Med Monthly July 2014

Med Monthly July 2014

the

our Y & t e i D Practice issue

Registered Dietitian:

Coaching and Educating Patients to Improve Their Health and Quality of Life

We All Know the Greatest Wealth is Health, so...

pg. 40

How Wealthy Are You? pg. 42

Turning the Increased Global Focus on Diet to Your Practice’s Advantage pg. 38

HOW ARE POPULAR DIETS AFFECTING OUR PATIENTS’ HEALTH? pg. 36

contents

46

ART MEETS SCIENCE: A Profile on Dr. Michael Dobbs

features

36 HOW ARE POPULAR DIETS AFFECTING OUR PATIENT’S HEALTH? 38 TURNING THE INCREASED GLOBAL FOCUS ON DIET TO YOUR PRACTICE’S ADVANTAGE 40 REGISTERED DIETITIAN: Coaching and Educating Patients to Improve Their Health and Quality of Life 42 HOW WEALTHY ARE YOU?

insight 10 NOT EVEN CELL DEATH CAN STOP THE ALARM 12 NIH STUDY LINKS HIGH CHOLESTEROL LEVELS TO LOWER FERTILITY 14 LAUNCHING HEART-HEALTHY NUTRITION RESOURCE

practice tips 16 12 MISTAKES TO AVOID WITH EMAIL MARKETING 18 CMS LAUNCHES “ROAD TO 10”

international 22 INVESTMENT IN MIDWIFERY CAN SAVE MILLIONS OF LIVES OF WOMEN AND NEWBORNS

research and technology 24 NEW RESEARCH SET TO IMPROVE QUALITY OF LIFE FOR DENTURE PATIENTS 26 DRUG COMBINATION MAY BE HIGHLY EFFECTIVE IN RECURRENT OVARIAN CANCER 28 GENE EXPRESSION PROFILING DRIVES PERSONALIZED MEDICINE WORLDWIDE

legal 30 PROPOSED MODIFICATIONS TO EHR INCENTIVE PROGRAMS 32 TIPS FOR NEW ENROLLMENT & REVALIDATION FOR PARTICIPATION IN MEDICARE & MEDICAID

20 ENT UNDERCOVER

14

34 POTENTIAL RISKS OF HEALTHCARE JOINT VENTURES BETWEEN INSURANCE COMPANIES AND HOSPITALS

the arts 46 ART MEETS SCIENCE: A Profile on Dr. Michael Dobbs

healthy living 48 HEAVENLY BLUEBERRY SMOOTHIE

in every issue LAUNCHING HEART-HEALTHY NUTRITION RESOURCE

4 editor’s letter 8 news briefs

54 resource guide 76 top 9 list

January 1, 2014 begins the attestation period for Stage 2 Meaningful Use. If you are a member of the North Carolina Medical Society, you have access to the resources provided for our members to help your practice achieve Meaningful Use in 2014.

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editor’s letter The staff of Med Monthly is excited to bring our readership an editorial topic that every practice can relate to: ‘Diet and Your Practice’. Our national and international writers focus on how doctors and health care professionals can incorporate diet topics and applications into their practices.

Carrie Noriega, MD in her feature discusses ‘How Are Popular Diets Affecting Our Patient’s Health’. Dr. Noriega talks about several diets including the Paleo Diet that became popular in 2013. This diet may have severe consequences for people with chronic medical problems especially diabetics and hypertensives. People on blood pressure medications may experience fainting from hypotension and diabetics may become ill from hypoglycemia.

Marie Klee, Chief Editor of Carrotstick.dk, has a compelling feature: Turning the Increased Global Focus on Diet to Your Practice’s Advantage. Marie suggests, “Our diet plays a big part in our lives, and you have the opportunity to use this knowledge in your medical practice to improve the life quality of your client-patients.”

Registered dietitian Ashley Acornley, with Triangle Nutrition Therapy, has a must read article on Coaching and Educating Patients to Improve Their Health and Quality of Life. It is mutually beneficial to refer patients with general nutrition questions to a dietitian’s office. The more educated and informed a patient is, the more likely they are going to be proactive about their health and be able to control or prevent diseases throughout their lifetime.

In How Wealthy Are You? Nidhi Vats Behl, one of our international contributors, writes “We all know the greatest wealth is health”. So, how much of an investment are we making in our health? Having a healthy body is the remedial answer to most of our problems whether medical, cosmetic or psychological.

Don’t miss our upcoming August issue that is sure to pique the interest of every physician: ‘Concierge Medicine’. We discuss the advantages and disadvantages of concierge type practices as it applies to the doctor and patient.

Thank you for making Med Monthly part of your practice. We strive to offer you, the physician and practice owner, insight on attracting new patients, keeping your current patients informed and enhancing your bottom line. Please refer topics you find in Med Monthly to your colleagues.

Philip Driver Publisher

4 | JULY 2014

Med Monthly July 2014 Publisher Philip Driver Managing Editor Ashley Austin Creative Director Thomas Hibbard Contributors Ashley Acornley, MS, RD, LDN. Nidhi Vats Behl Laura Dawahare Barbara Hales, M.D. Lisa English Hinkle Marie Klee Eric A. Klein Charles L. Kreindler Carrie A. Noriega, MD Allison Perry Barbara Taylor Denise Price Thomas

contributors Ashley Acornley, RD, LDN holds a BS in Nutritional Sciences with a minor in Kinesiology from Penn State University. She completed her Dietetic Internship at Meredith College and recently completed her Master’s Degree in Nutrition. She is also an AFAA certified personal trainer. Her blog can be found at: ashleyfreshfromthefarm.wordpress.com

Nidhi Vats Behl is an experienced professional with more than 6 years, in Healthcare industry with renowned organizations like: Fortis & Aditya Birla. Currently she is working as a freelance copy writer.

Barbara Hales, M.D. is a skilled expert in promoting your health services. As seen on NBC, CBS,ABC and FOX network affiliates as well as Newsweek, Dr. Hales writes all the content you need to promote your medical services. Her latest book is on the best seller list and she can do the same for you. Check out her site at www.TheWriteTreatment.com

Med Monthly is a national monthly magazine committed to providing insights about the health care profession, current events, what’s working and what’s not in the health care industry, as well as practical advice for physicians and practices.

We are currently accepting articles to be considered for publication. For more information on writing for Med Monthly, check out our writer’s guidelines at medmonthly.com/writers-guidelines

Marie Klee is a Danish freelance nutritionist.

She writes articles about health, nutrition and wellness and also works as a corporate health strategist.

She is chief editor on the Danish health website Carrotstick.dk. Carrotstick is a blog-like health forum that has a scientific approach to health, and commits to delivering high quality articles about food, nutrition and general health. Connect with Marie on LinkedIn.

Carrie Noriega, MD P.O. Box 99488 Raleigh, NC 27624 medmedia9@gmail.com Online 24/7 at medmonthly.com

is a board certified obstetrician/ gynecologist who has worked in both private practice in the US and a socialized medical system.

As an adventure racer and endurance mountain bike racer, she has developed a special interest in promoting health and wellness through science and medicine.

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designer's thoughts

From the Drawing Board In the “Research and Technology” section of the July Med Monthly we inform our readers about a new insight in treating recurrent ovarian cancer with drug combinations, the benefits of gene expression profiling to the medical community and the clinical trials of affordable mini implants for denture patients.

Clinical Trial Analysis Suggests Drug Combination May Be Highly Effective in Recurrent Ovarian Cancer, reports on new clinical trial analysis on the drug combination of the drug olaparib (which blocks DNA repair) and the blood vessel inhibitor drug cediranib, vs. olaparib alone. The drug combination nearly doubles the progression-free survival benefit. “Of particular note is the fact that both drugs used in this trial are in pill form and could offer an alternative to intravenous chemotherapy,” said Percy Ivy, M.D., associate chief of NCI’s Investigational Drug Branch.

Frost & Sullivan finds physicians are increasingly relying on gene expression profiling to get a thorough picture of their patients’ genetic profiles prior to arriving at a diagnosis and recommending a course of treatment. Gene Expression Profiling Drives Personalized Medicine Worldwide explains how cloudbased data tools for accessing genomic information will prove particularly useful in information sharing and large investments are already taking place in the software industry, anticipating the rapid growth in this technology over the next five years.

The article New Research Set to Improve Quality of Life for Denture Patients describes how the University of Manchester is leading a first of its kind trial into the quality of life of people wearing dental implants. A new trial will provide a cost-benefit analysis and an assessment of the impact of mini implants on people’s quality of life, compared to dentures secured by conventional titanium implants.

MedMonthly will continue to report on the latest medical research and technology. If there are topics or insights on advances in medical technology you would like to share with us for future issues, please contact us at medmedia9@gmail.com.

Thomas Hibbard Creative Director

6 | JULY 2014

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news briefs

‘Liquid Biopsy’ Offers New Way to Track Lung Cancer Scientists have shown how a lung cancer patient’s blood sample could be used to monitor and predict their response to treatment – paving the way for personalised medicine for the disease.

The recent study, published in the journal Nature Medicine, also offers a method to test new therapies in the lab and to better understand how tumours become resistant to drugs.

Small cell lung cancer (SCLC) is an aggressive disease with poor survival and new treatments are desperately needed. In many cases the tumour is inoperable and biopsies are difficult to obtain, giving scientists few samples with which to study the disease.

Now research carried out at Cancer Research UK’s Manchester Institute, based at The University of Manchester – part of the Manchester Cancer Research Centre – has looked at the potential of using circulating tumour cells (CTCs) – cells that have broken off from the tumour and are circulating in the blood – to investigate a patient’s disease in a minimally invasive manner.

The researchers, working closely with lung specialist and Medical Oncologist Dr Fiona Blackhall at The Christie NHS Foundation Trust, found that patients with SCLC had many more CTCs in a small sample of their blood than patients with other types of cancer. Importantly, the number of CTCs for each patient was related to their survival – patients with fewer CTCs in their blood lived longer.

Professor Caroline Dive, who led the study, said: “Access to sufficient tumour tissue is a major barrier to us fully understanding the biology of SCLC. This liquid biopsy is straightforward and not invasive so can be easily repeated and will allow us to study the genetics of each lung cancer patient’s individual tumour. It also means that we may have a feasible way of monitoring patient response to therapy, hopefully allowing us to personalise and tailor individual treatment plans to each patient.”

In addition, the team were able to use these CTCs to grow tumour models in mice, which they termed CTCderived explants (CDXs). When they treated these mice with the same chemotherapy drugs as the SCLC patients they showed that the CDXs responded in the same way as each donor patient.

“We can use these models to help us understand why so many SCLC patients acquire resistance to chemotherapy and to search for and test potential new targeted treatments,” added Professor Dive.  Source: http://www.pressreleasepoint.com/liquid-biopsyoffers-new-way-track-lung-cancer 8 | JULY 2014

MDxHealth and HistoGeneX Awarded $1.8 Million IWT Grant to Develop Companion Diagnostics for Cancer Immunotherapy MDxHealth SA and HistoGeneX N.V. announced that they have been awarded $1.8 million (€1.3 m) from the Flemish Institute for the Promotion of Innovation by Science and Technology (IWT) to fund the development of companion diagnostics for cancer immunotherapy. The joint initiative, called the Immunomics project, combines comprehensive histological profiling of tumor immune responses (including quantitative assessment of the tumor microenvironment) with advanced (epi)genome-wide molecular profiling of cancer antigens to develop a new generation of companion diagnostics that are able to predict cancer prognosis and/or response to innovative immunotherapy based therapeutic interventions.

“Our current collaboration with MDxHealth has allowed us to introduce epigenetic testing technologies to our pharmaceutical and oncology clients, further expanding our molecular capabilities and menu,” said Dr. Mark Kockx, CEO of HistoGeneX. “This grant enables us to offer immunocompetent profiling, which combined with MDxHealth’s next-generation sequencing capabilities, provides significant value to developers of immunotherapeutics for cancer treatment.”

“The collaboration with HistoGeneX has broadened our PharmacoMDx services, expanding on our biomarker discovery program at the Center of Pharmaco (epi)Genomics, a joint-venture with Ghent University. This grant enables our partnership to expand further into the emerging field of immunotherapeutics,” stated Dr. Jan Groen, CEO of MDxHealth.

MDxHealth’s PharmacoMDx solutions leverage Next-Generation and Deep Sequencing technologies for the discovery of effective individualized epigenetic-based diagnostic and personalized therapeutic products. The identification and validation of epigenetic biomarkers are playing an increasingly important role in the development process of new compounds and companion diagnostics.  Source: http://www.newswiretoday.com/ news/143420/

Need for Management Skills in the Indian Healthcare Sector Doctors driven by an urge to improve the fragmented healthcare sector in India are exploring career options in healthcare management. A considerable number of Indian doctors after gaining experience across the globe are relocating back to India and are increasingly making an informed choice of entering hospital management roles in the country.

While the country has witnessed a boom of private hospitals, independent healthcare ventures and mid-size clinics across India, the challenge is to sustain and stand out, as the sector is facing an acute shortage of specialized trained professionals in hospital administration and management. “Healthcare sector of the country is still working on a stereotypical model where the senior most doctor is made the medical superintendent without considering whether he holds the required management skills or not. The need of the hour is for a polished leadership with the required management skills to be able to run a facility successfully” says Dr Manjunath, Director-Jayadeva Institute of Cardiovascular Sciences and Research.

India holds an advantage over peers in Asia and the West in terms of the lower cost of high-quality medical services, but specialization has become important to sustain this competitive advantage. Globally, varsities have realized this gap and have launched management courses tailored especially for a sector as volatile as healthcare. “For those who are unable to give another two years of their career to a generic MBA, we have tailor-made a year-long postgraduate course with a healthcare management specialization - the MSc in Health Sciences Management, awarded by Northumbria University, UK”, said Dr Lissy Vadakel, Director at the Management Development Institute of Singapore’s (MDIS) School of Health & Life Sciences. This niche specialization would equip fresh graduates, experienced practitioners and others interested in Healthcare Management to attain the diverse skill-sets required in sustaining a lifelong career in the modern healthcare sector.

“Healthcare sector needs people who understand the industry well and also have learnt management concepts. Senior doctors who are better equipped to use their vast experience in clinical settings should not be moved into administrative positions like medical superintendent. For doctors who wish to pursue management degrees they need to have an inclination towards leadership and management and consider their move

as a further progress in their specialization if they continue to serve in the healthcare industry. ” says Dr Sreenivasan Narayana, CEO & Founder, DocTree.in. A management specialization designed especially for the healthcare industry would complement the clinical education and expertise of healthcare professionals. The proficiencies gained following completion of the course would potentially open up new avenues and ensure rapid professional growth, preparing graduates to take on management roles in a variety of healthcare settings such as acutecare hospitals, long-term care facilities, clinics, ambulatory centres, physician practices, pharmacy chains, pharmaceuticals, medical technology, health insurance, healthcare consulting and research, and emergency services. “Business administration and entrepreneurship are not taught in medical schools. This is a gap that a professional degree tailored towards the healthcare sector would be able to address. Specialized courses in Healthcare management would enable graduates to better understand and relate with the strategic concepts and good business practices, and then put these into implementation”, added Dr Vadakel.  Source: http://www.pressreleasepoint.com/need-management-skills-healthcare-sector

SOON COMING NTHLY O IN MED M

coming In the up , Med 014 issue August 2 l be theme wil ’s ly th n o M e e Medicin Concierg

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insight

NOT EVEN CELL DEATH CAN STOP THE ALARM

Researchers at the University Hospital of Bonn have discovered astonishing communication pathways of the immune system

10 | JULY 2014

E

ven after a cell dies, components of the immune system remain active and continue to fuel inflammatory reactions. An international team of researchers under the direction of scientists from the Institute of Innate Immunity at the University Hospital of Bonn has discovered how this incredible form of communication works. The findings offer potentially novel approaches for therapies against many serious diseases that affect a large part of the population, such as gout, atherosclerosis and Alzheimer’s disease. The exciting new results are now published in the renowned journal “Nature Immunology”.

When there is stress in living immune cells, – for example due to the detection of microbes, or the deposition of uric acid crystals in joints, cholesterol in blood vessels or Alzheimer’s plaques in the brain – the so-called ‘inflammasome’ sounds the alarm.

Inflammasomes are large multiprotein complexes, which form when they sense cell stress. The inflammasomes activate an enzyme, which stimulates important messengers that in turn trigger an inflammatory reaction. During this cell activation, the affected immune cells die and thus the inflammatory reaction should come to a halt. “This mechanism primarily protects the body from infections and harmful influences,” says Prof. Eicke Latz, the director of the Institute of Innate Immunity at the University Hospital in Bonn.

Strikingly, these new findings reveal that inflammasomes remain active even when the cells have died. The scientists were able to demonstrate that activated inflammasomes also have enzymatic functions outside of the living cell and can thus activate additional messengers. In a type of chain reaction, the inflammasomes released from dying cells are taken up by neighboring immune cells where they can activate more inflammasomes. This discovery was made by an international team of researchers under the direction of the members from the Institute of Innate Immunity, together with scientists from Hannover Medical School, the University of Massachusetts Medical School (USA), the German Center for Neurodegenerative Diseases (DZNE) in Bonn, the University of Trondheim (Norway), the University of Newcastle (Australia) and the Zurich University Hospital (Switzerland).

Protein complexes shift into defense mode When the inflammasomes are switched on, within seconds they form functional protein complexes, which can be as large as a bacterium.

“In the event of stress or infection, this protein complex forms and provokes the activation of pro-inflammatory messengers within the cell and – as we now know – this can also occur outside of the cell. In this way, there can be a very rapid inflammatory reaction which helps the undesired insult or microbial invaders to be eliminated as quickly as possible,” explains lead author Dr. Bernardo S. Franklin, a fellow of the Alexander von Humboldt Foundation working in Prof. Latz’s team.

Using fluorescence techniques, the researchers labeled the inflammasome in immune cells. Whenever it was active, it formed a fluorescent protein complex, reminiscent of small stars glowing inside the cell. Using this method, the scientists were able to track the inflammasome after cell death, and show that it remained switched on as an intact protein complex. They also found that once released from the dead cell, it stimulated neighboring cells to undergo an inflammatory reaction.

Furthermore, they found that these extracellular complexes accumulate in the lungs of patients with chronic lung disease.

Starting points for new therapies against widespread diseases “Normally, the immune system is very helpful for averting harmful damage to tissue by initiating an inflammatory reaction,” says Prof. Latz. However, if such inflammatory reactions are excessive or if they persist for longer than necessary, this may contribute to common diseases of Western society, such as gout, Alzheimer’s disease, diabetes or atherosclerosis. With the discovery of extracellular inflammasomes, the researchers have revealed an interesting avenue for potential new therapies: “If we are able to produce suitable antibodies, it is likely we could contain the alarm of the inflammasome outside of cells and thus keep harmful chronic inflammatory reactions at bay, without affecting the necessary response inside the cell” says Prof. Latz.  Source: http://www.pressreleasepoint.com/noteven-cell-death-can-stop-alarm

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insight

NIH study links high cholesterol levels to lower fertility Couples with highest cholesterol took longest to achieve pregnancy

12

| JULY 2014

High cholesterol levels may impair fertility in couples trying to achieve a pregnancy, according to a study by researchers at the National Institutes of Health, the University at Buffalo (New York), and Emory University in Atlanta.

Couples in which each partner had a high cholesterol level took the longest time to reach pregnancy.

Moreover, couples in which the woman had a high cholesterol level and the man did not also took longer to achieve pregnancy when compared to couples in which both partners had cholesterol levels in the acceptable range.

“We’ve long known that high cholesterol levels increase the risk for heart disease,” said the study’s first author, Enrique Schisterman, Ph.D., chief of the Epidemiology Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the institute that led the study. “In addition to safeguarding their health, our results suggest that couples wishing to achieve pregnancy would improve their chances by first ensuring that their cholesterol levels are in an acceptable range.”

The study findings were published online in JCEM, The Journal of Endocrinology and Metabolism, a publication of the Endocrine Society.

Cholesterol is a waxy, fat-like substance found in all cells of the body. It’s used to make a number of substances, including hormones and vitamin D. High blood cholesterol levels typically do not cause any signs or symptoms, but can increase the chances for heart disease.

For the current analysis, the researchers studied couples who were not being treated for infertility but who were trying to conceive a child.

The researchers enrolled 501 couples from four counties in Michigan and 12 counties in Texas from 2005 to 2009. The couples were part of the

Longitudinal Investigation of Fertility and the Environment (LIFE) study, established to examine the relationship between fertility and exposure to environmental chemicals and lifestyle.

The women taking part in the study ranged from 18 to 44 years of age, and the men were over 18. The couples were followed until pregnancy or for up to one year of trying.

Study volunteers provided blood samples, which the researchers tested for free cholesterol. The measurement of free cholesterol is used in research, and differs from the cholesterol test given in doctors’ offices. Cholesterol tests administered by physicians measure the cholesterol subtypes: HDL cholesterol, LDL cholesterol and triglycerides. For the study, Dr. Schisterman and his colleagues relied on a test to measure the total amount of cholesterol in the blood, but which did not distinguish between cholesterol subtypes. The researchers theorized that blood cholesterol might be related to fertility as the body uses cholesterol to manufacture sex hormones like testosterone and estrogen.

The researchers calculated the probability that a couple would achieve pregnancy by using a statistical measure called the fecundability odds ratio (FOR). The measure estimates couples’ probability of pregnancy each cycle, based on their serum cholesterol concentrations.

The researchers found that on average, those couples in which the female did not become pregnant during the study duration had the highest free cholesterol levels. In general, high free cholesterol levels were correlated with longer times to pregnancy and lower fecundability odds ratios. Couples in which the female had a high cholesterol level and the male did not also took longer to achieve pregnancy when compared to couples in which both partners had cholesterol levels in the acceptable range. In their analysis, the study

authors accounted for potential racial differences, as well as differences by age, body mass index, and education.

Among study participants, Hispanic males had the highest free cholesterol levels.

Standard cholesterol testing by physicians typically evaluates cholesterol scores in terms of the balance of HDL and LDL cholesterol, with a low ratio of HDL to LDL cholesterol signifying an increased risk for heart disease. Although the researchers did not evaluate the ratio of these two cholesterol subtypes, Dr. Schisterman said that high free cholesterol levels are likely to indicate an unfavorable HDL to LDL ratio.

“From our data, it would appear that high cholesterol levels not only increase the risk for cardiovascular disease, but also reduce couples’ chances of pregnancy,” Dr. Schisterman said.  About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s website at http://www.nichd.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih. gov.

Source: http://www.nih.gov/news/ health/may2014/nichd-20.htm

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insight

Million Hearts and Eating-Well Magazine Launch Heart-Healthy Nutrition Resource

14 | JULY 2014

The Million Hearts initiative announces the launch of a new Healthy Eating and Lifestyle Resource Center, developed in partnership with the Centers for Disease Control and Prevention and Eating-Well magazine.

The resource center features lower-sodium, hearthealthy recipes and family-friendly meal plans, with an emphasis on managing sodium intake, a major contributor to high blood pressure and heart disease.

By helping individuals and families access content and recipes to promote consumption of healthier foods, this consumer-friendly addition to existing Million Hearts tools supports the initiative’s goal of preventing 1 million heart attacks and strokes.

“Because sodium is a major contributor to high blood pressure, it is important to help people understand how they can manage sodium intake at home,” said Janet S. Wright, MD, FACC, Executive Director of Million Hearts. “This online resource offers practical, accessible eating and lifestyle-based solutions for people looking for ways to reduce sodium in their diet and create hearthealthy, tasty meals for themselves and their families.

All the recipes featured in the resource center include nutritional facts and use everyday ingredients found at local supermarkets and have been tested by Eating Well’s test kitchen. Search and filter options make it easier to quickly find the right meal based on prep time, cuisine, course, and number of servings. The meal plans are flexible, easy to use, convenient, and can be customized to an individual’s dietary needs.

“This resource helps people see that it’s not about giving up the food you love, but choosing lower sodium options that taste great,” said Dr. Tom Frieden, Director of the CDC. “Small changes can make a big difference.

We can prevent 11 million cases of high blood pressure each year if everyone reduced their daily sodium intake to 2,300 mg.”

To learn more about the Million Hearts Healthy Eating and Lifestyle Resource Center, visit http:// recipes.millionhearts.hhs.gov/ . Million Hearts is a joint initiative of the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services. For more information about the initiative and to access resources, visit http://millionhearts.hhs.gov. 

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practice tips

12 Mistakes to Avoid With Email Marketing (And Becoming a Medical Rock Star)

By Barbara Hales, M.D. www.thewritetreatment.com

Have you implemented email campaigns?

Email marketing is one of the most effective and least costly tools available to you today. While providing a multitude of benefits, the cost is minimal.

behavior that either ignores you or deletes your messages.

Then you will have actually induced harm because they are no longer receptive to you and what you need to communicate with them.

Benefits of Emails

2. Not Segmenting Your List

By simply utilizing email marketing, you can: • • • •

Go viral Attract more patients Retain current patients Raise yourself well above your colleagues in your patients’ eyes • Become appreciated by your patients • Show more involvement and approachability as you provide solutions to their health problems • Become the “talk of the town”

Damage Control

Don’t set yourself up for failure before you’ve begun.

It’s great that you are ready to dive into the marketing pool! There is however some strategies that will determine whether you are successful or ineffective.

Make the most of your email marketing by avoiding these costly mistakes.

1. Being Irrelevant

When patients provide their email address to you along with permission to use it, they are expecting you to use it with discretion and not “sell” to them or sell their names.

They expect to get messages that are relevant and important to them. Sending out email that is uninteresting and inappropriate will tarnish your image and foster a 16 | JULY 2014

Separate your patients based on gender, age and conditions that they may suffer from. Then gear your messages or solutions to them. They will appreciate this more and the open rate will increase exponentially.

An example of this would be to restrict age-related conditions to those over 50. A 25-year old individual would not be interested in reading about this, more than likely.

3. Long and Complicated Copy

Keep it Short and Simple.

Time is a precious commodity and one that people don’t have much of. Keep the message to the length needed to convey the information. For more detail, provide a link where patients can read more about it if they are interested.

4. Being Inconsistent

If you send out your messages the first Monday of the month, then patients will look for your emails. If you are not consistent, you will disappoint them initially and then they won’t look for your emails again. Train them to expect your messages.

5. Timing is Everything

When is the most likely time for a patient to open your email? If it is to new parents, they are most apt to read their email after the children are in bed so sending the blast

out in the evening makes the most sense. On the other hand, business professionals may view their emails during Monday through Friday during working hours.

6. Dull, Old Subject Lines

Subject lines should evoke emotion.

Your subject lines, like headline news, should captivate your patients’ attention. The words should lure them in with the promise of a great story, solutions or benefits. No one wants to open up “the same old, same old”, regardless of who it’s from.

7. No images

A Picture is worth 1000 words.

Add a video to the mix. If you are describing a new medical device or technique that you do, let them see it as you explain the procedure. This will not only captivate and engage patients, it will help facilitate their understanding of what you are trying to convey.

take a look at who is opening them. This information is readily available with your analytics program.

Remove the email addresses that lead to bounces over time and ones where patients never opened your messages.

Decide whether emails that went ignored are because the messages were not new, or not relevant to the patient receiving them. This will enable you to target future messages better or to revise your content.

Contact these patients by phone. Are they still your patients? Do they use their computers? Are the messages too frequent? Try to understand them better on a personal level.

Email List -

The New Backbone of Your Business

8. Time Sucker

You are getting your patients’ email addresses, aren’t you?

If you haven’t, you are leaving money on the table and losing out on a golden resource! You can always start now.

Send for your free gift at: Barbara@TheWriteTreatment. com Get our Exclusive Report “15 Easy Ways to Leverage Your Content For Successful Marketing” 

9. Viral Spread

About TheWriteTreatment.com The Write Treatment, LLC has helped promote medical practices and health professionals with fresh website content, blogs, newsletters, email campaigns and social marketing.

Your email campaigns need not force you into taking time out of each day to create and send. A series of emails can be done at one time and then automated to go out on scheduled days or months in advance.

Viral spread is a good thing.

Encourage your patients to spread your emails with a link at the bottom to click and forward to their friends.

Attach social media buttons so that your message can be sent to their list of friends and fans on social media sites, allowing you to be seen by a much larger audience.

Send your emails to your social media groups and Facebook Page so that they are seen and forwarded from these sites as well. Your emails enable you to promote new followers and interact with current “friends”. Linking back to your website will drive more views to your online site as well.

10. Not Knowing What Works

Implement an analytical program.

There are many tools available to see how effective a specific message is and how much interest was evoked.

One of the easiest tools to implement is Google Analytics which will help you test each email to see opening rate, bounce rate and amount of time spent as well as how many times a person clicked onto your website. (I.e. All helpful information for future emails).

11. Ignoring ROI

Figure out how much return of investment you acquired by your email campaigns. Consider how many patient appointments your messages brought in vs. the time that it took for you to create them.

The Write Treatment

Ezines and NewslettersCost Effective Powerful Tools • Drive traffic to your business website • Build relationships between yourself and patients • Get new patients • Announce a new service or product • Give great impact Have you got a newsletter yet or want to spread a message?

Contact Barbara Hales, M.D. for a free consultation.

Barbara@TheWriteTreatment.com 516-647-3002

12. Out With The Old, In With the New

After you have been sending out your emails for a while, WWW.MEDMONTHLY.COM |17

practice tips

CMS Launches “Road to 10” to Help Small Practices Jump Start the Transition to ICD-10

By Centers for Medicare & Medicaid Services www.cms.gov

18 | JULY 2014

On April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 11393) was enacted, which said that the Secretary may not adopt ICD-10 prior to October 1, 2015. Accordingly, the U.S. Department of Health and Human Services expects to release an interim final rule in the near future with a new compliance date for the use of ICD-10 codes beginning October 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015.

Centers for Medicare & Medicaid Services (CMS) has released “Road to 10,” an online resource built with the help of providers in small practices. This no-cost tool is intended to help small medical practices jump start their ICD-10 transition.

“Road to 10” includes specialty references and gives providers the capability to build ICD-10 action plans tailored for their practice needs. l l l

Get an overview of ICD-10 Explore Specialty References Build your personal action plan

How will my practice benefit from ICD-10?

Prepping for the compliance date is critical ICD-10 will provide an enhanced platform for physician practice. As of October 1, 2015, the ICD-10 coding classification will become the new baseline for clinical data, clinical documentation, claims processing, and public health reporting. Understanding patient encounters and preparing for the transition will be critical to the financial sustainability of each practice.

From proper observation and documentation to improved clinical documentation, progress notes, operative reports, and histories, the benefits of ICD-10 begin with enhanced clinical documentation enabling physicians to better capture patient visit details and lead to better care coordination and health outcomes.

Ultimately, better data paves the way for enhanced quality and greater effectiveness of patient care and safety.

While the transition to ICD-10 will require work, it is temporary. The benefits of ICD-10 will impact everything from patient care to each practice’s bottom line.

Why prepare for ICD-10?

Reasons to prepare for ICD-10 can be broken down into four categories:

Clinical

l Informs better clinical decisions as better data is

documented, collected, and evaluated l Provides new insights into patients and clinical care due to greater specificity, laterality, and more detailed documentation of patient diseases

l Enables patient segmentation to improve care for

higher acuity patients

l Improves design of protocols and clinical pathways for

various health conditions

l Improves tracking of illnesses and severity over time l Improves public health reporting and helps to track

and evaluate the risk of adverse public health events

l Drives greater opportunity for research, clinical trials,

and epidemiological studies

Operational

l Enhances the definition of patient conditions,

providing improved matching of professional resources and care teams and increasing communications between providers l Affords more targeted capital investment to meet practice needs through better specificity of patient conditions l Supports practice transition to risk-sharing models with more precise data for patients and populations

Professional

l Provides clear objective data for credentialing and

privileges

l Captures more specific and objective data to support

professional Maintenance of Certification reporting across specialties l Improves specificity of measures for quality and efficiency reporting l Aids in the prevention and detection of healthcare fraud and abuse l Provides more specific data to support physician advocacy of health and public health policy

Financial

l Allows better documentation of patient complexity

and level of care, supporting reimbursement for care provided l Provides objective data for peer comparison and utilization benchmarking l May reduce audit risk exposure by encouraging the use of diagnosis codes with a greater degree of specificity as supported by the clinical documentation As with major changes in any industry, the transition to ICD-10 will require focused effort and attention. Use of the website at http://www.roadto10.org/ to help you overcome these challenges. Get started today!  WWW.MEDMONTHLY.COM | 19

practice tips

ENT UNDERCOVER

By Denise Price Thomas

‘‘

“I have a friend who is aging and having some difficulty hearing.

She decided to get a hearing aid.

She was pleasantly surprised at what she could hear once she had her new hearing aid. In fact, she decided not to tell anyone in her family about it. Since then, she has changed her Last Will and Testament four times!”

Gladys Friday

Health Care Comedienne, Denise Price Thomas’ alter ego

A

s an Undercover Patient, I begin my assessment in the lobby of a practice or hospital using all my senses. I’ll narrow my observations here down to my ENT (Ear, Nose, and Throat) senses.

Ears:

I understand the reason we have two ears and only one mouth, therefore I am reminded to listen twice as much as I speak. Unfortunately, patients overhear the bad as well as the good. Imagine being a patient and hearing screams from the room across the hall followed by a conversation that a child was accidentally given ears drops in her eyes!

This happened as I sat in an exam room, waiting to see a physician. Would YOU want to continue waiting for your turn? While in the exam room or lobby, I would much rather hear conversations about new in-house procedures, what physicians are doing for the community and why the employee of the month was nominated.

20 | JULY 2014

Nose:

After 34+ years in a health care career, I tend to be a bit “nosey” as an “Undercover Patient” asking questions and finding out all sorts of things the hospital or practice may or may not know about physicians, employees and more. Once I asked about a particular procedure and the appointment scheduler told me the physician was new to this procedure, only returning recently from a seminar on it. The scheduler continued, telling me they had just hired a new nurse to assist him with this procedure and had turned an exam room into the procedure room. Although I enjoy hearing about the continuing education, I became a little reluctant to be scheduled as the first patient. (nosey, yes: guinea pig, no) Employees should be kept informed and educated on what’s new, but should be educated about what is appropriate and inappropriate to share with the patient.

It’s helpful to provide your staff with a script to guide them in explaining topics to patients.

Throat:

“What does he think he is doing? He made me so mad I could SCREAM! I hate working with him!” It seems that “Voice Art” has become a lost art. We should always choose our words carefully.

When patients overhear comments such as these spoken while they wait for their appointment, their imagination will conclude the remarks must be about their physician. As humans, we will continue to make mistakes, however words spoken by us are our choice.

Communication, both verbal and non-verbal in health care is very important in how the public perceives your practice.

Health care professionals should allow their heart to guide them by listening to each patient with a desire to hear their story, looking them in the eye and connecting the dots before choosing their words.

Using these senses will help to build patient/physician relationships even stronger. These are windows to a heart filled with compassion. When kind, positive and encouraging words become the normal spoken throughout the facility, you become part of creating an environment in which your patients will be happy, employees will have more of a team approach and physicians will be able to take care of their patients.  www.denisepricethomas.com

“Training Wheels in Heels” Denise Price Thomas Trainer for Health Care Professionals Focusing on Exceptional Customer Service, Effective Communication & Exemplary Compassion 34+ year career in health care and certified in health care management Undercover Patient Providing Insight to Your Practice Through the “Eyes of a Patient” Conference Speaker Presenting also as “Gladys Friday”, Health Care Comedienne

Home Grown/Nationally Known www.denisepricethomas.com denisepricethomas@gmail.com 704-747-8699

We may not always know what others are hearing around us.

Perhaps we should come back to our senses: EARS We can use our EARS to hear what is being said throughout our facility. It’s much easier to prevent problems than to correct them. Listen for good news and acknowledge it when we hear it.

NOSE We should be “NOSEY” and ask our patients their opinion of our facility. KNOW what their perception is and always have a plan of action and a desire to improve.

THROAT Start each day off right. Acknowledge every person in a cheerful and professional tone. Speaking kind and encouraging words to those around us helps to create a most positive working environment.

WWW.MEDMONTHLY.COM | 21

international

Investment in Midwifery Can Save Millions of Lives of Women and Newborns

22 | JULY 2014

A report released today by UNFPA, the United Nations Population Fund together with the International Confederation of Midwives (ICM), WHO and partners reveals that major deficits in the midwifery workforce occur in 73 countries where these services are most desperately needed. The report recommends new strategies to address these deficits and save millions of lives of women and newborns.

‘‘

“This report, like the Every Newborn Action Plan recently adopted by the World Health Assembly, sets a clear way forward. Both aim to encourage governments to allocate adequate resources for maternal and newborn health services within national health sector plans.”

- Dr. Flavia Bustreo, WHO Assistant DirectorGeneral for Family, Women’s and Children’s Health

The 73 African, Asian and Latin American countries represented in the “State of the World’s Midwifery 2014: A Universal Pathway – A Woman’s Right to Health” suffer 96% of the global burden of maternal deaths, 91% of stillbirths and 93% of newborn deaths, but have only 42% of the world’s midwives, nurses and doctors. The report urges countries to invest in midwifery education and training to contribute to closing the glaring gaps that exist. Investments in midwifery education and training at agreed international standards can yield – as a study from Bangladesh shows – a 1,600% return on investment.

“Midwives make enormous contributions to the health of mothers and newborns and the well-being of entire communities. Access to quality health care is a basic human right. Greater investment in midwifery is key to making this right a reality for women everywhere,” said Dr. Babatunde Osotimehin, UNFPA Executive Director.

Midwives have a crucial role to play in the achievement of the Millennium Development Goals (MDGs) 4 (decrease child death) and 5 (increase maternal health).

When educated to international standards and within a fully functional health system, they can provide about 90% of the essential care to women and newborns and can potentially reduce maternal and newborn deaths by two thirds. Despite a steady decline in maternal deaths in the 73 countries that are covered in the report – dropping yearly by 3% since 1990 – and newborn deaths – decreasing by 1.9% per year since 1990 – there is more these countries need to do to address the severe shortage of midwifery care.

“Midwives are central to midwifery care and the lives of women and newborn babies. The report precedes the Lancet Special Series on Midwifery, which together with the report will provide the evidence to guide all policymakers in their quest to end preventable maternal and newborn deaths,” said ICM President Frances Day-Stirk.

The report, launched at the 30th ICM Triennial Congress in Prague, Czech Republic highlights the progress made since the inaugural 2011 report and solutions to the barriers outlined in four key areas: availability, accessibility, acceptability and quality of midwifery services: A number of countries have effectively strengthened midwifery and improved access: Nearly half (45%) of the 73 countries have implemented measures to retain midwives in remote areas and 28% are increasing the recruitment and deployment of midwives, while 20% have implemented new codes of practice and 71% have improved information collection enabling countries to address shortages and education standards.

Despite progress, inequities such as lack of access to services and poverty have increased within and among countries. There are still not enough adequately educated midwives to support the health of women and newborns, and this contributes to hundreds of thousands of preventable deaths annually. Today, only 22% of countries have potentially enough midwives to provide life-saving interventions to meet the needs of women and newborns, which leaves over three-fourths (78%) of the countries with severe shortages in proper care. As the population grows, so does the gap in critical resources and infrastructure, unless urgent action is taken.

The 2014 report includes recommendations to close these gaps and to ensure all women have access to sexual, reproductive, maternal and newborn services. These include issues such as preventive and supportive care from a collaborative midwifery team, immediate access to emergency services when needed, and completing postsecondary education. From a broader perspective, women should delay marriage, have access to healthy nutrition and receive four pre-birth care visits.

“This report, like the Every Newborn Action Plan recently adopted by the World Health Assembly, sets a clear way forward. Both aim to encourage governments to allocate adequate resources for maternal and newborn health services within national health sector plans. This should include funds for the education and retention of midwives. We will continue to support countries to develop and strengthen their midwifery services as a critical intervention to save the lives of women and newborns,” said Dr. Flavia Bustreo, WHO Assistant Director-General for Family, Women’s and Children’s Health.  Source: http://www.pressreleasepoint.com/investmentmidwifery-can-save-millions-lives-women-and-newborns WWW.MEDMONTHLY.COM | 23

research & technology

24 |JULY 2014

New Research Set to Improve Quality of Life for Denture Patients

The University of Manchester is leading a first of its kind trial into the quality of life of people wearing dental implants.

Around 3.7 million people in Britain have no natural teeth and many find it difficult to wear lower dentures, causing problems in chewing and speaking that have a significant effect on their quality of life.

Most of those who have lost their teeth are over the age of 65, and the impact of ill-fitting dentures on their lives is so severe that the World Health Organization has classified individuals with such difficulties as disabled.

One solution to this problem is to fit titanium implants into the lower jaw to hold dentures in place, but this requires significant surgery, which not all patients are able to undergo. An alternative for these patients is to opt for newly developed mini-implants, which are less traumatic to put in place.

The University is working with Central Manchester University Hospitals NHS Foundation Trust (CMFT) to lead the trial which is the first of its kind to provide a cost-benefit analysis and undertake a robust assessment of the impact of mini implants on people’s quality of life, compared with dentures secured by conventional implants.

Managed by Manchester Academic Health Science Centre (MAHSC), a partnership between the University and six lNHS partners, the trial is funded by the National Institute for Health Research (NIHR) Research for Patient Benefit Programme.

Professor Martin Tickle, a Senior Research Professor in the School of Dentistry at The University of Manchester, who leads on population health for MAHSC, said: “This pilot trial is one step towards MAHSC’s aim of improving quality of life and it is of particular importance for an ageing population.

“We hope the results of this study will inform a much larger trial that we hope to roll-out across the UK.” The trial has recently started and so far, 16 patients have been recruited. Overall, 44 participants will be selected to take part, 22 of which will receive conventional implants, while the others will be provided with mini implants.

Over the course of six months, the researchers will follow-up with the patients to collect information on their experiences, including the level of pain they have encountered, their ability to chew, and the overall impact of treatment on their quality of life.

“When dentists try to help people whose lives are severely affected by denture problems, it is of critical importance that they know which product is most effective and best suited to the individual patient before treatment goes ahead,” Dr Craig Barclay, Consultant at The University Dental Hospital of Manchester, part of CMFT, and Honorary Senior Lecturer in Restorative Dentistry at The University of Manchester, said.

“We hope that the study will improve quality of life for

‘‘

“We hope that the study will improve quality of life for patients with dentures, by enabling clinicians to provide the most appropriate treatment.”

patients with dentures, by enabling clinicians to provide the most appropriate treatment.”

MAHSC is one of only six UK academic and health partnerships currently designated as an Academic Health Science Centre (AHSC) – a mark of international excellence in healthcare research – and the only one north of Cambridge. Its role is to join world-leading academics with NHS Trusts and Clinical Commissioning Groups in order to ensure the best ideas emerging from the scientific community are translated into standard healthcare to benefit patients more quickly and more effectively.

Source: http://www.pressreleasepoint.com/new-research-setimprove-quality-life-denture-patients

PEDIATRICIAN

or family medicine doctor needed in

FAYETTEVILLE, NC

Comfortable seeing children. Needed immediately.

Call 919- 845-0054 or email: physiciansolutions@gmail.com www.physiciansolutions.com WWW.MEDMONTHLY.COM | 25

research & technology

Clinical Trial Analysis Suggests Drug Combination May Be Highly Effective in Recurrent Ovarian Cancer

Significant improvement with the use of a combination drug therapy for recurrent ovarian cancer was reported at the annual meeting of the American Society of Clinical Oncology meeting in Chicago. This is the first ovarian cancer study to use a combination of drugs that could be taken orally. The drugs were tested in a phase I combination study followed by a randomized phase 2 trial sponsored by the National Cancer Institute (NCI), part of the National Institutes of Health.

26 | JULY 2014

The trial compared the activity of a combination of the drug olaparib (which blocks DNA repair) and the blood vessel inhibitor drug cediranib, vs. olaparib alone. Trial results showed a near doubling of progression-free survival benefit (the length of time during and after treatment that the cancer did not get worse) for the combination therapy over use of the single drug alone. “The findings of this study are exciting because they support the idea that combining these two targeted oral

therapies results in significant activity in ovarian cancer, more so than olaparib alone,” said Joyce Liu, M.D., M.P.H., the lead investigator and medical oncologist at the Susan F. Smith Center for Women’s Cancers at Dana-Farber Cancer Institute , Boston. “We are looking forward to further exploring this combination in ovarian cancer and potentially increasing effective treatment options for our patients with this cancer.”

Over 22,000 cases of ovarian cancer are diagnosed annually in the United States. Seventy-five percent of the cancers are classified as high-grade serous type, the women have more advanced disease at diagnosis, and their tumors are more aggressive. Of this high-grade type, about threequarters of patients respond to initial treatment but nearly all will recur and need follow-up treatment. That treatment will be based on how the cancers have responded to previous therapies and are broken down into two categories based on patients’ responses to chemotherapy regimens that include platinum: • Platinum-Sensitive – these are patients most likely to benefit from Poly ADP-Ribose Polymerase (PARP) inhibition. PARP inhibitors, such as olaparib, are targeted drugs that block an enzyme involved in many functions in the cell, including the repair of DNA damage.

• Platinum-Resistant – these are patients whose disease recurred within six months of completion of conventional chemotherapy (using the drugs cisplatin or carboplatin) and are generally less responsive to subsequent treatments and have not responded as well to PARP inhibitors. They are currently treated with non-platinum chemotherapy, single-agents, with or without addition of the blood vessel inhibitor drug called bevacizumab.

An anti-angiogenic agent, or blood vessel inhibitor called cediranib (which inhibits a protein known as VEGFR) and olaparib, a PARP inhibitor, are each clinically active in recurrent ovarian cancer. Preclinical laboratory studies suggest these agents add to and enhance the activity of each other, and an early phase 1 study showed that the combination of cediranib and olaparib was well-tolerated with minimal side effects.

For this reason, 90 patients from nine centers were randomly assigned to one of two study arms for the phase II clinical trial: the first taking capsules of olaparib (400 milligrams [mg] twice daily) and the other taking a combination of the two drugs (200 mg olaparib in capsule form twice daily and 30 mg of cediranib by tablets once daily). The study arms were stratified by BRCA gene mutation status and receipt of prior anti-angiogenic therapy. The BRCA gene is one of the most commonly mutated genes in breast cancer.

Patients, whose median age was 58, were enrolled from October 2011 to June 2013. As of March 2014, median

progression-free survival was 9.2 months for olaparib and 17.7 months for the combination therapy, which is a significant advantage. The overall rate of toxicity was higher for patients on the combination therapy. Fatigue, diarrhea, and hypertension were the most common toxic effects, all of which were manageable.

“Of particular note is the fact that both drugs used in this trial are in pill form and could offer an alternative to intravenous chemotherapy,” said Percy Ivy, M.D., associate chief of NCI’s Investigational Drug Branch. “Therefore, this combination therapy could be used anywhere in the world where patients can be safely monitored for the side-effects of olaparib and cediranib, such as diarrhea and hypertension.”

Based on these results, two phase 3 trials are being planned for platinum-sensitive and platinum-resistant ovarian cancer patients by one of NCI’s new National Cancer Trial Network Groups, the NRG Oncology Group (formerly 3 cooperative groups: the National Surgical Adjuvant Breast and Bowel Project (NSABP), the Radiation Therapy Oncology Group (RTOG), and the Gynecologic Oncology Group (GOG).

This trial was funded by NCI and received supplementary funds from the American Reinvestment and Recovery Act. The National Cancer Institute (NCI) leads the National Cancer Program and the NIH effort to dramatically reduce the prevalence of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI website at http://www.cancer.gov or call NCI’s Cancer Information Service at 1-800-4-CANCER (1-800422-6237).  About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Reference Liu, JF, et al. A randomized phase 2 trial comparing efficacy of the combination of the PARP inhibitor olaparib and the anti-angiogenic cediranib against olaparib alone in recurrent platinum-sensitive ovarian cancer. NCT 01116648.

ASCO late breaking abstract #5500. http://www.cancer.gov/ clinicaltrials/search/view?cdrid=673213&version=HealthPr ofessional Source: http://www.nih.gov/news/health/jun2014/nci-02. htm WWW.MEDMONTHLY.COM | 27

research & technology

Gene Expression Profiling Drives Personalized Medicine Worldwide

28 | JULY 2014

G

ene expression profiling can bring significant improvements to disease profiling and diagnoses based on genetic disposition. Recent technology advances in this area are in fact enabling personalized medicine, where physicians provide patients with tailor-made treatment plans to fight diseases.

Cases of cancer, cardiovascular diseases, and neurological disorders stand to benefit the most from these developments, since these conditions manifest differently in each patient.

New analysis from Frost & Sullivan, Advances in Gene Expression Profiling, finds that gene expression profiling technology has established a presence in North America and most of Europe. Emerging markets, on the other hand, include India, China, South Korea and Australia.

“Physicians increasingly rely on gene expression profiling to get a thorough picture of the patient’s genetic profile prior to arriving at a diagnosis and recommending a course of treatment,” noted Technical Insights Research Analyst Madhumitha Rangesa.

“With multiple disease diagnostic tests currently undergoing clinical trials and approval procedures, patients will soon have access to interpretable genetic profiles a definite way to boost patient awareness and encourage preventative care.”

However, regulatory barriers pose a huge challenge for providers and life science firms, mainly due to the lack of standardization. The industry should focus on creating a standard platform for gene expression profiling scoring high on accuracy, sensitivity, and performance. In addition, the industry must invest in more clinical trials to enhance the credibility of gene expression profiling tests and create standardized protocols to enable life science firms to conduct clinical trials across developer platforms.

Having tight protocols in place will also support the development of data storage, management, and visualization platforms. These platforms will be necessary as the declining costs of next generation sequencing (NGS) lead to a boom in raw genetic data production. Large investments are already taking place across the industry, with life science firms actively trying to enter the software world and software players looking to capture start-up genetic profiling companies. Cloud-based data tools for accessing genomic information will prove particularly useful in related industries including pharmacogenomics and oncology diagnostics.

“Gene expression profiling will continue to grow rapidly over the next five years as consumer awareness grows,” stated Rangesa. “In fact, gene expression profiling will become a crucial aspect across pharmacogenomics, direct to consumer genetic testing and academic research.”

Advances in Gene Expression Profiling, a part of the Technical Insights (technicalinsights.frost.com) subscription, covers the key technologies used in gene expression profiling for drug discovery, clinical diagnostics, and academic research.

It also highlights the major drivers as well as technical and business challenges facing players in this space. Further, this research service includes detailed technology analysis and industry trends evaluated following extensive interviews with market participants.

Technical Insights is an international technology analysis business that produces a variety of technical news alerts, newsletters, and research services.

About Frost & Sullivan Frost & Sullivan (frost.com), the Growth Partnership Company, works in collaboration with clients to leverage visionary innovation that addresses the global challenges and related growth opportunities that will make or break today’s market participants. For more than 50 years, we have been developing growth strategies for the global 1000, emerging businesses, the public sector and the investment community. Is your organization prepared for the next profound wave of industry convergence, disruptive technologies, increasing competitive intensity, Mega Trends, breakthrough best practices, changing customer dynamics and emerging economies? Contact us: Start the discussion.

Source: http://www.newswiretoday.com/news/143661/ WWW.MEDMONTHLY.COM | 29

legal

Proposed Modifications to Electronic Health Care Record (EHR) Incentive Programs

By Eric A. Klein Sheppard, Mullin, Richter & Hampton LLP Last year, HHS revised policies and definitions surrounding what constitutes certified EHR technology— required for meaningful use incentive program payment eligibility—from the 2011 Edition criteria to the 2014 Edition criteria. Now, CMS has issued a proposed rule in response to hardships expressed by vendors, hospitals and healthcare providers regarding updating their systems per the new standards within the given time frame.

The rule would allow the ongoing use of the 2011 Edition criteria or a hybrid of the two through the end of 2014.[1] Hospitals and providers that would otherwise be required to move to Stage 2 of the program—to attest to meeting requirements focusing on clinical processes—would be able to remain at Stage 1 for another year.

The focus of Stage 1 is capturing and sharing data.

These delays are strictly for hospitals 30 | JULY 2014

and providers that were unable to fully implement a 2014 Edition criteria compliant system because of delays in the availability of the technology.

CMS “strongly recommend[s]” that hospitals and providers new to the Incentive Programs and yet to select EHR technology adopt a 2014 Edition certified system. To encourage this, participants in the Medicaid EHR Incentive Program would not be able to obtain an incentive payment for newly adopting, implementing, or upgrading to 2011 Edition technology.

Applicable to participants who joined the Incentive Programs in 2011 or 2012, the rule would also delay the start of Stage 3 of the program until 2017. Stage 3, the final stage of evolution for meaningful use criteria, focuses on improved outcomes such as quality, safety, and efficiency.

Requirements for Stage 3 are planned to be finalized in the first half of 2015.

Will these delays suffice? As health

information technology and data management is a rapidly transforming sector, how might this experience inform future Edition certification processes in terms of realistic expectations for the development and implementation of new technology standards? The relevance of this question is magnified by the fact that this delay is the second major health information technology delay of the year. In March, Congress intervened to push back, yet again, the ICD-10 compliance deadline from October 2014 to October 2015.

CMS is accepting comments on the proposed rule until July 21, 2014.  This article was written with contributions from Rachel Landauer.

Source: http://www.natlawreview. com/article/proposed-modificationsto-electronic-health-care-record-ehrincentive-programs

legal

Tips for New Enrollment & Revalidation for Participation in Medicare & Medicaid

By Lisa English Hinkle

Chair of the Health Care Practice Group McBrayer, McGinnis, Leslie and Kirkland, PLLC

T

he new enrollment and revalidation requirements for providers and suppliers for Medicare/ Medicaid participation was previously detailed on this blog. As promised as a follow-up, this blog post will describe enrollment best practices and tips for ensuring that enrollment or revalidation is properly 32 | JULY 2014

accomplished. Not only is initial enrollment now more onerous, but revalidation is required for all physicians and other providers/suppliers who were enrolled before March 25, 2011, which generally means that all physicians and physician groups must complete the re-enrollment process.

A failure to re-enroll means that CMS will de-activate payment until a successful re-enrollment process is completed.

In some cases, CMS may even revoke participation. Thus, it is crucial that physicians, providers, and suppliers get it right the first time.

First things, first: watch the mail! Staff should be counseled about where to direct revalidation requests for prompt attention to avoid deactivation based on a failure to respond to a MAC request. Providers and suppliers should check the CMS website to see if a revalidation request has been sent.

Next, do not forget the application fee. For CY 2014, the fee is $542.00 for institutional providers and this must be paid in the event of initial enrollment, revalidation, or the addition of a practice location. Always submit an application fee receipt.

Many completing the forms may be tempted to use the online Provider Enrollment, Chain and Organization System (“PECOS”). The system can be used for an initial enrollment application, to change enrollment information, and to submit changes to an existing enrollment record, among other things. While the system allows for faster completion and processing, the system is still under development which means that electronic submission is complicated. Because inaccurate applications can result in rejection, we recommend that enrollees submit an re-enrollment application using the paper form. At a minimum, all information should be verified before it is entered into PECOS, as there have been many issues with correcting inaccurate information once it has been submitted.

Before the form leaves the office, an appointed person should check all of the following: • Is the form version correct?

• Is the address correctly reported?

• Is the application dated?

• Are the signatures dated?

• Is all the requested information complete and accurate?

• Is the correct National Provider Identifier used?

• Does the mailing have the correct postage amount?

All physicians, providers, and suppliers must adjust how we think about enrollment. Enrollment is no longer a one-time application; enrollment is an on-going process that requires vigilance, internal policies and procedures and a devoted team that can commit time and attention necessary to the forms.  Source: http://www.natlawreview.com/article/tips-newenrollment-revalidation-participation-medicare-medicaid

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legal

Potential Risks of Healthcare Joint Ventures Between Insurance Companies and Hospitals

By Barbara E. Taylor and Charles L. Kreindler Sheppard, Mullin, Richter & Hampton LLP 34 | JULY 2014

Healthcare joint ventures are nothing new. Since the mid-2000’s, physician-hospital ventures have been resurgent, notwithstanding the Office of Inspector General’s skepticism regarding the risk of fraud and abuse when investors are sources of referrals and the filing of numerous whistleblower actions under the False Claims Act (e.g., the nine cases filed against Health Management Associates, Inc., which have been transferred to the District of District of Columbia for consolidated and coordinated proceedings). More recently, a new kind of joint venture has come on the scene: partnerships between insurance companies and healthcare systems. Partly in response to healthcare reform, these ventures seek to “align incentives” between these traditional adversaries. Since 2010, a number of health systems have either acquired or decided to form their own insurance companies. Partnering with insurance companies, however, may be the more practical approach, since health systems can take advantage of insurance companies’ information technology and expertise, while avoiding the cost, time and regulatory approvals required to build an insurance plan from scratch.

In 2013, Florida Hospital was among the first to go down this path, announcing a joint venture with Health First Health Plans. More recently, in April 2014 Independence Blue Cross and DaVita HealthCare Partners announced the creation of Tandigm Health, touted as a “unique joint venture” using a coordinated care model to deliver higher quality care at lower cost.

To date, these joint ventures have not generated significant litigation arising under fraud and abuse laws. But as this trend accelerates, care should be taken to appreciate the potential risks under applicable laws, including antitrust (Sherman Act §1), Ethics in Patient Referral Act (Stark law), Civil Monetary Penalties Law (42 U.S.C. §1320a-7a), Anti-kickback Act (41 U.S.C. §51, et seq.), civil False Claims Act (31 U.S.C. §3729, et seq.), state corporate practice of medicine (e.g., Cal. Bus. & Prof. Code §§2052 & 2400), state insurance regulations, and medical tort liability. For example, the press release announcing Tandigm Health’s creation states that it “will partner with primary care physicians … to provide enhanced resources to help them deliver more personalized, high-quality care” and “will reward doctors for the quality of care they provide, not the quantity of care.” But as the Stark law presently stands, arrangements to improve patient care may be banned where payments tied to achievements in quality and efficiency vary based on services ordered instead of only hours worked. (See American Hospital Association TrendWatch Report, The Value of Provider Integration (March 2014).

More generally, members of joint ventures are treated like partners for purposes of tort liability, i.e., they are liable for torts of one member committed in furtherance of the enterprise. Thus, the form of entity chosen can have significant consequences. For example, in U.S. ex rel. DeKort v. Integrated Coast Guard Systems, 705 F.Supp.2d 519, 544, 557 (N.D. Tex. 2010), the district court dismissed joint venture allegations and claims based on joint and several liability under the False Claims Act, notwithstanding defendants having described themselves as “partners” in a “joint venture,” because the entity under contract with the Coast Guard was a limited liability company. Of course, even if technical joint venture liability is not imposed, a defendant can still be potentially liable for its own conduct and under other theories such as alter ego.

In sum, joint ventures between insurance companies and hospitals herald a new era in the provision of health care. Whether a new wave of litigation results remains to be seen.  Source: http://www.natlawreview.com/article/potentialrisks-healthcare-joint-ventures-between-insurancecompanies-and-hospitals

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features

How Are Popular Diets Affecting Our Patient’s Health?

‘‘

So what are the most popular diets right now and what should we, as physicians, know about them?

By Carrie A. Noriega, MD

Our patients choose to follow new diets for various reasons including weight loss, lifestyle changes, and ethical reasons. When our patients are researching their new diets they frequently turn to magazines, the Internet, or their favorite celebrity’s of the moment diet for their information. Unfortunately the information isn’t always 36 | JULY 2014

accurate nor do our patients always understand the pitfalls of the various diets. So what are the most popular diets right now and what should we, as physicians, know about them?

In 2013 the most googled diet was the paleo diet. This diet became popular among crossfitters and is now moving

more into the mainstream population. The paleo diet is a low carb diet that is based on the premise that our bodies are genetically adapted to eating like a caveman. This diet only allows dieters to eat what a caveman would have eaten.

Followers of this diet can eat grass-fed meat, seafood/fish, eggs, fruits, vegetables, nuts, seeds, and healthful oils. The founder of the paleo diet, Loren Courdain, PhD, claims that by eating these foods you may lose weight and reduce your risk of developing many types of common chronic illnesses.

So how healthy is this diet and will you lose weight? It is unclear whether long-term weight loss is achieved on this diet as very few studies have been done and the sample size in each has been very limited. Since this diet is high in protein, dieters need to be conscience of making lean protein choices or the fat intake can be quite high. Long-term followers of the paleo diet may need more diligent screening for heart disease as the higher fat intake may put them more at risk for heart disease. The positive aspect of this diet is the high fiber, potassium, and vitamin B-12 intake but since it doesn’t allow dairy it is low in calcium and vitamin D. It is recommended that dieters take calcium and vitamin D supplements to compensate for this as well as a multivitamin.

The juice cleanse diet is another popular diet at the moment, as it has been featured on The Dr. Oz Show and is popular with celebrities.

This diet was started by a documentary filmmaker who sought to overhaul his health by drinking only fresh fruits and vegetables for 60 days. It is the 3-day version of this diet that is so popular among people seeking quick weight loss and diet cleanses. This diet begins with abstaining from red meats, sugar, caffeine, processed food, and dairy for 2 days prior to the cleanse. During the entire diet you drink water with lemon and ginger in the morning and in the evening a cup of herbal tea. The 3-day cleanse involves drinking five meals consisting only of juiced fruits and vegetables followed by eating a dinner of fruits and vegetables. At the end of the 3 days you can return to eating 3 meals a day of whole foods, nothing processed, while continuing to have one juice a day and the lemon water and herbal tea.

The consequences of the 3-day cleanse on general health appear to be short term. Dieters mostly complain of fatigue, headaches, irritability, and low blood sugar but these are remedied when food is reintroduced to the body. Short-term weight loss is common but since it is

mostly from water loss, long-term effects don’t tend to be noticed. This diet may have severe consequences for people with chronic medical problems especially diabetics and hypertensives. People on blood pressure medications may experience fainting from hypotension and diabetics may become ill from hypoglycemia. Cleanses should be avoided by pregnant and breast-feeding woman.

The most balanced of the popular diets is the Mediterranean diet. This diet is based on the cuisines of the countries bordering the Mediterranean Sea. The emphasis of this diet is fruits, vegetables, whole grains, nuts, legumes, olive oil and spices. It recommends eating fish and seafood several times a week and eating poultry, eggs, cheese and yogurt in moderation. This diet also allows for a small amount, 5oz for women and 10oz for men, of red wine daily. Research has shown that this diet decreases the risk of heart disease by lowering blood pressure and LDL cholesterol. Additionally, a reduction in Alzheimer and Parkinson disease has been noted.

From a health perspective, the Mediterranean diet is excellent. If weight loss is the goal of this diet than it is important to monitor the calorie intake to insure that the intake is less than the calories expended. The fat, protein, and carbohydrate intake is all inline with nutritional recommendations. Calcium and vitamin D supplements may be needed if the dairy intake is low but this may be compensated for if enough fortified foods are eaten. This diet is healthy enough that it can safely become a lifelong way of eating.

It is important to realize that our patients are trying many of the diets that are trending at the moment and they may have unintentional long-term health consequences.

Some diets, like the Mediterranean diet, are healthy long-term food choices. Other diets, especially those that eliminate whole food groups, may have detrimental long-term health effects that patients aren’t even aware of. Often, if these deficiencies are brought to the patient’s attention, they may be compensated for with nutritional supplements or by making slight alterations to the diet.

If diets low in vitamin D and calcium are followed longterm without augmenting them with supplemental vitamin D and calcium it may place patients at higher risk for osteoporosis and thus require earlier screening.

High fat diets may require more diligent monitoring for heart disease, even in patients in the normal weight range.

Therefore, it is important for us to discover any diets our patients are following so it can be determined how they may be affecting our patient’s health.  Sources: http://thepaleodiet.com http://www.rebootwithjoe.com/rebooting/plans http://www.mayoclinic.org/healthy-living/nutrition-andhealthy-eating/in-depth/mediterranean-diet/art-20047801 WWW.MEDMONTHLY.COM | 37

features

Turning the Increased Global Focus on Diet to Your Practice’s Advantage

Learn to use the improved spotlight on healthy living to guide the way you treat patients and promote your practice

By Marie Klee Chief Editor Carrotstick.dk

38 | JULY 2014

The global focus on diet has increased immensely in the last couple of years. More people are overweight and/ or obese and many people get sick because of a poor diet and lifestyle. Fortunately, an increased number of people are starting to watch what they eat and what they actually put into their shopping carts. Also, the fitness industry is exploding and over $30 billion dollars are spent on diet related products and programs every year in the US, with this number including diet foods and drinks.1 You can turn this increased interest in food and diet into a tool for promoting your practice and creating more loyal patients. And not only by prescribing more weight loss medicine.

If you are not already giving your patients thorough information about a healthy diet, you should. You may underestimate the positive influence you can provide for your patients’ lifestyle choices. In Denmark, where I live, diet is almost never a topic in the doctor’s office. It is simply not prioritized. But why? We’ve all known someone whose life has improved significantly after making healthy lifestyle changes, such as incorporating exercise and healthy eating as a part of their daily regimen. And many of us have heard about people who were dependant on medicine, but were able to cut down their doses or even say goodbye to their prescriptions after adapting healthier life choices.

Giving your clients nutritional advice should it reach further than the examination room?

As a nutritionist, I say yes. Eating healthy (and exercising) is a way to improve overall health, both physically and mentally. Our diet plays a big part in our lives, and you have the opportunity to use this knowledge in your medical practice to improve the life quality of your patients, even more than you already do.

You want your patients to remember your advice and have access to your diet knowledge when they leave your office. They should be thinking about your ”food rules” in the back of their minds in their everyday routines.

Here are some recommendations If you are a regular reader of MedMonthly magazine, you have probably read Amanda Kanaan’s article about blogging entitled “Website Blogging, An Affordable and Effective Way to Boost Google Rankings and Patient Traffic” in the May issue. An online presence of your practice is your first priority and blogging is an excellent choice to increase your internet exposure.

You probably already have a website. But how often do you update it? Keeping your website up to date and creating new content for your website is very important. Updating your website at least once a week is key, if you want your website to have a good Google ranking. You can easily do

‘‘

“Our diet plays a big part in our lives, and you have the opportunity to use this knowledge in your medical practice to improve the life quality of your clients, even more than you already do.”

this by writing blog posts – or get someone to do it for you.

And if you want to focus more on diet within your practice, this is a good place to start.

Referring your patients to your website for nutritional tips and/or diet plans is a great way to 1) get your patients to focus more on their diet and 2) to generate more visitors to your website and your practice, because people can ”like and share” your information.

If you don’t have the interest, the skills or the time, then partner with one of your local registered dieticians.

A collaboration like this could include blog posts for your website, meal plans, e-books, talks about diet and health and so on. An additional benefit of this type of relationship is the mutual referring to each other – one business to another. You and your collaborator can acquire new clients through this reciprocal arrangement.

And since a visit to the doctor’s office is far more common than a visit at a dietician or nutritionist’s clinic, this is also a great place to display nutritional information that people can take for free.

Even if you just make a leaflet with some common nutritional tips and call it ”Dr. (your name)’s Nutritional Advice for Better Health”, it is a good way to increase your patients’ awareness towards watching their diets. You want your name to be on the flyer, so that if your patient decides to bring a copy for her friend or hang it on the refrigerator – it is more inexpensive marketing for you.

You could also consider ordering materials from health services or public institutions, which are often free. Leave them in your waiting room so you further create the awareness that diet is an important part of overall health.

You could also put a sticker with the contact details and logo of your practice on the printed pieces.

These are just a few of the possibilities you have to influence the diet of your patients. From my point of view, it is our responsibility as health professionals to set new standards and contribute more to the need for health promotion in our modern society. Prevention is the best medicine.  Source: 1 http://www.worldometers.info/weight-loss/ WWW.MEDMONTHLY.COM | 39

features

Registered Dietitian:

Coaching and Educating Patients to Improve Their Health and Quality of Life

By Ashley Acornley, MS, RD, LDN Triangle Nutrition Therapy

H

ave you ever considered visiting a Registered Dietitian for any of your particular health or nutritional concerns? Perhaps you were in the hospital for surgery, and needed a professional to provide meal-planning tips when you returned home. Or recent lab work revealed a new medical diagnosis and you are interested in learning how to improve your health through nutrition.

Maybe you are an avid marathon runner and want to learn tips and tricks for improving your hydration and athletic performance for an upcoming event. No matter what your age, concern or condition is, a Registered Dietitian can help coach and educate patients to improve health and quality of life.

Benefits of Medical Nutrition Therapy

Registered Dietitians work in a variety of settings, such as hospitals, outpatient facilities, private practices, grocery stores, fitness centers, military bases, and many more. Although Dietitians are employed in multiple 40 | JULY 2014

settings, they are a very underutilized component of the healthcare team.

Instead of emphasizing and teaching the importance of diet and exercise to prevent diseases, medical teams prefer to prescribe medication as a “quick fix” to the issue after the disease is diagnosed. Dietitians are skilled at providing preventive care to patients, and also provide Medical Nutrition Therapy (MNT) for existing conditions. Educating our clientele and providing MNT to patients can greatly improve health outcomes of patients, regardless of their status or condition.

As Ann Wigmore explains, “The food you eat can be either the safest and most powerful form of medicine or the slowest form of poison.”

There are many reasons why doctors and the remaining healthcare team should refer more of their patients to Registered Dietitians. There are many benefits of nutrition counseling for overall health and wellness. Registered Dietitians are the only health professionals credentialed to provide Medical Nutrition Therapy to patients.

Medical Nutrition Therapy can mean

a wide variety of things, including weight loss or gain, pregnancy and breastfeeding nutrition, childhood nutrition, disease management (Type 1 and 2 Diabetes, heart disease, cholesterol, blood pressure, etc.), food allergies, and sports nutrition. Even if a patient has general nutrition questions involving meal planning or grocery shopping, this is the time to refer them to a Dietitian’s office. This type of referral relationship is beneficial to the patients in your medical practice. The more educated and informed a patient is, the more likely they are going to be proactive about their health and control or prevent any diseases throughout their lifetime. Initially, eating a healthy diet and maintaining an active lifestyle can improve weight status and muscle tone, energy, sleep patterns, and mood. Over time, living a healthy lifestyle can cut healthcare costs, limit the number of doctor visits and sick days, and decrease hospital bills. Doctors need to strongly consider referring more patients to Registered Dietitians, because after all, “the greatest wealth is health.” (Virgil). 

About Triangle Nutrition Therapy

Triangle Nutrition Therapy is a private practice that focuses on improving patient’s health status through diet and exercise. Triangle Nutrition Therapy was established in Raleigh NC in 1995 by Tracy Owens.

The initial vision of the company was to provide high quality outpatient Medical Nutrition Therapy (MNT) to patients. At that time, there were only a handful of private practice dietitians in business, and Tracy left her current position at Rex Hospital to provide alternative outpatient choices for patients.

Tracy also had a personal interest in sports nutrition and noticed that the trainers, coaches, and parents of her kids’ sports teams continued asking for help at games and practices. After teaching a sports nutrition workshop for coaches and athletes at Rex Hospital, she knew there was a large audience and niche for teaching sports nutrition. There is so much misinformation about sports nutrition and a huge gap between what is and what should be. Tracy wanted to educate athletes of all ages to reach their full potential. She did not want a lack of sports nutrition knowledge and application be the reason to hold athletes back in their success. Tracy passed her CSSD exam to become certified in sports dietetics, and continued to specialize in sports nutrition within the practice. Tracy is currently the sports dietitian for UNC Greensboro.

In 2009, Registered Dietitian and AFAA Certified Personal Trainer Ashley Acornley joined the Triangle Nutrition team due to the increasing customer and business demands. Tracy Owens and Ashley Acornley continue to provide a variety of nutrition counseling services to improve health and enhance energy. Their office resides in Raleigh, NC but they travel throughout the Triangle area for various lunch n learns, health fairs, and group presentations. Their nutritional counseling is completely individualized, and they see clients for issues such as weight loss, weight gain, sports nutrition, hypertension, high cholesterol, Type 1 and 2 Diabetes, eating disorders, meal planning, pregnancy, and gestational diabetes. They also provide meal planning and preparation services, grocery store tours, and metabolic testing (BodyGem). They are in network with BCBS NC and Cigna insurance plans. United Healthcare patients receive 20% off their self pay services. They also accept new patients and self pay patients.

Triangle Nutrition Therapy looks at health holistically, and has recently broadened their services, and they believe that nutrition, physical activity, skincare, and overall sense of well-being contribute to optimal health! They provide in-home and group personal training, host a 12week virtual “Wedding Crunch” program for brides-to-be and their wedding party, and are independent consultants for Rodan and Fields skincare. Tracy and Ashley both encourage their clients to consider their overall physical, mental, and emotional health when trying to make improvements in their lifestyle habits. As Jim Rohn’s famous quote states, “you need to take care of your body, it’s the only place you have to live.”

Contact information: Triangle Nutrition Therapy 4030 Wake Forest Road, Suite 300 Raleigh, NC 27609 www.trianglediet.com 919-876-9779 Tracy Owens, MPH, RD, CSSD, LDN tracy@trianglediet.com @trainingtable R+F Skincare:

Owens.myrandf.com

Ashley Acornley, MS, RD, LDN ashley@trianglediet.com @Ashley_SportsRD R+F Skincare:

www.aacornley.myrandf.com “Like” Triangle Nutrition Therapy on Facebook!

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features

HOW WEALTHY ARE YOU?

We all know the greatest wealth is health So, how much of an investment are we making in our health? We all are conscious about fitness these days because we want to look great.

Having a healthy body is the remedial answer to most of our problems, whether medical, cosmetic or psychological.

By Nidhi Vats Behl Freelance Copy Writer 42 | JULY 2014

T

here are many “diet issues”. Under the diet umbrella come a lot of subtopics, such as eating disorders, obesity, disease that arises out of obesity, child/adolescent obesity, healthy eating and many more related topics.

Once you have realized that you have to improve your health, a visit to your doctor is a must.

As a diet conscious patient, it’s imperative to prepare well before proceeding to your doctor’s appointment.

Below is a preparatory list of things to do before your consultation.

1. Fear during childhood or adolescent: Try to recall any past incident which is still affecting you. Studies have shown that when person is depressed they inclined towards active eating, leading to increased intake of calories.

2. Time you became fat: Think of the time when you started gaining weight. Were you obese since childhood? If not, then when you started gaining weight, were there any specific reasons behind your weight gain. Any specific incident in your life like: career change, geographic relocation, loss of job, loss of your loved one, etc.

3. Allergies: It is important for your doctor to know about your allergies. People can be allergic to food groups like milk and wheat or have allergies to dust, pollination, or medicine. So make it a point that you think well in advance about any allergic reaction you have faced in past.

4. Medical problems: Have you been sick frequently, have any disease or any surgical procedures performed.

Recall your family history, recalling any hereditary problems, especially genetic problems known to you through discussion with your parents and relatives.

Include maternal and paternal information when answering this question. If you have any recent medical issues that you are encountering, but you have not consulted your doctor, please share these with your doctor. It will help in understanding whether is it okay to start a diet plan at that moment or not.

5. Physiological problems: In general, problems which are associated with the mind are termed as ‘Psychological problems”. This would include depression and peer pressure. Are you phobic or fearful of anything like water, heights, animals, crowds, etc. There many things which any one of us may be sensitive to or even fear.

Write down well in advance anything that comes to mind for your visit. You may not feel it affects you directly, but it may have effects on what and how you eat.

6. Current food habits and schedule: What is your daily diet routine? Make a table and write the time and kind of food you eat each day. It will be best if you make chart for a complete week. This will help your doctor

to understand any patterns you might be following. If you follow a special diet, such as vegan, make sure to include that information. Also try to include a “List of favorites”.

7. Laboratory test: Recently (within last six months) have you had any laboratory tests. This would include radiological or pathological. Try to include this information with your other medical records during your visit to the doctor.

8. Diet alterations: Include any recent changes in your normal diet pattern, such as increases of protein in your diet or reducing sugary dietary items or carbohydrates levels. These changes will be important for your doctor to know at your appointment.

9. Share your professional lifestyle: Your occupation can affect your eating habits. Information such as if your type of work is physically active or sedimentary, has odd working hours, or involves frequent travel can influence your eating habits. This is important information for your physician to have at your consultation.

continued on page 44

WWW.MEDMONTHLY.COM | 43

continued from page 43

10. Clearly discuss your thoughts/outcome: Explain clearly what you are trying to achieve with this consultation. Do you want to have balanced diet in your life? Do you want to reduce weight?

Or do you want to become healthier?

Telling your expectations can help your doctor execute your eating plan more effectively. Similarly, ask your care provider what is the total plan of action. Discuss and understand what is required to achieve your goal.

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Consider these ten points before meeting your doctor and your right path will become closer to a cake walk. The doctor-patient understanding will be better.

The outcome of this initial session with your physician will be a detailed study analysis about your body mechanism. Your doctor will analyze all your information and will accordingly advice you of some treatment or may have to get some additional medical tests performed before starting you on to your new journey.

Reminder facts:

1. Bad eating habits are not developed overnight. So you need to have patience.

Diet change or weight loss is long term and continuous process.

2. Your physician is the first person to get in touch with, but he may not be an expert. In this case, he will refer you to a specialist to assist with a nutritional and healthy dietary lifestyle.

3. Remember, changing your diet will bring a permanent healthy change to yourself over a period of time, while quick, short term diets can be harmful to your health.

4. The most important thing is to write down your goals.

Changing your thought process to control your actions is a must to succeed. Stop with the excuses that you don’t have time to exercise, I have done enough but see no results, or maybe I’ll try a different doctor.

And remember, you didn’t gain all your weight overnight, so why should you expect to lose it any quicker. Stay focused, have patience and results will come your way. It’s an investment that will pay off attractively in the end.  44 | JULY 2014

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the arts

Art Meets Science:

A Profile on Dr. Michael Dobbs

By Laura Dawahare and Allison Perry Information Specialists, UK Public Relations One doesn’t expect that the chief of neurology would have a lot of downtime. But, as Dr. Michael Dobbs explains, working as a neurologist at UK HealthCare can sometimes mean just that.

“KNI (Kentucky Neurosiences Institute) has unsurpassed expertise to treat stroke patients, and Kentucky has one of the highest rates of stroke occurrence in the nation,” says Dobbs. “So I have spent more nights than I care to count consulting with physicians around the state, trying to determine whether their patients need the level of care that KNI provides. Sometimes that means I stay awake waiting for phone calls.”

Dobbs admits that he hates to be idle. So, what to do with that middle-of-the-night free time?

He paints.

As a child, Dobbs loved to draw, but the rigors of a medical school education, a family and a stint at Harvard University to earn a master’s degree in public health 46

| JULY 2014

Pine Mountain

foreclosed the opportunity to pursue his hobby.

While his primary interest was drawing, painting had always intrigued him. “I thought paints would be too Dr. Michael Dobbs messy, however, so I stuck with (Photo from UKNow) drawing,” says Dobbs.

But one day in 2010, helping his daughter Catherine shop for her school art supplies, he spied a set of oil paints on clearance. “I thought, hey, it’s only $15, not much to lose there, and I bought it on a lark.”

He chuckles as he shows his first attempt — a portrait of Catherine. “I don’t consider it a failure, but it wasn’t the best,” he laughs. “But I still kept it. I like to use it to remind myself of the progress I’ve made.”

Dissatisfied with his first foray, Dobbs began to study art books — but not Painting for Dummies. “You know those

coffee table books about art? It turns out they have a lot of useful commentary that can inform a painter as they practice and improve their skill,” he explains. “It helped make my second attempt passable.”

While portraiture fascinated him, Dobbs struggled with the time investment required for such detailed work, and so he moved on to study landscapes. He explains that they take less time to finish — as little as 60 minutes — although he admits that he must sometimes return to a painting before he’s satisfied. “One of my paintings, “Sunrise, Blue Ridge Mountains,” took four or five extra rounds to finish, because I didn’t like how I portrayed the light reflecting off a mountainside.”

When Dobbs’ work began to generate interest, a friend put him in touch with the National Brain Tumor Foundation, who placed his “Sunrise, Blue Ridge Mountains” in their annual fundraising auction. Dobbs remembers clearly his reaction to the call confirming his first ever sale.

“It was a very personal experience. I still wonder — who bought it? Where do they live? A part of me was launched into the world, and I will likely never see it again.”

The fact that UK has “officially” embraced the concept of the arts in healing through the Arts in HealthCare Program is a big deal to Dobbs, who feels the art displayed throughout the medical center enriches the experience for patients, their families, faculty and staff.

“I had a stroke patient few years ago whose family wheeled her around the hospital to look at the art,” Dr. Dobbs recalls. “It clearly calmed her, and she even told her friends that she was living in a museum.”

“Art in an otherwise institutional setting allows patients, family, faculty and staff to pause and take a breather from a stressful situation.”

Dobbs’ commitment to the Arts in HealthCare extends beyond mere admiration for the program. “I wanted to be a part of this awesome new enterprise, so I contacted Jacquie (Hamilton, director of the UK Arts in HealthCare Program) and offered to do an exhibition of my work,” he says. The proceeds from the sale of his art at the show, which is tentatively scheduled for the fall, will benefit the Arts in HealthCare program.

Dobbs believes that art informs his medical practice

Sunset With Hay Rolls

and vice-versa. “I like to paint loosely and without too many details,” he says. “As a neurologist, I know that the viewer’s brain will fill in the details subconsciously, and I believe that allows them to contribute a more personal interpretation — and perhaps a deeper meaning — to the art.”

This scientist/painter challenges the prevailing wisdom that science is concrete, while art is more fluid. He asserts that they are more similar than different.

“Science and art have undeniable parallels,” he says. “The interpretation of both depends on the viewer’s perspective.

Neither necessarily represents fundamental truth in nature.

Both science and art can be used to find truths, but both must be interpreted to achieve significance.”  Source: http://uknow.uky.edu/content/art-meets-scienceprofile-dr-michael-dobbs WWW.MEDMONTHLY.COM | 47

healthy living

HEAVENLY BLUEBERRY SMOOTHIE

By Ashley Acornley, MS, RD, LDN Even if they weren’t a well-known superfood, blueberries would still be on my top five favorite foods list of all time. Now in season, you can use fresh or frozen blueberries to make this flavorful, nutrient-dense, breakfast-or-power-snack smoothie anytime. The addition of bananas, honey, flax meal, and yogurt makes for a balanced and super-tasty treat with protein, fiber, heart healthy fats, and carbohydrates. Slurp it up!

Nutritional Facts: Makes 4 servings

Calories: 250 Fat: 2.6 g Cholesterol: 2 mg Sodium: 117 mg Carbohydrates: 50 g Fiber: 4 g Protein: 9.5 g

Preparation: Cut banana into small pieces and place into bowl

Ingredients:

(makes 2 cups) One frozen banana, thawed for 10-15 minutes ½ cup unsweetened vanilla soy milk 1 cup fat free vanilla yogurt 2/3 cup fresh or frozen blueberries 1 ½ tsp flax seed meal 1 ½ tsp honey 48 | JULY 2014

of blender. Add soy milk, yogurt, flax, and honey.

Blend on lowest speed until smooth, about 5 seconds. Gradually add the blueberries while continuing to blend on low. Once the blueberries have been incorporated, increase speed and blend to desired consistency.

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Arkansas P.O. Box 627 Helena, AR 72342 (870)572-2847

Massachusetts 239 Causeway St. Boston, MA 02114 (617)727-5339 http://1.usa.gov/zbJVt7

Rhode Island 3 Capitol Hill, Rm 104 Providence, RI 02908 (401)222-7883 http://sos.ri.gov/govdirectory/index.php? page=DetailDeptAgency&eid=260

California 2005 Evergreen St., Ste. 1200 Sacramento, CA 95815 (916)263-2382 www.medbd.ca.gov Colorado 1560 Broadway St. #1310 Denver, CO 80202 (303)894-7750 http://www.dora.state.co.us/optometry/ Connecticut 410 Capitol Ave., MS #12APP P.O. Box 340308 Hartford, CT 06134 (860)509-7603 ext. 4 http://www.dph.state.ct.us/ Florida 4052 Bald Cypress Way, Bin C08 Tallahassee, FL 32399 (850)245-4474 doh.state.fl.us Georgia 237 Coliseum Dr. Macon, GA 31217 (478)207-1671 www.sos.state.ga.us Hawaii P.O. Box 3469 Honolulu, HI 96801 (808)586-2704 optician@dcca.hawaii.gov

Nevada P.O. Box 70503 Reno, NV 89570 (775)853-1421 http://nvbdo.state.nv.us/ New Hampshire 129 Pleasant St. Concord, NH 03301 (603)271-5590 www.state.nh.us New Jersey P.O. Box 45011 Newark, NJ 07101 (973)504-6435 http://www.njconsumeraffairs.gov/ ophth/ New York 89 Washington Ave., 2nd Floor W. Albany, NY 12234 (518)402-5944 http://www.op.nysed.gov/prof/od/ North Carolina P.O. Box 25336 Raleigh, NC 27611 (919)733-9321 http://www.ncoptometry.org/ Ohio 77 S. High St. Columbus, OH 43266 (614)466-9707 http://optical.ohio.gov/

South Carolina P.O. Box 11329 Columbia, SC 29211 (803)896-4665 www.llr.state.sc.us Tennessee Heritage Place Metro Center 227 French Landing, Ste. 300 Nashville, TN 37243 (615)253-6061 http://health.state.tn.us/boards/do/ Texas P.O. Box 149347 Austin, TX 78714 (512)834-6661 www.roatx.org Vermont National Life Bldg N FL. 2 Montpelier, VT 05620 (802)828-2191 http://vtprofessionals.org/opr1/ opticians/ Virginia 3600 W. Broad St. Richmond, VA 23230 (804)367-8500 www.state.va.us/licenses Washington 300 SE Quince P.O. Box 47870 Olympia, WA 98504 (360)236-4947 http://www.doh.wa.gov/LicensesPermitsandCertificates/MedicalCommission. aspx

WWW.MEDMONTHLY.COM | 49

U.S. DENTAL BOARDS Alabama Alabama Board of Dental Examiners 5346 Stadium Trace Pkwy., Ste. 112 Hoover, AL 35244 (205) 985-7267 http://www.dentalboard.org/ Alaska P.O. Box 110806 Juneau, AK 99811-0806 (907)465-2542 http://bit.ly/uaqEO8 Arizona 4205 N. 7th Ave. Suite 300 Phoenix, AZ 85103 (602)242-1492 http://azdentalboard.us/ Arkansas 101 E. Capitol Ave., Suite 111 Little Rock, AR 72201 (501)682-2085 http://www.asbde.org/ California 2005 Evergreen Street, Suite 1550Â Sacramento, CA 95815 877-729-7789 http://www.dbc.ca.gov/ Colorado 1560 Broadway, Suite 1350 Denver, CO 80202 (303)894-7800 http://www.dora.state.co.us/dental/ Connecticut 410 Capitol Ave. Hartford, CT 06134 (860)509-8000 http://www.ct.gov/dph/site/default.asp Delaware Cannon Building, Suite 203 861 Solver Lake Blvd.

Dover, DE 19904 (302)744-4500 http://1.usa.gov/t0mbWZ Florida 4052 Bald Cypress Way Bin C-08 Tallahassee, FL 32399 (850)245-4474 http://bit.ly/w1m4MI 50

| JULY 2014

Georgia 237 Coliseum Drive Macon, GA 31217 (478)207-2440 http://sos.georgia.gov/plb/dentistry/ Hawaii DCCA-PVL Att: Dental P.O. Box 3469 Honolulu, HI 96801 (808)586-3000 http://1.usa.gov/s5Ry9i Idaho P.O. Box 83720 Boise, ID 83720 (208)334-2369 http://isbd.idaho.gov/ Illinois 320 W. Washington St. Springfield, IL 62786 (217)785-0820 http://bit.ly/svi6Od Indiana 402 W. Washington St., Room W072 Indianapolis, IN 46204 (317)232-2980 http://www.in.gov/pla/dental.htm Iowa 400 SW 8th St. Suite D Des Moines, IA 50309 (515)281-5157 http://www.state.ia.us/dentalboard/ Kansas 900 SW Jackson Room 564-S Topeka, KS 66612 (785)296-6400 http://www.accesskansas.org/kdb/ Kentucky 312 Whittington Parkway, Suite 101 Louisville, KY 40222 (502)429-7280 http://dentistry.ky.gov/ Louisiana 365 Canal St., Suite 2680 New Orleans, LA 70130 (504)568-8574 http://www.lsbd.org/

Maine 143 State House Station 161 Capitol St. Augusta, ME 04333 (207)287-3333 http://www.mainedental.org/ Maryland 55 Wade Ave. Catonsville, Maryland 21228 (410)402-8500 http://dhmh.state.md.us/dental/ Massachusetts 1000 Washington St., Suite 710 Boston, MA 02118 (617)727-1944 http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/ dentist/ Michigan P.O. Box 30664 Lansing, MI 48909 (517)241-2650 http://www.michigan.gov/lara/0,4601,7154-35299_28150_27529_27533---,00. html Minnesota 2829 University Ave., SE. Suite 450 Minneapolis, MN 55414 (612)617-2250 http://www.dentalboard.state.mn.us/ Mississippi 600 E. Amite St., Suite 100 Jackson, MS 39201 (601)944-9622 http://bit.ly/uuXKxl Missouri 3605 Missouri Blvd.

P.O. Box 1367 Jefferson City, MO 65102 (573)751-0040 http://pr.mo.gov/dental.asp Montana P.O. Box 200113 Helena, MT 59620 (406)444-2511 http://bsd.dli.mt.gov/license/bsd_ boards/den_board/board_page.asp

Nebraska 301 Centennial Mall South Lincoln, NE 68509 (402)471-3121 http://dhhs.ne.gov/publichealth/Pages/ crl_medical_dent_hygiene_board.aspx

Ohio Riffe Center 77 S. High St.,17th Floor Columbus, OH 43215 (614)466-2580 http://www.dental.ohio.gov/

Nevada 6010 S. Rainbow Blvd. Suite A-1 Las Vegas, NV 89118 (702)486-7044 http://www.nvdentalboard.nv.gov/

Oklahoma 201 N.E. 38th Terr., #2 Oklahoma City, OK 73105 (405)524-9037 http://www.dentist.state.ok.us/

New Hampshire 2 Industrial Park Dr. Concord, NH 03301 (603)271-4561 http://www.nh.gov/dental/

Oregon 1600 SW 4th Ave. Suite 770 Portland, OR 97201 (971)673-3200 http://www.oregon.gov/Dentistry/

New Jersey P.O Box 45005 Newark, NJ 07101 (973)504-6405 http://bit.ly/uO2tLg

Pennsylvania P.O. Box 2649 Harrisburg, PA 17105 (717)783-7162 http://bit.ly/s5oYiS

New Mexico Toney Anaya Building 2550 Cerrillos Rd. Santa Fe, NM 87505 (505)476-4680 http://www.rld.state.nm.us/boards/Dental_Health_Care.aspx

Rhode Island Dept. of Health Three Capitol Hill, Room 104 Providence, RI 02908 (401)222-2828 http://1.usa.gov/u66MaB

New York 89 Washington Ave. Albany, NY 12234 (518)474-3817 http://www.op.nysed.gov/prof/dent/

South Carolina P.O. Box 11329 Columbia, SC 29211 (803)896-4599 http://www.llr.state.sc.us/POL/Dentistry/

North Carolina 507 Airport Blvd., Suite 105 Morrisville, NC 27560 (919)678-8223 http://www.ncdentalboard.org/

South Dakota P.O. Box 1079 105. S. Euclid Ave. Suite C Pierre, SC 57501 (605)224-1282 https://www.sdboardofdentistry.com/

North Dakota P.O. Box 7246 Bismark, ND 58507 (701)258-8600 http://www.nddentalboard.org/

Tennessee 227 French Landing, Suite 300 Nashville, TN 37243 (615)532-3202 http://health.state.tn.us/boards/dentistry/

Texas 333 Guadeloupe St. Suite 3-800 Austin, TX 78701 (512)463-6400 http://www.tsbde.state.tx.us/ Utah 160 E. 300 South Salt Lake City, UT 84111 (801)530-6628 http://1.usa.gov/xMVXWm Vermont National Life Building North FL2 Montpelier, VT 05620 (802)828-1505 http://bit.ly/zSHgpa Virginia Perimeter Center 9960 Maryland Dr., Suite 300 Henrico, VA 23233 (804)367-4538 http://www.dhp.virginia.gov/dentistry Washington 310 Israel Rd. SE P.O. Box 47865 Olympia, WA 98504 (360)236-4700 http://www.doh.wa.gov/LicensesPermitsandCertificates/ProfessionsNewReneworUpdate/Dentist.aspx West Virginia 1319 Robert C. Byrd Dr. P.O. Box 1447 Crab Orchard, WV 25827 1-877-914-8266 http://www.wvdentalboard.org/ Wisconsin P.O. Box 8935 Madison, WI 53708 1(877)617-1565 http://dsps.wi.gov/Default. aspx?Page=90c5523f-bab0-4a45-ab943d9f699d4eb5 Wyoming 1800 Carey Ave., 4th Floor Cheyenne, WY 82002 (307)777-6529 http://plboards.state.wy.us/dental/index.asp WWW.MEDMONTHLY.COM | 51

U.S. MEDICAL BOARDS Alabama P.O. Box 946 Montgomery, AL 36101 (334)242-4116 http://www.albme.org/ Alaska 550 West 7th Ave., Suite 1500 Anchorage, AK 99501 (907)269-8163 http://bit.ly/zZ455T Arizona 9545 E. Doubletree Ranch Rd. Scottsdale, AZ 85258 (480)551-2700 http://www.azmd.gov Arkansas 1401 West Capitol Ave., Suite 340 Little Rock, AR 72201 (501)296-1802 http://www.armedicalboard.org/ California 2005 Evergreen St., Suite 1200 Sacramento, CA 95815 (916)263-2382 http://www.mbc.ca.gov/ Colorado 1560 Broadway, Suite 1350 Denver, CO 80202 (303)894-7690 http://www.dora.state.co.us/medical/ Connecticut 401 Capitol Ave. Hartford, CT 06134 (860)509-8000 http://www.ct.gov/dph/site/default.asp Delaware Division of Professional Regulation Cannon Building 861 Silver Lake Blvd., Suite 203 Dover, DE 19904 (302)744-4500 http://dpr.delaware.gov/ District of Columbia 899 North Capitol St., NE Washington, DC 20002 (202)442-5955 http://www.dchealth.dc.gov/doh 52 | JULY 2014

Florida 2585 Merchants Row Blvd.

Tallahassee, FL 32399 (850)245-4444 http://www.stateofflorida.com/Portal/ DesktopDefault.aspx?tabid=115

Louisiana LSBME P.O. Box 30250 New Orleans, LA 70190 (504)568-6820 http://www.lsbme.la.gov/

Georgia 2 Peachtree Street NW, 36th Floor Atlanta, GA 30303 (404)656-3913 http://bit.ly/vPJQyG

Maine 161 Capitol Street 137 State House Station Augusta, ME 04333 (207)287-3601 http://bit.ly/hnrzp

Hawaii DCCA-PVL P.O. Box 3469 Honolulu, HI 96801 (808)587-3295 http://hawaii.gov/dcca/pvl/boards/medical/

Maryland 4201 Patterson Ave. Baltimore, MD 21215 (410)764-4777 http://www.mbp.state.md.us/

Idaho Idaho Board of Medicine P.O. Box 83720 Boise, Idaho 83720 (208)327-7000 http://bit.ly/orPmFU

Massachusetts 200 Harvard Mill Sq., Suite 330 Wakefield, MA 01880 (781)876-8200 http://www.mass.gov/eohhs/gov/departments/borim/

Illinois 320 West Washington St. Springfield, IL 62786 (217)785 -0820 http://www.idfpr.com/profs/info/Physicians.asp

Michigan Bureau of Health Professions P.O. Box 30670 Lansing, MI 48909 (517)335-0918 http://www.michigan.gov/lara/0,4601,7154-35299_28150_27529_27541-58914-,00.html

Indiana 402 W. Washington St. #W072 Indianapolis, IN 46204 (317)233-0800 http://www.in.gov/pla/ Iowa 400 SW 8th St., Suite C Des Moines, IA 50309 (515)281-6641 http://medicalboard.iowa.gov/ Kansas 800 SW Jackson, Lower Level, Suite A Topeka, KS 66612 (785)296-7413 http://www.ksbha.org/ Kentucky 310 Whittington Pkwy., Suite 1B Louisville, KY 40222 (502)429-7150 http://kbml.ky.gov/default.htm

Minnesota University Park Plaza 2829 University Ave. SE, Suite 500 Minneapolis, MN 55414 (612)617-2130 http://bit.ly/pAFXGq Mississippi 1867 Crane Ridge Drive, Suite 200-B Jackson, MS 39216 (601)987-3079 http://www.msbml.state.ms.us/ Missouri Missouri Division of Professional Registration 3605 Missouri Blvd.

P.O. Box 1335 Jefferson City, MO 65102 (573)751-0293 http://pr.mo.gov/healingarts.asp

Montana 301 S. Park Ave. #430 Helena, MT 59601 (406)841-2300 http://bsd.dli.mt.gov/license/bsd_ boards/med_board/board_page.asp Nebraska Nebraska Department of Health and Human Services P.O. Box 95026 Lincoln, NE 68509 (402)471-3121 http://www.mdpreferredservices.com/ state-licensing-boards/nebraska-boardof-medicine-and-surgery Nevada Board of Medical Examiners P.O. Box 7238 Reno, NV 89510 (775)688-2559 http://www.medboard.nv.gov/ New Hampshire New Hampshire State Board of Medicine 2 Industrial Park Dr. #8 Concord, NH 03301 (603)271-1203 http://www.nh.gov/medicine/ New Jersey P. O. Box 360 Trenton, NJ 08625 (609)292-7837 http://bit.ly/w5rc8J New Mexico 2055 S. Pacheco St. Building 400 Santa Fe, NM 87505 (505)476-7220 http://www.nmmb.state.nm.us/ New York Office of the Professions State Education Building, 2nd Floor Albany, NY 12234 (518)474-3817 http://www.op.nysed.gov/ North Carolina P.O. Box 20007 Raleigh, NC 27619 (919)326-1100 http://www.ncmedboard.org/

North Dakota 418 E. Broadway Ave., Suite 12 Bismarck, ND 58501 (701)328-6500 http://www.ndbomex.com/

Texas P.O. Box 2018 Austin, TX 78768 (512)305-7010 http://bit.ly/rFyCEW

Ohio 30 E. Broad St., 3rd Floor Columbus, OH 43215 (614)466-3934 http://med.ohio.gov/

Utah P.O. Box 146741 Salt Lake City, UT 84114 (801)530-6628 http://www.dopl.utah.gov/

Oklahoma P.O. Box 18256 Oklahoma City, OK 73154 (405)962-1400 http://www.okmedicalboard.org/

Vermont P.O. Box 70 Burlington, VT 05402 (802)657-4220 http://1.usa.gov/wMdnxh

Oregon 1500 SW 1st Ave., Suite 620 Portland, OR 97201 (971)673-2700 http://www.oregon.gov/OMB/

Virginia Virginia Dept. of Health Professions Perimeter Center 9960 Maryland Dr., Suite 300 Henrico, VA 23233 (804)367-4400 http://1.usa.gov/xjfJXK

Pennsylvania P.O. Box 2649 Harrisburg, PA 17105 (717)787-8503 http://www.dos.state.pa.us/portal/server. pt/community/state_board_of_medicine/12512 Rhode Island 3 Capitol Hill Providence, RI 02908 (401)222-5960 http://1.usa.gov/xgocXV South Carolina P.O. Box 11289 Columbia, SC 29211 (803)896-4500 http://www.llr.state.sc.us/pol/medical/ South Dakota 101 N. Main Ave. Suite 301 Sioux Falls, SD 57104 (605)367-7781 http://www.sdbmoe.gov/ Tennessee 425 5th Ave. North Cordell Hull Bldg. 3rd Floor Nashville, TN 37243 (615)741-3111 http://health.state.tn.us/boards/me/

Washington Public Health Systems Development Washington State Department of Health 101 Israel Rd. SE, MS 47890 Tumwater, WA 98501 (360)236-4085 http://www.medlicense.com/washingtonmedicallicense.html West Virginia 101 Dee Dr., Suite 103 Charleston, WV 25311 (304)558-2921 http://www.wvbom.wv.gov/ Wisconsin P.O. Box 8935 Madison, WI 53708 (877)617-1565 http://drl.wi.gov/board_detail. asp?boardid=35&locid=0 Wyoming 320 W. 25th St., Suite 200 Cheyenne, WY 82002 (307)778-7053 http://wyomedboard.state.wy.us/

WWW.MEDMONTHLY.COM | 53

medical resource guide Urgent Care & Occupational Medicine Consultant

ACCOUNTING Boyle CPA, PLLC 3716 National Drive, Suite 206 Raleigh, NC 27612 (919) 720-4970 www.boyle-cpa.com

Lawrence Earl, MD COO/CMO ASAP Urgentcare Medical Director, NADME.org 908-635-4775 (m) 866-405-4770 (f ) http://www.asap-urgentcare.com/ UrgentCareMentor.com

EQUIPMENT APPRAISER Brumbaugh Appraisals 8601 Six Forks Road, Suite 400, Raleigh, NC 27615 (919) 870-8258 www.brumbaughappraisals.com

Utilization Solutions service@pushpa.biz (919) 289-9126

ADVERTISING

www.pushpa.biz

MedMedia9

PO Box 98313 Raleigh, NC 27624 (919)747-9031

DENTAL www.medmedia9.com

BILLING & COLLECTION

Biomet 3i

4555 Riverside Dr. Palm Beach Gardens, FL 33410 (800)342-5454 www.biomet3i.com

Dental Management Club Applied Medical Systems, Inc. Billing - Coding - Practice Solutions 4220 NC Hwy 55, Suite 130B Durham, NC 27713 (800) 334-6606 www.ams-nc.com

CODING SPECIALISTS Place Your Ad Here

CONSULTING SERVICES, PRACTICE MANAGEMENT Physician Wellness Services 5000 West 36th Street, Suite 240 Minneapolis, MN 55416 888.892.3861 www.physicianwellnessservices.com

Urgent Care America

17595 S. Tamiami Trail Fort Meyers, FL 33908 (239)415-3222 www.urgentcareamerica.net

54 | JULY 2014

EXECUTIVE ACCOUNTING & FINANCE RECRUITER Accounting Professionals Agency, LLC Adrienne Aldridge, CPA, CGMA, FLMI President 1204 Benoit Place Apex, NC 27502 (919) 924-4476 aaldridge@AccountingProfessioinals Agency.com

4924 Balboa Blvd #460 Encino, CA 91316 www.dentalmanagementclub.com

www.AccountingProfessionalsAgency.com

The Dental Box Company, Inc.

FINANCIAL CONSULTANTS

PO Box 101430 Pittsburgh, PA 15237 (412)364-8712 www.thedentalbox.com

DIETICIAN Triangle Nutrition Therapy 4030 Wake Forest Road, Suite 300 Raleigh, NC 27609 (919)876-9779 http://trianglediet.com/

ELECTRONIC MED. RECORDS

Sigmon Daknis Wealth Management 701 Town Center Dr. , Ste. #104 Newport News, VA 23606 (757)223-5902 www.sigmondaknis.com

INSURANCE, MED. LIABILITY Jones Insurance 820 Benson Rd. Garner, North Carolina 27529 (919) 772-0233 www.Jones-insurance.com

AdvancedMD 10011 S. Centennial Pkwy Sandy, UT 84070 (800) 825-0224 www.advancedmd.com

CollaborateMD 201 E. Pine St. #1310 Orlando, FL 32801 (888)348-8457 www.collaboratemd.com

LOCUM TENENS Physician Solutions

PO Box 98313 Raleigh, NC 27624 (919)845-0054 www.physiciansolutions.com

medical resource guide MEDICAL ARCHITECTS MMA Medical Architects

520 Sutter Street San Francisco, CA 94115 (415) 346-9990 http://www.mmamedarc.com

MEDICAL MARKETING

Bank of America

MedMedia9

PO Box 98313 Raleigh, NC 27624 (919)747-9031 www.medmedia9.com

WhiteCoat Designs

Web, Print & Marketing Solutions for Doctors (919)714-9885 www.whitecoat-designs.com

MEDICAL ART Deborah Brenner

877 Island Ave #315 San Diego, CA 92101 (619)818-4714 www.deborahbrenner.com

MedImagery

Laura Maaske 262-308-1300 Laura@medimagery.com http://www.medimagery.com

PRACTICE FINANCING

MEDICAL PRACTICE SALES Medical Practice Listings

8317 Six Forks Rd. Ste #205 Raleigh, NC 27624 (919)848-4202 www.medicalpracticelistings.com

Mark MacKinnon, Regional Sales Manager 3801 Columbine Circle Charlotte, NC 28211 (704)995-9193 mark.mackinnon@bankofamerica.com www.bankofamerica.com/practicesolutions

PROFESSIONAL SPEAKER Capri Health

Angela Savitri, OTR/L, RYT, IHC, RCST速 919-673-2813 angela@caprihealth.com www.freedomfromchronicstress.com

REAL ESTATE York Properties, Inc.

MEDICAL EQUIPMENT Assured Pharmaceuticals Matthew Hall (704)419-3005 mhall@assuredpharma.com

MEDICAL PRACTICE VALUATIONS

Commercial Sales & Leasing (919) 821-7177 www.yorkproperties.com

BizScore

PO Box 99488 Raleigh, NC 27624 (919)846-4747

www.assurepharma.com

STAFFING COMPANIES

www.bizscorevaluation.com

Additional Staffing Group, Inc.

Tarheel Physicians Supply 1934 Colwell Ave. Wilmington, NC 28403 (800)672-0441

MEDICAL PUBLISHING www.thetps.com

MEDICAL EQUIPMENT FINANCING Bank of America

Mark MacKinnon, Regional Sales Manager 3801 Columbine Circle Charlotte, NC 28211 (704)995-9193 mark.mackinnon@bankofamerica.com www.bankofamerica.com/practicesolutions

Headquarters & Property Management 1900 Cameron Street Raleigh, NC 27605 (919) 821-1350

MedMedia9

PO Box 98313 Raleigh, NC 27624 (919)747-9031

8319 Six Forks Rd, Suite 103 Raleigh, NC 27615 (919) 844-6601 Astaffinggroup.com

SUPPLIES, GENERAL www.medmedia9.com

MEDICAL RESEARCH

CNF Medical 1100 Patterson Avenue Winston Salem, NC 27101 (877)631-3077 www.cnfmedical.com

WEBSITE DESIGN

Scynexis, Inc.

3501 C Tricenter Blvd.

Durham, NC 27713 (919) 933-4990

MedMedia9 www.scynexis.com

PO Box 98313 Raleigh, NC 27624 (919)747-9031 www.medmedia9.com WWW.MEDMONTHLY.COM | 55

classified listings

Classified To place a classified ad, call 919.747.9031

Physicians needed North Carolina GP Needed Immediately On-Going 3 Days Per Week at Occupational Clinic . General Practictioner needed on-going 3 days per week at occupational clinic in Greensboro, NC. Numerous available shifts for October.

Averages 25 patients per day with no call and shift hours from 8:30 am to 5:30 pm. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com 3-5 days per week in Durham, NC . Geriatric physician needed immediately 3-5 days per week, on-going at nursing home in Durham. Nursing home focuses on therapy and nursing after patients are released from the hospital. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com GP Needed Immediately On-Going 1-3 Days Per Week at Addictive Disease Clinics located in Charlotte, Hickory, Concord & Marion North Carolina. General Practitioner with a knowledge or interest in addictive disease. Needed in October on-going 1-3 times per week. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Primary Care Physician in Northwest NC (multiple locations). Primary care physician needed immediately for ongoing coverage at one of the largest substance abuse treatment facilities in NC. Doctor will be responsible for new patient evaluations and supportive aftercare. Counseling and therapy are combined with physician’s medical assessment and care for the treatment of adults, adolescents and families. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Pediatrician or Family Medicine Doctor in Fayetteville Comfortable with seeing children. Need is immediate - Full time ongoing for maternity leave. 8 am - 5 pm.

Outpatient only. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com

56 | JULY 2014

Immediate need for full time GP/FP for urgent cares in eastern NC. Urgent care centers from Raleigh to the eastern coast of NC seek immediate primary care physician. Full time opportunity with possibility for permanent placement. Physician Solutions, PH: (919) 845-0054, email: physiciansolutions@gmail.com General Practitioner Needed in Greensboro. Occupational health care clinic seeks general practitioner for disability physicals ongoing 1-3 days a week. Adults only. 8 am-5 pm. No call required. Please contact Physician Solutions at 919-845-0054 or email us at physiciansolutions@gmail.com.

Pediatrician or Family Physician Needed Immediately at clinic in Roanoke Rapids, NC. Pediatric clinic in Roanoke Rapids, NC seeks Peds physician or FP comfortable with children for 2-3 months/on-going/full-time.

The chosen physician will need to be credentialed through the hospital, please email your CV, medical license and DEA so we can fill this position immediately. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Occupational Clinic in Greensboro, NC seeks FP/GP for On-Going Shifts. Locum tenens position (4-5 days a week) available for an occupational, urgent care and walk in clinic. The practice is located in Greensboro NC. Hours are 8 am-5 pm. Approximately 20 patients/ day. Excellent staff. Outpatient only. physiciansolutions@gmail.com Diabetic Clinic 1 hour from Charlotte seeks FP/GP/ IM for On-Going Shifts.Primary care physician needed immediately for outpatient diabetic clinic one hour outside Charlotte, NC On-going. Hours are 8 am -5 pm with no call. Approximately 15-20 patients a day. Call or email for more information. 919-845-0054 physiciansolutions@gmail.com Clinic between Fayetteville and Wilmington seeks FP/ GP/IM Mar 22 FT ongoing. A small hospital’s outpatient clinic located within an hour of both Fayetteville and Wilmington seeks PA to work FT ongoing beginning March 22. Shifts can be either 8 or 12 hours. No call. email: physiciansolutions@gmail.com

Classified To place a classified ad, call 919.747.9031

Physicians needed North Carolina (cont.)

Addictive Disease Clinic in Charlotte, NC and surrounding cities seeks GP/FP/IM for on-going shifts An addictive disease clinic with locations with locations in Charlotte, NC and surrounding cities seeks a GP with an interest in addictive medicine for on-going shifts. This clinic has 15-25 open shifts every month and we are looking to bring on a new doctor for consistent coverage. The average daily patient load is between 20 and 25 with shifts from 8 am - 5 pm and 6 am - 2 pm. If you are interested in this position please send us your CV and feel free to contact us via email or phone with questions or to learn about other positions.

Physician Solutions, PH: (919) 845-0054, email: physiciansolutions@gmail.com

Greensboro occupational health care clinic seeksgeneral practitioner for intermittent shifts. Primary care physicians needed for occupational medicine. Adults only. Hours are 8am-5pm. Large corporation, no call required. Please contact Physician Solutions at 919-8450054 or email: physiciansolutions@gmail.com.

IM/FP needed in Fayetteville clinic immediately. Fayetteville health department needs coverage March through June full or part time. Patients adult health and women’s health. Adults only. No call 8a-5p.

Please contact Physician Solutions at 919-845-0054 or email: physiciansolutions@gmail.com.

Geriatric physician needed immediately 2 to 5 days per week, on-going eastern NC. Nursing homes in Durham, Fayetteville and Rocky Mount seek GP/IM/ FP with geriatric experience to work full or part time.

Nursing home focuses on therapy and nursing after patients are released from the hospital. 8a-5p, no call.

Please contact Physician Solutions at 919-845-0054 or email: physiciansolutions@gmail.com.

Child Health Clinic in Statesville, NC seeks pediatrician or Family Physician comfortable with peds for on-going, full-time shifts. Physician will work M-F 8 am - 5 pm, ongoing. Qualified physician will know EMR or Allscripts software. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com

Nursing home in Durham seeks PT/FT NP/PA for immediate ongoing scheduling. Durham nursing home seeks part time or full time mid-level for ongoing locums.

Must have geriatric experience. 8-5p. Other facilities in Fayetteville and Rocky Mount. Please contact Physician Solutions at 919-845-0054 or email us at physiciansolutions@gmail.com.

Peds Clinic near Raleigh seeks Mid-Level Provider for on-going coverage 4x/wk. Health Department pediatrics clinic 45 min from Raleigh needs coverage 4 days a week from January through June. Provider will see about 20 patients daily, hours are 8am-5pm with an hour for lunch. Please contact Physician Solutions at 919-8450054 or email: physiciansolutions@gmail.com.

Fayetteville occupational health care clinic seeks GP for May. Primary care physicians needed for occupational medicine. Adults only. 8-5p. Large corporation, no call required. Intermittent dates in the future and second office in Greensboro with ongoing scheduling.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Employee Health Clinic seeks Mid-Level Provider for FT on-going coverage near Charlotte. Practice 45 minutes from Charlotte seeks on-going coverage for employee health clinic beginning in March. Provider will see about 20-24 patients daily, hours are 8am-5pm with an hour for lunch. Please contact Physician Solutions at 919-845-0054 or email us at physiciansolutions@gmail.com.

Nursing home in Durham seeks PT/FT Geriatrics doctor for immediate ongoing scheduling. Durham nursing home seeks part time or full time MD for ongoing locums. Must have geriatric experience. 8-5p. Other facilities in Fayetteville and Rocky Mount. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

FT/PT Mid-Level Provider needed for Wilmington practice immediately. Small internal medicine private practice 45 minutes outside Wilmington seeks mid-level provider starting immediately. FT/PT. M-F 8:00-5:00.

Possible permanent placement. Please contact Physician Solutions at 919-845-0054 or email us at physiciansolutions@gmail.com.

Family Practice 1 h SE of Raleigh seeks coverage.

Goldsboro FP seeks MD for July 6-7 and intermittent shifts. 8-5p. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com. continued on page 59 WWW.MEDMONTHLY.COM | 57

PRIMARY CARE PRACTICE - Hickory, North Carolina This is an outstanding opportunity to acquire one of the most organized and profitable primary care practices in the area. Grossing a million and a half yearly, the principal physician enjoys ordinary practice income of over $300,000 annually.

Hickory is located in the foot-hills of North Carolina and is surrounded by picturesque mountains, lakes, upscale shopping malls and the school systems are excellent. If you are looking for an established practice that runs like a well oiled machine, request more information.

The free standing building that houses this practice is available to purchase or rent with an option. There are 4 exam rooms with a well appointed procedure room. The owning physician works 4 to 5 days per week and there is a full time physician assistant staffed as well.

For the well qualified purchasing physician, the owner may consider some owner-financing. Call us today.

List price: $425,000 | Year Established: 2007 | Gross Yearly Income: $1,500,000

Medical Practice Listings Selling and buying made easy

MedicalPracticeListings.com | medlisting@gmail.com | 919-848-4202

CALLING ALL WRITERS

Are you educated in the medical and health care field and looking to showcase your exceptional writing skills?

To become a contributing writer in Med Monthly magazine, contact MedMedia9 at medmedia9@gmail.com

OR FAMILY MEDICINE DOCTOR NEEDED IN

ROANOKE RAPIDS, NC In mid December, a pediatrician or family medicine doctor comfortable with seeing children is needed full time in Roanoke Rapids (1 hour north of Raleigh, NC) until a permanent doctor can be found.

Credentialing at the hospital is necessary.

Med Monthly

Editorial Calendar: Aug. - Concierge Medicine 58 | JULY 2014

PEDIATRICIAN

Contact us:

919.747.9031 medmedia9@gmail.com medmonthly.com l

Sept. - Medical Billing Options

Call 919- 845-0054 or email: physiciansolutions@gmail.com www.physiciansolutions.com

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Physicians needed North Carolina (cont.)

Pediatric clinic near Greensboro needs 10 weeks of 3 day a week coverage beginning June 1. Burlington pediatric clinic seeks coverage June 1 3 days a week for 10 weeks. 8-5p. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Greenville Clinic seeks GP. GP/IM needed for intermittent shifts. Must have experience or be willing to do pain management and trigger point injections. 8-5p.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Raleigh practice seeks BC FP for permanent placement in new facility summer 2013. Board Certified Family Practitioner sought for FT permanent placement in new clinic in Raleigh to start summer of 2013.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Clinic between Fayetteville and Wilmington seeks FP/ GP/IM Mar 22 FT ongoing . A small hospital’s outpatient clinic located within an hour of both Fayetteville and Wilmington seeks PA to work FT ongoing beginning March 22. Shifts can be either 8 or 12 hours. No call. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Western North Carolina Clinic needs continuing physician coverage. Clinic seeks coverage for their walk in clinic which sees all ages. Ongoing, 8am-5pm, no call.

35-40 patients a day. Well established clinic located in a beautiful area. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

IM/FP/Peds opportunity in Fayetteville clinic immediately. Fayetteville clinic needs immediate coverage for the following clinics: adult health, women’s health and STD. No call 8a-5p.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Pediatrician Needed MD June-Aug, Burlington NC 3x week for 10 wks starting June 1st, 8-5 Mon-Fri Burlington, NC: located 1 hour west of Raleigh. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Pediatrician, IM & FP needed, Fayetteville NC Urgent Need for immediate MDs - Pediatrics, Family Practice or Internal Medicine - PT/FT, 8-5 Mon-Fri. Ongoing. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Locum & Permanent MD Needed , Kinston NC Urgent Need for immediate MD placement, 8-5 MonFri. Must be able to do family planning & light maternity, Kinston, NC: 1.5 hours outside Raleigh. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

PT MD needed for Occupational practice, Greensboro NC. Urgent need for PT MD to do disability physicals 2-3 days weekly, 8-5, on-going scheduling.

Greensboro, NC. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Permanent PA or MD needed in Goldsboro, NC On-going permanent position Mon- Fri 8-5, Goldsboro, NC: 1 hour 10 minutes outside Raleigh. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Family Practice MD needed 2-3x/week, Goldsboro intermittent dates, 8-5p,Goldsboro, NC 1h SE of Raleigh. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

FULL TIME MD needed for Family Practice in Washington, N.C. Family Practitioner needed for FT MD June 15-Sept 1 on-going Mon- Fri 8-5, Washington, NC, 1 hour 45 minutes outside Raleigh. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Geriatric Experienced Mid Level or MD, Durham NC Must have geriatric experience, PT/FT, Locations in Durham, Rocky Mount & Fayetteville, NC. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Family Practitioner opportunity available one hour east of Charlotte Monday through Friday. The hours will be 8:00am until 5:00pm either full time or part time.

You will be seeing 15-20 new patients a day. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

continued on page 60 WWW.MEDMONTHLY.COM | 59

classified listings

Classified

continued from page 59

To place a classified ad, call 919.747.9031

Physicians needed North Carolina (cont.)

Immediate opportunity for a Primary Care Physician at a large practice located one hour south of Raleigh. The hours are from 8:00am until 5:00pm You will be treating generally 20-25 patients per day. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Family MD opportunity at an Urgent Care facility that sees all ages in the Jacksonville, NC area. This will be an ongoing schedule from 8:00am until 6:00pm 1-2 days a week, including weekend dates. You will treating generally 30-35 patients a day. There is potential for permanent placement. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Primary care physician opportunity for busy occupational medicine practices near Greensboro/Fayetteville, NC. There are two locations with positions available within 15 minutes of Greensboro and Fayettteville. Your schedule will be from 8:00am until 5:00 pm either full time or part time, no call necessary. Patient treatment will consist of adults only in both facilities. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Exceptional Family Physician opportunity at a practice in the Raleigh, NC area. Schedule will be ongoing Monday through Friday from 8:00am until 5:00pm. Must be comfortable with treating all ages. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Immediate Pediatrician opportunity at a small outpatient hospital. Located between Fayetteville and Wilmington, this facility requires someone for intermittent shifts. Please contact Physician Solutions at 919845-0054 or email physiciansolutions@gmail.com.

continued on page 62

MD STAFFING AGENCY FOR SALE IN NORTH CAROLINA The perfect opportunity for anyone who wants to purchase an established business.

Family Physician opportunity for a leading medical practice in the Raleigh area. Must be able to start immediately and be comfortable with seeing all ages.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Primary Care Physician opportunity for a leading women’s practice in the Lenoir, NC area. Treating Physician must be comfortable with light OB and well women’s exams. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

General Practitioner/Internal Medicine Physician opportunity for intermittent shifts at a prominent practice in the Greenville, NC area. Treament schedule will be from 8:00am until 5:00pm. The practicing physician must have experience or be willing to perform pain management and trigger point injections. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

60 | JULY 2014

l One

of the oldest Locums companies client list l Dozens of MDs under contract l Executive office setting l Modern computers and equipment l Revenue over a million per year l Retiring owner l Large

Please direct all correspondence to driverphilip@gmail.com.

Only serious, qualified inquirers.

NC OPPORTUNITIES

Woman’s Practice in Raleigh, North Carolina.

LOCUMS OR PERMANENT

Physician Solutions has immediate opportunities for psychiatrists throughout NC. Top wages, professional liability insurance and accommodations provided.

Call us today if you are available for a few days a month, on-going or for permanent placement.

Please contact Physican Solutions at 919-845-0054 or physiciansolutions@gmail.com For more information about Physician Solutions or to see all of our locums and permanent listings, please visit physiciansolutions.com

We have a established woman’s practice in the Raleigh North Carolina area that is available for purchase. Grossing a consistent $800,000.00 per year, the retained earnings are impressive to say the least. This is a two provider practice that see patients Monday through Friday from 8 till 6. This free standing practice is very visible and located in the heart of medical community. There are 7 well appointed exam rooms, recently upgraded computer (EMR), the carpet and paint have always been maintained. The all brick building can be leased or purchased.

Contact Cara or Philip for details regarding this very successful practice.

Medical Practice Listings; 919-848-4202

PHYSICIANS NEEDED: Mental health facility in Eastern North Carolina seeks: PA/FT ongoing, start immediately Physician Assistant needed to work with physicians to provide primary care for resident patients. FT ongoing 8a-5p. Limited inpatient call is required. The position is responsible for performing history and physicals of patients on admission, annual physicals, dictate discharge summaries, sick call on unit assigned, suture minor lacerations, prescribe medications and order lab work. Works 8 hour shifts Monday through Friday with some extended work on rotating basis required. It is a 24 hour in-patient facility that serves adolescent, adult and geriatric patients.

FT ongoing Medical Director, start immediately The Director of Medical Services is responsible for ensuring all patients receive quality medical care. The director supervises medical physicians and physician extenders. The Director of Medical Services also provides guidance to the following service areas: Dental Clinic, X-Ray Department, Laboratory Services, Infection Control, Speech/Language Services, Employee Health,

Pharmacy Department, Physical Therapy and Telemedicine. The Medical Director reports directly to the Clinical Director. The position will manage and participate in direct patient care as required; maintain and participate in an on-call schedule ensuring that a physician is always available to hospitalized patients; and maintain privileges of medical staff.

Permanent Psychiatrist needed FT, start immediately An accredited State Psychiatric Hospital serving the eastern region of North Carolina, is recruiting for permanent full-time Psychiatrist. The 24 hour in-patient facility serves adolescent, adult and geriatric patients. The psychiatrist will serve as a team leader for multi-disciplinary team to ensure quality patient care/treatment. Responsibilities include:

evaluation of patient on admission and development of a comprehensive treatment plan, serve on medical staff committees, complete court papers, documentation of patient progress in medical record, education of patients/families, provision of educational groups for patients.

Send copies of your CV, NC medical license, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624 PH: (919) 845-0054 | email: physiciansolutions@gmail.com WWW.MEDMONTHLY.COM | 61

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To place a classified ad, call 919.747.9031

Physicians needed North Carolina (cont.)

Pediatrics Opportunity - Roanoke Rapids Area Northeastern North Carolina Pediatric Practice seeks on-going physician for full time coverage beginning mid-October through the end of the year. Practice sees about 16-25 patients a day, hours are 8:00-5:00 with negotiable call. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Primary Care Physician - Washington area Seeking a physician for a general primary care practice.

Treatment will include seeing 3-4 pediatric and about 10 adult patients per day. The hours are 8:00- 5:00pm M-F. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Family Physician –Williamston area Immediate opportunity at a developing family practice in the Williamston area. You will be treating 8-16 patients per day from 8:00-5:00 pm. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

MD Suboxone Duties Suboxone is a prescription medicine used for the maintence treatment of oproid dependence. Duties include opioid dependence recovery, rehabilitation, substance abuse and general Internal medicine. We have 4 practices to support with 3 to 5 day coverage. This means you have choices in the city you wish to practice. Slow to moderate patient pace with an exceptional staff and facility. Please contact Physician Solutions at; (919) 8450054 or Email; physiciansolutions@gmail.com Family Practice located in Winston Salem has an opening for a Family Practice MD. The hours are from 8 till 6 Monday through Friday with NO call duties. You will average seeing a dozen patients per day with a small experienced staff. This position starts in March and will last through the summer of 2014. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Family Practice Opportunity, treating patients of all ages, looking for a FP or well informed Pediatric MD to work a full schedule Monday through Friday in Raleigh NC. This job is available immediately and is on-going contracted assignment. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@ gmail.com 62 | JULY 2014

Methadone Treatment facility in the Western part of North Carolina has an immediate opening for a dependable MD. This is a highly regulated facility and the nursing staff performs most of the routine duties. The physicians that currently work in this environment really enjoy the work environment. We are accepting applications for this position and we will consider 3 to 5 shifts per weekly. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Physician Assistant to work primary care settings in North Carolina. We have 5 or 6 primary care practices that are looking for permanent or locum to perm PA’s.

Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Fayetteville area practice on-going physician for full time coverage. Practice sees about 16-25 patients a day, hours are 8:00-5:00 with negotiable call. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Pediatrician needed for permanent placement at Fayetteville area practice. Board Certified or Board Eligible. Practice sees about 16-25 patients a day, hours are 8:00-5:00 with negotiable call. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Winston Salem clinic seeks PA for FT ongoing locums position immediately. Average daily patient load is 25.

Primary care services as well as some pain management. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Chiropractic Clinic seeks mid-level provider in Greenville, NC for Monday and Tuesdays shifts beginning in April. No call required, 8-5. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Cardiology practice has immediate opportunity for full time mid-level or physician in Fayetteville area to provide primary care assistance for the practice. The position has the potential for permanent placement. No call required, 8-5 M-F. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com

continued on page 65

Eastern North Carolina Family Practice Available Well-appointed Eastern North Carolina Family Practice established in 2000 is for sale in Williamston, NC. This organized practice boasts a wide array of diagnostic equipment including a GE DEXA scanner with a new tube, GE case 8000 stress testing treadmill and controller and back up treadmill, Autoclave and full set of operating equipment, EKG-Ez EKG and much more.

The average number of patients seen daily is between 12 to 22.

The building is owned by MD and can be purchased or leased.

The owning physician is retiring and will assist as needed during the transition period. The gross receipts for the past three years are $650,000 and the list price was just reduced to $240,000.

If you are looking to purchase a well equipped primary care practice, please contact us today.

Contact: Cara or Philip at 919-848-4202

medlisting@gmail.com medicalpracticelistings.com

Modern Med Spa Available

Located in beautiful coastal North Carolina Modern, well-appointed med spa is available in the eastern part of the state. This Spa specializes in BOTOX, facial therapy and treatments, laser hair removal, eye lash extensions and body waxing as well as a menu of anti-aging options. This impressive practice is perfect as-is and can accommodate additional services like; primary health or dermatology.

The Gross revenue is over $1,500.000 during 2012 with consistent high revenue numbers for the past several years. The average number of patients seen daily is between 26 and 32 with room for improvement. You will find this Med Spa to be in a highly visible location with upscale amenities. The building is leased and the lease can be assigned or restructured. Highly profitable and organized, this spa POISED FOR SUCCESS. 919.848.4202 medlisting@gmail.com medicalpracticelistings.com WWW.MEDMONTHLY.COM | 63

What’s your practice worth?

When most doctors are asked what their practice is worth, the answer is usually, “I don’t know.”

Doctors can tell you what their practices made or lost last year, but few actually know what it’s worth.

In today’s world, expenses are rising and profits are being squeezed. A BizScore Performance Review will provide details regarding liquidity, profits & profit margins, sales, borrowing and assets.

Our three signature sections include:  Performance review  Valuation  Projections

Scan this QR code with your smart phone to learn more.

919.846.4747 bizscorevaluation.com

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Physicians needed North Carolina (cont.)

North Charlotte area practice has immediate opportunity for mid-level provider. Position is 2-3 days per week (flexible) beginning in March 2014. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Clinic seeks PA immediately 3 days per week ongoing in Rocky Mount. Small clinic in Rocky Mount seeks 2-3 days coverage a week immediately. Few peds, 8-5pm M-F days flexible. Temp to perm. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Occupational Therapist (OT) - 3 positions available in Eastern, NC. We have opportunities for 3 on-going Occupational Therapists. These positions are 40 hour per week temp status to permanent positions. Contact Ashley or Cara at; physiciansolutions@gmail.com or PH: (919) 845-0054 for more details.

Immediate opportunity for a Family or Internal Medicine MD to practice 3 to 5 days per week in Charlotte.

Light patient volume along with top wage make this a very attractive position. If you have 3 to 5 hour shifts you can work from Monday through Friday, we would like to discuss this upscale practice opportunity.

Contact Ashley or Cara; (919) 845-0054 or Email us at physiciansolutions@gmail.com Primary care practice in North Raleigh has an immediate opening for a well rounded Medical Doctor in Raleigh, NC. 3 to 5 days per week seeing 16 to 22 patients between the hours of 8-5. This is an on-going opportunity with some flexibility as there are two other providers as co-workers. Outpatient with no hospital duties makes this a very desirable locum’s job. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Family practice in Wake Forest, NC seeks 2 to 3 shifts per week from a Board Certified FP. There is one doctor and 2 PA’s already practicing here and the growth requires another provider. No call, no hospital and great colleagues and facility. Contact Ashley or Cara at; physiciansolutions@gmail.com or PH: (919) 845-0054 for more details.

Addictive medicine practice would like FP or IM physician to see 8 to 15 patients per day in Charlotte, NC. This position requires a solid level of Administrative writing skills for outlining patient protocol. The ideal doctor will have 2 to 4 shifts per week. Providers with Suboxone credentials can start within days. If you would like to obtain Suboxone certification, the process time is one to two weeks (on-line course). Call (919) 845-0054 or Email us at physiciansolutions@gmail.com Wilson, NC Urgent care treating 25 to 35 patients per day has an opportunity for a well qualified MD. The shifts are 10 hour days during the week and 6 to 8 hour shifts on the weekend. This allows you to work 3 to 4 days per week comfortably. You must be comfortable seeing children to geriatrics and basic suturing skills are required. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com Walk-in primary care practice in Wilmington, NC would like to add 1 to 3 shifts per week for a primary care doctor. Heavy population of female patients and young adults are seen between 8 and 5 M-F. This is an ongoing locum opportunity. Contact Ashley or Cara; (919) 845-0054 or Email us at physiciansolutions@gmail.com On-going contract with an Assistive Living and Nursing Home organization in Raleigh, Durham, Greensboro, Charlotte, Wilmington, High Point, Greenville, Wilson, Asheboro, Rocky Mount, Asheville and Hillsboro. The mentioned cities are the major cities we need Geriatric MD’s to see patients. 6 to 8 doctors are required as this a long term locum opportunity. You will be paid hourly (no commissions or fee splits) plus mileage and lodging when necessary. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com PA opportunity in Raleigh, NC for long term locum opportunity. This large primary care practice would like to add one, possible two physician assistants. If you can provide 3 to 5 shifts per week, we would like to introduce you to this up-scale practice. No call, no hospital and no pain management. This job starts May and is on-going. Call (919) 845-0054 or Email us at physiciansolutions@gmail.com

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classified listings

Classified

continued from page 65

To place a classified ad, call 919.747.9031

Physicians needed North Carolina (cont.)

Asheville, NC needs long term PA opportunity in this beautiful mountain city. This is a 40 hours per week on-going positions that can develop into permanent.

No call or hospital. This is a locum assignment for the serious PA to work with 3 MD’s and several other PA’s.

Primary care medicine at its best in this modern facility.

Contact Ashley or Cara; (919) 845-0054 or Email us at physiciansolutions@gmail.com Charlotte area pediatric practice seeks on-going mid-level for immediate coverage, 1-2 shifts per week.

Hours are 8:00-5:00 with no call. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com Vascular Surgeon needed for multi-practice specialty group located in Greensboro area to cover weekend shifts. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Family practice with Sports Medicine focus in Greensboro, NC seeks physician assistant, practice sees all ages. Must be familiar with electronic records. Practice sees 20-25 patients a day, hours are 8:00-5:00. Contact Ashley or Cara; (919) 845-0054 or Email us at physiciansolutions@gmail.com Family practice with busy allergy clinic in Rocky Mount, NC seeks full time physician assistant to join their practice. Clinic hours 8-5 with no call. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com Immediate opportunity for Physician Assistant with Fayetteville area family practice and Heart clinic. Practice is conveniently located with excellent support staff. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Immediate opportunity for Geriatrics or Family Physician with statewide practice. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Urgent Care with busy Occupational Medicine practice in Greensboro, NC seeks Internal Medicine Physician with North Carolina DOT Certification for intermittent shifts. All shifts are 8-5, with no call. Contact Ashley or Cara; (919) 845-0054 or Email us at physiciansolutions@gmail.com 66 | JULY 2014

Urgent Care in Fayetteville, NC with busy Occupational Medicine practice seeks Internal Medicine Physician with North Carolina DOT Certification for intermittent shifts. All shifts are 8-5, with no call. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Pediatrician needed for practice one hour north of Raleigh, NC Mondays and Wednesdays on going. All shifts are 8-5 with no call. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com Family Physician needed to see all ages in Eastern North Carolina clinic. Flexible dates, and on-going opportunities available. Contact Ashley or Cara; (919) 845-0054 or Email us at physiciansolutions@gmail.com Urgent Care in Greensboro, NC with busy Occupational Medicine practice seeks Physician Assistant with North Carolina DOT Certification for intermittent shifts. All shifts are 8-5, with no call. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com Urgent Care with busy Occupational Medicine practice in Fayetteville, NC seeks Physician Assistant with North Carolina DOT Certification for intermittent shifts. All shifts are 8-5, with no call. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Multi-speciality practice seeks family physician to cover shifts from July 11-Sept 5 (3-5 days/week) in Carolina Beach. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com Family practice in Holly Springs seeks physician to cover intermittent shifts throughout the summer. Hours are 8-4p, practice sees 10-15 patients per day. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Primary care practice in North Raleigh has an immediate opening for a well rounded Medical Doctor. 3 to 5 days per week seeing 16 to 22 patients between the hours of 8-5. This is an on-going opportunity with some flexibility as there are two other providers. Outpatient with no hospital duties makes this a very desirable locum’s job. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com Family Medicine Physicians needed for Fayetteville primary care clinic, physician will see all ages. Hours are 8-5 with no call. Contact Ashley or Cara; (919) 845-0054 or Email us at physiciansolutions@gmail.com

Classified To place a classified ad, call 919.747.9031

Physicians needed North Carolina (cont.)

Urgent Care with busy Occupational Medicine practice seeks Internal Medicine Physician with North Carolina DOT Certification for intermittent shifts. All shifts are 8-5, with no call. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com Addictive medicine practice would like FP or IM physician to see 8 to 15 patients per day. This position requires a solid level of Administrative writing skills for outlining patient protocol. The ideal doctor will have 2 to 4 shifts per week. Providers with Suboxone credentials can start within days. If you would like to obtain Suboxone certification, the process time is one to two weeks (on-line course). Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com

Physicians needed South Carolina A family and urgent care in Little River, SC seeks an FP/EM physician for 1 to 2 days per week, on-going shifts. The practice is a one-physician facility and is looking for a physician to come in regularly. The practice is small and does not have a large patient load.

The qualified physician will have experience in Family or Emergency medicine. If you have any availability and a SC medical license contact us today and we will do our best to work around your schedule. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com

Physicians needed Virginia Pediatric Locums Physician needed in Harrisonburg, Danville and Lynchburg, VA. These locum positions require 30 to 40 hours per week, on-going. If you are seeking a beautiful climate and flexibility with your schedule, please consider one of these opportunities. Send copies of your CV, VA. medical license, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, email: physiciansolutions@gmail.com

Urgent Care opportunities throughout Virginia. We have contracts with numerous facilities and eight to 14-hour shifts are available. If you have experience treating patients from pediatrics to geriatrics, we welcome your inquires. Send copies of your CV, VA medical license, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, E-mail: physiciansolutions@gmail.com Virginia practice outside of Washington DC seeks IM doctor FT/PT now – June 1. IM physician needed immediately FT/PT for Virginia clinic near Washington DC. 8-5p Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Nurse Practitioners needed North Carolina Permanent NP needed in Goldsboro, NC On-going permanent position Mon- Fri 8-5 Goldsboro, NC: 1hour 10 minutes outside Raleigh.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Charlotte Occupational clinic seeks NP in March for ongoing coverage. Nurse practitioner needed in employee health clinic for large corporation in Charlotte.

8a-5p ongoing full time or part time. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Permanent NP needed in Goldsboro, NC On-going permanent position Mon- Fri 8-5 Goldsboro, NC: 1hour 10 minutes outside Raleigh.

Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

Charlotte Occupational clinic seeks NP in March for ongoing coverage. Nurse practitioner needed in employee health clinic for large corporation in Charlotte.

8a-5p ongoing full time or part time. Please contact Physician Solutions at 919-845-0054 or email physiciansolutions@gmail.com.

continued on page 68 WWW.MEDMONTHLY.COM | 67

classified listings

Classified

continued from page 67

To place a classified ad, call 919.747.9031

Medical Marketing & Sales needed North Carolina Accounts Manager; Physician Solutions has an immediate opportunity for a professional to work from our North Raleigh corporate offices. Duties include; calling on developed practice accounts while developing new accounts. Recruiting physicians and overseeing all marketing and sales duties. Please contact Physician Solutions at; (919) 845-0054 or Email; physiciansolutions@gmail.com

Wanted: Urgent Care Practice Urgent care practice wanted in North Carolina.

Qualified physician is seeking to purchase an established urgent care within 100 miles of Raleigh, North Carolina.

If you are considering retiring, relocations or closing your practice for personal reasons, contact us for a confidential discussion regarding your urgent care. You will receive cash at closing and not be required to carry a note.

WebSite Development and Hosting Sales; MedMedia9 is accepting applications for Sales Associates in all parts of North Carolina. We are looking for Independent Medical Sales Reps that are looking for a really solid product that is needed by 6 out of 10 practices, cost effective and will enhance their practice income while attracting new patients. Easy sales delivery by a confident professional. Please send your resume and contact information to; medmedia9@gmail.com or go to www.medmedia9.com the About Us tab and view the Reseller Application. We pay exceptional commissions and offer the best back office support. We welcome the opportunity to discuss our program with you. 

Internal Medicine Practice for Sale Located in the heart of the medical community in Cary, North Carolina, this Internal Medicine practice is accepting most private and government insurance payments.

The average patients per day is 20-25+, and the gross yearly income is $555,000.

Listing Price: $430,000

Medical Practice Listings Buying and selling made easy

Call 919-848-4202 or e-mail medlistings@gmail.com www.medicalpracticelistings.com

68 | JULY 2014

Call 919-848-4202 or email medlistings@gmail.com www.medicalpracticelistings.com

Practices for Sale Medical Practices Primary Care specializing in Women’s Practice Location: Morehead City, N.C. List Price: Just reduced to $20,000 or Best Offer Gross Yearly Income: $540,000 average for past 3 years Year Established: 2005 Average Patients per Day: 12 to 22 Building Owned/Leased: MD owned and can be leased or purchased Contact: Cara or Philip at 919-848-4202

Family Primary Care Practice

Location: Minutes East of Raleigh, North Carolina List Price: $15,000 or Best Offer Gross Yearly Income: $235,000 Average Patients per Day: 8 to 12 Total Exam Rooms: 6 Physician retiring, Beautiful practice Building Owned/Leased: Owned (For Sale or Lease) Contact: Cara or Philip 919-848-4202

Family Practice/Primary Care

Location: Hickory, North Carolina List Price: $425,000 Gross Yearly Income: $1,5000,000 Year Established: 2007 Average Patients Per Day: 24-35 Total Exam Rooms: 5 Building Owned/Leased: Lease or Purchase Contact: Cara or Philip at 919-848-4202

Med Spa

Location: Coastal North Carolina List Price: $325,000 Gross Yearly Income: $1,050,000.00 Year Established: 2005 Average Patients Per Day: 25 to 30 Total Exam Rooms: 4 Building Owned/Leased: Leased Contact: Cara or Philip at 919-848-4202

Practice Type: Mental Health, Neuropsychological and Psychological Location: Wilmington, NC List Price: $110,000 Gross Yearly Income: $144,000 Year Established: 2000 Average Patients Per Day: 8 Building Owned/Leased/Price: Owned Contact: Cara or Philip at 919-848-4202

Practice Type: Internal Medicine

Location: Wilmington, NC List Price: $85,000 Gross Yearly Income: $469,000 Year Established: 2000 Average Patients per Day: 25 Building Owned/Leased: Owned Contact: Cara or Philip at 919-848-4202

Dental Practices Place Your Ad Here

Optical Practices Place Your Ad Here

Special Listings Offer We are offering our “For Sale By Owner” package at a special rate. With a 6 month agreement, you receive 3 months free.

Considering your practice options? Call us today.

WWW.MEDMONTHLY.COM | 69

Practice for Sale in Raleigh, NC Primary care practice specializing in women’s care Raleigh, North Carolina The owning physician is willing to continue with the practice for a reasonable time to assist with smooth ownership transfer. The patient load is 35 to 40 patients per day, however, that could double with a second provider. Exceptional cash flow and profit will surprise even the most optimistic practice seeker. This is a remarkable opportunity to purchase a well-established woman’s practice. Spacious practice with several well-appointed exam rooms and beautifully decorated throughout. New computers and medical management software add to this modern front desk environment.

List price: $435,000

Call Medical Practice Listings at (919) 848-4202 for details and to view our other listings visit www.medicalpracticelistings.com

ADVERTISE YOUR PRACTICE BUILDING IN MED MONTHLY By placing a professional ad in Med Monthly, you're spending smart money and directing your marketing efforts toward qualified clients.

Contact one of our advertising agents and find out how inexpensive yet powerful your ad in Med Monthly can be.

medmonthly.com | 919.747.9031

3 OCCUPATIONAL THERAPISTS POSITIONS IN JACKSONVILLE, NC These positions are 40 hour per week temp status to permanent positions with the following qualifications required: l Have graduated from an accredited Occupational Therapist program with a Masters Degree and 1 year experience or a Bachelors Degree with 3 years experience in Occupational Therapy. Program must be accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). l Possess and maintain a valid license or certificate to practice as an Occupational Therapist in any of the 50 states, District of Columbia, the Commonwealth of Puerto Rico, Guam or the US Virgin Islands. l Possess and Occupational Therapist Registered (OTR) certification by the National Board for Certification of Occupational Therapy (NBCOT). l Possess a minimum of one year experience as an Occupational Therapist, preferably working in the neurological based practice setting and with a familiarity of TBI specific patient care practice needs.

HOW TO APPLY: Send us your Resume/CV along with the following: available date to start, salary history, cover letter, eight hour shifts available per week. We will contact you by Email or phone to discuss our program. Make sure you provide your phone numbers and Email address.

Contact Ashley or Cara at: physiciansolutions@gmail.com or phone (919) 845-0054 for details

Internal Medicine Practice Wilmington, North Carolina Newly listed Internal Medicine practice in the beautiful city of Wilmington, NC. With Gross revenues over $400,000, 18 to 22 patients per day, this practice is ready for the physician that enjoys beach life. The medical office is located in a brick wrapped condo and is highly visible. This well appointed practice has a solid patient base and is offered for $85,000.

Medical Practice Listings l 919-848-4202 l medlisting@gmail.com l medicalpracticelistings.com

NC MedSpa For Sale MedSpa Located in North Carolina

Primary Care Practice For Sale

We have recently listed a MedSpa in NC

Wilmington, NC

This established practice has staff MDs, PAs and nurses to assist patients. Some of the procedures performed include: Botox, Dysport, Restylane, Perian, Juvederm, Radiesse, IPL Photoreju Venation, fractional laser resurfacing as well as customized facials. There are too many procedures to mention in this very upscale practice. The qualified buyer will be impressed with the $900,000 gross revenue. This is a new listing, and we are in the valuation process.

Established primary care on the coast of North Carolina’s beautiful beaches.

Fully staffed with MD’s and PA’s to treat both appointment and walk-in patients.

Excellent exam room layout, equipment and visibility.

Contact Medical Practice Listings today to discuss the practice details.

Contact Medical Practice Listings for more information.

For more information call Medical Practice Listings at 919-848-4202 or e-mail medlistings@gmail.com

www.medicalpracticelistings.com

Medical Practice Listings 919.848.4202 | medlistings@gmail.com www.medicalpracticelistings.com

Would You Like to Become a MedMedia9 Sales Associate?

MedMedia9 is creating a national sales force to market our Medical Website Design and Hosting products. We are signing up a limited number of sales associates to provide us with medical practices that need and are ready to implement their Practice Website.

MedMedia9 designs and hosts websites exclusively to the medical community. Our websites are priced extremely competitively with excellent commissions and we are a ‘Made in the USA’ company. We only design and host websites for health care practices, including medical, dental and optical.

If you would like to have another exciting tool to offer your practice clients, this could be the perfect fit that is financially rewarding. Call us today at our corporate offices in Raleigh, North Carolina to request more information on becoming a MedMedia9 Sales Associate. www.medmedia9.com 919-747-9031 medmedia9@gmail.com

Contact Tom Hibbard, Creative Director or Philip Driver, CEO for additional details.

PRIMARY CARE PRACTICE East of Raleigh, North Carolina We are offering a well established primary care practice only minutes east of Raleigh North Carolina. The retiring physician maintains a 5 day work week and has a solid base of patients that can easily be expanded. There are 6 fully equipped exam rooms, a large private doctor’s office, spacious business office, and patient friendly check in and out while the patient waiting room is generous overlooking manicured flowered grounds. This family practice is open Monday through Friday and treats 8 to a dozen patients per day.

Currently operating on paper charts, there is no EMR in place. The Gross revenue is about $235,000 yearly.

We are offering this practice for $130,000 which includes all the medical equipment and furniture. The building is free standing and can be leased or purchased.

Contact Cara or Philip at 919-848-4202 to receive details and reasonable offers will be presented to the selling physician.

Medical Practice Listings Selling and buying made easy

MedicalPracticeListings.com | medlisting@gmail.com | 919-848-4202

Adult & pediAtric integrAtive medicine prActice for sAle

Women’s Health Practice in Morehead City, NC

This Adult and Pediatric Integrative Medicine practice, located in Cary, NC, incorporates the latest conventional and natural therapies for the treatment and prevention of health problems not requiring surgical intervention. It currently provides the following therapeutic modalities: • • • • •

Conventional Medicine Natural and Holistic Medicine Natural Hormone Replacement Therapy Functional Medicine Nutritional Therapy

• • • • • •

Mind-Body Medicine Detoxification Supplements Optimal Weigh Program Preventive Care Wellness Program Diagnostic Testing

There is a Compounding Pharmacy located in the same suites with a consulting pharmacist working with this Integrative practice. Average Patients per Day: 12-20 Gross Yearly Income: $335,000+ | List Price: $125,000

Newly listed Primary Care specializing in Women’s care located in the beautiful coastal city of Morehead City. This spacious practice has 5 exam rooms with one electronic tilting exam table and 4 other Ritter exam tables. Excellent visibility and parking make this an ideal location to market and expand. This practice is fully equipped and is ready for a new owner that is ready to hit the ground running. The owning MD is retiring and will be accommodating during the transition period. This medical building is owned and is offered for sale, lease or lease to own. The gross receipts for the past 3 years exceed $540,000 per year. If you are looking to purchase an excellent practice located in a picturesque setting, please contact us today.

Medical Practice Listings Buying and selling made easy

Call 919-848-4202 or email medlistings@gmail.com www.medicalpracticelistings.com

Call 919-848-4202 or email medlistings@gmail.com www.medicalpracticelistings.com

Primary Care Specializing in Women’s Health

Located on NC’s Beautiful Coast, Morehead City

Practice established in 2005, averaging over $540,000 the past 3 years. Free standing practice building for sale or lease. This practice has 5 well equipped exam rooms and is offered for $38,000.

919.848.4202 medlisting@gmail.com medicalpracticelistings.com

WWW.MEDMONTHLY.COM | 79

Pediatrics Practice Wanted Pediatrics practice wanted in NC Considering your options regarding your pediatric practice? We can help.

Medical Practice Listings has a well qualified buyer for a pediatric practice anywhere in central North Carolina.

Contact us today to discuss your options confidentially.

PRACTICE FOR SALE

OCCUPATIONAL HEALTH CARE PRACTICE FOR SALE Greensboro, North Carolina Well-established practice serving the Greensboro and High Point areas for over 15 years. Five exam rooms that are fully equipped, plus digital X-Ray. Extensive corporate accounts as well as walk-in traffic. Lab equipment includes CBC. The owning MD is retiring, creating an excellent opportunity for a MD to take over an existing patient base and treat 25 plus patients per day from day one. The practice space is 2,375 sq. feet. This is an exceptionally opportunity. Leased equipment includes: X-Ray $835 per month, copier $127 per month, and CBC $200 per month. Call Medical Practice Listings at (919) 848-4202 for more information.

Asking price: $385,000

Medical Practice Listings Call 919-848-4202 or e-mail medlistings@gmail.com www.medicalpracticelistings.com

To view more listings visit us online at medicalpracticelistings.com

FAMILY PRACTICE FOR SALE A beautiful practice located in Seattle, Washington This upscale primary care practice has a boutique look and feel while realizing consistent revenues and patient flow. You will be impressed with the well appointed layout, functionality as well as the organization of this true gem of a practice. Currently accepting over 20 insurance carriers including Aetna, Blue Cross and Blue Shield, Cigna, City of Seattle, Great West and United Healthcare. The astute physician considering this practice will be impressed with the comprehensive collection of computers, office furniture and medical equipment such as Welch Allyn Otoscope, Ritter Autoclave, Spirometer and Moore Medical Exam table.

Physician compensation is consistently in the $200,000 range with upside as you wish. Do not procrastinate; this practice will not be available for long.

List price: $255,000 | Year Established: 2007 | Gross Yearly Income: $380,000

Medical Practice Listings Selling and buying made easy

MedicalPracticeListings.com | medlisting@gmail.com | 919.848.4202

the top

Health IT Tips

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WORD OF MOUTH

Speak to healthcare institutions similar to your own that have adopted and implemented their IT systems.

Ask them about their experiences and recommendations.

SELECTING A VENDOR

Work with vendors that are willing to work alongside your facilities’ IT department to build system interfaces.

Make sure you work with a vendor that will provide you with all the documentation required to allow your facility to build and maintain its own interface at no extra charge.

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4

Specifically review your organizations work practices, policies and procedures that will be affected by the IT system. It is imperative that you involve the end users in the initial process to help incorporate their current processes into your new electronic format.

EMPLOYEE TRAINING FOR SYSTEM FAILURE

Make sure your employees are trained on what to do when the health IT system goes down and are aware of the backup measures that need to be implemented. This is way it is really important to get end user feedback about any challenges they are facing.

ENTRY PROTOCOL

Asking users to re-enter a patient’s name, gender and age before a record opens is a good way to reduce the chance of having wrong information inputted in incorrect patient records.

6

| JULY 2014

2

REVIEW YOUR REQUIREMENTS

VERIFICATION SCREEN WITH PATIENT’S PHOTO

To reduce the frequency of errors involving placing orders in the wrong patient’s chart, use a verification screen with the patient’s picture included in the ordering process for your staff to confirm that the record is correct.

Common concerns for IT implementation include incorrect data input, entering the wrong data in the incorrect patient file, or system errors that could result in patients receiving the wrong medication and treatment. Here are our top 9 health IT tips

7 8

REDUCE DECISION SUPPORT ALERTS

User interfaces make it easy to undo actions if a mistake is made without losing important data. Limit clinical decision support alerts to ones that are essential for safe patient care to minimize distractions and prevent alert fatigue.

SUPPORT FOR YOUR STAFF DURING TRAINING

It is really important not to allow employees to use health IT systems until they have proven they are capable to do so.

During the initial stages of implementation, it is vital you have 24-hour support at hand for all end users.

9

CONSTANT SYSTEM EVALUATION

Set up parameters to monitor and gauge the health IT system’s performance and effectiveness in your practice.

Encourage a culture where your staff recognizes the need to report events and near misses involving your health IT system to assist in future improvements.

WWW.MEDMONTHLY.COM | 77

4 Essential Reasons You Need Search Engine Optimization For Your Practice

1

SEO ATTRACTS TARGETED RELEVANT TRAFFIC WITH HIGH CONVERSION POTENTIAL

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4

3

M edM edia9

medmedia9.com

SEO WILL HELP POTENTIAL PATIENTS FIND YOUR WEBSITE

SEO PROVIDES INFORMATION & CREDIBILITY

SEO IS AN INVESTMENT IN THE FUTURE OF YOUR PRACTICE

MedMedia9

Your website is your most important practice marketing tool. How does yours look? We design websites for small and large practices as well as more personal physician websites than anyone in the business. We want to showcase your practice and you.

• • • •

Don’t Fall Behind Your Competition, Lead Them

Allow Colleagues to Quickly Find You For Referrals.

Supply patients with medical forms they will have filled out for their initial visit.

Provide healthy information from your web site to your patients.

Allow patients to print directions to your practice from Google Maps and Email you for quick questions or to arrange an appointment.

A website designed and hosted by MedMedia9 will increase your new patient volume and more than pay for itself quickly, we guarantee it.

919-747-9031 www.medmedia9.com medmedia9@gmail.com

Scan this QR code with your smartphone to learn more.