Department of Medicine adds divisions for hospital medicine, palliative care

The Department of Medicine is taking steps to expand its current Division of General Internal Medicine and Geriatrics into two distinct divisions, allowing for a deeper focus in key clinical areas while maintaining the ability to collaboratively care for Hoosiers.

Going forward, the department will have one Division of Aging, Geriatric Medicine, and Palliative Care, and one Division of General Internal Medicine and Hospital Medicine.

Each division will be comprised of two sections: The Division of Aging, Geriatric Medicine, and Palliative Care will consist of a section of aging and geriatric medicine and a section of palliative care; and the Division of General Internal Medicine and Hospital Medicine will consist of a section of general internal medicine and a section of hospital medicine.

Department Chair David Aronoff, MD, said the decision to restructure reflects a desire to seize an opportunity for growth rather than a response to any deficit. By making these changes, the department can expand its clinical programs, grow its research efforts and more effectively lead health system strategies in these essential clinical areas while attracting new generations of faculty and trainees.

“We know we face an unavoidable demographic reality where senior adults are the fastest growing segment of our patient population, and our health system partners are looking to us for a coherent strategy on how to provide care to the aging. We know, too, that there is a critical need in Indiana for more primary care and palliative care services,” Aronoff said. “Our inpatient, hospital-based teams have also expanded greatly over the past two decades and are expected to grow more.”

“By establishing divisions and sections dedicated to geriatric medicine, palliative medicine, general internal medicine and hospital medicine, we can give these areas of our clinical work the leadership focus they deserve, and build clearer paths for recruitment, education and strategic planning,” he said.

As it stands, the current Division of General Internal Medicine and Geriatrics is one of the largest units in Indiana University School of Medicine, with more than 300 faculty members providing care within IU Health hospitals, Eskenazi Health and at the Richard L. Roudebush VA Medical Center while also training medical students, residents and fellows and leading key research missions.

For more than 20 years, the division has been directed by physician-scientist and palliative care expert Greg Sachs, MD.

Sachs helped the division become a premier medical unit, with a nationally distinctive aging research enterprise, a record of translational clinical innovation and a far-reaching educational mission.

Being only the third person to serve as chief since its inception in 1973, Sachs grew the division from 140 faculty members to more than 340, thanks to the development of the palliative care program, major expansion of hospital medicine and significant increases in research funding.

Sachs announced earlier this year that he will retire in June. With that milestone approaching, the Department of Medicine recognized it as a natural moment to build upon the foundation Sachs formed.

Hospital medicine, geriatrics and palliative care are huge clinical missions within the Department of Medicine.

Hospitalists have the privilege of caring for patients experiencing hospitalization, and they play an instrumental role in the efficient and safe running of hospital operations. Members of the department’s geriatrics team are actively improving the health and vitality of older adults through innovative research that transforms clinical care. And when patients are facing serious illness and potentially the end of life, palliative medicine physicians lead multidisciplinary teams of advanced practice providers, nurses, chaplains and social workers to provide compassionate care to patients and their families.

By distinguishing these medical specialties within individual divisions, it better reflects the scale and impact of the work being done in these areas of the department, Aronoff said.

Forming the Division of Aging, Geriatric Medicine, and Palliative Care, and the Division of General Internal Medicine and Hospital Medicine will bring the Department of Medicine’s total number of specialty divisions up to 11.

The department will soon launch searches for directors of its two new divisions.

In the meantime, Areeba Kara, MD, MS, will serve as the interim director of the current Division of General Internal Medicine as Sachs begins his retirement.

Kara became the associate chief of the division in 2022. This role enabled her to assist in all aspects of division management, including recruitment and retention efforts, budget construction and more.

Kara attended medical school at the Aga Khan University in Karachi, Pakistan, before completing her internal medicine residency at IU School of Medicine. She joined the faculty in 2003 to be part of the then-emerging hospital medicine program at IU Health Methodist Hospital. She pursued additional training in research, obtained a master’s degree in clinical research in 2013, and is one of the school’s most productive scholars in hospital medicine.

"It is an honor to be asked to lead the division that has been my academic home,” Kara said. “As we plan our next metamorphosis, I will always have the best interest of our patients, faculty, staff and trainees at heart.”

“I am grateful to Dr. Kara for stepping up to fill this leadership need,” Aronoff said. “I know she will be a steadfast advocate for our general internal medicine faculty and staff as we navigate these structural changes.”

“I want to thank Dr. Sachs for years of forward-thinking and contributions to IU School of Medicine,” Aronoff continued. “Without his fine leadership, our department would not be in a position to properly enter this new era.”