PACEMAKER: August 1996
Doctors repair mom's heart before she
delivers baby
Isabel Garcia doesn't know how or when, but sometime as a young
girl growing up in Honduras, she contracted rheumatic fever.
While rheumatic fever's immediate symptoms include fever and joint
pain, the disease can also cause long-term heart damage.
Garcia's heart problems apparently surfaced during her fourth
pregnancy, when she experienced severe shortness of breath. Because
she had not previously been diagnosed, doctors in her home city of
Tegucigalpa believed the problem resulted from pneumonia, and treated
her accordingly.
Meanwhile, Garcia struggled to make ends meet and raise a family
of four. Speaking through an interpreter, she tells of working
strenuous, 11-hour days in a Tegucigalpa mattress factory for $3 a
day. "Life was very hard," she says. "I wanted something better for
my children."
In 1993, Garcia immigrated to Coralville, Iowa, where she found a
job at a plant in nearby West Branch. Two years later she became
pregnant with her fifth child.
"Everything seemed normal at first," she says of her pregnancy.
"Then I had problems with swollen feet, and the doctor sent me to Dr.
Viviana Martinez-Bianchi at the Family Practice Clinic (at the
University of Iowa Hospitals and Clinics)."
Family Practice physicians referred Garcia to the UIHC's
Maternal-Fetal Medicine specialists, directed by Jennifer Niebyl, MD,
Professor and Head of the Department of Obstetrics and Gynecology.
The Maternal-Fetal Medicine team subsequently referred Garcia to
Kevin Mulhern, MD, Assistant Professor in the Department of Internal
Medicine, for treatment of mitral stenosis, a narrowing of the mitral
valve.
Dr. Mulhern, who specializes in the care of women with heart
disease during pregnancy, collaborated with the Maternal-Fetal
Medicine team to coordinate Garcia's care.
"In the past, many women with mitral stenosis died from heart
failure during pregnancy. With our team approach, a patient's odds
for success are much greater now than before," Dr. Mulhern says.
Dr. Niebyl says the Maternal-Fetal Medicine team collaborates with
specialists like Dr. Mulhern to ensure the best outcome for mother
and baby. Mrs. Garcia's problem was serious, and required highly
specialized care, she says.
Dr. Mulhern says, "Mrs. Garcia had high blood pressure and fluid
accumulation in the lungs, and her mitral valve opening was only 20
to 25 percent of normal. Both she and her baby were at risk."
Dr. Mulhern first prescribed medical therapy. Later in the
pregnancy, Garcia developed lung congestion again and she became a
candidate for a heart valve repair procedure called percutaneous
balloon mitral commissurotomy.
Cardiologist James Rossen, MD, performed the commissurotomy on
December 12, 1995. In the procedure, Dr. Rossen relieved Garcia's
mitral stenosis by separating the mitral valve's leaflets with a
balloon catheter.
"The results were very good," Dr. Mulhern says. "She returned home
after a few days, all of her medications were discontinued, and she
delivered a healthy baby two months later (Garcia's delivery was
supervised by Obstetrician Carl P. Weiner, MD, assisted by Obstetric
Anesthesiologist Robin Goldsmith, MD).
According to Dr. Niebyl, Garcia's success illustrates the value of
the UIHC's Maternal-Fetal Medicine team. "We're actually the only
specialty group of its kind in the state," she says. "When serious
complications arise during pregnancy, we're fully prepared to provide
the latest, most effective therapies to our patients."
Drs. Mulhern and Niebyl emphasize that most patients referred to
the UIHC's High Risk Obstetrics program are referred by physicians
from throughout Iowa and neighboring states. "We collaborate very
closely with community physicians," Dr. Mulhern says. "Their
involvement is critical to assuring that these patients get the best
care possible."
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Psychiatrist cites ballplayer as role
model for Tourette patients
His 5-foot-11 frame packs a powerful punch, enough to sustain a
notable career in professional baseball, including a dramatic
three-run home run in the 1993 World Series.
But Jim Eisenreich's physical talents weren't enough to overcome
the nervous tics that accompanied his Major League debut in 1982. As
a promising young outfielder with the Minnesota Twins, fans and the
media interpreted his involuntary jerks, twitches, and grunts as
"stage fright."
Although he had endured his embarrassing tics since youth,
Eisenreich had no idea why he behaved as he did. Increasingly
humiliated and self-conscious, he experienced a series of
on-the-field hyperventilation episodes that led him to quit baseball
altogether.
Doctors finally diagnosed Eisenreich with Tourette syndrome, an
inherited, neuropsychiatric disorder characterized by repetitive
involuntary motor and vocal tics (Eisenreich's symptoms do not
involve the inappropriate bursts of profanity often associated with
Tourette syndrome).
Helped by drug therapy, Eisenreich made a widely heralded return
to the Major Leagues in 1987 with the Kansas City Royals. He remained
with the team until signing with the Philadelphia Phillies, helping
them to storybook appearance in the 1993 World Series.
Eisenreich continues to reside in Kansas City, where he has become
a highly visible advocate for people with Tourette sydrome. This
commitment led to an association with Neuropsychiatrist, Gary R.
Gaffney, MD, who at that time was affiliated with the University of
Kansas Tourette Syndrome Clinic. In 1993, Dr. Gaffney joined the
University of Iowa staff as an Associate Professor of Psychiatry.
Dr. Gaffney retains a strong link with Eisenreich, in part because
of the UIHC Tourette Syndrome Clinic's national reputation. "This is
truly a regional center with a long-standing reputation for
excellence," he says. "We treat patients from a wide geographic
region, with patients coming here from places like Alaska, Arkansas,
Kansas, Missouri, Wisconsin, Nebraska, and Minnesota, in addition to
Iowa."
Eisenreich has visited the UIHC Clinic, while Dr. Gaffney helped
Eisenreich complete a video, "Tourette Syndrome: Handling it Like A
Winner, the Jim Eisenreich Story."
More recently, Dr. Gaffney began serving as Medical Advisor to the
recently organized Jim Eisenreich Foundation for Children with
Tourette Syndrome. The Foundation supports programs that improve the
lives of people and families living with Tourette syndrome and its
associated disorders.
"It's been a very positive relationship," Dr. Gaffney says. "Jim's
a wonderful advocate for people with Tourette syndrome, in addition
to being a great athlete and family man. And Iowa's program has been
a long-time leader in treatment of patients with Tourette syndrome.
In the 1960s, Dr. Richard Jenkins and his group here at Iowa became
the first to treat Tourette patients with Haldol, which once was the
standard medical therapy for these patients."
Eisenreich credits Dr. Gaffney with having a congenial approach to
children with Tourette syndrome that is both effective and
appropriate.
"I wish he'd been around when I was a kid," Eisenreich says. "He's
great with the young people, not hard-core like the doctors were when
I was young."
In addition to Dr. Gaffney, the UIHC Tourette syndrome team
includes Sam Kuperman, MD, an internationally recognized
neuropsychiatrist and Tourette syndrome specialist. Other staff
members include Gretchen Holt, MS, Special Education Coordinator;
Psychopharmacologist Paul Perry; Nurse Joan Beckman, RN; Research
Assistant Joan Kempf; and Geneticist Rick Devor, PhD, Assistant
Professor of Psychiatry.
Anyone with questions about the UIHC's Tourette Syndrome Services
may contact Dr. Gaffney at (319) 353-6695 or Dr. Kuperman at (319)
356-1482. Dr. Gaffney can also be reached through the UI's Virtual
Hospital site on the World Wide Web.
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Tenacity gets girl a cochlear implant
At times the road to success takes a little twisting and turning
of the wheel.
No one understands that better than Gene and Laure Warner of White
Bear Lake, Minnesota. The Warners traveled a long, difficult road in
getting a cochlear implant for their 2-year-old daughter, Andria.
"Somebody had to do it," Gene says. "Somebody had to challenge the
system."
Andria seemed perfectly healthy following her birth in 1994. As
the months passed, however, she didn't respond to sounds and voices.
An initial hearing test revealed mild to moderate hearing loss.
"At that point, we were just devastated," Laure says.
Worse news followed. "We had another test at the Mayo Clinic,"
Laure says. "They told us she was profoundly deaf and recommended
hearing aids."
Unfortunately, hearing aids were inadequate for Andria's special
needs. Over the next several months, acting on their own, the Warners
extensively researched a newer technology for deaf people, cochlear
implants. Cochlear implants produce sounds that, with training, can
be interpreted as words.
"We learned everything we could," Laure says. "We found out that
cochlear implants benefit many deaf people. We also found out our own
health insurance policy, like a lot of policies, doesn't cover
cochlear implants because they were 'experimental.'"
The Warners were incredulous. Everything they had read and heard
suggested that cochlear implant technology had advanced well beyond
the experimental stage. They vowed to fight the company's policy, in
hopes they could effect change, if not for their child's sake, then
for someone else's.
Meanwhile, the family's extensive research had produced a short
list of the nation's best cochlear implant programs. At the top of
this list was the University of Iowa Hospitals and Clinics, along
with Otolaryngologist Bruce Gantz, MD, and Audiologist Holly
Fryauf-Bertschy.
"We visited Iowa and came away very much impressed," Laure says.
"We were pretty much convinced that's where we wanted to go."
Inspired by their daughter's handicap and the hope she could lead
a better life with a cochlear implant, the Warners cranked up the
heat on their insurance company. They also contacted Minnesota Gov.
Arne Carlson and State Rep. Harry Mares.
Even better, in a remarkable coincidence, the Warners received a
call from news reporter Trish VanPilsen, who was pursuing an entirely
different story for WCCO-TV in Minneapolis. "She didn't know anything
about Andria's situation, but when we told her, she was very
interested in the story," Laure says.
With a critical appeal pending before the insurance company,
VanPilsen informed the company that the Warners had granted her
permission to videotape the hearing. "That's all it took," Laure
says. "They called right back and said they'd partially cover the
implant if we did it in Minnesota."
This was encouraging news for the Warners, but not entirely
satisfactory. They wanted the best for Andria, and the best meant
coming to Iowa's program, which is supported in part by grants from
the National Institutes of Health, the Lions Clubs International
Foundation, and the Iowa Lions Foundation.
Under continued scrutiny by WCCO, the company relented and
approved a trip to Iowa City.
"We're very happy for Andria," Gene Warner says. "But a lot of
details remain to be worked out. The company's decision affects only
us, and the coverage excludes speech therapy and auditory training.
Well, that's like having a new car with no keys. If you can't use the
technology, it does no good. We hope to change this part of the
policy as well."
Meanwhile, the Warners saw their dreams come true on May 16, 1996,
when Dr. Gantz surgically placed Andria's cochlear implant. The next
critical step occurred when Audiologists Fryauf-Bertschy and Danielle
Kelsay conducted the first tests to determine if Andria would
actually hear sounds through the implant.
As the first beeps were delivered through Andria's speech
processor, her bright eyes and hand motions suggested an excellent
result. Though no one can be exactly sure how Andria perceived these
first sounds, she clearly experienced an entirely new sensation. This
opened the door for audiologists to deliver new sounds that more
closely resemble human speech.
"With training and over time, people like Andria can learn to
communicate effectively with their implants," Fryauf-Bertschy says.
"There's a lot of learning involved, but it makes a remarkable
difference for the majority of deaf people who receive this
technology."
For the Warners, Andria's progress makes their struggle
worthwhile. For Gene in particular, however, winning a battle for
Andria isn't like winning the war. His crusade for insurance reform
has gone to the Minnesota legislature, which is considering a bill
that would mandate that health insurance policies cover cochlear
implants.
"To me, it's just criminal that any insurance company could deny a
deaf person the opportunity to benefit from a cochlear implant," Gene
says. "We're doing everything we can to get this changed."
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New technique turns cancerous tumors into ice
balls
When the South Vietnamese capital city of Saigon fell to Communist
North Vietnamese troops in 1975, Nho Nguyen became a prisoner in his
own country.
Nguyen, now 66, and thousands of other former South Vietnamese
soldiers were sentenced to "re-education camps" by their captors.
Speaking through an interpreter, Nguyen says the camp, located
southeast of Saigon (now Ho Chi Minh City) in a region called Ben
tre, was oppressive and degrading. Prisoners had to grow their own
food and perform hard labor during the day, while being shackled to
fellow inmates at night. Family visits were severely restricted. Many
prisoners died from disease or, like one of Nguyen's friends, while
trying to escape (One of Nguyen's sons was among the "boat people"
who fled Vietnam; he was never heard from again and is presumed
dead.)
Following seven years in captivity, Nguyen and many other
long-time prisoners were released when U.S. officials intervened,
citing human rights concerns. Nguyen had "too many enemies" to resume
living in his home village of Thahn Phu, so he moved to a mountainous
area of Vietnam and became a coffee grower.
"It was a tough go," he says. "The land had to be cleared of
trees. It was very hard."
Five years ago, Nguyen and his wife, Nhien, five sons and one
daughter, resettled in the United States, starting life anew in Cedar
Rapids, Iowa. While Nguyen was relatively healthy upon his arrival,
he soon received emergency treatment for severe abdominal pain.
Nguyen, who had contracted hepatitis B years earlier, was
subsequently diagnosed with liver cancer following examinations by
Cedar Rapids physicians Jeff Nielsen, MD, and Martin Wiesenfeld, MD.
This was not totally surprising, since hepatitis B seems to
predispose some patients to cancer.
Nguyen received follow-up evaluation at the University of Iowa
Hospitals and Clinics, where an interdisciplinary team of physicians
identified him as a good candidate for a relatively new procedure
called cryosurgery. In cryosurgery, liquid nitrogen is used to freeze
the liver tumor into an ice ball, thereby killing the cancerous cells
and small blood vessels that feed the tumor.
The UIHC's cryosurgery team includes Bruce Brown, MD, Associate
Professor in the Department of Radiology; Peter Jochimsen, MD,
Professor in the Department of Surgery; Maureen Martin, MD, Associate
Professor of Surgery and Director of Organ Transplantation, and
Oncologist Mark Karwal, MD, Assistant Professor (Clinical) of
Internal Medicine.
Dr. Martin says the preferred treatment for patients with liver
cancer is surgical resection of the part of the liver involved by
cancer. "But some patients cannot undergo surgery because the tumor
involves both sides of the liver or they have cirrhosis. These
patients may now be candidates for cryosurgery."
Dr. Karwal says cryosurgery works best when performed in
conjunction with partial tumor resection, but cryosurgery alone can
be performed.
During the procedure, cryosurgery probes are precisely placed
using intraoperative ultrasound guidance to assure complete tumor
destruction.
The UIHC cryosurgery team plans to collaborate with three other
centers-Emory University in Atlanta, the M.D. Anderson Cancer Center
in Houston, and the Mayo Clinic in Rochester, Minnesota-in research
studies designed to evaluate the effectiveness of cryosurgery.
Researchers are especially interested in determining whether
cryosurgery, or an alternative treatment, chemoembolization
(Pacemaker, October 1993), is more effective. In chemoembolization,
interventional radiologists visualize the tumor with CT portography,
then position a catheter in the hepatic artery to deliver a
chemotherapeutic agent directly to the tumor through a hepatic
artery.
Dr. Jochimsen says both procedures benefit patients, but a
scientific study is needed to determine which procedure works best
for which types of liver cancer patients.
Questions about the cryosurgery procedure may be addressed to Dr.
Martin at (319) 356-1334, Dr. Jochimsen at (319) 356-3584, or Dr.
Karwal at (319) 353-8506.
Return to the top
Manasse leads Health Sciences Center during
era of turbulent change
Had anyone asked three years ago about the University of Iowa's
Health Sciences Center, the typical response might have ranged from
puzzlement to curiosity.
Although the UI had world-class health sciences resources, unity
and central identity were missing. That began to change in September
1993 when Henri R. Manasse Jr., became the UI's first Vice President
for Health Sciences.
Dr. Manasse, who has a doctorate in pharmacy administration, faced
myriad challenges in developing the vice president's role and in
shaping the Health Sciences Center, which evolved quickly after his
arrival.
His tenure at Iowa occurred during a turbulent era of health
policy and market reforms. Among the organizational tasks facing him
after his arrival were the recruitment of a director and CEO for the
University of Iowa Hospitals and Clinics and deans for the Colleges
of Medicine and Dentistry, and a director for the University Hygienic
Laboratory.
The appointments of R. Edward Howell; Robert P. Kelch, MD; David
C. Johnsen, DDS; and Mary J. R. Gilchrist, PhD, successfully filled
these vacancies over a two-year span. More recently, Dr. Manasse
coordinated the recruitment and appointment of Melanie Creagan
Dreher, PhD, as Dean of the College of Nursing.
Further organizational advances coordinated by the vice
president's office included creation of the Clinical Enterprise, and
comparable Enterprises for Dentistry, Nursing, and Pharmacy. These
actions, supported by the State Board of Regents and accomplished in
collaboration with other health sciences leaders, positions the UI as
a competitive corporate entity in the nation's changing health care
marketplace.
Related market positioning changes included construction of an
Organized Delivery System for statewide delivery of health care, and
subsequent transition of these integrated delivery services into a
health maintenance organization. The University of Iowa Health System
(UIHS) also was created with Board of Regents approval to allow the
UIHC and the College of Medicine's physicians to position themselves
for providing care review to broader populations of patients.
"This was a vital step in assuring Iowans continued access to the
entire spectrum of patient care services at the University of Iowa
Hospitals and Clinics, from primary care through tertiary/quaternary
care," Dr. Manasse says. "With the increasing prevalence of managed
care networks and HMOs, Iowans' access to UIHC services could have
been severely compromised. As a vital resource for all Iowans, we
simply couldn't allow that to happen."
Other organizational changes achieved during the past three years
included the creation of health plans for UI staff (UICare and UI
Unity Choice), and formation of three subsidiaries of the University
of Iowa Health System:
-UI Affiliated Health Providers, L.C.;
-UI Community Medical Services;
-UI Community HomeCare Inc.
Mirroring the changes in other communities nationally, tangible
progress has also been made in cooperation between the UI's health
sciences units and Mercy Hospital in Iowa City. "I believe
cooperative, joint ventures among providers within the community will
be absolutely essential in the near future," Dr. Manasse says. He
cites the agreement between Mercy and the UIHC to participate as
providers in each other's health plans as beneficial to the entire
community.
While market positioning was an important initiative, so were
academic program developments, such as creation of the Nurse
Anesthetist master's level program with the colleges of Nursing and
Medicine, and the Rural Gerontological Nurse Practitioner Program.
Dr. Manasse's office also played a significant role in integrating
the UI's health professions education program. "Interdisciplinary
education is the wave of the future," Dr. Manasse says. "The
University of Iowa is on the cutting edge. We have a real opportunity
to be a national leader in this area."
Under the vice president's direction, a clinical faculty
appointment track was created to permit some faculty physicians and
other health professions faculty to focus their skills and
professional careers on patient care. Clinical track options have
subsequently been offered to faculty in 16 specialty departments and
in the Colleges of Dentistry and Pharmacy.
Policy positioning initiatives launched during Dr. Manasse's
tenure included revisions in the Iowa Code's provisions for
educationally-related costs; the impact of federal clusters on
Medicare and Medicaid legislation; and mandatory proof of health
insurance coverage for health sciences students.
The UI's Health Sciences Center has collaborated with the Iowa
City Area Chamber of Commerce in marketing the Iowa City-Coralville
region as a center for health care.
Several international health initiatives-the UI's first in this
field-began after Dr. Manasse's arrival. These included contracts,
agreements, or cooperative exchanges with health care centers in
Russia, Poland, Slovakia, and Australia. A faculty directed Global
Health Task Force is now offering a Certificate Program in Global
Health. Courses are provided by faculty throughout the UI.
"I think it's very important to this university that the Health
Sciences Center has been brought into parity with the UI provost and
other vice presidents on campus," Dr. Manasse says. "It gives us a
strong voice in the UI's decision-making process."
Dr. Manasse's tenure ended following his appointment as executive
vice president designate of the American Society of Health-System
Pharmacists in Bethesda, Maryland. He officially leaves the UI on
August 31.
UI President Mary Sue Coleman has appointed UI Vice President for
Research David J. Skorton to provide interim oversight and leadership
to the Health Sciences Center.
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What's in a dinosaur egg? CT scan tells all
In a scene reminiscent of Jurassic Park, scientists used modern
hospital technology to glimpse the prehistoric past.
Some two dozen onlookers watched in wonderment on July 16, 1996,
as radiologists and radiologic technologists at the University of
Iowa Hospitals and Clinics used CT technology to scan the contents of
15 fossilized dinosaur eggs.
The 70-million-year-old eggs, remnants of the late Cretaceous
period, are somewhat larger than chicken eggs. All are cracked to
some degree, with shell fragments clearly visible via CT scan. The
eggs' identity has puzzled paleontologists recently, even though when
collected they were thought to belong to the horned and full-necked
dinosaurs, the ceratopsians.
James C. Larew, President of the Board of Directors of the Iowa
City Area Science Center Inc., says the specimens were obtained from
the Paleontological Institute in Moscow, which is part of the Russian
Academy of Sciences, as a part of the Great Russian Dinosaurs
Exhibition.
"The recent dramatic changes in the former Soviet Union have
brought about the opportunity to bring, with love and care, some of
Russia's scientific treasures to this country," he says. "This is one
of the largest dinosaur exhibitions ever assembled, and one that may
never again be seen outside of Moscow."
The Great Russian Dinosaurs Exhibition, which is visiting Iowa
City through September 2, features 24 complete dinosaur skeletons, 50
dinosaur skulls, impressions of dinosaur skin, and three clutches
(groups) of dinosaur eggs.
One of those clutches, with 15 oblong eggs, has stirred debate
within the paleontological community. Retrieved from the Gobi Desert,
this clutch has been identified in public exhibits as eggs of
Protoceratops.
Protoceratops dinosaurs were approximately the size of a sheep
with a large frill at the back of its skull and beak-shaped jaws.
They had no horns as did some of their relatives who were clearly
herbavores (plant eaters).
"Some paleontologists hypothesize that the eggs in this exhibit
are not Protoceratops eggs at all, but rather eggs of another kind of
dinosaur, oviraptorsaur," Larew says. "That's a major reason why they
wanted to examine these eggs and see what's inside, if anything."
Oviraptorsaurs-"egg thieves"-had a short head with powerful,
toothless jaws. Some paleontologists theorize that the strong, short
jaws, probably covered with a horny beak, were used to crush eggs or
the hard shells of prehistoric mollusks. Others disagree.
Correctly identifying the eggs would advance scientists'
understanding of these dinosaurs.
Just as the CT scanner permits radiologists to precisely image
patient anatomy, it provided scientists with thin, X-ray-like
"slices" of what's inside the eggs, and even eggshell thickness. Upon
preliminary examination, most eggs appeared empty, either because
baby dinosaurs hatched and left the nest or because the eggs never
developed. One egg appeared to contain a solid object, suggestive of
a developing dinosaur skull. However, sophisticated 3D imaging
revealed the object was probably a rock.
"I'm sure the paleontologists will come up with some unexpected
observations," Larew says.
Russian paleontologist Nicholas Kalandadze was "extremely
impressed" by CT technology, which was first used as a
paleontological tool two years ago and which is unavailable to
Russian paleontologists in their native land. "What's exciting to me
is how this technology has the potential to be used to evaluate other
fossilized specimens in this exhibit-specimens of as much scientific
interest as these dinosaur eggs. It could help us answer many
intriguing questions about our prehistory."
In addition to Larew and Kalandadze, other participants in the
dinosaur egg CT scan included Wilbur Smith, MD, Professor in the
Department of Radiology; Paul Chang, MD, Associate Professor of
Radiology; and Laurie Austin, a member of the Australian casting team
that is acting as custodians of the exhibit.
The Great Russian Dinosaurs Exhibition was organized by Dr.
Patricia Vickers-Rich, Director of the Monash Science Centre, Monash
University, Melbourne, Australia, and Chris Tassell, Director of the
Queen Victoria Museum in Launceston, Tasmania, Australia. The
exhibition successfully toured the five largest cities in Australia
over the past two years, where it was viewed by more than 1 million
Australians.
In addition to Iowa City, the U.S. exhibition has been shown at
the Mesa Southwest Museum in Mesa, Arizona, and will open at the New
Jersey State Museum in Trenton in mid-September.
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UIHC earns high ranking in magazine's
hospital survey
The University of Iowa Hospitals and Clinics moved higher in the
hospitals considered the "best of the best" in U.S. News & World
Report's 1996 guide to "America's Best Hospitals".
UIHC ranks 13th on the magazine's honor roll of the nation's top
16 hospitals, and three medical specialties-Otolaryngology (ranked
3rd), Ophthalmology (6th), and Orthopaedics (8th)-rank among the
nation's top ten.
In the seventh annual rankings published in the August 12, 1996,
issue, six UIHC medical specialties moved into national recognition
for their excellence.
New to the rankings are Cancer (20th), AIDS (28th),
Gastroenterology (33rd), Rheumatology (33rd), Geriatrics (36th), and
Gynecology (38th). UIHC's Neurology services moved up to 13th from
23rd last year. Endocrinology moved up six places to 22nd. UIHC
Urology services moved from 25th up to 21st .
The rankings are compiled using a mathematical model that combines
three years of U.S. News & World Report reputational surveys, two
years of federal death-rate statistics, and up to nine categories of
data.
Charles Riggs Jr., MD, Medical Director of the John and Mary
Pappajohn Clinical Cancer Center, was among many UIHC health care
professionals excited by the latest survey results. He said the
report recognizes the Clinical Cancer Center's emerging excellence in
the field of cancer patient care.
"This survey reflects the strong collaboration we have among
physicians in seven different departments," he said. "Together, we've
focused strongly on providing community outreach, ongoing cancer
research, and patient care. We've accomplished much since the
Clinical Cancer Center opened three years ago."
Dr. Riggs expects the Clinical Cancer Center's mission in service
to the people of Iowa will continue to grow. "We're currently seeking
designation from the National Cancer Institute as a Comprehensive
Cancer Center, which will open up new opportunities in clinical and
basic research," he said.
R. Edward Howell, UIHC Director and CEO, noted that only 32 states
have hospitals ranked on the Best Hospitals list. "In addition,"
Howell said, "for Iowans to have such a comprehensive array of highly
ranked medical specialties for their health care affirms the wise
planning and strong support provided by state government, regential,
and university leaders to this statewide medical resource. The
comprehensiveness of excellence in these rankings again underscores
why it is imperative that UIHC's services continue to be accessible
for all Iowans, regardless of the health plan they choose."
