4 doctors awarded MacArthur genius grants

Winners were recognized for delivering care to underserved areas, improving patient safety and developing new types of palliative and HIV care.

By Tanya Albert Henry — Posted Oct. 20, 2008

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Four physicians and a medical historian each will ponder how to put $500,000 to good use.

The five are among 25 people who received an unexpected call from a MacArthur Foundation representative in late September informing them that they had been named 2008 MacArthur Fellows. The designation comes with a half-million dollars given over the next five years with "no strings attached."

That's a lot more zeros than physicians see on checks from Medicare and Medicaid, said newly named fellow and Alabama family physician Regina M. Benjamin, MD, a former AMA Board of Trustees member. She would like to put some of her award toward scholarships for minority and rural junior high school students to help them choose health care careers. Beyond that, she's still thinking through how to make the most of the opportunity she has been given.

"I am overwhelmed, excited and humbled by this," said Dr. Benjamin, chair of the AMA Council on Ethical and Judicial Affairs and a past president of the Medical Assn. of the State of Alabama. "I want to make sure I take some time and think about how I can make a difference with the money."

The MacArthur Foundation recognized Dr. Benjamin for "forging an inspiring model of compassionate and effective medical care in one of the most underserved regions of the United States" and for "ensuring that the most vulnerable among us have access to high-quality care." She founded the Bayou La Batre Rural Health Clinic in 1990 and uses her pickup to drive to isolated and immobile patients who cannot get to her. She also has helped others around the nation establish clinics in remote areas.

The foundation also gave one of its "genius grants" to Baltimore critical care physician Peter Pronovost, MD, PhD, for his work to improve hospital patient safety. Dr. Pronovost was chosen a 2008 fellow because he "is sparing countless lives from the often deadly consequences of human error and setting new standards of health care performance in the United States and internationally."

The Johns Hopkins University School of Medicine anesthesiology and critical care professor, and director of the Johns Hopkins-affiliated Quality and Safety Research Group, created a system that cuts bloodstream infections from central venous catheters in intensive care units through use of a checklist of five precautionary steps. A study in Michigan ICUs showed that the system slashed infections by 66%. Now hospitals in the U.S. and Europe are adopting it. Dr. Pronovost has several other projects under way, including a Web-based ICU safety reporting system.

Dr. Pronovost said the fellowship is unique because the MacArthur Foundation doesn't need to approve the projects the money goes toward and doesn't expect any reports. "They trust the creative vision of the recipients," he said.

Innovations in AIDS care

In New York, 2008 MacArthur fellow Wafaa El-Sadr, MD, MPH, is exploring how this unexpected money will help her and colleagues in the U.S. and around the world create innovations in the areas of HIV/AIDS and tuberculosis care.

"The fellowship has made me stop and think about some of the things I wanted to do but have not had the funding to do," said Dr. El-Sadr, director of the International Center for AIDS Care and Treatment Programs and the Center for Infectious Disease Epidemiologic Research at Columbia University Mailman School of Public Health in New York.

Dr. El-Sadr, also chief of the Division of Infectious Diseases at Harlem Hospital Center, has identified alternative medications for patients who cannot tolerate a preferred HIV therapy. She also has led investigations of preventive measures, such as early trials of antimicrobial gels that may inhibit HIV.

Dr. El-Sadr is internationally recognized for her leadership in preventing maternal-child HIV transmission. Beyond perinatal retroviral inhibitors reducing infant risk of contracting HIV, she has shown that aggressive drug therapy throughout pregnancy and beyond is vital to a child's well-being.

Dr. El-Sadr "sets ever-improved standards for health care delivery for patients facing devastating disease under severe economic hardship," the MacArthur Foundation said.

New York geriatrician and internist Diane Meier, MD, was named a 2008 fellow for her work in palliative care. The foundation noted that she is "addressing an urgent medical and social need for transforming treatment for the seriously ill into more human and effective care."

Dr. Meier established the Hertzberg Palliative Care Institute at Mount Sinai School of Medicine and serves as director. The program assists patients and families in navigating the complexities of illness and devises strategies for managing pain as well as anxiety, depression, sleeplessness and appetite loss. Dr. Meier also serves as director of the Center to Advance Palliative Care and is a geriatrics and internal medicine professor at Mount Sinai.

"This award is not for me. This fellowship is for everyone who has been working so hard in this field for so many years," Dr. Meier said.

In addition to an astronomer, an urban farmer, a neuroscientist and a novelist, this year's fellows also included a historian of medicine. Nancy Siraisi, PhD, has written books looking at new aspects of Renaissance medical practice, said the MacArthur Foundation. Her research has explored the impact of medical theory and practice on Renaissance society, culture and religion. Previous work focused mainly on how Greek and medieval Arabic manuscripts influenced Renaissance medicine.

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