yOUR PRIMARy SOURCE FOR PROFESSIONAL HEALTHCARE NEWS JUNE 2014 / $5
SOU TH LOU ISIANA ED ITION PRACTICE MANAGEMENT
On Rounds Physician Spotlight
New Model Could Save Private Practices By TED GRIGGS
Dr. Adam Olsan Adam’s Ark Growing up in the Sportsman’s Paradise, most young fishermen dream of buying their own boats one day. But, Lake Charles-based radiologist Dr. Adam Olsan is doing one better – he’s building his own ... page 3
Minority Physicians Seek to Reframe Reform Shifting the health reform conversation from political positions to economic benefits and including community providers in medical research are among the top priorities for the National, New Orleans and Louisiana Medical Associations ... page 4
Making sure that physicians continue to have a huge impact on the state economy has prompted the Louisiana State Medical Society to examine two innovative practice models: • The Louisiana Physicians ACO, the state’s only physician-owned Accountable Care Organization. In these voluntary networks, providers coordinate care and are eligible for bonuses when they deliver that care more efficiently. Each ACO has to care for at least 5,000 Medicare patients for three years. Providers make more money if they keep their patients healthy. The ACO includes physicians from New Orleans to Alexandria. LSMS plans to track the ACO through mid-2015, tracking whether the organization saves money, makes money and improves quality of care. • Direct Primary Care. Patients buy a primary care membership for $49 to $100 a month, which covers everyday health needs including lab work. Patients buy a catastrophic coverage policy to cover hospitalization. The model, legal in at least 18 states, cuts out many of the administrative headaches physicians now deal with on a daily basis. Jeff Williams, chief executive officer of the Louisiana State Medical Society, said LSMS is trying to find ways to make it easier for physicians to stay in private practice and in the state. (CONTINUED ON PAGE 8)
The Changing Rural Health Landscape By CINDy SANDERS
Dr. Keith Mueller
Will the Affordable Care Act help or hurt Americans living in rural areas? As is true of many complex laws, there probably isn’t going to be a single, simple, clear-cut answer. Some of the elements should be beneficial; others could have unforeseen or unintended consequences that ultimately limit access to care. Noted rural health expert Keith Mueller, PhD, head of the Department of Health Management and Policy for the University of Iowa College of Public Health and direc-
Access “The Patient Protection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A Second Look” under the quick link for the Rural Health Panel at rupri.org.
tor of the Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis, has been an integral part of preparing two policy briefs focused on ACA’s impact on rural America. Mueller also serves as chair of RUPRI’s Rural Health Panel, which released “The Patient Pro(CONTINUED ON PAGE 10)
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Louisiana Medical News
Dr. Adam Olsan Adam’s Ark
By LISA HANCHEy
Growing up in the Sportsman’s Paradise, most young fishermen dream of buying their own boats one day. But, Lake Charles-based radiologist Dr. Adam Olsan is doing one better – he’s building his own. A native of Monroe, La., Olsan is the son of two doctors – his dad, Richard, is a retired ER physician, and his mom, Lea, is a retired English professor. At age five, the talented youngster took up the violin, joining the youth symphony as a teen. He also took piano lessons for five years and later dabbled with the guitar. “The learning curve for the violin is steeper than the guitar,” he opined. “You can do a lot with a few chords on the guitar.” During high school, Olsan played both football and baseball. When it was time to choose a career, the multi-faceted teen decided to protect his hands and pursue medicine. He attended Tulane University, obtaining a Bachelor of Science degree in cell and molecular biology. For medical school, Olsan remained in New Orleans and went to Louisiana State University School of Medicine. After graduating, Olsan did his internship in Internal Medicine and residency in Diagnostic Radiology. “I like the objectiveness of radiology,” he explained. While in medical school and during his internship, Olsan went on several adventurous back-packing trips. Among the more memorable excursions was one with his college roommate, Matt Yates, a chemical engineering major, to the Grand Canyon. While there, an overnight flash flood nearly trapped them in the gigantic gorge. “We had made it half-way up the canyon that day and during the night there was a massive rain that washed out parts of the trail above us,” he recalled. “Everyone who was at that campsite had to be escorted out with a ranger. Along the way, the rangers told us to press ourselves against the side of the canyon wall to keep from getting hit by debris from workers clearing the trail above us. That was pretty neat.” Olsan and a med-school classmate also back-packed in Chile, where they had to use their very broken Spanish to negotiate a camping spot on a local rancher’s land. During his residency at Ochsner, Olsan met his wife, Angie Taylor, a radiologic technologist. After marrying in 2003, the couple moved to Rochester, N.Y., where Olsan’s father resides, for Olsan’s fellowship in MRI at the Univer-
sity of Rochester Medical Center. “MRI is an interesting and challenging field and the job market in MRI at that time was good,” he said. Coincidentally, his college roommate, Yates, who obtained his PhD, had also moved to Rochester, where he now serves as chair of the Chemical Engineering Department at the university. Following completion of his fellowship in 2005, Olsan selected a job in Lake Charles to be closer to Angie’s parents, who were living there. “It’s nice to be in a part of the country that is growing,” he
EDWIN G. PREIS, JR. L. LANE ROY ROBERT M. KALLAM FRANK A. PICCOLO JOHN M. RIBARITS CATHERINE M. LANDRY JAMES A. LOCHRIDGE, JR. CHARLES J. BOUDREAUX, JR. DAVID L. PYBUS DAVID M. FLOTTE LEAH NUNN ENGELHARDT EDWARD F. KOHNKE IV JENNIFER A. WELLS JONATHAN L. WOODS M. BENJAMIN ALEXANDER KEVIN T. DOSSETT KENNETH H. TRIBUCH CARL J. HEBERT MARJORIE C. NICOL MATTHEW S. GREEN EZRA L. FINKLE JEAN ANN BILLEAUD JOHN F. COLOWICH JOHN L. ROBERT, III WILLIAM W. FITZGERALD DARYL J. DAIGLE CAROLINE T. WEBB MANDY A. SIMON NATHANIEL C. PITONIAK ANDREW B. BROWN THOMAS H. PRINCE RACHAL D. CHANCE CRAIG R. BORDELON, II JARED O. BRINLEE KELLYE E. ROSENZWEIG KARNINA D. DARGIN
said. “There are a lot of industrial projects planned for the area over the next several years, so there will be significant changes. The fact that I’m going to be here experiencing these changes and providing healthcare to the citizens of Southwest Louisiana in this environment is exciting.” For the past nine years, Olsan has practiced with Radiology Associates of Southwest Louisiana, a division of Access Radiology. He also serves as Medical Director of Advanced MRI in Lake
Charles. “A lot of the cases I read now are MRIs,” he explained. Four years ago, Olsan started his biggest project – building his own wooden boat. “It gave me the opportunity to work with my hands,” he said. “It’s just something that is different from my daily life. It’s challenging and something my kids will remember helping me with – to a certain extent. They hand me pieces of wood.” The Olsans have two children – eight-year-old McKenzie, who was given her great-grandmother’s maiden name, and Benjamin, age 4. The 17–foot boat is made with pine and epoxy. After finishing the hull, Olsan, with the help of a few friends, flipped the vessel over so that he could complete the deck. Once completed, the boat will be equipped with a motor. “It’s actually a duck hunting boat,” he explained. Soon, he will be recruiting more volunteers to flip it over again for the final stages. “I posted on facebook that I need people to help me,” he said. “I shouldn’t have any problems getting it flipped back.” His goal is to finish the vessel by hunting season and maybe display it at the Wooden Boat Festival in Madisonville, La. this October.
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Louisiana Medical News
JUNE 2014 • 3
Minority Physicians Seek to Reframe Reform By TED GRIGGS
Shifting the health reform conversation from political positions to economic benefits and including community providers in medical research are among the top priorities for the National, New Orleans and Louisiana Medical Associations. “For a long time, physicians didn’t participate in governmental conversations. We don’t really do a good job advocating for ourselves or our patients when it comes to healthcare,” said Joia Crear-Perry, MD, National Medical Association Board of Trustees Region V Chair. “But that horse has already left Dr. Joia the barn. Healthcare is a Crear-Perry part of government, and we are part of it so we need to learn to be more active in those conversations.” Whether that means learning more about the Affordable Care Act, Accountable Care Organizations, or pay-for-performance initiatives, physicians have to stay informed, for themselves and their patients, Crear-Perry said. The NMA held its Region V conference in New Orleans in late April. CrearPerry said the National, Louisiana and New Orleans associations have tried to frame the proposal to expand Medicaid coverage as an economic conversation rather than a
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Louisiana Medical News
political one. Louisiana is competing economically with rest of the country and the world. Those efforts are being hampered because the state is losing too many of its people, very valuable resources, too early because they lack access to adequate healthcare services. Too many Louisiana residents die years before they should, in part because those patients aren’t under a physician’s care before they get a serious illness. The associations, which champion care for the poor and minorities, are trying to take a more active role at the state and national level. Crear-Perry said expanding Medicaid, which has been heavily opposed in Louisiana, could help with that. The expansions have worked elsewhere. Kentucky, a conservative state like Louisiana, was able to close free clinics because so many residents got insurance and were able to go to their own healthcare provider, Crear-Perry said. That would be considered a miracle in Louisiana. The Medical Associations would like to reframe the discussion, moving away from political ideologies to how Louisiana cares about all of its residents. “We have a bunch of uninsured people who work every single day. They wash our clothes. They work in these restaurants. They serve our food,” Crear-Perry said. Those folks don’t have health insur-
ance or sick days. The state is doing them a huge disservice by refusing to expand Medicaid. Crear-Perry said there’s little chance the state will expand the program, but that doesn’t mean physicians in the associations should stop trying. For example, the associations are partnering with Dillard University on a program that would train nurses to do the research in doctors’ offices. The pilot program’s goal is to eventually increase the amount of prescription drug research done through community providers. A lot of times, pharmaceutical companies go to the biggest hospital systems, such as LSU or Ochsner Health System, for clinical trials, Crear-Perry said. And just as frequently, those trials fail to include African-American patients. “We have medications that we’re using where there might not have been one person of color in the trial,” Crear-Perry said. The Medical Associations would like to see some of the mom-and-pop shops take part in the clinical trials. In many cases, those family practices are well-established in their communities, and the practices have a large volume of patients. Having physicians and patients participating in and knowledgeable about the trials will ensure that the medications being used are studied across a broad spectrum of individuals, she said. Part of the problem for community
providers is that they lack the infrastructure of a major health system. An LSU or an Ochsner may be able to absorb the cost of a registered nurse for a clinical trial or pay transportation costs for participating patients. But small practices don’t have those resources so a different economic structure will be required. The big pharmaceutical companies have the money, and they know they’re not doing a very good job of getting people of color into those studies, Crear-Perry said. Big pharma has been criticized by the U.S. Food and Drug Administration for just that, but drugmakers haven’t really come up with a fix. The New Orleans Medical Association’s pilot project with Dillard could change that. If the training program proves successful in New Orleans, the National Medical Association could try it out across the country. So far, pharmaceutical companies have been receptive to the idea, Crear-Perry said. The pilot program hopes to overcome some African-American patients’ reluctance to participate in clinical trials, she said. Having doctors who have a relationship with the target patients will help and could change that. “I’m just kind of tired of hearing this thing where they keep saying say, ‘Yeah, we don’t have any people of color in the studies.’ But no one’s doing anything substantive to change that,” Crear-Perry said.
Catching Fire: Lean Healthcare Transformations
Joan Wellman pioneered application of Toyota principles in healthcare; helps complex health systems facilitate large-scale change By LyNNE JETER
Last June, healthcare leaders from around the country – Stanford’s Lucile Packard Children’s Hospital, Oregon Health & Science University, UCLA Health, the University of Michigan Health System, and Vancouver Coastal Health – converged on the campus of Nemours Children’s Hospital in Orlando to see lean healthcare transformation in action. As usual, Joan Wellman, president of Seattle-based Joan Wellman & Associates (JWA Consulting), worked quietly and diligently behind the scenes, connecting hospital system administrators with companies in a strategic way to build a more reliable healthcare system using lean manufacturing principles. “A lean transformation is excruciatingly patient-focused,” said Wellman, who pioneered the application of Toyota principles in healthcare and helps complex systems facilitate large-scale lean healthcare transformations. “Every activity in the organization is assessed, relative to whether it adds value for the patient. As waste is removed, more time and resources are paid to the patient. It’s a very smart move to use these principles in a highly competitive environment because if you can do more for your patients with the same resources, you obviously have competitive advantage.” Wellman’s lean transformation journey began in the early 1990s, when she was consulting with Boeing on its lean manufacturing effort. “We were taking executive teams from Boeing to Japan,” explained Wellman. “In the course of two weeks, we took them by Toyota, Honda, Fuji, Xerox and other prize-winning companies to see how their manufacturing processes work. They saw the same principles in action at all these companies.” In 1994, Wellman recalls a Boeing executive, who served on the board of directors of a Seattle hospital, pondering whether lean principles could apply to healthcare. “At that time, none of us were healthcare consultants, but we saw the appeal,” she recalled. “We took a group of clinicians to Boeing’s final assembly line in Everett, Washington, and trained them in lean principles alongside operators on the line. Then we went back to the hospital and scratched our heads, trying to figure out how to make it palatable to healthcare professionals so the same principles could be applied. We looked at the waste and problems in hospi-
tal processes as we would in a lean manufacturing line.” Wellman spent a year at the hospital, better understanding the healthcare sector and the application of lean manufacturing principles to a healthcare setting. In 1996, Wellman became involved in delivering a series of lectures at Seattle Children’s Hospital about concurrently improving patient flow and quality while also reducing costs. In 1998, “it was time to put our big toe in the water,” said Wellman, who established JWA Consulting in 2000. A few years later, her book, Leading the Lean Healthcare Journey: Driving Culture Change to Increase Value (CRC Press), was published with co-authors Pat Hagan and Howard Jeffries, MD. The book chronicles healthcare improvements at Seattle Children’s Hospital, Memorial Care, The Everett Clinic in Washington, and Children’s Hospitals and Clinics of Minnesota. “I don’t see the lean principles movement slowing down at all because of the Affordable Care Act,” said Wellman, whose firm has grown to 22 associates. “I see an increased commitment and attention to building a more reliable system – with better quality, better safety, and better patient flow – at a lower cost. Applying the lean production system to healthcare is one of few models anywhere that simultaneously addresses all of those issues.” A lack of time, attention, and leadership passion are the primary barriers to lean principle implementation in healthcare systems, said Wellman. “Mainly, it’s the lack of time,” she said. “Money is not the issue because it’s rare for organizations to look back and say they aren’t getting financial gains from doing this work.” The application of lean principles is also aggressively being used in another segment of the healthcare industry: the design of healthcare facilities around the world, said Wellman, whose firm is becoming well known for its work in what JWA Consulting refers to as Integrated Facility Design, applying lean principles to the design and construction process. “We just finished up some work in the Netherlands, and helped design a healthcare facility in Saudi Arabia,” she said. “We’re also doing work in Canada and the U.S., whose clinical processes are fairly similar but social systems are quite different. All those factors have to be taken into account. One thing’s for sure: With the healthcare industry facing financial challenges and other market pressures, lean healthcare transformation is catching fire.”
Creating High-Powered Healthcare Improvement Engines Chapter 3 of Leading the Lean Healthcare Journey: Driving Culture Change to Increase Value (CRC Press, 2010), written by Joan Wellman with co-authors Pat Hagan and Howard Jeffries, MD, begs the question: What additional value do consumers in the United States receive for the extraordinary financial commitment made to healthcare? “A 2008 Commonwealth Fund Report ranked the United States last in quality of healthcare among 19 comparative, developed nations,” said Wellman, noting the United States spends twice as much per capita on healthcare than other developed nations. “Not a stellar track record for a society paying top dollar.” The chapter, “Creating High-Powered Healthcare Improvement Engines,” provides a blueprint for change through: • Brutally honest leadership • Moving from ‘episodic’ project based improvement to continuous improvement; • Changing the mindset and the management system of the organization vs. just applying lean methods; • Developing lean leaders; and • Developing a long term plan that ensures that this is a pervasive effort. “Although the quantitative evidence demonstrates undeniable success, some of the emotional aspects of staff and clinicians engaging in improving the healthcare system are even more exciting,” said Wellman, after helping an organization through the early years of its lean transformation. “The sense of accomplishment – ‘we can do this!’ – is palpable. Even during the very early days of this organization’s lean transformation, improvement team members frequently expressed their enthusiasm for being engaged in the work. Other team members saw this as one of the most rewarding times of their careers. Still others keep asking, ‘When are we going to do this again?’ Such comments are the reward for the lean leader.”
Louisiana Medical News
JUNE 2014 • 5
Drowning in Sea Change MGMA Tackles Tough Issues to Help Practices Stay Afloat By CINDY SANDERS
Value-based reimbursements, ICD-10 reboot, meaningful use, clinical integration physician alignment, transparency, PQRS, 5010 implementation, e-prescribing, staffing and training, compliance, audits … oh yes … and caring for patients There’s no question the American healthcare system is in the midst of sea change as foundational rules are rewritten and a new infrastructure for care delivery is being put in place. While providers, practice managers and administrators are supportive of many of the concepts, it doesn’t make the transition any easier. With wave after wave of change washing over practices, it’s certainly ‘sink or swim’ time. For those trying to navigate the rough waters, the Medical Group Management Association’s extensive resources, advocacy and insights on critical issues help shore up practice managers as they fight to keep afloat. Laura Palmer, FACMPE, a senior industry analyst and subject matter expert for MGMA, said practices across the country are facing unprecedented change. While much of it is tied to the Affordable
Care Act, a move to restructure the delivery and payment system was underway even before the landmark legislation was set in motion but has since been greatly accelerated. Today’s prac- Laura Palmer tice managers are being asked to alter ‘business as usual’ on most every front. Benefits & Eligibility Referencing the ACA impact, Palmer said it’s about much more than just expanding coverage. “It’s really a change in how insurance plans work,” she noted. Keeping up with who covers what, where, with whom and at what point has become increasingly complex as staff members drill down through eligibility requirements and benefits to figure out the bottom line for patients. While access might be expanding as more people join the insurance rolls, Palmer noted there has actually been a trend of narrowing networks. Not every physician or service provider is on every plan level under a payer. Adding to the confusion, not every family member is on
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Louisiana Medical News
the same plan. “We’re starting to see more differentiation, and it’s more difficult for the patient and provider, who needs to know where to send someone for referrals,” she noted. Whereas traditionally a lab company would have been on every plan under a payer, that’s not necessarily true today. A platinum plan might have more options than a gold or silver plan. “It’s a lot more complicated,” Palmer said. “You can’t depend on what you knew in the past to be true.” Therefore, she continued, it’s critical to regularly check coverage parameters and limits. Verifying benefits annually used to be pretty common. However, Palmer said that no longer works. “Best practices say we really need to check eligibility and benefits every single visit for every single patient,” she said. Although patient benefits tied to large employers or government entities still aren’t likely to change more than once a year, the same isn’t necessarily true for smaller employers. And, Palmer pointed out, people change jobs much more frequently now so even if a company’s plan hasn’t changed, the patient’s job status might have. Appropriate Staffing True access to care doesn’t mean simply having the coverage in place to allow a patient see a provider. The second part of the equation is having providers available to meet appointment demands within a reasonable time frame. “The days of a doctor’s office being closed for two hours over lunch are long gone,” Palmer said. In fact, she noted, many practices are looking at evening and/or weekend hours, group care settings and adding non-physician extenders to meet demand. From a reimbursement standpoint, practices must see enough patients to keep the doors open. From a quality standpoint, which now ties to reimbursements, it’s critical to meet best practice parameters. Palmer noted evidence-based standards might call for a patient with a specific complaint to be seen within 48 hours. Practices have to figure out how to do that or risk the consequences … both of missing quality benchmarks and of lowered patient satisfaction scores, which also will soon tie into reimbursement rates. “You don’t want patients to go to the Emergency Room because they couldn’t get an appointment,” Palmer said. She added, “Practices need to make sure they have adequate staff coverage and a triaging system in place to ensure patients are getting the right care in the right environment in the right time frame.” Making New Friends “Practices that in the past might have been competitors in a particular commu-
nity are now having to play nice with each other,” Palmer pointed out of new coverage rules and clinical integration models. Tied to the narrowing network trend, providers are finding payers and plans increasingly dictate referral patterns. Palmer said new payment models, such as the formation of accountable care organizations, also are forcing more collaborations encouraged by both the financial setup and patient need. She added that while this kind of collaboration across care settings is generally viewed as a good move for quality patient care, it is different than traditional practice silos and will take time for providers to adjust to creating more community-based care than has been available in the past. Adjusting to New Payment Models Although the vast majority of reimbursements remain in the fee-for-service world, the switch to a value-based system is already underway. “The practical aspect of how we deliver care is already changing,” Palmer said. Practices have begun investing in changing technology and staffing models before reimbursements have caught up to the new way of doing business. Case managers, nutritionists and non-physician providers are being added … even when those services aren’t clearly reimbursable across most payers … because of the value they add to patient care. Currently, Palmer noted, only about 3-5 percent of a practice’s reimbursements are tied to quality metrics. While those numbers have remained pretty steady for the past few years as reported to MGMA, Palmer said she was eager to see if there is a change indicated in this year’s data. Anecdotally, she said MGMA staff members have heard from more practices that contracts are being negotiated with quality metrics in mind. Despite payments lagging a bit behind, Palmer said practices have really embraced the concept of value-based care. “It’s the right thing to do,” she stated. “I think physicians and practices know to really manage care, the best way is to look at total patient care.” ICD-10 Recognizing that not every provider in every setting is on the same page about the latest ICD-10 delay (with a new implementation date of Oct. 1, 2015 as confirmed by CMS in May), Palmer said it cropped up as the number one concern for 2014 in MGMA’s annual Medical Practice Today survey. Chief among worries are cash flow concerns, vendor issues, testing, and adequate staff training. Palmer noted, “The delay in implementation is going to allow for more testing, and that’s got to be good (CONTINUED ON PAGE 8)
Rock Star Researchers
Andrew Yoo, PhD among Medical News’ market area recipients of the prestigious Presidential Early Career Award By LYNNE JETER
Andrew Yoo, PhD, is a rapidly rising star in the research world. Yoo, assistant professor of developmental biology at Washington University School of Medicine in St. Louis, Mo., followed a $2.3 million NIH Director’s New Innovator Award, announced in October 2012, with one of the nation’s highest honors 14 months later. Notified two days before Christmas, he was among 102 investigators to receive a Presidential Early Career Award for Scientists and Engineers, the highest honor given by the federal government to independent researchers early in their careers. “The impressive achievements of these early-stage scientists and engineers are promising indicators of even greater successes ahead,” said President Obama. “We’re grateful for their commitment to generating the scientific and technical advancements that will ensure America’s global leadership for many years to come.” The Presidential Early Career Awards signify the high priority the Obama Administration places on producing outstanding scientists and engineers to advance the nation’s goals, tackle grand challenges, and contribute to the American economy. Yoo is one of only four recipients from the Department of Health and Human Services, and the only one west of the Mississippi River. At Washington University, Yoo is known for his work identifying the function of small RNA molecules –microRNAs – in controlling the packaging of the genome and the reprogramming of cell fates. Specifically, Yoo’s lab has shown that human skin cells can be instructed to become brain cells, using microRNAs. The Mallinckrodt Foundation, Ellison Medical Foundation and the National Institutes of Health (NIH) finance research in Yoo’s lab to investigate cell fate conversion. The work may lead to better ways to help patients with neurodegenerative disorders, such as Huntington’s or Parkinson’s disease. Yoo earned a doctorate in 2005 from Columbia University in cellular, molecular and biophysical studies, and joined Washington University in 2011 after a postdoctoral fellowship at Stanford University. He’s received other significant honors for his research, including a Helen Hay Whitney Foundation Fellowship, Mallinckrodt Foundation New Investigator Award and Ellison Medical Foundation New Investigator in Aging Award. Yoo’s realization of a research career was “a gradual process rather than a momentary realization,” he said. “I was heavily influenced by the kind of science courses I took during my undergraduate years,” he said. “I was enrolled
(L-R) Andrew Yoo, PhD, stands among fellow researchers Robert W. Gereau IV, PhD, and Michael R. Bruchas, PhD, who were awarded $6.2 million in NIH grants in 2012 to pursue innovative ideas that have the potential to transform human health. Yoo was awarded a $2.3 million grant to study the role of microRNAs in controlling the packaging of the genome and the reprogramming of cell fates.
in an honors program that emphasized research and encouraged me to take courses such as mathematical modeling of biology, molecular mechanisms of memory formation, and so forth. This was a good fit for me, as I found myself always leaning towards courses that taught how to figure things out. Over the years, I slowly developed my desire to be part of a research team that makes scientific discoveries and contributes to society.” Yoo’s research on microRNAs and how these molecules influence cell fates began a decade ago, when he was a graduate student in the lab of Iva Greenwald, PhD, a professor of biochemistry and molecular biophysics at Columbia University College of Physicians and Surgeons. “Due to the lack of modern techniques, studying microRNAs was a difficult task back then, and I told myself that
I’d try studying something different for my post-doctoral training,” he recalled. “I eventually decided to join Dr. Gerald Crabtree’s lab at Stanford University to study genetic pathways that control the activity of chromatin remodeling proteins during neural development. I figured out the genetic pathway and it happened to involve microRNAs. Basically, microRNAs called me back. From there and based on my previous observation that microRNAs may have a significant impact in controlling cell fates, I went on to test if brain-enriched microRNAs would alter non-brain cells into brain cells. I found that expressing microRNAs turned human skin cells into neurons, allowing us to non-invasively generate brain cells from specific individuals. This finding became the foundation of my lab. We’re currently trying to figure out why these microRNAs
are so potent in determining the neuronal fate, and develop models of neurological diseases in petri dishes.” Yoo’s research team consists of five graduate students, a staff scientist, a postdoctoral fellow and a lab manager/senior technician. “Michelle Richner, whom I was lucky enough to have as the first person to join the lab, has been working with me the longest,” he said. “We’re all a bunch of hardworking scientists.” Yoo became associated with Mallinckrodt Foundation and the Ellison Medical Foundation through the generous awards received from them. “My association with NIH started when I competed nationally and won an award called NIH Director’s New Innovator Award,” he said. “These awards were geared toward early stage investigators and I was lucky enough to be selected to receive them.” The White House notified Yoo about being selected to receive a Presidential Early Career Award on Dec. 23. “That was the best Christmas gift ever!” he said. The awards, established by President Clinton in 1996, are coordinated by the Office of Science and Technology Policy within the Executive Office of the President. Awardees are selected for (CONTINUED ON PAGE 10)
Louisiana Medical News
JUNE 2014 • 7
New Model, continued from page 1 A recent report issued by the American Medical Association shows private physicians’ offices are vital to the state and national economy. Louisiana physicians accounted for $7.7 billion in economic activity and supported 93,974 jobs statewide in 2012. Each of the state’s 9,804 patient physicians – those whose main occupation is treating patients – supported close to 10 jobs. Nationally, the numbers are even larger. Physicians’ economic impact totaled $1.6 trillion while supporting close to 10 million jobs, an average of nearly 14 per doctor. It’s the other side of the equation that’s disheartening, Williams said. The health system wasn’t designed to turn Jeff Williams physician practices into clearinghouses for insurance companies, but somehow they have morphed into this situation, Williams said. Meanwhile, non-MDs, such as optometrists and nurse practitioners, are being allowed to increase their scope of practice. All of these things are pushing more doctors to give up their practices and go to work for hospitals, retire or to leave Louisiana and practice in states that are a little more physician-friendly, he said. Spending on physician services grew
more slowly between 2009 and 2012 than at any time in the last 15 years, according to the federal government. It’s not that hospitals don’t have a huge economic impact, Williams said. They do. But the footprint of a hospital’s economic impact doesn’t necessarily change much if another doctor, or five, begin working there, he said. Unlike private practices, a hospital’s ancillary services are already established and grouped in that service area. Senate Bill 516 would make direct primary care legal in Louisiana. The bill passed the Senate with no opposition and was pending in the House of Representatives at press time. Williams said direct primary care differs in a very important way from concierge medicine. With a concierge practice, someone, the patient or the physician practice, is still submitting an insurance form, Williams said. Direct primary care removes insurance from the equation, and that dramatically lowers overhead costs. Overhead can account for 70 percent of a practice’s costs, Williams said. With the new practice model, some physicians have cut overhead to less than 20 percent of total costs. “You don’t need billers. You don’t need coders. You don’t care about meaningful use in electronic medical records. ICD-10 is not on your radar,” Williams
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said. “Basically it takes all of the bureaucracy out of medicine, and it allows doctors to see patients.” Typically, primary care physicians see 20 to 30 patients a day, which severely limits the amount of time spent with each patient, Williams said. In other states that allow direct primary care, physicians might see 12 patients a day. “For most, costs go down, and quality goes up,” he said. Another attractive component of direct primary care is that it complies with the Affordable Care Act. Employers can use direct primary care to avoid paying the tax penalty levied
against businesses that don’t offer health coverage to their workers, Williams said. A fast-food franchise with 20 locations might have to lay off people or reduce workers’ hours, both of which are bad for the company. But with direct primary care and catastrophic coverage on the back end, employers save money and comply with the ACA, he said. LSMS is excited about direct primary care’s possibilities. “In medicine, everything’s bad news, bad news, bad news. This is one that’s good news,” Williams said.
Drowning in Sea Change, continued from page 6 for everyone.” She added, she thinks it will give vendors the needed extra time to resolve software issues and practices time to get the technology and training in place. However, Palmer acknowledged there would be some practices that once again put ICD-10 on the back burner only to panic again next year instead of using this time to really prepare. Practice Setup “Integration and alignment issues are still a big topic of conversation,” Palmer said. What is the most effective practice model? Should practices merge? Sell to a hospital? Specialize or become multidiscipline? The ‘correct’ answer, she said, truly varies depending on circumstances and location. “Healthcare is local,” Palmer pointed out. “What would work in Maine won’t necessarily work in Arizona.” The MGMA Lifeline MGMA’s resources can serve as a lifeline to practice managers who are treading water as fast as they can. Palmer stressed the organization’s role is not to make decisions for practice managers but to put them in a position to proactively
make thoughtful choices based on their own unique set of circumstances. The goal, she said, is to “bring people vetted information – good information from reliable sources – so practice managers can make informed decisions.” She continued, “There isn’t one right answer. The joke around here is if you’ve seen one practice … you’ve seen one practice.” Although new delivery models are building local alliances, there is certainly still a competitive relationship among practices in a given geographic area. Palmer said a key benefit of MGMA is that it provides a safe environment for peer networking to allow the exchange of information across regions. Where a practice manager might not ask the competing cardiology practice down the street how they are handling benchmarking or succession planning, MGMA membership provides a forum where that manager could talk to cardiology practices outside the market catchment area to find out how they are addressing those issues. Finally, she noted, MGMA offers the tools to allow managers to excel in their careers. “We provide professional development so we grow the next generation of practice managers,” Palmer stated.
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www.louisianamedicalnews.com 8 • JUNE 2014
Louisiana Medical News
Meeting Demand for Online Based PharmD Education
LECOM is only nation’s second osteopathic school to offer Doctor of Pharmacy Degree Program via distance education By LYNNE JETER
BRADENTON, FLA.—The Lake Erie College of Osteopathic Medicine School of Pharmacy (LECOM) recently unveiled an online Doctor of Pharmacy (PharmD) degree, only the nation’s second osteopathic school to offer the traditional four-year professional program via distance education. The inaugural online class of 24 students will meet on the Florida campus Aug. 18 for orientation, with an anticipated June 2018 graduation. LECOM administrators plan to reach capacity of 96 students in four years. LECOM follows Creighton University, the only other osteopathic program nationwide, in its increased online degree coverage. Creighton began its Doctor of Pharmacy online degree program in 2001. “We knew this was a program students wanted,” said Katherine Tromp, PharmD, director of distance education for LECOM in Bradenton, Fla. “The pent-up demand was there. The distance education program makes it easier for medical professionals who already maintain a busy schedule with work and family responsibilities. But don’t let it fool anyone into thinking it’s an easy program. “The LECOM online Doctor of Pharmacy curriculum is quite comprehensive, and takes about 60 hours a week to fulfill the laboratory, casework and presentation portions of the program. Time management skills are vital to the student’s and program’s success.” Even though the majority of the program is online, students will be required to attend orientation and laboratory sessions on site, and also complete their clinical and experiential rotations at pharmacies, hospitals and wellness centers across the country. Students will also be required to travel to testing sites for exams. Of 185 PharmD programs offered worldwide, very few schools administer the coursework almost entirely online. In the United States, there are seven institutions accredited to offer the coursework online: two osteopathic schools, Shenandoah University, University of Florida, University of Montana, University of North CarolinaChapel Hill, and the University of Oklahoma-Tulsa. The schools’ program curriculums vary. The University of Florida’s online doctor of pharmacy degree program, which requires limited campus visitation, focuses on Medication Therapy Management (MTM), an emerging area of pharmacy practice that recently became a billable service for some Medicare Part D and Medicaid recipients. UF is the only university offering this concentration. LECOM is a solitary school of pharmacy functioning from two locations nearly 1,200 miles apart. On campus in Erie, Pa., an accelerated pathway allows PharmD
students to complete the degree program in three years. On the Florida campus, students may opt for the traditional pathway or online, both four years. All three curricula offer a similar spectrum of didactic courses, credit hours, and experiential edu-
cation and experiences. Course electives include research independent study, cultural competence for healthcare professionals, advanced pharmaceutical compounding, drug discovery and development, health disparities, clini-
cal toxicology, gerontology issues, travel medicine and a practical business study to build a solid personal finance foundation. LECOM also offers a long-distance curriculum for the master’s degree program in medical education.
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The Changing Rural Health Landscape, continued from page 1 tection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A Second Look” in late April. The new review is a follow-up to the original analysis released shortly after the legislation was signed into law. “Like a lot of people, we were pleasantly surprised at the level of enrollment,” Mueller said of the panel’s reaction to recently released health exchange numbers. He explained that on top of the 8-plus million that was widely reported, there has also been a fair amount of enrollment in qualified health plans (QHP) on the open market. At this point, Mueller noted, it isn’t clear what the urban/rural breakdown is among enrollees. However, Mueller continued, the number of uninsured individuals in rural areas is generally about the same or a little higher than in urban areas. “Small employers in rural areas are less likely to have made an employee plan available than small employers in urban areas,” he noted. While having more people insured is a positive, Mueller pointed out coverage comes with a presumption that someone
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will actually be there to deliver care. “You have to address both the financial access and the availability of services,” he continued. “You’ve increased the demand so you also have to increase the supply.” Mueller continued, “In rural areas where there’s already a shortage of providers, you’ve exacerbated the situation. There are still many more counties that are primary care shortage areas than there ought to be … and that’s a fundamental service.” In addition, he said there are pockets where there is a shortage of emergency services and general surgeons. Mueller said the health delivery system has to be integrated locally across the full continuum of care from primary through quarternary care. “You need to have a system where no matter where I live, there is a point of entry for me to get all those services,” he stated. On a more positive note, Mueller said Title 5 of ACA, which deals with workforce issues, did increase funding for the National Health Service Corps. There has also been increased attention regarding how providers could be used more efficiently in federally qualified health centers, including a push to have nonphysician providers practice at the top of their licensure. Even before ACA, Mueller pointed out, healthcare systems were already evolving with pilot programs testing innovative payment and delivery models. Technology, he said, will provide a criti-
Physicians’ health Foundation oF louisiana
cal role … particularly the use of telehealth in rural areas. Instead of having to bill for each discreet service, Mueller said newer payment models allow for bundled services, “leaving it up to doctors to figure out the best way to get to the value proposition.” That is a win for telehealth, he noted, since the service is often left out of traditional payment plans. Another plus for telehealth is that patient satisfaction also plays into reimbursement … being able to ‘see’ a specialist at home using technology to assist in a consult rather than driving to an urban market, should increase convenience and satisfaction for rural patients. It allows them to receive the care, albeit differently, that would be found in a much larger city. “That, to me as a researcher and analyst, is the most exciting direction because it means that people will get the care they need when they need it no matter where they are living,” Mueller said. Of serious concern, however, is the financial fallout in states that did not opt to expand Medicaid as was intended by ACA to help offset payment reductions in other
areas, such as those to disproportionate share hospitals. “The states that did not expand Medicaid are states with larger rural populations so the non-expansion has a disproportionate rural effect,” Mueller said. He added, “So far there hasn’t been a huge effect because those reductions are scheduled to happen over time.” However, Mueller continued, “The longer those states don’t expand (Medicaid), the greater the impact.” He noted the financial strain would be felt more sharply in rural areas because those hospitals tend to have much thinner operating margins in the first place. Mueller noted, “We have put in place over the last couple of decades various ways to sustain service delivery in the rural areas. The scary scenario would be because of financial pressures, we pull the rug out from under (them). If that happened, there would be places in rural America where access would be severely limited.” He concluded, “You don’t stop what has been working, even if it isn’t perfect, until you have a better solution in place. I think we’re working on a better solution right now … but it’s not in place, yet.”
Rock Star Researchers, continued from page 7 their pursuit of innovative research at the frontiers of science and technology and their commitment to community service as demonstrated through scientific leadership, public education, or community outreach. The recipients are employed or funded by the following departments and agencies: Department of Agriculture, Department of Commerce, Department of Defense, Department of Education, Department of Energy, Department of Health and Human Services, Depart-
ment of the Interior, Department of Veterans Affairs, Environmental Protection Agency, National Aeronautics and Space Administration, National Science Foundation, the Smithsonian Institution, and the Intelligence Community, which join together annually to nominate the most meritorious scientists and engineers whose early accomplishments show the greatest promise for assuring America’s preeminence in science and engineering and contributing to the awarding agencies’ missions.
Presidential Early Career Award winners from Medical News markets: Department of Education Dr. Young-Suk Kim, Florida State University Department of Energy Dr. Gary Douberly, University of Georgia Department of Health and Human Services Dr. Richard Ho, Vanderbilt University Medical Center Dr. Sallie Permar, Duke University School of Medicine Dr. Ida Spruill, Medical University of South Carolina
Providing assistance with the identification, treatment, and monitoring of physicians who suffer from a physical or mental condition, in order to promote patient safety and to ensure the continued availability of skilled physicians
Dr. Andrew Yoo, Washington University School of Medicine National Aeronautics and Space Administration Dr. Tamlin Pavelsky, University of North Carolina National Science Foundation Dr. Moises Carreon, University of Louisville Dr. Daniel Goldman, Georgia Institute of Technology Dr. Samantha Hansen, University of Alabama
10 • JUNE 2014
Louisiana Medical News
Legislative Affairs BY CINDY BISHOP
By CINDY BISHOP
As I write this column, the Louisiana Legislature is entering into the 10th week of the 2014 Regular Session. The magnitude of the healthcare issues debated this session have been far-reaching. From medical marijuana, to Medicaid expansion, to reigning in abortion clinics, to the plethora of health insurance (payor) issues, to scope of practice issues (expansion of medical practice for optometrists). This past week, the House of Representatives considered House Bill 1065 by Rep. Rogers Pope which allows optometrists to perform eye surgery. Proponents of the bill argue that the bill simply gives patients access to healthcare. However, the medical community counter argues that the optometry bills being considered this session give optometrists open-ended authority to perform almost any surgical procedure. According to the Louisiana Ophthalmology Association, “House Bill 1065 would authorize optometrists to perform procedures using multiple methods and instruments including scalpels, lasers, needles, ultrasound, ionizing, radiation and by burning and freezing tissue.” On Tuesday, May 6, House Bill 1065 cleared the House floor and heads to the Senate. Senator David Heitmeier, chairman of the Senate Health and Welfare Committee, has a similar bill pending before the Louisiana Senate. As a matter of disclosure, I represent a statewide medical specialty group of surgeons (the Louisiana Orthopaedic Association) who strongly believe that only board-certified or board-eligible surgeons should be authorized to perform surgery on a patient’s eyes. Another issue that was debated lengthily this past week was House Bill 711 by Rep. Hunter Greene (R-Baton Rouge), before the House Insurance Committee. Current law provides that healthcare providers are responsible for collecting the amount of any co-insurance or deductibles applicable to a health insurance policy from the insured. Under the provisions of House Bill 711, the healthcare insurer issuing a policy that requires co-insurance or deductibles from the insured would have been responsible for collection of those amounts. Proponents of House Bill 711 argued that this measure would consolidate and simplify health insurance for consumers by placing the responsibility of collecting health benefit co-insurance and deductibles on the parties who are responsible for the development, marketing and administration of their associated benefit plans – the health insurance issues.
Opponents of the measure (the Louisiana Association of Health Plans and insurance carriers) argued that by requiring the health plans to collect co-payments and deductibles would turn them into “collection agencies.” They argued that patients are fully aware of their financial responsibilities and are knowledgeable about their co-payments and deductibles. At the conclusion of a lengthy debate on the subject matter, Rep. Hunter Greene decided to voluntarily defer further consideration of his measure. Last week, the Senate Health and Welfare Committee debated Senate Bill 541 by Senator Fred Mills of Breaux Bridge. Current law authorizes the prescribing of therapeutic marijuana for certain medical conditions. Senate Bill 541 provides that a physician as defined may prescribe therapeutic marijuana, tetrahydrocannabinols, or a chemical derivative of tetrahydrocannabinols for therapeutic use if all of the following occur: • The physician is a certified neurologist, oncologist, or ophthalmologist licensed to practice medicine in Louisiana. • The physician is registered to prescribe controlled dangerous substances with the DEA. • The physician has obtained a license to prescribe therapeutic marijuana. • The physician has a bonafide physician-patient relationship with a patient who suffers from a qualifying medical condition and the physician determines that therapeutic marijuana is the best treatment option for that patient. Proposed law provides that the prescriptive authority shall only extend to certified neurologists, oncologists, and ophthalmologists and shall only be prescribed for the treatment of a qualifying medical condition. Proposed law creates the Therapeutic Marijuana Utilization Review Board and provides for its membership. Proposed law provides that the board shall have rulemaking authority and shall work in conjunction with the commissioner of the Dept. of Agriculture and Forestry, the Louisiana Board of Pharmacy, and the Louisiana Board of Medical Examiners to facilitate the necessary licensing to prescribe, produce, and dispense therapeutic marijuana in Louisiana. Proposed law places the Therapeutic Marijuana Utilization Review Board within the Department of Health and Hospitals. Proposed law provides that the Dept. of Health and
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(CONTINUED ON PAGE 12)
Louisiana Medical News
JUNE 2014 • 11
Legislative Affairs, continued from page 11 Hospitals shall supply staffing and facilities to assist the board in administering the provisions of proposed law. Proposed law establishes criteria and licensing qualifications for therapeutic marijuana dispensers, therapeutic marijuana treatment facilities, therapeutic marijuana producers, therapeutic marijuana production facilities, and physicians licensed to prescribe therapeutic marijuana and authorizes the board to develop the policies to implement proposed law through the adoption of rules. Proposed law provides that the House and Senate committees on health and welfare shall have oversight over rules adopted by the Therapeutic Marijuana Utilization Review Board. Proposed law provides that the applicant for any license must be determined to be suitable which means that the applicant is: • A resident of the state. • 21 years of age or older. • A person of good character, honesty, and integrity. • A person whose prior activities, criminal record, if any, reputation, habits, and associations do not pose a threat to the public interest. • A person who is capable of and likely to conduct the activities for which the applicant is licensed. • A person who does not owe the state or any local governing authority or any municipality any delinquent sales taxes, penalties, or interest. • A person who agrees in writing to hold harmless and indemnify the licensing authority, the state, or the board for any and all liability arising out of the issuance of the license. • A person who is not disqualified. Proposed law provides that a person will be disqualified from obtaining a license based upon any of the following: • The conviction or a plea of guilty or nolo contendere by the applicant for any offense punishable by imprisonment of more than one year, any offense involving a controlled dangerous substance, or a crime of violence or a sex offense. • The person is not current in filing all applicable tax returns and in the payment of all taxes, penalties, and interest owed to the state of Louisiana or any political subdivision of Louisiana, excluding items under formal appeal. • The failure to provide information and documentation to reveal any fact material to a suitability determination, or the supplying of information which is untrue or misleading as to a material fact pertaining to the suitability criteria. Provides that the licenses provided for by proposed law shall be issued by the following licensing authorities: A therapeutic marijuana treatment center license shall be issued by the Louisiana Board of Pharmacy. • A therapeutic marijuana dispensing agent license shall be issued by the Louisiana Board of Pharmacy. • A license to prescribe therapeutic marijuana shall be issued by the Lou12 • JUNE 2014
Louisiana Medical News
isiana Board of Medical Examiners. • A therapeutic marijuana production facility license shall be issued by the commissioner of the Dept. of Agriculture and Forestry. • A therapeutic marijuana producer license shall be issued by the commissioner of the Dept. of Agriculture and Forestry. Proposed law provides for the creation of the Louisiana Therapeutic Use of Marijuana Fund. Provides that the fund shall be administered by the board. Proposed law provides that the Dept. of Agriculture and Forestry, the Louisiana Board of Medical Examiners, and the Louisiana Board of Pharmacy shall be reimbursed for any expenses those departments incur for the investigation and licensing functions. Proposed law provides for an exemption from prosecution if a person is in possession or producing, manufacturing, dispensing, or distributing therapeutic marijuana as authorized by proposed law. Proposed law provides that therapeutic marijuana shall not be covered by health insurance. Proposed law provides that no licenses shall be issued until all rules have been adopted. Effective January 1, 2015. (Amends R.S. 40:1046.1-1046.15; adds R.S. 36:259 LSU Student Jacob Irving testified in favor of the bill. “Essentially what I was saying was that medical marijuana would be good for people with spasticity. The alternative treatments all revolve around treatment and there is no cure. All other treatments are invasive. They consist of either major surgery, physical therapy, high-dose botox injections, serial casting. Most of the treatments are for children and are designed to prevent a child from developing improperly. Developing improperly can lead to very terrible effects on the human body, including muscle contractions and bone growth abnormalities. When they reach a certain age, most people with spasticity receive little or no treatment. In many cases this is due to the realities of getting older, more responsibilities and life-time insurance caps. A study also showed that 63 percent of adult spastic cerebral palsy patients reported chronic pain. Marijuana when combined with physical therapy has shown very positive results for spasticity. Currently, I have a home stretching routine that consists of hours and hours and hours a week. Sometimes even 40 or 60. This is necessary because my muscles have a natural tendency to be very tight and weak, and to survive outside in the real world you have to be able to do certain things. As a full time college student, marijuana would make it easier to manage my time by making my home physical therapy more effective and efficient.” After a lengthy hearing, Senate Bill 541 was defeated by a vote of 6-2 in the Senate Health and Welfare Committee. The 2014 Regular Session of the Louisiana Legislature adjourns sine die on June 2, 2014. Legislative Affairs content is provided by Checkmate Strategies, publisher of Health Care Information Services. All content © Checkmate Strategies and Louisiana Medical News, LLC. For more information, readers may contact Cindy Bishop at 225.923.1599 or P.O. Box 80053, BR, LA 70598, or send email to firstname.lastname@example.org. Our website is www. checkmate-strategies.com
In the News Memorial’s Cancer Center Receives National Achievement Award LAKE CHARLES- The Lake Charles Memorial Cancer Center recently received the Commission on Cancer (CoC) Outstanding Achievement Award for 2013. Memorial is one of 74 cancer programs in the United States and the only cancer program in Louisiana to receive the award. “These 74 cancer programs surveyed in 2013 currently represent the best of the best—so to speak—when it comes to cancer care,” says Daniel P. McKellar, MD, FACS, Chair of the CoC. “Each of these facilities is not just meeting nationally recognized standards for the delivery of quality cancer care, they are exceeding them.” The 74 award-winning, cancer-care programs represent approximately 14 percent of programs surveyed by the CoC in 2013. Established in 2004, the CoC’s Outstanding Achievement Award is designed to recognize cancer programs that strive for excellence in providing quality care to cancer patients. Programs are evaluated on 34 cancer program standards categorized within one of five cancer program activity areas: cancer committee leadership, cancer data management, cancer conferences, clinical services and quality improvement. Programs are further evaluated on seven commendation standards. Award recipients must have received
commendation ratings in all seven commendation standards, in addition to receiving a compliance rating for each of the 34 cancer program standards.
Lakeview Regional Surgical Specialists Is Proud To Welcome Dr. Lance Wehrly, Orthopedic Surgery COVINGTON- Dr. Lance J. Wehrly is a board certified orthopedic surgeon at Lakeview Surgical Specialists and is affiliated with Lakeview Regional Medical Center where he treats a large range of pathologic conditions of the hand, shoulder, Dr. Lance J. hip, knee and ankle. He Wehrly specializes in knee and shoulder arthroscopy and hip, knee and shoulder replacement. Dr. Wehrly graduated with highest distinction from the University of IllinoisUrbana with a Bachelor of Science in Cell and Structural Biology and received his medical degree from the University of Illinois at Chicago. He completed a general surgery internship at Ochsner Clinic Foundation in New Orleans followed by an orthopedic residency also at Ochsner Clinic. Prior to joining the Lakeview Regional staff, Dr. Wehrly practiced at the Dean Clinic in Janesville, Wisconsin. Dr. Wehrly is board certified through the American Board of Orthopedic Surgery and is a member of the American Academy of Orthopedic Surgeons and the American Medical Association.
Baton Rouge Mental Health Facility Expands BATON ROUGE- Seaside Health System, a provider of inpatient and outpatient mental health services across Louisiana, recently expanded its 4363 Convention Street, Baton Rouge behavioral health facility following seven months of renovations. According to Laurence Conkerton, Administrator, Seaside Health System and Program Director of Baton Rouge Outpatient Services, the Convention Street facility has now opened as a 64 bed inpatient behavioral health center and is also home to a dedicated Geriatric Tract that will serve the mental health needs of the senior population. Seaside Health System previously provided inpatient mental health services from a 30 bed facility in its former Gonzales, Louisiana location. The Baton Rouge Seaside Health System on Convention Street held an open house and tour of the newly renovated complex on March 24 and is now fully operational. Serving adults 21 years of age and older through its in-patient program, the Joint Commission accredited facility with a staff of 80 provides services in the treatment of dementia, Alzheimer’s, major depressive disorders, schizophrenia, Chronic Paranoid Schizophrenia among other mental health concerns. The Convention Street location also provides outpatient services including a partial hospitalization program for patients 18 years of age and older for a variety of mental health issues. The outpatient program is also Joint Commission accredited. Medical directors for the Seaside Health System in Baton Rouge are Robert Blanche, MD and Nick Campo, MD. Seaside Healthcare is a Louisiana headquartered mental healthcare corporation operating inpatient or outpatient facilities in a number of Louisiana locations including Baton Rouge, New Orleans, Thibodaux, Mandeville, Zachary, and Opelousas.
In the News Ochsner’s Telestroke Program Reaches 3,000th Consult In Less Than Five Years NEW ORLEANS – During a stroke, 1.9 million irreplaceable brain cells are lost each minute. Time is of the essence. Yet most rural and many urban hospitals do not have neurologists on call to diagnose and care for emergency stroke patients. Since August 2009, however, through Ochsner’s TeleStroke program, over 3,000 patients around the state have been able to receive specialized care from Ochsner neurologists in that integral timeframe between symptom onset and treatment. Ochsner Medical Center was the first hospital in Louisiana to use telemedicine to treat stroke. In the four and a half years since its implementation, Ochsner has become one of the fastest growing networks in the country with 20 active spoke hospitals, and its 3,000th patient consultation was performed at Minden Medical Center on March 28, 2014. “Ochsner’s Telestroke service has been an extremely beneficial addition to our ER offerings,” said Dr. G. Max Stell, Emergency Department Medical Director, Minden Medical Center. “Our physicians value the neurology support when patients present with potential stroke symptoms. We are thrilled to be able offer services that can improve chances of survival and decrease disability for stroke patients.” With Ochsner Medical Center in New Orleans functioning as the “hub,” TeleStroke links specially-trained vascular neurologists to “spoke” hospitals 24/7 for collaborative care. Via the TeleStroke program, Ochsner stroke neurologists are present virtually at more than 20 hospitals around the state. Through secure wireless data and video communication, Ochsner’s stroke team partners with on-site clinicians to evaluate, diagnose and direct care for patients, as well as to ensure timely thrombolytic therapy is administered when appropriate. The National Institute of Neurological Disorders and Stroke found that stroke patients who received tissue plasminogen activator (t-PA) within three hours of the beginning of stroke symptoms were more likely to recover from their stroke with little or no disability. Because Ochsner’s Telestroke neurologists are able to see patients as they arrive in their local area hospitals, they are able to evaluate and prescribe t-PA treatment more quickly. This timeliness has resulted in a Telestroke t-PA utilization rate more than four times the national average and a reduced complication rate. In many cases, a TeleStroke consultation will allow patients to stay at their local hospital. In more complicated cases the patient may need to be transferred to Ochsner or another facility for specialized treatment. Telestroke is still
beneficial in these cases because the neurologist will have already met and started treatment on the patient.
Our Lady of the Lake College Welcomes New President BATON ROUGE – Our Lady of the Lake College welcomes Tina S. Holland, PhD, as the new President of the private Catholic institution located in Baton Rouge, Louisiana. Holland will lead the four-year college which provides a strong foundation in health sciences, nursing and liberal arts programs. Holland joins Our Lady of the Lake College from Holy Cross College in Notre Dame, Indiana where she served as the Executive Vice President and Provost and also held the roles of Vice President for Student Affairs, Mathematics Professor, and the Director of the Conditional Acceptance Program. “In my more than twenty years in higher education I have been a student of the enterprise, and I’ve been fortunate to have worked for dynamic and visionary leaders who have taught me well. That sort of quality mentoring together with my scholarly research in the theory and practice of presidential leadership in Catholic higher education I think will serve me well,” said Holland. Our Lady of the Lake College is a subsidiary of Our Lady of the Lake Regional Medical Center and is sponsored by the Franciscan Missionaries of Our Lady Health System. Devoted to excellence in teaching and learning, Our Lady of the Lake College is a studentcentered academic community guided by its institutional mission with an extensive and growing tradition of service to the community. Dr. Holland earned her PhD in Higher Education from Indiana State University and received her MA in International Relations from the University of San Diego. Before attending graduate school she graduated from the United States Naval Academy and served as an officer in the United States Marine Corps. Holland and her husband, Peter, join the Baton Rouge community from northern Indiana, where they raised their four children.
Baton Rouge General Names Stephen Mumford Vice President of Clinical Service Lines BATON ROUGE – Stephen Mumford, BS, RN, CNOR, has been named Vice President of Stephen Clinical Service Lines for Mumford Baton Rouge General/ General Health System. Since joining the organization in 2005, Mumford has served in multiple patient care and healthcare management positions. Most recently, as Director of Perioperative Services for Baton Rouge General, he was instrumental in the hospital’s surgical services expansion and the open-
ing of its new Gastroenterology Center on Perkins Road. In addition, he implemented innovative Lean Six Sigma performance improvement principles in the perioperative setting with the highest goal-oriented standards for excellence in quality, efficiency and service. In his new role, Mumford will provide leadership and strategic direction for the business development of key service lines including Cardiovascular, Oncology, Women’s and Children’s, Perioperative Services and Radiology. He is a member of the Association of Perioperative Nurses, holds a Certified Nurse, Operating Room (CNOR) certification and is a member of the men’s club at St. Jude Catholic Church. Mumford is a native of Baton Rouge and attended St. Michael the Archangel High School. He graduated from Louisiana State University with a Bachelor of Science in Kinesiology and received his nursing degree in 2005.
Schumacher Group Appoints New CEO LAFAYETTE- Schumacher Group (SG) Founder and Executive Chairman, Dr. William “Kip” Schumacher, announced that the company is pleased to welcome a new Chief Executive Officer to its team, Rich D’Amaro, a seasoned veteran in the healthcare industry to manage day-to-day operations. Dr.
Schumacher will remain active as Executive Chairman, responsible for the long-range vision of the company and sustaining its legacy of patient-focused, quality care. Rich D’Amaro D’Amaro joins SG from Subsidium Healthcare in Atlanta, Georgia, which he founded in 2001. Notable career milestones for D’Amaro include CEO/President of Tatum LLC, also a strategic consulting firm to the healthcare industry, and 20 years as Managing Partner & Chairman of the International Health Care Practice at the global powerhouse, KPMG. D’Amaro has also served as a board member at many distinguished institutions, including Vanderbilt University Technology Corporation, Saint Joseph’s Healthcare System, Healthcare Georgia Foundation and EnduraCare Acute Care. “Putting patients first’ is more than a catchy phrase at Schumacher Group; it drives every business decision we make, every day,” stated Dr. Schumacher. Schumacher Group, founded in 1994, began with a handful of small Louisiana emergency departments. The company has since greatly expanded its continuum of care, with contracts in 28 states and over 250 hospitals, serving 4 million patients annually.
GENERAL SURGEON GENERAL SURGEON
OCHSNER HEALTH SYSTEM is seeking a Board Certified/Board Eligible General Surgeon toSYSTEM join our growing team in Baton Rouge. Both Eligible newly OCHSNER HEALTH is seeking a Board Certified/Board trained and experienced physicians are encouraged to apply. Salary offered will General Surgeon to join our growing team in Baton Rouge. Both newly be competitive and commensurate experience and training. trained and experienced physicianswith are encouraged to apply. Salary offered will be competitive and commensurate with experience and training. Ochsner is perfectly positioned to provide value and efficiencies in the healthcare reform environment accountable care, medical homes, budgetincuts, declining Ochsner is perfectly of positioned to provide value and efficiencies the healthcare reimbursement, and of increased regulation. reform environment accountable care, medical homes, budget cuts, declining reimbursement, and increased regulation. The Greater Baton Rouge region has over 1,400 employees serving our patients in ten Ochsner Health Centers and Ochsner Medical Center serving Baton Rouge, a The Greater Baton Rouge region has over 1,400 employees our patients 151-bed facility.Health We employ more 130 physicians and mid-level providers in ten Ochsner Centers andthan Ochsner Medical Center Baton Rouge, a who provide an excellent referral Ochsner Healthand System is a physician151-bed facility. We employ morebase. than 130 physicians mid-level providers led, multi-specialty, healthcare delivery system employing whonon-profit, provide anacademic, excellent referral base. Ochsner Health System is a physicianover 900 physicians. The system includes healthcare 9 hospitalsdelivery and more than 40 health led, non-profit, academic, multi-specialty, system employing centers. offer a generous and includes comprehensive benefits package. over 900We physicians. The system 9 hospitals and more thanWe 40 also health enjoy theWe advantage of practicing in a favorable malpractice environment in centers. offer a generous and comprehensive benefits package. We also Louisiana. Please visit at www.ochsner.org. enjoy the advantage ofus practicing in a favorable malpractice environment in Louisiana. Please visit us at www.ochsner.org. Baton Rouge represents the best of Louisiana’s vibrant culture. It is a very family-oriented city with greatofschools, restaurants, shopping, Baton Rouge represents the best Louisiana’s vibrant culture. It isand a an abundance of sportscity andwith cultural We are the state capital, very family-oriented greatopportunities. schools, restaurants, shopping, and an with a metropolitan of over 600,000 and Louisiana State abundance of sportspopulation and cultural opportunities. We home are thetostate capital, University and Southern University. with a metropolitan population of over 600,000 and home to Louisiana State University and Southern University. Please CV to: email@example.com, Please e-mail CV e-mail to: firstname.lastname@example.org, Ref. # AGSBR02 or Ref. #AGSBR02 or 488-2240. call for information: (800) call for information: EOE. Please e-mail CV to: (800) email@example.com, Ref. # 488-2240. AGSBR02 or call for information: (800) 488-2240. EOE. Ochsner is an equal opportunity employer and all qualified applicants will receive Sorry, no visa opportunities consideration forJ1 employment without regard to available. race, color, religion, sex, national origin, sexualno orientation, status, protected veteran status, or any other Sorry, J1 visadisability opportunities available. characteristic protected by law.
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In the News Courtney Named Medical Director for Tri Parish Rehab Hospital FRISCO, TX- Maxim Management Group has named Dr. Jenness D. Courtney III as the rehabilitation director of its Tri Parish Rehabilitation Hospital in Rosepine, Louisiana. Courtney will be joining the medical staff and be responsible for directing and leading the rehabilitation treatment team. The announcement was made by Mark Harris, chief executive officer of Maxim Management Group. “We are excited to welcome Dr. Courtney to Tri Parish Rehabilitation Hospital,” Harris said. “His over 10 years experience in physical medicine and rehabilitation is a great asset to the Tri Parish team and will ensure that we continue to provide high quality health care to our patients .” With his new position, Courtney will be responsible for the overall quality of rehabilitation treatment for the hospital. He will lead the interdisciplinary team, consisting of physical therapists, occupational therapists, speech therapists, social services, certified rehabilitation nurses and support staff. The team will
provide a broad range of high quality inpatient rehabilitation services. His leadership responsibility will expand as the Tri Parish Rehabilitation Hospital increases in size this spring. The 20-bed hospital will be opening 16 additional beds inside Beauregard Memorial Hospital in DeRidder, Louisiana. Courtney earned his undergraduate and doctorate of medicine at Louisiana State University. He completed his residency in physical medicine and rehabilitation at the University of Arkansas for Medical Sciences. He is board certified by the American Board of Physical Medicine and Rehabilitation. Courtney is a member of the American Academy of Physical Medicine and Rehabilitation, the Louisiana Society of Physical Medicine and Rehabilitation, Louisiana State Medical Society and the Shreveport Medical Society.
Khan Joins Lakeview Regional Behavioral Health Center As Medical Director COVINGTON - Dr. Abdul Majid Khan is a psychiatrist specializing in the care of adult patients with various types of mental illness, such as depression,
eating disorders, bipolar disorder, anxiety disorders, and other psychiatric illnesses. He is trained to provide various treatments, including the prescription of medications, Dr. Abdul Majid Khan different forms of psychotherapy and cognitive-behavioral therapy, among other techniques. Dr. Khan is the Medical Director of Lakeview Regional Behavioral Health Center. Dr. Khan, a New Orleans native, completed his psychiatric training at Louisiana State University Health Sciences Center in New Orleans and Ochsner Medical Center, having started at Charity Hospital before Katrina. He has served as Medical Director of Acute Inpatient Psychiatric facilities, Partial Hospitalization and Intensive Outpatient Programs in the private sector. He has also provided consulting for the Department of Corrections for more than two years. He has been on faculty as an Assistant Professor of Psychiatry with the LSU Department of Psychiatry in New Orleans and was most recently a Unit Director at Greenbrier Hospital in Covington. Dr. Khan also co-founded Axis One Behavioral Solutions. Dr. Khan is a member of the Louisiana Psychiatric Medical Association, American Psychiatric Association and the American TeleMedicine Association.
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Louisiana Heart Hospital Awarded Advanced Certiﬁcation For Primary Stroke Centers LACOMBE – The Joint Commission, in conjunction with The American Heart Association and American Stroke Association, recently awarded Louisiana Heart Hospital the Advanced Certification as a Primary Stroke Center. Achievement of Primary Stroke Center Certification signifies an organization’s dedication to fostering better outcomes for patients. LHH’s Primary Stroke Center Certification has demonstrated that their program meets critical elements of performance to achieve long-term success in improving outcomes for stroke patients. “By achieving Joint Commission certification, Louisiana Heart Hospital has demonstrated its commitment to provide the highest level of care for stroke patients, said Glenda Dobson, RN, Vice President of Clinical Services for LHH. Certification is a voluntary process and The Joint Commission has recognized Louisiana Heart Hospital for successfully undertaking this challenge to elevate its standard of care and instill confidence in the communities we serve. LHH was the first Chest Pain Accredited Center on the Northshore and we are now pleased to add Stroke Accreditation to our achievements.” The Joint Commission’s Primary Stroke Center Certification program was developed in collaboration with the American Stroke Association and is based on the Brain Attack Coalition’s “Recommendations for the Establishment of Primary Stroke Centers.” Certification is available only to stroke programs in Joint Commission-accredited acute care hospitals. 14 • JUNE 2014
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In the News Baton Rouge General Names Dr. Robert Kenney VP of Medical Operations BATON ROUGE – Baton Rouge nephrologist Robert J. Kenney, MD, has been named Vice President of Medical Operations for Baton Rouge General/ General Health System. An American Hospital Association sponsored National Patient Safety Fellow with nearly 30 years of nephrology practice experience as well as having served in clinical leadership roles, Dr. Kenney will lead Baton Rouge General’s patient care quality and safety operations and serve as a clinical liaison for hospital-based physicians. Focused upon improving patient care outcomes and enhancing service, his new executive role will entail the oversight of the General’s performance improvement initiatives called “Work Excellence” – a platform for improving the structure, safety and reliability of patient care processes and procedures that are based upon the best practice principles of Lean Six Sigma, a rigorous production model originally adopted by expert manufacturers GE and Toyota. Recently serving as Baton Rouge General’s Medical Director of Quality and Patient Safety, Dr. Kenney remains active in Graduate Medical Education, holding a core faculty membership position in Baton Rouge General’s Internal Medicine Residency Program affiliated with Tulane University School of Medicine. A Louisiana native, Dr. Kenney earned his medical degree from Tulane University School of Medicine, completing his residency training in internal medicine and his fellowship in nephrology at the University of Texas Health Science Center in Dallas. Board certified in internal medicine and nephrology, he is a Fellow of the American College of Physicians and a member of the Renal Physicians Association, American Society of Nephrology, American Medical Association, and the National Kidney Foundation. Dr. Kenney has served as a national expert in his field and published multiple scholarly articles.
Homer H. Williams, MD, Joins Memorial Medical Group LAKE CHARLES- Memorial Medical Group welcomes family medicine physician Dr. Homer Williams to the staff of Moss Memorial Urgent Care Clinic. Dr. Williams received his medical degree from University of Mississippi Medical Center in Jackson. Dr. Homer Williams He then went on to complete his family practice residency at Forbes Family Practice Department inMonroeville, Pennsylvania. Medical News is pleased to provide space for press releases by providers in our Grand Rounds section. Content and accuracy of the releases is the sole responsibility of the issuer.
After moving to the Lake area in the early 90s, Dr. Williams has practiced family and emergency medicine at various medical centers and clinics including Southwest Louisiana Center for Health Services,DeQuincy Family MedicalCenter, DequincyMemorial Hospitaland Allen Parish Hospital. Immediately prior to joining Memorial Medical Group, Dr. Williams saw patients at Imperial Calcasieu Urgent Care. Dr. Williams will see patients at Moss Memorial Urgent Care Clinic.
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