ROBERT C. BYRD HEALTH SCIENCES CENTER WEST VIRGINIA UNIVERSITY
meeting the challenge WVUhealth SUMMER 2013 Vol. 4, Issue 1
A publication of the Robert C. Byrd Health Sciences Center West Virginia University, Morgantown, West Virginia www.hsc.wvu.edu Administration James P. Clements, PhD President, West Virginia University
PAIN PILL EPIDEMIC
TREATMENT WORKS, BUT FEW HAVE ACCESS
Christopher C. Colenda, MD, MPH Chancellor for Health Sciences Patricia A. Chase, PhD Dean, School of Pharmacy David A. Felton, DDS, MS Dean, School of Dentistry J. Gregory Rosencrance, MD Interim Dean, Charleston Division Konrad C. Nau, MD Dean, Eastern Division Elisabeth “Betty” Shelton, RN, PhD Interim Dean, School of Nursing
ON THE STREET WHERE YOU LIVE
ONLINE PROGRAM LETS VETS TRAIN ANYWHERE
ULTRASOUND: INSTANT ANATOMY
THE BUSINESS OF HEALTH
Arthur Ross, MD Dean, School of Medicine Jeffrey Coben, MD Interim Dean, School of Public Health Judie Charlton, MD Chief Medical Officer WVU Healthcare Bruce McClymonds President and CEO, WVU Hospitals J. Thomas Jones President and CEO, WV United Health System Editorial Board Bill Case, Editor Heidi Specht, Creative Director Danielle Conaway, Associate Editor Stephanie Bock Geri Dino, PhD Norman Ferrari, MD Amy Johns Misti Michael Gary Murdock Amy Newton Lynda B. Nine Tricia Petty Julia W. Phalunas Shelia Price, DDS Contributors Bob Beverly Christian Brooks Aira Burkhart Ann Chester Jeff Driggs M. G. Ellis April Henry Autumn Hill Leigh Limerick Amy Newton Lori Savitch
© 2013 West Virginia University West Virginia University is governed by the West Virginia University Board of Governors and the West Virginia Higher Education Policy Commission. West Virginia University is an Equal Opportunity/Affirmative Action Institution. Cover illustration: Autumn Hill
Our responsibility is clear: we have to make the most of every opportunity we have to serve our patients, to bring out the full potential of our students, to serve the state and nation, and to discover new and better ways to address individual and community health.
Dear Readers: Before we started this issue of WVUhealth magazine, the Health Sciences Center reached out to alumni, healthcare professionals, policymakers, and civic leaders across our state and asked them: What is the biggest health challenge facing your community? What would you like to see West Virginia University’s health schools or WVU Healthcare doing to help advance health in the state? Have you seen any health improvements in your community recently? How did they happen? Their responses were both sobering and inspiring. West Virginians know, in their hearts and in their families, the impact of the statistics that make headlines. Throughout this issue, you’ll see some of their comments,
alongside the stories that show WVU’s involvement in the lives of patients, students, and communities. Our responsibility at the University and at all of our Health Sciences campuses is clear: we have to make the most of every opportunity we have to serve our patients, to bring out the full potential of our students, to serve the state and nation, and to discover new and better ways to address individual and community health. We are a powerful force for health. We will continue to listen to the voices of the people of West Virginia and dedicate our efforts toward transforming their lives and eliminating health disparities. Christopher C. Colenda, MD, MPH Chancellor for Health Sciences West Virginia University
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photo Geoff Davis 2 | WVUhealth
meeting challenge the
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THE PAIN PILL
EPIDEMIC WEST VIRGINIA CONFRONTS ADDICTION by Amy Johns
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West Virginia had the
highest rate of prescription drug overdose deaths in the U.S.
Source: WV Rx Quitline
When you have been an addictions expert for as long as Rolly Sullivan, MD, has, you’ve seen it all. In the 80s, the issues were mostly alcohol and a little cocaine. In the early 90s, heroin became a problem. “Since the late 1990s, it has completely reversed and we are overwhelmed with the number of prescription opioid patients coming to our doors. It’s a never-ending stream,” said Dr. Sullivan (MD, ’80), director of the addictions program for WVU Healthcare’s Chestnut Ridge Center. Opioids – narcotic prescription painkillers, such as oxycontin, hydrocodone, dilaudid, and morphine — work by decreasing a person’s perception and reaction to pain. But along with pain relief, they produce feelings of euphoria and a kind of seductive “wellness.” That’s powerful motivation for recreational use of the drugs, which can easily lead to addiction. And in West Virginia, the toll is measured in drug-related violence, crime, and deaths, especially in the state’s southern counties.
In fact, according to Drug Enforcement Administration Agent Mark Simala, the “Oxycontin Express,” the roads that lead to and from the infamous Florida pill mills, runs right through the state. “West Virginia is geographically sandwiched between major cities like Columbus, Detroit, and Pittsburgh,” Simala said. “You have drug dealers sitting in these areas that know West Virginians have a reputation of being drug users, so why not flood those areas with pills that they can make money from?” A STATEWIDE EFFORT According to the Governor’s Advisory Council on Substance Abuse, more than 150,000 West Virginians need to be treated for addiction. Gov. Earl Ray Tomblin assembled the council in 2011 to tackle the issues of prevention, early intervention, treatment, and recovery. “Drug abuse in our state shatters
“In southern West Virginia and also in the Charleston area, the most frustrating issue is substance abuse, which is clearly driven by mental health issues. The epidemic of prescription drug addiction is one that’s devastating to many of our citizens, to their families, and to productivity in our economy.” —Dan Foster, MD
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families and erodes our communities,” he said, declaring that conquering prescription drug abuse is one of his top priorities. Law enforcement, courts, corrections officials, educators, health professionals, and religious and community leaders throughout the state are part of the governor’s council. Last year, they helped shape legislation that limited the sale of pseudoephedrine — a drug that can be used to make methamphetamine — and mandated that all pain clinics in the state be registered. They also demanded action from the state’s physicians, enlisting their help to prevent drugs from being diverted from patients to abusers. More than 200 West Virginia physicians and other clinicians attended a recent training session in Morgantown to learn how they could fight prescription drug abuse. The course was co-sponsored by the WVU
School of Medicine and U.S. Sen. Jay Rockefeller’s office. “I hear every day from concerned West Virginians – parents, health professionals, law enforcement – about how prescription drug abuse is hurting our communities,” Sen. Rockefeller said. “One of the biggest identified issues is that we need to make sure those who prescribe drugs are getting the information they need to avoid over-prescribing and better identify patients at risk of abuse.” “Treating the addict is not the most glamorous part of medicine, so it’s true that not enough physicians have been interested or capable of treating these patients. Or there are other doctors who are taking advantage of addicts just to make a buck,” Sullivan said. “With education and the attention that someone like Senator Rockefeller brings to the issues, we can start to change that.”
A report by WVU’s Injury Control Research Center shows the parallel rise of opioid pill sales, addiction, and overdose deaths in the U.S. since 1999.
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Addiction treatment is one of the places in medicine we have gone backwards. We really need more residential treatment centers in the state. But in the early 90s, the insurance industry just decided they were too expensive and quit paying for them. Rolly Sullivan, MD
TREATMENT IN HIGH DEMAND Almost all addicts have complicated lives because of their addiction, Sullivan said. They need help learning how to stay clean and stay away from the people, places, and things that trigger drug abuse. At WVU Healthcare’s Chestnut Ridge Center, four psychiatrists are treating about 400 patients in clinic — 200 each week. Patients are provided with an individual plan that may involve a medication to treat drug abuse, as well as group therapy. They must also attend a 12step program, such as Narcotics Anonymous. Patients who live far from Morgantown can get treatment through the Center’s telepsychiatry program (see story next page). “I once believed that opioid addiction is an almost hopeless disease. But now I know better,” Sullivan said. “We have some unbelievable success stories because we have good medications to treat substance abuse now. We have people in our program who have been clean for the last seven years – they’re back to work, living normal, successful lives.”
But the success stories have to be balanced against the thousands of West Virginians who can’t get access to treatment. “Addiction treatment is one of the places in medicine we have gone backwards,” Sullivan said. “We really need more residential treatment centers in the state. But in the early 90s, the insurance industry just decided they were too expensive and quit paying for them.” Sullivan’s experience has made him a vocal advocate for policy changes that would get more addicts into treatment. “People in West Virginia are asking for that more than anything – health professionals, the public, even law enforcement. What they are asking for consistently is treatment, and that’s the hardest to come by.”
Watch a special “Doctors on Call” television program featuring WVU experts discussing West Virginia’s prescription drug abuse problem at: http://www.youtube.com/watch?v=vU-eXDQM6bc
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“I think the biggest health challenge facing the community and beyond would be mental health issues. For as long as I know, that issue has been stigmatized and folks have been reluctant to get help or have not gotten help because of the stigma pertaining to mental health…Mental health issues are just as important as physical health issues. They are intertwined.” —Sandra Chapman, JD Former president of the West Virginia Board of Education
but few have access Telepsychiatry aids patients
by Danielle Conaway
44 percent of
adults living in West
Virginia with serious mental illness are being treated.
Source: National Alliance on Mental Illness
WVU psychiatrists provide adult, child, and adolescent telepsychiatry services in eight rural West Virginia counties.
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Dr. Patrick Marshalek treats mental health and addiction patients in rural West Virginia counties through telepsychiatry. The patient and partnering medical staff at the remote location communicate with the WVU doctor via a web camera and a secure, HIPPA-compliant computer server.
photo Heidi Specht “I was holed up in a hotel for two weeks doing drugs,” recalled Jessica*, who lives in a rural West Virginia town. “My family thought I was dead.” That day was a long time coming. Her mother and grandfather were alcoholics and addicts, and she first started doing drugs with her mother. Crack, cocaine, LSD, marijuana, heroin, OxyContin, prescription pills, crystal meth – she said they tried almost every drug. “At the time, it seemed normal and kind of a fun way to bond with her, but now I know that’s just crazy.” Other family members tried many times to convince her to enter a detox program. She nearly lost custody of her daughter forever, and she was in and out of rehab for years. But in that hotel, during a drug binge that could have ended her life, she had a moment of powerful clarity. “I know it sounds crazy, but it was just a spiritual moment where I knew I had to get help. I told my grandma I was coming home, and I got into the program,” she said. But for people fighting addiction in West Virginia, help isn’t always easy to find. “There aren’t nearly enough resources for patients,” said WVU psychiatrist Patrick J. Marshalek (MD, ’06.) “The state needs expanded addiction services at all levels, including acute *Name has been changed
inpatient, outpatient, and residential. Resources available to those without insurance are lacking even further.” Jessica was lucky. She found an intensive outpatient program at the Prestera Center – a behavioral medicine system serving eight central and southern West Virginia counties. Though the two have never met in person, the program also includes regular telepsychiatry sessions with Dr. Marshalek over a secure Internet video connection. Psychiatrists at the WVU Chestnut Ridge Center in Morgantown provide adult, child, and adolescent telepsychiatry clinics in eight West Virginia counties. “In Morgantown, we’ve seen patients who commute from as far away as McDowell County due to scarcity of treatment providers. Physical and emotional pain from poor socioeconomic standing makes opioids seem alluring. In some ways, rural areas aren’t very different from urban areas when it comes to opioid addiction,” Marshalek said. At partnering medical sites like Prestera Center and Southern Highlands Community Mental Health Center, a certified addiction counselor or a behavioral health nurse on site works with the WVU psychiatrist at
Chestnut Ridge Center in Morgantown. “Telemedicine allows us to put a physician in a place where previously it was not possible because of financial or travel reasons. We still get to deliver high quality care that we are used to delivering in person,” Marshalek said. At first, Jessica said, it was a little intimidating to talk with a doctor through a computer screen and a web cam. But she grew more comfortable with Marshalek quickly. “He honestly cares and always wants to help. If you make a mistake, he gives you a second chance. Without this program, I would not be getting the care that I need.” But WVU’s telepsychiatry program isn’t reaching everyone who needs it. Waiting lists for the clinics are in the hundreds. And many others aren’t seeking the care they need. Fear of disclosure or rejection from friends or family are a few reasons why people with a mental illness or an addiction might not seek help. “There’s a stigma related to mental health issues in general and an additional stigma on addiction. Addiction should be viewed more as a chronic illness or a chronic disease,” Marshalek said. “Folks can get better given the right types of treatment. We can make this better. It’s not like waving a magic wand, and it’s healed, but it’s a manageable condition over time.” SUMMER 2013 | 9
ON THE STREET WHERE YOU LIVE STREET MEDICINE PROGRAM HITS HOME FOR WVU STUDENTS by Jeff Driggs
CHASM Services 2012 • Face-to-face medical encounters: 111 • Blood pressure checks: 603 • Volunteer hours, students and faculty: 400 •Supplies distributed: 876 • Rounds: 29 photo M. G. Ellis 10 | WVUhealth
“One of the biggest issues in the state of West Virginia is access to care. Access to care can mean different things other than the distance geographically, such as no insurance or limited insurance.” —Howard Gamble, MPH Wheeling-Ohio County Health Department
On a brisk February evening, Steve Auciello and more than a dozen of his fellow medical students gathered in a Charleston parking lot. Armed with bags of socks, underclothes, donated toiletries, and snack items, the group circled up for introductions, planned their route, and took off on foot to the Charleston Emergency Men’s Shelter a block away. A group of men standing outside the shelter door saw the group approaching and smiled in recognition. “I think this is outstanding,” said Minor Fisher, a homeless veteran. “This is something that should be done.” Fisher had his blood pressure taken during the visit and received clothing and supplies from the group. “As a veteran, just having them talk to us and care means a lot,” Fisher said. “We really appreciate the attention.” Project CHASM (Charleston Homeless and Street Medicine) is a student-led volunteer organization that works to serve the health needs of homeless people in the state capital. It’s based in WVU’s Charleston Division – but on this night, as is often the case, they were joined by students from Marshall University, the West Virginia School of Osteopathic Medicine, and the University of Charleston. “When I look back on my years at WVU, this is what is going to really stay with me,” said Auciello, who graduated from medical school in May. “There’s a
gentleman that I have followed, who I have probably talked to about ten different times. He has a lot of medical problems; each time we talk to him now he’s getting one solved, and he is moving in the right direction. When I see him, he flags me down right away and makes sure I check his blood pressure and catch up with him a little bit.” James Mears, MD, of the Charleston Division Family Medicine faculty, works with the CHASM students. Over time, he’s seen improvement in many patients, particularly those whom the students have been able to guide into other medical resources. “We have seen people that had high blood pressure and other health issues that went and got treated because of these checks,” he said. But the students benefit, too. “It’s very rewarding seeing the students grow as professionals,” Dr. Mears said. “You have to have the heart to be a giver and provide. So much of our time is spent in the clinic and the classroom that taking a little extra time out is a sacrifice, but I think the rewards are there.” By the end of the evening, the group had seen more than 30 people, given dozens of blood pressure readings, and offered advice on everything from keeping warm to smoking cessation. “Charleston’s not a huge city, but there are a lot of people who need help,” said Joe Andrzejewski, a fourth-year medical student. “You don’t really think about it. But when you’re here and see it, it opens up your eyes to how much need there is out there.”
“I think the biggest health challenge is providing care to the working poor and uninsured....” —Bob Whitler CAMC vice president, government and community affairs
Left: WVU Charleston Division School of Medicine graduate Steve Auciello helps meet the health needs of homeless people in the state capital. SUMMER 2013 | 11
“Several efforts have improved community health in southern West Virginia. For instance, in Chapmanville and Madison, we have improved our built environment. In Madison, we have a walking trail, new little league fields and a new surface and walking track at Scott High School. Folks are always out exercising on the trails and track now. Also, I think the CARDIAC Project is maturing and we are seeing improvements in the health of our children. Finally, we have a real grassroots effort to improve health through REV UP Madison.” —Senator Ron D. Stollings, MD Chair, West Virginia State Senate Health and Human Resources Committee
Turnaround? Pediatric heart specialist William Neal, MD, has monitored the body mass, blood pressure, and cholesterol levels of thousands of West Virginia schoolchildren for 14 years, long enough for some of the first kids he screened to have children of their own. Now, despite discouraging trends in the state’s overall health, new data from West Virginia University’s Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project reveals cause for cautious optimism.
Data Shows First Signs of Change
The blood pressure of fifth-graders CARDIAC has screened showed a marked decrease in the 2011-2012 school year. Obesity among kindergarteners has dropped sharply, said Dr. Neal. Neal founded CARDIAC in the 1990s and remains its director. “A 3.5 percent decrease is very significant,” Neal explained. “This is the first time we have noted such a large decline rather than steady increase.” In addition to school nutrition improvement initiatives, Neal believes increased awareness of obesity and its hazards has inspired more families to practice healthier habits. “Our goal is to reduce death from heart disease in West Virginia to the national average by 2020,” Neal continued. “Hopefully, obesity will decrease as a result of our citizens living a healthier lifestyle, and a reduction in diabetes will follow.” CARDIAC initially collected the health data from fifth-graders, but has since expanded to include measurements at various ages ranging from kindergarten to middle school. As high cholesterol tends to run in families, a new CARDIAC family-based program will offer free screening for all firstdegree relatives of children identified with very elevated cholesterol levels. The initiative will be funded by the WVU Department of Pediatrics.
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NOTHING TO LOSE AND EVERYTHING TO GAIN MARY BABB RANDOLPH CANCER CENTER CLINICAL TRIAL PROVIDES SECOND CHANCE Four years ago, Preston County resident Becky Benson learned that she had acute myeloid leukemia (AML), a particularly aggressive type of blood cancer. It started with a headache that would not respond to treatment. In a hospital emergency room, physicians reviewed her blood tests and quickly suspected that Benson had cancer. “When they said that word, the whole room went dark,” she said. “I was too scared to cry. But I promised my family that I would fight.” Distance learning allowed USAF Lt. Col. Sandra Cotton to progress in the School of Nursing’s doctoral program while deployed oversees. Submitted Photo
SCHOOL OF NURSING ONLINE GRAD PROGRAM LETS VETS TRAIN ANYWHERE Veterans and active-duty members of the armed forces can participate in WVU online degree programs wherever they are in the world. For nurses, web access to the School of Nursing’s graduate nursing programs is often the key to uninterrupted career and personal advancement. U.S. News & World Report has ranked WVU in the nation’s top three online nursing master’s curriculums for veterans. The magazine also placed WVU at No. 21 among online nursing programs for all students. WVU clinical assistant professor Sandra Cotton, DNP, RN, (pictured above) completed her doctor of nursing practice at WVU in 2012. The School’s online programs gave Dr. Cotton a leg up while deployed overseas.
Benson needed a bone marrow transplant to survive, but first her cancer needed to be put into remission. Although she had multiple rounds of chemotherapy over the next four months, the cancer quickly grew back each time. Her physicians were discouraged, and one talked with her about end-of-life care. She wasn’t ready to quit. Luckily, she heard about a clinical trial that was enrolling patients at the Mary Babb Randolph Cancer Center offering a new chemotherapy regimen. Benson enrolled in the trial, and within weeks was able to receive a bone marrow transplant. She credits Dr. Michael Craig, director of the Hematopoietic Malignancy and Bone Marrow Transplant Service, for helping her find a marrow donor. Benson is eager to tell her story to others who might benefit. “The only way they are finding cures for cancer is through clinical trials,” she said. “When you’re fighting for your life, you have to do everything you can.” Learn more about clinical trials offered by the Mary Babb Randolph Cancer Center at wvucancer.org.
“The responsiveness of WVU faculty and staff to veterans was prime in helping me begin doctoral work while deployed in Iraq, and then to pick up study once home,” said Cotton, who retired as a lieutenant colonel after 34 years of service. “In addition, faculty and staff and several student organizations sent friendly cards, notes, toiletries, and snacks while I was deployed,” she said. “This connection to home really boosted morale. The support while deployed was phenomenal, and was shared with fellow troops. This national recognition reaffirms what those of us who are vets already know about the School: It’s simply the greatest!”
Becky Benson SUMMER 2013 | 13
America’s Top Rural Doc Larry Rhodes’ calm voice, graying beard, and well-worn cowboy boots are familiar to hundreds of parents in rural West Virginia who have a child with heart disease or a congenital heart defect. He travels the state holding outreach clinics for children with cardiovascular issues. And in 2013 he was named the National Rural Health Association’s Rural Health Practitioner of the Year.
photo Eve Faulkes
WVU School of Medicine ranked No. 3 for Rural Medicine by U.S. News The WVU School of Medicine has received its highest ever national ranking for an educational program, coming in at number three in rural medicine. The ranking is published in the latest issue of U.S. News and World Report’s 2014 edition of “America’s Best Graduate Schools.” A graduate of the WVU School of Medicine, Dr. Rhodes trained in pediatric heart care in Boston and joined the faculty at WVU for several years prior to accepting a faculty position at Children’s Hospital of Philadelphia. There, he gained national and international acclaim as a foremost expert in pediatric electrophysiology— a specialty generally practiced deep within the walls of a major medical center.
Norman Ferrari, MD, vice dean for education and academic affairs in the WVU School of Medicine, said, “We have had a required rural health experience in our curriculum for more than two decades. It has influenced many to stay and make West Virginia their home – that’s been especially important in rural areas of the state.” The School of Medicine overall was ranked No. 85 for research institutions, and No. 66 in primary care. The 2014 edition of “America’s Best Graduate Schools” also included lists of other health schools and programs, which were ranked last year: WVU School of Pharmacy – No. 26, Physical Therapy – No. 62, and Occupational Therapy – No. 116.
To the surprise of his colleagues around the country, Dr. Rhodes left Philadelphia in 2006 to lead WVU’s children’s heart program. He is now chair of Pediatrics and Physician-inchief of WVU Children’s Hospital, with a mission to serve all of West Virginia’s children. Jill Cochran, a family nurse practitioner in Greenbrier County, calls on him frequently. “Having someone of Dr. Rhodes’ caliber with whom rural providers can consult is a wonderful resource in assuring excellent care of children in rural areas of the state,” she said. Since 2011, he has also served as director of the WVU Institute for Community and Rural Health. Last year, under his leadership, 400 WVU students in eight separate health professions programs completed 2,700 weeks of training at rural sites. He has also developed new scholarship and incentive programs for medical and dental students planning careers in rural health.
photo Amy Johns Sky Gwinn’s grandfather, Dr. James Gwinn, is 88 years old and practices family medicine in Oak Hill, West Virginia. Sky wants to follow in his footsteps: to be a doctor, see patients, and make a difference in people’s lives. “I think that’s the number one goal of anybody going into medicine,” he said. As one of WVU’s Dakota Rural Health Scholars, Sky’s plan is to return to hisJackson hometown of Meadow neuroscience graduate student Bridge, West Virginia, to practice medicine after completing his residency and Paul Holcomb military duties. neuroscience graduate student For more of Sky’s story, see http://bit.ly/10KB9Nh. George Spirou, PhD director, WVU Center for Neuroscience
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Ultrasound: Instant Anatomy
photo Heidi Specht
WVU School of Medicine first-year students (l to r) Benjamin Crowder, Lauren Glikes, and Nicole Garcia use handheld ultrasound to examine a patientâ€™s heart. Thanks to their portability, devices like this one have become more affordable and are gaining popularity among physicians.
A portable tool for rural patients by April Henry
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“There is a definite shortage of physicians, dentists, and pharmacists in our state, particularly in rural communities. Elderly patients often have to travel quite a distance to receive specialized care, for which many of them do not have the funding. I would like to see students in all health-related disciplines spend a portion of their practicum or residencies in small communities.” —R. Kelly Massie, Jr., RPh, PharmD, ’82
The longitudinal ultrasound curriculum at WVU will enable students to make advanced medical technology more accessible to rural West Virginians. “A lot of times, we see a patient and say, ‘Go get the technology and the labs, and then we’ll talk about it.’ With portable ultrasound, you can say, ‘Right here, I have this ability to hopefully make a diagnosis for you right now.’ Especially in rural West Virginia, that can be a crucial difference. For some West Virginians, a hospital might be 60 or 80 miles away,” said Joseph Minardi, MD, (WVU, MD, 2003) who leads the ultrasound curriculum in the School of Medicine. With ultrasound, WVU School of Medicine first-year students view the heart’s chambers, watch the valves open and close, and identify the direction of blood flow. During the first-year gross anatomy course, using ultrasound boosts students’ understanding of the body’s anatomy and shows structures and organs in real time with real patients. “My favorite part of ultrasound is being able to interact with the standardized patients and volunteers. In the first two years of medical school, it’s possible to hone one’s mind onto the science aspect and begin to lose focus on the true purpose of medicine: the patient. Learning ultrasound allows us the patient interaction and care that will define the difference between becoming a good doctor and becoming a truly great physician,” said Benjamin Crowder, a first-year WVU School of Medicine student.
“With portable ultrasound you can say, ‘Right here, I have this ability to hopefully make a diagnosis for you right now.’ Especially in rural West Virginia, that can be a crucial difference.” “So far it’s the best bedside tool that’s ever been invented for a physician,” Minardi said. But this technology doesn’t replace a good doctor-patient relationship. “With ultrasound, you’re often spending a few extra minutes with your patient,” he added. “You might think you found something on the physical exam and then you can confirm it and be sure with ultrasound immediately.” Ultrasound is not just for physicians. Physical therapists frequently use it in their practices; Minardi is working on a training program for nurses to help them use ultrasound for starting IV access. “That’s something we’re continuing to grow and expand.”
Ultrasound devices send sound energy through the body and record how it reflects back on handheld devices or screens as small as a tablet or as large as a standard computer monitor. In a doctor’s office, it can be used to evaluate skin infections, musculoskeletal disorders, cardiovascular disease, lung disorders, and many other health problems.
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“My hope is that I can help my patients, especially those in need of or without insurance, to have lower cost alternatives in their medications.” —J. Shane Beam, PharmD, MBA, ’12
Business of Health by Amy Newton
Joint healthcare-business degree programs at WVU enable pharmacy, medical, and dental students to apply a real world approach to the business aspect of healthcare. The Master of Business Administration dual-degree program at WVU is a cooperative effort of the WVU Schools of Medicine, Pharmacy, and Dentistry and the WVU College of Business and Economics. “The background knowledge from the MBA program will give me the skills and tools I need to look at the big picture economically for a medication,” said third-year student pharmacist Nick Vucurevich of Mechanicsburg, Pa. “A pharmacist can weigh its potential advantages for patients. With business skills, I will be more able to predict demands for medications, or help to decide what medications to include on formularies that would provide the most benefit medically to patients as well as economically to the payers.”
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Health professionals devote years learning how to care for patients, but once they’re out of school, they often find that financial issues complicate healthcare in ways they haven’t anticipated. “Physicians are asked on a regular basis to make decisions on the allocation of resources,” said Arthur Ross, MD, MBA, dean of the WVU School of Medicine. “These decisions have an impact upon the quality and safety of patient care.” Earlier in his career, Dr. Ross earned a master’s degree in business administration, a decision that he says benefits anyone in a healthcare leadership role. “I think we all need some fundamental understanding of business principles,” he said. The MBA program at the WVU School of Pharmacy grew in part from the experience of J. Shane Beam, who
photo Bob Beverly Pharmacy Dean Dr. Patricia Chase and WVU College of Business and Economics Dean Dr. Jose “Zito” Sartarelli sign an agreement to establish the dual degree program.
earned his PharmD and MBA degrees in 2012 before a formal dual-degree program was created. “The most knowledgeable pharmacist in the world cannot help his or her patients if there’s not enough money coming in to keep the doors open. My hope is that I can help my patients, especially those in need of or without insurance, to have lower cost alternatives in their medications,” Dr. Beam said. With the dentistry field dominated by independent practitioners, an MBA degree will help dentistry providers learn more about the business aspect of running a small or private practice. “WVU is only one of eight dental schools nationally to offer an MBA option,” said David Felton, DDS, dean of the WVU School of Dentistry. “The DDS/MBA course will provide the necessary skill set that will enable our graduating dentists to make good business decisions in their practices, and improve their delivery of care for their patients.”
“The MBA dual degree program adds to their curriculum a dose of skills that will enable them to become more responsive to the needs of their organizations and, ultimately, their patients,” said Jose “Zito” Sartarelli, PhD, Milan Puskar Dean, WVU College of Business and Economics. Currently, four students have enrolled in the dual-degree sequences, three from pharmacy and one from dentistry. “Compassion, treatment, and improving the quality of life for their patients will still remain at the forefront of the care our graduates will deliver,” said Patricia Chase, PhD, dean of pharmacy. But now, they’ll also be finding ways through business to serve their patients better. That gives our graduates a competitive edge when they graduate and enter the workforce.”
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BRIEFS School of Nursing WVU was selected for a two-year, $700,000 Advanced Education Nursing Traineeship grant from the U.S. Department of Health and Human Services. It will provide stipend support to 36 students in the Master of Science in Nursing program. School of Public Health Jeffrey Coben, MD, has been named interim dean for the School of Public Health. Dr. Coben, a member of the WVU faculty since 2004, is the director of the Injury Control Research Center. School of Medicine Every member of the medical school’s Class of 2014 passed the United States Medical Licensing Examination (USMLE) Step 1 on the first attempt. Celebrating with the students, Dean Arthur J. Ross called it “a rare and phenomenal accomplishment” for any medical school, comparing it to “pitching back-to-back perfect games or having an undefeated season.” Fourth-year medical students Justin Arner and Connor Louden spent February on a surgery rotation at Oman Medical College, thanks to the school’s academic partnership with WVU. They are the first WVU medical students to do part of their training there since the school opened in 2001. The Physical Therapy Program celebrated 40 years of service in 2012; it has more than 900 graduates. One founding faculty member from 1972, John Petronis, MS, PT, currently serves as assistant chair.
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Ronald L. Gross, MD, a 1982 graduate of the School of Medicine, has been appointed chair of the Department of Ophthalmology and director of the WVU Eye Institute. Dr. Gross was previously the Clifton R. McMichael Chair in Ophthalmology at the Baylor College of Medicine. School of Pharmacy Dean Patricia Chase, PhD, has been selected as president-elect of the American Association of Colleges of Pharmacy. After a year in this post, she will be the organization’s leader in 2014-15. Dr. Chase is the third WVU pharmacy dean to head the group since 1948. The Class of 2014 is collecting coins around campus to establish a “CENTennial Class Scholarship Fund” to help support future pharmacy students. School of Dentistry First-year student Mona Meky has been named a National Health Service Corps Scholar. After graduation and training, she is committed to practice dentistry in a high-need area in exchange for this scholarship support. The State of West Virginia has allocated $1.5 million to promote the recruitment and retention of new dentists in professional shortage areas throughout the state. Graduating dentists can receive up to $50,000 for a two-year commitment to practice a shortage area. Charleston Division L. Clark Hansbarger, MD, associate vice president for health sciences and dean of the WVU School of Medicine’s Charleston Division for the past decade, retires at the
end of June. A specialist in family medicine and pediatrics, he is the former director of the West Virginia Department of Health. J. Gregory Rosencrance, MD, will serve as interim dean. Elizabeth Scharman, PharmD, professor of clinical pharmacy and director of the West Virginia Poison Center, won the American Academy of Clinical Toxicology’s 2012 Distinguished Service Award. Health Sciences Center Students in Dentistry, Pharmacy and Medicine will be their own “first patients” in the new WVU Center for Healthy Practitioners, supported by the Benedum Foundation. The center will train students in disease prevention based on personal behavior change. Chancellor Christopher C. Colenda, MD, MPH, has been selected to a one-year term as chair of the Liaison Committee on Medical Education, the accrediting body for medical schools in the United States and Canada. Research A widely reported study led by Dana King, MD, chair of the Department of Family Medicine found that baby boomers have higher levels of hypertension, diabetes, high cholesterol and higher rates of disability than their parents. The results appeared in the March issue of JAMA Internal Medicine. Lan Guo, PhD, of the Mary Babb Randolph Cancer Center was awarded a five-year, $1.67 million grant from the NIH to study the impact of carbon nanotube exposure on pulmonary diseases, including fibrosis, a precursor to lung cancer.
West Virginia United Health System J. Thomas Jones, who as leader of the West Virginia United Health System engineered its growth into the largest healthcare organization in the state, told the group’s board on Jan. 25 that he intends to retire at the end of 2013 after a 41-year career in healthcare. Chancellor Christopher C. Colenda, MD, MPH, has been selected to fill the post.
University Healthcare All WVU-related healthcare services in the Eastern Panhandle now are part of University Healthcare – a name that will let patients know they’re being cared for by a member of the University’s health group no matter which office they choose. The hospitals serving Berkeley and Jefferson counties – formerly City Hospital in Martinsburg and Jefferson Memorial in Ranson – are now known as University Healthcare-Berkeley Medical Center and University Healthcare-Jefferson Medical Center.
“The WVU presence here has brought major improvements in the healthcare delivery system — better technology, more specialists, improved facilities and a strong affiliation with the state’s leading teaching medical institution.” Bob Baronner President, Bank of Charles Town
WVU HEALTH SCIENCES COMMUNITY ENGAGEMENT IMAGES WVUhealth’s summer 2013 image contest focused on photographs that portrayed West Virginia’s engagement with communities, schools, and the world as a whole. Below are the winners.
1 First Place: Freedom’s Run Children’s Run, Fall 2012 Second Place: American Legion Riders, Chapter 81, of Pine Grove, West Virginia., conducted a 145mile poker ride on September 30, 2012, to benefit Bonnie’s Bus. Motorcycle riders lined up in front of Bonnie’s Bus during their stop at the WVU Health Sciences Center. Third Place: Freedom’s Run, Fall 2012
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AMERICA’S TOP RURAL DOC WVU’s Larry Rhodes, MD see page 14