Columbia Business Times - April 2014

April 2014 Dr. Timothy O’Connor and Reece Borst

Page 34

VIP Treatment A local doc hops on a trend Page 43

Disaster Zone The faulty state of Fulton State Page 50

P.Y.S.K. Jim Sinek

Page 31

Vet Tech Page 56

From left to right: John “Boo” Cathey, Cassie Rohe, Scott Bradley (V.P.), Sonya Reil, D. Scott Adams, Betsy Ames.

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Invest in the lives of our student-athletes by joining the Tiger Scholarship Fund today!

www.TSF-Mizzou.com or call 573-882-0704.

Academic Integrity | Social Responsibility | Competitive Excellence

10 \\\ April 2014

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12 \\\ April 2014

columbiabusinesstimes.com /// 13

GROWING PLANTS. ENRICHING LIVES.

Giving Gardens A Retail Greenhouse

Giving Gardens is a retail greenhouse owned and operated by CMSE – every purchase made supports our mission to employ adults with developmental disabilities.

Open 7 days a week!

Mon - Sat 8:30am - 6pm Sunday 11am - 5pm

Just off the beaten path you’ll find our wide variety of Perennials, Annuals, Tropicals, Vegetables & Flowering Hanging Baskets and our NEW line of Native plants!

Mark your calendars for May 10th... and join us for the Special Olympics Fundraiser Selling Hot Dogs & Soda - Come Join the Fun! Visit us on the web for a complete list of plants as well as information about our agency at

www.cmsegivinggardens.com 573-442-6935 • 4040 S. Bearfield Rd., Columbia 14 \\\ April 2014

Take Grindstone Pkwy to Bearfield Rd., Go south 1/2 mile on Bearfield (Just past the Cottages)

columbiabusinesstimes.com /// 15

From the Publisher

Editorial Chris Harrison, Group Publisher ChrisH@BusinessTimesCompany.com Sarah Redohl, Managing Editor SarahR@BusinessTimesCompany.com Katrina Tauchen, Copy Editor Katrina@BusinessTimesCompany.com

The Lazarus phenomenon

DESIGN Kristin Branscom, Art Director Kristin@BusinessTimesCompany.com

“Miracles are not contrary to nature, but only contrary to what we know about nature.” — St. Augustine On Feb. 26, 2014, Walter Williams, 78, a resident of Lexington, Miss., was at home when his hospice nurse called a coroner who arrived and declared him dead at 9 p.m. He was delivered to a local funeral home, where he was found to be moving.

The next day he was well enough to be talking with family. Unfortunately, Williams, after having a defibrillator implanted in his chest, died 15 days later.

We’ve all heard stories or experienced firsthand an unexplainable medical miracle. The incident involving Walter Williams is inexplicable, but the fact is, this type of incident has occurred enough to warrant a place in the medical lexicon. The Lazarus phenomenon, or Lazarus syndrome, is the spontaPhoto by neous return of cardiopulmonary circulation after Taylor Allen multiple failed attempts at resuscitation and has been documented at least 38 times since 1982. The name comes from the biblical account in which Jesus raised Lazarus from a tomb, four full days after his death. Although there is no scientific evidence that supports why or how this phenomenon occurs, there are hypotheses, which create theories, which drive scientific research that will ultimately lead us to the answer. For now, however, it is a medical miracle.

Our focus this month is on health and medicine, and as you likely noted by our cover, one of our features recounts local medical miracles. It’s no secret that Columbia is the health care mecca of central Missouri. We have world-class facilities, doctors, nurses and researchers here, many who have their own stories of medical miracles. This month we have the opportunity to share a few with you.

We also take a look at the economic impact of the revitalization of Fulton State Hospital. It is one of the most important medical facilities in our region, and if we have both sides of the political aisle discussing the urgent need for a new facility that creates jobs, lowers workers’ compensation claims and creates a better work environment for employees and better treatment for patients, it’s time to figure out how to allocate the funding and get this project in high gear.

We also include a feature article on how the University of Missouri College of Veterinary Medicine is leveraging research and innovation to the market and creating viable products for the treatment and diagnosis of animal-related problems.

As always, we hope you enjoy this issue as much as we enjoyed putting it together for you. We love feedback, good and bad, so don’t hesitate to email me any time at chrish@businesstimescompany.com.

›

April 2014

Chris Harrison, Group Publisher

When 4-year-old Reece Borst suffered medical distress shortly after his birth, Dr. Timothy O’Connor jumped into action and recommended a new treatment that saved the newborn’s life. Read more about Reece and other reallife medical miracles on page 34.

Photo by Anthony Jinson.

Creative Services Gillian Tracey, Creative Marketing Assistant Gillian@BusinessTimesCompany.com Whitney Buckner, Creative Marketing Assistant Whitney@BusinessTimesCompany.com MARKETING REPRESENTATIVES Angie Huhman, Marketing Consultant Angie@BusinessTimesCompany.com Jermaine Rivera, Marketing Consultant Jermaine@BusinessTimesCompany.com CONTRIBUTING PHOTOGRAPHERS Taylor Allen, Casey Buckman, Whitney Buckner, Anthony Jinson, Kendra Johnson CONTRIBUTING WRITERS Jim Camoriano, Al Germond, Vicki Hodder, Kristi McCann, Monica Pitts, Bondi Wood, Nancy Yang Interns Madison Alcedo, Steven Benna, Claire Boston, Abby Connolly, Kaylie Denenberg, Kendra Johnson, Abby Kass, Torie Ross MANAGEMENT Chris Harrison, General Manager ChrisH@BusinessTimesCompany.com Renea Sapp, Vice President of Finance ReneaS@BusinessTimesCompany.com Erica Pefferman, Vice President of Operations Erica@BusinessTimesCompany.com Cindy Pudney, Operations Manager CindyS@BusinessTimesCompany.com SUBSCRIPTIONS Subscription rate is $19.95 for 12 issues for 1 year or $34.95 for 24 issues for 2 years.

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DR. TIMOTHY O’CONNOR AND REECE BORST

PAGE 34

VIP Treatment A local doc hops on a trend PAGE 43

DISASTER ZONE The faulty state of Fulton State PAGE 50

P.Y.S.K. JIM SINEK PAGE 31

VET TECH PAGE 56

OUR MISSION STATEMENT The Columbia Business Times and ColumbiaBusinessTimes.com strives to be Columbia’s leading source for timely and comprehensive news coverage of the local business community. This publication is dedicated to being the most relevant and useful vehicle for the exchange of information and ideas among Columbia’s business professionals.

columbiabusinesstimes.com /// 17

About The Last Times What people are saying ›› Dear Editor, Roughly half of all proposed nuclear reactors in the U.S. never produced electricity, a driving reason why capital markets abandoned nuclear power decades ago. The nuclear financing scheme now relies on captive electric customers and taxpayers to fund new nuclear reactors, decommissioning nuclear reactors, disaster insurance and waste storage.

The Toshiba-Westinghouse nuclear reactor projects in Georgia and South Carolina are only possible because monopoly utilities charge customers years in advance for electricity that might be produced in the future.

Georgia’s $14 billion nuclear cost estimate is shared by the U.S. Department of Energy with a $6.5 billion federal loan guarantee.

Credit rating agencies regularly downgrade the credit scores of utilities that apply for nuclear reactor licenses even when the financ-

ing costs are deferred to customers or involve federal loan guarantees. Georgia and South Carolina customers, not shareholders, should receive the dividends produced if these reactors become operational because they assume the financial risk.

Nuclear reactors are one of the most expensive ways to boil water, construction aside.

Exelon in Illinois, the largest nuclear utility in the country, is telling the Illinois Legislature it may close three nuclear reactors because the reactors cannot compete. Expect Exelon to look to the state legislature for a fix to the deregulated market it helped create in 1998.

The financial history of the nuclear industry is a better indicator for what the future holds than the claims the nuclear industry makes about itself now.

Ed Smith Safe Energy Director Missouri Coalition for the Environment

What's happening online 1canoe2 @c1canoe2 Thanks for the amazing feature @ColumbiaBiz! We love it :)

Feb 27

Sam Fleury @sam_fleury Mar 4 Look out! @jeffreyowen8 is getting the business from @SarahRedohl from @ColumbiaColg @COMOChamber pic.twitter.com/ZbBe38fZoc

Around the office Thank you to everyone who came out for the CBT’s March launch party at Flat Branch March 5.

What wonderful conversations and libations. We should do that more often!

What a match! Thanks for coming out to the CBT’s Fight for Philanthropy March 4 after the Chamber Showcase. Our winner, Mary Ropp, raised $1,766.84: $500 from the CBT, a $500 match from Tiger Pediatrics, a $500 match from Dr. Jalali Sahba and $266.84 from the crowd at the mixer. In total, the CBT's five fighters raised nearly $2,000 for charity.

Write to CBT editor Sarah Redohl at Editor@BusinessTimesCompany.com columbiabusinesstimes.com /// 19

April 2014

Vol. 20, Issue 10 columbiabusinesstimes.com

Departments

34 Medical Miracles

From the remarkable treatment of an aggressive cancer, to a Parkinson’s disease breakthrough, to a life-saving hypothermia treatment for a newborn in distress: These real-life medical miracles show the power of skilled physicians, family support and an optimistic outlook.

43 VIP Treatment Retainer. Boutique. Concierge.

Whatever one chooses to call the new personalized care model, internist Dr. Don Delwood joins a national trend to bring better care to Columbia.

46 Meeting Medical Demand As the market for health care in Columbia expands, local hospitals and companies seek to simplify the process and ensure a steady supply of medical professionals.

17 From the Publisher 19 Letters to the Editor 23 Movers and Shakers 24 Briefly in the News 27 A Closer Look 28 Business Update 31 P.Y.S.K. 33 Opinion 62 Nonprofit Spotlight 65 Technology 67 Celebrations 68 Deeds of Trust 69 Economic Index 70 Business Licenses 71 By the Numbers 72 6 Questions 74 Flashback

50

56

Disaster Zone

Vet Tech

Fulton State Hospital sits in desperate need of a massive structural overhaul, and the quest for funding is bringing together lawmakers and legislatures on both sides of the aisle.

Where academia meets business, innovations result. Some instructors at MU’s College of Veterinary Medicine with the entrepreneurial bug have taken their research to the next level.

Two-thirds of Missouri families need some form of child care to work or to go to school. Child Care Aware 速 of Missouri helps to connect families all over the state to child care programs that meet their specific needs. While employees are spending their time at work and focusing on productivity, they can rest assured their child is being cared for.

n, HR Attentio ls! na Professio

If a new employee is moving to the area, Child Care Aware 速 of Missouri can provide no cost referrals to a child care center or home.

Questions about how to get started?

Give us a call or visit our website.

22 \\\ April 2014

Movers and Shakers ›› Professionals grow, serve and achieve

Dalrymple

Gattermeir

E. Tate

A. Tate

Randerson

›› Scott Dalrymple Columbia College has announced Dalrymple as the 17th president of the college. He replaced Gerald Brouder, who announced his retirement in January 2013.

›› Jim Gianopulos Air Masters Corp. welcomed Gianopulos as the newest member of its HVAC service team.

Gianopulos will be responsible for quoting, proposals and handling HVAC accounts.

›› Dr. Joseph Muscato Dr. Muscato has been named medical director of the Stewart Cancer Center at Boone Hospital. Muscato is a hematologist-medical oncologist and is the founder of Missouri Cancer Associates.

›› Drew Clark Clark recently joined the Tiger Institute as a business strategist for its Living Lab team, which focuses on new health innovations.

›› Ryan Belmar and Fred Green MBS Textbook Exchange Inc. has promoted Belmar to MBS Direct client services representative and Green to MBS Direct vice president, client services. ›› Columbia Board of REALTORS The Columbia Board of REALTORS recently announced its 2014 officers. Becky Sterling from RE/MAX Boone Realty will serve as president, Dave Gerhart of Crane and Crane Real Estate will be president-elect, Dennis Lynch of RE/MAX Boone Realty will act as treasurer, Pam Socha from House of Brokers will serve as MLS chair and Jessica Kempf from Crane and Crane Real Estate is the immediate past-president. ›› Dave Moncey Gateway Mechanical announced the addition of Moncey as the newest member of its plumbing team. Moncey will be responsible for plumbing estimates and project management.

›› Marsha Fischer Fischer was recently selected as a participant in the American Arbitration Association Higginbotham Fellows Program. It’s a highly competitive process, and Fischer was chosen from a nationwide pool of candidates. She will begin the yearlong program with a week of training and networking in San Francisco this May. ›› Columbia Public Schools The Professional and Community Education Department at the Columbia Area Career Center has announced two new hires to roles in the administration of adult education through Columbia Public Schools. Elizabeth Tate will serve as community education coordinator. Aaron Tate will be the workforce development coordinator. ›› Judy Schmuck Schmuck, an alumna of William Woods University, has been named Volunteer of the Year

by District VI of the Council for the Advancement and Support of Education.

➜ Are you or your employees

making waves in the Columbia business community? Send us your news to Editor@BusinessTimesCompany.com

snellen

Wright

Potterfield

›› Mike Randerson Columbia College has announced that Col. Randerson was awarded the Citizen of the Year award from the mid-Missouri chapter of the Military Officers Association of America. Randerson is the vice president for adult higher education. The award recognizes an individual who has made significant military-related contributions in the community. ›› University of Missouri Office for Advancement The University of Missouri Office for Advancement has made four recent hires.

Paul Ross joined as the new assistant vice chancellor for advancement. Deb Snellen was appointed director of organizational and professional development. Dale Wright received a promotion, making him the executive director for advancement for the Robert J. Trulaske Sr. College of Business. Carin Huffman Grinch became the new director of donor relations. ›› Larry Potterfield Potterfield, founder and CEO of MidwayUSA, received the Lifetime Achievement Award from the Outdoor Channel. The award is given to individuals who have made a significant impact on the shooting sports industry. Potterfield earned the award because of his creation and execution of programs that have made a dramatic impact on the Second Amendment and youth sporting activities. CBT columbiabusinesstimes.com /// 23

Briefly in the News

›› A rundown of this month’s top headlines

Forbes award Forbes named Central Bancompany, the parent company of Boone County National Bank, to its 2014 America’s Best Banks issue.

This is the fifth consecutive year the bank holding company has made the list.

Central Bancompany is Missouri based and has 13 full-service community banks and more than 250 locations.

Sub love

Erbert & Gerbert’s Sandwich Shop, a Wisconsin-based national sandwich chain known for its gourmet subs, is expanding to Columbia, with plans to open two locations within the next few years.

$1,000

The Mid-Missouri Tourism Council presented a $1,000 check to Columbia’s Office of Cultural Affairs after raising funds through its fourth annual online silent auction.

The funds will be distributed to mid-Missouri applicants such as Greenhouse Theatre Project and the We Always Swing Jazz Series.

Quick care Go for Greater

Columbia College’s Marketing Department recently won two Education Digital Marketing Awards for its internal Marketing Channel and “Go for Greater” campaign. Recognition was based on creativity, marketing execution, message impact, technology application and innovative content.

The Higher Education Marketing Report, a publication for college marketing professionals, presented the awards.

The college earned a gold award in the blog sites category for its Marketing Channel, which aims to educate internal audiences on various marketing initiatives. It also earned a silver award in the online display ad category for the “Go for Greater” campaign.

24 \\\ April 2014

University of Missouri Health Care and Hy-Vee announced Feb. 25 that they are partnering to open walk-in medical clinics at Hy-Vee’s three Columbia locations.

Construction for the Mizzou Quick Care clinics began in mid-March. Clinics in Hy-Vee’s Conley Road and Nifong Boulevard locations will open by Aug. 1, with the Broadway Hy-Vee clinic coming Oct. 1.

The clinics will be open seven days a week and will provide physicals, flu shots, pregnancy tests, some adult immunizations and treatment for patients with minor illnesses and injuries.

Dr. Susan Pereira, a family medicine physician at MU Health Care and an MU School of Medicine associate professor, will be the medical director of the clinics.

Houzz award Debby Cook of Columbia’s Debby Cook Interiors has been awarded a 2014 Best of Houzz award from Houzz, a home remodeling and design website. The more than 16 million monthly users who comprise the Houzz community chose Cook’s 10-yearold interior design firm. Cook won the award for customer service. A Houzz statement says customer satisfaction honors are determined by a variety of factors, including the number and quality of client reviews a professional received in 2013.

What’s happening

New clips

Finding homes

3-D knee

Video goggles

A new Supercuts hair salon will open this spring on Broadway Bluffs Drive next to Chipotle in Columbia.

The location will employ five or six stylists and will be the third Columbia Supercuts. Franchise owner Adam Crews’ family also owns Columbia’s three Cost Cutters Family Hair Salons, along with six other individual Cost Cutters locations across the state.

Irene Sackreiter of Columbia became one of the first people in the United States to have a knee implant developed using 3-D printing technology.

Dr. Sonny Bal of the MU School of Medicine is among the first surgeons in the United States to use this technology for knee replacements.

home sales The Columbia-based Missouri Realtors Trade Association found that the average selling price of properties was higher, and time on the market held steady.

The average price rose 12.5 percent to $147,541, compared to $131,133 a year ago, and the median price of $115,000 was up 9.1 percent from $105,409 in 2013.

Gym upgrades

Fayette-based Central Methodist University will see 7,000 square feet added to its 28,000-square-foot recreation center as part of a more than $1 million facility renovation.

The upgrade will include a new multipurpose room and multiuse court suitable for sports such as basketball and volleyball. The project started in March and has a September estimated completion.

Columbia’s PW Architects Inc. and Coil Construction will serve as the project’s architect and general contractor, respectively.

Boone County National Bank was awarded a $15,000 grant from the Federal Home Loan Bank of Des Moines to support homeownership opportunities for families and individuals. The grant supports homebuyers who can make a mortgage payment but are unable to purchase a home because they cannot afford upfront costs.

“The homeownership fund will allow us to help members of our community transition into homeowners,” Deborah Graves, senior vice president, mortgage loan department manager, said in a statement.

Patients at Women’s and Children’s Hospital can now watch their favorite movies while having an MRI scan performed.

More than a dozen mid-Missouri credit unions raised funds to purchase a set of $44,000 MRI-compatible video goggles and headphones.

“We appreciate this generous donation from credit unions of central Missouri,” Keri Simon, executive director of Women’s and Children’s Hospital, said in a statement.

“Support like this from our community helps us provide familyfriendly care to children throughout our state.”

Women’s and Children’s Hospital performs 2,500 to 2,700 MRI scans of children each year.

Smashing records Aiming to raise a record $150 million this fiscal year, the MU Office of Advancement is on track to meet its goal, having raised $88.3 million in the year’s first six months.

“Right now, Mizzou is all about progress,” says Tom Hiles, MU vice chancellor for advancement. “We have a wonderful new chancellor and a great team of advancement professionals in place. It’s an exciting time to work with donors and alumni who care so deeply about Mizzou.” CBT

columbiabusinesstimes.com /// 25

26 \\\ April 2014

A Closer Look

New Businesses in

Columbia

›› A quick look at emerging companies

1. Schilb Antiquarian Rare Books

3. Advantage Metals Recycling LLC

5. BrightStar of Mid-Missouri

A new retail antique bookstore has opened in downtown Columbia. Schilb Antiquarian Rare Books, located at 100 N. Providence Road, has an array of rare books, manuscripts and artwork for show and sale.

Items sold by the store vary in price, ranging from a $50 piece of artwork to a $50,000 alchemy and herbal manual from the 16th century. Scott Schilb, the store’s owner, has been collecting antique books since his time in graduate school at Southern Baptist Theological Seminary 10 years ago.

Contact: Scott Schilb, 573-825-8044

With 16 facilities, Advantage Metals Recycling is Kansas and Missouri’s largest scrap recycler. Located at 705 N. Proctor Drive, AMR recycles unwanted metal household or farm items and pays cash in return. The company also recycles business and industrial metal items in an effort to help preserve and protect the environment, and it will purchase junk vehicles. AMR was founded in 1977 as Galamba Metals Group.

In 2008, the business was purchased by The David J. Joseph Co. and renamed Advantage Metals Recycling.

Contact: Raynard Brown, 816-861-2700

BrightStar of Mid-Missouri, which opened March 3, is a new home health care agency that provides care and staffing to people of all ages. Services include medical care, companion care, disability care and nursing care, among others. With the motto “making more possible,” BrightStar’s goal is to provide clients with as much attention as they need by offering a wide variety of care services. Services are available 24 hours a day, seven days a week. The company is located at 108 E. Green Meadows Road, Suite 8.

Contact: Matthew Hayes, 573-777-9222

2. 9th Street Public House

4. Coegi A new digital marketing company has come to Columbia to bring together several technologies and create a one-source shop for companies that want to advertise digitally.

Coegi, which is Latin for “to bring together,” offers management of digital advertising campaigns locally, regionally and nationally.

The company focuses on real-time bidding and social media advertising. Some services of Coegi include banner, video and free roll advertising. Its goal is to implement ads across multiple Internet options using several technology platforms.

Contact: Jack Miller, 573-777-4130

The 9th Street Public House provides customers with a classic pub experience.

Owner James Kanne refers to the pub as a cozy, casual and classy corner. Located at 36 N. Ninth St., 9th Street Public House specializes in local and craft beers and choice whiskey. It also serves traditional cocktails.

Customers can bring food in from anywhere and relax and enjoy the seven televisions in the pub, one of which is a 130-inch highdefinition projector. With continual rotation of its tap beers, 9th Street Public House prides itself on trying new things.

Contact: James Kanne, 573-673-1671

6. Hair Spectrum, The Red Door Salon LLC Hair Spectrum, The Red Door Salon, is a hair salon in Columbia. Erika Haberstock has been running the business since Feb. 1, and she is the salon’s only employee.

Located at 711 Vandiver Drive, Suite E, Hair Spectrum offers the typical array of services: hair cutting, coloring, highlights, lowlights, waxing, shampoo/condition services, etc. Eventually, Haberstock plans to bring in a nail technician to add manicures and pedicures to the list of services. Additionally, she plans to have one or two self-employed hair stylists rent booths from her. CBT Contact: Erika Haberstock, 573-443-1163

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4

1

6 5 ➜ Are you an entrepreneur? Are you sprouting a new business? Tell us about it at Editor@BusinessTimesCompany.com columbiabusinesstimes.com /// 27

Dr. Jeremy Maxwell.

Photos by Anthony Jinson.

28 \\\ April 2014

GOLF games

Business Update

›› Transformed, trending and up-to-the-minute

Swinging for Success

Dr. Jeremy Maxwell uses selective functional movement to improve golf games and quality of lives.

Without even the slightest twist or crack of your neck, Dr. Jeremy Maxwell will have you feeling, seeing and performing better. His specific chiropractic techniques will have elite athletes ready to compete at the highest level of competition and also prevent injuries for those less active.

Maxwell, owner of Maxwell Family Chiropractic in Columbia and Fayette, is a level III TPI-certified medical professional, and in addition to his regular clientele, he works closely with the Columbia College golf team, professional golfers and others who are passionate about the game.

The corrections he makes to a person’s body specifically focus on the top two bones of the neck and correcting the upper cervical.

“I had patients that I couldn’t get to the next level, so I was sending them to physical therapists.

They weren’t getting any better.

I knew there was something else out there, and this was it.”

— Dr. Jeremy Maxwell, owner, Maxwell Family Chiropractic “This type of technique influences the brain stem in a very specific way,” Maxwell says. “That’s the master controller of your entire body that controls your postural tone. The body has no other choice but to function the way it was designed, and this adjustment can enhance the way your body does that.”

Stan Utley, PGA Tour winner and golf instructor, was the one who inspired Maxwell to become a competitor in this niche market. Utley had experienced back pain for 15 years, and after he received this type of adjustment, all his pain went away.

Utley invited Maxwell to the World Golf Fitness Summit in 2010 by saying, “I think I have something you’re looking for.”

By Kristi McCann

Once there, Maxwell was introduced to the Titleist Performance Institute, which was created

by Dr. Greg Rose and Dave Phillips. The two men saw a need for a team of professionals to care for golfers. They have certifications for fitness people, medical professionals and instructors and focus on selective functional movement.

“I had patients that I couldn’t get to the next level, so I was sending them to physical therapists,” Maxwell says. “They weren’t getting any better. I knew there was something else out there, and this was it.”

More than a hobby Since then, Maxwell has been on an accelerated career path. He completed his level III certification in 2013 and is one of only two medical professionals in the state of Missouri who have that certification.

“Dr. Maxwell helped me in about five minutes this year at the Missouri Open,” Jay Delsing, professional golfer, says. “When I hobbled over to him, I could hardly move, and in just a very short time, I had tremendous freedom of movement and considerably less pain.”

“When the brain stem is impacted like that, we’re affecting balance, vision and perception of alignment abilities,” Maxwell says. “A lot of people feel more comfortable and balanced over the ball. Their visual perception is different because, quite literally, your head is on straight.”

Maxwell’s niche chiropractic techniques are not just for professional golfers; in fact, he recommends these adjustments for anybody who’s interested.

“Golf is one of the few hobbies that can last a lifetime if you take care of yourself,” he says. “A lot of people in any hobby like it but not enough to sacrifice in order to maintain the hobby for the rest of their life. Most retired people think, ‘All right, I want to play golf,’ and they pay for

Dr. Jeremy Maxwell trains senior Columbia College golfer Logan Murphy using the K-Vest.

equipment, but they don’t invest in the most important piece of equipment — their body.”

Moving forward For competitive athletes, Maxwell recommends receiving these adjustments as young as high school because by that point in their lives, they have already been through quite a few traumas.

The earlier the problems are detected, the better opportunity he has to help retrain their motor skills and make sure their nervous system and cognitive abilities are track.

The golfers at Columbia College have benefited from new technology used in Maxwell’s office called the K-Vest, which is a 3-D biofeedback tool to help golfers get in proper position. This vest assists golfers by retraining their motor skills once they have been realigned and helps speed up the process.

“I’m looking forward to seeing how the Columbia College golfers are going to do this year,” Maxwell says. “We’ve worked on them for two years, and it will be fun to see firsthand how our work affects their game.” CBT columbiabusinesstimes.com /// 29

Meet Brian Richards, owner of Sauna Space. Brian obtained an SBA Export loan from The Bank of Missouri to expand his Near Infrared Sauna business. The SBA loan helped him purchase inventory, equipment and working capital so he was able move into a larger warehouse to meet the demands of his growing domestic and international customer base.

An SBA loan from The Bank of Missouri is one of the best financing options for small and growing businesses. An SBA loan can help you finance an entire business, equipment and fixtures, business real estate and much more.

www.bankofmissouri.com/business-sba-loans

30 \\\ April 2014

Karin Bell Vice President, SBA Manager

Crystal Morris SBA Sr. Loan Admin. Asst.

Geoff Karr SBA Lender

P.Y.S.K. Person You Should Know

›› Job description: President of Boone Hospital Center

Jim J. Sinek

›› Years lived in Columbia/mid-Missouri: Six months

President, Boone Hospital Center

›› Original hometown: Pomeroy, Iowa Age:

55

›› Education: B.S. in business, Buena Vista University, Storm Lake, Iowa; master’s in hospital and health administration, University of Iowa, Iowa City, Iowa; J.D., Creighton University School of Law, Omaha, Neb. ›› Community involvement: Tolton High School volunteer, Chamber of Commerce member ›› Professional background: Hospital administration lawyer ›› A favorite recent project: Stewart Cancer Center ›› A Columbia businessperson I admire and why: Randy Morrow, chief operating officer for Boone Hospital Center. Randy is the cornerstone of Boone. He is loyal, intelligent, passionate, dedicated and engaged. He demonstrates excellent leadership and is a community supporter. ›› If I weren’t doing this for a living, I would: Be coaching high school or college baseball or football. ›› What people should know about this profession: It is incredibly gratifying and rewarding if you are passionate about caring for people. ›› What I do for fun: I run, coach, read, spend time with my family, travel and scuba dive. ›› Family: Wife, Stephanie; daughter, Quincy; and son, Joseph

Photo by Anthony Jinson

➜ I’m passionate about my job because it’s an opportunity to work with an excellent

team of physicians, clinicians, support staff, board members and volunteers serving people from mid-Missouri with health care needs.

›› Favorite place in Columbia: MKT Trail ›› Accomplishment I’m most proud of: Earning a law degree and passing the Iowa bar exam ›› Most people don’t know that I: Scuba dive and coach. CBT columbiabusinesstimes.com /// 31

Roundtable › Al Germond

point-of-view

Tiger Territory scant evidence that there’s much in the way of outreach on either side of The early reports about Dr. Richard Elm Street. It seems a reminder is in order for those who govern to restate Bowen Loftin, the incoming 22nd chanthat Columbia is a company town tied closely to MU, sprung to its prescellor of the University of Missouri, have ent significance as a seat of learning and regional center because the seeds been good. Sixty-four-year-old Loftin of this land grant university were fortuitously planted here 175 years ago. comes to us from Texas A&M University.

With 50,000 students and branch campuses, A&M has an overwhelming presence in Brazos County and the twin cities of Bryan-College Station, with a metro Al Germond is the area population of 231,623 situated about host of the Columbia 80 miles northwest of Houston. Sporting Business Times sartorially distinctive cravats, Loftin has Sunday Morning plunged into his new administrative role Roundtable at 8:15 responding to an array of challenges with a.m. Sundays on KFRU. the first responder, on-the-scene zeal of a He can be reached at fireman. He was immensely popular espeal@columbia business cially with students across Aggieland, and times.com. press accounts cite tensions during his University officials unabashedly promote increasing Columbia’s camtenure as A&M president with the board pus enrollment to 40,000 students. This, in turn, has spurred investof regents and Gov. Rick Perry, including ments to house the anticipated addition of thousands of new students a vetoed tuition increase while state support continued to decline. over the 35,000 already studying here. Some of us remain skeptical and recall enrollment declines 30 years ago and academic We scratch and claw our way wanting to know more cutbacks when Peter Magrath was president and Barabout Texas A&M. A few glimpses come via the Internet bara Uehling was campus chancellor. We remember and from Irwin A. Tang’s The Texas Aggie Bonfire, which proposed curriculum enhancements such as “Food for describes the fiery extravaganza tied to the Aggie-Longthe 21st Century” and the cutbacks and program conhorn (University of Texas) rivalry that went terribly solidations when 1985 enrollment was slightly less than wrong on Nov. 18, 1999, when 12 students died. That’s 22,000. Yet, there are infrastructure issues, and it is really the only bad news. The good news is that like MU, embarrassing how both sides have recently stumbled TAMU as it is known locally participates in the prestiover what will be a win-win for all of us. gious 59-member Association of American Universities, joined the SEC the same time MU did more than a year ago, funds an ambitious $700 million research An enthusiastic approach program and two business incentive programs: Start There’s skepticism about the amplitude of rah-rah for Up Aggieland and the Aggie Angel Network. The UniOld Mizzou that emanates these days from the preversity with somewhat rough origins is laced with tracincts of city and county government. Readings on the ditions, including its distinctive Corps of Cadets. As an applause meter from the north-of-Elm-Street governDr. Richard Bowen Loftin academic business, our curiosity is especially directed ing crowd have been rather weak it seems. The needle at relationships between TAMU and the governments pressed more positively during a recent interview in of Brazos County and the cities of Bryan and College Station and how they which Loftin distinguished himself with enthusiastic, straightforward talk work together smoothly and cooperatively. about the challenges he faces as chancellor. He affirmed his desire to reach out and immerse himself in working with local elected officials to get things done. Will they share his ebullient enthusiasm? We certainly hope so.

The MU connection Maybe we can learn from Loftin’s experience working on transit issues Loftin has moved to a region that’s been marked over the years by varying that could be worth emulating here. Loftin should continue greeting peolevels of enthusiasm and support for MU. I’ve often wondered about the ple with “howdy” and challenging teams to “gig ’em” when competition depth and sincerity of relationships between university officials and their gets tough. His attitude is infectious, and we will have much to gain from governing counterparts in city and county government. To an outsider, it. This bronco rider is now in our corral — and the ride promises to be very these relationships often appear to be little more than acknowledging interesting. CBT one another’s presence sprinkled with cat fights over picayune issues and

It seems a reminder is in order for those who govern to restate that Columbia is a company town tied closely to MU, sprung to its present significance as a seat of learning and regional center because the seeds of this land grant university were fortuitously planted here 175 years ago.

columbiabusinesstimes.com /// 33

34 \\\ April 2014

Three remarkable tales of real-life medical drama

The miracle of modern medicine lies in the eye of the beholder.

Physicians are men and women of science who work to provide the most favorable outcomes for their patients. For them, medicine is about risks and benefits; they play the odds. Their training and experience teach them that treatments for most diseases evolve over time and that the real miracle is how far we’ve come.

Physicians also know that patients facing life-threatening or debilitating conditions seem to do better with an optimistic outlook. Some studies show that family support can increase the chance of survival; others recognize faith and optimism.

The following stories show both sides of the coin. They showcase incredible treatments that continue to improve patient outcomes. They also illustrate something less tangible. In the words of Albert Einstein, there are two ways to live: one as though nothing’s a miracle, the other as though everything is.

By Nancy Yang | Photos by AnthonY Jinson columbiabusinesstimes.com /// 35

From left: Dr. Timothy O’Connor; Bob, Reece and Tiffany Borst.

36 \\\ April 2014

Window of time On a wintry night last February, 4-year-old Reece Borst told his mother that God was calling him to heaven. His mother shrugged it off. “We’re Catholic,” she says, adding jokingly: “I’ve decided he’s going to be a priest.”

It would take a whole lot more to rattle Tiffany Borst. Back in May 2009, she and her husband, Bob Borst, were confronted with every parent’s nightmare. Five hours after birth, Reece had been airlifted to Children’s Mercy Hospitals and Clinics in Kansas City. Doctors there were concerned about severe mental and physical disabilities and said the couple might need to make a decision about life.

“Right before they put him on the helicopter, they let me hold him for just a minute,” Tiffany says. “I know they did that in case he passed away.

It was that severe.”

Reece, the youngest of Tiffany and Bob’s four children, suffered distress at the end of what looked like a normal, full-term pregnancy. When Dr. Lynn Puckett, Tiffany’s obstetrician-gynecologist, broke her water, excess fluid caused a placental abruption.

“There was an 18-minute period of time when the baby was in distress,” Tiffany says. “We were talking about a C-section, but pretty soon it was too far into the delivery. When he came out, he was limp, he was purple, and he wasn’t breathing.”

Dr. Timothy O’Connor, a neonatologist specializing in premature and ill newborns and high-risk pregnancies, inserted an endotracheal tube. The procedure, known as intubation, provided an airway for Reece’s lungs, which had been drowning in fluid.

“Basically, they breathed for him,” Tiffany says.

“They revived him. They wheeled him away, and my husband and I were so traumatized. We were in shock; we didn’t know what was happening. Dr. O’Connor came in and sat down, and I knew this was not good.”

O’Connor explained that Reece’s blood acidity was very high, which indicated that the placental abruption had deprived his body of oxygen, which could cause many organs to function abnormally early on. He told them about a new treatment at Children’s Mercy in Kansas City called hypothermia therapy, which cools the body, thereby decreasing the brain’s need for

oxygen. The therapy would buy them time until his breathing could become normal.

“They said that we had a very small window of time, and if we didn’t do it right away, we would miss it,” Tiffany says. “For me, we had no other options. My husband had some connections to a NICU nurse in Kansas City, and we called her immediately. She said, ‘Do it.’”

The hospital staff packed baggies of ice around Reece’s head, and five hours after birth, the newborn was in the helicopter, hurdling toward Kansas City. Bob followed by car, scanning the evening sky for signs of Reece’s journey, while Puckett and Dr. Paula Stuebben, the Borst family’s pediatrician, checked on Tiffany, who was still at Boone Hospital.

“I was so grateful to them,” Tiffany says. “Dr. Puckett had been there all day, and Dr. Stuebben came by on her own time. All the docs at Boone went above and beyond.”

The next morning Tiffany’s father drove her to Kansas City. She and Bob, with their other children joining them later, stayed at the Ronald McDonald House, which Tiffany calls a Godsend. Ten days later, Reece’s vital organs were functioning properly, and he came home. The hypothermia treatment had saved his life.

But it was still unclear whether his brain would function normally. After a few weeks, the Borsts noticed that he wasn’t looking to the left, which indicated stroke-like behaviors. They called O’Connor, who referred them to First Steps, which provides therapies that can catch long-term problems ahead of time. With the help of a physical therapist and later an occupational therapist, Reece’s brain in effect developed new pathways during a critical time of development.

“Once he began walking, he was fine, and the funny thing is, now he’s probably my smartest kid,” Tiffany says. “Dr. O’Connor basically saved Reece’s life three times, in my opinion. There are so many miracles in this story.”

Over the past three years, Reece Raises Hope, a charitable organization set up by his aunt Barbara Simmer, has raised $18,000. Proceeds have funded a hypothermia treatment program at the University of Missouri Hospital and Clinics, Ronald McDonald House and the Neonatal Intensive Care Units in Columbia. columbiabusinesstimes.com /// 37

From left: Dr. Thor Norregaard, Dale Swoboda and Dr. Terry Rolan.

38 \\\ April 2014

Implanting hope

It wasn’t too long ago that Dale Swoboda thought his bike-riding days were over. For years, Swoboda and a friend had been cycling 15 to 20 miles once or twice a week, but by last August, he couldn’t keep up.

“My disease was beating me down,” he says.

Swoboda, a core faculty member and co-coordinator of the School of Public Policy at Walden University, has Parkinson’s disease, a progressive disorder of the nervous system that causes tremors, muscle rigidity and slow, imprecise movement.

Swoboda’s symptoms began about three or four years ago when he started experiencing stiffness in his thigh, especially while driving long distances. Over time it spread to other joints, and he developed a tremor. Dr. Terry Rolan, a movement disorder neurologist at University of Missouri Health Care, diagnosed and treated him for essential tremor, the disease Kathryn Hepburn had. But a year later, Swoboda developed new symptoms.

He needed more sleep than usual, lost his sense of smell, developed a false and expressionless face and became a bit clumsy. Rolan added the diagnosis to Parkinson’s.

“Right after I was diagnosed, I went to a wedding in Silicon Valley, and at the reception, I snuck out and cried for a half hour,” he says. “I had gone to see a counselor and brought up the fact that at some point all I could do is sit on the bench on the trail instead of ride, and that saddened me.”

With no cure for Parkinson’s, Swoboda relied on medications to improve his symptoms, but he knew that over time their effectiveness would diminish.

Swoboda’s wife, Georgalu, with whom he wrote a textbook in 2008, researched options and learned about another treatment that offered hope.

“Dr. Rolan asked, ‘Have you ever heard of deep brain stimulation?’” Swoboda says. “My wife and I just smiled at each other.” Rolan explained that in the past, doctors hadn’t used DBS until later stages of Parkinson’s but were now getting results earlier.

He warned, however, that DBS wasn’t a panacea and that Swoboda would do well if it alleviated all but his problems with balance and smell.

Deep brain stimulation, which was approved by the FDA to treat Parkinson’s disease in the late ’90s, involves two surgical procedures. During the first, a surgeon implants tiny electrodes in the brain’s subthalamus. The second surgery involves inserting a

battery-operated device, similar to a pacemaker, into the patient’s chest. The device delivers electrical impulses to the electrodes, which stimulate areas of the brain that control movement. Experts believe that the impulses block signals that cause tremors, stiffness and other symptoms.

Swoboda says that he and Georgalu were bound and determined to give DBS a try. Rolan recommended Dr. Thor Norregaard, a neurosurgeon at MU Health Care, for the surgical procedures, which took place last fall. Norregaard has more than 25 years of surgical experience for tremor conditions such as Parkinson’s disease.

The initial procedure is not for the faint of heart.

Because neither the brain nor the skull has nerve endings, and because Swoboda needed to be alert enough to respond to cues during the surgery, he received no general anesthesia. The medical team did numb his scalp, but Swoboda describes the experience as unnerving.

“When they drilled, it sounded like a jet plane taking off,” Swoboda says. “It was very loud, but I didn’t feel a thing.” He says he was secured to the operating table with what’s called a halo, a device that restricts movement of the head and enables surgeons to accurately place the electrodes without damaging the brain. The procedure took about four and a half hours. Two weeks later, Norregaard implanted the battery in Swoboda’s chest.

About a month afterward, Rolan turned on the stimulator and programmed it. He says that though Swoboda is responding well, he’ll need to make periodic adjustments to the DBS unit over time.

“The key to making the right adjustments that benefit the patient the most involves not only skill as a movement disorder neurologist but experience in programming these devices well,” he writes in an email. Rolan has been involved in programming deep brain stimulators since their initial use in the late ’90s.

Swoboda says that over the past six months, his fingers are more nimble, he doesn’t shuffle as much, he takes one pill instead of four and expression has returned to his face. He’s also back to riding his bike.

“The goal of the surgery is to stave off the symptoms, to make the progression slow way down,” he says. “We won’t know for several years if that’s the case, but it’s starting off great. My wife says I’m doing 70 percent better than I was. I’ll take 70 percent.” columbiabusinesstimes.com /// 39

From left: Mark Judy and Dr. Joe Muscato.

Remarkable Mark There’s a saying about the U.S. Postal Service: “Neither snow nor rain nor heat nor gloom of night stays these couriers from the swift completion of their rounds.” Perhaps they should add cancer, too.

Mark Judy has been delivering the mail in Macon County, rain or shine, for 10 years. He also raises cattle, restores tractors and recently built much of his new home himself. He has rarely missed a day’s work, despite the fact that during half his tenure with the USPS, he’s undergone chemotherapy.

Judy is a cancer patient who has beaten the odds by a long shot. When he began treatment for colon cancer five years ago, the median survival rate for his condition was eight months.

Since then, he has responded dramatically.

Dr. Joe Muscato, his hematologist-oncologist, has never seen anything like it. He calls it a home run, one of a handful he’s seen during his 32-year practice.

In the summer of 2008, Judy began experiencing bleeding and changes in appetite. He finally went to the doctor the following winter after he also had pain in his upper right side. Results from a sonogram and CAT scan showed that his liver was massively involved with cancer.

Local doctors referred him to Missouri Cancer Associates, where Muscato learned from biopsies and other tests that the cancer had started in his colon. Judy began chemotherapy, and a week later, his symptoms had subsided. Muscato was surprised to see that his liver had shrunk as well. Since then, Judy has received 86 cycles of chemotherapy, more than Muscato has ever given a patient — or probably ever will again.

“It’s because it’s such an unusual situation,” Muscato says. “We don’t really know if the cancer’s suppressed or if it will stay away.” After consulting with a colleague at Washington University, Muscato decided on a five-year stopping point to see what would happen.

“I think I’ve been the topic of conferences because they’ve never seen this before,” Judy says. “We were at the point where we either had to stop the chemo or keep going on with it. My last treatment was on Jan. 13, 2014.” Muscato

continues to follow up by monitoring his CEA tumor marker, which can be measured in the blood, as well as other tests and exams.

“Dr. Joe said we will have to deal with uncertainty,” Judy says. “It probably will show up somewhere, but it’s just something that you’ve got to deal with. Everybody’s asked if it bothered me, and I said it didn’t because I know where I’m going when I die.

I think that the good Lord works through doctors, and everything that’s happened is through the power of prayer.”

“Dr. Joe said we will have to deal with uncertainty. It probably will show up somewhere, but it’s just something that you’ve got to deal with.” — Mark Judy Muscato supports Judy’s strong faith, which includes involvement in his church and community. He adds that Judy’s courtship and marriage to his wife, Jerri Ann, which all happened while he was on chemo, can be an additional source of strength.

“In general, support is very important,” Muscato says. “I always say, I’ll take it anywhere I can get it.” He adds that when it comes to battling cancer, research suggests that married people fare better than those who aren’t married.

A little comic relief now and then doesn’t hurt either. Judy says he’s always enjoyed joking around with the staff at Missouri Cancer Associates. “Dr. Joe’s pretty straight with me,” he says. “Me and him are both jokesters, so we have a good time with all this, but he’s pretty straightforward.”

At one point during his treatment, Judy’s CEA tumor marker had dropped by nearly half in just two weeks. Muscato gave him the good news: “Mark, I think you’re going to outlive the post office.” CBT columbiabusinesstimes.com /// 41

42 \\\ April 2014

Retainer. Boutique. Concierge. Whatever one chooses to call the new personalized care model, one local doctor joins a national trend to bring better care to Columbia.

From left: Dr. Don Delwood, Matt Darrough and Sherri Ash.

TheVIPTreatment

By Bondi Wood | Photo by Whitney buckner When Matt Darrough was a teenager 25 years ago, he fell from a tree while bow hunting, resulting in a spinal cord injury and broken back. Also, 25 years ago, internist Don Delwood opened a primary care practice in Columbia’s Boone Clinic. It would be several years before the two men’s paths crossed, but eventually Darrough became Delwood’s patient, and their journey together began as most traditional doctor/patient relationships do.

However, next month, both men will embark on a new journey into personalized care practice, a practice model new to Columbia but increasingly popular across the nation. Although Delwood describes this new model as a personalized care practice, the

press sometimes refers to similar models as retainer, boutique, direct medical or concierge practices.

In mid-May, Delwood will have completed the transition from a traditional primary care provider practice in which he had 2,000 patients to becoming a member of the MDVIP network, where he will cap his patient load at 600, each of whom will pay an annual fee for more comprehensive exams, 24/7 access to Delwood and personalized services.

More time, fewer patients Initially the biggest change for Delwood’s patients will be paying an annual fee of $1,650; however, included in that fee is the cost of a

comprehensive exam, much broader in scope than traditional annual physicals of the past.

The wellness exam will be specific to each patient and will include screenings and labs not typically covered by insurance. Furthermore, Delwood will use the results of the exam to develop a wellness plan for each patient.

“I wanted a model of care where my patients stay as healthy as possible for as long as possible,” Delwood says.

The annual fee also includes an MDVIP patient membership, which provides access to a national network of MDVIP-affiliated doctors, as well as referrals to several prestigious medical facilities such as Johns Hopkins, M. D. Anderson Cancer Center and Mayo Clinic. columbiabusinesstimes.com /// 43

Delwood and all other MDVIP doctors are limited to a practice capped at 600 patients. With fewer patients, Delwood will be able to spend more time with them and tailor a specific wellness plan for each.

“The biggest issue for me is trying to provide opportunities for the patient to be able to talk about their health care in an unhurried way,” Delwood says. “I was looking for an environment where we could talk without outside influences or other barriers.”

Although Delwood is the first in mid-Missouri, he is one of thousands of doctors across the country flocking to the retainer or personalized care model of practice.

American Medical News reports: “The key drivers of why doctors convert to a concierge practice are they don’t feel they are practicing the manner in which they ought to be in terms of understanding the patient. Many of these doctors want to slow down the pace.”

Darrough, a local attorney, has been Delwood’s patient for nearly 10 years and enthusiastically agreed to the new model.

“Since injuring my back 25 years ago, I literally have seen hundreds of doctors,” Darrough says.

“I was immediately interested in a plan that gets me more acquainted with my doctor.”

Doctors are bound by a code of ethics to provide continuity of care, in essence, not to abandon their patients. Delwood, with the help of MDVIP, developed a four-month transition plan that provides his patients with the opportunity to transition to the new practice or to find them another primary care physician.

“The response has been very positive,” Delwood says. “Some of my patients were familiar with the concept or had it where they used to live.

There has been a high level of excitement.”

Having explained the transition process to nearly 2,000 patients, Delwood believes he will be close to reaching his 600-patient limit. And, he says, he has been getting phone calls from new patients interested in joining the personalized care practice.

“I am taking new patients, but when it fills up, it fills up; we’ll start a waiting list,” Delwood says.

Assessing the trend MDVIP was founded in 2000 by two primary care physicians from Florida who had been practicing for several years. According to Chief Marketing Officer for MDVIP Chris Lillich, “The two had found their practices to be too impersonal with too many patients, and they wanted to get back to their original vision of patient-centered care.”

44 \\\ April 2014

Since its inception, MDVIP and other similar physician networks have enjoyed immense growth and success. Even during the tough economic climate of the past few years, MDVIP has maintained a 94 percent renewal rate year over year.

In addition to the high renewal rate, research studies have shown the new model, with its focus on prevention, has actually saved the health care industry millions of dollars.

In 2012, an American Journal of Managed Care article reported MDVIP-member patients, when compared to nonmembers, were readmitted to hospitals 97 percent less frequently for acute myocardial infarction, 95 percent less frequently for congestive heart failure and 95 percent less frequently for pneumonia. The study analyzed data from the only five states that provide physician-specific data. Within just those five states, the estimated cost savings to the system was $119.4 million in 2010 alone.

Industry reports state between 7 and 10 percent of physicians will be moving to some form of retainer or personalized care model in the next one to three years. There are several reasons for the shift. Nationally, there is a shortage of primary care physicians, creating more patients per doctor. Medical school graduates are not entering the internist or family practice fields, limiting future numbers of primary care physicians. However, the

Additional services offered by some retainer practices • More time with physician during each visit • Same-day appointments or within 24 hours of calling • Extended evening and weekend office hours • Around-the-clock access to your physician, including pager, cellphone or home phone numbers • Personalized coordination of hospital care • House calls • Accompanied visits to specialists • Procedures and services that may not be covered by traditional health insurance, such as annual physicals, preventive care, weightloss programs and wellness advice • Less crowded waiting areas • Spa-like amenities Source: Dr. Michael Bihari, author of “Is Your Doctor Thinking about Switching to a Retainer Practice?” May 2013

most foreboding harbinger on the horizon is the Affordable Care Act, which is designed to pump 20 to 40 million formerly uninsured new patients into an already overcrowded system searching for primary care providers. Simply put, demand is outpacing supply.

Although Delwood did not cite the ACA as a factor in his decision, Lillich says it is a factor for many other physicians joining the ranks of MDVIP doctors.

“The ACA is generating a lot of interest in this model, especially with the roll out and confusion this fall,” he says. “People are looking for different options because of the uncertainty about what the future might hold.”

An article examining concierge medicine in the Internet Journal of Law, Healthcare and Ethics states, “Concierge models accomplish everything that healthcare reform is aiming to do, from lowering medical costs to improving access and increasing the quality of care.”

Still, opponents of concierge, retainer or other personal care models cite equal access to care as a primary concern.

The future of personalized care practices It’s true the earliest concierge practices did not accommodate equal access and were intentionally targeted at the wealthy. They had annual fees in excess of $20,000 and seldom accepted insurance. However, that original concept has diversified over the years and significantly reduced fees. Many but not all models will accept insurance.

Delwood, using the MDVIP model, will accept insurance and Medicare.

“I’ll still be in the same office,” Delwood says.

“I’ll still be on call at Boone Hospital; I’ll still share call with my group of doctors. I’ll still accept Medicare and traditional insurance.”

Public debate continues on whether the personalized care model excludes the poor. Proponents claim the cost, which is generally less than $5 per day, is affordable. The real culprit, proponents say, is people’s inability to prioritize their budgets to cover the cost of prevention and wellness.

For Darrough, who has struggled with the legacy of a life-altering injury, the decision is simple. He says: “Dr. Delwood is the best doctor I’ve ever had, but there’s only so much he can do in a few minutes. My friends with no major illnesses don’t understand the preventative aspect is huge. Until you’ve been ill, you don’t understand.

It’s a no-brainer for me.” CBT

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M o n e y, M e d i c i n e , Measurements & Meeting Demand As new models of ca re emerge a nd the ma rke t f o r he a lth ca re in C olumbi a continues to expa nd, loca l hospita ls a nd compa nies seek to simplify t h e p ro c es s a nd ensure a ste ady supply of medical profess i o na ls .

46 \\\ April 2014

Checking into a hospital for surgery is a detail-oriented enterprise. There’s the presurgery medication and food requirements to think about, the decision on whether to donate blood for possible transfusions after surgery, admission paperwork to complete and transportation arrangements to be made, to name just a few of the particulars.

And that’s before the business side of surgery comes into play. Surgical procedures themselves may involve an apparently complex array of arrangements and physicians, with their varied responsibilities, schedules and bills. Take knee joint replacements, an increasingly common surgery performed hundreds of thousands of times each year in the United States. Each knee replacement patient is treated at a minimum by an orthopaedic surgeon and an anesthesiologist and spends days recovering in the hospital following surgery.

Other procedures might call for a radiologist or a pathologist as well. All in all, the potential for a billing headache may seem high.

At University of Missouri Health Care Hospitals, a physicians group — University Physicians — helps organize the process. University Physicians is a multispecialty practice group that includes more than 500 physicians employed by the MU School of Medicine who offer care at the university’s hospitals and outpatient clinics. The group handles what’s called the “professional billing” that charges for physician effort, training and skills used during a procedure, University Physicians Executive Director Scott Hofferber says. Those bills are based not on a particular physician’s personal pay rate but on the procedures performed.

“So the doctor’s going to bill for the services he or she renders,” Hofferber says.

“And the payment is the same regardless of who renders it.”

Every surgical procedure and service has a so-called Current Procedural Terminology code assigned to it under a system developed and maintained by the American Medical Association. Physicians involved in a procedure inform University Physicians of the tasks or services they provided, and the group applies the appropriate code to each, Hofferber explains. University Physicians acts as a sort of physician fee clearinghouse, collecting all the CPT codes from a procedure and issuing a bill.

By Vicki Hodder Photo by Casey Buckman Photography

columbiabusinesstimes.com /// 47

MU surgical patients can expect to receive a second bill, considered a “technical fee,” he says. Mailed separately by any of MU’s hospitals, that bill covers such costs as charges for hospital rooms, equipment and laboratory tests.

Meeting demand TimeLine Recruiting, a national physician and health care staffing firm based in Columbia, highlights a number of community characteristics to attract physicians to the area.

Recruiters point to Columbia’s vibrant downtown, its wide range of amenities and its schools, says Lora Utley, TimeLine’s director of recruiting.

“It’s a college town with a medical school,” Utley notes. “We have good education here for physicians and their kids — and that appeals to any family and certainly to a physician’s family.”

TimeLine recruiters are working in a field feeling the pinch of a physician shortage driven by America’s aging population and the needs of those newly insured by the Affordable Care Act. Throughout the country, physicians are in short supply. By 2015, the physician shortfall will number 62,000, and by 2025, that shortfall will have grown to 130,600, according to Association of American Medical Colleges predictions.

Columbia can bear witness to that shortage, says Drew Lanham, the national director of TimeLine Recruiting. TimeLine Recruiting, a division of health care staffing firm Maxim Healthcare Services, focuses on recruiting physician faculty within academic medicine. Lanham notes that it has become generally more difficult to recruit physicians in every specialty over the past three to five years. The physician shortage “is everywhere,” he says.

“The shortage is here; the competition is here,” Utley agrees. “It’s in every community across the nation.”

TimeLine Recruiting works to offset that shortage with both tactics and incentives.

The firm’s recruiters start by widening the pool of candidates, talking to as many physicians as possible throughout the Midwest, for example, as they seek to fill a position in Columbia, Lanham says. TimeLine administrators also urge facilities recruiting physicians to recognize the national nature of the job market. The facilities should take a look at the median salaries as benchmarked by the Medical Group Management Association, billed as the premier association for professional administrators and leaders of medical group practices, Utley says.

Along with salaries, recruiting facilities can attract physicians by offering benefits that are proving popular. For example, Lanham says, student loan reimbursement appeals strongly to physicians who often have to repay between $300,000 and $400,000 in education debt. Any facility that can help shoulder that loan burden is offering a major bonus, Lanham says.

Another popular benefit is the option of a bonus structure, offering physicians the ability to make more money. Such bonuses may be based on such things as quality measures or a physician’s number of patient visits, Lanham says. Quality of life concerns, such as the ability to have a definite end to the work day, are also a significant factor in attracting physicians, he says.

With all its amenities, TimeLine has found that Columbia, which Utley considers midsized, neither a small town nor a metropolitan area, has a lot of recruiting appeal. “It’s a community that’s fun to talk about, to get physicians interested in,” Utley says. CBT

MU School of Medicine Physicians by Type

(509 full- and part-time physician employees as of Dec. 31, 2013) Medicine......................................................... 99 Child health.................................................... 55 Family medicine.............................................53 General surgery............................................. 40 Emergency center......................................... 34 Radiology....................................................... 34 Anesthesiology............................................... 31 Orthopaedics.................................................. 31

Pathology........................................................25 Obstetrics/gynecology.................................. 19 Psychiatry...................................................... 19 Neurology....................................................... 16 Ophthalmology............................................... 16 Physical medicine and rehabilitation........... 14 Otolaryngology............................................... 12 Dermatology....................................................11

Number of Hospital Beds (1 bed equals 10 beds) MU*

Boone

Number of Physicians

(1 stethoscope equals 10 doctors) MU School of Medicine+

MU Health Care+

Boone++

Includes both full- and part-time physicians, as of Dec. 31, 2013 15 directly employed by Boone Hospital Center

+

++

The Boss Mitch Wasden CEO and COO of MU Health Care

Total Personnel

MU: 5,804* Boone: 1,745**

Jim Sinek President and CEO of Boone Hopsital

Outpatient Visits

MU: 568,675* Boone: 162,454**

Admissions

Births

MU: 23,956* Boone: 17,003**

MU: 1,813* Boone: 2,196**

Total Operating Expenditures MU* Boone**

$672.3 MIL $275.7 MIL $175 Mil

$350 Mil

$525 Mil

$700Mil

Amount in Millions of Charity and Uncompensated Care Provided MU Health Care Hospitals/Clinics

University Physicians practice plan

$31.6* $19*

*For the fiscal year ending June 30, 2013 **American Hospital Association DataViewer Report, generated March 2014

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columbiabusinesstimes.com /// 49

50 \\\ April 2014

Amid crumbling walls and outdated facilities, Fulton State Hospital sits in desperate need of a massive structural overhaul, and the quest for funding is bringing together lawmakers and legislatures on both sides of the aisle who hope an improved facility will increase safety, save money and provide jobs.

B y C la i r e B o s t o n | P h ot o s b y a n t h o n y J i n s o n columbiabusinesstimes.com /// 51

posal, HB 2020, suggests a five-year debt repayment plan that would cost the state less in interest than Gov. Jay Nixon’s proposed 25-year bond issue, all proposals have the potential to add professional jobs to Columbia and also save Missouri millions.

Crunching the numbers

no secret that Fulton State Hospital needs to be fixed.

The place is crumbling. An asbestos-infested gym sits above the dietary center where patients’ food is prepared. Emergency exits at the maximum-security Biggs Forensic Center literally hang off the side of the building, their addition caulked in place with super-strength safety sealant that patients can’t rip out of walls. After all, in 1937, when Biggs opened, there were no standards for emergency exits, says Marty Martin-Forman, a 34-year Fulton veteran who now serves as the hospital’s chief operating officer.

Biggs may have been state-of-the-art once, but standards for mental health facilities have evolved in the past 77 years. Now, its long narrow hallways and staircases take 188 security cameras to monitor; yet, there are still blind spots. If a patient or staff member needs assistance at the end of a hall, aid may be out of sight and far away.

The hospital, which at its 1851 opening was the first public mental health facility west of the Mississippi River, sprawls on more than 95 acres in Fulton, about a half hour’s drive from Columbia. The facility maintains 30 separate buildings, four of which house its 350 patients.

The hospital has a 376-bed capacity, and the average client stays 2.7 years.

If funding comes through, many of Fulton’s current facilities could be demolished as early as next year. Biggs would be gone, as would the hospital’s administration building, dietary building and a number of unused buildings scattered across the campus. In their place would be a new one-story maximum and intermediate security complex that embraces modern technology and consolidates patient and administrative services, recreational and vocational space and staff training rooms.

Lawmakers from both sides of the Statehouse aisle agree that the hospital needs to be rebuilt. Legislators are considering different bonding proposals to fund the $211 million project. Although a recent Missouri House pro52 \\\ April 2014

“There’s no doubt, it’s a big construction project,” says Sen. Kurt Schaefer, R-Columbia, who chairs the Senate Appropriations Committee and has been pushing for funding for years. “The need for a new facility is really the chief driver for the project, but it’s great that it also generates jobs, and I’m not going to discount that.”

The Missouri Economic Research and Information Center, the research branch of Missouri’s Department of Economic Development, estimates that a $211 million construction project has the potential to create 2,532 new jobs.

The new jobs would almost exclusively benefit the area around Columbia and Fulton: 1,477 jobs would deal directly with construction, and about 1,055 would be related to the supply chain and other businesses that benefit from construction workers’ spending.

Construction jobs also pay more than Missouri’s average private-sector salary. Department of Economic Development spokeswoman Amy Susan says that 2012 construction pay averaged more than $50,000 annually, ahead of the state average of just more than $43,000.

The construction jobs, however lucrative, are only expected to last through the hospital’s tentative 2019 completion date, according to a December 2013 estimate of hospital rebuild plans. What could last longer, however, are jobs for registered nurses.

“There’s another kind of business, and that’s the ongoing permanent professionals

“The hospital is a disaster.

It’s bad for patients, it’s bad for employees, it’s bad for the state of Missouri, And it’s bad for treatment.”

— Rep. Chris Kelly, D-Columbia

who will work there,” says Rep. Chris Kelly, D-Columbia, another longtime supporter of Fulton’s funding.

The new hospital plans don’t substantially alter the hospital’s number of beds or 1,184 employees, but a new facility could help Fulton address its chronic shortage of registered nurses.

“RNs are kind of at the center of treatment,” Martin-Forman says. Although RNs play an integral role in the hospital, Fulton almost always has vacancies.

Martin-Forman says recent pay raises helped lower the RN vacancy rate to 18 percent. But vacancies hovered between 25 and 30 percent last year, and one December 2013 hospital estimate put the rate as high as 40 percent. Reports say better facilities could help keep professional staff positions full.

“That’s something else, too,” Kelly says.

“Those are very good and very permanent jobs.”

Columbia-area RNs averaged annual salaries of nearly $57,000 in 2012, according to Department of Economic Development research.

Schaefer says there is a definite connection between the Fulton and Columbia economies, driven in part by hospital workers living in Columbia and choosing to send their children to Columbia’s schools. The University of Missouri School of Medicine sends psychiatric residents to Fulton, and hospital materials advertise Columbia as a popular living choice for professional staff.

Statewide savings Beyond Columbia, a new hospital would also come with substantial savings for the state.

Poor hospital construction leads to high rates of workers’ compensation claims. Patients can behave dangerously, and Biggs’ narrow hallways and corners put workers at a disadvantage.

“You can’t catch all the blind spots where people might wait behind the corner,” Department of Mental Health spokeswoman Debra Walker says.

Workers’ compensation costs the hospital $4 million annually, by far the highest cost at any state facility. One in three workers at this hospital will file for workers’ compensation during their careers, which makes the hospital statistically a more dangerous place to work than the Missouri Department of Corrections. Reports say the state expects workers’ compensation claims to decrease in a new facility.

Serious injuries to staff members are down 33 percent in recent years, though Martin-For-

columbiabusinesstimes.com /// 53

man says the hospital still struggles with high rates of moderate injuries, such as soft tissue damage. Some injuries can be blamed not on patients but rather on outdated facilities.

Due to the hospital kitchen’s impractical location down the road from Biggs, dietary workers have to load patients’ meals onto box trucks before every meal.

Even routine activities such as food transport can be risky for staff members.

Martin-Freeman recalls one dietary worker who broke his arm loading food into the truck on a windy day. He wasn’t at fault. A gust of wind blew the heavy truck door into his arm, which resulted in a workers’ compensation claim for the hospital and several months of missed work for the man. Martin-Freeman says even seemingly small changes, such as combining the dietary center with Biggs, would cut down on costs and improve worker safety, which could affect retention rates.

“I don’t want you to expect to be hurt here,” Martin-Forman says. “That’s not OK.”

Moving forward Expecting a hospital rebuild, the Department of Mental Health and the Missouri Office of Accountability’s Facilities Management, Design and Construction Division have deferred $73 million in hospital maintenance costs. The maintenance might have to be funded if rebuild funds aren’t available soon.

“We are at the end of what we can do with what we have,” Martin-Foreman says.

As the Statehouse works to come to a funding agreement, Kelly says the rebuild makes economic sense, but his underlying support for the project lies in patient and worker quality of life. Kelly says he’s seen the hospital’s dark hallways and cramped quarters during legislative tours and that he feels the outdated facilities’ upgrade is 25 years overdue.

“The hospital is a disaster,” Kelly says.

“It’s bad for patients, it’s bad for employees, it’s bad for the state of Missouri, and it’s bad for treatment.”

Schaefer says the fact that hospital space is simply too antiquated to help patients recover motivates him to find funding.

“The importance really is that we need the facility,” he says. CBT 54 \\\ April 2014

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Where academia meets business, innovations result.

Springing up from the halls and labs of the MU College of Veterinary Medicine, some instructors with the entrepreneurial bug have taken their research to a whole new level. By Jim Camoriano

vettech 56 \\\ April 2014

The University of Missouri is known for many things. When it comes to fields of study, conversation more often than not revolves around the journalism school. In sports, it’s the SEC. In the music and entertainment world: Sheryl Crow, Brad Pitt or Chris Cooper. And in the business sector, it’s Sam Walton.

What you might not realize is the impact MU has had on the animal kingdom, well beyond its mascot, Truman the Tiger.

Inventions keep springing up from the halls and labs of the College of Veterinary Medicine, where a few instructors with the entrepreneurial bug have taken their research to a whole new level.

Researchers at MU are responsible for many animal health products on the market today. Some of these include the use of a computer tablet and sensors to detect where a horse may be hurting, the prevention of pink eye in cattle, acceleration of an animal’s immune system and a oral cleansing gel for dogs.

Honing the big idea Going from a big idea to a business is no small task. It takes an enormous amount of networking, persistence and funding. The good news for entrepreneurs in mid-Missouri is a culture dedicated to making those dreams reality. The Missouri Innovation Center plays a big role in this effort. Under its auspices, the Life Sciences Business Incubator opened five years ago to help companies develop viable ideas. The incubator rents lab space near the university’s football facilities and MU’s nuclear reactor.

Jake Halliday, CEO of the Innovation Center, says the 20-plus companies at the Incubator are thriving in a market conducive for entrepreneurship. “In Columbia, we have all the elements of the infrastructure you need to launch high-tech ventures,” he says. “We have physical lab space and legal, regulatory and grantwriting support. It’s not Boston, but it’s a nice-sized commmunity that has everything you need to get going.”

One of the companies operating out of the incubator is Equinosis, makers of the Lameness Locator, an increasingly popular system among veterinarians across the country. Its founder is Dr. Kevin Keegan, a professor of equine surgery at MU’s College of Veterinary Medicine.

The system identifies lameness in a horse via electronic monitors placed on the animal. The sensors transmit data wirelessly to a computer, which can detect any irregular or uneven body movement. What makes it unique is that it measures the energy of the vertical motion of the horse’s torso rather than observing the gait with the naked eye, which has been the traditional method for determining lameness.

A U.S. patent for the system contains the names of three men with connections to MU. Besides Keegan, the other creators are Dr. P. Frank Pai and Dr. Yoshiharu Yonezawa. Pai is a professor in the Mechanical and Aerospace Engineering Department at MU, and Yonezawa had worked at the university in years prior.

Keegan says their creation, which is now being used in about 140 locations around the world, was more of an evolution than a single concoction in a lab.

In the 1990s, Keegan put horses on treadmills and used highspeed cameras to complement the subjective evaluation of lameness. He teamed up with Pai to develop a way to measure a horse’s movement. Then came the chance meeting that would change everything.

A colleague encouraged him to attend a conference in Colorado put on by the Institute of Electrical and Electronics Engineers. “It was strange that a veterinarian would go to a conference full of engineers,” he says. While there, Yonezawa, a Japanese engineer from the Hiroshima Institute of Technology, approached him.

“He noticed I was from Columbia, which is where he had come many years ago to do a post-doctorate,” Keegan says. Keegan shared his work and the science behind it. Yonezawa was all in.

“I supplied the horses and the idea, Dr. Pai pioneered the algorithms, and Dr. Yonezawa made the sensors,” Keegan says.

Their ideas would need significant financial backing for them to progress from their lab to nationwide vet clinics. A local angel investment group, Centennial Investors, provided early money, which was then used to apply for more funding. They received an initial grant from the National Science Foundation’s Small Business Technology Transfer Program. “From there we sold prototypes, got matching funds and then sold more prototypes,” Keegan says. “It has been a good process, and we have generated more revenue than funding, so we’re in the black.”

Financial partners and translational research Investing money in a startup is not as easy as meeting up, pitching an idea and walking away with a big check. “If it’s an idea we really want to pursue, we’ll start peeling back layers of the onion, looking at their financials, intellectual property, competition and claims,” says Bruce Walker, president of Centennial Investors, a local angel investing group that provides funding for early-stage enterprises. “If it passes our tests, then members who are interested will ante up, typically $7,500 to $10,000 each.” Walker says the range of their startup funding is from $150,000 to just more than half a million dollars. columbiabusinesstimes.com /// 57

Centennial Investors has provided early funding to several successful startups, but every once in a while, companies decide to expand to other areas, such as Immunophotonics (cancer therapies).

“Companies may have another medical partner in a different city,” Walker says, offering a reason for local departures. “They sometimes feel the need to move where the venture capital is.”

After startups get some measure of funding, programs will begin holding competitions for grant money. Nonprofit Arch Grants of St. Louis has already provided almost $2 million to 35 programs, including a $50,000 check to Immunophotonics.

Although its funding is fairly small, Arch Grants touts its relatively easy application process as an attractive draw for entrepreneurs; it does not take equity from firms and only requires startups to have a presence in St. Louis.

Walker, who also served as dean of MU’s business school for 20 years, says he’s seeing much more local support for commercializing inventions. “There’s a real culture of entrepreneurial support in Columbia.”

so he could focus on the project. “The administration has been very open.”

Carolyn Henry, a veterinary oncologist at MU, says she sees a positive level of collaboration on the MU campus. “We now have curriculum related to entrepreneurship and a culture that encourages multidiscilinary, translational research and development,” she says. Translational refers to treatments for animals that hold promise for crossing over and benefiting humans.

An example is Henry’s own study of drug development for anticancer therapies. She has worked with a radiopharmaceutical compound originally developed in Columbia that was used on dogs with bone cancer. Dow Chemical eventually developed it as a therapy for human cancer patients under the name Quadrant.

In addition, MU’s College of Veterinary Medicine was one of the institutions that carried out the pivotal trial for approval of the drug Palladia, the first ever FDA-approved anticancer therapy for dogs.

More evidence of the collaboration of translational research and development in Columbia is the fact that Henry helps direct research at Columbia’s Ellis Fischel Cancer Center.

Spirit of entrepreneurship

Keegan agrees, though he says the environment in Columbia was challenging at first. For example, the first NSF grant required the primary investigator for a startup to be employed by the business concern. “I couldn’t leave my university job, so it was rough at first.” But the university, he says, was gracious enough to allow him to take a sabbatical 58 \\\ April 2014

Although most undergraduates look to start their own private practice, a spirit of entrepreneurship is also rising within the student ranks. Henry says they have recognized the need to provide students with exposure to alternative career options.

The college’s small animal clinic has an oncology clinical trials service separate from its typical trials service. “Students learn what is truly involved in conducting clinical research to the level of quality that will result in products making it through the approval process and to the health care market,” Henry says. “The typical barriers to innovation and entrepreneurship are simply being pushed aside by the energy on this campus.”

The serious focus on merging the talent of academia with business can also be seen in the number of area partnerships. You can count on one hand the number of universities in America that house a school of medicine, veterinary medicine, engineering, agriculture and law all on the same campus. When colleagues at these schools interact, innovations result. By the time you add the support of local Regional Economic Development Inc., the Columbia Chamber, angel investors and the Life Sciences Incubator, you have acquired significant momentum.

It also helps that mid-Missouri has the prestigious Kansas City Animal Health Corridor,

the stretch between Columbia and Kansas City housing firms specializing in animal health nutrition, innovation and production. The KC animal health and nutrition industry accounts for nearly one-third of the total sales in the global animal health market.

The animal health corridor was a great bonus for Bruce Addison, founder of Addison Biological Laboratory. The longtime Missouri resident wanted to remain in the state, and he got his wish; most of his clients are within a few hundred miles of his operation in Fayette. In addition, they export products to more than 25 countries around the world.

Addison counts himself blessed to have the College of Veterinary Medicine within a small commute from his operations. “When I’m on a research project, I can pay bright and talented people right there [at the college], instead of having to hire somebody outside, bring them in, only to see them leave,” he says. “You can solve a lot of

up and running. “I spent the first seven years working 90 hours a week,” he says. “A lot of people will tell you that you can’t do it, but if you listen to them, you might as well work for someone else.”

Another very successful product for Addison is the Maxi/Guard Oral Cleansing Gel for dogs and cats. Many dogs by the age of 3 have developed significant gingivitis. Addison says the overwhelming majority of owners just don’t think to brush their dogs’ teeth on a regular basis, which can shorten the lifespan of their pets.

The oral care product had its roots at the University School of Medicine, where Addison was working as a microbiologist and part of a research team. While they were working on a mouthwash for people, Addison began thinking toward an animal solution. “I figured a spray wouldn’t be effective for dogs because it would get in their face,” he says. So they developed a gel. Its success has been incredible. One story is of a handful of toy dogs bred in Dallas that, after going on a daily application of the product, went beyond a year without needing its teeth cleaned.

The application is relatively simple: Put a drop on your finger, and apply it on each side of the dog’s mouth. “When dogs usually undergo traditional oral treatments, they don’t sit in a chair and listen to you talk,” he says. “They have to be put under general anesthesia, which scares a lot of pet owners. With this product, you don’t have to worry about that.”

Nose to the grindstone problems and make a lot of breakthroughs here in mid-Missouri with the talent we have.”

The company is perhaps best known for its licensed vaccine for bovine pink eye, a product Addison himself invented that stems from his research in graduate school.

Addison Labs is one of the older vet technology companies in the area. It has learned what it takes to survive the economic upswings and downturns for the past three decades. The U.S. Chamber of Commerce selected it for the prestigious Regional Blue Chip Enterprise Initiative Award, and last year the Missouri Chamber selected Addison’s company as a Fast Track Award winner, which recognizes the fastest-growing companies in Missouri over the past three years. “Sometimes you get lucky,” Addison says.

It’s luck, perhaps, and a lot of investment. Aside from financial help from private investors, Addison kept his nose to the grindstone to get his company

Dr. Kevin Keegan

Dr. P. Frank Pai

Bruce Walker

Bruce Addison

Founder of the Lameness Locator

President of Centennial Investors

Co-inventor of the Lameness Locator

Founder of Addison Biological Laboratory

One thing aspiring entrepreneurs need to be aware of, Addison says, is the cost associated with going to market. He reiterated the need for angel investing by groups such as Centennial Investors to get projects off the ground.

“It took four years and $2 million to license our original pink eye vaccine,” he says. “Federal regulations and pricing continue to increase, and what used to take six months to realize now takes five years.”

That hasn’t stopped Addison’s group from plowing ahead though. More products seem to be on the way. They recently returned from a Las Vegas conference and had sales meetings with representatives from Japan, Britain and Brazil.

Keegan also has advice for those getting into startups. One must balance the promise and pitfalls and be diligent. “You have to have a strong family because it’s very difficult,” he says. “You have to surround yourself with people who are facilitators and move around people who are obstructionists.” CBT columbiabusinesstimes.com /// 59

Here are some inventions and work with ties to MU and the School of Veterinary Medicine

IMPEDX Diagnostics

EternoGen

Elemental Enzymes

Rapid blood culture technology

More durable collagen replenishment therapy

Production of more stable enzymes, which can operate under higher temperatures and last longer in harsh environments

Gold nanoparticle therapy for prostate cancer

NanovA A dental filler product with durable restoration, as well as bone screws and coronary stents using nanotechnology (formed by two MU professors)

Equinosis

Neogen

A system that detects lameness in horses, using sensors placed on the horse and run by a computer tablet (founded by an MU vet professor)

Genetic testing markers for improved quality of beef cattle

Zoetis Animal Health

Tensive Controls A new therapy to treat cancer cachexia, or weight loss and diminished appetite in cancer patients

Clinical trials for the first-ever FDA-approved anticancer therapy for dogs

A chamber to allow visualization of swallowing in dogs with neurological disease as a model for people with neurodegenerative diseases

IMMVAC in Columbia Gene therapies for treatment of neurological diseases such as Lou Gehrig’s disease and Batten disease

Dow Chemical

60 \\\ April 2014

A radiopharmaceutical compound that led to a drug that relieves bone pain in cancer patients

Vaccines and serums that vets use to protect against E. coli, salmonella and other pathogens

Idexx Bovine pregnancy test

A smartphone app that helps in management of cattle under heat stress

Electrochemotherapy for treatment of various solid tumors

Animal Health Specialties An exclusive worldwide license to use melanocortin to treat dry eye in dogs

Addison Biological Lab In FAYETTE Treatment for bovine pink eye and an oral care product marketed for dogs and cats

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Nonprofit Spotlight ›› Alternative Community Training

The Instrumental Advocate ACT works to build a single community.

Thirty years ago, Alternative Community Training didn’t even exist in its current form. It was a small private school called Woodhaven that focused on fulfilling the educational needs of students in Columbia with mental and developmental disabilities. In 1987, that all changed. Now, under a new name, ACT provides career services and training, in-home care and transitional programs for almost 500 people across a range of facilities, with more than 300 staff members and partnerships with businesses and other nonprofit organizations across mid-Missouri.

Person-centered approach A large contributor to ACT’s success over the past two decades has been its person-centered approach to services. Executive Director Mark Hassemer says every service ACT provides came from an expression of need in the community.

Don Howser Board president “ACT gives all of us involved and people in the wider community the ability to look past what you might believe people can do to find their true potential.”

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“It didn’t start because I had a great idea, or the board had a great idea, or my colleagues had a great idea,” he says. “We worked to develop relationships with all of our stakeholders, and these programs developed out of their needs, not because they were contrived out of something we necessarily think is important but from what we heard was needed throughout the community.”

This person-centered approach begins from the moment clients walk into ACT’s facility.

Their involvement in ACT’s variety in programming is dependent solely on individual goals and needs. Hassemer and his staff then work to find a program that will best suit each individual and what he or she hopes to accomplish by being part of the ACT community.

Currently, ACT supports six programs across its campus in Columbia and throughout mid-Missouri communities. These programs include ACT Career Services, ACT Works,

Carolyn Sullivan Board vice president “One of the most important aspects of ACT is allowing the people we serve to achieve their fullest potential.”

By Torie Ross

behavior development services, community integration, community living and personal assistance.

ACT Career Services and ACT Works, two of the organization’s most successful programs, provide work opportunities for people who utilize ACT’s services. These opportunities may come from within Columbia businesses through the ACT Career Services program or in house at ACT’s facility through ACT Works. The latter of the two services involves a recycling program where workers, both with disabilities and without, disassemble VHS tapes and other outdated mediums and recycle the parts for sale to manufacturers for use in new products.

Into the community Day services at ACT allow people with disabilities to go out into Columbia and other nearby communities and perform volunteer service. Hassemer says activities such as this go a

Bob Schaal Board member “My main objective as a board member is to introduce ACT and the people we serve to the community.”

Lyle Johnson Board member “ACT brings the joy and importance of work to the people we serve. It’s purposeful, and it’s a large part of feeling like a valued member of the community.”

➜ 2200 Burlington St. Columbia, MO 65202 573-474-9446

“People in this line of work aren’t in it for the money; they’re in it to help people. Finding those people is our biggest challenge today.”

— Mark Hassemer, executive director, ACT long way in reinforcing self-worth and accomplishment, something everyone can experience and benefit from. “You’ll see people getting into vans and heading out to parts around Columbia and mid-Missouri,” Hassemer says.

“They’re going to volunteer sights; we’ve been delivering Meals on Wheels for over 20 years.

We’re finding ways for people with significant disabilities to get involved in their communities and partnering with a lot of other nonprofits to do that.”

Rez Farid Board member “As a doctor who has a lot of patients with disabilities, ACT has helped me serve them better and be more proactive in their treatment. I think that community influence is a key part of ACT’s mission.”

Community integration allows ACT to fulfill its mission of creating a single inclusive community and finding ways for every member of that community to be involved in a positive and fulfilling manner. The organizing members of ACT believe that one of the organization’s strongest benefits is not to the people it serves but the education these types of integration programs give to people unfamiliar with ACT. Hassemer is quick to note that just being in the community does not mean being part of the community and that the programs he and his team have developed work very hard to bridge that gap.

Looking ahead While ACT looks ahead to expanding its programming and ability to serve the community, those involved are also realistic about their limits and needs. A large part of the board of directors’ work has centered on staffing. In a highly competitive job market, Hassemer says it is not as easy recruiting quality staff members as it once was. “People in this line of work aren’t in it for the money; they’re in it to help people,” he says. “Finding those people is our biggest challenge today.”

Susan Goldammer Board member “At ACT, the most important thing we can do, and something we’re all charged with, is giving a voice to the voiceless.”

ACT is also seeking out more partnerships with businesses in Columbia to expand its career services program and a newer program, STEP, which helps high school students with developmental disabilities learn and develop important skills for entering the job market after graduation.

Since the beginning, ACT has relied heavily on City of Columbia governmental organizations as well as businesses throughout Columbia and central Missouri for support in creating programs and growing its services. When ACT first appeared in 1987, it served a little more than 50 people; now, coming in strong at almost 500 people served on a daily basis, ACT is an instrumental advocate for people with disabilities.

After almost 30 years as executive director, Hassemer says watching the organization grow has been “quite a ride,” and he is looking forward to what comes next. CBT To assist ACT through either monetary donations or through donation of time, visit actservices.org, or call 573-474-9446.

Photos by Kendra Johnson. Not pictured: Cheri Ghan, Scott Maledy and Lisa Tye.

Steve Lee Board member “Community integration is a huge part of what we do here at ACT. That is the most important part of fulfilling ACT’s mission of creating an inclusive community.”

Trish Wallace Board member “I see ACT from the perspective of a board member, a parent of a child ACT served and as an occupational therapist, so I know how much thought goes into each program.”

columbiabusinesstimes.com /// 63

64 \\\ April 2014

Technology

›› Monica Pitts reviews the latest trends in tech

Health Matters The University of Missouri and Boone Hospital Center are making investments toward online technology geared to improve provider/patient communication in the office and out.

Online training From the first moment of, “How many alcoholic drinks do you consume a day?” some of us may be on edge and reluctant to talk to our doctors. We might be afraid of being judged, or we don’t even want to discuss the negative behavior with this highly educated person in a lab coat. Here’s the thing: Our doctor knows misuse of alcohol and drugs can affect our health; they just aren’t sure how to help us open up and talk about it.

MU ADEPT, Alcohol and Drug Education for Prevention and Treatment, is working to clear up the judging lab coat stigma and turn medical visits into teachable moments. Using SBIRT, a nationally recognized, evidence-based approach, the program works to put patients at ease and make them more receptive to the idea of adopting healthier behaviors.

The training is required for MU medical students, residents in several specialties, School of Nursing and social work students.

The online training component is also available to the public at no charge. SBIRT training starts online with a pretraining survey and then moves into a series of videos and learning modules followed by online quizzes. At the end of the online training, students participate in clinical practice followed by a competency evaluation to ensure their newfound skills are ready for use to fight negative health behaviors and the lab coat stigma.

Boone Hospital also uses online training to keep its professionals on point. Its website, bjclearn.org, is a center for lifelong learning providing personal and professional learning opportunities for staff.

Monica Pitts

The concept of staying connected online isn’t a new one. We’ve all used email for years, and social media keeps us even more connected than we need at times. As we turn more to the Internet for communication, it may seem odd that the only times you communicate with your doctor are during face-to-face, five-minute sessions, sometimes scheduled months apart. When the doctor asks, “Do you have any questions or concerns?” patients can feel like deer in the headlights and forget all the things on the must-ask list or successes to share about progress toward the goals outlined at the last appointment.

Cerner Corp. The institute initiates projects pairing health professionals with developers to marry advanced programming techniques and Web interfaces with a goal of improved patient care.

One such project, Gateway to Health, is geared toward educating patients about unhealthy behaviors they seek to overcome such as quitting smoking or lowering alcohol consumption. These patients are taken through a step-by-step process online starting with educational resources, moving toward setting goals and then recording progress toward those goals.

The doctor is automatically notified each step of the way through a widget on his or her patient chart summary starting first with a suggestion to enroll a patient based on health history. As the patient completes the educational and goal-setting components of the online program, the doctor is kept informed via the chart summary application. This keeps everyone in the loop and ready to discuss potential challenges and celebrate successes at the next appointment. CBT

Boone Hospital Center

Boone Hospital Center provides patients with a website enrollment option. The site allows patients to access and review their information such as lab and radiology results. The website also provides secure email correspondence with the patients’ health care providers as well as helpful information about testing, health topics and other related news.

The Tiger Institute for Health Innovation was founded in 2009 as a partnership between MU and

These forums allow for enhanced communication with patients, visitors, staff and physicians. These online communities often share thanks from past patients with staff for the care they provide; communicate community events, health tips and educational resources; and assist in improving patient service. facebook.com/boonehospitalcenter twitter.com/boonehospital pinterest.com/boonehospital instagram.com/boonehospitalcenter myboonehealth.com

➜ P i t t s i s t h e c h i e f c r e at i v e d i r e c t o r o f M ay e C r e at e D e s i g n . columbiabusinesstimes.com /// 65

66 \\\ April 2014

Restored V i s i o n

Celebrations ›› Restoration Eye Care

Eye for Business

Restoration Eye Care experiences growth, looks to expand its facilities and services.

Dr. Tim D. McGarity. Photo by Kendra Johnson.

Timeline 2011 › McGarity is asked by H. Kell Yang to take over his practice and all patient care, under the name Timothy D. McGarity M.D.

› McGarity’s clinic adds new and advanced technologies to improve accuracy of LASIK and cataract operations.

2012 › The company adds laser technology to all operations on top of the LASIK and cataract surgery, which improves accuracy and eliminates the use of blades.

2013 › McGarity’s clinic begins serving areas in northern Missouri, primarily Macon.

2014 › The clinic undergoes a name change and becomes known as Restoration Eye Care.

Tim McGarity first established an interest in the anatomy of the eye during his second year of medical school at the University of Arkansas, where he graduated in 2002. He was determined that restoring sight quickly was a valuable field, and in 2011, he was given an opportunity to run a business.

Then an assistant professor of clinical ophthalmology at the University of Missouri, McGarity had already put his medical and surgical residencies into use. But that July, H. Kell Yang asked McGarity to take over his practice, which he renamed Timothy D. McGarity M.D. Later renamed to Restoration Eye Care to better express its goals and purpose, the clinic specializes in LASIK and cataract surgery, though it also offers procedures for glaucoma and eyelids and performs other general eye tests.

“We updated the name because we wanted our name to reflect what we do,” McGarity says.

McGarity compares the human eye to a camera, for which there are two lenses that allow you to focus and see a clear image. The front lens, which is the cornea, is the target of LASIK. The inside lens, called the crystalline lens, is the target of cataract surgery.

Although eye surgeries come with side effects, McGarity describes LASIK as a typically painless, quick and safe procedure.

He says that complications are extremely rare, and reducing side effects is simple: Just close your eyes to let them heal, and use eye drops to prevent discomfort. Surgery patients may have foggy vision for the first day or two following the procedure, but their sight will be surprisingly crisp afterward, McGarity says.

by Steven Benna “We use all laser technology, meaning no blades,” McGarity adds. “We invested heavily in technology and lasers, which provides more accuracy and safety.”

The cost of the procedure ranges from $1,600 to $2,400, depending on the circumstances.

“It’s an economically driven business.

Our growth rate has increased with the progressive rebound of the economy.” — Dr. Tim McGarity, owner/founder, Restoration Eye Care Economy and growth Restoration Eye Care performs an average of 40 LASIK surgeries and 100 cataract surgeries per month, McGarity says. However, last month the clinic saw an increased amount of LASIK procedures.

“It’s an economically driven business,” McGarity says. “Our growth rate has increased with the progressive rebound of the economy.”

With that increased business, Restoration Eye Care has outgrown its clinic capacity, and to accommodate the growth, McGarity plans to open a new and bigger clinic by early 2015. The eye clinic, which operates primarily out of Columbia, began serving northern Missouri toward the end of 2013. In the early months of 2014, McGarity and staff also began serving the Lake of the Ozarks region. CBT columbiabusinesstimes.com /// 67

Deeds of Trust

›› Worth more than $300,000

$18,940,000 AP Investors LLC First National Bank of St. Louis LT 1 Fellows Add 5

$903,989 Tran, Nancy and Trung Commerce Bank LT 32 Arrowhead Lake Estates

$16,700,000 Stadium Lodging LLC First National Bank of St. Louis LT 1 Fellows Add 7

$900,000 JQB Construction Inc. Boone County National Bank LT 7 PT Old Hawthorne Plat 1

$7,963,046 Stricker, William E. and Pamela H. The Central Trust Bank LT 601 Bluff Creek Office Park Plat 6

$900,000 Schnell, Dennis and Rebekah Canton State Bank STR 16-51-12/SW/SW

$4,994,000 Beres Foods LLC BMO Harris Bank LT 3 Broadway Bluffs Subdivision $3,918,057 Chance, Albert B. Trust Landmark Bank LT 17 Fox Run Sub Plat 2 $1,769,057 Grove Hollyhock Properties LLC First Midwest Bank of Poplar Bluff LT 22 Valley View North

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$500,000 Boone Development Inc. Commerce Bank LT 1A Scheulen Acres Blk 2 $470,550 Shindler, Phillip A. and Jerilou Landmark Bank LT 15 Deerfield Ridge Plat 2 $463,000 Loop 70 Properties LLC Enterprise Development Corp.

LT 91A Alamo Place Plat 1A

$417,000 Harding, Richard C. and Linda J. USAA Federal Savings Bank LT 81 Woodlands Plat 4A The $355,000 Duemmel, Michael E. and Monica Sue Landmark Bank LT 139 Pines The $345,500 Hager, Chad M. and Nora L. Mid America Mortgage Services Inc. LT 135A Woodlands Plat 5A The LTS 135 and 136 $343,079 Hoffman, Pamela L. and Daniel R. The Central Trust Bank LT 3 PT Champetra Lake 4 $335,000 Palmer, Robert V. and Candace L. First Internet Bank of Indiana STR 13-47-13 //N SUR BK/PG: 886/174 FF Tract 8A $330,000 Pate-Jones Construction Inc. Hawthorn Bank LT 224 Heritage Woods Plat 2 $325,799 Shortline Properties LLC First Midwest Bank of Poplar Bluff LT 301 Westcliff Plat 3

$435,000 Wallace, Doug M. and Kathy D. The Bank of Missouri STR 22-49-14 //E Sur BK/PG: 1395/7 FF Lot 9

$321,000 Herd, Nicholas L. and Jennifer L. The Callaway Bank STR 19-50-12 /SE/SE SUR BK/PG: 4117/48 AC 4.140

$1,048,000 MJM Enterprises LLC The Bank of Missouri LT 102D Eastport Plat 1A-3

$417,000 Habermehl, Brian and Leigh Bank of Cairo and Moberly LT 707A Villas at Old Hawthorne Plat 7 The

$316,000 Ambilichu, Moses Tabe West Plains Bank and Trust Co. LT 213A Vineyards Plat 2A The

$1,000,000 KCP Hospitality Inc. Boone County National Bank LT 2 Centerstate Plat 3

$417,000 Harding, Richard C. and Linda J. USAA Federal Savings Bank LT 81 Woodlands Plat 4A The

$1,090,000 Keithahn, Living Trust; Mari Ann and Stephen Commerce Bank LT 20 Arrowhead Lake Estates

[

$540,000 Patterson Property Management LLC Hawthorn Bank LT 20 BL 1 Fairway Meadows

$417,000 Simms, Sam R. and Karen L.; Divincenzo, Frank Landmark Bank STR 10-47-12 //NW SUR BK.PG: 2754/78 AC 10.000

$463,000 Loop 70 Properties LLC Enterprise Development Corp.

LT 91A Alamo Place Plat 1A

$1,106,380 Berendzen/Gage Rentals LLC First State Community Bank LT 6 Dannarville Sub Blk 2

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$1,769,057 Grove Central City Properties LLC First Midwest Bank of Poplar Bluff LT 5 BL 1 Hunthill Sub

$540,000 Midwest Columbia Properties LLC Hawthorn Bank LT 5 BL 1 Fairway Meadows

335

Deeds of trust were issued between Feb. 3 - Mar. 3

$304,000 Beronja, George and Kelly Hawthorn Bank LT 34 Gans Creek Sub Plat 1 Blk 3 CBT

Economic Index ›› It’s all about the numbers Arts: (City of Columbia Office of Cultural Affairs) Total allocation FY13: $94,125 FY14: $92,667 Total amount requested FY13: $172,449 FY14: $159,537 Total project budget of all organizations FY13: $2,748,708 FY14: $2,595,077 Average award amount FY13: $4,482 FY14: $4,878 Highest request FY13: $10,000 FY14: $10,000 Lowest request FY13: $1,500 FY14: $1,750

Construction: Residential building permits January 2014: 77 January 2013: 60 Value of residential building permits January 2013: $12,203,291 January 2012: $16,453,587 Detached single-family homes January 2014: 35 January 2013: 23 Value of detached single-family homes January 2014: $8,665,189 January 2013: $4,211,642 Commercial building permits January 2014: 15 January 2013: 22 Value of commercial building permits January 2014: $6,489,026 January 2013: $5,482,566

Commercial additions/alterations January 2014: 14 January 2013: 18

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Value of commercial additions/alterations January 2014: $5,489,026 January 2013: $3,502,566

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Housing: Single-family homes sales, Boone County January 2014: 75 January 2013: 98 Single-family active listings on market, Boone County January 2014: 667 January 2013: 604

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Single-family homes average sold price, Boone County January 2014: $202,371 January 2013: $166,735 Single-family home median sold price, Boone County January 2014: $166,000 January 2013: $159,500 Single-family homes average days on market, Boone County January 2014: 88 January 2013: 81 Single-family pending listings on market, Boone County January 2014: 123 January 2013: 131

Utilities: Water January 2014: 47,050 January 2013: 46,064 Change #: 986 Change %: 2.1 percent Electric January 2014: 47,565 January 2013: 46,694 Change #: 871 Change %: 1.9 percent CBT columbiabusinesstimes.com /// 69

New Business Licenses ›› Columbia residents and their upstarts

A.C.A. Auto Sales 1812 Monroe St. Car sales AA Auto Sales LLC 1111 N. Providence Road Used vehicle sales Hair By Kristy 124 E. Nifong Blvd., Suite H Cosmetology Alice Schawo LPC 3610 Buttonwood Drive Mental health counseling Big Daddy’s BBQ 301 W. Sexton Road, Suite B Food concessions trailer Nikko Enterprise Corp.

111 S. Providence Road, Suite 101 Retail, antique books Red Mango 1009 E. Broadway Yogurt and smoothies Coegi LLC 500 W. Business Loop 70 Digital marketing and advertising company El Campo Azul 504 W. Business Loop 70 Mexican restaurant and bar

70 \\\ April 2014

Advantage Metals Recycling LLC 705 Proctor Drive Scrap metal manufacturer Hair Spectrum, The Red Door Salon 711 Vandiver Drive, Suite E Salon Jade Henigman Hair 1505 Chapel Hill Road, Suite 105 Hair stylist MFA Oil Co. 1 Ray Young Drive Co-op buying and selling refined fuels BrightStar of MidMissouri 108 E. Green Meadows Road, Suite 8 Private duty home health care Zaxby’s 1411 Cinnamon Hill Lane Casual-fast food, dine-in or carry-out restaurant Skin Solutions 2800 Forum Blvd., Suite 4 Spa: facials, massage, chemical peel, waxing

9th Street Public House 36 N. Ninth St. Drinking establishment

Sprint 2540 Broadway Bluffs Drive, Suite 105 Retail sales of wireless communication/access

Lucky’s Farmers Market 111 S. Providence Road Groceries, general line

Subway Business Office 2000 Forum Blvd., Suite 4 Business office for Subway and Five Guys

Frost Supply 1809 Santa Fe Place Distributor of electrical, safety and utility tools

Universal Protection Service 2300 Bernadette Drive Security guard service

Shelter Distribution 1716 E. Business Loop 70 Distribution of commercial and residential roofing product PSC Industrial Outsourcing LP 210 W. Sand Bank Road Manufactured gas plant remediation consultants Toys “R” Us 2300 Bernadette Drive, Suite 302 Retail toy store Feel Good Chairs 2300 Bernadette Drive Therapeutic vending massage chairs, Columbia Mall Value Giant LLC 1810 Paris Road Buy and sale of retail, including precious metals 1040 Tax Biz 203 N. Providence Road, Suite 101 Tax preparation and insurance services A to Z Facility Solutions LLC 100 N. Broadview New and used furniture, Web based The Bernhardt Group LLC 2232 S. El Centro Court Full bookkeeping and individual tax return service Property Care Services LLC 5607 Button Buck Circle Clean and repair apartments, paint CBT

By the Numbers ›› Boone County statistics

Age distribution in Columbia

They say if you haven’t got your health, you haven’t got anything.

Take a look at the numbers behind the industry responsible for good health and good care in Columbia.

Source: 2012 U.S. Census

percentage

Carroll Wilkerson, CFP® Jared W. Reynolds, CFP®

Average higher-paying jobs* Source: Bureau of Labor Statistics

= $10

0-9

Pharmacists:

10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89

90+

Age Groups Top 10 causes of death in Boone County, 2011

veterinarians:

Source: Missouri Department of Health and Senior Services Missouri Information for Community Assessment

= 10 people

Average lower-paying jobs*

Do you know the answers to these questions?

Source: Bureau of Labor Statistics

Medical & clinical laboratory assistants: pharmacy technicians: Cancer Heart disease Stroke Accidents & adverse effects Other digestive diseases Chronic lower-respiratory infection Alzheimer’s Diabetes Pneumonia/ influenza Suicide

*Hourly pay based on a 40-hour work week

Percent of total employment (U.S. and Columbia) Source: Bureau of Labor Statistics

Industry stats: Health care and social assistance in Columbia Source: U.S. Census Bureau, 2007 Economic Census

15,522 employees

88.2%

•

What happens when your advisor retires before you do?

•

Has your advisor changed with the economy, or is it still buy, hold, and hope?

•

What happens to your accounts if your advisor doesn’t wake up tomorrow?

FIND A BETTER WAY:

876

83.5%

Employer Establishments

5.9%

9.1%

3% 2.9% u.s.a.

columbia

Health care practitioner and technical

Health care support

Personal care and service

4.7%

2.7%

Other

$2 million

Value of sales, shipments, receipts, revenue or business done

$784,685 Annual payroll

573.875.3939 • WRWEALTH.COM Chronic disease indicators in Boone County Department of Health and Senior Services County Data Profiles, 2011 Health and Preventive Care Practices

Disease No health care coverage Smoking No leisure time physical activity Less than five fruits/vegetables per day Overweight Obese High blood pressure High cholesterol Diabetes

2011 19.8 percent 20.7 16.5 86.3 30.3 25.1 26.5 45.4 8.5

2007 14 18 18.2 71.7 35.5 25.9 14.2 17.8 5.7

columbiabusinesstimes.com /// 71

6 Questions

➜ Mizzou Athletics Training University of Missouri Columbia, MO 65211

›› Get to know your professionals

Rex L. Sharp

Associate athletic director/sports medicine, University of Missouri 1. How many trainers do you employ? Our Mizzou Athletic Training staff has continued to grow as the comprehensive scope of the athletic program has grown.

When I arrived in 1996, the MU Athletic Training staff consisted of four full-time certified athletic trainers, three certified athletic training graduate students and eight undergraduate student athletic trainers. Presently, we have 12 full-time certified athletic trainers, six certified graduate assistant athletic trainers and an exciting new undergraduate athletic training program of study that has an enrollment of 36 undergraduate athletic training students. The athletic training program is in its infancy, and all 36 of our students are sophomores.

Fun Fact: 72 \\\ April 2014

4. What sports teams see the most injuries, in total? By sheer volume of numbers of participants and injury exposures, fall football easily accounts for the highest number of injuries/illnesses.

In fact, as a program we average three injuries/illnesses per day for the entire year. That accounts for some numbers. Track and field and spring football are second and third, respectively. However, the sport that experiences the highest injury rate per participant is women’s gymnastics.

Photo by Anthony Jinson.

2. How many athletes do you oversee? My primary clinical athletic training responsibility is with the Mizzou Football program, making for direct oversight of 127 student athletes. By virtue of being the director of sports medicine, or whatever title may apply, I oversee the athletic health care needs for all 540 student athletes.

3. Do your trainers specialize in one sport? We have a very diverse, well-rounded group of athletic trainers at Mizzou. Although each staff member may concentrate his or her clinical efforts with his or her assigned intercollegiate sport, each is well prepared to work with or assist with other sports as needed.

I have always subscribed to the philosophy of hiring good, well-trained, energetic people and providing the resources they need to perform their job functions at a high level.

5. Is there a trainer present at every practice and game, or are they just on call? At least one staff athletic trainer is present at each practice and competition, and with the accessibility provided by cellphones, our staff is on call 24 hours every day, all year.

6. What is something most people are surprised to know about this profession? Athletic trainers are often perceived as a hybrid between strength coaches and personal fitness trainers, when in reality, athletic trainers are licensed health care professionals primarily focusing on three very important components: athletic injury prevention; athletic injury evaluation, treatment and management; and athletic injury rehabilitation. Prevention starts with ensuring the athlete has a thorough preparticipation history, screening and physical examination. Prevention also involves substance-abuse screening and education, designing and organizing venue-specific emergency action procedures to be activated in the event of a serious injury, monitoring the safety of extreme environmental conditions and preventive taping (ankle taping/ knee taping, etc.). In addition to prevention, athletic trainers are responsible for the acute and post-acute treatment and management of injuries and serve as referral sources for physical and mental health consultations and the overall organization and administration of a comprehensive athletic health care program that makes athletic participation as safe as possible. CBT

➜ Sharp Fxxxx and his staff were recognized twice as the Big 12 Conference Athletic Training Staff of the Year: in 2000 and 2011.

ADVERTISER INDEX Accounting Plus............................................... 75 ACT Inc..................................................................61 Anthony Jinson Photography....................49 Boone County National Bank.......................5 Caledon Virtual....................................................9 Carpet One...........................................................6 Casey Buckman Photography..................45 Central Trust & Investment Co................. 55

It’s possible It’s possibl You can increase the appraisal of your home when you’re ready to sell.

Child Care Aware............................................. 22 City Of Columbia Water & Light...................4

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Clapboard Pictures........................................66 Cmse Giving Gardens....................................14 Columbia Chamber Of Commerce........ 13 Commerce Bank.............................................26 Evans & Dixon LLC............................................ 11 Flat Branch Pub & Brewing...........................19

GAYLA’S TIP:

Gfi Digital............................................................69

“

Hawthorn............................................................76

Jeep, Dodge Ram...............................................3 Mercedes Benz of Joe Machens..............20 Joe Machens Ford, Lincoln, Mercury....... 15 KMIZ.......................................................................30 Landmark Bank...................................................2 Mayecreate Web Design...............................16 Mediacom............................................................ 12 Mid-City Lumber Co................................22,73 Missouri Employers Mutual.........................18 Naught Naught Insurance Agency..........54

raphy

“

Granite or quartz countertops in a kitchen today can help increase the appraised value.

ard Photog ra

Moresource Inc...................................................7

CASEY’S TIP: Kari Reich

Midwest Computech......................................61

rd Photog

Joe Machens Chrysler,

Buyers are looking for tile showers in a new home in 2014.

Kari Reicha

Joe Machens Volkswagen...........................42

phy

Room 38.............................................................. 55 Smart Business Products............................68 State Farm Insurance Stephanie Wilmsmeyer................................54 Tech Electronics..............................................26 The Bank Of Missouri..................................... 28

Mid-City Lumber has four locations in Central Missouri. You can reach Gayla and Casey at their Jefferson City store. Call 573-636-6138 for their expert, on-location help wherever you live.

The Olde Un Theatre.....................................70 Tiger Scholarship Fund..................................10 University Of Missouri Health Care.........64 Visionworks........................................................ 22 Watkins Roofing...............................................69 Wilkerson & Reynolds Wealth Management...................................................... 71 Wilson's Fitness..................................................8

4709 Paris Road • Columbia, MO 573.474.9531 • midcitylumber.com columbiabusinesstimes.com /// 73

Flashback ›› Then and now

➜ The Columbia business landscape is always evolving, but it’s important to remember our historical roots.

By Claire Boston Photo by Whitney Buckner

Although it hasn’t housed the University of Missouri’s Student Health Center in more than a decade, the building at 410 S. Sixth St. on the west side of MU’s campus is still known simply as “Old Student Health Center” on university maps.

The building’s façade bears no signage, but today it houses parts of MU’s College of Engineering. Faded window paintings of shamrocks, the symbol of engineering, decorate its main doors.

The Old Student Health Center was designed in 1935 and constructed in 1936 by St. Louis-based architectural firm Jamieson and Spearl. The firm was also behind a number of storied MU spaces, including Memorial Union, Faurot Field and Elmer Ellis Library.

Columbia’s history in the health care industry dates to the early 1900s; the health center was connected to two hospitals. Prior to constructing the

health center, in 1922 Jamison and Spearl worked on Noyes Hospital, which sat in front of the center. Before Noyes, Parker Memorial Hospital was designed by Thomas Nolan, a Columbia-based architect, and constructed in 1889. The space became MU’s first teaching hospital in 1901. The hospitals were absorbed into the new University Hospital in 1956, but MU still uses the buildings, now called Noyes Hall and Parker Hall, to house parts of the Psychology Department and the MU Counseling Center.

Between 1945 and 1947, MU’s student body more than doubled as veterans returned from World War II. The pre-war student body hovered around 4,000 but swelled to 11,000 by the 1946-47 academic year. To accommodate the influx of students, MU acquired temporary housing from the federal government, including building T-18, a

dome-shaped war surplus barrack that sat between the Old Student Health Center and McAlester Hall.

MU’s Design Services, a division under the umbrella of MU Campus Facilities, conducted a 1962 repair to the building’s bricks, mortar and caulking. By then, Jamieson and Spearl had shuttered, but it outlasted its founders’ deaths and oversaw a 1953 renovation of Jesse Hall.

Nestled behind Noyes Hall and Parker Hall, the health center was small and difficult for many students to find. Its pharmacy closed in 2001, which required students who wanted to fill prescriptions on campus to trek to University Physicians Medical Building’s first-floor pharmacy, located at 1020 Hitt St. on the other side of campus.

The center itself moved to the fourth floor of the medical building in December 2002 and began taking students there in January 2003. CBT

➜ We love Columbia business history. If you have any interesting photos and stories, please send them to Editor@BusinessTimesCompany.com 74 \\\ April 2014

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