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First Quarter 2014

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Hybrid Medicine in the New Era of Healthcare IN THIS ISSUE: HEALTH CARE REFORM TAKES EFFECT | COMMUNITY GETS A LOOK AT BARMC | NON-SURGICAL PROSTATE CANCER TREATMENT


CONTENTS

First Quarter 2014

PUBLISHER/CHAIRMAN Rick Clapp President Santiago Mendoza Jr.

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EDITORIAL

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Editor Mary Alys Cherry Medical Director Victor Kumar-Misir, M.D. Contributing Writers Mary Alys Cherry Betha Merit Victor Kumar-Misir, M.D. Santiago Mendoza, Jr. Shane Sigg, D.C.

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ART Creative Director Brandon A. Rowan Photography/Editing Brian Stewart

ADVERTISING Director of Advertising Patty Kane

Letter From the Medical Director 7 Pandemics and Pandemonium: Today’s Imminent Challenge Features 8 Health Care Reform Takes Effect 10 Follicle Frenzy Raises $10,000 for Families Fighting Cancer 12 Hybrid Medicine in the New Era of Healthcare 14 Kelsey-Seybold Founder Succumbs at 101 15 Chrysalis Project Awarded $1.5 Million Federal Contract 16 Community Gets a Look-See at New Hospital in Webster 18 Non-Surgical Prostate Cancer Treatment a First in Texas 19 MD Anderson Moon Shots Program Takes Flight 20 Inspiration from Erin Asprec: Memorial Hermann Southeast CEO 22 The End of the Ice Age? 6 |www.BestPracticesMD.com | First Quarter 2014

Account Executives Shannon Alexander Patty Bederka 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

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From the Medical Director

LETTER

PANDEMICS AND PANDEMONIUM Today’s Imminent Challenge

he World Health Organization (WHO) Emergency Committee meeting on December 4, 2013 noted that recent outbreaks of Middle East Respiratory Syndrome (MERS), a SARS- like virus, in Europe and the Mediterranean, “...continues to be of concern, in view of ongoing cases.” WTO recommended “...strengthening surveillance” and “...continuing to increase awareness.” The course of human history has often been catastrophically altered by pandemics and plague causing major upheavals in the geo-political, socioeconomic landscape of the planet. For example, the Flu pandemic of 1918 infected 50 million people worldwide and killing 10 million. Currently, experts warn that there is a constant and ominous threat of an apocalyptic ‘spillover’ global pandemic from SARS, MERS, influenza virus mutations, and, as well, from biological weapons of mass destruction. The recent SARS experience of rapid global spread, devastated economies and disrupted populations illustrates the dire need for awareness and more importantly, preparedness: In the third quarter of 2002, local outbreaks of a severe infectious respiratory disease in the South China Pearl River Delta, quickly spread to Hong Kong, and from there, by airplane, worldwide, with thousands of infected patients, hundreds of deaths, and devastated national economies – all within a few months. This represents the first incidence in this century of dreaded zoonotic disease – the spillover of infectious, lethal microorganisms from animal reservoirs to humans, and subsequent human-tohuman transmission, which can lead to a disastrous global pandemic. On November 16, 2002, a 46-year-old male chef in the Foshan region of South China, was exposed to domestic civet cats, and developed a severe respiratory illness that quickly spread to his wife, daughter, and her husband. In December, in nearby Zhonghshan province, 28 similar cases appeared. On January 30, 2003, Zhou Zuofeng, who had visited Zhongshan, checked in at a Guangzhou hospital, and within 2 days, infected more than 30 healthcare workers. He was transferred to a teaching hospital, and infected the ambulance driver en route, and 23 health care workers. On February 21, 2003, one such

infected healthcare worker, a 64-year-old nephrology professor, Liu Jianlun, went to Hong Kong to attend his nephew’s wedding. He checked into the Kowloon Metropole Hotel, Room #911, and infected 16 hotel guests within 1 day. He died on March 04, 2003. One of the infected guests was a 78-year-old grandmother from Canada, staying in Room #904, across the corridor from him, for only 1 night – February 21, 2003. She then flew home to Toronto, where she became ill, and infected her son. Very quickly, several hundred residents of Toronto contracted the disease, of which 31 died, including her son. The city of over 2 million was plunged into a public health and socio-economic crisis.

“Are we prepared for the next big one?” One such Toronto resident, a Pilipino nurse attendant, flew home for an Easter visit, checked into a Luzon hospital, causing a major outbreak across the Philippines. On February 21, 2003, Esther Mok, a Singapore resident, who had flown to Hong Kong on a shopping vacation, checked into the Metropole Hotel, Room #938. She returned to Singapore where she was hospitalized with pneumonia. Very quickly, there were 200 cases, of which 33 died, including Ms. Mok’s father, mother, uncle and her pastor. She herself survived. The Singapore officials notified the WHO in Geneva that they had an outbreak of what they termed “severe acute, respiratory syndrome of unknown origin.” The WHO adopted the acronym “SARS”, and issued a global travel advisory alert. A doctor, who had taken a throat swab from Ms. Mok, boarded a plane, on his way to New York to attend an infectious disease conference. A Singapore coworker, noticing he had respiratory symptoms, notified the Singapore authorities, who in turn notified the WHO in Geneva, which then alerted German officials, who met the plane in Frankfurt and quarantined him. As a result, New York and the United States escaped. On March 15, 2003, China Airlines Flight #112 was flying from Hong Kong

to Beijing, China, with a feverish male passenger. Upon touchdown, in Beijing, 22 passengers and two crew members were infected and spread to 70 hospitals, involving 400 healthcare workers, patients and their visitors. During the same period, a ChineseAmerican businessman traveled from Hong Kong to Hanoi, giving rise to 150 cases in Vietnam. While in Hanoi, he was examined by Dr. Carlos Urbani, an Italian parasitologist, the local WHO communicable diseases expert. He traveled to Bangkok, where he died 12 days later, but had brought SARS to Thailand. The SARS-CoV, RNA virus reservoir in South China Horseshoe bats, had undergone a mutant spillover from bitten civet cats to humans, and had circled the earth by plane, going global in just a few months, infecting 8098 individuals, 774 of whom died, with devastating costs to national economies. In addition to billions spent publicly and privately in preventing, curtailing and treating outbreaks, there were untold trade and retail business and personal losses. In May 2003, the Conference Board of Canada stated the impact of SARS on the travel and tourism industry was an expected loss of $1.1 billion that year. Toronto tourism lost $500 million, 4 major conventions and 28,000 jobs. Two-thirds of Ontario nurses felt their health and safety had been compromised. But for the fact that the SARS virus was transmitted via large, airborne droplets, only to very close contacts, there could have been a major pandemic. Not so for H1N1 influenza, which killed 10 million people in 1918, 2 million in 1957, and 1 million in 1968. Are we prepared for the next big one? Hell no! We are in dire need of instantly deployable systems for mass, multilingual screening and surveillance for early detection and medically assisted isolation of infected individuals. Victor Kumar-Misir, M.D., is an international physician, who has spent the past 40 years integrating trans-lingual, cross-cultural 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 key-note speaker in several countries, including the Society for Intercultural Education Training and Research (SIETAR). email: imeddrs.vm@gmail.com © Victor Kumar-Misir, M.D. 2013 All rights reserved.

First Quarter 2014 | www.BestPracticesMD.com|

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HEALTH CARE REFORM TAKES EFFECT What Choices Do Businesses and Individuals Have? ON JANUARY 1, 2014, four years after the date of enactment, President Obama’s landmark health care reform law is scheduled to take effect. By that date, businesses and individuals must make a series of choices about their health insurance coverage.

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any Americans believe erroneously that health care reform – also known as “Obamacare” and more formally as the “Affordable Care Act” (ACA) – includes a new, government-run health plan. In fact, rather than establish a new plan, the health care reform law seeks to ensure that virtually every American has health insurance. Whether the law ultimately is viewed as a success will depend crucially on how well it ensures that Americans have health insurance coverage. The law is complex, and readers should consult with a qualified attorney or financial advisor to determine how the law applies in their particular circumstances.

The Elements of the Health Care Reform Law Although the massive health care reform law is complex, at bottom it contains five major initiatives that, taken together, seek to ensure that Americans have health insurance: • Employer mandate. Employers must provide to their employees’ health insurance that meets certain minimum essential coverage requirements, or pay a penalty for failing to do so. Employers are required to provide coverage only for the worker, not for members of his or her family. The employer must bear the bulk of the cost of providing the insurance, although a worker can be required to contribute an amount up to 9.5% of the worker’s income. In July 2013, the Administration deferred the enforcement of the employer mandate, announcing

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that the IRS will not fine employers for failing to provide insurance before January 2015. • Individual mandate. Beginning January 1, 2014, every American must have health insurance that meets the minimum essential coverage requirements. Someone who does not receive insurance through an employer or under Medicare or Medicaid must purchase insurance, or pay a penalty for failing to do so. • Pre-existing conditions. The law prohibits insurance companies from denying coverage or charging higher premiums based on the state of the applicant’s health (pre-existing conditions). • Exchanges. The law requires each state to set up an “exchange” or “marketplace,” an Internet portal where people seeking insurance can get information about coverage options and fees. If a state fails to establish an exchange, the federal government will do so for the state. The exchanges were up and somewhat running on October 1, 2013. • Subsidies. Families with income between approximately $24,000 and $94,000 may receive a federal subsidy when they purchase insurance on an exchange. Workers eligible for employerprovided insurance coverage are not eligible to receive a subsidy. Under the law as written, families with income under approximately $24,000 were to receive insurance at no

cost under Medicaid. This provision of free insurance represented a significant expansion of existing Medicaid coverage, and the law required the states to pay a portion of the Medicaid expansion cost. The Supreme Court, however, held that the federal government cannot constitutionally require the states to contribute to this expansion of Medicaid. Thus, each state now has a choice whether to expand Medicaid for its residents. Many states (typically those with Democratic governors) have decided to expand Medicaid and provide the additional free insurance. But many other states (typically those with Republican governors) have chosen not to do so. Low-income families living in states that do not expand Medicaid will have health insurance only if they access it through an employer or purchase it on an exchange. Perversely, as the law is written, families with income under $24,000 are not eligible to receive subsidies when purchasing insurance on an exchange, because the law assumed they would receive insurance for free. Thus, very few low-income families living in states that do not expand Medicaid are likely to have insurance coverage.

Complying With the Insurance Mandates Whether the mandates work to ensure that Americans have health insurance will depend on the extent to which employers and individuals comply. An employer can avoid the mandate in a few ways: • Businesses with fewer than fifty employees are not subject to a penalty for failing to provide insurance to their employees. There is some concern that small businesses might choose to remain under fifty employees to avoid the mandate.


Some special rules apply here: • Businesses substantially owned by a single person or entity are aggregated to determine whether the group as a whole has fewer than fifty employees. Thus, splitting a single business into two businesses under the same owner will not avoid the fifty employee limitation. • Part-time employees are aggregated to produce the number of “full-time equivalent” employees. For instance, two employees working half-time will be treated as a single full-time employee in determining whether the business has fewer than fifty employees. • Businesses are not required to provide insurance to part-time workers, defined as employees who work fewer than thirty hours per week. (Note that part-time workers are aggregated for purposes of determining whether a business has fifty employees, but, even if a business thus goes over the fifty employee threshold, the business is not required to provide insurance to those parttime employees.) Some businesses already have indicated they will hold part-time workers to fewer than thirty hours to avoid the mandate. • Some businesses that cannot take advantage of the above exceptions might choose to pay the penalty rather than provide insurance to their employees. Employers might be less concerned about offering insurance now that their employees cannot be rejected for individual coverage. The penalty on an employer for failing to provide insurance – which won’t begin until 2015 in any event – is only $2,000 annually per employee, much less expensive than paying for employee coverage. An employer could share these savings with employees by providing additional bonuses, which an employee could use to purchase insurance on an exchange. To the extent an individual does not receive insurance from his employer (or under Medicare or Medicaid), he or she is required to purchase insurance under the individual mandate. But young and healthy workers might choose to pay the penalty rather than purchase insurance. The maximum penalty is $2,085 per family or 2.5% of taxable income, whichever is greater. Moreover, the IRS, which is charged with collecting the penalty, can do so only by a reducing a tax refund otherwise due. Thus, the penalty cannot be collected from people who pay no income tax (or who do not overpay their tax through estimated payments).

Effects of the Law

In the final analysis, how well does the ACA ensure that Americans have health insurance? Following the above analysis, it is reasonable to expect that a significant number of members of the following groups will not have insurance coverage:

• Employees who choose not to make the required contribution to purchase employerprovided insurance (either because they are young and healthy or because they cannot afford to do so).

DOCTORAL

DIGITS

• Family members of a worker who does not receive family coverage from his employer and does not purchase family coverage. • Families with income below about $24,000 in a state that does not expand Medicaid. • Families who are exempt from the penalty because insurance would cost more than 8% of their income.

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• Undocumented workers. • Healthy people who choose to pay the penalty rather than purchase insurance. The latest studies estimate that the ACA will shrink the number of uninsured by about half, from 60 million to 30 million. This reduction will come at a cost to both the government and to affluent Americans. A portion of the cost is funded by a new 3.8% tax on investment income received by families with adjusted gross income above $250,000. The remaining cost must be recouped through spending cuts – the law seeks to implement cuts in Medicare reimbursement amounts – additional taxes, or new government borrowing. There is a subsidiary issue that arises from the low penalty amounts. If employers chose not to provide employee coverage and healthy people decline to purchase insurance on their own, then the people who purchase insurance are those more likely to be sick. That is an untenable situation for insurance companies, who could be forced to raise rates significantly or exit the business altogether.

What Should Businesses and Individuals Do? Businesses must decide whether to provide employee insurance coverage in 2014, and, if so, whether also to provide family coverage. They also should consider whether to scale back (or not increase) number of employees or hours for part time employees before the employer mandate becomes enforceable in 2015. Individuals who are not eligible to receive coverage from employers or under Medicare or Medicaid must decide by January 1, 2014, whether to purchase coverage on the exchanges (perhaps with benefit of a subsidy) or allow the IRS to reduce tax refunds they would otherwise receive by the amount of the penalty for failing to do so.

Tax penalty per individual if you don’t have health insurance in 2014, or $285 per family, or 1 percent of income, whichever is greater. In 2016 these penalties rise to $695 per individual, $2,085 per family, or 2.5 percent of income.

3 percent About one in every thirtythree babies is born with a birth defect in America. Not all birth defects can be prevented but some steps can be taken to increase odds for a healthy birth. Please visit www.cdc.gov/ncbddd and consult your health provider during your pregnancy.

12,000 Approximate number of women who are diagnosed with cervical cancer in America each year. Regular screenings are key to beating this cancer as it is highly curable when found and treated early.

First Quarter 2014 | www.BestPracticesMD.com|

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Texas Children’s, Baylor to extend health efforts with ExxonMobil grant

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exas Children’s Hospital and Baylor College of Medicine have embarked on a program to extend their world class medical care and public health expertise into Papua New Guinea with a $3.1 million, two-year grant from ExxonMobil and other coventurers of the PNG LNG Project. This program, aimed at improving maternal and child health outcomes, is possible due to a new partnership with the ExxonMobil-operated PNG LNG Project for expansion of the Baylor College of Medicine International Pediatric AIDS Initiative (BIPAI), Papua New Guinea’s National Department of Health and the University of Papua New Guinea School of Medicine and Health Sciences (UPNG). The grant will enable the deployment of BIPAI’s pediatricians and public health experts in partnership with the Department of Obstetrics and Gynecology at Baylor College of Medicine, to expand on pediatric, maternal and public health education, training, mentoring, capacity building and research in Papua New Guinea. “The main goals of this new partnership are to build local capacity for healthcare and ultimately improve health outcomes in Papua New Guinea,” said Michael Mizwa, chief operating officer of BIPAI. “Working in collaboration with UPNG faculty, our team will help teach, train and improve clinical, public health and research programs.” Though they have decreased in recent years, child and infant mortality rates in Papua New Guinea still remain high, with most deaths attributed to preventable and treatable diseases including pneumonia, diarrhea, malnutrition, HIV, and tuberculosis. (In 2010, the infant mortality rate - the number of infants dying before reaching the age of 1, per 1,000 live births each year - was 69, and the under 5 mortality rate was 37.) Maternal mortality rates also remain high, with most deaths attributed to preventable complications, mostly obstetric hemorrhage. (The 2010 maternal mortality rate per 100,000 births for Papua New Guinea was 250.) The grant also provides funding for the UPNG School of Medicine to hire an obstetriciangynecologist from the neighboring country of Australia to help with the initiative. BIPAI operates a network of state-of-the-art clinical centers across southern and East Africa -- with more than 175,000 HIV-infected children and their family members receiving life-saving treatment - while also providing high-quality healthcare training and clinical research. It was founded by Dr. Mark Kline in 1996. Kline is now physician-in-chief at Texas Children’s Hospital and chair of pediatrics at Baylor College of Medicine.

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Clear Springs High teacher Sandi Bicknell’s loses her hair while raising $10,000 to help to families fighting cancer.

Follicle Frenzy raises $10,000 for families fighting cancer

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hen the Clear we would reach the $10,000 mark,” Springs High School Bicknell said. Student Council Once a particular fundraising finished the Follicle level was surpassed, the “rules Frenzy Project, one female and of the game” allowed players to three male teachers were left with opt out of shaving their heads. very little hair, but there was more However, several male teachers than $10,000 to help a family in honored Bicknell by buzzing their need. hair while hers was being cut at In support of the pep rally. Breast Cancer Coach Aaron Awareness Gautney, Coach “I chose to do it Month in Alan Bjorkgren because the students and teacher Trent October, the Council and at Clear Springs High Mayberry sat sponsor Sandi alongside Sandi School really went Bicknell set Bicknell in makecrazy to help families shift barber out to create a fundraiser that chairs on the affected by cancer.” would aid two gym floor while Clear Springs’ professional families feeling the financial stylists went to work with clippers. burdens of fighting cancer. The “I chose to do it because the Student Council’s goal was lofty students at Clear Springs High and their means of getting there School really went crazy to help were unique. families affected by cancer. Raising Club members challenged the $10,000 is not something that student body and faculty to donate happens every day and everyone by promising that for every $500 should feel really good about what raised, a teacher on the campus they did,” Coach Gautney said. would have their head shaved. JSC Credit Union employees The price set on Sandi Bicknell’s showed support for the project by hair was $10,000. “My philosophy surprising Sandi Bicknell with a is always to ‘Go Big or Go Home’ wig during the rally. but I really never imagined that


Fourth Quarter 2013 | www.BestPracticesMD.com|

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Hybrid Medicine in the New Era of Healthcare URGENT CARE MEDICINE (UCM) is the provision of immediate medical service offering outpatient care for the treatment of acute and chronic illness and injury.

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t requires a broad and comprehensive fund of knowledge to provide such care. Excellence in care for patients with complex and or unusual conditions is founded on the close communication and collaboration between the urgent care medicine physician, the specialists and the primary physicians. Urgent care does not replace your primary care physician. An urgent care center is a convenient option when someone’s regular physician is on vacation or unable to offer a timely appointment. Or, when illness strikes

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outside of regular office hours, urgent care offers an alternative to waiting for hours in a hospital Emergency Room.

Understanding the Scope of Urgent Care Practice Because urgent care practitioners are on the “front lines” of medicine, they need to be proficient in evaluating and caring for – at least initially – any patient who walks into an urgent care medicine center or urgent care clinic. For this reason, there is some overlap in the scope of practice

between UCM and all existing medical specialties that involve direct patient care. Because of the convenience of UCM centers, patients choose these facilities when they are unable to see their usual doctor in a timely fashion or choose not to go to a hospital emergency department. For most patients seen in an ambulatory medicine setting, the UCM specialist can fully care for the presenting problem, either independently or in consultation with another specialist. Sometimes patients will require follow-up with or referral to another specialist, transfer


Urgent Care Makes a Difference

“The clinics are state-of-the-art offering a full complement of urgent care medicine.” to an emergency department, or direct hospitalization (with inpatient care by the consultant). UCM specialists do not perform surgery (other than wound repair and skin lesion removal), do not care for inpatients, and typically do not engage in the continuing medical care of chronic medical problems. Of all of the existing specialties, UCM shares the most in common with family practice and emergency medicine, though there is enough uniqueness of practice that UCM, in reality, is a separate specialty with a distinct knowledge base, skill set, and required breadth of experience. UCM shares with family practice (FP) its broad scope: caring for both male and female patients of any age with any complaint. UCM differs from FP in that its primary focus is on acute medical problems.

Urgent Clinics Medical Care Urgent Clinics Medical Care are highly flexible Primary Care Centers that offer a combination of Urgent Care Medicine / Episodic / Convenience Care; linked to Occupational Medicine (coming soon) and an Electronic Medical Record System. It’s the latest example of a trend in which doctors, hospitals and even retailers are making it easier for patients to walk in and receive care in nontraditional settings – saving them time and money. Urgent Clinics Medical Care has two convenient locations open in 2013. They are located in the shopping centers on the corner of Beltway 8 S. Sam Houston Parkway E. and Pearland Parkway and

in the Laurel Bay Shopping Center of the Marina Bay in League City. The clinics are state-of-the-art offering a full complement of urgent care medicine to include medical treatment of all your urgent care needs; school, sports and employment physicals; and flu shots. The clinic is also equipped with state-of-the art x-ray and laboratory equipment. Urgent Clinics Medical Care are open from 9 a.m. to 9 p.m. Sunday through Thursday and 10 a.m. to 10 p.m. on Friday and Saturday. Urgent Clinics Medical Care offers a less expensive, high-quality alternative to freestanding emergency rooms and hospital based emergency rooms. Urgent Clinics Medical Care, Inc. is a Houston based operator of Urgent care clinics in the Houston area with plans to expand throughout the region. Currently the company has approximately a dozen clinics under construction or development. For more information contact Urgent Clinics Medical Care, Inc. Corporate offices 713.785.1119, or visit www. UrgentClinicsMedicalCare.com.

“I worked in an overcrowded, high cost Emergency Room for many years, so it has been a breath of fresh air working for a company that truly values their patients.  We strive to provide comprehensive, high quality, cost effective urgent care services with the utmost compassion.  The patients that I have treated at Urgent Clinics Medical Care have all been very appreciative.  Many have commented on the quick, convenient, and courteous care they have received.  Everyone at the clinic works together as a team to make the patient›s experience one they will not forget.”   -Angela St. John, PA “I feel very passionate about what we are doing at UCMC, I come from a hospital and free standing ER environment and noticed that the majority of patients seen are truly urgent care patients. Our team at UCMC are dedicated to educating the community on the difference between Hospital and free standing emergency rooms and the capabilities of Urgent Clinic Medical Care. Our staff members are highly trained and certified and all live within the communities we serve. We are in your neighborhood where you come first.” -Johnna Cacace, RN, Operations Manager

A special thanks to the American Academy of Urgent Care Medicine for their eloquent description of Urgent Care Medicine (UCM). You can learn more about the American Academy of Urgent Care Medicine by visiting them at www.aaucm.org Fourth Quarter 2013 | www.BestPracticesMD.com|

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Kelsey-Seybold founder succumbs at 101

Kelsey-Seybold has begun construction on a new medical office building in Clear Lake that will bring all its existing physicians and medical services under one roof. The new Clear Lake Clinic, which will open in the summer of 2014, will be located at 1010 South Ponds Drive near the Gulf Freeway and will replace Kelsey-Seybold’s two existing clinics.

By Mary Alys Cherry

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outheast Texas lost a gifted physician and medical pioneer with the death of Dr. Mavis P. Kelsey, who introduced collaborative healthcare to the Houston area with the founding of the KelseySeybold Clinic six decades ago. Doctors and colleagues the world over paused to remember the man, who also was a visionary, author and philanthropist during his 101 years, on hearing of his death at his home Nov. 12. “Dr. Kelsey was a true visionary and creative thinker who founded and developed a premier medical group that combines family and internal medicine with the highly focused expertise of specialists in all medical fields,” said Dr.

Spencer Berthelsen, chairman of Kelsey-Seybold’s board of directors. “His strong belief in a coordinated approach, grounded in a wellness-based philosophy, has enabled Kelsey-Seybold to provide a very high level of quality and efficient care to patients since day one. Beyond being a brilliant physician, Dr. Kelsey was a caring and kind friend to the Kelsey-Seybold family of employees and many other people in his life. Without question, Dr. Kelsey is among Houston’s most influential physicians leaving behind his legacy as a physician, pioneer, leader and mentor.” Born Oct. 7, 1912, he grew up in the small Northeast Texas town of Deport, back in the days before homes there had electricity and running water and was inspired to

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seek a career in medicine by his grandfather, Dr. Joseph Benson Kelsey, who took him along on house calls in a horse-drawn buggy. He graduated from Texas A&M University and went on to earn his medical degree at the University of Texas Medical Branch at Galveston, where he later was an instructor in pathology after serving an internship at Bellevue Hospital in New York City. Dr. Kelsey honed his medical skills and embraced the idea of the collaborative care model at Mayo Clinic in Rochester, Minn., where he served a fellowship that was interrupted by World War II. After serving four years as a flight surgeon in the Army Air Force in Alaska, attaining the rank of lieutenant colonel and receiving the Legion of Merit, he returned to Rochester, to finish his fellowship. Afterwards, he joined the Mayo Clinic staff and also earned a master’s degree in medicine at the University of Minnesota. He returned to Texas in 1948, bringing with him his wife, Mary Randolph Wilson of Beaumont, and their four sons and a bold dream to create a “Mayo Clinic of the Southwest.” He founded Kelsey-Seybold Clinic the next year with Drs. Bill Seybold and Bill Leary and

his brother Dr. John R. Kelsey – developing branch clinics, prepaid medical care and occupational medicine. Keeping pace with greater Houston’s fast-growing population, Kelsey-Seybold grew quickly and today serves more than 400,000 patients at 20 locations. The clinic’s 415 providers collaboratively practice in more than 55 medical specialties. He directed the clinic’s relationship with NASA’s Johnson Space Center, which led to other large-scale patient groups, and pioneered in nuclear medicine, the use of paramedical personnel and electronic patient records and performed early research on the clinical use of radioisotopes – while also publishing some 50 medical articles. Over the years he served as professor of medicine and dean of the School of Post Graduate Medicine at the University of Texas, on the staff of MD Anderson Cancer Center and at Baylor College of Medicine and wrote about a dozen books. He was preceded in death by his wife, son Cooke, and brother, John; and is survived by three sons and their wives – John and Gaye, Tom and Ann and Mavis Jr. and Wendy, all of Houston – and numerous grandchildren and nieces and nephews.


Yet damage to surrounding normal tissues limit the amount of radiation that can be used to kill tumors. Moreover, side effects of radiotherapy can have long lasting effects on patients – especially in the brain where radiation can affect learning, memory and physical functions. Thus, finding ways to mitigate damage may allow more effective cancer treatment to increase survival and improve quality of life for survivors. Pre-clinical results indicate that the Chrysalin treatment restores radiation-damaged neural integrity and promotes neurogenesis in the hippocampus. “These effects of Chrysalin may be very important,” said Dr. Mostafa Waleed Gaber, associate professor

“Some are calling Chrysalin a possible medical miracle.”

Chrysalis project awarded $1.5 million federal contract CHRYSALIS BIOTHERAPEUTICS

has been awarded a $1.5 million contract from the National Cancer Institute to continue its development of Chrysalin to mitigate radiotherapyinduced damage to normal brain tissue.

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ome are calling Chrysalin a possible medical miracle. The project is a collaboration between the University of Texas Medical Branch at Galveston, Baylor College of Medicine and Chrysalis, which has offices in Galveston. Nearly one in 161 people will be diagnosed with brain or nervous system cancer during their lifetime with radiotherapy the primary tool for controlling tumor growth, according to SEER Cancer Statistics.

at Baylor College of Medicine and co-director of the Small Animal Imaging Facility at Texas Children’s Hospital, “especially in children where successful radiotherapy treatment of brain tumors may have life-long effects on cognitive function.” Chrysalin is a naturally occurring regenerative peptide that is being developed by Chrysalis BioTherapeutics under worldwide license from UTMB to mitigate effects of nuclear radiation and radiotheraphy. “If we can reduce side effects of radiotherapy in the brain and other tissues, we can use more effective radiotherapy protocols to kill tumors, save lives and improve quality of life,” said Dr. Darrell Carney, Chrysalis CEO. Chrysalin was originally developed by Dr. Carney at UTMB and has been tested in human clinical trials (dermal healing and bone fracture repair) with no adverse effects. For more information on Chrysalis, visit the company website, www.chrysbio.com First Quarter 2014 | www.BestPracticesMD.com|

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Katie Pryor, Jill Williams, Laurie Dahse and Sandy Adams were at the Bay Area Regional Medical Center tour to represent the American Heart Association and Go Red for Women Luncheon.

The community gets a look at the new Bay Area Regional Medical Center, going up in Webster.

Community Gets a Look-See At New Hospital in Webster By Mary Alys Cherry

Clear Creek ISD Marketing Director Eva DeCardenas thought “the tour was spectacular and reflected the magnitude of the project and the complexity of building a hospital.� While much work is still to be done on the $161 million medical facility, construction is moving at a fast clip. When completed, the 373,000-squarefoot, nine-story, 104- bed acute care hospital and the adjoining 674-space parking garage will have expansive capability to accommodate 248 beds and approximately 900 parking spaces. Lyons said the hospital is designed to offer superior inpatient and outpatient services, as well as a full complement of medical and surgical clinical services.

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everal hundred physicians and community leaders got an up close look at the new Bay Area Regional Medical Center on Highway 3 between Blossom and Orchard Streets in Webster in November as construction teams worked to meet their spring deadline. Gathering under a tent in front of the adjacent Texas Gulf Coast Medical Group building on Blossom Street for a barbecue lunch, the crowd got updates on the hospital from CEO Dr. Michael Lyons and Medistar Corp. CEO Monzer Hourani, who is overseeing construction. Others on hand to greet Webster Mayor Floyd Myers and arriving dignitaries were Senior Vice President of Operations Ron Castagno, Business Development Senior Vice President Santiago Mendoza, Jr., Carter Validus Advisors CEO Michael Seton and Medistar CEO Monzer Hourani. Later, small groups were led through the building by tour leaders, who explained the floor plan.

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With the tour of the new hospital about to begin, Bay Area Regional Medical Center Senior Vice President Santiago Mendoza, Jr., Medistar CEO Monzer Hourani, Carter Validus Advisors CEO Michael Seton and hospital CEO Dr. Michael Lyons, Senior Vice President Ron Castagno, from left, stop for a photo.


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Non-surgical prostate cancer treatment a first in Texas

can result when the sensitive nerves surrounding the prostate are damaged or severed during surgery can be devastating. The gist of all this is that the standard treatment — surgical prostate removal — causes more damage than the disease ever would have. “The problem is, most men who test positive, even if the risk is one in 1,000 of dying of prostate cancer,” said Walser, “still just want to get it out of there. You never know if you are going to be that one.” In the past, there was no way for doctors to remove prostate cancer without removing the whole prostate gland. This is because the available imaging technology was not powerful enough to illuminate the cancer and the available laser ablation technology was not focused enough to remove the cancer without damaging surrounding tissue. But in recent years, the technology has improved significantly. “Our approach pairs the most advanced MRI imaging to pinpoint the precise location of cancer in the prostate and

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new non-surgical prostate cancer treatment offered at the University of Texas Medical Branch virtually eliminates the side effects of impotence and incontinence that can occur when patients receive the traditional treatment for prostate cancer – surgical prostate removal. UTMB’s Chairman of Radiology Dr. Eric Walser is one of only a few physicians in the world and the only physician in Texas who performs this groundbreaking procedure. Using a state-of-the-art, MRI-guided laser ablation instrument developed at UTMB, he zaps away the cancer without removing the prostate. With national standards for prostate cancer screening changing so dramatically over the past year, many men are confused about what it means to have prostate cancer, whether they should be tested for it and what they should do if they test positive. The American Urological Association’s new prostate cancer screening guidelines say that men under 55 should no longer receive routine prostate screening and that men over 80 should not receive it if they have a life expectancy less than 10 to 15 years. The association determined the odds of preventing prostate cancer death with a PSA (prostate specific antigen) blood test for men ages 55 to 69 amounted to one life spared for every 1,000 men screened over a decade.

“The standard treatment — surgical prostate removal — causes more damage than the disease ever would have.”

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This is on the heels of the U.S. Preventive Services Task Force’s statement last May, saying that much more harm than good was being done to men who underwent screening, biopsy and surgical removal of their prostate gland. The vast majority of prostate cancers are so slow-growing that they will never cause a problem. On the other hand, the impotence and incontinence that

the most advanced laser technology to remove it completely, with virtually no risk of impotence or incontinence,” said Walser. Walser, who has been performing this procedure for three years, says this new way of treating prostate cancer offers men much more peace of mind than active surveillance or “watchful waiting,” the traditional alternative to radical treatment. NIH-funded clinical trials of this new procedure so far show that it is safe and effective, with results from Phase 1 just published online in the journal Radiology and Phase 2 currently being conducted at the University of Chicago Medicine.


MD Anderson Moon Shots Program takes flight By Mary Alys Cherry

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t’s only been a little more than a year since its launch and already, the MD Anderson Cancer Center Moon Shots Program has received more than $140 million in private philanthropic commitments to the program, which is targeting eight cancers, including two kinds of leukemia and another blood cancer, melanoma, lung, ovarian, prostate and triple negative breast cancer. M.D. Anderson President Dr. Ronald DePinho hailed the donation total as “a remarkable accomplishment that underscores the generosity of supporters and their confidence in this accelerated effort to conquer cancer.”

“The MD Anderson Cancer Center Moon Shots Program has received more than $140 million in private philanthropic commitments.” The latest large donation -- $50 million – comes from Jho Low, CEO of the Hong Kong investment firm, Jynwel Capital Ltd., who matched an earlier $50 million donation by Lydia Hill, granddaughter of Dallas oil tycoon H.L. Hunt. Another $4.5 million was raised for the Moon Shots Project at the November gala fundraiser at the Kennedy Center in Washington, D.C., when former Secretary of State James A. Baker III of Houston was honored as the focus of “A Conversation With a Living Legend” featuring NBC’s Tom Brokaw as emcee and CBS’s Face the Nation moderator Bob Schieffer conducting the interview. “Two absolutely crucial factors allow us to even think about driving innovation through the program,” Dr.

DePinho, said. “One, our plans rest on the bedrock foundation of more than 70 years of patient care and research excellence at MD Anderson, and two, they couldn’t occur without the generous and mindful financial support of donors and organizations.” Major gift commitments include: • Lyda Hill, $50 million • Jynwel Charitable Foundation Limited / Mr. Jho Low, $50 million • Robert J. Kleberg, Jr. and Helen C. Kleberg Foundation, $10 million • Marathon Oil Corporation, $3 million • Cullen Trust for Health Care, $2 million • Bosarge Family Foundation, $2 million • Mr. and Mrs. William J. Kyte, $2 million • The John G. and Marie Stella Kenedy Memorial Foundation, $1.5 million Among the 750 VIPs attending the Living Legend tribute were Dr. DePinho and his wife, Dr. Linda Chin; Congressman Mike McCaul and his wife, Linda; former MD Anderson President Dr. John Mendelsohn, former Texas Lt. Gov. Ben Barnes, former gubernatorial candidate Tony Sanchez, former Secretary of State Henry Kissinger, Susan Baker, Rose Cullen, Kelli and Eddy Blanton and Luci Baines Johnson. After the TV “conversation,” DePinho present the Making Cancer History Award to Baker, who has been on the MD Anderson Board of Visitors since 1974 and served as chief of staff for both Presidents George H.W. Bush and Ronald Reagan, as secretary of the treasury under Reagan and secretary of state under Bush. “We profoundly thank those who have invested their resources and their trust in the Moon Shots Program. We’re intensely dedicated to rewarding their inspiring confidence with major advances on behalf of cancer patients and survivors, and ultimately to prevent these diseases outright,” DePinho said.

WHILE THERE MAY BE NO CURE FOR A BROKEN HEART, JAMIE ROSE, MATCHMAKER COMES CLOSEST TO HAVING THE RIGHT TREATMENT

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ose Matchmaking is Houston’s premier boutique-style matchmaking firm. The company focuses on providing its clients with discreet, caring oneon-one matchmaking. Jamie Rose is the only certified and BBB-accredited independent matchmaker in the greater Houston area. She meets every potential client in person herself and hand picks matches that will work best for the client. All clients must be interviewed by Jamie and pass a background check before Rose begins its search. These meetings can last for hours with Rose pouring over a client’s, past, present and future needs. The first step is to fill out Rose Matchmaking’s online form or give the firm a call directly. Once your information is received, you will be contacted by an appointment coordinator who will set up the initial one on one appointment. All of Rose Matchmaking’s clients receive expert guidance from Jamie herself. As CEO and founder, Jamie consults with her clients to determine their relationship goals and needs. Jamie’s clients are usually very busy people who rely on her to introduce them to quality individuals. Most clients can easily get dates on their on they look to Jamie to find them the right person who will become more than just a date. Along with matchmaking, Rose Matchmaking has experts available to help in other areas of life - including coaching and counseling, date feedback, image consulting, health and wellness, and invitations to private events. All of its services are completely customizable and are comprised to suit each client. One may not go so far as to call Rose the Love Doctor, but her methods have resulted in more than a few happy hearts. Rose Matchmaking is at 1330 Post Oak Blvd. in the Galleria area. Get started today by filling out Rose’s form or calling 713-963-3663 or emailing info@rosematchmaking.com. For more information, visit www.rosematchmaking.com First Quarter 2014 | www.BestPracticesMD.com|

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Q: You are an inspiration to young women both for careers in medical/ hospital administration and also as CEO. Please speak to that, as far as how one can plan towards these careers. A: I feel very fortunate to do what I do. I love my job. It is an absolute pleasure. The typical route for a young person is to pursue a master’s degree in health administration or business administration. That would be followed by a fellowship within a health organization. Often the organization will retain you in a permanent position. The types of questions to ask yourself to determine if you are well suited for a job in the healthcare industry are: Do you enjoy working with diverse populations, and different types of people? Do you embrace change? This job is about building relationships and influencing people. Q: What are some of the different challenges you face at Memorial Hermann Southeast, a full service hospital, as compared to the challenges you faced in your six years as CEO of the Memorial Hermann Heart and Vascular Center in the Texas Medical Center? A: The challenge in both places is to ensure that you surround yourself with the best talent and then keep them passionate and energized about what they do. That energy is generated by engagement and re-recruiting them every chance you get. The unique challenge at Memorial Hermann Southeast is balancing the competing priorities of our varied services and programs, while making sure the focus remains on the patient and serving the community. Q: What was your inspiration to choose a career in healthcare administration?

INSPIRATION FROM ERIN ASPREC Memorial Hermann Southeast CEO By Betha Merit

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rin Asprec, CEO of Memorial Hermann Southeast, has led a path straight upwards, modeling her passion for excellence in healthcare services and patient care since she took over the reins in March 2010. Asprec relies on outstanding communication and focusing on goals, employing her unflagging energy for people and relationships. She has a strong commitment to patient safety, clinical quality and service, and a relentless goal to achieve excellence through learning, transparency and growth.

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A: I was born with a rare congenital heart condition and spent a lot of time in hospitals up until the age of seven. I have many recollections of being a patient and what that felt like. As a newborn, I actually coded in the NICU (Neonatal Intensive Care Unit) and a doctor walking by resuscitated me and incidentally became my physician. I wanted to give back to the institution that gave me life and ensure firsthand that the community would have access to the same care I got for a very long time. Q: Why Memorial Hermann?  What is unique and special about your hospitals?


A: I love Memorial Hermann and it is primarily due to our sense of community. We serve as a safety net for the community. We conduct community service projects at least once a quarter to support a variety of charities and services. We give over a million dollars to the United Way. Memorial Hermann is focused on more than just acute care. We are interested in advancing the health of the community. Q: Our readers want to know about you too.  Please tell us about your personal interests, goals, family, whatever you feel comfortable sharing. A: My passion is healthcare, health and wellness. I have been happily married for 15 years, and have a four-yearold son. My second passion in life is music! I play the violin, piano, and sang for the Houston Symphony Chorus for several years. Today, I am

taking piano lessons with my son in the hopes of one day playing a duet with him. Q: You get the last word. What else would you like to tell our community? A: Thank you for the privilege and honor of serving this community. I hope to be able to do it for a very long time. I want to emphasize that we are making investments today at Memorial Hermann Southeast to ensure a healthy future for residents of Houston’s Bay Area. This includes developing new programs and expanding services to provide access to the most innovative treatment options and advanced technology, such as our Esophageal Disease Center, thoracic outlet syndrome care, vascular care, spine surgery and more (please visit our website at www.memorialhermann.org/ southeast).

First Quarter 2014 | www.BestPracticesMD.com|

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The End of the Ice Age? By Shane Sigg, D.C.

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HAT ARE THE FIRST WORDS usually out of someone’s mouth as soon as someone sprains/strains an ankle, pulls a muscle, or any other acute soft tissue injury occurs? I can attest to this being an athlete my entire life, being a father, and most commonly due to being a Doctor of Chiropractic. The words are said and usually yelled from afar, “SOMEBODY GET AN ICE PACK”! If something was hurt, ice was the fix. Being that ice can be administered by anyone with no formal trainings or certifications needed, the treatment spread like wildfire. Now when I hear those painfully screeching words I cringe, knowing what I know now. The purpose of me writing this article is not to persuade or tell anyone the conventional way of treating acute injuries with ice (aka cryotherapy) is wrong. But to inform you that the tides are changing the way acute injuries are being treated and to show you why numerous Head trainers of professional and collegiate athletic teams are no longer using ice as a treatment option. Editor in Chief of the Physician and Sports Medicine Journal, Dr. Nick DiNubile, once posed this question: “Seriously, do you honestly believe that your body’s natural inflammatory response is a mistake?” It is Far from a mistake. There is not one treatment, especially slapping an ice pack on injured tissue, which can replicate/duplicate the intelligence and complexity of our own bodies. The rational for using ice is to reduce the swelling and inflammation correct? Why would one want to inhibit the first phase of the healing process, which is the inflammatory response? You don’t and you shouldn’t! In the May 2013 article in the Journal of Strength and Conditioning Research/National Strength and Conditioning Association entitled “Topical cooling (icing) delays recovery from eccentric exercise- induced muscle damage,” says it all. In the last line of the article it stated that “These data suggest that topical cooling, a commonly used clinical intervention appears to not improve but rather delay recovery from eccentric exercise- INDUCED MUSCLE DAMAGE.” Ice has never been proven scientifically to facilitate in recovering

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faster from injury. Theoretically, pain can increase after icing secondary to the back flow of lymphatic drainage that may further increase post-ice swelling. The only thing that has been shown is that it can temporarily reduce pain levels. But at what cost? Delaying the body’s natural defense, which is triggering the inflammatory response to begin the healing process. You cannot have tissue repair or remodeling without inflammation. Why has it taken us this long to realize and start implementing or actually stop implementing ice when it does not facilitate in muscle recovery or tissue damage? Known for thousands of years, Chinese Medicine believes that cold stops the flow of Qi and blood and without either healing is not possible. It is known in Chinese Medicine that those that use ice, even for acute injury, will have a greater possibility of re-injury or upheaval of old pain due to injury years down the road from using ice. Ice encapsulates, drives things (pathogens, injuries, etc.) deeper into the body and weakens the flow of Qi and blood. Chinese Medicine practitioners steer clear of ice and urge patients to do so as well. From my own experience in practice with acute soft tissue injuries, patients are healing faster than ever without

using ice. Swelling is removed from the injured area via the lymphatic drainage system. To facilitate the healing process and removing of the swelling and debris, stimulation of the involved areas muscles is imperative. That’s precisely why icing does not work. It immobilizes the affected area completely without any contraction or movement of the area. For example, if you injure your wrist you would not begin by flexing or extending the injured joint because that would cause pain and delay the healing process. You would begin by moving muscles and joints distally to the injured area. Actions simple as wiggling, flexing, and extending them would be the first movements you would want to try. You would only perform if it did not induce any pain whatsoever. I recommend starting slowly and working your way to the injured area which can take days, weeks, or months depending on the area involved and the severity. Lastly, I will end with some quotes from Gary Reinl and Dr. Kelly Starrett in their book, Iced! The Illusionary Treatment Option: Gary asked, “Why would anyone want less inflammation? Don’t they agree that inflammation is phase one of the universally recognized three-phase healing process (e.g. inflammation, repair, remodel) and that without it, optimal healing is impossible.” The response, “Well of course, but they don’t want all of that swelling.” Gary asked, “So they do want the inflammation, they just don’t want the swelling?” The Response, “Correct.” Gary asked, “Okay, since swelling is essentially the accumulation of waste at the end of the inflammatory cycle, the only way to move that waste is via the lymphatic system, and the lymphatic system is basically a passive system nearly fully reliant on muscle activation around the lymphatic vessels; how could shutting off the signals between the muscles and the nerves, which is precisely what happens when you ice damaged tissue, accomplish that task?” The response, “It doesn’t.” Debate over. Any Questions or concerns please feel free to contact me at Verticalchiropractic@ hotmail.com. Also for additional reading recommendations or journals.



Best Practices First Quarter 2014