MEDICAL COLLEGE GEORGIA OF Our health care team members don'tjust save lives. Advertising Directory They have lives. Aquinas High School Augusta Preparatory Day School . Charles Schwab 9 . . . • Episcopal Day School 1: Open MRI ofGeorgia Back cover . . Currently recruitingfor Richard Ret Thispage all Health Professions Robinson-Humphrey The Navy Medical Corps is more than a practice, it's a way oflife. 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Richard Ret accounting is SIMPLER • practice management is (706) 868-1000 MORE EFFECTIVE • insurance billing is FAST and (800) 755-3632 ACCURATE • EASYto LEARN and USE • managed care is made MANAGEABLE piANCHARD&(ALHOUN www.augustahouses.com SIMPLE COMPUTER SOLUTIONS (706) 261-6917 DAY MEDICAL COLLEGE GEORGIA OF T What do you see when you At a Glance 2 peer into a baby's face, other New treatmentsforsickle cellpain andpediatric cancers are among the items than chubby cheeks and making news at the Medical College ofGeorgia. button noses? Medical College of Critical Steps 4 Georgia School ofNursing research has Tlic Medical College of Georgia is making the tough calls needed to optimize its tapped into the world ofsecret signals clinical, educational and research missions. babies use to communicate with their Retooling for the 21st Century 6 mothers,often via their expressions.This MCG edition ofMedical College ofGeorgia President FrancisJ.Tedesco reflects on thefuture ofthe university. Today describesjust how important this Baby Face 10 communication is to the bonding Nursing research is studying the importance offacial expressions to the process. mother-infant bond. There are no secret signals in U.S. Stress Test 14 Medical Licensure Examinations,but MCG that doesn't make the tests any less mad- Take apeek at aplace where only the bravest dare to tread: the dening for medical students.We invite School ofMedicine testing sitefor national licensure. you to learn how MCG students cope Stopping to Smell the Roses 18 with the ultimate test ofnerves.And Dr. Paul Stanton (School ofMedicine, '69) has a fullplate aspresident ofEast read about one test-taker in particular: Tennessee State University, but he's never too busy toforget what's important in life. artist/medical student Marti Haykin. The Fitness Factor 20 The licensure test was no day at the A/CG'5 new wellness center will soon be a reality. beach for Marti,but this remarkably Plan Your Giving 21 talented young woman has seldom walked away from a challenge. Charitablegifts of life insurance. Yet another member ofthe MCG AlumNews 22 family who thrives on challenge is Dr. News from MCG'sfive alumni associations. Paul Stanton,a School ofMedicine alumnus and president ofEastTennessee State University.The surgical suite MCG President: FrancisJ.Tedesco,M.D. Editor: ChristineHurleyDcriso Executive Editor: fames B. Osborne,Ed.D. Art Director: BrentD. Burch prepared him well for his unflappable DirectorofMarketing Photographer: PhilJones approach to academia. Meet him in this and PublicRelations: Dale Crail MCG edition of Today. Also included in this edition ofthe ©2000,Medical College ofGeorgia.The Medical College ofGeorgiaisthe states'health sciences university.Focusingon health care education,research andpatient care,theAugusta-basedinstitution magazine is an update on MCG's efforts consists ofMCG Hospital,morethan 80supportclinics,statewide outreach programs and the Schools of to ensure ample clinical experience for Allied Health Sciences,Dentistry,Graduate Studies,Medicine and Nursing. its students.As MCG President Francis Medical CollegeofGeorgiaTodayissponsoredby grants fromMCG Foundation.Inc.andthe MCG School ofMedicineAlumniAssociation.It isproducedby the Division ofInstitutional Relations; JU.nTievdeerssciotypAodidnrtessso,utevienrhyisdeSctiastieonofisthe AMuegduisctaalMCaoglalzeignee,of(7G0e6o)rg7i2a2;-5Au8g3u3s,taP.,OG.eoBrogxia1430059,1A2u.gAudsvtear,tiGseionrggiinaqu3i0r9i0e3s.sPhuobullidshbeeddqiuraerctteerdlyt,oMCG firmly rooted in the best interests of Todayis furnishedto alumni andfriends ofMCG withoutcharge.The appearance ofadvertisements in MCG's most valuable asset: its students. stheirsvipcuebsliacdavetritoinseddo.es notconstitute an endorsementby the Medical College ofGeorgiaofthe productsor GLANCE AT A Pinpointing Pain hematologist/oncologist and director ofMCG's Comprehensive Sickle Cell Center. Crises also can be precipitated by such events as illness, emotional Whether a drug that lubricates the stress or a change in weather which affects the surfaces ofred blood cells and blood tone ofthe blood vessels. vessels can alleviate the pain ofa sickle "This is notjust a painful nuisance. Long-term cell crisis is under investigation at the studies show that those with more frequent pain Medical College ofGeorgia Comprehensive Sickle have more organ damage and die at an earlier age," Cell Center. Dr. Kutlar said. Symptoms are treated with pain MCG is one of40 centers nationwide evaluat- medication. ing the effectiveness ofFLOCOR-a drug used to FLOCOR is given intravenously for 48 hours, treat heart attacks-in reducing the pain that results during which time patients are monitored closely when blood flow is restricted by sickle-shaped red in MCG Hospital and pain levels recorded. Studies blood cells sticking to each other and to blood also are done to determine how long FLOCOR vessel walls. stays active in the body. Another sub-study is A sickle cell crisis results from extensive looking at the drug's use in acute chest syndrome, blood deprivation to the arms,legs, organs,bones a combination ofinfection and sickling in the lungs and bone marrow, said Dr.Abdullah Kutlar, ofsickle cell patients, which can destroy both lungs. 2 MEDICAL COLLEGE OF GEORGIATODAY New Cancer Program HPV and have had only normal Pap smears. About 70 types ofHPV exist and are a Shafqat Shah, a pediatric hematologist- common cause ofgenital warts, said Dr. Daron G. Dr.oncologist, has implemented a new stem Ferris,MCG principal investigator on the vaccine and bone marrow transplant program at study funded by Merck. the Children's Medical Center. The new vaccine is for HPV 16, the most com- Potential transplant candidates include children mon ofsome 20 types ofthe virus that raise the risk with almost any type ofcancer that resists standard ofcervical cancer."Ifwe can prevent women from treatment, recurs or spreads.Typically only getting infected with HPV 16 and other oncogenic extremely high doses ofchemotherapy or radiation HPV types, [we'll have] the first vaccine to prevent will destroy these cancers,but at the price of cancer ofthe lower genital tract,"Dr. Ferris said. destroying bone marrow."But ifyou can give that treatment, eradicate all the last tumor cells then rescue the patient by giving stem cells,you may be Less-Invasive Treatment A able to cure a patient,"Dr. Shah said. Bone marrow produces blood components. technique that targets the "sentinel" lymph Stem cells, the 'mother' cells ofbone marrow, are node to which breast cancer is most likely found in the marrow and circulating in the blood. to spread may give women the option of The aim ofeither a stem cell or bone marrow having less tissue removed from under their transplant is to provide a fresh supply ofstem cells arm, reducing the discomfort and disability that to repopulate the bone marrow. often follows surgery. With an autologous transplant, a child's own Standard breast cancer surgery includes remov- bone marrow or stem cells are retrieved before ing nearby lymph nodes under the arm to check high doses ofchemotherapy or radiation are given. for cancer, said Dr. Rory R. Dalton, chiefofthe Afterward, the child gets the marrow or stem cells surgical oncology service at the Medical College back intravenously. Other times a sibling, other ofGeorgia. But only about 30 percent have cancer relative or a donor who is simply a good genetic that has spread to the nodes.Those 30 percent of match is used. women must know it has spread to help determine treatment, Dr. Dalton said. But now doctors may identify those women by applying techniques Battling Back Pain developed for melanoma. Since skin and breast lymph nodes are easy to The Medical College ofGeorgia is one access,surgeons can inject a radioactive substance ofseveral U.S. sites studying whether in the tissue near the tumor in the breast or the botulinum toxin, a bacterium that weakens melanoma.They watch with a camera as the muscles, can ease back pain resulting from substance moves to the lymphatic system, the same excessive muscle contraction. path a spreading tumor would take.They then use "When you want to move a muscle, [the body a hand-held probe to determine the radioactive fires] a motor neuron.That signal travels to the end substance's first stop.There they make a small inci- ofan axon terminal, releasing a neurotransmitter sion and take outjust that lymph node, rather than that allows the muscle to contract,"said Dr. Michael the 15 to 30 that are routinely removed."[That MCG H. Rivner, director ofthe electromyography node is] the guard at the gate ofall the other laboratory. Botulinum targets axon terminals, lymph nodes.That is the node most likely to have interrupting this normal contraction process. tumor in it ifthe cancer has spread from the main tumor and through the lymphatics,"Dr. Dalton said. So surgeons remove the sentinel lymph node HPV Vaccine Tested and pathologists check it for tumor cells. As part ofthe continued evaluation ofthe new MCG he Medical College ofGeorgia is testing biopsy approach, is participating in a study a vaccine against human papilloma virus,a protocol sponsored by the University ofLouisville common sexually transmitted disease that is in which women who have the biopsy procedure a major risk factor for cervical cancer. also have the more standard dissection.About The vaccine-developed by the Merck Research 1,000 women nationwide will participate in the Laboratories and CSL, anAustralian biotech com- study in which the findings ofbiopsy and pany-is being studied nationwide in a three-year dissection can be directly compared by looking at trial in young, healthy women who do not have the results ofboth in the same woman. VOLUME 28, NUMBER 2 /WINTER 2000 3 u CRITICAL STEPS 1/1 UJ to ensure a to patient base that sustains MCG's < u educational, research and clini- cal missions. u The Board of CRITICAL STEPS Regents has MCG authorized IS) CL Health, Inc., a HI 501(C) (3) not-for-profit entity created in solely to support MCG's educational, research and patient care missions. Its 5 MCG board consists ofregents, officials and community members. Over the last year, Don Snell, president and chief u MCG executive officer of Health, Inc., CRITICAL STEPS has thoroughly assessed the local, in regional and statewide health services CL MCG UJ environment and Hospital and I- bursement.The Clinics' financial status."Unless MCG 1/1 shortfall is expected Hospital and Clinics is able to restruc- < U to grow consider- ture and assemble a new health system, H ably within a few it is going to face increasing financial E years.The Board of difficulties," said Mr. Snell. MCG u Regents has The Health, Inc. board on Peggy O'Leary Seigler CRITICAL STEPS approved actiMonCs G Oct. 12 approved Mr. Snell's plan to requested by create an integrated delivery system. MCG CL President Francis Under the plan, Hospital and J. UJ MCG MCG Tedesco to address Hospital and Clinics (including Hospital, the m — Clinics' immediate deficit an estimated Children's Medical Center, Georgia — < $22 million in fiscal 2000 through RadiationTherapy Center and Georgia u cost reduction, increased hospital fees WarVeterans Nursing Home) will be MCG (still the lowest in the region) and an managed by Health, Inc.,which S MCG early-retirement option for will operate as a cooperative organiza- u employees which results in savings to tion under the Board ofRegents. CRITICAL STEPS the institution without adding costs to The Physicians Practice Group, theTeachers Retirement System.These MCG's School ofMedicine faculty OL UJ steps, when fully implemented, along practice group, will continue to operate J— he Medical with a one-time increase in indigent- as a separate entity."We agree with the MCG College of care trust funds recently authorized by direction in which Health, Inc. is <u Georgia and Georgia Gov. Roy Barnes, will help going,"said Dr. Curt Steinhart, PPG MCG the University reduce the immediate deficit. president and Health, Inc. board System ofGeorgia Additionally, the Board ofRegents is member."The faculty is fully behind it. u Board ofRegents have requesting $5 million in the fiscal 2000 It is the best vehicle to accomplish the ITICAL STEPS taken critical steps this supplemental budget to help alleviate tripartite mission ofthe Medical year to optimize the problem. College ofGeorgia." MCG's efforts in However,because the same circum- The plan calls for revising the cur- health sciences educa- stances creating the fiscal 2000 shortfall rent management structure and recruit- tion, research and patient care. will cause additional serious shortfalls in ing and developing a new management MCG Hospital and Clinics, along the next two years and beyond, other team.Team members will include a with other teaching hospitals nation- long-term steps are necessary.These chieffinancial officer, chiefmedical offi- MCG wide, have suffered a well-documented steps will enable Hospital and cer, chiefinformation officer,vice presi- decrease in resources stemming from Clinics to partner and collaborate with dent for human resources and vice reduced federal and third-party reim- regional and state health care providers president for strategic support. 4 MEDICAL COLLEGE OF GEORGIATODAY and workforce reductions, according to MCG Health, Inc. Board Mr. Snell. Savings generated by the early-retirement program, approved by the Board ofRegents inAugust, will Mr.Thomas F. AUgood Sr., Chairman depend on how many ofMCG's 757 (Regent) eligible employees opt to retire and on how many oftheir positions must be Mr.TomJ. ColemanJr. refilled. If50 percent ofthose eligible (Regent) sign up for early retirement and 40 percent oftheir positions are refilled,the Mr. Charles H.Jones savings would be $9.1 million in the first (Regent) year ofthe program's implementation, said MCG President FrancisJ.Tedesco. Mr. Donald M. LeebernJr. Cumulative savings of$130 million (Regent) could be realized over a 10-year period. A plan for staggering departures and Dr. LindsayA. Desrochers criteria for replacing necessary positions (Chancellor appointee) MCG is being monitored by an committee headed by the vice presi- Mr. D. Douglas BarnardJr. dents for fiscal affairs, academic affairs (community member) Don Snell and business operations.The Board of Regents also will review the process. Dr. George Gowder MCG The Board ofRegents and Only positions essential to operations (community member) Health, Inc. are developing final agree- will be replaced. MCG ments for managing and operating To further control costs, Dr.Julius Scott MCG Hospital and Clinics."Under the Health, Inc. plans to renegotiate the (community member) agreements, all hospital and clinic facili- purchase ofmany campus services. ties will remain under Board ofRegents Some campus services provided to the Dr. FrancisJ.Tedesco MCG ownership and will operate under lease Hospital and Clinics may be (Medical College ofGeorgia) MCG arrangements with Health, Inc.," eliminated; others may be reduced. MCG said Mr. Snell. Patient fees and other Health, Inc. will also provide Dr. Darrell G. Kirch MCG revenues supporting Hospital and some services back to the campus. (Medical College ofGeorgia) Clinics will continue that support under The plan calls for a continuum of MCG a contract between Health, Inc. care with an expanded primary-care Dr. Curt N. Steinhart MCG and the Board ofRegents. network, development ofsub-acute care (Medical College ofGeorgia) employees with an investment in the units, exploration ofa pulmonary unit, Teachers Retirement System can remain improved home health relationships and Mr. Don Snell MCG employees ifthey choose,but improved hospice relationships.The (ex officio) will provide services under contract system also plans to explore the MCG with Health, Inc."The manage- development ofclinical centers of Ms. Patricia Sodomka ment and operation ofthe hospitals excellence in pediatrics, women's (ex officio) and clinics will,by agreement, maximize health, cardiovascular services, cancer, education and research activities of neurosciences, musculoskeletal health, Mr.Thomas KellyJr. MCG the faculty and students,"said occupational medicine and gerontology. (ex officio) Mr. Snell. Another goal is installing enterprise- The master affiliation agreement wide information systems. between the Board ofRegents and The plan also calls for better MCG MCG Health, Inc.should be complete indigent-care management."The public To contact Health, Inc.: and presented to the Board ofRegents does not realize what a financial burden for action byJan. 12, according to Mr. uncompensated care is for our hospital," Telephone: (706) 721-6804 Snell. He plans to fully implement the said Mr. Snell.The plan will continue a plan byJuly 1, the beginning ofthe public education campaign, ask for Web site:www.mcg.edu/news/transition next fiscal year. increased state support and provide Even after aggressively managing more efficient care delivery and work E-mail: [email protected] MCG attrition and early retirement, with the state to develop a statewide Health, Inc. will likely face management approach to the increasing problem. VOLUME 28, NUMBER 2 / WINTER 2000 5 With less than six weeks until our last December 31 ofthe 1900s, I'm sure we've all heard our fair share of"year 2000-isms." So I promise not to use cliches such as ASTADTE ODF TRHE UENIVSERSSITY "paradigm shift" or"new millennium" anywhere in this speech. I would, however,like to talk about retooling for the 21st century I admit that comes dangerously close to cliche. Each year, the State ofthe University Address is my opportunity to give an MCG account ofour stewardship of and to renew our vision for the future. So I'd like to begin by posing two questions:Why are we here? And how are we doing? As articulated in our mission state- ment,we're here to provide outstanding Retoolin educational programs for health pro- fessionals, biomedical scientists and educators at the undergraduate, graduate and postgraduate levels.Were here to provide a high-quality, state-of- the-art health care system and to encourage, test and improve access Century through the use ofinnovations in health 21st care delivery.And we're here to be a leading center ofexcellence in research through the generation and application ofbiomedical knowledge and tech- nology to human health and disease. Dr. FrancisJ. Tedesco How are we doing?That's the more President, Medical College ofGeorgia difficult ofthe two questions.We're near the conclusion ofour SACS institution- al self-study process, which involved MCG more than 200 members ofthe community. Occurring once every 10 years, the self-study process provides the opportunity for us to review and analyze the academic, research, clinical and administrative functions ofthe institution in our effort to continuously enhance the effectiveness ofour operations. Never an easy task, this assessment took place during a period ofsignificant change for our institution and academic health centers in general. One ofthe synonyms for change is evolution.Another is renewal. Regener- ation. Innovation.Whatever word we choose, change can be unsettling and discomforting. Nonetheless, the self- study committees and working groups, under the guidance ofthe steering committee, conducted a thorough 6 MEDICAL COLLEGE OF GEORGIATODAY assessment ofthe campus.While we drawbacks also present an opportunity identified areas that need some work, ...an opportunity for us to create a You'll be glad we're very much anticipating the visit more contemporary, more efficient to hear ofour Reaffirmation ofAccreditation institution ...an opportunity for us to team in late February. truly change, in positive and innovative about our new One ofthe most tangible manifesta- ways, how we educate our students, CD callable tions ofchange on our campus today is conduct research and provide care to early retirement. our patients. As you know. We didn't emerge 7.67% MCG, as an academ- as one ofthe nation's ic health center, is MCG oldest medical facing a financial cri- Since s schools by buckling sis which is expected to challenges. Look Annual Percentage to continue into inception in 1828, at our history'We Yield (APY)* Callable future years. survived a four-year Certificates of Deposit Academic medical closure during the centers across this we've educated more War Between the country are experi- States.We survived • FDIC insured to 5100,000 per depositor, per institution** encing declining Flexner's 1909 report patient volumes and than 25,000 physicians, on medical educa- • Interest paid semi-annually patient care revenues. tion.We survived the • Final Maturity in 15 year - 08/19/14 The Federal dentists, nurses, Depression, when • Non-callable for 2 years Balanced BudgetAct the nationwide @ and managed care's financial crisis • Callable thereafter 100 par reduction in biomedical scientists prompted a regents' Call reimbursement to decision to close the teaching hospitals and allied health medical school.And Jerry Rogers, 2ndVP Investments has placed financial we'll survive this. or strains on our We'll continue to Rick Cundey, 2ndVP Investments institution. professionals. devise ways to com- 706-724-2601 • 1-800-241-2401 After careful bat these financial review, I recom- Today, were admitting problems.We have mended the early- received a one-time Robinson-Humphrey retirement plan to SI2.9 million dollar A Subsidiary of Salomon Smith Barney the Board of the highest-caliber grant from the state Regents because I to help offset the OneTenth Street believe that ofthe immediate budget Augusta, GA 30901 students in the options available for deficit. downsizing the This grant was TheCD isnon-callableforthefirsttwoyears, workforce, this has institution s history. one in a number that and thencan becalledeven'sixmonthsthere- the least negative » was awarded to afterbythe issuingbank.Thefinal stated effect on our MCG public hospitals maturityis08/19/14, Minimum deposit SI,000, Subjecttochangeandavailability. family.The Internal throughout the state Althoughweare not requiredtodoso,we Revenue Service is that had not been endeavortoprovideasecondarymarketso considering the plan, fully reimbursed for that theprincipalamountinvested. (APYasof and we should have a what they had spent 08/19/14). decision early next year. on indigent care. "APYinterestcannot remain ondeposit in the sameCD; Interestwillbepaidsemi-annually. What are the drawbacks ofoffering In addition, in the upcoming "FDICinsurancecoversamaximum amount early retirement to address a budget supplemental budget process, the Board of5100,000perdepositor, perinstitution shortfall? Surely the loss ofa tremen- ofRegents has proposed a S5 million (includingprincipal and interestcombined) in dous amount ofinstitutional memory item to help offset the hospital's fiscal each insurablecapacity. and intellectual talent will be felt for a 2000 shortfall. SalomanSmithBarneyisaservicemark time.And those that remain at the So let's not become paralyzed by ofSalomanSmithBarneyInc. institution will have to do the same this issue, one that is actively being 1999 Smith BarneyInc. MemberSIPC amount ofwork with fewer colleagues addressed,when we have so many good AMemberofCingrou to assist them. But I contend that these things to celebrate. VOLUME 28, NUMBER 2 / WINTER 2000 7 — a Augusta Preparatory AQUINAS Day School HIGH A Community of Learners p Ek s. m 4 h 1 (Preserving our (Past...Securing our future... SRA'S only Catholic High School" • Safe, nurturingenvironment with beautiful, newfacilities Spiritually and • 100% College attendance • Outstandingfaculty academically prepared. • 25%oftheclassof2000receivedNationalMeritrecognition FinancialAid&Scholarshipsavailable • Oneofeightschools inGeorgiaselectedasaCumLaiideschool Aquinas High School 3* 2 years - Grade 12 1920 HighlandAvenue Augusta, GA 30904 Accepting Applications for the 2000-2001 school year (706)736-5516• Fax:(706) 736-2678 706.863.1906 apds.com Emailaddress:[email protected] WebPage:www.gabn.net/aquinas APDSpracticesanon-discriminatoryadmissionspolicy. Since MCG's inception in 1828, made significant and historic contribu- The regents' fiscal 2001 budget we've educated more than 25,000 tions to the body ofscience. proposal includes $4 million for a bio- MCG physicians, dentists, nurses, biomedical researchers have conducted medical sciences collaboration between scientists and allied health professionals. research that led to breakthroughs such the University ofGeorgia and MCG. Today, we're admitting the highest- as fertility pills, birth control pills and By combining the expertise of faculty at caliber students in the institution's beta-blocking drugs.This year, our both institutions, Georgia can become history.And our students are being sponsored awards surpassed $28 million more competitive for federal support. taught by outstanding faculty.You are in direct and indirect costs. Our sickle This collaboration is the first phase in a talented, motivated group. cell program is world renowned. creating a statewide Biomedical Services Since 1988, the institution has And in the biomedical sciences, Network, which draws on and leverages invested more than $300 million on researchers in our Institute ofMolecular university system resources for recog- new construction and major renovation: Medicine and Genetics recently nizing, treating, curing and preventing theAmbulatory-Specialized Care identified the mechanism that enables a human disease. Center, the children's hospital, our fetus to avoid rejection by the mother's A change.A different approach. multidisciplinary research building, the immune system.This finding may lead Retooling for the 21st century. — Sports Medicine Center, to name a few. to new treatments to combat infectious The Georgia Research Alliance A $35 million nursing and allied health diseases and better immunosuppressive strategic partnership ofGeorgia's education building is on the state of therapy for transplant patients.The research universities,busi—ness communi- Georgia's capital priority list.We're also Vascular Biology Center is gaining ty and state government recently ear- building a 42,000-square-foot wellness increased understanding ofthe many marked funding for completion ofthe center for students and faculty. functions ofnitrous oxide, including its second phase ofour research building in Foun—dation assets have topped $100 role in relaxing blood vessels.These its proposed budget.And with our new million a tenfold increase since 1988. biomedical research strengths are vice president for research in place to And,since 1990,we've established over the foundation ofan exciting new oversee these research developments, 20 endowed chairs, representing each of initiative designed to link the great things are in store for us. One of our five schools. expertise and resources ofuniversity Dr. Kluger's initiatives is to improve As a research university,we have system institutions. MCG's technology transfer program 8 MEDICAL COLLEGE OF GEORGIATODAY