FOCUS TOPICS CARDIOLOGY • LEGISLATIVE ISSUES
March 2021 >> $5 ON ROUNDS
Skilled Hands of a Cardiac Surgeon and Violinist
Baptist Medical Group’s John Michael Craig, MD, has demanding morning warm-up John Michael Craig, MD, said with a laugh that his interest in medicine began soon after high school at Harding Academy when empirical reasoning told him his 85-mph fastball was not going to be a ticket to the big leagues.
Profile on page 2
THA, TMA, TNA Outline Legislative Priorities By CINDY SANDERS
The 112th Tennessee General Assembly convened in mid-January. As the state and nation continue to navigate COVID-19, legislators are looking at issues and fallout pertaining to the pandemic In addition, hundreds of bills have been filed that intersect with the broad topic of healthcare. While many will never make it out of committee, the major provider and facility organizations – Tennessee Hospital Association, Tennessee Medical Association and Tennessee Nurses Association – will keep watch for those impacting their membership while also pursuing action on their own legislative priorities.
Hospitals are a year into caring for the sickest COVID-19 patients with dedicated but exhausted staff. The Tennessee Hospital Association’s 2021 legislative agenda focuses on bringing relief to hospitals struggling to stay staffed and stay competitive while serving all comers. Joe Burchfield, senior vice president of Government Affairs for THA, outlines three top priorities for the year.
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Memphis Medical Society Forecasts 2021 Legislative Issues
No Sale - Saint Francis Remains Steadfast in Memphis
2021 will be a doozy of a year for healthcare legislation in our state. I wonder why?
Article on page 5
Sally Deitch, CEO Tenet Healthcare, Mid-South Group discusses what’s next.
Regional One Health and West Cancer Center Partner to Provide Cancer Care Midtown. See this and other local news in Grand Rounds beginning on page 6.
By LAWRENCE BUSER
Sally Deitch, RN, has always welcomed a good challenge, and she has recently had a handful. As chief executive officer of Tenet Healthcare Corporation’s Mid-South Group, she was involved throughout 2020 finalizing details of a $350-million sale of Tenet’s Memphis-based St. Francis Hospital and Bartlett-based St. Francis
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Hospital to Methodist Le Bonheur Healthcare. “The sale was announced in November of 2019, but we had to focus on taking care of our patients, and then the pandemic hit,” she recalled. “That changed our focus and attention and impacted everything from government shutdowns to dealing with the surgeons at the hospitals. “We had to change from one direction to (CONTINUED ON PAGE 3)
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Skilled Hands of a Cardiac Surgeon and Violinist
Baptist Medical Group’s John Michael Craig, MD, has demanding morning warm-up By LAWRENCE BUSER
John Michael Craig, MD, said with a laugh that his interest in medicine began soon after high school at Harding Academy when empirical reasoning told him his 85-mph fastball was not going to be a ticket to the big leagues. He liked working with people, he liked challenges, and he liked science, but what he really liked was providing care to another human being. “There were no other careers like medicine that provided that depth of interconnection with people,” recalled Craig, a thoracic and cardiovascular surgeon with Baptist Medical Group since 2012. “I try to impress that upon my students. I’ll ask them ‘What’s
the most important thing we do in medicine, and why are we here?’ You might say it’s to do the best cardiac surgery we can do, to perform our specialty at the highest level. You might say it’s to perform the most skilled surgical operations possible or provide cutting edge medical technology. “Those are good answers, but the number one, most important thing we do in medicine is alleviate the suffering. When you think about things in that context, you see your mission as a physician much more broadly than ‘Hey I’m here to perform the technical aspects of a cardiac surgery.’ There’s a much bigger picture.” Craig majored in biology and chemistry at Southern Adventist University in
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Chattanooga. He then graduated from the University of Tennessee College of Medicine at Memphis, where he also did an internship and residency in general surgery and a fellowship in vascular surgery. “I was planning to go into general surgery, but during my second year of residency when I did my first rotation on a cardiacthoracic service, it just blew me away,” he said. “Cardiac surgery wasn’t even on my radar, but it was so fascinating: the physiology, the cardiovascular system, the laws that govern blood flow, the physics behind it, the surgical techniques and seeing the machinery of the body at work while looking into the chest during cardiac surgery. It was like standing at the edge of the Grand Canyon. It can make you feel very small. “It is a really special moment every time, and I haven’t ever lost that sense of reverence and respect for the human body. There was nothing else I’d seen in any field of medicine that really captivated my sense of awe like cardiac surgery.” Craig was then accepted to a threeyear training fellowship at Harvard’s Massachusetts General Hospital in Boston. He was happy, though, returning to Memphis to be with family and friends. “Going to Mass General was like winning the lottery, and at the beginning of my career in Memphis it helped me get my feet on the ground in a very established, very good field of surgeons,” said Craig, who calls himself a Memphian by choice as well as by birth. “It can be daunting for a younger surgeon to break into that, so (the Harvard training) added a little curiosity on the part of the referring doctors. I also had the support of those surgeons who trained me here, and you know when you train somebody you look at them like they’re your kid. You want to see them go far and do well.” The Baptist heart transplant surgeons perform 15 to 20 heart transplants per year. The life expectancy of patients averages 10 to 15 years, although some of their heart transplant recipients are 30 years out and still doing well. “Now keep in mind, their average life expectancy before they get these transplants is about six months so you can see what a miracle that is,” said Craig, adding that they range from the teens to the 70s in age. “I just saw a guy in my office who is 20 years out from his transplant and in his 70s. He’s been under very close surveillance and his heart’s working beautifully. “It takes a lot more than just a surgeon to perform an operation and have a good outcome. You develop confidence through repetition and history, but it also comes from knowing that you’re surrounded by a robust team of professionals who will go all out for the patient. The COVID-19 virus that can ravage the lungs has created a new demand
for a cardiac-respiratory support treatment called extracorporeal membrane oxygenation or ECMO. It is a treatment of last resort for a select group of critically ill patients who have run out of options. “We basically use the lung component of the heart-lung machine to support or do the work of their lungs,” said Craig. “We normally would have a patient with respiratory failure on ECMO for about two weeks, but with COVID we’ve seen patients survive runs of 10 weeks, which is not something we previously thought was possible. We’ve learned to just persist through the ups and downs because some may survive a really long run. We are still trying to understand the long-term effects of COVID infection on the lungs but many of the ECMO patients have made tremendous recovery.” There is no typical day for Dr. Craig. He’s often putting out fires, large and small, which can be disruptive to a “routine” schedule. He may be part way into his morning, but then find himself making a time-sensitive surgical trip to another hospital in another state. “It is not unusual to embark on the plans and commitments for a given day and then unexpectedly find myself in Texas a few hours later harvesting a heart.” Perhaps the one constant is his unique morning routine to warm up his body and his mind. “For me to feel like I’m on top of my day I get up at 3 o’clock in the morning, then do some fairly intensive exercises since surgery’s a bit of a physical job,” said Craig, who was a triathlete during his residency. “Then I play the violin as a mental exercise. They know from doing PET scans that playing music uses more parts and functions of your brain simultaneously than just about anything else. “There’s the playing, the reading, the music, the right and left hands doing different things. You’re using fine motor skills. You’ve got to warm up your body and your mind in order to perform at your absolute best.” He credits his wife Julie for her support and for the sacrifices when medical emergencies call him away from holiday gatherings or for the three birthdays of their four children – Thomas, 14, Emily, 11, and 7-year-old twins Catie and Andrew. Craig enjoys coaching his sons and their teammates in baseball. Recently they were practicing outside despite some chilly January temperatures. During their workout, their head coach happened to show up unannounced. He made sure the moment was not lost on the boys. “You’re working hard out here in the freezing cold, doing the right thing when you think no one is watching,” Craig told them. “That’s real integrity.” memphismedicalnews
No Sale, continued from page 1 another in December 2020 when the deal fell through, but we still had to focus on what was in front of us and that was taking care of our patients. It created a very challenging environment from an operational standpoint. If it wasn’t hard enough recruiting staff when you’re in the process of a sale, throw in the pandemic on top of that and, well, everybody’s looking for somebody. It created unique challenges for the facility.” The sale – with six MedPost urgent care centers and physician practices affiliated with the two hospitals – fell through after 12 months of challenges from other Memphis healthcare providers. In addition, the Federal Trade Commission moved to block the sale for antitrust concerns. Faced with lengthy litigation, Methodist and Tenet decided to drop the planned sale and go their separate ways. Dallas-based Tenet has 110,000 employees, 65 hospitals and some 500 other healthcare facilities nationwide. Deitch has been with Tenet for 13 years. “After the change of plans, our number one goal was to make sure the community understood that Tenet’s commitment to, not only Memphis but to these other hospitals, would remain steadfast,” she said. “Tenet is not looking for another buyer and we are not going to shut down facilities. “These (St. Francis) hospitals are financially stable, and always have been, so it really is a focus on making sure that our physicians and our community knows the hospitals are viable and will remain here for a very long time.” She said there are several large, longterm programs in development that will underscore that commitment from Tenet, as well as from the medical community. “I can’t talk about them yet because we’re working out some contracts,” she added, “but it will reinvigorate the hospitals.” Deitch also aims to create partnerships in the community, perhaps capitalizing on their somewhat smaller profile in the Memphis medical market. “We are, what some might say, like Switzerland: we will never be the giant provider in town,” she said. “We are the number three provider in town, but we have a lot to offer.” Deitch said short-term goals are all about staffing. “My colleagues in the community are all experiencing the same challenge, and that is a nursing shortage,” she said. “The pandemic gave nurses the ability to go out and take contract jobs and travel and make a lot of money, which really created a challenge to hire nurses who wanted to remain in Memphis. Our number one short-term goal is to build back the employee base and make sure we can deliver on what we say we’re going to do. “It’s always the chicken-or-the-egg question: Can you hire people before you have programs up, or vice versa? We’ll make sure we’re addressing that.” As CEO, she describes her management style as situational. “It really depends on what the needs are,” she said. “I love to grow teams and I love to coach people to the next level of their career and watch them grow, and I memphismedicalnews
have very high expectations on how they perform. “If you need me to micro-manage you, I can, though that’s not my preference. It’s not something I like to do, but I also don’t like to be completely hands-off and leave you to your own devices and let you do things that I don’t think are congruent with where the organization is going.” Deitch, a native of El Paso, Texas, comes from a family of educators and nurses. Her father was a high school football coach for nearly 40 years and won three Texas state championships, including back-to-back titles before his retirement in 2017. She has an undergraduate nursing degree and a master’s degree in nursing administration from the University of Texas-El Paso, and a master’s degree in healthcare administration from Trinity University. “Nursing has just always been in my DNA,” she said. Her first job was as a staff nurse at an El Paso hospital in 1990. “There was never a point where I said ‘Oh, I want to be an administrator.’ I actually was exposed from a department leadership level when I was right out of school. My director was a year from retirement, and I think I’d been in the department three months and one day she said, ‘You’re young. You’re new. You just got out of school. You should know this.’” Deitch was 23. Her preceptors told her to just do whatever the director asked. “By the time I was done with my first year I had done our capital budget, our operating budget, her scheduling, payroll, rewrote her policies and procedures, did performance improvement for the department, and had gone through a regulatory survey,” she recalled. “When she retired the next year, it was a surgeon who went to the CEO and said ‘We want Sally to be the next director (of endoscopy services and the operating room.)” The CEO was skeptical. “The first words out of his mouth were, ‘How old are you?’” said Deitch. “I can remember thinking ‘I don’t think you’re allowed to ask me that.’ But he said ‘I’ll give you a chance. I’ll give you six months.’ I just always wanted to be a bedside nurse, so I worked a half day in clinical and half day on the administrative side. Then I became chief nursing officer at 27, and then chief operating officer when I was 31. Now, I’ve been in a CEO role for 20 years. “The majority of my life has been in some kind of administrative role, yet I feel like a nurse and think like a nurse.” Deitch has worked or run hospitals in El Paso, San Antonio, Oklahoma City, Birmingham, Memphis, and four in South Carolina. She and her husband have five boys, ranging from seventh grade to college. Her main free-time activity, when there is such a time, is playing golf. “I’ve heard Memphis described many times as a big, small town,” Deitch said. “I think there’s a lot of truth to that. It’s also a very gracious big, small town. It’s been very much a pleasure not only being here, but really becoming part of the community.”
There’s an Impending Triple Threat to Your Medical Practice What would happen to your practice if you died, suffered a disability, or needed to retire? Unlike with most businesses, you couldn’t just hand over the reins to a trusted family member. Most states bar non-doctors from owning medical practices. If the worst happened, your family would not have an automatic right to the practice’s assets or future income. The triple threat: 1. Death 2. Disability 3. Departure Chirag Chauhan,
You can eliminate this “triple threat” by working with your financial proAIF®, CFP® fessional to properly structure a buy-sell agreement, funded by permanent life insurance. A traditional buy-sell agreement can become very complex and complicated. Instead, consider a cross purchase buy-sell. In a cross-purchase structure, each practice owner buys life insurance on the other practice owners. For example, owner one would be the policy owner and beneficiary for owner two, and vice versa. At the death or incapacity of an owner, the other would use the insurance proceeds to buy out the business interest. Threat Event
Cross Buy-Sell Feature Planning Objective
Income tax-free death benefit can be used to cover buyout in the event of an owner’s death.
Policy cash values can grow over the life of the policy, tax deferred. With enough time and proper funding, cash values can provide funding to help fund a buyout if an owner becomes disabled. The Long-Term Care Service Rider can be added for an additional cost to provide an accelerated death benefit to fund a buyout if an insured’s health becomes impaired and triggers the long-term care rider.
3. Departure (hypothetical example)
Policy cash value can accumulate tax-deferred and may be available to help fund an installment $100,000 per year for 10 years buyout if an owner decides to retire.
For example, when one of the owners’ pass, the life insurance benefit goes to the deceased owner’s estate for their business interest. The deceased owner’s shares are given to the surviving owners so they each have an equal amount. The benefits of this strategy are: • Fewer policies are needed, compared to a traditional cross purchase buy-sell arrangement. • The policies and cash values are generally not subject to the business’ creditors. • The surviving shareholders will receive full basis credit for the purchase of the stock. This will reduce the capital gains tax when the surviving owners eventually sell the business. • The life insurance proceeds will not trigger Corporate Alternative Minimum Tax, or an AMT, because the policy is not owned by a C Corporation. Considerations to keep in mind: • The owners will need to use their own after-tax funds to pay for the life insurance policies, and premiums are not deductible. • If the owners are different ages or would be rated differently, one may have to pay a disproportionate amount of premiums. • The company cannot record the cash value in the policy as a business asset. • Writing a buy-sell agreement is an essential step to avoid financial disasters. It protects against the risk of a practice owner leaving unexpectedly and allows for a smooth transition of ownership with minimum impact on the practice’s liquidity or value. • There’s a lot to consider when writing a buy-sell agreement. For the best results, choose professionals who have a track record of working with physicians and an in-depth knowledge of their unique succession needs. For more information, contact, financial advisor and managing partner of Bluff City Advisory Group, at firstname.lastname@example.org or 901-365-3447.
THA, TMA, TNA Outline Legislative Priorities, continued from page 1 Nurse Graduate Licensure: THA looks to codify a current executive order that allows nursing graduates who haven’t yet taken the National Council Licensure Examination (NCLEX) to begin practice under the supervision of a licensed registered nurse while they await testing and licensure. Burchfield noted new graduates have a gap of up to three months between finishing their studies and being able to sit for the exam and complete the licensure process. “The nurse graduate executive order helped close a fundamental gap in the workforce pipeline that existed before the pandemic but was exacerbated as staffing needs became a critical issue in 2020,” Burchfield explained. “By enabling immediate practice with proper supervision from experienced nurses, nurse graduJoe Burchfield ates are able to complete the orientation and training process at the hospital and are better prepared for full practice upon licensure. Allowing the licensure and onboarding processes to occur concurrently benefits everyone.” CON: While the pandemic pushed back action on CON reform, or possible repeal, last year, Burchfield said THA expects it to be a priority for lawmakers in 2021. Adding to the overall discussion, the Health Services and Development Agency, which oversees the CON program, is up for sunset in 2021. Although THA understands the desire for CON reform and recognizes support exists among legislators to take action, the association believes parts of the program are essential to keep hospitals in business. The CON program assess community need and growth to avoid oversaturation in a market and ensure orderly development. “Certificate of need requirements help level the playing field between hospitals that are subject to federal regulations, requiring them to treat all individuals regardless of their insurance status or ability to pay, and other non-hospital providers – like imaging centers and ambulatory surgery centers – that are not subject to the same requirements,” said Burchfield. “The unique role of hospitals in the
healthcare system has never been more apparent than in the current pandemic, as hospitals played the central role in response to the surge in the most seriously ill COVID-19 patients,” he continued. “One of the most significant ways hospitals are able to maintain overall operations and preparedness for any emergency is through the critical revenue generated through outpatient procedures. Unregulated growth of non-hospital providers whose business model is to focus on the most lucrative patients and procedures undermines a hospital’s ability to sustain the money-losing but essential services they provide to the community.” Hospital Assessment: The annual hospital assessment is once again part of THA’s legislative agenda for 2021. The voluntary assessment, which began in 2010, generates $602 million in state dollars and totals $1.7 billion for the TennCare program when adding the federal match. “The impetus for the hospital assessment in 2010 was the Great Recession and a series of cuts proposed to the TennCare program in order to balance an austere budget. The items funded since that time have avoided a number of benefit limits for TennCare enrollees and a hefty provider rate reduction,” Burchfield said. He noted 49 states and the District of Columbia have some type of assessment program in place, so Tennessee is not unique in this funding mechanism. Burchfield added the new TennCare III waiver has no impact on the assessment, which will continue to fund the same items in the budget and in the same manner. Not every hospital is required to pay the assessment, though. Exclusions exist for public hospitals, critical access hospitals, state-owned mental health hospitals, St Jude Children’s Research Hospital and rehabilitation hospitals.
While at the ready to weigh in on any number of bills impacting physicians, the Tennessee Medical Association is heavily focused on three key issues in 2021 – graduate medical education funding, balance billing and scope of practice. Julie Griffin, vice president of Legislative Affairs for TMA, shared insights on the organization’s stance on each of these top
G. Coble Caperton
priorities. Graduate Medical Education Funding: Last summer, the Centers for Medicare and Medicaid Services ruled Tennessee must scrap its longstanding formula to fund graduate medical education slots through TennCare and develop a new plan. Griffin said a key concern is the ruling puts millions of dollars Julie Griffin and all of the state’s residency program at risk, including additional GME funding TMA worked to get added to Governor Lee’s 2019 budget. She said limited funding and slots are already an issue in Tennessee. Despite putting money towards attracting and educating medical students with outstanding programs available statewide, far too many leave to finish their training. “Over 60 percent of residents end up staying in the state where they actually do their residency,” said Griffin. “We are now an exporter of students.” She said increasing funding and training options in Tennessee should mean many of those young physicians opt to build a life and a practice in the state. “The economic benefit of having a physician in a community is broader than just the care delivery,” she noted, adding that benefit is even greater in rural areas. TMA’s priority will be to have a seat at the table in determining the new formula for resident funding and to preserve the additional slots gained in 2019. Griffin said her understanding from discussions with TennCare officials is that CMS wants a more streamlined process to ensure the state monies and the federal match flow directly to the creation of residency slots. “We are very concerned about what we’re going to do to ensure those dollars are secure,” she noted. However, Griffin added, Oklahoma went through a similar process a few years ago and ultimately did wind up receiving their full GME match after reworking their funding formula. Balance Billing: Everyone agrees patients shouldn’t be surprised with thousands of dollars in unexpected healthcare costs. TMA is leading a coalition of hospital-based physician specialty organizations to address narrow networks from
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health insurers that they believe is at the root of the problem. A federal bill passed last year, and there is currently a similar measure gaining momentum at the state level. Griffin said the reason to have a state law on top of the federal act is to ensure there is no gap in patients who are covered under the law. Although there are differing views, Griffin said the concern is the federal language is specific to self-funded ERISA plans and doesn’t apply to commercial markets. Additionally, the state plan puts a mechanism in place for the uninsured to start in the negotiation process for pricing. State-wide listening sessions are being hosted with SB001/HB002 sponsors, Sen. Bo Watson and Rep. Robin Smith. Based on a successful model used in Georgia, their bill would only require patients to pay according to their in-network responsibility if they receive a surprise medical bill and would allow out-of-network physicians to pursue fair payment from health insurance companies through an independent arbitration process if the initial payment was unsatisfactory. “We want to take the patient out of the middle and make the decision between provider, payer and arbitrator,” said Griffin. Scope of Practice: An ongoing contentious issue, a three-year moratorium on any scope-of-practice legislation redefining supervisory parameters for advanced practice nurses expired in 2019. The pandemic allowed the issue to simmer for another year, but in 2021, both advanced practice nurses and physician assistants look to make a push for independent practice. TMA has steadfastly promoted physician-led, team-based healthcare delivery as the best model for patient safety and quality of care. “There are things with the current system that absolutely do need to change,” Griffin said of some areas of common ground. “We are always willing to sit down and find ways to reduce barriers to an advance practice nurse or PA who is trying to extend care to patients,” she continued. “However, we do not think the best care for patients is to sever a required relationship with a provider who absolutely has more education and training than the extender seeing the patient.”
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THA, TMA, TNA, continued from page 4 TNA
“Our 2021 legislative agenda reflects TNA’s mission is to protect and promote the professional nurse” said Kathleen Murphy, director of Government Affairs for the Tennessee Nurses Association. The statewide organization continues to focus on legislation addressing scope of practice issues in a Kathleen Murphy quest for more independence for advanced practice registered nurses (APRNs). Other agenda items for 2021 include increased funding for school nurses and enhanced attention to workplace safety. Scope of Practice: “We are supporting SB176/HB184 which will allow advanced practice registered nurses to continue prescribing and caring for their patients without the economic burden of a contract agreement,” said Murphy. “Along that similar line, we are also supporting APRN’s ability to prescribe home health orders in SB478/HB743.” She said the two pieces of legislation go toward addressing access issues for Tennesseans. “These bills allow patients to choose who their provider is and do not force patients to establish new relationships with a provider they have never seen before to meet an administrative requirement,” she stated. Murphy added, “Nurses have always been prepared to step up when needed. As we have seen this year more than ever, nurses answer no matter what the call is.” She noted nurses have worked tirelessly, often at the risk of their own health and wellbeing, during the pandemic. “We look forward to working with the legislature to cut the red tape holding APRNs back and promoting a legislative agenda that provides access to high quality care to all Tennesseans no matter where they live.” School Nurses: The pandemic highlighted a range of unmet needs, including adequate access statewide to school nurses. Murphy said TNA is working with sponsors to increase funding and improve the student-to-nurse ratio. “We know that the health of a student impacts their learning ability. Now more than ever, we need to ensure our students are physically and mentally healthy and able to learn no matter the setting.” Workplace Safety: Murphy noted concerns over safety in the workplace is an issue that needs to be revisited. “People who assault a healthcare provider when they are preforming their duties are no longer charged with increased fines,” she explained. “We believe that increase was a deterrent that is essential to helping keep our workplaces safe. We will be working with sponsors to put healthcare workers back into the Tennessee code that was unfortunately removed in the 2020 August special session.”
Memphis Medical Society Forecasts 2021 Legislative Issues 2021 will be a doozy of a year for healthcare legislation in our state. I wonder why? Writing this is a challenge, as we know that these priorities can change and shift at a moment’s notice based on politics, hidden agendas, covert tactics, and the ever-present pandemic. So, as of about midMarch, here are By Clint Cummins the priorities for our organizations this year. Scope of Practice This issue is expected to rear its head once again this year, as it has every year since 2014. What is the beef? TMA, Memphis Medical Society and many other physician groups feel that a physicianled team is still the best environment for patient care in our state because it does not compromise patient safety or quality of care. Furthermore, silos and fragmentation are one of the greatest issues in healthcare today, creating unnecessary waste and fostering poor communication in healthcare systems. Nurse advocacy groups feel that APRN scope should be expanded to allow for no physician oversight, allegedly allowing those providers to open practices in rural areas. The current laws require physician oversight of any medical clinic opened in our state. Physician groups counter that there is no evidence that expanding scope will prompt any healthcare discipline to move to a rural area and patient safety could be compromised, particularly in more complex cases. Balance Billing Balance billing, or surprise medical billing, has been an ongoing issue for years. Each one of us has probably received a “surprise” bill from an ED visit, ambulance ride, anesthesia administration, and other sources. Hopefully, we are turning a corner. Around that corner should be a new healthcare environment that protects our patients and fairly reimburses providers. As you likely saw at the end of year, the federal government passed the No Surprises Act as part of the year-end omnibus legislation package. So, why do we need further legislation at the state level? The federal legislation only covered those enrolled in plans covered by ERISA (federal law that establishes minimum standards for federally administered health plans). We need a more comprehensive solution for Tennessee that covers non-ERISA (private) health plans. TMA leads a coalition of hospitalbased physician specialty organizations in protecting patients from narrow networks
created by health insurance companies. State-wide listening sessions are being hosted with SB 001/HB 002 sponsors, Sen. Bo Watson and Rep. Robin Smith, as they offer a physician-friendly balance billing solution. Their bill would only require patients to pay according to their in-network responsibility if they receive a surprise medical bill and would allow out-of-network physicians to pursue fair payment from health insurance companies through an independent arbitration process if the initial payment was unsatisfactory. Graduate Medical Education (GME) Graduate medical education is a term used to reference residency training for medical school graduates in our state. That training was funded through a formula that provided a 2:1 funding match to state dollars by The Centers for Medicare and Medicaid Services (CMS) From 19972019, that funding was not increased one dollar. That means no new doctors trained in our state via government funding. Hospitals carry the burden of funding any additional training spots. As you may recall, the fight for increased GME funding in Tennessee started right here in Memphis in 2019 with MMS’s Legislative Committee and a
passionate group of medical students that soon enveloped the entire state. TMA took the reins and partnered with other groups to increase the number of residency training slots in the state. Unfortunately, that amazing work showed a light on another unbeknownst issue. CMS ruled last summer that Tennessee must scratch its longstanding formula to fund graduate medical education slots through TennCare. It places millions of dollars and all of Tennessee’s residency programs at risk. You have to love federal red tape! This initiative is vitally important to maintaining and growing the physician talent pipeline in our state that will ultimately lead to better care of our citizens. There will be plenty of other things to watch that will impact healthcare, including laws addressing health department authority, COVID-19 rules and regulations for businesses, licensure for nursing and medical assistants, and many more. Stay tuned to communication from all of our organizations throughout the session. We will need you! Clint Cummins is the CEO of the Memphis Medical Society.
MID-SOUTH MEDICAL GROUP MAAGEMET ASSOCIATIO
MID-SOUTH MEDICAL GROUP MANAGEMENT A S S O C I AT I O N
WHO WE ARE The Mid-South Medical Group Management Association (MSMGMA) formed in 1987 when a group of practice managers across Memphis started meeting to discuss common experiences in their offices. The group has now grown to include more than 100 members from the Memphis area. MSMGMA is the premier association for professionals who lead Medical Practices. Through regular in-person and/or virtual educational meetings, networking events, and access to statewide webinars and conferences, our group serves as a powerful resource for Practice Executives.
WH MID SOUTH MGMA ? Healthcare is one of the most complex industries in the country. MSMGMA offers resources to every type of practice manager, whether you are in a private office or a hospital system. MSMGMA offers opportunities to learn from other practice executives and mentor those newly in their roles. We provide education opportunities, bringing in speakers from across our region to discuss applicable topics to your practices.
MID-SOUTH MEDICAL GROUP M Join A Ntoday A G for EM N Tmember/renewal ASSOCIA TION ourEnew discount through January 31, 2021.
BENEFITS OF MEMBERSHIP
Mid-South MGMA I 1067 Cresthaven Rd, Memphis, TN 38119 Education & Information Resources email@example.com Monthly meetings and annual spring and fall conferences Bi-monthly newsletter
Networking Membership Database & Members Only section on our website Monthly networking luncheons with educational speakers included
Easy access to industry news, job postings, and scholarship information Active guidance toward certification and fellowship in the American College of Medical Practice Executives
State and national information about legislative issues that impact your practice
MEMBERSHIP LEELS & DUES ACTIVE: $350
Includes state-wide Tennessee Medical Group Management Association membership and local MSMGMA membership. Active Members are engaged in membership or leadership of a medical group practice formally organized for the purpose of healthcare delivery or individuals that provide administrative or related support services to one or more medical group practices, such as management companies, consultants, billing, etc.
An affiliate Member is a vendor/supplier which supplies products or services to medical groups and will be entitled to a limited membership with no voting privileges, but will be permitted to attend meetings and participate in other activities of the MSMGMA. It is the hope of the MSMGMA that the MSMGMA and the affiliate member will each benefit mutually in the exchange of information, ideas and economic support. The MSMGMA does not in any way endorse the products, supplies or services of an affiliated member.
A student Member is a person who is currently enrolled full time through an accredited postsecondary college or university in a baccalaureate or masters level program that enhances or corresponds to the profession of medical practice MARCH management. Student 2021 members will be entitled to a limited membership with no voting privileges and cannot hold office but will be permitted to attend meetings and participate in other activities of the MSMGMA.
GrandRounds Regional One Health and West Cancer Center Partner to Provide Cancer Care at Midtown Location Regional One Health and West Cancer Center and Research Institute have partnered to bring exciting changes to the Midtown cancer center. Effective March 1, 2021, the West Cancer Center Midtown location has transitioned to a hospital outpatient department of Regional One Health. The new Regional One Health Cancer Center, located at 1588 Union Avenue, will continue to provide the exceptional level of care the patients and community have experienced at this location under West Cancer Center. Patients at this location will continue to see the same providers through an agreement between Regional One Health and West Cancer Center. “The launch of the Regional One Health Cancer Center marks the culmination of several months of work to ensure continued access to high quality oncology services in the midtown area,” said Reginald Coopwood, MD, president and CEO of Regional One Health. “Like Regional One Health, West Cancer Center has a long tradition of providing compassionate care and exceptional services to patients. Their expertise is invaluable to us, and we are proud to partner with them to provide care to individuals in this community faced with cancer.” West Cancer Center’s CEO, Mitch Graves stated, ”West is proud to join Regional One Health in expanding cancer care in the core of our community. It is nice to enter into a relationship where both entities strive to exceed in clinical excellence, patient centric care and access.” “Regional One Health has grown our specialty care footprint in the community over the past several years, and the addition of oncology services is another indicator of this growth,” said Dr. Coopwood. Services at this site include the diagnosis of cancer and benign blood diseases in addition to treatments including medical oncology, surgical oncology and gynecological oncology. To learn more about the Regional One Health Cancer Center and the services offered, visit www.regionalonehealth. org/cancer-center.
Le Bonheur Children’s Hospital Names New COO Le Bonheur Children’s Hospital is pleased to announce that Brandon Edgerson, MS, PharmD, has been named chief operating officer. Edgerson previously served as vice president of Operations. Edgerson played a critical role when Le BonBrandon heur and the world were Edgerson impacted by COVID-19. He has provided exemplary leadership
to Le Bonheur’s COVID testing capabilities, reactivation planning and vaccination program. Edgerson has been a part of the Le Bonheur family since 2006 when he began serving as director of Pharmacy. In his previous role as vice president of Professional Services, Edgerson oversaw operations in the Pharmacy, Lab, Radiology, Rehabilitation Services, Nutrition, Spiritual Care, Child Life, Social Work, Volunteer Services and Respiratory Care. He was named vice president of Operations in 2020 and added responsibility for facilities and hospitality services. In addition to his work at Le Bonheur, Edgerson has held the offices of President and Secretary/Treasurer for TSHP and been involved in various professional organizations such as TPA, Children’s Hospital Association, American Society of Health-System Pharmacists, and the UTHSC Pharmacy Alumni Board. Edgerson earned his PharmD from Xavier University of Louisiana in New Orleans, completed his residency training at The Ohio State University Medical Center and earned his master’s from The Ohio State University.
Memphis Medical District Collaborative Honors Tommy Pacello, Announces New COO The Memphis Medical District Collaborative (MMDC) recently announced the hire of Abigail (Abby) Sheridan as the organization’s Chief Operating Officer. Sheridan brings 15 years of operations and finance experience working with local and national nonprofits to the MMDC Abby Sheridan team. Most recently, Abby served as Deputy Director for the Congress for the New Urbanism, where she was responsible for implementing the strategy and managing the operations of a national nonprofit dedicated to championing the development of walkable, mixed-use urbanism. At MMDC, Sheridan will lead the operations of the organization as it embarks upon a new strategic plan. Sheridan will oversee financial management of the organization, and provide leadership and execution capacity for special projects, strategic planning, grant applications, and board relations. Abby brings a passion for peoplecentered communities to Memphis and looks forward to working with the MMDC staff, partners, and community to build a more vibrant and prosperous Medical District. The MMDC recently announced the passing of Tommy Pacello, who was President and Founder of the organization. “Tommy was a larger-than-life figure who brought his remarkable pas-
sion and vision to help us all imagine a more vibrant and inclusive Memphis and Medical District. His leadership and friendship will be celebrated by all of us who knew him,” Abby Miller, Executive Vice President, MMDC. Dr. Lewis Reich, Chairman of the Board of Directors, issued the following statement on behalf of the Board of Directors: “Tommy Pacello accomplished volumes in his short life and Memphis has lost a true champion. We were so very fortunate to have been able to get to know and work with him on the Memphis Medical District Collaborative. His intelligence, dedication, and integrity were values ingrained in Tommy’s character. The MMDC was Tommy Pacello’s professional vision, one that he spent the final years of his life building and tirelessly nurturing. However, his smile turned incandescent when he talked about his wife and two young daughters. Tommy will be deeply missed.” Alex Feldman has been named Interim President.
Life and legacy of Joseph Simone, MD Joseph V. Simone, MD, a clinician who helped lead the first curative treatment for childhood leukemia, died Thursday, January 21, 2021, at the age of 85. In addition to his work on the legendary Total 5 clinical trial, Simone served as the third director of St. Jude Joseph V. Simone Children’s Research Hospital from 1983–92. Under his leadership, the hospital instituted an HIV/ AIDS clinical program, dramatically elevated its research, and created one of the world’s largest long-term follow-up clinics for childhood cancer survivors. A native of Chicago, Simone joined St. Jude in 1967, during an era when childhood cancer was a veritable death sentence. The hospital’s first director, Donald P. Pinkel, MD, recruited Simone by saying, “You must have a Moby Dick to chase.” Within a couple of years, Pinkel put Simone in charge of the hospital’s leukemia program. Simone eventually served as associate director for clinical research before becoming the hospital’s director. Along with Pinkel, Simone helped develop and lead the Total 5 protocol for acute lymphoblastic leukemia (ALL). That clinical trial raised the ALL survival rate from 4 percent to 50 percent and set the stage for decades of progress in curing childhood catastrophic diseases. In 1982, Simone met with Chuck Sherr, MD, PhD, aiming to lure the young scientist away from his post at the National Cancer Institute. Sherr and his wife and scientific colleague, Martine Roussel, PhD, ultimately agreed to the move. “Joe lent us his unflagging support for the next 10 years and gave me a voice in institutional development,”
said Sherr, who founded the Department of Tumor Cell Biology. “He was the ideal boss, a patient listener, deliberative, honest, wise, funny, always available, outspokenly friendly, and, as a proven clinical researcher with significant past accomplishments, equally committed to improving basic science.” Nobel laureate Peter Doherty, PhD, also credits Simone for his recruitment to Memphis. Simone brought scientific attention to St. Jude by entering the Pediatric Oncology Group in 1981 and later paved the way for St. Jude to be a charter member of the National Comprehensive Cancer Network. It was also (continued on page 8)
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GrandRounds Dr. Patrick Curlee, Sr. Joins OrthoSouth Named one of the fastest growing private businesses in the Memphis area, OrthoSouth is proud to count Dr. Patrick Curlee as the newest member of its stellar multidisciplinary spine center team. Dr. Curlee is a board certified orthopaedic surgeon, fellowship trained in congenital, traumatic, and degenerative spinal disorders. He believes in a multidisciplinary approach to the surgical and nonsurgical treatment of spinal disorders, which includes physical therapy, physiatry, and the most advanced surgical techniques, such as minimally invasive spinal surgery. Dr. Curlee’s philosophy is a natural fit with the OrthoSouth spine center model of a patient-centric, multidisciplinary, collaborative practice. He will see patients at OrthoSouth’s new clinic at 2100 Exeter Road in Germantown.
Cathy Sanchez Named Director of Financial Aid at UTHSC Cathy Sanchez, MSc, has been named the director of Financial Aid in Enrollment Management for the University of Tennessee Health Science Center. Sanchez will provide leadership in the Office of Financial Aid by developing and implementing financial aid programs for students, Cathy Sanchez maintaining the strategic vision for Enrollment Management, and executing the procurement of aid funds from federal, state, and private sources. She will also collaborate with the colleges to identify opportunities for new scholarship programs for to reduce student debt. Sanchez has served in multiple roles in higher education over the past 20 years that include financial aid counselor, assistant director, and director of financial aid. In her roles as assistant director and director, Sanchez has maintained above a 95 percent student satisfaction rate by designing staff training courses, initiating communication functions for easier student access and developing financial literacy presentations for students. Before joining UTHSC, Sanchez was the assistant director of Financial Aid at the University of North Texas Health Science Center. She also held positions at George Fox University, Point Loma Nazarene College and the Citibank Student Loan Corporation. Sanchez has a bachelor’s degree in Business and Economics from George Fox College. She holds a master’s degree in Learning Technologies from the University of North Texas.
Dustin Fulton, EdD, Named Assistant Dean for Admissions in College of Medicine Dustin Fulton, EdD, has been named assistant dean for Admissions in the College of Medicine at the University of Tennessee Health Science Center. Fulton has served as interim assistant dean since May 2020. Fulton most recently served as associate director in Student Affairs and Community Dustin Fulton Engagement, and previously held the position of senior equity assurance administrator in the Office of Equity and Diversity. He has been with UTHSC since 2014. In his new role, Fulton will report to Catherine Womack, MD, associate dean for Student Affairs and Admissions. Fulton will oversee and direct all operations and programs related to the admittance of medical students to the College of Medicine, including managing the operations of the college’s Office of Admissions. He will develop and implement recruitment strategies that link the College of Medicine mission to the admission of a diverse group of students and assist in evaluating the outcomes of the admissions process. His role will also include overseeing the college’s New Student Orientation, White Coat Ceremony, and other special programs. Fulton has a bachelor’s degree in Business Administration from the University of Tennessee, Knoxville. He earned a master’s degree in Leadership and Policy Studies with a concentration
in Student Personnel and a doctorate in Higher Education Administration, both from the University of Memphis.
College of Medicine Inducts Inaugural Class of Academy of Master Educators The University of Tennessee Health Science Center’s College of Medicine has inducted its inaugural class to the Academy of Master Educators. The academy recognizes and celebrates contributions to education by dedicated physicians and other medical educators. The academy, which was formed in 2019, is being led by Mukta Panda, MD, MACP, FRCP, assistant dean for Medical Student Education and WellBeing in the UTHSC College of Medicine in Chattanooga, and Michael Whitt, PhD, associate dean for Medical Education and chair of the Department of Medical Education in the College of Medicine. Faculty members Mukta Panda and educators in the College of Medicine are nominated by their peers for the program which seeks to recognize and promote distinction in all pre-clinical and clinical educational Michael Whitt domains by “fostering excellence in patient-centered care and a commitment to developing future leaders through the tenets of the Hippocratic oath, the art of medicine, empathy, education, scientific rigor, professionalism, mentorship, and col-
laborative teamwork.” This year’s class inducts seven new members: Bindiya Bagga, MD, associate professor in the Department of Pediatrics, Division of Pediatric Infectious Diseases; Mark Bugnitz, MD, professor in the Department of Pediatrics, Division of Pediatric Critical Care; Bruce Keisling, PhD, associate professor in the Department of Pediatrics and executive director of the Boling Center for Developmental Disabilities; Patrick Koo, MD, associate professor and director of Internal Medicine Clerkship at in the College of Medicine in Chattanooga; Kris Maday, PA-C, associate professor and director of the UTHSC Physician Assistant Program; Jigme Sethi, MD, division chief for Pulmonary/Critical Care and affiliated professor in the College of Medicine in Chattanooga; and Ajay Talati, MD, professor and division chief of the Department of Pediatrics, Division of Pediatric Neonatology. To become a member of the academy, faculty must be nominated by their peers, a student, or a resident. Self-nominations also are accepted. Once nominated, the individual will formally apply and submit an educational portfolio, which will then be reviewed by the Academy Membership Committee, including members from UTHSC and external reviewers. Once inducted, the membership is a three-year term and provides a onetime $1,000 award to be used for educational advancement of the member. At the end of each term, each member may be offered renewal, based on continued excellence in education and contributions to the academy.
Campbell Clinic First and Only in Memphis to Perform New, 3D Printing Technique for Scoliosis Campbell Clinic’s Dr. Jeffrey Sawyer is the first and only pediatric Orthopaedic surgeon in the mid-south region offering 3-D printing to treat scoliosis, the most common deformity in children with about 4 million cases in the United States. 3-D printing allows doctors to determine the precise location of where along the patient’s spine to insert the screw that is needed to help straighten the spine. This technique has proven successful, since it allows doctors to be more accurate when treating scoliosis by providing them with a preview of what their patients’ spines look like so that they can accurately prepare for the correction instead of seeing it for the first time in surgery. Sawyer’s use of the pediatric 3-D printing technique allows young patients’ spines to be straightened before it is too late in their growth for adjustments to be made. Studies have shown that adults with scoliosis are more likely to require long-term care. Therefore, making these adjustments along childrens’ spines while they are still growing can prevent many adults from future scoliosisrelated disabilities. This technique is new to the Mid-South and in the last year, and has only been used via Sawyer. Sawyer has practiced at Campbell Clinic for twenty one years. He is a member of the Scoliosis Research Society and has held numerous leadership positions in the Pediatric Orthopaedic Society of North America (POSNA), where he is set to become the president in 2023. Visit https://www.campbellclinic.com/physician/jeffreysawyer/
GrandRounds during his tenure that the hospital considered and, ultimately, rejected an offer to relocate to Washington University in St. Louis. “Although our Board of Governors ultimately resisted the move, I believe their extensive deliberations convinced them that our organization was transitioning from a triple-A team to the major leagues,” Sherr said. “Joe’s deft handling of many extant complexities and unwavering commitment to St. Jude fostered the subsequent recruitment of many additional chairpersons and triggered the advent of new construction on our campus that has continued to this day. Like so many others, I adored him—he was a remarkable man.” After leaving St. Jude, Simone played leadership roles at cancer centers around the country, including Memorial Sloan-Kettering Cancer Center in New York and the Huntsman Cancer Institute at the University of Utah. He also founded Simone Consulting, which provided a range of services in cancer care and cancer research. A brilliant researcher and clinician, Simone was beloved for his gregarious nature and his joviality. In honor of his many achievements, the hospital created in 2014 the Joseph Simone Endowed Chair in Basic Research. “Joe was a remarkable, unforgettable person. Despite being a giant in the field and a leading academic voice, he was down-to-earth, approachable, and exceptionally kind. Joe had a special talent of getting to know everyone, and he used this to bring out the best in each person as well as to bring people together,” Pui said. “I will miss him dearly but take comfort in knowing that his legacy lives on in our hearts and in the work of St. Jude.” Simone is survived by his wife, Pat, and his daughters, Pattie, Julie and Margaret.
Family Nurse Practitioner Kristin Wilson Joins Mays & Schnapp Neurospine and Pain Mays & Schnapp Neurospine and Pain announces Kristin Wilson, FNPBC, has joined its team. She brings years of experience of working with chronic pain patients to Mays & Schnapp, where the medical team strives to relieve patients’ pain, restore their function, Kristin Wilson and return patients to living their lives. Wilson earned a Bachelor of Science in nursing from Baptist College of Health Science and continued her education to receive a Master of Science in nursing from the University of Tennessee Health Science Center. She is a member of the American Association of Nurse Practitioners and the Society for Pain Management Nursing.
Wilson sees patients at Mays & Schnapp’s East Memphis location.
West Cancer Center & Research Institute Welcomes Three Physician Partners West Cancer Center & Research Institute is governed by a physician partnership to ensure care for cancer patients is clinically superior with the latest technology and research. Matthew Ballo, MD, FACR, Richard Fine, MD, FACS and Eric Wiedower, DO, current physicians at West, joined this partnership February 2021, adding expertise in Radiation Oncology, Breast Surgery and Medical Oncology. West is home to 100 Matthew Ballo oncology specialists with 21 partners to ensure all decisions at the cancer center improve treatments options and quality of life measures for all patients. Dr. Fine joined Richard Fine Margaret West Comprehensive Breast Center, the Breast Center at West, in 2012 from Atlanta, where he was Director of Advanced Breast Care. With a residency and fellowship from Rush Eric Wiedower Presbyterian-St. Luke’s Medical Center, he quickly earned an impressive reputation in Breast Surgery and was one of the first in the U.S. to perform image guided breast biopsies. Fine is also past president and chairman of the board for the prestigious American Society of Breast Surgeons (ASBS) and continues to hold leadership positions. UTHSC/West fellowship trained, Eric Wiedower, DO, joined the Medical Oncology faculty in 2016. Recognized for exemplary performance and leadership, Wiedower served as Chief Resident at the University of Kansas and Chief Fellow at UTHSC/West. His practice is focused on the North Mississippi community at the Desoto Campus, where he has a stellar reputation with both patients and their families. Director of Radiation Oncology, Matthew Ballo, MD, FACR, is recognized internationally as a pioneer in Radiation Oncology. He trained at MD Anderson and Mt. Sinai Medical Center. He joined West Cancer Center in 2014, after 17 years of practice at MD Anderson Cancer Center in Houston, TX. Ballo was the first to use Tumor Treating Fields for Mesothelioma in the US, is highly published and respected by fellow providers, West leadership and patients.
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