Flynn, he committed the Division to a bigger role in the Association of Chiefs and Leaders in General Internal Medicine (ACLGIM). Several GIM faculty took national leadership posts, including John Flynn (Membership Chair), April Fitzgerald (Leadership Forum editor), and Fred Brancati (President).
       
To the tradition of the Winter Party (which brings together over 250 faculty, fellows, students and staff for food and dance), he added two additional annual celebrations: the Spring Picnic and the SGIM Alumni Dinner (the largest of its kind nationally) (See photos)

Following negotiations with the Dean’s Office, GIM spun off the University Health Service into an administratively distinct entity led by Dr. Spiro Marinopoulos. In return, the SOM agreed to a major expansion of the budget aimed at improving quality and timeliness of care. Long housed in limited space on Carnegie 1, UHS moved first into freshly rehabilitated offices at Bond Street and in 2012 to brand new offices in a new student housing tower on Wolfe Steet in the Science and Technology Park.

The JHH Hospitalist Program grew substantially during this period, under the outstanding leadership of Dr. Dan Brotman. When Dr Brotman arrived in 2005, the Program was small in size and impact. By 2012, the Program had developed a local reputation for clinical excellence and a national reputation for innovation and scholarly achievement. Key milestones under Dr. Brotman’s leadership included: attaining 24/7 coverage, establishing a unique ‘Hospitalist Scholars Program’ to provide faculty with $12,000 annually each to support their scholarly projects, winning K awards for cardiovascular (Dr. Rehan Qayyum) and quality and safety research (Dr. Henry Mitchtalik), opening a procedure service praised for both efficiency and educational value, and recruiting a strong associate director (Dr. Carrie Herzke). Recruited in 2006, Dr. Lenny Feldman led two historic initiatives: a web-based Consultative and Perioperative Medicine CME program which was adopted by SHM, and two unique federally-funded training programs in Urban Health (med-peds and internal medicine). In 2012, JHH Hospitalist Program faculty accounted for 10% of all scholarly abstracts presented at the national scientific meetings of SHM.

A long-time ally of the Welch Center, the Division developed relationships with a range of new centers and programs including the following:  

The Hypertension Center, under the leadership of GIM's Dr. Gregory Prokopowicz, aims to improve the management of hypertension by providing the highest level of consultative care for patients with high blood pressure that is difficult to diagnose and/or treat. Additionally, the Center is dedicated to acquiring and disseminating knowledge through clinical research on the diagnosis and treatment of hypertension and educational programs for both patients and physicians about hypertension and its management.. 

The Evidence-based Practice Center (EPC), directed by Dr. Eric Bass, with the assistance of Dr. Karen Robinson and Dr. Jodi Segal, produces comprehensive systematic reviews of important medical topics using interdisciplinary teams that integrate clinical expertise with expertise in evidence-based methods, including  meta-analysis, decision analysis, benefit-harms analysis, and cost-effectiveness analysis. The EPC also collaborates with other EPCs and AHRQ programs to advance the methodology of systematic reviews, their transparency, and their use in dissemination and translation of findings.

The Center for Drug Safety and Effectiveness serves as a nexus for individuals at Johns Hopkins who are involved in research, education, clinical programs and public service to improve prescription drug use and pharmaceutical policy in the United States and around the world. It addresses such problems as prescription drug abuse and barriers to accessible and affordable medicines in developing countries. The Center's co-directors (Dr. Caleb Alexander and Dr. Jodi Segal) and its associate director Dr. Sonal Singh, are all GIM-affiliated.

The Center for Health Services and Outcomes Research (CHSOR), under the direction of Dr. Albert Wu, jointly appointed in GIM, conducts interdisciplinary research on timely issues in health care, including research on the organization, financing, staffing and technology of health services and their impact on quality of care, patient outcomes, resource utilization, and costs. Priority is given to research on Federal and state policy issues, and managed health care. Special attention is devoted to the impact of health policies and services on vulnerable population groups such as children, the elderly, uninsured, mentally ill, and disabled persons.

The Center for Medical Technology Policy (CMTP), under President and CEO, part-time GIM faculty member Dr. Sean Tunis, defines and publishes methodological standards and guidance for comparative-effectiveness research and patient-centered outcomes research that reflect the information needs of patients, clinicians, and payers. It also develops technically sophisticated and highly implementable processes and products that enhance the clinical research enterprise, as well as facilitating  dialogue, debate and consensus around coverage and reimbursement and other policies that promote high priority research.

Under the leadership of Drs. Fred Brancati, Jessica Yeh, Felicia Hill-Briggs, and Nae-Yuh Wang and , the Diabetes Prevention and Control Core fosters collaborative, multidisciplinary diabetes and endocrinology research, and translates that research into programs to train health care professionals in the diagnosis and management of diabetes. The Center strives to understand the causes of both type 1 and 2 diabetes and promote translational research that is aimed at reducing the burden of these diseases in the United States.

The GeneSTAR Research Program, led by Dr. Diane Becker, consists of integrated studies primarily sponsored by the National Institutes of Health, with industry support for investigator-initiated research questions. GeneSTAR is a prospective epidemiologic family-based study conducted in initially healthy siblings of people with documented premature coronary disease under 60 years of age, their adult offspring, and the coparents of the offspring.

Several additional faculty members achieved noteworthy accomplishments:

Dr. Lisa Cooper, a former GIM Fellow and renowned disparities researcher, achieved several major milestones. She was elected to ASCI and IOM. She became the first woman of African ancestry to attain the rank of full professor at JHSOM. She was named the inaugural James Fries MD Professor of Medicine. And with NHLBI funding, she established the Center to Eliminate CVD Health Disparities which undertook an historic program of interventions to improve blood pressure control in East Baltimore.

Dr. Eric Bass, a former GIM Fellow and longtime Fellowship Program Director, led the Evidence-Based Practice Center to national prominence and successful grant renewals. After having served as JGIM Editor-in-Chief during the Klag Administration, in 2012 he was elected President of SGIM.

Dr. Larry Appel, a former GIM Fellow, achieved several major milestones. He was named to deliver the Connor Lecture at AHA, he was named to direct the Welch Center for Prevention, Epidemiology, and Clinical Research, and he was elected to IOM.

Dr. Jeanne Clark, a former GIM Fellow, built a research program in obesity and related conditions, led the GIM Fellowship for 5 years during a period of reform and expansion, led the DOM’s Womens Task Force, won the David Levine Mentoring Award and a Mentoring Ward from the SOM’s Vice Dean, was named the inaugural Frederick Brancati Chair, and was named Associate Director, then Interim Director of the GIM Division.

The GIM Division embarked on cancer health services research and clinical epidemiology. Dr. Jessica Yeh developed a research program in diabetes and cancer. Dr. Claire Snyder developed a program in cancer survivorship and patient-reported outcomes, winning GIM’S first grants from the American Cancer Society, the National Cancer Institute and the Patient Centered Outcomes Research Institute (PCORI). And Dr. Craig Pollack, recruited from the RAND Corp in Washington, DC, developed a program in disparities research related to prostate cancer.

Three GIM faculty members, Drs. Fred Brancati,  Dan Brotman and Hunter Young, played key roles in winning a landmark $20M Innovation Challenge grant from the Center for Medicare and Medicaid Services (CMS). Nicknamed J-CHiP, the project aims to reform acute and chronic disease care so as to reduce costs by improving quality and reducing unnecessary care.

New faculty recruitments during this interval included: Drs. Raquel Charles-Greer, Nisa Maruthur, Wendy Bennett, Claire Snyder, Craig Pollack, Sonal Singh, Mariana Lazo, Kim Gudzune, Jay Vaidya, Rasika Mathias, Karen Robinson, Lisa Yanek, Vinayak Kottoor, Anastasia Rowland-Seymour, Zackary Berger, Rochelle Brown, Sosena Kebede, April Fitzgerald, Tony Boonyasai, Ahmit Pahwa, Muhammad Amer, Zishan Siddiqui, Padmini Ranasinghe, and Ibironke Oduyebo. GIM also welcomed faculty who transferred from other programs including Dr. Gail Geller and Dr. Felicia Hill-Briggs. And GIM assisted with the recruitment of academic internists with primary appointments in other units including Caleb Alexander, Jeremy Greene, and David Dowdy.

Under Dr Brancati’s leadership, GIM embarked on a series of novel collaborations with industry. This story is captured in Dr Brancati’s February 2012 Dean’s Lecture entitled “Academia, Industry, and the Health of the Public.” In particular, he championed institutional partnerships with two corporations: Healthways and Walgreens. The Healthways relationship led to an NHLBI-funded comparative effectiveness trial of weight loss strategies in primary care (PI Dr Larry Appel). In a New England Journal of Medicine paper, Appel and colleagues described a successful web- and telephone-based weight loss program that was conducted at a fraction of the cost of in-person programs that had become the cornerstone of NIH efficacy trials. Healthways and Hopkins turned this research success into a commercial product called INNERGY. The Walgreens relationship is leading to the development of a physician-pharmacist collaborative care model for high blood pressure that will be rigorously tested in a randomized controlled trial.

GIM research funding underwent an historic expansion from $12M (annual direct costs) in 2004 to $30M (annual direct costs) in 2012, not including J-CHiP or grants  through the School of Public Health or the Berman Bioethics Institute.

In 2011-12, Dr. Brancati received several honors: he won the Kelly West Award from the American Diabetes Association for outstanding achievement in diabetes epidemiology; he won an Excellence Award from the ACLGIM for his outstanding performance as GIM Division Director; he was elected to the American Association of Professors; he was named a Distinguished Service Professor by the SOM’s Board of Trustees for his service as a division director, mentor, and innovator; he received an Osler Tie for his outstanding service as a teacher and research mentor for the Osler Housestaff; an inpatient service staffed by Hospitalist faculty and housestaff was named for him; and the SOM created an endowed ‘Frederick Brancati, MD’ Chair, dedicated to support the GIM Division Director. Dr. Clark was named the inaugural recipient of the Chair.

Due to declining health, Dr. Brancati resigned the Chief post on 1 January 2013. Dr. Jeanne Clark assumed the post of Interim Director and appointed Dr Brancati as Associate Director.



Hopkins GIM is grateful to Drs. Diane Becker, John Flynn, Michael Klag, Lawrence Klein, David Levine, Victor McKusick, Richard Moore, Brent Petty, and Craig Smith, for their contributions to this document.



 

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