College of
Human
Medicine

Dean's Update

December 13, 2019

Friends,

The residence halls on the East Lansing campus have put up their holiday light displays, so I know the winter solstice is nigh. Regardless of the time of year, the work of the college continues. The competency and RPT committees have been meeting, students of every year are in clinics; people are busy.

In the clinic I visited this week, staff are focused on making sure patients and families have a great experience and receive the care they need efficiently and safely. This helps me sleep well at night.

The new structures of MSU Health are starting to make a difference in how the university provides and manages care. At the Department Advisory Committee this week, Chief Medical Officer Tony Avelino announced a new quality structure for the university practice. This is a key step for us. In the past, there has been a system for reporting safety violations, and we will work toward an organized system for investigating sentinel events and reporting near-miss events.

I should probably say a little more about sentinel and near-miss events. A sentinel event is any unanticipated event that results in, or could result in, serious injury to a patient. As an example, perhaps a patient accidently gets an antibiotic injection to which they have an allergy. This is a sentinel event revealing there is a problem in the system even if the patient does not get a reaction this time. Maybe the lighting in the refrigerator is poor, or the injection vial labeling is confusing, or people need more training to verify allergies. Sentinel events need to be investigated and analyzed to see what can be done to change our systems to prevent another occurrence. Our current systems include reporting these events electronically, but moving from reporting to analysis and improvement will be an important step for us.

A near-miss happens when we almost make a meaningful mistake. For example, the wrong antibiotic is prepared and ready for administration, and when the staff verifies the patient’s allergies, the staff realizes the antibiotic could result in a serious reaction. In this case the verification system prevented the sentinel event, and a good system will track these near-misses to find systematic weaknesses in procedures, like the lighting in the refrigerator is poor or the medication ordering system is confusing. This is another opportunity for our clinics as we centralize quality efforts in MSU Health.

Perhaps the most important change we can make to create a safer, higher quality clinical experience for our patients, is to have everyone involved in making our system safer and better. Our staff are incredibly dedicated and interested in doing their best for our patients. On some of my “quality and safety rounds” every staff person I meet can talk about safety and quality improvement projects in the clinic. My goal is to hear from all staff about quality and safety programs every time I visit a clinic. We have great people, and for us to have great clinical programs, we need everyone, regardless their employment level or training, thinking and talking about how we get better and provide higher quality, safer care to each and every patient we see.

One highlight this week was my visit to our Southeast Michigan Campus sites in Southfield and Novi to announce the college’s new Division of Neuroscience, based in Southfield, and Division of Otolaryngology (aka, Ear, Nose, and Throat or ENT), based out of Novi.

Our partnership with Ascension Providence has grown since the campus started in 2014 and these divisions represent new opportunities for the college’s faculty and students. It was great to be with our newest division directors (Dr. Teck Soo of Michigan Spine & Brain Surgeons and Dr. Seilesh Babu of the Michigan Ear Institute) as our Community Assistant Dean, Val Overholt, led through the announcements this week with the support of Dr. Manhal Tobia, Chief Medical Officer of Ascension Providence.

Both divisions house strong residency programs that I am sure will be of benefit to our students interested in these disciplines. I want to send out a special thank-you to Jerry Kooiman and Mark Brieve for their work supporting these partnerships and events. You can read more about the events here. Working with internal and external partners who brought about these divisions, brings strength and breadth to the programs of the college, and I’m confident they will help our students, faculty, and patients.

Serving the People with you,  

Aron

Aron Sousa, MD, FACP
Interim Dean
Michigan State University
College of Human Medicine

December 6, 2019

This week I have continued my quality and safety rounds in the clinics. These visits are among the most enjoyable parts of my work week – only teaching is reliably more fun. A main theme running through each week is how amazing the medical assistants (MAs) in our clinics are. They seem to do almost everything imaginable, including checking people in, handling patient complaints, rooming patients, taking vitals, giving shots, and providing patient education.

We have MAs who are dedicated to improving the quality of our clinics, who work essentially as surgical techs, and who improve workflow and order supplies. Our MAs often have worked in our clinics a long time and may know the lives of patients as well, or better than, other clinicians. I’ve been fortunate to work with many great MAs over my time in the medicine clinic, but until I started doing my quality and safety rounds, I really did not know how many different roles they play across our system. We are so fortunate to have these wonderful people working with us.

Just to call out and update you on some wonderful advocacy and community building by one of our faculty, check out the work of Jane Turner. She has been successfully advocating for patients who have been bullied because of their race in a local school system. Physicians have a special opportunity to improve lives, because society often listens to physicians. Dr. Turner’s work is another example of how physician leadership and advocacy can help make the world a better place.

I am a little hesitant to speak too soon, but many of our clinics really improved their efficiency and productivity over the last quarter or so. As many of you know, the financial performance of our clinical practice has struggled over the years; however, there have been some nice improvements during the last few months. People should feel good about it because it represents a lot of hard work by many talented people. There is still much to do, including implementing a system-wide quality reporting and assurance program, but progress counts.

We also did well with Tuesday’s Give Green Day. We raised more than twice our goal for student scholarships, which was well beyond our expectations. Next year we will increase the goal, because we can raise more than $12,000 on Give Green Day. My thanks to the 50 people who contributed, especially those of you who gave what you could – that is the most generous gift possible.

As a final note, I want to thank the Dean’s Staff Advisory Committee, who met with me this week. (You can see who is on the committee here.) They are an engaged and dedicated group who have accomplished so much already. The committee conducted a survey of college staff and created four subcommittees and a leadership group. These subcommittees are working on projects to improve communication, centralize policy publication, improve staff engagement, and expand availability of training across campuses. My thanks to the committee for their ideas and enthusiasm (and thanks to NBII for starting the committee).

Serving the People with you,  
Aron

Aron Sousa, MD, FACP
Interim Dean
Michigan State University
College of Human Medicine

November 27, 2019

Friends,

This is a short week for those of us not on call – thank you to everyone spending their holiday taking care of patients, keeping experiments going, and generally keeping the lights on and people safe. At so many levels, the work of the college continues daily and depends on someone to pick up duties – my appreciation to each of you working during the holiday season.

As you might imagine, I attend many meetings, and when I learn something applicable to this update, I will pass on what I can. Late last week I received an update on three investigations that have been ongoing at the university:

  • The police investigation of the concerning events at Bryan Hall is complete and was sent to the Ingham County prosecutor’s office. No criminal charges are expected, although the MSU student disciplinary process is ongoing and, by protocol, details are confidential.
  • The vandalism at the MSU Hillel is under investigation by the East Lansing police and the FBI, and no further details are available.
  • The MSU IRB is reviewing its procedures and visiting colleges and partners in the wake of an IRB-reviewed survey on responses to social media posts that offended students taking the survey.

I recognize this information is not conclusive, which can feel unsatisfying when the events have been offensive and frightening to many people. For now, an update on investigations and analysis is all we know, and I will pass on information as I get it.

This week brings us Thanksgiving and the opportunity to be grateful to and appreciative of those in our lives who keep us warm, fed, watered, and safe to any extent. Many of us rarely consider the basics of survival, and we should recognize the work of those before us who made the lives we live possible. It’s our mission to make the world a better place for those who come after us.

Thoughtful financial giving is one way to influence the future of the world for the better, and I hope you find causes and organizations to which you give your time, talent and money. Personally, I mainly give to local service organizations and College of Human Medicine scholarships. 

It’s now my job, literally, to pitch contributing to CHM scholarships on December 3, Give Green Day, MSU’s university-wide day of giving. I’m happy to do this because I genuinely believe in our students and our college’s work. Our students are admitted to CHM by demonstrating their desire to help those around them, however, large student debt makes it difficult for our students to focus on making the world better.

Our students have some of the highest debt in the country. The vast majority of their debt is due to high tuition set by the university (and not the college). We could reduce debt by admitting students from wealthier families, but that is not why we exist. And, we could reduce debt by admitting fewer students from disadvantaged backgrounds, but that is not why we exist. And, we could reduce debt by admitting fewer students with children, but that is not why we exist. 

We exist to provide the opportunity of education to people who will make the world a better place. We choose our students because they want to improve health care for all. Let’s make a difference together on Give Green Day. Tuesday, join me by contributing here to the College of Human Medicine Student Scholarship Fund.

For whatever struggles and uncertainties we face, I hope there is comfort in knowing that everyone in the college is contributing to the great work of finding new and better ways for our communities to be healthy, helping people heal, and teaching students to help people and communities heal. As we venture off this week to be with friends, families, and the warmth of our own solitude, may blessings find us, every one.

Serving the people with you,

Aron

Aron Sousa, MD, FACP
Interim Dean
Michigan State University
College of Human Medicine

November 22, 2019

Friends,

This week I spent time with faculty, students, staff, donors, government officials and observed  the reach of the college from a range of perspectives. Over the last decade and a half, the college has been able to share the opening or groundbreaking of three buildings in Grand Rapids, two buildings in East Lansing, and one in Flint. This is an astonishing record of growth and expansion. On Monday, we celebrated the latest of these achievements with the groundbreaking of the Doug Meijer Medical Innovation Building in Grand Rapids. This new building will be on MSU land between the college’s Grand Rapids Research Center and the Secchia Center.

The Doug Meijer Medical Innovation Building is MSU’s first public-private partnership and represents the next steps for the college and West Michigan communities as a medical innovation center. The building is located on MSU property and is being funded and built by a developer, while the college has reserved naming rights. Through the very generous gift of Doug Meijer and the Meijer Foundation, the building will house a radiopharmacy and will provide diagnostic and therapeutic radiopharmaceuticals for research and patient use. I want to acknowledge Norm Beauchamp, Jerry Kooiman, Dick Temple and their team for the talent, vision, and hard work they have put into this achievement.

I continue to enjoy my visits to our clinics, and marvel at the great work our people perform each week. Our faculty and staff take care of the most challenged families in our communities; families who struggle to keep food on the table and have a chronically ill child. Our staff work with these families to help them with transportation, food security and housing, as well as health care. With the most recent cold snap, our staff provided a family with hats and warm clothes when they were in need. Medicine is often not about medications, diagnosis, or therapy. It’s inspiring to see our staff and faculty bring caring to medicine every day.

This week MSU released the results from the university-wide “Know More” survey on culture, climate, and relationship violence and sexual misconduct. I cannot and should not try to summarize it in a few paragraphs here. The scale of injury in our university community is shocking, and the scope of the problems are all the more disturbing when we consider that our results are consistent with other institutions and our society. I encourage you to visit the website to learn what the report found and to find resources for support. The release of the survey and the media attention that follows will, for some of us, bring to surface previous traumas and struggles. There are resources available at the website for us to use to support each other.

As I visit departments, clinics, communities and students, I welcome discussions of this report and the work the college is doing to improve our own climate, address abuse and harassment, and improve civility and caring in our classrooms, clinics, and workspaces. The people of our college experience all the injuries and injustices outlined in the Know More report, and it’s our challenge to make our college and our world a better place. We are sojourners on a long, essential journey, and I could not be in better company.

Serving the people with you, 

Aron Sousa, MD, FACP
Interim Dean
Michigan State University
College of Human Medicine

November 15, 2019

Friends,

I hope you all have had a good week. I have had the chance to visit a clinic, connect with alumni and donors, and visit with hospital partners this week.

It feels like each week I find a new way to be impressed by the impact of our college across the country and the world. Our colleagues at the Royal College of Surgeons of Ireland and a couple of new medical schools have visited our college to learn about the Shared Discovery Curriculum and continue to work with us on their favorite parts of our curriculum. Some schools are interested in the Academy, others are interested in JustInTimeMedicine while others are looking carefully at progress testing. So many people have worked hard on the innovative structures in the curriculum; it is nice to see that work transform medical education in other schools.

One of the best parts of this week’s American Association of Medical Colleges meetings is connecting with the CHM diaspora. (Marsha Rappley sends her greetings to everyone!) We had a chance to connect with alumni who are making a difference in the Phoenix area and around the west. Each time I meet with alumni they ask about faculty and staff who made a difference in their education – one session felt a bit like a meeting of the Wanda Lipscomb mentee club! The picture above, is of our student representatives to the AAMC, Osose Oboh, Paola Lepe and Connor Knowles, who attended the conference last weekend and met with some local donors and alumni with Drs. Beauchamp, Lipscomb and me.

When I meet with alumni and donors, I try to spread the word about the college’s need for scholarships. This is the prime focus of my fundraising. Our student debt is very high and the debt will not improve measurably without more scholarships. (Consider becoming a monthly donor to a College of Human Medicine scholarship here.)

The staff and our faculty have many insights to share with leadership, and I have benefited from my visits to clinics. For my part, it is fun to meet with folks in clinics they clearly care so much about. One of the great frustrations for staff has been the loss of providers in the last couple of years. One solution in the clinics I have visited is the incorporation of nurse practitioners in the practice. My conversations with staff and practitioners, including the nurse practitioners, consistently revolves around how rewarding it is to work in teams and how much they think these teams improve both patient care and practitioner resilience. One of the great opportunities of our new health structure is closer collaboration between practitioners from different fields. 

In each clinic I visit, the staff clearly see themselves as advocates for patients. Sometimes this advocacy is help getting the patient clinical information or arranging a handicap parking sticker or just working within the system to get a patient into an already full clinician schedule.

This is advocacy to which we can all contribute. In many ways advocacy is one of the clearest demonstrations of how much we care for people and our community. One of our pediatric faculty showed up in the news just this week advocating for her patients in a local school system. You can read about Jane Turner’s advocacy for kids facing bullying and racism in schools here. That’s serving the people.

One of the great strengths of the college is the network of hospitals that join together to be a part of our research and educational programs. This week I visited hospital partners in Flint. The work we have done together in that community has been supported by Hurley, McLaren, and Genesys, as well as the C.S. Mott Foundation. These hospital and community partners made possible the creation of the Division of Public Health and the creation of the MSU-Hurley Pediatric Public Health Initiative which have resulted in a federally-supported nutritional food prescription program, more than $60 million in external funding in Flint in the last five years, more than 80 new jobs in downtown Flint, and subcontracts supporting more than 30 community organizations. This is the kind of community benefit that results when hospitals, the college, and the community work together for the public good. It was great to meet with our partners and those meetings fill me with hope and gratitude.    

Serving the people with you, 

Aron Sousa, MD, FACP
Interim Dean
Michigan State University
College of Human Medicine

November 8, 2019

Dear friends,

I continued visiting clinics this week and met with staff, faculty, and students who are working hard each day to bring excellent care to our patients. I was struck this week by how much extra work is done by faculty and staff when we lose providers. 

Staff often bear the brunt of patient frustration when they cannot get an appointment – patient frustration that is often based in fear about their health. We still take care of those patients. There are faculty working late every night to provide care to extra patients whose provider had reduced clinical time or moved on to another location. 

In each clinic visit, I have been so impressed by the dedication of our staff to their patients. This week I spoke with a staff member who is particularly concerned about disabled patients who struggle to get into the clinical center and navigate our clinics there. This staff person will get a chair with arm rest from another section of the clinic for patients who have trouble standing without using their arms to pull themselves up for support. It may not seem like a large task, but I was so impressed by this staff person’s initiative to find any way to help her patients. (I am asking MSU HealthCare to see about making sure we have better chairs for patients in the clinics.)

There were two Early Clinical Experience (ECE) students in clinic that morning. It is great to have ECE students thinking about quality improvement projects with our staff – I think it is a great chance for the education program to help the clinical program and for the clinical program to help students become the kind of physicians we need.

I also want to take a moment to mark the passing of Bill White, former C.S. Mott Foundation President. A group from the Dean’s office and the Division of Public Health attended to the public remembrance of Bill. You can find more details about Bill on our memorial page

Bill White was a national leader in philanthropy, focusing on community schools, after school programs, and fostering civil societies. Bill was a larger than life kind of person, and he was a key advocate in the C.S. Mott Foundation's support for the college’s expansion in Flint. Listening to Bill tell stories about U.S. presidents, foreign leaders, and interesting characters he had known, was not only delightful but also instructive. He had a great sense of humor, and always focused his stories on how to make communities better and more civil places to live.

Finally, this week was the start of the American Association of Medical Colleges’ annual meeting. We’ve been meeting donors and celebrating Dr. Mona Hanna-Attisha as the inaugural winner of the Vilcek-Gold Award for Humanism in Healthcare. Additionally, Dr. Wanda Lipscomb has finished her year as chair of the Group on Student Affairs, so a shout out to Dr. L and our faculty presenting at AAMC and the Generalist Meeting this week.

Serving the People with you,

Aron

November 1, 2019

It’s been a big week for our medical school, including the promotion of Dean Beauchamp to the MSU Executive Vice President for Health Sciences, Doug Meijer’s $19.5 million gift for the Doug Meijer Medical Innovation Building announcement, and the $5 million gift from Peter Secchia for the Grand Rapids Research Center (GRRC).  The Secchia gift helps close the final funding gap for the GRRC and is a continuation of Peter and Joan Secchia’s dedication to MSU and the success of the College of Human Medicine. The $19.5 million gift from Doug Meijer and the Meijer Foundation is the largest, single individual gift to the college, and it will help the newly named building in Grand Rapids bring innovative, liminal technology to our people.

And, if you otherwise missed the news, with Dean Beauchamp’s promotion, I was appointed as interim dean after a vote of the College Advisory Council (CAC). I appreciate the CAC’s confidence and have benefited from the support and enthusiasm of those I have spoken with in the last few weeks.

This week I completed my first “quality and safety” rounds at one of our clinics. I have decided to do these early morning rounds once or twice to learn what staff, faculty and students are doing to provide excellent care to our patients and education to our learners. The staff I visited this week are ensuring our patients receive high quality care as safely as possible, and I am impressed how the staff are leading superb efforts. For example, when an insurance company changes medication on their formulary, patients often need to have a different prescription to ensure their treatment continues with medication covered by their insurance.  Getting the new prescription changed and filled in a timely, safe manner requires communication with multiple people along with opportunities for mistakes to occur. 

The staff have recognized near and full misses when patients have not received their new script in a safe, timely way. However; in collaboration with the physicians and nurse practitioners in the clinic, staff are implementing a series of pre-approved orders to get patients replacement scripts faster and safer than in the past.  This is extremely important and is an example of a great safety culture of people who do the work, find ways to improve safety regardless of where they are in the hierarchy. Unfortunately, there is not a good way for staff to automatically track these medication delays, so it’s hard for them to document improvements without adding to their already long task lists with a manual tracking system. 

In a wonderful confluence of patient care and education, this clinic has an Early Clinical Experience (ECE) student who will be conducting a quality improvement project. This student will be able to help document the improvement of care as staff implements their new system. This is exactly why people should get care in an academic setting.  Students, staff and faculty working together to provide great care in a learning environment, improves the care people receive. The student will get a great educational experience, the staff will improve the safety and quality of care our patients receive, and clinical providers will be able to focus on the patients.

I really appreciate the staff’s dedication to getting their patients the medicines they need and providing high quality care. It’s this kind of work that makes MSU and our college a great place to work and receive care. 

As I said, it has been a big week. We hosted President Stanley and Trustees Kelly Tebay and Brianna Scott at the Secchia Center and the Grand Rapids Research Center.  I think they had a great visit meeting with scientists, Rick Leach, Jack Lipton and Dan Campbell, and hearing from Dick Temple about the buildings and the programs in those great spaces.  President Stanley, who is an infectious disease physician, sat in on part of a Middle Clinical Experience (MCE) Weekly Scholar Group (WSG). He was scheduled to be there for 15 minutes, but when I stopped in to pull him out, he said, “give me some more time, I’m still learning here.” I really appreciate everyone who helped make their visit to Grand Rapids a wonderful event. 

One successful step for the college happened this week in New Orleans. The college and Xavier University of Louisiana announced the CHM Mission SMART (SpartanMD Acceptance Realization Track) initiative. The two institutions are collaborating to give students at Xavier an early assurance option for entering the College of Human Medicine. Xavier is a historically black university with a history of sending us great students.  You can learn more about the college’s early assurance programs (EAP) here and the early assurance opportunity (EAO) for MSU undergraduates here. The short version is that EAP and EAO programs allow students to apply and be accepted to the college in their junior year. These students are still evaluated by the admissions committee, and the college is not required to admit students endorsed by undergraduate EAP and EAO programs. 

I must give a shout out to Liz Lyons, CHM’s director of diversity recruitment and admissions coordinator, and QuoVadis Webster, Xavier’s director of premedical programs, for bringing this program to fruition for both of our institutions. You can learn more about the signing event here - it was a great day!

If you have been following campus activities this week, you know about the painful events which ensued. From my conversations with people in the residence halls, the students involved did not intend to offend or cause hurt; however, it happened, and these types of events live on through social media as aching reminders of a misstep.

I am committing the college to be a supportive place for our patients, students, staff, and faculty. Faculty and leadership are learning how to use trauma informed communication to express care rather than presupposing privilege when we do not know each other’s personal histories. Being with each other, sharing stories and taking an interest is how we learn and grow as people and as professionals. I am happy to be on the journey with you.

Aron Sousa, MD
Interim Dean
Michigan State University College of Human Medicine

October 25, 2019

Friends, 

Today I began serving as interim dean of the College of Human Medicine as the MSU Board of Trustees has appointed Norman Beauchamp the Michigan State University executive vice president for health sciences. Norm is taking on this new role to help MSU do better for the people we serve, and I am taking on the interim deanship again for the same reason. We know and appreciate that you share this goal of serving the people of our state.

I am truly excited and honored to take on the interim dean role again during this interesting and momentous time. The changes in our system are deeply important and will require collaboration among all of us, regardless of our role or title. The events of the last several years demonstrate the need for a different structure and culture for our health programs, and I believe Norm has the vision and the talent to remake MSU health programs as a transformative agent for the public good.

I will do everything I can to ensure the College of Human Medicine is a vibrant part of MSU’s success. A first effort will be listening to those we serve, those who struggle, and those who have suffered. In the last couple of months, the university has taken important steps toward making this a safer, more responsive, and more sanative community. Those steps must continue as real progress toward a real destination. 

As you know, I served the college in the interim role before, and one of my most productive and enjoyable activities last time was to meet with units and departments. When I start the interim role on October 25th, I will be visiting units, communities and departments as one of my first organized priorities. We have a long and rich history of leadership across the missions of the college, and that leadership and experience will be instrumental in our success as we move forward.

A key to my willingness and ability to do the interim deanship is the wonderful people in Academic Affairs who always step up and take on additional roles and work when the college needs them. We are fortunate that Dr. Dianne Wagner has agreed to be interim senior associate dean for academic affairs as I move to the interim dean role. She did a wonderful job leading us through the implementation of the Shared Discovery Curriculum the last time I was interim, and I have every confidence in her ability to handle the senior associate dean’s job this time. The overall SDC curricular team is not changing with this new structure, and I am confident students, staff and faculty will find stability and opportunity as these new roles and relationships develop.

There will be some uncertainty as the new structure develops, but there can be no uncertainty that we, as a college, are dedicated to our patients, our students, the public, and each other. For that I am enormously grateful to you all. 

Serving the people with you,

Aron Sousa, MD
Interim Dean
Michigan State University College of Human Medicine