Leading Medicine Magazine, Vol. 4, No. 3, 2007

A PUBLICATION OF THE METHODIST HOSPITAL SYSTEM • VOLUME 4 • NUMBER 3 • 2007

Robotic technology: the doctor is in HPV: A PRIMER ELIMINATING ABNORMAL HEART RHYTHMS THE DANGERS OF SECONDHAND SMOKE YOUNG PHYSICIANS JOIN THE FAMILY BUSINESS

LEADING MEDICINE LEADING MEDICINE Volume 4, Number 3, 2007

R.G. GIROTTO President & CEO

MARC L. BOOM, MD

Contents

Executive Vice President

JOHN E. HAGALE, CPA Executive Vice President, CFO & Chief Administrative Officer

R AMON “MICK” CANTU, JD Senior Vice President & Chief Legal Counsel

H. DIRK SOSTMAN, MD Chief Medical Officer & Chief Academic Officer

MARK E. KIMBELL Senior Vice President & Executive Editor

ERIN SKELLEY Director of Marketing

EMMA V. CHAMBERS Managing Editor

DENNY ANGELLE STEFANIE ASIN DARLA BERRY MARY BROLLEY ERIN FAIRCHILD AMI FELKER SHESHE GIDDENS GEORGE KOVACIK GALE SMITH Contributing Writers

BRIDGETT AKIN / BRI DESIGN, INC. Design

FANTICH STUDIO Photography Leading Medicine is published by The Methodist Hospital System Corporate Communications Department for patients, physicians, employees and supporters. ©2007 The Methodist Hospital System All rights reserved. Materials may be reproduced with acknowledgement for noncommercial and educational purposes. Permission from the editor required for any other purpose.

Send address corrections and letters to Leading Medicine The Methodist Hospital System Corporate Communications 8060 El Rio Houston, Texas 77054 Tel: 713.790.3333 or esource@tmh.tmc.edu If you wish to cancel your free subscription to Leading Medicine magazine, contact us at 713.790.3333 or esource@tmh.tmc.edu.

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CEO MESSAGE...........................2

THE FAMILY BUSINESS Children follow in their parents’ footsteps and join the medical profession .......................................20

STRAIGHT AND TALL Minimally invasive procedure used to treat osteoporosis, spinal fractures and severe back pain ...........................................3 BUILDING A HEALTHY COMMUNITY Taking Strides4Stroke into the community........................................6 BREAKING GROUND Construction begins on the Research Institute facility .............8 FOUNDATION OF SUPPORT .......................................9 VISION LOSS Methodist leads clinical trials to treat wet age-related macular degeneration .................................10 WOW FACTOR Robotic technology gives doctors quicker access to patients.........13 THE GREATEST GIFT Studies show living kidney donations provide better survival rates..................................16

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TEE TIME Surgery allows golf pro to return to work and sport he loves ................................24 ABNORMAL HEART RHYTHMS Promising new therapy offers more effective treatment of atrial fibrillation...27 HPV A primer ..............................30 360-DEGREE VIEW High tech navigational tool increases precision and accuracy of complex surgeries .......................33 ACCOLADES .............................35 HEALTHY LIVING The dangers of secondhand smoke ...............36 COMMUNITY HOSPITALS Methodist Sugar Land Hospital first to offer heart surgery in Fort Bend County ..................................38 MY TURN Patient satisfaction..40

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A MESSAGE FROM THE CEO Dear Readers, Over the years, much has been written in this magazine about stroke and other neurological diseases. Our top-ranked neurology and neurosurgery departments care for patients with these debilitating diseases with the latest treatments and procedures. Not only are we dedicated to serving these patients, but we also are committed to raising awareness to try to prevent strokes from happening in the first place.

As you will read in this issue, Methodist has embarked on a five-year education campaign to raise awareness for stroke, the third leading cause of death in the United States. The initiative, Taking Strides4Stroke, is geared toward educating our community about stroke prevention and the signs and symptoms of stroke. A few months ago, we held our first Stride4Stroke 5K fun run and walk, attracting 2,000 participants and raising more than $400,000. This campaign is one of the many ways we, at Methodist, show our commitment to our community.

Our commitment, of course, starts with the quality care we provide our patients. Patients at the Eddy Scurlock Stroke Center at the Methodist Neurological Institute have some of the best stroke outcomes in the nation, according to the American Heart Association’s Get With The Guidelines, a quality improvement program for hospitals with stroke programs. They recently gave us an A+ on its report card for stroke care!

We also are very grateful for the support from the community. The Scurlock Foundation recently gave a $1 million gift to the Eddy Scurlock Stroke Center. This is in addition to the generous gift the foundation and the Jack Blanton family contributed a few years ago, bolstering our capabilities to offer the latest in stroke treatment, research and education.

Another way we lead is by being a compassionate and value-oriented employer. The Methodist Hospital System recently was selected by FORTUNE magazine as No. 9 in the country on its “100 Best Companies to Work For” list. This is a wonderful honor to be in the top 10 of this prestigious list, but more important, is what it says about our employees. Our employees are unmatched in their dedication to our patients, our values and to each other. They deserve this recognition and it makes me so proud to work alongside them.

Enjoy this issue of Leading Medicine and thank you for your friendship to The Methodist Hospital System.

OFFICERS OF THE METHODIST HOSPITAL SYSTEM BOARD OF DIRECTORS JOHN F. BOOKOUT Senior Chair

HON. EWING WERLEIN JR. Chair

ERNEST H. COCKRELL Vice Chair

DAVID M. UNDERWOOD Vice Chair

RONALD G. GIROTTO President & CEO

D. GIBSON WALTON Secretary

EMILY A. CROSSWELL Asst. Secretary

ROBERT K. MOSES Asst. Secretary

CARLTON E. BAUCUM Treasurer

JACK S. BLANTON Asst. Treasurer

BOARD OF DIRECTORS MORRIE K. ABRAMSON REV. DR. W. EARL BLEDSOE MARY A. DAFFIN CONNIE DYER GARY W. EDWARDS JAMES A. ELKINS III BISHOP JANICE RIGGLE HUIE ROBERT E. JACKSON, MD SANDRA SMITH JACKSON, RN, EDD VIDAL G. MARTINEZ GREGORY V. NELSON REV. DR. THOMAS PACE PLINY C. SMITH, MD JOSEPH C. (RUSTY) WALTER III STEPHEN P. WENDE, DD

ADVISORY MEMBERS REV. RICK GOODRICH WADE R. ROSENBERG, MD

R. G. Girotto President Chief Executive Officer The Methodist Hospital System 2 VOLUME 4, NUMBER 3

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Minimally invasive surgery turns back the clock on age-related vertebral problems Carmen Mottu

CARMEN MOTTU IS A BUSY WOMAN. SHE’S AN ACTIVE MEMBER OF THE RED HAT SOCIETY, a women’s organization whose members are identifiable by their red hats and purple attire. She loves to travel, visiting New York City for the first time last year, walking nonstop to places like the Empire State Building and Times Square. And she has 11 grandchildren who keep the 73 year old on the go.

Last year, Mottu would have told you a very different story. What she thought was a pinched nerve quickly developed into a pain so intense, she couldn’t drive over a bump in the road without crying out in pain.

BY GALE SMITH

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PHOTOS BY RICARDO MERENDONI

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STRAIGHT & TALL

Osteoporosis affects 44 million Americans and causes more than 700,000 vertebral compression fractures annually in the United States.

Normal

Fractured

Dr. Hani Haykal

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“IT WAS EXCRUCIATING,” said Mottu, who retired from Nabisco after 40 years. “I couldn’t even roll out of bed without crying, it hurt so bad.”

Initial X-rays showed a fracture in her vertebra. The diagnosis: osteoporosis — bone loss and softening of the bones, which can be caused by age, hormonal imbalances or diets deficient in calcium. Osteoporosis can result in one of the many sections of the spinal column weakening and fracturing, leading to severe pain, vertebral and hip fractures, and in some cases a severe hunchback.

Mottu’s primary care physician recommended she see Dr. Hani Haykal, director of neuroradiology at the Methodist Neurological Institute.

Haykal is an interventional neuroradiologist who specializes in spine treatments, particularly a procedure

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called kyphoplasty for vertebral fractures caused by osteoporosis.

“Osteoporosis, spinal fractures and severe back pain can all be treated using this procedure,” Haykal said. “Patients, especially women, need to understand that by age 50, a woman has a 40 percent chance of suffering an osteoporosis-related fracture in her lifetime. That’s right up there with the risk of breast, uterine and ovarian cancer combined.”

In May 2006, Haykal performed the minimally invasive procedure on Mottu. After administering local anesthesia and intravenous sedation to the patient, Haykal made two small incisions on each side of the fractured vertebra. He inserted two metal tubes — smaller than ordinary drinking straws — into the broken bone, then threaded a balloon-

tipped catheter through the tube and used the inflated balloon to restore the vertebra to its original shape and improve its alignment.

Finally, he removed the balloon and packed the vertebra with acrylic cement, a durable and permanent version of standard orthopedic cement. The procedure took a little more than an hour.

Mottu, who went home the next day, says she remembers a little soreness after the procedure but nothing compared to the pain she felt before.

Kyphoplasty lessens the acute pain and disability associated with vertebral compression fractures, as well as restores body height and shape. This procedure also may reduce the risk of experiencing another fracture.

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Vertebral Compression Fractures Treated with Kyphoplasty

The balloon is inserted into the fractured vertebral body via the tube. The balloon is inflated, reducing the fracture and elevating the endplates.

About 95 percent of Haykal’s patients report significant or total pain relief within a few days after the procedure. Even with this success, Haykal says many family physicians and patients do not know this treatment is available.

Aside from kyphoplasty, the standard medical treatment for osteoporosis-related pain is bed rest, narcotics or cumbersome braces.

According to Haykal, conventional therapies don’t always work, and bed rest can actually worsen bone loss. Narcotics can alter a person’s state of mind, and patients frequently dismiss braces as too difficult to use.

“Kyphoplasty works and it works well,” he said.

Osteoporosis affects 44 million Americans (women more than men), causes more than 700,000 vertebral WWW.METHODISTHEALTH.COM

compression fractures annually in the United States and accounts for $18 billion in annual health care costs.

Haykal is training fellow physicians in kyphoplasty because of the number of patients seeking help and because he wants more physicians to be informed about diagnosing and treating spinal fractures caused by osteoporosis. He also is researching other potential uses for the minimally invasive surgery, including use on patients with spinal fractures caused by certain types of cancers, like myelomas.

As for Mottu, she says, “I’m 73, but I tell my grandkids I feel like I’m 27.”

To learn more about kyphoplasty or to schedule an appointment, call 713.790.3333.

Once the vertebra is in the correct position, the balloon is deflated and withdrawn, leaving a cavity within the vertebra.

The cavity is filled with a special cement to support the surrounding bone and prevent further collapse. The cement forms an internal cast that holds the vertebra in place.

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Taking Strides4Stroke into the community B Y

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Jan Flewelling’s passion for teaching is readily apparent when she speaks to community groups, health care professionals or students about stroke.

Joan Censullo’s knack for numbers and statistics is evident when she discusses the devastating impact of stroke and the necessity of implementing a certified stroke program. Put the two women together, and you have a team so powerful, their efforts have become a key element of The Methodist Hospital System’s Taking Strides4Stroke: Community Awareness Campaign.

When it comes to stroke, The Methodist Hospital System is fighting this killer on multiple fronts. In addition to treating acute stroke patients, offering the latest in cutting-edge research and technology, and providing neuro-rehabilitation and physical therapy options, Methodist is now taking stroke education into the community.

“Stroke is highly preventable, but the key is catching the warning signs

S M I T H

early enough,” said Flewelling, stroke outreach coordinator at the Eddy Scurlock Stroke Center at the Methodist Neurological Institute (NI). “People need to know the symptoms for stroke and the critical need to seek immediate medical attention.”

Flewelling’s “stroke education road show,” as she likes to call her presentation, takes her to many different venues — Houston-area churches, fire stations, community hospitals, elementary schools, large corporate offices, as well as other organizations.

“Most people having a stroke don’t know what’s happening to them, and onlookers and family members don’t know what is happening either. We’re working to change that on a patient level and on a broader population level as well,” Flewelling said.

Stroke is the third leading cause of death and the number one cause of long-term disability in the United States.

Every 45 seconds someone in the

Jan Flewelling brings stroke awareness to members of the Christ Faith Church.

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United States has a stroke. Every three minutes, someone dies.

In Texas, the mortality rate for stroke is more than double the national average. In the greater Houston area alone, the stroke mortality rate quadruples the national average. Through Methodist’s fiveyear education campaign, the hospital system is taking these daunting statistics and transforming them into a teaching tool for the greater Houston community.

With the help of Censullo, stroke project specialist with the NI, Flewelling and other Methodist Stroke Center staff are reaching out to communities and their local hospitals, helping them develop stroke program infrastructures and stroke certification content.

“Texas is one of 10 states in the nation’s ‘stroke belt,’ which is where the highest incidence of stroke occurs in the United States,” Censullo said. “As one of 14 certified primary stroke centers in Texas and a comprehensive stroke facility, Methodist is fortunate to be able to offer patients a complete range of stroke care innovations.”

The Methodist Stroke Center was named a national primary stroke center by the Joint Commission on Accreditation of Healthcare Organizations in 2005. Methodist received this certification because of its exceptional efforts to foster better outcomes for stroke care.

Methodist’s Stroke Center offers 24/7 coverage and is the largest dedicated stroke unit in Texas with 18 beds. Under the leadership of Dr. David Chiu, the center’s medical director, a dedicated group of health care professionals covers all areas of stroke treatment, research — including diagnosis, innovative treatment, prevention, rehabilitation and recovery — and education.

“Beyond the scope of direct patient care capabilities, we also can offer our colleagues at other hospitals the tools to effectively care for patients in their own communities,” Censullo said.

Flewelling and Censullo have spent more than 36 years combined working with stroke patients and teaching others about stroke. Now, through Methodist’s stroke awareness campaign, they are able to work closely with academic, community and corporate partners to inform the public about stroke and how to identify and seek treatment for it. One by one, they are helping patients, caregivers and the public learn that stroke is no longer a death sentence.

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inutes matter when a person is having a stroke. Recognizing the signs of a stroke and acting quickly can mean the difference between life and death. “Leading Medicine,” a 30-minute television special produced by The Methodist Hospital, offers this lifesaving information.

To order your free DVD copy of this program that aired on KHOU-TV (Channel 11) this spring, call 713.790.3333.

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On March 24, the centerpiece of Methodist’s stroke education campaign unfolded in the form of the inaugural Stride4Stroke 5K Walk/Run at Rice University.

Houston Astros owner Drayton McLane served as honorary chair for the event, which attracted nearly 2,000 people and raised more than $400,000. Patient Bryan Norsworthy, who shared his stroke survival story with event participants, attributes his recovery to his mother’s knowledge of stroke symptoms and the immediate and effective treatment he received at Methodist’s Stroke Center.

Stride4Stroke is Houston’s only 5K dedicated to this debilitating disease. Funds raised are used by Methodist’s Eddy Scurlock Stroke Center in the Texas Medical Center, and for stroke-related activities at San Jacinto Methodist Hospital, Methodist Sugar Land Hospital and Methodist Willowbrook Hospital.

Visit www.methodisthealth.com/s4s.

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Breaking Ground to Further Medical Discovery

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ore than 250 dignitaries, community leaders and employees gathered on Jan. 31 to commemorate the breaking ground on The Methodist Hospital Research Institute facility. The 420,000-square-foot facility will face Bertner Avenue and will be attached to the Main Building of the hospital.

It will house approximately 90 principal investigators and the Methodist Institute for Technology, Innovation and Education (MITIE) — a first-of-its-kind training center in the United States. One of MITIE’s components will be a state-of-the-art surgical training and virtual hospital facility that will set standards for technical skill acquisition and demonstration of competency for primary and advanced training in multiple surgical disciplines.

Core laboratory facilities will enhance interdisciplinary studies, prepare new biological agents and small molecules for clinical trials, and contain advanced imaging equipment and a special lab for infectious disease research.

Goals

The New Building ❖ 420,000 gross square

feet ❖ 6 laboratory floors –

90 laboratory modules ❖ State-of-the-art

imaging facility (MRI, PET, etc.) ❖ Good Manufacturing

Processes (GMP) facility ❖ Surgical training and

virtual hospital facility

The Methodist Hospital Research Institute was initiated to develop better treatments and cures for patients in Houston and around the world. Its goal is to make the latest laboratory findings available to patients as rapidly as possible in the form of new treatments and clinical trials. The Research Institute is committed to moving the latest discoveries in the laboratory to the bedside in order to provide a new standard of care for its patients and those in other parts of the country. More than 650 active clinical trials and protocols currently are under way at the institute.

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A FOUNDATION OF SUPPORT

THE METHODIST NEUROLOGICAL INSTITUTE COMMUNITY COUNCIL MORRIE K. ABRAMSON

INCREASING COMMUNITY SUPPORT FOR THE METHODIST NEUROLOGICAL INSTITUTE

M. JOHN BAKER JR. JAMES R. BATH JACK S. BLANTON MEREDITH T. CULLEN GARY W. EDWARDS, COUNCIL CO-CHAIR JAMES A. ELKINS III THOMAS D. “DAN” FRIEDKIN KATHERINE “KATE” H. GIBSON MALCOLM GILLIS, PHD ROBERT H. GRAHAM LOLLIE L. JACK DANIEL R. JAPHET SR. DOROTHY C. JENKINS MARY F. JOHNSTON GREGORY A. KOZMETSKY BARBARA D. MACKEY ANNE K. MARTIN LEON M. PAYNE OMAR A. SAWAF ARTHUR A. SEELIGSON III DONNA S. STAHLHUT STUART W. STEDMAN HENRY J. N. TAUB II DAVID M. UNDERWOOD, COUNCIL CO-CHAIR ISABEL B. WILSON

EX-OFFICIO JOHN F. BOOKOUT RONALD G. GIROTTO

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early everyone knows someone who These physicians have assembled a cadre has suffered from stroke, Alzheimer’s, of neurologists and neurosurgeons, and neuro-specialist staff that offers the most comParkinson’s or epilepsy. The effects of prehensive services available for the diagnosis these debilitating neurological diseases touch and treatment of neurological diseases and millions of people every day — not only the conditions; and disorders of the brain and victims but their families and caregivers as well. spinal cord.

Neurological patients seek Nearly 900 supporters care at The Methodist he Neurological Institute’s have donated more than Hospital because of its tradition of medical excel$6.1 million to the NI, reputation for physicianlence would not be possible which includes three enscientists who are at the without the support of forwarddowed chairs in the past forefront of medical breakyear. This high-level phithroughs. U.S.News & World thinking individuals and organizalanthropy will continue Report consistently places tions that share Methodist’s to drive the NI’s future Methodist among the top 2010 Leading Medicine vision. growth and development.

10 neuroscience programs Major donors include: In 2006, The Methodist in the country, and one of Mr. and Mrs. Jack S. Blanton Sr. Hospital Foundation creonly three hospitals in Peggy and Gary Edwards ated the Methodist Neurothe entire South/Southwest The Hamill Foundation logical Institute Comregion ranked in the top 20.

The Curtis & Doris K. Hankamer munity Council, recruiting In 2004, Methodist estabFoundation a team of top community lished a fully integrated Houston Endowment Inc. leaders to help advocate neurological institute — Mr. and Mrs. Robert K. Moses Jr. for Methodist’s services; the first created in the Scurlock Foundation raise awareness of neuroregion since the 1960s, and Mr. and Mrs. Howard Sides logical diseases, prevenone of only four in North The Hon. and Mrs. tion and treatment; and America. The Methodist Ewing J. Werlein Jr. provide expertise in strateNeurological Institute (NI) The West Endowment gic planning. is comprised of the hospiThrough semi-annual tal’s neurology, neuromeetings, roundtable discussions and leadsurgery and neuroradiology departments; ership grand rounds at the hospital, the founand other neuro specialities. dation provides members with a way to learn The NI is led by Dr. Robert Grossman, this more about neurological diseases and how year’s recipient of the Cushing Medal — the Methodist is improving diagnosis, treatment highest honor bestowed by the American and patient care. This forum also allows Association of Neurological Surgeons and Dr. members to provide advice to help propel Stanley Appel, a neurologist and worldthe NI toward an unseen level of discovery renowned researcher in neurodegenerative and cure for neurological conditions. diseases.

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HON. EWING J. WERLEIN JR.

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New drug therapies show promise for treatment of macular degeneration IT CAUSES NO PAIN. Yet the leading cause of vision loss and blindness in those 65 and older in the United States — wet age-related macular degeneration (AMD) — robs people of their sight from the inside out.

Until recently, the disease, which often

While all cases begin as the dry form, wet AMD accounts for about 85 percent of all AMD-related blindness and can result in sudden and severe vision loss.

Wet AMD is caused by the growth of abnormal blood vessels that leak fluid and blood under the

AMD in the right eye, she agreed to join the Lucentis clinical trial.

Lucentis works by blocking new blood vessel growth and leakiness by binding and inhibiting VEGF-A, a protein that is believed to play a critical role in the formation of new blood vessels.

improved significantly — meaning improvement of three to four lines on a standard eye chart. Eight percent actually experienced a return to 20/20 vision.

This is unprecedented success in treating this increasingly common disease. The National Eye

appears suddenly, was difficult to treat. But the outlook has improved, thanks to Lucentis, a new drug approved recently by the Food and Drug Administration.

“It’s a devastating disease,”said Dr. David M. Brown, a retinal surgeon at The Methodist Hospital.

“Our research team has been working on AMD for a long time.” Clinical trials led by Brown found that Lucentis is very effective in treating wet AMD. There are two forms of AMD: dry and wet. The dry form refers to damage to the macula (central retina).

macula, causing scar tissue that destroys it.

Symptoms include blurred, gray or blank spots in the center of the visual field and distortion that makes edges or lines appear wavy.

“It happens so fast it’s unreal,” said Shirley Smith, who, in 2004, noticed a change overnight in the vision in her left eye. A retired office manager in her early 70s, Smith was treated with the best therapies available at the time, but she still lost 95 percent of the vision in that eye. When she began to have symptoms of wet

Before treatment, Smith’s vision was 20/200.

Within just four days of her first injection, she “started getting more light” into her eye. Now, with monthly Lucentis injections, her vision has stabilized at 20/60.

She calls it her “miracle drug.”

Smith’s experience is not unique. About 90 percent of patients in the trial who received monthly Lucentis injections experienced improved eyesight, and 40 percent of them

Institute estimates that there are 1.7 million Americans with the advanced form of AMD and that this prevalence will escalate to 2.95 million by 2020.

Dr. David M. Brown

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The FDA approval of Lucentis was based on data from two separate two-year Phase III clinical trials. Of the approximately 1,100 patients who participated in the trials worldwide, Brown and his colleagues enrolled the most patients. Data from several other studies also were included in the FDA submission.

Age-related macular degeneration affects the central part of a person’s vision — that which is crucial for performing daily activities like driving and reading; doing fine work like sewing or needlepoint; and even identifying the faces of loved ones.

Smith must use a magnifying glass to read or sew, but she is able to putter around in her garden — her “little piece of heaven” — daily. She estimates that she spends about three hours a day in her garden. “I’m an

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Shirley Smith calls Lucentis her “miracle drug.”

outdoor person. I thank God every morning that I can still see,” she said.

“The new treatment has done so much for my life.”

She cautions others not to ignore or accept the vision loss brought on by wet AMD, but instead to seek treatment. “It’s not a normal part of aging,” she said.

Brown, who has authored two studies

in the New England Journal of Medicine that announced Lucentis’ effectiveness, is happy for his part in the successful clinical trials that led to FDA approval. “The brave patients who participated in our trials helped make this treatment available to the millions of patients affected by AMD,” he said.

“Helping these patients stabilize and often improve

their vision was a goal that was unthinkable just a couple of years ago,” he said. “It’s been extremely rewarding to be part of this process.”

To find out more about Lucentis or to obtain a physician referral, call 713.790.3333 or visit www.methodisthealth.com.

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w o W

FACTOR Methodist is the first in Houston to use this wireless robotic technology to help provide 24/7coverage for patients.

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fter Michael Shea underwent emergency surgery at The Methodist Hospital for bleeding in his brain, he was recovering in the hospital’s neurosurgical intensive care unit (NICU) when, in the middle of the night, Dr. Saleem Zaidi arrived for a visit. Zaidi, neurointensivist director in the NICU, wasn’t physically in the same room. In fact, he wasn’t even in NICU. Zaidi was several miles away from Methodist, in his home, checking on his patient by way of a nearly six-foot-tall, remote-controlled mobile robot, nicknamed ROHAS (Remote Operated Health Assessment System).

“I didn’t know where Dr. Zaidi was physically, but I appreciated him looking in on me personally in the middle of the night,” said Shea, an engineer at McDermott International. “It certainly had the wow factor.”

ROHAS is one of two robotic “doctors” on staff at Methodist since the summer of 2006, caring for critically ill patients suffering from stroke and other neurological problems.

“In Mr. Shea’s case, I wanted to check on his condition even though I couldn’t be there physically,” Zaidi said. “The remote presence technology allowed me to see him and the ICU nurses and staff, and talk with them face to face. Ultimately, it impacts how we’re able to provide quality treatment.”

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n the other side of the hospital, in the Methodist Neurological Institute’s Eddy Scurlock Stroke Center, Dr. James Ling, neurologist and stroke physician, uses MURDOC (Mobile Unit Robot Doctor) to help care for patients in the 18-bed stroke unit.

Physicians, nurses, staff, patients and family members are used to seeing Ling effortlessly maneuver MURDOC down the hallways and into patients’ rooms. With the help of his nurse practitioner, Ling can run neurological tests and check patients’ reflexes following a stroke.

Between the two mobile robots, this remote presence technology elevates the quality of patient care at Methodist to a new level. The blue and black robots travel up to 2 mph, can be steered easily down a hallway or alongside a patient bed, and are equipped with infrared sensors to prevent the robot from accidentally bumping into anything or anyone.

Most importantly, the robots allow physicians, patients, nurses and other staff to “virtually” interact and talk at a moment’s notice.

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Dr. James Ling

From a remote location, Zaidi, Ling and other physicians use a laptop and joystick to guide the robot to patients’ bedsides, review medical chart information and speak with patients, nurses and family members.

Through a widescreen, two-way TV monitor, they can communicate with each other to determine the appropriate and immediate care needed.

Physicians can take digital photos or video of the patient and save them to the patient’s electronic medical record for future viewing. They also can load an image onto the robot’s TV monitor and explain a patient’s condition to loved ones. The ability to address patient care at a moment’s notice is especially helpful for treating acute stroke patients.

“This robotic technology gives us quicker access to the patients, and timeliness is everything in helping a stroke patient recover effectively,” according to Ling. “Our prime window of opportunity is within three hours of the onset of stroke symptoms, and as we tell our patients, time is brain.”

“It’s hard to quantify the subtleties, but it’s definitely better than just a phone call or an e-mail from my doctor.”

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“This technology supplements physician visits during those times when they cannot be physically present.”

ethodist’s NICU and Eddy Scurlock Stroke Center are the first in Houston to use this wireless robotic technology to help provide 24/7 coverage for patients, giving them immediate access to a physician.

The remote presence technology is part of a larger patient safety and quality initiative within The Methodist Hospital System.

“The robots are not meant to

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replace physicians seeing patients at the bedside,” said Dr. Marc Boom, executive vice president at The Methodist Hospital. “Instead, this technology supplements physician visits during those times when they cannot be physically present.”

Methodist received a major grant from the William Randolph Hearst Foundation for this robotic technology. The goal is to expand this technology to other locations within

the hospital and throughout the hospital system.

For Shea and his daughter, who has worked on artificial intelligence projects, the technology is a blessing. “It’s hard to quantify the subtleties, but it’s definitely better than just a phone call or an e-mail from my doctor,” he said. “The quality of care here is unique.”

Members of the Eddy Scurlock Stroke Team: nurse practitioner Don Bledsoe, Dr. Ken Ling and nurse practitioner Delmar Imperial-Aubin.

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VING DONOR W B Y

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hen Roman Dominguez discovered his diabetes had reached the point of needing dialysis because his kidneys could no longer function on their own, he and his wife called a family meeting.

“I’ll do it, Dad,” one of his five children said.

“No, I will,” said his youngest son Ricky.

All five of Dominguez’ children volunteered to donate a kidney to their father, and amazingly, all five were a match. But Ricky, just 22 years old at the time, was adamant — his kidney was going to save his father’s life and prevent him from undergoing dialysis. Just a few weeks later, Ricky and Roman underwent surgery together at the Methodist Transplant Center, and within hours, Ricky’s kidney was functioning normally in his father’s body.

Living kidney donation is on the rise at Methodist and across the nation, as people like Ricky Dominguez give the ultimate gift of life. Three years later, father and son are doing well and enjoy spending time together as a family.

“We’re a real close family,” Roman Dominguez said. “It was such an honor to have all my children come forward to donate their kidneys. We’ve always teased Ricky about his unexpected arrival in this world, but now I think we all know why we were blessed with him.”

“Organ donation is perhaps the greatest gift one human could offer another,” said Dr. Osama Gaber, director of transplantation at The Methodist Hospital. “Literally giving a piece of yourself in order to save another person’s life and prolong your time with that person … it is remarkable.”

Dr. Wadi Suki, a nephrologist who has been part of Methodist’s kidney transplant program since its inception in the 1960s, said he believes Americans are altruistic by nature. Suki once treated a patient who needed a pancreas and kidney transplant. The patient’s friend volunteered and was a match to donate the kidney. That friend put his life on hold while he waited months for a donor pancreas to become available for the patient. “What a friend,” Suki said.

Diabetes cases are skyrocketing across the nation, dialysis centers are popping up everywhere and the national waiting list for kidney transplants continues to grow quicker than donor organs become available. More than 75,000 Americans are currently awaiting lifesaving kidney transplants, and nearly 6,000 of those are Texans. Sadly, the lack of deceased organ donors means only 17,094 kidney transplants were Construction supervisor Ricky performed nationwide last year, and nearly 7,000 people Dominguez (left) donated one died waiting. of his kidneys to his father “Unless there is a change in laws regarding organ donation, Roman so he would not have there will not be quantum leaps in transplant volumes,” Suki to undergo dialysis. said. But he said there is encouraging news. Living kidney

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VOLUME 4, NUMBER 3 17

LIVING DONOR

“ The body is an amazing thing.

When a person donates one kidney, the other one grows and compensates for the function of the missing kidney.”

Dr. Horacio E. Adrogue, a nephrologist at Methodist and assistant professor at Baylor College of Medicine. “Our goal here is to treat diabetes and other forms of kidney disease in a manner that is best for our patients, and currently kidney transplant is considered the best treatment.”

Dr. Wadi Suki

donation in the United States has doubled in the last five years.

Methodist physicians encourage every patient to ask family and friends to become donors to treat their diabetes. Referrals for living kidney donation have quadrupled at Methodist recently. The hospital performs about 65 kidney transplants each year and is one of the top renal care centers in Houston.

Transplant patients at Methodist also have the opportunity to participate in research studies that offer new medications and protocols that could improve their outcomes.

“Diabetes is a devastating disease, and while dialysis will save a patient’s life by doing the work of the kidneys, it’s a temporary solution, one with complications and that really affects quality of life,” said

20,000

NUMBER OF DONORS

U.S. Organ Donors 1996 to 2005 TOTAL

15,000

10,000 LIVING 5,000

0

1996

1997

1998

1999

2000

2001

2002

2003

Source: Organ Procurement and Transplantation Network 2006 Annual Report

18 VOLUME 4, NUMBER 3

2004

2005

K

idney disease is a silent killer that affects other vital areas of the body, especially the heart. Reduced kidney function can eventually cause cardiovascular disease, along with anemia, bone disease, cognitive issues, neuropathy, skin cancer and calcification of blood vessels. Adrogue said kidney transplant drastically improves quality of life and length of life for patients with end-stage renal disease.

According to Methodist physicians, the progression of kidney disease is fairly predictable, making it easier for the transplant team to begin discussing dialysis and transplant with patients long before either treatment is necessary.

“Kidney transplant is not necessarily a walk in the park, so we wait until patients are near to the need of dialysis in order to get the best results and the longest benefit of a donated kidney,” Suki said. “If they can live comfortably with their own kidneys, they should. Once they WWW.METHODISTHEALTH.COM

experience tiredness, trouble concentrating, appetite issues and other obstacles to a good quality of life, then it’s time to proceed with transplant.”

With living donation, patients have plenty of time to approach family members, friends and others about donating a kidney. Living donation also provides a very controlled and planned process, giving physicians time to plan for the unexpected.

“We’ve seen great outcomes,” Gaber said. “In fact, recent studies show that patients who undergo transplants with kidneys from living donors have a 15 percent better survival rate than those who receive deceased donor kidneys.”

people in their 50s and 60s have donated kidneys. There are almost no long-term effects for living kidney donors, and they live normal lives after surgery.

“The body is an amazing thing,” Suki said. “When a person donates one kidney, the other one grows and compensates for the function of the missing kidney.”

Ricky said he doesn’t even notice the fact that he walks around every day with just one kidney. “It was worth it, and it was an easy decision,” he said. “I think anyone who has the opportunity to do what I did should just do it.”

To download an organ donor card, visit www.methodisthealth.com/transplant.

T

he kidney donor always goes into surgery first to ensure it is indeed safe to remove that person’s kidney. As with any surgery, there are risks to the living donation operation, but Gaber and Suki said they are very similar to any other elective procedure in a healthy person.

“We take risks of kidney donation very seriously, which is why all patients undergo a very thorough evaluation for medical, social and psychological well-being,” Gaber said. “These evaluations and the support we provide to donors and recipients help to keep risks under control. The donor comes first.

We want to make sure that both patients will lead healthy lives after the transplant.”

Just about anyone can be evaluated as a kidney donor. Donors must simply be in general good health, have enough function in the kidney that would remain, and be willing to give the gift of life. Most kidney donors are younger, but many

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UPCOMING EVENTS Saturday, June 30 2:55 p.m.

Astros vs. Colorado Rockies The Methodist Hospital System Day First 10,000 fans will receive an Astros jersey

Thursday, July 26 7:05 p.m.

Astros vs. San Diego Padres Methodist DeBakey Heart Center Heart Disease Awareness Night First 10,000 fans will receive an insulated lunch bag

Friday, August 10 7:05 p.m.

Astros vs. Milwaukee Brewers The Methodist Hospital System Weight Management and Diabetes Awareness Night

Saturday, August 25 6:05 p.m.

Astros vs. Pittsburg Pirates The Methodist Hospital System Night First 10,000 fans will receive Berkman Hobby Bobble

Sunday, September 16 1:05 p.m Astros vs. Pittsburgh Pirates The Methodist Hospital System Women’s Health Awareness Day

Dr. Osama Gaber

VOLUME 4, NUMBER 3 19

Like father, like son

BY DENNY ANGELLE

N

early every weekday afternoon, two doctors unwind from the day over cappuccino at a table in the lobby of The Methodist Hospital. Partners in medicine, they talk about patients and their respective practices.

They share more than a medical practice and a facial resemblance.

The older physician, Dr. Juan Olivero, and his son Dr. Juan Olivero Jr., are both nephrologists at Methodist and one of a handful of parent-child teams practicing at the hospital.

Olivero, senior, is a respected physician with a long history at Methodist. Olivero, junior, has practiced medicine with his father since July 2006. They share an office and staff — to tell them apart, the staff calls Junior “O2.”

“I am elated … very happy to be working with my son,” the elder Olivero says. “It is truly the best thing that has happened to me here.” pstairs, in a busy operating room, two surgeons perform bariatric surgery on a patient while television cameras record their every move and microphones under their scrubs record everything they say. Dr. Garth Davis patiently partitions a part of stomach while his father, Dr. Robert Davis, assists and occasionally lends a comment on the proceedings.

Even though they are wearing surgical masks, it is easy to tell the two apart. Garth is the taller of the two, and the jovial Robert is identifiable by his distinctive South African accent.

The Davises have practiced together for six years. “One of the benefits of being related is that neither of us is particularly shy about being brutally honest,” Robert Davis says. “And of course, neither is afraid to give the other a hard time.”

Much of this unique chemistry was captured over the past eight months by documentary cameras from The Learning Channel, for a 13-part TV series, which premiered in May (see sidebar on page 23).

When filming began, the working title for the series was Father and Son Surgeons.

“We certainly tease each other, you can’t necessarily do that with a colleague you are not related to,” Garth Davis explains. “He has certainly taught me a lot … he has taught me patience with patients. He may be a little more laid back than I am. But ultimately, I have the

U

20 VOLUME 4, NUMBER 3

Front row: Amy Coburn, Robert Grossman; Second row: Juan Olivero, Horacio Adrogue Jr., Horacio Adrogue; Third row: Juan Olivero Jr., Robert Davis, Garth Davis; Last row: Michael Raizner, Albert Raizner, Jeffrey Friedman, James Friedman

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and

one daughter

greatest respect for my father — as a surgeon and mentor, and especially as a father.”

When Garth was going through his surgical rotation as a resident, his father was one of his teachers. “He was my student then, not my son,” Robert Davis says.

“Once we were in surgery and he wasn’t holding a retractor in the right place. I became very impatient. I cursed him and said ‘move the retractor!’ And Garth said, ‘If you talk to me like that, I’ll tell my mother.’” parks may not fly as readily between the nephrologists in the Adrogue family, but Dr. Horacio Adrogue, father, and Dr. Horacio Adrogue, son, never fail to challenge each other for the benefit of their patients.

“We talk on a daily basis and work out any challenges or problems we could have with a patient,” the younger Adrogue says. “Working side by side with my dad gives me the opportunity to learn about medicine and life in general. His advice has proven invaluable time and time again.”

The elder Adrogue, a physician for more than three decades, welcomed his son into the practice four years ago. Although each physician has a slightly different focus in the type of patients he treats, they work together often.

S

oracio Jr. says he grew up seeing the respect given to his father by grateful patients. His colleague in nephrology, Juan Olivero Jr., also was affected by his own father’s work with patients.

Sociologists who study this sort of thing have a word for it — “patterning.”

Children go into the same profession as their parents because that is what they know, and what they are used to.

The younger Olivero remembers following his father to the hospital to make rounds, when he was seven or eight years old. It

H

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VOLUME 4, NUMBER 3 21

Like father, like son— and ONE daughter was around that time he got the idea that he might like to do this for a living.

But at age 18, Olivero decided to pursue a career in business, mainly because he was intimidated by the idea of spending 10 years going to school to become a doctor. “Even though I finished my business major, deep down I still wanted to become a physician.”

Adrogue Jr., however, knew early that he would walk down the same path as his father. “In high school, I had great biology teachers and that only helped to feed the interest I already had from seeing my dad do his work,” he says.

D

r. Jeffrey Friedman, a plastic surgeon at Methodist, also had an early interest in medicine. His father Dr. James Friedman, was a long-time obstetrician/gynecologist at Methodist, a former president of the hospital’s medical staff and now retired. “I spent a lot of time working at Methodist as a teenager to solidify my career choice,” the younger Friedman says.

He worked as an orderly in the emergency department and in the OB/Gyn operating room. “The best advice my father gave me was to do what I liked to do,” Friedman says. “(My father) was an excellent example of someone who took their work very seriously, paid attention to detail and remained engaged in terms of participating in the leadership of the hospital.”

A

few more physicians at Methodist are “secondgeneration” docs with retired physician fathers: Drs. James and Jay Bennett, in orthopedics; Dr. Dan

22 VOLUME 4, NUMBER 3

At left, James Friedman with son Jeffrey; Juan Olivero with baby Juan Jr.

Jackson is the father of internists Drs. I still see the man I saw many years Richard and Robert Jackson. Others ago — kind and very good with whose fathers are deceased include patients,” she says.

Dr. Sam Law, Dr. Jeffrey Jackson and Grossman is proud that his Dr. Bruce Ehni. daughter chose medicine. He agrees Dr. Amy Coburn is a third-generathat the strong family presence of tion physician in her family; granddoctors in the family influenced fathers on both her mother and her decision. father’s side were physicians. She says “I had great satisfaction when she was five or six years old when she chose her profession, and now she decided to become a doctor.

I see how patients like her and Coburn’s father is Dr. Robert what a very good physician she is,” Grossman, founder and director of Grossman says.”I don’t know how the Methodist Neurological Institute much I taught her, but I can say she and chairman of the Department of has taught me a great deal.”

Neurosurgery at The Methodist Hospital since 1980.

“It’s a profession in which I can make a really important difference in peoples’ lives. I saw in my father how satisfying it is to have a lifetime of learning, to build relationships, to help people and teach,” Coburn says.

“Dad has taught me that it is a privilege to take care of people.”

Coburn is an ophthalmologist at Methodist. She often cares for patients with neurological disorders that affect their eyesight.

“Working with him now, Albert Raizner with son Michael

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D

r. Albert Raizner, a cardiologist, at first thought he might be a negative influence on any medical aspirations for his son Michael. “When he saw the hours we kept and schedule I had, I felt he might be discouraged from going into medicine,” Raizner says. “Of course, he realized that medicine is an unbelievably rewarding profession.”

Cardiologist Dr. Michael Raizner has been a partner with his father for a year and a half, but the two saw a lot of each other as he did his cardiology training at Methodist for four years. “Dad has the magical combination of competency and charisma that makes him a special physician,” Michael says. “He has incredible energy and I’m proud to follow in his footsteps.”

“Working together, we have a very good balance,” the elder Raizner says. “Michael is very good about asking my opinion, and he is good about expressing his opinion. He is a colleague but there is that extra link that other colleagues do not have…we have a freedom of conversation that allows us to understand each other perfectly.”

Like many of the other fathers interviewed for this story, Raizner sees a bit of himself in his son’s medical career. “I’m impressed with his dedication and commitment and work ethic,” Raizner says.

“Those are the things I have prided myself on for many years.

I am proud that my son has decided to carry that along into the next generation.”

Robert Grossman with daughter Amy

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TV series spotlights father-son surgeons “Big Medicine,” a 13-part documentary series on The Learning Channel, premiered Monday, May 28, and airs every Monday at 8 PM CDT. The show features Drs. Garth and Robert Davis, surgeons at Methodist who perform bariatric weight loss surgery on overweight patients.

The series also focuses on 30 patients from the Weight Management Center at The Methodist Hospital, many of whom were obese when they decided to seek help in controlling their weight.

Camera crews followed patients and doctors everywhere — even on dates — to document these patient stories.

“My father and I have truly enjoyed watching some of our most successful patients share their stories with the country,” Dr. Garth Davis says. “Our patients are why we are in this field, and it’s remarkable to know they will inspire others to seek healthier lives.

“And of course, now everyone will see a son teaching his old man new tricks.”

But “Big D,” as Garth calls his father, conjures a few teaching tricks of his own and offers them with a quick sense of humor. His jovial approach puts patients at ease and helps prepare them for a major life decision.

“We offer a unique program at Methodist, incorporating longterm support in all of our patients’ care,” Dr. Robert Davis says. “We don’t lead patients blindly into surgery, and send them on their way.

Our nurses, dietitians and counselors help play a critical role in preparing them for surgery and supporting them throughout this dramatic life change.”

VOLUME 4, NUMBER 3 23

BACK INTO THE SW “If you do have a tear, surgery is going to be your best option to fix it because if you wait too long, you will tear the shoulder beyond repair.”

24 VOLUME 4, NUMBER 3

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B Y

G E O R G E

K O V A C I K

A GOLF PRO WHO CAN’T PLAY GOLF IS LIKE PUTTING A KID IN A CANDY STORE AND TELLING HIM HE CAN’T HAVE ANYTHING. THIS IS THE PREDICAMENT RIVER OAKS COUNTRY CLUB TEACHING GOLF PRO JAMES BROWN FACED LATE LAST YEAR.

WING OF THINGS

J

ames Brown was an all-around athlete in high school and college. He played football, baseball, basketball and golf. But over the years, the stress and strain of the games had taken their toll on his right shoulder. The pain was so severe he had to stop playing the game he loved — golf.

“I wasn’t able to turn as much, and I could feel significant pain every time I would follow through with my swing,” Brown said. “I was starting to lose some distance and hitting shots to the left, so I knew it was time to do something.”

Enter Dr. William J. Bryan, an orthopedic surgeon with the Methodist Center for Sports Medicine. Bryan happened to be out on the practice range one day when Brown approached him about his shoulder problems. Bryan told him he has seen many golfers who have torn their rotator cuff and don’t even know it. The next step was to undergo an MRI.

NOT JUST FOR BASEBALL PLAYERS When we hear about rotator cuff injuries we often think of a baseball pitcher who is out for the season after undergoing surgery. Not golfers. But many are plagued by shoulder problems, from tendonitis to a complete tear of the rotator cuff.

“Most golfers don’t tear their rotator cuff playing golf,” said Bryan, who is also a consulting physician for Physiotherapy Associates (PTA), the official health care provider for the Professional Golf Association (PGA), LPGA, Senior’s Tour and Butch Harmon’s Golf Teaching Summit. “But they do make the problem worse by continuing to play when it is torn.”

The rotator cuff is a group of muscles and their associated tendons that act to stabilize the shoulder. An inflamed rotator cuff (tendonitis) can cause pain when lifting the arm. When the rotator cuff is torn, it bumps up against the shoulder, causing persistent pain and stiffness. This stiffness (in the left shoulder for right handed golfers and right shoulder for left handed golfers) can cause golfers to change their swing to ease the pain, and more often than not can lead to a loss of distance and more balls heading into the woods.

HITTING THE WEIGHTS Rivers Oaks Country Club golf pro James Brown (right) underwent rotator cuff surgery on his right shoulder performed by Dr. William Bryan.

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A team of orthopedic surgeons from the Methodist Center for Sports Medicine including Bryan, Dr. Leland Winston and Dr. Bruce Moseley, recently spent a week at the Shell Houston Open tending to injured golfers. They were housed in one trailer, and in another trailer was a weight room that was always packed with golfers trying to bulk up so they can drive the ball a little farther.

VOLUME 4, NUMBER 3 25

BACK INTO THE SWING OF THINGS repair,” Winston said. “If you have persistent pain in the shoulder for two weeks, see a physician and get an MRI.”

ON THE ROAD TO RECOVERY

“What many golfers don’t understand is that while strength training is important, stretching is really the key,” said Winston, who is also a PTA consulting physician. “You can have the strongest shoulder in the world, but if you don’t have a good range of motion because

Brown’s MRI showed a complete tear of the rotator cuff, so he decided last October to stop playing golf and have surgery in early 2007.

“As a right-handed golfer, James was lucky that the tear was in the right shoulder because he will be able to recover quicker,” Bryan said.

“If it was in his left shoulder — the side of the body that drives through the ball — he would have a tougher Dr. Leland Winston road ahead of him.”

Technological advances in rotator cuff surgery have accelerated rehabilitation plans by 50 percent for of tendonitis or a rotator cuff many golfers. In fact, 10 weeks after tear, you are doing yourself more surgery, Brown was already taking harm than good when you are full swings. His goal is to be back at pumping iron. full strength and playing 18 holes by “If you do have a tear, surgery is early summer. going to be your best option to fix Brown is working with Bryan and it because if you wait too long, you PTA therapists to develop golf drills will tear the shoulder beyond to be performed along with rotator cuff repair exercises. He believes this experience and his work with Methodist and PTA will help his game and give him more tools when he is giving lessons.

“My shoulder injury makes me want to look for certain things in a person’s swing that may tell me that they are in the same position I was in,” Brown said. “As a pro, I always strive to improve someone’s game, and if that means sending them to someone like Dr. Bryan to get their shoulder Bryan analyzes fixed because I have Brown’s golf swing. noticed a problem, then I have done my job.”

To obtain a physician referral, call 713.790.3333 or visit www.methodisthealth.com.

26 VOLUME 4, NUMBER 3

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HAYWIRE Electrophysiologists use technology to eliminate abnormal heart rhythms

B Y

Driving home from work one day last fall, Clarence Rodefeld’s heart started beating out of control and he blacked out. He had a head-on collision, totaled his truck and broke three ribs. He was lucky it wasn’t worse.

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E R I N

Rodefeld knew what was happening. For 12 years, he suffered from a dangerous heart condition called atrial fibrillation.

“It’s scary. You don’t know if you’re about to have a heart attack.

You can feel your heart pounding out of your chest, and you know it’s critical. It can kill you,” Rodefeld said.

Approximately 2.2 million Americans live with atrial fibrillation, a condition that causes the heart to beat erratically, potentially causing heart attack or stroke.

F A I R C H I L D

“When people have atrial fibrillation, their hearts have regular bouts of erratic, fast beating,” said Dr. Miguel Valderrabano, director, division of cardiac electrophysiology at the Methodist DeBakey Heart Center. “They often have an uncomfortable awareness of their heartbeat.

Sometimes they have chest pain. They get weak.

They can show up with no symptoms at all or with more extreme complications such as stroke or heart failure.”

“It feels like you’re not in this world,” said Rodefeld, a 61-year-old warehouse manager. “It’s like you’re not a normal

human being. It zaps all the energy out of you.”

“The medical quandary around atrial fibrillation is its erratic behavior, which makes it challenging to treat,” said Dr. Nadim Nasir Jr., cardiologist and electrophysiologist at the Methodist DeBakey Heart Center. “Tiny electrical impulses continually run through a healthy person’s heart, giving it the impetus to beat and pump lifesustaining blood through the body. When these electrical impulses go haywire, atrial fibrillation occurs.”

VOLUME 4, NUMBER 3 27

HAYWIRE

Anti-arrhythmic medications can help slow do but medications tend to work on Rodefeld controlled his atrial fibrillation with medication for years, but there came a point when the medications weren’t enough. He had episodes of erratic heartbeats on a daily basis. There even came a time when he had to take two months of short-term disability from his job because of the condition. In and out of the hospital, he was sapped of energy and felt awful physically.

“My family knew that it changed me as a person.

All I wanted to do was sit around and feel bad,” he said. “I was scared.

It’s a frightening feeling to have your heart beat uncontrollably.”

28 VOLUME 4, NUMBER 3

Dr. Miguel Valderrabano

Anti-arrhythmic medications such as sotalol, flecainide, propafenone and amiodarone can help slow down the heart rate and regulate heart rhythm associated with atrial fibrillation, but medications tend to work only 40 to 60 percent of the time.

As patients age, the medications don’t work as well. In addition, many of these medications have significant side effects including lung, skin and eye toxicity. Some can

even lead to sudden cardiac death when used in diseased hearts.

If the condition can not be controlled with medication, electrophysiologists — physicians who specialize in the diagnosis and treatment of abnormal heart rhythms — mechanically and permanently interrupt the errant electrical impulses.

They accomplish this with ablation — a promising new therapy for more effective treatment of atrial fibrillation. The procedure allows them to identify the errant circuits and eliminate them by inserting a minimally invasive catheter through the groin veins into the heart and delivering heat or cold to the affected areas.

If atrial fibrillation is allowed to go unchecked, blood pools in the atria, the top chambers of the heart, and clots can form.

If a clot dislodges, it can cause a stroke. About 15 percent of strokes are caused by atrial fibrillation.

“Atrial fibrillation is a moving target. The electrical impulses change continually. The electrical activity of the heart, and more specifically the left atrium, is quite complex.

Consequently, mapping of these signals in an effort to target areas of ablation can be time consuming,” said Nasir, who is the medical director of the cardiac electrophysiology laboratory and director of clinical electrophysiology services at the DeBakey Heart Center.

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own the heart rate and regulate heart rhythm, nly 40 to 60 percent of the time.

Erratic heartbeats often begin at the point where the pulmonary vein enters the heart. One option is to treat the tissue surrounding the pulmonary vein entrance in the left atrium, electrically isolating the vein and stopping the errant electrical impulses.

Another option is to identify and ablate areas where the heart tissue is beating faster. These areas can trigger irregular heartbeats. A last option is to ablate where the nerves of the heart are.

There is great variation among patients in how the electrical currents operate.

One of the greatest challenges for electrophysiologists is to better understand this variability in order to better personalize treatment.

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Dr. Nadim Nasir Jr.

Rodefeld was referred to Valderrabano for ablation. Valderrabano ran a three-dimensional CT image of Rodefeld’s heart before the procedure to help visualize the anatomy and currents in his heart.

He then used the CT image during the procedure so that he could compare Rodefeld’s “live” heart to the one recorded on the CT scan.

With the technology available at Methodist, Valderrabano used the reconstructed 3D image of the heart and the real-time image of the catheter going into Rodefeld’s heart for more precise accuracy in the placement of the ablation energy treatment.

Valderrabano also used 3D magnet-guided navigation to manipulate the catheter remotely into the exact locations he wanted to ablate the errant tissue. This robotic system allows for manipulation of the catheter via magnetic fields that direct it to desired locations, speeding up the procedure and minimizing complications.

He also used intracardiac echocardiography, a technology that enables a physician to see the heart and vessels from the inside of the heart. He located the area near Rodefeld’s pulmonary vein and used radiofrequency energy to perform the ablation that short-circuited the errant currents and eliminated the irregular heartbeats.

“I feel tremendous,” Rodefeld said after his ablation. He advises people with uncontrolled atrial fibrillation to see a doctor because they can give patients comfort and control.

“I feel like I’m 40 again.

I’ve got my body, my attitude and my charm. It’s all back,” he said.

To obtain a physician referral, call 713.790.3333 or visit www.methodisthealth.com.

VOLUME 4, NUMBER 3 29

HPV:

a primer B Y

S H E S H E

G I D D E N S

Most people infected with HPV are not even aware that they have it, which makes it easy to spread.

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When the Food and Drug Administration approved a vaccine for the human papillomavirus (HPV) last year, most people knew little about the virus or its link to cervical cancer. But according to the Centers for Disease Control and Prevention, at least 80 percent of women will contract a genital HPV infection by age 50, making it the most common sexually transmitted infection in the United States.

HPV is the name for a class of viruses that includes more than 100 different strains, of which more than 30 are sexually transmitted. The CDC estimates that approximately 20 million men and women are currently infected with HPV and about 6.2 million Americans contract a new genital HPV infection each year.

Public awareness of HPV escalated in June of last year when print and TV ads for the drug Gardasil began to flood the market.

Gardasil, which is approved for use in females 9 to 26 years of age, is the first vaccine developed to prevent cervical cancer, precancerous genital lesions and warts. Worldwide, cervical cancer is the second most common cancer in women.

30 VOLUME 4, NUMBER 3

Although Gardasil does not protect against all HPV strains, it protects against the four strains most commonly found: types 16 and 18, which cause 70 percent of cervical cancers; and types six and 11, which cause 90 percent of genital warts.

The vaccine is given in three injections over a six month period.

Possible side effects include pain, swelling, itching and redness at the injection site; fever, nausea and dizziness.

Ideally, girls ages 11 and 12 should be vaccinated for the virus since current statistics show that by age 13, five percent of girls have had some sexual contact. “The vaccine is most effective for patients who have never been sexually active, but it is still effective even if a woman has been exposed to HPV,” said Dr. Denise Nebgen, a gynecologist at The Methodist Hospital.

If a girl or woman is sexually active and has contracted one of the strains of the virus, the vaccine will still protect against other strains.

Early vaccination gives girls the opportunity to build up antibodies to the four strains found in the vaccine.

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“Younger children have an elevated immune response to the vaccine and will develop a higher number of antibodies before they encounter the virus,” said Dr. Tri Dinh, a gynecologic oncologist at Methodist.

Hidden Disease

Dr. Tri Dinh

HPV AND CERVICAL CANCER:

By the Numbers

100 11,150 human papillomavirus cases of invasive

92 % of women with

subtypes have been identified

cervical cancer will survive after five years if it is treated early

80 % of sexually active women will have acquired genital HPV by age 50

82 % of women in the United States have had a Pap test during the last three years

cervical cancer will be diagnosed in the United States in 2007

20 % of women with cervical cancer are diagnosed when they are over 65

3,670 women will die from cervical cancer in the United States during 2007

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6.2 million new HPV infections

HPV is a hidden disease. It lives in the skin or mucous membranes, and with the exception of genital or anal warts caused by some strains, there are no physical symptoms.

Most people infected with HPV are not even aware that they have it, which makes it easy to spread.

Men and women can contract HPV through sexual intercourse or genital contact. Condom use does decrease the rate of transmission, but it does not completely eliminate it, which means that not even a condom can fully protect against transmitting the virus. Abstinence and monogamy are the best defenses against contracting the virus.

There is no cure for an HPV infection; however, a person with an intact immune system can fight off the virus on his or her own.

“Men are carriers,” Nebgen said.

“Women can clear the virus and there is study on men to see if they can clear the virus too.”

If the vaccine is ever proven effective in boys and men, then the health benefit to them would be the prevention of genital warts. Further, certain types of HPV can cause cancers of the penis and anus in men, but these are rare. Vaccinating males also would aid in halting the spread of HPV to females.

occur every year From the American Cancer Society, Inc. and the Centers for Disease Control and Prevention

VOLUME 4, NUMBER 3 31

HPV: a primer

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There are certain protocols in place to test for HPV infection if a woman’s Pap test shows cellular abnormalities. About 90 percent of the women exposed to the virus will fight the infection on their own. The rest will develop a persistent infection that will create abnormalities in the cervical cells. Eventually, if left untreated, precancerous abnormalities known as dysplasia can develop.

Not all women with precancerous changes to the cervix will develop cervical cancer. Sometimes it will go away without treatment. According to Dinh, in one study, more than 99 percent of cervical cancer specimens showed evidence of HPV infection.

However, HPV infection is not the sole cause of cervical cancer. There are other factors, such as smoking and a family history of cervical cancer, that play a role in determining if a woman will get cervical dysplasia and/or cancer.

Better Safe Than Sorry Nebgen and Dinh are concerned that women may think that they can forgo annual Pap tests if they are vaccinated against HPV. Since Gardasil does not inoculate against HPV strains that lead to 30 percent of cervical cancer, a woman’s first line of defense and detection is the annual well women exam, which includes a Pap test.

32 VOLUME 4, NUMBER 3

Dr. Denise Nebgen

This test is designed to detect abnormal and precancerous cells before they become cancerous.

Cervical cancer, which develops in the lining of the cervix, takes many years to develop from the initial HPV infection. Annual tests provide multiple opportunities for detecting cervical changes. If caught early, cervical dysplasia and cervical cancer can be treated easily.

“Some women still do not get an annual Pap screening, even when they have the opportunity to do so via their insurance coverage or public health clinic system,” Dinh said. “It is important that women know that Pap screenings are vital.

Even if we vaccinate everyone who is eligible, we would probably have only a 50 percent decline in cervical cancer.”

M

ethodist is the first hospital in Houston to offer a new technology that can more effectively screen for early precancerous changes in the cervix. The Thin Prep Imaging System is a liquid-based cytology (study of cells) method approved by the FDA. Thin Prep uses an interactive computer system that allows physicians to more accurately screen pap tests and diagnose abnormalities. Studies show that Thin Prep produces fewer false negative test results than the conventional Pap test.

For a referral to a Methodist OB/GYN, call 713.790.3333 or visit www.methodisthealth.com.

WWW.METHODISTHEALTH.COM

O-arm=accuracy+precision B Y

D E N N Y

A N G E L L E

Neurosurgeons at the Methodist Neurological Institute are the first in Texas to use the O-arm Imaging System, a multi-dimensional surgical navigation system for orthopedic and spine surgeries.

Five centuries ago, Christopher Columbus sailed across the Atlantic Ocean and discovered the New World. This, among his other explorations, would not have been possible without the invention of navigational tools such as the sextant, compass and spyglass.

A modern-day navigational tool being used by neurosurgeons at The Methodist Hospital allows doctors to successfully perform complex surgeries with an unprecedented level of accuracy and precision. Like Columbus, these physicians are blazing a new trail because they are among the first in the country to use this technology.

Dr. Paul Holman WWW.METHODISTHEALTH.COM

VOLUME 4, NUMBER 3 33

O-arm=accuracy+precision

S

urgeons traditionally use anatomic landmarks (obtained by conventional X-ray technology) to place screws in the spine. But the natural difference in patients’ anatomy — bone density, shape, thickness — makes the margin for error very small.

Holman says the O-arm technology automatically matches the patient’s anatomy to reduce any misplacement of hardware.

“When you’re placing screws they have to be accurate,” Holman said. “A misaligned screw can cause some problems that would have to be fixed with a second, follow-up surgery. So you can see how a more accurate map gives us an advantage in the operating room.”

The O-arm’s unique shape allows for 360-degree views of a patient. The doughnut shaped platform moves while the patient is still — which means better operating room efficiency and greater patient safety.

When it is not in use, the device can be folded away to keep it from getting in the surgeons’ way.

34 VOLUME 3, NUMBER 2

Above: The doughnut shaped O-arm provides surgeons with a 360-degree view of the patient.

The 30-inch flat panel monitor provides superior image quality and a very large field of view.

H

olman has used the O-arm in nearly 30 operations over the past few months. He finds the technology is most useful on thoracic spinal surgeries, closer to the neck and head.

“On the lower end of the spine, you have fewer nerves to worry about. The higher you get, the more accurate you need to be in placing any type of screws or implants,” he said.

Other neurosurgeons at Methodist, including Dr. J. Bob Blacklock and Dr. Rob Parrish, are proficient in the O-arm technology. “This technology is a real advance in our ability to perform complex spinal procedures and provide the most advanced care available,” Blacklock said.

In time, this imaging system can be used in more routine procedures, including minimally invasive surgeries that have smaller incisions and shorter patient recovery time.

“Computer assisted surgical navigation is a growing trend for minimally invasive spine procedures,” Holman said. “I think in a few years you are going to find this technology in hospitals all around the country.”

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Photos courtesy of Medtronic, Inc.

T

he O-arm is a platform-mounted, portable scanner that allows doctors to peer into the patient at any time before or during surgery. It produces threedimensional pictures in a matter of seconds, saving valuable time while a patient is on the operating room table.

“This system gives us a much greater degree of accuracy in a much shorter time,” neurosurgeon Dr. Paul Holman explained. “In the past, mapping the surgical site was a time-consuming process.”

The O-arm transforms conventional two-dimensional fluoroscopic images into 3D guides for complex spinal surgeries. Surgeons also can call up a 3D reconstruction of the target area, with images of the spine and surrounding tissue.

The higher resolution of the images then allows physicians to more accurately place screws and other instruments to repair the spine.

Screws often are used in spinal corrective surgery to anchor a rod that then serves to straighten the spine. They are used in repairing a spinal fracture, removal of tumors and lumbar decompression to relieve pain caused by pinched nerves.

Accolades DR. MARC BOOM, executive vice president of The Methodist Hospital, has been selected to receive a Distinguished Service Award from the American Heart Association for his outstanding work in fulfilling the AHA’s mission in Houston and Texas. As part of this prestigious award, a research grant has been named in his honor.

DR. ROBERT GROSSMAN has been chosen by the American Association of Neurological Surgeons as the organization’s 2007 recipient of the Cushing Medal. Named for Dr. Harvey Cushing, the first neurosurgeon in America, the award is the highest honor given to a physician in the field. Grossman was chosen for his work with young scientists through the Neurological Research and Education Fund, as well as his management of the American Board of Neurological Surgery.

DR. RICHARD KLUCZNIK, medical director, interventional neuroradiology, received the Torch of Hope Award from the Cancer League at its annual event in December. This award is given annually to an individual who has touched the lives of people around the world through significant contributions to research and medicine.

DR. ALAN KAPLAN is the recipient of the Dr. John W. Overstreet Award, given to Methodist physicians who are nominated by hospital staff for being among “the best of the best.”

He was chosen for his professional skill, integrity, sense of compassion, and demonstration of empathy and care for patients and fellow staff members.

DR. YOULI ZU a pathologist with The Methodist Hospital Research Institute, is the recipient of an NIH Career Award. This grant provides $604,800 over the next four years to support his research with a goal of understanding the molecular mechanism of anaplastic large cell lymphoma in children and adults.

THREE NURSES FROM THE METHODIST HOSPITAL SYSTEM were selected by the Houston Chronicle as part of its annual “Salute to Nurses.” From left, Elizabeth “Jean” Baker, BSN, RN, OCN, from The Methodist Hospital; Roy Barefield, RN, from San Jacinto Methodist Hospital; and Jaime Beseda, RN, from Methodist Willowbrook Hospital, are among 10 Houston-area nurses honored this year. They were selected from hundreds of nominations by patients, their families, colleagues, physicians and co-workers.

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VOLUME 4, NUMBER 3 35

HEALTHY LIVING

SECONDHAND SMOK B Y

M A R Y

B R O L L E Y

Although they aren’t yet old enough to vote, a group of suburban Houston middle schoolers is pushing for a law that will make their neighborhoods safer.

They want smoking banned in all public places in Pearland, a bedroom community of 41,000 residents; and the students from David Bean’s science class at Sablatura Middle School collected 418 signatures to back them up.

Presented with the petition, the Pearland City Council decided a smoking ban should be sent before the city’s voters this November.

The children’s well-publicized plea for smoke-free public places brought attention to the issue of secondhand smoke — a threat to children’s safety that gets far less attention than kidnappings, injuries or exposure to drugs.

“As awareness grows about the dangers of smoking around others — especially children — it might help people quit,” said Dr. Mario Gonzalez, a pulmonary specialist at The Methodist Hospital. “Parents want to protect their children.”

Gonzalez has seen the effects of secondhand smoke in his patients who suffer from lung diseases and lung cancer, as well as chronic obstructive pulmonary disease.

“It sneaks up on them,” he said. “They never smoked, and yet they are suffering.”

Doctors believe environmental tobacco exposure, or secondhand smoke, causes approximately 3,400 lung cancer deaths in adult nonsmokers in the United States each year. Tens of thousands more die of coronary heart disease believed to be caused by exposure to secondhand smoke.

Even for nonsmokers, the smoke from a cigarette, cigar or pipe is potent. It contains hundreds of chemicals known to be toxic or carcinogenic. In fact, it has been classified as a Group A carcinogen by the Environmental Protection Agency.

Over the last 20 years, warnings about secondhand smoke have increased. Lately, the drumbeat has gotten louder. The very public lung cancer death in 2006 of 44-year-old Dana Reeve, a nonsmoker who was the wife of the late Christopher Reeve, brought the subject to the forefront.

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One out of five women diagnosed with lung cancer has never smoked.

It’s no secret that lung cancer is lethal. About 160,000 Americans die from it each year. That’s more than breast cancer, colon cancer and prostate cancer combined.

And although 87 percent of those who develop lung cancer are or have been smokers, the remaining 13 percent who get lung cancer without ever having smoked themselves constitute “an overlooked minority,” according to Newsweek magazine.

The cancer is every bit as lethal for them, killing 60 percent within a year and 85 percent within five years.

A 2006 U.S. Surgeon General’s report focusing on the effects of secondhand smoke stated that although progress has been made, sustained efforts are required to protect the more than 126 million Americans who continue to be regularly exposed to secondhand smoke in the home, at work and in enclosed public places. Further, the report found that even the most sophisticated ventilation systems can’t completely eliminate secondhand smoke exposure.

Secondhand smoke is especially dangerous to those least able to protect themselves from exposure — infants, children and the elderly. The Surgeon General’s report noted that because the bodies of infants and children are still developing, they are especially vulnerable to the poisons in secondhand smoke.

WWW.METHODISTHEALTH.COM

KE KILLS It has been linked with sudden infant death syndrome. It causes breathing problems including pneumonia, bronchitis and asthma in children. And it causes tens of thousands of deaths each year from heart disease in adult nonsmokers.

The chorus of warnings is growing. The American Lung Association, American Cancer Society, American Heart Association and other trusted health advocates devote pages on their Web sites and lobby Congress regularly to make the case for smoking bans. Increasingly, city councils all over the country are grappling with this issue.

So, it’s clear. Parents who smoke in front of their children are exposing them to lifethreatening substances.

If at all possible, they should quit entirely.

At the very least, they should never smoke inside of a home or a car.

“I tell (my patients with kids) to stop smoking,” Gonzalez said.

He knows quitting is tough.

“Nicotine is more addictive than many drugs,” he said. “But (patients) can do it, as long as they realize that it’s not going to be easy. I promise them, ‘we’ll work together to help you quit.’”

Gonzalez encourages his patients who smoke to sign a contract with him to set a date for stopping smoking. “If they do it (quit smoking) the right way once, 60 to 70 percent of people can quit,” he said.

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Besides signing the contract, “doing it right” means making a concerted effort during the first two or three months to substitute exercise for smoking, reach out for help from loved ones, and throw away ashtrays and all evidence of the smoking habit.

The benefits of stopping smoking — or at least banning it from public places and from enclosed spaces where children are present — will pay off in healthier communities, Gonzalez hopes.

Despite resistance from some bar and restaurant owners who claim that smoking bans hurt their bottom line, more and more communities are opting to go smoke free.

At their appearance before the city council, the Pearland students unfurled a banner listing the 247 Texas cities that currently restrict smoking in public places.

A separate banner boasted, “Coming soon — Pearland.”

DID YOU KNOW? 250 3,400

Toxic chemicals in secondhand smoke, including more than 50 that can cause cancer Nonsmoker lung cancer deaths caused by secondhand smoke annually

22

Million U.S. children age 3-11 exposed to secondhand smoke

14

Number of states that have passed strong smoke-free air laws

U.S. cases of lower respiratory tract 150,000- New infections in children under 18 months of age 300,000 each year Sources: Centers for Disease Control and American Lung Association

VOLUME 4, NUMBER 3 37

B Y

A M I

F E L K E R

MethodistSugarLand Hospital MEETS GROWING DEMAND SINCE METHODIST SUGAR LAND HOSPITAL FIRST OPENED ITS DOORS TO FORT BEND COUNTY IN 1998, THE COMMUNITY HAS HAD ACCESS TO LEADING-EDGE TECHNOLOGY AND EXCELLENT MEDICAL CARE. LOCATED IN ONE OF THE FASTEST GROWING COUNTIES IN THE UNITED STATES, THE HOSPITAL HAS UNDERGONE SEVERAL EXPANSION PROJECTS TO MEET THE NEEDS OF THE BOOMING COMMUNITY.

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WWW.METHODISTHEALTH.COM

“IT’S NO LONGER NECESSARY FOR PATIENTS TO TRAVEL FAR FROM HOME TO UNDERGO SOME LIFESAVING PROCEDURES. WE’RE PROUD TO OFFER THESE SERVICES.” Last July, Methodist Sugar Land broke ground on its largest building expansion ever, a $177 million project that will eventually more than quadruple its beds, initially increasing from 54 to 180, with the capacity to grow quickly to 236 beds. The project is expected to be completed in summer 2008.

The hospital’s growth is fueled by the escalating popularity of the Sugar Land area, which was named the third best place to live in the nation on the 2006 CNN/Money magazine’s “Best Places to Live” list.

Methodist Sugar Land’s acting CEO, Chris Siebenaler, said the expansion keeps pace with the growth of Fort Bend County.

“We’re committed to serving the health care needs of our growing community,” Siebenaler said. “More advanced medical capabilities and technology have expanded what we can offer at community hospitals.”

The initial phase of expansion is already complete, with two cardiac catheterization labs — one with surgical capabilities. These additions establish Fort Bend County’s first cardiac surgery suite. In April, a 53-year-old grandfather underwent heat valve replacement and bypass surgery at Methodist Sugar Land.

Drs. Mahesh Ramchandani and Uttam Tripathy, cardiovascular surgeons with the Methodist DeBakey Heart Center, performed the surgery.

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It was the first open heart surgery ever performed in Fort Bend County.

“We’ve taken a very progressive step by offering open heart surgery at Methodist Sugar Land,” Ramchandani said. “It’s no longer necessary for patients to travel far from home to undergo some lifesaving procedures. We’re proud to offer these services close to home for our patients.”

The hospital also will expand current labor and delivery suites and enhance existing services in critical care, emergency department, surgery and imaging. In addition, the hospital’s five centers of excellence will expand, including cancer, heart, neurology, orthopedics and urology.

Over the past nine years, Methodist Sugar Land has undergone two expansions, which first increased its beds to 36, and then to 54. The previous expansions added an intensive care unit, cardiac catheterization lab and an expanded obstetrics department, capable of providing specialized care for premature infants.

Also, in 2004, the hospital opened a freestanding 20,000-square-foot cancer center and began offering cancer services that were previously available only in the Texas Medical Center. The cancer center offers chemotherapy infusion and intensity modulated radiation therapy, and serves as an American Cancer Society Resource Center.

“Physician researchers continue to make great strides in improving medicine and medical technology, and in making treatments more accessible to patients,” Siebenaler said. “We look forward to expanding these advancements for the Fort Bend community, maintaining the high quality The Methodist Hospital is known for.”

SUGAR LAND METHODIST HOSPITAL FAST FACTS 1998 OPENED 54 OPERATING BEDS 5 OPERATING ROOMS 600 AFFILIATED PHYSICIANS 20,000 SQUARE-FOOT FREESTANDING CANCER CENTER OPENED IN 2004 600 EMPLOYEES 5,000 INPATIENTS IN 2006 39,000 OUTPATIENTS IN 2006 35,500 ER VISITS IN 2006 16655 SOUTHWEST FREEWAY SUGAR LAND, TX 77479 281.274.7000

VOLUME 4, NUMBER 3 39

My Turn Peggy Creany

ServicePRIDE is the Key

H

igh patient satisfaction is considered one of the pillars of success at The Methodist Hospital System, and we have measured our patient satisfaction for many years.

We value our patients’ opinions and feedback and utilize the information to enhance patient service, safety and quality. We believe in creating service excellence that engages all employees in making our patient and guest needs a priority.

In 2003, we developed the ServicePRIDE program to standardize our customer service approach.

This program includes resources designed to support employees with ongoing service education, clearly defined and expected service behaviors and goals that are aligned with superior satisfaction results.

he Compass Award recognizes outstanding performance improvement in patient satisfaction and has been achieved by San Jacinto Methodist Hospital and The Methodist Hospital in the Medical Center. Methodist Sugar Land Hospital and Methodist Willowbrook Hospital are currently in the top ten hospitals in the country* rated by Press Ganey.**

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*Within our university hospital consortium (UHC) peer group. **Health care industry leader in patient satisfaction survey measurement.

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Our objectives? To create a service culture that reinforces expected employee behaviors through positive reinforcement; and to recognize employees who go above and beyond for our patients and guests.

We utilize patient surveys to measure our patient satisfaction. Our high ratings have achieved various accolades including the Compass Award from Press Ganey and Associates (see box). The company tracks patient feedback and scores hospital departments based on that feedback. They also compare our performance with that of other hospitals around the nation.

We are greatly appreciative of the feedback our patients provide through the surveys and the confidence they show in us by choosing to have Methodist care for them and their families. One of the most meaningful aspects of my job is when a patient contacts us directly to share their patient experience.

Like the Rev. Chris A. Williams Jr., who was a patient at The Methodist Hospital earlier this year. Here is an excerpt from his letter: “Although I was in pain and discomfort during my stay, I must commend every person that I or my wife had personal contact with during this one and one-half week stay.

From the doctors to the nurses to the PCAs, even to those assigned to clean the room and deliver food trays, we were always treated with the utmost respect and kindness.

Your staff must be hand selected, to have been so caring.

We received prompt attention regardless of the hour and regardless of the need. I attempted to keep a record of those who stood out, but to be truthful, the list was far too long.”

Letters like this are what make my job so meaningful and why I, along with the 10,000 other Methodist employees, come to work each day.

We appreciate our patients’ and families’ evaluation of their hospital experience.

If you or a family member becomes a patient, you may receive a survey in the mail after discharge and we want to hear from you. Please take the time to complete the survey and evaluate your stay. At Methodist, your opinion makes a difference!

Peggy Creany is the director of Guest Relations Administration for The Methodist Hospital System. Contact her at www.methodisthealth.com/ servicefeedback.

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