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PhysicianSpotlight

Meet the Medical Director at Pathways

Dr. Kevin Turner retires from state and takes medical director position with West Tennessee Healthcare By SUZANNE BOYD

As a social butterfly who enjoyed biology, medicine seemed to be a perfect match for Kevin Turner, MD. In his third year of medical school, he discovered psychiatry was where he felt he could do the most good. After 20 years working in a state institution, Turner is now turning to administration as medical director for Pathways Behavioral Health Services in Jackson, Tennessee. Growing up in Chicago, Turner knew he enjoyed working with people and it was while he was pursuing a degree in biology at Illinois Benedictine University that he decided medicine may be the route he wanted to take. “I enjoy talking with people and am a very social person,” said Turner. “Several of my friends were pre-med students and in talking to them, it peaked my interest. I did some graduate work in biology at Southern Illinois University before I began medical school there.” As Turner entered medical school, he envisioned himself having a Marcus Welby family physician type of life. That picture changed in his third-year rotations when he was exposed to psychiatry. “When I was doing my rotation, psychiatry was entering a very exciting time as new medications were being introduced that were very effective in treatment,” said Turner. “There were some big advances in medications at that time, such as Prozac. It really amazed me how well people responded to treatment and the difference medications could make in people with psychiatric disorders. I was very impressed.” After completing his first year of psychiatric residency at Rush Presbyterian Hospital in Chicago, Turner transferred to the University of Southern California for the remaining three years of his residency. “I really wanted to focus on psycho pharmacology and the program at Southern Cal was one of the top in the country for that,” he said. “It was what had really attracted me to psychiatry and I wanted to have the best training possible. At the time, they were ahead of the curve from other programs for using medicines to treat various psychiatric conditions.” To pay for his medical education, Turner utilized a public health scholarship which meant he would be obligated to practice in an area that was determined to have a medical shortage once he completed his training. After residency, he moved to Middle Tennessee to practice in McMinnville, a town of around 14,000. When the state made changes to westtnmedicalnews

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its TennCare program that were unfavorable to private practice, Turner went to work for the state of Tennessee at Western Mental Health Institute in Bolivar. Initially, the facility had 500 beds but when the state changed the focus of the mental health system to long-term care, patients and the facility became a 150bed institution. “The state reorganized the mental health system about ten years ago, and state hospitals started only treating severe cases, such as forensic or court committed patients, that could not be managed in other facilities such as Pathways,” said Turner. “I was the attending psychiatrist for patients on the two longterm units which had about 25 patients each and was responsible for managing their medications as well as making reports to the courts on patients’ status when needed.” In June 2017, Turner retired from the state after 20 years of service. In July, he was named medical director for Pathways Behavioral Health Services in Jackson. “My wife and I had lived in Jackson for about 13 years so our kids could go to school here,” said Turner. “I had also been moonlighting at Pathways for the past couple of years. I mainly provided off-hours coverage for them when they needed to admit a patient or if a problem arose on the inpatient unit that needed to be addressed by a physician. That experience allowed me to not only meet a lot of people that work there but it also gave me a sense of what was going on there. It was a good opportunity for me once I retired from the state. While I prefer the clinical side, I was at a point in my career that I was interested in the administrative side and wanted to develop that.” Pathways has a 28-bed inpatient unit in addition to outpatient clinics. Turner’s

President Trump Turns to Executive Orders to Reform Healthcare and Stocks Plummet By Denise Burke After repeated failures to repeal and replace the Affordable Care Act (ACA), President Trump took matters into his own hands and started issuing Executive Orders. On October 12, 2017, President Trump released his “Executive Order Promoting Healthcare Choice and Competition Across the United States.” The Order directed agencies to take action to: • allow small businesses to pool together to purchase health insurance, • permit short-term, limited-duration insurance policies to cover 12 months (currently limited to three months), and • expand access to employer-funded Health Saving Accounts. Later the same day, the President announced that the Administration would stop funding cost-sharing reductions available on the ACA Health Insurance Marketplaces until Congress appropriates the funding to cover the subsidies. The ACA, as enacted, requires insurers to offer plans with reduced co-pays and deductibles for persons with very low-incomes, but the ACA does not appropriate the cost-sharing subsidies to pay for the subsidies. Without Congressional authority, and thus, the legal authority to do so, President Obama agreed to pay costsharing subsidies, an action he believed necessary to entice insurers to enter the Marketplace. Ironically, President Obama’s prior actions that exceeded executive authority allowed President Trump to “undo” the action critical to the ACA without Congressional approval. Proponents of the Executive Orders claim that they are aimed at increasing competition in the healthcare marketplace, while critics claim their sole purpose is to undermine “ObamaCare.” Regardless of the intent, the President’s actions had immediate impact on the healthcare and healthcare insurance markets. While provider stock prices fell slightly, healthcare insurers were battered by the news. Centene, which provides services to government-sponsored healthcare programs, lost nearly 6%, managed care company Molina Healthcare lost more than 4% and Anthem was down nearly 3%. The day after signing the Order, the President tweeted “Health Insurance stocks, which have gone through the roof during the ObamaCare years, plunged yesterday after I ended their Dems windfall!” This is a classic case where two wrongs (and a tweet), don’t make a right. Healthcare is too important to individual well-being and the national economy, to be rewritten by each new President without Congressional approval. Healthcare providers and the healthcare insurance markets are complex industries that require significant lead time to adjust to change. Chaotic change unnecessarily stresses the nation’s healthcare system. Bipartisan efforts to stabilize the ACA in a less chaotic manner have been quietly under way since the last failed Republican attempt at full-scale repeal and replace (prior to the executive actions). Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) are sponsoring the Bipartisan Health Care The Author: Stabilization Act of 2017 that would: • make cost-sharing reductions available in the healthcare marketplace to individuals with incomes within 100-250% of the federal poverty level through 2019, • make catastrophic health plans available to everyone (currently only available to persons less than age 30 or individuals with financial hardships), • fund ACA assistance and enrollment programs, which have been faced with budgets cuts, andincentivize states to create innovative ways to improve healthcare. Denise Burke The bill language and a section-by-section summary can be found at www.help.senate.gov/download/bipar-stabilization-section-by-section. A possible second bill has been announced by Sen. Orrin Hatch (R-UT) and Rep. Kevin Brady (R-TX and Chair of the HouseWays and Means Committee). This bill would: • continue funding for cost-sharing reductions for until 2019 (limited to policies that don’t cover abortion), • provide limited relief from the individual mandate (through 2021) and employer shared responsibility mandate (retroactive to 2015), and • increase the contribution limits on health savings accounts. While the outlook for the healthcare industry is shrouded in uncertainty right now, the weeks and months ahead will almost assuredly be filled with new legislative proposals to modify the ACA in meaningful ways. There could even be some level of bipartisan cooperation moving forward but maybe it’s too early for Christmas wishes.

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