MU Department of Medicine 2011-2013 Annual Report Feb. 2014 | Page 29

2011-2013

Department of Medicine

29

OverView of clinical programs + Services
Dr. Bobba has been helping improve clinic experiences as a

APN survivorship clinics, APN chemotherapy counseling clinics,

clinical medical director. We have continued to develop many

and is providing urgent patient care in the Symptom Evaluation

multi-disciplinary treatment programs over the past two years

Clinic (SEC). The SEC is highly valued by patients, plays an

to include multi-disciplinary conference for urology, as well as

important role in patient satisfaction, and allows patients to have

the breast cancer program for which we are recruiting a medical

access to knowledgeable care in a timely fashion versus a non-

oncologist to serve as the program director. We anticipate the

oncology specialist with long waits in the ER. Under Dr. Freter’s

need to also recruit an additional breast medical oncologist.

direction, the division now offers a bone marrow biopsy service

The ENT program is a well-established program and needs a

line that offers patients conscious sedation in the context of a

medical oncologist to suppor t it. We are also working with an

well-trained team of faculty, fellows, trainees, nursing, and lab

orthopaedic oncologist to develop a sarcoma program for mid-

personnel to provide the best possible patient experience and to

Missouri. In order to further develop the melanoma service line,

insure maximum diagnostic information. The division provides

we need to recruit one medical oncologist. The hepatobiliary/GI

a 24/7/365 Hematology/Medical Oncology inpatient service

multi-disciplinary program is in need of a medical oncologist as

and consult service to the entire medical center and community

well. The hematologic oncology program has been established

(MOI, WCH, Rusk, VA, Boone Hospital). Outreach negotiations are

and is being developed with projected faculty recruitment to

currently occurring across Missouri in Jefferson City, Hannibal,

grow the program and to help set the foundation for a bone

Macon, Kirksville, Marshall, and Sedalia.

marrow transplant program in the future. We have established
a sickle cell disease program which has had a very favorable
media and patient response. The hemophilia treatment program
(in conjunction with Pediatric Hematology/Medical Oncology)
has continued to develop and now has its own separate clinic
location to emphasize its focused patient care nature. We are
in the process of the completion of a hemophilia grant and
340B pharmacy application that would funnel funding back
into the hemophilia program. Our APN group is now offering

Overview of education
We received 200 applications and sent 20 interview requests

indication, adequacy of specimen, and ordering of appropriate

for three open positions for the 2013 fellowship year. We

tests. We will then be able to better track the outcome of

matched all three in our highest five, of which we are proud.

the biopsies. We have division participation in the school of

Our program has very recently undergone a transition to

medicine educational programs including the problem based

Donald Doll, MD as program director. A. Mosharraf Hossain, MD,

learning series and case wrap ups by Drs. Freter and Doll.

remains on as assistant program director and is very involved

Faculty participated in core conference lectures to the medicine

in overseeing the fellows’ quality improvement (QI) projects.

residents and participate in the education of residents as an

Each fellow is involved in a QI project to include: work with the

ongoing activity involving specific curriculum for residents

computer physician order entry (CPOE) committee to create and

rotating on the Hematology/Medical Oncology inpatient service

implement the direct electronic medical record (EMR) entry of

conducted daily by faculty and fellows assigned to that rotation.

chemotherapy source orders which helped create an EMR form
that will help eliminate human error for chemotherapy treatment.
Drs. Triplett and Khozouz have written case discussions and
questions (evidence based) for Dr. Doll’s Hematology Case
Review book. We will use our last year’s American Society of
Hematology In-Service Exam (ASH ISE) score as pre-intervention
baseline. The fellows took ASH ISE again in February, 2012
and we will consider that as post intervention. Dr. Rastogi will
complete the analysis with pre and post intervention data.
Dr. Nistala is working to develop the protocol for Cetuximab
reaction monitoring to reduce the rate of reaction and it is near
completion. Fellows are involved in a QI project involving a
bone marrow biopsy quality indicator. They are looking at the

Dr. Doll is one of our institutions finest educators, receiving
multiple teaching awards. He gives weekly PBL lectures to
both medical residents and also surgical pathology residents.
All faculty are ongoing participants in daily contact with
trainees in multiple learning venues including the Hematology/
Medical Oncology inpatient service and consult service, and
outpatient clinics. The inpatient service is a 24/7/365 service.
The Hematology/Medical Oncology fellowship program has
educational conferences that include hematopathology/
hematology patient management conference where they
review peripheral blood smears, bone marrow readings, surgical
pathology coordination, molecular diagnostics, and patient
management. There are weekly board review conferences with