Memphis Medical News March 2014 by FW Publishing

FOCUS TOPICS NEUROLOGY/STROKE HEALTHCARE DESIGN/CONSTRUCTION

March 2014 December 2009 >> $5

PHYSICIAN SPOTLIGHT PAGE 3

Jason Weaver, MD ON ROUNDS Healthcare Leader: Mitch Graves President, CEO, Health Choice, LLC

MEMPHIS on the MEND BY PAMELA HARRIS

Hope House: Refuge and Resources for HIV/AIDS Families Nothing is more precious than the innocent faces of children. I recently encountered three such faces sitting across from me at a toddler table during their afternoon snack time at Hope House ... 5

‘Clock Is Ticking’ On SGR Repeal

Deadline to overturn ﬂawed reimbursement system is March 31 By EMILy ADAMS KEPLINGER

Memphis-area physicians, like others across the country, are anxiously waiting to see what happens with the proposed Sustainable Growth Rate Repeal and Medicare Provider Payment Modernization Act. For some doctors, it may dictate whether they have a future in private practice. For all doctors, it will affect their practice of medicine, in one way or another. In 1997, when the Sustainable Growth Rate (SGR) was originally formulated and approved, it was intended to give the federal government an equation by which it could control what was paid to doctors who treated Medicare patients. Jerome Thompson, MD, a pediatric ENT surgeon on the faculty at the University of Tennessee Health Science Center, also holds an MBA degree in economics from UCLA. His background in both medicine and economics gives him insights into the pending ramifications of the SGR repeal being enacted – or not. “The formula was supposed to include an annual increase in Medicare expenses,” Thompson said. “But there was a caveat that the (CONTINUED ON PAGE 16)

City’s Healthcare Construction Booming

Memphis institutions renovating, updating, innovating Baptist Cancer Center

By GINGER PORTER

In order to maintain Memphis’ status as a premier medical community, the city’s hospitals, medical education centers and physician practices are spending millions of dollars to excavate, renovate, update and innovate. Recurring themes are surgery centers, rehabilitation centers and emergency department upgrades. Methodist University Hospital is constructing a (CONTINUED ON PAGE 8)

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PhysicianSpotlight

Jason Weaver, MD

After widely traveled youth, doctor ﬁnds a home, and a calling in Memphis By RON COBB

Growing up in a military family, Jason Weaver lived all over the country depending on where his father, an Air Force pilot, was stationed. The youngster was a rolling stone who gathered no moss. Yet once he came to the University of Tennessee Health Science Center (UTHSC) for his internship in general surgery, his wandering days were over. The doctor put down roots that have firmly taken hold. Weaver completed his residency at the UT Department of Neurosurgery and at the Semmes-Murphey Clinic in 2007, and upon graduation he joined the staff at Semmes-Murphey, where he has been ever since. The doctor found a home in Memphis. His only venture elsewhere was to complete a clinical fellowship in spine oncology and neuro-oncology at the MD Anderson Cancer Center in Houston. “Memphis is a tremendous medical community,” Weaver said. “I have been blessed to train at the premier cancer center in the country, (but) I can honestly say that the oncology community here offers just as cutting edge, compassionate care. It is a rare circumstance that we would feel the need to send a patient to a large cancer center because they will get just as good, if not better, care here.” Upon retiring from the military, his father became chief of staff for the Omaha City Council, and Weaver stayed put in Nebraska long enough to take a strong liking to Cornhuskers football. He then matriculated at Drury University in Springfield, Missouri, and, for medical school, at St. Louis University. His interest in medicine had arisen while he was in high school, when a family member had a ruptured cerebral aneurysm. “I remember becoming very interested in neurosurgery at that time,” Weaver said. “Shortly thereafter, I read a book by Ben Carson called ‘Gifted Hands,’ and that further sparked my interest in the specialty. “In early medical school I was somewhat undecided, but I had a great mentor who happened to be a neurosurgeon. He encouraged me greatly and in fact introduced me to Semmes-Murphey Clinic and the University of Tennessee, where I was blessed to do my training.” Weaver’s interest in spinal oncology evolved as his training continued. At UTHSC, he said, interns are exposed to a wide variety of neurosurgical subspecialties. “Memphis has some of the best oncologists in the country,” he said, “who are making tremendous strides in cancer therapies. Because patients are living longer and better despite the diagnosis of memphismedicalnews

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cancer, there is tremendous opportunity to take a comprehensive approach in the management of brain and spine tumors. “That concept really hit me when Dr. Laurence Rhines, a neurosurgeon at MD Anderson specializing in complex spine tumor surgery, presented a talk on the oncologic resection of spinal column tumors here in Memphis. I was so captivated by his approach – that is, thinking more like an oncologist than a surgeon in the patient’s management – that I signed on to do a fellowship at MD Anderson.” Besides neurosurgical oncology, Weaver has a busy general neurosurgery practice, including spinal surgery and outpatient minimally invasive procedures. When asked to name his proudest accomplishment so far, he said, “It’s not about me,” and quoted a passage from Colossians. “Whatever you do, do your work heartily, as for the Lord rather than for men. . . . It is the Lord Christ whom you serve.” “My goal,” he added, “although I readily admit I fall short every day, is to work like it all depends on me and pray like it all depends on God.” Weaver’s rewards come from “those small victories that we see every day,” he said. “Also, I get a lot of satisfaction when former residents call me to tell me of a difficult tumor case that they were successful

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within their management. It is gratifying to know that you have trained someone to go out and apply a technique they learned from you and to hear their excitement in bringing a new technique to their community.” Weaver said that when he earned his medical degree in 2001, Semmes-Murphey was at the top of his list of training programs. The clinic recently celebrated its 100th anniversary. “I stayed because of the tremendous mentors I have in those who are now my partners,” he said. “There is a reputation for excellence in the medical community that extends beyond just Memphis. Associating with those who have been and continue to be leaders in medicine, neurosurgery, the community is truly an honor. Some of them are gone, but many I still learn from every day.” Weaver finds encouragement in the advances made over the past decade in fighting cancer. “Radiosurgery with tools such as Cyberknife® and Gammaknife® and other image-guided radiotherapy technologies allow for the pin-point accurate delivery of radiation to a tumor in the brain or along the spine,” he said. “This allows us

to deliver a tumor-killing dose of radiation while sparing the very sensitive surrounding normal neural tissues. “The tumor control rates and pain improvement effects have been tremendous. Oftentimes we will use this strategy alone or in combination with surgery to achieve optimal results. The surgical technique has also improved dramatically in the last decade with intra-operative imageguided surgery for brain and spine as well as all the complex spinal instrumentation. “Minimally invasive spine surgery has also come to the forefront in tumor management. Many don’t realize that minimally invasive spinal surgery was pioneered by my partners at Semmes-Murphey right here in Memphis.” Weaver has been married since 2003 to Virginia “Jenny” Weaver, MD, a bariatric surgeon and medical director of the Saint Francis Center for Surgical Weight Loss. They met on Weaver’s first day of an internship at The MED, where Jenny was chief resident of general surgery. “We started dating a few months later,” he said. “My fellow interns wondered why I got all the good vacations that year.”

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MARCH 2014

Hey Doc, Wake Up Better By TIM NICHOLSON

It’s easier than ever for someone to give his or her two-cents-worth. In 140 characters you can say whatever you want about almost anything to just about everyone. But hey, times have changed and the cost of an idea is a little higher than it used to be. So if you’re going to say it, make it count. And so we will. Sleep. That’s it. Sleep. Okay if you want your 99-cents-worth, the Sleep Cycle Alarm Clock App for your iPhone or Android phone. What does an alarm clock have to do with what we write about here? Well, this particular idea involves you, your patient community, your use of social media and mobile. We talk about those things here every month. But this time, instead of talking about it we’re going to do something together. The wellness benefits of a good night’s sleep are well documented and so no matter your specialty, there’s an application for your use of this app and a health benefit to be realized by you and your patient.

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MARCH 2014

Practice Family Medicine? When you’re sleep deprived, you often feel “worn down” – and that’s a clue that your body is vulnerable to infection. “Not getting enough sleep makes you more vulnerable to picking up illnesses and not being able to fight them off,” said Donna Arand, PhD, DABSM, clinical director of the Kettering Sleep Disorders Center in Dayton, Ohio. Can’t convince yourself or your patient that one or the other isn’t getting enough sleep? Let the app help. Cardiology your area of expertise? Then you know the story. But does your patient? Former President Bill Clinton confessed that he thinks lack of sleep had a lot to do with his hospitalization to unblock a clogged artery (okay, maybe the Big Macs were part of it too, but he’s on to something) “I didn’t sleep much for a month, that probably accelerated what was already going on,” Clinton said. He’s probably right. “When you don’t get enough sleep, you have an inflammatory response in your cardiovascular system – in the blood vessels and arteries – and that’s not a good thing!” said Arand. “We see the same thing in hypertension. If that sleep deprivation continues long term, chronic inflammation has been linked to things like heart attack, stroke, and diabetes.” In the Mid-South and Delta Region we’re all aware of the diabetes, okay I’ll say it, epidemic. The key underlying problem in Type 2 Diabetes is insulin re-

sistance, where the body does not make proper use of this sugar-processing hormone. Guess what? When you’re sleep deprived, your body almost immediately develops conditions that resemble the insulin resistance of diabetes. And it’s not just in those we can spot walking down the street. “In one study of young, healthy adult males, they decreased their sleep time to about four hours per night for six nights,” says Arand. “At the end of those six nights, every one of those healthy young men was showing impaired glucose tolerance, a precursor to developing diabetes.” Another study found that people in their late 20s and early 30s who slept less than 6.5 hours per night had the insulin sensitivity of someone more than 60 years old. So, what’s this got to do with the app? Many of us lack the discipline to do even the simplest things to improve our health. But a recent survey found that 9 out of 10 smartphone owners wake up with their smartphone. Maybe we can use that information do something powerful. You, your patients, our friends, and me are invited to participate in our Wake Up Better Y’all experiment. It’s not necessarily scientific but certainly a fun and well-intentioned effort to see if what we do here together can be good for us. Besides, one of the main features of the app is to wake you up at the right time. Not just the time you set the alarm for but in your lightest sleep phase. When that happens you’re more likely to awake renewed and on the ‘right side of the bed.’ And everyone around us will appreciate that. For more information on the Wake Up Better Y’all experiment and the Sleep Cycle App visit http://www.wakeupbetteryall. com or hit me up on twitter. Hat tip to the good people at webMD and Donna Arand, PhD, DABSM, clinical director of the Kettering Sleep Disorders Center in Dayton, Ohio. Tim C. Nicholson is the President of Bigfish, LLC. His Memphis-based firm connects physicians, clinics and hospitals to patients and one another through healthcare social media solutions, branding initiatives and websites. His column, “Hey Doc”, appears here monthly. Find him on twitter @timbigfish or email tim@gobigfishgo.com

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Hope House: Refuge and Resources for HIV/AIDS Families MEMPHIS on the MEND BY PAMELA HARRIS

Nothing is more precious than the innocent faces of children. I recently encountered three such faces sitting across from me at a toddler table during their afternoon snack time at Hope House. I tried to get smiles from Angel, T.J. and Christopher, with my own silly faces and smiles, but they were unimpressed with my efforts. Or maybe they were still sleepy from their nap. Regardless, as I looked into their faces, I couldn’t help but wonder what their lives were like and how often they really do smile. A tour of Hope House and conversation with its dedicated director, Elizabeth Dupont, EdD, gave me some insight into the lives of these children. Because while HIV is not a class-specific disease, it tends to be more prevalent among impoverished individuals -- and with that comes a life exposed to more violence, substance abuse and hunger.

Hope House in Memphis is one of only seven of its kind… in the world. It is a comprehensive social services organization devoted to effectively serving the needs of those infected and affected by HIV/ AIDS. Their mission is, “To improve the quality of life of HIV-impacted children and their families by addressing their educational, social, psychological and health From left, Angel, T. J. and Christopher with their teacher, Katie Pohlman. needs.” of Young Children) accredited program. Founded in 1995 by the Junior League They get two meals (breakfast and lunch) of Memphis, Hope House was launched and a stable environment to learn and as a day care for children affected by the grow. There is also “Play Therapy” to asHIV/AIDS virus. Today, the day care sist children who have been traumatized. has grown from five children to 18 chilPlay Therapy helps them express emotions dren with three teachers and a bus driver. and vent aggressions. They also have a licensed pediatric nurse Hope House also takes care of many on hand for emergencies and to make sure adults – some of whom are parents of the that all medication schedules are met. day care children there. There are classes Angel, T.J. and Christopher are in on parenting, finance, health and nutrithe Hope House day care/early childtion, social and language skills that may hood education program for children from help them get better employment, violence six weeks to five years. It is a NAEYC prevention and more. There are also sup(National Association for the Education

port groups, emergency financial assistance, and healthcare coordination. The full list of programs and services is on their website, www.hopehousememphis.org.

Community Outreach

Part of the mission of Hope House is to educate our community on HIV/AIDS. In spite of the fact that HIV/AIDS is more than 30 years old, there are still misconceptions about the disease and how it is spread. Even though this is a medical audience, there may be some of us who need this short refresher: • HIV is NOT spread through touch, tears, sweat or saliva. In addition, you cannot get HIV/AIDS by: • Breathing the same air as someone who is infected • Touching a toilet seat or doorknob • Drinking from a water fountain • Hugging, kissing or shaking hands with someone who is HIV positive (CONTINUED ON PAGE 16)

It’s not what we treat, it’s who.

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MARCH 2014

Do You Have Patients Who Would Benefit From Hyperbaric Oxygen Therapy (HBO)? Many healing actions could be greatly accelerated by by breathing 100% oxygen while under pressure. HBO is considered an important adjunctive therapy for a number of chronic conditions including: • Diabetic wounds • Preservation of damaged or injured tissue • Chronic osteomylitis • Radiation necrosis of bone and soft tissue • Vascular insufﬁciency ulcers Your wound care patients will include those with: • Diabetic wounds • Vascular insufﬁciency ulcers • Non-healing traumatic wounds • Non-healing surgical sites • Chronic non-healing wounds The Delta Hyperbaric & Wound Care Center is one of very few in the Memphis area! We have a team of dedicated and caring professionals who have advanced training in the treatment of hard to heal wounds and we offer a team management approach. The referring or primary care physician is responsible for the patient’s general medical management.

To request a hyperbaric or wound care consult, call us at 901-369-8645. www.DeltaMedicalCenter.com 6

MARCH 2014

by Bill Appling

Brain-Storming, a “Mental Explosion” Around the 1890’s, brain-storming was a medical term for “mental explosion.” Brain-storming seems to be almost a contradiction in terms since the brain is associated with intelligence and thought while the word “storm” conjures up images of total chaos. And yet brain-storming came to mean a new and, usually. a very creative idea. In 1953, advertising executive, Alex Osborn, described brainstorming in his book, “Applied Imagination” as having four key components: • Focusing on the quantity of ideas • Withholding criticism • Welcoming unusual ideas • Combining and improving ideas • According to experts, the challenge with brain-storming is that it doesn’t work very well. “Decades of research have consistently shown that brain-storming groups think of far fewer ideas than the same number of people who work alone and then later pool their ideas,” says Keith Sawyer, a psychologist at Washington University. “Brain-storming is dead and alternative thinking is here,” he’s quoted as saying in the MGMA, Connection Magazine from Nov/Dec 2013. Many caregivers and physicians shy away from techniques that could take them out of their comfort zone. With this in mind, the following three techniques are viable alternatives for generating fresh group ideas in the healthcare setting: • Kill a stupid rule • Use a different lens • Incorporate blockers This article states that according to Lisa Bodell, the founder of Futurethink, an innovation and foresight firm in New York, to implement the “kill a stupid rule” tool, employees gathered into two or three person teams and then, “If you could kill or change all the rules that get in the way of better serving your customers or just doing your job, what would they be and how would you do it?” After 10 to 20 minutes of exchange, everyone is asked to write their favorite stupid rule on sticky note and then place their rules on a white board grid that has two axes: Y is ease of implementation and X is degree of impact. The group then picks a few easy-to-implement, high-impact rules to kill on the spot. A medical group stumbled upon a slight variation of kill a stupid rule. It began when team distributed a short employee survey asking about experiences with the organization and recommendations for improvement. The survey was originally meant to serve as input for operational planning. What they got back was a list of “things they hate.” Rather than disregard the negative response as sour grapes they identified frustration patterns and selected a few quick wins for implementation. Implementing these quick wins has contributed to a culture that encourages staff to speak up and increases the

perception that they have been heard. A second approach to generating ideas is to view the problem through different lens. One approach is to use role-playing. Some say that role-play helps increase participation in individuals who have a fear of speaking up and challenging opinions. A third approach to generating ideas expands on role-playing by incorporating a blocker, a voice of dissent, to help generate ideas and prevent “groupthink” -- a phenomenon that occurs when a group wishing to stay harmonious produces poor decision-making results. Groupthink is often cited as playing a key role in the Challenger space shuttle explosion of 1986. Engineers knew about faulty parts months before takeoff but feared negative press, so they pushed ahead with the launch. The Citrin Group, an Alabama-based investment advisory, uses the blocker to disagree with their top executive team on every key issue. This process results in deeper conversation and multiple perspectives instead of a room full of agreement, according to Josh Linkner in his book Disciplined Dreaming. We have multiple challenges in our industry, and although brainstorming is commonly used it is not the silver bullet to problem- solving. We must consider viable alternatives to generate better solutions. By incorporating kill a stupid rule, viewing issues from a different lens and using blockers, we may be able to stimulate ideas that will better address our problems. Also, we must be cognizant of group settings to maximize participation and idea generation, according to the Connection Magazine article. One last thing on a different subject: Affordable Health Care. Could someone please tell me where they are hiding the affordable part? As you know, most lab work that comes from a physician’s office is required to be sent out to a reference lab per most all insurance companies. Recently I had some lab work ordered by my physician and of course, it had to be sent out to a reference lab. I had a new insurance company, but my previous insurance company was billed. I received a bill from the lab telling me I was not insured under the insurance plan submitted, so I was personally responsible. Now, I do not have a problem paying my bills, but this bill was $1,222.55. I called the billing office of this lab and gave them the correct information so they could re-bill with the correct insurance company. I received a new bill for $213.39. I was pleased but it made me think. Affordable? To whom? Why the insurance company, of course. Bill Appling, FACMPE, ACHE, is founder and president of J William Appling, LLC. He is a national speaker, presenter and a published author. He serves as an adjunct professor at the University of Memphis and is on the boards of Hope House and Life Blood. For more information contact Bill at j.william.appling@ outlook.com.

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MARCH 2014

City’s Healthcare Construction Booming, continued from page 1

Are You Currently Being Treated for

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You may qualify to participate if you: ✓ Are between 18 and 65 ✓ Have been diagnosed with a relapsing remitting form of MS ✓ Are naïve to treatment or have been treated with no more than one class of disease modifying therapy (DMT) Qualiﬁed participants will receive study-related exams and study medication at no cost. Call today to see if you may qualify: Lee Stein, M.D. Principal Investigator Neurology Clinic, P.C. 8000 Centerview Pkwy, Suite 300 Cordova, TN 38018 Ph: 901-848-7411 email: research@neuroclinic.org 8

MARCH 2014

new emergency department and moving its main entrance from Eastmoreland to Bellevue. The emergency department will include underground ambulance parking and a new entrance on Bellevue. Scheduled to be completed in July, the emergency area employs a new design. “This will be the first inner-core model ED in the state of Tennessee,” said Dave Rosenbaum, vice president, corporate facilities management, Methodist Le Bonheur Health Care. “All the medical care is centrally located in the inner area of the ED, surrounded by outer bays and corridors, so the patient and family are adjacent to the nurses’ station where all the critical medical activity is.” The model provides for a smaller waiting room and more efficient triage so that patients are sent quickly to the exam room. A call system similar to those in restaurants will alert family when a patient’s procedure is done. Methodist is also completing an expansion and renovation of the emergency department at its Germantown location, adding approximately 3,000 square feet and six exam rooms. Downtown, Methodist Le Bonheur is taking down an existing parking deck and putting a physician office building in its place. An existing building originally constructed in the 1990s to house physician offices now houses outpatient clinics, so physicians are scattered throughout the campus. Building on the new parking garage has begun and the physician building should be done in spring or summer of 2015. Baptist is constructing Baptist Cancer Center, in excess of 150,000 square feet and scheduled to be completed in autumn of 2015. “The Baptist Cancer Center will be the first integrated center in the Mid-South area,” said Zach Chandler, vice president of metro-Memphis market for Baptist Memorial Health Care. “It gives more convenient access to outpatient cancer services. Our goal is for the center to become a regional resource for cancer patients and their families.” The $84 million facility will have diagnostics, radiation oncology, chemotherapy/ infusion, cyberknife, physician offices, a stem cell transplant center, support services, survivorship care and the adjacent Women’s Health Center (diagnostic and screening mammography) and multidisciplinary clinics. Baptist is also building a 49-bed rehabilitation hospital at the corner of Wolf River Boulevard and Germantown Parkway. It will contain all private rooms and a dedicated stroke unit, an activity of daily living space, a mobility courtyard and a therapy gym. It should be completed late this year and will serve patients recovering from complex neurological conditions, strokes, brain and spinal cord injuries, complex orthopedic injuries, amputations and other conditions. Also scheduled to be completed late this year is Baptist’s pediatric emergency

department relocation. The $14 million project moves the department to the Baptist Women’s Hospital, which Baptist officials say their affiliated pediatricians have been requesting for years. The move will mean an expansion from five to eight exam rooms and the addition of outpatient pediatric diagnostics, including an MRI with pediatric anesthesia available. “A new service Baptist will be offering is the Pediatric Eye Center, the area’s first comprehensive eye center for babies and children. This is an important service, particularly for premature babies, who often have trouble with their eyes,” Chandler said. The newly named Regional Medical Center, formerly The MED, just finished three floors in Turner Tower with three different functions: a new outpatient surgery center, an updated long-term acute care hospital and a relocated rehabilitation hospital. In addition, the burn center receives another dedicated operating suite and a cosmetic upgrade to match the rest of the building. The relocation of the rehabilitation hospital from the Adams Building will allow for an expansion of medical areas and all private patient rooms. The outpatient surgery center brings a new service to the Regional Medical Center, said Angie Golding, director, corporate strategic communications. “We are glad to have all these services on board in an attractive, convenient and accessible location,” she said. “And all those areas where we are spending money now should drive revenue later.” Delta Medical Center just completed renovation to surgical suites, behavioral health units and an expansion of its emergency department. The emergency department was enlarged by 1,500 square feet for better traffic. “It was essentially to fast track and expedite customer service. The way it was designed in the past just did not have space to effectively triage patients and get them into the ER as quickly as possible,” said Bill Patterson, chief executive officer, Delta Medical Center. The behavioral unit renovation meant updating cosmetic features and bathrooms and bringing “major updates” to safety systems to make them current with modern standards. The infrastructure and technology of the surgery suites was updated to allow for more orthopedic procedures. Campbell Clinic has purchased a property in the medical center and renovated it to become another Campbell surgery center, opening in just a couple of weeks. “The facility should be able to manage 50 patients per day when operational,” said Cindy Armistead, Campbell surgery center administrator. “This will double Campbell Clinic’s existing outpatient surgery capacity, providing patients in the western half of the Mid-South with an additional, convenient option for outpatient orthopedic surgery.” The center, on Pauline Street, has four full-size operating rooms, six pre-op (CONTINUED ON PAGE 12)

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PROMPT AND PERSONAL – IT’S HOW REGIONS KEEPS THE WHEELS OF PROGRESS TURNING FOR SMALL BUSINESS. Dr. Susana Leal-Khouri

began her relationship with Regions in 1996 at the suggestion of her personal accountant. She was just starting her private practice, the Miami Dermatology Center, and needed to furnish the offices. “Regions has been very helpful in allowing us to be able to start and grow the practice. They’ve also helped make it possible for us to hire the right people,” says Dr. Leal-Khouri.

“Regions is always there when I have questions. My relationship with my Regions banker is personal and I have her on my speed dial.” What started as a single location has grown to three with a full-time staff of 17 employees. These days, the Miami Dermatology Center utilizes a wide range of Regions banking tools, from Business Analyzed Checking and Treasury Management to loans and lines of credit. Dr. Leal-Khouri plans to expand parking at her Coral Gables location, and Regions is part of those plans too. To learn more about the Miami Dermatology Center and how Regions can assist your business, visit regions.com/success.

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MARCH 2014

Regional One Health Opens $9 Million Surgery Center New center hopes to attract physicians as it expands services By AMY FRENCH

The success of the new Regional One Health outpatient surgery center – and to an extent the newly renamed Regional One Health system – will hinge on whether it can attract business through area physicians and keep them happy. If Dr. Michael Van Vliet’s impressions are any indication, the surgery center is off to a solid start. Van Vliet was one of the first surgeons to try the $9-million center, which opened in December and has three operating rooms available. A fourth is available to equip when demand grows. The center occupies roughly 18,000 square feet of previously undeveloped space attached to the Regional Medical Center in downtown Memphis, commonly known as The MED. “Now that I’ve used this surgery center, I will not go to any other,” said Van Vliet, who is also director of critical care for Firefighters Regional Burn Center, which is also attached to The MED. “I would operate there every day if I could.” The surgery center is a key component in a strategy to boost awareness of MED-affiliated services beyond acute care; branding research has shown that much of the community is unaware of outpatient and long-term care offerings.

MARCH 2014

Jana Jones, surgery center administrator, with the new center in the background.

To emphasize the overall organization’s multi-faceted appeal, leaders last month announced a new name for the system: Regional One Health. Outpatient surgery is not a new service for Regional One. In the past, physicians who partner with the system to staff its outpatient clinics have scheduled both inpatient and outpatient surgeries in a central surgical unit. The new outpatient surgery center is taking over the outpatient operations and is technically a hospital outpatient

department. That means the center can call upon MED-based specialists and resources whenever needed. But the surgery runs on the model of a freestanding ambulatory surgery center. That means surgeons across the community who get credentials are able to use it as an extension of their practices – with the center’s anesthesiologist and staff of nurses, surgical technicians and business personnel to support them. “Our folks get to know these surgeons and their preferences, and they’re just on

it,” said surgery center administrator Jana Jones. “They’re able to schedule surgeries back-to-back with very little turnaround time, which doctors love because their time is so valuable.” The surgery center can handle cosmetic and reconstructive, orthopedic, ENT, gynecologic, urologic and general surgeries. Leaders expect to add neurology and possibly oral surgery soon and have set a goal of 1,100 surgeries in the first year. After 30 operations, Van Vliet, who specializes in cosmetic and reconstructive surgery, said the center had exceeded his expectations. “I think the number one thing is that the patients are treated exceptionally well, with great service and excellent outcomes,” he said. “It really has a RitzCarlton sort of approach. There’s top-ofthe-line technology, and everything runs efficiently and on schedule -- like a wellorchestrated symphony, a well-oiled machine.” Snazzy features include advanced Lumenis lasers, customizable operating rooms and a large-screen monitor in the waiting room on which patients’ loved ones can follow their progress. Amenities also include free parking, Wi-Fi and easy access to laboratory and pharmacy (CONTINUED ON PAGE 12)

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A Look at the State’s CON Program By CINDY SANDERS

Last year, members of the 108th Regular Session of the Tennessee Legislature voted unanimously to extend the life of the Health Services and Development Agency through June 30, 2017. This action ensured the state’s certificate of need (CON) program would continue, uninterrupted, into its 44th year.

History of Tennessee’s Program

Melanie M. Hill, executive director for the Tennessee HSDA, noted the state has relied on a CON program to drive the orderly creation and expansion of health facilities and services since 1973, a year prior to a federal mandate for such programs. In Tennessee, the Health Facilities Commission administered the CON program until 2002 and was the predecessor to the current agency. Hill joined the Health Facilities Commission in 1998 and was named to the director’s post in 2001. The following year, the Tennessee Legislature passed the Health Services and Planning Act of 2002, which created HSDA. “Our sole responsibility is the certificate of need program and related activities,” Hill said, adding that includes providing technical assistance and collecting data on certain medical equipment including MRIs, PET scanners, CT scanners and linear accelerators, among others. “There is a requirement in the statute that the equipment be registered with the agency and that owners report usage data annually.” After establishing CON programs nationwide through the 1974 National Health Planning and Resources Development Act, the law was repealed in 1987, eliminating federal funding assistance for state planning offices. However, CON programs remain in place across much of the country. “There are 36 states plus the District of Columbia that have certificate of need programs,” Hill stated. She added each state is different with some having more stringent requirements than others. According to the American Health Planning Association’s website, there are 30 coverage areas for which state programs might choose to require a CON. On one end of the spectrum, Vermont requires an application be made for all 30 of those options from acute hospital beds and air ambulances to medical office buildings and ultrasound. On the opposite end of the spectrum, Ohio requires an approved CON only when adding skilled nursing/ long-term care beds for projects exceeding $2 million in cost. With 20 service and equipment areas covered by CON regulations, Tennessee falls a little right of the middle.

When you need it.

Application Trends

The economy and uncertainty over the Affordable Care Act have impacted the number of CON applications being filed in the state. Hill said, “We used to average 100-120 applications annually.” Now, she continued, “We’re probably looking more in the range of five full applications a month.” She added, “In 2008, we dropped from 121 applications to 56 in 2009.” After rebounding slightly to 62 CON applications in 2012, the number dipped down to 51 last year.

Gaining Approval for a CON

At the heart of the approval process is the need to meet three criteria: • Answering a healthcare need, • Proving a plan is economically feasible, and • Showing how the plan contributes to the orderly development of adequate and effective healthcare facilities and services. Actually, Hill noted, “Most applications are approved. It’s a fairly strenuous process so you really have to have your information together by the time you file.” Prior to filing an application, Hill said her agency could provide technical assistance to help navigate the process, important background information regarding utilization for those considering adding equipment or services, and insight into needs outlined in the state health plan. Although applications are assessed against the state health plan, which outlines the numbers that would indicate a community might need to add a facility or service line, Hill was quick to add there are valid reasons to override those numbers … or lack thereof. “That’s why it is guidance and not set in stone,” she said of the health plan. Hill added, “I hope we’re never strictly ‘just numbers.’ There are certainly circumstances in each community that are unique to that community.” For example, she said population figures alone might not warrant the addition of a second MRI in a community. However, she continued, if the owner of the current MRI doesn’t accept many insurance plans, or doesn’t participate in TennCare, or has excessive wait times for appointments, then circumstances could demonstrate a need for a second MRI operator in that area. Hill added the monthly CON meetings are open and transparent … and highly participatory. She said those for and against an application are welcome to come to the meeting and are given an opportunity to speak. She added that when an application is controversial, her team has even held town hall meetings to allow residents to voice concerns. She noted this extra step

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The MED Opens New $9-Million Surgery Center, continued from page 10 services, as well as access to a physicians’ lounge with a gym and conference room. Flash back to a few years ago, and it’s hard to imagine a MED-affiliated facility being likened to a swanky hotel. The expertise and care available through the system were widely regarded as top-notch, even unparalleled in the MidSouth, particularly in the areas of burn treatment, neonatal care and trauma care. But a large percentage of patients were insured through Medicaid or not at all. That helped to foster a perception that outside of the MED’s famed centers of excellence, its services were only for

people who couldn’t afford better. “When I got here, the perception was if you have a bad accident, go to the MED, but as soon as you’re stable, get transferred to Methodist or Baptist,” said Reginald Coopwood, MD, who took over as system CEO four years ago. “That was kind of a community unDr. Reginald derstanding.” Coopwood Coopwood sought to change perception and improve his organization’s financial outlook with “a serious focus

on the patient experience” at every level. Examples: • The hospital did not have private rooms. All rooms are now private, including those in the long-term rehab facility and long-term acute care facility. • Waiting areas weren’t comfortable for overnight stays. Now, updated features for patients’ loved ones include reclining chairs, shower areas and Wi-Fi Internet access. • Support staff didn’t always win praise as friendly or accommodating. Now, staff is trained on service-oriented expectations and held accountable if those

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MARCH 2014

expectations are not met. • Patient evaluations of service have improved drastically, Coopwood said. Also, he said, it has become rare for patients exiting critical care to transfer into competing facilities for long-term care. That’s progress. Building a clientele for the outpatient surgery center is part of the next phase. To broaden and diversify Regional One’s patient base, it’s important for physicians and healthcare consumers who haven’t looked to Regional One in the past to give it a try. “That is exactly where we are right now,” Jana Jones said. “We are trying to fill up this surgery center, and we would love to have interested doctors from outside The MED come and use the facility. It’s a beautiful facility.”

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bays, nine post-anesthesia care unit bays with an additional two beds in a pediatric recovery area. There is one sitting room and two overnight rooms. The new facility will improve access for patients from downtown, midtown, eastern Arkansas, Millington and Southaven, joining the Brierbrook Campbell Surgery Center, serving patients out east since 2002. The University of Tennessee Health Science Center (UTHSC) has been putting hundreds of millions of dollars into a five-year, multi-facet campus overhaul that began in 2012. The main features of phase one include completion of the pharmacy building, complete renovation of the library, some general capital improvements and construction of a translational research building and a cancer research building. The price tag is approximately $250 million for this phase. “In the science world, it is very hard to recruit funded investigators,” said Kennard Brown, JD, MPA, PhD, FACHE, executive vice chancellor and chief operations officer, UTHSC. “You have to have those up-todate facilities like the translational research building which will focus on bench to bedside applications to get them. That is what every facility across the country is trying to do now — you have to have these state-ofthe-art facilities to do that.” Phase two includes demolition of four designated buildings — the Fuert Building, the Beale Building, Randolph Hall and Goodman Dormitory to make room for new projects. A $30 million simulation laboratory will be built in the space where the Fuert Building stood. This phase also includes renovation of the historic quadrangle, including the Crowe, Looney and Nash buildings and the Nash Annex, as well as various capital maintenance projects. University officials have aspirations toward a third phase with renovation of the dental building, a new college of medicine building, a women’s and infants pavilion, housing and urban revitalization/development partnerships. memphismedicalnews

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1 in 8.

That’s your chance of developing Alzheimer’s disease at age 65.

That risk increases to a 1 in 2 chance at age 85. There’s much that we still need to learn about Alzheimer’s disease (AD). If you’re a healthy senior, you may be able to contribute to this understanding. The TOMMORROW study is an important clinical research study now seeking healthy senior participants between the ages of 65 and 83 to help us learn more about the early phase of AD.

A Look at the State’s CON, continued from page 11 isn’t requested very often, though. Ultimately, an 11-member board decides the fate of a CON application. There are three consumer appointees – one each from the speaker of the house, governor and lieutenant governor. Three more board members are state officials with the comptroller, commissioner for Commerce and Insurance and the director of TennCare each designating an appointee. The remaining five board members are chosen by the governor with one each being selected to represent home health, surgery centers, nursing homes, hospitals and physicians. While the related associations often provide a list of possible appointees, the selection is at the governor’s discretion.

The Big Picture

Although various groups have looked to limit or abolish the CON process, particularly during years when HSDA is under sunset review, there are many staunch supporters of the system. The Tennessee Hospital Association listed keeping the CON program running in its current format among its top legislative priorities last year. “In Tennessee, we’ve had a CON pro-

gram for 40 years. It’s a very stable process, and it’s one the healthcare industry understands,” Hill said. “I think it’s a growth management tool, and also it’s a cost savings tool.” Hill said perhaps one of the most important functions of her agency is to help ensure quality programming is available in Tennessee. The impact of the CON process on cardiovascular surgery outcomes has been the focus of a number of studies. Hill said, “A 2002 report from the University of Iowa College of Medicine showed states without CON programs for open heart surgery had a 21 percent higher mortality rate.” Similarly, she continued, when the Pennsylvania CON law expired, the state saw an influx of open heart surgery programs … quickly growing from 35 to 62. “They saw morbidity and mortality increase,” Hill said. “Any time you see that dramatic growth, you are decreasing volume for surgeons.” Less volume … less experience, she pointed out. Hill concluded, “You still have people who say the CON process is anti-competitive, but it’s really not … it provides a level playing field.”

What Requires a CON? As outlined by Tennessee code, certain facilities, services and actions trigger the need for an approved certificate of need before proceeding. Visit Tennessee.gov/ hsda for more information.

If you would like to learn more: NEUROLOGY CLINIC, P.C. 8000 Centerview Pkwy, Suite 300 Cordova, TN 38018

901-866-9252 research@neuroclinic.org Thomas Arnold, M.D. | Lee Stein, M.D. Kendrick Henderson, M.D. | Robert Segal, M.D. Barbara O’Brien, M.D. | David Pritchard, M.D.

If you are selected as a study participant, you will not have to pay for your investigational medication, study visits, or any tests that are part of the study. Transportation assistance may also be available.

Facilities Threshold: A modification, expansion or renovation in excess of $5 million for a hospital or $2 million for other healthcare facilities. • Hospital • Nursing Home • Recuperation Center • Ambulatory Surgery Center • Mental Health Hospital • Intellectual Disability Institutional Habilitation Facility • Home Care Organization (Home Health & Hospice) • Outpatient Diagnostic Center

Addition of Services • NICU • Open Heart Surgery • Positron Emission Tomography

MARCH 2014

• Change to the bed makeup of a healthcare institution.

• Swing Beds • Home Health • Psychiatric (Inpatient) • Rehabilitation (Inpatient) • Hospital-based Alcohol & Drug Treatment (for adolescents under a program of care exceeding 28 days) • Extracorporeal Lithotripsy • MRI • Cardiac Catheterization • Linear Accelerator

• Residential Hospice

• Hospice

• Nonresidential Substitution-based Treatment Center for Opiate Addiction

• Opiate Addiction Treatment (provided through a facility licensed as a nonresidential substitution-based treatment center)

In addition to the cost triggers listed under facilities, the following actions also require CON approval. Go online for details.

• Burn Unit

• Rehabilitation Facility

• Birthing Center

Actions

• Change in location or replacement of existing or certified facilities providing healthcare services, major medical equipment, or healthcare institutions. • Change of parent office of a home health or hospice agency from one county to another county. • Acquisition of major medical equipment with a cost in excess of $2 million. • Discontinuation of obstetrics. • Closure of any hospital that has been designated a critical access hospital or the elimination of any services for which a certificate of need is required in those hospitals.

Additionally, there are some actions that require individuals to notify or seek prior approval from the Tennessee HSDA even though a formal CON is not required. Details are available on the HSDA website. memphismedicalnews

.com

HealthcareLeader

Mitch Graves

President, CEO, Health Choice, LLC By JUDY OTTO

Mitch Graves believes in the power of data, in joint ownership of the effort to achieve better community health, and in a physician-led initiative of healthcare system governance — and he’s pulling together a plan that will prove the value of all three. Graves, a Memphis native, graduated from Christian Brothers University with a Bachelor of Science degree in business administration, and was awarded CBU’s Distinguished Alumnus Award in 2012. Since 2013, he has served as chairman of their Board of Trustees. He gained valuable insight and experience during his 25 years as president and CEO of Methodist Le Bonheur Healthcare’s (MLH) Affiliated Service Division, which included five surgery centers, hospice, home care, HME, diagnostic centers, employer clinics and minor medical centers. That experience has been serving Graves well since his move last year to take the helm as President, CEO of Health Choice, LLC, a physician-hospital organization (PHO) that is a joint venture between Methodist Le Bonheur Healthcare and MetroCare, a locally based not-for-profit Independent Physician Association (IPA). In 1985, Health Choice was a wholly owned subsidiary of Methodist, Graves said, while today it’s 50 percent owned by MLH and 50 percent by MetroCare’s 1,700 doctors, and serves as a clinically integrated/accountable care organization (ACO) rather than an MCO. The fact that it is physician-led rather than hospital- or health system-led makes the venture unique, he maintains — the only one of its kind in Memphis, bringing partners and elements together to create a network of high quality and low cost. The decision to transform Health Choice was part of what prompted Graves to make what he calls “a leap of faith,” which moved him from the health systems side to the physician hospital organization.

said, “and a large part of that is the data gathering. Valence will help move Health Choice from an administrative company to one that’s knee-deep in data analytics.” MetroCare is concurrently reorganizing to be the physician governance that will set the metrics and measures, he explained, working with MLH to set standards that will be approved over time. And the process will take time: four or five months to gather enough data, another six months to validate the data, he estimates.

What does such data accomplish?

“The only people who have ever had the full picture of data have been the insurance companies,” Graves said. “This will be the first time that healthcare providers have our hands on it, showing us the big picture. “We’re all about improving care. Once we find out where our pockets and areas of improvement are, we can really get after population health and try to keep people well and out of the hospital emergency department. That may come from education about eating, exercise or teaching diabetics to take better care of themselves. “Once we begin to get data, Metrocare will begin to bring the physicians together for the governance and start setting metrics and outcome measures, which our data and analytics will support. Then it’s operationalizing the data — determining how to make and measure improvements.”

The biggest obstacle, he said, is that patients aren’t getting any healthier. They’re still accessing care through the emergency department — the most expensive care option — instead of accessing primary care that should have been available to them through the Affordable Care Act. “We believe the patient-centered medical home is one of the benchmarks that you’ve got to do well to see improvement in any aspect of care. Unfortunately, there are 69,000 people eligible for Obamacare here in Shelby County, and only 10,000 have been accepted into the plan, so that still leaves a lot of uninsured patients. Then there’s the whole other 80,000 of the uninsured that didn’t qualify for Obamacare, but would have qualified for the state Medicaid expansion — which the state of Tennessee turned down.” Complicating data collection is the limited availability of medical records, he said. “Unfortunately, only about 50 percent of physicians have an electronic medical re-

cord. They’ve all got billing systems with charges and diagnoses codes, but a full chart of your last temperature, blood pressure, medications — no. Our long-term goal would be for all physician practices to have electronic medical records, and that’s where we’d go to mine good, rich data. “I will feel like we have been successful at Health Choice and Metrocare and Methodist LeBonheur Healthcare if we can improve the health of the population that we’re serving, reducing per capita cost, and improving the patient-family experience with healthcare. It’s what every health system ought to be aspiring to.” He identifies his most important career accomplishment as the development of Methodist Hospice, which opened with a 30-bed residential hospice three years ago. “I watched my mother and grandmother both die in the hospital,” Graves said. “It hit me that the hospital is not the place somebody should have to die.” The hospice accepts all, regardless of their ability to pay, so fund-raising continues to be ongoing, with more than half a million dollars required in donations each year. In his rare moments of non-healthcare involvement, Grace enjoys traveling and time with his family. As cheerleader, he supports his wife, Kelly Jo, a personal trainer, in efforts such as a recent relay race from Miami to Key West. His daughter, a sophomore at Ole Miss, is studying journalism.

Has Graves’ role switch been challenging?

“On the health systems side, it’s all about trying to increase the volume of your business. My new challenge is going to be to improve outcomes, and that sometimes means not as much volume. We’re developing strategies to keep people out of the emergency department by spending more time at their patient-centered medical homes — their primary-care doctors,” he said. In pursuit of three primary goals — improving the experience of care, improving the health of the community, and reducing per capita cost — Graves guided Health Choice in recently partnering with Valence Health, a leading provider of clinical integration, population health and value-based care solutions. “A large part of achieving those goals involves pulling all the pieces together,” he memphismedicalnews

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MARCH 2014

‘Clock Is Ticking’, continued from page 1 amount of increase could not exceed the growth of the Growth Domestic Product (GDP), the market value of all officially recognized goods or services produced within a year within a given country. And therein lies the problem.” Given the economic downturn that the country has experienced, that doesn’t leave much room for growth for the reimbursement payments. Mike Cates, executive vice president of the Memphis Medical Society, explains, “In March of every year since 1997, the SGR has been updated. The way a doctor is paid is by calculating relative value units that are converted into dollars. The intention of the implementation of the SGR was to make those costs more predictable so that the government could budget for those costs year to year. The end result has left doctors scrambling to manage their own budgets as the impact has threatened to decrease the amount of reimbursement doctors receive from treating Medicare patients by as much as 24 percent in 2014.” “The SGR formula is inherently flawed,” Thompson said. “It allows the federal government to cut into physicians’ practices from two different directions. First it allows cuts by specialty for doctors in private practices. Then it allows an overall cut, of 20 percent or more, to all doctors in private practice by reimbursing the hospitals more than they reimburse individual doctors. For example, private practice cardiologists received a 47

percent cut in their Medicare reimbursements for cardiac imaging, while hospitals received only a 2 percent reduction.” And in the bigger picture, it is not just the amount of Medicare reimbursements that have been taking a dive. Typically, private insurance follows the same path set by Medicare, about a year later. So picturing an annual 20 percent cut from Medicare, with private insurers to follow suit, does not bode well for physicians. Not for their incomes. Not for their patients. With approximately 20 percent of the U.S. population’s healthcare provided for by Medicare, if the SGR repeal is not successful, the result is likely to be a downgrading of healthcare to a lowercost provider. Medicare patients can still receive high-quality care, but it will likely be administered through charity at a facility that is either county-subsidized or church-subsidized. The number of people on Medicare has increased under the new Obamacare health program. Without the SGR repeal, doctors in private practice will continue losing money on every Medicare patient they treat. Subsequently, as has happened with some forms of insurance, those physicians in private practice may have to make the choice to stop seeing Medicare patients or, at the very least, begin reducing their number of Medicare patients. Each physician would be tasked with enacting their own limits. If that happens, those Medicare patients are likely to add

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to the already overcrowded patient load of emergency rooms at area hospitals. Ultimately, this issue will become another poverty issue that will impact communities. Indeed, the SGR formula is flawed. Instead of a small, steady growth over the years, it has shown a huge decrease in the reimbursement payments for doctors. In some past years, the federal government has enacted the equivalent of a temporary Band-Aid. “In 2013, physicians were facing a 21 percent cut in their Medicare reimbursement payments,” Thompson said. “The American Medical Association (AMA) and others in the legislature successfully lobbied and actually got a 2 percent increase.” Although this action stemmed the

bleeding last year, without the proposed SGR repeal, there will still be hemorrhaging in the medical community. So while joint bipartisan committees have come up with a new way to focus on Medicare reimbursements to physicians by proposing the SGR repeal, it still must receive approval from the Senate and the House of Representatives. Then it has to be signed into law by President Obama. “And the clock is definitely ticking,” Cates said. “The deadline for this deal is March 31, 2014. If the repeal is not successful, the new reimbursement rates will decrease by 24 percent and go into effect on April 1, 2014. If successful, the system will be replaced with stable payment updates of 0.5 percent through 2018. The overall goal is to shift Medicare to a system based on value vs. volume of care.”

Hope House, continued from page 5 • Sharing eating utensils • Using exercise equipment at a gym • About 16 percent of men and 78 percent of women become HIV positive through heterosexual contact. • HIV/AIDS IS spread via infected blood, semen, vaginal fluid and breast milk.

How Can You Help?

Donate. Hope House is a 501C (3) organization. It costs a million dollars a year to keep the doors open. Any amount you can spare would help create a better world for these disadvantaged families. Please give as generously as you can. You can mail a check to Hope House, 23 Idlewild St S, Memphis, TN 38104. Or there is an online donation form on the website. If you’re compelled to give a more tangible gift, some of the things they need are: Cleaning Supplies: Lysol/Clorox wipes, laundry detergent, dryer sheets, dish soap Kitchen Supplies: Tri-fold paper towels, foil or plastic wrap, paper (not Styrofoam) plates, trash bags School Supplies: Markers, paint, paint brushes, paper (colored, construction, poster) backpacks, books, puzzles (ages 1-5) Office Supplies: Printer paper, “Forever” postage stamps, clear page protec-

tors, three-ring binders Other Supplies: Toilet paper, canned food, gift certificates that can be used at local grocery stores, clothing for children – 6 weeks to 5 years. For more info and things needed, visit www.hopehousememphis.org/giving. Volunteers are needed to be classroom helpers, aftercare helpers, participate in games and crafts and to ride the bus home with children. They also need help keeping the lawn clean and mowed. Celebrity Readers: Nurses, Doctors, Hospital Executives, Medical Practice Managers, come share a few minutes and read a story to children. Or, do you have a special talent you can share with or teach the children? Music, dance – want to organize a talent show? If you’re interested in volunteering, there is a volunteer form online at www. hopehousememphis.org/volunteer I encourage everyone to go take a tour and see what Hope House is all about. And be prepared to have your heart strings tugged by children like Angel, T.J. and Christopher. Do you have a favorite non-profit or charity you’d like to see spotlighted in Memphis on the Mend? Send it to me at pamela@ memphismedicalnews.com.

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A New View on Clinical Stroke Research By CINDY SANDERS

Everyone wants to build a better mousetrap … but building it over and over again isn’t very efficient. Finding a way to keep the ‘mousetrap’ infrastructure in place while adding new features based on a collective body of knowledge is fundamentally the basis of the new National Institutes of Health Stroke Trials Network. Funded and managed by the National Institute of Neurological Disorders and Stroke (NINDS), NIH StrokeNet is focused on the three prongs of stroke research — prevention, treatment and recovery. The new structure utilizes a network of academic medical centers across the country working with nearby satellite facilities to coordinate and streamline stroke research by centralizing approval and review, while creating a comprehensive data-sharing system. The network also is expected to lessen the time required to set up clinical trials since the infrastructure will already be in place, thereby making research more efficient and less costly. Scott Janis, PhD, program director in the Office of Clinical Research at NINDS and the scientific director for NIH StrokeNet, explained, “We identified 25 geographically distributed regional centers and identified over 200 hospitals that will be part of the network. Dr. Scott Janis Many are primary stroke centers, but many are community hospitals aligned with the regional stroke participant.” The 25 lead sites were chosen based on a demonstration of past experience in stroke research and recruitment, including the ability to enroll underrepresented populations. Each center has been granted five-year funding with $200,000 in research costs and $50,000 for training stroke clinical researchers per year over the first three years. The completion of milestones will drive additional funding. The University of Cincinnati has been named the national clinical coordinating center. With the new structure in place, Janis said it should be possible to more rapidly add studies to the pipeline. NIH StrokeNet also creates a central institutional review board and has a built-in master trial agreement to further expedite launching new trials. Janis also noted the network calls on a truly intraprofessional team of providers and researchers — from first responders and emergency room physicians to the specialists caring for patients acutely all the way through to ambulatory rehabilitative therapists. By having a coordinated team across the continuum of care, including pediatric specialists in the 25 regional centers, the hope is that stroke patients will be rapidly identified and more easily followed throughout their journey. “This network fosters communication memphismedicalnews

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in a collaborative way,” he said. “We can’t control when someone has a stroke, but we can control our ability to identify them for a potential study.” Previously, the model for stroke clinical trials happened in a stand-alone manner. A large team, often over multiple centers across the country, had to be assembled, and the infrastructure set up for each trial. Then, once completed, the entire team had to be disassembled only to start the process all over again for the next study. The cumbersome method led to delays in patient recruitment and repeated

costs to initialize new projects. Sometimes those delays caused a stroke trial to go much longer than initially anticipated, costing millions of dollars more than the original estimate. “That effort in building and tearing down, building and tearing down, doesn’t efficiently allow us to ask the questions to move the science forward,” Janis said. Drug research to control stroke risk factors has improved to the point that Janis said sometimes the medicine had moved on by the time a stroke trial that had undergone delays managed to wind down. “You re-

ally want to get to answers more rapidly,” he noted. Janis said the tipping point to change the way stroke research occurred across the country came about in a couple of different ways. First, stroke experts identified key research priorities during a NINDS strategic planning meeting two years ago and stressed the need for an orchestrated effort. Second, Janis said NINDS already had honed their ability to manage a coordinated effort through SPOTRIAS (Specialized Programs of Translational (CONTINUED ON PAGE 20)

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MARCH 2014

Preparing for ICD-10 Conversion Part 2 Practice management consultant shares the ‘4 Ts’ for physicians to consider gested O’Brien. Medicare has announced “The group will need to Editor’s note: The Medithat testing will occur the week of meet regularly,” she said. cal News series, “Preparing March 3-7. A couple of ﬁscal intermediaries are requiring “Someone should create for ICD-10 Conversion,” providers to register to participate in the testing. At this and be the keeper of began last month with point, there’s no indication of another testing period, so if a work plan that lists “8 Steps” for physicians practices or clearinghouses miss that testing, there may not tasks, dates and who’s to take now. This month, be another opportunity before October 1. responsible. We recomimplementing the “4 Ts” is mend keeping a single – Jennifer O’Brien, MSOD, Practice Management the focus recommendation to work plan so that everyone Consultant, KarenZupko & Associates Inc. facilitate a smooth transition. can see the progress, looming dates, and the specifics of the shared Even though ICD-10 conversion has responsibility.” tion of the practice, including at least one been anticipated for many years industryphysician, biller, and clinical assistant, and wide, most physician practices haven’t Testing: Communicate representatives from other functions in the had the resources or the inclination to with your EMR, Practice practice that have diagnosis coding as part start preparing before now. Management Software (PMS) of their work, such as a surgery scheduler It’s not too late to bring those pracvendor, clearinghouse and or ancillary service provider,” said O’Brien. tices up to speed, said Jennifer O’Brien, biggest payors concerning “The practice manager or administrator, MSOD, a practice management consulif, when and how testing of someone who has an understanding of the tant with KarenZupko & Associates Inc. claims with ICD-10 will be whole practice, should also be included. “Time is of the essence, however,” she done. This will require true teamwork. No one said. “Physician practices need to under“Medicare has announced that testperson should be shouldering the bulk of stand the enormity of this mandated traning will occur the week of March 3-7. A the conversion for two reasons: it’s too sition that will affect their bottom line.” couple of fiscal intermediaries are requirmuch and it’s too risky. If one person is O’Brien recommends applying the ing providers to register to participate in doing almost everything and wins the lot“4 Ts.” the testing. At this point, there’s no indicatery in July, the conversion will fall apart.” tion of another testing period, so if pracPlace a year-at-a-glance calendar in Team: Establish a work group tices or clearinghouses miss that testing, a common staff area so all employees may for ICD-10 conversion. there may not be another opportunity see the deadlines and target dates, sug“The group should be a cross secbefore October 1. That’s just Medicare; communicate with other big payors to find out about their testing.” By LyNNE JETER

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Self-training exercises are available to all physicians, such as running a report of the 25 to 75 most frequently used ICD-9 codes and then crosswalking those to ICD-10. “I have a client who’s pregnant with her first, and due in April,” said O’Brien. “She’s already started on this process to teach herself how she’ll need to code and document differently and is planning on implementing necessary changes before she goes on maternity leave, so that when she returns in the summer, she’s not having to learn and prepare for ICD-10, in addition to adjusting to her new work-life balance.” Specialty societies, state medical societies, hospitals, software vendors and

consulting firms also provide ICD-10 training sessions for physicians and staff. “Sign up for those sessions, go to them, listen and learn,” he said. “For most physicians, the dread associated with attending coding training is akin to that of having a root canal. It’s not going to be fun; it may be barely tolerable. Thing is, it’s not optional. In the past, when physicians considered coding training, it’s been for the opportunity to improve their existing CPT and ICD-9 coding, which they’ve been doing for decades. They already have a base fund of knowledge and experience with those two coding systems. This is completely new to everyone. Basic training on how to use the system – look up, differentiate, assign and document codes – is essential for every physician. Everyone is starting at a base of zero.”

Tools: Identify all practice tools, processes and systems that use diagnosis codes.

“They’ll all need to be converted to ICD-10, and folks will need to be introduced to and trained in their use,” said O’Brien. “At one of the early meetings, have your work team brainstorm to create a list of all affected tools, processes and systems. For example, if the practice contracts with an outside lab, which includes diagnosis codes in its orders form, the lab will likely issue a new form. Creating the list is just to understand the scope and delegate specific assignments so that everything can get done by October 1.”

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Supersizing CHS HMA acquisition complete, nation’s largest chain of hospitals scoops forward By LYNNE JETER

Despite staunch opposition from various circles, Community Health Systems (NYSE: CHS) easily sealed its $3.9 billion acquisition of Naples, Fla.-based Health Management Associates (NYSE: HMA) three days shy of the 6-month engagement. On Jan. 27, trading of HMA stock ceased at $10.50 per share, with HMA stockholders also receiving .06942 shares of CHS stock for every HMA stock. Among concerned parties, the American Federation of Teachers (AFT) had criticized the CHS-HMA transaction, saying the deal has “apparent conflicts of interest” and “also has complications” related to Department of Justice (DOJ) investigations at both for-profit hospital operators. One probe: alleged Medicare fraud related to admissions practices. The AFT’s interest emerged from its role in managing $1 trillion in public pension plans, with a portfolio including $68 million and $34 million, respectively, in CHS and HMA stock. Nurses also expressed worries. On the morning HMA shareholders voted on the pending deal needing 70 percent approval, RNs challenged the CHS buyout of HMA, saying the massive hospital monopoly of 206 mostly rural-based hospitals in 44 states would threaten patient access and quality of care. RNs from West Virginia, Ohio, California, Pennsylvania and Florida represented National Nurses United (NNU), the nation’s largest nurses’ union, at a press conference before the shareholders meeting at HMA headquarters in Naples. Months earlier, NNU had filed a formal complaint with the Federal Trade Commission (FTC), noting “vigilant antitrust oversight is essential to prevent the predictable ills of an irreversible market consolidation” that would threaten patients and the public interest.

The Argument

“The deliberate practice of setting these disgracefully high charges, especially in communities where patients and families have nowhere else to go for hospital care, CHS and HMA are exposing countless numbers of people to financial ruin – or discouraging them from seeking care when they need it due to the cost,” said NNU co-president Jean Ross, RN, pointing out that CHS-affiliated hospitals are the sole provider of healthcare services in more than 55 percent of markets served, and are regarded among the nation’s memphismedicalnews

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priciest hospitals. “This is exactly why the merger, which would give these irresponsible hospital executives even more monopoly clout, should be stopped.” HMA shareholders weren’t swayed; the pending deal garnered 98 percent approval. The FTC approved the acquisition after the Franklin, Tenn.-based company agreed to divest two acute care facilities: Riverview Regional Medical Center, a 281-bed hospital in Gadsden, Ala., and Carolina Pines Regional Medical Center, a 116-bed hospital in Hartsville, SC. “This transaction provides us with increased scale and broader geographic reach as we work to create strong healthcare networks across the nation,” said CHS CEO Wayne T. Smith. “Our larger organization is well positioned to address the changing dynamics in our industry and dedicated to providing quality care for millions of patients and all the communities we serve.”

HMA Aftermath

Just before the marriage between companies became official, the DOJ shifted its primary focus on HMA to former HMA CEO Gary Newsome, who retired from the company last year to preside over a South American mission program for the Church of Jesus Christ of Latter-Day Saints. The government alleges that Newsome led the charge to pressure emergency department physicians and hospital administrators to increase the volume of inpatient admissions, “regardless of medical necessity.” Also feeling the investigation’s ripple effect: The University of Florida Health, a joint venture with HMA in three hospitals, and Primary Care Associates, a physician practice in Port Charlotte, Fla. “Unlawful financial relationships between hospitals and physicians solely to increase referrals are, unfortunately, a common practice that corrupts the healthcare system,” said Wifredo A. Ferrer, U.S. Attorney for the Southern District of Florida. “The system also suffers a direct financial hit when hospitals fraudulently increase admissions where they’re not indicated, solely to benefit hospitals’ bottom line. We won’t relent in our efforts to combat these kinds of fraudulent schemes and recover funds for the Medicare program.”

New Department of Dermatology Specializes in Complex Skin Conditions The UT Health Science Center (UTHSC) and UT Medical Group, Inc. (UTMG) have launched the university’s first-ever Department of Dermatology to expand the range of dermatological subspecialty care available in the Mid-South. The department focuses on the treatment of complex cases that may be difficult to manage, as well as skin conditions that result from systemic disease.

Adjacent to the clinic is UT DermPath, the department’s dermatopathology laboratory. Staffed by board certified dermatopathologists, the lab supports referring clinicians by rendering accurate, precise, and timely diagnoses of benign and malignant neoplasms and dermatologic diseases. UT DermPath holds accreditation from the College of American Pathologists and meets all Medicare CLIA (Clinical Laboratory Improvement Amendments) requirements. The lab offers 24/7 physician consultations and a full range of dermatopathology services for skin biopsies and other testing, including special and standard stains, direct immunofluorescent studies, immunohistochemistry, and diagnostic consultations on slides from other laboratories. “What we’re hoping to do, is build an academically-oriented department that will take care of people with very complicated skin disorders, not just in Memphis, but in the surrounding areas,” Dr. Schwarzenberger says. “We also want to advance the knowledge base of our specialty, to learn new things and make new discoveries that advance the specialty of dermatology.” UT Dermatologists:

Above Dr. Schwarzenberger examines a patient in the new office. Dr. Kathryn Schwarzenberger was recruited from the University of Vermont College of Medicine by UTHSC to lead the KaplanAmonette Department of Dermatology. The department is named in honor of local pioneering dermatologists Dr. Robert Kaplan and Dr. Rex Amonette. “I think there is incredible opportunity to grow here,” says Dr. Schwarzenberger, who holds the Amonette-Rosenberg Endowed Chair of Excellence in Dermatology. “Our residency training program is a major priority for all of us on the faculty; we train outstanding young dermatologists here and I hope to maintain and grow that tradition. We are working with the program to enhance and strengthen it. I look forward to working for the benefit of our patients and colleagues in Memphis and beyond.” The department includes an outpatient clinic at 930 Madison Avenue, where the team of board certified dermatologists specializes in the management of a wide variety of skin disorders including allergies, contact dermatitis, lymphomas, and infectious diseases. UT Dermatology staff also have clinical expertise in treating conditions related to rheumatologic and other medical conditions, such as lupus and scleroderma. Doctors make every effort to see patients with emergent conditions the same or next day. With six examination rooms and a procedure room for skin surgery, the office is equipped to serve a wide range of dermatologic patients. Doctors offer the latest topical and systemic therapies, including narrow-band UVB /PUVA phototherapy for severe or resistant cases of psoriasis, refractory atopic dermatitis and eczema, vitiligo, urticaria pigmentosa, and other skin disorders.

Kathryn Schwarzenberger, MD • Chair & Professor of Dermatology • Board certified by American Board of Dermatology • Fellowship training in immunodermatology Tejesh J. Patel, MD, MBBS • Dermatologist, Dermatopathologist & Assistant Professor • Board certified by American Board of Dermatology and in Dermatopathology by the American Boards of Dermatology and Pathology Kris Fisher, MD • Dermatologist, Dermatopathologist & Assistant Professor • Board certified by American Board of Dermatology and in Dermatopathology by the American Boards of Dermatology and Pathology • Fellow, American Academy of Dermatology Emily H. Jones, MD • Dermatologist & Assistant Professor • Board certified by American Board of Dermatology For more information:

UT Dermatology Clinic: 901-866-8805 UT DermPath Lab: Toll-free 855-DERMPATH

MARCH 2014

GrandRounds UT Medical Group Expands Nephrology Services

Dr. William Gabbard and Dr. Jagannath H. Saikumar have joined the department of nephrology at UT Medical Group. Gabbard earned his medical degree at the University of Tennessee Health Science Dr. William Center College of Gabbard Medicine and completed residencies in radiology and internal medicine at the UT Medical Center in Knoxville. He completed a fellowship in interventional Dr. Jagannath H. Saikumar nephrology at Ochsner Clinic Foundation in New Orleans and pursued additional training in interventional nephrology at the Dialysis Access Center of Atlanta. Gabbard is board certified by the American Board of Internal Medicine with subspecialty certification in nephrology. An assistant professor at the UT Health Science Center, he specializes in vascular access procedures, including fistulagram, fistula salvage, fistula and dialysis graft maintenance, thrombectomy, central line placement, and venous angioplasty. In addition, he cares for

patients with end stage renal disease and provides consultative nephrology services. Saikumar graduated from M.S. Ramaiah Medical College at Bangalore University, India. He completed internal medicine residency at the University of Toledo Medical Center in Ohio, followed by fellowship training in advanced nephrology at Henry Ford Hospital in Detroit. Saikumar earned a master’s degree in public health at Wichita State University in Kansas and a master’s degree in biomedical sciences at the University of Toledo. He is board certified by the American Board of Internal Medicine in internal medicine and nephrology. As an assistant professor of medicine at the UT Health Science Center, he also serves as a consulting nephrologist in UT affiliated hospitals. He specializes in chronic kidney disease, continuous renal replacement therapy, and acute kidney injury.

Andrei V. Alexandrov, MD, Named Chair, Department of Neurology, UTHSC

David M. Stern, MD, executive dean of the College of Medicine at the University of Tennessee Health Science Center (UTHSC), has appointed Andrei V. Alexandrov, MD, as chair of the Department of Neurol-

ogy and Semmes-Murphey Professor. Dr. Alexandrov comes to UTHSC from the University of Alabama at Birmingham, where he has been a Dr. Andrei V. Alexandrov professor in the Department of Neurology and director of the Division of Cerebrovascular Diseases. He has also served as director of the Comprehensive Stroke Center and the Neurovascular Ultrasound Laboratory. In addition, he was medical director of the Stroke Service and the Intermediate Care Stroke Unit at the University of Alabama Hospital in Birmingham. Dr. Alexandrov, who begins work at UTHSC in March, received his MD degree in 1989 from the First Moscow Medical Institute in Russia, specializing in clinical neurology at the Institute of Neurology, Russian Academy of Medical Sciences in Moscow. He completed his fellowship training in stroke and cerebrovascular ultrasound at the University of Toronto and The University of Texas. Dr. Alexandrov has published 137 original papers, 16 case reports, three textbooks, and 128 review articles, editorials, invited publications and book chapters. He is director of the Neurosonology Examination and honorary advisor to the board of directors of the American Society of Neuroimaging. He also sits on the boards of the Society of Vascular and Interventional Neurology, and the Intersocietal Accreditation Commission. Dr. Alexandrov is editor-in-chief of Brain and Behavior, and is an editorial board member of several publications including, Stroke, International Journal of Stroke, the Journal of Neuroimaging and the Stroke Interventionalist Journal. Dr. Alexandrov is an active, elected member of the American Neurological Association. He holds

a U.S. patent for using ultrasound to enhance perfusion (blood flow) of tissues (or sonothrombolysis), and specializes in the development of novel reperfusion (restoration of blood flow) therapies for stroke.

Methodist Le Bonheur Healthcare Names Vice President of Ambulatory IT Services

Methodist Le Bonheur Healthcare has named Cynthia Davis vice president of Ambulatory IT Services in the Information Technology Division. In this position, she is responsible for developing and implementing ambulatory IT services, and will report Cynthia Davis to Chief Healthcare Information Officer and Senior Vice President Alastair MacGregor, MB, CHB, MRCGP. Prior to joining Methodist, Cynthia headed her own clinician-led healthcare informatics consulting firm, CIC Advisory, specializing in strategy and planning, business intelligence and analytics, clinical informatics and optimization. Before forming her own firm, she served as vice president of Clinical Transformation at BayCare Health System in Clearwater, Florida, as well as vice president/chief information officer at DeKalb Regional Health Systems and Sumter Regional Medical Center. A registered nurse, Cynthia has also held senior management positions at MetroHealth and Munson Medical Center. Cynthia earned her MHSA from the University of Michigan. She is a fellow of the American College of Healthcare Executives, a member of the American College of Healthcare Executives College of Healthcare Information Management Executives (CHIME) and Healthcare Information and Management System Society (HIMSS).

A New View, continued from page 17

BETTER

MARCH 2014

Research in Acute Stroke). “The idea behind the network is to take what we already know how to do and do it in a more efficient way,” Janis said. NINDS has a long history of overseeing successful stroke clinical trials, including the first treatment for acute stroke, announced in 1995. Although sometimes slow, research translated from bench to bedside still has been so successful that mortality rates from stroke have declined significantly over the past decade. While still a leading cause of disability, stroke recently moved from the third leading cause of death in the United States to the fourth. Janis noted funding still would be available to researchers outside the network when appropriate. However, he

added, the goal would be to collaborate with the network and to coordinate trials through the new mechanisms now in place. “We want to be able to use this infrastructure we’re investing in to be our frontline sites for stroke trials,” he stated. In the Southeast, lead research sites include Emory University School of Medicine in Atlanta, Medical University of South Carolina in Charleston, Miller School of Medicine at the University of Miami, and Vanderbilt University Medical Center in Nashville. Providers and researchers can learn more about the network and clinical trials through the new website at nihstrokenet.org.

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GrandRounds Daniel Clark Joins Health Choice

Health Choice, LLC, has announced that Daniel Clark has joined Health Choice in the newly created position of vice president of Clinical Informatics & Analytics, as a member of our executive team, reporting to CEO Mitch Daniel Clark Graves. Clark will have oversight of the strategic direction, expansion and operation of data application and analytics for clinical integration and will work closely with MetroCare physicians to identify and prioritize quality initiatives designed to provide the highest quality care for patients. Bringing more than 18 years of clinical support experience, Clark joined Health Choice in January after more than 12 years at Methodist Le Bonheur Healthcare, where he served as corporate director of Clinical Decision Support. He holds a Masters of Health Administration degree from the University of Memphis, a Masters of Arts degree from the University of Cincinnati and a Bachelor’s degree from Ball State University. A Lean Six-Sigma Black Belt, Clark is an adjunct professor at the University of Memphis and is a Consulting Associate of MidSouth Quality Productivity Center (MSQPC).

New Financial Analyst at LifeLinc

Gini Moore has been hired by LifeLinc as Healthcare Financial Data Analyst. Moore will be responsible for a variety of data review and reporting relating to the billing services for anesthesia practices. She will also be reGini Moore sponsible forcollecting data and preparing reports related to performance standards as well as monitoring trends in multiple anesthesia practices. Additionally, Gini will routinely interface with the billing team to compile data/reports on industry standards and benchmarks. Gini brings over 13 years of experience in positions related to the financial aspects of the healthcare industry. This has included medical billing, insurance recovery audits and medical debt recovery and litigation. In her previous position, Gini was integral in the creation of a medical bill review department and a PPO network for a workers’ compensation TPA.

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UT Medical Group Launches Center for Reproductive Medicine Couples who are having trouble becoming pregnant now have additional fertility resources with the opening of the Center for Reproductive Medicine in Germantown. Headed by Dr. Laura Detti, a board certified reproductive endocrinologist who has repeatedly been named to Best Doctors®, the facility offers a full range of infertility services, including diagnosis, treatment and assisted reproduction. Infertility Diagnosis & Management According to statistics from the U.S. Centers for Disease Control, infertility affects more than 7 million Americans, including both men and women. The Center for Reproductive Medicine provides diagnostic testing and treatment for female infertility-related conditions such as uterine fibroids, polycystic ovarian syndrome, pelvic adhesions, tubal occlusion, endocrine dysfunctions, and recurrent miscarriages. Evaluations for male infertility are also offered, including sperm testing and analysis using Kruger strict morphology criteria. Assisted Fertilization Couples who need assistance with fertilization may be may be able to achieve pregnancy through techniques such as intrauterine insemination (IUI), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) using partner or donor sperm, and pre-implantation genetic screening (PGS). Embryology Laboratory Director Lucy Williams, TS, ELD, conducts these procedures in the Center’s Andrology Lab using the latest equipment, including tri-gas benchtop incubators, which facilitate optimal embryo development and improve pregnancy rates as compared to older incubator technologies. An experienced certified embryologist, Williams has a 20-year track record of achieving pregnancy rates above the national average at infertility laboratories in Tennessee, Illinois, Texas and Utah. Dr. Detti, who is also a certified sonographer, performs all ultrasound-guided procedures. In addition to providing a complete fertility evaluation of the couple, she uses ultrasound to monitor fertility treatments. She can determine when follicles are mature for ovulation and can determine the perfect timing for fertilization of the egg to occur. To assist patients with the costs of assisted fertilization, the Center offers financing through Advanced Reproductive Care, Inc., an organization that specializes in financing IVF procedures for patients at university-affiliated fertility clinics across the nation. The Center for Reproductive Medicine is the only ARC member in the state of Tennessee. Cryopreservation In addition to sperm testing and fertilization procedures, the Center helps couples preserve their fertility for the future by freezing sperm, eggs and tissue. Using a cutting edge process called “vitrification,” the lab extracts water from the egg, sperm or tissue before flash freezing it. The technique prevents the formation of ice crystals, resulting in cells that are more resilient and better able to survive and function after thawing. After freezing, the specimens may be stored in a liquid nitrogen container in the lab for a

Lucy Williams Embryologist

Dr. Laura Detti Reproductive Endocrinologist

Services Provided: • Semen analysis with Kruger strict morphology criteria • In-vitro fertilization (IVF) • Intrauterine insemination (IUI) • Sperm washing and freezing • Isolation of sperm from testicular aspiration or biopsy • Male and female fertility preservation through sperm and egg cryopreservation • Male and female infertility diagnosis and treatment • Genetic counseling • Fertility consultations prior to and after cancer treatments • Diagnosis and treatment of endocrine dysfunctions • Ultrasound services, including 3D and 4D ultrasound, sonohysterography, ovarian cancer screening, tubal patency detection, and follicular monitoring

UT Medical Group Center for Reproductive Medicine To make a referral, please call 901-866-8220. long time. Specimens that may not be needed for several years are transported to a cryobank for long-term storage. Cancer patients who must undergo toxic chemotherapy and radiation treatments are prime candidates for fertility preservation. Eggs, sperm and tissue can be retrieved before cancer treatment, frozen, and used once the cancer is in remission and the patient is ready to have a family. The Center for Reproductive Medicine lab is registered with the Food and Drug Administration (FDA), the state of Tennessee, and certified by The Centers for Medicare & Medicaid Services, which regulates all clinical laboratory testing performed on humans in the U.S. through the Clinical Laboratory Improvement Amendments (CLIA). About Dr. Detti Dr. Laura Detti is a reproductive endocrinologist who specializes in male and female infertility. She earned her medical degree at the University of Florence in Italy and completed OB/GYN residency there and at the University of Cincinnati and the University of Virginia. She completed fellowship training in reproductive endocrinology and infertility at Wayne State University School of Medicine in Detroit and research fellowships at Yale University, the University of Virginia, and the University

of Mississippi. Dr. Detti is board certified by the American Board of Obstetrics and Gynecology with subspecialty certification in reproductive endocrinology and infertility. She is a fellow of the American College of Obstetrics and Gynecology and a member of the American Society of Reproductive Medicine, American Institute for Ultrasound Medicine, and the Society of Gynecological Surgeons. She also serves as Associate Professor of Obstetrics and Gynecology at the UT Health Science Center. About Lucy Williams Lucy Williams holds certification in micromanipulation, embryology and andrology, and preimplantation genetic diagnoses. She has more than two decades of experience in clinical patient care, lab testing and analysis, and research and is widely-published. After earning her bachelor’s degree at Newman University in Wichita, Kansas and completing postgraduate study at the University of Minnesota in Minneapolis, she furthered her training at the Jones Institute for Reproductive Medicine and Eastern Virginia School of Medicine in Norfolk and at the Assisted Reproductive Technology Reproductive Center in Beverly Hills, California. She is a member of the American Society for Reproductive Medicine and the College of Reproductive Biologists and Technicians. MARCH 2014

GrandRounds Jeffrey Liebman named CEO of Methodist University Hospital

Jeffrey H. Liebman has been selected as the new chief executive officer for Methodist University Hospital. A seasoned executive with more than 25 years of healthcare leadership experience, Liebman currently serves as Jeffrey H. Liebman president of the Good Samaritan Medical Center in Brockton, Massachusetts. He was selected through a very thorough national search which included input from a cross section of physicians and Methodist Le Bonheur Healthcare senior leaders. Lieberman took the reins of Methodist University Hospital February 24. In addition to hospital leadership experience, Liebman also has experience with large physician practices, including Affiliated Physicians Group, a community-based Harvard primary care network that he grew from 28 to 220 physicians. Liebman earned a Bachelor of Arts degree from Queens College in New York, a Doctor of Dental Medicine degree from the Univer-

sity of Pennsylvania and a Master of Business Administration from the University of Chicago. In his role as Methodist University Hospital CEO, Liebman will provide strategic and operational leadership for Methodist Le Bonheur Healthcare’s flagship hospital, build strong collaborative relationships with the medical staff, strengthen Methodist’s affiliation with the University of Tennessee Health Science Center, and facilitate improvements in patient-and family-centered care, clinical quality and financial performance.

Campbell Foundation Event Footprints in Motion Auction and Party

WHEN: Saturday, April 12 at 6:30 PM LOCATION: Racquet Club of Memphis DESCRIPTION: An evening of fun, music from The Plaintiffs, and an exclusive, silent auction. All proceeds will benefit The Campbell Foundation and the Daniel and Molly Shumate Community Service Scholarship Fund to help provide resources for international medical missions (this year, a medical mission trip to Guatemala) and orthopaedic research conducted here in the Mid-South. COST: $75 per ticket To purchase tickets or for more information, please call (901) 7593233 or visit https://www.facebook.

com/events/254092108076007/?sou rce=1. Footprints in Motion raises awareness & funds to promote orthopaedic health and community outreach in the U.S. and in underserved areas around the world.

American Cancer Society Sets Annual Gala

The American Cancer Society will present the Great Gatsby Gala on August 16, 2014, at The Columns at One Commerce Square in downtown Memphis from 7-11pm. Sponsorships are available ranging from $1,000 to $50,000. Tickets are $250 per person. The American Cancer Society is the nation’s largest health charity and the largest non-governmental investor in cancer research. With our support, Tennessee researchers – including those at St. Jude Children’s Research Hospital, the University of Tennessee Health Science Center, and Vanderbilt University – are focusing on new discoveries to help achieve the Society’s goal of eliminating cancer as a major health problem. The total amount of active cancer research grants based in Memphis was over $3.73 million and $8.07 million in the state of Tennessee (as of January 2014.) For more details, contact Sonja Ray at Sonja.Ray@cancer.org.\ UT Medical Group Expands Nephrology Services

Charles N. Larkin, M.D. (right in photo) a pediatrician at Pediatrics East passes the gavel to the 2014 President, Gary W. Kimzey, M.D. an anesthesiologist at Medical Anesthesia Group during the Memphis Medical Society’s 137th Annual Meeting and Installation of Officers. The event was held on Saturday, January 25, 2014 at the Marriott - Memphis East.

Renee’ Frazier, CEO, Healthy Memphis Common Table, “I am happy to announce Joseph Webb, D.S.c, FACHE joined Healthy Memphis Common Table on February 3, 2014 as Chief Operating Officer. Dr. Webb will serve as the program manager for the Aligning Forces for Quality (AF4Q) initiative which includes Project Better Care, our health equity initiative and data & public reporting. Dr. Webb is a former CEO of Methodist South and is a well-established health care leader. We look forward to welcoming Joe as part of the Healthy Memphis Common Table team.”

MARCH 2014

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