AHC documents

Tentative discovery

By Erik Moore November 30, 2010
AHC documents, Medical school, Perspectives

If a tree falls in the forest, and no one is around to hear it, does it make a sound?

This metaphysical riddle challenges our ideas about reality and perception and whether or not our knowledge of how something works exists in an unperceived existence. It is also viewed as a technical question: without ears present to hear a sound wave, how can it be heard?

For all the things collected in archives, it is common to not have the exact item a person is looking for. This is sometimes due to the fact that it is lost or destroyed while at other times it is a result of having likely never existed in the first place.

In these situations the researcher is more often than not challenged with the metaphysical task of pairing known reality with perception of existence. The task is to take the documents that do exist and seeing whether or not they support a proposed theory. It is the metaphysical equivalent of the tree falling in the forest riddle: If a decision is made, and there is no record in the archives, can it be documented?

A recent research question dealt with such a gap in documentation. The topic seemed straight forward: When was the first medical ethics course taught in the Medical School? Every clue moved the researcher further back into time with less and less solid documentation. Working backward from the 1980s, the researcher discovered bits and pieces of evidence that further shaped an undocumented reality. Student advocates, departmental politics, and curriculum planning all lead to the late 1960s and focused squarely on the origins of the Department of Family Practice.

Definitive documents defining the development of the course or its justification were never found, but the archives provided historical mile markers and contextual evidence for the researcher to elaborate on this unperceived existence.

One document found along the way was an incomplete, undated copy of a medical ethics laboratory manual written by Elof Nelson, a chaplain at Fairview Hospital and the course instructor in the 1970s. Only the first 45 pages of the approximately 200 page manual are available. The remaining likely exists but is not yet preserved in the archives. The manual describes medical ethics as “search and tentative discovery [rather] than indoctrination.” The same can be said about historical research.

Read the partial lab manual below. It includes the full table of contents so in this case we know what we are missing.

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CHIP

By Erik Moore October 26, 2010
AHC documents

The reorganization of the health sciences and the promotion of interdisciplinary research and study at the University of Minnesota forty years ago affected not only administrators and faculty, but students as well. Sensing an opportunity to include themselves as part of the movement toward interdisciplinary education, students within the health sciences organized the Council for Health Interdisciplinary Participation, or CHIP. Today the acronym remains but it stands for the Center for Health Interprofessional Programs.

From its beginning, CHIP focused on projects developed by student members seen as a way to reach out into communities and provide new educational perspectives for students. These projects included recruiting minority students into the various health sciences programs, staffing St. Mary’s detoxification unit, working with the College of Pharmacy to create a drug educational seminar, and designing a national program on the education and eradication of venereal diseases.

CHIP also sponsored guest speakers to discuss health care topics not covered in their coursework. Two early notable speakers included Dr. Evan Shute and his advocacy for mega doses of vitamin E to combat disease and Dr. Andrew Weil, then a researcher at the National Institute of Mental Health, who discussed recent research on marijuana in his talk “Altered States of Consciousness: Drugs and Society.”

The Alumni News magazine wrote a profile on CHIP and its early accomplishments in the October 1972 issue. Read the article below.

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Base Hospital No. 26

By Erik Moore September 28, 2010
AHC documents, Hospitals, Medical school, Nursing

Every war requires that doctors and nurses become soldiers. The University of Minnesota Medical School first became involved with such an effort as World War I spread across Europe.

img0158.jpgIn October 1916, half a year before the United States declared war with Germany, the University of Minnesota and the Mayo Clinic began preparations for establishing a base hospital at the request of the Surgeon General. The unit, known as Base Hospital No. 26, organized itself over the summer of 1917 under the auspices of the American Expeditionary Forces and waited for the call to active duty. In December 1917, the War Department mobilized the unit. It was not until June 20, 1918 that the unit reached its destination of Allerey, France. In sum, the unit’s equipment and staff were designed to support a 1,000 bed hospital. It cared for nearly 6,000 patients through 1919.

Historical information about Base Hospital 26 is available from a variety of sources. The Minnesota Alumni Weekly chronicled the activities of the Base Hospital through regular articles and published letters from the unit’s staff. Also, several archival collections have material related to the unit including the papers of Dr. Moses Barron, a University of Minnesota pathologist who served as an officer in the unit. Included are photographs, correspondence, diaries, and related information all pertaining to Base Hospital No. 26.

See a short typewritten history below of Base Hospital No. 26 as an example of the materials available in the Barron papers at the University Archives.

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Above the fold

By Erik Moore September 10, 2010
AHC documents, Hospitals

This last week marked the 99th anniversary of the dedication of Elliot Memorial Hospital. The September 5, 1911 afternoon edition of the Minneapolis Journal announced the dedication taking place that day “rain or shine.”

img0156.jpgErected at a cost of $155,000 dollars, the Elliot family provided approximately $115,000 to honor Dr. Adolphus Elliot, a former Minnesota physician who passed away in 1902. The legislature provided the remaining $40,000 plus another $44,000 for equipment.

The site of the new hospital anchored the proposed new campus south of Washington Ave. Elliot Hospital spanned the southern edge of the new campus along the Mississippi River and the new anatomy building (now Jackson Hall) marked the northwestern corner. University President George Vincent ceremoniously laid the anatomy building’s cornerstone on the way to the hospital dedication.

In tandem with the gift from the Elliot family, 38 prominent individuals of Minneapolis provided the $42,000 to purchase the land for the new hospital as a gift to the University. Many of the family names are familiar today including Pillsbury, Dunwoody, Shevlin, McKnight, Gillette, Donaldson, and many others.

The 115 bed Elliot Memorial Hospital served two key functions. First, it was a modern clinical teaching facility for medical students integrated into the campus environment. Second, it provided free health care services for charitable cases from across the state. Initially all hospital services were offered free of charge.

Elliot Memorial Hospital is now the Elliot Wing of the Mayo Memorial Building.

Read more about the dedication and construction of the hospital from the Minneapolis Journal. Articles from below the fold or on subsequent pages are available at the University Archives. Also note the articles related to the State Fair.

What’s in a name?

By Erik Moore August 31, 2010
AHC documents, Lexicon

When did the Academic Health Center become the Academic Health Center?

For the first twenty-some years, the Academic Health Center was actually referred to as the University of Minnesota Health Sciences Center. At some point the moniker changed and we became the Academic Health Center.

Sometimes it is the simple questions that can be the most difficult to answer. A name change is usually a fairly significant event, but in certain cases it can be elusive to pin point an exact date especially if a string of attributive adjectives gives way to a proper noun.

The phrase “academic health center” is a common term found in the discussion of health sciences education since the 1940s. Yet, documenting the use of the name as it relates to Minnesota helps narrow the specific point we stopped referring ourselves as the Health Sciences Center and became the Academic Health Center.

The Board of Regents organized the Health Sciences in July of 1970 without using the term Academic Health Center or Health Sciences Center.

In January of 1992, the use of the proper noun is first documented in the Board of Regents minutes, yet it is only a cursory mention in the motion to acquire the Interstate Medical Center, P.A. in Red Wing and is not an official designation. This part of the motion reads

“WHEREAS, the Board of Regents, in recognition of the changing health care delivery environment, wishes to support and encourage the administration, the University of Minnesota Hospital and Clinic (UMHC) and its Board of Governors to seek new relationships — including but not limited to, joint ventures, affiliations, collaborative relationships and acquisitions — to assure the Hospital and Clinic’s ability to fulfill its mission of supporting the clinical, educational and research needs of the schools, colleges and programs of the Academic Health Center and enhancing its statewide service mission;”

Jump ahead to May 17, 1994 when the Board of Regents appointed William Brody as Provost. This documents the still institutional use of Health Sciences Center.

“President Hasselmo called the meeting to order, stating that the purpose of the meeting was to appoint the Provost of the University of Minnesota Health Sciences Center.”

On September 9, 1994, President Hasselmo presented to the Board of Regents the “Recommendations on Organizational Structure for Central Administration” and specifically discussed the creation and appointment of the provost position overseeing the Academic Health Center. Hasselmo noted the Regents’ approved the creation of the Provost, Academic Health Center in December 1993, but the actual terminology used in the minutes is Health Sciences Center. He also inaccurately stated that the recruitment of the Provost, Academic Health Center, occurred in May 1994 when in reality it was of the Health Sciences Center as documented above.

It turns out it is Hasselmo’s presentation and his anachronistic references that are the true first documented uses of the proper noun Academic Health Center and its replacement of Health Sciences Center at the University of Minnesota. They are further institutionalized by inclusion into the Regents’ minutes that same day as an approval of the “Restructuring Central Administration” motion.

Nostalgia & institutional memory

By Erik Moore August 16, 2010
AHC documents

Nostalgia is a formidable foe to institutional history. The “good-old-days” is a powerful posture to overcome using records and archival materials. Counter narratives exist to all tales of “glory days,” but can sound like sour-grapes without supporting documents.

It is always interesting then to find such a document that gives one pause in understanding how the organization functioned and what was the institutional culture of the time.

We know that the present day Academic Health Center formed in 1970 after the reorganization of the Health Sciences by the Board of Regents based on an external review committee’s recommendations. It also was in part the result of several internal reviews and projections on the future needs of training, space, and planning. This internal review began in 1964 under the leadership of President Wilson.

But what were the internal organizational flaws that would contribute to such a review and necessitate an administrative change?

Written in 1977, the following list gives somewhat of a contemporary account of the institutional culture of the health sciences from the previous decade. Written by John Westerman, then director of the University Hospitals, the list was part of an evaluation of the office of the Vice President for Health Sciences. Westerman notes that the list is based on “a number of difficulties” presented to the Board of Regents and President Wilson by the College of Medical Sciences and the School of Dentistry in 1964.

1. Space problems — Little was constructed since the completion of Mayo Tower in 1954.

2. Planning — No health sciences plan existed. One piece of real estate was the object of the six units involved.

3. Planning Funds — No capital finance fund or even plans was in place.

4. Operating Funds — The units were underfunded for the manpower obligations and were becoming the have nots of academic health units — with all the implications of recruitment, retention, attraction of research funds, etc.

5. The clinical facilities were functionally obsolete in a highly competitive marketplace.

6. The units showed little evidence of cooperative efforts or even awareness of each others goals and programs.

7. The units displayed an uncommon talent for lobbying with central officers, regents and the legislatures on an individual or even programmatic basis.

8. There was little knowledge of the combined characteristics of the center and increasing demand to deal with the health sciences as a totality.

9. Public demand of the early ’60’s called for increased health manpower from each of the units.

10. There was no effective mechanism for administrative coordination of the units and providing an effective interface with the many university interrelationships.

Reading the evaluation you will notice that it does not contain the actual performance review. This document is merely a copy and was not annotated. However, it is interesting to see by what criteria the VP for Health Sciences was evaluated.

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Stepping down

By Erik Moore August 3, 2010
AHC documents

Recent conversations in the Academic Health Center tend to focus on the pending retirement of Senior Vice President Frank Cerra, MD. Dr. Cerra plans to step down after nearly fifteen years as the administrative head of the health sciences in December.

Of course, Dr. Cerra is not the first vice president for health sciences to step down. In total there have been five fully appointed vice presidents/provosts; Dr. Lyle French (1970-1981), Dr. Neal Vanselow (1982-1989), Dr. Robert Anderson (1992-1993), Dr. William Brody (1994-1996), and Dr. Cerra (1996-2010), and one long-term acting vice president, Cherie Perlmutter (1989-1992).

img0153.jpgOf all the vice presidents, Drs. French and Cerra have the most in common. Both served as departmental chiefs at the University of Minnesota before their appointment. Both served in their position for more than ten years. Both oversaw major physical expansions of the health sciences complex. And finally, both indicated an interest to return to their departments to pick up the mantle of research & teaching.

Vice presidents Vanselow and Brody left the University to serve as Chancellor of Tulane Medical Center and President of Johns Hopkins, respectively. Dr. Anderson retired from academic life.

Pictured: 1983 Oil portrait of Dr. Lyle A. French.

Read the 1981 press release announcing Dr. French’s plan to step down and the accompanying summary of his time in office.

 

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ABCs of facility planning

By Erik Moore July 20, 2010
AHC documents, Facilities

In 1964 University of Minnesota President Wilson initiated the University Long-Range Planning Committee for the Health Sciences. Part of this committee’s charge was to determine the needed facilities to maintain and grow the programs in the Health Sciences.

The Health Sciences Design Coordinating Committee developed a framework for this growth in 1968 and published its schedule in the Health Sciences Planning Report.

The expansion project quickly became known for its use of alphabetical monikers to denote the new construction. Many of these alphabetical references are still used today often interchangeably with the facility’s given name.

Find your own building’s place in the alphabet and its original purpose then see which letters never made the transition from paper to brick and mortar.

Unit A: To house general dental clinics, School of Dentistry administration, basic science, medical, and public health teaching labs as well as general classrooms. The first of the expansion projects, the facility would later be named the Malcolm Moos Health Sciences Tower.

Unit B/C: To provide outpatient and ambulatory care, new emergency room, surgical and other research facilities, diagnostic radiation facility, and additional hospital beds. Designated at its design as the Phillips-Wangensteen Research Building.

Unit D: Subterranean facility adjacent to the Masonic Memorial Cancer Hospital to house radiation therapy. Considered part of the first phase of development to be initiated by 1973, the unit was unable to reach the revised 50-50 match required by federal guidelines in 1978.

Unit E: Designed to be a service center for storage, supply, and dietary kitchens with a proposed cafeteria and dining service on upper levels. Later named the Health Sciences Receiving and Distribution Center the unit is accessible via the delivery access area on East River Parkway underneath the Dwan Variety Club Cardiovascular Research Center and the Masonic Cancer Research Building.

Unit F: To provide additional shared classrooms and house the College of Pharmacy. Modified in 1975 to also include the School of Nursing, the building is now Weaver-Densford Hall.

Unit G: Proposed to expand shared classrooms and teaching labs, the building’s tower would house the remainder of the School of Public Health. The 1977 legislature removed funding for this unit and made the School of Public Health the only school to be without a building plan in the expansion project. The unit would have been built on the northwest corner of Harvard & Delaware, the current location of the Phi Chi Medical Fraternity house and the hospital parking ramp.

Unit H: Subterranean structure to tie the old and new hospital units together via a ground level concourse and provides expansion for surgery suites. Unit H became unified with Unit J as part of the second phase of expansion through 1986.

Unit J: Proposed new hospital facilities located on the former site of Powell Hall. Today’s University of Minnesota Medical Center, Fairview.

Unit K: Expanded cardiovascular research center with a probable location west of the Variety Club Heart Hospital. Unit K would later be combined with Unit E development to form Unit K/E. Today Unit K is the Dwan Variety Club Cardiovascular Research Center.

There is no mention of a Unit I. View a 1968 illustration of the proposed development through 1986.

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Back to the future of continuing medical education

By Erik Moore July 6, 2010
AHC documents, Medical school

Predicting the future is a popular means to finish a review of past accomplishments. Often, these forecasts rely heavily on current trends in technology to safely guess advances and efficiencies.

An example of one such prediction is in the 1955-1957 Biennial Report of the Department of Continuation Medical Education.

Formalized in 1937, the Department of Continuation Medical Education, formerly known as Postgraduate Medical Education and today named the Office of Continuing Medical Education, enjoyed a major boost to its programming in 1945 through a nine year, $250,000 grant by the Kellogg Foundation to increase opportunities for participation in its teaching programs. Although review courses for practicing physicians were part of the Medical School’s curriculum for decades, the department provided a permanent home for the “interdepartmental” education program.

The 1955-1957 report cites recent developments in the audio-visual field as a major future trend. Specifically it looks toward the use of television as a means to distribute postgraduate medical education. The report then imagines a world where continuing medical education moves past the limited scope of closed-circuit television and will be

“widely disseminated allowing physicians, even in remote areas, to keep abreast of medical progress simply by watching their TV screens for appropriate periods each week.”

An equivalent modern predication might be live-streaming of lectures or procedures via one’s smart phone or other mobile device. Gone will be the tether to the lecture hall or conference room. And as for the future of PowerPoint as an educational tool? The Magic 8-Ball says “Ask again later.”

Read the 1955-1957 Biennial Report below. The report also includes an overview of the department beginning with the 1945 Kellogg grant through current programs.

CME Report

Joining the fold

By Erik Moore June 21, 2010
AHC documents, Veterinary medicine

This year marks the fortieth anniversary of the Academic Health Center at the University of Minnesota. The anniversary specifically acknowledges the reorganization of the health sciences units on campus into a new administrative structure that combined the schools and colleges of medicine, nursing, public health, pharmacy, and dentistry under the leadership of the newly created office of the Vice President for Health Sciences.

Notice, however, that the College of Veterinary Medicine is not apart of the original grouping?

In the document Health Sciences Mission Statement and Proposed Structure and Governance, approved by the Board of Regents on July 10, 1970, the relationship between the restructured Health Sciences and the College of Veterinary Medicine is described as close, but separate. The document explains that

“The Regents have authorized a unified organization of the health sciences that will bring together in a single administrative structure programs in medicine, nursing, public health, dentistry, pharmacy, and the University hospitals. Veterinary medicine which has related interests will be joined closely to this administrative unit.”

And continues

“The Regents recognize the multi-lateral relationships in which the College of Veterinary Medicine is involved. The affairs and activities of the College of Veterinary Medicine will be important to the Health Sciences and vice-versa. It is proposed that the Dean of the College of Veterinary Medicine carry adjunct status in the Health Sciences to facilitate coordination and cooperation but that the status of the College otherwise remain as it is at present.”

The status of the CVM was a free standing professional graduate program led by a dean who reported to the senior vice president for academic affairs.

This organizational structure differs from the recommendations put forward by the External Committee on Governance of the Health Sciences in 1970 that encouraged the Dean of the College of Veterinary Medicine report directly to the Vice President of Health Sciences.

When did the College of Veterinary Medicine officially join the Academic Health Center?

On September 13, 1985, the Board of Regents approved the recommendation of the Education Planning and Policy Committee to change the administrative reporting structure of the College of Veterinary Medicine so that it

“Shall be designated as a unit of the Health Sciences with a line reporting relationship to the Vice President for Health Sciences.”

This year actually marks two anniversaries: First, the 40th anniversary of the Academic Health Center, and second, the 25th anniversary of the full partnership of the College of Veterinary Medicine.

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