September/October 2022 Arkansas Medical News

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Coronaphobia, a Perplexing Social Anxiety Disorder

ON ROUNDS

Slow pandemic reintegration posing a problem for healthcare professionals

A Joint Effort Orthopaedic surgeon Lawrence O’Malley educating providers, patients about sports medicine’s changing role Orthopaedic surgeon Lawrence O’Malley, MD, is bringing sub-specialized care to Arkansans of all ages. Starting Out A sports medicine specialist at UAMS Baptist Health Orthopaedic Clinic-Conway, O’Malley is a Memphis native who developed an interest in medicine early on.

By LYNNE JETER Coronaphobia, a newly minted term, perhaps best describes patients suffering from social anxiety spurred by the pandemic – and it’s a problem for doctors. Some patients have become accustomed to sequestering in their homes during the early stages of the pandemic – while also transitioning to zoom meetings and phone calls with medical providers – that they’re reluctant to return to in-person visits, especially when restrictions are placed on companions in the waiting room. The problem has led to more-than-usual cancellations and no-shows. “Coronaphobia describes the excessive fear of contracting the virus and the stress and avoidance of public places and situations that result from fear,” said Mary-Catherine Segota, PsyD, co-founder of Counseling Resource Services. “An increase in anxiety during the pandemic led to fears of leaving the (CONTINUED ON PAGE 4)

HealthcareLeader

Article on page 2

The Waiting is the Hardest Part

Navigating the Pandemic, Greg Sharp, MD, CMO, Arkansas Children’s Hospital

Consider this common scenario: A new physician joins your practice – whether from out-ofstate, residency, or another practice. Your practice is contracted with a multitude of payors including Medicare, Medicaid, TRICARE, managed care organizations (MCOs) that administer some of these programs, and various commercial payors. Article on page 4

Please find more local Arkansas healthcare news beginning on page 7.

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Covid has changed the landscape for other common childhood illnesses By BECKY GILLETTE

The COVID-19 pandemic has changed the landscape for other common childhood illnesses such as Respiratory Syncytial Virus (RSV).

Greg Sharp

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PhysicianSpotlight

A Joint Effort

Orthopaedic surgeon Lawrence O’Malley educating providers, patients about sports medicine’s changing role By MELANIE KILGORE-HILL

Orthopaedic surgeon Lawrence O’Malley, MD, is bringing sub-specialized care to Arkansans of all ages.

Starting Out

A sports medicine specialist at UAMS Baptist Health Orthopaedic Clinic-Conway, O’Malley is a Memphis native who developed an interest in medicine early on. “My mother was a nurse and my dad had a lot of health problems, including two transplants, so I was always around medicine and thought I wanted to be a physician,” he said. After graduating from Kentucky’s Murray State University, O’Malley earned his medical degree from the University of Tennessee and developed an interest in orthopaedics while working at a surgery center in college. He went on to provide care for Clemson University athletics from 20132015, and for Tulane University athletics from 2015-2016. He also served as the head team physician at the University of Tennessee-Martin and provided care for the Jackson Generals, the Double-A affiliate of the Arizona Diamondbacks.

Coming to Arkansas

O’Malley relocated to Arkansas in 2017, shortly after the University of Arkansas for Medical Sciences opened a Conway clinic in conjunction with Little Rock-based Baptist Health. “The position opened at UAMS that was just sports medicine and what I love most is arthroscopy, so it was just the right fit,” he said. He now sees patients from Jonesboro to Fort Smith - often rural Arkansans grateful to receive subspecialty care without the drive to a big city. “Patients are starting to understand the difference between a general orthopaedist, who does a little bit of everything, and a sports medicine practice like ours where we each do one thing all the time and utilize other subspecialty partners within the group,” he said. O’Malley focuses much of his practice on shoulder, hip and knee arthroscopies performing 15 or more surgeries a week - typically a conglomerate of arthroscopic rotator cuff and shoulder labral repairs. “What patients need is what I do,” he said, noting frequent surgeries of the knee, ACL, meniscus, multi-ligament knee injury and hip arthroscopy. 2

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Advances in Arthroscopy

O’Malley said arthroscopy has been around for nearly a half century, while rotator cuffs and ACLs started in the late 90s. Hip arthroscopy has evolved greatly in the past decade and is becoming more refined, along with rotator cuff techniques, thanks primarily to improvements in stronger anchors. “With arthroscopy the original problem was a lack of good anchors,” he said. “Today’s high strength suture helps the tendon to anchor in a knotless design so it’s not abrasive.”

Redefining Sports Medicine

Another welcome change is increased awareness of demographics in sports medicine. “Sports medicine isn’t just for high school and college athletes,” said O’Malley, whose practice includes patients aged 13 to 85. “Anybody is a candidate for arthroscopy.” While he treats the young and old alike, O’Malley said there’s been a definite uptick in adult patients sustaining injuries from popular fitness programs that contribute to overuse. “When I was a resident, P90x was in style and we saw a lot of injuries from that,” he said. “Now it’s a variant of other high intensity strength and conditioning type workouts that are causing overuse injuries.” He advises patients to be mindful of age and limitations rather than comparing themselves. “People who are 20 and people who are 40 shouldn’t necessarily be lifting the same weight,” he said. “We get in trouble when we’re 50 and think we’re 20. We need a mindset that says, ‘I want to stay healthy and active and lift what I can, but I have limitations and don’t need to compete with the guy next to me.’ Our strength may be there, but it’s not all the same.”

Avoiding Overuse

Runners are especially prone to overuse injuries, along with baseball, softball and volleyball players. That’s because many of today’s athletes play year-round on travel, club and school teams, rarely taking time off or mixing up sports. “The better athletes are multi-sport, because we weren’t created to repeat the same throwing motion year-round,” he said, noting the added mental health advantages of changing sports. “I see twelve and

While he treats the young and old alike, Lawrence O’Malley, MD, said there’s been a definite uptick in adult patients sustaining injuries from popular fitness programs that contribute to overuse. 13-year-old pitchers who’ve been the best on their team for four years but wore their shoulders out by high school, and they’re being replaced by kids who’ve matured properly. We have to stop overuse of young athletes and give them breaks to protect from overuse injuries.” O’Malley, who enjoys running, weight lifting and intermittent HIIT workouts, said it’s crucial that athletes of all sports crosstrain, whether it’s swimming, biking or Crossfit. “You need to work out the entire body to achieve maximum results, and weight training is a crucial part of that,” he said. O’Malley especially promotes strength training in senior adults at increased risk for osteoporosis - a disease he considers “an epidemic in our older population.” “It doesn’t have to be heavy, but some resistance exercises are important because bones like being resistant,” he said, noting the importance of motion and tension in orthopaedic healing.

Primary Care and Orthopaedics

While he’s advocating for changes in the sports world, he’s also educating providers about their role in orthopaedic care. “I see plenty of patients who've come in with an MRI diagnosis that could’ve been made over X-ray,” he said. “I know it can be difficult for a PCP to order an X-ray before an MRI, but it’s so

often unnecessary and adds to overall healthcare costs.” In the absence of trauma, he encourages providers to prescribe anti-inflammatories and physical therapy rather than advanced imaging. “Don’t rush MRIs, because often scans will show some sort of tearing in athletes, but that may not be the cause of their pain,” he said. “There are a lot of adaptive features that develop when someone’s constantly throwing a ball, so it’s usually (with throwing athletes) a therapy problem and not a surgical problem.” He also encourages providers to reach out for a second opinion. “Don't’ be afraid to say, ‘I don’t understand this MRI,’” he said. He also said it’s crucial for PCPs to provide patients with scan results prior to seeing a specialist. “So often patients are coming from another facility and we don’t have access to their imaging, since it can’t always be emailed,” he said. “As orthos we want to see the actual image to help make a quick diagnosis and minimize the number of office visits.” As part of the largest orthopaedic group in Arkansas, O’Malley said patients at UAMS Baptist Health Orthopaedic Clinic-Conway receive the same level of care sub-specialists would provide for their own families. “There’s not a partner here I wouldn’t let operate on my family,” said O’Malley, a husband and father. “That’s just how we practice.” arkansasmedicalnews

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Navigating the Pandemic, Greg Sharp, MD, CMO, continued from page 1 “It is an interesting phenomenon,” said Arkansas Children’s Hospital Senior Vice President & Chief Medical Officer Greg Sharp, MD. “We didn’t see RSV the first year of COVID. About half the kids were at home instead of at school. RSV commonly affects infants and young children who are often infected when the virus is brought home by older siblings. So that spread of infection was significantly diminished by kids being homeschooled and precautions at school such as kids washing hands frequently, classrooms not as full, masks required and distancing, with a collective effect of decreasing normal infections.” Normally the highest incidence of RSV illness is in the winter months. It will usually begin in late November with January to February the peak time for illness and hospitalizations. In the first winter of COVID, hospitalizations for RSV were very low. “Then, in the spring and summer of 2021, COVID numbers were diminishing and people started to let their guard down,” Sharp said. “Many people quit wearing masks in social situations. We had a tremendous surge of RSV in May, June and July of 2021. We had a typical rate of January RSV and associated hospitalizations occur in June and July. We had never experienced that before. Our hospital was full, and other hospitals around the U.S. and the world experienced the same phenomenon.” This year there has been a mini surge of RSV and other respiratory viruses in late summer which trended up after school started. “We are definitely seeing an increase and it is yet to be seen what will happen as we go through the winter months,” Sharp said. “While there are no vaccines for RSV, I would really advocate people get flu vaccines for themselves and their kids. Flu begins in the southern hemisphere during its winter which is our summer, and flu has been pretty significant over the southern hemisphere the past three months. There are predictions that this could be a bad flu year here. We need to get kids vaccinated for the flu.” Another fallout of the pandemic has seen some children falling behind on childhood vaccinations. Sharp said there are a lot of reasons for that. In the first year, people were worried about taking their child to the doctor’s office where they might catch COVID. And some of the misinformation campaigns about COVID vaccines have led to parents having more concern about other childhood vaccines. “We want families to talk to their child’s pediatrician or primary care provider about making the decision to vaccinate. There are many sources of misinformation online, but a trusted primary care physician or pediatrician can help families find good, reputable information backed up by science.” Many scheduled vaccines are given during the first 18 months of life. If a child gets behind and doesn’t get them arkansasmedicalnews

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until they are required to attend public school, he or she is vulnerable during those gap years. Studies have indicated many parents are reluctant to give kids, particularly those 5 and under, the COVID vaccines because COVID is generally milder in children than adults. It has been fairly uncommon for otherwise healthy children to have issues with severe COVID or long COVID. Severe illness in young children is not impossible, but has been less common. But Sharp said adverse effects of COVID vaccines in children have been very low, and the benefits far outweigh the risks. “My grandchildren have been vaccinated, not just for protection of the child, but for the protection of others,” Sharp said. “A child might get a mild case of COVID, but goes to visit grandparents. We have seen severe illness and deaths in adults who were exposed to their children and grandchildren.” Another trend is a large surge of behavioral problems with children as an indirect result of COVID. Sharp said some of that surrounds the upheavals in school the first year of COVID. Other factors are not having the same level of social interactions and some of the fear that surrounds the conversation about COVID. Some children have had family members become sick or die from COVID. “All of these things have had a big impact on the psychological well-being of children,” Sharp said. It was also a difficult time for children with autism spectrum disorder (ASD). While prevalence of ASD has progressively increased over the past 20 years, Sharp suspects this is largely due to increased awareness by parents, teachers and pediatricians who are more likely to recognize ASD now. “The other thing is it is such a spectrum,” Sharp said. “On one end, you can have a child extremely affected who is essentially not verbal and very socially withdrawn. On the other end, you have mild symptomology with a child who faces some challenges in social situations. Then you have everything in between.” Sharp considers being medical director at Arkansas Children’s Hospital a dream job. “I grew up in a small town in Arkansas, Crossett,” Sharp said. “I went to medical school at the University of Arkansas for Medical Sciences, and fell in love with Children’s Hospital and pediatric healthcare. I decided to become a neurologist because at the time I was in pediatric residency, there was only one neurologist at this hospital. I recognized a need, and that determined my course to train to become a child neurologist in order to return to Arkansas Children’s. His primary rule for the job he has now held for four years is to do what is best for the children. That can mean encouraging vaccinations, selecting the best therapy for a child, or growing or

developing a new program. It’s all about meeting the needs of the children of our state. An avid fly fisherman, he and his wife, Lynn, have a house on the Little Red River. On weekends, you will frequently find him on the Little Red fishing for trout. He recently went fly fishing in Alaska. “I like being outside in nature,” Sharp said. “If you catch fish, that is a bonus but I pretty much release everything I catch. We have five grown daughters, and four grandchildren. My wife and I used to have a weekly date night eating at a new restaurant. That and many other activities like going to church in person got

curtailed significantly by COVID. We are just now starting to get out more in public. The World Health Organization recently announced we are significantly trending toward the end of COVID and I think we all look forward to getting more back to life as normal.” In addition to residencies in pediatrics at UAMS and ACH, Sharp did a residency/fellowship in child neurology at Mayo Clinic in Rochester, Minn. Sharp is board certified by the American Board of Pediatrics and by the American Board of Psychiatry and Neurology with Special Competence in Child Neurology, and Added Qualification in Clinical Neurophysiology and Epilepsy.

There are many sources of misinformation online, but a trusted primary care physician or pediatrician can help families find good, reputable information backed up by science. — Greg Sharp, Arkansas Children’s Hospital Senior Vice President & Chief Medical Officer

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Coronaphobia, a Perplexing Social Anxiety Disorder, continued from page 1 house for some, and eventually symptoms of agoraphobia and panic disorder. What does this mean for healthcare providers, and how does it influence how we screen and probe for psychiatric issues?” Individual reactions to the pandemic have differed in many ways, Segota explained. “The initial adjustment to the shock of sudden and necessary lockdown and dealing with such issues as virus contagion, contamination fears, distance from loved ones, changes in patterns and routines, and isolation was difficult for almost everyone,” she said. “Adding to this was the unanticipated extension of the pandemic spanning two-plus years, which led to additional difficulties adjusting and more distress. Now that we are beginning to return to integrated social interactions and a ‘new normal,’ we see that some individuals have not adjusted as well as anticipated nor resumed their prior level of functioning.” Preliminary anxiety related to the pandemic was initially associated with obsessive compulsive disorder and healthrelated anxieties, said Segota. “An increase in anxiety during the pandemic led to fears of leaving the house for some and eventually symptoms of agoraphobia and panic disorders,” she said. “Agoraphobia typically last six months or longer and is accompanied by symptoms characteristic of panic disorder.” Dr. Brian Thoma, an interventional pain physician for Cahaba Pain

and Spine Care in Hoover, Ala., said the nearly six-week surgical shutdown in early 2020 greatly impacted patients who rely on pain-relieving procedures to stay functional. That includes the new SGB block for patients with PTSD that many military veterans call a game-changing reset. “Early in the pandemic, I recall a young woman being referred to us for an epidural blood patch, a procedure we’re asked to do for patients with a terrible headache after a lumbar puncture,” said Thoma. “The patient was reluctant to come in, but ultimately the headache was bad enough that she wanted the procedure. Fortunately, it worked well for her.” As society transitions to a new phase of the pandemic, it’s essential to ask critical questions to help assess the presence of clinical anxiety and to help differentiate disorders, said Segota, who suggests implementing a questionnaire that assesses COVID-related stressors and socialization reintegration difficulties. “Ask about the following stressors: financial problems (difficulty paying bills, debt), work problems (unemployment, decreased hours/roles, conflicts with colleagues), educational problems (difficulty completing course work), housing problems (instability, moves), relationship problems (isolation, separation or divorce, conflict with family or friends, intimacy problems), personal or loved one's health problems (new or worsening

Brian Thoma

Jacqueline Hobbs

illness, medication issues, disability) and caregiving problems (emotional stress, time demands). Ask about mood and adjustment to changes, sleep, energy, appetite, and desires for activities outside the home. Ask about attempts to increase activities outside the house or avoidance of those activities.” Some health systems have introduced new programs to address these problems. For example, Kaiser Permanente this month is unveiling to its members on-demand emotional support through the Ginger app. Ginger’s emotional support coaches are available 24/7 to help with stress, low mood, sleep troubles and more. The first 90 days are free.

Jacqueline Hobbs, MD, PhD., an associate professor in the University of Florida College of Medicine’s department of psychiatry, emphasized the importance of the pandemic not being over. “It’s a pandemic seemingly without end. It’s a recipe for a mental health crisis,” she said. “The latest coronavirus variant is fueling a surge in cases while Americans worry about ever-more infectious versions to come.” The pandemic is so prolonged that it has become a chronic stressor, said Hobbs. “People don’t feel like there’s an end in sight,” she said. “We get little glimpses of the finish line, but then we’re right back at it.”

The Waiting is the Hardest Part By JD THOMAS AND ANDREW SOLINGER Consider this common scenario: A new physician joins your practice – whether from out-of-state, residency, or another practice. Your practice is contracted with a multitude of payors including Medicare, Medicaid, TRICARE, managed care organizations (MCOs) that administer some of these programs, and various commercial payors. You’re busy, and you want your new physician to start seeing patients immediately. But before you can bill any of these payors, the physician needs to be credentialed and enrolled with each of them. It’s a time-consuming and convoluted process, different for each payor and full of many hurry-upand-wait moments. Our example describes a medical practice, but it’s not just physicians who require credentialing. Dentists, counselors and many other healthcare providers must also be credentialed by their respective payors in order to bill for the services that they provide. Some providers are waiting 30 days to as much as a year for MCOs and other payors to verify documentation, review applications, and make approval decisions. Unfortunately, this growing backlog for government and private payors can lead to the temptation to cut corners when submitting claims 4

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during the gap between application subalready paid, may lead to overpayments. mission and approval, but by doing so Medicaid and other government payors they may ultimately create significant typically view such claims as fraudulent civil, and possibly criminal, liability. under the False Claims Act and other So, how can a civil – and even practice bill for a criminal – laws. new provider’s serMost payors Some providers are vices after a creden– including federal tialing application healthcare prowaiting 30 days to is submitted but grams, MCOs, and as much as a year before it has been commercial payors approved? Claims –retroactively apfor MCOs and other submitted for new prove providers’ payors to verify and as-yet uncrecredentials back to dentialed providers the date of applidocumentation, must be carefully cation. This prereview applications, considered in order sumes, however, to avoid compliance that the applicaand make approval issues. A significant tion is ultimately decisions. area of concern approved, and that during the credenthe provider comtialing/enrollment plies with all other process is the potential for a practice to requirements set forth by the payors. If bill for services rendered by new praca credentialing application is denied for titioners using the credentials of an alany reason, whether it’s incomplete data, ready-credentialed provider in the same failure to meet the payor’s standards, or practice. Staff may see this as an easy on any other basis, a new application way to avoid holding claims, but it comes must be submitted, and the retroactive with tremendous risk. Depending on how approval date will typically be the new the claim is billed, it likely results in inacapplication date. This means that the curate claims being submitted, and any period between the first application and claims submitted by the still-un-credenthe application denial is lost for purposes tialed provider may either be denied or, if of submitting claims, and any claims sub-

mitted by that provider during that period run the risk of either being denied or resulting in potential overpayments. Regardless of how a practice decides to handle new providers’ claims, it is imperative to understand each payor’s rules and regulations. Medicaid payors have increased their focus in this area. If a practice participates in government healthcare programs, additional attention must be paid to ensure that all claims are accurate and submitted for properly credentialed providers. Buyers considering the purchase of a medical or dental practice or practice management company would be wise to verify that no claims have been billed for non-enrolled/ non-credentialed providers under another provider’s number. Failure to exercise due care in this area can lead to significant liability.

JD Thomas is a partner at Waller and a former federal prosecutor. He advises healthcare clients in government investigations and prosecutions, qui tam and False Claims Act defense and other enforcement actions. Andrew Solinger is an associate at Waller where he assists clients in responding to investigations, audits and other inquiries brought by federal and state government agencies and regulators. arkansasmedicalnews

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Hospitals Cut Jobs and Services as Rising Costs Strain Budgets By KATHERYN HOUGHTON, Kaiser Health News

Bozeman Health had a problem, one that officials at the health system with hospitals and clinics in southwestern Montana said had been building for months. It had made it through the covid-19 pandemic’s most difficult trials but lost employees and paid a premium for traveling workers to fill the void. Inflation had also driven up operating costs. The system, which serves one of the state’s richest and fastest-growing areas, was losing money. It spent nearly $15 million more than it brought in from January to June of this year, President and CEO John Hill said. On Aug. 2, Hill announced that Bozeman Health had laid off 28 people in leadership positions and wouldn’t fill 25 open leadership jobs. The system has a workforce of about 2,400 and an approximately $450 million budget for the year. The pandemic has intensified a long-running health care worker shortage that has hit especially hard in large, rural states like Montana, which have few candidates to replace workers who depart. Expensive stopgaps — including traveling nurses — caused hospitals’ costs to rise. Staffing shortages have also left patients with longer waits for treatment or fewer providers to care for them. In addition to Montana, hospitals in California, Mississippi, New York, Oregon, and elsewhere laid off workers and scaled back services this summer. Health systems have pointed toward low surgery volumes, high equipment prices, sicker patients, and struggling investments. Parallel to those problems, hospitals’ largest expense — payroll — skyrocketed. “If you talk with just about any hospital leader across the country, they would put workforce as their top one, two, and three priorities,” said Akin Demehin, senior director of quality and patient safety policy for the American Hospital Association. Workers left the health care industry in droves during the pandemic, citing low pay and burnout. Nationwide, hospitals competed for contract workers to fill the void, which drove up prices. That left hospitals with an awkward balancing act: keep existing employees and fill essential roles while cutting costs. arkansasmedicalnews

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Bozeman Health Chief Financial Officer Brad Ludford said the system went from spending less than $100,000 a month on short-term workers before the pandemic to $1.2 million a week last fall. That number is now closer to $1.4 million a month. Overall, the system’s labor costs are roughly $20 million a month, an increase of about 12% compared with this time last year. Hill said the health system took other measures before cutting jobs: It stopped all out-of-state business travel, cut executive compensation, and readjusted workloads. Simultaneously, it tried to convert contract workers into full-time employees and to retain existing staffers though a minimum wage increase. Hill said the hospital system has had some success but it’s slow. As of mid-August, it had 487 vacancies for essential workers. “It still has not been enough,” Hill said. Vicky Byrd, a registered nurse and the CEO of the Montana Nurses Association, said nationwide shortages mean nurses are asked to do more with less help. She wants to see more hospitals offer longtime employees the kind of incentives they’ve used for recruitment, such as giving nurses premium pay for picking up additional shifts or bonuses for longevity. “It’s not just about recruiting — you can get anybody in the door for $20,000 bonuses,” Byrd said. “But how are you going to keep them there for 10 or 20 years?” Hospitals’ financial challenges have evolved since early in the pandemic, when concerns focused on covid response costs and revenue that didn’t come in because people delayed other care. In 2020, because of federal aid and a return to more normal service levels, many of the nation’s wealthy hospitals made money. But hospital officials have said the financial picture shifted early in 2022. Some hospitals were hit hard by the omicron surge, as well as rising inflation and staffing challenges. Hospitals received millions of dollars in pandemic relief from the government, but industry officials said that has dwindled. Bozeman Health, for example, received roughly $20 million in federal aid in 2020. It received $2.5 million last year and about $100,000 in 2022.

Providence, a health system with hospitals and clinics across the West, including Providence St. Patrick Hospital in Missoula, Montana, reported a net operating loss of $510 million for the first three months of 2022. (Katheryn Houghton / KHN)

John Romley, a health economist and a senior fellow at the University of Southern California’s Schaeffer Center for Health Policy and Economics, said that with federal aid drying up and inflation taking off, some hospitals may now be losing money. But he cautioned that more data is needed to determine how hospitals overall have fared compared with previous years. Providence, a health system with 52 hospitals across the West, reported a net operating loss of $510 million for

the first three months of the year. In July, Providence announced it was putting in place a “leaner executive team.” The system operates one of Montana’s largest providers, Providence St. Patrick Hospital in Missoula. Kirk Bodlovic, chief operating officer of Providence Montana, said the new structure hasn’t affected local positions yet, although he said hospital leaders are scrutinizing open jobs that aren’t essential to patient care. He said the hospital is continued on page 6

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Hospitals Cut Jobs and Services, continued from page 5 trying to reduce its reliance on contract workers. “Recruitment efforts are not keeping up with the demand,” Bodlovic said. Hospital job cuts across the nation have pushed out some health care professionals who had stuck with their jobs during the stress of the pandemic. And the cuts have meant some patients have needed to travel further for treatment. In Coos Bay, Oregon, the Bay Area Hospital faced community backlash after it announced it would cut the contracts of 56 travel workers and end its inpatient behavioral health services. Hospital officials cited the high cost of filling open positions quickly. St. Charles Health System, headquartered in Bend, Oregon, laid off 105 workers and eliminated 76 vacant positions in May. The system’s CEO at the time, Joe Sluka, said in a news release that labor costs had “skyrocketed” largely because of the need to bring in contract

clinical workers. He said the hospital ended April with a $21.8 million loss. “It has taken us two pandemic years to get us into this situation, and it will take at least two years for us to recover,” Sluka said in the release. In Montana, Bozeman Health hasn’t been able to offer inpatient dialysis at its largest hospital for months, so patients who need that service have been sent elsewhere. Hill said he expects some delays for services outside of critical care, such as lab testing. Ludford said the hope is that the system will begin breaking even in the second half of this year. About 100 miles away, Shodair Children’s Hospital in Helena halved the number of patients it accepted because of staffing shortages. It’s the only inpatient psychiatric hospital for kids in Montana and is constructing a $66 million facility to expand bed capacity. CEO Craig Aasved said the 74-bed hospital downsized roughly two years ago

instead of adding contract workers so it could leave space for patients to quarantine in case of covid outbreaks. Aasved said he’s scrambling to get another unit open. Shodair, which historically hasn’t relied on travel workers, hired four traveling workers in recent months, he said. “It’s a double whammy: We lost revenue because we’ve closed beds, and then you’ve got the additional expense for travelers on top of that,” Aasved said. “The goal is no layoffs, no furloughs, but we can’t stay in what we’ve been doing forever.” He said the hospital increased pay for some employees and opened a nurse residency program roughly six months ago to bring in new people. But those steps haven’t delivered immediate help. Nearby, the CEO of St. Peter’s Health, Wade Johnson, said the hospital closed part of its inpatient unit and scaled back hours for some services because of

staffing shortages. Some beds remain out of use. Administrators are exploring automation of more services — such as having patients order food by iPad instead of through a hospital employee. They also are allowing more flexible schedules to retain existing staffers. “Now that we’ve adapted to life with covid in many regards in the clinical setting, we are dealing with the repercussions of how the pandemic impacted our staff and our communities as a whole,” Johnson said.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

What We Owe Long COVID Patients The complexity of delivering an accurate diagnosis By DR. ZIJIAN CHEN When Gov. Andrew Cuomo shut down New York City in March 2020, we knew little about treating COVID-19. While treatment has improved considerably, most dialogue has focused on two types of patients—those with severe, even lethal illness, and those with milder symptoms. Yet there is a third category of patients: those suffering from long COVID, whose symptoms linger for an extended period or mysteriously reappear months after their original infection. Clinicians recognized the existence of these long COVID patients early in the pandemic. May 13, 2022, marked the two-year anniversary of the opening of the Mount Sinai Center for Post-COVID Care in New York City, a first-of-its-kind unit in the U.S. Since then, long COVID has emerged as one of the biggest but leastaddressed medical concerns. Anywhere from 10% to 30% of those who contracted COVID-19 suffer chronic aftereffects, some lasting many months after the initial diagnosis. These patients face increased risk of thromboembolic disease, cardiovascular complications, hepatic and renal impairment, and systemic inflammatory response syndrome. While most of the U.S. has returned to “normal” (or at least a new version of it), these long COVID sufferers, through no fault of their own, have been left behind. They may have avoided the most serious outcomes of COVID-19 initially but are missing out on the return to life as they knew it. And while these patients struggle,

so do their health-care providers—many of whom suffer from long COVID themselves after fighting on the front line as intensive care units and morgues exceeded capacity. Long COVID presents varying and unpredictable symptoms and has no known cure, so with very little information, health-care providers are facing an uphill battle when it comes to providing adequate care to these patients. The absence of a standard set of interventions leaves caregivers vulnerable to liability risks stemming from misdiagnoses—either by not recognizing that the patient has long COVID or by diagnosing long COVID when, in fact, the patient has another serious disease. Medical errors do happen; in fact, diagnostic error is the No. 1 cause of serious harm, making it the top concern for preventing patient injury. In light of these findings, patients need to present clinicians with the full range of symptoms and ask for comprehensive diagnostic tests to be run in order to identify if it’s long COVID or another ailment. In return, health-care providers need to bring experts from varying fields together. Forming a strong multidisciplinary care team, communicating clearly and often with patients, keeping detailed chart notes, conducting exploratory testing, following up frequently with the patient and proactively referring to specialists are all essential elements of effective long COVID care. If a patient suspects they suffer from long COVID or presents a variety

of symptoms after having COVID-19, their assembled care team—which often starts at the office of their primary care provider—should first rule out a separate underlying illness. Health-care professionals need to find a balance whereby they maintain, when appropriate, a high index of suspicion for long COVID, without letting long COVID become a catchall diagnosis. Knowing that long COVID can present as more than 200 symptoms affecting 10 organ systems, health-care providers find it challenging to pinpoint which ailments, if any, were a direct result of COVID-19. With so many individual symptoms, patients may see a range of specialists, calling for a high degree of collaboration between providers. That there are other ailments masquerading as long COVID emphasizes the importance of seeing patients quickly and providing a thorough evaluation. Common long COVID symptoms like chest pain and heart palpitations could also be the presentation of some other, more emergent condition. As frustrating and debilitating as long COVID can be, it can mask worse diseases that might lead to costlier medical bills and a more rapid decline in a patient’s health—as well as a higher chance for litigation against physicians if these diagnoses are missed. When signs of long COVID emerged in the summer of 2020, many doctors were skeptical. Even now—two years later— skeptics remain. Consequently, many patients feel that medical professionals continued on page 7

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PUBLISHER Pamela Z. Haskins pamela@arkansasmedicalnews.com EDITOR P L Jeter editor@arkansasmedicalnews.com ADVERTISING SALES 501.247.9189 pamela@arkansasmedicalnews.com GRAPHIC DESIGNER Sarah Reimer sarah@arkansasmedicalnews.com CONTRIBUTING WRITERS Chiraq Chauhan, Dr. Zijian Chen, Becky Gillette, Katheryn Houghton, Lynne Jeter, Melanie Kilgore-Hill, Andrew Solinger, JD Thomas All editorial submissions and press releases should be sent to pamela@memphismedicalnews.com Subscription requests can be mailed to the address below or emailed to pamela@memphismedicalnews.com. Arkansas Medical News© is privately owned and operated by Ziggy Productions, LLC. P O Box 164831 Little Rock, AR 72206 President: Pamela Z. Haskins Vice President: Patrick Rains Reproduction in whole or in part without written permission is prohibited. Arkansas Medical News will assume no responsibility for unsolicited materials. All letters sent to Arkansas Medical News will be considered the newspaper’s property and unconditionally assigned to Arkansas Medical News for publication and copyright purposes.

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GrandRounds AHA Annual Meeting HOT SPRINGS - The Arkansas Hospital Association's annual meeting will be held November 9-10 at the Hot Springs Convention Center. To register - visit www.arkansashospitals.org or call Lyndsey Dumas by phone (501-2247878) or by email (ldumas@arkhospitals. org).

Baptist Health Announces Associate Vice President of Hospital Operations in North Little Rock NORTH LITTLE ROCK – Callie Parks, who has worked in various roles at Baptist Health since 2018, was recently named associate vice president of hospital operations at Baptist Health Medical CenterNorth Little Rock. Parks’ time with Baptist Health started Callie Parks with her serving as an administrative resident before she became an administrative fellow. In September 2020, she was named associate vice president of ambulatory innovation at Practice Plus and Baptist Health. While in her associate vice president role, she had operational oversight of a number of clinics in central Arkansas, oversaw ambulatory projects with the University of Arkansas for Medical Sciences and participated in innovative practice ideas and startups. Most recently, she served as the interim vice president of operations for our Western Region, which includes Baptist Health’s Fort Smith and Van Buren hospitals. Parks received a Bachelor of Science in Biology at the University of Central Arkansas and Master of Health Administration at the University of Arkansas for Medical Sciences. She is a member of the Medical

Group Management Association and American College of Healthcare Executives.

New Doctors Join Arkansas’ Largest Cancer Center LITTLE ROCK – Arkansas’s largest cancer center, CARTI, announces the hire of five new doctors to better serve patients at their 18 locations across the state. The doctors specialize in Hematology/Oncology, Radiation Oncology, Interventional Radiology and Dental Medicine. “CARTI patients expect and deserve the best and so that’s what we look for when we recruit new doctors for our team,” said Adam Head, CARTI CEO. “Each of these new team members bring with them something unique and their skillsets will only enhance our staff as we further expand our comprehensive cancer care presence across the state.” Blake B. Jacks, MD, attended the University of Arkansas for Medical Sciences where he also did his residency. Jacks completed a fellowship in Interventional Radiology at Miami Cardiac and Vascular Institute and is board certified by the American Board of Radiology. He will be practicing Interventional Radiology at CARTI Little Rock. Derek Middleton, MD, is a graduate of the University of Arkansas for Medical Sciences. He has completed fellowships in Hematology/Oncology and is board certified with the American Board of Internal Medicine. Dr. Middleton will practice at the CARTI clinics in Little Rock, El Dorado and Magnolia. Howard Morgan, MD, joins CARTI after attending medical school at Louisiana State University Health Sciences Center, Shreveport, and completing an internship in Radiation Oncology at the University of Texas continued on page 8

What We Owe, continued from page 6 are failing them. In the early 1990s, given limited research, some healthcare providers did not yet believe that chronic Lyme was a real disease. Similar doubts have been expressed about long COVID. When health-care providers struggle with doubts about long COVID, they should remember that COVID-19 can result in something other than shortterm symptoms or death. There’s another scenario—a third category of COVID19 patients—and we need to accept that reality. This work first appeared in The New York Daily News and online at www. nydailynews.com. arkansasmedicalnews

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The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

Inflation Markets rarely give us clear skies, and there are always threats to watch for on the horizon, but the right preparation, context, and support can help us navigate anything that may lie ahead. So far, this year hasn’t seen a full-blown crisis like 2008–2009 or 2020, but the ride has been very bumpy. We may not be flying into a storm, but there’s been plenty of turbulence the first of 2022. How businesses, households, and central banks steer through the rough air will set the tone for markets over the second half of 2022. The sources of turbulence are clear. A global economy that was already vulnerable to inflation from supply chain disruptions, tight labor markets, excess stimulus, and loose monetary policy came under more pressure when Russian aggression in Ukraine added sharply rising commodity prices and pushed Europe into what may be the brink of a recession. The effects have included renewed pressure on interest rates, which hurt bond investors and contributed to tightening financial conditions, and a much more aggressive stance by the Federal Reserve (Fed) and other global central banks. Add in the typical market challenges of a midterm election year and the third year of a bull market, and it’s not surprising it’s been a bumpy ride. Understandably, rising prices, slowing economic growth, and a challenging first half for both stocks and bonds have many investors on edge, and fatigue from more than two years of COVID-19 measures doesn’t make it any easier. But markets are always forward looking, so it’s important to remain focused on what lies ahead. There will most certainly be challenges, but there are also some tailwinds from a strong job market, still resilient businesses, and the likelihood that inflation will soon start to slow. Markets historically can even get a little lift from lower uncertainty around elections as midterms approach. Turbulence cannot be avoided, but it also need not deter us from making progress toward our financial goals. When times are turbulent, the surest path toward progress remains sound financial advice from dedicated professionals who have logged many hours in similar conditions.

the average level of prices. Each month, the Bureau of Labor Statistics releases a report called the Consumer Price Index Chirag Chauhan, (CPI) to track these AIF®, CFP® fluctuations. It was developed from detailed expenditure information provided by families and individuals on purchases made in the following categories: food and beverages, housing, apparel, transportation, medical care, recreation, education and communication, and other groups and services.2

How Applicable Is the CPI? While it's the commonly used indicator of inflation, the CPI has come under scrutiny. For example, the CPI rose 7.9 percent for the 12-months ending in February 2022. However, a closer look at the report shows movement in prices on a more detailed level. Energy prices, for example, rose 25.6 percent during those 12 months.1

Are Investments Affected by Inflation? They sure are. As inflation rises and falls, three notable effects are observed.

First, inflation reduces the real rate of return on investments. So, if an investment earned 6 percent for a 12-month period and inflation averaged 1.5 percent over that time, the investment's real rate of return would have been 4.5 percent. If taxes are considered, the real rate of return may be reduced even further.3 Second, inflation puts purchasing power at risk. When prices rise, a fixed amount of money has the power to purchase fewer and fewer goods. Third, inflation can influence the actions of the Federal Reserve. If the Fed wants to control inflation, it has various methods for reducing the amount of money in circulation. Hypothetically, a smaller supply of money would lead to less spending, which may lead to lower prices and lower inflation.

Empower Yourself with a Trusted Professional

When inflation is low, it's easy to overlook how rising prices are affecting a household budget. "If the current annual inflation rate is 7.9 On the other hand, when inflation is high, it may percent, why do my bills seem like they're 10 be tempting to make more sweeping changes in percent higher than last year?"1 response to increasing prices. The best approach may be to reach out to your financial Many of us ask ourselves that question, and it professional to help you develop a sound illustrates the importance of understanding investment strategy that takes both possible how inflation is reported and how it can affect scenarios into account. investments.

Inflation & Your Money

What Is Inflation? Inflation is defined as an upward movement in

1. USInflationCalculator.com, 2022 2. BLS.gov, 2022 3. This is a hypothetical example used for illustrative purposes only. It is not representative of any specific investment or combination of investments. Past performance does not guarantee future results.

Chirag Chauhan, MBA, AIF®, CFP® is the managing partner of Bluff City Advisory Group in Memphis, Tennessee. For more info, please visit bluffcityadvisory.com.

Dr. Zijian Chen is the Assistant Professor of Medicine at the Icahn School of Medicine at Mount Sinai, and Peter A. Kolbert, Senior Vice President of Claim and Litigation services for Healthcare Risk Advisors, part of TDC Group. SEPTEMBER/OCTOBER 2022

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GrandRounds Southwestern Medical Center, Dallas. Morgan will practice Radiation Oncology in the CARTI Little Rock center. Mackenzie Sitzman, DMD, will become the second dentist on staff at CARTI and will be serving patients in the Dental Clinic in Little Rock. She attended the University of Louisville School of Dentistry in Kentucky. Naveen Yarlagadda, MD, is a graduate of Osmania Medical College, Hyderabad, India. He has done residency work in Internal Medicine at the University of Buffalo—SUNY, New York, and a fellowship in Hematology/ Oncology at the University of Arkansas for Medical Sciences. He is board certified through the American Board of Internal Medicine. Yarlagadda will see patients at CARTI locations in Little Rock, Crossett and Saline County. CARTI is actively recruiting for clinical and non-clinical roles within the organization. To see a list of available openings, please visit CARTI.com/ careers.

White River Health Welcomes Cardiologist BATESVILLE – White River Health is pleased to welcome Bhaskar Bhardwaj, MD, Interventional Cardiologist. Bhardwaj practices is at White River Health Cardiology, formerly known as WRMC Cardiology, located at 16 Hospital Circle, Suite A, in Batesville. Bhaskar He joins Drs. Mahesh Bhardwaj Anantha, Richard VanGrouw, and APRNs, Crystal Allen and Wil Moore. Bhardwaj received his Bachelor of Medicine and Bachelor of Surgery from Indira Gandhi Medical College, Shimla, India. He completed his residency from the University of Missouri in Kansas City, Missouri. Bhardwaj completed a Fellowship in General

and Intervention Cardiology from the University of Missouri in Columbia, Missouri and a Structural Cardiology Fellowship from Oregon Health and Science University. He is Board Certified in Internal Medicine, General Cardiology, and Interventional Cardiology. Bhardwaj is a member of the American College of Cardiology, American Heart Association, and the Society of Coronary Angiography and Intervention. Interventional Cardiology focuses on providing treatment and care to patients with heart disease. Bhardwaj treats patients with heart attack or chest pain by performing angiograms and stents in life-threatening situations, to relieve blockages in the heart vessels. His practice includes diagnosing and treating patients with several heart conditions including coronary artery disease, congestive heart failure, valvular heart disease and abnormal heart rhythms using advanced imaging techniques and appropriate medications. “I am grateful to be at the White River Health,” said Bhardwaj. “I am eager to treat patients with all cardiovascular diseases and as a team, we can work together to provide great care for the patients with cardiovascular diseases. White River Health Cardiology is open Monday through Thursday from 8AM to 4PM. To schedule an appointment, call (870) 793-7519.

Pack Joins Conway Regional as New CFO CONWAY - Bill Pack has accepted the position of Chief Financial Officer (CFO) for Conway Regional Health System. As CFO, Pack will be responsible for the financial operations of the health system which includes Conway Regional Medical Center, Conway Regional Rehabilitation Hospital, Dardanelle Regional Medical Center, Conway Regional Surgery Center, and

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numerous outpatient centers and clinics located throughout north Central Arkansas. He will lead Conway Regional Health System’s accounting, business office/admissions and medical information teams. Pack has more than 30 years of experience at healthcare systems in Colorado and Texas, most recently serving as a system vice president with Centura Health in Denver. Prior to Centura, he was vice president of finance/ chief financial officer with organizations such as CHI St. Luke’s in Houston, CHRISTUS in San Antonio, and SCL Health in Denver. He holds a Master of Business Administration (MBA) in Healthcare Management from Marylhurst University in Lake Oswego, Oregon, and a bachelor’s degree in Accounting from Louisiana State University in Shreveport. Pack is originally from Pine Bluff, Arkansas. He and his wife, Shelly, are in the process of moving to Conway. The Packs have a daughter, Meredith, who is a college student at the University of Denver. Marlee, the Pack’s second daughter, died in 2019 after a heroic battle with a rare form of cancer. The loss of Marlee was transformational for Bill and Shelly Pack and shaped how they view life and pursuing purpose driven work. “We have gained a great teammate as well as a talented leader who truly seeks to make a difference in his community,” said Matt Troup, president CEO of Conway Regional Health System. “We are extremely blessed to have someone of his background and talent join our team. To have ‘fit and talent' is a rare combination.”

Three Physicians with Northeast Arkansas Ties Join St. Bernards Clopton Clinic JONESBORO - St. Bernards Healthcare have announced that three physicians have joined the St. Bernards Clopton Clinic medical team. Riley Pace, MD, arrives at St. Bernards after completing an Internal Medicine/Pediatrics Internship and Residency with the University of Tennessee Health Science Center (UTHSC) in Memphis, his hometown. He earned his Doctor of Riley Pace Medicine in 2018, also from UTHSC. Pace has family from the Randolph County area, and he now joins a team of more than 20 multi-specialty healthcare providers close to them. “Clopton Clinic has

served Northeast Arkansas for nearly six decades,” Pace said. “I hope to build upon the strong foundation already laid here.” Pace’s arrival will only strengthen the care options at St. Bernards Clopton Clinic, said Ben Owens, Jr., MD, Internal Medicine Specialist. “Access to care remains a critical component of what we do,” Owens said. “Dr. Pace’s family is from this area, and he understands the specific challenges our patients face each day. He’ll prove an incredible addition to St. Bernards as a whole.” Pace holds professional memberships with the American Academy of Pediatrics, the American/Tennessee Medical Association, the Harvey Team Committee at Le Bonheur Children’s Hospital and Phi Chi Medical Fraternity. In his spare time, he enjoys watching and attending sporting events, including the Memphis Grizzlies and Arkansas Razorbacks, traveling and spending time with family. He lives in Jonesboro with his wife, Haley. Dr. Veronica Easton arrives at St. Bernards after completing a Palliative Care Fellowship with the University of Tennessee Health Science Center (UTHSC) in Memphis. A graduate of Valley View High School, Easton worked at St. Bernards Medical Center while earning her bachelor’s degrees in Biology Veronica Easton and Chemistry from Arkansas State University. She obtained her Doctor of Medicine in 2018 from the University of Arkansas for Medical Sciences (UAMS) in Little Rock before completing an Internal Medicine Residency with UTHSC in 2021. She now joins a team of more than 20 multi-specialty healthcare providers started by the late Dr. Owen Clopton nearly 60 years ago. “The Clopton Clinic team has a long history of serving this community,” Easton said. “It’s a privilege to be a part of that legacy, helping patients here.” Easton holds certification with the American Board of Internal Medicine. She lives in Jonesboro with her husband, Chad, a physical therapist with St. Bernards, and their daughter, Rylee. Dr. Amanda Sale stays with St. Bernards after graduating this summer from the organization’s Internal Medicine Residency Program (IMRP). A native of Piggott, Sale obtained her bachelor’s and master’s Amanda Sale

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GrandRounds degrees from Arkansas State University. She then completed a Master of Business Administration in Healthcare Management before earning her Doctor of Medicine in 2019 from American University of Integrative Sciences in Barbados. “As part of St. Bernards Internal Medicine Residency team, I had the privilege of practicing inside the Clopton Clinic building for three years,” Sale said. “The physicians here have served Northeast Arkansas for years, and I’m grateful for the opportunity to continue helping patients alongside them.” Sale holds certifications in Fundamental Critical Care Support, Critical Care Ultrasound and Basic Life Support (BLS)/Advanced Cardiac Life Support (ACLS) as well as a professional membership with the American College of Physicians. She lives in Jonesboro with her husband, Trae. For more information, including appointment requests, visit https://www.stbernards.info/locations/st-bernards-clopton-clinic or call the St. Bernards Healthline at 870.207.7300.

Washington Regional Names Megan Burks Director of Critical Care FAYETTEVILLE — Washington Regional has named Megan Burks, RN, MSN, as critical care director. In her new role, Burks will oversee the medical center’s intensive care unit (2300) and critical care unit (2200). Burks began her nursing career at Washington Regional Megan Burks as a student nurse intern before officially joining the team as a registered nurse in the intensive care unit in 2015. She holds a Bachelor of Science in biology from the University of Arkansas, a Bachelor of Science in Nursing from the University of Arkansas for Medical Sciences and a Master of Science in executive nursing administration from the University of South Alabama.

UAMS Health Opens Long COVID-19 Clinic in Fayetteville FAYETTEVILLE — The University of Arkansas for Medical Sciences (UAMS) is offering a new clinic in Fayetteville for patients who still have symptoms of a COVID-19 infection three weeks or more following a positive COVID test. arkansasmedicalnews

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Some people are reporting that they are continuing to experience COVID19 symptoms weeks or months after their diagnosis. Commonly called long COVID, these symptoms — such as shortness of breath, muscle aches, cough, fatigue, loss of taste or smell, or difficulty concentrating — are either symptoms that people did not have prior to the virus or ones that have worsened since their diagnosis. “Because the coronavirus can attack the lungs, heart, brain and other organs, there can be lasting internal damage,” said Sheena CarlLee, MD, a UAMS internal medicine doctor and director of the UAMS Health Long COVID Clinic. “If these organs are damaged, it can significantly increase the risk of long-term health problems.” CarlLee said the need for the clinic became apparent as she and her colleagues began to see former COVID patients return to the clinic with lingering symptoms from the virus. CarlLee also pointed out that even patients who had mild symptoms when they tested positive can develop other symptoms months later that may be related to their COVID-19 infection. “We are seeing patients with a wide variety of symptoms that require a unique treatment regimen,” she said. “We treat the whole patient. Our long COVID clinic offers extensive evaluation from a team of students and trained health care providers from the disciplines of medicine, pharmacy, nursing, physical therapy, occupational therapy and radiation sciences. Furthermore, the team works closely with researchers on the Little Rock campus to improve our knowledge and treatment options for patients affected by long COVID.” The UAMS Health Long COVID Clinic is unique in that it is one of the only clinics in the state dedicated to treating long COVID, said CarlLee. The clinic is located at the UAMS Health Neighborhood Clinic at 1125 N. College Ave. in Fayetteville. To schedule an appointment, please call 479-713-8701.

Sunny Singh, MD, Named Director of UAMS Baptist Health Cancer Center in North Little Rock LITTLE ROCK — Sunny R. K. Singh, MD, has joined the University of Arkansas for Medical Sciences (UAMS) Winthrop P. Rockefeller Cancer Institute as a hematologist/oncologist and director of the UAMS Baptist Health Cancer Center in North Little Rock. Singh oversees all operations at the satellite cancer center jointly operated

Mercy Hospital Fort Smith Blesses New Helipad FORT SMITH – The landing of a Mercy Life Line helicopter on Wednesday, September 7, helped mark the beginning for a new helipad at Mercy Hospital Fort Smith, part of the ongoing expansion at the hospital. The new helipad, located in front of the Physicians Building at the hospital, is part of the $162.5 million expansion of the emergency room and intensive care unit at Mercy Fort Smith. Relocating the helipad will improve patient transport to the ER. “This is a first, giant step toward getting the new ER and ICU operations underway,” said Dr. David Hunton, president of Mercy Clinic Fort Smith. “We appreciate the work Mercy Life Line does in helping get patients to us and, when needed, getting other patients out where they need to go.” The goal at Mercy in Fort Smith, Dr. Hunton said, is to become a Level II trauma center, and the helipad blessing is a “great first step in that direction. We look forward to all the construction projects as they will provide our community with better access to health care.” The blessing was conducted by Father Paul Fetsko, vice president of mission at Mercy Fort Smith, who offered prayers for the new helipad and for Mercy coworkers and the community. DJ Satterfield, administrative director for Mercy Life Line, said Wednesday’s blessing marked the beginning of expanded care for area residents. “This blesses our teams and our aircraft and all the patients we will care for who need us as a lifeline,” he said. “As the prayer of the dedication stated, this helipad will care for the sick and serve the sick as we serve Christ.” As part of the expansion project at Mercy, the ER space will grow from 29 to 50 rooms and ICU capacity will increase from 38 to 64 patients. The project is expected to be completed in late 2024.

by the UAMS Winthrop P. Rockefeller Cancer Institute and Baptist Health. The center, which includes radiation therapy, medical oncology and an infusion clinic, is located at the Baptist Health Springhill Medical Plaza, 3401 Springhill Drive in North Little Rock. Singh joins a team of medical and radiation oncologists, nurses and radiation therapists from UAMS. Fellowship trained in hematology and oncology at Henry Ford Hospital in Detroit and at UAMS, Singh has expertise in treating various cancers and blood disorders. He was chief resident at John H. Stroger Jr. Hospital of Cook County in Chicago. He received his medical degree from King George’s Medical University in India. “Dr. Singh will lead our clinical and research efforts at the UAMS Baptist Health Cancer Center,” said Michael Birrer, MD, Ph.D., Cancer Institute director and UAMS vice chancellor. Our partnership with Baptist Health allows us to reach more Arkansans battling cancer, and I know these patients are in good hands with Dr. Singh and his talented team.” Among his many professional honors and associations, Singh is a

member of the American Society of Clinical Oncology, American Society of Hematology and the International Association for the Study of Lung Cancer. He is co-author of a textbook chapter and multiple peer-reviewed scientific journal articles on cancer research. UAMS and Baptist Health announced the opening of the UAMS Baptist Health Cancer Center in North Little Rock in August 2021. The center provides hematology, medical oncology, infusion and radiation therapy servicesfor most cancer types with the exception of full body radiation therapy and brachytherapy. More complex cancer treatments such as surgery and conditions requiring stem cell transplants are referred to UAMS for treatment. Singh is accepting new patients. For appointments, call (501) 214-2170.

CHI St. Vincent Heart Institute Announces Two New Physicians CONWAY and SEARCY — CHI St. Vincent has announced that two physicians have joined the staff. continued on page 10

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GrandRounds Dr. Ronak Soni will be seeing patients at the Conway Regional Cardiovascular Clinic located at 525 Western Avenue, Suite 202 in Conway. The clinic Ronak Soni specializes in the diagnosis, treatment and management of diseases of the heart and blood vessels and its physicians are instrumental in helping patients manage a wide range of conditions from blood pressure to life threatening heart attacks, congestive heart failure and irregular heart rhythms. Soni completed his fellowship in interventional cardiology at Ascension Borgess Hospital at Michigan State University and cardiovascular fellowship at The University of Toledo in Ohio. He completed his residency in internal medicine at the Central Michigan University College of Medicine. Dr. Soni is a member of the American College of Cardiology, is board certified by the American Board of Internal Medicine and earned his medical degree from Government Medical College in Surat, India. The cardiologists at Conway Regional Cardiovascular Clinic specialize in diagnosis, treating and managing

disease of the heart and blood vessels. To schedule an appointment with Dr. Soni, call 501.358.6905. Dr. Avnish Tripathi will be seeing patients at the Unity Health Cardiology Clinic in Searcy which focuses on the diagnosis and treatment of diseases and conditions of the heart and vascular systems. The clinic is located at 711 Santa Fe Drive. Tripathi completed Avnish Tripathi his interventional cardiology fellowship at Mass General Hospital and Harvard University. He conducted his cardiology fellowship at the University of Louisville. Dr. Tripathi completed his internal medicine residency at the University of Mississippi Medical Center in Jackson and previously served as assistant professor of internal medicine at the University of Kentucky Medical College in Bowling Green, Kentucky. He earned his medical degree from Government Medical College in India. The healthcare professionals at the Unity Health Cardiology Clinic work to diagnose and treat diseases and conditions of the heart and vascular systems. To schedule an appointment with Dr. Tripathi, call: 501.279.9393

Washington Regional Achieves Reaccreditation as NWA’s only Level II Trauma Center FAYETTEVILLE — Washington Regional Medical Center has achieved reaccreditation from the Arkansas Department of Health as a Level II Trauma Center within the Arkansas Trauma System. The medical center’s trauma team underwent a rigorous two-day, on-site inspection to achieve the designation. Washington Regional Medical Center COO and Administrator Birch Wright said the reaccreditation demonstrates Washington Regional’s commitment to providing high-quality care for Northwest Arkansas and nearby regions. “As the only Level II Trauma Center in Northwest Arkansas, Washington Regional Medical Center provides the highest level of trauma care in the region, including 24/7 immediate coverage by general surgery, orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology and critical care,” Wright said. Washington Regional was first designated as a Level II Trauma Center in 2012 and treated 1,141 patients with serious traumatic injuries last year.

Washington Regional Performs State’s First Persona IQ® Knee Replacement FAYETTEVILLE — Washington Regional Medical Center recently became the first hospital in Arkansas to offer total knee arthroplasty, or knee replacement surgery, using the Persona IQ® Smart Knee. The new implant produced by Zimmer Biomet is the first of its kind and is equipped with sensor-based technology to provide patients and their physician with information that can be used to improve outcomes following joint replacement surgery. C. Kris Hanby, MD, an orthopedic surgeon at Ozark Orthopaedics and medical director of the Washington Regional Total Joint Center, performed the surgery. “The stem of this smart knee implant captures data about the function of the knee, such as the patient’s range of motion, step count, walking speed and stride length,” Hanby said. “This is the first implant that’s capable of telling us how the patient is doing following surgery which helps us make sure the knee implant is functioning properly. This information aides in recovery by providing patients with the peace of mind that their new knee is working as it should and will alert us if there is a problem that needs to be addressed.” Patients and their physician can view data from the Persona IQ® using a special care management platform. Kris Hanby While a wide range of total joint replacement patients may be candidates to receive the Persona IQ® Smart Knee, Hanby says it may be particularly beneficial for younger patients. “Initially, I think the Persona IQ will be implanted in more younger patients who we want to see have the longest lifespan with their artificial knee. But as the technology becomes more mainstream, I believe we’ll see it become the standard type of artificial knee in the coming years.” The total knee arthroplasty was performed using Zimmer Biomet’s ROSA® Knee System, a state-of-the-art robotic technology that helps surgeons personalize joint replacement procedures for each patient for enhanced precision. Washington Regional became the first hospital in Northwest Arkansas to use the system in 2020.

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