SUMMER 2007
Duke Surgery
News from the Department of Surgery | Duke University Medical Center
2
Message from the Chair
6
Surgical Simulators
8
Quality and Patient Safety
10 Research | Grants | Clinical Trials
14 Faculty News
15 Honors | Awards | Accomplishments
The Duke Voice Care Center
A TEAM APPROACH
From opera to gospel, from drill sergeant to
preschool teacher, millions of professionals
depend on their voices for singing or speaking. The human voice is one of our most
valuable communication tools, and anything
that changes the way we talk or sing can
be a voice problem. The Duke Voice Care
Center brings a team of vocal specialists
together to diagnose voice disorders and
provide effective treatment.
Voice problems can result from a variety
of medical conditions, medication, or voice
overuse. These disorders can be complicated
in origin but in most cases can be improved,
while other voice problems can be signs of a
serious underlying condition. The Duke Voice
Care Center’s integrated approach of voice
care includes a team of trained health care
providers—otolaryngologists, speech pathologists, and a singing-voice specialist—who
are skilled in addressing a range of illnesses
and disorders from neurological disorders
and cancer to benign lesions.
STATE-OF-THE-ART DIAGNOSTICS
The Duke Voice Care Center has access to
specialized diagnostic tools to examine vocal
“At the Duke Voice Care Center, we treat cords, including videolaryngostroboscopy, a
voice disorders from the common to the procedure where a strobe light is inserted
complex and restore a patient’s confidence into the throat to examine the movement
in their daily communication,” says David L. and vibration of the vocal cords. Magnified
Witsell, MD, Center Director and Associate pictures and high-quality videos of the voice
Professor, Division of Otolaryngology–Head box in action captured from this procedure
and Neck Surgery. “People often think there’s can identify a range of complex conditions
nothing that can be done for their voices. It that may interfere with voice quality, pitch,
takes an interdisciplinary team to properly and volume.
Richard L. Scher, MD, Associate
treat a disorder, and our patients are often
Professor, Division of Otolaryngology–Head
astonished with the results.”
and Neck Surgery, says, “At the
“It’s wonderful to be treated by someone Duke Voice Care Center, we comwho really understands my condition…” bine the expertise of our team of
health care professionals along
—Martha Gabriel, patient
with state-of-the-art diagnostic
The Center also provides services for equipment to determine the cause of the
individuals who do not have a voice disorder voice problem and develop an integrated
but who want to improve the quality of their plan to improve the patient’s voice.”
voice. Professional vocalists can learn new
ways to improve projection and overall sound, A GRATEFUL PATIENT
and treatment can include singing lessons as Martha Gabriel, a hotel receptionist, noticed
a new hoarseness in her voice. She consulted
part of the voice enhancement program.
several doctors, but none could pinpoint the
continued on page 5
MESSAGE
F R O M
Duke Department of Surgery
Chair
Danny O. Jacobs, MD, MPH
Vice Chairs
Theodore N. Pappas, MD
William J. Richardson, MD
David H. Harpole Jr., MD
Gregory S. Georgiade, MD
Eric J. DeMaria, MD
Paul C. Kuo, MD
Douglas S. Tyler, MD
Division Chiefs
Peter K. Smith, MD
Michael B. Hocker, MD
Bruce A. Sullenger, PhD
Paul C. Kuo, MD
Allan H. Friedman, MD
James A. Nunley II, MD
Ramon M. Esclamado, MD
Henry E. Rice, MD
L. Scott Levin, MD
Frank DeRuyter, PhD
Judd W. Moul, MD
Center & Institute Directors
Kent J. Weinhold, PhD
Ricardo Pietrobon, MD, PhD
Bruce A. Sullenger, PhD
Cynthia K. Shortell, MD
H. Kim Lyerly, MD
Allan H. Friedman, MD
Henry S. Friedman, MD
Administration
David O. Anderson
J. Michael Slaughter
Michael R. Gagnon
Newsletter Editor
Patricia A. Deshaies
Administration
Clinical Effectiveness
Faculty Affairs and Education
Financial Affairs
Network General Surgery
Research
Veterans Affairs
Cardiovascular & Thoracic Surgery
Emergency Medicine (Interim)
Experimental Surgery
General Surgery
Neurosurgery
Orthopaedic Surgery
Otolaryngolgy-Head & Neck Surgery
Pediatric General Surgery
Plastic & Reconstructive Surgery
Speech Pathology & Audiology
Urology
Center for AIDS Research
Center for Excellence in
Surgical Outcomes
Duke Translational Research
Institute (DTRI)
Center for Vascular Diseases
Comprehensive Cancer Center
The Preston Robert Tisch
Brain Tumor Center
The Preston Robert Tisch
Brain Tumor Center
Executive Director
Academic Affairs Sr. Director
Planning and Clinical
Operations Director
Marketing and Communications
Director
T H E
C H A I R
“Attahop”—Job Well Done!
It
was a crisp, brightly lit afternoon in the fall of 1975. Through divine
intervention, an adrenaline-fueled sudden influx of pedal dexterity,
or random chance, I had successfully tackled the challenging forward of the opposing team during his breakaway towards our goal. Truth
be known, this event occurred during the closing seconds of a freshmanyear college soccer match that we had already won. In the interest of full
disclosure, I will note that our coach had beneficently only allowed me to
join the contest in the closing minutes.
Just after the final gun sounded, one of my teammates and good friends,
Tony, ran on the field, clapped me on the back, and said, “Attahop!” It
was a new expression for me—one that I had never heard growing up in
Arkansas or while finishing high school in Vermont. Tony, an outstanding
student and talented soccer player from South Boston, was amused that I
didn’t understand what he was saying.
I could recite his explanation of the meaning of attahop almost verbatim to this day, but the space available for my “Chair’s Message” won’t
permit it. The gist of his several-minutes-long dissertation was that this
colloquial expression was used to convey congratulations for a job well
done—an extraordinary effort that might not have been expected, probably wasn’t necessary, and wouldn’t be recorded on the “official” stats
sheet. Like sweating in a dark suit, the responsible individual might have a
warm feeling, but no one else would necessarily notice unless they were
paying very close attention or were otherwise invested. Tony probably was
not “invested” but was certainly watching carefully, and I greatly appreciated his acknowledgement.
Attahop has been part of my lexicon ever since. I have enjoyed seeing
the quizzical looks on the faces of the recipients when I have said or written it—and the unspoken concern about the state of my mental health
when I have tried to explain its meaning. I love stories and this one, I think,
provides an excellent segue for me to applaud just a few of our many
accomplishments over the past few years.
When I arrived as Chair of the Department, it was apparent to me that
we had an opportunity to invert a biological imperative observed in nature
where form follows function. We could improve our infrastructure so as to
encourage the activities that would facilitate our ability to address the chalopen to continue
lenges of our health care environment while
endeavoring to improve our performance.
Our goal was to build on our tradition of
excellence to be recognized as a premier
academic department of surgery nationally
and internationally.
We agreed that we wanted to: 1) integrate our patient care, teaching, research,
and administrative activities (which would
require achieving the proper balance of high
volume clinicians and protected investigators); 2) improve our financial health while
investing in research; 3) communicate better
and more effectively coordinate our activities
(thus, strategic planning was of paramount
importance); and 4) ensure that we had
the appropriate organizational structure and
support personnel to enact our strategic
initiatives across all missions. In a sense, we
endeavored to change our structure and
function so as to improve our “form.”
By working with Health System leadership, our trainees, and all of the approximately 900 members of the Department of
Surgery, much has been achieved.
Patient Care
We have partnered with the Health System,
other departments, and institutes, as well
as our Private Diagnostic Clinic, to create
multidisciplinary programs while increasing
and improving productivity, efficiency, and
service. Over the past four years:
s 4HE OVERALL SIZE OF THE CLINICAL FACULTY HAS
increased by approximately 10 percent
s 7E SUCCESSFULLY NEGOTIATED FOR IMPROVED
compensation (an additional $1.5 million
per year) for faculty members who provide
patient care services at our local Veterans
Affairs hospital
s 7E SUCCESSFULLY PARTNERED WITH (EALTH
System leadership to establish the American
College of Surgeons National Quality
Improvement Program at Duke University
Hospital in an effort to improve patient
services and anchor our quality improvement initiatives
s 4OTAL CASE VOLUME HAS INCREASED BY percent while outpatient case volume has
INCREASED BY PERCENT 0HYSICAL PLANT
constraints have limited the growth of
the inpatient surgical services. Recognition
of the limitations (e.g., the number of
inpatient operating rooms) led to a successful partnership with the Health System
to modernize and increase the number
of operating rooms available at our main
hospital. The modernization has required
3
Summer 2007
s
s
careful coordination and close communication between the various stakeholders
(Nursing, Anesthesia, Medicine, Obstetrics
and Gynecology, and Surgery) as we design
the operating rooms of the future and
decide their features
7E WORKED WITH $UKE 5NIVERSITY (OSPITAL
leadership to invigorate key perioperative
services and our perioperative committee.
These changes were sorely needed and
likely facilitated improved OR efficiency
and utilization
3ERVICES PROVIDED BY FULLTIME FACULTY SURgeons at Durham Regional Hospital have
been enhanced. Duke surgeons now
ACCOUNT FOR NEARLY PERCENT OF THE TOTAL
number of inpatient surgeries performed
at Durham Regional Hospital, compared
with less than 10 percent in 2002. Shifting
case volume to DRH has helped us meet
demands for new operating room start
times at Duke University Hospital. Further
enhancements are currently under way as
we implement a plan to support cardiac
and thoracic surgical care at our partner
institution
7E HAVE RECENTLY LAUNCHED THE $UKE 6OICE
Care Center, which is a multidisciplinary
collaborative effort between audiologists,
speech pathologists, and head and neck
surgeons
7E ARE ESTABLISHING A SIGNIFICANT PRESENCE
at Duke Raleigh Hospital. Faculty surgeons
in urology, surgical oncology, and thoracic
surgery are successfully establishing practices while maintaining their ties to our
educational and academic programs
7E ARE IN THE FINAL STAGES OF IMPLEmenting a multidisciplinary vascular center
which will be a partnership between the
Hospital and the departments of Radiology,
Cardiology, and Surgery
7ORKING WITH OUR #HIEF OF 5ROLOGY AND
PDC leadership, we will soon inaugurate
the Duke Prostate Cancer Center, another
model of interdepartmental and multidisciplinary collaboration
7E HAVE SUCCESSFULLY IMPLEMENTED A
Physician Assistant Hospitalist Program to
support patient care activities and improve
safety and efficiency
Education
Since 2002, we have:
s #ONTINUED TO RECRUIT SOME OF THE NATIONS
finest medical school graduates to train as
residents and fellows
s 2EVISED AND MODERNIZED OUR CORE CURRICUlum in surgery for medical students under
the direction of a new student program
director
s %STABLISHED THE 3URGICAL %DUCATION AND
Activities Laboratory, which contains the
latest surgical simulation and training
devices
s !SSISTED OF OUR RESIDENCY AND FELLOWship programs who completed successful
ACGME site visits (with special commendations received by Cardiovascular and
Thoracic Surgery, and Otolaryngology—
Head and Neck Surgery)
s ,AID THE FOUNDATION FOR CERTIFICATION AS A
Comprehensive Education Institute for certification and continuing education by the
American College of Surgeons
Research
We are fortunate to have a long and distins
guished track record in basic and translational
research. Our recent efforts have focused
on strengthening our research efforts by
promoting interdisciplinary and interdepartmental programs and teamwork. Among
s
other accomplishments, we have been able
to identify talented individuals within the
Department of Surgery, connect them to
centers of excellence in our Health System,
and advocate for resources to allow them to
do their work. To date, we have:
s
s 2EALLOCATED PERCENT OF THE $EPARTMENTS
research space that has significantly
improved research dollar density per
square foot and will allow us to maximize
the support we receive from the School of
s
Medicine when its financial restructuring
is complete
s )MPROVED THE SUPPORT PROVIDED TO KEY
members of our Experimental Surgery division that allowed the Center for Aids
s
Research to return to Duke
s 3UCCESSFULLY NEGOTIATED FOR APPROXIMATELY
10,000 net square feet of space in the new
medical science research building
s 3UCCESSFULLY NEGOTIATED THE CONTINUATION
As a result of our efforts, patient care colof the American College of Surgeons
lections and work productivity per FTE have
Oncology Group at Duke under new leadincreased yearly, while most departmental
ership
and divisional expenses have been minimized s 3UPPORTED THE DEVELOPMENT OF THE #ENTER
and maintained at or below cost-of-living
for Excellence in Surgical Outcomes (CESO)
increases.
at Duke. The center’s mission is to con-
office have led to additional performance
improvements
s $ESIGNED AND IMPLEMENTED A NEW FACULTY
compensation plan that recognizes the
practical realities of the current sources
of our revenue and more clearly communicates expectations while acknowledging
and rewarding faculty members for their
very important academic and educational
contributions
s #REATED A REINVESTMENT PLAN WHEREBY A
significant portion of any financial margin
realized by the Department is centrally
reallocated to divisions that meet mutually
agreed upon performance targets across
all missions
s #OMPLETED A COMPREHENSIVE STRATEGIC PLAN
by the members for the Department and
all of its major divisions
s 2ECRUITED DIVISION CHIEFS AND SECTION HEADS IN
General Surgery, Urology, Otolaryngology—
Head and Neck Surgery, Endosurgery,
Vascular Surgery, and Pediatric General
Surgery
s )MPLEMENTED A DEPARTMENTWIDE EMPLOYEE
recognition program that provides a finanAdministration
cial
award and recognition for non-phys 2EDESIGNED
AND
REORGANIZED
THE
sician employees who are nominated by
Department’s administration to desigtheir peers and/or supervisors for making
nate formal vice-chairs for administration,
contributions across all missions that are
research, education and faculty affairs,
“Above & Beyond” what is expected
clinical effectiveness, veterans’ affairs,
financial affairs, network general surgery,
and patient services. Directors of marking Communication and Advocacy
and communications, information technol- The best organizations communicate effecogy, planning and operations, and finance tively with their constituencies. However,
were hired and a primary administrator it is increasingly difficult to communicate
was identified for each surgery division. well such that a multi-pronged approach is
The Department’s central advisory group required. We have strived to improve com(comprised of the vice chairs of adminis- munications by creating a department newstration and finance, senior development letter and revitalizing all of our divisional,
officer, executive director, and senior direc- center, and department websites. Working
tor of academic affairs, along with the with our marketing director, we instituted
executive and medical directors of the Duke e-Surgery News and this newsletter
Private Diagnostic Clinic), meets regularly which we use to push and pull information
to advise me on how best to manage to and from members of the Department
the Department across all missions while electronically. “Town meetings” are held for
coordinating our activities with those of all faculty and staff members, and I meet with
the School of Medicine and Health System. division chiefs and vice-chairs bimonthly on
Our newly created Clinical Operations average. I was honored to be re-appointed
and Finance Committee serves to help to the Health System’s board of directors. In
guide decisions necessary in confronting this role, I believe that I have been able to
growing financial pressures experienced effectively advocate for all of our patients,
by the membership and to improve trans- faculty, staff members, and trainees.
parency and communication. All of these
activities occurred while approximately $1 Diversity
million was eliminated from the central I believe that hospitals and academic medibudget. Recently completed internal and cal centers, like other social organizations,
external audits of our central business must be modern not only in their approach
duct innovative clinical and translational
research while working with global teams
of experts across all relevant disciplines in
virtual research environments. The center
performs and promotes “research about
research” methodology, its aim to facilitate
research innovation and improve quality, productivity, and return on investment. These
efforts of CESO leadership greatly contributed to Duke securing its recently awarded
Clinical and Translational Science Award
s 3UPPORTED ESTABLISHING THE $EPARTMENTS
Center for Translational Research (which
antedated the development of Duke’s
Translational Medicine Institute and its
leadership was also instrumental in helping
Duke secure its Clinical and Translational
Science Award)
s )NCREASED .)( EXTRAMURAL AWARDS BY percent from 2002 to 2006 despite senior
research faculty turnover (who left to assume
leadership opportunities at other institutions) with 53 percent of the total funding
being awarded to surgeon-scientists.
to patient care and education, but also in
their attention to the quality of the work,
to interdepartmental and interdisciplinary
relationships, and to the breadth and depth
of the workforce. The latter requires sensitivity to the importance of race, ethnicity, and
gender in society. I am committed to these
ideals. Some progress has been witnessed
at Duke, but much more work needs to be
done. The number of female surgeons in our
department has increased from eight to 32
over the past several years, and the number
of underrepresented minority clinical faculty
members has increased from four to 13. We
are working diligently to continue to improve
these numbers. A total of 31 job offers were
extended to faculty members last year, with
29 percent to women and 13 percent to
underrepresented minority candidates. Also,
five of our seven categorical general surgery
trainees were women this past year, and
we graduated three female general surgery
chief residents in June 2007. Last year all of
our first-year house officers in Urology were
female.
Development
The future of most academic health centers will depend on their ability to initiate,
develop, and successfully implement capital
campaigns. Every growth strategy that I
have seen recently has been substantially
dependent upon philanthropy. We have recognized the need for a more organized
and coordinated fundraising effort in our
Department. We were able to identify and
recruit a senior development officer assigned
solely to the Department of Surgery. This was
a fortuitous event. Through our joint efforts,
we have created five new endowed professorships since July of 2005. Fundraising for
a new endowed assistant professorship has
been completed and is under way for two
others. The total number of proposals for
philanthropic support for the Department
of Surgery has increased substantially, from
virtually nil in 2002 to over $4 million of
support received this year with pledges
exceeding an additional $3 million. Currently,
approximately two-thirds of our endowed
income is being re-invested.
We have begun a concerted effort to provide more regular and meaningful stewardship reports to endowment donors. A major
challenge has been our deeply entrenched
practice and long history of supporting or
promoting “tribute campaigns.” Recently,
we have focused our efforts on developing a
On the cover from left to right: Richard Scher, MD,
Caroline Banka, SLP, Jackie Fuller, RN, David Witsell,
MD, Leda Scearce, SLP, Seth Cohen, MD, Karen
Poston, and Gina Vess, SLP
comprehensive vision that can be translated
into a case statement or white paper that
can be used to work with potential donors.
We have recognized the need for a more
robust fundraising enterprise that complements the School of Medicine’s recently revitalized development activities and long-range
plans. The Department’s development officer
and I recently attended an advanced workshop hosted by Advancement Resources on
medical philanthropy. The highly informative
seminars were used to create a plan for the
Department that included hiring an outside
consultant to help inform and educate our
faculty and staff members about the realities of modern fundraising—the facts and
fictions, myths, and truths. Our first “philanthropy institute” sessions were held several
months ago and were very well attended
and received.
I was introduced to attahop’s other
meaning later in my freshman college year as
our soccer season was ending. The score was
tied in our final game with one half to play.
As our team was taking the field, Tony yelled,
“Attahop, guys!” He meant that we were to
proceed intently and with a sense of urgency
because there was a difficult task ahead of
us. So too must we proceed to address the
challenges of our current environment while
acknowledging the good things we have
done so far. To the faculty and staff of the
Department of Surgery who have made this
all possible:
Attahop!
Danny O. Jacobs, MD, MPH
The David C. Sabiston Jr. Professor
Chair, Department of Surgery
Surgeon-in-Chief
Duke University Medical Centerr
The Duke Voice Care Center
continued from cover
cause, dismissing her problem as the effect treatment will probably last another five to
seven weeks, and I fully intend to stick with
of allergies.
“I hated opening my mouth at times. it,” she says.
“People receiving voice care often
Sometimes I’d get so embarrassed by the
way I would sound,” says Gabriel. “It took a experience a revived sense of confidence
real effort for me to talk, and it didn’t need when socializing or participating in professional activities,” says Seth M. Cohen,
to be that way.”
Gabriel finally got the answer to her MD, Assistant Professor, Division of
hoarseness from the Duke Voice Care Center. Otolaryngology–Head and Neck Surgery.
Her current treatments include speech ther- “Many of our older patients feel as though
apy with a speech pathologist, and she is they sound like their younger selves. They
already experiencing positive results through feel like they’ve recaptured their youth.”
breathing exercises and by repeating certain
syllables and sentences.
For appointments or more information
“It’s wonderful to be treated by someone about the Duke Voice Care Center, call 919who really understands my condition. My The Duke Voice Care Center team:
· Laryngologists are ear, nose, and throat surgeons who have undergone specialty
training related to voice disorders. The laryngologist assesses and treats the medical
factors that are contributing to the voice problem.
· Speech pathologists specialize in voice disorders. The speech pathologist assesses
how a patient’s voice is working and how the environment and the way the voice is
used may be contributing to the problem. The speech pathologist also provides voice
therapy to help patients take care of their voice and use it in the most efficient way.
· Singing-voice specialists may be involved if the patient is an entertainer or singer.
The singing-voice specialist is a speech pathologist with extensive training and experience as a voice teacher and performer. The singing-voice specialist identifies factors
that may be causing or contributing to problems with the singing voice and provides
rehabilitation through exercises and training.
dukesurgery.org
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N E W T E C H : : P R O C E D U R E S : : I N I T I AT I V E S
Photo courtesy of
Immersion Medical Inc.
SURGICAL SIMULATORS
Offer New Tools for Resident Education
by Lauren Shaftel
A
recent Annals of Surgery study found
that surgical simulators can be useful in building the operative skills of
surgery residents. “A novel component to
the surgical residency-based curriculum at
Duke is the inclusion of surgical simulation
technology,” says Marnelle Alexis, EdD,
Assistant Professor in the Practice of Medical
Education in the Department of Surgery.
“The simulators will make possible for surgery
residents and others to have effective and
measurable hands-on surgical skills training
experience in real time.”
Duke Surgery is fast becoming a leader
in the use of simulation as part of resident education through the creation of the
Surgical Education and Activities Laboratory
(SEAL), which provides residents with roundthe-clock access to six minimally invasive
laparoscopic surgical simulators, four threedimensional virtual reality laparoscopic surgical
simulators, and two endoscopy simulators
used for practicing flexible bronchoscopy
6
Summer 2007
and upper and lower gastrointestinal (GI) operative field through the laparoscopic lens.
They also help residents gain skills in the
flexible endoscopy procedures.
“The simulators expand the educational simultaneous use of a variety of instruments
mission of Duke Surgery’s residency pro- with both hands.
The endoscopy trainers provide haptic
gram,” says Aurora D. Pryor, MD, Assistant
Professor, Division of General Surgery, and feedback which makes the scope insertion
SEAL Medical Director. “Simulators can really and manipulation feel like working with a
help in mastering basic skills and can provide real patient. This feature, coupled with the
a very beneficial new tool to help us opti- use of real-time computer graphics and anamize the surgical training program we offer tomic models developed from actual patient
data, creates an environment that closely
here at Duke.”
In the SEAL, residents can hone skills mimics an actual procedure. Trainees perand practice minimally invasive procedures forming an upper GI endoscopy, for example,
without the pressures of the operating room, are able to insert the scope into the “patient”
says Eric J. DeMaria, MD, Professor, Division and use the program’s tools to replicate
of General Surgery, and Director of the Duke patient swallowing, suction of gastric fluid,
EndoSurgery Center. “The idea is to change and even lens cleaning. A “virtual attending”
some of the mechanisms of surgical educa- can provide useful information and feedback
tion to include the development of skills to trainees as they perform the procedure.
The six minimally invasive laparoscopic
outside the operating room environment,”
simulators also provide haptic feedback.
he says.
Jennifer H. Aldrink, MD, General
The two virtual reality simulators help
trainees become familiar with visualizing the Surgery Chief Resident, who recently com-
Duke Surgery residents using endoscopic simulator
pleted residency training, uses the SEAL to
augment her surgical training. “This lab
allows residents to practice and become
more efficient as surgeons, and we can then
take these skills with us to the operating
room,” she says.
“Our goal is to create a facility and an
environment for optimal training in the new
skills increasingly required for the practice
of modern minimally invasive surgery,” says
R. Randal Bollinger, MD, PhD, Professor,
Division of General Surgery, and Senior
Educational Advisor for the Department.
The multidisciplinary SEAL advisory board
is working to expand the program. The
Department of Surgery, with the institutional
support of Duke University Medical Center
(DUMC), is currently seeking accreditation by
the American College of Surgeons as a Level
I Comprehensive Education Institute. “This
designation will continue to allow DUMC
and the Department of Surgery to retain
its standing as a simulation pioneer and to
offer optimal skills-training to trainees at all
levels and across various disciplines,” says
Dr. Alexis.
With the expansion of the SEAL, additional simulators will allow the program
to address all specialties that can benefit from this state-of-the-art teaching lab.
Simulation may be an ideal complementary
training technique for procedures such as
video-assisted thoracoscopic lobectomy, a
procedure used by thoracic surgeons to
remove cancerous tumors without opening
the chest. Medical students, residents, fellows, and attending surgeons will also be
able to benefit from the simulators providing
them an opportunity to practice and perfect
techniques.
“The program is in its infancy, but it’s
here to stay,” says David H. Harpole Jr.,
MD, Professor, Division of Cardiovascular
and Thoracic Surgery, and Vice Chair, Faculty
Affairs and Education. “It’s an investment in
personnel and very intricate equipment, but
the rewards are limitless.”
For more information on the Surgical
Education and Activities Lab, contact
Dr. Alexis at 919-681-7681 or visit
dukesurgery.org/seal.
dukesurgery.org
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N E W T E C H : : P R O C E D U R E S : : I N I T I AT I V E S
QUALITY AND PATIENT SAFETY
Continue to be Priorities for Duke Surgery
by Lauren Shaftel
Duke Surgery’s commitment to quality and patient
safety is reflected in the many programs in place
to maintain and advance patient outcomes.
NATIONAL SURGICAL QUALITY
IMPROVEMENT PROGRAM
Underscoring its commitment to quality
and patient safety, Duke’s Department of
Surgery recently joined the American College
of Surgeons’ National Surgical Quality
Improvement Program (NSQIP). An initiative
first developed and implemented at Veterans
Affairs hospitals nationwide beginning in the
mid-1990s, NSQIP has only recently moved
into the private sector, and Duke is one of
142 participating institutions.
“This is a critically important endeavor
for our surgical services as we begin to collect robust data that we can use to improve
the quality of care that we provide to our
patients,” says Danny O. Jacobs, MD, MPH,
Professor and Chair, Department of Surgery.
“The highest quality surgical care is always
safer, in my opinion.”
NSQIP is a validated, risk-adjusted, outcomes-based program which uses several
components, including data collection, analysis, and feedback mechanisms, to quantify
quality and safety measures by standardized
inter-institutional comparison. The information generated by the program is designed
to foster discussion and improvement at
individual participating institutions.
“This program will allow us to discover
what we could be doing better and how
we compare against VA medical centers
and other acute Level I trauma centers,”
says Matthew Harker, MBA, Director for
Information Technology for the Departments
of Surgery and Medicine at Duke.
8
Summer 2007
Currently, the program is in use in Vascular
Surgery at Duke, with the expectation of
expansion into other areas moving forward.
In the data collection phase, nurse reviewer
Patricia A. Tucker, RN, BSN, who has years
of quality improvement experience in Duke’s
Department of Anesthesia, is responsible for
collecting preoperative risk factors, intraoperative variables, and 30-day postoperative
mortality and morbidity outcomes for about
40 patients per week. Tucker then enters this
data into the NSQIP website.
Analyzed data is presented to participating sites through comprehensive semiannual
reports and real-time online benchmarking
reports. These reports allow the centers to
continually monitor their quality-improvement efforts and to compare outcomes
with other participating medical centers and
against national averages on a blinded basis.
At Duke, NSQIP represents an important
collaborative effort between Duke University
Hospital and the Department of Surgery,
underscoring the commitment of improving
and maintaining the most stringent criteria
for patient safety and quality.
“The two entities are sharing the cost of
participating in the program, and I think that
reflects our shared dedication to this important mission,” says Harker.
The useful information generated by the
program may be presented at various morbidity and mortality conferences.
“This kind of information will be extremely
helpful to us,” says William J. Richardson,
MD, Professor, Division of Orthopaedic
Surgery, and Vice Chair, Clinical Effectiveness,
and physician champion of the program. “It
will help us to identify improvement measures to decrease our incidence of complications and improve outcomes.”
The program has just gotten under way
at Duke, but shows great promise as a quality and safety improvement tool.
“I think it will lead to better quality and
safer surgery,” says Dr. Richardson.
For more information on NSQIP, contact
Dr. Richardson at 919-684-5711.
DUKE SURGERY PATIENT SAFETY
Currently in use in the Divisions of Orthopaedic
Surgery, Neurosurgery, and Urology, Duke
Surgery Patient Safety (DSPS) is a mechanism
through which clinicians and staff can report
adverse events electronically, ensuring timeliness and a streamlined approach to chronicling and acting upon safety and quality
concerns within the Department of Surgery.
Through the easy-to-use online system,
users can enter information about the division, the surgeon, and the specialty involved,
as well as the date, specific complication,
and any relevant details. Users can also rank
the severity of the complication on a scale
from one to five.
“This system allows us to keep track of
complications in a simple, user-friendly manner, and this helps us work toward the goal
of continually improving the patient safety
and quality measures we have in place here
at Duke,” says Ricardo Pietrobon, MD,
PhD, MBA, Assistant Professor, Division
of Orthopaedic Surgery, and Director of
Biomedical Informatics in the Duke
Translational Medicine Institute.
For more information on DSPS, contact
Dr. Pietrobon at 919-668-2054.
CENTER FOR EXCELLENCE
IN SURGICAL OUTCOMES
Duke’s Center for Excellence in Surgical
Outcomes (CESO) brings together an international network of researchers interested
in the valuable pursuit of conducting surgical outcomes research. The CESO facilitates
collaborative grant- and manuscript-writing
and encourages national and international
partnerships between researchers.
“Duke Surgery is committed to leading
the way in collaborative outcomes research,
and the CESO is an important tool for
achieving this goal,” says Dr. Pietrobon. “We
are working toward becoming a hub for surgical outcomes research.”
Surgical outcomes research studies the
end results of surgical interventions by examining quality of life and mortality indicators
and other variables. Outcomes research can
provide important information to patients
and clinicians when weighing the risks and
benefits of certain procedures.
At present, surgery faculty members and
other Duke researchers are working with
colleagues at academic institutions in 22
countries, including France, Portugal, Greece,
India, and Singapore. Current and recent
CESO projects include research into outcomes factors after certain types of orthopaedic and oncological procedures.
To maintain and improve the virtual
research environment that allows for international collaboration, the CESO uses the
“research about research” methodology to
continually find new and innovative ways to
monitor and identify problems and create
new tools to facilitate this unique way of
working.
For more information on CESO, contact Dr. Pietrobon at 919-668-2054 or visit
www.ceso.duke.edu.
DUKE SURGERY RESEARCH CENTRAL
The CESO and Duke Surgery are in the process of developing a beneficial project management tool for researchers: Duke Surgery
Research Central (DSRC). DSRC is designed
to streamline and standardize the research
process from conception to closeout of the
research project. The initial phases of DSRC
provides researchers with access to software
tools such as Writely®, which allows several
collaborators to access and create or edit
documents. DSRC also provides tools such
as remote access to computers capable
of conducting statistical computations and
English translation of grant proposals and
manuscripts.
DSRC is a free resource for researchers in
the Department of Surgery, and its mission is
to provide assistance throughout the life of
a given research project. Once a researcher
has developed a research proposal, DSRC
resources can identify potential sponsors,
review guidelines, secure institutional approvals, and provide assistance with everything
from navigating compliance requirements to
processing payroll and budget.
“Our overall goal is to provide a level of
assistance that allows researchers the ability to focus on the development of a solid
research agenda and not have to spend so
much time with administrative details,” says
Christeen Butler, CRA, senior specialist for
research administration in Duke Surgery.
Although DSRC continues to evolve, it is
already serving as a model for other entities
within Duke that are looking for new, innovative ways to facilitate a collaborative relationship for research development among
their faculty and staff.
For more information on DSRC, contact
Christeen Butler at 919-684-4084.
DSRC PHASES
DUKE SURGERY RESEARCH CENTRAL
PHASE I
Research Statement of Intent
PHASE II
Application for Funding
PHASE III
Pre-Award
PHASE IV
Award
PHASE V
Post-Award
PHASE VI
Close Out
RESEARCH :: GRANTS :: CLINICAL TRIALS
The Duke Translational Research Institute
BRINGING DISCOVERIES “BENCH TO BEDSIDE”
Now, as the director of the new Duke
For Bruce Sullenger, PhD, Professor and
Chief, Division of Experimental Surgery, Translational Research Institute and the Duke
Joseph W. and Dorothy W. Beard Professor, Center for Translational Research, which was
and Director of the Duke Translational established in 2005 by the Departments of
Research Institute (DTRI), the idea of moving Surgery and Medicine as a forerunner to
discoveries from the laboratory into some- the DTRI, Dr. Sullenger has the opportunity
thing that can benefit patients is not just a to help other researchers across the Duke
new buzzword. It is something he has been campus make a difference too.
The DTRI is a new organization at Duke
passionate about for most of his career.
“There are scientists who like to study dedicated to helping move discoveries from
something. I’m a scientist who says, ‘How the laboratory to first-in-human studies. It
can I benefit society by doing biomedical is part of the larger Duke Translational
research?’” Dr. Sullenger was trained in one Medicine Institute (DTMI), which is funded
of the best basic science labs in the country, by a five-year grant from the National
that of Thomas Cech, PhD, who won the Institutes of Health (NIH).
Historically the
Nobel Prize
NIH has supported
for chemis- DTRI…a one-stop-shop for studies of
TRY IN human disease and early stages in drug, basic research to
understand the
“People quesdiagnostic, and device development
mechanisms
of
tioned when I
biological
procame to Duke
from a chemistry department, but I wanted cesses. And now the NIH is recognizing that
to join a clinical department to make a dif- a major obstacle in improving health is that
once a discovery is made, support is needed
ference,” he says.
to develop and prepare the discovery for firstin-human studies.
10
Summer 2007
As support from the private sector
becomes increasingly difficult with venture
capitalists and investors reluctant to invest
in new inventions not yet in human testing,
more of the responsibility for moving these
discoveries along is being pushed back to
academic medical centers.
The DTRI is well positioned for this important endeavor and provides experienced
leadership, critical resources, and infrastructure for academic translational researchers.
Two fundamental areas of focus for the
DTRI include:
s #REATING AN INFRASTRUCTURE ORGANIZED
in a way that facilitates translational
research across the School of Medicine
and across the university. The infrastructure will take advantage of the five
areas where Duke has already made
major investments to radically change
the practice of medicine: cell therapy,
immunology and vaccines, molecular
therapeutics, imaging, and “-omics”
(genomics, proteomics, etc.)
s 3UPPORTING THE DEVELOPMENT OF TRANSLAtional research teams—teams of investigators who collaborate between the
“bench” scientists and clinical researchers—allowing cross-analysis access to
early phases of development and the
planning of how to bring discoveries forward into useful therapies for
patients more quickly
For years Duke Surgery has been facilitating the collaboration between researchers
and surgeon-scientists and has been the top
ranked department of surgery in the nation
for over a decade in terms of peer-reviewed
research funding. The DTRI will continue
to support this successful model and will
soon be developing first-in-human trials
with NIH funding for pilot projects, bringing discoveries from bench to bedside much
more rapidly.
For more information on the DTRI,
contact Dr. Sullenger at 919-684-6375 or
visit dtmi.duke.edu/dtri.
Researchers Weaving a
New Way to Repair Damaged Joints
U
sing a unique weaving machine of Health, the National Aeronautics and Space
their design, Duke researchers have Administration, and the Coulter Foundation.
“If further experiments are successful, the
created a three-dimensional fabric
“scaffold” that could greatly improve the scaffold could be used in clinical trials within
ability of physicians to repair damaged joints three or four years,” says Franklin Moutos,
a graduate student in the Orthopaedic
with the patient’s own stem cells.
“We don’t currently have a satisfactory Bioengineering Laboratory who designed
remedy for people who suffer a cartilage- and built the weaving machine. “The first joints
damaging injury,” says Farshid Guilak, PhD, to be treated this way would likely be hips and
Professor, Division of Orthopaedic Surgery, shoulders, though the approach should work
and Lazlo Ormandy Professor. “One major for cartilage damage in any joint.”
Current therapies to repair cartilage
advantage of this system is that since the
cells are from the same patients, there are damage are not effective, according to
no worries of adverse immune responses or the researchers. The only bioengineering
approach to such joint repair involves removdisease transmission.”
The researchers reported the new tech- ing cartilage cells from patients and then
nology in the February 2007 issue of the “growing” them in a laboratory to form
journal Nature Materials. The research was new cartilage. However, it can take several
supported by the National Institutes of months to grow a piece of cartilage large
Farshid Guilak, PhD, with Franklin Moutos.
enough to be implanted back into the
patient. Additionally, this laboratory-grown
cartilage is not as durable as native cartilage.
In laboratory tests, the fabric scaffold
that the researchers created had the same
mechanical properties as native cartilage.
Researchers believe that in the near future,
surgeons will be able to impregnate customdesigned scaffolds with cartilage-forming
stem cells and chemicals that stimulate their
growth, then implant them into patients during a single procedure.
Stem Cell Activity Deciphered in the Aging Brain
N
eurobiologists have discovered why
the aging brain produces progressively fewer new nerve cells in its
learning and memory center. The scientists
state the finding, made in rodents, refutes
current ideas on how long crucial “progenitor” stem cells persist in the aging brain.
The finding also suggests the possibility
of treating various neurodegenerative disorders, including Alzheimer’s disease, dementia,
and depression, by stimulating the brain’s
ability to produce new nerve cells, says senior
study investigator Ashok K. Shetty, PhD,
Professor, Division of Neurosurgery, and
Medical Research Scientist at the Durham
VA Medical Center.
Results of the study appear online in the
journal Neurobiology of Aging. The research
was funded by the National Institutes of
Health and the U.S. Department of Veterans
Affairs.
Previous studies by Dr. Shetty and others
had demonstrated that as the brain ages,
fewer new nerve cells, or neurons, are born
in the hippocampus, the brain’s learning and
memory center. In one study, Dr. Shetty and
colleagues showed that the production of
new neurons in rats slows down dramatically
by middle age—the equivalent of 50 years
in humans, but scientists did not know the
cause behind the decline.
The common assumption had been that
the brain drain was due to a decreasing
supply of neural stem cells in the aging
hippocampus, says lead study investigator Bharathi Hattiangady, PhD, Research
Associate, Division of Neurosurgery. Neural
stem cells are immature cells that have the
ability to give rise to all types of nerve cells
in the brain.
In the current study, however, the
researchers found that the stem cells in
aging brains are not reduced in number, but
instead they divide less frequently, resulting
in dramatic reductions in the addition of
new neurons in the hippocampus.
“This discovery provides a new avenue
to pursue in trying to combat the cognitive
decline associated with conditions such as
Alzheimer’s disease and with aging in general,” says Dr. Hattiangady.
The team now is searching for ways to
stimulate the brain to replace its own cells in
order to improve learning and memory function in the elderly.
dukesurgery.org
11
RESEARCH :: GRANTS :: CLINICAL TRIALS
SURGERY RESEARCH GRANT ACTIVITY
RESEARCH
Gayathri R. Devi, PhD, Assistant Professor,
Division of Experimental Surgery, was
awarded a grant from the Department of
Defense for “Modulation of regulatory T
cells as a novel adjuvant for breast cancer
immunotherapy.”
CLINICAL TRIALS
awarded a grant from Neuro Therapeutics
Pharma Inc. for “Evaluation of the anti-epileptic effects of loop-diuretic prodrugs in
acute primate seizure models.”
David H. Harpole Jr., MD, Professor, Division
of Cardiovascular and Thoracic Surgery, was
Detlev Erdmann, MD, PhD, Assistant awarded a grant from MedImmune Inc. for
Professor, Division of Plastic and Reconstructive “MTA-role of EphB4 in lung tumor progresSurgery, was awarded a grant from the sion and prognosis.”
Plastic Surgery Educational Foundation for
“Human adipose derived adult stem cells as Jeffrey H. Lawson, MD, PhD, Associate
an engineered bone substitute for segmental Professor, Division of General Surgery, was
awarded a grant from Yale University for
osseous defects.”
“Biological vascular grafts.” Dr. Lawson
Guido Ferrari, PhD, Assistant Professor, was also awarded a grant from Pervasis
Division of Experimental Surgery, was Therapeutics Inc. for “Evaluation of intimal
awarded a grant from the Vaccine Research hyperplais in a porcine model using gel foam
and endothelial implants.”
Center for “Comprehensive T cell VIMC.”
Stephen J. Freedland, MD, Assistant
Research Professor, Division of Urology, was
awarded a grant from the Department of
Defense for “Statin use and prostate cancer
progression following radical prostatectomy.”
Hui-Wen Lo, PhD, Assistant Professor,
Division of Experimental Surgery, was
awarded a grant from the National Institutes
of Health for “Nuclear EGFR signaling network in human cancer.”
Matthias Gromeier, MD, Assistant Aurora D. Pryor, MD, Assistant Professor,
Professor, Division of Neurosurgery, was Division of General Surgery, was awarded
awarded a grant from the Southeastern a grant from the Society of American
Brain Tumor Foundation for “Evaluation of Gastrointestinal Endoscopic Surgeons for
oncolytic poliovirus recombinants in a syn- “Laparoscopic computer simulator vs. usage
geneic rodent glioma model.” Dr. Gromeier of box-trainer as a model for resident education.”
was also awarded a grant from the National
Institutes of Health for “Targeting translation Kent J. Weinhold, PhD, Professor, Division
of Experimental Surgery, was awarded a grant
control in malignant glioma.”
from the Fred Hutchinson Cancer Research
Michael M. Haglund, MD, PhD, Associate Center for “HVTN laboratory program.”
Professor, Division of Neurosurgery, was
12
Summer 2007
Charles B. Cairns, MD, Associate Professor,
Division of Emergency Medicine, was
awarded a grant from Cardiovascular Clinical
Studies LLC for “Blinded observational outcomes study of PRIME ECG in the emergency department.” For information contact
Amanda Anderson at 919-684-5537.
Abhinav Chandra, MD, Assistant Professor,
Division of Emergency Medicine, was
awarded a grant from The Medicines
Company for “Evaluation of the effect of
ultrashort-acting clevidipine in the treatment
of patients with severe hypertension.” For
information contact Giselle Molinar at 919684-5035.
Dev M. Desai, MD, PhD, Assistant Professor,
Division of General Surgery, was awarded a
grant from Bristol-Myers Squibb for “BENEFIT
clinical trial.” For information contact Sherri
Jarvis at 919-681-6898.
Craig F. Donatucci, MD, Associate Professor,
Division of Urology, was awarded a grant
from Eli Lilly and Company for “Study to
evaluate the efficacy, dose response, and
safety of Tadalafil.” For information contact
Jill Smith at 919-668-3613.
William E. Garrett, MD, Professor, Division
of Orthopaedic Surgery, was awarded a grant
from Omeros for “Safety of OMS103HP in
patients undergoing autograft ACL reconstruction.” For information contact Libby
Pennington at 919-684-6071.
Daniel J. George, MD, Associate Kirk A. Ludwig, MD, Assistant Professor, s 'ENENTECH )NC FOR h0HASE )) 4RIAL OF
Bevacizumab plus Erlotinib for patients
Professor, Departments of Medicine and Division of General Surgery, was awarded
with recurrent malignant glioma.” For
Surgery, was awarded a grant from Novartis a grant from Tioga Pharmaceuticals Inc. for
information contact Diane Powers at 919Pharmaceuticals Corporation for “A single “Study evaluating two doses of Asimadoline
668-5498.
arm, Phase II study of RAD001 in patients on the duration of post-operative ileus.”
with metastatic, hormone-refractory prostate For information contact Mimi Chitty at s !MGEN )NC FOR h4WOSTAGE 0HASE )) STUDY
to evaluate the efficacy and safety of AMG
CANCERv AND FOR h/RAL ,"( ALONE AND IN 919-681-1471.
102 in subjects with advanced malignant
combination with IV docetaxel and oral
glioma.” For information contact Shanta
prednisone.” Dr. George was also awarded Claude T. Moorman III, MD, Associate
Anthony at 919-681-1695.
A GRANT FROM 0FIZER )NC FOR h35 IN Professor, Division of Orthopaedic Surgery,
combination with Taxotere and Prednisone was awarded a grant from Histogenics s .OVACEA FOR h0HASE )) MULTICENTER OPEN
label case-controlled (Part 1), randomized,
in patients with metastatic hormone refrac- Corporation for “Neocart Phase II clinical
active-controlled (Part 2) study of AQ4N,
tory prostate cancer” and for “Pilot study trial protocol.” For information contact Kate
in combination with radiotherapy and
of SunitiniB malate in patients with newly Babusiak at 919-684-3193.
Temozolomide, for safety, tolerability, and
diagnosed prostate cancer prior to prosactivity in subjects with newly diagnosed
tactectomy.” For information contact Ana David A. Reardon, MD, Associate Professor,
glioblastoma multiforme.” For information
Departments of Pediatrics and Surgery,
Garcia-Turner at 919-668-8816.
contact Karen Carter at 919-668-2329.
Division of Neuro-Oncology, was awarded
Sridharan Gururangan, MBBS, Associate grants from these companies:
Professor, Departments of Pediatrics and s .OVARTIS 0HARMACEUTICALS #ORPORATION FOR
“Imatinib Mesylate in combination with
Surgery, was awarded a grant from St. Jude
Temozolomide in patients with GBM.” For
Children’s Research Hospital for “A Phase I
information contact Waynette Freeman at
trial of Capecitabine rapidly disintegrating
919-684-3440.
tablets and concomitant radiation therapy
in children with newly diagnosed brain stem s 'LAXO3MITH+LINE FOR h! 0HASE ) )) OPEN
label, multi-center trials of Pazopanib
gliomas and high grade gliomas.” For informain combination with Lapatinib in adult
tion contact Shanta Anthony at 919-681-1695.
patients with relapsed malignant glioma.”
For information contact Shanta Anthony at
919-681-1695.
dukesurgery.org
13
FA C U LT Y N E W S
New Chief, Division of Pediatric General Surgery
Henry E. Rice, MD, Associate Professor, has been appointed Chief, Division
of Pediatric General Surgery for the Department of Surgery. Dr. Rice will
lead the Division of Pediatric General Surgery in its mission of offering comprehensive surgical care for infants, children, and adolescents, as well as
developing innovative advancements in pediatric surgery through groundbreaking research.
Dr. Rice’s areas of expertise include treatment of congenital malformations, neonatal surgery, pediatric oncology, and thoracic and abdominal surgery. He has
particular experience in the use of partial splenectomy for children with congenital hemolytic anemia.
$R 2ICE JOINED $UKE 3URGERY AS !SSISTANT 0ROFESSOR IN AND BECAME !SSOCIATE
Professor in 2005. He will continue serving as Director of Pediatric Trauma for Duke. Dr.
2ICE RECEIVED HIS MEDICAL DEGREE AT 9ALE 5NIVERSITY 3CHOOL OF -EDICINE IN COMPLETED
his general surgery residency at the University of Washington in 1996, and finished his
PEDIATRIC SURGERY FELLOWSHIP AT #HILDRENS (OSPITAL OF "UFFALO IN New Leadership in Education
Aurora Pryor, MD, Assistant Professor, Division of General Surgery, has
been appointed Surgical Director of the Surgical Education and Activities
Laboratory (SEAL). In this role, Dr. Pryor will lead Duke Surgery’s educational
efforts to teach students, residents, and practicing surgeons basic and
advanced laparoscopic, endoscopic, bronchoscopic, and other minimally
invasive surgery skills in the simulation laboratory and will work closely with
Drs. David Harpole, Vice Chair, Faculty Affairs and Education, and Marnelle
Alexis, SEAL Director.
Bryan M. Clary, MD, Assistant Professor, Division of General Surgery, has
been appointed Program Director of the General Surgery Residency Program.
Dr. Clary will work closely with Drs. David Harpole, Vice Chair, Faculty Affairs
and Education, and Paul C. Kuo, Professor and Chief, General Surgery.
Dr. Clary will assist Duke Surgery’s residency initiatives to ensure compliance
with the Accreditation Council for Graduate Medical Education (ACGME)
and GME policies and procedures, and develop a competency-based training program to enhance Duke Surgery’s educational opportunities.
NEW FACULTY
Duke University
Private Diagnostic Clinic (PDC)
Randall Mark Best, MD
Division of Emergency Medicine
Clinical interests include practice
of emergency medicine coupled
with medical-legal issues including medical malpractice and
regulatory law.
Contact Dr. Best at 919-684-5537.
James Keith DeOrio, MD
Division of Orthopaedic Surgery
Clinical interests include complete foot and ankle surgery
including ankle replacement.
Contact Dr. DeOrio at
919-684-6166.
Alexander Limkakeng Jr., MD
Division of Emergency Medicine
Clinical interests include adult
and pediatric emergency medicine, observational medicine,
and acute cardiac disease.
Contact Dr. Limkakeng at
919-684-5537.
Gloria Guifen Liu, MD
Division of Orthopaedic Surgery
Clinical interests include nonoperative management of spine
problems, lumbar rehabilitation
for musculoskeletal problems.
Contact Dr. Liu at 919-684-6403.
Mark L. Shapiro, MD
Division of General Surgery
Clinical interests include ventilator-associated pneumonia, shock
and resuscitation, blunt cerebrovascular injuries, thoracic trauma, hypertonic saline in sepsis, and trauma.
Contact Dr. Shapiro at
919-684-3636.
14
Summer 2007
HONORS :: AWARDS :: ACCOMPLISHMENTS
DUKE RANKS AMONG
TOP U.S. HOSPITALS
Duke Surgery Contributes
to Duke Hospital Honors
&OR THE TH YEAR IN A ROW $UKE 5NIVERSITY
Hospital has been named as one of the top
10 U.S. hospitals in the annual U.S.News &
World Report’s best hospital edition.
With an overall ranking of #7 for the second year in a row, Duke also ranked highly
in 15 specialty areas, with top 10 rankings
in 10 of them. Duke is the only hospital in
North Carolina and in the southeast, ranked
in the top 10. Duke Surgery specialties were
ranked as follows:
#6
#7
#8
#9
#9
#20
#23
Orthopaedics
Digestive Disorders
Heart & Heart Surgery
Cancer
Urology
Ears, Nose, Throat
Neurology and Neurosurgery
DUKE SURGERY HONORS AND
CONFERENCE ACTIVITIES
Peter K. Smith, MD,
Professor
and
Chief,
Division of Cardiovascular
and Thoracic Surgery, was
awarded the Distinguished
Service Award by the Society
of Thoracic Surgeons (STS),
established to recognize outstanding contributions to the Society. Under the diligent
leadership of Dr. Smith, who serves as
Chair of the STS/AATS (American Association
of Thoracic Surgery) Joint Workforce on
Nomenclature and Coding, new methodology was implemented to utilize data from
the STS National Cardiac Database to more
accurately capture time and acuity data for
the procedures most commonly performed
by cardiothoracic surgeons. This new methodology was a subject of great debate
both at the Medicare Relative Value Update
Committee (RUC) and at the Centers for
Medicare and Medicaid Services and was
ultimately approved by the RUC.
Steven A. Olson, MD, Associate Professor,
Division of Orthopaedic Surgery, was named
Chief Medical Officer of Duke University
Hospital. Dr. Olson joined the Department
of Surgery faculty in 2000 and also serves as
Chief of the Orthopaedic Trauma Service. In
these roles, and as Chair of the Perioperative
Executive Committee, Dr. Olson will continue
to direct numerous successful performance
improvement initiatives for Duke.
Jeffrey R. Marcus, MD, Assistant Professor,
Division of Plastic and Reconstructive Surgery,
was appointed Surgical Director of Duke
Children’s Hospital and Health Center. In this
capacity, Dr. Marcus will work closely with
Danny O. Jacobs, MD, MPH, Professor and
Chair, Department of Surgery and Henry
E. Rice, MD, Associate Professor and Chief,
Division of Pediatric General Surgery as well
dukesurgery.org
15
HONORS :: AWARDS :: ACCOMPLISHMENTS
as Drs. Joseph St. Geme III, Chair of Pediatrics,
and Dennis Clements, Chief Medical Officer
of Duke Children’s Hospital, to address
patient and staff needs. Dr. Marcus was also
awarded the Strength, Hope, and Caring
Award by Duke University Hospital after
receiving high praise from a child’s father
for treating his son and improving his child’s
health and well-being after no other physician would treat him.
William J. Richardson, MD, Professor,
Division of Orthopaedic Surgery, was
appointed Medical Director for the
Musculoskeletal Clinical Service Unit at Duke.
Dr. Richardson currently serves as Vice Chair
for Clinical Effectiveness for the Department
of Surgery and has been a leader for team
training and patient safety programs at Duke
University Hospital.
Gerald A. Grant, MD, Assistant Professor,
Division of Neurosurgery, was selected as
Editor in Chief of Clinical Neurosurgery,
a publication sponsored by the Congress
of Neurological Surgeons. Prior to joining
Duke Surgery, Dr. Grant served as Lieutenant
Colonel in the United States Air Force. Dr.
Grant served in Operation Iraqi Freedom as
a neurosurgeon providing expert neurosurgical care to the U.S. and coalition troops stationed in Balad, Iraq, during 2005-2006.
Danny O. Jacobs, MD, MPH, Professor and
Chair, Department of Surgery, was awarded
the David C. Sabiston Jr., MD, Professorship
from the Duke University School of Medicine.
Dr. Jacobs was also elected Vice Chair of the
Private Diagnostic Clinic (PDC) Administrative
Board at Duke.
16
Summer 2007
Ramon M. Esclamado, MD, Professor and
Chief, Division of Otolaryngology-Head and
Neck Surgery, was awarded the Richard
J. Chaney Professorship in OtolaryngologyHead & Neck Surgery from the Duke
University School of Medicine.
Thomas A. D’Amico, MD, Associate
Professor, Division of Cardiovascular &
Thoracic Surgery, won the 2007 Dwight
C. McGoon Award given by the Thoracic
Surgery Residents Association. The award
is presented annually at the American
Association for Thoracic Surgery meeting
and honors those who have significantly
contributed to resident education and the
practice of thoracic surgery.
Lisa Clark Pickett, MD, Assistant Professor,
Division of General Surgery, was appointed
General Surgery Division Chief for Durham
Regional Hospital.
Scott Pruitt, MD, PhD, Associate Professor,
Division of General Surgery, was elected
as a member to the Southern Surgical
Association. Dr. Pruitt was also awarded a
VA Merit Review where his grant received a
score in the third percentile.
Frank DeRuyter, PhD, Associate Professor
and Chief, Division of Speech Pathology and
Audiology, received a fellowship award during the November 2006 Annual American
Speech and Hearing Association (ASHA).
There are currently 120,000 active members
in ASHA and over the past 70 years, only
1500 members have been elected as fellows.
Douglas S. Tyler, MD, Professor, Division of
General Surgery, was appointed a new member
of the American Surgical Association in 2006.
Betsy Tuttle-Newhall, MD,
Associate Professor, Division
of General Surgery, was
awarded the Health Resources
and Services Administration
Medal of Honor for her work
in the Organ Transplantation
Breakthrough Collaborative by
acting U.S. Surgeon General
Ken Mortisuga, MD, MPH.
The award was presented at the 2nd National
Learning Congress on Organ Donation and
Transplantation. Dr. Tuttle-Newhall testified
in front of the North Carolina House of
Representatives subcommittee on patient
safety and organ and tissue donation/legislation. She was also awarded the Duke School
of Medicine Professional Award which is
given to faculty members who exemplify and
model professional behavior as voted by the
second-year medical student class.
Ashok K. Shetty, PhD, Professor, Division
of Neurosurgery, was selected
as an Editorial Board Member
of the journal Stem Cells, the
first journal devoted entirely to
the peer-accepted publication
of stem cell and regenerative
medicine research.
Stephen J. Freedland, MD,
Assistant Professor, Division of Urology, won
second prize in the American Urological
Association basic science essay contest.
Detlev Erdmann, MD, PhD, Assistant
Professor, Division of Plastic and
Reconstructive Surgery, was promoted to
Professor of the University of Heidelberg,
Germany.
Shu S. Lin, MD, PhD, Assistant Professor,
Division of Cardiovascular and Thoracic
Surgery, was selected by the American
Association for Thoracic Surgery to receive
the 2nd Dwight Harken Research Scholarship
for the period July 1, 2007, through June 30,
2009, for his research proposal, “The interactions of adaptive immune response and
innate immune pathways in the development of aspiration-induced chronic pulmonary allograft dysfunction.”
Michael M. Haglund, MD, PhD, Associate
Professor, Division of Neurosurgery, was
appointed the Scientific Program Chair for
the 2007 Neurosurgical Society of America
meeting. Dr. Haglund was invited by the
American Epilepsy Society to serve as the
Chair of the Epilepsy Surgery special interest
group for their next three annual meetings.
He was also selected by the Consumers’
Research Council of America for inclusion in
the 2006 edition of the Guide to America’s
Top Surgeons.
James R. Urbaniak, MD, Professor, Division
of Orthopaedic Surgery, and Virginia Flowers
Baker Professor, has been elected President
of the International Federation of Societies
for Surgery of the Hand at the triennial
meeting in Sydney. In addition he was honored with the Pioneer in Hand Surgery award
at the meeting. This award is given in recognition of leaders and major contributors in
the development, education, and practice of
hand surgery at the international level and
for dedicated services and unforgettable lifetime achievements in medicine. Dr. Urbaniak
was also named the Buncke Lecturer for
the 2007 annual meeting of the American
Society for Reconstructive Microsurgery.
L. Scott Levin, MD, Professor and Chief,
Division of Plastic and Reconstructive Surgery,
received the Duke 2007 Master Clinician/
Teacher Award which honors faculty for
their great accomplishments in both clinical
care and teaching. He also received an honorary fellowship award from the Colleges
of Medicine of South Africa for his dedi-
cated work on plastic surgery education. He
was also named Governor of the American
College of Surgeons.
Judd W. Moul, MD,
Professor and Chief,
Division of Urology,
was elected for a twoyear term as the Chair
of the Health Education
Council for the American
Urological Association. Dr. Moul was listed
in America’s Top Doctors 2006, Castle
Connolly’s acclaimed guide to the nation’s
top medical specialists for cancer, as well as
“Best Doctors 2006,” which is endorsed by
the North Carolina Medical Society.
Richard K. Osenbach, MD, Assistant
Professor, Division of Neurosurgery, received
the following honors: named Chairman,
Joint Section on Pain of the American
Association of Neurological Surgeons/
Congress of Neurological Surgeons; elected
to the Board of Directors, North American
Neuromodulation Society; elected to the
Board of Directors, American Academy
of Pain Medicine; elected to the Advisory
Committee for the American Medical
Association Guides to the Evaluation of
Permanent Impairment.
Alison S. Clay, MD, Assistant Professor,
Division of General Surgery, has been elected
to Fellowship by the American College of
Chest Physicians. Dr. Clay has been reappointed to the Education Committee for the
American Thoracic Society as well as placed
on the Clinical Practice Committee.
DUKE SURGERY FIRST
ABOVE & BEYOND WINNERS
Congratulations to the following Duke Surgery
employees recognized for their extraordinary
contributions to the Department:
Clinton A. Leiweke, Program Manager,
Fresh Tissue Lab, Division of Plastic and
Reconstructive Surgery, for his commitment
and dedication in facilitating the educational
mission of the Fresh Tissue Lab.
Stafford
Scott
Balderson,
Physician Assistant, Division of
Cardiovascular and Thoracic
Surgery, for his dedication to
the mission of teaching, research,
and patient satisfaction.
Cecilia Burns, Medical
Secretary, Division of
Otolaryngology–Head
and Neck Surgery, for
her ongoing commitment to helping others in the Division by
training numerous secretaries and giving generously of
her time and talents.
Stephen H. Johnson, Research Specialist,
Division of Orthopaedic Surgery, for his
important research contributions and exemplary role as veterinary technician and coordinator of resident and fellowship training in
the microsurgery research lab.
Dev M. Desai, MD, PhD, Assistant Professor,
Division of General Surgery, has been named
Head of the Duke Pediatric Abdominal
Transplant Program.
dukesurgery.org
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MISSION
The Department of Surgery is committed to excellence, innovation, and leadership in meeting the health care needs
of the people we serve, and fostering the very best medical
education, and biomedical research.
VISION
As one of the leading national and international academic
departments of surgery, we will assemble and integrate a
comprehensive range of health care resources providing
the very best in patient care, medical education, and clinical
research. As the health care providers of choice in the region, we will improve the health of the communities we
serve through the development of new and better models of
health care. Through careful stewardship of our resources, we
will preserve and promote our core missions of outstanding
clinical care, discovery research, and improved health for
the communities we serve.
Partners in Philanthropy
A gift to the Duke Department of Surgery is a gift of knowledge, discovery, and life. Every dollar is used to further our
understanding of surgical medicine, to develop new techniques, technology, and treatments, and to train the surgeons
and researchers of the future.
If you would like to make a philanthropic investment in Duke
Surgery, visit dukesurgery.org/gift or contact Elizabeth Vannelle phone: 919-667-2530 email: beth.vannelle@duke.edu
For Duke Surgery appointments call:
1-800-MED-DUKE (for referring physicians)
1-888-ASK-DUKE (for patients)
dukesurgery.org
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