May 2015 • Vol. 45, No. 5
Mecklenburg Medicine A Publication of the Mecklenburg County Medical Society | www.meckmed.org
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Mecklenburg Medicine â€˘ May 2015 | 3
Table of Contents 5 President’s Letter: A Tisket, a Tasket By Simon V. Ward III, MD
6 Feature: Sun Damage Fuels Rise in Skin Cancer and Burns Through Billions of Dollars By Lee McCracken
8 Feature: Affordable Care Act Collaboration in Mecklenburg County By Madison Hardee
9 MMAE 12 MCMS Annual Meeting 15 Advertising Acknowledgements 15 Charlotte AHEC Course Offerings 15 National Health & Wellness Observances for May 2015 16 Member News 16 Upcoming Meetings & Events 18 At the Hospitals 20 Independent Physicians of the Carolinas
May 2015 Vol. 45 No. 5 OFFICERS President Simon V. Ward III, MD President-Elect Stephen J. Ezzo, MD Secretary Elizabeth B. Moran, MD Treasurer Scott L. Furney, MD Immediate Past President James B. Hall, MD
BOARD MEMBERS John R. Allbert, MD Raymond E. Brown, PA W. Frank Ingram III, MD Stephen R. Keener, MD, MPH Scott S. Lindblom, MD John P. McBryde, MD Shivani P. Mehta, MD, MPH Robert L. Mittl, Jr., MD Pulak D. Patel, MD Cheryl L. Walker-McGill, MD, MBA
EX-OFFICIO BOARD MEMBERS Sherry Ward, President Mecklenburg Medical Alliance & Endowment Sandi D. Buchanan, Executive Director Mecklenburg County Medical Society Michelle Conner, DDS, President Charlotte Medical Society Docia E. Hickey, MD NCMS President-Elect Darlyne Menscer, MD NCMS Delegate to the AMA Marcus G. Plescia, MD, Health Director Mecklenburg County Health Department
On the Cover: White Coat Wednesday Mecklenburg County Medical Society members are headed to Raleigh for White Coat Wednesday, a day of advocacy. For more information, see Member News on page 16. 1112 Harding Place, #200, Charlotte, NC 28204 704-376-3688 • FAX 704-376-3173 firstname.lastname@example.org Copyright 2015 Mecklenburg County Medical Society Mecklenburg Medicine is published 10 times per year by the Mecklenburg County Medical Society, 1112 Harding Place, Suite 200, Charlotte, NC 28204. Opinions expressed by authors are their own, and not necessarily those of Mecklenburg Medicine or the Mecklenburg County Medical Society. Mecklenburg Medicine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. Mecklenburg Medicine is not responsible for unsolicited manuscripts. Non-members may subscribe to Mecklenburg Medicine at a cost of $30 per year, or $3.50 per issue, if extra copies are available. Classified Ads: Open to members, nonprofits and non-member individuals only; advance approval of the Managing Editor and advance payment required. Member rate is 0, non-members $20 for the first 30 words; $.75 each additional word. Display Ads: Open to professional entities or commercial businesses. For specifications and rate information, contact Mark Ethridge at email@example.com. Acceptance of advertising for this publication in no way constitutes professional approval or endorsement of products or services advertised herein. We welcome your comments and suggestions: Call 704-376-3688 or write Mecklenburg Medicine, c/o Mecklenburg County Medical Society, 1112 Harding Place, Suite 200, Charlotte, NC 28204.
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Douglas R. Swanson, MD, FACEP, Medical Director Mecklenburg EMS Agency
EXECUTIVE STAFF Executive Director Sandi D. Buchanan Meetings & Special Events Trisha G. Herndon Finance & Database Specialist Stephanie D. Smith
MECKLENBURG MEDICINE STAFF Managing Editor Sandi D. Buchanan Copy Editors Lee McCracken Stephanie Smith Advertising Mark Ethridge firstname.lastname@example.org Editorial Board Stephen J. Ezzo, MD N. Neil Howell, MD Scott S. Lindblom, MD Jessica Schorr Saxe, MD Simon V. Ward III, MD Graphic Design — Wade Baker
A Tisket, a Tasket By Simon V. Ward III, MD
y parents liked each other. That is something I never took for granted. Anyone who has been in or close to a bad marriage knows well the pain. Dad liked talking to Mom at the end of the day. Many times, when work had been busy, he would bring home an armload of charts to work on sitting at the kitchen table — finishing notes, checking lab results and calling patients. That was fine. The problem was that he did not like working hospital charts in the record library. As it was against hospital rules to take charts out of the building, he waited until the end of the day when the medical records folks had gone home. He would bring the hospital charts home and work them just as he did his office charts. The charts would be returned to their stack early the next morning. That all worked just fine. Until one evening… Dad was working charts at the kitchen table. Some minor emergency called him away from his work, so he laid the chart he was working on in the seat of the chair and went off to take care of the problem. We had Doberman Pinschers when I was growing up. They are one of the most intelligent breeds and will learn to be what they are trained to be. Ours were trained to be family pets — not chewers and they rarely stole food. That night, our Doberman became very interested in that medical record. A short time later, my folks walked back into the room to find what had been a moderately thick hospital record in thousands of small pieces scattered all over the room. I was studying for an exam, but vividly remember my parents on hands and knees late into the night piecing that record back together. Somehow, they came up with enough Scotch tape to connect all the pieces. The next morning, the only thing Mom could find to hold this chart, now a pile of tattered pages eight inches high, was a wicker basket. Dad took it in to medical records and told the director that it was a “basket case.” She was not amused. Dad had been in trouble before — the time he let a husband come into the delivery room (how radical was that?). This time, he almost got himself kicked off the medical staff. Thankfully, he wasn’t, but the director of medical records kept that basket on the corner of her desk for years just to remind her of the shenanigans that her doctors could perform. What is it that makes medical care so interesting? So much so that even a canine friend would want to review a medical chart? It’s not physics. Physicists are very bright people, and there is nothing simple about physics. Newton’s second law says that force equals mass times acceleration. That is a basic law that governs how a mass in motion will always act. Medicine often breaks rules instead of following them. Blood sugars often do not obey the rules. Even with the same diet and the same dose of medication, there will be unexplained rises and falls in the sugar level. A basic rule of obstetrics is that nulliparas move slowly and have long labors, while multiparas move faster and have short labors. Anyone who does deliveries knows that sometimes a first baby will be born within an hour of the first contraction and that a multipara may take many hours of hard labor to deliver. Practitioners in every specialty learn early on that rules that govern how the human body behaves helps to understand processes, but the rules are broken often
and vigorously. One has to always be ready for unexpected changes in a patient’s status. Medicine is not law. Our legal colleagues, like physicists, also are very smart people. Making it through law school and passing the bar are not easy tasks. But, physicians don’t think like lawyers. We have this basic need to find the truth and educate our patients and others. Our defense attorneys keep telling us to shut up and answer the question in two words or less. Our world is humans against the maladies of nature. The law world is humans against humans. Finding the truth means nothing if you don’t win the case. We may not make good lawyers, but we can find ourselves having to function as arbitrators in order to care for patients. A very unhappy mother has just discovered her teenage daughter is sexually active. The mom wants us to come up with reasons why having sex is not a good idea. Our young patient really needs a professional who will provide reliable contraception, an HPV vaccine and age-appropriate counseling about reducing the risk of contracting hepatitis or HIV. We have to negotiate with one party in order to provide the proper care to another party. Medicine is not economics. On a recent busy day in the office, my office manager informed me that my payment for a modestly priced continuing education course had been turned down for reimbursement by the business folks. They did not trust me when I said the money was used for the course. I was instructed to contact the bank to confirm the check had cleared. That same day had required several decisions that could have significant and long-term effects on the health of my patients’ unborn children. While the patients had questions about their care, not one expressed distrust of the decision made. When a surgeon closes an incision, the patient trusts that the surgery was done correctly. When the cardiologist feeds the catheter through the heart, the patient trusts it is done correctly. It has to be done correctly the first time. The business folks would probably make their own mothers produce a cleared check, and yet our patients will trust us to do what is right for their health or the health of their families. We are the practitioners of a craft unlike any other. We use scientific principles, but always recognize the rules may not be followed. We always work to find the true cause of a malady and make it better, but also have to apply negotiating skills to accomplish that. Our work often does not lend itself to a recheck. The code has to be managed right while it is happening. The anesthesia induction has to be handled correctly. We work every day to get it right the first time, so we deserve the trust our patients put in us. P.S. Pitch for electronic medical record salespeople: EMRs cannot be eaten by dogs.
Mecklenburg Medicine • May 2015 | 5
Sun Damage Fuels Rise in Skin Cancer and Burns Through Billions of Dollars By Lee McCracken, Contributing Writer
cientists revere the sun. Physicians not so much. The sun sustains all life on Earth, and solar energy is one of the most viable sources of renewable energy. Yet, damage from the sun’s ultraviolet rays kills millions of Americans each year and is the reason more than $8 billion is spent annually in treating skin cancer. Charlotte’s temperate climate keeps adults and children happy in the Queen City. Helping them to keep their skin healthy is the commitment of dedicated dermatologists. “I spend a lot of time talking with people about how long they will be living in their skin,” says Elizabeth Rostan, MD, founder of Charlotte Skin & Laser. Elizabeth Rostan, MD “Physicians should be talking with their patients about the health of their skin over a lifetime.”
Sun-kissed Isn’t Healthy
Lifestyle and prevention are important factors in controlling skin cancer. As with other diseases, skin damage due to sun exposure is accelerating faster and faster. Nearly 5 million people are treated for skin cancer each year, with more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon. And, more people develop skin cancer because of tanning than get lung cancer from smoking. Jennifer Helton, MD, owner of Steele Creek Dermatology, who also is Board-Certified in dermapathology, educates her patients on how sun exposure changes skin, hastens the aging of cells and can lead to cancer. The sun-kissed look that’s admired and associated with health and vitality actually is associated with skin disease. Radiation from Jennifer Helton, MD ultraviolet rays induces oxidative stress in the skin that stimulates inflammation and hyperpigmentation. “No matter the statistics, tanned skin is still promoted as prettier — just look at the models in magazines,” says Helton. “But if you have a tan, you have sun damage.” And it’s a huge hit to the U.S. economy. According to the Centers for Disease Control, the average annual cost for skin cancer treatment increased 126 percent between 2002 and 2011, whereas the average annual cost for treatment of all other cancers increased by 25 percent. Melanoma isn’t the most common type of skin cancer (accounting for less than 2 percent), but it is the most serious. The American Cancer Society estimates about 73,870 new melanomas will be diagnosed in the United States in 2015, and some 9,940 people will die of melanoma. The rates of melanoma have been rising for at least 30 years. Even worse, women ages 18-39 are now eight times more likely to be diagnosed with melanoma than they were 40 years ago. One person dies from melanoma every 57 minutes.
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Men are at risk, too. The majority of those diagnosed with the disease are white men over age 50, but young men account for more than 60 percent of melanoma deaths. Melanoma is one of three cancers with an increasing mortality rate for men, along with liver cancer and esophageal cancer.
‘Ban the Tan’
Getting that “base tan” for the prom or a beach getaway is a reminder why state legislation to ban tanning-bed use for everyone under 18 (now known as the Jim Fulghum Teen Skin Cancer Prevention Act) is so important. The proposed legislation memorializes the former Republican state representative and neurosurgeon from Wake County, who was an early and strong supporter. Current state law prohibits children 13 or younger from using salon equipment, unless a doctor gives the child a written prescription. Those ages 14-17 must have parental permission. In March, dermatologists gathered at the legislative building in Raleigh to support the third introduction of the bill at the General Assembly. It was first introduced in 2013 and passed the House of Representatives with bipartisan support. It then went to the Senate. Legislators and physicians are hopeful this year’s companion bill to the House version (HB 158) that was introduced in the Senate will pass. The bill has the support of the American Cancer Society, the N.C. Medical Society, the N.C. Pediatric Society, the N.C. Oncology Society, the N.C. Dermatology Association and the state Child Fatality Task Force. The American Suntanning Association and Planet Beach, one of the largest indoor tanning franchises in the United States (they have Charlotte locations on Carmel Road and South Tryon Street) also support the bill. The introduction of the tanning bed legislation comes on the heels of the U. S. Surgeon General’s national “Call to Action” on skin cancer last year, which included reducing the harm from indoor tanning as a major goal. For more information, visit www.preventskincancernc.org.
Abnormal Bumps and Spots
The most prevalent forms of skin cancer — basal cell carcinoma and squamous cell carcinoma— are worrying physicians, too. “There’s an epidemic of non-melanoma skin cancer,” says Rostan. “These rarely are life-threatening, but they can be disfiguring.” Basal cell carcinoma is the most common form of skin cancer, with an estimated 2.8 million diagnosed annually in the United States. “It’s not unusual now for me to see patients under the age of 40 with a basal cell or squamous cell lesion,” Rostan adds. “It’s difficult for young adults to see their future, but beyond how normal aging will affect their skin, sun damage accelerates the process of pre-cancerous changes.”
Squamous cell carcinoma is the second most common form, and it is more dangerous. The incidence of squamous cell carcinoma has been increasing up to 200 percent over the past three decades in the United States. “Squamous cell carcinoma can be very locally destructive to the skin, and there is the risk of metastasis,” explains Helton. The danger areas for squamous are the head and neck — especially the nose, lips and ears. In African-Americans, especially those with light skin, SCC tends to be more aggressive and is associated with a 20-40 percent risk of metastasis. Basal cell carcinoma frequently appears as a pearly bump, whereas squamous cell carcinoma often looks like a rough, red scaly area, or an ulcerated bump that bleeds. “Any area that changes or grows should be brought to the attention of a dermatologist,” Rostan recommends. In addition, areas on the lips can go undetected for a long period of time, so lip balm or lipstick with sunscreen is important. “All skin changes over a lifetime with aging, but chronic sun damage intensifies thinning of the epidermis and the cells can become abnormal,” says Helton. “This may lead to the development of precancers or skin cancer.” Actinic keratosis is the most common precancer, affecting more than 58 million Americans. About 65 percent of all squamous cell carcinomas and 36 percent of basal cell carcinomas develop in spots previously diagnosed as actinic keratosis. Again, the annual healthcare cost of treating non-melanoma skin cancers in the United States is significant: about $4.8 billion, compared to $3.3 billion for melanoma.
That’s what we can promise your patients. Once you’ve made the decision to refer to hospice, the next choice is easy.
Sun Protection Is Essential • Exposure to both ultraviolet A and B rays can lead to skin cancer. Use a water-resistant Broad-spectrum SPF 30 or greater on all sun-exposed skin. • Most people only apply 25-50 percent of the recommended amount of sunscreen. Be sure any leftover sunscreen is not older than the printed expiration date. • Skin cancer can form on the lips. Apply a lip balm that contains SPF 30 or higher. • The ears, scalp and neck also are highly susceptible to sun damage. Both men and women should wear hats. • Dermatologists recommend sun-protective clothing (including hats and lightweight gloves) and laundry detergent to treat clothing.
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“Precancers, basal cell and squamous cell cancers can be treated, but there’s no easy way,” says Rostan. “They can be burned off, scraped off or cut out. If caught early, they are fairly easy to remove, but scarring is likely.” The best line of defense, however, is sun protection. “Adults and teens must apply the care they give children, using sunscreen and protective clothing, to themselves,” advises Rostan. “Smart lifestyle behaviors can prevent skin cancer and enable people to live long lives in healthy skin.”
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Foundation for the Carolinas Mecklenburg Medicine • May 2015 | 7
Affordable Care Act Collaboration in Mecklenburg County By Madison Hardee, Legal Services of Southern Piedmont
he 2015 Affordable Care Act (ACA) open enrollment period ended on February 15 with nearly 11.7 million enrollments nationwide. North Carolina continues to boast the third highest number of enrollments of all states in the Federally Facilitated Marketplace (FFM). In our state, the average monthly premium for 2015 is less than $100, thanks to financial assistance that benefits 92 percent of enrollees. Here in Mecklenburg County, we also have a lot to be proud of. With more than 140,000 plan selections during the second open enrollment period, Charlotte is among the top metropolitan areas in the country. What is the secret to our success? Collaboration. For the past year, local ACA advocates have been working together as “Get Covered Mecklenburg” to coordinate outreach and enrollment efforts. With monthly meetings and ongoing communication, Get Covered Mecklenburg partners started planning months in advance of the Nov. 15, 2014 start date. Organizations, including Legal Services of Southern Piedmont, Care Ring and Cognosante, provided in-person enrollment assistance at more than 30 locations across the county. Navigators were stationed at local clinics, churches, libraries and even a barbershop. They played an important role in helping consumers step by step through the enrollment process, not only with the application, but also with understanding cost-sharing and provider networks. With the leadership of Enroll America, Get Covered Mecklenburg was able to connect with print, radio and television media to reach more people and share information about upcoming events. During the second Open Enrollment Period, MedLink of Mecklenburg generously sponsored four large, county-wide Saturday enrollment events, which brought together more than 10 organizations and dozens of volunteers to help consumers at the Children and Family Services Center in uptown Charlotte. At those events, we collectively celebrated each enrollment, made referrals to local clinics and took lots of pictures of smiling, newly insured families. Get Covered Mecklenburg partners also hosted smaller, targeted outreach events, including “Wellness Wednesdays” in partnership with the Charlotte Mecklenburg Libraries, a Latino enrollment event in partnership with the Camino Community Center, a
refugee enrollment event in partnership with Project 658 and several “last chance” events in the final days. In the coming months, we must work together to make sure the newly insured understand how to use their coverage effectively and pay monthly premiums to stay covered. Although the next open enrollment period does not start until November At the January enrollment event, volunteer navigator Mary Allen 2015, life changes, such as helped Willie get covered for $0 per month. marriage, birth of a child, loss of coverage or a permanent move, will continue to qualify many consumers for a special enrollment period. In some cases, an increase in income alone may be sufficient to sign up outside of open enrollment. Free in-person help remains available year round for anyone who has questions about coverage or needs enrollment assistance. Across North Carolina, consumers can schedule an appointment with a navigator by calling 1-855733-3711 or by visiting connector.getcoveredamerica.org. Are you on Social Media? Follow @getcoveredmeck on Twitter.
Open Enrollment 1 vs. Open Enrollment 2 in North Carolina OE 1
Enrollment Period Length
Insurance companies in N.C. marketplace
Plans available in Mecklenburg County
Plan selections in N.C.
559,473 (& counting!)
Percent of N.C. enrollees receiving financial assistance
One of many Get Covered Mecklenburg planning meetings.
Legal Services Navigator Fara Soubouti helped Vivian and her son renew their ACA coverage at the November enrollment event.
8 | May 2015 • Mecklenburg Medicine
This letter is to recap some of what MM AE has done this year, inform you abou t what is still ahead and encourage each become involved in your MMAE. Our of you to official year begins and ends in May — upon the installation of new officers. So under the careful planning of Programs Vice far MMAE, -President Becky Williford, has presente d programs from Project 2 Heal, Lily Pad Sharon Luggage and Carolinas Weight Man Haven, agement Clinic. Our Community Health Classroom, spear-headed by Kathy Klim showcased three local, board-certified aller as, gists who spoke about peanut allergies, whe at and gluten intolerance, and the eight food which individuals are most allergic. s to The Holiday House committee reports $60, 000 was raised during our 2014 Holiday House — all of which went into our End to be given to health-related nonprofits in owment Mecklenburg County. Currently, the End owment sits at $1.8 million — an impressiv By the time this letter is published, “Lov e amount! e Letters — What Legacy Do You Wan t to Leave Your Family?” presented by Kare Drancik of Neuberger Berman Advisor n Institute, will have taken place. SunTrust Bank sponsored this event at Lumiere Fren As our last hurrah during my presidency, ch Kitchen. our Annual Meeting will be held Tuesday, May 19, at Carmel Country Club. MMAE’ slate of officers will be introduced and insta s new lled. Checks will be presented to our 2015 grant recipients. Mary Tribble will give a “Doing Well, Doing Good,” a most timely talk entitled topic for our organization as we seek to best use our time and resources. MMAE’s bylaws, have been updated to better reflect how we do business. Linda Kramer and her committee spent many hour tending to this important, but thankless, s task. Thanks to everyone who voted to raise MM AE’s county dues to $50 annually. The incre ase will go to the cost of doing business this day when websites are mandatory and in prices are not decreasing. Know that your Board works very hard to spend MMAE wisely. We work from a budget that does money not allow use of Endowment funds for oper ating expenses. So, we are seeking new of revenue. One such avenue that Alice sources Nichols has explored this year is online retailers, that allow direction of a portion charitable organizations. Amazon Smiles of sales to and Beauty Kind (brought to us by mem ber Barbara Lucas) are two that are up and Stay tuned for more information about how running. MMAE can earn cash when members buy products from these sites. Many of our members have asked about a printed version of the directory. Due to financial concerns, MMAE has tried to conv an online directory through Wild Apricot. ert to However, members continue to ask for a printed version. I am happy to announce Finance Committee and the Board have that the approved the printing of a members-only version of the directory for 2015. To be copy, your renewed membership MUST eligible for a be to MMAE by July 31st. Watch for your membership letter in the mail. MMAE Board meetings — held the third Wednesday of months September–May at 10 a.m. at the Mecklenburg County Med Society office — are open to our members ical . As a member, you are welcome to atten d and listen to the business of MMAE in Also know that MMAE LOVES voluntee action. rs. There are committees that need voices and ideas. Share your talents! I look forward to seeing you at our rema ining 2014-15 events,
g: n i t e e M ual , 2015
Annsday, Manytr19y Club
Tue mel Cou n of Grants Car esentatio Pr
S herry Ward
Membership Directory Deadline! July 31, 2015 County Dues - $50 Watch for membership letter in the mail! Mecklenburg Medicine • May 2015 | 9
E H D T ATE E V A THE 10TH ANNUAL A DECADE DEDICATED TO
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10 | May 2015 • Mecklenburg Medicine
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Mecklenburg Medicine â€˘ May 2015 | 11
The Mecklenburg County Medical Society Annual Meeting on March 18 at the Myers Park Country Club featured guest speaker, Jeanne Robertson.
12 | May 2015 â€˘ Mecklenburg Medicine
Mecklenburg Medicine â€˘ May 2015 | 13
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NATIONAL HEALTH & WELLNESS OBSERVANCES
Advertising Acknowledgements The following patrons made Mecklenburg Medicine possible.
Alexander Youth Network..................................... Insert Brackett Flagship Properties.........................................10 Carolinas HealthCare System......................................23 Charlotte Eye Ear Nose & Throat Associates.............14
Charlotte Radiology............................................... 14, 21
ALS Awareness Month Arthritis Awareness Month Asthma and Allergy Awareness Month Better Hearing and Speech Month Better Sleep Month Celiac Awareness Month Clean Air Month Correct Posture Month Cystic Fibrosis Month Hepatitis Awareness Month Huntington’s Disease Awareness Month Lyme Disease Awareness Month National Cancer Research Month National High Blood Pressure Education Month National Lupus Awareness Month National Melanoma Skin Cancer Awareness Month National Mental Health Month National Stroke Awareness Month
Charlotte Speech & Hearing Center............................10
May 4 Melanoma Monday May 5 World Asthma Day May 16 World IBD Day (Inflammatory Bowel Disease) May 10 World Lupus Day May 20 World Autoimmune Arthritis Day May 31 World No Tobacco Day May 3-9 Brain Tumor Action Week May 6-12 National Nurses Week
Hospice & Palliative Care Charlotte Region................7 kure Network.......................................................... 11, 22 LabCorp.........................................................Back Cover Novant Health..................................................................2 Parsec Financial...............................................................3
Charlotte AHEC Course Offerings Charlotte AHEC is part of the N.C. Area Health Education Centers (AHEC) Program and Carolinas HealthCare System.
Continuing Medical Education (CME) 5/2 UNC Pathology 5/19 & 6/16 Measuring Healthcare Improvement 9/11-12 AAFP Post Graduate Symposium 9/25-27 The Southern Pain Society Annual Meeting 10/2 1st Annual Advanced Clinical Practitioner (ACP) Symposium 10/2 UNC Cancer Center – Survivorship 10/23-24 Fall Foliage Cancer Conference 11/14 Facture Management Trauma 11/14 Hematology Symposium Online DOT Medical Examiners Course For more information or to register for these courses, call 704-512-6523 or visit www.charlotteahec.org.
Mecklenburg Medicine • May 2015 | 15
Upcoming Meetings & Events MAY Upcoming MCMS Events n
Wednesday, May 27 White Coat Wednesday for MCMS members. Raleigh, N.C. Thursday, May 28 MCMS Membership Event. U.S. National Whitewater Center River Jam BBQ. Sponsored by Spaugh Dameron Tenny. 7-9 p.m.
Upcoming Meetings and Other Events Meetings are at the MCMS office unless otherwise noted. n
Tuesday, May 5 Charlotte Pediatric Society meeting. The Duke Mansion. 6 p.m. Wednesday, May 6 Fighting for Women With Fashion planning meeting. Safe Alliance office. 6 p.m. Monday, May 11 Executive Committee meeting. 5:45 p.m. Tuesday, May 12 MedLink meeting. Mecklenburg County Health Department. 8:30 a.m. Monday, May 18 MCMS Board meeting. 5:15 p.m. – dinner. 5:45 p.m. – meeting. Wednesday, May 20 MMAE Finance Committee meeting. 9 a.m. Wednesday, May 20 MMAE Board meeting. 10 a.m. Thursday, May 21 CAMGMA meeting. Myers Park Baptist Church Cornwell Center. Noon. Friday, May 22 July/August magazine deadline. Monday, May 25 Memorial Day – MCMS office closed.
16 | May 2015 • Mecklenburg Medicine
White Coat Wednesday
Legislative Advocacy Day May 27, 2015
Mecklenburg County Medical Society Members are headed to Raleigh!
Join other MCMS members as we stand together on issues that are important to you and your patients! RSVP to Sandi Buchanan at email@example.com if you would like to join us.
NCMS AGENDA AND INFORMATION: 8-8:30 a.m.: 8:30-11 a.m.: 11 a.m.-Noon: Noon-1 p.m.: 1-3 p.m.: 3 p.m.:
Meet at the North Carolina Medical Society for an Advocacy Day overview (222 N. Person Street, Raleigh) Head to the Legislative Building to personally meet with your legislators. Attend a Healthcare Committee or continue legislator one-on- one meetings. Lunch in the Legislative Cafeteria, if no personal meetings are scheduled. Continue legislative visits or sit in on the action in the General Assembly. Adjourn
Legislative Advocacy Day is your chance to learn more about the ins and outs of government affairs and how best to approach your legislator regarding healthcare issues. The NCMS will hold a briefing in the morning with tips on“dos and don’ts”in relaying your message to legislators and on the hotbutton medical and patient issues currently in the spotlight at the General Assembly.
Legislative Issues n Federal Healthcare Reform n Medicaid Reform Medical Liability Reform n Scope of Practice
The Smith Arthritis Fund Committee Is Now Accepting Grant Applications The Smith Arthritis Fund was established in 1979 when Carolyn Kirkpatrick Smith donated $41,500 for arthritis research. This fund is administered through the Mecklenburg County Medical Society and is designed to support research projects as they relate to the needs of patients suffering from rheumatologic diseases. Each year, the committee awards about $1,000 per grant. There are no rigid restrictions. The Smith Arthritis Fund Committee of the Mecklenburg County Medical Society is now accepting grant applications from interested physicians through the end of June. Contact the Medical Society office for more information.
Maureen P. Andreassi, MD
Maureen P. Andreassi, MD Internal Medicine Novant Health First Charlotte Physicians 1401 Matthews Township Pkwy. #200, Matthews, NC 28105 704-384-6901 Stony Brook University School of Medicine, 1994
James G. Benonis, MD
James G. Benonis, MD Anesthesiology Providence Anesthesiology Associates 200 Providence Road #200, Charlotte, NC 28207 704-749-5819 Temple University School of Medicine, 2002
Stephen J. Blaha, MD
Stephen J. Blaha, MD Obstetrics and Gynecology Eastover OB/GYN Associates – Arboretum 7810 Providence Road #300, Charlotte, NC 28226 704-446-7800 Wake Forest University School of Medicine, 2008
Lisa K. Burke, MD
Lisa K. Burke, MD Emergency Medicine Carolinas HealthCare Urgent Care – Arboretum 7810 Providence Road #102, Charlotte, NC 28226 704-543-6636 University of North Carolina-Chapel Hill, 1989
Jewell P. Carr, MD
Jewell P. Carr, MD Family Medicine CMC Elizabeth Family Medicine 2001 Vail Ave. #400, Charlotte, NC 28207 704-304-7000 Wake Forest University School of Medicine, 2010
Nicole R. Cullen, MD
Nicole R. Cullen, MD Gastroenterology Charlotte Gastroenterology & Hepatology 13808 Professional Center Drive, Huntersville, NC 28078 704-377-4009 University of Pittsburgh School of Medicine, 2008
Jessica J. Deane, MD
Jessica J. Deane, MD Obstetrics and Gynecology Eastover OB/GYN Associates – Arboretum 7810 Providence Road #105, Charlotte, NC 28226 704-446-7800 University of Vermont College of Medicine, 2010
David E. Kang, MD
David E. Kang, MD Urology Urology Specialists of the Carolinas 201 Queens Road, Charlotte, NC 28204 704-372-5280 Duke University School of Medicine, 2007
Larissa A. Kavanagh, PA-C Novant Health Uptown Primary Care 301 S. College St. #250, Charlotte, NC 28202 704-316-4810 South University Physician Assistant Program, 2014 Larissa A. Kavanagh, PA-C
Darin N. Kennedy, MD
Darin N. Kennedy, MD Family Medicine CMC Elizabeth Family Medicine 2001 Vail Ave. #400, Charlotte, NC 28207 704-304-7000 Wake Forest University School of Medicine, 1997
Jerry F. Matkins, Jr., MD
Jerry F. Matkins, Jr., MD Obstetrics and Gynecology Eastover OB/GYN Associates – Main 1025 Morehead Medical Drive #450, Charlotte, NC 28204 704-446-7800 University of North Carolina-Chapel Hill, 1992
Catherine E. Moore, MD
Jonathan R. Romeo, DO
Catherine E. Moore, MD Hematology and Oncology Oncology Specialists of Charlotte 2711 Randolph Road #100, Charlotte, NC 28207 704-342-1900 Southern Illinois University School of Medicine, 2008 Jonathan R. Romeo, DO Allergy/Immunology Allergy & Asthma Center of Lake Norman 15815 Brookway Drive, Huntersville, NC 28078 704-655-1466 Nova Southeastern University College of Osteopathic Medicine, 2008 Amanda L. Schuman, PA-C Charlotte Radiology 1705 East Blvd., Charlotte, NC 28203 704-334-7800 Mercy College Physician Assistant Studies, 2009
Amanda L. Schuman, PA-C
Jason G. Shultz, MD
Miguel A. Yanez, MD
Jason G. Shultz, MD Medical Oncology Oncology Specialists of Charlotte 2711 Randolph Road #100, Charlotte, NC 28207 704-342-1900 Medical University of the Americas (Nevis), 2009 Miguel A. Yanez, MD Plastic Surgery Piedmont Plastic Surgery & Dermatology 5815 Blakeney Park Drive #100, Charlotte, NC 28277 704-542-2220 University of Puerto Rico School of Medicine, 1986
Mecklenburg Medicine • May 2015 | 17
At the Hospitals
Novant Health Matthews Medical Center Named Bariatric Surgery Center of Excellence Novant Health Matthews Medical Center has been named a Bariatric Surgery Center of Excellence (BSCOE) for the second time since first receiving the designation in 2011. This renewed accreditation, granted by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), acknowledges Novant Health’s commitment to providing high-quality and safe care for bariatric surgery patients that exceeds clinical benchmarks and guidelines. “We are proud to be nationally recognized again as a Bariatric Surgery Center of Excellence. Our bariatric team, whether in the office, on the hospital floor or in the operating room, takes great pride in providing patients with the best experience and best outcomes possible,” says David Voellinger, MD, medical director of Novant Health Matthews Medical Center, Bariatric Center. “This recognition reinforces our belief that we are providing excellent care for our patients struggling with severe obesity. We will continue to raise awareness, promote prevention and offer treatment and support for this chronic, life-threatening disease.” Matthews Medical Center offers weight-loss surgery seminars and a range of minimally invasive laparoscopic and surgical weight-loss options. Medical weight-loss options, bariatric clinical nurse coordinators and navigators, nutritional counseling, exercise coaching and support groups also are available. For more information or to refer a patient, contact Novant Health Bariatric Solutions in Matthews at 704-316-7740. n
Novant Health Presbyterian Medical Center Receives Target: Honor Roll Elite Plus Award On February 12, at the 2015 International Stroke Conference in Nashville, TN, Novant Health Presbyterian Medical Center received the newly created Target: Stroke Honor Roll Elite Plus award from the American Heart Association/American Stroke Association (AHA/ASA). n
This recognition comes with AHA/ ASA’s addition of two levels of awards to the Target: Stroke Honor Roll as part of the national campaign “Target: Stroke Phase II.” Elite Plus status is reserved for hospitals with door-to-needle times of tissue plasminogen activator (tPA) within 60 minutes for at least 75 percent of applicable patients, and within 45 minutes for at least 50 percent of applicable patients. tPA is the only drug approved by the U.S. Food & Drug Administration to treat an ischemic stroke. Quicker treatment is associated with better outcomes for patients who qualify. Presbyterian Medical Center was the only hospital in Charlotte to meet Elite Plus standards. Novant Health Names Andrew Mueller, MD, President of Charlotte Market Novant Health has named Andy Mueller, MD, president of the greater Charlotte area. Prior to this role, Mueller was senior vice president of physician services with Novant Health. In his new position, Mueller will have responsibility for strategic growth and development of the Charlotte region, overall community efforts and service lines, in addition to his existing medical group role. Harry Smith, the former president of the greater Charlotte area, now will serve as senior vice president of professional and support services. Smith will work with laboratory, rehabilitation, respiratory therapy, imaging, neurodiagnostics and sleep medicine, as well as contracted services, such as environmental services, food and nutrition, patient transport and laundry/linen services. Paula Vincent, formerly senior vice president of foundation and development, will fill the chief operating officer role currently vacant at Novant Health Presbyterian Medical Center. She also will be responsible for a number of system-level initiatives designed to accelerate progress toward true integration across our System. n
Novant Health Matthews Medical Center Breaks Ground for New Women’s Center On May 1, Novant Health Matthews Medical Center broke ground on a new addition to its women’s center. n
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The women’s center aims to enlarge its physical footprint and increase patient comfort by constructing a 26,500-squarefoot, all-inclusive addition. The expansion project will create a single comprehensive care location, dedicated to women, with increased capacity and new programs to support women in the community. Earlier this year, Matthews Medical Center completed a renovation of its existing women’s center rooms. The renovated rooms feature a guest sleep bed, Jacuzzi, shower, hair dryer and more. The expansion project will add seven labor and delivery rooms, resulting in 30 total labor and delivery beds. The new space also will enlarge the facility’s special care nursery The project also includes two gynecological beds for inpatient stays. Currently, patients who need extra attention after a hysterectomy or gynecological procedure receive their overnight stay in the hospital, but not in a dedicated women’s area. The expanded women’s center will provide more customized care and attention for these patients. “We’ve seen obstetric volumes nearly double here at Matthews, and we anticipate more growth over time,” says Pat Campbell, vice president of Novant Health’s Women’s Services. “We’re delighted to build a new women’s center to meet that need — and to provide the warmth and care women deserve. Women continuously provide warmth and care for their families and our community, and they surely merit this beautiful new medical space.” For more information about women’s services at Novant Health Matthews Medical Center, call 704-384-CARE (2273) or visit NovantHealth.org/Matthews. CORRECTION: n Novant Health Heart & Vascular Institute Introduces CardioMEMS Patient Monitoring The March issue stated that a CardioMEMS program was introduced at Novant Health Presbyterian Medical Center in September 2014. This program is still under development and will be available to accept referrals later this year. To refer a patient to other Novant Health Heart & Vascular Institute services, call 704-343-9800 or fax 704-347-2011.
At the Hospitals
New Therapy to Help Children With Cancer Andrew Gilman, MD, director of the pediatric blood and marrow transplantation program at Carolinas HealthCare System’s Levine Children’s Hospital, is a major contributor to the development of a new therapy to help patients fight neuroblastoma, a cancer of immature nerve cells that most often occurs in infants and young children. The FDA approved the drug, Unituxin, a monoclonal antibody, on March 10 as part of first-line therapy for pediatric patients with neuroblastoma. The drug fills a need by providing a treatment option that extends survival in children with high-risk neuroblastoma. Gilman has been involved with the development of this therapy since 1996. He wrote and directed the Phase I study of the therapy and is co-director of the Phase III study, which served as the basis for FDA approval. The results of his study were published in the New England Journal of Medicine. The drug will now be readily available for children with neuroblastoma outside the context of a clinical trial. Future studies may look at moving this therapy earlier in the treatment regimen for newly-diagnosed patients, and there also is an ongoing trial for the antibody for relapsed patients. n
Carolinas MED-1 Impresses at South Carolina Disaster Exercise Carolinas MED-1, the mobile hospital owned by Carolinas HealthCare System, recently was part of a multi-state disaster exercise. Some 7,000 Army and Air National Guard troops and civilian emergency management personnel centered most of their efforts in and around Georgetown, S.C. The scenario was a Category 4 hurricane striking the South Carolina coast. The purpose of the exercise was to test the ability of military and civilian agencies to work together in such an emergency. Among the VIPs to tour Carolinas MED-1 during the exercise was Gen. Frank Grass, chief of the National Guard Bureau and a n
member of the Joint Chiefs of Staff. Grass was briefed by Dave Callaway, MD, MED-1 operational medical director and a former Navy physician who deployed with the Marines in Iraq in 2003. Carolinas MED-1 consists of two 53-foot tractor trailers plus support vehicles. The 14-bed, 1,000-square-foot patient care component is designed, equipped and staffed to manage minor to severe emergency medical conditions, including operative trauma surgery and intensive medical care. Volunteer “victims” who were treated in Carolinas MED-1 during the South Carolina hurricane disaster drill presented with realistic trauma injuries.
CHS Medical Practices Achieve Stage 7 Status HIMSS Analytics has awarded 230 Carolinas HealthCare System clinics with Stage 7 Ambulatory Awards. Developed in 2011, the EMR Ambulatory Adoption Model provides a methodology for evaluating the progress and impact of electronic medical record systems for ambulatory facilities owned by hospitals in the HIMSS Analytics® Database. Stage 7 represents the highest level of EMR adoption and indicates a health system’s advanced electronic patient record environment. As of the fourth quarter of 2014, only 6.21 percent of the more than 30,000 U.S. ambulatory clinics in the HIMSS Analytics® Database received the Stage 7 Ambulatory Award. HIMSS Analytics collects, analyzes and distributes essential health IT data related to products, costs, metrics, trends and purchase decisions. It delivers quality data and analytical expertise to healthcare delivery organizations, IT companies, governmental entities, financial, pharmaceutical and consulting companies.
System Recognized by NCHA for Quality and Patient Safety Carolinas HealthCare System recently was honored by the North Carolina Hospital Association (NCHA) for its commitment to quality improvement and patient safety as part of a three-year national initiative sponsored by the U.S. Centers for Medicare and Medicaid Services (CMS). The System was part of CMS’ Partnership for Patients’ Hospital Engagement Network (HEN) initiative, aimed at reducing hospitalacquired conditions by 40 percent and readmissions by 20 percent by December 2014. With support from the national HEN, Carolinas HealthCare System prevented nearly 7,900 potential harm events, equal to $48 million savings in related care costs, between 2012 and 2014. In 2013, Carolinas HealthCare System received an additional 15-month contract by CMS called Leading Edge Advanced Practice Topics (LEAPT). Through LEAPT, eight CHS hospitals tested solutions to complex healthcare topics focused on reducing: injury or death from severe sepsis and septic shock; antibiotic resistance; readmissions among patients with co-morbidities; and surgical complications.
International Medical Outreach Enhances Health in Central America Carolinas HealthCare System and the Heineman Foundation of Charlotte are enhancing the health care of women and children in Central America with the recent installation of a breast cancer diagnostic unit and a neonatal intensive care unit (NICU) in public hospitals in Belize and Guatemala. The units opened at the Karl Heusner Memorial Hospital in Belize City and at Hospital Regional de Cobán in Guatemala. The diagnostic unit is the first in a Belize public hospital, making mammography and ultrasound services available to thousands at a low or no cost. The unit can screen, diagnose and upload tests for referrals to clinical providers globally. The donation of infant beds, warmers and monitors in Cobán will reduce infant deaths caused in part by overcrowding in the NICU. The breast cancer diagnostic unit equipment was transported and assembled by Bowen & Bowen and Aramark. The NICU equipment was transported by Chiquita Brands vessels to Guatemala. n
Mecklenburg Medicine • May 2015 | 19
Independent Physicians of the Carolinas
Independent Physicians of the Carolinas is a nonprofit 501(c)(6) membership organization whose mission is to create public awareness of medical doctors not employed by a network or hospital system and to provide educational programs and resources to physician members and their administration. Visit us at IndependentPhysicians.org.
Julia Parkhurst, MS, PA-C
Allergy & Asthma Center of Lake Norman is pleased to announce the addition of Julia Parkhurst, MS, PA-C to the practice. Parkhurst, along with Drs. Christina Collura and Jonathan Romeo, will see patients at the Huntersville and Mooresville locations.
Charlotte Gastroenterology & Hepatology’s physicians, staff, family, friends and 107.9 The Link’s Matt & Ramona had a strong showing at the Colon Cancer Coalition’s Get Your Rear in Gear 5K on March 7. A presenting sponsor, Team CGH received the Top Corporate Fundraiser award. Three of their 93 team members placed in their designated age groups. Get Your Rear in Gear also presented Charlotte Gastroenterology & Hepatology with a special award recognizing their participation and sponsorship since 2010. Hat’s off to Matt Harris of 107.9 The Link who started a colon cancer dialogue in our community. Listeners have been calling in to discuss colorectal cancer screenings and what motivates them to undergo a colonoscopy. Funds raised during the event stay in the Charlotte community.
V Pain Clinic has moved its Rock Hill office to 410 S. Herlong Ave., Suite 101. The office has expanded and they are performing procedures in the new procedure room equipped with a digital C arm and ultrasound-assisted guidance. The phone number is unchanged at 803-909-3600. Visit online at www.vpain.us. Updates are available on Facebook. Mecklenburg Heart Specialists recently received its re-accreditation from ICANL for nuclear cardiology.
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Join the team of Carolina Digestive Health Associates on Saturday, May 30 at Freedom Park to take part in the Charlotte Take Steps Walk to raise awareness and funds for cures for digestive diseases. Registration is at 3 p.m. and the Walk begins at 4 p.m. The Crohn’s and Colitis Foundation of America (CCFA) Carolinas Chapter is hosting this event. To join a team, visit www.ccfa.org/chapters/carolinas/events/ charlotte-nc-take-steps-walk.html.
New Members for 2015: Christina Collura, DO, Allergy & Asthma Center of Lake Norman Peter Ford, MD, Vascular Solutions Erin Goshorn, MD, Pediatric Eye Care and Strabismus Enam Haque, MD, Queen City Plastic Surgery Darlington Hart, MD, Cornerstone Medical Kent Moore, DDS, MD, Charlotte Oral Surgery Augustine Onwukwe, MD, Access Care Medical Jon Romeo, DO, Allergy & Asthma Center of Lake Norman Daniel Seward, MD, ProMed Healthcare Selwyn Spangenthal, MD, Charlotte Lung and Health Center C
Renewed Members for 2015: Ashvin Amara, MD, Amara Pain & Spine Kenneth Ashkin, MD, Ballantyne Sleep Center Steven Bauer, DO, Ballantyne Medical Associates Larry Berman, MD, Larry F. Berman, MD, P.A. M. Reza Bolouri, MD, Alzheimer’s Memory Care Jennifer Caicedo, MD, Allergy Asthma & Immunology Relief Gisele Girault, MD, Pain Medicine Specialists of Fort Mill Wendell Goins, MD, Mid-Carolina Surgery Specialists Neal Goldberger, MD, Carolina Bone & Joint Omar Idlibi, MD, Carolina Medical Lab Carlos Jorge, MD, Ballantyne Medical Associates Sharon Kanelos, MD, Integra Rehabilitation Physicians Charles Lapp, MD, Hunter-Hopkins Center James Liu, MD, South Charlotte Cardiology Steven McEldowney, MD, Allergy & Asthma Care of Blakeney Wissam Nadra, MD, Lakeshore Pediatric Center Sheila Natarajan, MD, Integra Rehabilitation Physicians Deborah Nixon, MD, Dermatology Specialists of Charlotte Maeve O’Connor, MD, Allergy Asthma & Immunology Relief Steve Plunkett, MD, Southeast Radiation Oncology Group Aamer Qureshi, MD, Mecklenburg Heart Specialists Matthew Samarel, MD, Kids First Pediatrics David Schulman, MD, South Charlotte Dermatology Robert Wozniak, MD, Lancaster Endocrinology
Mecklenburg Medicine â€˘ May 2015 | 21
August 10, 2015 Charlotte Knights vs Gwinnett Braves
Have a Ball on Us! Maximum of 2 tickets per request
Parking passes available for the first 8 replies Gates open at 6 PM, game time 7:05
Menu Carved BBQ pork, hamburgers, hotdogs, Vegetarian pasta, fruit, Chefâ€™s choice dessert
Provide name, phone number, and # of tickets you wish to reserve Reply to firstname.lastname@example.org.
Join us for family fun and exciting baseball!
22 | May 2015 â€˘ Mecklenburg Medicine
See you at BB&T BallPark !
“My work in the arts is my passion. I rarely called in sick to my job at the museum. And then I was told I had terminal cancer.” Christopher was diagnosed with stage 4 kidney cancer, and oncologists at Levine Cancer Institute treated him with an experimental drug not available anywhere else in the region. It’s been three years since his diagnosis and he has his life back.
LEVINE CANCER INSTITUTE World-class cancer care close to home. See Christopher’s full story at CarolinasHealthCare.org/CancerStory
Mecklenburg Medicine • May 2015 | 23 LCI_Awareness_Christopher_Mecklenburg_Medicine.indd 1
3/4/2015 11:03:35 AM
Mecklenburg County Medical Society
PRSRT STD U.S. POSTAGE PAID CHARLOTTE, N.C. PERMIT NO. 1494
1112 Harding Place, #200 Charlotte, NC 28204 CHANGE SERVICE REQUESTED MCMS Mission: To unite, serve and represent our members as advocates for our patients, for the health of the community and for the profession of medicine.
LabCorp Laboratory Corporation of America
PATIENT SERVICE CENTERS
Ballantyne Billingsley** Carmel** Cabarrus Charlotte** Gastonia Stat Lab Huntersville Huntersville** Lake Norman Matthews Northridge* Pineville Randolph** Rock Hill Salisbury** Salisbury* Shelby Statesville** University**
… for all of your laboratory testing needs
15830 John Delaney Drive 300 Billingsley Road, Suite 200A 5633 Blakeney Park Drive, Suite 100 478 Copperfield Blvd. 1718 E. 4th Street 660 Summitt Crossing, Suite 206 14330 Oakhill Park Lane 10030 Gilead Road, Suite B100 134 Medical Park Drive, Suite 102 1500 Matthews Township Parkway, Suite 1147 5031-G West W.T. Harris Blvd. 10410 Park Road, Suite 450 1928 Randolph Road, Suite 109 2460 India Hook Road, Suite 101 611 Mocksville Avenue 514 Corporate Road 809 N. Lafayette Street 1710-A Davie Avenue 10320 Mallard Creek Road
*Drug Screens only **Blood Draws only
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Charlotte, NC Charlotte, NC Charlotte, NC Concord, NC Charlotte, NC Gastonia, NC Huntersville, NC Huntersville, NC Mooresville, NC Matthews, NC Charlotte, NC Pineville, NC Charlotte, NC Rock Hill, SC Salisbury, NC Salisbury, NC Shelby, NC Statesville, NC Charlotte, NC
704-540-0251 704-332-6904 704-542-7061 704-795-2710 704-372-6609 704-854-9497 704-948-8101 704-875-9130 704-799-6230 704-849-0154 704-598-6266 704-341-1145 704-334-2629 803-328-1724 704-637-1676 704-221-4407 704-480-7004 704-878-0948 704-549-8647