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PHYSICIAN SPOTLIGHT PAGE 2
Joseph Fouche, MD
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March of Dimes: Making a Difference for Tiny Tennesseans January is National Birth Defects Prevention Month. March is in the name. November is National Prematurity Awareness Month ... 5
Rural Hospitals: The Challenge to Remain Open By SUZANNE BOyD
Across the country, many rural hospitals are closing. In the past 25 years, more than 470 rural hospitals have closed. Since 2010 rural America has seen over 1500 hospital beds vanish. According to the National Rural Health Association (NRHA) 43 rural hospitals have closed in the past three years, with almost a third of the closures occurring since January 2014. West Tennessee is not immune to the trend, since it has seen its share of closings in the past few years. Shifts from fee-for-service to pay-for-performance reimbursement models, an overall cut in reimbursements and Congressional gridlock have taken a negative toll on U.S. hospitals’ bottom lines. But rural hospitals are hit particularly hard, because they are caught between a rock and a hard place where they serve higher rates of uninsured patients but are also more likely to be located in states that have rejected health reform and the funds to cover the uninsured that come with it. Add to that, other (CONTINUED ON PAGE 6)
By the Numbers: The Latest Stats on Cancer Death rates down, more work awaits What’s Happening to our Safety Net? Changes, challenges of free clinics and covering the uninsured America’s free and charity clinics are undergoing a transformation, and not necessarily in a good way ... 8
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By CINDy SANDERS
As the ‘official sponsor of birthdays,’ the American Cancer Society (ACS) found a reason to rejoice in their latest report – Cancer Facts & Figures 2015. Since hitting a peak in 1991, cancer deaths have fallen 22 percent over two decades in the United States, which means more than 1.5 million deaths have been avoided … and more birthdays celebrated. An ACS infographic showed 3.3 million cancer survivors in the United States in 1973. Today, there are more than 14.5 million cancer survivors, and that number is (CONTINUED ON PAGE 4)
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PhysicianSpotlight
Joseph Fouche, MD By SUZANNE BOyD
While he may have dreamed of one day running plays in the National Football League, Joseph Fouche, MD is formulating plays of a different sort these days. As a hematologist/oncologist at the Alice and Carl Kirkland Cancer Center, the burly former football player from Tulane with the heart of a teddy bear is devising a game plan to help patients beat cancer. Although he is a native Jacksonian, Fouche hails from one farther south than the one he chose to practice medicine in and one that is closer to his Louisiana roots, Jackson, Mississippi. After graduating from Callaway High School, Fouche capitalized on his success on the gridiron to pay for his college education by earning a scholarship to Tulane University in New Orleans. While Fouche realized his football career would not extend beyond college, he was not sure what career he would pursue. In his sophomore year, a friend suggested a genetics class, which led to his discovering a desire to be a physician. “I was mainly more focused on life, not really what I would pursue in a career,” said Fouche. “My genetics teacher, Dr. Joan Bennett, told me a story about a football player who went on to become a doctor. She really took an interest in me as well as where I was headed. I had a couple of uncles who were surgeons but I had not considered medicine until then. Dr. Bennett started mentoring me and helped me get a volunteer position in a hospital and really encouraged me to pursue medicine.” After graduating from Tulane, Fouche earned his medical degree in 2008 from Case Western Reserve University School of Medicine in Cleveland, Ohio.
He initially thought surgery would be the route he would take but then switched to cardiology. While interning, he met another influential mentor who encouraged him to look at oncology. “I signed up for a rotation and realized she was right,” said Fouche. “It was the perfect fit for my personality. I think of all the specialties, oncologists have the most compassion. We have a relationship with our patients unlike no other that allows you to become very close to them and their family. A cancer diagnosis is a scary thing and while the dying process can be a factor, cancer is more about life than death. Working with cancer patients really changed my perspective to focusing on life because that is what is in front of us each day.” Fouche returned to New Orleans to complete his Internal Medicine residency
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at Tulane University School of Medicine in 2011 followed by a three-year Hematology/Oncology fellowship. Tulane’s program is one of the top hematology programs in the country and it gave Fouche exposure to a wide range of patients. “Because New Orleans is rich with different cultures, it afforded me the opportunity to treat a wide range of cancers and blood disorders,” he said. “I also learned to be a better clinician there. I came one year after Hurricane Katrina and the impact that had on the resources available really made me learn to use my intuition as well as be creative in treatment options for patients.” Fouche says the lifestyle of those living in New Orleans is one element that makes the people there different and is something that cannot be duplicated anywhere. “The area is so underserved and there is a day-to-day struggle just to get the basic necessities of life. Healthcare gets put on the back burner. It does cause issues with cancer care and Katrina certainly has had an impact on that,” he said. “Resources are being diverted to other places so there are funding issues for insurance and care that are even worse than other places. Subsequent to that, cancer care is lagging behind a little and while some may say it wasn’t an ideal place to start my training, it just meant I learned to be more creative to make sure they got the care they needed.” In his second year of his fellowship, Fouche heard of a position in Jackson, Tennessee with the Alice and Carl Kirkland Cancer Center. Although he did not know much about the area, he did have family in Memphis and his wife, Sophia, had family in Nashville, so he thought he would look into it. What he found in Jack-
son blew him away. Even with other offers on the table, he knew this was where he wanted to practice and just needed to convince Sophia that life in a smaller town was the right choice. In August of 2014, he joined the staff of the Kirkland Cancer Center. “I had interviewed some other places but I really wanted liked the medical community, the staff here as well as the slower pace of Jackson. The patient centered approach here meant I would have more time with patients to plan their course of treatment. That was not something my other options offered,” said Fouche, who is Board Certified in Hematology and Oncology. “I think it is important to have time to spend with the patient in order to better determine their goals as well as what the best course of treatment is. Developing a relationship with them and their families helps to make their care that much more personal.” The biggest change for Fouche and his wife, who is expecting their first child in September, has been the food. “I think New Orleans has the best food in the world. But we have made it our goal to try every restaurant in the area,” he said. “The trade-off is getting to work with and care for some of the best people. The sense of camaraderie among all the clinicians is also a huge bonus.”
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Tight Budgets Don’t Slow Changes In Healthcare Marketing Digital use by hospitals, clinics continues to grow By BETH SIMKANIN
Growing costs are affecting every aspect of healthcare, including marketing. Fortunately for that segment of the industry, the addition of an important new dynamic currently is being accomplished despite the strong economic challenges. Mid-South hospitals, clinics and medical centers are turning to digital marketing, including search engine optimization, mobile marketing and social media, for costeffective ways to reach the growing number of consumers who look online for healthcare information. The addition of digital marketing can be added to a total marketing effort without breaking a budget. Marketing teams need only decide what other segments of their overall effort should be scaled down. “We have reallocated our funds from traditional marketing efforts to include our digital efforts,” said Jennilyn Utkov, senior director of marketing and communications for Le Bonheur Children’s Hospital. “We must focus on how things are presented visually online, so we have invested more in video and photography to tie our message together.” Reducing expenditures in other areas seems appropriate because some tactics have become less effective as the Internet becomes a more important tool for an everincreasing segment of the population. According to the Pew Research Center, 72 percent of Internet users say they have looked online for health information within the past year. The Internet, paired with advice from referring physicians, is helping patients make more informed healthcare choices. “Our audience mainly consists of 25to 44-year-olds with children, and they rely less on traditional media and instead are accessing information online,” Utkov said. “We must meet their needs and provide the right content in the right place for the right audience.” Michelle Hodges, brand marketing director at Memphis Orthopaedic Group, warns that marketers in the healthcare industry shouldn’t lose sight of the overall picture. “Marketing isn’t just about social media or traditional media; it’s any activity that moves a practice in a positive, desired direction,” Hodges said. “It takes a strategic marketing plan composed of many elements (including traditional media) supporting each other to move the needle forward, and targeting physicians and medical practices is a large part of that strategy. It’s estimated it takes five or more encounters with a practice name for it be recognized.” She said a mix of publications from general interest to niche such as medical media is a vital element in supporting brand recognition and growth. “Respected medical publications lend westtnmedicalnews
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credibility to the practices that advertise. It’s all about your marketing mix. Advertising in a medical publication supports our grass roots efforts of personally calling on these physician offices to generate referrals and awareness of service lines/locations/ hours. It’s a “no brainer” in terms of marketing strategy as it targets a very specific demo we are trying to reach,” she said. Hospitals such as Regional One Health advertise on traditional media platforms such as radio, television and billboards, but the marketing focus is on building brand awareness, not services, accordingly to Allison Vance, director of corporate marketing for Regional One. “Consumers come to our website to take action. Allison Vance For example, they want to see what specific healthcare services we provide and find a physician,” she said. “They can access that easily from our site.” Content management and search engine optimization is a key factor in delivering targeted, measurable results online. Healthcare marketers can identify information consumers are accessing and what information is critical. For example, Utkov can identify that Le Bonheur’s practical parenting blog on family-relevant topics is a popular feature on its website. In addition, content must be brief, specific and responsive. “The average person online has an attention span of eight seconds,” said Darnell Settles, web marketing manager for Baptist Memorial Health Care. “A large percentage of (web) traffic comes from organic research, which means someone is actively looking for information, and it must be concise and extremely targeted.” Mid-South marketing experts agree that mobile marketing is a growing trend. Consumers access healthcare information from their mobile phones. According to the Pew Research Center, 52 percent of smartphone owners use their phone to research health-related information, and 19 percent have downloaded a smartphone app to track or manage health. “We track our web analytics and we have discovered that over half of our web traffic comes from consumers accessing our website from their smartphone,” Utkov said. “It is necessary to make your website readable from a smartphone.” Consumers can access all Mid-South hospitals’ websites in a mobile format. In addition, smartphone apps create convenience for patients. Baptist designed a smartphone app called “Minor Med Rest & Relax at Home.” Patients can preregister and check in to one of their four minor medical facilities directly from their smartphones. Health-related non-profits know that mobile marketing can assist them in their
efforts. The Mid-South Transplant Foundation, the Mid-South’s federally designated organ procurement organization, plans to implement a program in which residents can register to become organ and tissue donors by swiping their driver’s license on a smartphone. “Residents can go to our website and register to become an organ and tissue donor any time now,” said Randa Lipman, community outreach manager for MidSouth Transplant Foundation. “Eventually, donors will be able to register simply by swiping their ID on a phone. This is already being done by Donate Life Arizona.” Social media gives hospitals and clinics the chance to share patient stories and connect consumers. Marketing departments manage content, respond in real time to consumers’ questions and monitor dialogue on social media platforms such as Facebook, Twitter and Instagram. “We strategically reach out to our clients and their needs on social media platforms,” said Ed Rafalski, PhD, senior vice president of strategic planning and marketing for Methodist Le Bonheur Healthcare. “Facebook is effective in reaching out to cancer patients and support groups.” The West Cancer Center’s “Fight
On” campaign, a partnership with the University of Tennessee Health Science Center and Methodist Healthcare, created a forum for cancer fighters, survivors and supporters to share their Dr. Ed stories on Facebook. Rafalski Also, Le Bonheur uses its Facebook page to highlight practical parenting tips from its blog. Former patients can post testimonials directly on the hospital’s Facebook page. Healthcare marketers research what social media platforms are appropriate for their audiences, which vary in age. “We realize that not all demographics use Facebook, so our presence varies there,” Rafalski said. “Millennials, Generation X and Baby Boomers all have different needs, and we are doing research to find out where these audiences are getting their information.” “Consumers have many choices for healthcare due to insurance increasing its provider networks and the evolution of retail clinics,” Vance said. “There are more options than there were five years ago.”
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By the Numbers: The Latest Stats on Cancer, continued from page 1 projected to jump to 18.9 million by 2024. Each year, the ACS compiles the most recent data on cancer incidence, mortality and survival using data from a variety of sources including the National Cancer Institute, National Center for Health Statistics and the Centers for Disease Control and Prevention. The most recent five-year data (2007-2011) showed the overall cancer incidence rate held steady in women and declined by 1.8 percent per year in men. The decrease in men was attributed to rapid declines in colorectal cancer (3.6 percent per year), lung cancer (3 percent per year) and prostate cancer (2.1 percent per year). During the same time period, the average annual decline in cancer death rates was 1.8 percent in men and 1.4 percent in women. Lung cancer, while still the deadliest form of the disease, has declined 36 percent between 1990 and 2011 among men. Women have also seen double digit declines attributable to reduced tobacco use. On another happy note, breast cancer death rates for women are down more 35 percent from peak rates, and prostate and colorectal cancer deaths are down by nearly half (47 percent). Despite the good news, though, ACS officials also noted there is much more work to be done. “The continuing drops we’re seeing in cancer mortality are reason to celebrate, but not stop,” stated John R. Seffrin, PhD, chief executive officer for ACS, when the report was released in January. He added cancer was still responsible for nearly one in four deaths in the United States in 2011. Furthermore, Seffrin noted the country’s second leading cause of death overall is actually the top cause of death among adults ages 40 to 79. Looking to this year, the ACS has projected 1.658 million new cancer cases will be diagnosed in 2015, and 589,430 Americans will lose their battle with the disease. Of the new cases, the estimate is that men will account for about 848,000 diagnoses across all sites and women 810,000. Prostate, lung and colorectal cancers will account for about half of all cases in men with prostate cancer accounting for around 25 percent of all new diagnoses. Among women, it is anticipated the three most common diagnoses in 2015 will be breast, lung and colorectal cancers. Of those, breast cancer is expected to ac-
count for 29 percent of all new cancers for women this year. Of the 589,430 estimated deaths in 2015, the gender breakdown is 312,150 men and 277,280 women. The most common causes of cancer death are lung, prostate, colorectal and breast cancer with these four accounting for almost half of all cancer deaths. More than a quarter of all cancer deaths (27 percent) will be attributable to lung cancer. While death rates have declined, the report noted mortality improvements aren’t equal from coast-to-coast. In fact, cancer death rates vary by state and region with the Southeast being on the lower end of improvement scale (15 percent decline in overall cancer mortality) and the Northeast on the higher end (between 25-30 percent decline). The variation has been attributed to a number of reasons including risk factor patterns (such as the number of smokers), distribution of poverty, and access to healthcare.
Risk Awareness
A recent survey by the American Institute for Cancer Research found there is an ‘alarmingly low’ awareness of key cancer risk factors, and many Americans put fear before facts. The Cancer Risk Awareness Survey, released on Feb. 4 in conjunction with World Cancer Day, found Americans worry about factors over which they have little or no control … such as genetic risks or food additives … with less than half recognizing the correlation between an increased risk of cancer and alcohol, obesity, lack of physical activity and poor diet. The findings of the biennial survey give providers and other health experts an idea of whether or not cancer messaging is being heard by the American public. This year’s results were decidedly mixed. Only 42 percent surveyed were aware a diet low in vegetables and fruit increases cancer risk. This number has trended downward since 2009, when it stood at 52 percent. Only 43 percent knew alcohol increases cancer risk, an increase of five percentage points since the 2013 survey. And only about 1 in 3 Americans (35 percent) realized diets high in red meat have been convincingly linked to colon cancer. This figure has not changed since the survey was last conducted in 2013.
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Awareness that carrying excess body fat is a cancer risk factor is rising. In this latest survey, 52 percent realized obesity and overweight impact cancer risk, a rise of 4 percentage points. Awareness that being inactive increases cancer risk jumped 6 percentage points, from 36 percent in 2013 to 42 percent in 2015. There was a high recognition of several known risk factors for cancer includ-
ing 94 percent of those surveyed correctly identifying tobacco use and 84 percent citing excessive sun exposure as risks. However, a significant number of those surveyed also worried about risks for which research has yet to provide a definitive answer. Pesticide residue on produce (74 percent), food additives (62 percent), genetically modified foods (56 percent), stress (55 percent), and hormones in beef (55 percent) were all cited as concerns.
President Obama’s Precision Medicine Initiative After first introducing the topic during the State of the Union Address, President Barack Obama held an event at the White House at the end of January to unveil details about the Precision Medicine Initiative, a major research push to pinpoint the best, most precise treatment options for individual patients considering genetic profile, environment and lifestyle. In a fact sheet created for the program, White House officials stated, “The Precision Medicine Initiative will pioneer a new model of patient-powered research that promises to Dr. Margaret Foti accelerate biomedical discoveries and provide clinicians with new tools, knowledge and therapies to select which treatments will work best for which patients.” While the move away from ‘one-size-fits-all’ medicine is not limited to cancer research, oncology is at the centerpiece of the initiative and a recipient of significant funding. If passed, President Obama’s 2016 budget includes a $215 million investment in the program including $130 million to the National Institutes of Health to develop a voluntary national research cohort of a million or more volunteers to propel the science forward and to create a model for responsible data sharing. Additionally, $70 million is specifically earmarked for the National Cancer Institute to scale up efforts to identify genomic drivers to various cancers, and a major objective of the initiative is to create ‘more and better treatments for cancer.’ In response to the Jan. 30 announcement, American Association for Cancer Research CEO Margaret Foti, PD, MD (hc), said, “We live in an extraordinary time when the scientific opportunities and our ability to translate this new knowledge into ways to both save and improve the quality of life of patients are simply astounding. This is why we are so excited about today’s event at the White House and specifically about President Obama’s major investment in the enormous potential of precision medicine, which is in the very early stages of transforming healthcare.” Similarly, the Pancreatic Cancer Action Network voiced their appreciation and support for the initiative. “The Pancreatic Cancer Action Network applauds President Obama for his new Precision Medicine Initiative and for making an important investment to advance cancer research and arm the scientific and medical community with the cutting edge tools and resources needed to fight cancer,” said Julie Fleshman, president and CEO of PanCAN. “This is especially welcome news for patients fighting pancreatic cancer who face a five-year survival rate of just 7 percent.” With personalized medicine for pancreatic cancer still in the early stages, she added, “We recognize, as President Obama highlighted, that the “onesize-fits-all” approach does not work for pancreatic cancer and recently launched Know Your Tumor, a personalized medicine service available through our patient services program. In addition to providing molecular profiling that may help a patient’s oncologist determine the best treatment options, we will collect tumor information from thousands of pancreatic cancer patients to assist with future research and development of new therapies and diagnostics for pancreatic cancer.”
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March of Dimes: Making a Difference for Tiny Tennesseans By CINDY SANDERS
January is National Birth Defects Prevention Month. March is in the name. November is National Prematurity Awareness Month. But for the staff of March of Dimes Tennessee, every month … every day … is another opportunity to advocate on behalf of mothers and children to build a stronger, healthier state. Each year, one of eight babies in Tennessee is born prematurely. While the organization hosts a number of fundraisers, the premier event is March for Babies, and 76 percent of the money raised from those walking events across the state goes to fund research and programs supporting the mission. Tamara Currin, MS, MCHES, associate director of Program Services and lead for Advocacy & Government Affairs for MOD Tennessee, noted, “For our program plan, we have three main initiaTamara tives that we’re looking at Currin for at least three years.” She added the key objectives focus on early elective deliveries, tobacco usage in
women of childbearing age, and disparities in preterm birth. Early Elective Deliveries Currin said March of Dimes nationally spearheaded a partnership with the Tennessee Department of Health, Tennessee Hospital Association, Tennessee Initiative for Perinatal Quality Care (TIPQC) and other interested entities in 2012 to address the issue of elective early inductions. She noted the ‘Healthy Babies are Worth the Wait’ campaign has been
a successful example of how collaborative efforts can really make a difference. Although babies are born prematurely every day naturally, Currin said the concern is over those times when labor is electively induced. “We know that the longer babies are in mom’s body, the healthier they will be,” she said. “The lungs and the brain are some of the last things to develop in utero.” An infant’s brain at 35 weeks weighs only two-thirds what it will at 39 to 40 weeks. Even being born just a few weeks early could hamper a newborn’s ability to coordinate sucking, swallowing and breathing. Currin credited the partnership for building awareness among the healthcare community. A letter was sent to birthing centers across the state asking them to pledge to put in a ‘hard stop’ for scheduled inductions before 39 weeks. Currin explained clinicians now have to speak with a designated physician in the facility to explain why an early induction is medically necessary. Other efforts have included awareness campaigns for consumers. The ‘Don’t Rush Your Baby’s Birth Day’ public service announcement encourages moms with healthy pregnancies to allow labor to
begin naturally. The results have been stunning. In 2012, Tennessee ranked poorly nationally with close to 15 percent of all births being early elective inductions. By 2014, the average between January and August had fallen to around 2 percent. “This is just a remarkable improvement and much credit to the partnership,” Currin said. Tobacco Cessation “We have 23 percent of women of childbearing age who smoke in Tennessee,” said Currin. “That’s a leading risk factor for prematurity and low birth weight.” In addition to MOD programming, she said the organization also has a statewide community grant-funding effort to target specific areas or objectives. “We actually have a grant we’re funding in Johnson County,” she said of an effort in Upper East Tennessee. “As a part of a prenatal program, they are providing Baby & Me: Tobacco Free, an evidencebased approach to primarily cessation, but it also addresses the environment and other smokers in the home.” The goal is to achieve a 20 percent quit rate among (CONTINUED ON PAGE 8)
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Rural Hospitals: The Challenge to Remain Open, continued from page 1 adjustments that benefited rural hospitals are being phased out. The U.S. Supreme Court’s summer 2012 ruling on the constitutionality of the Affordable Care Act gave states the ability to opt out of Medicaid expansion. Only 25 states and the District of Columbia chose to expand. More than 40 percent of rural hospitals nationwide are operating in the red and most hospital closures are in states not expanding healthcare coverage, according to the NRHA. When the Affordable Care Act (ACA) was signed, the expectation was that virtually all of the nation’s 48 million uninsured would gain health insurance either through subsidized health insurance policies purchased on health exchanges or through expanded state Medicaid programs. In anticipation of this outcome, significant changes were made to the Medicare and Medicaid payments system. Most notably the ACA requires that the federal government begin making deep cuts in so-called Disproportionate Share Hospital (DSH) payments to hospitals serving areas with high numbers of Medicaid patients and people without insurance. Rural Americans are more likely to fall in the low-to moderate income range and less likely to have health insurance. Fifteen percent of rural Americans fall into the “coverage gap,” where they are not eligible for Medicaid coverage, but earn too little to afford health insurance in the Affordable Care Act (ACA) marketplace. According to Tennessee Hospital Association President Craig Becker in an article in the Memphis Daily News, between the ACA and other cuts, which begin in 2016, Tennessee is looking at $7.4 billion in cuts over a 10-year period. Becker
anticipates that in 2019 Tennessee hospitals could face $1 billion in cuts. The impact on Tennessee for not expanding its Medicaid program is missing out on $2.3 billion in federal funds. Craig Becker Declining inpatient volume, falling reimbursement rates and failure to bring in enough revenue make rural hospitals the most vulnerable to closure as demonstrated by the most recent string of closure announcements. Four have closed in West Tennessee – Haywood Park Community Hospital in Brownsville, Camden General, Gibson General and Methodist Fayette in the past year and a half. Haywood Park Community Hospital, the only hospital in the county, shut down its inpatient and emergency room services on July 31, 2014 and converted the 62bed hospital into an urgent care clinic. According to a release from the hospital, inpatient admissions had dropped from 1300 in 2009 to less than 250 in 2013. The Emergency Room had also experienced a sharp decline and was averaging 15 or fewer patients per day. The release attributed the hospital’s demise to changes in guidelines for inpatient admissions and federal reimbursement cuts under the ACA that had not been set off by Medicaid expansion in Tennessee, which made maintaining a full service hospital unsustainable. In an article on the closing in The Tennessean, Tennessee Hospital Association President Craig Becker noted that the Brownsville conversion was the first Tennessee hospital closure publicly linked by
it operators to the state’s refusal to expand its Medicaid program. He said this would only be the start of such closings. “Hospitals cannot just accept the cuts that are coming in the ACA versus not having the Medicaid expansion.” Prior to the Haywood Park closing, West Tennessee Healthcare announced that in January 2014, Gibson General Hospital would become an outpatient center and was renamed Trenton Medical Center. In February 2015, construction was started on a new medical facility that is set to open in late 2015. The facility will consolidate the Medical Center and Sports Plus Rehab Center on a 2.83-acre site. Also in Gibson County, WTH’s Humboldt General Hospital has undergone some changes to become an emergency center operating as the north campus of Jackson-Madison County General Emergency Room. The facility also offers outpatient clinical and rehabilitation services. Methodist Healthcare announced its hospital in Somerville, Tennessee, Methodist Fayette Hospital would close Friday, March 27. The hospital has been averaging a daily inpatient census of approximately one patient, which was down from 2010 when the average daily census was 5.1. In a press release Gary Shorb, CEO for Methodist Healthcare, cited the low census as simply not sustainable. Fayette’s situation is rather unique as the community has easy road access to a number of communities and Fayette residents were choosing to drive to a larger hospital rather than go to Methodist Fayette. When a hospital closes, it is a slow death says Tom Gee, CEO of Henry
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County Medical Center. “There is just only so much overhead you can carry to keep things running,” he said. “By the time a hospital closes, there is really minimal impact because 60-70 percent of the staff is already gone. When your census is down you still have to have a certain level of staff to maintain Tom Gee services but you have already scaled back by that point. Many patients have already found another facility for their care as they have slowly matriculated before you close.” “While we have seen no change in the number of patients from outlying communities who have sought care here over the past year, we do expect to see more patients in the coming months as our hospital has become a part of all BlueCross/BlueShield plans in the area,” said Lisa Ragsdale, Director of Marketing for Regional Hospital of Jackson. Gee described the financial problems exacerbated by political conflicts over health law as “the most serious threat to our institution” in the 23 years he has been Lisa Ragsdale at the helm of Henry County Medical Center. The Tennessee Hospital Association was quoted in an article in The Tennessean as saying that the hospitals struggling the most are in West Tennessee, which has been more economically stressed than the rest of the state. Gee knows the issues keeping a rural hospital afloat, and in order to do that he has reduced workforce by 25 positions, contemplated discontinuing services such as oncology and asked the county to pick up the costs of ambulance services. To survive Gee says you have to go with your gut instincts. “Watch volumes constantly and make sure you have a great mix of surgical specialties. Increase outpatient volumes while watching and reducing inpatient costs, keep charges low and be the low cost provider while demonstrating you are providing quality care and watch cash flows,” he said. “We are doing ok despite the many cuts we have had due to ACA. The next five years are going to be tough if we do not get some relief. With the current reimbursement as it is, it will be a tough row to hoe.”
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Personalized Messaging A marketing manifesto By CINDY SANDERS
With better understanding of the human genome, physicians and researchers have opened up exciting new lines of personalized medicine where providers deliver radiation with pinpoint accuracy and tailor treatments to fit a patient’s unique needs. While a highly scientific, very targeted approach is often used to promote improved outcomes, it is rarely employed when it comes time to promote a facility or provider expertise to improve income. If precision medicine has been shown to work, why not also utilize precision marketing?
A Call to Arms
In his 2011 manifesto for transforming healthcare marketing, “Joe Public Doesn’t Care About Your Hospital,” author Chris Bevolo explored why the digital world had made it possible … and desirable … to change not only the message but also the manner in which it is delivered. His September 2014 follow-up, “Joe Chris Bevolo Public II: Embracing the New Paradigm,” offered practical strategies for making the move from mass marketing campaigns to much more precise digital and content marketing options. The norm, Bevolo pointed out, has been to take a shotgun approach via mass marketing. “It really was a call out to the industry to say, ‘This isn’t working … we need to stop this,’” he said of his first book. Change doesn’t come easily, pointed out Bevolo, executive vice president for healthcare marketing communications firm ReviveHealth. And just as the industry was beginning to get the hang of Facebook and Twitter, the digital landscape shifted again. “Social media is still important, although we’re beginning to see the limits of what it can do from a marketing standpoint,” said Bevolo. “Instead of a few big players, you’re seeing more and more players emerge,” he continued of the segmentation of social media. “It’s an important supportive tool, but I think there was a time when people thought it would totally revolutionize marketing.” Instead, it is one device in the bigger picture of digital marketing, which is revolutionizing the way providers and administrators reach their target audiences. Bevolo said ‘search’ should be a primary driver of how customers … also known as patients … find you and your message. Whether by purchasing prime real estate in popular search engines or effectively using tags, it’s certainly a competitive advantage to be among the first few sites that pop up when someone looks for “urologist, Saint Louis,” or “safest hospitals, Tampa area.” westtnmedicalnews
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Additionally, emerging technologies allow practices and health systems to really drill down and target specific messages to specific populations in a way that is timely and useful. “It has to be relevant, and it has to be relevant to what they need in the moment,” Bevolo stressed.
Content is King
Bevolo said there is no question that people are facing information overload, and he noted research has shown individuals are hit by thousands of marketing messages daily but can only process about 100 of them. “How do you become one of the 100 out of 3,000 or 6,000?” he asked. “The key is relevancy.” Bevolo continued, “That’s the challenge for any marketer, but it’s particularly challenging for hospitals. What they have to offer is not relevant to the vast majority of people at any given time.” Expecting consumers to hone in on messages that don’t apply to them isn’t realistic, he said. “If you’re not in need of a doctor at this moment, you don’t care about awards, service lines or how great a hospital’s doctors are,” he pointed out. “Yet, we try to do broad marketing. Not only is it silly, it’s a waste of money and time … and you don’t have time to waste, and you don’t have money to waste.”
When patient volume is down, Bevolo said the gut reaction is to believe it’s because not enough people know about you and your wonderful services. The prevailing sentiment is that if you just get a message out there about how good you are, then people will a) hear it, b) care about it, and c) will take action on it. “All three are false, by and large,” he said. Bevolo continued, “That’s the fundamental breakdown in logic … that telling people how great you are will get people through your doors. I don’t care how good the billboard is, it’s not going to make me run in and have my gall bladder taken out if I don’t need it removed.” With limited resources, why pay to broadcast to a million people when only 30,000 need your message, he questioned. However, Bevolo was quick to add, targeting the 30,000 doesn’t mean you are giving up on the other 970,000. Instead, he continued, you just have to rethink the messages. “You’re missing a lot if you don’t focus on people who do not need services today,” he said. “There’s an opportunity to connect with those people around something that is relevant to them.” Bevolo suggested using digital options such as blogs, channels, websites and apps to share messages about prevention, healthier living and other topical content.
A young mother might not care that you are the top joint replacement hospital in the area, but she might really want to learn how to make quick, healthy lunches for her children. A retiree who isn’t interested in how many babies you delivered last year could be eager to learn about fall prevention measures. “That’s how you resonate with Joe Public … because you are the arbiter of health,” Bevolo shared. He said to think of consumers entering the system through a large funnel. Whereas hospitals and practices have typically tried to get to potential patients, who reside near the bottom of the funnel (right before they become your patient), the idea is to target them farther up the funnel. “Those people will need care one day; and if you are the resource they turn to when they are healthy, you’ll be the one they turn to when they do need services.” Of course, Bevolo noted that is often easier said than done. Delivering educational information in a non-sales way requires flipping a mental switch. “The reason it’s so hard is because it is a 180 degree shift from how it’s always been done and how physicians and operational leaders think it should be done,” he said. “It’s not just about marketers changing their approach … it’s about changing a whole industry.”
But When Can We Tell People About Our Awards? Okay … you are understandably proud of achieving or exceeding important quality, safety and outcomes benchmarks. Those awards do say something about your skill set and are important to specific segments of the population. While a seven-year-old with a broken arm might not care about your top-ranked cardiology program, you can bet it makes a difference to a 55-year-old in need of bypass surgery. Healthcare marketing expert Chris Bevolo said sharing information about awards as a secondary sales tool is appropriate in several promotional marketing outlets. Continuing with the cardiology award theme, the first good option would be to include that information in direct marketing pieces where you have pre-identified individuals with heart disease. Sharing accolades through your website is also appropriate. “If I’ve gotten to your cardiology section, I’m probably interested,” Bevolo pointed out. A third option is to take advantage of digital searches. Bevolo said it is a smart use of technology to target people through keywords like “top cardiologist.” Locally, you might buy the phrase so your ad would pop up when people in your geographic region initiated a search for a cardiologist. Writing meaningful content about cardiology topics and using tags at the end of your content could also help you pop up on national searches. And for those wondering about Bevolo’s accolades, there are plenty. The nationally recognized futurist is a frequent speaker on healthcare marketing and strategy. In addition to his “Joe Public” books, he has authored two other books and numerous articles. In 1995, Bevolo founded Minneapolis-based Interval to serve clients across the healthcare spectrum. Last year, Nashville-based ReviveHealth, which O’Dwyer’s ranks as one of the nation’s top 15 healthcare marketing firms, acquired his company. Bevolo serves as executive vice president of consumer marketing for ReviveHealth and continues in his mission to transform healthcare marketing.
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TODD D. SIROKY, ATTORNEY 316 South Shannon Street Jackson, TN 38301 731-300-3636 www.sirokylaw.com MARCH 2015
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What’s Happening to our Safety Net? Changes, challenges of free clinics and covering the uninsured By JULIE PARKER
America’s free and charity clinics are undergoing a transformation, and not necessarily in a good way. According to a 2014 report by the National Association of Free and Charitable Clinics (NAFCC), patient demand has spiked 40 percent while donations have dropped 20 percent. “As soon as there was the perception of universal healthcare, the likelihood of receiving donations goes down,” Colin McRae, JD, told the Wall Street Journal in December. For the last two fiscal reports ending June 30, OrlandoDr. Kathryn Crampton performs free back-to-school phycical. based Shepherd’s Hope, one of the nation’s most successful free clinic networks, experienced a 22 percent In Medical News’ coverage area, Arincrease in patient volume, seeing 16,973 kansas and Kentucky are among 28 states patients in 2012-13, and nearly 21,000 that have expanded Medicaid. patients in 2013-14. Based on trends, the Alabama, Florida, Georgia, Louifree clinic expects patient volume to climb siana, Mississippi, Missouri, North and to 24,000 for the 2014-15 fiscal year. South Carolina, Tennessee, Texas, and “It’s a concoction of the most toxic Virginia are among 18 states that haven’t kind without the resources to resolve it,” expanded Medicaid and aren’t likely to, said Marni Stahlman, CEO of Shepherd’s with the exception of Tennessee, one of Hope, noting a May 2013 report by the four states anticipated to possibly expand Congressional Budget Office showed that in 2016. even though the healthcare law is exDavid W. Strong, who will leave pected to reduce the number of uninsured the University of North Carolina (UNC) by 25 million in 2023, 31 million AmeriHealth Care system next month to take cans will remain uninsured. “The role of over as CEO of the expansive Orlando the free clinic is more critical than ever.” Health network in Florida, pointed out an Medicaid expansion, or the lack of it, aspect of Medicaid expansion that doesn’t lies at the heart of the problem. get much press.
“It’s important to note the bulk of every state’s Medicaid program is already funded by the federal government,” said Strong. “All states are relying on significant federal funds now. Unfortunately, by not expanding Medicaid, Florida and North Carolina are among the biggest losers in the country because of the population base. Ultimately, we all bear the burden for the lack of expansion because people will continue to seek care in our emergency departments and facilities.” Much national attention has been placed on Florida, the nation’s fourth most populated state with 18 million residents and the highest percentage of 65 and older adults. The sunshine state ranks 41st on the list of highest volume of uninsured residents nationwide. “What you have is a really bad sandwich. Without resources, insurance, or access to healthcare, many Floridians who’ve been captured in the healthcare coverage (Medicaid) expansion gap find themselves without anything,” said Stahlman. “There’s also a gap on the high end.” According to a 2014 Modern Healthcare report, the nation’s busiest emergency room is Florida Hospital, with 206,800 visits to emergency departments at Florida Hospitals in Altamonte, Apopka, Celebration Health, East Orlando, and Kissimmee – and Winter Park Memorial Hospital. Orlando Health’s Orlando Regional Medical Center accounted for the nation’s
March of Dimes: Making a Difference, continued from page 5 participants. Currin noted the Tennessee Department of Health also provides funding to a number of local health departments across the state to host smoking cessation programs for pregnant women. Addressing Disparities While Hispanic and Caucasian women in Tennessee have preterm rates of 11.4 percent and 11.3 percent respectively, African-American women have a prematurity rate of 17.2 percent. Currin said MOD is currently funding two community grants in the Memphis area. One targets pregnant women who are homeless. The second, Fit4Me, addresses obesity among women of childbearing age and looks at a healthy body weight before and between pregnancies with a focus on overall nutrition. In Chattanooga, Currin said a grant initiative is just wrapping up that addresses both disparities and tobacco cessation by utilizing churches, which play a prominent role in the black community, to bring about change. “They built partnerships with African-American churches 8
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and provided training on how to quit smoking to the leadership spearheaded by the ‘first lady’ of the church … the pastor’s wife,” she explained. Healthy Babies, Healthy Business Phil Toothman, state director of Communications and Marketing for March of Dimes, said the organization is attacking the problem of prematurity from multiple angles. Knowing businesses wind up absorbing the cost of prematurity in terms of increased health premiums, lost productivity Phil and absenteeism, the Toothman hope is to enlist the help of state businesses to help spread the word about the importance of prenatal health. “The average cost of caring for a preterm baby versus a healthy, full-term baby is 12 times,” Currin said. “The healthy baby is $4,389 on average, and a preterm baby is $54,194,” Toothman added of
medical costs. He also noted the medical costs could soar to $1 million or more for the tiniest babies who required months of hospitalization. MOD estimates preventing prematurity in Tennessee could equal an annual savings of up to $515 million. Making Progress Although there is a long way to go, Toothman and Currin said Tennessee has made measurable progress over the last several years led by the impressive improvement in the rate of elective early deliveries. After a number of years with a failing grade, Tennessee moved to a ‘D’ on the national Premature Birth Report Card in 2012 and received a ‘C’ in 2014. Although the state’s overall prematurity rate of 12.5 percent is still higher than MOD would like to see, Toothman noted, “We’ve experienced six years of improvement in that number.” For an organization that works hard to support Tennessee’s tiniest residents, the staff knows baby steps are something to celebrate.
fifth busiest ER, including emergency departments at the Arnold Palmer Hospital for Children, University of Florida (UF) Health Cancer Center, Dr. P. Phillips Hospital, Lucerne Hospital, South Seminole Hospital and the Winnie Palmer Hospital for Women & Babies. “Florida is at a particular disadvantage because we have one of the highest uninsured rates in the nation, and a comparatively smaller percentage of residents on employer healthcare plans to absorb the cost,” said Florida Hospital CEO Lars Houmann. “Federal, state and local funding sources cover some but not all costs. And so the burden is passed on to insured patients and their employers in what’s commonly called the cost shift … a hidden tax applied to premiums, co-pays and deductibles.” University of Florida economists predict $4.7 billion in Medicaid dollars will be sent to other states in 2016, including nearly $400 million to Ohio, where Republican Gov. John Kasich has reduced the state’s budget by $404 million over two years by expanding coverage. Despite previous opposition to the idea, recently reelected Florida Gov. Rick Scott announced more than two years ago that he supports a legislature-approved, three-year Medicaid expansion. However, Scott, a Republican, hasn’t marked it priority. Even with gubernatorial support, Tampa General CEO Jim Burkhart said Medicaid expansion won’t be an easy sell to state lawmakers. “It’s going to be a pretty heavy lift because there are lots of people who think they know a different way, or don’t think we should do it at all, or only believe we should do it for people that don’t match up with what the federal government says you have to have in your criteria for the money to be made available,” he said. “At least discussion is ongoing. We’re hopeful it’ll continue and lead to something concrete.” Mississippi Gov. Phil Bryant, a Republican, has firmly said no, thanks. “For us to enter into an expansion program would be a fool’s errand,” in case Obamacare is repealed or altered in a way that forces states to foot the bill,” he told the Associated Press. “We’d have no way to continue the coverage.” While states continue to determine the best solution, ER visits are piling up. The average admission cost of an ER visit is roughly $4,600 versus the average cost of a visit to the free clinic valued at $77, said Stahlman, referring to 21,000 visits anticipated this fiscal year. “Do the math on 21,000 visits last year, each valued at $77 ($1.6 million) versus $4,600 ($96.6 million),” she said. “The role of the free clinic is more critical than ever.”
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MedicalEconomics BY BILL APPLING
Who Benefits From Mergers & Acquisitions In the Healthcare Sector? Gregg Lemkau, co-head of global mergers and acquisitions in the Investment Banking Division of Goldman Sachs said, “We have seen twice as many mergers & acquisitions (M&A) activity by July 2014 as we saw for the same period of 2013. I think the biggest driver of the recovery (in M&A) is the return of the strategic acquirer. There haven’t been this many M&As (70 percent) since 2007.”
What is driving the increase in M&As? • Very low interest rates • Large cash balances (balance sheet) • Abundant capital available • Low inorganic opportunities • Increase in equity markets Let me hit on a few industries, so this doesn’t turn into a term paper. Drug makers, health insurers and biotechnology companies in the S&P’s 500 Index returned 12 percent in 2013, including reinvested dividends. That’s the first time in 15 years that the industry has led during the first 79 days into a new year. (Bloomberg, March 22, 2013) The last time healthcare companies led the S&P during the first three months of the year was 1998 when the industry surged 42 percent in the third-biggest gain on record. (According to data compiled by Bloomberg.) The US equity benchmark posted an annual gain of 27 percent.
PHARMACEUTICAL The pharmaceutical industry seemed designed on all sides, with declining R&D productivity, expiring patents on blockbuster products and relentless downward pricing pressure that forced companies to look closely at the bottom line. One effect of this onslaught has been an upsurge in the level of M&A activity as players within the industry consolidate to cut costs, expand research pipelines and lengthen geographic outreach. Novartis and GlaxoSmithKline agreed to swap a series of assets in a multibillion-dollar deal that will reshape two of the world’s biggest drug makers. For Novartis, the “transformational” deal would strengthen the company’s position in the high-value but fiercely competitive area of cancer drugs, where it is number two to Swiss rival Roche. “Diversity is still important but this will allow us to focus on businesses where we are holding a leading position,” said Joe Jimenez, CEO of Novartis to Financial Times, referring to the group’s three remaining core units: pharmaceuticals, eye care and generic drugs.
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In addition to acquiring GSK’s existing cancer treatments, which had sales of $1.6 billion last year – Klavartis will have opt-in rights for new oncology products emerging from the UK group’s research and development pipeline. (Financial Times, April 2014.) The complex transaction adds to a flurry of merger and acquisition activity among the pharma groups. Activist investor Bill Ackman and Valent have teamed up to launch a bid worth more than $50 billion for Allergan, the maker of Botox ( Financial Times) • Now more than ever, life sciences companies are conducting clinical research outside the U.S. ( ACE ) • Pfizer has rallied 31 percent in the past year after the U.S. Food and Drug Administration approved its arthritis and blood thinner drugs and the company divested its infant nutrition and animal health business. ( Financial Times) • In the wake of Pfizer’s $68 billion mega-merger with Wyeth in 2009 the company laid down plans to trim its manufacturing and shut down eight sites in 2010 and further earmarked six to close by 2015, affecting over 6,000 workers. • Similarly, Merck & Co. has continued to cut back following its $41 billion merger with Schering-Plough in 2009 and then announced in November a further ten sites would be closed. • Fresh off Pfizer’s acquisition of Hospira for $17 billion, Ian Read, CEO, at this year’s BIO CEO Conference, said discussions are still in the works, though it still needs to iron out details, of whether its innovative and established products businesses are “sustainable if they’re independent.” Ultimately, he said the decision will be made to create maximum shareholder value. At the same conference, Read said that Pfizer has had discussions with several partners looking at portfolio / geographic swaps, adding that the industry has to consolidate. And as far as acquisitions moving, Read said the “problem is that when we look at opportunities other companies are willing to pay more because of their tax situation or to fill in or pipeline.”
INSURANCE The stock price of United HealthGroup Inc., America’s largest healthcare company is up 263 percent since the ACA was signed into law just
over four years ago. Over the 10-year period prior to the ACA, UnitedHealth stock (UNH) was down by 10 percent. United Health is the 17th largest company in Fortune Magazine’s top 500 U.S. companies. Through subsidiaries in 50 states and Puerto Rico, United Health provided 70 million Americans with health insurance – about 22 percent of the nation. The message shareholders are learning is that a decade of competitively providing healthcare is grim, but for years of partnership with ACS – PARTY TIME. There would have been no ACA in 2010 if the White House had not given into demands from the giant profit-making health insurance groups. Had he not done so, Obama’s healthcare bill – his priority promise made during the 2008 presidential campaign – would not have passed. Morgan Stanley’s Andrew Schenker estimates health insurers will get $90 billion in revenues. With the price of insurance stocks now spiked by elimination of competition,
NEED A GIFT SHE WILL
all the major health insurance stocks were Dow Jones’ top performers in 2013. United Health stock was up 33 percent; WellPoint rose by 50 percent, Aetna ticked up by 46 percent and Cigna jumped by 60 percent. Other points to note: • Profits have risen so impressively even though ACA had language that specifically was supposed to limit the profits earned to 20 percent of the revenues. • The healthcare industry is exempt from the Federal Anti-Trust Law, but there are opportunities for collusion. They are even better at threatening physicians, hospitals and other providers to take or leave it. This is bloody scandalous and should be a cause for concern for both Republicans and Democrats. 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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®
Use of InterStim Therapy Continues to Expand Oxford physician leads region in InterStim procedures for OAB and FI sufferers By JULIE PARKER
When InterStim® therapy was FDAapproved in March 2011 for treating patients with fecal incontinence (FI) – 14 years after the federal agency approved it for use on overactive bladders (OAB) – only a scant number of specialty-trained urologists around the country began offering the innovative sacral neuromodulation therapy for bladder and bowel control. Even though it’s easy to assume the lion’s share of discovery and testing on the Medtronic device emanated from major metropolitan areas, much of the early work actually took place in the tiny city of Oxford, Miss., via uroloDr. Land gist Doyle “Land” RenRenfroe froe, MD. Renfroe, founding partner of Oxford Urology Associates, has quickly become the “go to” doctor for InterStim, a reversible treatment that uses electrical pulses to stimulate sacral nerves just above the tailbone. He has arguably performed more InterStim procedures than any urologist in the southeastern United States.
Problem Solving
“I first began studying severe cases of overactive bladder in the late 1990s.” said Renfroe, 52, who earned undergraduate and medical school degrees from the University of Mississippi, where he also ran track during college. “At that time, very few doctors in the United States were doing the procedure.” Chuck Secrest, MD, at Mississippi Urology in Jackson, Miss., introduced Renfroe to InterStim therapy. Medtronic’s bladder control therapy, delivered by the InterStim system, has been FDA-approved since 1997 for urinary incontinence (UI) and since 1999 for urinary retention and significant symptoms of urgency-frequency. Here’s how it works: The sacral nerves – generally S2, S3 and S4 – activate or inhibit the bladder, sphincter and pelvic floor muscles that contribute to urinary control. More specifically, S3 influences pelvic floor behavior. Electrical stimulation artificially excites nerve pathways that may activate or inhibit muscle action, depending on their normal function. Electrical pulses may stimulate somatic nerve fibers without prompting simultaneous contractions of the bladder. This may decrease the UI symptoms of urgency, frequency, urinary retention and urge incontinence. 10
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Implanting the InterStim neuromodulation system requires outpatient surgery with local and/or sedation anesthesia. The sacral neurostimulator is inserted under the skin via a small incision in the upper buttock. The long-term lead is implanted under the skin, with one end of the lead connecting to the neurostimulator and the other lead end placed in the sacral foramen adjacent to the third sacral nerve (S3). Generated by the neurostimulator and delivered by the lead, the electrical stimulation modulates nerve activity to improve bladder and bowel function in many patients who were often out of treatment options. Each patient undergoes a test phase prior to final implantation to ensure a positive response prior to implanting the permanent neurostimulator. This therapy is not an option for patients with a mechanical obstruction of the urethra or prostate.
Taking Off
Renfroe completed his first InterStim procedure in 2002. A simple screening test to verify candidacy for the therapy has driven patients to Renfroe, whose volume of Medtronic’s bladder control therapy cases continues to increase. As a result of his success, Renfroe has spoken at the corporate offices of Medtronic in Minneapolis, Minn., discussing case studies and the benefits of InterStim, and to other groups regionally. “This procedure can absolutely restore a patient’s quality of life,” Renfroe emphasized. “Patients with overactive bladders and fecal incontinence will frequently refuse to leave their homes for fear of not being able to quickly find a bathroom. It can become psychologically debilitating.” InterStim therapy is a treatment for patients with chronic, debilitating symptoms of voiding dysfunction who have been unsuccessful finding relief via medication or diet alteration. Because this type of bladder dysfunction can have a crippling impact on a patient’s social and personal life, effective therapy provides great potential for life-changing benefits. “For patients who have reached that point, this can be a life-changer,” Renfroe said, pointing out that success rates for InterStim therapy top 90 percent. Other specialists have noticed the impressive results. “Dr. Renfroe knows more about this procedure than just about anybody because he’s done more of them than anybody else in this part of the country,” said urologist Jeffrey G. Clark, MD. “Doctors seek advice from other doctors who have done certain procedures. Land is the guy to see about InterStim; there’s no question about it.”
GrandRounds HCMC Announces New Health & Wellness Website PARIS - Henry County Medical Center announces the launch of its new Health & Wellness website, https:// hcmc-tn.spirithealth.com. The website features tips on how to stay healthy throughout the decades of your life, and offers fresh, fun, timely health information to keep you and your family well. By visiting the website, you will familiarize yourself with screening guidelines to proactively manage your health. There is also a section for teens and men so you know when it’s time for their checkups. The new website, https:// hcmc-tn.spirithealth.com, also features a physician finder, a list of HCMC’s services, as well as fun, informative articles on everything from how to deal with knee pain, to the link between weight loss and disease risk. You’ll find tips for boosting brain power with exercise, and home cooking for healthier eating, including nutritious recipes that are updated regularly. The new Health & Wellness website was created by HCMC in conjunction with Spirit of Women keeping the communities health and well-being in mind at all times. The goal is to provide women and their families with access to current health information so they can make informed decisions about wellness, and learn about the services offered at HCMC. The new website also includes fun articles and recipes that are updated regularly, according to Tory Daughrity, Director of Marketing and Public Relations. HCMC is a proud member of Spirit of Women, a national network of leading hospitals dedicated to improving women’s lives with innovative health and community programs. Spirit of Women hospitals touch the lives of millions of women each year through the presentation of educational events, consumer membership programs, annual conferences, marketing communications and grassroots efforts to improve the health and well-being of women everywhere. Spirit of Women enables participating hospitals to focus on community needs while providing the strength of national support. The new Health & Wellness website content sources include U.S. Department of Health and Human Services Office on Women’s Health and the Centers for Disease Control and Prevention. Interested in joining Spirit of Women? Membership is valued at over $20 but is currently FREE to celebrate the launch of our new Health & Wellness site. If you would like additional information on the program please call the HCMC Find Line at 731-644-3463.
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