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PHYSICIAN SPOTLIGHT PAGE 3
Lance Line, MD
ON ROUNDS Doubling Residency Slots USF Health Morsani COM hosts one of the nation’s largest distributive residency programs; maintains high retention rate of new doctors TAMPA, FLA. – While the gap between medical graduates and the number of residency slots nationwide continues to challenge industry leaders, the University of South Florida (USF) Health Morsani College of Medicine (COM) is bucking the trend. ... 4
A Blank Canvas Pontotoc doc takes reins at newly created Mississippi Office of Physician Workforce Family physician John R. Mitchell, MD, of Pontotoc has been named executive director of the Mississippi Office of Physician Workforce (MOPW), the newly created state organization tasked with putting more primary care doctors to work in medically needy areas ... 7
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Backyard Success
Oxford RN-turned-entrepreneur finds sweet niche with VMA technology for spine and neck imaging By LyNNE JETER
OXFORD—Paul Gunnoe and Ortho Kinematics Inc. (OKI) receive calls daily from spine and imaging companies in the United States and abroad wanting to know where to access the new Vertebral Motion Analysis (VMA) technology. Demand for the new technology, which combines a patented Motion Normalizer™, standard fluoroscopic imaging, and automated image recognition software to capture and analyze spine motion, was already rising after the North American Spine Society’s 28th annual convention last month in New Orleans, La., where Gunnoe and OKI presented validation research. In January, OKI will commercially launch the VMA technology. “It’s one of those great things that happen in your life where you wake up in the morning and say, ‘thank you, God!’ Then you add ”please help me not screw (CONTINUED ON PAGE 8)
Paradigm Shift New gero-psychiatric unit, approach broadens reach for St. Dominic’s Behavioral Health Services By LyNNE JETER
In July, St. Dominic’s Behavioral Health Services unveiled its new high-tech gero-psychiatric unit designed specifically to meet the needs of patients 65 years of age or older. The move allowed the Dominican Sisters-established healthcare organization to address all health needs of aging Mississippians – physical, mental, emotional and spiritual – in a highly effective manner. “We can do good work with patients in our unique, structured program, which involves families and caregivers in the treatment process,” said psychiatrist J. David Richardson, MD, who leads the program. His longer-term vision involves two program phases geared to active intervention in the 26-bed unit.
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PhysicianSpotlight
Lance Line, MD By LUCY SCHULTZE
Ice hockey. Bobsledding. Freestyle skiing. Not exactly the kinds of sports a south Mississippi orthopedist has much opportunity to connect with. But for Lance Line, MD, serving as a volunteer Olympic team physician gave him the chance to treat those winter-sport athletes during his first assignment this past August in Lake Placid, N.Y. “It was interesting, since I was treating different kinds of injury patterns which you don’t normally see down here,” said Line, who served as team physician for the U.S. men’s national junior ice hockey team. “I always wanted to be involved in higher-level sports, and also to see some different things beyond the typical SEC sports,” he said. “It was a great way to broaden my horizons.” A founding partner of Southern Bone & Joint Specialists in Hattiesburg, Line had dreamed for many years of applying to serve as an Olympic team physician. He was turned on to the idea early in his practice by an athletic trainer and physical therapist who had taken part in the 1996 Olympics in Atlanta. “I always wanted to do it, but couldn’t until I had enough experience and had the time to devote,” Line said. “Now that my kids are in college and I’ve got some help with my practice, I thought I’d go ahead and apply.” Once he’d been accepted into the program, Line was offered the Lake Placid assignment as his first preliminary event. He spent 10 days in Lake Placid at the U.S. Olympic Training Center, one of three such centers provided to teams and athletes by the U.S. Olympic Committee. While his primary role was treating players competing for a spot on the 2014 U.S. National Junior Team, he was the only physician on duty at the center. That
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meant he was also on call to serve members of the bobsledding, luge and freestyle skiing teams who came through during his time there. “We had four or five of the wintersport teams there continuing to train, and everybody’s on a different training schedule,” Line said. Hockey teams from Finland, Sweden and Canada were also on hand to compete as the U.S. Hockey Committee whittled down its team from a total of 44 players to 31. “It was pretty intense and pretty quick,” Line said. “All the kids were on the chopping block as far as who makes it and who doesn’t.” In the treatment room, the athletes got a kick out of knowing the physician assigned to the hockey team was from Mississippi. But for Line, the notion wasn’t as much of a stretch. A native of Ohio, he grew up playJNLMSMed-2 JNLMSMed-2
ing street hockey and was always a fan of the sport. He helped put together a streethockey league in Hattiesburg that was active for a dozen years. That said, he’d always steered clear of blades. “You really don’t want to see me on the ice,” he laughed. Line’s family moved from Kent, Ohio, to Cleveland, Miss., when he was 15 years old for his father to take over a family business on his mother’s side. When Line enrolled at the University of Mississippi, a career in medicine wasn’t even on his radar. “I wanted to be a pilot and fly,” he said. “But it was pretty clear early on that my eyes weren’t good enough, so I looked into other things. I’d always been good in the sciences, so I started the pre-med track and just kept going.” Line pursued a medical degree at the UM Medical Center. The summer after his first year in medical school, he had the opportunity to work at Methodist Rehabilitation Center with three orthopedic surgeons in the specialties of sports medicine, joint replacement and hand surgery. “That was back in the day when you could really scrub in and get your hands dirty early,” he said. “I spent an invaluable summer with them and got to see three different specialties. That turned me on to orthopedics.” It was a natural fit for Line, who’d played sports during high school and college. After a residency at UMMC, he completed a fellowship in sports medicine and arthroscopy in Richmond, Va., which included an internship with the Pittsburgh Steelers professional football program. In 1995, Line joined Doug Rouse, MD, and Ricky Conn, MD, at Southern Bone and Joint Specialists, which has since grown to 14 members covering all ortho-
pedic specialties. Line serves as a team physician for the University of Southern Mississippi, William Carey University and Pearl River Community College, as well as many area high schools. While the athletes he treats locally work hard to get better, Line witnessed at the Olympic training center another level of motivation entirely. “They are very aware of their bodies, and they know when it’s right and when it’s wrong,” he said. “They have a very one-on-one relationship with the therapist or chiropractor who works on them, and they’re using very specific training techniques you just don’t see in a college or pro-football training room. “With football players, they don’t know what’s hurting, they just hurt, and sometimes you have to drag them in. But these athletes are about doing whatever it takes to make it right.” Today, Line is looking forward to the next time he’s called upon by the Olympic Committee. As opportunities come along, he’ll have the chance to accept or decline an assignment. “Eventually, you may get assigned to a team, and you become that team’s regular physician for that sport,” he said. “Then you just basically cover them two or three times a year.” Olympic team physicians are not paid for their work and are responsible for their own travel expenses. The volunteer aspect gave it a different feeling for Line. “It’s more fun than if you were just going to work somewhere else,” he said. “You’re going to serve. You just feel that everybody is pushing for the same goal.” Outside of his practice, Line and his wife, Marcia, enjoy traveling. They have two children, Hayes and Haley.
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SOLUTIONS
Doubling Residency Slots USF Health Morsani COM hosts one of the nation’s largest distributive residency programs; maintains high retention rate of new doctors By LYNNE JETER
Editor’s note: The Solutions series is a new feature of Medical News, focusing on innovative answers to the growing chasm between the number of medical graduates and residency slots.
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TAMPA, FLA. – While the gap between medical graduates and the number of residency slots nationwide continues to challenge industry leaders, the University of South Florida (USF) Health Morsani College of Medicine (COM) is bucking the trend. Within the next couple of years, the number of residency slots will nearly double to 1,400. “We have one of the nation’s largest distributive residency programs, with 730 USF residents at seven sites, and a proposal to add another 700 residents,” former USF Health CEO Stephen Klasko, MD, also former dean of the Morsani COM, said before he left the school in August to become the first executive selected to head both Thomas Jefferson University and the TJUH System in his home state of Pennsylvania. Klasko significantly contributed to the medical school infrastructure expansion, allowing meaningful strategic growth of the residency program. The ambitious plan fits the distributive model, allowing USF Health Morsani COM the ability to sponsor or participate in residency programs as “civilians,” explained Charles Paidas, MD, vice dean for clinical affairs and GME for the USF Health Morsani COM. “We’re offering a shopping list of educational and research initiatives that are required for GME certification,” said Paidas, noting that Naples Community Hospital in Naples, located more than 150 miles away, represents the school’s most recent affiliate addition, and that a pact for other affiliations is in the works. When Paidas, the plan’s architect, became associate dean for GME in 2009 after five years with the school, the residency program faced governance and operation issues that required improved oversight. He assembled a strategic committee that allowed the school to garner impeccable institutional review commendations from the Accreditation Council for Graduate Medical Education (ACGME). In 2011, he was promoted to his current post. At the suggestion of USF medical students, Paidas also brought together Association of American Medical Colleges (AAMC) executives, GME leaders and medical school deans to the USF Health
GME Summit last year. The well attended event “begs the issue of a replay this year,” he said. “Our goal was to characterize the state of GME in Florida. For example, the average number of residents per 100,000 population in the U.S. is 35.9. Florida’s at 17.5. That’s a raw data point that tells you we need to double the workforce. That translates to 2,900 residency slots in the state.” Boosting the number of residency slots also improves the chances of keeping new doctors in Florida. “Florida had nearly a 59.6 percent retention rate of residents who complete their training and stay here,” noted Paidas. “The mantra around the country is: wherever you do your residency – not where you attended medical school – is likely where you’ll practice. USF pushes that to 68 percent.” Of 128 total first-year resident slots, USF Health Morsani College of Medicine placed medical graduates in the following specialties, according to the National Resident Match Program: Dermatology: 4 Emergency Medicine: 10 Family Medicine: 8 Internal Medicine: 29 Medical-Preliminary/Ophthalmology: 1 Neurological Surgery: 2 Neurology: 5 Obstetrics-Gynecology: 5 Orthopedic Surgery: 4 Otolaryngology: 3 Pathology: 4 Pediatrics: 15 Physical Medicine & Rehabilitation: 2 Plastic Surgery (integrated) 3 Psychiatry: 8 Radiology-Diagnostic: 8 Radiation Oncology: 1 General Surgery: 6 Surgery-Preliminary: 2 Surgery-Preliminary/Urology: 3 Vascular Surgery: 2 Medicine-Pediatrics: 3 “This past year, we matched all 128 first-year slots in the first round of Match,” said Paidas. “We haven’t done that in 20 years!” mississippimedicalnews
.com
Wellness Programs’ Impact on the Medical Field By JENNIFER PATEL
With rising healthcare costs companies are searching for ways to not only reduce costs, but also create healthier employees. Stats highlighting a decrease in used sick days and reductions in overall healthcare costs have many employers looking into health and wellness initiatives to encourage employees to live healthier lives. As more companies begin to incorporate wellness programs, the time for healthcare providers to become directly involved is now. While today’s employers are beginning to see the benefits of wellness programs and preventive care, they didn’t always. In the past, employees have been left to worry that taking time off for doctors appointments or tending to other preventative care issues will result in a negative reaction from management. Because of this, employers have to find ways to encourage employee participation in wellness programs. One successful method of encouragement that employers
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have discovered is to have direct participation from healthcare professionals. The following are ways healthcare professionals can, and are beginning get involved with health and wellness plans. Encourage Preventive Care The Centers for Disease Control and Prevention (CDC) estimate that 68 percent of adults and 33 percent of youth are currently overweight or obese. Chronic obesity-related conditions, including heart disease and diabetes, have a big impact on health and wellness. In addition, chronic
diseases reduce the overall quality of life with half of all chronic diseaserelated deaths occurring in people under the age of 70. Healthcare professionals are in an ideal position to offer tools for employees to be healthy. In an effort to combat employees’ reluctance to leave work for such care, employers are beginning to bring in healthcare professionals to offer biometric and preventative screenings in the workplace. This is beneficial for both parties as less time is spent away from work. Offer Expertise Generally speaking, most employers are not healthcare experts, which gives physicians extra advantages. When putting together a wellness program, employers look at screenings, physical activity and incentives for positive results. But what constitutes positive results and what is the best way to get there? Not only can the healthcare industry
provide valuable insight when designing these programs, but it can assist in educating employees on what they should be doing, why it’s important, and then monitoring to ensure that no issues arise. Inviting additional healthcare professionals to implement a wellness program will provide extra validation to the importance of a healthy workplace. Build Relationships One of the biggest obstacles that employers face when encouraging employees to take part in health and wellness programs is a desire to not be the squeaky wheel. Whether or not it is admitted, employees still feel that taking time off work is seen as something that can affect their growth within the company. The way businesses address this issue is by building positive relationships with their employees and letting them know it’s more beneficial for the entire team if one employee is too sick and needs to stay home and get well. By encouraging preventative care, as well as offering educational opportunities, employees build positive relationships with both their bosses and the healthcare professionals. Through relationships with employers, healthcare professionals are given access (CONTINUED ON PAGE 7)
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Early Warning System: Researchers Identify Diabetes Risk Biomarker By CINDY SANDERS
What if a simple blood test could provide information that your patient had a significantly elevated risk of developing diabetes within the next decade? What might that mean from the standpoint of early intervention and prevention? While it’s much too soon for this type of clinical application, researchers at the Vanderbilt Heart and Vascular Institute (VHVI) and Massachusetts General Hospital have identified a novel biomarker that lends itself to such intriguing questions. Led by Thomas J. Wang, MD, director of the Division of Cardiovascular Medicine at Vanderbilt and physician-in-chief for VHVI, the team recently published results of their discovery of elevated 2-aminoadipic acid (2-AAA) as a precursor to diabetes in The Dr. Thomas J. Journal of Clinical InvesWang tigation. Tapping into the rich data source of the Framingham Heart Study, which is now following its third generation of participants, the Wang research team studied blood samples gathered more than a decade ago from 188 individuals who ultimately developed type 2 diabetes and 188 who did not develop diabetes. Using these blood samples, the investigators were able to compare levels of metabolites to see if there were any differences between the group that went on to develop diabetes and the group who did not. Wang noted newer technology now makes it possible to profile hundreds of metabolites at one time. “One of the things that really lit up when we looked at the people who developed diabetes was 2-aminoadipic acid,” he said. “Having elevated levels of 2-AAA predicted risk above and beyond their blood sugar at baseline, their body weight, or other characteristics that put them at risk.” Wang added there doesn’t appear to be a specific threshold of risk at this point … the higher the levels of 2-AAA, the higher the risk of developing diabetes. In fact, those in the top quartile of 2-AAA concentrations had up to a fourfold risk of developing diabetes during the 12-year follow-up period compared to those in the lowest quartile. Interestingly, the researchers found 2-AAA might not be just a passive marker. As part of the same study, the team conducted mouse model testing and discovered giving 2-AAA to the mice actually altered the way the animals metabolized glucose.
“It suggests the molecules might be playing a direct role in how the body processes glucose rather than being an innocent bystander in the process,” Wang said. He added that elevated levels of 2-AAA don’t necessarily mean the molecule is bad for the body. Instead, it could be a defense mechanism where the body is producing higher levels to fight risk from another, as yet unknown, source. Figuring out the metabolite’s exact role in the functioning of pancreatic cells is one area for future research. If, indeed, 2-AAA turns out to be a defense mechanism to stave off diabetes, the good news is that the metabolite could be given to humans in the form of nutritional supplements. On the other hand, if 2-AAA turns out to be harmful to the body’s glucose regulation system, further research could reveal methods to lower the metabolite’s presence. Wang was quick to say the next step is to conduct additional research to measure 2-AAA in other human populations outside of the Framingham study through both retrospective and prospective studies. More in depth animal model studies are also in the pipeline. “A lot of the effort will be focused on trying to understand the biologic effect of 2-AAA in developing diabetes,” he said of the work going forward. However, Wang said the current research results at least raise the possibility that somewhere in the future knowing how high a person’s circulating 2-AAA levels are could impact clinical practice by allowing providers to adopt a more aggressive intervention posture among those at highest risk, whether that be through exercise, weight loss or pharmacologic measures. It is conceivable that 2-AAA might be the type of red flag for diabetes that high cholesterol is for heart disease. “Understanding why diabetes occurs and how it might be prevented is a very intense area of investigation because of the serious consequences of having the disease,” Wang said. “Down the road, this might be one part of the armamentarium of tests that could be considered. If this were proven useful in further studies and could be used clinically, it would be an easy test to administer.” As for the impact of the findings right now, Wang added, “In 2013, it highlights a specific pathway that might be related to diabetes risk that we previously didn’t know about.” Considering the prevalence of type 2 diabetes and growing obesity epidemic in the United States, that is an important lead for researchers working to develop strategies to interrupt the disease progression and stop risk from becoming a reality. mississippimedicalnews
.com
A Blank Canvas
Wellness,
continued from page 6 to a wealth of potential new clients at no cost to them. Invest in Your Employees As the healthcare industry’s role within workplace health and wellness plans increases, it’s important to turn the looking glass upon itself. While providers may have the closest access to the care, it can be difficult to find time to care for themselves. With high rates of smoking, stress levels and long hours, the healthcare industry suffers from many of the same ailments it attempts to rectify. By implementing a health and wellness plan of their own, healthcare professionals are able to practice what they preach. By providing the necessary time to take part in the program, determining what programs are needed, as well as offering incentives, healthcare professionals can not only be a part of others’ programs, but their own. Invest in employee enrichment and see how a wellness program positively impacts a company’s bottom line. Hallmark Business Connections, the business-relationships unit of Hallmark Cards, helps businesses build and strengthen relationships that help them thrive. One valuable service the company provides is corporate wellness program development. For guidance on strategic wellness program implementation, email Jennifer Patel at Jennifer.Patel@ hallmarkbusinessconnections.com or visit www.hallmarkbusinessconnections.com.
Pontotoc doc takes reins at newly created Mississippi Office of Physician Workforce Family physician John R. Mitchell, MD, of Pontotoc has been named executive director of the Mississippi Office of Physician Workforce (MOPW), the newly created state organization tasked with putting more primary care doctors to work in medically needy areas. Mitchell, a hospital- Dr. John R. Mitchell ist with North Mississippi Medical Center in Pontotoc and faculty member with the center’s Family Medicine Residency Program, takes over from workforce interim director Diane Beebe, MD, professor and chair of the University of Mississippi Medical Center (UMMC) Department of Family Medicine. A veteran of the Medical Corps of the U.S. Army and the Mississippi Army National Guard, Mitchell is a board-certified specialist and recently served as chair of the physician workforce’s advisory board. A graduate of the University of Mississippi and the UMMC School of Medicine, he began his medical career as a pharmacist before practicing medicine in his hometown. “Dr. Mitchell brings to this office passion and vision for improving healthcare ac-
cess in Mississippi,” Beebe said. “From his years practicing as a rural family physician, from teaching students and residents, and from his involvement in state and national medical organizations, he understands the needs of this state. I’m delighted he’s willing to take this challenge with us and look forward to great things.” State lawmakers created the MOPW last year to reduce the shortage of primary care doctors in a state with the nation’s lowest per capita supply. The office oversees the state’s physician workforce development needs by nurturing the creation of family medicine residency programs, fostering the development of a physician workforce in all specialties as needed, evaluating the existing workforce, and establishing the state’s workforce requirements. To reach the national average, Mississippi would have to add more than 1,300 primary care physicians, whose specialties include family medicine, internal medicine, pediatrics and obstetrics/gynecology. “I know it’s a daunting task, but desperate times are sometimes great motivators,” said Mitchell, who completed his family medicine residency in Tuscaloosa, Ala., and a primary care faculty development fellowship at Michigan State University.
His ideas for bringing change to the state include adding at least three medical residency training programs around Mississippi over the next several years, developing partnerships that would expand medical training opportunities in rural areas, and building a strong relationship with the Mississippi Rural Physicians Scholarship Program, which cultivates rural college students desiring to return to their roots to practice medicine. “Where you come from, your past, probably more than anything else, has a lot to do with whether you go into primary care,” Mitchell said. “It’s called ‘the missionary zeal.’ My idea of a physician when I was growing up was our family physician. When I became interested in family medicine, I always wanted to practice back at home.” A member of the American Academy of Family Physicians, Mitchell serves as an alternate delegate to the organization’s Congress of Delegates. His numerous posts have included president and board member of the Mississippi Academy of Family Physicians, president of the Northeast Mississippi Medical Society, and past president of the Mississippi Chapter of the American Medical Directors Association.
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Backyard Success, continued from page 1 this up,” joked Gunnoe, RN, CEO of the imaging informatics company that specializes in the diagnostic side of spinal instability. This year, VMA prototypes were strategically placed in seven spine and imaging practices across the country, including two locations in Mississippi – New South Neuro Spine (NS2) in Flowood and Southern Neurologic & Spinal Institute in Hattiesburg. Its visibility got a boost when investor and retired NFL quarterback Brett Favre called it quite “impressive.” “Everyone that sees it wants it,” said Gunnoe. “The real trick has been handselecting the practices to beta launch the units in.” VMA technology, developed by OKI and approved by the FDA for lumbar and cervical imaging, uses fluoroscopy to provide previously unavailable views of the spine in motion, allowing neurosurgeons to pinpoint spinal irregularities more accurately. “We’re offering a diagnostic test that simply wasn’t available before,” said Gunnoe. “Comparing the spine and heart, the spine is the second largest problem area of the body, yet there’s almost nothing along the lines of accurate diagnostic tools. For example, for the heart, there are x-ray and CT diagnostic options. For the back, there’s x-ray and MRI. From there, where do you go? There’s a functional stress test for the heart, but nothing for the spine. Finally, we can provide the functional test
the spine’s been lacking.” With the VMA, surgical success rates should surge through better patient selection, Gunnoe emphasized. “Because of the gap in diagnostic capability, the surgical success rate in the spine is somewhere around 74 percent when it comes to relieving pain,” he said. “Most device makers are concentrating on how to create a better device for surgery, but they don’t address the 17 percent gap that’s due to misdiagnosis. It’s not the fault of the surgeon; it’s the lack of technology to develop a better diagnostic tool. By comparison, with the EKG of the heart and other functional tests as diagnostic tools, the surgical success rate of the heart is around 95 percent. One could assume that the gap between the two is due to the lack of a similar diagnostic capability in
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the spine.” Importantly, VMA technology emits 29 percent less radiation to the patient than traditional x-rays. The use of fluoroscopy provides specialists with video consisting of hundreds of individual still images versus three to six still images of flexion, extension and center from the standard x-ray procedure to evaluate the cervical and lower spine. Image recognition software locates the vertebrae on each frame and plots angulations and translations at each level. A set of biomechanical measurements is overlaid on the video
images to provide neurosurgeons with expansive data at a glance. “We provide results that are 68 percent more accurate, and 79 percent more precise,” said Gunnoe. The ultimate goal for the VMA technology: to become the diagnostic standard of care in accessing cervical and lumbar pain, said Gunnoe. “Insurance companies see it as a much more effective, accurate and costefficient tool to diagnose the patient,” he noted. “It’s designed to be the first line of diagnostics.”
Track Record OXFORD – Paul Gunnoe considered medical school after earning a biology degree from Ole Miss. Instead, he chose to earn an RN degree from Pearl River Community College, and had plans to pursue certification as a registered nurse anesthesiologist (CRNA). “Once I got into the field and did a year of clinical work and had started CRNA school, I was introduced to travel nursing, which led to entrepreneurial opportunities,” said Gunnoe, then a critical care nurse for a hospital in Dallas, Texas. “I always had a niche for business, and … when the opportunity presented itself, God blessed me and it’s worked out pretty good.” While working as a travel nurse, Gunnoe listened to concerns voiced by medical practitioners about staffing and other issues. After drilling down a bit, Gunnoe started several healthcare staffing companies, including one of the industry’s largest and fastest-growing nurse staffing firms. While Paul Gunnoe developing the businesses, he noted improvements needed for the industry’s staffing solution software, so he designed, developed and implemented a version that staffing companies and hospitals could use to manage their supplemental staffing needs as well as their own internal staff. When a client was involved in a labor dispute, he formed a labor action division to handle hospital staffing and operations. “I learned early on, that if you’re going to start a company, you’d better ask yourself one question: what problem are you fixing? And if you can’t answer that, you don’t need to be starting that company,” he said. Gunnoe also developed a talent for raising capital and driving revenue growth for early-stage companies. He formed Gunnoe Investment Group LP in 2006, which focuses on healthcare company turnarounds and startups. Last summer, Gunnoe partnered with Ortho Kinematics Inc. (OKI) to bring the VMA technology to market. Even though Gunnoe runs operations from Oxford, where he lives with his wife, Martie, and their two children, Garrett and Tanner, the company remains Texas-based due to special funding from the Texas Emerging Technology Fund. Since the fund was created in 2005, state lawmakers have allocated nearly $200 million to 133 early-stage Texas-based companies and $177 million in grant matching and research money to Texas universities. Earlier this year, the Texas Legislature approved replenishing the fund with $50 million for two years. “(Texas) Gov. Rick Perry has focused heavily on funding emerging technology in the healthcare sector,” explained Gunnoe, who Gov. Phil Bryant recently appointed to the state’s Medical Care Advisory Committee. “I hope Mississippi adopts something similar.”
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Gaining Perspective on the Reimbursement Landscape: Glass Half Empty … or Half Full By CINDY SANDERS
To see something in a different light often requires a shift in perspective. David A. Williams, CPA, MPH, FHFMA, leader of healthcare reimbursement and advisory services for HORNE LLP, believes this certainly holds true for practices and facilities facing everincreasing budget pressures. David A. Williams
Glass Half Empty Williams, a partner in HORNE’s Ridgeland, Miss. office, noted for many healthcare providers, any incremental increase in revenue is eaten up by rising costs — from increased wages to higher prices for supplies to hikes in rent and utilities. He pointed out that for hospitals, the largest revenue stream is for inpatient stays, and the largest single payer is Medicare, which can represent from the low 40s to the high 60s in terms of percentage of patients. “There has been a market basket update, but for the last couple of years, it’s been less than 2 percent,” he said. Williams noted the government puts in the full market basket update but then begins reducing the rate by looking at adjustments tied to value-based purchasing, readmission rates and acquired conditions, in addition to other factors. “Normally you’re seeing very minimal increases. It’s caused a flattening of revenue per patient,” he said. Then, Williams continued, after payment increases are netted out, “Medicare is subject to a 2 percent reduction to fulfill the sequestration order.” He added that Medicaid, which typically covers anywhere from 5-15 percent of patients … or higher depending on location and a hospital’s safety net status, is not currently subjected to sequestration. Yet, he said, hospitals are faced with mounting concerns about Medicaid expansion, uncompensated care, and cuts to disproportionate share hospital payments. For hospitals in states that didn’t opt to expand Medicaid rolls, administrators are worried about rising levels of uncompensated care for those that fall into the gap in the Affordable Care Act between traditional Medicaid eligibility and qualifying for federal subsidies on the healthcare exchange. Even for providers who are in states that did expand Medicaid, mississippimedicalnews
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Williams said uncertainty still exists about how reimbursement will actually net out. Traditionally, Medicaid has reimbursed providers at a set match rate for direct patient services and a 50 percent rate for the administrative portion of the episode of care. Although the ACA Medicaid expansion plan covers 100 percent of patient services for three years and then rolls down incrementally to 90 percent over subsequent years, the administrative match remains at 50 percent so the state does incur additional cost by expanding rolls. Additionally, Williams said certain provisions of the ACA require mandatory changes for states regardless of expansion, including: welcome mat population or those who were eligible for Medicaid but had not enrolled previously, foster children expansion to age 26, expanded eligibility for children, primary care physician fee increase, and health insurer fee. In Mississippi, a non-expansion state, the estimated amount of the mandatory changes is between a $272 - $436 million increase in spending. With this amount of growth, the state is not expected to increase the reimbursement rate for a full episode of care. Medicare DSH payments also are causing administrators to lose sleep at night. Initially, the ACA plan called for a 75 percent reduction in Medicare DSH payments. However, Williams said part of the final regulation that went into effect Oct. 1 of this year moderated that number a bit by moving to an empirical DSH payment for uncompensated costs … a complex, calculated cut that softens the blow some by looking at a hospital’s relative share of Medicaid inpatient utilization as a proxy for uncompensated patients. Williams said that for one hospital in the Mississippi Delta, the original Medicare DSH reduction would have meant a loss of $5.6 million. “But,” he continued, “because of the additional payment to fund the uncompensated cost, it was actually a reduction of $2 million.” While that is still a significant loss, “It could have been worse,” Williams noted. Still, he continued, “You’re faced with the fact your revenue isn’t growing as fast as your expenses. It’s very concerning to most every healthcare organization around.” Glass Half Full So if revenue isn’t going up, the logical place to increase margins is to decrease costs. Yet, healthcare providers want to
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Paradigm Shift continued from page 1
Gaining Perspective
Two hallways, visible from the nurse’s station at the front of the unit, house 13 units each. One phase involves patients who have been diagnosed with dementia or are showing symptoms that dementia may be the diagnosis. “Perhaps these patients have always done well in a nursing home but suddenly become easily agitated or paranoid,” said Richardson. “After 85, sometimes it can be difficult to sort out what’s age-appropriate forgetfulness versus dementia. An evaluation workout will help us figure out what’s going on to cause the change and have an intervention with conservative medication and education to families of caregivers.” The second level is established for patients who continue to function well and have lived independently or with little supervision, but who have developed depression or anxiety. “I want that section to be one in which people feel they’re in an interactive therapy program,” said Richardson. “I’ve heard from potential patients who have visited other gero-psych wards and have mostly seen patients who couldn’t speak coherently. These potential patients clearly became anxious, wondering ‘is that what’s in store for me?’ Those thoughts bring a whole new level of paranoia.” The inpatient program complements St. Dominic’s longstanding outpatient program. “Years ago, the hospital looked long term at Behavioral Health Services and recognized a true community need for a gero-psych program,” explained Richardson, who joined St. Dominic’s in January. “Many doctors’ patients are getting elderly and they want a place to refer their patients for treatment, where they feel comfortable.” Even though many referrals come from primary care providers, family and self-referrals comprise a growing percentage of new patients. “The typical length of stay is 10 to 14 days,” said Richardson. “There’s a point when you can be in the hospital too long and regress.” Statistically, the geriatric population has a higher level of dependency on pain medication and alcohol, said Richardson. “We don’t like to think of grandma having a problem with drinking,” he said. Richardson’s role at St. Dominic’s is a capstone to a career that began after residency at the Baylor College of Medicine in Houston, Texas. While on staff at the University of Mississippi Medical Center, Richardson was tapped for independent psychiatric consultations at the Mississippi State Hospital in Whitfield operated by the Mississippi Department of Mental Health. “Most of the patients I saw were there for long-term care,” he said. “I fell in love with the population. The doctor-patient relationship is so important to them.” Richardson’s affable personality makes it easy for patients to communicate. “I tell them my criteria with memory problems,” he joked, “is that it has to be worse than mine!”
continued from page 9 make sure they provide the best care possible without sacrificing a patient’s well being simply to save a few dollars. “A lot of people equate higher quality with higher cost, but that’s not necessarily true,” Williams pointed out. In fact, he said, doing the right thing in the right way is often significantly more cost efficient. “A major cost in providing care to patients is variation in the clinical process of care,” Williams said. He added it is easy to find real world examples of this type of variation where one hospital’s cost for an average hip replacement is $45,000, yet another one might have an average cost of $22,000. “What’s the disconnect?” he asked of the two cost scenarios. “A lack of standardization of using evidence-based protocols,” he answered. By using data available through electronic health records coupled with a partnership with technology company Health Catalyst, Williams said HORNE is able to mine the available information to look at clinical pathways and search out deviation from standard protocols that adds to the cost of care. He was quick to add that the technology doesn’t seek to stop physicians from exercising their medical judgment but does highlight where there are outliers when it comes to following clinical protocols. “Best practices and evidence-based medicine say that these are the best protocols out there,” he pointed out. Following those protocols not only saves money, but also should optimize quality. With increased transparency, payers and patients will have access to information regarding those positive outcomes and lower costs, which could ultimately drive volume. A Foot in Both Boats
Administrators and chief financial officers are caught between the fee-forservice and value-based payment worlds right now. Williams said they are trying to keep their heads above water in the current payment system … and now reimbursement experts want them to shift their focus to population management. Although making the move is understandably frustrating, Williams believes it is also the best option to ultimately improve the bottom line. “There has to be a change in culture from what it’s been in the past,” he noted. “We tell them, ‘Let’s prepare for it by being the most efficient, effective deliverer of care and eliminating patient waste.’ That puts you in a competitive advantage over those providers that have a higher cost structure.” It is a different mindset, Williams continued, to stop attacking reimbursement from the top and instead improve revenue by cutting costs. “If you deliver high quality at a lower cost, then your margins are going to be greater. We see opportunities,” he concluded.
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Integrative Medicine Goes Mainstream
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ABIOM finalizes board certification exam for emerging specialty By LYNNE JETER
TAMPA, FLA. – Mimi Guarneri, MD, FACC, and fellow founding members of the American Board of Integrative Medicine (ABIOM) spent the lingering days of summer putting the final touches on a new board certification examination for a specialty that’s garnering national attention. “Creation of integrative medicine as a specialty by the American Board of Physician Specialties (ABPS) guarantees excellence in the field and assures consumers of healthcare the practitioner they’re seeing has reached a high standard of practice,” said Guarneri, board-certified in cardiology, internal medicine, nuclear medicine and holistic medicine. Tampa, Fla.-based ABPS, the first multi-specialty certifying body to offer physician certification in integrative medicine, is the official certifying body of the American Association of Physician Specialists (AAPS) and one of three national certifying organizations of MDs and DOs. The ABPS has led industry response to trends in urgent care, disaster medicine, hospital medicine and family medicine obstetrics. Andrew Weil, MD, said the formation of ABOIM – one of 18 ABPS boards – marks an important milestone in the development in the field of integrative medicine. “Finally, there’s a way for qualified physicians to present themselves as experts in offering competent integrative care to patients,” said Weil, who helped establish integrative medicine as a specialty. Of the other two national certifying organizations, the American Board of Medical Specialties (ABMS) represents the largest national organization certifying MDs and DOs. The American Osteopathic Association Bureau of Osteopathic Specialists (AOABOS) certifies DOs only. “Integrative medicine focuses on getting to the underlying cause of disease and implementing personalized programs that help people achieve optimal health,” said Guarneri. “In conventional medicine, we’re taught to make a diagnosis and prescribe a treatment. In integrative medicine, we look for the underlying cause of the problem or health challenge. For example, in conventional medicine, we may diagnose diabetes and prescribe a medication. In integrative medicine, we look at what a person is eat-
ing (to determine if) they’re deficient in micronutrients linked to diabetes. If they’re physically fit, are they exposed to toxins? Are they under stress? All of these can cause diabetes. We may prescribe medicine, but we also look to correct the underlying cause. We treat the whole person – body, mind and spirit – and we look at an individual’s relationships to family, community and planet.” ABOIM and the Consortium of Academic Health Centers for Integrative Medicine define integrative medicine as “the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals, and disciplines to achieve optimal health and healing.” Guarneri, founder of the Scripps Center for Integrative Medicine in La Jolla, Calif., and president of the American Board of Integrative Holistic Medicine (ABIHM), pointed out that as a cardiologist, her goal is to also reverse the patient’s health challenges. “Integrative medicine provides me the tools that weren’t available in my conventional medical training,” she said. “As a cardiologist, I’m well versed in the role of medication, surgery and stenting for treatment of cardiovascular disease. But, it’s my training in integrative medicine that’s taught me the principles of nutrition, the evidenced-based use of natural supplements, and the role of the mind-body connection. Integrative medicine allows me to complete the circle of care.” Eudene Harry, MD, medical director of Oasis Wellness & Rejuvenation Center in Orlando, Fla., was thrilled to learn about the new board certification in integrative medicine. “It’s very good that integrative medicine is being acknowledged as a specialty,” said Harry. “The message is: let’s not be exclusive. Let’s be inclusive. Let’s look at all evidence-based material and treat it equally.” Harry, who specializes in both holistic and emergency medicine, said integrative medicine allows “more focus on information-gathering.” “That’s going to be helpful,” she said. “Medications don’t address the issue that’s driving the patient to the doctor’s office.”
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Integrative Medicine Board Certification 4-1-1 ABOIM certification is available to both allopathic and osteopathic physicians in the United States and Canada who are practicing integrative medicine and have completed a residency training program approved by the Accreditation Council of Graduate Medical Education (ACGME), American Osteopathic Association (AOA), Royal College of Physicians and Surgeons of Canada (RCPSC), or College of Family Physicians of Canada (CFPC). Complete eligibility requirements are available online. Qualified physicians interested in becoming board certified in integrative medicine may submit an application by Dec. 1; the initial exam will take place next May. Applications are available online at www.aapsus.org and may be obtained by contacting the ABPS Certification Department at (813) 433-2277.
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Managing Addictions
Addiction medicine professionals prepare for ‘busy season’ By LYNNE JETER
As another dismal economic year draws to a close, addiction and substance abuse clinics are gearing up for an influx of patients. “We say in our business that the drinking season begins at Thanksgiving and ends on Super Bowl Sunday,” said Percy Menzies, M. Pharm., founder of Assisted Recovery Centers of America (ARCA), based in St. Louis, Mo. “We opened in February and just recently had to turn away patients for the first time. It’s that busy. We’re also dealing with a huge iatrogenic epidemic of addiction to prescription pain drugs. For the first time, more people have died of drug overdose than automobile accidents. Heroin has become the cheap ‘generic’ form of opioid pain killers.” Despite the revolving door headlines about celebrities frequenting rehab clinics, addiction medicine remains one of the most underfunded diseases in the United States. According to a 2012 report published by The National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia), “Addiction Medicine: Closing the Gap between Science and Practice,” 15.9 percent (40.3 million) of Americans have the disease of addiction. That’s more than heart conditions (27 million), diabetes (25.8 million) or cancer (19.4 million). Even though one in five deaths is attributable to tobacco, alcohol and other drug use, the U.S. spent $107 billion to treat heart conditions, $86.6 billion to treat cancer, and $43.8 billion to treat diabetes in 2010. But only $28 billion was spent on addiction treatment. Another eye-opening statistic: Of every
dollar spent by federal, state and local governments on risky substance use and addiction, 95.6 cents pay for consequences; only 1.9 cents go to prevention and treatment. Genetic predisposition, structural/ functional brain vulnerabilities, psychological and environmental influences are clear risk factors for addiction, as is the age of first use. Ninety-seven percent of addiction cases start with substance abuse before the age of 21, while the brain is still developing. As a result of all risk factors, one-third of the population over the age of 12 is susceptible to substance abuse. “This clearly articulates the monumental challenge ahead of us,” said Menzies, who left an executive role with DuPont Pharmaceuticals to open ARCA’s first integrated outpatient clinic in 2001, and in early 2013, a 25-bed residential substance abuse clinic. He’s on a campaign to move addiction into the mainstream of medicine. “For too long,” he said, “we’ve been on the outside of the margins.”
Addiction Medicine Challenges
Various factors keep addiction and substance abuse programs in the shadows of medicine: the professional stigma that makes it difficult to recruit healthcare providers, the social stigma that pervades society and the field of addiction medicine, misconceptions among other healthcare providers, and the often unbalanced mix of medications and treatment. “When I give talks to medical school students, and ask who wants to specialize in addiction medicine, not one hand goes up,” said Menzies, noting that of 985,375 active
physicians nationwide, only 1,200 are practicing addiction medicine specialists and 355 are practicing addiction psychiatrists. “They don’t see it as a very lucrative business.” The report also noted a significant differential in requirements for addiction counselors by state. Only one state has a minimum requirement of a master’s degree, six states require an undergraduate degree, and 10 states require an associate’s degree. Fourteen states require only a high school degree or GED equivalent, six states have no minimum degree requirements, and 14 states don’t require any licensure or certification. Only 10 states mandate a physician as a medical director or staff member of residential treatment programs. “The majority of people who work in addiction treatment are in recovery and lost everything to their addiction and want to give back to society,” he said. “Part of the challenge is that they come with their own baggage. Being in recovery doesn’t make them an expert. That’s one of the major obstacles we face in this field.” Menzies, who is not in recovery, recalled how his relatives – many are healthcare professionals – questioned his decision to move into addiction medicine. “Others ask me if my practice failed, because they believe no self-respecting healthcare professional would go into this field voluntarily,” he said, with a chuckle. The social stigma of the disease exacerbates misconceptions of addiction. “If you go to your physician and say, ‘doc, I’m drinking too much,’ he’s likely to say ‘stop drinking’ and maybe advise you to go to AA,” he said. “If you go to a psychiatrist and say, ‘I’m drinking too much,’ he’s
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likely to say, ‘you’re depressed. Let me give you an anti-depressant.’ If you go to your pastor and say, ‘I’m into drugs and alcohol,’ he may say, ‘you should come to church more often.’ My goal is to treat addiction like any other chronic medical condition, such as diabetes or asthma, through the right combination of medications, counseling, behavioral therapies, and psychiatric care.”
Drug Intervention Challenges
Ironically, drug and alcohol treatment has a dark and checkered history, noted Menzies. “Highly dangerous and addicting drugs were touted as ‘cures.’ This has resulted in a very unhealthy segmentation of treatment,” he explained. “Only a small percentage of alcoholics are treated with medications, but addiction to opioids is predominantly treated with addicting and abusable drugs like methadone and buprenorphine, which adds to the stigma and deters many physicians from getting into this field.” Nearly 35 years ago, the federal government developed naltrexone as the first non-addicting medication to prevent detoxed heroin addicts from relapsing, added Menzies. “DuPont introduced this medication in 1984; in 1994, the same medication was approved for the treatment of alcoholism,” he said. “Naltrexone faced opposition from many treatment providers and the practical challenge of medication compliance.” Vivitrol, a monthly injection of naltrexone, was introduced in 2006 but has yet to gain significant use. “It’s an amazing medication to prevent relapse to alcohol or opioid use, but there’s so much opposition to it,” he said. “It gives patients a fighting chance of not relapsing when they return home to the familiar environment of past drug and alcohol use. The true test of any treatment program is how well patients do when they return home. Vivitrol is a potent tool to keep patients engaged in long-term treatment.”
Improving the Environment
In 1956, the American Medical Association (AMA) referred to alcoholism as an illness that should be treated within the medical profession. In 1989, the AMA adopted a policy naming addiction as a disease. Yet less than 6 percent of referrals to publically-funded addiction treatment emanates from healthcare providers. Addressing the education, training and accountability gap is paramount to moving addiction medicine into the mainstream. Among the report’s next-step recommendations, improved screening and assessment tools need to be developed, national accreditation standards for all addiction treatment facilities and programs that reflect evidencebased care need to be established, addiction medicine workforce needs to be expanded, addiction treatment facilities should be licensed as healthcare providers, and research and data collection to improve and track progress and search for a cure needs a financial shot in the arm. “The stigma of addiction,” said Menzies, “can only be removed with better outcomes.” mississippimedicalnews
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GrandRounds Southern Miss Professor Gould Named Associate Dean in College of Health Dr. Trent Gould, who has served in a variety of roles during his 10 years at The University of Southern Mississippi, has been named associate dean in the College of Health. An associate professor in the School of Human Performance and Dr. Trent Gould Recreation, Gould has also served as the school’s interim director for the past year while splitting duties as the assistant school director for graduate studies. A native of Warren, Ohio, Gould earned his bachelor’s degree from Bowling Green State University (1998); his master’s degree from Ohio University (2000) and his doctorate from Ohio University (2003). He joined the faculty at Southern Miss in the fall of 2003. Gould points out that his duties as associate dean translate into 50 percent administration; 25 percent research and 25 percent teaching in the School of Human Performance and Recreation. He notes that the College of Health is positioned well in the University in terms of enrollment, accredited programs and research productivity, but emphasizes that areas of improvement do exist.
Executives (ACPE), American Medical Association (AMA), Mississippi State Medical Association (MSMA), American College of Healthcare Executives (ACHE) and has previously served on Baptist’s credentials committee.
Delta Health Alliance receives $900,000 grant from USDA for health projects Delta Health Alliance is one of fifteen organizations throughout Mississippi to receive funding from the United States Department of Agriculture (USDA). In a
town hall meeting in Jackson, USDA Secretary Tom Vilsack announced that DHA would receive $900,000 to strengthen electronic health systems among Delta providers and improve facilities at a certified rural health center located in Washington County. According to Karen Matthews, Delta Health Alliance CEO, the USDA grant will improve provider care for Mississippi Delta residents through expanded use of electronic health records and the use of an electronic medical record-based health management program. Matthews
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Baptist Health Systems Announces Chief of Medical Operations Michael Dudley Maples, MD, has joined Baptist Health Systems as the Vice President and Chief of Medical Operations. Dr. Maples comes to Baptist from Medical Assurance Company of Mississippi where he has served as medical director since 2003. From 2002 Dr. Michael until 2007, he was medi- Dudley Maples cal reviewer for the State of Mississippi’s Department of Disability Determination. From 1985 until 2002, Dr. Maples was a practicing cardiothoracic surgeon with The Cardiovascular Surgical Clinic of Jackson at Baptist. Dr. Maples attended the University of Mississippi, Vanderbilt University, and graduated AOA from the University of Mississippi Medical Center. He is active in several professional associations including American College of Physician
Read Mississippi Medical News Online: MISSISSIPPI MEDICAL NEWS.COM mississippimedicalnews
went on to say that providers will have improved access to a patient’s medical information and can utilize tools to provide quality care and improve health outcomes for patients with chronic diseases. The USDA grant will also be used to expand the work of the Leland Medical Clinic, a new project of Delta Health Alliance. The Leland Clinic is operating as a patient-centered medical home, which means it is addressing the needs of its patients through a team approach focusing on patient’s health, using enhanced technology and chronic disease management.
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GrandRounds UMMC names new chair of emergency medicine
SRHS Welcomes Provider to the Neuroscience Center
Dr. Alan Jones, UMMC professor of emergency medicine, has been named chair of the Department of Emergency Medicine. Dr. Jones earned his undergraduate degree with honors in molecular biology at Millsaps College and his medical degree at UMMC. He completed his residency in emergency medicine and served as chief resident at Carolinas Medical Center in Charlotte, N.C. Following residency training he completed a clinical trials research fellowship, and while serving on the emergency medicine teaching faculty at Carolinas he completed coursework for a master’s degree in public health from the University of North Carolina at Charlotte. He returned to UMMC in 2011 as a full professor and vice chairman of emergency medicine. He also serves as the department’s director of research and its research fellowship program. He succeeds Dr. Richard Summers as chair of the department. Dr. Jones has authored numerous scientific publications and is currently either a principal investigator or co-investigator on four National Institutes of Health R01 grants. He recently began a one-year term as president of the Society for Academic Emergency Medicine.
The Board of Trustees of Singing River Health System has recently welcomed a new member to the Pain Management team within the Neuroscience Center. Dr. Michael Cosgrove, MD, received his medical degree from the Dr. Michael Jefferson Medical ColCosgrove lege in Philadelphia. He performed a residency at Maine Medical Center in Portland, Maine. He also performed a fellowship at DartmouthHitchcock Medical Center in Lebanon, N.H. Cosgrove is board certified in Anesthesiology and board certified in Pain Management. He will be practicing with the Neuroscience Center in Ocean Springs.
Memorial Physician Clinics adds Nephrologist Memorial Physician Clinics welcomes Jedd Seigerman MD, in the practice of Nephrology. Dr. Seigerman joins Dr. Douglas Lanier, Dr. Amery Creighton, Dr. Joseph O’Gorman, Dr. Biju Marath, Dr. Edwin Quinones, and Dr. Erica HopDr. Jedd kins. Seigerman
Dr. Seigerman graduated Cum Laude with his undergraduate degree from Lehigh University, Bethlehem, Pa. He earned his medical doctorate from Temple University, Philadelphia, Pa. Dr. Seigerman completed his internship and residency in internal medicine at Wilford Hall Medical Center, Lackland Air Force Base, Texas. He was fellowship trained in nephrology at UT Health Science Center Lackland Air Force Base Combined Program, San Antonio, Texas. Dr. Seigerman is Board Certified in nephrology and internal medicine.
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ASSOCIATE PUBLISHER Kathy Arich karich@mississippimedicalnews.com Ad Sales: 601.941.3075 ACCOUNT EXECUTIVES Perry Patterson LaCour placour@mississippimedicalnews.com Ad Sales: 601.941.1603 NATIONAL EDITOR Pepper Jeter editor@medicalnewsinc.com
Dr. Richard Summers has been appointed UMMC associate vice chancellor for research. He previously served as professor and chair of UMMC’s Department of Emergency Medicine. He is also an accomplished physician-scientist with nearly 300 publications to his credit. He has established a national reputation for his work on quantitative models of human physiology on behalf of NASA’s Digital Astronaut Program, particularly in regard to measuring the effects of microgravity on space travelers. An honors graduate of the University of Southern Mississippi in mathematics and chemistry, Dr. Summers completed medical school at UMMC. In addition to his clinical training, he completed a post-doctoral research fellowship in the Department of Physiology and Biophysics under the mentorship of Dr. Arthur Guyton and Dr. Tom Coleman. He holds a secondary faculty appointment as professor in that department. He succeeds Dr. John Hall, professor and chair of the Department of Physiology and Biophysics, as associate vice chancellor for research. Hall held the position since 2005.
LOCAL EDITOR Lynne Jeter lynne@medicalnewsinc.com
Chuck A. Reece, President of Rush Foundation Hospital and Executive Vice President and Chief Operating Officer of Rush Health Systems, was recently elected Chairman of the 2013-2014 Mississippi Hospital Association (MHA) Board of GoverChuck A. Reece nors during MHA’s 82nd Annual Leadership Conference. Mr. Reece has held numerous administrative positions within Rush Health Systems since 1997. He is a graduate of Mississippi State University and the Executive MBA program at Vanderbilt University. He and his wife have two children and three grandchildren. He currently serves on the board of the East Mississippi Business Development Corporation and is an Elder of First Presbyterian Church of Meridian.
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CHIEF EXECUTIVE OFFICER Chris Ferrell
UMMC appoints new associate vice chancellor of research
Reece named chairman of MHA Board of Governors
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