July/August 2018 • Vol. 48, No. 7
Mecklenburg Medicine
able to prove that you are better,” said to be seen,” said the other. “If you are ains rem at “Th .” erer Sorc a are you will stop you from living and forbid of that. Just as good a Wizard as en otherwise?” asked the Wizard. “I happ will hat “W kly, all ” ise-“Oh, I’m a Wizard; you may be sure erw Oth ain. Wizard of this dom . “But never mind. I’ll beat Old Pric Chief Mecklenburg A Publicatione of the County Medical Society | sily www.meckmed.org you the with the star unea at the one ing look , at man e and littl hand the the Prince to the little man, “I will mak ny said thor ,” a sant ed plea orm.” He wav ce. “That does not sound especially you equal the sorcery I am about to perf see me t ed “Le show l. but riva you to be planted,” returned the Prin his ned, liste upon le eyes peop l The Mangaboo Sorcerer, turning his heartless, crue no bells at all in the great glass hall. ver disco d loan y coul kindl othy y right.” “My name is Gwig,” said the Dor ebod ld, som wou ill she “W asked: ing sweet music. Yet, look where so he smiled upon the assemblage and once the tinkling of bells was heard, play erer. Now was the Wizard’s turn, sorc a was he d, “will somebody please loan me a e zar prov to Wi the did lly said usua g em!” gs Gwi t through the air. “Ah fligh his in e is , ehow som no great interest. It was one of the thin his, lost had le, observe me carefully. You see, ther Mangaboos did not wear hats, and Zeb own hat, if you please. Now, good peop my . use erer “I’ll Sorc d. the me a hat?” No one did, because the zar said Wi it,” the d see me arke ly. “Let kerchiefs, either. “Very good,” rem and held it upside down, shaking it brisk hat his , off floor took He glass the handkerchief?” But they had no hand ty.” emp upon e hat quit the is ed of nothing.” He plac out t my person. Also, my hat g abou ethin d som eale te conc crea ing will noth “I , and e man e sleev shrill nothing up my zard. “Now,” said the littl e and to grunt and squeal in a tiny, fully, returning it afterward to the Wi ch began to run around here and ther whi se, b mou a thum than one r een He took the hat and examined it care bigge betw no t head pigle its te , and holding removed the hat, displaying a little whi out, caught the wee creature in his hand hed reac d it zar that Wi so e , Th made a pass with his hand, and then floor e. the littl or upon big one for they had never seen a pig before, separate piglet in an instant. He placed ance voice. The people watched it intently, of the two parts becoming a whole and each t, apar it ed pull he zard continued this surprising perform er fing and b r thum apart, making four piglets. The Wi ed pull was will I these ing, and finger and its tail between the othe of noth one from then g and ethin som the other, making three piglets in all; the Wizard of Oz, “having created could run around, and pulled apart in a very comical way. “Now,” said ting grun t and pushed it into the first, and pigle g her alin anot sque up all ht feet, caug his he at en about the two were one. Th that so her, made a toget until nine tiny piglets were running them ed push and ts Wizard placed underneath his hat and this he caught up two of the pigle of the creatures remained. This the one e singl in his , a make something nothing again.” With said but l ce unti Prin her the toget then ed ched him, and one, the nine tiny piglets were push a bow to the silent throng that had wat gave man hy e littl “W e g. where it disappeared. And so, one by Th Gwi d ely. arke entir rem red ,” Wizard long his hat the last piglet had disappea erer.” “He will not be a wonderful Sorc my of e.” aliv those keep mystic sign above it. When he removed than ot ter cann grea you are the ers you cannot brea wonderful Wizard, and your pow are curiously constructed, and that if you s that sign r eive quee perc cold, calm voice: “You are indeed a ing “I y. mak n repl bega the He was Watch me carefully.” g to stop your breath,” . goin now am I begin e to g caus goin “Be d. I’m . zar utes Wi the min one not?” enquired ” he asked. “About five sharp knives, which he joined together, long will it take you to stop my breath? from his pocket and took from it several case t. ern effec leath a take to The little man looked troubled. “How drew ning he begin ead, Inst was . did not watch him long the charm of the Sorcerer as man e the, littl brea to the ble but d; trou h zar muc Wi ng the havi rd erer and passes towa handle to this sword he was ty stroke that cut the body of the Sorc sword. By the time he had attached a around his head, and then gave a migh e twic or and once all, it at rled after another, until they made a long him whi of e d, insid swor p blood no bones or leaping forward he raised the shar apart on the floor she saw that he had fell erer this Sorc in the e, of So the Wizard lost no more time, but tabl es vege halv all two are e the as “W the Prince. expected to see a terrible sight; but Wizard, astonished. “Of course,” said the cried will e!” and , tabl now exactly in two. Dorothy screamed and vege dead he’s y hy, reall “W is tainly, sir. He much like a sliced turnip or potato. meat. Will your Sorcerer die?” “Cer all are tly h grea eart d, the that the place where he was cut looked of zar top Wi e on littl ople the d “Pe “No,” answered the Wizard. ce. “What do you mean by that?” aske country. Are you not vegetable, also?” grow upon his bush,” continued the Prin may s erer Sorc r teries of our Vegetable Kingdom.” othe that , once at t him you much better than I can here the mys to ain expl will wither very quickly. So we must plan “I ce, Prin the ied to our public gardens,” repl puzzled. “If you will accompany me
R e a d
It’s Good
4
Your Health
The Vegetable Kingdom
red some of his people to carry the two case again, the man with the star orde ern leath so their into s piece the put and t he might find something proper to eat; pness from his sword and taken it apar and wanted to join the party, thinking ens, gard the hall to g the e goin e leav After the Wizard had wiped the dam to wer ted they star d hear n Jim ens. Jim pricked up his ears when he e man and the two children, and whe halves of the Sorcerer to the public gard seat was amply wide enough for the littl e Th . drawing the buggy with the Jim them then with t, ride nex to ce d Prin zar the Wi , invited the ers of the Sorcerer first bear the ts, stree the ugh Zeb put down the top of the buggy and thro ed mov n for a good many people lived there; but there quite contentedly. So the processio The glass city had several fine streets, n. frow nor e smil er neith the kitten jumped upon his back and sat d coul and it. There were paths through these d of vegetable people who had no hearts many pretty brooks that flowed through by ered wat and ens gard strangers inside of it, and last the crow with red might see and examine the flowers and these it came upon a broad plain cove walked beside the Prince, so that they and buggy the of out when the procession had passed through got now Zeb r,” said she. “Did the glass houses e ornamental glass bridges. Dorothy and the star. “They grow.” “That’s quee with man the es ered answ ,” gardens, and over some of the brooks wer them t buil one we are so angry when a Rain of Ston bridges?” asked the little girl. “No fine as they are now. That is why and e larg as ed pass grow to first ey them plants better. “Who built these lovely Th for s do.” year wait until they he replied. “But it took a good many together again, in time, and we must grow will they the er but o; und “N in your city grow, too?” “Of course,” ging . ired chan ly enqu tant she they were, because the colors were cons our roofs.” “Can’t you mend them?” comes to break our towers and crack could hardly tell what kind of flowers othy had broad leaves and grew Dor ch but whi city; ts, the plan est the to near e cam grew ch ers, whi the same way when they was it and ow; yell or through many beautiful gardens of flow blue then t, nex bled, “where a respectable horse has to er would be pink one second, white the nibble. “A nice country this is,” he grum to n bega d and head his n shifting lights of the six suns. A flow dow ched stret bow grass.” “How does it taste?” aske over a field of grass Jim immediately e. “As a matter of fact, I’m eating rain hors the to ned plai said ce com ,” close to the ground. When they passed Prin blue the it’s and , ow field Wizard, who was in the buggy. “N the party had reached a freshly plowed eat pink grass!” “It’s violet,” said the complain about its color.” By this time not Sorcerer into it and covered I’ll it the of of ty es plen halv me two give the put they Jim. “If in the ground. Then they hole a dug and es the Wizard. “Not bad at all,” said spad glass with e bush, from which we shall in time be nd.” Several Mangaboos came forward said the Prince, “and grow into a larg ,” soon very ut spro will e Dorothy: “This is our planting-grou “H h. eart bushes where you came from, on the water from a brook and sprinkled the the reply. “Do not all people grow upon was ly,” tain “Cer boy. him up. After that other people brought the d aske es?” s.” “Do all your people grow on bush hear of.” able to pick several very good sorcerer outside of the earth?” “Not that I ever
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Table of Contents
July/August 2018 Vol. 48 No. 7
6 President’s Letter: Transparent Uncertainty
OFFICERS
By Scott L. Furney, MD, President, MCMS
6 Charlotte AHEC Course Offerings for July/August 7 Feature: Childhood Illiteracy — A Public Health Crisis By Kimberly Lewis, MD, Pediatric Resident, Carolinas Medical Center
8 Feature: Supporting Charlotte’s Gender Non-Conforming and Transgender Youth and Their Families By Karen Graci, Manager, Healthcare Outreach Initiative, PFLAG Charlotte
9 Feature: Improved Medicare Care for All Would Help Children and Families By Jessica Schorr Saxe, MD, Chair, Health Care Justice-NC
9 National Health & Wellness Observances 10 Mecklenburg County Parks by Region 11 New Members/Upcoming Meetings & Events 11 MECK-PAC 12 Feature: Working on Behalf of Kids: Child Health Committee By Sara Horstmann, MD, Chair, MCMS Child Health Committee
13 14 16 18
Adolescent Well-Care: Surveillance and Screening At the Hospitals Independent Physicians of the Carolinas Advertising Acknowledgements
President Scott L. Furney, MD
President-Elect Elizabeth B. Moran, MD Secretary Babak Mokari, DO
Treasurer John R. Allbert, MD
Immediate Past-President Stephen J. Ezzo, MD
BOARD MEMBERS
Raymond E. Brown, PA Sarah M. Edwards, MD E. Carl Fisher, Jr., MD Donald D. Fraser, MD Vishal Goyal, MD, MPH Jane S. Harrell, MD Stephen R. Keener, MD, MPH B. Lauren Paton, MD Anna T. Schmelzer, MD Rachel L. Storey, DO Andrew I. Sumich, MD G. Bernard Taylor, MD
EX-OFFICIO BOARD MEMBERS Tracei Ball, MD, President-Elect Charlotte Medical Dental & Pharmaceutical Society Sandi D. Buchanan, Executive Director Mecklenburg County Medical Society Darlyne Menscer, MD NCMS Delegate to the AMA
Douglas R. Swanson, MD, FACEP, Medical Director Mecklenburg EMS Agency
EXECUTIVE STAFF Executive Director Sandi D. Buchanan
Finance & Membership Director Stephanie D. Smith
Meetings & Special Events Coordinator Jenny H. Otto
1112 Harding Place, #200, Charlotte, NC 28204 704-376-3688 • FAX 704-376-3173 meckmed@meckmed.org Copyright 2018 Mecklenburg County Medical Society 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. 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.
MECKLENBURG MEDICINE STAFF Editor Scott L. Furney, MD Managing Editor Sandi D. Buchanan Copy Editors Lee McCracken Stephanie Smith
Advertising Mark Ethridge mecklenburgmedicine@gmail.com Editorial Board Stephen J. Ezzo, MD N. Neil Howell, MD Jessica Schorr Saxe, MD Graphic Design Wade Baker
Mecklenburg Medicine • July/August 2018 | 5
President’s Letter
Transparent Uncertainty By Scott L. Furney, MD
W
eaving my way through a complex clinic, I marveled at the number of times I was uncertain about some aspect of a patient’s care. “How long will this go on? Does my patient have early appendicitis? Will this medication work, when the others have not?” In this short Life that only lasts an hour How much — how little — is within our power — Emily Dickinson We have developed extraordinary knowledge in our careers. Each of us has studied hard, graduated and embarked on lifelong education as a matter of necessity and pride. Despite my personal commitment, I find it fails me regularly. In almost every encounter, I find myself uncertain about something. Today, I looked up a new medication on a patient’s list, reviewed the dosing duration for tick-borne illness and numerous other things. In all of it, I had to ask the patient to bear with me as I learned how to care for him. While the admission is humbling, I find patients are mostly accepting and appreciative. There are exceptions, though. How do you gauge the patient’s willingness to allow I am unlikely to blunt uncertainty in their care? Does the patient’s emotional this change how much you disclose? Is it ethical to release response much further, information that will make a patient worry unnecessarily, or but I can be there to unethical not to? At issue today were two explain and incorporate incidentalomas. Ordering a scan that was indicated, I his or her wishes into stumbled upon two simple our plan. cysts. One was in the kidney and one “too small to characterize” was in the pancreas. With medical knowledge and training, one would reasonably conclude that they are benign and no further imaging is indicated. Am I certain of this? How should I advise the patient, who is well-educated and extremely reasonable? I am lucky enough to work with a medical student, to whom I posed these questions. His answer helped me, as they often do. He said, “It depends on how you frame the issue.” Framing is a great answer, but I had to identify the frame and acknowledge the bias it introduced. In the end, I sent him the report with the facts of the case, framed around my logic and my recommended approach. Now that I have dealt with my uncertainty, I wait with baited breath for the patient’s response.
6 | July/August 2018 • Mecklenburg Medicine
One could imagine the range of responses, from nonchalant to terrified. With the facts and frame, I can narrow that possible range and reduce anxiety of the unnarrated facts. I am unlikely to blunt the patient’s emotional response much further, but I can be there to explain and incorporate his wishes into our plan. If I am 99.9 percent certain, but the patient cannot sleep at night, my 0.1 percent uncertainty is only good enough for my conscience. You can see now why I was drawn to the short poem by Dickinson. All I can do is be transparent with my uncertainty and let the patient’s preferences guide us to the compromise that satisfies our differing needs. When done well, I can exit the room feeling comfortable that we share in the uncertainty. In humble service,
CHARLOTTE AHEC COURSE OFFERINGS Charlotte AHEC is part of the N.C. Area Health Education Centers (AHEC) Program and Carolinas HealthCare System.
JULY/AUGUST 2018
Continuing Medical Education (CME) Online Risk Management: Patient Identification Online Social Media: Risks and Benefits for Physicians Online Prevention and Management of Concussion/Mild Traumatic Brain Injury Online Motor Vehicle Crash Victims Online MTAC Trauma Modules Online Get the 4-1-1: Everything Primary Care Providers Should Know About Parent Training in Behavior Therapy While Working With Families With Young Children With ADHD Online Electronic Medical Record on Trial (Risk Management) For more information or to register for these courses, call 704-512-6523 or visit www.charlotteahec.org.
Feature
Childhood Illiteracy — A Public Health Crisis By Kimberly Lewis, MD, Pediatric Resident, Carolinas Medical Center
C
harlotte, like many other cities in the United States, is in the midst of a crisis. A 2013 Harvard study evaluating socioeconomic mobility, ranked some of America’s largest cities by the likelihood that a child born into poverty in that city could rise to a higher quintile of income during his or her lifetime.1 Among the 50 cities included in the study, Charlotte ranked 50th, suggesting that, despite the ongoing growth in population, industry, housing and banking in Charlotte, low-income families have yet to see the economic benefits. The American dream does not exist for them, because no matter how hard they work, their efforts rarely translate to financial success and freedom. In response to these findings, in 2015 a group of 20 community members created the Charlotte-Mecklenburg Opportunity Task Force to find the factors affecting the paucity of opportunity facing Charlotte’s low-income families. Its findings revealed several interrelated factors that affect family access to opportunities, including early child care and education, college and career readiness, and child and family stability (leadingonopportunity.org). As a resident physician, I have spent my entire life thus far in some form of school or educational training. Therefore, education as a determinant and predictor of future opportunity piqued my interest. Low-income families often cannot afford high-quality child care.
Children from low-income families are exposed to 30 million fewer words by age 3 than children from wealthier families. This leads to a dramatic difference in the child’s vocabulary. One in three low-income families have no books in the home.2 These children essentially are in a state of educational starvation during some of the most important years for brain development. Failure to attain early childhood literacy has lifelong social and economic impacts that often extend to future generations. Poor reading skills in third grade are a significant risk factor for dropping out of high school, as reading skills remain poor.3 Failure to graduate from high school has major implications that can significantly impact a child’s life trajectory. Those who do not complete high school are much more likely to be jobless, and those with jobs have incomes about half that of their peers with high school diplomas. Female high school dropouts are nine times more likely to become single mothers when compared to those with bachelor’s degrees. Furthermore, those without a high school diploma have a 63 times higher rate of incarceration when compared to those who attended a four-year university.4 While the breadth and depth of this problem is overwhelming, small interventions can make a huge difference. Several organizations in Charlotte accepted the challenge to solve this crisis. In 2014, the group now called Read Charlotte organized with the goal of doubling the number of Charlotte’s third-graders reading on grade level from 40 percent to 80 percent by 2025. Four essential pillars guide their work. The first two pillars aim to support children through kindergarten. The second two pillars focus on all school-age children. Their website (www.readcharlotte.org) is full of suggested reading lists for children and tips for creating a language- and literature-rich environment at home. Where is the Land of Opportunity? The Geography of Intergenerational Mobility in the United States. Raj Chetty, Nathaniel Hendren, Patrick Kline and Emmanuel Saez. Harvard University, 2013. 2 Promoting Family Literacy Through the Five Pillars of Family and Community Engagement (FACE), Nai-Cheng Kuo, School Community Journal, 2016, Vol 26, No.1. 3 KIDS COUNT Report, Early Warning! Why Reading by the End of Third Grade Matters, Annie E. Casey Foundation, 2010. 4 The Consequences of Dropping Out of High School: Joblessness and Jailing for High School Dropouts and the High Cost for Taxpayers, Andrew Sum, Ishwar Khatiwada and Joseph McLaughlin, 2009. 1
Mecklenburg Medicine • July/August 2018 | 7
Feature
Supporting Charlotte’s Gender Non-Conforming and Transgender Youth and Their Families PFLAG Charlotte in Partnership with Mecklenburg County Medical Society By Karen Graci, Manager, Healthcare Outreach Initiative, PFLAG Charlotte
W
hen our now 18-year-old child came out as transgender almost three years ago, I didn’t know transgender individuals experience higher rates of verbal harassment, physical assault, poverty and unemployment.1 I didn’t know transgender youth experience higher rates of depression and anxiety.2 I didn’t know 40 percent of transgender adults had attempted suicide. I didn’t know 74 percent of those first suicide attempts were at age 17 or younger.1 I didn’t know 40 percent of homeless youth in our country identify as LGBTQ.3 I didn’t know any of this, yet I was still so scared — for our child’s life, our child’s future … and for our What began in 2016 as family of four. a small project by three My child knew she was moms seeking care for transgender by age 10, but it took her five more years before she their own children has ready to share her gender grown into a partnership was identity with us. I know how with the Child Health lucky we were that she finally found those words. My husband Committee of the and I, along with our child’s older Mecklenburg County sister, had been witnessing each Medical Society. day the heartbreaking pain that can be caused by an adolescent’s gender dysphoria — the feeling of distress that can result when your sex assigned at birth does not align with your gender identity. Over the course of the next year, we listened. We asked lots of questions. And we asked for help. Our support network expanded to extended family and friends, inclusive educators, affirming mental health professionals and the staff of Time Out Youth. We were connected with PFLAG Charlotte, a support, education and advocacy group for the LGBTQ community. Yet even with all this support, we failed to find a pediatrician who could help my child. Finally, we were connected with a family medical provider who would travel the journey with us. It was the real turning point for our child. A year ago, I was invited to manage PFLAG’s Healthcare Outreach Initiative. What began in 2016 as a small project by three moms seeking care for their own children has grown into a partnership with the Child Health Committee of the Mecklenburg County Medical Society. Through this collaboration, our team of three parent volunteers has expanded to a team of seven parent volunteers, a behavioral health provider, a family medical provider and a pediatrician who collectively have presented our “Bridging the Healthcare Gap” workshop to almost a thousand pediatric, family medicine, OB/GYN and behavioral health professionals in Mecklenburg County and beyond.
8 | July/August 2018 • Mecklenburg Medicine
To those of you who know our PFLAG Health Outreach Team, we thank you. For those we haven’t met, we are happy to come to your practice to conduct our workshop. We will share our stories, discuss the social and health challenges faced by LGBTQ individuals, and talk about the many ways healthcare providers can be more inclusive and affirming. When LGBTQ individuals are supported in their identities, their rates of depression, anxiety, selfharm and suicide decrease. How is my family now? I couldn’t be more proud as our child prepares for her last AP exam next week and for her high school graduation in June. As she looks forward to heading to college in the fall, her older sister is completing her junior year in college. Our kids may be leaving the nest, but our family of four feels whole again. If you are interested in scheduling a workshop, email pflagcharlotte@ gmail.com or call 704-557-6135.
The following local resources are available to healthcare providers and LGBTQ patients and families:
The Charlotte Transgender Healthcare Group (www.cthcg.org) PFLAG Charlotte (www.pflagcharlotte.org) n Time Out Youth (www.timeoutyouth.org) n Transcend Charlotte (www.transcendcharlotte.org) n n
Below are several upcoming regional and national conferences: n July 6: Gender Spectrum Professionals’ Symposium, Moraga, CA (www.genderspectrum.org) n August 2-4: Philadelphia Trans Wellness Conference (www.mazzonicenter.org/trans-wellness) n August 9-12: Gender Odyssey Seattle (www.genderodyssey.org) The Report of the 2015 U.S. Transgender Survey, James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016), Washington, DC: National Center for Transgender Equality. 1
Mental Health of Transgender Youth in Care at an Adolescent Urban Community Health Center: A Matched Retrospective Cohort Study, Reisner, Sari L. et al., J Adolesc Health. 2015; 56:274-279. 2
Serving Our Youth: Findings from a National Survey of Service Providers Working with Lesbian, Gay, Bisexual and Transgender Youth who are Homeless or At Risk of Becoming Homeless, Durso, L. E., & Gates, G. J. (2012), Los Angeles: The Williams Institute with True Colors Fund and The Palette Fund. 3
Feature
Improved Medicare Care for All Would Help Children and Families By Jessica Schorr Saxe, MD, Chair, Health Care Justice-NC
W
hy talk about Medicare in an issue about children? Isn’t Medicare for seniors? Don’t all children have health insurance? While it’s true health insurance coverage for children is at record highs, there are still gaps. Nationally, 5 percent — more than four million children — are uninsured. That number includes almost 150,000 children in North Carolina. And children are affected by the health of others. We continue to have 28 million uninsured people in the United States. Many of them are parents, grandparents and caretakers. We also have a growing number of underinsured — those with insurance who either avoid care because the cost is prohibitive or who get needed care and have bills they can’t pay. The number of underinsured Americans has been We continue to have 28 rising and now has million uninsured people reached 41 million. One out of three in the United States. Many Americans goes of them are parents, without needed care grandparents and caretakers. due to cost. We, as physicians, We also have a growing also are affected by number of underinsured — the current state of our healthcare system. those with insurance who In a recent JAMA either avoid care because the article on “Physician Well-Being and the cost is prohibitive or who get Regenerative Power needed care and have bills of Caring,” Thomas Schwenk, MD, they can’t pay. discusses the fact that physician burnout is related to fragmented care and complicated bureaucracies that distance us from patients. Barriers interfere with the caring for patients that inspired most of us to go into medicine, which causes burnout. Dr. Schwenk makes a compelling case that our current healthcare system is the source. While addressing physician resilience and lifestyle balance is important, we will not be able to remedy dissatisfaction until we fix the underlying cause. If we improved Medicare by broadening the coverage and then expanded it to all, we could cover everyone, eliminating both uninsurance and underinsurance; and we could decrease the bureaucracy that makes us miserable and stands between us and our patients. Can we afford it? The United States currently spends about twice per capita what other developed countries
spend, and almost a third of our spending is on administrative costs. By cutting those costs and negotiating the costs of drugs and devices, we could save enough to cover all. It would help children, their caretakers and other Americans. Physicians and other providers could stop investing time in responding to the demands of hundreds of insurance plans and worrying if their patients can afford care. Turning our energies to caring for our patients would be far more fulfilling. Health Care Justice-NC, a chapter of Physicians for a National Health Program, supports Improved Medicare for All (also known as single-payer health care). Visit www.healthcarejusticenc.org and the Facebook page. If you agree, you can join by signing the chapter resolution on the website. There is no charge to join. Contact hcjusticenc@gmail.com. You can find all the information you might want on this topic at the Physicians for a National Health Program website at www.pnhp.org. The latest surveys show an increase in support for a single-payer health system to 51 percent nationally. Health Care Justice-NC has 1,300 members — probably including many of your friends and colleagues — and counting. You are welcome, as well.
NATIONAL HEALTH & WELLNESS OBSERVANCES JULY 2018 Fireworks Safety Month Park and Recreation Month UV Safety Month July 15-21: Every Body Deserves a Massage Week
AUGUST 2018 Breastfeeding Month Children’s Eye Health and Safety Month Immunization Awareness Month Medic Alert Awareness Month August 1-7: World Breastfeeding Week August 6-12: Health Center Week August 7: National Night Out
Mecklenburg Medicine • July/August 2018 | 9
Feature
MECKLENBURG COUNTY PARKS The Mecklenburg County Park and Recreation Department is home to 210 parks and facilities located on more than 21,000+ acres of parkland throughout Mecklenburg County. Central Region Abbott Park, 1300 Spruce St. Alexander Street Park, 739 E. 12th St. Anita Stroud Park, 2215 Double Oaks Road Baxter Street Park, 942 Baxter St. Biddleville Park, 500 Andrill Terrace Bryant Park, 1701 W. Morehead St. Camp Green Park, 1221 Alleghany St. Chantilly Park, 222 Wyanoke Ave. Charles Avenue Park, 800 Charles Ave. Cherry Park, 1509 Baxter St. Clanton Park, 1520 Clanton Road Clemson Avenue Park, 3028 Clemson Ave. Collins Park, 4500 Applegate Road Colonial Park, Providence Road Cordelia Park, 2100 N. Davidson St. Druid Hills Park, 2801 Lucena St. E.B. Moore Park, 901 Marsh Road Eastover Park, 2730 Randolph Road Edgehill Park, 975 S. Edgehill Road Enderly Park, 1501 Enderly Road First Ward Park, 301 E. 7th St. Five Points Park, 200 French St. Fourth Ward Park, 201 N. Poplar St. Frazier Park, 1201 W. 4th St. Freedom Park, 1900 East Blvd. Greenville Park, 1330 Spring St. Grier Heights Park, 3100 Leroy St. Independence Park, 300 Hawthorne Lane Lakewood Park, 3131 Kalynne St. Latta Park, 601 E. Park Ave. LC Coleman Park, 1501 McDonald St. Lincoln Heights Park, Catherine Simmons Ave. Little Peoples Park, 120 Harrill St. Marshall Park, 800 E. 3rd St. Martin Luther King Park, 2600 Ravencroft Drive Merry Oaks Park, 3508 Draper Ave. Midwood Park, 2100 Wilhelmina Ave. Ninth Street Park, 417 W. 9th St. North Charlotte Park, 901 Herrin Ave. Our Children’s Memorial Walkway,1201W. 4th St. Ext. Pearl Street Park, 1200 Baxter St. Pressley Road Park, 1500 Pressley Road Progress Park, 1301 Parkwood Ave. Randolph Road Park, 201 Billingsley Road Reid Neighborhood Park, 3207 Amay James Ave. Revolution Park, 2425 Barringer Drive Romare Bearden Park, 300 S. Church St. Sedgefield Park, 621 Elmhurst Road Seversville Park, 530 Bruns Ave. Shamrock Park, 2545 Jeff St.
Sixteenth Street Park, 620 E. 16th St. Solomons Park, 3299 Venice St. Southside Park, 2645 Toomey Ave. Third Ward Park, 1001 W. 4th St. Thompson Park, 1129 E. 3rd St. Tryon Hills Park, 220 W. 30th St. Veterans Park, 2136 Central Ave. Waddell Street Park, 1505 Waddell St. Westerly Hills Park, 3900 Amerigo St. West Charlotte Park, 2401 Kendall St. Wilmore Park, 900 Spruce St. Wingate Park, 2731 Mayfair Ave. North Region Allen Hills Park, 4701 Cheviot Road Blythe Landing, 15901 NC 73 Briarwood Park, 5399 Waterwood St. Clarks Creek Park, 9801 Mallard Creek Road Coulwood Park, 100 Coulwood Park Drive David B. Waymer Park, 14200 Holbrooks Road David B. Waymer Flyer Field, 15401 Holbrooks Road Derita Creek Park, 3509 Frew Road Eastway Park, 423 Eastway Drive Firestone Park, 3501 Firestone Drive Fred Alexander Park, 1832 Grier Grove Road Friendship Sportsplex, 2310 Cindy Lane Hornet’s Nest Park, 6301 Beatties Ford Road Howie Acres Park, 4200 Redwood Ave. Jetton Park, 19000 Jetton Road Kirk Farm Fields, 210 E. Mallard Creek Church Road Mallard Creek Community Park, 3001 Johnston-Oehler Road Nevin Community Park, 6000 Statesville Road Newell Park, 9130 Newell Baptist Church Road North Mecklenburg Park, 16131 Old Statesville Road Ramsey Creek Park, 18441 Nantz Road Reedy Creek Park, 2900 Rocky River Road Richard Barry Memorial Park, 13707 Beatties Ford Road Robert Caldwell Bradford Park, 17005 Davidson-Concord Road Robert L .Smith Park, 1604 Little Rock Road Rural Hill Park, 4431 Neck Road Shuffletown Park, 9500 Bellhaven Blvd. Sugaw Creek Park, 943 W. Sugar Creek Road Theresa Clark Elder Neighborhood Park, 6315 Rockwell Church Road Tom Hunter Park, 919 Tom Hunter Road Tuckaseegee Park, 4820 Tuckaseegee Road Unity Park, 6401 Kelsey Drive Viewmont Park, 5400 Viewmont Drive South Region Albemarle Road Park, 9120 East W.T. Harris Blvd. Archdale Park, 5400 Cherrycrest Lane
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Ballantyne District Park, 9405 Bryant Farms Road Carmel Road Park, 2365 Carmel Road Berewick Regional Park, 5910 Dixie River Road Cedarwood Park, 6624 Reddman Road Colonel Francis Beatty Park, McKee/Tilley Morris Road/ 4330 Weddington Road Copperhead Island Park, 15200 Soldier Road Elon Park, 11401 Ardrey Kell Road Flat Branch Park, 11830 Tom Short Road Grayson Park, 750 Beal St. Harrisburg Road Park, 7701 Harrisburg Road Hickory Grove Park, 6709 Pence Road Huntingtowne Farms Park, 2400 Ramblewood Lane Idlewild Road Park, 10512 Idlewild Road James Boyce Park, 300 Boyce Road Julian Underwood Park, 5400 Galway Drive Marion Diehl Park, 2219 Tyvola Road Mason Wallace Park, 7301 Monroe Road McAlpine Creek Park, 8711 Monroe Road McKee Road Park, 4201 McKee Road Methodist Home Park, 3200 Shamrock Drive Oakhurst Park, 3500 Craig Ave. Olde Providence Park, (at OP School), 3800 Rea Road Park Road Park, 6220 Park Road Rama Road Park, 1035 Rama Road Ramblewood Park, 10200 Nations Ford Road Renaissance Park, 1200 W. Tyvola Road Sheffield Park, 1311 Tarrington Ave. Steele Creek Park, 4100 Gallant Lane Squirrel Lake Park, 1631 Pleasant Plains Road William R. Davie Park, 4635 Pineville-Matthews Road Winterfield Park, 3010 Winterfield Place Yorkmont Park, 6417 Vickers Road Inclusive Parks Inclusive playgrounds are for children of all abilities. The surface is appropriate for wheelchairs and walkers and the equipment is accessible via ramps. Adapted swings are appropriate for children who may still need the safety of a shoulder strap and high seat back. Inclusive playgrounds also contain sensory equipment that provides unique visual, tactile and auditory stimulation. Chantilly Park Clemson Park Colonel Francis Beatty Park Cordelia Park Freedom Park Grier Heights Park Idlewild Park Jetton Park Mallard Creek Park
Marion Diehl Park Merry Oaks Park Methodist Home Park Nevin Park Park Road Park Reedy Creek Park Revolution Park William R. Davie Park
Member News
NEW MEMBERS Courtney A. Castoro, MD Anesthesiology Providence Anesthesiology Associates 131 Providence Road #200 Charlotte, NC 28207 704-749-5800 University of Arizona, 2010 Maycie Elchoufi, MD Internal Medicine Eastern Virginia Medical School, 2002
Upcoming Meetings & Events JULY/AUGUST
Meetings are at the MCMS office unless otherwise noted.
Wednesday, July 4 MCMS office closed for Independence Day. n Tuesday, July 10 MedLink meeting. Community Care Partners of Greater Mecklenburg 4701 Hedgemore Drive, Charlotte 8:30 a.m. n Monday, July 16 Executive Committee meeting. 5:45 p.m. n Thursday, July 19 CAMGMA meeting. Myers Park Baptist Church Cornwell Center Noon n Monday, July 23 September magazine deadline. n Monday, July 23 MCMS Board meeting. 5:15 p.m.-dinner, 5:45 p.m. meeting. . n Tuesday, Aug. 14 MedLink meeting. Community Care Partners of Greater Mecklenburg 4701 Hedgemore Drive, Charlotte 8:30 a.m. n Monday, Aug. 20 Executive Committee meeting. 5:45 p.m. n Wednesday, Aug. 22 October magazine deadline. n
Back row, second from left: John Allbert, MD, along with other OB/GYN physicians, advocated for doctors and patients while attending the White Coat Wednesday in Raleigh.
The MCMS MECK-PAC Board seeks to identify, educate and support those candidates who have a real understanding of the issues physicians face in caring for patients, and who support legislation that positively impacts the practice of medicine. These issues include, but are not limited to, medical malpractice reform, payment and contract negotiations, pay for performance and scope of practice. MECK-PAC is truly a grassroots organization. Decisions to support candidates are made at the “ground level” by physicians who serve on the MECK-PAC Board. There is careful study of a candidate’s positions in order to determine the candidate’s philosophy regarding medical and health care issues. The MECK-PAC Board continues to work with elected officials and is watchful for any legislation that may impact the practice of medicine. MECK-PAC is a State PAC, and it is not currently allowed to contribute to those individuals seeking election to federal office. Now is the time for Mecklenburg County physicians to get involved and help ensure better government and quality health care for our patients, our community and our families. Please continue to support our efforts on behalf of all doctors.
John Allbert, MD Co-chairman
John Williford, Jr., MD Co-chairman
If you are a member of the MCMS and would like to be involved on the MECK-PAC Board, contact Stephanie Smith at ssmith@meckmed.org. You can contribute online at www.meckmed.org or send a personal check to MECK-PAC, 1112 Harding Place, Suite 200, Charlotte, NC 28204.
Mecklenburg Medicine • July/August 2018 | 11
Member News
Working on Behalf of Kids: The Mecklenburg County Medical Society Child Health Committee By Sara Horstmann, MD, Chair You likely went into medicine for the same reasons I did — to help people live healthier, happier lives. Although what I do day to day is fulfilling in its own right, spending time advocating for kids helps me prevent burnout. On the Child Health Committee, we recognize the importance of working on behalf of all children in Mecklenburg County. Here is some information about what we do and why we are doing it. If you’d like to get involved, even if you don’t care for children in your practice, you are welcome and encouraged to join us! n No Missed Days Campaign. We have partnered with the Mecklenburg County Department of Public Health and CharlotteMecklenburg Schools to help ensure every child entering kindergarten or seventh grade is up to date with vaccines and ready to learn on the first day of school. Currently, hundreds of kids in our county miss multiple days of school due to incomplete health records. Students are not allowed to attend school until they are appropriately vaccinated and have their health assessments completed. We are sending letters to providers encouraging them to send a letter to their patients reminding them to set up well checks. We also are reaching out to daycare centers with the same information. Please consider opening up extra sessions this
summer to meet the need of our CMS students and their families, or volunteering at the county-wide Big Shots events. n Transgender Youth. We have partnered with PFLAG Charlotte to help provide education and resources to all medical providers in Mecklenburg County on how to help transgender patients. Please read the article in this issue for more details and contact information. n ACES and Resilience. As we move toward population health, one major influencer on health outcomes has become apparent: Adverse Childhood Experiences (ACES) and exposure to Toxic Stress directly impacts health outcomes for children and adults. Resilience encompasses the protective factors that mitigate the effects of toxic stress. We have partnered with the Carolinas Collaborative, Winer Family Foundation and Charlotte AHEC, to engage our entire community in a discussion on this very important topic. This one-day symposium (November 16) will focus on the science behind these effects, as well as provide examples of evidence-based solutions. We will use this as an opportunity to come up with a path forward in making Charlotte the most resilient community in North Carolina. If you would like to learn more, or if you want to get involved, email sara.horstmann@atriumhealth.org.
Developmental and Behavioral Services Resource Guide In 2001, the Child Health Committee, chaired by Jessica Schorr Saxe, MD, identified a need for physicians to have information on public and private agency resources serving the needs of children with developmental and behavioral issues in order to refer patients and their families. They decided to create a resource guide. A subcommittee chaired by Andrew Shulstad, MD, oversaw production of the guide. In 2004 and again in 2007, the guide was distributed to all pediatricians and family physicians. In 2007, a web-based version was made available to all physicians and the public on the MCMS website with the following categories: Developmental Assessment and Care Autism n Psychological and Behavioral Concerns and Counseling n Religion-Affiliated Counseling Services n Speech and Hearing Services n Community Advocacy, Support Groups and Schools n Neurologists n n
IT’S NOT JUST ADULTS. OVER 64% OF YOUTH WITH DEPRESSION DO NOT RECEIVE ANY MENTAL HEALTH TREATMENT. STOP THE TREND. SECU Youth Crisis Center, a Monarch program, is the first of its kind in North Carolina for ages 6–17. We are currently accepting referrals.
MonarchNC.org (844) 263-0050
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Hard copies are no longer printed, but the guide is still available online at www.meckmed.org under Community Resources. If your practice/agency would like to be considered to be added to the guide, contact Stephanie Smith at ssmith@meckmed.org.
Feature
ADOLESCENT WELL-CARE: Surveillance and Screening Community Care of North Carolina and Community Care Partners of Greater Mecklenburg
There are two assessments that are components of the adolescent well-visit — and both are recommended in the NC 2018 Health Check Program Guide. STRENGTHS AND RISKS:
DEPRESSION:
Bright Futures Fourth Edition emphasizes a strengths-based approach at all well-visits and recommends a psychosocial assessment at all well-visits. In the early years of the NC CHIPRA Grant, a survey of adolescents across the state regarding their health care, revealed that being asked about what was going well and goals for the future is a priority for adolescents (not just being asked about what is going wrong). For adolescents, assessing for risks and strengths is a key part of the well-visit.
Both Bright Futures and the USPSTF (U.S. Preventive Services Task Force) recommend routinely screening adolescents for depression starting at age 12. Depressive symptoms and depression itself are common in adolescents (depression—up to 6 percent; 20 percent will have at least one episode of major depression before age 18). Additionally, suicide is the second leading cause of death of youth ages 10-17.
Coding: 96160 – health risk assessment
Coding: 96127
Tools: Bright Futures Supplemental Adolescent Questionnaires, the RAAPS (Rapid Assessment for Adolescent Preventive Services), and HEADSSS.
Tools: PHQ-2/PHQ-9 Modified for Adolescents. To assess for suicidality – SAFE-T (Suicide Assessment Five-step Evaluation and Triage), SBQ-R (Suicide Behaviors Questionnaire-Revised), SIQ (Suicidal Ideation Questionnaire).
See the CCNC Pediatrics: Adolescent Depression: Screening, Follow-up and Co-management Guidelines for an office process algorithm. The toolkit also contains information on SSRI use in pediatric primary care, and on referral to, and communication with, mental health professionals. Find the guidelines at https://www.communitycarenc.org/sites/default/files/2018-01/adolescent-depression-toolkit-april-2017.pdf.
Reading as an Anxiety and Depression Prescription The Smithsonian Institute, Huffington Post and Boston Globe suggest that reading is an excellent way to reduce stress. A study from the University of Sussex found that reading for pleasure can reduce stress up to 68 percent. Want to relax? Here are some suggestions: Read something for fun. Read about topics you enjoy. Read articles or books on your hobbies.
Want to know more? Here are a few links to explore: www.smithsonianmag.com/smart-news/doctors-are-now-prescribing-books-to-treat-depression-180948211/ www.huffingtonpost.com/healthline-/five-ways-reading-can-imp_b_12456962.html nationalreadingcampaign.ca/wp-content/uploads/2013/09/ReadingFacts1.pdf www.takingcharge.csh.umn.edu/reading-stress-relief Mecklenburg Medicine • July/August 2018 | 13
At the Hospitals of the vagus nerve, placement of probes for seizure monitoring, and implanting of NeuroPace. Call 704-316-3070. Novant Health Hosts Neurosciences Symposium The neuroscience team at Novant Health is hosting a two-day Neurosciences Symposium on Friday, Oct. 12, noon-5:30 p.m., and Saturday, Oct. 13, 9 a.m.-6 p.m. Both sessions will be held at the Harris Conference Center at 3216 CPCC Harris Campus Drive in Charlotte. The symposium will feature a number of talks and presentations centered on outpatient neurology and neurosurgery, as well as stroke and neuro critical care. More than 150 providers, nurses and clinical team members from Novant Health and other regional healthcare systems are expected over the two-day seminar. Three distinct packages containing unique vendor options ranging from booth and exhibits to the title sponsorship for the symposium are available for industry partners. Interested physicians are encouraged to attend. Registration for this event is required. Please email McKenzie Whalen at mwhalen@novanthealth.org. n
Novant Health Brain and Spine Surgery Opens in Huntersville A satellite Brain and Spine Surgery clinic has opened at 10305 Hamptons Park Drive, suite 101, Huntersville. Jennifer Orning, MD, and Tara Halpin, PA, will see patients at the new clinic on Tuesdays, 8 a.m.-5 p.m. X-ray services will be provided on site. The practice is dedicated to the treatment of brain, spine and circulatory system conditions that cause pain and disability. Surgical procedures include: removal of blood clots in the brain that cause or may cause a stroke; removal of brain and pituitary tumors; placement of stents to treat brain aneurysms or narrowing blood vessels; surgery to address abnormal blood flow in the brain and spine; surgery to remove pressure on the brain; spine reconstruction; and surgical treatments and monitoring devices for epilepsy, including stimulation n
Novant Health Queen City OB/GYN Opens in South End Novant Health Queen City OB/ GYN recently opened in the South End neighborhood at 2400 South Blvd., suite 103, in Charlotte. The clinic is staffed by Jessica DeaneWyman, MD, and Kathleen Jessica Deane-Wyman, MD Persavich, MD. Both worked in private practice in Charlotte for several years before opening Queen City OB/GYN. Dr. Deane-Wyman received her medical degree from the University of Vermont College of Medicine and went on to complete her residency in obstetrics and gynecology at Carolinas Medical Center, where she was recognized for surgical excellence. Deane-Wyman enjoys the relationships she is able to build with her patients at all stages of life. She has a special interest in high-risk obstetrics, menstrual disorders, pelvic and vulvar pain, contraception, infertility and minimally invasive surgery. Dr. Persavich received her medical degree from the Indiana University School of Medicine and went on to complete her residency in obstetrics and gynecology at Carolinas Medical Center, where she Kathleen Persavich, MD served as the administrative chief resident and was recognized for surgical excellence. Persavich has enjoyed her calling to women’s health and finds each relationship uniquely rewarding. Visit www.NHQueenCityOBGYN.org. n
Wound Care, Senior Care and Infectious Disease Care Now Available in Matthews Novant Health has opened three new clinics inside the Matthews Medical Office Building at 1450 Matthews Township Pkwy. The clinics provide services for disease management, wound care and senior care. n
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Novant Health Infectious Disease Specialists is located in suite 280. The clinic is open MondayThursday, 8 a.m.-4:30 p.m., and is led by Cynthia Nortey, MD. Dr. Nortey is board-certified in Cynthia Nortey, MD infectious disease and internal medicine and has been providing infectious disease management and care to the Matthews community for more than 10 years. Call 704-316-3340. Novant Health Wound Care Matthews also is located in suite 280. The clinic is open Mondays, Wednesdays and Thursdays, 8 a.m.-4:30 p.m., and is led by Marshal Parsons, MD. Dr. Parsons specializes in advanced Marshal Parsons, MD wound care, using a variety of clinical treatments, therapies and support services to treat chronic wounds, including diabetic, neuropathic, pressure, and ischemic ulcers; venous insufficiency; traumatic wounds; surgical wounds; vasculitis; burns and other non-healing wounds. Call 704-316-5166. Novant Health Senior Care is located in suite 400. The clinic is open MondayFriday, 8 a.m.-5 p.m., and is led by Maureen Andreassi, MD. Boardcertified in internal medicine, Dr. Andreassi provides Maureen Andreassi, MD comprehensive services for adults age 60 and over, including treatment for osteoporosis, memory assessments, health maintenance and preventative screenings. Call 704-316-5140. Novant Health Arboretum Pediatrics 51 Now Open Novant Health Arboretum Pediatrics 51 has opened at 3135 Springbank Lane, suite 100, Charlotte. Calli Wirsing, MD, has joined Novant Health and will serve as the first physician in the practice, with more coming Calli Wirsing, MD on board in late summer and early fall. Dr. Wirsing has been practicing in the area for seven years and will see patients from birth to college age. Call 704-384-5151. n
At the Hospitals
We are Levine Children’s When you choose any Atrium Health pediatrician for your family, you’re choosing more than a doctor — you’re choosing all the best care for your child, backed by Levine Children’s Hospital. It’s always been like that — but it hasn’t always been as clear as it will be now. With great excitement, Atrium Health has announced the Levine Children’s name now will be used across all its children’s services. “Levine Children’s is a great name today, and we’re looking to enhance it,” says Stacy Nicholson, MD, MPH, president of children’s services. “We’re looking to expand the Levine Children’s name across all of the ways we care for children.” Now there’s one name for all the ways Atrium Health cares for children, but what does that mean, exactly? In addition to 150 pediatricians, Atrium Health has more than 150 specialists across more than 30 specialties — plus children’s urgent cares, hospitals, emergency departments and more. By bringing all these services together under a single, trusted name, we are reinforcing what’s been there all along: connected, highquality care that’s all about kids. When you bring your children to any Atrium Health office, you’ll now see the Levine Children’s name and know they’re always getting the right care, at the right location, with the right level of specialty. The only real change you might notice is a feeling of being part of something bigger and added reassurance that your child has access to all the best care right here.
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Gene Woods Named One of “100 Great Leaders in Healthcare” President and CEO of Atrium Health Eugene Woods recently was listed as one of Becker’s Healthcare 2018 “100 Great Leaders in Healthcare.” Woods joined Atrium Health, previously Carolinas HealthCare System, in
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April 2016 and quickly collaborated with the organization’s more than 65,000 teammates to unite around a redefined vision to be the first and best choice for care and a new mission statement to improve health, elevate hope and advance healing for all. Under his leadership, Atrium Health has been recognized as one of the “Best Employers for Diversity” by Forbes, number one on the list of “Best Places for Women and Diverse Managers to Work” by DiversityMBA and one of the “150 Top Places to Work in Healthcare” by Becker’s Healthcare. Woods is passionate about protecting and expanding access and coverage to all Americans, better engaging with our communities to advance positive health outcomes, and achieving equity of care by eliminating disparities. In January 2017, Woods assumed the role of chairman of the board of trustees of the American Hospital Association and currently serves as immediate-past chair. As a leader of the national organization that represents and serves nearly 5,000 hospitals, healthcare systems, networks and other providers of care, and 43,000 individual members, Woods and his colleagues actively work to provide quality care to millions of Americans and to help them reach their highest potential for health.
Carolinas Medical Center Named One of “100 Great Hospitals in America” Atrium Health’s flagship hospital, Carolinas Medical Center, recently was listed in Becker’s Healthcare 2018 edition of “100 Great Hospitals in America.” Carolinas Medical Center was founded in 1940 as Charlotte Memorial Hospital and has since grown to be the region’s only Level I Trauma Center, as well as an approved transplant center for heart, kidney, pancreas and liver. The hospital serves as one of North Carolina’s five Academic Medical Center Teaching Hospitals, providing residency training for more than 200 physicians in 15 specialties. Carolinas Medical Center was recognized with other hospitals across the nation for excellence in clinical care, patient outcomes, and staff and physician satisfaction.
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Using Technology to Help Kids Control Asthma and Prevent Asthma Attacks Developed and piloted at Atrium Health, Carolinas Asthma Coach is a web-based platform designed to provide a unique patient-centered experience to help patients suffering from asthma truly understand what asthma is and how it is treated. The interactive, digital experience — incorporating characters, sports and humor — engages patients, caregivers and their doctors in a tailored conversation about asthma.
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How does it work? Before a visit with the doctor, a pediatric patient and her/his caregiver engage with Carolinas Asthma Coach and receive tailored education about asthma, triggers and treatments. Carolinas Asthma Coach gathers information about goals, adherence and symptoms and provides personalized recommendations for both the patient and provider. The patient, caregiver and provider share in the decision-making and create a personalized treatment plan at the point of care. Andy McWilliams, MD, author of the Carolinas Asthma Coach study and principal investigator, explains the end goal is to help patients, caregivers and providers have a more productive doctor visit and ensure they are all equally involved in creating a feasible and sustainable action plan to maintain good control of the patient’s asthma. Led by a multidisciplinary team of Atrium Health clinicians, patients and researchers, Carolinas Asthma Coach was implemented and piloted in four pediatric, family medicine clinics and the children’s emergency department to evaluate the effects and feasibility of the platform in pediatric care settings. Since its pilot, results showed 90 percent of participants and caregivers engaged and shared in the treatment decision with their provider, patients’ knowledge and understanding of asthma improved on average 52-77 percent and 100 percent responded they would recommend Carolinas Asthma Coach to a friend. The tool currently is being revised to include 5- and 6-year-old patients, is being translated into Spanish and will enable the platform to be accessed from home or clinic. Once the 2.0 version is complete, Carolinas Asthma Coach will be implemented in Levine Children’s Hospital Emergency Department to evaluate its success for patients visiting the ED for asthmarelated needs.
Mecklenburg Medicine • July/August 2018 | 15
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. Charlotte Gastroenterology & Hepatology looks forward to its continued support of the Pancreatic Cancer Action Network through its gold-level sponsorship of PurpleStride Charlotte. This 5K event takes place on Saturday, Sept. 15, at Romare Bearden Park in Uptown Charlotte. Darst Dermatology is pleased to announce its new laser, the Cynosure Elite+™. The advanced laser technology is available for a range of treatments, from tiny spider veins to more noticeable veins that often appear on the face or legs, unwanted body hair on all skin types, pigmented lesions such as “age” spots and rosacea. The Cynosure Elite+™ used with our Zimmer Cryo Chiller provides patients with minimal discomfort during their procedures. Combined with the Cynosure Icon laser, Darst Dermatology can treat a large variety of skin problems. For more information on laser treatments with Elite+™ , or to schedule a consultation, call 704-321-3376. Integrative Health Carolinas at 2132 Lombardy Circle in Charlotte opened May 7. Ana-Maria Temple, MD, is accepting new pediatric patients. Call 704-533-1203 for more information or to schedule an appointment. Visit www.mimspa.com for information on the services at The Med Spa at Matthews Internal Medicine. Follow on Instagram and Facebook @medspaatmim for daily updates. All services are performed by physicians with 20-plus years experience or by a licensed medical aesthetician/ laser safety officer. Call 704-899-5038 to schedule an appointment. Davidson Family Medicine continues to grow. Within the past year, it has added Trisha S. White, MD, Jamie Floyd, PA, and Nicole Deschenes, FNP, to its growing roster of clinicians. DFM recently has renewed its Patient Center Medical Home status, originally obtained in Trisha S.White, MD Jamie Floyd, PA Nicole Deschenes, FNP 2008. Office hours have been extended to include evenings and weekends to meet the growing health care needs in the north Mecklenburg area. DFM clinicians continue to provide care to students at Davidson College, volunteer at the Ada Jenkins Free Medical Clinic and precept UNC medical students.
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Alzheimer’s Memory Center is pleased to announce Reza Bolouri, MD, will be speaking at the Alzheimer’s Association Annual Education Conference on Wednesday, Aug. 29, at Friendship Missionary Baptist Church in Charlotte. Alzheimer’s Memory Center will sponsor the conference. Alzheimer’s Memory Center will sponsor the 2018 Walk to End Alzheimer’s in October. Dr. Bolouri also participated in the “2018 Gerontology Conference: Working Together for Successful Aging” as a speaker for the session on dementia/Alzheimer’s this past May. Justin Favaro, MD, PhD, with Oncology Specialists of Charlotte, was the spokesperson for the annual “Fight the Good Fight” (FTGF) 7K event in May, which coincided with National Brain Tumor Month. FTGF focuses on an incurable brain cancer, Glioblastoma Multiforme or GBM. Dr. Favaro spoke to local news regarding a more recent treatment of GBM, Novocure’s Optune® medical device, which produces electric wave-like Tumor Treating Fields or TTfields through electrodes placed on the scalp. The TTfields interfere with GBM cancer cell division. “We’ve seen tumors get smaller or stay stable when patients have been treated with the Optune® device,” Favaro commented in the news interview. To find out more about GBM support, go to www.fightthegoodfights.org. The latest method of scalp cooling to prevent chemotherapy-induced alopecia is the DigniCap® Scalp Cooling System that uses a computerized temperature-controlled unit attached to an insulated silicone cap. Dipika Misra, MD, and a DigniCap® patient, Mary Lacey, talked about the system on “Charlotte Today.” Dr. Misra, with Oncology Specialists of Charlotte, who treats patients with DigniCap® at her clinic, has joined Lacey to provide awareness, education and fundraising for more patients to have accessibility to the DigniCap® while undergoing chemo. The duo has presented the method to various cancer groups, such as Susan G. Komen Charlotte and Carolina Breast Friends. Currently, only three infusions centers in North Carolina offer DigniCap®. To find out more, visit www.dignicap.com.
Mecklenburg Medicine • July/August 2018 | 17
Randolph Audiology & Hearing Aid Clinic TOMORROW’S TECHNOLOGY FOR TODAY’S EARS
Wade Kirkland, M.A. Audiologist
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No-cost trial period on hearing aids
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Auditory processing evaluations
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All new patients receive complimentary balance and memory screenings
704-367-1999 Randolph Medical Park | Randolph Building 3535 Randolph Road, Suite 211 Charlotte, NC 28211 Terry P. Jordan, M.S. Audiologist
SERVING THE CHARLOTTE AREA FOR OVER 20 YEARS
www.randolphaudiology.com
Advertising Acknowledgements The following patrons made Mecklenburg Medicine possible.
Atrium Health................................................................................. 19 Carolina Neurosurgery & Spine Associates...................................3 Charlotte Eye Ear Nose & Throat Associates................................4 DJL Clinical Research, PLLC..........................................................4 Flagship Healthcare Properties..................................................... 18 LabCorp...........................................................................Back Cover Monarch........................................................................................... 12 Novant Health....................................................................................2 Parsec Financial Wealth Management............................................4 Randolph Audiology & Hearing Aid Clinic................................ 18 Southeast Radiation Oncology Group............................................3
MOORESVILLE MEDICAL OFFICE 143 Joe Knox Avenue | Mooresville, North Carolina
PROPERTY HIGHLIGHTS • Immediate availability • ± 1,942 SF available • Former Endocrinology space with: 4 Exam Rooms Nurse’s Station Lab
Office Break Room Reception Area
• Building signage • Less than 1 mile to I-77 • ± 3.5 miles to Lake Norman Regional Medical Center • Located in the heart of Mooresville
WILL ROBERTSON d. 704-971-8904 will@FlagshipHP.com
GREG McINTOSH d. 704-749-7248 greg@FlagshipHP.com
DEVELOPMENT • CAPITAL SOLUTIONS • ACQUISITIONS • BROKERAGE • ASSET MANAGEMENT • PROPERTY MANAGEMENT • ENGINEERING • CONSULTING Flagship Healthcare Properties is a fully integrated commercial real estate firm committed to healthcare. Flagship has developed over 1.6 million square feet and currently manages over 3 million square feet of healthcare space. The firm invests through and is manager of Flagship Healthcare Trust, a private REIT. 2701 Coltsgate Road, Suite 300 | Charlotte, North Carolina 28211 | 704-442-0222 | www.flagshiphp.com
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A PLACE…
filled with light
where each and every heartbeat begins
A GATHERING GROUND…
Where diverse thinkers come together And connections are made
AN AMBITION…
Working with partners to build something new To better more lives
Bringing health, hope and healing
FOR ALL
Carolinas HealthCare System is
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 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
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15830 John Delaney Drive 300 Billingsley Road, Suite 200A 5633 Blakeney Park Drive, Suite 100 478 Copperfield Blvd. 8401 Medical Plaza Dr, Ste 140 1718 E. 4th Street 660 Summitt Crossing, Suite 206 16525 Holly Crest Lane, Suite 250 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 809 N. Lafayette Street 1710-A Davie Avenue 10320 Mallard Creek Road
*Drug Screens only **Blood Draws only
20 | July/August 2018 • Mecklenburg Medicine
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