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An Alarming Trend & How You Can Disrupt It Odds are you have treated a trafficking victim in your practice

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SEPTEMBER 2020


CONTENTS || FEATURES

Slathered in Sunscreen as a Child; Advanced Dermatology as an Adult JOANNA MCGETRICK, MD, HAS A PASSION FOR PROTECTING HER PATIENTS

6 PUBLISHER John Kelly jkelly@orlandomedicalnews.com ——————— AD SALES John Kelly, 407-701-7424 ———————

FEATURES 5 6

EDITOR PL Jeter editor@orlandomedicalnews.com

COVER STORY An Alarming Trend and How You Can Disrupt It

——————— CREATIVE DIRECTOR Katy Barrett-Alley kbarrettalley@gmail.com

PHYSICIAN SPOTLIGHT Slathered in Sunscreen as a Child; Advanced Dermatology as an Adult

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EOCC MEDICAL CITY New Age Networking for Healthcare Professionals is Here!

8

How Should Incidentally Discovered Thyroid Nodules be Managed?

9

Medical Marketing in the “New Normal”

CONTRIBUTING WRITERS Jan Edwards Dorothy Hardee, Moin Kola, MD Michael C. Patterson Jeff Ramos Matthew Shlapack, MD Erin Somers ———————

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A Reminder that Early Detection of Colon Cancer Saves Lives

SOCIAL MEDIA DIRECTOR Jennifer Cerna ———————

11

CBD Increases Blood Flow to the Brain After One Dose

12

Heading Back to School with Asthma in the Time of COVID-19

13

Why a Practice Should Outsource Medical Billings

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Opinion: Barriers Remain

All editorial submissions and press releases should be emailed to editor@orlandomedicalnews.com

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ADVENT UNIVERSITY INTERN Noelle Kelly ——————— CIRCULATION jkelly@orlandomedicalnews.com

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Orlando Medical News July 2020 is published monthly by K&J Kelly, LLC. ©2018 Orlando Medical News. All Rights Reserved. Reproduction in whole, or in part without written permission is prohibited. Orlando Medical News will assume no responsibility unsolicited materials. All letters to Orlando Medical News will be considered Orlando Medical News property and therefore unconditionally assigned to Orlando Medical News for publication and copyright purposes.

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An Alarming Trend and How You Can Disrupt It Odds are you have treated a trafficking victim in your practice EDITOR’S NOTE. This is the first in a series that informs on child sex trafficking in the Orlando area and what our readers, those in the healthcare community, can do to disrupt what is happening to its victims.

BY JAN EDWARDS, PRESIDENT, PAVING THE WAY FOUNDATION, INC.

You may be shaking your head thinking, “no way is this happening in our office,” we would have seen and reported it. Here is another truth bomb for you. Florida has the third highest number of calls to the national trafficking hotline, behind California and Texas. According to DCF, Orange County has the second highest number of child trafficking cases in the state. So not only is it possible, it’s probable one of your patients is a possible victim. You could be a little upset or angry at me for bringing this topic up, and that’s ok. See, the only way we can truly disrupt the cycle of this horrific crime against our children is to become educated about it, learning the signs and, most importantly, be empowered to do something about it. For a moment, imagine being a young girl or boy – entering your practice, scared, with no voice, feeling helpless. Trapped by the fear of saying anything to anyone and if they do say something, losing the one person that ‘loves’ you. Consider, shy looks different than suppressed. Acting out isn’t always ADHD. Now, imagine one of your nurses gets a sense that something is off and not wanting to rock the boat, feels unsure and helpless to say anything as well. Unsure of what action to take. Hopeless praying that helpless notices and does something. You and your team play a crucial role in disrupting the cycle of exploitation. • 85 percent of trafficking victims reported being in a medical setting for various concerns but did not feel safe enough to ask for help. • 57 percent of survivors reported never being asked trafficking or abuse assessment questions during any health care visit. ** Frightening? For child, Yes. Upsetting for your staff. Yes. Preventable? Absolutely! Here’s the good news! We have an opportunity to interrupt this pandemic. There is a solution and it starts with us. I’m inviting you to be an active participant in ending this silent crime. How do you do that? Read on.

Maybe you’ve heard about it on the news – Jeffery Epstein. Ghislaine Maxwell. 39 children missing in Georgia…all of it seems so far way. Well, I’m going to burst your “happiest place on earth” bubble. If you are not fully aware of it, it can have an impact on your business, your staff, your reputation, and most importantly, your patients. That trend is human trafficking. Specifically: child sex trafficking. Trafficking is a global pandemic. According the International Labor Organization and latest Trafficking in Persons report, there are over 40 million people being sold into a life of slavery. The sad, almost incomprehensible part of this, according to the TIP Report, 30 percent or close to 7 million children are being exploited every year around the world and the number continues to grow. They are used as forced labor, domestic servants, or for sexual exploitation. The almost incomprehensible part is that the average age of entry is 12. You know what that means, right? Children as young as 6 years old are suffering a life we cannot even imagine. As shocking as that may be, here is another surprise, some of those victims may have walked through your door and been treated by you. How can that be? Well, according to a Journal of Family Violence study sample, in which all traffickers involved were family members, nearly 65 percent of the traffickers were the mothers of the victims, and 32 percent were the victim’s father. Almost 60 percent of familial trafficking victims have ongoing contact with their trafficker, making it extremely difficult for children and teens to remove themselves from harmful situations and protect themselves – both physically and psychologically. *

FIRST: Get educated! Here are some signs to look for:

Adult Victims: • Appears disheveled, disoriented • Signs of fear, anxiety or tension • Visible ‘ownership’ tattoos • Signs of physical abuse such as burn marks, bruises or cuts • Avoids eye contact • Resistance to assistance • No ID or Fake ID • Signs of being controlled, hesitant to answer health questions • Cannot speak or will not speak on their own behalf

Child Victims: • Bruises, cuts, burns • Pain in jaw or abdomen • Headaches • Vaginal discharge • STI’s • UTI’s • Withdrawn • Agitated • Disassociation • Afraid of their caregiver

SECOND: Bring compassion to your patients by understanding the mind of a victim. According to the National Sexual Violence Resource Center, one in four girls and one in six boys in the United States will be sexually abused before turning 18. Yet only 12 percent of child sexual abuse is reported to authorities.

HELP LINES AVAILABLE 24/7 EVERYDAY. 888-373-8888 or text ‘Help’ to 233733. For minors, call the Abuse Hotline, 800-962-2873 5

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CONTINUED P.9

VIDEO: Debunking Myths about Human Trafficking


PHYSICIAN || SPOTLIGHT

Slathered in Sunscreen as a Child; Advanced Dermatology as an Adult Joanna McGetrick, MD, has a passion for protecting her patients

Board-certified dermatologist Joanna McGetrick, MD, was highly aware of the sun’s dangers long before she opened her new practice, Premier Dermatology of Lake Nona.

program, which only accepted six people per year at the time, provided hands-on dual training in dermatology and internal medicine. This unique education qualifies her to not only treat skin problems at the surface level, but also diagnose and treat certain underlying conditions that cause them. “Being dual-trained has positioned me to help my

As a native Floridian born and raised in Winter

patients in so many ways beyond just treating the skin’s

Haven, her parents slathered her in sunscreen any

surface,” said McGetrick. “My practice can prescribe

time she stepped outside – and for good reason. Her

systemic medications to help patients manage advanced

grandmother was diagnosed with metastatic melanoma

psoriasis. I can address treatment for conditions like

in her forties, the most serious type of skin cancer,

lupus and all the cutaneous manifestations of chronic

and was one of the first patients to survive the earli-

disease, such as diabetes. Occasionally, I’ll even provide a

est treatment trials. This family lesson led to plenty of

preliminary diagnosis for internal cancers, such as colon,

exposure to dermatologists throughout Joanna’s child-

breast or lung cancer, based on metastases that have

hood and young adulthood, as well as a passion for

presented on the skin.”

promoting the importance of sun protection.

Beyond the sometimes life-saving diagnoses and

As a dermatologist in Florida, McGetrick often sees

treatments McGetrick delivers, her favorite thing to

patients who’ve spent a lifetime in the sun. Before re-

treat is, surprisingly, acne. “Acne comes in a broad

locating to Central Florida to open her current practice,

spectrum, from small flareups to deforming acne with

she practiced in Jacksonville and St. Augustine. “Working in a beach town, you unfortunately see a lot of skin cancer and very sun-damaged skin,” she said. “Part of my mission, particularly with new patients, is providing sun protection education and pre-cancer prevention, as well as resurfacing techniques and treatments.” McGetrick received her Bachelor of Science de-

horrible scarring – and it’s all something I can fix,” said

rick. “From performing cosmetic procedures to treating

McGetrick. “Depending on the severity, we’ll work on a

acne, actinic keratoses and itchy rashes to identifying

treatment plan for up to a year. While this process can

problems going on inside the body based on changes in

be labor intensive for both patients and physicians, the

hair, skin and nails, I’m able to practice both cerebral and

results make an incredible impact on patients’ self-confi-

procedural medicine on a daily basis. Regardless of the

dence and overall quality of life.”

treatment plan, I’m working to make peoples’ lives bet-

As she builds her practice in Central Florida, McGet-

gree from University of Florida and attended medical

ter – and it’s an incredibly rewarding feeling.”

rick looks forward to connecting with fellow physicians

school at the University of Chicago Pritzker School of Medicine. She completed an intensive residency at the University of Wisconsin, where she was also a chief resident for the dermatology department. The five-year

Need help creating a professional brand?

When she’s not working, McGetrick enjoys spending

and building relationships with new patients and fami-

time with her husband and two young children. She is

lies that span generations. “I love dermatology because

an avid Gators fan who loves practicing yoga and chas-

every day – and every patient – is different,” said McGet-

ing her dogs.

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SEPTEMBER 2020


EAST ORLANDO CHAMBER OF COMMERCE

EOCC || MEDICAL CITY

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CALENDAR:

New Age Networking for Healthcare Professionals is Here!

Virtual the Member Academy: Roadmap to Member Success WEDNESDAY SEPT 9 - 9:00 – 10:00 AM Powered by Powernet, Member Exclusive

Virtual EOCC Educational Series “On the Menu” WEDNESDAY, SEPT 9 - 12:30 AM – 1:30 PM Featuring “Getting in Front of Future Clients & Maximizing Efforts” with Rob Haynes Powered by Powernet Free for EOCC Members | $10 for Non-members

BY DOROTHY HARDEE

In February, we delighted in the success of the East Orlando Chamber of Commerce’s first Healthcare Council Collaborative Meet & Greet. Our goal was to be the connector helping to increase referrals, expand visibility within the community ultimately increasing revenue. The results were exciting as more than seventy people within the healthcare field joined us at CERTUS of Waterford Lakes for an early morning breakfast networking event. Oh, those were the days. COVID-19 no doubt changed everything and continues to complicate our lives as we try to establish a new normal in business. We swiftly adjusted to virtual opportunities seeking out the best options for networking in technology. Powernet gave us the flexibility of breakout rooms allowing professionals to interact in small groups. Our August test drive met with rave reviews from participants experiencing the transition from room to room in five plus minute sessions within the hour-long event.

Healthcare Council Collaborative Virtual Peer-to-Peer Referral Forum & Breakout THURSDAY, SEPT 10 - 8:00 – 9:00 AM Powered by Powernet, Free to Healthcare professionals

Virtual Spectrum Reach Nuevo: Reconnect with Your Customer & Your Community THURSDAY, SEPT 10 - 2:00 -3:00 PM Free to attend

East Orlando Chamber’s Virtual Job Seekers Series FRIDAY, SEPT 11 - 12:30 – 1:30 PM The Ultimate Guide on How to Use LinkedIn to get a Great Job Featuring Roger Lear In partnership with OrlandoJobs & Meteoric Studios Registration required. Free to all

Virtual September Chamber Luncheon “Ninth District Court in the East” WEDNESDAY, SEPT 16 - 12:00 – 1:00 PM Featuring The Honorable Donald A. Myers, Jr., Chief Judge, Ninth Judicial Circuit Court Powered by Powernet Free to EOCC Members | $10 for Non-members

Virtual Coffee Club Nona THURSDAY, SEPT 17 - 8:30 – 9:30 AM (3rd Thursday of the month) Real World Thursday Marketing Panel Powered by Powernet

East Orlando Chamber’s Virtual Job Seekers Series FRIDAY, SEPT 18 - 12:30 – 1:30 PM Career Expert Day – LIVE# Career Experts Answer Your Job & Career Questions In partnership with OrlandoJobs & Meteoric Studios Registration required. Free to all

Virtual Non-Profit Council Roundtable – Member Non-profit Benefit Sponsorship 2.0

WEDNESDAY, SEPT 23 - 9:00 – 10:00 AM Powered by Powernet

Misters & Sisters Great Lunch Adventures is BACK! WEDNESDAY, SEPT 23 - 11:00 AM – 12:30 PM Bonefish Grill Waterford Lakes Registration is Required All attendees to wear masks

7 Please visit EOCC.org for a complete listing of September events

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SEPTEMBER 2020

Dr. Kyle Clifton with Ascent Audiology was sold after participating. “Just like any of the other chamber events, this most recent health council breakout was engaging and even fun to attend. The virtual breakout with other health professionals was a relaxed way to let others in the healthcare community know what we do in my practice. Networking with other healthcare facilities is why I joined the chamber and I cannot thank EOCC enough for putting on events just like this one. I look forward to the next event even if it is virtual.” Dr. Colin Bartoe, Functional Neurology Chiropractic Center was thrilled to have connected with three potential referral clients during the event. The pandemic has challenged small practices with the prospect of being completely shut down with an outbreak. Virtual connections can meet the need for physicians seeking to keep their practices relevant as we slowly explore our new normal for opening safely.

CONTINUED P.11


How Should Incidentally Discovered Thyroid Nodules be Managed? BY MATTHEW SHLAPACK, MD

returned indeterminate. What is the next step? Thyroid nodule biopsy results can be broadly divided into four main categories: benign, malignant, insufficient specimen, and indeterminate pathology. Patients are understandably frustrated to go thru a procedure such as a biopsy only to hear that the question of malignancy remains unanswered. The good news is that proceeding with a repeat biopsy or empiric thyroidectomy is no longer always required. We are now fortunate to have additional evaluation tools at our disposal. There are several, well-validated, genomic tests that can be run on thyroid aspirates or even the pathology slides themselves. Often, the results of this additional testing will clarify if an indeterminate result is benign or malignant. Mrs. Smith’s thyroid nodule aspirate was sent for additional testing and she was relieved to hear that her thyroid nodule is benign. She will benefit from a repeat ultrasound in the future to document stability, but at this time, no further workup or treatment is required. Providers will continue to be confronted with thyroid nodules being found incidentally during imaging exams.

Mrs. Smith undergoes a routine carotid artery doppler study as part of her evaluation following a recent CVA. While she is pleased to hear that no significant blockage or stenosis was present, the technologist remarks that Mrs. Smith does have a distinct thyroid nodule present in her right thyroid lobe. What should be done next? Thyroid nodules are being diagnosed with increasing frequency. Studies estimate that between 1:3 and 1:2 adults have a thyroid nodule. While experts disagree if all the increase in diagnosis is secondary to more imaging studies being performed, most do agree that a large part of this rise is being driven by increased imaging. While thyroid nodules are common, it is essential that when found, they are evaluated. The workup of thyroid nodules is aimed at answering two questions. Are the nodule or nodules hot nodules, producing excess thyroid hormone? Do the thyroid nodules contain thyroid cancer? Hot nodules are variably described as toxic nodules or hyperfunctioning nodules. While exceptions can occur, as a rule, hot nodules are not malignant. With this in mind, determination, if thyroid nodules are hot, should typically be done first. This can usually be accomplished by a simple measurement of TSH. If the TSH is within normal limits, the nodule or nodules are most likely not hot and sending the patient for a thyroid uptake and scan is usually not necessary. If the TSH does return suppressed, then further evaluation to confirm hyperfunctioning should be considered. Once it has been confirmed that a patient’s thyroid nodules are not hot, the focus shifts to an assessment of possible malignancy. Unfortunately, this question can only be answered by performing a biopsy and obtaining tissue. The good news is that not every thyroid nodule requires a biopsy. We now have excellent research regarding the likelihood of a nodule being malignant. This has resulted in a specific set of guidelines that aid us in deciding which patients should and should not be referred for biopsies. These guidelines focus on three main groups of information. The first set of information regards reported symptoms and patient-specific risk factors for thyroid cancer such as a history of exposure to radiation or a family history of thyroid cancer. The second set relates to specific exam findings such as associated lymphadenopathy and immobility of the nodule itself. Finally, the ultrasound appearance of the nodules plays an essential role in determining if a biopsy is appropriate. Returning to our patient. Mrs. Smith was found to have a normal TSH. She does not have risk factors for thyroid cancer or concerning exam features; however, her right-sided thyroid nodule did meet the criteria for biopsy based on the appearance of ultrasound. She underwent an ultrasound-guided fine needle biopsy. She returns to your office and is frustrated to hear that the pathology

We must remain cognizant of how distressing these findings can be to our patients. As in all areas of medicine, our patients are exposed to a steady barrage of information from questionable sources, now more than ever. Referral to an Endocrinologist with experience in the evaluation of thyroid nodules can often lead to definitive answers within a few appointments. This specialist can also oversee any needed surveillance, which often can be done with as little frequency as an annual follow-up. As the trend of increased imaging continues, there is no doubt that incidental findings will continue to confront us. The great news is that the advances that have been made in the area of thyroid nodules have provided us with the tools to adequately evaluate them, both for our patients’ safety and their peace of mind! Matthew Shlapack, MD, is a Board-Certified Endocrinologist practicing at Orlando Endocrinology with a mission to ensure that patients benefit from all the latest advances in medicine, helping to preserve their health and maintain their independence. Shlapack completed both his Internal Medicine Residency and his Endocrinology Fellowship at The University of South Carolina, School of Medicine, and was awarded his Doctor of Medicine degree from Ross University Medical School. He graduated from The University of Maryland, College Park with bachelor’s degrees in both Neurobiology, Physiology, as well as Psychology. He attended Ross University Medical School. Visit http://orlandoendocrinology.com

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Medical Marketing in the “New Normal”

CONTINUED ...

An Alarming Trend and How You Can Disrupt It Many victims don’t self-identify or share what’s being done to them. They actually think it’s how life is. It’s ‘normal’ – even though it hurts. They fear what might happen if they tell anyone; they experience feeling embarrassed, guilty and full of shame about what they’ve experienced. Sadly, these young victims falsely believe all of this is their fault. How traffickers control their victims is by threatening their lives, their safety and including their loved ones. Traffickers, much like abusers,’ train children to avoid sharing their experiences with anyone. Victims are told lies, coerced and manipulated to keep quiet. “If you tell the police, you’ll go to jail.” “You like it, you know it.” “You deserve it. You’re worthless and no one else cares about you.” “If you tell anyone, I’ll do the same thing to your little sister.” The pre-frontal cortex is not fully developed leaving them even more vulnerable to believe the lies and make rash decisions.

BY ERIN SOMERS

When the calendar flipped January 1st, 2020, little did we know our lives were about to be turned upside down. I never imagined I would hear the term “new normal” so many times, but here we are. The new normal is proving to be challenging for many, especially in healthcare. On the clinical/administrative side, we follow guidelines that are clearly defined to keep our patients and our medical teams safe. With marketing, it’s a completely different story. Things are far from black and white. Practice administrators and managing partners are scrambling to find the new normal in marketing. As an experienced medical marketer, I can see many issues, especially with independent practices and facilities. It’s confusing, frustrating and there is a serious concern for the bottom line during these uncertain times. If you are reading this and thinking, “This is me,” let me assure you, you are definitely not alone. One big change is the role of the physician liaisons, once a vital part of medical marketing. Unfortunately, most of them are now working in a decreased capacity, if at all. Additionally, most health fairs and community outreach events have been postponed or cancelled outright. Declining revenue is also affecting marketing efforts. As an experienced medical marketer, let me offer you one piece of advice. Don’t stop your marketing efforts, change them. You must modify your marketing into our “new normal.” If you don’t know how, hire someone who does. This time is reminiscent of fall 2008 when the U.S. stock market took a big hit. The knee jerk reaction then was to stop spending money on marketing, which turned out to be a big mistake. During times like these, it’s time to think outside of the box. You may be thinking that diving into social media is the primary answer, but a tweet is not going to pay your bills. Your social media needs to be properly strategized and supported with other elements of marketing. How do you find the right medical marketer to guide you through the new normal? All medical marketers are different and every marketer has their own program and skill set. Meet with potential candidates and let them know what your needs are. A good marketer will listen carefully and take notes. Share your marketing efforts as well as the challenges you currently face. Before meeting, a strong marketer will become familiar with all your current marketing efforts. Marketing is about telling your story, so share how you are currently utilizing your website, social media, medical writing, podcasts, field work/events and printed collateral material. Can your candidate take your practice to the next level after seeing what you have already done? When interviewing, I cannot stress enough how important it is to follow your gut. Remember, clinical/administrative is black and white, while marketing is gray. There are many shades to choose from. Is this

candidate the right shade for your needs? How well will they complement your current marketing and, more importantly, how will they improve it? You must be honest in your evaluation of your current marketing. Are you consistently adding new written/video content to your website? How strong is your medical writing? Are you blogging on a regular basis? Blogs need to have discipline. If you are only blogging once in a great while, you are missing out. During this new normal, I would seriously recommend adding more video to your website, and using it on other social media platforms. I’m not talking about a phone video from your twice removed cousin Sal. I’m talking about professional video that will last a long time and give you a good ROI. Not all medical marketers can provide quality video production. It’s very important you hire someone with that experience. The wrong hire could end up costing you time, money, and reputation. According to Hub Search research in early 2020, 54 percent of consumers wanted to see more video content. More than 50 percent of consumers wanted to see more videos from the brands they use… more than any other type of content. A staggering 90 percent of consumers said video helps them make final buying decisions. These findings were before the COVID-19 crisis, and I believe these numbers will trend even higher next year. How are your competitors doing? How are they maneuvering with the new normal? A great way to find out is with a competitive analysis. A strong marketer can do this task and provide priceless insight for you and your leadership. During these challenging times, don’t over-stress about handling your marketing. Instead, hire someone who understands your vision, can tell your story, and will set you apart from your competitors. It’s important to remember that patients are consumers. They have a choice as to where they spend their healthcare dollars. A skilled medical marketer will help them choose you. Now is the time to strategize on your marketing so you can thrive in the “new normal.” Erin Somers is a medical consultant that specializes in marketing, video production and customer service. Erin@ErinSomersConsulting.com

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THIRD: Empower your team to take an action. Put the National Trafficking Hotline number in your phone and have your team do the same. They can call 24/7, 7 days a week. That number is 888-373-888 or text ‘Help’ to 233733. For minors, call the Florida Abuse Hotline at 800-962-2873. That one phone call can end the cycle of abuse and exploitation and assist the family in getting the help they need to begin the healing. As mandatory reporters, it’s our responsibility to assess the unthinkable and gently ask the tough question. “Is anyone hurting you?” Then be prepared to take appropriate actions.

LASTLY: Reduce risk. The most powerful and practical way to reduce risk is to provide training for your team as a priority. It can save lives – which is part of your oath. You can share this article. Post this link on the company’s intranet. Engage in conversations during daily meetings. Volunteer at a local shelter. There are many resources both offline and online to protect your practice and your patients. Visualize your staff, feeling empowered; they are trained to interact with possible victims. Picture them looking fulfilled when they’ve used their training and knowledge to end the trend and save a child from a life of slavery. You would be superheroes. Your staff would be proud to be a part of a practice that is a safe place for children and families. You can take pride in standing together, protecting the most vulnerable patients. You have the opportunity to make a massive difference by being aware and taking a new action. Educate. Empower. Prevent. There is a solution and it starts with us. Together we can pave the way to a brighter future.


A Reminder that Early Detection of Colon Cancer Saves Lives of biopsy or polyp resection or a perforation in the colon or rectum. The recovery from the procedure and sedation is fairly quick. The doctor will go over the results of the procedure and typically give a copy of the report after procedure. The interval between colonoscopies is determined by several factors like type of polyp, pathology of the polyp, size of polyp, nature of bowel preparation and family history of colon cancer or polyp. The other modalities of colon cancer screening include stool tests and abdominal CT scan or CT colonography. The two kinds of stool tests are first, detection of occult (hidden) blood in the stool and second, detection of abnormal DNA in the stool called cologard. The stool tests are available as options for colon cancer screening in average risk populations. CT colonography is a noninvasive exam that involves performing a CT scan of the abdomen that uses advanced computer software to examine the colon. If any of these tests are positive, then a colonoscopy should be undertaken to evaluate for colon cancer. The stool test for occult blood was first introduced to detect colon cancer. However, this concept has evolved over the years. The emphasis now is to prevent colon cancer. This is possible if the lesions can be detected when they are at the polyp stage so they can be removed before they turn into cancers. This is best achieved with colonoscopy which allows detection, resection and

BY MOIN KOLA, MD

As COVID-19 has surged and patients are choosing to delay much needed diagnostic care, I wanted to emphasize for patients and primary care physicians the importance of early screening for colon cancer. Colon cancer is the fourth most common cancer diagnosed in men and women in the United States. Colon cancer is the second leading cause of cancer deaths in men and women in the United states. It is estimated that around 150,000 of new colorectal cancers will be diagnosed in the United States in 2020. The rate of new diagnosis of colorectal cancer per year in men is 42.1 per 100,000 men and 32.3 per 100,000 women. Increasing age appears to be the most important risk factor. African Americans appear to have slightly more incidences compared to other ethnicities at an overall rate of 40.4 per 100,000 in men and women combined. Recently, with the advent of new therapies, the current five-year survival rate with colorectal cancer is around 63 percent. Factors that may increase the risk of colorectal cancers include increasing age, African American ethnicity, personal or family history of colon cancer or polyps, sedentary lifestyle, high fat diet, obesity, Diabetes, cigarette smoking, drinking alcohol and personal history of Inflammatory Bowel Disease like ulcerative colitis. Colon cancer is asymptomatic in the initial stages. As it grows, it leads to symptoms like rectal bleeding, change in bowel habits like constipation, erratic bowel habits or diarrhea. Other possible symptoms include sense of incomplete evacuation, loss of weight or appetite, abdominal pain or development of anemia. Any such symptoms should prompt patients to seek medical intervention to detect colon cancer at the earliest stage. Most colon cancers start with a polyp, a small lump in the colon. Over a period of time, this grows and at a certain stage it makes a biological switch from benign to malignant. It is, therefore, possible to detect this disease at the benign stage when it is a polyp that can be resected and stopped from progressing to cancer. There are several colon cancer screening tests. However, the most effective and commonly performed test is a colonoscopy. During this procedure, the doctor inserts a small tube with a camera mounted on its tip to examine the colon under intravenous sedation. The colon needs to be cleaned out a day prior to the colonoscopy so the doctor can take good look into the colon, then evaluate for the presence of polyps or cancers. The bowel clean-out typically involves drinking a clear liquid diet and some sort of bowel cleansing solution a day prior to the colonoscopy. On the day of the colonoscopy, the individual will need to be accompanied by a responsible adult to drive them home. If a polyp is seen on the colonoscopy, it will be resected and submitted for pathology to determine its nature. Colonoscopy is generally a safe procedure. Few of rare risks of colonoscopy includes a reaction from sedation or anesthesia, bleeding from site

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removal of polyps. There are no interventions available to prevent colon cancers. However, certain lifestyle measures may help to reduce the risk of developing colon cancers. These include no cigarette smoking, consumption alcohol in moderation, maintaining healthy body weight, regular exercise and consumption of a high fiber diet. Dr. Moin Kola is a Board-Certified Gastroenterologist with the Digestive and Liver Center of Florida who has provided Gastroenterology services in Central Florida for 10 years. Dr. Kola completed his Gastroenterology fellowship at Case Western Reserve University and Inflammatory Bowel Disease (IBD) visiting fellowship with Crohn’s and Colitis Foundation of America at the Cleveland Clinic. He began his gastroenterology training in England and holds the distinction of being a member of Royal College of Physicians of the United Kingdom. Dr. Kola’s expertise include colon cancer screening, gastroesophageal reflux disease, peptic ulcer disease, inflammatory bowel disease, celiac disease, irritable bowel syndrome, fatty liver disease and various and various other gastroenterology and liver disorders. Dr. Kola is a member of American College of Gastroenterology (ACG) and American Society of Gastrointestinal Endoscopy (ASGE).

SEPTEMBER 2020


CBD Increases Blood Flow to the Brain After One Dose

CONTINUED ...

New Age Networking for Healthcare Professionals is Here!

The results showed that CBD significantly increased blood flow in the hippocampus and the orbitofrontal cortex. The orbitofrontal cortex area within the brain plays a role in decision-making, and the hippocampus is involved in memory.   “Cannabidiol is one of the main constituents of cannabis and is gaining interest for its therapeutic potential” said lead author Dr. Michael Bloomfield, professor of Psychiatry at UCL. “There is evidence that CBD may help reduce symptoms of psychosis and anxiety. There is some evidence to suggest that CBD may improve memory function. To our knowledge, this is the first study to find that CBD increases blood flow to key regions involved in memory processing, particularly the hippocampus. This supports the view that CBD has region-specific blood flow effects in the human brain, which has previously been disputed.”

A new study in the August 2020 Journal of Psychopharmacology reports an increase in blood flow to the hippocampus and orbitofrontal cortex after one 600mg dose of Cannabidiol (CBD). LINK TO THE STUDY CBD and Tetrahydrocannabinol (THC) are both derived from the cannabis plant. Together, they are part of the cannabinoid group of compounds found in cannabis and hemp plants. However, the USA definition of hemp is containing less than 0.3 percent THC. THC is the psychoactive compound responsible for the euphoric, ‘high’ feeling often associated with cannabis. The compound interacts with CB1 receptors in the central nervous system and brain and creates the sensations of euphoria in higher doses. However, CBD is non-psychoactive and does not fit the CB1 receptors well. CBD is also believed to be responsible for some of the therapeutic effects of cannabis such as pain relief.  The study was performed by a team at the University College of London (UCL). The goal of the study was to understand the relationship of CBD with the human brain. The research team studied 15 participants, with no history of cannabis use, ingest a capsule of 600mg of CBD on different occasions for one week, then 600mg of a placebo. Seven days later, participants were given the capsule they did not take. Participants didn’t know which capsule they were taking on each occasion. Next, researchers used an MRI brain scanning technique, arterial spin labeling, which measures blood oxygen level changes.

Analysis This study is a positive start to provide definitive proof that CBD can benefit blood flow to the areas of the brain which control decision making, memory, and potentially pain. This new insight can give physicians and researchers evidence to facilitate larger studies of the use of CBD on patients suffering from memory disorders (Alzheimer’s Dementia, Lewy Body Dementia, Parkinsonian dementia, Alcohol related Dementia) as well as potential other ailments. The more research that is performed on the cannabis plant that can demonstrate the use of cannabis is safe and effective as a medicine, the more widely prescribed/recommended it will be in domestically and globally. Michael C. Patterson, founder and CEO of U.S. Cannabis Pharmaceutical Research & Development of Melbourne, is a consultant for the development of the medical marijuana industry nationwide and in Florida. He serves as a consultant to Gerson Lehrman Group, New York and helps educate GLG partners on specific investment strategies and public policy regarding Medical Marijuana in the U.S. and Internationally. He can be reached at mpatterson@uscprd.com

A poll of the virtual general session confirmed the sentiment to not only repeat the virtual breakout option but to do it on a monthly basis. You asked and we listened! Join us for the next East Orlando Chamber Healthcare Council Collaborative Virtual Meet & Greet Thursday, September 10, 2020 at 8:00 AM. The East Orlando Chamber Healthcare Council Collaborative is focused on the entire landscape with special attention to offering focused peer-to-peer networking to increase referral sources. We will introduce your neighboring physicians, more about the Healthcare Collaborative and how the EOCC is helping grow your practice through referrals, community outreach and new opportunities with increased revenue potential. If you are a physician or healthcare professional, register today. RSVP is requested. Want to know how else the Chamber can work with you to elevate your business? Let’s meet to discuss your business objectives and how the EOCC helps drive results making you a long-term member of one of the oldest established chambers in Central Florida. John Kelly with Orlando Medical News is a big fan. “Our audience is healthcare, but our advertising partners are small local businesses. Sales is all about relationships. The best part of the East Orlando Chamber is it fosters relationships. At the end of the day the thing that stands out to me most importantly is the leadership. They sit down with membership, learn about your prospects & connect you with chamber members.” As we reach half a year of the COVID-19 nightmare, many businesses are teetering on the brink, trying to decide which expenditures make sense to continue. So, you ask yourself why you should consider membership in the East Orlando Chamber. As businesses are looking at ways to save money, they also seek ways to retain and attract employees. Not only does the chamber offer networking opportunities and great cost-saving benefits, but it now provides a direct primary care plan and health benefits program, with a group rate with pricing individuals would find hard to beat. The chamber partnered with Joe Filice, president of Avalon Insurance Services, to provide members some of the most unique benefits around. In fact, this move makes our organization the first chamber in the state to offer an affordable package for any size business. Have we piqued your interest? Give us a call to find out more at (407) 277-5951 or visit our website at eocc.org. The East Orlando Chamber of Commerce everywhere East of I-4. Dorothy Hardee is the administrator of the East Orlando Chamber of Commerce.

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SEPTEMBER 2020


Heading Back to School with Asthma in the Time of COVID-19 Steps parents should take to protect their child with asthma in the new year Each year when summer break ends and school begins, parents of kids with asthma often face anxiety about a new environment, a new teacher and the potential of new asthma triggers in the classroom. This year, anxiety is heightened because of the increased health risk that people with asthma face if diagnosed with COVID-19. Nationwide, asthma is the most common chronic condition among children and here in Orlando, there are more than 61,000 children who live with the disease. In 2010, there were 640,000 pediatric emergency room visits due to asthma in children 15 and younger, and asthma remains the number one cause of school absences. Whether a child is physically headed back to the classroom or engaging in distance learning, it is important that parents, teachers and the children’s healthcare provider discuss all factors that could impact the child’s asthma in the new school year. When heading back to the physical classroom, children with asthma can face poor indoor air quality, especially since the school has been vacant for several months. Dust, dirty HVAC filters and classroom pets can irritate a child’s asthma or even cause an asthma event. And these factors aren’t limited to the classroom. Pet dander, mold, dust and dirty air filters can cause asthma exacerbations at home. Now, with the threat of COVID-19, parents have more to consider when their child with asthma starts school. Children with moderate to severe asthma may be at higher risk of getting more serious symptoms if they are infected with COVID-19, but the disease is so new that experts are still doing research on this topic. We recommend that parents of children with asthma take these steps to ensure that school – whether in the classroom or at home for distance learning – stay safe and healthy in the new year:

request a quick-relief inhaler with a valved holding chamber/spacer. Make sure to keep one at home and one at school. The use of a nebulizer may spread COVID-19 virus particles in the air and may not be allowed to be used in school settings. 4. Learn about the signs of unhealthy air: Are you concerned about the quality of air in your local school or at home? Learn the signs and symptoms

that can indicate unhealthy air. Learn how to identify problems and solutions regarding indoor air quality. During the COVID-19 pandemic, many parents face difficult decisions on whether to send their child back to the classroom or keep them at home for distance learning. These decisions can be more challenging with children with asthma, so we encourage these parents to follow the steps provided and get more resources on pediatric asthma at Lung.org.

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1. Review your child’s Asthma Action Plan: Before school starts, visit your child’s healthcare provider for their annual check-up and review their Asthma Action Plan. During this visit, make sure that your child is up to date on all vaccinations, including the annual flu shot.

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SEPTEMBER 2020


OPINION

Barriers Remain

Why a Practice Should Outsource Medical Billing BY JEFF RAMOS

JAMES CARPENTER

MSN, APRN, FNP-BC President/CEO | The Health Carpenter

The revenue cycle is a critical part of any practice. As we depend more and more on technology to run our daily lives and business functions, it’s important to ensure your practice is equipped with the right tools to meet your practice’s needs while you grow. The cost and complexities associated with creating and running internal billing is very high. The administrator will need to hire, train, certify and carry out an increasingly complex compliance plan. The average cost of recruiting, hiring, and training a new employee is estimated to be between $3500.00 and $4200.00, and does not include the decreased production caused by turnover. When selecting a third party partner, the ideal outcome is to select a third-party billing partner who can help you generate more income through lowering labor costs, and increasing revenue through denial management, self-pay follow-ups, and calculating fees. Your billing partner needs to have a strong handle on the practice’s critical KPI’s and the practice manager should be sharing and discussing these on a regular basis. A quality RCM partner will stay current on all of the changes in health regulations and keep the providers current so they can focus on what they do best.

Billing is a vital part of daily life in a medical practice and it is often a predictor if a practice is financially strong. Many practices have a good handle on this important part of the revenue cycle, but have difficulty determining when it’s time to look into third party billing. There are many things to consider when evaluating the needs of your practice and whether third party billing would be beneficial for your practice. The following is a list of things to consider as you evaluate your own practice and the many benefits of • Collection amounts continue to increase, and cash recovery is poor. • Coding rejections keep occurring. • Chronic credentialing issues. • Changing reimbursement models If you are experiencing some of the above-mentioned scenarios, perhaps its time to take a look at outsourcing with a third party.

Jeff Ramos, CMRM, can be reached at Elevate Medical Resources, specializing in practice management, revenue cycle optimization, and private practice business support by emailing Jeff@elevatemedicalresources.com

I am a board-certified family nurse practitioner and owner of The Health Carpenter in Orlando, Florida, where our principal goal is to increase access to affordable health care. My first few weeks in practice have provided a great perspective on the subject of access to care. Although legislation went into effect, allowing nurse practitioners to practice independently, the board has yet to release an application enabling us to do so. My education and training have given me the tools to provide the care that our community deserves. Still, the barriers for a healthier community remain almost impenetrable, and immediate action is necessary, especially in light of our current pandemic.

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SEPTEMBER 2020


ORLANDO || GRAND ROUNDS

Digestive and Liver Center of Florida Opens Newly Renovated Location Digestive and Liver Center of Florida, an industryleading Gastroenterology and Colorectal practice, is on the rise and expanding now more than ever. The newly renovated location, at 737 W. Oak Street in Kissimmee FL, is the company's second office that has a state of the art endoscopy center. The new office is located in the landmark at 737 W. Oak Street, located right off of John Young Parkway in Orlando. With three new physicians adding to the practice alone in Q3, it leaves no question as to why the practice has added yet another endoscopy center to their company. Digestive and Liver Center of Florida specializes in abdominal pain, colon cancer, constipation, Crohn's disease, GERD, hepatitis, pancreatic cancer, rectal bleeding, ulcerative colitis among others. Adding another endosco-

py center for the south Orlando region is a strategic move that will allow them to have a physical presence in a place where there is a high driven medical need market. For more information about the new Digestive and Liver Center of Florida office, contact info@dlcfl.com. Digestive and Liver Center of Florida is an independently owned and operated medical company. With six Gastroenterolgists and three Colorectal Surgeons, they

Pinnacle Adds CovID Rapid Antigen Detection Test

Digestive & Liver Center of Florida Welcomes Sheryl Rosa-Cruz, MD

Pinnacle IVD (Pinnacle) is pleased to announce the addition of the CovID Rapid Antigen Detection (RAD) test to its existing diagnostic test product line which includes the Pinnacle CovID NEO IgG / IgM Antibody Test. The RAD is one of the first point of care antigen tests that requires no additional laboratory equipment, and is able to provide highly accurate results in just 15 minutes. It has been submitted to the FDA for Emergency Use Authorization (EUA), and promises to play a pivotal role in America’s fight against COVID-19 by providing quick, easy detection of active virus. As pioneers in colon cancer screening and other in vitro diagnostics, Pinnacle has once more jumped to the forefront of the medical device industry, by pairing the RAD with cutting edge smartphone technology. Due to this pairing much needed non-personal data and streaming analytics are able to be provided to the CDC, and other health agencies to aid them in implementing a targeted and effective strategy for combatting the COVID-19 pandemic. “Our team is working collaboratively with strategic partners and the FDA to provide the highest quality testing protocols, educational materials, and risk mitigation strategies to ensure safe and effective use of our COVID-19 testing solutions,” said Charlie Balentine, President of Pinnacle IVD Corporation. “We believe pairing a point of care antibody test with a point of care antigen test can give providers the information they need to take action without dealing with the issues caused by increasingly long wait times for laboratory results. We’re also taking steps to scale our US and global manufacturing capacity to meet the overwhelming demand. We look forward to doing our part to get America and the world back to work, and our children back to school safely by providing practical, scalable COVID-19 testing solutions.” In order to fast-track Emergency Use Authorization, Pinnacle is working closely with the FDA, it’s legal counsel Foley and Lardner LLP, Syntactx, a Clinical Research Organization, George Mason University and other partners to perform clinical studies. The results of those studies will be posted on Pinnacle’s website at https://www.pblabs.com/products/pinnacle-rapidantigen-test For sales and distribution information please contact 1-877-465-0826 or email covidinfo@pblabs. com in order to be connected with our authorized distributors.

Senior Partners, Dr. Harinath Sheela and Dr. Srinivas Seela, are pleased to announce that Dr. Sheryl Rosa-Cruz will be joining their practice. She will be one of two Spanish speaking, female Gastroenterologists starting early September and will be seeing patients at Digestive and Liver Center in Sanford at 1403 Medical Plaza Drive, Suite 206 in Sanford and at 100 N. Dean Road in Orlando. "Having the addition of another female GI is excellent for our practice and the fact that she is Spanish speaking as well, is substantial," said Nicole McElfresh, marketing director at Digestive and Liver Center of Florida. Dr. Rosa-Cruz has a dual board certification in Internal Medicine and Gastroenterology. She received her Doctor of Medicine from the Universidad Autonoma de Guadalajara in Mexico in 2009, where she graduated with honors. Afterward, she fulfilled her internship year at the New York Medical College. Continuing her training, she completed her specialty in Internal Medicine and then her fellowship in Gastroenterology at the VA Caribbean Healthcare Center in San Juan, Puerto Rico. After residency and prior to starting fellowship, Dr. Rosa-Cruz had the privilege of being Chief Resident for a year, and she was also appointed the Chief Fellow in her final year of the Gastroenterology subspecialty training. Dr. Rosa-Cruz's interests include diagnosing and treating all gastrointestinal disorders including Gastroesophageal reflux disease (GERD), abdominal pain, H.pylori, peptic ulcer disease, constipation, diarrhea, irritable bowel syndrome, inflammatory bowel disease, and liver disorders among others. She is also an advocate of the importance of timely colorectal cancer screening. She is a member of the American College of Gastroenterology, the American Gastroenterology Association, and a Diplomate in the American Board of Gastroenterology.

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create a team of excellence. Digestive and Liver Center of Florida was founded in 2005, by two brothers who had a dream of providing medical excellence. Along with their current medical office, Digestive and Liver Center of Florida also has an in-house EndoSurgical Center and operating room. The Physicians of the Endo Surgical Center of Florida, LLC welcome you to the Endoscopy Center in East Orlando, a free-standing ambulatory center in the state specializing in endoscopy, offering patients a convenient, yet sophisticated alternative to the hospital. The center's location on Dean Road was carefully chosen for its surroundings; safe and free parking and easy access to Rt. 408 and Rt. 417. The physician staff is comprised of board-certified Gastroenterologists who have served in Orlando and trained at Yale University School of Medicine and Medical College of Virginia. The subspecialties offered within the group provide a broad range of expertise in the gastrointestinal field. We believe that our team of physicians and nurses are second to none.

Moffitt Cancer Center, AdventHealth launch first collaborative cancer clinical trial in Central Florida Moffitt Cancer Center and AdventHealth, after announcing their major partnership last September, have launched their first collaborative clinical trial – a Phase I trial testing the effectiveness of a promising new combination therapy for lung cancer. The focus of the trial is to discover the effects of the drug ceritinib (Zykadia®) used in combination with docetaxel (Taxotere®) on participants with a specific type of non-small cell lung cancer. Both drugs are FDA approved cancer treatments; this trial will assess their effectiveness in combination with one another. The trial, which is now accruing patients, is open at AdventHealth Celebration, where a Moffitt – AdventHealth clinical research unit is in the final stages of construction and is scheduled to open this fall. The new facility will have 28 chairs in the infusion center to provide standard-of-care therapies and 14 chairs in the clinical research unit, where investigation treatments will be administered. Care will be provided to patients with solid tumors and blood cancers. The opening of the trial is another significant milestone in the partnership’s goal to establish AdventHealth as a consortium partner within Moffitt’s National Cancer Institute (NCI) Cancer Center Support Grant, which signifies NCI Comprehensive Cancer Center designation. NCI designation is the gold standard for cancer research and positively influences clinical care. It’s bestowed upon the nation’s top institutions in recognition of innovative and impactful science, interdisciplinary research, education and training, and the ability to translate discoveries into patient care. Moffitt and AdventHealth have established a research consortium that both institutions hope will be recognized by the NCI in 2026.

Ponte Health's PHirst App has Deployed The technology team at Ponte Health has deployed their first application into the market, available for download on iOS at the Apple App Store. PHirst App is a one-touch application for improving the health, safety and welfare of the public. With a simplified user interface, PHirst App ensures ease of use for all ages and languages, offering one’s personal Care Circle a quick and effective response experience. PHirst App has one goal in sight: to keep loved ones safe, preserve their wellbeing, and provide opportunity for response immediately when needed.

SEPTEMBER 2020


NORTH CENTRAL FLORIDA || GRAND ROUNDS

Interventional Cardiologist Joins AdventHealth’s Employed Group of Doctors

Ocala Health Receives Get with the Guidelines-Stroke Gold Quality Achievement Award OCALA – Ocala Health has received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, researchbased guidelines founded in the latest scientific evidence. Ocala Health earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. Care transition interventions such as patient education before discharge and follow-up visit scheduling are also a part of the quality achievement measures that Ocala Health implements in order to ensure patients remain on the

Community Health Centers Adds Third Covid-19 Drive-Up Test Site Community Health Centers, Inc. will be adding a third drive-up COVID-19 testing location beginning on Friday, September 11th in the Four Corners area of south Lake County. This new drive-up testing location is located in Cagan Crossings at 509 Cagan View Rd, Clermont, FL 34714. Testing is available to high risk and symptomatic patients including shortness of breath, fever, body aches and/or cough. Testing will be done by appointment only for new and existing patients. To schedule an appointment, call 407905-8827 or 352-314-7400. Community Health Centers – Pine Hills 840 Mercy Dr, Orlando, FL 32808 Monday and Thursday’s 9:00 a.m. to 4:00 p.m. Community Health Centers – Apopka 210 E 7th St, Apopka, FL 32703 Tuesday & Wednesday’s 9:00 a.m. to 12:30 p.m. Community Health Centers – Four Corners 509 Cagan View Rd, Clermont, FL 34714 Friday’s 9:00 a.m. to 12:30 p.m. There is no cost for the COVID-19 test, however, depending on health insurance, a medical visit fee may be applicable. Patients may also qualify for our sliding discount program, based on family size and income.

road to recovery. Ocala Health additionally received the Association’s Target: Stroke Elite award. To qualify for this recognition, hospitals must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke. Also, Ocala Health received the Association’s Target: Type 2 Honor Roll award. To qualify for this recognition, hospitals must meet quality measures developed with more than 90 % of compliance for 12 consecutive months for the “Overall Diabetes Cardiovascular Initiative Composite Score.” Ocala Regional Medical Center has also met specific scientific guidelines as a as a Comprehensive Stroke Center, featuring a comprehensive system for rapid diagnosis and treatment of stroke patients admitted to the emergency department.

UF Health The Villages® Hospital Receives Get With The Guidelines

UF Health Leesburg Hospital Receives Award: Stroke Honor Roll Silver Plus Quality Achievement Award

– Stroke Silver Plus Quality Achievement Award

University of Florida Health Leesburg Hospital has received the American Heart Association/American Stroke Association’s Get With The Guidelines® Target: Stroke Honor Roll Silver Plus Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. UF Health Leesburg Hospital earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. Before discharge, patients should also receive education on managing their health; have a follow-up visit scheduled; as well as other care transition interventions. UF Health Leesburg Hospital additionally received the association’s Target: StrokeSM Honor Roll award. To qualify for this recognition, hospitals must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke.

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Interventional Cardiologist Dr. Cesar Jara has joined AdventHealth Medical Group. Jara is board certified in internal medicine, cardiovascular diseases, interventional cardiology and cardiac computed tomography. In his new practice, Jara will specialize in cardiovascular disease prevention and management, interventional cardiology, coronary and peripheral vascular interventions, structural heart disease and more. Jara received his medical degree from Universidad Peruana Cayetano Heredia in Lima, Peru. He completed an internal medicine residency, chief medical resident attending year, as well as cardiology fellowship and an interventional cardiology fellowship, at the University of Miami Miller School of Medicine. Through his 15-year career, Jara has been continually involved in quality initiatives, as well as program development. He served as cardiac catheterization lab medical director for Health First's Cape Canaveral Hospital in Cocoa Beach and helped launch the interventional cardiology program for the catheterization lab in 2010. He also served as the first structural cardiologist for the hospital’s Transcatheter Aortic Valve Replacement (TAVR) program in 2015. He is a Fellow of the Society for Cardiovascular Angiography and Interventions (FSCAI) and served as an elected member of the organization’s quality committee. In addition, he is a Fellow of the American College of Cardiologists (FACC).

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University of Florida Health The Villages® Hospital has received the American Heart Association/American Stroke Association’s Get With The Guidelines® - Stroke Silver Plus Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. UF Health The Villages® Hospital earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. Before discharge, patients should also receive education on managing their health; get a follow-up visit scheduled; as well as other care transition interventions. “UF Health The Villages® Hospital is dedicated to improving the quality of care for our stroke patients by implementing the American Heart Association’s Get With The Guidelines – Stroke initiative,” said Carolyn Stewart, ARNP, stroke coordinator at the Hospital. “The tools and resources provided help us track and measure our success in meeting evidence-based clinical guidelines developed to improve patient outcomes.” UF Health The Villages® Hospital is also recognized on the association’s Target: StrokeSM Honor Roll with the Bronze Quality Achievement Award. To qualify for the Target: Stroke Honor Roll, hospitals must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke.

SEPTEMBER 2020


VOLUSIA/BREVARD || GRAND ROUNDS

Halifax Health Offering Sign On Bonus for Nurses

On Aug. 3, AdventHealth Daytona Beach CEO Ed Noseworthy (right) presented Rainer and Julie Martens, founders of Pictona, with a check for $100,000 as part of a five-year partnership with the new 24-court pickleball complex in Holly Hill.

AdventHealth and Local Pickleball Complex Announce Five-Year, $100,000 Partnership AdventHealth Daytona Beach has announced a fiveyear, $100,000 partnership with Pictona, the $6 million, 24-court pickleball complex in Holly Hill that opened to the public on July 15. The name Pictona is a creative amalgamation of “pickleball” and “Daytona Beach.” Pickleball is one of the fastest-growing recreational sports in the country. According to a report by the Sports & Fitness Industry Association, there are an estimated 3.3 million pickleball players in the U.S., and the USA Pickleball Association reported a 650% increase in the number of people playing the sport over the previous six years. Played by all ages, pickleball has become especially popular among those 55-and-older because it has a lower impact on the knees, shoulders and hips. Located at 1066 Ridgewood Ave., Holly Hill, Pictona is one of the largest facilities of its kind in Florida. “Both of our organizations are committed to improving the health and wellbeing of the communities we serve,” said Ed Noseworthy, AdventHealth Daytona Beach CEO. “As part of our partnership, we’ll provide health

Harry (Buddy) Blanke, MD Joins Halifax Health Harry (Buddy) Blanke, MD., a boardcertified family physician, has joined the medical team at Halifax Health – Primary Care New Smyrna Beach, 807 State Road 44, New Smyrna Beach. Dr. Blanke is a retired Colonel from the United States Air Force where he served on active duty for almost 28 years. He received his Bachelor of Arts degree from The Citadel, a Master’s Degree from Webster University, and a Master’s Degree in Strategic Studies from the Air War College before taking his pre-requisite science classes for medical school at Spartanburg Community College and the University of South Caroline-Upstate. He attended the Medical University of South Carolina for medical school and completed his residency at Halifax Health – Family Medicine Residency Program, service as chief resident his third year. Dr. Blanke provides full-spectrum care including preventive care, sports, geriatric and community medicine, women’s health and minor surgical procedures.

screenings and classes on diabetes and nutrition, including youth nutrition classes using Pictona’s community garden.” All 24-courts, including the 16 outdoor ones, have LED “tournament-level” lighting to allow for nighttime play, and the eight covered courts will be sponsored by AdventHealth. In addition to competitive tournaments, the complex will offer fitness classes and yoga, healthy eating classes, youth development programs, and workshops for physical education teachers to help bring the sport to local students. There will also be outdoor recreational games, including croquet, shuffleboard, bocce ball, table tennis and horseshoes. The first competitive tournament will be in October and is expected to draw 400 players from throughout Central Florida. In October 2021, Pictona is scheduled to host the USA Pickleball Association’s Atlantic South Regional Tournament which is expected to draw 700 to 800 players from multiple states as well as at least 1,000 spectators.

Halifax Health | Brooks Rehabilitation – Center for Inpatient Rehabilitation Welcomes Dr. Ivy Garcia. Ivy Garcia, MD, board certified in physical medicine and rehabilitation, has joined the team at Halifax Health|Brooks Rehabilitation – Center for Rehabilitation. A graduate of the Universidad Autonoma De Centro America in San Jose, Costa Rica, Dr. Garcia completed an internship at Ponce University Hospital in Ponce, Puerto Rico. She later completed residency training in physical medicine and rehabilitation at Kansas University Medical Center, in Kansas City, Kansas. Dr. Garcia went on to become medical director of both the Kansas Medical Center Inpatient Unit, as well as the Consult Service and received the Faculty Award of Excellence from the University of Kansas Department of Rehabilitation Medicine. Dr. Garcia is a member of the American Academy of Physical Medicine and Rehabilitation. Ivy Garcia, MD will be joining Jorge Perez, MD and Meghan Cochrane, MD at Halifax Health | Brooks Rehabilitation – Center for Inpatient Rehabilitation, a 40-bed state-of-the-art inpatient rehabilitation center. As a physical medicine and rehabilitation physician, Dr. Garcia will be evaluating patients and designing comprehensive, patient-centered treatment plans for patients, that will maximize their function and quality of life. Halifax Health and Brooks Rehabilitation’s partnership began in 2013 with the opening of an inpatient rehabilitation center at Halifax Health Medical Center of Daytona Beach. The facility was created to serve a wide variety of rehab patients. As the area’s only Level II Trauma Center and designated Comprehensive Stroke Center, Halifax Health can care for patients with spinal cord, stroke, traumatic brain, amputee, and complex orthopedic injuries with long-term rehab needs close to home. Brooks Rehabilitation in Jacksonville has been a leading provider of physical and neuropsych rehabilitation services for more than 40 years and is the highest accredited rehab provider in Florida. To learn more about the Halifax Health|Brooks Rehabilitation – Center for Rehabilitation, visit www.halifaxhealth.org/brooks or call 877.842.5432.

Vascular Surgeon Joins AdventHealth’s Employed Group of Doctors Vascular surgeon Dr. Willythssa Stephie Pierre-Louis has joined AdventHealth Medical Group. As an AdventHealth Medical Group physician, Pierre-Louis joins AdventHealth’s employed group of physicians with more than 300 providers, including 160 primary care doctors and specialists in Volusia, Flagler and Lake counties. In her new practice, she provides a full spectrum of vascular surgery services and has a special interest in carotid disease, thoracic and abdominal aneurysms, venous disease, dialysis management and lower extremity arterial disease. She earned a Bachelor of Science in biophysics and structural biology with a minor in mathematics, as well as her medical degree, from the University of Connecticut. She also completed a residency in integrated vascular surgery from the University of Cincinnati Medical Center. She is a member of the Society for Vascular Surgery, the Vascular and Endovascular Surgery Society, the Society for Clinical Vascular Society, and the American College of Surgeons. Pierre-Louis is fluent in French and HaitianCreole, and proficient in Spanish.


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Get Back to Work, School & Play 15 Min./24 Hr. Results • 15 Min. Antibody Test - $59.95 • 24 Hr. PCR Nasal Swab Coronavirus test - $25w/Insurance $105 without Insurance

A new series of RAPID Covid Testing centers are now opening across central Florida offering 15 minute Serology (finger prick test) results and PCR (nasal swab) results in only 24 hours. Covid Testing LLC are an Orlando based firm who recognized the current challenges people were having in terms of the speed that testing was taking and results were being delivered, and have created drive through locations where the patients arrive and remain comfortably in their cars. No appointment is necessary. Our Serology blood test will test for IgM and IgG indicating both the presence of an active virus older than 5 days, and whether the patient formerly had the virus and now has the antibodies. The results will be provided to the patient in 15 minutes while onsite The PCR will show if the patient has an active virus within the 5 days. In addition, the PCR results are e mailed to the patient so that they can then travel. Covid Testing LLC also works with companies, Schools and physician’s offices to provide both appointment and group bookings. Additionally, with large groups they can come to your location. The price for the testing is $59.95 for the Serology and the PCR is covered under insurance, however there is a $25 rush service charge in order to deliver the results in 24 hours from the Orland based Lab . The initial site is located on 33rd next to the Fields Lamborghini Motorscars dealership, and near to the Millenia Mall. Additional locations are planned to open shortly including near to the Orlando airport on South Semoran, Winter Park, Sanford, Kissimmee, and the Villages. Covid Testing LLC is here to service the Orlando community and ensure that we can all return to normal as soon as possible. For more information call 1888 – 341-1711 or visit www.covidtestingllc.com.

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SEPTEMBER 2020

Profile for Orlando Medical News

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