In 2005, Dr. Fred Brancati was named Director of the Division by Dr. Weisfeldt. He undertook a series of reforms and innovations designed to improve efficiency, productivity, cohesion, equity, and divisional reputation.

Working with Dr. John Flynn and Dr. Dan Brotman, he fully united the research and clinical wings of the Division. Previously, the two wings were treated as distinct entities by the Department of Medicine with separate budgets, leadership, and goals. Unification allowed a series of improvements including: greater access to clinical work for researchers; greater access to research resources for clinician-educators; greater fluidity in roles for junior faculty; more efficient and transparent management; and more leverage in negotiations with the Department and the School.

He overhauled and unified the administrative structure of the Division. Previously, the Division had a core staff of 3 FTEs; most of the budgetary and human resources work was decentralized in the offices of senior faculty. That created problems for supervision, standardization, quality assurance, and cross-coverage. He identified budgetary and human resources work as ‘core’ functions and invested his recruitment dowry in the creation and expansion of core divisional staff--now comprised of 12 FTEs.

He established an Executive Committee for the Division including the Clinical Director, the Hosptialist Director and the Fellowship Director, along with their Associate Directors. By formalizing such Associate roles and connecting them with part B salary, he began to address the gender disparity in leadership opportunities and corresponding salary differentials. To promote salary equity, he instituted a policy of transparency with regards to salary, showing scatterplots of salary at annual state of the division presentations. This approach was later adopted by the DOM.

He launched the Division’s first website. Key goals were to enhance recruitment of fellows and junior faculty, facilitate patient access to GIM physicians, keep faculty informed about each other; allow easy faculty access to policies and paperwork, aid in resident training, support new centers and initiatives, and keep a real time census of GIM faculty and programs. The website rose to national prominence, appearing first or nearly so in Google searches of “general internal medicine” and related topics.

He launched GIM Grand Rounds, held three times a month immediately following DOM Grand Rounds on Friday mornings. The format includes 5 minutes of announcements, a 5-minute introduction of the speaker, a 30-minute presentation, and 10 minutes of question and answer. By assigning faculty unfamiliar with each other as introducer and speaker, the format creates connections between far flung units in a large, diverse division.

With Dr. Jeanne Clark and Dr. Geetanjali Chander, he established the Hopkins GIM Housestaff Research Awards Program. Now in its 6th year, the program is a national competition for house officers who intend careers in academic GIM and who have completed research projects in clinical epidemiology, medical education, bioethics, or other areas of GIM research. The program has increased the Division’s profile nationally and has brought over 20 outstanding young GIM scholars to Hopkins at a formative point in their careers. Two of the winners later came to Hopkins GIM—one as a fellow, another as faculty.

Working with Drs. Eric Bass, Jeanne Clark and Geetanjali Chander, he markedly expanded the budget of the GIM Fellowship, mostly by capturing value created by fellow’s clinical activities. The new funds supported more core faculty effort, two weekly lunch conferences, upgraded computing equipment, and more generous travel allowances.

Working with Dr. Joe Cofrancesco and Dr. Jessica Yeh, he formed GIM’s first Core resources. Founded and led by Dr Cofrancesco, the Clinician-Educator Mentoring and Scholarship Program (CEMSP), provides mentoring and research assistant support to clinically oriented faculty whose scholarly interest lie outside the NIH and AHRQ-funded research infrastructure of the Division. Founded and led by Dr. Yeh, the GIM Methods Core provides broad support to researchers from throughout the Division, ranging from design and biostatistics to data management and analysis. The Core underlies several other research initiatives connected to the Division, including the Osler Housestaff Research Program, the Diabetes Prevention & Control Core, and the Welch Center Methods Core.

With the help of Dr. John Flynn, he committed the Division to a bigger role in the Association of Chiefs and Leaders in General Internal Medicine (ACLGIM). Several GIM faculty took national leadership posts, including John Flynn (Membership Chair), April Fitzgerald (Leadership Forum editor), and Fred Brancati (President).       

To the tradition of the Winter Party (which brings together over 250 faculty, fellows, students and staff for food and dance), he added two additional annual celebrations: the Spring Picnic and the SGIM Alumni Dinner (the largest of its kind nationally)

Following negotiations with the Dean’s Office, GIM spun off the University Health Service into an administratively distinct entity led by Dr. Spiro Marinopoulos. In return, the SOM agreed to a major expansion of the budget aimed at improving quality and timeliness of care. Long housed in limited space on Carnegie 1, UHS moved first into freshly rehabilitated offices at Bond Street and in 2012 to brand new offices in a new student housing tower on Wolfe Steet in the Science and Technology Park.

The JHH Hospitalist Program grew substantially during this period, under the outstanding leadership of Dr. Dan Brotman. When Dr Brotman arrived in 2005, the Program was small in size and impact. By 2012, the Program had developed a local reputation for clinical excellence and a national reputation for innovation and scholarly achievement. Key milestones under Dr. Brotman’s leadership included: attaining 24/7 coverage, establishing a unique ‘Hospitalist Scholars Program’ to provide faculty with $12,000 annually each to support their scholarly projects, winning K awards for cardiovascular (Dr. Rehan Qayyum) and quality and safety research (Dr. Henry Mitchtalik), opening a procedure service praised for both efficiency and educational value, and recruiting a strong associate director (Dr. Carrie Herzke). Recruited in 2006, Dr. Lenny Feldman led two historic initiatives: a web-based Consultative and Perioperative Medicine CME program which was adopted by SHM, and two unique federally-funded training programs in Urban Health (med-peds and internal medicine). In 2012, JHH Hospitalist Program faculty accounted for 10% of all scholarly abstracts presented at the national scientific meetings of SHM.

A long-time ally of the Welch Center, the Division developed relationships with a range of new centers and programs including the following:  

The Hypertension Center, under the leadership of GIM's Dr. Gregory Prokopowicz, aims to improve the management of hypertension by providing the highest level of consultative care for patients with high blood pressure that is difficult to diagnose and/or treat. Additionally, the Center is dedicated to acquiring and disseminating knowledge through clinical research on the diagnosis and treatment of hypertension and educational programs for both patients and physicians about hypertension and its management.. 

The Evidence-based Practice Center (EPC), directed by Dr. Eric Bass, with the assistance of Dr. Karen Robinson and Dr. Jodi Segal, produces comprehensive systematic reviews of important medical topics using interdisciplinary teams that integrate clinical expertise with expertise in evidence-based methods, including  meta-analysis, decision analysis, benefit-harms analysis, and cost-effectiveness analysis. The EPC also collaborates with other EPCs and AHRQ programs to advance the methodology of systematic reviews, their transparency, and their use in dissemination and translation of findings.

The Center for Drug Safety and Effectiveness serves as a nexus for individuals at Johns Hopkins who are involved in research, education, clinical programs and public service to improve prescription drug use and pharmaceutical policy in the United States and around the world. It addresses such problems as prescription drug abuse and barriers to accessible and affordable medicines in developing countries. The Center's co-directors (Dr. Caleb Alexander and Dr. Jodi Segal) and its associate director Dr. Sonal Singh, are all GIM-affiliated.

The Center for Health Services and Outcomes Research (CHSOR), under the direction of Dr. Albert Wu, jointly appointed in GIM, conducts interdisciplinary research on timely issues in health care, including research on the organization, financing, staffing and technology of health services and their impact on quality of care, patient outcomes, resource utilization, and costs. Priority is given to research on Federal and state policy issues, and managed health care. Special attention is devoted to the impact of health policies and services on vulnerable population groups such as children, the elderly, uninsured, mentally ill, and disabled persons.

The Center for Medical Technology Policy (CMTP), under President and CEO, part-time GIM faculty member Dr. Sean Tunis, defines and publishes methodological standards and guidance for comparative-effectiveness research and patient-centered outcomes research that reflect the information needs of patients, clinicians, and payers. It also develops technically sophisticated and highly implementable processes and products that enhance the clinical research enterprise, as well as facilitating  dialogue, debate and consensus around coverage and reimbursement and other policies that promote high priority research.

Under the leadership of Drs. Fred Brancati, Jessica Yeh, Felicia Hill-Briggs, and Nae-Yuh Wang and , the Diabetes Prevention and Control Core fosters collaborative, multidisciplinary diabetes and endocrinology research, and translates that research into programs to train health care professionals in the diagnosis and management of diabetes. The Center strives to understand the causes of both type 1 and 2 diabetes and promote translational research that is aimed at reducing the burden of these diseases in the United States.

The GeneSTAR Research Program, led by Dr. Diane Becker, consists of integrated studies primarily sponsored by the National Institutes of Health, with industry support for investigator-initiated research questions. GeneSTAR is a prospective epidemiologic family-based study conducted in initially healthy siblings of people with documented premature coronary disease under 60 years of age, their adult offspring, and the coparents of the offspring.

Several additional faculty members achieved noteworthy accomplishments:

Dr. Lisa Cooper, a former GIM Fellow and renowned disparities researcher, achieved several major milestones. She was elected to ASCI and IOM. She became the first woman of African ancestry to attain the rank of full professor at JHSOM. She was named the inaugural James Fries MD Professor of Medicine. And with NHLBI funding, she established the Center to Eliminate CVD Health Disparities which undertook an historic program of interventions to improve blood pressure control in East Baltimore.

Dr. Eric Bass, a former GIM Fellow and longtime Fellowship Program Director, led the Evidence-Based Practice Center to national prominence and successful grant renewals. After having served as JGIM Editor-in-Chief during the Klag Administration, in 2012 he was elected President of SGIM.

Dr. Larry Appel, a former GIM Fellow, achieved several major milestones. He was named to deliver the Connor Lecture at AHA, he was named to direct the Welch Center for Prevention, Epidemiology, and Clinical Research, and he was elected to IOM.

Dr. Jeanne Clark, a former GIM Fellow, built a research program in obesity and related conditions, led the GIM Fellowship for 5 years during a period of reform and expansion, led the DOM’s Women's Task Force, won the David Levine Mentoring Award and a Mentoring Ward from the SOM’s Vice Dean, was named the inaugural Frederick Brancati Chair, and was named Associate Director, then Interim Director of the GIM Division.

The GIM Division embarked on cancer health services research and clinical epidemiology. Dr. Jessica Yeh developed a research program in diabetes and cancer. Dr. Claire Snyder developed a program in cancer survivorship and patient-reported outcomes, winning GIM’S first grants from the American Cancer Society, the National Cancer Institute and the Patient Centered Outcomes Research Institute (PCORI). And Dr. Craig Pollack, recruited from the RAND Corp in Washington, DC, developed a program in disparities research related to prostate cancer.

Three GIM faculty members, Drs. Fred Brancati,  Dan Brotman and Hunter Young, played key roles in winning a landmark $20M Innovation Challenge grant from the Center for Medicare and Medicaid Services (CMS). Nicknamed J-CHiP, the project aims to reform acute and chronic disease care so as to reduce costs by improving quality and reducing unnecessary care.

New faculty recruitments during this interval included: Drs. Raquel Charles-Greer, Nisa Maruthur, Wendy Bennett, Claire Snyder, Craig Pollack, Sonal Singh, Mariana Lazo, Kim Gudzune, Jay Vaidya, Rasika Mathias, Karen Robinson, Lisa Yanek, Vinayak Kottoor, Anastasia Rowland-Seymour, Zackary Berger, Rochelle Brown, Sosena Kebede, April Fitzgerald, Tony Boonyasai, Ahmit Pahwa, Muhammad Amer, Zishan Siddiqui, Padmini Ranasinghe, and Ibironke Oduyebo. GIM also welcomed faculty who transferred from other programs including Dr. Gail Geller and Dr. Felicia Hill-Briggs. And GIM assisted with the recruitment of academic internists with primary appointments in other units including Caleb Alexander, Jeremy Greene, and David Dowdy.

Under Dr Brancati’s leadership, GIM embarked on a series of novel collaborations with industry. This story is captured in Dr Brancati’s February 2012 Dean’s Lecture entitled “Academia, Industry, and the Health of the Public.” In particular, he championed institutional partnerships with two corporations: Healthways and Walgreens. The Healthways relationship led to an NHLBI-funded comparative effectiveness trial of weight loss strategies in primary care (PI Dr Larry Appel). In a New England Journal of Medicine paper, Appel and colleagues described a successful web- and telephone-based weight loss program that was conducted at a fraction of the cost of in-person programs that had become the cornerstone of NIH efficacy trials. Healthways and Hopkins turned this research success into a commercial product called INNERGY. The Walgreens relationship is leading to the development of a physician-pharmacist collaborative care model for high blood pressure that will be rigorously tested in a randomized controlled trial.

GIM research funding underwent an historic expansion from $12M (annual direct costs) in 2004 to $30M (annual direct costs) in 2012, not including J-CHiP or grants  through the School of Public Health or the Berman Bioethics Institute.

In 2011-12, Dr. Brancati received several honors: he won the Kelly West Award from the American Diabetes Association for outstanding achievement in diabetes epidemiology; he won an Excellence Award from the ACLGIM for his outstanding performance as GIM Division Director; he was elected to the American Association of Professors; he was named a Distinguished Service Professor by the SOM’s Board of Trustees for his service as a division director, mentor, and innovator; he received an Osler Tie for his outstanding service as a teacher and research mentor for the Osler Housestaff; an inpatient service staffed by Hospitalist faculty and housestaff was named for him; and the SOM created an endowed ‘Frederick Brancati, MD’ Chair, dedicated to support the GIM Division Director. Dr. Clark was named the inaugural recipient of the Chair.

Due to declining health, Dr. Brancati resigned the Chief post on 1 January 2013. Dr. Jeanne Clark assumed the post of Interim Director and appointed Dr Brancati as Associate Director.

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