Information and news from Physicians’ Clinic of Iowa for healthcare professionals.
Less Invasive Approach to Heart Valve Surgery The minithoracotomy, long used as a minimally invasive approach to lung surgery, is one of the latest in a series of surgical techniques that have crossed from one field of medicine to another. Now being applied to heart surgeries at Physicians’ Clinic of Iowa, the minithoracotomy utilizes a smaller incision than traditional open-heart surgeries — leading to shorter hospital stays, abbreviated recovery times, reduced scarring, less pain and fewer complications for patients. Traditional heart surgeries utilize a median sternotomy, a splitting of the sternum that involves an incision typically more than 10 inches in length. The minithoracotomy requires an incision of approximately 3 inches and allows surgeons to approach the heart from an interspace between the ribs. “I think this surgery is a great improvement for our patients,” says Mark G. Barnett, M.D., FACS, cardiothoracic and vascular surgeon at Physicians’ Clinic of Iowa, who began applying the minithoracotomy to his open-heart
surgeries about six months ago after years of utilizing the technique in lung surgeries. “After you do a number of these, you find out it’s much less painful and allows for a much quicker recovery.” Considerable amounts of time and money were invested to bring the minithor-acotomy to the heart surgery program at Physicians’ Clinic of Iowa. Over the course of a year or so, St. Luke’s Hospital, where Dr. Barnett performs this procedure, purchased longer surgical instruments — which are required to perform the technique because the incision is so small and deep — along with specialized camera equipment that, when worn on a surgeon’s headlight, allows surgical assistants to see what’s happening during the operation. Meanwhile, Dr. Barnett studied the technique by attending a number of seminars and meetings about its application to heart surgery and observing other
surgeons perform heart surgery using a minithoracotomy. Dr. Barnett considers the minithoracotomy best suited for heart patients needing a valve repair or replacement, such as those suffering from aortic or mitral stenosis, aortic leaking, or mitral regurgitation. However, not all patients are good candidates for the technique. Those having a coronary bypass or experiencing an aortic aneurysm should not undergo the procedure. ... continued on page 2
Inside this Issue: • Minithoracotomy Heart Valve Surgery
• About the PCI Medical Pavilion
• PCI Orthopaedic Services
• Message from Dr. Bill Devine
• ‘For Medical Professionals’ Web Section
• PCI Surgical Cancer Care
• ‘Together in Health’ Moves PCI Forward
• New Providers and Services
Together in health.
Cover story continued...
Physicians’ Clinic of Iowa Orthopaedic Services
“You just can’t try to do too much through a mini approach,” he says. “I want to be able to do this safely and really get a 99% success rate.” So far, surgeons at Physicians’ Clinic of Iowa have yet to see any major complications following a heart surgery involving a minithoracotomy.
PCI offers an experienced and highly collaborative musculoskeltal team. Our doctors and physical therapists work closely to ensure patients are provided with an optimal treatment plan in the most convenient manner possible. Patients also benefit from onsite imaging including X-ray and MRI.
Podiatric Medicine / Surgery
While recovery times after traditional open heart surgeries typically last at least a couple of months, Dr. Barnett has seen many of his microthoracotomy patients return to full activity within just one month.
Physical & Occupational Therapy
• General Orthopaedics (fractures, tears and injuries)
• Hand Therapy
“I think this will be a really wonderful addition to the program,” Dr. Barnett says.
• Lower Extremity Surgery
“Patients will be able to get cutting-edge heart valve surgery done through very small incisions, and they won’t have to go to Chicago, Cleveland or New York to have that done. We can do that right here with equal or better results.”
• Foot & Ankle Surgery • Hand Surgery • Upper Extremity Surgery • Spinal Surgery
• Foot Injuries and Fractures • Ingrown Nails, Corns & Calluses • Heel and Arch Pain; Arthritis Pain • Wound & Ulcer Care
• Neurological Rehabilitation • Orthopaedic Rehabilitation • Sports Rehabilitation • Strength Training • Work Injuries
Updated Web Resources
‘Together in Health’
Thank you to those who participated in our referring provider survey this fall. With your input, we have expanded the ‘For Medical Professionals’ section of our website to provide you with easy access to information and resources.
As our practice moves forward we felt it was important to ensure our message accurately reflect the value we strive to bring to those we serve.
Here’s what you’ll find: •
Referring a patient by phone or fax
PCI provider directory
—Mark Barnett, MD, FACS
Share your feedback instantly
E-versions of ‘Specialist Connection’
First published in MD News Jan/Feb 2012.
Easy download forms and maps
Current physician opportunities
• Bunions and Hammertoes
Simply put, we want to be a partner—at every level. And that means working together with our referring providers. We want to work as a team toward improved patient health and also build a partnership patients can trust. PCI believes that coordination between providers is just as important as quality of care, and will strive to make each experience with PCI a postive one. Our goal is your goal, improved patient health, and we’re in it together.
Together in health.
Ritu Munjal, MD
Kyle D. Switzer, DO
Specializing in bone health, Dr. Munjal treats patients with osteoporosis, osteopenia, and other bone disorders. She is a certified Clinical Densitometrist and offers in-office DEXA testing, vertebral fracture assessment, infusion services and more.
As a fellowship-trained sports medicine physician, Dr. Switzer has experience in both medical and surgical treatments for injuries involving bones, joints, ligaments, muscles, and tendons, including minimally invasive procedures for many orthopaedic problems.
P: (319) 398-1578 | F: (319) 399.2038
P: (319) 398-1545 | F: (319) 399.2039
Osteoporosis & Bone Health
Orthopaedic Surgery & Sports Medicine
A message from: Dr. Bill Devine, President of Physicians’ Clinic of Iowa I’m honored to share our first issue of Specialist Connection with you. We hope it becomes a way for you stay in touch with what PCI has to offer and what’s on our horizon. In each issue we’ll highlight emerging procedures, techniques and services as well as new providers, specialty information and PCI news and resources. Our biggest news is the construction of Physicians’ Clinic of Iowa Medical Pavilion— expected to open in January 2013. I feel it is important to share that we recognize that this project has not been without challenge and we are aware that it has been the source of angst in some circles. I want to reiterate to you—our colleagues and partners—that our goal has always been to bring PCI services together in an efficient and patient friendly way. There is absolutely no hidden agenda or undisclosed plans in building this facility. While the original concept called for the building to be on open land in Hiawatha, patient convenience would have suffered and doing so would have been counter to our goal of efficiency. In addition, both Cedar Rapids hospitals, the City of Cedar Rapids, and many businesses came to PCI and asked us to remain in the Downtown area—to be part of the developing Medical District and help revitalize the community postflood. With these factors in mind, the facility became more than just a way for PCI to consolidate—it gained added purpose as part of the healthcare community and our physicians embraced the opportunity. It’s human nature for change to generate anxiety. There have been rumors concerning this building and how it affects our healthcare community. I’ve even heard one about our secret plan to build our own hospital—which is absolutely not true. While I cannot address each inaccuracy in this message, I ask that if you have a question about something you’ve heard, please ask us directly before taking it as fact. We are passionate about this project and our board members and physicians are happy to answer your questions. If they don’t know the answer they will direct you to someone who does. Our intention is to remain an independent specialty group practice that serves the needs of both Cedar Rapids hospitals and Eastern Iowa residents through two-way partnerships. We will continue to collaborate and be an active part of the healthcare community in order to improve the experience for our patients. Let’s keep communication open. If you have suggestions for content in future issues of Specialist Connection, please contact Michelle Luty at (319) 398-1527. On a personal note, last week I received a rather inhospitable visit from Mr. Grimm Reaper. Had it not been for a ton of luck and unbelievable health care, I would not be writing this now. Thanks for all the well wishes. It has meant a lot to me and my family. Sincerely, A. William Devine, Jr., MD—Urologist and President, Physicians’ Clinic of Iowa
Hosne A. Begum, MD Hematology & Oncology
Board-certified in hematology, medical oncology and internal medicine, Dr. Begum is experienced in diagnosing, treating and managing care for all types of cancers and disorders of the blood. She also has considerable clinical research trial experience.
P: (319) 297-2900 | F: (319) 297.2969
PCI Surgical Cancer Care Surgery is often a central part of the care plan for newly diagnosed cancer patients. Physicians’ Clinic of Iowa surgeons treat nearly all patients who require oncological surgery at each Cedar Rapids hospital and Surgery Center Cedar Rapids. This volume of experience translates into a high rate of positive outcomes for surgical procedures. Our surgeons—including cardiothoracic, general, otolaryngology and urology— work together with medical oncologists, radiation oncologists, pathologists, primary care physicians and others to ensure the best course of treatment. Because we are a strong source for oncological surgery in the area, we are committed to coordinating care with both Cedar Rapids cancer centers: •
Hall-Perrine Cancer Center (319) 365-HOPE (4673) www.hallperrinecancercenter.org
Helen G. Nassif Community Cancer Center of Iowa (319) 558-4876 www.communitycancercenter.org
NEW Bone Health Services Physicians’ Clinic of Iowa–Osteoporosis is a subspecialty clinic that evaluates patients with suspected or known osteoporosis, osteopenia and other metabolic conditions characterized by low bone mass or thinning of bone tissue. We offer DEXA Bone Composition and density testing used to screen for and detect bone loss. Our approach includes thorough screening, assessment, diagnosis and treatment for adult men and women.
Services include: • • • • • •
Medical Management of Osteoporosis Bone Density Testing (DEXA) Vertebral Fracture Assessment (VFA) Infusion Services for: - Reclast® - Prolia® - Boniva® Laboratory Testing Physical Therapy & Strength Training
600 7th Street SE • Cedar Rapids, IA 52401 P: (319) 398-1500 • TF: (800) 628-6601
Visit us online to sign up for the e-version of ‘Specialist Connection’.
To learn more about our approach, team, treatments and services visit www.pcofiowa.com.
Physicians’ Clinic of Iowa Medical Pavilion
You can also view this newsletter on our website under the new ‘For Medical Professionals’ section!
Convenient. Coordinated. Affordable.
Opening January 2013 Together in health.