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FOCUS TOPICS SENIOR HEALTH • HEALTHCARE REFORM

November/December 2017 >> $5 December 2009

AHA 87th Annual Meeting Eyes Medicaid/ACA Reform

ON ROUNDS

Gov. Asa Hutchison touts block grants for realistic, manageable and sound achievable budget Leading Alzheimer’s Researcher Sue Griffin Urges Physicians to Talk Prevention with Patients Exercise, Healthy Diet and Maintaining Good BMI Essential to Preventing Disease University of Arkansas for Medical Sciences (UAMS)/ Central Arkansas Veterans Healthcare System (CAVHS) researcher Sue Griffin, PhD, has gained international recognition for a significant breakthrough in the early events and potential for strategies toward overcoming and preventing Alzheimer’s disease. Griffin is a pioneer in researching the role of neuroinflammation in the genesis and progression of Alzheimer’s ... 3

By BECKY GILLETTE

LITTLE ROCK—The Arkansas Hospital Association’s 87th Annual Meeting/Trade Show in October included a presentation from Gov. Asa Hutchison regarding support for repealing and replacing the Affordable Care Act, and his application for a waiver to change the way Medicaid is administered in Arkansas. Participants also heard a presentation from Patricia M. Boozang, senior managing director, Manatt Health, New York, with cautions about how proposed changes in to Medicaid in recent repeal and replace proposals could adversely impact hospitals and other healthcare providers. “I think the legislative effort related to the overall repeal and replacement of the Affordable Care Act (ACA) is stalled for the moment,” Boozang said. “There is a market stabilization legislative effort that is underway, but that is pretty narrowly focused on a couple of individual market related issues in the ACA and doesn’t directly impact Medicaid. But I think we are likely to see some proposals to reduce federal Medicaid funding to states re-emerge somewhere down the line, whether 2018 or later.” One proposal that had been part of prior repeal and replace proposals is to (CONTINUED ON PAGE 4)

HealthcareLeader

AHA Chairman Darren Caldwell Opines on Devastation of Eliminating Health Coverage

See the Grand Rounds section beginning on page 6 for healthcare spot news from around the Natural State.

Believes while Medicaid reforms are needed, shifting cost to hospitals is not sustainable By BECKY GILLETTE

Arkansas Hospital Association Chairman Darren Caldwell, CEO of Unity Health – Harris Medical Center in Newport, understands that there is a need for reform in the way Medicaid is administered. But some current proposals to gut or to eliminate the Affordable Care Act (ACA) could be devastating to hospitals by eliminating healthcare coverage for hundreds of thousands of people. Doing that could lead to the uninsured not getting preventive healthcare or primary care,

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ResearchSpotlight

Leading Alzheimer’s Researcher Sue Griffin Urges Physicians to Talk Prevention with Patients

Exercise, healthy diet and maintaining good BMI essential to preventing disease By BECKY GILLETTE

University of Arkansas for Medical Sciences (UAMS)/Central Arkansas Veterans Healthcare System (CAVHS) researcher Sue Griffin, PhD, has gained international recognition for a significant breakthrough in the early events and potential for strategies toward overcoming and preventing Alzheimer’s disease. Griffin is a pioneer in researching the role of neuroinflammation in the genesis and progression of Alzheimer’s. Griffin’s research specifically focuses on the way neurons respond to stress to promote neuron survival in situations that are acute, that is, stresses that are of limited intensity and duration. “In short, limited neuronal stress leads to activation of the brain’s immune cells, glia, for the production and release of cytokines that, in turn, prompt the neurons to make proteins necessary for membrane and structural integrity,” Griffin said. “One of these proteins that is produced in response to glial cell release of the immune cytokine interleukin-1 (IL-1) is the beta amyloid precursor protein, which is an integral membrane protein that is necessary for membrane repair. Another neuronal protein that is produced in response to production and release of IL-1 is a small protein called P-tau that is necessary to maintain the neuron’s internal structure. “All is well when a stress is limited so that neuronal repair and normal order is restored. Problems begin when the neuronal stress is prolonged, for example, years of an unhealthy life style with overeating and insufficient exercise. In this situation, we must consider the effect of long term neuronal stress, prolonged glial responses with prolonged overproduction and release of cytokines like IL-1 that are inflammatory – perhaps necessary in the body to fight pathogens but not good in the brain over any extended period. Why is that? Because the overproduction of the beta amyloid precursor protein over a prolonged period results in the laying down of the beta amyloid plaques that are abundant in the brain of Alzheimer patients, getting in the way of the normal flow of information from one neuron as it speaks to another, and generally take up a lot of brain space.” Griffin said that, unfortunately, the prolonged production of the other protein, which IL-1 induces, P-tau, results in formation of tangles of P-tau inside the neuron another feature of Alzheimer’s. Griffin’s Cytokine Cycle© conceptualizes how neuronal stresses such as head arkansasmedicalnews

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trauma, genetics, an unhealthy life style, and/or aging induce excesses in cytokines, creating positive feedback cycles that culminate in the appearance of tangled proteins inside the brain’s nerve cells and the plaques outside the nerve cells that we see in Alzheimer patient brains. Griffin works with a large team of investigators under the aegis of an NIH/ NIA-sponsored program at UAMS, and collaborates with scientists elsewhere in the world, all focused on finding a preventive that might delay onset and, in that way, “prevent” or “cure” Alzheimer’s. Because of the current crisis of lifestyle diseases, which are now recognized as potential risk factors for development of Alzheimer’s, she feels it is urgently important for providers to talk to patients about prevention. “It is so apparent, especially here in Arkansas, what we must do; that is, we must begin to adopt and practice healthier lifestyles not just for Alzheimer’s, but, importantly toward preventing a variety of diseases that often occur years before Alzheimer’s is likely. All are intimately linked. You can’t talk about what is good for the brain without talking about what’s good for the heart – and really, the whole body.” Griffin said she hopes physicians’ message for parents is that we need to make sure that our children are living a healthful lifestyle. “Parents should teach by example. We have a big problem right here in Arkansas with high rates of obesity in children, which goes hand-in-hand with type 2 diabetes. Both of those conditions should be avoided and more likely could be by eating right and getting enough exercise.” What doctors say really matters,

meaning that taking even just one minute to suggest changing from the high carbohydrate diets of many children to more

well-balanced meals, Griffin said. It is hard to describe to a five-yearold, or even some thirty-year-olds, what a carbohydrate is. But Griffin says even young children can benefit by education about The Nutrition Facts that are on most everything we buy like how much a teaspoon of sugar weighs (four grams) and how many grams of sugar are in a regular size can of soda pop (39 grams). “The important message is that there are things people reading this article can do to help children lower their risk of having Alzheimer’s in old age, but more importantly having mid-life horrors like type 2 diabetes, heart disease, and liver and pancreatic cancers that are associated with obesity and its consequences,” Griffin said. “The public deserves and needs to know this. Let them know there are really good reasons to be watching what they are doing with regard to their weight, diet, (CONTINUED ON PAGE 5)

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AHA 87th Annual Meeting Eyes Medicaid/ACA Reform, continued from page 1

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cap federal Medicaid funding to the states. Boozang said that would shift the spending risk for the program to the state. “The state, in turn, has to respond to that,” she said. “The way all states would respond would be to make cuts to the program, which could include cuts to eligibility which flow down to hospitals in the form of more uncompensated care, or cuts to provider reimbursements. These proposals to cap federal Medicaid funding for states create new risks and challenges for healthcare providers and for consumers.” Boozang said while in the pause period where there is no active proposal to cap federal Medicaid funding to the states, it is incumbent on states and stakeholders in the program to understand what those proposals would mean for the states. “It is important for states and consumers to do the data analysis based on what we expect these proposals to look like, and have an open discussion about the potential impact to coverage and healthcare in the state,” she said. Hutchinson said he has consistently opposed any change that would shift the cost of Medicaid onto the states. He did support the Graham-Cassidy bill, which failed to get enough votes to be adopted. He said the block grants that were the foundation of that bill would have allowed Arkansas to design its own healthcare initiatives in a way that would best cover and protect Arkansans. Hutchinson has repeatedly said reforms are needed because Medicaid is not sustainable in any state, including Arkansas. He said Graham-Cassidy would have put federal spending on a realistic, manageable and achievable budget. “This sort of discipline is long overdue in Washington and the states must be a partner in making our healthcare programs more sustainable,” Hutchinson said. Boozang said even without a replacement for the Affordable Care Act, another important dynamic is there is a lot the current administration can do administratively. States, including Arkansas, have submitted waiver proposals to the Trump administration even in advance of any changes happening in Congress. Arkansas and other states have waiver proposals before the administration. Boozang said that is the vehicle the state is using to try to tailor the Medicaid program the way the governor and policymakers think appropriate. “This is a trend you see nationally,” she said. Despite the failure of Graham-Cassidy—and regardless of the constraints of the current system—Hutchinson said he remains committed to the state’s ongoing reform efforts in Arkansas Works and traditional Medicaid, and will continue to focus on creating a more efficient, sustainable system of healthcare in the Natural State for future generations. Pres. Donald Trump expressed disappointment at the failure of the GrahamCassidy bill and said continuation of the ACA amounts to a massive bailout for insurance companies. Others don’t see

it that way. Boozang said what he is talking about is the cost sharing provision required under ACA to help low income people purchase insurance who might otherwise have trouble accessing care due to being unable to meet deductibles or cost sharing. “This is something that was required by the ACA to lower costs for low-income consumers,” she said. “I don’t think of it as a bailout, but a payment for something insurance companies are required to do under the statute.” The ACA has been in the cross hairs of Republicans since it was adopted in 2010. But Boozang said a lot of data from Arkansas and other states, as well, shows that the ACA actually has been really crucial for the bottom line of hospitals in terms of reducing the amount of uncompensated care. “It makes them more fiscally stable, and helps them serve an insured population instead of uninsured population,” she said. “That has been especially critical for rural hospitals. And there is a growing body of evidence of how critical the rural hospitals are. ACA makes them more stable. It helps them avoid shutting down services and beds, and has helped them bring jobs and higher-than-average salaries to their communities. It has really bolstered the stability of rural hospitals.” Boozang expects that proposals to cap funding will re-emerge that would introduce new risks and challenges to state Medicaid programs. Medicaid is the biggest source of federal funding flowing into Arkansas, as in many states, so there are real budget concerns from reducing funding to states. While new federal legislation is paused, Boozang expects the pace of administrative actions on Medicaid will accelerate in the form of 1115 waivers, 1332 waivers, regulations/guidance and other activity. Under Section 1115 of the Social Security Act, the Secretary of Health and Human Services has broad—but not unlimited—authority to approve a state’s requests to waive compliance with certain provisions of federal Medicaid law. Hutchison has proposed an amendment to its Arkansas Works 1115 Medicaid demonstration projects that would limit eligibility to less than or equal to 100 percent of the federal poverty level, establish a work requirement, eliminate the employer-sponsored insurance premium assistant program and eliminate conditions associated with the waiver of retroactive eligibility. That proposal would remove an estimated 60,000 people in Arkansas from Medicaid. While they would be allowed to move to subsidized Affordable Care Act marketplaces or employersponsored plans, it’s uncertain how many might be able to afford high-cost plans.

For more visit: Arkansas Hospital Association, www.arkhospitals.org/

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AHA Chairman Opines, continued from page 1 and then using emergency rooms for their needs. Hospitals would be required to provide the care, but wouldn’t be reimbursed for the cost of the care. “Gov. Asa Hutchinson supported the Graham-Cassidy Bill,” Caldwell said. “I believe the governor is truly trying to figure out how to make Medicaid in Arkansas sustainable. But I do not agree the current proposed methodology would do that. Right now, the government insists hospitals see patients regardless of their ability to pay. To gut the Medicaid program to ration down access would result in the hospital industry being required to pick up services for a population that doesn’t understand the need for primary care to be their responsibility. This would be like asking Walmart to continually take on customers that check out and don’t pay.” Caldwell does see problems with the current Medicaid system. “A smoker doesn’t believe it is harmful until becoming ill,” Caldwell said. “Exercise often doesn’t matter until you’ve had a heart attack. The population needs to understand the way things are going now is unsustainable. We just disagree that hospitals should be the ones to fund all the changes.” Caldwell said one thing the healthcare industry is great at is living with perpetual changes. “We recognize healthcare is too big a percentage of the GDP, (20 percent) and that it is not sustainable. We need more emphasis on our value to society and less on our expense. So, it doesn’t make good sense to put in so many restrictions and criticisms when it is so vital.” The uncertainly about ACA certainly is a concern for hospitals, especially considering the many other challenges they face. Those include the difficulty of providing adequate staffing for physicians, nurses, lab technologists and other licensed staff members. “It is an extremely shallow pool of graduates for an extremely large industry,” Caldwell said. “There are always fewer graduates than there are openings, particularly in the South…We find physicians, in particular, are less likely to choose to live in rural areas even though they may be able to make more. In rural parts of the state, unless you grow your own, you are in trouble. It is hard to get young people to dedicate so much time and money for education, and then want to go back home to a rural area.” Another issue, he said, is that today younger physicians and other healthcare professionals are often more interested in lifestyle than income. They may prefer urban areas where they have trained because they are on call less, there is more support, and the urban area where they trained is what they are most familiar with. Caldwell grew up in Dumas, and received a bachelor of science in biomedical engineering from Louisiana Tech. He decided his calling wasn’t the design side of engineering, and that he was more interested in the business and public relations side of medicine. His first job after college was working as an assistant administrator at Delta Memorial Hospital in Dumas. His first CEO position two years after college was administrator of the DeWitt Hospital arkansasmedicalnews

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of Nursing. Since 1991, he has worked at hospitals in DeWitt, Dumas and Monticello. He started his current job with Unity Health-Harris Medical Center Aug. 15, 2015. Caldwell sees his role at AHA “to stay out of the way of an excellent staff and let them do their job while making sure they can best serve the membership of the hospital association. I will conduct the meetings. I will be a sounding board when there are issues that relate to the industry.” When Unity Health purchased Harris Medical Center in Feb. 2015, it went from a for-profit to a not-for-profit facility. “Since then, one of my challenges has been to create a culture where it can become more mission oriented and less financial oriented,” Caldwell said. “We want the people involved with the patients to be involved with the solution.” Caldwell strives for a management style that encourages cooperation and frank communication. “I like to create an environment where people feel comfortable to express themselves freely,” he said. “I think if you are going to ask employees to speak up, you have to be respectful enough to listen and really hear them.” In 2014 the AHA Board of Directors selected Caldwell as the recipient of the Weintraub Memorial Award, the highest honor bestowed upon an individual by the AHA. Caldwell and his wife, Robin, have three children, Kelsey, 29; Sydney, 22; and Parker, 19; and five grandchildren. The family enjoys camping, fishing, golf, and watching football and basketball. Caldwell played tennis, football and basketball when he was younger.

For more visit: Arkansas Hospital Association, www.arkhospitals.org/ Unity Health—Harris Medical Center, http://www.wcmc.org/harrismedical-center

Griffin, continued from page 3

and exercise. Do it for our children so then we may have a cascade effect through the coming generations. “We are confronting all kinds of changes in our society,” she said. “We are all learning about bump-stocks that turn guns into almost tommy guns. So why can’t we see this thing about obesity? Why is that taboo? It really is imperative to face up to our health problems in the U.S.”

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GrandRounds Ronda Henry-Tillman, M.D., Named Chief of Breast Oncology at UAMS

LITTLE ROCK – Ronda Henry-Tillman, M.D., has been named chief of Breast Oncology in the College of Medicine Department of Surgery at the University of Arkansas for Medical Sciences (UAMS). She sees patients in the second floor clinics at the UAMS Ronda HenryWinthrop P. Rockefeller Tillman Cancer Institute. Henry-Tillman has served as a member of the UAMS faculty since 1998 and holds the position of professor in the Department of Surgery and co-leader of the Breast Tumor Disease Oriented Committee in the UAMS Cancer Institute. After earning her medical degree at the University of California San Diego School of Medicine, Henry-Tillman completed her surgical residency in the UAMS Department of Surgery and fellowship training in the UAMS Fellowship in Diseases of the Breast program. She previously served as director of the UAMS Cancer Control program and was instrumental in the development of the university’s mobile mammography program. Her research efforts have focused primarily on colorectal and breast cancer disparities in underserved populations.

She has received numerous awards and honors including being named to Best Doctors in America and Castle Connolly’s Exceptional Women in Medicine.

Mercy Hospital President Named to Arkansas Hospital Association Board

FORT SMITH – Ryan Gehrig, president of Mercy Hospital Fort Smith, has been appointed to serve on the Arkansas Hospital Association Board of Directors for a term extending through 2021. A hospital executive since 1999, Gehrig was named president of MerRyan Gehrig cy Hospital in 2012. Mercy Fort Smith is accredited by the Joint Commission and operates six hospitals.

Three Physicians Join CHI St. Vincent Primary Care

HOT SPRINGS & JACKSONVILLE – Three new physicians have joined the team of primary care providers at CHI St. Vincent Primary Care. Dr. Asma Khan has joined CHI St. Vincent Primary Care – Hot Springs and is now accepting patients. The Asma Khan clinic is located at 1 Mer-

cy Lane, Suite 506, in Hot Springs. Dr. Khan specializes in family medicine. She attended medical school at the Royal College of Surgeons-Ireland in Bahrain and completed her residency at Michigan State University hospital in Marquette, Mich. Dr. Rebecca Luper has joined CHI St. Vincent Primary Care in Hot Springs. Dr. Luper is currently accepting patients at the clinic, located at 1707 Airport Road. As a family practice physician, Dr. Luper treats both adults and children. She completed Rebecca Luper her residency at the University of Arkansas for Medical Sciences Area Health Education Center in El Dorado and attended medical school at the University of Oklahoma College of Medicine in Oklahoma City. Before coming to CHI St. Vincent, Dr. Luper worked as a hospitalist and a family practice physician in El Dorado and Junction City. Dr. Julian Hernandez has joined CHI St. Vincent Primary Care – Jacksonville Main Street and is currently accepting patients. The clinic is located 1110 W. Main St. in Jacksonville. Dr. Hernandez completed his residency at the University of ArkanJulian Hernandez sas for Medical Sciences Area Health Education Center in Fayetteville. He attended medical school at the Autonomous University of Guadalajara in Guadalajara, Mexico. He is fluent in both English and Spanish.

Mercy, Cooper Clinic Integration a Win for Patients Mercy Breaks Ground on $40 Million Multispecialty Facility SPRINGDALE — Nearly 200 people gathered for a ceremonial groundbreaking at the site of Mercy’s planned $40 million multispecialty facility, which will add almost two dozen primary and specialty care providers in Springdale. Hospital President Eric Pianalto, a native of Tontitown, said the Springdale clinic is the largest of seven in a $247 million expansion that will also add a seven-story tower to the Rogers hospital. He noted that the clinic’s proximity to his hometown deepens the meaning of Mercy’s effort to increase access to health care in the area. The clinic will feature 29 exam rooms dedicated to primary care and 34 exam rooms for specialty care, said Dr. Steve Goss, president of Mercy Clinic. That space will accommodate 10 primary care physicians and 12 specialists “and that’s just to start,” he said. Some of the specialties will be cardiology, urology, pulmonology, orthopedics and ear, nose and throat. The clinic will house a 24-hour emergency department with 12 exam rooms and one trauma room. There will be a helipad for acute cases in which a patient would be stabilized for transport to the Rogers hospital or farther away, depending on needs, Dr. Goss said. Dr. Larry Schemel, whose Mercy practice is at 1110 W. Robinson Ave. in Springdale, will transition to the new facility when it opens, Dr. Goss said. Mayor Doug Sprouse said city officials are grateful that Mercy chose to increase its footprint in Springdale. Construction will begin immediately on the 60,000-square-foot building, which is expected to take 15 months to complete. The 31-acre site at Elm Springs Road and 48th Street, just off Interstate 49, allows room for anticipated expansion. Pianalto recognized the Shewmaker family for its contribution of a $1.5 million lead gift that gives a robust start toward Mercy Health Foundation’s goal of raising $5 million for the multispecialty facility’s construction. More details about the campaign will be announced at the Foundation’s O Night Divine Charity Ball on Dec. 2.

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FORT SMITH –A plan to combine Cooper Clinic, P.A., and Mercy Clinic Fort Smith became official November 1, said Dr. Cole Goodman, president of Mercy Clinic. The boards of directors of Cooper Clinic and Mercy Clinic approved the agreement last month, and 61 Cooper Clinic providers, including 48 physicians, elected to integrate with Mercy. Another 400 Cooper Clinic co-workers will join Mercy, and 28 Cooper Clinic practices will become part of the Mercy system. Mercy Fort Smith has grown to serve more than 450,000 residents in 13 counties in Arkansas and Oklahoma through its network of care facilities. Previous to the Cooper Clinic integration, Mercy operated 48 clinic locations across that service area. Mercy Clinic employs 188 providers, including 154 physicians, and another 521 co-workers. With the integration of Cooper Clinic, Mercy will offer several new specialties, enabling a greater level of continuity of care. Those specialties include dermatology, endocrinology, gastroenterology, nephrology, occupational medicine, and ear, nose and throat, among others. When integration of the clinics is complete, patients new to Mercy will see

the many benefits of Mercy’s investment in technology and a comprehensive electronic medical records system. Among them is the MyMercy online platform where patients can schedule appointments, ask for prescription refills, see test results, directly message their providers and have e-appointments. Physicians and co-workers in both organizations are involved with efforts to ensure a smooth and seamless transition for patients. Most Cooper Clinic doctors will integrate with Mercy, but those who will not have notified their patients of those plans. In addition, few physician offices will move, and affected patients will be told of those relocations. Many business operations already have been combined, while others will be phased in over the coming months. This development will combine the strengths of both Cooper Clinic and Mercy and provide a strong foundation for the continuation of quality healthcare in the River Valley. Visit www.mercy.net/fortsmithFAQ for answers to many of the questions concerning the changes.

PUBLISHER Pamela Z. Harris pamela@memphismedicalnews.com EDITOR Pepper Jeter editor@arkansasmedicalnews.com SALES 501.247.9189 CREATIVE DIRECTOR Susan Graham sgraham@nashvillemedicalnews.com GRAPHIC DESIGNERS Susan Graham, Katy Barrett-Alley CONTRIBUTING WRITER Becky Gillette All editorial submissions and press releases should be sent to pamela@memphismedicalnews.com Subscription requests can be mailed to the address below or emailed to pamela@memphismedicalnews.com. Arkansas Medical News is now privately owned by Ziggy Productions, LLC. P O Box 1842 Memphis, TN 38101- 1842 President: Pamela Harris Vice President: Patrick Rains Reproduction in whole or in part without written permission is prohibited. Arkansas Medical News will assume no responsibility for unsolicited materials. All letters sent to Arkansas Medical News will be considered the newspaper’s property and unconditionally assigned to Arkansas Medical News for publication and copyright purposes.

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GrandRounds Spine Surgeon Joins Conway Regional Neuroscience Center CONWAY - Conway Regional Health System welcomes Regan S. Gallaher, MD, to its medical staff. Dr. Gallaher, a board certified neurosurgeon who performs neck and back spinal procedures exclusively, will join the Conway Regional Neuroscience Center and Regan S. Gallaher practice alongside Neurologists Tim Freyaldenhoven and Keith Schluterman and Elana Russell, APRN. Dr. Gallaher comes to Conway from Jefferson Regional Medical Center in Pine Bluff, where he practiced for the last four years, and Washington Regional Medical Center before that. Dr. Gallaher holds a medical degree from the University of Arkansas for Medical Sciences and completed a residency in Neurosurgery from the University of New Mexico at Albuquerque. Dr. Gallaher also has a bachelor’s degree from Hendrix College.

Dr. Logan Lynch Joins Physicians at St. Bernards Surgical Associates JONESBORO - Dr. G. Logan Lynch has joined physicians at St. Bernards Surgical Associates.

He earned his Medical Degree from the University of Mississippi School of Medicine and completed an internship and residency in the Department of Surgery at the University of Missis- G. Logan Lynch sippi Medical Center in Jackson, Miss. During the last year, Lynch served as administrative chief resident of general surgery there. He holds an undergraduate degree in biology from Delta State University in Cleveland, Ms., where he met his wife of eight years. They have two children, Carson, 6, and Juliet, 3. He served as a volunteer at Jackson Free Clinic, providing care to the medically underserved. Lynch joins Drs. John Cook, Jennifer DiCocco, Willie Harper, Joshua Tolleson and Lynn Wiggins at St. Bernards Surgical Associates.

Glaucoma Specialist Christopher Lee, MD, Joins UAMS Harvey & Bernice Jones Eye Institute LITTLE ROCK — Christopher Lee, MD, has joined the Harvey & Bernice Jones Eye Institute at the University of Arkansas for Medical Sciences (UAMS). He will also serve as an assistant

professor in the UAMS College of Medicine’s Department of Ophthalmology. Lee specializes in glaucoma. Lee comes to UAMS from the University of Texas Southwestern Christopher Lee Medical Center in Dallas, Texas, where he completed his residency and fellowship, following an internship in internal medicine at St. Joseph Mercy Hospital in Ann Arbor, Michigan. A graduate of Northwestern University with a Bachelor of Science in civil engineering, he earned his medical degree at the University of Texas Health Science Center at San Antonio. His clinical interests include medical and surgical glaucoma, cataracts and comprehensive ophthalmology. His research interests focus on the effect of glaucoma on the retina as it pertains to injections for treatment of glaucoma. During his residency, Lee was part of a research team that developed a handheld mobile device to provide home monitoring for patients with diabetic macular edema and macular degeneration.

NARMC Announces Two New Nurse Managers HARRISON - North Arkansas Regional Medical Center (NARMC) is proud to announce the promotion of two nurses

to its nurse management team, Jessica (Gass) Gutting, BSN, RN and Jenny Harmon, MSN, RN, COI. Gutting has been with NARMC since 2011 and was recently promoted to Nurse Man- Jessica Gutting ager of the Critical Care Unit. She is a 2010 graduate of Arkansas Tech University and has experience in an intensive care unit, emergency room, medical/surgi- Jenny Harmon cal floor, obstetric unit and psychological unit. She has been a charge nurse, clinical supervisor and interim nurse manager during her time at NARMC. Harmon is from the Harrison area and recently moved back to become the Nurse Manager of the Med/Surge unit. She graduated with her LPN and RN from North Arkansas College and went on to receive her BSN from Arkansas Tech University in 2012. She also obtained her MSN from American Sentinel University in 2015. Harmon is currently pursuing her second master’s degree as a Nurse Practitioner at the University of Central Arkansas.

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