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MacArthur Award Offers Three Internal Medicine Faculty Ability to Pay it Forward

February 13, 2023
by Julie Parry

Of the 19 MacArthur Fellows affiliated with Yale University at the time of their award, three of them are faculty from the Department of Internal Medicine: Gretchen Berland, MD, Mary Tinetti, MD, and Emily Wang, MD, MAS. “Gretchen, Mary, and Emily are shining examples of the stellar, dedicated, ingenious faculty we have within the department, and I could not be happier that the MacArthur Foundation chose to honor them in this way,” said Department Chair Gary V. Désir, MD, Paul B. Beeson Professor of Medicine and Vice Provost for Faculty Development and Diversity.

Gretchen Berland, MD

Currently an Associate Professor of Medicine (General Medicine), Berland took an unconventional route into patient care. While she studied pre-med as an undergraduate, she pursued a career in television, and worked at WGBH in Boston, Mass., and MacNeil/Lehrer Productions, in New York, N.Y. But medicine would draw Berland back, and she earned her MD in 1996. She combined her passions of medicine and television and produced short films during her residency and internship. She joined the YSM faculty in 2001.

She recalls receiving a call in 2004 about her MacArthur honor during a screening of her documentary film, Rolling, with the National Clinician Scholars Program (NCSP) at Yale. Berland herself was a fellow with the program at UCLA from 1999-2001.

“The caller asked if I was sitting down, and they told me this incredible news. It's like the Wonka Golden Ticket, but the thing that was the most memorable part of the message was that they wanted to let me know they really valued my creative work. You hear a week before the public announcement is made. I remember the day vividly. It is an incredible privilege," said Berland.

Berland is a general internist at YSM, and cares for patients in the hospital and the ambulatory setting. Her research combines the documentary filmmaking with participatory action research to study patient experience and to better understand health culture and behavior. Berland calls the MacArthur Fellowship the good karma coin and it represents a means to pay it forward. She tries to apply this practice in her daily life as a physician, and in her creative endeavors. Her goal with the creation of Rolling was to understand the experience of being in a wheelchair. When she released the film, they gave it away.

Berland wrote about her experiences during the creation of documentary and the impact it had on her personally in her 2007 New England Journal of Medicine Perspective piece, “The View from the Other Side — Patients, Doctors, and the Power of a Camera.”

“Making the film Rolling taught me so much about how we tend to make so many assumptions about who people are and why they're in the circumstances that they're in. The practice of filmmaking reminds me that there's someone out there who you may think you know, though almost certainly have a dimension of their life experience that you know nothing about and could likely influence your how you see the world.”

“I try to apply that rule with bedside and colleagues and it just makes life a whole lot more interesting, makes life a whole lot more rewarding. For me, I try to approach the practice of medicine increasingly from a place of humility. As I get older, I think that is the most important thing.”

Berland will be “forever grateful” for the honor. “This award has given me more opportunities to pay it forward. In the end, that's the most important thing you can do.”

Mary Tinetti, MD

Tinetti is the Gladys Phillips Crofoot Professor of Medicine (Geriatrics), Yale School of Medicine (YSM), and Public Health, Yale School of Public Health (YSPH). Her interests were always in treating chronic problems in older patients, rather than acute diseases. In the 1980s, geriatrics was a new field, and Tinetti gravitated to it. She liked the intellectual challenge of caring for older adults, and found the work personally satisfying.

She was named a MacArthur fellow in 2009. At the time, Tinetti’s work was focused on the consequences of falls in older adults, but her interests were evolving into decision making for older people with multiple chronic conditions. She remembers receiving the call, notifying that she was named a MacArthur fellow.

“The MacArthur Fellowship helped support my focus on the problem of multiple chronic conditions and decision-making with multiple chronic conditions. Being named a MacArthur fellow is a psychological boost as well as a financial boost. Someone believes in you,” reminisced Tinetti. “I think that colleagues at other institutions were perhaps a little more willing to collaborate on a risky project than they otherwise would've been. But you never know, right? Because you don't know what would've happened without the award.”

The following year, Tinetti spent a year in Washington, D.C. as a Health & Aging Policy fellow with The Atlantic Philanthropies. As a fellow, she worked at the Centers for Medicare and Medicaid Services, and learned more about how clinical decisions were supported in health care.

Upon the conclusion of her fellowship, she returned to New Haven, and began to lay the groundwork for what would eventually become her “second body of work,” Patient Priorities Care (PPC). PPC engages clinical decision making to address what matters most in the care of older adults with multiple conditions, using the 4Ms framework: what Matters, Medication, Mentation, and Mobility. Patient Priorities Care works well for patients of all ages, but can particularly benefit to adults who are struggling to manage their multiple conditions, who see many clinicians, who may receive conflicting recommendations, and who may be overwhelmed by their current care regimen.

PPC officially launched in 2016 and has spread across the nation with hundreds of physicians and other health professionals, treating patients within its framework. She has found that many, although not all, health professionals resonate with the approach.

“At first, they don't quite understand it and they revert to treating each individual disease in isolation. But you can always see when they get that aha moment, where we work with them to consider the entire patient, all of their conditions, all of the effects of their treatments good and bad, and their life context, the social determinants of health. Given all those aspects, what are the major things that are keeping them from achieving their outcome goal?” Tinetti explained. “So they all of a sudden get that movement from diseases in isolation to all of these factors together and making decisions based on that.”

Tinetti and the PPC team is changing the care of older adults. To learn more about PPC, visit their website.

Emily Wang, MD, MAS

Wang’s honor from the John D. and Catherine T. MacArthur Foundation came in 2022. Wang, professor of medicine (general medicine), YSM, and of public health (social and behavioral sciences), YSPH, has dedicated her career to solving for inequities in health care for people with a history of incarceration.

Wang recalled when she received the notification. “I received a cryptic text while riding on the Yale shuttle, and next thing I know I am in my office talking to officers from the MacArthur Foundation hearing about the award. It was a complete and utter surprise,” said Wang.

She was inspired to begin this work while volunteering in a women’s prison in North Carolina and working in a prison in Botswana as a medical student. During her residency, she co-founded a primary care program for individuals released from incarceration, employing community health workers with prior incarceration to guide individuals through getting insurance, navigating healthcare, and connecting with housing and employment. The program was founded in 2011 and is now led by Shira Shavit, MD. It grew nationally into the Transitions Clinic Network, where Wang continues to direct research activities.

In 2008, Wang joined the faculty at YSM. At this time, Wang sought to understand whether something about incarceration itself makes people more prone to worse health outcomes. Her research focuses on cardiovascular disease, cancer, opioid use disorder, gun violence, and COVID-19, and has partnered directly with those impacted. In 2020, Wang and her team launched the SEICHE Center for Health and Justice. This collaboration between YSM and Yale Law School works toward community transformation by identifying legal, policy, and practice levers to improve the health of those impacted by mass incarceration. The SEICHE team combines real-world experience with scientific research to identify innovative solutions for addressing the health impacts of mass incarceration on individuals, families, and communities as well as produce evidence-based solutions for the depopulation of prisons and jails and investing in community health and safety.

Among Wang’s honors, she served as co-chair for the National Academy of Sciences, Engineering, and Medicine’s committee on “Decarcerating during COVID-19.” Wang currently serves on the World Health Organization’s Health in Prisons Programme, and recently co-led a curriculum for European prison health providers. Wang was elected into the American Society for Clinical Investigation in 2022.

Nominated anonymously from leaders in their respective fields, the Fellowship is presented to individuals in a variety of fields who have shown exceptional originality in and dedication to their creative pursuits.

“Emily is just an absolute perfect example of someone who should get the award. This award will open so many doors for her,” said her fellow recipient Tinetti.

The Department of Internal Medicine at Yale is among the nation's premier departments, bringing together an elite cadre of clinicians, investigators, educators, and staff in one of the world's top medical schools. To learn more, visit Internal Medicine.

Submitted by Julie Parry on February 14, 2023