FOCUS TOPICS ORTHOPEDICS/SPORTS MEDICINE • PEDIATRICS • HEALTH LAW • PRACTICE MANAGEMENT
September/October December 2021 2009 >> $5 ON ROUNDS
Ramon Ylanan, MD, Feels Honored to be Razorbacks’ Sports Medicine Specialist It takes a team of specialists to help athletes reach the top Just like it takes a team to play sports ranging from football to soccer, it takes a team of coaches, mental Ramon Ylanan health professionals, nutritionists, academics, and sports medicine doctors to provide the help athletes need to reach their top level of performance.
Kids and COVID-19
A closer look at the pandemic’s toll on Arkansas’ children By MELANIE KILGORE-HILL
As COVID-19 takes its toll on Arkansans, the state’s youngest residents are among the latest victims of the pandemic’s newest variant. Arkansas Children’s, the only health system in the state focused solely on children, experienced a record number of COVID19 hospitalizations in August with 31 patients positive on a single day. Throughout the rest of August and early September, Arkansas Children’s Hospital in Little Rock, the system’s facility with intensive care capabilities, often saw as many as 10 to 11 children in the Pediatric Intensive Care Unit – many reliant on ventilators. By late September the spike was settling, but providers caution that numbers could rise again if masking compliance and vaccination rates fall. Statewide, Arkansas’ 10-and-under age group saw 3,208 additional cases between June 30 and July 30, a 15 percent increase in the total number of cases, according to an arkansascovid. com analysis of Arkansas Department of Health data. According to a release, “the 25-34 age group suffered a significant outbreak as well, experiencing a 12 percent increase with 6,780 additional cases.” (CONTINUED ON PAGE 4)
New Stark Rules for Physician Compensation Within Group Practices
Profile on page 3
Personnel Management During a Labor Shortage Labor shortages are creating havoc for many businesses in the United States, and medical practices are not immune. Article on page 5
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By DENISE BURKE
New Stark Law rules governing physician compensation within group practices go into effect on January 1, 2022. Physician groups should be close to finalizing a review of their compensation policies to make sure they are compliant by January 1, 2022. On November 20, 2020, the Department of Health and Human Services (HHS) issued a sweeping set of final rules to revise regulations under the federal physician self-referral law, commonly referred to as the Stark Law. The Stark Law prohibits a physician from referring a patient to an entity with which the physician (or an immediate family member) has a financial relationship, for the furnishing of designated
health services (DHS) for which payment may be made under the Medicare program, unless an exception applies. DHS includes, among other services, lab, imaging, physical therapy, DME and outpatient prescription drugs. Physician practices primarily rely on the Stark Law’s in-office ancillary services exception to protect DHS referrals within the practice. Significant changes/clarifications to the in-office ancillary services exception were included in the final rules. Important details about Physician Compensation Under the New Stark Law: If a physician group practice wishes to share (CONTINUED ON PAGE 4)
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Ramon Ylanan, MD, Feels Honored to be Razorbacks’ Sports Medicine Specialist It takes a team of specialists to help athletes reach the top Just like it takes a team to play sports ranging from football to soccer, it takes a team of coaches, mental health professionals, nutritionists, academics, and sports medicine doctors to provide the help athletes need to reach their top level of performance. “I’m part of the team that takes care of the Razorback teams, along with my partners who are orthopedic surgeons,” said Ramon Ylanan, MD, a Sports Medicine Specialist with the University of Arkansas for Medical Sciences (UAMS) Orthopaedics and Sports Medicine in Fayetteville. “We have created a teamoriented care model with athletes at the center of that equation. We have layers of specialists to take care of athletes. My part is one small cog in the bigger wheel. It is a blast to be able to do what I do.” For the fall football season, the first thing is to give players a physical to make sure they haven’t had any new injuries. If an athlete has an injury, they try to get out in front of it and be proactive. In about 90 percent of the cases, the injury can be managed without surgery. Once the football season starts in early September, it becomes a seven-daya-week job for Ylanan and his partners. The team has regular practice Mondays through Fridays, Saturday games and Sunday post-game injury clinics. They also take care of soccer and volleyball players through November-December. Starting in November, they go into both men’s and women’s basketball with an average of two home games a week, and then into track, softball and baseball. In the course of a year, the only month there aren’t sporting events at the college is July. With every sport, it is rare to find an athlete who gets to the college ranks who
PHOTO COURTESY OF UAMS
By BECKY GILLETTE
Ramon Ylanan, Sports Medicine Physicians with UAMS Orthopaedics and Sports Medicine in Fayetteville, is shown working with an athlete at the training facility on campus.
hasn’t had some injury in the past. Some are more nuisances and others can affect performance. “We figure out how to rehab them, and change the way they work in the workout room so the injury isn’t aggravated,” Ylanan said. “Some are recovering from surgeries. We try to be proactive on whatever the issue. We will be smart how we train them, and how we take care of them. We talk with the coaching staff and come up with a plan to allow the athletes to be able to do what they want to do.” Ylanan said sports medicine is always an interesting field with new tricks, gadgets, and thought processes about how to get a competitive advantage, how to keep athletes safer, and help them recover from an injury faster. “There are always new things, but it
is hard to figure out what is worth the time and money,” Ylanan said. “You would be surprised what old ways still really work in the training room. Regarding concussion, we have three tools to get baseline tests before they get on the field that include vision, cognitive, and balance testing. With baselines of all those aspects, if an athlete has an injury, we have a measuring stick from which to compare.” A lot of the athlete injuries can be handled non-operatively. “The right kind of medicine and therapy can treat most student athlete injuries,” he said. “That is also true with weekend warriors. With the right rehab and medicine, you can get people back to what they love doing. And if a patient needs surgical intervention, I have a great partner to handle that.”
Before vaccines were available for Covid-19, a lot of people became less active in order to prevent catching or spreading the virus. Ylanan said there was a bit of deconditioning, but now people are getting really active again. People are back to playing pickup basketball in the gym, pickleball has become really popular, and interest in lacrosse and ice hockey are increasing. Any of those sports can cause injuries, but Ylanan said the health benefits of exercise are tremendous. And it doesn’t necessarily need to be extremely intense exercise to get good results regarding blood pressure, cholesterol levels, and weight control. He recommends walking or riding a bike as there are many excellent trails throughout Northwest Arkansas. “People in quarantine were getting bikes and becoming active in ways they had never done before because it was safer to be outside than inside while exercising,” Ylanan said. “It took almost six months to get a bike for my son because of the demand.” Ylanan and his wife, Melissa, have two children, AJ and Mia. “My current hobby is watching my kids doing all the fun things they enjoy,” he said. “My son plays baseball, football, soccer, basketball and wants to try track. I coach my son’s baseball team. My daughter is into a little bit of everything, dance, tumbling, volleyball, basketball and softball. My kids are all about being active.” Ylanan joined UAMS Health Orthopaedics and Sports Medicine in 2019, and has more than 11 years of sports medicine and SEC team physician experience. He was born and lived in the Philippines until he was 16. His great-grandfather on his father’s side, Regino Ylanan, was also a physician, a major figure in the field of (CONTINUED ON PAGE 4)
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Kids and COVID-19, continued from page 1 A growing problem
“Earlier in the pandemic a busy day was five kids with COVID-19, and now we’re seeing around 20 to 40,” said Jessica Snowden, MD, division chief of Pediatric Infectious Disease at UAMS Pediatrics and associate director for Clinical and Translational Research at Arkansas Children’s Research Institute. Unlike the first variant, Jessica Snowden which seemed to hospitalize only the high-risk, Snowden said the Delta variant is hitting kids with no preexisting conditions, while those with obesity, diabetes and other risk factors face an even greater threat. “It seems like they’re getting sicker faster,” Snowden said of the hospital’s most recent COVID-19 patients. “Delta appears to be able to infect kids more readily than earlier and we don’t quite understand the physiology behind that.” Exasperating the Delta strain is the fact that countless kids aren’t old enough to vaccinate. The result, Snowden said, is longer hospital stays and more kids on ventilators. “We’re looking at whether it’s just because more kids are getting sick or because the Delta variant is more aggressive,” she said.
In July 2020, ACRI researchers were part of a statewide team that received a $770,000 National Institutes of Health grant to understand more about variants of COVID-19 circulating in the state by increasing capacity for genomic sequencing, tracking and analyses of virus samples. The collaboration is among scientists at Arkansas Children’s Research Institute, the University of Arkansas for Medical Sciences, the Centers for Disease Control and Prevention and the Arkansas Department of Health. The Arkansas Sequencing (ArkSeq) Consortium will be a source for samples from across the state to be used for sequencing COVID-19 variants. ACRI committed to providing an additional $200,000, in part from Arkansas Biosciences Institute funds, to expand sequencing capacity. “As a provider on the ground this is valuable work, because we’ve shifted from earlier variants which affects how we manage patients,” Snowden said. “Their works is allowing us to adapt quickly and provide the best care for kids, as some monoclonal antibodies and meds are no longer effective with Delta, and we don’t yet know what future variants will look like.”
Erring toward caution
With school in full swing and cold and flu season approaching, expected seasonal health threats also are magnified. “COVID is now so incredibly contagious that we need to assume any cold symptoms are COVID, so isolation will be very important,” Snowden said, pointing to a recent uptick in cases of RSV, rhinovirus and parainfluenza. Unlike fall of 2020, providers can no longer assume children are relatively safe from the virus, and stress the 4
need to take symptoms seriously. “We’re all tired and ready for it to be over,” Snowden said. “It’s important for all of us as providers to keep reinforcing the importance of testing and isolation, because the only way it’s going to end is if we follow guidelines and stay home when sick.”
Challenges to providers
While the pressure of caring for young patients can take its toll, Snowden said it’s essential to assume positive intent toward each family. “As providers we have to keep in mind that children are very rarely the ones making decisions about how the deal with the virus,” she said. “It’s never a child’s fault that he’s sick, and it’s up to all of us to care for them — even those families who may not have made the same decisions I made for my family. No one chooses to put their child in harm’s way. Many adults are victims of misinformation, and it’s really important for us as physicians to remember that.” Snowden also stressed the importance of self-care for physicians, especially those on the front line. “It’s a really a challenging time for all of us, and one of most important things we can do is figure out what it is that works for us to maintain our equilibrium,” she said. “We’re being challenged more than ever, but we have to take care of ourselves so we don’t burn out. What is it that helps us individually recharge?”
Learning from the past
Going forward, she encourages physicians to reconsider their approach to health literacy and communication postpandemic. “How did we get in a position where so much misinformation can take hold, and how can we avoid getting in this situation again as a community?” she asked, pointing to barriers such as medical access and telehealth. “This brought
about core gaps in infrastructure, especially in rural settings where there are healthcare deserts exasperating disparities we know exist. We need to look at equity and infrastructure and how we communicate as we recover to make sure this doesn’t happen again.” Growing health disparities were highlighted in September, with the release of a study from the Centers of Disease Control and Prevention that found American children and teenagers have seen a significant increase in weight gain since the pandemic began. According to the report, the biggest jumps occurred in younger school-aged children and those who were already prone to obesity. The study looked at 432,302
people between the ages of two and 19 years old and found, among other things, that the percentage of obese children and teens increased to 22 percent, compared with 19 percent before the pandemic. It’s one more challenge today’s pediatricians will face going forward, but Snowden remains optimistic about the future – thanks in part to an uptick in vaccination rates statewide. “Another interesting thing is this whole generation of kids will grow up with a different understanding of science, and what it means to care for your community,” she said. “It makes me hopeful that they’ll grow up with a worldview that sees public health through a different lens than any of us ever did.”
Ramon Ylanan, MD, Feels Honored, continued from page 3 sports medicine in the Philippines going back into the 1920s. Growing up, Ylanan played a ton of different sports including tennis, volleyball and golf, but had a special love for baseball, which he played all the way through high school. “Being in sports and loving everything to do with sports made it natural for me to want to specialize in sports medicine, which I love,” Ylanan said. “I like taking care of all the kids at the university. They are kids who are enjoying their sport, and I find a way to make sure they can do all the fun stuff they enjoy. I’m blessed and honored to be able to do it.” Prior to serving as the head primary care Sports Medicine Specialist for the Razorbacks, Ylanan was team physician for the University of South Carolina Gamecocks. His experience includes caring for six NCAA College World Series teams, as
well as multiple NCAA Track and CrossCountry Championship Razorback teams. In addition to his SEC experience, Ylanan has provided care for the Columbia and Alabama Ballet companies, multiple high school programs in the Birmingham, Ala., Columbia, S.C., and Fayetteville, Ark., areas, and has served as medical director for the HogEye Marathon. After earning his medical degree from Ross University, he completed his family medicine residency at the University of Missouri and serving as a chief resident, he completed his Sports Medicine fellowship at the American Sports Medicine Institute in Birmingham, Ala. For more information, go to: UAMS Orthopaedics & Sports Medicine Clinic in Fayetteville, Orthopaedics & Sports Medicine Clinic in Fayetteville | UAMS Health
New Stark Rules for Physician Compensation Within Group Practices, continued from page 1 “overall profits” from DHS with any of its physicians, it must: (1) aggregate all DHS profits from the entire group, or (2) aggregate all DHS profits from any component of the group that consists of at least five physicians. Many practices have historically maintained separate profit-sharing pools of at least 5 physicians by ancillary service type (lab, imaging, infusion). Such “split pooling” is no longer acceptable after January 1, 2022. Once pooled, overall DHS profits should be divided in a reasonable and verifiable manner that is not directly related to the volume or value of the physician’s referrals of DHS (per capita, by seniority, based on the practice’s revenues that are not attributed to DHS, etc.) Separate pools of five physicians within a group are not required to utilize the same distribution methodologies to distribute shares of the overall profits from, so long as the profits from all the DHS referred by the physicians within the pool are aggregated. However, the
same methodology for distributing overall profits must be applied to every physician within the pool. A group practice is not required to distribute all of the DHS to physicians. It may choose to retain some of the profits. There is an exception for profits from DHS that are directly attributable to a physician’s participation in a value-based enterprise which can be distributed directly to the participating physician, without having to aggregate the profits with the overall profits of the group practice or a pool of five or more physicians within the group practice. This would include downstream compensation derived from payments made to a group practice that relate to the physician’s participation in a value-based arrangement (whether or not the group practice participates in the value-based arrangement). After years of conflicting guidance, CMS clarified that DHS does not include Medicaid. The in-office ancillary services excep-
tion is an extremely long, detailed and complex exception to the Stark law. This article only discusses a single element of the in-office ancillary services exception. Despite the complexity of the law, the Stark Law is a strict liability statute and violations and/or alleged violations can lead to significant penalties and/or government and whistleblower actions. Physician groups should promptly work to review their compensation arrangements with trusted advisors to ensure that any needed changes to compensation policies can be adopted and implemented prior to the January 1, 2022 compliance date. The opinions expressed in this article are intended for general guidance only. They are not intended as recommendations for specific situations. As always, readers should consult a qualified attorney for specific legal guidance. Denise Burke is a partner with Waller Lansden Dortch & Davis, LLP who provide legal counsel to the healthcare industry. She can be reached at email@example.com.
Personnel Management During a Labor Shortage By ELIZABETH WOODCOCK, MBA, FACMPE, CPC
Labor shortages are creating havoc for many businesses in the United States, and medical practices are not immune. Although there may be some relief as federal government’s bonus checks end this fall, the problem will not come to a screeching halt. Indeed, experts believe that the growth of the ambulatory sector – 22,000 of the 23,000 jobs added in health care in May alone -- will propel even more challenges. Moreover, the workload burden has been unrelenting, causing some employees to migrate out of healthcare altogether to other, less stressful – and often higher-paying jobs. Regardless of how you slice it, the labor shortage is a reality. Although you could rely on luck to get you through this challenge, consider taking proactive steps to mitigate the risk of an inadequate labor force: Show Your Appreciation. There are no words for the turmoil you and your practice have endured over the past 18 months, but there is also no doubt that the pandemic touched the personal lives of everyone on your team. Show support for your team with a gesture like bringing a light breakfast to snack on, accompanied by a sign that reads: “thanks for all you
do;” give everyone on your team a handwritten note: “I appreciate you, and everything you do for our patients.” Consider adding a gift card for a major retailer or gas station – or offer a gift certificate for a movie theater with a bag of popcorn. Encourage your colleagues to take action as well; make sure your team knows they are appreciated. Engage with Your Team. Make a list of all your employees and commit to spending at least 10 minutes with each of them in the next 30 to 60 days. Ask each member of your team: “How are you?” (Yes, just this simple question demonstrates your engagement and can stand out during this tumultuous time.) Follow it with: “What can we do to make you be more successful at your job?” You will be amazed at the suggestions – and your team will appreciate being asked. Review Compensation. The labor shortage is not the only influence on staff; as more health care organizations embrace a virtual delivery platform, there is a significant shift in the employment market. Employees can work for anyone – anywhere in the world. Your employees may be bombarded by offers from your local hospital, community health center, or nursing home, but they may also be receiving offers from organizations based in
California, Alaska, or other far-flung places. It is an opportune time to make sure that you’re paying competitively. As many employees may focus solely on the hourly rate, it also pays to document the benefits you offer – and even attach a dollar value. Consider listing your full compensation package, to include health insurance, disability benefits, leave, and so forth. It might also be time to add a benefit such as childcare or tuition reimbursement, a payroll-deduction emergency savings account, and an extra health day (or two) for mental health or to make up preventive care skipped during the pandemic. Proactively Recruit. Do not wait until a position opens if you find great talent. Turnover is bound to happen, and it’s a much better investment to pay an extra few months’ salary – rather than wait for someone to resign and scramble. Consider
looking in unexpected places – maybe you’ve had an interaction in a retail setting with someone who went above and beyond from a customer service perspective; or recruit back a former employee who decided to stay at home, compelling him or her with a flexible, part-time schedule. Part-timers can be a huge win for your practice, as there are often days of the week that demand higher resources (e.g., Mondays) that might be perfect for a part-timer – and your virtual business, if applicable, could accommodate someone working from home. Attrition does not have to be negative, but it certainly needs to be managed. Conduct exit interviews to learn from departing staff members what could have been done to improve the work environment. Most importantly, set a plan in motion now to avoid getting shocked by the resignations that may be coming across your desk in the near future. The contents of The Sentinel are intended for educational/informational purposes only and do not constitute legal advice. Policyholders are urged to consult with their personal attorney for legal advice, as specific legal requirements may vary from state to state and/or change over time. Reprinted with permission; September 2021 Sentinel. All rights reserved. ©SVMIC
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GrandRounds White River Health System Welcomes Cardiologist BATESVILLE – White River Health System is pleased to welcome Mahesh Anantha, MD, FACC, Interventional Cardiologist. Dr. Anantha joins the team at WRMC Cardiology located at 16 Hospital Circle, Suite A, in Batesville. Dr. Anantha obtained his medical de- Mahesh Anantha gree from Madras Medical College. He completed his Residency from Creighton University School of Medicine, serving as chief resident during his training. He completed Cardiovascular Disease Fellowship from the University of Minnesota, a research Fellowship, from the Mayo Clinic College of Medicine. He then went to Yale University for Advanced Interventional Cardiology/ Endovascular Intervention Fellowship followed by Interventional Cardiology Fellowship at the University of Arizona. He is board certified in Internal Medicine, General Cardiology, and Echocardiography. Dr Anantha specializes in treating patients with heart attack or chest pain by performing angiograms and stents in life-threatening situations, to relieve blockages in the heart vessels. He also specializes in treating patients with leg pain, ulcers, and patients at risk of losing limbs due to poor blood flow by
performing catheter-based procedures and placing stents. His practice includes diagnosing and treating patients with several heart conditions including coronary artery disease, congestive heart failure and abnormal heart rhythms using advanced imaging techniques and appropriate medications.
CARTI Adds Complex Surgical Oncologist Dr. J. Camilo Barreto LITTLE ROCK – CARTI has added complex surgical oncologist J. Camilo Barreto, M.D., F.A.C.S., to its team of cancer specialists, bringing its medical team to 43 physicians representing 12 specialties. Dr. Barreto will see patients at the CARTI J. Camilo Cancer Center in Little Barreto Rock. Dr. Barreto has extensive experience in the treatment of patients with complex cancers of the digestive tract, skin and soft tissues. He believes cancer treatment should be individualized and created through a collaborative team approach. Before joining CARTI, Dr. Barreto treated patients at the University of Arkansas for Medical Sciences in Little Rock, where he also served as an associate professor within the surgery department. He earned his medical de-
gree from Anahuac University School of Medicine in Mexico City, Mexico, then completed residencies in general surgery at the National Institute of Medical Sciences and Nutrition in Mexico City, Mexico, and the University of Chicago Medical Center in Chicago, Illinois. He completed fellowships in surgical oncology at the University of Chicago Medical Center and minimally invasive surgery at the Mayo Clinic in Rochester, Minnesota. Dr. Barreto is board certified by the American Board of Surgery and is a fellow of the American College of Surgeons, a member of the American Society of Clinical Oncology and Society of Surgical Oncology.
NEA Baptist Opens Two New Clinic Locations JONESBORO – NEA Baptist announced the opening of its new location for NEA Baptist Pediatric Clinic, and NEA Baptist Dermatology and Mohs Surgery. The two clinics are the first project for The Reserve at NEA, which is the only lifestyle medical park in the region and connects directly to the NEA Baptist medical campus. The pediatric clinic will have two board certified pediatricians and two nurse practitioners. Dr. MaryJoanne Umeora, Dr. Camille Chan, Priscilla Fortner and Tomorrow Potter will provide pediatric care to patients 0-18 years old in the new space. The clinic will share a 12,000-squarefoot building with NEA Baptist Dermatology and Mohs Surgery led by Dr. Zach Nahmias. Nahmias is a board-certified dermatologist with Mohs surgery certification. For more information about the clinics, visit www.neabaptistclinic.com/ specialties/pediatrics and www.neabaptistclinic.com/specialties/dermatology
Dr. Sam Baxter Joins Arkansas Surgical Hospital
Arkansas Children’s Celebrates Opening of $17.5 Million ACH Pine Bluff Clinic PINE BLUFF - Arkansas Children’s Hospital (ACH) Pine Bluff Clinic in association with Jefferson Regional, the state’s only pediatric health system celebrates the clinic opening and the donors who helped make the new clinic a reality. The 10,250-square-foot, kid-savvy clinic is a strategic hub for families in the Southeast Arkansas region, delivering care close to home through services like preventative care, developmental screenings, community resources and health education. Providers began seeing patients at the clinic in late July. The physicians will also provide frontline care to newborns delivered at Jefferson Regional through the statewide ACH Nursery Alliance. The new mission-centered clinic requires a $17.5 million investment to cover construction and operating costs for the first five years. Thanks to the support of the Pine Bluff community and donors across the region, more than $10 million in philanthropic gifts have been secured for the ACH Pine Bluff Clinic.
NORTH LITTLE ROCK—Dr. Samuel Baxter is the latest orthopedic surgeon to join the medical staff at Arkansas Surgical Hospital. Dr. Baxter focuses on hip and knee surgery, performing procedures such as arthroplasty, arthroscopy, Samuel Baxter and revision total joint replacements. After receiving his medical degree from the University of Arkansas for Medical Sciences, Dr. Baxter completed his residency training in orthopedic surgery at the University of Missouri in Kansas City. He then completed an adult reconstruction fellowship at the University of California-Davis. Dr. Baxter is seeing patients at Martin Orthopedics. To schedule an appointment with Dr. Baxter, patients can call the hospital’s referral assistance line at 866-273-1271 or go online to www. ArkSurgicalHospital.com and click “request an appointment”.
Sports Medicine Physician Joins Baptist Health Orthopedics Clinic-Fort Smith FORT SMITH – Jonathan Tobey, MD, recently joined Baptist Health Orthopedics Clinic-Fort Smith. He specializes in sports medicine. Dr. Tobey earned a medical degree from the University of Texas Health Sciences Center at Houston. He completed an ortho- Jonathan Tobey pedic surgery residency at the University of Oklahoma and a fellowship in sports medicine at the University of New Mexico in Albuquerque. He grew up in a suburb of Houston and was passionate about playing sports. But in school, two of his favorite subjects were science and engineering. In addition to general orthopedics, Dr. Tobey treats many types of sports (CONTINUED ON PAGE 7)
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GrandRounds and non-sports related injuries affecting bones, tendons and cartilage in the shoulders, hips and knees. He will see both adolescents and adults in the community and will serve as the team physician for Northside High School’s football team. Dr. Tobey will work alongside Jef-
frey Evans, MD, John Harp, MD, Eric Heim, MD, Michael Wolfe, MD, and Lacey Kennon, APRN, at the clinic located at 1506 Dodson Ave. in Fort Smith. For more information on services provided visit baptist-health.com or to learn how you can make an appointment, call 1-888-BAPTIST.
New UAMS Baptist Health Cancer Center Opens in North Little Rock NORTH LITTLE ROCK — The first UAMS Baptist Health Cancer Center is now open on the campus of Baptist Health Medical Center in North Little Rock, bringing the full spectrum of cancer research, diagnostic and treatment services available at UAMS’ Winthrop P. Rockefeller Cancer Institute to more Arkansans. The UAMS Baptist Health Cancer Troy Wells, CEO, Baptist Health, North Little Rock Center in North Little Rock is staffed Mayor Terry Hartwick, UAMS Medical Center CEO by a team of oncologists, nurses and Steppe Mette, MD radiation therapists from UAMS. The center includes two clinics, both located at 3401 Springhill Drive in the Baptist Health Springhill Medical Plaza: UAMS Baptist Health Medical Oncology and Infusion Clinic staffed by: • Konstantinos Arnaoutakis, M.D. • Rangaswamy Govindarajan, M.D. • Saira Hassan, M.D. • Sindu Malapati, M.D. • Christina Porter, APRN • Crystal Huddleston, RN UAMS Baptist Health Radiation Therapy Center staffed by: • Leslie Harrell, D.O. • Richard Crownover, M.D., Ph.D. • Gary Lewis. M.D. • Sanjay Maraboyina, M.D. • Paige Sapp, RT The center will provide medical oncology, infusion and radiation therapy services for most cancer types with the exception of brain/spine, full body therapy and brachytherapy. More complex cancer treatments, including surgery, will be referred to UAMS for treatment.
Baxter Regional and Highlands Oncology Break Ground on New Center MOUNTAIN HOME - Baxter Regional Medical Center and Highlands Oncology Group picked up shovels and broke ground on their new joint cancer treatment and research facility during a groundbreaking ceremony in Mountain Home. Highlands at Baxter Regional is expected to open next year, offering cancer patients in Northern Arkansas and Southern Missouri the ability to receive their treatments closer to home. The new 33,000 square foot all-glass building will cost $15 million to build and feature comprehensive oncology care, including chemotherapy infusion, research and clinical trial drugs. Together, both Baxter Regional and Highlands Oncology will have a staff of over 200 doctors and nurses on campus available to treat cancer patients. Both organizations agreed their first responsibility was to make sure that patients came first, even if it costs them money.
Alice L. Walton Foundation and Cleveland Clinic Announce Initiative to Enhance Access to Specialty Care Services in Northwest Arkansas BENTONVILLE - The Alice L. Walton Foundation and Cleveland Clinic announced a joint initiative to identify ways of providing access to Cleveland Clinic’s renowned specialty care services in Northwest Arkansas. The organizations will assess speAlice L. Walton cialty care needs in the region and develop recommendations for healthcare solutions to best meet those needs. Specialty care services require specialized knowledge or skill related to a specific health condition. A recent study shows many Northwest Arkansas residents currently seek spe-
cialty care outside the region. Founded in 2017, the Alice L. Walton Foundation works to enhance quality of life for individuals and communities through providing access to offerings that enhance well-being. In 2020, Walton announced the formation of the Whole Health Institute, and earlier this year, she announced the formation of the Whole Health School of Medicine and Health Sciences. Both of these organizations, based in Bentonville, Ark., focus on redesigning the systems that impact health and well-being with the goal of making whole health accessible and affordable to all. The Alice L. Walton Foundation and Cleveland Clinic envision that any future specialty care initiatives they may develop in the region would collaborate with the Whole Health Institute to identify opportunities for increased patient experience and engagement, with the goal of improving health outcomes.
Mercy Clinic Focuses on Care for Patients with COVIDRelated Symptoms FORT SMITH – Mercy Fort Smith has opened a clinic focused on the treatment of COVID-19 patients and people with symptoms of the illness. Mercy Clinic COVID Care – Fort Smithis located at the former Convenient Care clinic at Mercy Tower West, 6801 Rogers Ave. in Fort Smith. The clinic is open 3-9 p.m. six days a week and is available to walk-ins only (no appointments needed). Patients do not need to be established with Mercy to utilize the clinic. The clinic is closed on Thursdays. Mercy set up this dedicated clinic to keep those with COVID-19-related symptoms, including moderate to severe respiratory illnesses, separate from other patients. The clinic was designed with the goal of protecting the community and allowing Mercy to continue to serve all patients seeking care. Mercy urges anyone with acute symptoms such as fever; dry cough; tiredness; aches and pains; sore throat; diarrhea; conjunctivitis; headache; loss of taste or smell; or rash on skin or discoloration of fingers or toes to utilize the clinic. Those with severe symptoms including difficulty breathing or shortness of breath, chest pain or pressure or loss of speech or movement should seek immediate medical attention at the closest emergency room. COVID-19 testing and other diagnostic processes such as testing for strep throat and influenza will be used to diagnose and treat patients at Mercy Clinic COVID Care – Fort Smith. Patients will be evaluated by a physician or advanced practice nurse, who will create a treatment plan for each patient following a diagnosis. Masking and social distancing are required at Mercy Clinic COVID Care – Fort Smith, as well as at all other Mercy facilities. Patients are allowed to have one person accompany them during each appointment. (A complete list of Mercy Fort Smith’s visitor guidelines is available here.) Anyone experiencing COVID-19 symptoms can schedule a test with Mercy by calling 479-573-3939. COVID-19 testing is at Mercy Convenient Care – 79th Street, 3505 79th St. in Fort Smith. COVID-19 vaccine appointments are available by visiting mercy.net/FSMVaccine or calling 833-364-6777.
GrandRounds UAMS Research Team Finds Potential Cause of COVID-19 ‘Long-haulers’ LITTLE ROCK — A UAMS research team has identified a potential cause of long-lasting symptoms experienced by COVID-19 patients, often referred to as long-haulers. The findings were published in the journal, The Public Library of Science ONE (PLOS ONE). At the heart of the team’s findings is an antibody that shows up weeks after an initial infection and attacks and disrupts a key regulator of the immune system, said lead researcher John Arthur, M.D., Ph.D., professor and chief of the Division of Nephrology in the UAMS College of Medicine, Department of Internal Medicine. As many as 30 percent of COVID-19 patients experience lingering fatigue, brain fog and shortness of breath. The cause of long COVID-19 has eluded scientists, but the UAMS team’s discovery sheds important new light on the molecular-level mechanisms behind it. The antibody creates problems for the immune system by attacking the angiotensin-converting enzyme 2 (ACE2). The ACE2 enzyme helps regulate the body’s response to the virus by metabolizing a peptide that activates the immune system. The attacking antibody interferes with ACE2’s work, which makes the antibody a prime suspect for
the long-lasting illness. The research team was brought together quickly this spring by the UAMS Translational Research Institute to test the hypothesis that developed through discussions between Arthur and UAMS’ Terry Harville, M.D., Ph.D., a professor in the College of Medicine Department of Pathology and medical director of the Histocompatibility and Immunogenetics Laboratories. Researchers Karl Boehme, Ph.D., Craig Forrest, Ph.D., and Shana Owens, Ph.D., in the Department of Microbiology and Immunology developed the assay (test) used to identify the two antibodies. Researchers tested plasma or serum for ACE2 antibodies in 67 patients with known SARS-CoV-2 (the virus that causes COVID-19) infection and 13 with no history of infection. In 81 percent of blood samples from patients in Arkansas and Oklahoma with a history of COVID-19, the samples had the antibody that attacked the ACE2. In participants with no history of COVID-19, no antibodies were created to attack the ACE2 enzyme. The multidisciplinary team also includes College of Medicine researchers Christian Herzog, Ph.D., Department of Internal Medicine; Josh Kennedy, M.D., Department of Pediatrics; and Juan Liu, Ph.D., from the Department of Pathology.
Washington Regional to Acquire Property for Future Expansion
FAYETTEVILLE — Washington Regional Medical System is preparing to meet the growing health care needs of Northwest Arkansas after acquiring approximately 15 acres near the Washington Regional campus in Fayetteville. The property, part of the Drake Farms development in Fayetteville, is located adjacent to the Washington Regional campus and will allow for future expansion of services. Plans for the property are being finalized and include facilities for expanded inpatient hospital services, outpatient surgical services, to include overnight stay capabilities, ambulatory care services, and a center for wellness focused on whole person care. Washington Regional seeks to continually improve the patient experience and clinical outcomes, while offering convenient, cost effective and comprehensive care within technologically-advanced surgical settings. Drake Farms is a 175-acre mixed use development that will ultimately include residential, commercial and institutional space, as well as green space and other amenities. The architects on the Washington Regional project are HRD and Tommy Van Zandt with Cushman & Wakefield Sage Partners represented
the seller in the transaction. Washington Regional also acquired the option to purchase two additional parcels within the Drake Farms development consisting of approximately 25 acres of land in the future.
Interventional Cardiologist Joins Conway Regional Cardiovascular Clinic CONWAY -Yalcin Hacioglu, MD, an interventional cardiologist, has joined the Conway Regional Cardiovascular Clinic. Hacioglu will be practicing alongside Don Steely, MD, and Rimsha Hasan, MD, in the diagnosis, treatment, and manageYalcin Hacioglu ment of cardiovascular disease at Conway Regional. He has more than 20 years of experience as an interventional cardiologist and has practiced throughout Central Arkansas. Hacioglu completed a fellowship at the University of Arkansas for Medical Sciences in Little Rock and a residency and internship at St. Luke’s Roosevelt Hospital Center in New York. For more information about Dr. Hacioglu or cardiovascular services available at the Conway Regional Cardiovascular Clinic, visit www.conwayregional. org.
ANPA 2021 Annual Conference
Friday, October 22, 2021 at 8:00am CT | Saturday, October 23, 2021 at 6:00pm CT Hot Springs Convention Center 134 Convention Boulevard Hot Springs, AR 71901 For more info or to register for this conference go to https://bit.ly/3kLl4ef
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