By BECKy GILLETTE
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PhysicianSpotlight
Samuel Bledsoe, MD, sees increased lifespan of 5-10 years.
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(CONTINUEDCurrently,ONPAGE4 Tracy Gaudet, MD is Leadingfrom the Center of the Whole Health Movement Impact on quality of life is immeasurable.
Samuel Bledsoe
“We do this by educating communities and workplaces, convening and catalyzing thought leaders, and radically transforming health systems,” Gaudet said. “The goal is to improve health outcomes and quality of life, reduce healthcare costs, and influence a change in how medical education is taught and healthcare is delivered. Whole Health Institute is working with health systems, employers, community partners and medical schools, including the University of Arkan sas for Medical Sciences, to offer training and experiences in whole health principles.
The AMA has advocated against the culture of violence in America, including domestic violence, gun violence, racism, police brutality, and xenophobia— violence physicians health professionals
Arkansas has some of the worst health outcomes in the U.S. with high rates of diabetes, obesity, hypertension and stroke. The U.S. overall doesn’t fare well, with the country’s life ex pectancy ranked 28th out of the 37 Organization for Economic Co-operation and Development countries despite spending more on healthcare than any of the other countries.
By BECKy GILLETTE
But Arkansas is now the epicenter of a potentially transformative movement to address the underlying causes of poor health outcomes while also reducing healthcare costs. Northwest Arkansas is home to Whole Health Institute headed by Executive Director Tracy Gaudet, MD, a non-profit organization “with a vision to empower and equip people to take charge of their physical, mental, and spiritual health to live full and meaningful lives.”
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Cardiovascular disease, the number one cause of death in the U.S., is driven, in part, by modifiable risk factors such as obesity, diabetes, high blood pressure, and high cholesterol. of these modifiable risk factors are improved by bariatric surgery,” said Samuel Bledsoe, MD, FACS, FASMBS, Medical Di rector of Bariatric & Metabolic Surgery at Ar kansas Heart Hospital’s Encore Medical Center in Saline County. “This results in a longer and healthier life. Bariatric surgery
Tracy Gaudet
ShalynMcKittSmith Risk Factors
Greatly Improved by Bariatric Surgery
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resolves diabe December 2009 >> $5 PRINTED RECYCLEDONPAPER PRSTSTD U.S. NO.357AGEPOSTPAIDFRANKLIN,TNPERMIT FOCUS TOPICS CARDIOLOGY • WHOLE HEALTH • HEALTHCARE LAW • HEALTH WORKER SAFETY (CONTINUED ON PAGE 3)COMMEDICALNEWS.ARKANSASONLINE:ONROUNDS February 2022 >> $5 AHLA’s Top 10 Health Law Issues to Watch in 2022 Concerns cover gamut of healthcare authority affecting legislationfederal The American Health Law Association (AHLA) healthcarescrutinizesCongressrollspandemicyearwatchissueshealththerevealedrecentlytop10lawtothisastheonandlegislation. Article on page 5 MustandAgainstIntimidationThreats,DoctorsHealthWorkersEnd
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Beginning in 2016, the American Diabetes Association (ADA) has stated in their Standards of Care that an individual with diabetes and a BMI of greater than 40 should go directly to surgery, and an uncontrolled diabetic should have surgery if the BMI is greater than 35. This rec ommendation from the ADA changed the rationale for bariatric surgery.
Cardiovascular Risk Factors Greatly Improved by Bariatric Surgery, continued from page 1
Bledsoe said bariatric surgery de creases the risk of an individual with dia betes having a heart attack by 44 percent and the risk of a stroke by over 40 percent. Bariatric surgery has a protective effect in those with diabetes on diseases of the eye leading to blindness and on kidney dis eases leading to dialysis.
There are people who should consider a gastric bypass. A bypass can be a better procedure for patients with diabetes and those who suffer with severe reflux. Bled soe said in those two situations, a bypass should be considered, but not required. The pandemic has definitely been hard on people as it relates to their weight. People are exercising less and increasing their intake of unhealthy foods. This has led to the “Quarantine 15.” While diet and exercise are worsening, sleep disor ders, stress, and substance abuse issues are also increasing which can also have a det rimental effect on weight.
“They were led by a physician, Dr. Bruce Murphy, who wanted to continue to grow the institution. Of course, bariatric surgery lends itself well to a facility that specializes in cardiology since cardiac pa tients are oftentimes candidates for bariat ric surgery and bariatric surgery patients are often suffering from cardiac disease. It was a perfect match. After that meeting, I told my wife we really needed to consider moving back to Little Rock. Shortly, it be came clear that we were destined to return to my home state of Arkansas and join the Arkansas Heart Hospital.” He started seeing his first patients at the Bariatric and Metabolic Institute in January of 2017. Since then, they have become one of the fastest growing bariat ric practices in the country. They started with a staff of four and now have a staff of over 20. They have hired three more bar iatric surgeons and have three additional providers seeing patients. “We have about 1,200 patient en counters a month in the clinic, and we project to do over 1,000 surgeries in 2022,” Bledsoe said. “January of 2021 was most notable in that we opened Encore Medical Center, a 90,000-square-foot facility in Bryant with a primary mission of bariatric surgery. The growth has been crazy, but fulfilling both personally and professionally.”TheBledsoe family is one of the most prominent medical families in the state. His mother, Sen. Cecille Bledsoe of Rog ers, is chair of the Senate Health Com mittee. His father, James Bledsoe, MD, is Arkansas EMS and Trauma Director. Get in touch with the Bariatric and Metabolic Institute by going online to bmi.arheart.com, filling out the informa tion and watching an educational video. The office will check the patient’s insur ance and get back in touch. Patients can also call the office at (501) 219-7770 to make appointments with Bledsoe or any of his partners, J.D. Fuller, MD, JJ Tucker, MD, and Oscar Talledo, MD.
“In the past, we performed surgery for obesity and one of the downstream benefits was resolution of the diabetes,” Bledsoe said. “Today, we do surgery for diabetes, and one of the downstream benefits is weight loss. For anyone who struggles with diabetes, they owe it to themselves to at least consider the possi bility of bariatric surgery.”
“It has a very safe track record and the results are outstanding,” Bledsoe said. “Most patients lose an average of 60 per cent of their excess body weight. This can all be accomplished with a very low risk of complications.”
“I’ve seen a lot of anecdotal evidence of this ‘Quarantine 15,’” Bledsoe said. “I have a number of patients who have lost a large amount of weight and have put some back on due, in part, to the pan demic and quarantine. Most of this was due to the interruption in the rhythm of their lives that resulted in them modify ing what made them successful in the first place. Most of my patients struggle with their weight more than the aver age person. It stands to reason that they are probably struggling more now.”
Bledsoe began training in bariatric surgery in 2004. When he completed his training in 2009, he made bariatric sur gery the focus of his practice. Currently, bariatric surgery is more than 95 percent of what he does. By early 2022, he had done nearly 3,000 bariatric cases as pri maryAftersurgeon.hecompleted his residency in Birmingham, Ala., initially he and his wife decided to go to Alexandria, La. There was a premier healthcare system in town with a talented group of surgeons who were looking to add another partner. Bled soe took a job with them in 2009.
Bledsoe honestly believes that education is the key to long-term success with weight loss surgery. You can be given the tool, but if you misuse the tool, your results won’t be as good long term.
Samuel Bledsoe, MD, in Surgery
“Everyone should meet with a dieti cian skilled with bariatric patients, an ex ercise specialist knowledgeable concerning the morbidly obese, and psychologists who truly understand the mental needs of this patient population,” he said. “This preoperative time is not to weed people out, but to help people succeed in their goals. It helps people understand how to best utilize their new tool. It teaches patients how to implement successful habits. It puts people in the best mental framework for continued success after life throws them the inevitable curve balls.”
“Bariatric surgery can also reverse the damage to the liver caused by non-alco holic fatty liver disease, which is found at much higher rates in people with diabe tes,” Bledsoe said. “All of this results in a longer and healthier life span with a recent study showing an increase in lifespan of 5-10 years for the average patient receiv ing bariatric surgery.”
arkansasmedicalnews com FEBRUARY 2022 > 3 tes 83 percent of the time. Hypertension goes into remission in about 60 percent of cases. High cholesterol is improved in the overwhelming number of cases. Of course, obesity is dramatically impacted by bar iatric surgery with most patients losing more than 50 percent of their excess body weight.”Ofall the benefits, the improvement for people with diabetes is what Bledsoe finds most exciting. “The interesting thing is how quickly this happens, because the resolution of the diabetes can happen immediately,” he said. “The patient can come into the hospital with diabetes and on multiple medications. They can then leave the hospital with normal blood sugar and on no medications. Most people, even most doctors, don’t realize this.”
The long-term follow up is also im portant. The accountability and contin ued education are critical. Patients should meet with their surgeon several times in the first year after their procedure and at least annually thereafter. Bledsoe said this allows for typical post-operative checks, keeps them accountable for weight loss maintenance, and allows for continued education over time.
“Honestly, we made great friends and built a thriving practice in town,” Bledsoe said. “We thought we were going to stay there forever.” In 2016, his brother, Arkansas Sur geon General Greg Bledsoe, MD, and his entire extended family came to visit over Memorial Day. “He began telling me about Arkansas Heart Hospital,” Bledsoe said. “It sounded intriguing, but I wasn’t overly interested. I decided to go ahead and set up a time where I could meet with the administra tion of the facility. At the meeting, I was really captivated by the unique way Ar kansas Heart Hospital takes care of pa tients and how responsive they were to the changing medical landscape.
Bariatric surgery has definitely im proved over the decades. Laparoscopy has allowed for minimal access to the abdominal cavity meaning a lower rate of complications and shorter recovery times. Increased education for patients and improved training for physicians and hospitals has allowed for better access for patients and better outcomes from the procedure. Bledsoe said that, at this time, having bariatric surgery is as safe as hav ing your gallbladder removed and far safer than having colon surgery. He considers sleeve gastrec tomy a great innovation and is the proce dure of choice for about 80 percent of his patients.
For a healthcare professional interested in exploring how whole health can transform their practice, there is the online course Clinical Series designed for healthcare providers and clinicians.
There are up to 32 total hours of training, along with Continuing Education Credit available at no charge.
“Whole Health Institute is excited to help lead the way in this area as part of a newly announced initiative, State Trans formation Collaboratives,” Gaudet said. “The Collaboratives was formed by the Center for Medicare and Medicaid Services and brings to gether organizations, including Whole Health Institute, to sup port locally-driven healthcare transformations that prioritize the needs of the communities. Arkansas is one of only four states chosen to pilot the program based on the significant opportunity to impact health equity and because of the momentum around alternative pay ment models.”
Tracy Gaudet, MD is
“For veterans, there was a threefold reduction in opioid use, increased perception of care, engagement in their care and their self-care, engagement in life, and decreased stress,” Gaudet said. “For staff, there was decreased burnout, increased motivation, and reduction in resignations for physicians, nurses, and other health services employees. The total spend for healthcare of the active cohort declined by 30 percent relative to the general VA population. The cost savings opportunity for whole health is immense, while the im pact on quality of life is immeasur able. Now the opportunity is to take what was learned in that system, and evolve it and expand it across the pri vate sector, as well.” Whole health is about rewiring how we think about health, well-being, and self-care by focusing on the whole per son. Typically, healthcare providers start with the illness or condition. Gaudet said in doing that, we are missing out on the biggest motivational factors, the patient’s goals and dreams.
For both employee well-being and clinical training programs, they are con tinuing to evolve the models and evaluate the impacts with plans to extend pilots to additional businesses and health systems.
The series begins with Whole Health Foundations, which first focuses on provider well-being. Then, the courses Practicing Whole Health I, II, and III develop skills that allow clinicians to move beyond the disease-centered care to an approach that equips patients to live full and meaningful lives. And the skills labs offer real hands-on learning models.
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One example is their work to break down barriers to whole health by moving away from value-based payment struc tures and toward value-based models, that incentivize healthy outcomes over the number of visits.
moved to Northwest Arkan sas about two years ago with her husband and son. “We love it! What I have been most impressed with is how genuine and kind the people are here,” she said. “This kind of authenticity is really quite rare, and it makes both living here and doing this collaborative work, a true gift.”
One of the biggest predictors of wellbeing is people’s relationships, so Whole Health is helping providers think about what it means to have a care team, or a whole health community. Gaudet said as health providers, we can encourage pa tients to engage with well-being profes sionals, coaches, instructors, facilitators, and groups that are supporting their selfcare journey and centering on what mat ters most to them.
The Whole Health movement fo cuses on driving transformation through living laboratories. This means piloting programs with aligned organizations start ing with Northwest Arkansas; learning and measuring outcomes, and then scaling up. Gaudet said that through these programs, Whole Health is leveraging new technology and best practices, and providing educa tional experiences to care teams, employer groups, and communities toward the goal of improving health outcomes.
Leading from the Center, continued from page 1 East View of Whole Health Institute Building ©Marlon Blackwell Architects
Whole Health Institute has several col laborations underway including the Sup porting Lifelong Success Neurodiversity Initiative and exploring the integration of whole health into the Community Health Worker Program, among others.” Making whole health available to all people in all communities is ambitious and yet Gaudet sees real opportunity to be a catalyst for change with Arkansas at the epicenter. One strategy for broadening the reach is a train-the-trainer model, mean ing they are providing courses for whole health advocates to become facilitators so they can then go out and educate oth ers in whole health principles. And they are leaning into the existing whole health movement, working with regional part ners, while participating in the national conversation around whole health.
“And, in so doing, patients are find ing more relief and improvement in their chronic conditions such as pain and men tal health, and needing to rely on their clinical teams less and less,” Gaudet said.
Whole Health Institute was founded by Alice Walton, who is also the major force for the establishment of the Whole Health School of Medicine and Health Sciences, a separate, four-year, medical degree (MD) granting school that works closely with Whole Health Institute. The School of Medicine will educate medical students through a whole health approach, which integrates conventional medicine with holistic principles and practices, taught by leading medical practitioners and scientific minds.
“In our courses and training, we help individuals explore their own aspirations and purpose,” she said. “We empower and equip people to take charge of their own well-being by addressing mind, body, and spirit, helping them identify their own areas of focus. We then support them in acquir ing new skills and support for behavior change. One patient may want to simply keep up with their grandchild while an other may need the tools to deal with a lifealtering condition. We have to understand their barriers and goals to help them flour ish in whatever phase of life they’re in.”
“We have additional free, expert-led and peer-to-peer courses available for individuals, clinicians, well-being profes sionals, and anyone interested in explor ing a whole health approach no matter where they are on their journey,” Gaudet said. “Introductory and training courses include Explore My Whole Health, Tak ing Charge, Ambassador, and Facilitator Training to meet people where they are on their well-being journey. Ambassador and Facilitator Train ings provide skills to lead others in a whole health experience. For a complete list, visit the course page of the website. Prior to coming to Whole Health In stitute, Gaudet was the founding Executive Director of the Veterans Health Adminis tration’s Office of Patient-Centered Care and Cultural Transformation, an office charged with leading a whole health move ment which included reaching 350,000 staff and ultimately millions of veterans. The VA healthcare delivery was re-envisioned and produced outstanding results.
“We are working with employer groups to create well-being activations that integrate whole health practices into exist ing programs,” Gaudet said. “And on the clinical side, we are partnering with health systems, like Arisa (Behavioral Health Sys tem), to advance patient engagement and self-care management as part of the pro vider training to integrate whole health into the mental health practices.”
“We have free, expert-led and peer-topeer courses available for individuals, clinicians, well-being professionals, and anyone interested in exploring a whole health approach no matter where they are on their journey. Whole Health Institute focuses on training that starts with defin ing purpose and creating self-care plans.
“The two organizations will work hand-in-hand as their visions align and are rooted in whole health principles, with the shared goals to improve health outcomes and quality of life, reduce healthcare costs, and influence how medical educa tion is taught and healthcare is delivered,” GaudetGaudetsaid.
The website https://www. wholehealth.org/ offers resources for individuals to integrate a whole health approach.
Pandemic-Related Enforcement and Oversight “The COVID-19 pandemic ushered in an unprecedented array of measures to provide relief, assistance, and monetary protections for Americans, businesses, and healthcare systems and providers, among others,” said Jody Rudman of Husch Black well LLP, pointing to the CARES Act availability of $2.2 trillion in relief funds through a number of programs, including the Paycheck Protection Program (PPP) and Provider Relief Fund. “With any funding mechanism of such a substantial size, posthoc enforcement is inevitable.”
Moving Toward a Common Definition for ArrangementsValue-Based
Provider Mergers & Acquisitions Face New
“In 2022, we may see further clar ity regarding how OIG (DHHS’ Office of Inspector General) and CMS interpret the new regulations,” said Tiana Korley, Uni versity of Michigan Office of the General Counsel. “The ambiguity and newness of value-based arrangements will eventually be a target for whistleblowers. It’ll be interest ing to see whether good faith participation in value-based enterprises negates bad intent in causes of action involving the AKS (AntiKickback Statute). We also may see the first advisory opinions that provide additional in sight as to how OIG applies the regulations to specific arrangements.”
Concerns cover gamut of healthcare authority affecting federal legislation ShalynMcKittSmith
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“Ransomware is a current darling of cybercriminals,” said Nathan A. Kottkamp of Williams Mullen. Even though “all en tities should have robust cyberinsurance to help mitigate the costs of managing an attack … it would be helpful if there was straightforward and consistent guidance on what to do in response to an attack. Unfortu nately, recommendations and actual experi ences vary.”
“While the global marketplace has slowly reopened and manufacturing has resumed, we’re still competing for scarce resources with other countries. The U.S. also has experienced an inability to man age the uptick in imports at major shipping ports due largely to a lack of drivers for the trucks that play an important role in carry ing goods out of ports for delivery. Critical medical supplies and equipment remain in short supply, potentially jeopardizing patient care or worker safety,” said Herald. Look for FDA guidance and waivers, OSHA enforcement, the Defense Produc tion Act, role of states, supply chain fraud and crisis standards of care issues.
For example, on Dec. 9, 2021, the American Hospital Association, American Medical Association, two hospital groups and two physician practices filed a lawsuit challenging a “presumption in favor of the median in-network rate during disputes be tween providers and health insurers.”
COVID is a Catalyst for APP Expansion Expect Advance Practice Professionals (APPs) to continue significant opportunity for expansion concerning their scope of ser vices and level of independence in the clini cal and business end of providing services, said Robin Locke Nagele of Post & Schell PC. “During COVID, APPs, facilitated by the COVID waivers, have demonstrated their value in ensuring access and continuity of care,” said Nagele. “However, they also face considerable uncertainty about their status as the waivers expire.”
The “No Surprises Act” for greater transparency in emergency room bills took effect Jan. 1, but several key provisions of the bill remain subject to future rulemak ing, including implementation of plan and issuer drug price reporting and implementa tion of the good faith estimate process and advanced explanation of benefits (EOB) for insured individuals.
The Healthcare Workforce IDEA (Inclusion, Diversity, Equity & Accessibility) Defining diversity, unconscious bias and microaggressions, and the use of statis tics in diversity initiatives are three areas to watch.“The conversation around what con stitutes diversity and how to achieve it will continue to evolve in 2022,” said Tiffany Buckley-Norwood of Trinity Health. “It’s important to remain up to date on the laws regulating this area to avoid pitfalls.”
A pandemic within a pandemic is a major concern, cautions Purvi Maniar of Norton Rose Fulbright US LLP.
“Providers should closely monitor the challenge and its impact on the depart ments’ regulations as litigation moves for ward,” said Lisa A. Lucido, of Hall Render Killian Health & Lyman PC.
“While rates of childhood mental health concerns and suicide have been ris ing steadily since 2010, the pandemic also intensified this (mental health) crisis,” said Maniar, who suggested looking for increased market activity in significant behavioral health transactions, regulatory advances, current market and consolidation, height ened scrutiny – and silver linings. “Much like the overall acceleration in telemedicine trends that resulted from the pandemic, the progress we have recently seen in behav ioral health, including increased access to telebehavioral health and early attention to pediatric mental health, and will continue to see in 2022 and beyond, represent some of the silver linings of a tumultuous period for healthcare in the U.S.”
AHLA’s Top 10 Health Law Issues to Watch in 2022
“The change in administration has brought a more aggressive approach to an titrust enforcement with a sharp focus on the healthcare industry,” said Lisl Dunlop of Axinn Veltrop & Harkrider LLP. Expect investigations with broader scope, new guidelines and changing ap proaches, more investigations of consum mated transactions, and an increased attention to non-hospital provider merg ers, said Dunlop.
Securing the Supply Chain for Healthcare Providers Challenges with the supply chain of PPEs and ventilators persist, said Michael Herald of Guardian Healthcare.
Antitrust Headwinds
The American Health Law Association (AHLA) recently revealed the top 10 health law issues to watch this year as the pandemic rolls on and Congress scrutinizes healthcare legislation.
Beware, DigitalAccessConsiderationsRansomware:WhenSystemExceedstheValueofAssets
Healthcare EmploymentWorkforceLawIssues to Watch Vaccine mandates, COVID-19 li ability, staffing shortages, and whistleblower cases on the rise exemplifies four key em ployment law issues in play. “We thought 2020 was unprecedented, but healthcare employers were faced with new challenges in employ ment law as the world adapted to COVID-19 in 2021,” said Shalyn Smith McKitt, a litiga tion associate lawyer in the Birmingham, Ala. office of Balch & Bing ham LLP. “And 2022 won’t be any different. The introduction of vac cines in 2021 led to workforce dilemmas and the shift to the new ‘normal’ called for regula tion of the industry regarding the safety and welfare of healthcare employees.”
Behavioral Health Transactions Outlook for 2022
Racially motivated violence on rise Even more disturbingly, though ra cially and ethnically motivated violence is not new, reports of verbal and physi cal abuse by white supremacists attacking the personal characteristics of health care professionals from historically and racially marginalized groups represents a deeper layer of racism. Early in the pandemic, the AMA warned that xenophobic language around the SARS-CoV-2 threatened to further fuel discrimination and hate crimes specifically against Asian Americans, which were already a significant concern due to long-standing interpersonal and structural racism.But as researchers have pointed out, while general workplace violence across health care is well-documented, such inci dents rooted in racism like the one recently in Boston are too often decontextualized and classified as “disruptive” rather than racial violence. This, the authors (PDF) tell us, “represents a violent avoidance, silence, and complicity to the insidious nature of white supremacy, which is deeply embedded in the structure and culture of medical institutions.”
While not a new occurrence, the reported uptick in intimidation, threats and attacks toward people in the medical field has been on the rise for at least the last decade—and has become even more of an alarming phenomenon since the beginning of the COVID-19 pandemic.Therecent neo-Nazi protest against leading anti-racist physicians at a Bostonarea hospital is yet another sad chapter in the long history of threats and intimidation of health care workers for simply carrying out the duties of our profession. The AMA is deeply concerned about this threatening behavior and how it has contributed to an increasingly hostile working environment across medicine, particularly for those on the front lines of our nation’s response to COVID-19. Research confirms what our per sonal experiences have long told us. The World Health Organization (WHO) esti mates that as many as 38 percent of those in our field suffer physical violence at some point in their careers, and many more are threatened with verbal aggression. Here in the U.S., injuries caused by violent at tacks against medical professionals grew by 67 percent from 2011 to 2018—with health care workers five times more likely to experience workplace violence than workers in all other industries, according to figures from the U.S. Bureau of Labor Statistics.
• The development of robust surveil lance and data collection systems, tech nologies, and standards to track hate-based violence directed at physicians and health care workers by patients or community members.•Security and safety response proto cols to protect physicians and other health care workers to ensure their freedom from hate-based violence and intimidation.
COVID-19-related violence against physicians has also translated to the digi tal world, with recent surveys indicating that at least one-quarter of reporting U.S. physicians having experienced attacks or harassment on social media on topics such as vaccines, guns, patient care, race, or religion. Another survey found that physicians reported experiencing not just verbal abuse but death threats, including a harrowing incident specifically cited where a Black woman physician reported being threatened with rape as a result of her work in civil rights advocacy.
Health care organizations, including hospitals, health systems, and independent practices, should work collaboratively to share best practices for effective violence prevention strategies in and out of health care settings. Examples of where further work is needed to develop best practices and widespread adoption include:
Our AMA is actively monitoring this situation to consider how we can better le verage our strengths and resources to pro mote the collective safety and security of all health care workers and organizations under attack for championing equity and justice for their patients and communities. We all have a role in helping to cre ate an environment where physicians and health care workers can speak openly and honestly about the real-world threats they encounter in the workplace and come up with sensible solutions to protect our peers and our Violencepatients.has no place in the medical profession, and so we as individuals and as leaders in organized medicine have a re sponsibility to do whatever we can to pre vent it from occurring inside and outside of the workplace. This is important for the health and well-being of everyone working in medicine today, but particularly for those who have been historically marginalized. The steps we take today to create a safer and more inclusive environment for all physicians will, in turn, create a safer and more welcoming environment for our patients—and our best chance to advance equity and improve the health of the na tion.
By GERALD E. HARMON, MD, PREsIDENT AMA
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Simply telling our colleagues in medi cine to cope with harassment and menacing behavior is unacceptable. It is imperative that physicians and health professionals feel safe and secure, whether we’re caring for patients or working to advance equity on a broad scale in our communities. We must protect those who heal The AMA strongly believes that people in all workplaces have the right to a safe environment, out of harm’s way and free of any intimidation or reprisal. Society needs to protect its citizens from individuals or groups that encourage and advocate violence as a means for resolv ing deep social issues. While it’s clear that more work is needed to curb the incidence of violence against the medical profession, AMA policy puts us on this path to pro tecting the very people who devote their lives to improving the health of their pa tients—and the nation.
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The AMA remains committed to tak ing the necessary steps to help shed light on the various protocols, procedures and mechanisms to ensure a safer and more se cure environment for physicians and health care professionals. But we can’t do it alone.
• Solidarity-based strategies to mobi lize individuals and organizations, across the health care ecosystem, to name, con front, and effectively resist hate-based vio lence and intimidation.
Threats, Intimidation Against Doctors and Health Workers Must End
Yet another global study from 2020 found that health professionals were roughly 50 percent more likely than other community members to have been ha rassed, bullied or hurt as a result of the COVID-19 pandemic.
The AMA has advocated against the culture of violence in America, including domestic violence, gun violence, racism, police brutality, and xenophobia— and violence against physicians and professionalshealthis no exception.
For example, in light of ongoing at tacks on physicians and public health of ficials during the COVID-19 pandemic, the AMA adopted policy in 2020 aimed at improving the safety of—and condemning acts of violence against— physicians, health professionals, first responders and public health officials in society. This position joins a host of previously adopted policies aimed at preventing violent acts against health professionals, addressing workplace bullying in the practice of medi cine, and standing up against online bully ing or harassment Notably, the AMA’s recognition of racism as a public health threat is part of an upstream solution to confront our nation’s legacy of structural racism and acknowledge the subjection of Black and Brown people to acts of violence, including violence in and out of medical settings.
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GrandRounds
The 87,000-square-foot facility will be conveniently located off I-530 at exit 32, minutes away from Pine Bluff and Jefferson Regional’s campus, one block away from the Jefferson Regional White Hall Health Complex, and roughly 30 minutes from Little Rock. The hospital will provide inpatient rehabilitation services for adults who have experienced a loss of function or disability due to stroke, brain injury, spi nal code injury, neurological disorders, orthopaedic surgery and other condi tions. Featuring all private rooms, the rehabilitation section of the hospital will provide intense, interdisciplinary rehabil itation therapies and medical care to im prove patients’ functional independence and help them return home. The facility’s distinct behavioral unit will offer a continuum of inpatient and outpatient behavioral health services for adults and seniors, including crisis stabilization for acute mental health and substance use disorders; detoxification from alcohol and drugs; and treatment for anxiety, depression, post-traumatic stress disorder and many other behav ioral health illnesses. The new hospital will replace and increase the number of existing acute re habilitation and behavioral health beds currently operating at Jefferson Region al. Kindred Rehabilitation Services has managed the hospital’s rehab unit for the past 28 years. The new facility is anticipated to open in early 2024.
Jefferson AnnouncesRegionalTransition
Hires Rex Jones as CEO, Names Mellie Bridewell New President LAKE VILLAGE — Rex Jones is join ing the Arkansas Rural Health Partner ship (ARHP) as chief executive officer, effective May 1, 2022. He will succeed Mel lie Bridewell, who will continue to serve the nonprofit as president, a new senior leader ship position that will allow her to focus on strategic growth initia tives for the organiza tion. Bridewell also will maintain her position at the University of Ar kansas for Medical Sci ences (UAMS), which is a partner in the ARHP, as a regional director in the Office of Strategy Management.AsARHP’s CEO, Jones will work with the UAMS strategy team on initiatives and collaborations focused on improv ing health care access and delivery in ruralJonesArkansas.joins UAMS and the ARHP from Magnolia Regional Medical Cen ter, where he is the chief executive of ficer, a position he has held since 2016. He also has served on the AHRP board of directors for eight years, including a stint as the board’s president from 2015 to 2016. A hospital administrator for 25 years, Jones has led rural hospitals in threeDespitestates. the impacts of COVID-19, the ARHP has experienced exponential growth within the past few years, includ ing the addition of new rural hospital members, cross-sectional partners, a significant increase in grant and contract funding, and various new programs and services benefiting the health and well ness of rural residents. In addition, ARHP senior leadership have been consistently invited to contribute to planning and decision-making efforts impacting rural health at the local, regional, and nation al-level.ARHP board members and senior leadership outlined the need for en hanced infrastructure and organization al restructuring to support continued growth during a strategic planning re treat held in May 2021. The first phase of infrastructure sup port was the addition of Frazier Edwards as the new vice president of strategic partnerships and business development. Edwards was hired in Fall 2021 to devel op business lines directly supporting the financial viability of ARHP hospital mem bers. The second phase of key personnel support is the addition of the president role.
PINE BLUFF - Family Medicine Phy sician Toni Middleton, M.D. has been named Chief of Staff for Jefferson Regional in Pine Bluff. Dr. Middleton earned her medical degree from the Uni versity of Arkansas for Medical Sciences (UAMS) and completed her residency in Family Medicine in Pine Bluff at the UAMS-Area Health Education Center. She is currently a professor at the UAMS-South Central Family Medicine Residency program and sees patients at the UAMS clinic in Pine Bluff.Dr. Middleton will serve as Chief of Staff for two years.
Rex Jones Mellie Bridewell
arkansasmedicalnews Arkansas Rural Health
Middleton Named Jefferson Regional Chief Of Staff
In Nursing Leadership
CARTI Opens Cancer Center in El Dorado LITTLE ROCK – CARTI has announced the opening of the CARTI Cancer Center in El Dorado, located at 1601 North West Avenue. The center provides medical on cology and PET imaging services to cancer patients of south Arkansas. The facility, built in the former Office Depot, includes an infusion suite with 30 heated recliners and an onsite lab. The cancer center will be open Monday - Thursday from 7 a.m.4:30 p.m. and Fridays from 7 a.m. - 3 p.m. This is the fifth comprehensive cancer center in CARTI’s network of treatment lo cations, bringing its statewide presence to 18 treatment locations in 15 communities. CARTI currently has south Arkansas locations in El Dorado, Crossett and Magnolia. Patient care will be provided by medical oncologist Dr. Balan Nair and Kayla Williams, APRN, MSN. Dr. Nair has been treating patients in El Dorado since 1998. Phase II of the project will bring additional services, including radiation oncology and imaging services, including mammography, CT and MRI. Phase II is expected to be completed in late 2022.
MichelleCooperPowell
Jefferson Regional’s New Inpatient Rehabilitation and Behavioral Health Hospital to be Located in White Hall WHITE HALL - Jefferson Regional and Kindred Rehabilitation Services have announced that their joint-venture, 76bed hospital – a combination of a 40-bed inpatient rehabilitation facility with an ad ditional 36 behavioral health beds – will be located at 1600 West Holland Avenue in White Hall, Arkansas, just north of Pine Bluff and south of Little Rock.
Ashley Lawhon Scott
Dr. Scott Cooper Begins New Role as President of Mercy Clinic Northwest Arkansas ROGERS – Dr. Scott Cooper was re cently named president of Mercy Clinic Northwest Arkansas. Dr. Cooper, a boardcertified orthopedic surgeon, works with more than 200 integrat ed, multispecialty phy sicians at 22 clinic loca tions in his new role. After 18 years as an independent provider, Dr. Cooper joined Mercy in 2014, when his practice inte grated into the Mercy network of health care providers in the region. Mercy’s re cord of high ratings for health and safety is just one of the reasons he credits for taking on this new leadership role. Serving as president of Mercy Clinic Northwest Arkansas is just one of many leadership positions Dr. Cooper has held in his career. He previously served as president of the Arkansas Orthopae dic and Arkansas Medical societies and currently is the state’s representative to the Board of Councilors for the American Academy of Orthopaedic Surgeons. Dr. Cooper is adding Mercy Hospital Northwest Arkansas peer physicians Dr. Lance Faddis, recently named chief ad ministrative officer, and Dr. Sonal Bhakta, chief medical officer, to his leadership team, creating a tight-knit physician leadership structure.
PINE BLUFF - Assistant Chief Nurs ing Officer Michelle Powell, MSN, MBA, RN, APRN, has assumed the position of Chief Nursing Officer (CNO) at Jefferson Regional. The current CNO, Lou ise Hickman, RN, BSN, MA, CLNC, will move into the role of Chief ClinicalPowellOfficer.has been with Jefferson Re gional for 23 years and has served as As sistant CNO for three years. Hickman has served as CNO for 18 years, and in her new position, she will hold administra tive responsibility for Surgical Services, Cardiology/Cath Lab, Pharmacy and the School of Nursing. Arkansas Urology Announces New Chief Nursing Officer LITTLE ROCK – Arkansas Urology, the state’s largest and most innovative urology practice, is pleased to announce and welcome Ashley Lawhon of Little Rock as their new chief nurs ing officer.Lawhon, who graduated from Bap tist Health School of Surgical Technology in 2002 as a surgical tech, went on to graduate from Baptist Health School of Nursing as a registered nurse in 2006. She then became a perioperative services charge nurse at OrthoArkan sas and then an operating room charge nurse at Arkansas Surgical Hospital. Most recently she has been with Pain Treatment Centers of America as an ad ministrator and chief operating officer where she oversaw daily operations for 10 clinic locations and seven ambulatory surgeryLawhoncenters.will oversee all clinical nurs ing operations along with managing an cillary services and clinic-based surgical and procedure services at Arkansas Urol ogy’s Little Rock campus and North Little Rock campus.
Partnership
Toni Middleton
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NORTH LITTLE ROCK - The Bridge Way, one of the leading psychiatric hos pitals in Arkansas, announced that Me gan Miller, L.C.S.W., has been named Chief Executive Officer. A native Arkan san, Miller has nearly 20 years of experience in mental health. She began her career as a mental health parapro fessional in 2003 and quickly advanced to leadership roles. She has served com munity mental health organizations, outpatient clinics, and acute care hos pitals throughout her career. She first joined The BridgeWay as Director of Clinical Services in 2012. Miller earned a Master of Science in Social Work from the University of Ten nessee, and a Bachelor of Science de gree in biology from Lyon College. To schedule an assessment, or make a referral visit our website atwww. TheBridgeWay.com. Arkansas Surgical Hospital Now Offers Bikini Incision Anterior Hip Replacement Surgery
Barbara Porchia, DPM, and Harshad Ladha, MD, Join UAMS LITTLE ROCK — Barbara Porchia, DPM, is the newest member of the University of Arkansas for Medical Sciences (UAMS)’ orthopaedic team of foot and ankle providers.She is joined at UAMS by Harshad Ladha, MD, an epilep tologist.Porchia, a po diatrist from Camden, who has more than 20 years of experience treating foot and ankle conditions, is seeing patients every Tuesday through Friday at the UAMS Orthopaedic Clinic at 10815 Colonel Glenn Road, SuiteAs500.an assistant professor in the UAMS College of Medicine Depart ment of Orthopaedic Surgery, she joins fellowship-trained foot and ankle surgeons
Atiq received his medical degree from the Khyber Medical College, Uni versity of Peshawar, Pakistan, and com pleted his residency and chief residency in internal medicine at the Edward Hines Jr. Veterans Administration Hos pital and Foster G. McGaw Hospital of Loyola University in Chicago. He com pleted his fellowship training in medical oncology and hematology at Memorial Sloan-Kettering Cancer Center in New York.He is a past president, speaker of the house and chairman of the board of the Arkansas Medical Society. He made news in 2021 when he erased the outstanding debts of nearly 200 former patients of the cancer treat ment center he founded in Pine Bluff.
Barbara HarshadPorchiaLadha
- Dr. Samuel Baxter, an orthopedic surgeon at Ar kansas Surgical Hos pital, now offers bikini incision anterior hip themusclesmakingmentmethodreplacements.Thisless-invasiveofhipreplacesurgeryavoidsincisionsinthesurroundinghip,resultinginless tissue damage. Dr. Baxter, who is trained in the biki ni anterior hip replacement procedure, says it may also reduce healing times. Dr. Baxter sees patients at Martin Orthopedics clinics in Little Rock and White Hall. Patients can contact Arkan sas Surgical Hospital at 501-748-8075 for assistance scheduling an appoint ment
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The national recognition is the cul mination of more than 30 years of ser vice to the American College of Physi cians. Among Atiq’s past leadership roles in the organization are chairing its Board of Governors in 2019-2020 and serving on the executive committee of the Board of Regents. He also chaired the ACP’s health and public policy com mittee in 2020, during which time he co-authored a key policy statement on racism and health. He previously served as governor of the Arkansas chapter.
Robert D. Martin, M.D., and Chelsea Matthews, M.D., to provide comprehensive foot care as part of UAMS’ rapidly expanding orthopaedic services.Porchia treats a wide range of foot and ankle conditions. She manages pa tients with corrective orthotic footwear; treats podiatric nail disorders, including removal of unhealthy tissue in patients with diabetes and peripheral vascular disease; performs heel-pain injections; removes warts and treats ingrown nails; performs ulcer assessments; provides prophylactic and emergent foot wound care; and prescribes diabetic shoes and foot braces to improve mobility and function. She has a special interest in diabetic foot care. Before coming to UAMS, Por chia was in private practice full-time in Camden, where she continues to see patients on Mondays. She has been practicing at South Central Foot Care, PLLC since 1999, and for several years, operated satellite offices for the clinic in El Dorado, Little Rock and Forrest City. She paused her private practice in 2003 to complete a two-year podiatric surgical residency at the Illinois Masonic Medical Center in Chicago. Previously, she was in private prac tice in New Orleans after completing a residency in primary podiatric medicine at St. Michael Hospital in Cleveland. She received a Bachelor of Science degree in education from the Univer sity of Arkansas at Little Rock, followed by her Doctor of Podiatric Medicine degree from Kent State University Col lege of Podiatric Medicine (formerly the Ohio College of Podiatric Medicine) in Cleveland.Harshad Ladha, MD, an epileptolo gist, recently joined the University of Arkansas for Medical Sciences (UAMS)’ Level 4 Comprehensive Epilepsy Center as an assistant professor in the Depart ment of LadhaNeurology.comesto UAMS from Emory University School of Medicine in Atlanta, Georgia, where he was a clinical neuro physiology fellow and then an epilepsy fellow. Earlier, Ladha was a resident at the University of Alabama at Birming ham, first in internal medicine and then in neurology, after earning his medical degree from the Dr. V.M. Government Medical College in Solapur, India. He also has a Master of Public Health de gree with a focus in epidemiology from the University of Texas Health Science Center in Houston, Texas. Ladha’s expertise and clinical inter ests include comprehensive manage ment of all types of epilepsy in adults, pre-surgical evaluation and invasive EEG monitoring for patients with medi cally refractory epilepsy, managing neu romodulation devices (VNS/RNS/DBS) and video EEG monitoring. Ladha is seeing patients at the UAMS Health Epilepsy and Neurology Clinic on the sixth floor of Freeway Medical Tower at 5800 W. 10th St. in Little Rock.
Reproduction in whole or in part without writ ten permission is prohibited. Arkansas Medical News will assume no responsibility for unsolicited Allmaterials.letters sent to Arkansas Medical News will be considered the newspaper’s property and unconditionally assigned to Arkansas Medical News for publication and copyright purposes. arkansasmedicalnews.com Omar Atiq
David F. Fran
NORTH LITTLE ROCK
Megan Miller Named Chief Executive Officer of The BridgeWay
Megan Rains
LITTLE ROCK — Omar Atiq, MD, a medical oncologist specializing in head and neck cancers and cutaneous malignan cies at the Winthrop P. Rockefeller Cancer In stitute at the University of Arkansas for Medi cal Sciences (UAMS), is now president-elect of the American College of Physicians (ACP), the largest medical specialty organiza tion in the United States. A professor in the UAMS College of Medicine’s Department of Internal Medicine, Division of Hematology and Oncology, Atiq is the first Arkansan elected to the position. His election was announced Jan. 14, after he was nominated in the fall by the ACP Gov ernance Committee and endorsed by the ACP Board of Regents. His new title will take effect at the conclusion of the organization’s annual business meeting in Chicago on April 30. He will then as sume leadership of the organization of internists, which has 161,000 members worldwide, in 2023.
Miller Samuel Baxter PUBLISHER Pamela Z. pamela@arkansasmedicalnews.comHaskins EDITOR P L editor@arkansasmedicalnews.comJeter ADVERTISING SALES pamela@arkansasmedicalnews.com501.247.9189 GRAPHIC DESIGNER Renee rphillipsmail@bellsouth.netPhillips GRAPHIC DESIGNERS Susan Graham, Katy Barrett-Alley CONTRIBUTING WRITERS Becky Gillette, Gerald E. Harmon, MD, Lynne Jeter All editorial submissions and press releases should be sent pamela@memphismedicalnews.comto Subscription requests can be mailed to the address below or emailed pamela@memphismedicalnews.com.to Arkansas Medical News is now privately owned by Ziggy Productions, LLC. P O Box 164831 Little Rock, AR 72206 President: Pamela Z. Haskins Vice President: Patrick
UAMS’ Omar Atiq, MD, Named President-Elect of American College of Physicians
Baptist Health Pain Management Clinic-Fort Smith Now Open FORT SMITH – David F. Fran, MD, DABA, DABPM, is now accepting new patients at the Baptist Health’s newest clinic in the River Valley. Baptist Health Pain Management ClinicFort Smith opened on the second floor of the Baptist Health Medical Plaza at 1500 Dodson Ave. The clinic is led by Dr. Fran, who is board certified in anesthesiology and pain medicine and has more than 20 years’ experience in the field of pain management.Whetherchronic or acute pain, Dr. Fran and his team offer both invasive and non-invasive treatment options in cluding medication management, joint injections and radiofrequency ablations.
GrandRounds
LITTLE ROCK – Arkansas Chil dren’s Hospital (ACH) has been reveri fied as a Level I pediatric trauma center by the American College of Surgeons (ACS), affirming the highest level of care available for patients who experi ence traumatic injuries. The Level 1 verification, which is the highest national trauma recogni tion, will last through December of 2024. This achievement honors ACH’s dedication to providing best-in-class care for injured patients from the pre hospital phase through the rehabilita tion process and marks the third time the program has been reverified. ACH is the state’s only Level 1 pediatric trau ma center.Verified trauma centers must meet the essential criteria that ensure trauma care capability and institutional perfor mance, as outlined by the American College of Surgeons’ Committee on Trauma in its current Resources for Optimal Care of the Injured Patient manual. To qualify for reverification, Arkansas Children’s Hospital voluntarily participated in ACS’ rigorous process, which included an on-site review with external trauma care experts. Verified hospitals must provide a full spectrum of care to address needs of injured patients, including access to:
• In-hospital anesthesiologists. The ACS is a scientific and educa tional association of surgeons that was founded in 1913 to raise the standards of surgical education and practice and to improve the care of the surgical patient. The College has over 72,000 members and it is the largest associa tion of surgeons in the world. Long standing achievements have placed the ACS in the forefront of American surgery and have made it an important advocate for all surgical patients.
ONLY FIVE PERFORMANCES
DIRECTED BY DR. JAMES D. WHITMIRE PRESENTING SPONSORS MARCH 31 – APRIL 3 at Mid-America Seminary
Dr. Loren Deputy, and Dr. Alicia Asbury Join CHI St. Vincent Pediatric Clinic in Hot Springs HOT SPRINGS - CHI St. Vincent announces that Dr. Loren Deputy and Dr. Alicia Asbury, have joined the team of leading pediatricians at the CHI St. Vincent Pediatric Clinic in Hot Springs. Dr. Deputy is now seeing patients at the clinic located at 225 McAuley Court. Dr. Deputy attended medical school at the University of Arkansas for Medical Sciences. She completed her residency in pediatrics at Arkansas Children’s Hos pital.CHI St. Vincent also announced that Dr. Alicia Asbury has joined the team of leading pediatricians at the CHI St. Vincent Pediatric Clinic in Hot Springs. Dr. Asbury is now seeing patients at the clinic, lo cated 225 McAuley Court. After attending medical school at the University of Arkansas for Medical Sciences, Dr. Asbury completed her internship and residency in pediatrics at Arkansas Children’s Hospital. Dr. Asbury is a member of the American Academy of Pediatrics. The physicians and nurse practi tioners at the CHI St. Vincent Pediatric Clinic provide exceptional services, in cluding all immunizations required by the American Academy of Pediatrics, preventive care, sick care and quality time with parents and families to help them understand health issues and treatments.
• Operating rooms that are equipped and ready at all times.
Dr. Fran earned his medical degree from the University of the Visayas, Gul las College of Medicine Cebu, in the Philippines. He completed a residency in anesthesiology and a fellowship in pain management at Virginia Com monwealth University School of Medi cine in Richmond, Virginia. Baptist Health Pain Management Clinic-Fort Smith is open Monday through Friday from 8 a.m. to 5 p.m. For more information about the clinic or to schedule an appointment, visit baptist-health.com
Arkansas Children’s Hospital Remains the State’s Only Level 1 Pediatric Trauma Center
• A pediatric intensive care unit ca pable of addressing the special needs of children requiring critical care.
GrandRounds midamericapassionplay.org
• Neurosurgical and neurological care for severely injured patients.
• Trauma surgeons and emergency medicine specialists, including pediat ric surgeons, available 24/7.
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Loren Deputy Alicia Asbury
• Orthopedic care for severely in jured patients.
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