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Medical Milestones

Spring 2013

Fast Track Emergency Care Page 10 Innovations Page 4

Injury Prevention Program Page 8

Physician Spotlight Page 12


To our community Lake Charles Memorial Hospital has once again earned The Joint Commission’s Gold Seal of Approval® for accreditation. Memorial received this high standard for health care quality and safety in our hospitals, home care and behavioral health programs. The Joint Commission’s hospital standards address important functions relating to the care of patients and the management of hospitals. The standards are developed in consultation with health care experts, providers, measurement experts and patients. Accreditation is a voluntary process that happens every three years.

“Achieving Joint Commission accreditation, for our

The entire Memorial Health System underwent a rigorous unannounced on-site survey this past August. A team of Joint Commission expert surveyors spent a week with us, evaluating the hospital for compliance with standards of care specific to the needs of patients, including infection prevention and control, leadership and medication management.

organization, is a major step toward maintaining excellence and continually

With Joint Commission accreditation, we are making a significant investment in quality on a day-to-day basis from the top down. Joint Commission accreditation provides us a framework to take our organization to the next level and helps create a culture of excellence. Achieving Joint Commission accreditation, for our organization, is a major step toward maintaining excellence and continually improving the care we provide.

improving the care we provide.”

Larry Graham, CEO

An independent, not-for-profit organization, The Joint Commission is the nation’s oldest and largest standards-setting and accrediting body in health care. It evaluates and accredits more than 20,000 health care organizations and programs in the United States, including more than 10,600 hospitals and home care organizations, and more than 6,600 other health care organizations that provide long term care, behavioral health care, laboratory and ambulatory care services. We hope this latest achievement will only further strengthen your trust in us to provide you, our community, with the best health care possible.

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memorial

Medical Milestones Page 4

Innovations 4 ThermoSuit速

Stepping Up 6 Memorial Takes Over Moss Regional

Injury Prevention

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ACL Testing for Lady Athletes

Cover Story

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Emergency Medicine on the Fast Track

Physician Spotlight

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Page 6

Michael Broussard, MD, Outdoorsman

Look Good, Feel Better

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Support for Women Fighting Cancer

Coming Events 16 Education Classes and Support Groups

Healthy Advice 18 Memorial Launches Health Blog

Page 10

On the Cover Dr. Jon Gray, Emergency Medicine Page 14 3

Page 12


Cardiac ThermoSuit速

Photo credit: Charlotte Hungerford Hospital, Torrington, CT.

Studies have shown that patients at risk for brain damage have better outcomes when they are treated with therapeutic hypothermia.

Innovations

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Minimizes Brain Damage Medical advancements have allowed doctors to work quickly and successfully in restoring heart function after a cardiac arrest. Doctors can usually get the heart beating normally again and open up any blockages, but the patient can be left with brain damage. “The brain damage comes from what we call a reperfusion injury,” says Dr. J. King White, a cardiologist with the Heart & Vascular Center, a part of the Memorial Medical Group. “This happens when the blood flow to the brain has been cut off and then it is restored. The renewed blood flow can aggravate tissue and damage organs.” Studies have shown that patients at risk for brain damage have better outcomes when they are treated with therapeutic hypothermia. Cooling the body suppresses many of the chemical reactions that happen with a reperfusion injury. The New England Journal of Medicine states patients are twice as likely to have full neurological recovery when treated with therapeutic hypothermia. Lake Charles Memorial Hospital (LCMH) is now putting this practice to action with the non-invasive ThermoSuit® System that cools the body from 98 to 91 degrees in less than 30 minutes. The process can be 40 times faster than a standard cooling blanket.

The computer-controlled pumping and temperature monitoring system includes a touch-screen with a message panel to guide the user though the feedbackcontrolled cooling process. The system can be set up in less than 10 minutes by nurses and does not require catheterization.

This procedure is used on patients who suffer a cardiac arrest and are successfully resuscitated. Patients are cooled down as soon as they hit the emergency room. They are then moved to the cath lab and cardiologists work to open any blocked artery. Ninety-percent of these patients have a blocked artery in their heart that caused the cardiac arrest.

“This is the fastest cooling product on the market,” Dr. White says. “The quicker you can cool somebody, the better advantage you have in preventing brain injury. The patient remains cool for about 24 hours. The cooling not only helps the brain, but it also stabilizes the heart.”

“The suit uses a simple concept of bathing a person in ice water,” Dr. White says. “Even though the process sounds simple, it’s going to be a life safer for cardiac arrest patients.”

Another added benefit is the ThermoSuit® System is the fastest, safest and most effective cooling device for the treatment of heatstroke. Every year, hundreds of patients in the United States die from the effects of heatstroke. Children left in hot cars, athletes practicing in sun-drenched fields, or workers doing physical labor in hot and humid conditions. The ThermoSuit® will be used to treat those patients too.

The device features a lower blanket that cools the patient from below and a top sheet that cools from above. The top sheet includes a Velcro® opening that enables easy access to the patient during the cooling process.

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Memorial Provides Safety Net for Moss Regional

During these tough financial times, Lake Charles Memorial Health System has taken the lead in preserving the health care safety net for the working poor and uninsured served by Moss Regional.

Larry Graham, CEO and President Memorial Health System

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January 17, 2013 will go down as a historic day for Southwest Louisiana medicine. critical services and offers new opportunities for students,” said Louisiana Department of Health and Hospitals Secretary Bruce D. Greenstein. “With the invaluable contributions of the region’s legislative delegation and the local provider community, we’ve worked to ensure this plan meets the needs of Southwest Louisiana and builds a stronger foundation for the future.”

The reality of budget cuts has led to uncertainty on whether Walter O. Moss Regional Medical Center would keep its doors open with each passing year. The hospital’s services have gained renewed strength and will now live on as a part of the Lake Charles Memorial Health System. LSU has been working to accelerate a system redesign through public-private partnerships over the past several months due to Congress’s sudden action in July that reduced Louisiana’s Federal Medical Assistance Percentage (FMAP) rate to the lowest it has been in more than 25 years.

Lake Charles Memorial will continue clinical care, medical research and education programs provided through Moss, which serves as the safety-net hospital in Southwest Louisiana. This agreement will also help preserve graduate medical education in the area, sustaining Memorial’s longstanding Family Medicine Residency Program which is affiliated with LSU and referred to as Memorial/LSUHSC Family Medicine Center Residency Program. .

“As Lake Charles’ only community-owned, not-for-profit hospital and as the region’s health care leader, we have a legacy of stepping up to provide critical health care access based on the needs of the patients we serve,” said Larry Graham, CEO and President of the Memorial Health System.

“Memorial has always been a team player when it comes to the health care needs of our community, and all of our decisions begin with the question: What is the right thing to do for our community?” Graham asked. “Memorial believes that preserving the health care safety net for the working poor and uninsured served by Moss Regional is the right thing to do. Lake Charles Memorial Health Care System understands and welcomes this new model of patient services, and we will do our best to work together with our partners to ensure quality health care for our community. Again, because it is the right thing to do!”

This agreement is similar to the historic public-private partnerships happening at several other state run hospitals throughout Louisiana. Memorial will lease Moss from the LSU system. West Calcasieu Cameron Hospital will partner with Lake Charles Memorial Hospital in this endeavor through a separate agreement. This allows LSU to avoid previously planned staff layoffs at Moss and maintain patient services at the existing location while a final agreement is reached. This agreement is part of Lake Charles Memorial Hospital’s investment to strengthen the local health system.

Memorial has hired a consulting firm to help with the public to private transition of Moss Regional. The transition is scheduled to start in March with the merger becoming official by late June.

“We’ve worked with LSU over the past several months to tackle a long-needed restructuring of the State’s public hospital system, while ensuring that our path maintains

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Memorial Sports Medicine Launches ACL Injury Prevention Program Athletes jump onto the force plate while a computer records data and video to see if they are at risk of ACL tears. If you have kept up with professional sports lately you have probably heard the plight of famed athletes such as Robert Griffin III, Rajon Rondo and, most recently, Lindsey Vonn. All three have suffered a career altering knee injury that is becoming more common in all levels of sports. The tearing of the anterior cruciate ligament or ACL is on a rapid increase as young athletes play sports year round. “Female athletes are four times more likely to have an ACL injury than males,” says Jamey Rasberry, director of Memorial Sports Medicine. “Soccer and basketball are the most common sports where this injury usually happens.” Females are at a higher risk because of the angle of their knees, the relative length of their bones, and muscle imbalances. The tear usually is a noncontact injury that happens with a sudden change of direction or when an athlete lands awkwardly after a jump. When female athletes jump their knees tend to come together when they land. This can strain the ligaments in the knee and cause the ACL to tear.

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Trainers analyze the jumps to develop a training program to prevent injuries. says Scott Lounsberry, owner of Athletic Republic in the Lake Area. “Research has shown there is a correlation between the knees coming together and the length of the tibia that leads to knee instability.”

Fixing the injury is no picnic. “If an athlete sustains this injury, they will usually have a surgical reconstruction of the ligament if they wish to play sports again,” says Dr. Brett Cascio, an orthopaedic surgeon with Orthopaedic Specialists, a part of the Memorial Medical Group. “We use a graft to replace the torn ACL and it can take anywhere from seven to 12 months to return to sports after this surgery. Some athletes never make it back to their previous level of play.

Memorial and Athletic Republic will study female athletes in Beauregard and Calcasieu Parishes three times a year over the next three years. The plan is to eventually expand the program to all Southwest Louisiana schools. The data will then be used to implement a training program to prevent ACL tears from happening, therefore, combining science and prevention to keep athletes safe from devastating knee injuries.

Memorial Sports Medicine is teaming up with Athletic Republic in hopes of preventing these injuries from ever happening. Female high school athletes are being tested to see if they are at risk for an ACL tear.

The ACL prevention program will also focus on improving the diet of local high school athletes. Proper nutrition is a part of keeping muscles, ligaments, and joints healthy. A preliminary study of local female athletes’ diets shows troubling trends and a lot of room for improvement.

Athletes jump onto and off of a force plate, designed by Athletic Republic, which measures the force of the jump. Sensors are placed on the athlete, while a camera and computer system records the data to analyze the mechanics of the jump. “The study is looking for trends such as stress on the knee, knee movements, hip weakness, and tibia or lower leg length,”

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Cover Story

Medicine on the Fast Track If you have paid a visit to an emergency room (ER) lately, chances are you were not the only one in the waiting room. Cuts and broken bones are common in ERs around the country as more and more people use the emergency room for urgent care. And, with one of the worst flu seasons in recent memory, it has been a busy year for those working in emergency medicine.

all of the ER’s have gone up just with the increased number of patients. So we’re trying to respond to that and expand the capacity of our emergency department so we can get people through quicker.”

The new year has brought with it a record number of patients that come through the Lake Charles Memorial ER on a daily basis.

The increased patient load has sparked a $200,000 renovation to Memorial’s ER. The upgrades will add four new patient bays tailored specifically to deal with non-life threatening injuries and illnesses.

“We’re getting more and more sick people. This winter especially has been very high in volume,” says Dr. Robert Anderson, medical director of Memorial’s emergency department. “Because of that, the wait times in pretty much

These types of patients tend to wait the longest because the more serious patients take top priority. This new fast-track system aims to get those patients in and out quicker by routing them through the urgent care track.

Nancy Coffey, RN, talks with a patient with minor injuries. 10


Dr. Robert Anderson says the ER renovations will cut down on patient wait time. “Hospitals around the country are adopting the use of these fast-track units as more patients rely on ERs for non-life-threatening illnesses because either they don’t have a regular doctor or have trouble getting to see one on short notice,” says Nancy Coffey, a registered nurse and Memorial’s ER director. Currently, patients who come to the ER seeking minor emergency care can expect to spend an average of two hours from start to finish. Memorial hopes the renovations will decrease this waiting time. The new construction will bring about a reshuffling of the ER as well. A brand new triage room will be added to the ER along with a new family room. The front registration area will also change as most patient registration will happen at the bedside using the hospital’s workstations on wheels. “The goal is to make our emergency room more efficient with quicker service,” Dr. Anderson says. “When you are hurt or sick, waiting for help is the last thing you want to do. These changes will help speed things up, while still providing top medical care.” Construction in the ER began in early January and should be completed in the Spring.

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Memorial’s new triage room. One of the many upgrades to the ER.

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Physician Spotlight

Michael Broussard, MD Oncologist & Outdoorsman

Fighting cancer is a job that is ever changing and brings with it long days and short nights for Dr. Michael Broussard, an oncologist with Medical Oncology Associates of SWLA, a part of the Memorial Medical Group. He lives and breaths a world where he treats people in a constant fight for survival. Still, to him, cancer patients are some of the best he has ever had the privilege to work with.

“They are some of the most appreciative, easy going cooperative un-combative patients you’ll ever run in to,” Dr. Broussard says. “It makes your job very easy when you don’t have to fight the disease and the people having the disease.” Truth be told, Dr. Broussard had his sights set on cardiology or nephrology (a branch of medicine dealing with the study of kidney function and disease) first, but switched to oncology after completing a rotation while in medical school. He started out as an electrical engineering major at McNeese State, but quickly realized medicine was where he wanted to be. Dr. Broussard finished medical school at LSU in New Orleans in 2006 and has been treating patients at Memorial ever since. 12


“The medicine involved is always interesting. It’s constantly changing,” Dr. Broussard says. “It’s not a stagnant field. There are new advancements all the time. There are a lot more target therapies, a lot more oral chemotherapies, better responses, better survival rates and better outcomes.” Medicine is a passion he shares with his wife Dr. Karen Fisher, a gynecologist in the Lake Charles area. Dr. Broussard has an unmatched love for the outdoors. He can tell you what time of year it is based on what is huntable. Technology doesn’t work where he ventures, so his cell phone and pager don’t make the trip. He is no trophy hunter, it is the peace of the outdoors and bounty of the harvest which rewards him. He doesn’t play favorites when it comes to hunting or fishing. Whether fishing for bass in the freshwaters of his childhood home or for reds and specs in the saltwater of Southwest Louisiana, he does it all. A dove hunting trip to the Texas Hill Country is annual occasion.

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“I guess if I had to pick one thing that I could do everyday for the rest of my life I would probably pick duck hunting,” Dr. Broussard says. “I just as soon be out squirrel hunting as I would duck hunting or sitting on a boat catching a red fish.” Growing up in the small unincorporated town of Borodino, about an hour north of Lafayette, he recalls the days of waking up in the morning and disappearing into the Louisiana timber for days on end. That’s where he grew up and where he returns to hunt the same grounds he did as a kid. Only this time he has three side kicks, his children, two boys and one girl who range in age from five to seven. Passing on to them his release from the fast paced world we live in. “That’s probably the coolest thing I ever did in my life. Doing things with my kids is where it’s at,” he says. That is the neatest thing in the world, trying to teach them something that you grew up doing. It’s awesome.”

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Look Good . . . Feel Better

Rhonda Victor (right) is happy with the tips Katherine LeBlanc gave her when it comes to applying makeup. Timid and reluctant, Rhonda Victor walks into Memorial’s Shearman Conference Center, unsure of what to expect through the doors ahead.

Look Good Feel Better is a free American Cancer Society (ACS) program that teaches beauty techniques to female cancer patients to help them combat the appearance-related side effects of cancer treatment.

She is greeted with warm smiles and the faces of other women who battle the same disease she is…cancer. A bag of makeup and a pair of beauticians await Rhonda with a program that will help her look good and feel better.

It is a brand neutral program offered in collaboration with the Personal Care Products Council Foundation, a charitable organization supported by the cosmetic and personal care products industry and the Professional Beauty Association/ National Cosmetology Association.

“I had never heard of it, but I was like ‘okay’ I’ll try it,” Rhonda says. “If my family wouldn’t have come and got me I wouldn’t have come, because I changed my mind.”

“The cosmetologists teach them how to take care of their skin, what not to do when they are going through cancer treatment,” 14


“I cried twice because I was so happy.”

Jesse Oliver

Rhonda Victor, Cancer Patient

says Michele Bryant, Health Initiative Director for ACS. “We also teach them about wearing wigs, how to take care of them and put them on.” Rhonda pours out the makeup in her bag and is amazed by the amount and quality of what is inside. Katherine LeBlanc of Appearance Beauty Salon shows her how to apply the products and gives her tips on looking her best. It leads up to a psychological boost for those who attend. “It might have sparked a little something,” Rhonda says with a smile. “I am glad I came and met all the ladies. They showed me how to do some stuff I didn’t know how to do. Just to be out somewhere and see others like you are okay and making it. That is encouraging.” Those like Jeanne Vincent, who recently completed her treatment for breast cancer.

Rhonda Victor

“It’s very pleasant. It made me feel better about myself having makeup on again,” Jeanne says. “It’s given me that boost. My morale can get really low, but this has lifted me up.”

Jeanne Vincent

Women who attend Look Good Feel Better are encouraged to come back with their new supply of products. Rhonda and Jeanne plan to return, offering support for those who face the same battle. “It’s a relief to be able to talk to somebody else that is going through it because most people don’t know what it is like,” Jeanne says. “Everybody needs that support knowing that somebody is there for you.” Look Good Feel Better takes place noon until 2 p.m. on the fourth Monday of every other month in Memorial’s Shearman Conference Center. For more information, call (337) 433-5817.

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Calendar of Events are offering women struggling with cancer - the diagnosis,

Support Groups

treatment and concerns about their appearance - a chance to Look Good...Feel Better. For more information, call

COPING WITH CANCER For those cancer patients who are newly diagnosed, undergoing treatment, or who have completed treatment. For more

(337) 433-5817. Fourth Monday of every other month March 25, May 27, July 22

information, call Memorial’s Chaplain, Rev. David DeWitt at (337) 802-1933.

Shearman Conference Room

Third Tuesday of Each Month • Chaplain’s Office Noon – light refreshments served

Noon - 2:00pm SARCOIDOSIS SUPPORT GROUP

DESIGNER GENES A support group by and for the parents of children with genetic disorders. Located at Memorial Hospital for Women, 1900 W.

A group for people in our area dealing with this incurable disease, to come together to share their stories, health tips and support. For more information, call Sabrina Sonnier at (337) 8425939.

Gauthier Road. For more information, call the group’s founders, Ashleigh Hornsby (337) 853-7657 or Jessi James (337) 563-1178. Second Saturday of Each Month Memorial for Women • Noon

First Tuesday of each month Shearman Conference Room 6pm - 7pm

DIABETES SUPPORT GROUP

LA LECHE LEAGUE A breastfeeding group, La Leche League offers a series of

Don’t underestimate the importance of education and peer support when living with diabetes. Located at Memorial’s

meetings consisting of four classes that are helpful for pregnant moms and moms who are already nursing. Meetings are free and

Diabetes Education Office, 1801 Oak Park Boulevard. For more information, call Memorial’s Diabetes Education at (337) 494-

open to mothers and babies. First Thursday of Each Month

6425. First Tuesday of Each Month Diabetes Education Office • 10am – 11am

Memorial for Women Education Room 2 10am – 11:30am

SISTERS SURVIVING A breast cancer support group for African-American women, but open to any woman regardless of race. For more information, call (337) 433-5817. Third Tuesday of Each Month MOB II Conference Room • 6pm

blood drive COMMUNITY BLOOD DRIVE Approximately half of the nation’s blood supply is collected at blood drives. Memorial partners with United Blood Services to provide for our patients. Join us for the next Community Blood Drive, which will be held in the parking lot across Oak Park Boulevard from Memorial’s main entrance. For more information, call (337) 235-5433. Fourth Monday of Each Month 2pm – 6pm

LOOK GOOD, FEEL BETTER Looking good can often be an important step toward feeling good - especially for women who are fighting the cancer battle. With that in mind, Memorial and the American Cancer Society

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Spring 2013 Prenatal and Family Education Classes Registration is required for all classes. For more information or to register, call 480-7243. All classes are held in the education rooms at Memorial for Women, 1900 W. Gauthier Road. Tours are available after all prenatal classes and at 1:30pm on the first Thursday of each month. PREPARED CHILDBIRTH CLASS 4-WEEK SERIES

both parents. The children will have hands-on practice with dolls

This class is highly recommended for its hands-on, and often fun, approach to dealing with labor, delivery and recovery. Birth

to learn how to interact with a new baby. Parents will receive informative guidelines and everyone will tour the mother/baby

preparation is discussed regarding natural delivery, birth with an

unit. Mondays.

epidural and cesarean birth. Bring your pillows, your questions and don’t forget to breathe. Recommended during the last three

March 18, May 6, June 24, July 29 6pm – 7pm • $10/Family

months of pregnancy. Tuesdays. March 5, 12, 19, 26

BABY CARE CLASS The Baby Care Class reviews newborn characteristics, general

May 7, 14, 21, 28 July 9, 16, 23, 30 6:30pm – 8:30pm • $35/Couple

baby care, early parenting issues and community resources. Recommended during the last 3 months of pregnancy. Mondays. April 15, May 20, July 8 6:30pm – 8:30pm • $10/Couple

ONE DAY PREPARED CHILDBIRTH CLASS Learn comfort, relaxation, positioning, breathing, and massage techniques for increasing the comfort level and enhancing the

INFANT AND CHILD CPR CLASS FOR FAMILY AND FRIENDS

birth experience during this condensed version of the Prepared Childbirth Series. Recommended for the last 3 months of

Learn and practice rescue for choking and CPR for infants. This is NOT a certifying or credentialing course, but is recommended for expectant parents, new parents and support persons.

pregnancy. Saturdays. April 13, June 1

Monday, March 11, Tuesday, April 16

9am – 4:15pm • $35/Couple BREASTFEEDING CLASS Learn positioning, latch-on, early feedings and the importance of assessing baby’s intake during the Breastfeeding Class. Recommended during the last 3 months of pregnancy. Thursdays. March 21, April 11, May 9, June 13 and July 11 6:30pm – 8:45pm • $10/Couple SIBLING CLASS This class is recommended during the last three months of pregnancy. Preparing siblings for the arrival of a new baby can be as confusing as it is joyous. This class focuses on the unity of the family. Older siblings ages 2-10 are asked to attend with one or

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Monday June 3 Monday, July 15 6:15pm – 8:30pm • $10/Person SAFE SITTER The best sitter is a safe sitter! The Safe Sitter® Class is designed for boys and girls ages 11 to 13. Sitters learn safety tips, how to recognize a medical emergency, what the appropriate action should be during an emergency, such as when a child or infant is choking, and how to have fun with children. Wednesdays. June 12, June 19, July 10 $35/Sitter


Join our blog! Are you looking for healthy advice on how to choose a doctor or how to stay well? How about getting information on a specific condition or illness? Do you want to know the latest happenings and advancements at your local hospital? Lake Charles Memorial Health System has launched a blog to help answer all those questions. The Memorial Health Blog will bring readers advice from the top doctors and experts in the Memorial Medical Group on a wide range of topics. Go to http://memorialhospitalswla.wordpress.com/ to access the blog. It can also be found by going to our Facebook page www.facebook.com/LakeCharlesMemorial and clicking on the Memorial Health Blog tab. Updates are posted every Wednesday morning. You can subscribe to the blog by clicking the Follow icon at the bottom right corner of the page. All you have to do is enter your email address.

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Letters Marilyn Wheeldon It was our first experience with the Heart & Vascular Center and our appointment was super! Everyone we encountered was most professional, well mannered, and put the patient first. At no time were we treated as if we were just another chore they had to attend to. At no time did they say or imply that I (the wife) was to sit in the corner and just stay out of their way and to not ask any questions. What a change from our previous provider. Dr. Fernando Ruiz and Kim Jones, LPN, make a beautiful team and really do complement each other. When we asked if they could accommodate L.J.’s calendar when scheduling a procedure - to our surprise, the response was “we will make it happen!” We have never had that response before. Then, following the appointment, I called back and talked to a lovely lady at scheduling. She spent at least an hour or more coordinating L.J.’s nuclear stress test, his CTA, and his subsequent follow up appointment. This took a lot of time and patience on her part because of the doctor’s call schedule and the upcoming holiday schedules. At no time did she ever indicate that she was inconvenienced nor did she ever show any rudeness or impatience. I cannot say enough about how impressed we are that the staff was able to pull all of this off and do it professionally, with integrity, and a sincere willingness to accommodate the patient and me, his wife. I can honestly say that all of the values and virtues that I hold dear and precious, I witnessed at the Heart & Vascular Center. Again, thank you so much!


1701 Oak Park Blvd. Lake Charles, LA 70601

Memorial Medical Milestones Kathy DeRouen Senior Vice President of Marketing Matt Felder Communications Manager This is a publication from Lake Charles Memorial Hospital. The information in this newsletter is intended to inform physicians about subjects pertinent to their patients and practices, not as medical education. © 2013 Printed in U.S.A.

Get Healthy. Get Excellence. Ranked in the top 10% of the nation and as one of the top 2 hospitals in Louisiana for overall orthopedic services, Lake Charles Memorial Health System is recognized for expert orthopedic specialists and superior clinical outcomes. Healthgrades® five-star hospitals offer vastly better patient outcomes. With excellence at this level, these are the surgeons you want.

5-Star Clinical outcomes for: • Overall Orthopedic Services in 2013 • Joint Replacement in 2013 • Total Knee Replacement in

Thomas Axelrad, MD, PhD Orthopedic Trauma Surgery

Brett Cascio, MD Orthopedic Shoulder, Hip & Knee Surgery

Nathan Cohen, MD Orthopedic Hip & Knee Surgery

Lawrence Weber, MD, PhD Orthopedic Elbow, Wrist & Hand Surgery

2013 • Total Hip Replacement for 4 Years in a Row (2010-2013) • Hip Fracture Treatment for 2 Years in a Row (2012-2013)

Orthopaedic Specialists is a part of the

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Spring 2013