FOCUS TOPICS ONCOLOGY HEALTHCARE REAL ESTATE
March/April December 2015 2009 >> $5
PHYSICIAN SPOTLIGHT PAGE 2
Thomas B. Sneed, MD ON ROUNDS
Hospitals create additional demand for use of land and existing buildings By BECKY GILLETTE
Baptist Health Building New $130-million Hospital in Conway Hospital to have 96 beds, eight operating rooms, and a Level III traumacenter emergency room CONWAY—Located about a 30-minute drive from Little Rock, Conway has experienced some of the largest population growth in the state with the number of residents increasing from about 44,000 in the 2000 U.S. Census to about 60,000 currently ... 3
Arkansas Cancer Coalition Facilitates Arkansas Cancer Plan: the Bible for Cancer Coalition provides bird’s eye view of cancer treatment and programs in state LITTLE ROCK--Whether it is addressing the serious issue of access to treatment for cancer patients who need transportation or finding other resources providers can access for cancer patients, the Arkansas Cancer Coalition (ACC) is a one-stop resource center for the state ... 5
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Medical Corridors: Distinguishing Element of the Arkansas Economy While competition is alive and well in the healthcare industry, the congregation of facilities in close proximity to each other at the site level is usually driven by some form of working partnership between the users, said Hank Kelley, CEO of Kelley & Flake Commercial Inc., a real estate firm in Little Rock. “Having a ‘Medical Corridor’ like we have in Little Rock brings a regional rather than local emphasis to each facility and the city, as well,” Kelley said. “When we introduce new business owners to our region, we point with pride to the excellent medical facilities that line up on I-630 starting with Children’s Hospital in the downtown area, The Veterans Hospital, the University of Arkansas for Medical Sciences (UAMS) and CHI St. Vincent in the Midtown area, and CARTI, Baptist Health and the Arkansas Heart Hospital in West Little Rock, all connected by I-630 and I-430 for ease of access.” Kelley said this medical corridor and the individual healthcare facilities within this area are some of the most important distinguishing characteristics to the economy in Central Arkansas and the state. The economic development does not end at the doors of the healthcare facilities. Large healthcare facilities serve as anchors to the neighborhoods where they locate. “There is no doubt they create additional demand for use of land and existing buildings in the area,” Kelley said. “An example of this is the new (CONTINUED ON PAGE 4)
HealthcareLeader Chad Aduddell Chief Operating Officer for CHI St. Vincent By BECKY GILLETTE
LITTLE ROCK--When Chad Aduddell moved to Little Rock in 2012 to become president of Catholic Health Initiatives (CHI) St. Vincent Infirmary, he was tasked to confront the major challenges of operating in the black during a period of declining reimbursements and looming healthcare reforms that ended up dramatically increasing the number of insured patients.
Doing more with less requires hospitals to hone management by looking for opportunities to reduce costs through improving operational efficiency, while enhancing care to improve treatment outcomes. Aduddell, who had proved himself as having turnaround experience at hospitals in Oklahoma and Texas, rose to the challenge by helping oversee consolidations that included the acquisition by CHI St. Vincent of Mercy Hot (CONTINUED ON PAGE 8)
To promote your business or practice in this high profile spot, contact Pamela Harris at Arkansas Medical News. email@example.com • 5012479189 PRINTED ON RECYCLED PAPER
Thomas B. Sneed, MD Medical oncologist with CARTI By BECKy GILLETTE
LITTLE ROCK--Thomas B. Sneed, a medical oncologist with CARTI, had several careers before entering the field of medicine. He was a computer programmer, a restaurant manager in New Orleans, and taught ballroom dance before taking a job as a research technologist at the University of Arkansas. While working in medical research, he also did hospice volunteer work. That was when he decided to make medicine his life’s work. After graduating from the University of Arkansas for Medical Sciences (UAMS), Sneed trained at the Portland Program for Internal Medicine, and then did a fellowship at the MD Anderson Cancer Center for Oncology/Hematology. It wasn’t hard to decide where he wanted to end up practicing medicine. A native of North Little Rock, he decided to come home where he has now been in practice 15 years, joining CARTI a year and a half ago. In addition to seeing patients in Little Rock, Sneed travels to Russellville three
days a week and Conway one day a week. Going where the patients are rather than expecting them to travel to him is just one reason why Sneed’s patients say over and over again what a great doctor he is.
“Many cancer patients are not wealthy, and can’t afford to travel across the state,” Sneed said. “If you are feeling bad from dealing with a disease, you don’t want drive 150 miles if you can help it.” Sneed has seen dramatic improvements in cancer treatments, especially in certain kinds of malignancies, in recent years. “There has even been progress in lung cancer, which was virtually unthinkable in the past,” Sneed said. “The improvements in cancer treatments are largely due to the exploration of genome of a cancer cell, which can help us can target abnormal genes to retard the growth or destroy the cancer cell. All of this has been made possible by technology that just came into being in the 1980s and is now being fully exploited. Sneed understands how frightening and difficult it is to be facing cancer. He doesn’t give patients unrealistic expectations, but he does encourage them to have hope. “If you have hope, then you have a reason to go forward and attack the disease,” Sneed said. “I think in order to be a good doctor you have to be a human being first. You must be willing to open yourself up to feeling emotions. You are there to help the patient and part of that is treating the patient like a human being. Human beings have other desires than to just live another day. They want to live and they want to get better, but they also want people to understand they have things they want to accomplish that are important to them.” Sneed said one of the reasons he chose oncology is that when people are faced with life-threatening illnesses, they often become more completely what they were before. “Most people are good people, and most people become better people when faced with a life-threatening situation,” he said. “I basically believe people are good. Given an opportunity to rise to the occasion, almost all of them do.”
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Sneed has found that the attitudes of cancer patients can greatly influence healing. “People who are able to get up in the morning and have a reason to be alive are more likely to tolerate therapy and have a chance to get better,” he said. “I encourage my patients to live, and not just simply exist.” The improvements in cancer treatment include a revolution in the management of the side effects of chemotherapy. “Medications we have now to manage the side effects of chemo are extraordinary,” he said. “People come in who remember how horrible it was 25 years ago. Now we have medications that can prevent nausea. Cancer treatments have gotten more specific. We are not condemned to making people super sick and maybe killing the cancer. We are able to specifically target cancer cells in a way we were not able to do before. There are new opportunities for treatment every day that will make patients live longer and better.” Another development that Sneed is excited about, is the development of CARTI across the state and how that has helped individual practitioners and patients. “CARTI allows physicians to have the opportunity to enroll patients in clinical trials, and to develop advanced techniques for therapy and diagnosis that wouldn’t be there if I was out alone in the community,” Sneed said. He checks every day on the computer to see progress at the new CARTI Cancer Center facility under construction in Little Rock. “We are excited about the opportunities that are coming up with the new CARTI Cancer Center.” Sneed has advice for family medicine doctors regarding patients who have cancer: “Don’t assume there is nothing better to offer your patients without inquiring. There are many exciting things happening in our subspecialty that I couldn’t have guessed about 15 years ago.” A good example of that is recent proof that low dose CT scans are beneficial for detecting lung cancer very early at a stage when treatment is more likely to be successful. Sneed describes himself as “an Arkansas boy who came back home to practice medicine doing something he loves.” He said his family is very important to him, but they complain they rarely see him. Sneed is a history lover, particularly ancient Roman history, and he also appreciates art of all kinds. When he travels, the first thing he does is visit famous museums. While he has been to many museums both in the U.S. and abroad, one of his favorites is right here in Arkansas. “Crystal Bridges is one of the best museums I’ve ever been to,” he said. arkansasmedicalnews
Baptist Health Building New $130-million Hospital in Conway Hospital to have 96 beds, eight operating rooms, and a Level III trauma-center emergency room By BECKy GILLETTE
CONWAY—Located about a 30-minute drive from Little Rock, Conway has experienced some of the largest population growth in the state with the number of residents increasing from about 44,000 in the 2000 U.S. Census to about 60,000 currently. Faulkner County population has been on a similar trajectory. Long a referral center for not just Faulkner County but also Conway, Cleburne, Perry and Van Buren and Cleburne counties, Conway is soon to become a two-hospital town. Currently the Conway Regional Health System has a 154-bed hospital, about 125 physicians and 1,400 employees. The new Baptist Health Medical Center-Conway is being planned to provide 96 beds, eight operating rooms, and a Level III trauma-center emergency room. The new hospital will be located on about 37 acres on the west side of Interstate 40, near Exit 129. It is expected to employ about 425 people when it opens. Jamie Gates, executive vice president, Conway Area Chamber of Commerce, said the new hospital would firmly establish Conway as a regional destination for healthcare. “You could live 70 miles west or 70 miles north, and we are probably your stop for healthcare,” Gates said. “We have a healthy mix of employers including three colleges, manufacturers and the natural gas industry. And now healthcare is emerging as one of our largest employers.” The new hospital is needed because of the unprecedented population growth in the past ten years in Conway and the surrounding area, said Troy Wells, president and CEO of Baptist Health. “The new Baptist Health Medical CenterConway will address the healthcare needs of Troy Wells Faulkner County and surrounding areas,” Wells said. “It will be operated as a notfor-profit, faith-based community hospital offering comprehensive clinical services.” Wells said some of the most notable features of their hospital being built today, versus older hospitals, involve technology. This new medical center will be designed to integrate state-of-the-art equipment and technology. “Today, we have to retrofit existing hospitals to accommodate new technolarkansasmedicalnews
ogy, but in a new facility, it will be included in the design,” Wells said. “This would include both clinical technology, as well as information technology.” Baptist Health is collaborating with 30 Conway-based physicians in developing the hospital and plans to continue to partner with them as they manage the medical center going forward. Ben Dodge, MD, an orthopedic surgeon who is chairman of the Physician Steering Committee for Baptist Health Medical Center-Conway, said at the ground-breaking July 7, 2014 that the new hospital is the culmination of years of hard work and perseverance by a dedicated group of physicians and the steering committee that worked closely with Baptist Health Administration on the development of this project. “We are impressed with Baptist Health’s professionalism, integrity, and insight into the healthcare needs of Arkansans,” Dodge said. “We now look forward to the construction and subsequent opening of Baptist Health-Conway in early 2016.” Other alliances are also under consideration. “Baptist Health is interested in improving the health and well-being of this entire region, not just Faulkner County,” Wells said. “Part of our ability to do this might mean working with other providers in the region in a collaborative fashion. That might include other health systems, physicians or other community members such as schools, government, social service organizations, etc.” The construction phase of the 216,000-square-foot Baptist Health Medical Center-Conway is expected to generate approximately 250 jobs. GSR Andrade is providing architectural design services and CDI is serving as the general contractor. Baptist Health is the largest healthcare provider in Arkansas and has the state’s largest primary-care physician network. The Conway facility will be the ninth hospital operated by Baptist Health in Arkansas. Baptist Health has hospitals in Little Rock, North Little Rock, Arkadelphia, Heber Springs, Stuttgart and Hot Spring County. It is the state’s third largest non-government employer with only Walmart and Tyson Foods employing more people in the state. Visit www.baptisthealth.com
Don’t Let The March Winds Blow You Into A Billing Frenzy!
Spring is a time to renew, or start over. It is a time to organize and replace what is broken and outdated. Does your medical office need a spring cleaning? Starting with your billing and accounts receivable may be just the thing to make 2015 the best year ever for your medical office! Some people love the idea of spring cleaning or culling out the mess. The only thing better than getting your hands dirty with insurance denials or payer-specific edits may be delegating the job completely. The decision to use a billing service specializing in revenue cycle management may be one of the best decisions for your growing practice. AHIN Professional Services offers years of hands on, multi-specialty practice knowledge. Our certified coders are well versed in todays every changing requirements making sure our physicians receive the maximum payment for the services they provide. Rid your office of dirty task such as: • Daily claim review, scrubbing and submission • Hours on the phone with insurance companies • Claim error reports • Patient statement processing and mailing • Answer patient phone calls regarding billing AHIN Professional’s expert staff will provide your office all of the above as well as: • Electronically submitted primary, secondary and tertiary claims • 96% claims paid on first submission • End to end revenue cycle management • Fee schedule review and analysis • Denial management and resolution • Reporting analytics • And much, much more Research estimates medical offices in the U.S. leave millions on the table each year because staff is not aware of various payers plan specific billing requirements and medical policies. This year more than 11 million people signed up or renewed for health insurance on the state and federal exchanges. Correct medical billing is more important now than ever. These plan specific billing requirements, along with the rules and regulations of coding standards are constantly changing. It is almost impossible to incorporate the necessary training for your staff to maintain adequate knowledge in these areas. Keeping up with these standards and others is a number one priority for AHIN Professional. Our analytical tools allow us to provide you with detailed information for your practice. We can show you how to use these tools to increase your revenue. Let us work for you and allow you to do what you do best, provide excellent medical care to your patients. Allowing our staff to provide billing services to your practice may be more cost effective than employing staff and space allocation for them. If you are ready for a fresh new look and feel to your accounts receivable contact AHIN Professional Services @ 501-378-3233 or email info@ahinservices. com
Kim Allen, CPEHR Director, AHIN Professional Services www.ahinservices.com AHIN Professional Services @AHINPro
Heart Center of Excellence Construction Progressing at National Park Medical Center Hot Springs project a result of Capella Healthcare reinvestment By BECKY GILLETTE
HOT SPRINGS—An expansion of the National Park Medical Center (NPMC) that is expected cost in the range of $30 to $35 million over the next three years will create the area’s first stand-alone Heart Center of Excellence. “The expansion will provide folks with immediate, greater access to an excellent cardiology program,” said Jerry Mabry, president of Capella Healthcare’s Arkansas Market. Capella, based in Franklin, Tenn., is the owner of NPMC. “In fact, I feel it’s the best cardiology program in this region.” A groundbreaking for the project was held Nov. 18, 2014, for the 67,000-squarefoot expansion that will include renovations and additional space for the existing emergency department, in addition to the Heart Center. The expansion is located on about nine acres of land west of the current hospital between Hollywood Avenue and the Hot Springs Country Club golf course. NPMC has added two interventional cardiologists to their staff in the past year. The expansion won’t increase the number of beds at NPMC from the current 166, but will specialize those beds, particu-
larly in the area of cardiology. Mabry said the expansion demonstrates that NPMC is being a good steward in the way it approach the healthcare delivery system with the emphasis on making life better for local residents. “We have a large compliment of specialists, physicians, and hospital personnel who dedicate their lives to being better and providing better care for you and the public,” Mabry said. “We have been extremely appreciative of the outpouring of support from physicians, patients and the community, especially in the past year and a half. We have been very busy continuing to pursue our mission of what’s required to deliver the very best short and long-term healthcare solutions to this region. Our
commitment to this process has never wavered and is stronger today than ever.” Mabry said the project is a benefit of the policy of Capella Healthcare to reinvest 100 percent of its excess cash flow back into its hospitals in the form of equipment and expansions, which ultimately builds better healthcare for the community. The new addition’s location will be accessible from Hollywood Avenue, and the Heart Center will have its own separate entrance. The Heart Center will include a new waiting area, four state-of-the-art cardiac catheterization labs, a pre and post-op area, an eight-bed cardiovascular intensive care unit, and a high-tech cardiac rehabilitation and physical therapy department. “We are proud of the progress and
improvements that NPMC continues to make to the healthcare climate of Hot Springs,” said Joe Dierks, chairman of the NPMC Board and CEO of Greenleaf Financial. “The hospital’s leadership is committed to continuously increasing the healthcare services and specialists available in the Hot Springs community.” Dierks said the project will ultimately mean more and better healthcare services available to the community, more jobs available to area residents, and a financial stimulus to the area. The NPMC slogan is, “Caring Comes First. Always.” “It’s the level of individualized care and dedication to each individual patient’s well-being that really sets this facility apart from the others,” Dierks said. “They always put the patient first, and that is why this expansion is so important. By streamlining the emergency department, and making all the Heart Center of Excellence services located in one convenient location, the patient experience will be even more improved, making the care process even better for patients.” The increased space for the emergency department will ultimately lead to a more (CONTINUED ON PAGE 8)
Medical Corridors: Distinguishing Element, continued from page 1 NEA hospital in Jonesboro. A healthcare facility serves as a different type of anchor than a large retail user, but they do attract other businesses. Medical users want to be in the same area.” Restaurants and other specialty service retailers are particularly drawn to the traffic associated with medical facilities. Medical specialists who admit patients to the healthcare facility are also attracted to locate in the area. “Some medical users who admit patients to more than one hospital will resist locating on a specific campus location to avoid the view they are exclusive to a particular hospital,” Kelley said. “But healthcare systems are active in the acquisi- Hank Kelley tion of medical practices and those clinics will likely locate as close to the healthcare facility as possible.” The old real estate saying that it is all about “location, location, location” is never more true than with healthcare real estate. It is vital that the facilities be located near major roads or interstates. “It is extremely important that a regional patient can find the facility with minimum instructions and turns from the 4
primary highway system,” Kelley said. “Patients can be intimidated by secondary road systems and congested traffic if they are not accustomed to it in their daily life. We always evaluate the ease of access and visibility of various sites before making a recommendation to our medical clients about the real estate they need.” Proximity to major roads or intersections is particularly important in largely rural Arkansas, which has Little Rock as the medical hub for the state. “Many patients come in from rural locations outside of the central Arkansas area so, geographically, the easier the access, the better,” said James Harkins, a partner with Flake & Kelley. “This would be especially true for those patients who are coming in for life-saving James treatments such as those Harkins needed for cancer. The location of the CARTI is a prime example of a well-located facility as this is located just off of I-630 at the Barrow Road exit. As people come into the community for these types of treatments, there is already enough stress in their lives. This does not need to be exacerbated by having a treatment facility that is hard to access.”
Healthcare real estate is some of the more expensive property. In addition to needing to be located on major roads, costs are driven by the specialization of the finish of the building with more mechanical and electrical needs than a traditional office space. This category of real estate also contains risk when dealing with the retrofit of space from one clinical user to another as leases expire. Companies building new hospitals usually buy additional land surrounding the facility. “They want enough land to be able to expand, as well as potentially sell outparcels for groups where it is mutually beneficial,” Harkins said. “The hospitals really want physicians on their campus who can generate revenue for the hospital, as well as grow their own practice.” Because of recent changes in healthcare laws, there is increased interest by physician groups in locating near hospital campuses. “Physicians are interested in close proximity to hospital campuses,” Harkins said. “There are additional guidelines that physicians are required to follow, additional back office needs, and additional compliance needs. What you see is physician groups, especially specialists, moving closer to campuses and partner-
ing up with other physicians to have a set referral base. Having a referral base, hospital and other physicians together helps offset the additional cost of compliance and instability in not having that referral in place.” Expansions for medical office buildings can be driven by hospitals. “We have seen hospitals themselves be the catalyst for medical office buildings, and some physicians chose to be employees of larger medical system in order to really focus on what they do, which is to treat patients, not get bogged down with compliance and administration issue,” Harkins said. There can also be synergies from a number of varying specialty healthcare facilities being in close proximity. Specialists can benefit from a robust referral base. “And the benefits to the patients are positive in that if numerous treatments are required, their travel time can be cut down substantially if they are able to remain on one campus or in one location for all treatments,” he said. Harkin said the fall opening of the new $90 million CARTI Cancer Center, managed by Flake and Kelly, as well as the new Baptist Health Hospital in Conway, are both exciting additions to the healthcare landscape in Arkansas. arkansasmedicalnews
ARKANSAS on the MEND
BY BECKY GILLETTE
Arkansas Cancer Coalition Facilitates Arkansas Cancer Plan: the Bible for Cancer Coalition provides bird’s eye view of cancer treatment and programs in state By BECKy GILLETTE
LITTLE ROCK--Whether it is addressing the serious issue of access to treatment for cancer patients who need transportation or finding other resources providers can access for cancer patients, the Arkansas Cancer Coalition (ACC) is a one-stop resource center for the state. “We have the bird’s eye view of cancer control initiatives here in Arkansas,” said Trena Mitchell, MA, executive director, ACC, Little Rock. “We are facilitators and conveners of the Arkansas Cancer Plan, the bible for cancer that covers everything from prevention all the way down to survivorship. It is a Trena guide that our commuMitchell nity-based organizations, healthcare providers and clinics can use to incorporate evidence-based strategies to reduce and ultimately eliminate the burden of cancer in Arkansas.” With its partners who are coalition members, the ACC serves as a repository for information about who is working on which cancer strategies. “We are a hub for cancer resources and data,” Mitchell said. “We have a pulse on everything dealing with cancer in Arkansas. We know who the cancer control partners are in different areas of the state. We are provided with funding to implement the goals, objectives and strategies of the Arkansas Cancer Plan.” The ACC holds quarterly meetings that feature different partners who give updates and information about how they are working with cancer patients in their county. “There is no one model to fit every
single county,” Mitchell said. “Each organization puts its own spin on how they implement the strategies of the cancer plan.” Other services of the ACC include offering funding to community-based organization to offer trainings to healthcare
Dr. Erdem received his Doctor of Medicine degree from Istanbul University in Turkey.
• Cerebral Aneurysm Coiling
He went on to receive specialty degrees
• AVM Embolization
in the area of Diagnostic Radiology,
• Kyphoplasty, Vertebroplasty • Sacroplasty • Head and Neck Tumor Embolization • Acute Stroke Intervention
• Minimally Invasive Spine Decompression
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• Carotid and Intra Cranial Stents
• SI Joint Fusion
To submit or view local events visit the Arkansas Medical News website.
“There was a time here when partners in Arkansas worked in silos. People were doing a little here and little there. There was impact and change, but it wasn’t felt all over Arkansas. Since the coalition stepped
Baptist Health welcomes Neurointerventional Radiologist, Dr. Eren Erdem who joins Neurosurgery Arkansas.
• Spine Tumor Ablation
Online Event Calendar
providers. Grants ranging from $700 to $2,500 are awarded to assist with continuing education symposiums. “I think we are winning the war in creating awareness that cancer can be eliminated if we work together,” Mitchell said.
• Minimally Invasive Disc Herniation Treatment
Neuroradiology and Neurointerventional Radiology at Long Island College Hospital in New York, Children’s Hospital of Philadelphia and Lahey Clinic in Boston. Dr. Erdem has been serving as Associate Professor of Radiology at the University of Arkansas for Medical Sciences as section chief and is excited about joining Drs. Tim Burson, David E. Connor and David Reding with Neurosurgery Arkansas.
• Spine Pain Management
For more information or to schedule an appointment call 501-224-0200. 9601 Baptist Health Drive, Suite 310
Arkansas Cancer Coalition, continued from page 5 in, there has been a more synchronized approach to cancer care in Arkansas. People are realizing the coalition is here, and is available and willing to take on any fight we have to in order to eliminate the burden of cancer in Arkansas.” Successes Mitchell points to include increased cancer screenings and better data collection. “The Arkansas Central Cancer Registry is making great strides to have comprehensive cancer incidence and mortality data which helps us know which counties need the most assistance,” Mitchell said. “When the data indicates a strong need,
TA K E
the staff of the ACC helps find partners in that area if we don’t already have an established partner. We can go into a county and provide technical assistance and funding. We can conduct a needs assessment, and find out the major issues.” One example of how data has been used to develop programs is that after learning that melanoma diagnoses in Arkansas rose 53 percent from 1997 to 2007, the staff of the Donald W. Reynolds Cancer Support House developed a Be Sun S.M.A.R.T. program to educate people about how to protect themselves from UV exposure.
D E E P
“The Be Sun S.M.A.R.T program is amazing because it reaches thousands of individuals with an educational message and screening,” said Miriam Njoki Karanja, MBA, ACC director of programs. “It’s very comprehensive and is even recognized by the U.S. Centers for Disease Control and Prevention.” One of the quarterly ACC meetings is the ToNjoki bacco and Disease: Lung Miriam Karanja Cancer Symposium held annually in November.
B R E AT H . . .
C A R T I C A N H E L P Y O U B R E AT H E E A S I E R .
In Arkansas, lung cancer is the leading cause of cancer death, causing more deaths than breast, colon and prostate cancers combined. But now there is hope with Low-Dose CT screenings, which are expected to reduce lung cancer deaths by 20 percent in high-risk patients.
Low-Dose CT scans are recommended for those who meet the following criteria: • Current or former smokers (aged 55 to 74 years old) • Smoking history of at least 30 pack years (number of packs per day x number of years = pack years) • No history of lung cancer
The following major medical societies endorse Lung Cancer Screenings with Low-Dose CTs: American Cancer Society American Medical Association American College of Chest Physicians American Lung Association American Society of Clinical Oncology
American Society for Radiation Oncology American Society of Thoracic Surgeons American College of Radiology National Comprehensive Cancer Network U.S. Preventive Services Task Force
To learn more about Lung Cancer Screenings, talk to your physician or call CARTI at 1-800-482-8561. Ad Sponsored by:
“Lung cancer kills too many people in Arkansas,” Karanja said. “This educational program continues to expand as partners seek to help Arkansans, and keep our kids from ever touching tobacco. The symposium arms healthcare providers and community advocates with the tools they need to fight tobacco and lung cancer. The Lung Cancer Symposium helps providers understand tobacco users, how to work with them to stop smoking using evidence-based treatment strategies for healthcare providers to use to talk to patients who use tobacco. “Tobacco use is the cause of not just the illnesses, but it interferes with treatment,” Karanja said. “So we are trying to make it standard for all healthcare providers to ask patients about tobacco use, and assist them with cessation including referring them to the Arkansas Tobacco Quitline. Their chances of quitting are much greater with counseling than just by providing pharmacological therapy and sending them on their way.” Karanja said it is important for healthcare providers to understand how addictive nicotine is and that many patients really need help to quit. Counseling and encouragement from healthcare providers can have a big impact. The November symposium also provides an update on electronic cigarettes. “They are everywhere,” Karanja said. “We didn’t know they would explode to this magnitude. People are coming in and saying: ‘I don’t smoke, but I use an e- cigarette.’ Some patients believe if they use an e-cigarette, they are safer. We help providers understand the language of those who are addicted to nicotine.” A new study from Portland State University shows e-cigarettes have higher levels of formaldehyde than cigarettes, and it’s been known for years that formaldehyde is a known carcinogen. Another effort of the coalition is assisting with programs to help with transportation for cancer patients. If people miss appointments because of lack of transportation, it can have a major negative impact on early detection of cancer when it is more treatable. It can also greatly impact the effectiveness of treatments for cancer. Some people just need a gas card, while others might need a cab or van to pick them up.
How You Can Help. There are many ways in which you can join the fight: • Become a coalition member • Join a specific ACC work group • Help develop new information tools • Make a tax-deductible or in-kind contribution at www. arcancercoalition.org
What’s Happening to our Safety Net? Changes, challenges of free clinics and covering the uninsured By JULIE PARKER
America’s free and charity clinics are undergoing a transformation, and not necessarily in a good way. According to a 2014 report by the National Association of Free and Charitable Clinics (NAFCC), patient demand has spiked 40 percent while donations have dropped 20 percent. “As soon as there was the perception of universal healthcare, the likelihood of receiving donations goes down,” Colin McRae, JD, told the Wall Street Journal in December. For the last two fiscal reports ending June 30, Orlando-based Shepherd’s Hope, one of the nation’s most successful free clinic networks, experienced a 22 percent increase in patient volume, seeing 16,973 patients in 2012-13, and nearly 21,000 patients in 2013-14. Based on trends, the free clinic expects patient volume to climb to 24,000 for the 2014-15 fiscal year. “It’s a concoction of the most toxic kind without the resources to resolve it,” said Marni Stahlman, CEO of Shepherd’s Hope, noting a May 2013 report by the Congressional Budget Office showed that even though the healthcare law is expected to reduce the number of uninsured by 25 million in 2023, 31 million Americans will remain uninsured. “The role of the free clinic is more critical than ever.” Medicaid expansion, or the lack of it, lies at the heart of the problem. In Medical News’ coverage area, Arkansas and Kentucky are among 28 states that have expanded Medicaid. Alabama, Florida, Georgia, Louisiana, Mississippi, Missouri, North and South Carolina, Tennessee, Texas, and Virginia are among 18 states that haven’t expanded Medicaid and aren’t likely to, with the exception of Tennessee, one of four states anticipated to possibly expand in 2016. David W. Strong, who will leave the University of North Carolina (UNC) Health Care system next month to take over as CEO of the expansive Orlando Health network in Florida, pointed out an aspect of Medicaid expansion that doesn’t get much press. “It’s important to note the bulk of every state’s Medicaid program is already funded by the federal government,” said Strong. “All states are relying on significant federal funds now. Unfortunately, by not expanding Medicaid, Florida and North Carolina are among the biggest losers in the country because of the population base. Ultimately, we all bear the burden for the lack of expansion because people will continue to seek care in our emergency departments and facilities.” arkansasmedicalnews
Much national attention has been placed on Florida, the nation’s fourth most populated state with 18 million residents and the highest percentage of 65 and older adults. The sunshine state ranks 41st on the list of highest volume of uninsured residents nationwide. “What you have is a really bad sandwich. Without resources, insurance, or access to healthcare, many Floridians who’ve been captured in the healthcare coverage (Medicaid) expansion gap find themselves without anything,” said Stahlman. “There’s also a gap on the high end.” According to a 2014 Modern Healthcare report, the nation’s busiest emergency room is Florida Hospital, with 206,800 visits to emergency departments at Florida Hospitals in Altamonte, Apopka, Celebration Health, East Orlando, and Kissimmee – and Winter Park Memorial Hospital. Orlando Health’s Orlando Regional Medical Center accounted for the nation’s fifth busiest ER, including emergency departments at the Arnold Palmer Hospital for Children, University of Florida (UF) Health Cancer Center, Dr. P. Phillips Hospital, Lucerne Hospital, South Seminole Hospital and the Winnie Palmer Hospital for Women & Babies. “Florida is at a particular disadvantage because we have one of the highest uninsured rates in the nation, and a comparatively smaller percentage of residents on employer healthcare plans to absorb the cost,” said Florida Hospital CEO Lars Houmann. “Federal, state and local funding sources cover some but not all costs. And so the burden is passed on to insured patients and their employers in what’s commonly called the cost shift … a hidden tax applied to premiums, co-pays and deductibles.” University of Florida economists predict $4.7 billion in Medicaid dollars will be sent to other states in 2016, including nearly $400 million to Ohio, where Republican Gov. John Kasich has reduced the state’s budget by $404 million over two years by expanding coverage. Despite previous opposition to the idea, recently reelected Florida Gov. Rick Scott announced more than two years ago that he supports a legislature-approved, three-year Medicaid expansion. However, Scott, a Republican, hasn’t marked it priority. Even with gubernatorial support, Tampa General CEO Jim Burkhart said Medicaid expansion won’t be an easy sell to state lawmakers. “It’s going to be a pretty heavy lift because there are lots of people who think they know a different way, or don’t think
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Healthcare Leader: Chad Aduddell, continued from page 1 Springs in April 2014—which shares with CHI St. Vincent Infirmary the distinction of being the oldest hospital in the state, both established in 1888. Aduddell now serves as the Chief Operating Officer for CHI St. Vincent and provides operational leadership for the 282bed hospital now named CHI St. Vincent Hot Springs, along with three other acute care facilities: CHI St. Vincent Infirmary (615 beds), CHI St. Vincent North (69 beds), and CHI St. Vincent Morrilton (25 beds). Aduddell said the turnaround work had to fit the mission of CHI St. Vincent to create healthier communities and be consistent with their ministry to serve the poor, needy and underserved. Financial performance couldn’t come at the cost of quality or providing compassionate care. Yet failure to operate in the black threatened not just healthcare services, but the strong economic base that provides jobs for thousands of people. “Healthcare has now grown to represent more than 18 percent of the national economy,” Aduddell said. “Costs continue to increase at an unsustainable rate, reimbursement is going down and, at the same time, we need to provide access to more people because of the Affordable Care Act (ACA). While the ACA is not perfect, the private option and Medicaid expansion has increased coverage to 240,000 Arkansans who weren’t covered about a year ago at this time. Ultimately, we have to create
value by improving quality outcomes and safety, improving the patient experience, increasing access and decreasing costs.” Before the hospitals were combined into one operating system, both were facing significant challenges including Mercy Hot Springs operating at a loss. “Bringing those two legacies together into one consolidated Catholic healthcare ministry gave us the opportunity for growth, for economies of scale and for increased efficiency by reducing duplication and waste,” Aduddell said. “There was a lot of work to do, but we took two goodsized organizations and merged them into one that was larger, stronger and more efficient. Efficiency takes leaders who have the experience to go out and find opportunities to improve processes and efficiency, take waste out and negotiate favorable prices with vendors and suppliers.” Since the integration with CHI St. Vincent, that Hot Springs hospital has grown its business and is now operating near capacity. “The hospital has never been this busy,” Aduddell said. “The ER and clinics are busier than ever. Just in this short period of time, it has turned around. It is thriving. It has been very positive for us and the community has been so supportive.” Aduddell said it is likely that more consolidation will be seen in the future. “Relationships that didn’t exist before may exist in the future,” he said. “We don’t think the acquisition of Mercy Hot Springs
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is the end. We think that is the start. We believe that we need to continue to grow. We want to grow into a statewide network, and we believe that is going to be necessary for us to be sustainable long term.” Currently CHI St. Vincent is in discussion with Conway Regional Hospital regarding a potential partnership. “From the beginning, one of the goals in the relationship was for both organizations to retain their identity,” Aduddell said. “We want to come together in a way to gain economies of scale, creating winwins without a purchase or merger. We are taking that same approach talking to other facilities across the state, ways to partner together for both organizations to find value.” The term used in healthcare is “to bend the cost curve.” The cost curve has been on a steep growth rate that is unsustainable. “So we are looking at ways to partner with other community hospitals across Arkansas to create value and take cost out of the system,” Aduddell said. “We see growing into a statewide network as an important part of our goal, and we are actively working on that today. We are also developing the Arkansas Health Network, a clinically integrated network with physician leadership to prepare for the next era of healthcare, the goal of which is to shift the focus from volume to value. Today, we are paid in a fee-for-service environment. The thought is that in the future, the focus will be on proactively managing the health of a population of patients, and not just moving volume through the system.” Aduddell showed an early aptitude for leadership. He had an athletic scholarship to the University of Tulsa where he was elected captain of the track team. “I wasn’t by any means the best athlete, but I was a pretty serious and competitive guy, driven with an intensity to do things the right way,” he said. “So even with things like practice, I was always able to lead my teammates to take preparation very serious. That has been my approach to life: be prepared.” While he considers himself a quiet introvert, he was also president of his college fraternity. He said that was odd because he wasn’t a particularly social person. “It certainly wasn’t because of my charisma, but because I was respected by my peers and was able to lead them in a way that was productive for the entire organization,” Aduddell said. Aduddell’s first job after receiving a master’s degree in business with a healthcare administration focus was working for the St. Anthony Hospital in Oklahoma City, Okla. “I learned a lot from those guys that I still use today,” he said. One is that feedback is the breakfast of champions. Even when receiving criticism, he looks at it as an opportunity to learn and improve. A second lesson is the importance of face-to-face communications. “I was amazed that the chief of staff of this 650-bed hospital in Oklahoma City, Dr. Richard Boothe, always made time for me,” he said. “I try to make time for
people to be here one-on-one. I’m not a big e-mailer. When you want to read emotions and intent, so much gets lost in emails. I’ve resisted sitting here and pounding out that two-page email response, I prefer to talk in person.” And a third piece of advice he received was, “It is good to be right, but it is better to be right and effective.” You can be right, but not effective. “It is not about me being right,” he said. “It is about being effective, I try to look for the win-win.” Aduddell said he and his wife, Angie, have enjoyed living in Little Rock and greatly appreciate the beauty of the Natural State. They have four daughters, ages 5, 7, 12 and 14. He coaches girls’ soccer and with family and professional responsibilities, doesn’t have time for hobbies. But he still loves running, and uses his early morning jogging time to not just stay fit and reduce stress, but reflect and prepare himself for the day.
Heart Center of Excellence continued from page 4 streamlined experience for the patient, as well as the hospital’s nurses and physicians, said Mandy Golleher, NPMC director of marketing and volunteer services. The new Heart Center is designed to have a separate entrance primarily for an efficient workflow for patients, physicians and guests. “The stand-alone Heart Center of Excellence will allow for all of NPMC’s heart services to be housed in the same area, as well as increased access for NPMC’s continually growing heart and vascular program,” Golleher said. “It means that all of our cardiac-focused services and procedures will be located in one area, which is connected directly to the Emergency Department. So if I am having a heart attack and I go to the emergency department, I can be quickly transported into the state of the art cardiac cath labs, then to the postcath procedure area, then to the cardiovascular ICU if necessary.” Additionally, the cardiac rehabilitation facility will be located in the same building, so patients will know that if they are coming in for anything heart-related, they will go to the Heart Center entrance at NPMC. NPMC is a referral center for a large surrounding area, including Garland, Polk, Grant, Hot Spring, Clark and Montgomery counties. Jim Fram, president and CEO of The Greater Hot Springs Chamber of Commerce, said healthcare is one of the targeted industries the chamber works to attract. “They continue to be one of Hot Springs’ and Garland County’s and the region’s largest employers,” Fram said. Earl Swensson Associates are the architects for the project. B&F Engineering is the engineering firm on the project, and the contractor is CDI Contractors. The project is planned for completion in early 2016. arkansasmedicalnews
By the Numbers: The Latest Stats on Cancer Death rates down, more work awaits By CINDY SANDERS
As the ‘official sponsor of birthdays,’ the American Cancer Society (ACS) found a reason to rejoice in their latest report – Cancer Facts & Figures 2015. Since hitting a peak in 1991, cancer deaths have fallen 22 percent over two decades in the United States, which means more than 1.5 million deaths have been avoided … and more birthdays celebrated. An ACS infographic showed 3.3 million cancer survivors in the United States in 1973. Today, there are more than 14.5 million cancer survivors, and that number is projected to jump to 18.9 million by 2024. Each year, the ACS compiles the most recent data on cancer incidence, mortality and survival using data from a variety of sources including the National Cancer Institute, National Center for Health Statistics and the Centers for Disease Control and Prevention. The most recent five-year data (2007-2011) showed the overall cancer incidence rate held steady in women and declined by 1.8 percent per year in men. The decrease in men was attributed to rapid declines in colorectal cancer (3.6 percent per year), lung cancer (3 percent per year) and prostate cancer (2.1 percent per year). During the same time period, the average annual decline in cancer death rates was 1.8 percent in men and 1.4 percent in women. Lung cancer, while still the deadliest form of the disease, has declined 36 percent between 1990 and 2011 among men. Women have also seen double digit
Safety Net, continued from page 7 we should do it at all, or only believe we should do it for people that don’t match up with what the federal government says you have to have in your criteria for the money to be made available,” he said. “At least discussion is ongoing. We’re hopeful it’ll continue and lead to something concrete.” Mississippi Gov. Phil Bryant, a Republican, has firmly said no, thanks. “For us to enter into an expansion program would be a fool’s errand,” in case Obamacare is repealed or altered in a way that forces states to foot the bill,” he told the Associated Press. “We’d have no way to continue the coverage.” While states continue to determine the best solution, ER visits are piling up. The average admission cost of an ER visit is roughly $4,600 versus the average cost of a visit to the free clinic valued at $77, said Stahlman, referring to 21,000 visits anticipated this fiscal year. “Do the math on 21,000 visits last year, each valued at $77 ($1.6 million) versus $4,600 ($96.6 million),” she said. “The role of the free clinic is more critical than ever.” arkansasmedicalnews
declines attributable to reduced tobacco use. On another happy note, breast cancer death rates for women are down more 35 percent from peak rates, and prostate and colorectal cancer deaths are down by nearly half (47 percent). Despite the good news, though, ACS officials also noted there is much more work to be done. “The continuing drops we’re seeing in cancer mortality are reason to celebrate, but not stop,” stated John R. Seffrin, PhD, chief executive officer for ACS, when the report was released in January. He added cancer was still responsible for nearly one in four deaths in the United States in 2011. Furthermore, Seffrin noted the country’s second leading cause of death overall is actually the top cause of death among adults ages 40 to 79. Looking to this year, the ACS has projected 1.658 million new cancer cases will be diagnosed in 2015, and 589,430 Americans will lose their battle with the disease. Of the new cases, the estimate is that men will account for about 848,000 diagnoses across all sites and women 810,000. Prostate, lung and colorectal cancers will account for about half of all cases in men with prostate cancer accounting for around 25 percent of all new diagnoses. Among women, it is anticipated the three most common diagnoses in 2015 will be breast, lung and colorectal cancers. Of those, breast cancer is expected to account for 29 percent of all new cancers for women this year. Of the 589,430 estimated deaths in 2015, the gender breakdown is 312,150 men and 277,280 women. The most common causes of cancer death are lung, prostate, colorectal and breast cancer with these four accounting for almost half of all cancer deaths. More than a quarter of all cancer deaths (27 percent) will be attributable to lung cancer. While death rates have declined, the report noted mortality improvements aren’t equal from coast-to-coast. In fact, cancer death rates vary by state and region with the Southeast being on the lower end of improvement scale (15 percent decline in overall cancer mortality) and the Northeast on the higher end (between 25-30 percent decline). The variation has been attributed to a number of reasons including risk factor patterns (such as the number of smokers), distribution of poverty, and access to healthcare.
A recent survey by the American Institute for Cancer Research found there is an ‘alarmingly low’ awareness of key cancer risk factors, and many Americans put fear before facts. The Cancer Risk Awareness Survey, released on Feb. 4 in conjunction with World Cancer Day, found Americans worry about factors over which they have little or no control … such as genetic risks or food additives … with less than half recognizing the correlation between an increased risk of cancer and
alcohol, obesity, lack of physical activity and poor diet. The findings of the biennial survey give providers and other health experts an idea of whether or not cancer messaging is being heard by the American public. This year’s results were decidedly mixed. Only 42 percent surveyed were aware a diet low in vegetables and fruit increases cancer risk. This number has trended downward since 2009, when it stood at 52 percent. Only 43 percent knew alcohol increases cancer risk, an increase of five percentage points since the 2013 survey. And only about 1 in 3 Americans (35 percent) realized diets high in red meat have been convincingly linked to colon cancer. This figure has not changed since the survey was last conducted in 2013. Awareness that carrying excess body
fat is a cancer risk factor is rising. In this latest survey, 52 percent realized obesity and overweight impact cancer risk, a rise of 4 percentage points. Awareness that being inactive increases cancer risk jumped 6 percentage points, from 36 percent in 2013 to 42 percent in 2015. There was a high recognition of several known risk factors for cancer including 94 percent of those surveyed correctly identifying tobacco use and 84 percent citing excessive sun exposure as risks. However, a significant number of those surveyed also worried about risks for which research has yet to provide a definitive answer. Pesticide residue on produce (74 percent), food additives (62 percent), genetically modified foods (56 percent), stress (55 percent), and hormones in beef (55 percent) were all cited as concerns.
President Obama’s Precision Medicine Initiative After first introducing the topic during the State of the Union Address, President Barack Obama held an event at the White House at the end of January to unveil details about the Precision Medicine Initiative, a major research push to pinpoint the best, most precise treatment options for individual patients considering genetic profile, environment and lifestyle. In a fact sheet created for the program, White House officials stated, “The Precision Medicine Initiative will pioneer a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge and therapies to select which treatments will work best for which patients.” While the move away from ‘one-size-fits-all’ medicine is not limited to cancer research, oncology is at the centerpiece of the initiative and a recipient of significant funding. If passed, President Obama’s 2016 budget includes a $215 million investment in the program including $130 million to the National Institutes of Health to develop a voluntary national research cohort of a million or more volunteers to propel the science forward and to create a model for responsible data sharing. Additionally, $70 million is specifically earmarked for the National Cancer Institute to scale up efforts to identify genomic drivers to various cancers, and a major objective of the initiative is to create ‘more and better treatments for cancer.’ In response to the Jan. 30 announcement, American Association for Cancer Research CEO Margaret Foti, PD, MD (hc), said, “We live in an extraordinary time when the scientific opportunities and our ability to translate this new knowledge into ways to both save and improve the quality of life of patients are simply astounding. This is why we are so excited about today’s event at the White House and specifically about President Obama’s major investment in the enormous potential of precision medicine, which is in the very early stages of transforming healthcare.” Similarly, the Pancreatic Cancer Action Network voiced their appreciation and support for the initiative. “The Pancreatic Cancer Action Network applauds President Obama for his new Precision Medicine Initiative and for making an important investment to advance cancer research and arm the scientific and medical community with the cutting edge tools and resources needed to fight cancer,” said Julie Fleshman, president and CEO of PanCAN. “This is especially welcome news for patients fighting pancreatic cancer who face a five-year survival rate of just 7 percent.” With personalized medicine for pancreatic cancer still in the early stages, she added, “We recognize, as President Obama highlighted, that the “one-sizefits-all” approach does not work for pancreatic cancer and recently launched Know Your Tumor, a personalized medicine service available through our patient services program. In addition to providing molecular profiling that may help a patient’s oncologist determine the best treatment options, we will collect tumor information from thousands of pancreatic cancer patients to assist with future research and development of new therapies and diagnostics for pancreatic cancer.”
GrandRounds UAMS Startup Receives $14.5 Million to Develop Drug Therapies for Meth Users LITTLE ROCK – A University of Arkansas for Medical Sciences (UAMS) BioVentures startup company, InterveXion Therapeutics LLC, has received two federal grants totaling $14.5 million for development of drug therapies that can help methamphetamine drug abusers break their addiction. The therapies are designed to reduce or prevent the euphoric rush that drug users crave by keeping methamphetamine in the bloodstream and out of the brain, where the drug exerts its most powerful effects. The larger of the two grants, $9.55 million over three years, will support research that will determine whether a methamphetamine vaccine may be safely advanced into a clinical trial with human participants. The vaccine is a promising new strategy that could stimulate a patient’s own immune system to generate long-acting, protective anti‑methamphetamine antibodies. The other grant of $5 million over three years will support production of the anti-methamphetamine monoclonal antibody that has been successfully tested in a first clinical study of healthy adults. The grant will also fund more research to show that the antibody is safe for methamphetamine users. The additional study will prepare researchers for the next clinical trial involving methamphetamine-using participants. This antibody does not stimulate the immune system, but it selectively and quickly binds methamphetamine in the blood and prevents it from entering the brain and other tissues where it causes multiple health problems, including addiction. It would be the first medication that can reduce methamphetamine’s effects for prolonged periods of time. The antibody has an immediate impact on the user and is effective for about a month. The vaccine takes several weeks to become effective, and it may blunt methamphetamine’s effects for nine months or longer.
Both grants are to InterveXion from the National Institutes of Health (NIH) National Institute on Drug Abuse (NIDA). UAMS is a sub-awardee. Mike Owens, Ph.D is co-program director and co-principal investigator on the vaccine grant. He is a professor and director of the UAMS Center for Alcohol and Drug Abuse and InterveXion’s chief science officer. W. Brooks Gentry, M.D., is co-program director and co-principal investigator on the monoclonal antibody grant. He is a professor and chair of the Department of Anesthesiology in the UAMS College of Medicine and InterveXion’s chief medical officer. Misty Stevens, Ph.D., M.B.A., is operations director for InterveXion and is co-program director and co-principal investigator for both grants. Ralph Henry, Ph.D., is vice president for biopharmaceutics at InterveXion and a coinvestigator on both grants. Assuming the antibody and vaccine receive federal Food and Drug Administration (FDA) approval, they can be provided as an integral part of a methamphetamine user’s complete treatment program, which consists of counseling and possibly other medications to reduce craving. Neither the monoclonal antibody nor the vaccine should interact with other medications, nor should they impact brain function or interfere with psychiatric counseling. The vaccine would be less expensive than the antibody, but it is expected to be less effective for some people, especially those with compromised immune systems.
Pollock Moves To Fort Smith Internal Medicine FORT SMITH – Solangel Pollock, MD, has joined Trevor Hodge, MD, at Sparks Fort Smith Internal Medicine located at 708 Lexington. Both physicians are accepting new patients. The clinic offers general medical care for adult men and women including routine exams, diabetes management, and hypertension management, treatment of skin conditions and
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management of chronic diseases. She joined Sparks in March 2014 after working in a busy urgent care facility in Miami, Fla. Dr. Pollock became Internal Medicine Board Certified in 2007. Before that she fulfilled her residency at Jamaica Hospital Medical Center in Queens, New York, which is considered one of the most intense programs in the nation with 72-hour “on-call” duties including trauma and burn patients. Pollock grew up in a small town in Cuba where her mother was a nurse and was inspired to provide medical care for others. From 1996-1999, Dr. Pollock was the ultimate “town Doctor,” treating much of the population of Villa Clara, Cuba. She is fluent in both Spanish and English. Dr. Pollock became a proud American citizen in 2004. Her husband is a retired military physician from Arkansas who served twice in Iraq. They are both excited to be living in Arkansas.
Emergency Medicine Physician Greg Bledsoe Joins UAMS LITTLE ROCK — Greg Bledsoe, M.D., M.P.H., has joined the University of Arkansas for Medical Sciences (UAMS) and will be treating patients in the UAMS Emergency Department. Bledsoe is also an associate professor in the Dr. Greg Department of EmergenBledsoe cy Medicine in the UAMS College of Medicine and is board certified in emergency medicine. He came to UAMS from Marshall Medical Center South in Boaz, Alabama, where he was chairman of the Department of Emergency Medicine. Bledsoe completed medical school and residency at UAMS in 2002. He then spent five years on faculty in the Department of Emergency Medicine at the Johns Hopkins University School of Medicine, completing a two-year fellowship in international emergency medicine and a Masters in Public Health from the Johns Hopkins Bloomberg School of Public Health. His international medical experience includes time in Honduras, Tanzania, Sudan, China, Qatar, Antarctica, and the Arctic, including the North Pole. He was also the personal physician to former President Bill Clinton during Clinton’s tour of Africa in 2002 and has served as an instructor and medical consultant for the U.S. Secret Service. In addition to his position at UAMS, Bledsoe was chosen by Gov. Asa Hutchinson as the surgeon general for the state of Arkansas.
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