Florida Cancer Specialists FCS Magazine Fall 2014

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Fall 2014

THE MAGAZINE

It's Complicated...

Dr. Vance Wright-Browne Fall 2014

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FCS THE MAGAZINE fall 2014

in this issue

DEPARTMENTS 8 10 12 26

Events FCS News The Radar Screen Oncology News

SPOTLIGHT

14 D octor Spotlight: Jose Alemar, M.D. 18 Nurse Spotlight: Denise McAllister 22 Office Spotlight: Palm Beach Gardens 24 Research Spotlight: RX To Go Pharmacy

FEATURE 4 Profile: Dr. Vance Wright-Browne It’s Complicated …

BEST. MEETING. EVER. + 2014 Clinical Summit October 24–25, Orlando JW Marriott www.flcancer.com/2014clinicalsummit

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FCS The Magazine

editor's

FCS THE MAGAZINE

Message from

Dear Colleagues,

PRESIDENT

As we enter the second half of 2014, I wanted to provide an update for the first half of the fiscal year.

WILLIAM N. HARWIN, M.D. STEPHEN V. ORMAN, M.D. MEDICAL DIRECTOR

MARK S. RUBIN, M.D. SCIENTIFIC DIRECTOR OF CLINICAL RESEARCH, DIRECTOR, DRUG DEVELOPMENT PROGRAM

LOWELL L. HART, M.D.

DIRECTOR OF RESEARCH OPERATIONS

ROBERT C. WHORF, M.D.

EXECUTIVE MANAGEMENT CHIEF EXECUTIVE OFFICER

BRAD PRECHTL

CHIEF FINANCIAL OFFICER

LIBBY SLATER

CHIEF OPERATING OFFICER

TODD SCHONHERZ GENERAL COUNSEL

TOM CLARK

CHIEF MARKETING & SALES OFFICER

SHELLY GLENN

CHIEF HUMAN RESOURCES OFFICER

SHARON DILL

SENIOR VICE PRESIDENT, RADIATION/RADIOLOGY AND PARTNERSHIP SERVICES

ED MERCADO

VICE PRESIDENT OF REVENUE CYCLE

SARAH CEVALLOS

VICE PRESIDENT OF CLINIC FINANCIAL SERVICES

CHRISTINA SIEVERT

SENIOR MANAGEMENT JEFF ESHAM JEREMY BEHLING TARA RUSKA JEFFREY RUBIN RAY BAILEY LOIS BROWN MELODY CHANG RICH DYSON MICHAEL ESSIK INGA GONZALEZ KATIE GOODMAN CHRISTOPHER HOUSER SUE KEARNEY LOIS POEL DENICE VEATCH SAMANTHA WATKINS

IN PARTNERSHIP WITH

PRODUCED BY

fall 2014

contents

Brad Prechtl, CEO

PHYSICIAN LEADERSHIP ASSISTANT MANAGING PARTNER, DIRECTOR, EXECUTIVE BOARD

letter

FCS has continued to grow and now has 83 practice locations, 166 physicians, 120 nurse practitioners and physician assistants and just over 2,000 employees. Our dedicated team members have been instrumental in helping to launch the Operational Excellence Program with over 80 standard operating procedures, increased informatics sales by over 150 percent compared to 2013, reduced overtime by almost 8 percent, expanded the Integrative Oncology Program, conducted over 12,000 patient surveys while maintaining customer loyalty scores of over 82 percent, secured CAP accreditation for our cytology lab and grew our lab service usage and clinical trials enrollment.

While we continue to experience growth, there have been some significant challenges with the changing payer landscape and some insurers, our Revenue Cycle and Managed Care teams have risen to the occasion. While focusing on doing what is best for the patient and for FCS, the Managed Care Billing and Collections Department has assisted 4,611 patients as of August 31, maintained co-pay collections at 91 percent, and the Revenue Cycle Departments have reduced AR days outstanding significantly. Earlier this year, many FCS physicians, NPs, PAs and Senior Managers traveled to ASTRO, ASCO, and FLASCO conferences to present posters, papers, and lecture to enhance their clinical knowledge.

With the new Tampa Cove Bend location, FCS welcomes Drs. Ron Schiff, Faithlore Gardner, and Egberto Zayas and their staff members. Dr. Vipul Patel is now practicing in both Inverness and at the new Ocala facilities along with Drs. Patrick Acevedo and Maen Hussein and their team members. Dr. Andres Soriano is now in Englewood.

In addition, this year we continue to strengthen and expand our executive and senior management teams and expertise with the additions of Libby Slater (CFO), Ed Mercado (SVP Radiation/Radiology & Partnership Services), Tara Ruska (controller), Melody Chang (director of Pharmacy Operations), David Curry (director Integrated Clinical Services), Rich Dyson (director of Procurement), Michael Essik (director of Financial Analytics and Development) and Christopher Houser (director of Information Systems). Also, we welcomed Drs. Marilyn Raymond (West Palm Beach/Wellington) and Gerald Sokol (Hudson) to the FCS Executive Board.

Our HR department has filled over 285 positions year to date while maintaining a turnover rate comparable to 2013. They have implemented new technology to streamline onboarding, reviews and analytics and have developed and conducted leadership training for corporate and Region 1 and 2 managers and supervisors, which will be offered to others during the remainder of 2014.

By June of 2014, the FCS Foundation received more patient applications than in all of 2013 and patient grants also exceeded 2013. Employee giving has increased and we hope more team members will join the payroll deduction program and commit to a bi-weekly, tax-deductible donation. Beth Bush was welcomed as the new Foundation manager.

Led by Jackie Bearse, a Foundation advisory board member, the Rio Carnival event held in Naples this spring was an enormous success. June was a particularly busy month as the Foundation moved to its Lakewood Ranch location and launched a volunteer program. Paid and volunteer staff are working together to implement technology and streamline processes that will result in more user-friendly and efficient customer service for those who need the support of our Foundation.

During the first half of the year, the marketing team continued to focus on brand awareness by: promoting FCS physicians and locations; providing information and communication support through content on the FCS TV screen in waiting rooms (100-plus graphics and 20-plus videos); television ads featuring FCS patients, physicians and staff on 22 stations throughout Florida (check out the FCS YouTube channel); radio ads on SiriusXM (throughout North America); NPR statewide; WDUV (Regions 3, 4 and 5); Tampa Bay Buccaneers and FSU (73 stations); press releases; TV appearances; letters to patients and physicians; 19 billboards and so much more.

As we begin the second half of 2014 and continue commemorating our 30th anniversary, I want to thank you for your continued dedication, hard work, support and commitment to FCS and, most importantly, to our patients.

Brad Prechtl, CEO Fall 2014

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PROFILE

It’s Complicated …

And for Vance Wright-Browne, M.D. that’s always a good thing

BY ZANDRA WOLFGRAM

W

hether piecing together a puzzle, tending to more than 200 orchids or listening to a piece of classical music, Dr. Vance Wright-Browne relishes a challenge.

"Things that are easy bore me. I lose interest very quickly,” the 51-year-old physician with warm brown eyes says. “I like things that have several different levels, different nuances that you have to put together.”

“ I like things that have several different levels, difference nuances that you have to put together.”

— DR. VANCE WRIGHT-BROWNE

And that is precisely why she also loves oncology.

"I love something that gives me the ability to sort things out. I love doing something that other people are a little intimidated by. With chemotherapy you can make someone very sick, you can kill someone, in fact, if you don’t know what you’re doing,” Browne says.

This caregiver knew exactly what she was doing when she chose her educational path. Her mother was a teacher and so Browne gave consideration to pursuing the two careers she respected and admired most: teaching and medicine.

"For me medical school was really a choice that I made in the context of wanting to do something meaningful with my life. I thought it was important. I thought it was one of the things I could do to make a difference, which may sound corny,” she says. In medicine she found a challenging career that would give her the “opportunity to shape a life, long term.”

Medical school was the easier choice the West Indies native recalls. (She earned her undergraduate and medical degree at the University of West Indies; completed her internship and residency at the University of Connecticut; and was awarded a fellowship at University of Texas, MD Anderson Cancer Center.)The tougher choice for Browne was deciding to go into oncology. As with most

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PHOTO BY SCOTT HOLSTEIN

PROFILE

"It’s filled with very complicated medical problems and addressing them allows you to really turn somebody’s life around.”

— DR. VANCE WRIGHT-BROWNE

things in her life she was drawn to and intrigued by the intricacies of oncology.

treatment and get them thinking they can do this and go through one of the most difficult things,” she explains.

"It’s filled with very complicated medical problems and addressing them allows you to really turn somebody’s life around,” she says.

Browne says to unlock the secret of putting patients at ease, her “medical bag” is filled with a lot of empathy and … psychology. “I can tell more about a patient in the first five seconds before they say anything, just by the way they sit in a chair, the look on their face, the way they walk in when you call their name. So you can tell a huge amount just from being observant,” she says.

And for a compassionate caregiver there is still great reward in failure.

“I enjoy complexity. I enjoy patients that have many medical problems to sort through. Even if you don’t succeed, you still get to bond and can make a huge difference in their lives,” she reasons.

Browne has worked with Florida Cancer Specialists since 1996. She serves patients with office hours at both the North Port and Port Charlotte offices situated just north of the Charlotte Harbor estuary, which flows into the Peace River near Punta Gorda, Fla. In addition to the challenge of medical cases her 30-plus daily patients provide, this FCS oncologist welcomes the opportunity to develop personal relationships with her patients.

Though she says empathy is key, she insists a good physician has to have the ability to put themselves in that patient’s shoes and “help them walk the walk.” Again, for Browne, there is joy in the nuances of just how to provide care for each patient. “You have to realize the way you might treat and speak to and manage a 40-year-old with two young kids is completely different from the way you might approach care for a 75-year-old retiree. Your job is to get them both through

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But figuring people out is just the first step. For Browne, the next thing, and a critical one, is to treat patients like people. “They need you to know they have a life outside. And you need to be able to make them understand that you know that and that they are not just a number.”

For Browne, the more she behaves as a caring friend, and the more she learns about the whole human being she is caring for, the better doctor she becomes to her patients. “I do tend to run late, because I do look at pictures of grandkids and we do talk about things that are not very doctorly, because that’s part of who they are,” she reasons.

Outside of the office, Browne gives just as much. When she is not spending time with her husband of 28 years and her three daughters, ages 22, 17 and 13, she is active in her church, sits on the board of the Tidewell Hospice and the Lung Cancer Research Council and is a member of the American Society of Clinical Oncology. Despite winning numerous prestigious medical awards over the years, she still

contends she is the ultimate receiving end. “I’ve gotten more from this than I’ve given,” she says. “Although it’s difficult, you gain so much more from the patients that you give to, that’s one of the reasons you keep coming back.”

When it comes to cancer Browne doesn’t like to play favorites, but she has them. She particularly likes working with breast and lung cancer patients.

Breast cancer, she contends, gives her a chance to treat patients often in a younger demographic and lung cancer is a field she has seen dramatically evolve first hand.

When she was a fellow there was very little treatment for lung cancer and now the field has “exploded,” such that there are multiple treatments and patients are living longer. And that is what draws her to it. “We are taking what was once a death sentence for Stage IV patients and seeing some outlive the median survival rate of a year to three and occasionally five years. When I was a fellow, the average was just six months,” she recalls.

That said, Browne remains in general oncology to stave off becoming “bored” with any one disease. “We are getting more and more options and that’s why I do what I do,” she says.

Though there are strides that warrant celebrating, Browne says it’s important to remain realistic. “We are not giving people 20 years, but at the same time in an 18-year career when you can see colon cancer’s median survival rate triple … That’s not a cure, but we are converting cancer to more and more of a chronic disease and patients are living longer. To me, that’s inspiring that that can happen during one career.”

Most would agree finding cures for cancer can’t happen soon enough, but Browne says we need to remember how far we’ve come. “Chemotherapy began to be used in the 1960s, that’s only 50 years ago,” she reminds.

For Browne, like getting to know her patients, the future of oncology lies in putting a “face” to cancer. She explains that as we look deeper into the cancer genome we have learned there are more and more subtypes of cancer. One type of breast cancer isn’t the same as another. The way the field is going is individual profiling of a patient’s cancer.

"It only makes sense,” she says. “The smarter we get about figuring that out, the better our treatments will be.” And we have no doubt Browne will relish every moment of the challenge. n

Fall 2014

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events

Relay for Life

MAY 16, 2014 

The Relay for Life event was held Friday, May 16, at Albert Whitted Park, and FCS was on hand with a table nearby the Survivor’s tent. Attendees enjoyed FCS bags with a T-shirt, sunscreen, lip balm and materials on FCS. A good time was had by all!

Photo: Yinaira Rodriguez, Andrea Bolivar and Maria Ramos-Person with Dr. Knipe's patient.

30th Anniversary Celebration Continues

2014 

Our offices around the state continue to celebrate the 30th anniversary of FCS with various events.

Highland office: Bottom Row L-R: Dr. Sinha, Maria Ramos-Persons, Regina Hammonds, Stephanie Abbott, Dr. Luong, Heather Blanchette ARNP, Barri Rowland. Middle Row L-R: Betsy Feaster, Nancy Hockey, Amanda Hellard, Andrea Bolivar, Yini Rodriguez, Cindy Vavasis, Adissa Wassmer, Sarah Boses, Panta Xiong, Ken Copeland. Back Row L-R: Geno Marasco, Norm Leslie (hiding), Willinda Devone, David Rojas, Chris Thibodaux, Tina Bardine, Mary Dinos, Nancy Nolan, Rachel Larry, Michael Byrd, and Jason Hehr

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FCS The Magazine

events

Fall/First Annual FCS IT Chili Cookoff and Cornhole Tournament AUGUST 29,, 2014  FCS Gator Team 

Breast Cancer Symposium 2014 

Breast cancer 1: Eric Nelson, Rhonda Webster, Abby Sadowski, Orianna Lilette, Ashley Pruitt

Fall 2014

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FCS

news

Florida Cancer Specialists & Research Institute Welcomes

Dr. Faithlore Gardner NEW PHYSICIAN TO PRACTICE IN CAPE CORAL OFFICES

Florida Cancer Specialists & Research Institute (FCS), the leading community oncology/hematology practice in the state, is pleased to announce that Faithlore Gardner, MD, has joined the practice and will be seeing patients in two office locations in Cape Coral, Fla. Dr. William Harwin, Founder and President of FCS, said, “We are very pleased to welcome Dr. Gardner to the FCS family. She comes to us following her fellowship at the Mayo Clinic with excellent credentials, and I know she will be a great addition to our practices in Southwest Florida.”

FCS CEO Brad Prechtl said, "Dr. Gardner will bring added convenience and expanded services to our offices in Cape Coral. In addition, Dr. Gardner has a keen interest in clinical research and will help advance our clinical trials program to the benefit of our patients in the Cape Coral community.”

Dr. Gardner comes to Florida Cancer Specialists, having just completed her fellowship at Mayo Clinic. She received her medical degree from the University of South Florida (USF)/Moffitt Cancer Center and completed her medical residency at Vanderbilt University, prior to being awarded her hematology and oncology fellowship at the Mayo Clinic in 2011. She has over ten years of research experience, and her work has been both published and presented within the medical community, including the 23rd Annual Mayo Clinic Hematology/Oncology Review.

Dr. Gardner is a member of the American College of Physicians, American Medical Association, American Society of Clinical Oncology and American Society of Hematology.

Dr. Gardner said, “I am very excited to be joining Florida Cancer Specialists. As a pioneer in community oncology, the practice has set the benchmark for more personalized care and greater access to national clinical trials, all within local communities, close to where patients live. I’m also looking forward to returning to Florida, since I received my medical degree from USF in Tampa.”

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Florida Cancer Specialists’ Physicians Participated in

Stand Up To Cancer Broadcast DRS. TETREAULT, COGBURN & GERSTEN EMPHASIZED NEED FOR INCREASED RESEARCH Florida Cancer Specialists & Research Institute (FCS) supported a television simulcast event called Stand Up to Cancer (SU2C), which was broadcast nationally. Three FCS medical oncologists were invited to participate at a local market level in three cities to apprise viewers of the latest information on cancer research and the impact it has had on their local communities.

Dr. Scott Tetreault shared new breakthroughs with viewers on WTXL - ABC 27 in Tallahassee; Dr. Julia Cogburn discussed the importance of research on WTSP – CBS 10 in the Tampa Bay region; and Dr. Todd Gersten delivered a message of hope and optimism to WFLX – FOX 29 viewers in West Palm Beach.

Dr. William Harwin, Founder and President of FCS, said, “As one of the few community oncology practices in the nation that maintains a sophisticated clinical trial research program, as well as two drug development units in our network, we know how vital these efforts are in developing new treatments for all types of cancer. Programs such as Stand Up to Cancer put cancer research at the top of viewers’ minds, and hopefully, will encourage them to donate generously to help advance cancer research in the future.”

Brad Prechtl, CEO of FCS, added, “Through our strategic partnership with the Sarah Cannon Research Institute, one of the most respected clinical trial organizations in the U.S., we are able to offer our patients access to cutting-edge clinical trials that are often only available at large academic medical centers, usually in large cities.

As a statewide community oncology practice, FCS is able to provide unprecedented access to clinical trials for our patients in communities across Florida, both large and small. That is the very heart of our mission.”

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the radar

screen

What’s on Your Radar?

✚

BY SCOTT TETREAULT

NATIONAL NURSES DAY This year, instead of a thank you card, give your nurses, and your

patients, a REAL present. Rituxan infusions take forever. This distresses patients and nurses, although the doctors seem oblivious.

At last year’s ASH, the team at Ohio State reported their experience with rapid Rituxan infusions. If patients did not have a grade 3 or 4 infusion reaction to Rituxan number one, then subsequent doses were administered rapidly: an average of 62 minutes more rapidly. There were no problems. As part of the study, they reported nursing satisfaction.

I think you’ll agree that it is hard to do better than the 100 percent satisfaction that they

defibrillator placed. They need “orders” for

reported. (ASH abstract 2985)

✚

ALONG THOSE SAME LINES

the Coumadin. Well, I have some good news

✚

ADD CARBO TO NEO-

for you. The correct answer is to do…wait

ADJUVANT CHEMO IN

for it….nothing. Just simply continue the

TRIPLE NEGATIVE BREAST

Coumadin and maintain INR in range.

Two randomized trials, Alliance and The

The reference study was published in the

German Breast Group, have reported on

New England Journal, you know, the “white”

4 for adjuvant breast cancer could not be

the addition of carbo to the neo-adjuvant

journal, so it ain’t junk science. Bimie et al

given dose dense Q 2 weeks because of “skin

plan in triple negatives. The bottom line

randomized 600 patients like this to either

toxicity.” But just 4 weeks ago, the University

is that adding carbo greatly increases the

Coumadin continuation or bridging and the

of Wisconsin group published their results in

pathologic CR rate. The optimal way to give

Coumadin continuation patients actually

51 patients given dose dense TC times 4 and

it is probably alone, as a single agent, weekly

did BETTER with less bleeding and

the patients did fine. It is hard to imagine

at AUC of 1.5 for 18 weeks. An empirical

hematomas etc.

that outcomes will be any different in the

argument could be made to combine it with

long term from Q 3 week TC but I suppose

taxol weekly also.

I had always heard through the

grapevine that Taxotere—Cytoxan times

conservative docs could legitimately want to wait for their five year outcomes data before

✚

WE ALL HATE INTERFERON I don’t think any adjuvant

LESS BLEEDING? NO WAY,

treatment in any disease is given

THAT’S WEIRD

with less enthusiasm than interferon. So

So, I know you love these phone

the recent EORTC 18071 results showing

on a recommendation for adjuvant chemo if

✚

they knew that from day 1 to day “last” the

messages: your patient, who is stable on

a disease-free survival benefit comparable

elapsed time would be just 42 days?

Coumadin, has to have a pacemaker or a

to interferon are welcome news. Of course,

embracing the results. But just think about how many more women might look favorably

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FCS The Magazine

news

updates here is where the usual warnings about not

is: giving two years or so of Tarceva after

therapy in premenopausal ER positive

jumping the gun and being cautious and

resection of an EGFR positive lung cancer.

curable breast cancer patients, along come

blah blah blah need to be written, but we

But importantly, Radiant defined EGFR

SOFT and TEXT. So, the answer now,

all hate interferon so much that if yervoy is

positive as IHC positive or FISH positive.

approved for this indication, it won’t take

Two years of adjuvant Tarceva was a failure,

long to replace the gold standard.

no benefit---but of course, lots of side effects. The story may not be over, though,

at least in your highest risk patients, is ovarian suppression plus aromasin. But really, the investigators did NOT present

for you Tarceva fans because they are going

a control group, the tamoxifen only arm

FOR CURABLE LUNG

back and trying to establish a benefit in

is still in the lab so the statisticians haven’t

CANCER PATIENTS,

truly mutated EGFR patients. That will

exactly applied all of their brainpower to

JUST STOP. STOP WHAT

take some time, I think. And according to

YOU’RE DOING

this question yet. I have such sympathy

the the “Samsung” investigators in Korea,

Well, stop what you’re doing if you are

for our FCS breast cancer doctors with

adding three cycles of Cis/Docetaxel for

advising erlotinib after curative surgery and

consolidation after combined chemo—xrt

stop what you’re doing if you give a few

added nothing but toxicity.

✚

trial tested a strategy that we ALL have thought of at one time or another and that

✚

doctor and patient could have a three-day long discussion of all the controversies

cycles of chemo after combined chemo— xrt for inoperable patients. The Radiant

some of our young curable patients. The

TEXT SOFTLY

surrounding the various aspects of local

Just when you thought you had

and systemic therapy and still not

the easy answer to anti-estrogen

cover everything…

TRUE Warrior R FLO

ANCER SPECIALISTS SALU I DA C TES

A

Karen Warmack is not only ghting her own personal battle with cancer, but is speaking out on behalf of others battling the disease. She recently testied in support of “The Cancer Treatment Fairness Act” before Florida lawmakers. Her testimony led to the enactment of the law.

Florida Cancer Specialists Medical Oncologists Scott Tetreault, MD • Viralkumar Bhanderi, MD • Paresh Patel, MD Tallahassee Location 1600 Phillips Road, Suite 300 Tallahassee, FL 32308 | (850) 877-8166

Tallahassee North Location 2626 Care Drive, Suite 200 Tallahassee, FL 32308 | (850) 219-5830

FLCancer.com

Fall 2014

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DOCTOR SPOTLIGHT

Jose Alemar, M.D. Focused, driven … and grateful to be here

BY LYNDA BELCHER

M

ayagüez is located in the center of the western coast on the island of Puerto Rico. As a child growing up there, summertime for Dr. Jose Alemar meant carefree days camping on the beach with his family. Today, the 41-year-old oncologist still finds nothing more soothing than waking to the sound of waves lapping on the beach. But these days, he only has a day drive from his home in Palm Harbor north to the Panhandle’s Rosemary Beach to play on the sugar white sand beaches with his wife and two young kids.

Whether deciding exactly how best to spend his precious time off on a family vacation or navigate his career path to a successful practice, Alemar is clearly focused on making the most of any experience — and grateful for the opportunity.

When he was just a young teen, Alemar was a fixture at the bedside of a close high school friend while she fought cancer. He had already decided he wanted to go into medicine, a surgeon perhaps. But after this experience, oncology called to him. “I saw that the surgeon could do nothing for her,” he says. He also saw health care that was lacking and pledged, “When I am a doctor, I will do things differently.”

You can take things for granted, but I don’t because I know in my career there was a time I wasn’t able to provide the care that I wanted,” Alemar says. “With FCS you are more in touch with your patients. No one is breathing down your neck telling you how to treat your patients, and you have so many resources just one phone call away and under one roof.”

After receiving medical training at the University of Puerto Rico School of Medicine, Alemar completed his internship, residency and fellowship at the University of South Florida College of Medicine in Tampa. He has been practicing

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oncology for 10 years; three of them with Florida Cancer Specialists & Research Institute (FCS), where he is thrilled to represent his region as an elected member of the executive board. And, yes, he is grateful to be able to do things much differently now.

— DR. ALEMAR

"You can take things for granted, but I don’t because I know in my career there was a time I wasn’t able to provide the care that I wanted,” Alemar says. “With FCS you are more in touch with your patients, no one is breathing down your neck telling you how to treat your patients and you have so many resources just one phone call away and under one roof.”

Working for the largest, privately held oncology practice in the country is not lost on Alemar, who knows firsthand what the alternatives could be.

“Having friends in other states and countries and seeing how doctors practice with what resources they have makes you appreciate what you have…

And there’s a lot of gratification to me being able to provide this kind of service,” he says.

For Alemar, practicing good medicine means using all of his available resources, including his native culture and language. Being Hispanic has given him a unique perspective, particularly when it

And that’s what makes your day exciting and motivates you and makes you want to keep going. You think, ‘Who’s going to be the next miracle?’”

comes to helping patients and families faced with end of life decisions. “In America we are pretty practical and accept the end-of-life fairly well. In Puerto Rico, we would have a patient on life support and hope and pray to the very end for the last miracle,” he explains. Understanding the nuances of certain ethnicities means “you already know where they are going to be coming from and what their expectations are,” he says.

Alemar will be the first to admit he’s witnessed some “divine intervention.”

He recalls two older patients he fondly refers to as “the miracle sisters.” When he successfully treated one for esophageal cancer, she brought in her sister a couple of years later and insisted he give her the same “miracle” treatment.

The sister had an inoperable tumor on her gall bladder. “For both of them to pull through is amazing to me, and I’m not sure I can take the credit,” he says. “And that’s what makes your day exciting and motivates you and makes you want to keep going. You think, ‘Who’s going to be the next miracle?’”

— DR. ALEMAR

patients. For him that means an opportunity to collaborate with wellness experts to provide alternative care. After referring many of his patients suffering from neuropathy to an acupuncturist, he reports that eight out of 10 have more sensation and less pain.

Another “no brainer” is giving patients access to a nutrition expert.

Alemar’s region now has a dedicated dietician on staff to help patients create a balanced wellness plan. “I tell them it’s like a road trip. You would not go on a trip without putting gas in the car. Well, cancer is the same.

You cannot heal if you are not eating,” he reasons.

As for the future of the health care industry, “It’s going to be what we make it to be,” Alemar says. And for this driven doctor, as with everything else in his life, every day may not be a walk on the beach but he will surely make the most of it. n

Of course Alemar does not wait for divine intervention; he opts for integrated care. The fact that this is one of the most extraordinary times of change in health care only inspires Alemar to find creative solutions for his Fall 2014

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Cancer Cuts by the Numbers cancer patients in the United States receive care at a community-based cancer clinic or local doctor’s office.

If sequestration forces those clinics to close, those patients would have to travel farther for their care.

Tell Washington to #SaveCancerCare

Urge Washington to repeal sequestration cuts to cancer care for Medicare patients now!

Learn more and take action at www.ourcommunitycounts.org

NURSE SPOTLIGHT

Thank You, Florence Nightingale Denise McAllister

BY ZANDRA WOLFGRAM

G

rowing up the youngest of eight children in Centerville, Tenn., had many things to offer Rebecca Denise McAllister. But a library was not one of them.

During her elementary school years she would race home clutching the latest edition of the Weekly Reader to ask her mother permission to order a book. After reading a book about Florence Nightingale her destiny was determined. She was nine years old.

"That was all it took and I knew right then and there that I wanted to be a nurse,” the fair-haired, 51-year-old said. “She was a woman, nurse and leader well beyond her years, and I recognized how one person can make a difference in terms of wellness and disease prevention.”

What began in 2011 as a part-time job to keep up her credentials led to a full-time job as Bergier’s ARNP, and one she hopes is her last stop before retirement. But don’t expect this passionate practitioner to slow down any time soon. In addition to caring for an average 15 patients a day, McAllister is engaged on boards and committees with several local and national health care organizations, including the Myelodysplastic Syndrome Foundation, the American Cancer Society and the Leukemia & Lymphoma Society (LLS). Earlier this year, her winning campaign raised $93,000 and successfully seated Dr. Bergier as Man of the Year for LLS;

and her Making Strides team, which called themselves “Answer for Cancer: — DENISE MCALLISTER Team Bergier,” came in first place.

That was all it took and I knew right then and there that I wanted to be a nurse.”

McAllister, too, has made an indelible difference throughout her 28-year nursing

career … and she didn’t waste much time getting started. After moving to Gainesville to pursue her dreams, she soon became a certified nursing assistant at Alachua General Hospital, which helped pay her way through college.

Eventually, this tenacious, hardworking caregiver earned a bachelor’s degree in science and a master’s degree as an advanced oncology certified practitioner from the University of South Florida, making her both an ARNP and an AOCNP.

Working a year at Emory University Hospital in Atlanta, nearly 20 years as a clinical nurse at the prestigious H. Lee Moffitt Cancer Center & Research Institute in Tampa and another five as a clinical nurse consultant for Celgene Corporation exposed McAllister to cutting-edge clinical trials and therapies. It also connected her with some of the top expert scientists and physicians in the country, including Dr. Gregoire Bergier, who practices out of Florida Cancer

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FCS The Magazine

Specialists & Research Institute’s Clearwater office on McMullen Booth Road.

For McAllister, the more immersed she becomes in the field she loves, the bigger the reward and return. “Dr. Bergier allows me to work with autonomy; and working at FCS gives me exposure to all disease states and supports me being involved in the community — all of which makes me more well rounded,” she says.

After more than two decades in an academia environment, research still calls to this energetic oncology nurse. After hours and on weekends, McAllister can often be found penning papers and articles and speaking to fellow practitioners all over the country.

The intrigue of Chemotherapy Induced Peripheral Neuropathy captivated McAllister enough to focus her master’s thesis on it;

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NURSE SPOTLIGHT

since then she has co-authored articles on the subject related to colon cancer among several other areas of interest for various abstracts and journals. Currently, she’s snatching time where she can to complete a paper on the impact Myelodysplastic Syndrome has on quality of life in older adults. McAllister enjoys expressing herself through writing, but the ultimate driver is to improve health care. “I encourage my nursing practitioner students to publish when they can. Not only to get their name out, but more importantly, to contribute to literature which helps patients in the end,” she says.

McAllister believes FCS is attracting quality caregivers because it has its priorities in the right place. “I work among a team of people who put the patient first every day and who are really devoted to doing the right thing by others,” she says. Because patients are a central focus, McAllister reasons its why turnover is low and retention is high. “In the beginning of my career I had never thought about working in an oncology setting, but I love the culture here,” she says.

Still a country girl at heart, with her son, Stephen, grown and moved out of state, McAllister enjoys camping in her RV with her husband, Rodney, and letting her five miniature schnauzers (named after characters from the “Dukes of Hazzard” television show) run rampant on her three-acre property in Dover, Fla. Like Florence Nightingale, this good-natured nurturer is on a mission. “I wake every day in hope of trying to contribute to my patients' cure and overall well being,” she says. “I can see the impact of what I do at the end of the day and it doesn’t get much better than that.” n

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I can see the impact of what I do at the end of the day and it doesn’t get much better than that.”

— DENISE MCALLISTER

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OFFICE SPOTLIGHT

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FCS The Magazine

Palm Beach Gardens

Celebrating one year of quality-of-life care

BY ZANDRA WOLFGRAM

P

alm Beach Gardens is known for its lovely green spaces, championship golf and the good life. With a great climate, private gated communities and an easy, laidback lifestyle, there’s a reason golf, tennis and celebrities

to serve the community’s growing healthcare needs. On June 1, 2013, FCS merged with Palm Beach Cancer Institute and became the fourth FCS location in the West Palm Beach area. This office rounds out the total FCS locations to 83 throughout the state.

settle here.

Incorporated in 1959 by John D. MacArthur, the City of Palm Beach Gardens spans about 56 square miles, making it the town with the largest land area in Palm Beach County. With more than 50 percent of the area forested or landscaped green space, Palm Beach Gardens' residents enjoy year-round leisure activities and the beauty of a garden community befitting its name.

In addition to green space, the city is award winning for its Art in Public Places program and its pro-active business climate that embraces innovation. Not to mention that it’s an ideal vacation spot.

I am familiar with both the location and the team.

This office is like home.”

— DIANE MANN

Part of the vacation vibe of this pretty city is partly due to the 12 championship golf courses within the city limits. It only makes sense then that the Professional Golfer’s Association of America (PGA) is headquartered here and why big tournaments, such as The Honda Classic, the Ryder Cup and several other official PGA championships, have been hosted here.

Palm Beach Gardens — which is just a dozen or so miles north of West Palm Beach — is a growing market. Realtor.com reports that 19 percent of residents are folks who have relocated to the area within the past year. Since 2000, the area has grown nearly 30 percent overall. And with nearly 50 percent of the populations aged 45-plus, it has also proved an ideal location for Florida Cancer Specialist & Research Institute (FCS) to establish a dedicated office

The Palm Beach Gardens team operates from the second floor of a five-floor facility on scenic PGA Boulevard. The 30-plus member staff is led by six doctors and three ARNPs. Diane Mann is a 38year veteran of the health care industry who was recently hired on as the office manager. Having worked at the location as a medical lab technologist prior to the merger meant Mann could jump right in to her new role overseeing the day-to-day operations. “I am familiar with both the location and the team. This office is like home,” the New York transplant says.

Florida Cancer Specialists physicians and staff welcomed local dignitaries, patients and their families to a Ribbon Cutting and Patient Appreciation Breakfast at the Palm Beach Gardens office recently to celebrate its expanded services at the location and the one-year anniversary of the merger with Palm Beach Cancer Institute. After a year as an official FCS site, Mann says things are running smoothly and patients are settling in to the new practice thanks to the “personable, close-knit and friendly” FCS team dedicated to patient care.

Palm Beach Gardens is respectfully called a “signature city,” because like the FCS office located here, it contributes to the area’s “quality of life by fostering an environment of excellence.” n

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RX TO GO

In-House Pharmacy Working For Positive Outcomes

M

ost cancer patients envision chemotherapy as a time-consuming intravenous therapy that has severe side effects. But this year, approximately 25 percent of all cancer drugs will be available in a pill form.

Many of the new, targeted oral chemotherapies give patients independence from long infusions and a better quality of life.

Oral chemotherapy, as defined by the American Cancer Society, is any drug you take by mouth to treat cancer and is available in liquid, caplet and tablet form.

The Florida Cancer Specialists’ in-house pharmacy, known as Rx To Go, is the stepping-stone for all patients and physicians who have agreed to move forward with oral chemotherapy. Rx To Go is located at the corporate office in Fort Myers, Fla. and specializes in limited distribution and limited access oral chemotherapy drugs. Patients, physicians, nurse practitioners, pharmacists, nurses, office managers and medical assistants can all interact with Florida Cancer Specialists’ oral oncology pharmacy.

Howell works with Rx To Go Pharmacy Director Raymond Bailey, and FCS clinics throughout the state, to facilitate FCS The Magazine

The pharmacy is able to provide high-touch patient care, a patient adherence program, clinical services, prior authorizations, patient assistance and overnight delivery to homes. Howell also can schedule focus groups, in-practice programs, dinners, meetings and educational programs for FCS physicians and staff to make them aware of available services.

I enjoy the faceto-face interaction within each office while problem solving and bringing new information regarding FCS and Rx To Go Pharmacy.”

Since Rx To Go is not able to have face-to-face interaction with all clients, Pharmacy Liaison Michael Howell has been brought on as the face of the pharmacy — and to remind clinical staff that the pharmacy is available to help with all patients, in any way possible.

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quality patient care. His mission is to establish and maintain professional working relationships with clinical practitioners, office managers and pharmacy personnel while ensuring the best possible outcome for the Florida Cancer Specialists’ patient.

— MIKE HOWELL

Howell spent nine years as a medical sales consultant and over 10 years in the pharmaceutical industry in sales and management. While in medical sales the past three years, there was an opportunity to join FCS Rx To Go Pharmacy as a pharmacy liaison. With his past experience and desire to work within the cancer environment, he felt as if this was exactly where he needed to be.

Howell says that working with Rx To Go Pharmacy for the past year has been the highlight of his career to date. As a liaison, he enjoys working with the practitioners and nurses with the common goal to help the patients and make their experience as enjoyable and as seamless as possible.

"I enjoy the face-to-face interaction within each office while problem solving and bringing new information regarding FCS and Rx To Go Pharmacy," he said. n

Mike Howell

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Oncology

news

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FCS PRESENTS ABSTRACTS AT AMERICAN SOCIETY OF CLINICAL ONCOLOGY’S 50TH ANNUAL MEETING Nation’s Largest Independent Oncology/Hematology Practice Expounds on Clinical Trial Research

Florida Cancer Specialists & Research Institute (FCS) announced today that the American Society of Clinical Oncology (ASCO) selected 15 abstracts co-authored by several FCS Physician Investigators for presentation at its 50th annual meeting, which was held in Chicago, IL May 30 – June 3, 2014. The annual meeting brought together over 25,000 oncology professionals to discuss this year’s theme, “Science and Society." Among the FCS physician investigators whose abstracts were presented at the annual meeting are Drs. Lowell Hart, Andrew Lipman, Scott Lunin, Michael McCleod, Manish Patel (FCS Associate Director of Drug Development), James Reeves, Scott Tetreault, David Wright, Robert Green, Daniel Spitz and William Harwin, Founder and President of FCS. Dr. Lowell Hart, Scientific Director of Clinical Research and Director of the FCS Drug Development Program said, “The research program at Florida Cancer Specialists rivals that of many large cancer centers. With two drug development units in our network and a dedicated program of Phase 1 Clinical Trials, FCS is on the cutting-edge of identifying newer targeted therapies that are changing the future of cancer treatment.”

ASCO recognized FCS in 2011 with a national Clinical Trials Participation Award for its outstanding research program, and FCS physicians have consistently provided leadership with ASCO’s statewide affiliate, the Florida Society of Clinical Oncology (FLASCO).

As a statewide strategic partner of the Sarah Cannon Research Institute (SCRI), one of the largest and most respected clinical trial research organizations in the United States, Florida Cancer Specialists is committed to refining the science and the study of malignancies and sharing knowledge and new findings that will rapidly advance and improve cancer treatments for our patients.

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FCS’ MAN/WOMAN OF THE YEAR NOMINEES RAISE OVER $250,000 FOR LEUKEMIA & LYMPHOMA SOCIETY Nominees Lend Support and Raise Funds for Blood Cancer Research

Florida Cancer Specialists & Research Institute (FCS) is pleased to announce that Drs. Gregoire Bergier, Jennifer Cultrera, Shachar Peles and Chief Marketing & Sales Officer Shelly Glenn, who were each nominated as Man/Woman of the Year for 2014 by several local Florida chapters of the Leukemia & Lymphoma Society (LLS), collectively raised over a quarter million dollars for the non-profit organization. After a spirited competition at each local chapter, the four FCS nominees led fundraising efforts that will help continue blood cancer research, and three of the four earned the coveted title of “Man/Woman of the Year."

Nominated by the Suncoast Chapter of LLS, Dr. Gregoire Bergier and FCS CMO Shelly Glenn were both successful in their bids to become Man/ Woman of the Year. Dr. Bergier, who practices in Largo and Clearwater, and who is a local board member for LLS, raised over $93,000; Ms. Glenn collected over $65,000 during her fundraising efforts. LLS officials noted that both Ms. Glenn and Dr. Bergier exceeded the all time records for the Suncoast Chapter, raising more dollars than any other Man/Woman of the Year Nominee previously. “I feel sincerely privileged as an LLS Board Member and medical oncologist/hematologist to have not only had the opportunity to participate and be named Man of the Year," Dr. Bergier said, "but also to help raise funds and awareness for critical research that translates into better therapies and survival rates.”

Dr. Jennifer Cultrera was also successful in the competition to become Woman of the Year for the LLS Northern & Central Florida Chapter, where she also serves on the board of directors. Dr. Cultrera, who practices at the FCS offices in Leesburg and The Villages, raised just over $50,000 for the local chapter. Dr. Cultrera said, “I am thrilled by this honor. It has been so gratifying to be a part of this amazing program. I know that my efforts will help fund the therapies and treatments that help save lives today and continue much-needed research for future patients.”

The West Palm Beach Chapter of LLS nominated Dr. Shachar Peles as Man of the Year; he practices in the West Palm Beach and Atlantis, FL offices of FCS. Although Dr. Peles did not win his campaign, he did raise over $38,000 for LLS. Dr. Peles said, “The Man/Woman of the Year competition is a remarkable program that not only supports blood cancer research but also patient services, advocacy, public and professional education, and community services as well. It was an honor just to be nominated by an organization that contributes so much to blood cancer research.”

Shelly Glenn, FCS Chief Marketing Officer, added, “I am extremely honored to be named Woman of the Year and I want to thank my incredible campaign team, my friends and family – especially my amazing husband – and my company, Florida Cancer Specialists, for all their support and generosity during this campaign. This is just one example of how many of our physicians go far beyond their commitment to treating cancer patients with blood cancers by agreeing to support fundraising efforts such as this. It is a testimony to the level of compassion and care our doctors have for their patients.”

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FLORIDA CANCER SPECIALISTS EXECUTIVE BOARD UPDATE

Please join us in congratulating Dr. Marilyn Raymond on being appointed to the FCS Executive Board. Dr. Raymond earned her undergraduate degree from University of Georgia. She attended medical school at Medical College of Georgia and completed her internship, residency and her fellowship in Hematology/Oncology at University of Alabama at Birmingham Hospital. Board certified in Internal Medicine and Medical Oncology, Dr. Raymond sits on the Board of Susan G. Komen – South Florida and Sojourners Breast Cancer Support Group. A member of ASCO, Dr. Raymond is a Board Member of Good Samaritan Medical Center and the Vice Chairman/Governing Board, Medical Director of Breast Center and Ethics Committee- all at Good Samaritan Medical Center.

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We Support the Health of your Practice With the Same Dedication that You Support Your Patients Your number one priority is the health of your patients. With the changing healthcare landscape, our number one priority is the business health of your practice.

Dedicated exclusively to the viability of community oncology, ION Solutions provides contracting, technology, education and advocacy support that ensures you have the tools to run your practice both efficiently and effectively. With the practice support of ION Solutions, you can navigate this changing environment and focus on providing quality care for your patients.

To learn how ION Solutions enables community oncology practices to improve operational efficiency, financial performance and quality of care, contact your Strategic Account Manager or visit IONonline.com.

To experience ION Solutions advocacy support, visit ourcommunitycounts.org.

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A cancer diagnosis changes everything.

Fighting cancer is a long journey. Florida Cancer Specialists Foundation helps make the road a little easier.

We deeply care about our patients and their struggles. Florida Cancer Specialists Foundation was created to help patients who need fi nancial assistance while undergoing treatment. The Foundation allows those fighting their battle with cancer to concentrate on recovery rather than their overdue rent, mortgage, electric or water bill.

Please visit our website for ways to donate. Florida Cancer Specialists Foundation is a 501(c)(3) non-profit organization.

1600 Phillips Road, Suite 300 | Tallahassee, FL 32308 | (850) 877-8166

Foundation

2626 Care Drive, Suite 200 | Tallahassee, FL 32308 | (850) 219-5830

foundation.flcancer.com