http://familymedicine.med.wayne.edu

med.wayne.edu

http://familymedicine.med.wayne.edu

http://familymedicine.med.wayne.edu1


TABLE OF CONTENTSDr. Schenk Appointed to Dean’s Office3 Greetings from the Chair4 New Faculty5 FTA and Voluntary Faculty6 In MemoriamFrank Raiford, MD7 Community at the Heart of FM8 FM Residency10 OEM Residency12 External Funding14 Teaching Awards15 Honors16 Publication Highlights19 Publications21 Interpersonal Violence22 Editorial and Peer Review Activities24 Faculty Development25 Great Lakes Review26 UME27 Behavioral Science28 Presentations31 “People of Detroit” project32 Practice-based Research33 Increasing Influenza Vaccinations34 Cancer Epidemiology35 Student Grant Awards36 UFP - Detroit37 UFP - RO38 WSU Service Awards39 DFM WebsiteMaryjean Schenk, M.D., M.P.H., M.S.Chair of the Department of FamilyMedicine, was appointed interimassociate dean for academic and studentprograms at Wayne State UniversitySchool of Medicine. In this role, Dr.Schenk will be devoting her effortsto providing overall leadership to ourundergraduate medical educationenterprise, with a focus of leadingthe 2006 LCME accreditation process.During this time, Dr. Schenk alsowill continue to serve as chair of theDepartment of Family Medicine.Dr. Schenk joined Wayne StateUniversity in 1991 and became chairof the Department of Family Medicinein 2001. She has been a leader incurriculum development at the Schoolof Medicine.After joining the faculty, Dr. Schenkbegan work on designing andimplementing a National Instituteof Environmental Health Sciencesfundedmedical student curriculumon occupational and environmentalhealth that has since been integratedinto all four years of the medicalschool curriculum. As director ofclinical curriculum development, shewas responsible for the reorganizationof the School’s public health andpreventive medicine course andimplementation of the communityclinic clerkship. She also served asdirector of the highly competitiveUndergraduate Medical Educationfor the 21st Century academic awardfrom the U.S. Department of Healthand Human Services Bureau of HealthProfessions and played an integral rolein the institutional self-study for themedical school’s highly successful 1998LCME accreditation.As an alumna of the School of Medicine,Dr. Schenk holds master’s degrees inhealth planning and administration andindustrial health from the Universityof Michigan. Her research focuses oncancer epidemiology.2 Department of Family Medicine 2004 Annual Report


From the ChairGREETINGSGreetings to our Family Medicinefriends and colleagues,This year’s report is dedicated to ourmission of service to the communityand the citizens of our great state ofMichigan. Wayne State University isrecognized as an outstanding medicalschool, and the Department of FamilyMedicine is leading the way in themedical student education program,residency education, communitybasedresearch, and communityoutreach.The results of the teaching, scholarship,and service contributions of all of thefaculty are evident in the increasingnumber of medical students choosingFamily Medicine at Wayne StateUniversity. We very much hope thatthis interest will continue to flourish.The Family Medicine Interest Grouphas visionary student leadership whohave chosen a slogan that they believewill attract an increasing numberof students to our beloved specialty.That slogan is: Family Medicine: Thespecialty of choice(s).The Future of Family Medicineproject (http://www.futurefamilymed.org/) provides the framework uponwhich we will reinvent our specialtyto address the health needs of thepopulation in the 21st century, andthese medical students are ready toembrace this bold vision. Access tohealth care by the citizens in manyMichigan counties is dependent uponthese new Family Physicians.I now need you to choose to the supportthe DFM through your contributionsto our core missions of medicaleducation, research, and communityservice. I look forward to developingand implementing a program tosupport these core missions. Pleasecontact me to develop a plan ofsupport. A planned giving envelope isprovided for your convenience, or, ifyou prefer, I would be happy to hearfrom you via email or phone.Sincerely,Maryjean Schenk, MD, MPH, MSAssociate Professor and ChairDepartment of Family MedicineWayne State University101 E. AlexandrineDetroit, MI 48201(313) 577-1421mschenk@med.wayne.eduhttp://familymedicine.med.wayne.edu3


FACULTYIntroducing New Faculty . . .ChairpersonMaryjean Schenk, MD, MS, MPH313-577-0884mschenk@med.wayne.eduAssociate ChairpersonBruce R. Deschere, MD, MBA313-577-1424Deschere@med.wayne.eduAssociate ChairpersonRick K. Severson, PhD313-577-6852severson@med.wayne.eduDepartment AdministratorJoan C. Price, MBA313-577-4062jcprice@med.wayne.eduDivision HeadsJames E. Blessman, MD, MPHOccupational & Environmental Medicine313-577-1421jambles@med.wayne.eduRichard E. Gallagher, PhDMedical Education313-577-6861rgallgh@med.wayne.eduTsveti Markova, MDFamily Practice Residency313-340-4322tmarkova@med.wayne.eduJohn Porcerelli, PhDBehavioral Science313-340-4348jporcer@med.wayne.eduKendra L. Schwartz, MD, MSPHPractice-based Research313-577-0880kensch@med.wayne.eduProfessorsTerrance L. Albrecht, PhDRichard Gallagher, PhDHikmet Jamil, MD, PhDVictoria Neale, PhD, MPHLouis A. Penner, PhDRick Severson, PhDAssociate ProfessorsRebecca Cline, PhDJohn Porcerelli, PhDLinda Roth, PhDMaryjean Schenk, MD, MPH, MSKendra Schwartz, MD, MSPHAssistant ProfessorsJames E. Blessman, Jr, MD, MPHPatrick Bridge, PhDJoseph Brocato, PhDBruce Deschere, MD, MSBAMelissa Franks, PhDJohn Graff, PhDFelicity Harper, PhDNejla Israel, MDHarsha Jayatilake, MDNehman Lauder, MDTsveti Markova, MDJames Meza, MDPierre Morris, MDKodavayour Nirmal, MDSharon Popp, PhD, MSWThomas Roe, MDFrederick C. Rosin, MDPromita Roychoudhury, MDRaouf Seifeldin, MDJames N. Skupski, MD, MPHJinping Xu, MDRebecca Cline, Ph.D.Dr. Rebecca Cline joined the Department of FamilyMedicine as an associate professor in the Communicationand Behavioral Oncology Program at Karmanos CancerInstitute. Previously she was at the University of Florida.She serves as a source of expertise in health communication,particularly related to behavioral aspects of cancer andchronic disease, interpersonal communication in healthcare, the roles of everyday communication in health andhealth behavior, and the complex challenges of analyzinghow populations interpret and respond to health messages,and designing effective health messages.Felicity Harper, Ph.D.Dr. Felicity Harper is an assistant professor in theDepartment of Family Medicine and a scientist in theCommunication and Behavioral Oncology ResearchProgram at the Karmanos Cancer Institute. She alsoprovides clinical mental health services through the WertzCounseling Service. After graduating from the Universityof Kentucky, Dr. Harper completed a postdoctoralresearch fellowship at the National Institute of MentalHealth. She will apply her training and experience inpsychosocial oncology and family violence to helpimprove the emotional well-being, quality of life, andhealth behaviors of cancer patients and their families.Pierre Morris, M.D.Dr. Pierre Morris joined the Department of FamilyMedicine as a clinical faculty member within theresidency program after completing his training hereand serving as Chief Resident. In his faculty position, heteaches residents and medical students in both inpatientand ambulatory settings. He also serves as an academicadvisor, mentor, and supervisor within the residencyprogram. Dr. Morris additionally provides direct patientcare at the University Family Physicians-Detroit clinic.LecturerJuliann Binienda, MA4 Department of Family Medicine 2004 Annual Report


Full Time Affiliate and Voluntary FacultyTHANK YOUCLINICAL PROFESSORSPeter Coggan, M.D., M.S.Ed.George Mogill, M.D.Gary Otsuji, M.D.Mary Elizabeth Roth, M.D.Paul T. Werner, M.D.CLINICAL ASSOCIATE PROFESSORSRay Breitenbach, M.D. *Arthur Cooper, D.O.George Costea, D.O. *Bernard Dash, D.O.George Dean, M.D.Cynthia Fisher, M.D.George Hill, M.D.Paula Kim, M.D.Gerald Rakotz, M.D. *David Rodgers, M.D.Merton Shill, Ph.D.Jean Sinkoff, M.D.Walter J. Talamonti, M.D. *Anthony Vettraino, M.D.CLINICAL ASSISTANT PROFESSORSAntonio Aguirre, M.D.Terence Bielecki, M.D.Donald Bignotti, M.D.Kenneth Bollin, M.D.Margit Chadwell, M.D.John Chahbazi, M.D.Eric Coffman, D.O.Seid Cosovic, M.D.Keith Defever, M.D.Anna Demos, M.D.Michelle Diebold, M.D.Phillip Durocher, M.D.Luke Elliot, M.D.Aaron Ellis, M.D.Lawrence Fallat, D.P.M.Michael Fox, D.O.Fabian Fregoli, M.D.Kathleen Fulgenzi, M.D.Salvatore Galante, M.D.Michael Goldstein, M.D.Gina Gora, M.D.Miguel Granados, M.D.Thomas Graves, M.D.Fred Grose, M.D.Kassem Hallak, M.D., M.S.Robert Hasbany, M.D.William Heckman, M.D.Nikhil Hemady, M.D.Cecelia Hissong, M.D.Eileen Hopman, M.D.Ronald Hunt, M.D.Neil Jaddou, M.D.Dennis Joy, M.D.Steven Karageanes, D.O.Sander Kushner, D.O.Paul Lazar, M.D.Robert Lechy, M.D.John Lehtinen, M.D.Robert Levine, M.D.Barbara Levine-Blase, D.O.Donna Manczak, M.D.Margaret Meyers, M.D.James Meza, M.D.Nevena Mihailoff, M.D.Daroche Mohammadi, M.D.Mark Nugent, M.D.Christopher Pabian, M.D.Kris Parnicky, M.D.Mark Paschall, M.D.Jatin Pithadia, M.D.Matthew Ptaszkiewicz, M.D.Frank Raiford, M.D. **Dennis Ramus, M.D., C.P.A.Jaclyn Randel, M.D.William Raue, D.O.Al Romero, M.D.Leonard Rosen, M.D.Promita Roychoudhury, M.D.Barry Scofield, M.D.Raouf Seifeldin, M.D.Theodore Shively, D.O.Maria Shreve-Nicolai, M.D.Milton Simmons, M.D.James Stewart, M.D.Amos Taylor III, M.D.Larry Thompson, M.D.Rodrigo Tobar, Jr., D.O.Robert Urban, M.D.David Walsworth, M.D.Sander Weckstein, M.D.Gary Reis Weltman, M.D.Michael J. Worzniak, M.D.Gary Wozniak, M.D.Scott Yaekle, M.D.Srikala Yedavally-Yellavi, D.O.Louinda Zahdeh, M.D.Louis Zako, M.D.CLINICAL INSTRUCTORSHoward Schwartz, M.D.Gayla Zoghlin, M.D.ADJUNCT ASSOCIATE PROFESSORSEdward Kerfoot, Ph.D.Suzanne Mellon, Ph.D.ADJUNCT ASSISTANT PROFESSORSPatricia Armstrong, Ph.D.Jodie Eckleberry-Hunt, Ph.D.Jane Thomas, Ph.D.Anne Van Dyke, Ph.D.Patricia West, Ph.D., R.N.ADJUNCT INSTRUCTORRoger Wabeke, MSc. CIH* Promoted from Clinical Assistant Professorto Clinical Associate Professor** DeceasedWe appreciate ourdedicated voluntaryand affiliated facultywho contribute greatlyto the success of oureducationalprograms.http://familymedicine.med.wayne.edu5


In MemoriamFrank P. Raiford III, MD, who practicedfamily medicine in Detroit for over50 years, died from complications ofkidney disease in August, 2004. Dr.Raiford helped to found BoulevardGeneral Hospital in the early 1960sin order to provide a hospital whereblack patients would feel welcome.Boulevard joined three other smallhospitals to form Southwest GeneralHospital; when Southwest closed,Dr. Raiford joined the staff of HarperHospital and Grace Hospital.Dr. Raiford was born in Detroit. Hisfather was a physician educated at theUniversity of Michigan, and he tooattended the University of Michiganand was the only African Americanin the class of 1940. He received bothhis baccalaureate and medical degreesthere and also joined the Alpha PhiAlpha social fraternity.One of Dr. Raiford’s special interestswas nutrition, and he grew vegetablesfor his family in his large garden. Healso enjoyed reading science fictionand building and displaying modeltrain sets.Survivors include daughters ScheraByas, Jill Hewitt, and PerryneThompson; a son, Kevin; sixgrandchildren, and a great-grandson.The family generously requested thatdonations be made to the Departmentof Family Medicine.(Special thanks to Jeanne May forassisting on this story.)Planned Giving to the Department of Family MedicineGifts by alumni and friends can make a positive impact in many ways onthe DFM, including its research programs and student programs. Carefullyplanning your investment in the DFM can stretch the value of your gift,enabling you to do much more for the department and our students andfaculty than you may think possible.A carefully planned gift can also benefit you and your family. Your tax savingscan be substantially increased, and some planned gifts can provide incomefor your lifetime or the lifetime of another individual.Examples of planned gifts include: cash; publicly traded stocks or bonds;a bequest in a will or trust; life-income gifts; retirement fund assets; lifeinsurance; charitable lead trusts; and other assets as well.Please contact Claude Jackson, School of Medicine Development Officer, at313-577-2830 to discuss these gift opportunities in more detail.Contributions to this fund will enhance our medical student programs.6 Department of Family Medicine 2004 Annual Report


Community at the Heart of Family MedicineCOMMUNITYThe Community Outreach Committee of the Department is now fully functioningwith representation from residents to faculty to support staff. This committee providesstrategic planning and leadership for all community outreach activities.Our family medicine faculty and residents possess the knowledge and the skills to achieveunification with patients and their healthcare needs. As we describe below, they alsodemonstrate active involvement and leadership in community outreach activities.• Hundreds of individuals have haddirect contact with our residents andfaculty through community healthcareinitiatives to patients.• Every family medicine resident andfaculty member participated in at least onecommunity outreach event in 2004.• The DFM residency program providedleadership in a wide variety of communityoutreach activities. Major efforts includedthe development of Community HeartWalking Clubs with Sinai-Grace Hospitaland participation with Detroit PublicSchools in Health Career Events.• In December, DFM and UFP faculty andstaff provided holiday treats for familieschosen by Sinai-Grace Hospital anddelivered by Family Medicine residents.Gifts included clothing and a special giftfor each family member and Farmer Jackand Target gift cards.Family Medicine Residents“Cover the Uninsured” Health FairFord Field - Detroit - May, 2004com·mu·ni·tya unified body of individuals:as a: the people with commoninterests living in a particulararea b: an interactingpopulation of various kindsof individuals (as species) in acommon location c: a groupof people with a commoncharacteristic or interest livingtogether within a larger society.Merriam-Webster MedicalDictionary, © 2002 Merriam-Webster, Inc.• We actively participated with theAmerican Heart Association CulturalHealth Initiative of Metro Detroit inplanning conferences and health fairs inthe community.• We worked with the CommunityHealth Institutes of the Detroit MedicalCenter to reach out to the under- and uninsuredin the community.Family Medicine Residents and Faculty2nd Annual Healing Hearts Health FairUFP Family Practice Centerhttp://familymedicine.med.wayne.edu7


GMEFamily Medicine ResidencyTsveti Markova, MDFamily Practice Program DirectorResidency faculty physiciansTsveti Markova, MDResidency Program DirectorFrederick Rosin, MDAssociate Program DirectorNejla Israel, MDAssistant Program DirectorNehman Lauder, MDKodavayour Nirmal, MDPierre Morris, MDThomas Roe, MDBruce Deschere, MDContact information:Carol BartleyResidency Program Coordinator313-340-4325email: cbartley @med.wayne.eduRochelle PriceAdministrative Assistant313-340-4322email: rprice@med.wayne.eduMichel Julian-SmithSecretary313-340-4320email: mjulian@med.wayne.eduFor more information aboutthe Family Medicine Residencyprogram visit our web site at:http://www.med.wayne.edu/fam/residency/fm_residency/index.asp.The Family Medicine ResidencyProgram reached new heights in 2004.We received a full 5-year accreditationby the Accredited Council of theGraduate Medical Education. Theprogram continues to improve itslearning curriculum and providesa sound educational environmentfor residents and faculty physicians.“Achieving maximum length ofACGME accreditation,” says TsvetiMarkova, MD, Residency ProgramDirector, “is a testament to the qualityof the program and the commitment ofthe Department, residents, faculty andstaff. It is stimulating and challengingto work with such dedicated groupof people constantly striving forimprovement.”Robust Evaluation SystemUnder the direction of Tsveti Markova,MD, and Patrick Bridge, PhD, theResidency Program completelyreorganized its evaluation system in2004. In accordance with documentingthe residents’ progress with the ACGMEgeneral competencies, new evaluationforms were developed. The residentsreceive feedback from their faculty,peers, nurses in the clinic, and otherpreceptors. Faculty advisors haveevolved into mentors whose role is notsimply to communicate “pass” or “fail”on rotations, but to monitor residents’progress, document deficiencies in alearning contract, and discuss a planfor improvement.The new evaluation system wasdesigned to encourage and motivateany resident, regardless of skill level,and is conducted over time to discerngrowth. Overall performance isevaluated with baseline and end-ofyearthree-station Objective StructuredClinical Evaluations, in which residentsare videotaped interacting withstandardized “patients”. Residentsdiscuss results with their facultymentor and a behavioral science facultyto improve their patient-centeredapproach.We have also implemented mini-CEXevaluations, which involve evaluatinga single component of performance,like history-taking or physicalexamination skills, while workingin the clinic. These exercises assess“interpersonal skills” and “medicalknowledge” competencies. “Residentsare here to learn, and immediateconstructive feedback is crucial for theirdevelopment,” says Dr. Markova.Integrated Family Medicine RotationThe new Integrated Family MedicineRotation, facilitated by JuliannBinienda, MA, adds to the depth ofthe curriculum. Residents learn ina longitudinal format about care forelderly patients, end-of-life issues,providing care to the homeboundpatients, attending sports events asteam physicians, accessing pointof-careevidence based resources,implementing practice managementprojects, billing and coding, and givingtalks to church members or high schoolstudents on common medical topics.Residents integrate these activities intotheir continuity practice to becomewell-rounded family physicians.Several residents commented on their experiences inthe residency in 2004:“Wayne State University’s Family Medicine programis one of the best programs in Michigan. It is afriendly yet competitive and challenging program.”“Being in the WSU Family Medicine residencyprogram has been a fulfilling experience. It trainsresidents to be well rounded in all aspects of being agood physician and a friend to the patient.”“My residency experiences have allowed me to seejust how destructive certain diseases, especially selfinflicteddiseases such as smoking and obesity, canbe. I also see how essential follow up and patienteducation are for these patients.”“I’m proud to be in this residency program. It hasadded a lot to my medical information and skills.We have an excellent program director, staff, andlearning experience. I feel so confident to go out inpractice after being here for three years.”8 Department of Family Medicine 2004 Annual Report


Family Practice ResidentsGMEResearch Forum Winners1st place (tie). Francis Bayaca, MD.Emotional Abuse & Women’s Health:A Primary Care Study.Research Mentor: John Porcerelli, PhD.Also won second place at the Sinai-Grace Hospital Research Forum for oralpresentations.Residents and faculty turned out for the DFM resident researchday, April 2004.1st place (tie): Manhal Naoumi, MD.Characteristics of “Favorite” Patients.Research Mentors: John Porcerelli, PhD andJuliann Binienda, MA3rd place: Mary Santiago, MD. Casepresentation. “EmphysematousPyelonephritis”Faculty Advisor: Nehman Lauder, MD.Also won first place at the Sinai-GraceHospital Research Forum for posterpresentations.2004 Family Medicine ResidentsPGY 1 PGY 2 PGY 3Amin, Saima MD Banzhof, Rebecca MD Attallah, Simona MDNaqvi, Fatima MD Bariana, Sam MD Hirani, Sushma MDNecsutu, Simona MD Dhillon, Baldev (Dave) MD Jagadish, Haripriya MDOthayoth, Sunitha MD Gladson, Marina MD Katial, Vaishali MDRai, Sherapartap MD Mapili, John MD Klimkowski, Walter MDRaykova, Vania MD Mullah, Farah DO Mir, Taseen MDRegis, Louella MD Nwaizuzu, Peter MD Naoumi, Manhal MDSussman, Rachel DO Raja, Maheswari MD Raman, Arathi MDRosbolt, James DOSchramm, Danielle MDSuryadevara, Nagalakshmi MD2004 Residency GraduatesFrancis Bayaca, MDPrivate Practice Group, Watsonville, CAJira Coumarbatch, MD Detroit Public School SystemRajiv Dua, MDPrivate Practice Group, Ellicott City, MDVanessa Fernandes, MD Private Practice Group, Ann Arbor areaJayanthi Jambulingam, MD Private Practice Group, Philadelphia, PennsylvaniaThomas Mathew Jr., MD Private Practice Group Montgomery, ALDavid Mohan, MDInternal Medicine Residency, SGH, DetroitPierre Morris, MDFaculty of WSU/DMC Family Practice Residency ProgramMary Santiago, MDPrivate Practice Group, DMCMichael Simpson, MD Private Practice Group, Kankakee, Illinoishttp://familymedicine.med.wayne.edu9


GMEDivision Occupational and Environmental Medicine2004 was a busy and productive yearfor the Division of Occupational andEnvironmental Medicine (OEM). A fewselected items are highlighted below,and a complete description of Divisionactivities can be found on our web pageat: http://www.med.wayne.edu/fam/residency/oem/news.asp.Educational ActivitiesOEM Residency ProgramThe mission of the residency programis to ensure that physicians trained inour program are capable of managingcurrent and upcoming occupationaland environmental health challenges.Our goal is to offer residents an upto-date,challenging and rewardingtraining experience preparing them tobe leaders in clinical as well as academicoccupational and environmentalmedicine.The Division held its graduationceremony at The Longacre House,Farmington Hills, in June to honorIfeyinwa Ilechukwu, MD, MS; SaimaSiddiqui, MD, MS; and Stephen Shaya,MD. Current residents are second-yearMada Jamil, MD, and first-year BindishPatel, MD. Dr. Patel, a 2000 graduateof Wayne State University Schoolof Medicine, completed the FamilyMedicine Residency Program at HenryFord Health System, where he was chiefresident.OEM Rotation CourseThe OEM Rotation Course is a monthlongcourse in Occupational andEnvironmental Medicine offered on aquarterly basis to residents and medicalstudents in the Detroit metropolitanarea. During 2004, residents from BonSecours Cottage Health Services, NorthOakland Medical Center, ProvidenceHospital, St. John Hospital, andWayne State University Family PracticeResidency Programs completed therotation, along with several WayneState University medical students.July Retreat to Develop Guiding PlansOn July 24, the Division held a seminarat Eugene Applebaum College ofPharmacy and Health Sciences forfaculty members of the OEM division,preceptors, and program graduates todevelop Guiding Plans--questions andpossible assignments--for each of the165 ACOEM Learning competencies.Participants included: Beverly Blaney,MD, MS; Daniel Fink, MD; DavidBassett, PhD; Hikmet Jamil, MD,PhD, FFOM.I; James Blessman, MD,MPH; James Skupski, MD, MPH;Jayant Eldurar, MD, MS; John Graff,MS, PhD; Linda Roth, PhD; Mark A.Nugent, MD, MPH; Maryjean Schenk,MD, MPH, MS; Michael Goldstein,MD; Noori Ibrahim, MD, MS; PadmaMorrisetty, MD, MS; Roger Wabeke,MSc, MscChE, CIH, CHMM, PE; andSaima Siddiqui, MD, MS.Regional, National and InternationalActivitiesDivision faculty and residents attendedthe Annual Scientific Meeting ofthe Michigan Occupational &Environmental Medicine Association(MOEMA) in September. ProgramDirector James Skupski, MD, MPH,was elected to the MOEMA ExecutiveCommittee and will serve as an ACOEMalternate delegate.Division Director James Blessman,MD, MPH, was asked to serve a secondterm as a member of National AdvisoryCommittee on Occupational Safety &Health, which advises the secretaries oflabor and health and human serviceson occupational safety and healthprograms and policies. Members ofthis prestigious 12-person advisorycommittee are chosen on the basisof their knowledge and experience inoccupational safety and health.In September, Hikmet Jamil, MD,PhD, FFOM.I, gave two presentationsat the XXXV International Congresson Military Medicine at Washington,D.C: 1) Medical Complaints Among10 Department of Family Medicine 2004 Annual Report


GMEIraqi American Refugees with MentalDisorders and 2) Iraqi AmericanVeterans of the Persian Gulf War: PTSDand Physical Symptoms.Dr. Jamil serves as a consultant forStony Brook University/ USAID HEADPROGRAM/SB Environmental HealthProject for Iraq. In this role Dr. Jamilhosted delegates from Iraq AcademicInstitute who visited the Residencyprogram. The delegates attendedmorning report, met with the OEMfaculty and then visited the WSU andUniversity of Michigan Departments ofEnvironmental Health and the ACCESSCommunity Health and ResearchCenter in Dearborn.Bengt Arnetz, MD, PhD, MPH, MScEpi,Head of the Department of SocialMedicine and Center for EnvironmentalIllness and Stress Disorders, UppsalaAcademic Hospital, Uppsala, Sweden,visited the Department of FamilyMedicine in March. Dr. Arnetz’s work isin the area of stress medicine and healthsystems research and development. Hepresented a department seminar on thetopic, “The Search for Biological StressMarkers: Theory and Practice.” Dr.Arnetz returned in May and conducteda retreat aimed at identifying skills,interests, and resources within the DFMand WSU that can be focused towardhaving a major impact in the region.We are delighted that Dr. Arnetz willassume the position of OEM DivisionDirector in January, 2005.OEM faculty and preceptors meet to discuss curriculum.http://familymedicine.med.wayne.edu11


FACULTY SCHOLARSHIPFaculty were principal orco-investigators on 23federally funded grants,and another 10 grantsfrom foundations, andlocal or state agencies.External FundingAbbey A (PI), Penner L (Co-I).“Tailored Risk Reduction Strategies for UrbanAdolescents”INPHAASE, Wayne State University2004 – 2005; total cost $50,000Albrecht T (PI), Ruckdeschel J, Penner L, EgglyS (Co-Is)“Effects of Physician Communication on PatientAccrual”National Cancer Institute7/2001 – 3/2005; total cost: $1,224,706Albrecht T (PI), Penner L, Ruckdeschel J,Bhambani K, Taub J, Pendelton S (Co-Is).“Parental Role and Pediatric Cancer Pain andSurvivorship”National Cancer Institute8/2003 – 7/2006; total cost $866,105Albrecht T (PI),“Cancer Information Service-Region 8”National Cancer Institute8/2003 – 7/2006; total cost $1,690,152Albrecht T (PI), Franks M, Ruckdeschel J (Co-Is)“Biophysical Process and Treatment DecisionMaking”National Cancer Institute9/2004 – 9/2006; total cost $226,500Bannerjee M (PI), Schwartz K (Co-I)“Racial Disparities in Treatment Patterns forBreast Cancer”Blue Cross Blue Shield of Michigan Foundation4/2002 – 3/2005; total cost $75,000Binienda J (PI)“End-of-Life Educational Grant”VistaCare Hospice Foundation4/2003 – 6/2004; total cost$4,000Bridge PD (PI); Berry-Bobovski L (Co-I)“Development of a Prostate Health AwarenessCurriculum for the Hispanic Community”Center for Disease Control/Michigan Departmentof Community Health10/2004 – 9/2005; total cost $29,850Deschere B (PI), Malone JM (Co-I)“Innovations in Graduate Medical Education”Michigan Department of Community Health1999 – 2004; total cost $1,500,000Everson R (PI), Severson R., Sakr W, Sarkar F,Powell, I (Co-Is)“Polymorphisms in Prostate Cancer Carcinogenesis”National Cancer Institute10/2000 – 9/2004; total cost $1,186,267Flack J (PI) Severson R and 12 others (Co-Is)“Center for African American Urban Health”National Institutes of Health9/2003 – 5/2008; total center cost $5,946,924Frank, RR (PI), Popp SM (Co-I)“Geriatrics and Gerontology: Health, Well Beingand Disease in the Elderly”John Hartford foundation/AAMC7/2001 – 7/2004; total cost $97,039Graff, JJ (PI)“Assessing smoking and drinking in thedevelopment of tongue cancer and evaluationof quality of life following different treatmentoptions: A feasibility study”National Cancer Institute10/2004 – 9/2006; total cost $209,075Hamre M (PI), Severson R, Metzger K (Co-Is)“Use of State Motor Vehicle Records to EvaluateOptions for Default Geocoding of Patient Addressat Diagnosis”National Cancer Institute9/2003 – 03/2005; total cost $119,162Jamil, H (PI)“Health Assessment of Iraqi Americans Residingin Southeast Michigan”ACCESS Community Health and Research Centerand Pfizer Corp6/2004 – 5/2005; total cost $52,000Kato I (PI), Neale AV (Co-I)“Does Use of Alternative Medicine Delay Treatmentof Health and Neck Cancer?”National Cancer Institute9/2003 – 9/2005; total cost $228,028Kato I (PI), Severson R, and 5 others (Co-Is)“Genetic Susceptibility to Infection RelatedCancer”National Cancer Institute2/2003 – 1/2006; total cost $609,485Kato I (PI), Severson R, Majumdar A, Land, S(Co-Is)“Luminal Exposure, Genetics and Colon CancerRisk”National Cancer Institute8/2002 – 7/2007; total cost $2,540,611Katz S (PI), Schwartz K, and 6 others (Co-Is)“Determinants and Outcomes of Surgical Treatmentfor Early Stage Breast Cancer: Is DCISDifferent than Invasive Disease”National Cancer Institute2001 – 2004; total cost $2,156,069Neale AV (PI), Abrams, J (Co-I)“Correcting the Literature After ScientificMisconduct”US Office of Research Integrity9/2002 – 8/2005; total cost $298,000Neale, AV (PI), Schwartz K (Co-I)“MetroNet Communication and Data ManagementInfrastructure”US Agency for Health Research and Quality9/2002 – 8/2005; total cost $99,831Penner L (PI), Jackson J, Lichtenberg P (Co-Is)“Michigan Center of Urban African AmericanAging Research”Institute on Aging and National Institute ofNursing Research2003 – 2006;Petersen GM, Korczak J (Co-PIs), Schenk MCo-I)“Pancreatic Cancer Genetic EpidemiologyConsortium”Funding Agency?7/2002 - 6/2007;Porcerelli J (PI) Sharar G, Mayes, L, Blatt S, EppersonN, Cross L (Co-Is)“Longitudinal association between objectiverelations and patient-practitioner relationshipsamong hig-risk obstetric patients: A crosslaggedstructural equation study”Internal Psychoanalytic Association2004 – 2005; total cost $39,700Schenk M (PI), Schwartz K, Neale AV (Co-Is)“Building MetroNet: an Urban Primary CareResearch Network”DHHS HRSA Bureau of Health Professions9/2002 – 8/2005; total cost $583,20012 Department of Family Medicine 2004 Annual Report


FACULTY SCHOLARSHIPSchwartz AG (PI), Schwartz K, Graff JJ (Co-Is)“Surveillance, Epidemiology and End Results(SEER) Program”National Cancer Institute2003 – 2010; total cost $32,000,000Schwartz K (PI), Neale AV, Israel N (Co-Is)“Practice Variations in the Use of Lipid-LoweringDrugs”Blue Cross Blue Shield of Michigan Foundation2002 – 2004; total cost $193,220Schwartz K (PI), Neale AV (Co-I)“Reducing Disparities in Influenza Vaccine Acceptance”Association of American Medical Colleges/Centers for Disease Control and Prevention10/2003 – 9/2005; total cost $149,934Schwartz K (PI), Severson R (Co-I)“Study Centers of Case-Control Study of RenalCell Cancer among Caucasians and AfricanAmericans”National Cancer Institute2001 – 2006; total cost $3,523,775Schwartz K (PI), Severson R (Co-I)“A Collaborative Case-Control Study of RenalCell Carcinoma”National Cancer Institute6/2001 – 12/2005; total cost $1,410,963Schwartz K (PI), Bock C (Co-I)“Accuracy of Geocoding”National Cancer Institute9/2004 – 9/2005; total cost $126,410Taub J (PI), Severson R, Matherly L (Co-Is)“Differences in Etiology of Acute LymphoblasticLeukemia between Caucasian and AfricanAmerican Children”Wayne State University4/2004-3/2006; total cost $238,151DR. DESCHERE SERVES AS TEAM USA PHYSICIANBruce Deschere, MD, served as the physician to2004 Team USA at the World Synchronized SkatingCompetition in Zagreb, Croatia. Twenty-three teamsfrom 18 countries participated in this world-class event.Dr. Deschere has provided medical coverage at skatingevents for the past five years, where he treats a varietyof medical problems, including sprains, bruises and cuts.Velie E (PI), Severson R, and 10 others (Co-Is)“Energy Balance and Breast Cancer in Blackand White Women”National Cancer Institute7/2002-6/2007; total cost $541,125Younis A (PI), Schwartz K (Co-I)“Arab American and Chaldean Council Women’sBreast Cancer Intervention Program”Blue Cross Blue Shield of Michigan Foundation1/2004 – 12/2004; total cost $75,000Bruce Deschere and Team USAhttp://familymedicine.med.wayne.edu13


FACULTY TEACHINGTom Roe and Nejla Israel received theSchool of Medicine College TeachingAward2004 Teaching AwardsThe Department of Family Medicineproudly announces the followingteaching awards that were presented tofaculty and preceptors in 2004.Family Medicine ResidencyInaugurated in 1985 by the DFM, theTeacher of the Year award is givenannually in appreciation of andrecognition for outstanding teachingby a physician in a discipline otherthan family medicine. The recipient isselected by the WSU Family Medicineresidents and receives a plaque andletter of appreciation at the residents’graduation ceremony. In 2004, theaward was presented to Vijay Kudesia,MD, cardiology. The Paul T. WernerTeacher of the Year award is also givenin appreciation of and recognition foroutstanding teaching, in this case to aDFM faculty member. In 2004, FamilyMedicine residents chose Thomas Roe,MD, to be so honored, for the secondyear in a row.Occupational and EnvironmentalMedicineEach year the DFM residents in theOccupational and EnvironmentalMedicine residency program present aplaque honoring excellence in teachingto one of their faculty. The OEMResidency Teacher of the Year for 2004was presented to both Joe Fortuna,MD, MPH., and Sal Galante, MD,MPH, of Delphi Corporation. TheDelphi administrative rotation is highlyrated and greatly valued as an integralpart of the residency program.Departmental TeachingThe DFM Education Committee reviewsall faculty teaching portfolios andrecommends that the DFM award$250 and a certificate to selectedfaculty noted for their dedicationto excellence in teaching and theirimportant contribution to the DFM’seducational mission. The recipients ofthe 2004 DFM Teaching Awards wereDivision of Medical Education facultymember Patrick Bridge, PhD, andFamily Medicine Residency DirectorTsveti Markova, MD. In additionto many other successful educationalendeavors, Drs. Bridge and Markovacollaborated in 2004 on directing andimplementing a complete revisionof the Family Medicine Residencyevaluation system.School of MedicineFull-time faculty who have taught at theWSU School of Medicine for 3 or moreyears are eligible to receive a collegeteaching award. DFM 2004 recipientsreceived their plaques and a $1000award at the School of Medicine HonorsConvocation in November, 2004. Ourhonorees were Nejla Israel, MD, andThomas Roe, MD. In addition toteaching medical students, residents,and colleagues, Dr. Israel manages thefamily medicine residency didacticlecture program and the OB-GYNteaching within the department. Dr. Roedirects or co-directs all undergraduatemedical education programming in thedepartment.Patrick Bridge and Tsevti Markovareceived the Department of FamilyMedicine Teaching AwardTom Roe received the Paul T. WernerTeacher of the Year Award.14 Department of Family Medicine 2004 Annual Report


Honors, Awards & New Appointments in 2004FACULTY HONORSTerrence L. Albrecht, PhD• Appointed, Voting Member toScientific Leadership Council, KarmanosCancer Institute• Member, WSU Institute of GerontologyInternal Advisory Board• Invited Member, Core WorkingGroup, American College of SurgeonsOncology Group EducationCommittee• Nominated, Permanent PanelMember, NIH Center for ScientificReview Community Level HealthPromotion Study Section, 2004/05Council ZRG1 HOP-J 90 (2005-2008)Patrick D Bridge, PhD• Awarded, Department of FamilyMedicine 2004 Teaching AwardJoseph Brocato, PhD• Appointed Director, GraduateMedical Education, The DetroitMedical Center• Appointed Adjunct Associate Deanfor Community Medical EducationBruce R Deschere, MD, MBA• Named as one of the 2004 “BestDoctors in America”• Appointed, Chief of Family Medicine,Sinai Grace Hospital, Detroit• Served, Team USA physician, 2004World Synchronized Skating CompetitionRichard E Gallagher, PhD• Elected, Advisory Council of theAmerican Association for CancerEducation• Member, Scientific Program Committee,American Association forCancer Education 2004 AnnualNational Conference.John Graff, PhD• Member, North American Associationof Central Cancer Registries(NAACCR) Program Committee• Member, National Cancer InstituteSEER Program – US National LongitudinalMortality Study (NLMS)Steering CommitteeFelicity Harper, PhD• Invited Member, NIH Roadmap InitiativeNetwork (“BiopsychosocialProcesses and Treatment Decision-Making”) Steering Committee• Invited Member, Karmanos CancerInstitute Palliative Care ProgramSteering CommitteeTsevti Markova, MD• Awarded, Department of FamilyMedicine 2004 Teaching Award• Elected Fellow, American Academyof Family Physicians• Elected Member at Large, Board ofDirectors, Michigan Academy ofFamily Physicians• Elected Member, Department ofFamily Medicine Review Committee• Named as one of “America’s TopFamily Doctors” by the Consumers’Research Council of America• Appointed by Dean, Department ofObstetrics and Gynecology ReviewCommitteeAnne Victoria Neale, PhD, MPH• Promoted to Professor, Departmentof Family Medicine, Wayne StateUniversity• Member, Society of Teachers ofFamily Medicine (STFM) ResearchCommitteeLinda M Roth, PhD• Appointed, Director of FacultyDevelopment, School of Medicine,Wayne State UniversityMaryjean Schenk, MD, MS, MPH• Appointed, Associate Interim Dean,Academic and Student Programs,School of Medicine, Wayne StateUniversity• Appointed by Provost, School ofMedicine Dean Search CommitteeKendra L Schwartz, MD, MSPH• Awarded tenure, Department ofFamily Medicine, Wayne State University• Promoted to Chair, Medical PediatricsIRB (MP4), Wayne StateUniversityDr. Schenk celebrates withKendra Schwartz (left) whowas awarded tenure, and withVictoria Neale (right) who waspromoted.http://familymedicine.med.wayne.edu15


FACULTY SCHOLARSHIPHighlights from 2004 PublicationsEleven DFM membersfirst authored apublication in a peerreviewedjournal in2004. This is an increasefrom seven first-authorpublications in 2003.Bridge PD, Berry-Bobovski LC, Gallagher RE. Promoting informed decision making:Evaluating a community-based prostate health awareness program. Journal of CancerEducation. 2004; 19 (3): 174-179.• The study purpose was to evaluate the effectiveness of a community-basedprostate health awareness program.• Participants reported having been tested for prostate cancer, yet their pretestknowledge base was lower than expected. Significant knowledge increases weredetected on the posttest.• A community-based prostate health awareness program prior to the patientphysicianencounter can assist healthcare professionals in the education process andgive men the tools to make an informed decision about theirCline RJ, Young HN. Marketing drugs, marketing health care relationships: Acontent analysis of visual cues in direct-to-consumer prescription drug advertising.Health Communication. 2004; 16 (2): 131-157.• The article proposed a social cognitive theoretical framework for investigatingand explaining the effects of direct-to-consumer advertising (DTCA) of prescriptiondrugs on the physician-patient relationship.• The study identified visual features of print DTCA that function as identity andrelational motivators for consumers.• Results indicate that DTCA may market disenfranchising images that mayfunction to increase rather than decrease disparity in health care information andaccess, despite their argued educational function.Echlin PS, Upshur RE, Markova TP. Lack of chart reminder effectiveness on familymedicine resident JNC-VI and NCEP III guideline knowledge and attitudes. BioMedCentral Family Practice. 2004; 5 (1): 14 (7 pages).• This pilot study examined if change in a previously identified clinical practiceguidelines (CPG) compliance factor (accessibility) would produce a significantincrease in family medicine resident knowledge and attitude toward the guidelines.The primary study intervention involved placing a summary of the Sixth Report ofthe Joint National Committee on Prevention, Detection, Evaluation, and Treatmentof High Blood Pressure (JNC VI) and the National Cholesterol Education ProgramExpert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol inAdults (NCEP III) CPGs in adult patient charts in the residency ambulatory clinic sitefor a period of three months.• Pre- and post-intervention analysis failed to demonstrate a significant differencein CPG knowledge or attitude changes.• The barriers to CPG compliance were identified as: 1) lack of CPG instruction; 2)lack of critical appraisal ability; 3) insufficient time; 4) lack of CPG accessibility; and5) lack of faculty modeling. The recent findings in resident knowledge-behavior gapsmay lead the investigation of physician CPG non-compliance away from generalizedbarrier research toward the development of information that maximizes the sense ofurgency and certainty of each individual practitioner.16 Department of Family Medicine 2004 Annual Report


Highlights from 2004 PublicationsFACULTY SCHOLARSHIPHarper FWK, Arias I. The role of shame in predicting adult anger and depressivesymptoms among victims of child psychological maltreatment. Journal of FamilyViolence. 2004; 19: 359-367.• We studied victims’ affective responses to childhood psychologicalmaltreatment as a predictor of adult emotional adjustment. Feelings of shamemay have particular relevance to victims and serve to moderate the relationshipbetween such child maltreatment and anger and depression in adults.• Results showed that for men shame moderated between child psychologicalmaltreatment and adult anger, while shame moderated the relationship betweenchild psychological maltreatment and depressive symptoms for women.• Feelings of shame may be a key determinant of emotional adjustment forboth male and female victims, however, men and women may benefit fromdifferent therapeutic techniques to treat and prevent depression and anger insurvivors of child psychological maltreatment.Israel N, Markova T, Pani A. Sarcoidosis: A blurry presentation of systemicdisease. Family Practice Recertification. 2004; 26 (11): 22-32.• Extra-pulmonary manifestation of sarcoidosis can be mild and non specificand may be unrecognized.• Acute uveitis is a rare initial presentation and can precede the pulmonarydisease by many years, so careful observation and follow up are necessary.• Appropriate timely treatment is critical because of the risk of sight –threatening disease.Jamil H, Nassar-McMillan SC, Lambert R. The aftermath of the Gulf War: Mentalhealth issues among Iraqi Gulf War veteran refugees in the United States. Journalof Mental Health Counseling. 2004; 26 (4): 295-308.• We surveyed a group of Iraqi Gulf War veteran refugees to assess levels of posttraumaticstress disorder (PTSD), depression, panic, and anxiety.• The study hypothesis was that PTSD will be significantly associated withsymptoms of depression, panic and anxiety.• High levels of each of the symptom categories were found among those withPTSD. PTSD sufferers also had elevated levels of depression and panic.Neale AV, Schwartz KL. A primer of the HIPAA Privacy Rule for practice-basedresearchers. Journal of the American Board of Family Practice. 2004; 17 (6): 461-465.• The Health Insurance Portability and Accountability Act (HIPAA) Privacy Ruleset rigorous standards for the protection of personal information contained inpatient medical records.• The Privacy Rule has several provisions for procedures and processes thatallow researchers to access personal health information in the absence ofindividual consent.• We address common questions about the research use of protected healthinformation and present definitions and interpretations of selected Privacy Ruleterms with particular meaning to the conduct of practice-based research.continued . . .http://familymedicine.med.wayne.edu17


FACULTY SCHOLARSHIPHighlights from 2004 PublicationsPenner LA. Volunteerism and social problems: Making things better or worse?Journal of Social Issues. 2004; 60 (3): 645-666.• Presidential Address to Society for the Psychological Study of Social Issues(Division 9 of American Psychological Association)• Presents model of reasons why people decide to work as volunteers.• The effects of September 11 attacks on volunteering in United States appear tobe a dramatic, but short-lived increase in volunteering. Increases were found for allcharities and service organizations. The greatest impact on volunteering was foundamong people with higher education levels.Porcerelli JH, Cogan R, Hibbard S. Personality characteristics of partner violent men:A Q-sort approach. Journal of Personality Disorders. 2004; 18 (2): 151-162.• We developed a personality profile of men who are violent toward their partners.• The profile was developed from ratings of 52 expert mental health clinicians fromMichigan using a reliable and valid Q-sort instrument designed to assess personalitypathology and personality traits.• Partner-violent men, as compared to non-violent/distressed men, had higherantisocial and borderline personality disorder scores and were characterized ascontrolling, hostile, over-reactive to criticism, feeling victimized by another,impulsive, and conflicted about authority.Schwartz KL, Kulwicki A, Weiss LK, Fakhouri H, Sakr W, Kau G, Severson RK.Cancer among Arab Americans in the metropolitan Detroit area. Journal of Ethnicityand Disease. 2004; 14 (1): 141-146.• Little is known about the cancer distribution among Arab Americans.• An Arab/Chaldean surname list was created and matched with the Detroit SEERregistry to determine proportional incidence ratios for specific cancer sites amongDetroit area Arab Americans.• Compared to U.S. non-Arab whites and data from the Middle East, Detroit areaArab Americans men had greater proportions of leukemia, multiple myeloma, liver,kidney, and bladder cancers. Local Arab women were more likely to experienceleukemia, thyroid and brain cancers than those in the two comparison groups.Xu J, Schwartz K, Monsur J, Northrup J, Neale AV. Patient-clinician agreement onsigns and symptoms of ‘strep throat’: A MetroNet study. Family Practice. 2004; 21(6): 599-604.• Adult sore throat patients may reliably report their symptoms, but may not beable to assess and report accurately on relevant physical signs of pharyngitis.• Patients have a tendency to over-report physical signs of pharyngitis.• This study indicates the potential difficulties associated with telephone triage ofsore throat patients or other illnesses that require assessment of physical signs.18 Department of Family Medicine 2004 Annual Report


Peer-reviewed Publications, Books & ChaptersFACULTY SCHOLARSHIPAlbrecht TL, Ruckdeschel JC, Ray F, PetheB, Riddle DL, Strom J, Penner LA, CoovertMD, Quinn GP, Blanchard CG. A portable,unobtrusive device for video recording clinicalinteractions. Behavior Research Methods,Instruments, & Computers. (In press).Albrecht TL, Ruckdeschel JC, Ray FL. A newdesign for videorecording clinical interactions:Addressing portability, unobtrusiveness,and protection of human subjects. BehaviorResearch Methods, Instruments, & Computers. (Inpress).Albrecht TL, Ruckdeschel JC, Riddle DL,Blanchard CG, Penner LA, Coovert MD, QuinnGP. Communication and consumer decisionmaking about cancer clinical trials. PatientEducation and Counseling. (In press).Albrecht TL, Ruckdeschel JC, Riddle DL,Blanchard CG, Penner LA, Coovert MD, QuinnGP. Discussing clinical trials with cancerpatients. Medical Encounter. (In press).Barnholtz-Sloan J, Severson RK, Stanton B,Hamre MR, Sloan AE. Pediatric brain tumorsin Hispanics, non-Hispanics, and AfricanAmericans: Differences in survival afterdiagnosis. Cancer Causes Control. (In press).Bernstein D, Penner LA, Roy E, Clark-StewartA. Psychology. 7th ed. Boston, MA: Houghton-Mifflin; (In press).Bradley CJ, Neumark D, Bednarek HL, SchenkM. Short-term effects of Breast Cancer on labormarket attachment results from a longitudinalstudy. (In press)Bradley CJ, Neumark D, Oberts K, Luo Z,Brennan S, Schenk M. Combining Registry,Primary, and Secondary Data Sources toIdentify the Impact of Cancer on Labor MarketOutcomes. Medical Decision Making. (In press)Bridge PD, Berry-Bobovski LC, GallagherRE. Promoting informed decision making:Evaluating a community-based prostate healthawareness program. Journal of Cancer Education.Fall 2004;19(3):174-179.Brocato J, Mavis BE. The research productivityof family medicine department faculty: Anational study. Academic Medicine. (In press).Chatterjee N, Hartge P, Cerhan JR, Cozen W,Davis S, Ishibe N, Colt J, Goldin L, SeversonRK. Risk of non-Hodgkin’s lymphoma andfamily history of lymphatic, hematologic, andother cancers. Cancer Epidemiology, Biomarkers& Prevention. Sep 2004;13(9):1415-1421.Cline RJW, Young HN. A content analysisof messages to consumers about physicianpatientcommunication in direct-to consumeradvertising of prescription drugs. Journal ofFamily Practice. (In press).Cline RJW, Young HN. Direct marketingdirects health care relationships? The role ofdirect-to-consumer advertising of prescriptiondrugs in physician-patient communication. In:Ray EB, ed. Case studies in health communication.2nd ed. Mahwah, NJ: Lawrence ErlbaumAssociates; (In press).Cogan R, Porcerelli JH, Kamoo R, LeitmanS. Defense mechanisms and violence towardpartners and strangers: Defense MechanismManual and Defense Mechanisms RatingScale. Journal of the American PsychoanalyticAssociation. Summer 2004; 52(2):477-478.Cogan R, Porcerelli JH. Personality disordersand adaptive functioning of patients beginningand ending psychoanalysis. Psychology &Psychotherapy: Theory, Research and Practice. (Inpress).Cogan R, Porcerelli JH. Personality pathology,adaptive functioning, and strengths at thebeginning and end of psychoanalysis. Journalof the American Psychoanalytic Association.Winter 2004; 52(4):1230-1231.Cogan R, Stringer CA, Aldredge-Clanton J,Porcerelli JH. Diagnosis of ovarian cancer:Regression in early memories in the face ofdanger. Journal of the American PsychoanalyticAssociation. Winter 2004; 52(4):1242-1243.Colt JS, Severson RK, Lubin JH, et al.Organocholorine compounds in carpetdust and risk of non-Hodgkin lymphoma.Epidemiology. (In press).Coumarbach J, Israel N, Markova T. Newonset LVOT in an elderly patient (an unusualpresentation). Family Practice RecertificationJournal. (In press).Day JBF, Kau TY, Severson RK, KalemkerianGP. Lung cancer in women: Analysis of thenational Surveillance, Epidemiology, and EndResults database. Chest. (In press).Dovidio JF, Penner LA, Piliavin JA, SchroederDA. The psychology of helping and altruism. 2nded. Mahwah, NJ: Lawrence Erlbaum. (In press).Echlin PS, Upshur RE, Markova TP. Lackof chart reminder effectiveness on familymedicine resident JNC-VI and NCEP IIIguideline knowledge and attitudes. BioMedCentral Family Practice. Jul 5 2004; 5(1):14.Engels EA, Chatterjee N, Cerhan JR, Davis S,Cozen W, Severson RK, et al. Hepatitis C virusinfection and non-Hodgkin lymphoma: resultsof the NCI-SEER multi-center case-controlstudy. International Journal of Cancer. Aug 102004; 111(1):76-80.Engels EA, Chen J, Hartge P, Cerhan JR, DavisS, Severson RK, et al. Antibody responsesto simian virus 40 T antigen: A case-controlstudy of non-Hodgkin lymphoma. CancerEpidemiology, Biomarkers & Prevention. (In press).Engels EA, Viscidi RP, Galloway DA, Carter JJ,Cerhan JR, Davis S, Cozen W, Severson RK, etal. Case-control study of simian virus 40 andnon-Hodgkin lymphoma in the United States.Journal of the National Cancer Institute. Sep 152004; 96(18):1368-1374.Finkelstein MA, Penner LA, Brannick M.Motive, role identity, and prosocial personalityas predictors of volunteer activity. SocialBehavior and Personality. (In press).Finkelstein MA, Penner LA. Predictingorganizational citizenship behavior:Integrating the functional and role identityapproaches. Social Behavior and Personality.2004; 32(4):383-398.Frank RR, Popp S, Mendez J, Bridge P, RoeT, Stellini M, Steinberg J, Cardozo L. WayneState University School of Medicine: Geriatricscurriculum for undergraduate medicaleducation. Academic Medicine. Jul 2004;79 (7Suppl):S192-198.Fryzek JP, Schenk M, Kinnard , Greenson JK,Garabrant DH. The association of body massindex and pancreatic cancer in residents ofsoutheastern Michigan. Journal of the NationalCancer Institute. (In press)Hamre MR, Severson RK, Chuba PJ. Survivalof women with breast invasive cancersubsequent to Hodgkin’s disease. PediatricBlood & Cancer. 2004; 43(4):339 Abstract #O.049.Harper FWK, Arias I. The role of shamein predicting adult anger and depressivesymptoms among victims of childpsychological maltreatment. Journal of FamilyViolence. 2004; 19:359-367.Harper FWK, Austin A, Cercone-KeeneyJ, Arias I. The role of shame, anger, andaffect regulation in men’s perpetration ofpsychological abuse in dating relationships.Journal of Interpersonal Violence. (In press).Harper FWK, Brown AM, Arias I, Brody G.Corporal punishment and kids: How doparent support and gender influence childadjustment? Journal of Family Violence. (Inpress).Hartge P, Colt JS, Severson RK, et al.Residential herbicide use and risk of Non-Hodgkin lymphoma. Cancer Epidemiology,Biomarkers & Prevention. (In press).Israel N, Markova T, Pani A. Sarcoidosis:A blurry presentation of systemic disease.Family Practice Recertification. November 2004;26(11):22-32.Jamil H, Harkim-Larson J, Farrag M, Kafaji T,Jamil LH, Hammad A. Medical complaintsamong Iraq American refugees with mentaldisorders. Journal of Immigrant Health. (Inpress).Jamil H, Nassar-McMillan SC, Lambert R. Theaftermath of the Gulf War: Mental healthissues among Iraqi Gulf War veteran refugeesin the United States. Journal of Mental HealthCounseling. 2004; 26(4):295-308.Jayatilake HP, Schwartz K. Influenza vaccinedoes not prevent acute otitis media in youngchildren. Journal of Family Practice. Jan 2004;53(1):17-18, 20.Johnson M, Nriagu J, Hammad A, Savoie K,Jamil H. Asthma prevalence and severity inthe Detroit Arab American community. Journalof Immigrant Health. (In press).Lantz PM, Janz NK, Fagerlin A, Schwartz K, etal. Satisfaction with surgery outcomes and thedecision process in a population-based sampleof women with breast cancer. Health ServicesResearch. (In press).Layne J, Porcerelli JH, Shahar G.Psychotherapy of self-criticism in a caseof mixed anaclitic-introjective depression.Clinical Case Studies. (In press).Liebman S, Porcerelli JH, Abel S. Reliabilityand validity of Rorschach aggression variablesin an adjudicated sample. Journal of PersonalityAssessment. (In press).Lubin JH, Colt JS, Camann D, Davis S,Cerhan JR, Severson RK, Cozen W, HartgeP. Epidemiologic evaluation of measurementdata in the presence of detection limits.Environmental Health Perspectives. (In press).http://familymedicine.med.wayne.edu19


FACULTY SCHOLARSHIPPeer-reviewed Publications, Books & ChaptersMarkova T, Roth LM, Monsur J. Synchronousdistance learning as an effective and feasiblemethod for delivering residency didactics.Family Medicine. (In press).Mittal V, Salem M, Tyburski J, Brocato J, et al.Residents’ working hours in a consortium-widesurgical education program. American Surgeon.Feb 2004; 70(2):127-131.Morris P, Markova T, Roe T. Shoulder pain:First presenting symptom of advanced breastcancer in a male. Patient Care (In press)..Morton LM, Hartge P, Holford TR, Holly EA,Chiu BCH, Vineis P, Stagnaro E, Willett EV,Franceschi S, La Vecchia C, Hughes AM, CozenW, Davis S, Severson RK, et al. Cigarettesmoking as risk of non-Hodgkin lymphoma:a pooled analysis from the InterLymphconsortium. Cancer Epidemiology, Biomarkers &Prevention. (In press).Neale AV, Jacobson N. Users’ guide to theJABFP online manuscript management system.Journal of the American Board of Family Practice.(In press)Neale AV, Schwartz KL. A primer of the HIPAAPrivacy Rule for practice-based researchers.Journal of the American Board of Family Practice.Nov-Dec 2004;1 7(6):461-465.Nelson DA, Darga LL, Simon MS, SeversonRK. Radial bone density and breast cancerrisk in white and African-American women.Osteoporosis International. Jul 2004; 15(7):535-540.Patel DA, Bock CH, Schwartz K, Wenzlaff AS,Demers RY, Severson RK. Sexually-transmitteddiseases and other urogenital conditions as riskfactors for prostate cancer: A case control studyin Wayne County, Michigan. Cancer CausesControl. (In press).Penner LA, Brannick M, Connell P, WebbS. The effects of the September 11 attacks onvolunteering: An archival analysis. Journal ofApplied Social Psychology. (In press).Penner LA, Dovidio JF, Schroeder DA, PiliavinJA. Altruism and prosocial behavior. AnnualReview of Psychology. (In press).Penner LA. Volunteerism and social problems:Making things better or worse? Journal of SocialIssues. 2004; 60(3):645-666.Porcerelli JH, Cogan R, Hibbard S. Personalitycharacteristics of partner violent men: A Q-sortapproach. Journal of Personality Disorders. Apr2004; 18(2):151-162.Porcerelli JH, Cogan R, Kamoo R, Leitman S.Defense mechanisms and self-reported violencetoward partners and strangers. Journal ofPersonality Assessment. Jun 2004; 82(3):317-320.Porcerelli JH, Hibbard S. Projective Assessmentof Defense Mechanisms. In: Hilsenroth M,Segal D, eds. Objective and projective assessmentand psychopathology. (pp.466-473). Vol 2.in Hersen M (Ed-in-Chief), Comprehensivehandbook of psychological assessment. New York:John Wiley & Sons; 2004Rose EA, Neale AV. Pica. Encyclopedia ofGastroenterology. San Diego, CA: ElsevierScience; 2004:178-179.Roth L. Learning and performancestrategies of the occupational medicinecertification examination. In: McCunney R,ed. A practical approach to occupational andenvironmental medicine home study guide. 2nded. Philadelphia: Lippincott-Raven; 2004:xxxix-xlvi.Sathiakumar N, Graff JJ, Delzell E, et al. Anupdated study of mortality among NorthAmerican synthetic rubber industry workers.Occupational and Environmental Medicine. (Inpress).Schwartz K, Deschere B, Xu J. Screening forprostate cancer. Journal of Family Practice. (Inpress).Schwartz K, Monsur J, Northrup J, West P,Neale AV. Pharyngitis clinical prediction rules:Effect of interobserver agreement: A MetroNetstudy. Journal of Clinical Epidemiology. Feb2004;57(2):142-146.Schwartz KL, Kulwicki A, Weiss LK, FakhouriH, Sakr W, Kau G, Severson RK. Cancer amongArab Americans in the metropolitan Detroitarea. Journal of Ethnicity and Disease. Winter2004;14 (1):141-146.Tubbs CG, Safeek A, Mayo HG, Markova T.Clinical inquiries o routine eye exams reduceoccurrence of blindness from type 2 diabetes?Journal of Family Practice. Sep 2004; 53(9):732-734.Welch Cline RJ, Young HN. Marketing drugs,marketing health care relationships: A contentanalysis of visual cues in direct-to-consumerprescription drug advertising. HealthCommunication. 2004; 16(2):131-157.Xu J, Schwartz K, Monsur J, NorthrupJ, Neale AV. Patient-clinician agreementon signs and symptoms of ‘strep throat’: aMetroNet study. Family Practice. Dec 2004;21(6):599-604.Xu J, Sobel JD. Candida vulvovaginitis inpregnancy. Current Infectious Disease Reports.Dec 2004; 6(6):445-449.Yang H, Li X, Stanton B, Fang X, Lin D, Mao R,Liu H, Chen X, Severson RK. Workplace andHIV-related sexual behaviors and perceptionsamong female migrant workers. AIDS Care. (Inpress).Young HN, Cline RJW. Textual cues in directto-consumerprescription drug advertising:Motivators to communicate with physicians.Journal of Applied Communication Research. (Inpress).Young RF, Severson RK. Breast cancerscreening barriers and mammographycompletion in older minority women. BreastCancer Research and Treatment. (In press).Quinn GP, Albrecht TL, Marshall R, Henry T,Hutsell C. Thinking like a marketer: Trainingfor a shift in the mindset of the public healthworkforce. Health Promotion Practice. (In press).20 Department of Family Medicine 2004 Annual Report


Interpersonal ViolenceRESEARCHFamily physicians need to recognizevictims and perpetrators of violenceJohn Porcerelli, PhD, associateprofessor and director of the Division ofBehavioral Science, has identified themajor psychological characteristics ofphysically abusive men to help doctorsrecognize and counsel them and thevictims of their violent behavior.In their multi-site study published in2003 in the Journal of the AmericanBoard of Family Practice, Dr. Porcerelli,with Patricia West, RN, PhD of St. JohnHospital and Medical Center, foundthat 10 percent of patients (bothmales and females) who used primarycare clinics reported some type ofphysical victimization in the past year.In addition, victimized women hadreported more physical complaintsand depressive symptoms than nonvictimizedwomen and men.In a follow-up study, psychologicallyabusedwomen reported morerespiratory, cardiovascular, GI anddepressive symptoms than nonabusedwomen. “Given the strongrelationship between physical andpsychological abuse and health,it’s imperative that researchers andclinicians work together to identifythe most salient characteristics ofboth victims and perpetrators to aidthe identification of these individualsand to develop effective psychosocialtreatment strategies,” Dr. Porcerellisaid.Dr. Porcerelli and his colleague,Rosemary Cogan, PhD (Texas TechUniversity) have published threerecent articles describing somesalient psychological characteristicsof partner-violent men. These studieshave identified the pathologicalpersonality characteristics and copingstrategies of men who are physicallyabusive toward their partners.John Porcerellidenial biased reporting. Instead werelied upon experienced psychologistsand clinical social workers throughoutMichigan to describe male clients intheir practices who have been violenttoward their partners. The cliniciansused a reliable and valid instrumentto describe their patients, thusstandardizing the assessment process.The result is a clinically relevantprofile of partner-violent men that canbe used by health care professionals toaid them in their assessment.(Special thanks to Amy DiCresce forassisting on this story)“Given that abusive men tend todeny their problems and their abusivebehavior, our research team decided notto use self-report instruments to assessthese individuals to eliminate theirhttp://familymedicine.med.wayne.edu21


FACULTY SERVICEEditorial and Peer Review ActivitiesWe continue to have a substantial commitment to editorial and peer reviewactivities. The editorial office of the Journal of the American Board of FamilyPractice (www.jabfp.org) is housed within the DFM, with Victoria Neale, PhD,serving as the Deputy Editor, and Kendra Schwartz, MD, serving as AssociateEditor. In 2004, the JABFP adopted ‘Rapid Review’, an on-line program formanuscript submission, peer review and tracking. This transition to a paperlessweb-based manuscript management system has resulted in greater efficiencyfor the editorial team.Many DFM faculty members volunteer their time and expertise to read andcritique submissions to journals and grant funding agencies. This devotion toadvancing primary care research and practice, plus the commitment to nurturingtheir colleagues is a tremendous service to us allTerrence L. Albrecht, PhD• Editorial Board, CommunicationMonographs• Peer Reviewer: Journal of theNational Cancer Institute; Psycho-Oncology• Grant Reviewer: Susan B. KomenGrant Awards• NIH Review Panels:- Review Panel for PAR-037, Small Grants Program forBehavioral Research in CancerControl, National Cancer Institute- Review Panel Member, NIHCenter for Scientific ReviewCommunity Level Health PromotionStudy Section, 2004/05Council ZRG1 HOP-J 90- Review Panel Member, NIHCenter for Scientific Review SpecialEmphasis Panel, ZRG1 RPHB-B(05) Cancer TreatmentJuliann Binienda, MA• Peer Reviewer: Health PsychologyPatrick D Bridge, PhD• Peer Reviewer: Medical Care;Journal of Cancer EducationJoseph Brocato, PhD• Editorial Board, Family MedicineRebecca Cline• Associate Editor, Health Communication• Associate Editor, Journal of AppliedCommunication Research• Associate Editor, Women’s Studiesin Communication• Associate Editor, CommunicationStudies• Editorial Board, The SpeechCommunication Annual• Editorial Board, CommunicationResearch Reports• Peer Reviewer: International Journalof Men’s Health• Member, Review Panel, PAR 04-020,National Cancer Institute, SmallGrants Program for BehavioralResearch in Cancer ControlRichard E Gallagher, PhD• Associate Editor, Journal of CancerEducation• Peer Reviewer: Journal of PalliativeCare• Grant Reviewer: National CancerInstitute Initial Review Group-Education• Chair National Cancer InstituteSpecial Emphasis Panel for R-25applicationsJohn Graff, PhD• Peer Reviewer: American Journal ofIndustrial MedicineFelicity Harper, PhD• Abstract Reviewer- Association for theAdvancement of Behavior TherapyAnnual Meeting (BehavioralMedicine Special Interest Group)- American PsychosocialOncology Society Annual MeetingHikmet Jamil MD• Consultant, International Boardof the Yemeni Journal for MedicalSciences, The University of Scienceand Technology, Yemen22 Department of Family Medicine 2004 Annual Report


FACULTY SERVICETsevti Markova, MD• Peer Reviewer, Journal of theAmerican Board of Family Practice;Annals of Family Medicine; Journalof Family PracticeAnne Victoria Neale, PhD, MPH• Deputy Editor, Journal of theAmerican Board of Family Practice• Peer Reviewer: Archives of InternalMedicine; Medical Care• Grant Reviewer: RehabilitationInstitute of Michigan 2004 DelHarder Grant CompetitionLouis Penner, PhD• Consulting editor, Journal ofPersonality and Social Psychology• Editorial Board, Journal of SocialIssues• Peer Reviewer: Journal ofExperimental Social Psychology;Journal of Personality; EuropeanJournal of Social PsychologyLinda M. Roth, PhD• Peer reviewer: Academic Medicine;Teaching and Learning in MedicineMaryjean Schenk, MD, MS, MPH• Peer reviewer: Journal of theAmerican Board of Family PracticeKendra Schwartz, MD, MSPH• Associate Editor, Journal ofAmerican Board of Family Practice• Editorial Board, Journal of FamilyPractice• Peer Reviewer: Journal of AmericanBoard of Family Practice; Cancer• Abstract Reviewer: NationalAssociation of Central CancerRegistriesRichard K. Severson, PhD• Editorial Advisory Board, Journalof the National Cancer Institute• Abstract Reviewer, North AmericanPrimary Care Research Group• Judge, Sinai-Grace HospitalResearch Day, Wayne StateUniversity• Member, Steering Committeefor WSU Research EnhancementGrants• Member, Scientific Peer ReviewPanel, Great Lakes Research intoPractice Network• Judge, 27th Annual FamilyPractice Research Day Conference,Michigan State Universityhttp://familymedicine.med.wayne.edu23


FACULTY DEVELOPMENTRichard Gallagher, Tsevti MarkovaKendra Schwartz, Roulf Seifeldin andJohn Graff work at a faculty developmentworkshop.Pierre Morris, Juliann Binienda, NejlaIsrael and James Scupski participate infaculty development.Faculty DevelopmentFocus: Increasing Scholarly Productivityof Clinician-Educator FacultyThe Department of Family Medicineset a goal to advance scholarshipamong our clinician-educator facultyand has conducted research-specificfaculty development efforts focusingon developing the clinician facultyinto academic faculty. Starting in1998, the DFM has annually devotedfour half-day sessions to a presentationand a journal club on an evidencebasedclinical practice topic relevantto family medicine. The program isfacilitated by Kendra Schwartz, MD,MSPH, Victoria Neale, PhD, MPH,and Linda Roth, PhD. Presentationsare provided primarily by cliniciansand have covered topics such asdiagnosis (sort throat and depression),treatment (hypertension and type IIDM), prevention (breast and cervicalcancer screening), and prognosis (lowback pain). Journal clubs immediatelyfollow the presentations and reviewarticles on the same topics, using astructure provided by the Users’ Guideto the Medical Literature series fromJAMA.A second DFM faculty developmenteffort initiated in 2002 and facilitatedby Linda Roth, PhD and RickSeverson, PhD included a series of bimonthlyscholarly workshops. Theseworkshops covered topics such aspatient-oriented evidence that matters(POEMs), case reports, literaturereviews, writing research questions,and basic study designs.In order to assess the effectivenessof these programs, the DFM hasannually surveyed the clinician facultyregarding their attitudes towardresearch and scholarship. In 1999,29.4% of the clinician faculty reportedthey were confident in their research/scholarly skills and 35.3% reportedthat they were committed to research/scholarship. In 2004, these values roseto 60.0% who were confident in theirresearch/scholarly skills and 86.7%who were committed to research/scholarship.Scholarly Activity ProductivityThis emphasis on research andscholarly activity throughout thedepartment has not only changedattitudes, but has also resulted inincreased publications among clinicalfaculty. In 2003, an original researcharticle was published with threeclinician faculty as first-time authors.In 2004, clinician faculty authoredseven publications.Over the past three years, six clinicianfaculty have contributed to the Journalof Family Practice’s feature of systematicpatient-oriented review of researcharticles, called POEMS (patientorientedevidence that matters),facilitated by Dr. Schwartz who servedas the mentor for these activities.In the last two years, DFM clinicianfaculty have presented eight times atprofessional meetings. Additionally,by the end of this academic year, allclinical faculty will have developedan evidence-based clinical practiceseminar and delivered it to theircolleagues within the DFM at thefaculty research seminar and at FMGrand Rounds.The DFM has demonstrated a strongcommitment developing clinicianeducatorsas scholars. The culturehas changed and the faculty clearlyrecognize and support scholarlyactivity as a priority.24 Department of Family Medicine 2004 Annual Report


CONTINUING MEDICAL EDUCATION16th Annual Great Lakes Family Medicine ReviewThe 16th Annual Great Lakes Family Medicine Review was held in May, 2004,and attracted 112 attending physicians and residents from Michigan andneighboring states. Guest speakers were recruited from those highly rated atprevious review courses and were primarily from the Southeast Michigan Centerfor Continuing Medical Education (SEMCME) consortium. Speaker evaluationsfor the course were at an all time high this year with superb reviews from theaudience.The five-day course covered a wide variety of topics over a span of 5 days andwas approved for 41.75 hours of prescribed credit by the AAFP. A course textand board questions review book were also offered to the participants. Boardstylequestions were incorporated into each lecture session to make the coursemore valuable to those participants preparing to take their boards.Planning for the course began during the previous year’s meeting, with excitingideas and suggestions to make the course even better for the following year.Chaired by Maryjean Schenk, MD, the Family Medicine CME committee meetson a monthly basis to review course content and participant feedback.Nik HemadyCongratulations to the following CME Committee members for their excellentwork: Dwight Encinas, MD; Camille Fleming, MD; Nik Hemady, MD, (Chair);Farzin Namei, MD; Audrey Newell, MD; and Barry Scofield, MD.Featured DFM faculty speakers:Bruce Deschere, MD• “Treatment of Type II Diabetes”Harsha P. Jaytilake, MD• “Pediatric Asthma”Thomas Roe, MD• “GERD, Peptic Ulcer Disease, and IBD”Maryjean Schenk, MD• “Cancer Screening and Routine Health Maintenance”Kendra Schwartz, MD• “Breast Disease”• “Osteoporosis”http://familymedicine.med.wayne.edu25


UMEDivision of Medical EducationThe School of Medicine (SOM) oftenrelies on the Department of FamilyMedicine’s Division of MedicalEducation, led by Dr. RichardGallagher, for professional medicaleducation support in the developmentand implementation of the SOM’seducational efforts. More recently theSOM has taken steps to strengthen itscapacity to provide such support.In past issues of this publication,we’ve reported on the leadership ofDr. Thomas Roe in the developmentof the Clinical Medicine courserequired for freshman and sophomoremedical students. In collaborationwith co-directors Dr. Michael Stellini,Internal Medicine, and Dr. Kathy Ling-McGeorge, Pediatrics, we continue tokeep the course innovative. This courseis notable for its small group case-basedformat.Recently, there have been requests foradditional support from the medicaleducation division. In recognition of Dr.Patrick Bridge’s expertise in the areasof program and student evaluation,the Office of Academic and StudentPrograms has asked him to expand hisleadership in that office. In addition, Dr.Bridge has works with Dr. Matt Jackson,Immunology and Microbiology, and Dr.Kenneth Ginsburg, Assistant Dean forClinical Education, in the developmentand application of a program formedical students to use personaldigital assistants (PDAs) to documentstudent-patient contact. This meetsthe new requirement for institutionalre-accreditation.In October, the Office of FacultyAffairs appointed Dr. Linda Roth asthe School of Medicine’s Director ofFaculty Development. Dr. Roth workswith Dr. Stephen Lerner, AssociateDean, and Karen Crist, Director ofthe SOM’s Medical Education SupportGroup, to implement such schoolwidedevelopmental experiences as amanuscript-writing course and a semiannualSOM new faculty orientation.Finally, Drs. Gallagher and Bridge havebeen assisting with a SOM review ofYear III clerkships in preparation for theupcoming accreditation visit in 2007.The review has involved a detailedwritten report by, and meeting with,each clerkship director. Students andeach respective department chair alsoparticipate in the evaluation process.This self-study process has producedaction plans to correct identifieddeficiencies and to strengthen theclerkship experiences.The DFM is takes pride in the recognitionof our medical education division bythe School of Medicine.Tom Roe, Sharon Popp, Lisa Blackwell, Richard Gallagherand Linda Roth (not pictured: Patrick Bridge)26 Department of Family Medicine 2004 Annual Report


Division of Behavioral ScienceGMEBehavioral Science faculty are expandingtheir research program in the areas ofdepression, domestic violence, andpatient-provider interaction.Health Impact of Depressive Disordersin Urban Primary CareRecently, Division members havebegun to explore the relationshipbetween various depressive disorderswithin urban practices. With StevenHuprich, PhD, a nationally-recognizedexpert in depressive personality basedat Eastern Michigan University,we are assessing the prevalence ofdepression-related physical healthimpairment brought about by thevarious types of depression experiencedby African American women. Our aimis to improve physician recognition ofdepressive disorders in urban clinicalpractice settings.Social Factors in HealthJohn Porcerelli and Juliann BiniendaRebecca Cline, Felicity HarperLou Penner, Teri Albrecht, Juliann Biniendaand John PorcerelliRecognition and Management ofViolent VictimizationDomestic and partner-violence isan ongoing research focus of ourdivision. We have conducted multipleeducational interventions regardingassessment and management ofdomestic violence and elder abuse inprimary care settings. Residents whomwe have mentored have won awards forreports on research studies exploringthe relationship between emotionalabuse and health.In 2004, the Division welcomed twonew faculty with joint appointmentsin the Communication and BehavioralOncology Sub-Program at the BarbaraAnn Karmanos Cancer Institute.Rebecca Cline, PhD, and FelicityHarper, PhD, joined this new programwith Teri Albrecht, PhD (programleader) and Louis Penner, PhD. Theircombined areas of expertise includehealth communication, patientproviderinteraction, social supportand health, biopsychosocial aspects ofcancer treatment and survivorship, andsocial marketing approaches to healthbehavior change. They are currentlyfunded by the National Cancer Institutefor R01 research grants studying themediating role of physicians in patientaccrual to clinical trials and parentalinfluence on pediatric cancer painand stress, and an R21 project ondeveloping measurement strategiesof biopsychosocial processes andtreatment decision making.http://familymedicine.med.wayne.edu27


FACULTY SCHOLARSHIPPresentations at Professional MeetingsFaculty made 48 presentationsat professional and nationalmeetings in 2004.Albrecht TL. The social marketing mindsetand cancer screening. Paper presented at: theBCCCP/Wisewoman Annual Meeting, May,2004; Traverse City, MI.Albrecht TL. Video and other trainingmethods and resources. Paper presented at: theInternational Congress on Geriatric Oncology:Cancer in the Elderly 9th Annual Conference,October, 2004; San Francisco, CA.Barnholtz-Sloan J, Severson RK, Stanton B,Hamre MR, Sloan AE. Pediatric brain tumors:Racial differences in incidence and survival.Paper presented at: Annual Meeting of theSociety of Neuro-Oncology, November, 2004;Toronto, Canada.Berry-Bobovski LC, Bridge P, Bridge TJ.Developing strategies for reaching Hispanicmen with prostate cancer health awarenessmessages. Paper presented at: the AmericanAssociation for Cancer Education 38th AnnualMeeting, October, 2004; Maryland.Binienda J, Schwartz K. Interacting withhospice patients: Effects on empathy andattitude of third-year medical students. Paperpresented at: Society of Teachers in FamilyMedicine 37th Annual Spring Conference,February, 2004; New Orleans, LA.Binienda J. Improving medical studentattitudes toward care of dying patients. Paperpresented at: Association for Death Educationand Counseling 26th Annual Conference,April, 2004; Pittsburg, PA.Broadway SC, Cline RJW, Weiler RW, MorrisMC. Implied knowledge: Prescription druginformation on health education criteria.Paper presented at: the American Public HealthAssociation Annual Meeting, November, 2004;Washington, DC.Brocato JJ, Joyce B. Collaborative chiefresident training: Form and function in theage of work hours and general competencies.Paper presented at: The Generalistis in MedicalEducation, November, 2004; Boston, MA.Cline RJW, Morris MC, Broadway SC, WeilerRW. “It wasn’t what you said! It was howyou said it”: Messages about prescriptiondrug abuse. Paper presented at: the NationalCommunication Association Annual Meeting,November, 2004; Chicago, IL.Cline RJW, Morris MC, Weiler RW, BroadwaySC. Lack of definition: An analysis ofprescription drug terms in health educationtextbooks. Paper presented at: the AmericanSchool Health Association Annual meeting,October, 2004; Pittsburg, PA.Cline RJW, Morris MC, Weiler RW, Morris MC.Ignored by the best: Prescription drug-relatedcontent in model drug abuse preventionprograms. Paper presented at: the AmericanPublic Health Association Annual Meeting,November, 2004; Washington, DC.Cline RJW, Young HN. Marketing health carerelationships by marketing drugs? Results ofa program of content-analytic research and itsimplications. Paper presented at: the NationalCommunication Association Annual Meeting,November, 2004; Chicago, IL.Cline RJW. Chair and participant: Town HallMeeting and Briefing on Promoting HealthCommunication. Paper presented at: theNational Communication Association AnnualMeeting, November, 2004; Chicago, IL.Cline RJW. Knowing what “we know”: Askeptic’s questions in response to “Publichealth and the media: Communicating inroutine and emergency environments”. Paperpresented at: the National CommunicationAssociation Annual Meeting, November, 2004;Chicago, IL.Cline RJW. Preparing health communicationsprofessionals: Models of programs andissues in graduate education in healthcommunication. Paper presented at:the Kentucky Conference on HealthCommunication, April, 2004; Lexington, KY.Cline RJW. The light and dark sides to theinternet: Health- and risk-promoting websites.Paper presented at: the RTI Fellows 2nd AnnualSymposium, “Health Technology and PublicPolicy: Issues and Innovations Shaping theFuture,” December, 2004; Research TrianglePark, NC.Cogan R, Porcerelli JH. Personality pathology,adaptive functioning and strengths at thebeginning and end of psychoanalysis. Paperpresented at: Annual Meetings of the AmericanPsychoanalytic Association, January, 2004; NewYork, NY.Cogan R, Stringer A, Aldredge-Clanton J,Porcerelli JH, et. al. Diagnosis of ovariancancer: Regression in early memories in theface of danger. Paper presented at: AnnualMeeting of the American PsychoanalyticAssociation, January, 2004; New York, NY.Colt JS, Severson RK, Lubin JH, et al.Organochlorine compounds in carpet dustand non-Hodgkin’s lymphoma risk. Paperpresented at: Annual Meeting of the AmericanCollege of Epidemiology, September, 2004;Boston, MA.Dailey R, Binienda J, Neale AV, Schwartz K.Barriers to treating hypercholesterolemia in anurban family practice setting. Paper presentedat: the Michigan Family Practice Research DayXXVII, May, 2004; East Lansing, MI.Davis A, Stevens N, Kim S, Roth L, TysingerJ. STFM Group on faculty development’selectronic toolbox: A resource for all STFMmembers. Presented at: the Annual Meetingof the Society of Teachers of Family Medicine(STFM), May, 2004; Toronto, Ontario.DeHaven MJ, Neale AV, Kennedy K, Roth LM.What do successful practice-based researchersrecommend to build PBRNs? Paper presentedat: the North American Primary Care ResearchGroup (NAPCRG) 32nd Annual Meeting,October, 2004; Orlando, FL.Deschere B. Update on diabetes mellitus.Presented at: Great Lakes Family PracticeReview, OHEP, 2004; Birmingham, MI.Dua R, Markova T, Schwartz K, Northrup J.Use of online resources in a family medicineresidency program for answering questionsat the point-of-care. Paper presented at: theMichigan Family Practice Research Day XXVII,May, 2004; East Lansing, MI.Eggly S, Albrecht TL, Penner LA, ClineRJW, Ruckdeschel JC, et al. Challenges tothe current guidelines for communicatingbad news in the outpatient oncology clinic.Paper presented at: the American Academy onthe Physician and Patient Annual Meeting,October, 2004; Indianapolis, IN.28 Department of Family Medicine 2004 Annual Report


FACULTY SCHOLARSHIPEngels EA, Viscidi RP, Carter JJ, Galloway DA,Cerhan JR, Davis S, Cozen W, Severson RK,et al. Case-control study of simian virus 40(SV40) and non-Hodgkin lymphoma (NHL) inthe U.S. Paper presented at: Annual Meeting ofthe American Association for Cancer Research,March, 2004; Orlando, FL.Everson RB, Bangsi D, Zhou JY, Butler C, SunY, Patel NP, Dey J, Heibrun LK, Severson RK,et al. Impact of a polymorphism in CYP3A4 on risk of premalignant, latent, andnewly-diagnosed prostate cancer and survivalafter prostatectomy in an ethnically-diversecommunity. Paper presented at: AnnualMeeting of the American Association forCancer Research, March, 2004; Orlando, FL.Frank R, Popp S, Mendez J, Bridge P, StelliniM, Steinberg J, Cardozo L. Integratinga geriatrics and gerontology curriculumacross undergraduate medical education.Paper presented at: AAMC/John A HartfordFoundation, June, 2004; St. Louis, MO.Gallagher RE, Bridge P, Berry-Bobovski LC. Atobacco prevention program for adolescents:Strategies for maintaining temporal programintegrity. Paper presented at: the EuropeanAssociation for Cancer Education 17th AnnualConference, May, 2004; Caen, France.Gorey K, Schwartz K. Increasing racial groupbreast cancer survival differentials in America(1973 to 2003): Observational evidenceconsistent with a health insurance hypothesis.Paper presented at: the Annual Meeting ofthe American Public Health Association,November, 2004; Washington, DC.Graff JJ, Colombo E, Bell B, Nicolin P.Metropolitan Detroit cancer surveillancesystem. Paper presented at: North AmericanAssociation of Central Cancer Registries AnnualConference, June, 2004; Salt Lake City, UT.Graff JJ, Delzell E, Sathiakumar N, et al. Anupdated study of mortality among NorthAmerican synthetic rubber industry workers:Final results and regulatory implications onindustry. Paper presented at: Health EffectsInstitute Annual Conference, May, 2004;Boston, MA.Graves KD, Harper FWK, Schmidt JE,Andrykowski MA. Move over social support:Influence of social constraints on quality of lifein women screened for ovarian cancer. Paperpresented at: Society of Behavioral Medicine,March, 2004; Baltimore, MD.Graves KD, Harper FWK, Schmidt JE, etal. Linguistic analysis of cancer patients’expressive writing: Association withpsychosocial variables and differences amongdisease stages. Paper presented at: AmericanPsychosocial Oncology Society, January, 2004;Orlando, FL.Graves KD, Harper FWK, et al. The wonderof words: Relationship between linguisticcharacteristics and behavior change aftercancer diagnosis and treatment. Paperpresented at: NCI-ACS Cancer SurvivorshipResearch Conference, June, 2004; Washington,DC.Greene M, Eggly S, Penner LA, et al. Patientand companion questions during discussionsof bad news in oncology interactions: A pilotstudy. Paper presented at: American MedicalAssociation, 2004; Atlanta, GA.Hammad A, Nriagu J, Savoie K, Johnson M,Jamil H. Acculturation & asthma among ArabAmerican immigrants in metropolitan Detroit,Michigan. Paper presented at: CDC Winningwith Asthma Conference, April 14-16, 2004;Atlanta, Georgia.Hamre MR, Severson RK, Chuba PJ. Survival ofwomen with invasive breast cancer subsequentto Hodgkin’s disease. Paper presented at: theInternational Society of Pediatric Oncology,SIOP 36th Congress, September, 2004; Oslo,Norway.Harper FWK, Graves KD, Schmidt JE, et al.The role of social support and positive moodin cancer related distress in breast and lungcancer patients. Paper presented at: AmericanPsychosocial Oncology Society, January, 2004;Orlando, FL.Harper FWK, Schmidt JE, et al. Positivepsychosocial and physical health behaviorchange after cancer diagnosis and treatment.Paper presented at: Society of BehavioralMedicine, March, 2004; Baltimore, MD.Harper FWK, Yingling K, Schumacher M,Rowland R. Post-diagnosis physical behaviorchange in prostate cancer survivors and theirwives. Paper presented at: NCI-ACS CancerSurvivorship Research Conference, June, 2004;Washington, DC.Harris D, Roth LM, Hash RB, Smith MU.Academic faculty competencies: A tool foridentifying and addressing role-specific skills.Presented at: the Annual Meeting of theAssociation of American Medical Colleges,November, 2004; Boston, MA.Jamil H, Hakim-Larson J, Farrag M, et al.Complaints among Iraqi American refugeeswith mental disorders. Paper presented at:the Military Medicine XXXV InternationalCongress, September, 2004; Washington, D.C.Jamil H, Nassar-McMillan SC, Salma WA, TaharM, Jamil LH. American veterans of the GulfWar: PTSD and physical symptoms. Paperpresented at: the Military Medicine XXXVInternational Congress, September, 2004;Washington, D.C.Jamil H, Rice V, Hammad A, Jamil LH, PassH. Tobacco use among Arab American adultsin southeastern Michigan. Paper presentedat: the American Public Health Association132nd Annual Meeting, November 6-10, 2004;Washington, D.C.Johnson M, Nriagu J, Hammad A, Jamil H,Savoie K. Acculturation and environmentalhealth risks among Arab American immigrantsin Detroit, Michigan. Paper presented at: theAmerican Public Health Association 132ndAnnual Meeting, November 6-10, 2004;Washington, D.C.Kato I, Severson RK, Majumdar A, etal. Luminal lipid exposure, genetics andcolon cancer risk. Paper presented at: FirstNCI Epidemiology Leadership Workshop,September, 2004; Chicago, IL.Kelly KM, Harper FWK, et al. Perceived riskof colon cancer: Impact of numeracy andquestionnaire adminstration method. Paperpresented at: Society of Behavioral Medicine,March, 2004; Baltimore, MD.http://familymedicine.med.wayne.edu29


FACULTY SCHOLARSHIPPresentations at Professional MeetingsThe DFM was well represented at theMichigan Family Practice Research Dayannual conference at Michigan StateUniversity. Manhal Naoumi, Joe Monsur,Francis Bayaca, Mary Santiago,Pierre Morris, Rhonda Dailey, Raj Duaand Jinping Xu all presented findingsfrom recent research studies.Joe Monsur took the first place awardin his category for his presentationof “Pilot evaluation of rapid HbA1cmeasurements”.Maibenco DC, Dombi GW, Kau TY, SeversonRK. Impact of micrometastases on the longtermsurvival of women with T1 breast cancer.Paper presented at: San Antonio Breast CancerConference, December, 2004; San Antonio, TX.Manning B, Morzinski J, Quirk M, RothL, Tysinger J, Whiting E. Local facultydevelopment: Getting started on a shoestring.Presented at: the Annual Meeting of the Societyof Teachers of Family Medicine (STFM), May,2004; Toronto, Ontario.Markova T. The match process: Interviewingtechniques and development of a solid CV.Paper presented at: Michigan Academy ofFamily Physicians (MAFP) First Annual Studentand Resident Conference, September, 2004;Plymouth, MI.Markova T. Women in medicine. Keynotespeaker at the American Medical Women’sAssociation of the WSUSOM Annual Women’sTea, November, 2004; Detroit, Michigan.Monsur J, Schwartz K, Neale AV, West P. Pilotevaluation of rapid HbA1c measurements.Paper presented at: the Michigan FamilyPractice Research Day XXVII, May, 2004; EastLansing, MI.Morris MC, Cline RJW, Broadway SC, WeilerRW. The failure of health textbook activitiesto address proper use of prescription drugs.Paper presented at: the American School HealthAssociation Annual Meeting, October, 2004;Pittsburg, PA.Morris MC, Cline RJW, Weiler RW, BroadwaySC. Dare to inform: The absence ofprescription drug abuse information in D.A.R.E.curricula. Paper presented at: the AmericanPublic Health Association Annual Meeting,November, 2004; Washington, DC.Morris P, Markova T, Roe T. Arm pain, thefirst presenting symptom of male breast cancer.Paper presented at: the Michigan FamilyPractice Research Day XXVII, May, 2004; EastLansing, MI.Neale AV, Northrup J, Marks E, Abrams J.Correction and use of the literature followingscientific misconduct. Paper presented at:the ORI 2004 Research on Research IntegrityConference, November, 2004; San Diego, CA.Nriagu JO, Johnson M, Hammad AS, SavoieKL, Jamil H. An index for assessing householdenvironmental risk factors. Paper presented at:8th World Congress on Environmental Health,February, 2004; Durban, South Africa.Nriagu JO, Johnson M, Hammad AS, SavoieKL, Jamil H. Asthma burden among ArabAmericans in metropolitan Detroit, Michigan.Paper presented at: World Asthma Meeting,February, 2004; Bangkok, Thailand.Penner LA. Doing behavioral research in amedical setting: Problems and pitfalls. Paperpresented at: Society for the PsychologicalStudy of Social Issues, 2004; Washington, DC.Penner LA. Medical interactions and thequality of health care. Paper presented at:Research Center Group Dynamics, 2004;University of Michigan, Ann Arbor, MI.Pieper D, Brocato JJ, Mavis BE, Roth L, LernerS, Coggan P. A faculty development selfassessmentsurvey in a large medical schooland associated hospital medical educationconsortium. Paper presented at: ContinuingMedical Education Congress, Abstract #R10b,May, 2004; Toronto, Canada.Porcerelli JH, Birndorf SA, Kamoo R. Objectrelations development from childhood to lateadolescence. Paper presented at: the AnnualMeeting, Society for Personality Assessment,March, 2004; Miami, FL.Quinn GP, Albrecht TL. Folic acid educationfor Hispanic women. Paper presented at: theMaternal and Child Health Epidemiology 10thAnnual Conference, December, 2004; Atlanta,GA.Rothman N, Skibola C, Morgan G, Brennan P,Wang S, Smith M, Boffetta P, Yeager M, Brooks-Wilson A, Spinelli J, Armstrong B, WacholderS, Becker N, Cerhan JR, Chiu BCH, CozenW, Davis S, Foretova L, Grazia EM, Hartge P,Isovich J, Lan Q, Maynadie M, Moore P, deSanjose S, Severson RK, et al. Evaluationof genetic susceptibility for non-Hodgkinlymphoma in the InterLymph Consortium.Paper presented at: Annual Meeting of theAmerican Association for Cancer Research,March, 2004; Orlando, FL.Schwartz K, Neale AV, Northrup J, MonsurJ, Tobar R, Wortley P. Does a universal offerof influenza vaccine improve acceptance?A MetroNet study. Paper presented at: theNorth American Primary Care Research Group(NAPCRG) 32nd Annual Meeting, October,2004; Orlando, FL.Schwartz K, Xu J, Dailey R, Neale AV,Northrup J. Characteristics of naturalmenopause symptoms in primary care patients:A MetroNet study. Paper presented at: theNorth American Primary Care Research Group(NAPCRG) 32nd Annual Meeting, October,2004; Orlando, FL.Webb M, Porcerelli JH. Object relations,intelligence and psychotherapy in anadolescent inpatient sample. Paper presentedat: Symposium at the Annual Meeting, Societyfor Personality Assessment, March, 2004;Miami, FL.Weiler RW, Cline RJW, Morris MC, BroadwaySC. Prescription drug education: A systematiccomparison of comprehensive healtheducation curricula, CSAP designated modelprograms’ curricula, and D.A.R.E. curricula.Paper presented at: the American Public HealthAssociation Annual Meeting, November, 2004;Washington, DC.Xu J, Dailey R, Neale AV, Northrup J,Schwartz K. Characteristics of naturalmenopause symptoms in primary care patients:A MetroNet study. Paper presented at: theMichigan Family Practice Research Day XXVII,May, 2004; East Lansing, MI.Young HN, Cline RJW, Lipowski E. Usingsocial cognitive theory to understandconsumers’ communication intentionsresponse to direct-to-consumer prescriptiondrug advertising. Paper presented at: theNational Communication Association AnnualMeeting, November, 2004; Chicago, IL.30 Department of Family Medicine 2004 Annual Report


“People of Detroit: A Living Project:?Front row: Nena Stanley (SOM Year I), GeorgiaWilder, Maryjean Schenk, Kanayo Orji (Year II);Middle: Robert Lui; Back row: Marilyn Zimmerman,Reddog Sina (Year I), John Stasko (YearII), Dayna Le Platte (Year I), Meegan Green (YearII), Shree Venkat (Year II)http://familymedicine.med.wayne.edu31


RESEARCHJinping Xu, Joe Monsur, Monina Bartoces,Victoria Neale, Rhonda Dailey,Kendra Schwartz, Marlene LipmanPractice-based ResearchThe Division of Practice-based Research(PBR) is responsible for conductingresearch important to the primarycare of patients and also sponsors theDetroit-area practice-based researchnetwork, called MetroNet. MetroNetinfrastructure funding is covered inpart by a grant from the DHHS HealthResource Services Administration. Wejust completed a renewal applicationto maintain and expand our team formore exciting PBR projects.PBR faculty members areKendra Schwartz, MD,Victoria Neale, PhD, andJinping Xu, MD. Divisionstaff include MarleneLipman, Joe Monsur,BS, Rhonda Dailey, MD,and our newest member,Monina Bartoces, PhD.Dr. Bartoces is a recentgraduate of Universityof South Carolina, withexpertise in epidemiologyand biostatistics.Over the past year, the Division hasbeen very busy. Our accomplishmentsinclude:• Our research group published asecond report from our “sore throat”study. Dr. Xu first-authored thispaper that compared patients’ andphysicians’ assessments of sore throatsigns and symptoms.• Inspired by discussions at thenational PBRN meetings, Drs. Nealeand Schwartz published a review ofhow the Health Insurance Portabilityand Accountability Act (HIPAA)Privacy Rule affects PBR.• We completed a MetroNet study ofinfluenza vaccine acceptance duringlast year’s vaccination season (thankgoodness we weren’t trying to conductit this year), which was presented atthe fall meeting of the North AmericanPrimary Care Group.• We presented three studies at theannual Michigan Family PracticeResearch Day (FPRD) in East Lansing.o Dr. Dailey presented our BlueCross Blue Shield of MichiganFoundation-funded study of thetreatment of hypercholesterolemiain an urban family practice center.o Mr. Monsur took the firstplace award in his category forour study comparing HbA1cresults determined by standardmethodology, which requires avenipuncture sample, to a newfingerstick method.o Dr. Xu also presented adescriptive study of the naturalhistory of menopause symptoms.The Division submitted six grantproposals for PBR funding in 2004.We are waiting for responses on two.Unfortunately the remaining four werenot funded. It is sometimes difficult toconvince large funding agencies, suchas the National Institutes of Health,that PBR is not only worthwhile,but necessary. However, we’ll keeptrying.The Practice-based Research Divisionis committed to working with localphysicians and residency programsto build MetroNet and expand thefield of PBR in a diverse metropolitanarea. It is only through practice-basedresearch and the cooperation of manyprimary care physicians that we canbegin to answer clinical questions thatarise from our Detroit care. If you areinterested in joining MetroNet, or ifyou have any questions or suggestions,Dr. Schwartz can be reached at 313-577-0880.32 Department of Family Medicine 2004 Annual Report


Increasing Influenza VaccinationsRESEARCHStudy after study has shown thatamong the older population, AfricanAmericans are less likely than whitesto receive an influenza immunizationevery year — even though it is coveredby Medicare and can help them surviveinfection with the dangerous influenzaA virus. A yearlong study led WSUresearchers to a simple but effectiveway to eliminate the disparity betweenraces: Ask every patient if he or shewould like the vaccine.“We found that there was no differenceby race in the acceptance of the vaccinewhen we offered it in a systematic way,”said Kendra Schwartz, M.D., M.S.P.H.,associate professor of family medicine.A $150,000 grant from the Centers forDisease Control funded the study. Dr.Schwartz and co-investigator VictoriaNeale, Ph.D., M.P.H., directed nursesand medical assistants from sevenDetroit-area clinics to approach everyvisiting patient who was at least 65years old, and ask two questions: “Haveyou had a flu shot this season?,” and ifthe patient hadn’t, “Would you like toget your flu shot today?”Conducted during the 2003 flu season,the nurses spoke to 452 patients. Dr.Schwartz said, “Forty-seven, or about10 percent, had already received thevaccine. Of the remaining 405, 53percent were white, 39 percent wereAfrican American, and seven percentwere of another race or ethnicity. Wheneach eligible patient was offered theflu shot in a uniform and systematicmanner, there was not a significantdifference in the acceptance of thevaccine.” Overall, 61 percent of AfricanAmericans accepted the shot, comparedto 68 percent of white Americans.“We also found no significant differencesin vaccine acceptance by sex, or byeducation level. The only thing thatpredicted whether a person wouldaccept the vaccine — and it was astrong predictor — was whether theyhad a flu shot in the past,” Dr. Schwartzsaid. “Of those patients who refused thevaccine, most said they were afraid theshot would make them sick.”The researchers purposely designed theintervention to be as quick as possible,so that even the busiest of clinics couldfully participate. The seven clinics inthe study are part of MetroNet, whichis a practice-based research networkcomprised primarily of family medicineoffices in the Detroit metropolitan area.Dr. Schwartz is the director of MetroNet.The seven clinics were: North OaklandMedical Center Family Practice Center;Arbor Lane Family Physicians; Drs.Cooper and Dash, P.C.; Tobar’s FamilyMedicine, P.C.; Henry Ford MedicalCenter-Hamtramck; Madison MedicalArts Center; and University FamilyPhysicians-Royal Oak.“We believe this study indicates that ifprimary care providers make an effortto offer it to every person, AfricanAmerican and white patients are justas likely to accept the vaccine,” Dr.Schwartz said. The study results werepresented at the 2004 annual meetingof the North American Primary CareResearch Group (NAPCRG).(Special thanks to Amy DiCresce forassisting on this story)MetroNet’s first federallyfunded study wassponsored by the Centerfor Disease Control andPrevention.Joe Monsur, Kendra Schwartz, Rhonda Dailey, CDCofficer Pascale Wortley, Jinping Xu and Victoria Nealemet to discuss study recruitmenthttp://familymedicine.med.wayne.edu33


RESEARCHKendra Schwartz and John GraffCancer EpidemiologyDFM faculty are active in cancerepidemiology research, using theopportunities available throughthe Metropolitan Detroit CancerSurveillance System (MDCSS). TheMDCSS collects cancer informationin Wayne, Oakland and Macombcounties, both for the MichiganDepartment of Community Healthand the National Cancer Institute’sSurveillance, Epidemiology and EndResults (SEER) Program. KendraSchwartz, MD (Co-PI) and JohnGraff, PhD (Co-I) are leaders of thislarge MDCSS SEER research contract.A number of DFM researchers haveplayed a significant role in thecollaborations with the SEER program,utilizing MDCSS data for research:John Graff, PhD• “Assessing smoking and drinkingin the development of tongue cancerand evaluation of quality of lifefollowing different treatment options:A feasibility study”Kendra Schwartz, MD, MPH• “Determinants and Outcomes ofSurgical Treatment for Early StageBreast Cancer: Is DCIS Different thanInvasive Disease?”• “A Collaborative Case-ControlStudy of Renal Cell Carcinoma”• “Accuracy of Geocoding”Maryjean Schenk, MD, MPH, MS• “Utility of SEER Data in theDescriptive Epidemiology of HIVassociatedCancers”• “Labor Market Outcomes of CancerSurvivors”• “Feasibility of Ultra-rapid CaseAscertainment of Patients Diagnosedwith Pancreatic Cancer”• “Pancreatic Cancer GeneticEpidemiology “Consortium”Victoria Neale, PhD, MPH• “Adaptation and Quality of LifeAmong Cervical Cancer Survivors”• “Does Use of Alternative MedicineDelay Treatment of Head and NeckCancer?”Rick Severson, PhD is a very activefaculty member in the KarmanosEpidemiology unit and the PopulationStudies and Prevention Program. His2004 research projects include:• “Use of State Motor VehicleRecords to Evaluate Options forDefault Geocoding of Patient Addressat Diagnosis”• “Luminal Lipid Exposure, Geneticsand Colon Cancer Risk”• “Genetic Susceptibility to Infection-Related Cancer”• “Molecular and Cellular Toxicologywith Human Applications”• “Energy Balance and Breast Cancerin Black and White Women”• “Polymorphisms in prostate CancerCarcinogenesis”Rick Severson34 Department of Family Medicine 2004 Annual Report


Student Grant AwardsStudents win research awards forfamily medicine studiesThe Department of Family Medicinehas made a commitment to researchthrough a number of initiatives,but over the past few years, it hasmade a concerted effort to mentormedical students who are consideringan academic medical career. Thatcommitment is paying off in researchfunding for its students and facultymembers.Mehul Patel and John Staško have beenrecognized with 2004 student researchawards from the Blue Cross Blue Shieldof Michigan Foundation. Throughthese projects, they contribute to thesciences of epidemiology and familymedicine and gain early experiencein research methods and academicmedicine.Patel, under the guidance of KendraSchwartz, MD, MSPH, is studying“Racial/Ethnic Differences in CervicalCancer Survival.” He was part of a studythat determined that although theincidence of cervical cancer is higher inHispanic women as compared to non-Hispanic or African-American women,Hispanics had higher survival rates.Patel performed this work using datafrom the population-based Surveillance,Epidemiology and End Results (SEER)Program to better characterize racialand ethnic differences in outcomes forcervical cancer.Staško, under the guidance of VictoriaNeale, PhD, MPH, developed his own“Health Care Access Among Overthe-RoadTruckers.” Staško intends tointerview 30 truck drivers at variousMichigan truck stops to learn moreabout their health status and perceivedhealth care access needs. Because theyare on the road so much, truckersoften “tough it out” until they returnhome and might benefit from qualityclinics located at truck stops. Staško isinterested in collecting data to supporta possible appeal to the state to getsubsidized care for this underservedpopulation.“The leadership in WSU’s Departmentof Family Medicine is interested inintroducing the next generation offamily physicians to the vital roleof primary care research,” Dr. Nealesaid. “For the sake of our patients,we are interested in practiced-basedresearch and collaborative researchthat produces new knowledge aboutthe origins of disease and illness, howhealth is gained and lost, and how theprovision of care can be improved.”(Special thanks to Amy DiCresce forassisting on this story)Mehul Patel and Kendra SchwartzVictoria Neale and John StaskoMedical studentsinterested in research areencouraged to enroll inour one-month elective,“Research Methods inFamily Medicine”http://familymedicine.med.wayne.edu35


FAMILY PRACTICE CENTERUniversity Family Physicians - DetroitFor the Family Practice Center in Detroit, the year 2004 was most challenging andoffered many opportunities for streamlining the office procedures and providingefficient health care to our patients and the communities we serve. There was anorganized effort to improve patient satisfaction and decrease health disparitiesin this urban medical center.UFP – Detroit15400 W. McNicholsDetroit, MI 48235(313) 340-4300Nejla Israel, MDNehman Lauder, MDTsveti Markova, MDThomas Roe, MDFrederick Rosin, MDPromita Roychoudury, MDIn a staff-residents-faculty retreat, Dr. Markova, Director of Clinical Operationsat the site, introduced the concept of interdisciplinary teams. The officewas reorganized using this approach into three teams, each practicing asan independent unit within the organization. By participating in monthlymeetings and with real time problem solving, all team members became activeparticipants in the clinical operations decision-making. Residents, faculty andstaff had the opportunity to create and implement projects for more efficientpatient care. Patients expressed satisfaction with the reorganization. They wereserved with greater efficiency while preserving the continuity of care with theirown physician.We have also experienced growth in patient volume. The site continues to be apremier site for the Breast and Cervical Cancer screening program in collaborationwith the Karmanos Cancer Institute, funded by the state to provide preventivecare services for the uninsured and underserved. The Family Practice Centerstrengthened our collaboration with Sinai-Grace Hospital by organizing manycommunity outreach events and maintaining a very active inpatient service.UFP – Detroit faculty and staff work together to provide comprehensive patientcare.36 Department of Family Medicine 2004 Annual Report


University Family Physicians - Royal OakFAMILY PRACTICE CENTERThe University Family Physician group at Royal Oak comprises five familyPhysicians dedicated to clinical care and excellence in teaching. They are allfaculty members at the Wayne State Medical School in the Department of FamilyMedicine. The office is located in the suburbs of Oakland County, on WoodwardAvenue, just north of 10 mile road. Our group of doctors is very committed toproviding comprehensive health care, diagnosis and treatment of diseases, withappropriate referrals when needed. We also provide prenatal care, geriatric andpediatric services as well as perform office procedures such as skin biopsies, wartremoval, pap smears and other gynecological procedures. After hours care is alsoprovided using the call back-up system.This site is a faculty-clinician based practice that caters to a diverse population.Our group of doctors includes Dr Deschere, Nirmal, Rosin, Schwartz and DrXu. Several of our staff is also actively involved in research based activities atthe University, including Drs. Schwartz and Xu. The new Medical Director ofthis facility, Dr Kodavayour S. Nirmal, is committed to ensuring growth of thepractice, and it is already showing signs of expansion. There are several newenrollments every day and it is very gratifying to see the result of the efforts ofthe staff at this facility.Our care aims to focus on total health of the family as a whole, and we offerpreventive health care services aimed at health promotion, immunization, andprotection from illnesses. We also offer diagnostic services and several testsincluding blood tests, urine tests, ECG and X-rays are performed at this sitePatient satisfaction with our group is very high. Employee satisfaction at theclinic is also very high.UFP – Royal Oak2654 Woodward Ave.Royal Oak, MI 48067(248) 543-7770Bruce Deschere, MDKodavayour Nirmal, MDFrederick Rosin, MDKendra Schwartz, MDJinping Xu, MDUFP-Royal Oak is also the site for several practice based research projects. It isalso the preferred site for many medical students and residents for their rotation,training and continuity clerkship experience. The exposure to clinical care hasmade it very sought after by learners. The atmosphere is one of teamwork andemployees are proud to be a part of the group.UFP – Royal Oak faculty and staff work closely together to provide clinical care.http://familymedicine.med.wayne.edu37


Wayne State University Service AwardsRichard Gallagher (35 years of service) celebrateswith Vickie Muhammad (15 years)Juliann Binienda (10 years of service), Maryjean Schenk (10years), and James Blessman (15 years)Linda Roth (10 years of service), Naida Simon (10 years), and VictoriaNeale (20 years)38 Department of Family Medicine 2004 Annual Report


http://familymedicine.med.wayne.eduWEBSITEPlease visit theDepartment of Family Medicine’s website.http://familymedicine.med.wayne.edu39


Wayne State University is an equal opportunity/affirmative action employer.NON PROFIT ORGUS POSTAGEPAIDDETROIT MIPERMIT NO 3844Department of Family Medicine101 E. AlexandrineDetroit, MI 48201The Department of Family Medicineat Wayne State University iscommitted to excellence in research,scientific advancement of familyand occupational medicine, andleadership in medical education.For additional information regardingour research, education programs orother projects, contact theDepartment of Family Medicine at313-577-1421 or visit our websitehttp://familymedicine.med.wayne.eduEditor-in-ChiefMaryjean Schenk, MD, MPH, MSEditorVictoria Neale, PhD, MPHAssociate EditorLinda Roth, PhDCover ThemeThomas Roe, MDGraphic DesignerMary C. Myrand, BFA40 Department of Family Medicine 2004 Annual Report

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