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Carolina Vascular & Vein Specialists Delivering a Continuum of Quality Health Care

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Social Media Practice Insurance Checkup


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Editor’s Note

More with Less Health care has entered a new and exciting chapter, with the introduction of minimally invasive advances. Today, treatments that replace major surgery with as much as a tiny incision are part of the armamentaria of almost every medical

Editor Heidi Ketler, APR Contributing Editors Lester S. Borden Jr., M.D. Rod Guthrie Amanda Kanaan

specialty, including our cover story on Carolina Vascular & Vein Specialists. Photography - Anna Paschal Photography

Patients of Dr. Andrew Hearn of CVV have access to minimally invasive and noninvasive treatments for a range of conditions, from aneurysms to varicose veins. He also provides keen insight into how personal lifestyle changes – the epitome of noninvasive – might have the greatest impact on a patient’s overall health and wellbeing.

Also this month, we welcome Dr. Lester Borden, who reviews strategies for improving the risk/benefit ratio associated with PSA screening, including active surveillance, in men whose risk of prostate cancer is relatively low. Attorney Rod Guthrie suggests an annual insurance checkup for physician practices and offers a list of insurance considerations. Regular contributing editor Amanda Kanaan returns in support of the use of social media as a useful information and communication tool connecting doctor and patient.

We also welcome your practice news and professional insight. And when it comes to advertising to the medical community, consider that The Triad Physician offers more for less. Every month, we connect with more than 6,000 physicians, doctors of osteopathic medicine, physician assistants, nurse practitioners, administrators and hospital staff. With great respect and appreciation,

Heidi Ketler Editor

2

The Triad Physician

Creative Director - Joseph Dally

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Category

Contents

COVER STORY

4

Carolina Vascular & Vein Specialists

Delivering a Continuum of Quality Health Care

september 2012

FEATURES

9

Marketing

Three Reasons Why Doctors Should Consider Social Media

V ol . 1 , I s s u e 7

13

DEPARTMENTS 12 Legal Time for Your Annual

Urology

Insurance Checkup?

14 News

Active Surveillance for Prostate Cancer

- Forsyth Is First Hospital In State to Achieve Cycle IV Accreditation

Dr. Lester Borden discusses strategies

Amanda Kanaan reviews social

to improve the risk/benefit ratio of PSA

media benefits that give practices

screening, such as selective screening,

a competitive edge, including cost-

and active surveillance over aggressive

effective marketing and improved

treatment.

patient relationships.

- Diversity MBA Magazine Recognizes Achievements of Two Novant Leaders

15 News

- Newborn Channel Provides Baby

- Bariatric Center Earns Center of

Care and Postpartum Education Excellence Recertification

16 News

- New physician and physician assistant listing

On the cover: Andrew Hearn, vascular surgeon with Carolina Vascular & Vein Specialists, serves as medical director of the interventional diagnostic lab at Alamance Regional Medical Center, where he is also chief of surgery.

- Letter of Apology

- 2013 Editorial Calendar

September 2012

3


Category On the Cover

Carolina Vascular & Vein Specialists Delivering a Continuum of Quality Health Care By Amanda Kanaan

Carolina Vascular & Vein Specialists has set the standard in vascular

Dr. Hearn, a graduate of the Ohio State University College of

care in the Triad since its origination in 2006. The Burlington practice

Medicine, completed a vascular surgical fellowship at Good

offers a comprehensive approach to vascular disease, ranging from

Samaritan Hospital in Cincinnati.

preventive services to diagnostic expertise to innovative, minimally invasive surgical and endovascular techniques.

“Simply put, when patients go to him for venous problems, he can improve their quality of life,” says Richard L. Gilbert Jr., M.D.,

Andrew Hearn, M.D., owner and the sole practitioner at Carolina

a family practitioner in Burlington who doesn’t hesitate when

Vascular & Vein Specialists, was the first surgeon in the Triad

referring patients from his family practice to Dr. Hearn. “It used to

dedicated solely to vascular surgery. Certified in both vascular and

be in the old days when you had the type of problems he treats,

general surgery by the American Board of Surgery, Dr. Hearn started

you lived with them. No more. His procedures are minimally

the vascular lab at Alamance Regional Medical Center. At ARMC

invasive, offering a high reward and low risk. It’s rare that patients

he has recently served terms as medical director of the vascular

who I refer to him don’t feel significantly better afterward.”

interventional lab and chairman of the department of surgery. Treating the whole patient is a point of pride for Dr. Hearn, whose practice stresses a holistic approach to improving wellbeing, whether he is evaluating a young person with spider veins or treating an older patient with an aortic aneurism. “The philosophy in this office is that patients are human beings, not just medical problems,” he says. “We have a caring staff that strives to address all their concerns. We want them to leave our office feeling better.”

Diagnosis via Doppler: It’s Not Just for Meteorologists Quality care at Carolina Vascular & Vein Specialists starts with proper diagnosis. A Doppler ultrasound measures blood flow and blood pressure by bouncing high-frequency sound waves off of circulating red blood cells. “Everybody has heard of Doppler when it comes to weather, which uses ultrasound to bounce off the clouds and tell you which direction the clouds are moving and how fast,” says Dr. Hearn. “In a likewise fashion, we can use Doppler with arteries Improved quality of life for patients is central to treatment at Carolina Vascular & Vein Specialists.

4

The Triad Physician

and veins to tell us which direction the blood is flowing, how fast and if there might be a blockage.”


legs will look better, and the patient will be more apt to put on those shorts, more likely to slip on a bathing suit. In the long run, they’ll be more active and that makes them healthier.”

Noninvasive Treatments Becoming Standard More than half of the patients Dr. Hearn sees come in with a vein problem – the most common vascular condition. And the good news is treatment has evolved to the point where long hospital stays are the exception, not the rule. “With vascular care, there’s been a revolution in the last five years with nonsurgical treatment,” Dr. Hearn says. “That means patients return to their daily lives much quicker than before.”

Doppler ultrasound is available at Carolina Vascular & Vein Specialists for on-site diagnosis.

Vein stripping or surgery that removes The Doppler ultrasound is among the on-

While many might dismiss varicose vein

varicose veins in the leg is no longer the

site, state-of-the-art technology available at

treatment as cosmetic only, Dr. Hearn

gold standard for the chronic problem

Carolina Vascular & Vein Specialists.

stresses that the improved appearance

that affects half of Americans, particularly

of the legs pays off in multiple ways and

women.

“Ultrasound tells us immediately what’s

encourages patients to treat the problem.

going on with all aspects of circulation,”

“Now we can make the problem much

says Dr. Hearn. “There is no delay in

“People who feel self conscious about

better by doing a laser procedure in the

learning the results; It’s immediate. There

their legs don’t want to wear shorts in the

office,” says Dr. Hearn. “What used to be

is no waiting around for test results.”

middle of a 95-degree North Carolina day,

a hospital stay with possible complications

and that becomes lifestyle limiting,” he

and a recovery period can now be

Two of the most common ailments Dr.

says. “I like the term ‘healthy appearance’

accomplished in an afternoon.”

Hearn finds following ultrasound diagnosis

when talking about why to treat. Their

are peripheral arterial disease and varicose veins. PAD usually affects the arteries in the legs, causing numbness and pain, particularly when walking or climbing stairs. Varicose veins are swollen, twisted and often painful veins filled with an abnormal collection of blood. The legs often ache and feel heavy. If an ultrasound confirms either, Dr. Hearn directs patients to the catheterization lab at Alamance for an angiogram, an imaging test that uses X-rays to view the body’s blood vessels. With further information, Dr.

Hearn

immediately.

can

authorize

treatment

Noninvasive diagnosis and treatment at Carolina Vascular & Vein Specialists typically leads to fewer complications and quicker recoveries.

September 2012

5


Endovenous ablation relies on radiofrequency or laser energy to

Generally recovery involves one night in the hospital and a return

cauterize or burn abnormally enlarged veins close to the surface

to normal activity within a few days.

of the leg skin. This image-guided procedure starts with an IV into the vein that’s not working, thus fixing the vein from the inside out.

Surgery is no longer the only option, either, when uterine fibroids develop, says Dr. Hearn, noting many women do not want to

“The heat of the laser gently closes down the abnormal vein,” Dr.

undergo a hysterectomy, which routinely calls for a recovery time

Hearn says. “It takes a half hour, and the patient walks out of our

of six weeks.

offices and returns to work the next day.” “We offer uterine fibroid embolization, which is really a fancy name Minimally invasive treatments can even help aortic aneurisms,

for going in with a catheter and shutting off the blood supply to the

one of the most feared complications in vascular disease, often

uterus or uterine fibroids,” he says.

occurring in patients 70 or older. When the aorta becomes bigger than it should be, the consequences can be internal bleeding and

Tiny particles the size of grains of sand block the blood flow to

if not treated, death.

the fibroid tumor, causing it to shrink and alleviate the symptoms associated with the fibroids.

Whereas once traditional surgery was the only treatment, Dr. Hearn stages a stent procedure done under light sedation is now

“This is a treatment that is about 85 percent effective, and there’s

another option. A synthetic graft is attached to the end of a thin

no incision,” Dr. Hearn says. “There’s usually a one-night stay in the

tube inserted through the femoral artery in the groin. The graft is

hospital and minor cramping that resolves itself due to the change

threaded up into the aorta and placed at the site of the aneurism,

in blood flow. Patients are back to work within a week’s time.”

reinforcing the weakened section of the aorta to prevent rupture.

Treating the Whole Patient “I It can be a less risky procedure than an open operation and the

Dr. Hearn is a proponent of ensuring all of his patients’ needs are

recovery is quick,” says Dr. Hearn.

met, not just their vascular concerns. Two of the main causes of vascular disease are smoking and diet. Both are topics he routinely discusses with his patients, offering treatment options, therapies and support. “We talk to our patients about smoking cessation techniques and what is available to them,” he says. “Cholesterol is another precursor to vascular disease. We work with our patients to control their cholesterol and improve their nutrition.” Dr. Hearn is a proponent of a conservative approach, something he practices himself by wearing compression stockings, among the simplest tools for addressing leg problems. Usually recommended to control chronic leg swelling that stems from venous insufficiency, compression stockings are an excellent option for anyone suffering from leg problems. “Our entire approach at Carolina Vascular & Veins Specialists is based on making our patients feel better,” Dr. Hearn says. “Sometimes that can be accomplished by wearing stockings; other times it can be through exercise or proper nutrition. Sometimes a stent is necessary or a laser treatment. Whatever the problem, we’ll work to find the solution.” Carolina Vascular & Vein Specialists is located at the campus of Alamance Regional Medical Center in the Grandview Specialty

Dr. Hearn counsels patients about the lifestyle changes that can improve their vascular health.

6

The Triad Physician

Building in Burlington. Call (336) 585-1869 or log on to www. carolina-vascular.com for information.


Expertise

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September 2012

7


Marketing

Three Reasons Why Doctors Should Consider

Social Media Physicians are eager to embrace new ad-

for health information, and nearly all of

vances in medical technologies, but as a

those people (94 percent) turn

whole they tend to be late adopters when

to Facebook. Addition-

it comes to progressive communication

ally, they found that

tools, such as social media.

Americans using

By Amanda Kanaan

social media for Although health care is innately social,

health care are af-

policies, like the Health Insurance Portabil-

fluent, and on aver-

ity and Accountability Act (HIPAA), have

age, 41 years of age.

caused, what I believe to be an unhealthy fear among physicians to interact with pa-

It’s clear that social media is not a fleeting

tients outside of the office.

trend, and patients find it to be a valuable

think their social media strategy to not just

resource for health care information and

focus on marketing but on an overall busi-

Whether you cite HIPAA, a lack of time or

interaction. So now the real question is,

ness strategy to improve outcomes and

limited computer skills as reasons for not

“what’s the advantage for doctors?”

lower the cost of providing care.

Three Advantages of Social Media for Doctors

The physician-patient relationship is a

major opportunities to use social media to your advantage.

1. Cost-Effective Marketing

the opportunity for both to speak, listen,

While there are many advantages to so-

understand and learn from one another.

Are Patients Really Using Social Media?

cial media, one of the major benefits is

Embrace the opportunity to educate and

the ability to attract new patients. Social

interact with your patients to help better

First, let’s take a look at the numbers when

media acts like a megaphone, amplifying

manage their conditions and coordinate

it comes to patient interaction online. Ac-

your message across various channels and

care. Just be careful to never give personal

cording to a 2012 study by Pricewater-

potentially reaching those who may have

medical advice or reveal patients’ private

houseCoopers, a survey of more than 1,000

no idea who you are. This is especially

health information online. Think of your

adults in the United States revealed:

effective when it comes to patient testimo-

online interactions as communicating with

• One third of consumers now use

nials and connecting with other referring

your patient population as a whole in or-

social media sites for health-related

doctors online. It’s a powerful branding

der to avoid HIPAA concerns.

activities;

tool in enhancing the reach of your repu-

pursuing social media, there’s a strong possibility you could be missing out on three

two-way street, and social media provides

• 40 percent of consumers have sought

tation. Facebook now even offers analyt-

3. Competitive Edge

out reviews of treatments, physicians

ics for your page so you can monitor the

Social media is an extremely powerful

and other patient experiences;

impact you’re having online and analyze

platform that allows physicians to position

• 45 percent of consumers say informa-

what type of content resonates best with

themselves as an expert in their specialty.

tion from social media sources would

patients. This makes the ROI much more

For example, maybe a doctor wants to

affect their decisions; and

trackable.

position himself/herself as an expert in ro-

• 73 percent would welcome social

botic surgery within the ob/gyn specialty.

media-based tools for such things as

2. Patient-Centered Relationships

While their peers sit on the sidelines, doc-

making an appointment or asking a

The reason patients are eager to connect

tors have an opportunity to take a leader-

question.

with their doctors online isn’t so they can

ship role and put themselves ahead of

see where you went to dinner on Saturday

the competition. Now is the time to build

A separate survey by the National Research

night. They want to use social media as a

up your social media network online and

Corp. reported that more than 40 percent

tool to better manage their health. This is

show your patients that you are not only a

of respondents rely on social networking

prompting health care organizations to re-

leader in your specialty but also in terms

8

The Triad Physician


Amanda Kanaan is the president and founder of WhiteCoat Designs, a North Carolinabased marketing agency catering specifically to physicians. WhiteCoat Designs offers doctors affordable marketing solutions to help them grow their practices. Services include website design, search engine optimization (SEO), social media management, online reputation monitoring, brochure and collateral design, branding makeovers and physician liaison services to build patient referrals. Ms. Kanaan can be reached at amanda@whitecoat-designs. com or (919) 714-9885. To learn more, visit www.whitecoat-designs.com.

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of the progressive way you interact with

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Although social media may not be an op-

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tion for all practices, the advantages of

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participating are at least worth consider-

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ing. Negative reviews will happen whether you like them or not. The good news is that

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social media at least gives you the opportunity to be part of the conversation and show off your customer-service skills. If you decide to pursue social media, you need to ensure you have the time to interact consistently and if not, who you are going to trust to manage your page for you. Also, it is strongly advised – even by AMA – to put social media policies in place. This ensures all members of your practice understand what type of behavior is acceptable on your social media sites. The policy also should be easily accessed by patients.

Physicians/Providers • Brian D. Stone, MD • Kent J. Nastasi, MD • Ingrid M. Hoffmann, MD • Holly M. McPherson, MD • Elizabeth R. Scannell, MD • Carrie C. DeLong, PA-C • Joel M. Hartman, MD

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Start the Conversation Have an opinion on social media for health care? Want to ask Amanda Kanaan a question about getting started with social me-

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www.facebook.com/APPiedmont

www.twitter.com/AP_Piedmont

www.allergypartners.com/piedmont/blog

dia? Send her a message on Facebook at /whitecoatdesigns or on Twitter @whitecoatdesign.

September 2012

9


Guest Column

No Headache Real Estate Brokerage Services Exploring medical office options and ne-

ond to none and was something our prac-

Triad Commercial Properties’ founding

gotiating a lease on the chosen space call

tice was grateful to have negotiated on our

partners each have more than two decades

for expertise that few local commercial real

behalf,” Betsy Hicks, Practice Manager for

of real estate experience, much of which is

estate brokerage firms offer. If you’re a phy-

Physicians for Women of Greensboro, said.

in real estate development and is inclusive

sician or medical office manager seeking

“Triad Commercial Properties exceeded

of extensive ground-up development expe-

new or expanded office space, Triad Com-

our expectations and became a partner we

rience. Triad Commercial Properties is the

mercial Properties is the answer to your

trust and rely on and has proved to be ‘the

Triad’s leading commercial real estate bro-

property leasing worries.

Agent of Choice’ in the Triad area medical

kerage firm based on market share in medi-

office market.”

cal office, general office, and industrial and investment property transactions.

Triad Commercial Properties provides commercial real estate brokerage and ad-

When seeking medical office space, the first

visory services to clients in Winston-Salem,

objective of the Triad Commercial team is to

“Our mission for medical office practices

Greensboro, High Point and surrounding

become extensively acquainted with a prac-

is clear: provide unparalleled value-added

counties. The firm is a third-party service

tice’s overall real estate objectives to man-

brokerage services or development as-

provider, specializing in real estate bro-

age the flow of market information, allowing

sistance as a third-party service provider,”

kerage. Triad Commercial Properties lists

physicians and their staffs to focus on daily

Bobby Finch of Triad Commercial Prop-

properties for sale or lease but is focused

office operation priorities. Triad Commer-

erties said. “By employing a single real

on tenant and buyer representation.

cial Properties quickly positions itself as a

estate provider, local medical practices

strategy partner with medical practices and

control dissemination of information to

“Triad Commercial Properties provided us

provides access to a team ready and willing

the real estate market. A strategic, properly

with skill, care and expertise throughout

to provide, at no up-front cost, services such

sequenced negotiating process provides

the office search process. The experience

as cataloging of properties, property value

leverage to optimize results.”

in the medical office submarket was sec-

opinions and market analysis.

Triad Commercial Properties has extensive market knowledge of real estate for medical practices and counts Piedmont Ear Nose & Throat Associates (PENTA) in Winston-Salem among its valued clients.

10

The Triad Physician


Real Estate Consulting Services Offered • Tenant representation • Buyer representation • Listing representation, including sale, lease and sub-lease • Disposition/acquisition strategy • Consulting • Lease review and abstraction • Financial analysis • Sale and leaseback analysis

land, retail and income properties. An independent company, Triad Commercial Properties offers extensive market knowlPictured above is Signature Place in Greensboro, NC where Triad Commercial Properties has represented Central Carolina OBGYN, Greensboro Orthopaedics, Southeastern Heart and Vascular Center, and Solstas Lab Partners.

edge, flexibility and rapid response and is widely respected for its financial analysis capabilities.

Triad Commercial Properties offers a thor-

Consistently ranked as the market’s lead-

ough understanding of site and building

ing commercial real estate brokerage firm,

For more information about

development, with special expertise in

Triad Commercial Properties offers a com-

Triad Commercial Properties, please

structuring leases for all sizes of medical

plete line of services for office, industrial,

go to www.TriadCommercial.com.

practices. Focusing solely on brokerage and third-party advisory services, Triad Commercial Properties offers expertise with no inherent conflicts of interest associated with ownership or development agendas. “Another benefit of using a single real estate source is that medical practices can better ensure the confidentiality of activities. This could be particularly important to a practice or business in an acquisition mode,” Ryan Gioffre of Triad Commercial Properties said. “By aligning with a real estate company with deep resources, medical practices can accomplish necessary tasks during peak real estate activity periods without permanently adding staff or burdening existing staff members with new or unfamiliar assignments.” Medical practices throughout the Triad also benefit from the knowledge Triad Commercial Properties has gained through numerous transactions negotiated on behalf of other companies and practices. Among other benefits, broad market knowledge allows medical practices to assess costs compared to those of other general and medical office users.

About (l) Ryan Gioffre and (r) Bobby Finch Triad Commercial Properties’ Bobby Finch and Ryan Gioffre are members of the North Carolina Medical Managers Association and have represented many of the Triad leading medical practices. Ryan Gioffre (336) 821-3303 direct ryan@triadcommercial.com

Bobby Finch (336) 812-3303 direct bobby@triadcommercial.com

September 2012

11


Legal

Time for Your Annual

Insurance Checkup? By Rod Guthrie

Physicians, perhaps more than any other

exclusions in insurance policies is far be-

professionals, spend enormous amounts

yond the scope of this article.)

of time and energy preparing themselves to practice in their chosen fields. Unfortu-

However, professional liability is not the

nately, as with most other professionals,

only way a physician can be subjected to a

they receive very little practical training in

claim. Premises liability, products liability,

how to operate a business.

acts (intended or unintended) by an employee – all are potential sources of claims.

There are basic business needs, such as

Medical practices are in no way immune

securing and maintaining office space,

from accidents involving automobiles,

hiring and retaining competent employ-

vans, wheelchairs, etc. The receptionist

ees and paying those employees. Another

you ask to pick up a record or X-ray on his/

basic need that most busy professionals

her lunch hour who causes an auto colli-

find easy to ignore, or at least neglect, is

sion could be considered in the course of

adequate insurance protection.

his/her employment and thereby bring the employer into the mix.

For physicians who own and manage their own practices, here are some suggestions

Workers’ Compensation. This coverage

on the types of insurance coverage avail-

is not optional. North Carolina mandates

able and well advised.

that any employer with three or more employees provide compensation to those

Property and Casualty. This provides

employees when they are injured on the

protection from damage to or destruction

job. The courts of our state have consis-

of property (real, personal, equipment,

tently expanded the application of “in the

etc.) you own or possibly lease. Fire, wind,

course and scope of employment,” gener-

water and theft are some of the risks usu-

ally making claims more common and this

ally covered, but these policies are very

insurance more expensive.

often customized or endorsed to meet specific needs. It’s important to ask and

Employment Practices. Claims of dis-

confirm whether the property is insured

crimination, sexual harassment or unfair

only for its value at the time of loss or for

practices in the workplace continue to

replacement cost.

increase. Specific insurance coverage is usually available for this type of claim

Liability. Professional negligence claims

and should be included in your insurance

are certainly a risk in every licensed occu-

portfolio. Insurance also can be acquired

pation, but nowhere more so than the med-

to protect your practice from theft by em-

ical profession. Adequate coverage here

ployees.

should be a given and reviewed regularly to determine that the breadth and limits of

Excess Liability. This insurance, often

the policy you have are sufficient. Every

referred to as “umbrella” coverage, is de-

insurance contract contains a significant

signed to apply only when your underly-

number of exclusions. (A full discussion of

ing “primary” liability coverage has been

12

The Triad Physician

Rod Guthrie is a founding partner with Bennett and Guthrie P.L.L.C., a Winston-Salem law firm focusing on defending claims of all types. The firm represents a variety of insurance carriers and business clients, including a number of health care providers throughout the Triad area. Mr. Guthrie regularly handles claims involving insurance coverage disputes, professional negligence and general liability. exhausted. Relatively inexpensive, it is a cost-effective way to provide peace of mind against major claims that might expose personal assets. Here again, it is important to confirm that the policy coordinates with the other coverage in place to avoid gaps. Disability. The inability to work, particularly for highly compensated individuals, can be devastating. Disability insurance, long-term and/or short-term, is designed to protect your income while recovering from an injury or illness or even a permanent impairment of your earning ability. Even in insurance, this adage holds true: “An ounce of prevention is worth a pound of cure.” Regular review of your insurance needs is good business and good medicine. Readers are invited to contact a lawyer at Bennett & Guthrie P.L.L.C. and have their legal questions answered. Call (336) 7653121 or send an e-mail to Rod Guthrie at rgutherie@bennett-guthrie.com.


Urology

Active Surveillance for

Prostate Cancer By Lester S. Borden Jr., M.D.

Prostate cancer continues to be a signifi-

Another strategy which is now part of

cant public health problem and remains

standard practice is to offer active surveil-

the most common non-cutaneous cancer

lance for men diagnosed with lower-risk

and the second-leading cause of cancer

prostate cancer. Realizing that the risk of

death for men in the United States. An es-

death from competing medical comorbidi-

timated 217,000 men were diagnosed with

ties is substantial in older men, not all men

prostate cancer, and more than 30,000 men

diagnosed with prostate cancer need to un-

were estimated to have died from prostate

dergo aggressive treatment. Active surveil-

cancer in 2010.

lance involves clinical follow up with serial PSA testing and physical examination,

Prior to 1990, one out of four men diag-

along with periodic biopsies of the pros-

nosed with prostate cancer was diagnosed

tate to monitor for evidence of progression.

Dr. Lester Borden is with Alliance Urology Specialists, Greensboro. He earned his medical degree at Ohio State University College of Medicine, Columbus, Ohio. He completed his urology residency at Wake Forest University, Winston-Salem, and a fellowship in urologic oncology at Virginia Mason Medical Center, Seattle, Wash.

with metastatic disease and only about 50 percent of men were deemed candidates

Active surveillance is not the same as the

for curative therapy. In the early 1990s,

concept of “watchful waiting,” which im-

which can include urinary-, sexual- and

prostate specific antigen (PSA) blood test-

plies treatment only when a man develops

bowel-related side effects. The potential

ing was approved for the use of early pros-

symptomatic or metastatic disease. Rather,

disadvantages of this approach include the

tate cancer detection. The introduction of

active surveillance is the concept of moni-

psychological consequences of living with

PSA screening allowed prostate cancers to

toring the disease with the goal of inter-

a cancer that is not treated and the obvious

be detected much earlier, with less than

vening with definitive therapy at a curable

risk of disease progression during surveil-

4 percent of all men currently presenting

stage, if necessary in the future. In other

lance. Currently, data suggest a very low

with metastatic disease.

words, it is a strategy of trying to select out

risk of progression or death from prostate

the men who truly require aggressive cura-

cancer in appropriately selected men who

Despite the earlier detection of prostate

tive therapy, while avoiding it in those who

undergo active surveillance, although lon-

cancer and the decreasing death rates from

will not.

ger follow up is necessary to determine the true risk of progression while on a surveil-

prostate cancer throughout the past two

lance protocol.

decades, there remains substantial contro-

Men with lower-risk cancer, including

versy surrounding PSA screening for pros-

those with a PSA less than 10 ng/mL, a

tate cancer. Although high-level evidence

Gleason score less than or equal to 6, and

Active surveillance is now a standard op-

exists that suggests improved survival rates

those with an early clinical stage and with

tion for management of men with low-risk

in men who undergo PSA screening, many

lower-volume disease on biopsy, are felt to

prostate cancer. This approach will help

question whether this benefit outweighs

be the most appropriate candidates for a

to significantly reduce the number of men

the risks associated with treatment.

surveillance approach. Therefore, not all

who undergo unnecessary aggressive treat-

men diagnosed with prostate cancer are

ment and, thereby, reduce the risk or harm

Multiple strategies have been employed

suitable candidates for active surveillance

associated with PSA screening. While pros-

to improve the risk/benefit ratio of PSA

and many men diagnosed with prostate

tate cancer is certainly over diagnosed in

screening for men. Selectively screening

cancer should still seek aggressive curative

the current era, over diagnosis no longer

only those men with longer life expectan-

therapy with surgery or radiation.

implies overtreatment. Future research will help to improve the selection of men who

cies (greater than 10 years) and those most at risk – the men who receive the greatest

The potential advantages of surveillance

are best managed with active surveillance,

benefit of screening – helps.

are clear. Men are not subjected to the

and protocols for surveillance are likely to

potential risks of surgery or radiation

become more standardized with time.

September 2012

13


News

Forsyth Is First Hospital in State to Achieve Cycle IV Accreditation Forsyth Medical Center has become the

means our program has met or exceeded

attack to ensure that they are not

first hospital in North Carolina to earn

the SCPC’s stringent criteria, and patients

sent home too quickly or needlessly

Cycle IV Chest Pain Center designation

with chest pain and heart attack symptoms

admitted to the hospital

from the Society of Chest Pain Centers.

who come to Forsyth Medical Center

Forsyth is now one of 26 facilities across

can expect the highest level of excellent,

Forsyth Medical Center first became an

the nation to have this designation.

quality care.”

accredited chest pain center in 2008. Last year, the hospital affiliated with the

Society of Chest Pain Centers (SCPC)

SCPC rigorously evaluated Forsyth Medical

Cleveland Clinic heart care program to

accreditation denotes the highest level

Center for its ability to assess, diagnose and

enhance patient care and outcomes.

of expertise in dealing with patients with

treat patients who may be experiencing a

Forsyth Medical Center has earned the

symptoms of a heart attack, according to a

heart attack. The hospital demonstrated

Society of Thoracic Surgeon’s three-star

Forsyth press advisory.

that it has processes in place to meet strict

rating for heart surgery and was the first

criteria aimed at:

in North Carolina to earn heart failure

“As an accredited chest pain center, we

•R  educing the time from onset of

certification from The Joint Commission.

emphasize the importance of standardized

symptoms to diagnosis and treatment;

diagnostic and treatment programs that

•T  reating patients more quickly during

Heart attacks are the leading cause of death

provide more efficient and effective

the critical window of time when the

in the United States, with 600,000 people

evaluation,” said Robert Preli, M.D.,

integrity of the heart muscle can be

dying annually of heart disease. More than

cardiologist and medical director of the

preserved; and

five million Americans visit hospitals each

cardiac catheterization lab at Forsyth Medical Center. “Achieving Cycle IV status

•M  onitoring patients when it is not

year with chest pain.

certain that they are having a heart

Diversity MBA Magazine Recognizes Achievements of Two Novant Leaders Two Novant Health leaders have been named among the “Top 100

30- and 60-day readmission rates and returns to the emergency

Under 50 Diverse Executive & Emerging Leaders” by Diversity MBA

department. Dr. Nnadi and his team successfully developed

Magazine.

innovative roles for technicians to advance pharmacy practice in North Carolina by starting an associate degree in pharmacy

Michael Nnadi, Pharm.D., vice president and chief pharmacy officer

education.

for Novant Health, and Chere Gregory, M.D., medical director of the neurosciences department at Forsyth Medical Center, were

Chere Gregory was the first African-

selected based on their position within their company and for their

American

scope of responsibility, community service work and education

fellowship in neurocritical care at The

achieved. The honorees were featured in Diversity MBA Magazine’s

Johns Hopkins University School of

summer 2012 issue and honored at the magazine’s awards gala this

Medicine and the first African-American

woman

to

complete

a

woman in the United States to open and

month.

direct a neurocritical care unit. Under

14

The Triad Physician

Michael Nnadi provides pharmacy

her leadership, Forsyth Medical Center

services to 13 hospitals. According to

became the first hospital in North Carolina and South Carolina to

a Novant press advisory, he initiated

earn The Joint Commission’s accredited Primary Stroke Center

consolidation

among

designation. Dr. Gregory is also an integral member of the team

Novant’s hospitals and has assisted in

that envisioned and recently launched the Maya Angelou Center for

improving medication safety that reduced

Women’s Health and Wellness at Forsyth Medical Center.

of

pharmacy


News

Newborn Channel Provides Baby Care and Postpartum Education The Newborn Channel now available at High Point Regional Health System delivers essential newborn and parenting information, such as infant and mom care, siblings and family living, work-life balance and more. The free resource for parents and families also is available online at www.newbornchannelonline.com and via smartphones by texting the word “newborn” to 411247. The educational content on the Newborn Channel is overseen and reviewed by a medical advisory board that ensures it is

up to date and presented in a clear and understandable way for parents and their families. The Newborn Channel promises engaging and accessible programming on many topics, including: •D  iapering, bathing and general infant care •M  om health and birth recovery topics •B  reastfeeding basics and tips for success • Car seat safety • Smoking cessation • Sudden infant death syndrome

Programs and transcripts are available on demand. “The Newborn Channel helps supplement our nurses’ patient education efforts,” said Donna Timpf, Women’s Center Program coordinator. “Because it is always available, our nursing and education staff is able to recommend quality, up-to-date education for new parents in their time of need.” Instructions on how to access the Newborn Channel online can be found at www. highpointregional.com.

Bariatric Surgery Center Earns Center of Excellence Recertification The Regional Center for Bariatric Surgery

Roux en-Y (RNY) gastric bypass; sleeve

High Point’s Regional Center for Bariatric

at High Point Regional Health System

gastrectomy; and adjustable gastric banding

Surgery also is accredited through the

earned recertification as a Bariatric Center

(AGB). Bariatric surgical procedures have

American College of Surgeons Bariatric

of Excellence from the Clinical Sciences

been shown to effectively treat obesity

Surgery Center Network accreditation

Institute of OptumHealth Care Solutions.

particularly when patients are dedicated to

program, which recognizes facilities with

following their surgeon’s post-operative diet

the highest quality standards of care and

and follow-up recommendations.

excellent clinical outcomes.

“The staff at the bariatric center is an exceptional team,” said Carin Hiott, director of chronic care at High Point Regional. “It is not just their knowledge and expertise that sets them apart, it is truly the genuine care and concern they have for each individual patient.” According to a High Point Regional Health press advisory, through a rigorous evaluation

process,

OptumHealth

has developed networks of centers of excellence that provide access to clinically superior, cost-effective health care. The Regional Center for Bariatric Surgery offers four surgical weight-loss options: the sleeve gastric bypass (SGB), sometimes referred to as the mini gastric bypass;

September 2012

15


News Welcome to the Area

Physicians

Heather Norris Beard, DO

Emergency Medicine Wake Forest University Baptist Medical Center Winston-Salem

Sidney Lee Callahan, DO Obstetrics and Gynecology Greensboro

Joshua Wesley Courtney, DO Anesthesiology Mooresville

Shuja Ahmed, MD Winston-Salem

Fahad Aziz, MD Internal Medicine Winston-Salem

Jennifer Rebecca Badik, MD

Pediatrics; Diabetes; Pediatric Endocrinology Pediatric Sub-Specialists of Greensboro Greensboro

Miranda Elizabeth Blevins, MD Family Medicine; Family Practice Davis Regional Hospital Statesville

Fred Gary Bromberg, MD

Administrative Medicine; Internal Medicine Wake Forest University Baptist Medical Center Winston-Salem

Lydia Turlykina Cater, MD

Hospitalist; Internal Medicine Wake Forest University Baptist Medical Center Winston-Salem

Kehinde Temitayo Eniola, MD

General Preventive Medicine; Adolescent & Young Adult Medicine; Family Medicine; Geriatric Medicine; Family Practice Winston-Salem

Timothy Alois Fife, MD

Facial Plastic Surgery; Head and Neck Surgery; Maxillofacial Surgery; Allergy and Immunology; Otolaryngology - Plastic Surgery Within the Head & Neck; Otolaryngology - Sleep Medicine; Otolaryngology, Otology-Neurology; Otology; Otorhinolaryngology Wake Forest University Baptist Medical Center Winston-Salem

Onyedika John Ilonze, MD

Internal Medicine; Hospitalist Wake Forest Baptist Health, Winston-Salem

Melanie Jeannine Johnson, MD

Child Psychiatry; Psychiatry Wake Forest University Baptist Medical Center Winston-Salem

Robert Peter Lockwood, MD

Anesthesiology - Critical Care Medicine; Anesthesiology - Pain Medicine Wake Forest University Baptist Medical Center Winston-Salem

Riddhishkumar Shah, MD Internal Medicine; Hospitalist Cone Health Internal Medicine Greensboro

Nicholas Jay Sparler, MD

Anesthesiology Wake Forest University Baptist Medical Center Winston-Salem

Andrea Jennings Strathman, MD

Hospitalist Winston-Salem

Physician Assistants

Jesse Joseph Miller, MD

Family Medicine; Hospitalist; Internal Medicine; Pediatrics; Psychiatry; Public Health; Urgent Care Winston-Salem

Jade Leigh Breeback, PA

Neonatal-Perinatal Medicine; Pediatrics Clemmons Internal Medicine; Pulmonary Disease and Critical Care Wake Forest University Baptist Medical Center Winston-Salem

Dawn Marie Delo O’Reilly, PA

Catherine Meghan O’Hara, MD

Heather Joy Van Wingen, PA

Winston-Salem

Internal Medicine Wake Forest University Baptist Medical Center Winston-Salem

Wake Forest Dept of Emergency Medicine Greensboro

Peters Ehiosuorea Okonoboh, MD

Abdominal Surgery; Critical Care Surgery; Emergency Medicine; General Surgery Wake Forest Baptist Health Winston-Salem

Hospitalist; Internal Medicine Wake Forest University Baptist Medical Center Winston-Salem

The practice had forwarded a number of final edits to me before the article was to be published; however, in the rush to meet deadlines, I completely overlooked the e-mail that contained them. We will begin a series of features on each of the Duke Eye Center of Winston-Salem physicians starting in the October issue. I would like to convey once again my sincere apologies to Drs. Parag Gandhi, Philip McKinley, Frank Moya, Terry Semchyshyn and Carol Ziel for my oversight and for the embarrassment this has caused you. It is certainly my goal each month to highlight top-notch physicians and surgeons, such as you, and the remarkable ways you serve our community every day. I thank you for your understanding regarding this extremely unfortunate incident.

The Triad Physician

Cone Health Family Practice Greensboro

Cristina Maria Miller, MD

The cover story in the July/August issue of The Triad Physician was published with misspellings and erroneous information, which resulted in much embarrassment for the entire medical staff at Duke Eye Center of Winston-Salem.

16

Jose Salvador Reyes, MD

Sangita Verma, MD

Theresa Ann McClung, MD

This is a letter of apology to all of you.

Sincerely, Angela W. Griffin

Obstetrics and Gynecology Woman Care, Winston-Salem

Anesthesiology Wake Forest University Baptist Medical Center Winston-Salem

Emergency Medicine WFBH Medical Center Winston-Salem

Dear Readers,

Laura Best Ramsay, MD

David M White, PA

The Triad Physician 2013 Editorial Calendar January

Glaucoma Wound Management Accounting

February

Asthma and Allergies Heart Disease Consulting for your Practice

March

Nutrition Sleep Disorders Legal

April

Autism Irritable Bowel Syndrome IT Services

May

Arthritis Women’s Health Medical Billing

June

Men’s Health Vascular Diseases Medical Collections

July

Imaging Technologies Psoriasis Medical Insurance

August

Orthopaedics Gastroenterology Medical Real Estate

September

Atrial Fibrillation Urology Web Design

October

Cancer in Women COPD - Lung Health Medical Software - EMR

November

Alzheimer’s Disease Diabetes Financial Planning

December

Pain Management Spine Disorders Practice Management


News North Carolina’s Premier Interior Design Firm

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September 2012

17


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Triad Physicain 2012-09