Kentucky Doc Winter 2021 by Rockpoint Publishing

winter 2021 • volume 12• issue 4

PROFILE IN COMPASSION

JOHN PATTERSON MD, MSPH, FAAFP

In the Footsteps of Albert Schweitzer, MD

Also Inside

COVID-19

VACCINES Many Questions & Some Answers

COVID-19

IMPACT An Interview with Future Physicians from UK College of Medicine

PROTECT YOURSELF AND YOUR FAMILY THIS FLU SEASON!

GET YOUR SHOT! CONSULT YOUR DOC! STOP THE SPREAD!

www.kyma.org/flu

Wehave have your your back, We soyou you can can move move forward. forward. so When a problem occurs, you need a proactive partner that can navigate When a problem occurs, you need a proactive partner that can navigate unforeseen challenges and help you solve the tough legal issues that come unforeseen challenges and help you solve the tough legal issues that come with practicing medicine. In our collaborative claims process, our in-house with practicing medicine. In our collaborative claims process, our in-house attorneys and our roster of local defense attorneys help you – attorneys and our roster of local defense attorneys help you – our valued members – to be ready for what lies ahead. our valued members – to be ready for what lies ahead.

Move forward with us at www.svmic.com. Move forward with us at www.svmic.com.

CONTENTS COVID-19 (SARS-CoV-2 virus) Vaccines: Questions & Answers • PAGE 5 P R O FI LE I N COMPASSI ON In the Footsteps of Albert Schweitzer, MD: John Patterson • PAGE 12 The Lexington Medical Society Past & Present • PAGE 16 PE T HEALTH Winter and Your Pets • PAGE 20 COM MUN I T Y NE W S

FROM THE

EDITOR

Announcements & Awards • PAGE 22 How COVID-19 impacts Training our Future Physicians • PAGE 26 BUSI N ESS 10 Marketing Strategies for Medical Practices • PAGE 30

EDITORIAL

BOARD MEMBERS Robert P. Granacher Jr., MD, MBA, editor of Kentucky Doc Magazine Terry Clark, MD John Patterson, MD Tuyen Tran, MD Thomas Waid, MD Nicholas Coffey, M2 at UK College of Medicine Bowling Green Campus

STAFF Brian Lord Publisher David Bryan Blondell Independent Sales Representative Jennifer Lord Customer Relations Specialist Barry Lord Sales Representative Anastassia Zikkos Sales Representative Kim Wade Sales Representative Janet Roy Graphic Designer Aurora Automations Website & Social Media

Robert P. Granacher Jr., MD, MBA, Editor-in-Chief, Kentucky Doc Magazine

Welcome to the 2021 Winter edition of KentuckyDoc Magazine. Whew! 2020 is finally behind us and the promise of COVID-19 vaccination relief lies ahead. Our lead-off article is written by LMS member and pathologist Terry Clark, MD. He brings us up to date with a summary of the vaccine progress and its roll-out, which is currently being given to front-line healthcare workers and nursing home residents in Kentucky. He reviews a webinar produced by the Kentucky Department of Public Health and distributed to Kentucky physicians in early December 2020. The next article in our magazine is by LMS member Bob Granacher, MD. Dr. Granacher reverses course on LMS member John Patterson, MD and presents John in the Profile in Compassion series, generally written by Dr. Patterson. Dr. Granacher opines that Dr. Patterson is a polymath and compares him to John’s role model, Albert Schweitzer, MD. The third article is by long time LMS member, Tom Waid, MD. Dr. Waid takes us through the birth of the LMS during President John Adams time in office and brings us to the current time of the LMS. It is a wonderful journey through the history of our society and reacquaints us with some of the medical leadership that guided us to the present. Dr. Waid’s article is followed by a second article by Bob Granacher. It is a first-person account of the impact COVID-19 upon policy makers and students at the UKCOM. Dr. Granacher chronicles the barriers raised by COVID-19 to medical student education

at UKCOM and the attempts by the College to mollify them. Included are first person interviews of M2, M3 and M4 students and faculty/administrators. The last article in this volume is by our publisher, Brian Lord. Brian gives a concise review of 10 marketing strategies for medical practice and he clearly distinguishes marketing from its lesser cousin: advertising. It contains useful business information for medical practitioners wanting to grow their practices. Please see our call to enter the annual essay contest for physicians and students. Details are found on page 31. KentuckyDoc wishes all our readers a healthy and bountiful new year. Stay well, Robert P. Granacher, Jr, MD, MBA

Mailed to 100% of physicians licensed in Fayette County. Mailed to 75% of doctor office managers & other decision makers in Fayette County Practices. For advertising rates and to find out how to get your article published, please call

859-368-0778

brian@rockpointpublishing.com

© Copyright Kentucky Doc Magazine 2021. All rights reserved. Any reproduction of the material in this magazine in whole or in part without written prior consent is prohibited. Articles and other material in this magazine are not necessarily the views of Kentucky Doc Magazine. Kentucky Doc Magazine reserves the right to publish and edit, or not publish any material that is sent. Kentucky Doc Magazine will not knowingly publish any advertisement which is illegal or misleading to its readers. Kentucky Doc Magazine is a proud product of Rock Point Publishing.

doc 5

www.kentuckydoc.com | Winter 2021 | Kentucky

COVID-19 (SARS-CoV-2 virus)

VACCINES Many Questions and Some Answers By Terry Clark, MD

As with almost everything related to the COVID-19 pandemic, there has been a great deal of confusion as to the exact timeline for the delivery of vaccine into the arms of people. Two vaccines have been approved for Emergency Use Authorization (EUA) in the U.S. and vaccinations began the week before Christmas. The information presented here is predominantly from a webinar hosted by members of the Kentucky Department of Public Health, Immunization Branch

Safety and Planning. This information was presented at a webinar on Dec 1. The final steps in the process of delivering vaccinations is the responsibility of the state health departments. In my opinion, the Department of Public Health in Kentucky has been very proactive in their planning. In a similar webinar in October, the urgent need for facilities or groups that intended to deliver vaccine to register with the Department was stressed. Details from the Dec 1 webinar are below. Some of the information is also gleaned from press releases from the vaccine developers and various spokespersons from CDC, FDA and the Operation Warp Speed program. I recommend anyone who can, go to the kycovid19.ky.gov link for detailed vaccine information. VACCINES Continued on Next Page

doc | Winter 2021 | www.kentuckydoc.com

6 Kentucky

At a Glance: The First Vaccines Moderna/NIH •

Produced in the U.S.

•

Stored in conventional freezers immediately after manufacture

Pfizer/BioNTech •

Produced mainly in Germany

•

Requires specialized refrigeration at a temperature of minus 70 degrees Centigrade.* *Only a few facilities in Kentucky have electronic freezers cable of that range. Because of this, the Pfizer vaccine will be shipped in bundles of 975 doses contained in dry ice bulk containers that can maintain temperature for at least 20 days. Once removed they can be stored in traditional refrigerator/freezers for 5 days.

VACCINES continued from Previous Page

Where are the first vaccines coming from? The two vaccines approved for EUA are the Moderna/NIH and the Pfizer/BioNTech vaccine. I won’t go into biologic detail on them, but they are very similar and can essenntially be interchanged as far as function goes. The Moderna vaccine is produced in the U.S. and the Pfizer mainly in Germany with recent U.S. production beginning in Kalamazoo, Michigan. The Pfizer requires specialized refrigeration at a temperature of minus 70 degrees Centigrade. Only a few facilities in Kentucky have electronic freezers cable of that range. Because of this, the Pfizer vaccine will be shipped in bundles of 975 doses contained in dry ice bulk containers that can maintain temperature for at least 20 days. Once removed they can be stored in traditional refrigerator/freezers for 5 days. The Moderna vaccine can be stored in conventional freezers immediately after manufacture.

What is the timing of the vaccine deliveries? The first batch of vaccines were sent out to Kentucky within a few days of EUA approval. There were reportedly 6.4 million doses ready for release in the U.S, with 38,000 apportioned to Kentucky. A total of 40 million doses are promised by the manufacturers by the end of December with about 200 million total by the end of March. Two doses, a few weeks apart, are required by either vaccine so the expectation is 100 million U.S. persons vaccinated by the end of March. The vaccines will be distributed according to population to each state. Kentucky represents about 1.4% of the U.S. population. The 38,000 doses allocated in the first shipment is 1/2 of that because the other half is being held to be shipped when the second dose is required. VACCINES Continued on Next Page

doc | Winter 2021 | www.kentuckydoc.com

8 Kentucky

VACCINES continued from Previous Page

How are the vaccines shipped to the final vaccinating facilities? The distribution is supposed to go through a system developed by the Trump Administration Operation Warp Speed project that includes delivery by the manufacturers to a couple of central distributing facilities that will put together bundles of vaccine kits. The kits include all the supplies needed to give each injection along with the vaccine vials. From the central facilities the vaccine bundles and vaccine are shipped by UPS and FedEx directly to the vaccination sites as directed by the KDPH. The government or USPS does not ship any of the vaccine. Shipments are supposed to be made weekly out of the central facilities. The exact timing and quantities, except for the first shipment are as yet unknown.

Who decides which people get the vaccines first? The final vaccination sites (hospitals, long term care facilities, clinics, pharmacies, businesses, churches, state prisons, state drug rehab centers, etc.) will be prioritized through the authority of each state governor via the state Health Departments. Each entity wishing to serve as a vaccination site must register with the KDPH and develop a plan that includes facility storage plans, the number of doses needed, a plan to prioritize among their recipients, and an injection system including follow up for a second dose.

VACCINES Continued on Next Page

At a Glance: Vaccine Delivery From the central facilities the vaccine bundles and vaccine are shipped by UPS and FedEx directly to the vaccination sites as directed by the KDPH.

doc 9

www.kentuckydoc.com | Winter 2021 | Kentucky

Your Family, Your Health, Our Passion Family Practice Associates of Lexington, P.S.C. Proudly serving Kentucky for 35 years.

NEW

• Family Practice • Pediatrics • Internal Medicine • Primary Care for your entire family!

Hamburg Pavilion Location

Brannon Crossing Location

1775 Alysheba Way #201

615 East Brannon Road, Ste. 100

Lexington, KY 40509

Nicholasville, KY 40356

859.278.5007 www.fpalex.com

doc | Winter 2021 | www.kentuckydoc.com

10 Kentucky

In Phase 1a health care workers and patients in long term care facilities will be the first to receive vaccine. VACCINES continued from Previous Page

What are the national priority groups and who determined them? There is a CDC standing committee, the Advisory Committee on Immunization Practices (ACIP) that has traditionally set national priorities for roll out of vaccines. The ACIP met on December 2, where they made a determination as to which risk category of people will get the first vaccines. At the Dec 2 meeting, formal recommendation was made only for Phase 1a criteria. Additional recommendations will be forthcoming in a few weeks as the earliest priority groups finish vaccinations. In Phase 1a health care workers and patients in long term care facilities will be the first to receive vaccine. The health care workers will receive vaccine at hospitals using the Pfizer product since they have the required low temperature freezers. The long term care facility (patients and staff) will receive vaccination in the facilities from vaccinating teams sent by Walgreen and CVS pharmacies. These pharmacies have made arrangements for ultracold storage. As announced by Gov. Beshear on Dec 4, eleven (11) hospitals across Kentucky will give 12,675 first dose vaccinations. There will be 25,325 doses for long term care facilities. Second doses will be given in 3-4 weeks to those same people. This first round of vaccinations will not cover all persons within this highest priority group, which is estimated to be nationally about 25 million persons. It is hoped that all will be vaccinated by mid January as additional promised vaccine is delivered by the manufacturers. As mentioned above, formal recommendations have only been made by ACIP for prioritizing health care workers and patients in long term care facilities. The rate at which additional vaccine becomes available may dramatically affect the prioritization needed after January. The following descriptions are from earlier drafts of considered recommendations by ACIP. Persons at high risk for severe respiratory or other life threatening sequelae due to COVID-19 disease would be in Phase 1b. These comorbidities include obesity, diabetes, hypertension, chronic lung disease, renal failure, congestive heart failure, immunocompromised patients and patients with cancer chemotherapy. On December 26, the CDC formally recommended that individuals 75 and older be included in the 1b group. It is also recommended that

persons 65 or older that are in lower risk congregate settings also be in this group, which could include older teachers, prisoners, residents of assisted living facilities, or Alzheimer groups. It is hoped that all phase 1a and 1b vaccinations will complete by the end of March. Individuals in Phase 1c include “Essential workers”. This is estimated to be about 120 million Americans. Exactly who is in that category will be determined by each state. There are criteria developed by the National Academies of Sciences, Engineering and Medicine that will be used in Kentucky. The meat packing industry association has petitioned that its employees be near the head of that category, and other groups may be lobbying for priority as well. Younger teachers, food chain workers, transportation workers are a few examples included in the guidelines. Outreach and teams to vaccinate within minority communities that have seen especially high rates of death are recommended to be a focus within this group as well. Exactly how these individuals will be reached with vaccines is somewhat vague. Most pharmacies along with CVS and Walgreen will eventually provide vaccinations, with required appointments by individuals for vaccinations. How the “essential workers” will be individually notified to make appointments is unclear. It is hoped that this category of individuals will all be vaccinated by the end of May. Phase 2 includes all persons 65 and older. Of course, many of these people will also fit into one of the higher priority groups. Drive thru vaccination sites may eventually be organized by ad hoc groups to add to availability at health clinics, some physicians offices, as well as pharmacies by this time. It has been predicted by the leaders of the Operation Warp Speed project that essentially any one will be cleared for vaccination availability by June. This would include all persons 18 years (or possibly 16) and older that didn’t fall into any of the other categories. Children were not formally part of the initial studies although additional studies are beginning with children and it is expected that by the last quarter of 2021 EUA for children of at least 4 years and older will be granted.

About the author Dr. Clark has practiced Pathology in Kentucky since 1980. He attended residency at the Univ. of Kentucky and Surgical Pathology Fellowship at the Univ. of North Carolina, Chapel Hill. He was on faculty at the Univ. of Kentucky from 1986-1989 and entered private practice in Lexington in September 1989. He was on staff at Baptist Health Lexington as well as numerous smaller hospitals within Kentucky. He retired from active practice in 2020. He has been a member of the Lexington Medical Society since 1990.

Persons at high risk for severe respiratory or other life threatening sequelae would be in Phase 1b.

These questions were raised during the webinar: Q: Should recovered Covid patients receive the vaccine? A: Yes, persistent immunity after infection has not been proven. Occasional cases of second infection are documented, and can be severe. Antibody levels tend to fall off after natural infection, sometimes to undetectable levels within a few months. Q: Will masks still be needed after vaccination? A: Yes, at least for the next 6 months. As of today, the data has not been released that would establish that the vaccines prevent asymptomatic infections that would still be contagious to others. The data released so far only confirmed the vaccines protected recipients from moderate to severe symptomatic disease. The mask is important in protecting everyone else, and additionally, we still do not know how long the vaccine protection lasts. Once infection prevalence falls, masks may not be necessary. Q: If someone has been tested for Covid antibodies and is positive should they still get the vaccine? A: Yes, same reason as for previously recovered symptomatic patients. Incidentally, it is felt that there is no clinical reason to test for antibody response after vaccination at this point. Perhaps, if additional booster protocols are developed for nonresponders, postvaccination antibody rmeasurment will be helpful. Q: Is the vaccine safe and effective for pregnant women? A: Unknown. However, Corona virus infection during pregnancy has occurred and severity is variable, with some deaths. Most babies are not found to be infected at birth but subtle long term effects are unknown. The EUA will probably not include use in pregnancy. Q: Will older people respond to the vaccine as well as the younger adults? A: Studies have shown only minimal differences in the vaccine antibody response with age. Efficacy so far seems to be very strong even in older persons, but more information will come with additional accumulation of cases. Q: Can we trust the predictions for vaccine availability and rapid reliable delivery? A: Unknown. The first shipments of vaccine to Kentucky and other states before Christmas was reported to be less than promised. In July 2020, Pfizer and the Operation Warp Speed task force predicted that by the end of December they would have 100 million doses ready to deliver within 24 hours. By Thanksgiving the combined Moderna and Pfizer â&#x20AC;&#x153;guaranteeâ&#x20AC;? was 40 million doses to the U.S. by the end of Dec and 200 million total by the end of March. Pfizer/German BioNTech also has contracts for 80 million doses to the United Kingdom, 200 million to the European Union, and 100 million to Germany individually. They probably have additional commitments that have not been publicized. Moderna also has promised tens of millions of vaccine doses to foreign governments. Operation Warp Speed administrators have promised all Americans would be able to be in line for vaccination by June. At least 600 million doses of vaccine will be necessary in the U.S. by the end of the summer. There are at least 3 additional vaccines that should have enough data to judge efficacy by February and these may add many millions more doses in the latter part of 2021 that will help. Q: For Kentucky specifically, can we guess on a timeline for vaccinations of all the people in the state? A: No. All we can do is go by the national numbers predicted and hope we get our 1.4% as promised. From the first U.S. 100 million recipients/200 million doses (Dec-Mar) we hope to get 1.4 million people vaccinated. Our population is about 4.5 million.

doc | Winter 2021 | www.kentuckydoc.com

12 Kentucky

PROFILE IN COMPASSION

JOHN PATTERSON In the Footsteps of Albert Schweitzer, MD

By Robert P. Granacher Jr., MD, MBA

John Patterson, MD, MSPH, FAAFP, has been very well known by me since 2015. He has been a member of the KentuckyDoc Editorial Board with me since that time. John is best known for his Profile in Compassion series that is found within each of the KentuckyDoc quarterly magazines. The longer I came to know John, the more I recognized that he was a Profile in Compassion. Others who have known him have noted that he was inspired by Albert Schweitzer’s life examples. Schweitzer is best known as a highly compassionate physician who practiced in Africa and won the Nobel Peace Prize in 1952. There have been 394 quotations attributed to Dr. Schweitzer. Three of them strike me as describing my colleague, John Patterson, MD:

1. “The purpose of human life is to serve, and to show compassion and the will to serve others. 2. Success is not the key to happiness. If you love what you are doing, you will be successful. 3. Until he extends his circle of compassion to include all living things, man will not himself find peace.”

I have been enabled by my relationship with John at the Lexington Medical Society. I have observed him in two major accomplishments for our society. He chairs the Lexington Medical Society’s Wellness Commission. I also observed his contributions of compassion when he assisted me and Chris Hickey, LMS CEO, to develop the Physician Wellness

Program. That program is listed in this volume, and the reader may wish to see the offering for our LMS physicians, medical students, and residents who need therapy, counseling, or crisis intervention. Back to Albert Schweitzer, MD: in his lifetime, he was known as a polymath. A polymath is an individual whose knowledge spans a significant number of

*Photo credit: Bundesarchiv, Bild 145 Bild-00014770 / CC-BY-SA, CC BY-SA 3.0 de, https://commons.wikimedia.org/w/index.php?curid=20488725

Are you between the age of 45-75?

GOOD

COLON CANCER SCREENING SAVES LIVES

NEWS!

Is COST a keepin

for You may qualify for a free B U T O N L screened Y IF Youare: may qualifyYfor O Ua colonoscopy if you GTOE DO D GET TE ! free colonoscopy ifSyou are:

G O O D N E W S !

YOU MAY QUAL IsIsCOST COSTa akeeping keepingyou youfrom frombeing being COLONOSCOP screened screenedfor forcolon coloncancer? cancer?

Uninsured or

GGOOOODD NNEEW WSS!!

Uninsured or undersinsured Underinsured

Age 45-75

Albert Schweitzer, MD | 1955

under 45 may qualify in some cases

Uninsured: No public/private insurance Undersinsured: High deductible plan No insurance. withpublic/private out-of-pocket greater YY Omaximums O U UMM AA YY QQ UU A than A L ILFI Y F YF O FO R RA AF R FR EEE 5% individual annual income Underinsured:

Uninsured:

CC OO LO LO NN OO SC SC OO PY P YI FI FY Y OO U UA A RR E :E :

High deductible plans

No Medicare Part B Coverage

A Kentucky Resident

COLON CANCER SCREENING SAVES LIVES Includes Legal Immigrants: green card holders work/student visa refugee

John A. Patterson MD, MSPH, FAAFP

he received a bachelor’s degree from Vanderbilt University in Nashville, Tennessee in Psychology. Upon his graduation from Vanderbilt, he entered medical school at the University of Tennessee in Memphis and received his Doctor of Medicine there. In his last year of medicine, he was able

PATTERSON Continued on Next Page

Uninsure

Uninsured: N

Underinsured

Age Age45-75 45-75

out-of-pocke

under under 4545 may may qualify qualify in in come come cases cases

individual inc

SCREENING SAVES LIVES A Kentuc Uninsured UninsuredororUnderinsured Underinsured but ONLY if you get tested! This program is funded by the includes legal Uninsured: Uninsured: NoNo public/private public/private health health insurance insurance Kentucky Colon Cancer green card ho Underinsured: Underinsured: High High deductible deductible plan plan with with out-of-pocket out-of-pocket maximums maximums greater greater than than 5%5% of of work/student Call 859-309-1700 or 877-597Screening Program individual individual income income refugees 4655 A Kentucky to discuss eligibility! A AKentucky KentuckyResident Resident Resident includes includes legal legal immigrants: immigrants: green green card card holders holders work/student work/student visas visas refugees refugees

Funding provided by: Don’t let cost keep Kentucky Colon Cancer Screening Program

BUT ONLY IF YOU subjects and is known to draw on complex bodies of knowledge to solve specific problems. G EInTmy T E S T E D ! judgment, John is also a polymath. For instance,

Age 45-7

under 45 may

CREENING Includes S Legal Immigrants: BUT ONLY

IF YO

green holders C• A L L card 859 .309.1700

you from being • work/student visa TO DISCUSS screened for colon cancer. You may qualify for a Gfree SC SC RR EEN E N I NI N G SA SA VV ES E SL ILVI V ES E• Srefugees

colonoscopy ifN are: BB UU T TO O N Lyou Y L YI FI F YY OO U UG G ET E TT E TNot S ET SE T D ED ! ! back for your fol going

SCREENING SAVES LIVES

CC AA L L L8 5 89 5 .93. 0 39 0 .91.71 0 7 0 0O O R R8 7 8 7 .75because .9 57 9 .74. 6 45 6your 5 5 deductible is T Age 45-75 CALL to see if yo TO T OD D I SI C SC UU S S SE L E ILGI G I BI B I LI Iinsurance? LTI Y TY

BUT ONLY IF YOU GET TESTED!

FREE colonoscopy! Uninsured: No private/public health Not Not going going back back for for your your follow-up follow-up colonoscopy colonoscopy insurance or because because your your deductible deductible is is TOO TOO HIGH HIGH oror you you LOST LOST your your Underinsured: high deductible plan insurance? CALL CALL toto see see if if you you are are eligible eligible toto receive receive aa withinsurance? out-of-pocket maximums TO DISCUSS ELIGIBILITY FREE FREE colonoscopy! colonoscopy! greater than 5% individual income

CALL 859.309.1700

A Kentucky Resident Includes Legal immigrants: THIS PROGRAM IS FUN green card holders COLON CANCER SC student/work visas THIS PROGRAM IS FUNDED BY THE refugees KENTUCKY COLON CANCER SCREENING PROGRAM TH T IHSI SP RPO RG OR GA RM A MI SI SF U FN UD NE DD E DB Y B YT H TE H EK EKN ET NU TC UK CY KY CO CL OO LN O NC A CN AC N ECRE RS C SR CEREEN E INNI G N GP RPO RG OR GA RM AM

For more information about

doc | Winter 2021 | www.kentuckydoc.com

14 Kentucky

PATTERSON continued from Previous Page

to complete a fellowship in Pathology. He then entered his internship at the University of Tennessee in Memphis as a rotating Internal Medicine intern. He left the University of Tennessee and entered the University of Kentucky, College of Medicine to complete a residency in Family Practice. Later in his career during 30 years of Family Practice in Irvine, Kentucky, he again returned to the University of Kentucky part-time and obtained a Master of Science degree in Public Health and he completed a residency in Preventative Medicine while practicing in Irvine. If this was not enough, John has become certified as a mindfulness practitioner of some repute in this region. John has studied mindfulness-based stress reduction at the University of Rochester and the University of Massachusetts. He has become certified in a therapeutic program of Yoga from an institute in San Rafael, California. Mindfulness-based stress reduction is an evidenced-based program that offers training to assist people with stress, anxiety, depression, and pain. It was developed at the University of Massachusetts Medical Center in the 1970s. It uses a combination of mindfulness meditation, body awareness,

Yoga, and exploration of patterns of behavior, thinking, feeling, and action. John practiced medicine as a family practitioner for most of his career. He developed a medical clinic in Irvine, Kentucky wherein he had two employees to assist him, a Licensed Clinical Social Worker, and a Ph.D. Dietician. As if he did not need more things to occupy him during his 30 years in Irvine, he was Volunteer Medical Director for the Hospice program and cared for Hospice patients in the office, the small local hospital, and the nursing home. He enjoyed making house calls most of all, as they provided him an opportunity to see the extraordinary beauty of the Appalachian foothills and see patients in the context of their home environment. John is the Past President of the Kentucky Academy of Family Physicians. He is certified in Family Medicine, Integrative Holistic Medicine, Mind-Body Medicine, Mindfulness-Based Stress Reduction, Mindful Medical Practice, Yoga Therapy, and Physician Coaching. I had the opportunity to review eight letters written to John by professional colleagues who have taken his mindfulness classes. Almost all these letters contain

references to his compassionate nature, and all lauded him for his achievements, relationships with people, teaching skills, and in particular, his contributions to the mindfulness network. It is beyond the scope of this missive to report them all. In a review of Johnâ&#x20AC;&#x2122;s CV, it is obvious that he will rarely turn down a speaking engagement, and he has lectured on mindfulness locally and throughout much of the eastern United States.

John presents with a very quiet manner, and yet he is probably one of the most efficient, educationally attuned persons I have ever met. He does all of this with others while using extreme compassion.

About the author Robert P. Granacher, Jr., MD, MBA practices clinical and forensic neuropsychiaty in Lexington KY. He is a noted scientific author and past president of the Kentucky Psychiatric Medical Association and the Lexington Medical Society and a member of the volunteer faculty as Clinical Professor of Psychiatry at the University of Kentucky College of Medicine.

TAKE CARE OF YOUR PATIENTS BY TAKING CARE OF YOURSELF.

the lexington medical society

PHYSICIAN WELLNESS PROGRAM Go to LexingtonDoctors.org/services/wellness-program/ for information

The LMS Physician Wellness Program was designed as a safe harbor for physicians to address normal life difficulties in a confidential and professional manner. • • • •

Starting its 5 th year and has helped dozens of physicians 8 free sessions each calendar year Easy access: 535 2nd St., Ste. 207 Complete confidentiality

CALL 1-800-350-6438

to make an appointment Leave a message in either Dr. Smith's or Dr. Hough's voice mailbox. They will call you back to schedule—it's that simple!

CURRENTLY OPERATING USING TELEHEALTH DUE TO COVID-19

doc | Winter 2021 | www.kentuckydoc.com

16 Kentucky

The

LEXINGTON MEDICAL SOCIETY

Important and Earnest Past & Present By Thomas Waid, MD, MS

In 1799, George Washington, the Father of our country died. In 1799, the Lexington Medical Society was born. Just seven years after the Commonwealth of Kentucky became the 15th state, Dr. Samuel Brown chartered what is now the third oldest medical society (only Massachusetts and New Jersey precede it) in the Nation, and the first to be founded west of the Appalachian Mountains. Our Medical society roots trace back to the earliest years of our country when anyone who wished to practice medicine could do so without a degree or certification. Closely aligned with the Transylvania Medical School, membership in the LMS was granted only to those physicians deemed qualified, and membership was an endorsement of the applicants educational credentials. Therefore, the purpose of the LMS in its early existence was to act as a de facto board of medical licensure. Some of the most prominent physicians of the early 19th century, such as Dr. Ephraim McDowell, the Father of American Surgery, and Dr. Daniel Drake, the foremost medical educator of his day, were members. Indeed, there has been a history of excellence and

engagement from the Societyâ&#x20AC;&#x2122;s founding to the present. Segue to the present. In August, Dr. Dale Toney, an LMS member, was installed as KMA President 2020-2021. Looking back to the first election in 1851-1852, Dr. Toney would be the 21St LMS member to ascend to the KMA Presidency. His election continued a tradition dating back to 1853 when the second KMA President elected, Dr. William S. Chipley, was an LMS member (see list on page 18). Additionally, four LMS members have climbed the ranks of the American Medical Association to become Board Chair and President. These include Henry Miller M.D. (1859-1860), Fred W. Rankin M.D. (1942-1943), Ardis Dee Hoven M.D. (2013-2014) and most recently Steven J. Stack M.D. (2015-2016). You will recognize Dr. Stack as being the current Health Commissioner for the Commonwealth who has been a leader through the COVID19 pandemic. Truly, such an impressive list establishes the importance of the LMS in organized medicine, not only in the Commonwealth, but on the national stage.

Some Prominent LMS Members (Left) Dr. Ephraim McDowell | (Center) Ardis Dee Hoven, MD (Below, Left) Dr. William H. Richardson (Below, Right) Matthew Cotton Darnell MD

(Above) In 1799, Dr. Samuel Brown chartered the LMS. (Right) Dr. Daniel Drake, the foremost medical educator of his day.

(Left) Colonel Ethelbert Dudley, MD (Above) Fred Wharton Rankin, MD (Right) Steven J. Stack, MD

Leaders are not always Presidents, and the LMS has produced many leaders, too many to mention here. Notably, Dr. Jack Trevey served as a member of the KY House of Representatives 19781979, and as a member of the KY Senate from 1979 until his untimely death. The LMS’s highest physician honor is named after him and was, in 2017, given to LMS member and KY Senator Dr. Ralph Alvarado who has been a stalwart advocate of healthcare and physician centric legislation. Previously, I mentioned Dr. Stack and it would be remiss of me if I did not mention his immediate predecessor as Health Commissioner Dr. Angela Dearinger who served notably in the previous administration. Although the LMS is no longer the de facto licensing body for commonwealth physicians as it was in the early 19th century, it still has its influence within the Board of Medical Licensure. LMS member Dr. Sandra Shuffett, is currently KBML President. She is also a member of the UK Board of Trustees. I cannot name all of those who should be recognized as I was given space for only one article. Why embellish the LMS and its members in the time of

COVID-19? After all, most of the articles written since the advent of the pandemic have been COVID-19 related. The answer is this: one should never let the urgent obscure the important. Truly COVID-19 is the priority of the day, and this publication has addressed this urgency with many articles regarding life and practice during COVID. However, for the physicians of our Commonwealth, support of their practice and profession remains paramount. No medical society has offered more than the LMS. The LMS Physician Wellness Program, as safe harbor for physicians to address “normal life” difficulties in a professional and confidential manner, is extensive proof of that support. Important and earnest, past and present, that is the LMS. Earnest is defined as the following: “resulting from or showing sincere and intense conviction”. I know no better word to singularly describe the mission of the LMS to its members, and to its partnership with the KMA. May the next 220 years be even more exceptional. LMS Continued on Next Page

doc | Winter 2021 | www.kentuckydoc.com

18 Kentucky

LMS continued from Previous Page

KMA Presidents from LMS William S. Chipley M.D. 1853-1854 Henry M. Skillman M.D. 1870-1871 Lyman Beecher Todd M.D. 1881-1882 David Barrow M.D. 1889-1900 F.H. Clarke M.D. 1904-1905 J.A. Stucky M. D. 1921-1922 R. Julian Estill M.D. 1927-1928 W. B. McClure M.D. 1930-1931 John W. Scott M.D. 1939-1940 C.A. Vance M.D. 1948-1949 Richard G. Elliott M.D. 1960-1961 David A. Hull M.D. 1975-1976 James B. Holloway, Jr. M.D. 1983-1984 Richard F. Hench M. D. 1986-1987 Preston P. Nunnelley M.D. 1990-1991 Ardis Dee Hoven M.D. 1993-1994 Andrew R. Pulito M.D. 2003-2004 Thomas K. Slabaugh M.D. 2007-2008 John R. White M.D. 2008-2009 David Bensema M.D. 2014-2015 Dale Toney M.D. 2020-2021

AMA Presidents from LMS Henry Miller M.D. 1859-1860 Fred W. Rankin M.D. 1942-1943 Ardis Dee Hoven M.D. 2013-2014 Steven J. Stack M.D. 2015-2016

About the author Thomas Waid, MD, MS, is a professor of internal medicine specializing in nephrology at the University of Kentucky College of Medicine. He graduated with a Bachelor of Science degree in pharmacy from the University of Cincinnati in 1972. He received his masterâ&#x20AC;&#x2122;s degree and medical degree from the University of Kentucky in 1980. Since that time, he has served in numerous leadership positions including as medical director of the kidney transplantation program from 1985 to present; the medical director of the pancreas transplant program 1995 to present; the medical director of the heart transplant program from 1992 to 2007; the medical director of the lung transplant program from 1992 to 2007; and the director of dialysis until 2008. Dr. Waid co-founded the continuous renal replacement therapy program with Dr. Marek Kacki when they were both fellows. Dr. Waid also started the organ failure and transplant network in 2008 and has been its medical director since its inception. He is the past president of Lexington Medical Society and currently serves on the LMS Board of Directors. He currently chairs the LMS commission on advocacy and political activity and also serves on as a Kentucky Medical Association planning committee member.

Do you have uninsured patients in need of FREE breast and/or cervical screening?

Please refer program eligible patients to a participating local health department or a contracted provider to receive FREE Mammograms and Pap Tests.

Eligibility Requirements: • Age 21 or older • Has a household income at or below 250% of the federal poverty level • Has no health insurance (no Medicare, no Medicaid, or no private health insurance)

All I Need to Know is Where I Need to Go! Call 1-844-249-0708! The Kentucky Women’s Cancer Screening Program (KWCSP) offers FREE breast and cervical cancer screenings. The program provides Mammograms and Pap tests and follow-up services, education and outreach to low income, eligible women. Once in the program, if a woman has an abnormal screening, the KWCSP covers the cost of most diagnostic tests. If a pre-cancer or cancer is found, the program connects her to treatment through Medicaid’s Breast and Cervical Cancer Treatment Program (BCCTP). The KWCSP provides services through Kentucky’s local health departments, community health clinics and other healthcare providers. A woman does not have to reside in the same county in which she receives services. Healthcare providers, please refer eligible women to a participating KWCSP clinic/provider. For a participating clinic/provider listing call KWCSP, 1-844-249-0708.

Winter2021 2021 | www.kentuckydoc.com doc •|Winter

20 Kentucky

pet health

WINTER AND YOUR PETS KEEP THEM WARM AND SAFE

ith the onset of winter, remember cold weather poses serious threats to your pets’ health. Odds are your pet will be spending more time inside during the winter, so it’s a good time to make sure your house and family are properly prepared. Winter Wellness Get Your Check-Ups: Cold weather may worsen some medical conditions such as arthritis. Many vets encourage you to get your pet examined by a veterinarian at least once a year. This is as good a time as any to get him/her checked out to make sure they are ready and healthy for the coming cold weather. Think Like Your Pet: Just like people, pets’ cold tolerance can vary from animal to animal, based on their coat, body fat stores, activity level and health. Be aware of your pet’s tolerance for cold weather and adjust accordingly.

Other Precautions: Just like us, older pets may have more difficulty walking on snow and ice and may be more prone to slipping and falling. Long-haired or thick-coated dogs tend to be more coldtolerant, but they are still at risk in cold weather. The opposite is true: Short-haired pets feel the cold faster because they have less protection,

and short-legged pets may become cold faster because their bellies and bodies are more likely to come into contact with snow-covered ground. Give Your Pets Choices for Sleeping: Just like you, pets prefer comfortable sleeping places and may change their location based on their need for more or less warmth. Give them some safe options to allow them to vary their sleeping place to adjust to their needs. If they are avoiding a space to sleep, it may not be comfortable or warm. Stay Inside: Cats and dogs should be kept inside during cold weather. It’s a common belief that dogs and cats are more resistant to cold weather than people because of their fur, but it’s untrue. Cats and dogs are can suffer from frostbite and hypothermia just like people do and should be kept inside as much as possible. Yes, longer-haired and thick-coated dog breeds, such as huskies and other dogs, are bred for colder climates and are more tolerant of cold weather, but no pet should be left outside for long periods in below-freezing weather. Watch the Wind Chill: No matter what the temperature is, wind chill can threaten a pet’s life. Exposed skin on noses, ears and paw pads are at risk for frostbite and

hypothermia during extreme cold snaps. For this reason, short-haired dogs often feel more comfortable wearing a sweater, even during short walks. Foot Care: Rock salt and other chemicals used to melt snow and ice can irritate the pads of your pet’s feet. Wipe all paws with a damp towel after going for walk before your pet licks them and irritates their mouth. Dogs are at particular risk of salt poisoning in winter due to the rock salt used in many areas, often when licking it from their paws after a walk. Store de-icing salt in a safe place. If your dog ingests rock salt, call a veterinarian immediately. Poisoning Possibilities: Antifreeze is a deadly poison, but it has a sweet taste that may attract animals and children. Wipe up any antifreeze spills immediately and keep it, like all household chemicals, out of reach.

Cats and dogs should be kept inside during cold weather.

“ONE-STOP SHOPPING” • Large Dog-Only Pool • Grooming • Vet Services • Long & Short-term Boarding • Large Play Areas • Convenient Weekday & Weekend Daycare Hours • Centrally-located in Downtown Lexington •

(859) 255-2275 UptownHounds.com

SHEABELPETS.COM • 859.320.0274 2568 Richmond Rd, Lexington, KY 40509

NO CHRISTMAS VACATION MOMENTS: Because your pet will be spending more time inside during the winter, it’s a good idea to make sure your house is properly pet proofed. We all remember the cat in the movie “National Lampoon’s Christmas Vacation.” Let’s avoid this. Use space heaters with caution around pets; they can knock them over and start fires or chew cords and get electrocuted. Keep Christmas lights up and decorations away from your pet; they look like toys to chew. Avoid Ice: Finally, we encourage you, when walking your dog, stay away from ice. You do not know if the ice will support your dog’s weight, and if your dog breaks through or slips on the ice, it could be dangerous. If you cannot walk on it, they cannot walk on it. Their joints are prone to injury like yours. Information in this article is courtesy of:

• American Veterinary Medicine Association • ASPCA • Humane Society of the United States

doc | Winter 2021 | www.kentuckydoc.com

22 Kentucky

COMMUNITY NEWS A N N O U N C E M E N T S , AWA R D S , E V E N T S & M O R E

Saint Joseph Hospital Honors Outstanding Staff With Employee, Leader of the Year Awards LEXINGTON, Ky. (Dec. 1, 2020) – Saint Joseph Hospital has announced its 2020 Employee of the Year and Leader of the Year award recipients. Andrea Maynard, of Lexington, supervisor of Rehab Therapy Services, and Christy Browning, RN, CEN, of Wellington, were presented with Employee of the Year awards. Vickie Heierman, of Lexington, director of Rehab Services, was named Leader of the Year. Vickie Heierman was also named CHI Saint Joseph Health’s overall Leader of the Year for 2020. Saint Joseph Hospital annually recognizes one outstanding Employee of the Year who demonstrates the core values of reverence, integrity, compassion and excellence. This year, there were two recipients. “Andrea is driven to do her best as an individual, in patient care, as a team leader and as a mentor,” a nominator said. “She communicates well with co-workers and staff. She is a good steward and encourages others to be as well.” Maynard’s colleagues say she leads by example, treating all employees and patients with dignity and respect regardless of gender, race, age or socioeconomic status.

Andrea Maynard

Of particular note is Maynard’s dedication to the Haitian community. She has participated in several mission trips to Haiti to help build homes, teach and provide medical services, and has even learned to speak Creole to improve her ability to communicate. Browning was also a recipient of an Employee of the Year award. “Christy never fails to show compassion to her patients, their families, visitors and her co-workers,” a nominator said. “She sees and treats people holistically, always finds a silver lining, demonstrates perpetual patience and respect, and never fails to find a kind word or action to soothe her patients and families in crisis. She truly has a heart of gold.” Browning is the only Certified Emergency Nurse (CEN) on her floor, and actively works to educate patients on the processes and procedures taking place. Her colleagues say her dedication to education and collaboration also means that she is an excellent resource for new members of the team. Similarly, Saint Joseph Hospital annually presents one employee serving in a managerial position with the Leader of the Year award. Selection criteria include an outstanding demonstration of leadership led by CHI Saint Joseph Health’s core values of reverence, integrity, compassion and excellence. This year, the hospital recognizes Vickie Heierman.

Christy Browning, RN, CEN

Vickie Heierman

“Vickie always complies to our mission and does what is asked of her,” said a nominator. “Recently the rehab director at Saint Joseph East retired, and when asked, Vickie started filling in with their Rehabilitation Department as well. Even though she now works at various facilities, you never hear her complain. Vickie does all that is asked of her and truly shines our mission.” Even after 41 years at Saint Joseph Hospital, Heierman continues to take on new roles and supports the community in a variety of ways. Whether she’s playing the flute in a band during Spirit Week or collecting canned goods for a local giving program, Heierman is eager to be a leader who is active in all areas of the community. All award winners were recognized during a special virtual ceremony.

Saint Joseph Hospital Receives Get With The Guidelines-Stroke Gold Plus Quality Achievement Award American Heart Association Award recognizes hospital’s commitment to quality stroke care LEXINGTON, Ky. (Nov. 11, 2020) – Saint Joseph Hospital has received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. Saint Joseph Hospital earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date,

doc 23

www.kentuckydoc.com | Winter 2021 | Kentucky

SHARE YOUR STORY WITH THE COMMUNITY. E M A I L B R I A N @ R O C K P O I N T P U B L I S H I N G . C O M T O H AV E Y O U R N E W S P U B L I S H E D.

evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. Before discharge, patients should also receive education on managing their health and get a follow-up visit scheduled, as well as other care transition interventions. “This is yet another honor for the outstanding team of caregivers at Saint Joseph Hospital,” said Bruce Tassin, CEO, CHI Saint Joseph Health, and president, Saint Joseph Hospital. “We are pleased that our commitment to provide the highest quality care continues to be recognized by national experts. We also appreciate the work that the American Heart Association is doing to provide evidencebased clinical guidelines for the safety of stroke patients across the country.” Saint Joseph Hospital also received the Association’s Target: StrokeSM Elite Honor Roll award and the Association’s Target: Type 2 Diabetes Honor Roll award. To qualify for the Stroke Elite Honor Roll, hospitals must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only

drug approved by the U.S. Food and Drug Administration to treat ischemic stroke. To qualify for the diabetes honor roll, hospitals must meet quality measures developed with more than 90% of compliance for 12 consecutive months for the “Overall Diabetes Cardiovascular Initiative Composite Score.” “We are pleased to recognize Saint Joseph Hospital for their commitment to stroke care,” said Lee H. Schwamm, M.D., national chairperson of the Quality Oversight Committee and executive vice chair of Neurology, director of Acute Stroke Services, Massachusetts General Hospital in Boston. “Research has shown that hospitals adhering to clinical measures through the Get With The Guidelines quality improvement initiative can often see fewer readmissions and lower mortality rates.” According to the American Heart Association/American Stroke Association, stroke is the No. 5 cause of death and a leading cause of adult disability in the United States. On average, someone in the U.S. suffers a stroke every 40 seconds and nearly 795,000 people suffer a new or recurrent stroke each year.

UK HealthCare’s performance in the 2020-21 Best Hospitals rankings: For the fifth consecutive year, the University of Kentucky Albert B. Chandler Hospital at UK HealthCare has been named the No. 1 hospital in Kentucky and the Bluegrass Region by the U.S. News & World Report Best Hospitals rankings and ratings. For the fourth straight year, the University of Kentucky Markey Cancer Center has earned a top 50 national ranking for cancer care, climbing to No. 29 in the 2020-21 Best Hospitals rankings. Additionally, five adult specialties at UK HealthCare and seven common adult procedures and conditions received a highperforming designation.

Nationally ranked

» UK Albert B. Chandler Hospital: #1 hospital in Kentucky » UK Markey Cancer Center: No. 29 in the nation for cancer care

RENT THIS CABIN

"We are pleased to recognize Saint Joseph Hospital for their commitment to stroke care."

In the Beautiful Red River Gorge CAMPING CABINS AND PRIMITIVE CAMPSITES ALSO AVAILABLE

– Lee H. Schwamm, M.D., national chairperson of the Quality Oversight Committee and executive vice chair of Neurology, director of Acute Stroke Services, Massachusetts General Hospital in Boston

Call or visit website for reservations.

(606) 668-2599 ksbrown@mrtc.com www.kentuckywildflowersllc.com

As a Physician in the U.S. Air Force, you’ll have one job: treat patients. We’ll give you all the support you need so you can be the doctor you were meant to be. For more information, contact your local recruiter or visit airforce.com.

Call 1-800-588-5260 or

Pr o

•

Iss ue

•

M ay

20 17

PL EA SE

TA KE

ON E

su m m er

20 17

•

vo lu m e

•

is su e

Th Cold eD o iffe r Flu re ? nc e

D AN

R IN M EN T •H LT H •B A R G A IN S •L

IF ES TY

Co Fluld

Is Sh Ge ot ttin Ne g ce a F ss lu ar y?

Ho d wt sp urin o st re g ay ad th h in e g ea l g se erm thy as on

M Rev ort e ga rse ge s

be yo nd

Ch ick Re en cip So e up

Sp en Sa de ve rs rs vs .

an d

eg g

Sa Ra vin in g fo y Da r a y

Yo ur ne st

Vo l.

•

Iss ue

AT I

•

W ESSAY C

M ar ch

20 16

IN NI

G A Z I

PL EA SE

N E

TA KE ON E

Pr of ile in Co m pa ss io n

M is ed Jo C ici hn a Gu lli ne AL SO rle ng yM IN S

AY “H S do ea be cto lthy ba tte rs an to rrie r ca pro d h ph rs re vid ap ys an , de e py icia d fi n solu ne w ell tio ne ns ss .”

WIN NE

M a C ed INSID os ic tA a E na l S lys c is ri be s:

EST

AL SO

He ar t

cti on of po help rta in nt g p th eo ing pl e ."

Dr file in C Bl . C ompas si He ay ar ar d y on a K t Do e in cto s d r

Vo l.

SuFU mm N er!

fa ll

20 16 • vo lu m e

8 • is su e

ev b ice le s 17 F Lo ood se s W to eig He ht lp

Li Wvin

A He ge ari -Re ng la W ted oe s

AL SO

“N ea “S tnik lo s” bs v ” s.

IN SI DE

Th of e M M ale en op Ve au rsio se n ?

•H

LT H

•B

E FO

AT I

•L

N U E

A M Loo ed k ica In l F sid itn e B es od sF y ac Str ilit uc y tur e

FIT NE SS ISS UE

Th e

EA S E T TM UC EC EN CE TIO T SS N FU CA L

Os SI te 12 LEN o M T Pr ILLIONDISEAS poro Ca ost MEN E AFF si s EA EC a n TS M RL ce te TR EAN Y D r

He ar t

At ta ck s

U SI ND M GN ERS AY S T SA AN AND VE D S IN YO YM G UR PT TH E LI OM FE S

M HE e AL n TH 's

A Fit nsw ne er 5 ss s to Qu C Go Rea es om od so n Ch fo s W tion mo Sh oo rY a s n s o o lk Ac e e tiv s fo the ur H ing ea is ity r Y R lth ou igh r t

PA eL g RK L60 P I N lu DI S s SE O AS N’ E S

C co opin ne nd g co rve itio wit nt c n t h a ro ell ha c lm s hr t us in t dam onic cle he a m bra ges ov in em th en at t

Die H t E ow ffe to cti ve ly

ss t e 11 •A ug us t2 01 7

Vo l.

•

Iss ue

•

M ar ch

20 17

PL EA SE

TA KE

ON E

H ke ow in ep can fu ter yo yo th nct nal ur u eir io or pe nin gan AN ak g a s th D ? t yo ey – w an u h do ha d ea to t we lt ke ll. hy ep

• R rs ek in dle

Pr Pa ac ss tic io Ex 20 pe 1 e nf rie 7 E nc of o es ssa th y C M r th at Ig on ed e nit te e • st ici Su W sta in ne in ne

sp rin g

•

vo lu m e

•

is su e

Go od He Kid alt n h ey Ho fo me rK R id em ne e y P die ain s Cle 10 F an oo se ds th Th e L at ive r

20 17

KI O D AN

SHARE YOUR STORY. BUILD TRUST. REACH YOUR TARGET.

GROW YOUR BUSINESS. We curate and publish local content in a family of magazines created for health-conscious readers in the Central Kentucky area. Share your story, build trust and grow your practice through targeted advertising.

& M A G A Z I N E

REACH OVER 75,000 READERS

60 Plus

REACH OVER 60,000 READERS

REACH OVER 11,000 READERS

859-368-0778

brian@rockpointpublishing.com

doc | Winter 2021 | www.kentuckydoc.com

26 Kentucky

HOW COVID-19 IMPACTS

Training our Future Physicians at the University of Kentucky College of Medicine This article is a review of the impact of COVID-19 upon training our physicians for the future in Kentucky. This review is based upon the current UK policy for students in training, particularly our medical students. It is based upon an updated primer for medical students about current infection control measures as they enter clinical areas. This was obtained from Dean DiPaola of the University of Kentucky, College of Medicine. Also, two M3s and one M4 were also interviewed, an M2 from the Bowling Green campus was interviewed, and Charles (Chipper) Griffith, M.D., the Senior Associate Dean for Medical Education at the UK College of Medicine was interviewed as well.

By Robert P. Granacher Jr., MD, MBA

Current Infection Control Measures to be Used by UKCOM Medical Students This is based on an updated handout (September2020) for all medical students at all UK campuses. All students will be screened upon entry to the clinical areas by using a survey that is unique to medical students. This survey is to be completed every day that the student comes onto a campus (within four hours prior to arrival). M3s and M4s must wear a standard surgical mask (not a homemade or cloth mask) whenever they are at work at UK Healthcare. The VA will have separate rules for using

cloth masks in certain areas. Medical students are to follow local hospital guidance for St. Claire Hospital in Morehead and the Medical Center at Bowling Green. The mask is to be kept in a bag when not at work and reused every day unless it becomes soiled. This is the “universal” mask. If the student enters any type of isolation room, they are required to use a dedicated mask for that room and discard it when leaving the room. Then, the student will replace their “universal” mask on their face. All (third year) M3 and (fourth year M4 students can be fit-tested and get access to an N95 mask. The student cannot use an N95 mask if they have not been fit-tested. The student must keep this N95 mask and

reuse it. When the student uses an N95 mask, they are to place a standard surgical mask over it and then discard the surgical mask afterwards. M3 and M4 students are not allowed to enter the rooms of, or provide direct care to patients, with known COVID19 or patients with a “high suspicion” of having this illness. This is true even if using an N95 mask. Students can enter the rooms of, or provide direct care to patients, with “asymptomatic tests” or patients with “low suspicion” of having COVID-19. The student should follow appropriate guidelines for PPE (Personal Protective Equipment) in these situations; this may include use of an N95 mask and/or eye protection. Communications about COVID-19 testing

doc 27

www.kentuckydoc.com | Winter 2021 | Kentucky

status and decisions about “low suspicion” or “high suspicion” are the responsibility of the student’s supervising residents and faculty. If there is any uncertainty, the final decision resides with the supervising faculty about whether the student can provide care to a patient. If the student has concerns, they are required to contact their course-clerkship-site director, one of the student affairs deans, or a regional campus dean. Students can use PPE, and they should

follow the same procedure for PPE use and conservation as faculty or residents. As always, the student is required to practice appropriate hand hygiene before and after all patient contact. If the student is ever concerned about access to PPE, they are to immediately notify their supervising faculty, course-clerkship-site director, one of the student affairs deans, or their regional campus dean. As much as possible, the student is to maintain appropriate distance while at work

(ideally six feet). This may not always be possible in all clinical settings. In those settings that are not possible, students should ensure that they are wearing their mask and follow the guidance of the faculty or residents on the scene. If students are unsure about COVID-19 documents, those are available to them at a published website. They also have available to them a website for CDC guidance for putting on and removing PPE. UKCOM Continued on Next Page

All (third year) M3 and (fourth year M4 students can be fit-tested and get access to an N95 mask.

doc | Winter 2021 | www.kentuckydoc.com

28 Kentucky

UKCOM continued from Previous Page

UK Medical Faculty Observations of Medical Students Adjusting to COVID-19 Dr. Griffith is the source who advised that national standards for developing programs and policy for medical students attending medical school during COVID-19 are used. LMS member, Dr. Twyen Tran worked actively on the Veteran’s Administration and the UKCOM campus policies. When COVID-19 started, the MCAT examination was closed initially, but it has now been reopened for college students wishing to take that examination for entrance to medical school. There has been a problem with the STEP program. This testing is generally done after the first two years, after the fourth year, and after the first postgraduate year. At the time of my interview with Dr. Griffith, no one had yet taken the test. This will influence licensure, and national guidance is still needed on this. About our medical students at the University of Kentucky, STEP-1 and STEP-2 are still somewhat delayed. Even with that difficulty, all our students should be able to start residency. The biggest M1-M4 challenge that concerns Dr. Griffith is that our M1s may not be as cohesive because of the fragmentation of their programs. It is difficult for them to be together, and he worries that they might have difficulty with bonding. Gross anatomy classes have been a particular problem. For the M1s, gross anatomy specimens

are generally prosected, but the students must wear masks and PPE as they handle specimens. For the M4s who chose to take the elective course in dissection, only the person doing the dissection at the time can be near the cadaver. The other three students on the dissection team must step away and watch from a distance. There has also been difficulty teaching physical examination principles because of the distancing requirements for COVID-19. M3s and M4s are all required to maintain social distancing, and they are placed with a team. Dr. Griffith is working on a preresidency boot camp with online simulation scenarios for M4s as they transition to residency. Dr. Griffith feels that COVID-19 has added a severe stressor to our medical students. He is concerned about the mental health functioning of many students, and because of that, the College of Medicine has a dedicated psychologist specifically assigned to assist medical students. Also, it is worthwhile mentioning that the Lexington Medical Society now provides the Physician Wellness Program to our medical students and residents, as well as our Lexington Medical Society physicians. That therapy and counseling program is now well underway and is becoming a national model. It is available to all UKCOM qualified medical students, residents, and Lexington Medical Society member physicians. There is no fee to the doctor or student/ resident patient, and referrals are handled with extreme confidentiality through the UKCOM, and the Lexington Medical Society (see information in this volume).

Views of UKCOM Medical Students and the Impact of Covid-19 Terry Clark, MD, LMS member, interviewed a fourth-year medical student (M4) about the effects of mitigation protocols for COVID-19. There has been a significant restructuring of policy for all UKCOM students, particularly M3 and M4 students, due to the virus. Much of the student’s information is redundant and can be understood best by reading the current infection control measures above. The student did share that third year rotations were initially canceled, and students were allowed to spend time studying for the “shelf exams” covering emergency medicine, neurology, obstetrics and gynecology, internal medicine, and the units for surgery. These examinations were completed through Zoom events with special arrangements to proctor for possible cheating. The tests were administered by contracted testing companies. Most students were allowed back in the hospital for some rotations about four weeks before the 2020 academic year ended. Step 2 examinations (national boards) were postponed. Students entering the 2020-2021 academic year were treated like every other University of Kentucky student. They were required to demonstrate a negative PCR COVID-19 test prior to arriving on campus or quarantine until testing at a UK site was obtained. Random testing was performed throughout the year. Daily symptom screening questionnaires were to

dependable. thorough. trustworthy. LANDSCAPING, MOWING, MULCHING, LEAF REMOVAL, GUTTER CLEANING, PRESSURE WASHING

One M3 student noted difficulty expressing empathy to those who needed it, because of both patient and student having a mask. be performed by the student online every day, and masks were always to be worn on campus. The information for N95 masks for M3s and M4s is found above. There was little opportunity to complete offsite clinical rotations at other institutions. Residency applications by M4s, and the accompanying interviews, were done in a virtual manner by Zoom. Two M3 students were interviewed, and it should be noted that all UKCOM interviewees gave permission directly to the interviewer to have this information displayed in this article without attribution to their names. One M3 student noted difficulty expressing empathy to those who needed it, because of both patient and student having a mask. She was unable to see the faces of her patients, and she had to wear goggles. Neurological examination of cranial nerves was difficult due to mask wearing by the patient. There was a barrier to seeing pulmonary patients, and she is concerned that this will result in a poor pulmonary experience going forward for the students into the M4 year and residency. She did not feel that the students were learning enough pulmonary medicine because of COVID-19. A male M3 student was also interviewed. He noted that it was difficult to see any respiratory patients who had certain symptoms. He also found it difficult to communicate with patients due to the masks. He had significant difficulty with a rotation where he had to evaluate intellectual disability patients because of their masks. There seemed to be variance among the attending physicians in how they communicated with students about expectations or clinical information imparted during their rotations due to the COVID-19 restrictions. The last student to be interviewed was from the Bowling Green campus from UKCOM. This was an M2 who noted that he was very uncomfortable when his school was locked down for two months. He felt his biggest challenge was being away from his classmates. He very much likes to interact with other students, and he became extremely lonely. Now he has solved that by going to the campus every day with a study partner. He does think he has had enough faculty support, and they are very accessible. He notes that some students in the M1 and M2 years seem to avoid the school campus because they are fearful that they will contract COVID-19. Overall, it seems that the students on the UK campus and the Bowling Green campus are adjusting reasonably well to what must surely be an extremely stressful event for them. We wish our medical student colleagues the best of health, and it appears that the faculties of the UKCOM are meeting the needs of medical students the best that can be done at this time while following national standards for medical students.

Pilot Landscaping 859-447-5075

FREE QUOTES • CALL SHAWN HILL great for seniors and busy families

Leave the cleaning to Kentucky’s Finest! Take the stress of cleaning off of your plate. With ten years of dependable service to Lexington families, seniors and businesses, Kentucky’s Finest offers experience you can trust. FLEXIBLE SCHEDULES: WEEKLY • BI WEEKLY • MONTHLY

d owar H y t ote Mis Call free qu for a

6 0 6

1 0 7 3 275-

Kentucky’s Finest

LLC

HOME & COMMERCIAL CLEANING

10 doc | Winter 2021 | www.kentuckydoc.com

30 Kentucky

MARKETING STRATEGIES

for Medical Practices By Brian Lord, Publisher, KentuckyDoc Being a Physician in 2021 and growing your own practice in today’s culture is an ever-evolving world in many aspects of medicine, but especially true when it comes to attracting and retaining patients. However difficult it may be, marketing is a must for doctors. I know they did not teach you this in medical school. But when you start your own practice or join a practice you are in the business world. Those who invest in marketing themselves thrive, while others who resist tend to fall behind. Luckily, a few simple tactics can quickly boost your medical practice’s online and offline presence, making it easier for patients to find you. Before we dive in, there a few key things to remember as you plan your marketing strategy: » Marketing is not advertising, though advertising can play a part in your marketing strategy. Marketing involves public relations, media planning, client support, market research, and community involvement as well as advertising. » Marketing is an ongoing process. Your strategy will adapt to changes in the industry and the world around you. Invest in a long-term strategy to grow your business over time rather than trying a “set-it-and-forget-it” scheme that will likely fall short. If you want people to be involved in your medical practice, then you need to be involved in reaching them. » Marketing is an investment. You should not only plan to spend time and money on your marketing strategy, but you should also track results to determine your return on investment to ensure

you’re on track towards success. » Marketing is a conversation between you and your clients. As such, you should focus on what your target audience— whether patients, other doctors, or a combination of both—wants and needs from their doctor, i.e., you. Here are the 10 marketing strategies for doctors and medical practices: 1. Build a Website Your medical practice needs an online home, somewhere you can be found by current and potential patients. Luckily, you don’t need to be an HTML wiz to get up and running with a customized site. Online services like Wix and Squarespace are straight-forward, easy to use, and relatively inexpensive. Alternatively, you can hire someone to design and code a site for you— you can find freelance contractors on sites like UpWork or Fiverr. How you proceed depends on your comfort level, time, budget, and skills. 2. Market With Educational Content A regularly updated blog with original or curated content provides many opportunities to address the needs and interests of your audience. Consider a local magazine like Health&Wellness, for example, to develop content in print that can then be posted on your blog, website and social media. This content marketing helps build your personal brand and establishes you an expert by writing about your specialty, trends and patient stories, for starters. In addition to publishing online, print

magazines are at an advantage as people hold on to and revisit them. Market to people who are looking for health solutions for themselves or a loved one. 3. Provide content on Facebook There are more than 1.94 billion monthly active Facebook users worldwide. So develop a professional Facebook page for your medical practice (separate from your personal page). This allows you to frequently contact your audience and remind them of your presence. Post tips, news, and small videos that allow people to hear your voice, learn your personality, and get to know you and what you offer. It’s also an ideal forum for your magazine and blog posts—to share useful and interesting links that may be re-shared, providing virtual word-of-mouth about you. 4. Connect on Twitter and Instagram Twitter, Instagram, and other social networks like Snapchat and LinkedIn provide additional opportunities to connect and share with your audience. This may seem a like a lot of work but you can easily repost what you have on Facebook on these sites. 5. Become a Source for Journalists There are few better ways to establish expertise and gain exposure than by being cited in media. Make connections with journalists for print, online, and TV. Regularly reach out to them and let them know you are a medical professional who can provide context and legitimacy to their stories.

6. Send an Email Newsletter Capturing email addresses and regularly emailing to your list of contacts drives traffic to your website, blog, and social network pages, which in turn, drives additional appointment requests and referrals. Start with your current patients to keep them informed of what you are doing in the business, the community, offers and reminders. You can even use promotional giveaways to encourage people to recommend and send referrals to your business. Create a newsletter template with an inexpensive mailing service like MailChimp or Constant Contact. Not sure what to include? Try starting with highlights of your recent work in the articles of local magazines (again this gives you credibility, especially if they are medical magazines) and link back to your blog posts to drive traffic. 7. Deliver Unexpected Care Packages This is a new way to reach people. Make sure you know what is going on with your patients and their needs. Are they on hard times, dealing with death or major illness? Sending care packages or simple gift cards shows you care about people and builds return as people hear about the loving act.

Prizes awarded in each of three categories: Active Physician, Resident, U.K. Medical Student 1st Place: $500 2nd Place: $200

Remember, we seek professionals we trust; we trust those we know care about us. So, show how much you care. This is also good for your staff to build a great work environment. 8. Leverage Patient Reviews Your current patients and referring doctors are your best marketing partners. Harness the power of happy clients to help spread your name to potential patients by requesting referrals. Use giveaways for this, as well, as incentive. 9. Start a patient referral program A record of top-notch care and genuine concern for your patients will go a long way towards encouraging positive word-ofmouth and referrals to friends and family. But there’s nothing wrong with a little reminder. Print referral cards with a simple message like “Share the gift of good health” and your office information, then be organized about handing them out, perhaps as part of your care packages. When you do get a referral, be sure to follow up to let your referring patients know how much you appreciate them with a handwritten note, phone call, or small token (so long as its value is $10 or less).

10. Improve your SEO Search engine optimization (SEO), improving the likelihood you can be found via online search, can help drive targeted leads (i.e., patients and referring doctors) to your website. Make sure you use the content you have in magazines and your blog and this will help a lot. Google and other search engines like original content. You can improve your SEO with localization like adding your practice’s address on your web pages. These 10 tips will help you reach and grow your private medical practice. WE understand that it takes time to make this happen. So, even if you hire someone to do all this for you, make sure you give time to provide leadership to this each week. Many physicians hire a marketing person/company to run all of this for them and then are hands-off. Remember, you are the brand. So, control your brand; it represents you. Stay on top of how others represent you.

2021 LMS 7th Annual Essay Contest Essay Question: “How do physicians and healthcare personnel encourage use of the SARS-CoV-2 9CoVID-19) vaccine?“

3rd Place: $100 Essays are due no later than March 1, 2021 to LMS, Go to lexingtondoctors.org for details. Winners will be published in the Spring 2021 issue (April) of the Kentucky Doc Magazine

BUSINESS DEVELOPMENT || |MARKETING & || |SOCIAL MEDIA || |VIDEO COACHING BUSINESS DEVELOPMENT MARKETING SALES SOCIAL MEDIA PRACTICEISSUES ISSUES|| |COACHING COACHING BUSINESS DEVELOPMENT MARKETING &&SALES SALES SOCIAL MEDIA VIDEO PRACTICE ISSUES COACHING BUSINESS DEVELOPMENT | MARKETING & SALES | SOCIAL MEDIA |VIDEO VIDEO|| ||PRACTICE PRACTICE ISSUES

Helping Helping you you Develop Develop the the Practice Practice

20+ Years of Results, 20+ Years Driving Results, 20+ Years ofofDriving Driving Results, 20+ Years of Driving Results, and Being Measured by and Being Measured by Them andand Being Measured byThem Them Being Measured by Them

You You Envisioned Envisioned

businesses grow. II work to businesses grow. I work businesses grow. work toto to businesses grow. I work

What Whatcan canaaconsultant consultantdo dofor foryou? you? Think of me as both an “outsource resource, ”” as well as aa acoach to help: Think me both “outsource resource, ”as well coach help: Think ofof me asas both anan “outsource resource, well asas toto help: Think of me as both an “outsource resource, ” as as well as acoach coach to help:  Make sense of your competitive environment, Make sense your competitive environment,  Make sense ofof your competitive environment, Make sense of your competitive environment,  Leverage available tools to your advantage, and Leverage available tools your advantage, and  Leverage available tools toto your advantage, and Leverage available tools to your advantage, and  Ensure you accomplish goals important to your personal vision. Ensure you accomplish goals important your personal vision.  Ensure you accomplish goals important toto your personal vision. Ensure you accomplish goals important to your personal vision.

Arrange Arrange confidential discussion about the challenges you face. Arrange confidential discussion about the challenges you face. Arrangeaaaaconfidential confidentialdiscussion discussionabout aboutthe thechallenges challengesyou youface. face.

I’m with practical I’maI’m coach with practical I’m a acoach coach with practical a coach with practical experience helping professional experience helping professional experience helping professional experience helping professional help you market your practice, help you market your practice, help you market your practice, help you market your practice, differentiate your services and differentiate your services and differentiate your services and differentiate your services and increase your patient base. increase your patient base. increase your patient base. increase your patient base.

 502.208.9639 502.208.9639 502.208.9639  jimrayconsultingservices.com jimrayconsultingservices.com jimrayconsultingservices.com  jimrayconsultingservices.com  /JimRayConsultingServices /JimRayConsultingServices /JimRayConsultingServices /JimRayConsultingServices  /jimray4 /jimray4 /jimray4 /jimray4  to My Business Podcast on iTunes Listen My Business Podcast on iTunes Listen My Business Podcast on iTunes Listen Listen tototo My Business Podcast on iTunes