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BUFFALO PHYSICIAN
Volume 29, Number 1
ASSOCIATE VICE
PRESIDENT FOR
UNIVERSITY
ADVANCEMENT
Dr. Carole Smith Petro
DIRECTOR O F
PUBLICATIONS
Timothy J. Conroy
PUBLICATIONS MANAGER
Judson Mead
PRODUCTION MANAGER
Ann Raszmann Brown
EDITOR
Nanette Tramont, R.N.
ART DIRECTOR
Alan J. Kegler
STATE UNIVERSITY O F
NEW YORK AT BUFFALO
S C H O O L O F MEDICINE
AND BIOMEDICAL
SCIENCES
Dr. John Naughton, Vice President
for Clinical Affairs, Dean
EDITORIAL BOARD
Dr. John A. Richert, Chairman
Dr. Russell W. Bessette
Dr. Martin Brecher
Dr. Harold Brody
Dr. Richard L. Collins
Mr. Ravi Desai
Dr. Alan J. Drinnan
Dr. James Kanski
Dr. Elizabeth Olmsted
Dr. Barbara Majeroni
Dr. Charles Paganelli
Dr. Thomas Raab
Dr. Stephen Spaulding
Dr. Bradley T. Truax
TEACHING HOSPITALS AND
LIAISONS
The Buffalo General Hospital
Michael Shaw
Buffalo VA Medical Center
Arlene Kelly
The Children's Hospital of Buffalo
Erie County Medical Center
Mercy Hospital
Millard Fillmore Health System
Frank Sava
Roswell Park Cancer Institute
Sisters of Charity Hospital
Dennis McCarthy
© The State University of New York
at Buffalo
Buffalo Physician is published
quarterly by the State University of
New York at Buffalo School of
Medicine and Biomedical Sciences
and the Office of Publications. It is
sent, freeof charge, to alumni, faculty,
students, residents and friends. The
staff reserves the right to edit all copy
and submissions accepted for
publication.
Address questions, comments and
submissions to: Editor, Buffalo
Physician, State University of New
York at Buffalo, University
Publications, 136 Crofts Hall, Buffalo,
New York 14260; or by e-mail at
notes@pub.buffalo.edu.
Send address changes to: Buffalo
Physician, 147 CFS Addition, 3435
MainStreet, Buffalo, New York 14214

Dear Alumni and Friends,

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his issue of the Buffalo Physician focuses on the increased emphasis the medical school
and the Graduate Medical Dental Education Consortium have directed to Primary
Care education and on selected aspects of medical practice in Western New York and
throughout the country. Ms. Nan Tramont, the Editor, has done an excellent job of
coordinating a large amount of information on these important areas. As I have reported
previously, the medical school and the Consortium have made
' ,
significant commitments to foster educational change at the medical
student and graduate medical education levels. The faculty through­
out all aspects of the medical school are now involved in a thorough
evaluation of the current curricular offerings, and are working
diligently to ensure that new initiatives designed to prepare UB's
graduates appropriately for the future will be ensured. Never before
in the history of American medicine has the need to coordinate
educational needs with future professional career needs been as
intense and necessary. UB will continue to provide leadership in this
important area, and through the Buffalo Physician you will be kept abreast of the school's
progress.
Best regards.
Sincerely,

John Naughton, M.D.
Vice President for Clinical Affairs
Dean, School of Medicine and Biomedical Sciences

Dear Fellow Alumni,

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lans are well under way for this year's Spring Clinical Day. Dr.Jack Coyne, program
chairperson, has organized a morning program centering on the theme of the
physician's role in recognizing child abuse. This topic, along with the increasing
recognition of family abuse, has become a national concern. The planned program
should be most educational and informative for all participants.
This year's Stockton Kimball Lecture will be given at Spring Clinical Day by Dr.
Richard Krugman, dean of the School of Medicine at the University
of Colorado, Denver, Colorado.
Recently, the five-year class reunion chairpersons met to review
plans for their respective class dinners and social events. As part of
this, many of you will be contacted by them for contributions to a class
gift. Please be generous if you are called and remember that funds
collected are used to benefit scholarship programs for deserving
medical students.
Recently, the Distinguished Medical Alumnus Award was pre­
sented to Dr. Noel Rose. This presentation was made at the Past
President's Dinner and it recognized Dr. Rose's outstanding achievements, as well as the
past efforts of numerous Medical Alumni Presidents.
The academic year for medical students is well under way, and early reports show a
very enthusiastic response by students for the Community Physician Program under Dr.
Roger Dayer's direction.
We on the board thank you for all your continued support and encouragement as we
prepare for this year's major event at Spring Clinical Day.
Sincerely,

Russell W. Bessette, D.D.S., M.D. '76
President, Medical Alumnus Association

Making Primary Care Primary • UB's innovative
Music's charms. Page 3.

programs are leading the nation in the push for
primary care.

Practicing their Calling

It's a brave new world for
today's practitioner as physicians are finding the
idyllic image of the solo practitioner as endan­
gered as the 10-cent phone call.

Then and Now
Medical School

ElAlumni
UB's emphasis an primary care
makes it a national leader.
Page 6.

Spoonful of Humor
Classnotes
1

On the cover: Residents David Milling, M.D., and Colleen
Mattimore, M.D., (on the right), and medical students Tami
Seaman and Steve Cook (on the left) help make up the cadre of
new and future primary care physicians trained at UB.

Below-average cognition may
herald treatment dropout risk

drinkers who tended to have more pre­
vious treatment experience. But the most
striking finding, researchers said,
showed that treatment completers
scored
significantly differently than
lcoholics who have below-average
cognitive abilities are more likely dropouts on the NAART and Trails B
to drop out of residential treat­
tests.
ment programs than those with
Over half of inpatients who scored
average or above-average cogni­
below-average dropped out of treatment,
tive abilities, according to a recent compared to only 19 percent of the
study by the Research Institute on Ad­
inpatients in the above-average group
dictions.
and 28 percent in the aver­
RIA research scien­
age group.
tists Donna M.
Czarnecki recom­
Czarnecki, Ph.D.,
mends that providers as­
and
Gerard
J.
sess clients' dropout risk
Connors, Ph.D., stud­
at intake, taking into con­
ied 136 clients admit­
sideration how much they
ted to the RIA's 28-day
drink, their treatment his­
Clinical Research Center
tory, general abilities and
treatment unit. The study
whether or not cognition is
compared clients who
impaired.
completed the program
"Because of the way
with those who left be­
alcohol and other
fore it ended, either
drugs affect the brain,
against medical advice
many clients may have
or because they were
some impairment when
discharged for adminis­
they first enter treatment.
trative reasons.
Initially, the cognitively
Cognitively limited dients may
The study showed rates need extra help in treatment.
limited clients may be over­
similar to those generally
whelmed by the standard
reported for such programs: 69 percent treatment program. They may need
of the clients completed the treatment
something extra to help them in treat­
program; 31 percent did not. As part of ment."
+
their admissions screening, investiga­
tors administered the North American
Adult Reading Test (NAART) and the
Trailmaking tests. The NAART, which
entails reading aloud, provides a rough
estimate of intelligence.
new study by UB researchers has
"Reading is not usually affected by
shown that breast-feeding prema­
long-term alcohol abuse, so this should
ture infants during the first three
provide a stable estimate of intelligence
to four weeks of life may help
or general ability," Czarnecki said.
protect them from developing the
"Trails B, which is a paper and pencil
potentially life-threatening bowel
test, is a behavioral measure that is sen­
inflammation, necrotizing enterocolitis.
sitive to cognitive impairment."
The findings show that premature in­
Clients who dropped out were heavier

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Breast-feeding premature babies
may offer protection bom NEC

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fants who are not breast-fed have about
a three times greater risk of developing
NEC during the first four weeks than
premature babies who receive any
amount of breast milk during that time.
Risks were nearly the same for breastand bottle-fed babies at two weeks, the
results showed, with the protective ef­
fect beginning to appear during the third
week, when the risk of NEC for babies
who had received no breast milk was
twice that of breast-fed babies.
Vivien Carrion, M.D., assistant pro­
fessor of pediatrics and lead investigator
on the study, presented the findings at
the Society for Pediatric Research meet­
ing in April.
The retrospective case-control study
involved 100 premature infants admit­
ted to The Children's Hospital of Buffalo
between January 1986 and December
1992 who developed NEC, and a ran­
dom group of 100 infants from the same
neonatal intensive care unit who did
not.
Babies were matched for age, weight
— all weighed less than 1,500 grams at
birth — and other significant factors.
An analysis of feeding methods from
the infants' medical records showed that
breast-feeding was significantly more
prevalent among the babies who did not
develop NEC than among those who
did. Babies in the control group also
were breast-fed longer than infants in
the case group.
"Our study shows that infants fed any
breast milk for three weeks or longer
prior to diagnosis were at lower risk for
NEC than those who were not breast­
fed," Carrion said. "There were no other
factors that accounted for the difference
between groups."
Members of the research team also
included Nadir Parsa and Linda Duffy,
Ph.D., both of the department of pediat­
rics and Children's Hospital.

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Music has charms to soothe a
savage surgeon, UB study says

IIB study shows most with SIBS
do not go on to develop sepsis

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laying music during surgery may
help some surgeons relieve stress
and improve their performance, a
UB study suggests.
But only music selected by the
surgeon had a strong positive ef­
fect during an experiment designed to
mimic the stress of surgery. Results
showed that music selected by the re­
searchers known specifically for its calm­
ing influence resulted in only slightly
decreased cardiovascular activity and
no improvement in performance.
The study, conducted by Karen Allen,
Ph.D., andjim Blascovich, Ph.D., of the
Center for the Study of Biobehavioral
and Social Aspects of Health, appeared
in the Sept. 21,1994 issue of the Journal
of the American Medical Association.
Various studies have shown the role of
music in relieving patients' anxiety and
pain before, during and after medical pro­
cedures, including surgery. Allen and
Blascovich said theirs is the first to study
music's therapeutic effect on surgeons.
They assessed how music affected sur­
geons' cardiovascular reactivityand per­
formance, enlisting 50 male volunteers
who listened to music during surgery to
perform mental arithmetic tasks in a
laboratory setting.
The tasks were performed twice un­
der three conditions — music of choice,
music selected by the researchers
(Pachelbel's Canon in D, a well-known
classical orchestral piece often included
in commercial "stress-reduction" tapes)
and no music. Baseline cardiovascular
readings were taken before and after each
task, and readings monitored during each
task and music condition. Performance
was rated for speed and accuracy by a
researcher blind to the study conditions.
Results showed the surgeons per-

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esearchers at the University at
Buffalo's Center for Pharmaco­
epidemiology have concluded that
one of the definitions of sepsis
and the conditions that precede it
— adopted two years ago to help
identify patients at risk of the most com­
mon cause of death in hospital intensive
care units—may, in fact, raise false alarms.
The study found that contrary to the
definitions promulgated by the Ameri­
can College of Chest Physicians and the
Society for Critical Care Medicine, 72.3
percent of patients with systemic in­
flammatory response syndrome (SIRS),
considered a precursor of severe sepsis,
do not go on to develop the condition.
The UB study included 1,754 patients
— one of the largest databases compiled
on patients at risk of developing sepsis.
A total of 1,649 patients, or 94 percent
of the group, developed SIRS.

Self-selected music engendered the best
performance.
formed substantially better when lis­
tening to their own selection.
Cardiovascular response also was sig­
nificantly lower during the self-selected
music segment. Average pulse rate was 78
beats per minute during the self-selected
music, compared to 110 during both the
Pachelbel selection and when no music
was playing. Both systolic and diastolic
blood pressure rose significantly in re­
sponse to stress during the no-music and
Pachelbel segments, but remained stable
during the physicians' choice of music.
No specific category of surgeon-selected
music was associated with favorable physi­
ological responses and improved perfor­
mance. "This experiment lends credible
support to the importance of individual
taste and selection of music," the authors
state. "James Galway and the Chieftans
playing Irish music complete with drums
and tin whistles had a more positive influ­
ence on the surgeon than the soothing
Pachelbel used as the control."
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New name better reflects mission
and origins of research group

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o recognize the partnership of
science and philanthropy that has
been a part of the Medical Foun­
dation of Buffalo since its found­
ing in 1956, the board of direc­
tors has announced that the
organization's name has been changed
to the Hauptman-Woodward Medical
Research Institute, Inc.
The institute's new name recognizes
the contributions of its president and
UB professor of biophysical sciences,
Herbert A. Hauptman, and the benefac­
tion of Helen Woodward Rivas and her
daughter, Constance W. Stafford, as well
as better describes its biomedical re­
search mission.
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©

HOSPITAL

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Dent Neurologic Institute offers
Positron Emission Tomography

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he Millard Fillmore Health Sys­
tem has become the first private
health care organization in West­
ern New York to offer Positron
Emission Tomography through
the Dent Neurologic Institute.
Isotopes for the sophisticated nuclear
imaging will be provided by UB, which
was the first to bring the technique to
the area at its Center for Positron Emis­
sion Tomography — a cooperative ven­
ture between the university and the
Department of Veterans Affairs — lo­
cated at the Buffalo VA Medical Center.
Millard's PET scanner — the Exact
HR PET Scanner — is one of the three
most technically advanced scanners in
the world. It was installed at Millard's
Gates Circle facility last spring.
"The potential of PET is limitless. Its
measurements of functional physiologic
activity in the body will not only allow
more timely service to patients in need,
but will also facilitate a greater under­
standing of the functioning human body
in all its complexity," said William
Kinkel, M.D., founding director of the
Dent.
+

strong community ties to her position
at Roswell Park," said Thomas Tomasi,
M.D., Ph.D., Roswell president and
CEO.
Well-known in the Western NewYork
community, Bontempo is the recipient
of the Outstanding Woman in Business
and Industry Award from UB's Com­
munity Advisory Council; the Clifton
C. Thorne Award for Outstanding
Achievement in Health Care and Hu­
man Services from Empire Blue Cross/
Blue Shield; and the 1989 Western New
York Chapter of the National Confer­
ence of Christians and Jews Certificate
of Recognition in Medicine, among oth­
ers. She holds honorary doctorates from
Niagara University and Canisius Col­
lege.
Bontempo received her master's de­
gree in health administration from St.
Louis University in Missouri and ad­
vanced certification in health manage­
ment and finance from Yale University.
She is a fellow of the American College
of Healthcare Executives and an active
member of the American Public Health
Association and Association of Cancer
Centers.
+

Angela Bontempo takes senior
vice presidential post at RPCI

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ngela Bontempo, former president
and chief operating officer of Sis­
ters of Charity Hospital, has been
appointed senior vice president
and executive director of Roswell
Park Cancer Institute.
Bontempo will oversee Roswell's ad­
ministrative, operational and fiscal man­
agement.
"Ms. Bontempo brings a high level of
administrative experience as well as

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Angela Bontempo

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Roswell and Millard lo establish
outpatient cenlei al Suburban

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oswell Park Cancer Institute and
Millard Fillmore Health System
have agreed to establish an ambu­
latory oncology facility at Millard
Fillmore Suburban Hospital. The
new center will provide the full
range of outpatient cancer services, in­
cluding chemotherapy and radiation
therapy.
The agreement marks the first time
that Roswell, a National Cancer Insti­
tute-designated comprehensive cancer
center, will operate a satellite unit at a
community hospital. The project must
undergo review and win approval by the
local Health Systems Agency and the
state Office of Health Systems Manage­
ment.
Roswell and Millard officials said the
facility, to be known as the Ambulatory
Oncology Centers of Roswell Park Can­
cer Institute and Millard Fillmore Hos­
pitals, will ensure access to high quality
cancer care to more than 450,000 people
in Millard Fillmore's primary service
area.
The 11,500-square-foot building is
scheduled to be completed in the fall of
1995. Roswell will lease space in the
facility.
Roswell will be responsible for pro­
viding technical and professional sup­
port for radiotherapy services; Millard
will be responsible for chemotherapy
services and related support services.
Roswell is recruiting a director for the
center and Roswell and Millard will con­
tract with each other for various admin­
istrative services.
As part of the agreement, a 6 MEV
linear accelerator, which Roswell will
acquire as part of its major moderniza­
tion project, will be located at the cen­
ter.
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HOSPITAL

N E W S

transplant immunology."
Joseph Jacobs, founder and chairman
of Jacobs Engineering Group, Inc., an
international engineering and construc­
tion firm with headquarters in Pasa­
dena, California, described his brother
as a "compassionate human being who
left an indelible mark in the field of
medicine in Buffalo and at Buffalo Gen­
eral."
Conditions of the grant also stipulate
that there be 100 percent participation
by hospital and foundation trustees in
the foundation's current "Campaign for
Visionary Healthcare in the 21st Cen­
tury."
+

Sisters Hospital opens expanded
women's specially referral cenler

Artist's rendering of Buffalo General Hospital's Institute for Molecular Medicine and Immunology.

Record gifl will establish center
for immunology research al BGH

he Buffalo General Foundation
will receive a $3 million gift to
support the creation of an Insti­
tute for Molecular Medicine and
Immunology (1MMI) in memory
of former Buffalo General Hospi­
tal President Theodore T.Jacobs, M.D.,
'38, who died last April at the age of 82.
William V. Kinnard, Jr., M.D., dis­
closed that Joseph J. Jacobs, Ph.D.,
brother of Theodore, will provide the
gift in the form of a challenge grant that
requires BGH's foundation to raise an
additional $6 million.
"The grant is the largest ever received
by Buffalo General and its foundation,
and we are tremendously grateful to
Joseph Jacobs and the Jacobs family for
helping us to establish this vital re­

search facility," said Kinnard, who suc­
ceeded Jacobs as BGH president in 1975
and served in the position until 1990.
Citing Buffalo General Hospital's
strong commitment to organ transplan­
tation and programs involving the im­
mune system and disease, Kinnard said
creation of the IMMI will have a major
impact on improving patient care and
enhancing the treatment of disease.
Kinnard said plans for the IMMI are
being developed in collaboration with
UB's School of Medicine and Biomedical
Sciences and with other local health
care providers, including Roswell Park
Cancer Institute and The Children's
Hospital of Buffalo. He indicated that
construction of the institute would be
completed by the end of the decade.
"As we envision it, the institute will
consist of major sub-divisions encom­
passing
cancer
immunology,
immunopharmacology, genetics and

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isters Hospital has opened the Sis­
ters Specialty Center for Women, a
referral center staffed byspecialists
to complement the care provided
by a woman's primary care physi­
cian.
The new center, located in the Seton
Building adjacent to the hospital, will
consolidate services already in opera­
tion, such as Sisters' Breast Care Center,
with new programs "to further expand
our program into a referral center which
will support, not compete with, our
private physicians," explained David R.
Verstreate, vice president for operations
at Sisters. "We offer a variety of spe­
cialty services all in one location and
thus provide a continuity of care for
women, originating with and led by
their primary care doctor."
The center will offer infertility ser­
vices, endocrinology, natural family
planning, breast care, perinatal medi­
cine, medical obstetrics, urogynecology,
post-reproductive gynecology and gy­
necological oncology.

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BECOMES A NATIONAL LEADER IN THE PUSH FOR PRIMARY CARE

S NATIONAL HEALTH CARE REFORM WAS GOING DOWN THE POLITICAL TUBES IN WASHINGTON LATE

THIS PAST SUMMER, A REFORM PROGRAM THAT PROMISES TO HELP CHANGE THE FACE OF MEDICAL

PRACTICE FOR DECADES TO COME WAS GAINING MOMENTUM IN BUFFALO.

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The highly regarded and ever-expanding initiative, which would increase the number of medical students and
residents pursuing primary care careers, introduced its first programs in the autumn of 1992. Led by the
University at Buffalo School of Medicine and Biomedical Sciences, in conjunction with the Graduate Medical
Dental Education Consortium of Buffalo (GMDECB), the primary care program is already reshaping the way
medicine is taught in Buffalo. This marks the first year, for instance, that a clerkship in family medicine becomes
a routine part of the third year. Primary care faculty are attending workshops to enhance teaching skills, and
a novel program that places primary care residents into community practices is growing.
Last June, the medical school won a prestigious, three-year, $600,000 Robert Wood Johnson Foundation
grant to continue the work; last September it won a two-year, $500,000 grant from New York State for the same
purpose.
"I think there's a lot to be excited about," John Naughton, M.D., vice president for clinical affairs and dean
of the medical school, said as he rattled off a litany of initiatives.
"We're seen as one of the leaders, I think," Naughton continued. "More of our people are being asked to give
talks at national meetings on our experiences, and people are coming to visit us to see what is going on."
One of those visitors was Randall Zuckerman, chair of the American Medical Student Association's Generalist
Physicians in Training Program. He was particularly impressed by an "externship" program that allows
undergraduate medical students to work alongside primary care physicians
i n their practicesduring thesummer. "Ina lot o fschools, primarycare is

^ ^

talked about," said the third-year Dartmouth Medical School student. "But

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K r a t t

you have the full weight of the institution behind it."
The Buffalo program strives to tip back the specialist-generalist scale without using too heavy a hand. The
boldest move was the medical school's declaration that it would cap the number of residencies and evenly
distribute them between primary care and the sub-specialties. The remainder of the effort, however, employs
a gentler touch — one that seeks not to force people into primary care, but to make Buffalo more hospitable
to primary care, and thereby encourage more young professionals to choose it on their own. The strategy is both
simple and radical — remaking the image of the generalist.
"Students come in with a lot of misconceptions about what primary care in the community is like," said John
Feather, Ph.D., executive director of the Primary Care Resource Center, which coordinates many of the Buffalo
initiatives, "that they [generalists] are behind the times, that it's not as challenging intellectually. You know,
the classic Norman Rockwell picture of the family physician listening to the little girl's doll."
By improving teaching technique, encouraging research and exposing students to generalists in their own
practices, the programs seek to transform the old model of Rockwell's kindly but quaint doc into a role model
worthy of the best and brightest.
"It really takes a broader range of skills to be a generalist, but that hasn't been where society was placing their
values," noted Thomas Rosenthal, M.D., chair of family medicine and project director for the Robert Wood
Johnson grant.

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UB's primary care plishment in and of itself." In 1991-92,
emphasis can be traced the GMDECB's primary care residency
back a quarter century, slots totaled 40 percent; in 1992-93,
to its establishment of 41 percent; in 1993-94, 42 percent;
one of the nation's first and in 1994-95, 43 percent.
family medicine pro­
As for UB medical school gradu­
grams. In the mid-1980s, ates, the proportion entering primary
as medical graduates na­ care residencies has hovered around
tionally were showing 40 percent since 1991, with a jump
less and less interest in from 38 percent in 1993 to 42 percent
primary care, Naughton in 1994. Since the first of the demon­
said he began thinking stration project's undergraduate pro­
about providing more grams didn't begin until 1992, this
comprehensive ambula­ year's match may be a better indication
tory experience for of their effect. "If you wanted to get a
fourth-year students. completely accurate view you would
Then, in 1989, the state have to look at five years after resi­
authorized a demonstra­ dency," said Feather. "The problem is
"Primary care was the type of care I was interested in when I
tion project in which UB's that all the initiatives are not going to
entered medical school. UB strongly supports primary care. I feel
consortium of teaching have an impact on those numbers for a
hospitals would pool $5 decade. It's a very long process. We're
encouraged to go in that direction rathher than disuaded."
million from increased turning around a battleship."
I education reimburseNaughton said that while he re­
TAMI SEAMAN
1 ments to fund a broad mains committed to the original goals,
Analysts have grappled for years primary care initiative. The Reimburse­ "The object is not to reach 50 percent
with the paradox of a medical educa­ ment Demonstration Project's center­ for 50 percent's sake." The most im­
tion system that turns out ever more piece was a commitment to cap the portant goal, he said, is to increase the
physicians to practice at ever rising number of GMDECB residencies and proportion of generalists practicing in
cost without improving access to health allocate half to primary care by the the community, adding that he thinks
care. In 1978, an Institute of Medicine mid-1990s. The medical school also the last several years have laid the
task force suggested that things would talked enthusiastically
improve if 50 percent of physicians about sending 50 percent
DAVID MILLING, M.D.
were generalists, the minimum in most of its graduates into pri­
industrialized countries. The national mary care residencies.
"What they're doing here — increasing the ambulatory care
Council on Graduate Medical Educa­
The 50 percent goals
experience, giving you more clinic and more contact on an
tion has recommended the same. But remain to be met.
there are still two specialists for every
Residencies have been
outpatient basis — really enhances the primary care ideal."
generalist practicing in the United capped at 788, but the
States. Even if every last medical school proportion of primary
graduate were to suddenly choose pri­ care slots remains below
mary care from here on, it would still half.
take a full decade to reach a 50-50
"This is the year it was
balance.
supposed to reach 50 per­
"There's been much discussion of cent," said Roseanne C.
this for years and years, but not much Berger, M.D., associate
momentum," said Naughton.
dean for graduate medi­
"In an era where scientific advances cal education. "But what
and technological advances lend them­ we have done over the
selves to creating more specialists, now last three years is increase
we have to recognize that while those the total number of posi­
advances are important, the manage­ tions in primary care and
ment of them has to be done in a different restricted growth in the
way than we've been doing," he added. non-primary care posi­
"And that means a changing attitude in tions. And that has been
the way medicine is practiced."
viewed as a major accom­

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foundation for that.
In a broad sense, the effort is based
on the notion that familiarity with pri­
mary care practice will breed respect
for it. Planned changes in the medical
school curriculum, for instance, would
introduce patient-based clinical teach­
ing in the first year. An interdiscipli­
nary clinical correlations approach will
enhance basic sciences, and there will
be an emphasis on problem-solving
and self-learning skills.
"We feel that if we can produce
students who feel real comfortable and
well-skilled in the ability to discover
the maximum amount of information
through their eyes, ears and hands,
and in talking to patients, taking histo­
ries and doing the physical exam, then
they will feel better equipped to enter
a broad-based generalist field," said
Rosenthal. "We've been teaching medi­
cal students by giving them large
amounts of information organized ac­
cording to organs. We would like to
restructure it so that information is
still learned, but now organized ac­
cording to real world presentation."
Plans call for expanding the use of
office settings for pediatric and inter­

nal medicine clerkships.
At the same time, efforts
are under way to increase
ambulatory training op­
portunities for primary
care residents.
Key to these efforts is
the Community Aca­
demic Practice program,
which has designated
nine community prac­
tices around the region
as ambulatory training
and research sites for pri­
mary care residents, as
well as medical students.
CAP sites must demon­
strate a community ori­
"The primary care externship program got me hooked. I got to see
entation and be willing
how patients progressed over time — not how lab values do. It's
to make residents an in­
corny, but I really like that. It's why I went to medical school."
tegral part of their prac­
tice. They must also be
willing to participate in
STEPHEN COOK
practice-based research.
Each CAP site is connected to gree of prestige," he said.
HUBNET, the medical computer net­
On the undergraduate side, more
work operated by UB and its teaching students are learning about generalist
hospitals. Above all, each CAP must practice through the Primary Care
meet strict quality criteria. "This is one Externships open to them in the sum­
of the first times that community prac­ mers after their first and second years.
tices have had to undergo This voluntary program started in 1992
COLLEEN MATTIMORE, M.D.
a thorough investigation with 40 students and grew to 60 stu­
of quality," noted Paul dents by last summer. This summer 70
James, M.D., coordina­ slots are planned for students who will
"The academic faculty, world-renown for its research, combined
tor of the CAP program. spend six weeks working side by side
with the strong faculty of general pediatricians in the community,
James said that since with a generalist in a variety of com­
offers the perfect blend of primary care medicine."
the first sites were desig­ munity practices.
nated last year, their role
"They learn a great deal of clinical
has been expanded to medicine, but the goal of the program
serve as community- is to see what life is like as a primary
based continuity clinics care physician," said Michael Edbauer,
for some primary care D.O., assistant clinical professor of pe­
residents. "Many of us diatrics and externship coordinator. "I
believe that it would take don't think people appreciate what a
that sustained effort of positive feeling it is to interact with a
three years before people family and have them put their faith in
get a real clear picture of you, how much that means to a per­
the benefits of providing son."
care outside the hospi­
The program pays $1,500 to partici­
tal," he said.
pating first-year students and $2,000
James has been en­ to second-year students. Zuckerman,
couraged by the number of the American Medical Student Asso­
of practices applying for ciation, said the stipend not only helps
CAP designation. "There financially pressed students take ad­
seems to be a great de­ vantage of the externship, but it is also

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a symbol that generalists are valued.
"As far as I know, there are no other
schools in the country doing anything
like that," he said.
Other efforts aimed at elevating the
stature of primary care involve teach­
ing and research. The Teaching Effec­
tiveness Program offers workshops and
resource materials designed to enhance
the teaching skills of residents, as well
as full-time and voluntary faculty. Re­
cent workshops included "The Internet

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and HUBNET," "The Preceptor as
Mentor" and "Physician Self-Aware­
ness." The thinking behind the pro­
gram is that clinical teachers have a
great effect on career choice, and bet­
ter teachers make better mentors, pre­
ceptors and role models. A related
effort has led to a new master's degree
program called Education for the
Health Professions. The program, of­
fered by the UB Graduate School of
Education, began this autumn with 10

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physicians, most of them in primary
care specialties.
UB is also offering primary care fac­
ulty and residents opportunities to learn
or enhance research skills. According to
one description of the program, "The
development of a cadre of primary care
residents and faculty with an interest
in primary care research provides medi­
cal students with role models, and the
research they conduct generates pri­
mary care experiences for students."

Cooperation Marks the Movement to Balance UB's Generalists and Specialists
Creating a more even balance
between generalists and specialists
doesn't come easy. Not in terms of
the work required, and certainly
not in terms of the anxiety pro­
duced.
"I think there's concern among
all faculty," said John Naughton,
M.D., vice president for clinical af­
fairs and dean of the UB medical
school. "Specialty faculty is con­
cerned that they don't lose their
role in the medical education pro­
cess. And they won't. But they do
have to join with the total faculty in
not only educating physicians in
their own discipline, but joining in
the education of generalist physi­
cians."
Naughton said that ultimately
specialists have less to fear from
educational changes than they do
from the outside world. Managed
care has begun altering the generalist-specialist balance on its own —
so much so that about 60 percent of
specialists will be unnecessary by
the year 2000, according to re­
searchers at The Johns Hopkins
School of Public Health who exam­
ined physician work-force require­
ments for the Council on Graduate
Medical Education. Other areas
continue to be underserved by even
basic health care, and calls persist
for a comprehensive national ap­

proach to work force strategy. In the
current environment, UB's primary
care emphasis may be as much a
matter of sound career counseling
as prudent public health policy.
"By the year 2000 it's projected
there will be over 125,000 excess
specialists of all types in this coun­
try," said James Nolan, M.D., chair
of UB's department of medicine.
"The worry is, if we don't make the
primary care specialties more at­
tractive we will end up training spe­
cialists and there won't be jobs for
them."
Nolan recently chaired theAmeri­
can College of Physicians' Task
Force on Physician Supply. The
panel, reporting in the Oct. 1,1994,
issue of the Annals of Internal Medi­
cine, concluded that the generalistspecialist imbalance was so severe
and so persistent that "a national
commission is required with regu­
latory authority to set targets for the
total number and types of physi­
cians."
Gerald Sufrin, M.D., chair of both
urology and the Council of Clinical
Department Chairpersons, senses
that all faculty members realize the
urgency of UB's effort. "I don't de­
tect among the various specialty de­
partments that there is an over-em­
phasis on this," he said, adding that
specialists want to play a continuing

role in training generalists. "There's
a real sense that we should be part of
the solution," he said.
According to the plan for imple­
menting the Robert Wood Johnson
initiative, that will happen. In de­
scribing the use of psychiatry fac­
ulty as on-site preceptors to selected
primary care residents, the plan
states: "This effort is a beginning
step in our commitment to use the
generalist initiative to strengthen the
roles of our specialty faculty in the
training of generalist physicians."
Thomas Rosenthal, M.D., chair
of family medicine and project di­
rector for the Robert Wood Johnson
initiative, noted that changes in
medical education and training un­
der the initiative benefit everyone.
"Clearly our intent is to produce
excellent clinicians, and that more
of those clinicians will go into pri­
mary care," he said. "But we hope
we will have excellent specialists as
well as excellent generalists."
The basic sciences share an
equally significant role with the generalist and specialist faculty,
Naughton added.
"Obviously, the challenge to the
institution is that all three of these
important elements are working in a
synergistic way," he said. "And I
think they are."
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Family medicine and social and preventive medicine assis­
tant professor CarlosJaen, M.D., Ph.D., recently completed a
landmark study of residents of Buffalo's lower West Side that
found them considerably sicker than the U.S. population at
large. The results of the first comprehensive health survey of
this population found that the West Side residents face major
barriers to receiving adequate health care and that they suffer
from higher-than-average rates of smoking, alcohol con­
sumption, asthma and diabetes.
The Primary Care Resource Center instituted summer
assistantships for health services and clinical outcomes re­
search beginning in 1992-93. Plans call for expanding the
assistantships and incorporating primary care into existing
student research programs. Complementing the research
emphasis is a clinical scholars plan that would allow a
generalist resident to work toward a related advanced degree,
such as one offered by the department of social and preventive
medicine. A program description notes that it "will contrib­
ute importantly to altering the dichotomous view of general­
ist and specialist physicians as occupying opposite poles of
the intellectual continuum in medicine."
The list of specific programs and plans designed to turn out
more generalists goes on. A new recruitment program for
primary care residents combines previously separate efforts;
it is symbolized by a series of glossy brochures that proved so
popular a second printing was needed. Efforts are under way
to identify which medical school applicants are more likely to
pursue primary care, as are plans to make greater use of
interdisciplinary and collaborative opportunities in teaching
and the development of a tracking process to better learn how
all the programs are affecting ultimate career choices.
"There seems to be a great deal of interest among stu­
dents," said Dennis A. Nadler, M.D., associate dean for
academic and curricular affairs. "When you offer students
opportunities, you engender interest, and I believe we have."
The work going into it all is considerable.
The Primary Care Resource Center, which has taken over
ivy-covered Beck Hall, oversees many of the initiatives, coor­
dinating the medical school's primary care departments with
the GMDECB's residency programs. More than 100 faculty
members have been involved in planning and implementing
the Robert Wood Johnson Generalist Initiative, which itself
has seven goals and 35 objectives.
Michael Beachler, a senior program officer for the Rob­
ert Wood Johnson Foundation, said Buffalo has been
making a name for itself. "They're pretty good at getting
their own graduates into primary care residencies," he
said.
"It's not just the medical school, it's also the consortium
of hospitals around the area that have come together to
move in that direction. That's pretty unheard of. From my
end, kudos to both, the hospitals as well as the medical
school leadership."

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A Primer on Primary Care at UB
QUESTION: What is the primary care program?
ANSWER: It is not so much a single program—there is not
even a formal name for it — as it is a philosophical
commitment by UB and its teaching hospitals to produce
more generalists. The commitment has led to an array of
initiatives. Some of the major ones involve:
# Dedicating 50 percent of residency training slots to
primary care.
# Revamping the medical school curriculum to more closely
link clinical experiences to the basic sciences, as well as to
emphasize problem-solving and self-learning.
# Developing new community-based sites for medical edu­
cation and training.
# Improving teaching skills.
# Emphasizing primary care research.
QUESTION: How is it organized?
ANSWER: The focal point is the Primary Care Resource
Center, which operates under the direction of the Graduate
Medical Dental Education Consortium of Buffalo and the UB
departments of family medicine, medicine, pediatrics and
social and preventive medicine.
QUESTION: How is it funded?
ANSWER: Funding started with the Reimbursement Dem­
onstration Project in 1989. Under this project, the state
Department of Health made GMDECB hospitals eligible for
higher academic medical center teaching reimbursements. In
return, and in cooperation with area health insurers, they
pooled $5 million to cap and redistribute residencies and to
fund generalist projects, which began in 1992. Technically,
the project expired in 1994, but it is being renegotiated and
is expected to continue.
In 1992, UB also won a $150,000 planning grant under
the Robert Wood Johnson Foundation Generalist Physician
Initiative, and it was one of 14 sites nationally to be awarded
a follow-up implementation grant last June. That grant is
worth $600,000 over three years.
Last September, UB won another $500,000 grant from
the state health department, also to support generalist
initiatives.
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Practicing
Their Calling
It's a brave new world for today's practitioner

Only a few short decades ago, physicians had only a few choices to make to fulfill their calling, ft But as the
nation's hand-wringing over health care costs continues, those who are making a career in medicine are finding
that the idyllic image of the solo practitioner that many followed into medical school is as endangered as the 10cent phone call. Instead, many physicians are finding that surviving and thriving in private practice means
negotiating an alphabet soup of coalitions with names like IPA, PPO and HMO.

ft

Today, private-practice

physicians are finding a world of options in a climate of change, ft One option becoming increasingly more
popular is the group practice, either a single-specialty group or a multi-specialty group that encompasses a variety
of disciplines,

ft

A recent study by the American Medical Association showed that the number of group practices

increased dramatically in the two decades following 1965, then largely leveled off. In 1991 (the latest year for
which figures were available), the AMA reported 16,576 group practices were in operation.

Yet the number of physicians practicing in groups
has continued to increase. Also in 1991, 32.6 per­
cent of physicians (excluding those employed by the
federal government) were part of a group. "Between
1965 and 1991," the report notes, "the number of
groups increased by 286 percent and the number of
group physicians increased by 550 percent."
Multi-specialty groups were reported to include
a mean number of 24.6 physicians — more than
double the mean group size in 1965. Single-spe­
cialty groups grew from 4.1 physicians in 1965 to

©

6.8 in 1991.
The reasons for the increase are varied.
"Over the last several years, medical groups are
better positioned to deal with managed care contracts,"
said Penny Havlicek, manager of the AMA's group
practice database and an author of the study. "[A
health-maintenance organization] can find in one group
practice a provider for a large region, and they'd rather
do that than contract with a lot of independent physi­
cians. Certainly from a managed care perspective, groups
are easier to deal with."

And more remu­
nerative for their phy­
sicians. Havlicek noted
that 1991 figures
showed the average
group-practice
physician's net income
(after expenses but be­
fore
taxes)
was
$202,000; for solo or
two-physician practices,
the figure was $173,100.
And regardless of
how Congress decides
to structure the nation's
health care deliverysys­
tem, powerful market
forces already are at
work. In Minnesota and
California, two states where managed care has
made significant inroads, physicians are finding
HMOs and other coalitions impossible to ignore.
"There certainly are pressures in existence
that are serious pressures in terms of practic­
ing efficiently," said David W. Emmons, an
economist with the AMA's Center for Health
Policy Research. "There are regions where
large numbers of the patients have moved into
managed care programs." In such regions, he
says, physicians find it advisable to contract
with those programs — or risk being cut out of
the patient stream entirely.
Still, Emmons says, the trends may be less
overwhelming than they seem. In 1993, he said,
about 48 percent of the United States' 670,336
physicians had a contract with an HMO.
But only about one-third of their revenues
come from HMO, independent practice asso­
ciation (IPA) and preferred provider organiza­
tion (PPO) contracts. The balance comes from
more traditional health insurance providers.
Beyond economics, Havlicek said "lifestyle"
issues may also come into play when physicians
choose a situation in which to practice.
"With women increasingly going into medi­
cine, and also raising families, group practices
may be seen as more accommodating to
women," she said. "This might be true of
young male physicians as well" — motivated

"YOU

really

by the regular hours,
vacation and weekend
coverage and other sup­
ports that a group prac­
tice provides. (Not that
the life of a physician
ever lends itself to copi­
ous family time — no
matter what kind of
practice they're in, doc­
tors average nearly 59
hours a week at work.)
Still, what matters
most is how effectively a
physician can practice his
craft and his art. We took
a sampling of doctors in
several private-practice
situations — solo prac­
tice, multi-specialty group, single-specialty group,
staff-model HMO, group-model HMO and hos­
pital staff — and asked about the opportunities
and limitations they face.

have to be more

Solo practitioner
of a businessman
these days than
in the past. The
days of hanging
out a shingle and
making gobs of
money are long
gone."

Edward A. Toriello, M.D.
Orthopedic surgeon

"You really have to be more of a business­
man these days than in the past," said Edward
Toriello, M.D., '80, who works in a two-physi­
cian practice in Brooklyn. "The days of hang­
ing out a shingle and making gobs of money are
long gone."
That pragmatism is crucial to today's solo
practitioners, who are feeling the squeeze eco­
nomically as never before. Toriello, whose
orthopedics practice is not far from the neigh­
borhood where he grew up and very much
based on that neighborhood's economics, said,
"My little microcosm is kind of a dinosaur, in
that many of us in this area are still solo
physicians. It seems that Brooklyn and Queens
have a lot of small industry. [By comparison],
Long Island has Drummond Corp. If your
community has 80 to 90 percent of its workers
work at Drummond and Drummond decides
to go managed care, you pretty much have no
choice."

Fduurd V. Toriello. >1.1).
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Multi-specialty
group

But for now, Toriello
is enjoying "the indepen­
dence and freedom that
you have to practice
medicine the way you
feel is best, not only for
myself but also for my
patients. I like that." He
and his associate, Chris
Pavlides, M.D., share

Richard L. Collins, M.D.
Internist
Buffalo Medical Group

Richard

Collins,

M.D., '83, has seen many
sides of medical prac­
tice: from working in a
hospital outpatient
clinic, to directing a
community health cen­
ter, to two years as an
HMO staff physician.
For three years now, he
says he has found the
right balance — as an
internist with the Buffalo Medical Group, a

office staff and split the
rent, but maintain sepa­
rate patient loads.
Toriello sees patients
three days a week, 25 to
30 patients a day. Many
are elderly people whose
insurance is Medicare,
and so the orthopedist suffers what he calls
"the constant downward pressure on Medicare
fee schedules." When he's not in the office,
there's plenty of surgery to do, and Toriello
also performs independent medical evaluations
for insurance companies, "to diversify my in­
come stream."
He frequently works six-day weeks, and
notes that traditional wisdom says "the first 10
years is really building a private practice and
building relations with internists who will re­
fer patients to you. Following that, you're in a
position where your feeders are pretty well
established and you can take a day off." He is,
he notes dryly, in his ninth year of practice.
"There are days and weeks when I feel like
I'm running faster just to stay in place," he
acknowledged. "And I do see that I have to be
ready to move should the situation change."
Toriello says he has made contacts with the
physician-hospital organizations of several lo­

multi-specialty group practice with multiple
locations and 80 physicians.
The situation appeals to the entrepreneur in
him — and to the family man.
"I enjoy the independence that comes from
a practice like this. I can determine my own
hours and patient load."
At the same time, says Collins, who has
three small children, "Within the group it is
comfortable because we share. There are four
other primary care physicians with whom I
share weekend calls. Four out of five weekends

"WITHIN
THE GROUP
it is comfort­
able because
we share.

Four

out of five
weekends I'm

I'm not on call, and that's good for family and
freedom. My family life remains my top prior­
ity."
A multi-specialty practice, he says, tends to
support itself through internal referrals—back
and forth between the primary care physicians
and Buffalo Medical Group's phalanx of gyne­
cologists, cardiologists, neurologists, general
surgeons, allergists, orthopedists and so on.
And the group's reputation is a built-in market­
ing tool; "people are always calling Buffalo
Medical Group saying, 'I want to be taken care
of by someone in your group.' I have four or five
calls per day inquiring about setting up care,"
he said.
The group recently strengthened its eco­
nomic position by announcing that it plans to
ally with Health Care Plan, one of Western New

not on call,
and that's
good for family
and freedom.
My family life

cal hospitals, "trying to preserve the ability to
negotiate with managed care organizations."
Still, he says, his solo practice is "a fun thing
as opposed to the drudgery of just going off to
work every day. I went into medicine to be my
own boss, to enjoy the freedom of working
with patients and doing what I feel is best. The
trouble with working for someone is, if they're
paying the freight, they frequently can call the
tune as well."

remains my top
priority."

Richard L. Collins, M.D.
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York's largest HMOs.
The two intend to re­
main autonomous but
will develop a more
comprehensive working
relationship.
But Collins, who
serves as a clinical assis­
tant professor for UB's
School of Medicine and
Biomedical Sciences,
stresses that he's solely
responsible for his own
patient panel. Group
members share equip­
ment — the primarycare physicians share a
portable EKG machine,
for example — and also share the costs of the
group's support functions to reduce their indi­
vidual costs. In addition, Collins employs a
nurse and a secretary out of his own choice to
meet the unique needs of his patients.
There's also the less tangible benefit of collegiality. "You want to look at an organization
that's going to give you support in terms of
weekend coverageand the kind of people you're
working with. If you're practicing by yourself,
your knowledge base is limited to yourself and
the books on the shelves in your office. It's very
secure to be able to walk 10 feet and share a case
with your colleagues.
"And it's important to be compensated for
the amount of work you do rather than simply
be salaried. It's kind of nice to be compensated
for the exact amount of hours that you do put
in and see patients."

"BEING IN A
specialty
practice has
allowed us to
cover most areas
of my specialty
with quality and
cost-effective­
ness. That's
really the crux of
a large single-

Single-specialty group practice

specialty group."

Sanford R. Hoffman, M.D.
Otolaryngologist
Buffalo Otolaryngology Group, P.C.

It was nearly a quarter-century ago that
Sanford Hoffman, M.D., '65, joined Irwin
Ginsberg, M.D., to form the Buffalo
Otolaryngology Group. "He had a very dy­
namic practice," Hoffman said. "It's a very
varied specialty, and I wanted to practice as

many aspects as I possi­
bly could."
Today, the group
encompasses nine part­
ner physicians and two
new associates with a
subspecialty in facial
plastic surgery.
And Hoffman, who
is also a clinical assistant
professor in the medical
school, and chairs the
department
of
otolaryngology
for
Millard Fillmore Health
System, says he has never
stopped learning.
The group has a
monthly meeting devoted to business and sci­
entific topics, and daily conferrals, both formal
and informal, on specific cases and proce­
dures. The ear-nose-and-throat specialists also
"cross-cover" each other in surgeries, he says,
providing a second pair of eyes for the delicate
procedures.
"Being in a specialty practice has allowed us
to cover most areas of my specialty with qual­
ity and cost-effectiveness," Hoffman said.
"That's really the crux of a large single-spe­
cialty group. You can get some efficiencies of
care. You can buy better equipment; you can
afford to have your associates go to meetings
and courses which will increase their knowl­
edge and also their efficiency; you can have
more efficient building and appointment sys­
tems, even in multiple locations."
Buffalo Otolaryngology has expanded into
sinusology, rhinology and head and neck surgery.
"If you have a large group," Hoffman said,
"it allows you to talk with more authority to
the insurers and the employers, the people
who are paying the health dollars. You can
show that you have these services, and you can
really evaluate yourself and look at your own
practice to make sure it stays quality-oriented."
For example, he says, "We were among the
first in the country to develop outcomes mea­
sures for sinus disease."

Sanl'ord K. Hoffman. M.D.

©

tionship with that per­
son. The whole program
is based on that physi­
cian." It helps, he says,
that the HMO has stan­
dardized record keep­
ing: "When I see that
person, I have his full
chart in front of me."
And preventive care,
he says, is "part of the
history and tradition of
HMOs.
It's
in
everybody's interest to
keep people well.
We've devoted a lot of
effort and energy to
health education and
preventive guidelines"
— such measuresas flu
vaccinations, mammography screening and
childhood immunizations.
"There's a real sense of group. People talk to
each other," Katz said. "There's collegiality
built into the practice. We're really being called
upon increasingly to be efficient, to manage
care as effectively as we can. And to do that
well, it's harder and harder for an individual to
accomplish that."

Staff-model HMO
Leonard A. Katz, M.D.
Director of Research and
Education Programs
Health Care Plan

"It's the model the
country's talking about," Leonard Katz,
M.D., says of the Buf­
falo health maintenance
organization he serves.
In a decade, Health
Care Plan has grown
from 35 physicians to
nearly 100, says Katz,
who is a practicing gastroenterologist, a former
associate dean of the
medical school and a professor of medicine in
the department of medicine.
Health Care Plan, he says, is a "true group
practice" — a configuration of professionals in
all specialties including primary care. And, he
says, "because everybody is paid by the same
source, the issue of finances basically is dropped
out. The payment comes through the broader
organization, and that means that we're really
all in it together."
Within the organization, small primary-care
teams — a family physician, an internist, a
pediatrician, nurse practitioners, physician as­
sistants, even office staff — work together at a
particular site, and arrange for night and week­
end coverage.
"That's what groups can do — they can
develop systems of care," Katz said. "They can
make all kinds of support arrangements for the
care of patients they're looking after."
The staff-model HMO is built around two
tenets: the idea that a primary-care physician
should coordinate all of a patient's care, and the
idea that prevention is the best medicine.
As a specialist, Katz says, he sees himself
"trying to provide the best help I can to both the
patient and to the [primary-care] physician,
because that physician has a long-term rela­

"IT'S

the model

the country's
talking about, a
true group
practice because

Group-model IIMO
Kenneth E. Bell, M.D.

everybody is
paid by the same

Medical Director, Orange County
Kaiser Permanente Medical Group
Anaheim, California

source; the issue
of finances

There's business. And there's medicine.
And Kenneth Bell, M.D., '61, likes to keep a
comfortable distance between them.
Bell is an obstetrician/gynecologist who is
medical director, Orange County, for the Kai­
ser Permanente Medical Group in Southern
California. The group is a for-profit organiza­
tion that contracts exclusively with the Kaiser
Foundation Health Plan, a non-profit insur­
ance company.
This "group-model" approach — as op­
posed to a staff-model situation, in which phy-

basically is
dropped out."

Leonard A. Katz. M.I).
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sicians work directly for the in­
surer — makes all the differ­
ence, he says.
"All the quality clinical deci­
sions are made by physicians of
the medical group," he said.
"The physicians in this medical
group take care of the practice
of medicine. They have other people they have
hired to take care of the business. When we see
patients, we don't spend time worrying about
how much it costs or whether the patient can
afford it or whatever.
"The bottom line is, my incentives are aligned
with the patients. I don't earn more or less
because of the amount of care I give. I have no
incentive to operate on somebody, for example.
On the other hand, I have a tremendous incen­
tive to keep people healthy, because that cuts
the cost of care."
Bell, who was Kaiser Permanente's chief of
obstetrics and gynecology in Orange County
for 10 years before becoming medical director,
still sees some patients — "I like delivering
babies," he said. He's a clinical professor of ob/
gyn at the University of California, Irvine. And
he's in a position to see how economic trends
are changing the practice of medicine.
"There are many problems around the coun­
try with physicians being forced into groups
they have no affinity for," he said. "They have
to do this because this is the only way they can
maintain a practice."
Private-practice physicians, he says, for a
long time had no limitations on their earning
power. "Now we're having limitations, and the
trick is to maintain and improve quality while
cutting costs."
Kaiser Permanente — "the largest private
health care delivery system in the world," Bell
notes — stresses continuing medical educa­
tion, encouraging physicians to spend a halfday each week on their own education.
It's a team approach, and that, Bell says,
places its own demands on physicians.
"There's a loss of autonomy compared to
somebody running his own little office," he
said. "You have to work as part of a team, and

there's tremendous peer pres­
sure to produce quality care, to
practice efficiently and have
good outcomes.There's no place
to hide.
"Somebody who has to do
everything fully by themselves
will not be happy in this. It does
require a team-spirited belief that we can ac­
complish more as a group than each individual
going off on his own."

"ALL THE
quality clinical

Hospital stall
Eric Ten Brock, M.D.
Internist
Buffalo General Hospital

decisions are
made by
physicians of the
medical group.
The physicians
in this medical
group take care
of the practice
of medicine."

"If you're doing something you like," says
Eric Ten Brock, M.D., '80, "one of the natural
things is to want to teach it to somebody and
share it with somebody."
And teach he does — at The Buffalo General
Hospital, where he hired on in 1985 and where
he built up the pulmonary and critical care
programs that he now directs.
Ten Brock, a clinical associate professor at
the medical school, at any one time might be
responsible for a pulmonary critical care fel­
low, a resident and maybe a medical student.
He juggles that teaching load with staff respon­
sibilities that include administering the medi­
cal intensive care unit, the hospital's sleep
apnea disorder lab and the pulmonary lab. He's
also chairman of Buffalo General's ethics com­
mittee.
He does see patients and shares on-call
duties with "a few other physicians who are
also full-time hospital-based." But he acknowl­
edges that "in solo or group practice a greater
percentage of time is involved with direct
patient care."
Building up the hospital's pulmonary divi­
sion, though, has been its own reward. Ten
Brock says it's the "if I were king" response —
you see how it's done in various hospitals, find
out where the problems lie and then try to
make it all work better.
"If you run an intensive care unit you see

Kenneth E. Bell, M.D.
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©

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certain things that you might not want to
happen. You're not always called to 'put out a
fire' — you're trying to prevent those things
from happening if at all possible."
For example, Ten Brock said, he has stan­
dardized the procedures for patients' "ad­
vance directives" — do-not-resuscitate or­
ders, health care proxies, living wills — that
can be crucial in intensive-care situations.
Another example: a review process for how
well the staff responds to each cardiac arrest
"code" emergency.
"These are things that were either not de­
veloped or existed in an unstructured form"
when he came on staff, he says. "A full-time
physician like myself can help firm that up
somewhat by making it a little more regi­
mented."
A hospital staff position, Ten Brock says,
means working within the system. "You're part
of a larger organization, so you're not necessar­
ily the only person who has input as to whether
a certain decision is made in the way you would
like it to be made. You're building something for
the hospital, not necessarily for your own ben­
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A non-profit University program for students, faculty & staff

The Commons • North Campus • (716) 645-3554 • Fax: 645-3884

Uric Icn Itrock. >1.
(

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ACADEMIC HEALTH
PROFESSIONALS
INSURANCE
ASSOCIATION
Insuring care for those who care

Subscriber
Owned • Organized • Governed
PHYSICIANS • DENTISTS
HEALTH PROFESSIONALS
NURSES • RESIDENTS
Superior policies for academic full-time
and voluntary clinical faculty

tt

Competitive premiums
it

Rewarding educational programs

ttComplete legal service
it-

Comprehensive coverage
it-

Dividend opportunities

Academic Health Professionals
Insurance Association is a subscriber
owned and organized reciprocal
licensed by the Insurance Department
of New York State. Policy and programs
of the Association are determined by a
representative Board of Governors
elected by subscribers at SUNY
Health Science Centers.
Enrollment open at all times.
Transfers arranged without loss.
ACADEMIC HEALTH
PROFESSIONALS
INSURANCE ASSOCIATION

Empire State Building
350 Fifth Avenue, Suite #1512
New York, New York 10118
Ph. 212-947-4541
Fax 212-947-4572

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Evails and programs scheduled
for Sesquicenlennial celebration

A

s the School of Medicine and Biomedical Sciences' Sesquicentennial
celebration nears, the History of the Medical School Committee is
busy developing and planning exhibits, programs and events to
commemorate 150 years of medical education.
Slated to begin in January 1996 and continue through com­
mencement 1997, the celebration would culminate on Founder's

Day — May 11, 1996 — with commencement ceremonies, including the
retaking of the Hippocratic Oath by the 50th anniversary reunion class.
In the spring of 1996, the American History of Medicine will hold its
annual meeting in Buffalo.
Key also to the celebration is a medical school ethics symposium
featuring several distinguished speakers in the field of medical ethics,
slated for the fall of 1996. Other regularly scheduled medical school events
and lecture series will also tie into the Sesquicentennial during the
celebration.
The Medical
Alumni Associa­
tion will publish a
special Sesquicen­
tennial edition of
its alumni direc­
tory, producedby
Harris Publica­
tions. Also to be
published are a
Pictorial History of
the
Medical
School, a special
edition of Buffalo
Physician and a
collection of es­
says.
The medical
school will also
sponsor a series of
community ex­
hibits of its his­
tory to be dis­
played
at the
Above, photographs taken from the amphitheater of the lecture
teach i ng hospi tals
OR in the old High Street building of the medical school by
Edward J. Zimm, M.D., '42.
and various other
sites as well. +

MEDICAL

SCHOOL

Jacobs releases groundbreaking
MS research results
CLINICAL TRIAL OF RECOMBINANT BETA INTERFERON
SHOWS DRUG SLOWS BOTH PROGRESSION OF
DISEASE AND NUMBER OF EXACERBATIONS

B

ecombinant beCa inCerferon, ad- been done on multiple sclerosis," Jacobs
minisCered intramuscularly in said. "Before this, there was no believ­
weekly doses to patients with ac­ able treatment."
tive relapsing multiple sclerosis,
The recombinant beta interferon used
is the first drug to significantly in the trial is manufactured by Biogen; it
slow the progress of the disease as is the first drug identical to natural beta
well as lessen the number of its flareups, interferon used in a blinded study to
according to results of a Phase 111 clini­ demonstrate a statistically significant
cal trial conducted by Lawrence Jacobs, impact on the progression rate of the
M.D., professor of neurol­
disease. Natural beta inter­
ogy, head of the department
feron acts both as an antivi­
of neurology at The Buffalo
ral and an immunomo­
General Hospital and chief
dulatory agent.
of the Baird Multiple Scle­
The multicenter trial
rosis Center.
studied the effects of the
Jacobs presented his
drug and a placebo on 301
groundbreaking results at
patients with definite MS of
the annual meeting of the
the relapsing-remitting or
American Neurological As­
relapsing-progressive type
sociation last October. The
of at least one year's dura­
Lawrence Jacobs, M.D.
study marks the first time a
tion. The patients, aged 18
drug in a blinded clinical trial slowed
to 55 years, were free of exacerbation in
the progression of disability in MS. In the two months prior to the trial.
the trial, recombinant beta interferon
The study showed that recombinant
increased the time to progression of beta interferon lengthens the time for
disability — the length of the period the disease to become more disabling,
during which active relapsing patients demonstrating a 75 percent increase in
sustain a particular baseline — by 75 the projected time it takes for the dis­
percent. The trial also showed a 31 ease to progress one unit on the Kurtzke
percent reduction in relapse rate among Expanded Disability Status Scale (EDSS)
patients experiencing the disease's de­ — a standard measure of disability pro­
bilitating exacerbations, and showed a gression in MS. At the end of one year of
significant reduction in the number of treatment, 20.1 percent of placeboactive brain lesions measured on MRI.
treated patients had progressed by 1.09
"This is the best study that has ever
EDSS units, compared to 12 percent of

©

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patients on recombinant beta interferon.
At two years, 36.3 percent of placebo
patients had progressed, compared to
22.6 percent of treated patients.
Based on an analysis of the data,
predictions of median time to progres­
sion by 1.0 EDSS unit were 3.1 years for
placebo patientsand 5.4 years for treated
patients.
Patients receiving recombinant beta
interferon had approximately one-third
fewer exacerbations (0.62 per year) than
patients receiving the placebo (0.9 ex­
acerbations per year) — representing a
31 percent reduction in relapse rate
among treated patients. Placebo patients
were also twice as likely to have three or
more attacks during the study as were
treated patients.
Data from MRI studies showed a sta­
tistically significant reduction in the
number and volume of active lesions in
treated patients compared to placebo
patients — an approximately two-fold
difference in the mean number and vol­
ume of such lesions. No discernible
effects were seen on T2 lesion volume, a
measure of both active and inactive le­
sions.
Treated patients in thestudy reported
only modest side effects, including oc­
casional and transient flu-like symp­
toms (an average of eight days over two
years for treated patients compared with
two days over the same time for placebo
patients). Nine percent of recombinant
beta interferon patients stopped treat­
ment — half of which were attributed to
side effects.
The study was conducted at four clini­
cal centers in the U.S.: UB and Millard
Fillmore Hospital's Baird MS Center;
the Mellen MS Center at the Cleveland
Clinic, Cleveland, Ohio; the University
of Oregon, Portland, Oregon; and Walter
Reed Army Medical Center/Georgetown
University, Washington, D.C.

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MEDICAL

SCHOOL

Insuring care for those who care
THE ACADEMIC HEALTH PROFESSIONALS INSURANCE
ASSOCIATION CONTINUES TO GROW AS IT PROTECTS
SUNY'S FACULTY PRACTITIONERS

H

early four years after its found­
ing, the Academic Health Profes­
sionals Insurance Association —
formed by and for faculty practi­
tioners at the State University of
New York's science centers —
boasts a membership that has nearly
tripled to its current 647.
From the beginning, Buffalo physi­
cians and dentists played a pivotal role,
numbering over half of the original 220
subscribers and maintaining that lead­
ership today.
The reciprocal insurance company
began as an outgrowth of the series of
medical malpractice insurance crises that
plagued New York State physicianssince
the early 1970s. The realization that
faculty practitioners at SUNY science
centers had developed an excellent
record of risk avoidance and control in
medical malpractice, and that this ex­
cellence was not recognized by conven­
tional insurance companies, spurred
physicians and dentists at Buffalo, Brook­

lyn, Syracuse and Stony Brook to decide
they might do better on their own.
After years of study, planning and,
finally, advance funding, they formed
the new company, electing William P.
Dillon, M.D., associate professor of gynecology/obstetrics and chief of the di­
vision of maternal/fetal medicine at The
Children's Hospital of Buffalo, its chair.
Dillon still holds that post, presiding
over a board of governors representing
the four health science centers and the
United University Professions.
Subscribers at each center elect their
board members for four-year terms, and
members serve without compensation.
Management is the responsibility of the
attorney-in-fact, Medical Quadrangle,
which has worked with Academic in
initial planning and operations since its
inception.
All specialties are included, as well as
residents and health professionals.
About half of the membership are full or
associate professors.Somewhat over half
ANESTHESIOLOGY
CRITICAL CARE
DENTISTRY
DERMATOLOGY
EMERGENCY MEDICINE
FAMILY MEDICINE
INFECTIOUS DISEASES
INTERNAL MEDICINE
MEDICINE
NEUROSURGERY
NEUROLOGY
NUCLEAR MEDICINE
MICROBIOLOGY
OB/GYN
OPHTHALMOLOGY
ORTHOPEDIC SURGERY
OTOLARYNGOLOGY
PATHOLOGY
PEDIATRICS
PLASTIC SURGERY
PSYCHIATRY
RADIOLOGY
REHABILITATION MEDICINE
SURGERY
UROLOGY

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are insured under claims-made policies
— the only type available when Aca­
demic was licensed. A substantial num­
ber transferred to occurrence policies
when this choice was authorized by law
in 1992. (Claims-made policies cover
only incidents arising and reported
within the policy year but may go back
to the first claims-made policy if these
are held continually by the insured;
occurrence policies apply to incidents
occurring during the policy year, re­
gardless of when a claim is filed.)
Supported by individual capital con­
tributions in the form of loans, pre­
mium payments and guarantees of fi­
nancial responsibility, Academic is fis­
cally sound with assets of over $ 10 mil­
lion. Dividendsare promised in the near
future, pending approval of the State
Insurance Department.
Academic requires its subscribers to
participate in risk management educa­
tion programs to maintain its superior
record in claims frequency (the lowest
in the state) and settlements. Premium
credit of 5percent for two years is granted
for successful completion of the basic or
advanced course. During 1992-93, nine
seminars were conducted and 377 sub­
scribers attended.
—

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Baird receives 1994 Parke Davis
Teacher Development Award

B

onald E. Baird, D.O., clinical as­
sistant professor of family medi­
cine, has received the 1994 Parke
Davis Teacher Development
Award.
The award recognizes Baird's
contributions as a clinically based in­
structor for both graduate and under­
graduate medical education.

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Neuroanatomy museum opens to the public
UNIQUE INSTALLATION FEATURES EXTENSIVE COLLECTION OF SPECIMENS AND
THE HISTORY OF IMAGING THE BRAIN FROM PNEUMOENCEPHALOGRAM TO PET

i

n unusual museum de­
voted exclusively to the
human brain, thought to
be the only installation of
its kind in the U.S.,
opened officially at the
medical school with the dedi­
cation of the UB Museum of
Neuroanatomy last September.
Harold Brody, M.D., Ph.D.,
professor of anatomy and cell
biology at UB for more than 40
years and the museum's cre­
ator, said, "The brain is so fun­
damentally beautiful, I wanted
the displays also to be attrac­
tive. I knew that if they didn't
look appealing, it would turn
people off." Brody, a 1961
graduate of the medical school
and former chair of anatomy,
said the idea became a spark in
his mind ever since he saw a similar
installation in Copenhagen, Denmark,
while there on a Fulbright fellowship in
1963.
Medical students in Europe tradition­
ally learned their anatomy from such
permanent exhibits because of the scar­
city of cadavers for dissection, Brody
said. He helped to establish a successful
donor program at The University of
Copenhagen, and brought back with
him the idea for a neuroanatomy mu­
seum.
Thirty years later, thanks to 30-year
reunion gifts from his Class of 1961, the
medical school's Class of 1962 and pri­
vate individuals, his idea has been trans-

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The extensive collection features specimens, Xrays and photographs, as well as CT, MRI and PET
scans of the brain.
formed into an extensive collection of
specimens detailing the structure of the
human brain from many viewpoints.
Some 70 specimens are suspended in
crystalline liquid in individual Plexiglas
boxes, spotlights dramatizing their char­
acteristic folds and contours. Hand-made
pins tipped in blue, orange, green, lav­
ender, red, and light blue identify each
specimen's features.
Lining the walls are color photo­
graphs of the brain, along with a series
of X-rays, CT scans, MRI scans and PET
scans.

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MEDICAL

SCHOOL

One display reveals the medial sur­
face of the right hemisphere; another is
delicately dissected to reveal each layer
of the brain. Other displays show the
cranial nerve supply, the brain's blood
supply and the path of nerve impulsesin
the brain that ultimately produce vi­
sion.
These and several dozen additional
specimens fill 10 glass display cases.
Each specimen is accompanied by a
written description keyed to the colorcoded pins. Leaving no details to chance,
Brody, along with his assistant, Thomas
Wietchy — an anatomy master's degree
candidate — and Katerina Smith, a se­
nior histology technician, made the pins
themselves from dental wire dipped in
acrylic pigments and epoxy. The speci­
mens were dissected by Brody, Wietchy
and several medical students.
Medical, dental and nursing students,
occupational-therapy and physicaltherapy students, doctoral candidates
in psychology and speech communica­
tion and hospital residents in neurology

UB professor and researcher
Thomas Beam dies suddenly

A professor in the department of
medicine and associate professor in
the department of microbiology, Beam
was chief of the Buffalo VA Medical
Center's infectious diseases section for
11 years, and was serving as associate
chief of staff for education at the hos­
pital at the time of his death.
He was certified by the American
Board of Internal Medicine.
Beam received his bachelor's and

T

homas R. Beam,Jr., M.D., a pro­
fessor and researcher in the Uni­
versity at Buffalo School of Medi­
cine and Biomedical Sciences and
consultant to the U.S. Food and
Drug Administration, died un­
expectedly August 17, 1994 in his of­
fice in the Buffalo VA Medical Center.
medical degrees from the University
He was 48.
of Pennsylvania in 1968 and 1972,
Beam was an infectious-diseases ex­ respectively. He joined UB as an in­
pert known internationally for his structor in the department of medi­
work on drug-resistant bacteria and cine in 1974.
viruses. In 1989, he was appointed to
Widely quoted in the national news
direct an innovative, two-year project media, Beam was featured in stories
established by the FDA and Infectious about the mounting problem of drugof
Diseases Society
resistant bacteria on CBSAmerica to speed up the
TV's "48 Hours" and in a
FDA's approval process for
cover story in Newsweek.
new antibiotics, and to en­
A prolific researcher,
hance its monitoring of
Beam authored or codrugs on the market for
authored numerous text­
early warnings of adverse
book chapters and ar­
effects.
ticles in professional
He also chaired the
journals. He was a re­
FDA's
Anti-Infective
viewer for many profes­
Drugs Advisory Commit­
sional publications, in­
tee and, in that capacity,
cluding the Journal of the
in October 1990 oversaw
American Medical Asso­
hearings focusing on pro­
Thomas R. Beam, Jr., M.D.
ciation, Journal of Infec­
posals for modifying the
tious Diseases, Annals of
FDA's guidelines for approval of new Pharmacotherapy and American Jour­
antimicrobial drugs.
nal of Kidney Diseases.

and neurosurgery have been using the
exhibits as study aids for more than a
year. Brody wants the exhibit to be used
by everyone and is particularly inter­
ested in bringing in students from area
public schools.
Groups of high-school students al­
ready have toured the museum, as did a
group of students on campus for the
summer.
Brody will add specimens and addi­
tional materials to the museum as time
and money permit. In the meantime, he
hopes to establish regular hours when
the museum will be open to the public.
"I feel this is such a valuable asset,
that anybody interested in the structure
of the brain should have access to it," he
said. "I think this could make a tremen­
dous contribution in a very specific way
to the medical school and the commu­
nity."
+

He was chairman of the Antibiotics
Use and Clinical Trials Committee of
the Infectious Diseases Society of
America. He also served as the society's
liaison to the European Community
and was an honorary member of the
Critical Care Medicine Society of Para­
guay.
He was the editor-in-chief of two
national medical journals: Infections
in Medicine and Abstracts in Infectious
Disease.

Beam was a fellow of the American
College of Physicians and the Infec­
tious Diseases Society of America, and
was a member of many professional
organizations. He also served as a con­
sultant to numerous health facilities
in Western New York, including
Roswell Park Cancer Institute; J.N.
Adam, Craig and West Seneca Devel­
opmental centers; The Buffalo Gen­
eral Hospital; and the Erie County
Medical Center.

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MEDICAL

Susan McLeer named lo chair
department of psychiatry

Richard Erbe co-authors textbook
lor "electronic superhighway"

her tenure as vice chair, McLeer was
assistant and associate dean of under­
graduate medicaleducation from 1976 to
1982. A visiting professor of behavior
usan V. McLeer, M.D., an expert in science at Catholic University in Lille,
disorders of sexually abused chil­ France, she completed a four-year visit­
dren and battered women, has been ing professorship at Smith College in
appointed chair of the department Northampton, Massachusetts, last June.
of psychiatry.
She also had a private psychia­
McLeer was formerly
try practice in Philadelphia.
professor and vice chair of the
A fellow of the American
department of psychiatry at
Psychiatric Association and
The Medical College of Penn­
the Philadelphia College of
sylvania in Philadelphia and
Physicians, she is a member
director of its division of child
of several other professional
and adolescent psychiatry.
societies, including the Ameri­
A member of the American
can Academy of Child and
Medical Association's work­
Adolescent Psychiatry, the
Susan V. McLeer, M.D.
ing group on domestic vio­
Coalition of Physicians
lence, McLeer has testified on the bat­ Against Family Violence and Physicians
tered woman syndrome in several for Social Responsibility.
trials. She has published numerous ar­
ticles in refereed journals on domestic
violence against women and children,
and has lectured widely on these topics.
She was principal investigator on a
recently completed four-year study of
aul R. Knight, M.D., Ph.D., profes­
symptoms and psychiatricdisorder per­
sor
and chair of anesthesiology and
sistence following child sexual abuse,
professor
of microbiology, was
and will continue her research at UB in
appointed to a four-year term on
this area and in the field of post-trau­
the Surgery, Anesthesiology and
matic stress disorder in children.
Trauma
Study Section, Division of
McLeer earned her medical degree
Research
Grants,
for the National Insti­
from The Woman's Medical College of
tutes
of
Health.
Pennsylvania, now the Medical College
Study sections review grant applica­
of Pennsylvania, and holds a master's
tions submitted to NIH, make recom­
degree in psychiatry administration
from that institution. Following a pedi­ mendations on the applications to the
atric internship at Strong Memorial appropriate NIH advisory council or
Flospital in Rochester, she did her psy­ board and survey the status of research
chiatric residency at the Medical Col­ in their fields of science.
Knight was nominated to the post
lege of Pennsylvania, and completed a
fellowship in child and adolescent psy­ because of his demonstrated compe­
chiatry there and at the Eastern Penn­ tence and achievement as evidenced by
the quality of his research accomplish­
sylvania Psychiatric Institute.
ments, publications in scientific jour­
She joined the faculty of her alma
nals
and other significant activities,
mater in 1976 and built her career there in
achievements
and honors.
psychiatry and pediatrics. In addition to

B

ichard W. Erbe, M.D., professor of
pediatrics and medicine and chief
of the division of genetics at The
Children's Hospital of Buffalo, has
co-authored, with faculty from
Harvard and Stanford, a medical
textbook available on the electronic su­
perhighway.
The textbook, "Scientific American
Medicine," is designed to give general
practitioners, medical students, resident
physicians, nursesand other health care
professionals an overview of medical
disciplines outside their own.
Erbe's chapter, "Medical Genetics,"
details advances made in the past 15
years in the prediction, diagnosis and
management of genetic disorders. The
textbook is available worldwide on CD
ROM and locally on UB's electronic
medical network, HUBNET.
Erbe has been a researcher and teacher
of genetics for more than 25 years. Be­
fore joining the UB faculty in 1989, he
was an associate professor of pediatrics
and genetics at Harvard Medical School.
A former member of the editorial
board of The New England Journal of
Medicine, Erbe has authored or coauthored more than 70 scientific ar­
ticles, reviews and book chapters.
+

Knight appointed lo National
Institutes of Health study section

©

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Medical student wins James
Coiner Minority Research award

D

B medical student N. Kalaya
Okereke has been selected as one
of 12 medical students across the
country to receive a James Comer
Minority Research Fellowship
from the American Academy of
Child and Adolescent Psychiatry.

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MEDICAL

The fellowship is funded through the
National Institute of Mental Health. The
award offersoutstanding minority medi­
cal students early exposure to research
in child and adolescent psychiatry. The
award includes a $2,200 grant for sum­
mer research with a child and adoles­
cent primary investigator.
Okereke is working with Gary Cohen,
M.D., and Peg Bohnert, M.D., both of
the departments of psychiatry and pedi­
atrics, and Richard Clopper, Ph.D., of
the departments of psychiatry and psy­
chology ^ on a project at The Children's
Hospital of Buffalo to assess the hospital's
psychiatric consultation and liaison ser­
vices.
+

0E

Leon E. Farhi, M.D.

Buck wins fellowship lo sludy
tubal ligation safety, effectiveness Medical, biological engineering
institute selects Farhi as fellow

G

I

ermaine S. Buck, Ph.D., assistant
professor of social and preventive
medicine, has won one of two fel­
lowships sponsored annually by
the Merck Company Foundation
and the Society for Epidemiology
Research.
The $190,000, three-year award will
allow her to begin a long-term study of
the safety and effectiveness of tubal
ligation. The study will involve 3,000 to
4,000 women who will be followed for
10 to 20 years.
Buck was one of 40 researchers con­
sidered for the fellowships, which are
awarded through a national competi­
tion.
Winners are selected by an indepen­
dent scientific advisory committee that
considers the accomplishments of the
researcher, the soundness of the pro­
posed research project and the commit­
ment of the researcher's institution to
the applicant and the research.

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eon E. Farhi, M.D., distinguished
professor and former chair of
physiology, has been named a fel­
low of the American Institute of
Medical and Biological Engineer­
ing.

Farhi has studied the human circula­
tory system and physiological problems
of human lung gas exchange for more
than 35 years. He has authored or coauthored more than 100 scientific ar­
ticles and abstracts.
He was instrumental in developing
new approaches for measuring cardiac
output and distribution of respiratory
gases within the lungs and tissues of the
human body. Working with colleagues
at UB, he developed a technique to
measure circulatory functions in a
weightless state that was applied by
NASA in a space shuttle flight in 1989.
Farhi received his medical degree in
1947 from the Universite St. Joseph in
Beirut, Lebanon. He has served as edi­

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tor-in-chief of theJournal ofAppliedPhysiology: Respiratory, Environmental and Ex­
ercise Physiology, an editor of Undersea
Biomedical Research and on the editorial
board of Respiration Physiology. He is the
principal investigator of two NASA-spon­
sored research projects with funding of
more than $3 million to study cardiopul­
monary function in microgravity.

Slaplelon elected president of
pediatric nephrology society

F

Bruder Stapleton, M.D., A. Con| ger Goodyear professor and chair
of pediatrics and pediatrician-inchief of The Children's Hospital
of Buffalo, was elected president
of the American Society of Pediat­
ric Nephrology.
He will serve a one-year term for the
society, which represents 420 pediatric
kidney specialists in North America,
formed to foster professional and pub­
lic education, improve patient care and
promote relevant scientific research. +

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A L U M N I

1994 reunion classes donate over 154,000
to medical school for scholarship fund

I

ast year's reunion classes made generous do­
nations to the medical school during the an­
nual Spring Clinical Day and Reunion Week­
end festivities.
In all, $54,302 was pledged to the medical
school to be used for scholarships for worthy
students. Following is a list of participating class
members and class totals.
CLASS OF 1944 — 35,500
Dr. Howard R. Barnett
Dr. Willard H. Boardman
Dr. Robert L. Brown
Dr. Samuel Cassara
Dr. Edmund M. Collins
Dr. Herman Edelberg
Dr. Richard W. Egan
Dr. Thomas F. Frawley
Dr. Frank T. Frost
Dr. Raymond A. Hudson
Dr. Frank H. Long, Jr.
Dr. William K. Nowill
Dr. Casimer F. Pietraszek
Dr. William A. Potts
Dr. Theodore C. Prentice
Dr. Charles H. Rosenberg
Dr. Joseph Ross
Dr. Sidney M. Schaer
Dr. James R. Sullivan
Dr. Paul L. Weygandt
Dr. Robert G. Wilkinson, Jr.

CLASS of 1949 — $5,040
Dr. Carmelo S. Armenia
Dr. J. Bradley Aust, Jr.
Dr. Harold Bernhard
Dr. Manuel H. Brontman
Dr. Paul T. Buerger
Dr. Ralph S. Canter
Dr. Lawrence M. Carden
Dr. Julian M. Cullen
Dr. Philip C. Dennen
Dr. John D. Egan
Dr. George M. Erickson
Dr. Jacqueline L. Paroski
Dr. Max A. Schneider
Dr. John T. Sharp
Dr. Leonard D. Steiner
Dr. Irma M. Waldo
Dr. Judith Weinstein
Dr. James A. Werick

CLASS OF 1954 — $4,685
Dr. Nicholas C. Carosella
Dr. Louis C. Cloutier
Dr. John L. Conboy
Dr. Leonard P. Cons tan tine
Dr. Byron A. Genner III
Dr. Robert W. Haines

©

Dr. William J. Howard
Dr. Eugene C. Hyzy
Dr. Allen L. Lesswing
Dr. Lucille M. Lewandowski
Dr. Charles H. Marino
Dr. Donald J. Murray
Dr. Walter A. Olszewski
Dr. Robert M. Oshrin
Dr. Robert J. Pletman
Dr. Stephen A. Spink
Dr. Edwin B. Tomaka
Dr. Paul L. Weinmann
Dr. Harry S. Weinstein
Dr. Donald M. Wilson

CLASS OF 1959 — $6,113
Dr. Charles W. Anderson
Dr. George R. Baeumler
Dr. William P. Blaisdell
Dr. Robert J. Brennen
Dr. Robert A. Brenner
Dr. Robert J. Clayton
Dr. James M. Cole
Dr. ConstantineJ. G. Cretekos
Dr. Thomas D. Doeblin
Dr. Sterling Doubrava
Dr. Joseph A. Ferlisa
Dr. Jacob Krieger
Dr. Joseph F. Monte

CLASS OF 1964 — $4,275
Dr. Jeffrey S. Carr
Dr. Walter A. Ceranski
Dr. Joseph A. DiPoala, Sr.
Dr. Lowell S. Eranstoft
Dr. Michael Feinstein
Dr. Norman A. Gerber
Dr. George Glowacki
Dr. Harold Glucksberg
Dr. Gerald B. Goldstein
Dr. Michael Goldhamer
Dr. Arnold H. Israelit
Dr. Stephen P. Katz
Dr. David A. Leff
Dr. Lillian V. Ney
Dr. Robert G. Ney
Dr. J. Frederick Painton, Jr.
Dr. Noel R. Rose
Dr. Stephen C. Scheiber

Dr. JohnJ. Scomillio
Dr. James C. Tibbetts,Jr.
Dr. Francis R. Weis, Jr.
Dr. Richard W. Williams
Dr. Richard E. Wolin

CLASS OF 1969 — $9,167
Dr. David H. Amler
Dr. Alan J. Blanc
Dr. Joel B. Bowers
Dr. MoiraJ. Burke
Dr. James L. Cavalieri II
Dr. Carl J. DePaula
Dr. Dorothea A. Downey
Dr. Penny A. Gardner
Dr. Robert J. Gibson
Dr. Lawrence S. Greenberg
Dr. Hanley M. Horwitz
Dr. William K. Major, Jr.
Dr. Bernard C. Muscato
Dr. Jonathan T. Paine
Dr. James A. Patterson
Dr. Michael N. Pisick
Dr. Michael M. Pugliese
Dr. Douglas L. Roberts
Dr. Cheryl C. Rosenblatt
Dr. Steven J. Sandler
Dr. Ian M. Schorr
Dr. David S. Schreiber
Dr. Robert S. Shaps
Dr. Lester S. Sielski
Dr. Wilbur L. Smith, Jr.
Dr. Gerald D. Stinziano
Dr. Harvey I. Weinberg
Dr. JamesJ. White, Jr.
Dr. Madeline J. White
Dr. Frederick S. Wilkinson II
Dr. Marion E. Wind

CLASS OF 1974 —$7,288
Dr. Daniel R. Beckman
Dr. Mark L. Bernstein
Dr. Alan G. Burstein
Dr. John H. Clark
Dr. Stephen Commins
Dr. Anna G. Engel
Dr. Jockular B. Ford
Dr. Nicholas E. Fuerst
Dr. Wayne B. Glazier
Dr. Howard R. Goldstein
Dr. Richard Herschcopf
Dr. Jayne E. Kremzier
Dr. David W. Leffke
Dr. John P. Manzella
Dr. Diane L. Matuszak
Dr. Bruce F. Middendorf
Dr. Sarah E. Moore
Dr. Daniel J. Morelli
Dr. Kathleen M. Mylotte
Dr. GuidoJ. Napolitano
Dr. Benjamin I. Opara
Dr. Lawrence A. Oufiero
Dr. Sanford R. Pleskow
Dr. Eric J. Russell
Dr. Elliott A. Schulman
Dr. Joel A. Simon
Dr. James A. Smith
Dr. Reginald M. Sutton

Dr. Bradley T. Truax
Dr. Robin L. Trumball
Dr. Edward L. Valentine
Dr. Robert M. Weiss
Dr. James M. Wetter
Dr. Stuart A. Wolman
Dr. Evangelos D. Xistris
Dr. Stephen A. Yerkovich

CLASS OF 1979 —$5,856
Dr. Philip S. Anson
Dr. W. Walter Backus
Dr. Walter A. Balon
Dr. Gale A. Barg
Dr. Robert L. Baron
Dr. B. Joy Blumenreich
Dr. James P. Bracikowski
Dr. Robert A. Brandis
Dr. Mark E. Brenner
Dr. Carl V. Bundschuh
Dr. Linda A. Cardone
Dr. Letitia R. Clark
Dr. Peter Condro, Jr.
Dr. Andrew T. Costarino, Jr.
Dr. John W. Crofts
Dr. Scott C. Denne
Dr. Thomas C. Doolittle
Dr. Bruce E. Dunlap
Dr. Nancy G. Dvorak
Dr. Frederick A. Eames
Dr. James G. Egnatcik
Dr. Frederick C. Finelli
Dr. Charles J. Francemone
Dr. Barbara A. Fretwell
Dr. N.Joseph Gagliardi
Dr. Kenneth A. Hogrefe
Dr. Richard T. Irene
Dr. Peter J.Jederlinic
Dr. Roger E. Kaiser Jr.
Dr. Tade A. Kashimawo
Dr. Andrew J. Majka
Dr. Ramon J. Pabalan
Dr. Lewis A. Roberts
Dr. Jessica Rockwell
Dr. Robert J. Rose
Dr. Betty S. Spivack
Dr. David D. Stahl
Dr. Todd D. Stern
Dr. Sonia M. L. Wornum

CLASS OF 1984 —$4,410
Dr. Dominic J. Altieri
Dr. Robert F. Amberger
Dr. Nancy Bach
Dr. Ephraim E. Bach
Dr. Mary T. Caserta
Dr. James A. De Caprio
Dr. John M. Fisch
Dr. Diane T. Flanigen-Roat
Dr. Douglas J. Floccare
Dr. John K. Fong
Dr. Andrew J. Francis
Dr. Roland Greco
Dr. Zina D. Hajduczok
Dr. William M. Healy
Dr. Andrew M. Knoll
Dr. William C. Leskovec
Dr. Gregory A. Logsdon

Dr. Thomas C. Mahl
Dr. Linda D. Mandanas
Dr. Nora E. Meaney-Elman
Dr. Michael G. Mercado
Dr. Paul Misthos
Dr. Herbert B. Newton
Dr. JohnJ. Picano
Dr. Lauren Pueraro
Dr. William E. Reichman
Dr. Richard M. Rosenfeld
Dr. Martin Ross
Dr. Ira J. Schmelkin
Dr. Andrew M. Schneider
Dr. Scott C. Sherman
Dr. Rony Y. Shimony
Dr. Ann K. Smith-Rudnick
Dr. Michelle N. Stram
Dr. Jeffery G. Straus
Dr. Lin-Lan Tang-Huang
Dr. Andrew S. Tanner
Dr. Frederick W. Tonetti
Dr. Carol W. Weinstein
Dr. Charles S. White
Dr. Edward A. Zane
Dr. Benson L. Zoghlin
Dr. Mitchell E. Zuckerman

CLASS OF 1989 —$1,968
Dr. Christopher J. Bartolone
Dr. David R. Bloom
Dr. Joseph F. Ceravolo
Dr. James Chong
Dr. Hayley Cohen
Dr. Barbara J. Creighton
Dr. Raffi M. Der Sarkissian
Dr. Jane K. Doeblin
Dr. Fred L. Dreher
Dr. Tai-Hwang M. Fan
Dr. Wayne A. Forde
Dr. Dawn A. Gais
Dr. Joseph S. Giglia
Dr. Thomas Grimaldi
Dr. Lee R. Guterman
Dr. Anne Kristina E. Hart
Dr. Philip G. Lauria
Dr. Salvatore S. Lauria
Dr. Michael Licata
Dr. Louis J. LoBalsamo
Dr. James L. Meisel
Dr. Alison R. Moliterno
Dr. Yasmin Panahy
Dr. Mark R. Pundt
Dr. Anne G. Rizzo-Fantin
Dr. Stephen G. Rohn
Dr. Mary E. Schamann
Dr. Kevin M. Senn
Dr. Jeanette M. Smith
Dr. Stuart R. Varon
Dr. Reynold Villedrouin
Editor's Note: While every effort is
made to verify the accuracy of the
listing, omissions and misprints may
occur. This report lists all donors
who have made gifts as of November
8, 1994. If you have any questions,
comments or concerns, please call
Michael E. Benzin, Director of the
Annual Appeal, at (716) 645-3312.
Thank you.

Spring Clinical Day and Reunion
Weekend on for April 28 - 29,1995
' ark your calendars and be sure to set
aside the time to attend the 58th An­
nual Spring Clinical Day and Reunion
Weekend at the Buffalo Marriott.
Reunion dinners will be held on
1 Friday evening, April 28. On Saturday,
April 29, Stockton Kimball lecturer Richard
Krugman, M.D., dean of the University of
Colorado School of Medicine, will speak on
"The Physician —• Healing the Abuse in Our
Families."

Class of 1955

Class of 1975

"Forty years have passed.
We have so much to
share. Plan your sched­
ules now to gather here
in Buffalo and see old
friends."
John H. Peterson, M.D.
Chairperson

"We would like to
welcome you back to
our 29th Year Re­
union. We need you
to make it a success.
Please join us."
John C. Stubenbord,
M.D.
Chairperson
John C. Stubenbord, M.D.

John H. Peterson, M.D.

Class of 1980

"It was 94 degrees in Buf­
falo for our 10th year
reunion. Please come
and heat up the town
again!"
Margaret Paroski, M.D.
Chairperson

Class of 1945

"Each season hasits own
beauty and attainments.
The continuum of life
fixates beyond our peak
years. This is our 50th
year as physicians. Let
us all join in our reunion
circle on April 29,1995.
The most — the best —
reunion to date!"
Herbert E.Joyce, M.D.
Chairperson

James R. Kanski, M.D.

Margaret Paroski, M.D.

Roger s. Doyer, M.D.

Class of 1960

"Time to, once again, become reacquainted,share
our memories and ruminate about the future."
James R. Kanski, M.D.
Co-Chairperson
Roger S. Dayer, M.D.
Co-Chairperson

Class of 1965

"Let's get together and
celebrate 30 years on
April 29, 1995."
Joseph Cardamone, M.D.
Chairperson

Robert J. Patterson, M.D.

Sidney Anthone, M.D.

Joseph Cordamone, M.D.

Class of 1950

"Don't miss our 45th. We are counting on you to
make it a success."
Robert J. Patterson, M.D.
Co-Chairperson
Sidney Anthone, M.D.
Co-Chairperson

Donald Copley, M.D.

Elizabeth Maher, M.D.

Dona|d Ting|cy/ MD

Class of 1985

"The medical school and Main Street in Buffalo
look a whole lot different now compared to the
early '80s. Come check it out and party with old
friends."
Elizabeth Maher, M.D.
Co-Chairperson
Donald Tingley, M.D.
Co-Chairperson

Class of 1970

Class of 1990

"Our 25th reunion sched­
uled for April 29, 1995, is
too important to pass up.
It should also be great
fun because we expect
more than 30 of our class­
mates will be attending.
Please do your best to join
us for this very special
quarter-century celebra­
tion!"
Donald Copley, M.D
Chairperson

"Yes, it has been five
years. Mark it down —
April 29, 1995 — our
fifth year reunion. Come
and see what residency
has done to your class­
mates!"
Raymond Paolini, M.D.
Chairperson
Raymond Paolini, M.D.

A L U M N I

James Plall While Society holds
Annual Meeting for members

Members of
the James
Piatt White
Society at the
organization's
1994 Annual
Meeting.

T

he James Piatt White Society held
its annual meeting last October
21 at The Country Club of Buf­
falo. The distinguished organiza­
tion, based on the values and prin­
ciples of the former dean and
founder of the School of Medicine and
Biomedical Sciences, contributes gen­
erously to the school's mission of pro­
viding the highest quality education,
research and patient care, and helps the school continue its
leadership role as one of the premier medical schools in the
country.
Gifts to the medical school by members of the society have
helped fund biomedical and clinical research, provide schol­
arships, purchase state-of-the-art laboratory equipment and
maintain innovative programming.
Members of the James Piatt WHite Society for 1994 are:
Dr. Kenneth M. Alford '37
Dr. Kenneth Z. Altshuler '52
Dr. Richard Ament '42
Dr. William S. Andaloro '45
Dr. George R. Baeumler '59
Dr. Jared C. Barlow '66
Dr. Charles D. Bauer '46
Dr. Ralph T. Behling '43
Dr. Richard A. Berkson '72
Dr. Harold Bernhard '49
Dr. and Mrs. Willard H. Bernhoft '35
Dr. Theodore S. Bistany '60
Dr. John C. Bivona,Jr. '68
Dr. Willard H. Boardman '44
Dr. Dennis L. Bordan '70
Dr. Martin Brecher '72
Dr. Robert J. Brennen '59
Mrs. Ann Brody
Dr. Harold Brody '61
Dr. Melvin M. Brothman '58
Dr. Robert L. Brown '44
Dr. August A. Bruno '51
Dr. William M. Burleigh '67
Dr. David W. Butsch
Ms. Janet F. Butsch
Dr. John L. Butsch
Mr. David N. Campbell
Dr. Joseph G. Cardamone '65
Dr. Nicholas C. Carosella '54
Dr. and Mrs. Norman Chassin '45
Dr. and Mrs. Joseph A. Chazan '60
Dr. Michael E. Cohen '61
Dr. James M. Cole '59
Dr. Donald P. Copley '70
Dr. Edward B. Crohn '43
Dr. Julia Cullen '49
Dr. Daniel E. Curtain '47

e

Dr. Richard H. Daffner '67
Dr. Peter S. D'Arrigo '56
Dr. Roger S. Dayer '60
Dr. Alfred H. Dobrak '39
Dr. Sterling M. Doubrava '59
Dr. Kenneth H. Eckhert, Sr. '35
Dr. Robert Einhorn '72
Dr. and Mrs. George M. Ellis, Jr. '45
Dr. Alfred S. Evans '43
Dr. John A. Feldenzer '83
Dr. Jack C. Fisher '62
Dr. Thomas F. Frawley '44
Dr. Matt A. Gajewski '39
Dr. Penny A. Gardner '69
Dr. Kenneth L. Gayles '73
Dr. John W. Gibbs, Jr. '67
Dr. Mala Ratan Gupta
Dr. Thomas J. Guttuso '60
Mrs. Gilda L. Hansen BA '44
Dr. Reid R. Heffner, Jr.
Dr. William J. Hewett '61
Dr. Joseph M. Hill '28
Ms. Elizabeth H. Hiller
Dr. John M. Hodson '56
Dr. Kenneth L. Jewel '68
Dr. Herbert E.Joyce '45
Dr. Stephen T. Joyce '63
Dr. James R. Kanski,Jr. '60
Drs. Julian and Mayenne Karelitz '68
Dr. Arthur C. Klein '62
Dr. Jacob S. Kriteman '67
Dr. Paul S. Kruger '72
Dr. Joseph L. Kunz '56
Dr. and Mrs. Marvin Z. Kurlan 64
Dr. Francis J. LaLuna '68
Dr. Andre D. Lascari '60

Dr. Won Yub Lee
Dr. Eugene V. Leslie '51
Dr. Laurence M. Lesser '70
Dr. and Mrs. Harold Levy '46
Dr. Lucille Lewandowski '54
Dr. Jack Lippes '47
Dr. Hing-Har Lo '74
Mrs. Grace S. Mabie
Dr. William K. Major, Jr. '69
Dr. Don L. Maunz '63
Dr. Charles J. McAllister '73
Dr. Margaret P. McDonnell '82
Dr. Harry L. Metcalf '60
Dr. Merrill L. Miller '71
Dr. Eugene R. Mindell
Dr. Joseph F. Monte '59
Dr. Philip D. Morey '62
Dr. John D. Mountain '33
Dr. Arthur W. Mruczek, Sr. '73
Dr. Richard J. Nagel '53
Dr. Richard B. Narins '63
Dr. John P. Naughton
Drs. Robert G. and Lillian V. Ney '62
and '64
Dr. Timothy T. Nostrant '73
Dr. Thomas P. O'Connor '67
Dr. Carrie P. Ogorek '81
Dr. Yasuyo Ohta
Dr. Elizabeth P. Olmsted '39
Drs. Dean and Donna Orman '65 and
'84
Dr. John S. Parker '57
Dr. and Mrs. Robert J. Patterson '50
Dr. Clayton A. Peimer
Dr. Victor L. Pellicano '36
Dr. James F. Phillips '47
Mr. R. Willis Post
Dr. Bert W. Rappole '66
Dr. Albert C. Rekate '40
Dr. Frank T. Riforgiato '39
Dr. Charles J. Riggio '60
Dr. Richard R. Romanowski '58
Dr. Charles H. Rosenberg '44
Dr. Jeffrey S. Ross '70
Dr. Albert G. Rowe '46
Dr. Eric J. Russell '74
Dr. Agnes Samuel '76
Miss Thelma Sanes
Dr. Arthur J. Schaefer '47

Dr. Max A. Schneider and Mr. Ronald
S. Smelt '49
Dr. Robert N. Schnitzler '65
Dr. David S. Schreiber '69
Dr. Joseph I. Schultz '57
Dr. Roy E. Seibel '39
Dr. Elizabeth G. Serrage '64
Dr. Edward Shanbrom '51
Dr. John B. Sheffer '47
Miss Alice Simpson
Dr. James A. Smith '74
Drs. Robert Smolinski and Claudia
Fosket '83 and '85
Dr. JohnJ. Squadrito '39
Dr. Melvin J. Steinhart '62
Dr. William C. Sternfeld '71
Ms. Elizabeth A. Storch MS '72 — Lib
Mr. Barry S. Swartz
Dr. Michael S. Taxier '75
Dr. James C. Tibbetts,Jr. '64
Dr. Charles S. Tirone '63
Dr. Edward A. Toriello '80
Dr. Bradley T. Truax '74
Dr. Arnold Wax '76
Dr. Harold J. Weinstein '72
Dr. Philip B. Wels '41
Dr. JamesJ. White, Jr. '69
Dr. Gary J. Wilcox '73
Dr. Richard G. Williams '80
Dr. and Mrs. Marvin N. Winer '39
Mrs. Rose Marie L. Wong BS '50 —
Pharmacy
Dr. John R. Wright
Dr. Gregory E. Young '77
Dr. Wende W. Young '61
Dr. and Mrs. Franklin Zeplowitz '58
Dr. and Mrs. David C. Ziegler '65
Editor's Note: While every effort is made
to ensure theaccuracy of this listing,omis­
sions and misprints may occur. This re­
port lists all membersbetween October23,
1993 and October 21, 1994. If you have
any questions, comments or concerns,
please call Michael E. Benzin, Director of
the Annual Appeal, at (716) 645-3312.
Thank you.

The Perfect
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Roswell, ECMC and
Children's Hospitals

Noel Richard Rose, M.D., Ph.D., '64, receives the Alumni Association's specially designed crystal
bison from association vice president Frank T. Schreck, M.D., '79.

Noel Rose receives Distinguished
Medical Alumnus Award for 1994

H

oel Richard Rose, M.D., Ph.D.,
professor of molecular microbi­
ology and immunology at The
Johns Hopkins University, re­
ceived the Distinguished Medical
Alumnus Award at a dinner at the
Park Country Club of Buffalo last Sep­
tember.
Rose, a specialist and pioneer in the
field of autoimmunity, is a 1964 gradu­
ate of the UB medical school. A gradu­
ate of Yale University, he received a
doctorate from the University of Penn­
sylvania in 1951.
He founded Wayne State University's
department of immunology and micro­
biology in 1973, and in 1982 became
the first chair of the department of im­
munology and infectious diseases, now
the department of molecular microbiol­
ogy and immunology, atjohns Hopkins.
Rose began his academic career at
UB, joining the faculty as an instructor
in bacteriology and immunology in
1951. At UB, he worked with Ernest
Witebsky, distinguished scientist, re­
searcher and director of UB's Center of

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Immunology. Rose became director of
the center, which now bears Witebsky's
name, after his mentor's death in 1969,
and holds honorary life-long member­
ship on the Ernest Witebsky Center
Committee.
During his 22 years at UB, he also was
director of Erie County Laboratories,
head of the old E.J. Meyer Memorial
Hospital department of laboratories and
director of UB's diagnostic laboratories.
Rose left UB in 1973 to establish and
head Wayne State's immunology efforts.
In 1982, he went to Johns Hopkins,
where he chaired the department of
immunology and infectious diseases for
11 years. He is a professor in the
departments of molecular microbiology
and immunology, medicine and envi­

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ronmental health sciences and director
of the World Health Organization Col­
laborating Center for Autoimmune Dis­
ease in Baltimore since 1968.
Rose's current research is related to
self-non-self discrimination and autoim­
mune disease. He has published more
than 500 articles and abstracts in pro­
fessional journals and has edited 10
books. He is editor in chief of Clinical
Immunology and Immunopathology and
sits on several editorial boards.

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S t u

S i l v e r s t e i n ,

M . D

ONE LAST STANDARDIZED TEST TO TAKE!
his week I find myself spending all my spare time studying for the Pediatric Boards, which I
will confront next Tuesday in a hotel room in Portland, Oregon. 1 hardly have any time to catch
the details of the O.J. trial and the latest dilemmas confronting Judge Lance Ito

I am awaiting the appearance of a
cable channel devoted entirely to the
O.J. case. ("I want my O.J.TV.")
Whoops! I guess it already exists and it's
called CNN, or the 300-hour PBS spe­
cial on the history of baseball. Base­
ball is the only sport in
which a PBS special is
more captivating than
a live game.
I am hoping that
this is the last time 1
will have to spend
what seems like an
eternity filling in those
microscopic circles
with a number two
pencil. I am also not
looking forward to re­
ceiving instructions on
how to fill in the holes.
You would think they
consider that since ev­
eryone in the room is a
licensed physician and
has spent the equivalent
of one month each taking
standardized exams, they
would just say, "look you
know what to do, go ahead
and start."
No such luck. They'll have
that same woman from the sec­
ond grade with the blue hair tell­
ing us that the penalty for cheating

©

H u m o r

is expulsion from the room and the
possibility of serving on the
O.J. jury. (I'll get the same
feeling I get listening to
the

YAAWN.

flight attendant explain again how to act
in the events of a water landing even
though we are flying over
Idaho.)
I'm not sure if I am more
anxious about taking the
Boards, or myjob prospects
upon passing them. I have
actually had pediatric col­
leagues tell me that I am
lucky that I have comedy
to fall back on. It was sup­
posed to be the other way
around, wasn't it? Perhaps
one day I'll tell my chil­
dren, "You want to be a
doctor? You'llstarve! First
do something that will put
food on the table —
standup comedy!"
Newsweek even ran a
story about patients look­
ing up their symptoms on
the Internet and communi­
cating to others about them.
I hope Hillary and her com­
mittee don't see the story,
or patients will have to get
used to hearing, "Take two
bytes and call me in the
morning."
Stu Silverstein, M.D., president of
Standup Medicine Seminars of San
Francisco, lectures nationwide on
humor in medicine.

CLASSNOTES

the wedding of Rich Stamile's
PHILIP

C .

DENNEN

daughter in Tulsa.

' 4 9 ,

BERNARD C. MUSCATO '69,

chapter of High Risk Pregnancy
— Management Option, James,
Steer, Weiner and Gonik, edi­
tors, published by Saunders last
May. He has seven granddaugh­
ters and two grandsons.

5

O

was appointed to a six-year term

R I C H A R D I . A L T E S M A N ' 7 6 , of

on the board of directors of

Briarcliff Manor, New York, is

Mercy Hospital of Buffalo. He is

president of the Westchester

a past president of the medical

Psychiatric Society and received

staff there.

added qualifications to his
boards in addictions psychiatry.
He is medical director of Stony

S

J O H N B . F R A N K E L ' 5 3 , of St.

Paul, Minnesota, returned from
OB/GYN practice in Southern

Bernard C . M u s c a t o ' 6 9

California in the early 1990s,
of

A R T H U R M . S E I G E L ' 7 0 , of

Lodge Hospital in Briarcliff

Guilford, Connecticut, just re­

Manor. He and his wife Linda

ceived his pilot's license. His

celebrated their 22nd anniver­

neurology practice, he says,

sary recently. They have a son,

keeps him busy.

14, and daughter, 12. "Anyone

moved to Washington and

JOHN J . LAMAR, JR. '63,

helped establish a prenatal care

Salem, Newjersey, was recently

MICHAEL A. HABERMAN '73,

clinic. He retired in June 1993 to

appointed chief of pediatrics at

of Atlanta, Georgia, was installed

passing through New York City

St. Paul and married a grade

Memorial Hospital of Salem

injuneasthe 140th president of

school classmate. They have 13

County. His second grandchild

the Medical Association of At­

children and 13 grandchildren.

and first granddaughter, Skyler

lanta, at 2,000 members, the larg­

Nicole Devine, was born lastjuly,

est county medical society in the

weighing 7 lbs., 10 oz.

Medical Association of Georgia.

9

6

E D W I N R . L A M M ' 6 0 , of Lake­

land, Florida, became medical
director of the Wound Care In­
patient Subacute Center, Merid­
ian Health Care Center,last May.
He has been medical director of
the Meridian Nursing Center
since 1988. He has four grand­
children. Two of his four chil­
dren are married.
JAMES

M A R K E L L O ' 6 1 , of

Greenville, North Carolina, re­
cently retiredas professor of pedi­
atrics from East Carolina Univer­
sity School of Medicine. He and
his wife, Rhea Markello, R.N., who
also recently retired her nursing
management post from East Caro­
lina University Medical Center,
spend summers at their Eden, New
York, residence.

was elected president of the
Chicago Radiological Society.

authored the "Forceps Delivery"

9

wife Sandra K. Fernbach, M.D.,

K E N K L E M E N T O W S K I ' 6 6 , of

Grand Island, New York, spent
time last July in Buffalo's sister
city in Poland, Rzeszow, teach­
ing extracapsular cataract and
implant surgery. He also took
$250,000 worth of implants and
ophthalmologic equipment do­
nated by vendors to Rzeszow.
B A R R Y S H U L T Z ' 6 8 , of Sink­

ing Spring, Pennsylvania, has
been re-elected president of the
Urologic Society of Pennsylva­
nia. He is president of Genito­
urinary Associates of Reading.
He has a daughter in graduate
school at Dartmouth, a son in
pre-med at Davidson and an­
other son in high school. He
recently met with Tom Cumbo
'68 and Bruce Stoesser '68 at

He is the first psychiatrist to
serve in this capacity. He was
also elected as an alternate di­
rector to the Medical Associa­
tion of Georgia's board of direc­
tors. A fellow of the American
Psychiatric Association, he
served as the president of the
Georgia Psychiatric Physicians

should stop and say hello."

1 9

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0

S

P A B L O R O D R I G U E Z ' 8 1 , of

Warwick, Rhode Island, was
awarded the 1994 American
Medical Association's Young
Physicians Section's Community
Service Award during the AMA's
annual meeting in Chicago. He
chairs the Rhode Island Minor­
ity Health Advisory Committee,
which awards grants for minor­
ity community-based health pro­
motion programs.

Association. He is in privateprac­

J O E S E R N A ' 8 2 , tells us he is

tice in Atlanta.

"fortunate to continue living,

E R I C R U S S E L L ' 7 4 , of Chi­

cago, Illinois, has been promoted
to professor of radiology at
Northwestern University Medi­
cal School. He lectured at Sym­
posium Neuroradiologicum, in
Kuamoto, Japan, on imaging of
the nasopharynx. Daughters
Gabrielle, 12, and Meredith, 7,
attend Latin School of Chicago;

roaches and all, at the center of
the universe — Phoenix, Ari­
zona." He is a staff physician
with the U.S. Indian Health Ser­
vice and is "still" the same rank
as Data. His loving wife of 10
years, Ana Laura, continues to
ask around his sixth or seventh
night at home, "Don't you have
a call night coming up soon?"
They have four children, Jose

©

CLASSNOTES

M O L L Y A . O ' G O R M A N ' 8 6 , of

Fuhrer had Evan Fuhrer last fall.

J . CURTIS HELLRIEGEL '33, a

Salt Lake City, Utah, is an assis­

longtime Buffalo obstetrician-

W A L T E R J . G A U D I N O ' 8 7 , of

tant professor of gastroenterology
at the University of Utah's Pri­

Massapequa, New York, is the

mary Children's Medical Center.

acting chairman of the depart­

gynecologist, died lastJuly after
a long illness. An early advocate
of natural childbirth, he served

ment of physical medicine and
M I C H A E L J . B A R T I S S ' 8 7 , of

rehabilitation at Nassau County

Pinehurst, NorthCarolina, is prac­

Medical Center. He is married,

as chief of staff at Millard
Fillmore Hospital in 1966. He
also was an associate professor

ticing pediatric ophthalmology

with a 2-year-old daughter and

and strabismus surgery with Caro­

another child on the way. He'd

lina Eye Associates. His daughter,

like to hear from any classmates

J U L I A N J . A S C H E R ' 4 0 , died

Kelsey, 6, and son Nolan, 5, have

in the Long Island area.

last January after a long illness.

MICHAEL E. ROSENBAND '89,

J O H N G E R L I N G ' 4 3 , ofAtlanta,

of New York, New York, com­

died in December 1993.

of obstetrics and gynecology.

a new baby sister, Maeve Kathleen,
bornjuly 7,1994. "Momandbaby

David Kountz '85

are doing fine."

pleted his residency in internal
JOHN K. QUINLIVAN '45, a

Miguel, 9; John David, 6; Laura

D E B I D E M E S T I H A S ' 8 7 , ofBuf-

medicine at Mt. Sinai Hospital

Andrea, 2; and Benjamin Adam,

falo, is an attending in pediatric

in June 1993. As an attending

plastic surgeon who served as
clinical assistant professor of

1. "Our daring colleague, Sin Ping

emergency medicine and prac­

physician there in 1993-94, he

Lee, is doing well as a solo practi­

ticing primary care pediatrics at

was awarded the 1994 Physician

plastic and reconstructive sur­

Health Care Plan. She married

of the Year Award. He is pursu­

gery at UB, died last August after

New York State trooper Shawn

ing a fellowship in cardiology at

a brief illness.

tioner in Chandler, Arizona."
D E N I S E M . G O O D M A N ' 8 3 , of

Dalton last September.

North Shore Hospital in Long

Chicago, Illinois, has accepted a

B. EDWARD HECKMANN '48,

Island. He married Gattya Lahau

died unexpectedly last June in

position as assistant professor of

B R I A N G A L E ' 8 7 , ofRiverdale,

pediatrics and pulmonary and

New York, is taking a fellowship

critical care medicine at North­

in cross sectional imaging at the

In
int pprivate
i i v a i t , practice
pi
i i v _ c. 1
ifrom
1U111 1949
X 717 to
I
1975, he also worked for Erie

western University Medical

New York Hospital, Cornell

School. She is also an attending

Medical Center. His daughter,

physician at The Children's Me­

Grace, turned 2 in September.

morial Hospital of Chicago.

He writes that Russell and Nancy

in May 1993.

his home in Snyder, New York.

of

County and New York State and

Charlottesville, Virginia, is be­

was associated with Sisters and

ginning her second year of a

Millard Fillmore hospitals.

PAMELA A. CLARK ' 9 0 ,

pediatric endocrinology fellow­

A N D R E W K N O L L ' 8 4 , of Syra­

M NETTE
N E T T E M.
M . MCDERMOTT
M C D E R M O T T '83,
'83,
ship at the University of Vir­ KAJM

died after a seven-year battlewith

cuse, New York, has been pro­

ginia. She married Michael

moted to the rank of commander

DeHodge, a buyer for the Uni­

breast cancer. She had built a

in the U.S. Naval Reserve.

versity of Virginia, last June.

large internal medicine practice
in Waynesboro, Virginia, and

DAVID

KOUNTZ

'85,

of

Sicklerville, New Jersey, assis­
tant professor of medicine at
Hahnemann University in Phila­

Riviera Beach, Florida, home last

versity School of Medicine and

March.

Molly A. O'Gorman '86

Graduate School.

a

ment, Inc., there.

of John F. Kennedy, died in his

exercises of the Hahnemann Uni­

f

offered controversial testimony

investigating the assassination

Excellence at the commencement

f

J O S E P H R . D O L C E ' 3 1 , who

before the Warren Commission

Practicing Physician Award of

u

served as medical director for
Skyline Rehabilitation Manage­

in 1964 as a ballistics expert

delphia, received the Battafarano

B

OBITUARIES

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PLANTING A TREE UNDER WHICH YOU WILL NEVER SIT

I
DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this
man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is
still supporting UB today through the endowment his bequest created.

T H I S P E R M A N E N T endowment in Dr. Harrington's name has grown to over $300,000 and
today it supports the famous Harrington Lecture Series, which twice a year brings distinguished
scientific speakers to the School of Medicine and Biomedical Sciences.

DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established
permanent and important endowed funds at the school. They enable UB to provide scholarships to
outstanding students, enhance scientific research, support excellence in teaching and meet the everchanging needs of the school.

You TOO can provide the School of Medicine with a measure of permanence through a
bequest. Proper estate planning helps you develop a smart financial plan. A charitable bequest
provides the satisfaction that comes from planting a tree under which you will never sit, but which will
bear fruit for generations to come.

FOR A CONFIDENTIAL consultation on making a bequest to the UB School of Medicine and
Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor,
please contact:

STEPHEN A. EBSARY, JR.
ASSISTANT DEAN AND DIRECTOR OF DEVELOPMENT
SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES

UNIVERSITY AT BUFFALO
(716) 829-2773

J
BUFFALO PHYSICIAN
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