I am struck by the dichotomy in health care news. First I read about how the physical exam

is antiquated, and more than that, it is an impediment to good medicine. Why? Because it

takes too long, and physicians don’t have much time to spend with a patient. Why palpate

for the spleen or liver when the complaint is a sore throat? Why do a testicular exam when

the complaint is an ear ache? In the rush to see more patients in less time, do we really want

to discard the thorough physical exam?

I am sure everyone has some story of something they discovered while examining a patient

that was unexpected. Even I have one, although over the years I think the story has under-

gone revisions. I once discovered a Virchow node in an asymptomatic patient and made the

diagnosis which turned out to be correct of gastric cancer. It is hard to be too pleased with

oneself in making a diagnosis which at the time I am sure was not curable and also to think

that Rudolf Virchow, the German pathologist, first described the node and its association

with gastric cancer in 1848.

How would you do a complete exam, or even a focused one, if you never learned the proper

technique? This is why we have continued to have a group of physicians, all retired, who

spend time observing and teaching third year students on the wards how to do a complete

physical. Most students are smart enough to realize what an amazing opportunity this is to

learn from the “master.” Many feel this is the best part of their clerkship experience. Some

feel this is a complete waste of time. We call them promising orthopedists.

Seems to me we are confusing the art of the physical exam with the argument over the worth

of the yearly physical. There are many who now question the efficacy of the yearly physical

as far as cost, time and outcomes. Is it really cost effective in the healthy patient? Is it fre-

quent enough for the ill? For a 15 minute visit with a specific problem of course a focused

exam is necessary.

But then I read that we shouldn’t worry how much time is spent with the patient, in fact the

new trend is to do more home visits and spend as much time as needed. We are talking about

universal home visits, not just for elderly with limited mobility where home visits have been

shown to reduce recurrent hospitalizations, but for non-emergent illnesses in anyone.

On one hand we are saying that it takes too long to completely examine someone, yet we can

have physicians spend time driving all over town to see someone with a cold in their home

because it is more convenient for the patient. Given the limited ability to do anything in

someone’s home without ancillary support, how can this be good or cost effective medicine?

The first thing you need to do if you try and bill someone for a home visit is to list the reason

why the person couldn’t be seen in the office. Therefore, we are talking about a cash busi-

ness. Now it starts to make sense. If you drive fast enough and charge enough this could be

cost effective for the physician. Why not uberdoc? Call for the closest roving physician.

Now don’t steal this idea while I work on the ap.

July 2017 Volume 21, Issue 7

GW Medicine Notes A Monthly Publication of the GW Department of Medicine

From the Chairman The End-of-the-Year Party was a huge

success.

To continue the tradition, we also had

the end of the year photo taken at the

party (see page 4).

AWARDS

Department of Medicine Faculty of the Year Shant Ayanian, MD

Non-Department of Medicine Faculty

Member of the Year Philip Zapanta, MD

Clinic Attending of the Year

David Popiel, MD

VA Attending of the Year Dan Chen, MD

Fairfax Attending of the Year

Homan Wai, MD

Fellow of the Year Aung Myint, MD

Jorge Rios Resident of the Year

Nawaf Abaalkhail, MD

VA Resident of the Year Betsy Kidder, MD

Fairfax Resident of the Year

Lei Lynn, MD

“ICU” Resident of the Year

Veeshal Modi, MD

Intern of the Year

Seemal Awan, MD

Preliminary Intern of the Year

Austin Debeaux, MD

Annual Susan Hasselquist Award Presented to a resident who exemplifies

compassionate care combined with clinical and

diagnostic excellence Caitlin Mingey, MD

Gordon Moshman, MD ‘78 Primary Care

Resident Award Sara Pike, MD

Congratulations to All !!

Alan G. Wasserman, M.D.

End of the Year Party

Department of Medicine July 2017 Grand Rounds

Page 2 GW Medicine Notes

Need to find a resident on an

inpatient team?

We are no longer using RF phones for primary

communication, and no longer using Amion for

schedules! Login to gwu.medhub.com, click on

"Schedules," and click "Calls/shifts." Residents

are listed in black and attending are listed in

blue. Please use Tiger text to reach the appropri-

ate physician. (You can also find the on-

call Administrative Chief Resident on the

MedHub schedule for programmatic needs. If

you have trouble with your MedHub account,

please contact Mary Mitchum at mdmitch-

um@mfa.gwu.edu.)

Resident Lecture Series July 2017 Noon Conference

MAR 1 Journal Club MAR 2 GME Core Lecture

MAR 3 Medicine Grand Rounds MAR 4 Chairman’s Rounds

MAR 7 “Oral Health in Primary Care”- Dr. Pierre Carter MAR 8 Mortality & Morbidity-

Drs. Dana Kay and JoeDelio MAR 9 “Genetic Screening”- Dr. Macri and Andrew Nance, MS4 MAR 10 Medicine Grand Rounds

MAR 11 Chairman’s Rounds MAR 14 TBD

MAR 15 “Chronic Disease Prevention and Management: A Dentist’s Perspective”- Dr. Pierre Carter

MAR 16 GME Core Lecture MAR 17 Medicine Grand Rounds

MAR 18 Chairman’s Rounds MAR 21 “Special Topics in Adult Oral Healthcare: Geriatrics,

Oropharyngeal Cancer, Infectious Disease Prevention, and Women’s Health”- Dr. Pierre Carter MAR 22 Clinicopathologic Conference-

Drs. Abeer Alfaraj and Rami Al Sharif MAR 23 TBD

MAR 24 Medicine Grand Rounds MAR 25 Chairman’s Rounds MAR 28 TBD MAR 29 TBD

MAR 30 TBD MAR 31 TBD

JULY 6 “Educating Tomorrow’s

Physicians”

Richard Simons, MD

Senior Associate Dean for MD Programs

Professor of Medicine

GW Medical Faculty Associates

JULY 13 “Chronic Pain”

Danielle Doyle, MD

Assistant Professor of Anesthesiology and

Pain Medicine

GW Medical Faculty Associates

JULY 20 “Advances in Biology and

Therapy of Lymphoma”

Mitchell Smith, MD

Professor of Medicine

Division Director

Division of Hematology/Oncology

Department of Medicine

GW Medical Faculty Associates

JULY 27 “GSTM1, APOL1 and Kidney

Disease”

Gabor Bodonyi-Kovacs, MD

Assistant Professor of Medicine

Division of Kidney Disease & Hypertension

Department of Medicine

GW Medical Faculty Associates

The George Washington University Medical Center (GWUMC) is accredited by

the Accreditation Council for Continuing Medical Education (ACCME) to

sponsor continuing medical education for physicians. GWUMC designates this continuing medical education activity on an hour-for-hour basis in Category I of

the Physician’s Recognition Award of the American Medical Association.

(AMA).

JULY 1 JULY 4 HOLIDAY

JULY 5 “Intro to HIV”- Dr. Marc Siegel JULY 6 “Hospital Wound Care”- Kathleen Kurntke

JULY 7 Medicine Grand Rounds

JULY 8 “Oral Health”- Pierre Cartier JULY 11 “Sepsis”- Dr. Katrina Hawkins

JULY 12 Mortality and Morbidity- Drs. Sara and Tina JULY 13 “Thyroid Nodules”- Dr. Jill Paulson

JULY 14 Medicine Grand Rounds JULY 15

JULY 18 “Drug Allergies”- Dr. Richard Nicklas JULY 19 “TBD”- Dr. Khaled el-Shami

JULY 20 “Radiology”- Dr. Michael Burke

JULY 21 Medicine Grand Rounds JULY 22

JULY 25 “Reading CXR”- Dr. Jalil Ahari JULY 26 “Neutropenic Fever”- Dr. Afsoon Roberts

JULY 27 JULY 28 Medicine Grand Rounds

JULY 29

JULY 3 “Alcohol Withdrawal”– Dr. Karolyn Teufel JULY 4 HOLIDAY

JULY 5 “Thyroid Nodules”- Dr. Jill Paulson

JULY 6 Medicine Grand Rounds JULY 7 “Intro to HIV”- Dr. Marc Siegel

JULY 10 “Sepsis”- Dr. Katrina Hawkins JULY 11 Patient Safety Conference

JULY 12 “How to Host a Family Meeting”- Dr. Erica Schockett

JULY 13 Medicine Grand Rounds

JULY 14 “Congenital Heart Disease”- Dr. Christian Nagy

JULY 17 “DVT Prophylaxis”-Dr. Sara Wikstrom JULY 18 “Arrhythmia”- Dr. Alan Solomon

JULY 19 “Anaphylaxis”- Dr. Richard Nicholas

JULY 20 Medicine Grand Rounds JULY 21 “UTI”- Dr. Jillian Catalanotti

JULY 24 “Advance Care Planning”- Dr. Katalin Roth JULY 25 “Neutropenic Fever”- Dr. Afsoon Roberts

JULY 26 “Approach to Anemia”- Dr. Shant Ayanian JULY 27 Medicine Grand Rounds

JULY 28 TBD

JULY 31 TBD

CARDIOLOGY

GRAND ROUNDS

WILL RETURN

IN SEPTEMBER

Medicine Team Contacts

GW Medicine Notes Page 3

Patients made a gift in the physician’s honor to the

Grateful Patient Discovery Fund, which supports

crucial priorities for GW’s Department of Medicine.

Ashte Collins- Renal

Shailendra Sharma- Renal

James Ahlgren- Hem/Onc

Jonathan Reiner- Cardiology

Allen Solomon- Cardiology

Paul Silver- DGIM

Robert Jablonover- DGIM

Tania Alchalabi- Geriatrics

Katalin Roth- Geriatrics

Dianne N. Thompson, MD received her Medical Degree from

Howard University School of

Medicine in 2014; and just completed her three year residency

here at GW. She will continue at the Washington DC Veterans

Medical Center for one additional year as a Chief Medical Resi-

dent in July 2017. She will obtain special training through the

VA system to be their “Quality Improvement” chief this year.

Dr. Thompson has participated in research projects at both

Howard University School of Medicine and Johns Hopkins Uni-

versity and is published. She has a record of voluntary service;

serving the uninsured and underserved patients of the Wash-

ington DC metropolitan area and participated in the Mammo-

day Program, which offered free breast cancer screening and

diagnostics. Dr. Thompson is known for her gentle bedside

manner and has an interest in using quality improvement to

make inpatient geriatric care safer. She plans to practice medi-

cine as a generalist, and is currently deciding between the in-

and outpatient settings. She is bilingual, speaking English and

Spanish.

Joseph Delio, MD received his Medical Degree from The

George Washington University, School of Medicine, and

stayed on at GW for Internal Medicine residency. He will con-

tinue at the GWU MFA for one additional year as a Chief Med-

ical Resident, starting in July 2017.

Dr. Delio is published, and has presented in a number of fo-

rums and has also participated in research activities. He is in-

terested in Pulmonary and Critical Care Medicine as a career.

Dr. Delio is known for his excellent organizational skills (he has

an undergraduate accountancy degree), and his personal in-

terests include baking, skiing, and reading the Stock Market.

Kanika Gupta, MD received her Medical Degree from The

George Washington University in 2014 and also stayed on at

GW for Internal Medicine residency. She will continue at the

VAMC as a Chief Medical Resident for one additional year

starting in July 2017. Kani will receive extra training to be the

VA’s “Evidence-based Medicine” chief resident this year and

will also be the program’s liaison to the NIH Clinical Center.

Dr. Gupta is interested in hematology/oncology as a career.

Dr. Gupta has six publications, four of which are as first author,

and has published and presented a number of abstracts and

posters. She is known for her website-design prowess and her

calm, rational demeanor. She has native fluency in English,

spoken Hindi and conversational fluency in Spanish.

Vani Pyda, MD received her Medical Degree from Drexel Uni-

versity College of Medicine in 2014. She just completed her

three year residency here at GW. She will continue at the GWU

MFA for one additional year as Chief Medical Resident in July

2017.

Dr. Pyda has served on the editorial board of The Department

of Medicine’s Humanities magazine, Cuentos. Her career inter-

ests include Primary Care, Preventative Medicine and wellness,

and Weight Management. Dr. Pyda’s hobbies include caring

for her new cat, and she has a phenomenal singing voice –

previously performing with the Lehigh University Echoes a ca-

pella singing group.

Lei Lynn, MD received her Medical Degree from the University

of North Carolina School Of Medicine, Chapel Hill in 2014. She

completed her Internal Medicine Residency at The George

Washington University in June 2017 and will continue with the

MFA for one additional year as Chief Medical Resident in July

2017.

Dr. Lynn plans to have a career in Hospital medicine. Her hob-

bies include floral design, and she even arranged the flowers

for her own wedding. Dr. Lynn is fluent in English and Manda-

rin.

Please Join Us In Welcoming Our New Chief Residents

Grateful Patient Discovery Fund

Congratulations…to Dr. Ashte Collins and his family on the newest addition to their family.

Carter Collins who arrived on 6/13 (a little early) while on vacation in Miami.

The George Washington University Medical Faculty Associates

Department of Medicine, Suite 8-416

2150 Pennsylvania Avenue, NW

GW Medicine Notes Page 4

2016 - 2017 Department of Medicine End-of-the-Year Party

June 9, 2017