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.