Insight magazine November 2021

OZARKS HEALTHCARE

WINTER 2021 | VOL. 1 | ISSUE 2

& Lung

Heart MEET THE TEAM PROVIDING EXCEPTIONAL PATIENT-FOCUSED CARE FOR A LARGE VARIETY OF CARDIOPULMONARY NEEDS, ALLOWING PATIENTS TO STAY CLOSE TO HOME

DR. JOSEPH BARNARD Returns to West Plains

CENT ER HIGH TOUCH MEETS HIGH TECH Cutting-edge Technology at OZH

ORTHOPEDIC CARE World-class Care Right at Home

Inez Pahlmann Kim Grennan Owner/Broker

Broker/Realtor

417-293-7277 417-256-1000

Email: Kim@CoveringTheOzarks.com

CoveringTheOzarks.com

FindPropertiesInTheOzarks.com

Strong communities: Realized

At Simmons Bank, we believe healthy, vibrant communities don’t just happen on their own. They happen when people make an investment in each other. Because we accomplish more together than we do alone.

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OZH

TABLE OF CONTENTS

DEPARTMENTS 6 Letter from the President & CEO

10

OZH Newcomers

14

Foundation

16

Volunteers

34

Pharmacy

38

Staff

40

Mental Health

16 FEATURES 12

The Boy is Back in Town Dr. Joseph Barnard returns to West Plains focusing on family medicine.

18

Heart & Lung Center

34

Ozarks Healthcare’s patient-focused specialists deliver convenient diagnoses and treatments of a large variety of cardiopulmonary needs.

22

High Touch Meets High Tech The latest in technological diagnostic and treatment tools is right here at Ozarks Healthcare.

30

The Doctor is In Dr. Troy Caron explains why a small hospital environment gives him an advantage over larger health systems.

32

Feel It in Your Bones Meet the skilled orthopedics team at Ozarks Healthcare.

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ON THE COVER:

From Left: Dr. William A. McGee,

Dr. Biplab Saha, Dr. Achenkunju George, Dr. Praveen B. Datar, Dr. Muhammad Khan, Dr. Archana Sinha and Julie Gunter, APN. Photography by James Moore

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was the first healthcare provider in this region to offer physical and occupational therapy as well as speech language pathology services for inpatient, outpatient, nursing home, home health and school settings.

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WINTER 2021 | INSIGHT |

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INSIGHT OZARKS HEALTHCARE

A PUBLICATION OF

1100 Kentucky Ave. • West Plains, MO 65775 417.256.9111

ozarkshealthcare.com

WINTER 2021 VOLUME 1 | ISSUE 2 OZARKS HEALTHCARE SENIOR LEADERS OZH President/Chief Executive Officer Thomas Keller

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Vice President of Finance Nichole Cook

Vice President of Clinics Todd Tamalunas

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Associate Editors

Hannah Martin and Brittany Simers

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Contributing Writers Amy Gordy and Dwain Hebda

Contributing Copy Editor Melinda Lanigan

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Contributing Photographers Patty Ingalls and James Moore

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►

Contributing Designer Ashlee Nobel

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Ozarks Healthcare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.

WINTER 2021 | INSIGHT |

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OZH

LETTER FROM THE PRESIDENT & CEO

Heart of the Ozarks

“

In this edition of Insight, I am excited to share a focus on some of the new, incredible technology that is being used to help care for our patients at Ozarks Healthcare.

I

n this issue, you will find some of the advanced procedures being performed at our Heart and Lung Center, such as intravascular ultrasound, which provides our cardiologists with intricately detailed imagery of heart arteries, allowing them to precisely diagnose and treat sometimes difficult heart conditions. To date, our cardiologists are performing between 80 and 90 percent of heart procedures from the wrist, which is a significant milestone reached in reducing the invasive factor of these procedures.

On the pulmonology side of our Heart and Lung Center, our board-certified pulmonologists have brought bronchoscopic lung reduction valves to our treatment capabilities, which has enabled us to better help our patients “breathe easy” and provide more in-depth care.

We also share more about our Stryker Spinal Navigation System, which helps Dr. Troy Caron, our board-certified orthopedic and spine surgeon, with the

As you read this issue, I hope you find the same excitement I am fortunate to see every day at Ozarks Healthcare as we continue to make amazing advancements for the health of our community.

”

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exact placement of screws during spine surgery. The implementation of our telehealth options through the COVID-19 pandemic is another technological highlight, which allow patients to still receive the care they need while communicating face-to-face with our caregivers at home. Our pharmacy, one of the busiest areas of our health system, is making strides every day to better serve our patients, offering a mobile app to make filling and requesting prescriptions accessible at the touch of a finger, along with plans in place for medication synchronization.

Of course, at the heart of this issue are plenty of stories, including that of two of our chaplains, who not only share the same last name, but also a love for healing.

As you read this issue, I hope you find the same excitement I am fortunate to see every day at Ozarks Healthcare as we continue to make amazing advancements for the health of our community.

TOM KELLER President and Chief Executive Officer Ozarks Healthcare

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OZH

CONTRIBUTORS Amy Gordy WRITER

Amy Gordy is a freelancer editor, writer and copyeditor in North Little Rock, Arkansas. She’s served as editor for and been published in several local magazines and provides marketing content for regional catalogs. She’s a yoga instructor at Blue Yoga Nyla in North Little Rock, and, in her spare time, is working on her first screenplay.

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Ashlee Nobel DESIGNER

Ashlee Nobel is a graphic designer and illustrator with a background in publication design. After working her way up to Creative Director over two magazines in Little Rock, she set out on her own to freelance and focus on her art, creating Lee Lee Arts + Design.

When she's not drawing or designing she enjoys gardening, biking and reading.

Melinda Lanigan COPY EDITOR

Melinda Lanigan is married with six daughters and is a Florida native. She has worked in the publishing industry since 1995 as a copy editor, writer, production director, and in project and distribution management. When she's not deconstructing sentences, she is singing and playing guitar and keyboard with her band, The Allie Cats, in Tallahassee, Florida. She also enjoys spending time with her fur baby rescues — three dogs, five cats and a horse named Maggie.

Patty Ingalls PHOTOGRAPHER

Patty Ingalls is the owner/photographer of Patty Ingalls Photography and The Zizzer Zone.

She runs a boutique portrait studio specializing in Seniors, Families, Boudoir, Headshots and Commercial work. When she's not in the studio, she's chasing West Plains Zizzer varsity sports teams for The Zizzer Zone. She's had several images published in Shutter Magazine and won Best Photographer in West Plains the past three years. Contact her through info@pattyingalls.com or visit pattyingalls.com

Dwain Hebda WRITER

Dwain Hebda is a writer, editor and journalist whose work annually appears in more than 35 publications. A Nebraska native, he has an extensive resume spanning nearly 40 years in print. Hebda is also founder and president of YA!Mule Wordsmiths, an editorial services company in Little Rock, Arkansas. An empty-nest father of four, he and his wife, Darlene, enjoy travel and pampering their three lovely dogs.

James Moore PHOTOGRAPHER

James Moore is a photographer and filmmaker located in north central Arkansas. For over 20 years, he has used his talents in the marketing sector, creating content and building brands for local and national companies across a broad spectrum of industries. He has three amazing sons and a beautiful wife.

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OZH

NEWCOMERS

NEWCOMERS ARMING UP THE HOSPITAL FOR YOUR TOTAL CARE B Y DWAIN HEBDA

Dr. Joseph Barnard FAMILY PRACTICE Joining Ozarks Healthcare earlier this year was a homecoming for Dr. Barnard. The primary care physician grew up here from the age of 10, and when he completed his medical residency, there was no doubt where he would set up his practice.

“I’ve always loved this community,” he said. “I know a lot of people around here, and so coming back was really a no-brainer for me. I just felt drawn back to the community and wanted to do what I could to help the people I know and who I grew up around.”

Barnard, 41, completed his medical school training at Kirksville College of Osteopathic Medicine and split his residency between Cox Health Family Medicine and the American Academy of Family Physicians. His medical career places him in good company within his own family, too, “My wife Kista is an RN; she’s a travel nurse,” he said proudly. “My son Dagen actually starts medical school next July. You could say that medicine is a family affair with us, and you’d be right.”

The Barnards, who also have a teenage daughter, Haley, also share a love for the outdoors, going camping, hiking and kayaking in the surrounding wilds at every opportunity.

Dr. Daniel Kolm EMERGENCY DEPARTMENT Dr. Daniel Kolm started his career journey intending to be a pilot. But fate forced the native Californian into an unscheduled landing in medicine instead. He’s felt right at home ever since — especially in the emergency room.

“I enjoy a variety of things, and on any shift, you can have anything walking in the door. In fact, you usually do,” he said. “I like the hands-on end of it where I’m interacting with people and sometimes getting to do procedures.”

Kolm completed his undergrad and medical training at the University of North Dakota, Grand Forks. He completed his residency in emergency medicine at the University of Kansas Medical Center in Kansas City, Kansas. He said he’s found ample use for his skillset in West Plains.

“It’s been great, it really has. Everybody that I’ve met has been absolutely awesome,” he said. “They work together well and work as a team so that everybody succeeds.”

When he’s not soaking in the adrenaline of an emergency department shift, Kolm enjoys outdoor activities and rooting for his favorite sports teams including baseball’s San Francisco Giants, the Kansas City Chiefs of the NFL and most of all, the San Jose Sharks of the NHL.

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“ ”

Since I have been here, everybody is extremely friendly and approachable.

You’re never afraid to ask a question. All the staff are very, very welcoming.

Dr. Yijia ‘James’ Mu EMERGENCY DEPARTMENT Dr. Yijia “James” Mu may be one of the newest faces at Ozarks Healthcare, having joined the emergency department team in 2021, but he brings a wealth of talents and experiences rivaling more tenured physicians.

The son of Chinese nationals, Mu grew up near Charleston, South Carolina, and attended college in North Carolina. He completed medical school at the University of Pittsburgh and his residency in emergency medicine at Jackson Memorial Hospital in Miami. From there, he brought his medical expertise (as well as fluency in three languages) to West Plains.

“I wanted to find a community where I could do community medicine,” he said. “I also really wanted to do critical access medicine. I want to have the ability to do all procedures and just be well-rounded. I think that’s the biggest plus about working here.”

When he’s not in the thick of things in the emergency department, Mu likes to combine his love for travel and good food.

“Anytime there’s good food — the farmers market, good restaurants in town — I’m always there,” he said. “I love to drive, so anytime I can I just get on the road, I like to do that and discover new things.”

Dr. Anum Nida HOSPITALIST Dr. Anum Nida’s path to West Plains is a unique journey, one that started with a career in IT. “I was getting my bachelor’s of technology in Canada, and there was a nursing department where they had these simulator manikins,” said the Vancouver native.

“I was in there fixing a printer, and I saw them resuscitate this manikin. It was the biggest motivation.”

Nida completed medical training at Aureus University School of Medicine in Aruba and residency at Catholic Health – University of Buffalo in New York. She landed with Ozarks Healthcare in late September of 2021.

“I always wanted to work in a rural area just to experience life there. I’ve always lived in a city,” she said. “I also have a family member here who works for this hospital. So, I’d heard good things, and when I interviewed, I loved the place.

“Since I have been here, everybody is extremely friendly and approachable. You’re never afraid to ask a question. All the staff are very, very welcoming.”

Away from work, Nida has also found time to indulge her hobbies.

“I love to cook, and I love photography,” she said. “I like to travel, take pictures. That’s something I’m really passionate about.”

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OZH

NEWCOMERS

THE BOY IS

Back in Town B Y DWAIN HEBDA

F

or Dr. Joseph Barnard, there’s nothing quite like the comforts of home. The family practice physician, who set up shop at Ozarks Healthcare earlier this year, always knew he wanted to contribute to his hometown even if it took a little while to figure out just how to do it.

“My family moved to West Plains when I was about 10 years old,” he said.

“I graduated from West Plains High, and for the first couple years, I really didn’t know what I was going to do. For a while there, I thought of maybe going into the FBI, but when I started with general studies in college, I kind of gave up on that idea.”

Instead of law enforcement, healthcare beckoned as a way to serve others in the town he loved to call home. He landed a gig at Ozarks Healthcare as a physical therapy tech and switched to Ozarks Technical College where he earned a two-year physical therapy assistant degree.

Above: Dr. Joseph Barnard and wife Kista.

Opposite Page: Dr. Joseph Barnard and wife Kista with their children.

Photos courtesy of Barnard.

“

“I worked for the hospital and around some of the other clinics and things in the area for about three years,” he said.

“In the meantime, I met my wife. By 2008, I started having the conversation that I wanted to go to medical school. I just wanted to do more. I won’t necessarily say I was bored with physical therapy, but I just felt like I was very limited.”

Everyone who attends medical school makes personal sacrifices, and Barnard was no exception. For two years, he’d drive from the family home in Thayer, Missouri, to Springfield to take classes three times a week, then back to West Plains where he continued to work full time. In 2012, he flipped his schedule to live in Springfield during the workweek, then come home on weekends serving his family and home health clients. That grind also lasted two long years.

The sacrifice paid off when he returned to West Plains for his first medical job out of residency. The time he spent previously at the hospital helped

It was really easy for me to go into family medicine because when you’re doing PT, you’re seeing a patient for 30–45 minutes and you really get to know them.

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”

the transition to his new practice, just as it did in medical school.

“The work experience that I had definitely helped,” he said. “I could tell right off the bat when we were doing some of our simulated patient encounters in school, it was much easier for me to talk to a patient because I’d already been doing it.

“It was really easy for me to go into family medicine because when you’re doing PT, you’re seeing a patient for 30–45 minutes and you really get to know them.

So, you can tease out the questions that you need to ask, the information that you need. I think it carried over a lot.”

Barnard said his biggest advantage, however, is his wife Kista, who’s an RN and travel nurse. He said having a partner who can understand the stress of a job in healthcare these days is a resource he values greatly.

“It’s really hard for anybody to understand that, unless you’ve actually just been in this situation,” he said. “If there was one thing about having somebody in the family who is a healthcare professional, it’s that

she often gives me a perspective that maybe I didn’t think about.

“It could be something that we’re talking about, ‘Oh I had this come in today and blah, blah, blah,’ and oftentimes

she can offer perspective, being a nurse.

She’s spent a lot of time with patients and kind of getting to know family dynamics and stuff. I think that has probably been the greatest advantage.”

Partners in Nursing Education

“

“The West Plains campus gave me the resources I needed to help me study to reach my goals.

I already had a heart to take care of people and Missouri State-West Plains gave me the necessary tools to make that happen.”

MERINDA CRIGLER

REGISTERED NURSE, OZARKS HEALTHCARE ASSOCIATE OF SCIENCE IN NURSING, MISSOURI STATE UNIVERSITY-WEST PLAINS

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OZH

FOUNDATION

Capital Campaign to Provide Mobile Screenings B Y DWAIN HEBDA | P H O T O G R A P H C O U R T E S Y O F OZARKS HEALTHCARE

O

zarks Healthcare is always looking for ways to extend its reach and provide world-class levels of care throughout its service area. In support of this, the Ozarks Healthcare Foundation is undertaking a capital campaign to purchase a mobile mammography unit to bring screening capability to rural and underserved areas.

“We cover a very large market area geographically, and a lot of it is very rural,” said Josh Reeves, vice president of development and advocacy and director of facilities. “Right now, some of our clinics are over an hour’s drive away from a lot of people who need our medical and diagnostic services.

“This unit will allow us to go out to the folks who are in our outlying counties and give them access to mammography screenings.”

The mobile mammography unit is expected to cost around $750,000 and offer the latest in diagnostics and imaging equipment.

“This is a full-service mammography unit, with 3D mammography,” Reeves said. “It basically

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functions as a clinic on wheels. This is the same Above: The proposed mobile mammography unit, type of screening that you can expect to get inside which would offer the latest of a hospital or an outpatient imaging facility, ex- in diagnostics and imaging equipment. cept in this case the mobile unit comes to you.”

Once put into service, the unit will be scheduled on a regular route that visits each Ozarks clinic on a consistent baThis unit will allow us to sis. As available, it will also be used for special go out to the folks who are events such as commuin our outlying counties nity festivals and general health fairs on an and give them access to as-needed basis. mammography screenings.

“We’ll also be able to go to businesses, schools, churches, anyone that contacts us that feels that they have a need for screening, we’ll be able to consider those requests,” Reeves said.

The unit is the latest weapon in the hospital’s arsenal to provide a consistent quality of care to

“ ”

“

What our own data is telling us is that people would be far more likely to go to a mobile unit if it’s available. Therefore, we see this investment as something that can directly save lives because it’s helping people catch things early.

”

patients, no matter where they may live.

Reeves said this effort took on added significance during the COVID pandemic when many people were afraid to seek medical care for fear of the virus.

“Ever since the COVID pandemic began, there have been a lot fewer people seeking screenings as a part of routine healthcare. People just don’t want to come into a facility and be around a lot of other people,” he said. “That has led to some pretty serious situations where people’s health conditions had advanced because they weren’t caught and treated earlier. It was basically like giving cancer a head start.

“What our own data is telling us is that people would be far more likely to go to a mobile unit if it’s available. Therefore, we see this investment as something that can directly save lives because it’s helping people catch things early.”

Any individual or company can donate to the cause through the Foundation’s website, at ozarkshealthcare.com. Once there, click the pink “Support Us” button. To learn more about the drive or to support the Foundation in general, call (417) 853-5200.

The Choice is Yours Serving the area since 1971

417-256-7191 | wilestitle.biz

21 Court Square, West Plains, MO 65775 onthesquare@wilestitle.com

Follow us on

@WilesTitleCo WINTER 2021 | INSIGHT |

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VOLUNTEERS

Chaplains — an Integral Part of Care B Y DWAIN HEBDA | P H O T O G R A P H Y B Y JAMES MOORE

T

Parrott, who’s been in ministry for nearly 50 years eresa and James Trimmer are familiar sights around the wards of Ozarks and in hospital ministry for 13, said one group many people don’t think about needing spiritual uplift are Healthcare, but they aren’t doctors or nurses or even housekeeping deliver- front-line staff. However, he said, given the events of the past 18 months, the chaplains have paid particing an extra blanket. Still, the duo plays an essential role in the recovery of patients as part of the corps of ular attention to the doctors and nurses who have been stretched to their limits. volunteer chaplains serving the hospital.

“It certainly has become more important to the “The biggest reward anybody can get from this is staff in recent months,” he said. “We try to be more the love that you can show,” Teresa said. “A lot of pavisible and more available to them. When a chaplain tients don’t have family, and the biggest thing they have is fear. What you can give them is you can be a is around, they see the patients and then they also try to check on the staff and see how they’re doing, maybe substitute family. You can still give them hope. Hold have prayer with them. Recently we’ve had chaplains their hands, and you become that family.” that have taken candy to the staff.

“The rewards are just phe“We also come in and have nomenal,” agreed Jim. “You meet extra prayer with them through unbelievable people doing this. shift changes and in the afWhen you see someone go home The biggest reward ternoon over the overhead. or you walk into a room and they Just checking on their general say, ‘I’m on my way home,’ that’s anybody can get well-being, not only spiritually really a reward. It’s a very importfrom this is the love but physically and emotionally ant time that we can bring Christ as well. We’re available to them into it and say we prayed for God’s that you can show. at any time and are glad to talk healing; God’s going to take care with them, meet with them, pray of you.” with them, whatever their needs The Trimmers are just two of may be. That certainly has esca18 volunteer clergy in the chaplated over the past few months.” lain program, offering comfort and consolation to The chaplains are getting a boost with the expanpatients and staff alike. At least seven faith traditions sion of the hospital’s chapel, something Parrot said are represented within their ranks, but all are here to will allow for the ministry to expand into regular provide the same brand of loving pastoral care.

It’s a ministry that runs on the individual dedication services. In the meantime, dedicated clergy like the of its volunteers, said Michael Parrott, who’s served Trimmers are willing to go to any lengths to tend to their hospital flock. three years as hospital chaplain/chaplain coordinator.

“We work right beside the medical workers,” Jim “We do not have chaplains physically in-house 24 hours a day, but every day of the week except Sunday, said. “We’re on 24-hour call, and it could be 10 in and oftentimes on Sunday, there’s someone here,” he the morning, it could be midnight; when there are said. “We do have chaplains who live fairly close to issues, they call us and we go. We stay with the famthe hospital, and they are on a call-in list. The op- ilies. We’re praying for the doctors and nurses. Our erator will start at the top of the list and work down ministry is for everybody. We’re available, no matter who it is, we’re available to be there with them.” until they find someone who can come in.”

“ ”

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Teresa (left) and James Trimmer are two of 18 volunteer clergy in the chaplain program.

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From Left: William A. McGee, M.D.; Biplab Saha, M.D.; Achenkunju George, M.D.; Praveen B. Datar, M.D.; | OZARKS HEALTHCARE | WINTER 2021 Muhammad Khan, M.D.; Archana Sinha, M.D.; Julie Gunter, APN.

& Lung

Heart

C ENT ER

SETS OZARKS HEALTHCARE APART

B Y DWAIN HEBDA | P H O T O G R A P H Y B Y JAMES MOORE

YOU MIGHT EXPECT A PROPER HEART AND LUNG SPECIALTY PRACTICE TO FEATURE MULTIPLE MEDICAL EXPERTS, AN EXCELLENT SUPPORT STAFF AND THE CAPABILITY TO HANDLE A WIDE RANGE OF HEALTHCARE CONDITIONS ALL UNDER ONE ROOF. YOU MIGHT NOT EXPECT TO FIND IT IN A HOSPITAL LIKE OZARKS HEALTHCARE IN A COMMUNITY THE SIZE OF WEST PLAINS. SUCH IS THE LEVEL OF CARE THAT THE CLINIC PROVIDES, RIVALING MUCH LARGER HEALTH SYSTEMS.

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Praveen B. Datar, M.D. BOARD-ELIGIBLE PULMONOLOGIST AND CRITICAL CARE SPECIALIST

Muhammad Khan, M.D. BOARD-CERTIFIED INTERVENTIONAL CARDIOLOGIST

Julie Gunter, APN BOARD-CERTIFIED NURSE PRACTITIONER

Biplab Saha, M.D. BOARD-CERTIFIED PULMONOLOGIST AND CRITICAL-CARE SPECIALIST

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“Our patient-focused

specialists deliver convenient diagnoses and treatments for a large variety of cardiopulmonary needs from chronic conditions to emergent acute care.”

“At the Heart and Lung Center, our dedicated team provides exceptional care to the community allowing patients to stay close to home,” said Jessica Henry, the Heart and Lung Center’s clinical manager. “Our patient-focused specialists deliver convenient diagnoses and treatments for a large variety of cardiopulmonary needs from chronic conditions to emergent acute care.

“We are continually striving to expand our cardiopulmonary services to best fit the needs of our patient population. We not only want to provide the treatment our patients need but to be their support system as well.”

The Heart and Lung Center’s crew is star-studded with two board-certified cardiologists, two board-certified interventional cardiologists, a board-certified cardiothoracic surgeon, a board-certified pulmonologist and critical-care specialist, a board-eligible pulmonologist and critical care specialist, and a board-certified nurse practitioner.

While that lineup would fit in at a metropolitan hospital, the clinic’s ability to pivot and react to changing patient needs quickly is something you can only find in a small-hospital environment. This, said Dr. Biplab Saha, is something that sets the Ozarks practice apart.

“One of the reasons why we are able to do things so quickly is because we don’t have the bureaucracy of a bigger hospital,” he said. “Some hospitals have been trying for years to implement the things that we do today, and still, they still have not gotten it.

“But we, being a small institution and very close-knit, we all know each other, we’re very supportive. And if we need something, we can easily go talk to the executive leadership, and it will get done.”

Another area that is paying off for patients is the introduction of new medical technology.

Intravascular ultrasound for cardiac patients and bronchoscopic lung reduction valves on the pulmonary side are just the latest in cutting-edge devices and procedures the clinic has recently implemented. Both of which, noted Dr. Hussain Ibrahim, interventional cardiologist, reduce the invasive nature of procedures, allowing more medically fragile patients to benefit and speeding healing across the board.

“In our cath lab, we are now doing more than 80 to 90 percent of heart procedures from the wrist,” he said. “The technology that we have now is a new state-of-the-art ultrasound. The resolution is higher now and everything is up to date compared with any large hospital system.

We will have the same kind of ultrasound you will find anywhere.”

This combination of high tech and high touch applies in the many procedures the Heart and Lung Center performs. Open heart surgery, cardiac catheterization, balloon angioplasty, stent placement, pacemaker and defibrillator placement just scratch the surface on the list of cardiac procedures, while the pulmonary side offers treatments for obstructive sleep apnea, asthma, COPD, emphysema and lung cancer, among many others.

Henry said being able to offer such treatments in a local setting is in step with the community-first mentality of Ozarks Healthcare as a whole.

“Our patients are our family, friends and neighbors. We can invest our services into our hometowns. Our staff can provide personalized care without the need to travel long distances,” she said.

“The best thing about working here is being able to serve our own community and creating relationships between staff and patients. I’m proud to work side by side with our specialists to deliver local care to our patients.”

“... being a small

institution and very closeknit, we all know each other, we’re very supportive.

And if we need something, we can easily go talk to the executive leadership, and it will get done.”

Archana Sinha, M.D. BOARD-CERTIFIED CARDIOLOGIST

William A. McGee, M.D. BOARD-CERTIFIED CARDIOTHORACIC SURGEON

Achenkunju George, M.D. BOARD-CERTIFIED CARDIOLOGIST

Hussain Ibrahim, M.D. BOARD-CERTIFIED INTERVENTIONAL CARDIOLOGIST

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High Touch MEETS

High Tech B Y DWAIN HEBDA

Combining the best of technological tools and medical know-how is a winning formula when it comes to patient outcomes. Ozarks Healthcare provides the best of both worlds, offering the latest in technological diagnostic and treatment tools placed in the hands of skilled medical professionals. Here’s a summary of just a few of the cutting-edge medical advancements working wonders for patients.

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M

In traC Avascular Ultrasound RDIAC DEPARTMENT

edical devices that lend precision to a diagnosis help improve outcomes and reduce healing times. That’s precisely the role of intravascular ultrasound used in Ozarks Healthcare's cardiac department.

“What we do is we put a wire inside the artery, like the heart artery for example,” said Dr. Hussain Ibrahim. “Then we put a very small ultrasound probe on there that goes inside the artery and takes the pictures from inside the heart artery.”

Ibrahim said the procedure takes a lot of the guesswork out of diagnosing and treating heart conditions.

“When we are doing an angiogram, we are depending on and estimating, for example, the size of the artery and the stent needed, or how bad the blockage is — whether it is 60 percent, whether it is 70 percent or 80 percent,” he said. “With this ultrasound, when it goes inside the artery, we can see exactly how big the artery is. That helps us in two ways. You can diagnose whether this is something which is a severe blockage or not. Then with the treatment, it really reduces poor outcomes because we are no longer estimating; we’re precisely putting in the size of stent that is needed.”

This Spread: Intravascular ultrasound (IVUS) is a catheter-based imaging technology that allows physicians to visualize blood vessels from the inside out.

Photos courtesy of Philips Media.

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“IT’S A RELATIVELY NEW TECHNOLOGY THAT’S COME ALONG OVER THE LAST FIVE YEARS ... MOST PEOPLE THINK IT’S GOING TO BE THE STANDARD OF CARE IN THE VERY NEAR FUTURE.”

S tr yker Spinal Na viga tion S ys tem ORTHOPEDICS

I

magine you’re working on a remodeling project that requires you to drive a screw into the drywall of a bathroom. Imagine doing so by just eyeballing it, rather than taking steps to make sure you’re about to drill into a wall stud and not an electrical conduit or plumbing. Now imagine how much better you’d feel if you had a device that helped ensure you were driving that screw where it could do the most good rather than cause more damage.

That’s essentially the value of the Stryker Spinal Navigation System, which helps orthopedic surgeons more precisely place screws during spinal surgery.

“It gives us a different way of placing screws,” said Dr. Troy Caron, a board-certified orthopedic surgeon. “It just gives you one extra level of safety

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| OZARKS HEALTHCARE | WINTER 2021

for the patient so you know exactly where you’re putting things.”

In the past, surgeons relied on 2D images such as X-rays to help determine the placement of the screws. With the new navigating system, surgeons utilize the equivalent of an antenna that maps the patient’s body similar to a CT scan. The surgeon then uses a special device that interprets this body scan information to demonstrate the exact drill point.

“It’s a relatively new technology that’s come along over the last five years,” Caron said. “More and more surgeons are using it, and most people think it’s going to be the standard of care in the very near future.

The fact that we have it here already shows that Ozarks Healthcare is really ahead of that curve.”

Above: The Stryker Spinal Navigation System showing the exact drill point in a patient's spine.

Photo courtesy of Ozarks Healthcare.

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| OZARKS HEALTHCARE | WINTER 2021

Above: Spiration® Valve System for the endobronchial treatment of severe emphysema, a form of Chronic Pulmonary Obstructive Disorder (COPD).

Photo courtesy of Ozarks Healthcare.

Bronchoscopic lung reduc tion valve PULMONOLOGY

P

atients with severe breathing conditions now have an alternative to invasive lung surgery.

According to Dr. Biplab Saha, a bronchoscopic lung reduction valve can help in cases ranging from chronic lung ailments to COVID-19.

“It’s very important that this hospital offers this technology,” Saha said. “I have known patients who have refused to go for treatment just because they don’t want to travel. So, it is really great that patients can get care within 15 to 30 minutes driving distance rather than driving hours and hours.”

In patients with COPD or emphysema, lung portions often deteriorate to the point they can overinflate, which applies pressure on the healthy

lung portions, complicating breathing. In the past, surgery was required to remove the damaged sections, a procedure many patients were too sick to survive.

The new valve replaces that procedure. Once implanted, it allows one-way outward flow of air from damaged lung segments, keeping them deflated and allowing the healthy lung tissue to operate more efficiently.

Saha has also pioneered an application for COVID-19 patients whose lungs were already damaged or were damaged by use of a ventilator.

In these cases, the valve helps stabilize breathing functions until the damage can heal.

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“SOMETIMES PATIENTS ARE EASILY TRAVELING AN HOUR ROUND-TRIP JUST TO COME AND SEE US. SO, EVEN OUR OLDER POPULATION HAS BEEN PRETTY QUICK TO MOVE TOWARD THE TELEHEALTH OPTION. THEY JUST FEEL SAFER THAT WAY.”

Telehealth

SYSTEM-WIDE

W

hen COVID-19 came to West Plains, Ozarks Healthcare faced the same challenge many hospitals faced: Patients staying home for fear of infection, skipping primary and follow-up visits.

Telehealth proved the answer and it’s remained a well-used tool ever since, said Brittany McGee, nurse practitioner.

“Prior to the pandemic, we really didn’t offer telehealth to our patients,” she said. “The population at the clinic I work with, internal medicine and primary care, is very high-risk with a lot of elderly and very complex patients. So, it was a pretty easy decision to move pretty quickly to the telehealth model.”

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| OZARKS HEALTHCARE | WINTER 2021

The system provides both video conferencing and telephone options for patients to connect to a health care professional. Many visits are also done through the hospital’s COVID-19 hotline.

McGee said the nature of the patient's case and their degree of technical ability dictates which medium is used.

“It’s been a great option because we cover such a huge area as a rural health care system,” McGee said. “Sometimes patients are easily traveling an hour round-trip just to come and see us. So, even our older population has been pretty quick to move toward the telehealth option. They just feel safer that way.”

Above: Brittany McGee, FNP, family nurse practitioner, uses telehealth to meet with patients through video conferencing or over the telephone.

Photography by James Moore.

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Doctor is In THE

B Y DWAIN HEBDA

PHOTOGRAPHS COURTESY OF

OZARKS HEALTHCARE

F

or a guy who came from one of the least-populated states in the nation, Dr. Troy Caron has spent a lot of time in big-city hospitals. The board-certified orthopedic surgeon from Maine has practiced in Tampa, Seattle, Dallas and St. Louis at various points in his career, which helped shape this physician and sharpen his skills.

But something in him always wanted to get back to a quiet life, which is what he’s found at Ozarks Healthcare.

“The large hospital systems, maybe they have technology, but as a physician you don’t really have a voice in how you treat your patients,” he said. “In those large hospital systems, the CEO wouldn’t know me and I wouldn’t know him if we walked by each other in the hallway. Whereas here, I can call up to (Ozarks Healthcare CEO) Tom Keller on the phone and have a meeting with him that same day.”

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“

I had an interest in the musculoskeletal system which is why I chose orthopedics. I was actually thinking about neurosurgery as well, so the spine was a kind of natural middle ground for orthopedics with a specialty in the spine.

Left and Above: Dr. Caron performing a minimally invasive spine decompression through a small tube. He removes the overgrown bone and ligaments that impinge nerves and cause back and leg pain for the patient.

”

Caron has found hospital leadership not only accessible but responsive to the needs of physicians.

When he worked in St. Louis, he lobbied for a spinal navigation system that would boost the precision of surgical procedures.

“It was like, ‘Ah, it’s too much money, blah, blah, blah,’” he said. “By the time I left, they still didn’t have that technology up in the big city because of all the bureaucracy you had to go through. Whereas, I came down here and was able to negotiate with the companies to get a navigation system. I mean, the first day I came down, we had computer navigation.

“I love not having as much red tape to go through to get better care for our patients.”

Orthopedics and Caron were basically made for one another. A lifelong athlete and gym rat, he’s always had a keen interest in the science behind health and performance.

“I’ve always kind of been into health and fitness, working out and playing sports at school. Just health in general, I was always interested in that,” he said. “I was interested in going into physical therapy initially, and when I was in undergrad, I was basically looking at a master’s of PT versus med school.

“It’s almost as hard to get into master’s of PT programs, so I went the medical school route because I

could do more with it. From there, I had an interest in the musculoskeletal system which is why I chose orthopedics. I was actually thinking about neurosurgery as well, so the spine was a kind of natural middle ground for orthopedics with a specialty in the spine.”

Caron landed with Ozarks Healthcare in 2020 and quickly settled into seeing patients, many of whom are older and suffering from a degenerative process where the spinal canal narrows with age. He deploys the full complement of treatment options for these patients.

“Typically, we treat those conservatively at first with injections and physical therapy,” he said. “But if they get to the point where they need surgery, I’ll do that too. Minimally invasive decompression of the lumbar spine is probably the most common surgery that I do.”

Here again, Caron said, working in a small hospital environment gives him an advantage over larger health systems.

“We have the same team that I pretty much work with all the time in the OR, so you get that kind of family-type approach taking care of patients,” he said. “We’re all on the same team in the same family taking care of our patients, whereas in the larger systems, you work with different people every day, and it doesn’t have that kind of small-town feel to it.”

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Feel It in Your

BONES OZARKS HEALTHCARE PROVIDES WORLD-CLASS ORTHOPEDIC CARE B Y DWAIN HEBDA | P H O T O G R A P H S C O U R T E S Y O F OZARKS HEALTHCARE

A

mericans are living longer and staying active, both of which are stoking the demand for orthopedic healthcare professionals. As skeletal systems deteriorate with age or are damaged due to overexertion or sports injuries,

Dr. Susan Jolly

ORTHOPEDIC SURGEON

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orthopedic healthcare professionals are on the front line for treatments ranging from injections and therapy to the latest in surgical techniques. All of which, it should be noted, are available right here at Ozarks Healthcare in the hands of the hospital’s skilled orthopedics team.

Dr. Susan Jolly came to Ozarks Healthcare after having spent more than 20 years in Denver. She relocated to West Plains as a way to get back to her roots.

“I grew up in a small town in Ohio, so I always wanted to get out of the city,” she said. “I came to the area before to purchase a horse, and I liked the people. So, when I decided to move, I came here.

“After six years here, I know most of the people who work here. I can walk into the community and see people that I’ve either treated or that I work with, and I enjoy that

— just the small-town personality overall.”

Jolly said the clientele hasn’t changed much in her time at Ozarks Healthcare, but that doesn’t mean the orthopedic staff is a one-trick pony when it comes to care.

“This is very much a general orthopedic practice,” she said. “I think we’re fortunate here in that we do have well-trained people who offer very good orthopedic care. I would say the care we provide is equal or better here than anywhere because of the personal touch. We’re providing exceptional patient care and very collegial care as well.”

Dr. Troy Caron

ORTHOPEDIC SURGEON

Dr. Edwin Roeder ORTHOPEDIC SURGEON

Dr. Troy caron arrived in West Plains from St. Louis where he was working in the latest of a string of large hospitals. He arrived looking for a more hands-on, personal type of care, augmented by technology.

A year later, he’s enjoying a practice offering one-on-one attention to patients and cutting-edge technology at his disposal in the form of the Stryker Spinal Navigation System.

“What I want people to know about our expertise here is that there’s not a whole lot that we don’t do. We can do pretty much every procedure here that they do in other places,” he said.

Word is getting out about the high degree of care available. Caron said even through the challenges of the COVID-19 pandemic last year, the spine clinic saw healthy growth. He sees that as an endorsement of the quality of care.

“People who think they have to go to a big city or travel long distances to find the best care are mistaken,” he said. “We can do it right here.”

When he’s not helping relieve people of pain, Caron likes to spend a lot of time in the gym doing CrossFit, running and weight training.

Since arriving at Ozarks Healthcare three years ago, Dr. Edwin Roeder has settled into a satisfying practice where he’s had the opportunity to work with local athletes.

“I’m team physician for the West Plains High football team, which is a big deal,” he said. “I also work closely with a lot of the other high schools. I do a lot of sports medicine-types of things. I’ve always had an interest in shoulder and knee injuries; I do a lot of rotator cuff repair and knee reconstructions.”

Roeder said working with athletes of all shapes and sizes has become a particularly enjoyable part of his daily caseload.

Treating athletes of all ages carries over into other areas of practice as well.

“I’m able to incorporate a lot of things we’re doing with sports medicine into my knee reconstruction patients,” he said.

“People go home quicker and are able to get back to an active life a lot quicker after those procedures.”

Roeder stays active himself, thanks to the area's natural offerings.

“The Ozarks, particularly this part of the country, have a ton to offer,” he said. “My wife and I hike around here. I enjoy fishing and kayaking on the rivers as well.”

“

I think we’re fortunate here in that we do have well-trained people who offer very good orthopedic care. I would say the care we provide is equal or better here than anywhere because of the personal touch.

”

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FAST, EASY, AFFORDABLE

MEDICATION OZARKS HEALTHCARE PHARMACY UTILIZES TECHNOLOGY AND FEDERAL PROGRAMS TO BETTER SERVE CUSTOMERS B Y AMY GORDY | P H O T O G R A P H Y B Y JAMES MOORE

O

zarks Healthcare Pharmacy is an essential hub within the Ozarks Healthcare system, providing prescription services, vaccinations and over-the-counter items to patients and the public. The pharmacy is a one-stop shop for medicinal needs, and technology like the Rx2Go app, available on iOS and Android devices, makes filling prescriptions fast and easy. Customers just download the app, then use it to request refills at the pharmacy — no waiting in line at the counter or holding on the phone.

Katie Mahan, director of retail pharmacy and 340B, encourages all pharmacy customers to try the app. “It’s a handy feature that saves the patient time.

They don’t have to call us, which decreases the number of phone calls we get in the pharmacy. The customer receives an auto-text when their prescription is ready,” she said. The pharmacy also offers mailing services free of charge.

Another innovative advancement on the horizon for Ozarks Healthcare Pharmacy is the integration of medication synchronization. This is great news for customers who fill multiple prescriptions in a month as it will allow all the monthly medications to be filled in one single trip to the pharmacy. “We don’t have it going quite yet, but it’s something we are working toward with a goal to have it up and rolling in early 2022,” Mahan said.

Ozarks Healthcare Pharmacy prides itself in getting medications to customers quickly, easily and at the lowest prices. The pharmacy accepts all major insurance plans and offers affordable pricing for non-insured and underinsured patients through the 340B Drug Pricing Program, which is a federal program that requires manufacturers participating in Medicaid to provide outpatient drugs to eligible health care organizations at significantly reduced prices. The process is easy — there’s no paperwork to

“

Every day, I see people go without insulin because they can’t afford it. The 340B program saves these people hundreds of dollars a month, and sometimes that’s just on one prescription.

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| OZARKS HEALTHCARE | WINTER 2021

”

Katie Mahan (right) at Ozarks Healthcare Pharmacy providing prescription services, vaccinations and over-the-counter items to patients and the public.

WINTER 2021 | INSIGHT |

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COVID-19 VACCINATIONS ARE AVAILABLE TO THE PUBLIC TUESDAYS AND FRIDAYS FROM 10 A.M.–4 P.M. ON A WALKIN BASIS OR BY APPOINTMENT ANY OTHER DAY OF THE WEEK EXCEPT SUNDAY. Katie Mahan, PharmD., Outpatient Pharmacy/340B Director

fill out, but you must be seen by a 340B practitioner to qualify. For a complete list of participating practitioners, call the pharmacy at 417-256-1793.

“This program is great for those who don’t have any prescription coverage on their insurance, or the copays are so high they can’t afford the medication.

To qualify, there is no paperwork, but patients must go to one of our 340B providers. That practitioner will write a prescription and let the pharmacy know they need it filled 340B,” Mahan said.

In an age where prescription costs can be skyhigh, many patients sometimes find themselves choosing between their prescription and paying bills or buying groceries, and Mahan has seen many opt to skip essential medications because they simply cannot afford them. Some bearing the most financial burden include Symbicort, Advair, Lantus, Januvia, Xarelto and numerous others.

“Every day, I see people go without insulin because they can’t afford it. The 340B program saves these people hundreds of dollars a month, and sometimes that’s just on one prescription. We use it a lot on diabetic medications. Also, inhalers are incredibly expensive. Those are probably the two biggest areas. There are so many patients who would have to go without, but because of the 340B program, they are able to afford life-saving medications.”

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GET THE SHOT Ozarks Healthcare Pharmacy provides a convenient space to get your COVID-19 vaccination or booster shot as well as vaccinations for influenza, tetanus, shingles and pneumonia. Pfizer, Moderna and Johnson & Johnson COVID-19 vaccinations are available to the public Tuesdays and Fridays from 10 a.m.–4 p.m. on a walk-in basis or by appointment any other day of the week except Sunday.

“We try to be very accommodating. Just come in, fill out a consent form, receive the shot and wait 15 minutes for observation. You will be in and out very quickly,” said Katie Mahan, PharmD., Outpatient Pharmacy/340B Director.

Mahan encourages anyone hesitant about the COVID-19 vaccination to speak with their healthcare provider or pharmacist about concerns. “We are seeing some people finally come in to get the shot when someone close to home gets sick. Many are worried about immediate side effects like flu-like symptoms. I encourage people to talk to their doctor or pharmacist and avoid getting information on social media — that’s where a lot of misinformation is coming from.”

Mahan notes that it’s also time to get flu shots, which are available in the pharmacy on a walk-in basis every weekday from 10 a.m.– 4 p.m. You can get your flu and COVID-19 shot at the same time. The pharmacy will also travel to give flu shots on-site at businesses with 10 or more workers.

For more information on vaccines, please call the pharmacy at 417-256-1793 or walk in at 1211 Porter Wagoner Blvd., Ste. 18, West Plains.

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OZH

STAFF

The Thin

BLUE LINE

B Y DWAIN HEBDA | P H O T O G R A P H Y B Y PATTY INGALLS

M

ost people do not come into the hospital thinking about the security measures that are in place to protect them, the staff and medical personnel. R.D. Reid, Ozarks Healthcare's supervisor of security, communications and public safety, understands that fact to the point of being philosophical about it.

“The security here, sometimes, is kind of like an insurance policy to most folks,” he said. “People know we’re there, but they don’t have to use us a lot. But when they do need us, they are absolutely happy to have that insurance policy.”

Reid manages a staff of seven security officers, counting himself, which may sound like a lot until you think about the 1,300 employees, countless patients, hundreds of thousands of square feet and acres of parking lot to be secured, 24 hours a day, seven days a week.

“Our primary task here at the hospital is to ensure a safe environment for all of our coworkers, patients and visitors,” he said, adding many people would be surprised at the number of assaults that happen to healthcare workers on the job,

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particularly when dealing with patients who are under the influence.

“When I was a younger law enforcement officer, the evil drug in our community was marijuana,” he said. “Then one day, a horse named methamphetamine rode into town. That in itself changed our community, changed law enforcement, changed a lot of things. When we admit somebody to the hospital who’s under the influence of methamphetamine, they’re absolutely dangerous at that time.

“Then, if our doctors require that they be here for two or three days to let methamphetamine run its course, they can end up being an unsettled patient for the hospital, the nursing staff, the security team and so on.”

Reid drills his troops on the proper way to assess and handle such situations, even to the point of taking a patrolling shift himself to keep abreast of current operations. He’s also advocated for new technology such as a forthcoming mass notification system called Rave.

“We’ll utilize it to send out emergency codes whether it’s some type of facility-wide response or a specific team

“

It’s important that our coworkers and patients are safe but also that they feel safe.

”

Above (from left): The team of seven security officers, Sean Cody, Travis Hall, R. D. Reid, Randy Smith, Jason Cook, Jake Simers and Larry Rhoads.

Opposite Page: R.D. Reid, Ozarks Healthcare's supervisor of security, communications and public safety.

response,” he said. “Each person in our organization will have the ability to download this app on their phone. If they fall into what they perceive as a dangerous moment where they need a response, they simply push a button on this app. They won’t even have to talk to us; it will immediately come up on the security phone.”

Reid said he hopes the new system helps strengthen employees’ confidence

in the safety of their work environment.

“It’s important that our coworkers and patients are safe but also that they feel safe,” he said. “If they don’t feel safe, then that affects their productivity and our sustainability of coworkers here at our hospital. I preach that message all of the time. As security personnel, we think our campus is pretty safe, but we want everyone else to think that, too.”

WINTER 2021 | INSIGHT |

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OZH

MENTAL HEALTH

Healthy Ways to

COPE WITH STRESS » Take breaks from watching, reading or listening to news stories.

» Take care of your body: • Take deep breaths, stretch or meditate.

• Try to eat healthy, wellbalanced meals.

Pressures of the Pandemic

OZARKS HEALTHCARE BEHAVIORAL HEALTH CENTER ADDRESSES MENTAL HEALTH OF THE COMMUNITY DURING THE COVID-19 HEALTH CRISIS

B Y AMY GORDY

T

he weight of the pandemic continues to build on Americans even a year and a half after it first reached our state. We’ve seen shutdowns, business closures, school closures, job loss, death, illness, food shortages, hospital bed shortages and the continued encouragement for social distancing and isolation as the country waits for the vaccine-hesitant to step up.

This is a lot for people to bear — too much to bear, in fact. Experts have been tracking the mental health of Americans throughout the pandemic. The National Center for Health Statistics (NCHS) in partnership with the Census Bureau has been distributing 20-minute online surveys, called the Household Pulse Survey, and the results are in. Americans need mental health support now more than ever. At the start of the pandemic in 2019, 8.1% of adults aged 18 and over had symptoms of anxiety disorder, 6.5% had symptoms of depressive disorder, and 10.8% had symptoms of anxiety disorder or depressive disorder. A survey in September 2021, reveals 28% of adults aged 18 and over had symptoms of anxiety disorder, 22% had symptoms of depressive disorder and 32% had symptoms of anxiety disorder or depressive disorder.

In another study conducted by the Centers for Disease Control in June 2020,

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• Exercise regularly.

• Get plenty of sleep.

• Avoid excessive alcohol, tobacco and substance use.

• Continue with routine preventive measures (such as vaccinations, cancer screenings, etc.) as recommended by your healthcare provider.

• Get vaccinated with a COVID-19 vaccine

it was found that 13% of those surveyed reported having started or increased substance use, 26% reported stress-related symptoms and 11% reported having serious thoughts of suicide in the past 30 days.

Yet, there is evidence that the pandemic is not affecting all Americans equally. According to the National Institute of Mental Health, “As is often the case, unfortunately, the most vulnerable among us are also feeling the mental health effects most intensely. Job loss, housing instability, food insecurity and other risk factors for poor outcomes have disproportionately hit minority communities.”

There is no debating that the pandemic is doing major damage to our mental health, but fortunately, there are also great physicians offering guidance and solutions close to home. Ozarks Healthcare Behavioral Health Center (BHC) is a department of Ozarks Healthcare and provides psychiatry, psychotherapy, case management, health home, crisis services and psychosocial day treatment programs. BHC serves a seven-county region that includes Howell, Oregon, Shannon, Texas, Wright, Douglas and Ozark counties with facilities in West Plains and Mountain Grove, as well as Ozarks Healthcare clinics in Mountain View and Thayer.

The team at BHC includes psychiatrists, social workers, nurse practitioners,

» Make time to unwind — Try to do some other activities you enjoy.

» Connect with others — Talk

with people you trust about your concerns and how you are feeling.

» Connect with your community or

faith-based organizations — While social distancing measures are in place, try connecting online, through social media or by phone or mail.

Source: Centers for Disease Control and Prevention

nurses, community support specialists, peer specialists, family support providers, and counselors to provide comprehensive and compassionate care to members of the community ages 6 and older. Anyone can take advantage of the services provided

by BHC — no referral needed — with the Open Access Program. Patients are seen as quickly as possible, asked about their history and current symptoms and given necessary appointments or referrals for further needed services.

The BHC mission “To provide exceptional, compassionate care to all we serve,” strikes a chord during this time when everyone needs a little more compassion, grace and empathy. For more information, contact Ozarks Healthcare Behavioral Health Center at 417-257-6762.

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