Moving forward

Recent months and actions in our state and nation have taught hard lessons about the senseless loss of life. When news spread of the circumstances of the death of Ahmaud Arbery in Brunswick, just a few miles from our Southeast Campus, our students felt fear and insecurity. The more recent death of George Floyd and surrounding events hammered home that we have not come far enough in this nation. How do we best move forward as a society and a medical school from here? Clearly change is needed, but what change? I am particularly glad that we have each other now as we work through this pivotal societal issue. Drs. Doug Miller, Renee Page, LaShon Sturgis and Vanessa Spearman-McCarthy along with Linda James and others from Academic Affairs, and I met this week with some of our student leaders to listen and to learn and I am grateful to our students for this. I promise that we will keep talking and listening and moving on this very difficult and persistent issue. And, I want to assure each of you here — each student, resident, fellow, faculty and staff member — that you are valued and loved and that the diversity among us is embraced and respected. That principle is inviolate and the core of MCG. 

Expanded emphasis on implicit and unconscious bias in our curriculum

One change that will happen is an expanded emphasis throughout our curriculum on bias and how it can both sneak and storm into our lives. Dr. Page, associate dean for curriculum, is leading this charge. These conversations and lessons have been there, just not emphasized consistently throughout our curriculum. Dr. Page, who shares that her own family has experienced bias, says these important, hard discussions are not for big lecture halls but for small groups that better enable frank conversations. While she is still working on the details, our increased emphasis on case-based learning, which, like good story telling, tends to be more impactful because it puts medical education in the context of an individual and his or her circumstances, is a great fit for this and for our students who will go forward to be leaders wherever they land. I know this effort will be great because Dr. Page is committed to it, to our students and to MCG. There will be more as we think logically through how we help make change in each aspect of our tripartite mission of education, science and service, as well as society. Please share with me or Drs. Page or Miller or other MCG leaders, your insights about how, as a medical school, we can be better and help others be better as well. And please know that I believe diversity is a fundamental strength of MCG and of society.

Developing program will directly address health disparities in Georgia

As physicians, we focus on “health care” but “health” is much more than health care. Last December, a growing group of us began meeting to strategize about how we could better address the “health” of what I often refer to as the “Other Georgia.” Most of you know that our state has more than 10 million residents with about 5.8 million people living in the Atlanta metropolitan area alone. But I am talking about the rest of us, the Georgia outside the perimeter. Our health is affected by socioeconomic determinants, like whether we graduated from high school, our income and overall family situation, and behaviors like whether we smoke, exercise and our food choices, as well as where we live. Zip code rather than genetic code is the major determinant of health in these regions of our state. In these regions, top killers like hypertension, heart disease, stroke and cancer, and now COVID-19, can occur and kill disproportionately and blacks are particularly impacted. There is nothing more tragic than taking care of a 40-year-old black man who has had a severe, disabling stroke that simple control of his hypertension could have prevented. Our partners in this include Georgia State University, the state’s largest university by enrollment, as well as our well-established regional campuses, the 18 Georgia Public Health Districts, the Federally Qualified Health Centers and Area Health Education Centers (AHEC) across our state.

Georgia State University, public health centers are key partners in the effort

Together we are forming the Georgia Research Institute in Translational Science, or GRITS, an “Other Georgia” focused initiative that will target patients and communities with poor health measures and outcomes. We will bring better care to these folks that starts before children are born and increase access to not just health care but innovations in care like clinical trials. This work will enable all of us to learn even more about the diverse population of our state, the health disparities that afflict, and to develop even better strategies to address disparities. It will also enable us to help educate and inspire a new generation of providers who will carry on this tradition that we are privileged to help start. The hard-working core group plans to submit a Clinical and Translational Science Award grant application to the National Institutes of Health by this December. You will be hearing plenty more on this in the coming months and years. But already there is way too long a list of key players to mention here. I do want to thank my co-chair Dr. Mike Diamond, AU senior vice president for research, and Georgia State University co-chairs Dr. Michael Eriksen, interim vice president for research and economic development and founding dean of the GSU School of Public Health, and Dr. Kelly Stout, assistant vice president for research operations and strategic initiatives, for their commitment to this important initiative for Georgia and Georgians. 

COVID-19 highlights the disproportionate impact of disease

COVID-19 has made headlines with its disproportionate effects on certain populations, in this case that includes those with disabilities, racial and ethnic minorities, older individuals and essential workers like many of you. While COVID-19 is still very much with us, you can begin to feel everyone shaking off the dust a bit as businesses stir back to life and our own clinical, research and educational operations begin to resume more normal approaches. Still it is a new normal as we all work to pick up our lives and work and education safely. Please let me thank each of you again for your innovativeness and diligence over the last few months in keeping MCG moving. Per your usual, you have shown great leadership skills here and nationally in ongoing efforts to define a new and evolving normal.

Dr. Satish Rao serves on national task force on reopening of motility clinics in COVID’s wake

We have covered in these writings before the major research initiatives of Dr. Satish S.C. Rao, in debilitating conditions like fecal incontinence and other gastrointestinal motility problems. I am now pleased to share that this J. Harold Harrison MD Distinguished University Chair in Gastroenterology, who directs neurogastroenterology/motility and the Digestive Health Clinical Research Center here, is among a dozen leaders comprising the American Neurogastroenterology and Motility Society Task Force organized to establish guidelines for the reopening of more than 120 motility laboratories like ours across the country. These guidelines include things like when to do COVID-19 testing, determining urgency of and scheduling motility procedures, optimizing personal protective equipment, enabling social distancing in both waiting spaces and procedure rooms and additional efforts to clean and prepare the space for patients. While it’s hard to imagine Dr. Rao has time to do another thing, we agree he was a great choice for how to safely and efficiently get back to business. Please note that Dr. Rao has also served as president of the American Neurogastroenterology and Motility Society.

MCG graduate Dr. Matt McClain enables cutting edge COVID care in Rome

Tough times can be a difficult but determined educator, sometimes pushing each of us to do even more. Take 2000 MCG graduate Dr. Matt McClain. He is a radiologist in Rome, Georgia, who teaches our third- and fourth-year students at our Northwest Campus based there about this field that enables us to peer into the body, enabling better diagnosis and treatment. Like so many of you, COVID-19 made him want to help and helped him see a bit outside his box. Dr. McClain wondered if the convalescent plasma therapy we discussed here recently, which provides antibodies from those who successfully fought off the novel coronavirus to very sick individuals still fighting the infection, could help his community. Early on he began filling out the extensive Investigational New Drug application that he hoped could help bring this therapy to his community.

Dr. McClain is a PI on Mayo Clinic’s expanded access protocol for the treatment

Great story short, he worked with Rome Radiology president Dr. Kirk Kizziah, a Mercer School of Medicine graduate; retired radiologist Dr. Bill Harbin, a Vanderbilt graduate; infectious disease physician Dr. John Hostetler, a Medical College of Virginia graduate; fellow MCG graduate Dr. Gary Voccio, a pulmonologist and critical care specialist, who is now health director for the Department of Public Health Northwest District also based in Rome; and Ann Hook, former oncology services director at Redmond Regional Medical Center, to build a strong coalition that could enable a convalescent therapy program at Floyd Medical Center and Redmond. Along the way, he found the quickest route to this treatment for his community was actually becoming a principal investigator in the Mayo Clinic’s expanded access protocol, which he now is. As we plan to make happen with our developing GRITS, this significant effort made this novel treatment available to people where they live. Also like our plans for GRITS, Dr. Leonard Reeves, associate dean of our Northwest Campus, reached out to offer the help of our students and residents. Dr. McClain even founded a nonprofit called Plasma Therapy to help collect the antibodies while his son Jack, who is in premed at UGA, built a website and Facebook page to help solicit financial support. That is some serious teamwork. Thank you Dr. McClain and Rome. 

Please continue to take good care of yourselves.