Houston Medical Times

Serving Harris, Brazoria, Fort Bend, Montgomery and Galveston Counties

HOUSTON

Volume 10 | Issue 10

Inside This Issue

October Edition 2020

The Importance of Self-Care for Healthcare Professionals during COVID-19

By Tom Florence, EVP Merritt Hawkins

S UTHealth Surgeons at Memorial Hermann First in Texas to Perform Double Lung Transplant See pg. 9

INDEX Legal Matters........................ pg.3 Oncology Research......... pg.5 Mental Health...................... pg.6 Healthy Heart....................... pg.8

Harvard Psychiatric Leader Appointed to Posts at Baylor College of Medicine and Menninger Clinic See pg. 10

ince the COVID-19 virus began its rapid spread across the U.S. healthcare professionals have been tirelessly working and caring for patients, risking their own health and even their lives each day they walk through the hospitals’ and doctors offices’ doors.

When constantly looking out for others, it can be easy to neglect the importance of taking care of oneself.

However, self-care is an essential practice for all individuals, particularly for those who are being exposed to the coronavirus and seeing the significant and sometimes fatal impacts that it has had on countless individuals throughout the entire world.

While everyone responds to situations differently and has different methods of coping with stress and anxiety, below are options for healthcare workers to employ in order to practice self-care and help minimize the risks of burnout and mental and physical illnesses as a result of working

through the COVID-19 pandemic.

Vocalize your feelings.

Don’t hesitate to talk with your coworkers or an on-site chaplain regarding how you are feeling.

Caring for coronavirus patients and consistently facing the dangers it presents to you and to others can have a tremendous emotional impact on you and your well-being. It would also be

wise to speak to a therapist, especially if you begin to experience “compassion fatigue,” in which your desire to provide care and help to others diminishes.

Participate in the hobbies and activities that you enjoy.

Exercising on a regular basis carries significant benefits and helps to see Self Care... page 14

Baylor St. Luke’s Medical Center is the First to Bring Applied Artificial Intelligence to Stroke Care in Greater Houston

A

s a leader in stroke care, Baylor ai to bring the first FDA-cleared St. Luke’s Medical Center (Baylor computer-aided triage system in the St. Luke’s) has partnered with Viz. Greater Houston area. Baylor St. Luke’s is the first in the Greater Houston area to partner with Viz.ai to bring its award-winning software that utilizes artificial intelligence to analyze images for suspected large vessel occlusion (LVO) strokes.

As one of the leaders in stroke care in Houston and surrounding areas, Baylor St. Luke’s continues its commitment to leverage the most advanced innovations to improve

access to the most optimal treatments for patients who are suffering an acute stroke. Viz.ai solutions will allow Baylor St. Luke’s to further enhance the power of its stroke care team through rapid detection and notification of suspected LVO strokes and allow stroke specialists to securely communicate to synchronize care and determine the optimal patient treatment decision.

Stroke specialists with access to Viz.ai’s technology can potentially save critical minutes, even hours, in the see Stroke Care ... page 14

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Legal Matters Top Antitrust Issues in Physician-Hospital Alignment

By Matthew C. Hans, J.D. Herbert F. Allen, J.D. Polsinelli, PC

A

great realignment is underway among America’s doctors. The shift away from independent practice towards full hospital employment or affiliation with a hospital system has been motivated by growing costs for independent practices, including rising physician salaries, and flat or declining reimbursement. The antitrust laws will play an important role in determining how this wave of physician and hospital alignment will play out.

Hospital Acquisition of Physician Practice – Reduction in Competition?

When a hospital acquires an independent physician practice or employs its doctors directly, the

antitrust laws treat the transaction as a merger between the hospital and the physician practice. Antitrust concern arises when the combination of the newly-hired physicians with physicians already employed by the hospital creates new market power that may substantially lessen competition, or tend to create a monopoly in violation of Section 7 of the Clayton Act. But how do courts and agencies determine whether or not an acquisition that has not yet occurred may substantially lessen competition at some point in the future? At a very high level, the analysis includes the following steps: 1. Geographic Market.

This analysis focuses on patients’ willingness to travel for particular services, as well as the degree to which health plans need certain physicians in a geography to market a successful plan to employers.

Generally, geographic markets for primary care doctors may be narrower than the market for specialists who perform elective procedures, since

patients may be willing to travel for elective procedures, while many patients prefer local access to a primary care service.

Geographic market definition can be outcome-determinative in many antitrust cases, since it determines how many other physicians are included in the denominator when it comes to calculating market shares.

2. Market Share. Transactions that result in market shares of less than 30% have been held not to present competition concerns. On the other hand, very high market shares can be sufficient for a plaintiff to make out a prima facie case that the transaction will probably lead to anticompetitive effects.

3. Other Evidence. While courts recognize that market concentration statistics are of great consequence,

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they are not conclusive indicators of anticompetitive effects.

Other evidence might include documents from the parties about the motivations for the transaction and testimony from payers about any changes in bargaining leverage that might be attributable to the transaction, or evidence that the transaction will yield efficiencies that will enhance the merged firm’s ability and incentive to compete.

Professional Services Agreements: “Employment Light”

The professional services agreement (PSA) has become a very popular model for physician practices that wish to affiliate with a hospital, yet retain some degree independence.

In the typical PSA, a hospital will see Legal Matters...page 14

October 2020

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The Sealy & Smith Foundation establishes John Sealy Distinguished Chair in Innovations in Molecular Biology at UTMB

A

$1 million gift from The Sealy & Smith Foundation has established the John Sealy Distinguished Chair in Innovations in Molecular Biology at The University of Texas Medical Branch. Dr. Pei-Yong Shi, a professor in the Biochemistry and Molecular Biology Department and vice chair for Innovation and Commercialization, has been named the inaugural recipient.

“I’m honored to be named to this distinguished chair and excited to continue our work here at UTMB,” Shi said. “This investment is an acknowledgment and reminder of the importance of this research as we combat infectious threats to health.”

Shi, who joined UTMB in 2015, is internationally recognized for his scholarship, leadership and his innovative scientific approach to counter numerous diseases. His

areas of research include virology, drug discovery, vaccine development, pathogen diagnosis and cancer therapy.

“This distinguished chair recognizes Pei-Yong’s fundamental contributions to understanding the molecular biology of pathogenic RNA viruses and his pioneering countermeasures to these important threats to global health,” said Dr. Mariano Garcia-Blanco, professor and chair of the Biochemistry and Molecular Biology Department.

Shi’s ability to quickly adapt allowed him and his team to be one of the first to engineer a reverse genetic system of SARS-Cov-2 allowing scientists to safely make the virus in the lab and manipulate it in a petri dish. Shi and his team also developed tools to streamline the COVID-19 vaccine development process,

among other achievements.

When the Zika virus suddenly jumped from a mostly ignored and relatively minor disease to a global threat, Shi and his lab were already on the cutting edge Dr. Pei-Yong Shi of related research.

His lab immediately advanced scientific knowledge of the virus by developing the first genetically engineered clone of the Zika virus early in that epidemic.

Just this month, Shi and his team published a paper in Proceedings of the National Academy of Sciences detailing a mutation in the Zika virus that likely led to its sudden spread and the cause of birth defects to

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Now with the sudden and debilitating spread of COVID-19, Shi and his team have once again quickly adapted the research techniques they developed to study flaviviruses such as Zika and West Nile, to meet this see UTMB...page 12

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Houston Medical Times

Oncology Research Flu Season During COVID-19: Is Your Family Prepared?

By Haris Baig, D.O., Texas Oncology

T

his year’s impending flu season will be like no other given the overlap with the continuing COVID-19 pandemic. Late September marks the start of Fall, and October means lower temperatures and seasonal influenza. It’s also time – especially for those living with cancer, and their families and caregivers – to get an annual flu shot.

Yes, even during a global pandemic, flu shots are strongly recommended.

We’re already coping with one contagious respiratory virus. How are we supposed to prepare for another widespread infection? While it’s still unclear how COVID-19 will impact the severity of flu season, we do know that cancer patients and those 65 years and older are at higher risk for flu complications, according to the National Institutes of Health (NIH).

Because of the current pandemic, we’re already taking many of the preventative steps helpful for fending off the seasonal flu, such as washing hands more often, disinfecting frequently touched surfaces, and wearing face coverings in public. But there can be significant risks if the viruses overlap and infections begin to overwhelm healthcare systems, deplete testing supplies, and harm those with compromised immune systems, including cancer patients. That’s why everyone should practice extra caution this year, taking the necessary steps to slow COVID-19 and stop the flu in its tracks.

Get your flu shot.

Yes – especially during COVID-19.

The World Health Organization (WHO) recommends everyone 6 months of age or older should be vaccinated for the flu every season. This is crucial for cancer patients, their caregivers, and families.

The flu shot is proven to be safe and effective for people with cancer, and healthcare providers have been issued guidance that ensures the safety of administering the flu vaccine during

COVID-19.

Wear a mask.

In the same way that masks protect you, and those near you, from spreading and contracting COVID-19, masks can help control the spread of the flu through mucus and respiratory droplets.

Cancer patients, and those they interact with, should be mindful of public mask policies, especially in public places where social distancing is difficult to maintain and during in-person visits to receive care.

Socialize responsibly.

As the holidays approach, it’s hard to avoid spending time with loved ones, but continuing to practice safe social distancing will help slow the spread of the flu and COVID-19, while minimizing additional strain on hospitals amid flu season. It’s important for cancer patients and their loved ones to know the risks and discuss any questions with your doctor.

Stay home if you’re sick.

In the era of COVID-19, flu-like symptoms can be a sign of a serious infection that is not the flu. Symptoms shared between COVID-19 and the flu include, but are not limited to:

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• Cough • Sore throat • Runny or stuffy nose • Fever or chills • Headache • Body aches

If you have any of these symptoms, stay home. Make a plan with your family or a caregiver for medical supplies or other necessities. It’s important for people with cancer to call their doctor immediately if they get a fever.

It’s understandable to experience anxiety about the impending flu season and COVID-19. Talk to your doctor about concerns related to your risk for infection. Don’t wait until flu season hits close to home. Get your flu shot and continue being vigilant to prevent the spread of COVID-19 and the flu.

October 2020

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Mental Health POV: The Benefits of Mindful Living How Taking A Moment to Live In The Present Can Improve Overall Sense Of Well-Being

By Isaac Saldivar, PhD

T

he importance of maintaining mental health seems to be a universal endeavor that we often ignore or set aside until the metaphorical battery of our lives starts to run low, at which point we run for the nearest outlet looking for a recharge. The capacity to improve and maintain good health is fundamental to our overall quality of life. However, being “mentally healthy” can be difficult to define, even amongst behavioral scientists—and that’s their job. Even when we define mental health in our personal lives, it can be difficult for us to personify or embody that within everyday life.

You may ask yourself, How exactly

do I go about promoting mental health?

How does that even look or feel? How on earth do I find the time? I mean, who wouldn’t want to feel less stressed and more relaxed? Certainly, we would all welcome the lessening of burdens that, without a doubt, life will place squarely on our shoulders. But where do we begin? One of the essential lessons I have learned, both personally and professionally as a clinical psychologist, is that living a healthy life does not spontaneously combust into existence.

It requires deliberate and continuous effort. This means making a habit of living healthy is a choice, and we must actively choose to promote it.

One simple and practical way to help improve the quality of my mental life is through cultivating a healthy and resilient mindset simply by the practice of paying attention, or being mindful. Mindfulness involves placing our attention on self-awareness in the present moment, or the “here-and-now.”

Not only does mindfulness provide a

useful tool for promoting a happier, healthier lifestyle, it is also simple, accessible and—best of all—costs nada (nothing).

That’s it, folks. It is that simple.

There is no joining of a monastery, years of meditation or chanting of mantras required. These are all adequate ways of practicing mindfulness, but the simple act of self-awareness seems to be a natural state of the mind and requires no one particular or specific technique in order to engage in present-moment awareness.

The quality of our thoughts determines the quality of our mental experiences. Naturally we can see that

our mental states create the subjective experience we refer to as “self.” Through self-awareness, mindfulness strengthens not only our mental capacity to be resilient but also our capacity to attend optimally when dealing with whatever life throws our way. So, whether you’re peacefully meditating or in the middle of a chaotic day, mindfulness can help re-center one’s awareness and help you be your best. Additionally, the immediate and long-term effects of mindfulness promote a mind that functions better, is more emotionally stable and overall mentally healthy.

A common misconception of see Mental Health...page 12

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Keys to The Best Possible Stroke Recovery Even Now The COVID-19 Pandemic Shouldn’t Reduce Access To Stroke Rehabilitation

By The American Heart Association orld Stroke Day is October 29, and, for the 795,000 lives changed by stroke in the U.S. each year, rehabilitation offers a way to achieve the best possible recovery from a stroke. Even as the COVID-19 pandemic changes the way healthcare is delivered, it is important for stroke survivors to take advantage of the first three months after a stroke. Though recovery continues for years after a stroke, this “golden” time is when the brain is able to most quickly adjust to the damage done by the stroke so the survivor can learn new ways to do things.

An individualized rehabilitation program is critical. The pandemic has required rehabilitation professionals to get creative to deliver essential therapies to stroke survivors, such as sessions via video call.

The American Stroke Association

with a team of health care providers as some challenges – such as remembering medications or depression - may not be immediately clear.

• Support from friends and family is especially important during stroke rehabilitation. If a stroke survivor is in a rehabilitation facility that has visitor restrictions due to COVID-19, stay connected.

On October 29, 2020, World Stroke Day, the AHA will come together as One CycleNation, uniting across the US to raise funds and awareness for prevention and treatment of heart disease and stroke. CycleNation is the American Heart Association and American Stroke Association’s nationwide movement aimed to empower Americans to get heart and brain healthy.

Global architectural firm, Gensler, is supporting the movement

provides recovery tips and resources for stroke survivors and their caregivers: • Ask the doctor for an assessment of physical and cognitive challenges you face after stroke and a specific plan to address each challenge.

• Work with your doctor to get a plan to manage risk factors to prevent another stroke. This may include being physically active, not smoking and managing your blood pressure.

• As soon as your medical team gives the “all clear,” start your personalized rehabilitation program right away. Don’t delay.

• Talk with your health care provider about any financial constraints, such as ability to pay for medications, so a plan can be developed to identify alternative community resources.

• Communicate and follow up regularly

in Houston. “We are thrilled to be a part of this year’s One CycleNation and the Houston Heart Walk,” said Mark Talma, Technical Designer at Gensler. “The work of the American Heart Association is critical, and I am excited that Gensler can support it. The American Heart Association plays a huge role in supporting and educating the public about some of the biggest medical challenges facing our communities today. As we approach World Stroke Day in October, I am reminded of my grandmother who suffered a stroke shortly after I was born.

I watched as she struggled through the many challenges and subsequent effects that strokes can bring and the lessons in strength and perseverance she embodied. It is for this reason I am proud to be a participant and team leader for Gensler and join the AHA in support of heart health and awareness.”

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UTHealth Surgeons at Memorial Hermann First in Texas to Perform Double Lung Transplant on Patient Whose Lungs Were Damaged By COVID-19

U

THealth transplant surgeons at Memorial Hermann were the first in Texas to perform a double lung transplant on a 70-year-old man whose lungs were severely damaged

by COVID-19.

Francisco Medellin is a retired construction worker who lived with diabetes and had no other underlying health conditions. He contracted the virus in June and was on antibiotics for seven days. When his breathing continued to get worse and he began to turn blue, his family took him to the Emergency Center at Memorial Hermann The Woodlands Medical Center where he was diagnosed with COVID-19-induced pneumonia and acute respiratory distress syndrome (ARDS), a condition that occurs when fluid buildup prohibits the lungs from filling up with enough air,

restricting oxygen from reaching the bloodstream.

“Mr. Medellin’s blood oxygen level was in the 60s, sometimes dipping into the 50s,” said Dr. Soma Jyothula, associate professor of medicine with McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth). “A healthy patient’s oxygen level is around 95. He was extremely ill and, at that point, very lucky to be alive.”

Jyothula said for six weeks doctors tried unsuccessfully to treat him with steroids, Remdesivir – an investigational drug that is thought to stop the coronavirus from producing an enzyme that is needed to replicate itself, and convalescent plasma, a process where plasma is taken from patients who have recovered from

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COVID-19 and given to those who still have it.

“After all of these treatments he still needed 80 to 100 percent oxygen at rest,” said Jyothula, who is also medical director of the lung transplant program at Memorial Hermann. “At that point, we determined that the only way he would survive was if he underwent a double Francisco Medellin seen here regaining his strengh lung transplant.”

More than 2,700 lung performed Medellin’s transplant. transplants were performed in “The most common reason why the United States in 2019 and patients are dying from COVID-19 is approximately two-thirds of those lung damage. I believe we are going to were double lung transplants. Jyothula see even more patients needing lung said that patients survive longer when transplants in the future because of receiving a double lung transplant as this virus.” opposed to a single lung transplant.

The United Network of Organ He added if a patient makes it to one Sharing (UNOS) determines who gets year post-surgery, many times they lungs first by using a lung allocation have a lifespan of 10 to 12 years. score (LAS) calculator for people

“The two main reasons a person over the age of 12. The calculator would get a lung transplant are looks at factors like a person’s blood pulmonary fibrosis and emphysema. tests, lung function, their need for Now we can add COVID-19 patients oxygen, the medical urgency and to that list,” said Dr. Manish Patel, how long the patient might survive associate professor of medicine post-transplant compared to others with McGovern Medical School at on the list. The higher the score up UTHealth, surgical director of the to 100, the quicker the transplant. lung transplant program at Memorial Medellin was one of the sickest Hermann and the surgeon who

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see Lung Transplant...page 12

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Harvard Psychiatric Leader Appointed to Posts at Baylor College of Medicine and Menninger Clinic IRobert J. Boland, M.D., to serve as a Vice Chairman and Chief of Staff

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aylor College of Medicine and The Menninger Clinic jointly announce the hiring of Robert J. Boland, M.D., as vice chairman of the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine and chief of staff at The Menninger Clinic. Boland will join the organizations on January 4, 2021, after transitioning from Harvard Medical School and Brigham and Women’s Hospital.

Boland is currently vice chair of education and director of the psychiatry residency program at Brigham and Women’s Hospital. He is also an associate professor of psychiatry at Harvard Medical School and is board certified in psychiatry with expertise in medical education, psychosomatic medicine and geriatric psychiatry. He is an alumnus of Georgetown University where he earned his undergraduate and medical degrees.

Prior to joining Brigham and Women’s Hospital five years ago, Boland had an 18-year tenure at with the Alpert School of Medicine at Brown University, Providence, R.I He developed a special interest in depression resulting from medical illness and, with Brown and the Centers for Disease Control, he examined the influence of depression on the course of HIV in women. Boland later participated in the National Institute of Mental Health-sponsored Collaborative Depression Study. That project remains one of the longest studies of depression to date, for which Dr. Boland has written widely on the influence of depression on medical illness. Currently, he is an associate editor of Journal of Technology in Behavioral Science.

“Dr. Boland brings exceptional leadership experience and skills to The Menninger Clinic and to Baylor College of Medicine. His focus on innovation and the application of technology in our field of medicine is important to patients of the Texas Medical Center,” says Wayne Goodman, M.D., Chair and the D.C. and Irene Ellwood Chair in Psychiatry in the Baylor College of Medicine Department of Psychiatry and Behavioral Science.

As one of Baylor’s teaching hospitals for psychiatrists and psychologists, The Menninger Clinic values Boland’s mentoring of

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Robert J. Boland, M.D.

early-career psychiatrists and other mental health clinicians. In addition, His work in geriatric psychiatry and consultation-liaison psychiatry required the ability to treat complex patients, which Menninger has specialized in treating for 95 years.

“Dr. Boland is an innovator in the way patient care is delivered to meet the needs of communities today,” said Armando E. Colombo, president and CEO of The Menninger Clinic. “We share a common belief about the opportunity of psychiatry to improve the productivity and health of individuals, families and communities.”

For more than 30 years, he has been an active member of the American Psychiatric Association and its Council on Psychosomatic Medicine. Reflecting his distinguished reputation among peers nationally, Boland was chosen earlier this year to serve as an editor for one of the largest selling psychiatry textbook series. In addition, Boland served as the chair for the Psychiatry Residency Review Committee for the Accreditation Council and is a former president of the American Association of Directors of Psychiatric Residency Training.

“Identifying the next chief of staff with both academic and clinical relationships nationally was important to our joint search committee,” Colombo added. As one of the Texas Medical Center’s nationally ranked hospitals, The Menninger Clinic serves Houston and all of Texas and is also a trusted assessment and treatment provider for people across the country.

Boland succeeds John M. Oldham, MD, MS, who retired September 4, 2020 as the chief of staff at the Menninger Clinic.

Boland and his wife, Susan, have two adult children. Susan serves as the Director of Telemetry at the Landmark Medical Center in Rhode Island.

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OPPORTUNITIES FOR STROKE RECOVERY HAVE NEVER BEEN GREATER UPDATED GUIDELINES EMPHASIZE IMPORTANCE OF QUICK ACTION

690,000

795,000

U.S. strokes are caused when a clot cuts off blood cy rc A kAnr cS rUN InAVa (called an ischemic stroke).

Americans will have a new or recurrent stroke this year.

Stroke is the No. 5 cause of death in the United States, killing more than 142,000.1

PER YEAR

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QUICK TREATMENT = LESS BRAIN DAMAGE! Importance of Getting to the Hospital Quickly

1 in 19 DEATHS

Nr rc rUN UcokVrA^ Ar rUN nor oVTa cS ornc]N oc {cs JAa IN evaluated and receive treatment in time. Stroke treatment begins in the ambulance. Calling 9-1-1 can help patients get treated more quickly and get them to a hospital that specializes in stroke care.

LEARN AND SHARE THE WARNING SIGNS OF STROKE Spot a Stroke F.A.S.T.

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FACE DROOPING

Does one side of the face droop or is it numb?

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IV alteplase

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Is one arm weak or numb?

Mechanical thrombectomy is a procedure that can physically remove a large blood clot from a blocked artery in the brain.

SPEECH DIFFICULTY

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TIME TO CALL 9-1-1

AS SOON AS POSSIBLE WITHIN

If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get to the hospital immediately.

9-1-1

1. Heart Disease and Stroke Statistics-2019 Update: A Report from the American Heart Association 2. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke

Call 9-1-1 at the rst sign of stroke.

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October 2020

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Page 12

UTMB

Continued from page 4 new challenge. His team just recently made headlines for using an enzyme produced by fireflies to develop better tests for COVID-19 as well to better understand this new virus.

Mental Health

Continued from page 6 mindfulness is that the goal is to promote a relaxed state of mind, or that picturesque images of nature should be passing through the mind’s eye like some mindfulness screen saver. However, the actual practice of mindfulness more accurately deals with the deliberate cultivation of present moment self-awareness. The goal is simply being self-observant in the always present, always-changing, here-and-now. So, whatever that is for

Lung Transplant

Continued from page 9 patients with a score of 78.4. He was listed for transplant on Aug. 26, 2020 and received his organs the very next

WHAT WE OFFER:

“This generous endowment supports and enhances UTMB’s efforts to alleviate the human and economic toll imposed by infectious diseases here at home and worldwide,” said Dr. Ben G. Raimer, interim president of UTMB. “With the visionary support of The Smith & Sealy Foundation and the innovative work of amazing

researchers such as Dr. Pei-Yong Shi, we are making real progress toward better preventives, treatments and cures.”

“Dr. Shi’s research—and that of all those at UTMB working diligently day in and day out to keep us safe, to help us stay a step ahead of the next deadly disease and to help us understand the challenges we face—is truly inspiring,”

said John W. Kelso, president of The Sealy & Smith Foundation. “We must support those doing this work so they are able to innovate, experiment and find solutions to improve health and well-being in the Galveston community, the state of Texas and around the world.”

you, if it’s happening now, you’re doing it right!

One simple and easy way to start practicing mindfulness is to start off small. For starters, practicing mindfulness for just one minute sounds doable and can help build familiarity and still have benefit. So, if you’re interested in starting your own mindfulness routine, the next time you have one minute, I encourage you to try this mindful listening exercise. If you like, it’s fine to set a timer, but the idea is just to start of small and gradually increase one’s capacity to be mindfully present.

Start off simply by closing your eyes and allowing yourself to hear all the sounds around you. Take a moment to really just immerse yourself in all the sounds going on around you. There is no need to label what you hear, don’t try and identify anything, just listen.

Let the sounds just play on your ears and just listen. That’s it. After your minute of mindful listening check-in with yourself on the quality of your experience. What did you notice? What sounds did you hear? Were there any sounds you attended to that maybe you were previously unaware of? One minute of mindful listening can be a great

illustration of how being in the present moment enriches our experiences. This simple practice is a great way to start practicing mindfulness.

The only other requirement of mindfulness is the manner in which self-awareness is cultivated: that is non-judgmentally and with a great sense of self compassion. In essence, we learn to cut ourselves some slack and allow ourselves to just be. I believe this, above all else, to be the most fundamental to living mindfully, because through cultivating a life of non-judgment and self-compassion, we cultivate a capacity to show ourselves kindness.

day.

“Most double lung patients are in the hospital at least three weeks post-surgery. Mr. Medellin was released less than two weeks after surgery,” Jyothula said. “He will spend two to four weeks in inpatient rehab

to regain his strength, and then he will get to go home to his family.”

Before his transplant, Medellin was the primary caregiver for his wife. He has nine children and 32 grandchildren, and he said he cannot wait to be with them again.

“To think that I was only a few days away from dying and now I have a second chance at life is truly a miracle,” Medellin said. “I’m extremely grateful to the team who saved me and gave me the chance to get back to my family.” 

• Integrating the Montessori method into the public school curriculum • Currently offering Pre-K thru 8th • Open enrollment until positions fill

• Comprehension Stem Program • Character & Leadership Development • High Tech – 7 computers per classroom

2319 N. GRAND BLVD., PEARLAND, TX. 77581 www.hmps.net | 281-485-2500 October 2020

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Self Care

Continued from page 1 improve an individual’s overall quality of life. Not only does it change your body, metabolism, heart, and spirits, but it also allows you to set aside specific time in your routine to focus on you.

Stay connected to the people in your life.

While socialization and spending time with loved ones may look different during this time, technology has made it possible for individuals to stay connected with their friends and family members when they are unable to see them in person. By regularly communicating with and connecting with others, health professionals reduce the risk of anxiety and depression. In fact, one study of social relationships

Stroke Care

Continued from page 1 triage, diagnosis and treatment of strokes.

Combining groundbreaking applied artificial intelligence with seamless communication, Viz.ai’s image analysis facilitates the fast and accurate triage of suspected LVOs in stroke patients and better collaboration between clinicians at comprehensive and referral hospitals.

Viz.ai synchronizes care across the whole care team, enabling a new era of “Synchronized Care”, where the right patient gets to the right doctor at the right time.

“Viz.ai’s applied artificial intelligence solutions have been

Legal Matters

Continued from page 3 contract to purchase all the clinical services of a physician practice to treat patients of the hospital. The physician practice retains responsibility for day-to-day practice management and assigns its right to bill for its services to the hospital. The hospital will assume responsibility for price setting and negotiating payer contracts.

Historically, PSA arrangements have been viewed as similar to direct employment of the physicians by the hospital, which means merger law will apply. If a court determines that a PSA arrangement does not result in a single merged entity through employment or otherwise, then the antitrust statute applicable to agreements will apply: October 2020

Houston Medical Times and health found that connectedness leads to a variety of additional health benefits, while lack of social connection with others can lead to an increased risk of death.

Properly nourish your body.

When always focusing on patient care and not self-care, it can be rather easy for doctors and nurses to neglect proper eating and sleeping habits.

However, in order to be capable of providing the best care possible for their patients, healthcare providers must make sure that they are sustaining their energy with healthy diets and adequate sleep (at least 7 hours). Additionally, making concerted efforts to drink water throughout the day is essential, as well.

Staying hydrated not only benefits an individual’s physical health, but it also helps to improve cognitive abilities.

Take time for yourself.

Whether it’s meditation, a brief walk outside, or a number of other methods, taking time to escape the stressful environment within a COVID-19 hospital setting is imperative for the mental and emotional well-being of healthcare professionals. Doing so allows time for processing your thoughts and feelings and gives your mind a chance to reset, which will ultimately help you focus and maintain your concentration better when you are back at work.

Remember that it is difficult to effectively help others if you are not mentally and physically well yourself.

Monitoring your own self-care habits will help to ensure that you are in the best condition to help those who need care most during the global pandemic.

developed by top stroke clinicians and technical experts in the world and we are excited to be able to bring these transformational technologies to Baylor St. Luke’s and our community,” said Dr. Chethan P Venkatasubba Rao, Medical Director of Neuroscience ICU, Baylor St. Luke’s. “Before, we had to make decisions on the fly or quantify the images from the CAT scan, which is a laborious process which that can take hours to complete. The Viz.ai software bypasses the guess work and allows for early intervention, which results in improved outcomes for our patients.”

Viz LVO is transforming hospital workflow and synchronizing stroke care with a cloud-based artificial intelligence system that automatically analyzes

CT scans for suspected LVOs. It alerts neurovascular specialists of a suspected LVOs, enabling earlier imaging review and better collaboration between specialists.

“We are excited to partner with Baylor St. Luke’s Medical Center who has the foresight and commitment to provide cutting-edge applied artificial intelligent solutions to help transform healthcare to improve access to life-changing therapies for its community,” said Dr. Chris Mansi, neurosurgeon, co-founder and CEO of Viz.ai. “In this new era of Synchronized Care, Baylor St. Luke’s will provide its community with access to its expertise throughout its entire stroke network.”

Section 1 of the Sherman Act. There are two rules of decision under Section 1 of the Sherman Act. 1. The Rule of Reason. Under the Rule of Reason, a Court will assess whether the anticompetitive effects of an agreement outweigh its legitimate justifications in a properly defined relevant market.

2. The per se rule. The per se rule is reserved for types of agreements that are so plainly anticompetitive that no elaborate study of the industry is needed to establish their illegality.

The Supreme Court has cautioned that the per se rule is appropriate only after courts have had considerable experience with the type of restraint at issue, and only if the courts can predict with confidence that it would be invalidated in all or almost all

instances under the rule of reason.

To date, no court has conclusively determined which rule of decision should apply to PSAs that do not result in a single entity.

Physicians and hospitals are increasing working together in a variety of ways, each with its own antitrust risks. Hospital acquisitions of physician groups raise concerns over market concentration. Contractual arrangements that are less than full acquisitions, like PSAs, can receive antitrust scrutiny for market concentration, but also for conspiring to harm competition.

Hospitals and physicians should both remain cognizant of these issues as they work together. 

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MINIMALLY INVASIVE HEART PROCEDURES. MAXIMUM CARING.

SMALL INCISIONS. BIG DIFFERENCE. It’s not enough to perform minimally invasive procedures, if we don’t have a deeper understanding of what you and your heart need – from diagnosis through recovery. Our affiliated specialty trained interventional cardiologists and cardiovascular surgeons are adopting innovative techniques that not only treat your heart but aim to lessen the impact on your life, so you can get back to what matters most. And with Safe Wait™ enhanced safety measures at all of our facilities, you can get the care you need with peace of mind.

Advancing health. Personalizing care.

October 2020

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