Annenberg Center for Health Sciences teaches near and far — for 25 years and counting
By By Janice Kleinschmidt
In the late 1970s, Dolores Hope and Eisenhower Medical Center President John Sinn approached Walter Annenberg about developing a medical education center. Annenberg agreed to a $5 million gift, supplemented a few years later with $5 million for educational programs. At the November 1981 dedication (watch the video), Annenberg suggested “Medicine for the 21st Century” be inscribed over the door. “I believe this encompasses a fundamental responsibility we have to contemplate and improve the economics of illness,” he said. “Elsewhere in the world, others will be working for the same goal. But we of Eisenhower will be in the forefront of this crusade.”
Well before the turn of the century, leaders at the Annenberg Center for Health Sciences peered into the distant future. Inspired by Walter Annenberg’s vision for the center, President Thomas Zimmerman and his staff organized a forum hailed as “Medicine for the 21st Century.”
Best-selling author Ray Bradbury kicked off the event, which was co-sponsored by NASA and the American Medical Association. Participants included U.S. astronauts Alan Shepard and Buzz Aldrin, Russian cosmonaut Oleg Atkov, and noted Russian scientist Oleg Gazenko.
That forum during the first week of December 1988 — one of so many highlights in the nonprofit center’s 25-year history — hints that the center’s sphere of influence extends far beyond the Eisenhower Medical Center campus where it resides. In fact, that influence transcends talk.
On Dec. 7, 1988, there were major earthquakes in Armenia: 6.9 followed about four minutes later by 5.8 and then swarms of earthquakes for months,” recalls Zimmerman, now executive director of the International Society of Microbial Resistance and a research professor at Virginia’s George Mason University Office of International Medical Policy. The quakes resulted in about 50,000 deaths, more than 100,000 injuries, and numerous cases of post-traumatic stress disorder.
NASA’s chief medical officer, Arnauld Nicogossian, and the director of Moscow’s Institute of Biomedical Problems — both attending the Annenberg Center forum — agreed to apply telemedicine technology to aid Armenia. According to Zimmerman, NASA contributed $300,000 toward a telecommunications spacebridge that was used through June 1989, with Nicogossian’s office serving as the hub for agencies and hospitals in the United States and Russia. “It was the first large-scale, international telemedicine effort,” Zimmerman says. “What is left behind is a state-of-the-art diagnostic center with telecommunications capability,” funded to the tune of $2 million by Moscow State University.
The forum also brought together the director of Russia’s national library of medicine and the CEO of a British publishing house. Zimmerman was invited to join a U.S. team visiting Russia in 1989 to explore opening the flow of medical information between the East and West. The publishing initiative resulted in a Russian version of the Journal of the American Medical Association.
Construction on the Annenberg Center began in 1980 and was completed in November 1981.
Archive photos courtesy Annenberg Center
Early in its history, the Annenberg Center reached out to European medical leaders and associations. “International developments are an unusual ‘target of opportunity’ for the Center,” Zimmerman wrote in his 1984 annual report. “The Center is able to move energetically at a time when universities are introspective and retrenching. Few professional associations are able to look beyond national membership interests. In addition, the names Eisenhower, Annenberg, and Hope are internationally recognized and invest substantial credibility to the Center.”
In May 1983, Annenberg Center representatives visited France, Scotland, Switzerland, and West Germany. The following two years, they revisited those countries, as well as Luxembourg.
Then, in 1986, the center hosted the World Medical Assembly, attracting about 500 participants from 50 countries. The forum was conducted in five languages.
From Jan. 1, 1983, through July 1, 1985, the Annenberg Center held 48 international conferences/symposia with a total of 5,447 participants. “Educating health professionals to meet the challenges of change is an essential task of the AC,” Zimmerman wrote in his 1986 annual report. “The scope of this transition runs from new technology and knowledge to social and economic transition.”
Frontiers of Biomedical Science, co-sponsored with the Research Institute of Scripps Clinic in 1988, drew together 30 international scientists to explore the most promising directions for future investigation and collaboration. Nobel Prize winners comprised at least a quarter of the participants.
Annenberg Center officials are especially proud of a three-day conference in 1996 on preventing medical mistakes that they say resulted in the founding of the National Patient Safety Foundation and a USA Today front-page story.
In the first few years of the 21st century, participation ballooned. In 2003, more than 63,500 healthcare professionals attended 2,000 programs, conferences, and series events and the center issued more than 25,400 continuing education certificates.
Over 1 Million Served
The Annenberg Center continues an aggressive schedule of programming covering everything from AIDS and infantile apnea to music in medicine and family violence. Attendees come from around the world — from Argentina to Yugoslavia — and include physicians, nurses, dentists, allied health professionals, scientists, administrators, and social workers.
“Science and medicine change tremendously every seven years,” says President and CEO Philip Dombrowski. “Half of what [medical students] learn in school becomes obsolete. The continuing education is the bulk of what they are going to learn to practice. That’s what we provide.”
More than 1 million physicians have received continuing education credits from Annenberg Center, which is accredited by 13 state and national organizations to provide certified continuing education for physicians and physicians’ assistants, nurses and nurse practitioners, pharmacists, respiratory care practitioners, optometrists, psychologists, social workers and counselors, clinical laboratory workers, and dentists.
To reach the greatest number of healthcare providers, the Annenberg Center long ago developed a video and audio production studio and teleconferencing capabilities. The first tele-conference was linked by a rented satellite dish to 19 major U.S. cities in 1985. Two years later, the center had its own half-million-dollar satellite uplink “transportable” and broadcast two international teleconferences — one to Western Europe and one to Latin America — reaching 4,381 participants in 110 cities.
On the center’s fifth anniversary, Dr. Ole Harlem of the World Federation for Medical Education in Oslo, Norway, paid tribute to Walter Annenberg’s foresight: “We all know too well that the gap between what we know, what we therefore can do, and what we are really doing is all too wide — especially in medicine and healthcare. If we want to narrow this gap, we must improve medical education and especially continuing medical education. You, Mr. Ambassador, have given us a very important tool to make it possible.”
Echoing those sentiments, Dr. Pablo Pulido of the Pan American Federation of Associations of Medical Schools in Caracas, Venezuela, said, “We work with medical schools and we want to put medical education in close contact with the needs of the people and our populations. Therefore, a center such as yours is crucial to provide solid communications. It’s important to have ideas, but more important to have them put into action — and this is what you are doing.”
Beaming the Message
The center’s three-camera studio — complete with tape machines, switchers, a lighting grid, and sets — produced documentaries that were aired nationwide, broadcast live conferences (including a bi-monthly series across the United States and Canada on respiratory care), and even provided live interviews for network programs (such as Suzanne Somers’ remote appearance on The Larry King Show).
“Over the years, we upgraded equipment as the technology changed,” says Facilities Manager Fred Allard. “We had a full broadcast-quality studio.” The center has provided uplinks to ABC, CBS, NBC, MSNBC, and CNN.
“We would not have been able to do any of these neat things internationally if not for the support of [the late] Alex and Geri Dreier,” Allard says, referring to the couple that funded the studio and mobile satellite truck and trailer, dubbed Medical Teleport Earth. Dreier was a retired ABC and NBC news anchor, one-time Annenberg Center board member, and strong believer in the center’s potential for worldwide impact. “He had vision,” Allard says.
The center even sent a camera crew to the University of Cleveland Clinic in 1996 to provide a live uplink on minimally invasive surgery. The signal reached a dozen sites in the United States and Europe.
In 1990, the Annenberg studio produced two documentaries funded by the W.K. Kellogg Foundation of Battle Creek, Mich.: one addressing the impact of deforestation on residents in the Dominican Republic and the other engineered to reduce the high infant mortality rate in Brazil.
Dr. David Kaminsky, a local pathologist, not only helped the center develop more than 10 years of teleconference programs to 120 sites, but also started Africa Calls, a distance-learning program that began in 1998 reaching out to physicians in Third World countries lacking access to modern diagnosis and treatment techniques.
Writing about a 2006 teleconference to Sudan, Mutaz Ali of the Omdurman Ahlia University said, “Africa Calls remains one of the first, if not the first, well-conducted program in cytopathology [the branch of biology dealing with the structure, function, pathology, and life history of cells] in Sudan. … This program encouraged and helped cytologists to be enrolled in continuing professional development. … Dr. Kaminsky … shows [that] cytology is an art that demands nurturing and a science [that] requires training.”
Jolly Good Fellows
“One of the things the Annenberg Center has always prided itself in is coming up with new and innovative education programs,” says Executive Vice President George Hurrell.
In 1998, the center introduced an intensive weekend mentoring program for fellows in educational institutions throughout the country.
“It’s a combination of state-of-the-art clinical discussions and more practical discussions that help the young physicians in terms of career planning” such as academic versus private practice and physician-patient communication, Hurrell says. The center invites 50 to 75 fellows in specific therapeutic areas such as irritable bowel disease, oncology, rheumatology, and ophthalmology. Pharmaceutical companies pick up all expenses for the attendees.
“There’s a heavy focus in the program on clinical-case presentations,” Hurrell says. “We encourage them to bring difficult clinical cases from their institutions. It’s an opportunity to present to faculty mentors and their peers and get expert consultation. We really bring in the top leaders in the field and try to keep the ratio of less than one [mentor] to 10 [fellows], sometimes one to six or seven.”
The response has been overwhelmingly positive, not only from the young physicians, but also from mentors. As a bonus, the center last year added to the schedule an evening dinner lecture by an art expert on some of the pieces in its extensive collection of artwork reproductions involving medicine.
Hurrell says the mentoring program is unique in that it provides “structured interaction” between young physicians and world-class thought leaders.
“We have always been very excited about the program,” he says, “because we have had this impact.”
Close to Home
Focusing nearer to the center’s sphere of influence means looking at community outreach. Programs have included a Saturday morning alcohol- and drug-awareness hour, Jazz Without Booze performances, and lectures on a wide variety of health-related topics. Local residents attending these programs learn about the latest healthcare information on such common ailments as arthritis, asthma, diabetes, and high blood pressure.
Annenberg Center estimates that 80,000 people have attended general education programs, some in collaboration with Eisenhower Medical Center. The arthritis program alone has attracted almost 53,000 people. And the annual Day of Hope for Diabetes event, which marked its 12th year in March, drew 1,100 local attendees.
The center also hosts the Indian Wells Center for Healthy Living’s monthly lectures and Healthy Nite Out, which includes a heart-healthy dinner and lecture. In addition to medically related programs, the 485-seat Annenberg auditorium hosts the Rancho Mirage Speaker Series, which this year included investigative journalist John Stossel, actress Sigourney Weaver, and Sen. George Mitchell.
In March, Leonore Annenberg announced a donation of $2.5 million to endow a fund to support and expand the center’s medical education programs. A separate Annenberg Foundation grant funds the Leonore Annenberg Lecture Series. The first lecture, also in March, featured an eminent cardiologist from Cedars-Sinai Medical Center talking about recent advances in heart disease. Although only 150 people attended, Dombrowski considers the event a success.
“The lecture, which started at 7 [p.m.] was supposed to end at 8 [p.m.]. People stayed until 10 o’clock asking questions,” he says.
Future lectures, all free to the public, may feature nonphysicans, though all will be health-related. For example, Dombrowski suggests someone from the Federal Drug Agency might talk about drug approval or someone from a prominent foundation might talk about global health needs.
Eyes on the Future
Dombrowski — who has been with Annenberg Center since Nov. 1, 2005 — first became aware of the institution in the early 1990s. A former executive director of The Transplantation Society international medical society in organ transplantation, he turned his attention to medical education more than 20 years ago. He was working for Physicians World in New Jersey when the Annenberg board of directors selected him to fill the CEO position.
“I said this would be one of the few places I would actively consider,” he says of the offer. Now he’s looking for the next generation’s leaders in medical education. “There’s a lot going on right now,” he says. “And there are not a lot of people who have been in the field for very long.”
Dombrowski called people from across the United States, including at Duke University, American College of Cardiology, American Academy of Family Practitioners, and University of Alabama to tell them what he had in mind. “They didn’t
hesitate,” he recalls. “They said, ‘If the Annenberg Center is involved in this, we want to be involved in it.’”
Leadership in Continuing Medical Education will be funded in part through tuition fees, but Dombrowski says he also hopes to secure a grant from a charitable foundation.
“We are looking to develop an entire curriculum where we are working with some of the large medical associations, medical education departments of large teaching institutions, and medical education groups within pharmaceutical companies, looking to help them understand what the issues are in medical education, what are some of the roles that they need to start filling,” Dombrowski explains. The program could include a one-week course, a series of courses, and/or “interventions” in which a mentor is assigned to work with enrollees at their institutions.
The nine-member planning committee — which first met in November 2006, presented the concept to the Society for Academic Continuing Medical Education in March, and then met again in May — is conducting a needs assessment to shape the program. Another current project involves converting the video studio into a high-speed Internet center.
“[The studio] was part of technology that was analog-based, and now the whole industry has gone digital,” Dombrowski says. Annenberg Center hopes to tap into the high-speed network installed for the Palm Desert college campuses and start renovating the studio before the end of the year.
This month, the center embarks on the next step in its Asian-Pacific Summit: Addressing the Challenges in Solid Organ Transplantation. Faculty members from the United States, Europe, and Australia will travel to Sapporo, Japan, to present state-of-the-art science in transplantation of organs such as kidneys, lungs, and livers to about 300 Japanese doctors and nurses. Additionally, they will help Japanese physicians develop English writing skills to enable them to write abstracts so they can have their own scientific advances widely published in medical journals or presented orally in medical forums.
“The frustration is the science is probably excellent, but people who have to review abstracts, if they have to ferret out science within the paper, they just reject it,” Dombrowski says. In January 2008, the program will be offered in Seoul, Korea, and Hong Kong.
Also in January, Annenberg Center will make a presentation at the annual meeting of the Alliance for Continuing Medical Education in Orlando, Fla. Funded by a $1.7 million, three-year grant through the U.S. Department of Defense, the center is teaching doctors how to prepare for outbreaks of avian flu, anthrax, and other widespread health threats. For more than a year, it has conducted lectures (both straight and interactive) and recently initiated Web-based, print, and Palm Pilot-based programs on bioterrorism and biosecurity. Performing three- and six-month follow-ups with physicians allows Annenberg Center to evaluate “which mechanism provides the greatest impact of doctors retaining knowledge or beginning implementation [of that knowledge],” Dombrowski says.
Zimmerman says one of the aspects of Annenberg Center that sets it apart among medical education facilities is the fact that it is not part of a university with attendant encumbrances. That not only gives the center control over its mission of lifelong learning, but also, he says, “an opportunity to address vital community consumer-level issues like the alcohol-awareness program.”
Walter Annenberg’s vision, however, faced obstacles early on. “A clear part of the vision was to extend the reach of the Annenberg Center from its geographical, physical presence to move information up to healthcare professionals and the public through awareness, generally using electronic tools,” Zimmerman says. “The first challenge was the attempt to build a critical mass of support within the board that shared that vision.” Some board members, he explains, supported a national and international outreach, while others were more concerned for the local healthcare presence of Eisenhower Medical Center.
Then misfortune struck the Annenberg Center in September 1988, when John Sinn died. “He was a very, very strong element, and I think one of the definitive challenges was the loss of his leadership,” Zimmerman says. “I think that the natural centrifugal force of a campus of many intense interests comes from a sense of competition for resources.” Today’s board members, Dombrowski says, seem to be on the same page, and he sees no need to alter the center’s original mission statement. “I think that the [continuing medical education] field has evolved, and how we are supporting and implementing that mission is different,” he says. “But I think it is still valid and just as relevant to us in 2007 as it was in 1981 when Ambassador Annenberg first stated it.”
25 Years of Healthy Living: A Timeline
With video of the Annenberg Center's 1981 dedication featuring Bob Hope, Walter Annenberg, and a letter from Pope John Paul II
Click here for the story behind the Annenberg Center’s art collection.