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STFM 37th Annual Conference 2004
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Thursday, May 13
8:15–10 am
"Crisis, Caring, and Conscience"
Emily Friedman, Chicago
In this new century, family
medicine faces several serious challenges,
both internal and external.
Indeed, many clinicians are questioning
the very future of their chosen
path. But it is in times of crisis that
change is most possible, especially
when physicians of conscience look
beyond their own situation to the larger opportunities.
There are crises of access to care, insurance, racial
and ethnic disparities in health status, medical
profiteering, and ethics breakdowns. In such a maelstrom,
the family physician and those who teach him/
her must create a stable and safe harbor, for the sake
of us all.
Emily Friedman is an independent writer, lecturer,
and health policy and ethics analyst based in
Chicago. She is contributing editor of Hospitals and
Health Networks and contributing writer for the
Journal of the American Medical Association, Health
Progress, and other periodicals. She was contributing
editor and ethics columnist for the Health Forum
Journal from 1986 until July 2003. She is most noted
for her work in health policy, health care trends, the
social ethics of health care, issues associated with
managed care, health care for the underserved, health
care history, demographics, and the relationship of the
public with the health care system.
Ms Friedman has written more than 600 articles
and editorials in the past 24 years. She is the editor of
the books Making Choices: Ethics Issues for Health
Care Professionals, Choices and Conflict: Explorations
in Health Care Ethics, and An Unfinished Revolution:
Women and Health Care in America, and is author of
The Aloha Way: Health Care Structure and Finance in
Hawaii and The Right Thing: Ten Years of Ethics
Columns from the Healthcare Forum Journal. She is
currently writing a history of health care in the state of
Minnesota and also writes on health care for the World
Book Encyclopedia Yearbook and the Encyclopedia of
Bioethics.
She also serves as adjunct assistant professor at
the Boston University School of Public Health. She is a
consultant on information dissemination to the Agency
for Health Care Research and Quality, US Department
of Health and Human Services. She has made many
radio and television appearances, including "ABC
News Nightline."
She has won many awards and honors, including
being named an honorary life member of the American
Hospital Association, a fellow of the Association for
Health Services Research, and an honorary lifetime
fellow of the American Academy of Medical
Administrators. Her regular column, "Making Choices,"
in Health Forum Journal, has won the National Award
of Excellence from the American Society of Business
Publication Editors (the largest competition in US
business publishing) and the Gold Award from the
American Society of Healthcare Publication Editors
(the highest award that the Association grants).
Friday, May 14
8:30–10 am
Blanchard Memorial Lecture –
"Academia and the Care of the
Chronically Ill"
Edward Wagner, MD, WA MacColl
Institute for Healthcare Innovation at
the Center for Health Studies, Seattle
Edward Wagner, MD, is a general
internist/epidemiologist and director
of the WA MacColl Institute for
Healthcare Innovation at the Center
for Health Studies (CHS). He is also professor of health
services at the University of Washington School of
Public Health and Community Medicine. Current
research interests include the development and testing
of population-based care models for diabetes, frail
elderly, cancer, and other chronic illnesses, the
evaluation of the health and cost impacts of chronic
disease and cancer interventions, and interventions to
prevent disability and reduce depressive symptoms in
older adults. He has written two books and more than
200 journal articles. He serves on the editorial boards
of Health Services Research, the Journal of Clinical
Epidemiology, and British Medical Journal–USA (a
regional edition of BMJ), and acts as a consultant to
multiple federal agencies and private foundations. He
directs "Improving Chronic Illness Care (ICIC)," a
national program of The Robert Wood Johnson Foundation.
The overall goal of ICIC is to assist health
systems improve their care of chronic illness through
quality improvement and evaluation, research, and
dissemination. He is also principal investigator of the
Cancer Research Network, an NCI-funded consortium
of 10 HMOs conducting collaborative cancer effectiveness
research. He served as director of the CHS since
its inception 15 years ago until April 1998. He has
turned his energy toward directing the WA MacColl
Institute for Healthcare Innovation. This Institute,
within CHS, is concerned with developing and evaluating
health care innovations that serve the needs of the
chronically ill.
Saturday, May 15
8:30–10 am
"You Do WHAT Research in a
Family Medicine Department?"
Mary Marden Velasquez, PhD,
University of Texas HSC at Houston
Researchers from other disciplines
often find it surprising when
they learn of the wide range of studies
conducted in family medicine. Yet,
where else would we find a setting
where health problems as diverse as
smoking, HIV, diabetes, cocaine abuse, domestic
violence, and STDs are addressed? Our research
program in the Department of Family Practice and
Community Medicine at the University of Texas HSC at
Houstan uses the Transtheoretical Model of Behavior
Change (TTM) and Motivational Interviewing (MI) in a
majority of our studies. The TTM provides a method for
assessing and understanding behavior change and a
framework for developing interventions based on
patients’ readiness to change. Brief interventions
based on MI provide clinicians with strategies that can
be used to facilitate behavior change. Medical students,
residents, and fellows benefit from learning to
use these models in patient care, and the TTM and
motivational approaches provide fertile ground for
behavioral medicine researchers who are interested in
a variety of health problems. In this session, Mary
Marden Velasquez, PhD, will describe use of the TTM
and brief motivational interventions in her current
clinical trials in prevention of alcohol-exposed pregnancies,
STD prevention, and treatment of substance
abuse. She will also discuss use of the TTM in clinical
research and patient care by family medicine faculty,
residents and fellows, including work in diabetes,
pregnancy and smoking, advance care planning
directives, childhood obesity, and eating disorders.
Dr Velasquez is an associate professor in the
Department of Family Practice and Community
Medicine at the University of Texas Health Science
Center at Houston. For the past 15 years, she has
been involved in the conceptualization, design, and
implementation of research studies using the TTM.
Her area of specialty is the development and implementation
of interventions using the TTM's stages of
change and motivational enhancement. Recent work
has included development of stage-based interventions
in the areas of HIV prevention, respiratory health,
prenatal health, alcohol abuse, smoking cessation,
and prevention of fetal alcohol syndrome. A recent
emphasis has been on developing curricula for teaching
medical students and residents to use brief
motivational interventions in medical settings. She is
lead author on a stage-based treatment manual for
substance abuse, and author of numerous journal
articles and book chapters on using brief interventions
to facilitate treatment adherence and promote behavior
change in patients with a variety of health problems.
Dr Velasquez also has an extensive background in
Motivational Interviewing and is currently principal
investigator on several NIH- or CDC-funded studies
that use this approach. She is an internationally
recognized trainer in both MI and the TTM, and is a
past member of the steering committee for the International
Motivational Interviewing Network of Trainers.
Sunday, May 16
8:30–10:00 am
"Integrative Medicine and the
Future of Health Care"
Andrew Weil, MD, University of Arizona
Integrative medicine is healing oriented
medicine that takes account
of the whole person (body, mind, and
spirit) as well as all aspects of
lifestyle. It emphasizes the therapeutic
relationship and makes use of all
appropriate therapies, both conventional and alternative.
This is medicine our patients want, and it makes
economic sense. Integrative medicine emphasizes
prevention more than conventional medicine. It also
offers the promise of bringing into the mainstream
treatments that cost less and produce outcomes equal
to or better than many conventional ones. Embracing
integrative medicine does not mean abandoning
scientific method or ignoring the importance of evidence.
As momentum builds for this system, it is
important to find ways to introduce integrative medical
education into the training of physicians. A joint family
medicine residency/integrative medicine fellowship is
a logical and important step in this process.
Andrew Weil, MD, received his MD from Harvard
Medical School in 1968. After completing a medical
internship at Mt Zion Hospital in San Francisco, he
worked a year with the National Institute of Mental
Health, then wrote his first book, The Natural Mind.
From 1971–1975, as a fellow of the Institute of Cur -
rent World Affairs, Dr Weil traveled widely in North and
South America and Africa collecting information on
drug use in other cultures, medicinal plants, and
alternative methods of treating disease. From 1971–
1984 he was on the research staff of the Harvard
Botanical Museum and conducted investigations of
medicinal and psychoactive plants. At present, Dr Weil
is director of the integrative medicine program at the
College of Medicine, University of Arizona, the first
effort to change medical education to include information
on alternative therapies, mind/body interactions,
healing, and other subjects not currently emphasized
in the training of physicians. He also holds appointments
as clinical professor of medicine and clinical
assistant professor of family and community medicine.
He has a general practice in Tucson, focusing on
natural and preventive medicine and diagnosis.
Dr Weil is the author of many articles and of
several books: The Natural Mind; The Marriage of the
Sun and Moon; From Chocolate to Morphine; Health and
Healing; Natural Health, Natural Medicine; Spontaneous
Healing; Eight Weeks to Optimum Health; and his
most recent book, Eating Well for Optimum Health: The
Essential Guide to Food, Diet, and Nutrition.
Dr Weil also publishes a monthly newsletter, Dr
Andrew Weil’s Self Healing, maintains a popular Web
site, Ask Dr. Weil, www.drweil.com, and appears in
videos featured on PBS. A frequent lecturer and guest
on talk shows, Dr Weil is an internationally recognized
expert on medicinal plants, alternative medicine, and
the reform of medical education.