VITAL SIGNS
CRUISE CONTROL: This summer’s issue of Cruise Travel
magazine will profile DHMC medical transcriptionist Andrea
Peterson. Certified in wilderness emergency medicine, she
once lent a hand on a cruise when the weather turned wild.
THEN & NOW
Website asks patients: “How’s your health?”
T housands of patients in Chi-
cago, Ill.; Long Beach, Calif.;
survey. Second, it provides pa-
tients with tools to inspire confi-
Wasson and his team have re-
cruited cities and organizations
from all across the U.S. to sign
on to use the site—at no charge.
A reminder of the pace of change, and other cities across the coun- dence in themselves so that, as For example, in Chicago and
and of timeless truths, from a book try may not know it, but they’re Wasson puts it, they “can and Long Beach, they worked with
titled Hiram Hitchcock’s Legacy: being cared for, in part, by a should take control of [their] the Chambers of Commerce. In
member of the Dartmouth facul- own health and health care.” Chicago, Mayor Richard Daley
When Mary Hitchcock ty. Those are among the cities Anyone can use the site— taped TV spots asking, “How’s
Memorial Hospital opened where large numbers of doctors not just those whose doctors your health, Chicago?” A size-
have asked their patients to go have adopted it as a tool. For ex- able segment of the population
in 1893, “many citizens were
online and, before their next ap- ample, this writer filled out the then went on the website and
skeptical. Thirty-six beds pointment, fill out a survey at survey and was told that at my filled out the survey.
seemed excessive! . . . There www.howsyourhealth.org. next appointment I should ask Innovative: Then comes an
The site was the brainchild of my doctor, “What medications even more innovative and useful
was also a certain amount of
DMS’s Dr. John Wasson, a na- am I taking, in what doses, what part of the system. When enough
fear regarding hospitals— tionally recognized leader in are they for, and how much do people in a city have filled out
after all, people often went health-care quality improve- they cost?” I was reminded to in- the survey, the aggregate infor-
ment; several of his colleagues in clude nonprescription drugs, mation—stripped of personal
there and died! . . . Others
DMS’s Department of Commu- herbal medica- identifiers—
were pleased and impressed nity and Family Medicine; and tions, and nu- The site is deceptively simple. There g o e s i n t o a
with such a large and Dr. Regina Benjamin, founder of tritional sup- is more to it than meets the eye. database that
a rural clinic in Alabama. plements. And allows public-
modern facility. . . . [It] also
Specific: The survey is decep- I was told to ask, “What vacci- health officials to make informed
had gas and electricity.” tively simple. After answering a nations do I need to keep track decisions about the quality and
number of basic questions, the of? And where can I get reliable delivery of care. The state of
patient gets back a summary of information in a form I can un- New Jersey and the city of Mil-
findings plus a list of sources of derstand so I can talk about my waukee, Wisc., have been par-
further information about his or health in an informed way?” ticularly enthusiastic about this
her own specific health situa- And that, the site’s creators feel, capability.
tion. An individual of average can’t help but improve outcomes. In addition, once enough of a
intelligence and health may at
22
TIM HALL
about that point be thinking,
Number of fireplaces in
“So what? This isn’t telling me
the 1893 MHMH building anything I didn’t already know
—after all, who supplied the in-
14,000 formation in the first place?”
But there is much more to the
Number of light fixtures in
site than meets the eye. It is only
DHMC’s Lebanon facility a small part of a system that has
when it opened in 1991 been 10 years in the making and
is now improving the quality of
care delivered all over the U.S.
4,000 First, the website is a place where
Approximate number
patients can collect and easily re-
converted to use compact trieve their own health informa- Even on a clear day, it’s not possible to see the Chicago skyline from Dartmouth. But
fluorescent bulbs by 2007 tion and concerns; 100,000 pa- the Dartmouth experts behind an innovative website can see aggregate health in-
tients have now filled out the formation on 100,000 patients—in Chicago and other cities across the country.
18 Dartmouth Medicine—online at dartmed.dartmouth.edu Summer 2008
VITAL SIGNS
I N V E S T I G A T O R I N S I G H T
n this section, we highlight the human side of recent published papers that are
given doctor’s patients have
filled out the survey, that doctor
I biomedical investigation, putting a few ques-
tions to a researcher at DMS-DHMC.
relevant to our work; check on our
cell cultures and our mice; go back
can use the database to ask ques- down to the animal facility and do what I
tions like “What percentage of Brent Berwin, Ph.D. forgot to do the first time; and check in with the
my patients are seeing another Assistant Professor of Microbiology and Immunology lab members to see what they are doing, how
doctor?” It’s not common for pa- Berwin studies how white blood cells induce immune things are going, and how we can press forward.
tients to volunteer such infor- responses—in particular, how molecular chaperones On top of all that, I am usually writing grants
mation or for doctors to ask— (molecules that help proteins fold) activate the im- and manuscripts or attending meetings.
but it can be very important to a mune system, how white blood cells clear bacteria af-
patient’s health for that informa- ter an infection, and how immune cells induce anti- What were your first paying jobs?
tion to be known. Or a doctor tumor responses. He joined the faculty in 2004. In high school, I had the usual array of restau-
might ask, “How many of my pa- rant jobs—busting suds. In college, I worked in
tients have feelings of depression What are the keys to being a successful scientist? the chemistry department stockroom and, dur-
that they haven’t told me Work hard. Plan well. Think things through. ing the summers, for the Oregon Department of
about?” Many patients will con- And be in an environment where you enjoy Fish and Wildlife doing a census of salmon and
ceal such feelings unless prodded working and spending time. squawfish in the McNary Reservoir on the Co-
about them. lumbia River in Oregon. And for two years be-
The benefits run deeper still. What got you interested in science? fore going to grad school, I was a technician at
All the information from pa- I’ve always enjoyed science, although for a long Oregon Health and Science University.
tients all over the country goes time I thought I’d end up working for the Ore-
into a very sophisticated data- gon Department of Fish and Wildlife (which I What are your favorite nonwork activities?
base that promises to yield valu- did for a couple of summers). Then I came back Pretty much anything outside: hiking, biking,
able information about the from my senior year of college abroad, needed a running, swimming, canoeing, etc. I think it’s
health of the nation as a whole. job, and got sucked into working in a virology important to engage in activities outside the lab
For example, participating lab for two years— to get the blood flowing, work off frustrations,
doctors can compare their prac- that was the begin- and maintain sanity.
tice patterns with those of other ning of the end.
doctors, asking such questions as What place would you most like to travel to?
“How does my handling of aller- Are there any There are not many places I wouldn’t want to
gies compare with that of other misconceptions people explore—in times of peace. I love traveling. I
doctors?” or “Am I using the best have about your field? visited a lot of places on an around-the-world
possible medicines to treat a giv- Lots. Most people trip after graduate school. I think my credit card
en condition—with appropriate outside of science is still recovering from that.
consideration for efficacy, safety, don’t really under-
and cost?” stand what we do Do you always have a working hypothesis in the lab?
Aggregated: And at the most from day to day. If you consider “let’s try this and see what hap-
aggregated level, the database And it’s always vaguely entertaining when a ran- pens” a working hypothesis, then yes, we do.
will allow national outcomes re- dom person asks me about some obscure disease
searchers to track regional differ- or condition they have, fully expecting me to What do you like most about your job?
ences and other variables in pat- have a working knowledge of the entire thera- The people I work with and around—what a
terns of care and pinpoint what peutic and medical field. good group of intelligent, entertaining, and mo-
does and what does not make for tivated people. I’m proud that our lab members
differences in the quality of care. What’s a typical day like for you? enjoy each other’s company and can work, play,
For that, of course, is what After getting to the lab, I try to get any long or and (usually) laugh together. I also feel pretty
everyone is after—from the pa- continuing experiments under way; check the lucky to have a job where I get paid to do some-
tient in Long Beach, Calif., to baseball box scores and make sure my fantasy thing I enjoy. That said, my department chair
the doctor in Lebanon, N.H. baseball team is doing okay (or not); search for jokes that I’m lucky to have a job at all.
Roger P. Smith, Ph.D.
Summer 2008 online at dartmed.dartmouth.edu—Dartmouth Medicine 19