PHYSICIAN SPOTLIGHT: Douglas Hanto, MD, PhD
Can the field of Continuing Medical Education shed the pall of hassle and obligation to become something truly relevant in physicians’ practices?
Douglas Hanto, MD, PhD, is committed to showing it can.
“I’ve complained about it like every other physician,” said Hanto, who came from the surgery faculty at Harvard Medical School to direct the CME program at Washington University School of Medicine in St. Louis.
“People in the physician community do have an impression of CME being something that’s not really all that helpful,” he said. “But as I’m meeting with people to discuss what CME could be and should be, everyone gets excited about the possibilities for what it could be in the future.”
With Hanto at its helm, the CME program at Wash U is poised to play a key role in what he describes as a revolution currently transforming the field of continuing education.
“The landscape really is changing dramatically, so we’re taking a good hard look at what we do, what is being done around the world and where we could work to focus our efforts and bring the greatest benefit,” he said.
“Part of the revolution is moving away from mundane, uninteresting activities into more robust activities for which you can actually measure their impact on physicians’ practices.”
Hanto brings to the effort both his extensive experience as an educator and his more than 30 years of active clinical practice. He has also taken on the role of chief of general surgery at the Veteran’s Administration Medical Center.
The move to St. Louis has also allowed Hanto to reconnect with colleagues from a previous stint on the Wash U faculty from 1985-91.
“There are a lot of people who come to train here and stay here a long time,” he said. “A lot of the people I knew from being here before have been very welcoming and supportive.”
A native of Montana, Hanto attended St. Olaf College in Northfield, Minn., for his undergraduate studies and went on to earn a medical degree from the University of Arizona College of Medicine in Tucson.
He holds a PhD in surgery from the University of Minnesota in Minneapolis, where he completed his internship and residency in general surgery followed by research and clinical fellowships in the field of transplantation and liver surgery.
For his first job after his training, Hanto came to St. Louis, where he helped to launch the liver-transplant program at Barnes-Jewish Hospital and St. Louis Children’s Hospital.
He has since practiced on the faculty of the University of Cincinnati College of Medicine and most recently at Harvard Medical School, where he was the Lewis Thomas Professor of Surgery and chief of the Division of Transplantation at Beth Israel Deaconess Medical Center. Hanto also served as the associate chair of surgery and vice chair for faculty development and academic affairs.
His current role is as associate dean for continuing medical education, a new position for Wash U. The CME program was previously led by W. Edwin Dodson, MD, who continues to serve as associate vice chancellor and associate dean for admissions.
“Ed had been doing an outstanding job directing the CME office for 15 years and wanted to focus more on admissions,” Hanto said. “Meanwhile, CME was undergoing changes and the medical school wanted to have a designated person to focus on taking the program forward.”
Among key changes in the field of CME is how the Internet has opened up a new world of opportunities for distance learning. Boring online slideshows are not the goal, however.
“With some of these courses, you don’t even really have to look at the slide presentation to answer the questions at the end,” Hanto said. “There is a shift toward exercises that provide a self assessment and give you the chance to evaluate your active process and demonstrate some improvement.”
That shift, Hanto said, comes alongside a focus on linking CME with issues of patient safety and quality improvement, as well as increased requirements for maintenance certification across medical specialties.
“Another very important part of CME, in my view, is getting evidence-based medicine to the practicing physician and providing them with the tools to implement it,” he said.
Of particular interest for Hanto is developing new strategies for reaching out to primary-care physicians in the community.
“We’re looking at reaching out to minority physicians and meeting some of their specific needs,” he said. “We also plan to do more community outreach to the public, including the Mini-Medical School program which has been very popular.”
In terms of making use of technology’s opportunities, Hanto is exploring ways of employing social-media vehicles like Facebook and Twitter for medical education purposes, for example to spread the word when important new articles are published.
He’s also looking into designs like a 15-Minute CME that break up the program into daily bites.
“Physicians are increasingly interested in shorter, regular kinds of CMEs,” he said. “With a program that’s 15 minutes a day for a week, they could just log on in the morning and do 15 minutes of a CME activity.
“You can do a program on discharging an asthmatic patient, and at the end of that week, you’d have a pretty good idea of the evidence-based steps you need to take to discharge a patient with asthma.
“Not only will the physician feel good about it, the patients will feel good about it and the hospitals will also be very happy.”
The last critical step, though, would be comparing the physician’s hospital readmission rate for asthmatic patients before and after the course.
“The goal is not just doing something, but assessing its impact,” Hanto said. “I think we owe that to the public and to ourselves.”
Outside of work, Hanto enjoys running, skiing, golf and reading fiction. He is also currently writing his first novel.
The father of three grown children with four grandchildren, he is engaged to Mary E. Klingensmith, MD, a Wash U professor of surgery with whom he serves as a director on the American Board of Surgery.