The Resource Guide to Your Medical Community
www.BestPracticesMD.com Fourth Quarter 2012
PLUS The State of Modern Healthcare Today UTMB Plans $82 Million Expansion Local Docs Help Overseas
Unit Cost Analysis Determine Your Practice’s Cost For Each Service
Healthcare Risk Management Page 10
Utilizing Video Marketing Page 14
Breast Cancer:
A Survivor’s Story Page 22
CONTENTS
Fourth Quarter 2012
Letter From the Medical Director 7 The State of Modern Healthcare Today - Trends and Challenges CLICK! 8 Best Practices Quarterly Launch Party Physician’s Corner 10 Risk Management in Physician’s Offices Feature 12 Performing a Unit Cost Analysis Business of Medicine 14 Video Marketing for Healthcare Professionals Local Focus 16 Dr. Greg Clariday and Dr. Farid Noie 20 UTMB Plans $82 Million Expansion in League City 22 A Survivor’s Story - Local Resident Fights Cancer at M.D. Anderson 4 |www.BestPracticesMD.com | Fourth Quarter 2012
PUBLISHER/CHAIRMAN Rick Clapp President Santiago Mendoza Jr.
EDITORIAL Editor Mary Alys Cherry Medical Director Victor Kumar-Misir, M.D. Contributing Writers Mary Alys Cherry Nolen Davis Rod Evans Joe Herrera Amanda Kuenstler Victor Kumar-Misir, M.D. Santiago Mendoza, Jr. Pat Patton
ART Creative Director Brandon A. Rowan Graphic Specialist Victoria Ugalde Photography/Editing Brian Stewart
ADVERTISING Director of Advertising Patty Kane Account Executives Patty Bederka Natalie Epperly Rob Kumar Santiago Mendoza Jr. Amber Sample
PHONE: 281.474.5875 FAX: 281.474.1443 www.BestPracticesMD.com Best Practices Quarterly is trademarked and produced by Medical Best Practices Group, LLC. Best Practices Quarterly is not responsible for facts as presented by authors and advertisers. All rights reserved. Material may not be reproduced in part or whole by any means whatsoever without written permission from the publisher. Advertising rates are available upon request. Best Practices Quarterly P.O. Box 1032 Seabrook, TX 77586 R.Clapp@Baygroupmedia.com
From the Medical Director
LETTER
The State of Modern Healthcare Today - Trends and Challenges Modern medicine is capable of incredible feats of human preservation and health promotion. By Victor Kumar-Misir, M.D.
In principle medicine is fundamentally the interface between the patient’s clinical database and the medical literature, mediated by the medical profession. Patients – increasingly internet instructed – are conscientious consumers, demanding best care. There is an opportunity to establish costsaving, care-enhancing, practical doctor/ patient partnerships by creatively utilizing the four pillars of information technology. Clinical database – Medical care is an informed decision-making process. Despite the sophistication of modern investigative technology, much of the information necessary for making diagnostic conclusions and therapeutic decisions remains the subjective information locked in patient memory, retrievable by communication. Poor communication, especially when due to limited English proficiency, leads to delayed or missed diagnosis, and incurs otherwise unnecessarily excessive investigations and consultations, all heavily costly to the healthcare provider fiscally, and to the patient physically. Effective communication requires time, language compatibility and comprehensiveness. Automated self-administered, translingual questionnaires can provide comprehensive clinical information, reducing costs and enhancing high quality care individually. They can also provide mass, multilingual, medical screening on site, to identify and isolate infected individuals, in order to curtail the global proliferation of pandemic microbes. Medical literature, already voluminous, is rapidly expanding and constantly changing. Since William Osler’s 1898, 1811page compendium of the world’s medical knowledge, the medical literature has exploded into a voluminous library, in print and increasingly online. There is a need for instant, selective access to the most recent literature, 24/7. The medical profession – a complex Collective Medical Expertise in diaspora. Today, the medical profession is a plethora of healthcare specialists of various disciplines in diaspora, but lacks the traditional institutional medical record connectivity, leading to costly duplication of services and investigations.
There is a need for cost-saving, universally standardized, online, secure, doctor-to-doctor medical data connectivity. In reality, modern medical care is no longer an isolated private doctor/patient encounter. Modern medicine is, in practice, the interface between the retrievable patient database and the voluminous medical literature, mediated by an unconnected, diversified, collective medical expertise in diaspora, limited by availability, accessibility and affordability, and subject to licensing, litigation and fiscal acceptability and accountability. Availability Multi-specialty clinics and hospitals are concentrated mainly in urban areas. In many rural communities and in the third world, medical services are unavailable. The need for telecomputing and secure, costsaving telemedicine for distant care is apparent. Accessibility After business hours, regular patient care may not be time-accessible, leading to overutilization of expensive emergency rooms for minor illnesses. While this may be relieved by rotating physician coverage, urgent care centers and walk-in clinics, they do not offer follow-up care. Timely transmission of covering doctors’ medical data to personal physicians, for efficient follow-up, is necessary to facilitate continuity of care and reduce costs. Accountability A doctor’s performance is now under the scrutiny of patients, peers, public, press and plaintiffs. The medical record has emerged as a barometer, whereby a doctor’s competence is now judged. The need for comprehensive recordkeeping is thus of paramount importance in a largely litigious society, as well as to appease controlling licensing and other regulatory bodies. Acceptability The Supreme Court’s 1993 Daubert vs Dow decision replaced individual expert testimony with evidence-based medicine that relies heavily on published studies, which are voluminous but often conflicting, controversial and inconsistent. This has led specialty organizations to formulate acceptable diagnostic and therapeutic management
protocols, which membership doctors are recommended to follow. The need for online, updated specialtyspecific management guidelines online is a medico-legal necessity to ensure acceptable standards of care. Affordability By far the greatest impediment to healthcare delivery today is affordability. The very explosion and sophistication of medical investigative and therapeutic modalities that epitomize medical care excellence has unfortunately made healthcare largely unaffordable by the individual, and has delayed the Alma-Ata Declaration of 1978 – “Health for All by the year 2000”. The advent of government and private-based third party coverage are competing for ways of equitable healthcare delivery to citizens. Amiability In navigating the complex multi-disciplinary healthcare delivery infrastructure today, at any one moment in time, the patient’s satisfaction with the interpersonal provider/patient encounter is essentially governed by bedside manner and body language, compassion and empathy, as well as translingual communication skills and cross-cultural sensitivity. In conclusion, after William Osler’s inspiring 1898 monumental work, the 20th century saw an astronomical explosion in medical knowledge and capability. The challenge to the 21st century is to make this incredible life-and-limb-saving capability available and accessible to all, regardless of language, literacy, location or level of income. The establishment of the global digital telecommunications infrastructure and advances in interactive voice/video telecomputing technology, integrated with medical knowledge datasets and linguistic equivalents, now make it possible to realize the lofty goal of the Alma-Ata Declaration – “Health for All” (HFA). Better communication and Better connectivity = Better care and Better cost
Victor Kumar-Misir, M.D., is an international physician, who has spent the past 40 years integrating translingual, cross-cultural healthcare delivery with emerging information-management technologies, with the goal of delivering healthcare to all individuals, regardless of language, literacy, location or level of income. Fourth Quarter 2012 | www.BestPracticesMD.com|
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Kippy Caraway and Mary Alys Cherry – BAHM’s Publisher
Victoria Ugalde - BAHM and Patty Kane - BAHM
Santiago Mendoza, Jr., Rick Clapp and Rob Kumar Dr. Virginia Nisbet and John Nisbet
Dr. Swet Chaudhari and Pauline Sawyer
Best Practices Quarterly Launch Party Entertainer Mickey Hobbs
Nolan Davis and Joy Weiner
Jim Guidry, Lynda Guidry and Pat Patton
The Best Practices Quarterly Magazine Launch Party, held at Cullen’s Live Wednesday, Aug. 16, was hosted by the medical quarterly’s Chairman /CEO Rick Clapp and President Rob Kumar. The evening was both a very successful Launch Party, and also an event that honored and recognized the outstanding physicians and healthcare professionals in the Bay Area Houston area. Best Practices hit two home runs: A brand new issue of the magazine, and a huge turnout of over 100 people to celebrate the launch of the new publication that is a resource guide to the medical community. Entertainer Mickey Hobbs, who is always a favorite singer in the Bay Area Houston area, did a wonderful job of entertaining the crowd. The goal of Best Practices is to promote and economically develop our local Bay Area Houston Medical Complex and all of the physicians and healthcare professionals. The magazine’s focus is to recognize local doctors, medical and healthcare workers who are making a difference, and also educate consumers about all the various services and new medical technology that is available locally without having to go to the congested Houston Texas Medical Center. Clapp, who is also chairman of Bay Area Houston Magazine said, “we never expected the great success we have experienced on our inaugural issue. Not only was it an editorial and quality advertising piece, it was also a financial success. Needless to say, we are excited about the future and plan on having licensing agreements with individuals in Fort Bend County, Beaumont and Kingwood area by the end of the year.” Best Practices’ coverage area includes Pasadena, Pearland, Friendswood, Webster, Clear Lake City, Seabrook, Kemah, League City, and Galveston County. A total of 10,000 copies will be printed each quarter, and will be delivered to doctor’s offices, medical complexes, hospitals, office parks, marinas, yacht clubs, country clubs, fine restaurants and upscale merchants. If you, or anyone you know would like a licensed agreement with Best Practices, contact Rick Clapp at 218 -474- 05875, or r.clapp@baygroupmedia.com. Lisa Brinkley, Santiago Mendoza, Jr. and Brandy Gates
Rupendra Radia and Paul Antony
Dr. Cynthia Phillips and Preston Phillips
Margaret Sucre’ Vail and Henry Vail
Risk Management in Physician Offices
I RECENTLY LISTENED TO A CONFERENCE put on by Josh Hyatt DHSc(c), MHL, CPHRM, a Risk Management Specialist with NORCAL Mutual Insurance and Kelley Chrouser, PhD, Manager of Education with American Society of Healthcare Risk Managers (ASHRM ) who raised several key points in the world of risk management and physician offices.
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n the realm of risk management, the potential for claims against physician’s offices has often lain quiet like a sleeping grizzly bear but in the last few years the grizzly has awoken and you may have to run for your life. According to Physician Insurer Association of America, PIAA, data collected across the nation found that between 1985 -2010 an increase of 87% of malpractice claims have been brought against physicians’ practices. General Surgeons have seen claims increase of 102% as their indemnity has increased by 65%. From 1997 – 2008 jury rewards have increased by 130%. Even though Texas has placed a cap on non-economic damages to $250,000, the struggle of defending yourself and your practice can take a heavy toll on your practice, emotional well being and your reputation. As a global picture, some of the risks stem from less regulation of physician offices than hospitals but the anxiety is still the same. Most physician offices are very informal and normal everyday events can drift into a practice, which becomes the liabilities. A physician often can become overwhelmed with the enormity of these complications he/she is faced with on a daily bases and can feel like they have little or no control. Much like a sleeping bear, there are few things you can do when coming across a grizzly. We will take a look at liabilities in physician’s offices and strategies to decrease the chance of awakening the bear. Some of the major culprits of malpractice are missed or delayed diagnoses, medication
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error/adverse drug reactions, lack of communication and poor documentation. According to PIAA, in a 1999 report, the five diagnoses most associated with malpractice claims are: Myocardial Infarction, Breast Cancer, Appendicitis, Lung Cancer and Colon Cancer. Much of this is “due to extensive publicity and the public’s expectations for prevention and cure.” (PIAA) When these claims are taken to court the jury can focus on the 30 year old man, for example, who came in with chest pain after mowing his lawn. Was a stress test done, was the standard of care met? The lack of documentation often supports the lack of care in the jury’s mind and they can easily resonate with the plaintiff.
10 high risk areas for physician offices • • • • • • • • • •
Decreased patient satisfaction Terminating patients from practice Vicarious liability issues Lack of adequate follow up Poor medication management Lack of communication with patients and other providers Office staff exceeding their scope of practice Inadequate or missing documentation Difficulties with electronic medical record transition Lack of risk management planning
By Amanda Kuenstler
So what can you do? Is the old saying true? Happy people don’t sue…well, sometimes. Today the public has a stronger sense of what they want out of their physician. Issues surrounding patient satisfaction are: poor communication, extensive wait times, “doctor didn’t listen to me,” telephone callbacks, and increase cost are some of the dissatisfiers.
“Between 1985 - 2010 an increase of 87% of malpractice claims have been brought against physicians’ practices.” Some strategies to help improve patient satisfaction are to use a variety of loopclosures by making sure diagnostic test and consultant referrals are followed. Evaluate your billing process and discuss payments prior to patient’s arrival. Also taking care of telephone etiquette and maintaining a call log system. Many patients complain of the lack of attentiveness of their physician. One way to avoid this is to ask open ended questions, not just ‘yes’ ‘no’ questions. Repeat back the most concerning symptoms to the patient. And give the patient enough time to ask questions. The National Patient Safety Foundation is promoting communication between healthcare providers and patients by teaching three simple questions to the patients.
“Each certified and licensed allied health professional has a defined scope in which they are legally bound. Knowing these scopes of practice is vital to decrease your liability.”
1.What is my main problem? 2. What do I need to do? 3. Why is it important for me to do this? These three questions can help your patients identify and leave your office with more understanding of their situation. Another dissatifier is extensive wait times for patients. I recall waiting in the pediatric cardiologist office with my ten year old son, with a new diagnosis of heart abnormalities. We waited over an hour in the lobby and then another hour in the exam room. While sitting with a squirming ten year old, I could hear the physician in the next office on the phone talking about buying a $250,000 boat. You can imagine I was infuriated and my steely eye stare at the physician when he walked in. He did not apologize for the wait time and we never went back. Strategies to improve wait times are to evaluate your scheduling system. Leave enough time for acute patients. Be respectful of your patient’s time thanking them for extended waiting and explain extended wait time issues. (not sure making a boat deal is legitimate!) . Another patient satisfaction strategy improvement is calling the patient 24 to 48 hours in advance to ensure their appointment. Two other liabilities are vicarious liability and staff exceeding their scope of practice. These are key elements to an effective risk strategy. The legal principle is: Respondent Superior: “let the master answer.” By definition means: An employer is held liable for the negligence of his employee, as long as the employee was acting within the scope of their employment. Know your employees job descriptions and what they can and cannot do. Create policies and procedures in the office or guidelines and communicate them to your staff of what is expected. And make
sure your staff is trained and competencies documented on items such as new equipment, etc. Each certified and licensed allied health professional has a defined scope in which they are legally bound. Knowing these scopes of practice is vital to decrease your liability. Another liability in today’s clinic settings is diagnostics. This is one of the highest liabilities today according the National Patient Safety Foundation, NPSF “Studies have shown that malpractice claims related to diagnostic errors outnumber all other classes of medical error.” These often happen in physician offices. Key strategies can be found at (www.npsf.org/the-doctorscompany). Having a plan and system in place to follow up with test results and consultant referrals is imperative in today’s fragmented healthcare situation.
RULE OF THUMB: You ordered it you own it!
If you did not order it and you see a positive result on a test, make sure you either call the physician who ordered it or encourage the patient to follow up with that physician. Due to the complexity of varieties of specialists a patient can become confused on who will give them the results of tests. For example, they may go to their general practitioner instead of the oncologist who ran the tests, and ask for the results, leaving the practitioner to explain a positive cancer result due to the lack of communication from the oncologist’s office. This places the general practitioner in an odd situation. But in a Supreme Court ruling Taig v. Glazer in 1999, the courts stated, “ It is the responsibility of the medical system and healthcare providers to assure that patients are being treated and being followed. Even in the case of a non-compliant patient, this responsibility does not dissolve. So, even if your fellow practitioners fail to communicate, your responsibility is to help the patient receive the best care possible. Lack of communication, inadequate documentation and difficulties with the electronic medical record seem to blend in together. “A lack of EFFECTIVE patientphysician communication is the second highest cause of malpractice claims,” a plaintiff attorney wrote this quote. Key strategies to address better communication is your rapport with the patients, “Ask me 3 questions suggested by the NPSF, as discussed in the previous section, can be seen on video at (www.npsf.org/ uncategorized/ask-me-3-video-released). It is also important to use plain, basic language. If a translator is needed, a phone translator service needs to be already set up as a plan in your office. Documentation of
your communications with the patient and other medical providers is extremely essential to document follow through. The statement, “ if it wasn’t documented it wasn’t done” is not necessarily true. There are many things done everyday that are not documented that can be proven as your everyday course of practice but it is so much easier to defend if it was written down. Strategies to address documentation are to identify any patient education given to the patient, note questions raised by the patient and all advice given. In the newer age of the electronic medical record we are often more confused than when we used plain pencil and paper. Many software programs are fragmented information when printed and making sense of the record can be surmounting. Computers were supposed to make our lives easier. Right? EMR’s often come with prompts, alerts and meta data causing an overload of information. Transition to EMR from paper process will be difficult to manage but it can be done. Strategies include learning to think differently, processing your thoughts differently and organizing your routine differently. It is important to take time to practice to learn the technical aspects of the programs used and allow your cognitive skills to catch up. The main goal of the physician office is to have a risk management plan. Have you ever had a day that was seemingly going well and you look up and feel like a the grizzly bear is inches away from you face? It is a little too late for an exit strategy at this point so risk management planning is key to manage your physician office practice.
Key points to remember • • • • •
Help control panic in the office. Give staff the confidence to know “what to do next” Control problems before they get out of hand Establish clear guidelines and expectations Improve awareness of critical issues provides for a structured work environment.
Developing a risk management plan and focusing on strategies stated above will improve your office management and give more confidence to you and your employees. This will not however, ensure a claim may be made against your office practice, but you can have more confidence it may end with a better outcome. Amanda Kuenstler is the owner and president of Kuenstler Consultations, Inc., a legal nurse consulting company.
Fourth Quarter 2012 | www.BestPracticesMD.com|
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Performing A Unit Cost Analysis By Joe Herrera
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WITH THE PRESSURE ON PHYSICIANS TODAY to accept payer contracts that are reduced to either just above Medicare rates (or even worse ‘below’ Medicare), it is very important for physicians to know their “unit cost” for providing a particular service.
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his unit cost analysis takes into account all of the resources associated with providing a service and calculates how much it costs to provide the service at the smallest practical unit. An example is determining the cost of providing a physical exam, a wellness exam, or any other procedure predominantly performed by the physician. Actual unit cost information is highly useful to the physician when creating budgets, establishing a fee schedule or negotiating rates with payers. Until a unit cost analysis is performed, the physician does not truly know what the ‘profitability’ is of the reimbursement for a particular procedure or service. The analysis provides the physician with either a figure to use to negotiate more acceptable reimbursements or to determine whether the particular contract is even worth renewing.
While most physicians might agree with the presumed benefits of unit cost information, they might question the practicality of actually performing a unit cost analysis, fearing that it requires vast and expensive resources such as computer systems or accounting training. However, these elements are not necessarily needed and the physician can acquire accurate and actionable cost information about the care provided by simply following some important steps that can be modified easily to suit the physician’s specific practice environment:
“Until a unit cost analysis is performed, the physician does not truly know what the ‘profitability’ is of the reimbursement for a particular procedure or service.”
Define the unit of service to be evaluated. Some of the more common units of service include an office visit, physical exam, officebased procedure, etc.
Determine the volume of units of service provided. A period of time must be chosen to do this accurately and it must be complied with throughout the analysis process.
Calculate the direct costs of providing the service. This includes physician and staff salaries, benefits, medical supplies, diagnostic tests, or any other resources used at the time of the service.
Calculate the indirect costs. This can include administrative staff salaries and benefits, facility costs, insurance premiums, office equipment and supplies, and any other resource that is not directly associated with the service or procedure (but without them that service or procedure could not be possible). Calculate the depreciation and value of equipment used.
provided in the designated period of time to arrive at a depreciated cost per unit of service.
Determine the full cost of the unit of service. By adding the costs from steps 3, 4 and 5 you arrive at the cost per unit of service. As physician practices continue to operate in today’s extremely challenging payment environment, the need for accurate and actionable cost information is crucial. This unit cost information will also serve as a valuable resource for budgeting, management improvement, and efficiency planning purposes. Altus Practice Management can help physicians perform a detailed unit cost analysis for all major services and procedures you perform that will provide a good foundation for not only improving profits, but also for determining the profit potential of existing and future managed care contracts. To learn more, call 832-230-8893 or email APM@altushms.com.
Using straight line depreciation to calculate this cost will result in an amount that can be divided by volume of units of service
Altus Practice Management is led by Joe Herrera, Vice President of Physician Services. Joe has more than 25 years of healthcare management and practice consulting experience. Fourth Quarter 2012 | www.BestPracticesMD.com|
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Video Marketing for Healthcare Professionals By Nolen Davis
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SEARCHING FOR A DOCTOR or any health care professional is one of the most important choices a person can make. Doctors therefore must market themselves effectively to assist in those decisions.
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tatistics show that video marketing is the optimum medium for today’s business owners to advertise, reach target audiences, optimize search engine ranking, showcase products and services, engage, communicate clearly, and educate customers. The health care industry is no exception. Doctors, dentists, physical therapists, and clinicians need to get their message out about all aspects of their practice and emphasize their specialties. Video for health care practices is the most effective way to get your practice noticed, distinguish you from the crowd, bring people to your website, keep them there longer, generate calls for appointments, build loyalty, inspire patient confidence, and generate referrals. Video is also the most cost effective marketing tool for the health care industry. The health care industry has the same marketing goals as any other industry. However, because it involves health, there are additional emotional, sensitivity and confidence components that take priority and must be kept in mind. Videos are excellent for explaining sensitive information when words alone may not be enough. That is why a professionally produced video is a must in this industry.
The Power of Video We all are aware that Internet marketing is big in every industry in today’s business world. Again, the health care industry is no exception. The Internet has become a vital part of business promotion for private practices, hospitals, and other health care related products and services. The Internet has determined not only how customers and patients search for a doctor but how they choose a doctor as well. A portion of a health care professional’s advertising budget is certainly allocated to Internet marketing. A health care professional’s website is like an online brochure. But, even with a website with all the bells and whistles customers still have to read the content and navigate effectively to discover what sets your practice apart from the others. Simply put, websites may not fully engage clients or potential patients. A video on your website could make all the difference. A video on a dentist’s website, for example, can inform patients not only about tooth and gum conditions but also inform and invoke interest in other products and services you offer that they may not have been aware of. It is the
“Video is an optimal way to focus on one specialty or aspect of your practice and the most effective way to show a combination of elements about your office services.” optimal way to educate patients about advances in modern dentistry and calm their fears by assuring them of the painless treatments you offer. A well-produced video is the most powerful way to introduce yourself and your staff to prospective patients. A patient learning about your practice and services directly from the very people who offer them while allowing them to experience the look and feel of your office is a significant engagement with potential patients seeking a professional to take care of their health. They will feel more knowledgeable, comfortable, and familiar and that will inspire confidence in you and your office.
Video is an optimal way to focus on one specialty or aspect of your practice and the most effective way to show a combination of elements about your office services. You may want to emphasize experience or that your practice has served a certain area and population for many years, and offer patient testimonial videos to show patient trust and loyalty. But, you also want it known that your practice has grown with a look to the future keeping up with all the state-of-the-art medical advances. A video on your website is the best way to drive both objectives home to your clients. Internet search engines are used to direct customers to websites but, you definitely need an advantage to move your website up search engine’s response chain. When a potential patient searches the Internet for a foot doctor for example, and gets 5,470,000 responses, it is overwhelming. Where is your practice’s website in all that? And, they would be required to search for a specific subject and your site could be missed altogether. You need an advantage to optimize your search engine exposure. That’s where video comes in. Videos enhance search optimization on engines like Google, Yahoo and AOL. Having a video makes your website 50 percent more likely to appear on Google’s first page results. Once on your site, 55 percent of people will stay more than double the time after viewing a video that engages, educates, captivates and communicates clearly. It has always been said that the best advertisement is word of mouth. People
“You can display videos in your office, on your website, at presentations, conventions, on YouTube, or on your Facebook page.”
may trust it more than paid ads especially where their health is concerned. Social networks are the new word of mouth because the referral comes from a “friend.” The new difference is each word of mouth referral on a social network site reaches many people not just one. Videos play an important part in this most trusted word of mouth approach because although the referral comes from a third party, videos allow you to show your stuff. Also, authentic professionally done testimonial videos are almost a must have because of their huge influence on potential customers. Research shows that 31 percent of people will make a positive decision after viewing a testimonial video. Imagine your testimonials shared on the vast social network. Your practice can have its own Facebook page, Twitter account, YouTube channel, or blog. You can belong to a micro-community related to your specialty or geographic area. Your video on social networks can generate referrals, showcase your practice, and result in calls for appointments. This kind of promotion is priceless! Videos are extraordinarily cost effective because they are so versatile. You can display videos in your office, on your website, at presentations, conventions, on YouTube, or on your Facebook page. Videos have a particular advantage because they can be tailored to a specific population such as seniors, women, or athletes. Particular health issues, or procedures can also be the focus of a video such as high blood pressure, stroke prevention, or
cosmetic surgery. Videos can be particularly beneficial for rehabilitation therapy -- not only for marketing or during physical rehab, but for post rehab patient care. So, how does a patient choose which dentist or doctor to go to? A better question might be how does a health care professional exhibit and market his or her specialties, expertise, experience, office environment, and customer service, in a way to attract patients and help them make that choice? The answer is video. For more information on video marketing please call Bay Group Media at 281.474.5875 Fourth Quarter 2012 | www.BestPracticesMD.com|
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Rotarians honor Dr. Greg Clariday SPACE CENTER ROTARY has made Dr. Greg Clariday an honorary member of the Clear Lake club to recognize his outstanding contributions to not only the local community but his work in the Guerrero Clinic in Guerrero, Mexico.
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very year, Dr. Clariday and his team travel to the Guerrero Clinic and perform hundreds of cataract and other eye surgeries for the less fortunate. When the news spreads that he is returning to the clinic, hundreds line up waiting for his arrival. He currently is head of ophthalmology for The Crystal Foundation and travels semiannually to Guerrero to assist the indigent people of the Copper Canyon region. He also travels semi-annually to San Fernando, Mexico with a medical outreach mission ministry through his Gateway Community Church of Clear Lake. The Clear Lake ophthalmologist says he has a deep passion for giving back and became involved with the Crystal Foundation in the spring of 2003. “I was really looking for some way to give and to be of some help,” he says. “When I found the Crystal Foundation, it was the answer to my prayers.”
To help improve the quality of life for a small village, a group of physicians, surgeons and a host of volunteers headed by Rotarian Walter Branson of Brazosport travel to Guerrero in the Chihuahua state to provide much needed medical services to the less fortunate. The majority of the people served by the Crystal Foundation have eye problems – mostly cataracts. “There is a large incidence of cataracts in this region,” Branson says. “No one really knows why. Many of these people are nearly blind when they come to us. When they leave, they can see again for the first time in 10 to 15 years.” A typical trip involves about 50 to 60 people – four ophthalmologists (two Americans and two Mexicans), eight optometrists, two dentists, two opticians, nurses and volunteers, including Dr.
Clariday’s staff. Each doctor typically performs 30 to 40 procedures every day during the weeklong visit. “Though it’s hard for most of us to imagine, think for a moment what life would be like without access to quality medical care. Living with pain and disease is a way of life for people in many countries, and one of our closest neighbors, Mexico, is wrought with some of the worst poverty and scarcity in the world,” Branson said. Everyone gives freely of their own time and talent, but the rewards are great they say. Though they don’t make any money for their services, they receive something even better.
Dr. Farid Noie Provides Dental Aid in Nigeria
Dr. Farid Noie of the Unicare Center Cosmetic & Implant Dentistry visited Southeast Nigeria for ten days in September to provide aid during a mission trip with Relief Network Ministries. (Left) Dr. Noie works with a patient. (Top) Dr. Noie visits with a local orphanage.
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Ambulatory Surgical Centers Built from the Ground Up
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orldwide Surgical Solutions in Houston has innovated a revolutionary new hybrid ambulatory surgical center called the Series 1. This facility, along with its sister facilities, will reshape the ASC industry as we know it today.
Integrated Communications High tech equipment and communication processes create a tactical base for each surgeon in the operating room. The surgeon is able to call throughout the world for teleconferences to demonstrate techniques, teach or video procedures.
First in the USA and the World The design/build ASC’s contain two to four operating suites with one to two procedure rooms and three to eight beds for each pre and post operating recovery area. They come fully loaded with space age technology and a technician on-site for the first three years to make sure the ASC runs smoothly. The time taken is only 12 weeks from start to finish instead of 12 to 16 months required by the traditional design/build model.
Looking the Part With terrific features on the inside, how about the outside? Any façade available today can complete the exterior – including brick, rock, wood, stone.
Game-Changing Innovation Worldwide Surgical Solutions is partnering with the Stryker Corporation and its family of companies to provide some of the world’s best operating equipment and integrated communications known to man today. They have a host of other supporting corporate partners as well that are quite impressive: GE Healthcare, McKesson, Steris, Anesthesia Plus and Knightsbridge Capital with their family of fine financial institutions to fund each and every project quickly.
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Financing Centers Worldwide Surgical Solutions has several financial partners who are ready and willing to finance each and every ASC Series 1 and its prospective group once qualified, quickly across the country. Knightsbridge Capital and their family of institutions have offered financing for over 30 years. Flexibility The design can also be built in some existing buildings if they meet the specifications. This concept can also be moved from one location to another if the need arises. Contact Worldwide Surgical Solutions in Houston, Texas for additional details about our Surgical Centers. Visit their website at: www.worldwidesurgicalsolutions.com
Urgent Care or Emergency Room? Where Do I Go? By Santiago Mendoza Jr.
ONE OF THE QUESTIONS I get asked a lot is, “What is the difference between an Urgent Care and an Emergency Room?”
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y answer, long or short, always starts the same: If your situation is life-threatening, like chest pain, severe injury or head trauma, always go to an emergency room that is attached to a hospital. Then I go into my explanation of why they need to consider 3 simple categories: Treatment, Cost and Insurance. Treatment An urgent care clinic can usually treat non-life threatening conditions and the time you wait to be seen can be shorter than going to an emergency room.
other major trauma - go straight to the nearest ER. Don’t take a chance with anything lifethreatening. The ER is the best place for these and other critical conditions, including: • Chest pain • Difficulty breathing • Severe bleeding or head trauma • Loss of consciousness • Sudden loss of vision or blurred vision When an Urgent Care Center can better meet your needs • Minor burns or injuries • Sprains and strains
Cost Treatment at an urgent care center usually costs less.
• Coughs, colds, and sore throats
Insurance Most urgent care facilities accept insurance that are accepted in an emergency room and an urgent care may be able to give you a discounted rate if you pay cash and work out something with them.
• Allergic reactions
According to the National Association for Ambulatory Care: When you need to go to the Emergency Room If you have a serious condition - stroke, heart attack, severe bleeding, head injury or
• Ear infections • Fever or flu-like symptoms • Rash or other skin irritations • Mild asthma • Animal bites • Broken Bones And when in doubt, call ahead. If the urgent care clinic in question can’t accommodate your condition, they will advise you to go to the nearest emergency facility. Santiago Mendoza, Jr. is the President, secretary and founder of Best Practices. Fourth Quarter 2012 | www.BestPracticesMD.com|
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(Left)The University of Texas Medical Branch at Galveston has received preliminary approval from the UT System Board of Regents for an $82 million expansion project at its Victory Lakes Specialty Care Center in League City.
UTMB plans $82 million expansion in League City By Mary Alys Cherry
T
he University of Texas Medical Branch is planning an $82 million expansion at its Victory Lakes Specialty Care complex in League City that will include emergency services. The expansion project received preliminary approval from the UT System Board of
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Regents at its Aug. 22 meeting and has been placed in its 2012-18 capital improvement program. The 142,000-square-foot addition to the 110-square-foot Specialty Care Center at Victory Lakes – built at a cost of $61 million and opened in 2010 -- will include additional operating rooms, an emergency department, observation units and associated support space
that will allow for procedures and surgeries requiring up to an average 72-hour stay. The Victory Lakes Center’s ambulatory surgery and complex diagnostic services will be expanded to provide 39 impatient beds, 17 emergency/urgent care beds, additional operating rooms and endoscopy rooms, plus space for future development, UTMB said. Increased imaging capabilities including an X ray fluoroscopy facility, ultrasound and a CT unit will be added within the existing facility, a spokesman said. UTMB said it expects to possibly get approval for the project’s design at the next meeting of the UT Regents in November and complete construction by February 2015. It will pay for the expansion with revenue financial system bonds that will be repaid from revenues generated by the project. The proposed expansion, the Galvestonbased medical facility said, represents the next step in implementation of the Campus Master Plan, and includes consideration for future expansion to meet the needs of the community. Along with the operating rooms, UTMB plans to add 17 emergency and/or urgent care beds, a spokesman said, along with 39 inpatient beds, and endoscopy rooms while setting aside 25,000 square feet of space for future development.
s ’ r S o v tory i v r u S A League City resident fights cancer at MD Anderson’s Regional Care Center in Nassau Bay By Rod Evans IT WAS SO SMALL that the radiologist thought it was probably just a bit of scar tissue. That explains why Bay Colony resident Carol Bertsche was thoroughly surprised when she received the diagnosis: breast cancer. Invasive ductal carcinoma is its clinical name, but by any name it still spells “cancer” and the diagnosis got the Ohio native’s full attention. “Luckily, the radiologist chose to be proactive and ordered a biopsy,” Bertsche, 60, recalls. “It was not something that would have been found in a normal breast exam, but because it was caught so early, my doctors gave me a reassuring prognosis.” Bertsche was also fortunate that she lives in the Bay Area and is within easy driving distance to the MD Anderson Cancer Center’s Regional Care Center in the Bay Area. Rather than having to make the nearly 40-mile round trip journey from her home to Houston’s Texas Medical Center to be treated at MD Anderson’s main campus, Bertsche was only about 10 minutes away from the same level of world class care offered at the
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Houston facility. The Bay Area location is one of four regional care centers operated by MD Anderson, with the others in Katy, Sugar Land and The Woodlands. Following the March 2012 diagnosis, the entirety of Bertsche’s treatment took place
“It was not something that would have been found in a normal breast exam, but because it was caught so early, my doctors gave me a reassuring prognosis.” at the Bay Area facility. Armed with loads of information obtained in her quest to be as informed about the disease as possible, Bertsche and surgeon Richard Ehlers, M.D., the center’s medical director, chose the least invasive treatment option, which included a lumpectomy (a procedure in which only the tumor and a small portion of surrounding breast tissue are removed) and partial breast radiation.
The lumpectomy was performed on April 4 and the final radiation treatment took place on April 27. She was back at her job as a senior administrative manager at UTMB Galveston three to four days after surgery. She went through one week of radiation treatment (two sessions per day) and now, with the cancer in remission, takes an antihormone medication prescribed for postmenopausal women and will follow up with her oncologist every couple of months for the next five years. “It was wonderful being just 10 minutes away from the hospital. Everything was contained in one building, which is nice and well lit. The radiation oncology waiting area is very nice, with a large aquarium and the staff and nurses are extremely sensitive and supportive,” Bertsche says. Bertsche stresses that women should get regular mammograms in order to spot any problems in the early stages. If cancer is diagnosed, she says getting as much information as you can on your particular form of the disease is critical in helping you take charge of your treatment.