y any standard, the University of Virginia Health Sciences

Patients from around the world as well as from central Virginia come to the University Medical Center for the best medical treatment.

Center is one of the most respected academic medical centers in the country. Our faculty is among the most eminent in the country, and indices of patient satisfaction are high. For example, overall satisfaction with appointment availability reached 97 percent this year.

Nine medical departments were included in U.S. News & World Report's listing of the best hospitals in the country. "Any institution listed among the top 42 medical centers in any specialty should be considered a leading center," the authors of the report stated. Those specialties cited for distinction were endocrinology, otolaryngology, cancer, urology, gynecology, orthopedics, AIDS care, neurology, and rheumatology.

Dr. George Beller, head of the Division of Cardiovascular Medicine, is one of fifty-one U.Va. physicians included in the most recent edition of The Best Doctors in the Country.

The citizens of central Virginia and around the world have benefited from the innovative techniques pioneered by our specialists. The University of Virginia performed the first pediatric bone marrow transplant in the state, extending treatments available to young cancer victims. It was also one of the state's first hospitals to adopt a less invasive heart bypass procedure that allows patients to return home after a two-day stay. In addition, U.Va. faculty are known throughout the world for their expertise in treating supposedly inoperable brain tumors.

The University's medical and nursing schools are widely acclaimed for training compassionate, highly skilled professionals. Both schools recruit the most outstanding students and place them in classrooms, laboratories, and patient-care settings with some of our nation's most distinguished educators, women and men at the height of their careers who bring expert knowledge and a passion for excellence to teaching.

HEALTH CARE FOR THE TWENTY-FIRST CENTURY

Reexamining Treatments A common medical procedure for patients in shock or with impaired heart function--performed more than a million times each year--may do more harm than good in some patients, according to a study conducted by Health Sciences researchers Dr. William A. Knaus and Dr. Alfred F. Connors, Jr., pictured above. Dr. Knaus chairs the recently formed health evaluation sciences department, and Dr. Connors is director of health services research and outcomes evaluation at the University Medical Center. The physicians and their research team found that right heart catheterization has been associated with a 21 percent higher risk of death in the critically ill and may produce as much as $10 billion in additional health care costs each year. During this procedure, a balloon-tipped catheter, or threadlike tube, is inserted into a large vein in the patient's neck and comes to rest in the pulmonary artery, where it measures blood flow and filling pressures. The research is part of a $28 million effort sponsored by the Robert Wood Johnson Foundation to understand the outcomes of various commonly used medical treatments. After examining the records of 5,735 patients, the physicians called for further studies leading to new practice guidelines for right heart catheterization. Dr. Knaus has emphasized that the procedure can provide important information about patients, but that physicians must consider associated risks in deciding who should receive the technology.

Academic medical centers like the Health Sciences Center subsidize their academic enterprise from clinical earnings. At a time when state and federal support for medical education is projected to decline, the advent of managed care threatens future achievements.

Rather than retrench, the Health Sciences Center has taken a bold, entrepreneurial approach to meeting this challenge. It is determined to build on its strengths in specialty medicine, while providing the people of central Virginia with the best health care available. Key elements in this strategy involve deploying a full continuum of care that extends from prevention and wellness to intensive care, rehabilitation, and hospice services; cultivating a larger service area; and developing cooperative relationships with other hospitals as well as insurers.

HealthCare Partners, a joint venture of the Medical Center and the University of Virginia Health Services Foundation, has acquired or developed a number of primary care practices as a way of enlarging our service area. Capitalizing on recent advances in communications and computer technology, the Health Sciences Center has created telemedicine links with Rockingham Memorial Hospital and the new Augusta Medical Center in the Shenandoah Valley that allow it to provide medical consulting and educational programs. Telemedicine workstations will be installed in rural clinics to ensure that patients receive the highest possible care in their local community.

The Health Sciences Center is lowering costs by adopting a more centralized approach to decision-making and resource allocation and has instituted even more competitive pricing. This year, the state granted the Health Sciences Center codified autonomy, a status that provides more authority under specific conditions for capital building projects, contracting and leasing, personnel, and purchasing activities.

Another strategy of the Health Sciences Center is to build its endowment for the medical and nursing schools, while developing new sources of funding for these programs. This year, the National Institutes of Health (NIH) awarded the Cancer Center a $3.8 million grant to support interdisciplinary research designed to produce therapies for cancer. The NIH awarded the nursing school $1.1 million to create the Center for the Study of Complementary and Alternative Therapies for Pain. Recognizing our expertise in telemedicine and neurology, the Defense Department's Advanced Research Projects Agency selected U.Va.'s Virginia Neurological Institute to design, construct, and test a prototype for telesurgery at remote locations.

HALTING SERIOUS ILLNESSES

Nine medical departments at the University of Virginia are listed in U.S. News & World Report's "1996 America's Best Hospitals" guide. The specialties cited for distinction are endocrinology, otolaryngology, cancer, urology, gynecology, orthopedics, AIDS care, neurology, and rheumatology.

Members of the medical school faculty are rapidly pushing back the frontiers of knowledge from modern laboratories in a score of disciplines, making new discoveries and pioneering the new approaches that will provide the foundation for health care for years to come.

The ability of our cells to divide is critical to our well-being. Without cell division, wounds would never heal nor broken bones mend. But when the cell division process slips out of control -- when cells begin to divide without rhyme or reason -- the result is a cancerous tumor.

Having discovered a molecular process that is responsible for division within the cell, Lloyd Gray, associate professor of pathology, and Doris Haverstick, assistant professor of pathology, have identified two readily available pharmaceutical compounds that break the chain of connections within the cell that causes it to divide. Gray and researchers at the University Cancer Center are presently testing this treatment on patients with leukemia, breast cancer, and prostate cancer, as part of the phase 1 clinical trials needed for FDA approval.

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