By Dave Steger

Welcoming New Faculty: Jeffrey J. Siracuse, MD, RPVI

July 8th, 2014 in Faculty News

Siracuse_JeffreyJeffrey J. Siracuse, MD, RPVI, Attending Surgeon, Division of Vascular and Endovascular Surgery, Boston Medical Center and Assistant Professor of Surgery and Radiology, Boston University School of Medicine, received his medical degree from New York Medical College in Valhalla, NY. He completed his residency in General Surgery at Beth Israel Deaconess Medical Center/Harvard Medical School, research fellowship in the Harvard-Longwood Vascular Research Training Program,  and his clinical Fellowship in Vascular and Endovascular Surgery at New York-Presbyterian Hospital/Columbia University College of Physicians Surgeons and Weill Cornell Medical College. He is board certified by the American Board of Surgery.

His research and clinical interests include minimally invasive and open treatment of aortic aneurysms, critical limb ischemia, cerebrovascular disease, dialysis access, thoracic outlet syndrome, and venous disease.

Welcoming New Faculty: Teviah Sachs, MD, MPH

July 8th, 2014 in Uncategorized

Sachs_TeviahTeviah Sachs, MD, MPH, Attending Surgeon, Section of Surgical Oncology, Boston Medical Center and Assistant Professor of Surgery, Boston University School of Medicine, received his medical degree from New York Medical College in Valhalla, NY. He completed his residency in General Surgery at Beth Israel Deaconess Medical Center/Harvard Medical School and a Fellowship in Surgical Oncology at Johns Hopkins Hospital in Baltimore, MD. He is board certified by the American Board of Surgery.

His clinical interests include alimentary tract surgery with a special interest in hepatic and pancreatobiliary disease.   He completed a Masters of Public Health in clinical effectiveness and his research interests pertain to surgical outcomes and surgical education.

Dr. David McAneny, Vice Chair, Department of Surgery featured in Reuters Health discussing BMC’s ICOUGH Program

June 24th, 2014 in Faculty News

A Risk-Stratified, Mandatory Prophylaxis Protocol Reduces Postop VTEs

By James E. Barone MD

June 12, 2014

NEW YORK (Reuters Health) – A protocol combining mandatory estimation of risk and prophylaxis orders significantly reduced the incidence of venous thromboembolic events (VTEs) at Boston University and Boston Medical Center, researchers there report.

They found an 84% decrease in the rate of deep venous thrombosis (DVT) – from 1.9% to 0.3% – while the incidence of pulmonary embolism (PE) dropped 55%, from 1.1% to 0.5% (p<0.01 for both).

Senior author Dr. David McAneny spoke with Reuters Health by phone and said, “We were gratified by the improved outcomes after the implementation of our programs.”

The before-and-after study was prompted by the authors’ recognition that their hospital had a high rate of VTE compared to other institutions participating in the National Surgical Quality Improvement Program (NSQIP).

Dr. Peter K. Henke, a professor of surgery and Associate Chair of Research at the University of Michigan, has studied VTE extensively. He said the paper is a “solid contribution to the literature, particularly addressing a high VTE rate at their institution and approaching this in a systematic manner with marked improvement.”

Prior to developing the VTE prevention strategy, no formal prophylaxis guidelines were in place.

The team adopted the Caprini VTE risk stratification method for all general and vascular surgery patients and developed standardized prophylaxis regimens-including drugs, mechanical devices, and ambulation orders-linked to the risk scores.

“The inter-rater reliability of Caprini scoring has been good,” said Dr. McAneny. “In addition to surgery residents, our physician assistants are an important part of maintaining consistent practices.”

Their electronic medical record was modified to require completion of both the risk score and the orders for prophylaxis.

Heparin and mechanical compression were optional for the lowest-risk patients, who were walked frequently. Low-risk patients were treated with either heparin (low dose unfractionated or low molecular weight) or compression boots, and those scored as moderate-risk got both heparin and boots.

High- and highest-risk patients were to receive extended prophylaxis of boots and heparin for seven to 10 days or 30 days, respectively, continuing if necessary after hospital discharge.

At the University of Michigan, “We use the Caprini scoring system and have mandatory risk assessment,” said Dr. Henke. His group typically administers 30-day prophylaxis only for oncology patients and those with inflammatory bowel disease.

The Boston paper, published online in the Journal of the American College of Surgeons, said the prophylaxis order mandate could be overridden by a physician, but the reason had to be documented in an automatic drop-down menu.

After the prophylaxis program began, recommended prophylaxis in the 749 low- and moderate risk-patients was given 100% of the time. Of the 99 high-risk patients, 89% received appropriate prophylaxis as did 10 (77%) of the 13 patients in the highest risk group. All protocol deviations were documented in the electronic record.

Dr. Henke, who was not an author of the study, wondered about patients who received prophylaxis but did not benefit. He said, “This is often a neglected part of aggressive VTE prophylaxis. Anticoagulants do have bleeding risks, and at the very least, a significant monetary cost.”

Dr. McAneny’s group is now analyzing failures of the protocol. He said, “We are investigating patients who developed VTEs despite the protocol, questioning if those events were a function of improper scoring, withholding recommended prophylaxis, or some other reason.”

Before the protocol was adopted, audits of nursing practice showed that only 19.6% of 250 patients were out of bed at the time of the visit vs. 69.1% after the intervention (p<0.001).

Other NSQIP hospitals of over 500 beds during the years studied had annual rates of 0.8% for DVT and 0.4% for PE.

Using a risk-adjusted NSQIP data for the authors’ hospital, the ratio of observed to expected VTE was 3.41 prior to instituting the program, and steadily decreased to an odds ratio of 0.94 (p<0.05).

“It will be difficult to get the rate of VTE to zero because the risks of bleeding from anticoagulation sometimes outweigh the risks of VTE so that prophylaxis cannot be administered,” said Dr. McAneny also noting that certain patients will develop VTEs despite appropriate prophylaxis.

He mentioned several important factors in the success of their program such as its standardization, buy-in by the surgeons-they are all competitive people and none wants to be on the wrong side of the outcomes curve, a user-friendly system with check-box format, mandated VTE hazard scoring and prophylaxis selection or declination, electronic reminders, and regular monitoring and feedback of data.

SOURCE: http://bit.ly/1j7DXOq

J Am Coll Surg 2014.

Nilton Medina, MD, Awarded George H. Kaye Alumni Award for Outstanding Service to Others

May 15th, 2014 in Faculty News

Nilton-Medina-MDNilton Medina, MD, Attending Surgeon, Division of Plastic and Reconstructive Surgery, Boston Medical Center and Associate Professor of Surgery, Boston University School of Medicine,was awarded the very first George H. Kaye Alumni Award for Outstanding Service to Others from the Biomedical Science Careers Program (BSCP) at their annual Evening of Hope event.

The award was established in honor of George H. Kaye who was a founding member of BSCP and worked with others to create an organization that would provide students of every race, ethnic background, gender, and financial status with encouragement, support, and guidance needed for the successful pursuit of biomedical science and other science-related careers. 

Dr. Medina first met Mr. Kaye at a BSCP Conference in 1996 as a college student. He was a recipient of a Hope Scholarship in 1998, and has given back to BSCP as a Student Advisor for the last decade. 

About the Biomedical Science Careers Program (BSCP)
The Biomedical Science Careers Program (BSCP), founded in 1991, was incorporated as a not-for-profit organization in 1994. BSCP’s first student conference took place in March 1992 and was attended by 300 high school, college, medical and graduate minority students. Since its inception, more than 10,000 minority students and over 1,100 underrepresented postdoctoral trainees and junior faculty members have participated in BSCP programs. The founding sponsors of the Biomedical Science Careers Program are the Harvard Medical School Minority Faculty Development Program, the New England Board of Higher Education and the Massachusetts Medical Society.

Gerard Doherty, MD, Installed as President of American Association of Endocrine Surgeons (AAES)

April 28th, 2014 in News

Doherty Headshot

Gerard Doherty, MD

Gerard Doherty, MD, chief of Surgery at Boston Medical Center (BMC) and chair of the Department of Surgery at Boston University School of Medicine (BUSM) has been installed as President of the American Association of Endocrine Surgeon (AAES). He will serve as President through 2015.

As president, Doherty will preside at council assemblies and the annual members’ assembly. He will appoint members to all committees, serve as an ex-officio member of each, appoint successors to open positions, and deliver the 2015 Presidential Address.

Endocrine surgery is the discipline of surgical management of endocrine disorders, including the understanding of the disease process, and comprehensive care of surgical endocrine disease of the neck and abdomen. The AAES is dedicated to the science and art of endocrine surgery, and maintenance of the highest standards in clinical practice.

“Being chosen by my colleagues to fulfill this role is a distinct honor. The AAES has been my professional home throughout my career, and I admire the many achievements that we have made as a group to improve the care of patients, to advance the field, and to train the next generation of practitioners.”

Doherty’s clinical focus is endocrine oncology and comprises surgical diseases of the thyroid, parathyroid, endocrine pancreas and adrenal glands, as well as the surgical management of multiple endocrine neoplasia (MEN) syndromes.

Prior to coming to Boston Medical Center and Boston University in 2012, Doherty spent a decade as chief of General Surgery at the University of Michigan Health System. He is the immediate past-president of the Michigan Chapter of the American College of Surgeons and has held multiple leadership positions in national and international professional groups, including the Board of Directors of the American Thyroid Association.

A graduate of Holy Cross and Yale School of Medicine, Doherty completed his residency at the UC-San Francisco, including Medical Staff Fellowship at the National Cancer Institute. He joined the faculty at Washington University School of Medicine in 1993 and became professor of Surgery there in 2001.

About the Association of Endocrine Surgeons

The American Association of Endocrine Surgeons (AAES) is dedicated to the advancement of the science and art of endocrine surgery. Our members have clinical expertise in and research interests that focus on endocrine surgical diseases. They are certified by either the American Board of Surgery of the United States, the Royal College of Surgeons of Canada or the equivalent governing boards in Mexico and South America. Our membership has recently expanded to include international leaders in endocrine surgery and allied specialists that have demonstrated a similar focus of practice. The AAES is committed to providing surgical expertise in diseases of the thyroid, parathyroid, adrenal glands as well as in neuroendocrine tumors of the pancreas and GI tract. Our goal is to discover and promote the best treatments for endocrine disease to help improve our patients’ lives.

About Boston Medical Center

Boston Medical Center is a private, not-for-profit, 496-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. Committed to providing high-quality health care to all, the hospital offers a full spectrum of pediatric and adult care services including primary and family medicine and advanced specialty care with an emphasis on community-based care. Boston Medical Center offers specialized care for complex health problems and is a leading research institution. Boston Medical Center and Boston University School of Medicine are partners in the Boston HealthNet – 14 community health centers

Gerard Doherty, MD and Peter Burke MD, featured in Boston Globe Opinion Piece

April 17th, 2014 in News

 

Gerard Doherty, MD, James Utley Professor and Chairman, Department of Surgery, Boston University School of Medicine and Surgeon-in-Chief, Boston Medical Center and Peter Burke, MD, Professor of Surgery, Boston University School of Medicine and Cheif of Trauma Services at Boston Medical Center were published in The Podium Opinion section of The Boston Globe discussing Boston’s trauma centers and the preparation for the events surrounding the Boston Marathon bombings. 

Click here to read the article.

Globe Op-Ed

Dr. Alik Farber on Lessons From Boston’s Emergency Response One Year Ago

April 10th, 2014 in News

Alik Farber, MD, Chief, Division of Vascular and Endovascular Surgery at Boston Medical Center and Associate Professor of Surgery at Boston University School of Medicine was a guest on WBUR discussing “Lessons From Boston’s Emergency Response One Year Ago“.

Click here to listen to the radio segment.

 

 

BU School of Medicine and Boston Medical Center Seeking Chair, Department of Orthopaedic Surgery

March 21st, 2014 in News

Boston Medical Center (BMC) and Boston University School of Medicine (BUSM) are jointly seeking a new Chief and Chair of Orthopaedic Surgery.

We are seeking an energetic and academically committed individual with strong clinical credentials and a research background who is prepared to lead a department and serve as a key leader at our academic medical center.  The Department of Orthopaedic Surgery has 11 faculty members; 28 residents; 7 nurse practitioners; 6 physician assistants and over 30 administrative staff.  The Department offers the usual complement of Orthopaedic services including hand and upper extremity, joint reconstruction, knee, Orthopaedic pediatrics, spine, sports medicine and trauma and fractures. In the most recent academic year, the Department had 31,000 office visits and over 3,000 surgical cases.

The Department has a thriving graduate medical education program with residents rotating between Boston Medical Center, Lahey Clinic Medical Center, Shriner’s Hospital for Children and Veterans Affairs (VA) Healthcare System. In addition, the Department has a Trauma Service/Program, an ACGME accredited Sports Medicine fellow/program and a Spine Fellow program.

BMC is a 496-bed academic medical center located in Boston’s historic South End. The hospital is the primary teaching affiliate for Boston University School of Medicine. BMC provides a full range of pediatric and adult care services, from primary to family medicine to advanced specialty care. It is the largest and busiest provider of trauma and emergency services in New England. Emphasizing community-based care, BMC is committed to providing consistently excellent and accessible health services to all—and is the largest safety-net hospital in New England.

BMC is the principal teaching affiliate of Boston University School of Medicine (BUSM). BUSM is highly ranked and committed to urban and international health and has recognized leader in groundbreaking medical research.

We ask that candidates who wish to be considered send a CV and cover letter describing the experiences that qualify them for our position and their vision of what an academic Department of Orthopaedic Surgery should aspire to be. Please send all materials directly to: Gerard Doherty, MD, Utley Professor and Chair of Surgery, Boston University School of Medicine and Surgeon-in-Chief, Boston Medical Center via email to gerard.doherty@bmc.org. Please include “Orthopaedic Chair” in the subject line.

Boston University and Boston Medical Center are equal opportunity employers, committed to their common mission of improving the health of Boston’s residents while adhering to the highest standards of academic medicine.

BMC and BUSM are affirmative action/equal employment employers.
Women and minorities are encourage to apply.

Boston Doctors Reveal Lessons Learned in Marathon Attack

March 21st, 2014 in Faculty News

 

http://www.necn.com/03/20/14/Boston-doctors-reveal-lessons-learned-in/landing.html?blockID=864098&feedID=11110

Department of Surgery Welcomes Robert W. Schulze, MD, FACS, FCCM

February 7th, 2014 in Faculty News

Robert W. Schulze, MD, FACS, FCCM

Robert W. Schulze, MD, FACS, FCCM

The Department of Surgery is pleased to announce that Robert W. Schulze, MD, FACS, FCCM, has joined the department. Dr. Schulze is an Attending Surgeon in the Section of Acute Care & Trauma Surgery at Boston Medical Center and Associate Professor of Surgery at Boston University School of Medicine. He was most recently Director of Surgical Nutrition and Surgical Critical Care at SUNY Downstate Medical Center in Brooklyn, NY and Attending Physician of Surgery at Kings County Hospital Center also in Brooklyn, NY.

Dr. Schulze is a graduate of Boston University (BA, MA, MD). He completed a residency in General Surgery at the University of Medicine and Dentistry of New Jersey in New Brunswick, NJ, and a Fellowship in Trauma and Critical Care at the University of Maryland in Baltimore, MD. In addition, Dr. Schulze completed a research fellowship at New England Deaconess Hospital. 

Dr. Schulze has authored and co-authored numerous chapters and scientific publications and is a Fellow of the American College of Surgeons (ACS) and the American College of Critical Care Medicine. His research and clinical interests include surgical education, ARDS, advanced ventilator management, sepsis, pre-hospital trauma care and violence prevention programs.