July/August 2013 Physicians Bulletin

July/August 2013 • USA $1.95

Running His Way

Thomas Brooks, M.D.

ALSO INSIDE

Practice Can Make Perfect Creighton University’s Clinical Skills Club

A Focus on Collaboration Catholic Health Initiatives

Testifying for a Reason Joe Stothert, M.D. A Publication of the Metro Omaha Medical Society • www.OmahaMedical.com

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This Issue JULY/AUGUST 2013

features

departments

6 1

COVER: Running His Way Thomas Brooks, M.D.

8

Editor’s Desk

9 1

Practice Can Make Perfect Creighton University’s Clinical Skills Club

1 0

NMA Message

1 2

Financial Update

1 4

Clinical Update

2 6

MOMS Events

2 7

MOMS Coming Events

2 8

Member News

3 0

Campus Update

3 3

New Member Update

1 2

A Focus on Collaboration Catholic Health Initiatives

4 2

Testifying for a Reason Joe Stothert, M.D.

4 Physicians Bulletin July/August 2013

Another Example of Bureaucracy Getting in the Way What Happened in Lincoln this Session Fee-only vs. Broker

Informed Consent: Addressing What Patients Need to Know

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2013 VOLUME 34, NUMBER 4 A Publication of the

Metro Omaha Medical Society 7906 Davenport St. • Omaha, NE 68114 (402)393-1415 • www.omahamedical.com Officers President | Marvin J. Bittner, M.D. President-Elect | Debra L. Esser, M.D. Secretary-Treasurer | David D. Ingvoldstad, M.D. Past President | Pierre J. Lavedan, M.D. Executive Director | Carol Wang EXECUTIVE BOARD Marvin Bittner, M.D. Debra Esser, M.D. David Ingvoldstad, M.D. Pierre Lavedan, M.D. Mohammad Al-Turk, M.D. Jane Bailey, M.D. Lori Brunner-Buck, M.D. David Filipi, M.D. Harris Frankel, M.D. Sherrill Murphy, M.D., Michelle Knolla, M.D. William Orr, M.D. Laurel Prestridge, M.D. William Shiffermiller, M.D. Gamini Soori, M.D. Jeffry Strohmyer, M.D. EDITORIAL/ADVERTISING STAFF Publisher | Omaha Magazine, LTD Editor | Marvin Bittner, M.D. Art Director | John Gawley Senior Graphic Designer | Katie Anderson Junior Graphic Designer | Paul Lukes Director of Photography | Bill Sitzmann advertising sales Todd Lemke • Sandy Besch • Greg Bruns Gwen Lemke • Gil Cohen • Alicia Smith • Vicki Voet • Paige Edwards • Jessica Linhart for advertising information: 402-884-2000

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P.O. Box 461208, Omaha NE 68046-1208. © 2013. No whole or part of contents herein may be reproduced without prior permission of Omaha

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Magazine or the Metro Omaha Medical Society, excepting individually copyrighted articles and photographs. Unsolicited manuscripts are accepted, however, no responsibility will be assumed for such solicitations. Omaha Magazine and the Metro Omaha Medical Society in no way endorse any opinions or statements in this publication except those accurately reflecting official MOMS actions.

6 Physicians Bulletin July/August 2013

Always Local, Always Beautiful May/June 2012

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Each issue also features human interest pieces, including architect/designer/builder profiles, hot products, maintenance columns, room spotlights, landscaping columns, neighborhood profiles, home transformations, home happenings, mortgage columns, new business stories, green A Home For All Ages design features, and much, much more.

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editor’s desk

Marvin Bittner, M.D. President Metro Omaha Medical Society

Another Example of Bureaucracy Getting in the Way

T

his year, I visited Europe. To prepare for

the trip, I did many things. Some people might criticize one of the things I did.

What was that thing? The night before I left Europe, I stayed at the Tryp Hotel at the Barcelona airport. It was my visit to the hotel’s website that might lead some people to criticize me. I used that website to make my hotel reservation.

The website is in Spanish. I have some facility in Spanish, but my command of the language is limited.

Given the limitations of my Spanish, some people would call on me to use a certified translator whenever I provide medical care to a Spanish-speaking patient who has limited proficiency in English. Would those people criticize me, as well, for making a hotel reservation on a Spanish website even though my command of Spanish is limited? Those people, fearing the consequences of a communications problem in a clinical setting, would call on me to use a certified translator for patient encounters. Would they point out the risks of misunderstanding the reservation process on the Tryp Hotel website?

Well, you may read this ... and think this is silly.

What is the chance of a problem if I, despite the limits of my Spanish, make a reservation on the Tryp Hotel website? Now ... if my efforts were to buy the hotel – not just stay there a night, I’d work with someone with unquestioned fluency in Spanish (or Catalan). It’s a matter of judgment – there’s a difference between staying one night and buying a hotel.

8 Physicians Bulletin July/August 2013

I’m afraid, though, that the advocates of universal use of certified translators don’t appreciate the role of professional judgment. As physicians, we encounter a variety of situations. We repeatedly ask ourselves – consciously or unconsciously: “Is this situation within my expertise or do I require assistance?” A situation where I briefly see a patient on the mend is not the same as a situation where I tell a patient: “You have AIDS” (or “Tiene SIDA”). We, as physicians, need to assert our role as professionals who make judgments about our expertise and its limits.

The certified translator advocates are not the only group that rejects professional judgment.

Traditionally, we identify areas where we need to augment our knowledge and ways to do so.

The accreditors of continuing medical education, however, certify only those programs that meet their standards. The consequence: bureaucracy that is just as wasteful as insisting that I consult a native Spanish speaker for help with the Tryp website. Those who attack professional judgment – translators, CME accreditors, and the list goes on – will fight hard.

Jobs are at stake for certified translators and CME accreditors, and they will defend their turf. As physicians, we need to work together in organizations such as MOMS and the Nebraska Medical Association to fight bureaucracy and waste. We need to focus our society’s resources, instead, on what will truly improve the health of our patients.

YEARS

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Metro maha Medical Society STRATEGIC PARTNERS The Metro Omaha Medical Society Strategic Partners offer products and services that are of value to our member physicians.

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For more information on our Strategic Partners, visit www.omahamedical.com July/August2013 Physicians Bulletin 9

nma message

Dale Mahlman Executive Vice President Nebraska Medical Association

What Happened in Lincoln this Session

T

he Nebraska Legislature adjourned

on June 5 and, like school kids, we thought summer break could begin. Not so fast.

This year, the Nebraska Medical Association advocacy team followed more than 100 bills.

Many remain in committee or were indefinitely postponed. However, several bills will continue to have our attention during the summer months.

The reality is that when the Legislature adjourns, our days remain much the same – we just don’t have the official activities taking place at the capitol. With interim studies and legislative resolutions still to be discussed, we have the opportunity to visit the capitol many days when the temperature inside and outside are nearly the same: very warm.

This session saw the return of the filibuster.

LB 577, the bill that would expand Medicaid, was a casualty of the filibuster this year. While supporters of expansion, including the NMA, were able to garner more than 25 votes to pass the legislation, we were unable to obtain the 33 votes necessary to end the filibuster and bring the issue to a vote. With an almost certain governor veto waiting, it was an extremely close vote if the supporters had the 30 votes necessary to override a veto. With at least 54,000 uninsured Nebraskans denied the opportunity for health insurance, we are preparing for the discussion on LR 241 during the interim. The study was introduced by State Sen. Kathy Campbell (Lincoln) and State Sen. Jeremy Nordquist (Omaha) to examine the financial impact and

10 Physicians Bulletin July/August 2013

financing options for Medicaid expansion under the Affordable Care Act. Other similar studies and resolutions will be initiated during the interim, including the creation of the Exchange Stakeholder Commission created by the passage of LB 384, the Nebraska Exchange Transparency Act. This commission will include two members to represent the interest of health-care providers in the state, and the NMA has begun to look for interested and qualified representatives to serve.

Another opportunity for NMA involvement is the passage of LR 22, a joint effort of the Banking and Insurance Committee and Health and Human Services Committee to convene a Partnership Towards Nebraska Health Care System Transformation.

While the 2014 session is still six months away, we are mindful of the work that remains to be done on behalf of physicians. Term limits will affect as many as 17 districts across the state in 2014, and we are hopeful that at least a couple of NMA physicians will decide to run for the Legislature next year. Our advocacy team would welcome a medical expert inside the chamber to help with the issues of interest to medicine.

We appreciate all the time and effort our NMA members provided during the 2013 session and look forward to your continued support next year. Those phone calls, emails, and letters to your senators made a difference and hopefully took little of your valuable time.

And now for that summer break‌

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July/August2013 Physicians Bulletin 11

Legal update

Fee-only vs. Broker: Ross Polking lifeWealth Adviser The Foster Group

N

early 500,000 Americans fall under

the loose description of “financial adviser” as their profession and, typically, most are happy to manage your money for you. However, less than 7 percent of these advisers actually provide any level of critical advanced personal financial planning, which essentially addresses all of life’s other financial complexities outside of their client’s portfolio of assets. In addition, most investors are not aware that there exists a difference in the type of relationship between advisers and clients. Let’s take a closer look, because understanding who you are working with can be a potential enhancement or threat to your financial plan.

Fiduciary vs. Suitability

Independent Registered Investment Advisors (RIAs), are legally held to a fiduciary standard.

RIAs must always ask, “Does this investment serve the client’s best interest, or would an alternative solution be more appropriate?” Brokers or agents, on the other hand, are held to a suitability standard. This simply entails determining whether an investment fits for a client given his or her circumstance, yet may not necessarily be the very best choice.

Four “Differences” and What They Mean

Transparency vs. Disclosure

The policy for RIAs, as governed by the SEC and Investment Advisors Act of 1940, must be complete transparency – nothing hidden, nothing held back. Conversely, brokers or agents only have to disclose certain, limited facts when selling an investment product. They’re not required to disclose every aspect of the transaction. That certainly doesn’t mean they don’t or won’t, but the requirement to do so may not exist.

Fee vs. Commissions

When RIAs provide advice, every possible conflict of interest is removed. There cannot be acceptance of “soft dollars” or revenue-sharing from any source. Their clients should be the only ones paying them, rendering their advice completely objective. A broker, on the other hand, may be compensated for every transaction made, which can encourage activity (i.e., trading) and sales of products that might not perfectly align with the client’s goals.

Custody

In most RIA models, there’s an independent, third-party custodian – such as Charles Schwab, TD Ameritrade or Fidelity – that always houses client assets in the client’s name – your name.

12 Physicians Bulletin July/August 2013

There should be no advisor custody of any client securities or cash. In most brokerage models, it’s a matter of in-house custody. Give your money to a brokerage firm and they will hold it, and typically earn interest on your money by lending it out.

Taking time to understand how your adviser’s practice is structured, how they are compensated, if they are a true fiduciary, and how your dollars are invested will help you make sound decisions when it comes to choosing a financial consultant. Who you work with does matter. Take the time to become informed and ask the right questions up front to ensure your best interests are kept in focus.

Editor’s Note

The information and material provided in this article is for informational purposes and is intended to be educational in nature. We recommend that individuals consult with a professional advisor familiar with their particular situation for advice concerning specific investment, accounting, tax, and legal matters before taking any action.

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PRSRT STD

clinical update

Dan Rosenquist, M.D., COPIC’s Patient Safety and Risk Management Department

M

edical liability claims in Nebraska

for surgical complications often include the element of informed consent. Key to defending unavoidable surgical complication cases is good documentation of patient selection in the medical record and the discussion of the risks and benefits in an informed consent document.

Typical to these types of claims is a dispute over who said what and whether a particular side-effect was discussed. International experts published a study in PLOS Medicine1, an open access journal for research on world health, which found that physicians in Australia routinely underestimate small risks that vex patients. Even though the research focused on Australian physicians, there are important points that apply to how we practice medicine here, what we need to know about informed consent and how to perform it properly.

The research analyzed 481 medical liability claims in an effort to understand disputes in the process of obtaining informed consent.

The authors found that almost one-half were disagreements about whether a particular sideeffect should have been discussed. The vast majority of these cases was surgical procedures and revolved around five adverse outcomes: the resultant need for further surgery, poor cosmetic results, impaired vision or hearing, pain, and infertility or sexual dysfunction.

The authors suggest that surgeons are often unsure what risks should be discussed prior to a procedure or treatment. In addition, the research found that doctors reported the most common cause for not going over a particular risk was the perception that the risks were too rare or that a specific risk was covered under the discussion of a more general risk. Approximately 90 percent

Informed Consent: Addressing What Patients Need to Know

of the disputes were around “who said what and when,” otherwise known as “he said, she said” disagreements.

“Documentation of the details of consent discussions in the lead-up to surgical procedures is particularly important, as the vast majority of informed consent disputes involve complications following operations,” stated the article. “Our findings suggest that doctors may underestimate the premium patients place on understanding the risks of them in advance of treatment. Improved understanding of these situations helps to spotlight gaps between what patients want to hear and what doctors perceive patients want (or should want) to hear. It may also be useful information for doctors eager to avoid medico-legal disputes.”

Informed consent guidelines:

Informed consent is a process. The informed consent document (or the term “surgical permit” in some instances) refers to the signed written document that affirms and memorializes the informed consent process.

Informed consent should be given on the basis that a patient has a clear appreciation and understanding of the facts, implications and future consequences of an action. In order to give informed consent, the individual concerned must have adequate reasoning faculties and be in possession of all relevant facts at the time consent is given. Competency can also be alleged to be impaired if significant medications were given prior to the consent.

Proper use of informed consent:

The informed consent process is important prior to any procedure or long-term medication that carries significant risks and benefits. The informed consent document needs to be completed for specific procedures in many institutions prior

14 Physicians Bulletin July/August 2013

to performing a procedure.

While assistants and delegates can assist in providing educational materials and responding to questions, the essential step of assessing the six elements of informed consent (see “Informed Consent at a Glance”) should be completed by the person performing the procedure. This essential step should not be delegated.

What should you disclose to the patient?

Certainly any common side-effects should be mentioned. A substantial risk is one that a physician knows or that a reasonably careful physician should know would be important to the patient to understand in deciding whether to agree to a particular course of treatment. One question you might ask: “What would a reasonable person want to know prior to agreeing to this procedure?”

Informed Consent at a Glance:

• Informed consent is a process. It involves a verbal discussion with documentation and may involve a written permit. Informed consent cannot be delegated.

• There are six elements to informed consent: • Discuss the clinical issues, illness, injury or condition and the nature of the clinical decision.

• Discuss the nature of the treatment you suggest.

• Discuss the alternatives, including doing nothing.

• Discuss the substantial risks, if any, involved in undergoing the treatment and the substantial risks, if any, of alternative treatments, and the risks of not proceeding.

• After discussing, assess the patient’s understanding.

• Explore patient preferences.

1 PLOS Med 9(8): e1001283

July/August2013 Physicians Bulletin 15

Cover Feature: Thomas Brooks, M.D.

The Brooks File Hometown: New York City Undergraduate Degree: Creighton University in biology and French Medical Degree: Creighton University Medical Center Residency: St. Louis University in anesthesiology Specialty: Pain Management Location: University of Nebraska Medical Center

Dr. Thomas Brooks

Running His Way

Family: Wife, Barbara; daughter, Erin; two sons, Timothy and Matthew Hobbies: Running, swimming, boating, and shooting trap and sporting clays Why I Joined MOMS: “I joined MOMS for the collegiality.”

Pardon the commercial plug, but Thomas Brooks, M.D. is sold on his Vibram FiveFingers® running shoes.

For the record, his running footwear look nothing like traditional running shoes. But they have allowed Dr. Brooks to continue to run – without pain, he said.

“FiveFingers force you to change your running style,” he said. “I used to have a long stride. You can’t do that in FiveFingers. There’s no cushion on the heel. When you come down hard on your heel, it hurts.”

16 Physicians Bulletin July/August 2013

“I developed a short, quick stride.”

Dr. Brooks, whose specialty is pain management, turned to the unusual running footwear to rid himself of the pain he was experiencing when he ran. Vibram FiveFingers, according to the manufacturer, “is based off of the bare human foot, bringing unparalleled flexibility, comfort, and balance to its wearer.”

Dr. Brooks said: “It’s called barefoot running, although it’s not truly naked foot running. It has to do with the

feature

exposure – your toes are free to move independently.”

He played soccer in high school, and swam and rowed in college.

“During those periods of time in college, I started running. It wasn’t my primary event.”

Friends would ask him to run. He’d finish his swim workouts at Creighton, then run five miles. “In college, it was a social event.”

Then, medical school and his residency got in the way of his running.

Time passed. Dr. Brooks started running again after he finished his residency and while he was practicing in Salina, Kan. He started running again, but broke his ankle in what he described as a “dumb bicycle accident. I was standing still and kind of fell over.”

“The longest time, I couldn’t get back into running. It hurt when I ran.

I didn’t run for 10 years.”

Then, he found himself getting older and putting on weight. Just feeling unhealthy, he said.

It’s now early 2010, and Dr. Brooks is working in Springfield, Mo., in private practice with a pain management-anesthesiology group. He invested in a $100 pair of Asics running shoes, and started running again. He developed planter fasciitis in his right foot and stopped running. Four weeks

later, he tried again and stopped again for six weeks. “It wouldn’t go away.”

His ailment started affecting his work.

While visiting family in Omaha for the holidays in 2010, Dr. Brooks stopped by Scheels. He noticed the special footwear and bought a pair.

Some 30 months later and now living and working in Omaha, he’s logged more than 500 miles on his first pair – he tracks mileage via an app on his phone.

Dr. Brooks advises anyone wanting to try this style of running to start slowly. He ran just two-tenths of a mile the first time he donned his new footwear. Now, he can be seen running in his neighborhood park with his dog, Riley, several times a week. He typically runs about two to three miles an outing.

“I am not a marathon runner, nor do I ever want to be. I run for fitness and my sanity.”

Dr. Brooks said he typically gets one of two responses when he shows – and tells – people about his approach to running: “‘That’s really cool – tell me more.’ Or, ‘Man, you’re crazy. Doesn’t it hurt your feet? I could never wear those.’”

Dr. Brooks tells them they can.

July/August 2013 Physicians Bulletin 17

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feature

Members of the Clinical Skills Club in action are, from left, Chad Wenzel, David

Practice Can Make Perfect

Stordahl, Sarah Forrest, Amanda Wellnitz and Nick Ingraham

I

t started out as a way to provide opportunities for first- and second-year medical students to

apply what they were learning.

But the founders of the Clinical Skills Club at Creighton University School of Medicine discovered an added benefit: They realized that teaching is very enjoyable and rewarding.

The club got its start through a conversation among three Creighton medical students: Kevin Gysling, then a third-year student and Florida native, along with Chad Wenzel and Amanda Wellnitz, both second-year students at the time.

“Kevin had the original idea: Connecting the basic knowledge of science you learn in your first two years to practical applications. Basically, it’s about applying what you learn, just earlier than previously taught,” said Wenzel, who, with Wellnitz, just finished his third year of medical school.

Or: “Wouldn’t it be cool to have a way to teach first- and second-year students about colonoscopies or how to do a blood draw so anatomy and pathology become easier to understand and more interesting,” he said.

Early in the Fall of 2011, the three medical students turned to Eric Peters, M.D., and Janet Stawniak, for help. Dr. Peters serves as director of Medical Simulation Education at Creighton’s Clinical Education and Simulation Center, while Stawniak serves as the center’s education director.

“Dr. Peters was over the moon that we came up with this idea. It was a club we all felt very passionate about,” said Wenzel, from Oshkosh, Wis. “We weren’t adding to the curriculum in any way, but just thought students could benefit by connecting concepts in this fashion. Dr. Peters and Jan were excited to get the club up and running as soon as possible. We achieved our goal of adding practical simulations to tie fundamental book knowledge and clinical skills together in a cohesive and fun environment.”

Wellnitz, from Johnson Creek, Wis., explained that the club provides opportunities for first- and second-year students – under the direction of Dr. Peters and Stawniak – to apply what they learn in lecture to a clinical setting. Participation is optional, but the club’s founders quickly discovered that demand was strong.

July/August 2013 Physicians Bulletin 19

feature

feature

Relax.

Discover solutions that put you at ease.

Chad Wenzel, left, and David Stordahl practice performing chest compressions.

Sessions are offered several times each semester. Students participate in 15-minute sessions of groups of five. They are alerted via email of the upcoming sessions – and open spots quickly fill up. “Students find they can’t respond quickly enough,” Wellnitz said.

Sessions might focus, for example, on suturing and installing central lines, or involve simulated births or code situations using computerized and robotic mannequins – topics that piggyback on what students are discussing in lecture. About 40 students can participate in a nightly session.

Dr. Peters and Stawniak often lead the first few sessions, but then allow the club’s student leaders to take over. Wellnitz said she has enjoyed teaching – experiences that will be beneficial when she is a resident.

“You hear: ‘See one, do one, teach one.’ That’s what Kevin, Chad and I did. We watched and learned, and then we ‘did.’ When you are teaching others, you really have to know your stuff.”

The Clinical Skills Club is set up to continue even after its founders move into their professional careers. Gysling is now Kevin Gysling, M.D., after graduating recently. Wenzel and Wellnitz, now fourth-year students, will start to turn leadership of the club over to Diana Dean and Justin Cohenour, who are new thirdyear students.

Wellnitz said the club works because it provides opportunities to learn in a stress-free environment. It’s fun and relaxed. If you don’t get it the first time, you try again.

“Then, when you do a procedure for real – you realize you’ve gone through it before.”

20 Physicians Bulletin July/August 2013

At MMIC, we believe patients get the best care when their doctors feel calm and confident. So we put our energy into creating risk solutions designed to eliminate worry. Solutions such as medical liability insurance, physician well being, health IT support and patient safety consulting. It’s our own quiet way of revolutionizing health care.

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feature

Washington North Dakota

Montana

Maine Minnesota

Vermont New Hampshire

Oregon Idaho

Wisconsin

South Dakota Wyoming

Michigan

Nebraska

Nevada

Rhode Island Connecticut Pennsylvania

Iowa

Utah

Illinois

Ohio

Indiana

West Virginia

Colorado Kansas

California

Massachusetts

New York

Missouri

New Jersey Delaware Maryland

Virginia

Kentucky North Carolina Tennessee

Arizona

Oklahoma New Mexico

South Carolina

Arkansas

Georgia Alabama

Louisiana Texas

Mississippi

Florida

Map indicates states with a CHI facility.

A Focus on Collaboration: Catholic Health Initiatives

T

o describe Catholic Health Initiatives’

commitment to clinical integration and its focus on physician partnerships, a senior executive for the Denver-based organization uses the word “collaboration.”

“The key word I would use in terms of CHI’s involvement with physicians is ‘collaboration,’” said T. Clifford Deveny, M.D., CHI’s senior vice president for physician practice management.

“And by that I mean collaboration in every way – financial, operational, clinical. There really are no more important partners for a health system than physicians.”

Catholic Health Initiatives has stressed the importance of engaging its physicians in recent years, and has doubled the number of employed physicians organization-wide during the past two years to slightly more than 2,000, Dr. Deveny said. CHI employs approximately 1,000 advancedpractice clinicians to complement its growing physician enterprise, he added, which is a key

part of the organization’s effort toward clinical integration and a focus on physician partnerships.

“I like to think CHI has developed the competencies to collaborate with all kinds of physicians – not just employed, but independent physicians as well – to provide the right care, at the right time, in the right setting, at the right price through a range of different initiatives, including accountable care organizations, joint ventures and clinically integrated networks.

And we feel we are doing that well in the Omaha market.”

Now the nation’s third largest faith-based health system, CHIs’ start came in early 1995 when a group of Catholic health-care leaders began to explore ways to strengthen health ministry.

Their vision was for a national Catholic health ministry, sponsored and governed by an equal religious-lay partnership, which would live out its mission by transforming health-care delivery and creating new ministries to promote healthy communities.

A year later, leaders from three health systems – Catholic Health Corporation, Franciscan Health System and Sisters of Charity Health Care Systems – joined to form Catholic Health Initiatives.

This vision now includes 86 hospitals, including Alegent Creighton Health and Nebraska Spine Hospital in Omaha. CHI also includes Saint Elizabeth Regional Medical Center in Lincoln, Good Samaritan Hospital in Kearney and Saint Francis Medical Center in Grand Island.

Rick Hachten II, president and CEO of Alegent Creighton Health, said Alegent Creighton Health and CHI have a long and successful history.

“For our first 17 years as a co-sponsor and now as our sole sponsor, the affiliation with CHI allows us to continue to offer high-quality health care to the communities we serve in this region while building on the strengths and resources available to us by CHI, a national leader in health care across the country,” Hachten said. “Together with CHI, we will create a strong, faith-based, expanded health-care network while remaining

July/August 2013 Physicians Bulletin 21

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feature committed to training the health professionals of the future as the primary teaching partner of Creighton University’s health sciences school.”

CHI serves more than 4 million people annually through its acute care hospitals, its long-term care, assisted- and residential-living facilities, its community-based health services, its home care, and its research and development services.

Its current initiatives include a five-year, $2.2 billion investment that seeks to transform healthcare delivery through universal electronic health records and more than 100 tele-health programs that seek to alleviate provider shortages and expand access to specialty care in remote areas.

CHI also seeks to create a national home care organization that delivers care to more patients in their homes.

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CHI, with a presence in 18 states, features these national services and subsidiaries

• CHI Foundation: Its purpose is to improve, increase and encourage philanthropy throughout the health system. The foundation provides operational services to support efforts for local foundations in its system.

• CHI Institute for Research and Innovation: Its focus is to direct research and development initiatives in CHI’s Center for Clinical Trials, Center for Health Care Innovation and Center for Translational Research.

• Consolidated Health Services: This home care service-provider operates in more than 30 locations throughout the country.

• Venture Capital Group: Its focus is to identify strategic partnerships, investment opportunities and growth activities for CHI. The organization invests directly in companies that build CHI’s care delivery capabilities.

• Virtual Health Services: This entity provides a platform for innovation and new care delivery models. VHS currently offers telePharmacy and teleRadiology services.

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July/August 2013 Physicians Bulletin 23

feature

The Stothert File Hometown: Longmeadow, Mass.

Undergraduate Degree: MacMurray College in Jacksonville, Ill., in biology, chemistry and philosophy Medical Degree: St. Louis University Doctoral Degree: University of Washington in Seattle in pulmonary medicine and physiology Residency: St. Louis University in general surgery Fellowship: University of Washington in trauma and critical care Specialty: general surgery, trauma, critical care Location: UNMC Family: wife, Jean Stothert; daughter, Elizabeth Leddy; and son, Andrew Stothert Why MOMS: “The main reason would be the fact that it was expected that I would support the medical community in Omaha. It’s an appropriate expectation.”

Dr. Joseph Stothert

J

Testifying for a Reason

oe Stothert, M.D., figured he had little to be nervous about during his initial time testifying before legislators in the Nebraska Unicameral.

First, public speaking wasn’t an issue. “I don’t have any problems with public speaking. I’ve been doing it since high school. And crowds don’t bother me.”

24 Physicians Bulletin July/August 2013

Second, he’s not afraid to speak about issues that are important to him. One of those issues is Nebraska’s motorcycle helmet law. “Helmets are a protective device – the same thing as seat belts for a car. If you want to keep your brain, wear a helmet. I’m on the side of truth, justice and the American way. We prefer to have whole people

feature who don’t have brain damage. This is one thing (wearing a helmet) that is necessary in order to prevent or limit brain injury that occurs with motorcycle accidents.”

Finally, he realized he knows more about safety issues than the people who are hearing his testimony. “Don’t be afraid of people when testifying – you know more about medicine than anybody in the room.”

Dr. Stothert estimates he has testified before Nebraska lawmakers about a dozen times about helmet safety, seat belts and issues related to nursing and EMS. He said he wasn’t nervous the first time he testified and hasn’t been since.

His approach: Do your homework, and be prepared to support your testimony with current data. “I’ve been surprised at the lack of understanding of some people, and their questions. If you are prepared well, no one throws you a curve.”

Dr. Stothert recalled the response he received from a bill’s sponsor to repeal Nebraska’s helmet law when he explained that the chance of death in motorcycle accidents is twice as high in people not wearing helmets: “That’s not bad,” the lawmaker replied. “I thought it was worse than that.”

Avoid making comments in situations such as this, Dr. Stothert advised. “It is sometimes difficult not to say something to attack them.

Present the data and let those on the fence decide.”

Dr. Stothert encouraged his peers to testify on issues that are important to them. But the communication process should begin well before it’s time to testify, he said.

He suggested that physicians email or write their lawmakers about these issues. Take them aside, he said, and start a conversation.

Then, when lawmakers are discussing legislation during public hearings, the relationship is already established. This is important because lawmakers sometimes have their minds made up before the legislative process begins.

When testifying, Dr. Stothert offers this advice: • Avoid reading your testimony. It’s OK to glance at your text occasionally to make sure you haven’t strayed.

• Avoid talking to the microphone.

• Eye contact is critical. Keep your focus on the legislators, not the audience, at the hearing – because they are the ones who make decisions. Move from person to person.

Dr. Stothert said he will continue to testify – focusing on the data – whenever a lawmaker introduces legislation to repeal Nebraska’s helmet law.

“Every now and then we get a bye year – but that’s rare.”

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Serving Omaha/LaVista, Lincoln, Grand Island, Blair July/August 2013 Physicians Bulletin 25

moms events Omaha Storm chasers EVENT

The Metro Omaha Medical Society and Foster Group hosted a day at the ball park on June 9 for members and their families. Despite a rain delay, the Omaha Storm Chasers came out swinging and went on to a 7-0 win over the Oklahoma City Redhawks.

1.

1

Dr. Matt Rivard (right) with father AJ Rivard, and daughter, Jordan Rivard.

Jordan represented MOMS by throwing the ceremonial first pitch.

2. Dr. Todd Lovgren with wife Drue and son Barrett.

3. Ross Polking (center) and Brooke DenHartog (right) of Foster Group were in attendance along with Angela Ten Clay.

4.

A family outing for, from left, Julia Crotzer, Dr. David Crotzer, Cecilia Crotzer, Dr. Becky McCrery, Ellen Crotzer, and Elizabeth Foreman (friend).

2

4

26 Physicians Bulletin July/August 2013

3

moms events PAST PRESIDENTS LUNCHEON

Former leaders of the Metro Omaha Medical Society convened at Spezia in May for the annual Past Presidents Luncheon. Dr. Marvin Bittner, MOMS president, provided a recap of the society’s activities during the past year.

5.

From left, Drs. Frederick Paustian, Allen Dvorak, Rowen Zetterman, Muriel Frank, Perry Williams and John Mitchell.

6.

From left, Drs. Allen Dvorak , Marvin Bittner, Rowen Zetterman and John Mitchell.

5

Coming Events Creighton Campus – August 20 UNMC Campus – September 10 Speed Dating for Your Medical Specialty This event allows students to visit face-to-face with MOMS member physicians, rotating every few minutes, to discuss their specific fields of medicine and the related challenges and opportunities. Students gain valuable insight into multiple specialties.

September 20 NMA Annual Session and House of Delegates Omaha Marriott (Regency) The event will include a Omaha physician and MOMS past president, Dr. Kevin Nohner, will be inaugurated as NMA President.

6

September 25 Retired Physicians Meeting MOMS Board room – 7906 Davenport Street Dr. Ayman El-Mohandes, Dean of the College of Public Health at the University of Nebraska will discuss the integration of primary care and public health.

Sept – Nov Senator Meetings These meetings allow member physicians the opportunity to discuss health care issues face-to-face with the state legislators that represent the metro Omaha districts and legislative candidates. These meetings are open to all member physicians.

Watch the MOMS eBulletin or www.omahamedical.com for an updated list of Senator Breakfasts as they are scheduled.

Call 402-393-1415 for more information or to make reservations for any of the MOMS events.

July/August 2013 Physicians Bulletin 27

Member news

Rowen Zetterman, M.D.

Bob Kizer, M.D.

Dr. Zetterman to

Creighton assistant

direct faculty mentorship development

professor works to advance NG tube technology

R

A

owen Zetterman, M.D., has been appointed director of UNMC

Faculty Mentorship Development. The goals of this newly created director position are to partner with UNMC colleges and institutes to: • Promote professional development and retention of faculty.

• Facilitate attainment of individual career goals at UNMC. • Enhance faculty job satisfaction.

• Assist junior faculty in prioritizing and work-life balance needed for a successful academic career.

• Identify and institute national best practices models in faculty mentoring.

Dr. Zetterman is an internist, gastroenterologist and hepatologist, as well as a professor of internal medicine at UNMC. He is dean emeritus of Creighton University School of Medicine and a former chief of staff for the Nebraska-Western Iowa VA Health Care System. He was vice chair for clinical operations in the department of internal medicine at UNMC prior to becoming chief of staff.

He has served in leadership positions such as president of the American College of Gastroenterology, chairman of the Board of Governors and the Board of Regents of the American College of Physicians, president of the Metro Omaha Medical Society, and president of the Nebraska Medical Association.

He is currently a member of the Board of the Accreditation Council for Graduate Medical Education and an ACP delegate to the American Medical Association, where he is a past-chair of the AMA Council on Legislation.

Nebraska Department of Economic Development Grant is

helping fund a Creighton University professor’s vision to change the way patients and caregivers view nasogastric (NG) tubes. Bob Kizer, M.D., an assistant clinical professor of medicine in the Division of Gastroenterology at Creighton University School of Medicine, is developing a prototype to increase the comfort and safety of what is traditionally an uncomfortable and difficult-to-place tube.

“We are trying to remove as many barriers as possible in order to provide better options for all those in need of nasogastric nutrition or suction,” Dr. Kizer said.

Current technology requires most NG tubes be placed in a hospital setting with X-rays available to verify placement. Dr. Kizer believes his prototype will improve the accuracy of these placements, thereby limiting the number of replacements and X-rays required. This may also open the door for caregivers to place and maintain tubes in a home or skilled nursing environment.

Dr. Kizer’s second hurdle: the discomfort caused by the currently available tubes. NG tubes are known to lead to gagging, vomiting, nose bleeds, sore throat and a general feeling of discomfort, which Dr. Kizer has experienced firsthand.

“You don’t normally think about swallowing in your day-to-day life, but when you have a tube in, you pay attention and you dread every one,” he said. “There has to be another way.”

Dr. Kizer estimates this prototype has been about five or six years in the making. He hopes to have it ready for testing by the end of 2013.

In memoriam Roger A. Brumback, M.D. Feb. 15, 1948 – May 14, 2013

28 Physicians Bulletin July/August 2013

Donald J. Pavelka, M.D. Jan. 12, 1927– June 6, 2013

Member news

Kevin Garvin, M.D.

James Armitage, M.D

Paul Tomich, M.D.

Curtis Hartman, M.D

Dr. Garvin

Elections and inductions

gives Wilson lecture

for three UNMC faculty members

K

evin Garvin, M.D., professor and chair

of orthopaedic surgery and rehabilitation, delivered the Philip D. Wilson, Jr., M.D., Honorary Lecture in Arthroplasty at the Hospital for Special Surgery (HSS). Dr. Garvin, who completed a hip fellowship at HSS, presented, “Prosthetic Joint Infection of the Hip: Are We Making Progress?”

Dr. Garvin received his medical degree from the Medical College of Wisconsin and completed both an internship and his residency at the University of Arkansas for Medical Sciences.

Founded in 1863, HSS is the nation’s oldest orthopaedic hospital. It was ranked No. 1 for orthopaedics in the nation in 2012-2013 by U.S. News and World Report and is a world leader in orthopaedics, rheumatology and rehabilitation.

Since 1968, HHS has held a Visiting Professor Lecture Series, featuring both distinguished research and honorary service lectures. The series showcases lectures by renowned visiting faculty who are nationally and internationally recognized for their expertise in the field of musculoskeletal health and is designed to augment both the basic science and applied clinical practice knowledge of our attending physicians.

Information presented in these lectures focuses on musculoskeletal research and related clinical science perspectives.

J

ames Armitage, M.D., oncology-hematology, has been elected to the TESARO

board of directors. TESARO is an oncology-focused biopharmaceutical company dedicated to improving the lives of cancer patients by acquiring, developing and commercializing safer and more effective therapeutics.

Dr. Armitage is the Joe Shapiro Chair for the Study of Oncology and Clinical Research at UNMC. He is a member of numerous professional organizations, and served as president of the American Society of Clinical Oncology and as president of the American Society for Blood and Marrow Transplantation. Dr. Armitage has authored or co-authored numerous articles, book chapters and abstracts, and currently serves on the editorial boards of several peer-reviewed journals. He has served the UNMC in a variety of leadership roles, including as vice chairman of the Department of Medicine, Henry J. Lehnhoff Chairman in the Department of Internal Medicine, and dean of the College of Medicine.

P

aul Tomich, M.D., obstetrics-gynecology, has been elected fellow-at-large for the

American Congress of Obstetricians and Gynecologists (ACOG). Dr. Tomich has been on the UNMC faculty since 2002. He has previously served as assistant secretary for ACOG. Dr. Tomich is professor and director of the division of maternal-fetal medicine at the University of Nebraska College of Medicine and medical director of obstetrics at the Nebraska Medical Center.

He completed his medical degree at Loyola University Stritch School of Medicine in Chicago and his residency at the Mayo Clinic in Rochester, Minn. He also completed a fellowship in maternalfetal medicine at Washington University School of Medicine in St. Louis.

He served on the faculty of Loyola University for 22 years before moving to the University of Nebraska. His academic interests include prenatal diagnosis and ultrasound in pregnancy, medical complications in pregnancy, women’s advocacy in health care, patient safety in obstetrics and medical education.

C

urtis Hartman, M.D., orthopaedic surgery, has been inducted as a fellow of the

American Academy of Orthopaedic Surgeons. The academy is the largest medical association for musculoskeletal specialists. Its fellows have completed medical school, plus at least five years of specialty study in orthopaedics in an accredited residency program, passed a comprehensive oral and written exam, and have been certified by the American Board of Orthopaedic Surgery.

July/August 2013 Physicians Bulletin 29

CAMPUS update

Family Medicine Residency Program receives honor

T

he American Academy of Family

Physicians (AAFP) Foundation honored Creighton’s Family Medicine Residency Program with a 2013 Pfizer Immunization Award for its work. The annual award recognizes those family medicine residency programs that best overcome barriers to immunization in underserved communities. Creighton was one of nine programs from across the country selected to receive the recognition this year.

“We are proud to recognize these programs, which have made it their mission to raise awareness and protect their communities from infectious diseases,” said Craig M. Doane, AAFP Foundation executive director and secretary. “These programs share our vision of improving health for everyone, and we hope they will serve as

examples of best practices for others who look to increase vaccination rates in their communities.”

The selection committee chose this year’s recipients based on their ability to find creative, team-based solutions to increase immunization rates. Creighton was specifically recognized for the program’s implementation of a comprehensive system to increase immunization rates in a medically underserved population.

Senior Associate Dean named Fellow for second time

D

evendra K. Agrawal, Ph. D., senior associate dean for Clinical and Translational Research at Creighton University School of Medicine, was elected as a Fellow in the Cardiovascular Section of The American Physiological Society (APS). Fellowship is voted on annually and is open to active members of APS who have demonstrated continuous, meritorious research in cardiovascular physiology. Agrawal is already a fellow of the American Academy of Allergy, Asthma and Immunology and of the American Heart Association.

and sustainable, reaching patients not only in these Big Ten Cancer Centers, but nationwide.”

The clinical trials that will be developed will be linked to molecular diagnostics, enabling researchers to understand what drives the cancers to grow and what might be done to stop them from growing.

University of Nebraska joins cancer research consortium

T

he Big Ten universities will join together

against a common foe — cancer.

Leaders from the universities’ cancer centers, including the University of Nebraska, kicked off the Big Ten Cancer Research Consortium recently in Chicago. They are uniting to transform cancer research through collaborative oncology trials that leverage the scientific and clinical expertise of the Big Ten universities.

“UNMC is proud to be a part of this consortium which is rich in both scientific research expertise and superior clinical care for patients,” said Ken Cowan, M.D., Ph.D., director of the Fred & Pamela Buffett Cancer Center at the University of Nebraska Medical Center in Omaha. “From development of new, improved diagnostic tools to detect cancer earlier, to more effective therapies for treating each patient’s specific tumor, the outcomes of this collaboration will be broad

Sharing Clinics celebrate anniversary

T

he student-run SHARING Clinics

celebrated their 16th anniversary recently with a birthday party at UNMC’s Durham Outpatient Center. The celebration was held to honor longtime supporters such as Chancellor Harold M. Maurer, M.D., as well as student and faculty volunteers.

The SHARING Clinics allow students to provide low-cost, high-quality health care to the underserved patient population in Omaha.

Study to look at benefits, risks of diabetes drugs

U

NMC and the Omaha VA Medical Center,

along with 36 other sites, will take part in a nationwide study to compare the long-term benefits and risks of four widely used diabetes drugs in combination with metformin. The project is called

30 Physicians Bulletin July/August 2013

VP named chief academic officer for Alegent Creighton Health

D

onald Frey, M.D., Creighton University’s

vice president for Health Sciences and Roland L. Kleeberger Professor of Family Medicine, has been appointed chief academic officer for Alegent Creighton Health and Alegent Creighton Clinic.

“The evolution of Alegent Health and Creighton Medical Associates into Alegent Creighton Health has already brought about incredible positive change in the Omaha healthcare landscape,” Dr. Frey said. “This next step represents even further transition toward a stellar academic health system that will offer the region outstanding patient care, high quality research and a first-rate educational experience for our future healthcare professionals.”

As chief academic officer, Frey will help build and optimize the health system’s academic structure and ensure students and residents receive the best possible training.

Frey will remain in his role at Creighton University and as a family physician at Alegent Creighton Clinic in the Old Market while serving in this advisory position for Alegent Creighton Health.

the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) Study.

The five-year, $2.1 million study funded by the National Institutes of Health aims to enroll about 5,000 patients nationwide diagnosed with type 2 diabetes within the last five years currently only taking metformin. During the study, participants will take metformin, along with a second medication randomly assigned from among four classes of medications, all approved for use with metformin by the U.S. Food and Drug Administration.

While short-term studies have shown the effectiveness of different drugs when used with metformin, there have been no long-term studies of which combination works best and has fewer side-effects. When metformin is not enough to help manage type 2 diabetes, physicians may add one of several other drugs to lower glucose (blood sugar).

“We know the effectiveness of drugs in lowering the blood glucose levels in the short term, but we don’t know which combinations of medications work the best and how long the combinations work for,” said Cyrus Desouza, M.D., professor and chief of the UNMC Division of Diabetes, Endocrinology & Metabolism.

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the new

July/August 2013 Physicians Bulletin 31

‘A Fantastic Learning Experience’ imply put, Diane Parsons said, her time serving as executive

director of the Metro Omaha Medical Society was the high point of her professional career.

Parsons ended her tenure with MOMS – which spanned seven years – in July when she and her husband, Richard, moved to Florida where they will become involved in property management.

“I thoroughly enjoyed working with and getting to know the members of MOMS. They helped make serving as executive director of MOMS my favorite position,” Parsons said. “I thank the members for providing me with a fantastic learning experience.”

Parsons will be missed, said Marvin Bittner, M.D., MOMS president.

“When a problem came up, she was the one with the answer. When challenges occurred, she was the one who remained enthusiastic.”

Parsons said the improvements made in the electronic process for NCVO, and the renovation and consolidation of the MOMS and NCVO offices rank as her top accomplishments during her time with the society.

“I believe these advancements will allow MOMS to better serve its members moving forward,” she said.

Parsons began her professional career in Fremont as an EKG-EEG technician. She later served as office manager for several Fremont physicians and as clinic coordinator for Health Care Professionals. In 1994, she became billing manager for Creighton University’s Department of Surgery, and later served the department as accounts receivable manager and general surgery residency coordinator.

She was hired by MOMS to serve as NCVO manager in November 2006, and was named MOMS’ executive director in April 2011.

Application for Membership This application serves as my request for membership in the Metro Omaha Medical Society (MOMS) and the Nebraska Medical Association (NMA). I hereby consent and authorize MOMS to use my application information that has been provided to the MOMS credentialing program, referred to as the Nebraska Credentials Verification Organization (NCVO), in order to complete the MOMS membership process.

Personal Information Last Name: _____________________________ First Name: _______________________ Middle Initial: ______ Birthdate: _________________________________________________ Gender: Male or Female Clinic/Group: __________________________________________________________________________________ Office Address: ________________________________________________________________ Zip: __________ Office Phone: ____________________ Office Fax: ___________________ Email: _________________________ Office Manager: _______________________________________ Office Mgr. Email: ________________________ Home Address: ____________________________________________________ Zip: ________________________ Home Phone: __________________________________________ Name of Spouse: ________________________ Preferred Mailing Address: Annual Dues Invoice: Event Notices & Bulletin Magazine:

Office

Home Other: __________________________________

Office

Home Other: __________________________________

Educational and Professional Information Medical School Graduated From: __________________________________________________________________ Medical School Graduation Date: ____________________ Official Medical Degree: (MD, DO, MBBS, etc.) _______ Residency Location: _____________________________________________ Inclusive Dates: _________________ Fellowship Location: _____________________________________________ Inclusive Dates: _________________ Primary Specialty: ______________________________________________________________________________

Membership Eligibility Questions YES

NO

(If you answer “Yes” to any of these questions, please attach a letter giving full details for each.)

Have you ever been convicted of a fraud or felony?

Have you ever been the subject of any disciplinary action by any medical society, hospital medical staff or a State Board of Medical Examiners?

Has any action, in any jurisdiction, ever been taken regarding your license to practice medicine?

(Including revocation, suspension, limitation, probation or any other imposed sanctions or conditions.)

Have judgments been made or settlements required in professional liability cases against you?

I certify that the information provided in this application is accurate and complete to the best of my knowledge.

_____________________________________

Signature

___________ Date

B

Fax Application to: 402-393-3216

32 Physicians Bulletin July/August 2013

Mail Application to: Metro Omaha Medical Society 7906 Davenport Street Omaha, NE 68114

Apply Online: www.omahamedical.com

new member update

member benefits

Did you Know?

MOMS Collaborates to Benefit Public Health The Metro Omaha Medical Society continually strives toward its mission of improving the general health of the community by collaborating with many local health-care related organizations. When you choose to be a MOMS member, you help to strengthen these efforts.

These organizations include, but are not limited to: • Live Well Omaha and Live Well Omaha Kids

Sara Barton, M.D.

Martin Winkler, M.D.

Medical School: New York University School of Medicine

Medical School: University of Nebraska Medical Center

Residency: Brigham & Women’s Hospital in Boston in Obstetrics and Gynecology

Residency: St. Mary’s Medical Center, San Francisco, in general surgery

Fellowship: Brigham & Women’s Hospital in Reproductive Endocrinology and Fertility

Fellowship: Baylor College of Medicine in Houston in vascular surgery

Specialty: OB-GYN/Reproductive Endocrinology and Fertility

Specialty: Vascular Surgery and Advanced Wound Care

Location: Heartland Center for Reproductive Medicine

Location: Alegent Creighton Bergan Mercy Wound Care Clinic

Dr. Barton is an avid practitioner of yoga. She loves to travel, and enjoys hiking and backpacking with her husband, Jake, and their two young children.

She has also lived in Chile and is proficient in Spanish.

Dr. Winkler has a career long interest in controlling lymphedema. His practice is limited to advanced wound care and clinical research in healing venous leg ulcers.

While in high school, he developed an interest in beekeeping and has continued this interest to present day. He has been tending his current hives for the past 14 years despite an ongoing challenge of many beekeepers – combating colony depletion disorder, where a large percentage of his bees disappear during the winter months. He has found many uses for honey as a sugar substitute in maintaining a healthy diet and is always willing to share his recipes.

• NMA Childhood Obesity Prevention Project • Hope Medical Outreach Coalition • OneWorld Community Health Centers • Domestic Violence Coordinating Council • Douglas and Sarpy County Health Departments • Immunization Task Force Want to get involved and help to make a difference?

Contact the Metro Omaha Medical Society today!

NEW MEMBERS Brian Boerner, M.D. Endocrinology, Diabetes & Metabolism Winslow Borkowski, M.D. Neurology Jennifer Fillaus, D.O. Nephrology

Andrew Frager, M.D. Radiology Krishan Ariyarathna, M.D. Internal Medicine-Hospitalist Jane West, M.D. Radiology

Interested in becoming a MOMS Member?

Call 402-393-1415, apply online at www.OmahaMedical.com or complete the application on page 32.

July/August 2013 Physicians Bulletin 33

Your home...your builder.

Exceptional.

Selecting a builder is as much an expression of taste as it is a statement of confidence. No one understands this better than Curt Hofer & Associates.

As one of the area’s most respected custom homebuilders, we provide a one-of-a-kind experience in creating your once-in-a-lifetime home.

Your wants, your needs, your style, your preferences – everything we do at Curt Hofer & Associates is advanced with the thought of you in mind.

That means spending time with you, from the very beginning and at every step along the way.

From individual rooms, to how these rooms come together to create a home, to the landscape and exteriors that immediately bid you welcome, the team at Curt Hofer & Associates knows how to bring the best ideas to life – yours. The result? Your home...your builder. Exceptional.

CURT

HOFER

& ASSOCIATES

Your home...your builder. Exceptional.

2332 Bob Boozer Drive Omaha, NE 68130 Phone: 402.758.0440 n

www.cur thofer.com

34 Physicians Bulletin July/August 2013

BEING NAMED ONE OF THE 15 TOP HEALTH SYSTEMS IN THE USA IS GOOD NEWS FOR US. IT’S ABSOLUTELY AWESOME NEWS FOR OUR PATIENTS.

At Alegent Creighton Health, we challenge ourselves every day to transform healthcare. And, according to a national study, we’re succeeding. We’ve been named one of the 15 top health systems by Truven Health Analytics.™ We received top honors based on a dozen factors including patient satisfaction, lower mortality rates, fewer complications and better patient safety. Of course, our patients are the real winners. Because when it comes to delivering excellent, nationally recognized care, we are never standing still. AlegentCreighton.com.

Metropolitan Omaha Medical Society 7906 Davenport Street Omaha, NE 68114

PRSRT STD U.S. POSTAGE

PAID

PERMIT NO. 838 OMaha, NE

ADDRESS SERVICE REQUESTED

Heart Transplantation? Yes. Your 24-hour link to comprehensive cardiac diagnostics and treatments, physician-to-physician consults, referrals, admissions and transport service.

Physicians’ Priority Line: 1.855.850.KIDS (5437) childrensomaha.org

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