- Who Is Involved in the Effective Health Care Program
- About the Eisenberg Center
- Eisenberg Center Conference Series 2011
Anthony L. Back, MD is Professor of Medicine at the University of Washington in Seattle. He is Director of the Cancer Communication and Palliative Care Programs at the Seattle Cancer Care Alliance (SCCA) and Fred Hutchinson Cancer Research Center (FHCRC). He is a board-certified medical oncologist whose primary research interests are doctor-patient communication and palliative care, and he practices gastrointestinal oncology. Dr. Back was a Faculty Scholar on the Project on Death in America and is a member of the ASCO Communication Task Force. He is the Principal Investigator the Oncotalk Teach, communication skills training program for Medical Oncology fellows (R25 CA 119019), and is an investigator on other NIH-funded observational studies of doctor-patient communication about hope and information (R01 PI J.R. Curtis) and prognosis in hematologic malignancies (R01 P.I. Stephanie Lee).
Clarence H. Braddock, III, MD, MPH is Professor of Medicine and Associate Dean for Undergraduate and Graduate Medical Education at Stanford School of Medicine, Director of the Stanford Center for Medical Education Research and Innovation, and Director of Clinical Ethics at the Stanford Center for Biomedical Ethics. His research focus has been physician-patient communication and informed decision-making, having developed an assessment scale of the quality of informed decision making (IDM) in clinical practice and applied it in numerous published studies of informed decision making in a number of areas, such as office practice, intensive care units, orthopedic surgical practice, and preventive and screening services. His work has been influential in our empiric understanding of the gap between the ethical ideal of shared decision making and the reality of clinical practice. In addition, the IDM framework he developed has informed new approaches in medical education and assessment of clinical competence in interpersonal communication. His work in this area has extended into cultural competence, having led a national effort among eighteen medical schools to developing patient-centered curriculum in cultural competence and healthcare disparities.
Ronald M. Epstein MD is Professor of Family Medicine, Psychiatry, Oncology and Nursing at the University of Rochester Medical Center, where he directs the Center for Communication and Disparities Research and the Deans Teaching Fellows Program. His federally-funded research on improving patient-physician communication focuses on marginalized populations, stigmatized conditions such as depression and HIV, and, more recently end-of-life care. He has developed innovative educational programs in mindful practice, communication skills, physician self-awareness and assessment of professional competence, including peer assessment. He has over 160 peer-reviewed publications. He has published influential papers outlining habits of mind of master clinicians (Mindful Practice, JAMA 1999), assessing professional competence (JAMA 2002, NEJM 2007), and the effects of a mindful communication program on physician empathy, burnout and clinical care (JAMA 2009).
Dr. Epstein graduated from Wesleyan University and Harvard Medical School. Honors include the George Engel and John Romano Dean’s Teaching Scholar at the University of Rochester, and the Lynn Payer Award from the American Academy on Communication in Healthcare, a Fulbright scholarship at the Institute for Health Studies in Barcelona and a visiting scholarship at the University of Sydney.
Brian J. Zikmund-Fisher, PhD is an Assistant Professor in the Department of Health Behavior and Health Education, University of Michigan (UM) School of Public Health, a Research Assistant Professor in the UM Department of Internal Medicine, and a member of both the UM Center for Bioethics and Social Sciences in Medicine and the UM Risk Science Center. Dr. Zikmund-Fisher received his PhD in Behavioral Decision Theory (a combination of decision psychology and behavioral economics) from Carnegie Mellon University. He uses this interdisciplinary background to study factors that affect individual decision making about a variety of health and medical issues, with a particular emphasis on risk communication and numeracy (people's ability to use numbers to inform their decisions). He co-directed the recently published National Survey of Medical Decisions (the DECISIONS Study) and has current projects studying perceptions of risk from dioxin exposure within affected communities, communication of genetic test results to optimize cancer screening, development of novel risk graphics, and approaches for overcoming cognitive and emotional biases in decision support materials. At Michigan, Dr. Zikmund-Fisher teaches graduate courses in risk communication and designing memorable health messages.
Liana Fraenkel MD, MPH is Associate Professor of Medicine in the Section of Rheumatology and Associate Program Director for the Investigative Rheumatology Fellowship at the Yale School of Medicine and Chief of Rheumatology at the VA Connecticut Healthcare System. Dr. Fraenkel’s research interests lie in applying scientifically rigorous approaches to better understand and improve both patient and physician decision making. This topic has been the focus of her career development awards and investigator-initiated project grants since 1998. Her efforts resulted in a series of papers describing the use and value of conjoint analysis to ascertain patient treatment preferences across a range of sociodemographic groups and diseases, and customization of the original software program to improve use with patients.
In addition to developing conjoint analysis into a method to facilitate construction of patients’ preferences, Dr. Fraenkel’s work has led to new insights into decision making which have important clinical implications. For example, using conjoint analysis, she has demonstrated that rheumatoid arthritis patient preferences for more aggressive treatment with disease modifying antirheumatic drugs differ by race, with Black patients preferring less aggressive treatment compared to White patients with similar disease severity. These results may help explain the disparity in utilization of newer riskier drugs in minority patients. In collaboration with investigators in the Netherlands, her most recent work using a version of Best Worse Scaling has found that patients’ and rheumatologists’ decisions to escalate care in rheumatoid arthritis (when clinically indicated) are influenced by different factors. This finding suggests that improved communication between patients and their physicians might increase the number of arthritis patients receiving treatment concordant with published guidelines. Dr. Fraenkel is currently working on developing web-based decision support tools, based on Fuzzy Trace theory, for patients facing decisions involving medications with significant risks of toxicity.
Dominick L. Frosch, PhD is Associate Staff Scientist at the Palo Alto Medical Foundation and Assistant Professor of Medicine at the University of California, Los Angeles. Dr. Frosch completed his PhD in clinical health psychology at the University of California, San Diego and a fellowship as a Robert Wood Johnson Health & Society Scholar at the University of Pennsylvania. For the past 12 years his research has focused on developing, evaluating and implementing patient decision support interventions. He has served as PI for three randomized controlled trials of decision support interventions (DESIs) for prostate cancer screening and currently serves as PI for a large scale federally funded randomized implementation project (1R18AE000023-01). He has also served as PI for demonstration projects, funded by the Foundation for Informed Medical Decision Making, focused on the implementation of DESIs in routine clinical practice in primary and specialty care settings since 2006. His research draws extensively on qualitative research methods to identify factors associated with successful implementation of DESIs, as well as patient perspectives on shared decision-making and patient centered care.
Paul M. Haidet MD, MPH is the Director of Medical Education Research and a Professor of Medicine, Humanities, and Public Health Sciences at the Pennsylvania State University College of Medicine. Dr. Haidet received his medical degree from the Pennsylvania State University, and his masters in public health from Harvard University. Dr. Haidet's career has focused on relationships in medicine, including patient-physician, student-teacher, and individual-organization relationships. His work in these realms has been cited widely, and he is the recipient of several national awards, including the 2011 Master Scholar Award from the International Association of Medical Science Educators. Dr. Haidet serves as the current President of the American Academy on Communication in Healthcare, and is a deputy editor for the journal Medical Education. Most recently, Dr. Haidet has been exploring the intersections of jazz music and medicine, in an effort to improve the improvisational skills of physicians.
Paul K. J. Han, MD, MA, MPH is a Clinical Investigator with the Center for Outcomes Research and Evaluation at Maine Medical Center. He received an A.B. from Cornell University, an M.D. from the New York University School of Medicine, and an MPH and MA in Bioethics from the University of Pittsburgh. He is a board-certified general internist and palliative medicine physician, and completed Internal Medicine residency training at UCLA Medical Center, and a research fellowship in cancer prevention at the National Cancer Institute (NCI), where he also served as a Medical Officer with the Division of Cancer Control and Population Sciences, prior to joining Maine Medical Center in 2009.
Dr. Han’s research focuses on risk communication, medical decision making, cancer, and palliative and end-of-life care, and his work bridges the disciplines of behavioral and health services research. His specific interests are in the communication and management of uncertainty in health care, and on improving methods and outcomes of communicating scientific uncertainty to patients. His clinical activity is in palliative medicine, and he is an attending physician at the Hospice of Southern Maine.
Laurence B. McCullough, PhD is the inaugural holder of the Dalton Tomlin Chair in Medical Ethics and Health Policy (since May 2008) in the Center for Medical Ethics and Health Policy, Baylor College of Medicine (BCM), Houston, Texas, where is also Professor Medicine and Medical Ethics and a Faculty Associate of the Huffington Center on Aging (since 1988). He has also served as Associate Director for Education of the Center for Medical Ethics and Health Policy since 2004. He is Adjunct Professor of Ethics in Obstetrics and Gynecology and of Public Health at the Weill Medical College of Cornell University in New York City and Adjunct Professor of Philosophy at Rice University. He received an American Council of Learned Societies Fellowship for 1995-1996 and was elected a Fellow the Gerontological Society of America in 1997 and of the Hastings Center in 2003. He received his AB in Art History from Williams College (1969) and his PhD in Philosophy from the University of Texas at Austin (1975) and held a post-doctoral fellowship at The Hastings Center (1975-1976). He has held prior appointments on the medical and philosophy faculties at Texas A&M University (1976-1979) and Georgetown University (1979-1988), where he was a Senior Research Scholar in the Kennedy Institute of Ethics. Dr. McCullough is a past president of the Society for Health and Human Values (1987-88), now merged into the American Society for Bioethics and Humanities.
Dr. McCullough has published more than 400 articles, case studies, and editorials in the peer-reviewed literature and 12 books. Medical Ethics: The Moral Responsibilities of Physicians, co-authored with Tom L. Beauchamp (Prentice-Hall, 1984), has been translated into Spanish (Barcelona, 1987) and Japanese (Tokyo, 1992). With Frank A. Chervenak, MD (Given Foundation Professor and Chairman of Obstetrics and Gynecology, Weill Medical College of Cornell University), he is co-author of Ethics in Obstetrics and Gynecology (Oxford University Press, 1994). He is co-editor with Nancy L. Wilson of BCM's Huffington Center on Aging of Long-Term Care Decisions: Ethical and Conceptual Dimensions (Johns Hopkins University Press, 1995). His Leibniz on Individuals and Individuation appeared in 1996 (Kluwer Academic Publishers). In 1998 his John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine and (as editor) John Gregory's Writings on Medical Ethics and the Philosophy of Medicine appeared (Kluwer), as well as Surgical Ethics (Oxford), co-edited with Baruch A. Brody and James W. Jones. He is also co-editor with Baruch A. Brody, Mark Rothstein, and Mary Anne Bobinski of Medical Ethics: Codes, Opinions, and Statements (Bureau of National Affairs 2000) and co-author with them of a companion volume commenting on these documents (BNA 2001). With James W. Jones and Bruce W. Richman he is co-author of The Ethics of Surgical Practice: Cases, Dilemmas, and Resolutions (Oxford University Press 2008). With Robert B. Baker of Union College (Schenectady, New York) Dr. McCullough is co-editor The Cambridge World History of Medical Ethics (Cambridge University Press 2009). He is also preparing a second edition of Ethics in Obstetrics and Gynecology with Drs. Chervenak and John Coverdale, Professor of Psychiatry at BCM, to appear 2011. In addition, Dr. McCullough has published 70 invited chapters in scholarly volumes in bioethics and medical humanities and 125 chapters in medical textbooks.
Mary C. Politi, PhD is a clinical psychologist and an Assistant Professor in the Division of Public Health Sciences, Department of Surgery at Washington University in St. Louis. Dr. Politi’s research program focuses on using systematic methods to help patients work through the uncertainties of health decisions through developing and evaluating patient decision tools, examining techniques to aid patient-clinician discussions about health decisions, and exploring ways to improve communication about risks. Her research also investigates the influence of numeracy and health literacy on medical decision-making. Currently, Dr. Politi is a co-Director on Washington University’s Comparative Effectiveness Research Training program (KM1 CA156708), where she has helped to develop and implement mentored hands-on comparative effectiveness research training using research data, administrative data, and electronic health records. She is also involved in several funded projects (e.g. CIHR 212366; UL2010-4805) examining the implementation of shared decision making and risk prediction modeling into clinical practice. Dr. Politi’s current leadership roles include work with national organizations such as the Society for Behavioral Medicine and the Society for Medical Decision Making, and international groups such as the International Patient Decision Aids Standards Instrument (IPDASi) group. She was previously (2007 – 2010) awarded fellowships to attend the Dartmouth Summer Institute on Informed Patient Choice, and she also (2008-2009) served on the Uncertainty Working Group at the National Cancer Institute.
Hilary A. Llewellyn-Thomas, PhD is Professor Emeritus, Department of Community and Family Medicine, Dartmouth Medical School. For over 30 years, Dr. Llewellyn-Thomas has worked in the decision sciences in health care, with a particular emphasis on the theoretical and methodological issues inherent in the study of patients’ information comprehension and the elicitation of patients’ preferences. Her research focuses on the issues involved in incorporating patients’ perspectives into health care. Specific areas include: 1) patients’ attitudes toward experienced and anticipated health states; their preferences for treatment alternatives, involvement in treatment decisions, and participation in clinical trials; their attitudes toward the time involved in waiting for, undergoing, and recovering from treatment; and their understanding of the risk/benefit probabilities involved in different treatment options; 2) concepts of decisional conflict and decision support as a clinical skill; and 3) evaluation of the effectiveness of interventions designed to support informed patient choice.
Dr. Llewellyn-Thomas received her BSc (1968) and MSc (1977) degrees from the University of Toronto, and her PhD (1983) degree from the Institute of Medical Science in the Faculty of Medicine at the University of Toronto. From 1989 until 1999, Dr. Llewellyn-Thomas held two consecutive 5-year awards as a National Health Scholar, from the National Health Research and Development Program in Canada. In 1993-1994, she served as the President of the Society for Medical Decision Making. In 1994-1997, she served as a Member of the Advisory Committee on Science and Research for the Medical Research Council in Canada. Since its formation in 1999, she has continued to serve as a co-author of the regularly-updated Cochrane Collaboration’s Systematic Review of Patients’ Decision Aids.
In 2000, Dr. Llewellyn-Thomas was recruited from the University of Toronto to Dartmouth Medical School to assume a Professorship in the Department of Community and Family Medicine and in the Center for the Evaluative Clinical Science (CECS; now The Dartmouth Institute for Health Policy and Clinical Practice, or TDI). As the CECS/TDI’s Andrew Thomson, Jr. Fellow in Shared Decision Making, she served as a founding Research Director for the Center for Shared Decision Making at Dartmouth-Hitchcock Medical Center, and as Co-Director of the Center for Informed Choice in TDI.
Since its formation in 2003, she has continued to serve as the co-editor of the International Patients’ Decision Aids Standards Collaboration. In 2004, the Society for Medical Decision Making awarded Dr. Llewellyn-Thomas the John M. Eisenberg Award for Leadership in Medical Decision Making Research. In 2007, she served as the Director of the inaugural annual Dartmouth Summer Institute on Informed Patient Choice (SIIPC); she obtained AHRQ grant support and continued as the Director for subsequent SIIPCs in 2008, 2009, and 2010.
Robert J. Volk, PhD is Professor and Deputy Director for Education in the Department of General Internal Medicine at The University of Texas MD Anderson Cancer Center. A health services researcher, he is co-principal investigator of the John M. Eisenberg Center for Clinical Decisions and Communications Science, an AHRQ-funded center for translation of complex scientific information into materials for consumers, clinicians and policymakers. He also served as Associate Director of the Houston Center for Education and Research on Therapeutics (CERTs), a research center funded by AHRQ and focusing on health communication, decision making, and adherence in therapeutics. Dr. Volk is a member Steering Committee for the International Patient Decision Aids Standards (IPDAS) Collaboration, which recently published a series of standards for developers and users of patient decision aids. These standards serve as a blue-print for developers of patient decision aids to ensure comprehensive, evidence-based principles are used consistently as new patient decision aids are created and existing aids are evaluated or updated. Dr. Volk’s research focuses on issues of decision making under conditions of uncertainty, particularly among patients with low health literacy, with applications in cancer screening and treatment. His work in decision-making spans research on patients’ preferences and values to applied studies in patient decision support and decision aids for promoting informed choice.
Steven H. Woolf, MD, MPH is Professor at the Departments of Family Medicine, Epidemiology and Community Health at Virginia Commonwealth University and is director of the Virginia Commonwealth University Center on Human Needs. He received his MD in 1984 from Emory University and underwent residency training in family medicine at Virginia Commonwealth University. Dr. Woolf is also a clinical epidemiologist and underwent training in preventive medicine and public health at Johns Hopkins University, where he received his MPH in 1987. He is board certified in family medicine, preventive medicine, and public health.
Dr. Woolf has published more than 150 articles in a career that has focused on evidence-based medicine and the development of evidence-based clinical practice guidelines, with a special focus on preventive medicine, cancer screening, quality improvement, and social justice. From 1987 to 2002, he served as science advisor to and then member of the United States Preventive Services Task Force. Dr. Woolf edited the first two editions of the Guide to Clinical Preventive Services and is author of Health Promotion and Disease Prevention in Clinical Practice. He is associate editor of the American Journal of Preventive Medicine and served as North American editor of the British Medical Journal. He has consulted widely on various matters of health policy with government agencies and professional organizations in the United States and Europe, and in 2001 was elected to the Institute of Medicine.