Thomas M. Zizic, M.D. Professorship in Rheumatology and Immunology

Dr. Zizic’s primary faculty responsibility was to assist Dr. Stevens in developing an experiment in medical education, known as the Johns Hopkins Rheumatic Disease Unit at the Good Samaritan Hospital. The tradition at Johns Hopkins illustrated and promulgated by such giants as Drs. A. McGehee Harvey and Phillip Tumulty was that if you wanted to be a good rheumatologist, then you had to be a good internal medicine physician. Hence, Drs. Stevens and Zizic decided to develop the Rheumatic Disease Unit for the care of all rheumatic disease patients irrespective of whether they were being admitted for the treatment of a bacterial pneumonia, orthopedic surgery or a flare up of systemic lupus erythematosus. They offered senior students who had finished their Osler clerkship in medicine and wanted to prepare for an internship in internal medicine the opportunity to rotate on this service. Appropriately, they were called “sub interns”. These sub interns were directly supervised by Osler residents who were directly supervised by either Dr. Stevens or Dr. Zizic. This Johns Hopkins rotation was entirely elective for both Johns Hopkins students and residents. By its second year, the rotation became so popular that a lottery system was utilized to determine participation. For the next five years, Dr. Stevens and Dr. Zizic became full time faculty members at both the University of Maryland and the Johns Hopkins University School of Medicine. With the expansion of the Rheumatic Disease Unit to both Universities, Dr. Zizic was appointed as the Associate Director of the Rheumatic Disease Unit.

The concentration and aggregation of patients facilitated by the Rheumatic Disease Unit was a fertile ground for clinical research. Even rheumatology patients who were undergoing orthopedic surgery were admitted to the unit with shared care during the perioperative period. The partnership between Dr. Zizic and Dr. David Hungerford, a Johns Hopkins Professor of Orthopedic Surgery, led to collaborative research that lasted for more than a decade.

This research resulted in an understanding of the role of increased bone marrow pressure in the development of ischemic bone disease and subsequent osteonecrosis and some benefits regarding both prevention and treatment of the disorder. In steroid induced osteonecrosis, almost all patients were cushingnoid prior to the development of their bone disease. Keeping Prednisone doses at less than 25 milligrams a day for less than two continuous months, virtually obviated the development of osteonecrosis. If this was not possible, then early diagnosis was paramount as the simple procedure of core decompression was extremely successful and, in most patients, prevented the need for total joint replacement.

Rheumatology is a difficult discipline to support and sustain oneself solely through the generation of income from patient care. The patient cases are often very complicated with multisystem involvement, requiring an extensive review of systems, more thorough interim physical exams and more time consuming reimbursement issues for an extensive and constantly expanding armamentarium of expensive biologic agents. Yet reimbursement for patient care is often no more than that of an internist caring for a single system disease. It is Dr. Zizic’s hope, that by endowing this professorship, he can help other clinical rheumatologists have the time to teach students, residents and fellows, as well as, immerse themselves in the research that they are passionate about, without having to depend solely on income generated through patient care.

LAURA HUMMERS, M.D., Sc.M. is an Associate Professor of Medicine in the Division of Rheumatology. She graduated from the University of Rochester School of Medicine and trained in internal medicine at Thomas Jefferson University. Dr. Hummers pursued her fellowship in rheumatology at Johns Hopkins University. She received her Sc.M. degree in Clinical Investigation at the Bloomberg School of Public Health in 2010.

Dr. Hummers joined the faculty at the Johns Hopkins Scleroderma Center in 2003. She has served as Co-Director of the Center for the past 21 years, training numerous clinicians and mentoring physician-scientists in the field. She also oversees clinical operations for the Division of Rheumatology as Clinical Director. Dr. Hummers is internationally recognized for her clinical expertise in the management of scleroderma and related conditions. She has a particular expertise in treating patients with and raising awareness for scleromyxedema, scleredema, and eosinophilic fasciitis.

Dr. Hummers actively oversees a number of clinical trials and investigations at the Scleroderma Center, serving as an advisor to industry partners on clinical trial development. She focuses on identifying the biomarkers and clinical predictors of complications in scleroderma. Dr. Hummers also co-directs the Scleroderma Precision Medicine Center of Excellence where she works with colleagues to develop modeling techniques to identify predictors of the disease and increase patient understanding and advocacy in treatment. She has supported the evolution and enhancement of the Center’s research registry and biospecimen repository to better understand a patient’s long-term disease trajectory and improve outcomes and future clinical trial design.

Dr. Hummers is dedicated to continuing education and professional development. She actively contributes to the National Scleroderma Foundation as a member of the Medical and Scientific Advisory Board, which supports advocacy, research, and support for patients and chairs the Physician Education Committee. In addition to mentoring several faculty members and trainees in the Division of Rheumatology, she is consulted regularly for her expertise by rheumatologists across the country and is asked to speak at international conferences on the management of scleroderma, scleromyxedema, and other rare scleroderma mimics.