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CBSSM Seminar: Darin Zahuranec, MD

Wed, January 20, 2016, 3:00pm to 4:00pm
NCRC, Building 16, Room 266C

Darin Zahuranec, MD

Assistant Professor, Neurology

Title:  Improving decisions on life-sustaining treatments after stroke

Abstract:  Individuals with acute stroke face the sudden onset of new deficits, along with a need to make many decisions about medical treatments with impact on the potential for survival and long-term disability. This talk will review the challenges in decision-making after acute stroke and discuss possible solutions for the future.


Bioethics Grand Rounds

Wed, March 22, 2017, 12:00pm
UH Ford Amphitheater & Lobby

Autumn Fiester, PhD, Division of Medical Ethics, Department of Medical Ethics & Health Policy, Perelman School of Medicine University of Pennsylvania

Title –  The “Difficult” Patient Reconceived: Learning the Skills of Mediators in Managing Challenging Clinical Encounters.

Abstract: Between 15%-60% of patients are considered “difficult” by their treating physicians.  Patient psychiatric pathology is the conventional explanation for why patients are deemed “difficult.” But the prevalence of the problem suggests the possibility of a less pathological cause.  I argue that the phenomenon can be better explained as responses sourced in conflicts related to healthcare delivery and that the solution to the “difficult patient” is to teach better conflict management skills to clinical providers.


1. Apply the mediator's concepts of "positions" and "interests" to patient-provider conflicts
2. Identity the moral emotions and explain their significance in managing the "difficult" patient
3. Learn seven maxims for diffusing conflict in clinical encounters

Available via live stream at:

CBSSM Seminar: Julie Wright Nunes, MD, MPH

Wed, May 17, 2017, 3:00pm
NCRC, Building 16, Room 266C

Julie Wright Nunes, MD, MPH
Assistant Professor, Internal Medicine

Title: Patient Education and Care: Challenges and Opportunities in Chronic Kidney Disease

Abstract: Twenty million people, or 20% of U.S. adults ages 60 and older, have chronic kidney disease (CKD). CKD is a significant public health threat carrying high risk of morbidity, mortality, and renal failure. Health behavior theory suggests that patient motivation and healthy behavior change require patients to have knowledge of their chronic condition, as well as the self-efficacy and skills to do what is needed to stay healthy. The chronic care model promotes early patient engagement in care. Yet, less than 20% of  patients with CKD are aware of their diagnosis. Even patients who are aware often do not understand the implications of their CKD diagnosis or what they need to do to optimize their health. Dr. Wright Nunes will discuss her research aimed to develop, test, and disseminate sustainable patient-centric education and coaching support interventions to improve quality of care and outcomes in patients who have CKD.

Woll Family Speaker Series: Debate on Conscience Protection

Fri, March 09, 2018, 12:00pm to 1:00pm
Med Sci II, West Lecture Hall

The Woll Family Speaker Series on Health, Spirituality and Religion

We are excited to be hosting a debate on Conscience Protection on Friday March 9th from 12-1 as part of the UMMS Program on Health, Spirituality and Religion. Please save the date! CME Credit provided (see below).

Point: Healthcare professionals are "obligated to provide, perform, and refer patients for interventions according to the standards of the profession.” NEJM, 2017

Counterpoint: Healthcare professionals have the right to opt out of performing or referring for procedures they view as objectionable in accord with their religious or personal values.

Join Dr. Naomi Laventhal and Dr. Ashley Fernandes in this academic discussion as part of the University of Michigan Program on Health, Spirituality and Religion.

CBSSM Seminar: Reshma Jagsi, MD, PhD

Wed, May 18, 2016, 3:00pm to 4:00pm
NCRC, Building 16, Room 266C

Reshma Jagsi, MD, PhD
Associate Professor, Radiation Oncology

"Stewardship and Value:  Are we choosing wisely in managing breast cancer?"

Abstract: This lecture will begin with a brief discussion of the moral foundations of physicians' obligations to serve society, in addition to the patients they directly serve.  It will then consider analogies between financial stewardship and antibiotic stewardship, and it will conclude by focusing on several examples of opportunities for better physician stewardship in breast cancer, including slow uptake of short courses of breast radiation and rapid increases in the use of bilateral mastectomy for unilateral disease.

CBSSM Seminar: Jeff Kullgren, MD, MS, MPH

Wed, October 19, 2016, 3:00pm to 4:00pm
NCRC Building 16, Conference Rm 266C

Jeff Kullgren, MD, MS, MPH
Assistant Professor, Internal Medicine

Consumer Behaviors among Americans in High-Deductible Health Plans 
More than 1 in 3 Americans with private health insurance now face high out-of-pocket expenditures for their care because they are enrolled in high-deductible health plans (HDHPs), which have annual deductibles of at least $1,300 for an individual or $2,600 for a family before most services are covered.  Though it is well known that HDHPs lead patients to use fewer health services, what is less known is the extent to which Americans who are enrolled in HDHPs are currently using strategies to optimize the value of their out-of-pocket health care spending such as (1) budgeting for necessary care, (2) accessing tools to select providers and facilities based on their prices and quality, (3) engaging clinicians in shared decision making which considers cost of care, and (4) negotiating prices for services.  Such strategies could be particularly helpful for people living with chronic conditions, who are even more likely to delay or forego necessary care when enrolled in an HDHP.  In this seminar we will examine these issues and review preliminary results from a recent national survey of US adults enrolled in HDHPs that aimed to determine how often these strategies are being utilized and how helpful patients have found them to be, which patients choose to use or not use these strategies and why, and identify opportunities for policymakers, health plans, and employers to better support the growing number of Americans enrolled in HDHPs.

Mon, April 17, 2017

Brian Zikmund-Fisher is quoted in a recent MarketWatch article, "How doctors are getting patients more involved in their own care." Dr. Zikmund-Fisher points out, "Patients are often overwhelmed by massive amounts of data they now have access to. The easier we make it for them to understand, the more likely it is they will use it and the less time the doctor has to spend explaining it.” The article goes on to cite a web-based application developed by Dr. Zikmund-Fisher and colleagues that allows health-care providers and researchers to create graphics that use icons in arrays that show risk information in ways that make it easier for people to grasp information.

A study by former CBSSM Co-Director, Angela Fagerlin, is also cited in the article.


Our People

CBSSM is an interdisciplinary group committed to improving individual and societal health through research, education, and public outreach. Our unit attracts scholars from across departmental and disciplinary boundaries and in so doing, provides fertile ground for new synergies. CBSSM affiliates with scholars from across the University of Michigan and the Ann Arbor VA Health System to collaborate on research projects.

Our team includes:

  • Social and cognitive psychologists
  • Bioethicists
  • Clinicians from many medical specialty areas
  • Public health researchers
  • Decision scientists
  • Behavioral economists
  • Survey methodologists

CBSSM Seminar: Timothy R. B. Johnson, M.D.

Tue, October 03, 2017, 3:00pm
NCRC, Building 10, G065

Timothy R. B. Johnson, M.D.
Arthur F. Thurnau Professor and Chair, Department of Obstetrics and Gynecology
Bates Professor of the Diseases of Women and Children
Professor of Obstetrics and Gynecology and Women’s Studies
Research Professor, CHGD

Title: Global Health Ethics and Reproductive Justice: Breadth and Depth in CBSSM

Global Health Ethics and Reproductive Justice (in this instance sexual rights and gender equity, specifically gender and sexual harassment/assault in Academic Medical Centers) appear to be areas where a number of CBSSM members have interest, expertise and are working inter-disciplinarily in domains that will differentiate CBSSM nationally and internationally. Could and should these develop into CBSSM thematic interests? Whatever the case, they will remain topics of significant interest across CBSSM and are worthy of broad discussion and  understanding.

Tue, March 13, 2018

CBSSM's Reshma Jagsi, Sarah Hawley and colleagues found that only half of women who could benefit from genetic testing get it, and often not before they have surgery. Steven Katz was lead author on this study.