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January/February December 2018 2009 >> $5

Non-Surgical Weight Loss Programs: Making People Healthier, Happier


Alexander Orsini, MD, Touts Advances to Treat Heart Failure Cardiologist recommends physicians talk to patients about smoking and obesity LITTLE ROCK—Alexander Orsini, MD, who practices with Arkansas Cardiology, gets great satisfaction from seeing heart failure patients today who have been successfully treated with the ground-breaking medicine Entresto ... 3

Behavior change key to successful weight loss and eventual weight management By BECKY GILLETTE

With Arkansas having the third highest adult obesity rate in the nation with about one in three residents obese, there is a compelling reason for healthcare providers to do more to help people lose weight. There are non-surgical weight loss programs available that can help people live longer, healthier, happier lives. “We focus on individual behavior change emphasizing what the individual needs to have successful weight loss and eventually weight management,” said Natalie Williamson, MS, CPT, who is program team leader for the Weight Loss Program-HMC at Baptist Health in Little Rock. “We meet with each participant weekly to monitor their progress and to make (CONTINUED ON PAGE 6)

Improved Sightlines FDA Approves Novel Gene Therapy


In mid-December, the U.S. Food & Drug Administration announced approval of Luxturna (voretigene neparvovecrzyl), the first directly administered gene therapy approved in the U.S. to target a disease caused by mutations in a specific gene … in this case, a rare form of inherited vision loss ... 5

UAMS Trauma System Saves Lives and Taxpayers’ Money

System has seen considerable growth under Ronald Robertson leadership By BECKY GILLETTE

See the Grand Rounds section beginning on page 7 for healthcare spot news from around the Natural State.



Ronald Robertson, MD, chief of the Division of Trauma, Critical Care and Acute Care Surgery in the University of Arkansas for Medical Sciences (UAMS) College of Medicine, has overseen major growth in both the number of patients and the number of trauma certified physicians on staff since he took over as medical director of the Arkansas (CONTINUED ON PAGE 4)

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Alexander Orsini, MD, Touts Advances to Treat Heart Failure Cardiologist recommends physicians talk to patients about smoking and obesity By BECKy GILLETTE

LITTLE ROCK—Alexander Orsini, MD, who practices with Arkansas Cardiology, gets great satisfaction from seeing heart failure patients today who have been successfully treated with the ground-breaking medicine Entresto. “From a purely cardiology point of view, the biggest development we have had in my 21-year career is in medication,” Orsini said. “The drug Entresto is our first ground-breaking drug for heart failure in 15 years. It was approved in October 2016. It keeps people out of the hospital and keeps people alive better than any drug we have had before. It is truly a novel, ground-breaking drug. Bad heart failure patients can suddenly breathe, walk and leave the hospital.” He has seen certain patients literally get a new lease on life because of the medication. One is a young woman with a bad heart who was denied a kidney transplant because her heart was not strong enough. Now she has improved enough that she is on the kidney transplant list. When patients who have had trouble breathing or even walking across the room take the medicine, the results can mean years more of being able to enjoy life. Orsini finds that particularly rewarding. The other big, single largest development since he has begun practicing is the transaortic valve replacement where aortic values can be replaced with the minimally invasive catheter approach. “That is the single coolest development of my 21 years of practice,” Orsini said. “Historically, we had to open up the chest to replace the valve. If you were old and frail, we couldn’t replace the valve and people would die of a bad aortic valve. Now we make a cut in the groin, head up to the heart and replace that valve. We wake them and they can have lunch with their family later in the day and go home the next day. And they can breathe.” He recently had a 90-year-old patient who was dying in the hospital until he went to the cath lab and came out immediately feeling tremendously better. “He cried afterwards and said, ‘I ARKANSASMEDICALNEWS


can’t believe it. I feel better already’,” Orsini said. “We got him through and he went to rehab walking and getting active again. That is a man who a few years ago would have died. Instead, we get to enjoy him for a few more years. That is wonderful.” Orsini developed an interest in medicine early. As a kid, he particularly enjoyed all his science classes. By the time he was in college, though, he knew he wanted more than working in a lab; he wanted to be in a job interacting with people regularly. He finds people fascinating. He also had a good role model in the family. “My uncle was a pediatrician,” Orsini said. “I followed him around. He had good satisfaction with his job and enjoyed his patients. And I found that the human body is fascinating.” Orsini was born in Fayetteville, and moved to Little Rock when he was three. He graduated from Catholic High School in 1987 and from the University of Arkansas for Medical Sciences College of Medicine in 1995. At medical school, choosing a specialty proved to be challenging because he loved everything: ear nose and throat, OB\GYN, hematology, etc. But he was especially drawn to cardiology because it provides an opportunity to really help

someone while also establishing long-term relationships with patients. “Cardiology includes exciting, fast-paced things like heart attacks, but I also get to see patients in clinics,” Orsini said. “I get to know them and their families. You get the satisfaction of seeing patients whose lives have been saved and the gratitude from the patients and their families. You get a lot of hugs, pies and cakes, and all the perks of getting to know a bunch of nice people.” Orsini spends more time in the clinic talking to patients about obesity, smoking and exercise than he does explaining cardiology procedures. “If cardiologists could stop people from being overweight and smoking, we would be bored and bankrupt,” he said. Do patients listen? Not as much as he would like. “About half of our smokers quit if we stay after them,” Orsini said. “But if you take 100 people who weigh 300 pounds or more, maybe five percent will listen. My success rate is far less than with smoking. Morbid obesity is truly epidemic and it is really hard to overcome.” Still, he recommends family care physicians talk to their patients about obesity. And he does find it especially rewarding when a patient comes in who has been successful in dropping weight. “When people do listen to you and lose weight, they are so happy,” he said. “They come in with a smile and say, ‘Weigh me! Weigh me’! It is really fun just to be around them. They are so happy. They breathe better, and may have dropped two or three medications. You can feel their positive energy and happiness. It is very rewarding getting people to drop weight.” Orsini believes the next frontier in heart health will be not advances in cardiology directly, but working on helping people with weight control. More needs to be done to pound in the message of the importance of a low carb diet and exercise. “That would be the greatest thing we could do cardiac-wise to get our nation eating healthier, moving and not smoking,” he said. Orsini is well regarded by his pa-

tients. Debbie Blanton of Okolona, a pharmacist in Arkadelphia, said Orsini has treated several members of her family including herself, her husband, Jim, a retired FBI agent, and his father, James Blanton, who passed away at age 92. “He and his whole office staff feel like part of our family,” Blanton said. “He is very personable and so intelligent, rare but great qualities for a cardiologist. He is very passionate about what he does. He hears every word that you say. He’s one of those one-in-a-million guys who can have MD behind his name, but also be a normal person. I just can’t say enough about him. He’s a treasure to us.” Personally, Orsini stays in shape by jogging. He has been running 5 to 10 miles a day several times a week for about 20 years. His other hobbies are reading, playing the guitar and going to sport activities for his three sons. He and his wife, Angela, who have been married 22 years, have three surviving sons: David, 16, is a swimmer and twins Jacob and Noah, 9, play tennis and basketball. They lost another son, Michael, who passed away at age 13 months from leukemia. The couple since has established the Michael Orsini Endowment at Arkansas Children’s Hospital. Orsini is affiliated with the Arkansas Heart Hospital, Baptist Health Medical Center North Little Rock and Baptist Medical Center Little Rock.

For more visit: Important Facts about Entresto, important-facts.jsp

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UAMS Trauma System Saves Lives, continued from page 1 Trauma System in 2013. The only adult Level One Trauma Center in the state that takes care of the sickest patients saw 1,600 trauma activations and had three trauma surgeons when Robertson took over the program. In 2017, the number of trauma activations had increased to 2,784 for the year and staff had grown to nine full-time physicians with additional training in trauma, critical care and acute care surgery. “The program has grown considerably,” Robertson said. “It has been very fulfilling. We have been able to hire some of the most skilled trauma surgeons in the country who have trained at some of the best trauma programs in the country. Outside of UAMS, there is not another hospital in the state with fellowship-trained trauma surgeons. We have a unique ability to take care of the trauma situation.” Robertson, a native of Kansas City, Mo., was raised on a farm and initially intended to become a veterinarian. But while attending the University of Arkansas at Fayetteville, he became more interested the health of people. Then, while doing his residency at UAMS, he was mentored by two physicians passionate about trauma care, John Cone, MD, and Terry Collins, MD. “I was totally enthralled by trauma patients,” Robertson said. “I have always enjoyed taking care of sicker patients. I love the notion that I don’t know what is coming through the door next. I am a bit of an adrenaline junkie. I decided trauma

was where I wanted to be.” Robertson, who has been on the UAMS faculty since 1996, said the types of trauma they treat break into two major categories: blunt injuries from falls, and motorcycle, car and ATV accidents, and penetrating injuries such as gunshot and knife wounds. About 80 percent of their cases are blunt and 15 percent penetrating. UAMS is unique having the only true tertiary trauma referral center in the state at the only academic medical center in the state. “Geographically, we are located in

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the center of the state, so everything tends to flow in to us,” Robertson said. “On the edges of the state, there are other trauma centers that help but, by and large, we provide the largest amount of trauma care to patients in Arkansas.” Robertson said Arkansas was a bit late to the game developing a statewide trauma system. But that allowed the people involved in the development of the trauma system launched in 2010 to look at every other system in the country for ideas about how to have the best integrated statewide trauma system. “By doing so, we are now considered to have one of the best trauma systems in the country,” Robertson said. “We have a centralized trauma call center, and can get patients with special needs to the right place at the right time. We have a statewide trauma registry, and every trauma patient gets a trauma wrist band that follows the patient from pre-hospital to hospital and discharge. This allows us to query our data registry and find out where our problems are and formulate a corrective plan to fix any problems.” There is also a trauma image repository of CT scans done in any trauma center around the state. Whatever hospital receives that patient can pull those images into their facility. “It allows us to streamline care and become much more efficient, which is particularly important for injuries that are time sensitive such as people with serious brain injuries or bleeding in the abdomen,” Robertson said. “It allows us to provide the best care possible for those patients. It also prevents people from having radiation exposure twice. There are cost savings, patient benefits and a physician benefit from the standpoint we know early on what we are dealing with. We formulate a plan before the patient ever gets here.” A study done by UAMS faculty published in the Journal of the American College of Surgeons in April 2017 estimates that implementation of a statewide trauma system in Arkansas reduced the rate of preventable deaths due to injuries nearly in half over five years and saved 79 lives over a 12month period. “From their analysis of the economic

impact of lives saved, the study investigators concluded that the Arkansas Trauma System annually saved $186 million, giving state taxpayers a roughly ninefold return on investment from the $20 million per year in public funding the system has received,” the study authors said. Robertson also oversees a program called Stop the Bleed teaching police and others how to do tourniquets for gunshot wounds in the field. “Unfortunately, our country has suffered mass shooting and multiple casualty events,” Robertson said. “What we have learned as we have studied those is to have the biggest impact in those type of events, you need to provide the first responders with the ability to control the bleed. People suffering from life-threatening hemorrhage can die within four or five minutes. If we can arm people with knowledge about how to appropriately apply a tourniquet, we have the best opportunity to save these patients’ lives.” The Stop the Bleed program has been used to train state police and Little Rock police, and they are currently working on training teachers around the state. “Our goal is to try to make this as broad a scope as we can, and impact the largest number of Arkansans we can, to arm them with that knowledge if they are ever in that situation to be able to help someone else,” Robertson said. Another important development with trauma has been to develop multi-modal pain therapy utilizing anti-inflammatory medicine, peripheral pain blocks and narcotics. “Everyone is aware of the opioid crisis and trying to move away from prescribing narcotics,” Robertson said. “By using multi-modal pain therapy, the need for narcotic usage is dramatically decreased.” Robertson and his wife, Carla, are empty nesters with four adult children. They enjoy being outside, hiking and photography. They like to travel and especially enjoy Mexico. “We travel, but we always enjoy being able to explore Arkansas,” Robertson said. “Arkansas is a breathtaking state and so much is offered here. I also work on cars. Things like that sort of allow me to escape and not be locked into being a doctor 100 percent of the time.” Robertson was the recipient of the Robert M. Bransford, MD, Memorial Award for Outstanding Chief Resident in General Surgery in 1995 as well as the Society of Laparoendoscopic Surgeons Resident Achievement Award winner in 1994.

Check out this article online at for these additional resources: Arkansas Department of Health Arkansas Trauma System Arkansas Trauma System Saves Lives and Taxpayers’ Money Arkansas Trauma Society



Improved Sightlines FDA Approves Novel Gene Therapy By CINDY SANDERS

In mid-December, the U.S. Food & Drug Administration announced approval of Luxturna (voretigene neparvovecrzyl), the first directly administered gene therapy approved in the U.S. to target a disease caused by mutations in a specific gene … in this case, a rare form of inherited vision loss. “Today’s approval marks another first in the field of gene therapy — both in how the therapy works and in expanding the use of gene therapy beyond the treatment of cancer to the treatment of vision loss — and this milestone reinforces the potential of this breakthrough approach in treating a wide-range of challenging diseases,” said FDA Commissioner Scott Gottlieb, MD, at the announcement. Luxturna, by Spark Therapeutics, is approved for the treatment of patients with confirmed biallelic RPE65 mutation-associated retinal dystrophy, one cause of Leber congenital amaurosis (LCA) – a congenital condition causing vision loss typically associated with nystagmus with normal-appearing or near normal-appearing retinas. Despite cursory appearances, however, the retinas are not normal, and the progressive disease leads to blindness, explained Stephen Russell, MD, the

Schrage Professor of Ophthalmology at the University of Iowa and one of the lead researchers of the recently approved gene therapy. Often, parents of LCA patients first note the baby isn’t attentive to the mother’s face. Diagnosis is typically made by electroretinography. The RPE65 gene helps create an enzyme essential for normal vision. Those with mutations in the gene have reduced or absent levels of RPE65 activity. Luxturna uses a naturally occurring virus that has been modified with a recombinant DNA technique to deliver a normal copy of the RPE65 gene directly to retinal cells to improve vision. Physicians inject billions of modified viruses into both eyes of the patient. In the Phase 3 trial, which was conducted at the University of Iowa and at the Children’s Hospital of Philadelphia, nearly 90 percent of patients demonstrated significant response to the therapy. The study utilized an obstacle course bathed in varying light levels to measure post-treatment improvement in navigation over baseline. Following treatment, patients experienced meaningful progress in their visual acuity … enough that they could navigate the maze in low to moderate light without a cane or guide dog. They also showed improvement in light sensitivity and peripheral vision, which are two visual deficits these patients also experience.

FDA Highlights Potential Risk with Compounded Vancomycin While new treatments like the recently approved targeted gene therapy continue to come online to improve vision, not all recent ophthalmology news is good from the FDA. The federal agency released a warning brief in October 2017 regarding the risk of legal blindness with eye injections of compounded drugs containing vancomycin. “Raising awareness about emerging safety issues associated with compounded drugs is a top priority for the FDA’s compounding program,” noted Janet Woodcock, MD, director of the FDA’s Center for Drug Evaluation and Research. In early October, she said the agency provided details about a case of severe vision loss associated with eye injections of a compounded drug containing vancomycin and sanctioned the addition of a severe vision loss warning in FDAapproved labels of injectable vancomycin. However, Woodcock noted, “Since labels for compounded drugs are not reviewed or approved by the FDA, this warning will not necessarily be included in the labels of compounded drugs with vancomycin for injection. Therefore, healthcare providers administering eye injections of compounded drugs containing vancomycin for prophylaxis may not be immediately aware of this potentially blinding postoperative complication associated with its use.” The new warning came after the FDA received an adverse event report last August from a physician concerning a patient diagnosed postoperatively with bilateral hemorrhagic occlusive retinal vasculitis. Although rare, the potentially blinding complication has been observed in dozens of patients who have received intraocular injections of vancomycin formulations toward the end of otherwise uncomplicated cataract surgeries.

“There are at least 17 different genes, which if mutated can cause Leber congenital amaurosis,” explained Russell. “About 8 to 10 percent of LCA patients will have biallelic RPE65 mutations.” With LCA affecting only about 1 in 80,000 individuals and the specifically

targeted mutation impacting a small percentage of that population, the number of individuals who will benefit from this new therapy is quite small. Still, the potential impact is huge. “We’ve been working on gene (CONTINUED ON PAGE 7)

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Non-Surgical Weight Loss Programs, continued from page 1

(PART 1)

An audit these days for a physician clinic may begin innocuously, with a request for a handful of medical records; an unannounced, on-site visit from a Medicare or Medicaid auditor; or with a piece of mail that could easily be mistaken for junk mail. Audits have many origins, and a relatively recent development which may begin a lengthy and expensive audit process is the issuance of a “Comparative Billing Report” (CBR). A company called “Global Tech” issues these CBRs to physician providers. Global Tech, according to its website, is a Federal services firm based in Arlington, Virginia, and has been contracted by the Centers for Medicare & Medicaid Services (CMS) to develop and disseminate certain “educational tools,” like these CBRs, to physician practices. While the Medicare Administrative ConThe Authors: tractors (MACs) have been distributing similar peer-comparative reports for several years, CMS has now expanded this program to a national level with Global Tech. CBRs are not currently sent to hospitals, but only to physician practices. If you receive a CBR, you should pay close attention to the document. It could very easily be mistaken for a piece of junk mail. CBRs are sent to provide insight into billing trends and to inform providers with regard to how that provider’s billing practices compare to its peers across the region. CBRs contain data-driven tables and graphs that contain an explanation of findings comparing a particular provider’s billing and payment patterns to those of its peers, both in the same state and across the nation. The stated goal of these CBRs is to offer a tool that helps providers better understand applicable Medicare billing rules and improve the level of care they provide to their Medicare patients. The possible bad news is that, generally speaking, if you receive a CBR, it means that you have been identified as an “outlier” as compared to your peers, with respect to utilization of a particular CPT code and/or performance of a particular procedure.  In fact, you should be especially on alert for receipt of a CBR if you or your practice is a high volume practice which bills certain CPT codes repetitively. As a proactive measure, you should review your most commonly submitted codes and confirm that your claims submission and supporting documentation are in accordance with Medicare (and Medicaid) requirements regarding the same. Recommended follow-up after receiving a CBR includes:

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• Conducting reviews of your documentation to be sure that your documentation supports the particular CPT code that is at issue, and that the overarching medical necessity is clearly documented. • Identifying Medicare regulations, payment policies and reimbursement guidelines which are applicable to the particular CPT code(s) at issue. • Considering engaging counsel to assist with the foregoing. While the stated goal of the CBR is educational in nature, keep in mind that data mining is continuous with all CMS contractors; and once your practice has been identified as an outlier, receipt of a CBR is very possibly only the first of many steps that may follow in the precarious course known as a Medicare audit.





Natalie Williamson

any necessary adjustments.” Williamson said their program covers a lot of territory including nutrition, exercise, stress, shopping, planning, cooking, eating out, hydration and balance. “It is a lifestyle that we teach with the goal of having weight loss turn into weight management,” Williamson said. “If you don’t make it a lifestyle, then you will continue to yo-yo up and down with your weight.” Candidates for the weight loss program include anyone looking to lose 20 or more pounds who is interested in sustainable weight loss and management. Williamson said their program focuses on portion control, nutrition and metabolism. The “secret” to success is being consistent and ready. Williamson said there are five stages to change and it is important to prepare. “Just because you want to manage your weight does not mean you are ready to do so,” Williamson said. “It does not happen overnight. It is a series of ups and downs.” She recommends exercise because that helps speed up the metabolism to burn more calories. “Metabolism is the pacer for caloric intake,” Williamson said. “The more healthy muscle we have, the more energy our body needs to run it. The type of exercise a person needs is individualized, just like a person’s diet. Each individual has different needs, likes and dislikes.” The program can be done in conjunction with bariatric surgery for weight loss. Williamson said the surgery itself does not fix what someone eats or wants to eat. “The lifestyle changes have to come regardless for the surgery to be effective long term,” she said. “If you don’t change the lifestyle, the weight will only come back.” Williamson said some people really like electronic devices such as the BodyGem that measure your resting metabolic rate (RMR). “This is how many calories you burn at rest,” Williamson said. “This will also tell you if you are suffering from a low metabolism or a high metabolism. When you eat either too much or too little for what you need, it causes you to gain weight or not be able to lose weight. Many factors affect metabolism but only 2 factors increase metabolism: exercise

and eating habits. The more you move, the more you burn, but too much of a deficit has the opposite effect. Lack of calories will cause your body to resort to other sources of fuel – muscle. Losing muscle lowers metabolism, causing your RMR to decrease and directly lowers the amount of calories you can eat without gaining weight. Eating only one big meal a day will slow your metabolism down or put it in starvation mode.” Williamson said the bottom line, diet and exercise are individualized. Age, activity, medications, chronic medical conditions and activity need to be factored in. There is no one size fits all diet program or exercise program – but there are programs out there that can be tailored for you.” Nancy Owens, a personal trainer and group fitness instructor who is director of a program called Best Life at St. Bernards Health & Wellness in Jonesboro, relates well to people in the program. “In my own personal journey, I was not really a fitness person for many years,” Owens said. “I saw working out and dieting as torturous. I would go on a diet and work out for a while, get decent results, and then sink back to old behaviors. I was on a see saw. I came to realize wellness was more than a diet and more than working out. It was balancing your own life. As I began to do this for myself, people would

Nancy Owens

ask me how I was doing it.” The Best Life program is designed to teach people how to incorporate movement and sensible ways of eating that aren’t about deprivation and aren’t about extremes. It is about making small changes. “To be a healthy person, you can have some of the things you love to eat in balance,” Owens said. “Instead of doing some extreme plan, I always ask participants to begin with being aware of how much you are eating so you have a real idea of your calorie intake. There are a lot of apps now on phones where you can track what you are eating.” Owens said success is based on making sensible choices. For example, calories from sodas or sweet drinks can add up very quickly. “Even with diet sodas, you are taking in artificial chemicals and that is really no better,” Owens said. “In many cases, diet (CONTINUED ON PAGE 7)



Non-Surgical Weight Loss Programs, continued from page 6

sodas cause the same kind of rise in insulin in the body.” Keeping a food diary is a good idea. Owens is sometimes shocked when looking at someone’s food diary that they have so few vegetables or fruit in their diet. “For many of us, it is so much easier to grab something that is processed,” Owens said. “The closer to nature it is, the more likely it is going to have more nutrition. How much of your food looks like food? How closely does it resemble nature?” Healthy eating has gotten a bad rap, she believes. She tries to dispel the idea that you can’t enjoy food and still be a desirable weight. “I throw spinach into my smoothies all the time,” she said. “There are a lot of healthy foods that are really delicious. I always do one food demo with my programs to show how easy it is to prepare healthy food and how good it tastes. Healthy is not boring. Healthy is delicious if you just do a little bit of research.” Starting to work out after not being

active can be daunting. Owens likes to start people out slow with basic workout movements. It is rewarding to see how fast people can improve. “People who were not very strong and had little endurance really start showing improvement within four to six weeks,” she said. “They are starting to feel energetic. That momentum gets them excited and then they can increase the exercise intensity.” While she works with people in individual training and group classes, she also talks to participants about the benefits of incorporating movement into their day. “If you sit at a desk all day and get up, get up and walk for ten minutes when you have a break,” Owens said. “It gets all your major muscles moving, it lifts your mood, and it gets your heart beating stronger. If you are looking for heart health, you are going to have to tax your heart a bit. Create a plan, know your goals—whether they are better heart health or weight loss – and know all the steps to get there.”

For more visit: St. Bernards Health & Wellness, Baptist Health offering new weight loss device,

Improved Sightlines,


continued from page 5 therapy without a lot of success for nearly 40 years,” said Russell. “This is the first unequivocal example of success.” He noted that Edwin Stone, MD, PhD, a colleague at Iowa, recently published a paper that found of the 1,000 families with retinal degeneration with whom Stone works, about 76 percent could be genetically characterized. Of that group, nearly 75 percent had a mutation in the gene small enough to fit into the adeno-associated virus (AAV) vector gene used in the Luxturna study. “In the area where I’m working, perhaps as many as 50 percent of patients with retinal degenerations can be treated in a similar manner … so it begins to allow you to see the potential impact,” Russell added. Although quick to emphasize the science isn’t yet there, the fact remains that the RPE65 study opens new doors … but it also raises new questions. One unanswered question, Russell continued, is “how this fits in with personalized medicine because the cost for developing gene therapy for rare gene mutations is a costly, highly regulated process. How are the costs of these sorts of treatments going to be handled?” Despite unanswered questions, Russell concluded, “It’s all very exciting. Things are changing fast, and that’s good.”

Arkansas Children’s Hospital Earns Honors As A Top Nurse Employer In Arkansas LITTLE ROCK -, the web’s leading career site for nurses, has recognized Baptist Health Medical Center as one of the top hospitals for nurses to work for in Arkansas. Over the past two years, has collected 735 surveys of nurses from 72 hospitals in Arkansas about their workplace satisfaction. The data from the reviews from Arkansas state revealed that Arkansas Children’s Hospital has one of the highest levels of job satisfaction among its nurses. Reviewers cited supportive coworkers, flexible scheduling, and competitive pay as the basis for the 4.3 star rating with 96% of the nurses surveyed recommending the hospital as an employer. provides a safe platform on which nurses leave honest workplace reviews. Completely anonymous, nurses share their opinions about culture, nurseto-patient ratios, and other matters important to them. Making the list of top hospitals shows the facility is focused on nurse satisfaction. Nurse recruitment -- a challenge today -- becomes easier when the hospital can demonstrate its commitment to nurses by pointing to an unbiased source. The full rankings of the Best Hospitals in Arkansas for Nurses is available to view at

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GrandRounds Bobbitt to Recommend Patterson as UAMS Chancellor LITTLE ROCK – University of Arkansas System President Donald R. Bobbitt has recommended Cam Patterson, M.D., as the next chancellor at the University of Arkansas for Medical Sciences (UAMS). Patterson, currently senior vice president and chief operating officer at Weill-Cornell Medical Center, New Dr. Cam Patterson York Presbyterian Hospital, is expected to join UAMS June 1, 2018 after seeing a major construction project on that campus through completion. The other finalist, Stephanie F. Gardner, Pharm.D., Ed.D., interim chancellor, senior vice chancellor for academic affairs and provost at UAMS, will continue to lead the institution through the transition. “We were very fortunate to have two extremely high-quality candidates who both offered strong skill sets to help lead UAMS into a very crucial period in its continued tradition of innovation and excellence,” Bobbitt said. “In the end, Dr. Patterson’s experience in leading a very complex clinical enterprise and his varied background in clinical care, research and administrative leadership elevated his candidacy. I am thrilled to bring him on board and welcome him and his family to Arkansas. “I am also extremely grateful to Dr. Gardner for her leadership and her candidacy for this position. She has proven herself to be an exceptional leader and an invaluable member of the UAMS leadership team.” The recommendation is subject to approval by the Board of Trustees of the University of Arkansas, which will meet by telephone to consider the appointment after the holiday break. “I am humbled and honored for the opportunity to lead UAMS during such an important time for academic health centers across the country,” Patterson said. “I know that we have many key initiatives underway and decisions to make in both the short- and long-term, and I am committed to working with our team to ensure we continue to provide the very best education, health care and research for the state. I enjoyed my time visiting with the students, faculty and staff on campus and look forward to learning more about UAMS and the state of Arkansas as I prepare to make this transition. I also want to acknowledge and offer my sincere thanks to Dr. Gardner for her leadership. I am excited to work with her to advance the mission of UAMS.” “I want to offer my congratulations to Dr. Patterson and welcome him to the UAMS family,” Gardner said. “I look forward to working with him. I truly believe there is no other institution more important to our state than UAMS and




I am excited about our future under Dr. Patterson’s leadership.” Chaired by Jeannette Shorey, M.D., associate provost for faculty and professor of Internal Medicine, the advisory search committee included representatives from campus faculty, administration and staff, supporters from across the state and a Trustee of the Board of Trustees of the University of Arkansas. “The committee deserves a lot of praise for the hard work and many extra hours they put into this national search that came in addition to a commitment to their current positions,” Shorey said. “Our group worked hard alongside the search firm to help identify individuals who we felt to be the best fit for this campus at this time. I’m very grateful to each of them.” Patterson has served as senior vice president and chief operating officer at Weill-Cornell Medical Center since 2014. A cardiologist, Patterson previously held numerous academic and clinical appointments at the University of North Carolina, including as physician-in-chief at the UNC Center for Heart and Vascular Care and executive director of the UNC McAllister Heart Institute.

Conway Regional Welcomes New Hospitalist and OB/ GYN to Staff CONWAY - Kristy King, MD, an internal medicine physician, has joined the Conway Regional Health System hospitalist team. She has more than 10 years of experience in primary care medicine in various hospital settings. Dr. King has prac- Dr. Kristy King ticed at several area hospitals including St. Vincent Rehabilitation Hospital and Conway Regional. Dr. King completed a three-year residency in internal medicine at West Virginia University Hospital at Morgantown and holds a medical degree from the University of Arkansas for Medical Sciences at Little Rock. She also holds a Bachelor of Science in Biology from the University of Arkansas at Pine Bluff. Katy Cox, MD, an OB/GYN, has also joined the Conway Regional Health System medical staff. She began practice at Conway OB-GYN Clinic in January and will see patients exclusively at Conway Regional. She will practice alongside Carole JackDr. Katy Cox son, MD, Phillip Gullic, MD, Keitha Holland, MD, and Lauren Nolen, MD, at Conway OB-GYN Clinic. The practice has two clinics. Dr. Cox will practice at the 525 Western Ave, Suite 303 office located at Conway Regional Medical Center. Dr. Cox completed a four-year residency from St. Louis University and holds a medical degree from the Uni-

versity of Arkansas for Medical Sciences. She also holds a bachelor’s degree in Biology from Hendrix College. She is married to Adam Cox, MD, an Internal Medicine specialist at Conway Regional Medical Clinic-Prince St.

Parson Named Chief Quality Officer FORT SMITH – Stephanie Parson, MSN, RN, CAPA, was recently named Chief Quality Officer of Sparks Health System. In this role, Parson oversees quality initiatives and patient safety for Sparks Regional Medical Center and its staff. She most recently served as Quality Stephanie Parson Department Manager where she was given oversight of the Joint Commission Accredited Primary Stroke and Congestive Heart Failure programs at Sparks. Parson holds a Master of Science in Nursing Leadership and Management from Western Governors University, and is currently pursuing a Post-Master’s Family Nurse Practitioner Certificate from Morningside College. She’s been with Sparks since 2001 where she worked as a nurse in the Ambulatory Surgery Center.

GoHealth Urgent Care and Mercy Partner to Create Premier Network of PatientFocused Urgent Care Centers in Multiple Midwest Markets ST. LOUIS, MO. – GoHealth Urgent Care, one of the nation’s fastest-growing urgent care providers, and Mercy, one of the nation’s most innovative and integrated care delivery health systems, announced they have partnered to create a substantial network of urgent care centers across the Midwest that will put patients first and deliver superior care and convenience. The joint venture will provide patients in Missouri, Oklahoma and Arkansas with greater access to innovative urgent care through state-ofthe-art technology and unique patient access tools—wherever and whenever they need it the most. Mercy and GoHealth Urgent Care plan to open more than 30 co-branded Mercy-GoHealth Urgent Care centers over the next two years, with convenient retail locations throughout St. Louis, Springfield, Oklahoma City and Northwest Arkansas. The joint venture will begin serving Mercy communities this summer, combining GoHealth Urgent Care’s industry-leading patient satisfaction ratings, technological advancements and award-winning center and website designs with Mercy’s longstanding reputation for high-quality, fully integrated acute and ambulatory health services. With these new MercyGoHealth Urgent Care centers, GoHealth Urgent Care will become one

of the nation’s five largest urgent care companies. Each Mercy-GoHealth Urgent Care center will operate seven days a week with extended evening hours, welcome walk-in patients and offer online preregistration and check-in to ensure that patients can access providers as quickly as possible and control when and where they are seen. The centers will feature electrostatic “smart glass” procedure rooms, transparent charting on a wide screen in each exam room, mobile x-ray equipment and Mercy’s unified electronic health record (EHR), including the user-friendly MyMercy patient portal. Mercy has grown to 44 acute care and specialty hospitals with over 40,000 co-workers, and a multispecialty physician group with more than 2,000 physicians. Mercy has a long history of care innovation and was among the first organizations in the U.S. to have a comprehensive, integrated electronic health record. In addition, Mercy was named a “Most Wired” health care organization by the American Hospital Association in 2017 for the 14th time since 1999 and has created a nationally recognized Virtual Care Center. GoHealth Urgent Care continues to rapidly expand its footprint across the U.S. The urgent care provider has grown more than 10-fold since the beginning of 2015.

Nurse Practitioner Kat Wilkerson Joins Baptist Health Urgent Care-Benton BENTON – Baptist Health Urgent Care in Benton is proud to welcome Anna “Kat” Wilkerson to its team of healthcare providers. Wilkerson, an Advanced Practice Registered Nurse (family specialty), brings several years of experience in emergency medicine Kat Wilkerson and long-term care to the center. Wilkerson most recently served as a Registered Nurse at Saline Memorial Hospital while also floating in the ER at Baptist Health Medical Center. During this time, she also served as an RN supervisor on weekends at Heartland Rehabilitation and Care Center. She previously worked at Mollen Immunization Clinics administering flu shots seasonally, as well as home health and skilled nursing and rehabilitation centers. The Benton center opened in October, joining four other Baptist Health Urgent Care centers in Arkansas. The center treats a variety of urgent care and family health needs from allergies, skin conditions and stings/bug bites to broken bones, childhood illnesses and vaccinations.



GrandRounds CHI St. Vincent Names RNRP Program Manager, Promotes Nurse Leaders LITTLE ROCK – CHI St. Vincent has announced the addition of a new manager for its Registered Nurse Residency Program (RNRP) and the promotion of two nurse leaders at CHI St. Vincent Infirmary in Little Rock. Nisa Trenthem was recently hired to oversee the RNRP, a specialized program that helps newly graduated registered nurses transition to an acute-care environment. The program uses classroom instruction, simulations, case studies and clinical and Nisa Trenthem observational experiences to help improve and maintain high-quality patient care. The program has transitioned more than 500 RN residents since 2009. In addition to Trenthem’s hiring, Jenny Bowe has been named clinical director of maternal child health, medical services, and behavioral health, and Tabitha Jenny Bowe Childers has been named clinical director of emergency services. Trenthem most recently was part of the start-up leadership team for the new Baptist Health Medical Center Tabitha Childers in Conway, where she supervised the ICU, Cardiac Cath Lab and Interventional Radiology Services. Before that, she was assistant director of nursing at the University of Arkansas for Medical Sciences. She has a master’s degree in nursing, and she started her nursing career in 2001 as a staff nurse in the emergency department at Methodist University Hospital in Memphis. Bowe has been at CHI St. Vincent Infirmary since 1977 and has served in a number of leadership roles, including as clinical nurse manager of the Neonatal Intensive Care Unit and clinical nurse manager of maternal child health. She obtained her master’s degree in nursing in 2015. Childers had been nurse manager in the Emergency Department since starting at CHI St. Vincent Infirmary in 2015. Before that, she was clinical supervisor at White River Health Systems. She also oversees the Intensive Care Unit and General Surgical and Surgical Step-Down departments. She started her career as a staff nurse in Alaska in 2000. Childers recently obtained her master’s degree in nursing administration.



Sparks ENT Expands in New Location FORT SMITH - Amy Stinson, DO, has joined Sparks Ear, Nose and Throat - West and is now accepting patients in a brand new location. Dr. Stinson is board certified in Otolaryngology and Facial Plastic Surgery and has been practicing in Fort Smith Dr. Amy Stinson since 2012. As a native of Fort Smith, she is active with several local non-profits including The C.A.L.L. and the Children’s Emergency Shelter. Dr. Stinson will work alongside Gary R. Highfill, M.D., and Donnelle Wagner, D.N.P, in a new clinic located at 520 Towson Avenue, Suite A. The clinic offers comprehensive services to diagnose and treat a wide range of conditions affecting the ears, nose and throat for patients of all ages, such as: • Chronic Ear Disease • Nasal Disease • Pediatric Airway Disease • Sinus Disease • Sleep Apnea Surgery • Thyroid & Parathyroid Surgery • Balloon Sinuplasty For more information on these providers, visit

Sparks New Information Systems Director Hired FORT SMITH – Joel Rownak has been selected as the new Director of Information Systems at Sparks Health System effective Jan. 15, 2018. As Director of Information Systems, Rownak will oversee technology and telecommunication Joel Rownak operations for both hospitals in Fort Smith and Van Buren, as well as the clinics. Rownak most recently served as Manager of Information Systems at Northwest Health in Springdale. He earned a Bachelor of Science in Business Administration from the University of Arkansas in Fayetteville and brings nearly 20 years of information technology experience to Sparks. Joel and his wife, Emily, have nine children. Sparks Health System includes Sparks Regional Medical Center, Sparks Medical Center – Van Buren, Sparks Clinic, Sparks PremierCare and the fully hospital-integrated Marvin Altman Fitness Center. For more information about Sparks Health System, visit www.

Baptist Health Welcomes Several Specialty & Family Practice Physicians LITTLE ROCK – Baptist Health recently welcomed several new providers including an interventional cardiologist, vascular neurologist, endocrinologist, and family physician to the healthcare system. Dr. Mohan Edupuganti is an interventional and general cardiologist at Baptist Health Cardiology and Medicine Clinic located in Little Rock. He completed his residency in Internal Medicine at Baptist Health System in Birmingham, Alabama, Dr. Mohan and a General and InEdupuganti terventional Cardiology Fellowship at the University of Arkansas for Medical Sciences. His areas of specialization include peripheral vascular disease, nuclear cardiology, transthoracic echo and trans-esophageal echo, vascular ultrasound, arrhythmia/pacemaker/defibrillator management, congestive heart failure management, lipid (cholesterol) management and preventive cardiology, venous disease, valvular heart disease and of course interventional and general cardiology. Dr. Sushrut Dharmadhikari is the newest vascular interventional neurologist to join Baptist Health Neurosurgery Arkansas in Little Rock. Dharmadhikari completed his residency at the UniverDr. Sushrut sity of Miami, as well as Dharmadhikari two fellowships – one in Vascular Neurology and the other in Endovascular Surgical Neuroradiology. His specialties include acute ischemic stroke, subarachnoid hemorrhage, hemorrhagic stroke, cerebral venous sinus thrombosis, cerebral angiography,

acute ischemic stroke interventions, cerebral aneurysm embolization, arteriovenous malformation embolization, arteriovenous fistula embolization, carotid angioplasty and stenting, intracranial angioplasty and stenting, head and neck tumor embolization, epistaxis embolization, cerebral venous sinus sampling, cerebral venous sinus thrombectomy and stenting, spinal angiography and transcranial doppler. Across the river, Dr. Sowmya Chandra Reddy joined Baptist Health Specialty Clinic-North Little Rock. She completed her residency in Internal Medicine at the University of Arkansas for Medical Sciences and a fellowship in Endocrinology at the University of Dr. Sowmya Alabama in Birmingham. Chandra Reddy Reddy’s areas of specialization include diabetes mellitus and its subtypes, insulin pump therapy and its management, benign thyroid disorders and thyroid cancer, ultrasound guided fine needle aspiration of thyroid nodules, disorders of lipid metabolism, adrenal disorders, bone health and osteoporosis, pituitary disorders, hypogonadism and polycystic ovarian syndrome, parathyroid disease and obesity and metabolic syndrome. Dr. Stephanie Cody is the new provider at Baptist Health Family ClinicHillcrest in Little Rock. She has practiced family medicine in Arkansas for the past 13 years. Cody and the clinic offer a wide range of medical services for the entire family including adult Dr. Stephanie Cody wellness exams, allergy testing, pediatric care, dermatological procedures, imaging, immunizations, lab testing, management of acute and chronic illnesses and preventive health.

Mercy to Begin Construction on Clinic in North Bentonville BENTONVILLE — Mercy will begin construction next week on a 7,400-squarefoot primary care clinic that will serve north Bentonville. The clinic is among seven clinics Mercy will open as part of a $247 million expansion in the region that includes the addition of a seven-story tower to the Rogers hospital. Mercy Clinic Primary Care – Walton Boulevard will house four providers and feature 14 examination rooms at 1401 N. Walton Blvd. Mercy Clinic President Dr. Steve Goss said north Bentonville’s population is growing, creating a need for more primary care providers in the area. Mercy’s expansion, called the Community Presence Plan, is part of an effort to care for patients closer to home. Crossland Construction Co. started construction the second week of January and will complete the building in eight to nine months. Mercy’s investment in the site and building is expected to total $4.1 million. The clinic will be Mercy’s sixth location in Bentonville. JANUARY/FEBRUARY 2018



GrandRounds CARTI Hires Chief Financial Officer, VP of Business Development

Dr. Jason Knott Joins Physicians at St. Bernards OB-GYN Associates

LITTLE ROCK - CARTI has named two new members to its senior management team, according to Adam Head, president and chief executive officer of the statewide network of cancer care providers. Jake Stover has joined CARTI as chief Jake Stover financial officer and vice president of financial affairs, while Rebecca Pearrow will serve as vice president of business development. Stover is a magna cum laude graduate of Rebecca Pearrow the University of Arkansas at Little Rock where he received a Bachelor of Health Science degree and was awarded as the inaugural Academic All-American while playing Division 1 baseball for the UALR Trojans. Also holding an undergraduate certificate in accounting, Stover later earned a Master of Health Services Administration degree at the University of Arkansas for Medical Sciences. Prior to joining CARTI, Stover most recently served as associate vice chancellor for finance and treasurer at the University of Arkansas for Medical Sciences. A native Arkansan from Newport, Pearrow is a magna cum laude graduate of Arkansas Tech University where she received a Bachelor of Science in Therapeutic Recreation before later earning a Master of Business Administration at Harding University. Pearrow most recently served as director of marketing and business development at Northwest Health/Siloam Springs Regional Hospital in Siloam Springs.

JONESBORO - Dr. Jason Knott has joined physicians at St. Bernards OBGYN Associates. He earned his Doctor of Osteopathy degree from Kirksville College of Osteopathic Medicine and completed a residency in the Department of Obstet- Dr. Jason Knott rics and Gynecology at New Hanover Regional Medical Center in Wilmington, N.C. Knott holds an undergraduate degree in genetics from the University of Georgia. He comes to Jonesboro from Batesville, where he was in a group private practice. He also worked at Lincoln Medical Center OB-GYN Associates in Fayetteville, Tenn., and Women’s Health Partners in Gadsden, Ala. In addition, Knott provided GYN services to underserved patients in a federally funded health clinic in Gadsden and provided weekend call coverage for private practice in southeast Alabama. Trained in da Vinci robotics assisted surgery, Knott is certified by the American Board of Obstetrics and Gynecology and is a fellow of the American Congress of Obstetricians and Gynecologists.

Kevin Cullinan Promoted At CHI St. Vincent LITTLE ROCK – Kevin Cullinan of Little Rock was promoted to the position of vice president of ancillary and support services at CHI St. Vincent. Cullinan has been with CHI St. Vincent since 2012 and was previously market director Kevin Cullinan of orthopedics and peri-

NARMC Receives National Recognition for Performance Leadership in Excellent Outcomes HARRISON – On National Rural Health Day, North Arkansas Regional Medical Center (NARMC) was recognized by The Chartis Center for Rural Health/iVantage Health Analytics and the National Organization of State Office of Rural Health (NOSORH) for overall Excellence in Outcomes, reflecting top quartile performance among all rural hospitals in the nation. The rankings are determined each year using iVantage Health Analytics’ Hospital Strength INDEX®, the industry’s most comprehensive and objective assessment of rural hospital performance. In partnership with NOSORH, iVantage Health Analytics has developed a data-driven program designed to identify excellence across a broad spectrum of indicators relevant to hospital performance and patient care. The Hospital Strength INDEX captures performance metrics for all rural and Critical Access Hospitals. Leveraging data from public data sources, INDEX aggregates data from more than 50 individual metrics into three major categories and eight pillars to derive a single strength overall rating for each facility.




operative services. As vice president of ancillary and support services, he will continue to oversee CHI St. Vincent’s orthopedics program, perioperative services, respiratory therapy, rehab services, and patient access. In addition to continuing those responsibilities, with this promotion he now has operational oversight for imaging, clinical engineering, facilities, and security for CHI St. Vincent. Earlier this year, Cullinan was named one of just 11 recipients of the prestigious “Tomorrow’s Leaders” award from the Catholic Health Association. He is recognized as an expert in managing bundled payments for joint replacements and is a frequent speaker on the topic at events across the country. He is a board member of the Arkansas Specialty Surgery Center and is on the advisory board for the University of Arkansas-Fort Smith master’s in healthcare administration program. Cullinan has a master’s degree from Cornell University and a bachelor’s degree from the University of Albany.

Dr. Joe Elser Joins CHI St. Vincent Primary And Convenient Care - Little Rock (Chenal) LITTLE ROCK – Dr. Joseph Elser, a board-certified pediatrician, has joined CHI St. Vincent Primary and Convenient Care – Little Rock (Chenal). Dr. Elser is well established and known in the community, having served for three decades of division chief Dr. Joseph Elser in general pediatrics for the University of Arkansas for Medical Sciences at Arkansas Children’s Hospital. He was a professor of pediatrics at UAMS/ACH. His specialty is pediatric headache management. He has repeatedly been named by various publications as one of Arkansas’s best doctors. He trained as a resident at UAMS/ ACH and attended medical school at UAMS. Dr. Elser’s clinic is located at 16221 St. Vincent Way in Little Rock.

General Surgeon Vinicio Medina and Travis Hess, MD, Join CHI St. Vincent Hot Springs HOT SPRINGS – Two physicians have joined CHI St. Vincent Hot Springs. Vinicio Medina, MD, is the newest staff member at CHI St. Vincent Surgery Clinic – Hot Springs. Medina practices general surgery. Dr. Medina received Dr. Vinicio Medina training in general surgery at the Morristown Medical Center in Morristown, N.J., and was a research fellow at New York University Langone Medical Center. He attended medical school at the University of Cuenca in Cuenca, Ecuador. Dr. Travis Hess has joined the staff of CHI St. Vincent Hot Springs as a physician working in the Emergency Department. Dr. Hess completed his residency at the Louisiana State University Health Sciences Center in Baton Rouge, La. Dr. Travis Hess He attended medical school at the University of Texas Medical School in Houston.

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GrandRounds Two New Members Join Arkansas Children’s Hospital Board of Directors LITTLE ROCK – Two new members have joined Arkansas Children’s Hospital Board of Directors: Dr. Tionna Jenkins of Little Rock and Ross M. Whipple of Arkadelphia. Jenkins serves as senior advisor of Health Equity with the Clinton Dr. Tionna Foundation’s Clinton Jenkins Health Matters Initiative. For five years, she has been responsible for leading the collaborative efforts with key industry, corporate, governmental, and nongovernmental stake- Ross M. Whipple holders to develop and implement a blueprint for action focused on solutions addressing systems change in Arkansas, which has resulted in $41.3 million prevention investments at the state level. In late 2012, Jenkins accepted a three-year appointment to the U.S. Department of Health & Human Services’ Regional Equity Council. One of her current projects is a partnership with Verizon Wireless, the Verizon Foundation and the Clinton Health Initiative to help better integrate technology with Arkansas health care, thereby improving patient-provider communications. Jenkins earned a PhD in public policy from the University of Arkansas at Fayetteville, an MPH from the University of Arkansas for Medical Sciences, and a BS from Philander Smith College. Ross Whipple serves as Managing Partner of Horizon Capital Partners, Chairman of the Board of Trustees of the Ross Foundation and President of Horizon Timber Services. Inc. Whipple formerly served as Chairman/CEO of Summit Bank. With over 40 years of banking experience, combined timber management and charitable organizations insight, Whipple has a broad base of relevant financial and operational experience. Mr. Whipple earned a B.S.B.A. from Henderson State University and an M.B.A. from the University of Arkansas. He is active in several organizations including: Arkadelphia Chamber of Commerce, First Presbyterian Church and the Ouachita River Water District. He is actively involved with Henderson State University, serving on their Board of Trustees and their Foundation Board. Other boards in which he is involved, include the Arkansas Forestry Association, Clark County Industrial Council, Economic Development Corporation of Clark County, UAMS Foundation, Bank of the Ozarks and U of A Steering Committee.



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At four months pregnant, Sasha arrived at UAMS in a coma. We gave her hope — and a baby son. Early in Sasha’s pregnancy, a tangle of blood vessels ruptured in her brain. She was airlifted to UAMS, where neurosurgeons are on call 24/7. By the time she arrived, she had no pulse and had to be revived twice. The UAMS team of neurosurgeons, high-risk pregnancy specialists, and other medical experts joined forces to save two lives. Thanks to the high level of care and expertise at UAMS, Sasha and her family had hope. Just months and two surgeries later, Sasha has a bright future and a healthy new son.

we providing life-saving neurosurgical care Get Sasha’s full story at

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