MD-Update Issue 145

THE BUSINESS MAGAZINE OF KENTUCKIANA PHYSICIANS AND HEALTHCARE PROFESSIONALS ISSUE #145 WWW.MD-UPDATE.COM

Blossoming with Care

UofL Health Urologist Sees Innovation and Holistic Care as Her Future in Urology

VOLUME 13 • #2 • April 2023

ALSO IN THIS ISSUE NEW PODIATRIST AT SAINT JOSEPH HOSPITAL’S WOUND CARE CENTER ADDICTION MEDICINE AT THE PAIN TREATMENT CENTER OF THE BLUEGRASS INFECTIOUS DISEASE SPECIALISTS AT NORTON HEALTHCARE HEALTH EQUITY IS COMMUNITY CARE AT NORTON HEALTHCARE

More personalized cancer care. More hope.

CHI Saint Joseph Health has been leading the way in cancer screenings, diagnosis and treatment for more than 40 years. As we continue to bring world-renowned cancer care to our communities, we’ve expanded our affiliation with Cleveland Clinic Cancer Center - rated as one of the nation’s top 5 cancer programs by U.S. News & World Report - to reach more Kentuckians.

To schedule a cancer screening, call 844.940.HOPE (4673).

Bardstown • Corbin • Lexington • London • Mount Sterling

THE BUSINESS MAGAZINE OF KENTUCKIANA PHYSICIANS AND HEALTHCARE PROFESSIONALS World Class Hand Care

VOLUME 12 • #4 • SEPTEMbEr 2022

Legendary practice Kleinert Kutz continues the training and legacy of its founders

ALSO IN THIS ISSUE SPORTS MEDICINE AT UofL HEALTH & ATHLETICS TAKING THE PAIN OUT OF JOINT PAIN AT WELLWARD REGENERATIVE SPORTS MEDICINE AT CHI SAINT JOSEPH HEALTH NEW ORTHOPEDIC CENTER AT BAPTIST HEALTH LOUISVILLE

2023

Editorial Calendar

World Class Hand Care Legendary practice Kleinert Kutz continues the training and legacy of its founders

ISSUE #146 (June) WOMEN’S & CHILDREN’S HEALTH

ALSO IN THIS ISSUE SPORTS MEDICINE AT UofL HEALTH & ATHLETICS TAKING THE PAIN OUT OF JOINT PAIN AT WELLWARD REGENERATIVE SPORTS MEDICINE AT CHI SAINT JOSEPH HEALTH

OB/GYN, Women’s Cardiology, Oncology, Urology, Pediatrics, Radiology,

NEW ORTHOPEDIC CENTER AT BAPTIST HEALTH LOUISVILLE

World Class Hand Care

VOLUME 12 • #4 • SEPTEMbEr 2022

Legendary practice Kleinert Kutz continues the training and legacy of its founders

ALSO IN THIS ISSUE SPORTS MEDICINE AT UofL HEALTH & ATHLETICS TAKING THE PAIN OUT OF JOINT PAIN AT WELLWARD REGENERATIVE

ISSUE #147 (September) MUSCULOSKELETAL HEALTH

Orthopedics, Sports Medicine, Physical Medicine & Rehabilitation, PT/OT

ISSUE #148 (October) CANCER CARE

Oncology, Plastic Surgery, Hematology, Radiation, Radiology

SPORTS MEDICINE AT CHI SAINT JOSEPH HEALTH

NEW ORTHOPEDIC CENTER AT BAPTIST HEALTH LOUISVILLE

ISSUE #149 (December) IT’S ALL IN YOUR HEAD

Neurology, Neuroscience, Ophthalmology, Pain World Class Hand Care Medicine, ENT, Psychiatry, Mental Health Legendary practice Kleinert Kutz continues the training and legacy of its founders

VOLUME 12 • #4 • SEPTEMbEr 2022

Editorial topics and dates are subject to change ALSO IN THIS ISSUE SPORTS MEDICINE AT UofL HEALTH & ATHLETICS TAKING THE PAIN OUT OF JOINT PAIN AT WELLWARD REGENERATIVE SPORTS MEDICINE AT CHI SAINT JOSEPH HEALTH NEW ORTHOPEDIC CENTER AT BAPTIST HEALTH LOUISVILLE

World Class Hand Care

To participate, please contact Legendary practice Kleinert Kutz continues the training and legacy of its founders

VOLUME 12 • #4 • SEPTEMbEr 2022

Gil Dunn, Publisher • GDUNN@MD-UPDATE.COM • 859.309.0720 (direct) • 859.608.8454 (cell) Send press releases to gdunn@md-update.com ALSO IN THIS ISSUE SPORTS MEDICINE AT UofL HEALTH & ATHLETICS TAKING THE PAIN OUT OF JOINT PAIN AT WELLWARD REGENERATIVE SPORTS MEDICINE AT CHI SAINT JOSEPH HEALTH NEW ORTHOPEDIC CENTER AT BAPTIST HEALTH LOUISVILLE

LETTER FROM THE EDITOR/PUBLISHER MD-UPDATE MD-Update.com

Welcome to the Internal Systems issue of MD-Update In this issue we cover a wide spectrum of topics: urology, addiction medicine, infectious disease, wound care, and community medicine. I invite you to read about your colleagues who are advancing care throughout Kentuckiana. Some of them are embarking on new aspects of their career; some are fulfilling a lifelong dream. Each of them has a story that I hope you will find interesting.

Match Day There were big smiles on the faces of graduating medical students at the UK College of Medicine in Lexington and in Northern Kentucky on Match Day, March 24, 2023. Thanks to UK Public Relations we are able to bring you a few of those faces. Maybe you can remember how you felt on your Match Day. I believe that joy is contagious.

Dilemma or Problem?

Our MD-Update Mental Wellness columnist Dr. Jan Anderson reveals a strategy for identifying and dealing with a dilemma, versus fixing a problem. The bad news is we all have dilemmas; they are part of the human condition. The good news is, there are effective ways to deal with them. Dr. Jan explains how on page 22.

Speaking of dilemmas, our very wise financial columnist, Scott Neal, discusses bond pricing, yields, timing, allocation, and re-investing. If your dilemma is “Do I buy stocks, or bonds? Do I sell or hold?” take a few minutes to read Scott’s column on page 7, after you’ve read how to deal with a dilemma.

SB #150 A year ago, in June 2022 in MD-Update #140, the prescient Dr. Cameron Schaeffer predicted that legislators in Frankfort would insert themselves into the doctor- patient relationship of children with gender-dysphoria issues. Dr. Schaeffer was correct, and SB 150, which restricts a doctor’s care for their patients, was passed into law over Governor Beshear’s veto. I invite any physician who wants to share their views on a difficult subject to reach out to me.

Future topics The MD-Update editorial calendar is on the preceding page. As always, I invite you to look for your specialty. When you find it, give me a call. I’d like to hear from you. I’m sure you have a good story or two to tell.

Until the next issue, all the best,

Gil Dunn Editor/Publisher MD-Update

2 MD-UPDATE

SEND YOUR LETTERS TO THE EDITOR TO: Gil Dunn, Publisher gdunn@md-update.com, or 859.309.0720 phone and fax

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ISSUE #145

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CONTENTS

ISSUE #145

4 6 7 8 10

HEADLINES ACCOUNTING FINANCE LEGAL COVER STORY

lossoming 10 B with Care

UofL Health Urologist Sees Innovation and Holistic Care as Her Future in Urology SPECIAL SECTIONS: 14 ADDICTION MEDICINE 16 INFECTIOUS DISEASE 18 WOUND CARE 20 CARDIOLOGY/ LIFESTYLE MEDICINE 22 MENTAL WELLNESS 24 NEWS 28 EVENTS

COVER PHOTOGRAPHY BY ROBERT BURGE

FEATURED

14 ADDICTION MEDICINE

16 INFECTIOUS DISEASE

18 WOUND CARE

20 CARDIOLOGY/ LIFESTYLE MEDICINE ISSUE #145 3

Headlines

Introducing Match Day Across America The UK College of Medicine celebrated its largest group of matching students and its highest percentage of students matching into Kentucky residency programs.

LEXINGTON The University of Kentucky

College of Medicine recognized its fourthyear students who learned their pivotal next step in training — residency — during Match Day celebrations on March 24, 2023.

DR. RICHARD LINGREEN Over 30 Years of Practicing Medicine, Helping Thousands of Patients Specialist in Addiction Medicine Board Certified in Pain Management

(859) 278-1316 www.pain-ptc.com Full-Service Pain Management & Addiction Medicine Eric Vogt 4 MD-UPDATE

The Class of 2023 was the college’s largest group to match with celebrations across Kentucky in Lexington, Morehead, Bowling Green, and for the first time, Northern Kentucky.

The UK College of Medicine-Northern Kentucky Campus welcomed its fourth class last summer and will graduate its inaugural class this spring.

On Match Day at noon Eastern Time, students across the country simultaneously opened letters from the National Resident Matching Program. Each letter contained the location and specialty of the residency program where the student will spend their first years as official doctors.

Sonia Bhati, a fourthyear Northern Kentucky Campus student who is from Cincinnati, said she had been “dreaming of Match Day for many years.” The event exceeded her expectations when she learned she will remain close to Northern Kentucky at her top choice, the University of Cincinnati’s neurology residency program.

“I initially wanted to become a neurologist because of the resiliency that I’ve seen in patients

LEXINGTON CAMPUS MATCH DAY PHOTOS BY MARK MAHAN MEDIA

Headlines

Hana Kebede and Jodi Llanora

Issac Domenech-Gonzalez

Ryan Yadav, NKY

I’ve helped care for as a medical student,” Bhati said. “I’m really excited for the difference I can make for people.”

UK College of Medicine students celebrated Match Day with their classmates and families at Kroger Field in Lexington, Houchens Industries L.T. Smith Stadium in Bowling Green, the Center for Health Education and Research in Morehead, and at Newport Aquarium in Northern Kentucky.

The expansion of the UK College of Medicine’s Match Day celebrations and its reach in the Commonwealth are a reflection of the College’s strong and successful partnerships with community organizations. The UK College of Medicine collaborated with health care systems St. Claire HealthCare, Med Center Health, and St. Elizabeth Healthcare and academic institutions Morehead State University, Western Kentucky University, and Northern Kentucky University to develop its regional campuses in Bowling Green and Northern Kentucky, along with the Rural Physician Leadership Program in Morehead.

“The success we enjoyed this year on Match

Day wouldn’t be possible without teamwork,” said Charles Griffith, MD, MSPH, acting dean of the UK College of Medicine. “It was thanks to our faculty and staff who supported this class through four years of training. It was because of our community partners who are integral to our regional campuses and programs. And of course, it was because of our students who took this journey with us, and the families who supported them along the way.”

Within the Class of 2023, 78 students — 42% of the UK College of Medicine’s largest group of matching students — will pursue a residency program in Kentucky, the highest percentage in school history and more than twice as many students per year prior to regional campus expansion. Meanwhile, 32% of the Class of 2023 matched at UK. Top specialties among the matches included internal medicine, surgical specialties, family medicine, pediatrics, obstetrics and gynecology, and anesthesiology.

In addition, eight students matched at Med Center Health in Bowling Green in internal medicine, obstetrics and gynecology,

and surgery; one student matched into family medicine in Morehead; and five students matched into family medicine at St. Elizabeth Healthcare.

“Our partnerships have helped us actualize our vision of training physicians in Kentucky for Kentucky. Our community partners are directly supporting the state’s future workforce by matching our students into their programs,” said Stephanie White, MD, MS, senior associate dean for medical student education. “These results show the power of a collective vision, and we are so appreciative of their continued sponsorship.”

Kenny Spear, a fourth-year student at the Northern Kentucky Campus, was excited to be one of the five who matched at St. Elizabeth Healthcare, which was his top choice for residency.

“I feel very well prepared to go into residency based off of the experiences I had during my clinical years at St. Elizabeth as a medical student,” Spear said. “I’m excited to keep working with St. Elizabeth’s supportive physicians in residency.”

Melissa Becker, NKY

Allie Kipler, NKY NORTHERN KY CAMPUS MATCH DAY PHOTOS BY AUDREY KIRBY

ISSUE #145 5

Accounting

Public Health Emergency Ending and 1135 Waivers

BY ANNA HENSLEY, CPA, HEALTHCARE SERVICES CONSULTANT

On January 30, 2023, the Biden administration announced the anticipated ending of the Public Health Emergency declarations.

These declarations are set to expire on May 11, 2023. Due to heavy reliance on 1135 waivers throughout the time that the emergency extended, the ending of the Public Health Emergency will have a large impact on hospitals. 1135 waivers are used to waive various administrative requirements to increase access to medical services during a time of national emergency. Now that the emergency is coming to an end, healthcare entities should take steps to ensure their compliance with laws and regulations while returning to normal operations.

It will be important for hospitals to review

their policies and procedures to ensure compliance with regulations and standards that will be changing and to update these policies if necessary. It is important to note that some waivers end at the conclusion of the Public Health Emergency, while others end 151 days following the conclusion of the Public Health Emergency.

Prior to May 11th, administration and leaders in each department throughout hospitals should be asked the following questions in order to ensure that they are prepared for the coming changes: • Is your department currently relying on any waivers that are still in effect?

• Is your department currently relying on any waivers that have expired?

• Has your department developed a plan and sent out communications to wind down any reliance on waivers by the expiration date?

• Does your department understand state laws in areas that will be affected when waivers default back to state laws after expiration?

CMS and others have released guidance on the current 1135 waivers and on the end of the Public Health Emergency in order to help prepare practices. For hospitals that are highly reliant on 1135 waivers, this guidance will be key to preparing for a return to normal operations.

If you have questions about these updates or requirements, please reach out to us for more information. Contact Anna Hensley, CPA, Healthcare Services Consultant, at ahensley@ deandorton.com | 859.425.7622.

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6 MD-UPDATE

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Finance

Investment Questions Loom Large

BY SCOTT NEAL

Last month, a longtime friend told me a story about a 78-year-old acquaintance of his who had lost a very significant amount of money last year (2022). She was taken by surprise because she had invested nearly all her money in government bonds or bond funds and anticipated that her investment would be “safe.” Safe, in her mind, meant that her portfolio of bonds would not ever go down. Yet she watched as the value of her portfolio went down month after month. Like so many investors, she had been told “stocks are risky, bonds are safe.” Also, like many investors, she looked at her bond portfolio much like a savings account: put money in, collect some interest along the way, and either sell the bonds or cash them upon maturity for full face value; neither risking nor losing anything at all.

The value of bonds fluctuates inversely to the prevailing interest rate. As interest rates go up, bonds fall in value, and vice-versa. Think about it for a moment. If you own a $1,000 bond that pays 4% each year until it matures, as the holder of the bond you will collect $40 interest per year ($1,000 times 4%). But suppose prevailing market rates are now 5%. If you try to sell your bond the buyer will likely say, “I can invest in a new bond and get 5% and since I am only going to get $40 a year from your bond, I will not be willing to pay full value for your bond. Therefore, the current market value of your bond has gone down. That’s an oversimplification, but my aim here is to explain one of the big reasons bonds fluctuate in value, often as much, or more, than stocks.

Many people think that the only rates that matter are those imposed by the Federal Reserve. We all know that the Fed has been raising rates in its attempt to stem inflation.

However, the Fed only controls short-term rates. Rates on longer-term notes and bonds are controlled by the bond market, and, like stocks, are bid up and down based on how the bond market perceives the risk of holding

Do you get the impression that bonds need to be managed? I hope so, because they do. the bonds to maturity, among other things.

(By the way, in 2020, rates briefly fell into negative territory.) One way to mitigate the risk of bonds fluctuating in value is to buy an individual bond and simply hold it to maturity. You then collect the face value as long as the issuer has the funds to redeem them. You must be willing to see the value fluctuate on your monthly or quarterly statement. It’s also a good idea to spread the maturity dates over several periods so as to avoid having all your bonds coming due at one time. We see people making the mistake of investing their entire portfolio into one maturity date because it’s the highest yielding at the time they are investing.

Reinvestment is then subject to the prevailing rate at that time. A better approach might be to ladder maturities so that similar amounts come due at various intervals in the future.

Do you get the impression that bonds need to be managed? I hope so, because they do.

Most investors (and retirement funds) obtain professional management of bonds by buying into a bond fund. Bond funds (which are essentially a managed portfolio of bonds with various maturities and quality) don’t have a maturity date. Therefore, a redemption value is not locked in, as it can be with individual bonds. The manager of the fund keeps buying and selling bonds in an attempt to earn a total return (interest paid plus or minus gain/loss on the sale). The fund will have a calculated “average maturity date,” but there is no promise of value at that date. I have a feeling that my friend’s acquaintance—the one mentioned at the beginning of this article—held bond funds

and watched the value of her portfolio go down as interest rates went up last year. Since the total return on the aggregate bond market has been negative for three years, she may have a long recovery period.

Many advisors will say that the best way to mitigate investment risk is to have a portfolio that is diversified between stocks and bonds.

“Get the asset allocation right, then buy, hold, and rebalance; and all will be okay,” they will say. That did not work out so well last year. A portfolio invested 40% in the Barclays U.S. Aggregate Bond index and 60% in the S&P 500 would have been down by almost 16% because both stocks and bonds went down.

At this writing in the beginning of April, that 60/40 mixture has recovered about 6% since the end of the year. Both indices are under extreme pressure. This is probably not a good time for asset allocation strategies to produce positive return.

So, what’s a person to do? There are really three factors that contribute to total return: 1) asset allocation, 2) security selection, and 3) timing. If asset allocation is off the table, then more weight must be put on security selection and timing. These two should be controlled by your belief about where the economy is headed and what will perform well in that economic environment. You might be wrong in your belief and need to adjust course as time goes on. The big questions we wrestle with are: Will the Fed need to keep raising rates or will they be able to bring in a soft landing? Will we suffer a recession this year? Will inflation continue?

What about employment and wages? One thing is certain—the answers to these questions are not knowable with certainty. That means one must pay attention as they unfold and be willing to adjust.

Scott Neal, CPA, CFP is the president of D. Scott Neal, Inc. with offices in Lexington and Louisville and now serving clients in 27 states. He can be reached at 1-800-344-9098 or by email to scott@dsneal.com ISSUE #145 7

Legal

Stark Law Blanket Waivers to End in May 2023

BY JAY L. PHILLIPS, ESQ.

It is essential for healthcare providers to understand the Stark law, 42 U.S.C. §1395nn (Stark), a critical regulation that impacts the practices of all CMS participating physicians.

Stark protects patients and taxpayers from fraud and abuse by preventing financial incentives from influencing physicians’ medical decision-making and promoting fair competition in the healthcare industry. On January 30, 2023, the Biden administration announced its intent to end the national health emergency declarations on May 11, 2023. With the end of these declarations, the blanket waivers of the sanctions imposed for violating the Stark law related to COVID-19 that C.M.S. issued in March 2010 will also end.

Stark Law: The Basics The Physician Self-Referral Law, commonly known as Stark, prohibits physicians from referring patients for designated health services (DHS) to entities in which the physician or an immediate family member has a financial interest.1 Stark further prohibits a healthcare entity from presenting or causing to be presented claims to Medicare for DHS furnished under a prohibited self-referral.2 Stark is a strict liability law which means a defendant is liable for violating the statute regardless of whether they knew what they were

doing was illegal. The Stark regulations establish many exceptions or “safe harbors” to the Stark prohibition, including for various types of physician investment and compensation arrangements, provided the structure satisfies all the elements of the applicable safe harbor.

Upon the request of CMS or the OIG (Office of Inspector General), an entity that provides DHS covered by Medicare or Medicaid must report physician investment, ownership, and compensation information.

This information can include the names and NPIs (National Provider Identifiers) of the physicians and their immediate relatives the entity has a financial relationship with, in conjunction with details of the ownership, investment, and compensation arrangements.

Stark violations can result in severe penalties. Potential sanctions include denial of reimbursement, refunding Medicare and Medicaid paid claims, civil penalties of up to $15,000 per billed claim for DHS arising from a prohibited arrangement, a civil penalty of up to $100,000 and exclusion for schemes to circumvent Stark, and a maximum fine of $10,000 per day for any delay or omission of required reporting relating to the sanction section of Stark.3 In addition to these penalties, Stark violations can violate the Anti-kickback Statute and the False Claims Act.

Empowering physicians to focus solely on the demands of their clinical practice

Recent Stark Law Prosecutions What does a violation look like in practice?

Frequently settlements occur before a Stark law prosecution proceeds through the court system, but settlements are often made public by the Department of Justice. For example, in 2022, BioReference Laboratories and their parent company OPKO Health, Inc., agreed to pay $9.85 million to resolve allegations that BioReference paid above-market rents to physician landlords for office space to induce referrals from those physicians to BioReference.4 When a Stark prosecution proceeds, it often takes the form of a qui tam action in which a private citizen brings an action against a person or company on the government’s behalf and shares in any recovery obtained.

In U.S. ex. rel. Bartlett v. Ashcroft, former senior officers of a Pennsylvania hospital filed a qui tam action against physicians and the physician-owned imaging company. The suit alleged that for a year, the physicians referred over 8,000 patients to the hospital for inpatient services and other DHS. In return, the hospital paid the referring physician-owned imaging company $410 per scan. Those payments were then distributed to the physician owners. The district judge found that this scheme violated Stark law, and the case continued to work through the federal system.

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Legal

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What Were the Blanket Waivers?

On March 30, 2020, CMS issued blanket waivers of the Stark penalties and sanctions retroactive to March 1, 2020, for arrangements to furnish DHS solely related to “COVID19 Purposes,” including diagnosis, medically necessary treatment, securing other physicians’ services, and overall to enable positive public health outcomes. So long as a “COVID-19 Purpose” was met, physicians and entities were not subject to prosecution for what otherwise constitutes prohibited conduct.

A few examples of conduct CMS deemed covered by the blanket waivers included: a hospital paying physicians above their previously-contracted fair market value rate for furnishing professional services for COVID19 patients in particularly hazardous or challenging environments; lending money to a physician practice that provided exclusive anesthesia services at the hospital to offset lost income resulting from the cancellation of elective surgeries to ensure capacity for COVID-19 needs; or a physician referring a Medicare beneficiary to a home health agency

owned by an immediate family member of the referring physician because there were no other home health agencies with the capacity to provide the medically necessary service to the beneficiary during the pandemic.

Effective May 11, 2023, none of the waivers will be available to protect these arrangements, regardless of whether they have a COVID-19 purpose. Consequently, any physician and entity with a financial relationship must either reform the contract to satisfy a Stark safe harbor or end it.

clinical decision-making on clinical judgment rather than financial incentives. Healthcare providers must stay current on changes to these regulations and seek legal guidance if they have questions or concerns about compliance.

Conclusion

2 Centers for Medicare and Medicaid Services, “Physician Self-Referral,” accessed on March 3, 2023, via https:// www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/index. Designated Health Services include clinical laboratory services; physical therapy; occupational therapy; outpatient speech-language pathology services; radiology and (certain other imaging services); radiation therapy services and supplies; durable medical equipment and supplies; parenteral and enteral nutrients, equipment, and supplies; prosthetics, orthotics, and prosthetic devices and supplies; home health services; outpatient prescription drugs; and inpatient and outpatient hospital services.

The Stark law aims to prevent fraudulent activities, such as overutilization of services, unnecessary procedures, and kickbacks, promote fair competition and prevent conflicts of interest in the healthcare industry.

Understanding the Stark law and the AntiKickback Statute is critical for healthcare providers to avoid potential violations and protect patients and taxpayers from fraud and abuse.

Compliance with these regulations promotes fair competition and ensures physicians base

Jay L. Phillips is a business and compliance attorney with Sturgill, Turner, Barker & Moloney, PLLC. He can be reached at jphillips@sturgillturner.com or 859.255.8581.

This article is intended to be a summary of state or federal law and does not constitute legal advice.

ENDNOTES 1 42 U.S.C. § 1395nn(a)(1)

3 42 U.S.C. § 1395nn(f) 4 https://www.justice.gov/opa/pr/bioreference-laboratories-and-parent-company-agree-pay-985-million-resolvefalse-claims-act ISSUE #145 9

Cover Story

Blossoming with Care

UofL Health urologist sees innovation and holistic care as her future in urology a fellow there, and she had interviewed there previously. Fortunately, they discovered that opportunities for both a pulmonologist and a urologist existed in Louisville. “We knew it was a great place to raise a family and we have been here ever since.”

BY JULIET EHRLICH LOUISVILLE/SHELBYVILLE Exhilaration is what

Kellen B. Choi, DO, FACOS, and UofL Health and UofL School of Medicine faculty urologist experiences each time her choices for patient care result in relief from pain or discomfort. But then, passion by its nature ignites many peak moments like this, and the thrill that her chosen specialty of urology excites within her is palpable. For Choi, these exhilarating experiences travel a broad-based, complex root system whose limbs are many. There are the surgical and clinical branches, and the teaching, advisory, investigative, and innovative branches as well. This surgeon planted her seeds in the opportunity rich medical landscape of Louisville, Kentucky. Her tree is flowering.

Principal Concerns and Progressive Approach

Foundation Stones Choi’s first roots were watered in the small town of Daejon, South Korea. From an engineering father and elementary school teacher mother was spawned the family’s first doctor.

Choi’s easy laughter comes often and we hear it now. “My family was quite surprised. My brother hated the sight of blood, emphatically rejecting medicine, while I knew from age eighteen that I wanted to be a doctor!”

Foundation stones still had to be laid however, and the family moved to College Station where her father pursued a PhD at Texas A&M in the early 1990s when she was in elementary school. For the prodigal daughter, medical training began after five elementary school changes, a return to Korea, and a resettling back in Houston when she was in high school.

Choi received her undergraduate degree from Texas A&M in biomedical science, following in her father’s footsteps as an Aggie, then completed her medical graduate work at University of North Texas Health Science Center. West Virginia’s Charleston area Medical Center welcomed her to begin an engrossing five-year urology surgery program.

10 MD-UPDATE

Kellen B. Choi, DO, FACOS, UofL Health and UofL School of Medicine faculty urologist.

“I originally imagined a pediatric path, but realized I was drawn to the adult population even more,” says Choi. “I was shadowing my favorite attending and got to see so many cool surgeries and fell in love with operating,” she recalls. Once graduated, good standing and good luck conspired. Providence lowered a colossal cornerstone into her laudable foundation when she became a pupil of Steve Siegel, MD, a world-renowned urologist in neuro-urology and sacral nerve modulation. Choi’s reconstructive urology fellowship ensued. They travelled to Mayo Clinic as part of her training with him. It was there she was exposed to the bladder pacemaker.

It was time to build a nest, and in the late winter of 2017, new roots were put down in Kentucky. Choi’s husband Alex Ng, MD, pulmonologist, critical care specialist and faculty member of UofL, had done training as PHOTOGRAPHY BY ALEXANDRA ROGERS AND ROBERT BURGE

“I discovered a passion for this specialty because it is like surgical family medicine for the urologic system. Over time I might treat a man for enlarged prostate, his wife for incontinence, their daughter for prolapse and maybe their son for vasectomy. In urology, I get to do the work up, direct the course of care, operate if necessary and follow up too.

I never have to hand my patients off. I love the continuity of care and the deeper human connection,” says Choi.

The field by its nature brings Choi patients who are experiencing difficult and painful dysfunction. They must talk to her about delicate and embarrassing symptoms, so it is necessary to develop trusting relationships quickly. Choi gets to the heart of things on the initial visit learning about the patient’s family, social support, and even hobbies to help them be more comfortable. “Only then can I make the best plan for them. No two bodies are the same,” says Choi.

An identical presentation may arrive in patients with very disparate systems of belief, support, lifestyle, and access, and so she chooses individually tailored modalities for each patient. It is clear that Choi’s rapport with her patients is not only important to them and to her personally, but her understanding of the whole person can contribute to their outcome. “I am very good at making connections with all kinds of people,” she says. “We moved so often when I was young, I had to!” Choi’s understanding is incisive and her emotional intelligence keen. In the medical realm, that is no small thing.

Cover Story

Choi is trained on the da Vinci® robot, using it for 10 to 15% of her surgeries for chronic testicular pain and severe vaginal or bladder prolapse.

ISSUE #145 11

Cover Story

Treating the Whole Body “My holistic approach to patient care was built into my osteopathic training,” Choi relates. “Non-invasive, non-surgical first. I go step by step, applying this methodology, and employing behavioral modifications first.”

This doctor understands how aberrations in the musculoskeletal system can affect urologic function, and she uses her knowledge to inform her investigations. Misaligned hips alone can lead to pelvic floor dysfunction, which can cause voiding problems. “I seek to discover and treat underlying cause. Surgery is always my last resort, but if necessary, my patients appreciate that I am a surgeon.”

Choi’s principal concerns are general urology, complex voiding dysfunction, neuro-urology, female patients with pelvic organ prolapse, and reconstructive urology. With the lighthearted, laser direct candor she uses so successfully in her practice, she sums up her intentions concerning voiding dysfunction.

“I help those who can’t pee to pee, and those who pee too much, to not,” she says.

There is a pervasive misconception that urology is for males only. Women have kidneys and bladders too! Anyone can be challenged with difficulties within the urologic

system. While her treatments for testicular issues are clearly male and vaginal prolapse problems clearly female, Choi treats both for cancers, kidney stones, excretion leakage from front or rear, and various bladder problems.

“Referrals foster important exchanges, and I love that collaboration,” says Choi. “Studies suggest collaboration among doctors corroborates with more successful outcome.”

Neuro-urology is a subspecialty for this busy doctor, and she speaks passionately about innovation when working with spinal cord injury, MS, and Parkinson’s patients for UofL Health – Frazier Rehabilitation Institute. “Neurologic systems affect each for various reasons. When the heart is irregular, heart pacemakers are used. When the bladder is irregular, the bladder pacemaker is used.”

Choi also employs the da Vinci® robot, performing ten to fifteen percent of her surgeries for chronic testicular pain and severe vaginal or bladder prolapse this way.

The innovations exciting her now are two new procedures at UofL Health – Shelbyville Hospital. Choi is now offering the minimally invasive UroLift® procedure to help men with enlarged prostate. And, just installed in her clinic on the hospital campus is the region’s

only video urodynamics testing. Choi’s voice quickens as she describes it. “A fully leaded room surrounds a dynamic machine with a video component. We see the bladder filling and emptying, enabling fully accurate readings for function in real time.”

More Hats than Days Choi is principal investigator for a clinical trial for a novel bladder pacemaker. She dedicates a research day for clinical trials while conserving a couple of days each for clinic and surgery. She is also a teacher of humanities, compassionate medical care, and pedological, problem-based courses while serving as advisory dean. The work is gratifying. “I love plugging into first year students, educating, guiding and following them clear through their fourth year.” Choi surely enjoys the fruits of her labor as she increasingly sees her female students considering her specialty.

“They see a woman who has successfully navigated motherhood and a career as a surgeon.

They are inspired, but also students inspire me to be better.”

There must be quite a few young women aspiring to walk in her footsteps. Choi’s tree, it seems, is still burgeoning.

Choi’s rapport with her patients is not only important to them and to her personally, but her understanding of the whole person can contribute to their outcome.

“A fully leaded room surrounds a dynamic machine with a video component. We see the bladder filling and emptying, enabling fully accurate readings for function in real time.”—Kellen Choi, DO

12 MD-UPDATE

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Addiction Medicine

Treating Addiction, One Patient at a Time

Long time, board-certified anesthesiologist joins legacy Pain Treatment Center of the Bluegrass

Richard Lingreen, MD, is board certified in five different specialties and subspecialties of anesthesiology, pain medicine, and addiction.

BY GIL DUNN LEXINGTON When The Pain Treatment Center

of the Bluegrass in Lexington was founded by anesthesiologist Ballard Wright, MD, in 1988, pain management was relatively new.

From Wright’s one man, one office practice, The Pain Treatment Center of the Bluegrass (PTC) has evolved into a practice with three buildings in Lexington, a satellite clinic in Somerset, and a partnership with CHI Saint Joseph Health to provide pain services at their hospitals in Berea, Bardstown, and London.

The medical staff has grown to ten physicians with board certification in pain management and medical specialties in neurology and neuroimaging, anesthesiology, physical medicine and rehabilitation, palliative care, family practice, and addiction medicine. Working in collaboration with the physicians, the Center employs over a dozen mid-level providers and a behavioral medicine staff, as well as nurses and medical assistants.

In May 2023, Richard Lingreen, MD, joins The Pain Treatment Center of the Bluegrass.

“The Pain Treatment Center is aware of their legacy of being pioneers in the specialty of pain treatment in Kentucky,” says Lingreen.

14 MD-UPDATE

Kay Wilson, DNP, APRN, works with patients on medication-assisted therapies.

Psychiatric nurse practitioner Joannie Cook, PMHNP-BC, has worked with addiction medicine patients for 10 years.

“They are a patient-oriented practice and seek to provide excellent, compassionate care to the citizens of Kentucky. During my interview, I knew that I wanted to be part of that.

They want to be the best.”

Lingreen is board certified in five different specialties and subspecialties of anesthesiology, pain medicine, and addiction. Lingreen was the first practitioner in Kentucky to perform MILD, a minimally invasive procedure for alleviating pain caused by lower lumbar spinal stenosis, and he proctored many physicians on the procedure. Along with the MILD procedure, Lingreen will perform other interventional techniques to help alleviate his patients’ pain. But, “I hope to continue to work with PTC to grow their addiction medicine program, as so many pain patients not only suffer from pain but also suffer from opioid use disorder,” he says.

are using medications in higher doses, or for longer periods of time than recommended; are having a persistent desire or cravings for opioids; are having trouble getting things done at work, school, or at home due to opioid use; or are experiencing recurring interpersonal or social problems due to the use of opioids, then they need help. The Pain Treatment Center of the Bluegrass combines behavioral therapy and medication assisted therapy to help patients with opioid misuse or abuse.

Opioid Use Disorder and Its Symptoms Opioid use disorder (OUD) is a long-lasting condition that can lead to disability, relapses, and even death. According to the DSM-V, opioid use disorder is a pattern of opioid use that causes problems or distress. When patients

From Treating Pain to Addiction Opioid use disorder is a public health condition that affects everyone. Addiction to opium-derived pain medicine can strike anyone regardless of income, social position, education, or family background. “Due to genetics, opioids can make some people feel euphoric, which unfortunately can make it more likely that they misuse or abuse the medication,” says Lingreen. To avoid the possibility of opium addiction many surgeons have altered the type and the amount of pain medicine they prescribe to post-op patients, often using non-opiate analgesics. That change in pain management care is working well, says Lingreen, but it doesn’t work in all cases, and

PHOTOS PROVIDED BY THE PAIN TREATMENT CENTER OF THE BLUEGRASS

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many people need opioids to manage their acute or chronic pain. However, as he states, you have to be aware of the fact that “people have different tolerances and individual pain receptors which react differently to different dosages. With some patients, the more you raise their dosage, the more you can raise their tolerance, which leads to addiction.”

Medication Assisted Treatment Working in addiction medicine is a process.

“I like addiction medicine because you can really change people’s lives for the better,” says Lingreen. The Pain Treatment Center of the Bluegrass has multiple means to facilitate the addiction recovery process, including medication-assisted treatment (MAT) and psychological counseling using cognitive behavioral therapy (CBT).

Medication-assisted treatment comes in the form of three medications: buprenorphine/ naloxone (also known as Suboxone, Zubsolv, Subutex, or Sublocade), naltrexone (also known as Vivitrol, ReVia, or Depade), or methadone.

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“I like addiction medicine because you can really change people’s lives for the better.”

— Richard Lingreen, MD According to the CDC, these medications work to “normalize the brain chemistry, relieving cravings and in some cases preventing withdrawal.” Lingreen will work in tandem with Kay Wilson, DNP, APRN, to determine which and when patients are candidates for MAT. “You have to give people a substitute that reduces the addiction craving while they get their lives back on track,” says Lingreen.

Behavioral Therapy for Opioid Use Disorder Cognitive behavioral therapy is an important aspect of opioid use disorder treatment.

These therapies involve encouraging sufferers

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Addiction Medicine

to change, teaching them about the treatment, and helping them prevent relapses.

Evidence-based opioid use disorder treatment involves several facets, including: • Diagnosis and treatment plans personalized for the patient and their family • Long-term management • Professionally-administered behavioral therapies • Recovery support, including community services, peer support specialists, and mutual aid groups.

Psychiatric nurse practitioner Joannie Cook, PMHNP-BC, who works for The Pain Treatment Center of the Bluegrass, has worked with addiction medicine patients for 10 years and has seen much success with her patients.

Cook notes that “It takes reflection for a person to know that they have an issue with opioids and the courage to do something about it. I am here to help patients with that reflection and give them the tools they need to combat addiction.”

In his experience Lingreen says that CBT works well when incorporated with the medical substitutes like Suboxone for opioid-based pain drugs. Both Lingreen and Cook know that patients will often relapse during the treatment process, and they are in it for the long haul with the patients. “During the treatment program, as the patient’s brain plasticity changes and the receptors modify, they need the cognitive changes more than the medicines. It takes time, maybe a year or two or three, but when we see the shift from higher dosage of the substitutes to more therapy, that’s when we know we’re making progress and changing lives,” says Lingreen.

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During his twenty-five years of treating patients, Lingreen has learned much about pain treatment and recovery. He says, “You become a friend of the patient. You’re still the doctor, but you develop a bond with them that’s amazing.

They get their lives back. They get their children and jobs back. They are so appreciative and thankful. They tell me how grateful they are for what I’ve done for them. But I tell them, ‘You did it, I was just there to show you how.’

We do that one patient at a time.”

ISSUE #145 15

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Infectious Disease

Spreading the News

The pandemic shined a light on the importance of research in infectious disease

BY JIM KELSEY LOUISVILLE The COVID-19 pandemic had

an immediate global impact, changing the way we live our lives. Some changes, such as virtual school, were temporary. Others, such as increased use of telehealth, are here to stay.

At Norton Healthcare in Louisville, Kentucky, a big change came in the organization’s way of working with infectious diseases.

“Everybody now is trying to plan how to get ready for the next pandemic, assuming that COVID-19 was a rehearsal, because a new virus with only a 1% mortality rate is a very mild pandemic,” says Julio Ramirez, MD, chief scientific officer at the Norton Infectious Diseases Institute. “With this mild pandemic, we did so poorly. Imagine if we get a bad virus.

One of the areas of being better prepared is to have research in the field. COVID-19 brought the concept of the Norton Infectious Diseases Institute to Norton Healthcare. There are multiple areas that we can do research on infectious diseases and we plan to do that.”

“There’s a dearth of information in pharmaceutical research into infectious diseases.

Being able to participate in both clinical trials as well as investigator-initiated research has been really interesting. This helps solve some of those problems concerning which antibiotics we should use for which patients,” says Ashley Wilde, PharmD, BCIDP, director of Infectious Diseases Clinical Programs and Research at Norton.

Meet Ashley Wilde, PharmD, and Julio Ramirez, MD Wilde was born in Minnesota but spent most of her formative years growing up in Indiana. She earned her PharmD at Purdue University, then did a pharmacy residency at Hartford Hospital in Hartford, Connecticut.

She then returned to the Midwest, joining Norton in 2011.

16 MD-UPDATE

Director for Infectious Diseases Clinical Programs and Research Ashley Wilde joined Norton Healthcare in 2011.

Originally from Argentina, Norton Infectious Diseases Institute Chief Scientific Officer Julio Ramirez has lived in Louisville since 1987.

Ramirez, who has been in Louisville since 1987, was born in Argentina. He attended La Plata Medical School and did his residency in internal medicine at the University of Chile. He completed a residency in internal medicine at Lincoln Medical Center, then his infectious diseases fellowship at the University of Louisville. He joined Norton Infectious PHOTOS BY JAMIE RHODES

Diseases Institute to guide infectious diseases research in 2021.

“Usually in the area of research we tend to develop expertise in a particular area, a particular field,” Ramirez says. “I was interested in the field of respiratory infections, primarily pneumonia, and this has been my area of research over the years.”

Wilde was interested in the treatment and study of infectious disease early in her career as well.

“As a pharmacist, infectious disease is very interesting because it challenges how you approach and manage patients,” Wilde says.

“With research there is much that needs to be known about the best management because infectious diseases really struggle getting industry research. Unlike other specialties, like cardiology where medications can be taken every day for the rest of your life, antibiotics do not fall into that area.”

Wilde’s scope of work involves a unique mix of both patient care and research.

“My team oversees the use of antibiotics in patients in the hospital,” Wilde says. “I help support them when it comes to figuring out best approaches. I also support some of the clinical trials going on at Norton Healthcare in a variety of capacities, whether it’s working on protocol development, or manuscript development, or even serving as a research pharmacist on some of our investigational studies.”

Wilde also has a one-year infectious diseases residency training program in which she serves as the program director and as a preceptor.

In his role at Norton, Ramirez is nearly 100 percent involved in research activities.

His patient interactions are generally limited to seeing patients who are involved in a clinical study. His primary focus is on research involved with the field of respiratory infection.

“When you do training for infectious diseases, there’s not a single area of medicine that you’re not going to see patients because infec-

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tions happen all across the board,” Ramirez says. “We interact with all the specialties.”

“A lot of what I do is to optimize patient outcomes by helping people understand when antibiotics need to be used and when they don’t,” Wilde says. “Kentucky has, for reasons that we don’t fully understand, very high antibiotic use. Data from the CDC shows that Kentucky has the fifth-highest antibiotic prescriptions per 1,000 population in the United States. Culturally, our patients get prescribed a lot of antibiotics either because of comorbidities that particularly affect the southeastern United States or because there is an expectation that when we go to see a provider for symptoms that an antibiotic is prescribed.”

Is Infectious Disease a Cultural Issue?

One of the challenges in researching the impact and treatment of infectious diseases is understanding the various cultural and environmental reasons for varying outcomes, even within the same state. For instance, if outcomes in rural Appalachia differ from those

in urban Louisville, what specific cultural, economic, or geographic factors contribute to those differences, and why?

“One of the challenges that we have doing research in infectious diseases is getting minorities to be represented in clinical research,” Wilde says. “One of the things that we do at Norton Healthcare is really try to support specific efforts to encourage minorities to participate in clinical research so that we don’t keep perpetuating this under-representation when we extrapolate the results to a population.”

For example, Ramirez pointed out that studies on pneumonia determined that socio-economic status — not ethnicity — was the primary reason for infection in pneumonia patients.

“It’s not their race that predispose them to infection,” Ramirez says. “It’s their socio-economic position.”

It is data-driven insights like that which both Ramirez and Wilde say makes their work so important. The answers all not always clear.

Medical professionals are doing their best to treat their patients based upon best practices.

Infectious Disease

But those best practices can change when presented with new information.

“The primary misconception of the public is that we know a lot in medicine, but in reality, we know probably 50%, and the other 50% is still for us to learn in infectious diseases,” Ramirez says. “If you have a physician that in the last three years didn’t change the way that he treats patients, this physician has not studied. You need to keep evolving because we keep learning.”

“When we work with providers trying to get the right antibiotics to the right patients, I think a lot of people have the perception that we’re telling them that they were doing it wrong,” Wilde says. “What we’re really trying to do is collaborate with them to try to optimize those clinical outcomes.”

And trying to be better prepared for the next pandemic.

“If people were not aware of research in infectious diseases, COVID-19 changed the spectrum,” Ramirez says. “The importance of doing research in infectious diseases became very clear to the worldwide population.”

ISSUE #145 17

Time Heals All Wounds

Joseph Skurka, DPM’s extensive experience in wound care benefits patients at Saint Joseph Hospital’s Wound Care Center “Probably 70 to 90 percent of the ulcers that I deal with, LEXINGTON Have you heard the especially with vascular or sysold song, “The foot bone’s contemic diseases like diabetes, are nected to the shin bone, and the lower extremity,” says Skurka. “I shin bone’s connected to the knee diagnose some of the symptoms bone…” It is a fun way for chilinitially, then refer them to an dren to learn about the human interventionalist if they have vasskeletal system. But that message cular issues. I take care of diabetic about the connectivity of the body foot ulcers and I refer them out to is a lesson that extends well beyond endocrinologists to get their blood childhood. For wound care spesugar under better control.” cialist Joseph Skurka, DPM, it is Skurka says that these wounds The oxygen chamber at the Saint Joseph Hospital Wound Care Center, initially used have little to do with age or genliterally matter of life and death.

“I deal with a lot of patients by the US Navy to treat decompression sickness in the 1940’s and carbon monoxide der. They are primarily related poisoning in the 1960s. Today, wound care centers use oxygen to treat difficult and that tend to fall through the cracks to lifestyle and non-compliance delayed wounds caused by a wide variety of sources from severe infections to comand they end up with below-the- promised skin flaps by increasing the amount of oxygen in the blood with use of pres- with their physician’s guidance. knee and above-the-knee amputa- sure and pure oxygen, which decreases cell degradation and induces angiogenesis.

“It comes down to lack of tions,” says Skurka, who specializes adherence to what the doctors in podiatry and wound care at Saint Joseph tion. Upon obtaining his degree, he taught in are telling them to do,” he says. “My patient Hospital’s Wound Care Center in Lexington. an Inuit village for two years, then transferred population is people with COPD, peripheral “My goal is to keep their legs on. If I keep their to Fairbanks, Alaska, where he taught math artery disease, and peripheral vascular disease. toe on, I keep their foot on. If I keep their foot and science. He applied to medical school If they are having an issue with their heart on, I keep their leg on. If I keep their leg on, and attended Barry University in Miami, and their arteries, their feet are furthest away, they’re going to keep walking and they’re going Florida, then did his residency at the VA facil- so they may see symptoms in their toes and to stay alive.” ity in Dayton, Ohio. From there he joined feet and legs before they see it in other areas.”

Skurka’s path to Saint Joseph Hospital’s Cumberland Foot and Ankle in Somerset, Poor diet, smoking, and alcoholism all Wound Care Center was a bit disjointed, but Kentucky, before moving to Lexington where contribute to the development of these condijust like the human anatomy, it is all connect- he joined Lexington Foot and Ankle. tions, which can lead to long-term antibiotics, ed. He grew up in Michigan and attended But why his interest in podiatry in wound hospital stays, neuropathy, and amputations.

Michigan State University where he studied care? Well, that’s all connected too. His grand“People may think wound care is easy, but physiology, human anatomy, and microbiology. father dealt with venous stasis ulcers. it is actually very difficult, because you have to There he heard about the WAMI (Washington “He had been struggling with them for 10 to balance many variables. The patient population Alaska Montana Idaho) Program and moved to 15 years and ended up going to a wound care is difficult because of the non-compliance, so Alaska. Through the WAMI program, people center,” says Skurka. “A podiatrist corrected his you need to be extremely patient,” says Skurka. who were Alaskan residents for more than a year situation and that’s how I fell into podiatry.”

“I create an environment that allows the body could apply to medical school at the University to do its job. Every patient’s environment is a of Washington, which reserved 10 percent of Wound Care Is Health Care little different, so you have to custom-make that the annual admissions for Alaskan residents.

As a podiatrist and wound care specialist, environment for each patient. That includes While on this path to medical school, how- Skurka sees many patients dealing with ulcers antibiotics, watching their blood sugar, staying ever, Skurka took a detour and got a master’s and other wounds much like his grandfather’s. on top of them about smoking. Some of these degree in education from the University of He knows not only how painful and debil- people are working 16-hour days and the reason Alaska. While studying, he did a variety of itating these wounds can be, but also how they’re not healing is, they are putting too much odd jobs, including crab fishing and construc- dangerous as well. pressure in that area. You have to compromise

BY JIM KELSEY

18 MD-UPDATE

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Wound Care

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with them and find a happy medium that allows them to heal as well as keep working.”

The Wound Care Center at Saint Joseph Hospital cares for patients with a variety of conditions, including acute and surgical wounds, fasciitis, diabetic and other ulcers, traumatic wounds, and radiation therapy. The specialists working in the center customize treatments for each patient.

Healing Is Part Family Part of finding that happy medium is getting to know the patients and their families.

Understanding their needs, their lifestyles, and what they want to achieve helps Skurka builds that custom-made environment and map a course to healing and long-term health.

“In most cases I’m very familiar with their family and I stay in touch with the family members,” says Skurka. “I find that the most important thing to do is to get to know each other. I explain everything in detail, in a way that they understand, so that we are all on the same page.

One of the most important parts of my job is persistence. It’s being there for them and never

Joseph Skurka, DPM, recently joined CHI Saint Joseph’s Wound Care Center in Lexington.

giving up, never throwing in the towel until the patient tells me to throw in the towel.”

Skurka says that the recent introduction of cutting-edge technology enables better mapping of very small arterials and arteries, and pinpointing and repairing occlusions.

“Even the slightest improvement in a patient’s lifestyle or mindset can have a major impact. But generally, that lifestyle change doesn’t happen overnight because of one wound or one word of caution from a physi-

cian. It comes over time, with a patient, fully invested doctor there every step of the way.

“If I can change somebody’s course, I’m going to put them in a better spot,” says Skurka. “They’re probably going to keep their legs on, they’re going to stay alive longer, they’re going to be able to see their grandchildren graduate from high school and possibly get married. That’s quality of life and that’s what I shoot for. The goal is to get them out of wound care so I can run out of patients in Kentucky.”

Sounds like a feat worthy of a song.

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859.313.4855 ISSUE #145 19

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Cardiology/Lifestyle Medicine

An Alternative Look at Supporting Medical Care

Community health workers at Norton Healthcare build relationships with patients, removing barriers to care and addressing social determinants of health.

BY LYNNE CHOATE LOUISVILLE After generations of going with-

out adequate health care, people can become accustomed to not getting proper treatment and accept being ill as a part of life.

Some have doubts about the value of healthcare as a whole and some maintain a low bar for what is acceptable. That is a mindset that health care providers and leaders across Norton Healthcare want to change.

“It is not acceptable to be underserved. It is not acceptable to be overlooked when it comes to health care,” says Kelly C. McCants, MD, executive director, Institute for Health Equity, A Part of Norton Healthcare, and executive medical director, Norton Heart & 20 MD-UPDATE

Vascular Institute Advanced Heart Failure & Recovery Program. “Community health workers are an answer to bring those who historically have been underserved to health care and help forge a better, healthier future.”

Partially funded through a grant from the Norton Healthcare Foundation, eight community health workers have joined the Institute for Health Equity. The team members understand where the patient is coming from and can help connect the patient to resources in the community that they either couldn’t find on their own, or that no one else has referred them to. These workers build relationships with patients to remove barriers to care and address social determinants of health. The team is trained PHOTOS PROVIDED BY NORTON HEALTHCARE

Tiffani Graves, health equity program manager, Kelly McCants, MD, executive director, Institute for Health Equity and executive medical director, Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program and Myra Rock, director, Institute for Health Equity.

to help develop personalized road maps to healthier lives, taking into account the unique needs and cultural sensitivities of underserved populations.

“Our team of community health workers is embedded within the communities we serve to engage and support patients and families in overall health and wellness,” says Latasha L. Hayes, program coordinator and leader of the effort.

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Each community health worker specializes in serving a unique patient population, such as the Hispanic, African American, or refugee communities. Collectively, the team speaks 10 languages and dialects. While specializing in specific populations, the health workers are cross-trained to provide support to any patient or family. Having a designated area of expertise allows for dedicated attention to the distinctive social determinants of health impacting a particular community.

“Our team motto is ‘We are the people we serve.’ Every one of us has made it here by way of a broken road. We are bound to usher the next person through their adversities,” says Michelle Jones, office coordinator, Institute for Health Equity.

Building Trust with Holistic Support

Michelle Jones, office coordinator, Institute for Health Equity, a Part of Norton Healthcare, talks with a community member.

Healthcare. “The community health workers are embedded in the community. They are a staple within low-income public housing locations and across Norton Medical Group’s primary and pediatric care offices, where providers can refer them quickly to a patient in need of support.”

For one patient, a community health worker may be a connection to a local food pantry.

For another, the worker may help to arrange reliable transportation to appointments. Some patients need coaching on how to access community resources.

Dr. Kelly McCants participates in Norton Healthcare’s Walk and Talk with a Doc Others may not fully program at the Norton Healthcare Sports & Learning Center. understand the benefits of establishing a relationship with a primary care provider. Whether managing a crisis, breaking down barriers to care or developing personal health goals, community health workers have the patient’s back.

“I recognize that I was put on this earth to serve others,” says Jones. “In the evening, when I take personal inventory of my day, Changing attitudes toward health does not happen overnight. It takes education, support, practice, determination and more. Perhaps most importantly, it takes trust. Lasting change will not come without partnership and collaboration. That’s why community health workers offer holistic support, considering every aspect of health to fill the gaps in care.

“Reaching the patient where they are is important,” says Myra Rock, director, Institute for Health Equity, A Part of Norton

Cardiology/Lifestyle Medicine

I am able to rest when I know I’ve helped someone.”

Benefits Ripple through Whole Families The benefits of these efforts have a ripple effect on entire families as their health improves — a benefit to providers, too.

“As a doctor, I want to see my patients live a healthier life. I want to know they are eating good foods, getting good rest, and thriving,” says McCants. “These community health workers are providing the tools and resources needed.”

More than addressing transportation and food needs, supplies such as diapers and clothing, beds, and playpens, even assistance in finding safe, affordable housing; the list of patients’ needs conveyed to the community health workers has been endless. Preventing and managing long-term stress brought on by these great needs can lower risk for many health issues, including heart disease, obesity, high blood pressure and depression.

“I know we will not eliminate stress, and unfortunately, we can’t resolve all the barriers in someone’s life — but we are making strides,” says McCants.

With eight community health workers in place, the Institute for Health Equity has plans to expand, especially as referrals from providers continue to increase.

ISSUE #145 21

Mental Wellness

Problem or Dilemma?

There’s A Difference. (PART 1) How our brain works when faced with a difficult decision

BY JAN ANDERSON, PSYD, LPCC

Here’s the thing…

• Short-term vs. long-term Whenever I hear a client say those words, I • Individual vs. community don’t have to get out the latest version of the • Justice vs. mercy DSM (Diagnostic and Statistical Manual). I already have a pretty good idea of what’s coming. Here’s why Bad-Ass Dilemmas pack Here’s the thing… is usually code for BAD such an emotional wallop: (Bad-Ass Dilemma).

1. You’re forced to make the decision with Dilemmas are soul-sucking problems that inadequate information. (Your brain doesn’t seem to defy a satisfactory solution. like that.)

We’re not talking about fretting about mak- 2. The outcome of your decision is uncertain. ing a “bad” choice at a new restaurant. It won’t (Your brain really doesn’t like that.) reverberate through the rest of your life with That’s why I like working with BADs. (Yes, everlasting consequences.

I know. There’s something wrong with me.)

But trying to decide if you should stay in your unhappy marriage for the sake of your Dilemmas Are Catch-22 children? Staying in a miserable job because of Hell Holes the money? Those are dilemmas. Awful ones.

Dilemmas are so difficult because they are double-bind choices. Take the stay-or-go Dilemmas Are Tough: There dilemma in an unhappy marriage with kids.

Is No Right Answer Virtually all researchers and therapists agree How are you supposed to make a good that children are better off when their parents decision when there is no correct choice? stay together — unless the marital strife has • Do I put myself first this time become damaging to the children as well. or be there for them?

• Divorce is hard on kids.

• Do I tell my partner about my (fill in • Bad marriages are hard on kids, too. the blank), or do I keep it a secret?

We also know from study after study on • Do I make a bold business/career divorce that your children have the best chance move or do I play it safe? of turning out okay if you do two things: There are consequences and 1. Don’t ask your kid to choose between you the stakes are high: and your ex.

• What if you can’t repeat your success in 2. Provide a stable home life. that new job or business venture? And your Here’s the thing: You’re supposed to pull off imposter syndrome is exposed? this feat of mature, perfectly-calibrated parenting • If you break up with your partner, how do during what may be one of the most unstable you know you’ll find someone better? Or periods of your entire adult life. At the time we find anyone? What if you end up all alone? most need and want to be strong and supportive • What if your calculated business risk of our kids — to be at our best as parents — we doesn’t work out? And you end up living are likely to be at our most uncertain, volatile, under a bridge? weak, guilt-ridden, catatonic, or despairing.

On top of that, many dilemmas have You see what I mean. an ethical component to them that Dilemmas — life is full of them. And you’re seriously challenges our values: not alone. It’s part of the human condition.

• Truth vs. loyalty 22 MD-UPDATE

Try a Different Kind of Thinking There is a way out of a dilemma. It starts with a paradigm shift.

This is the part of the story where you encounter the crazy wisdom of an eccentric character with odd ideas. Here’s how I stumbled into that role one day as I worked with a parent experiencing a truly awful dilemma: adult-child estrangement.

CLIENT: My adult child has completely cut me off. I’ve been told never to contact them again. If I keep trying and reach out anyway, they say I’m violating their boundaries. But here’s the thing: If I give up and stop reaching out, I’m afraid it only confirms what I’ve been accused of all along: “You weren’t a good parent. You weren’t there for me.” I’m damned if I do and damned if I don’t. So what do I do? Should I give up or should I keep trying?

ME: Give up and keep trying at the same time.

CLIENT (sits in stunned silence): You sound

Mental Wellness

like Yoda. How do you do two opposite things at the same time? Who does that?

ME: Smart, successful people do it all the time.

It’s called “both/and thinking.” It’s an alternative to “either/or” thinking and it’s particularly useful with human dilemmas like this, where there is no correct either/or choice.

CLIENT: Sounds woo-woo. Is this stuff for right-brain creative types?

ME: A very clever scientist did it. It happened when he shifted out of either/or thinking and stopped asking if an object was in motion or at rest. He shifted into both/and thinking and started wondering if an object could be both in motion and at rest at the same time. I think his name was Einstein.

Your brain has a truly remarkable ability: It can hold two contradictory thoughts at one time and wrestle and play with them and come up with an even better third option. I like to call this third option Door #3.

CLIENT: Now you sound like a game-show host.

ME: Come on down!

CLIENT: Actually, it sounds hard.

ME: It can be hard at first. Either/or thinking is the basis of Western science and all the advancements it has brought us. That’s why when you first start doing both/and thinking, it can feel like your head is going to explode.

ME (continuing): Some problems in life truly are either/or, but many dilemmas are the both/and type. So my motto is: When an either/or mindset isn’t working, drop it and shift into a both/and mindset. There are some signs that register in your brain and your behavior that will self-motivate you to change gears.

2. Are you stuck? When you feel forced to choose between two lose/lose options, no wonder your brain shuts down and you get seriously stuck.

3. Are you over-correcting or under-correcting? An either/or Catch-22 can render you catatonic or drive you manic.

CLIENT: That gives me something to work with. What’s next? How do I get myself to do this paradigm shift once I realize I need to?

ME: Here’s something that may help: You’re already doing it and you don’t even know it.

How to Jumpstart Both/And Thinking 1. Recognize that you’re already doing it.

unsatisfactory. You’re not trying to blend your black-and-white, yin-and-yang opposites into a mushy circle of gray. This only truly satisfactory solution will be distinctly yin and yang.

Both at the same time.

Both/and thinking is mind blowing and life changing.

If we have only an either/or lens to view the world, we risk missing the point and even doing harm. No wonder this kind of thinking, when applied to the wrong situations, is linked to anxiety and depression.

I’m a big fan of both/and thinking because we need this: • Less suffering for yourself.

• Less conflict with others.

Know that you already are doing this “integrating of opposites” thing all the time, right in The beauty of both/and thinking is that your own body. Just standing upright requires it allows natural opposites to co-exist opposing muscle groups in your body to do without judgment. two opposite things at the same time. The • I want to be with you and I want time alone. integration of these opposite actions is what • You hurt my feelings and you love me. allows you to keep your balance.

• I love my child/parent/spouse (fill in the blank) and I disapprove of them at the same 2. Reframe the problem. time.

Rather than asking, “Do I pick A or B?” • I am vulnerable and I am strong. start an internal dialogue like “How can I accommodate both A and B?” Keep playing The best part? Both/and thinking around with and wrestling with these oppo- creates balance. sites. Once you’ve identified the two opposite • Mind and body. extremes, ask, What am I leaving out? Where • You count. I count, too. am I being extreme? The idea is to keep the • You can work hard and rest deeply. internal negotiation going (you may need help • You can be ambitious and not be a jerk. with this) until you reach a creative consensus, • You can forgive and seek justice. a third option that is superior to the original • You can be good enough right now, and you two ideas. can get better.

This is the first part of a series on both/and 3. Don’t compromise. thinking. Next Up: The Only Way to Move The Downside of Don’t get caught in the trap of thinking this Forward: Accept the Way Things Are as You Either/Or Thinking is about trade-offs and compromise and stop Push for Change. Check it out on my website 1. Are your options limited to one extreme or the process too soon. You’ll end up with anoth- at www.DrJanAnderson.com or contact me for the other? Are they both lose/lose? er lose/lose proposition that’s unsatisfying and a complimentary consultation!

ISSUE #145 23

News Baptist Health Invests in Robotic Bronchoscopy for Minimally Invasive, Earlier Lung Cancer Diagnosis LOUISVILLE Patients at five Baptist Health

hospitals will soon benefit from a same-day procedure to diagnose and treat lung cancer, using robot-assisted technology.

Baptist Health Floyd was the first to begin using the Ion™ endoluminal system in February and has performed 16 procedures using robotic bronchoscopy. The robotic bronchoscopy program will be phased in at Baptist Health Louisville, Baptist Health Hardin, Baptist Health Lexington, and Baptist Health Paducah.

“Robotic bronchoscopy is an approach that helps us safely and quickly access lesions or nodules deeper in the lung, near a major blood vessel or near a portion of already Angela Mahan, MD diseased lung,” says Angela Mahan, MD, a Baptist Health Medical Group thoracic surgeon and system medical director for thoracic oncology.

“With this system, we can catch small lung cancers in the early, most treatable stages and avoid subsequent biopsies. The earlier the diagnosis, the sooner we can begin treatment, giving patients their best chance at a longer life.”

The robotic approach is also beneficial for those with other health concerns, such as severe lung disease or active smoking, both of which can increase infection risk or other rare complications associated with more traditional biopsy options.

Robotic bronchoscopy uses an ultra-thin, flexible tube with a camera in it, going in the nose or mouth and through narrow airways in the lung to the lesion. The catheter can move 180 degrees in all directions and can navigate through the lungs to reach nodules in any airway segment.

Once the nodule is reached, the catheter is locked into place and a needle collects tissue from the mass or nodule. The outpatient procedure, performed under general anesthesia, takes one to two hours. Patients usually go home the same day, with some soreness or numbness in the mouth and throat.

“Baptist Health is investing in leading-edge cancer care solutions such as robotic bronchoscopy to help detect lung cancer earlier, when more effective treatment options are available,” said Amanda Henson, Baptist Health system vice president, service lines.

“We want people to know that if they choose Baptist Health for their lung issues, they have access to a higher level of care.”

An annual lung CT screening test, which uses a low dose of radiation, can detect

the cancer when it’s small. The non-invasive screening is recommended for those most at risk for lung cancer: those over age 50 who have smoked, those who once smoked heavily but quit, those with a history of lung cancer, and those with other risk factors such as exposure to asbestos or who have chronic obstructive pulmonary disease (COPD). All Baptist Health hospitals offer lung CT screening.

Baptist Health has partnered with Ion’s maker previously. Ion is made by Intuitive, the company that makes the da Vinci® surgical system, and is built on more than two decades of leadership in robot-assisted technology. Baptist Health currently has da Vinci robotic surgical systems at six of its owned hospitals.

Baptist Health Acquires Paris Practice LEXINGTON Baptist Health has acquired

Cardiovascular and Sleep Consulting Services in Paris. The practice, now named Baptist Health Medical Group Cardiology, remains at its original location at 24 Clinic Drive in Paris. Services offered include stress testing, echo, stress echo, carotid studies, peripheral arterial studies, EKG, heart monitors, and device checks.

The practice includes cardiologist Cristen “Kelly” Waespe, MD, a graduate of the UK College of Medicine, as well as Autumn “Brooke” Schneider, APRN; Kimberly Hamilton, APRN; and Jennie Trautwein, APRN. 24 MD-UPDATE

Cristin “Kelly” Waespe, MD PHOTOS PROVIDED BY BAPTIST HEALTH

Autumn “Brooke” Schneider, APRN

SEND YOUR NEWS ITEMS TO MD-UPDATE > news@md-update.com

New Physicians and PAs Join CHI Saint Joseph Medical Group – Cardiology NICHOLASVILLE CHI Saint Joseph Medical

Group – Cardiology continues to grow with the addition of Shawn Flynn, MD. Flynn, a Louisville native who has worked throughout Kentucky, says going into the medicine was an easy decision for him. His faith in Jesus Christ is paramount, and he believes he was meant to serve his community.

“I felt called by God to go into medicine. As a Christian cardiologist, I can help take care of all matters of the heart. For patients, it’s a very scary time, and I think I can counsel them physically Shawn Flynn, MD and spiritually. I can walk alongside them on whatever path they may be on at that time,” says Flynn.

Flynn is a proponent of prevention and regularly reminds his patients that exercise, quitting smoking, and lowering carbohydrate intake can help achieve a healthy heart.

Flynn earned his BS and MS in biochemistry and medical degree from the University of Louisville. He is certified by the American Board of Internal Medicine in Cardiovascular Disease and Interventional Cardiology.

LEXINGTON Sharat Koul, DO, has joined the

CHI Saint Joseph Medical Group – Cardiology team in Lexington, Nicholasville, Mount Sterling, and Lebanon. Koul brings more than two decades of medical experience and a selfless, patient-first philosophy to the team.

Koul has served communities across the country, working at hospitals and medical centers in Evanston, Illinois, Chicago, Lexington, Atlanta, and Danville, Sharat Koul, DO where he served as medical director of Vascular Disease and Limb Preservation at Ephraim McDowell Regional Medical Center. Koul has spent the last 15 years in the cardiovascular field as an interventional cardiologist and medical director.

Koul earned his BA in biology from the University of Virginia and his DO degree from the Kirksville College of Osteopathic Medicine in Missouri. He completed medical training at the Cleveland Clinic. His work has been published more than a dozen times in manuscripts, publications, and journals. Koul also co-owns a carotid artery mechanical dilatation-perfusion catheter patent. He is certified in interventional cardiology and cardiovascular disease by the American Board of Internal Medicine, among other certifications. He is also a fellow of the American College of Cardiology and the Society of Cardiac Angiography and Interventions.

MOUNT STERLING Renita Crouch, PA, has

joined the CHI Saint Joseph Medical Group – Cardiology team in Mt. Sterling. Crouch has worked in cardiology throughout her more than three decades in health care. Her interest in the medical field started at an early age when her father was diagnosed with heart

disease, and she credits her parents for supporting her as she found a career she loved.

Crouch graduated from UK where she completed the physician assistant program and has an extensive background in caring for cardiology patients and primary and secondary prevenRenita Crouch, PA tion. She is certified by the National Commission on Certification of Physician Assistants and has earned certifications in advanced cardiovascular life support and cardiopulmonary resuscitation. Crouch is also a member of the Kentucky Academy of Physician Assistants and the American Academy of Physician Assistants.

LEXINGTON Brittnee

Angle, PA-C, has joined CHI Saint Joseph Medical Group – Cardiology in Mount Sterling, Lexington, Lebanon, and Britnee Angle, PA-C Nicholasville.

Angle is certified by the National Commission on Certification of Physician Assistants (NCCPA) and has an American Heart Association Advanced Cardiovascular Life Support (ACLS) certification. She graduated magna cum laude with a BS in human nutrition and a MS in physician assistant studies from the University of Kentucky.

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PHOTOS PROVIDED BY CHI SAINT JOSEPH HEALTH

ISSUE #144 25

News

CHI Saint Joseph Health Welcomes New Vice President of Mission Integration LEXINGTON CHI Saint

Joseph Health welcomed David M. Franz, MHA, MAHCM, FACHE, as the new market vice president of mission integration.

Franz will lead efforts David M. Franz, to integrate the minMHA, MAHCM, FACHE istry’s mission “to make the healing presence of God known in our world by improving the health of the people we serve, especially those who are vulnerable, while we advance social justice for all” into the day-today work of caregivers across Kentucky.

“We are excited to welcome David to lead our mission integration efforts as we live our mission in everything we do,” says

Anthony Houston, EdD, FACHE, CEO, CHI Saint Joseph Health. “When we talk about humankindness, we recognize that caring for the mind, body and spirit of not only our patients, but also our caregivers, is important to providing the highest quality of care across our ministry.”

Franz brings more than 25 years of experience in health care to the role, the last eight as director of Mission Integration at Ascension Living in St. Louis, Missouri. In that role, he established mission integration infrastructure and strategy for ethics, community benefit, resident experience, and spiritual care for over 50 senior care ministries around the country.

He developed and implemented multi-level formation programs for executive and community leadership to promote Ascension’s mission and values and understanding of ministry.

Franz will also lead Mission Integration across the Southeast Division of CommonSpirit Health, which includes health care systems in Arkansas, Ohio and Tennessee/Georgia.

Saint Joseph Jessamine Welcomes Podiatrist NICHOLASVILLE Joseph Skurka, DPM, recently

joined CHI Saint Joseph Health – Podiatry, practicing at Saint Joseph Jessamine in Nicholasville as well as the Wound Care Center at Saint Joseph Hospital in Lexington.

A Michigan native, Skurka attended Michigan State University, where he received a BS in physiology and microbiology. He received a master’s degree in education Joseph Skurka, DPM from the University of Alaska Fairbanks. In 2008, he returned to school and received his Doctor of Podiatric Medicine degree from Barry University in Miami, Florida. Skurka is certified by the American Board of Preventive Medicine.

New Bariatric Surgeon Joins CHI Saint Joseph Health – Center for Weight Loss Surgery LEXINGTON David Swedler, DO, has joined the

CHI Saint Joseph Health – Center for Weight Loss Surgery, where he will serve as a robotic bariatric surgery specialist in the Lexington area.

Originally from the Midwest, Swedler completed his general surgery residency in Brooklyn, New York, and did a fellowship in advanced gastrointestinal minimally invasive surgery in Miami, Florida. He continued as a surgeon in Washington state, where he was one of three surgeons in the highest volume robotic bariatric surgery practice in the United States.

“I am very fortunate to be part of the team in weight loss surgery,” says Swedler. “This practice enables me to take the time to get to know people on a deeper level, and go through their weight loss journey with them. I see firsthand 26 MD-UPDATE

the positive and profound changes in peoples’ mental and physical health over time, and that’s very rewarding.”

Swedler specializes in robotic bariatric surgery, including complex revision procedures, and is looking forward to helping patients in the Lexington area embark on weight loss and overall health journeys – watching their transformation thanks in large part to the weight loss surgery.

“I went into health care because I wanted to be a useful member in the community,” says Swedler. “I never imagined just how much joy this career would bring me as I’ve helped so many people achieve personal goals they have never been able to reach before in their lives. With the advancements of minimally invasive surgery, particularly PHOTOS PROVIDED BY CHI SAINT JOSEPH HEALTH

robotics, we have much more extensive knowledge of bariatric surgery comDavid Swedler, DO pared to even 10 years ago. This translates to excellent patient experiences and great outcomes.”

Swedler has practiced general surgery for nearly 10 years, specializing exclusively in bariatric surgery since 2016, working at hospitals in New York, Florida, and Washington. He is a certified American Society for Metabolic and Bariatric Surgeon (ASMBS). Swedler earned his BS in molecular genetics at The Ohio State University and completed his DO degree at Touro University in Vallejo, California.

SEND YOUR NEWS ITEMS TO MD-UPDATE > news@md-update.com

Lexington Clinic Welcomes Three New Physicians Benjamin ‘Bo” Schneider, MD, joined Lexington Clinic O r t h o p e d i c s - Sp o r t s Medicine on Bob-OLink Drive. Schneider is board certified in foreBenjamin Schneider, MD foot, rearfoot, and ankle reconstruction surgery by the American College of Foot and Ankle Surgeons. He specializes in orthopedic services and sports medicine focusing on the foot and ankle for athletic and traumatic injuries, as well as treatment of degenerative conditions of the foot and ankle, including total ankle replacement, bunions, hammertoes ankle and foot arthroscopy and minimally invasive surgery techniques.

Regina Raab, MD, joined Lexington Clinic Neurology at the Clinic’s South Broadway location.

Raab received her medical degree from Regina Raab, MD Northwestern University Medical School and completed her residency in neurology at Northwestern University Hospitals. Raab’s professional interests include sleep medicine and traumatic brain injury.

Brandon Gish, MD, joined Lexington Clinic Pain Medicine at South Broadway. Gish is board-certified in anesthesiology and pain Brandon Gish, MD medicine and utilizes a multimodal approach to pain management to promote an active lifestyle, avoid pain medications, and alleviate pain. His goal is to restore function, mobility, and overall wellness for patients utilizing treatments including epidural injections, facet radiofrequency ablation, neuromodulation (spinal cord and DRG stimulation), minimally invasive lumbar decompression (mild), and basivertebral nerve ablation (Intracept).

New COO at Lexington Clinic Lexington Clinic welcomed Gary Lake as its chief operating officer of Surgical & Technical Services. Lake comes from Midwest Medical in Wisconsin, where he Gary Lake served as the COO and led healthcare operations and designed business solutions alongside C-suite executives to direct project teams for a successful merger and transition of all systems, processes, and operations, integrating departments and staff with the acquiring entity.

Gary earned his MS in industrial engineering at Purdue University. He has previously served at CHI in Omaha, Nebraska, where he served as the division director of Neuroscience and Stroke, overseeing the orthopedic spine hospital.

“Gary’s background in operations, strategy and core business solutions are critical as we continue to grow and expand our services to serve the healthcare needs of Central Kentucky,” says Stephen J. Behnke, Lexington Clinic CEO.

Lexington Clinic Partners with agilon health to Introduce Value-based Primary Care Delivery Lexington Clinic has formed a new partnership with agilon health inc. (NYSE: AGL), to transition its primary care delivery system to a full-risk, value-based care model to enhance outcomes and quality of care for Central Kentucky Medicare patients beginning in 2024.

“Partnering with agilon health is a natural fit for Lexington Clinic, where our mission is to constantly innovate and improve healthcare access for Kentuckians,” says Stephen J. Behnke, MD, MBA, CEO, Lexington Clinic.

“With the support and partnership of agilon health, we will meet the challenges of tomorrow head on with a model rooted in value for our patients and the principle that our patients and their whole health should be at the center of how we operate.”

PHOTO PROVIDED BY THE LEXINGTON CLINIC

Lexington Clinic is the largest multi-specialty medical group in Central Kentucky, with 25 locations in a region of 1.3 million residents. Founded in 1920, Lexington Clinic has a “rich history of medical innovation and superior care,” as it treats 2,000 patients per day, or 600,000 annually. Today, the company has more than 200 providers, in over 30 specialties, supported by a staff of 1,000 professionals and 60 primary care providers.

Lexington Clinic’s 2023 Board of Directors

Michael T. Cecil, MD

Kyle J. Childers, MD

Robby K. Hutchinson, MD

Tharun Karthikeyan, MD

At Lexington Clinic’s annual Board of Directors meeting the following officers were elected to serve for the year: Michael T. Cecil, MD, president; Kyle J. Childers, MD, vice-president; Robby K. Hutchinson, MD, secretary; and Tharun Karthikeyan, MD, treasurer.

Other members of the board include An-Yu Chen, MD, Brandon Devers, MD, Jamil Farooqui, MD, Kimberly Hudson MD, Jordan Prendergast, MD, Mr. Nick Rowe, and Mr. Alan Stein.

“Lexington Clinic is committed to perfecting the patient experience. By using modern data analytics, best practice protocols, experience, and compassion, we aim to provide the highest quality care to the people of Central Kentucky,” said Dr. Cecil, board president.

ISSUE #144 27

Events

Tony Houston, EdD, FACHE, CEO, CHI Saint Joseph Health, gave the opening remarks for the Humankindness Gala.

Humankindness Gala Celebrates Building Healthier Communities LEXINGTON The inaugural Humankindness Gala benefitting the CHI Saint Joseph

Health Foundations was held Saturday April 15, 2023 at the Central Bank Center in Lexington. This was the first time that all five of the Kentucky CHI Saint Joseph Health Foundations held a joint celebration.

By all accounts it was a success. There were 615 guests in attendance, including 33 physicians, advanced practice providers, leaders, and caregivers who were honored for their dedication to the CHI Saint Joseph Health ministry. Guests enjoyed an evening filled with dancing to the music of City Heat from Atlanta, a silent auction, and Mission Moment raising funds for each CHI Saint Joseph Health facility. Over $100,000 was raised to support the physicians and caregivers at CHI Saint Joseph Health.

“It was an exciting night to have the opportunity to bring all of our foundations together to celebrate our caregivers, who strive each day to improve the health of all patients we serve,” said Meredith Herald, MBA, manager of major gifts and event lead, CHI Saint Joseph Health Foundations. “Our caregivers show human kindness every day, and it is only fitting that they were recognized at the Humankindness Gala.”

Doctors who were named Physician of the Year included: Dale Absher, MD, Saint Joseph Hospital; Lynda Newman, MD, Saint Joseph East; Daniel Gaspar, MD, Saint Joseph Berea; Rebekah Boulanger, Saint Joseph London; Tyler Holley, MD, Flaget Memorial Hospital; John Sanders, MD, Saint Joseph Mount Sterling; and Lucia Hardi, MD, CHI Saint Joseph Medical Group.

28 MD-UPDATE

Bill Meck, WLEX chief meteorologist, was emcee of the gala.

Laura Babbage, MA, BSN, market director, mission integration for CHI Saint Joseph Health.

Events

Saint Joseph Hospital Physician of the Year Dale Absher, MD, with his daughter, Natalie.

Saint Joseph East Physician of the Year Lynda Newman, MD, and husband, Bill.

Saint Joseph Berea Physician of the Year Daniel Gaspar, MD, and his wife, Sabrina.

Flaget Memorial Hospital Physician of the Year Tyler Holley, MD, and his wife, Sadie.

Will Krost, MD, Lexington Clinic, Emergency Medicine, Associate Medical Director and his wife, Jill.

Scott and Jennifer Neal. Scott is president of D. Scott Neal Fee-Only Financial Planners and the MD-Update Financial columnist since 2008.

Danesh Mazloomdoost, MD, and his wife Shadi Talai. Mazloomdoost is medical director and owner of Wellward Regenerative Medicine.

Richard Lingreen, MD, and his wife, Karen. Lingreen, anesthesiologist and addiction specialist, recently joined The Pain Treatment Center of the Bluegrass.

Thomas Von Unrug, MD, internal medicine at CHI Saint Joseph Health, and wife, Ester.

Kathleen Martin, MD, gastroenterologist at CHI Saint Joseph Health and Carmel Jones, president, Saint Joseph Medical Group.

Dan Goulson, MD, CHI SVP, chief medical officer Saint Joseph Health and his wife, Nancy

Gil Dunn, publisher/editor, MD-Update, with Angela Stamper.

PHOTOS BY JOE OMIELAN

ISSUE #145 29

Events

Sidney Johnson, future nursing student at EKU, and her mother, Kristy Salley, APRN, CHC, at Baptist Health Lexington.

Lee Dossett, MD, CMO, Baptist Health Lexington, and wife Jennifer, RN.

CHI Saint Joseph cardiologist Hussam Hamdalla, MD, and wife, Heba.

Malia and George Dimeling, MD, cardiothoracic surgeon at CHI Saint Joseph Health.

CHI Saint Joseph interventional cardiologist Michael Schaeffer, MD, and wife Shannon.

Joseph Thomas, MD, UK Gill Heart Institute, and wife Priya Warrier, MD, Family Allergy & Asthma.

Neil and Sheila Griffeth, MSN, RN, market VP, CHI Saint Joseph Health.

CHI Saint Joseph cardiothoracic surgeon Hamid Mohammadzedeh, MD, and wife Sepideh.

Rebecca and Tony Houston, FACHE, market CEO, CHI Saint Joseph Health.

30 MD-UPDATE

Events

Central KY Heart Ball Breaks a New Record LEXINGTON The Central Kentucky Heart Ball was held on Friday,

February 24, 2023, at the Central Bank Center in Lexington. Under the leadership of chair couple Brett and Billie Jo Setzer of Setzer Construction, the event witnessed its best year ever, raising more than $800,000 for the battle against heart disease and stroke.

Eastern Kentucky University Head Football Coach Walt Wells was honored during the event. Coach Wells was saved by the quick actions of EKU Athletics staff, who administered CPR and utilized an AED on him after he experienced a cardiac event and collapsed in his office last year.

Special guests from the University of Kentucky Football program were also present, including Head Coach Mark Stoops, UK football player and heart disease survivor Kenneth Horsey, and former UK football player and stroke survivor Chris Oats.

Dania and Toufic Fakhoury, MD, with Uzma Aslam, MD, and Azhar Aslam, MD, director of chest pain center at Baptist Health Lexington.

Mark Stoops, UK head football coach, and Brett Setzer, Heart Ball co-chair.

Community Trust Bank market president Jeff Koonce and wife Diane with Baptist Health Lexington president Chris Roty and wife Lynn.

Tony Houston, market CEO, CHI Saint Joseph Health, raises a toast to open the 2023 American Heart Association Central Kentucky Heart Ball.

Heart Ball sponsors Jack and Carol Russell with Heart Ball chair couple Brett and Billie Jo Setzer.

PHOTOS BY PAUL MARTIN

ISSUE #145 31

Events

Kentuckiana Heart Ball Breaks Record Again LOUISVILLE The Kentuckiana Heart Ball was

Rob Jay, CEO, ScionHealth.

Juan Villafane, MD, pediatric cardiologist at Cincinnati Children’s Elizabethtown Heart Institute, and his wife, Vickiee 32 MD-UPDATE

Greg Brislin, MS, chest pain coordinator at UofL Health – Jewish Hospital, and wife, Jill.

Carolina Rodriguez Curiel, growth and community engagement specialist at Passport Health Plan by Molina Healthcare.

PHOTOS BY HOLLY KEE PHOTOGRAPHY

held on Saturday, February 25, at the Omni Hotel in Louisville. This year’s co-chairs were Dr. Toni Ganzel, dean of the School of Medicine at the University of Louisville, and John Walsh, CEO, UofL Health – Jewish Hospital and Heart Hospital.

The 2023 Kentuckiana Heart Ball was a record-breaking event, with more than $1.1 million raised. During the event, the Live Fierce. Stand for All. Award, sponsored by ScionHealth, was presented to Carolina Rodriguez Curiel, growth and community engagement specialist at Passport Health Plan by Molina Healthcare. The award is given annually to a person in the Kentuckiana area who has made a significant impact on advancing equitable health outcomes in the community.

David Foy, a heart survivor who collapsed during the Kentucky Derby Festival mini-marathon in 2019 and was saved by bystander CPR, was also honored during the event.

Toni Ganzel, MD, dean of the School of Medicine at the University of Louisville, and John Walsh, CEO, UofL Health – Jewish Hospital and Heart Hospital.

LEXINGTON MEDICAL SOCIETY FOUNDATION rd

33 ANNUAL GOLF TOURNAMENT

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SCRAMBLE format Lunch & Awards Dinner $200/player or $600/foursome All proceeds to benefit medical nonprofits in the Lexington area

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MARK SLAUGHTER, MD Cardiothoracic Transplant Surgeon

Better patient outcomes start here, where hearts are in the right place.

Welcome to UofL Health – Heart Hospital, an exciting chapter in the epic Jewish Hospital story. When you are searching for specialists to care for your patients, experience is key. With a history as one of the nation’s best hospitals for cardiology and heart surgery, this is home to over 40 medical heart firsts and is the area’s only Heart Hospital dedicated to comprehensive cardiovascular care. Our world-class network offers you a true partnership in the care of your patients.

Here, patients with a wide spectrum of heart issues have exclusive access to a network of specialists that can heal, protect, revive, and even replace hearts. With every referral, we work hand in hand with our referring physicians to provide heart care that is truly life-changing for patients, and their families.

Here, your heart is in the right place.

Visit UofLHealth.org or call 502-587-4000.