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Your Middle TN Source for Professional Healthcare News


Jonathan Metzl, MD, PhD ON ROUNDS

TDH Addresses State’s Opioid Epidemic In 2015, Tennessee had the tenth highest drug overdose mortality rate in the United States, most of which was due to prescription drugs ... 3

March of Dimes Honors Outstanding Middle Tennessee Nurses at Annual Gala Nashville Medical News is honored to serve as media sponsor for the annual March of Dimes Nurse of the Year Awards ... 8

Tax Reform is Here … Proceed with Caution The Tax Cuts and Jobs Act (TCJA) has officially been passed and signed into law. While the TCJA was touted as a simplification of the tax code, it inherently contains many complexities ... 12

Searching for Middle Ground Changes at Nashville General, Meharry Impact Future of Indigent Care By MELANIE KILGORE-HILL

The recent announcement of an end to inpatient services at Nashville General Hospital at Meharry has prompted a flurry of questions regarding the future of medical care for the city’s most at-risk population.

Big Changes in Nashville Healthcare

In her surprise November announcement, Nashville Mayor Megan Barry cited increased operating costs and decreased inpatient volume as catalysts behind a shift Mayor Megan Barry Dr. James Hildreth Dr. Joseph Webb toward outpatient services at the city’s safety net hospital. It was a move few saw coming. Shortly before the Mayor’s announcement, Meharry Medical College made headlines with news of a partnership with HCA Healthcare under which Meharry third- and fourth-year students will train at TriStar Southern Hills Medical Center. Although Nashville General has served as the school’s training hospital for many years, Meharry President James Hildreth, PhD, MD, said partnership with a new organization has been a long time coming. “Patient volume is a big factor in the ability to train students to become physicians, and we began working on identifying a new partner a year ago when it became clear that the patient volume at Nashville General wasn’t going to turn around quickly,” Hildreth said. The situation at Nashville General has led Meharry officials to develop relationships with affiliate hospitals outside of Tennessee to (CONTINUED ON PAGE 4)

Matthew Walker: Celebrating 50 Years of Service to the Community By CINDY SANDERS

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Matthew Walker Comprehensive Health Center (MWCHC) has continuously served the needs of Nashvillians for 50 years. Renowned physician, surgeon, educator and community activist Matthew Walker, MD, founded the Meharry Neighborhood Health Center in March 1968 to care for area residents where he saw gaps in services and insufficient access to care. “I believe his vision was that North Nashville, particularly, would have a place of affordable quality care,” said Katina Beard, CEO of MWCHC. “He believed in culturally competent care, even then.” Walker was inspired to replicate a center he visited in Mound Bayou, Miss., where he spent part of his time training young surgeons. “Mound Bayou had the first community health center in the South,” said Beard. “He saw the model and brought it back here.” Designated as Tennessee’s first federally qualified health center, the facility combined multiple

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The Crossroads of People & Medicine Jonathan Metzl Takes a Path Less Traveled By MELANIE KILGORE-HILL

and humanities has prepared him well for his multi-faceted role leading Vanderbilt’s Center for Medicine, Health and Society – a multidisciplinary center that studies the social and societal dimensions of health and illness. “On one hand I’m very appreciative of my knowledge in medical training and learning about the best way to diagnose and treat illnesses, but I’ve also become increasingly cognizant of the way socioeconomic and cultural barriers prevent our country from making the most people healthy that it can,” Metzl said. “I became more interested in the ways health is a social justice issue, in addition to just my clinical interest.”

“You can do whatever you want in life, after medical school.” That was the running joke at home for Jonathan Metzl, MD, PhD, director of the Center for Medicine, Health, and Society at Vanderbilt University. One of four boys born to a pediatrician father and psychoanalyst mother, Metzl and his brothers all went on to pursue medical careers. And while a family of physicians isn’t necessarily unusual, the Metzl’s story is. “My father was an immigrant who escaped Europe during World War II,” Metzl explained. “The message we got growing up and one that we live by is that taking care of people is the way of giving back to those who saved our family’s lives during a time of intense turmoil.”

A Good Fit

Varied Interests

It was a message the Kansas City native took seriously. After receiving bachelor’s degrees in biology and English literature, Metzl earned his medical degree from the University of Missouri. He then earned a master’s degree in poetry during his psychiatry resi-

dency at Stanford University … and went on to receive a PhD in American culture from the University of Michigan while working as a psychiatrist. Metzl’s unique insight into medicine

Metzl joined Vanderbilt in 2010 to help shape the direction of the newly formed center. “This was a chance to build institutional structure around issues I cared about, so it seemed like a great opportunity to spread information about medical and scientific knowledge and also to train students to understand the basic socioeconomic issues of health,” he said.

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Addressing Disparities

While strides have been made in racial and socioeconomic disparities, Metzl said there’s still a way to go as Americans struggle to separate healthcare from politics. “It feels like over the last few years we’ve taken a step back,” he said. “If you take the Democratic or Republican framework away, the general premise of having a healthy country is to afford as many people as possible the right to healthy communities and access to healthcare. I feel like healthcare has became incredibly political and increasingly unjust.” Uniquely positioned to address those disparities, the center includes an interdisciplinary faculty and a popular undergrad program in medicine, health and society. They’ve also built a master’s program and established a community identity looking at issues of social health and all of its biological, medical and political complexities. The center is also a resource for the medical community, with ongoing forums ranging in topic from military health and food politics to disabilities. “Although we’re in a college setting, we’re open for clinicians from across the Nashville area,” Metzl said. “Our professors speak in community settings and are engaged locally in many ways – from working with military communities to city planning.” As the program grows, so does its integration into the increasingly diverse Nashville community.

A Respected Voice

Metzl’s personal areas of interest include psychiatry, race and health, the history of mental health, and gender. He’s currently engaged in a study on common sense solutions to gun violence. “My research looks at things we can do from a public policy standpoint to lessen gun violence in America,” said Metzl, who’s a frequent contributor to journals that examine policy positions and interventions to help lessen rates of gun violence. “There are ways people wrongly stigmatize mental illness for gun violence when that’s just not the case,” he said. A frequent public health commentator for national news outlets, Metzl also has authored a number of books including The Protest Psychosis: How Schizophrenia Became a Black Disease; Against Health: How Health Became the New Morality; and Prozac on the Couch. His op-ed pieces have been published nationally.

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TDH Addresses State’s Opioid Epidemic Leaders Collaborating on Statewide Best Practices By MELANIE KILGORE-HILL

It’s not the first time a collective effort by the medical community has saved lives. In 2005, the Institute for Health Improvement’s “100,000 Lives” campaign kicked off an 18-month initiative, which ultimately prevented more than 120,000 patient deaths related to medical injuries and hospital acquired infections. “We can’t just look at individual or regional hospitals,” Reagan said. “We have to have a statewide vision because it’s a statewide problem.”

In 2015, Tennessee had the tenth highest drug overdose mortality rate in the United States, most of which was due to prescription drugs. In fact, opioid abuse kills more Tennesseans each year than homicides or motor vehicle accidents. That sobering fact prompted the Tennessee Department of Health to host a November symposium called “Turning the Tide: Collaborating to Prevent Opioid Abuse.”

Areas of Focus

Call to Responsibility

“This epidemic is way out of proportion to previous levels of overdose deaths, and healthcare is involved directly or indirectly in most of these cases,” said event organizer David Reagan, MD, PhD, chief medical officer for the Tennessee Department of Health. “Healthcare is very uniquely positioned to impact each of the key Dr. David Reagan areas of response.” Working alongside TDH Commissioner John Dreyzehner, MD, MPH, and Deputy Commissioner Michael Warren,

MD, MPH, Reagan addressed more than 200 medical providers to better define the role of healthcare providers in fighting opioid abuse.

Finding Best Practices

“There’s been a lot of different efforts across the state, some very innovative and successful,” Reagan said. “What healthcare hasn’t been successful at in the past is taking a good intervention, validating it in different environments, and spreading it across the state or nation to improve quality of care. That’s really what this summit was all about. How do we work together to do something concrete about this statewide?”

The symposium has prompted leaders to organize groups focused on four key areas with the most potential impact: patient education, prescriber education, perioperative pain management, and emergency department pain management. Leaders are now working on proposals for first projects in each of these areas and creating the collaborative space and structure necessary to move forward. Reagan said some groups are almost ready to go, and additional groundwork and development are being identified to allow projects to spread statewide. “Progress is being made everywhere, but there’s still a lot of prescriber education that needs to happen,” said Reagan, noting common challenges still facing the

industry. “The way we’ve been thinking about using opioids in patients has been too limited and almost stereotypical in some ways, and those stereotypes are being shaken to the foundation by new information that shows we, as providers, aren’t as good at chronic or acute pain management as we thought we were.”

Uniquely Positioned

He’s hopeful, though, as more physicians are committing to collaboration and to adopt better practices. “Healthcare is uniquely positioned the make a difference, and we’re seeing more and more remarkable bright spots across the state,” Reagan said. “That’s because many Tennessee providers are learning they can give great patient care with minimal or no opioid use and still receive positive patient satisfaction scores.” In doing so, providers are also preventing accidental addiction, which accounts for the majority of opioid abuse. “It’s a win-win because patients don’t want to become addicted either,” Reagan said. “We didn’t get into this overnight so we won’t get out overnight, but we can build something collaboratively and make progress in the next 12 months,” he concluded.

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Searching for Middle Ground, continued from page 1 train students. Hildreth said the college now sends as many as 80 percent of the program’s 105 third- and fourth-year students out of Nashville – a trend he hopes to reverse through the new arrangement with HCA. “HCA is one of the most efficient, best run healthcare organizations in the country and, in some ways, is leading many of the changes that will be happening in medicine,” Hildreth said. “There’s also a long and deep connection between the two organizations.” Many Meharry-trained physicians work at HCA hospitals nationwide, and a Meharry alum will oversee the HCA-Meharry training program. While patient volume was a primary factor in his decision, Hildreth cited additional advantages to a Meharry-HCA partnership. “Having students train in that environment is exciting because students will be exposed to a whole range of clinical specialties under one roof instead of having to hopscotch around the country,” Hildreth said. “It will enrich their experience and give them a more realistic idea about which specialties they want to pursue.” Mayor Barry said the partnership would benefit the community, as well. “The great new partnership between Meharry Medical College and HCA TriStar Southern Hills Medical Center has provided the community with an opportunity to rethink how we can best provide healthcare for our most vulnerable populations,” she said.

New Arrangements

Hildreth knew the decision to partner with HCA would come as a surprise to many, given the sometimes overlooked fact that Meharry actually owns the building where Nashville General Hospital is located. “The reason why so many hospitals are closing their doors is that it’s too challenging for a small, free-standing hospital to be successful today,” he said. “In a larger context, we own the building but don’t have any say over how it’s run.” Under the current arrangement, Meharry owns the building and provides physicians, while Nashville General operates under control of hospital administrators and the Hospital Authority of Metropolitan Nashville and Davidson County. “We really are two separate, autonomous organizations, but one of the things we’ve tried to do is work with (hospital CEO) Dr. Webb on an integrative delivery model to create seamless care delivery for patients,” explained Hildreth. The care model adopted by Nashville General under Webb’s three-year leadership emphasizes preventative services and disease management through a medical home model. After Mayor Barry announced inpatient services at Nashville General would end, Hildreth proposed the idea of Meharry leading the efforts in defining a new model. “This building is ours, and we have a vested interest in caring for the indigent,” Hildreth said. “We’re taking the lead in deciding a 4



ultimately using our resources in a way that will improve patient outcomes,” the mayor said. “I’m grateful to Dr. Hildreth and Meharry Medical College for helping to lead the process of bringing community stakeholders to the table to develop that model.”

A Different Perspective

new model for indigent care. We want to emphasize that we’re not going anywhere. As long as there’s clinical activity in that building, we’ll be a part of it.”

Outpatient Options

Hildreth has high hopes for the outpatient model, as 90 percent of patient encounters at Nashville General are currently ambulatory. His goal is to sustain and improve outpatient services for the indigent to reduce the number of emergency room visits among a population that often utilizes the ED for complications from chronic diseases like diabetes and hypertension. As planning continues, Hildreth said it might be possible to offer limited, specialized inpatient services like behavioral health. “There might be some way to leverage the facility to satisfy the most needs,” he said. “Those are the kinds of conversations that still need to take place.” Hildreth is now leading a work team of all stakeholders in the situation to make recommendations to the mayor and Metro Council about the best model for indigent care in Nashville moving forward. He also is attentive and sympathetic to the outpouring of emotion from Nashville General supporters. “I don’t fault them for being upset because Nashville General has been an icon in this city for a long time,” he said. “We intend to fully maintain that spirit and mission.”

The History of Nashville General

Nashville General Hospital first opened as City Hospital on April 23, 1890 with one physician, seven nurses and 60 beds. From day one, the hospital’s mission was to provide healthcare services to the desperately ill or those persons unable to care for themselves. In 1998, Metropolitan Nashville General Hospital moved from its original site on Hermitage Avenue to the Meharry Medical College campus, blending the two historic medical institutions that shared a single goal. That commitment, Barry said, isn’t going away. “Metro looks forward to supporting a model for integrated care that is focused on the needs of patients, addressing current gaps in service and

Still, the patient volume argument used to justify the overhaul concerns Nashville General Chief Executive Officer Joseph Webb, DSc, MSHA, FACHE. “The notion that we have all these empty beds is a misconception,” said Webb, noting that the hospital is licensed for 150 beds by the state through a Certificate of Need. Of that total, 114 have been listed as operational. “When we look at those 114 beds, we would have to utilize semi-private occupancy – which would increase infection control risks,” he said. When you reduce that number to private occupancy and remove bassinets, Nashville General has 86 single occupancy rooms. Webb said the hospital’s occupancy rate for 2017 was 58 percent, just a fraction below the national average of 61 percent. Apparently, those numbers don’t add up for city officials. “Over the years, the number of Nashvillians being served through the inpatient hospital at Nashville General has declined by half, with less than 30 patients a day in October of this year, while the hospital has required more and more dollars every year from taxpayers,” Barry said. In the absence of inpatient services, Webb’s primary concern is the long-term care of those who do require inpatient care. “There are a number of hospitals across the city, so once inpatient services are no longer offered how do you maintain quality healthcare?” questioned Webb, noting Nashville General’s 32,000 emergency department visits annually.

A Promising Model

Webb said the chronic disease care model implemented under his watch has led to statistically significant improvements in patients with diabetes and hypertension. “Rather than dismantling that, you should be duplicating it,” said Webb, stressing the difficulty of continuing the current model in an outpatient only setting. “You start to create fragmentation in care delivery when you disrupt the transition of care,” he said. “It’s similar to an ecosystem because you have an emergency department for difficult-to-manage patients in crisis or those without a primary care provider. The most expensive level of care is crisis, but once you stabilize patients and put them in inpatient care, your patient isn’t going somewhere else. The outpatient function doesn’t work as well because you no longer have that resource to stabilize the patient, and he’s no longer embedded in your integrative delivery system. Once you disrupt that in this difficult-to-manage population, you lose a coordinated method of care.”

Intervention & Outcomes

Webb said metrics being used to measure outcomes for this population have shown statistical improvement since interventions went into place. “If you’re in healthcare and have researched any of these areas, you can appreciate a model that will deliver outcomes in the midst of an environment where you have the worst possible health outcomes in the nation,” he said. “We’re showing that through proper modeling, you can improve outcomes with statistical significance, which indicates that it is not by chance,” he continued. “You don’t change a model generating those kinds of outcomes, although a funding model might need to change.” Funding a safety net hospital is no easy task, and Webb said it’s unrealistic to expect an indigent care hospital to maintain a 75-day supply of cash. He believes that misperception is being used to fuel the removal of inpatient services for the poor in a city recognized as the apex of healthcare in the United States. “Nashville has an $84 billion healthcare industry, and we’re ready to disrupt the one system that seems to be working for indigent care in search of a better one,” Webb said. “Right now there seems to be a lot of question marks.”

More Questions than Answers

Just where will Nashville’s indigent receive inpatient care? That question represents the biggest question mark yet, with no firm answers. “If we can refocus the work at Nashville General toward meeting the demand for its ambulatory clinic care services, while also creating an indigent healthcare fund to ensure the handful of new patients needing inpatient care can get it at other hospitals, then we’ll allocate our limited resources more effectively toward the best healthcare outcomes,” Barry said. According to the mayor, 90 percent of indigent healthcare in Nashville is provided at other hospitals. However, Webb said patients routinely get transferred to Nashville General from hospitals whose missions don’t include indigent care. “If you do get those hospitals to switch missions, their margins will be impacted, and a private system isn’t likely to change their mission just to care for an indigent population,” Webb said. “I’m curious to see if those individuals are going to receive free care or if some funding will be provided to care for them. And if they get funded … how will you fund them in multiple hospitals, and why would you when you could fund them in one place and get the outcomes you’re getting now? Economically and from a pure health outcomes standpoint, we need to look at this for what it is and ask what’s the most economically feasible and patientcentered way of addressing healthcare in Nashville.” Those questions and many more are sure to be on the table in the coming months as stakeholders look at the best way forward for patients, providers and the community. nashvillemedicalnews


Social Media: A Public Health Threat? Research, AMA Policies Raise Red Flag on #Overuse By CINDY SANDERS

Instagram, Facebook, Snapchat, Twitter, YouTube – social media has become a pervasive part of the way Americans share information. While there are many admirable outcomes – from being able to keep up with friends and family across the country or around the globe to rapidly deploying breaking news – research increasingly links use to less desirable outcomes including significant increases in depression, anxiety, and accidents. At the recent Interim Meeting of the American Medical Association, the national physician organization adopted two new policies directly addressing the growing concerns attached with social media overuse. The new policies join an earlier call to action to dissuade distracted driving, walking, or machinery use while operating hand-held devices. The earlier policy came out of the AMA’s 2015 Annual Meeting. The two new policies adopted in late 2017 coincide with increasing evidence regarding the behavioral health impact of spending too much time in front of screens or on social media channels. “One of the concerns we have is there is new data that demonstrates as screen time goes up in children, there’s an increase in health prob-

lems, depression and anxiety,” said AMA Board Secretary Jesse M. Ehrenfeld, MD, MPH, an anesthesiologist who holds several leadership roles at Vanderbilt. He added the link between social media and these issues are what drove adoption of the new policies. In addition to behavioral health Dr. Jesse M. Ehrenfeld concerns, too much screen time is associated with upticks in sleep issues and childhood obesity, which can lead to a host of other health problems. Ehrenfeld and colleagues recognize digital devices play an important role in society but have called on physicians, public health officials, and policymakers to become more active in finding a balance between screen time and other activities. “Mobile phones and tablets undoubtedly have educational and recreational benefits,” said Ehrenfeld, “but it is critical, particularly for young people, that screen time be balanced with physical activity and sleep.” The new policy, he continued, encourages more content in the health education curricula of primary and secondary schools addressing the current imbalance. “But also importantly, we think primary care

physicians ought to assess their patients and talk to parents about the need to balance screen time and physical activity,” he continued. “To improve the health and wellbeing of young people, all of us must do more to address the harmful effects of screen time.” The other new policy adopted in midNovember focuses on the negative health impact of social media usage. The AMA pointed to recent statistics showing 68 percent of adults and 71 percent of teenagers use Facebook with many users checking social media every day … often multiple times a day. Citing several recent studies that have found a notable link between increased use of social media and increased levels of anxiety and depression, the new policy urges schools to provide safe and effective educational programs to help students identify and mitigate the onset of mental health impacts from social media. “According to research conducted by Pew, across the country nearly a quarter of teens are online ‘almost constantly,’ and 92 percent go online every day,” said Ehrenfeld. “Social media has the power to bring people closer together and to build communities, but research also is showing a link between increased social media use and an uptick in anxiety and depres-

making a move?

sion. In addition to increasing awareness of these dangers among parents and teens, we must do more in our schools to identify and address them as early as possible.” He added the AMA is looking to develop tools and protocols around digital media. “The AMA wants to make sure that we’re partnering with the right organizations to make sure we understand the impacts of social media usage,” Ehrenfeld noted of taking a collaborative approach to tackling the issue in both youth and adults. Colleagues in the American Academy of Pediatrics, for example, have created social media guidance for pediatricians and have developed a toolkit and a number of policy statements to address media usage in children and adolescents. “If, as a physician, we can identify someone who may be at risk, then we can intervene,” Ehrenfeld pointed out. He added the new policy calls for creating screening tools to help identify warning flags for negative physical and behavioral health impacts. When it comes to the ubiquitous use of digital media, he concluded, “We know these tools are important for lots of reasons including educational purposes, but the key is to balance their usage and to make sure the usage is safe and not detrimental to the person who has the device.”

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The Impact of Behavior on Health Status in Tennessee United Health Foundation’s Annual Rankings Highlight Good & Bad By CINDY SANDERS

As Tennesseans begin 2018 filled with good intentions to kick bad habits, United Health Foundation’s annual America’s Health Rankings® might serve as extra motivation to stick to those resolutions. Once again, the Southeast falls to the bottom of overall health status linked to challenges with weight, inactivity, smoking and drug abuse. Tennessee fell one spot to 45th in the 2017 rankings. Despite the obvious health concerns faced by the region, Karen Cassidy, MD, chief medical officer for UnitedHealthcare Commercial and Medicare for the MidSouth and Gulf States, said it was important to recognize all states have areas of leadership and areas of challenge in the

report. The goal is for healthcare providers, policymakers, public health officials and community partners to take a deep dive to look at trends and search for solutions. “I don’t want people Dr. Karen Cassidy to feel negative about a ‘bad grade’ and not be able to get past that and be able to use this information in a positive way,” she said. “From a national standpoint, we’re seeing a rise in premature deaths,” Cassidy noted, adding this is the third straight year for an increase. Likely contributors to that metric include an upward tick in the rate of drug-related deaths, a second

consecutive year of increased cardiovascular deaths, and continued high rates of obesity and of unhealthy behaviors. “As we’ve seen, obesity and diabetes rates are going up every year. I think that directly speaks to premature deaths … you can’t pull those apart,” said Cassidy. Drug-related deaths are a growing concern. “In Tennessee, we saw an increasing trend … it’s up 27 percent over a five-year period,” she noted of the rise from 15.7 to 19.9 deaths per 100,000 population. Excessive drinking is another issue to monitor. While Tennessee’s low prevalence of excessive drinking continues to be a strength, the state did see a 29 percent jump in the number of adults who reported binge drinking or chronic drinking over the past year.

Cassidy encouraged providers to initiate difficult conversations regarding lifestyle choices. For the many who are already talking to patients about the link between behavior and health, Cassidy said becoming familiar with available resources within the community and through a patient’s health coverage could help take those conversations to another level. “Make sure you’re really aware of the benefits your patients have,” she advised, noting many plans have unique programs to help build healthy habits at no charge. To read the extended article and access additional Tennessee statistics, go online to

Matthew Walker: Celebrating 50 Years of Service, continued from page 1 medical services under one roof, becoming a national model of comprehensive care delivery in the process. “It’s a model that is always pertinent and on time,” Beard noted with a smile of the system’s continuity. Two years after opening its doors on Jefferson Street, the center was renamed in honor of its visionary founder. What started with 19 full- and part-time physi-




cians and dentists at one location in 1968 has grown to 107 healthcare professionals across an array of clinical specialties and ancillary services at three Middle Tennessee locations: Nashville, Clarksville and Smyrna. By 1979, MWCHC had become a freestanding facility. For the next 25 years, the center operated from its home on Herman Street before moving to its spacious

‘new’ location 14 years ago. Today, the family and internal medicine clinics at 1035 14th Ave. North serve both adult and pediatric populations and offer chronic care management, wellness checks, routine screenings, women’s health services, nutritional counseling, pharmacy and laboratory services, medical imaging, dentistry, behavioral health services, and social services. Matthew Walker is also home to a number of special grant projects including the Vanderbilt-MeharryMatthew Walker Center of Excellence in Sickle Cell Disease. The staff and leadership of MWCHC focus on their role as an integrated part of the community. “Social determinants of health? The community health center already understood that from its inception,” noted Beard. “Over the years, the community health center model changed to become more just about health, and now it has transformed Katina Beard again … it’s boomeranged back.” In that spirit, Matthew Walker hosts a number of events during the year that foster connections with patients and partnerships with other resource providers to complement health outreach efforts. Last month, children 12 and under were invited to ‘Smiles with Santa,’ which offered dental screenings and well child visits alongside fun activities and a picture with the Jolly Old Elf himself. The popular SALT (Seasoned Adults Living Triumphantly) program meets the first Tuesday of each month and combines recreational and educational activities for seniors. Similar to the innate recognition of the importance social determinants play on health outcomes, Beard said community health centers were inherently built around the concepts of patient-

centered care and a primary care medical home. “We’ve always worked inside that frame. We’ve always had the patient at the center.” At times, however, Matthew Walker and other health centers have been forced to make tough financial choices. “It costs money for everything we do, and we work for a population with few resources,” explained Beard. “The lean days were when we had to start to eliminate services,” she added of a period earlier this decade. Interestingly, she noted, the Affordable Care Act impacted volumes as enrollees were signing up for coverage before contracts were completed with MWCHC. After a few tough years, MWCHC is again on solid ground under Beard’s leadership. She has spent almost the entirety of her career at Matthew Walker, beginning as an intern during undergrad and going full-time after finishing her master’s in public health. Taking on increasing responsibility over the past two decades, Beard was named to the top post in 2015. “My vision is we’re a trusted source of care in the communities we serve,” she said. “We want to be a source of care for individuals regardless of their income or insurance status.” She added that increasingly means caring for those with coverage drawn to the quality and convenience of having coordinated care under one roof. Reflecting on Matthew Walker’s 50-year history, she noted, “The affinity people have in their hearts for the health center has been amazing to me. There’s a heartfelt appreciation for how the health center has served this community.” Beard concluded, “I’m really grateful to be here at this time in this season of growth and prosperity and being able to serve in the way we want to serve. It’s just a really good time right now.”



A Servant’s Heart

Nursing on the Front Lines of Public Health By CINDY SANDERS

Without fail, nurses and nursing students from across Middle Tennessee health systems, practices and educational institutions have stepped up when called upon to lend their expertise and skills to help those in need here at home, across the country in the wake of national disasters, and on a global scale. These selfless nurses are joined in their generosity by the area’s full complement of physicians and other healthcare professionals who personify Tennessee’s reputation as the Volunteer State. Recently, Nashville Medical News had the opportunity to chat with one of the region’s longstanding community outreach leaders – Saint Thomas Health Chief Advocacy Officer Nancy Anness, MSN, APN, FNP-BC – about the call to serve and ongoing need. Long before Anness and Saint Thomas Chief Strategy Officer Amber Sims were in their current senior leadership roles, the duo launched the Day of Hope, Health Nancy Anness & Healing as their pilot project for Saint Thomas Health’s Formation for Catholic Healthcare Ministry Leadership program. In the decade since, the event has grown to offer a more comprehensive set of services to the uninsured and underinsured in Middle Tennessee and has now spread throughout Ascension, reaching a national audience. “All of the folks that participate volunteer to be there,” Anness said of the program’s growth, adding it takes a wide array of both clinical and non-clinical professionals to pull off the large events. “Of all the volunteers, hundreds and hundreds of nurse volunteers are at every medical mission we have, whether it be in Nashville or in one of our rural locations.” While the first medical mission was held at Holy Name Catholic Church, the event quickly outgrew the space and now takes place at Nashville Municipal Auditorium. “We’ve had over 20,000 patient encounters for Middle Tennesseans and their families,” Anness added. The need locally for such care is certainly mirrored in other communities. Anness said similar medical missions have been held in Rutherford, Hickman, and Warren counties. While Saint Thomas Health doesn’t have clinics in Grundy County, the team felt called to host a mission there. Grundy County ranks at the bottom of health outcomes in Tennessee and has no hospital within the county borders. “Without even having a presence there, over 350 people showed up,” Anness marveled at the number of uninsured and underinsured who gathered at the local high school for help with everything from vision screenings and dental work (organized by Hope Smiles of Nashville) to well checks, labs and mammography. nashvillemedicalnews

Although the Day of Hope, Health & Healing events gather large teams of volunteers and are often accompanied by press coverage, Anness said that same missional spirit is routinely found in nurses working across the city. “We have eight community health centers now that serve predominantly the poor, the uninsured, and the underinsured throughout Middle Tennessee,” she noted. “Many of those are staffed with nurse practitioners.” Anness added nurse practitioners have

the ability to fulfill the vision of Loretta Ford, EdD, RN, PNP, FAAN, FAANP, who co-founded the first nurse practitioner program with Henry Silver, MD, at the University of Colorado in 1965. “When the role was created in the 1960s, it was really created around going to areas of great need,” she said of staffing rural and isolated areas where there often wasn’t a physician and later addressing medical manpower shortages in urban areas. “Nurse practitioners and nurses have really filled the gap …

particularly where there have been areas of need … throughout our history and throughout the country.” Anness said there are plenty of care gaps to fill today … from at-risk schools and public housing communities to rural and isolated areas to homeless outreach. “Of all the places no one wants to go, I see nurses filling those gaps time after time after time,” she said. “Once they know there’s a need there, I see nurses pick up and be willing to go and to serve.”

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Publisher’s Note: Nashville Medical News is honored to serve as media sponsor for the annual March of Dimes Nurse of the Year Awards. We salute the winners and all the nominees for their dedication in caring for our community. Now in it’s eighth year, the March of Dimes Nurse of the Year Awards recently honored 17 outstanding leaders who embody compassion and professional excellence across 16 categories of nursing specialties and education. “These nurses are very deserving of this honor, and we are pleased to play a role in saluting these patient champions for the care they provide daily,” said Community Health Systems Senior Vice President and Chief Nursing Officer Pam Rudisill, DNP, RN, MSN, NEA-BC, FAAN, who served as the 2017 Nurse of the Year event chairperson. March of Dimes hosts Nurse of the Year events throughout the country to recognize nurses who live out the organization’s vision for a healthier, stronger generation of babies and families. In Middle Tennessee, more than 110 highly accomplished nursing professionals were nominated for the 2017 awards. A distinguished committee of nursing professionals selected the 17 honorees through a structured screening and review process, which culminated in a gala luncheon held at Belmont University’s Maddox Grand Atrium. More than 15 organizations helped sponsor the November event, and Nashville Medical News served as a media sponsor for the fifth year. Continuing tradition, WSMV News Channel 4 meteorologist Dan Thomas emceed the awards program.

More than 110 Middle Tennessee nurses were nominated for the annual March of Dimes Nurse of the Year awards. A total of 17 honorees were chosen in 16 categories.

March of Dimes Honors Outstanding Middle Tennessee Nurses at Annual Gala ADULT CRITICAL CARE Mary Shea, RN HCA/TriStar Centennial Medical Center Described as a “champion of growth in shared governance,” Shea has stepped up as a leader at her facility with her ability to provide outstanding

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hands-on clinical care and willingness to serve in organizational roles to improve the delivery and quality of care to enhance outcomes. She serves as chair of the unit-based council for the Medical/Surgical Intensive Care Unit, as well as chair of the Critical Care Council. In addition to giving her time at work, she also donates her personal time working toward improved care for patients.


Vanderbilt University Medical Center Wilson-Liverman is director of the Division of Midwifery and Advanced Practice (MWAP) and an associate professor in the Department of OB/GYN. A certified nurse midwife since 1999, she joined the faculty at Vanderbilt in 2007. Her research interests include midwives in residency education and midwife-led obstetric triage units. She developed and instituted a prenatal care clinic for patients who have fetuses diagnosed with anomalies to provide continuity of care and normalization of pregnancy. She also expanded the Maternal Special Care Unit to provide around the clock coverage by MWAP faculty to improve access and decrease length of stay and costs for the triage visits.

Jennifer Wilbeck, DNP, APRN, FAANP

settings. She pioneered Emergency Nurse Practitioner (ENP) education nationally and has led the specialty at Vanderbilt since its inception in 2006, which was the first dual ACNP/ FNP program in the country to train students specifically for sub-specialty practice in the emergency department. In addition to maintaining a clinical practice, Wilbeck has lectured nationally, been engaged in scholarly interests including the role of simulation in nurse practitioner training and served as a mentor for many students. She was also the founding board chair for the American Academy of Emergency Nurse Practitioners.


Mental Health Cooperative Shoemaker has a clear passion for helping others. Her work in behavioral health often leads her to some of the area’s most vulnerable patients who feel hopeless before being introduced to proper treatment. While she has witnessed great despair, Shoemaker said there is also great joy in the journey to recover hope. “Outpatient behavioral health is so rewarding. I absolutely love watching the progression of someone with mental illness as they begin to think past the basic necessities of life and thrive into leadership of their own lives,” she said.


Vanderbilt University School of Nursing

Wyatt King, RN

Certified as an acute care, family and emergency nurse practitioner, Wilbeck has more than 17 years of practice experience in both rural and urban emergency department

Calm in chaotic situations, King’s professionalism and skills are routinely on display in scenarios where minutes matter. For stroke patients, starting evidence-based care




as quickly as possible has long-lasting consequences on outcomes. King has been instrumental in the development and implementation of stroke care in the Emergency Department and in reaching the community to rapidly recognize the signs of stroke. Considering it an honor to be a nurse in the emergency setting, he noted, “I have had the great opportunity to be a part of many people’s lives in their worst times.”

GENERAL MEDICAL Eliza (Annie) Greer, RN

HCA/TriStar Skyline Medical Center As a nurse, Greer has said she is most proud of actions that have made the trials of her patients’ lives a little easier to bear. Her focus is firmly on quality to ensure the best possible outcomes are reached. Greer’s nominator described her as “an awesome nurse who has so much love and compassion towards her patients.”


Monroe Carell Jr. Children’s Hospital at Vanderbilt Abbu serves as a role model for other nurses in continuing education and improvement of professional practice. Over the past 12 years, she has proudly served patients and their families as a bedside nurse, manager and now as clinical business coordinator for Neonatal Services at Monroe Carell. She said, “I realize that no mater my role, I have an obligation to improve care and to uphold professional practice.” Abbu completed her Doctor of Nursing Practice degree last month. “My focus as a future DNP leader is on the benefits of nurse mentoring, its impact on all levels of professional practice, retention, and patient outcomes,” she added.


Vanderbilt University Medical Center A nationally listed End of Life Nursing Education Consortium (ELNEC) trainer in pediatrics, Havrilla has focused much of her work on facilitating workshops in caring for the perinatal/neonatal populations. She has also participated in presentations on cultural considerations at the end of life in the NICU. “The care we provide our families at the end of life is never easy,” she has said, “but being able to walk beside them through this journey and to make a difference in patients’ lives and the lives of their families is worth it.” nashvillemedicalnews


MANAGED CARE James Stritzinger, RN Amerigroup Stritzinger works tirelessly to assist medically underserved families through positive leadership and effective case management. A pediatric case manager with Amerigroup since 2015, he helps families with fragile children in a variety of roles ranging from education to care coordination to full case management.


HCA/TriStar Skyline Medical Center The director of Critical Care Services, Lunger strives to build highly skilled, competent clinical teams to ensure safe, effective, compassionate care is delivered with every patient encounter. An avid believer in the importance of patient-caregiver communication, she as been described as “always approaching patients, families and staff with compassion, patience and a truly caring heart.” In addition to her work on behalf of patients, Lunger also advocates on behalf of nurses in the unit to promote the delivery of quality care in a safe, effective work environment.

NURSING EDUCATION Beth Fentress Hallmark, PhD, CHSE Belmont University Gordon E. Inman College of Health Sciences & Nursing

As a certified simulation educator and director of simulation for Belmont’s College of Health Sciences, Hallmark has actively disseminated findings associated with simulation-based teaching and learning in nursing and through interprofessional collaborations with other disciplines. She also serves on the editorial board for Lippincott DocuCare electronic health record, regularly mentors junior faculty with regard to nursing pedagogy, scholarship and publication. Hallmark’s nominator described her as an individual of “integrity, creativity and intellect who is a nationally recognized professional role model dedicated to notable standards of excellence.”


Monroe Carell Jr. Children’s Hospital at Vanderbilt Sparta has served as a preceptor and mentor to new nurses, teaching them to admit and care for micro preemies in Vanderbilt Children’s NICU. She has also

oriented new shift leaders and helped support them in their critical role. With 32 years of experience as a bedside and charge nurse, Sparta brings a sense of calmness and professionalism as she manages high-risk deliveries to the benefit of both her tiny patients and their anxious parents.

research and pilot project combines pediatric oncology and animal-assisted therapy to enhance treatment and increase comfort.


Lipscomb University School of Nursing

Patricia Detzel, MSN, CNM

Vanderbilt University Medical Center Working as a sexual assault nurse examiner (SANE) as a nurse clinical preceptor, Detzel is helping develop a new SANE program to bring comfort and care to victims at one of the most traumatic times of their lives. Passionate about her field, she often gives presentations to educate other nurses and help them to develop the necessary skills to function effectively in sexual assault examinations. A certified nurse midwife, Detzel also serves as an assistant professor for Clinical Obstetrics and Gynecology and sees patients for a range of health issues through the Vanderbilt Center for Women’s Health


Monroe Carell Jr. Children’s Hospital at Vanderbilt Continually improving quality is of the utmost importance to Pugh. She works to support bedside nurses on their quality projects and provides them with the resources to foster success. Additionally, Pugh led a multidisciplinary task force that included nurses, physicians, case workers and administrators to implement cue-based feeding in the NICU. She also implemented PART – Pediatric Assessment and Response Team – using simulations to allow nurses to practice code situations in the NICU.

RESEARCH Mary Jo Gilmer, PhD, MBA, RN-BC, FAAN Vanderbilt University School of Nursing

Gilmer has made significant contributions to advance the state of science in pediatric palliative care. She has spent years in active clinical care and research with families and children facing life-limiting conditions. Her contributions include research with the bereaved after a child’s death, which has led to an increased understanding of the multiple responses and adjustment over time in the face of loss. Widely published, her most recent


Now in her senior year, Mannel is described as a true team player by faculty. She’s always willing to lend a hand to help staff and her fellow students. Mannel is well prepared in both the classroom and clinical setting to care for patients and is engaging with patients and their family members. She also demonstrates the professionalism and compassion throughout her interactions that are the hallmark of a good nurse.


Vanderbilt University School of Nursing Moore has a special interest in underserved populations and caring for the special needs of women. She has taught for more than 25 years at Vanderbilt University School of Nursing (VUSN) while practicing in a diverse number of settings that include family planning, sexual assault examination, private practice and communitybased healthcare clinics. In 2015, she was named director of the Women’s Health Nurse Practitioner Specialty Program at VUSN and is active in clinical scholarship, examining strategies to improve and promote effective patient care and communication. Additionally, Moore is the author of several articles on women’s health topics.

January Online Bonus Editorial Go online to NashvilleMedical for additional January news, including: Extended edition of “The Impact of Behavior on Health Status in Tennessee” with additional graphics and state-specific information from the latest “America’s Health Rankings” report. “Reducing Risk by Rethinking Weight,” which explores the link between obesity and cancer with insights from experts at the American Institute for Cancer Research. A recent Gallup poll reconfirms “Americans Love Nurses” as the profession takes the top spot for honesty and high ethical standards. More Grand Rounds




Actively Retired: Catching up with Sharon Adkins Sometimes, you just know when it’s time. Such was the case for Sharon Adkins, MSN, RN, who retired from her role as executive director of the Tennessee Nurses Association Sept. 29. “One of my goals in taking the position was to build partnerships with entities like the Tennessee Hospital Association and patient advocacy groups, and we‘ve been able to do that,” said Adkins, who led the state nurses association for 11 years. “We have a really good staff and an excellent board, and it felt like I was leaving at a time when the organization was very strong and could continue to move forward. I didn’t feel like I was leaving anything undone.” While nursing is no longer a full-time job, Adkins is Sharon Adkins staying involved with the TNA through the Government Affairs Committee’s legislative and patient advocacy work. “I’m not giving that up at all,” Adkins said. “As a volunteer, I’m a TNA member, and I’m going to participate in that role.” Adkins added some of her greatest memories during her time with the TNA included speaking to nursing schools across the state, which helped give TNA a face to those unfamiliar with or new to the organization. For Adkins, retirement has been anything but slow. At 70 years young, she’s finding new ways to give back to her church and community, spending time with her growing family and discovering new interests. The matriarch to four children, nine grandchildren and five greatgrandchildren has been taking pottery classes and has converted her barn into a picturesque art studio situated on 20 wooded acres in rural Sumner County. “I decided that with most of my family in other states, I wanted more time with them,” Adkins said. “I wanted time to do all the things I haven’t had time to do. This is where my heart is.”

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TNA Names Tina Gerardi Executive Director By MELANIE KILGORE-HILL

Jan. 2 marked the first day on the job for Tina Gerardi, MS, RN, CAE, the newly appointed executive director of the Tennessee Nurses Association. Gerardi, who replaced the recently retired Sharon Adkins, brings three decades of experience in nursing advocacy at both state and national levels to her Tina Gerardi new role. After earning a bachelor’s degree in nursing with a concentration in community health from the State University of New York at Plattsburgh College, the New York native worked eight years as a staff nurse and assistant nurse manager at Albany Medical Center. She went on to receive her master’s in nursing from SUNY Binghamton, graduating as a dual major with a family nurse practitioner certificate and as a clinical nurse specialist with a concentration in education. Gerardi worked as a clinical nurse specialist and risk management clinical director before serving as director of clinical support services and quality improvement at Saratoga Community Hospital. She discovered a passion for advocacy as director of clinical consulting at the Healthcare Association of New York State, which led to an appointment as deputy directory and eventually CEO of the New York State Nurses Association. She spent the last several years working for the Tri-Council for Nursing – an alliance of four autonomous nursing organizations including the American Nurses Association (ANA) and the American Organization of Nurse Executives (AONE) – in a grantfunded role related to academic progression. Gerardi said the TNA position was an opportunity to get back into directly supporting her fellow nurses. “Tennessee is now undertaking efforts that New York has already done, so I’ll be able to bring some of that experience and help move the profession forward in that way,” Gerardi said. “It was very enticing to have the opportunity to get back into the ANA family, which I really missed over the last four years.” Gerardi looks forward to embarking on clearly defined goals for the TNA. “I know there’s a two-year moratorium on new legislation, so I want to look at language for APRNs in Tennessee and work on expanding their scope of practice,” she said. “I also want to look at the different chapters throughout the state and work on bringing the whole organization together, since a more symbiotic relationship around advocacy and legislative work will help advance the profession.” She also is gearing up to tackle industry-wide challenges like reimbursement cuts, which affect every facet of nursing. “The healthcare system has been in chaos for several years, and it really affects every budget for every facility,” she said. “It affects

nursing staff and the ability to provide for patients the way they want to. “Advocacy on behalf of patients and access to quality patient care will continue to be a huge part of what we do as a profession, and bedside nurses do that every single day. Nursing is the most trusted profession, so we have to keep hammering that home with lawmakers. We know what’s best for patients, and they need to listen to us,” she stated. While she still misses patient care, Gerardi said the decision to pursue association work has been a rewarding one. “I was having a hard time when I was making that decision, but I knew I could make a difference,” she said. “My mentor told me the profession is now my patient and that helped ground me. Advancing the profession is my new role, and I’ve embraced that.”


PUBLISHED BY: Graham | Sanders Publishing, LLC PUBLISHERS Susan Graham & Cindy Sanders SALES 615.397.2836 Cindy Sanders Maggie Bond, Pam Harris, Jennifer Trsinar MANAGING EDITOR Cindy Sanders CREATIVE DIRECTOR Susan Graham CONTRIBUTING WRITERS Lucy Carter, Melanie Kilgore-Hill, Cindy Sanders CIRCULATION —— All editorial submissions and press releases should be emailed to: —— Subscription requests or address changes should be mailed to: Nashville Medical News 105 Spring Ridge Lane Nashville, TN 37221 615.646.3916 • (FAX) 615.673.8819 or e-mailed to: Nashville Medical News is published monthly by Graham | Sanders Publishing, LLC. All rights reserved. Reproduction in whole or in part without written permission is prohibited. Nashville Medical News will assume no responsibilities for unsolicited materials.        All letters sent to Nashville Medical News will be considered the newspaper’s property and therefore unconditionally assigned to Nashville Medical News for publication and copyright purposes. @NashMedNews



Mark Your Calendar NMGMA Not-to-Miss Meetings Those with careers in healthcare administration know there is always more work than hours in the day. It’s easy to feel overscheduled and constantly short on time. But sometimes, the best thing you can do is to make time for another meeting … particularly the ones geared to helping you work more efficiently and keeping you compliant. A monthly investment of a couple of hours can pay big dividends throughout the year. The Nashville Medical Group Management Association focuses on improving the effectiveness of medical group practices through education and skills development for practice managers. NMGMA meets the second Tuesday of each month from 11:30 am-1 pm. The new meeting location for 2018 is at Saint Thomas West Hospital at 4220 Harding Road. From the free visitor parking in the Seton Garage, take the elevator to the D level and enter the hospital via the skywalk. Turn right into the hall marked “Conference Rooms.” To register, go to Upcoming Topics: Tuesday, Jan. 9, “Coaching through Change” by Melanie Adams, executive director with the Center for Executive Education at Belmont University; Tuesday, Feb. 13, “Best Practices of the Hiring Process” by James Fields, owner and president of Concept Technology. Interested in learning more? Practice managers can email NMGMA President Joy Testa at to register for their first NMGMA meeting as a guest.

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Blog Log The Nashville Medical News Blog features additional insights and information from a cross-section of industry leaders. The blog can be accessed directly through NashvilleMedicalNews.Blog or from the homepage of the main website. NEW IN JANUARY: Todd Rubin, MD, a fellowshiptrained orthopaedic surgeon with Hughston Clinic Orthopaedics in Nashville, discusses tips to share with patients to help them maximize bone health and manage arthritis, particularly during these cold winter months.



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Tax Reform is Here … Proceed with Caution The Tax Cuts and Jobs Act (TCJA) has officially been passed and signed into law. While the TCJA was touted as a simplification of the tax code, it inherently contains many complexities. To start, the conference report itself is 1,097 pages long. The report lists the changes By LUCY CARTER that were passed related to the tax law, but it doesn’t give much detail surrounding those changes. It is likely that clarification will be provided throughout 2018 and in future years. But … understandably … people want to know how it will affect them and their businesses sooner rather than later.

The Basics for Individuals

Rates are going down across the board for individuals, and standard deduction amounts are increasing. The deduction for miscellaneous expenses (including unreimbursed business expenses, professional fees, and investment fees) is going away. Likewise, the deduction for personal exemptions will not be available after 2017. Beginning in 2018, the deduction for sales tax will be included in the total deduction for sales and local taxes and property taxes, but it is capped at $10,000 per year.

The Basics for Businesses

Business tax rates were reduced. The federal tax rate for C-corporations was reduced to 21 percent (previously 35 percent for personal service corporations) beginning Jan. 1, 2018. But before you rush out to incorporate, keep in mind that this rate applies to income retained in the

corporation. C-corps are not pass-through entities so if you take cash from the C-corp in the form of salary (deductible to the corporation, taxable to the individual), you negate the benefit of the low corporate bracket. Of course, another way to take cash from your corporation is in the form of dividends (not deductible to the corporation), which allow you to take advantage of the 21 percent rate at the corporate level. But when you combine that with the capital gains rate that you will pay on the dividends personally, you are back to a combined rate of as much as 41 percent (combined corporate and individual). Much discussion has centered around the impact of tax reform on pass-through entities. Whereas the House proposal called for a flat tax rate for pass-through business income, the final bill provides for a 20 percent deduction of “combined qualified business income” – a compli-

cated calculation. The most important takeaway is the fact that, for the most part, the deduction will not apply to specified service income (i.e., personal service income from a medical practice).

James McIntyre, PhD, research professor of Radiology and Radiological Sciences at Vanderbilt, has received a METAvivor grant for his research: “A Novel Self-Reporting Paclitaxel Prodrug without Systemic Neurotoxicity: Preclinical Assessment for Targeted Treatment of Metastatic Breast Cancer.“ METAvivor is a non-profit organization dedicatd to funding research for Stage IV metastatic breast cancer. The Community Foundation of Middle Tennessee awarded Saint Thomas River Park Hospital a grant to launch a breastfeeding education program in the hospital’s Family Birth Unit. This past fall, IQuity became one of the first recipients of the  SBIR/STTR Matching Fund Grants Program, which is administered by LaunchTN and funded by the state’s Department of Economic and Community Development. The funding will be used to further IQuity’s ongoing analysis of the gene expression data in long non-coding RNAs (lncRNA) and the utility of lncRNA’s ability to detect and monitor autoimmune diseases and related conditions.

care. He is an associate of Tennessee Oncology, PLLC, where he practices medical oncology. In other ASCO news, W. Kimryn Rathmell, MD, PhD, Cornelius A. Craig Professor of Medicine and director of the Division of Hematology and Oncology at Vanderbilt University Medical Center, has been elected to a three-year term on the ACCO Nominating Committee. Leadership Health Care (LHC), an initiative of the Nashville Health Care Council to nurture the talent of Nashville’s emerging health care leaders, recently announced its 2017 award winners. Jessica Harthcock, CEO and founder of Utilize Health, was named the Health Care Emerging Leader of the Year, Stephen Smith, program manager, Meharry Medical College, received the Ambassador of the Year award, and Kraft Healthcare Consulting was named the Supporting Organization of the Year for its ongoing commitment to LHC and enriching the next generation of healthcare industry leaders. The Middle Tennessee chapter of the American College of Healthcare Executives recently announced the 2018 Board of Directors and officers. Immediate Past President: Charlotte Burns, FACHE, HCA TriStar Health Division; President: Trent Beach, PharmD, FACHE, CHSPSC LLC; President-Elect: Anna Pannier, FACHE, Ascension Information Services; Vice President: Dan Ryan, Ryan Search & Consulting; Secretary: Peter Harmon, HCA; and Treasurer: Laurie Babin, FACHE, nThrive. The full list of the board and committee chairs is available online. Belmont University’s Simulation Program recently received full accreditation in the Teaching/Education Area from the Society for Simulation in Healthcare (SSIH) and the Council for Accreditation of Healthcare Simulation Programs.

What’s Next?

With the bill newly passed, there are more questions than answers at this point. Unfortunately, in the midst of all of the news about the tax law, there is also plenty of misinformation circulating. More clarification will come about as the dust settles. But the best advice for 2018 is to proceed with caution – and contact your tax advisor before you make any changes. Lucy Carter, CPA, is a member (owner) in KraftCPAs PLLC and practice leader of the firm’s healthcare industry team. Contact her via email at For more information, visit healthcare.htm.

GRAND ROUNDS Belmont Nursing Celebrates 45 Years Belmont’s School of Nursing (SON) recently celebrated its 45th year with a continuing educating presentation and luncheon that welcomed alumni from every decade of the school’s history. In addition, several updates to the program were announced including implementation of a new concept-based curriculum specially designed by SON faculty to promote critical thinking, compassionate care and essential skills needed in the workplace of the future.

Wishes Granted

Lipscomb University’s Clinical Mental Health Counseling Program has been awarded a $1.8 million grant to improve mental health services in Nashville by training the behavioral health and education workforce for an integrated approach to meeting mental health needs. The HRSA grant is the largest awarded by any organization to Lipscomb in the university’s history. The funding will be used to address the

unmet mental health needs among the medically underserved populations in the city with a particular emphasis on advancing services available to immigrant populations and residents whose primary language is not English. March of Dimes recently announced a $60,870 grant from Amerigroup Foundation to help prevent premature birth and improve the health of moms and babies through efforts to curb smoking in Tennessee, which ranks among the top states in the nation with the highest prevalence of pregnant smokers. The  funding will expand the reach of smoking cessation programming across the state.  Vanderbilt-Ingram Cancer Center has received $2.3 million to fund a clinical research trial testing a combination of three immunotherapy compounds for patients with a specific type of advanced breast cancer. The trial for patients with estrogen receptor-positive (ER+) metastatic breast cancer is one of 10 projects launched by the nonprofit Stand Up To Cancer (SU2C)

Women 20 18 TO WATC H

NOMINATIONS ARE NOW OPEN To nominate, please visit and click the Women to Watch icon. Nomination Deadline: Feb. 15, 2018 Presenting Sponsor: Life Credit Union Gold Sponsors: KraftCPAs & Nashville Health Care Council

Let’s Give Them Something to Talk About! Awards, Honors, Achievements

Howard A. “Skip” Burris III, MD, FACP, FASCO, has been elected to serve as president of the American Society of Clinical Oncology (ASCO) for the term beginning in June 2019. He will take office as president-elect during the ASCO Annual Meeting in Chicago in June 2018. An active ASCO Dr. Skip Burris III member since 1991, Dr. Burris is president of clinical operations and chief medical officer for Sarah Cannon, the Cancer Institute of HCA Health-

January 2018 NMN  
January 2018 NMN  

Nashville Medical News January 2018