THE BUSINESS MAGAZINE OF KENTUCKY PHYSICIANS AND HEALTHCARE ADMINISTRATORS Issue #80
Special Section
Aesthetic Medicine & Dermatology
An Enduring Legacy of Compassionate Care:
Volume 4, Number 5
Plastic Surgeons of Lexington redefines “family” practice amidst the hectic evolutions of their field
Also in this issue VASCULAR ADVANCEMENT CHANGING ROLE OF HOSPITALIST INSIDE A MEDICAL SPA & PLASTIC SURGERY PRACTICE SURGERY ON SUNDAY COMES TO LOUISVILLE
We’re improving access to quality health care because you live and work here.
Better care is here. And here to stay. At KentuckyOne Health, we’re continuing to improve access to high quality health care. We believe that every Kentuckian from the hills of eastern Kentucky to the city of Louisville should receive the same level of care. As we welcome the University of Louisville Hospital and the James Graham Brown Cancer Center into our system, our more than 200 health care locations from hospitals to home health agencies are more committed than ever to creating healthier communities across Kentucky. Continuing Care Hospital Flaget Memorial Hospital Frazier Rehab Institute James Graham Brown Cancer Center
Jewish Hospital Jewish Hospital Medical Centers: East, South, Southwest, Northeast Jewish Hospital Shelbyville Jewish Physician Group
Our Lady of Peace Saint Joseph Berea Saint Joseph East Saint Joseph Hospital Saint Joseph Jessamine
KentuckyOneHealth.org
Saint Joseph London Saint Joseph Martin Saint Joseph Mount Sterling Saint Joseph Physicians Sts. Mary & Elizabeth Hospital
University of Louisville Hospital VNA Nazareth Home Care The Women’s Hospital at Saint Joseph East
from the publisher’s Desk
Volume 4, Number 5 Issue #80 Publishers
Sometimes things just work out.
Gil Dunn Print gdunn@md-update.com Megan Campbell Smith Digital mcsmith@md-update.com
It was several months ago that we started talking
Editor in Chief
Jennifer S. Newton jnewton@md-update.com
with Dr. Andy Moore, II, about featuring his family’s practice, Plastic Surgeons of Lexington, in the
Graphic Designer
Aesthetic Medicine issue of M.D. Update which
James Shambhu art@md-update.com
you now have in your hands. We talked about
Contributors:
the focus of the family-owned & operated private
Molly Nichol Lewis Sean Maguire, MD Scott Neal Jodi Whitaker
practice, the unique relationship of three brothers following in their father’s footsteps and the newest addition to the practice, son-in-law, Dr. Joe Hill. I had first met Dr. Moore four years ago when I wrote an article for our magazine about “Surgery on Sunday,” the volunteer organization he founded in Lexington, KY that provides plastic surgery services for patients who do not qualify for government assistance and do not have health insurance, but need plastic surgical repair. On August 18, 2013 “Surgery on Sunday” began operating at Jewish Hospital in Louisville, spearheaded by Dr. Erica Sutton with help from Dr. Whitney Jones, Dr. Russell Williams, and many others. I feel it’s a joyful coincidence that we can bring you the Plastic Surgeons of Lexington story at the same time “Surgery on Sunday” is extending its good work to the largest healthcare market in Kentucky. There is good news about healthcare in Kentucky, you just have to look for it. There was great news recently for Kentucky with the announcement of National Cancer Institute designation for the UK Markey Cancer Center, a potentially monumental step forward in patient care and research funding. M.D. Update will be bringing you a conversation with some of the physicians at Markey Cancer Center in our next issue, focused on Oncology. Please review the M.D. Update “Editorial Opportunities” on page 21. I invite you to contact us if your specialty is coming up later this year. I look forward to hearing from you and telling your story. All the Best, Gil Dunn Publisher, M.D. Update 17
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Submit your Letter to the Editor to Jennifer S. Newton at jnewton@md-update.com 2 M.D. Update
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38 Mentelle Park Lexington KY 40502 (859) 309-0720 phone and fax Standard class mail paid in Lebanon Junction, Ky. Postmaster: Please send notices on Form 3579 to 38 Mentelle Park Lexington KY 40502 M.D. Update is peer reviewed for accuracy. However, we cannot warrant the facts supplied nor be held responsible for the opinions expressed in our published materials. Copyright 2013 Mentelle Media, LLC. All rights reserved. No part of this publication may be reproduced, stored, or transmitted in any form or by any means-electronic, photocopying, recording or otherwise-without the prior written permission of the publisher. Please contact Mentelle Media for rates to: purchase hardcopies of our articles to distribute to your colleagues or customers: to purchase digital reprints of our articles to host on your company or team websites and/or newsletter. Thank you. Individual copies of M.D. Update are available for $9.95.
Contents
Issue #80
cover story 4 HEADLINES 5 FINANCIAL 6 LEGAL 9 PRACTICAL INSIGHTS 13 COVER STORY 18 SPECIAL SECTION
AESTHETIC MEDICINE
20 SPECIAL SECTION
DERMATOLOGY
24 NEWS 32 EVENTS
An Enduring Legacy of Compassionate Care
Plastic Surgeons of Lexington redefines “family” practice amidst the hectic evolutions of their field By Tim Corkran PAGE 13
Special Section AESTHETIC MEDICINE & DERMATOLOGY 18 Aesthetic Integration: 18
Physician’s Center for Beauty 20 PA-C Allows Physician Time to Focus: Cassis Dermatology & Aesthetics Center 23 It Points to Tanning: Dermatology Consultants Sees Melanomas Rise in Youth
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23 Issue#80 3
Headlines
Jewish Hospital Joins Surgery on Sunday Program Jewish Hospital, part of KentuckyOne Health, has joined the Surgery on Sunday program to provide essential outpatient procedures for free to those in need. The inaugural event in Louisville kicked off on Sunday, August 18, 2013 when approximately 12 patients received colonoscopies at the Jewish Hospital Outpatient Care Center Endoscopy Unit. Subsequent events will be held periodically throughout the year. Jewish Hospital in Louisville is the fourth in the nation to participate. Surgery on Sunday, Inc. is a non-profit organization that provides essential outpatient surgical services for free for those in need who cannot afford insurance and who are not eligible for federal or state programs. Patients are referred from existing organizations in the community and receive much needed surgical procedures. For income-eligible patients with no health insurance, all services and supplies— from the pre-operative visit with a volunteer surgeon, to the imaging studies, to the medications needed before and after surgery, to physical therapy, to the post-operative appointment—are free. Surgery on Sunday is completely volunteer-driven and all of the professionals who assist at the hospital—surgeons, anesthesiologists, certified nursing assistants, nursing staff, administration, and others— donate their time and expertise for the procedures. Approximately 30 volunteers were on hand to make Surgery on Sunday a success for patients. “Too many people in our community do not have adequate medical coverage, which makes receiving basic outpatient medical procedures like a colonoscopy out of reach,” said Erica Sutton, MD, University Surgical Associates and assistant professor of surgery at the University of Louisville, who spearheaded the effort to bring Surgery on Sunday to Louisville. In addition to Sutton, Whitney Jones, MD, a gastroenterologist with Midwest Gastroenterology Associates, and Russell Williams, MD, a general surgeon with Associates in General Surgery, performed
“I am passionate about the prevention of colorectal cancer and am so pleased to begin Surgery on Sunday with colonoscopy procedures,” said Jones, who founded the Colon Cancer Prevention Project. “If we can help more individuals in need receive a critical procedure at no cost and keep them from missing work, we are eliminating barriers to
Louisville
4 M.D. Update
Whitney Jones, MD, a gastroenterologist with Midwest Gastroenterology Associates joined 30 other volunteers for the inaugural Surgery on Sunday in Louisville. above
Erica Sutton, MD, University Surgical Associates spearheaded the effort to bring Surgery on Sunday to Louisville.
right
Below Russell Williams, MD, a general surgeon with Associates in General Surgery, performed procedures for the inaugural Surgery on Sunday at Jewish Hospital.
procedures for the inaugural Surgery on Sunday at Jewish Hospital. “By volunteering a few hours on a Sunday, we can help fill an important need for care in our community,” said Williams. A colonoscopy is an important screening tool for the prevention of colorectal cancer. Kentucky has the second highest rate of colorectal cancer in the nation. Data from the Kentucky Behavioral Risk Factor Surveillance System reports that only 63 percent of Kentuckians at risk for colon cancer have been screened for the disease.
care and potentially saving lives.” The American Cancer Society recommends colorectal cancer screening for men and women aged 50-75. For African-Americans, screening should begin earlier, at age 45. Saint Joseph Hospital, also part of KentuckyOne Health, has participated in Surgery on Sunday since 2005. It was the first hospital to open its doors to the program. To learn more about Surgery on Sunday, visit www.surgeryonsunday.org. ◆
financial
Going Beyond Retirement Planning A Pew Research Center study released this month revealed that living to an age that is substantially longer than current life expectancy isn’t what most Americans really want. More than two-thirds of adults 18 and over say that they would like to live somewhere between 79 and 100; the median ideal age is 90. In comparison, the U.S. average is 81 for women and 76.2 for men. One has to wonder how much cultural bias is factored into the respondents’ answers. Most of us don’t know many people who live past 90. Moreover, our culture has drawn a diminishing picture of those who do. According to the study, the majority of people (54%) indicate that medical treatments these days are worth the costs because they allow people to live longer and have better quality of life, 41% say they often create as many problems as they solve. Of interest to us financial advisors is that 57% say they either do not worry too much or at all about outliving their money. We repeatedly warn our clients about the Flaw of Averages in planning for their future. Just as the combination of health risks that each of us carries is unique, so goes our financial circumstances. Now for a book review: David Solie, a geriatric psychologist and an expert in intergenerational communication, has written a book, How to Say It® to Seniors. We have found it useful in communicating with our parents and elderly clientele. Early in the book, he reframes the cultural bias that seniors be seen as only diminishing and asks the reader to consider that seniors have developmental tasks, not unlike those development tasks of other stages of life. Drawing upon the work of Erik Erickson, Solie calls it “the secret mission” of older adults. “Seniors’ developmental tasks compel them to maintain control over their lives in the face of almost daily losses, and simultaneously to discover their legacy, or that which will live on after them.” In my opinion, he is a bit too repetitive in making this point. For those of us who serve this population, communication is key and
the barriers to effective communication between the elderly and those of us who are middle-aged can sometimes be huge. Appendix I, “A Note to Professionals,” is worth the price BY Scott Neal of the book. In chapter 6, Solie introduces what he calls the predictable dilemmas of getting old. While predictable, we have found that when left unattended these dilemmas often become crises. We therefore see part of our job as financial advisors to help mitigate, if not eliminate, those predictable dilemmas long before they have a chance of reaching crisis stage. We can do this in two ways: 1) developing solid financial plans that can be adjusted to changing lifestyles and 2) becoming legacy coaches for our clients. The Predictable Dilemmas identified by Solie are: Where will I live? We all need a place to live, even at age 100. Most of our clients tell us that they want to “age in place,” meaning that they want to stay in their present residence for as long as possible; yet, what we find when we probe just a bit is that often they live in a rather large house that is equipped for a healthy middle-aged person with a growing family, not someone living alone who is unable to climb stairs. Many financial advisors only see one other option: assisted living center or nursing home. We see many alternatives, but nearly all require some prior planning to pull off with minimal disruption. How can I best manage my health? Most financial advisors are only interested in how a client will pay for his or her healthcare. We believe that how a person pays for health care is the second question. The first question is to think about the plan of care itself. In visiting their physicians with my aging parents, I have witnessed just how difficult it can be for
them to talk about the expected outcome of certain treatments and to consider how a certain illness or treatment might affect their financial plan. How will I cope all by myself? If communication difficulties haven’t come up before hand, they almost always will in the moment of grief. Resistance to change is often heightened when faced with a loss. In preparing to relieve this dilemma, we delve deeper than simply calculating the need for life insurance; we often explore what life will be like in the absence of the significant other. What should I do about money? Just as many physicians may think that they only have to deal with dilemma 2 above, many financial advisors will only consider finances in what they do. Additionally, he or she will do so only from the perspective of a much younger person. The health plans developed by you and our financial plans make complete sense to us, so why is it that our elderly client cannot see it as we do? Solie contends that how we present the plans can make an enormous difference. What is the right way for me to say good-bye? In the third trimester of life, legacy starts to emerge more clearly and usually with a greater sense of urgency. Solie says that our predictable response to the end of life messages expressed by our elders might be “Don’t worry, everything will be okay.” He suggests that part of the right good-bye is giving the person control over the form that the good-bye will take. Expressing legacy goes well beyond estate planning, it is being clear about how you want to be remembered. In my role as financial planner, I want to be remembered as one who saw beyond the numbers of a person’s financial life and helped them to navigate the uncertainties of life through thoughtful planning. Scott Neal, CPA, CFP is president of D. Scott Neal, Inc., a fee-only financial planning and investment advisory firm with offices in Lexington and Louisville. He can be reached at scott@ dsneal.com or by calling 1-800-344-9098. ◆ Issue#80 5
legal
Beyond Making the Rounds Hospitalists & Quality of Care under the ACA By now, everyone knows the Affordable Care Act’s (“ACA”) motto is “increase quality, decrease costs.” As providers transition from the fee for service payment model to new payment systems that are tied to quality, one subset of providers will play a pivotal role in bringing health care into a new era: hospitalists. Hospitalists (physicians who provide care solely to hospital inpatients) are poised to lead the way in ensuring that patient care is no longer a series of disconnected dots, but rather a continuum of ongoing service. As primary care providers (“PCPs”) and subspecialists increasingly limit time set aside for hospital visits, it is up to hospitalists to improve inpatient efficiency, manage patient expectations, and coordinate the overall inpatient experience. The unique nature of hospitalists, still a recently new specialty, makes meeting the lofty expectations of the ACA
6 M.D. Update
more attainable. There are a number of ways that the ACA is emphasizing quality care: (1) integrating care through the creation of more Affordable Care Organizations, BY Molly Nicol Lewis Patient Centered Medical Homes, and even electronic health records; (2) incentivizing positive patient outcomes, for example the Medicare Advantage program now issues bonus payments to plans with four or five star ratings, and CMS has expanded this to additional plans while also increasing bonuses and also rewarding plans for improvement in their star ratings; and (3) reducing cost through programs such as
Medicare’s Hospital Readmissions Reduction Program, which is designed to ensure that hospitals only discharge patients when they are fully prepared and safe for continued care at home or at a lower acuity setting and penalizes hospitals with excessive rates of readmission within 30 days of discharge. Hospitalists are vital to hospitals wanting to ensure they receive the full amount of Medicare payments for several reasons including, but not limited to, those explained below.
Presence
Because hospitalists only work within the walls of a hospital, they have the undeniable appeal of simply being present when needed. In the past, a PCP would be taken away from his practice to make hospital rounds – leaving an inpatient waiting for the physician’s arrival and an outpatient waiting for his return. This practice led to
Hospitalists are vital to hospitals wanting to ensure they receive the full amount of Medicare payments … unresponsiveness and unnecessary lulls in care. Now, because a hospitalist is located at the hospital 24/7, inpatients can be seen by a physician repeatedly throughout their stay. Likewise, a PCP is left with more time and energy to dedicate to outpatients, thus raising the quality of care in both settings.
The Home Field Advantage
As a result of this constant presence, hospitalists enjoy a familiarity with the hospital setting that PCPs may not. By knowing how
a hospital is run on a day-to-day basis, hospitalists can improve integration and coordination of services provided by different departments while increasing efficiency, establishing protocol, and demanding accountability in the inpatient setting. Because the hospital is “home,” hospitalists are more likely to serve on committees or spearhead projects for the betterment of the hospital.
Accountability
Hospitals generally are limited in the con-
trol they can exercise over PCPs. Other than granting or denying hospital facility privileges, a hospital has little authority to manage behavior or measure performance. By employing directly or contracting with hospitalists to provide services, hospitals can ensure their rules and authority are followed. By sharing a unified vision and common principles, specific quality indicators can be more easily met.
A PCP’s Evolving Role for Inpatient Care
Of course, the industry cannot rely on hospitalists alone to meet ACA standards. It takes a village. PCPs still play a key role in establishing quality inpatient care. When a PCP has a patient admitted to the hospital, his role in the patient’s care has not ended. Instead, PCPs should see the inpatient stay as a momentary transition in care for which
To learn more about working with MESA, contact us today. 1-877-601-6372 | MESAMedicalGroup.com |
Issue#80 7
legal
they are responsible for retaining oversight. PCPs should step up, not step back, to ensure continuity of care. If a PCP is concerned about an aspect of a patient’s medical history or fact that the patient may not be forthcoming with, the PCP should alert the hospitalist to this information. While a hospitalist may be better equipped to care for a patient in the hospital, a PCP’s knowledge and history with a patient cannot be discounted. Often the admitting physician, a PCP is in the best position to know the patient’s current and past medical condition. PCPs should make their contact information known, both to hospitals and patients, so that hospitalists know how to reach them if the need arises. No matter how great the care they offer to inpatients, an individual will never refer to a hospitalist as “my doctor.” Once out of
the hospital, a patient can no longer call the physician or follow up with him for care. The PCP must be ready to resume his role fully and knowledgably. After an inpatient is discharged, PCPs should expect a complete discharge summary. After all, like an emergency department doctor, a hospitalist’s role ends at the hospital’s door. PCPs will need to know test results, medications, and future treatment plans. PCPs should collaborate with hospitalists about when and how discharge summaries should be received. Fortunately, electronic health records (“EHR”) are greatly improving the ability for physicians to stay abreast of an inpatient’s care, even if they are not physically present in the hospital. As emphasis on EHR increases and more providers implement EHR systems in their practice, collaboration between PCPs and hospitalists will also increase. The better
the information contained in the EHR, the easier it is to provide efficient and proper care after a hospital discharge. To meet ACA demands, hospitalists and PCPs must work with, not against, each other. As demand for hospitalists rapidly increases, PCPs need to make sure they are on board with this emerging role in health care. It will take teamwork to stay afloat in the ACA’s waves of change. To ensure quality and continuity, we must have all hands on deck. 
Molly Nicol Lewis is an Associate of McBrayer, McGinnis, Leslie & Kirkland, PLLC. Lewis concentrates her practice in healthcare law and is located in the firm’s Lexington office. She can be reached at mlewis@mmlk. com or at (859) 231-8780. This article is intended as a summary of federal law and does not constitute legal advice. ◆
Treating a full range of vascular conditions The UK Gill Heart Institute Vascular Surgery program offers a comprehensive array of treatment plans. Our services range from conservative management of the causes and risk factors of vascular disease to complex open and endovascular approaches.
Joseph Bobadilla, MD
Eric Endean, MD
David Minion, MD
Our vascular surgeons operate in state-of-the-art hybrid operating rooms and catheterization laboratories equipped with all the tools needed to treat the most complex vascular conditions. The types of vascular problems addressed include, but are not limited to: • Thoracic, abdominal and thoracoabdominal aneurysm • Carotid disease • Renal and visceral artery disease • Lower extremity arterial insufficiency • Varicose veins and venous disease
Ehab Sorial, MD
Eleftherios Xenos, MD, PhD
To refer a patient to one of our vascular surgeons, call UK•MDs at 859-231-9922.
To learn more about the UK Gill Heart Institute Vascular Surgery program, please email Karen Riggs, UK Physician Liaison Program director, at karenriggs@uky.edu. 4-4885
8 M.D. Update
Practical Insights
Update on the Pain Treatment Center of the Bluegrass Plugged In: The Pain Treatment Center invests in new imaging technology
Photography by Liz Haeberlin
By Jennifer Newton LEXINGTON Healthcare would not be the same today without the technology that powers diagnostics. Imaging technology can make all the difference in quickly and efficiently diagnosing patient conditions. For the Pain Treatment Center of the Bluegrass (PTC), additional advantages of making a significant investment in upgrading and expanding their technology include centralizing imaging services, meeting Medicare accreditation standards, making expansion possible, and adding bone density services.
The Center’s updates include:
1. Purchase of a new GE Lightspeed 16-slice CT scanner to replace its old 4-slice CT scanner 2. Purchase of a Dexa scanner to evaluate bone density 3. Upgrade of their X-ray machine, which is now located in the new imaging area 4. Purchase of a PACS system in order to read the images from each of these machines and integrate the images into their current EMR system A main goal of the update was “to consolidate all of the Center’s imaging equipment into one area convenient to patients,” says Heather Wright, CEO of PTC. In the past, the CT had been in the basement of their 280 Pasadena site, and patients had to walk down
Somerset Satellite Clinic The Pain Treatment Center of the Bluegrass has moved their existing satellite clinic location in Albany, Kentucky, to Somerset, Kentucky. PTC had been leasing a space in Albany, but they were able to purchase a space of a little over 4,000 square feet in Somerset, a location that gives them room to expand. Geographically, they are still able to service their patients
Julie Riegger, RT, Imaging Director, (r) and Cristal Worrix, RT, review images from the CT scanner at the PAC system, which allows them to read and integrate the images into their current EMR system. above right Riegger takes an x-ray in the new PTC imaging suite, which is designed for patient convenience and future growth. above
the stairs or use the outside elevator to get to it. The x-ray was located upstairs in the same building, in a portion of the surgery center that the practice rented. The practice did not have a Dexa scanner but had done bone density studies on their CT scanner. To solve these problems, the Center took over the back portion of their 2416 Regency location, which had housed the doctors’ offices, and moved the doctors’ offices to a different location within the building; thus, allowing them to put all of their imaging machines in one location convenient for patients, according to Ms. Wright. In addition to moving the CT to the imaging area, the Center purchased a new
and referring doctors from the Albany area, as the Somerset location is around 25-45 minutes from Albany and Monticello, the towns where most of the Albany clinic patients came from. Moreover, it allows them to now service additional towns and counties in the south central region, such as Somerset, Jamestown, Columbia, London, Corbin, etc. The patients in these areas would generally not have been referred by their doctors to the Albany
Riegger and Worrix performing a scan on PTC’s new GE Lightspeed 16-slice CT scanner. Patients can have scans performed in-house and on the same day as their initial appointment.
16-slice CT scanner. The upgrade was necessitated by new Medicare accreditation standards, as the Center’s 4-slice CT did not
clinic but would have gone to PTC’s Lexington location, thus providing significant convenience to those patients. Bonnie Hoots, who worked in the Albany office, has relocated to the Somerset clinic and works three days in the Somerset location. Currently, Dr. Peter Wright, medical director, Lois Downing Wright, PA-C, and Rodney Mullins, nursing assistant, commute to Somerset on Wednesdays to see the patients referred to that
location. Hoots will be joined in the office by Regina Ward, a certified medical assistant (CMA) who interned with PTC’s Lexington location as both a CMA and while getting her health administration degree. She will be working as both the office manager and as a CMA in the Somerset office. Eventually, if the office grows big enough, PTC has the capacity to run a satellite clinic five days a week there, says Dr. Wright. ◆ Issue#80 9
Practical Insights Worrix performs a Dexa scan, which provides an easy report regarding bone density.
meet the standards, states Ms. Wright. Moving the X-ray not only allowed the Center to consolidate imaging services, but also makes way for future expansion. The X-ray was previously located in the surgery center area. By moving it, they have made the space available for the addition of a third operating room. Another of the Center’s purchases, the
Dexa scanner provides for bone density studies on their patients. In the past, if physicians required a bone density evaluation on patients, they used the CT scanner. “The advantages of the Dexa for the Center staff are: it is fast, provides an easy report regarding bone density, allows them
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10 M.D. Update
to use the CT for true imaging studies, and allows the CT and the Dexa to be used at the same time on different patients,” says Peter Wright, MD, medical director of PTC. The Dexa is important to the patients because many of the medications the patients are on can cause bone loss. Moreover, as patients age, and depending on how much calcium and vitamin D they get in their diet, they experience bone loss. Therefore, it is important to know if patients are experiencing bone loss, and thus suffering from osteoporosis, because they are more susceptible to bone fractures, especially in their hip and spine. Patients fill out a questionnaire that determines their risk factors for osteoporosis. If they meet the factors, then they undergo a Dexa scan to determine if they are indeed experiencing bone loss and if so, to determine if they need to change their diet, exercise, and/or medicine regimen. For all of the imaging machines, the patients get the option of having the scans done at the Pain Treatment Center or at a center they choose, says Dr. Wright. If they get the scan done at the in-house imaging department, the benefit is that “the scan can often be done on the same day as their appointment, so they do not have to go to another office at a different day and time. The other benefit is that the scans and the results are in our system so there is less time experienced in waiting for results, and it is less likely the scan will get overlooked or the results not given back to the ordering physician,” says Dr. Wright. To prepare for the updated technology, PTC’s radiological techs (RTs) have all received training on the new CT machine and the Dexa. Moreover, the CT has to be accredited by the Intersocietal Accreditation Commission (IAC), and then the accreditation is submitted to Medicare. With the accreditation, Dr. Wright and Director of Imaging Julie Riegger have gone through additional CME courses. ◆
Practical Insights
UK Vascular Team Broadens Scope of Practice By Jodi Whitaker
Courtesy of UK HealthCare
Lexington In his 11 years as a vascular surgeon, Dr. Eleftherios Xenos, director of the vascular laboratory at UK, said he has seen tremendous progression in endovascular procedures. The changes have been exciting for both Xenos and his staff. “You do things now that wouldn’t have been considered 15 years ago,” Xenos said. “You don’t really get surprised because it happens gradually, but if you look at the big picture, it’s very impressive.” Xenos said the surgeries are now less invasive, and patients are able to go back to full activities faster. In some cases, the newer procedures have meant a difference between life and death. “We see older and older patients, and sicker people, just because we can perform these procedures on them now,” Xenos said. “Before, these people weren’t surgical candidates.” The majority of Xenos’ patients are age
Dr. Eleftherios Xenos, director of the vascular laboratory at UK.
60 and older, with the exception of trauma patients, who are usually younger. One of Xenos’ youngest patients has been a 19-year-old involved in a crash who was unable to undergo an open-chest procedure because of a brain bleed from his accident. Xenos said that with younger patients, grafts are checked yearly with a CAT scan to ensure the graft is functioning properly. UK HealthCare’s Department of Vascular Surgery has broadened the scope of treating venous disorders by providing surgical options in three unique areas: Fenestrated Grafts, traumatic aneurysms and dissections, and HeRO Grafts.
Fenestrated Grafts
Fenestrated grafts were only recently approved by the FDA as a way to fix aortic aneurisms. UK HealthCare is the only facility in Lexington - and one of few in the state - to use this technology. The fenestrated graft was designed to
Would you rather be here? Or HEAR?
Engineered for performance. Issue#80 11
Practical Insights treat a complex form of abdominal aortic aneurysm in which the weakened, enlarged vessel wall is too close to the arteries leading to the kidneys and other nearby organs. Previously available aortic stent grafts could not be safely used to treat these aneurysms, which meant major surgery or in some cases, death, for the patient. A fenestrated graft – a tubular, fabric graft that uses metal stents as supports – features custom-positioned holes that ensure proper blood flow through the aorta and to the kidneys and other nearby organs. In about 10 percent of aneurysm patients, the area affected lies close to arteries that branch into the kidneys, small bowel, and liver. The fenestrated graft allows blood flow to continue downward without going into the aneurysm. The procedure takes about four hours to complete and involves a team of physicians that includes a cardiothoracic surgeon and a vascular surgeon.
Traumatic Aneurysms
As the only Level 1 Trauma Center in
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Lexington and the surrounding areas, UK HealthCare is the only hospital able to treat traumatic aortic lesions. These occur primarily in patients whose aortas are torn during events such as vehicle accidents, shootings, or stabbings. Previously, traumatic aneurysms were approached with open repair, which had significant complications. But with the development of angiography and other procedures, it is now possible to not only diagnose these injuries in a patient, but to repair them as well in a less invasive manner. As with other vascular surgeries, repairing a traumatic aneurysm (when possible) formerly required an open-chest surgery in every instance. Now, through transcatheter surgery, the patient usually has a shorter hospital stay, a shorter recovery period, and fewer risk factors.
HeRO Graft
A HeRO Graft offers subcutaneous vascular access that bypasses the central venous system and provides continuous blood flow directly from a target artery to the heart.
HeRO Grafts are used primarily in patients on kidney dialysis. Over time, repeated dialysis can block a patient’s superior vena cava. The HeRO Graft creates a new channel for arterial blood flow for the patient, even when he or she is not receiving dialysis. The HeRO Graft has two pieces implanted under the skin. During the surgery, an outflow component is inserted into a large vein in the neck. The tube is directed past any blockages caused by other accesses. The second piece of the HeRO Graft is then sewn into an artery just like other grafts. The graft is then connected to the outflow component, allowing blood to flow from the artery, through the graft, and into the heart outflow component. The UK Vein Clinic, located at UK Good Samaritan Hospital, provides comprehensive management of venous disorders including venous insufficiency, minimally invasive treatment of varicose veins, cosmetic treatment of spider veins, and telangiectasias. In addition to Xenos, the UK Vein Clinic staff includes Dr. David Minion, Dr. Ehab Sorial, and Dr. Joe Bobadilla. ◆
cover story
Left to Right
An Enduring Legacy of Compassionate Care:
Andrew Moore, II, MD; Sherwood Moore, MD; Michael Moore, MD; Joseph Hill, MD (seated) bring over 100 years of combined plastic surgery experience to patients at Plastic Surgeons of Lexington
Plastic Surgeons of Lexington redefines “family” practice amidst the hectic evolutions of their field By Tim Corkran Photography by Liz Haeberlin
The three Moore brothers followed in their father’s footsteps: Andrew Moore Sr., MD, began the practice in the 1950s and was Lexington’s first plastic surgeon. Dr. Hill completes the “family” practice as Dr. Andy Moore’s son-in-law.
In the last 25 years, few specialties have experienced such dramatic changes to their public perception as plastic surgery, which was once seen mainly as a specialty that repaired damaged exteriors so that patients could lead normal lives. Today, the surgeons of Plastic Surgeons of Lexington (PSOL) practice both reconstructive and enhancement procedures with a mission for compassion and forthright advising that ensures their patients feel understood and fully informed about their aesthetic procedures. Issue#80 13
cover story
Dr. Woody Moore, MD, joined PSOL in 1995. He currently spends time at the VA Hospital, in Lexington serving veterans’ needs.
The PSOL team of Andrew Moore, II, MD, Mike Moore, MD, Sherwood Moore, MD, and Joe Hill, MD, combine for over 100 years of experience in the field of plastic surgery – and share a legacy they are all proud to live up to. The three Moore brothers followed in their father’s footsteps: Andrew Moore Sr., MD, began the practice in the 1950s and was Lexington’s first plastic surgeon. Dr. Hill completes the “family” practice as Dr. Andy Moore’s son-in-law. Dr. Moore Sr. practiced a broad spectrum of plastic surgery, but Dr. Mike explains that his main focus was the honorable goal of “trying to put people back together again.” How he approached his calling was even more honorable: “Taking care of people without concern for their ability to pay and doing it the best way you can” was his philosophy, says Dr. Andy. This air of compassion informs the practice today. He goes on, “When we make important decisions in this office, we try to remember the past we came from.”
Compassionate Care in the Office
PSOL offers a common suite of procedures, about 40% of which are enhancement and 60% reconstructive, but its doctors are committed to certain practices that distinguish them from other Lexington plastic surgeons. While many practices employ patient educators, the doctors at PSOL serve that role directly. “I prefer to spend as much time with the patient as possible,” says Dr. Andy. Dr. Mike concurs, “I like “When we make important decisions in this office, we try to remember the past we came from. I prefer to spend as much time with the patient as possible,” Dr. Andy Moore, II. 14 M.D. Update
my patient interaction. I take the time to use books and diagrams to explain what I am going to do.” This commitment to patient contact is consistent with their attitude of full disclosure about procedure appropriateness. Dr. Mike says they are committed to thorough patient communication. “You have to do it honestly and ethically so that you are giving the patient what they need, not just what they want. Because what they want may not be attainable – and it may in fact, be detrimental.” He continues, “When I go over the risks and benefits, some patients decide the risks outweigh the benefits and forego a procedure.” Seeing every patient as a whole person – and their features as a part of a whole body – are anchors in the practice. While elective enhancement procedures are an important revenue stream in the practice, Dr. Mike refuses to refer to his patients as customers or consumers. “When you use the term ‘patient,’ you are taking on their psychological, physiological, sociological, and pharmacological well-being,” he says. The doctors at PSOL also take the time to
educate their patients about the big picture of their prospective procedures, be they reconstructive or aesthetic. Using nasal reconstruction as an example, Dr. Mike says, “You have to know the nose’s relationship to the lip, to the chin, to the forehead, to the head, and even to the body. If you are not considering all those body parts together, when you start to enhance or reconstruct one particular area, you are not truly considering the well-being of the patient.” The practice also has two policy elements that put patients at ease. Referrals are handled the same day if requested (something that four doctors in the office allows) and an in-office surgical room for minor procedures has been set up and may avoid more costly ER or hospital visits. Despite this service turning out to be revenue neutral, PSOL remains committed to it because of the comfort it allows patients.
Joe Hill, MD, brings compassion
have helped over 5500 people and cutting edge surgical skills in the eight years they have to the PSOL practice and is been using donated space. known in the office as “Dr. Surgeons from the region’s Future.” biggest hospitals have long been involved, and now some of those hospitals – Saint Joseph Main, Kentucky One in Louisville, and most recently Baptist Health – are offering their own versions. Dallas, Texas and Omaha, Nebraska hospitals have begun
Translating Compassionate Care to the Community
The Drs. Moore and Hill readily extend their philosophies beyond the office, strengthening their professional and personal communities. They have been integral in maintaining the 20-member “Journal Club,” which is open to all Lexington plastic surgeons. This informal professional organization allows it members to collaboratively review developments in the field and maintain open lines of communication between practices. “The resulting collegiality of the plastic surgery community in the Bluegrass has been noted by a number of visiting surgeons,” says Dr. Andy. PSOL surgeons are also active in The Commission for Children with Special Healthcare Needs (which Dr. Andy Moore Sr. founded), Shriners’ Hospital for Children, and Baby Health. Dr. Sherwood Moore currently spends time at the VA Hospital, serving veterans’ needs. Most notably, Dr. Andy’s Surgery on Sunday (SOS) program (profiled in these pages in February, 2009) continues to gain national recognition and inspire similar programs elsewhere. SOS’s plastic surgeons, along with 400 other healthcare providers, volunteer weekly to provide reconstructive services to the working poor,
“When you use the term ‘patient,’ you are taking on their psychological, physiological, sociological, and pharmacological well-being,” Dr. Mike Moore.
Issue#80 15
cover story
their own Surgery on Sunday programs. A group from Rome, Georgia came to observe as they begin theirs. In reference to his motivation to create Surgery on Sunday, Dr. Andy likes to quote his father, who said, “If you want to help the poor, you don’t have to go overseas. There are plenty of poor people here in Kentucky.” With his inspired guidance, Dr. Andy is certainly doing his father’s legacy justice.
A Rapidly Evolving Field
PSOL’s “patient not consumer” attitude contrasts with how the field of plastic surgery is currently trending. The rapidly evolving field is consumer-driven in many of its innovations. “Case studies and testimonials about enhancements are marketed directly to the patient,” says Dr. Andy. As a result, people have access to marginally accurate information. He continues, “There are a lot more celebrity testimonials about the efficacy of some new procedures than there are scientific studies.” Some of the latest surgical and non-surgical developments include fat grafting, in which a patient’s own tissue is used for filler; silicone gel implants with increased gel cross-linking allowing for anatomic shape; skin removal after massive weight loss; non-invasive body contouring 16 M.D. Update
Surgery on Sunday has helped over 5500 people in the eight years it’s been in existence. Drs. Mike, Andy and Woody Moore donate their time along with 400 other health care providers from across Kentucky.
using freezing techniques; and skin care products. The durability of these is unknowable, as Dr. Andy says, “It’s difficult to know which will emerge as the most successful treatments.” While they agree that many of the innovations are exciting, the doctors at PSOL take a cautious approach to the changes in the field. Dr. Mike cites their father who was fond of saying, “Don’t be the first on the ship; don’t be the last off the ship.” This is consistent with their deliberate approach to giving patients a clear picture of what they can realistically expect amidst the media and advertising barrage about the possibilities of aesthetic procedures. Dr. Mike continues, “It’s imperative that we avoid over the top claims about what we might achieve.”
Redefining “Family” Practice
While the legacy of Dr. Moore Sr. is palpable in the philosophy of PSOL, the daily practice is strengthened by a more immediate familial element: the bonds of brotherhood. Simply put by Dr. Mike, the Moore boys “know they have each other’s backs.” Forged on years of sharing the same bed-
room and attending the same boarding school, Dr. Andy, Dr. Mike, and Dr. Woody are beyond many of the prideful insecurities they have observed in other partnerships. This glues the practice together. “When you practice with family members, you have a lot more to lose if the partnership falls apart,” states Dr. Andy. And there is nothing to hide here: the Moore boys have seen each other fail and succeed for a lifetime.
to have this mentor-mentee relationship on a daily basis,” he says. He knows with another family it might have been different, but he cites the Moore brother’s “character and what they are about” as the key. They in turn value him greatly, as Dr. Hill holds up the spirit of the practice and brings an interest in cutting-edge practices. Dr. Andy says, “Joe has the compassion and surgical skills – and a lot of new ideas. Around here,
While the legacy of Dr. Moore Sr. is palpable in the philosophy of Plastic Surgeons of Lexington, the daily practice is strengthened by a more immediate familial element: the bonds of brotherhood. Besides, Dr. Andy quips, “If someone feels unjustly treated, we can always call Mom, and she will straighten it out.” There is healthy competitiveness between Dr. Andy and Dr. Mike; they know they counterbalance each other in style and experience. “We don’t always agree,” says Dr. Mike, “but we are willing to help each other even in those disagreements.” This commitment manifests itself in an ethos of collaboration and forgiveness in the facility. As Dr. Mike say, “Compared to many partnerships, there are probably a lot more apologies that go on here.” And Dr. Hill, the relative outsider, agrees, “They are special people.” Besides the patients of PSOL, Dr. Hill can be seen as the main beneficiary of the Moore brothers’ enduing collaboration. The first of his generation in the practice, he is in the luxurious position of being in the midst of three physicians who care for him as family and have a combined 75 years in those hallways (Dr. Andy joined in 1983, Dr. Mike in 1986, and Dr. Woody in 1995). “I really appreciate the opportunity
everybody calls him ‘Dr. Future.’” And the future of the practice is fast approaching. Facility and technological advances are constant and personnel changes imminent. In addition to creating the inpractice surgery, PSOL has a satellite office in Richmond. They have begun using fillers and Botox. Previewing new technologies is a regular part of their schedule; recently they looked at laser hair removal and noninvasive fat removal equipment. Dr. Andy plans only to practice at PSOL for a few more years. He is considering new challenges that involve less of the red tape that modern medical practices entail. Everyone in the practice expects Dr. Mike’s son, Evan, who is just starting residency, to eventually join up. PSOL is on the lookout for more new talent – that is talent that wants to practice in the spirit of compassionate and deliberate care that has become their hallmark. With a third generation of Moore family doctors who have direct access to that tradition, it’s safe to assume the PSOL of the future will embrace it. ◆ Issue#80 17
Special Section Aesthetic Medicine
Aesthetic Integration
Physician’s Center for Beauty takes a trifold approach to aesthetic services and treatments By Sean Maguire, MD Louisville Physician’s Center for Beauty is a medical spa and plastic surgery practice located in Louisville, Kentucky. Established in 2005 by a group of physician investors, the practice is located in St. Matthews in a 3,200-square foot retail space with easy access and parking. The business is comprised of three parts that are well integrated. The clinical segment is comprised of plastic surgery and medical aesthetics. The skin care portion of the business encompasses diagnostic and consultation services as well as the sale of physician-directed skin care products. The spa piece of the business includes aesthetic services provided by three licensed aestheticians and massage performed by a licensed massage therapist. As a full-time plastic surgeon, I am present on-site performing all medical procedures myself and supervising all aspects of the business. Plastic surgery is the core of our practice, and the office is where I see patients in con-
sultation. Surgery is performed at an accredited ambulatory surgery center, off-site. My training includes a residency in head and neck surgery in which I was board certified prior to completing plastic and reconstructive surgery training. I also completed a fellowship in aesthetic and laser surgery in Maui, Hawaii prior to beginning clini18 M.D. Update
Dr. Sean Maguire is a plastic surgeon and medical director of the Physician’s Center for Beauty in Louisville, Kentucky.
cal practice in Louisville. I have a strictly fee-for-service cosmetic practice and perform face and neck lifts, cosmetic eyelid and brow surgery, rhinoplasty, breast and body contouring, and liposuction. Aesthetic medical services offered include injectable treatments such as Botox® and dermal fillers, laser treatments, and non-invasive body contouring. I perform all the injectable treatments myself. Laser procedures performed by myself include vein treatments, laser skin resurfacing and laser tattoo removal. Laser procedures that are delegated to aesthetic staff and overseen by me include
intense pulsed light (IPL) for pigmentation and redness/rosacea, laser hair removal, and dermal genesis (skin tightening). The aesthetic and skin care portion of the business is coordinated by a full-time skin care consultant, Marilyn Cannon, who serves as the “gatekeeper” of the practice. Under my supervision, she evaluates patients initially with a detailed history and focused dermatologic exam, makes product recommendations, and coordinates aesthetic, medical, and surgical treatments. The initial consultation includes a Visia® complexion analysis, which takes standardized photos of the face. It also quantifies several parameters of the skin including fine lines, pigmentation, texture quality, and pore size. This is then used to demonstrate the results of treatment recommendations made by the skin consultant. Recommendations may include prescription and non-prescription
skin care products, laser treatments, aesthetic treatments such as chemical peels, Botox® or filler injections, or full-scale plastic surgery procedures. We employ three full-time licensed aestheticians who are overseen by our practice manager. They spend the majority of their time performing medical spa services including facials, chemical peels, microdermabrasion, and body treatments. Laser procedures that are performed by aestheticians are directly supervised by me, in accordance with Kentucky Board of Medical Licensure guidelines. Aestheticians also administer our non-invasive body contouring treatments including Exilis® and CoolSculpting®, again under my direct supervision. The model of our practice is one that fully integrates plastic surgery, medical aesthetics, spa services, and skin care product sales. It works well because I am on-site full time to oversee all that we do. I perform all medical and surgical procedures myself, without delegating to a nurse, PA, or nurse practitioner. I think this adds value to our patients’ experience and provides a level of trust not available at many other medical
The model of our practice is one that fully integrates plastic surgery, medical aesthetics, spa services, and skin care product sales. spas. The location in a heavily trafficked retail center allows for a fair amount of walk-in business, while still maintaining privacy for our patients. ◆
Expertise no one can match
Michael Sekela, MD, surgical director of the Gill Heart Institute
Michael Sekela, MD, and the UK HealthCare cardiothoracic surgery team offer expert care for coronary bypass and major aortic surgery as well as arrhythmia surgery (the MAZE operation). We also offer valvular heart surgery including minimally invasive, transfemoral and transapical approaches to aortic valve replacement. To learn more about the UK Gill Heart institute Cardiothoracic Surgery program, please email Karen Riggs, UK Physician Liaison Program director, at karenriggs@uky.edu. To refer a patient to Dr. Sekela or one of our cardiothoracic surgeons, call UK•MDs at 800-888-5533.
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Special Section Dermatology
Cassis Dermatology & Aesthetics Center: PA-C Allows Physician Time to Focus By Jennifer S. Newton
Growth. In the context of clinical dermatology, the connotation of the word “growth” may be insidious when applied to an atypical skin lesion. However, from a business standpoint, growth is a measure of success, which is exactly the path Cassis Dermatology & Aesthetics Center has been on since we last spoke with them in 2011. The growth is evident in the addition of a new practitioner to help manage volume and plans to build out an additional 4,200 square feet of adjacent office space for more exam rooms, dedicated procedure rooms, and a conference room. Construction is set to begin soon and be complete in early 2014. Solo practitioner Tami Cassis, MD, added Heather Hill, PA-C, to her staff
Prospect
Dr. Tami Cassis (left) is pictured with some of her staff: (Left to right) Heather Hill, PA-C, Della Dickson, Julia Thompson, Kelly Friel, Susie Collins, RN, and Diane Buss.
rashes, and tick bites. This frees Cassis to focus on skin cancer screenings and patients at high risk for skin cancer. When deciding what type of practitioner to add to Cassis Dermatology & her practice, Cassis’ position Aesthetics Center will soon add about a year and a half 4,200 square feet of adjacent on the Kentucky Board of ago. With the addition office space. Medical Licensure (KBML) of Hill, she has been able took a fortuitous turn when to lighten her patient load a little, while she was appointed the KBML’s physician accommodating more patients overall. representative on the Physician Assistant “When you have more extenders and more (PA) Board. While she knew nothing about practitioners, you can offer more services PAs at the time, other members of the PA and more time slots to patients,” says Cassis. Board were helpful in deepening her underWhile Cassis’ dermatology practice has standing of the profession. As a result, a two-prong focus – clinical and cosmetic Cassis began a dermatology rotation with dermatology, Hill sees only clinical patients. PA students at UK as an extension of the “I see more of the acute dermatology,” says residency rotation she does for dermatology Hill. She focuses on issues such as acne, residents at UofL. “The more exposure I warts, changing moles, psoriasis, shingles, got, the more understanding I had, the way 20 M.D. Update
more I felt comfortable with having PAs,” says Cassis. Hill, who was not a student at UK, sought out Cassis for training and was a natural fit for the specialty and this particular practice. From Hardin County, Kentucky, Hill received her bachelor’s degree from UofL and her PA-C from South University in Savannah, Georgia. “As a PA you don’t necessarily specialize,” says Hill. “When I did my rotation, I did it with [Cassis] because regardless of where I want to work, I’m going to need to be able to recognize rashes … and know when I need to refer.” According to Cassis, Hill has been a huge asset with her pediatric population.
A Passion for Early Detection
A 2012 National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) report cited skin cancer rates skyrocketing as rates of other major cancers were decreasing. “When that stat came out … it was the smack in the head for me that we are still not doing enough
as physicians … I need to get more vocal,” says Cassis. Cassis admits dermatology has been downplayed in the past, in part because melanoma is the only skin cancer with the threat of death, but she believes better education can change attitudes. “You will live from basal cell and squamous cell, but do you really want part of your face cut off?” she asks. The good news is there are an increasing number of good options for treatment and prevention of pre-cancers. Photodynamic therapy has become more mainstream, and most insurance is now covering at least part of it. Chemotherapy creams and immunomodulators are getting easier for patients to use. A new cream for actinic keratosis (AK), Picato (ingenol mebutate), boasts a
Physician Assistant Heather Hill exams a lesion with a dermascope.
treatment period of three days as opposed to six weeks to three months, which has compliance increasing exponentially. Cassis just recently purchased MelaFind®, a handheld instrument similar to a Dexa scan that gives a statistical significance for a suspicious mole. By using Issue#80 21
Special Section Dermatology
light refraction, the device can penetrate below the skin to measure the architectural disorganization of a lesion and give a range from -5 to 9. MelaFind is FDA-approved, and while Cassis is still a little skeptical, she says she is optimistic because “she was impressed enough with the science.” The appeal is the ability to catch melanomas much earlier without relying solely on a practitioner’s expertise and avoiding the biopsy of benign lesions. Currently it is not covered by insurance. She also cites the advent of pharmacies that specialize in dermatologic agents as helping physicians providing the right drug at the right cost for patients. Cassis particularly likes Bluegrass Pharmacy in Lexington for their high-level of understanding and customer service. “They really understand dermatology and understand the rebate
providing a full range of aesthetic services is a natural fit for a dermatologist. After all, it was in fact dermatology that did the research behind many of today’s cosmetic treatments. Says Cassis of dermatology and plastic surgery, “We’re different, but we have some overlap. We don’t do cosmetic surgery, but we do non-surgical treatments.” CoolSculpting® is one of the newer treatments Cassis loves. Essentially the
With the addition of a PA, I can keep skin cancer my number one priority for patient care and still do the cosmetic person without feeling like I’m slighting acute dermatology patients. cards, insurance, mailing drugs to patients, the nurses limited time and my no time … They understand me!” says Cassis.
The Extension of Aesthetics Services
On the other side of the practice, Hill’s joining the Center has enabled Cassis more opportunity for cosmetics. For Cassis,
freezing of fat, the treatment is easy with minimal downtime, and patients get great results. In skin care, SkinMedica, recently purchased by Allergan, is improving the side effects of Tretinoin, the most commonly prescribed acne medication and the best treatment for fine lines and wrinkles, and is developing a non-prescription product with the efficacy of Tretinoin.
The Future of Dermatology
Cassis foresees the continued development of biologics for psoriasis and more topical chemo-preventive therapies for AK, the most common type of pre-cancer. A promising new oral medication 22 M.D. Update
Julia Thompson, cosmetic coordinator, performs CoolSculpting on a patient’s abdomen.
for basal cell carcinoma has been FDAapproved for about a year. The first of its kind, Erivedge (vismodegib) is currently only approved for basal cell nevus syndrome. “What has really opened up our eyes is they’re responding so well to this drug with minimal side effects that maybe we can now start to do clinical trials to see if this type of drug or this class of drug works for the patient that’s got the big basal cell on their nose, maybe we don’t have to cut,” says Cassis. ◆
For patient referral contact:
Norton Commons 9301 Dayflower Street, Suite 100 Prospect, Kentucky 40059 (502) 326-8588 www.cassisderm.com
Special Section Dermatology
It Points to Tanning
Lexington Dermatologist looks to tanning for increased melanomas in college age patients By Ashley Barlow The amount of college age patients coming to see Lexington dermatologist Erika N. Music, MD, has been steadily increasing. “We’re seeing an explosion of melanoma in patients in their 20’s or even younger,” says Music. “It’s unbelievable the extent of skin cancer we’re seeing in patients at such a young age. I think much of it is tanning bed related,” she says. This sudden increase has dermatologists at Dermatology Consultants encouraging their patients to stop the use of tanning beds right away. In March 2012, the Kentucky House of Representatives approved House Bill 249
in 1976 by Joseph P. Bark, MD, and now Music still regularly sees patients of all ages, has offices in Lexington and Richmond, showing that dermatology is more than just Kentucky. Other providers in the prac- treating acne. “That’s one of the many positice include Kelli Greer Webb, MD, Ryan tives about dermatology, you can see pretty much any age,” she says. Filiatreau, PA-C, and The skin is the “I always liked that it Samantha Stratton, didn’t tie you down to PA-C. Music was familwindow to a one age group or sex.” iar with Bark’s reputation patient’s internal The providers at of giving quality care in Dermatology Consultants a friendly, professional health. most commonly diagnose environment for patients – Dr. Erica N. Music skin cancer at an early and staff alike. “He’s stage however they often great. He’s been an excellent mentor for me, and everyone here really see more advanced cases in more rural locaenjoys working with him,” says tions, such as Cynthiana and Richmond. Music says that she sees patients with melaMusic. noma or other types of skin cancer that have been untreated for years due to restricted Current Trends in Dermatology healthcare or lack of awareness. Music emphasizes that dermatology is As time passes and technology more than cosmetics and superficial work. develops, the field of medicine The skin can help indicate a bigger probadvances as well. Dermatology lem. “The skin is the window to a patient’s is no exception. In today’s sociinternal health. I have seen patients present ety, the ideas of gradual, natuwith a new rash and they were diagnosed ral results with less downtime with cancer later,” she says. It’s that prinhave gained popularity and have ciple of caring for a person’s overall wellpatients looking for prevention of being that keeps Music coming to work skin disease and aging. Lately the and enjoying her job. “I enjoy everyday practice of skin tightening and fat Dr. Erica N. Music, getting to meet new people. I have formed reduction is growing in popularDermatology great relationships with patients; it’s so satlimiting the use of tanning beds ity among patients. Also increasConsultants, isfying to hear someone say, ‘You saved my for teenagers under the age of 18 ing is the use of teledermatology, sees tanning as life.’ That’s why I do it, to help people and without written permission from treatment over the internet. Music a possible cause improve their lives. ◆ their parent. explains that she has had patients for skin cancer in Music, a native of Lexington, younger patients. email her photos of the affected received her medical degree from areas, and she can give them diagFor patient referral contact: nostic information quicker. the University of Kentucky College The technology in the office has kept of Medicine. She mentored under dermatologist Martha Post, MD, throughout her pace as well. Examples at Dermatology high school and college studies. Music was Consultants are Exilis®, a radio frequency encouraged by Post to consider dermatology device that delivers thermal energy and due to its flexible hours and family-friendly heat to targeted areas for fat loss and skin 1401 Harrodsburg Road, C415 schedule. Music completed her dermatol- tightening, and Sculptra®, an injectable that Lexington, KY 40504 ogy residency at Cook County Hospital helps the body form its own collagen and in Chicago. In 2010 Music returned to restore lost volume that results from aging. (859) 278-9492 Lexington and joined Dermatology They also are using a new laser to treat www.dermconsultants.com wrinkles around the eyes and lips. Consultants. Despite the trend of younger patients, Dermatology Consultants was founded
Lexington
Issue#80 23
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Rains Named Medical Director of Emergency Medicine Services at Good Samaritan Hospital
Kentucky College Of Medicine, Rains is board certified in emergency medicine and is currently an assistant professor in the Department of Emergency Medicine, University of Kentucky. Rains previously served as a resident representative for the Kentucky Chapter of the American College of Emergency Medicine Physicians (KACEP) Board of Directors and the UK College of Medicine Scholarships and Grants Committee.
As medical director, Rains will work closely with the emergency services multidisciplinary team to enhance the emergency care provided at UK Good Samaritan Hospital.
Housman Appointed to LifePoint Hospitals ® National Physician Advisory Board
LEXINGTON MESA Medical Group in collaboration with UK HealthCare announced the appointment of Dr. Allison Rains as the new medical director of Good Samaritan Hospital’s Emergency Medicine Services.
A graduate of the University Of
LEXINGTON MESA Medical Group’s William Hunter Housman, MD, has been appointed to LifePoint Hospitals ® National Physician
Baptist Health Announces New Physicians LOUISVILLE Tracy Ander, DO, neurology, has joined Baptist Neuroscience Associates, part of Baptist Medical Associates. Ander is a Tracy Ander, DO 2009 graduate of the Ohio College of Osteopathic Medicine in Athens, Ohio. She completed her traditional rotating internship and adult neurology residency at Grandview Hospital & Medical Center in Dayton, Ohio in 2010 and 2013, respectively. Ander is board eligible in neurology. Ismat Asad, MD, family medicine, has joined Baptist Medical Associates’ location at 10216 Taylorsville Road, Suite 600, in Ismat Asad, MD Jeffersontown. Asad is a 1998 graduate of the Sylhet Osmani Medical 24 M.D. Update
College and Hospital in Sylhet, Bangladesh. She completed her family and geriatric medicine residency at the University of Louisville in 2013. Asad is board certified in family medicine. Jonathan Hodes, MD, MS, FACS, neurosurgery; Kelley Kiesler, MSN, APRN, and Angela Mullins, MSN, APRN, have joined Baptist Surgical Associates as Baptist Jonathan Hodes, MD Health Center for Advanced Neurosurgery. The practice is located Kelley Kiesler, MSN, APRN at 3900 Kresge Way, Suite 41. Jonathan Hodes, MD, MS, FACS, is Angela Mullins, MSN, APRN a 1980 graduate of Indiana University School
Advisory Board. LifePoint, a hospital company focused on providing quality healthcare close to home, says the National Physician Advisory Board will provide strategic guidance to the company on efforts related to enhance clinical quality, physician engagement, and innovative models of healthcare delivery. “I am particularly honored for both the opportunity to stand among such remarkable physicians from across the U.S. and to work closely with LifePoint, who had
of Medicine in Indianapolis. He completed his internal medicine residency at Indiana University Medical Center in Indianapolis in 1982. Hodes completed fellowship at the National Institute on Aging in Bethesda, Md. in 1984. He completed neurosurgical residency at the University of California-San Francisco in 1988, a neurovascular surgery clinical fellowship at the University of Western Ontario in 1989 and a neurointerventional radiology fellowship at Lariboisiere Hospital in Paris, France in 1991. Blakely Dueitt Kute, MD, oncology and hematology, has joined CBC Group: Consulting in Blood Disorders and Cancer, part of Baptist Blakely Dueitt Kute, MD Medical Associates, located at 4003 Kresge Way, Ste. 500. A Louisville native, Kute is a 2007 magna cum laude graduate of the University of Louisville
School of Medicine. She completed her internal medicine residency at the University of Alabama, Birmingham in 2010. Kute completed a medical oncology and hematology fellowship at James Graham Brown Cancer Center in 2013, serving as chief medical fellow her final year. She is board eligible in oncology and hematology. Jennifer Ford, MD, has joined Baptist OB/GYN Associates, part of Baptist Medical Associates, with offices in Shelbyville and St. Matthews. Ford is a Jennifer Ford, MD 2009 graduate of the Mercer University School of Medicine in Macon, Ga. She completed her obstetrics and gynecology residency at the University of Louisville in 2013. Ford also holds a master of social work from the University of South Carolina in Columbia. She is board eligible in obstetrics and gynecology.
SHELBYVILLE/LOUISVILLE
news the vision to formulate and empower our team as we lead healthcare towards a more patient-centered, outcome-based model,” said William Hunter Housman, MD, MESA Medical Group. “This opportunity falls directly in-line with and continues to help strengthen our mission at MESA.” MESA Medical Group, a physician-led company, is a service provider of Emergency Medicine and Hospital Medicine to currently 26 hospitals throughout Kentucky, Indiana, Ohio, and West Virginia.
the UK HealthCare Neurosurger y Department, where he serves as an assistant professor. Fraser is a highly skilled, dedicated and compassionate clinician. He was instrumental in the design of the Hybrid operating suite for cerebrovascular procedures. He is the current medical director for the
Neurosurgery Intensive Care Unit and has been a very active member of the Stroke Program. Over the last three years, this team has led UK HealthCare in achieving the American Heart Association’s Gold Plus Award three times, as well as a recent Primary Stroke Center recertification with The Joint Commission. Fraser earned his medical degree from the Weill Medical College of Cornell University, where he also completed his
UK HealthCare Announces New Roles for Physicians
LEXINGTON UK HealthCare has announced additional roles for three physicians in key patient care areas: Dr. Laura Fanucchi, UK HealthCare Enterprise Medical Director for Translational Care In her new role, Fanucchi will work collaboratively within UK HealthCare, joining current initiatives to explore avenues to improve post-acute care for our patients. Fanucchi will help ensure that they provide high quality and efficient care across the continuum. Fanucchi attended Emory University School of Medicine and completed her Internal Medicine internship and residency at New York/Presbyterian Hospital – Weill Cornell in New York, NY. In 2008, she also received her MPH from Emory University Rollins School of Public Health. Fanucchi is a respected Internist who also has focused her time in quality improvement. Since arriving at UK HealthCare in 2012, Fanucchi has been actively involved in quality and safety initiatives that include the Pharmacy and Therapeutics Committee, the UK HealthCare Patient Safety Team, a coleader of the IV Drug User and Substance Abuse PI group, the Post-Acute Care team, and the Provider Documentation Council.
Dr. Justin Fraser, Medical Director for Cerebrovascular Surgery In this role, Fraser will work with the Kentucky Neuroscience Institute and Stroke Service leadership to enhance the comprehensive neurological care provided to our patients. Since joining UK HealthCare in 2011, Fraser has been an integral member of
24th Annual
BB&T/Lexington Medical Society Golf Outing
Wednesday, August 28, 2013 University Golf Club of Kentucky
Thank you to our sponsors: Gold Sponsor
White Tee Sponsors
Special thanks to our food and beverage sponsors:
Committee Members John W. Collins, M.D., Chairman
James W. Baker, M.D.
Wendy G. Cropper, M.D.
W. Lisle Dalton, M.D.
Kenneth V. ì Tadî Hughes, III, M.D.
John Maher, BB&T
David Smyth, Family Financial Partners
Jon H. Voss, M.D. Gil Dunn, M.D. Update
All proceeds to benefit the Lexington Medical Society Foundation. JC-9181 4.8542x7.25 HP4C Golf Outing v2.indd 1
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news training in neurological surgery as well as interventional neuroradiology. His clinical interests in neurosurgery include cerebrovascular, skull base, and endovascular neurosurgery. The author of numerous papers and book chapters, Fraser lectures both nationally and internationally on these and other topics within the field. Dr. Andrew Bernard, Chair of the UK HealthCare Intensive Care Unit Committee In this role, Andrew and the team will work collaboratively across all of our ICUs to ensure the provision of high quality, safe, patient-centered and efficient intensive care. Bernard attended medical school at the University Of Kentucky. He completed a general surgery residency and a trauma and critical care fellowship at UK. Bernard is recognized as a national leader in trauma care and is an excellent trauma and acute
care surgeon. He is respected for his patientcentered approach. Since 2002, Bernard has been very active in quality and safety initiatives that include the Interdepartmental Trauma Quality Assurance Committee, UK Organ Donation Council where he has served as chair since 2007, and the Transfusion Subcommittee. He is currently the medical director of UK HealthCare’s Trauma and Acute Care Surgery service line and chair of the Kentucky Trauma Advisory Committee, which oversees Kentucky’s trauma system.
UK HealthCare Names Lee Medical Director of Stroke Care
LEXINGTON Dr. Jessica D. Lee has been named UK HealthCare Medical Director of Stroke Care. Lee assumes the responsibilities formerly held by Dr. Michael Dobbs.
In her new role, Lee will work with members of the enterprise stroke leadership team on maintaining compliance with stroke core measures, stroke center certification, and other quality initiatives in stroke care. Lee attended the University Of Mississippi School Of Medicine and is a fellowship-trained vascular neurologist with a strong background in patient safety. Since 2009, Lee has been actively involved in the American Academy of Neurology’s Patient Safety and Education Committees. She has spoken regionally and nationally on “Patient Safety 101 for Neurologists” and has worked to develop curricula for neurology residency training programs. From 2009-2011, Lee was the medical director of the Parkland Health and Hospital Systems Neurology Clinic. From 2010-2012 she was named the medical director of the Acute Stroke Unit and 5th Floor Medical-Surgical Unit of the University Hospital-Zale Lipshy. In this role, she (with nursing leadership) improved hand washing compliance of the physician staff to 100 percent as well as completed a successful Meaningful Use implementation with the stroke related measures. From 2011-2012 she also served as the medical director of the Inpatient Neurology Services at UT Southwestern Medical Center. Since coming to UKHC in 2012, Lee has been leading development of a vascular neurology fellowship training program, as well as a telehealth stroke care clinic within the Stroke Care Network.
CMKI Announces 2013-2014 Class of Hand Fellows
LOUISVILLE The Christine M. Kleinert Institute for Hand and Microsurgery (CMKI), a world-renowned nonprofit education and research organization, is proud to announce the 2013-2014 Class of Fellows. Individuals accepted into the Hand Surgery Fellowship include: Michael Coffey of Dayton, OH; James Donovan of Flint, MI; Scott Farner of Louisville, KY; Micah Jones of Farmington Hills, MI; Camela Pokhrel of Chicago, IL; James Treadwell of York, PA; Haritha Veeramachaneni of Los Angeles, CA; Kiley Ziegler of Kansas City, MO; Francisco Aguilar of Bogota, Columbia; Sajjad Hussain of Lahore, Pakistan; Fernando Polo of Toledo, Spain; Chris Milner of Sheffield, United Kingdom; Javier Ruiz of 26 M.D. Update
news Monterrey, Mexico; Gregorio Santana of Santo Domingo, Dominican Republic; Luis Vicentela of Santiago, Chile; and, Eduardo Zancolli of Buenos Aires, Argentina. University of Louisville Orthopedic Surgery Residents rotating in hand surgery in 201314 from Louisville, KY are: Adam Cochran; Victor Fehrenbacher; Shane Kibbe; and, Zach Yenna. CMKI congratulates this year’s Senior Hand Surgery Fellows: Anas A.R Altamimi of Irbed, Jordan; Carlos Lozano of Monterrey, Mexico; and, Shihheng Chen of Taipei, Taiwan. CMKI’s Research Fellow is Dong Han from Shanghai, China.
learning a child’s diagnosis helps decrease parents’ uncertainty about the future. He will also explore how families are affected when advanced technologies don’t turn up a diagnosis for a child. The study grant is part of the NIH’s Clinical Sequencing Exploratory Research program under the direction of the National Human Genome Research Institute. CSER supports both the methods development needed to integrate sequencing into the clinic and the ethical and psychosocial research required to responsibly apply personal genomic sequence data to medical care.
UofL Pediatrician Investigates Dobbs Publishes Genetic Testing "Psychiatric University of Louisville pediatrician Manifestations Kyle Brothers, MD, is a co-investigator on of Neurotoxins" a new National Institutes of Health study seeking to improve diagnoses of genetic disorders and to examine the impact of genetic testing. The multi-year grant, potentially totaling more than $7.6 million, was announced in a HudsonAlpha press release. Brothers’ research will consider whether
LEXINGTON Dr. Michael R. Dobbs, associate professor and interim chair of the University of Kentucky College of Medicine’s Department of Neurology and director of the UK
HealthCare/Norton Healthcare Stroke Network, has edited and published the latest edition of “Psychiatric Clinics of North America” titled “Psychiatric Manifestations of Neurotoxins.” Building on work that he had done with co-editor Dan Rusyniak of Indiana University for Neurologic Clinics, this compilation addresses cognitive and behavioral aspects of neurotoxic exposures. Dobbs, one of only a handful of neurologists in the world with specialty expertise in clinical neurotoxicology, has previously published through Elsevier/Saunders the reference text, “Clinical Neurotoxicology: Syndromes, Substances, Environments,” which has become the leading book in the field. He has also published several journal articles and book chapters on clinical neurotoxicology and two editions of “Neurologic Clinics” devoted to neurotoxicology.
UK Researcher Earns 2013 Discovery Award
The Society for Free Radical Biology & Medicine recently named
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the University of Kentucky’s Dr. Allan Butterfield as the recipient of its 2013 Discovery Award. The SFRBM’s Discovery Award is given out every other year to a researcher who has presented significant advancements in the field of redox research. Recipients must be nominated by a SFRBM member with details justifying their consideration. Butterfield was nominated by professor Daret St. Clair of the UK Department of Toxicology, with a seconding letter written by professor Barry Halliwell, from the National University of Singapore. The Senior Awards Committee evaluated eight candidates that were nominated for the 2013 Discovery Award. Butterfield was recognized for his role as a pioneer in developing and investigating the model of amyloid beta-induced early oxidative stress in the progression of Alzheimer’s Disease and Amnestic Mild Cognitive Impairment. He has been a leader in the field of redox proteomics, having applied these and other tools to unravel relevant targets of brain protein oxidation in neurodegeneration and relevant mechanisms of cancer chemotherapy-mediated cognitive dysfunction. This highly mechanistic and translational work provided relevant contribution as a worldwide reference in this area of investigation. Butterfield will give a featured lecture at SFRBM’s 20th Annual Meeting in San Antonio, Nov. 20, titled, “Pathogenesis and Progression of Alzheimer’s Disease and Potential Mechanisms of Chemotherapy Induced Cognitive Impairment: Roles of Oxidative Stress and Insights from Redox Proteomics.” He will also be presented with a cash award, medal and offered an invitation to publish a review article in Free Radical Biology and Medicine, SFRBM’s journal. Butterfield is the Alumni Association endowed professor of Biological Chemistry at UK and serves as director for both UK’s Center of Membrane Sciences and the UK Markey Cancer Center’s Free Radical Biology in Cancer Shared Resource Facility. Additionally, he is a faculty associate for UK’s Spinal Cord and Brain Injury Research Center and is a faculty member of UK’s Sanders-Brown Center on Aging.
news their pain. To make matters worse, many of these patients, due to the formation of scar tissue, are unable to have their stimulators replaced. “This new device uses specialty components and shielding that does not interfere with MRI scans. This is a significant breakthrough for stimulator patients, many of which will require one or more MRI scans at some point in their lifetime.” said Harned. Harned is the first physician in Kentucky to implant and offer this device, which he hopes will replace previous models in the near future.
Kentuckiana Heart Walk Aims to Raise $1 Million
LOUISVILLE More than 10,000 Louisville and Southern Indiana residents are expected to lace up their sneakers in support of the American Heart Association’s Kentuckiana Heart Walk on Saturday, September 21. The annual event, which hopes to raise a record $1 Million to fight heart disease and stroke – America’s No. 1 and No. 4 killers – begins at 8:00 am. For the first time, Kentucky and Southern Indiana walkers will start at Waterfront Park and travel together down River Road, making it the largest crowd in the Heart Walk’s history. The non-competitive, 1- to 3-mile walk includes teams of employees from local companies, along with friends, family members and survivors of all ages. Attendees will have the opportunity to remember survivors and loved ones lost to heart disease and stroke through a special memorial wall. The event will also include a kid’s zone, games, music and heart-healthy snacks. The Kentuckiana Heart Walk is a component of the My Heart. My Life. behavior platform, the American Heart Association’s groundbreaking national movement that calls on all Americans to create and embrace an overall healthier lifestyle in order to improve cardiovascular health. This new platform is an important component of the American Heart Association’s sweeping national goal: to improve the cardiovascular health of all Americans by 20 percent and to reduce deaths from cardiovascular disease and stroke by 20 percent by the year 2020. Nearly 70 percent of Americans do not engage in regular physical activity. This inactivity doubles the risk of heart disease – which is largely preventable through a healthy lifestyle.
Lexington Clinic Offers New Spinal Cord Stimulator Compatible with MRIs
LEXINGTON Lexington Clinic is the first medical center in Kentucky to provide a new line of spinal cord stimulators that are compatible with magnetic resonance imaging (MRI). Spinal cord stimulation therapy uses a small pulse generator and electrodes implanted in the spine, to send electrical pulses to the spinal cord. These electrical pulses disrupt the nerve impulses that make you feel pain, and can offer patients significant relief from chronic back and leg pain. While spinal cord stimulators are immensely beneficial to patients with chronic pain, they can prove problematic for disease diagnosis; because they render full-body MRI scans unsafe. MRI scans provide extremely detailed images of soft tissues including joints, muscles, blood vessels, nerves, and ligaments, allowing for faster and more accurate diagnosis of multiple health conditions. “An MRI is a giant magnet. The stimulator models currently being used contain a significant amount of iron, which if exposed to an MRI, could cause damage to the device and injury to the patient,” said Michael Harned, MD, Lexington Clinic pain management physician. Due to the potential for harm, stimulator patients have been limited to CT scans, which utilize X-rays and show far less detail, for diagnostic purposes. For those in critical need of an MRI, the only option was removal of their stimulator, triggering the return of
UofL Studying Adult Stem Cell Treatment for Peripheral Arterial Disease
LOUISVILLE A network of cell therapy research centers established by a National Institutes of Health (NIH) grant at the University of Louisville is now enrolling patients in its first clinical trial – a Phase II study of a novel adult stem cell treatment for peripheral arterial disease (PAD). In 2012, Dr. Roberto Bolli was awarded $3.4 million over seven years from the NIH’s National Heart, Lung and Blood Institute to participate in the Cardiovascular Cell Therapy Research Network (CCTRN), a consortium of seven adult stem cell centers in the United States with expertise in conducting clinical trials of novel treatments for cardiovascular diseases. With UofL, CCTRN members are Stanford University, Texas Heart Institute, University of Florida, University of Miami, Minneapolis Heart Institute Foundation, and Indiana University. At UofL, the study will be led by Bolli, director of the Institute of Molecular Cardiology, chief of the Division of Cardiovascular Medicine and the Jewish Hospital Heart & Lung Institute Distinguished Chair in Cardiology. The clinical trial, “Patients with Intermittent Claudication Injected with ALDH Bright Cells,” is known as PACE. The goal is for the CCTRN sites to collectively enroll 80 patients in one year. PACE is a randomized, placebo-controlled study in which patients will be followed for one year. The treatment group will receive what are known as aldehyde dehydrogenase bright cells, which are stem cells taken from the patient’s bone marrow and then processed through a technology owned by the company Cytomedix Inc. (OTC: CMXI), an industry partner in the trial. Issue#80 29
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Markey Earns Prestigious National Cancer Institute Designation
The University of Kentucky Markey Cancer Center was joined by national, state and local leaders on July 12 to celebrate its designation as a National Cancer Institute cancer center. The UK Markey Cancer Center is the 68th medical center in the country to receive this prestigious designation, and is the only NCI-designated cancer center in the state of Kentucky. Earning NCI designation was a lengthy
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process that required strong efforts in research, recruiting, and improving many of the programs at Markey. As a result of the designation, patients will have access to new drugs, treatment options, and clinical trials offered only at NCI centers. The UK Markey Cancer Center will be able to apply for federal research grants available only to NCI-designated cancer centers, with the potential to bring millions in additional funding to the area. Additionally, the NCI designation allows Markey to communicate and collaborate on new advances in cancer care with other NCI-designated cancer centers across the country. Locally, Markey will be able to increase community engagement, including volunteers, patient advisory groups, and education and intervention programs.
UofL Diabetes & Obesity Center Wins Second Multimillion-Dollar NIH Grant
LOUISVILLE A center created with a five-year National Institutes of Health grant at the University of Louisville in 2008 has won its
second five-year grant. The NIH’s National Institute of General Medical Sciences has awarded an $11.25 million “Center of Biomedical Research Excellence” grant to UofL’s Diabetes and Obesity Center. Part of the Division of Cardiovascular Medicine in the Department of Medicine at UofL, the Diabetes and Obesity Center was created as a way to address the profound effect that diabetes and obesity have had on our nation’s health and general quality of life, said its director, Aruni Bhatnagar, Ph.D. Also a key component of the grant is its continued support of junior investigators. Within the past four years, seven junior investigators within the center have acquired independent federal funding, making it one of the most successful COBRE programs in the nation.
Saint Joseph Hospital Foundation Announces New Board Leadership
LEXINGTON The Saint Joseph Hospital Foundation, part of KentuckyOne Health,
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news is pleased to announce new appointments to its 2013-2014 executive committee and board of directors. Executive committee appointments include: Chair, Alan VanArsdall, President, Central Bank, Nicholasville, Ky. Vice-Chair, Greg Yeary, Wealth Management Advisor, Assistant Vice President, Merrill Lynch, Lexington, Ky. Treasurer, Susan A. Dean, Vice President Commercial Banking, U.S. Bank, Lexington, Ky. New members to the board of directors include: Susan A. Dean, Vice President Commercial Banking, U.S. Bank, Lexington, Ky. William E. Henderson III, Vice President of Sales and Marketing, RJ Corman Railroad Company, Lexington, Ky. Stephen Hillenmeyer, President, Stephen Hillenmeyer Landscape Services, Lexington, Ky. Kimberly Stigers, MD, radiologist and co-director of the Saint Joseph Breast Center,
Lexington, Ky. The primary purpose of the Saint Joseph Hospital Foundation is to raise and administer funds to support the core values and mission of Saint Joseph Saint Dr. Kimberly Stigers Hospital, Joseph East, and the Saint Joseph Jessamine RJ Corman Ambulatory Care Center. One of the Foundation’s goals is to bridge the gap between medicine and compassion. The Foundation is always looking for ways to assist those in need and is funded solely by the generous contributions of those wishing to assist our efforts.
Baptist Health Hospitals Make State’s Top Five in National Rankings
LOUISVILLE Two of Baptist Health’s seven hospitals were named to the top five of Kentucky hospitals ranked by U.S. News &
World Report. This is the second year for the publication to issue rankings for each state and metro area of at least one million in population. Baptist Health Louisville was named #1 in the Metro Louisville area and #2 in Kentucky – tied with the University of Kentucky Albert B. Chandler Hospital. Baptist Health Lexington made the rankings for the first time this year, coming in at the #4 spot for Kentucky. Baptist Health Louisville performed nearly at the level of nationally ranked U.S. News Best Hospitals in 10 adult specialties: cardiology and heart surgery; diabetes and endocrinology; ear, nose and throat; gastroenterology and GI surgery; geriatrics; gynecology; nephrology; orthopedics, pulmonology and urology. Baptist Health Lexington performed nearly at the level of nationally ranked hospitals in eight specialties: cancer; cardiology and heart surgery; diabetes and endocrinology; gastroenterology and GI surgery; geriatrics; gynecology; neurology and neurosurgery; and pulmonology. ◆
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Issue#80 31
events
16th Annual Shoulder Symposium Challenges Attendees on Traditional Treatment
course. “Recent literature has provided evidence which has lead clinicians to question Lexington Never shy about challengtheir views and ing traditional thought and practice, approaches to rotathe Shoulder Center of Kentucky tor cuff disease. titled its 16th Annual Shoulder We felt we needed Symposium, “The Rotator Cuff: to get the practicWhat Are We Really Treating?”. Robin Cromwell, PT, Lexington ing clinicians and The invited faculty included estab- Clinic, responds to question the researchers in lished physicians, physical therapists, on frozen shoulder diagnosis the same room to and certified athletic trainers. In and rehabilitation during panel discuss the inforaddition to traditional lectures, the discussion. mation and address 170 attendees took part in lively panel discussions and debates about clinical any concerns they may have,” said Aaron issues practitioners face when evaluating Sciascia, MS, ATC, NASM-PES, sports medand treating rotator cuff disease. The meet- icine program coordinator. W. Ben Kibler, founder of The Shoulder ing culminated with a hands-on laboraCenter of Kentucky and Lexington Clinic tory session where the Shoulder Center of Kentucky and Lexington Clinic physical Orthopedics-Sports Medicine Center, contherapy staff described and demonstrated siders the Shoulder Symposium “the most their method of rehabilitation for non-oper- current, state of the art thinking in the field on shoulder disease.” Information on the ative and post-operative rotator cuff care. Rotator cuff injuries are among the most Shoulder Center of Kentucky can be found common musculoskeletal issues surrounding at www.lexington-clinic.com/shoulder and the shoulder, highlighting the need for this (859) 258-8575.
Presenters at the 16th Annual Shoulder Symposium were (L-R) Peter Hester, MD, Lexington Clinic; Michael Shaffer, PT, ATC, University of Iowa; Bill Mallon, MD, Triangle Orthopedics, NC; Robin Cromwell, PT, Lexington Clinic; Jed Kuhn, MD, Vanderbilt University; W. Ben Kibler, MD, Lexington Clinic; Brian Leggin, PT, DPT, University of Pennsylvania; Aaron Sciascia, MS, ATC, PES, Lexington Clinic.
2013 KMA Annual Meeting Set for September 9-11
Louisville The 163rd KMA Annual Meeting will take place at the Hyatt Regency Louisville, Monday September 9, through Wednesday, September 11. This year’s General Session and specialty group meetings will focus on “Safeguarding Kentucky’s Health.” With recent restrictive changes to Kentucky law in prescribing and dispensing controlled substances, physicians are encouraged to take an active role in preserving and protecting the physicianpatient relationship. General Session and House of Delegates meetings will take place on Monday, September 9, and Tuesday, September 10. Full-day specialty group sessions will be held on Tuesday and Wednesday. G e n e r a l S e s s ion s : Monday, September 9 8:30 AM Welcome & Announcements William C. Harrison, MD, KMA President 8:35-10:30 AM Xtreme Makeover-PCMH Edition John Bender, MD, FAAFP, Chief Executive Officer Miramont Family Medicine, Fort Collins, Colorado Special Events on Monday Night 5–7 PM KPPAC Reception, Regency Ballroom South— Hyatt Regency 7 PM President’s Installation & Awards Dinner, Regency Ballroom North/Center—Hyatt Regency Installation of Fred A. Williams, Jr, MD – KMA President 2013-2014 & Rhonda Rhodes – KMAA President 2013-2014 Tuesday, September 10 8:30 AM Welcome & Introductions James L. Borders, MD, Program Chair 8:35 AM Practicing Safe Medicine in Dangerous Times Greg L. Jones, MD, Medical Director Kentucky Physicians Health Foundation, Louisville, Kentucky 10:15-11:30 AM Prescription Drug Overdose Andrew Kolodny, MD, Chair, Department of Psychiatry Maimonides Medical Center, Brooklyn, New York
2335 Sterlington Road, Suite 100 Lexington, Kentucky 40517 (859) 268-1040 Fax: (859) 268-6165 Email: lprober ts@barcpa.com www.barcpa.com
32 M.D. Update
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