West TN Medical News February 2014 by FW Publishing

FOCUS TOPICS CARDIOLOGY MERGERS & ACQUISITIONS HEALTH LAW

February 2014 >> $5

PHYSICIAN SPOTLIGHT PAGE 3

David Gibson,

Physicians’ Steps for Legal Recourse Shaky By EMILy ADAMS KEPLINGER

ON ROUNDS

New Defibrillator Offers Options, Advantages

Stern physician implants recently developed system The old way was no longer an option. To live, the patient needed something new ... 5

Malpractice suits are filed almost every day. Not all of them are justifiable. What steps are in place for physicians’ redress? According to Mike Cates, executive vice president of the Memphis Medical Society, “Anybody can be sued. The difference is how much proof there is to sustain a case. And generally there is not much case law to support malpractice counter-suits.” And while the First Amendment of the U.S. Constitution guarantees freedom of speech, slander and libel are not without their own consequences. A plaintiff making untrue, defamatory accusations against a physician can certainly impact future earnings. But the problem with defending such claims lies with the burden of proof. To prove a physician has been defamed, he or she has to prove their harm or injury was a direct result of a malpractice suit, or even from bad ratings on websites and social media. “Social media and websites offer visibility for physicians,” Cates added. “But if someone chooses to make derogatory comments or assign poor ratings, it is very hard for a doctor to counter because most of those postings are anonymous. It would be almost impossible to discern who to sue for (CONTINUED ON PAGE 6)

HealthcareLeader

James Ross Changing Healthcare Landscape Not Slowing Drive for Med School

Chief Operating Ofﬁcer, Jackson Madison County General Hospital/West Tennessee Healthcare By SUZANNE BOyD

ONLINE: WESTTN MEDICAL NEWS.COM

As a Boy Scout in Chester County, James Ross got a taste of what a healthcare career may look like through the Explorer program. Just as the scouting program let him sample various aspects of healthcare, Ross’s career has been much of the same. Today as chief operating officer for Jackson Madison County Gen-

FLEET INCENTIVES FOR MEDICAL PROFESSIONALS

eral Hospital, those experiences are at the heart of who he has become. “I knew I would do something in the medical field when I realized I enjoyed working the first aid booths as a scout,” said Ross. “That led me to enter the Emergency Medical Technician program at Jackson State Community College after graduating high school in 1979. After

(CONTINUED ON PAGE 4)

MERCEDES-BENZ OF MEMPHIS S E R V I N G

T H E

M I D - S O U T H

F O R

O V E R

3 0

Y E A R S .

FOR ADDITIONAL PROGRAM DETAILS VISIT:

mbofmemphis.com/ ama-specialprograms.htm Available for qualified customers only.

PRINTED ON RECYCLED PAPER

PRSRT STD U.S. POSTAGE PAID FRANKLIN, TN PERMIT NO.357

About Every 34 Seconds, An American Will Have A Coronary Event.

Choose The Jackson Clinic Team of 11 Board Certiﬁed Cardiologists

Put Your Heart In The Right Place

For The Jackson Clinic’s Board Certiﬁed Cardiologists, your heart is their specialty. Supported by the highest level of diagnostic technology, our cardiologists use the latest cardiovascular treatment methods to provide you and your family the best in care close to home.

Front Row (left to right): Dr. Shahzad Shah, Dr. Antwan Robinson, Dr. James H. Crenshaw, Jr., Dr. Sandra V. Dee, Dr. Jason C. Cherry, Dr. T. James Humphreys Back Row (left to right): Dr. Chibuzo Nwokolo, Dr. Abdul Rashid, Dr. John W. Baker, Dr. Joseph Okolo, Dr. Michael O. Osayamen

FEBRUARY 2014

westtnmedicalnews

.com

PhysicianSpotlight

David Gibson, MD St. Thomas Heart Group By SUZANNE BOyD

Serving a rural community such as Henry County is one very rewarding benefit to his cardiology practice for David Gibson, MD. With his primary practice in Nashville with Saint Thomas Heart, the cardiac division of Saint Thomas Health, Gibson travels over two hours once a week to Paris, TN, to see patients. It is the relationships developed with his patients that is at the heart of why he chose medicine as a career. “In 2002, we were contacted about establishing an outreach area in Paris. Although it was two hours from Nashville, the idea was not beyond the realm of possibility,” said Gibson. “We have gone from once a week clinics to having a cardiologist there five days a week since the fall of 2013. Besides seeing patients in the office, we have the ability to perform a wide range of diagnostic procedures in addition to cardiac catheterization procedures.” The Saint Thomas Heart Group – Paris, TN, offers general cardiac care, as well as diagnostic cardiac care including stress testing, nuclear profusion, and echocardiography as well as heart catheterization procedures. “We have really become a full term cardiac practice in Paris with the exception of heart surgery and coronary intervention procedures. With a cardiologist there five days a week, we can see patients the hospitalists refer to us that are in the hospital, as well as patients in our office,” said Gibson. “What it means for the community is there is a broad spectrum of cardiac services at home without having to travel to a larger city for treatment or to see a physician. Two of my colleagues specialize in advanced heart failure and transplantation. By having them in Paris one day a week, patients that may need that level of treatment can see the specialist in Paris to evaluate if they qualify. It has been a great clinic, there for both us and the community.” An Arizona native, Gibson grew up with no major medical influences in his life, but found science intrigued him throughout school. He majored in biochemistry at the University of Arizona but as his undergraduate career progressed, he questioned whether he would stay in the field of science. “I knew with biochemistry I would most likely be working in industry or research,” said Gibson. “I had

Read Medical News Online: WESTTNMEDICAL NEWS.COM

westtnmedicalnews

.com

always seen myself as a people person and wasn’t sure I would be comfortable being in a lab all the time. For a time, I sort of juggled between medical school and physical therapy.” After completing his Bachelor’s degree, Gibson took a year off to work in research at a cancer center. “I had missed the deadline to apply to medical school and that year sort of gave me a chance to catch my breath. It was also a matriculation of my interest in science and my desire to interact with people. It really gave

me the clear direction toward medicine I needed,” said Gibson. “I also got married to my wife Wendy in that year, so we had a little bit of time to ourselves before the chaos of medical school started.” Gibson received his medical degree from the University of Arizona but was open to going elsewhere to complete his internship and residency training in internal medicine. As he looked at various programs, he found he really liked the program at Vanderbilt University. “Coming from Arizona, I didn’t want to go too far North or East and have to live in the cold,” said Gibson. “But I really liked Vanderbilt and the handful of people that I met there. We were expecting our first child, a son, when we moved and were made to feel so welcome by all the Southern hospitality showered on us when we arrived.” It was rotations in his third and fourth years of medical school that got Gibson thinking cardiology. In his month long cardiac surgery rotation, Gibson spent time watching Jack Copeland, MD, a well known authority in cardiac surgery, primarily transplantation. “To be able to go into the operating room and see these absolutely amazing surgeries got me to looking at cardiology. I wasn’t sure at first if I wanted to go the medical route or surgical but it was still an instrumental time for me to make the decision on which

path to choose.” After completing his internship, Gibson was considering either gastroenterology or cardiology as his specialty, but it was cardiology that won out and he remained at Vanderbilt to complete a cardiology fellowship. “Cardiology combined medicine, surgery and technology,” said Gibson. “You have the ability to do so many different things and it is never the same thing each day which I find exciting.” Although he planned to return to Arizona to start his practice after completing his fellowship in 1997, Gibson found that all the pieces were falling into place to keep his family, which now included a daughter, in Nashville. Today, Gibson is with the same group of physicians, which is now known as Saint Thomas Heart. Just as his practice has grown, so did his family over the years to include another son. After 16 years of practice, Gibson likes where he is. “I love getting to know my patients here and feel like this is home, even though I don’t live here,” said Gibson. “Many of my patients hate the idea of going to the ‘big’ city especially as they age and they really appreciate that we will come here to see them. I have gotten such satisfaction in developing personal relationships with those I have treated over the years and I can say I definitely love my outreach days.”

save the date ®

Go Red For Women Event DaTe

TuesDay, aPril 8, 2014 loCaTion

The Carl Perkins CiviC CenTer Time

Doors oPen aT 6:00Pm • Dinner aT 7:00Pm locally sponsored by

GoRedForWomen.org FEBRUARY 2014

James Ross, continued from page 1 which I went to work for the ambulance service in Henderson and started working toward my two-year degree at Jackson State, taking mainly science courses.” Ross then went to Union to pursue his associate degree in nursing while continuing to work as an EMT. In 1985, he earned his associate degree in nursing and started working at Jackson General as a surgical intensive care unit nurse as well as his EMT job. He has maintained his EMT license over the years and has been appointed by the governor to serve on the State Emergency Medical Services Board for the past six years. This organization governs all the provisions of EMT services across the state including education and training programs. In 1987, Ross earned his bachelor degree in nursing from Union and went to work full-time as the critical care clinical coordinator at JMCGH, his first taste of management. “Working for West Tennessee Healthcare has allowed me opportunities to serve in different administrative and leadership roles throughout the organization as well as in the community, and has allowed me to develop my management style, leadership skills while advancing in responsibilities. In 2001, I became vice president of hospital services and in 2009 was named chief operating officer,” said Ross, who earned a Master of Science in Health Administration in 1992 through the University of Alabama at Birmingham’s Executive Program. “Our former CEO, Jim Moss, would rotate vice president’s responsibilities in terms of hospital departments they managed. This allowed us to grow our knowledge base system wide and was a tactic to decrease ‘turf’ wars among management.” In addition to his EMT, nursing and administration degrees and licensure, Ross has one more feather in his cap; a nursing home administrator license. “When Hardin County Medical Center tragically lost their administrator, Jim asked me to help out. They were not an affiliate of the sys-

tem’s but were more of an alliance. They were in a tough bind and I was glad to serve,” said Ross. “The hospital owned a nursing home so I got licensed as a nursing home administrator. Jim encouraged me to maintain it just like my EMT license, since you never know when you could be called to help someone.” When it comes to his management style, Ross finds his clinical background beneficial in terms of communication as well as giving him a holistic picture of healthcare. His style is one of collaboration and consensus building. “I like to bring all parties involved together to see how best to address an issue or opportunity,” said Ross. “I have learned that people need to understand the decision being made rather than giving them an authoritarian response.” Ross’s philosophy was dramatically shaped by two medically unexplainable events. In late 2002, he had a left main coronary aneurysm, also known as the widow-maker. In 2008, his heart got into a lethal rhythm. “I underwent nine hours of surgery for the aneurysm. I had the option to go anywhere in the world to have it done but elected to stay here because I knew that regardless of what happened to me, my family would have the support they needed to get through it,” said Ross. “The second incident, I was lucky that my wife, Cindy, who is a Nurse Practitioner and daughter, Kelsey, were with me because they have both been trained in cardiopulmonary resuscitation (CPR).” These events caused Ross to reflect. “I realized, even more, the importance of carrying that love and respect for others through to everyone you come in contact with,” said Ross. “My second incident really caused me to realize the importance of how rapid response, advanced technology and being properly trained is so very important in the provision of healthcare. Giving back to this community that has given me so much, raising awareness of heart issues and how important being pre-

pared to respond is, has been in the forefront of my endeavors.” Transcending his personal experience Ross said the American Heart Association has championed research and technology that has raised the level of care provided. “Every critical care nurse has to be advanced-life-support-trained beyond basic cardiac life support,” he said. “To bring that on home, we now have a STEMI team which is a fancy term for having a Myocardial Infarction (MI) team in place at the hospital. EMTs out in the field can send us the patient’s EKG from the field so that by the time they arrive, our team is in place, the course of treatment has been determined and all the staff needed is in place and ready to go. It is a streamlined process that has cut down response time and meant better outcomes for patients.” West Tennessee Healthcare has initiated several other innovative treatment modalities over the past few years that enable their staff to deliver the latest care to cardiac patients. “With electrophysiology services, the cardiologist that specializes in electrical impulses of the heart can determine if the heart is out of rhythm and if that is caused by a cardiac nerve ending, it can be alleviated in a non-surgical manner,” said Ross. “We have also started performing trans-aortic valve replacement for patients who are too sick for surgery. Our therapeutic hypothermia program, enables us to cool down a cardiac patient after a heart attack to allow the body to better recover.” Ross credits the AHA with spearheading many of the advancements in cardiology, several which saved his life. “This organization has been behind much of the technology, research, science and training that is at the core of heart programs across the country. They are responsible for the development of automated external defibrillators. They support training and the concepts and fundamental efforts of what you should do first with Advanced Cardiac Life Support and basic CPR,” said

Ross. “Kelsey had gone through a kid 911 camp which allowed her to know what to do when my heart stopped. I owe a lot to the research, technology and training the AHA has spearheaded that healthcare providers use daily.” Ross co-chaired the inaugural ‘Red Tie’ society for the West Tennessee Chapter of the American Heart Association. “We started the group last year in conjunction with the Go Red event. The 25 members were men who had either had heart issues or have had spouses or loved ones who have been affected by it. We wanted to not only raise money but awareness of heart disease. Members received a heart on a keychain with an aspirin in it as when you think you are having a heart attack, chewing aspirin can be vital,” said Ross. “This year’s class will be announced at the LIFT Center on February 14.” Over his more than 34-year career in healthcare, Ross has had nearly the full gamut of experiences. He has delivered five babies in the back of ambulances, he has been a nursing home administrator and beyond that, he grew up with a father that worked in a funeral home. “God has really blessed me with a perspective of how life shapes you and how different people can impact your life. My motto has been meet the need and make a difference,” said Ross. “I hope that is how people see me, that no matter what it is, whether it is chairing an event, helping someone find their way or buying a meal for a patient’s family, whatever it is, I did my part in meeting the need and making a difference.”

Take 2 ads and call us in the morning…

Jackson Family Dental Care

Affiliated with Dental Partners

NEW PATIENT SPECIAL

We LOVE to see you SMILE! Contact us today! Offer Expires in 30 days. Includes exam, cleaning and x-rays. New Patients Only. A Proud Member of the Dental Practice Group of Tennessee. D0150, D0330, D0272, D0210, D1110, D0140, D0220, D0230, D9972

FEBRUARY 2014

(731) 256-0448

78 Lynoak Cove Jackson, TN 38305 Make an appointment instantly on our website!

http://www.demandforce.com/b/JacksonFamilyDental

Medical News’ prescription to grow your practice or business.

No More Cold Calls! Make all your calls warm —

advertise in Medical News. westtnmedicalnews

.com

New Defibrillator Offers Options, Advantages Stern physician implants recently developed system By AMy FRENCH

The old way was no longer an option. To live, the patient needed something new. Over the years, doctors had placed conventional defibrillator implants in his chest twice. Each device had done its job, monitoring the patient’s disease-weakened heart and providing a jolt if necessary. But infections related to kidney problems forced removal both times and prohibited a third try with the previous approach. That left the man, an Arkansas resident in his 60s, at great risk of cardiac arrest. By extension, it also rendered him ineligible for a kidney transplant, amplifying another threat to his life. A workable new solution was out there, but it was so new that few doctors had access to it. Fortunately for this patient, Chris Ingelmo, MD, at Stern Cardiovascular Foundation was among the few. Last month, Ingelmo’s implant of a recently developed defibrillator called an S-ICD® System was thought to be the first in Tennessee. The S-ICD® doesn’t require direct

“Particularly young women with certain medical conditions might not want that oldstyle defibrillator where it’s in the top of their chest and visible all of the time,” he said. “This can be inside the bra. So you still have a bump, but it’s not as conspicuous.” The new device, which the FDA approved in 2012, is not in wide distribution yet. Demand has exceeded supply, and the manufacturer – Boston Scientific – has given priority to doctors who gained experience with the S-ICD® during PHOTO COURTESY OF BOSTON SCIENTIFIC clinical trials. contact with the heart and surrounding Ingelmo observed blood vessels. That’s a big advantage for one S-ICD® implant patients on dialysis or dealing with other procedure and perhealth risks, such as cancer or past infecformed another while in tions. fellowship at Cleveland “Also, it’s a fairly good option just Clinic in Ohio before from a cosmetic standpoint,” Ingelmo said. joining Stern. To preDr. Chris The S-ICD® is bigger than a tradipare for January’s proceIngelmo tional defibrillator, but its placement just dure, he sought further under the skin on the left side of the chest training and certification through Boston makes it less obtrusive. Scientific.

Other doctors with Stern will train for the S-ICD® procedure in the next few months, enabling access for more patients. Ingelmo estimated that 20 percent or more of patients in need of a defibrillator implant could be considered for the S-ICD®. Stern’s success with the S-ICD® comes on the heels of another procedural first. In December, doctors at Stern performed one of the region’s first LARIAT procedures – a surgery that cuts the risk of stroke for patients who can’t take blood thinners. Stern’s efforts to make new technology and procedures available to patients as soon as – or before – they are FDAapproved or widely available is in keeping with a proud tradition of innovation that goes back to founder Neuton Stern, who brought Memphis’ first EKG machine to the city in 1919. At any given time, Stern is involved with 20 to 25 clinical trials, said Frank McGrew III, MD, who coordinates much of that involvement. “Almost all aspects of how we treat cardiovascular disease need improvement,” McGrew said. “So we’re always looking for new things. In fact, the number of clinical trials we do really compares quite favorably to that of major medical centers.”

There Is More Than One Way To Treat PVD – And There Is One Center That Has Them All. West Tennessee Heart & Vascular Center brings together interventional cardiologists, vascular surgeons and interventional

My leg pain was stopped with medication.

I got laser treatment.

A stent fixed my problem right away.

radiologists to provide a one stop for all types of testing and all treatment options for Peripheral Vascular Disease (PVD) from balloons or stents, to lasers or clot dissolving medications. And there is only one number to call if you have questions: 541-CARE.

4 Co

WTHVC.org • 541-CArE

westtnmedicalnews

.com

FEBRUARY 2014

GRAND OPENING BARLETT LOCATION

Comprehensive Pain Specialists can help to relieve your pain with a variety of medical treatments to help you get your life back. By combining traditional advanced and regenerative pain-management techniques, we provide efficient, effective and compassionate pain management for a broad range of pain syndromes. We are happy

to announce that Dr. Frank E. Jordan

has joined Comprehensive Pain Specialists.

Dr. Jordan has practiced for over 25 years in west Tennessee providing help to patients who suffer from chronic pain.

All Major Insurance & Self Pay Accepted

For existing patients, Dr. Jordan’s office is still the same. For new patients, please contact Dr. Jordan to schedule a consultation.

855.834.7246 Frank E.

Jordan M.D.

Board Certified Anesthesiology, Internal Medicine and Pain Medicine

160C West University PKWY | Jackson, TN 38305 1015 Kelly Dr, STE 200 | Paris, TN 38242 880 South Pickwick St, STE 2 | Savannah, TN 38372 6570 Stage Rd, STE 130 | Bartlett, TN 38134

CONDITIONS TREATED:

ALL FORMS OF CHRONIC PAIN ORIGINATING IN THE SPINE, JOINTS, MUSCLES AND NERVES CANCER PAIN SURGICAL PAIN AND INTRACTABLE NERVE DISORDERS

TO SCHEDULE YOUR APPOINTMENT CALL: TOLL FREE PHONE

855.834.7246 TOLL FREE PHONE

855.712.8155 www.CPSPAIN.com 6

FEBRUARY 2014

Physicians’ Steps, continued from page 1 defamation of character.” David Cook, a practicing healthcare defense attorney in Memphis for 37 years, said patients sue when they experience bad outcomes, whether the doctor is at fault or not. “We don’t follow British rule, where the loser of a case pays for all David Cook associated costs. Instead, in America, jury verdict is the final resolution for a dispute, and we have a constitutional right that guarantees any citizen who feels aggrieved has the right to file suit.” When physicians are beginning their practices, they are often advised to secure as much malpractice insurance as they can afford. Coverage is often calculated based on available data per specialty. Those going into higher-risk fields of medicine (i.e., obstetrics vs. dermatology) are advised to seek higher levels of coverage. But assuming the worst does happen and a physician is sued for malpractice, what then? “If the court finds in favor of the plaintiff,” Cook said, “the physician always has a right to appeal. A motion can be made for a new trial. Or a motion can be made asking the judge to reduce the verdict. In either scenario, the case would move along into the Tennessee Court of Appeals. Typically is takes six to 12 months for a case to be put on the docket and heard in the state Court of Appeals. The good news is that filing an appeal stops payment of court-ordered awards, but the clock doesn’t actually stop. Simple interest, at the rate of 10 percent, is being compounded annually from the day the original order was signed.” And getting the case heard by a higher court is no guarantee that the verdict will be overturned. In fact, the ruling of an appellate court could find errors in the original proceedings and order a new trial. Yes, the whole thing could start over again. Or the verdict could be upheld. In the latter scenario, the doctor has one more option, to appeal to the Tennessee Supreme Court. But that court has a right to refuse to hear the case. If there is not a constitutional issue at stake or other jurisdictional basis for the court, the case does not qualify for Supreme Court jurisdiction. However, if the case is accepted by the state Supreme Court, it is likely to be another six to 12 months before the case is heard. Recent state reforms are lessening the number of malpractice cases that actually

Read Medical News Online: WESTTNMEDICAL NEWS.COM

are filed. The state medical malpractice reform acts of 2008 and 2010 put qualifying stipulations in place. Plaintiffs are now required to file a certificate of good faith with the court to show that they have consulted with a medical expert about their case AND that they have been told their case has merit. These procedures have led to approximately a 40 percent decline in the number of malpractice cases filed since 2010. “Close to half of all physicians have been named in a lawsuit,” Cook said. “But many malpractice cases are dismissed or settled out of court and never go before a jury. Of the cases that do get heard, over 90 percent result in verdicts in favor of the defendant, the physician.” Michael Gelfand, MD, an infectious disease specialist on the teaching faculty at the University of Tennessee Health Science Center, has been sued several times, as have his colleagues who practice in high-risk specialties. One of Gelfand’s cases went to trial in federal court and resulted in a defense verdict. His other cases have been summarily dismissed with no payment ever having been made. “When it happens the first time, it feels like a personal matter,” Gelfand said. “You don’t expect that it would happen to you. Most people who enter the field of medicine do so primarily to take care of other people. Generally, the population of physicians is preselected for being altruistic because they care about the suffering of others. So it is always a shock when a patient lashes out. This is someone you were trying to help . . .” “The dynamics are not unlike a divorce. Feelings of ‘I did the best I could’ and ‘Why is this happening?’ are usually coupled with ‘How could someone I cared about lash out at me this way?’” When people feel harmed, they often want to avenge themselves. For instance, in the case of an obstetrician, the hoped-for outcome is a healthy baby. But unfortunately that is not always the case. And when there are problems with a baby, families often look for someone else to blame. Gelfand postulates that physicians have to erect psychological defenses in order to cope with being sued. “Doctors have to learn to take being sued less personally and learn to deal with it in a business-like manner,” he said. “However, there are some personal traits that can be remediated. For instance, if they have an ineffective communication style or do not establish interpersonal bonds with their patients, then they can work to improve those skills. But the greater risk in the aftermath of being sued is that of becoming desensitized to the point that it can poison a physician’s relationship with other patients. “A doctor doesn’t want to work from the prospective of preventing litigation. While negative emotions are normal, generally it is best to proceed with the practice of medicine and not seek a counter-suit. Although the physician retains the right of appeal, it often proves to be too difficult to prove the plaintiff’s intent was malice.” westtnmedicalnews

.com

by Bill Appling

What’s Next Here are a few statistics that might be of interest to you. It involves the ranking of insured people under the age of 18 as a percentage of the total US population in 2012: • Nevada was ranked first with 18.3 percent • Michigan was ranked 50th with 3.5 percent • Tennessee was ranked 29th with 7.3 percent (Source U.S. Census Bureau, Current Population Survey) Industry experts have speculated what 2014 will bring and how implementation of the Affordable Care Act will affect medical group professionals. The question, “Does healthcare reform represent incremental change or a fundamental shift?” was posed during the U.S. News Report Hospitals of Tomorrow conference, in Washington, D.C. last November and hospital executives pointed to mergers, acquisitions and new forms of integration to suggest that it is more of a fundamental change that demands new types of collaboration. I have mentioned in numerous articles that as the MGMA/ACMPE board of directors went through three years of transforming its organization into fundamental change (1) Beginnings; Focus and Action toward the desired state. (2) Neutral Zone; A time where we are between what has been and what are in the future. (3) Endings; Letting go of what has been a consistent and/stable mindset, philosophy, belief, structure, time, environment, role, responsibility, idea, world. We must stop doing things one way and begin doing them another way. Providers must move quickly out of the neutral zone or we will find ourselves reactive to the payers. The terms clinical integration (CI), accountable care organizations (ACOs) and population health management (PHM) are often uttered these days but can be somewhat ambiguous depending on the organization and the particular stakeholders. Although the terms allude to quality care, cost efficiencies and the future healthcare environment, it’s often difficult to ascertain the specifics. I have been working in healthcare since 1987. One of the biggest barriers to successful integration is physician resistance (sometimes rightly so) because physicians aren’t used to thinking and acting in concert with hospital executives and others. My biggest concern is that if physicians and hospitals don’t change this way of thinking we will lose control and insurance companies will continue to rake in millions of dollars at the expense of the patients and the providers. Insurers will be closely watching the rolling implementation of federal and state exchanges through the coming year. The initial rocky launch caused mass confusion and hindered enrollment. In particular, they’ll be scrutinizing the demographics and health risk composition of the emerging marketplace. Most experts say the key will be whether the risk pool is balanced between younger and healthier people and older and sicker people. If the website kinks are worked out – and they seemed to be at year’s end, insurers are poised to take advantage of a huge expansion in their customer base. “What’s not to like about the government saying everybody must have this product and we’re going to help people pay for it?”

westtnmedicalnews

.com

asked Joel Ario, former director of HHS’ office of health insurance exchanges. The first hint of how insurers did during the problematic first three months of open enrollment on the exchanges – and how investors will regard their prospects – came on January 16 when UnitedHealth Group detailed its fourth-quarter finances. Observers are also watching to see how the 80 new entrants to the individual and small group markets fare in 2014. Experts also anticipate more employers will buy coverage for their employees through private insurance exchanges offering multiple plan options, similar to the public exchanges. In this arrangement, firms give their employees a fixed contribution and let them choose an insurer and plan. Insurers are banking on continued growth in the Medicare Advantage. More than a quarter of all Medicare enrollees are now in private plans, and roughly 40 percent of new Medicare beneficiaries are choosing Advantage rather than traditional Medicare. Insurance consultant John Gorman expects the number of individuals enrolled in private Medicare plans to grow by 8 percent to 10 percent annually. When we were organizing the fundamental change/changes of the MGMA/ACMPE the board recognized that we had to have various stakeholders and volunteers from throughout the organizations. We knew we could not be lacking in data and sound information and had to be transparent with our membership. If not the chances of success would be virtually nonexistent. The organization is the leading association for medical practices administrators and practices has been in existence since 1926. Its national membership represents more than 33,000 medical practice administrators and executives in practices of all sizes, types, structures and specialties. Organizations and associations have very strong, deeply ingrained cultures. They have profound, long-standing traditions. They have powerful and intricate political dynamics. They are manipulated by influential and formidable personalities, in many cases, a bank of opinionated past individuals. They often value the status quo. Most are reactive than proactive. Quite frankly, most organizations and associations are hostile environments for change. In this type of environment, you don’t stand much of a chance of making a case without data. But the facts can be a powerful strategic resource in promulgating change, particularly fundamental radical change. Although the following four thoughts may seem too simple, I will tell you they were most helpful for the MGMA/ACMPE in our change and sanity. And they may help us keep our cool as we navigate the ACA waters that lie ahead… • Don’t get overwhelmed. • If your data voids are considerable, prioritize and get to work. • Concentrate data gathering in a short, specific time frame. • When perfect data is not available, use the best you have. 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.

FEBRUARY 2014

Hey Doc, Oh Yes They Are By TIM NICHOLSON

For the better part of the Social Era, physicians have decried the use of social media among their target demographic: grownups and the elderly. But guess what? Dads, Moms and even Grandma are all up in social media tools like Facebook and it’s time you connected with them there. In fact, a recent Pew Internet Research study found that 71 percent of adults online are on Facebook and that’s up from this time last year. Really, parents and grandparents are the only real growth areas for Facebook with 45 percent of people 65 years and older using Facebook. However, it’s not the only site to see growth. Twitter saw growth among adults. But it’s Pinterest that has the most momentum as over 1/3 of all women online report using the image and idea sharing platform to curate inspiration, health tips, recipes, fashion and other topics – often from people like you. Okay, let’s admit it. Most of the people offering these bits of hope and information are not nearly as well qualified as you to share ideas in a way that might lead to improved health. I’m going to guilt you into this. You should be using social media if for no other reason than to make sure that at least some of what women are curating makes sense in the context of a healthy lifestyle. Hey, when grandma falls down and can’t get up, we want her to have a button to push for help. But when we’re trying to coach mothers, grandmothers and other adults we’re willing to let the purveyors of gimmicks lead the way. It’s time for an intervention. Want more evidence in the case for your being present online? Consider this: From a recent study, 54 percent of patients are very comfortable with their providers seeking advice from online com-

FEBRUARY 2014

munities to better treat their conditions. It’s evidence that many trust that crowd sourcing of information from other likeminded individuals is reliable. This shows how people perceive the social media to be beneficial for the exchange of information about their health. Why shouldn’t you be the one from whom they curate it? Need a business reason? 41 percent of people said social media would affect their choice of a specific doctor, hospital, or medical facility. This shows that social media can be a vehicle to help scale positive word of mouth, which makes it an important channel for an individual or organization in the health care industry to focus on in order to attract and retain patients. Consumers are using social media to discuss everything in their lives including health and it is up to your organization to choose whether it’s time to tune in. Lest you think it’s just patient talking, here’s this from professionals like you: 60 percent of doctors say social media improves the quality of care delivered to patients. Wow! So there are doctors (maybe you’re one of them) who believe that the transparency and authenticity that social media helps spur is actually improving the quality of care provided to patients. So if you’re still saying, “My patient demographic and providers like me don’t take social media seriously” and that “neither patient nor doctor is there” – I say, oh yes they are. 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

Physicians Selling Practices

Trend watch: who’s making the move now and why By LYNNE JETER

Since Congress passed the Affordable Care Act (ACA) in 2010, doctors have been bailing out of practices posthaste. Exasperated by surging expenses, shrinking reimbursements and costly-to-cover government mandates, frustrated physicians are citing healthcare reform-related spending as a major reason for selling practices as the rollout progresses. According to a study by Jackson Healthcare, the nation’s third largest healthcare staffing agency, 12 percent of physicians who sold their practices before sweeping federal legislation became law made the change because they didn’t have appropriate resources to comply with the law and maintain a reasonable ROI. Within the last three years, the rate of physicians selling their practices for the same reason – especially now with dwindling ways to stay fiscally healthy – jumped to 30 percent. “Of those now considering selling their practices, 36 percent cite the complexity of the healthcare reform law as a reason; and 24 percent say they don’t have the resources necessary to comply with the law,” according to Jackson Healthcare’s report. “The burdens also appear to be taking physicians away from their families. They want better work-life balance, with less time working and more time in their private lives. Forty-three percent feel employment, rather than ownership, will give them that balance.” Even though no statistical differential denotes the type of physicians who want to remain in private practice versus those actively marketing their practice, nearly half actively seeking to sell are internal medicine subspecialists (23 percent), primary care physicians (14 percent) and surgeons (12 percent). Of those internal medicine subspecialists, 23 percent are otolaryngologists, 17 percent are urologists, and 13 percent are cardiologists. Reimbursement cuts (79 percent) and the cost of maintaining a practice (64 percent) were the most commonly cited reasons among internal medicine subspecialists who want to sell; 57 percent also pointed to the complexities of healthcare reform as a reason for selling, cited the report. Three of four surgeons marketing their practices said reimbursement cuts and healthcare law complexities were contributing factors in the decision to sell. Not surprisingly, hospitals and health systems are acquiring most physician practices (52 percent). Interestingly, solo practitioners accounted for 19 percent of physician practice buys, while physicianowned groups made 18 percent of group acquisitions. Ten percent of doctors who

sold their practices listed their buyer as “other.” Even though physicians are leaving the ownership aspect of private practice, most aren’t departing the practice of medicine. Only 9 percent sold their practices because they wanted to retire; 6 percent sold because they wanted to leave the practice of medicine. “Physicians in private practice still outnumber those employed, but this could be shifting as less than half of the respondents with an ownership stake say they plan to remain in private practice,” according to the report. The last cycle of hospitals snapping up private practices occurred in the 1990s, when hospitals saw the acquisitions as a way of gaining access to more patients. As a result, physicians got sweet deals. But in this buying cycle, the deals aren’t as financially rewarding. Yet the circumstances provide a way for private practice doctors to step out of time-consuming administrative roles while also appreciating a steady income and sometimes improved hours as employees. A post-sale downside that impacts physicians to widely varying degrees: adjusting to the loss of autonomy. Simply put, the private practice model has become very expensive to operate, John Dubis, CEO of St. Elizabeth Healthcare in Cincinnati, Ohio, explained to CNN Money. “That’s why it’s diminishing,” he said, noting that most of the 300 physicians employed by the hospital’s specialty physicians group were plucked from private practices. In December 2012, Montana-based St. Vincent Healthcare acquired Frontier Cancer Center, established in 1982. The close-knit group of five oncologists had struggled financially pre-healthcare reform, taking a significant hit in 2003, when Medicare changed the way it reimbursed doctors for chemotherapy drugs. Despite taking significant pay cuts, the group closed one of its four locations in 2008. With the dark cloud of bankruptcy looming, the group was happy to find a buyer. “We have a joke,” said Patrick Cobb, MD, an oncologist in the Frontier group told CNN Money, “that there are two kinds of private practices left in America: those that sold to hospitals and those that are about to be sold.” In a companion survey released by Jackson & Coker, a subsidiary of Jackson Healthcare, a majority of doctors want to see ACA defunded or repealed. A scant 6 percent said it should remain unchanged. “The more physicians learn about ACA, the more they dislike it and want to start over,” said Richard L. Jackson, chairman and CEO of Jackson Healthcare.

westtnmedicalnews

.com

Changing Healthcare Landscape Not Slowing Drive for Med School By KIMBERLY ALEXANDER

Now that the health insurance marketplace is open, many are wondering about the immediate effects the Affordable Care Act will have on the healthcare industry. For example, will medical degrees lose their luster? Will the financial uncertainty and politicizing of the profession discourage students from pursuing a medical degree? Will there be enough healthcare professionals to care for a growing population? At this point, the long-term financial and political implications of the healthcare overhaul, dubbed Obamacare, do not seem to be of real concern to students considering a medical career, at least not yet. Local student response bears this out as few students, if any, are asking about how the ACA will affect their reimbursement or bottom line as physicians. Jessica Clifford Kelso, a pre-professional advisor with the University of Memphis, said she hasn’t received any such questions from students or their parents. Dr. Susan Brewer, assistant dean for clinical curriculum and associate professor of medicine at the at the University of Tennessee Health Science Center College of Medicine, agrees.

“As far as ‘will this [the Affordable Care Act] have an impact on me?’ there’s not a lot of worry,” Brewer said. “There’s curiosity.” Another indicator that students aren’t yet concerned about how the ACA will affect their futures is the number of students applying to medical school. Nationally, these numbers are off the charts and don’t appear to be slowing down, even with the dismal rollout of the ACA marketplace. According to the Association of American Medical Colleges, the number of students applying to medical school in 2013 grew 6.1 percent to 48,014, which surpassed the previous record set in 1996 by 1,049 students.

Additionally, 20,055 students enrolled in medical school, which represents the first time that number has ever exceeded 20,000. The number of first-time applicants, another indicator of interest in medical school according to the AAMC, increased by 5.8 percent to 35,727. Local numbers and experiences support this. Students expressing aspirations for medical school have not diminished at the U of M, according to Kelso. Rather, such interest has increased. At the College of Medicine, medical school applications and enrollment are trending up. “We increased the size of our medical school class a few years ago from 150 to 165, and we are filling those slots and have plenty of applicants,” Brewer said. “So there’s been no decrease in enrollment in the last couple of years. In fact, just the opposite.” The College of Medicine reports a 25 percent increase in applicants in 2012, a steady 2013 and a 5 percent increase for 2014. Additionally, Brewer said, medical school enrollment nationally jumped almost 9 percent in 2012 and 2.8 percent in 2013. So filling vacant slots is not a concern for most medical programs. “Our problem is going to be a bot-

tleneck that emerges when our current medical students ... try to get residencies,” Brewer said. That’s primarily because the number of residency slots funded by Medicare has not increased since 1997. So the concern for most students, according to Brewer, is, “Am I going to be able to match in a residency when I finish my medical degree?” That is the critical question, not how ACA will affect the student. The reason is simple. “Because without a residency, no one can practice medicine,” Brewer said. The College of Medicine is taking steps to help its students get the training they need. It has a robust counseling program in place, which is especially helpful for students pursuing a competitive residency, and the college also is engaging in public outreach to legislators to make them aware of the residency and funding shortage. While there are many challenges and uncertainties in the current healthcare environment, Brewer doesn’t think these will “scare” students away from the profession. Rather, she’s more concerned about lowerincome people in Tennessee having access to healthcare. “I hope that the Affordable Care Act gets to be more affordable or leads to more affordable insurance options,” she said.

Healthcare is Changing.

ADMINISTRATORS How can you stay on top of the issues?

Join MGMA in 2014! Monthly luncheons with Executive Level Education! For more information, contact J. Neal Rager at 731-661-6340 or nrager@pscjackson.com.

WEST TN MGMA westtnmedicalnews

.com

FEBRUARY 2014

M&A Trends in the Reform Era A look back at 2013 … Look ahead in the new year By CINDY SANDERS

The Affordable Care Act, coupled with new models of reimbursement, has undoubtedly impacted the way the healthcare industry conducts business today and strategically plans for the future. For some industry sectors within healthcare services, a ‘strength in numbers’ mentality has caused a marked uptick in mergers and acquisitions in comparison to a few years ago. For others, the strategy has been to take more of a ‘wait and see approach’ while trying to figure out just how the new rules will impact their specific markets. Frank Morgan, who serves as managing director for Healthcare Services and Equity Research with RBC Capital Markets, recently shared his thoughts with Medical News on the level of activity in 2013 and his expectations for the coming year. With more than two decades experience in equity research and inFrank Morgan vestment banking, Morgan primarily focuses his research on facility-based healthcare services including hospitals, skilled nursing and assisted living facilities, long-term acute care (LTAC), behavioral health services and rehabilitation. Morgan, who has been recognized for his expertise within the health services industry by multiple national publications and industry rankings, is a popular speaker and participant in financial panels. Overall, Morgan said there was a general uptick in activity in 2013 compared to 2012. That was particularly true within the hospital sector. “’13 … if not a record year … was a very good year for M&A activity,” he noted. “You really saw it on the not-for-profit side,” he added. There are several reasons for the ‘super-sizing’ of hospital systems starting with implementation of ACA but exacerbated by other market forces including an increase in physicians seeking an employment model, implementation of EHR and changing payment methodologies. “The overarching uncertainty about how the world is going to play out over the next four or five years has led to the leveraging of strengths,” said Morgan. He added the leaders of individual hospitals or small systems are faced with deciding to weather the changes on their own or join forces to be part of a bigger group that has the infrastructure in place to manage and deal with the new healthcare delivery landscape. From mergers to acquisitions to strategic joint ventures, there was a lot of movement on the not-for-profit side, which makes up about 80 percent of hospitals in America. Dallas-based Baylor Health Care System and Temple, Texas-based Scott & White Healthcare completed their merger in late September to create the largest not-for-profit health 10

FEBRUARY 2014

system in Texas. Earlier in the year, Michigan-based Trinity Health merged with Pennsylvania-based Catholic East in one of the largest nonprofit mergers of 2013. And some interesting partnerships occurred between not-for-profit hospitals and systems and publicly traded operators. LifePoint Hospitals and Duke continued to acquire hospitals for their joint venture. One of the largest mergers occurred between a nonprofit hospital system and a major insurer when the Pennsylvania Insurance Department approved the affiliation between Highmark (a BlueCross BlueShield subsidiary) and West Penn Allegheny Health System, both based in Pittsburgh. After closing that deal in April, Highmark went on to add two more Pennsylvania-based hospital systems to its integrated delivery system, Allegheny Health Network. While a lot happened on the nonprofit side, Morgan noted there were also major acquisitions within the publicly traded hospital space. “On the for-profit side, there were two notable deals completed or announced in 2013 — Tenet Healthcare & Vanguard Health Systems and Community Health Systems & Health Management Associates.” In the first deal, Nashville-based Vanguard was the target of Dallas-based Tenet. The latter completed its acquisition of Vanguard at the beginning of October in a deal valued at approximately $4.3 billion ($1.8 billion purchase price plus assumption of $2.5 billion of Vanguard debt). The second deal, Morgan said, was announced last year and is anticipated to close in the first quarter of 2014. In this case, Franklin, Tenn.-based Community Health Systems seeks to acquire HMA, which is headquartered in Naples, Fla. Just before Thanksgiving, CHS and HMA announced the companies’ proposed merger had been declared effective by the Securities and Exchange Commission (SEC), clearing the way for a vote by HMA stockholders for or against adoption of the merger agreement. With a purchase price close to $4 billion plus assumption of debt, the overall value of the merger is anticipated to be in excess of $7.5 billion, making it the largest deal since the HCA buyout in 2006. Once the merger is executed, CHS will own and/or operate 206 facilities with more than 30,000 licensed beds. “From and M&A perspective, I would expect to see a continued robust level of activity,” Morgan said of 2014. However, given the limited number of publicly traded companies and the amount of activity that has already occurred in that space, he said he expects much of the future activity to be in the not-for-profit world. Behavioral health had a “decent” 2013, Morgan said. Franklin, Tenn.based Acadia Healthcare enjoyed another healthy year of growth. The company

began the year by completing previously announced deals acquiring Behavioral Centers of America and AmiCare Behavioral Centers and then proceeded to acquire additional individual facilities in Georgia, Tennessee, Florida, and Puerto Rico during the remainder of the year. Morgan said he expected the company to continue to grow in 2014. A behavioral health “marriage” announced in late 2013 is expected to come to fruition in 2014. In November, the leadership of Centerstone, which has a major presence in Tennessee and Indiana, and the H Group, with facilities in Illinois and Kentucky, announced their intent to affiliate. Although the H Group will operate under the Centerstone flag, David Guth, CEO of Centerstone of America, said the affiliation had no money or assets changing hands and was instead a joint effort to “create a stronger and more effective behavioral health service organization.” Earlier in November, Hazelden and the Betty Ford Foundation also announced a mega-merger in the addiction space. After a slow start, Morgan noted home health saw some movement by late 2013. “In home healthcare, we did see a little bit of pick up at the end of the year,” he said, noting Louisville, Ky.-based Almost Family acquired Nashville-based SunCrest Healthcare in December. Going forward, Morgan said, “2014 could potentially be a year where you see more consolidation in the home health space.” Other sectors, said Morgan, were considerably quieter in 2013. Senior housing saw some limited activity, as did dialysis. Morgan said the latter was already pretty consolidated with the two big players being DaVita and Fresenius. “Between the two, they already control about 55 percent of the domestic market,” he pointed out. It was also a fairly quite year for labs, hospice, skilled nursing and LTACs as these sectors restructure and re-evaluate expectations under ACA and the impact of post-acute bundled payments. In the lab space, Morgan noted, “They’re not redeploying capital for growth right now. They’re trying to pacify stockholders by buying back shares and paying dividends because of the weaker organic growth because of pricing and volume pressures.” In general, Morgan concluded, there was good news in the equity markets for a number of healthcare sectors in 2013. “The S&P was up almost 30 percent … healthcare services was up over 37 percent,” he noted. For some, the gains were even greater. Morgan said behavioral healthcare was up over 100 percent and hospitals up over 44 percent. Looking ahead, he said, “I still think you can have really attractive returns for 2014 given valuations are still reasonable and the growth opportunities presented by the Affordable Care Act, but I think you need to pick your subsectors carefully.”

PUBLISHED BY: SouthComm, Inc. CHIEF EXECUTIVE OFFICER Chris Ferrell MARKET PUBLISHER Pamela Harris pamela@memphismedicalnews.com Ad Sales: 501.247.9189 LOCAL EDITOR pharris@medicalnewsinc.com NATIONAL EDITOR Pepper Jeter editor@medicalnewsinc.com CREATIVE DIRECTOR Susan Graham susan@medicalnewsinc.com 931.438.8771 GRAPHIC DESIGNERS Katy Barrett-Alley Amy Gomoljak

James Osborne

Christie Passarello CONTRIBUTING WRITERS Kimberly Alexander, Suzanne Boyd, Ron Cobb, Amy French, Pamela Harris, Lynne Jeter, Emily Adams Keplinger, Cindy Sanders ACCOUNTANT Kim Stangenberg kstangenberg@southcomm.com CIRCULATION subscriptions@southcomm.com —— All editorial submissions and press releases should be emailed to: westtneditor@medicalnewsinc.com —— Subscription requests or address changes should be mailed to: Medical News, Inc. 210 12th Ave S. • Suite 100 Nashville, TN 37203 615.244.7989 • (FAX) 615.244.8578 or e-mailed to: subscriptions@southcomm.com Subscriptions: One year $48 • Two years $78 SOUTHCOMM Chief Executive Officer Chris Ferrell Chief Financial Officer Patrick Min Chief Marketing Officer Susan Torregrossa Chief Technology Officer Matt Locke Chief Operating Officer/Group Publisher Eric Norwood Director of Digital Sales & Marketing David Walker Controller Todd Patton Creative Director Heather Pierce Director of Content / Online Development Patrick Rains West TN Medical News is published monthly by Medical News, Inc., a wholly-owned subsidiary of SouthComm, Inc. ©2014 Medical News Communications. All rights reserved. Reproduction in whole or in part without written permission is prohibited. Medical News will assume no responsibilities for unsolicited materials.        All letters sent to Medical News will be considered Medical News property and therefore unconditionally assigned to Medical News for publication and copyright purposes.

westtnmedicalnews.com

westtnmedicalnews

.com

GrandRounds Dr. Peter Lin Earns Board Certification Dr. Peter Lin, a plastic surgeon at The Jackson Clinic, is now board certified, American Board of Plastic Surgery. Dr. Lin completed his undergraduate degree at the University of California, Los Angeles, CA. He received his Doctor of Medicine from Georgetown University School of Medicine, Washington, DC. Dr. Lin completed his General Surgery and Plastic Surgery Residency, as Dr. Peter Lin well as his General Surgery Internship at the University of California, Irvine, CA. He specializes in cosmetic and reconstructive surgery. Treatments include breast enhancement, liposuction and brow, face, and eyelid lifts. The Jackson Clinic also offers Botox and Collagen treatments. Additionally, laser treatments are available for unwanted hair, spider veins, birthmarks, sunspots, and rosacea.

West Tennessee Healthcare Announces Property Purchase West Tennessee Healthcare has announced plans to purchase a 2.7 acre tract located at 2017 South College Street in Trenton for $196,000 for a new Trenton Medical Center which will offer a range of medical services tailored to the health needs of the community. Gibson General Hospital, located at 200 Hospital Drive in Trenton, will close and the site will be sold to Gibson Electric Membership Corporation for $70,000. The agreement with Gibson Electric will allow West Tennessee Healthcare to provide its new Trenton Medical Center services in part of the existing hospital building until a new facility is constructed. The Trenton hospital, including its Emergency Room, closed on January 17. Trenton Medical Center began providing services at the current hospital site on January 20, 2013. Services will include an afterhours urgent care walk-in clinic, Sports Plus outpatient physical therapy, an onsite lab and imaging services. The new Urgent Care Clinic at Trenton Medical Center will be located in the former hospital emergency department. It will operate on weeknights from 4:00 p.m. to 9:00 p.m. and 8:00 a.m. to 1:00 p.m. on Saturdays. It will be closed on Sundays. Sports Plus outpatient physical therapy will remain a key part of Trenton Medical Center. All of the physical therapists, most whom have been with Sports Plus for years, will continue working with patients with no disruption in services. The on-site lab and imaging services will continue to operate to serve local physicians and residents. All of the primary care services currently offered on the Gibson General Hospital campus by various providers will remain unchanged. Humboldt Medical Center launched January 18, 2014 following the closing of Humboldt General Hospital and its Emergency Room on January 17, 2014. The health care services there are also being

westtnmedicalnews

.com

tailored to the needs of the area. Humboldt Medical Center will include a satellite location of Jackson-Madison County General Hospital Emergency Department staffed by a team of eight board certified doctors. It will also include Sports Plus outpatient physical therapy, outpatient laboratory and imaging services and a conference center. In Milan, the addition of a hospitalist program has been completed. The addition of 24/7 coverage by doctors who specialize in the care of hospitalized patients was announced in early December. The hospitalists collaborate with primary care physicians throughout Gibson County and beyond.

UT Medical Group Adds Interventional Cardiologist Interventional cardiologist Dr. Nadish Garg has joined the department of medicine at UT Medical Group, Inc. and been named assistant professor at the University of Tennessee Health Science Center. Garg earned his medical degree at Dayanand Dr. Nadish Garg Medical College and Hospital in India. He completed internal medicine residency and a fellowship in cardiovascular medicine at the University of Missouri, followed by an advanced fellowship in cardiac imaging at Methodist Hospital in Houston. Most recently, he attended the University of Arkansas Medical Sciences in Little Rock, where he completed additional training in interventional cardiology. Garg is board certified by the American Board of Internal Medicine Subspecialty Board of Cardiovascular Disease, the National Board of Echocardiography, and the Society of Cardiovascular Computed Tomography. He is a specialist in coronary and peripheral vascular interventions, cardiovascular imaging, heart failure and heart valve replacement, nuclear cardiology, cardiac CT, and echocardiography.

olds ranked number one in listing of funds with the most dollars contributed. Hands Up had donors that provided $404,742.88 for the year. There were 535 donors with an average gift of $456.03. The second highest in fundraising efforts was the VA Cemetery that will located in Henderson County. Donors contributed $144,896.65 to provide a matching gift for the cemetery. With 281 donors during 2013, the average gift was $515.55. The third highest fund was the Therapy and Learning Center with 1700 donors and a total of $54,490.54. Their average gift was $59.46. Ranking fourth in funds raised at the Foundation was the M. D. Anderson Memorial in Downtown Jackson. Four donors contributed $44,525.00 toward the construction of the nine-foot granite memorial. Fifth in the rankings of highest fundraising was the Reinbow Riding Academy’s Hippotherapy program. With 281 donors contributing $44,125.12, the average gift was $157.03. This program provides special needs children with therapy that is currently not covered under any local insurance programs. More donors gave to the Therapy and Learning Center (formerly the West Tennessee Cerebral Palsy Association and Kiwanis Center for Child Development) than any other fund with 1,700 donors. One of the largest efforts in our community, regarding

Medical News is pleased to provide space for press releases by providers in our Grand Rounds section. Content and accuracy of the releases is the sole responsibility of the issuer.

GUARANTEED

CLICUGKHS-

THRO

West Tennessee Healthcare Foundation Announces Top Ten Funds Since its beginning in 1984, the West Tennessee Healthcare Foundation has worked to improve the health and quality of life to those living in Jackson and West Tennessee. It is fitting that the Foundation began with a project new technology of the day utilizing a new type of technology called a “Life Line” unit where the elderly and those with limited mobility could alert authorities in case of an emergency. From this first project, the Foundation has grown to become a leader in charitable causes and support. Today the Foundation provides charitable support to over 500 “funds” that add to the quality of life of the Jackson and West Tennessee communities. The year of 2013 served as a record in many ways. The Foundation had revenue that exceeded $7 million. Nearly 5,000 donors made restricted gifts to the Foundation for specific causes that amounted to more than $3.5 million. Hands Up, a school for 3 and 4 year-

the number of gifts, this fund also was one of the top-five funds overall. Second in donor popularity with donors was the Children’s Medical Care Fund with 1,246 donors who contributed just over $7,000 with an average gift of $5.64 per donor. While the average gift was relatively small, donors at the grass roots level saw the importance of supporting the care of children at the Ayers Children’s Medical Center. Hospice of West Tennessee is one of the most loved charities of the WTH Foundation. During 2013, it was the third most popular recipient of donor dollars with 1,186 donors giving $25,383.29. The gifts averaged $21.40. The Kirkland Cancer Center Fund was the fourth most popular fund in number of gifts. More than 960 donors contributed $11,785.04. The fifth leading fund in the number of individual gifts to a fund was the Pathways fund. With 649 donors, funds were raised to assist in the mental health of Jackson area nearly $4,000. To find out more about establishing a fund or an endowment or a fund at the Foundation, email Frank McMeen at Frank. McMeen@wth.org

Get verified results (impressions and/or clicks) for (LOCAL) online advertising.

Increase web traffic

Powerful branding opportunity

Any metro market in the U.S. Preferred, certified brand-safe networks only

Retargeting, landing pages, SEM services available

DIGITAL@SOUTHCOMM.COM FEBRUARY 2014