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PHYSICIAN SPOTLIGHT PAGE 3
Martin C. Aldrich, MD ON ROUNDS
Improving Local Nursing Education Galen Tampa Bay gains SACS regional accreditation, expands community partnerships By LyNNE JETER
Residents Rising USF Health Morsani COM hosts one of the nation’s largest distributive residency programs ... 4
On Oct. 29, the Tampa Bay campus of the Galen College of Nursing will host Lee Cockerell, former executive vice president of operations for Walt Disney World Resort, to share practices in the hospitality industry that may be easily transferred to the healthcare setting from his recently released book, The Customer Rules: The 39 Essential Rules for Delivering Sensational Service. Cockerell’s motivational presentation at the Hilton St. Petersburg Carillon Park in St. Petersburg is just one of many steps that leaders of the Louisville, Ky.-based nursing college have taken to strengthen its footprint in the Tampa medical (CONTINUED ON PAGE 14)
Recognizing Integrative Medicine as a Specialty
The Five-Year Engagement SMH opens longanticipated new Courtyard Tower, private rooms spot great views ... 7
ABIOM ﬁnalizes board certiﬁcation exam By LyNNE JETER
Mimi Guarneri, MD, FACC, and fellow founding members of the American Board of Integrative Medicine (ABIOM) spent the lingering days of summer putting the final touches on a new board certification examination for a specialty that’s garnering national attention. “Creation of integrative medicine as a specialty by the American Board of Physician Specialties (ABPS) guarantees excellence in the field and assures consumers of healthcare the practitioner they’re seeing has reached a high standard of practice,” said Guarneri, board-certified Dr. Mimi Guarneri
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Martin C. Aldrich, MD Aldrich Cardiovascular Institute By JEFF WEBB
BRADENTON - Martin Aldrich feels lucky just to be alive, much less in a position that affords him the opportunity to help people who, like his mother, have life-threatening cardiovascular disease. “My family was exposed to the medical field extensively,” but in an unfortunate circumstance, said Aldrich, who grew up on a farm near Pittsburgh. “My mother had rheumatic fever and was diagnosed with severe mitral valve stenosis. She became very symptomatic with heart failure while she was carrying me, said Aldrich, 47, and the youngest of his parents’ three children. “Today, I would have been aborted. (But) it was a different time.” Aldrich’s mother survived the pregnancy and the delivery. “She did OK for a while, but then required surgery. She waited until I was 5 years old, so that if anything were to happen to her, I would remember her,” he said. That was important to her, Aldrich explained, because she had lost her mother when she was just 6 years old. “Mom underwent open heart surgery at Presbyterian Hospital in Pittsburgh. She did amazingly well. All was going well until she was diagnosed with colon cancer when I was 14. I can still remember the day she got the call from her doctor,” Aldrich recalled. She had a partial colectomy and did not require a colostomy or chemotherapy.” That process triggered Aldrich’s “tremendous respect for her internist. As a lay person, I was amazed that, with limited symptoms, they were able to diagnose her cancer,” he said. His mother later was featured in a television public service campaign to promote early detection. “My mom and dad were very active and you would never know that mom had so many health problems,” he said. Those childhood experiences were laying a foundation for Aldrich to pursue medicine. He majored in biology at Duquense University in Pittsburgh before being accepted at Hahnemann University School of Medicine in Philadelphia. “I always dreamed of being in a field with lifelong learning, altruistic aspects and contributing back to the world. I got lucky and went to medical school,” said Aldrich. But at first, he was not sure how that desire would manifest itself. “I actually got a little sidetracked and thought I wanted to be a surgeon,” so he completed an internship in general surgery at Hahnemann, and followed up with surgery residency and research at Emory University in Atlanta. “Then I woke up and decided that I was truly not happy. I realized that really wasn’t who I was. It wasn’t my personality,” he said. So, he medicalnews
went back to Pittsburgh for a three-year internal medicine residency at Allegheny General Hospital. By then, “deciding on cardiology was easy. With my mother’s cardiac history, I was intrigued to be on the other side of the table as a provider, helping heart patients,” he said. “Looking back on it, I’m surprised I didn’t settle on cardiology sooner, considering the impact it had on my mother’s life. She survived for decades. She was very fortunate.” Aldrich used the next three years to complete a cardiology fellowship at Allegheny General. His formal education behind him, Aldrich spent the next few years traveling as a locum tenens cardiologist in Seattle, Roanoke, Va., and Portsmouth, N.H. But when he decided it was time to open his own practice in 2005, Bradenton was an obvious choice, he said. During his first year of medical school Aldrich’s parents had moved to Bradenton, where “we had been visiting relatives and vacationing since I was 7 or 8,” he said. Also, his brother, a dentist, has a practice in Bradenton. (Aldrich’s sister and her husband also are dentists in Lancaster, Pa.). “Bradenton was a great place for me to be. … and there certainly was a need for physicians in this area,” said Aldrich, whose office is in University Park. The “new community” of Lakewood Ranch “was a big draw for me,” he said. Aldrich Cardiovascular Institute
employs about 10 people, he said, including a nurse practitioner and cardiac imaging technologists. “I see about 20 patients a day in the office,” said Aldrich. One day a week is dedicated to doing arterial procedures related to cardiovascular disease, and one-half day is spent doing vein procedures, he said. “I do the lion’s share of my hospital work out of Lakewood Ranch Medical Center,” Aldrich said, but he also sees patients who need him at Sarasota Memorial, Manatee Memorial and Doctors hospitals. “Lakewood Ranch is 100 percent supportive of my efforts and I owe them a great debt of gratitude for that. The nursing staff is amazing and I love working with them. … It’s a joy being here,” he said. Like many physicians, Aldrich said he struggles with balancing work with his personal life. “It’s something all physicians wrestle with,” he said. “Especially now, I think that’s one of the reasons you see so many physicians integrating with hospitals and larger organizations because they are trying to find that work-life bal-
ance. ...Being a solo practitioner is hard.” Lately, a good portion of Aldrich’s schedule has been devoted to a a professional passion, the Save a Leg, Save a Life Foundation. Aldrich started a Bradenton chapter of the national nonprofit organization, which strives to reduce the number of lower extremity amputations brought on by diabetes and peripheral artery disease. “We are in the process of educating the community and opening up the process to other providers about the need to raise awareness,” said Aldrich. “Taking care of these types of patients is a collaborative approach. Not one physician does it all and this is about improving the information, understanding and relationships among those who take care of patients with either non-healing wounds, or patients at risk for non-healing wounds,” he said. “We’re only in our fourth month, but we have 12 providers coming to our next meeting. We’re excited about the future and to have a local SAL/SAL chapter,” Aldrich said.
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Residents Rising USF Health Morsani COM hosts one of the nation’s largest distributive residency programs By LyNNE JETER
While the gap between medical graduates and the number of residency slots nationwide continues to challenge industry leaders, USF Health Morsani College
of Medicine (COM) is bucking the trend. Within the next couple of years, the number of residency slots will nearly double to 1,400. “We have one of the nation’s largest distributive residency programs, with 730
USF Health Morsani College of Medicine Specialty Residency Slots Dermatology: 4
Emergency Medicine: 10
Physical Medicine & Rehabilitation: 2
Family Medicine: 8
Plastic Surgery (integrated) 3
Internal Medicine: 29
Medical-Preliminary/ Ophthalmology: 1
Neurological Surgery: 2 Neurology: 5 Obstetrics-Gynecology: 5 Orthopedic Surgery: 4 Otolaryngology: 3
Radiation Oncology: 1 General Surgery: 6 Surgery-Preliminary: 2 Surgery-Preliminary/Urology: 3 Vascular Surgery: 2 Medicine-Pediatrics: 3
Pathology: 4 Total ﬁrst-year resident slots: 128. “This past year, we matched all 128 first-year slots in the first round of Match,” said Charles Paidas, MD, vice dean for clinical affairs and GME for the USF Health Morsani COM. “We haven’t done that in 20 years!” SOURCE: National Resident Match Program.
USF residents at seven sites, and a proposal to add another 700 residents,” former USF Health CEO Stephen Klasko, MD, also former dean of the Morsani COM, said before he left the school last month. The ambitious plan fits the distributive model, allowing USF Health Morsani COM the ability to sponsor or participate in residency programs as “civilians,” explained Charles Paidas, MD, vice dean for clinical affairs and GME for the USF Health Morsani COM. “We’re offering a shopping list of educational and research initiatives that are required for GME certification,” said Paidas, noting that Naples Community Hospital is the school’s most recent affiliate addition, and that a pact with other affiliations are in the works. When Paidas, the plan’s architect, became associate dean for GME in 2009 after five years with the school, the residency program faced governance and operation issues that required improved oversight. He assembled a strategic committee that allowed the school to garner impeccable institutional review commendations from the Accreditation Council for Graduate Medical Education (ACGME). In 2011, he was promoted to his current post. At the suggestion of USF medical students, Paidas also brought together AAMC executives, GME leaders and medical school deans to the USF Health GME Summit last year. The well attended event “begs the issue
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of a replay this year,” he said. “Our goal was to characterize the state of GME in Florida. For example, the average number of residents per 100,000 population in the U.S. is 35.9. Florida’s at 17.5. That’s a raw data point that tells you we need to double the workforce. That translates to 2,900 residency slots in the state.” Boosting the number of residency slots also improves the chances of keeping new doctors in Florida. “Florida had nearly a 59.6 percent retention rate of residents who complete their training and stay here,” noted Paidas. “The mantra around the country is: wherever you do your residency – not where you attended medical school – is likely where you’ll practice. USF pushes that to 68 percent.”
Florida Results for Nationa Resident Match Program 2013 Main Residency Match Bayfront Medical Center, St. Petersburg: 12 Cleveland Clinic Florida, Weston: 18 Florida Hospital-Orlando, Orlando: 36 Florida State University COM, Tallahassee: 22 Halifax Medical Center, Daytona Beach: 10 Jackson Memorial Hospital, Miami: 91 Larkin Community Hospital, South Miami: 8 Mayo School of GME, Jacksonville: 35 Miami Children’s Hospital: 24 Mt Sinai Medical Center, Miami: 29 Orlando Health, Orlando: 62 St. Vincents Medical Center, Jacksonville: 7 Tallahassee Memorial Healthcare, Tallahassee: 11 University of Florida, Jacksonville: 81 University of Florida-Shands Hospital, Gainesville: 143 University of Miami, Atlantis: 30 University of South Florida, Tampa: 128* West Kendall Baptist Hospital, Miami: 4 Total ﬁrst-year resident slots: 751. SOURCE: National Resident Match Program.
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We are proud to announce that Galen College of Nursing is
A C C R E D I T E D It is an honor for us to receive this acknowledgement of Academic Excellence from our peers. With SACS we have reached new heights, and weâ€™re just getting started.
www.GalenCollege.edu Galen College of Nursing is accredited by the Southern Association of Colleges and Schools Commission on Colleges to award associate degrees. Contact the Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097 or call 404-679-4500 for questions about the accreditation of Galen College of Nursing.
PROUDLY SERVING FLORIDA’S CULTURAL COAST
The Five-Year Engagement
SMH opens long-anticipated new Courtyard Tower, private rooms spot great views SARASOTA— When in less than an hour. After 41-year-old Travis Kessler schedspending a short time in reuled his total hip replacement, he covery, Kessler remembers an purposely put it off a week so that unusually warm welcome from he could recover on the 9th floor staff as they helped settle him of Sarasota Memorial’s new Courtin Room 901. Even though he yard Tower. remained somewhat groggy, But it wasn’t until he was he recalled the exciting mowheeled in from recovery and ment when the staff presented greeted by a sea of smiling faces him with a dozen yellow roses, and bouquet of roses that he reala fluffy bathrobe embroidered ized he was the very first patient with the SMH logo, and sevadmitted to the patient care tower. eral other small keepsakes to The orthopedic unit, which tops the commemorate his first-patient 9-story tower, was the first unit to status. open Sept. 9. By that afternoon, the “When I heard the tower was highest level of the Courtyard opening, I decided to put my surTower was filled with two gery off a week, and wow, I’m glad dozen additional firsts – 19 I did,” said Kessler, who relaxed more orthopedic patients who in a spacious private room the day After five years of construction, Sarasota Memorial completed its main campus rejuvenation in September and officially opened its new had joint replacement surgery after surgery. “Everything has been Courtyard Tower. On Sept. 9, the first patient was admitted to the new ninth floor orthopedic unit just before 9 a.m. Nearly two dozen more that morning were admitted patients were admitted by afternoon. perfect, and you can’t beat the view to the new unit that morning; – from my bed, I can see both the four others recovering from ocean and the bay.” prior days’ surgery in the old unit were transferred to the new one that afternoon. Each Kessler’s surgery started very early that morning. His orthopedic surgeon, Edward patient received a special card and flowers commemorating their presence on the tower’s (CONTINUED ON PAGE 9) Stolarski, MD, performed his joint replacement using a muscle-sparing anterior approach
A New Gold Standard?
First incisionless procedure for treating esophageal achalasia unveiled
When checking on the patient postoperatively that evening and the next mornAn incisionless procedure first performed in ing, Awad was pleased to learn the patient St. Louis at Washington University’s 7th Annual GI had zero pain from the procedure. She only Live Conference in July may very well represent a expressed slight discomfort from the postopnew gold standard for treating esophageal achalaerative barium swallow study and the IV in sia. her arm. “This is the closest we’ve gotten to the Holy “We wrote her (a script for) IV pain Grail dream of incisionless surgery, where the medication,” he said. “She didn’t use it — Michael Awad, MD, PhD, Director, patient goes to sleep, wakes up, feels no pain and once. We’d also written (a script) for TyleWashington University Institute for has no side effects or complications,” said surgeon nol, but she didn’t take even one Tylenol. Surgical Education. Michael Awad, MD, PhD, FACS, associate dean That’s almost unheard of after a procedure of medical student education, program director of like this.” general surgery, and director of the Washington Within a couple of days, the patient reUniversity Institute for Surgical Education. “We’re turned to her daily routine. “She’s noticed a not totally there yet, but we’re very, very close.” huge difference,” said Murad. “We’re thrilled with her outcome so far.” Awad and interventional gastroenterologist Faris Murad, MD, assistant professor of medicine, and director of endoscopic ultrasound at Washington University, performed The Long Preparation the area’s first POEM (Per Oral Endoscopic Myotomy) procedure on July 19, on a Murad and Awad began preparing for the introduction of the incisionless proce54-year-old female who awoke early the next morning ready to go for a run. dure to St. Louis for two years, when they first heard about POEM being introduced “We said, ‘no, you can’t do that yet,’” recalled Murad, with a laugh. in the United States. Worldwide since 2010, some 1,400 POEM procedures have been Immediately after completing the procedure, Murad and Awad could see how well performed. Nationally, there have been only 200 POEM cases, mostly at two locations. the patient’s esophagus opened. The largest POEM center in Portland, Ore., accounts for roughly half of them. Awad “Other than minor bleeding and some CO2 which leaked into her abdomen, the trained with Lee Swanstrom, MD, FACS, of The Oregon Clinic in Portland, who was case went great,” said Murad. “We’d practiced it and really understood the game plan.” (CONTINUED ON PAGE 8) By LYNNE JETER
The patient is our focus; a secondary aspect of this endeavor is the collaborative approach between surgery and GI.”
A New Gold Standard? continued from page 7 the first doctor to perform natural orifice surgery in the United States. The second largest center is Chicago; roughly 35 POEM procedures have been performed at NorthShore Hospital, and perhaps 25 cases at Northwestern Memorial Hospital. “One of the first times POEM came up in the U.S. was two years ago at a Society of American Gastrointestinal and Endoscopic Surgery (SAGES) conference in San Diego,” said Murad. “I was presenting at the conference and had heard discussion about POEM, but it was the first time I’d seen video and learned more about it. A consensus meeting discussing the best approach to POEM with preliminary data and other details was very enlightening. POEM has been slow to take hold in the U.S. because so much goes into it, and the procedure takes highly skilled people.” In St. Louis, a collaborative approach was taken with minimally invasive surgery and interventional endoscopy. Dr. Faris This collaboration paired Murad surgical experts in performing laparoscopic Heller myotomy, with interventional endoscopy and an esophagologist. Awad and Murad co-di-
Current Gold Standard for Treating Esophageal Achalasia The Heller myotomy is most commonly used to treat achalasia, a dysfunction of the lower esophageal sphincter (LES), which fails to relax properly, making passage to the stomach difﬁcult for food and liquids. Initially performed by Ernest Heller in 1913, the procedure, now performed laparoscopically, involves cutting the LES muscles. The myotomy only cuts through the exterior esophagus muscle layers that are squeezing the muscle, leaving the inner mucosal layer intact.
rected the start of the POEM program at Washington University. “In medicine, there’s been a huge push in the past five to 10 years toward minimally invasive surgeries so patients have better recovery times,” said Murad. “About seven years ago, the concept of NOTES (Natural Orifice Transluminal Endoscopic Surgery) laid the foundation for this procedure coming into play. If you look at what we do from a gastroenterology point of view, we’re limited by our equipment. Once the concept of NOTES came about, there’s been a huge push for more equipment for our scopes and procedures.
That’s revolutionized the thinking.” Because the POEM procedure pairs specialists in surgery and GI, Murad and Awad began concentrated efforts to expedite bringing the POEM procedure to St. Louis. “POEM is a convergence of disciplines, with both specialties focusing on the GI tract,” said Awad. “Traditionally, the approach to those disorders has come from different angles. GI approached it through use of medications and limited therapeutic maneuvers (injection of Botox and balloon dilation). On my end, we usually approach disease of GI tract with key-
hole surgery. We’ve been trying for years on a national level to make our procedures less invasive, and a huge jump was made 20 years ago with the advent of laparoscopic and minimally invasive surgery. It was a huge advance toward less pain, faster recovery, and fewer complications for patients.” To better prepare, Murad attended multiple national conferences that focused on POEM, in addition to taking various hands-on training courses. Awad attended the second annual POEM conference in Orlando earlier this year, while also reconnecting with his Portland mentor. Murad and Awad held five labs to practice the technique, and established procedures and criteria for the program. “We were ready early this year, but it was a matter of getting our first case, a good candidate that hadn’t been manipulated with dilations, injections, or previous esophagus surgery,” said Murad. Once the patient was selected, the two specialists had a trial run with the operating room team the night before the first POEM procedure. Washington University’s approach to POEM is unique, emphasized Awad. “Dr. Murad and I were both handson during the procedure, doing it in (CONTINUED ON PAGE 9)
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A New Gold Standard? continued from page 8 concert, with each of us doing an equal amount of the procedure,” he said. “The patient is our focus; a secondary aspect of this endeavor is the collaborative approach between surgery and GI.”
During the preparation phase, Awad and Murad connected with Haruhiro Inoue, MD, a professor at Showa University Northern Yokohama Hospital and Digestive Disease Center in Japan, who has performed 423 POEM procedures. The timing worked well for Inoue (pronounced “in-you-way”) to keynote the July 19 St. Louis Live Endoscopy Conference and also proctor the first POEM case at Washington University. “It’s too early for us to know long-term outcomes, but right now they’re matching laparoscopic outcomes,” said Murad. “As our understanding of the procedure improves, it might lead to better long-term outcomes.” Referrals primarily come from gastroenterologists, typically after primary care physicians have referred patients for the swallowing disorder. “We don’t understand the ultimate etiology of esophageal achalasia,” said Murad. “It may be virally mediated, triggered by something in the environment. I wouldn’t say it’s an autoimmune phe-
nomenon. Changes occur to the esophageal muscles and over a period of time, it becomes even more difficult for food and even liquids to pass since the muscles don’t work the way they’re intended. The goal of the POEM procedure is to release the muscle at the end of the esophagus so that food and liquids pass to the stomach rather than getting stuck in the esophagus.”
“Is the POEM procedure the new gold standard? That’s the hope,” said Murad. “We don’t have quite enough evidence yet to say that, but it’s emerging, and very promising. However, this particular procedure requires a great deal of technical expertise and a lot of specialized training. It won’t be done in all corners yet.”
POEM Procedure for Esophageal Achalasia Symptoms: Weight loss, chest pain/heartburn, regurgitation. Preoperative examination: Esophageal manometry, barium swallow study, blood test, and x-ray exam of chest and abdomen. POEM surgical steps: 1. With the patient in the operating room under general anesthesia, an endoscopy of the upper gastro-intestinal tract is performed to determine the length of the required incision of the muscle layer. 2. After the injection of a saline solution is made under the mucosa, a “mucosal incision is created which allows the endoscope to enter the submucosal space”. 3. A submucosal dissection is then performed down the esophagus to the top of the stomach. After creating the tunnel in the submucosa, the inner muscle layer is cut along its length. 4. The mucosal entry is closed by clips that will eventually fall off. Possible postoperative symptoms: Fever up to 101 degrees, chest pain due to the muscle layer incision performed, and throat discomfort. Day after surgery: A barium swallow study to confirm that the mucosal incision is tight and not leaking.
The Five-Year Engagement, continued from page 7 opening day. When Stolarski stopped by to check on Kessler and several other patients he operated on that morning, he was pleased with the outcome. Each patient was resting comfortably in a private room with oversized windows and expansive views of Sarasota’s waterfront and cityscape. Patients’ families were also delighted by the calming colors and comforts – flat screen TVs, free WiFi, a cushy futon that expanded to double bed status, and a private alcove for overnight guests. “I’ve always been impressed by Sarasota Memorial because of the expertise of its staff – from the surgical nurses and techs who help me in the operating room to the orthopedic nurses and rehabilitation therapists who care for my patients before and after surgery,” said Stolarski. “It’s the experience of the team and their specialized skills that help achieve the very best possible outcomes. But now it’s even better ... the new tower offers such a warm, healing environment.”
SOURCE: Showa University Northern Yokohama Hospital.
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Plan for Them, Not Yourself By SIMONE VIZCAYA
As a medical professional you have undoubtedly heard this before: “I didn’t go to the doctor sooner because I didn’t want the doctor to find something wrong with me.” Perfectly reasonable people choose to ignore warning signs in hopes that bad situations will simply rectify themselves. Far too often, these people hear horror stories about how “so and so found a lump and died three days later! Go to the doctor.” Of course, this only causes people to avoid medical attention longer. Nothing makes someone avoid reality more than a scare tactic. In a society where most people believe that they bring about what they think about, being a professional who specializes in the realities of life isn’t easy. Though we all joke that the two inescapable realities of life are death and taxes, we only seem to plan for one. There is an immediate repercussion for avoiding paying taxes; there is no immediate repercussion for avoiding funeral planning. That devastating consequence falls on the decedent’s family. Parents who spent their entire lives protecting their children rarely connect protection with funeral planning. Yet, parents who have prearranged save their grieving children hours of what can only be described as emotional torment. Though the funeral directors are wonderfully trained in managing all types of emotions, they must get a job done. A copious amount of information is required to issue a death certificate. As many families learn too late, the information in his or her family member’s wallet does not satisfy the government’s requirements. Many times the family is sent home to gather more information and return to the funeral home. This adds unnecessary strain in an already difficult situation. In our industry, we have learned that people should never be responsible for planning the funeral of someone they love. It is emotionally and financially devastating and causes widespread familial chaos. Each and every funeral professional has a story about families torn apart over some minute and seemingly unimportant argument over funeral services. Most people are not rational when mourning the death of a loved one. As the saying goes: “funerals are for the living not the dead.” Unfortunately, when no prearrangements are made, it is the survivors that live with decisions made in haste and pain. Though life insurance can sometimes take care of the financial burden, it cannot choose a casket, it cannot spend hours searching through records to find information. There is far more to death than dollars, just as there is far more to surgery than paying the bill. Emotional overspending is our version of a myocardial infarction, preventing it is the key. When a loved one passes (especially in a sudden tragic event) the family will exhaust every resource available to give the loved one a final farewell worthy of royalty. On several occasions family medicalnews
members admit that the decedent “would have wanted something small and simple” immediately prior to purchasing a twenty thousand dollar casket and catering for 100 guests. In many minds, the amount of money spent is in direct relationship to how much that person was loved. As funeral professionals our main concern is fulfilling the requests of the surviving family members, but we must admit that it pains us to see a widow max out credit cards to bury a husband who wouldn’t have wanted to leave her with such a financial burden. Though emotional overspending is trying, family dynamics also create catastrophic consequences. Most parents can’t imagine intentionally creating a devastating moment for his or her children. Yet not prearranging does just that. It takes an emotional fire and adds gasoline. Nothing rekindles old resentment like losing a parent. Siblings who never fought in adult hood can become mortal enemies when mom suddenly passes. There have been cases where lawyers got involved and burials were delayed. Unfortunately, funeral professionals are often caught in the cross fire when families fight. This makes the job of carrying out a respectable funeral significantly more difficult. Sadly, family feuds can last long after mom and dad have been laid to rest. In order to alleviate the emotional and financial burdens from mourning family members, the funeral industry has shifted its focus from planning funerals at the time of passing to recommending that people prearrange one’s own cemetery and funeral services. Nearly all funeral homes have a free booklet available to the public which guides him or her through the process. Contained therein is all the information needed at the time of a passing. These booklets provide a guiding light to navigate through a devastating time. By completing the booklet and prearranging the services, funeral professionals estimate that four or more hours of planning are eliminated at the time of death. By removing this burden, mourners are given the opportunity to mourn. Medical professionals have become very adept at providing bad news. Though telling someone he or she is gravely ill is difficult, being on the receiving end of that information is far worse. Though we know that the ultimate outcome of life is death, when death occurs it is invariably shocking and painful. No one should have to walk into a funeral home and pick out someone’s urn or casket on the worst day of his or her life. No one wants to think about death, unfortunately, that does not prevent it from happening. Plan for death, then go on living. It won’t hurt a bit. Simone Vizcaya has spent the last two years assisting families with their end of life plans. She spends most of her time providing information through lectures at various venues. Simone is passionate about what she calls, “passing on love to another human being on the worse day of his or her life.” If you wish to contact Ms. Vizcaya you may do so at Simonevizcaya@gmail.com.
Dinar Sajan, MD Psychiatrist
Dinar Sajan, M.D. completed her training in Adult Psychiatry from Northwestern Memorial Hospital Chicago, Illinois. It is the objective of Dr. Sajan and her staff to bring hope, health and harmony back into the lives of our patients. In an ever changing society of daily stress and constant confrontations, we comprehend the need for a calm and steady atmosphere. Our team of professional, led by Dr. Sajan, will lend guidance and a helping hand, while you achieve your goals. You are entitled to the best.
Kelli P. Gagne
Psychiatric Nurse Practitioner Kelli specializes in providing mental health services to residents of Assisted Living, Skilled-Nursing facilities and Memory Care Units. She provides all aspects of mental health needs onsite; eliminating the hassle of ofﬁce appointments. Her practice includes psychotherapeutic modalities, behavioral interventions, pharmacological prescribing and management, and crisis evaluation and disposition, and psycho-education. She understands the unique needs of patients, their families, and caregivers as they navigate the course of chronic mental illness, dementia, and adjustment disorders.
Psychiatric Evaluations, Medication Management, Supportive Psychotherapy, Cognitive Behavioral Therapy, Family & Group Counseling, Couples Counseling, Addiction Treatment
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Recognizing Integrative Medicine as a Specialty, continued from page 1 in cardiology, internal medicine, nuclear medicine and holistic medicine. ABPS, the first multi-specialty certifying body to offer physician certification in integrative medicine, is the official certifying body of the American Association of Physician Specialists (AAPS) and one of three national certifying organizations of MDs and DOs in 26 recognized medical specialties. The ABPS has led industry response to trends in urgent care, disaster medicine, hospital medicine and family medicine obstetrics. Andrew Weil, MD, said the formation of ABOIM – one of 18 ABPS boards – marks an important milestone in the
development in the field of integrative medicine. “Finally, there’s a way for qualified physicians to present themselves as experts in offering competent integrative care to patients,” said Weil, who helped establish integrative medicine as a specialty. Of the other two national certifying organizations, the American Board of Medical Specialties (ABMS) represents the largest national organization certifying MDs and DOs. The American Osteopathic Association Bureau of Osteopathic Specialists (AOABOS) certifies DOs only. “Integrative medicine focuses on getting to the underlying cause of disease and
Calling Florida Home The American Association of Physician Specialists (AAPS) and the American Board of Physician Specialties (ABPS), one of three national multi-specialty organizations nationwide, got its start in the Midwest, made a stop in the Deep South, and landed permanently in Tampa. Established in 1950 in Joplin, Mo., the national organization began certifying physicians in 1960. After being headquartered in Atlanta, the AAPS and ABPS relocated to Tampa in August 2007. “ABPS relocated to Tampa because of easy access for physicians due to our very close proximity to TIA and I-275/I-75,” said ABPS CEO William J. Carbone. “Moreover, the building presented a good future ROI for the association and its members. In addition, the quality of life and decrease in significant traffic – as was the case in Atlanta – offered a refreshing respite for staff. Being located between two large counties and the closeness of I-275 offered a valuable incentive in recruiting staff.”
VVC takes Vein Care to impoverished People of Haiti and the Dominican Republic– Hispaniola
Lending a helping hand
Please Donate www.vvcmission.com Your contributions will help to pay for travel, supplies and medications
Hispaniola Medical Charity Hispaniola Medical Charity is a nonprofit with 501(c)(3) status. Our mission is to provide medical, den-tal and surgical care to impover-ished people of Hispaniola, the is-land comprised of the nations of Haiti and the Dominican Republic. This charity was set up in honor of Dr. Hart’s father, Umbert Hart Sr. MD, who served as a surgeon in the Dominican Republic.
Under the direction of Dr. Hugo Hart, Vascular Vein Centers will be sending a team of healthcare pro-fessionals to treat impoverished patients with chronic venous insufficiency. Vein disease is a chronic disorder in which left untreated can cause pain, swelling, skin changes and ulceration to the lower legs which can be disabling. This is our 2nd mission trip. Last year we were performed over 56 procedures. With the exception of one person, every patient had open sores and ulcers to their legs.
implementing personalized programs that help people achieve optimal health,” said Guarneri. “In conventional medicine, we’re taught to make a diagnosis and prescribe a treatment. In integrative medicine, we look for the underlying cause of the problem or health challenge. For example, in conventional medicine, we may diagnose diabetes and prescribe a medication. In integrative medicine, we look at what a person is eating (to determine if) they’re deficient in micronutrients linked to diabetes. If they’re physically fit, are they exposed to toxins? Are they under stress? All of these can cause diabetes. We may prescribe medicine, but we also look to correct the underlying cause. We treat the whole person – body, mind and spirit – and we look at an individual’s relationships to family, community and planet.” ABOIM and the Consortium of Academic Health Centers for Integrative Medicine define integrative medicine as “the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals, and disciplines to achieve optimal health and healing.” Guarneri, founder of the Scripps Center for Integrative Medicine in La Jolla, Calif., and president of the American Board of Integrative Holistic Medicine (ABIHM), pointed out that as a cardiologist, her goal is to also reverse the patient’s health challenges. “Integrative medicine provides me the tools that weren’t available in my conventional medical training,” she said. “As a cardiologist, I’m well versed in the role of medication, surgery and stenting for treatment of cardiovascular disease. But, it’s my training in integrative medicine that’s taught me the principles of nutrition, the evidenced-based use of natural supplements, and the role of the mindbody connection. Integrative medicine allows me to complete the circle of care.”
The 14th annual Science & Clinical Application of Integrative Holistic Medicine will be held Nov. 3-7 at the Vinoy Renaissance St. Petersburg Resort in St. Petersburg. The 2013 conference, Transform Your Practice & The Future of Medicine, is sponsored by the Scripps Center for Integrative Medicine and the American Board of Integrative Holistic Medicine. Scripps Center founder Mimi Guarneri, MD, FACC, will launch the conference with a Nov. 2 event with “Bringing Integrative Medicine to Your Practice and Health Care System.” The American Association of Physician Specialists (AAPS) and the American Board of Physician Specialties (ABPS) will host an exhibit promoting the new medical specialty board certiﬁcation.
Eudene Harry, MD, medical director of Oasis Wellness & Rejuvenation Center in Orlando, was thrilled to learn about the new board certification in integrative medicine. “It’s very good that integrative medicine is being acknowledged as a specialty,” said Harry. “The message is: let’s not be exclusive. Let’s be inclusive. Let’s look at all evidence-based material and treat it equally.” Harry, who specializes in both holistic and emergency medicine, said integrative medicine allows “more focus on information-gathering.” “That’s going to be helpful,” she said. “Medications don’t address the issue that’s driving the patient to the doctor’s office.”
Integrative Medicine Board Certiﬁcation 4-1-1 ABOIM certification is available to both allopathic and osteopathic physicians in the United States and Canada who are practicing integrative medicine and have completed a residency training program approved by the Accreditation Council of Graduate Medical Education (ACGME), American Osteopathic Association (AOA), Royal College of Physicians and Surgeons of Canada (RCPSC), or College of Family Physicians of Canada (CFPC). Complete eligibility requirements are available online. Qualified physicians interested in becoming board certified in integrative medicine may submit an application by Dec. 1; the initial exam will take place next May. Applications are available online at www.aapsus.org and may be obtained by contacting the ABPS Certification Department at (813) 433-2277.
GrandRounds Health Management Associates Joins the Florida Hospital Association The Florida Hospital Association (FHA) has announced that Health Management Associates, Inc. (NYSE: HMA) has joined its statewide association of hospitals and health systems. HMA’s Florida network, its largest nationwide, includes 23 general acute care hospitals and a clinical affiliation with UF Health Shands Hospital. “We are honored to welcome HMA to the Florida Hospital Association,” said FHA President Bruce Rueben. “HMA is a dynamic organization that will strengthen and enhance our efforts to promote safe, effective, affordable care in the state of Florida.” The Florida Hospital Association serves as a unified voice for the Florida hospital community, advocating on behalf of its hospital and health system members to maintain and improve access to quality health care for all Floridians. “Our 23 hospitals and 15,000 associ-
ates from the western panhandle to Key West are an important voice in Florida, and we are pleased to combine our resources with other excellent health systems as we seek to bring awareness to the issues affecting Florida’s health care system and economy,” said Alan Levine, senior vice president and Florida group president. FHA’s HMA member hospitals include: Bartow Regional Medical Center, Bayfront Health Brooksville, Bayfront Health Dade City, Bayfront Health Port Charlotte, Bayfront Health Punta Gorda, Bayfront Health Spring Hill, Bayfront Health St. Petersburg, Heart of Florida Regional Medical Center, Highlands Regional Medical Center, Lehigh Regional Medical Center, Lower Keys Medical Center, Physicians Regional Medical Center-Collier Blvd., Physicians Regional Medical Center-Pine Ridge, Santa Rosa Medical Center, Sebastian River Medical Center, Seven Rivers Regional Medical Center, Shands Lake Shore Regional Medical Center, Shands Live Oak
Improving Local Nursing, continued from page 1 community. This summer, the Southern Association of Colleges and Schools (SACS) Commission on Colleges awarded Galen College of Nursing regional accreditation, a designation that represents the ultimate level of institutional accreditation in higher education. The College’s five-year accreditation status is retroactive to January 1, 2013 “Gaining regional SACS accreditation was a milestone for us,” said Kathy Burlingame, EdD, MSN, interim dean of Galen Tampa Bay. “Not very many proprietary schools have regional accreditation. It allows Galen to further the journey for national nursing accreditation for the associate degree (RN) program. It Dr. Kathy also helps with transfer Burlingame hours as other colleges recognize the accreditation as a golden standard.” The Galen College of Nursing already has accreditation from the Commission of the Council on Occupational Education, a nationally recognized accrediting agency of the U.S. Department of Education. The federal accreditation allows students access to federal financial aid. Also, Galen Tampa Bay is pursuing programmatic accreditation with the Accreditation Commission of Education in Nursing (ACEN, formerly the NLNAC) and was granted candidacy with ACEN on June 24. The State of Florida Board of Nursing, Florida commission on Independent Education, and Florida Department of Veterans’ Affairs have also approved Galen Tampa Bay’s associate degree in nursing and practical nursing programs. Institution-wide, Galen College of Nursing has nearly 3,000 students on four campuses in four states. By enrollment, the largest campus is San Antonio, Texas, fol14
lowed by Louisville, Ky. With nearly 800 students, Galen Tampa Bay is a close third. Galen Cincinnati represents the school’s smallest campus. “In Tampa, we have a diverse range of nursing students, from 18-year-olds fresh out of high school, to empty nesters in their mid-50s maybe seeking a different or advanced degree,” said Burlingame. “If granted SACS approval to add a new program next July, the whole team hopes to add the RN-to-BSN program online.” Galen Tampa Bay nursing programs are provided in a variety of formats – day, evening and online classes. Instead of once or twice a year, classes begin four times annually. “We strive to help our applicants begin their journey as soon as they are ready,” explained Burlingame. The Galen Tampa Bay campus has an onsite simulation center for hands-on practice requiring high-tech skills, and most importantly, has 32 affiliation agreements with clinics across a region that expands into the Manatee-Sarasota-Charlotte market. “With our regional SACS accreditation, we’re reaching out for more clinical partners so we can even better help the local medical community,” said Burlingame. Galen Tampa Bay originated as Humana Health Institute in 1989, beginning with the LPN degree program. In 1994, Humana and Galen partnered on nursing education. In 2005, the name changed to Galen Tampa Bay and the 2-year RN program began. “Galen’s longstanding presence and respected reputation is recognized by leading healthcare employers, and our facilities are modern and well-equipped,” said Burlingame. “In short, Galen strives to be the best nursing school it can be.”
Regional Medical Center, Shands Starke Regional Medical Center, St. Cloud Regional Medical Center, Venice Regional Medical Center, Wuesthoff Medical Center-Melbourne and Wuesthoff Medical Center-Rockledge. In addition to these hospitals, HMA has entered into letters of intent for the acquisition of Ocala’s Munroe Regional Medical Center in partnership with UF Health Shands Hospital and Bert Fish Medical Center - both of which are current FHA members and will continue their membership.
Moffitt Cancer Center Announces First Cancer Research Chair Endowed by the State of Florida Howard McLeod, Pharm.D., an internationally recognized expert in how genetic makeup affects an individual’s response to cancer treatment, joined Moffitt Cancer Center as the new medical director of the DeBartolo Family Personalized Medicine Institute and senior member in the Department of Cancer Epidemiology. McLeod is also the center’s first cancer research endowed chair, as established by the Florida Legislature. During the 2013 legislative session, state lawmakers approved the Quality Cancer Care and Research bill aimed at attracting more business to Florida’s top cancer hospitals. Part of the legislation includes endowment awards for Moffitt and two other state institutions to recruit research chairs. The endowed chairs are required to specialize in a cancer-related field of research that will facilitate coordination among research institutions within the state and attract other promising researchers and national funding. McLeod has been principal investigator for more than $16 million in grants and co-investigator for more than $80 million in grants from the National Institutes of Health. He has also authored more than 350 peer-reviewed papers on pharmacogenomics, applied therapeutics and clinical pharmacology. As the medical director of the Personalized Medicine Institute, McLeod will be involved with Moffitt’s Total Cancer Care® Study to create and share targeted cancer treatments that will improve outcomes, cure disease, extend survivorship and improve quality of life for patients. The Personalized Medicine Institute was established to expand Total Cancer Care® as a resource to the scientific community to enhance research collaborations and bring personalized treatments to patients sooner, according to William S. Dalton, Ph.D., M.D., director of the Personalized Medicine Institute and founder and CEO of M2Gen.
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World Class Medicine. Hometown Care.
Recognized nationally. tRusted locally. Caring for patients in 16 Greater Tampa Bay Area communities Tampa Bay Area Physicians Patrick Acevedo, MD
Sunil Gandhi, MD, FACP
Edgar G. Miranda, MD
Jose Alemar, MD
Larry Gandle, MD
Jeffrey L. Paonessa, MD
Rand W. Altemose, MD
Christopher B. George, MD
Janelle Park, MD
Thyag Ananthakrishnan, MD
Vivian Griffin, MD
Y. K. Peter Park, MD
Jorge Ayub, MD
Andrew E. Hano, DO
Hitesh Patel, MD
Jennifer L. Ball, DO
Vu Tran Ho, MD
J. Andrew Peterson, MD
Gregoire Bergier, MD
Nuruddin Jooma, MD, MPH
Raju V. Rao, MD
Sawsan G. Bishay, MD
Geetha J. Kamath, MD
V. Upender Rao, MD, FACP
Rafael W. Blanco, MD
Craig S. Kitchens, MD
Mark S. Robbins, MD
Kerry E. Chamberlain, DO
Richard A. Knipe, MD
Joseph Sennabaum, MD
Hafeez T. Chatoor, MD
Gajanan A. Kulkarni, MD
Ramesh K. Shah, MD, PA
Marion T. Chirayath, MD
K. S. Kumar, MD, FACP
Shalin R. Shah, DO
Mamta T. Choksi, MD
Julio Lautersztain, MD
Gerald H. Sokol, MD, MSc, FCP
Julia Cogburn, MD
Mary M. Li, MD, PhD
Thomas H. Tang, MD
Jennifer L. Cultrera, MD
Don D. Luong, MD
R. Waide Weaver, MD
Michael Diaz, MD
Joseph R. Mace, MD
David Wenk, MD
Robert L. Drapkin, MD
Vikas Malhotra, MD
David D. Wright, MD
Ramana Dutt, MD
Idelfia A. Marte, MD
Gail Wright, MD, FACP, FCCP
Matthew A. Fink, MD
Arthur J. Matzkowitz, MD
Lane D. Ziegler, DO
Gustavo Fonseca, MD
Magda Melchert, MD
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