2024-2025 review

Patient Care highlights

Advances in Leadership

We have continued to advance our commitment to providing exceptional care to older adults and those with critical illnesses, with exciting leadership transitions that further strengthen our clinical mission.

• Adam Marks, MD, MPH, assumed the role of section head of our division's Adult Palliative Medicine, bringing years of expertise in inpatient, ambulatory, and home-based palliative care.
• Caroline Vitale, MD, was appointed service chief of the newly formed Geriatrics, Palliative Care and Home-Based Primary Care Service within our division, where she continues to enhance care for older adults and their caregivers with ethical decision-making and quality of life in mind.
• Raymond Yung, MB,ChB, was appointed chief clinical officer for the University of Michigan Health System's Ambulatory Care, reflecting his long-standing commitment to improving care delivery.

Dedication to Patient Satisfaction

The Geriatrics Center East Ann Arbor clinic achieved an outstanding milestone, ranking in the 99th percentile in the United States for patient satisfaction by Press Ganey. The patient satisfaction report was based on data from 6.5 million patient encounters across the country, focusing on key insights to measure and improve the patient experience. After post-pandemic declines, the clinic’s performance is a testament to the dedication, compassion, and expertise of the care team.

Expanding Geriatric and Palliative Care

Our geriatrics clinic expanded into the new Ypsilanti Health Center with four of our providers - Grace Jenq, MD; Andrew Russell, MD, MPH; Kailash Dhir, DO; and Carolina Sierra Lopez, MD. They provide a total of eight half-days of geriatric primary and consultative care, each bringing a unique background and experience tailored to meet the needs of our geriatric population. We have also seen growth in our palliative medicine programs. Some highlights include:

• A 30% increase in clinical volume for our Inpatient Adult Palliative Care Consult Service
• A 64% increase in referral volume to our Adult Palliative Care clinics
• Additional hospital capacity for Adult Palliative Care Service to meet the needs of adult patients

The Adult Palliative Medicine section has also worked with leadership in the University of Michigan Rogel Cancer Center to expand capacity. In partnership with the Division of Hematology and Oncology, our faculty have been identifying patients earlier in the disease course that would benefit from palliative care, to ensure they are getting the right care at the right time.

New Nursing Home Guidelines for Protecting Against Infections

From antibiotic-resistant bacteria to common viruses, people in nursing homes are vulnerable to infections. Lona Mody, MD, MSc, recently led the writing of a new guideline in the Journal of Infection Control & Hospital Epidemiology which calls for at least one staff member at each nursing home to focus solely on infection prevention and lays out guidelines for training, vaccination, and protecting and supporting clinical staff. It also encourages more partnership among nursing homes and hospitals and public health agencies in their area and for non-clinical staff to be involved in infection prevention too.

research highlights

JAMA Internal Medicine

Lona Mody, MD, MSc, was appointed as associate editor of the Journal of the American Medical Association Internal Medicine (JAMA-IM) - one of the top ranked internal medicine journals in the country. With her involvement, Dr. Mody has been able to stay current in internal medicine, increase the division's visibility, while enhancing her own skills and influencing the field. JAMA-IM has several priority areas that align with her research interests such as aging, 'less is more', primary care, and women's health, and she is heavily involved in shaping the future of the journal and aging research. She has also been able to better mentor her mentees and national/international cadre of researchers. Several of our faculty have published in JAMA-IM since and we hope to continue to contribute high impact research. Julie Bynum, MD, MPH, authored an editorial in JAMA and was featured in a JAMA Author Interviews Podcast, where she discussed two recent D-CARE and IN-PEACE clinical trials that evaluated care models to support people diagnosed with dementia and their caregivers.

Chronic Pain Management in Veterans

About 24% of veterans who survive cancer remain on long-term opioid therapy after completing cancer treatment, placing them at risk for opioid addiction, overdose, and other related health conditions. Yet, there are no programs through the Veterans Health Administration to help veterans find alternatives to opioids or evidence to inform the choice of interventions. The Better Options for Chronic Cancer Pain study, led by Maria Silveria, MD, MA, MPH, is a five-year study funded by the Veterans Affairs (VA) to examine multimodal care and medication optimization of buprenorphine versus standard of care for veteran cancer survivors on opioids for pain. The multisite trial involves VA hospitals in Ann Arbor, Indianapolis, and Palo Alto.

Transfers Among Vulnerable Long-Term Nursing Home Residents

Ana Montoya, MD, MPH, and Julie Bynum, MD, MPH, published a cross-sectional cohort study on nursing home residents to find whether the risk of nursing home-to-nursing home transfer is higher among long-term nursing home residents with intellectual and developmental disabilities, serious mental illness, and/or Alzheimer's disease and related dementias. They found that residents with these conditions are at highest risk for transfer.

Education highlights

Teaching Excellence in Geriatric Medicine

Education remains at the heart of our mission, with our faculty deeply committed to training the next generation of healthcare professionals to deliver compassionate, team-based care for older adults. Kahli Zietlow, MD, serves as director of interprofessional education where she, and colleagues Rachel Denny, DO; Ethan Scott, MD, and Program Manager, Carrie Braun, have coordinated several key interprofessional experiences including "Meet the Health Professionals", "Collaborating with Health Professionals", and shadowing. The team has also collaborated with the Center for Interprofessional Education - a university-wide collaboration among Michigan's health professional schools - to integrate interprofessional learning into the clerkship and branches phases.

Rachel Denny, DO, assumed the role of associate program director of the Geriatric Fellowship in July 2025. Dr. Denny specializes in geriatrics and palliative care and co-leads the Medical Student Interest Group at the University of Michigan.

Kayla Sheehan, MD, was selected as the new associate program director for the Hospice and Palliative Medicine Fellowship. Dr. Sheehan focuses on the adult track fellows in the program. She also co-created the Geriatrics and Palliative Medicine track for residents in the Department of Family Medicine and developed a dedicated palliative care curriculum for the program. Soumya Rangarajan, MD, has been accepted as the Health and Aging Policy Fellowship (HAPF) program for the 2025-2026 year. The HAPF program provides professionals in health and aging with the experience and skills necessary to translate cutting-edge science and practical clinical experience into sound health policies that will positively impact healthcare for older Americans. Fellows are selected through a competition based on their commitment to health and aging issues, leadership potential, and interest in impacting policy.

Battlefield Auricular Acupuncture Education

As part of the Medical School's Medical Education Scholars Program, Neil Nixdorff, MD, led efforts to integrate auricular acupuncture, especially battlefield auricular acupuncture, into health professional education and clinical practice for pain management. Dr. Nixdroff taught and credentialed clinicians to use this evidence-based, low-barrier technique, including within Wolverine Street Medicine - a program to meet medical and social needs of those experiencing homelessness - and the division.

Transdisciplinary Aging Research Day

In 2025, the University of Michigan Institute of Social Research hosted its Transdisciplinary Aging Research Day, bringing together aging-related T32 trainees to network and learn from one another. The keynote presentation was given by Kenneth Langa, MD, PhD, who provided an overview of the Health and Retirement Study including future directions in cognitive aging research.

Planning for Aging in Place

Supported in part by a generous gift, our division created a continued medical education accredited course entitled, Planning for Aging in Place: Practical and Ethical Considerations for Health Providers. Led by Caroline Vitale, MD, and Kahli Zietlow, MD, the course provided clinicians and other healthcare professionals with practical resources on decision-making, care planning, aging in place, and ensuring financial capacity, safety, and security for older adults. The gift was granted for outstanding educational experiences and research opportunities for strengthening fellowship training within our division.