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May 2019 >> $5

Love Can Blossom Anywhere, Even in A Maternity Ward It was a dramatic moment – a medical emergency – at the hospital’s ER when a woman arrived in labor with a prolapsed umbilical cord, but two physicians on the scene saved the day . . . and then fell in love.

True-life fairly tale on page 3.

Outgoing President Of ACOG Offers An Objective Look Back After a year of serving as leader of the American College of Obstetricians and Gynecologists, Dr. Lisa M. Hollier reflects on the state of women’s health.

Interview on page 6.

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Nursing Profession’s Evolving Role Leaders Discuss the Issues, Challenges and Demands By BETH SIMKANIN

The role of a nurse has expanded and evolved. Today, nurses must undergo more intense, formal education than in years past and, in addition, are expected to take on more patient responsibility. At the same time, nurses are more specialized than ever – having more advancement opportunities in the medical field due to the number of specialties that have emerged to meet the growing demand for healthcare. “I’ve always heard that a nurse is a nurse,” said Wendy M. Likes, PhD, dean of the College of Nursing at University of Tennessee Health Science Center (UTHSC). She was one of four advanced practice registered nurses from the Memphis area who participated in a roundtable discussion concerning (CONTINUED ON PAGE 10)



Nurses’ Roundtable participants, from left, are Blanche F. Petty, Wendy M. Likes, Carla Kirkland and Cathy Stepter.

Light at the End of the Tunnel? Opioid Pilot Program Tackles Problem of Addiction, Overdoses By LAWRENCE BUSER

After all their long nights, stressful days and hard work, when healthcare students finally earn their degree, in most cases they also get a heavy financial load along with the diploma. The search is on for ways to lighten that load.

The numbers are staggering. On average, 115 people die every day nationwide from overdoses of opioids. In Shelby County, 159 people died from opioids in 2017, up from just 51 in 2011, according to the Shelby County Health Department. By next year, the total locally could exceed 250 such deaths annually. More people are dying from opioid overdoses than from car accidents. Last year, 854 patients showed up at Memphis-area hospitals presenting signs of opioid overdoses. Last year, in conjunction with the Tennessee Hospital Association (THA), Regional One Health (ROH) and other hospitals across the state began a pilot program called Opioid Light to cut back on the number of opioid prescriptions being issued from

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MAY 2019




A Match Made in the Maternity Ward MOGA Evolved After These Two Doctors Handled an Emergency


Doctors play a significant role in the lives of their patients with every visit, every surgical procedure, every diagnosis and every treatment plan. Doctor and patient hope for a positive outcome, and when that is achieved it’s moving on with life; moving on to another patient’s care. But more often than anyone likely realizes, patients can play a significant, lasting role in the lives of the doctors who care for them – or who unwittingly play matchmaker in a time of crisis and high drama.  “It was 1991 and I was a brand-new intern for overnight calls in the OB service at The Med, and during the night a patient arrived by ambulance in what was one of those true medical emergencies, like one you might see on a TV show,” Dr. Aric Giddens recalled. “The patient was in labor and there was an umbilical cord prolapse, and this third-year resident looked at me and said ‘Go scrub.’ I told her OK, though I’d never done a C-section. It was a very dramatic moment.    “We verified that the baby was alive, and then this resident did an incredibly fast C-section. I was very impressed because everyone else was running around and yet she was very calm and collected. I thought, ‘That’s how you do it. That’s the kind of doctor I want to be.’ Anyway, we

A Happy Reunion Seven years after obstetrics residents Andrea and Aric Giddens met, fell in love and got married after teaming up for an emergency C-section in 1991, that same patient walked into MOGA for OB care, only this time not in such distress. The patient relayed the story of her emergency C-section delivery of her first baby at The Med and indicated she wanted to have a natural delivery with no drama. So Dr. Andrea got the patient’s medical records, stared hard at them and then handed them to Dr. Aric and said, “Look at this.” It was the same patient. “The lady had no idea who delivered her first baby because the residents’ names were not recorded on the birth certificates; only the staff doctor’s was,” said Dr. Aric. “So we told the patient, ‘Hey, we’ve got a good story for you.’ She was really amazed, she delivered again and she’s been our patient ever since. In 2016 we even got to see her son we had delivered 25 years earlier.”



Dr. Aric Giddens

started talking, we started dating and we got married.” And that’s how Dr. Aric Gus Giddens and Dr. Mary Andrea Giddens became life partners and partners at Memphis Obstetrics & Gynecological Association (MOGA). Thanks to a very pregnant woman in distress. (They also now have three children of their own.) “I’m from Cochran, Georgia, and I was always interested in science,” he said. “My parents ran a small business, and I knew I didn’t want to do that because it was too much work. I was always a good student, and I thought maybe I’ll just be a doctor because no one in our family had done that. It was just totally blind, really. I didn’t have any close friends who were doctors, and I barely knew any doctors. “I knew I wanted to do something professional and be successful. My parents always said, ‘You can do this. Whatever you want to do, just do your best and be successful.’ Emory was very hard and I was from a small public high school, but I was very determined and I was not going to bail out. I decided if I chose to do something else, it would be my choice and not someone else’s.” He got through Emory undergrad as a biology major, got through Emory medical school and during clinical rotation thought about going into hematology or perhaps something with a surgical aspect. “So I did an OB rotation and really enjoyed that,” Dr. Giddens recalled. “You had the positivity of participating in the pregnancy and delivery, which is almost always a good thing, and then from the surgical side you got to fix things. Our patients are generally pretty healthy and on the younger side, versus internal medicine or surgery, and that really appealed to me.

“So I wound up in Memphis at UTHSC due to the (residency) match and met my wife and that’s where we are now.” MOGA has four offices, with locations on Humphreys Boulevard in East Memphis, Stage Road in Bartlett, Poplar Avenue in Germantown and on Airways in Southaven in DeSoto County, Mississippi. Dr. Giddens has been with MOGA 24 years, and things seem to have gotten more challenging over time. “It’s not just the practice of medicine now, it’s more the understanding of the business aspect of it for which you get zero training in medical school and residency,” he said. “It’s kind of learn-onthe-job things. What’s become more and more important is the payment model’s shift toward value-based care and pay-forperformance versus pay-for-service type of contracts with insurance companies and government payers. That’s made it a lot more difficult.” But some areas of technology that have been the bane of doctors’ offices nationwide – such as electronic medical records, standardized medical care and virtual medical records – may be turning

the corner and showing actual benefits for doctors and patients alike. “I’m also president of the medical staff at Baptist Memorial Hospital for Women, and they’ve done a great job using this technology and letting their medical staff know that we can do this and make it really easy to do the right thing,” Dr. Giddens said. “We have a standardized way of caring for certain things and giving alerts for certain high-risk conditions based on certain parameters. That’s been a long time coming. “Also, we’re the only group in the areas that’s gotten an award from Cigna four years in a row for meeting their quality and cost metrics at providing value care.”   He notes that patients today require a higher degree of acuity because patients present more issues such as diabetes, hypertension, obesity and challenges associated with delaying the child-bearing years. There also is a push in the practice to reduce the number of C-sections. Another change is in the gender population of the OB-GYN doctors themselves.


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Light at the End of the Tunnel? continued from page 1 emergency rooms, often the front line of medical care in this overdose society. “You do a physical exam – usually unconscious with pinpoint pupils is one sign – plus we get some background from the family, from the EMTs or whoever brought them in, and from police,” says Dr. Chantay Smartt, an emergency medicine physician at ROH. “Since we started this program in June of last year, we’ve been able to reduce our opioid use by about 20 percent, and for this institution that’s big because we see a lot of burns and trauma and we’re a major clinic for sickle cell pain. We have a lot of patients that other hospitals don’t.” Dr. Smartt and emergency room pharmacist Justin Griner, PharmD, agree that Opioid Light is the way to go, to reduce a patient’s exposure to opioids whenever possible and to spread the word throughout the hospital. “We’ve tried different things, providing Naloxone for patients to take home and reducing the number of opioids we send patients home with prescriptions for acute pain conditions,” Griner said. “The Opioid Light is an initiative we’ve been working with the THA on reducing the opioids patients receive when they’re in the emergency department in acute pain. It doesn’t mean we’re not treating acute pain, but we’re trying to use other nonaddictive agents when that’s appropriate.” As the only Level 1 Trauma Center

Dr. Chantay Smartt and Justin Griner

within 150 miles, Regional One sees far more than its share of critically injured patients in severe pain, making the drive to pull back on opioid use a difficult daily decision. “There are some conditions that obviously you’re going to give opioids for – major trauma, burns, sickle cell patients, post-surgical pain – but we’re trying to get the providers, the staff and the patients themselves to be aware that you can use an opioid, but you can also use non-steroidal things like Ibuprofen and Aleve,” said Dr. Smartt. “You can use opioids for breakthrough pain, but your main medication should be a Tylenol or Aleve or an Advil if your medical condition requires it. “Some patients – your end-stage renal, severe diabetics and congestive heart-failure patients – can’t take nonsteroidal medications, or if you’re allergic to them, but we’re trying to get other patients and their families thinking that there are other options that patients can use for pain control that are non-addicting.” The U.S. Centers for Disease Control published a study in 2017 noting that the more opioids a patient is exposed to

for acute pain, the more likely that patient will be using opioids a year later. “That speaks partially to the addictive nature of opioids,” Griner said. “Some manufacturers and even some medical journals in the past have indicated that opioids weren’t addictive, but obviously they are. I think that more and more institutions and providers are going to be moving toward the model of ‘if we can treat you appropriately with a medication that is not an opioid, then that is going to be our first choice.’” With the use of opioids so ingrained in the treatment of pain – there are more opioid prescriptions than people in Tennessee – changing the mindset is like trying to turn around a battleship, yet there are some positive signs. “Actually it’s been surprising that there has not been a lot of pushback,” said Dr. Smartt. “Most of our patients appreciate being educated. Once you tell them there’s a potential for addiction with this particular class of drug, a lot of them will say ‘then don’t give me that one.’ We do have patients who are already addicted, and for those we have places in the city where we can refer them. We can’t force them to go, however.

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“We’ve also just partnered with an organization called Navigation, and they send ‘navigators’ out to the hospitals. Most of them have recovered from addictions so they can talk on a one-onone level with the patient about what it is like to go through detox and that type of thing.” Under Opioid Light, ROH doctors and pharmacists try to determine how many opioid pills a patient might need – or if they need them at all – and provide the minimum with the short-range goal of switching to less potent options. The program includes an all-handson-deck Opioid Stewardship Committee that includes staff from chronic pain specialists, internists, anesthesiologists, general, orthopedic, plastic and trauma surgeons, to pharmacists, in which data is collected and literature reviewed in the effort to decrease the use of opioids if indicated, with the overall objective being to providing better, safer care for patients. “Treatment of pain in some services can be very challenging, but maybe they can switch to fewer pills per day and/or use other treatments like physical therapy and nerve blocks,” Dr. Smartt added. “It’s really been a collaborative effort.” Griner said gathering and providing data is a key element in the battle against opioid addiction. “Providing data is sometimes all that it takes,” he said. “Once a certain provider sees that a peer is using 30 percent fewer opioids to treat the same patients, that may be all it takes to say, ‘Hey, I need to explore some of these other options and reduce my own opioid use.’ Data is a big part of what we’re trying to do. “Our overall reduction so far is 20 percent and we hope there is still room for improvement, but with our trauma population and our sickle cell population we honestly don’t know. We’re playing this by ear a little bit in seeing how far we can go while still providing appropriate care to our patients.”

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Accessing the Spectrum of Quality Care Reflections on Women’s Health from ACOG Annual Meeting By CINDY SANDERS

disparities in maternal health outcomes, and support for the Alliance for InnovaThe American College of Obstetrition on Maternal Health (AIM), a national cians and Gynecologists (ACOG) has just data-driven maternal safety and quality wrapped the 2019 Annual Clinical and improvement initiative to improve materScientific Meeting. Held in Nashville from nal outcomes in the U.S.  May 3-6, the theme for this year’s national ACOG has always supported access gathering was “Accessing the Spectrum of to affordable healthcare, and we will conQuality Care.” tinue to oppose every The conference attempt to roll back also sets the stage for critical women’s health leadership transition. gains in the Affordable ACOG President Lisa Care Act, particularly M. Hollier, MD, MPH, for women with preexFACOG, welcomed isting conditions. We colleagues to the 67th also continue to oppose annual meeting before efforts to deny access to passing the gavel to reproductive healthcare 2019-20 President Ted and access to qualified L. Anderson, MD, PhD, providers through the during the annual busiTitle X Family Planning ness meeting. Program. Title X is the Hollier, now Immeonly federal program diate Past President, exclusively dedicated to shared thoughts on the providing low-income Lisa M. Hollier past year as she led the patients with access to organization of about 58,000 members. family planning and preventive health services and information. Medical News: What were Recent actions by the Administrasome of the key issues tion to change Title X will limit access addressed during the meeting to vital healthcare services to low-income and over the past year? women, men, and adolescents. These Dr. Hollier: This year’s meeting’s actions restrict information that physitheme – Accessing the Spectrum of Qualcians can provide to their patients, weaken ity Health Care – included an informasafeguards that ensure that Title X-funded tion-packed program that addressed the programs offer evidence-based contracepmost timely and challenging topics our tion, and impose medically unnecessary members face as ob-gyns. Healthcare requirements on healthcare facilities that access has been a key component of everywill exclude qualified providers from offerthing we’ve been working on during my ing care to low-income women. year as president, so having access as a Last year, ACOG and other leading focus of the meeting was vitally important. medical groups actively opposed these Access to quality healthcare is a key proposed changes and submitted pubto ensuring the health of women. ACOG lic comments to the U.S. Department of is pursuing policy and legislative soluHealth and Human Services. On April 9, tions to address the rising rate of maternal 2019, ACOG and leading medical groups mortality and severe maternal morbidity filed amicus briefs in several cases across in the United States. This includes advothe country in support of states’ and orgacacy for Medicaid coverage for women nizations’ motions for preliminary injuncup to a year postpartum, support for state tion to stop the recently issued changes to perinatal quality care collaboratives, supTitle X from going into effect.  port for efforts to reduce racial and ethnic

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Medical News: What key clinical areas were explored during the recent meeting?

Dr. Hollier: The trifecta clinical seminars covered topics that are most important to ACOG members, including endometriosis, genetics, substance use disorder and trauma-informed care, and DVT prophylaxis. This year we had a new session, EdTalks, which were three powerful, 10-minute presentations followed by a Q&A panel with the speakers. The EdTalks topics covered financial models, reproductive endocrinology and infertility, menopause, microbiomes, polycystic ovary syndrome, the annual well-woman visit, sterilization, and the environment. This was all in addition to more than 700 scientific ePosters with cutting-edge research in women’s health.

Medical News: Maternal mortality rates have been a big part of your efforts as ACOG president, what are your thoughts on improving care?

Dr. Hollier: The United States is the only developed country with a rising maternal mortality rate. This has been a tremendous impetus for change. My Presidential Program at the meeting and all of my presidential initiatives focused on implementable solutions to eliminate preventable maternal mortality. We are seeing changes in the leading causes of maternal mortality. With reductions in pregnancy-related deaths due to hemorrhage and hypertension, we are seeing that cardiovascular disease and cardiomyopathy are the leading causes. Fortunately, we know from maternal mortality review committees in states across the country that as many as 60 percent of maternal deaths are preventable. Because of the important role of cardiovascular disease in maternal mortality, a large part of my presidency was dedicated to updating ACOG’s clinical guidance on pregnancy and heart disease. Cardiovascular disease and cardiomyopathy account for about 1 in 4 maternal deaths and disproportionately affect black women. I am proud to say that the dedicated, multidisciplinary members of my presidential task force completed comprehensive guidance on this topic that covers screening, diagnosis and management of cardiovascular disease in pregnancy and the new Practice Bulletin was released during the annual meeting. ACOG members have also been working hard across the country to promote a culture of safety in hospitals, particularly in labor and delivery units. With the infrastructure and support provided by AIM, hospitals are implementing standardized, evidence-based practices that reduce complications and improve women’s outcomes. AIM is a national data-driven maternal safety and quality improvement initiative to reduce

maternal mortality and severe morbidity. Over the last several years, and with an additional $10 million grant from the Health Resources and Services Administration, the AIM program has grown and now enrolled 26 states … and counting. Our goal is to have participation from all 50 states, and I am confident that we will do it.

Medical News: During the national meeting, you passed the gavel to Dr. Anderson. Could you share some reflections on your time leading this organization over the past year?

Dr. Hollier: ACOG has made incredible progress on behalf of patients and our members in just one short year. Our committees have created and updated our clinical guidance. We’ve developed and created programs and education that help our members implement our Practice Bulletins and Committee Opinions in their clinics and in hospitals. ACOG members have taken to the Hill and gone to their state legislatures to ensure the leading voices of women’s healthcare are heard and influence legislative and regulatory policies. It’s been a year of accomplishment, and I am so proud to have handed the gavel to Dr. Ted Anderson as our 70th president of ACOG. I’m really proud of the advocacy work we’ve done with our partners to get better data on the causes and contributing factors to maternal mortality. We recently celebrated the passage of the Preventing Maternal Deaths Act, which was subsequently signed into law in December. ACOG staff, along with our dedicated members, spent nearly 10 years advocating for this important legislation that will now ensure funding and infrastructure for state-based maternal mortality committees. I’m thrilled that I could help usher this bill across the finish line and that it became law during my tenure.  To help ensure that advocacy holds a central role in our organization and our specialty, I created the ACOG Annual Junior Fellow College Advisory Council Advocacy Leadership Training program. This innovative and immersive program offers exclusive opportunities and experiences to our next generation of ob-gyn leaders, our JF chairs.  We’ve also invested in our Levels of Maternal Care program this year. The initial guidelines were developed and published in 2015 and were designed to promote collaboration among maternal facilities and healthcare providers with the goal that pregnant women receive care at a facility appropriate for their risk. ACOG and the Society for Maternal Fetal Medicine (SMFM) have worked together to develop and pilot the levels of maternal care verification program. The lessons learned from the pilot were published this year.   memphismedicalnews


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MAY 2019



Searching for Ways to Lighten a Financial Load

Healthcare Tuition Costs Weigh Heavily on Many Healthcare Students By CINDY WOLFF

The balance sits out there like a distant, dark cloud. It rumbles every so often to remind registered nurse Cynthia Barger that while she reached her goal of becoming a nurse, there’s a price to pay. It prevents her from buying a house. It

stops her from taking a real vacation. She bought a car, but she had to agree to a high interest rate because her credit report shows a student loan debt of around $70,000. That includes tuition for a master’s degree in nursing education that she recently completed in hopes of improving her salary. And for medical students, the final bill

for an education is at least double if not triple for some private universities. Students at the University of Tennessee Health Science Center (UTHSC) College of Medicine pay an average of $195,000 to complete their program. It’s an issue that received national attention recently when it was reported that

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Kenneth Langone, co-founder of Home Depot and chairman of the board of trustees at New York University along with his wife, Elaine, donated $100 million toward making NYU tuition free for medical students. He raised an additional $350 million to make NYU School of Medicine tuitionfree for years to come. “I think it’s fantastic,” said Scott Strome, MD, Executive Dean of the College of Medicine at UTHSC. Dr. Strome said he’s passionate about finding ways to help reduce student debt at UTHSC as he did while working at the University of Maryland where he was a professor and chair of the Department of Otorhinolaryngology. He said Maryland UniverScott Strome sity was able to raise approximately $8 million in 18 months to go toward reducing costs for students. After NYU’s decision, many in the industry are waiting to see if other prominent universities will follow. Dr. Strome said if that happens, the paradigm for state schools will change. “While a debt-free system is the right thing to do for our students, we need to do it in a responsible manner to pay for all the things medical schools need to be able to function,” he said. It also could change some of the pros students consider when deciding on a school. “Typically students might consider going to a state school system to be closer to family and because usually tuition is significantly less for an in-state student,” Dr. Strome said. If students can go to private medical schools with zero tuition, state schools might not look so attractive.” But that doesn’t mean schools like UTHSC won’t fill its classrooms with budding doctors. The university offers scholarships, including a few large merit-based ones and some need-based scholarships for each class. “We’ve seen an increase in medical school debt over the last two to three years, but with a greater increase in the percentage of our students receiving scholarships,” Dr. Strome said. “Our latest data shows that over 90 percent of our students receive some scholarship funding.” Students also have the option to apply for a full scholarship through the Army, Navy or Air Force Health Professions Scholarship Program, which covers all tuition and required fees including textbooks or equipment needed for study. Students all receive a monthly allowance for living expenses. As part of the program, once they gradu(CONTINUED ON PAGE 15)



MAY 2019



Reimagining Residency

AMA’s Next Push in Transforming Physician Training By CINDY SANDERS

In 2013, the American Medical Association (AMA) announced an ambitious effort to accelerate change in medical education. Starting with 11 founding medical schools on a mission to better prepare physicians to meet the future of medicine, the initiative has now grown to 37 participating schools. Yet, residency training has not mirrored those transformations … until now. The AMA recently launched a fiveyear, $15 million Reimagining Residency grant program to rethink how graduate medical education (GME) could best address the workforce needs of the current and future healthcare system, better support physician well-being and enhance preparedness to practice. It’s the next phase in the AMA’s quest to transform physician training. “When we really looked deeply at the changes being made in medical schools, we realized we’ve brought these now thousands of students through changes in undergraduate medical education (UME) but hadn’t changed residency,” said Susan Skochelak, MD, group vice president for Medical Education with the AMA and the driving force behind efforts to transform the way physicians learn and train to meet

the demands of a rapidly evolving healthcare system. Skochelak said the first cohort of students who benefitted from curricular innovations are now interns. “Each subsequent year, there will be thousands more students coming through these new med school programs,” she pointed out. Skochelak said the concern was there would be an implicit message that the training they undertook during medical school didn’t really matter if they arrived at residency only to find no

disruption in the status quo. “The next logical step is to say it’s a continuum of training and to bring these same principles and concepts of education forward to residency,” explained Skochelak. “We want to make a better handoff – a better connection – from medical school to residency in terms of learning approach.” She added practitioners must take the important new concepts that are part of health system science and understand

how quality, safety and patient-centered care are implemented in daily operations to ensure readiness for practice. Skochelak continued, “We want to support a positive learning environment … not just for students but for faculty and staff, as well.” Building off the successful model used to transform UME, Skochelak said those chosen for the new residency grant funding will join an AMA-convened consortium. “The best way, we’ve proven, to accelerate the change is to bring people together in a community of innovation,” she explained. The group will evaluate successes and lessons learned and work together to broadly disseminate successful initiatives to residency training programs across the country. In late 2018, the AMA announced the new program. At the beginning of this year, the organization put out a call for innovative proposals with a bold vision to promote systemic change in GME with Letters of Intent due Feb. 1, 2019. Last month, that large pool was narrowed down to 30 applicants who have been asked to submit full proposals. Skochelak said she anticipates eight will be selected for funding with the announcement coming in June at the 2019 AMA Annual Meeting in Chicago. The response has been tremendous.


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Nursing Profession’s Evolving Role, continued from page 1 Wendy M. Likes, PhD Title – Dean and professor, Ruth Neil Murry Endowed Chair College of Nursing, College of Medicine, Department of Obstetrics and Gynecology, University of Tennessee Health Science Center (UTHSC); Executive Director, Center for HPV and Dysplasia (CHAD) Regional One. Birthplace – Memphis, Tennessee Credentials, Nursing School – BSN, University of Memphis; MSN, UTHSC; DNSc, UTHSC; PhD, UTHSC; APRN-BC, FAANP. Nursing Experience – Volunteers twice monthly as family nurse practitioner at St. Jude Children’s Research Hospital; FNP, The Center for HPV and Dysplasia through Regional One Health.

the nursing profession. The event was conducted by Pamela Haskins, publisher of the Memphis Medical News.   “A professor at one time said that we need a super nurse, a nurse who can do anything – one who can go from working on the GI tract to delivering babies,” Likes said. “We don’t expect physicians to do that. It takes a special person to do each job.” Despite these changes, the roundtable participants all agreed one key element has remained the same – nurses are at the forefront of patient care and serve as an advocate for the patient. Held in conjunction with National Nurses Week, the roundtable included discussion of the high turnover of nurses in the Memphis area, workplace safety issues, the national shortage of nurses in a clinical and academic setting, the need for more nurses at an executive level and the restrictions on nurse practitioners in Tennessee.  Along with Likes, the other three participants in the roundtable discussion were: Carla Kirkland, family nurse practitioner, Saint Francis Hospital, and district 1 president of the Tennessee Nurses Association,  Blanche F. Petty, women’s health nurse practitioner, McDonald Murrman Center for Wellness and Health, Cathy Stepter, associate professor and graduate program chair, Baptist College of Health Sciences 

High Turnover

According to a recent study by NSI Nursing Solutions, a national nurse placement company, the average hospital nurse turnover rate in 2017 was 18.2 percent. Thirty-three percent of nurses who leave their jobs do so within the first two years. It was the highest recorded turnover in the healthcare industry in almost a decade. All four participants agreed that 10


MAY 2019

nurse turnover is a big concern. Blanche Petty, of McDonald Murrman, said many nurses are forced to do more because of budget cuts and advancements in technology, and as a result become a product of nurse burnout. “More and more falls on the nurses,” Petty said. “PCAs get cut and nurses have to fill in the gaps. As a result, they get burned out and leave.” She recalled an experience two decades ago when she was a recent graduate from nursing school and became a labor and delivery nurse in a hospital.  She was required to attend a six-week, highrisk obstetrics course to learn how to handle certain situations in the hospital. She said this course was a valuable resource, and similar courses could help onboard nurses right out of nursing school. “It can be an intimidating atmosphere when you get out of school and this course, as well as several charge nurses, helped me understand what to expect

working in a high-risk environment,” Petty said. “They don’t do this anymore, and it was so helpful to me at the time as a nurse right out of school.” Cathy Stepter with Baptist College of Health Sciences said some turnover could be prevented if residency programs were offered for nurses. “We need to support our nurses in their first year of practice,” Stepter said. “These nurses are novices coming in and need to be onboarded correctly. We need nurses ready, and there is a learning curve.”

Workplace Safety

Carla Kirkland of the Tennessee Nurses Association (TNA) said a key issue facing nurses in the state is workplace violence, from both patients and co-workers. Last year a patient was arrested for attacking a nurse practitioner and psychiatric nurse at two different Memphis-area hospitals.

According to Kirkland, this type of violence is on the rise. Likes said some work is being done on a local level to tackle the issue. Last year, UTHSC was awarded a $16,000 grant from Tennessee Promise, a state scholarship and mentoring program, in collaboration with Regional One Health, to train nurses to handle and defuse crisis situations in hospitals and other healthcare settings. The grant funds crisis management instructor training for six staff members at Regional One Health and two college of nursing faculty members on how to recognize escalating behavior and defuse potentially hostile situations. The training takes place in the classroom and in simulation settings with actors portraying patients in the new UTHSC Center for Healthcare Improvement and Patient Simulation, which opened last year. “Six hundred nurses have participated in the de-escalation training, which will, hopefully, assist in retention and avoid burnout,” Likes said. “The program is still ongoing, and we are in the process of measuring the outcomes.”

Nurse Shortage

All nurse participants stressed the need for more nurses in both a clinical and academic setting in the Mid-South. The U.S. Bureau of Labor Statistics predicts that 1.1 million additional nurses are needed to avoid a further nurse shortage nationwide. “There is a gap in the profession,” Likes said. “Many older nurses aren’t working in the field anymore. There aren’t enough experienced nurses who can onboard a novice nurse.” Stepter said salaries must increase in order to incentivize nurses. She thinks some nurses in the Memphis area choose to leave an employer to become a travel nurse – a nurse hired to work in a specific location for a limited amount of time – and then work locally because the pay is higher. The fact they are travel nurses (CONTINUED ON PAGE 11)

Carla Kirkland Title – Acute Care Nurse Practitioner, Saint Francis Hospital; Emergency Department, Memphis; District 1 President, Tennessee Nurses Association; President Elect, Tennessee Nurses Association. Birthplace – Bentonville, Arkansas. Credentials, Nursing School – BSN, Harding University; MSN, University of Tennessee Health Science Center; APRN, ACNP-BC, FNP-BC, ENP-BC. Nursing Experience – RN, ICU, Central Arkansas General Hospital, Searcy, Arkansas; and ICU, Saint Francis Hospital, Memphis; ACNP, Kraus Internal Medicine, Memphis.



Nursing Profession’s Evolving Role, continued from page 10 allows them the opportunity to make additional money when Blanche Foshee Petty working locally “because of the stipends and perks.” “We need to pay nurses Title -- Women’s Health Nurse not to travel,” she said. Practitioner, McDonald Murrman Likes and Stepter said the value Center for Wellness and Health. of nursing is difficult for hospitals to quantify because nursBirthplace – Memphis, Tennessee. ing isn’t a billable profession. (Grew up in Southaven, Mississippi.) “Nursing is a hidden cost at hospitals,” Stepter said. Credentials, Nursing School – BSN, “Many variables demonstrate Baptist College of Health Sciences; that we have better outcomes MSN, University of Cincinnati. WHNPwith nurses, and their salaries BC should reflect that.” Likes and Stepter said Nursing Experience – 26 yrs OB/gyn, there is a need for more nurse Regional One, Baptist and Methodist; faculty at colleges and unifive years at McDonald Murrmann. versities. They agreed that universities are turning away potential nursing students because there aren’t enough nurses with advanced degrees nationwide who can teach. “We are turning nursing students away who are applying,” Likes said. “We had 250 applicants for our BSN acceleration profor women and men with families. gram this past year, and we could only “It’s a great career choice,” Likes accept 60.” said. “The hours are consistent, and it’s Additionally, Likes said nursing salaa good lifestyle for parents. Many women ries are higher in a clinical setting than in wait until later in life to teach, and they an academic one, which can deter some are in an academic setting for only 10 to nurses from pursuing advanced degrees. 15 years before retiring.” “We don’t expose academia as a career choice for nurses,” Stepter said. More Nurse Executives “Teaching is very different from dealing Several participants emphasized the with patients. The impact of good faculty need for more nurse executives in area makes a big difference to students at a hospitals. Likes said nurses directly impact time when they are stressed. We need to the health of patients and are advocates encourage nurses to look at academia as for them, so they should be making decian option. We need people at all levels.” sions that impact patients on an executive Likes said it’s a common misconceplevel. tion that the academic field isn’t a good fit “Nurses aren’t at the table making

Cathy Stepter Title – Associate Professor and Chair, Graduate Nursing Program, Baptist College of Health Sciences. Birthplace – Memphis, Tennessee. Credentials, Nursing School – BSN, Union University, DNP, Georgia Southern University.

decisions at organizations,” Likes said. “If you look at a hospital’s executive board, only one or two nurses are represented. We need more nurses on an executive level.”

Advanced Nurse Practitioners

According to the American Association of Nurse Practitioners, 22 U.S. states have approved nurse practitioners to practice independently. This means they are allowed to assess, diagnose, interpret diagnostic tests and prescribe medications independently. Nurse practitioners must practice under the supervision of a licensed physician in Tennessee. Kirkland, who is the statewide president-elect for the TNA, said there likely will be legislation introduced to the state legislature for nurse practitioners to practice independently in Tennessee in the upcoming year. “In my experience, nurse practitioners and physicians work together well collaborating,” Kirkland said. “There are plenty of patients to go around. We are utilized to fill areas where there are staff

shortages.” She emphasized that the Coalition for Access to Care in Tennessee, which is a TNA multiple-advanced practice registered organization, is working to communicate with physicians to come up with a compromise and solution to the many issues facing the healthcare industry in Tennessee. Stepter said there is sometimes a knowledge gap among physicians regarding an advanced practice registered nurse’s duties and understanding all of the new certifications. “There have been many new certifications in advanced nursing over the years, and not every physician is well versed in them,” Stepter said. “Physicians and leadership don’t always understand the full scope of the nurse practitioner.” All of the roundtable participants said patients in rural areas in the state don’t have quality access to care. Kirkland said the state restrictions on nurse practitioners restrict access to patients in rural areas because they cannot find a collaborating physician to assist them. “Many rural clinics are closing, and patients from those areas are using the emergency room for their healthcare,” Kirkland said. “We can be an asset in those rural areas.”

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St. Jude Gene Therapy Cures Babies with ‘Bubble Boy’ Disease ongoing clinical trial of infants newly diagnosed with SCID-X1, the most common type of SCID, a rare disorder that commonly became known as “bubble boy disease.” The disorder received widespread public attention in 2001 with the release of the movie Bubble Boy which was inspired by the 1976 film The Boy in the Plastic Bubble. With Jake Gyllenhaal staring in the title role, Bubble Boy was a comedy – something that seemed strange to many then as well as now. In fact, one critic wrote at the time, “If you take it seriously, you’ll find yourself hating this movie. Just think of  Bubble Boy, as the kind of movie that isn’t supposed to be watched with a heavy heart.” The St. Jude announcement reported that ten infants have received the experimental therapy. It was developed in research led by the late Brian Sorrentino, MD, of the St. Jude Department of Hematology. Dr. Sorrentino, who was the senior author, died after the manuscript was submitted for publication.

Ewelina Mamcarz

Brian Sorrentino

The report stated that UCSF played an instrumental role in the St. Jude protocol

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by including targeted dosing of busulfan, a chemotherapy agent commonly used in bone marrow transplantation to make space in the marrow for donor stem cells to grow. It was found that the addition of very low doses of busulfan based on a model developed at UCSF increased engraftment of gene-corrected stem cells in the bone marrow without causing the side effects associated with standard doses, according to coauthor Mort Cowan, MD, a UCSF professor of pediatrics and principal investigator of the trial at UCSF, where four of the infants were treated. SCID is caused by a mutation in the interleukin-2 receptor subunit gamma (IL2RG) gene that produces a protein essential for normal immune function. Currently, the best treatment for SCID-X1 is bone marrow transplantation with a tissuematched sibling donor. But more than 80 percent of SCID-X1 patients lack such donors. They must rely on blood stem cells from other donors. This process is less likely to cure the SCID-X1 and more likely to lead to serious treatment-related side effects. The gene therapy involved collecting patients’ bone marrow, then using a virus as a vector to insert a correct copy of the IL2RG gene into the genome (DNA) of patients’ blood stem cells. The cells were then frozen and underwent quality testing. Prior to the gene-corrected blood stem cells being infused back into patients, the infants received two days of low-dose busulfan with the doses individually determined based on each patient’s specific ability to process the drug. The research was funded in part by the California Institute of Regenerative Medicine (CLIN2-09504); grants (HL053749, AI00988, AI082973, CA21765) from the National Institutes of Health; the Assisi Foundation of Memphis; and ALSAC, the fundraising and awareness organization of St. Jude. © 2017 ST. JUDE CHILDREN’S RESEARCH HOSPITAL; ALL RIGHTS RESERVED

Gene therapy developed at St. Jude Children’s Research Hospital has cured infants born with X-linked severe combined immunodeficiency (SCID-X1) according to a report released by the hospital. The life-threatening genetic disorder is sometimes called “bubble boy disease.” The name is a reference to measures taken to protect patients, who are born with little or no immune protection. Untreated, patients usually die early in life. In the hospital’s news release, Ewelina Mamcarz, MD, of the St. Jude Department of Bone Marrow Transplantation and Cellular Therapy, revealed that the children are producing functional immune cells, including T cells, B cells and natural killer (NK) cells, for the first time. These patients, now toddlers, are responding to vaccinations and have immune systems to make all the immune cells they need for protection from infections as they explore the world and live normal lives. This is a first for patients with SCID-X1, Dr. Mamcarz said. The results were published in the April 18 issue of the New England Journal of Medicine. According to the announcement, the patients were treated at St. Jude and UCSF Benioff Children’s Hospital in San Francisco with gene therapy produced in the Children’s GMP, LLC, a Good Manufacturing Practice facility located in Memphis on the St. Jude campus. The children were enrolled in an

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A Match Made, continued from page 3

When Dr. Giddens was in his residency, the field was 75 to 80 percent male. Today female physicians are in the majority, he said. The gender makeup at MOGA is about 50-50. “I certainly think that’s the wave of the future, that the OB-GYN field is predominantly female,” he said. “When I first started practicing, I think me being male was neither a positive nor a negative with patients. I think there are a lot of women now who would prefer to see a woman, but I’m at a stage in my career where I see a lot of my patients’ daughters. That’s kind of nice because they trust me and they convey their trust to their daughters.” Seven years after obstetrics residents Andrea and Aric Giddens met, fell in love and got married after teaming up for an emergency C-section in 1991, that same patient walked into MOGA for OB care, only this time not in such distress. The

patient relayed the story of her emergency C-section delivery of her first baby at The Med and indicated she wanted to have a natural delivery with no drama. So Dr. Andrea got the patient’s medical records, stared hard at them and then handed them to Dr. Aric and said, “Look at this.” It was the same patient. “The lady had no idea who delivered her first baby because the residents’ names were not recorded on the birth certificates; only the staff doctor’s was,” Dr. Aric said. “So we told the patient, ‘Hey, we’ve got a good story for you.’ She was really amazed, she delivered again and she’s been our patient ever since. In 2016 we even got to see her son we had delivered 25 years earlier. “Now, every time she sees my wife she says ‘I’m the reason you got married.’ We’re just amazed at the odds that this lady found us and had no idea, but it really happened.”

Searching for Ways, continued from page 8 ate, the students are required to serve in the military for the same number of years as it took for them to complete medical school. There is a similar program available to students who are willing to work for the National Health Service Corps. The federal program pays for medical and dental school in return for an agreement by the student to work in a rural area for the same time period it took them to earn their degree. The program was created to assist rural areas around the country that are suffering from a lack of primary care doctors. There are also programs such as the Tennessee Rural Partnership and the Tennessee State Loan Repayment Program that offer primary care physicians stipends in residency that can be used to pay loans, in exchange for a commitment to practice in rural health clinics. Strome said the university is looking at other ways to decrease ancillary costs

for students, such as offering financial literacy programs to help them manage their money. Also, the university is studying how to add affordable housing to the campus. As for Barger, she never wanted to be a doctor. It wasn’t just the expense, but she learned to love what nurses do while watching them attend a friend of hers. Barger works as an intensive care unit nurse at St. Jude Children’s Research Hospital, which has a tuition-reimbursement program that she’s using to help with her master’s degree loan. But, she still owes close to $70,000 in student loans. She knows of other nurses who carry similar debts – or more – who have resigned themselves to pay the minimum payment on the loan for the rest of their lives. “They’ll never get it paid off like that because of the interest,” Barger said. “I want it to be gone. My hope is to pay it off in five years.”

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Reimagining Residency, continued from page 9 “We had more than 250 entities write Letters of Intent,” Skochelak noted, adding the entries represented more than 300 organizations including state medical societies, specialty societies, consortiums, nonprofits and others. “We’re really very intrigued with the fact that the response with the Letters of Intent was broader than Susan Skochelak just traditional residency programs. It says that people are really interested and excited to move forward with innovation and change,” she added. Skochelak said about 20 percent of the Letters of Intent addressed physician burnout. Other workforce issues including addressing provider shortages and ideas tied to the impact of social determinants were also recurring themes. MEMPHISMEDICALNEWS


The eight proposals selected will share in the $15 million set aside to fund the initiative and will be divided up over five years. Like the medical school programming, Skochelak anticipates there will be a year of planning prior to implementation with these new residency learners followed over subsequent years. After selection, the eight institutional partners receiving grants will meet to agree upon standardized criteria for student assessment, resident selection procedures, onboarding and transitions, core curriculum in health systems science and common evaluation standards to measure performance. No matter which eight are ultimately chosen, Skochelak said she is excited about the depth and breadth of ideas and the response from the larger medical community. “Clearly, it indicates we’re in a climate where people know we can improve and do better, and they want to partner with others who can really help them reimagine residency,” she concluded.

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GrandRounds HealthChoice Selects George Wortham as CEO


UTHSC To Award 874 Degrees During Spring Commencement The University of Tennessee Health Science Center (UTHSC) will award 874 degrees to new healthcare professionals during its spring commencement ceremonies scheduled throughout the month of May. Each of the six colleges at UTHSC will hold a ceremony. The graduates include 119 from the College of Dentistry, 43 from the College of Graduate Health Sciences, 268 from the College of Health Professions, 158 from the College of Medicine, 99 from the College of Nursing, and 187 from the College of Pharmacy. UTHSC’s Chancellor Steve Schwab, MD, will confer the degrees.

Shannon Riedley-Malone, MD, Laura Engbretson, MD, Kathleen Behnke, FNP

Engbretson Center for Women and the work of its three providers. Dr. Malone graduated from the University of Tennessee College of Medicine at Memphis in 2007. She completed her OBGYN residency training at the University of Tennessee College of Medicine in 2011. She is a member of IHI Committee Baptist Women’s Hospital here in Memphis. Dr. Engbretson has practiced obstetrics and gynecology in the Memphis area since 2007. She is in private practice but also focuses on underserved neighborhoods in the Memphis area via the Morning Center, a mobile maternity unity providing charitable prenatal care.


HealthChoice, a Memphis-based physician hospital organization (PHO), has named George Wortham, MD, to replace outgoing president and CEO Mitch Graves, who will serve as chief executive of West Cancer Center & Research Institute. HealthChoice’s George Wortham board of governors approved the appointment last month. Dr. Wortham is a 20-plus-year member of MetroCare Physicians, an independent physician association that assists practices in reshaping the delivery of healthcare in the Memphis area and helping transform the healthcare system locally, from payments for procedures and sickness to value and outcomes. He has most recently served as CEO of the association since 2014. “Dr. Wortham brings a wealth of experience and know-how given his 30-year career in obstetrics and gynecology, his leadership with MetroCare Physicians, and his longtime relationships with HealthChoice, Methodist Le


Bonheur Healthcare and local insurance providers,” said Carter Towne, MD, board chairman. A Vanderbilt University alumnus, Dr. Wortham completed his post-graduate medical education and residency at the University of Tennessee Health Sciences Center in Memphis. Dr. Wortham assumed his new position May 1. HealthChoice is joint venture between Methodist Le Bonheur Healthcare and MetroCare Physicians.

Kathleen Behnke, FNP, has joined the Engbretson Center for Women as our nurse practitioner and will offer personalized care including a wide range of in-offi ce patient care including well woman exams, and pre and postnatal care. Behnke received her Master’s of Science in Nursing from the University of Tennessee Health Science Center in 2008.

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Volunteers lose their hair at a St. Baldrick’s Foundation head shaving event.

Shaved Heads Result in Fellowship Grants The St. Baldrick’s Foundation has awarded a $175,612 fellowship grant to St. Jude Children’s Research Hospital and a $5,000 Summer Fellowship grant to the University of Tennessee Health Science Center (UTHSC). St. Baldrick’s is a not-for-profit organization based in Monrovia, California, and the nation’s largest private funder of childhood cancer research grants. Volunteers went bald last month at various St. Baldrick’s head-shaving events across the nation – including Tennessee – to help raise funds now going to support the next generation of pediatric oncologists. Dr. Lisa Force, at St. Jude and St. Baldrick’s Fellowship awardee, will determine what the best interventions are to improve outcomes for children and adolescents with acute lymphoblastic leukemia (ALL). She will take into consideration the major disparities between countries in access to optimal treatment, early abandonment of therapy despite the potential for a cure, and availability of quality supportive care. Dr. Susan Miranda, at UTHSC and a St. Baldrick’s Summer Fellow, will have a medical student train in her lab to learn and assist in understanding the molecular mechanisms for estrogen silencing in osteosarcomas. It is estimated that 800 children will be diagnosed with osteosarcoma and it is thought that sex hormones play a role in the onset of the disease, as the cancer develops at the time of puberty.



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Mary M. Hurley, MD David Iansmith, MD Margarita Lamothe, MD Kashif Latif, MD

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GrandRounds Methodist Healthcare Foundation President Retires Paula Jacobson, who served as president of the Methodist Healthcare Foundation for 18 years, has retired. Jacobson, who joined Methodist in 2000, has overseen fundraising activities that support and strengthen clinical, research, and eduPaula Jacobson cational programs for Methodist Le Bonheur Healthcare (MLH). Jacobson, who retired last month, helped launch the Methodist Hospice Residence, the Comprehensive Sickle Cell Center and the Center of Excellence for Faith and Health at Methodist University Hospital. She also spearheaded the fundraising campaign for the new Shorb Tower at Methodist University Hospital, and coordinated the system’s 100th birthday celebration. “Paula’s fundraising successes have been essential to our organization’s ability to fulfill our mission,” said Michael Ugwueke, MLH CEO. “Paula will certainly be remembered for the relationships she fostered, the vision she and the Methodist Healthcare Foundation board set for philanthropy, and for her commitment to ensure MLH is able to provide care to all, regardless of ability to pay.”

Mitch Graves Named CEO of West Cancer Center Mitch Graves, who has more than 30 years in leadership positions with Methodist Le Bonheur Healthcare (MLH), began this month as the new Chief Executive Officer of West Cancer Center & Research Institute. As CEO of MItch Graves HealthChoice, LLC, a joint venture between Methodist Le Bonheur Healthcare and MetroCare Physicians, Graves was responsible for 125,000 patients with the creation of an Accounstable Care Organization that contracted with major payers including, Medicare, Cigna and United Healthcare- managing over $750 million  in medical spend while improving quality, patient’s health and experience. Before his tenure with HealthChoice, Graves was president and CEO of Methodist Le Bonheur Healthcare’s Affiliated Services Division for eight years. The Affiliated Services Division was comprised of surgery centers, diagnostic centers, minor med and urgent care centers, and sleep centers. This division also included Alliance Health Services which provides home care, hospice, and home medical equipment.



MAY 2019

Prior to being division president, Graves was Methodist’s Corporate Director of Finance. Graves serves on the Church Health Center’s finance committee, is board vice-chairman for Memphis Light Gas and Water and board vice president of the Economic Club of Memphis and serves as trustee for  Christian Brothers University  (CBU). On a national level, he is a member of United Healthcare’s Executive Advisory Council and Cigna’s National Health Care Advisory Council.

HealthLink International Opens Memphis Facility HealthLink International, a ‘total solutions provider’ for companies active in the medical device and human tissue markets, has opened a medical device facility in Memphis a t 3655 Knight Road. The new warehouse facility includes 108,500 square feet and has 32 employees .The facility is FDA-registered, ISO-13485 certified, and temperature-controlled. “We outgrew our previous warehousing space and needed something much bigger,” says Sebastiaan de Kok, Operations Director. “The decision to stay in Memphis as we grew was easy. The support from the community and the growth potential in Memphis played a big part in that decision.” Headquartered in the Netherlands, HealthLink has been in business since 2005.

Annual ‘Ride for Life’ Bike Tour Set for June 23 The eighth Annual ‘Ride for Life’ (for Organ & Tissue Donation Awareness) is scheduled 7 am Sunday, June 23 at Memorial Park, 5668 Poplar Ave. The 25-mile ride is a non-competitive, family-friendly, biking tour through East Memphis and Midtown designed to encourage health and wellness and underscore the need for Mid-Southerners to register as organ and tissue donors. Event registration includes SAG support, breakfast by the Crepe Maker and Say Cheese, T-shirt, finisher medal and post-ride party. Those interested in event details should visit www. MidsouthtransplantRFL.racesonline. com or

UTHSC Ranked Among Top 10 Safest Colleges in America The University of Tennessee Health Science Center (UTHSC) has been ranked in the Top 10 among the 2019 Safest Colleges in America, according to a list released by the National Council for Home Safety and Security (NCHSS). The organization compiled the list using data from law enforcement and FBI crime reports. It looked at 490 colleges, excluding those with fewer than 1,000 students and those that did not submit crime reports to the FBI. Two

variables were considered, the crime rates and the police adequacy for the size of the campus. UTHSC, which ranked at ninth on the list, is currently in the midst of a$30 million-plus security improvement program. These include video security technology, wireless and keyless access for all buildings, and a new Emergency Operations Center that will monitor security on campus and in the Memphis Medical District. More than 3,500 cameras, 500 access-controlled doors, and 3,000 wireless door locks will be installed in three phases installed. Keyless entry to buildings will allow exterior doors to have automatic lockdown capabilities in the event of an active threat. UTHSC is working with the Memphis Police Department’s Real Time Crime Center to have access to video in the university’s buildings, on campus, and within the Memphis Medical District, where the university’s cameras are located. New patrol vehicles have been added and the existing fleet has been updated.

Methodist Le Bonheur Healthcare Labs Earn Accreditation The laboratories at Methodist Le Bonheur Healthcare (MLH) have been awarded reaccreditation from the College of American Pathologists (CAP). The system of laboratories at MLH includes its five adult hospitals and Le Bonheur Children’s Hospital, as well as other providers such as affiliated physicians offices, surgery centers, and other outside services.  Mahul Amin, MD, is chairman of pathology for MLH. The U.S. federal government recognizes the CAP Laboratory Accreditation Program, begun in the early 1960s, as being equal-to or more-stringent-than the government’s own inspection program. During the CAP accreditation process inspectors examine the laboratory’s records and quality control of procedures for the preceding two years. CAP inspectors also examine laboratory staff qualifications, equipment, facilities, safety program and record, and overall management.   

UTHSC Selects Woods as Addiction Science Medical Director

John B. Woods, MD, has been named medical director for the Center for Addiction Science at the University of Tennessee Health Science Center (UTHSC). A graduate of the UTHSC College of Medicine, Dr. Woods also serves as an assistant professor in the College of Medicine. Prior to joining the university, Dr. Woods practiced internal medicine for 12 years in Jackson, Tennessee, with the largest multispecialty group in the state. He also started and owned a primary care practice in Jackson, worked in residential addiction treatment in Nashville, and was

the medical director for an intensive outpatient program in Shelby County. Dr. Woods said the new position affords him an opportunity to have a major impact on addiction in Tennessee. He said he thinks the backing of the university reduces the stigma surrounding addiction and treatment. The Center for Addiction Science was launched in the College of Medicine to combat the addiction epidemic in Tennessee. In 2016, it was named the first Center of Excellence in Addiction Medicine in the country by The Addiction Medicine Foundation, now the American College of Academic Addiction Medicine.

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