August 2019 MMN

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August 2019 >> $5

A Former Athlete Is Now Treating Current Athletes A former all-sports athlete, and a veteran of 17 marathons, understands when patients come to see her with what others might see as merely a minor ache or pain.

Story on page 2.

Lawmakers Consider Removing Surprise From Patients’ Bills The issue of surprise billing currently is debated by Congress which has resulted in multiple pieces of legislation being proposed and perhaps some legislation actually being passed.

Report on page 5.

Honors, Grants, And New Facilities Are in the News Summer has been a busy time for Memphis healthcare. St. Jude was one of several facilities honored for its work while the past month also saw several new care centers open their doors and a group of researchers win large grants.

Healthcare news items on pages 8-11. FOLLOW US


Josse’s Travels Bring Her To a Key Role at Medtronic Helps Launch Important New Orthopedic Device By BETH SIMKANIN

Sharrolyn Josse admits she was fascinated with the field of medicine as well as travel at a young age. She was exposed to both through her father, a physician, while growing up in South Africa, Canada and the United States. She always thought she would become a doctor, but discovered in college she wanted to have a career that allowed her the opportunity to travel. It turns out, her favorite pastime led her back to the same field that fascinated her as a young girl. Upon graduation from college more than 20 years ago, a move to France unexpectedly led her to a career in business and product development for spinal implants and technologies – a profession she’s committed to two decades later. She is vice president and general manager of core spine for Medtronic. “I’ve always been drawn to the medical industry because of my father,” she said recently in her office at the firm’s expansive Memphis campus. “I discovered later that I was interested in the business side of things. I love coming up with ideas and innovations that make a difference in people’s lives. It gives me great joy to meet people whose lives (CONTINUED ON PAGE 4)



Sharrolyn Josse with the Mazor X Stealth Edition.

Today’s Sports Medicine Puts The Athlete First; Not the Team By LAWRENCE BUSER

Sports medicine today looks much different than it did some 32 years ago when Dr. Barry Phillips was starting his career as an orthopedic surgeon and team doctor for high school, college and professional athletes. Today, he says, the techniques are better, the equipment is better, and the understanding of injuries and rehabilitation is better. There’s also a term for team physicians – athlete advocates – that wasn’t around in those early days of sports medicine. “It’s about putting athletes first,” says Dr. Philips, who is with Campbell Clinic Orthopaedics and has been the University of Memphis team physician for the past (CONTINUED ON PAGE 6)


“Summertime is always the best of what might be.” — Charles Bowden From all of us at Memphis Medical News: Safe travels, stay cool and keep reading! PRINTED ON RECYCLED PAPER



Doctor Stays Connected to Sports World

A Former Athlete, Dr. Laura Lendermon Now Treats Athletes By LAWRENCE BUSER

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As a former all-sports high school athlete, a college basketball and tennis player, and now a veteran of 17 marathons, including Boston and New York, Dr. Laura Lendermon understands when patients come to see her with what others might see as minor aches and pains. It’s a quality of life issue. “I get how it feels to be hurt and I get how it feels to be healthy, so that’s why I want to try to help people be on the healthy end of things,” says Dr. Lendermon, head of Lendermon Sports Medicine in Collierville. “If somebody comes in kind of whiny and says ‘I can only run 10 miles and then I start to hurt,’ most people might say, ‘Seriously, dude? Get a life.’ But when I hear that, I’m like ‘I get it ma’am.’ Keeping people in their sport is real important to me. “If I don’t work out, I’m not who I need to be. My husband doesn’t think I’m who I need to be, either. He’ll say, ‘You really need to go run.’ We have so many stressors in our lives, so if you can get out and exercise and do something that puts you in your good and happy and healthy place, that makes me happy to be able to help you do that.” Dr. Lendermon didn’t take a direct route from college to medical school. In high school at Harding Academy in Memphis, her goal was to be a doctor or a coach. After finishing at University of Tennessee at Martin, she chose inbetween and became a physical therapist, a combination of the medical and athletic worlds. After 10 years, she was running a large group of out-patient clinics that involved lots of travel as well as business and financial details. “I realized that I had gotten my hands away from the patients and decided this is crazy,” Dr. Lendermon recalled. “I either need to go really far in business and become an MBA, or become an attorney, or get a little bit farther down the food chain in the healthcare industry, so I decided to go to medical school.” At the University of Tennessee School Of Medicine in Memphis, she met classmate and future husband, Dr. Nav Rangi, now a Memphis anesthesiologist. They have a 17-year-old son heading for UT-Knoxville this fall. Still wanting to stay connected to the sports world, she then did a two-year primary care sports medicine fellowship after her residency with the famed Dr. James

Laura Lendermon

Andrews in Birmingham. (Dr. Andrews, a specialist in repairing damaged ligaments, has become one of the nation’s most well known and popular orthopedic surgeons, having helped a number of high-profile athletes.) In Birmingham she not only rubbed elbows with the stars, but also worked on some as well. “When I was there, Dr. Andrews would see people like Michael Jordan, Arnold Palmer, Jack Nicklaus, John Smoltz, Drew Brees – it was really neat,” she recalls. “I learned a lot about how to manage people and how to manage athletes from the highest pros to the gardenvariety Little Leaguer. (CONTINUED ON PAGE 7)



Methodist Le Bonheur Announces New Initiatives Methodist Le Bonheur Healthcare announced a series of initiatives aimed at “expanding and uplifting the financial health of its employees, patients and the community.” According to its announcement, Methodist will be making the following changes to its financial assistance policy: • Uninsured patients with income up to 250 percent of the federal poverty guidelines will be eligible for financial assistance, an increase from the current threshold of 125 percent. • Regardless of insurance status, Methodist will no longer pursue legal action against anyone who is at or below 250 percent of the federal poverty guidelines. • Methodist will no longer accept court ordered interest on medical debt, and will no longer collect court allowed Michael Ugwueke attorney fees and court costs from any patient. In a July 30 news conference, Michael Ugwueke, president and CEO of Methodist Le Bonheur Healthcare, said the updated financial assistance policy will go into effect August 2019 and that Methodist has begun the process of implementing these changes. “Nationally, and here at home, a conversation is occurring about elevating those in need and caring for medically underserved patients. Methodist is working to do our part to be a positive force for change in this important conversation,” Ugwueke, said. “We work each day to improve every life we touch by uplifting our associates, patients and the community.” Methodist’s announcement came approximately a month after the publication of a news report critical of some of the hospital’s financial policies and activity. The report, which received widespread media attention in Memphis, contained information concerning lawsuits and collection processes against patients – including its own employees – who owed the hospital money for treatment they received. Methodist Le Bonheur Healthcare is Memphis’ largest hospital system. Ugwueke said Methodist’s leaders recently led more than 20 listening sessions to hear directly from its employees, physicians and patients about how the health system can do more to fulfill their responsibility to contributing to the economic wellbeing of those they serve. “At our core, we are a learning organization committed to continuous growth. We are now taking another step MEMPHISMEDICALNEWS


in our journey to uplift our Associates, patients and the community we serve,” said Ugwueke. “Through this process, we were humbled to learn that while there is so much good happening across our health system each day, we can, and must, do better.” Methodist announced new initiatives to provide expanded opportunities for its employees as well as an updated financial assistance policy. Methodist’s commitment to employees is a holistic approach based on two pillars: raising minimum wages and partnering with their Associates to provide career paths that lead to professional growth and greater financial security. Over the next 17 months, Methodist will raise their minimum wage to $15 an hour for all employees. Effective in September of this year, minimum wages will increase from $10.08 to $13.50 and by January 2021, minimum wage will become $15.00 an hour. Ugwueke said Methodist has committed to creating more opportunities for interested Associates to gain the skills, experience, knowledge, and education needed to advance to even higher paying positions. According to Ugwueke, Methodist will be updating its financial assistance policies. Methodist completed a 30-day review process to evaluate how it currently is assisting patients who are struggling with medical debt. As part of this process, Methodist conducted more than 20 listening sessions with employees, physicians and patients, engaged a thirdparty expert to conduct the review and suspended court collection proceedings during the review period. The review compared Methodist’s billing and collections practices to those of other similar sized, urban, mission-driven healthcare organizations, with careful consideration given to the diverse population that Methodist serves.

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DR. RAZA HASHMI Dr. Raza Hashmi graduated from King Edward Medical College, Lahore Pakistan in 2002. He completed his internal medicine residency training from Weiss Memorial Hospital Chicago, IL, in 2007, where he received the Best Resident of the Year award. This was followed by additional fellowship training in geriatric medicine at University of Illinois at Chicago. He practiced as a hospitalist from 2009-2015 and completed his Rheumatology fellowship training at University of Louisville, KY in June 2017. He has recently joined Consolidated Medical Practices of Memphis and has started his rheumatology practice. Dr. Hashmi is board certified in both internal medicine and geriatric medicine. He is board eligible in Rheumatology. He is a member of the American College of Rheumatology and American College of Physicians. In addition to Rheumatoid arthritis, Dr. Hashmi has a special interest in psoriatic arthritis, Systemic Lupus Erythematosus, gout and osteoporosis. Dr. Hashmi also has expertise in treating other autoimmune diseases such as Sjögren’s syndrome, ankylosing spondylitis, vasculitis, scleroderma. He is proficient in performing joint injection for osteoarthritis as well as treatment of Carpel tunnel syndrome. He is accepting new patients to his practice. For referrals, please call our office at 901-259-0090.

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Josse’s Travels Take Her To Key Role at Medtronic, continued from page 1 in the operating room while driving down cost for the surgeon and patient. This means less time in the operating room, which saves money.” The product allows the surgeon to preplan surgery using a combination of three-dimensional imaging and navigation software so the surgeon can visualize the precise angle for the implant placement. The surgeon determines the size and length of the screws and the location where the screws need to be placed. Then, the software guides the robotic-surgical arm into position during surgery based on the instructions given during the preplanning process. The surgeon can visualize, in real time, the exact area where the surgical instrument places the implant on the patient’s spine. “This ensures less room for error, so the surgeon can execute exact precision during surgery,” Josse said. The Mazor X Stealth Edition was launched in January after Medtronic acquired Israeli-based Mazor Robotics last September. Medtronic combined its navigation technology with Mazor’s robotic surgery systems to create the product, which was approved by the U.S. Food and Drug administration in November last year. Since January, Medtronic says the Mazor X Stealth Edition has been used in 1,000 procedures in more than 50 hospitals in the U.S. The product is so new that Josse says surgeons in the Memphis area have not yet to used it in spinal surgeries.

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She points out that there is a learning curve for surgeons who want to use the new technology. They must undergo product training at one of Medtronic’s three U.S. training facilities. “Work flow is extremely critical, so it’s important for the surgeon to use the same steps every time,” Josse said. “We want to reduce any variables. We train surgeons and their staff so there is a team approach and everyone knows their roles.” Josse says she has met patients whose lives were transformed as a result of the robotic-assisted surgery. It’s given her tremendous joy and satisfaction to know she is helping to make a difference in patients’ lives. “If I had to have spine surgery, I would want to have this robotic-assisted surgery,” she said. Josse says her work to transform out-

comes for both surgeons and patients is never ending. The key to her work ethic is to view all challenges as opportunities. In addition to product development, her team works on solutions to drive innovation to the U.S. and global markets, while meeting market price demands at the same time. Josse says the future of roboticassisted spine surgery with navigation will involve soft tissues in the spine. For instance, surgeons will be able to replace collapsed discs in the spine with roboticassisted surgery in the future. Josse moved to Memphis in 2016. She says Memphis is a friendly city with a strong sense of community. She enjoys traveling to see her siblings, who live in different locations across the globe. She spends her spare time with her two children, ages 6 and 11, playing board games and attending art shows and school plays.


have been directly impacted by a product. We are constantly working to extend lives and relieve pain.” Josse manages Medtronic’s core spine initiatives, which assist neurosurgeons and orthopedic surgeons with surgical solutions for patients with various spinal conditions. According to Josse, the company’s recent launch of the Mazor X Stealth Edition combines robotic technology, navigation and instrumentation to give surgeons precise trajectory guidance for spinal procedures, something that’s never been done before under one platform in robotic-assisted spine surgery. Robotic-assisted surgery isn’t a new concept to physicians in healthcare -- it’s been around for almost two decades -- but Josse says that combining a robotics platform with navigation software ensures that the surgeon can plan for more precision in the operating room while using threedimensional CT imaging to visualize how the implant interacts with spinal anatomy so there are no surprises during surgery. As a result, Josse says, it reduces the potential for complications, like nerve damage, and aims to improve surgical outcomes. “It’s rare that robotics and navigation merge into a sole platform like this,” Josse said. “Competitors piece together parts of this technology, but Medtronic is the first to integrate the platform in the industry. The goal is to increase accuracy and safety

The Mazor X Stealth Edition.

Medtronic’s Device Unites Robotics and Navigation Medtronic launched the Mazor X Stealth Edition in January earlier this year after acquiring Israeli-based Mazor Robotics last September for $1.64 billion. The acquisition combined Medtronic’s spine implants, navigation and intraoperative imaging technology with Mazor’s robotic-assisted surgery systems. The Mazor X Stealth Edition combines robotic-assisted surgical technology from Mazor Robotics with Medtronic’s spinal navigation. “The marriage of robotics and navigation represents the future of computerized planning and execution in spine surgery,” commented Christopher R. Good, MD, spine surgeon at Reston Hospital Center in Reston, Va., director of Scoliosis and Spinal Deformity and president of The Virginia Spine Institute. “Robotics and navigation have both been shown to improve accuracy and precision in spine surgery,” Dr. Good continued. “The Mazor X Stealth Edition is a revolutionary new technology that uses cutting-edge software to plan the surgical procedure and then uses the robotic arm to guide implants and instruments through the steps of the surgical procedure with precision, while simultaneously using real-time imaging feedback to ensure the plan is being carried out as desired.” The U.S. Food and Drug Administration cleared the product for use last November. Medtronic reports the product has been used in 1,000 procedures in more than 50 hospitals in the U.S. since its introduction to the market in January.



Considerable Surprises May Lurk in ‘No Surprises’ Legislation By DENISE BURKE, JD

The term “surprise billing” is used to describe the situation when a patient receives a bill for the difference between the out-of-network provider’s fee and the amount covered by the patient’s health insurance, after co-pays and deductible. Patients often assume that providers such as radiologists, pathologists, physician anesthesiologists, emergency physicians and trauma surgeons are in-network because the treating hospital is in-network, thus they are “surprised” that the charges are not covered by their insurance. The issue of surprise billing has been hotly debated by the 116th Congress as an estimated 40 percent of patients received a surprise bill in 2018. Multiple pieces of legislation have been proposed and it seems likely that legislation will be passed, although the exact substance is yet to be determined. There is considerable agreement between the proposals on protecting patients in emergency situations, but there are notable and important differences beyond that agreement. For example, the Cassidy Senate Bill (“Protecting People from Surprise Medical Bills Act”) prohibits surprise billing when a patient is seeking non-emergency care by an out-of-network provider at an in-network facility. The version from the Energy and Commerce committee, (the “No Surprises Act”) would allow such billing if the patient is provided with written and oral notice and consent. The “Protecting People from Surprise Medical Bills Act” (HR 3502), would prohibit surprise billing for out-of-network after-emergency care when a patient cannot travel without medical transport, as well as for out-of-network imaging or lab services when ordered by an in-network provider. The Senate HELP Bill would require that patients receiving out-of-network ancillary services only pay the in-network cost-sharing amount and unstable patients who receive services emergency services would be responsible only for the amount

Is the missing

About the Writer Denise Burke is an accomplished healthcare attorney providing special regulatory counsel to private equity companies, hospitals, physicians, medical device companies and other healthcare clients on a wide range of complex regulatory/compliance, operations and transactional issues. She is a prior Chair of the Tennessee Bar Association Health Law Section and was named a Fellow of the Nashville Health Care Council in 2016. Burke has been consistently recognized by Best Lawyers for the past decade, including 2012’s “Lawyer of the Year” in healthcare law for the Memphis and West Tennessee area and as a “Woman of Influence” in 2017. She is also ranked in Healthcare by Mid-South Super Lawyers ®. She serves as a member of the Advisory Board of the Institute for Health Law & Policy at the University of Memphis Cecil C. Humphreys School of Law and the Common Table Health Alliance.

they would have paid in-network. The Senate HELP Bill would also require that patients be given advance notice of any outof-network care, an estimate of the costs, and referrals for alternative options for innetwork care. If a patient is not provided the required notice, the patient would not be responsible for the out-of-network cost. The Senate HELP Bill proposes to set rates for practitioner or facility based on the median in-network contracted rate for services in that geographic area and does not include arbitration style provisions. The (CONTINUED ON PAGE 8)

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A revolutionary type of minimally-invasive spine surgery offered at Campbell Clinic is benefiting patients around the Mid-South. Endoscopic spine surgery is a groundbreaking procedure that allows a surgeon to access the spine through a small port placed through an incision less than one centimeter in length. Through the port, a physician uses small tools to resect disc herniation, facet cysts and decompress neural elements. An endoscope allows direct light-based visualization of the anatomy as well as the tissue being removed. The physician also uses fluoroscopy to guide precise placement of the port and instruments to ensure the appropriate level and corresponding diseased area will be accessed. Dr. Gardocki currently performs discectomies, facet cyst resections, foraminotomies, and transforaminal and interlaminar decompressions using this approach in the lumbar, thoracic and cervical spine. The results thus far have been nothing short of amazing.

Dr. Raymond J. Gardocki Campbell Clinic Spine Center

As with any procedure performed in an outpatient ambulatory surgery setting, endoscopic spine surgery carries with it a host of clinical benefits for the patient. Those include: • a much smaller incision than normal, resulting in fewer limitations after surgery • limited amount of blood loss as compared to lengthier, inpatient procedures • better management of intra-operative and post-operative pain • preservation of spinal mobility • significantly lower risk of deep tissue infection and readmission • less disruption of surrounding muscle and tissue • and of course, the convenience of same-day surgery! During the procedure, patients are consciously sedated to ensure their comfort and to assist the surgeon with guidance around local nerve tissue based on immediate sensation. After the surgery, low-dosage Versed is administered to aid in pain control and to eliminate any recall of the procedure. While not all patients are candidates for conscious sedation surgery, many are eligible to have same-day surgery so that they may recover in the privacy and comfort of their own home. Despite the normal soreness associated with surgery, patients typically report immediate relief postoperatively from the symptoms associated with herniated discs such as weakness, numbness and pain. Most patients return home with no bandage that needs to be changed and no sutures that need to be removed. Typically, post-operative pain is controlled with NSAIDs and there is no need for narcotics. Dr. Ray Gardocki is a spine surgeon at Campbell Clinic Spine Center in Cordova. He is the first and only physician in the region to be trained in the endoscopic spine approach. Dr. Gardocki graduated from the University of Southern California School of Medicine in 1997 and completed his residency at the Los Angeles County/USC Medical Center in 2002. For more information about endoscopic spine surgery, or to schedule an appointment, call 901.507.7656.

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Today’s Sports Medicine, continued from page 1

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three decades. “We have to be mindful of the athlete’s physical and psychological well-being first and foremost. It’s the athlete first, then the family, and then the coach and team.” It wasn’t always that way. For example, getting an injured football player back Barry Phillips into action quickly was a priority for everyone involved. “Back in the 1990s an ACL repair and rehab was a one-year process, and then it dropped down to six months, and then 15 years ago we were trying to get them back at four to five months,” Dr. Phillips says. “Now that pendulum has totally swung back the other way. So now, most of the time, it’s a minimum of six months, or maybe nine months or even 12 months for a college football player. That’s with the knee. “We’ve learned that it’s not just getting strength back, but they’ve got to get their agility and coordination and reflexes back. There’s also the psychological part of getting hurt and getting operated on and going through rehab. It takes a lot of young people a full year or more to get back out there and really feel comfortable and forget about their injury and play again.” Dr. Phillips started out in 1987 at Campbell Clinic working with a pair of pioneers in local sports medicine – Dr. T. David Sisk who worked with University of Memphis athletic teams and Dr. Marcus Stewart who worked with teams at Ole Miss. He also did a fellowship with Dr. James Andrews of the famed Andrews Clinic in Birmingham. “They kept me interested in sport medicine and so I stuck with it,” says Dr. Phillips, who counts Dr. Barney Freeman as another important mentor. “I started out helping with University of Memphis teams and then with Team USA Baseball in Millington for about 13 years. Then I got started with the Memphis Chicks, then the Redbirds and then with major league baseball with the Cardinals at spring training.” Dr. Phillips says doctors, coaches, and trainers are working smarter today because there’s a better understanding not only of how to treat an injury, but also how to avoid injury and how to prevent a reoccurrence. Open surgery, casts, prolonged immobilization and hospital stays – the common treatment of the 1980s – has been replaced by minimally invasive surgery with much better rehab protocols. “With better rehab, we’re now able to get people back to all the goals they really want to get back to versus just being able to get back to doing some activity,” Dr. Phillips says. “If you don’t get them fully rehabbed, even if you have good surgery bad things happen.” Injury prevention also is far better today, he adds, with the presence of trained spotters and video analysts at foot-

ball games helping trainers on the sidelines spot possible injuries such as concussions. “We’ve learned a lot more about second-impact problems so instead of letting them go right back in when they seem to feel better we get them out, protect them and have them go through a concussion protocol which is continually changing,” says Dr. Phillips. “Also, there’s a lot less contact, particularly in spring football, so there’s a less chance of getting hurt. “If you had a 300-pound lineman two or three decades ago that was sort of a big deal, but today that’s sort of the standard. The backs are bigger, too. They’re all bigger. In the 80’s and 90’s, you had these long, drawn-out practices and that’s when a lot of injuries were occurring. Now the contact is in the game and a whole lot less in practice.” Keeping young pitching elbows healthy is one area that has gotten more challenging over the years, particularly with high school pitchers who throw harder, longer and do it year round. “Until six or seven years ago, I hadn’t done surgery on kids younger than 17, but now I’m seeing a lot of kids who are 15 or 16 years old,” Dr. Phillips says. “Pitching more than nine months a year and 90 pitches or more in a game puts them in an increased risk to get hurt. We’re trying to get the message out that over-use is a big part of it. Sometimes taking a few months off without pitching would be helpful.” Dr. Phillips, who also works with the University of Memphis women’s basketball team, says that 30 years ago ACL tears in the knees of the women were six to seven times the rate for men. “At that time their conditioning was probably not at the same level as with the men,” he says. “The good women players could play in high school and maybe not have a lot of competition, but in college they were playing at a higher level and probably hadn’t developed (physically) to that same level. “Now we work with the girls a lot on just stopping and jumping and landing. Jump programs have greatly decreased the chances of women tearing their ACL. That’s been a really nice event over the last couple of decades.” But today, sports medicine is no longer just about knees and shoulders and elbows. At this year’s annual meeting of the American Orthopedic Society for Sport Medicine, Dr. Phillips and his colleagues heard a heart-wrenching talk from Maddie Kocian, one of the many U.S. Olympic gymnasts who have spoken out about years of sex abuse by team physician Dr. Larry Nassar. Nassar was sentenced to up to 175 years in prison last year for molesting hundreds of young athletes as far back as 1972. “Probably 99 percent of the doctors who take care of these kids only have in mind trying to make them better, but our awareness of abuse was heightened by Maddie Kocian,” said Dr. Phillips. “As athlete advocates we strive to be the best we can be so the athletes can mentally and physically be the best they can be, and that is what sports are all about.” memphismedicalnews


Doctor Stays Connected, continued from page 2 “The coolest thing about Dr. Andrews was that, as well thought of and as successful as he is, he treats everybody the same. If you’re Michael Jordan he’s going to go in, sit down, cross his legs, take his time and hear to your story. And if you’re Paw-Paw the farmer in the next room, he’s going to go in, sit down, cross his legs, take his time and hear your story. I loved that. If someone asks me what about Dr. Andrews made the biggest impression on me, I’d say the way he treats people.” While Dr. Andrews is best known for his surgical skills, particularly Tommy John elbow surgery for baseball pitchers, Dr. Lendermon says an estimated 80 percent of orthopedic issues can be treated non-surgically. She believes surgery is the treatment of last resort. Enter the era of regenerative medicine. “For years my role has been to keep you out of the operating room, and let’s say you came to me and said, ‘Man, they told me I had to have a knee replacement. What can you do about it?’” Dr. Lendermon says. “I kind of kiddingly had a 12-step approach called ‘How to keep you out of the operating room.’ So we tried anti-inflammatories, ice and heat, physical therapy, bracing, over-the- counter supplements, and all these things. Then we got to the top of the heap and still weren’t where we wanted to be, so we’d hand you over to the surgeon and say, ‘Well, shoot. At least we avoided surgery for a couple of years.

“And that’s how we were until about five years ago.” Then she heard about a St. Louis orthopedic clinic that had gone from highvolume surgical knee repair to stem cell and regenerative therapy. Dr. Lendermon was intrigued. “I’m not a big box store,” she says. “I’m not Walmart. I’m a little boutique store that you come to, so I’m on the hunt for anything that’s cutting edge and new and the latest. I want to offer you something you don’t get everywhere else.” What she offers is autologous stem cells which are taken from one part of the patient’s body and are transferred to another. “With autologous stem cells, we take bone marrow from the pelvic bone above your hip, process that and get the stem cells out of it and put that into the joints that we typically do which are the knees, shoulder and hips,” Dr. Lendermon said. “We’ll also do it with subcutaneous fat. Believe it or not, there’s tons of stem cells in fat. So I tell people, fat is not the enemy. I love fat. If you have fat, you’re my friend.” Four months or so later, blood is drawn from the patient and platelet rich plasma is added to the joint to stimulate stem cells to regenerate at a higher rate. A similar treatment is then repeated 10 or 11 months later. “So we’re not getting you a new knee right out of the box that’s made of plastic and metal, but we can really turn back the

biological clock on your knee,” said Dr. Lendermon. “We’re not growing new tissue, but I feel that we’re healing the tissue you have. If you come in and say I’ve got a 60-year-old knee that’s kind of banged up and beaten up, we basically repurpose the knee and make it much younger than it was previously. I do think regenerative therapy has its niche.” Turning back her own biological clock, as a high school senior Dr. Lendermon had just accepted a scholarship to play basketball at UT-Martin when she got a phone call from coach Pat Summitt, the top name in women’s basketball at the time.

“She said, ‘Hey, we really want you to play at Knoxville’ and I’m like, ‘Ohhhhhhh,’’’ she says, recalling having to explain her dilemma to the basketball icon. “She said ‘if you had signed papers at any other school, I could sneak you back up here to Knoxville and you could sit out a year and play for me.’ But, she said, ‘I graduated from UT-Martin, so if I took you from there I’d be in deep trouble. “That was one of the blunders of my life, but I later went up there and helped with summer camps and worked as a college counselor. She was a great role model and influence for females.”

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GrandRounds St. Jude Included on U.S. News’ Most Distinguished List St. Jude Children’s Research Hospital has been ranked as the No. 2 pediatric cancer hospital on U.S. News & World Report’s 13th Annual “Best Children’s Hospitals” list. The publication ranks the 50 highest-scoring pediatric hospitals across the U.S. in 10 comprehensive specialties. The U.S. News Best Children’s Hospitals rankings rely on clinical data and on an annual survey of pediatric specialists. The rankings, which were announced at the end of July, methodology factors in patient outcomes, such as mortality and infection rates, as well as available clinical resources and compliance with best practices. St. Jude is the only National Can-

cer Institute-designated Comprehensive Care Center devoted solely to children, having recently received the NCI’s highest ranking of “exceptional.” The hospital has top survival rates for some of the most common and aggressive childhood cancers, including acute lymphoblastic leukemia and medulloblastoma. St. Jude creates more cancer clinical trials than any other children’s hospital in the U.S., and unlike most hospitals, no family receives a bill from St. Jude for anything, including treatment, travel, housing and food. St. Jude has maintained designated Magnet status by the American Nurses Credentialing Center. Magnet status is the highest honor granted to nursing services. Only 7 percent of all U.S. hospitals have achieved this recognition.

Campbell Clinic Set to Open Outpatient Facility This Fall

IS YOUR LICENSE IN JEOPARDY? Medical/Nursing Board Inquiries Investigations • Disciplinary Actions Attorney Ashley Cleek has been representing individual providers and hospitals in medical malpractice cases throughout Tennessee for the past 15 years. He also assists physicians, nurses, and midlevel providers who are under investigation or facing disciplinary action by the medical/nursing board. Mr. Cleek has significant appellate experience, handling numerous cases before the Tennessee Court of Appeals, Tennessee Supreme Court, and the United States Court of Appeals for the Sixth Circuit. He is an AVPreeminent® rated lawyer, which is the highest rating available in the Martindale-Hubbell® evaluation system.

Campbell Clinic plans to open its new four-story outpatient facility this fall. Construction of the 120,000-square foot outpatient facility in Germantown is on schedule to be completed this fall. The building, which broke ground in 2018, will feature expanded clinic and physical therapy space, new imaging suites, a sports performance center, and an outpatient surgery center with eight operating rooms. It is being built on a previously vacant five-acre parcel immediately to the east of Campbell’s existing 1400 South Germantown Road location. The company plans to continue to own and operate that location as an outpatient facility as it anticipates future growth.

Considerable Surprises, continued from page 5 No Surprise Act and the Cassidy Senate Bill incorporate a dispute resolution process (that does not involve the patient) to resolve issues between providers and health insurers when no agreement can be reached between the parties. The American Medical Association is supportive of alternative dispute resolution models, noting successful implementation in several states. While all stakeholders agree that patients need to be protected from surprise bills, it remains to be seen whether consensus can be reached or what unintended consequences may arise. For example, adoption of a fixed payment standard

might incentivize insurers to rely on default payments rather than contract with providers to join networks. The legislation might also lead to broader rate setting for physicians. Myriad practical considerations will also need to be addressed. For instance, the logistics of implementing some of the proposed notice requirements in an Emergency Department seem daunting. Right now there appears to be general consensus among Democrats, Republicans and the president that the issue needs to be addressed but with the political climate as unpredictable as ever there are probably more than a few “surprises” in store.

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GrandRounds Lifesigns Completes Relocation to Kirby Parkway Lifesigns, a provider of comprehensive physical exams, has moved to its new facility at 1727 Kirby Parkway, Suite 100. The firm, which has about 50 employees, had been at its previous location at 1714 West Massey Road for 25 years. The new facility will enable the firm to handle greater capacity. A spalike atmosphere enhances the patient experience, according to Scott Pritchett, CFO of Lifesigns and HealthyHere. The company reports that approximately 10,500 patients visited Lifesigns last year

Baptist Trinity Home Care & Hospice Earns Award Baptist Trinity Home Care & Hospice has been recognized by Strategic Healthcare Programs (SHP) as a “Superior Performer” for achieving an overall caregiver and family satisfaction score that ranked in the top 20 percent of all eligible SHP clients in 2018. Baptist Trinity Home Care & Hospice is a hospice partner of Baptist Memorial Hospital and part of a joint venture partnership with LHC Group, a national provider of in-home healthcare services. The annual SHPBest award program was created to acknowledge hospice providers that consistently provide high quality service to families and caregivers of patients receiving hospice care.

UTHSC’s Kim Wins Grant to Research Psychiatric Disorders Il Hwan Kim, PhD, assistant professor in the Department of Anatomy and Neurobiology in the College of Medicine at the University of Tennessee Health Science Center, has been awarded more than $1.53 million to identify neural circuit dysfunction that may Il Hwan Kim cause behavioral difficulties in several mental disorders. Difficulties with social interactions, as well as struggles with mental focus, are common symptoms in mental ailments such as schizophrenia, depression, and autism-spectrum disorder. Dr. Kim used basic medical knowledge like this from psychology, his first undergraduate college major, to establish his main research idea. “Schizophrenia, autism, and depression patients share social symptoms, so that’s very helpful for doctors to know… But for scientists, that connection could be a variant for our approach,” Dr. Kim said. “So, I decided to forget about the name of the disorders and focused on the individual behavioral symptoms, then find the underlying mechanisms as my starting point.” According to the National Institute of Mental Health (NIMH), one in every five children and adults experience menmemphismedicalnews


tal illness. In addition, nearly 60 percent of those with a mental illness did not receive mental health services in the past year. Research shows approximately 90 percent of people who die by suicide show symptoms of mental illnesses, a rate that has not changed since it was tracked beginning in 1965. Dr. Kim’s hopes his innovative approach may provide a new framework for treating these psychiatric disorders in the future.

Walk-In Urgent Care Facility to Open in Bartlett Urgent Team, part of the Urgent Team Family of Centers, one of the largest independent operators of urgent and family care centers in the Southeast, this month is scheduled to open a walk-in faculty in Bartlett on Highway 64. Urgent Team-Bartlett will be open seven days a week and will provide urgent care, family care, wellness services and occupational health services on a walk-in basis. With no appointment needed and X-ray available, Urgent Team will treat a variety of medical needs. Urgent Team-Bartlett will be open Monday through Friday, 8 am to 8 pm; Saturday 9 am to 5 pm; and Sunday 1 pm to 5 pm. The center will accept most insurance, including Medicare, Medicaid, and TRICARE. Walk-ins will be welcome.

Same-Day Total Joint Replacement Adds Convenience and Improves Outcomes for Patients As recently as a decade ago, patients undergoing joint replacement in the inpatient hospital setting would check in the day of surgery and spend three days in the hospital after having their joint replaced. Advances in care have shortened that average length of stay to some degree, but patients typically still may spend time in a hospital bed after these procedures before going home or being discharged to a rehab facility. At Campbell Clinic, patients are enjoying a much more convenient joint replacement experience through outpatient surgery. Most patients who take advantage of this outpatient option arrive during the morning and are home in time for dinner, without the necessity of an overnight stay. In this surgery center setting, our physicians have complete control over all aspects of patient care, overseeing everything from anesthesia to the nursing staff to on-site physical therapy. This comprehensive approach enhances patient outcomes and makes for a more efficient and cost-effective process for the patient and their physician.

Patrick Toy, M.D. Campbell Clinic total joint replacement surgeon

If a patient does need to stay the night, they can do so in a private room at a quiet, comfortable facility that lacks the frequent distractions and interruptions of a busier medical complex. Most patients are able to go home on the same day. They typically prefer to begin their recovery there surrounded with the support of their family. Campbell Clinic physicians perform hip, knee, shoulder and ankle replacements at our outpatient surgery centers located in Germantown and Midtown. In addition to more traditional joint replacement procedures, some physicians also perform total hip replacement using a direct anterior approach, partial knee replacement and reverse shoulder replacement. To ensure a high quality of care, Campbell Surgery Center uses rigorous standards when recruiting and hiring its employees. All members of the surgical and nursing staff are required to have worked in the field of orthopaedic surgery for a minimum of five years, and all are considered “advanced practice” nurses because they are selected from intensive care or trauma settings and are able to manage patients who have significant medical issues. A major benefit to having any type of surgery performed in an outpatient setting is a lower risk of complications, such as infection or re-admission, as compared to a hospital. The risk of infection among Campbell Clinic’s outpatient total joint patients is slightly lower. Improved efficiency also carries with it the advantage of reduced costs. With a changing healthcare landscape, cost containment is becoming a more critical factor for patients, payers and providers alike. Typically, the total joint patient is in and out of the facility within seven hours, door-to-door. This shorter stay and the lower associated overhead costs benefit everyone. Total joint replacement is a viable option for many patients suffering from pain related to osteoarthritis. Patients who have these procedures performed in the hospital setting as well as the surgery center usually experience positive outcomes. For patients who desire added convenience and don’t like to be away from home, however, outpatient joint replacement is an increasingly attractive alternative. Campbell Clinic is set to open a new ambulatory surgery center, featuring eight operating suites, at its new Germantown facility. The building is scheduled to open later this year and will feature the newest in modern medical technology. In addition to two outpatient surgery centers, Campbell Clinic Orthopaedics operates clinics in Germantown, Southaven, Collierville, the Medical Center and a Spine Center in Cordova. The group offers After Hours walk-in clinics in Germantown and Southaven, as well as daytime walk-in care at all five locations.

To find out if you or one of your patients may be a candidate for a same-day total joint replacement, visit to learn more, or call 901.759.3111 to schedule an appointment. SPONSORED CONTENT




GrandRounds UTHSC Selects Associate Dean Student Affairs, Admissions OrthoSouth has united the excellence and expertise of Memphis Orthopaedic Group, OrthoMemphis, and Tabor Orthopedics to form a comprehensive and collaborative practice intent on offering the most convenient and accessible orthopedic care available in the Mid-South.

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Catherine Womack, MD, has been named Associate Dean of Student Affairs and Admissions for the University of Tennessee Health Science Center’s College of Medicine. As associate dean, Dr. Womack will lead the Office of Student Affairs and oversee the Catherine Womack Office of Medical Student Admissions for the College of Medicine. Additionally, she will lead the student advisory system, the academic, career, mental health referral, and personal and professional conduct of the college’s more than 680 medical students. She will also provide guidance in the student preparatory process for residency match, oversee the medical student performance evaluation for every senior student, and help ensure all students obtain a medical residency position. Dr. Womack will oversee the professional and scholarship committees, as well as student events including the Second Look Weekend, the White Coat Ceremony, the Student Clinician Ceremony, and commencement. In addition, she will direct the UTHSC MPOWER House mentoring system, which Susan Brewer, MD, helped to establish prior to her recent retirement. A graduate of the UTHSC College of Medicine, Dr. Womack earned her MD degree in 1995. She completed an internship and residency in Internal Medicine from the college. Dr. Womack is the recipient of many honors and awards including the American College of Physicians Laureate Award, the Castle Connolly Exceptional Women in Medicine Award, and the Top Twenty Internal Medicine Teachers Award from UTHSC for multiple years. She joined UTHSC in 1998 and previously served as assistant dean of Student Affairs, interim chair of the

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Department of Preventive Medicine, and co-chief of the Division of Internal Medicine.

UTHSC Researcher Investigating Early Glaucoma Detection Siamak Yousefi, PhD, assistant professor in the Department of Ophthalmology and the Department of Genetics, Genomics, and Informatics at the University of Tennessee Health Science Center, was awarded an exploratory grant of $499,229 from the Siamak Yousefi National Institutes of Health (NIH) to use artificial intelligence as a tool to detect glaucoma early or in the beginning of its progression. Glaucoma is a group of disorders that damages the optic nerve and can result in vision loss and complete blindness. It is the second-leading cause of irreversible blindness worldwide and more than 3 million Americans are living with the disease. Routine eye exams are necessary for an accurate diagnosis and to prevent eye nerve damage. However, Yousefi believes there is one important factor keeping many from seeking proper treatment. “Half of the people who suffer from glaucoma don’t even know they have the disease because it’s very hard to detect. There are no symptoms and the brain will adapt to some part of the vision loss,” Yousefi said. “This can happen all the way to early, and in some patients, the moderate stages of the disease.” To address this problem, Yousefi has partnered with Tobias Elze, PhD, assistant professor of Ophthalmology at Harvard Medical School to develop a joint artificial intelligence algorithm. The algorithm is a non-invasive procedure that will process retinal images to determine if a patient is at risk for glaucoma or in the early stages of the disease. The project is being funded for two years.

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GrandRounds Cummins Elected to AAMSE Board of Directors Clint Cummins, the CEO and executive vice president of the Memphis Medical Society – a role he has been serving in since 2016 – has been elected to the board of directors of the American Association of Medical Society Executives (AAMSE). Clint Cummins AAMSE, which is dedicated to educating and supporting medical society professionals, made the announcement during its annual conference in Pitts-

burgh in July. Cummins has been an active member of AAMSE for 3 years, previously serving on the County CEO Committee. Founded in 1876, the Memphis Medical Society serves over 9,000 physicians across Tennessee. He has been an active member of AAMSE for 3 years, previously serving on the County CEO Committee.

Jami Lazarov Joins LifeLinc Corporation Memphis-based LifeLinc Corpora-

tion has expanded its leadership roster by naming Jami Lazarov as Associate General Counsel. Lazarov brings about eight years of legal experience in corporate agreeJami Lazarov ments and acquisitions. In her new role, Lazarov will advise and support the General Counsel in clinical services agreements, employment contracting, health law and risk

management, regulatory compliance, and general corporate matters. Prior to joining LifeLinc, Lazarov was a partner at Wyatt, Tarrant & Combs LLP. She completed her undergraduate studies at the University of Texas and attained her Juris Doctor degree from the University of Miami School of Law. LifeLinc Corporation provides preoperative solutions with a focus on clinical outcomes, patient satisfaction and workplace efficiency. The company currently operates in 13 states and maintains its administrative headquarters in Memphis.

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