Ja n ua ry 2 012
Wake Radiology Cary An imaging force in the Triangle
T H E M A G A Z I N E F O R H E A LT H C A R E P R O F E S S I O N A L S
Every 5 Seconds we help improve another life
Working in partnership with physicians for over 50 years to bring the beneďŹ ts of biomedical technology to patients around the world.
55 Board-certified subspecialized radiologists | 18 Triangle Locations Evening and weekend hours for many services | MRI 7 days a week Physician decision support
With This Many Choices, The Answer Is Easy. Neuroradiology Sports Imaging Pediatric Imaging Oncologic Imaging Diagnostic Imaging Interventional Radiology Advanced Breast Imaging
Advanced Imaging With Providers And Patients In Mind. With 55 board-certified, subspecialty trained radiologists at 18 convenient Triangle locations, Wake Radiology gives you and your patients many choices in imaging. We provide advanced comprehensive radiology services coupled with subspecialty expertise to give your patients a high level of care. Soâ€”the next time imaging is needed think of Wake Radiology. If you are not certain what imaging route to take, simply call our radiologists. They are available by phone for physician decision support and welcome the opportunity to assist you. When it comes to individualized provider and patient care, convenience, and subspecialized imaging the choice is easy.
ÂŠ2011 Wake Raleigh. All rights reserved. Radiology saves lives.
Wake Radiology. Excellent decision. WAKE RADIOLOGY EXTENDED HOURS Screening Mammogram: Evenings & Saturdays CT, Ultrasound & Routine Radiology: Saturdays MRI: 7 days a week
WAKE RADIOLOGY EXPRESS SCHEDULING Centralized Scheduling: 919-232-4700 Chapel Hill Scheduling: 919-942-3196
Wake Radiology Expands Imaging Services in Cary Office Strengthens Quality of Care in the Triangle
Vol. 3, Issue 1
Your Financial Rx
Insult to Injury
17 Duke News Wound Management
Paul Pittman advises investors to look
Early, Aggressive Treatment of Diabetic Ulcers Can Save Foot
out for overlapping holdings that can
Dr. Michael Kerzner offers clinical findings
increase costs without increasing
that underscore need for immediate and
specialized treatment of foot ulcers.
However much you value wildlife conservation in North Carolina,
That’s right! Your conservation effort is increased by a 3-to-1 matching gift. So, when you are one of the first to display the new North Carolina Wildlife Habitat Foundation NCDMV license tag, your $10 tag contribution to the organization becomes $40 in lands preserved. The all-volunteer North Carolina Wildlife fe Habitat Foundation assists in acquisition, on, management, and protection of land in North Carolina for the conservation of habitats needed to preserve wildlife
The Triangle Physician
right here in the Old North State. Conservation education efforts are preparing future generations to sustain your concern for the lands we protect today. At www.ncwhf.org, download the license tag application and see the good works in process. pp Your new tag shows your support and your n contribution is put to work…times four. co
Research identifies dangerous microbes in premature babies; Duke and Durham County Embark on Diabetes Initiative
18 Rex News Grants to Support Community Nonprofits
19 Business So You Have a Nice Website…Now What?
20 News Appointments, partnerships, accolades, expansions and welcome
JOHNSTON MEDIC AL CENTER Clayton A Healthier tomorrow begins today
JOHNSTON MEDIC AL CENTER Clayton
A H e a lt h i e r tom or r o w b e g i n s today
From the Editor
From the Editor
On a Mighty Mission T H E M A G A Z I N E F O R H E A LT H C A R E P R O F E S S I O N A L S
Wake Radiology in Cary is a force to be reckoned with, especially if the opponent is cancer or injury. Its mighty arsenal includes 55 board-certified radiologists and the most advanced imaging technologies available. With all the wonders of medical technology, they also are mindful of the power of basic human caring. Our cover story on this thriving practice offers great insight into the present realm of medical possibility. In this monthâ€™s issue of The Triangle Physician, the focus also is on diabetes, and Dr. Michael Kerzner writes on the need for early, aggressive treatment of diabetic food ulcers. You also will read about a Duke initiative to improve outcomes for diabetic patients in Durham County. In other news from Duke, researchers have embarked on a study of the role of dangerous
Editor Heidi Ketler, APR
Contributing Editors Michael S. Kerzner, D.P.M. Andrea S. Lukes, M.D., M.H.Sc., F.A.C.O.G. Paul Pittman, C.F.P. Amanda Kanaan Photography Jim Shaw Photography firstname.lastname@example.org Creative Director Joseph Dally
microbes found in low-birthweight babies.
Advertising Sales Carolyn Walters email@example.com
Returning to begin the new year with The Triangle Physician is financial planning expert
News and Columns Please send to firstname.lastname@example.org
Paul Pittman, always full of valuable insight and cautionary advice. Dr. Andrea Lukes gives us an overview of a treatment for age spots, best pursued in the winter months. Also in this issue, Rex Healthcare announces its annual call for community grant requests. Last year alone, Rex awarded more than $500,000 to 80 nonprofits across the Triangle. And Cirques des Sciences, a fund raiser for Morehead Planetarium and Science Center is coming.
The Triangle Physician is published by: New Dally Design 9611 Ravenscroft Ln NW, Concord, NC 28027 Subscription Rates: $48.00 per year $6.95 per issue Advertising rates on request Bulk rate postage paid Greensboro, NC 27401
Thanks to all who have contributed to a great start for The Triangle Physician in 2012. Best wishes to all those on a mighty medical mission for a great 2012! With deep gratitude and respect,
Heidi Ketler Editor
Every precaution is taken to insure the accuracy of the articles published. The Triangle Physician can not be held responsible for the opinions expressed or facts supplied by its authors. Opinions expressed or facts supplied by its authors are not the responsibility of The Triangle Physician. The Triangle Physician makes no warrant to the accuracy or reliability of this information. All advertiser and manufacturer supplied photography will receive no compensation for the use of submitted photography. Any copyrights are waived by the advertiser. No part of this publication can be reproduced or transmitted in any form or by any means without the written permission from The Triangle Physician.
The Triangle Physician
Category On the Cover
Wake Radiology Expands Imaging Services in Cary Office Strengthens Quality of Care in the Triangle Wake Radiology continues to lead the way in advanced patient care in the Triangle and surrounding areas with its Comprehensive Imaging Center in Cary. Opened in 1998, Wake Radiology Cary located at 300 Ashville Avenue has undergone numerous expansions, renovations and modality upgrades to better serve the area’s growing specialized medical community and its patient base.
help diagnose injury and disease in the most responsible manner utilizing X-ray, CT, ultrasound, nuclear medicine, MRI, PETCT, digital mammography, BSGI and other therapies through minimally invasive interventional radiology. In one location, Wake Radiology Cary offers services grouped according to the needs of patients and their physicians: interventional services; dedicated, state-
s the Triangle’s largest radiology
encompasses excellent medicine coupled
of-the-art comprehensive breast services;
group, our 55 board-certified and
with careful attention to patients’ conve-
diagnostic imaging services including MRI;
subspecialized radiologists perform more
nience, comfort, and peace of mind. Our
and PET·CT services.
than 650,000-plus procedures annually.
subspecialized radiologists utilize the ad-
Wake Radiology’s approach to imaging
vanced imaging technologies in Cary to
March 2010 – PET·CT staging and restaging – August 2010
PET-CT’s wide ranging applications PET-CT technology represents one of the most powerful tools in nuclear medicine imaging, and Wake Radiology’s subspecialty trained radiologists are experts at integrating multi-modality exams and clinical information to give a definitive answer. David Schulz, MD, one of the five dedicated PET-CT imagers at Wake Radiology explains, “PET-CT scans provide both metabolic and structural information, rather than merely detecting that a ‘mass’ or ‘lesion’ is present. PET is useful for initial treatment planning, treatment monitoring, restaging, and detection of suspected recurrence of numerous neoplasms, including but not limited to the most deadly cancers: lung, colon, and breast. Moreover, PET can often identify cancerous cells in many cases before traditional imaging such as CT or MRI.” Paramjeet Singh, MD of Cancer Centers of NC says, “PET-CT is an integral part of my practice. I use it for initial diagnosis and it has proven
PET·CT images of 57-year-old female with metastatic breast cancer. First PET-CT in March 2010 (left images, top and bottom) show the conglomerate of adjacent nodes. After cancer therapies, on the follow-up PET-CT in August 2010, the conglomerate of adjacent nodes clearly decreased in both size and number.
The Triangle Physician
essential in the follow-up and evaluation of treatment plans. Wake Radiology’s PET-CT imaging specialists are always just a phone
call away if I need to review findings or consult with them on a difficult case. The use of PET-CT has made an impact on my patient’s care for the better and has been a great help to me as a physician. “In addition to oncology applications, PET also has proven utility for neurological applications such as identifying refractory seizure foci and the differential diagnosis of frontotemporal dementia and Alzheimer’s disease. We are also excited about some new PET compounds aimed at detecting the plaques seen in the brains of patients with Alzheimer’s disease, potentially facilitating earlier diagnosis. The first of these compounds may achieve final FDA approv-
Postcontrast projection image of both breasts, as if looking upwards from the patient’s feet, demonstrating a large breast cancer in the breast on the left of the image. The breast on the right is normal.
al as soon as spring 2012, and we look forward to providing this specialized service
existing services, and it will also allow re-
Breast MRI is well established as the most
as it becomes available.”
ferring physicians to access MRI expertise
sensitive and specific method for early
and services in Cary that once were only
detection of breast cancers, and is recom-
The equipment, a Siemens Biograph True-
available at Wake Radiology’s Raleigh MRI
mended as an annual surveillance test for
Point PET-CT scanner, provides distinct
Center in Raleigh.” Some of the new ser-
patients with high Gail Model risk of breast
advantages over either PET (positron
vices offered include:
cancer by the National Cancer Institute (NCI). A woman can easily calculate her
emission tomography) or CT (computed tomography) alone. Since November 2008,
Gail Model risk in a few minutes using the
patients desiring dedicated subspecialty
Wake Radiology has garnered well-known
Breast Cancer Risk Calculator link on the
trained PET-CT reads have not needed to
regional accolades for its exceptionally
Wake Radiology website, wakerad.com. If
travel to UNC, Duke, or Rex hospitals for
high quality breast MRI program. After
the Gail Model risk exceeds 20 percent,
their PET-CT scans. The decreased travel
having performed more than 4,000 breast
most insurers will cover the cost of an an-
time, easy registration, and short wait times
MRIs in our Raleigh location, we now have
nual breast MRI. This is also true for any
have all helped to make this process as
expanded the service to the Cary office
woman who has undergone genetic testing
convenient as possible for hundreds of pa-
to complete the imaging spectrum of the
and is found to be BRCA (breast cancer
tients. At Wake Radiology PET-CT Services,
Comprehensive Breast Imaging Center.
genome) positive. In addition, for those patients who have undergone lumpec-
patients will experience fast, personalized service and a warm, tranquil atmosphere.
Nancy Crowley, MD, of Tolnitch Surgical
tomy and radiation for prior breast cancer,
Wake Radiology’s PET-CT service is a joint
Associates has been utilizing Wake Radi-
Breast MRI is the most specific method for
venture with WakeMed.
ology’s BMRI services since its launch in
excluding disease recurrence in the op-
2005 “This is a well-respected program that
erative site. Mammograms and ultrasounds
New Short Bore Magnet -
combines exceptional patient care with
are much less specific for this scenario.
concise reporting that’s available via PACS
(Picture Archive Communications System)
In 2010 a fixed MRI was added to Cary’s
within hours after the study is completed.
Many patients suffer for years with Crohn’s
extensive list of imaging modalities. Now
Their rapid turnaround in scheduling and
disease, which predominantly affects the
Wake Radiology is replacing the Siemens
reporting also benefits my patients who
small bowel (ileum, jejunum, and duode-
Essenza with a Siemens Avanto 1.5T MRI
are understandably anxious to learn the
num), but can affect any segment of the
unit to expand the broad range of services
outcome.” Dr. Crowley continues, “The ex-
GI tract. These patients commonly require
offered in one location. G. Glenn Coates,
pansion of services into Wake Radiology’s
lifelong imaging surveillance of disease ac-
MS, MD, director of body MRI, says, “The
Cary location will add an extra level of con-
tivity, which in the past has been conduct-
new magnet will allow additional compre-
venience for the women of Wake County.”
ed with CT almost exclusively. Due to the risks involved in chronic CT surveillance
hensive services that nicely complement
Images from abnormal pre/post contrast MR Enterography demonstrating acute upon chronic crohn’s disease.
Fluid sensitive MRGI
Motion independent, steady-state fluid sensitive images
Arterial phase bowel perfusion
Delaed phase bowel perfusion
from accumulated exposure to imaging ra-
under control. Many fantastic advances in
studies, even on the weekends. In addition,
diation, methods were developed to allow
cancer therapy have resulted in patients liv-
this allows review of any complex study be-
MRI (which uses no radiation) to replace
ing many years past their cancer diagnosis.
fore the patient’s study is completed.
CT as the imaging method for determining
In the past, required surveillance imaging
disease activity and response to medical
was exclusively performed with CT. How-
For claustrophobic patients, our extensive
ever, with patients now living much lon-
on-site presence allows us to give intra-
ger past their cancer diagnosis date, the
venous sedation, making the experience
MR enterography (MRE), a study specifi-
radiation exposure of many surveillance
more comfortable, with higher image qual-
cally designed for Crohn’s disease patients,
CTs has become a topic of great concern
ity than can be afforded on lower quality
will now be available at the Cary Office. This
in the medical community. As such, meth-
equipment, including ‘open magnets.’ The
will allow regional Crohn’s patients greater
ods have been developed to allow MRI to
end result is that the source of pain is more
options and convenience for their required
replace CT for lifelong surveillance imag-
accurately determined, and the extent of
lifelong imaging surveillance needs.
ing needs. Cancer survivors can now have
injury is described in greater detail.”
body MRIs instead of CTs to assess the sta“I value the relationship I have with the body
tus of their cancer.
DEDICATED BREAST CENTER Focused on lowering patient anxiety
MRI specialists at Wake Radiology, tremendously,” states Kittu Parekh, MD, digestive
Since Wake Radiology introduced compre-
health care. “Having this cutting-edge equip-
MRI is a powerful tool in assessing bone
hensive breast imaging services in 2007,
ment at Raleigh MRI and now in Cary, com-
and joint disease, ranging from sports in-
the area’s first center dedicated exclusively
bined with the expertise of their subspecial-
juries to early stages of arthritis. “Our up-
to women’s imaging has become well
ty body MRI radiologists, allows physicians
graded MRI in our Cary office allows us to
known for its personalized care. Compre-
options when it comes to imaging patients
implement state of the art protocols with
hensive breast services in Cary is staffed by
with Crohn’s disease and minimizes long-
the highest image quality. This allows us to
technologists and radiologists with exper-
term exposure.” Dr. Parekh continues, “It is
take full advantage of our musculoskeletal
tise in mammography, ultrasound, and in-
through a continued collaboration with GI
expertise,” states Nik Wasudev, MSK Imag-
terventional breast diagnostic procedures.
doctors and other physicians that the MRE
ing specialist. “Wake Radiology has the
The office specializes in digital screening
program has improved the quality of life for
largest and most experienced team of radi-
and diagnostic mammograms, ultrasound-
patients with this disease.”
ologists who have done a dedicated bone
guided breast biopsies, and stereotactic
and joint fellowship in our region. More-
(mammogram-guided) biopsies. The cen-
Cancer Surveillance Body MRI
over, one or more of our musculoskeletal
ter offers the area’s only breast-specific
Just as Crohn’s disease patients require
experts is now working seven days a week,
gamma imaging (BSGI), a nuclear medi-
lifelong imaging surveillance of disease
with on-site coverage Saturday and Sunday
cine study that shows malignant cells very
activity, many cancer survivors (cured
in our Cary office. We therefore have the
clearly. Bone densitometry also is available
or in remission) require lifelong imaging
ability to perform advanced studies such
in this dedicated women’s services area.
surveillance to determine if cancer is still
as MR arthrograms and contrast-enhanced
The Triangle Physician
Susan Kennedy, MD, a breast imaging radiologist, says, “Our emphasis is on patient convenience. We believe that they shouldn’t have to wait an inordinate amount of time for an examination; their time is important, too. For instance, the average duration of a patient visit for a digital screening mammogram in our Cary office is 13 minutes. “We perform digital screening mammograms on asymptomatic patients without a significant previous history every day. We then read these studies in a separate read-
Susan Kennedy, MD, consults with patient after diagnostic mammogram.
ing area, with optimal viewing conditions, without distractions, in order to be able to
“If a biopsy is needed,” she says, “it can
way to screen them, because if it is nega-
find subtle abnormalities that could indi-
often be scheduled within a day. So the
tive, the chances of their having breast can-
cate breast cancer.
whole process, including a biopsy and pa-
cer are very low. We also use it for difficult
thology results, is often completed within
clinical problems or patients who have
“We also perform diagnostic digital mam-
a week — that’s very reassuring to our pa-
hard to evaluate breasts — such as those
mograms at our Cary facility for patients
tients. Our office workflow is designed to
with dense tissue or lumps,” says Dr. Bird.
who have had an abnormal screening mam-
minimize the amount time patients are in a
mogram. The process is optimized to dimin-
state of apprehension.”
Overall, Dr. Kennedy says, “We are all very proud of our facility. We treat our patients
ish patient anxiety and inconvenience.” “Wake Radiology adopted BSGI,” explains
like family, with decency and respect, and
Dr. Kennedy continues, “For those patients
Dr. Richard Bird, FACR, “because the
make sure they are appropriately informed
with abnormal screening mammograms,
modality offered excellent promise as a
about their particular situation. We also be-
we call them ourselves to let them know
problem-solving tool.” BSGI is a nuclear
lieve the patient’s feelings are paramount
they need to return for a diagnostic mam-
medicine study that traces a tiny dose of
and that convenience matters so we offer
mogram and usually are able to schedule
a radioactive pharmaceutical to detect if
extended evening and Saturday screening
the patient for that study within the next 24
there is a metabolically active area, which
mammography appointments. We are truly
hours. All of our patients who have a diag-
can be a sign of cancer.
efficient, so our patients are not spending extra time in our waiting room. Dr. Ken-
nostic mammogram meet with one of our breast imaging specialists for their results
“This is useful for screening women who
nedy adds, “We’re always available to help
before leaving the office, so there is no
may have a somewhat increased risk for
the referring providers and accommodate
anxiety about the unknown.
breast cancer but do not meet the criteria
their requests. Wake Radiology’s compre-
to screen with breast MRI. This is another
hensive breast services in Cary and nine of our other breast imaging centers are proud to have received the American College of Radiology’s (ACR) designation of “Breast Imaging Centers of Excellence.” INNOVATIVE SACROPLASTY IS LATEST ADVANCE FOR INTERVENTIONAL SERVICES Wake Radiology’s Interventional Services has been the Triangle area’s only practice to offer sacroplasty, an innovative treatment for osteoporosis insufficiency frac-
These are a few of the mammography technologists of Wake Radiology. All techs are certified by the American Registry of Radiologic Technologists.
tures of the sacrum, which are extremely painful and afflict many elderly patients. January 2012
This procedure is the latest example of Wake Radiology’s
can to make these important services available on an out-patient basis.
quest “to advance patient pain relief using the latest in mini-
Contrast is also offered on weekends and the office is staffed by a radi-
mally invasive procedures as an alternative to surgery, that
ologist. The added benefit for providers is that our imaging reports are
involves lengthy recovery time,” says Carroll C. Overton, MD,
available via the Wake Radiology PACS system or on your fax machine
director of interventional services.
hours after the exam is complete. The Cary office is staffed weekdays with a PET-CT radiologist, an interventional radiologist, a MSK radiolo-
“Unlike spinal compression fractures, where patients can at
gist and up to two breast imaging radiologists. All subspecialized imag-
least gain a little bit of relief by sitting or lying down, with a
ing is read at various offices through our PACS system and our radiolo-
sacral fracture, they can’t sit and find pain relief. Sacroplasty
gists are available for physician decision support whenever needed.
has been tremendously helpful to our patients. Heretofore, we didn’t have anything to offer for this pain.” Sacroplasty is similar to vertebroplasty, the injection of special cement into the bone with the use of X-ray to guide the needle, and to Balloon Kyphoplasty, in which a balloon-like device is inserted to lift a crushed vertebra so that bone cement can then fill the void. Sacroplasty, Dr. Overton explains, “is an innovative way of doing basically a vertebroplasty in the sacrum. This is an extension of a procedure from one anatomic part to another.”
WR Physician Decision Support Body Imaging Hotline - 919-453-1127 Body MRI Hotline - 919-788-7978 Breast Imaigng Hotline - 919-233-5338 x 2123 Breast MRI Hotline - 919-788-7978 Interventional Radiology Hotline - 919-854-2180 Musculoskeleton Imaging Hotline - 919-782-4830 Neuroradiology Hotline - 919-676-5090 Pediatric Imaging Hotline - 919-782-4830 PET·CT Hotline - 919-233-7280
Results have been excellent. “Ninety percent of our patients get complete relief. Half of them get relief the day of their procedure, and the other half get progressive resolution of their symptoms over the next week.” Carole Drake – Express Scheduler
The service’s eight board-certified interventional radiologists provide a host of additional advanced procedures, including
Wake radiology EXPRESS SCHEDULING
treatment for arterial vascular disease, uterine artery/fibroid
STREAMLINE YOUR SCHEDULING
embolization, cancer therapies, advanced vein therapies,
Wake Radiology offers two way to expedite your scheduling process,
varicoceles and male infertility, dialysis access management,
Express Scheduling, requires only one call or fax to order any service, or
venous access procedures, and vertebroplasty and Balloon
schedule online via the Wake Radiology Scheduler’s Portal. Scheduling
Kyphoplasty for chronic back pain management.
has never been easier using our secure online link. As an additional feature, Wake Radiology Express Schedulers will contact referring
Another service offered in the interventional suite in Cary is
physicians’ patients to coordinate the best date, time, and location for their
vein therapies for varicose and spider veins, treatments that
procedures. Contact a Wake Radiology Referral Services Manager at 919-
are increasingly important for both women and men. Wake Ra-
218-2795 to find out how your office can register for online scheduling.
diology offers free consultations and emphasizes that skilled
WR Express Scheduling … 919-232-4700
vascular and interventional radiologists provide the highest level of patient care to help eliminate complications. Many insurance plans now cover the treatments. Patients may request a free consultation online at wakerad.com. We’re here when you and your patients need us Many of Wake Radiology’s offices including Cary are now offering evening and weekend appointments for screening mammography, CT, ultrasound (excluding vascular procedures), and X-ray. MRI service is available seven days a week in Cary with an MSK radiologist on site. We understand how busy patients are and how difficult it can be to take time away from work for diagnostic imaging so we are doing all that we
The Triangle Physician
Wake Radiology Cary | 300 Ashville Avenue | Cary, NC 27518 Diagnostic Imaging | Breast Imaging & Biopsy | PET·CT | MRI Interventional Radiology 919-233-5338 wakerad.com
Stay in the game Don’t be sidelined by an injury Athletes all over the world—professional, Olympic, collegiate, and recreational— rely on the superior care of the specialists at Duke Sports Medicine. Our integrated program offers orthopaedic surgery and physical therapy for injuries, as well as research-based training for injury prevention and elite performance.
Why premier athletes trust Duke Sports Medicine with their athletic future: ■
An orthopaedics team ranked sixth in the nation by U.S.News & World Report The Duke Women’s Sports Medicine Program, one of the first established in the nation An accredited FIFA Medical Centre of Excellence— one of only two in the United States
Expert care for knees and shoulders, with thousands of successful surgeries performed The Michael W. Krzyzewski Human Performance Research Laboratory (K-Lab): top-notch staff, state-of-the-art equipment, and methods proven to make the best athletes better
World-class treatment, rehab, and performance improvement—that’s Duke Sports Medicine.
Appointments are available within 24 hours. Call 888-ASK-DUKE (275-3853). facebook.com/dukeortho twitter.com/dukeortho
Insult to Injury Your Financial Rx
By By Paul Pittman, C.F.P.
“The firm made money, and the broker made money, so two out of three ain’t bad.”
are even more profitable for the financial institution. The old adage is “The firm made money, and the broker made money, so two out of three ain’t bad.” There are some brokers out there who do a good job of guiding clients’ financial lives, but for the great majority, their arsenal
I was recently interviewed for an article
Who do you think pays for advertising,
is still limited to retail products. Buying
in a national financial newspaper, and the
commissions, salaries, bonuses, payroll,
or owning an investment product with a
writer asked me, “What are some of the
overhead and all of the other expenses
3 percent expense ratio is like having a
stumbling blocks that individual investors
an investment company incurs? You might
racehorse with a 300-pound jockey. They
face going forward with a personal
have read in the news in the past that
may finish the race, but are not the smartest
financial recovery plan?”
Goldman Sachs paid out staggering year-
or the most efficient way to compete.
end bonuses to their employees. Your This was an easy question. There are two
If your fees are in the 3 percent range, and
investment dollars paid for that.
you have $1 million in investments, then
huge problems out there that stand to hamper any sort of true recovery in an
As my readers already know, I am not a
you are paying $30,000 a year just to own
investment portfolio. These two show up
fan of retail investment products. They
those investments. I believe that is about
after the battle has been waged and the
are for the uninformed. Mutual fund fees
$15,000 too much. Take that $15,000 a
returns are in. They are the equivalent of
sometimes run in excess of 3 percent a
year, compound it over the next 20 years
bayoneting the wounded.
year. Variable annuities run even higher. I
at 8 percent, and you see that fees can be
refer to these fees as a thief in the night,
costing you more than $700,000 in potential
robbing you of your returns.
with them, and there are many ways you
Fees are truly the silent killer in your
This is why I refer to fees as the silent
can be charged. There can be upfront
portfolio. Most financial institutions make
killer. What you don’t know can hurt you.
sales charges, or “loads.” There can be
money by hiring a sales force, or brokers,
When you consider a financial advisor, you
ongoing charges, such as management
to sell firm-recommended investment
should be hiring that person to enhance
expenses, 12b-1 fees, bid/ask spreads, also
your financial position and to guide you
redemption, trading and “wrap” charges.
products are very profitable to the firm.
to your goals, not to sell you fee-laden
“In-house,” or firm-sponsored products,
Fees: The Silent Killer All investments have fees associated
The Triangle Physician
Paul Pittman is a Certified Financial Planner™ with The Preferred Client Group, a financial consulting firm for physicians in Cary, N.C. He has more than 25 years of experience in the financial industry and is passionate about investor education. He is also a nationally sought-after speaker, humorist and writer. Mr. Pittman can be reached at (919) 459-4171 and email@example.com.
True diversification in a portfolio does
down to is performance, specifically, net
not have redundancy or overlapping.
performance. Remember my mantra: It’s
Without proper diversification, you (or
Not What You Make, It’s What You Keep!
your advisor) are basically gambling and
Repeat that to yourself every time you
speculating with your money. Make sure
review your portfolio.
you cover several different asset classes, sectors and countries. If you can mix in
Find a financial professional that is
an asset class that is non-correlating with
credentialed, experienced, unbiased and
about 10 percent of your portfolio, you can
unencumbered by a financial institution. A
actually lower your risk level even more.
quick analysis by this person can show you not only the weak parts of your financial
Now you can see, at least partially, why
plan, but also how much of your money
I believe fees and redundancy are the
you are leaving on the table.
biggest drag on a portfolio. What it all boils
Redundancy: A Real Drag I see this almost as frequently as I do high fees. On a regular basis someone will come into my office and show me a statement where they own four or five mutual funds or a firm-sponsored mutual fund allocation program, and they will ask if they are well diversified. For starters, it is important to be aware of the investment firms’ sources of revenue. They may be collecting fees from the investor and from the fund companies allowed in their investment programs. (Yes, sometimes the financial institutions get paid from both sides. So diversification sometimes means a diverse source of revenue for the house!) When I analyze the holdings of these funds, which is the only real way to test diversification, I see the top five stocks in each of the funds is basically the same. This means you may own GE, or IBM, or GM, or Home Depot, or others, five different times! This is called redundancy, or overlapping. Owning mutual funds and individual stocks together can make your overlapping problem multiply. You have to know exactly what you own. When you have significant overlapping, the risk of your portfolio rises, but the potential return does not necessarily rise with it. Womens Wellness half vertical.indd 1
12/21/2009 4:29:23 PM
Winter is the Time to Treat
By Andrea S. Lukes, M.D., M.H.Sc., F.A.C.O.G
Although being outside has enormous health benefits, the skin endures sun damage that can result in “age spots.” Birth control pills and pregnancy can worsen them for woman. Fortunately, there are safe treatments that can reduce their visible effect, and winter is the best time to utilize them. The Alma Laser effectively treats pigmented and vascular lesions, using advanced fluorescent technology (AFT). The pulsed light of AFT is absorbed by the target areas (age spots, rosacea, erythema, melasma, small blood vessels) without damaging healthy skin. Pigmented
the light energy heats the melanin in the lesion and causes it to fragment. The melanin fragments are then absorbed by the body and eliminated. By providing
Daily Regimen for Healing
properties and is now recognized as
smooth, consistent light pulses, the energy
Before women apply their makeup in the
a pigment-regulating and penetration-
delivered to the skin is gentle and effective.
morning, we recommend the following
In terms of vascular lesions, the light
selectively heats and closes off the blood
• Wash face in the morning and apply an
vessels, reducing the lesions.
antioxidant serum. • Wait 1-2 minutes and apply a hydrating
After laser treatment, patients should avoid
This serum has anticancer, antifungal, antibacterial,
inflammatory bioactivities. It also contains vitamin C and ferulic acid, which helps
long exposure in the sun (easier to do in
After reviewing many available options, we
prevent and treat damage at every level of
the winter) and keep the skin well hydrated
offer the exclusive SkinCeuticals brands.
with lotions. Most treatments do not need
The two top serums include Phloretin CF
anesthesia, but a topical anesthetic allows
and CE Ferulic.
us to treat the entire face – providing an
Phloretin CF is recommended for hyperpigmentation, erythema, uneven skin tone,
even treatment. Doing this once or twice
Phloretin CF is derived from apples and the
loss of elasticity, mottled appearance and
a year will help keep the skin looking
root bark of fruit trees. Phloretin is a broad-
photodamaged skin. This is best suited for
spectrum molecule that has antioxidant
women with normal or oily skin.
The Triangle Physician
CE Ferrulic is a topical antioxidant that provides eight times the natural skin’s photoaging protection. It was actually a three-time winner for best serum and received the 2009 Allure (women’s magazine) Best of Beauty Editors’ Choice Awards. Ingredients in CE Ferrulic include vitamins C and E; ferulic acid, which is a plant-based antioxidant; 15 percent pure L-ascorbic acid; and 1 percent alpha tocopherol. The serum is recommended for rosacea, fine lines and wrinkles, erythema,
photoaged or photodamaged skin. It is better suited for women with normal or
Managing your patients’ health is your life’s work. Managing physicians’ wealth is mine. Financial Rx for Physicians: • • • • •
Aiding Wealth Creation, Preservation and Protection Business Management Tax-strategies Liability Protection Asset Preservation
Trust your wealthcare to a specialist. The Preferred ClienT GrouP Paul J. Pittman CFP®
President and Managing Director
The hydrating sun screen is the second
919-459-4171 firstname.lastname@example.org www.pcgnc.com
step that we recommend as a “must” for daily skin care. Not many realize that over-the-counter brands do not provide the same type of protection available through physician offices.
Securities offered through LPL Financial Member NASD/SIPC Wealth preservation and protection • estate planning • charitable giving • buy-sell agreements and transfers
The SkinCeutical sun defense creams are optimal for daily use. We recommend the following: • Daily Sun Defense SPF 20 • Ultimate UV Defense SPF 30 • Sport UV Defense SPF 45 • Sheer Physical UV Defense SPF 50 These sunscreens are superior because they offer both a chemical block against UVA and UVB rays, and provide a physical block, with a transparent zinc oxide. These are ideal of all skin types because they are both PABA free and oil free. Women often find that feeling their best can involve small steps in good skin care. During these winter months, we are offering discounts. We also work in collaboration with aesthetic specialist Eileen Slutsky, RN/BSN, and plastic surgeon Cynthia L. Diehl, M.D., for those with a need for more extensive therapies.
Early, Aggressive Treatment of
Diabetic Ulcers Can Save Foot By Michael S. Kerzner, D.P.M.
Nearly 24,000,000 Americans have diabetes,
continued damage to the involved area;
with 15 percent developing foot ulcers each
treatment of any infection; good blood sugar
year. This results in 60,000 amputations
control; proper nutrition; and evaluation for
annually. Durham County, North Carolina,
possible peripheral arterial disease or other
has the third highest amputation rate in
diseases or illnesses.
the diabetic population based on statistics published through Medicare.
Delaying treatment can be a serious error, and diabetics need to be careful when trying
Part of the problem is diabetics have
to treat the wound themselves. Cleansing
decreased feeling in their feet and often do
wounds with some products can be too harsh
not realize they have an ulcer or wound. In
and can damage tissue. Allowing wounds to
addition, patients and families often do not
get too dry or too wet can slow healing and
know how quickly diabetic foot ulcers can
cause other complications. Patient’s should
break down, become infected and spread
always be encouraged to check with their
into deep tissue.
doctor on any home treatment.
Michael S. Kerzner, DPM, is the attending podiatrist at the Wound Management Institute at Duke University Medical Center. He is a board-certified podiatric physician with many years of experience in limb salvage and reconstruction. Dr. Kerzner earned his doctor of podiatric medicine from Temple University School of Podiatric Medicine in Pennsylvania.
improvement within the first four weeks healed greater than 63 percent of the time
In cases that are slow to heal or getting worse, it
within the following three months.
is important to seek advanced treatment from a
comprehensive wound care center.
specialized dressings to promote healing; and
application of a total contact cast; and use of negative pressure wound treatment devices,
It has been shown that early recognition
While standard treatment is important, it
bioengineered skin substitute and hyperbaric
of foot ulcers is a very important factor in
doesn’t always work. Studies show only 25
oxygen treatment for selected wounds.
preventing amputation and loss of limbs.
percent of diabetic ulcers will heal within
For this reason, it is recommended that
three months, despite the best of care. In
The goal of treatment is always
diabetics have their feet checked every visit
cases that are slow to heal or getting worse, it
the prevention of amputation,
to the primary care doctor, endocrinologist
is important to seek advanced treatment from
preservation of function
a comprehensive wound care center.
If an ulcer is found, there is standard
Recent data suggests that if a diabetic foot
treatment available that’s best provided by
ulcer does not show greater than 50 percent
a wound care physician. The treatment may
improvement after the first four weeks of
include debridement (removing unhealthy
appropriate management, then less than 9
tissue); application of dressings to keep the
percent will heal within the following three
wound moist and encourage the body’s own
months. The same study revealed that those
healing process (autolytic debridement);
wounds treated with advanced treatment
use of special shoes and boots to prevent
modalities showing greater than 50 percent
quality of life.
The Triangle Physician
Premature Babies Harbor Fewer, But More Dangerous Microbe Types One of the most comprehensive studies to
Seed, who is also with the Jean and George
giving babies probiotic substances to tip
date of the microbes living within extremely
Brumley Jr. Neonatal-Perinatal Research
the internal balance toward more favorable
low-birthweight infants found that hard-to-
Institute and the Duke Center for Microbial
bacteria, necessary for immunity and better
treat Candida fungus is often present, as well
Dr. Seed said while the study babies were
Dr. Seed stressed that certain bacteria and
Researchers at the Duke University Medical
colonized mainly by organisms found in
other microbes are helpful for growing ba-
Center and Nicholas School of the Environ-
stool specimens, in some cases Staphylo-
bies and their immune systems, so it is im-
ment looked at the microbes in 11 prema-
coccus epidermidis, a form of staph infec-
portant not to do any damage by creating an
ture infants and found much less diversity
tion, was abundant in many of the babies’
than in full-term infants.
as some harmful bacteria and parasites.
“It’s a question of balance,” Dr. Seed said. “The babies’ guts were taken over by mi-
The bacteria and yeast in the premature
“As vulnerable as these babies are, we still
crobes we know are dangerous if they get
babies’ digestive tracts are known causes of
wouldn’t want to wipe out all of the bacteria,
into the blood,” said senior author Patrick
devastating infections in these babies. The
even all of the potentially harmful bacteria.”
Seed, M.D., Ph.D., assistant professor of pe-
gut seems to be a reservoir for some organ-
diatrics at Duke. “Even after the babies were
isms that form infections, Dr. Seed said. Pre-
Other authors include Mariam LaTuga, M.D.;
no longer on antibiotics, healthier bacteria
vious to this work, “we only knew the tip of
Michael Cotton, M.d., M.H.S.; Ronald Gold-
didn’t appear in the babies very quickly.
the iceberg,” he said.
berg, M.D.; and James Wynn, M.D., all of Duke Department of Pediatrics; and Chris-
This may be one reason why premature babies are so vulnerable to infections.” All of the premature children were placed
The researchers used genomic (DNA) typ-
topher Ellis and Robert Jackson of Duke’s
ing of the bacteria, fungi and parasites to
Nicholas School of the Environment. (Mr.
determine which types were present.
Jackson is also with the Biology Department and the Center on Global Change at Duke
on antibiotic treatments after birth, which
would wipe out some types of bacteria and
It’s not clear if the newborns are picking up
yeast, but once they were off the antibiotics
these early infections from their mother’s
and taking food, the researchers expected
milk, blood or in other ways, or if the patho-
This research was supported by a pilot grant
to see more diversity of bacteria in the ba-
gens are from the environment surrounding
from the Duke Institute for Genome Sciences
bies’ developing digestive systems than they
& Policy; the Duke Department of Pediatrics – Division of Perinatal-Neonatal Medicine;
found. The findings were published in PLoS One open-access journal on Dec. 8.
“It’s important to know where these patho-
the Jean and George Brumley Jr. Neonatal-
gens come from so that doctors can possi-
Perinatal Research Network; and the Center
Five infants had blood infections, while
bly manipulate the babies’ environment or
on Global Change, as well as support from
three had necrotizing enterocolitis, an infec-
their digestive systems,” Dr. Seed said. He
the Gerber and Hartwell Foundations.
tion-related death of bowel tissue, said Dr.
noted other studies had shown value for
Duke and Durham County Embark on Diabetes Initiative Improving health outcomes and quality of
versity of Michigan’s School of Natural Re-
“Attacking a complex problem like diabetes
life for Durham County residents with type
sources and Environment.
requires a committed team, resources, community engagement and alignment of health
2 diabetes are the twin goals of a bold collaborative effort spearheaded by Duke Uni-
The five-year program is supported by a
care and societal forces,” says Robert M. Cal-
versity Medical Center, the Durham County
$6.2 million grant the Bristol-Myers Squibb
iff, M.D., vice chancellor for clinical research
Health Department and the National Center
(BMS) Foundation’s national diabetes initia-
at Duke and leader of the steering commit-
for Geospatial Medicine, based at the Uni-
tive, Together on Diabetes.
tee for the Durham Diabetes Coalition.
Duke Research News “We’re excited by this chance to build on
of a community. This powerful technology
and cancer – the leading causes of death
the vibrant relationships that already exist
allows researchers to visualize complex
in Durham. Only through community inter-
between Duke, the Durham Health Depart-
relationships between the locations of dia-
ventions like the Durham Diabetes Coali-
ment and other community stakeholders.
betes patients, patterns of health care and
tion can we really change the trends in new
Together, and with the support of the BMS
available social resources.
cases of diabetes and improve the care of persons with diabetes.”
Foundation, we will provide patients with diabetes and their health care providers
This information also is being used to ex-
with the tools they need to effectively man-
plore gaps in access to care and self-man-
The Durham Diabetes Coalition will em-
age their conditions and help them over-
agement resources, help patients connect
ploy a diabetes communication officer
come barriers to better health.”
with the community assets and identify in-
(DCO), who is responsible for designing
terventions that can result in better health
and implementing communication pro-
“Changing the course of the nation’s diabe-
outcomes, both for the individual and the
grams to provide relevant health and life-
tes epidemic requires radically new think-
neighborhood, as a whole. Geospatial data
style information to the community. The
ing and intensified collaborative action,”
also will be used to create a continuous
DCO also will develop community messag-
said Patricia M. Doykos, Ph.D., director of
feedback loop for improving the quality of
es and support programs to motivate resi-
the Bristol-Myers Squibb Foundation. “The
dents to participate in lifestyle initiatives as a group.
project is bringing both to everything, from how to account for the diverse drivers of
Diabetes affects nearly 25.8 million Ameri-
diabetes burden, to who can play a role, to
cans, or 8.3 percent of the country’s popu-
“We want this program to integrate health
what to do and how to measure whether it
lation. According to Gayle Harris, M.P.H.,
care all the way from the household and
is making a positive impact at the popula-
R.N., director of the Durham County Health
neighborhood to specialty clinics in order
Department, “One source estimates more
to provide people with the necessary tools
than 10 percent of Durham County resi-
to improve their outcomes,” says Dr. Califf.
During the planning phase, the coalition
dents have been diagnosed with diabetes
“We hope that Durham and the Diabetes
is employing geospatial mapping, which
and at least another 2 percent remain undi-
Coalition will serve as a model for similar
takes information related to disease and
agnosed. Diabetes is a significant risk fac-
diabetes management control interven-
health care and fits it to the physical map
tor for heart disease, stroke, kidney failure,
tions in communities across the country.”
Grants to Support Community Nonprofits Rex Healthcare, which awarded more
opportunities to partner with local nonprofit
for more than 20 years. The donations have
than $500,000 in community grants to 80
organizations who share in our commitment
helped provide crucial health education to
nonprofits across the Triangle last year, is
to providing a healthier community for
combat problems, such as tobacco use and
accepting applications for its next round of
residents of Wake County.”
obesity among the youths of Wake County, said Ann Rollins, Poe Center executive
charitable giving. Many nonprofits have come to rely on Rex’s Rex’s
ongoing community contributions. “We appreciate the long partnership and
health, human services, education and arts in this area. That includes worthy efforts in
“The gift from Rex supports everything we
collaboration we have with Rex,” Ms. Rollins
the communities, where Rex has medical
do, including our teacher leadership grants,”
campuses, such as Apex, Cary, Garner, Holly
said Fran Carruthers, vice president of
Springs, Knightdale and Wakefield.
development at Wake Education Partnership.
The application deadline for new grants is
The nonprofit has received grants from Rex
Jan. 13. Grants will be awarded in June for
the fiscal year that starts July 1. For more
“Rex Healthcare maintains a strong belief in
information on the criteria or to apply, visit
being an active corporate citizen,” said Gwen Shaw-Deberry, Rex’s community relations
Rex also has contributed to the Alice Aycock
www.rexhealth.com/community and click
coordinator. “We continue to seek new
Poe Center for Health Education in Raleigh
on “Community Request Forms.”
The Triangle Physician
So You Have a Nice Website…
Why Every Practice Needs to Invest in Search Engine Optimization By Amanda Kanaan – White Coat Designs
The old adage of “if you build it, they will
“family doctor Raleigh”, Google evaluates
come” does not ring true when it comes
the millions of websites in existence and
to the online world. You may have spent
ranks them according to which equate to be
thousands building a fancy website with
the most relevant. They take into account a
all the bells and whistles, but that does not
number of factors, some of which include
mean anyone, besides you and your staff, will
how many times your website mentions a
actually visit your site.
specific keyword or phrase, how long your website has been in existence, how often
One of the most efficient and cost-effective
you update the site, and how many outside
ways to increase traffic to your website is
websites link back to your site.
through SEO (Search Engine Optimization).
Amanda Kanaan is a medical marketing specialist whose company, WhiteCoat Designs, provides website design, SEO and online marketing along with print design, and branding and messaging services to local private practices and health care organizations. Email Amanda at email@example.com, call at 919-714-9885 or visit the website at www.whitecoat-designs.com.
Okay, so I realize that last thing medical
Since competition online is constantly
professionals need is another acronym to
growing, most agencies will charge a
remember, but this is one you may just want
monthly fee to continuously update and
to become familiar with – especially since it
monitor your SEO campaign. Just because
directly affects your bottom line.
you make it to #1 in Google does not mean
will take to rank (aka the more websites trying
you will stay there. Without continuous
to rank for your keyword, the harder it is and
The purpose of SEO is to increase the
efforts, your rankings can fall rather quickly.
longer it might take to gain your ranking).
number of visitors to your website by ranking
A successful SEO campaign is part science
high in search engines, such as Google,
and part skill of the SEO expert. Therefore, be
Try searching for a keyword or phrase you
Yahoo and Bing. This in turn of course leads
weary of agencies offering prices that are too
think your patients are using and see where
to increased exposure for your practice and
good to be true. Also be cautious of promises
your website ranks. I would also encourage
ultimately more new patient appointments
to rank your website in a certain position. No
you to research SEO articles online. I have
one can guarantee a particular
merely skimmed the surface when it comes
(granted that your website effectively sells your practice). With 85 percent of all website
ultimately only the
to fully explaining the SEO concept and how you can use it to your advantage.
t h e m s e lve s
Having a website and not optimizing it to
engines, SEO is
be found in search engines is like printing
a vital part of any
business cards and never handing one out. It’s
a waste of an investment unless you take the extra step to ensure patients can easily find
strategy. While it’s easy to
your practice online. In today’s competitive
lose your rankings,
health care market, SEO is a powerful tool
it’s not so easy to gain
that allows you to cost-effectively compete
to decide what order in which they will
your positioning in the first place. The
with your colleagues and acquire the patient
display websites when you search for a
competitiveness of the keyword that you
volume you need to successfully grow your
specific keyword. Let’s say you search for
would like to rank for determines how long it
Search engines such as Google use a complex algorithm
Campbell reappointed to Heart Rhythm panel
Region’s Doctors Make Best List
Kevin R. Campbell, M.D., F.A.C.C., of Wake Heart and Vascular Associates has been appointed to a second, two-year term on the Continuing Medical Education Subcommittee of the Heart Rhythm Society.
The statewide Business North Carolina has released the 2012 Best Doctors list.
Welcome to the Area Aarthi Srinivasan Agaram, MD Eric James Benner, MD
Business North Carolina annually recognizes best practitioners under an agreement with Best Doctors Inc., a Boston company founded by physicians affiliated with Harvard Medical School.
Pediatrics Duke University Hospitals, Durham
Described as a global health company, Best Doctors is dedicated to helping people and their treating doctors get the right diagnosis and right treatment. It provides medical consultation services.
Jeffrey Eric Carter, MD
Infectious Diseases, Internal Medicine Wilson Memorial Hospital
Goldsboro Heart Specialists recently extended eastward the medical footprint of Wake Heart and Vascular, a Raleigh-based cardiovascular practice.
Best Doctors itself was named this year to Inc. Magazine’s “Fastest-Growing Companies in America” list. A reported 116 percent revenue growth from 2007 through 2010, ($42,898,000 to $92,680,000, respectively) earned the company a slot on the top half of the respected list, considered the “gold standard of entrepreneurial success.”
Now, Wake Heart and Vascular (WHV) has a presence in 15 localities throughout central and eastern North Carolina.
Best Doctor listings by specialty are available by visiting: http://www.businessnc.com/index.php?src=gendocs& ref=BestDocs2011&category=BestDocs
William Glenn Filer, MD
The society is an international body that serves cardiac arrhythmia professionals and patients, and is the primary information resource on heart rhythm disorders. The subcommittee ensures that certain educational activities by the society meet the needs of society members and that all educational activities can be accredited.
Goldsboro Practice Joins Wake Heart Group
Frederick Douglas Burroughs, MD Pediatrics Knightdale General Surgery UNC Hospitals, Chapel Hill
Christopher Thomas Aboagye Da Costa, MD
Lawrence Anthony Dunn, MD Psychiatry Durham
Renata Gomes Ferreira, MD Anesthesiology Duke University Hospitals, Durham Physical Medicine and Rehabilitation UNC Hospitals, Chapel Hill
Amanda Coleman Guidon, MD
Goldsboro Heart Specialists, the practice of Waheed Akhtar, M.D., will remain at 2400 Wayne Memorial Drive in Goldsboro.
Rex Partners with Genome Project Rex Healthcare is collaborating with The International Genomics Consortium as a critical network Tissue Source Site. In this role, Rex will provide cancer tissue samples for analysis in The Cancer Genome Atlas project (TCGA), a historic National Institutes of Health (NIH) project. In addition, Rex will collect specific long-term clinical outcome data to facilitate research into the underlying cancer mechanisms. The International Genomics Consortium’s (IGC) Expression Project for Oncology (expO) has combined its network and mission with TCGA. The comprehensive, coordinated effort is working to accelerate the understanding of the molecular basis of cancer through the application of genome analysis technologies, including large-scale genome sequencing. Visit www.cancergenome.nih.gov for more information on TCGA and www.intgen.org for information on IGC.
WakeMed Expands Primary Care Access North Wake Internal Medicine and Susheel V. Atree, M.D.; Behnaz S. Atree, M.D.; and Rosa Messer, M.D., joined Wake Specialty Physicians as Wake Specialty Physicians – North Wake Internal Medicine. Dr. Susheel Atree and his wife, Dr. Behnaz Atree, opened North Wake Internal Medicine in WakeMed North Healthplex in 2004. Knightdale Family Practice and Anita Wilson, M.D., joined Wake Specialty Physicians as Wake Specialty Physicians – Knightdale Family Practice. Dr. Wilson has practiced at Knightdale Family Practice for the past year and previously worked as medical director for Solutions, a community support agency in Burlington, N.C., and Apex Family Medicine.
Neurology Duke University Medical Center Durham
Michael Barry Kastan, MD Duke Cancer Institute, Durham
Matthew William Luedke, MD Duke University Hospitals, Durham
Megha Kumudchandra Shah, MD Family Medicine Duke University Hospitals. Durham
Crystal Cenell Simpson, MD Nephrology, Internal Medicine Duke University Hospitals. Durham
Rebekah Ryanne Wu, MD Chapel Hill
Physician Assistants Justine R Barnes, PA Eastern ENT Sinus & Allergy Center, P.A. Goldsboro
Orlando Conty, M.D., joined Wake Specialty Physicians – Apex Medical Group, with experience in family medicine. Fluent in Spanish, Dr. Conty previously practiced at the Oregon Medical Group in Eugene, Ore.
Bambi Elayne Cohen, PA
Daphne J. Cates, M.D., joined Wake Specialty Physicians – Holly Springs Medical Center, with experience in family practice. Dr. Cates previously practiced at Vance Family Medicine in Henderson, N.C. She earned her medical degree from the University of Miami School of Medicine.
Aaron Christopher Kopp, PA
Cancer Center of North Carolina Raleigh
Kevin Scott Dendy, PA Triangle Orthopaedics, Durham Wake Med, Raleigh
Robert Allen Paul, PA Urgent Cares of America (NC), Inc. Clayton
Jan Maree Pixton, PA Southside Medical Center, Wilmington
All practices are accepting new patients and most major insurance plans. Details on all practices, locations and insurance plans can be found online at www.wakemedphysicians.com.
The Triangle Physician
Ainslee Elizabeth Smith, PA Raleigh
Ermelinda Xhemali, PA Durham
“More than a doctor. Like a friend.”
Trust. WHV is an independent group of heart specialists with locations throughout Eastern North Carolina - ready to provide the care for your patient’s heart when and where they need it. We’ve been pioneering and delivering innovative cardiovascular care for over 25 years. Through our affiliation with UNC Health Care, our physicians can also tap into the latest research and expertise associated with a world-class academic institution. And this in turn allows all our patients to have more access to clinical trials and new therapies, resulting in the best cardiovascular care available in the area.
Cardiovascular Professionals in Johnston County Mateen Akhtar, MD, FACC Benjamin G. Atkeson, MD, FACC Kevin R. Campbell, MD, FACC Randy A.S. Cooper, MD, FACC Christian Gring, MD, FACC
Matthew A. Hook, MD, FACC Eric M. Janis, MD, FACC Diane E. Morris, ACNP Ravish Sachar, MD, FACC Nyla Thompson, PA-C
WHV Locations in Johnston County 910 Berkshire Road Smithfield, NC 27577 Phone: 919-989-7909 Fax: 919-989-3147
2076 NC Hwy 42 West, Suite 100 Clayton, NC 27520 Phone: 919-359-0322 Fax: 919-359-0326
When it comes to your cardiovascular care – We know it by heart. To learn more, visit our website www.WHVheart.com or call us at 1-800-WHV-2889 (800-948-2889).
We know it by heart. Cardiovascular Services Echocardiography Nuclear Cardiology Interventional Cardiology Carotid Artery Interventions Cardiac Catheterization Cardiac CT Angiography and Calcium Scoring Electrophysiology and Cardiac Arrhythmias Peripheral Vascular Interventions Pacemakers / Defibrillators Stress Tests Holter Monitoring Lipid and Anti-Coagulation Clinics Vascular Ultrasounds / AAA Screening
WAKE AHEC AND WAKE RADIOLOGY PRESENT
Physicians in Emergency Medicine, Internal Medicine, Family Practice, Obstetrics and Gynecology as well as Physicians Assistants, Nurse Practitioners, Nurses and other healthcare providers involved in the care of women.
Diagnosis and Management Update
Saturday, March 17, 2012 | 7:15 AM to 2:30 PM
Embassy Suites Hotel Raleigh - Durham/Research Triangle 201 Harrison Oaks Boulevard | Cary, NC 27513
CREDITS This activity has been approved for AMA PRA Category 1 credit™ Wake AHEC CEU: 0.5 (5 contact hours)
PARTICIPANTS WILL LEARN HOW TO • Review a referral process based on clinical evaluation, ACS/ACR screening guidelines and ACR criteria • Evaluate current recommendations for completion axillary lymph node dissection for breast cancer after sentinel node biopsy • Recognize nomenclature used in breast pathology as it relates to breast cancer • Recognize the importance of using radiation to optimize the cure of breast cancer • Discuss progress in the treatment of breast cancer related to five molecular subtypes of breast cancer • Identify ways to refer patients to facilitate an interdisciplinary team approach
FOR MORE INFO AND TO REGISTER ONLINE VISIT www.wakeahec.org
ADA: Wake AHEC is fully committed to the principle of equal educational opportunities for all individuals and does not discriminate on the basis of any characteristic protected by federal or state law.
J O I N T L Y
S P O N S O R E D
The Triangle Physician January 2012