University of Iowa News
April 7, 2005
Artman Sets Course For UI Pediatrics, Children's Hospital of Iowa
The landscape of pediatrics has been shifting, and only departments and children's hospitals that respond to those changes will provide the best in research and clinical care.
That's the view of Michael Artman, M.D., who just completed his third month as head of the Department of Pediatrics in the University of Iowa Roy J. and Lucille A. Carver College of Medicine and physician-in-chief of Children's Hospital of Iowa at UI Hospitals and Clinics.
"Years ago, pediatric care and residency training were focused on in-patient, acute care in the hospital," Artman said. "Now, as we're eradicating more infectious diseases and getting better at managing conditions, children with chronic illnesses are living longer.
"We also face more public health concerns, such as obesity, drug abuse and violence, that require intervention beyond the doctor's office," he added.
Some of Artman's goals are to develop the clinical areas that have increasing demand for care, do everything possible to keep kids with chronic conditions like diabetes and asthma out of the hospital, and help set and deliver statewide standards of care.
More than 130 specialists from the Department of Pediatrics and 10 other departments, such as surgery and ophthalmology, provide care for pediatric patients and families in Children's Hospital of Iowa. Also, another 74 specialists and sub-specialists in other departments provide additional advanced services for children. Children's Hospital of Iowa can "take care of everything from 'A to Z,'" Artman noted.
The new physician-in-chief plans to add more sub-specialists in clinical care areas such as gastroenterology, cardiology, oncology, endocrinology, neonatology and nephrology (kidney care). Children's Hospital of Iowa is the only center in the state that has the personnel and facilities to deliver some of the most advanced pediatric medical and surgical subspecialty care, Artman said.
The department of pediatrics also has a strong research enterprise, ranking in the top 10 of all pediatric departments in NIH funding. Artman credits these strengths to the previous department head, Frank Morriss, M.D., who led the department for 17 years.
"Dr. Morriss did an amazing job over his tenure to build up the faculty," Artman said. "It's on his shoulders that we now stand. The foundation is so solid that it will be a lot easier for me to build the second story of this house."
Physicians who are not only good clinicians but also good scientists are among the experts who are essential to advancing UI pediatric research and clinical goals.
"We want doctors who are interested in providing the best of care and in trying to understand what we don't know," Artman said. "For example, we want the physician who treats a child with diabetes to ask, 'Why do these children get diabetes in the first place?'"
Artman also will ensure support for current researchers to push the frontiers of their investigations. "It's important these days to think about research thematically rather than just departmentally," he said.
"Most of our research has been basic science research. But the department is moving into more patient-oriented and translational research, which means taking laboratory findings into the clinical setting," Artman added.
Areas Artman seeks to develop include cardiology, muscle physiology and biophysics, and developmental biology and genetics, which involve understanding the genetic basis for various diseases and how early development contributes to later disease risk.
"For example, there is still much to understand about how the fetal environment can affect late-onset disease," Artman said. "Asking important biological questions will ultimately help us unravel the complexities related to human disease."
Artman also plans to step up studies to help determine the best medication dosages for children. Currently, many drugs go on the market for adults without having been tested in children.
"Often pediatricians are limited in having to prescribe drugs developed for adults and adult conditions and then trying to determine the right dose for a child, who may metabolize it differently," Artman said. "Nationwide, we need to be more systematic about studying drugs and drug therapy in children, and we have some of those research opportunities here at Children's Hospital of Iowa and the University of Iowa."
The department also will address public health issues such as substance abuse, obesity, risky sexual behavior and violence, Artman said.
"Among the questions I'm asking is: 'How do we put systems in place to prevent or solve these problems?'" Artman said. "To treat obesity, for example, is beyond the scope of a sub-specialist who is trying to see 12 children in a three-hour clinical block.
"It simply doesn't work just to advise a young child to exercise more and not eat so much. It's a lifestyle issue that often involves the entire family. So it's a very complicated problem that we as a children's hospital must partner with others to tackle," he added.
Delivering care effectively in a state like Iowa is a challenge, as some families do not have access to a pediatrician or family physician within many miles. "We need to partner with providers in the rural areas to work together to provide the best possible care and access for every child in the state who needs it," Artman said.
Although Artman spent the past 10 years in an urban setting, at New York University (NYU) School of Medicine and NYU Medical Center, he knows about rural health care through training, as well as personal background.
The UI had long been on the radar screen for Artman, who is originally from Kansas.
"Growing up in a small town in Kansas, I've known about the University of Iowa forever by reputation," he said. "It's exciting now to be here, and with both Dr. Robillard and Mrs. Katen-Bahensky implementing their visions, I think it's just the right time to be the new head of pediatrics and Children's Hospital of Iowa."
University of Iowa Health Care describes the partnership between the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide. Visit UI Health Care online at www.uihealthcare.com.
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