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General Internal Medicine

Overview

The Section of General Medicine is home to active and highly successful research programs, health services research, under the direction of Dr. Marshall Chin and medical ethics, under the direction of Dr. Mark Siegler. Our research faculty (ranging in academic rank from Assistant Professor to Professor) have established highly productive research careers, receiving funding from such agencies as the National Institutes of Health, the Agency for Healthcare Research and Quality, the Centers for Disease Control, the Robert Wood Johnson Foundation, the Charles E. Culpepper Foundation and other prestigious venues, and publishing in the New England Journal of Medicine, the Journal of the American Medical Association, the Journal of General Internal Medicine, and other national and international publications.

In addition to their work within the Section, the research faculty also collaborate broadly in related educational and research programs offered throughout the institution.

Basic Research

The MacLean Center for Clinical Medical Ethics

In 1983, with generous support from Dorothy J. MacLean and the MacLean family, the University of Chicago established the nation’s first program devoted to clinical medical ethics. Dr. Mark Siegler was appointed its founding director. The MacLean Center for Clinical Medical Ethics was pivotal in establishing and expanding the field of clinical medical ethics. It did this through its pioneering program in ethics fellowship training; its foundational role in ethics consultation; its close involvement in research and the protection of human subjects through an innovative concept of “research ethics consultation;” and by encouraging scholarly research and publication in clinical medical ethics. The center also encouraged the “empirical turn” in bioethics research, an approach that uses clinical epidemiology, health services research, and decision science techniques to study ethical matters in clinical practice. For more information, please visit: http://macleanethics.uchicago.edu/about/.

The MacLean Center faculty have published prolifically on subjects such as research ethics, end of life care, surgical ethics, pediatric outcomes, health policy, health disparities, genetics, and transplantation ethics. The Center’s current and former faculty and fellows have published more than 150 books on topics related to medicine and medical ethics. For an overview of our current faculty’s research interests, please visit: http://macleanethics.uchicago.edu/research/maclean_center_research/.

Additionally, for over 30 years, the MacLean Center has directed and sponsored programs for faculty and students at the University of Chicago. Since 1984, The Interdisciplinary Faculty Seminar Series has organized weekly meetings throughout the academic year to provide a sustainable interdisciplinary forum on issues in medicine and medical ethics. In recent years, the Seminar Series topics have included End-of-Life Care, Health Care Reform, Organ Transplantation, Pediatric Ethics, Global Health, Health Care Disparities, Medical Professionalism, Confidentiality, and Pharmaceutical Innovation and Regulation. Every November, the MacLean Center hosts the Dorothy J. MacLean Fellows Conference, which draws speakers and audiences from a wide range of disciplines. To view videos the MacLean Center Seminar Series and Conference or for more information, please visit: http://macleanethics.uchicago.edu/events/.

In addition, since 1981, the MacLean Center’s internationally renowned medical ethics fellowship program has graduated more than 320 fellows, many of whom hold endowed professorships and direct clinical ethics programs in the United States, Canada, Europe, and China. Current and former faculty and fellows have published more than 150 books in the field. Although most fellows have been physicians, the Center’s fellowship program has also trained nurses, social workers, legal scholars, theologians, social scientists and philosophers. For more information, please visit:http://macleanethics.uchicago.edu/fellowship/overview

Diabetes Outcome Research Program

Faculty in the Section of General Internal Medicine are national leaders in diabetes health services research. Investigators aim to develop and evaluate ways to improve diabetes care and prevention in real-world settings, particularly among vulnerable groups such as African Americans, indigent patients in community health centers, older adults, and minority children. Led by section faculty, the University of Chicago has one of seven NIH Centers for Diabetes Translation Research. The Chicago Center for Diabetes Translation Research takes the view that the patient, provider, health care system, and social system factors affect the quality of diabetes care and patient outcomes, and thus each of these elements must be targeted to maximize the chances of improving care (www.chicagodiabetesresearch.org) In addition, as patients grow from children to adolescents to adults to older persons, each developmental stage of life brings specific issues and challenges that must be addressed to optimize health outcomes. The Chicago Center for Diabetes Translation Research draws upon a longstanding history of innovation in educational and behavioral interventions, special strengths in community-based participatory research through collaborations with a consortium of Midwestern community health centers and local Chicago partners, and the unique strengths of a university with world-class strengths in the social sciences and biomedical sciences relevant to diabetes care. Major areas of interest for section researchers include:

  • Improving Diabetes Care in Community Health Centers
  • POWER-UP
  • Improving Outcomes of Older Persons with Diabetes
  • Diabetes Cost-Effectiveness Analysis Studies
  • Provider-Patient Communication and Shared Decision Making
  • Chicago Community-Based Programs
  • Organization and Financing of Diabetes Care

The faculty members from the Section of General Internal Medicine who collaborate on diabetes research projects include Marshall Chin, Deborah Burnet, Elbert Huang, Monica Peek, Lisa Vinci, Andy Davis, Neda Laiteerapong, and Arshiya Baig.

Center for Chronic Disease Research and Policy

The Section of General Internal Medicine is home to a research center whose primary aim is to influence healthcare policies by studying innovations in chronic disease prevention, treatment, and care organization. Center for Chronic Disease Research and Policy seeks to create an environment where research and policy seamlessly interact to most effectively serve the needs of each individual patient. Research in the Center includes the development of innovations for preventing and treating chronic diseases as well as evaluations of the economic implications of these innovations. Findings are then linked to the study of broader health care policies. The Center also hosts an annual symposium to convene policymakers from state and local government, industry experts, and researchers in order to have an interactive exchange about various policies and their impacts on access to necessary care for patients suffering from chronic diseases.
Areas of expertise that are represented in the Center are included below.

Content Expertise

  • Primary care services – FQHCs
  • Prescription drugs – 340B
  • Hospital care – community benefit
  • Chronic disease management – diabetes

Methodological Expertise

  • Decision analysis
  • Cost-effectiveness analysis
  • Quality of life
  • Decision aids/decision support
  • Medicaid support

Center leadership includes:

– Elbert Huang, MD, MPH, Director
– Neda Laiteerapong, MD, MS, Associate Director for Clinical Outcomes
– Tamara Konetzka, PhD, Associate Director for Health Policy
– Rachel Jantke, PhD, Administrative Director

Clinical Research

Within the Section of General Internal Medicine the faculty is involved in many important areas of clinical research. Projects currently being carried out by our clinical researchers are:

Dr. Andy Davis, Associate Professor of Medicine conducts research on ways to reduce cardiovascular risk, particularly in patients with diabetes. Traditionally physicians have focused their attention on glycemic control, despite the fact that blood pressure and lipids more strongly influence cardiovascular outcomes. In association with Lisa Vinci, MD he is conducting a study to see if group visits of diabetic patients with nurse practitioners, combined with limited case management, can empower patients to reduce their cardiovascular risk and improve their preventive practices. He is also a site principal investigator for an ongoing NHLBI trial of the home use of automated external defibrillators in patients who have suffered a previous anterior myocardial infarction (HAT).