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January 2017

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50 THE SENSATIONAL

BARIATRIC SPECIALISTS

OF SOUTH TEXAS Drs. Nilesh Patel, Subhash Reddy and Leah Dill further the definition of excellence and commitment to South Texas patients

“SERVING HUMANITY

TO HONOR GOD” Methodist Healthcare Ministries of South Texas continue to carry out their mission to improve the physical, mental and spiritual health of the underserved communities with quality care

56 THE MEDCARE ASSOCIATES BRING HEALTHCARE HOME Powered by passion, Dr. Saleh Jaafar and the MedCare Associate physicians bring care to the patient

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Hospice is a journey and we’re here to hold your hand every step of the way.

Alice | Austin | Bandera | Beaumont | Boerne Corpus Christi | Hondo | Jasper | Port Arthur | San Antonio


River City Hospice has earned The Joint Commission’s Gold Seal of Approval

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e provide compassionate care for our patients and those who love them most. Our experienced team of professionals are here to support you during the challenges that come with a terminal illness.

Because Every Moment Counts rivercityhospice.com | 1.877.537.4837


Back to Normal S p i n e A s s o c i at e s

Comprehensive Spine Center Adult & Pediatric Orthopaedic Spine Specialists Spine Associates’ Comprehensive Spine Center creates a direct link between your primary care provider and the management of your spine injuries. Our Comprehensive Spine Center provides a full scope of spinal services including the evaluation, treatment of the cervical, thoracic and lumbar spine by a nationally recognized orthopedic spine specialist. Working together with referring physicians, our team ensures that each patient receives a personalized treatment plan specific to his or her circumstance and lifestyle. Spine Associates is equipped with the most state-of-the-art imaging and diagnostic technology which

THE SMARTER CHOICE FOR SPINE CARE Comprehensive Spine Care that follows you from diagnosis to treatment to recovery - and even follows you home AREAS OF EXPERTISE - Robotic Assisted Spine Surgery - Minimally Invasive Spine Surgery - Adult & Pediatric Scoliosis Correction - Reconstructive Spine Surgery - Physical Therapy - Interventional Pain Management

enables our spine specialists to effectively and accurately diagnose and treat you. We also offer a full range of leadingedge, non-surgical and surgical treatment options including robotic assisted spine surgery and minimally invasive treatments to get you back to normal.

STOP LIVING WITH PAIN Call or email today and begin your personal treatment plan 800-9-SPINAL (800-977-4625) or info@myspineassociates.com

SPINE ASSOCIATES LOCATIONS: 9301 Southwest Freeway, Suite 600 | Houston, TX 77074 | 713-383-7100 3820 Pointe Parkway | Beaumont, TX 77706 | 409.767.8221 myspineassociates.com


THE BUYANOV PROCESS Consultation MRI Stem Cell Therapy Results DrBuyanov.com | 210.899.5493 2425 Babcock Rd. Suite 108 San Antonio, TX 78229

Ser ving pat i ents t hrou gh Te l e h e a l t h Innova recovery is a telehealth treatment center for men and women ages 18 and older. Easily accessible from anywhere in the state, Innova is designed for clients who want exceptional treatment in a setting that is conducive to their lifestyle.

Therapy for Post Traumatic Stress Cognitive Behavioral Therapy (CBT) Exposure and Response Prevention (ERP) Family Therapy Dialectical Behavioral Therapy (DBT) Eye Movement Desensitization Reprocessing (EMDR) Meditation Therapy

innovarecoveryclinic.com | 210.254.3618


• • • •

Most insurance plans accepted. Financing available.

Diabetic eye exams Macular degeneration Cornea transplants Eyelid surgery


At the Corpus Christi Rehabilitation Hospital, we specialize in rehabilitative services for patients with functional deficits, such as stroke, trauma, spinal cord injury, brain injuries, cardiac, orthopedic, complex medical conditions and other disabling impairments. Corpus Christi Rehabilitation Hospital has earned The Joint Commission’s Gold Seal of Approval® for its Stroke Program by demonstrating compliance with The Joint Commission’s national standards for health care quality and safety in disease-specific care. The certification award recognizes CCRH’s dedication to continuous compliance with The Joint Commission’s state-of-the-art standards. Learn more at CCRH.ernesthealth.com.

To learn more about CCRH and our services, visit our website at

5726 Esplanade Drive • Corpus Christi, TX 78414 • 361.906.3700


PRIMARY CARE.

Close to Home. Lori Shirley-Wenzel, MD Internal Medicine Alamo Heights, Broadway (210) 824-5392

Dustin Deemer, PA Family Medicine Alamo Heights, Sunset (210) 824-5201

Scott Horn, MD Family Medicine Alamo Heights, Sunset (210) 824-5201

Doris Ling, MD Family Medicine Castle Hills (210) 541-8689

Patricia Mackin, MD Family Medicine Castle Hills (210) 541-8689

Angela Malarcher, MD Internal Medicine Downtown (210) 224-1771

Lovelesh Manocha, MD Internal Medicine Downtown (210) 224-1771

Heberto Garza, Jr. MD Internal Medicine 281N & Thousand Oaks (210) 824-5392

Paul Smith, Jr, MD Internal Medicine 281N & Thousand Oaks (210) 824-5392

Felicitas Gonzales, MD Family Medicine 281N & Thousand Oaks (210) 200-6744

Yetunde Sokunbi, MD Family Medicine 281N & Thousand Oaks (210) 200-6744

Edward Lin, MD Family Medicine Northeast (210) 653-2693

Shashi Mittal, MD Family Medicine Northeast (210) 653-2693

Abe Rodriguez, MD Family Medicine Northeast (210) 653-2693

Julia Pursch MD Family Medicine Northwest (210) 453-1199

Blaine Carmichael, PA Family Medicine Schertz (210) 656-5600

Belmund Catague, MD Family Medicine Schertz (210) 656-5600

Victoria Chang, DO Internal Medicine Schertz (210) 656-5600

Kirsten Fikes, PA Internal Medicine Schertz (210) 656-5600

Ricardo Escamilla, MD Family Medicine Southeast (210) 333-0798

Salima Panjwani, PA Family Medicine Southeast (210) 333-0798

Lubna Naeem, MD Internal Medicine Stone Oak (210) 490-3800

Erica Ormeno, NP Family Medicine Overlook (210) 497-2338

Michelle Aliotta, MD Family Medicine Stone Oak (210) 496-2669

Luis Berrios, NP Internal Medicine Stone Oak (210) 496-2669

Daisy Ramirez-Estrada, MD Cesar Gerez-Martinez, MD Family Medicine Family Medicine Overlook Westover Hills (210) 497-2338 (210) 681-0126

Steven Bauer, MD Internal Medicine Overlook (210) 497-2338

Jessica Barrientos, PA Internal Medicine Overlook (210) 497-2338

Aaron King, MD Family Medicine Overlook (210) 497-2338

Sanjay Kumar, MD Internal Medicine Westover Hills (210) 681-0126

Cherry Maximo, MD Family Medicine Westover Hills (210) 681-0126

Inez King, NP Family Medicine Westover Hills (210) 681-0126 091315

For more information or to schedule an online appointment visit Med1st.com


Januar y 2017 Editor-in-Chief Sinjin Hilaski sinjin@mdmonthly.com Designer Meghan Goettl Senior Writer Rudy Arispe Executive Assistant Miranda Paredes Production Media Digital Source Contributing Writers

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Fueled By Faith For decades, Methodist Healthcare Ministries of South Texas has successfully paved ways for underserved communities to access healthcare, ultimately bettering South Texas’ physical, spiritual and mental health.

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South Texas’ Extraordinary Specialists Committed to excellence and carrying out their passion-powered mission, the Texas Bariatric Specialists are persistently bettering South Texas with their superior skills.

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Healthcare On The Homefront

With six clinics, Dr. Jaafar and the MedCare Associates bring hospital-quality, compassionate care to the patients.

Andy Tiwari Cynthia Huchingson Dr. Lisa Martén Dr. Kevin Ju Dr. Nicholas Nilest Heather McCreery, RN, MBA, CCRC Jay Reddy Jennifer Ziegler Lisa Martin Matthew Kelly Terri Suresh-DeNeui, MSN, APRN-BC Tiffany Briggs Tim Knifton Tracy Thompson SammyJo Wilkinson

Contributing Photographers Jason Roberts Paul Marshall Matt Nolan FOR ADVERTISING INFORMATION, PLEASE CALL 210.373.2599 OR EMAIL ELIOT@MDMONTHLY.COM. FOR EDITORIAL COMMENTS AND SUGGESTIONS, EMAIL EDITOR@MDMONTHLY.COM.

MDMonthly.com 22211 IH-10 W. #1206 | San Antonio, TX 78257 Cover Photo – Dr. Patel Paul Marshall Cover Photo – Dr. Jaafar Jason Roberts


MD Monthly Advisory Board At MD Monthly, we strive to provide exceptional information in the realm of healthy living and medical advice. Our goal is to bring relevant, informative and entertaining content to our audience. In seeking to fulfill our mission, we have established our MD Monthly Advisory Board, which is comprised of some the finest physicians and business owners in the industry. Throughout our next few issues, we will introduce our advisory board members. As always, we thank you for reading and look forward to continue producing informative, relevant content for you.

-Sinjin Hilaski Editor-in-Chief

Dr. Richard R.M. Francis, M.D. MBA, FRCS Ed., FRCS Ed. (Tr & Orth) Practicing medicine for nearly two decades, Dr. Richard Francis was educated at the University of the West Indies, the Royal College of Surgeons of Edinburgh and Baylor College of Medicine. Board certified in orthopedic surgery by the Intercollegiate Specialty Board of the Royal Colleges of the United Kingdom, he is a diplomate of the Intercollegiate Specialty Board in Trauma and Orthopaedic Surgery (UK). He has been a fellow of the Royal College of Surgeons in Edinburgh since 1995, and he provided four years of service as an assistant professor with the University of Texas where he was responsible for training residents and fellows in the field of spinal surgery. Additionally, Dr. Francis successfully completed a postdoctoral fellowship in spinal surgery and is currently an active member of the North American Spine Society and Scoliosis Research Society. Dr. Francis is one of the few spine surgeons capable of performing surgeries on children, as well as adults, and he prides himself as one of the first surgeons in the nation who was asked to perform artificial disc replacement and use robotic assistance in spine surgery. Since founding Spine Associates in 2003, he has built a reputation by maintaining a conservative approach to treating all spine conditions in both children and adults.

Dr. Constance M. Barone, M.D. San Antonio-based plastic surgeon Dr. Constance M. Barone has led a remarkable career with expansive experience in numerous areas of plastic surgery. A board-certified plastic surgeon, Dr. Barone has devoted her career to helping people look and feel better, while providing them with the safest, most technologically advanced care possible. With over 25 years of experience, Dr. Barone has garnered countless honors and awards, including being named in the Top 5% of America’s Most Honored Professionals, and most recently, being recognized as one of America’s Top Surgeons for 2016 by the Consumers’ Research Council of America. Naturally, her extraordinary career and laudable accomplishments have made her highly revered throughout the world as a surgeon, teacher, author, and innovator of some of the most state-of-the-art medical techniques used today. Dr. Barone is one of the few plastic surgeons in the U.S. who is skilled in transumbilical breast augmentation, and she prides herself on her ability to perform an array of cosmetic enhancement procedures. Dr. Barone continues her education in various fields of medicine and is constantly learning new methods, techniques, and technologies to offer patients the best care possible. Dr. Barone is proud to serve the residents of San Antonio and communities throughout the great state of Texas.

Janet Montagne Janet is the owner and Chief Executive Officer of River City Hospice, an agency providing compassionate care to the terminally ill and their loved ones, with 10 locations in Texas and one location in Idaho. Janet has over 25 years of experience in the healthcare industry where she has held many roles including Chief Operating Officer and business owner. Janet is a member of the Alzheimer’s Association, LiveWell Women’s Conference, Anayat House, Julie Rogers “Gift of Life” Program, American Heart Association, American Cancer Society and Leadership Southeast Texas. In addition, she is affiliated with numerous professional organizations such as Texas Association of Home Care, National Association of Home Care & Hospice and Texas & New Mexico Hospice Organization. Janet is married to David Montagne; they have four grown children and five grandchildren. In her free time, Janet enjoys spending time with her five grandchildren, traveling, reading, and involving herself and her company in community-wide and national charity events. 2017 - JANUARYMD Monthly

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Healthy Living

Way Of The Warrior With the Alpha Warrior Challenge, San Antonians have a new way to stay healthy, challenge themselves physically and have a true fullbody workout.

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Medical Business

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Ransom In The New Age

Informed Patient

The Link Between Nutrition and Healing

With the rise of cyber crimes, businesses and individuals are increasingly becoming targets of ransomware. Tim Knifton of Invisible Technology gives tips and tricks on how to avoid becoming a victim.

Dr. Nicholas Nilest examines the relationship between establishing healthy eating habits and the healing process for patients.

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Medical Business

Informed Patient

The Advance Of Analytics

Diminish Your Risk For Asthma

As data rolls in, population health and risk-adjustment programs are taking center stage in the healthcare and health insurance conversation. VitreosHealth is paving the way in better understanding the data and how smaller insurers can succeed.

Terri Suresh-DeNeui, MSN, APRN-BC, explains the recent research showing how increased Vitamin D intake can decrease your risk for asthma and other health complications.

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24 Medical Business

Governing An EverChanging Climate

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    !   !   !     !                         "   • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

        ! myemma.com/nside

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• • • • • • • • • •

Matthew J. Kelly MHA, President Board of Directors, CommuniCare Health Centers takes an in-depth look at America’s healthcare system and how organizations must navigate an ever-evolving situation in order to continue to provide quality care while staying fiscally viable.

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Research & Innovation

The Future Is Coming On Houston-based Celltex Therapeutics is broaching the next generation of healing chronic illnesses in America with regenerative medicine.


DO NOT UNDERESTIMATE

THE POWER OF A

SMILE COSMETIC DENTISTRY Your smile is the first impression that others have of you, so it makes sense that you would want it to be bright, white and healthy. More than 90 percent of all American adults believe that a smile is an important asset for social situations. Perhaps that is why so many patients are electing cosmetic dental procedures to improve their smiles and boost self-confidence. Typical cosmetic treatment options can include:

DR. STAN ZEBROWSKI, DDS DR. IRENE BLAESS, DDS

Porcelain Veneers

Cosmetic Bonding

Braces

Tooth Whitening/Bleaching

Snap On Smile ™ – Removable Dental Device

Northwoods Dental

De Zavala Dental

18160 San Pedro #104 | San Antonio, TX 78232

5999 De Zavala #122 | San Antonio, TX 78249

210-495-7800 | northwoods-dental.com

210-691-1333 | dezavala-dental.com


FINANCE/SAN ANTONIO

6 Tips ON TEACHING KIDS

Finance TALKING TO KIDS ABOUT MONEY

By Stacy Allred, Director, Wealth Structuring Group at Bank of America Merrill Lynch

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hen a child begins to edge into adulthood, how do you make sure they have the knowledge and skills needed to make smart financial decisions? It’s critical to recognize that becoming financially independent is a journey, one that may take longer in today’s uncertain economy. “Achieving financial autonomy is a transition rather than an abrupt change,” notes Eileen Gallo, co-author of "Silver Spoon Kids: How Successful Parents Raise Responsible Children." Fortunately, there are ways that allow parents to ease the journey to financial autonomy. Here are six tips and ideas for providing education 12

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about money matters and judicious financial support.

into stewardship, you need to learn about money and accountability.

1. Share information.

It can be helpful to ease into sharing elements of financial strategy. Rather than revealing your entire investment portfolio, perhaps start by reviewing a college savings account once each quarter.

Affluent parents are often so concerned about their children feeling entitled that they keep them in the dark about the family’s assets. But children often learn a family’s values best by observing those principles in action. Entitlement is a natural state we all go through in youth. To emerge

Achieving financial autonomy is a transition rather than an abrupt change

2. Explain the importance of budgeting and saving. Helping a teenager create a monthly budget is a great way to instill financial discipline. Sit down and discuss the basics of money management, or if there’s resistance to your involvement, bring in your financial advisor. They can help kids create a budget, learn basic skills and

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FINANCE/SAN ANTONIO

discuss planning their financial future. Parents can foster solid financial habits in their children by asking them what they are saving for right now and what that goal is going to cost. In effect, this gives them a chance to develop their own relationship with money and their own intrinsic motivations.

occasionally. When one occurs, resist the urge to swoop in and rescue your child financially. If you take away the consequences, you do your child a disservice. Instead, talk it through and work out a way to solve the problem together, whether that means cutting back on spending or getting a parttime job. 6. Offer selective support.

3. Use philanthropy as a teaching tool. You can learn important life skills, like doing research, decision making and accountability, through philanthropy. Also, it’s a great way for siblings to learn how to make joint financial decisions. For example, children can be allotted a giving budget and charged with jointly evaluating charities and deciding which ones to support. Naming grown children as co-advisors to a donor-advised fund (DAF) can get them started early on deciding the most effective ways to give to others, as they would be tasked with making recommendations to the DAF on how to spend its assets. 4. Introduce investing. Investing smaller sums with limited consequences is a great way to learn about making informed choices and managing risk. One option is to open custodial accounts with starter funds and let your child work with your financial advisor to create a small portfolio and evaluate its performance. Explain to your child that it’s not about never making a mistake, it’s about learning from those you make. 5. Let them falter. Whether it’s a bad investment or a splurge that busts the monthly budget, a misstep is bound to happen

There are some expenses it may make sense to fund, such as medical insurance, continuing education or therapy. Making sure your child has health insurance or the guidance they need is not an indulgence. Be clear about what you will fund and what the expectations are when you do fund expenses. Families with greater assets that want to set up trusts for kids can tie trust distributions to certain benchmarks. One idea Gallo suggests is to create a “results-oriented trust,” which identifies specific results for a beneficiary to achieve while offering some degree of flexibility. Alternatively, a trust could simply state that the children will receive their money whenever the trustee is confident that they are mature enough to handle it. A financial advisor can help you obtain more information about the various trusts you can use.

generations after them. For more information, contact Merrill Lynch Wealth Management Advisor Tiffany Mock Briggs of the San Antonio LaCantera office at 210.278.3813 or Tiffany_Briggs@ml.com. Neither Merrill Lynch nor any of its affiliates or financial advisors provide legal, tax or accounting advice. You should consult your legal and/or tax advisors before making any financial decisions. Investing involved risk. There is always the potential of losing money when you invest in securities. Merrill Lynch makes available products and services offered by Merrill Lynch, Pierce, Fenner & Smith Incorporated (“MLPF&S”), a registered broker-dealer and Member SIPC, and other subsidiaries of Bank of America Corporation (“BofA Corp”). Investment Products: Are Not FDIC Insured Are Not Bank Guaranteed May Lose Value © 2016 Bank of America Corporation. All rights reserved.

Every family will have its own idea about what assets to give the next generation and when. But the most valuable things to give your children may be the knowledge and skills they need to spend, save, invest and share their income responsibly. Beyond allowing them to become financially independent, such skills will put them in a better position to help others and make sure they in turn leave something for the 2017 - JANUARYMD Monthly

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MEDICAL BUSINESS/SAN ANTONIO

Taking Care Of

Loose Ends By Andy Tiwari

T

he end of the year can be a challenging time for many small businesses owners. They often are juggling existing clients while trying to position the business for the following year. Here are three items often overlooked to keep as priorities to start the year off right. An entrepreneur should document meeting minutes and close out lingering contracts. If you’ve been procrastinating on the idea of ending an unsuccessful business, now might also be an opportune time to finalize that painful decision.

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Correctly documenting meeting minutes is frequently overlooked but necessary to maintain proper corporate records. While you can’t necessarily “make up” for failing to document important decisions at the time they were made, it’s possible to “catch up” on some of the business’ actions by holding a quarterly or annual meeting. Depending on the type of business entity, this meeting might be held by the directors, managers, shareholders, members or partners. For single-owner companies, or where meetings aren’t feasible, a “consent” explaining the action taken can be used instead.

Meeting minutes should be signed by attendees and detail any actions taken, any plans laid out, or who voted for or abstained from a decision. Consents should contain the same information and be signed by the company’s decision makers. These records don’t have to be complex; often, all you need is a set of bullet points documenting important actions. In many instances, minutes can be prepared, emailed and separately signed by the appropriate parties. While Texas law is fairly forgiving when it comes to corporate recordkeeping, in many cases, small companies aren’t technically

required to record meeting minutes, these signed documents go a long way in demonstrating that a company is distinct from its owners. This is important protection against “piercing the corporate veil” claims, a technique used to directly sue a business owner instead of his or her company. One of the last things business owners find time for is tackling unnecessary contracts. For example, marketers know that consumers and business owners alike are more likely to continue paying a monthly or annual fee for a service they don’t need than they are to take the effort to cancel it. Many

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MEDICAL BUSINESS/SAN ANTONIO

business owners carry more phone lines than they actually use, credit lines they pay fees for but may not access, or even ongoing but ineffective and costly marketing. Business owners would be wise to set a goal of reviewing existing contracts and the business’ needs to see if closing a contract makes sense. Ending a contract also helps with budgeting for what’s ahead. Always review the contract language first to make sure that a cancellation won’t result in a penalty. But what if the business just isn’t working? The decision to liquidate a business is often extremely difficult – particularly for the business owner who has spent many hours and financial resources launching it. Tenacity and constructive optimism are key, but smart entrepreneurs know when to “throw in the towel” and move on. If you started a business that never really “took off” consider closing it so you are not stuck with additional expenses or even possible penalties for failing to file necessary documents.

early, the closure could still qualify for the prior tax year, a possible benefit. You will also need to notify any suppliers or vendors you worked with, settle all debts, or plan for the consequences of not doing so, and “close” your employer records with the IRS. If you had employees, you will also need to make sure final checks are cut, taxes are paid and that you comply with employment labor laws. If you filed a business entity, consult with legal counsel about whether terminating the entity’s existence makes sense. Dr. Charles Bailey is an interventional cardiologist and endovascular specialist. He is board certified in Internal medicine, cardiovascular disease and interventional cardiology.

Starting the year on the right path can seem daunting, but crossing some of the above items off of your checklist and even closing your “good idea” will position you and your business for a successful year.

Dr. Wassim Choucair is an Electrophysiologist and is board certified in internal medicine, cardiovascular disease, echocardiography and electrophysiology. He specializes in treating the electrical abnormalities of the heart that require pacemakers, defibrillators and the latest in ablative techniques to treat rhythm disturbances.

K. Andy Tiwari is principal and named partner of Tiwari + Bell PLLC and can be reached at www. TexasLegalPros.com or call 210-417-4167.

Just as you create a business plan, create an “end of business plan.” Consult with a tax advisor and legal counsel regarding strategies to sell the business or wind the business down. If done

Dr. Feras El-Bash is an interventional cardiologist and endovascular specialist. He is board certified in internal medicine, cardiovascular disease, interventional cardiology, echocardiography, nuclear cardiology, and endovascular medicine. Our physicians treat cardiovascular disease, peripheral artery disease, rhythm disturbances, as well as the risk factors that cause these disorders, such as high blood pressure, high cholesterol and diabetes. They are skilled in performing procedures to identify and repair blocked arteries and treat electrical abnormalities using the latest tools and technology.

SAME DAY APPOINTMENT AVAILABLE

2017 - JANUARYMD Monthly

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1202 E. Sonterra Blvd., Building 6, Suite 604 San Antonio, TX 78258 | 210.844.2393


MEDICAL BUSINESS/SAN ANTONIO

BEWARE OF

RANSOMWARE By Tim Knifton

M

ost of us get this dire email regularly: “I’ve lost my wallet overseas on vacation and need money wired to me to make it back home. If I don’t get the money right away, I will be destitute.” Over time, you have learned to delete these emails, but hackers have taken this same deception to a new level by withholding your computer’s data until you pay up. That’s right, you have to pay a ransom to get your own data back. 16

MD Monthly

CryptoLocker and CryptoWall are a type of malware, also known as ransomware, that allows thieves to encrypt your personal data until you pay them to release it. According to the FBI, between April 2014 and June 2015, the agency’s Internet Crime Complaint Center received 992 CryptoWall-related complaints, with victims reporting losses totaling over $18 million. The U.S. Department of Justice also has reported security researchers estimate that, as of April

2014, CryptoLocker has infected more than 234,000 computers, with about half of those being located in the United States. One estimate suggests that more than $27 million in ransom payments were made in just the first two months CryptoLocker appeared. Just recently, a ransom virus infected a whole city’s computer system in Canada. It cost about $58,000 to overhaul the dated computer network and another $65,000 to award an IT company to fix it.

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MEDICAL BUSINESS/SAN ANTONIO

In many cases, victims are instructed to pay from $200 to $10,000 by a specific deadline if they don’t have extra copies of their personal data backed up. The FBI also has reportedly said that the hacking software is so good, it’s easier just to pay the ransom.

The U.S. Department of Justice also has reported security researchers estimate that, as of April 2014, CryptoLocker has infected more than 234,000 computers Hopefully most businesses have in place proper IT security and protocols to prevent hackers. If you are a small business or a consumer, here’s some practical advice:

Don’t click on any email or attachment that seems suspicious and try not to visit websites that also seem mistrustful. Continuously use antivirus software and a firewall. It's critical to install and use antivirus software and firewalls from trustworthy companies. At the same time, make sure you keep the software updated. Try to avoid clicking on pop-ups or, better yet, disable these sneaky unsolicited messages that often are a hotbed for evil software. It’s essential to regularly back-up the content on your computer. If you back up and keep offline copies of your personal data, scams can have minimal impact on you. Then, if you are targeted, instead of paying a ransom to get your information back, you can have your system wiped clean and then reload your files.

If a hacker hits you, it’s best to file a complaint with the FBI’s Internet Crime Complaint Center or www.ic3.gov. Tim Knifton is owner of Invisible Technology, a San Antonio-based managed IT services and serversupport company, that can be reached at www.invisible.technology

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MEDICAL BUSINESS/AUSTIN

LEAVING YOUR

MEDICAL PRACTICE By Cynthia Huchingson

Y

ou know you’re guilty of thinking it. From the moment you hear the news about a doctor leaving a medical practice, you gasp and think, “Oh gosh, it must have not worked out.” When you talk about it to your cohorts, everyone lowers their voice to a strange, slow whisper, as if you might catch “the illness” if you speak about it too loudly. The connotations associated with doctors leaving their practice are vigorously negative, and a Google search on “leaving a medical practice” doesn’t provide much solace. It returns scores of petrifying legal ramifications if you don’t leave “just right.”

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But what if you could leave with unabashed confidence? Would you? 1. Start With Why The start of a new year is always a good time to think about change. Perhaps you are just beginning to think about changing medical practices, or worse, maybe an unanticipated change is going to smack you in the face when you least expect it. Regardless of whether your transition is pre-planned or a “pants on fire” response to an unavoidable termination, start with why. Are you unhappy where you are or just stuck? Is the system crumbling or do you just want to apply your amassed medical knowledge to the

world in a different way? Are there risks or changes inherent in your particular practice or field of specialty that would make precluding a departure impossible under a certain set of circumstances? Knowing why you’re leaving is important to ensure you don’t recreate any significant problems or challenges you had before. More importantly, however, knowing why helps you define your new opportunity. Outside of the practice of medicine, people are changing jobs all the time and it’s an overwhelmingly positive thing! Although there are few longitudinal studies reporting exact average lifetime job changes, a 2015 Bureau of Labor Statistics report on a

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MEDICAL BUSINESS/AUSTIN

subset of baby boomers reports 11.7 changes. New data suggests an even greater number of job transitions for younger generations. So why is everyone, other than doctors, moving around so much? For personal growth and new opportunity. 2. Define Your Next Best Self Medscape’s 2015 Physician Compensation Report published that an alarming 76 percent of physicians would not choose their current practice setting if they could choose it again. Don’t kid yourself – the data is whispered in the latter half of a very polished and politically correct sentence way in the back of the report, but it’s there. So if you’re in the 24 percent of doctors who are perfectly happy in your current practice just as it is, you can stop reading now. But if you’re one of the 76 percent, which statistically you probably are because that’s about 649,570 of you, it’s time to define your next best self. No, you can’t change our healthcare system overnight, and yes, changing jobs “is different” for doctors because of all of the “crazy and terrible” credentialing and legal requirements. Feel good to get that off your chest? Good. Because if you can get past that, which we all know is possible because doctors successfully do it all the time, then it sounds to me like 76 percent of the doctors out there today have a lot to give. What if each of the 649,570 of you asked: “What one thing can I do this year in either my current practice or a new practice/company that would allow me to more effectively pursue my passion within medicine?” This is your next best self. This is why

non-doctors find themselves changing jobs, because the change is needed in order for them to get there. And this is what changes industries – innovation is created through the amalgamation of idea sharing. The greatest innovations occur in the fastest changing industries and in the biggest cities, simply as a result of the rapidity of high-level information exchange. One idea begets another, which begets yet another. I wonder why the healthcare industry seems so “stuck.” Because doctors aren’t changing! 3. Go Wild Okay, not literally, but go wild in the sense that it’s going to feel a little wild. Define your next best self and then figure out how to do it. If you are going to leave your old practice, get legal counsel and business counsel. Do not attempt this alone. The legal, strategic, financial, operational, and marketing functions of a medical practice are specialties in and of themselves. Shortchanging the significance of these roles by doing them yourself or placing nonprofessionals in them hurts you, your company and the person you have placed in the role. Yes, we all are taught something about business through the normal course of life and our education, but “something about business” spells disaster in healthcare again and again. There’s a reason our nation’s leading companies only want to hire MBA’s from the best programs, because to do otherwise would be like hiring a doctor who completed their medical degree and residency online.

leave your current practice, begin to see that Texas Medical Association guideline called “Notice to Patients on the Departure of a Physician” in a new way. Instead of starting that ubiquitous patient notification letter with, “After much consideration, I regret to inform you…,” see this change as what it is. This is a huge opportunity to talk to every one of your patients from the past two years and tell them how your “next best self” is going to get us closer to the healthcare delivery system we all desire! That’s amazing news! Even if you decide to not leave your current practice, wouldn’t it be great to have the opportunity to mail a letter to every one of your patients with the same great news? Lead the new year with an unabashedly remarkable change, and our industry will thank you for it. For more information visit www.cynexconsulting.com or call 210.910.6266. Cynex Consulting is located at 311 Bowie Street, Suite 1806 in Austin, TX 78703.

With that knowledge in your lab coat pocket, go wild. If you decide to 2017 - JANUARYMD Monthly

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Health Analytics: BETTER OUTCOMES MEAN BETTER SUCCESS, NO MATTER WHAT HAPPENS TO THE ACA By Jay Reddy, CEO of VitreosHealth

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hings were looking down for the Affordable Care Act (ACA) even before Donald Trump won the election. Premiums for several health plans are increasing by an average of 25 percent next year. Consumers in many states have significantly fewer insurance options on the government exchange, including some with only one company from which to choose. Statistics recently released

MD Monthly

by the Centers for Medicare and Medicaid Services (CMS) show that several small health insurers and co-op plans incurred large charges under the ACA’s riskadjustment program. The probability of a full repeal of the ACA is unlikely. Even President-elect Trump is toning down his rhetoric saying he may keep significant parts of the law. However, undoubtedly, the law will see changes over the next few years.

However the ACA evolves, the shift in the healthcare industry, from feefor-service to value-based care, will continue. That is why this remains a great time for small- to mid-size payers. Payers that have the analytic tools to understand their members' needs, and can deliver quality outcomes, will succeed regardless of the state of the ACA. Let’s take a close look at one controversial aspect of the law and how it can actually benefit small- to mid-size payers.

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Does The Risk-Adjustment Program Favor Larger Payers? This is just the second year that risk-adjustment payments are due, and many smaller insurers have had to pay into the program both years. The intent of risk-adjustment payments is to transfer pooled funds from plans with lower-risk customers to those with higher risk. The goal of the program is to ensure that companies with sicker populations are not put in financial risk from caring for their members. It is also intended as a safety net since, under the ACA, it is illegal to deny anyone coverage due to a previous illness. The report from the CMS stated that, “These correlations confirm that risk adjustment is working as intended to transfer funds from issuers with low actuarial risk to plans with high actuarial risk.” However, many small insurers are crying foul, claiming that the risk-adjustment payments aren’t working as intended and the formula favors bigger payers with more claims experience, and more ability to manipulate data. These smaller payers argue that they are being unfairly penalized, and it only appears that they have healthier members when they really just don’t have as much claims data. These numbers do not tell the whole story. It’s not that these smaller payers don’t have as much claims data, it’s that they’re using the wrong data. Population health is local. Many of these smaller companies are using the same

actuarial-based risk stratification and predictive analytics tools as the larger companies. Those are tools that were developed using large data sets at a national level and tend to be a mile-wide and inch-deep in their predictive and prescriptive capabilities. Using these tools leaves smaller insurers exposed because they are employing analytics that do not capture the characteristics of their population’s state-of-health risk characteristics. How Smaller Insurers Can Succeed Smaller insurers have a smaller margin for error than larger insurers. So these companies need to be sharper in their analysis and execute it flawlessly. Smaller insurers need to use tools like risk adjustment, risk stratification, and predictive analytics to capture the characteristics of their local population to understand their unique risk, cost and utilization drivers. They need to be more agile, nimble, and innovative to developing distinctive programs that have a high

impact on outcomes, because the programs that work in Pennsylvania will not work in Texas, Oklahoma, California, etc. A good example is GlobalHealth, a regional payer located in Oklahoma that uses predictive analytics as the basis for its proactive outreach program that transformed the company, saved millions in healthcare costs and improved the health of its members. One of GlobalHealth’s priorities in creating their outreach program was finding an analytics partner with a solution that could seamlessly integrate and evolve with the company. They selected VitreosHealth. We can assist any small- to midsize payer in the same way that we helped GlobalHealth. The first thing we do is perform a State-ofHealth Analysis by taking the last three years of the payer’s data to understand the clinical, non-clinical, behavioral, financial and utilization risk drivers of their local populations. By understanding the historical

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patterns, VitreosHealth develops customized predictive models to identify future high-cost members. We also identify the gaps-in-care that drive these poor outcomes and help payers design tailor-made programs to target these potential high-cost members before they become high cost. VitreosHealth is three to four times better than most of the current market solutions in their predictive accuracy and our payment models are based on our customers’ improvement in outcomes.

972.954.9992. VitreosHealth is located at 5151 Headquarters Drive, Suite 220 in Plano, TX 75024.

About the author: Investing in data analytics can be difficult on small- to mid-size payers. VitreosHealth makes it easy by requiring no changes to their customer’s existing IT infrastructure. For more information visit www.vitreoshealth.com or call 22

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Jay Reddy co-founded VitreosHealth and serves as its CEO since 2009. Prior to Vitreos, Jay was the Chief Marketing Officer at CombineMed, a joint venture with the University of Pittsburgh Medical Center (UPMC), helping healthcare

organizations drive savings through strategic sourcing technologies. Before joining CombineMed, Jay was the CEO of MindFlow Technologies, a firm he founded with the vision of delivering operations productivity improvements for global 1000 enterprises through optimization-based decision support technologies. Under his leadership, MindFlow was ranked in the visionary quadrant by Gartner and ranked in the Top 100 emerging companies by ComputerWorld, prior to its acquisition in 2006. Jay holds an undergraduate degree in chemical engineering from IIT, Delhi, and earned his MBA from the University of Michigan, Ann Arbor.

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MEDICAL BUSINESS/SAN ANTONIO

GOVERNANCE IN TODAY'S

Healthcare Climate T

By Matthew J. Kelly MHA, President Board of Directors, CommuniCare Health Centers

he healthcare system in America is in the early stages of changes that will, in all probability, be the most significant since the advent of employer-funded health insurance. It will be funding methodologies that will drive the changes, but no aspect of the healthcare market will be exempt. The fallout remains unknown. Will it result in a singlepayer system, a modification of today’s employer-driven system or some other model? The shifting

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sands pose a significant challenge for leaders in healthcare organizations that must simultaneously prepare their organization for future changes while continuing to provide highquality care today. The governing body of any organization, be it called the Board of Directors, Trustees, Regents or some other title, is legally responsible for all of the activities of the organization. The board does so in four ways. First, it hires and supervises the CEO of the

organization. Second, it establishes the organization’s mission, vision and values. Third, it approves all organization policies and strategic plans. Finally, it provides oversight of the organization’s direction and ensures that the implementation of the approved policies is in accordance with its mission. There is an additional aspect of oversight that has recently become more critical to the organization: compliance with externally mandated

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requirements, whether governmental, payer or other third-party imposed. Most of the policy development and oversight activities are accomplished by the committees of the board, each focusing on specific critical activities, such as finance, quality and IT. The one thing that the board should never do is to become involved in day-to-day operational decisions and operations. This is why the board employs a CEO as he/she is there every day, while the average board will only meet for about 40 hours per year. Instead, the governance of healthcare organizations should be focusing on three fundamental aspects of service delivery: financial viability, stakeholder relations and quality of care Financial Viability The organization must be financially viable to survive. It is incumbent upon the board to ensure that the basic accounting principles and practices are in place and external audits are performed at least annually with the full results reported to the board. The financial status of the organization must be an integral part of every board meeting. The board should be informed of the mix of third-party payers for the institution as well as any problem payers. For

those larger institutions with multiple sites of care, detailing how each site is contributing to the overall financial health of the organization is critical for strategic planning.

for measuring the satisfaction of all three parties. The board must require that they be used and the results and conclusions be reported back by the leadership team.

Stakeholder Relations

Quality of Care

There are two to three groups that will determine the success of the organization. They are patients, employees and, depending upon the organization’s mission, referral partners. The satisfaction of all three parties with the institution are critical. If patients are dissatisfied with the services they receive, they won’t return and will tell others not to come. Their concerns focus on ease of access to facilities, waiting times, and most importantly, how they perceive they are treated. Employees are a most critical component. They are the face of the organization. They are the primary driver of patient satisfaction. The third group, referral partners, is critical for large academic medical centers or other tertiary care facilities, as they are dependent on these partners for a significant proportion of their patients. What barriers do referring physicians or clinics perceive in sending a patient to the institution? Why do they choose you? Why do they choose someone else? There are a myriad of survey instruments and services

This area measures the technical quality produced by the organization. Did the patient get better? Is the staff following industry standard practices in identifying and treating those diseases most prevalent in the population being served by the healthcare organization? There are a number of different quality of care measurement instruments available to measure outcomes and practices. The instrument chosen may well be determined by either an external regulator, i.e. State Health Department or accrediting agency, such as the Joint Committee on Healthcare Organization (JCAHO). No matter which instrument is chosen, the actual areas of monitoring must look at the highest volume diagnoses and procedures for the specific organization. The results of the monitors must be closely examined by the Quality Management Committee of the Board. They then will report any significant trends and outcomes to the full board. It is immediately evident that all three of these areas are not only critical to the survival of the organization, but they are interdependent upon each other. The financial health of a healthcare organization will be impacted by the number of individuals using its services. They will only choose to use its services if they see the organization as providing readily accessible, high-quality care. Yet establishing those well-equipped and staffed physical locations in close proximity to the population to be treated requires good financial health.

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Although industry challenges abound and changes lie ahead, a governing body can work with the leadership team to make a real difference in the development of an organization. CommuniCare Health Centers is a private, nonprofit healthcare organization headquartered in San Antonio. It provides adult medicine, senior care, pediatrics, OBGYN, behavioral health, and dental services to all residents, whether they are insured, underinsured, or uninsured and have done so for more than 50 years. Historically, CommuniCare, like most nonprofit organizations, had been reliant upon federal and charitable foundation grants for a majority of their annual income. The Board of Directors and the CommuniCare Leadership Team realized that with the passage of the Affordable Care Act, this was no longer going to be a tenable funding methodology. In 2010, CommuniCare had five sites of care and provided care to 34,231 individuals, who generated 127,400 outpatient visits. CommuniCare’s net revenue in 2010 was approximately $22,550,000. The immediate challenge was that significant numbers of patients who had utilized CommuniCare as their only source of healthcare would 26

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soon have choices of care under the provisions of the act. The first and most important decision of the board was that the ultimate mission of serving the most vulnerable populations would remain paramount. It was clear that CommuniCare needed to raise the revenues from the provision of care and lessen the reliance on grant funding. The leadership team was tasked with looking for opportunities for CommuniCare to expand into areas that not only had an uninsured population but also had underserved, insured populations. They were also tasked with establishing mutually beneficial relationships with the large healthcare systems in the community.

and quality measurement systems. By improving access to care, and not just maintaining but improving quality, Communicare grew to 13 sites of care, a +160 percent increase, treating 51,174 patients, a +49.6 percent, and ultimately generated 180,336 outpatient visits, a +41.6 percent increase, by 2015. However, the most telling statistic was the revenue increase of 180 percent to approximately $63,150,000. That rise is fully due to the fact that by 2015 more than 65 percent of all revenues were workload derived. It should also be noted that during that fiveyear period, not a single individual in need of care was turned away from CommuniCare due to lack of funding. The board was fully involved every step of the way, approving every new site of care, ensuring quality of care, and closely monitoring the financial impact of every decision made. If a governing body employs the right CEO and maintains focus on financial viability, stakeholder relations and quality of care, it will ensure the organization not only survives but thrives in today’s challenging healthcare market. For as the Greek philosopher Heraclitus said 2,500 years ago, “Nothing endures but change.” For more information visit www.communicaresa.org.

Through these efforts, CommuniCare not only expanded services within San Antonio but also expanded services into Hays and Kendall Counties with clinics in San Marcos, Kyle, Wimberley and Boerne. One fear was that with the rapid growth the quality of care would suffer. To address that concern, two new clinically trained board members, a physician and a nurse, revamped the board’s Quality Assurance Committee to closely monitor quality

JANUARY - 2017

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Research RISE OF THE

Professional The rise in the pharmaceutical industry is leading to an increased need for trained clinical research professionals

By Heather McCreery, RN, MBA, CCRC

T

he approval of new medications and medical devices by the U.S. Food and Drug Administration is the result of serious dedication and years of hard work by those in the clinical research field. There were approximately 4,700 new drugs tested in Phase I through Phase III trials, in which an estimated $56 billion was spent in clinical research in 2015 alone. According to Research and Markets, it’s estimated that by 2020 the number of global clinical trials will 28

MD Monthly

double creating a $64 billion market. Three-fourths of these clinical trials will be outsourced to clinical trial service providers. Therefore, the need for professionals in the clinical research field is growing each year. In the majority of health settings, the clinical research coordinator holds the critical position in the development process of medication and medical devices. Clinical research coordinators are responsible for recruitment and enrollment of study participants, capturing data, and interacting with a variety of groups, including the study sponsor, the

Institutional Review Board (IRB) and sometimes even the FDA. As a result, each day is unique for the clinical research coordinator. In spite of the scope of the pharmaceutical field, many clinical research coordinators learn their skills primarily through on-thejob-training. While practical, field training alone has limitations, including training inconsistencies and inadequate awareness of regulatory requirements. Northwest Vista College, one of the Alamo Colleges, offers training that

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MEDICAL BUSINESS/SAN ANTONIO

leads to earning an associate of applied science degree or advanced technical certificate for individuals interested in this growing field or those seeking more formalized training.

According to Research and Markets, it’s estimated that by 2020 the number of global clinical trials will double creating a $64 billion market Students interested in a career in clinical research can expect their first semester lecture topics to cover the basics of clinical research, including the phases of drug or device development, medical records management and working

with trial participants. As students gain an understanding of the scope of clinical research, they are also exposed to the legal and regulatory issues and management practices in clinical research settings, which is critical knowledge that often on-the-job training may not provide. For instance, many of the legal topics covered include aspects of confidentiality laws, compliance with FDA requirements, human resource issues and best practices in clinical research management. Students also take an ethics course which emphasizes the unique and complex issues surrounding research, including the evolution of ethical philosophies regarding clinical trials and the current ethical climate.

Additional coursework is taken to understand medical terminology, human anatomy and physiology, and drug classification and therapy. These courses are designed to prepare the student for integration into the clinical setting in which trials are conducted. In the final semester, students often enroll concurrently in a good clinical practice (GCP) course and an internship. GCP represents the internationally recognized quality requirements that must be observed throughout the conduct of a clinical trial. The internship provides the students with a real-world perspective in which they can practice educational lessons and ethical decision-making. For more information about the Clinical Research Coordinator at NVC, visit www.alamo.edu/nvc/academics/ departments/clinical-research Heather McCreery, RN, MBA, CCRC, is chair of Northwest Vista’s Workforce Technical Programs and Business Assistant Professor and Clinical Research Program Coordinator.

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HEALTHY LIVING/SAN ANTONIO

THE WILL OF THE THE ALPHA WARRIOR CHALLENGE COURSE IS NOW A PERMANENT FIXTURE AT RETAMA PARK Special To MD Monthly

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PHOTOGRAPHS BY Matt Nolan

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HEALTHY LIVING/SAN ANTONIO

A Tribe Of A

DIFFERENT KIND

The Tribe Strength and Conditioning Create A Community Centered On Self-Improvement By Miranda Elaine

B

arbells crash to the floor as the clock hits zero and the nourishing sense of accomplishment radiates throughout the room. A group goal is established and conquered by several intense individuals. This is a community that shares a common culture and belief that life is significantly more satisfying when health and fitness become a personal priority. The Tribe Strength and Conditioning racked its first barbell on August 3rd, 2015. Co-owners Ed Conway and Nick Vera envisioned a facility where they could share their passion for fitness and fulfill their desire to serve the community. With the sole purpose to provide a home 32

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away from home, The Tribe Strength and Conditioning was meant to be “a place where our members can feel welcomed and loved, but also be challenged physically,” Vera explained. For both owners, The Tribe was a product of a long-time aspiration to be a light in the lives of others.

Whether you’re seeking to gain strength, lose weight, increase work capacity or train for a specific sport,your goals will be realized through the consistency of training. - Ed

Conway

Conway and Vera’s inspiration stemmed from their respective athletic careers and fostered a passion in health and functional fitness. Though because of an unfortunate injury, head coach and coowner Ed Conway prematurely hung up his pads ending what would be a promising collegiate football career. While Vera, a former baseball player, spent three years after college playing for the St. Louis Cardinals organization prior to his current endeavor. Although functional fitness has its critics, “the proof is in the results,” Conway explained, adding that, “whether you’re seeking to gain strength, lose weight, increase work capacity or train for a specific sport, your goals will be realized through the PHOTOGRAPHS BY Miranda Paredes

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HEALTHY LIVING/SAN ANTONIO

consistency of training.” The Mayo Clinic defines functional fitness as “exercises that train your muscles to help you do everyday activities safely and efficiently.” These movements can benefit the body inside and outside of the gym. Consumer Reports describe it as “training with a purpose.” They credit functional fitness for improving balance and coordination through exercises that incorporate everyday movements. With extensive knowledge and experience in strength training, the program is prepared with a specific purpose in mind. The Tribe’s structure includes the option to incorporate strength, performance or conditioning into every workout. This allows each athlete to cater their training to their individual goal. When asked if someone has to be in shape to come try a class, Vera chuckled and explained, “That’s the common misconception of fitness in general.” All ages and levels of fitness can find a place at The Tribe. Indeed, their member base is as varied as

they come. Ranging from the Alamo Heights High School baseball team, for off-season strength training, to the determined mother of three who can workout and keep up with the best of them. “We have one of the most diverse communities around,” Vera shared proudly. The Tribe has turned an atmosphere of intimidation into a place that exudes warmth and

welcome. In just one year, over 130 members have found their “workout fix” here. Alongside Conway and Vera, head coach Beth Devos, assistant coach Matthew Miranda, and “Tribe Kids Coach” Jennifer Smith will continue to dedicate their time to serve and strengthen the central San Antonio community. For more information visit thetribesc. com or call 210.776.2363. The Tribe Strength and Conditioning is located at 827 East Rector Street in San Antonio, TX 78216.

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Faith

KEEPING THE

By Sinjin Hilaski

T

he need to expand access to quality healthcare is no new phenomenon. Indeed, Methodist Healthcare Ministries of South Texas have dedicated themselves to this mission, and over the past few decades, they have succeeded in streamlining and increasing access to exceptional care. Though the organization was formally founded in 1995, their roots with the South Texas medical community run deep and over half a century long. In 1955, the Southwest Conference of The United Methodist Church chartered a hospital in northwest San Antonio. Opening their doors for patients in 1963, Methodist Hospital, at the time, was the sole healthcare facility in today's South Texas Medical Center. Naturally, times and the landscape of the healthcare field began to shift nationally, and insurance companies desired 34

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For decades, Methodist Healthcare Ministries of South Texas has brought quality care to underserved communities and continues to build on their tradition of excellence

hospitals to have numerous locations to serve the communities. Seeing this shift, John Hornbeak, the formerpresident and CEO of Methodist Hospital, rose to the occasion and assembled the Methodist Hospital Board of Trustees to explore a novel partnership with the current Hospital Corporation of America. Through their daring innovation, former-president and CEO John Hornbeak and the Methodist Trustees transfigured the Methodist Hospital Board of Trustees into today's Methodist Healthcare Ministries (MHM) and the Methodist Healthcare System.

THEY WOULD ALL AGREE THAT GOD HAS BEEN GRACIOUS TO ALLOW US TO FULFILL THIS MISSION.

Methodist Healthcare Ministries—a private, faith-based, nonprofit—and the Methodist Healthcare System operates nine San Antonio hospitals, three surgery centers and an astounding 27 facilities. Although Methodist Healthcare Ministries operates independently from the Methodist Healthcare System, they share the same mission of “Serving Humanity to Honor God,” and Methodist Healthcare Ministries holds the responsibility for providing the local governance to ensure that the Methodist Healthcare System continues its rich tradition of being a benefit to the community with its quality care for all and charitable care, when needed. With the mission to improve the quality of care and access to care for underserved communities, Methodist Healthcare Ministries has

PHOTOGRAPHS COURTESY OF METHODIST HEALTHCARE MINISTRIES

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paved the way to actualize these goals and ultimately better the South Texas community. “We [Methodist Healthcare Ministries] have created access to quality care for uninsured and low-income individuals and families through the provision of direct primary care services in clinics we own and operate in San Antonio, as well as the health education, behavioral health and family wellness programs we offer throughout 74 counties in South Texas,” shared Jessica Muñoz, MHM Director of Communications. The motivating factor for increasing the quality of care and access to care for underserved communities stems from MHM's original founding board members. Their mission of serving humanity to honor god spurred the board of directors to carry out a tasks they knew no other entity could do at the time—to serve the uninsured people of South Texas. Since its inception, Methodist Healthcare Ministries'

ability to serve an outstanding number of patients through their programs has been as extraordinary as their enormous growth and success, something the founding members likely could have never foreseen. Jessica Muñoz adds that, “They would all agree that God has been gracious to allow us to fulfill this mission.” Methodist Healthcare Ministries astounding growth and success is a testament to working with faith and being flexible in an ever-changing landscape. Since 1995, MHM has expanded its reach across the 74 counties it serves with gusto. In 2016, the faith-based organization invested $91 million to support charitable healthcare clinics its owns and operates, including $25 million in grants to over 90 nonprofits across South Texas. With spirituality at its core, the need to improve the physical, spiritual and mental health of the least served South Texans speaks to the very heart of the organization. “We at Methodist Healthcare

Ministries believe all of God's children are deserving of healing; access to quality care should be available to all, regardless of ability to pay,” shared Jessica Muñoz. Acknowledging this, one of the organization's core objectives is to influence healthcare policy through advocacy conducted through public policy analysis, research, and building the capacity of other organizations to act as healthcare advocates. As a nonprofit, non-partisan organization, educating policy makers, elected officials and civic leaders about the impact of health policies is a critical component to Methodist Healthcare Ministries' work. In the way of keeping up with the ever-changing healthcare landscape and legislature, Methodist Healthcare Ministries is in a prime position due to their founding as a response to the changing healthcare landscape. MHM's board members recognized early on that change and healthcare would become synonymous, and in 2017 - JANUARYMD Monthly

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provided more than $25 million in funding to agencies throughout South Texas that support access to care, integrated delivery systems, patientcentered models and the social determinants of health.

response to this, they created durable core objectives that have allowed the organization as a whole to remain nimble and responsive to changes that impact its many communities. Looking forward, Methodist Healthcare Ministries is actively leading the way in an unprecedented effort to make regional improvements in the identification and treatment of co-occurring behavioral health problems and chronic disease in South Texas. Coupled with this, MHM is testing methods to better treat chronic illnesses, like diabetes, and associated risk factors by employing research that can potentially transform disease management. Dedicated to improving themselves, these initiatives would undergo evaluation to build a portfolio of integrated health solutions that can be scaled and replicated, allowing for a potential national impact on the delivery of care to vulnerable, underserved populations. With more healthcare changes on the horizon, Methodist Healthcare Ministries is preparing with their

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signature, strategic planning processes to ensure the organization as a whole continues its tradition of being responsive to current and future developments in healthcare, whilst expanding their care and advocacy efforts.

WE AT METHODIST HEALTHCARE MINISTRIES BELIEVE ALL OF GOD'S CHILDREN ARE DESERVING OF HEALING; ACCESS TO QUALITY CARE SHOULD BE AVAILABLE TO ALL, REGARDLESS OF ABILITY TO PAY.

Given their rich, faith-based foundation and dedication to providing care to the most vulnerable and underserved communities, Methodist Healthcare Ministries is a beacon of hope in the world of healthcare. Leading by example, the organization has lived true to its values and will undoubtedly continue to change the face of medicine and access to care throughout South Texas. By “Serving Humanity to Honor God,� Methodist Healthcare Ministries has dedicated themselves to the highest of values and successfully met their mark in expanding access to care. The organization's future burns brighter than the evening star, and all of South Texas will surely benefit from their continued success. For more information visit www.mhm. org or call 210.692.0234. Methodist Healthcare Ministries of South Texas is located at 4507 Medical Drive in San Antonio, TX 78229.

Indeed, in 2016 the organization was able to support approximately 850,000 patient visits through clinics owned and operated by Methodist Healthcare Ministries, federally qualified health centers, safety-net clinics, counseling services and regional community projects it has funded. Alongside this, MHM has PHOTOGRAPHS COURTESY OF METHODIST HEALTHCARE MINISTRIES

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INFORMED PATIENT/AUSTIN

'TIS THE SEASON FOR STRESS! KELLY MCCABE OFFERS TIPS TO OVERCOME HOLIDAY STRESS Special To MD Monthly

I

t’s the time of year where holiday stress has already kicked into full effect for many of us. And with that, we easily feel overwhelmed. Baylor Scott & White Health – Round Rock Psychotherapist Kelly McCabe offers advice to cope with the hustle and bustle. “Stress and feelings of being overwhelmed are warning signs and they need to be taken seriously,” explains McCabe. “Sit down with a family member or friend and have a heart-to-heart discussion about what's going on in your life. Consider everything from long work hours and deadlines to the stress of relationships with family and friends, holiday shopping and upcoming holiday parties.” McCabe suggests you work with family, friends etc. to create a plan to deal with the pressure and try to restore well-being. Some examples include: •

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Only accept party invitations with people you want to

MD Monthly

spend time with. Don’t feel pressured to say “Yes” to everyone. Set boundaries. Reduce long hours at work, set additional boundaries with relatives, friends and co-workers, and delegate projects. Refocus your mind and body: get a relaxing massage, visit a friend, take a multivitamin daily and work out daily. If you tend to feel down during these shorter days of fall and winter, you’re not alone. Seasonal Affective Disorder (SAD) is a type of clinical depression that affects people generally in the fall and winter, and it's estimated to affect 10 million Americans. A home remedy is to get more exposure to sunlight, go outside for lunch, or, if at all possible, try to adjust your work hours so you get home earlier. SAD can come about with symptoms that may include: having low energy, hypersomnia, overeating and

weight gain, and social withdrawal. According to McCabe, symptoms of SAD can potentially be alleviated with the following: • • •

Psychotherapy/counseling Light therapy, daily exposure to a light box that simulates artificial sunlight Diet, exercise and maximizing the amount of daylight exposure

“Consider getting professional help if your stress becomes all-consuming and you begin feeling persistent anxiety or depression,” says McCabe. A professional can evaluate your lifestyle and recommend treatments and stress-reduction techniques that can help with coping, enhance your immune system and protect you from future problems. For more information from Baylor Scott & White visit www.sw.org.

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INFORMED PATIENT/AUSTIN

10 TIPS

TO HAVE A HEALTHY

HOLIDAY SEASON

& NEW YEAR

BAYLOR SCOTT & WHITE MEDICAL CENTER – ROUND ROCK OFFERS WAYS TO TAKE STEPS TO KEEP YOU AND YOUR LOVED ONES SAFE AND HEALTHY. Special To MD Monthly

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ith the New Year upon us, and the holiday season rounding out, it’s time to re-dedicate ourselves to healthy living and keeping our families in peak physical and mental health. Baylor Scott & White offers their top 10 tips to keep up your family’s health. 1. Wash your hands as often as possible: It's flu season. Wash your hands with soap and clean running water for at least 20 seconds. 2. Wear a lot of layers to stay dry and warm: Wear appropriate outdoor clothing, like light, warm layers, gloves, hats, scarves and waterproof boots. 3. Keep stress under control: Give yourself a break if you feel stressed out, overwhelmed and out of control. Some of the best ways to manage stress are to find support, connect socially and get plenty of sleep.

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4. Do not smoke: Avoid smoking and secondhand smoke. Smokers have greater health risks because of their tobacco use, but nonsmokers also are at risk when exposed to tobacco smoke. 5. Get your annual exams and screenings: Ask your healthcare provider what exams you need and when to get them. Update your personal and family history. Get insurance from the Health Insurance Marketplace if you are not insured. 6. Get your vaccinations: Vaccinations help prevent diseases and save lives. Everyone 6-months-old and older should get a flu vaccine each year. 7. Keep an eye on your children: Keep potentially dangerous toys, food, drinks, household items and other objects out of children's reach. Protect them from drowning, burns, falls and

other potential accidents. 8. Be mindful of winter fires: Most residential fires occur during the winter months, so don't leave fireplaces, space heaters, food cooking on stoves or candles unattended. Have an emergency plan and practice it regularly. 9. Prepare food safely: Remember these simple steps: Wash hands and surfaces often, avoid cross-contamination, cook foods to proper temperatures and refrigerate foods promptly. 10. Eat healthy and stay active: Eat fruits and vegetables, which pack nutrients and help lower the risk for certain diseases. Limit your portion sizes and foods high in fat, salt and sugar. Also, be active for at least 2½ hours a week, and help kids and teens be active for at least one hour a day. For more information or health tips visit www.sw.org.

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INFORMED PATIENT/CORPUS CHRISTI

Good Nutrition SUPPORTS THE HEALING PROCESS By Dr. Nicholas Nilest, PT, DPT

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hen Rebecca Lindenberger came to Corpus Christi Rehabilitation Hospital after suffering a stroke, she expected daily visits from doctors, nurses and therapists. But what she didn’t expect were regular visits from the hospital’s dietitians. “At first I didn’t understand why I needed a dietitian,” says the 67-yearold Corpus Christi resident. “But then I was pleasantly surprised as I learned that changing my diet for 42

MD Monthly

the better could help in my recovery and help keep me out of the hospital in the future.”

I’VE SEEN PATIENTS ACTUALLY REDUCE THEIR MEDICATIONS WHILE IN THE HOSPITAL WITH US JUST BY MAKING HEALTHIER FOOD CHOICES

-KEELY DAVIS, DIRECTOR OF DIETARY SERVICES At Corpus Christi Rehabilitation Hospital, dietitians are members of

the interdisciplinary team that works with patients and their families as part of a comprehensive approach that the hospital takes in providing rehabilitative care. “Good nutrition is important in helping an individual heal,” says Keely Davis, Director of Dietary Services. “Evidence suggests that a diet of nutritious foods can help lower high blood pressure, manage diabetes and aid in wound healing. It also can help reduce the risk of heart disease, stroke, some cancers

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INFORMED PATIENT/CORPUS CHRISTI

and osteoporosis.” While benefits abound from maintaining a healthy diet, Davis and her team know that it often can be hard for patients to change their eating habits. And they’re not alone. In the United States, only 24 percent of adults eat five or more servings of fruits and vegetables a day, one of the core components of a healthy diet. “While at the hospital, we try to help the patient move forward with better dietary choices that can help improve his or her health immediately and down the road,” Davis says. “We meet with each patient individually to discuss eating patterns, food likes and dislikes, shopping habits, and short and long-term recovery goals. Once we agree upon a dietary plan that best suits the patient, we begin teaching the benefits of good nutrition, what to look for in foods, how to make healthier choices when shopping or eating out, and the best ways to prepare foods.” Davis says that a hands-on part of the dietary education involves a dietitian accompanying a patient through the hospital cafeteria’s food line to explain the options and help them make better decisions. “It’s rewarding to see the results of working with patients in this manner,” Davis says. “I’ve seen patients actually reduce their medications while in the hospital with us just by making healthier food choices.”

Davis says the goal is to help the patient leave the hospital armed with information and knowledge that will help them continue with a healthier diet when they return home – making better shopping, cooking and eating decisions.

AT FIRST I DIDN’T UNDERSTAND WHY I NEEDED A DIETITIAN...BUT THEN I WAS PLEASANTLY SURPRISED AS I LEARNED THAT CHANGING MY DIET FOR THE BETTER COULD HELP IN MY RECOVERY AND HELP KEEP ME OUT OF THE HOSPITAL IN THE FUTURE.

-CCRH PATIENT REBECCA LINDENBERGER

“We know it’s hard to change life-long habits, but often our patients leave feeling better than they have in a long time from a nutrition standpoint,” Davis says. “That can be a strong incentive in keeping a healthier lifestyle up. Even if they had a great experience at the hospital, I’m sure they’d rather not come back, and ongoing good nutrition can possibly help that.” While good nutrition is integral to the healing process, it’s also key in prevention of diseases as well. Davis offers these tips for anyone who is trying to incorporate a healthier diet into their lifestyle: •

fruits and veggies, and skip or limit processed items. If it doesn’t grow out of the ground or occur naturally, think twice before you buy or eat it. Keep a food diary. Even if you only do it for a week, it can reveal your true eating habits. Read food labels. Look for items with minimal ingredients in them that are listed “real” foods versus chemically produced items. Cut back the salt in your diet. Don’t add it to your foods and watch for hidden salt in canned goods and processed foods. Limit your alcohol consumption.

Corpus Christi Rehabilitation Hospital is a 35-bed, free-standing facility providing intensive physical rehabilitation services to patients recovering from strokes, brain and spinal cord injuries, and other impairments as a result of injury or illness. For more information visit CCRH.ernesthealth.com or call 361.906.3700. Corpus Christi Rehabilitation Hospital is located at 5726 Esplanade Drive in Corpus Christi, TX 78414.

Eat a balance of protein, fruits, vegetables, dairy and grains daily. Stay well-hydrated with water and other unsweetened beverages. Load up on “real” food, like

2017 - JANUARYMD Monthly

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INFORMED PATIENT/DALLAS-FORT WORTH

How Vitamin D REDUCES THE RISK OF ASTHMA

By Terri Suresh-DeNeui, MSN, APRN-BC, Founder of Evexias Medical Centers

A

sthma is a serious health problem in the United States and in other developed countries around the world. According to the Center for Disease Control and Prevention (CDC), the federal agency charged with tracking incidence of disease, about 17.7 million adults and 6.3 million children in the U.S. are living with asthma, a respiratory condition caused by inflammation and obstruction of the airways.

molds, dust mites, pollutants, smoke and other elements found in the air of urban environments.

While the causes of asthma remain unclear and no cure for this disease has been found, its symptoms, such as wheezing, shortness of breath, coughing, and chest pain and tightness, can be triggered by exposure to allergens and irritants. These include grass or weed pollen,

Vitamin D: Anti-Inflammatory and Immune Booster

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There are medications which can help manage symptoms of these asthma attacks, but a new study suggests that a well-known and easily available vitamin may reduce the risks of this debilitating disease. Vitamin D has come to the forefront in the treatments for asthma, and I’ve been a long-time proponent of this vitamin.

Evexias Medical Centers began prescribing high doses of Vitamin D before it was fashionable to do so. We are passionate about its healing properties.

Vitamin D works on many different levels and has numerous benefits. It’s a powerful anti-inflammatory and immune booster. Since asthma is a disease of inflammation and someone suffering from this condition is susceptible to colds and the flu, those two conditions combine to exacerbate the condition. Vitamin D treats both conditions. Irritants in the air, such as smog, can clog the bronchioles in the lungs of someone with asthma. However, this discomfort and difficulty in breathing is not due to air-intake. Asthma sufferers have trouble exhaling. This is due to inflammation of the tiny bronchioles in the lung; they start to spasm and then constrict. The person with asthma begins coughing and wheezing in an attempt to get the air out of their lungs.

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INFORMED PATIENT/DALLAS-FORT WORTH

Another contributing factor to the incidence of this condition in urban areas is the lack of sunlight. As we have previously noted, the best source of Vitamin D is from the sun. Medical science is still attempting to understand the chemical composition of Vitamin D and why it has such a positive effect on conditions such as asthma. We don’t really know what’s going on at the cellular level. Vitamin D has a hormone like structure and its action resembles a hormone in the body at the cellular level, but we don’t know why, yet. Though, we do know that low levels of Vitamin D have also been linked to cancer and heart disease. Knocking Out Colds and Flu Since we are in the middle of the cold and flu season, it is important to highlight the benefits of Vitamin D to help prevent these conditions. A Swedish study from a few years ago noted that a patient exposed to a cold or flu virus taking 50,000 units of Vitamin D over a three-day span could be completely well at the end of those three days. Children with asthma are particularly susceptible to colds and the flu, and I recommend these youngsters get plenty of Vitamin D supplements during the winter. In some countries, such as Sweden, where the winters are long and dark, the government mandates an increase in the dosage of Vitamin D and offers this free of charge. Studies show children should get at least 2,000 units of Vitamin D daily and adults should get 5,000 units during the winter months.

Testing for Vitamin D Levels and Supplement Quality Evexias Medical Centers offers a simple blood test to help patients determine whether they have a Vitamin D deficiency. We check Vitamin D levels on every patient. We have found that about 80 percent of the patient population is Vitamin D deficient, darker skin ethnicities suffer the lowest levels of Vitamin D. It’s also important to make sure the Vitamin D supplements are of the highest quality. Purchasing these supplements from a “big box” retailer is somewhat problematic. There is not an FDA overview on supplements in this country. In our practice, we use a pharmaceutical-grade Vitamin D, and this is not a supplement one can get in a normal retail store. It is also important for patients who are taking Vitamin D to also take Vitamin K-2 in order to properly metabolize calcium, which is also difficult to find. With a condition as acute as asthma, it is critical to consult one’s physician with any new developments. However, alternative therapies such as increasing Vitamin D are becoming more and more useful in treating this chronic condition. For more information visit www.evexiasmedical.com. About EVEXIAS® Medical Centers: The Texas-based centers are the premier industry leader and innovator of the Medical Wellness movement via superior patient care and the utilization of revolutionary, preventive and regenerative medical and aesthetic technologies. The mission is to partner with each patient to bring healing by understanding the root cause of a patient’s particular

health concern, and subsequently formulating an effective, individualized treatment plan, always recognizing the body, mind and spirit contribute to the overall health of humanity.

About the author: Speaker, author, coach and boardcertified nurse practitioner Terri SureshDeNeui has extensive training in her field. She has extended her education to include certifications in Anti-Aging/ Wellness Medicine and Bio-Identical Hormone Replacement Therapy. Terri owns and operates two thriving wellness clinics in Texas, Evexias Medical Centers, formerly Hormonal Health, Wellness, and Aesthetics. Her passion for speaking and educating has earned her accolades across the Dallas-Ft. Worth metroplex and invitations to write columns, book chapters, and speak in a variety of settings, including television, radio and seminars across the country. She has recently received certifications to teach Partnership Guru Alison Armstrong's work in the areas of gender communication, partnership and emotional healing.

2017 - JANUARYMD Monthly

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INFORMED PATIENT/DALLAS-FORT WORTH

CAN HIGH-IMPACT EXERCISE

&WEIGHT TRAINING

COUNTERACT THE EFFECTS OF

OSTEOPOROSIS?

By Dr. Richard Guyer and Dr. Isador Lieberman

I

n order to maintain bone density, post-menopausal women with the pre-osteoporosis condition known as osteopenia have a new challenge: making time for regularly scheduled, vigorous exercise. A new study recommends this group participate in high-impact exercise, including weight training, at least twice a week. The researchers who conducted the study found the results “disillusioning” because “older people generally have low enthusiasm for frequent exercise.” According to the medical journal Bone, which published the results of the study, researchers in Germany tracked the bone density changes in 55 middle-aged women with osteopenia. The subjects participated in four exercise

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sessions per week, which ran for 30 to 65 minutes. These sessions included a combination of bone-building exercises, such as low and high-impact aerobics, and resistance training with free weights and machines. Bone density scans were taken at regular intervals of all participants,

AT 25-YEARS-OLD, WE HAVE OUR PEAK BONE DENSITY, AND AS WE GET OLDER, WE BEGIN TO LOSE ONE PERCENT OR MORE OF DENSITY EACH YEAR.

including a control group of 43, and diet, medications, weight changes, depression and other factors which might affect this exercise regime were considered in the analysis. Of the group of regular, highimpact exercisers, bone density decreased by 1.5 percent in the spine and 5.7 percent in the hip. Among the control group, which did little or no exercise, spine bone density declined by 5.8 percent and hip density declined by 9.7 percent. Researchers found this difference between the groups as significant. What Is Osteoporosis? At the Texas Back Institute, we treat hundreds of patients suffering from osteoporosis each year, and we have opinions on the efficacy of using high-

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INFORMED PATIENT/DALLAS-FORT WORTH

impact exercise in order to build bone density in older women. First, it’s important to understand what osteoporosis is: a softening or dissolving of the bone. At 25-years-old, we have our peak bone density, and as we get older, we begin to lose one percent or more of density each year. In post-menopausal women, the rate of bone density loss accelerates to 2 to 3 percent each year for about five years. We all go through some degree of bone density loss with aging, but this is exacerbated by osteoporosis. Think of this process as a brick which is dissolving. At one time, a brick is solid, but over time, the nooks and crannies of the brick begin to dissolve and eventually you are left with just a shell. The difference between genders has to do with hormonal imbalance. Frankly, we are outliving parts of our bodies. We can keep the heart and lungs functioning, but the skeletal framework, the bones and muscles, continue to deteriorate. We are seeing an epidemic of osteoporosis due to several environmental factors. One of the primary culprits is soft drinks, which have phosphates in their ingredients, and this has the effect of “melting” away bones. How High-Impact Exercise Builds Bone Density The researchers found a significant difference between the subjects who participated in regular, rigorous exercise and those who didn’t. Why does high-impact exercise and weight training increase bone density? There’s a medical term called “Wolf’s Law” which notes that bones which are under stress will increase in density. Basically, the exercise causes the brain to signal the body to make more bone in order to deal with this stress. Highimpact exercise and weightlifting puts pressure on the bones and the bone responds by getting stronger. Think of it this way: when astronauts go up in space and they are not subjected to gravity, their bones soften

over time. The same thing happens to the bones when there is no pressure put on them. The osteoporosis is accelerated. There is an electrical and a physiological effect on bones when they are exposed to forces. In this case, this is exercise and weight training.

IN POST-MENOPAUSAL WOMEN, THE RATE OF BONE DENSITY LOSS ACCELERATES TO 2 TO 3 PERCENT EACH YEAR FOR ABOUT FIVE YEARS. Swimming, biking and other aerobic exercises are great, but they don’t cause the bone to grow denser in the manner of weight training and vigorous exercise, such as running and jumping. Potential Dangers Sometimes the “cure” for a physical malady, such as osteoporosis, will have unintended consequences which are more damaging than the condition itself. When older women undertake an aggressive program of high-impact exercise, they must take into consideration other conditions of their body which might lead to serious health issues. One of the problems of this approach is that as we get older, we lose some of our ability to balance. This is the most common reason older people fall and break a hip or other bones, and this is why yoga, pilates and tai chi are so important for this age group. These stretching exercises build flexibility and balance. This age group might also have arthritic joints, which would make highimpact exercise painful and could injure someone with osteoporosis. In fact, the osteoporosis may be so severe, highimpact exercise could cause a fracture. So, that’s why it’s very important to get a diagnosis on the level of osteoporosis and advice on the type of exercise and weight-training program from an expert. For more information visit texasback.com or call 1.800.247.2225.

About the Doctors: Dr. Isador Lieberman is a fellowship-trained orthopaedic and spinal surgeon. He is board certified by the American Board of Orthopaedic Surgery, and he holds a specialist certification from the Royal College of Physicians and Surgeons of Canada. He completed medical school and residency at the University of Toronto, and he completed spine surgery and trauma surgery fellowships at the Toronto Hospital in Canada and at Queen’s Medical Center in Nottingham, England. Dr. Lieberman specializes in the surgical treatment of spinal disorders. His clinical interests include: adolescent and adult scoliosis, deformity reconstruction, spinal tumors, minimally invasive, robotic and endoscopic spinal surgery, treatment of vertebral compression fractures, cervical and lumbar degenerative disorders, and trauma. Dr. Lieberman also established the Uganda Charitable Spine Surgery Mission which provides services to the less fortunate in Uganda who are afflicted with spinal ailments, including tuberculosis and scoliosis. Richard Guyer, M.D. is the co-founder of the Texas Back Institute and Director of their Spine Fellowship Program. Dr. Guyer is also co-director for the Center for Disc Replacement at the Texas Back Institute. Dr. Guyer earned his medical degree from the University of Pennsylvania School of Medicine. He completed his internship at Parkland Memorial Hospital in Dallas, Texas, and he continued with his residency program in orthopedic surgery at the Hospital of the University of Pennsylvania. Dr. Guyer then completed two spine fellowships in Ohio and California. Dr. Guyer holds many honors including founder of the Texas Back Institute Research Foundation and Chairman of the Board for the program. Dr. Guyer has received the Best Doctor Award from D Magazine for multiple years, is past president of the North American Spine Society and winner of the Volvo Award for Low Back Pain Research. 2017 - JANUARYMD Monthly

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INFORMED PATIENT/SAN ANTONIO

IT’S TIME TO STOP LOOKING

& Start Seeing DR. LISA MARTÉN OF THE SOUTH TEXAS EYE INSTITUTE DISCUSSES CATARACT SYMPTOMS AND TREATMENTS By Dr. Lisa Martén

A

cataract is an aging change inside the natural lens of your eye. You are born with a crystalline lens inside your eye that allows you to focus on objects at different distances. When you are younger, the lens is clear, but with time, it becomes more yellow and more opaque. The opacified lens is what we call a cataract. Cataracts affect vision and can change your glasses prescription, but cataracts do not cause pain. Symptoms will continue to worsen with time. Once your vision starts to interfere in your daily activities and keeps you from doing things you need or like to do, it is usually time to discuss this with your ophthalmologist. When to have cataract surgery is a 48

MD Monthly

decision you make with your surgeon. Some people wait longer than others, depending on their jobs, daily activities and goals for their vision. There are risks and benefits to any surgery. Having cataract surgery is an elective procedure, so you will want to make sure you are in good health to undergo local anesthesia, and you must be able to lie flat for approximately 10 minutes. There are different options for numbing the eye during surgery. There are several options for implants that allow different improvements to your vision after surgery. I have had the opportunity to implant several of the newest lenses on the market, and I was impressed by the accuracy and visual results. Some of my patients describe it as seeing in high definition. Though, no lens is perfect, so an eye exam with your surgeon will help you narrow down your options and what

lens is best for your vision. There are a few other options for cataract surgery, including laser assisted surgery, and realtime measurements done by an intraoperative device. This allows for a more precise and safer surgery to achieve clear vision after surgery. The surgery is pretty straightforward, but there are some restrictions on activities after surgery. Vision recovers quickly, but it can fluctuate for the first few weeks and during the time you are taking drops. Although they are rare, complications can occur, such as swelling, infection, inflammation and increased eye pressure. Most of these are limited, and can be treated with drops, but sometimes there is a need for more surgery. If you think you have cataracts, or if you just need an eye exam, please contact us for more information. Lisa Martén, M.D., is a board-certified ophthalmologist. She can be reached at the South Texas Eye Institute located at 2424 Babcock Rd, Suite 101 in San Antonio, TX 78229. For more information call 210.692.1388 or visit southtexaseyeinstitute.com.

JANUARY - 2017

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Dr. Nilesh Patel


SOUTH TEXAS’ PREMIER

Bariatric Specialists The Texas Bariatric Specialists Continue To Better South Texas With Equal Parts Passion, Skill and Commitment By Rudy Arispe


H

aving founded his practice in 2005, Dr. Nilesh Patel can cite an array of reasons why patients come to see him at Texas Bariatric Specialists. “Some want to get married in their mother’s wedding dress, some want to be able to ride a roller coaster, some want to be there for their child’s quinceañera, and others want to get their blood pressure or diabetes under control,” the bariatric surgeon said at his San Antonio office on Huebner Road, which is one of eight specialty clinics throughout South Texas. A frank, yet kind person, Dr. Patel doesn’t sugar coat his conversations with his patients. For whatever reason patients have come, he lets them know up front that it’s not going to be easy, and that bariatric surgery to lose weight and keep it off is a lifelong commitment. With a spirit of true dedication, Dr. Patel and his fellow surgeons, as well as the front office staff, promise to be with you every step of the way, just as he has been, for instance, with Raul Diaz, a patient who at his heaviest tipped the scales at 470 pounds. The Del Rio resident admits he was always a husky kid, and as he grew older,

his weight became an issue. It wasn’t long until he was older and was dealing with issues such as diabetes and high blood pressure, along with troublesome swelling in his legs. When his primary care physician told him that he didn’t expect Diaz to live past 50 years old, it was the proverbial wake-up call for him.

Someone who is morbidly obese can have body image issues and low self-esteem...I can be a little less intimidating to the point where they feel comfortable talking to me.

-Dr. Leah Dill

In June, 2015, Diaz underwent gastric bypass surgery. “The first two months were difficult because mentally I was still obese, although physically I could see the weight coming off,” he recalled. Today, he weighs around 225 pounds, and is striving toward a goal he has set of 175-180 pounds. Moreover, high blood pressure and diabetes no longer pose health threats, and Diaz is able to walk three miles a day. It is cases like Raul Diaz’s from which Dr. Patel derives deep satisfaction and why he is so committed to his patients. “Bariatric surgery gives us the opportunity to change people’s lives. The best outcomes happen while maintaining long-term, follow-up care,” Dr. Patel shared with a smile. “We follow up with our patients for life. Every one to two years we ask, ‘Did you achieve your goals? What have you done to celebrate your success?’ The continuity of care and relationship with patients is what drives me every day.” This is also why Dr. Patel seeks the most qualified bariatric surgeons and associates in the country to join his team, such as Dr. Leah Dill, who is one of only two female bariatric specialists in South Texas. In fact, Dr. Dill trained under Dr. Patel and has performed more than 500

Dr. Leah Dill

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Dr. Subhash Reddy surgical procedures alongside him. Dr. Dill believes that being a female weight loss surgeon has its advantages. “A majority of patients who tend to struggle with their weight are women, and they like to go to a female physician,” she said. “Someone who is morbidly obese can have body image issues and low selfesteem. It can be challenging for them just to make that first step to walk through the door to seek help. I try to be a little less intimidating to the point where they feel comfortable talking to me. All of our surgeons are caring and compassionate, but it’s nice to have a choice.” The Texas Bariatric Specialists recently acquired the skills and expertise of Dr. Subhash Reddy, who completed a oneyear, bariatric and advanced laparoscopic surgery fellowship at the University of California-San Francisco Medical Center prior to his general surgery residency at the renowned Cleveland Clinic. “General surgery gives you moderate experience in laparoscopy and mild exposure to bariatric surgery,” Dr. Reddy explained. “But a fellowship offers you hands-on training. You observe and train under surgeons who have been doing bariatric surgery for 15 to 20 years. Last year, I did 850 cases under the supervision of experienced physicians.” Dr. Patel stresses that acquiring PHOTOGRAPHS BY Paul Marshall

MDMONTHLY.COM


exceptional medical and surgical talent, like that of Dr. Reddy, allows his practice to offer world-class care to patients in San Antonio and throughout South Texas. “The way we built our practice demonstrates the fact that we do bariatric surgery better than most,” Dr. Patel explained humbly. “I’m not saying we’re the best, though we strive to be the best every day. If you lived two hours away, would you not travel that far for worldclass healthcare? In nine cities across South Texas we have full offices staffed for pre- and post-surgery.” By having eight clinics throughout South Texas—including in San Antonio, New Braunfels, Laredo, Killeen, Del Rio, San Angelo, Corpus Christi, and two in Austin—Dr. Patel’s practice can treat patients in their hometowns while continuing to exceed national standards.

Bariatric surgery gives us the opportunity to change people’s lives.

-Dr. Nilesh Patel

“Each week, we make the commitment to have one member of the staff travel to one of our outlying offices, in Laredo, Killeen or San Angelo, for instance. We’re serving communities that do not ordinarily have access to this type of care,” Dr. Patel shared proudly.

though they are totally committed to it. The fact is, some people just have poor metabolism and trouble losing weight.”

confronting that last obstacle on their journey. Our medical weight loss program can get them to their goal.”

These are the patients whom Dr. Patel and his staff are happy to help and they do so through their medical weight loss program, after the surgery that helps ensure the patients can successfully keep unwanted pounds from returning.

Last year, I did 850 cases under the supervision of experienced physicians.

“A lot of patients get stuck, and when you get stuck, we’re here for you,” he beamed. “You’ll never hear us just say, ‘Eat right and exercise’ because, of course, you are expected to do that. But sometimes you need extra assistance, which is why we have a relevant medical weight loss program for patients who had surgery and haven’t had the results they want. Now we go from being bariatric surgeons to medical weight loss doctors.”

Like Dr. Patel, Dr. Dill is elated to help patients reclaim their health.

Dr. Dill agrees with Dr. Patel, noting that the weight loss program, which consists of nutritional counseling, dietary recommendations and a variety of supplements, among other things, is also for people who perhaps do not fit the criteria of those needing surgery but who still require assistance to reach their weight loss goals. “We’re unique in that we help people drop that last 20 to 30 pounds that they can’t lose after surgery,” she said. “For the majority of patients, the surgery will get them fairly close to their weight loss goals, but sometimes patients are

-Dr. Subhash Reddy

“Weight loss surgery is a rewarding profession,” she said. “We get to see people’s lives changed in a very dramatic way, and it’s exciting to be part of their journey and experience.” With the skilled minds and compassionate hearts of Drs. Patel, Reddy and Dill, the Texas Bariatric Specialists are carrying out their own passion-powered journey in San Antonio and throughout South Texas to better the community’s health as a whole. Their dedication and commitment shines through in every interaction and conveys the message of a purpose that will only be marked by further success. For more information, visit www. texasbariatricspecialists.com or call 877.538.6909. The corporate headquarters for Texas Bariatric Specialists is located at 14603 Huebner, Building 2 in San Antonio, Texas 78230.

He also would like to dispel the myth about obesity. “A lot of people think morbid obesity is a self-inflicted problem,” Dr. Patel said, “as is the case with many insurance companies. They think, ‘You did it to yourself and therefore we shouldn’t pay for it.’ That’s the great misconception about causes of obesity that holds America back from solving the problem. I have seen people on liquid diets for months at a time, and they have experienced no weight loss at all. Fifteen to 20 percent of Americans are on lifelong diets and can’t lose weight, even 2017 - JANUARYMD Monthly

53


RESEARCH & INNOVATION/HOUSTON

THE FUTURE OF

Modern Medicine

HARNESSING THE REGENERATIVE POWER OF OUR OWN ADULT STEM CELLS Special To MD Monthly

d

o you remember how easy it was to recover from injuries and illness when you were younger? We are getting closer to rewinding the clock, or at least slowing it down with stem cells. The human body is comprised of more than 200 different cell types. Houston-based, biotechnology company Celltex Therapeutics Corporation uses an advanced technology that makes it possible to harness the regenerative properties of one specialized cell type – the adult mesenchymal stem cell (MSC). Stem cells play an essential role in the body’s natural healing process. As we age, these cells begin to decline in numbers, making it harder for us to recover from injuries, illness and aging. The regenerative and immunomodulatory abilities of adult stem cells make them therapeutically beneficial in pain and 54

MD Monthly

age management, degenerative conditions, like osteoarthritis, neurodegenerative conditions, like Parkinson’s disease, and autoimmune conditions, like rheumatoid arthritis and multiple sclerosis.

DECIDING TO HAVE THE THERAPY WAS ONE OF THE BEST DECISIONS OF MY LIFE. -

Helen Streaker

Using proprietary technology, Celltex can isolate, multiply and bank hundreds of millions of an individual’s own adult stem cells, quantities never before possible. With the 21st Century Cures Act officially signed into law, regenerative therapies will receive more attention for their abilities to help people with chronic illnesses in the United States. Helen Streaker is a good example. At 81-years-old, Helen is astounding

family and friends with her newfound energy and zest for life after having adult stem cell therapy, thanks to Celltex’s advanced technology. In 2011, Helen suffered a major stroke while on holiday with friends in Italy. “We were having lunch, and suddenly, I was unable to speak. I tried to get up, but I couldn’t walk,” she recounts. Helen was rushed to a local hospital where she received excellent care. She was shocked when tests revealed that she had unknowingly suffered two other minor strokes previously. Naturally, Helen required extensive physical therapy in the following months but made a good recovery. Later that year, Helen was diagnosed with peripheral neuropathy, which caused pain and weakness in her hands and feet, making it difficult to function. “I was taking three different pain medications in order to sleep at

JANUARY - 2017

MDMONTHLY.COM


RESEARCH & INNOVATION/HOUSTON

night. I also kept pills by my bedside table for pain, which woke me in the middle of the night,” she says. “I was in constant pain and had very little energy or zest for life. Life was not good.” Helen’s outlook began to change after her friend, Joyce Tucker, told her about her success with Celltex. Joyce had undergone two surgeries followed by weeks of therapy, but she still suffered from mobility issues and pain. After two years of working with six different orthopedic doctors, she was told her only option was to wear a brace and take pain medication. However, within three months of having adult stem cell therapy, Joyce was pain-free.

By the following Thursday, the pain caused by peripheral neuropathy had diminished and she decided to try sleeping without pain medication. “I didn’t want to take pain medication if I didn’t have to, so you can imagine my joy when I slept through the entire night pain free,” Helen shares. “I’m a new woman!”

WHEN I SAW THE CHANGE IN JOYCE, IT MOTIVATED ME TO LOOK INTO ADULT STEM CELL THERAPY FOR MYSELF. -

Helen Streaker

“When I saw the change in Joyce, it motivated me to look into adult stem cell therapy for myself,” says Helen of her friend’s improvements. “Deciding to have the therapy was one of the best decisions of my life.”

No longer taking pain medication, Helen reports more energy and no pain. A recent sleep study shows that she no longer has sleep apnea or restless leg syndrome, two major improvements in her quality of life.

Celltex obtained Helen’s MSCs through a single fat extraction, performed by a licensed physician, in a 30-minute outpatient procedure that required little to no recovery time.

“When you are in pain, you don’t function well because you can’t sleep. I am so thankful for the ability to sleep through the night and for the energy I have. I have also noticed that my balance has improved and I’m walking better. My family and friends have noticed and commented about it,” she says.

The MSCs are sent to the Celltex laboratory in Houston where they are isolated from the fat tissue, cultured and cryogenically banked in liquid nitrogen. The MSCs are safely stored in the United States at -300 degrees Fahrenheit in liquid nitrogen, for future use. Whenever a Celltex client is ready for therapy, the cells are removed from the bank, expanded to a therapeutic dosage and exported to Cancun, Mexico. In early 2016, Helen received a combination of intravenous and intralymphatic infusions containing hundreds of millions of her own adult stem cells. Helen received her first adult stem cell therapy on a Friday.

She reports her digestive tract works better, and she has had an increase in energy. Helen wakes up thinking, “What can I accomplish today?” Whereas before, she felt lethargic.

noticed other welcomed changes. “Before, I bruised very easily but recently I had dental surgery–which is usually followed by pain medication and bruising–but I didn’t need any pain medication and I was amazed to see that I had absolutely no bruising either. I am very grateful for all of the improvements I have experienced.” While stem cell therapy is not a cure, the regenerative benefits of adult stem cell therapy continue to help Helen in her daily life. “There is no cure for peripheral neuropathy; traditional medicine merely treats the symptoms and usually peripheral neuropathy gets progressively worse. People often get to the point that a wheelchair is necessary, not a pleasant prospect,” she says. “But here I am, no longer in pain. I walk better and my balance is significantly better. I certainly don’t feel my age.” Helen uses her newfound energy to spend time with friends and family, volunteer, travel and enjoy the arts. “Life is so much better for me. I would encourage everyone who has peripheral neuropathy, or any other condition that seriously diminishes their quality of life, to consider this therapy. It has given me back my life,” she shares with a smile. For more information visit celltexbank.com or call 713.590.1000. Celltex Therapeutics is located at 2401 Fountain View Dr., Suite 416 in Houston, TX 77057.

Friends have commented on changes in her physical appearance.“Some people ask if I’ve had plastic surgery!” she laughs. In addition to the noteworthy difference in her appearance after stem cell therapy, she says she has 2017 - JANUARYMD Monthly

55


BRINGING

Healthcare HOME

Dr. Saleh Jaafar and his compassionate team at MedCare Associates bring the hospital team to the patient By Rudy Arispe


L

ast September, when Rosalie Hallenberger’s 52-year-old son Carl lay dying from cancer in a hospital bed, two physicians from MedCare Associates tended to him regularly, night and day, while also comforting his mother. “Dr. Jaafar and his staff were a blessing to me and my husband,” she said. “They were there for us.” Incidentally, it was Carl who introduced his parents eight years ago to Dr. Saleh Jaafar, founder of MedCare Associates, and his team of family practice physicians, internists and nurse practitioners. Rosalie and her husband Charles have been patients of MedCare Associates ever since. Rosalie said she was ecstatic that the physicians of MedCare Associates, who were quite familiar with Carl and his medical history, were the ones 58

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JANUARY - 2017

administering to him at the hospital, rather than having a hospital physician be assigned to look after him. Having a “hospital team,” or hospitalists, from a private medical practice caring for their own patients at a hospital is what Dr. Jaafar proudly offers his patients.

I like being able to give hospice patients comfort, education and be an advocate for them. -Nurse Practitioner Rosslyn Blake “With healthcare in San Antonio, if a patient gets sick and ends up in the hospital, usually it is a hospital doctor who sees them,” said Dr. Jaafar. “With our group, we have our own hospital team, so our patients are seen by one of our own doctors. It’s one of the hallmarks of MedCare Associates, and we’re one of the few

practices in San Antonio to do this.”

and education, and to be an advocate for them.”

MedCare Associates, in essence, is unique in that the practice has its own clinic team, hospital team, nursing home team, rehab team and hospice care team, among others, Dr. Jaafar explained.

Dr. Jaafar’s idea of bringing a team of hospitalists to his MedCare Associate patients came to him after 10 years of seeing his patients in a hospital or clinic setting. “For the first 10 years of my practice, I did rounds on all my patients in the hospital before sunrise, so that I could go and be at the clinic all day,” he said. “I hated to surrender my patients to hospitalists who never met nor knew my patients. That is why I developed my own hospital team to care for MedCare patients—to keep a continuity of care for them.”

On a recent Wednesday morning, nurse practitioner Rosslyn Blake was driving to the Hill Country to see a hospice patient at his home. Blake, who has been with MedCare Associates for nine years, sees both hospice and nursing home patients throughout San Antonio, as well as in surrounding areas such as Kerrville and Pleasanton—“or wherever our patients are.” “My specialty is geriatric and family practice,” Blake shared. “I have always had an affinity for the elderly and vulnerable populations. I like being able to give hospice patients comfort

Dr. Jaafar and his staff were a blessing to me and my husband. -Rosalie Hallenberger He adds that his hospital team consists of four physicians and four physician’s assistants. PHOTOGRAPHS BY Jason Roberts

MDMONTHLY.COM


Founded in 1999, MedCare Associates has expanded to include six clinics: MedCare Associates of Stone Oak, Bandera Family Practice, MedCare Associates of Castroville, MedCare Associates of Boerne, Utopia Medical Clinic and Boerne Medical Clinic. Their services range from immunizations, EKGs, skin cancer removal, women’s health and wellness, and X-rays, to minor surgical procedures and physical examinations for children and adults, and pre-op examinations. Ever-evolving and improving, MedCare Associates has exciting plans for 2017, Dr. Jaafar said, and specifically noted that the practice plans to hire its own cardiology team, which would “create a full continuum of care” for their patients.

With our group, we have our own hospital team, so our patients are seen by one of our doctors. -Dr. Saleh Jaafar It is important to Dr. Jaafar that he and his physicians, physician’s assistants, and nurse practitioners are able to treat patients, not just in the city but in underserved rural areas as well, which is why his staff members, such as nurse Rosslyn Blake, will travel as far as Kerrville to see patients. His care

and concern for patients in rural counties stems from treating patients when he was the medical director of an emergency room in Hondo for five years in the late ’90s. “I never wanted to leave those patients,” Dr. Jaafar shared. “They have a lot of health deficiencies, and they are not able to see a doctor as easily patients who live in the city.” Dr. Jaafar also believes in giving back to the communities that MedCare Associates serve. His practice offers free services to patients of the Arthur Nagel Community Clinic in Bandera, which provides free, low-cost healthcare services to the residents of Bandera County who do not otherwise have access to medical care within the county. “We see patients who can’t afford to pay or who don’t have insurance,” he said. Founded by this benevolent practitioner with a heart of gold and dedication to serving patients with exceptional care and compassion, MedCare Associates, comprised of Dr. Jaafar and his fellow physicians, will continue to elevate the standard of quality care while bringing much needed healthcare to underserved communities. For more information visit medcare-associates.com.

GET TO KNOW YOUR DOCTOR:

Dr. Saleh Jaafar What was your first job? Dr. Jaafar: My first job was as the director of the emergency room for the Medina Community Hospital in Hondo. I would work 48 hour shifts with my two partners rotating in between my shifts. This job allowed me to develop my desire to continue my practice in rural areas that desperately need internists. As a result, in 1999, I opened two practices in Castroville and Bandera. A few years later, I opened a practice in Boerne, then Utopia and San Antonio. What would you do if you weren’t a doctor? Dr. Jaafar: I would most likely be a scientist or chemist. I have always been fascinated with these areas and can easily see myself in either field. What’s something about you that nobody knows? Dr. Jaafar: I am an avid hunter and fisherman. I spend most weekends on a boat or in the woods; these are my outlets and time to unwind. I always prepare the meat and fish from my trips by myself for my family's pleasure. What’s the best advice your parents gave you? Dr. Jaafar: I am from a family of 10 and my parents always have stressed the importance of family. I have always been told to take care of my siblings and place their needs before my own. I apply this principle in my life and make sure that my wife, kids, and the rest of my family are never in need of anything that I can provide. What did you enjoy most about medical school? Dr. Jaafar: My medical school experience involved traveling to various countries and throughout the U.S. to complete my schooling. It was a great experience training in other countries and learning about different cultures. I can now apply this experience to my practice as I better understand cultural variances. What’s your favorite childhood memory? Dr. Jaafar: The craziness of having nine brothers and sisters. There was never a dull moment in our home.

2017 - JANUARYMD Monthly

59


OP-ED/DALLAS-FORT WORTH

HOW THE

BOSTON MARATHON BOMBINGS CHANGED MY LIFE AS

A DOCTOR By Dr. Kevin Ju

A

s a young and curious child, I was always trying to figure out how things worked. When I was growing up in Houston, my parents, a computer programmer mom and a chemical engineer dad, encouraged my curiosity about how things worked. I spent a lot of time taking things, such as microwave ovens and lamps, apart and then putting them back together. In spite of having no doctors in my family, I was interested in biology and the human body at a very early age. I was fortunate 60

MD Monthly

enough to do some research at Baylor Hospital when I was in high school, and I was allowed to shadow a surgeon early on. This spurred my interest in medicine. I majored in biology at Stanford University in Palo Alto, California and wrote an honors thesis in neurobiology as an undergraduate. I later attended medical school at Harvard and then stayed in Boston for my residency training. My time in Boston was marked by a tragic event that forever changed the way I perceive the world around me.

The Boston Marathon Bombing On the morning of April 15th, 2013, both visitors and Bostonians alike were excited about participating in and watching the 117th Annual Boston Marathon. No one could guess the extent of the tragedy that was to follow. For me, it was another day of residency training at Boston Children’s Hospital. I was on call in the emergency room. Three years later, I still remember how difficult this experience was and how it made me a better doctor.

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OP-ED/DALLAS-FORT WORTH

The hardest thing any doctor has to do is triage emergency patients in a trauma setting. You are forced to make difficult decisions. When the Boston Marathon bombing occurred, this was the most difficult time I ever experienced.

WE HAD TO MAKE DECISIONS ABOUT WHICH SON OR DAUGHTER WE WERE GOING TO GET INTO THE OR FIRST, AND WHICH PATIENTS MIGHT BE ABLE TO WAIT ANOTHER 30 MINUTES. We had many children coming to our emergency room who had been badly injured by the bombs, but there was a limited number of surgeons and operating rooms available to treat them. We had to make decisions about which son or daughter we were going to get into the OR first, and which patients might be able to wait another 30 minutes. Those decisions are never easy, but sometimes you have to make them. Fortunately, we were able to get all of the patients in the operating room treated appropriately and properly. However, going through it was extremely stressful. This traumatic experience changed me. I realized the fragility of human life, and how important it is for a surgeon to remain clear-headed and focused on the job at hand, regardless of the chaos that might be swirling about. The Texas Back Institute became my clear next step. We treat any spinal condition, no matter how big or small the problem. Besides excelling clinically, the Texas Back Institute has an impressive

reputation for research and education. I got involved in basic scientific research early on, and I started doing medical research and teaching when I was at Harvard Medical School. Joining the Texas Back Institute not only allows me to continue to advance in the field of spine surgery with the Texas Back Institute Foundation, but their fellowship program allows me to train the next generation of spine surgeons. I have been fortunate to have had many excellent teachers and through this fellowship program, I can pass this knowledge along to the next generation. A Conservative Medical Philosophy My philosophy is to closely listen to my patients to understand how their symptoms are impacting their lives. Not everyone with the same symptoms should get the same treatment. It should be individualized to each patient based on their goals. I am also not afraid to spend the time to explain the diagnosis and the process for treatment. I want to make sure they get the answers to all of their questions. I believe that if patients understand the treatment and agree that this is the best approach, better outcomes result. Finally, I am a conservative surgeon. I am a firm believer in trying all other modalities, whether it’s highly targeted physical therapy or medications, before prescribing surgery. Surgery should be a last resort, but if it is necessary, my approach would be to craft the surgery to be minimally invasive with the least disruption possible for the patient. For more information visit www.texasback.com or call 1.800.247.2225.

About Dr. Kevin Ju: Dr. Ju’s academic career includes a bachelor’s of science degree from Stanford University, where he graduated with University Distinction as well as Honors in Neurobiology, and he received the J.E. Wallace Sterling Award for Scholastic Achievement. This was followed by high honors in all coursework and rotations at Harvard Medical School, where he earned his medical degree in 2010. He completed his residency training at the Harvard Combined Orthopedic Residency Program at Massachusetts General Hospital, and then he received additional fellowship training in spine surgery with the internationally recognized surgeons at the Emory University Spine Center. Dr. Ju has trained with both orthopedic surgeons and neurosurgeons, and he specializes in conditions of the neck and back, such as cervical, thoracic and lumbar spine issues. He is a member of many professional organizations dedicated to the promotion and maintenance of high medical standards and continuing education, including the North American Spine Society, the international AOSpine society and the American Academy of Orthopedic Surgeons. Dr. Ju has authored numerous peer-reviewed publications and instructional book chapters in the field of spine surgery, and he has presented at more than a dozen national and international spine conferences. Dr. Ju enjoys outdoor activities in his spare time including scuba diving, skiing, sailing and archery. Dr. Ju also enjoys technology, gadgets and is conversational in Mandarin Chinese.

2017 - JANUARYMD Monthly

61


OP-ED/AUSTIN

21ST CENTURY CURES ACT:

Stem Cell Patients MADE A DIFFERENCE

By SammyJo Wilkinson, Jennifer Ziegler and Tracy Thompson

T

he 21st Century Cures Act was passed by both the House and Senate with huge bipartisan majorities, and it was signed by President Obama on December 13th. The aim is to speed development of and access to new therapies. A section of the legislation addresses regenerative medicine, including $30 million in funding. The focus on accelerated approval will allow these therapies to reach

approval and insurance coverage more quickly. Patients For Stem Cells (PFSC), as a grassroots group, has been working for the past five years to ensure cellular therapy becomes more accessible to patients. We asked our thousands of followers to urge their representatives to include cellular therapy in the act, and lawmakers listened. Provisions were included in the act to encourage ongoing input from patients on the implementation of the act. Our continued focus will be to make sure patient input reaches the government agencies and regulators who will be implementing the act. Patient Voices Sarah Hughes met with her Texas Representative Pete Olson, who recounted her story on the House

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floor. He was visibly moved by her courageous lifelong battle with idiopathic systemic juvenile arthritis, which left her near death at 22-yearsold. Her own adult stem cells, expanded to reach a therapeutic dose by Celltex Therapeutics, put her disease into remission and allowed her to recover and enjoy a normal life. Sarah and her mother also testified at the FDA hearing on stem cells in September 2016.

I BELIEVE WE AS PATIENTS ARE ENTERING A NEW ERA OF OPPORTUNITY TO HAVE OUR VOICES HEARD. - Doug Oliver, founder the Regenerative Outcomes Foundation

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MDMONTHLY.COM


OP-ED/AUSTIN

Doug Oliver played a key role in ensuring regenerative medicine was included in the legislation. He regained his vision, after 10 years of blindness due to macular degeneration, thanks to his own stem cells. Doug’s story has reached millions through interviews with the national press and countless affiliate television and news media outlets. The news reached Tennessee Senator Lamar Alexander, who invited Doug to Washington D.C to help craft the legislation. Doug has a master’s degree in social work, extensive career experience in medical social work, compliance consulting and clinical case advocacy. Combined with his personal patient experience, this made him uniquely suited to advise Congress to boost funding, initiate regulatory reform and solicit ongoing patient input. Bernard Siegel, Founder of the World Stem Cell Summit, is pictured on the right with Doug. Bernard invited him to speak at four sessions at the conference, where he was well received by those in the industry.

Doug summed up his vision, stating: “I believe we as patients are entering a new era of opportunity to have our voices heard. The opportunity is right for patient advocates to consider a strategy to take advantage of what appears to be heightened interest in, and receptiveness to, patient input as true stakeholders. The Cures Act provides a mandate for this type of policy shift.” He believes it’s time to work together with the FDA. He hopes both patients and regulators will benefit by this new strategy, and reach mutual goals of safety, efficacy and access to treatments as soon as possible. His suggestions comes from discussions with top FDA officials. Recognizing that stem cell clinics need to self-regulate in participation with policy makers if they are to best serve patients, The Cures Act provides an incentive for that to happen. To further his work for “everything patients,” Doug has founded the Regenerative Outcomes Foundation, a 501(c)3 nonprofit offering stem cell clinics guidance in ethics, continuum of care, promotion and methods for optimizing patient outcomes. The first course will be offered March 8th-10th 2017 at Belmont University in Tennessee. Presenters include industry experts, as well as patients. SammyJo Wilkinson, one of the founding members of PFSC, said

“I was honored by Doug Oliver's request to speak about my stem cell patient experience. He has initiated so many positive changes, that now I feel we can roll up our sleeves and go to work on making this life-saving therapy more widely available.”

HE [DOUG OLIVER] HAS INITIATED SO MANY POSITIVE CHANGES, THAT NOW I FEEL WE CAN ROLL UP OUR SLEEVES AND GO TO WORK ON MAKING THIS LIFE-SAVING THERAPY MORE WIDELY AVAILABLE.

- SammyJo Wilkinson Patient advocacy remains Doug's core focus. He moderates Vision Quest Advocacy Network for patients who wish to learn about cellular therapy for eye diseases. To ensure the patient engagement provisions of the Cures Act get implemented, he will be launching surveys seeking input from all of us on what we want to see happen with the new stem cell legislation. PFSC subscribers interested in stem cell therapy will be kept informed on how to participate in this historic endeavor. For more information visit patientsforstemcells.org.

2017 - JANUARYMD Monthly

63


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MD Monthly- January 2017 San Antonio  
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