In July, Dr. Vanessa E. Cullins became AVSC's new vice president and medical director.

Dr. Cullins has an extensive clinical background and experience in reproductive health care, quality assurance, working with adolescents, and team management. During the last 10 years, she has worked simultaneously as an attending staff physician in the ob/gyn department of The Johns Hopkins Bayview Medical Center, an assistant professor in the ob/gyn department at The Johns Hopkins University School of Medicine, and acting director of the Bureau of Adolescent Reproductive and Women's Health for the Baltimore City Health Department.

In addition to her medical and public health degrees, Dr. Cullins comes to AVSC having recently completed a master's degree in business at the Wharton School's Executive MBA Program.

Q: What are some of the things that attracted you to AVSC?

Dr. Cullins: I am very excited by AVSC's expanded mission, which deals with issues of the well-being of the couple, family, and individual as they relate to family planning and reproductive health. AVSC's approach is based on a philosophy of clients' rights, and of staff empowerment to make decisions to ensure the preservation of those rights.

I believe that proactive, preventive reproductive health services will thrive only if clients' needs and rights are attended to. AVSC's use of problem-solving techniques that are systematic and initiated at the delivery site will help clients get their needs met.

Clients make different decisions at different points in their lives. And they don't make decisions in a vacuum; they take their loved ones into account. So, when asking clients questions and providing information, service providers and counselors need to acknowledge the clients' present and future reproductive intentions and personal circumstances. AVSC's efforts in counseling and informed choice are right on track with what I have always emphasized in my own work.

AVSC's quality-improvement approaches--COPE, whole-site training, and facilitative supervision--are the most advanced and easy-to-use I've seen in a health care context. AVSC is unique in that it knows how to operationalize a sustainable quality-improvement system. I am attracted to this competitive advantage.

Q: How will you use your expertise to manage a global medical program?

Dr. Cullins: I see this position truly as a management job, one that involves coordinating and collaborating with other people and programs. I'm not the type of person to toot my own horn, and I plan to work through others.

AVSC doesn't go into a country and do everything for the people there--we help identify provider and delivery-site needs, teach on the basis of those needs, facilitate the acquisition of resources, and support efforts to achieve institutional self-sufficiency. I see the way that AVSC works in the field as consistent with the way it manages itself here at home. I am very impressed by that. The agency restructured recently into a team-based environment and is incorporating continuous quality improvement into its daily work. By building on lessons learned, AVSC is helping systems run more effectively throughout the organization.

Q: What upcoming developments in medical technology do you foresee having an impact on AVSC's work?

Dr. Cullins: Research is currently being done on microbicides, medications that can kill or inhibit sexually transmitted viruses, such as HIV. Two types are being developed--one that kills viruses but not sperm so that the user can still conceive, and one that kills sperm, too, to protect against pregnancy.

Advances are being made in diagnostic testing techniques for sexually transmitted infections (STIs) that will likely have widespread implications for health care. Rather than having to go to a service provider or lab, a client may, in the near future, be able to take a color-indicator test at home, similar to the way that women can now test for pregnancy.

Giving clients the means to take control over their own health is vital in a preventive health field such as reproductive health. These developments should help us move further in client-centered care.

Karen Landovitz is an editor and writer at AVSC.