July/Aug 2019 Bulletin by Laura Griffin

Editors: Kacey Montgomery, M.D. | Erica Huffman, Executive Director

www.escambiacms.org

Bulletin JULY/AUGUST 2019 VOLUME 49, NO. 3

CONTENTS

While thinking about what subject in medicine I would write about next, I considered malpractice, loss of autonomy, new Florida opioid prescribing rules or possibly more on burnout. Not the most uplifting of subjects—then I reread the last bulletin’s message where I mentioned that “each physician represents a family. It is family that allows us to weather the storm of burnout.” So below I am sharing my family’s or at least my wife’s perspective. Whether it be a spouse, friend, sibling, significant other or colleague, I hope you all have someone as dedicated as I do in your corner. By Rocky Parra Today while shopping a complete stranger walked up to me with tears in her eyes and asked my name. I quickly told her “Rocky Parra”. Her eyes filled with tears as she proceeded to tell me “your husband saved my husband’s life and I couldn’t let the opportunity to thank you pass.” Naturally my eyes filled as well, I thanked her for taking the time to share her story with me. We spoke for several minutes before we parted and went about our days. She will never know how much that moment meant to me or to Brett. In a week where he’s on call and spending more time than usual at the hospital and the office, it was a tangible reminder of why he chose this profession—he wants to help people. Despite all that threatens to steal away the joy of medicine, like most physicians, he still loves taking care of patients, improving and on occasion even saving their lives. Due to HIPPA provisions and in an attempt to keep work at work, we don’t discuss specific patients. Instead days get categorized as “good” or “bad”, they are “productive” or “inefficient”, he walks in with a smile or frustration and I try to listen to what he can share and offer support where I can. Often, he will ask me to pray for a patient, not by name, but just to pray for who he will operate on that day or who he’s going in to see in the middle of the night and so I pray earnestly, for the patient, their family, the rest of their medical team and for Brett.

Page 4 - President’s Letter Ctd. Page 6 - Practice Mgmt. Page 8 - Medical/Legal Page 13 - Foundation Page 15 - Community

Save the Date August 27th Young Physicians Section Meeting V.Paul’s September 29th Women in Medicine Brunch Escape Wellness Spa October 10th Wine Gala Foundation Fundraiser The Fish House

Continued on Page 4 RETURN SERVICE REQUESTED PRSRT STD U.S. POSTAGE PAID PERMIT #258 PENSACOLA, FL

Founded in 1873

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Calendar

4771 Bayou Blvd. # 157 Pensacola, FL 32503 Ph: 850-478-0706 Fx: 850-474-9783 Email: info@escambiacms.org www.escambiacms.org

E.C.M.S. Bulletin

The Bulletin is a publication for and by the members of the Escambia County Medical Society. The Bulletin publishes six times a year: Jan/Feb, Mar/Apr, May/Jun, Jul/Aug, Sept/Oct, Nov/Dec. We will consider for publication articles relating to medical science, photos, book reviews, memorials, medical/legal articles, and practice management.

•

New Members Anwar, David, M.D IC NPI: 1609196377 West Florida Cardiology/Northwest Florida 8333 North Davis Highway 4th Floor Pensacola, FL 32514 (850) 969-7979 Fax: (850) 474-9352 www.nwfheartgroup.com

2019 Calendar

Vision for the Bulletin:

Appeal to the family of medicine in Escambia and Santa Rosa County and to the world beyond. A powerful instrument to attract and induct members to organized medicine.

August 27, 2019 | V.Pauls General Membership Meeting/CME/Young Physicians Section Meeting “Contracts and Contract Negotiations for employed physicians” Sunday, September 29, 2019 | Escape Wellness Spa

Mission:

Advancing physicians’ practice of medicine in our community.

Women in Medicine Brunch October 10, 2019 ECMS Foundation Fundraiser Wine Gala Student Tickets $25 The Fish House Deck November TBA General Membership Meeting/CME “Risk Management” TBD December OFF

Ad placement Contact Erica Huffman at 478-0706 Ad rates 1/2 page: $350 · 1/4 page: $200 · 1/8 page: $150

2019 MEMBERSHIP DUES 2019 ECMS Invoices have been mailed. If you did not receive a copy of your invoice please contact Erica Huffman at (850-478-0706).

View and opinions expressed in the Bulletin are those of the authors and are not necessarily those of the board of directors, staff or advertisers. The editorial staff reserves the right to edit or reject any submission. ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

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Letter President’s Letter Continued Continued from Page 1

The ripple effect of his call to medicine does not end with me, it also impacts our children. He always tries “to be a good dad, a good husband and a good doctor,” knowing sometimes to be good at one, he has to falter at another. When our children were younger it was sometimes difficult to explain why dad missed a school play, swim meet or birthday party. Fortunately, as they matured, they learned the benefits his career provided our family and that there was a trade-off, dad would be at everything he could, but sometimes patients need him more in that moment than we do. The children are not “children” any more, they are young adults, ages 22, 21, 18 and 14 trying to find their place in the world and figure out what they want to be “when they grow up”. I understand that some of them are technically grown up, but they have not specifically decided how they want to impact the world around them. We have always encouraged them to find something they love and look forward to doing each day. He almost discouraged them from pursuing medicine because the medical field he entered twenty-five years ago is not the field he practices in today; he said “be a dentist or engineer.” Ironically, his advice fell on deaf ears. Our youngest daughter is in the midst of applying to medical school. She has a passion for science and a desire to help people and believes medicine is the place for her. She’s right. When I take a step back and look at it objectively, medicine is still a great profession. There is no shortage of jobs available for physicians and the starting income is still well above the national average. There are jobs available in almost any location, city, rural, employed, independent, etc. The best part is that she naively won’t realize just how much medicine has changed the last two decades and she will be a force in shaping the future of it. I feel quite blessed to be a spectator, cheerleader and a prayer warrior to first my husband and now my daughter as they navigate this noble profession.

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Delegates 2019 ECMS Delegates to the Florida Medical Association • Brett Parra, M.D. • Ellen McKnight, M.D. • John Lanza, M.D. • Brian Kirby, M.D. • Casey Mickler, M.D. • Kacey Montgomery, M.D. • Susan Griffee, M.D. • Ken Long, M.D. • Hillary Hultstrand, M.D.

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Practice Mgmt. Challenges of Cultural Diversity in Healthcare: Protect Your Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Patients and Yourself Susan Education, The Doctors Company Physicians are increasingly faced with providing care to a multicultural society complicated by literacy issues. Ensuring safe and quality healthcare for all patients requires physicians to understand how each patient’s sociocultural background affects his or her health beliefs and behavior. Consider the following scenarios: A married 32-year-old Middle Eastern female with uterine fibroids presented at the office of a gynecologist. After years of infertility and pain, a hysterectomy was recommended. She spoke English moderately well but with a heavy accent. Offers of an interpreter were declined, including translation of the surgical consent form. Eight weeks posthysterectomy, the patient asked the physician how soon she could expect to become pregnant. An elderly female Asian patient was noncommunicative with the physicians and staff during the first three days of her hospitalization. She would not maintain eye contact or talk, even when an interpreter was provided. Communication regarding the patient’s care or concerns would occur only when a male family member was present. The staff and physicians—concerned with privacy issues—generally spoke with the patient when family members were not present. After several days of delayed treatment because consent for a necessary but nonemergent surgery could not be obtained from the patient, a visiting chaplain of the same nationality explained the cultural requirement that a male be present for a female’s care. Addressing the Problem The Doctors Company’s closed claims studies have shown that inadequate provider-patient communication is a frequent contributing factor to patient noncompliance, poor patient outcomes, and litigation. Effective provider-patient communication leads to an increase in patient satisfaction, better compliance, and improved outcomes. In multicultural and minority populations, the issue of communication may play an even larger role because of behavioral, cognitive, linguistic, contextual, and cultural barriers that preclude effective patient-provider communication. Research has shown that services for minorities can be improved by removing language and cultural barriers. When cultures and languages clash, physicians are unable to deliver the care they have been trained to provide. Culturally competent care depends on resolving systemic and individual cultural differences that can create conflicts and misunderstandings. If the provider is unable to elicit patient information and negotiate appropriate care, negative health consequences may occur. How can physicians easily acquire and maintain the skills to provide culturally responsive and appropriate care to the increasingly diverse population of patients in the United States? Traditionally, training in cross-cultural medicine has focused on providing a list of common health beliefs, behaviors, and key “dos and don’ts.” This approach does not take into account acculturation and socioeconomic status and can lead to stereotyping. An alternative approach, proposed by Drs. Joseph R Betancourt, Alexander R Green, and J. Emilio Carrillo, helps physicians elicit a patient’s beliefs and preferences in order to identify and deal with the patient’s concepts, concerns, and expectations. This communication model is called ESFT (Explanatory model of health and illness, Social and environmental factors, Fears and concerns, and Therapeutic contracting). Case Example Consider this scenario with an example of the ESFT approach: A 62-year-old Dominican patient presented with hypertension. In the past two years, she had been seen by several physicians, had multiple tests to rule out any underlying etiology, and tried a variety of medications to control her blood pressure. Despite these efforts, her blood pressure remained poorly controlled. The patient, whose primary language was Spanish, had limited English skills but refused an interpreter at all clinic appointments. It appeared that the patient was nonadherent with taking the antihypertension medicine, taking it only periodically when she felt tense or stressed. Further inquiry by the physician revealed that the patient was illiterate and did not understand the complex medication regimen she had been given. The physician was able to explore the patient’s explanatory model for hypertension using the ESFT approach. The patient strongly believed that her hypertension was episodic and related to stress. She didn’t take her daily antihypertension medication because it didn’t fit her explanatory model. The physician was able to reach a compromise by explaining that, although her blood pressure goes up during stressful times, her arteries are under stress all the time, even though she didn’t

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Practice Mgmt. feel it. Taking medications daily would relieve the arterial stress but would not help with her emotionally stressful episodes. The physician was able to negotiate with the patient to add relaxation techniques to her daily routine. Health Literacy The Doctors Company supports the Agency for Healthcare Research and Quality (AHRQ) interventions to reduce the complexity of healthcare, increase patient understanding of health information, and enhance support for patients of all health literacy levels. Studies have shown that people from all age, race, income, and education levels are challenged by an inability to obtain, process, and understand basic health information and services needed to make appropriate health decisions and to follow instructions for treatment. AHRQ has found that only 12 percent of the adult population has the skills to navigate and understand our complex health systems—skills reduced by stress and illness. We encourage you to explore the AHRQ Health Literacy Universal Precautions Toolkit. Steps You Can Take Consider taking the following steps: • Evaluate any personal attitudes, beliefs, biases, and behaviors that may influence your care of patients. • Conduct a self-assessment: Cultural and Linguistic Competence Health Practitioner Assessment available from the Georgetown University National Center for Cultural Competence. • Use a communication model such as ESFT or LEARN: • Listen to the patient’s perception of the problem. • Explain your perception of the problem. • Acknowledge and discuss differences and similarities. • Recommend treatment. • Negotiate treatment. • Ask the patient or interpreter to repeat back what you said during the informed consent process, during the discussion of the treatment plan, or after any patient educational session with you or your staff. The repeat-back process is a very effective way to determine the extent of the patient’s understanding. • Use “Ask Me 3,” a tool that identifies three simple questions all physicians should be ready to answer—regardless of whether the patient asks. More information is available in our article, “Rx for Patient Safety: Ask Me 3,” and “Ask Me 3: Good Questions for Your Good Health” on the Institute for Healthcare Improvement’s website. • Use language services for your limited English proficiency (LEP) patients. Partner with your health plans and hospitals to identify written and oral language services. Find out your state requirements. In some states, Medicaid plans may call for providing language access. • Explain to patients who refuse interpreter services that it is very important to the patient’s care and safety that you and the patient/family member understand each other. Suggest a referral to a physician who speaks the patient’s primary language. Be sure to document in the medical record the patient’s refusal and your explanation of the risks and benefits of an interpreter. • Improve cultural competence: • Recognize that culture extends beyond skin color. • Find out each patient’s cultural background. • Determine your cultural effectiveness. • Conduct culturally sensitive evaluations. • Elicit patient expectations and preferences. • Understand how your cultural identity affects your practice. • Obtain more information from these useful websites: • U.S. Department of Health and Human Services, Office of Minority Health, National Standards for Culturally and Linguistically Appropriate Services (CLAS) • U.S. Department of Health and Human Services, Think Cultural Health, A Physician’s Practical Guide to Culturally Competent Care • Agency for Healthcare Research and Quality, What Is Cultural and Linguistic Competence? • Health Resources and Services Administration, Culture, Language, and Health Literacy Resources

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Practice Mgmt.

Hurricane season in North America runs from June 1st to November 30th. While known as a concern for the southern Atlantic coast and Gulf Coast areas, according to FEMA, 40 of the 50 U.S. states have experienced hurricanes orruns tropical since 1866. Hurricane season in North America fromstorms June 1st to November 30th. While known as a concern for the southern Atlantic coast and Gulf Coast areas, according to FEMA, 40 of the 50 With that U.S. in mind, Fisher Bottrell Insuranceoroffers thestorms following information and tips to states have Brown experienced hurricanes tropical since 1866. help you and your organization prepare for hurricanes and tropical storms. With that in mind, Fisher Brown Bottrell Insurance offers the following information and tips to help you and your organization prepare for hurricanes and tropical storms. Hurricane Hazards Hurricane Hazards While hurricanes pose the greatest threat to life and property, tropical storms and depression also can be devastating. The primary hazards from tropical cyclones (which include tropical Whiletropical hurricanes poseand thehurricanes) greatest threat life and property, tropical storms andfrom depression depressions, storms, are to storm surge flooding, inland flooding also can be devastating. The primary hazards from tropical cyclones (which include tropical heavy rains, destructive winds, tornadoes, and high surf and rip currents. depressions, tropical storms, and hurricanes) are storm surge flooding, inland flooding from heavy rains, destructive winds, tornadoes, and high surf and rip currents. ▪ Storm surge is the abnormal rise of water generated by a storm's winds. This hazard is

historically the leading cause of hurricane related deaths in the United States. Storm Storm is thewaves abnormal of water generated by and a storm's This hazard is surge▪ and largesurge battering can rise result in large loss of life causewinds. massive historically the leading cause of hurricane related deaths in the United States. Storm destruction along the coast. surge and large battering waves can result in large loss of life and cause massive ▪ Storm surge can travel several miles inland, especially along bays, rivers, and destruction along the coast. estuaries. ▪ Storm surge can travel several miles inland, especially along bays, rivers, and ▪ Flooding from heavy rains is the second leading cause of fatalities from landfalling estuaries. tropical Widespread torrential associated with of these storms often ▪ cyclones. Flooding from heavy rains is the rains second leading cause fatalities from landfalling cause flooding hundreds of miles inland. This flooding can persist for several daysoften tropical cyclones. Widespread torrential rains associated with these storms after a storm has dissipated. cause flooding hundreds of miles inland. This flooding can persist for several days ▪ Winds from destroy buildings and manufactured homes. Signs, roofing aftera ahurricane storm hascan dissipated. material, and other items left outside can become flying duringhomes. hurricanes. ▪ Winds from a hurricane can destroy buildings andmissiles manufactured Signs, roofing ▪ Tornadoes can accompany landfalling tropical cyclones. These tornadoes typically material, and other items left outside can become flying missiles during hurricanes. occur▪in rain bands well away from the center tropical of the storm. Tornadoes can accompany landfalling cyclones. These tornadoes typically occur in rain bands well away from the center of the storm. Dangerous waves produced by a tropical cyclone's strong winds can pose a significant hazard waves produced by a tropical cyclone's winds can posesignificant a significant hazard to coastalDangerous residents and mariners. These waves can causestrong deadly rip currents, beach to coastal residents and mariners. These waves can cause deadly rip currents, significant beach ECMS | 8

Practice Management

Practice Mgmt.

erosion, and damage to structures along the coastline, even when the storm is more than 1,000 miles offshore. Here are some of the key tips to remember: • • • • • •

• • • •

Practice and drill for weather emergencies before a hurricane or tropical storm is imminent. Have an emergency response plan in place that includes options for evacuation, operating offsite, and sheltering in place. Establish a plan for communicating with your employees, clients, and other key stakeholders - both from your existing location and from potential offsite locations. Prior to any storm, inspect and take action to fully seal your building envelope (roof, flashing, windows, exterior walls, and doors). Ensure there is proper water drainage from roofs and ground areas. Lift any appliances, electronics, and computer equipment off the floor to protect from rising flood water and secure plastic tarps over all computer equipment and other valuables that are susceptible to water damage. Roll up any rugs and get them off the floor. Ensure sump pumps are fully operational and their batteries are charged (if applicable). Test operate emergency generators or procure portable emergency generators well ahead of a storm to ensure they work when needed. Prior to leaving the building, shut off electrical service to the main breaker, if the electrical system and outlets could be under water. However, if you need electrical service for other emergency purposes, it may be best to leave your electrical service on. Remove any debris or items that could become airborne and damage property. Secure all windows and exterior doors. Procure tarps and plywood, as well as identify a water remediation vendor well ahead of the storm. Following a major storm and when safe to do so, quickly assess damage and coordinate efforts with your insurance carrier and with FBBI Claims.

With the prevalence of storm tracking and live look-ins, hurricanes may seem routine. For those involved, however, there is nothing ordinary about hurricanes and tropical storms. By planning ahead and taking smart, timely action, you can help your organization and personnel weather storms safely.

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Medical/Legal Wine Tasting & Hors d'oeuvres Thursday October 10, 2019 5:30pm-7:30pm | The Fish House Deck $50 per person or $85 per couple $25 medical student/resident ticket bottles and cases available for purchase Mail your check made payable to the "ECMS Foundation" Credit Card payments: www.escambiacms.org/foundation Tickets must be purchased by 10/3 Proceeds to benefit ECMS Foundation Programs Blood Pressure Cuffs, Medical Student Scholarships, We Care, Physician Wellness & more! 4771 Bayou Blvd. #157 32503 850.478.0706 director@escambiacms.org

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Foundation

Congratulations to the 1873 Inductees Dr. Kurt Krueger Dr. Brett Parra Dr. Hillary Hultstrand Dr. Michelle Brandhorst Dr. Joanne Bujnsoki Dr. Ellen McKnight Dr. Jennifer Miley Dr. Jack Kotlarz Dr. Steve Ziller Dr. Robert Sackheim Dr. Ken Long

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Foundation

THE 1873 SOCIETY Since 1873, Escambia and Santa Rosa County Medical Society physicians have dedicated themselves to their patients and the people of Escambia/Santa Rosa County. To further our mission and build on the loyal support of our members, the Board of Directors approved the formation of The 1873 Society, a special recognition opportunity to formally honor physicians who contribute to our organization and have demonstrated a long-term commitment to the quality of health care and well-being of our community. As a member of The 1873 Society your good name as a physician will be honored in our community forever--entwined with the good works of the medical society in a cherished legacy. Membership in The 1873 Society is for physicians who have chosen to pledge $3,000 to Escambia County Medical Society Foundation, Inc. This can be accomplished through a single gift or a recurring gift of $1,000 over three years, THREE IN THREE! The 1873 Society members are recognized and awarded with their names permanently engraved on a traveling Wall of Honor to be displayed in the ECMS office and at ECMS and ECMSF events.

THE 1873 SOCIETY MEMBERS The individuals listed below are both founding members as well as others who have joined The 1873 Society since its founding. We thank you for joining their distinguished ranks. Joanne Bujnoski, D.O. Hillary Hultstrand, M.D. Kurt Krueger, M.D. Brett Parra, M.D. Ken Long, M.D. Robert Sackheim, M.D. Ellen W. McKnight, M.D. Michelle Brandhorst, M.D. Jennifer Miley, M.D. Steve Ziller, M.D. Jack Kotlarz, M.D.

Who is the Escambia County Medical Society Foundation? The Escambia County Medical Society Foundation is a non-profit organization dedicated to providing healthcare services on a volunteer and funding basis through its members. The Foundation was created in 1994. The primary goal is to assure access to adequate healthcare for the medically indigent citizens of the area, to study and promote improved methods and facilities for healthcare, to pursue the protection of public health, implement the means of financing healthcare at reasonable costs to cooperate with other organizations and institutions interested in pursuing these goals, and disseminate information concerning healthcare in general. Current Foundation programs include “We Care” and “Go Seniors!” Contact the ECMS Foundation for more information | 850.478.0706 or info@escambiaCMS.org

ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY

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Foundation ECMS Foundation Newsletter County Medical Society Members: I hope this finds everyone well and enjoying the summer. As the middle of the season progresses County Medical Society Members: I hope this finds everyone well and enjoying the summer. As the middle of the season progresses through July 4th and our Blue Angels, the Foundation continues to progress through its many programs. We have made a milestone and reach another gift in one, and have been able to expand several others. The FSU Medical Student Scholarship Program; the process of picking our fourth year medical student scholarship winner is almost complete, and we will notify the winner and you as soon as it is decided. This will conclude the seventh year that scholarships have been awarded! And as mentioned previously, we have completed the endowment, so no additional funds will need to be added in future years!! The Physician Wellness Program; If you didn't make it to the June 6th Society Meeting, you really missed out. Drs. Rick and Paige Spencer gave us a great presentation on the needs and benefits of the PWP. It continues to grow and several of our colleagues have made use of the Spencer's expertise. See our web site for more information. The 1873 Society; we had the pleasure of officially welcoming the initial members of The 1873 Society. These physicians have pledged contributions to our Foundation to help further its programs and have enabled all of them to grow. Check our web site to see how you can contribute and make a difference. The Blood Pressure Cuff Program; our Blood Pressure Cuff Program continues to grow. We have just taken delivery on another order of cuffs, and with your contributions have been able to upgrade the quality of the cuffs. AND - have been able to expand distribution to not only our indigent clinics, but to other Primary Care physician offices to help their patients! The We Care Program; through the volunteer services of all Medical Society physicians involved, We Care continues to provide needed medical care of indigent patients. If you are led to help by donating your services, please get in touch with Dr. Lanza. The Go Seniors Program; the transportation program continues to provide vouchers to help patients make their doctor's appointments. The Pensacola State College Endowment; this endowment is facilitated by the Foundation, to enable students at PSC to pursue health related fields of study. It continues to promote these graduates to stay in the area and practice their chosen field in the Pensacola region. Grant Applications; your Foundation has made two grant applications for funds that will enable us to grow and add additional programs. As any of you who have made applications know, it is a slow and fairly arduous process. But our staff is persevering, and we will keep you posted! Have a great rest of your summer. Be Safe!! Personally, Kurt A. Krueger, MD Pres., ECMS Foundation

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theCommunity Community InInThe Baptist Health Care Baptist Health Care to Build New Full-Scale Hospital Baptist Health Care announced plans June 26 to build a new full-scale hospital at Brent Lane and I-110 as part of a long-term master plan to transform the way health care is provided. The new hospital will provide a central location for clinical care, programs and services that will be easier for patients to access via the I-110 corridor. Baptist will maintain a significant presence at its current E Street location which will be redesigned as a hub for an expansion of vital community-based services that are more efficiently and effectively provided outside the conventional hospital setting. The majority of Baptist Health Care system administration, system support services, and Lakeview Center, as well as other programs and clinical services, will remain on the E Street campus. The initial footprint of the new facility is expected to be just over 650,000 square feet of patient care space. The investment is estimated to exceed $550 million. The new hospital is expected to open in summer 2023. More information is available at ebaptisthealthcare.org and through the BHC social media channels @baptisthealthcare. Brett Reichwage Earns Board Certificaiton Baptist Medical Group neurosurgeon Brett Reichwage, M.D., has earned board certification from the American Board of Neurological Surgery. Dr. Reichwage earned his medical degree at Indiana University School of Medicine in Indianapolis, Ind. He completed residency training and fellowship training at the University of Florida Department of Neurological Surgery in Gainesville, Fla. Baptist Health Care Technology Helps Reduce Hair Loss During Chemotherapy Baptist Health Care is the first in Northwest Florida to offer technology that can reduce hair loss in patients undergoing chemotherapy for cancer. Baptist now offers a scalp cooling system that uses a specially designed cap to lower the temperature of the scalp before, during and after a chemotherapy treatment. Scalp cooling decreases blood flow to the area around the hair follicles, reducing damage and minimizing hair loss. Total hair loss is usually not prevented with scalp cooling but can be greatly reduced. The results vary among individuals, and the treatment is not suitable for every chemotherapy patient.

Sacred Heart Health Care Madhuri joins UF Faculty Pediatric pulmonologist Dr. Madhuri Penugonda has joined the faculty of the University of Florida College of Medicine, which is affiliated with the Studer Family Children’s Hospital at Ascension Sacred Heart. She will practice full time at the new Children’s Hospital on Sacred Heart’s Ninth Avenue campus. Dr. Penugonda is board-certified in pediatrics and pediatric pulmonology. She received her medical degree from the Universidad Iberoamericana in Santo Domingo, Dominican Republic, completed her residency in pediatrics at the Nassau University Medical Center in East Meadow, N.Y., and performed a fellowship in pediatric pulmonology at Emory University in Atlanta. Dr. Penugonda has conducted research on corticosteroid and vaccine responsiveness in children with asthma. Before coming to Pensacola, she was an assistant professor in pediatric pulmonology at the University of Alabama in Birmingham. Dr. Penugonda is an assistant professor of pediatrics with UF, practicing full time in Pensacola. Palliative Medicine program expands The Palliative Medicine program at Sacred Heart Hospital Pensacola has expanded outpatient services to provide specialized, supportive medical care for all patients diagnosed with a serious illness, regardless of age or stage. The Sacred Heart Outpatient Palliative Medicine Clinic was established in 2017 to provide supportive care to patients diagnosed with cancer, but has opened its doors to even more patients. It is the only outpatient palliative medicine clinic in Northwest Florida. Dr. Lisa Papic sees adult patients, while Dr. Brian Donahue serves pediatric patients. Adult patients who qualify for outpatient palliative medicine include those diagnosed with advanced heart disease, chronic obstructive pulmonary disease, pulmonary fibrosis, Parkinson’s disease, dementia, stroke, kidney disease and cancer. Services for pediatric patients start at 23 weeks gestation and are available to children of all ages. Those who qualify include those diagnosed with of congenital heart disease, cystic fibrosis, muscular dystrophy, neurologic conditions, cancer and developmental delays associated with cerebral palsy. For more information about Palliative Medicine at Sacred Heart, call 850-416-7705.

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