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WITH THE SURGICAL HOSPITAL OF PHOENIX FALL 2013

WELCOME By: William J. Comer | CEO We weathered another summer! We officially launched our new

strategies for process improvement. Throughout the whole

name and had a terrific Open House with community friends,

implementation process, we have been fortunate to have

colleagues, physicians, and of course The Phoenix Coyotes

participation internally and from physicians as well.

Mascot; The Howler! We had fun giving tours, eating delicious food catered by our Cafe and of course; a ribbon cutting for our

As the process moves forward, we are more and more elated

future.

to identify the effect this has on patients and their families. We are very proud of our patient satisfaction scores, but as CEO, I

Being a native of Phoenix, I’m no stranger to the heat and

will not be content until our patients are all 100% satisfied.

certainly as I get older, it doesn’t get easier; the same seems to go for the healthcare system in Arizona as well. Whether

That is what my personal expectation would be if a family

an executive for an Arizona hospital, a small business owner

member were to have surgery in a prestigious institution such

or even a venture capitalist, we all recognize the drought of

as ours, and it’s my goal to make that the reputation that THE

business in the summer.

Surgical Hospital of Phoenix becomes known for. So whether you’re a current or future patient, one of our esteemed owning

THE Surgical Hospital of Phoenix refuses to use “the heat” as

physicians or simply a valued member of our community, we

an excuse -- we use it as an opportunity. We’ve been hard at

hope you’ll notice a difference and we welcome your feedback.

work these warm months to improve our internal systems and processes, implementing “Six Sigma,” which uses tools and


RECIPES FOR HEALTHY LIVING

Bourbon Salmon With Sautéed Green Beans By: Doug Blankenship | Executive Chef

Ingredients 1 6-ounce salmon filet

1 teaspoon garlic, minced

1 cup Jack Daniels Whiskey

2 tablespoons white wine (Chardonnay)

1 tablespoon honey

1 tablespoon extra virgin olive oil

2 tablespoons brown sugar

Salt and pepper to taste

¼ teaspoon chili flake 1 bay leaf 8 green beans, snipped

Directions Season salmon with salt and pepper and sear, flesh side down in a hot pan with olive oil. When you get a brown sear, flip over and finish in the oven.

Heat oil in a sautée pan and add green beans. Sautée for two minutes and add garlic and white wine. Cook until beans are tender and check for seasoning to taste.

In a small pot, add Jack Daniels, honey, brown sugar, chili flake and bay leaf.

Arrange beans in center of plate and top with salmon. Drizzle leftover glaze around the plate and garnish with a lemon wedge.

Reduce by half or until the mixture has a syrup consistency and discard the bay leaf. Pour over salmon just prior to completion in the oven and let fish bake to finish.

Guacamole Salad By: Doug Blankenship | Executive Chef

Ingredients 2 avocados, diced

¼ cup extra virgin olive oil

1 pint grape tomatoes

1 teaspoon salt

1 yellow bell pepper, diced

½ teaspoon black pepper

1 15-ounce can black beans,

½ teaspoon garlic, minced

rinsed and drained

¼ teaspoon cayenne pepper

½ cup red onion, diced 2 tablespoons jalapeño, minced ½ teaspoon fresh-grated lime zest ¼ cup fresh-squeezed lime juice

Directions Place tomatoes, yellow bell pepper, black beans, red onion, jalapeños and lime zest in a large bowl.

Just before serving, fold diced avocados into salad and check seasoning to taste.

Whisk lime juice, olive oil, salt, pepper, garlic and cayenne pepper together and pour over vegetables. Toss well.

May be served with tortilla chips or lettuce wraps.


CORNERED BY PAIN

Protecting THE Community Q&A with Grant Beardsley | Toxicologist, PeaceHealth You had a hand in developing the patented test used in PtProtect to manage and monitor the use, adherence and potential abuse of prescription pain medications. Why do you think this test is superior to any of the others being used across the country?

PtProtect is designed to detect more opiates and opioids than any other laboratory and accomplish detection without the expense or delay of an initial “screen” test. PtProtect uses a method called liquid chromatography tandem mass spectrometry (LC/MS/MS). This method is superior to the screen test methods intended to detect pain medications which often return false-positive and false-negative results that confound health care providers. The use of LC/MS/MS in PtProtect for detection of scheduled analgesic is performed on every

Why do you think it is important for physicians to take an active role in testing and qualifying the drug use within their patients?

The appropriate use of opioid therapy to treat chronic nonmalignant pain can reduce suffering and improve overall quality of life for many

patient’s specimen, every time.

patients. But potentially serious adverse effects and problematic

The doctor who orders a PtProtect test can be confident that the

positive impact opioids contribute for some patients who have chronic

analysis will provide the highest drug identification accuracy with detection to the lowest level for these important drugs. PtProtect provides interpretive comments with each test report to uniquely guide the doctor’s interpretation of the results relative to the patient’s known prescribed pain medications. The report simplifies patient management with easy to understand results.

behaviors, such as diversion and addiction, may overshadow the pain. Therefore, management of chronic opioid therapy requires regular monitoring to evaluate patient adherence and progress towards therapeutic goals. Just as coumadin therapy is monitored for patient safety using appropriate laboratory tests (i.e., Prothrombin Time INR), monitoring medications used in chronic opioid therapy is also a paramount safety need.

How does the test work?

When the patient and physician initially discuss opioid treatment,

What is a discrepancy rate and why is this important?

the patient should understand that they may be asked to participate

The PtProtect test reports a “discrepant” flag when a patient’s urine

in random (unannounced) urine drug tests; this provision should be included in the treatment agreement. The goal of testing is to improve patient care by protecting both the patient and the physician. PtProtect is an objective, clinical laboratory test that validates medication adherence and develops trust with the physician. PtProtect helps the physician demonstrate professional vigilance and progress toward the treatment goals.

test result doesn’t conform to the prescribed pain medication(s). A test with one or more discrepancies may be considered an aberrant report because the test revealed an unexpected result. Using a unique summary report prepared by the laboratory, providers can monitor their practice’s overall discrepancy rate (%) as a measure of continuous improvement. You have a reputation for being accessible to the doctors. Why is

PtProtect tests can be easily performed by asking the clinic or

this so important?

laboratory staff to collect a urine specimen prior to any visit with

Doctors have immediate questions about the tests they order for

a patient on chronic opioid therapy. Some practices may find it necessary to institute additional steps when collecting the specimen to help prevent tampering.

their patients. There are so many variables facing providers when monitoring pain medications: the complexities of laboratory analytical methods regarding sensitivity and specificity, the complexities

The patient’s sample, along with a list of their current, prescribed pain medications, is sent to the lab for the completion of the PtProtect test.

of medications and their metabolites, the complicated patient comorbidities and so on. Facilitating solutions to provider needs for patient care is the right thing to do; it’s also a privilege.

analysis for drugs of abuse and

Grant Beardsley, MS, is a 32-year PeaceHealth Laboratories veteran and has appeared as an expert witness in more than 50 drug testing trials. Grant holds a Master of Science in Pharmacology/Toxicology from the College of Pharmacy at Oregon State University and is certified as both a clinical chemist and toxicological chemist by the National Registry in

specimen validity tests to determine

Clinical Chemistry.

acceptability of the urine specimen.

Grant can be reached at 800-826-3616 ext 8137.

The testing includes a quantitative analysis for opiate and opioids, qualitative and confirmatory


COMMUNITY PARTNERS THE Surgical Hospital of Phoenix was proud to sign on as the official health care provider of the Phoenix Coyotes last year, and we are thrilled to be partnering once again with the team for the NHL’s 2013-2014 season. As a partner of such an outstanding organization, we’re pleased to spotlight the Coyotes’ faithful captain, Shane Doan, in the impressive profile that follows.

Coyote Profile

Shane Doan Shane Doan has made his presence felt both on and off the ice throughout his 17-year NHL career with the Phoenix Coyotes. The veteran forward recently completed his ninth season as the Coyotes captain and continues to serve as one of the league’s most respected leaders. The 2012-13 campaign saw Doan total 13-14-27 with a plus-6 rating in 48 games. He finished tied for the team lead in goals, third in scoring, and first among all Coyotes in hits (118). The Halkirk, Alberta native is the franchise’s all-time leader in games played (1,246) and game-winning goals (61). He currently leads all active NHL players in games played with the same franchise. With 331 career goals, Doan is now in sole possession of second place on the franchise’s all-time goals list behind Dale Hawerchuk (379). He has also moved within two points (815) of Thomas Steen (817) for second place in franchise history behind Hawerchuk at 929 points. In 2011-12, the Captain led the Coyotes to their first Pacific Division title in franchise history. Doan registered his ninth consecutive 50-point season and finished third on the team in scoring with 22-28-50. He captured his first career NHL hat trick with a three-goal performance vs. the New York Islanders on January 7, 2012. Doan was originally drafted by the Winnipeg Jets in the first round (seventh overall) in the 1995 Entry Draft and made his NHL debut on October 7, 1995. Since then, he has enjoyed plenty of success on the ice with Phoenix. Doan has recorded 50 or more points in 11 of his previous 13 seasons and has scored 20 or more goals in 12 of his 17 NHL seasons. In addition to his success in the NHL, Doan has represented Canada in international competition on numerous occasions. For the third consecutive year, he served as team captain

Image: Provided by Coyotes/Client

for Canada at the 2009 IIHF World Championships in Switzerland. Doan helped Canada win silver medals in 2009 and 2008 after guiding Team Canada to a gold medal win at the 2007 IIHF World Championships in Moscow. Off the ice, Doan remains one of the most active Coyotes throughout the Phoenix community. He works with many organizations including United Blood Services, Phoenix Children’s Hospital, Phoenix Rescue Mission, Flashes of Hope and Children First Academy - a kindergarten through eighth grade school for homeless children. The 36-year-old Doan won the NHL’s prestigious Mark Messier Leadership Award in 2012. The award recognizes the individual who is a superior leader in hockey and as a contributing member of society. It honors the individual who leads by positive example through on-ice performance, motivation of team members and a dedication to community activities and charitable causes. Doan was also awarded the King Clancy Memorial Trophy following the 2009-10 season. The award is given to the player who best exemplifies leadership qualities on and off the ice and has made a noteworthy humanitarian contribution in his community.


PHYSICIAN SPOTLIGHT

Dr. Charles M. Creasman, M.D. | Orthopedic Surgeon You’re a native of Arizona, but

In the early healing phase - certainly within a few months of surgery

completed your studies at some

- the hip replacement requires attention. Following surgery, yearly

of the nation’s most reputable

x-rays are recommended to ensure that the hip replacement is not

universities – including Harvard

experiencing wear or loosening.

and Tulane. How important was it for you to come back to your

How important is physical therapy to recovery for hip

roots to practice?

replacement patients? Are there any statistics you may have to

I’m fortunate to have had the opportunity to study and be in different parts of the country, but I’ve always found my way back home to Arizona. I often travel north to beat the heat, but always wander back south to take care of

share showing the positive benefits of sticking to a regimented physical therapy plan versus otherwise remaining more relaxed with the process? Physical therapy is extremely important after hip replacement. This should be closely monitored by a physical therapist who will receive specific instructions from the surgeon. Most patients may put all their

my fellow Arizonans.

weight on their hip after surgery; however, this is not true for every

What do you recommend preventatively for an aging population

walker or crutches and progress them to a cane to safely strengthen

to avoid the need for hip or joint repair later in life? At what point

the muscles around the hip. After the early healing phase, physical

in life do you feel preventative measures are most beneficial/

therapy will no longer be needed.

patient. The physical therapist will teach the patient how to use a

necessary to begin? I employ some very basic methods to prevent joint disease and osteoporosis. Maintaining a healthy lifestyle including weight, levels of calcium and vitamin D and working on flexibility are keys to preventing joint disease. At some point in life - possibly due to normal aging, wear and tear, injuries or inheritable disorders, joints may no longer be able to repair

During the healing phase, instructions should be followed on using handrails, not walking on wet or just waxed floors, carefully getting in and out a car, and safely putting on socks. After the healing phase, physical therapy is of significant benefit. In my experience, continued exercise leading to better endurance, walking with a normal gait and maintaining ideal body weight will create a longer functioning joint replacement.

themselves adequately. While there is no one method to eliminate joint wear and tear or reduce the risk of permanent damage, being educated at a young age and taking preventative measures such as maintaining healthy weight and avoiding high-risk activities that so frequently cause injuries can help. I always recommend that attention be sought immediately after experiencing joint pain as the result of an injury. Neglecting an injury may increase the need for more invasive treatment methods such as surgery down the road. What mistakes do you see your patients make when they have a

What do you recommend for patients that have arthritis and are

total hip replacement?

looking to soften its daily impacts on regular activities?

One of the most common mistakes that I see patients make after total

While arthritis is disabling, patients can still have a rewarding

hip replacement is taking too cavalier of an attitude toward recovery, which frequently accompanies their new mobility and complete resolution of their preoperative pain. It is very important in the early phases of recovery to follow all precautions, including continuing the use of prophylactic anticoagulants to prevent blood clots, keeping the incision clean and dry and avoiding certain positions that might cause the joint to sublux or dislocate.

and prosperous life living with arthritis. It is clearly logical that a healthy lifestyle promotes better overall health and better disease management. This would include exercise, eating well, and sleeping well. It is important for patients to improve their environment to make things easier and to compensate for the physical limitations. Maintaining ideal body weight, avoiding high impact activities, regular


stretching, and activities such as bicycling, swimming and lifting

Patients and their family members enjoy not having to take the extra

weights are beneficial. For patients that have arthritis, shoes with a

day off from work and it provides less of a disruption for their daily

rubber insole to add cushioning also helps. Over time, if the weight

lives. This “weekend concept” has not been easy to accomplish at

bearing joint becomes so painful that it cannot support your weight,

other hospitals in the Valley. The size and efficiency of THE Surgical

transitioning to upper extremity support such as a cane or walker may

Hospital of Phoenix provides an alternative for my patients scheduling

be more beneficial to prevent falls and further damage.

their surgeries. My affiliation with THE Hospital has vastly improved my ability to deliver the best care to my patients. The Saturday

You started doing surgeries on Saturdays at THE Surgical

schedule appears to be more efficient, more streamlined, and more

Hospital of Phoenix. How is this beneficial for patients?

beneficial to both the physician and the patient.

I started doing surgeries on Saturdays to accommodate the overflow of patients as needs dictated and it became busier. I have since noticed that this has become very popular with many patients for

Arizona Orthopedic & Fracture Surgeons

various reasons.

Phone: (602) 230-1400 | http://arizonaorthopedic.com

PHYSICIAN SPOTLIGHT

Dr. Mark J. Wang, M.D. | Orthopedic Spine Surgeon What inspired you to begin your

You studied at Stanford University and did extensive research

volunteer work overseas? What

on orthopedic surgery; what interested you in spine surgery? At

role has that experience played in

what point/why did you choose to pursue spine surgery?

affecting how you practice from day to day? Do you feel that your volunteer work has enriched your experience as a physician?

As an undergraduate at Stanford I began to take an interest in medicine and began to gravitate to the idea of helping people restore function lost due to age and injury. While there are many subspecialties in the world of orthopedic surgery, spine surgery is

I have always had a passion for

unique in its complexity. In fact, being a spine surgeon requires at

travel and an interest in other

least another year of specialty training after finishing a standard

cultures. During my residency

five year orthopedic surgery residency.

training at Stanford University, I was selected among my peers by the nonprofit organization, Operation Rainbow, to travel to Nicaragua with a team of renowned orthopedic surgeons to provide surgical care to the underserved. Practicing health care in a third world country gives you a vast appreciation of all the benefits that

For me, becoming a spinal disorders specialist was a natural choice, as I welcome the challenge of solving complex problems with innovative solutions such as minimally invasive surgery. What do you find is the primary source of pain for your patients?

we have in the United States; even the most basic elements of

This is a topic of every conversation that I have with my patients.

health care in the States were considered luxuries overseas. I think

The fact is that there is no simple answer to why people have

my work abroad has inspired me to provide all of my patients with

pain. Back and neck pain can arise from a variety of causes; from

the best, most compassionate care possible -- regardless of their

simple muscle strain, to problems with the joints around the spine,

background or the complexity of their case.

to narrowing of the spinal canal, just to name a few. It’s my job to identify the cause of my patient’s discomfort and find the least

Your patients and families have terrific feedback about your

invasive solution to alleviate the pain. Occasionally this may mean

communication and style; how important is your relationship

medications, therapy, injections, and even surgery depending on

with the families of the patients you treat?

the problem you have.

Good medicine begins with a good relationship. It is as simple as that. As a physician, the rapport that you have with your patient is

What are some preventative measures that patients can take to

critical to achieving a good outcome from treatment. Patients need

eliminate the need for more invasive procedures to alleviate pain

to be educated about their condition and given every opportunity

such as surgery?

to ask questions to help formulate a plan of treatment. I treat my

The best piece of advice I can give to my patients is to stay

patients like they are my family. I think they deserve that.

active. Most problems with the neck and back can be solved with the use of anti-inflammatory medicines, regular exercise, and


the avoidance of aggravating activities. Sticking to the basics of

where patients have been told that they need spinal fusion, I

eating a well balanced diet, avoiding smoking, and incorporating a

have been able to apply these less invasive and motion sparing

daily exercise routine will go a long way to keeping you out of the

techniques with great results.

doctor’s office. What do you recommend postoperatively for your patients to ensure the maximum results after surgery?

I probably sound like a broken record now, but I tell my patients routinely that they need to stay active after surgery to ensure the best results. Many times a coordinated approach with a good physical therapist after surgery can do wonders for the healing process. The whole point of surgery is to help restore function that has been lost due to a painful spinal condition. I have dedicated my

What are some common mistakes that are made

practice to helping patients return to the activities that they once

post-operatively made by your patients?

enjoyed but have been avoiding because of their pain.

As we make great strides in the field of less invasive spine surgery,

You specialize in “motion preservation,” tell us more about that technique and the benefits that motion preservation patient’s experience.

our patients have benefited tremendously from the resultant shorter hospital stays, fewer complications, and less pain postoperatively. Consequently, I have found that many patients are trying to return to activities too soon because their pain is so minimal after surgery.

Motion preservation is a philosophy that emphasizes maintaining

Educating our patients to the do’s and don’ts after spinal surgery

the body’s natural kinematics in the process of alleviating a

is critical. A well planned course of post-operative rehabilitation

problem with the spine. This in turn places less stress on the

is vital to achieving a good outcome. My advice is to work closely

neighboring areas of the spine and can result in less painful

with your doctor before and after surgery to ensure the best long

adjacent level degeneration over time. Motion sparing techniques

term results possible.

can range from minimally invasive procedures to alleviate pressure on the spine all the way to mechanical devices implanted in the

Spine Institute of Arizona

spine that mimic the natural motion of the body. In many instances

Phone: (602) 953-9500 | http://www.spineaz.com

THE HOSPITAL IN YOUR COMMUNITY By: Maggie Voss THE Surgical Hospital of Phoenix has rebranded our Community Team as “THE C.A.S.T.”, THE Community Assistance Support Team. We have recruited new members and have been working toward developing a fresh list of activities to help out those in our neighborhood. Our first project has been collecting school supplies for our annual Backpack Drive to benefit the kids at our neighborhood school, Maryland Elementary. In July, we held our inaugural Salsa and Guacamole Challenge with all proceeds donated to the annual Backpack Drive. In the next several months, our clinical staff and volunteers will come to Maryland Elementary to educate families about obesity, nutrition and exercise. Closer to the holidays, the kids of Maryland Elementary will be joining THE C.A.S.T to support the elderly community through their beautiful art and song at Assisted Living Homes and Skilled Nursing Facilities in the area. THE C.A.S.T is also proud to support the American Cancer Society. Last year, we formed a team, “THE Surgical Hospital Climbers” for the “Climb to Conquer Cancer”, an event which raised money for cancer research and support. This year, we’ve once again made the American Cancer Society a priority and are looking forward to getting even more involved to support such a great cause. We encourage you to get involved! Please contact Maggie Voss at 602-795-6020 x 6006 or by email at mvoss@thesurgicalhospital.com to join us out in the community!


6501 N. 19th Ave | Phoenix, AZ 85015 602.795.6020 | admin@thesurgicalhospital.com

DID YOU KNOW?

By: Gary Broder Construction is fully underway for the Light Rail extension that will run right past THE Surgical Hospital of Phoenix along 19th Avenue. When complete, the extension will create a convenient way for visitors without a car to visit the hospital. The northwest extension will take light rail service further north on 19th Avenue to eventually end near the I-17 freeway and Dunlap Avenue. The project includes the additions of three stations, one park-and-ride lot and convenient bus connections at Bethany Home Road, Glendale and Northern Avenues.


FALL 2013 Newsletter - THE SURGICAL HOSPITAL OF PHOENIX