East TN Medical News July 2015

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PHYSICIAN SPOTLIGHT PAGE 3

Dr. Samer Ammar

Rolling Out the President’s Precision Medicine Initiative NIH’s Collins, Sen. Alexander Discuss Next Steps in Nashville

By CINDy SANDERS

FOCUS ON

PERSONALIZED MEDICINE SPONSORED BY GI FOR KIDS

ON ROUNDS

Due Diligence: Preparing for an Acquisition or Merger Over the past several years, changes in the healthcare regulatory environment have generated increased interest in acquisitions and mergers among physician groups, hospitals and health systems ... 4

Homegrown Heart Local Nurse Practitioner Has Long History Helping Kids

During a National Institutes of Health Precision Medicine workshop held in Nashville at the end of May, NIH Director Francis Collins, MD, PhD, and Sen. Lamar Alexander (R-Tenn.) discussed the steps necessary to roll out a national effort to deliver highly personalized care.

The Precision Medicine Initiative (PMI) has near-term goals focused on diagnosing and treating cancer and longer-term goals that look to expand the scope to the full continuum of health and disease. In announcing the initiative earlier this year, President Barack Obama highlighted the impact of ivacaftor – a new class of drug to target the underlying cause of cystic fibrosis that is now approved for patients with 10 different mutations to the CF transmembrane conductance regulator (CFTR) gene. For those with one or more of the mutations, ivacaftor has demonstrated improvement of CFTR function and has significantly extended quality and quantity of life.

Collins, a physician-geneticist who is known for his landmark discoveries in disease genes and his leadership in mapping the human genome, said the plan is to launch a million-person (or more) PMI research cohort in the next few months.

“We do expect by the fall to begin the process of implementing what we are designing right now,” Collins said. He spoke from Vanderbilt University where he was onsite for a two-day PMI workshop focused on digital health data and research (CONTINUED ON PAGE 8)

PHOTO COURTESY OF VANDERBILT UNIVERSITY MEDICAL CENTER

Measuring the Impact of Interprofessional Education

Do Lessons Learned Translate from the Classroom to the Clinical Setting?

By CINDy SANDERS

“I’ve always wanted to work with kids,” said Wendy Taylor, DNP, CPNP, and “always knew I would go into the medical field.” Born and raised in East Tennessee, or “homegrown,” as she put it, Taylor started out volunteering ... 8

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Dr. Francis Collins, director of the National Institutes of Health, addresses attendees at a recent workshop on precision medicine.

IPE … or interprofessional education … has become a popular buzzword among educators preparing the next generation of providers. An interprofessional, team-based curriculum has been lauded as the best way to prepare healthcare professionals to work collaboratively in a value-based system where efficiency and quality are rewarded.

But does it work? Do the lessons learned in the classroom effectively translate into the clinical setting? And does this model of delivery actually have an impact on patient outcomes and the healthcare system itself?

Those were some of the questions posed by the Institute of Medicine’s Global (CONTINUED ON PAGE 9)

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Knoxville to be a Beacon of Purple for Dementia Awareness The movement started by one man gained momentum across Europe and spread to Asia, Australia and When Knoxville was the United States. Knoxville proclaimed a Purple City now intends to serve as a in May, it signaled the model for other communities commitment to make our across the country. community one of the first We believe Knoxville is dementia-friendly cities in the perfect place to start in the United States. the United States. When the A designated “Purple idea was suggested for our City” means community city, volunteers and organimembers and organizazations immediately came tions execute specific steps together to make it happen. to help people learn about Carolyn Pointer Neil, right, announces the launch of the Purple Cities Alliance, a formal effort to make Knoxville one of the first dementiaOn the day the alliance was dementia and help those friendly cities in the United States, while other alliance members and supporters look on at the kickoff event in Market Square on May 11. announced, Henley Bridge with dementia receive the Pictured from left: Dava Snyder of The Courtyards Senior Living; Russ Jensen of the City of Knoxville; Patrick Wade of The Pat Summitt was lit up with purple lights highest level of care and Foundation; Gwyn Earl of Trinity Care Senior Living; Dr. John Dougherty of the University of Tennessee Medical Center; Dr. Monica Crane of the University of Tennessee Medical Center; and Kathy Broggy of The Courtyards Senior Living. to signal Knoxville’s commitsafety. ment.

Such an initiative can Also on the day of the only succeed with the backBurchett. Tennessee Lady Vols Basketball a global network based on the vision and alliance announcement, Patrick Wade, ing of the community, its elected officials Assistant Coach Kyra Elzy also shared her efforts of Norman McNamara, a resident director of The Pat Summitt Foundation, and organizations dedicated to serving personal story of her family’s experience of Torbay, Devon, England, who was said: We’ve all felt the impact of this disthose dealing with the cognitive memory with dementia. diagnosed with dementia at age 50. Mcease, whether through Pat Summitt’s story loss.

The need for Purple Cities is clear.

Namara founded The Purple Angel orgaor an experience with a family member.

The Purple Cities Alliance initiative More than 5 million Americans live with nization to encourage his hometown – and We’re working to treat, prevent, cure and kicked off officially in Knoxville on May Alzheimer’s disease, one of the most comcities across the world – to gain insight and ultimately eradicate this disease, but for 11. The formal presentation explained mon types of dementia, and most Knoxunderstanding about dementia and theremillions of people living with it, we can the goals and efforts of the alliance and villians know someone suffering from fore become more supportive of commumake a difference today.” included proclamations from represencognitive memory loss. nity members living with the disease and The Purple Cities Alliance is led in tatives of Knoxville Mayor Madeline Overall, the Purple Cities Alliance is related conditions.

(CONTINUED ON PAGE 3) Rogero and Knox County Mayor Tim

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experience as well as practical experience working in the field of healthcare.

Greg Gilbert 862.862.6500 (direct) / ggilbert@lbmc.com Partner – Tax Services & Managing Partner of Knoxville Office

As managing partner for the Knoxville office Greg works closely with a variety of industries including physician practices, law firms, other professional services, automobile dealerships, construction, manufacturing, and not-for-profit organizations.

He provides estate, corporate, limited liability entity, and individual tax planning services. He has spent his entire professional career in the public accounting sector and enjoys sharing his talents by serving on various boards and committees including the finance committee at the Helen Ross McNabb Foundation, the East TN Historical Society and the 1956 Society at UT Medical Center.

Outside of the office, you are likely to find Greg on the golf course enjoying time with long-time clients who are now friends or his son Gregory.

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PhysicianSpotlight

FOCUS ON PERSONALIZED MEDICINE SPONSORED BY GI FOR KIDS

Home Sweet Home

Gastroenterologist Settles in East Tennessee, Serves the Pediatric Community

By JENNIFER CULP

Dr. Samer Ammar aspired to become a physician from an early age. As a child growing up in Damascus, Syria, Ammar was greatly impressed with the healthcare providers who treated him for childhood illnesses. “Since then, I had this ambition to become a physician so I could care for kids,” he remembered. By middle school, other students had begun to refer to him as “Dr. Ammar,” and by high school even some of his teachers called him by the nickname. “‘Dr. Ammar, come to the board!” he remembered, laughing. But the most significant influence in Ammar’s path to medicine was not a teacher, or even a physician, but his mother. “My mom had a huge impact on that decision-making process,” he said. “Especially during my high school years, she kept pushing me, and she made the environment friendly enough so that I could have the time and space to make this dream come true. I had to work hard, and she was the biggest help to me.

Every tool she had at that time available to her, she used to make my dream come true. ” Ammar’s dedication and his mother’s support paid off, and he entered Damascus University School of Medicine in 1986. After six year of medical training, he graduated with good training and an aspiration to continue his education abroad. After talking to family and friends about pursuing further medical education in other countries, he decided the United States was the best option. After arriving in the U.S. in late 1992, he did about a year and a half of research in general gastroenterology in Chicago, Illinois, while taking the three steps of the United States Medical Licensing Examination. After successfully earning his U.S. medical license, he moved to Shreveport to undertake residency at Louisiana State University. At this point, Ammar crossed paths with pediatric gastroenterologist John Herbst, who would prove to be another shaping force on his future. “My encounter with Dr. Herbst had an influence on my preference. He could see that I had an interest in pediatric gastroenterology and took my hand and let me work with him closely, and I found myself liking it more and more. I loved doing the procedures; I love to see kids with a variety of gastrointestinal pathologies. I think it’s rewarding when a patient comes back with dramatic improvement,” Ammar said.

Upon completing his pediatric residency in Louisiana, he moved to Indianapolis, Indiana, where he worked for three years to complete a pediatric gastroenterology, hepatology, and nutrition fellowship at James Whitcomb Riley Hospital for Children. After earning board certification in both general pediatrics and pediatric gastroenterology, Ammar easttnmedicalnews

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migrated north for three years to work in the Department of Pediatric & Human Development at Michigan State University in Grand Rapids, Michigan, then back to Illinois to work as a clinical assistant professor at Southern Illinois University for nearly seven more years. “Then an opportunity knocked on my door from East Tennessee,” he said. “I think this will be home from now on.”

Ammar didn’t undertake his journey around the United States alone; while working toward his residency he was joined by his wife, Manal. The couple met at a young age, Ammar explained, first meeting on family visits to his aunt and her grandmother, who were neighbors.

When they got older, “I went to medical school, she went to the college of economy and business management, and we kept in contact even after I departed Syria,” Ammar recalled, “and then we decided that this was what we wanted to do!”

The couple was engaged and married in 1998, and welcomed their first child in 2001. Their oldest is now 14, and they’ve added three more kids to the family in the years since. “I was just finishing my fellowship back then, and then we took a break for five years and then went back-to-back, as you can see—9, 7, and 5, every other year,” he laughed. All four of the Ammar children are competitive swimmers, “even my five-year-old!” Ammar exclaimed.

“He’s been swimming for three years, and this little guy, he has no fear whatsoever of water. He would jump in the water from anywhere.” Inspired by his oldest child, Ammar is working to expand his own skill set and learn to play piano music. “Even at my age, it’s a dream I had earlier in life, but you see, my kid’s now going through

this, and I have an opportunity to invest in that myself, so…I’m doing it!” he said.

Ammar enjoys hiking and playing tennis, but his greatest interest lies in meeting people of different cultures and perspectives.

“I think life is a journey, and as much as I continue to and would like to continue to grow in my own area, I think that growth on a personal level comes from meeting people of different cultures and different interests,” he said.

Ammar appreciates the variety inherent to the field of pediatric gastroenterology, the range in age of the patients he sees at GI for Kids and the diversity of problems with which he is able to help them. “There is an endless list of things we see in pediatric gastroenterology and ways we can change our patients’ lives to be more functional and make them feel better,” he noted. Ammar and his family have been living in Knoxville since June 2012, and “we love it here,” he said.

In 2013, Ammar received an IMPACT Award from East Tennessee Children’s Hospital for Service Excellence, and he plans to keep up the good work. “I’m looking forward to continuing to serve the east Tennessee community within my spectrum of expertise, and work with everyone here toward better health for children.”

Knoxville to be a Beacon of Purple, continued from page 2 Knoxville by a team of volunteers, practitioners and community leaders, and the advisory board includes representatives from Alzheimer’s Tennessee, Courtyards Senior Living, Alzheimer’s Association Eastern Tennessee Chapter, Elder Advocates, Knoxville Senior Directory, The Pat Summitt Foundation and Trinity Hills Senior Living. Other participating organizations include Senior Citizens Home Assistance Service, East Tennessee Personal Care Service, Amedisys Hospice, Senior Financial Group, WVLT-TV and the East Tennessee Area Agency on Aging and Disability.

The alliance provides dementia education and training resources to community members and organizations. To date, more than 40 organizations and businesses have joined the alliance, including Covenant Health, Tennova Healthcare and The University of Tennessee Medical Center.

Author and advocate Gary LeBlanc of Florida created an initiative to bring dementia awareness to hospitals. He suggested that a small purple angel be added to admission wristbands to alert staff to the possibility that the patient could be confused and/or have memory issues. This program now is in the planning stages of all three hospital systems in Knoxville.

Alliance members will educate busi-

nesses and organizations by providing free training and decals for their windows to signal that the staff is dementia-aware.

Those dealing with cognitive memory loss can get disoriented and act out of character.

For example, a man went to the grocery store, picked up a loaf of bread and carried it outside without payment. The store manager accused him of stealing.

This man would never steal anything; he simply forgot to pay. This incident was upsetting to all involved but would have been easier had the manager been trained to recognize the difference between a thief and a person with dementia.

Any organization or company that is interested in receiving more information and signing up as a community partner for the Purple Cities Alliance should visit www.purplecities.org.

Our goal is for all Knoxville and Knox County citizens and organizations to join us in the journey toward making Knoxville a Purple City. We have an opportunity to stand up for our loved ones, friends and neighbors by making our city a safe, welcoming and supportive place to live. And we can set the example for cities across the country to do the same.

We hope other communities will follow our lead and become Purple Cities, too.

Mission Statement: The Purple Cities Alliance has begun the journey toward making Knoxville one of the first Dementia Friendly Cities (“Purple City”) in the U.S. and will serve as a model for other communities across the country.

In a Purple City, community members and organizations execute specific steps to learn about dementia and help those with dementia feel safer and better cared for in our community. The Purple Cities Alliance is a team of local volunteers, practitioners, and community leaders leading this initiative. The Purple Cities Alliance provides dementia education and training resources that enable community members and organizations to become more dementia friendly.

The Purple Cities Alliance is encouraging all Knoxville and Knox County citizens and organizations to join us in the journey toward making Knoxville a Purple City. Together, we will make Knoxville one of the first Purple Cities in the U.S. and serve as a model for other communities across the country.

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LegalMatters

BY SCOTT POWERS

Due Diligence: Preparing for an Acquisition or Merger Over the past several years, changes in the healthcare regulatory environment have generated increased interest in acquisitions and mergers among physician groups, hospitals and health systems. While the purchase and sale of physician practices require consideration of a host of factors, such as analysis of the offer, terms of the acquisition and the structure of the transaction itself, the due diligence process represents a common feature of almost every merger or acquisition.

Due diligence is the process through which the parties to an acquisition or merger conduct an extensive investigation of the entity to be acquired.

This process is needed to achieve a complete understanding of the operational features and liabilities of each party involved in the transaction prior to finalizing the deal.

The due diligence process is both complicated and expansive, particularly in highly regulated fields such as healthcare. If conducted properly, due

diligence provides the parties to a transaction with a thorough understanding of each party’s operations and liabilities or, alternatively, uncovers issues that need to be addressed in order for the acquisition to close.

Due diligence possesses common features across most types of acquisitions and mergers. For a practice group considering such a transaction, these features afford the opportunity to prepare, even before an acquisition partner is identified.

The Due Diligence Process: Typically, the initial due diligence

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request will arrive at approximately the same time as the transaction’s letter of intent. The request should be accompanied by an appropriate confidentiality and non-disclosure agreement, which is designed to protect the disclosed information and establish the process for return or destruction of deliverables in the event the deal fails to close.

Often, the exchange of documents and information that make up the due diligence process will be well underway by the time the first draft of the acquisition agreement arrives, and may continue up to the execution of the final agreement.

The following is an overview of due diligence request categories and a listing of potential deliverables that are associated with each: Corporate/Company Records.

Charter documents (with amendments), bylaws and agreements among the owners, including any shareholder agreements or restrictions on the transfer of ownership.

Financial Records. Current financial statements, audited financials for previous years, tax returns, audit or determination letters from the taxing authority, description(s) and supporting document(s) for any indebtedness.

Assets. A listing of all real, tangible and intangible property of the practice, including furniture, fixtures, equipment and inventory; a description of intangible property, including licenses and contracts for information technology and software.

Contracts. Copies of all material contracts, including provider and managed care contracts, professional services agreements, supply agreements, physician employment agreements and leases; and a description of any oral agreements.

Regulatory Issues. Governmental approvals or permits required to operate the practice, including approvals related to federal payer programs; documentation and explanation regarding any investigations by any governmental authority, both past and present, including the resolution of the investigation; and credentialing/licensing information.

Employment/Human Resources.

Listing of current employees and their respective job descriptions and dates of hire; compensation information, along with employee bonuses, benefits and any pending employee claims, along with the status of each claim; and copies of employment agreements, along with any current employee handbook or policy manual.

Information Systems and Technology. Inventory listing of all server hardware, as well as system software overview, along with operational soft-

ware and license agreements; documentation regarding automated file transfer or data interfaces in place with external clients, along with electronic billing, collections, EMR and scheduling software.

Insurance. Copies of all insurance policies, along with detailed claims history and a listing of pending claims (including malpractice insurance, workers’ compensation insurance, directors’ and officers’ insurance, and any other general liability insurance or casualty policies on which the practice entity or its physicians are listed as the insured).

Environmental. Any information regarding compliance with applicable and environmental laws, as well as environmental reports and documentation regarding any permits or pending violations.

Legal and Litigation. Listing of all material litigation and claims, pending or threatened, against the practice or to which the practice is currently a party; description and copy of all material judgments, settlement agreements, and any demand letters or correspondence related to these matters, or any governmental inquiries or allegations.

How Does Due Diligence Become a Part of the Transaction?

A party’s thoroughness, organization and responsiveness in its disclosure of due diligence information may set the tone for the remainder of the acquisition process. The inability to locate and identify important information regarding its practice may also lead to uneasiness on the part of a potential purchaser.

Ultimately, the due diligence responses will provide a basis for the negotiation of the acquisition agreement, and will likely result in revisions to the representations and warranties made by the parties as a part of the acquisition agreement.

Due diligence information may also impact how long the representations and warranties in the transaction documents will be binding after the acquisition. In addition, the information could determine how long (and what amount of) contingency funds may need to be held in escrow post-closing.

Start Early – Be Prepared If an acquisition or merger may be on the horizon for your practice, reviewing and organizing the documentation and information that are likely needed in the due diligence process will be time well spent. Seeking the assistance of financial and legal advisors with experience in these matters could provide the opportunity to address acquisitionrelated issues even before an offer is on the table.

Scott T. Powers is a Partner with the law firm of Hunter, Smith & Davis, LLP. He is chair of the corporate practice group. Mr. Powers’ legal focus is on corporate transactional work, including mergers and acquisitions, banking and healthcare.

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Debt Collection Reimagined Consumer-friendly approach yields better results for providers

By Joe Morris Hospitals and physicians’ offices are in the business of helping sick people get better. But “business” is the operative word, and with treating the sick comes billing to insurance companies and individuals for services rendered. That sometimes can lead to collection action, and that’s something that healthcare providers do not enjoy, and that they’re not particularly well suited to undertake.

This is the space that Peachtree Acceptance has stepped into. The Asheville, N.C.-based company has spun off from an existing call center in the consumer-sales industry, and is working with healthcare providers (even veterinarians) of all sizes to provide support in all aspects of debt collection, says David Reed, vice president of business development.

“We can provide services for a hospital, physicians’ group, surgery center, or any other provider in the medical-services area,” Reed explained. “We can take over debt collection for them just for overdue bills, or we can come in as soon as the service is rendered and provide ‘early outs,’ or billing services from the outset. In each of those cases, we charge a percentage of the amount collected, and they get the rest.”

Peachtree Acceptance also can buy old debt from its clients, so that they can write it off their books and their taxes.

Medical debt is usually sold after its 180 days old, however, Reed said so often it makes sense to have Peachtree come in earlier in the process in hopes of getting the situation resolved to in a way that benefits both parties.

In fact, making sure that the debtor, as well as the medical provider, is well taken care of is what sets Peachtree Acceptance apart. Stories of being hounded by debt collectors abound for a reason, and so the company is working hard to create a much friendlier and accessible approach.

As an example, he points out a simple x-ray procedure. The patient gets a bill from the hospital, or surgery center, for the procedure and pays it. But what he or she may not realize is that there’s a separate charge for a radiologist to read the x-ray, and that may come through later. If the patient just tosses the bill away thinking it’s already been paid, he or she will go into default.

“A lot of this is because insurance and medical bills are confusing,” Reed said. “We want to explain what’s going on so that the person we’re working with understands their situation.”

In addition, a Peachtree representative also will use proprietary software and a comprehensive website to help debtors pay their bills, or create a payment plan, online. Giving the individual control over the process is a strong differentiator for Peachtree in the collection world, Reed said.

“They can go online, create that account, and set up a plan that works for them,” he said. “If it’s $30 a month, then that’s what they set up. If it’s not a big amount, then they can take care of the whole thing at once. Our main goal is to give them options, so they feel like they are in charge of setting the account, rather than being pushed into a plan.”

As the healthcare industry continues to evolve under the Affordable Care Act and other changes, care providers have less and less time to spend on back-office issues such as collections. What Peachtree Acceptance can do is relieve them of that burden, but do so in a way that’s kind and caring, and continues the excellent service that the patient has been receiving. In a world where there’s more medical choice than ever, that’s important.

“We’re very nice to people,” he said.

“Our customer-service professionals really do want to work with that person to take care of the debt. They’re not just going to call and demand full payment, right then and there. We don’t talk down to people. We educate them about what their options are, and explain how all the billing has worked because often they think they’ve paid everything and aren’t sure why they’ve wound up in a collection situation.”

“These entities want their patients, their customers, handled in a professional manner,” Reed said. “They’re understandably nervous about signing a contract with someone who’s not going to treat those patients well, and get them all upset. When that happens, those people go somewhere else for their care. We are an extension of that provider, and we talk to these people as though they are our patients. We want to resolve the issue so that they aren’t worried about it any more, and so they continue to seek their care from our clients.”

David Reed • 70 Hazel Mill Road • Asheville, North Caroline 28806 • 828-254-1643 ADVERTISEMENT

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Youhanna Al-Tawil, MD Medical Director

“It’s all about passion,”

said medical director Youhanna Al-Tawil, MD, speaking about his team at GI for Kids, PLLC. “If you do something because you really have a passion for it, I believe you can make a difference.” Al-Tawil’s enthusiasm is infectious and obviously shared by the other members of his group. Boasting board-certified pediatric gastroenterologists, nurse practitioners, behavioral health clinicians, registered dietitians, a physician assistant and a research coordinator, GI for Kids is staffed with a team

of experts who combine their efforts to combat pediatric gastrointestinal distress and disease on all fronts.

Recognizing how gastrointestinal problems affect all areas of a child’s life, the team takes care to consider the nutritional, emotional, social, and psychological needs of each patient. To this end, GI for Kids features a number of programs to help kids lead happy, healthy lives.

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K

idsFACT (Kids Fighting Against Crohn’s and Colitis Together) is a non-profit group created

by GI for Kids to provide support and improve quality of life for children suffering from pediatric inflammatory bowel disease (IBD). In addition to its primary purpose as a family-focused support group, KidsFACT raises funds to further education and research initiatives on Crohn’s disease and ulcerative colitis. Each year proceeds from a benefit hosted by the program send a KidsFACT kid to enjoy the summer at CCFA Camp Oasis in Nashville and provide a scholarship for one KidsFACT high school senior preparing to enter college. Recently, KidsFACT launched “The Poop Scoop,” a newsletter dedicated to informing IBD patients and their families about the latest medical, dietary, and psychological advances related to the disease. Celi-ACT is another support group for celiac disease and gluten intolerance organized by one of GI for Kids’ dietitians. In keeping with its commitment to education, the practice sponsors a vendor fair to teach affected individuals and their families how to purchase and prepare gluten-free food and make healthy dietary choices.

Gastrointestinal disorders in children have a serious impact on physical and emotional wellbeing. Also, some psychological illnesses adversely affect the gastrointestinal system. Transitions Behavior Health Center for Kids, located within GI for Kids, addresses stress and

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pain management related to gastrointestinal issues from a behavioral context. Therapists in the program are experienced in helping patients dealing with IBD, celiac disease, irritable bowel syndrome, and food allergies, along with eating disorders, depression, and anxiety. Transitions’ therapists work with patients and families to provide support and behavioral modification for issues related both to gastrointestinal diseases and general behavioral issues.

Obesity is a serious problem in children, affecting all aspects of health. Bee Fit 4 Kids is a multidisciplinary weight management program that helps overweight children and their families improve exercise and eating habits. With one-on-one programs tailored specifically to each child, GI for Kids’ registered dietitians and nurse practitioners work with each patient to make healthy, active lifestyle changes.

“I try to make us a one-stop office, where we can take care of everything!” Al-Tawil said. “I only hire people who have a passion for helping children. We have a team that can really respond to disease with expert, well-managed programs.” Al-Tawil is working to establish even more programs to help kids with chronic constipation and support children who have liver diseases. He is also interested in doing even more in future to help patients suffering from food allergies. Many food allergies caused by additives and preservatives in food are difficult to confirm through clinical testing and complicated to isolate and address. A multidisciplinary group like GI for Kids is well-suited to tackling the challenge: “You really have to take a team approach to work with these patients,” Al-Tawil explained.

GI for Kids is affiliated with East Tennessee Children’s Hospital and serves children from all surrounding areas. The Children’s Hospital’s endoscopy suite, one of few in the U.S. devoted to pediatric patients, is named in honor of Dr. Al-Tawil in recognition of his dedicated efforts to provide excellent healthcare for area children. GI for Kids’ comfortable infusion department is outfitted to make Remicade infusions and Humira treatments as pleasant an experience as possible. Patients requiring inpatient care are personally attended by GI for Kids’ inpatient nurse practitioner for the duration of their hospital stay.

If you are interested in learning more about GI for Kids’ programs, patient support groups, and community events, or if you would like to make a referral, please visit their website at www.giforkids.com or phone the office at (865) 546-3998.

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Rolling Out the President’s Precision Medicine Initiative, continued from page 1 cohort design.

In order to deliver individually tailored approaches to prevention and risk assessment, health maintenance, diagnosis and treatment, Collins said it was critical to build a large evidence base encompassing gender, race, ethnic, age and geographic variances. By sharing genomic information from participants, along with important clinical data from electronic health records and lifestyle and environmental information from mobile health devices and applications, researchers hope to better understand how genomic variations, in concert with other factors, impact the development and progression of disease.

Some participants will have their en-

tire genome mapped, which has become much more cost effective over the past decade. Collins, who was director of the National Human Genome Research Institute when human DNA sequencing was completed in April 2003, noted that first map cost about $400 million. Today, the price is about $2,000.

Collins said the hope is that individuals already enrolled in several large research cohorts like those with Kaiser Permanente, Mayo Clinic, Geisinger and the Veterans Administration might give permission to roll their data into this national effort. In addition to ‘stitching together’ some of the existing cohorts, Collins noted, “We will also have to find ways to fill gaps and invite

highly motivated people who want to take part to come join.”

The goal is for patients at a family practitioner’s office in a small town to be able to participate as easily as those at major academic centers or large health systems. However, Collins stressed, having an electronic health record would be crucial to participation. Even with EHRs, Collins admitted interoperability and data sharing could be an issue.

Alexander, who has been a vocal critic of the current EHR program, said problems ranging from excessive documentation to disrupted workflow to interoperability issues have electronic health records “in a ditch, nationally.”

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Homegrown Heart

SPONSORED BY GI FOR KIDS

Local Nurse Practitioner Has Long History Helping Kids

By JENNIFER CULP

“I’ve always wanted to work with kids,” said Wendy Taylor, DNP, CPNP, and “always knew I would go into the medical field.” Born and raised in East Tennessee, or “homegrown,” as she put it, Taylor started out volunteering at East Tennessee Children’s Hospital as a sophomore in college. Several degrees later, she continues to help sick children in East Tennessee as inpatient nurse practitioner for GI for Kids, PLLC. Taylor’s volunteering experience sparked an interest in nursing, and she earned a Bachelor of Science to pursue the occupation from Tennessee Wesleyan in 2004. She immediately applied to graduate school upon completing her undergraduate degree, and after postponing her entrance to work for a year, went on to earn a Master of Science in Nursing from Vanderbilt University in 2006 and a Doctorate of Nursing Practice from the University of Alabama in 2010. While working toward her doctorate, she did a capstone project on obesity in young children. By monitoring kids’ weight trends between birth and two years of age and then comparing the data to their positions on the growth curve at their kindergarten checkups, Taylor learned some interesting things: that the children’s birth weight had no impact on obesity, and that many parents skipped well-child checkups at ages three and four, after the children had received required immunizations at two. Skipping check-ups between ages two and five appeared to be linked to obesity in the kindergarten-aged children, indicating that regular follow-up and education are important factors in avoiding early obesity.

Taylor has a long history with GI for Kids. “Dr. Al-Tawil was my first employer—I worked with him for about three years when I graduated from nurse practitioner school,” she explained. After an eighteen month period in which she departed to work in general pediatrics, Taylor missed the specialty of pediatric gastroenterology and her co-workers at GI for 8

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Kids. “I enjoy the physicians, nurses, and staff we have here at GI for Kids; it’s just a really awesome group of people,” she said.

Additionally, “I enjoy the patient population. We have patients who have chronic medical problems, so we can establish longterm relationships with them, but most of our kids do really well, so there’s a lot more positive than negative in my job. You kind of get the best of both worlds,” she added.

Over the course of her time with GI for Kids, Taylor has seen the practice grow and thrive. “When I first started working for Dr. Al-Tawil, we didn’t have any dietitians, we didn’t have any psychologists, we didn’t have any ancillary staff. I think they have definitely impacted how we’re able to care for our patients. So many things go together: there’s medical, there’s nutritional, and then there’s an emotional/psychological aspect to care, so being able to provide all those services in one central location where the providers can communicate on a regular basis is definitely positive,” she said.

Taylor is the nurse practitioner for GI for Kids’ inpatient population, and she personally cares for all of the practice’s patients who are admitted to the hospital. In her role, Taylor treats kids from birth to 21 years of age suffering from problems ranging from Crohn’s disease, ulcerative colitis, severe gastroesophageal reflux disease, failure to thrive, liver illnesses, pancreatitis, to general or undiagnosed abdominal pain,

and consults on patients admitted to the hospital pediatric service in addition to caring for all patients admitted to GI for Kids’ service. “Basically, if the child is in the hospital and we’re involved, then…it’s me!” she explained. “I work with all of the other subspecialists with the pediatric team, providing the daily care for the patients who are in the hospital.” Taylor enjoys the variety of the work and the bonds she forms with her patients and their families. “Any time one person in a family is sick, whether it be a child or an adult, it affects every family member. So, especially in pediatrics while the child is our patient, there’s a lot of involvement with the parents as well. You’re there to educate them, to support them, to comfort them,” she said. “You really interact with the whole entire family.”

Taylor and her husband live in Loudon, Tennessee, with their eightyear-old daughter and three-year-old son. They enjoy boating in the summer, but are currently a little short on time to enjoy other hobbies, “especially when the kids start school!” she laughed. “You think that when they’re infants and toddlers that’s when your life is crazy, but it’s so not true! The older they get, the crazier it gets.” Taylor also stays pretty busy with her kids at work. Some days there may be fifteen patients to see, sometimes five, but given the variety of issues she treats, “the number of patients never dictates the workload,” she said. “You can never tell!”

The benefits of Taylor’s work, however, always outweigh the busy schedule.

“My favorite thing about being in the hospital is that it gives me a unique opportunity to bond with some of our families,” she said. “I feel personally privileged that these families allow us to share in some of the biggest moments in life with their kids. I think, for me, that’s what makes it more enticing to work with kids than adults. There are so many things—you get to watch them grow up!—that you’re kind of like a proud parent too when they graduate from high school, or win an award. You’re just invested with that family, and it’s nice to be a part of that.”

Alexander, who is the Senate health committee chair, and Patty Murray (DWash.) recently announced a bipartisan work group to pinpoint ways to improve EHRs. “The goal of this working group is to identify the five or six things we can do to help make the failed promise of electronic health records something that physicians and providers look forward to instead of something they endure,” Alexander said in announcing the new committee at the end of April.

That work, he noted in Nashville, would be critical to the success of personalized medicine. While there is a long road from the $215 million included in the president’s proposed fiscal 2016 budget for PMI and congressional approval, Alexander did say this was an area where bipartisan support exists. ”Precision medicine – tailoring treatments and cures to individuals – has the potential to affect and improve the life of every American,” he said.

Another concern addressed by Alexander and Collins was the impact … in terms of time and cost … of creating new therapies tailored to smaller numbers of people.

“I’m working with Sen. Patty Murray, the committee’s top Democrat, to examine how we can get safe, cutting-edge drugs, medical devices, and treatments from the discovery process through the regulatory process into medicine cabinets and into doctors’ offices more quickly,” Alexander said. He added work groups currently are looking at ways to lower costs and shorten timeframes while maintaining safety. “We hope to have that legislation ready by the first of next year,” Alexander said.

Collins noted precision medicine might actually help get more drugs on the market. “The era of blockbusters may no longer be one that is going to apply as we understand more and more differences between people,” he said.

“But look at it the other way,” he continued, “The failure rate in developing a new therapeutic is about 99 percent.”

Collins noted after spending an average of 14 years from idea through human trials, most therapeutics don’t wind up approved.

“That’s why the cost of the whole pharmaceutical industry is so high … because you have to pay for all those failures,” Collins said. “What precision medicine gives you is an opportunity, first of all, to pick the right target because we really understand at a much more detailed level what is happening with diabetes or cancer or heart disease.”

He added researchers not only start with more evidence before embarking on developing new therapeutic agents, but they also have the ability to pick groups that fit the target profile. A drug crafted to impact a specific mutated gene would not be tested in patients without that genomic profile. “”That means you can run a clinical trial that is much smaller, and therefore much cheaper … and you also will have a much higher likelihood of success.”

Collins pointed out such a drug used in a broad trial, as is often the case now, might look like a massive failure because it only worked 10 percent of the time. However, he added, if only tested in the 10 percent of patients that fit the target profile, that ‘failure’ suddenly becomes a roaring success. easttnmedicalnews

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Measuring the Impact of Interprofessional Education, continued from page 1 Forum on Innovation in Health Professions Education. In late April, a sixmember committee, chaired

by Malcolm Cox, MD, published their findings in the IOM report “Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes.”

The short answer to a long list of questions is that while the empirical evidence suggests this is a desirable way to train future providers, there simply isn’t enough scientific research to validate that opinion.

Asking the Question Cox, who is an adjunct professor of Medicine at the University of Pennsylvania Perelman School of Medicine and the former Chief Academic Affiliations Officer of the U.S. Department of Veterans Affairs, noted IPE became a common topic of discussion and debate among members of the Global Forum.

“One of the things that came up early on was that health professions education was ‘faith-based’ when it came to outcomes … that is we believed, without much data, that interprofessional education would be helpful, if not essential, to producing the kind of clinical workforce that the U.S. and world need in the future,” he said.

Cox noted a common sentiment among many educators is ‘the era of the Lone Ranger’ is over. He added, “I think that’s true … no one doubts that. Moreover, no one doubts that the U.S. health system is rapidly moving in that direction.” And in fact, Cox pointed out, data exists showing teams can provide safer, more effective, efficient care … but that isn’t the same as proving the best route to get there.

“How do we prepare health professionals to hit the ground running when they reach the clinical workforce so they are ready to work in teams rather than as individuals?” he asked. “What we discovered is that while teams are known to be effective, how to create great teams is unclear,” Cox continued.

is fine if the physician has the most knowledge on a subject, but there are times when the nurse or physical therapist or pharmacist should lead. The most effective team is where the expertise of professionals overlap so that the whole is greater than the sum of the parts.”

While a lot of emphasis is placed on leadership, Cox said the concept of ‘followership’ is equally important. “Physicians are great leaders but poor followers … I’m allowed to say this because I’m one of them,” he added with a chuckle.

In his experience, he added, “The only way you can really learn to work together as a team … is to work together as a team.”

IPE & Outcomes Cox said the committee studied the available research and literature for both the intermediate and final outcomes of IPE. The intermediate outcomes side of the equation is tied to learning outcomes and whether or not students understood, gained knowledge and developed new skills. “There’s pretty good information

that interprofessional education begins to promote collaborative behavior within students,” he said.

“But,” he continued, “we haven’t taken it to the final endpoint, which is do those learning outcomes lead to enhanced patient health and health system outcomes?” Cox said, “The conclusion was there is no data that links the learning outcomes to health and system outcomes … that’s where the gap is.”

While this committee was focused specifically on measuring IPE, Cox said he personally believes that all health education innovations should be held to the same evidence-based standard.

“We keep changing the way we educate, and there’s little solid data that any of these changes lead to measurable changes in health or system outcomes,” he said.

“Belief is one thing, but data is another.”

Filling the Gap Cox pointed out IOM studies are not geared to go beyond the question at hand … in this case, a question of measurement. However, the report included recommendations on how to move forward to produce more data to assess the real world outcomes of IPE on patients, populations and healthcare systems.

The committee highlighted four areas that should be addressed in order to truly evaluate the impact of IPE on collaborative practice – 1) more closely align the education and healthcare delivery systems, 2) develop a conceptual framework for measuring the impact of IPE (see graphic), 3) strengthen the evidence base for linking IPE to health and system outcomes, and 4)

better link IPE with changes in collaborative behavior. Furthermore, the committee made two recommendations: Interprofessional stakeholders, funders and policymakers should commit resources to a coordinated series of well-designed studies of the association between interprofessional education and collaborative behavior, including teamwork and performance in practice. These studies should be focused on developing broad consensus on how to measure interprofessional collaboration effectively across a range of learning environments, patient populations and practice settings.

Health professions educators and academic and health system leaders should adopt a mixed-methods research approach for evaluating the impact of IPE on health and system outcomes. When possible, such studies should include an economic analysis and be carried out by teams of experts that include educational evaluators, health services researchers, and economists, along with educators and others engaged in IPE. Cox said the first recommendation is focused on collaborative learning outcomes. The second, which he said is “the real crème de la crème” of the report, looks at linking IPE to health and system outcomes by using ‘mixed methods’ … incorporating both qualitative and quantitative research designs. “We need to know the how and why, as well as the what,” he stated, adding that without the qualitative piece, it’s difficult to generalize the quantitative results and apply findings to the larger population.

For More Info To access the full report, go online to iom.edu/Reports/2015/ Impact-of-IPE.aspx.

No ‘I’ in Team “The leaders of healthcare systems are not pleased with the graduates we are sending them,” Cox stated. While these new professionals might be well versed in disease recognition and the medical sciences, they aren’t well trained in working together, noted the physician-educator, who previously served as dean for Medical Education at Harvard Medical School Even when professionals from multiple disciplines are grouped together, Cox said it’s often more a matter proximity than actual teamwork. “Team leadership should be expertise- and situation-based rather than hierarchically based,” he pointed out. “Physicians are still giving orders and nurses are taking orders, which easttnmedicalnews

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GrandRounds Children’s Hospital At Erlanger Is First In Tennessee To Receive A “Virtual Window” To The Underwater World Tennessee Aquarium And The Sky Factory Donate Digital Cinema For Patients CHATTANOOGA – Thanks to the collaboration between the Tennessee Aquarium and The Sky Factory, patients, family members and guests of Children’s Hospital at Erlanger now have the unique opportunity to view an underwater experience through digital cinema. The partnership is the first in Tennessee and among many health care facilities around the world to offer guests the experience of viewing nature through a virtual window.

The window at Children’s Hospital features three unedited scenes filmed at the Tennessee Aquarium. The aquarium’s largest exhibit, the Secret Reef, features Green Thom Benson, Tennessee Aquarium Communications Manager; Julie Taylor, Erlanger Health Turtles, sharks, and colorful saltwater fish. The Reelfoot System Chief Development Officer; Cindy Rhodes, Children’s Hospital at Erlanger Chief Nursing Lake exhibit is home to crappie, sunfish, Map Turtles and Officer; and Dr. Alan Kohrt, Children’s Hospital at Erlanger Chief Executive Officer sturgeons. The aquarium’s Flooded Amazon River exhibit displays peacock bass, giant South American river turtles, tambaqui and catfish.

“We are extremely grateful for the support of the Tennessee Aquarium and The Sky Factory for allowing our patients and guests to benefit from not only a visual experience but also an educational experience by taking our patients and guests to various underwater worlds,” said Cindy Rhodes, Chief Nursing Officer at Children’s Hospital at Erlanger. “Providing a natural diversion will certainly have an impact on the child’s and parents’ hospital experience.”

The use of UltraHD RED Digital cinematography reproduces the relaxing, therapeutic benefits that are universally experienced when viewing living underwater environments. Research has established that viewing such environments restores emotional balance, reduces anxiety and even lowers blood pressure. Designed as a portal into large underwater environments, the virtual window presents the gentle flowing motions inherent in all marine life. It is this motion that triggers an automatic ‘relaxation response’ in the observer.

“We could not have received such high quality cinematography without the support of the Tennessee Aquarium,” said Jeff Johnson, The Sky Factory’s design specialist. “Chattanooga’s aquarium provided us with three gorgeous and diverse subjects, and what better place to debut them than in the region’s only Children’s Hospital.”

HealthcareServiceSnapshot

By JENNIFER CULP

Treadway Finds Helping Kids Achieve Nutritional Goals Rewarding Name: Ashley Treadway Position: Dietitian At a Glance: Treadway, MS, RD, LDN, typically sees seven to eight patients a day at GI for Kids, PLLC, creating and managing dietary plans for kids dealing with issues ranging from celiac disease, inflammatory bowel disease, obesity, to food allergies, as well as those who require enteral feeding. “Every diet is individualized. There’s no one-size-fits-all diet,” Treadway said. “Every patient is very individualized, from babies that are extremely premature to 19 years old!”

Although she always loved food and enjoyed cooking, Treadway, who earned her B.S. in Dietetics and M.S. in Clinical Nutrition from East FOCUS ON Tennessee State University, was originally interested in working with a PERSONALIZED MEDICINE geriatric population, but fell hard for pediatrics after encountering Dr. SPONSORED BY GI FOR KIDS Al-Tawil and GI for Kids. “At this point in my life, I can’t imagine doing anything else, especially now that I have a 10-month-old, which sort of puts things into a different perspective,” she said. “One thing about being an outpatient dietitian is that I can build a rapport with my patients. I see them for multiple visits, depending on what their needs are. I have patients I’ve seen for eight years, and watched them grow up. It’s rewarding; you really get attached to these families and love them like they’re your own kids.

It’s rewarding, knowing that I’m going to see the patients again and make a difference, and set achievable goals with them.”

Treadway manages enteral feeding for the practice, making sure children who must be fed through a tube or alternative feeding method meet their nutritional requirements. When it comes to children who need dietary management for weight loss or food allergies, Treadway employs a positive approach. “I don’t even like to use the word ‘diet,’ because it’s really a lifestyle change,” she explained. Along with Callie Juban, her fellow dietitian at GI for Kids, Treadway leads the KidsFACT support group for children and families living with pediatric inflammatory bowel disease. “I’m very passionate about being on the board of KidsFACT,” she said.

Treadway singled out Juban for praise: “Callie and I work very closely together, and she is wonderful. I couldn’t do my job without her, so I definitely want to give her props,” she added. She has similarly positive words for the entire GI for Kids team: “It’s a group effort to provide each child with the best care and to achieve the best outcome.”

When Treadway isn’t working to help children reap the benefits of better nutrition, you can find her outdoors. She enjoys gardening, spending time on the lake, walking her dog, and spending time with her baby and her husband of two years. “If it’s not raining, I’m outside!” she said. “I just enjoy being with my family.”

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GrandRounds Dr. Mejia Joins Premier Surgical Associates

HealthSlide Launches ROI Cost Calculator

Children’s Hospital Offers Telemedicine

KNOXVILLE – Jose Luis Mejia, MD, FACS, has joined Premier Surgical Associates as a general surgeon in the group’s Tennova offices at North Knoxville Medical Center and Physicians Regional Medical Center. Premier Surgical, headquartered in KnoxDr. Jose Luis ville, Tennessee, is the reMejia gion’s largest general and vascular surgery group.

Mejia received his initial medical training at the prestigious Central University of Ecuador, and treated patients at one of the largest public hospitals in Quito, the capital of Ecuador. He moved to the United States in 1999 and completed his residency in General Surgery at East Tennessee State University in Johnson City. After completing his residency, Dr. Mejia worked at Veterans Affairs Medical Center in Johnson City for eight years, serving as Clinical Associate Professor and Chief of Surgery.

Prior to joining Premier Surgical, Dr. Mejia has been on staff at Masssena Memorial Hospital in upstate New York, providing surgical and wound care to a variety of pediatric and adult patients.

KNOXVILLE — HealthSlide, Inc., a healthcare IT company that provides innovative interoperability solutions for hospitals nationwide, has announced the launch of its propriety ROI cost savings calculator. Hospital CIOs and CTOs can access the calculator on the company’s website at healthslide.com. The calculator shows both initial and ongoing savings of switching to the company’s flagship offering, Boomerang.

As the company’s flagship product and Enterprise Application Interoperability Server, Boomerang is designed for healthcare organizations and provides protocol switching, data transformation, and system monitoring in an easy to configure package.

HealthSlide’s cost comparison calculator aims to assist the hospital C-suite in determining the exact cost of decluttering and streamlining their system integration. Taking into account different variables, the calculator shows initial and ongoing savings. By inputting current costs of software, hardware, hardware fees, operating system support fees, consultants, training, and staff salaries, HealthSlide can compare a healthcare organization’s spending with the cost of implementing Boomerang.

KNOXVILLE – East Tennessee Children’s Hospital introduces telemedicine to connect pediatric specialists in Knoxville with patients who live miles away. The service uses high definition cameras and computer equipment to provide the Children’s Hospital specialist a real-time video image of the patient.

Appointments will take place at Morristown-Hamblen Hospital, with a nurse present to help. The service will save families time and money, cutting down on travel costs back-and-forth to Knoxville.

This technology was paid for with a grant from the Trinity Foundation of East Tennessee.

Hutcheson Partners With ApolloMD Group To Provide Emergency Physician Services FORT OGLETHORPE, Ga.– Hutcheson Medical Center announced today that it will be moving forward with its strategic plan by partnering with a new provider for emergency physician services, ApolloMD. Apollo is a leading multi-specialty, physician-led practice group based in Atlanta. ApolloMD currently operates in 17 states, including 15 emergency medicine contracts in Georiga. In the emergency department, ApolloMD providers specialize in process and quality improvements

that lead to decreased wait times and increased patient satisfaction. The physicians will work collaboratively with local medical staff members to improve patient flow and ensure access to the highest quality emergency care.

Full-time physicians have the opportunity to become owners in ApolloMD, enhancing the group’s ability to recruit and retain top clinical providers.

ApolloMD will partner with the medical staff, nursing team, and administration at Hutcheson to optimize the patient experience through its data-driven, patient centered model.

UT LIFESTAR To Operate Air Medical Base In Rockwood KNOXVILLE – The University of Tennessee Medical Center announced recently that UT LIFESTAR Aeromedical Services plans to open a base in Rockwood, Tennessee later in the summer. The facility will be located at the Rockwood Municipal Airport, 258 Rockwood Airport Dr. Last month, LIFESTAR reached an agreement with Air Evac EMS, Inc. to assume responsibility for medical operations of Air Evac Lifeteam located in Etowah, Tennessee. LIFESTAR also operates a facility in Sweetwater. The Rockwood base will be staffed by one of the teams from the Etowah/Sweetwater facilities. Services in the Etowah/Sweetwater area remain in operation as usual.

Caylor School of Nursing ACCEPTING APPLICATIONS FOR:

Family Nurse Practitioner (FNP (FNP)) Earn your FNP at the Kingsport Extended Learning Site!

Doctor of Nursing Practice (DNP) Earn your DNP completely online!

Call 1-800-325-0900 ext. 6210

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A Simple Vision

Center for Sight’s pediatric ophthalmologist helps kids see clearly

By Joe Morris Usually when you hear about someone with serious eye issues, the thinking is that it’s an adult. However, children can also have complicated vision conditions, and for those in and around Knoxville, Dr. Chris O’Brien and the team at the Center for Sight are ready to help.

Dr. O’Brien has been with the Center for Sight almost a year, and is one of the few pediatric ophthalmologists practicing in the state, or even the Southeast. Now children with eye alignment issues and a host of other problems no longer have to travel out of town, or even the state, for treatment. Along with Drs. Kenneth Raulston, Jr. and Stephen Franklin, he also sees adults for those same issues, as well as cataracts, strabismus, glaucoma, diabetes-related issues, and many more.

Dr. Chris O’Brien “Pediatric ophthalmology is definitely underserved here, and we are working to make sure that people know all that we can offer for children as well as adults,” Dr. O’Brien said.

“There are only about 900 practicing pediatric ophthalmologists in the United States, and they tend to congregate in the larger cities. It’s a very special skill set, for very special patients, and I am very glad to be offering my services, along with those of our entire team, to the East Tennessee community.”

A Knoxville native, Dr. O’Brien is a graduate of the economics program at Washington University in St. Louis, and is the only graduate to ever concurrently receive MD, MBA, and MPH degrees from Tulane University. He was chief resident during his residency in ophthalmology at New York Medical College, and also completed further, specialized training in pediatric ophthalmology and strabismus at the University of California – San Diego’s Shiley Eye Center, as well as at the Naval Medical Center San Diego. Following a stint in private practice on the West Coast, he returned to Tennessee last year.

As for choosing to focus on children’s eye care, Dr. O’Brien said first he was drawn to the complexity of eye medicine, and then to the further difficulties of pediatric patients.

“I liked the physics and light aspects of ophthalmology,” he explained. “During my surgical rotation, I got tired of taking out appendixes and went next door to look at what was going on with eye

surgery. I found I really liked looking through the microscope, the microsurgical aspect of this work, and then seeing how dramatic the results can be. Plus, I love that I can be someone’s general doctor for eye health, and then also be their specialist if they need surgery or some other intervention. Often in medicine we see a patient for non-surgical care, then send them to someone else for a treatment, then get them back. This lets me take care of them longitudinally as well as vertically.”

Working with children gives him special challenges because their eye care involves planning for future growth and physical changes. The rewards are many, he said, but a chief one is knowing that a small change at a young age can dramatically affect that child’s life from that day onward.

“I am excited by the opportunity to help a young person see better.

It is something that can dramatically impact the course of their life,” Dr. O’Brien said. “Get their vision straightened out and they can drive a car, play sports, or do whatever they want to do for the next 80 years.”

Children can also develop cataracts, retinal disease, or other abnormalities, so he is able to treat them alongside adults patients that he and other physicians see every day.

“Frequently, there are issues because a child is born prematurely, so I have gone into hospitals and clinics to see infants,” Dr. O’Brien said.

“Often we have been the third or fourth stop for children, or adults, with eye issues. Their cases are very challenging, and we really like being able to help them. It can be tough, but it’s worth it when the adults are able to see well again. And the kids? They bounce up like nothing ever happened.”

Best of all, he adds, the Center for Sight has become adept at dealing with all patients, regardless of age, quickly and efficiently.

“It’s a great team, where excellence is the norm,” Dr. O’Brien said.

“We provide a patient experience that’s fun for kids, and calming for adults, while also providing the top levels of surgical and nonsurgical care. We have a lot to offer the community, and we are always glad to step up and meet the challenges people of any age have when it comes to their sight.”

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