In this month’s Chair’s Spotlight, we highlight the work of Doreen Brettler, MD, a physician and professor of medicine in the Division of Hematology/Oncology. Dr. Brettler has spent her career caring for benign and malignant hematology patients, with primary concentrations in hemostasis and thrombosis. She currently sees a broad spectrum of patients at the University campus for bleeding and clotting disorders, genetic blood disorders, and low blood cell conditions, as well as other chronic diseases and low-grade hematological malignancies. In October, we sat down with Dr. Brettler to learn more about her work. 

In 2022, the Division of Hospital Medicine launched its Procedural Service as a way to help address patient flow challenges. The idea emerged from pre-pandemic conversations between Greg Leslie, MD, physician, assistant professor of medicine, clinical and interim division chief, and Michael Devine, DO, physician and assistant professor of medicine, both of Hospital Medicine, and subsequent discussions with fellow hospitalists. At the time, they had observed that while resident teams in the division had trainees who could perform bedside procedures such as lumbar punctures, paracenteses, and arterial punctures for blood draws because it was part of their training, nonresident teams were left to call on others for assistance. Drs. Leslie and Devine thought that if they could create a service where hospitalists were trained and credentialed to perform these procedures it would help with some of the flow challenges. They put a call out to fellow hospitalists to identify a core group who were interested in getting credentialed and were pleasantly met with enthusiasm. “It's been really fun to build this up,” said Dr. Devine, who currently serves as the director of the Procedural Service. “We had a whole spectrum of attendings at various levels in our division that have wanted to be part of this, from senior, decorated faculty to junior faculty that were interested in [learning and getting credentialed] in these procedures.”

With a core group of seven hospitalists credentialed to perform these procedures, they have started to have a noticeable impact on patient flow. “The biggest benefit of this Procedural team is that it allows for diagnostic or therapeutic procedures to happen as quickly as possible in order to let the teams advance the care plan, ” said Dr. Leslie.

In this month’s Fellow Spotlight, we highlight Allen Chang, MD, a fellow in the Clinical Informatics Fellowship. Here, Dr. Chang describes his clinical background, why he chose UMass for his fellowship, and a recent sightseeing trip around the U.S.! 

"My increasing fascination with generative AI and large language models coincided with the establishment of UMass’s new fellowship in Clinical Informatics, and joining the program was the perfect opportunity for me to meaningfully explore the role of these new tools in the delivery of healthcare, not just for patients, but for clinicians as well."

In this month’s Resident Spotlight, we highlight Nicolas Fandino-Rubio, MD, a second-year Categorical Internal Medicine resident at UMass Chan. Here, Dr. Fandino-Rubio describes his clinical and research interests, what makes UMass a great place for residency, and his passion for soccer. 

"I find myself frequently using my own heritage and language to connect with many of our patients and create a positive impact in their care."

Vaikom Mahadevan, MD, the Edward Budnitz, MD, Professor in Cardiovascular Medicine and chief of Cardiovascular Medicine, and an expert in adult congenital heart disease (ACHD) was recently consulted for consideration of transcatheter pulmonic valve replacement. The patient who had a history of congenital pulmonary stenosis, had undergone open repair at the age of 9 months. They subsequently underwent a surgical pulmonic valve replacement in 2021, and three months following surgery were anemic and began IV and oral iron replacement. The anemia progressed and the patient started requiring regular blood transfusions. After extensive hematology evaluation, the patient was found to have hemolysis with no other identifiable cause apart from the bioprosthetic heart valve. The patient also had an echocardiogram that suggested moderate pulmonary regurgitation and had some right heart failure symptoms, along with hypoalbuminemia. Records were obtained from the referring hospital and a telehealth appointment was made to evaluate the patient. Ultimately after consultation with Dr. Mahadevan and his team, a plan was made for the patient to undergo a transcatheter pulmonic valve-in-valve procedure at UMass Memorial Medical Center. In addition to Dr. Mahadevan, structural heart coordinators Ashleigh Poptic, ACNP-BC, and Nicole Majkut, PA-C, along with catheterization laboratory members Sue Maddelena, Tara Zidonis, Raul Navarro, and Stephanie Costello, worked to coordinate resources, appropriate equipment, and perform staff education in preparation for the procedure. 

In mid-September, the patient was pre-admitted under the care of Kevin O’Day, MD. They were then transferred to the cath lab for transcatheter tricuspid valve‐in‐valve (TPViV) implantation with the team led by Dr. Mahadevan, and including Jennifer Walker, MD, of Cardiac Surgery, Nikolaos Kakouros, MD, PhD, director of the structural heart disease program and co-director of the transcatheter aortic valve replacement program, and Dr. Ujjwal Rastogi, a structural heart fellow. The cardiac anesthesia team led by Dr. Brian Gebhardt provided anesthesia support. Procedural staff included Dan Niemi, RT, Mary Blair, RN, and Ivette Bryan-Picard, RN. 

The procedure and recovery went very well, and the patient was discharged the following day. The patient was able to return home within a week of the procedure and has continued follow-up care planned with their local adult congenital heart disease cardiologist.

We congratulate the entire team on this successful procedure!

Constantinos Michaelidis Receives Hospital at Home Users Group Clinician of the Year Award 

Constantinos (Taki) Michaelidis, MD, MBA, MS, medical director for UMass Memorial Health’s Hospital at Home Program, and assistant professor of medicine in the Division of Hospital Medicine, has been honored with the Hospital at Home Users Group Clinician of the Year Award. Dr. Michaelidis was celebrated for delivering exceptional patient care and for building and improving the hospital-at-home program. 

Sunita Puri Receives Amy Sylvester Award for Healthcare Excellence 

Sunita Puri, MD, associate professor of medicine, program director of the Hospice and Palliative Care Medicine Fellowship, and provider in the Division of Palliative Care, was recently awarded the Amy Sylvester Award for healthcare excellence from the NVNA and Hospice’s Charitable Fund Board of Trustees. Dr. Puri was recognized for her leadership, candor, and compassion in the palliative care conversation. The award is presented annually to individuals who have made an impact on health care in their communities by way of philanthropy, advocacy, or education. 

Irina Radu, MD, MHA, a cardiology postdoctoral fellow, presented her poster on the important work that the UMass Chan Postdoctoral Association is doing to empower diversity in postdoctoral scholars at this year’s UMass Chan Diversity Summit poster session that was held on October 11, 2023.  

Sunita Puri Featured on Voices of UMass Chan Podcast

In a new Voices of UMass Chan podcast out this week, Sunita Puri, MD, draws on her experience in the field of palliative care while discussing the hidden harms of CPR.

“[What] we should be talking about with [the patient] is, is CPR going to help restore the…quality of life you want and is your underlying issue reversible, meaning, do we have a reasonable chance of treating the cause of potential arrest,” said Dr. Puri. “When somebody has end-stage cancer, end-stage cirrhosis, heart failure, we have to be honest with patients and ourselves about the limits of what we can do and the limits of the body, and I don't think we're good in our society, in general, let alone in medicine, discussing limits.”

The UMass Memorial Cancer Survivorship Program is now live! The program is designed to give cancer survivors the tools and resources to aid in navigating life beyond cancer treatment and improve overall quality of life. 

More information can be found by visiting the site below.

Poem by UMass Chan Medical School Graduate Expresses Impact of “Images” 

Wendy Stead, MD, an infectious disease specialist at Beth Israel Deaconess Medical Center in Boston and graduate of UMass Chan Medical School had her poem, “Images of the Week,” published in the Journal of the American Medical Association. We invite you to read her powerful piece.  

Happy Halloween from the Department of Medicine!

The Department of Medicine Grand Rounds series continued this past month with presentations from Dr. Jonathan Gerber, chief of the Division of Hematology and Oncology, titled "The UMass Cancer Center - Past, Present, & Future," members of the Internal Medicine Residency Diversity Action Council, Drs. Sakeina Howard-Wilson, Divya Sudireddy, Andrew Sheridan, Alessandro Colletta, Victor Acosta-Rivera, Kanav Gupta, and Aditi Singh, MPH, ScM, titled "Redlining and its Effects of Health Disparities," Drs. Deborah Blazey-Martin, Christine MacGinnis, Wendy Mitchell, and Gregory Leslie, titled "Transitions of Care: Every System is Perfectly Designed to Get the Results that It Gets," and from Dr. Jon Kabat-Zinn, PhD, Professor Emeritus, UMass Chan Medical School, titled "Mindfulness at UMass and its Impact in the World - Forty-Four Years and Counting."

It has been a fantastic start to the year with outstanding presentations from our speakers. If you missed them or would like to view them again, please click the button below