I d like to offer my own list of things I ll be looking for some of which may seem a bit odd or non-academic to you.

Transcription

1 Good morning and welcome to Medical Grand Rounds. My name is Bob Aber and I currently serve as Chair of the Department of Medicine. This will be my fourteenth annual State of the Department update, and although I didn t expect to be doing another one, this will likely be my last as I ll explain in a few minutes. I ve subtitled today s presentation Preparing for Change. As always, I d like to thank the many individuals who helped pull together the data and information I ll be sharing with you this morning - my personal thanks to each of you. And a special thanks to Beth Diehm, Mark Spangler, and David Towery for coordinating the data collection and producing the slides. I d also like to say once again what an honor and privilege it 1

2 has been for me to serve as your Chair for the past 14 years. I continue to take great pride in our collective accomplishments, and we have much to celebrate again this year. Last year I indicated that Dean Hillemeier and I had agreed to initiate a Department review which would inform the search for our next Chair. The internal review was completed by March My personal thanks to Jeff Miller, Professor and Chair of Dermatology, for chairing the committee, and to the members of the committee for a job well done. Hopefully, all of you have seen the report of the internal review, and it is available from Mark Spangler if you d like a personal copy. I m not going to take time to rehash the report, but it provides an interesting and timely assessment of our strengths, weaknesses, opportunities and threats to build upon. 2

3 Three distinguished current chairs of Medicine visited on April 6 and 7, 2016, as external reviewers, including one (M.Z.) who had served as an external reviewer here in January, I made this recommendation to Dean Hillemeier because I thought it might be a useful way to assess our progress, or lack thereof, since the last review. The report of the external reviewers was shared during a faculty meeting on September 6, 2016, by Dean Hillemeier and Dan Shapiro, and is also available from Mark Spangler for anyone to review. This report included 19 recommendations designed to assist in the selection and resourcing of our next Chair. So all this is now history, and we are tasked with sourcing, identifying, selecting, recruiting and resourcing the next chair of our Department. The search firm Witt/Kieffer has been selected for sourcing, identifying and vetting candidates, and this process is underway. 3

4 A search committee Chaired by Ray Hohl, MD, Professor of Medicine and Director of the Penn State Cancer Institute and Co-chaired by Kent Vrana, PhD, Professor and Chair of the Department of Pharmacology, will be vetting, interviewing and selecting a group of finalists to recommend to Dean Hillemeier who will make the final selection. There will be ample opportunity and solicitation for faculty and staff in the Department to meet with candidates and share your input as to their strengths or weaknesses as well as your personal preferences I encourage you to participate actively in the process. Think for a moment about the 3 or 4 characteristics or attributes you believe to be most important in selecting our next chair I ll give you a moment to write them down. I d like to offer my own list of things I ll be looking for some of which may seem a bit odd or non-academic to you. The first is Level 5 Leadership and according to Jim Collins (Good to Great, Harper Collins 2001) it is the combination of professional will and personal humility. Such leaders set up their successors for even greater success, yet display a compelling modesty. They are, however, driven to produce results, and display workmanlike diligence in all they do. As Chip Souba, former chair of Surgery here once said They shine in the reflected light of others. Multipliers according to Liz Wiseman and Greg McKeown, serve as talent magnets, liberators, challengers, debate makers, and investors, and thereby, get twice the productivity from people in their organizations than do diminishers. Multipliers set direction and expectations, then hold people accountable for performance, but they also coach, mentor, and invest along the way. I wish I had thought more deliberately about my role as a multiplier in our department over the years. When I first saw the title of Angela Duckworth s best seller Grit, I instantly thought of John Wayne s portrayal of Marshall Rooster Cogburn in the 1969 film True Grit how many of you remember that film? It was John Wayne s only academy award winning performance! 4

5 According to Duckworth, grit is a combination of passion and perseverance which leads to exceptional performance. She emphasizes the importance of effort in turning natural ability or talent into skill, and then more effort in turning skill into performance. She has developed a tool for measuring grit, and has demonstrated its ability to predict outcomes in varied events such as the Beast Barracks, a sort of Hell Week at WestPoint, and the National Spelling Bee contest. So I m interested in finding someone with grit as our next chair. Meanwhile, Carol Dweck, a Professor of Psychology at Stanford University, has been studying and writing about the power of mindset on personal achievement and success. Those of us with a fixed mindset, on the left in this diagram, believe such things as intelligence, aptitude, talent, and even personality are fixed, and therefore respond to challenges, obstacles, praise and criticism in predictable ways compared with those of us with a growth mindset who believe all these things can be developed with persistence and effort not unlike Duckworth s thesis that passion and perseverance lead to successful performance. The convergence of these schools of thought leads me to believe that it is very reasonable, indeed even critical, to be looking for both grit and a growth mindset in our next chair. John Gardner has written much about the importance and power of self-renewal, both for organizations and for individuals. As he describes it so eloquently in his book titled Self- Renewal The Individual and the Innovative Society when organizations and societies (and individuals) are young, they are flexible, fluid, not yet paralyzed by rigid specialization and willing to try anything once. As it (or we) ages, vitality diminishes, flexibility gives way to rigidity, creativity fades and there is a loss of capacity to meet challenges from unexpected directions - hence maturation and senescence. Self-renewal involves supporting and encouraging continuous innovation and adaptation despite the pressures of maturation and senescence. Selfrenewing people never feel that they have arrived. They know that the really important tasks are never finished. They have a purpose in life and find meaning in what they do. They are indeed resilient. 5

6 I m not going to dwell on each of the remaining characteristics and attributes I ll be looking for in our next chair, emotional intelligence (Goleman), values driven (RITE), stewardship, sense of humor, collaborative, credible, and authentic, but you ll notice that the weight of the curriculum vitae, the number of NIH awards, and the number of peer-reviewed publications or book chapters are not on my list. These things may be indicators of the primary characteristics I ve listed, but not ends unto themselves. I m sure we ll each have our own personal list of things to look for, and again I encourage everyone to participate in the process. Now let s get on with today s update. I d like to begin moving through broad areas I ve covered in past years. These broad areas include Leadership and People; Faculty; Education; Quality Improvement and Patient Safety; Research; Clinical Affairs, and Finances. As always, I solicit and will appreciate any feedback you might have as to how to make this presentation more helpful to you, and will pass it along to my successor, and I apologize in advance for any omissions or mistakes made with the best of intentions to get things right. Leadership and People Nasrollah Ghahramani, MD (Professor, Interim Chief, Nephrology) became Vice Chair for Educational Affairs and Interim Chief of the Division of Nephrology on April 1, 2016, and has become fully engaged in both roles at this point. Are you feeling challenged enough Nas? I just recently announced that Brian McGillen, MD (Assistant Professor, General Internal Medicine), Director of the Hospitalist Program, is now Vice Chair for Clinical Affairs and Quality Improvement as of October 1 st. He brings his enthusiasm and experience to this new role. Chris Sciamanna, MD (Professor, Chief, Population Health Research & Development) became Vice Chair for Research Affairs on May 1 st following Brian Reeves departure to San Antonio, and is on a mission to strengthen our research enterprise by increasing our grant proposals substantially this year. Ann Ouyang, MD (Professor, Gastroenterology & Hepatology) is now Associate Chair for Faculty Development as of July 1, and has an ambitious agenda to improve mentoring, review and revise our criteria for promotion of fixed-term faculty, and improve peer evaluation of teaching. Colleen Rafferty, MD (Associate Professor, General Internal Medicine) became Associate Chair for Clinical Information Stewardship on October 1, to complement her new major Medical Center roles as Physician Advisor to the Clinical Documentation Integrity Program and to the Information Technology group. We re counting on her to make life with the Electronic Medical Record much happier and friendlier for all of us! We welcomed Kofi Clarke, MD (Professor, Chief, Gastroenterology & Hepatology) as Chief of the Division of Gastroenterology and Hepatology on September 1, Kofi came to us from the Allegheny Health System in Pittsburgh where he was Chief of Gastroenterology. Welcome again Kofi! 6

7 I ll just remind you of some leadership changes at the Medical Center and Medical Group level Judy Himes, MSN, RN, NE-BC, is now Chief Nursing Officer; Margaret Mikula, MD (Assistant Professor, Pediatrics) is interim Chief Quality Officer; Tom Tracy, MD (Professor, Pediatric Surgery) is now Chief Medical Officer; Tom Stoessel, MBA is Chief Strategy Officer; and David Swift is our new Chief Human Resources Officer. The search for our next Chief Quality Officer is underway and I m on the search committee. As part of the Penn State Hershey Medical Group re-organization Susann Schetter, MD (Associate CMO, Penn State Hershey Medical Group, Medicine Specialties, Department of Radiology, Vice Chair Outreach Penn State Hershey Medical Center, Division Chief, Breast Imaging) continues as Associate Chief Medical Officer for Medical Specialties, and Becky Gingrich, RN, MS is now Senior Director for Medicine, Cancer Institute, Heart and Vascular Institute and Ophthalmology. David Towery and I meet with Susann and Becky monthly to review our progress as well as to determine needs and resources to improve access, operational efficiency, staff and provider satisfaction, and patient satisfaction and safety. Larry Jones, MD (Assistant Professor, General Internal Medicine) and Laurie Nelson, MD (Assistant Professor, General Internal Medicine) have stepped up as Interim Medical Directors of our Internal Medicine East and West practice sites, respectively, while Stacy Hess remains on a reduced schedule. Thank you both for doing so in a time of need. Herbert Reynolds, MD (Professor Emeritus, Pulmonary, Allergy & Critical Care Medicine) our former Chair from 1988 through 2002, is now President of the College of Medicine s Emeritus Faculty Organization an organization I m looking forward to joining one day! Paul Haidet, MD (Professor, General Internal Medicine) is in the midst of his 2 year term as President of the Directors of Research in Medical Education. Leslie Parent, MD (Professor, Infectious Diseases & Epidemiology) was selected to participate in the prestigious Hedwig van Ameringen Executive Leadership in Academic Medicine ELAM Program for Women this year. She joins Eileen Moser, Ann Ouyang, Barb Ostrov and Luanne Thorndyke as past Department participants. Congratulations Leslie! Brian McGillen, MD (Assistant Professor, General Internal Medicine) received the inaugural Alan R. Turyan Community Values Award during the 2016 Inspire Awards Ceremony last month. This award was established by Dr. Turyan to honor the life of her late husband, Alan, and to recognize the outstanding collaboration, teamwork and care that takes place within the institution. Congratulations Brian! 7

8 The Eileen s Hennrikus, MD (Professor, General Internal Medicine) and Moser, MD (Associate Professor, General Internal Medicine) were selected as Distinguished Educators this past year making a total of 17 selected since its beginning in Michael Katzman, MD (Professor, Infectious Diseases & Epidemiology) continues his term as President of this group. Manny Williams, MD (Associate Professor, Gastroenterology & Hepatology) was recognized with a Junior Faculty Teaching Award by the Society of Distinguished Educators this past year congratulations to Manny! Cynthia Chuang, MD (Professor, Chief, General Internal Medicine) received a 2016 YWCA Tribute to Women of Excellence Award, and I had the pleasure of joining Jennifer Kraschnewski, MD (Associate Professor, General Internal Medicine) her husband, Justin, and her parents, when she received a Central Penn Business Journal Women of Influence Award in June. Jennifer is also a member of the Boy Scouts of America Presidential Task Force to Prevent Childhood Obesity. Tim Craig, DO (Professor, Pulmonary, Allergy & Critical Care Medicine) and Jonathan Zipkin, MD (PGY-4, Medicine/Pediatrics) were elected to Alpha Omega Alpha Honor Medical Society this past year. Alex Allen, MD (PGY-1, Medicine) and Jonathan Zipkin, MD (PGY-4, Medicine/Pediatrics) received Arnold P. Gold Foundation Humanism and Excellence in Teaching Awards during the Student Clinician Ceremony this past April. Five faculty Cynthia Chuang, MD (Professor, Chief, General Internal Medicine), Joseph Drabick, MD (Professor, Chief, Hematology/Oncology), Jennifer Kraschnewski, MD (Associate Professor, General Internal Medicine), Margaret Kreher, MD (Associate Professor, General Internal Medicine), and Marc Rovito, MD (Assistant Professor, Hematology/Oncology) are participating in the Penn State Hershey Leadership Academy this week which is offered in 8

9 conjunction with the Smeal College of Business bringing to 16 the number of Department faculty who have participated since its inception 4 years ago. Two faculty Larry Jones, MD (Assistant Professor, General Internal Medicine) and Eileen Hennrikus, MD (Associate Professor, General Internal Medicine) and a medical student - Caitlyn Moss, MS4 have joined the Council of the Pennsylvania Chapter of the American College of Physicians. L.J. Van Scoy, MD (Assistant Professor, Pulmonary, Allergy & Critical Care Medicine) participated in the Association of American Medical College s Early Career Women Faculty Professional Development Seminar this past July. The Department s Rewards and Recognition Committee is in its 8 th year. Karen Krok, MD (Associate Professor, Gastroenterology & Hepatology) joined as a faculty representative this year replacing Nas Ghahramani, a founding member, and Beth Diehm (Administrative Associate, Medicine Chair Office) is now Chair of the committee. The committee now includes two ad hoc members each year in order to stimulate more participation, and Pat Siegrist in Gastroenterology and Hepatology, and Rhonda Shaffer in General Internal Medicine are ad hoc members this year. We appreciate your effort on behalf of our Department! 9

10 Joining the Department s Honor Roll are Carol Creter (Administrative Secretary, Endocrinology), Tracey Erickson Administrative Associate, Nephrology), Tina Garman, RN (Clinical Program Coordinator, Infectious Diseases & Epidemiology), Mark Spangler (Administrative Support Coordinator, Medicine), Betsy Thompson, MS, PA-C (Gastroenterology, & Hepatology), Michael Witmer, LCSW (Case Manager HIV, Infectious Diseases & Epidemiology), and Tami Cassel (Administrative Associate, General Internal Medicine). Congratulations to each and thank you! Nurses working in areas of the Medical Center typically caring for Medicine service patients have also been recognized in various ways Joshua Adams, BSN, RN, CEN, CPEN (Nurse Manager, Medical Intermediate Care), Dan Barber, ASN, RN (Medical Intensive Care), Nicole Berstler, ASN, RN, CCRN (Medical Intensive Care) and Gina Koons, BSN, RN-BC (6 Acute Care) received a 2015 Elizabeth Powers Nursing Excellence Scholarship Award. Maggie Felmlee, BNS, RN-BC, OCN (6 Acute Care) received the 2016 Excellence in Acute Care Nursing Award, Jennifer Cousar, BSN, RN-BC, CCRN (Medical Intermediate Care) received a 2015 Lois Weninger Forney Nursing Excellence Award, and Kathryn Phelps, BSN, RN-BC (6 Acute Care) received the 2016 Paula Ribando Clinical Ladder II Excellence Award. Let s congratulate and thank our nursing colleagues for a job well done in caring for our patients! 10

11 A number of individuals or groups from the Department were recognized with 2016 Inspire Awards during the all-staff assemblies in September. Congratulations to all! Seven individuals were recognized for 25 years of service Carol Creter (Administrative Secretary, Endocrinology), Greg Caputo, MD (Professor, General Internal Medicine), Lisa Doster (Administrative Associate, Endocrinology), David Silber, MD (Associate Professor, Cardiology), Heather Skonier-Baer, RN (Clinical Case Manager, Gastroenterology & Hepatology), Margaret Sudol (Research Technologist III, Infectious Diseases, & Epidemiology), and John Zurlo, MD (Professor, Infectious Diseases & Epidemiology). Bill Davidson, MD (Professor, Cardiology) has achieved 30 years of service, and two faculty Hamid Al-Mondhiry, MD (Professor, Hematology/Oncology) and Tom McGarrity, MD (Professor, Gastroenterology & Hepatology) were recognized for 35 years of service. 11

12 And Elaine Eyster, MD (Professor, Hematology/Oncology) celebrated 45 years of service and the clock is still ticking! Congratulations to all for their service and many contributions over the years! Faculty Faculty size has increased slightly over last year at 223, and includes 199 clinical and 24 non-clinical faculty primarily engaged in research or education. We have 178 MD or DO clinical faculty, 15 MD/PhD clinical faculty, and 23 research faculty with terminal doctoral degrees. We also have 7 Physicians Assistants or Clinical Registered Nurse Practitioners among our faculty. 12

13 Maria Baker, PhD (Professor, Hematology/Oncology), Nasrollah Ghahramani, MD (Professor, Interim Chief, Nephrology) and Eileen Hennrikus, MD (Professor, General Internal Medicine) were promoted to Professor this year congratulations to each! Carolina Candotti, MD (Associate Professor, General Internal Medicine), Tonya Crook, MD (Associate Professor, Infectious Diseases & Epidemiology ), Ping Du, MD, PhD (Associate Professor, Infectious Diseases & Epidemiology), Jennifer Kraschnewski, MD (Associate Professor, General Internal Medicine), Liza Rovniak, PhD (Associate Professor, General Internal Medicine), and Manny Williams, MD (Associate Professor, Gastroenterology & Hepatology) were promoted 13

14 to Associate Professor, and Jennifer and Liza were awarded tenure. Congratulations to all six! Ashwani Garg, MD (Assistant Professor, General Internal Medicine) was promoted to Assistant Professor as he moved from the Penn State Cancer Institute to our Hospitalist program. Congratulations Ashwani! Becky Bascom, MD (Professor, Pulmonary, Allergy & Critical Care Medicine) joins Paul Haidet, MD (Professor, General Internal Medicine) on the College of Medicine s Promotion and Tenure Committee. 14

15 Cynthia Chuang, MD (Professor, Chief, General Internal Medicine), Tonya Crook, MD (Associate Professor, Infectious Diseases & Epidemiology), Ann Ouyang, MD (Professor, Gastroenterology & Hepatology) and Randy Young, MD (Professor, Chief, Pulmonary, Allergy & Critical Care Medicine) have joined the Department s P & T Committee this year, and Jerry Naccarelli, MD (Professor, Chief, Cardiology) remains its Chair. Reviews and deliberations have begun for the coming year. Twenty-nine new faculty have joined the Department since last year s State of Department update, including 3 Chief Residents. Please stand and be recognized if you are with us this morning Ayesha Ahmad, MD (Assistant Professor, General Internal Medicine), Omaima Ali, MD (Assistant Professor, Cardiology), Abdul Basit, MD (Assistant Professor, General Internal Medicine), Jose Pepe Cardenas-Garcia, MD (Assistant Professor, Pulmonary, Allergy & Critical Care Medicine), Kofi Clarke, MD (Professor, Chief, Gastroenterology & Hepatology), Daniel Cortez, MD (Instructor, Cardiology), Beth Foreman, DO (Instructor, Chief Resident), Janette Foster, MD (Assistant Professor, Pulmonary, Allergy & Critical Care Medicine), Stephanie Harris, DO (Assistant Professor, General Internal Medicine), Eliana Hempel, MD (Assistant Professor, General Internal Medicine), Diane Hershock, MD, PhD, (Associate Professor, Hematology/ Oncology), Rohit Jain, MD (Assistant Professor, General Internal Medicine), Allison Kasmari, MD (Instructor, Chief Resident), Fahad Khalid, MD (Assistant Professor, General Internal Medicine), (welcome back!), Fareeha Khalil, MD (Assistant Professor, Nephrology), Namratha Kodali, MD (Assistant Professor, General Internal Medicine), Jeffrey Kowaleski, MD (Assistant Professor, General Internal Medicine), Samantha Lin, MD (Assistant Professor, Pulmonary, Allergy & Critical Care Medicine), Richard Massaro, MD (Instructor, Cardiology), Shin Mineishi, MD (Professor, Hematology/Oncology), Ali Mohamed, MD (Assistant Professor, Hematology/Oncology), Sean O Donnell, MD (Assistant Professor, Hematology/Oncology), Brandon Peterson, MD (Assistant Professor, Cardiology), Sanam Razeghi, MD (Assistant Professor, Gastroenterology & Hepatology), Nitasa Sahu, MD (Assistant Professor, General Internal Medicine), Jennifer Schaub, MD (Assistant Professor, Nephrology), Natthapol Songdej, MD (Assistant Professor, 15

16 Hematology/Oncology), Kate Waksmundzki, MD (Instructor, Chief Resident) and Pradeep Yadav, MD (Assistant Professor, Cardiology) (welcome back!). Please join me in welcoming these colleagues to our Department! Four faculty - Richard Bernstein, MD (Assistant Professor, Pulmonary, Allergy & Critical Care Medicine), Matthew Evans, MD (Assistant Professor, Hematology/Oncology), Sarah Hussain, MD (Assistant Professor, Cardiology), and Meredith Schade, MD ( Assistant Professor, Infectious Diseases & Epidemiology) - completed the Junior Faculty Development Program this past year, and I again had the pleasure of hearing their project presentations. Congratulations to all four! Four additional faculty Ayesha Ahmad, MD (Assistant Professor, General Internal Medicine), Omaima Ali, MD (Assistant Professor, Cardiology), Eliana Hempel, MD (Assistant Professor, General Internal Medicine) and Hyma Polimera, MD (Assistant Professor, General Internal Medicine) are engaged in the program this year as well. Seven faculty Jeanine Beatty- Chadha, MEd (Instructor, General Internal Medicine), Cynthia Chuang, MD (Professor, Chief, General Internal Medicine), Faoud Ishmael, MD, PhD (Associate Professor, Pulmonary, Allergy & Critical Care Medicine), Urs Leuenberger, MD (Professor, Cardiology), Jennifer McCall-Hosenfeld, MD (Associate Professor, General internal Medicine), Thomas Riley, MD (Professor, Gastroenterology & Hepatology), and Amy Westcott, MD (Associate Professor, General Internal Medicine/Palliative Medicine) - served as mentors to participants in that program last year. And six Jed Gonzalo, MD (Assistant Professor, General Internal Medicine), Paul Haidet, MD (Professor, General Internal Medicine), Jennifer McCall-Hosenfeld, MD (Associate Professor, General Internal Medicine), Christopher Sciamanna, MD (Professor, Chief, Population Health Research & Development), Britta Thompson, PhD (Professor, General Internal Medicine), and Lauren Van Scoy, MD (Assistant Professor, Pulmonary, Allergy & Critical Care Medicine) - are engaged to do so this year. Our thanks to each of you. Education Jed Gonzalo, MD (Assistant Professor, General Internal Medicine) received a 2016 Society of General Internal Medicine National Award for Scholarship in Medical Education, and is coinvestigator on a 5 year HRSA-award which will include introducing a 3+3 year curriculum for medical students interested in careers in internal medicine. This will allow selected medical students to shorten their medical school experience (and debt!) by 1 year before entering residency here. Congratulations to Jed and his colleagues! Michael Katzman, MD (Professor, Infectious Diseases & Epidemiology) has been selected to participate in the Harvard Macy Institute Program for Educators in the Health Professions this year. He joins eleven other Department faculty who have completed this program. Amy Westcott, MD (Associate Professor, General Internal Medicine/Palliative Medicine) is now Director of Educator Development in Teaching and Learning Excellence (SLATE) Office within the College of Medicine. Specifically, she will identify and prioritize needs for effective teachers, develop and implement a Resident as Educator curriculum, and align faculty development in teaching and evaluation among other things for our organization. Amy has also been elected Chair of the American Geriatrics Society Teachers Section for 3 years. Britta Thompson, PhD (Professor, General Internal Medicine) and Paul Haidet, MD (Professor, General Internal Medicine) received the Association for the Study of Medical 16

17 Education s Silver Quill Award as contributing authors to the most downloaded article published during 2015 for their paper entitled Team cohesiveness, team size and team performance in team-based learning teams. Six faculty received the Department s Education Recognition Award during our Faculty Housestaff Banquet this past June Andreas Achilleos, MD (Assistant Professor, General Internal Medicine), Carolina Candotti, MD (Associate Professor, General Internal Medicine), Tonya Crook, MD (Associate Professor, Infectious Diseases & Epidemiology), Mike MaCauley, MD (Clinical Assistant Professor, Lebanon, VA), Nas Ghahramani, MD (Professor, Interim Chief, Nephrology) and Andrew Tinsley, MD (Assistant Professor, Gastroenterology & Hepatology). These faculty were selected on the basis of medical student and resident evaluations of their teaching. 17

18 Simon Mucha, MD (Assistant Professor, General Internal Medicine) received the Department s Special Recognition for Education Leadership and Service Award for his contributions as Assistant Director of our Internal Medicine Residency Program. Nancy Olsen, MD (Professor, Chief, Rheumatology) and Dan Wolpaw, MD (Professor, General Internal Medicine) received the Department s Excellence in Mentoring Award based upon nominations and letters of support from many of their mentees. Brain McGillen, MD (Assistant Professor, General Internal Medicine) received the Department s Distinguished Physician Award for Excellence in Housestaff Teaching from our residents during the Faculty Housestaff Banquet in June. 18

19 Fourteen Faculty received the 2016 Dean s Award for Excellence in Teaching during Fall Convocation last month Andreas Achilleos, MD (Assistant Professor, General Internal Medicine), Carolina Candotti, MD (Associate Professor, General Internal Medicine), Tonya Crook, MD (Associate Professor, Infectious Diseases & Epidemiology), William Davidson, MD (Professor, Cardiology), Michelle Freeman, MD (Assistant Professor, Pediatrics and Medicine), Nasrollah Ghahramani, MD (Professor, Interim Chief, Nephrology), Harold Harvey, MD (Professor, Hematology/Oncology), Edward Jones, MD (Assistant Professor, General Internal Medicine), Michael MaCauley, MD (Clinical Assistant Professor, Lebanon, VA), Brain McGillen, MD (Assistant Professor, General Internal Medicine), Simon Mucha, MD (Assistant Professor, General Medicine), Nancy Olsen, MD (Professor, Chief, Rheumatology), Andrew Tinsley, MD (Assistant Professor, Gastroenterology & Hepatology) and Daniel Wolpaw, MD (Professor, General Internal Medicine). Congratulations to all those recognized with special awards this past year, and thanks to all who continue to teach, coach and mentor learners on a daily basis! 19

20 Nicole Swallow, MD (Assistant Professor, General Internal Medicine) has been busy reassembling the leadership team of our residency program. Andreas Achilleos, MD (Assistant Professor, General Internal Medicine) continues as Associate Director for Outpatient Medicine, and Ryan Munyon, MD (Assistant Professor, General Internal Medicine) is now Associate Director for Inpatient Medicine. Eliana Hempel, MD (Assistant Professor, General Internal Medicine) has joined our faculty after a year as Chief Resident, and is Assistant Director for Ambulatory Education working closely with Andreas. Ron Miller, MD (Associate Professor, Nephrology) is now Assistant Director for Curriculum and Evaluation while continuing as Program Director for the Nephrology Fellowship. Debbie Stevens continues as our Residency Coordinator and is supported by Gretchen Landis. 20

21 Our Chief residents this year Beth Foreman, DO (Instructor), Alison Kasmari, MD (Instructor) and Kate Waksmundzki, MD (Instructor) are busy getting the new residents off to a great start. We filled all PGY1 positions in our categorical, preliminary and Medicine/Pediatrics programs again this past year, and 7 of the 29 new residents are Penn State College of Medicine graduates. Our In Training Exam scores for PGY-2 s were at the 54 th percentile nationally, and represent an opportunity for improvement. The pass rate in the American Board of Internal Medicine Certifying Exam was 100% among recent graduates, and the three-year rolling average is 88% ( ) which is also a target for improvement. One of the challenges for next year s Chief residents Sim Bedi, DO (PGYIII), James Kogut, DP (PGYIII) and Britt Marshall, MD (PGYIII) will be to improve upon these performance and outcome measures in the spirit of continuous quality improvement. 21

22 Kudos again to the faculty who serve as Jeffries Educational Mentors and Scholars (JEMS) to our categorical residents Shirley Albano-Aluquin, MD (Assistant Professor, Rheumatology), Adam Albert, MD (Clinical Assistant Professor, Lebanon, VA), Omaima Ali, MD (Assistant Professor, Cardiology), Ted Bollard, MD (Professor, General Internal Medicine), Mathew Evans, MD (Assistant Professor, Hematology/Oncology), Gisoo Ghaffari, MD (Associate Professor, Pulmonary, Allergy & Critical Care Medicine), Jed Gonzalo, MD (Assistant Professor, General Internal Medicine), Eliana Hempel, MD (Assistant Professor, General Internal Medicine), Karen Krok, MD (Associate Professor, Gastroenterology & Hepatology), Michael MaCauley, MD (Clinical Assistant Professor, Lebanon, VA), Jennifer McCall-Hosenfeld, MD (Associate Professor, General Internal Medicine), Nicole Osevala, MD (Assistant Professor, General Internal Medicine), Michael Pfeiffer, MD (Assistant Professor, Cardiology), Timothy Steckel, MD (Assistant Professor, General Internal Medicine), Amy Westcott, MD (Associate Professor, General Internal Medicine/Palliative Medicine), and Daniel Wolpaw, MD (Professor, General Internal Medicine) - they function as valuable resources, mentors coaches and career advisors. This may be an incomplete list, but our residents have logged 25 presentations at regional or national meetings, 29 publications, 4 Medical Grand Rounds presentations, 3 quality improvement projects and 4 IRB-approved research projects so far this year kudos to all for a job well done! We re hosting our inaugural fellow Maria Olender, DO (PGY-4/Instructor, Hospice and Palliative Fellow) - in Hospice and Palliative Care jointly sponsored with Hospice of Central Pennsylvania and the Lebanon VA Medical Center. Welcome Maria! 22

23 Turning to undergraduate medical education, our core clerkship continues to be rated well by students and their performance on the NBME subject exam is two points above the national mean. We re rated better at providing feedback and in observing parts of the history or physical exam than in previous years. We still get occasional reports of students perceiving mistreatment during their experience on medicine, but the reports are almost always anonymous and difficult to act upon. Sue Glod, MD (Assistant Professor, Clerkship Director) will continue to use student feedback to improve the experience for students. Adam Albert, MD (Clinical Assistant Professor, Lebanon, VA) and Ron Miller, MD (Associate Professor, Nephrology) were recognized by students as Medicine Clerkship Teachers of the Year kudos to both! 23

24 The Department continues to provide faculty in support of the four Student Societies. Two faculty continue as Society Heads Laurie Nelson, MD (Assistant Professor, General Internal Medicine - Waldhausen Society) and Lisa Sherwood, MD (Assistant Professor, General Internal Medicine - Mortel Society), and ten as Society Advisors (previously Clinical Skills Faculty) Gisoo Ghaffari, MD (Associate Professor, Pulmonary, Allergy & Critical Care Medicine), Eileen Hennrikus, MD (Professor, General Internal Medicine), Stacy Hess, MD (Assistant Professor, General Internal Medicine), Michael Katzman, MD (Professor, Infectious Diseases & Epidemiology), Samantha Lin, MD (Assistant Professor, Pulmonary, Allergy & Critical Care Medicine), Emily Link, MD (Assistant Professor, General Internal Medicine), Jennifer McCall- Hosenfeld, MD (Associate Professor, General Internal Medicine), Ryan Munyon, MD (Assistant Professor, General internal Medicine), Laurie Nelson, MD (Assistant Professor, General Internal Medicine), Ariana Pichardo-Lowden, MD (Assistant Professor, Endocrinology, Diabetes & Metabolism), Lisa Sherwood, MD (Assistant Professor, General Internal Medicine), and Jose Stoute, MD (Professor, Infectious Diseases & Epidemiology) Sue Glod, MD (Assistant Professor, General Internal Medicine/Palliative Medicine), Jed Gonzalo, MD (Assistant Professor, General Internal Medicine), Maggie Kreher, MD (Associate Professor, General Internal Medicine/Palliative Medicine), Liza Rovniak, PhD (Associate Professor, General Internal Medicine), and Amy Westcott, MD (Associate Professor, General Internal Medicine/Palliative Medicine) received 2015 OSLER Scholarship in Education Awards congratulations to all five. Lastly, I d like to bring a hidden gem to your attention the Penn State College of Medicine Physician s Assistant Program, led by Christine Bruce, MHSA, PA-C (Associate Professor, General Internal Medicine) which graduated its first class of 30 in

25 Four faculty, Trinell Genga, MS, PA-C (Assistant Professor, PA Program Clinical Coordinator), Edward Jones, MD (Assistant Professor, Academic Coordinator), Angela Pistoria, MSPAS (Assistant Professor, Teaching Faculty) and Chris, are members of our Department. Congratulations for a job well done. Quality Improvement/Patient Safety The Medical Center has made substantial progress in national rankings over the past year. We now have an A grade from Leapfrog up from C 2 years ago, and we rank #7 in our overall Academic Medical Center Quality and Accountability Performance Score in Vizient 25

26 (formerly UHC), and #1 in their safety subscore. Kudos to everyone here today for helping to make this happen! The Medical Center also achieved 7 of its 10 Quality Improvement and Patient Safety Goals this past year, missing only our goals in (1) eliminate hospital infections; (2) inpatient adult HCAPHS score; (3) inpatient pediatrics HCAPHS score. This also represents a substantial improvement over last year s 4 of 7 goals achieved. The Department achieved 3 of the 4 goals for which there was Department specific results missing only in Eliminate Hospital Acquired Infections because we experienced one additional CAUTI, one additional CLABSI, and 15 additional C. difficile infections compared with our prior year s baseline. Of the remaining 6 organizational goals, the four Patient Centeredness goals included 2 which were specific to the Children s Hospital, and 2 for which we do not have department specific data inpatient adult HCAHPS and medical group adult CGCAHPS. 26

27 Organizational goals for FY17 have been approved by the Board of Directors and include: (1) eliminate preventable mortality; (2) reduce 7 day all cause readmission; (3) improve patient access to care; (4) eliminate hospital acquired infections; (5) eliminate patient falls; (6) improve inpatient HCAHPS scores; and (7) improve outpatient CGCAHPS scores. Patient access to care and patient falls are new this year. Access to care is being measured as the percentage of new patients seen within 7 days of the request. Our baseline was 16.09% and our target is 21.09%. Year to date, we are at 19.21% so we are making progress. The Department contributes in a major way to each of these scores and must lead the way toward improvement. I recently announced that Brian McGillen is now Vice Chair for Quality Improvement and Clinical Affairs, and will be calling upon many of you to help us achieve our targets toward these goals. I m thanking you in advance for your support and contributions. The Inpatient Unit-Based Accountable Care Teams, or U-ACTS, are still meeting regularly, and I ve summarized some of their key activities this past year. Each team has set goals for this year and will be working to contribute progress toward our organizational goals. Outpatient teams are also developing and working toward goals for this year. 27

28 Research First, let s congratulate Larry Sinoway, MD ((Professor, Director, PSHVI and PII of CTSI), Urs Leuenberger, MD (Professor, Associate Program Director, CTSI), Susan McHale, PhD (Professor of Human Development and Family Studies, University Park, Associate Program Director, CTSI) and their colleagues, for a 4 year, $20 million competitive renewal of our Clinical and Translational Sciences Institute Award. This award provides the back bone for many core translational projects and strengthens our connections with University Park. 28

29 Second, kudos to Bob Levenson, PhD (PI, Pharmacology), Leslie Parent, MD (Professor and Vice Dean for Research and Graduate Studies for the College of Medicine and Medical Center, and Associate Vice President for Research at Penn State University) and their colleagues for a new Medical Scientist Training Program Award from NIH. Leslie and Bob are the Co- Directors of the program, and the Associate Program Directors are Aaron Lukacher, MD, PhD (Professor, Chair, Microbiology & Immunology), Jennifer Baccon, MD, PhD (Associate Professor, Obstetrics & Gynecology), and Melissa Rolls, PhD (Associate Professor, Biochemistry & Molecular Biology, University Park). We previously had NIH funding for our MD/PhD Program, but it lapsed in 2005, and has now been re-instated. A challenge to our Department is to retain our MD/PhD graduates in our residency and fellowship programs, and as future faculty members. Andrea Manni, MD (Professor, Chief, Endocrinology, Diabetes & Metabolism) was among the team of investigators recognized for Outstanding Collaborative Research on May 10, 2016, following the Spring Dean s Lecture. Congratulations Andrea! 29

30 Susan Hafenstein s (PhD, Associate Professor, Infectious Diseases & Epidemiology) work using cryoelectron-microscopy to demonstrate for the first time what happens to a virus shape when it enters a host cell has been widely discussed nationally. Her work was supported by NIH and Pennsylvania Department of Health CURE funds. On a different front, Matt Moyer s (MD, Associate Professor, Gastroenterology & Hepatology) work with a group of bioengineers at University Park in developing an EUS-guided endoscopic device to ablate abdominal and mediastinal lesions received the 2016 Lockheed Martin Design Excellence Award in April. 30

31 Out total sponsored research funding rose to $59.6 million as of June 30, 2016 and currently stands at $61.8 million as of August 31 st. Of this $61.8 million, $11.5 million (19%) is from NIH, $20.5 million (33%) is from other federal sources, $21.9 (35%) is from clinical trials, and $7.8 million (13%) is from other sources making a balanced portfolio, although most of us would like to see a larger portion from NIH. We should target getting 30-40% of a larger total portfolio from NIH so we can increase the Department s and College s ranking from #60 to top third. This would mean roughly a doubling of our current NIH funding. 31

32 Research expenditures of faculty having their primary appointment in the Department of Medicine, increased slightly to $22.6 million in FY16, and should continue to increase in FY17. We submitted 68 fewer research proposals than the year before, and are 14 proposals behind last year as of October 2, Realizing that this is a cyclic process with awards generally lasting 2 5 years and that we have lost several investigators in the past 2 years, I m not too surprised, but I do encourage all investigators to be aggressive about submitting proposals they are the leading indicators of future awards. 32

33 Start up and bridge funding is limited both are largely dependent upon our modest AEF reserves and any support we get from the College of Medicine. I must say, I am encouraged that new leadership in the College will provide additional support for our research endeavors. Leslie Parent has already offered to support selected physician scientists with equivalent effort funding to that which they currently have supported on grants to provide valuable time to do the work required for writing new proposals and getting preliminary data. This will help us moving forward. Despite the tightening climate for getting grants, five faculty had 2 or more NIH awards during FY16 Phillipe Haouzi, MD, PhD (Professor, Pulmonary, Allergy & Critical Care Medicine), Mark Kauffman, PhD (Professor, Cardiology), Nancy Olsen, MD (Professor, Chief), Leslie Parent, MD (Professor, Infectious Diseases & Epidemiology) and Brian Reeves, MD (Professor, Chief ( ), Nephrology) - making a total of 13 NIH sponsored faculty. 33

34 Phillipe Haouzi, MD, PhD (Professor, Pulmonary, Allergy & Critical Care Medicine) has gotten or received notice of two new NIH awards so far this year, and Song Guo Zheng, MD, PhD (Professor, Rheumatology) has received an NIH Star Award. Four faculty have active NIH K awards, including two CTSI KL2 awards Judie Howrylak, MD, PhD (Assistant Professor, Pulmonary, Allergy & Critical Care medicine) and Ray June, MD (Assistant Professor, Rheumatology) and two individual K23 awards Ariana Pichardo-Lowden, MD (Assistant Professor, Endocrinology, Diabetes & Metabolism) and Nazia Raja-Khan, MD (Assistant Professor, Endocrinology, Diabetes & Metabolism). Congratulations to each! 34

35 Rebecca Kaddis-Maldonado, MD (Infectious Diseases & Epidemiology) a postdoctoral scholar, and Breanna Rice, (PhD Program, Infectious Diseases & Epidemiology) a graduate student, both in Leslie Parent s lab, had active NIH Fellowship awards during FY16. As previously mentioned, Jed Gonzalo, MD (Assistant Professor, General Internal Medicine) is part of a team which received a federal HRSA award to focus on training more primary care physicians, and which will facilitate the development of a 3+3 year program for internal medicine. John Zurlo, MD (Professor, Infectious Diseases & Epidemiology) received additional funding from HRSA to support our HIV care program. 35

36 Cynthia Chuang, MD (Professor, Chief, General Internal Medicine) and Jennifer Kraschnewski, MD (Associate Professor, General Internal Medicine) have new awards from the Patient Centered Outcomes Research Institute. Cynthia (Professor, Chief, General Internal Medicine) also continues to serve as the Penn State Site PI for the PaTH Clinical Data Research Network sponsored by PCORI, and received a PSU Pathway to Partnerships (P 3 ) Award. She has also been asked to give the next Dean s Lecture in Spring, 2017 so plan now to attend. Three faculty received new Foundation Awards during FY16 Rebecca Bascom, MD (Professor, Pulmonary, Allergy & Critical Care Medicine), Jennifer Kraschnewski, MD (Associate 36

37 Professor, General Internal Medicine) and Lauren Van Scoy, MD (Assistant Professor, Pulmonary, Allergy & Critical Care Medicine). Nancy Olsen, MD (Professor, Chief, Rheumatology) and Larry Sinoway, MD (Professor, Director HVI, Cardiology) received 2016 CTSI Awards. Elaine Eyster, MD (Professor, Hematology/Oncology), Jennifer Kraschnewski, MD (Associate Professor, General Internal Medicine) and John Zurlo, MD (Professor, Infectious Diseases & Epidemiology) received awards from the Commonwealth of Pennsylvania. 37

38 Rebecca Bascom, MD (Professor, Pulmonary, Allergy & Critical Care Medicine) and Susan Hafenstein, PhD (Associate Professor, Infectious Diseases & Epidemiology) have received Woodward Family Endowment in Biomedical Engineering Awards Ping Du, MD, PhD (Associate Professor, Infectious Diseases & Epidemiology) and Jeffrey Pu, MD, PhD (Assistant Professor, Hematology/Oncology) received 2016 Tobacco Centers of Regulatory Science (TCORS) Awards. 38

39 L.J. Van Scoy, MD (Assistant Professor, Pulmonary, Allergy & Critical Care Medicine) received a new Social Sciences Research Institute Award. Drew Foy, MD (Assistant Professor, Cardiology) and Ariana Pichardo-Lowden, MD (Assistant Professor, Endocrinology, Diabetes & Metabolism) received Eberly Medical Research Endowment Innovation Fund Awards. 39

40 Heather Stuckey, DEd (Assistant Professor, General Internal Medicine) received a Brad Hollinger Eating Disorder Research Endowment Award. Rich Bernstein, MD (Assistant Professor, Pulmonary, Allergy & Critical Care Medicine) received a Junior Faculty Development Program Award to continue to work on his project 40

41 Fifty-eight faculty had 235 clinical trials or industry sponsored awards totaling $23.7 million last year, and 4 faculty were PI s on 10 or more such awards Chandra Belani, MD (Professor, Hematology/Oncology), Timothy Craig, DO (Professor, Pulmonary, Allergy & Critical Care Medicine), Elaine Eyster, MD (Professor, Hematology/Oncology) and Cristina Truica, MD (Associate Professor, Hematology/Oncology). L.J. Van Scoy, MD (Assistant Professor, Pulmonary, Allergy & Critical Care Medicine) received the Department s Junior Faculty Excellence in Research Award last June. 41

42 The Department s Housestaff Excellence in Research Award went to Kevin Rakszawski, MD (PGY-4, Hematology/Oncology) and Amy Welch, MD (PGY-6, Gastroenterology & Hepatology). Congratulations to both! Four residents are participating in the Longitudinal Research Track established last year Elizabeth Balraj, MD (PGY-3), Ruchi Desai, MD (PGY-3), Lionel Kankeu Fonkoua, MD (PGY-2), and Paula Henao, MD (PGY-3). 42

43 Paula Henao, MD (PGY-3) and Allison Kasmari, MD (Instructor, Chief Resident) were recognized as top poster presenters during the Medical Center s 2016 Annual Resident/Fellow Research Day. Congratulations to both! Let s congratulate all of our investigators, and mentors for a job well done! 43

44 Clinical Affairs Patient discharges flattened in FY16, but are projected to increase again this year. MICU census varies a bit, but is also steadily increasing. We have experienced more than a decade of pretty steady annual growth, and have been working hard to right-size the number 44

45 of providers we need to care for our patients. Our Hospitalist and Intensivist Groups have been growing steadily, including 4 nocturnists and 4 night shift APC s now, but there still have been periods of mismatch with respect to supply (of caregivers) and demand (from patient needs). I am deeply indebted to the core group of faculty who have kept our inpatient and Medical Intensivist Care services running despite such times of stress. As many of you may know, we have partnered with Mercy Virtual to bring the eicu to the Hershey Medical Center. We will be piloting this extra set of eyes and ears in the MIMCU and MICU during next month. This has entailed much work and planning by teams representing our nurses, hospitalists, intensivists and others, but with the goal of providing safer and more timely care to our sickest patients. My thanks to all who have worked so diligently to bring the eicu to Penn State. 45

46 We continue to struggle to achieve our budgeted visits in the outpatient clinics despite adjusting our budgeting methodology each year. Overall, outpatient visits have increased by 24% since a decade ago, but not consistently, despite adding more physicians and advanced practice clinicians. This past year, our 97,388 visits was almost 5000 more than the previous year, but still more than 4,917 short of budget. As a consequence of actions by the Medical Group Executive Committee, we are piloting new tools provider visit and fill rates, monthly dashboard reviews, and so on designed specifically to address the critical need for patient access to our care. The over-arching goals of Medical Group Leadership are to improve patient access and satisfaction, improve staff and provider satisfaction and engagement, and improve operational efficiency in our care processes. We are a large department with lots of moving parts and commitments, and I need each of you to take your commitment to your scheduled outpatient clinics seriously, and make up what you miss if it is humanly possible. 46

47 This slide provides a snapshot of our principal practice sites and procedure sites, including the medical and staff leadership as well as the numbers of visits and procedures at each site. In thinking about how we might differentiate ourselves in the market moving forward, we have established several multidisciplinary clinics Dermatology/Rheumatology and Renal Stone as examples or centers Pulmonary Fibrosis, Alpha 1 Antitrypsin Deficiency, and Cystic Fibrosis as examples to improve patient access and organize care for a group of patients with such disorders. We need to be at the forefront of developing and implementing care programs which will differentiate us in the local, regional and national markets. 47

48 Selected procedures GI Endoscopy and Sleep are increasing, whereas Bronchoscopy procedures have remained flat for 3 years. We are working on strategies to continue to grow each one. Thirty-six faculty - James Ballard, Noel Ballentine, Rebecca Bascom, Michael Beck, Chandra Belani, Sandra Blosser, John Boehmer, Edward Bollard, Gregory Caputo, Charles Chambers, David Claxton, Timothy Craig, Tonya Crook, William Davidson, W. Christopher Ehmann, Steven Ettinger, Elaine Eyster, Joseph Gascho, Ian Gilchrist, Harold Harvey, Raymond Hohl, Michael Katzman, Mark Kozak, Allan Lipton, Debra Miller, Gerald Naccarelli, Barbara 48

49 Ostrov, Ann Ouyang, Eric Popjes, Witold Rybka, David Silber, Lawrence Sinoway, Robert Vender, Cynthia Whitener, Randy Young, and John Zurlo - were included among the 2016 Best Doctors in America. Congratulations to each of you! Fourteen faculty or Advanced Practice Clinicians scored in the 99 th percentile for outpatient satisfaction (CG CAHPS) among providers nationwide, and represent 15% of HMC faculty in this category - Maria Baker, PhD, Edward Bollard, MD, Charles Chambers, MD, Cynthia Chuang, MD, Williamson Davidson, MD, Linda Farling, CRNP, Graham Jeffries, MD, Kathleen Julian, MD, Urs Leuenberger, MD, Nancy Parson, PA-C, Eric Popjes, MD, Lawrence Sinoway, MD, Erica Smeltz, CRNP, and Jeffery Wong, CRNP. Forty-six providers scored between the 75 th and 98 th percentiles nationally, representing 26% of HMC providers in this ranking category - Andreas Achilleos, MD, Peter Alagona, MD, Hamid Al-Mondhiry, MD, Beverly Azemar, CRNP, Gale Bentz, PA-C, John Boehmer, MD, Susan Borys, MD, Christine Bruce, PA-C, Gregory Caputo, MD, Joy Cotton, MD, Tonya Crook, MD, Peter Cygan, MD, Charles Dye, MD, Steven Ettinger, MD,, Elaine Eyster, MD, Joseph Gascho, MD, Ian Gilchrist, MD, Paul Haidet, MD, Annick Haouzi- Judenherc, MD, Stacy Hess, MD, Faoud Ishmael, MD, PhD, Monika Joshi, MD, Rayford June, MD, John Kelleman, MD, Mark Kozak, MD, Edward Liszka, MD, David Macaluso, MD, Andrea Manni, MD, Jennifer McCall-Hosenfeld, MD, Thomas McGarrity, MD, Debra Miller, MD, Ronald Miller, MD, Eileen Moser, MD, Laurie Nelson, MD, Brooke Olenowski, PA-C, Michael Pfeiffer, MD, Amie Prokop, PA-C, Denise Rhodes, CRNP, Soraya Samii, MD, Ian Schreibman, MD, Deborah Shepherd, CRNP, Lisa Sherwood, MD, Michelle Sponge, PA-C, Andrew Tinsley, MD, Jennifer Toth, MD, and Deborah Wolbrette, MD. Eleven faculty scored in the 99 th percentile for inpatient satisfaction (HCAPHS), or 22% of HMC providers in this category, Elizabeth Adams, DO, Rebecca Bascom, MD, Jed Gonzalo, MD, John Levenick, MD, Ariana Pichardo-Lowden, MD, Thomas Riley, MD, Witold Rybka, MD, Soraya Samii, MD, Andry Van de Louw, MD, Lauren Van Scoy, MD, and Margaret Wojnar, MD, and another eight (or 19%) scored between the 75th and 98th percentiles, Eric Chan, MD, Matthew Coates, MD, PhD, Harold Harvey, MD, Yuxia Jia, MD, PhD, Edward Liszka, MD, Ryan Munyon, MD, Syed Rizvi, MD, and Nelson Yee, MD, PhD. Congratulations to all our physicians, Physicians Assistants and clinical nurse practitioners who achieved these outstanding scores! Eleven faculty - Shirley Albano-Aluquin, MD, Sharon Banks, DO, Tonya Crook, MD, Chris Fan, MD, Joel Haight, MD, Emily Link, MD, David Macaluso, MD, Thomas McGarrity, MD, Matthew Moyer, MD, Sowmya Surapaneni, MD, and Andrew Tinsley, MD - were recognized as Hershey Heroes by patients or their family members for providing exceptional care! I periodically receive letters or s praising or, in some cases, criticizing patient care provided by faculty, residents, fellows, or other providers, and I want to acknowledge an ever increasing number (29 this year) who have received such praise during the past year Beverly Azemar, Rebecca Bascom, Simranjit Bedi, Timothy Craig, Tonya Crook, Linda Farling, Jennifer Goldstein, Venkata Gorrepati, Nicole Hancock, Eliana Hempel, Judy Himes, Faoud Ishmael, John Interrante, Urs Leuenberger, Nancy Olsen, Nisarg Patel, Brian McGillen, Debra Miller, Ronald Miller, Ryan Munyon, Colleen Rafferty, Abigail Rudy, Jennifer Toth, Andry Van de Louw, Lauren 49

50 Van Scoy, Robert Vender, Melissa Wentzel, Cynthia Whitener, and Randy Young. Congratulations to each of you, and thank you for serving our patients and their families so well. Lastly, congratulations to Becky Bascom, MD (Professor, Pulmonary, Allergy & Critical Care Medicine) and her colleagues for bringing a Center of Excellence in Pulmonary Fibrosis to our Medical Center as another example of a multidisciplinary care program which differentiates us in the market. Well done! Finances The high level financial picture of the Department was quite acceptable again last year, and we finished $595 thousand dollars better than our budgeted bottom line with $78 million of gross revenue, $22.7 million of net operating revenue, and $41.5 million of operating expenses. There continues to be significant financial support of the Department from the Hershey Medical Center through the combination of a clinical support payment (CSP) of $13.4 million and a physician administrative and teaching (PAT) payment of $5.4 million last year, lumped together as a Hospital Investment of $18.8 million on this slide, which will rise to $21.9 million budgeted this year reflecting our many and varied contributions to the success of the hospital and medical center. There is concern, however, at the highest levels of the organization, including our Board of Directors, that the increasing Clinical Support Payment, now $154 million for the entire Medical Group, is not sustainable given the shifting economic environment around payment for medical services, support for graduate medical education and other threats on the horizon. Hence, the Medical Group is again focusing on ways to optimize clinical productivity and reduce 50

51 unnecessary expenses. With this review will come a need for greater accountability for nonrevenue generating activities such as administrative, service, and some teaching activities. There will be more to come on these issues. As in the past, approximately 80% of our expenses are for faculty, staff and housestaff salaries and benefits, and HMC is funding our residency and fellowship programs to the tune of $7.1 million dollars annually. We continue to make clinical incentive payments to our physicians each year, and have budgeted approximately $1.9 million for this year. Each of the past 3 years we have had Department faculty receive part D incentive payments as well. We also paid approximately $100 thousand dollars in research incentives this past year (FY16). 51

52 Our AEF reserves have fallen a bit this past year due primarily to recruitment and bridge funding for investigators. The future investment in the Department will obviously be an important issue in the recruitment of the next Chair. The primary sources of renewing AEF reserves each year is the Chairs tax of 4.25% on net professional revenue, and gain-sharing according to an agreed upon formula when the Medical Center has a net positive bottom line as it did again this past year. So we ll likely see something to the tune of $1.5 million come back to the AEF reserves very soon. We will continue to use reserves for startup packages, bridge funding, pilot grants, innovative educational programs, and the like. 52

53 It remains important, however, to seek out opportunities to grow philanthropic support and endowments every year. I encourage each of you to identify colleagues or patients who may be interested in supporting your work or someone else s work in the Department or Medical Center, and to provide such information to our University Development liaison who is Michaelean McCormick. 53

54 One new philanthropic gift recently committed will establish an endowed faculty position in the Division of Pulmonary, Allergy and Critical Care Medicine., and another, in honor of Dr. Saroush Noori will support our Palliative Care Program. In closing, I set out a vision for our Department some years ago to be a Department in which each member is actively engaged in the pursuit of wisdom, such that, our collective wisdom ensures future success in each of our missions. Recognizing that a vision is something we aspire to be, but may never fully achieve, we must build commitment, create appropriate alignments, face adaptive challenges as they arise, and take risks in moving toward the ideal state we envision. 54

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56 I also tried to describe what it would look and feel like if we were to be the best in the nation in each of our 4 missions, and I established some high level goals which I have kept on my radar screen as we have moved forward. I ll leave it to you to judge how successful we ve been and, more importantly, what you can do to contribute to our collective success each day, and I look forward to the coming years with our next Chair. #2 #1 #3? #4 I m grateful for your support and collegiality over the years. It has been a special privilege to be associated with so many talented, innovative and inspiring people in our Department and Medical Center. I encourage you, once again, to participate actively in the selection of our next Chair. So who will be #4? Thank you for being here! 56