Best Practices 3rd Quarter 2014

Medical Community News and Information

Third Quarter 2014

Where Medicine Meets Technology

Built on Strength.

Structure. Physicians. Community.

www.BestPracticesMD.com

CONTENTS

Third Quarter 2014

PUBLISHER/CHAIRMAN Rick Clapp President Santiago Mendoza Jr.

EDITORIAL

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Editor Mary Alys Cherry Medical Director Victor Kumar-Misir, M.D.

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Contributing Writers Mary Alys Cherry Victor Kumar-Misir, M.D.

ART Creative Director Brandon A. Rowan Graphic Designer Kelly Groce Photography/Editing Mary Alys Cherry Brian Stewart

Letter From the Medical Director 7 How the cow quietly sustained humanity, inspired

civilization and saved mankind

Features 9 Dr. John C. Jennings named ACOG President 10 Houston Methodist listed among 100 best companies to work for 11 UTMB awarded $4.4m to develop universal flu vaccine 12 Bay Area Regional Medical Center - Built on strength 14 Bacteria and cancer: feeding your microbiome 16 Shriners Cleft Lip & Palate Clinic honors Houston plastic surgeons 17 Alcohol may ease nerves that cause atrial fibrillation 18 Book Review: Rethink Food: 100+ Doctors Can’t Be Wrong 20 More access to healthcare may lead to unnecessary mammograms 21 Operate your practice at the highest level 22 Drop belly fat to drop cancer risk 6 |www.BestPracticesMD.com |Third Quarter 2014

ADVERTISING Director of Advertising Patty Kane Account Executives Shannon Alexander Santiago Mendoza Jr. Debbie Salisbury

PHONE: 281.474.5875 FAX: 281.474.1443 www.BestPracticesMD.com Best Practices Quarterly is trademarked and produced by Medical Best Practices Group, LLC. Best Practices Quarterly is not responsible for facts as presented by authors and advertisers. All rights reserved. Material may not be reproduced in part or whole by any means whatsoever without written permission from the publisher. Advertising rates are available upon request.

Best Practices Quarterly P.O. Box 1032 Seabrook, TX 77586 R.Clapp@Baygroupmedia.com

By Victor Kumar-Misir, M.D. | imeddrs.vm@gmail.com

From the Medical Director

LETTER

How the cow quietly sustained humanity, inspired civilization and saved mankind

E

ARLY HUMANS curtailed

wandering, hunting and gathering, and settled down to village life, as a result of cultivation and the taming of the wild ox.

The domesticated cow then sustained humanity with milk, meat, manure, muscle, transportation and apparel.

The development of spoken language communication created communities, and eventually, linguistically distinct civilizations.

Eager to share experiences, contracts, ideas, etc., within and between generations, mankind began to record language in various written formats on a variety of media, from cave drawings, Egyptian hieroglyphics on papyrus (paper) and cuneiform indentations on tablets, to the complex ideograms of the Far East.

In the Near East, several millennia ago, a storyteller gazed at his cow (called “aleph”), and drew a symbolic triangular face with two horns and two large ears in the sand. He used that glyph symbol (V) to represent the voiced (or silent) vowel sound “ah” as in ‘aleph.’ Along with other glyphs like “beyt” (house) for the consonant “b” sound, the written phonetic script spread all over the emerging Middle Eastern “cradle of civilization.”

Phoenician glyph symbols “aleph”, “beyt”, “gemel”, “dalet”, “hey” and others, became adopted by the Greeks as “alpha”, “beta”, “gamma”, “delta”, “epsilon”, etc.

These written, phonetically pronounced Greek glyph symbols became widely exported, adopted and morphed into the Cyrillic script of Eastern Europe and Russia, and eventually, via the Roman Latin “alphabet” to the Western European Romance languages. Greek ‘α’ was rotated 90° to become the familiar ‘A’ of our very own English alphabet.

‘A’ for ‘apple’? Alas, the cow’s face value heritage became forgotten, lost in the sands of antiquity.

However, it is noteworthy that the resilient “aleph-alpha”, traditionally retained in scientific and mathematical literature, has now re-emerged as the ubiquitous internet symbol @ (“at”).

Durable calf skin (parchment) enabled the creation of the familiar bound page book format that replaced fragile Egyptian papyrus (paper) scrolls. Early Christians eagerly imported their scriptures in the new book format from the island of Byblos – hence the name bible.

Thus, the cow (aleph) quietly inspired the development of the phonetic alphabet, as well as the book format, which in large part, created and nurtured our scriptintensive western civilization.

But wait, there’s more

Throughout history, mankind has been decimated by microbial pandemics, in particular, highly infectious and lethal smallpox (variola).

Even prominent, protected people have not been spared: Benjamin Franklin’s 4-year-old son in 1756; Andrew Jackson at age 14, while a British prisoner during the War of Independence; and Abraham Lincoln in 1863, just after the Gettysburg Address.

British aristocratic smallpox survivors had disfiguring pock marks, and jealously noticed that their milkmaids, in contact with cowpox, had beautiful skin, and were immune to smallpox.

On May 14, 1796, Dr. Edward Jenner, noting this, took some cowpox exudate from a pustule on the hand of a dairy maid, Sarah Nelmes, and inoculated healthy, 8-year-old James Phipps. On July 01, 1796, exudate from a smallpox pustule was inserted into the boy, but he failed to develop smallpox. Dr. Jenner postulated smallpox could be prevented by inoculation with cowpox, and the practice spread, despite initial rejection and ridicule. His colleague, Richard Dunning, coined the word ‘vaccination,’ from the Latin word “vaca” meaning “cow.”

On May 14, 1806, President Jefferson wrote a letter to Jenner’s nephew, declaring “Medicine never before produced any single improvement of such utility.” He went on to make a prediction: “Future nations will know by history only that the loathsome smallpox has existed, and by you, have been extricated.”

The success of vaccination programs led the 1959 12th World Health Assembly

to adopt a goal of ‘global smallpox eradication.’ Dr. D.A. Henderson followed this up with vigor, and the worldwide vaccination program became a resounding success. In 1972, there were no more cases in the United States, and the U.S. discontinued smallpox vaccinations.

The last case of Variola major occurred in Bhota Island, Bangladesh, in 1975, and the last case of Variola minor occurred in Somalia on October 26, 1977. That led the 33rd World Health Assembly in 1980 to declare that smallpox had been eradicated globally. Before eradication, worldwide deaths from smallpox in the 20th century numbered over 300 million.

Thomas Jefferson’s prediction had come true.

This spurred enthusiasm for the global eradication of other microbial scourges.

Polio victim, President Franklin D. Roosevelt, founded the March of Dimes in 1938, which financed the development of the polio vaccine and its national eradication.

The U.S. measles vaccination program began in 1963. In 2000, the United States declared that measles had been eliminated from the U. S. However, in 2014, it was reported that the U.S. faced a 20-year spike in measles cases, imported by travelers returning from countries where the disease is still rampant.

Thus, the cow has not only contributed largely to Western civilization, but has nurtured and saved mankind – quietly.

At your next beef barbecue, take time to pay homage to the cow, and in addition, remind yourself to check your children’s vaccination record, and to support research and public health initiatives. ©Victor Kumar-Misir, MD 2014. All rights reserved.

Email:imeddrs.vm@gmail.com Dr. Kumar-Misir is an international physician, who has spent the past 40 years integrating trans-lingual, crosscultural healthcare delivery with emerging information-management technologies, with input from physician executives of national academies of medicine in over 30 countries.

He has been a media spokesman and keynote speaker in several countries, including the Society for intercultural Education Training and Research (SIETAR).

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S N A P S H O T S | P HOTO S

B Y

M A RY A LY S

Drs. Cindy and Gerry Castille look for their table at the Assistance League gala in the Hobby Marriott ballroom on the Gulf Freeway as the league celebrated 25 years of service to the Bay Area Houston community.

C H E R RY

Drs. Howard Dillard and Stephen Marcum visit during the Assistance League Gala at the Hobby Marriott. Their wives, Sharon Dillard and Melinda Marcum, were among the 14 founding members honored that evening.

Linda Byrd, Sharon Dillard and Melinda Marcum, from left, were among the 14 founding members of the Assistance League honored by a crowd of several hundred at the annual gala at the Hobby Marriott on the Gulf Freeway.

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LyondellBasell Plant Manager Doug Mathera and his wife, Johanna, join the crowd as the Assistance League celebrates 25 years of service to the community at its annual gala at the Hobby Marriott on the Gulf Freeway.

National medical group names League City physician president

By Mary Alys Cherry

D

R. JOHN C. JENNINGS

of League City, the new president of the American College of Obstetricians and Gynecologists, was sworn in during the group’s Presidential Inauguration and Convocation in early May in Chicago’s Skyline Ballroom.

The ACOG’s 65th president, a Tennessee native and 40-year Texas resident, is professor of ob-gyn at the Texas Tech University Health Sciences Center at the Permian Basin.

“It is truly an honor to be able to serve as President of ACOG and to represent the 58,000 obstetrician and gynecologist members who are practicing in the United States and other countries. We are the only exclusive specialists for women, and in that respect, we have an obligation to provide the very best in women’s health care.”

A graduate of Union University in Jackson, Tenn., Dr. Jennings completed his

medical degree at the University of Tennessee Health Science Center in Memphis, his internship at the University of Texas Health Science Center in Houston, and his residency the University of Tennessee in Memphis.

Dr. Jennings was in private practice in San Angelo for 12 years before entering academic medicine. He has previously served as head of gynecology and program director of ob-gyn at Wake Forest University in Winston-Salem, N.C.; professor and program director of ob-gyn at the University of Texas Medical Branch in Galveston; and chair and program director of ob-gyn at Texas Tech Health Science Center at Amarillo.

Dr. Jennings is a former chair of District XI and former president of the Texas Association of Obstetricians and Gynecologists.

He and his wife, Sue Ellen, who first moved to League City in 1993, have three daughters and six grandchildren. Two of their daughters and their families also live in League City.

CCISD Projects Lower Tax Rate for 2013 Bond

By Mary Alys Cherry

C

LEAR CREEK ISD had some very favorable news for taxpayers at its May school

board meeting – that the maximum tax rate increase for its 2013 bond is projected to be 8.5 cents or 2.75 cents less than authorized by voters when they went to the polls last May. At that time, a tax rate increase of 11.25 cents to fund $367 million in bond projects was approved by seven in ten voters. However, as a result of favorable interest rates and conservative financial planning, the maximum tax rate increase is projected now at 8.5 cents.

“This 2.75 cent savings on the tax rate represents a substantial positive impact for the taxpayers of Clear Creek ISD,” said Paul McLarty, deputy superintendent of business services. The school board adopted a variable-rate plan to finance $150 million of the of the first $200 million bond sale last December at an average rate of 1.31 percent. The remaining $50 million was placed at a fixed rate of 3.4 percent.

The combination of the very low variable rate debt, combined with better than expected fixed rate debt, provided the district with an estimated $51 million in interest rate savings through the life of the bonds, McLarty told the school board trustees.

“CCISD is consistently watching the interest market and refinances debt at lower rates no different than people do on their own homes,” Communications Director Elaina Polsen said. “Over the last ten years, these efforts have led to a $35.8 million in interest savings of previous bonds.”

The bond news came just before CCISD broke ground on two bond projects – one of which was the $98 million Clear Lake High School rebuild project with projected completion in January 2017. Hundreds of families, former alumni and faculty toured the 1970s building one last time and enjoyed a food-fair hosted by Clear Lake High School clubs, Polsen said. Groundbreaking for the $30 million McWhirter Elementary rebuild was held Thursday, May 29, she added.

DOCTORAL

DIGITS 3 cups Researchers at the Mario Negri Institute of Pharmacological Research found that a moderate amount of coffee consumption, particularly three cups a day, could possibly reduce the risk of liver cancer by 50 percent.

3,000 Approximately 3,000 people in the United States are on the waiting list for a heart transplant on any given day. About 2,000 donor hearts are available each year. Wait times vary from days to several months and will depend on a recipient’s blood type and condition.

1.3 million Rheumatoid arthritis (RA) is one of the most common and serious forms of arthritis that affects 1.3 million Amerians. It can lead to long-term joint damage, resulting in chronic pain, loss of function and disability.

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OR THE NINTH YEAR in a row, Houston Methodist has been ranked on Fortune magazine’s “100 Best Companies to Work For” list, remaining the only hospital system ranked in Texas.

Houston Methodist ranks No. 46 on the 2014 list, moving up 21 spots from last year. Houston Methodist is one of five Houston companies to receive the prestigious distinction, and one of 12 Texas companies on the list. Among the other U.S. companies listed, Methodist ranked No. 4 for the percentage of minorities employed.

“Our employees and physicians make it possible to be honored as one of the best companies to work for in America for nine consecutive years,” said Marc Boom, M.D., president and CEO of Houston Methodist. “Houston Methodist is a great place to work because of our employees’ complete and selfless dedication to our patients and to our values.”

The full list can be found at www. fortune.com Houston Methodist, which includes a flagship teaching hospital, five community hospitals and a topranked research institute, was awarded the ranking for providing an exemplary workplace for employees.

Houston Methodist was selected based primarily on a confidential survey sent to randomly selected employees, who were asked questions on the level of trust, pride and camaraderie within their workplace.

“Our employees and physicians make it possible to be honored as one of the best companies to work for in America for nine consecutive years.”

Houston Methodist also submitted documentation about its work environment, from benefits to corporate policies to employee demographics.

Houston Methodist offers competitive benefits, diversity in the workforce, recognition for employees and a unique environment focused on integrity, compassion, accountability, respect and

Pearland Emergency Care Center now open Houston Methodist’s new emergency care center in Pearland is now open.

Located at 11525 Broadway at Kirby Drive, the Houston Methodist Pearland Emergency Care Center provides free parking and fast service.

The Emergency Room has 10 exam rooms and is equipped with a full digital radiography suite, a low radiation dose 32-slice CT scanner, ultrasound and a full on-site stat chemistry lab. For conditions requiring hospital admissions or further evaluation, staff will facilitate transfers to Houston Methodist Hospital or a facility with the appropriate level of care.

To reach the new facility by phone, dial 713-441-3724.

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excellence.

Houston Methodist Hospital is consistently ranked by U.S. News & World Report as one of America’s best hospitals, ranking in 12 of 16 adult specialties for 2013, the most in the state. Houston Methodist Hospital also was ranked by the magazine as the No.1 hospital in Houston and in Texas.

Houston Methodist employs more than 15,000 employees, and is comprised of Houston Methodist Hospital in the Texas Medical Center, Houston Methodist Sugar Land Hospital, Houston Methodist St. John Hospital in Nassau Bay, Houston Methodist Willowbrook Hospital, Houston Methodist West Hospital, Houston Methodist San Jacinto Hospital in Baytown and Houston Methodist Hospital Research Institute.

Houston Methodist is affiliated with Weill Cornell Medical College and New York Presbyterian Hospital. For more information about Houston Methodist, visit www.houstonmethodist.org or follow them on Twitter and Facebook.

UTMB awarded $4.4m to develop universal flu vaccine

programs in the world.

“UTMB also has broad capabilities in the area of vaccine development and infectious diseases,” he said. “We believe these resources provide an excellent infrastructure to support this project as it moves forward through the vaccine development pathway to ultimately become a licensed vaccine.”

Vaccine development is one of the most ambitious of scientific undertakings, often taking several years and at least a half

R

ESEARCHERS at the University

of Texas Medical Branch are working to create a universal flu vaccine — one that could eliminate the need for an annual flu shot.

If approved for general use, the vaccine would be a public health breakthrough not only in preventing influenza in the United States but most importantly in the developing world, where the virus can have much more devastating effects due to the challenge of vaccinating these populations every year.

Thanks to a $4.4 million grant from the National Institute of Allergy and Infectious Diseases, UTMB researchers and Seattle-based biotechnology company Etubics Corporation plan to construct, produce and test a vaccine containing various antigens of the A and B strains of influenza.

If successful, clinicians could have a vaccine that recognizes all influenza viruses, not just a single type, ready for

“If successful, clinicians could have a vaccine that recognizes all influenza viruses, not just a single type.”

patients within five years, according to Dr. Frank Jones, chairman and chief executive officer of Etubics.

Co-principal investigator Dr. Slobodan Paessler, a professor in the UTMB Department of Pathology and director of the Preclinical Studies Core in the Galveston National Laboratory, said that UTMB has one of the most comprehensive university-based vaccine development

billion dollars for a vaccine to go from the lab to clinical trials to common use. There are only about 50 vaccines approved worldwide today.

UTMB researchers have earned worldwide recognition for their contributions to the field, and today are focusing on developing vaccines not only for infectious diseases but also agingrelated chronic illnesses such as heart disease, diabetes, cancer and Alzheimer’s disease.

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BARMC senior leadership team, from left to right: Ben Casmer, COO; Santiago Mendoza Jr., SVP Business Development & Marketing; Carol Dzierski, SVP Quality; Dr. Michael Lyons, CEO; Susan White, CNO; Lynn Clements, SVP Human Resources; Mike Metts, CFO

BAY AREA REGIONAL MEDICAL CENTER Built on Strength. Structure. Physicians. Community.

STRUCTURE

The Medical Center of the South continues to grow and welcomes its newest state-of-the-art hospital, Bay Area Regional Medical Center (BARMC), to Webster (Houston Bay Area) – located on Highway 3, between Blossom and Orchard Street.

The 375,000 square foot facility was built by Medistar Corporation with hurricane resistant glass that can withstand up to 225-mileper-hour winds. Bay Area Regional Medical Center (www.barmc.us), was built to give the Houston Bay Area community access to advanced technologies and high standards of health care.

The facility is designed and engineered to accommodate approximately 250 private patient rooms in 11 floors, when fully built out in future years. Also, the sixstory parking garage will

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accommodate approximately 675 parking spaces and will provide valet parking services available to their patients.

When the hospital open phase I in late July 2014, medical teams and patients will have access to:

• 104 private patient suites • 22 Intensive Care Unit (ICU) rooms • Five operating suites* • Two endo/procedure rooms • Three cardiac cath suites* • 24 Pre-/Post Anesthesia Care Unit beds • Full-service Emergency Department with 11 treatment rooms, including two trauma rooms • * One Hybrid Operating Room that functions as a cardiac cath suite and an operating suite Medistar Corporation, headquartered in Houston, is a leading medical and real estate development company in the U.S. that specializes in the design, development, financing and construction of hospitals and facilities for the healthcare industry, as well as corporate development, corporate facilities and hospitality venues. Medistar Corporation also designed and built the award winning long term acute care hospital, at 350 Blossom Street and the Medical Office Building located at 250 Blossom Street in Webster.

(To learn more about Medistar or other projects they have designed and built, please visit their website at www. medistarcorp.com.)

PHYSICIANS

Over 200 physicians in the Houston Bay Area were driven to build a hospital to meet their needs. As of June

Where Medicine Meets Technology

Carol Dzierski, SVP Quality and Susan White, CNO inside the new hospital.

2014, over 336 physicians in the Houston Bay Area have applied for privileges. BARMC was built to treat patients with the latest medical advancements.

Oversized operating rooms are furnished with top-of-the-line equipment to facilitate the latest surgical procedures. A hybrid operating room is specially designed for complex cardiac procedures.

Furthermore, the entire building has a welcoming atmosphere, filled with natural light, beautiful architectural features and inviting spaces.

According to many physicians in the community, BARMC will not only be the best place to heal, but also an ideal place for education and community gatherings.

After all, in addition to treating patients, they want to also serve the community.

The community asked for better care and BARMC delivered.

COMMUNITY

You are the center of attention.

BARMC’s facility, physicians, staff and actions revolve around one thing; you. They provide an efficient facility and streamlined processes so their talented clinical staff can devote their time to you. BARMC gives their physicians the support and technology they need to focus on you and believe you deserve the best care available.

The hospital’s core belief is

that every person deserves preeminent medical care. They have invested in advanced technologies, gathered a professional clinical staff and aligned the hospital with renowned physicians. Providing an unsurpassed level of quality care is BARMC’s way of contributing to a healthier community – a community they are proud to be part of.

MAKING BEST PRACTICES THE ONLY PRACTICE Physicians on the medical staff of Bay Area Regional Medical Center are dedicated to following evidencebased medicine in their approach to patient care. In addition to their commitment to best practices, BARMC physicians have access to advanced technologies that enable less invasive procedures whenever possible.

They also work in a collaborative professional environment. This is an environment that works well for the medical staff and will work wonders for patient satisfaction.

As soon as patients arrive, they receive a VIP welcome and treatment. All of the hospital’s rooms are private in-suites with free Wi-Fi throughout the hospital. BARMC is welcomed and recognized by all major health insurers. They also take the paperwork out of paperwork with their very own Electronic Medical Record (EMR) – MEDiChart.

“It is a privilege and honor to open our new hospital to serve the Houston Bay Area community.

It is especially gratifying to know that the opening of Bay Area Regional Medical Center has been eagerly anticipated not only by physicians, but by the entire community as well. Indeed, we feel that our hospital meets a health care need expressed by this community, and that we truly belong here.

Many of our staff members and physicians are from this area, and our organization has already influenced the health of the region by chamber memberships, our Go Red for Women Luncheon sponsorship for the American Heart Association and sponsoring several area wellness programs - even before we opened.

We created this hospital to answer the need for high quality health care in this region. To that end, I give you my pledge that we are committed to being the pre-eminent health care provider in Houston Bay Area.

Welcome to a new era of health care excellence.”

-Dr. Michael Lyons, CEO “Bay Area Regional Medical Center is founded on a very basic premise. That is that we are striving to create a safe and healing environment for you, our guest. Whether you are a member of our medical staff, a staff member, or a patient, we realize you have entrusted this organization. Our goal is to earn and enhance that trust with each and every encounter, each and every day.”

-Ben Casmer, COO “When patients and families come to the hospital, our responsibility is to provide the safest, highest level of care. We’re not just taking care of patients – we’re also taking care of their families.”

-Susan White, CNO “Quality health care is our focus. We are committed to supporting the clinical needs of our community with integrated health services provided with the highest ethical standards.”

-Mike Metts, CFO “We’re setting a whole new culture here. All of us – staff, physicians and patients – are working together toward a common goal: a positive patient experience.”

-Carol Dzierski, SVP Quality “My No. 1 goal is to offer a safe and fulfilling work environment for dedicated professionals. To me, patient satisfaction, employee satisfaction and physician satisfaction are the three elements that combine to create a truly healing experience.”

-Lynn Clements, SVP Human Resources “The era of accountability and patient-first care is here – therefore, it is imperative that we start with a culture of extremely happy employees which will lead to very satisfied patients and very engaged physicians.”

-Santiago Mendoza Jr., Business Development & Marketing Third Quarter 2014 | www.BestPracticesMD.com|

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“A lot of unknowns exist about which bacteria make up an ideal microbiome and which are truly harmful,” Daniel-MacDougall said. “But, we are learning that a diverse community of gut bacteria is beneficial to a person’s health.”

Keep a healthy diet rich in plant foods

Bacteria and cancer: feeding your microbiome The dangers of bacteria and simple ways to reduce cancer risks

H

OW DOES WHAT

people eat affect their chances of getting cancer?

Some new answers may be hidden in the millions of bacteria that live in one’s gut.

These bacteria make up the gut microbiome – the largest collection of bacteria in the body.

It starts forming when people are born, then grows and changes as they age over time.

Diet sustains these bacteria.

In turn, the bacteria help digest food and absorb essential vitamins and nutrients.

Carrie Daniel-MacDougall, Ph.D., MPH, is a nutritional epidemiologist at MD Anderson. She’s about to begin studies to learn more about how a person’s diet and microbiome jointly contribute to the risk of obesity and cancer.

“A diet that includes a variety of plant foods seems to fill your body with a healthy balance of bacteria,” DanielMacDougall said.

Plant foods, like fruits, beans and vegetables, also tend to be rich in fiber. And, fiber helps nurture a robust community of gut bacteria.

Eating a variety of fiberrich plant foods can also help reduce risks for many cancers, including colorectal cancer.

“Fiber helps nurture a robust community of gut bacteria.” bacteria to ensure a healthy mix.

Prebiotic foods feed the bacteria already living in the gut. They include asparagus, bananas, oatmeal, and beans or legumes.

Probiotic foods contain live bacteria. It’s considered “good” bacteria because it helps prevent the growth of harmful bacteria in the gut.

Yogurt with live or active cultures is a probiotic food.

Stick with a stable diet

“It’s your long-term choices that matter most when it comes to a healthy microbiome and lowering your cancer risk,” Daniel-MacDougall said.

“So, the first step is to choose a healthy diet that satisfies you.

Then, you’ll be more likely to stick with it over time.”

Microbiome research uncovers clues “Having a healthy mix of gut bacteria may lower a person’s risk of obesity or weight gain,” DanielMacDougall said. “Obesity is a known risk factor for many cancers, including colorectal cancer.”

Gut bacteria play a vital role in how much energy or calories the body extracts from food. They also help decide how many calories to store as fat.

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Include healthy prebiotic and probiotic foods

Eating prebiotic and probiotic foods may introduce new bacteria in the body.

It also can change existing

For additional tips on health and exercise, visit www. mdanderson.org/focused.

To learn more about the MD Anderson Cancer Center in the Bay Area, visit www. mdanderson.org/bayarea.

Dr. Douglas Barnes, chief of staff at SHC-Houston, from left; Cathy Moniaci, hospital administrator at SHC-Houston, Bryan Corey, chairman of the SHC-Houston Board of Governors; Dr. Steven Blackwell, director of the SHC-Houston cleft lip and palate program; Dr. Ernest Cronin, founder of the Cronin & Brauer Clinic; and Les Cave, president of the CHRISTUS Foundation for HealthCare at the SHC-Houston ribbon cutting reception.

Drs. Ernest Cronin, far left, and Steven Blackwell , far right, heard esteemed testimony from their former patients, Stephen Decker and Melissa Beem, pictured center, at the ribbon cutting reception.

Shriners Cleft Lip & Palate Clinic named to honor esteemed Houston plastic surgeons

Association certified cleft lip and palate program, where patients are provided specialty care in the fields of plastic surgery, oral and maxillofacial surgery, otolaryngology, orthodontics, genetics, audiology, speech pathology, pediatric dentistry, psychiatry, psychology, nursing and social services.

“This merger is really special,” Blackwell said. “The administration here at Shriners is completely behind the growth and development of this clinic, and we are happy to welcome the CHRISTUS Foundation and Dr. Cronin to our team.”

Former patients Stephen Decker, 22 and Melissa Beem, 20, attended the reception and spoke about the impact the reconstructive surgeries had on their lives.

Mr. Decker, who underwent seven surgeries from age 6 months to 16 years, shared his gratitude for the care received

by Dr. Cronin. “If it wasn’t for him, I wouldn’t be the man I am today. This experience has shaped my life and helped my struggles with self-identity.

I am excited about this new clinic because it is going to help so many people.”

For a referral to the Cronin & Brauer Cleft Lip and Palate

A

NEWLY EXPANDED

cleft lip and palate clinic was officially announced at a reception held at Shriners Hospitals for Children – Houston (SHC-Houston) on May 14, 2014, marking the continued legacy of two Houston plastic surgeons: Thomas D. Cronin, M.D., and Raymond O. Brauer, M.D. The new clinic, named the Cronin & Brauer Cleft Lip and Palate Clinic at Shriners Hospitals for Children – Houston, is a collaboration between the CHRISTUS Foundation for HealthCare’s Cronin & Brauer Cleft Palate and Facial Reconstruction Clinic and the existing cleft lip and palate program at SHC-Houston. Ernest Cronin, M.D., FACS, has joined with the SHC-Houston program, which is led by Steven J. Blackwell, MD, F.A.C.S., founding director of Shriners’ cleft program.

“This collaboration is a mechanism to continue the legacy of my uncle, Dr. Thomas Cronin, and his partner, Dr. Raymond Brauer,” Ernest Cronin said. “This clinic will perpetuate the work we began in 1988 when the Cronin & Brauer Clinic was founded, so seeing it prosper through this partnership with Dr. Blackwell and his team at Shriners is extremely important to me.”

Shortly after World War II, Thomas Cronin and Raymond Brauer made significant contributions in the field of cleft lip and palate reconstruction, as well as other areas of plastic surgery.

Together, with Ernest Cronin, they established the Cronin & Brauer Cleft Palate and Facial Reconstruction Clinic in 1988, a ministry funded by the CHRISTUS Foundation for HealthCare. Since 2010, SHCHouston has had an American Cleft Palate Craniofacial

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Clinic at Shriners Hospitals for Children – Houston, please contact Aura Orand at 800853-1240.

About Christus Foundation for HealthCare Since its creation almost 50 years ago, Christus Foundation for HealthCare, formerly St. Joseph Hospital Foundation, has worked to provide health care services and extend the healing ministry of Jesus Christ to those in need. Today, using primary care clinics, mobile clinics, and school-based clinics, Christus Foundation delivers healthcare to more than 60,000 Houstonians who are often overlooked and under-served.

About Shriners Hospitals for Children® Shriners Hospitals for Children is changing lives every day through innovative pediatric specialty care, world-class research and outstanding medical education. Our 22 locations in the United States, Canada and Mexico, provide advanced care for children with orthopedic conditions, burns, spinal cord injuries, and cleft lip and palate.

Patients receive all care in a family-centered environment regardless of the families’ ability to pay.

Alcohol may ease the nerves that cause atrial fibrillation

D

OCTORS IN THE U.S. AND JAPAN have devised a way

to treat atrial fibrillation by adding a little alcohol to minimally invasive therapies that target a cluster of misbehaving nerves known to trigger arrhythmia.

In the most recent Journal of the American College of Cardiology, the researchers say the new therapy may dull or stop the transmission of electrical impulses that cause atrial fibrillation.

Principal investigator Miguel Valderrábano, M.D., chief of cardiac electrophysiology at Houston Methodist DeBakey Heart & Vascular Center, found that adding four or fewer injections of 98 percent ethanol to the catheter-aided radio wave ablation of nerve clusters near the vein of a patient was enough to damage or kill the nerves. Doing so prevented the doctors from being able to artificially trigger atrial fibrillation using electricity.

Electrical stimulation is used during atrial fibrillation procedures to determine whether ablations were successful.

“This is a therapy that targets cardiac nerves previously shown to be involved in atrial fibrillation,” Valderrábano said.

“Radiofrequency ablation carries risks of collateral damage to other structures and there are also risks associated with surgical approaches. We show that chemical ablation with alcohol can achieve elimination of abnormal nerve activity, introducing a catheter through a neck vein and doing all the work through it.”

The addition of alcohol appeared to be far more effective at disrupting the nerves than the standard surgical therapy alone -- concentrated radio waves that cause tissues in a small area to burn and scar.

Catheter ablation is an effective treatment for atrial fibrillation, or a-fib, but the fix is not always permanent. Many patients find their a-fib returns months or years after the first procedure, and many opt to undergo a second ablation operation.

High frequency electrical stimulation was used to test the activity of nerve clusters and to verify that nerve activity could induce atrial fibrillation. Before treatment, stimulation induced a-fib in all patients. After alcohol injection in the vein, electrical stimulation never induced atrial fibrillation.

Cardiac arrhythmia is a general condition in which the heart does not beat correctly, and atrial fibrillation is the most common type. In a-fib, one or both of the heart’s upper two chambers quiver in between beats. A rapid heart rate is a typical symptom.

A-fib is uncommon in younger adults, but its prevalence increases with age.

Third Quarter 2014 | www.BestPracticesMD.com|

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Rethink Food is an awesome book which addresses many of today’s issues and questions about food and nutrition.

It was written recently and published

by Co-authors, local writer Amy-Lee Goodman and Shushana Castle.

Amy-Lee Goodman had a younger sister who for years suffered with a debilitating case of juvenile rheumatoid arthritis when she was nine years old.

For seven years she tried all conventional types of treatment, one form of chemotherapy, and the popular Enbrel injections twice a day. Nothing worked.

“After reading the China Study by Dr. T. Colin, my mother took my sister off all animal products (meat, dairy, eggs) and within three months the arthritis went into remission,” stated Goodman.

After interviewing doctors and food experts from her other popular book, The Meaty Truth, she realized that there wasn’t one resource out there that combined all these expert voices together from around the world into one resource. Most resources are country specific.

Rethink Food is different as it has both power in numbers and power in context that will hopefully persuade readers and the public to redefine our relationship between nutrition and disease. It is time to put health back into healthcare. It was not until most recently physicians have been educated about the correlation between nutrition, good health and disease.

Amy-Lee Goodman will be releasing her second book, The Meaty Truth, How our food is destroying our health and environment who is responsible, releasing October 2014. Her book takes a hard look at the connections between our food, health and environment. Her books are available on Amazon, Kindle, Barnes & Noble and most bookstores.

“Do we eat to live?

Or to live to eat?”

A CLOSER LOOK AT WHAT’S ON THE PLATE Local Amy Goodman co-authors Rethink Food

T

ODAY MORE THAN EVER in the

history of mankind have people been so consumed with food. We all eat food daily and some of us

consume more than others. There are many reasons why we prefer to eat certain diets such as the protein based, plant based or a combination of the two diets.

Do we eat to live? Or to live to eat? That is the question. Is nutrition a priority in making a choice of what foods you consume?

MEET LOCAL AUTHOR AMY-LEE GOODMAN Hometown – Clear Lake, Texas College – Wellsley College Degree – Undergraduate, BS Political Science Passion – Reading and Writing. Grandmother and mother influenced her passion to read Little Women and Little House on the Prairie.

Thesis – Ethics of Climate Change Negotiations

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Philosophy – Everything to this point taught about our food and nutrition is misconstrued and not exactly correct. I want to set the truth about our food, nutrition and environment.

Favorite music – All, especially The 60s, 70s Classics, like The Beatles.

Favorite Movie – Erin Brockovich Cannot tolerate – Injustice and massaging the truth.

Third Quarter 2014 | www.BestPracticesMD.com|

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More access to health care may lead to unnecessary mammograms

R

ESEARCHERS HAVE CONCLUDED that

providing better access to health care may lead to the overuse of mammograms for women who regularly see a primary care physician and who have a limited life expectancy.

The cautionary note from researchers at the University of Texas Medical Branch at Galveston is that screening women in this category could subject them “to greater risks of physical, emotional and economic suffering.”

Dr. Alai Tan, a senior biostatistician in UTMB’s Sealy Center on Aging and lead author of the study, said that “there has been little systematic attempt to define guidelines that would help determine when breast cancer screening might not be appropriate or overused.

“The American Cancer Society guidelines on screening, for example, have had no upper age limit,” Tan wrote in the study. “This is different from the case with prostate-specific antigen screening, where both the American Cancer Society and the American Urological Association have longstanding

guidelines that exclude men with a less than 10-year life expectancy.”

The study was published in the June edition of Medical Care, the official journal of the Medical Care Section of the American Public Health Association.

Using data from 2006 through 2009, researchers studied about 5 percent of the Medicare claims filed during that period by women whose life expectancy was less than seven years. They further studied where the women lived and whether they had a primary care physician.

In general, the researchers found that the use of mammograms decreases as a woman’s life expectancy grows smaller. However, they found that the general downtrend as a woman ages could be offset by better access to health care.

For example, the screening rate for a woman with a life expectancy of less than six years who had seen a primary care physician two or fewer times during the three-year period studied was about 20 percent. However, among women who had seen a

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primary care physician 13 or more times during that period who had a life expectancy of less than four years, the rate was about 34 percent.

The researchers also noted that there is about a four-year difference from when a cancer is diagnosed via screening and when it would be diagnosed clinically for women between 65 to 74. Previous studies have demonstrated that “survival benefits” were not apparent seven to 10 years after a screening.

The study also found that women with a limited life expectancy who lived in an area with greater access to mammography resources, more primary care physicians, mammographic facilities and radiologists, were more likely to be screened.

Mammograms have been heavily promoted for about 25 years and many patients have come to expect that a screening test such as this would be a routine procedure,

“The researchers concluded that life expectancy should be a factor in deciding whether a mammogram is needed.” the researchers wrote. The researchers concluded that life expectancy should be a factor in deciding whether a mammogram is needed.

Other authors of the study are UTMB’s Director of Biostatistics Yong-Fang Kuo and UTMB’s Vice President and Chief Research Officer Dr. James Goodwin.

Funding for the study was provided by the Cancer Prevention Research Institute of Texas and the National Institutes of Health.

Operate your practice at the highest level Docpoint optimizes your practice one click at time

T

O PROVIDE GREAT HEALTHCARE

you need to accomplish a few main objectives: one, form great relationships with your patients.

And two, well…care for their health.

Most doctors are driven to help people, not run a business. Yet, they must provide services to patients, manage patient care and recordkeeping, understand and integrate new technologies, and control costs of care delivery. Particularly challenging is the need to compete for and acquire new patients, to schedule and manage appointments, to minimize the lost revenue from unfilled appointments, and to optimize all aspects of the doctorpatient relationship that impacts patient retention and pricing sensitivity.

Docpoint, a startup in Houston is on the path to revolutionize the way patients and doctors manage their appointments and relationships.

Docpoint, provide doctor’s businesses with a powerful online system that can literally do anything. From increasing patient population, Maximizing doctor’s calendars, Marketing medical practices, and Managing the doctor relationships & reputation.

For example, missed appointments is a big issue that most doctors deal with, they result in significant lost revenue, and interrupt the flow of patient care and productivity. Recent research indicates that over 40 percent of individuals who missed an appointment said that they forgot the appointment. Docpoint recommends that doctors should follow various steps to minimize their missed appointments. First, patients should be reminded about their appointments at least one day in advance. Second, doctors should adopt a system for overbooking appointments. It is also helpful to have a system that analyses patient’s attendance to warn medical practices of unreliable patients so practices can manage these time slots more effectively.

Docpoint has a solution to minimize missed appointments and decrease loss revenue from missed appointments.

From automatically confirming patient’s attendance 48 hours in advance of their

upcoming appointments, text messages reminders, double booking capabilities, patient’s attendance trends analysis, to creating a wait list of patients ready to plug in any cancellations that come in at the last minute.

To maximize profitability, it is also important to ensure that options like the SMS notifications to patients who are overdue are implemented, and for certain specialties doctor can take advantage of Docpoint’s integrated specials system to advertise and fill available appointments slots for non medical related reasons.

Doctor-patient relationships are a very important aspect of successful doctors.

Docpoint has matured a system that is very thoughtful when it comes to patients as well. The proprietary “Patient Linx” system keeps patients informed in real-time via SMS if you are running late on schedule. This gives them time to reorganize their schedule and arrive for their appointment. The system also allows patients to communicate with their doctors through secure and customized text messages if healthcare professionals choose to do so. Practices will also be able to send out newsletters and receive feedback that is analyzed and presented in the form of a report when needed. Each of the patients will have a portal created with the ability to manage all aspects of their appointments. Patients will also have access to a dynamic page for their doctor which has details update in real time. This will keep them updated of recent events in the practice.

For every business, even the medical one, it is important to have an understanding of your audience.

The software’s ability to submit comprehensive demographic analysis and patients surveys will give you a good understanding of how you need to mold your practice to get a better audience.

Docpoint also moves with the times and is well integrated into the social media set up and works on populating approved content automatically.

To ensure efficient communications between the doctor practice staff, the staff at doctor’s practices will be able to keep in touch with doctors via the special Docpoint portal using text messaging.

Because all of this is placed on the Cloud, the doctor has access to it at all times and can manage his schedule no matter where he is. Docpoint is flexible enough to be incorporated seamlessly into your existing practice management systems.

Docpoint will manage your reputation online and will help improve your presence on search engines. Each and every one of these tasks is automated, leaving the doctor free to attend to patients and manage other aspects of running a medical business.

The professional executive team at Docpoint promises to keep leveraging on the latest technological trends to significantly improve the way medical practices are ran and take doctor practices to a new level.

Visit www.docpoint.com for more information.

Third Quarter 2014 | www.BestPracticesMD.com|

21

Drop belly fat to drop cancer risks MD Anderson expert shares the dangers of an expanding waistline and its connection to cancer risks

H

AVING TROUBLE

zipping up a pair of once baggy pants isn’t just a sign to buy a bigger pair. It also may mean that one needs to pay closer attention to his or her overall health. An expanding waistline can increase chances for certain cancers, including colorectal, pancreatic, breast (after menopause), and uterine cancer. Studies suggest that when it comes to health, a trim tummy is just as important as maintaining a healthy weight or low percentage of body fat.

“It’s not just fat directly under the skin,” said Sally Scroggs, health education manager in MD Anderson’s Cancer Prevention Center. “A wide waist also is a warning sign that fat may be growing around important organs, like the pancreas.”

This fat, known as visceral fat, can weaken or damage organs. Too much visceral fat can tell the body to make more insulin than it needs.

High levels of insulin over time can lead to diseases like diabetes and cancer. A heavy midsection also can put stress on the back and joints. This added pressure could result in aches and pains, causing one to be less active.

For post-menopausal women, lower estrogen levels can change the way the body stores fat. Instead of storing fat in the hips and thighs, women may see more fat in the abdomen. This extra tummy fat can disrupt hormones and increase chances of breast and uterine cancers.

The good news: Steps can be taken to reduce belly fat.

Scroggs offers this advice.

Body measurements

Women should aim for a 31.5-inch waist or below and men a 37-inch waist or below. Follow these steps to determine measurements: • Place a tape measure around the waist at the narrowest point between the bottom of the ribs and the top of the hipbone.

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•

Make sure the tape is snug but doesn’t squeeze the skin.

• Measure the waist after breathing out.

Another important measurement is the waist-tohip ratio. To get this number, place the tape measure loosely around the largest area of the hips. This area is usually around the buttocks. Take note of this number. Now, divide the waist measurement by the hip measurement to get the waist-to-hip ratio. Men should keep their ratio below 0.95 and women below 0.80.

Eat a belly-friendly diet

Choosing the right types and amounts of food can help trim belly fat. Try these diet tips: • Cut 100 calories from daily diet.

• Reduce the amount of sugar eaten.

• Eat more plant-based proteins like nuts and beans.

• Eat lots of dark leafy greens and berries.

• Choose whole grain breads and cereals, and low-fat dairy.

Exercise to lose fat

Aim for at least two-and-ahalf hours of moderate exercise each week to reduce chances for cancer. Increasing workout time or upping the intensity of workouts will improve chances of shedding that extra tummy fat.

Also, include strength training activities in workouts.

Strength training helps build muscle and increases the rate at which the body burns calories.

“Keeping a lean tummy is important for everyone at every age,” Scroggs said. “So, start making these healthy changes now.”

For additional tips on health and exercise, visit www. mdanderson.org/focused.

To learn more about the MD Anderson Cancer Center in the Bay Area, visit www. mdanderson.org/bayarea.