Research in a community hospital: some lessons from the Clarkson-Schnatz mentor-mentee pair in The North American Menopause Society Mentorship Program.

T om Clarkson and Peter Schnatz are demonstrating that good research can be done in a community hospital. This article is the third in my series of interviews with the six mentor-mentee pairs in the inaugural 2009 class in The North American Menopause Society (NAMS) Mentorship Program. Peter F. Schnatz, DO, is a graduate of Drew University and University of Medicine and Dentistry of New Jersey. He completed two residency training programs at the University of Connecticut, first in internal medicine, followed by obstetrics and gynecology. Peter joined the staff of the Reading Hospital and Medical Center in Reading, PA, in October 2009 as Associate Chair of Obstetrics and Gynecology and Director of the Residency Program. He previously was an attending physician at Hartford Hospital in Hartford, CT, with appointments as Associate Professor in both the Department of Obstetrics and Gynecology and the Department of Internal Medicine at the University of Connecticut. He was the University of Connecticut Clerkship Director and Director of the Women’s Ambulatory Service and Director of the Menopausal Medicine Clinic at Hartford Hospital. Peter continues to be involved with FaithCare, an organization that provides local, national, and international medical relief; indeed, he is the Founder and Chairman of the Board and Director of the Hartford FaithCare Wellness Center, a clinic in the inner city of Hartford for the needy and uninsured. He has also led medical missions to Nigeria, Siberia, and Haiti. Peter has always been committed to teaching and interacting with medical students and residents in obstetrics/gynecology, internal medicine, and family practice. Looking for a new challenge, Peter found it in Reading, taking on additional administrative responsibilities and initiating new educational programs. He found a department eager to include research activity, combined with open support from hospital administration. A lesson here is that this positive attitude toward research was a key factor in Reading’s successful recruitment of Peter. Clinical academicians today find it difficult to have time and support for research given the heavy time and economic demand for patient care. About half of Peter’s time is occupied with clinical commitments, and administration usually requires the other half. So it is still a challenge to find time for research, and not uncommonly, this requires evening and weekend hours. Some things never change! Peter’s current menopausal research focuses on cardiovascular disease, an interest that evolved from the publications of the Women’s Health Initiative. Collaborating with his mentor, Tom Clarkson, and the team at Wake Forest University, Peter is involved in several projects. One is determining vitamin D3 levels and bone density measurements in a clinical trial in monkeys being treated with vitamin D3 and either estrogen or placebo. This work produced two abstracts presented at the 2010 NAMS Annual Meeting, an oral presentation entitled ‘‘Identification of one of the potential mechanisms for increased cardiovascular risk among individuals with low vitamin D concentrations,’’ and a poster presentation entitled ‘‘Individual differences in plasma concentrations of vitamin D3 are associated with the beneficial effect of estrogen treatment on bone density of surgically postmenopausal monkeys.’’ There are some interesting logistics here and another lesson for clinicians interested in research. The monkeys are in North Carolina. Serum for measurement of vitamin D levels is shipped to Pennsylvania for analysis in a laboratory funded by the Reading Hospital. The lesson is that recruitment and negotiations provide an opportunity to initiate and support research. One thing is for sure: if you do not ask, you will not get support. Do not assume that a community hospital rules out research. Peter Schnatz’s experience is a great example. One of the benefits of the Clarkson-Schnatz mentor-mentee pairing has been the opportunity for Peter to translate basic animal research into clinical studies. Peter has extended the interest of Clarkson’s team in the relationship between monkey depression and coronary heart disease to a longitudinal study in women receiving mammogram screening. Assessment of depression in the women involved in Peter’s study linking breast arterial calcification and coronary artery disease (the NAMS poster prize in 2009) has supported the monkey findings, an association between depression and coronary artery disease. The benefits flow in the opposite direction as well, as Tom Clarkson, the mentor, has the opportunity to confirm in women the results in the monkey model. Peter is very thankful for the NAMS Mentorship Program and is eager to point out the gracious and accommodating