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March/April December 2020 2009 >> >> $5 $5 LETTER FROM THE PUBLISHER

Thank you! In this age of COVID-19, healthcare providers are front line warriors of this invisible war by caring for, comforting and reassuring

UAMS Researchers Publish Studies to Prevent Heart Damage from Chemo

More research needs to be done on the animal model before starting human drug trials By BECKY GILLETTE

us in the face of fear. As I observe our providers going about their work in this lightning-speed changing environment, I have even more respect and admiration for their dedication and determination to carry on, especially while also subjecting themselves to the dangers of COVID-19. Arkansas Medical News

One of the greatest risk factors for cancer is age. People who live longer are more likely to get cancer. Unfortunately, some undergo chemotherapy and win the battle against cancer, only to die from heart-related damage resulting from cancer treatment. That tragic outcome is one reason why there is excitement about recent research at the University of Arkansas for Medical Sciences (UAMS) showing promise for using the muscle-relaxant drug Dantrolene to prevent damage caused by the chemotherapy drug Doxorubicin. The UAMS team led by cancer researcher Valentina Todorova, PhD, published the findings in a research paper published in the February 2020 issue of the scientific journal Translational Oncology titled, “Dantrolene Attenuates Cardiotoxicity of Doxorubicin Without Reducing its Antitumor Efficacy in a Breast Cancer Model.” (CONTINUED ON PAGE 5)

Valentina Todorova

expresses tremendous


gratitude for the healthcare community’s

Focusing on Now, While Looking Ahead

expertise, flexibility, and most importantly, sacrifice. Pamela Z. Haskins Publisher

Mercy’s Steve Goss, MD, is bringing more providers, services to patients in Northwest Arkansas By MELANIE KILGORE-HILL

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Steve Goss



Meeting the needs of patients in the fastest growing part of the state is no small feat, but it’s one Steve Goss, MD, is committed to. Today, the president of Mercy Clinic of Northwest Arkansas is leading a network of

260 providers while bringing innovation and services to families and employers in Northwest Arkansas.

The road to medicine

A native of Pine Bluff, Arkansas, Goss’s


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Complex Neurosurgery Yesterday, Discharge Tomorrow Neurosurgeon Ali Krisht, MD, cites remarkable progress improving outcomes Ali Krisht, MD, director and lead neurosurgeon at CHI St. Vincent’s Arkansas Neuroscience Institute, is internationally known for his work including delivering more than 170 presentations and lectures around the world. He is chief editor of the journal Contemporary Neurosurgery, and rated among the top one percent of all neurosurgeons in the U.S. by the ratings firm Castle Connolly. In addition to all those achievements, Krisht is quick to give credit to others for the quantum leap seen regarding outcomes from neurosurgery in the past 40-50 years. “At one time in neurosurgery, 50 percent of the patients used to die or not do well. One of my mentors, Professor M.G. Yasargil, MD, with whom I worked here in Arkansas for 15 years, had a different understanding of the anatomy and how to navigate brain space. He converted that to 85–90 percent positive outcomes. Today, we can conduct complex surgeries, and



the patient will be out of the hospital in two days after an 18 to 19-hour surgery.” Krisht said Yasargil’s work created a domino effect for more advances. Now, in the neurosciences, one of the biggest advantages is being able to see the brain and

identify many of the pathologies without opening the skull. “With CT scans and now MRI, we are really able to get a lot of information and pinpoint almost exactly what kind of tumor it is, how you navigate getting to it

safely and follow it closely,” Krisht said. “Still, the advances are minute compared to our ignorance about how the brain functions and how diseases occur. We still are in the dark on how the brain connects, how the brain functions, the environment of the brain and so forth. “The difference between it and the rest of the body is like the difference between the oceans and the lands. With the liver, the kidneys and the stomach, there are different geographies where you can go from one place to another and you have more understanding of how they connect and how they function. The brain is more like an ocean. Wherever you dive, it’s still going to be a deep dive before you get some information, and there’s a lot of ocean to explore.” Neurosurgery used to be considered a last resort because of risks of death or poor outcomes. But today, neurosurgery is extremely safe. “In the majority of my cases now, there is less than a one percent chance (CONTINUED ON PAGE 8)


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Surging Health Care Worker Quarantines Raise Concerns as Coronavirus Spreads By JENNY GOLD

As the U.S. battles to limit the spread of the highly contagious new coronavirus, the number of health care workers ordered to self-quarantine because of potential exposure to an infected patient is rising at an exponential pace. In Vacaville, California, alone, one case — the first documented instance of community transmission in the U.S. — left more than 200 hospital workers under quarantine and unable to work for weeks. Across California, dozens more health care workers have been ordered home because of possible contagion in response to more than 80 confirmed cases as of Sunday afternoon. In Kirkland, Washington, more than a quarter of the city’s fire department was quarantined after exposure to a handful of infected patients at the Life Care Center nursing home. With the number of confirmed COVID-19 cases mushrooming by the day, a quarantine response of this magnitude would quickly leave the health care system short-staffed and overwhelmed. The situation has prompted debate in the health care community about just what standards medical facilities should use before ordering workers quarantined —

and what safety protocols need to become commonplace in clinics and emergency rooms. Dr. Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, is among those arguing hospitals need to change course. “It’s just not sustainable to think that every time a health care worker is exposed they have to be quarantined for 14 days. We’d run out of health care workers,”

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Nuzzo said. Anyone showing signs of infection should stay home, she added, but providers who may have been exposed but are not symptomatic should not necessarily be excluded from work. The correct response, she and others said, comes down to a careful balance of the evolving science with the need to maintain a functioning health care system. While hospitals are supposed to be prepared for just such a situation, Nuzzo said, their plans often fall short. “Absent any imminent public health crisis, it may not be one of their priorities,” she said. From 2003 to 2019, federal funding for the Hospital Preparedness Program in the U.S. was cut almost in half. In Northern California, potential exposure to the new coronavirus was exacerbated because hospitals were caught unaware by the community spread of the virus and hampered by federal protocols that initially limited diagnostic testing to patients with a history of travel to a country where the virus was known to be circulating or contact with a person with a known infection. “At the very beginning [of an outbreak] this will happen because you don’t know patients are infected and you only realize later that people were exposed,” said Grzegorz Rempala, a mathematician at the College of Public Health at Ohio State University who models the spread of infectious diseases. Now that the disease has started to spread through the community, any patient with respiratory symptoms potentially could be infected, though health officials note the likelihood remains low. As providers start routinely wearing protective gear and employing strict safety protocols, accidental exposure should decline. The Vacaville case offers stark insight into the fallout from the narrow testing protocols initially established by the Centers for Disease Control and Prevention. When a woman was admitted to NorthBay VacaValley Hospital with respiratory symptoms on Feb. 15, dozens of hospital

workers walked in and out of her room performing daily tasks. Days later, as her condition worsened, she was sent to UC Davis Medical Center, where dozens more employees were potentially exposed. Because the woman did not meet the testing criteria in place at the time, it took days for UC Davis to get approval to have her assessed for the coronavirus. After the test came back positive, about 100 NorthBay workers were sent into self-quarantine for 14 days. At UC Davis, an additional 36 nurses and 88 other employees were quarantined, according to the unions representing those workers. (A spokesman for UC Davis said the figures were not accurate but declined to give an estimate.) “We’re not used to being concerned, before we even do the triage assessment, [about] whether the patient is infectious and could infect hospital workers,” said Dr. Kristi Koenig, the EMS medical director of San Diego County. She said that thinking started to evolve during the 2014 Ebola outbreak. Hospitals should routinely mask patients who come in with respiratory symptoms, she said, given any such patient could have an infectious disease such as tuberculosis. Yet providers don’t often think in those terms. “In many ways we’re spoiled because we’ve gone from a society 50 or 100 years ago where the major killers were infectious disease,” said Dr. Michael Wilkes, a professor at UC Davis School of Medicine. “Now we’ve become complacent because the major killers are heart disease and diabetes.” Faced with this new infection risk, many hospitals are scrambling to retrain workers in safety precautions, such as how to correctly don and doff personal protective equipment. Sutter Health, which has 24 hospitals in Northern California, started ramping up its emergency management system five weeks ago in preparation for COVID-19. Before coming to the emergency room, Sutter patients are asked to call a hotline to be assessed by a nurse or an automated system designed to screen for symptoms of the virus. Those with likely symptoms are guided to a telemedicine appointment unless they need to be admitted to a hospital. Anyone arriving at a Sutter emergency room with signs of a respiratory infection is given a mask and sequestered. “A runny nose and a cough doesn’t tell you much. It could be a cold, it could be a flu, and in this weather it could be allergies,” said Dr. Bill Isenberg, Sutter’s chief quality and safety officer. A doctor or nurse in protective equipment — including N95 mask, gown and goggles — is deployed to assess the patient’s symptoms. If COVID-19 is suspected, the patient is moved into a private room. Sutter has treated several coronavirus patients who arrived from Travis Air Force Base, which housed evacuees from (CONTINUED ON PAGE 9)



UAMS Researchers Publish Studies to Prevent Heart Damage, continued from page 1 Todorova, an assistant professor in the UAMS College of Medicine, Department of Internal Medicine, said the side effects from cancer treatments can appear during treatment, after treatment or sometimes many years later. “We are looking at new ways to prevent this damage from occurring, specifically in breast cancer patients,” said Todorova, who has been a cancer researcher for 20 years and has been involved with publishing approximately 50 studies. “Typically, the damage starts as cardiomyopathy, which makes it harder for the heart to pump blood. This can then lead to congestive heart failure.” Doxorubicin is the most common and widely-used chemotherapy drug. In addition to breast cancer, Doxorubicin is commonly used alone or in combination with other drugs to treat many other types of cancer including bladder cancer, stomach cancer, colon cancer, Hodgkin and non-Hodgkin lymphoma, leukemia and others types of cancer. Todorova said the preliminary study that looked at the combination of Doxorubicin and Dantrolene in rats is very promising, but a lot more research is needed before clinical trials start in humans. The main action of Dantrolene is to reduce the abnormal calcium concentration in the muscle cells induced by Doxorubicin. Dantrolene also reduces oxidative stress associated with Doxorubicin treatment. “There is a long road ahead to use Dantrolene to potentially reduce or prevent heart damage,” Todorova said. Todorova gave a lot of credit for the work to teamwork between clinicians and scientists at UAMS. “It is a big team,” she said. One of those team members is Jeanne Y. Wei, MD, PhD, UAMS Jackson T. Stephens Professor of Geriatrics and executive director of the Reynolds Institute on Aging. Wei said one reason the research into reducing heartrelated impacts from chemotherapy is the older a patient is, the Jeanne Y. Wei more likely the patient is to have experienced cancer. And a treatment that cures one type of cancer might make the patient subsequently at a higher risk for second, different cancer. Wei said other organs besides the heart can be harmed from chemotherapy. “In this case we are interested in trying to ameliorate heart damage following chemotherapy and\or radiation in older patients, especially those with breast cancer,” Wei said, a board-certified cardiologist. “Older women who get Doxorubicin treatment have a four-fold higher risk of dying from heart disease because of agerelated changes and sustained damage to heart tissue. Up until now, there have not been many promising ways to treat them. To confound this difficulty, we didn’t have a way to predict who might or might not be able to tolerate some of these effective arkansasmedicalnews


chemo drugs.” Since the impacts sometimes may not manifest for ten to 20 years, even children treated with chemotherapy might later experience heart failure. “That doesn’t mean it is fatal, but the heart has more difficulty keeping up with increased demand such as what occurs with fever or other acute illnesses,” Wei said. “The likelihood of sustaining heart failure – the inability of the heart to keep up with demand – is much higher with people who have had chemotherapy because of the drug’s select effect on muscles. It damages the mito-

chondria so severely that it causes total havoc in the muscle cell. We hope in the future that by reducing the damage, even a little, that it will go a long way in protecting patients.” Wei said more research needs to be done on the animal model before starting drug trials with people. “People who take new treatments that come to the market too soon may sometimes end up on the back end with a lot of complications,” Wei said. “We just want to be careful and understand the correct dosage and be sure that there aren’t other undesirable side effects.”

This research was funded in part by the Arkansas Breast Cancer Research Project established in 1997 by the Arkansas General Assembly to research the cause, cure, treatment, early detection and prevention of breast cancer. Additional UAMS authors on the paper are Eric R. Siegel, MS, Department of Biostatistics; Yihong Kaufmann, PhD, Department of Surgery; Asangi Kumarapeli, MD, PhD, Department of Pathology; Issam Makhoul, MD, Department of Internal Medicine; and V. Suzanne Klimberg, MD, PhD, and Aaron Owen, both formerly of UAMS.

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Medical Real Estate Projects Exp Conway Regional Medical Office Building

Center to be dedicated primarily to Women’s Health LOCATION: Conway | PROJECT COST/SIZE: $13 million/42,530 SF | COMPLETION DATE: Fall, 2020

St. Bernards Surgical and Intensive Care Tower

New tower serves as gateway to advanced surgical and ICU suites LOCATION: Jonesboro | PROJECT COST/SIZE: $103 million/245,000 SF | COMPLETED: December, 2019






pand Patient Access in Arkansas Premier Medical Plaza

Retail conversion to medical, clinical and surgical facilities LOCATION: Little Rock | PROJECT COST/SIZE: $35 million/100,000 SF | COMPLETION DATE: Fall, 2019

Arkansas Heart Hospital’s Encore Medical Center

Full-service hospital providing innovative cardiac care LOCATION: Bryant | PROJECT COST/SIZE: $55 million/87,985 SF | COMPLETION DATE: FALL, 2020






Focusing on Now, While Looking Ahead, continued from page 1 first exposure to medicine was veterinary care. “Growing up I was always interested in sciences, and as a kid thought I’d be a chemist,” he said. “But we also lived on a small farm and took care of lots of animals, and I became interested in their care along the way.” Goss soon grew interested in caring for people, and attended Ouachita Baptist University before earning his medical degree from the University of Arkansas for Medical Sciences in Little Rock, where he also completed his residency training in internal medicine and pediatrics. In 1987 the young physician arrived in Bentonville and joined St. Mary’s Hospital, which was acquired by St. Louis-based Sisters of Mercy Health System in 1995. Following years of private practice and service on hospital leadership and advisory boards, Goss made the move to executive leadership in 2003, providing oversight to the system’s 40-plus providers. Today, he oversees a network of more than 260 providers across Mercy Northwest Arkansas.

Building a legacy

“I’m thrilled to have had the chance to take care of people, but part of the reason I accepted this role was the opportunity to affect more people in a region where I couldn’t do that one-on-one,” said Goss, who still sees patients one day a week at Mercy Clinic Primary Care Moberly Lane. “In recruiting physicians I can take pride in knowing many more patients are being cared for in a spirit that aligns with my own faith. Being a part of building this integrated group has been a privilege and a joy.” He attributes his success – and the system’s growth – to the commitment of coworkers and providers to Mercy’s Christ-centered mission. “It’s something that attracted them to work for us,” he said. “We’re not perfect, but we

hear from patients in and out of our facilities that they can feel that difference because it’s what we’re all about. How and why we do what we do is a distinguishing factor because of our collective culture.”

Rising to the challenge

Goss said the region’s rapid growth has presented a unique challenge to the medical community in both recruitment and reimbursement. “Arkansas’s Medicare reimbursement rate is the lowest in the country,” he explained. “We’ve learned to be pretty lean along the way, but have delivered on great quality metrics at the same time. Trying to do that in a region that’s growing so rapidly puts even more pressure on a system when you start adding providers and equipment. It can be a real conundrum, but we also have a productive group of providers and we pride ourselves on working hard, paying close attention to cost and trying to be proactive in getting out in front of things and not swept over by them. We’re always pressing ourselves to do things differently.” For Mercy, doing things differently includes a focus on virtual care and risk-based contacts – both proven to bolster outcomes as well as reimbursement. Currently, 40 percent of the system’s income is generated by risk-based contracts, making Mercy health system the largest ACO provider in the country. The proactive population health focus adopted by today’s accountable care organizations means patients are more likely to receive preventive care screenings like mammograms, colonoscopies and blood pressure and cholesterol checks. Goss said the collective approach to patient care also means providers are thinking beyond the doctor’s office. “We’re more interested now in how well people are doing outside of the clinic,” he


Arkansas’ diverse healthcare offerings impact the industry on a local, regional and national basis. Knowing who is ‘in charge’ is important to fostering relationships and partnerships to keep this vital industry moving forward. Each April, Arkansas Medical News provides a definitive list of leaders in the annual Arkansas Medical InCharge Healthcare issue, which is News HEALT formatted as a glossy, four-color magazine. H



CARE 2019

InCharge showcases a wide range of difference-makers, including:

 Hospital, health system and large practice leaders

 Top researchers and academic leaders  Go-to healthcare advisors including the top healthcare attorneys, bankers, accountants and consultants  Key healthcare investors and entrepreneurs  And other leaders … including some working behind the scenes …  who continue to grow Arkansas’ multi-billion dollar industry.





Matt Tro up, CE O Conway Region al

Cam Pa tte Chancel rson,

lor Universit y of Medical Arkansas for Scienc es

Beverly Nix Sto ne, CE St. Ber O nar Associ ds Healthcar ate e Provid d Regional ers (SH ARP)

Adam Head, CEO CARTI

? Larry Sh ackleford , CEO

Washingt on Reg ional

List of 200 Ex ecutives Bendin g the Cu rve in Arkans as Heal thcare

said. “Population health is trying to align all those things much better by paying attention to what’s happening at home. These ACO contracts are a way to increase reimbursement while working in that direction.”

Looking forward

Mercy Northwest Arkansas also is exploring the future of artificial intelligence and robotics, which Goss considers instrumental in the face of a looming healthcare workforce shortage. “There’s an estimate that by 2030, 30 percent of clinical roles will be vacant because of a lack of workforce,” he said. “We’re working hard to try to solve for getting work done, and technology has to be a large part of that solution.” Mercy’s internal medicine residency training program through UAMS is another notable accomplishment, said Goss. The program graduated its first class in 2019, and

Goss looks forward to continued growth through UAMS and partnerships with the Northwest Arkansas Council. He also hopes to address a regional shortage of specialty providers, but recognizes the answer lies beyond one system. “We may have to solve some of those challenges regionally, and work together to provide a great specialty service that’s not owned by any one clinic,” he said. Looking forward, Goss hopes to optimize the system’s growth by building on their 5-star CMS rating and recent ranking as a Top 100 Hospital by IBM Watson Health. “Staying on top of our game doesn’t came easy and it can slip away if we’re not paying attention,” he said. “Everything we do is about delivering quality patient care with compassion, and that’s more than words on paper to us. We’re always looking for likeminded providers because our mission is the core of patient care, and we’re committed to staying true to our values.”

Complex Neurosurgery Yesterday, Discharge Tomorrow, continued from page 3 of major problems like stroke, paralysis, coma or anything like that from surgery,” Krisht said. “This is even less risky than being in a car driving on the road. That is really important for people to know. People should not fear when they have the right surgeon with the right experience and the right knowledge.” Sometimes people are told their condition is non-operable or cannot be treated, but Krisht said there are centers like the Arkansas Neuroscience Institute at CHI St. Vincent where they tackle the non-operable and untreatable because they are not going to give up on patients. “Difficulty doesn’t exist and impossible doesn’t exist,” he said. “Ignorance exists. We can conquer a lot of things if we overcome our own ignorance about it. There are a lot of bright minds we have to invest in, and I’m sure we’ll make more progress.” Strokes are the fifth most common cause of death in the U.S., and a leading cause of disability. Stroke treatments have revolutionized stroke survival and recovery with the impact most felt in those who get care quickly. “If we can catch a patient within an hour or two or three, there is much that can be done today,” Krisht said. “If they have a small clot in the brain, you can give them medications that will start to break it down so the extent of the stroke is not as significant. Recently we reached a serious advancement in cases where you encounter a big clot like those that usually come from the heart in patients who have cardiac arrhythmias and are prone to developing clots in their heart, and they throw the clots up stream. We can now take them to the angio suite where we use a catheter to go and fish the clot out and reestablish blood flow.” A brain cath is similar to a heart cath. Krisht said you may not salvage every area that was affected, but you will end up

going from somebody who is completely paralyzed and unable to talk, to somebody who may have residual weakness, but can still walk and talk. “It is a remarkable improvement,” Krisht said. “What needs to be married to it is the social and maybe governmental input to enhance the process of getting these patients to the proper care quickly. Most people don’t want to believe they’re having a stroke. They’ll say, ‘My arm is numb and it feels heavy, but maybe I’m just tired.’ If they sit on it for another twoto-three hours, their condition will deteriorate to where it becomes an irreversible injury.” Krisht was born in Nigeria to Lebanese parents. His father had moved to Nigeria to get into the peanut business. Krisht returned to Lebanon for boarding school and later went on to medical school at the American University in Beirut. He completed his surgical residency training at Emory University in Atlanta and moved to Little Rock in 1994 for the opportunity to work with two men who would become his mentors, Yasargil and Ossama AlMefty, whom Krisht considered two of the most talented neurosurgeons in the world. Initially he planned a career as a professional soccer player. A complex fracture in his leg sidelined him from the game he loved, and required him to go through five operations in a year. While he recovered, it wasn’t enough to play soccer professionally. That is when he started thinking of medicine. He was interested in philosophy and psychology, which are related to the brain and the nervous system. He decided on surgery because it is more active than other options. “As an athlete, I like to wake up in the morning and be active,” he said. “I also like to paint and do a little sculpture, and I felt like you could apply the arts perspective along with the surgery, and it was a combination of all these things together.” ARKANSASMEDICALNEWS


Surging Health Care Worker Quarantines Raise Concerns, continued from page 4 the Diamond Princess cruise ship quarantined off the coast of Japan after an outbreak was detected on board. The Sutter patients were placed in negative pressure rooms so that contaminated air did not circulate to the rest of the hospital, and staff used an anteroom to take off gowns and masks. “We do everything humanly possible to minimize the number of people who have to enter [the room],” Isenberg said. Still, he said, some workers have been quarantined; Sutter would not disclose the total. Not all hospitals are adapting so quickly. National Nurses United, a union representing more than 150,000 nurses, recently held a news conference to call on hospitals to better protect their workers. Of the 6,500 nurses who participated in a survey the union circulated, fewer than half said they had gotten instruction in how to recognize and respond to possible cases of COVID-19. Just 30% said their employer has sufficient protective equipment on hand to protect staff if there were a surge in infected patients. As the virus continues to spread, hospitals should be stockpiling such equipment, figuring out how to add beds and planning for staffing shortages, said Dr. Richard Waldhorn, a professor of medicine at Georgetown University and contributing scholar at Johns Hopkins who

recently co-authored recommendations for hospitals on how to prepare for a COVID-19 pandemic. Hospitals should already be training providers to take on expanded duties, Waldhorn said. If a hospital becomes overwhelmed, the Medical Reserve Corps can be mobilized, as can networks of providers who have volunteered to aid in emergency situations. Once workers have been infected and recover, it might make sense to have them treat other coronavirus patients since they will have immunity. Eventually, as a disease becomes widespread, quarantine simply stops being a priority, said Nina Fefferman, a mathematician and epidemiologist at the University of Tennessee-Knoxville. “There’s a point where we stop trying to quarantine anyone and we just say, OK, we’re going to have more deaths from the fire department not being able to fight fire than from everyone getting the disease.” Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

GrandRounds GastroArkansas to Join GI Alliance

Major Spring Conferences in Arkansas

LITTLE ROCK - GastroArkansas, founded in Little Rock more than 40 years ago, has been selected to join GI Alliance, the nation’s largest independent gastroenterology services organization. The partnership is the first of its kind in Arkansas and focused primarily on quality of care for patients. GI Alliance is a physician-led GI services organization supporting the needs of more than 315 independent gastroenterologists operating in Texas, Louisiana, Illinois, Arizona, Indiana, and now Arkansas. GastroArkansas was the first multi-physician gastroenterology practice established in Arkansas and is the largest independent group in the state. GastroArkansas will continue to provide high-quality care in an independent manner while serving as a leader in gastroenterology care and working with other practices in Arkansas to establish the same level of care. Together GastroArkansas and the GI Alliance plan to raise the standard of care patients receive in all areas of the state.

(Subject to postponement) Arkansas Nurse Practitioners Association 5th Annual Spring Conference Statehouse Convention Center April 17 & 18, 2020 Arkansas Medical Group Management Assn 2020 Annual Conference Crown Plaza Little Rock April 29 & 30, 2020 Arkansas Medical Society 2020 Annual Meeting Doubletree Hotel Little Rock May 1, 2020

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GrandRounds Dr. Keith Norvill Joins CHI St. Vincent Neurosurgery Clinic in Hot Springs HOT SPRINGS - Dr. Keith Allen Norvill has joined the team of neurosurgeons at the CHI St. Vincent Neurosurgery Clinic in Hot Springs, Arkansas. Dr. Norvill brings more than 20 years of experience in the field, including 19 years of service Keith Allen with the United States Norvill Army Reserve Medical Corps. Dr. Norvill joins CHI St. Vincent from Dane Street, a national independent medical evaluation and peer review organization in Boston. He previously served eight years as a physician in Colorado at Parkview Medical Center in Pueblo and Centura Health in Colorado Springs. Dr. Norvill began his career as a neurosurgeon with Neurocare Network in Nacogdoches, Texas. After attending medical school at the Kirksville College of Osteopathic Medicine in Kirksville, Missouri, Dr. Norvill completed his post-graduate training at Texas College of Osteopathic Medicine in Fort Worth, Hermann Hospital in Houston and Doctor’s Hospital in Columbus, Ohio. Dr. Norvill is now seeing patients at the CHI St. Vincent Neurosurgery Clinic in Hot Springs located at 1 Mercy Lane, Suite 502, offering the most advanced care to patients with diseases of the brain, spinal cord, peripheral nerves or muscles. To schedule an appointment with Dr. Norvill, call 501.321.1329.

Rick Fleetwood Retires from Snell Prosthetics & Orthotics LITTLE ROCK – Snell Prosthetics & Orthotics announced that Rick Fleetwood, the company’s CEO, has retired. The company’s owner Frank Snell, CPO, LPO, FAAOP will continue to serve as president and will assume the CEO position upon FleetFrank Snell wood’s retirement. Fleetwood joined the 109-year-old company in 1975 where he first served as general manager of the company’s Little Rock office. He was promoted to CEO in 2000, and during his tenure has helped oversee the expansion of the company from one single central location to a company with ten locations across the state of Arkansas. During Fleetwood’s tenure, he has played a critical role in helping the company adapt to significant changes in certain areas of the industry including reimbursement, regulation, compliance, educational requirements and state licensure. At the time Fleetwood joined Snell Prosthetics & Orthotics (then known as Snell’s Limb & Brace Company) computers didn’t exist in




the office, and most O&P devices were still being fabricated from decades old methods. Snell Prosthetics & Orthotics has offices in Little Rock, Russellville, Fort Smith, Mountain Home, Pine Bluff, Fayetteville, North Little Rock, Hot Springs, Conway and Bryant.

CHI St. Vincent Appoints Nisa Trenthem as Director for Emergency Department LITTLE ROCK - CHI St. Vincent Infirmary has appointed Nisa Trenthem as Director of the Emergency Department in Little Rock. Trenthem, a nurse with more than a decade of professional experience, has served as Director of Education and Nursing Excellence since July Nisa Trenthem 2017. She will continue to serve in that capacity, while providing operational leadership for the Infirmary’s Emergency Department. Trenthem previously served as Assistant Director of Nursing at the University of Arkansas for Medical Sciences and Supervisor of the Intensive Care Unit, Cath Lab and Interventional Radiology at Baptist Health Medical Center. She received a Bachelor of Science Degree in Registered Nursing from the University of Arkansas at Little Rock and a Master’s Degree in Nursing Administration and Nursing Education from UAMS.

Bright Promoted to VP of Operations at NARMC HARRISON - North Arkansas Regional Medical Center (NARMC) is proud to announce that Josh Bright, PharmD, has been promoted to the Vice President of Operations for the medical center. He has been with NARMC since 2011 and recently Josh Bright served as the Director of Pharmacy. Dr. Bright serves on the Board of Directors for the North Arkansas Partnership for Healthcare Education (NAPHE) and currently is a member of Arkansas Chamber of Commerce’s Leadership Arkansas Class XIV. He is an Apexus Certified 340B Expert and also serves on the Board of Directors for the Arkansas Association of Health System Pharmacists as Chairperson of the Programs and Education Council. A native of Jasper, AR, he graduated Magna Cum Laude with a BS in Chemistry at Arkansas Tech University and received his Doctor of Pharmacy from the University of Arkansas for Medical Sciences in Little Rock. He is an active member of the American Society of Health-Systems Pharmacists, the Arkansas Association of Health-Systems Pharmacists (AAHP), and the Arkansas

Pharmacists’ Association (APA). Dr. Bright was named the 2017 Arkansas Pharmacists Association Distinguished Young Pharmacist of the Year and was named a 2019 Health Care Professional of the Year Finalist by Arkansas Business. His professional interests include chronic disease-state management, collaborative healthcare delivery systems, healthcare disparities and leadership. Dr. Bright lives in Harrison with his wife, Haley, and their three children.

Paul H. Phillips, MD, Named Chair of Ophthalmology and Director of Jones Eye Institute at UAMS LITTLE ROCK – Paul H. Phillips, M.D., has been appointed chair of the Department of Ophthalmology in the College of Medicine and director of the Harvey & Bernice Jones Eye Institute at the University of Arkansas for Medical Sciences Paul H. Phillips (UAMS). Phillips was chosen after a national search was conducted to succeed Westfall, who stepped down as chair of the department in August 2018 to become dean of the College of Medicine. Phillips was recruited to UAMS in 1997 and has held the rank of professor since 2008. He has served as chief of pediatric ophthalmology at Arkansas Children’s Hospital since 2006 and as director of the Ophthalmology Residency Program since 2015. He became the inaugural holder of the Stella Boyle Smith/Gissur J. Petursson, M.D., Chair in Ophthalmology in 2009. Phillips graduated summa cum laude with his medical degree from State University of New York at Buffalo Medical School in 1989. He interned at Hartford Hospital in Connecticut and completed his ophthalmology residency at the University of Florida Eye Center in Gainesville. He continued his training with a fellowship in neuroophthalmology at Emory University Eye Center in Atlanta, followed by a fellowship in pediatric ophthalmology and strabismus at the Wilmer Institute at Johns Hopkins School of Medicine in Baltimore. Phillips has been certified by the American Board of Ophthalmology since 1995. He is a member of the American Academy of Ophthalmology (AAO), the North American NeuroOphthalmology Society, and the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). He is a recipient of the AAO Senior Achievement Award and the AAPOS Honor Award and serves as senior associate editor of the Journal of AAPOS. He is president of the Consortium of Pediatric Neuro-Ophthalmologists.

Dr. John Frank Joins Washington Regional Emergency Department FAYETTEVILLE - John C. Frank, MD, recently joined Washington Regional as an emergency medicine physician. With a Level II Trauma Center, Washington Regional provides the highest level of emergency care available in Northwest Arkansas. John C. Frank Dr. Frank earned his medical degree at the University of Arkansas for Medical Sciences and completed an emergency medicine residency at Louisiana State University in Baton Rouge. He previously served patients as an emergency medicine physician at Our Lady of the Sea Hospital in Cutoff, Louisiana.

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GrandRounds Radiology Associates Hires Adam Finch, PA-C LITTLE ROCK - Adam Finch, PAC, R.R.A., R. T. (R)(CT)(VI)(ARRT) joined Radiology Associates, P.A. (RAPA) in February 2020. He received his Master of Imaging Sciences as a Radiologist Assistant in 2013 and his Master of Science in Physician Assistant Adam Finch Studies in 2019. He will be working in the central axis. We welcome him and he will be a great asset.

UAMS HealthNow to Provide Free, Online Screening for COVID-19 LITTLE ROCK - UAMS HealthNow has begun offering free screenings for all Arkansans who have questions about whether they may have the coronavirus that causes COVID-19. UAMS HealthNow is the 24-hour digital connection to health care professionals that the University of Arkansas for Medical Sciences (UAMS) began in January. People who have symptoms and who have been exposed to COVID-19 are urged not to visit a physician’s office, urgent care clinic, emergency room or hospital without first talking to the facility and getting instructions on how to prevent spreading the virus to health care providers and other patients. Using a screening tool with a series of questions about their symptoms, age, overall health, travel and other potential exposure to the COVID-19 virus, UAMS HealthNow will guide patients regarding next steps, if any. This may include advice to contact their local physician for further evaluation and possible testing for the virus. To access UAMS HealthNow, go to and click on the screening tool. This service will be available 24 hours a day, seven days a week to patients of all ages across the state of Arkansas and can be accessed from a smart phone, tablet, laptop or computer.

Arkansas Surgical Hospital Welcomes Newest Member to Surgery Team NORTH LITTLE ROCK - Neurosurgeon, Dr. Ali Raja, is joining the medical staff at Arkansas Surgical Hospital. As part of the Arkansas Surgical Hospital team, Dr. Raja will provide the same high level of patient care that patients of Arkansas Surgical Ali Raja Hospital have come to expect. He will use his skill and compassion to treat illnesses and injuries of the spine and neck. “I think of each surgery as an opportunity from God where my team and I may be arkansasmedicalnews


able to help ease another human being’s pain,” said Raja. His practice at Neurological Surgery Associates will also include microsurgical cranial and other neurosurgical procedures, including brain tumors and other pathologies of the brain. Dr. Raja will start seeing patients in clinic on Monday, February 3, 2020. To make an appointment with Dr. Raja, call Neurological Surgery Associates at (501) 225-0880. His most recent clinical appointments include Arkansas Children’s Hospital and the Arkansas Neuroscience Institute at St. Vincent Infirmary. Dr. Raja’s residency training took place at the University of Arkansas for Medical Sciences as well as the Department of Neurosurgery at Children’s Hospital of Pittsburgh, and Boston Children’s Hospital at Harvard Medical School.

Baptist Health Announces Leadership Change for Western Region FORT SMITH - Harrison Dean, who has served Baptist Health for 37 years, and is currently Western Region president, has announced his plans to retire later this year. Kim Miller will become president of the Baptist Health Western Region effective April 20. She most recently served as president and CEO of Beaver Dam Community Hospitals Inc. in Beaver Dam, Wisconsin. Miller will oversee Kim Miller the system’s hospitals in Fort Smith and Van Buren as well as affiliated physician clinics. Baptist Health’s Western Region has approximately 1,600 employees. Miller has more than 40 years of health care experience, in addition to being a registered nurse and a board-

certified fellow from the American College of Healthcare Executives. She received a master’s degree in Business Administration from St. Francis University in Pennsylvania. More information about Baptist Health’s operations in western Arkansas and eastern Oklahoma can be found by visiting

Rebecca Pittillo Named Associate Executive Director of Blue & You Foundation for a Healthier Arkansas LITTLE ROCK - Rebecca Pittillo, a regional executive for Arkansas Blue Cross and Blue Shield, has been named associate executive director of the corporation’s charitable nonprofit, the Blue & You Foundation for a Healthier Arkansas. Over the next Rebecca Pittillo year, Pittillo will work alongside Patrick O’Sullivan, the Foundation’s current executive director, to prepare for O’Sullivan’s retirement in January 2021. O’Sullivan has served as the Foundation’s executive director since 2006. The Foundation awards approximately $3 million in grants annually to nonprofit and governmental organizations and programs that positively affect the health of Arkansans. Since joining Arkansas Blue Cross in 2018, Pittillo has worked with regional teams in Pine Bluff, Hot Springs and Texarkana. Pittillo worked the first 21 years of her career at Jefferson Regional in Pine Bluff in a number of leadership positions. Prior to joining Arkansas Blue Cross, she was the executive director of the Jefferson Regional Foundation, served as a member of the Jefferson Regional Senior Leadership Committee and had oversight of all internal and ex-

ternal communication for the organization. Pittillo currently serves on the boards of Southeast Arkansas College, the Arkansas Community FoundationPine Bluff Chapter, White Hall School District and the United Way of Southeast Arkansas. She earned bachelor’s and master’s degrees from the University of Arkansas at Little Rock.

NEA Baptist Expands Physical Therapy in Paragould PARAGOULD – NEA Baptist is pleased to announce an expansion project to Outpatient Physical Therapy at their clinic location in Paragould, AR. In cooperation with Haag Brown Commercial Real Estate and Stonebridge Construction, NEA Baptist will expand the physical therapy portion of the building adding over 2,200 square feet. This additional space will provide treatment and traction rooms, waiting area, and gym space. Jeff Ramsey, Physical Therapist at NEA Baptist says that eight years ago when the doors to Paragould PT department opened, they committed to building the best therapy team in Paragould, focusing on patient-centered physical therapy services. Through the exceptional care and hard work, they have seen the therapy department grow, exceeding the limits of their current facility. The added space will allow more patients from Paragould, and surrounding areas access to quality physical therapy care and almost three times the current space.

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LISTEN. LEARN. SHARE. FREE PAIN MANAGEMENT TELEVIDEO CONFERENCES UAMS AR-IMPACT Speaker’s Bureau is a FREE interactive televideo lecture series designed to help Arkansas clinicians better manage their chronic pain patients and those who need their opioid dosage reduced. Each of our AR IMPACT team members will travel to the UAMS Regional Centers to provide lectures on various topics related to pain management and opioid use disorder. You can access these lectures remotely from your computer or handheld device. Check our website for continuing medical education information. See our speaker schedule for details. Questions? Email

TO JOIN A CONFERENCE: Visit and click the link to join


Leah Tobey, PT, DPT 1. Alternative pain relief & selfmanagement with physical therapy 2. Tips for the Busy Clinician: 5 minute lumbar exam Masil George, M.D. 1. Opioid Free-Success Stories of Effectively Stopping Opioids 2. Managing the Difficult Patient Encounter Leah Tobey, PT, DPT / Masil George, M.D. 1. Opioids and Falls: Is There a Link? 2. Recognizing and Responding to Suffering

Call 1-844-885-1319, then enter 415081971 For current event dates and times, visit arimpact.uams. edu/speakersbureau. Check back often to see additional topics!

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Arkansas Medical News March-April 2020  

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Arkansas Medical News March-April 2020  

Your primary source for professional healthcare news