FUNDerdome: Center for Applied Biopsychosocial Research
The proposed center seeks to create a transdisciplinary home for research that accelerates biopsychosocial discovery.
TL;DR
Two University of Rochester Medical Center professors have proposed the “Center for Applied Biopsychosocial Research.” Using the biopsychosocial model as the foundation for their work, they aim to unite visionaries across the University to accelerate real-world applications of biopsychosocial innovations. Jump to: their big idea; the why and why us; implications for Rochester’s reputation; the final pitch.
Welcome to another edition of FUNDerdome!
Quick housekeeping note before we dive into the next team—the University is heading into Phase II of the transdisciplinary research funding initiative. In this phase, the University is looking for fully developed and refined proposals to establish new and innovative transdisciplinary centers or institutes at the University. Ultimately, two to three proposals will be selected for five years of funding. And although this is exactly what the planning awards were for, receiving a planning award is not a prerequisite to apply for funding. Questions? Contact the Office of the Vice President for Research.
Back to FUNDerdome…
In the premiere, we covered the AI Horizons Institute and their work advancing the state of the art in generative AI. Moving away from the realm of HAL 9000, we enter the world of Hal (90), a nonagenarian man who is struggling to manage his health conditions while being a caregiver for his wife.
We’re diving into the proposed Center for Applied Biopsychosocial Research (CABR), which anchors itself in Rochester’s most person-centric point of pride in medicine: the biopsychosocial model.
The team
Co-leads:
- Benzi Kluger
Julius, Helen, and Robert Fine Distinguished Professor in Neurology
Professor, Center for Health and Technology
Professor, Department of Medicine, Palliative Care
- Kathi Heffner
Professor, School of Nursing
Professor, Department of Medicine, Geriatrics/Aging
Professor, Department of Psychiatry, Behavioral/Psychosocial Medicine
Quick background
Internist and psychiatrist George Engel (1913–1999) spent most of his career at the University of Rochester Medical Center with dual appointments in the Department of Psychiatry and the Department of Medicine, beginning in 1946.
In his time at Rochester—working with John Romano, who founded Rochester’s Department of Psychiatry and retired in 1971—Engel became an increasingly strong advocate for psychosomatic medicine, believing that the biomedical approach was too limited. He emphasized the need for medical students and practitioners to understand health and illness in the context of the patient’s life, weighing all familial, societal, cultural, and environmental factors.
Today, Engel’s work is encapsulated in the “biopsychosocial (BPS) model.” The model helped take a clinician’s focus off the disease and put it on the person, encouraging the exploration of psychosocial determinants of health and illness and the intersection of emotions, stress, and physiology. It is a central tenet in medicine, public health, psychiatry/psychology, psychoneuroimmunology, palliative care, and nursing.
Okay—Picture this…
What’s the main idea behind the institute?
Many people recognize the BPS model as part of Rochester’s DNA. However, despite being a continued source of inspiration for many of the University’s leading investigators, this part of Rochester’s genetic makeup has no real “home” within its research landscape.
The closest Rochester came to having a true biopsychosocial center was one led by Engel. It was unofficial and unfunded, but it trained some of the University’s most prominent thought leaders in clinical care and research. Since then, there have been a few attempts to revive the spirit of that center, including the National Institute of Aging-funded Rochester Center for Mind-Body Research (RCMBR) in the mid-2000s. Unfortunately, centers like RCMBR were unsustainable without University support. This proposal aims to win that crucial institutional support and fully realize—and build upon—Engel’s vision.
The CABR team will take advantage of how the BPS model creates a natural bridge across traditional boundaries by creating the flagship program for faculty and students who are passionate about person-centered approaches to health and health care. And they plan to do it through “horizontal collaboration.”
Fully embracing the spirit of transdisciplinary research, the CABR team will develop novel solutions to complex problems by working across fields, drawing their strength from the expertise and commonalities that exist among other Rochester researchers. Currently, they see opportunities working with researchers in divergent fields such as:
- Aging and pediatrics to improve anticipatory guidance tools for older adults by borrowing from developmental models in pediatrics for more seamless care throughout the lifespan
- Nephrology and oncology to improve shared decision-making around dialysis by working with experts in oncology to learn about how chemotherapy decisions are made.
- Palliative care and computer science to improve physician communication skills by using an artificial intelligence avatar for to help with training and feedback
To sum it all up, with institutional support, the CABR team anticipates the center will:
- Bring together visionaries across departments and schools to accelerate biopsychosocial-related discoveries
- Inspire nascent visionaries whose research requires highly transdisciplinary mentorship
- Increase research funding by opening new avenues for grants, patents, and philanthropy
- Re-establish Rochester as the leader for cutting-edge BPS discoveries.
And they’re currently working to win that support by using their planning grant funds to:
- Identify relevant research priorities, interests, strengths, collaborations, and gaps across campus
- Connect with external and internal experts to develop inspiring and effective pillars for the center’s mission
- Identify processes to leverage existing datasets and opportunities to rapidly capitalize on emerging technologies
- Engage leaders across campus in strategic and tactical discussions.
One example of how the CABR team is taking this off paper is a full-day retreat in early 2025. It will start with attendees giving lightning talks on their research, which will transition into a brainstorming and sharing session about the future of BPS research and how a University of Rochester Medical Center (URMC) BPS center could be a powerful resource for faculty and students, not to mention an important instigator of change in health care.
Success is in the air
Why and how is Rochester poised to take this on, and what strengths is this institute bringing to the table?
Why CABR, and why Rochester? We’ve already alluded to this to some degree, but there’s a strong case for heritage. As the birthplace of the BPS model, Rochester has developed a unique culture that integrates humanism into clinical care and research and aims to ensure health, dignity, and quality of life across the lifespan. The model—and the scientific context it provided—also gave rise to other major models, theories, and fields, including psychoneuroimmunology, founded by Robert Ader, a professor emeritus of psychiatry at the URMC; self-determination theory, founded by Edward Deci, the University’s Helen F. and Fred H. Gowen Professor in the Social Sciences and Richard Ryan, a clinical psychologist and professor of clinical and social sciences in psychology; and the field of geriatric medicine, pioneered by T. Franklin Williams and William Hall, professors emeriti of medicine at the URMC.
The tradition of care and research the BPS model helped establish has only grown richer, with Rochester gaining global renown in palliative care, geriatric oncology, social determinants of health, and emotional well-being.
Finally, Rochester has several active nationally and internationally recognized research programs that would support the new center. These are:
- Applied bioethics
- Applied self-determination theory
- Health applications of AI and machine learning
- Caregiver stress and support
- Communication and mindfulness in medicine
- Emotional well-being
- Geriatric oncology
- Neuropalliative care
- Neurophysiology and neurodevelopmental effects of stress
- Palliative care
Reputation. Reputation. Reputation.
How will the success of the institute enhance Rochester’s prominence and prestige?
The BPS model is broadly known inside the University and within select research circles outside it. Furthermore, Rochester has many prominent faculty members who are actively contributing to this work. The CABR has identified an opportunity for Rochester to use its existing clout in this area to fill a “gap.”
Despite the widespread acceptance of BPS concepts, no institutions of comparable prominence to Rochester have centers or institutes like the one the CABR team has proposed. Establishing this center would immediately make the University a leading institution in accelerating transformative BPS research, further positioning Rochester to attract and retain faculty with interests in this field.
Lastly, critiques of the BPS model have threatened to erode its relevance over the years. With a focused scholarly infrastructure (e.g., visiting professors, thematic retreats, white papers), this center would be poised to define the evolution of this model, integrate emerging technologies and ideas, empirically test core assumptions, and make Rochester a prominent thought leader in this area.
The final pitch
Speaking for the team, Benzi says there probably isn’t a better place in the world than Rochester for this center, and not just because the BPS model was born here. He highlights that the University’s culture creates a palpable blending of humanism and science. However, he also points to current care models where people are effectively reduced to the sum of their genes and health care delivery becomes an assembly line for efficiency, a trend his friend, Ray Dorsey, the David M. Levy Professor of Neurology at Rochester, calls the “McDonaldization” of medicine. It’s a reality Benzi was reminded of as he was struggling through an insurance issue for a patient with ALS.
“There’s a strong business presence in medicine that was not as obvious in 1977,” says Benzi, referencing industry changes since the BPS model was created. “A big part of the biopsychosocial model is emphasizing the soul of care and creating a bridge between strong science and humanistic values.”
Benzi sees the proposed center as an opportunity to take advantage of the biomedical model’s primary weakness: it’s predominantly valueless. “It’s simply materialism,” he says. “Without being very intentional about the goals of medicine and the underlying philosophy and creating a base of evidence to support this work and establish policies, we end up with patients not being seen as people. We end up with more of the same. More McMedicine.”
