July/August 2016 • Vol. 46, No. 7
Mecklenburg Medicine A Publication of the Mecklenburg County Medical Society | www.meckmed.org
Escape ...
and BREATHE in the air out THERE! (See the story on page 7 about urban air pollution and the story on page 10 about our national parks.)
Mecklenburg County Medical Society • Mecklenburg Medical Alliance and Endowment facebook.com/meckmed
@meckmedsociety
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CharlotteIRMD.com Mecklenburg Medicine • July/August 2016 | 3
Table of Contents 5 President’s Letter: Wherever You Are, That’s Home By Stephen J. Ezzo, MD, President, MCMS
6 Feature: Having Both Too Much, and Too Little, Free Speech By Gordon Hull, PhD, Director, Center for Professional and Applied Ethics UNC Charlotte
7 Feature: Clean Air Prescription Essential for Summertime Health By Laura Wenzel, MSW, Manager, Medical Advocates for Healthy Air
7 Advertising Acknowledgements 8 MMAE 8 Health Assessments Law for Public School Students Updated 8 National Health & Wellness Observances, July/August 9 Member News 9 New Members 9 In Memoriam 9 Upcoming Meetings & Events 9 Charlotte AHEC Course Offerings 10 Feature: 100 Years: National Park Service Celebration By Lee McCracken, Contributing Writer
11 At the Hospitals 13 Independent Physicians of the Carolinas
July/August 2016 Vol. 46 No. 7 OFFICERS President Stephen J. Ezzo, MD Secretary Elizabeth B. Moran, MD Treasurer Scott L. Furney, MD Immediate Past President Simon V. Ward III, MD
BOARD MEMBERS John R. Allbert, MD Maureen L. Beurskens, MD Raymond E. Brown, PA W. Frank Ingram III, MD Stephen R. Keener, MD, MPH Scott S. Lindblom, MD Shivani P. Mehta, MD, MPH Robert L. Mittl, Jr., MD Babak Mokari, DO Cameron B. Simmons, Jr., MD Cheryl L. Walker-McGill, MD, MBA
EX-OFFICIO BOARD MEMBERS Sandi D. Buchanan, Executive Director Mecklenburg County Medical Society
Karen Chandler, President Mecklenburg Medical Alliance & Endowment Michelle Conner, DDS, President Charlotte Medical Dental & Pharmaceutical Society Docia E. Hickey, MD NCMS President Darlyne Menscer, MD NCMS Delegate to the AMA Marcus G. Plescia, MD, Health Director Mecklenburg County Health Department Douglas R. Swanson, MD, FACEP, Medical Director Mecklenburg EMS Agency
EXECUTIVE STAFF Executive Director Sandi D. Buchanan
1112 Harding Place, #200, Charlotte, NC 28204 704-376-3688 • FAX 704-376-3173 meckmed@meckmed.org
Finance & Membership Coordinator Stephanie D. Smith Meetings & Special Events Jenny H. Otto
Copyright 2016 Mecklenburg County Medical Society
MECKLENBURG MEDICINE STAFF
Mecklenburg Medicine is published 10 times per year by the Mecklenburg County Medical Society, 1112 Harding Place, Suite 200, Charlotte, NC 28204. Opinions expressed by authors are their own, and not necessarily those of Mecklenburg Medicine or the Mecklenburg County Medical Society. Mecklenburg Medicine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. Mecklenburg Medicine is not responsible for unsolicited manuscripts.
Editor Stephen J. Ezzo, MD
Non-members may subscribe to Mecklenburg Medicine at a cost of $30 per year, or $3.50 per issue, if extra copies are available. Classified Ads: Open to members, nonprofits and non-member individuals only; advance approval of the Managing Editor and advance payment required. Member rate is 0, non-members $20 for the first 30 words; $.75 each additional word. Display Ads: Open to professional entities or commercial businesses. For specifications and rate information, contact Mark Ethridge at mecklenburgmedicine@gmail.com. Acceptance of advertising for this publication in no way constitutes professional approval or endorsement of products or services advertised herein. We welcome your comments and suggestions: Call 704-376-3688 or write Mecklenburg Medicine, c/o Mecklenburg County Medical Society, 1112 Harding Place, Suite 200, Charlotte, NC 28204.
4 | July/August 2016 • Mecklenburg Medicine
Managing Editor Sandi D. Buchanan Copy Editors Lee McCracken Stephanie Smith Advertising Mark Ethridge mecklenburgmedicine@gmail.com Editorial Board N. Neil Howell, MD Scott S. Lindblom, MD Jessica Schorr Saxe, MD
Graphic Design — Wade Baker
President’s Letter
Wherever You Are, That’s Home By Stephen J. Ezzo, MD
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mentioned in my last letter how my wife was injured while skiing. Although it could have ended on a better note, the vacation itself once again reminded me of the wonderment of life. When I met my wife-to-be in medical school in St. Louis, I had spent the first 18 years of my life in Florida and the last four in Georgia. Though uncertain at best, I harbored visions of becoming an internist, returning home to practice alongside my father (what a mentorship that would have been!), eventually assuming the practice upon his retirement. I vividly recall telling myself I had worked eight long years to get to this point and not to screw things up by getting involved in a personal relationship, which would detract from muchneeded study time and scuttle the best-laid plans. So, into my life strolled this Yankee girl (hey, everything beyond Richmond was Yankee to me ... north, west, it didn’t matter), who challenged me intellectually and electrified me emotionally. Our courtship opened up new worlds, one of which was joining a ski Our two worlds — family. Up until then I had a grand professional and total of four forgettable ski days to personal — are my credit. Soon I found myself on top of a 12,000-ft. mountain; the interwoven, and we highest point in Florida is 345 feet. should resist the It was a trial by fire — I watched temptation to wholly as she and her siblings carved their way down a run, stopped, glanced separate them. up at me and said, “Just like that.” I would creep sideways across the hill, looking for the perfect place to turn, which always seemed to be a bit farther away. Once in the trees and out of options, I kicked off my skis — I got quite good at that — took their names in vain (not so quietly) and walked down. And, repeated on the next slope. Here I am, 30-plus years later, wishing I had more days on the mountain and amazed I have arrived at this point. For me, it is the quintessential example of the twist and turns (or should I say slaloms) life holds. Indulge me once more, please. Every summer we spend some time (again, never enough) at her family’s cottage on Lake Huron in Canada. There’s a stretch of cottages along the shoreline and, a few years back, I sat watching the sun melt into the lake, enjoying a Cuban robusto. (And no, I did not violate the embargo; you can buy Cuban products in Canada regardless of your nationality. But frankly, Cuban cigars are overpriced and living on their reputation. The ones from Honduras and the Dominican Republic are just as good and less expensive.) A few cottages over a family celebrated a reunion and hired a bagpiper for entertainment. Thanks to the many trips made over the years, I actually could identify most of the tunes by name.
If you would have told me as a kid I would find myself in this setting, I would have thought you slightly touched in the head. Furthermore, I doubt I could have invented such a scene, even with my penchant for storytelling. To recap, Florida boy in Canada with a Cuban cigar and Canadian beverage, idly dreaming of what boats lay beyond the blue-pink horizon of a Great Lake, while soaking in traditional Scottish music. Life truly is a miracle. By now, if you have hung in this far, you may be thinking, “Nice stories.” Or not. What I hope most of you are thinking is, “What does this have to do with the practice of medicine, and how can I apply it to my life?” First, our cumulative experiences make us more rounded. We can see others’ opinions more objectively and, in the medical setting, grasp patients’ views of their illness with less of our own bias. Once we comprehend how our patients view their illness and the aspects that are critical to them, we can provide better, more personal, care. Second, what we have done, where we have been, allows us the opportunity to make a non-medical connection with our patients. This connection, I believe, is as crucial as the medical one, as it places the doctor-patient relationship on a less equitable plane. I am firmly convinced our patients open up to us more if they see us as more like them. Those issues seen as embarrassing may come to light more often if we are viewed as more down-to-earth than reserved professionals. I know we are pressed for time, and it cannot be done at each and every visit, but the occasional social query can have lasting benefits. Just the other day, a patient told me he was headed to my hometown for a vacation. He left with a list of local joints only a native would know. Our two worlds — professional and personal — are interwoven, and we should resist the temptation to wholly separate them. Incorporating the worlds results in a symbiosis with the sum greater than the parts. It can lead to those things we all strive for, such as deepening the bond with patients. Of course, it also can lead to the unexpected, such as the edge of a ski cliff. “There are no foreign lands. It is the traveler only who is foreign.” — Robert Louis Stevenson
Trivia question: Who is Louise Joy Brown? Answer on page 9.
Mecklenburg Medicine • July/August 2016 | 5
Feature
Having Both Too Much, and Too Little, Free Speech By Gordon Hull, PhD, Director, Center for Professional and Applied Ethics, UNC Charlotte
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vidence-based medicine sounds like a good and straightforward thing. It’s the idea that clinical medicine should aspire to base its practice on the best available scientific evidence of what works and what does not, and that clinicians should have such information readily available to them when working with patients. I want to suggest here that creative judicial interpretations of the First Amendment are making it hard to practice such medicine. There are two halves to the worry: one is based on too much free speech and the other on too little, but both make it difficult to use evidence in a clinical setting with patients. For too much free speech, consider that the growth of corporate free speech rights (especially post Citizens United), now is being applied to pharmaceutical advertising. In a 2012 case, an appellate court overturned the conviction of a pharmaceutical representative for marketing the drug Xyrem for off-label use, as long as his speech was “truthful.” In early March, the FDA reached a settlement with Amarain that the company is free to “engage in truthful and non-misleading speech” about potential uses for its product, even if those are unapproved. The product in question is fish oil, and the debate was over if it could be advertised to reduce the risk of cardiac events and not just as an intervention for patients with very high triglyceride levels. In the abstract, this might sound perfectly reasonable; only doctors can actually prescribe off-label, and surely they should be able to use the best evidence available to make those decisions, right? The problem is that in the world we live in, it is not clear if the free speech in question is “truthful and non-misleading.” The research Amarin cited in support of the off-label marketing was clearly paid for by Amarin. This is a common phenomenon, and it led one of evidence-based-medicine’s early champions, John Ionannidis, recently to publish a piece in the Journal of Clinical Epidemiology called “Evidence-Based Medicine Has Been Hijacked,” which argued, among other things, that “the industry runs a large share of the most influential randomized trials. They do them very well. … It is just that they often ask the wrong questions with the wrong short-term surrogate outcomes, the wrong analyses, the wrong criteria for success (e.g., large margins for noninferiority), and the wrong inferences. … The industry is
All the “truth” has been manufactured, and evidence going the other direction never gets funded or published.
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also sponsoring a large number of meta-analyses currently. Again, they get their desirable conclusions” (internal citations omitted). In a follow-up interview in Retraction Watch, the author added that part of the problem is declining public funding for research, which puts that research in the hands of industry, which has to answer to sales and marketing departments. None of this is a new complaint, but it generates very specific problems for off-label marketing, because it pulls the rug out from under the reasons given not to ban it. How can one possibly identify correctly which claims are “truthful and non-misleading?” All the “truth” has been manufactured, and evidence going the other direction never gets funded or published. So what about the too little free speech argument? Let’s set aside the complications of reproductive health debates, and look at firearms. Florida’s statute banning doctors from asking patients – including those with children – about firearms in the house, absent specific reasons to think “that the patient is suicidal or has violent tendencies,” was upheld by an appellate court last summer. The appellate court overturned a lower court opinion finding that the law “aims to restrict a practitioner’s ability to provide truthful, non-misleading information to a patient.” Are guns in the home clinically relevant? A recent New York Times analysis concluded that hundreds of children die – usually accidentally – because adults leave unsecured, loaded firearms where children can access them. The children then unintentionally shoot themselves or each other. The Times cites CDC statistics to the effect that gun accidents were the ninthleading cause of unintentional deaths of children ages 1-14 in 2010; applying evidence of inconsistent and under-reporting, gun accidents would make the top five or six. One could be forgiven for thinking that these deaths are almost entirely preventable. Despite this, the gun lobby is sponsoring more such laws. There are two situations in which selective judicial application of the First Amendment is being used to undermine the ability of clinicians to responsibly exercise evidence-based medicine and their own professional judgment in the context of doctor-patient relationships. In one, the problem is generated by too many free speech rights on the part of Pharma companies to peddle their products in off-label ways that are not backed by even a scintilla of objective evidence. In the other, the clinical relation is undermined by prohibiting speech on guns, despite the presence of clinically-relevant evidence that gun-owning parents need to be very, very careful to control access to their firearms, and many aren’t. Again, the doctor’s ability to use his or her professional judgment is undermined in ways antithetical to any sort of evidence-based medicine. When the evidence doesn’t exist, you nonetheless have to use it; when it’s solid, you have to ignore it.
Feature
Clean Air Prescription Essential for Summertime Health By Laura Wenzel, MSW, Manager, Medical Advocates for Healthy Air
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ummertime, with its warm, sunny days, is a great time to be outdoors, but it carries risks as well. We are familiar with prescriptions for hydration and sunscreen, but there’s another prescription that is becoming increasingly important: avoiding exposure to unhealthy air.
Why is air pollution becoming more dangerous?
Our rising temperatures due to climate change promote increased formation of ground-level ozone and sulfate particulate matter. This invisible air pollution has myriad adverse health effects and can be deadly. Ozone exists naturally in the upper atmosphere. It forms at ground level when sunlight and heat react with nitrogen dioxide and volatile organic compounds, emitted when we burn fossil fuels in our cars, power plants and factories. Groundlevel ozone can induce wheezing, inflammation, and lung scarring. The effect has been called a “sunburn” on the lungs. Tiny sulfate particles, also caused by combustion and manufacturing, get deep into the lungs and enter the bloodstream. They affect the cardiac and central nervous systems, and are associated with cancer.
Good prescriptions start with information, and tools from the EPA and the NC Division of Air Quality can alert you and your patients when pollution levels become dangerous.
Who is most at risk?
At-risk groups include children and teenagers, whose lungs are developing, the elderly, those with respiratory problems such as asthma, and athletes and outdoor workers. Particles can cross the placenta in pregnant women. Research suggests this pollution causes inflammation especially harmful to people with diabetes or obesity. Also, pre-existing health disparities can render people in low-income or minority communities more sensitive to air pollution.
How can you protect your patients?
Good prescriptions start with information, and tools from the EPA and the NC Division of Air Quality can alert you and your patients when pollution levels become dangerous. These include the Air Quality Index (AQI) forecast, AQI handouts, as well as handouts on ozone and particulate matter. The AQI scale ranges from 0 to 500. AQI values below 51 are considered healthy for everyone. Values above 100 indicate
unhealthy air, at first for sensitive groups and eventually for everyone. AQI wall posters, handouts and wallet cards are available at CharlotteAirAwareness.org. Weather reports often feature AQI forecasts, and you can view your area’s forecast at AirNow.gov, which also has phone apps, or request daily emails at www.enviroflash.info. Highly-readable EPA fact sheets in English and Spanish on ozone and particulate matter advise patients on avoiding exposure by using the AQI forecast to plan outdoor activities and reducing wood burning, for example. Download the fact sheets by Googling “Air Quality Guide for Ozone,” “Air Quality Guide for Particle Pollution,” “Heart Disease, Stroke and Outdoor Air Pollution” and “Enfermedades del Corazón, Ataques Cerebrales y la Contaminación del Aire.”
CME-Certified AHEC/MAHA Healthy Air Webinar Telling patients to restrict their activity in the summertime isn’t easy. Medical Advocates for Healthy Air (MAHA), an initiative of Clean Air Carolina, works to establish policies in North Carolina that reduce man-made sources of air pollution, so all of us can breathe easier. Visit the Clean Air Institute at MedicalAdvocatesforHealthyAir. org to view a CME/CEU-certified webinar on “Protecting Your Patients from Air Pollution.”
Advertising Acknowledgements The following patrons made Mecklenburg Medicine possible.
Brackett Flagship Properties.....................................13
Carolinas HealthCare System..................................15
Charlotte Eye, Ear, Nose & Throat Associates.......14 Charlotte Radiology....................................................3 Hospice & Palliative Care Charlotte Region..........14
LabCorp.....................................................Back Cover Metrolina Pain & Dependency Clinic.....................14
Novant Health..............................................................2 Oncology Specialists of Charlotte............................14 PACE of the Southern Piedmont................................9 Mecklenburg Medicine • July/August 2016 | 7
MMAE
To MMAE memvilbegere toshseripve,as your leader in the 2016-
It is an honor and a pri erry Ward, among Mimi Compton and Sh 2017 year and to follow anization. so dedicated to this org many others, who are try as a nurse, an in the healthcare indus w chapter After spending 30 years turning the page on a ne am I r, ato uc ed an d an and find administrator m the wisdom of others fro rn lea I y da ery Ev with MMAE. anization. ing a part of this fine org o are giving great satisfaction in be to those individuals wh ul tef gra am I t, os em First and for ard this year. They talent to serve on the Bo their valuable time and ividuals. They bring committed group of ind assion. are an impressive and ion, allegiance and comp vis of rity cla y, erg en d knowledge an . siness and our mission They understand our bu : AE M M als for We have two main go nd in the community. bra e ibl vis a our mission. To become who have a passion for ers mb me ge ga en d an To attract grants awarded, y, and $1.5 million in With its 83-year histor unity. We can be ce of honor in this comm MMAE has earned a pla lity ita House, Teen rk in founding the Hosp proving the proud of our good wo d other projects still im an t sis As ed M n, tio ec Health Conn ven track record of ity today. We have a pro serve. We health in our commun g an impact on those we kin ma d an ng ati uc ed fundraising, organization. truly are a remarkable w our endowment, we will continue to gro In the 2016-2017 year, hier community. ssion of building a healt mi r ou fill ful d an t an remain relev Very truly yours,
Karen Chandler
sident 2016-2017 MMAE Pre
Law Regarding Health Assessments for Public School Students Amended In August 2015, the law pertaining to health assessments for children entering school was amended. Beginning with the 2016-17 academic year, the amended law requires each child entering public school for the first time to submit proof of a health assessment, and it specifies the use of a new health assessment form. The new N.C. Health Assessment Transmittal Form can be found at www2.ncdhhs.gov/dph/ wch/doc/aboutus/HAForm2016.pdf The marked up version of the amended law can be viewed at www.ncga.state. nc.us/gascripts/BillLookUp/BillLookUp. pl?Session=2015&BillID=H13
8 | July/August 2016 • Mecklenburg Medicine
2016-17 MMAE BOARD President: Karen Chandler Treasurer: Leslie Aronovitz Corresponding Secretary: Lois Benjamin VP Membership: Jennie Carruth VP Grants and Disbursements: Gina Clegg VP Health Promotions: Pam Bullard VP Financial Development: Co-Chairs Sherry Ward and Anne Shoaf Cannon Award: Gail VanDerVeer VP Programs: Co-Chairs Judy Verross and Brenda Wing VP Planning and Development: Debbie Taylor Parliamentarian: Mitzi Yount Immediate Past President: Mimi Compton
Save the Date! 2016 HOLIDAY HOUSE November 4-6
The Home of
Dr. Elizabeth and Mr. Robert Rostan 1870 Queens Road West
NATIONAL HEALTH & WELLNESS OBSERVANCES JULY 2016 Fireworks Safety Month Eye Injury Prevention Month Park and Recreation Month UV Safety Month
AUGUST 2016 Breastfeeding Month Children’s Eye Health and Safety Month Immunization Awareness Month Medic Alert Awareness Month
Member News
In Memoriam
NEW MEMBERS Atul Khanna, MD Gastroenterology Charlotte Gastroenterology & Hepatology 2015 Randolph Road #208 Charlotte, NC 28207 704-377-4009 University College of Medical Sciences, 1999
DONALD E. HAMMER, MD February 29, 2016 Carolinas Medical Center University of Rochester, 1966 Emergency Medicine
Richard Edward Patterson, PA-C Carolina Neurosurgery & Spine Associates 225 Baldwin Ave., Charlotte, NC 28204 704-376-1605 Cuyahoga Community College Physician Assistant Program, 2003 Devi Thangavelu, MD Gastroenterology Charlotte Gastroenterology & Hepatology 13808 Professional Center Drive Huntersville, NC 28078 704-377-4009 SUNY Downstate College of Medicine, 2003
FRED E. WISE, JR., MD February 20, 2016 Nalle Clinic Medical College of Virginia, 1945 Radiology Trivia answer from page 5: Louise Joy Brown was born in the United Kingdom on July 25, 1978, as a result of IVF, and became the world’s first “test tube baby”. It is estimated that since her birth more than five million children have been born through IVF.
Upcoming Meetings & Events JULY Meetings at MCMS office unless otherwise noted.
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Monday, July 4 Independence Day – MCMS office closed. Tuesday, July 12 MedLink meeting. Mecklenburg County Health Department. 8:30 a.m. Friday, July 15 NCMS/MCMS Summer Mixer. The Lodge at the Ballantyne Resort. 5:30-7:30 p.m. Saturday, July 16 Opioid Prescribing Educational Session. The Lodge at Ballantyne Resort. 2-4 p.m. Monday, July 18 Executive Committee meeting. 5:45 p.m. Wednesday, July 20 Fighting for Women With Fashion meeting. Safe Alliance, Room 106. 6 p.m. Thursday, July 21 CAMGMA meeting. Myers Park Baptist Church Cornwell Center. Noon.
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Friday, July 22 September magazine deadline. Friday, July 22 Child Health Committee meeting. 7:30 a.m. Monday, July 25 MCMS Board meeting. 5:15 p.m.
Charlotte AHEC is part of the N.C. Area Health Education Centers (AHEC) Program and Carolinas HealthCare System.
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Charlotte AHEC Course Offerings
Tuesday, August 9 MedLink meeting. Mecklenburg County Health Department. 8:30 a.m. Monday, August 15 Executive Committee meeting. 5:45 p.m. Wednesday, August 17 MMAE Finance Committee/Board meeting. 9 a.m./10 a.m. Wednesday, August 17 and 31 Fighting for Women With Fashion meeting. Safe Alliance, Room 106. 6 p.m. Monday, August 22 October magazine deadline.
For a list of online classes offered during July and August, visit www.charlotteahec.org.
Program of All-Inclusive Care for the Elderly Eliminating fragmentation in care while promoting independence at home. One plan to cover all your healthcare needs; 100% 6133 The Plaza Charlotte, NC 28215 www.pacesp.com
PACE Education/Questions 704-617-7502 Referrals 704-887-3853
Mecklenburg Medicine • July/August 2016 | 9
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Feature
National Park Service Celebration By Lee McCracken, Contributing Writer
“Everybody needs beauty ... places to play in and pray in where nature may heal and cheer and give strength to the body and soul alike.” – John Muir, 1911
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he U.S. Congress, establishing Yellowstone National Park in March 1872 within the territories of Montana and Wyoming, began a worldwide movement for green spaces to be set aside and preserved as public parks or “pleasuring-grounds” for the benefit and enjoyment of people. On August 25, 1916, President Woodrow Wilson signed an act creating the National Park Service (NPS) as a federal bureau in the Department of the Interior. At the time, there were 35 national parks and monuments. Botanist and avid hiker John Muir, who was born in Scotland but came to Wisconsin in 1849 with his family, is said to have spurred the concept of the NPS. He once walked from Indiana to Florida, and then after sailing to California, walked from San Francisco to the Sierra Nevada, where he worked as a sheepherder. Then he moved to the Yosemite Valley and finally Oakland, where he began to write. Muir’s writings brought national attention to more places that eventually became national parks. His three-night camping trip with President Theodore Roosevelt in 1903 became known as the most significant camping trip in conservation history.
H ADVENTURE G I H
BIG SCREEN THE ON
In Charlotte, the IMAX Theater at Discovery Place is now showing“National Parks Adventure,”narrated by Academy Award-winner Robert Redford. The cinematography takes viewers soaring over red rock canyons, hurtling up craggy mountain peaks and into other legendary outdoor playgrounds, including Yellowstone, Glacier National Park, Yosemite, the Everglades and Arches.
Today, the National Park Service (nps.gov) comprises more than 400 areas and covers more than 84 million acres in 50 states, the District of Columbia, American Samoa, Guam, Puerto Rico, Saipan and the Virgin Islands. More than 300 million people visited the parks and monuments in 2015. While the Grand Canyon (No. 2) and Yellowstone (No. 5) may be the first to come to mind, the Great Smokey Mountains National Park ranked as the No.1 most-popular recreation area in 2015, with more than 10 million visitors. And, the Blue Ridge Parkway was the mostvisited area with 15 million visitors. The southeastern region of the United States is home to seven National Parks, each protecting unique wildernesses and marine ecosystems. The Centennial celebration features a Commemorative Coin Program, which includes a $5 gold coin, a silver dollar, and 50-cent This year, 16 days are fee-free days in the coin. In addition, the national parks. Whether you are staying close to U.S. Postal Service has home or traveling, you can visit the mountains or issued 16 new Forever coast on these remaining days: stamps featuring several national parks.
Simon Ward, MD, says his favorite spot is Zion National Park in Utah. Whether driving or walking, the towering sandstone mountains above the valley strike awe. “For the biggest rush, short of skydiving, the Angels Landing trail is the best.”
10 | July/August 2016 • Mecklenburg Medicine
IN FREE T E G
August 25-28: National Park Service Birthday Weekend September 24: National Public Lands Day November 11: Veterans Day
At the Hospitals
New Non-Surgical Treatment Option for Skin Cancer At Novant Health Presbyterian Medical Center, doctors are using skin brachytherapy, a form of radiation therapy, to treat nonmelanoma skin cancers. Using a device called the Leipzig applicator, doctors provide patients with a non-invasive approach to treatment by delivering radiation directly to the skin lesion. This alternative to surgery targets cancer cells without pain or damage to surrounding healthy tissue. Radiation is a good alternative to surgery not only in cases where surgery is not possible, but also in cases where expected functional or cosmetic outcome would be better with radiation therapy than with surgery. Leipzig helps fight cancer in difficult-to-treat locations such as ears, noses, lips and shins. The procedure is highly effective without the wound healing and scarring associated with surgery. Benefits of skin brachytherapy using the Leipzig applicator include no cutting, no pain, little to no scarring, no bleeding, less than 10-minute procedures, pinpoint accuracy, preservation of more healthy tissue and improved cure rates. Short-term side effects usually include mild redness of the treated area, but also can include dry peeling or moist skin. These side effects usually resolve within two weeks after treatment. Long-term side effects may include a slight discoloration of the skin at the treatment site and localized hair loss. For more information on Leipzig, call 704384-4188. n
Abbreviated Breast MRI Technology Available at Novant Health Novant Health now offers abbreviated screening breast MRI technology. This technology is used for screening women at high risk for breast cancer, which includes those with a close relative with breast or ovarian cancer, or those with genetic mutations. The new, abbreviated MRI version also is recommended for women who don’t have a high risk for cancer but who have dense breast tissue and want to undergo a screening beyond the standard mammogram. The abbreviated breast MRI technology is n
considered the most elite screening option for discovering breast cancer or abnormal tissue. North Carolina is one of 27 states that have passed a breast density notification law. This law requires that physicians notify women who have undergone mammography and were found to have dense breast tissue so that they can discuss with their physician if further action is needed, including additional screenings. To view a list of Novant Health clinics that offer abbreviated breast MRI technology, visit NovantHealthImaging.com/services/breast-mri.
iPads to help support educational programs for heart failure patients. The iPads will be used in hospitals and outpatient clinics to show patients 3D images of the heart and educational videos, making it easier for them to understand their disease and reinforcing the lifestyle changes needed to manage it. To ensure compatibility with the 3D software, the following models are being accepted: iPad 3, iPad 4, iPad Air, iPad Air 2 and iPad Pro. For more information or to make a donation, call 704-384-8993.
Novant Health Launches PhysicianLed Network in North Carolina In partnership with independent physicians across North Carolina, Novant Health is launching the Novant Health Clinically Integrated Network (NHCIN). This statewide physician network is designed to deliver highquality patient outcomes and improved patient access at a lower cost. NHCIN will be co-led by William Caldwell, MD, senior vice president for clinical integration at Novant Health and an independent otolaryngology (ear, nose and throat) specialist in Charlotte, and David Cook, MD, a family medicine physician with Novant Health Lakeside Family Physicians, along with a board of directors made up of both independent and Novant Health physicians. Collectively, members of the network will develop clinical pathways and protocols, create improved systems for care, share and analyze clinical outcomes data, and determine the most efficient way to deliver high-quality, affordable patient care. NHCIN members also will be able to provide consumers with greater continuity of care through increased clinical data sharing. This includes improved access to specialty care, and promptly sharing test results and other clinical information among the patient’s preferred health care providers. To learn more about the NHCIN visit, novanthealth.org/physician-services/novanthealth-clinically-integrated-network.
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Novant Health Seeking iPad Donations for Heart Failure Patients Are you upgrading your iPad this year? If so, why not donate your old model to help someone in need? Novant Health Foundation Presbyterian Medical Center is seeking new and gently used n
Novant Health Adds Three Leaders to Executive Team Carl S. Armato, president and chief executive officer of Novant Health, recently announced the healthcare system has expanded its executive team to better position the organization to meet the needs of its patients and team members. Tanya Blackmon, Denise Mihal and Janet Smith-Hill, all in current leadership roles within Novant Health, will join the expanded leadership team. Tanya Blackmon will serve as executive vice president and chief diversity and inclusion officer. Diversity and inclusion is a core value for Novant Health. Blackmon will help Novant Health use diversity and inclusion to strengthen key functions of the organization and to achieve business and patient care objectives. Denise Mihal is now executive vice president and chief nursing and clinical operations officer for Novant Health. With more than 30 years of experience as a nurse and healthcare leader, Mihal has a passion for enhancing patient care. Most recently, she led clinical operations for all Novant Health hospitals, working directly with facility nursing officers, surgical services, and trauma and emergency services leaders. Mihal also oversees clinical operations for Novant Health’s central staffing and scheduling office and case management team. Janet Smith-Hill will serve as executive vice president and chief human resources officer for Novant Health. Smith-Hill has 30 years of experience in nursing and human resources leadership. She embodies Novant Health’s values and supports the organization’s strategic imperatives by developing and implementing relevant people strategies and plans consistent with Novant Health’s mission of improving the health of our communities, one person at a time.
Mecklenburg Medicine • July/August 2016 | 11
At the Hospitals
Promising Treatment for Enlarged Prostate Now in Final Testing Phase Carolinas HealthCare System’s McKay Urology and Vascular & Interventional Specialists, a division of Charlotte Radiology, have partnered in a clinical trial to examine the effectiveness of prostate artery embolization (PAE), an emerging minimally invasive treatment for benign prostatic hyperplasia (BPH). Men with benign prostatic hyperplasia (BPH) already live with a number of unpleasant symptoms – difficulty urinating, a weak urinary stream, urination urgency, difficulty sleeping and erectile dysfunction. And many of the current medical therapies for the condition, which can arise from an enlarged prostate, have unpleasant side effects, such as impotence and urinary incontinence. Doctors are looking for an effective treatment that isn’t accompanied by those side effects. With PAE, small catheters are placed through a pinhole in the femoral artery in the thigh and threaded into the blood vessels that supply the prostate. These blood vessels are then blocked, which decreases blood flow to the prostate, shrinks it (if successful) and, over time, improves symptoms. Many patients feel relief within a week. Transurethral resection of the prostate (TURP), in which part of the prostate is removed through the penis, is the standard of care when prescription drugs don’t work. This trial is evaluating PAE against TURP. A control group — one-third of study participants — will receive TURP, which is what they’d get if they weren’t part of the trial. Recruitment of men ages 50-79 with a diagnosis of BPH is under way. Participants should be able to commit to treatment and follow-up in Charlotte. For referrals, contact Robbin Clark at Robbin.Clark@ carolinashealthcare.org or call 704-355-1322. n
Levine Cancer Institute Receives $1.6 Million Grant for Lung Cancer Program Carolinas HealthCare System’s Levine Cancer Institute has received a $1.6 million grant from the Bristol-Myers Squibb Foundation to n
support Lung B.A.S.E.S. 4 Life, an innovative program that will feature a mobile unit for early identification of lung cancer coupled with a comprehensive education, navigation and clinical intervention program to support better outcomes for lung cancer patients. Lung cancer is the second most common cancer diagnosis, and the leading cause of cancer death in the U.S. Access to optimal screening is paramount to early diagnosis, intervention and survival for those at high risk for contracting the disease. Lack of transportation to medical facilities, inability to secure the support resources necessary for adequate preventive care and poor understanding of risk factors prevent thousands of Americans from receiving necessary cancer screenings. By eliminating the barriers to care that prevent patients from accessing early diagnosis and life-saving treatment, Lung B.A.S.E.S. 4 Life will improve the quality of life and enhance survivorship for lung cancer patients in the Carolinas. The mobile unit, developed by Samsung Neurologica, will have a portable, fullbody, 32-slice computed tomography (CT) scanner to deliver high-quality images of both soft tissue and bone through low-dose CT technology. The vehicle is expected to be completed by late 2016 and will be piloted initially in Mecklenburg County, with plans to expand into rural areas where access to care is limited. Lung B.A.S.E.S. will provide lung cancer screenings, smoking cessation education and navigation services to assist patients with any followup intervention needed. Levine Cancer Institute has a long-standing commitment to increasing access to highquality care for all patients, regardless of where they live, which is demonstrated through implementing community-based programs in underserved communities. In addition to active screenings for breast, prostate and colon cancer, the Institute offers a robust navigation program that currently serves more than 12,000 patients. Conference Examined Effect of Media Violence on Children Speakers at a recent Youth Violence Prevention Conference agreed that parents have the best chance to control their children’s access to violent media, but also acknowledged the job is much tougher than it used to be. This year’s conference theme was “Media n
12 | July/August 2016 • Mecklenburg Medicine
Matters: The Impact of Violent Media on Today’s Youth.” The annual event, now in its 11th year, is sponsored by Carolinas Medical Center’s Violence Prevention Committee, headed by David Jacobs, MD, medical director of CMC’s F. H. “Sammy” Ross, Jr. Trauma Center and Charlotte AHEC. Ed Donnerstein, PhD, dean emeritus at the University of Arizona, quoted from a study of teens age 13-19 that found most spend about nine hours a day watching entertainment media, up from two-three hours a day 20 years ago. Donnerstein said another study showed that 60 percent of television shows today contain violence where characters intentionally hurt someone. The perpetrators often are heroes and
Attendees of the recent Youth Violence Prevention Conference at Charlotte’s Friendship Missionary Baptist Church listen to a panel discussion on how violent media can influence youth behavior.
attractive role models. The bad characters are never punished. Pain or negative consequences are not shown. “No one says Sesame Street doesn’t teach kids, but the same medium can teach kids how to hold a gun,” Donnerstein said. Vic Strasburger, MD, distinguished professor of pediatrics emeritus at the University of New Mexico School of Medicine, said the role of violent mass media on developing minds is one of several risk factors that may contribute to later violent actions. He offered four suggestions for parents who want to control their children’s exposure to media violence: • Discourage any screen time for children younger than 2 years old. It is much easier to limit screen time at an early age than try to dial it back when the kids are older. • Limit total entertainment screen time to less than two hours per day for older children. • Ban screens of any kind from bedrooms where kids could access them when parents are unaware. • Teach your kids media literacy. Discuss what they see on TV and let them know the violence is not real.
Independent Physicians of the Carolinas
Independent Physicians of the Carolinas is a nonprofit 501(c)(6) membership organization whose mission is to create public awareness of medical doctors not employed by a network or hospital system and to provide educational programs and resources to physician members and their administration. Visit us at IndependentPhysicians.org. The staff at Darst Dermatology proudly competed again in the 5th Annual Miles Against Melanoma 5K run/walk to help raise awareness and funds for melanoma skin cancer. Proceeds raised will stay in the local community and benefit the Carolina’s Melanoma and Immunotherapy Fund at Carolina HealthCare System’s Levine Cancer Institute. So far, Miles Against Melanoma N.C. has donated more than $70,000 to the fund. Oncology Specialists of Charlotte (OSC) was active in our community with fundraisers and support of causes to raise awareness about cancer during the month of May. OSC sponsored “Fight the Good Fight,” a 7K run in Huntersville for Glioblastoma Multiforme, a type of brain cancer. Physician member, Justin Favaro, MD, PhD, was the guest speaker at “Laugh For Life” at
the Comedy Zone to support Multiple Myeloma, a type of blood cancer. Joanne Monaco, OSC chemotherapy nurse, raised more than $22,000 in her annual “Fore the Cure” golf tournament at Raintree Country Club, benefitting Susan G. Komen Charlotte for breast cancer. Oncology Specialists of Charlotte welcomes Hadley Spencer, FNP-C. She earned a master’s degree in nursing from Clemson University and then attended Francis Marion University for family nurse practitioner certification. Spencer will be helping patients with cancer treatment management and Hadley Spencer, FNP-C survivorship monitoring. In honor of Skin Cancer Awareness Month, Marc Darst, MD, participated in the 2016 Skin Cancer Screening hosted by Carolinas HealthCare System and Levine Cancer Institute. It is the one month out of the entire year that national attention is focused on skin cancer, creating the perfect opportunity for dermatologists to educate the public on a much broader scale about the importance of early detection and how to SPOT Skin Cancer™. This was a free skin cancer screening in the community, where professionals could collectively influence positive behavioral change to improve public health, and, at the same time, clearly demonstrate how dermatologists offer a unique and significant value to the public.
PROPERTY SPOTLIGHT
FAIRVIEW CENTER
150 Fairview Road | Mooresville, North Carolina
Brackett Flagship Properties, LLC (BFP) is a full-service real estate firm providing comprehensive solutions for our healthcare system and physician clients, including: capital, development, sales, marketing, leasing, sale-leaseback structuring, property maintenance, asset management, and property management.
Your Healthcare Real Estate Specialists
• Medical office available for lease January 1st, 2017 • Currently occupied by Charlotte Gastroenterology • Ground floor availability • Suite 120 -
REED GRIFFITH
Partner, Director of Leasing & Brokerage direct 704-971-8908
TIFFANY SLAYDEN
Vice President Leasing & Brokerage direct 704-971-8906
WILL ROBERTSON
Associate Leasing & Brokerage direct 704-971-8904
± 5,000 SF
• Building signage opportunity available • Across the street from Lake Norman Regional Medical Center • Very nice move-in ready space
2701 Coltsgate Road, Suite 300 | Charlotte, North Carolina 28211 | 704-442-0222 | www.brackettflagship.com
Mecklenburg Medicine • July/August 2016 | 13
Leading-Edge, Compassionate Hematology & Oncology Care OUR CARE PROVIDERS James F. Boyd, MD Justin P. Favaro, MD, PhD Dipika Misra, MD Catherine E. Moore, MD Jason G. Shultz, MD Anne Poutier, FNP-C Since 2000, we have provided care for patients with cancer and blood disorders in both the clinic and hospital setting. To refer a patient to one of our experienced oncologists, call 704-342-1900.
2711 Randolph Rd., Suite 100 | Charlotte, NC 28207 7108 Pineville-Matthews Rd., Ste 102 | Charlotte, NC 28226
We’re here at 2am. We are the only hospice in the region with a dedicated After Hours team to care for your patients in the middle of the night. And we’ve been here for over 38 years. We’re available 24/7. Call us. We can help.
704.375.0100
hpccr.org
ONCOLOGYCHARLOTTE.COM | 704.342.1900
D E D E E N S R O T C O D L A LOC R NEW PRACTICE FO
Medical doctors needed part-time to treat Suboxone™ (Buprenorphine/Naloxone) patients. We offer flexible hours in a hassle-free environment. Metrolina Pain and dePendency clinic
704-995-5090 14 | July/August 2016 • Mecklenburg Medicine
We’ll help your pediatric eye patients get ready for the new school year. CEENTA offers a VIP line to reach our physicians within minutes.
704.295.3100
Celebrating 30 years and over 600 heart transplants
Breakthrough Treatments. Outstanding Outcomes. World-Class Heart Care.
From implanting our region’s first total artificial heart to achieving top patient survival rates, we’re leading the way in delivering breakthrough heart failure and transplant care.
Your partner for complete cardiovascular care. Connect with a dedicated referral specialist:
877-999-7484
More than 175 providers and 20 care locations across the Carolinas Mecklenburg Medicine • July/August 2016 | 15
Mecklenburg County Medical Society
PRSRT STD U.S. POSTAGE PAID CHARLOTTE, N.C. PERMIT NO. 1494
1112 Harding Place, #200 Charlotte, NC 28204 CHANGE SERVICE REQUESTED MCMS Mission: To unite, serve and represent our members as advocates for our patients, for the health of the community and for z the profession of medicine. Founders of: Bioethics Resource Group, Ltd., Hospitality House of Charlotte, Teen Health Connection, N.C. MedAssist, Physicians Reach Out
LabCorp Laboratory Corporation of America
PATIENT SERVICE CENTERS
Ballantyne Billingsley** Carmel** Cabarrus Charlotte** Gastonia Stat Lab Huntersville Huntersville** Lake Norman Matthews Northridge* Pineville Rock Hill Salisbury** Salisbury* Shelby Statesville** University**
… for all of your laboratory testing needs
15830 John Delaney Drive 300 Billingsley Road, Suite 200A 5633 Blakeney Park Drive, Suite 100 478 Copperfield Blvd. 1718 E. 4th Street 660 Summitt Crossing, Suite 206 14330 Oakhill Park Lane 10030 Gilead Road, Suite B100 134 Medical Park Drive, Suite 102 1500 Matthews Township Parkway, Suite 1147 5031-G West W.T. Harris Blvd. 10410 Park Road, Suite 450 2460 India Hook Road, Suite 101 601 Mocksville Avenue 514 Corporate Road 809 N. Lafayette Street 1710-A Davie Avenue 10320 Mallard Creek Road
*Drug Screens only **Blood Draws only
16 | July/August 2016 • Mecklenburg Medicine
Charlotte, NC Charlotte, NC Charlotte, NC Concord, NC Charlotte, NC Gastonia, NC Huntersville, NC Huntersville, NC Mooresville, NC Matthews, NC Charlotte, NC Pineville, NC Rock Hill, SC Salisbury, NC Salisbury, NC Shelby, NC Statesville, NC Charlotte, NC
704-540-0251 704-332-6904 704-542-7061 704-795-2710 704-372-6609 704-854-9497 704-948-8101 704-875-9130 704-799-6230 704-849-0154 704-598-6266 704-341-1145 803-328-1724 704-637-1676 704-221-4407 704-480-7004 704-878-0948 704-549-8647