Stephen C. Schimpff, MD

Stephen C. Schimpff is a quasi-retired internist, professor of medicine and public policy, former CEO, University of Maryland Medical Center, and senior advisor, Sage Growth Partners. He is the author of Fixing the Primary Care Crisis: Reclaiming the Patient-Doctor Relationship and Returning Healthcare Decisions to You and Your Doctor.

Major advances in radiation therapy for cancer treatment

Conditions

November 19, 2011

Radiation therapy has advanced dramatically in the past few decades and the rate of change is increasing rapidly. Innovations as a result of engineering and computer advances along with conceptual advances are making a dramatic difference.

Some of the new technologies include improved computer assisted treatment planning (smarter and faster and has more capability like auto-contouring, smart segmentation and improved algorithms) , continuous imaging guidance (fluoroscopic, stereoscopic, and cone beam CT), …

New approaches to cancer screening and diagnosis

Stephen C. Schimpff, MD

Conditions

November 10, 2011

I see five major themes in cancer care advances: new approaches to screening and diagnosis, better understanding of the role of viruses as causative agents, targeted therapies, new technologies and improved approaches to ensuring better quality of life.

Screening for the most common major cancers has been straight forward for years – women should get an annual mammogram and Pap smear, men should get a PSA test annually, both should get …

Quality of life issues in caring for cancer patients

Stephen C. Schimpff, MD

Physician

November 2, 2011

Not many years ago it was assumed that most cancers were not caused by viruses. Today it is clear that many are and the list is growing. Head and neck cancers are either caused by the environment (especially tobacco) or by the human papilloma virus, the same virus that causes cervical cancer and some genital warts.

The incidence of HPV-related head and neck cancer has been rising rapidly in the past …

Targeted therapies improve cancer treatment

Stephen C. Schimpff, MD

Meds

October 26, 2011

The revolution in medicine brought about by greater understanding of genomics has led to a number of targeted therapies in cancer care.

The basic concept is to first find the genomic change or mutation that leads to a disease, then learn its gene product and then develop a drug that inhibits the action of the aberrant gene product. The first was imatinib (Gleevec) for chromic myelocytic leukemia (CML.) When a …

Stem cells, surgery free heart valve repair and nutraceuticals advance heart care

Stephen C. Schimpff, MD

Conditions

October 10, 2011

The last post in this series discussed new advances in cardiology – the two themes of genetically informed therapy and technical advances. I will continue with three additional themes – regenerative medicine, minimally invasive approaches and prevention.

The third of the five themes is regenerative medicine. One major area of investigation is whether stem cells can heal the damaged heart. Perhaps the field is “more glamour than fact” just now …

Genetically informed therapy and technical innovations in cardiology

Stephen C. Schimpff, MD

Conditions

October 3, 2011

I want to give an overview of cardiac care advances – the first two themes are discussed here. I want to thank Dr. Mandeep Mehra, chief of cardiology at the University of Maryland for conceptualizing these themes for me.

First is genetically informed therapy. Pharmacogenomics is having an impact in the use of warfarin (Coumadin) and clopidogrel (Plavix). Warfarin dosage can now be titrated in part based on a person’s genomic makeup. In …

Heart valve repair without open surgery

Stephen C. Schimpff, MD

Conditions

September 2, 2011

A major innovation are the recent reports of success in replacing or repairing diseased or damaged aortic or mitral valves via catheter-based techniques instead of open surgery.

Mitral regurgitation is when the valve becomes unable to close tightly. Once the regurgitation becomes sufficiently severe to cause heart failure, the death rate reaches about 5% per year. Most such individuals are referred for cardiac surgery to either try to repair the valve, …

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Heart valve repair without open surgery

Medical device innovation saves lives but often at a high cost

Stephen C. Schimpff, MD

Tech

August 19, 2011

Innovation in medical devices has been profound in recent years – cardiac devices are a good example. The combination of engineering advances to create small, strong and wear-resistant devices and computational advances with smaller and smaller semiconductors loaded with more and more information have led to truly amazing advances. With more and more people with more and more chronic illnesses, the need is great and the opportunities for innovators is …

Why doctors should accept protocol medicine

Stephen C. Schimpff, MD

Policy

August 13, 2011

We hear that doctors do not like “protocol medicine” – they do not want to follow a “cookbook” when every patient is different. It is not a good understanding of the issues.

Some years ago when I worked in a branch of he National Cancer Institute and then the University of Maryland Cancer Center, we admitted many patients with acute leukemia. The treatment approach including the necessary special tests to …

Wireless devices will dramatically change how medicine is practiced

Stephen C. Schimpff, MD

Tech

August 9, 2011

I interviewed about 150 medical leaders just a few years ago for my book The Future of Medicine – Megatrends in Healthcare. Not one mentioned wireless devices as a coming megatrend. How fast the world changes! Nowadays everyone has a cell phone and we rarely stop to think that just two decades ago almost no one had them. We have a laptop or tablet computer that can access information from the web …

When to use a new technology and when to die with dignity

Stephen C. Schimpff, MD

Physician

July 29, 2011

American medicine overuses its technologies and innovation triumphs and way underutilizes old fashioned compassion, discussion and good common sense.

Over the past twelve weeks I have given weekly updates of medical megatrends in the fields of genomics, stem cells, transplantation and vaccines. These advances are the representation of innovations and entrepreneurship in biological, computer and engineering science. They are exciting advances and offer promise of hope …

Vaccines on the horizon and vaccine economics

Stephen C. Schimpff, MD

Meds

July 19, 2011

What else is on the horizon? There is progress to develop vaccines to control addiction to both nicotine and to opioids. Vaccination may be the best route to get control of the bacteria having a major impact on methicillin resistant Staphylococcus aureus (MRSA) and other highly pathogenic antibiotic resistant bacteria that have become endemic in hospital ICUs.

A vaccine for dengue is likely within the next five years. The World Health Organization …

Vaccines in the developing world

Stephen C. Schimpff, MD

Meds

July 15, 2011

When we think of vaccines we need to divide the world into the industrialized countries, those with transitional economies and the developing countries.

In the developing world, the proportion of the population less than 15 is very high, e.g., Mali has about 50% of its population under age fifteen compared to about 15% in the industrialized countries. This suggests that the emphasis in the …

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Vaccines in the developing world

Vaccines to prevent or treat non-infectious chronic illnesses

Stephen C. Schimpff, MD

Meds

July 5, 2011

A major megatrend in medicine will be the use of vaccines to prevent or treat (non infectious) chronic illnesses.

Although we tend to think of vaccines for preventing infections there are now two vaccines that prevent cancer (via preventing the infections that are in part causative), one vaccine on the market to treat residual cancer and many vaccines in development to prevent or treat other cancers …

The future of vaccines for infectious diseases

Stephen C. Schimpff, MD

Meds

June 23, 2011

In concert with sanitation and clean water supplies, vaccination has been the most cost effective means of preventing infectious diseases.

Most vaccines have been inexpensive, easy to administer (albeit objected to by the recipient’s arm!), safe and effective. From when I was a child until today the number of new vaccines has multiplied dramatically. This will only continue at an accelerated pace in the coming years. In the future many …

Can xenotransplantation help with the organ shortage?

Stephen C. Schimpff, MD

Conditions

June 15, 2011

There are many more individuals with end stage kidney failure, heart failure, chronic lung disease, or liver failure who would benefit from a transplanted kidney, heart, lung or liver than are available. Similarly, there are many people with unstable, difficult to control diabetes that could benefit from a ready source of pancreatic insulin-producing islet cells.

Today the only option for more organs available for transplant …

Cultural attitudes influence the benefit from stem cell therapy

Stephen C. Schimpff, MD

Meds

June 8, 2011

Embryonic stem cells are present after a fertilized egg divides for two or three days. They have the seemingly miraculous ability to turn into any of the tissue types in the body—whether brain neurons, beating heart cells, bone, or pancreatic islet cells. It is important to understand just where these cells come from.

Those used in science are …

Stem cells will bring us closer to personalized medicine

Stephen C. Schimpff, MD

Conditions

June 3, 2011

Stem cell therapies promise to be one of those scientific breakthroughs that will have an enormous impact on health care in the future.

Stem cells will bring us closer to the goal of personalized medicine, just as genomics is doing. The course of a disease will change once we have the technology to develop and then insert stem …

How stem cells will impact medical care

Stephen C. Schimpff, MD

Meds

May 27, 2011

Stem cells will usher in the era of regenerative medicine, allowing the creation of cells, tissues and organs to treat or cure diseases and injuries. This will be a fundamental alteration in our approach to medical care and a transformational medical megatrend. And it will be very “personalized medicine” to provide the specific individual with custom tailored new cells and tissues for organ repair or …

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How stem cells will impact medical care

Almost everyone over the age of 60 should receive the zoster vaccine

Stephen C. Schimpff, MD

Meds

May 25, 2011

Herpes zoster (or shingles) is caused by the same virus that causes chicken pox.

Zoster increases in incidence with advancing age. It is estimated that over 1 million Americans get shingles annually with the resulting acute discomfort and often chronic pain thereafter. A vaccine was introduced by Merck in 2006; the initial studies of 38,546 patients indicated …

Stephen C. Schimpff, MD

Stephen C. Schimpff, MD

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