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January 2014 • Vol. 44, No. 1

Mecklenburg Medicine A Publication of the Mecklenburg County Medical Society | www.meckmed.org

NEW YEAR, NEW HEIGHTS in health care Mecklenburg County Medical Society • Mecklenburg Medical Alliance and Endowment Founders of: Bioethics Resource Group, Ltd., Hospitality House of Charlotte, Teen Health Connection, N.C. MedAssist, Physicians Reach Out


World-class cardiovascular physicians, nurses and technology working together to save lives Novant Health Heart & Vascular Institute Adult cardiology 1718 E. Fourth St. Suite 501, Charlotte 704-343-9800 8310 University Executive Park Suite 550, Charlotte 704-384-0684 10030 Gilead Road Suite 201, Huntersville 704-887-4530 1450 Matthews Township Parkway Suite 380, Matthews 704-264-3500

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2 | January 2014 • Mecklenburg Medicine

Cardiovascular and thoracic surgery 301 Hawthorne Lane Suite 200, Charlotte 704-316-5100 10030 Gilead Road Suite 201, Charlotte 704-316-5100 1640 E. Roosevelt Blvd. Monroe 704-316-5100


Contents

Features

January 2014 Vol. 44 No. 1

7 Meet Your 2014 MCMS Board of Directors

OFFICERS James B. Hall, MD President Simon V. Ward III, MD President-Elect Stephen J. Ezzo, MD Secretary JP McBryde, MD Treasurer Janice E. Huff, MD Immediate Past President

and Leadership

In This Issue 4

Charlotte AHEC Course Offerings for January: Levine Cancer Institute Breast Cancer Symposium

5

President’s Letter: The Electronic Medical Record

BOARD MEMBERS Lloyd L. Bridges, MD Raymond E. Brown, PA Jonathan A. Buice, MD Scott L. Furney, MD William F. Ingram, MD Scott L. Lindblom, MD Shivani P. Mehta, MD Elizabeth B. Moran, MD Cheryl L. Walker-McGill, MD Thomas N. Zweng, MD

7 MMAE 10 Member News 10 Upcoming Meetings & Events 11 At the Hospitals 14 National Health & Wellness Observances for January 14 Advertising Acknowledgement

EX-OFFICIO BOARD MEMBERS Gretchen Allen President, Mecklenburg Medical Alliance & Endowment Keia V. R. Hewitt, MD President, Charlotte Medical Society Docia E. Hickey, MD NCMS Speaker of the House Stephen R. Keener, MD, MPH Medical Director, Mecklenburg County Health Department Darlyne Menscer, MD NCMS Delegate to the AMA Douglas R. Swanson, MD, FACEP Medical Director, Mecklenburg EMS Agency

Mecklenburg County Medical Society

1112 Harding Place, #200, Charlotte, NC 28204 704-376-3688 • FAX 704-376-3173 meckmed@meckmed.org Copyright 2014 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, call Mark Ethridge at 704-344-1980. 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.

EXECUTIVE STAFF Sandi D. Buchanan Executive Director Trisha G. Herndon Director, Meetings & Special Events Stephanie D. Smith Executive Assistant MECKLENBURG MEDICINE STAFF Editor Mark E. Romanoff, MD Managing Editor Sandi D. Buchanan Copy Editor Lee McCracken Advertising Mark Ethridge 704-344-1980 Editorial Board N. Neil Howell, MD James B. Hall, MD Jessica Schorr Saxe, MD Graphic Design — Wade Baker

Mecklenburg Medicine • January 2014 | 3


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Levine Cancer Institute Breast Cancer Symposium: February 22, 2014 Saturday, February 22, 2014 8:00am – 3:00pm Omni Hotel Charlotte

132 E. Trade St. Charlotte, NC 28202 Please join us for the Levine Cancer Institute Breast Cancer Symposium where experts in surgery, radiation therapy, endocrine therapy, cytotoxic chemotherapy, and cutting edge molecular-based therapies will provide insight into the optimal management of patients with breast cancer and its application to practice.

GUEST FACULTY: Lori J. Pierce, MD

Vice President for Academic and Faculty Affairs Professor of Radiation Oncology University of Michigan

Julie R. Gralow, MD

Director, Breast Medical Oncology, Seattle Cancer Care Alliance Clinical Research Division, Member, Fred Hutchinson Cancer Research Center Professor, Medical Oncology Division, University of Washington School of Medicine

Terry Mamounas, MD, MPH, FACS Medical Director, Comprehensive Breast Program MD Anderson Cancer Center Orlando

ACCREDITATION STATEMENT: The Carolinas HealthCare System/ Charlotte AHEC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. CREDIT DESIGNATION STATEMENT: The Carolinas HealthCare System/Charlotte AHEC designates this live activity for a maximum of 6.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Healthcare Professionals: 0.65 Continuing Education Units (CEU)

PROGRAM:

Registration/ Breakfast/ Exhibitors Value in Cancer Care, Derek Raghavan, MD, PhD 8:30 - 9:25 Updates in Surgical Oncology, Terry Mamounas, MD, MPH, FACS 9:25 - 10:20 Updates in Medical Oncology, Julie Gralow, MD 10:20 - 10:35 Break 10:35 - 11:30 Updates in Radiation Oncology, Lori Pierce, MD 11:30 - 12:30 Lunch / NAPBC Perspective, Terry Sarantou, MD, FACS 12:30 - 1:30 Molecular Medicine Case Presentations/Panel Discussion: Steven Limentani, MD, Moderator Julie Fisher, MD Steven Akman, MD Garry Schwartz, MD Lori J. Pierce, MD Julie R. Gralow, MD Terry Mamounas, MD, MPH, FACS Chad Livasy, MD 1:30 - 1:45 Break 1:45 - 2:45 Neoadjuvant Therapy Case Presentations/ Panel Discussion: Richard L. White Jr., MD, FACS, Moderator Lejla Hadzikadic-Gusic, MD, MSci Paul Baron, MD, FACS Brian Moore, MD, FACS Lori J. Pierce, MD Julie R. Gralow, MD Terry Mamounas, MD, MPH, FACS Mary Decker, MD 2:45 - 3:00 Closing Remarks: Richard L. White Jr., MD, FACS 7:00 - 8:00 8:00 - 8:30

TO REGISTER, VISIT www.charlotteahec.org. For questions, contact Carrie Jackman-Hoyle at 704.512.3702

4 | January 2014 • Mecklenburg Medicine CHS_Breast_Symposium_journalAd_2014_Final2.indd 1

11/15/13 1:19 PM


President’s Letter

The Electronic Medical Record By James B. Hall, MD, President

E

MR: Three letters that strike fear into the hearts of many older physicians. What were we told about this now old, new paradigm of medicine? Thanks to late Sen. Ted Kennedy and former Sen. Nancy Kassebaum, we learned the privacy of our medical records was paramount and, clearly, something had to be done to protect the privacy of these records.

you as a person with whom the ER physician can speak. So, what about HIPAA and the security of the electronic medical record? How many instances can you think of where, because someone lost or had a computer stolen or because a system was hacked, literally thousands of “charts” had been accessed along with personal and financial data? This has become a common occurrence and is even more of concern with the admitted lack

The need for safety

In typical governmental wisdom, HIPAA was born. This legislation produced the need for greater security, so we needed a way to ensure that security. The Institute of Medicine came out with a report that defined just how careless physicians were and how unsafe American medicine was/is. It said nearly 100,000 citizens die every year because of “medical errors” perpetrated on them in an unsuspecting fashion by physicians, nurses and hospitals, and, no doubt, drug companies “big pharma.” This report supported the need for greater safety, so we needed a way to make us safer. The U.S. economy was stagnant and in the tank due to expenses of conflicts in Afghanistan and Iraq, and the more significant problem of the housing bubble bursting when unsecured loans were being written at the behest of Fannie Mae and Freddie Mac when even they were unsecured. This, combined with the fact that Medicare and health care in general make up 18 percent of the GDP. If we could figure out how to promote cost savings and stop the rate of growth of health care, perhaps we could correct the economy. We were told by then Sen./candidate Obama that we could realize an annual cost savings of $80 billion by the initiation of efficiencies of the electronic medical record. The economy and the candidate produced the need for greater savings, so we needed a way to save the economy by producing those savings. The HIPAA rules (and their interpretation) have become so onerous that if your neighbor and best friend goes to the emergency room with a problem, legally you can’t find out what the problem is and how you can help. You might get a drone call if your friend has the wherewithal to sign a waiver and identify

of security built into the ACA. I would submit that if someone got into your chart room, they would have limited access to personal information, as opposed to a computer that affords access to thousands of data points at a time. So much for the security notion. If you look at and evaluate the Institute of Medicine report, it is immediately obvious there is nothing prospective (Level 1 data) about the report, but rather it represents theoretical projections of worst-case scenarios. Much like EMR data, once something is propagated over and over, it becomes gospel; this is certainly the case with this report, and it has become the measure against which all others are measured. I believe if the mystical number of 100,000 deaths were actually true, we would have seen increasing numbers of lawsuits clogging our courts. In fact, we have observed a decrease in filed malpractice suits.

Mecklenburg Medicine • January 2014 | 5


Without a doubt, errors in dosing orders have been decreased as the EMR immediately recognizes dosing limits and catches these errors. What the EMR doesn’t do is make sure abnormal labs are noted, orders written are not automatically dropped off and wrong diagnoses are not propagated. While these problems are operative in other systems, clearly the EMR presents a panoply of new safety issues that it certainly doesn’t resolve. So much for the safety factor.

A cost-saving benefit?

This leaves us with the extraordinary cost savings we were promised with the adoption of EMRs. Interestingly, there are no studies that have looked at a cost-benefit analysis of the application of EMR for the general economy. The early adoption by the government was based on work by the Rand Corporation, which, in a very self-serving fashion, made the case for the government to use what they had designed. By all ethical standards, that we as researchers are held to, this would fall under the umbrella of conflict of financial interest. (As for savings, I’m sure we would be amazed at how much money has been spent locally to convert to EMRs, not to mention the cost of support for those respective systems.) From a practical point

of view, a physician can hire a number of individuals to file charts for what one IT support person costs. Interestingly, what also has happened is that the cost to the government because of EMRs has increased as physicians now can more easily “document” what they “did” by simply “cutting and pasting.” So much for the cost savings. What’s the bottom line? Clearly, parts of the EMR have made our lives immeasurably more efficient — in the ability to retrieve lab work, view reports, look at radiological scans, send “e-scripts,” and transmit data. However, the original benchmark reasons for the adoption of EMRs (namely privacy issues, patient safety and cost savings) are not what were projected. All that really has been accomplished is that now insurance companies and the federal government can monitor our practice and capture data. We need to recognize that this can be both a blessing and a curse.

Save the

Date! MedLink of Mecklenburg Forum Tuesday, March 4 Harris Conference Center 216 CPCC Harris Campus Drive

6 | January 2014 • Mecklenburg Medicine

Depression is the disorder that no one wants to talk about. WE FIND THAT EVEN MORE DEPRESSING.

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MENTAL HEALTH AND HUMAN SERVICES MonarchNC.org/Cares • (866) 272-7826 350 Pee Dee Avenue, Albemarle, NC 28001

Putting the care into mental health care.


Save the

Date! James Gray Cannon Award

I

n 1984, the Mecklenburg Medical Alliance (MMAE) established the James Gray Cannon Award. It is presented to an individual who has demonstrated exceptional leadership on a voluntary basis toward the advancement of medical care and good health in the Charlotte-Mecklenburg community.  Past recipients include hospital volunteers, organization founders and board members.  They are people who, through their unselfish dedication to an organization or cause, have made a difference in our community. MMAE is seeking nominations for the 2014 awards.  Nominations may be made by completing a nomination form, which can be obtained from the Cannon Award chairman.  Volunteers in healthcare related organizations, as well as healthcare professionals volunteering outside their paid positions, are eligible for the Cannon Award.  Nominees remain under consideration for three years.  Physicians, their spouses, and members of the Alliance are not eligible.  The award is an engraved plaque and a $1,000 donation to the charity of the recipients’ choice.  The winner will be honored at a reception. We look forward to receiving your organization’s nomination for this humanitarian award.  If further information is needed or a nomination form is needed, contact Gail VanDerVeer at veer4135@aol.com or call 704-543-4567. The deadline for nominations is March 1.

Mecklenburg Medical Alliance and Endowment Grant Applications for 2014

The Mecklenburg Medical Alliance and Endowment has begun the process of receiving grant applications. The application period will be open until February 14. MMAE’s mission is to advocate for a healthier CharlotteMecklenburg community. Since 1982, when we established our nonprofit 501(c)(3), we have granted more than $1 million to projects that improve the health and quality of life of the people in our community. Only applications that promote health-related charitable, scientific and educational needs in Mecklenburg County will be considered. Visit www.mmaeonline.com for more information about application guidelines and the deadline for applying. — Linda Kramer, Vice President, Grants and Disbursements

MMAE

Community Health Luncheon Date Announced: Thursday, Feb. 20

Finding Your Way Through a Safe Healthcare Journey Myers Park Methodist Church | 1501 Queens Rd Patty Skolnik, founder and director of Citizens for Patient Safety, will share her expertise in the field of patient safety at MMAE’s Annual Community Health Luncheon on Thursday, Feb. 20. Having lost her only son, Michael, due to poor communication in a medical setting, Skolnik is an advocate for shared decision making, informed consent and better patient and provider relationships. Currently, she travels the world fostering a collaborative provider/patient culture that encourages patients to ask questions, seek second opinions, be presented with all options for treatment and have their values and preferences be heard. Named one of CNN’s “Intriguing People,” she has been invited to the White House to discuss health care. Skolnik has appeared on the “TODAY” show and “The Doctors.” At some point, each of us will find ourselves in the role of either a patient or caretaker. Mark February 20 on your calendar, and be assured you can “Find Your Way Through a Safe Healthcare Journey.”

Mecklenburg Medicine • January 2014 | 7


Feature

MEET YOUR 2014 MCMS BOARD OF DIRECTORS AND LEADERSHIP OFFICERS

James B. Hall, MD, President Born in Dayton, Ohio, Dr. Hall graduated from the Medical University of South Carolina and completed his internship and residency in obstetrics and gynecology at the Miami Valley Hospital/Wright State University Medical School in Dayton. He then completed a gynecologic oncology fellowship at the Massachusetts General Hospital/Harvard Medical School. He is on the OB/GYN teaching faculty at Carolinas Medical Center and is director of gynecologic oncology at the Levine Cancer Institute. Hall has been involved with the Medical Society’s Community Intern Program since 2003 and serves as the committee’s co-chair. Hall was named a Charlotte Magazine Top Doctor in 2013. Simon V. Ward III, MD, President Elect Born in New Orleans, Dr. Ward graduated from Louisiana State School of Medicine. He completed his internship and residency in obstetrics and gynecology at the Charity Hospital of Louisiana. Ward practices general OB/GYN with Rankin Women’s Center. Stephen J. Ezzo, MD, Secretary Born in St. Petersburg, Fla., Dr. Ezzo graduated from St. Louis University School of Medicine. He completed his residency in pediatrics at Carolinas Medical Center. He currently is practicing at Matthews Children’s Clinic and is a Physician Executive for Novant Health. Ezzo has served on the Matheson Foundation Committee and served as a delegate to the North Carolina Medical Society. John P. McBryde, MD, Treasurer A native Charlottean, Dr. McBryde graduated from Davidson College, spent time overseas and then completed his medical school training at Medical University of South Carolina in Charleston. He completed his residency in emergency medicine at Cook County Hospital in Chicago and completed a sports medicine fellowship at Carolinas Medical Center. He is a long-time faculty member of the Department of Emergency Medicine at CMC and also sits on the board of directors at the Heineman Foundation, where he is active in international medical outreach. McBryde was named a Charlotte Magazine Top Doctor in 2013. Janice E. Huff, MD, Immediate Past-President Born in Royal Oak, Mich., Dr. Huff graduated from the St. Louis University School of Medicine. She completed her internship and residency in family medicine at Carolinas Medical Center. Huff is a part-time faculty member of the Family Medicine Residency

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Program at CMC and is a clinical instructor in the Department of Family Medicine at UNC-Chapel Hill. She also practices part-time at Presbyterian Urgent Care and the Mecklenburg Health Care Center. Huff was appointed to the N.C. Medical Board in 2007, was president in 2011 and currently serves on several committees. She has served as chair of the MCMS Smith Arthritis Fund Committee and is the current co-chair of the Public Health Committee. DIRECTORS

Lloyd L. Bridges, MD Born in Miami, Dr. Bridges received his medical degree from the University of Miami School of Medicine and his residency in family medicine at Wayne State University in Detroit, where he was chief resident. He practices at Pine Lake Family Physicians in Matthews. Bridges has served on the MCMS Public Health Committee and the Membership Committee. Scott L. Furney, MD Born in Lake Orion, Mich, Dr. Furney completed his medical degree at the University of Michigan, where he also completed his residency and chief resident year in internal medicine. Furney is chairman of the Department of Internal Medicine at Carolinas Medical Center and medical director of the Faculty Physician Network. He remains clinically active, seeing both inpatients and outpatients at CMC. William F. Ingram, MD Dr. Ingram was born at Presbyterian Hospital and raised in Charlotte. He attended Davidson College, graduating with a degree in biology.  He earned his medical degree at the Medical University of South Carolina in Charleston, where he also completed a residency in anatomic and clinical pathology.  Following residency training, Ingram performed an additional year of training in surgical pathology at Johns Hopkins Hospital.  Since 2008, he has been a member of Presbyterian Pathology Group, serving as the medical director of the hospital’s microbiology and anatomic pathology labs. Scott L. Lindblom, MD Dr. Lindblom was born in Minneapolis, Minn. He graduated from the Medical College of Wisconsin and completed internship, residency and served as chief resident. He then completed a fellowship in pulmonary and critical care medicine at Barnes/Jewish Hospital at Washington University. Lindblom currently practices at Charlotte Medical Clinic and CMC as section chief for pulmonary and critical care. He recently was named medical director for CHS Adult Critical Care Services.


Shivani P. Mehta, MD, MPH Dr. Mehta completed her pediatric residency at Carolinas HealthCare System in 2011 and joined CHS as a faculty pediatrician at Teen Health Connection. She now works at CHS’s safety net pediatric practice, Myers Park Pediatrics Clinic. She trained at University of Michigan Medical School and received her MPH at Harvard School of Public Health. Mehta currently is involved in several CHS and community affiliated childhood obesity projects. She leads the 5210 Clinic at Myers Park Pediatrics, a lifestyle management clinic, and works with the clinic’s Obesity QI Project to develop a standard of care in managing overweight and obese patients. She and Dr. Erin Stubbs at Myers Park Pediatrics were awarded a grant through the American Academy of Pediatrics and MetLife to work on improving physical activity in children ages 0-5 in their clinic and at several child care centers in the community. She also is working with the Child Health Committee, Healthy Weight Healthy Child Coalition, Food Policy Council, Mecklenburg County Fruit and Vegetable Coalition and the ShapeNC Community Action Council.

thoracic surgery research. He is senior vice president of medical affairs for Novant Health in Charlotte and Upstate Medical Center in Gaffney. Zweng is co-chair of the Media and Public Relations Committee and has served on the Membership Committee and the Community Medical Preparedness Task Force.

Elizabeth B. Moran, MD Dr. Moran is a native Charlottean who earned her undergraduate degree in biology from Duke University. She then received her medical degree from Wake Forest University School of Medicine and completed her residency in obstetrics and gynecology at Carolinas Medical Center, serving as the administrative chief in her senior year. She is a Fellow of the American Congress of OB/GYN and has been in practice at Eastover OB/GYN in Charlotte since 2008.

Jonathan A. Buice, MD Born in Jasper, Ga., Dr. Buice received his medical degree from Emory University. He received his medical degree from Medical College of Georgia. His academic interests are pediatric emergency medicine and international medicine, general medical education and administration. Buice is the House Staff President at Carolinas Medical Center.

Cheryl L. Walker-McGill, MD, MBA Born in Kodiak, Alaska, Dr. Walker-McGill graduated from the Duke University School of Medicine. She completed her internship and residency in internal medicine and her fellowship in allergy-immunology at Northwestern University School of Medicine. She received a master’s degree in business from the University of Chicago. Previously, she served on the faculty at the Northwestern School of Medicine and currently serves on the faculty at the Wingate Graduate School of Business. Walker-McGill is a medical director at Daimler Trucks, North America, at the Mt. Holly and Gastonia facilities. She is the chair of the Allergy Immunology Section of the National Medical Association and is the secretary/treasurer of the N.C. Medical Board. Thomas N. Zweng, MD Born in Palo Alto, Calif., Dr. Zweng received his medical degree from the UCLA School of Medicine. At the University of Michigan Hospitals in Ann Arbor, he completed a surgery internship and residency and a fellowship in

PHYSICIAN ASSISTANT REPRESENTATIVE

Raymond E. Brown, PA-C As the first PA board member, Brown brings a wealth of experience to the board. He joined Charlotte Eye Ear Nose & Throat Associates in 1993, after practicing general medicine for nine years. Brown has specialized in otolaryngology for the past 13 years. He is a member of the N.C. Medical Society, president of Metrolina Association of Physician Assistants, vice–president of the N.C. Academy of Physician Assistants and a trustee for the N.C. Association of Physician Assistants Endowment. RESIDENT REPRESENTATIVE

ALSO SERVING ON THE BOARD AS EX-OFFICIO MEMBERS

Gretchen Allen President, Mecklenburg Medical Alliance & Endowment, 2013-2014 Keia V. R. Hewitt, MD President, Charlotte Medical Society Docia E. Hickey, MD N.C. Medical Society Speaker of the House Stephen R. Keener, MD, MPH Medical Director, Mecklenburg County Health Department Darlyne Menscer, MD AMA State Delegate and member of the AMA Subcommittee on Continuing Medical Education Douglas R. Swanson, MD Medical Director of the Mecklenburg EMS Agency and member of the N.C. EMS Advisory Council MECKLENBURG COUNTY MEDICAL SOCIETY EXECUTIVE STAFF

Sandi D. Buchanan Executive Director Trisha G. Herndon Director of Meetings and Special Events Stephanie D. Smith Executive Assistant

Mecklenburg Medicine • January 2014 | 9


Member News Upcoming Meetings & Events Meetings are at the MCMS office unless otherwise noted.

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Wednesday, Jan. 1 MCMS office closed for New Year’s Day. Friday, Jan. 10 Child Health Committee meeting. 7:30 a.m. Saturday, Jan. 11 MCMS Board Retreat. Whitehead Manor Conference Center. 7:30-11:30 a.m. Tuesday, Jan. 14 MedLink of Mecklenburg meeting. Mecklenburg County Health Department. 249 Billingsley Road. Multipurpose Room. 8:30 a.m. Tuesday, Jan. 14 Charlotte Dental Society membership meeting. Myers Park Country Club. 6 p.m. Wednesday, Jan. 15 MMAE Board meeting. 10 a.m. Thursday, Jan. 16 CAMGM meeting. Myers Park Baptist Church Cornwell Center. Noon. Monday, Jan. 20 MCMS Executive Committee meeting. 5:45 p.m. Wednesday, Jan. 22 Charlotte Pediatric Society membership meeting. Duke Mansion. 6 p.m. Wednesday, Jan. 22 March magazine deadline.

Join us! If you are not a member and would like to join the Mecklenburg County Medical Society, call us at 704-376-3688.

NCMS/MCMS Member Receives 2013 North Carolina Advocate State Award for Excellence

North Carolina Medical Society member Chris Teigland, MD, Carolinas Health System, medical director, Center for Advanced Practice, and chair, Department of Urology, was awarded 2013 North Carolina Advocate State Award for Excellence from the American Association of Nurse Practitioners.  The award is given annually to an individual in each state who has made a significant contribution toward increasing awareness and acceptance of NPs. Teigland’s tireless energy, effort, influence and persuasion was instrumental in the establishment of the CHS Center for Advanced Practice. Chris Teigland, MD (r) An NCMS member since 1988, Teigland was honored for developing and nurturing a model physician /ACP relationship and for his support of the ACP practice. We congratulate Dr. Teigland on this esteemed honor. ­— Reprinted with permission from the NCMS website.

Fighting for Women with Fashion 2013

Months of preparation culminated on October 1 with the third annual Fighting for Women with Fashion event. Once this year’s emcee, Erica Bryant of WSOC-TV, took to the stage, the excitement began. Under sparkling lights and to snappy tunes, doctors and lawyers by day transformed into models for a night. They strutted down the runway in fashions provided by Nordstrom to the applause and cheers of nearly 200 attendees. Tyra Banks would have been proud! The co-chairs for this year’s planning committee were Nancy Teaff, MD, and Laura Vaughn, Esq. Members of the Charlotte Women’s Bar and the Women Physicians Section of the Mecklenburg County Medical Society have planned our three Fighting for Women with Fashion events. We helped to raise more than $75,000 to benefit Safe Alliance’s Clyde and Ethel Dickson Domestic Violence Shelter. Our doctor-lawyer partnership began in 2011, initially to raise funds to build the new shelter, which opened January 2013. We continued our partnership to help meet the operating expenses of this vital community resource. The needs of the shelter, and the men, women and children that it serves, is ongoing. Nordstrom already has promised to provide the fashions for our 2014 event. Fighting for Women with Fashion is open to the public and both genders are welcome. We are looking for male physicians who are aspiring models or who want to express their inner extrovert to rock the runway next year. As sponsors, attendees and models, the legal profession has been robustly represented all three years. We hope more physicians will join us in all of these roles for the 2014 event. Anyone interested in participating can contact Stephanie Smith with the Medical Society at 704-376-3688. ­— Maureen Beurskens, MD

10 | January 2014 • Mecklenburg Medicine

Planning Committee


At the Hospitals

da Vinci’s Firefly Fluorescence Imaging: Enlightening Beyond the n Human Eye Daniel Watson, MD, urologist and co-director of Novant Health Robotics Center, didn’t think he needed the Firefly Fluorescence Imaging for the da Vinci Surgical System SI, until he saw it in action. Now he depends on da Vinci’s newest surgical software, which provides florescence imaging and more accurate views. The Firefly mode makes it possible for surgeons using the da Vinci Surgical System to use near-infrared technology in order to form real-time, image-guided identification of anatomy. It’s especially helpful when distinguishing between cancerous and healthy tissue, and accurately identifying blood supply. The Novant Health Robotics Center obtained Firefly capabilities about six months ago and is one of the few sites in North Carolina offering this cuttingedge technology. To use the Firefly mode, an anesthesiologist first injects a green fluorescent dye through a patient’s peripheral IV line. The dye then binds to the patient’s plasma proteins in the blood, which makes that blood shine green under the robot’s fluoroscopic camera. Firefly technology can be used in a variety of procedures and among a spectrum of specialties. Some surgeons find it irreplaceable during partial nephrectomies. Before Firefly, it often was difficult to pinpoint where the tumor began and where the kidney stopped, but thanks to Firefly’s enhanced green lighting, it’s easy to identify accurate margins of tumor and kidney. This means more precise removal of tumors and less disturbance of healthy tissue. General surgeons who use Firefly during colorectal surgeries also have found it irreplaceable. Wyatt Fowler, MD, surgical oncologist, frequently uses the Firefly mode during colectomies. The national anastomotic leak rate for colon surgery is about 7.5 percent, and inadequate blood supply when joining two ends of healthy bowels is directly associated with that n n

statistic. So far, Fowler has performed six colectomies with Firefly technology. In each of these cases, he flipped on the green light to check blood supply before stapling the anastomosis. During two of the six surgeries, the Firefly technology revealed inadequate blood supply. Fowler and his team then altered their course of operation and ascertained their revisions by flipping Firefly on again, thus ensuring good blood supply and a significantly lower risk of leakage. Firefly is altering the course of robotic surgeries by providing enlightenment, safety and more successful outcomes. To learn more about the Novant Health Robotics Center and the da Vinci Surgical System, visit www.NovantHealth.org and search for robotic surgery. Lymphedema Patients Benefit from New Low-Level Laser Therapy n at Novant Health Huntersville n Medical Center Low-level laser therapy, also known as cold laser, now is available to help lymphedema patients with the swelling, heaviness and discomfort brought on by their disorder. It even can reduce the likelihood of repeat infections in lymphatically swollen areas.  Treatments are painless and easily can be applied along with other hands-on therapy techniques in the rehab clinic.  Average effective treatment time is less than 15 minutes, meaning patients can receive the care they need with only minimal impact on their schedules. Call the rehab team at Novant Health Huntersville Medical Center to refer a patient or learn more at 704-316-5000. n

n

Novant Health Opens Its First Concierge Medical Practice On Nov. 18 , 2013, Novant Health Hallmark Care opened its doors. The practice will offer patients 24/7 access to their medical team, comprehensive physician exams, same-day or next-day appointments and low doctorpatient ratios that allow for longer healthcare visits. Hallmark Care physicians will serve no more than 350 patients each, compared to typical caseloads that can reach 2,000 patients or more per doctor. n n

“By limiting the number of patients we see, we really can get to know them and their medical histories — and we can be available when they need us,” says Dr. Lillian McKay Teigland, who is board-certified in family medicine and has been named among the best doctors in Charlotte and North Carolina. “Hallmark Care doctors will spend more time with patients, like doctors used to do, so we can develop trusting relationships and help our patients live better, healthier lives,” Teigland adds. Patients pay an annual program fee of $2,400 for an array of enhanced services that focus on prevention and provide seamless coordination with specialists, as well as detailed, personalized health plans and wellness goals. Patients have roundthe-clock access to physicians via phone and email and receive expedited lab results. Physicians also will make house calls when necessary and offer travel medical services, such as prescription refills, vaccinations and consultation. In addition to Teigland, Dr. T. Hayes Woollen Jr. and Dr. Christopher Snyder are physicians at Hallmark Care. Cardiologist Kenneth Weeks acts as an advocate and liaison for Hallmark Care patients who are hospitalized. Families can receive discounted membership fees, and medical services are eligible for health insurance coverage. For more information, call 704-384-7910 or visit nhhallmarkcare.org. Novant Health Cancer Care to Host Perspectives in Gastrointestinal n Cancer Symposium in February Physicians and other healthcare professionals are invited to attend this annual CME event to review current and emerging strategies for the management of gastrointestinal cancers. Nationally recognized experts will present on topics such as treatment for hepatocellular carcinoma, molecular-targeted agents for colon and rectal cancer, and approaches to evaluating pancreatic lesions.  This two-day event will be Feb. 7-8 in Charleston, S.C. Comprehensive event information, including agenda, pricing details and online registration, is available at www. novantonline.org/cme n n

Mecklenburg Medicine • January 2014 | 11


At the Hospitals

System Launches Comprehensive Analytics Capabilities to Improve Health in the Carolinas Carolinas HealthCare System officially has announced the development and adoption of comprehensive capabilities to successfully integrate data analytics for evidenced-based population health management, individualized patient care and predictive data modeling. These capabilities, managed by an in-house advanced analytics group, were adopted with the understanding that the future of health care is being fundamentally changed by data and technology, and sustainability of quality care is dependent upon the ability to use data in a meaningful way. This includes developing some of the most advanced healthcare analytics available and creating a comprehensive Enterprise Data Warehouse to store 10 terabytes of patient centered data – equivalent to storing the entire printed collection from the Library of Congress. Each data set collected is masked of the original contributor, but being able to “drill down” into the data helps reduce variations in care and deliver overall better care, outreach and coordination. These tools and programs also help reduce the cost of care and create better value, impacting the entire healthcare community in Mecklenburg County and across the nation. n

STEMI Network Receives National Recognition in Leading Cardiology Journal Carolinas HealthCare System’s coordinated approach to treating heart attack patients across a network of nine hospitals in the region recently was recognized in one of the nation’s leading cardiology journals. B. Hadley Wilson, MD, adult cardiologist at Carolinas HealthCare System’s Sanger Heart & Vascular Institute, is lead author on the study, which was published in the November issue of JACC: Interventional Cardiology. The outcomes of the study demonstrate the success of the System’s STEMI network, which was established in 2011 as part of n

the Regional Approach to Cardiovascular Emergencies (RACE) project. RACE connects emergency medical services and hospitals throughout North Carolina to develop standardized protocols for treating patients who are experiencing ST- elevation myocardial infarction (STEMI). As a result of faster treatment, long-term complications, such as heart failure and other cardiac problems often are avoided. In 2012, Carolinas HealthCare System achieved 98 percent compliance with the national 90-minute heart attack treatment time guideline. Between 2008 and 2011, there were sustained reductions in door-to-balloon (D2B) times after five key strategies were put in place at nine referral hospitals throughout the region. These strategies include a hospital referral system, a transfer protocol with time-oriented performance goals, expedited transport via ambulance or helicopter within 60 minutes, standard protocols enabling the transfer hospital physician to activate the PCI hospital cath lab and an online tracking system to give feedback to referring hospitals about transfer times and patient outcomes. Sanger Heart & Vascular Institute Achieves Highest Level of National Recognition Carolinas HealthCare System’s Sanger Heart & Vascular Institute received its fourth three-star rating from the Society of Thoracic Surgeons (STS), recognizing Sanger’s clinical excellence in coronary artery bypass graft (CABG) surgery. Some 12-15 percent of hospitals nationwide receive this highest level of recognition for quality outcomes. The STS three-star rating system is based on a hospital’s performance in terms of survival rates, the absence of complications, use of arteries as bypass grafts and assurance that appropriate medications are given perioperatively. The designation demonstrates that Sanger is a leader in cardiac care throughout the region, providing cutting-edge surgical procedures ranging from traditional heart surgery to less invasive treatment options. n

Levine Cancer Institute’s Wendel Naumann, MD, Published for National Cancer Drug Trial Wendel Naumann, MD, associate director of Gynecologic Oncology at Carolinas HealthCare System’s Levine Cancer Institute, n

12 | January 2014 • Mecklenburg Medicine

is principal investigator on a national trial that is testing the effectiveness of a novel targeted chemotherapy drug. The drug, vintafolide, can be safely added to standard chemotherapy and could become the new standard of treatment for patients with platinum-resistant ovarian cancer. Findings from the randomized phase II PRECEDENT trial were published in the Journal of Clinical Oncology in October. The results show a four-month increase for progression-free survival when vintafolide is added to liposomal doxorubicin for women with platinum-resistant ovarian cancer. This is clinically significant, as patients with platinumresistant ovarian cancer typically have a progression-free interval of less than four months and a survival of less than one year when treated with standard therapy. Women diagnosed with platinum-resistant ovarian cancer have developed resistance to chemotherapy drugs containing platinum, which currently are the most effective treatment options for ovarian cancer patients. This resistance makes the tumor very difficult to treat and increases the likelihood of the cancer spreading to other parts of the body. Vintafolide presents an alternate, and potentially life-saving, form of treatment. Two Physicians Perform World’s First Fetal Surgery Two Carolinas HealthCare System physicians have earned international acclaim following the successful completion of a new procedure in utero. Courtney Stephenson, DO, FACOG, director of the Charlotte Fetal Care Center and associate director of Maternal-Fetal Medicine, and David Iannitti, MD, chief of Hepatobiliary Surgery, are the first physicians in the world to treat a twin reversal arterial perfusion (TRAP) sequence pregnancy by using microwave ablation. TRAP sequence is an extremely rare complication that occurs in about 1 percent of twins who share a placenta. In TRAP sequence pregnancy, one twin is physically normal while the other is an abnormal mass of tissue, generally consisting of legs and a lower body but no upper body, head or heart. On behalf of this accomplishment, Dr. Stephenson and Dr. Iannitti presented their abstracts for the International Fetal Medicine and Surgery Society in Jerusalem this past May. n


Save the

Date!

Affordable pricing for your patients at all income levels Charlotte Speech and Hearing Center is the only hearing center in this area that provides discounts based on income levels. It is our mission to provide affordable high quality hearing healthcare for those in need. We have been serving the Charlotte area since 1967 and offer:

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North Carolina Society of Gastroenterology

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704.523.8027 - Ext. 10

www.charlottespeechhearing.com

Mecklenburg Medicine • January 2014 | 13


Huntersville Primary Care Off ice

has extra 4 exam rooms to ren t to any specialty except primary care – sharing waiting room. $2,750.00 per month, all incl usive.. There is a ready-to-use fluorosc ope (digital) available for $500 a month. Contact Chris Le at 704-806-619 7 or humbledoc@aol.com.

NATIONAL HEALTH & WELLNESS OBSERVANCES JANUARY 2014 Cervical Health Awareness Month National Birth Defects Prevention Month National Glaucoma Awareness Month Thyroid Awareness Month

Jan. 6-12 National Folic Acid Awareness Week

Jan. 28-Feb. 3 National Drug Facts Week Fifteen years ago, Don Rudisill decided it was time to get a pair of glasses. But what started as a single pair and one prescription soon became another pair at a stronger prescription. And then another. And another, stronger still. When he flunked a driving test, he knew something had to change. So how did an appointment at Charlotte Eye Ear Nose & Throat Associates, P.A. lead to Don tossing a baker’s dozen of prescription eyewear? To hear Don’s experience with cataract surgery, visit www.ceenta.com/don

Advertising Acknowledgement The following patrons made Mecklenburg Medicine possible.

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14 | January 2014 • Mecklenburg Medicine

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WORKING AS ONE The power of one system means smarter collaboration among physicians and better healthcare for all. Visit us at CarolinasHealthCare.org

Mecklenburg Medicine • January 2014 | 15


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.

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16 | January 2014 • Mecklenburg Medicine

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Mecklenburg Medicine January 2014  

A Publication of the Mecklenburg County Medical Society

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