Orlando Medical News 2015

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PHYSICIAN SPOTLIGHT PAGE 3

Brenda Holson, MD ON ROUNDS

Practicing Medicine without Politics

Volunteer physicians enjoy camaraderie at free clinics, made possible by state’s strong sovereign immunity law ... 5

What Does UnitedHealth’s Latest Move on Hysterectomies Mean?

Nation’s largest health insurer stiffens rules on hysterectomy coverage ... 10

A Gateway of Medical Care

UCF College of Medicine expands physician practice, partners with Florida Hospital, embraces new moniker

By JULIE PARKER

Florida Hospital and the University of Central Florida (UCF) Health are sinking deeper roots in Central Florida with a new physician practice located in the heart of Lake Nona.

Opened March 16, the new facility is located at the entrance of Lake Nona Medical City in the Gateway Building that UCF shares with Florida Hospital.

UCF Health is sharing the location with Florida Hospital as the two independent healthcare entities collaborate for optimal patient care. The combined practices feature primary care physicians, specialists, imaging and laboratory services, and physical therapy.

“We’re expanding our multispecialty

practice to serve more people across our community,” said Deborah German, MD, UCF vice president for medical affairs and dean of the medical school. “We’re excited to bring needed outpatient care to our Lake Nona neighbors.”

All UCF Health physicians are UCF College of Medicine faculty members. The initial doctors at the new location include internal medicine specialist Anteneh Addisu, MD, PhD, a physician-scientist (CONTINUED ON PAGE 4)

Exodus from Private Practice?

For doctors to focus solely on patient in post-ACA era, collective bargaining is needed

By J.B. BITAR, MD, FACC, SUSAN BITAR, MSN, RN

AND

It’s reasonable to say the outlook for physician providers is grim.

As pressure keeps mounting on physicians, some will seek early retirement, administrative positions or similar nonpatient care employment, or change careers. Already, many physicians in private practices are being acquired by hospitals

as employees. Their hopes are to avoid a reduction in pay and administrative burdens brought by Meaningful Use (MU) mandates. Most hospital-employed physicians now realize they cannot escape either problem.

As the physician shortage worsens, the gap is being filled by the growing employment of allied health extenders. The cost of medical education is quite high, (CONTINUED ON PAGE 4)

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PhysicianSpotlight

Brenda Holson, MD Founder, Interlachen Pediatrics

By JEFF WEBB

MAITLAND - When Brenda Holson started her practice in 1985, she and her business partner had two patients: “Her kid and my kid,” Holson said. “We were in a strip mall in Casselberry next to a bar that had lingerie nights on Thursdays.

The dads loved to bring the kids in on that night!” joked Holson.

“We moved, bought our own building in Maitland, merged with another group and changed the name,” she said. In the 30 years since, Interlachen Pediatrics has flourished as an independent practice with nine physicians, three nurse practitioners, supporting staff and an additional office in Oviedo. “But I’m the only one who has been here 30 years,” said the easy-going 63-year-old.

For Holson, that is no small accomplishment when she considers how the climate of the medical business has changed so dramatically. “Medicine has gone from house calls to what I call the bogeymen of medicine – the health companies and then the insurance companies trying to take us over. Now we’ve got the HMOs and the retail clinics that have been a real threat to private practice. And now the hospital acquisitions. It’s really been a change in the business of medicine,” said Holson. “But if you’re in an independent practice you can sort of change with the time, and that has been one of the funnest parts, figuring out how to change and have a better widget.

That’s what it’s really all about. It’s really going to take a lot of ingenuity to figure out where we fit in.”

Holson is in an opportune position to begin a dialogue with her colleagues about these circumstances. As president of the Orange County Medical Society, she hopes to increase membership by being more inclusive of all physicians. “The problem physicians have now is the hospitals’ acquisitions of the doctors. I would bet that a majority of the physicians in the county are owned by the hospitals or the insurance companies. There are very few independent doctors left,” she said. “Sometimes there is some conflict between the hospitals’ interests and the doctors’ interests, but because the doctors are hired by the hospital, they really don’t have much of a say. This is just what I’ve heard.”

Holson explained that she would like “to try to have the county medical society be inclusive of all doctors – ones employed by government, independents, and the medical schools” at the University of Central Florida and Florida State University. “I would like to have a situation where all doctors from all areas can get together,” she said. Increasing physician membership and voice “is not just an Orange County issue, or a Florida issue, it’s a national issue,” said Holson. orlandomedicalnews

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At the same time, Holson intends to advance the legislative agenda of the OCMS in the state capitol. “We are very closely aligned with the agenda of the Florida Medical Association, adding that she and others from OCMS were in Tallahassee recently.

It is no surprise that Holson knows her way around Florida. She grew up in Orlando the second of five children born to Jerry and Caroline Brown. “My dad was in citrus, as was my maternal grandfather, in Winter Garden and Eustis. Two of my brothers now run dad’s company, but it is no longer citrus, thanks to all of the freezes,” Holson said. She remembers going into the orange groves with her dad as he lit smudge pots to fight the frosts.

The freeze of 1989 was particularly devastating, she said, “and now the Brazilian competition makes it really hard to survive in the citrus industry in Florida,” she said.

Now, Florida Food Products in Eustis is more of a food processing operation than a citrus-growing operation, she said. Still, it is “one of the largest family-owned companies in Lake County,” she said.

After graduating from Edgewater High School in Orlando in 1970, Holson went to Nashville, where she earned a nursing degree at Vanderbilt University. “I didn’t really know I wanted to be a physician, but I really liked school and

I preferred it to working, and dad was paying,” she laughed, so she decided to give medical school a whirl.

“I just kind of fell into it, to be perfectly honest.”

She remained at Vanderbilt to obtain her MD and then moved north to The Children’s Memorial Hospital in Chicago to pursue her specialty. “I chose pediatrics because kids almost always get better and their illness is not self-induced… And you get to watch the child evolve over time,” she said.

Holson spent the next five years completing her internship, residency and a fellowship in pediatric allergy/clinical immunology – and giving birth to her son, Rush, in 1981. She separated from her husband in 1985 and that’s when she moved back to Orlando and received some life-shaping advice from her father. “You need to be your own boss. Why work for someone else and make them money,” she recalled. The seed he planted is what Holson cultivated into Interlachen Pediatrics.

Holson said she “definitely has plans for retirement.” Just last year she married Yates Rumbley, an attorney she met on a blind date that was set up by her live-in nanny – in 1989! “We dated for 18 years.

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He married for the first time at age 59,” but because it was “husband number two for me, I figured I’d better be cautious,” she said.

“I’ve done everything I can (professionally) and I think I have other interests I’d like to pursue,” she said. “One of those is volunteer medicine, possibly overseas. I think I’d like that.”

Holson is no stranger to globetrotting.

As an accomplished Himalayan mountain climber she “has been up to base camp of the three highest mountains in the world: Everest, K2 and Kangchenjunga,” she said, and made it to the top of Kilimanjaro in Africa. She has marveled at silverback gorillas in Uganda, hunted eagles in western Mongolia, dog-sledded in Finland, and in New Guinea she roasted pigs with tribesmen adorned in penis gourds. She is going to India again in November.

“Climbing is hard work, and it’s cold.

But I love it,” said Holson, who also works hard at home to prepare for those adventures. “I go to the gym every day, and I go to boot camp (training) every Monday, Wednesday and Friday at 6 a.m. I’ve done that for 10 years,” said Holson. “I’m an outdoors person and fitness is my hobby.”

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A Gateway of Medical Care, continued from page 1 with a molecular science doctorate, and Shazia Bég, MD, board-certified in internal medicine and rheumatology.

Bég specializes in diseases of the joints, muscles and bones, including arthritis and lupus. The medical school anticipates adding dermatology and additional specialties soon.

UCF Health’s first location opened in 2011 at University and Quadrangle Boulevards, just two blocks from the primary UCF campus in Lake Nona. The University Boulevard location includes faculty physicians who are board certified in primary and specialty care, including internal and family medicine, cardiology, endocrinology, rheumatology, geriatrics, sports medicine and nephrology. Both UCF Health facilities care for patients ages 16 and up and accept most insurance plans.

The name change – from UCF Pegasus Health to UCF Health – is designed to bring increased clarity to the public eye as the medical school advances alliances across Central Florida and the state in medical education, research and patient care.

The name, German pointed out, is consistent with other state university health practices, such as UF (University of Florida) Health, USF (University of South Florida) Health and FIU (Florida International University) Health.

“We wanted a name that would be relevant to people across our community,” she said. “UCF Health says it all.”

The name change is fitting because

the UCF College of Medicine became reality after local business, political, medical and community leaders lobbied for a medical school in Orlando. The community partnership raised nearly $7 million to provide full scholarships to the medical school’s charter class.

Now, UCF College of Medicine has more than 2,000 volunteer and affiliated faculty throughout Central Florida who teach, mentor and provide clinical experiences for students. Upper class students receive clerkship training in 11 hospital and clinical locations in Orlando, and as far away as St. Augustine and St. Petersburg.

The medical school, said German, is striving to create more university residency programs with area hospitals, including its first residency in internal medicine in partnership with the Orlando VA Medical Center and OB/GYN through Osceola Regional Medical Center. The internal medicine residency begins its second year this summer and is designed to bring more primary care physicians to the Central Florida community.

With the name change, UCF Health will also include the college’s Regional Extension Center (REC), which has assisted nearly 3,000 community physicians in the selection, implementation and meaningful use of electronic health records. That conversion has helped local physicians earn nearly $40 million in federal incentives.

The REC recently signed an agreement to train all of Florida’s 67 county health de-

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partments on the use of electronic records to improve patient care and increase safety.

“Healthcare is a team sport,” German said. “That’s how we teach our students and how we want to provide care. We’re partnering with providers across our community to improve the well-being of all.

Because as UCF teachers, scientists and clinicians at America’s Partnership University™, we know we’re healthier when we work together.”

Since it opened nearly four years ago, the medical school’s first clinic has placed a strong emphasis on teamwork. Primary care physicians collaborate with their specialist colleagues on complex cases. Patients with multiple medical issues may see all of their doctors under one roof, including cardiac, kidney and diabetes specialists. The clinic offers educational programs such as therapeutic yoga for arthritis patients, caregiver support for seniors, and seminars on topics ranging from stress management to super foods.

“Our goal is to provide seamless care to our patients,” said Maria Cannarozzi,

MD, board-certified in internal medicine and medical director of the practice. “We teach together and practice together. We show the same teamwork to our patients that we show in Dr. Maria how we train UCF medi- Cannarozzi cal students – our community’s healthcare leaders of tomorrow.”

UCF Health’s second location, the Gateway Building, was built by Tavistock, the developers of Lake Nona Medical City.

UCF is leasing a portion of the building along with Florida Hospital, which is providing medical care and imaging at the same location. The two providers have worked together to develop a clinic that features one-stop shopping for primary and specialty care and makes it seamless for patients to see physicians from both locations.

Exodus from Private Practice, continued from page 1

and post-graduate medical education requires years of residency and fellowship training – a huge time and financial commitment in higher medical education that may not yield a return on investment.

Two solutions may help solve this dilemma: 1. Physicians need to be represented by a group that addresses the following non-medical issues: restrictions imposed by regulations, insurance plan interference with care, and unfair compensation that’s out of line with the commitment of medical education. The Association of Independent Doctors could represent these issues on behalf of physicians.

2. Physicians may accomplish the same goal by tapping into the already existing American Medical Association (AMA) via local, state, and national branches.

By having thousands of solo physicians as members, the shared discontent with heavy-handed regulations and dwindling fees may be expressed to garner a more favorable outcome.

Membership would demand expediting these pressing issues to the forefront of the legislative agenda in Washington, DC. This would redirect the AMA to deal with real obstacles facing local physicians.

By joining forces, a momentum would be created by the physician manpower in this country – and also capture attention at the local, state, and federal level.

By lobbying on Capitol Hill, physician voices may be heard in unison. The control over how to treat patients would shift from insurance plans back to providers, where it belongs. Payment should be proportionate with the medical service provided – not with what CMS or private insurance plans deem appropriate. The focus should shift from MU measures to a true and simple

meaningful healthcare relationship between two people: the physician and the patient.

Actions the AMA could take to grab the attention of the politicians in Washington, DC: Request that members collectively become non-participants in the Medicare/ Medicaid program. Certain specialties are already non-participants.

Call for members collectively to not accept Medicare HMOs or private insurance contracts unless the reimbursement is higher than 100 percent of the local geographic Medicare fee schedule.

Recommend implementing an administrative service fee for processing or obtaining authorizations on insurance claims, and also charging insurance plans a set fee for unnecessary denials that cost a practice time and money. This may stop the game of denials played by the insurance industry to avoid or delay reimbursement for services.

After all, at the heart of the matter is the physician-patient relationship. The patient and the provider may disagree with what the payer may deem quality care. The quality of care exists when the doctor provides safe and effective care for the patient, and the patient is satisfied with the care rendered by the doctor. It’s not quality care when the doctor cannot control when or how to treat a patient, or when the provider has to play by the payer’s rules to receive a payment on behalf of the patient.

Personalization and the professional relationship between a physician and patient is a quality that cannot always be captured by mandates.

J.B. Bitar, MD, FACC, and his wife, Susan Bitar, MSN, RN, practice at Cardiology Care Center in Lake Mary. orlandomedicalnews

.com

Practicing Medicine without Politics Volunteer physicians enjoy camaraderie at free clinics, made possible by state’s strong sovereign immunity law

By JULIE PARKER

Every Monday afternoon, retired Clearwater cardiologist Paul Kudelko, DO, FACC, heads to the Clearwater Free Clinic in Clearwater to volunteer with third-year residents from Nova Southeastern University near Fort Lauderdale. He’ll return on Thursday morning to see patients.

In Orlando, internal medicine specialist Doris Cameron, MD, spends eight hours a week volunteering at Shepherd’s Hope, and a half-day on Friday at Grace Medical Home.

Besides being motivated by the pure enjoyment of practicing medicine without the politics while also giving back to their local communities, both physicians say volunteering in the free clinic arena is only possible because of Florida’s strong sovereign immunity laws.

“Many physicians shy away from volunteering at free clinics because they don’t understand how sovereign immunity covers them completely,” said Cameron. “If physicians were better educated about how sovereign immunity works in Florida, more would volunteer. Until then, their concern about liability remains a signifi-

cant barrier.”

Cameron began volunteering in 2009, three years before Florida lawmakers strengthened the sovereign immunity law.

Initially, she volunteered at Shepherd’s Hope a few hours a week. The mother of three added Grace Medical Home to the rotation when it opened in 2010.

“I was so concerned about the liability that I kept my medical malpractice in-

surance for a year while I researched the state’s sovereign immunity law to see if it really worked,” she said. “After I looked into it and saw the law had held up to challenges, I relaxed.”

In Clearwater, Kudelko retired in 2010 and spent a year establishing a new lifestyle that included a couple of extended vacations with his wife, Debbie, and reading “more books in a year than my entire

lifetime,” he said.

“When you’re a physician, you read for educational purposes, which is important in the field of cardiology that changes so much,” said Kudelko.

But Kudelko yearned to return to the practice of medicine in some aspect. In December 2011, he joined the volunteer staff at Clearwater Free Clinic. When the sovereign immunity laws were improved in 2012, it gave him the peace of mind to add more hours.

“As a retired physician, I do what’s needed to maintain my license, which includes 50 hours of post-graduate or CME credits every two years,” he said. “That’s a financial responsibility of my own. If I wasn’t able to have sovereign immunity, I’d also have to pay quite high fees for medical malpractice insurance. It would be unfeasible to volunteer.”

Cameron had been in private practice for decades and was growing frustrated with the changes in the practice of medicine that were, she said, “getting in the way of practicing medicine.”

“I was given five or 10 minutes to see a (CONTINUED ON PAGE 6)

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Protecting Volunteer Physicians Florida’s Sovereign Immunity Law strongest in nation • Removing language that prohibits SIthe Clearwater Free Clinic in Clearwater, covered clinics from receiving state shared that 70 percent of the clinic’s 150 funds to pay for services. Presently, physician volunteers are retired from prifunds form the state appropriation may vate practice. not be used to help clinics employ or “They love medicine, and want to expand the hours of a paid healthcare give back and provide care,” she said. provider, which repeatedly has been “Unfortunately, many physicians don’t proven to augment volunteer provider know about Florida’s sovereign immunity recruitment and retention, and to enlaw or we’d have more volunteers!”

By JULIE PARKER hance overall volume, quality and conThat sentiment is echoed by Sheptinuity of care. herd’s Hope CEO Marni Stahlman in A vital piece of legislation that many • Amending the law to clarify that emOrlando, whose free clinic network allows physicians remain unaware of makes it ployed and volunteer healthcare propatients to see doctors in a private practice easier for them to volunteer at the state’s viders practicing in SI-covered clinics setting with the agreement that patients free and charitable clinics: Florida’s robust will be granted sovereign immunity. will not be charged for a clinic visit. sovereign immunity (SI) law, considered This change would simply codify Flor“It’s a way for them to participate the strongest of its kind in the nation. ida’s Department of Health policy and with us without leaving their office, which “When physicians practice and volpractice. is sometimes very difficult,” said Stahlman. unteer in our free and charitable clinics, • Amending the law to permit SI-covered In 2012, state lawmakers updated they get to practice the pure art of mediclinics to charge patients a nominal fee, Florida’s SI law, initially enacted in cine,” said Mark Cruise, executive direcnot exceed $10, for administrative costs, 1992, to protect licensed medical providtor of the St. Petersburg-based Florida if necessary. This change would bring ers through the Volunteer Healthcare Association of Free and Charitable Clinthe law up to date with the continuing Provider Program under Florida’s Deics (FAFCC). development of the free and charitable partment of Health (Florida S.S. 766.28 “They don’t have to worry about clinic sector in Florida.

Sovereign Immunity Law). medical malpractice,” said Cruise.

At press time, two identical bills with Any licensed medical provider, while “There’s no insurance billing. They get to proposed changes were moving through practicing within the scope of their license spend as much time as they need with paboth chambers: Senate Bill 1146, introduced at a free clinic in Florida, is granted extients. Also, they get to see other colleagues by Sen. David Simmons (R-Altamonte tended SI as long as the patient is living in the community who are volunteering Springs), had moved to the judiciary comat or below 200 percent of the federal with them and share this rewarding expemittee, and House Bill 965, introduced by poverty level and is not insured.

The law rience outside their daily practice lives.”

Rep. Fred Costello (R–Port Orange ), had also applies to private medical practices, Cruise said the state’s 100-plus free been referred to the Health Quality Suband charitable clinics, the most of any committee; Appropriations Committee; state in the nation, are operating in part Health and Human Services Committee. because of the strength of the SI law. It’s “We’re optimistic that we can get this also a contributing factor to the opening of passed,” said Cruise. six new free and charitable clinics anticicontinued from page 5 Retired doctors represent a growpated in 2015. ing segment of the physician population Stephanie Garris, JD, executive dipatient. I had to be careful about referrals,” volunteering at free and charitable clinrector of Grace Medical Home in Orshe said. “When I volunteer, it’s pretty Group Benefits ics.

In fact, nearly 15 percent of Florida’s lando and chair of FAFCC’s Public Policy much my time. We don’t have a lot of spelicensed physicians plan to retire in the Committee, spends a significant amount cialists, so I can use the knowledge I have to next five years.

Their ability to serve paof time monitoring legislative and regula-Life & Disability Insurance treat the whole patient. I love doing that.” tients who will continue to fall through the tory issues, including keeping a keen eye Recently, Cameron diagnosed a male cracks is vital as the physician workforce on potential changes to the SI law. Investments & Asset Protection patient with ALS. He had been to the continues to decline.

“Physicians typically “That law makes it possible for us emergency room several times, didn’t have don’t retire well,” noted Garris. “These to recruit and retain physicians as volun- Retirement Preparation access to routine medical care, and his brilliant doctors want to serve.

The soverteers,” she said. “It’s vital to our sector.” symptoms had grown progressively worse. eign immunity law gives them freedom to FAFCC’s policy agenda for the 2015 Tax Strategies “Basically, nobody was able to diagdo so without having to purchase medical legislative session includes three changes nose him,” she said. “It was a bad diagnosis malpractice policies.” to the SI law: to give, but it was necessary for him to have Jeannie Shapiro, executive director of an answer and find ways to improve the quality of his life.”

Kudelko also sees patients with symptoms he normally doesn’t find in cardiology work, and appreciates the teamwork environment at the free clinic.

“I like the challenge and the fact that we help each other a lot,” he said. “HavIt won’t hurt, I promise. ing politics as an eliminated part of the equation makes a substantial difference.

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where licensed medical providers often see qualifying patients voluntarily and at no charge.

As a precaution, if a volunteer physician sees an existing patient who is determined to be ineligible for SI – for example, having new insurance or being over-income – the physician would have 30 days of extended SI. If a volunteer physician is affiliated with a Professional Association (PA) practice, the Florida Department of Health recommends establishing a SI contract to protect the corporation.

Under the SI program, if a patient served by a volunteer healthcare provider under contract files a lawsuit, the patient may only file it against the state, not the individual provider. In that case, the Department of Insurance will provide legal services, and if the court decides the patient suffered damages as a result, the patient may be awarded damages up to $100,000, paid by the state.

“In the 18 years we’ve been operating, nobody has had a challenge,” said Stahlman. “Shepherd’s Hope and other free and charitable clinics are in need of additional volunteer health professionals and it’s important for those considering it to realize this protection benefit.”

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Kudelko, a board member of the Clearwater Free Clinic since 2012, was surprised to learn that 70 percent of patients at the free clinic hold a job but don’t qualify for medical care.

“It seemed the intent of the Affordable Care Act was to close the gap, but instead it’s widened the cracks,” he said. “The patient population is very appreciative that someone’s there to help.”

Kudelko was familiar with the Clearwater Free Clinic when he was in private practice. He was also in charge of the internal medicine residency program at Suncoast Hospital, now Largo Medical Center in Largo.

“At that time, we used the free clinic for outpatient training of our residents,” he explained. “Then the hospital developed its own outpatient clinic and our residents no longer went to the free clinic, unfortunately. But for quite a few years when we were involved, I was there once a week reviewing charts.”

Returning to the free clinic in a volunteer capacity to mentor residents “is such a pleasure,” said Kudelko.

“Even though it’s a learning experience for these young people coming up as I mentor them, they give back to me in more ways than they could imagine,” he said. “The sovereign immunity law makes it all possible.” orlandomedicalnews

.com

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Youth Baseball Throwing Injuries

By RANDY S. SCHWARTZBERG, MD

An increasing number of shoulder and elbow injuries have been seen in youth baseball pitchers for the past several decades. These young athletes are at particular risk because of their developing bones, muscles, tendons, ligaments and open growth plates.

Some of the more serious injuries include growth plate (physeal) fractures that may require surgery and elbow ulnar collateral ligament injuries that may require reconstructive surgery (the Tommy John procedure).

Several culprits have been implicated for these injuries in youth pitchers including pitching mechanics, pitching quantity and pitch types.

RECOMMENDED PITCH LIMITS. AGES DAILY WEEKLY

9-10 50 11-12 75 13-14 75 15-16 95

75 100 125 N/A

RECOMMENDED PITCH LIMITS. AGES

SEASON YEAR

9-10 1,000 2,000 11-12 1,000 3,000 13-14 1,000 3,000

RECOMMENDED REST DAYS BASED ON PITCHING AMOUNTS. # OF PITCHES

REST OF DAYS

1-20 0 21-35 1 36-50 2 51-65 3 66+ 4

RECOMMENDED REST DAYS BASED ON PITCHING AMOUNTS. # OF PITCHES

REST OF DAYS

1-30 0 31-45 1 46-60 2 61-75 3 76+ 4

orlandomedicalnews

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What Causes Injuries in Youth Baseball Players?

Although there exists a variety of pitching motions, core principles have been identified that are considered proper.

Biomechanical studies have identified a handful of common mistakes in the pitching motion that increase stresses seen by the elbow and shoulder. Such increased stresses may increase the risk of injury.

Common examples of common pitching motion mistakes include not having the throwing elbow at its maximum height by the time of stride foot contact and the lead shoulder being in an open position at the time of stride foot contact. It is advisable for young pitchers to learn proper pitching skills at an early age to minimize risks of injury due to improper pitching mechanics.

Although pitching mechanics are important, the greatest reason for shoulder and elbow problems in youth pitchers is overuse. Pitching amounts have been examined in a handful of studies published in the sports medicine literature.

It is clear that young pitchers who throw greater than specified amounts are at a significantly greater risk of injury. Discreet recommendations have been garnered to minimize injury risk.

Tracking the amount of pitches that young players throw is the cornerstone of overuse prevention. Traditional attempts have revolved around placing limits on numbers of innings pitched. This is a flawed method because the number of pitches thrown can vary substantially in any given inning. Based on valuable research performed at American Sports Medicine Institute in Birmingham, Alabama, pitching limits for various ages have been developed. In fact, Little League Baseball has adopted these pitching limits.

Since the stresses of pitching on the shoulder and elbow are cumulative, pitch limits have been developed on a daily, weekly, season and yearly basis. It is recommended that such pitching limits be adhered to for youth pitchers. The recommended pitch limits are outlined in Tables 1 and 2. Recommended rest days based on pitching amounts are outlined in Table 3 and 4.

Do Pitch Types Matter?

A more controversial area in youth pitching revolves around pitch types.

Specifically, the curveball has been implicated for decades as a causative factor for injury in the young throwing athlete.

Recommendations by coaches, parents and physicians have often been to avoid throwing curveballs until puberty.

Interestingly, biomechanical research does not support this concern. In biomechanical studies of young pitchers, it has been demonstrated that fastballs place greater stresses on the elbow and shoulder than curveballs. Further, changeups place lower stresses on the elbow and

Youth baseball pitchers are at particular risk for injury because of their developing bones, muscles, tendons, ligaments and open growth plates.

shoulder than fastballs and curveballs.

However, it is likely that young pitchers lack the neuromuscular development and mechanics to throw curveballs properly.

When youth pitchers have multiple pitches, it is likely that they will practice pitching more to become accomplished with their expanded repertoire of pitches.

This increase in pitching quantity would be great concern for overuse injuries; thus, it is recommended that young pitchers delay throwing curveballs and other breaking pitches until the ages of 13 and 14.

Other research-based recommendations to minimize injury risk to youth pitchers have been noted. It is recommended that youth pitchers not play catcher due to the increased volume of throws that would be made at the position.

It is also recommended that youth baseball players not pitch on multiple teams with overlapping seasons. Additional recommendations include not throwing for three months each year and not continuing to pitch when they experience elbow

To learn more about these injuries and to view our full infographic on youth baseball pitching injuries, visit OrlandoOrtho.com

or shoulder pain. Arm pain while pitching should be evaluated by physicians who specialize in sports medicine.

It is hoped that adhering to these principles will optimize injury prevention in the vulnerable arms of the physically developing youth baseball pitchers.

Dr. Schwartzberg of Orlando Orthopaedic Center is a member of the American Academy of Orthopaedic Surgeons, the American Orthopaedic Society for Sports Medicine, the Arthroscopy Association of North America, the National Athletic Trainers’ Association and the Athletic Trainers’ Association of Florida. He is board certified in orthopaedic surgery and sports medicine.

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What Does UnitedHealth’s Latest Move on Hysterectomies Mean?

Nation’s largest health insurer stiffens rules on hysterectomy coverage

By JULIE PARKER

UnitedHealth Group, the nation’s biggest player in the health insurance market, recently announced a policy change to narrow the rules on hysterectomy coverage.

Even though the insurer’s plan to impose tighter restrictions on the use of the morcellator has garnered the most attention – many hospitals ceased using the laparoscopic surgical device after the FDA reported in April 2014 the fastspinning blade can actually spread uterine sarcoma in some women undergoing hysterectomies – the squeeze is also being felt on the performance of hysterectomies in general.

UnitedHealth (NYSE: UNH), the insurer of 40 million patients based in Minneapolis, Minn., now requires specific authorization before most types of hysterectomies are performed. Only vaginal hysterectomies – the least invasive and inexpensive option – done on an outpatient basis are exempt. The policy doesn’t affect hysterectomies performed in cancer treatment. Approximately half a million hysterectomies are performed annually in the United States.

Before UnitedHealth announced its policy decision, Anthem was the only

major commercial insurer requiring preauthorization for hysterectomies. Cigna and Aetna haven’t indicated they will follow suit. An Aetna spokesperson said the decision is “best left up to the physician and patient based on clinical circumstances,” a position also adopted by the American College of Obstetricians and Gynecologists (ACOG).

Days after UnitedHealth’s announcement, ACOG members buzzed about the issue at an ACOG national leadership conference.

“It’s been good fodder for discussion, though we’re taking it very seriously,” said Ravi Johar, MD, an OB/GYN from St. Louis, Mo., past president of the St. Louis Metropolitan Medical Society. “For UnitedHealth to reverse course, no one knows exactly what it means.”

Johar, council chair of the Missouri State Medical Association, said OB/GYNs are certainly accustomed to the pre-certification process.

“We’ll do what we’ve always done,” he said. “We’ll discuss with patients all of the options and go from there. The decision is between the patient and physician. My job is to provide the best medical care possible.

How that affects them financially is a big impact, but it’s not my area of expertise.”

UnitedHealth is a good weathervane in

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the post Affordable Care Act era, with its combination of market power, community support, and access to exceptional data, said Jay Wolfson, DrPH, JD, Distinguished Professor of Public Health, Dr. Jay Medicine and Pharmacy Wolfson at the University of South Florida (USF) Morsani College of Medicine.

“In this case in particular, it’s important to recognize that UnitedHealth, over the past couple of years, has been the most aggressive of the health insurers in tightening up their markets,” he said. “They began eliminating a lot of physicians and hospitals from their panels in many communities.”

For example, said Wolfson, cancer and children’s hospitals were removed from UnitedHealth’s list of risk providers, based on the argument of cost being significantly higher at those healthcare facilities than others.

“Procedures in hospitals like MD Anderson, Sloan Kettering and Moffitt may cost 50 percent more than non-specialty, community facilities,” he said. “That’s to be expected because they’re teaching hospitals.”

Wolfson also pointed out that United-

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Health acquired Optum, a healthcare technology firm established in 2010, which he considers one of the “best staffed analytic division of third parties.”

“Optum focuses on quality, outcome and cost-effective analyses of United’s (and other available) databases” said Wolfson.

“Their research translates into what, to whom and how much United will pay.”

That influence has infiltrated the healthcare industry in many ways. In January 2013, while outsourcing work with Optum before bringing the firm in-house, UnitedHealth Group’s Center for Health Reform and Modernization proposed the use of predictive modeling software, particularly in Medicare and Medicaid programs, as tools for care management and information security as a possible solution to both healthcare fraud and preventable hospitalizations.

“As part of the ACA, they’ll continue to drill down and drive down costs and utilization and attempt to be as directive as they can to their patients, physicians, hospitals … to optimize cost, utilization and safety while also reducing liability,” said Wolfson.

Some hospital systems are adopting a tough stance against UnitedHealth’s culling process and policy changes they view as unfavorable.

“Three years ago, BayCare (Health System, Tampa Bay’s dominant non-profit hospital chain), went up against UnitedHealth over reimbursement issues,” noted Wolfson. “Unlike most standoffs, there was no last minute negotiation and 450,000 members in Tampa Bay had to change hospitals and physicians because BayCare stood its ground against this healthcare delivery powerhouse.”

Wolfson also sees a trend of separate policy issues, in part led by UnitedHealth, that are shaking up the medical device manufacturing industry and the pharmaceutical sector.

“Until recently, pharmaceutical companies have had a tremendous influence in medical schools and communities concerning what medications physicians prescribe,” he said. “Now some medical schools across the country like ours have gone ‘drug-free’ and no longer allow pharmaceutical reps to teach in our classrooms or offer ‘educational’ program lunches.”

The same cycle holds true for manufacturers of medical devices, Wolfson said.

“The device manufacturing industry has also heavily affected medical practice,” he said. “Their significant influence is waning.”

In response to UnitedHealth’s policy change on hysterectomies, medical schools will place a stronger emphasis on technical skills to perform vaginal hysterectomies.

“We’ve developed a generation of surgeons who don’t know how to do vaginal (CONTINUED ON PAGE 12)

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Stock Market Jitters?

It may be time to take some profits

By SCOTT L. OLSON

With U.S. stock markets not far from record highs, it’s not surprising to hear that most analysts, economists, and investors are increasingly bullish about the stock market. After all, weren’t most TV financial gurus bullish all the way up to the last two devastating market crashes? If you listened to them you may have lost a small (or large) fortune? If we get our news from television, think back; were there any guru’s suggesting to sell stocks before the crashes of 2000 and 2007? Of course not.

Many of them make their money by getting you to invest in their funds so they are always bullish. They don’t preach against the trend and suggest taking profits, because it’s just not popular. They want you to forget what you lost in the last crashes.

In the investment world we have Bulls, Bears and Pigs. The pigs usually get slaughtered. Which one are you? How much did you lose in the Crash of 2000, then again in the Crash in 2007?

Many investors investment philosophy is usually not scientific, they are driven by fear and greed.

We meet with investors every day who are heavily invested in the stock markets and scared to death of losing.

Their approach is “Buy and Hope.” They are certain we will have another market collapse like in 2000 then again 2007, but they don’t know what to do. They don’t want to sell their stocks and funds because of greed. They want to make more, but they are afraid of losing 50 percent or 70 percent, or more – again.

Many don’t know what to do and are frozen in fear and indecision. They are afraid to stay in the markets, but too greedy to get out. Many investors don’t realize there are alternatives – investments which do not correlate (move with) the stock markets, bond markets or interest rates. Alternatives offer diversification not available with stocks, bonds and funds.

Do you remember the Crash of 2000 (3-24-2000 to 10-9-2002)? The stocks we called “Dot-Com” became Dot-Gone.

Hundreds of Dot.com stocks disappeared.

The S&P 500 lost almost 50 percent. If you owned GM you lost every dime you invested. Somehow, the new GM (Government Motors) still has all your assets, but the new stock was given to political donors (Unions) and you got nothing. Even the largest, and most widely held stocks, like Cisco, lost 88 percent, Intel lost 81 percent, Microsoft lost 61 percent and the world’s largest company, GE lost 59 percent.

None of these stocks got back to “even” from the Crash of 2000 when it happened again. In the Crash, or economic collapse of 2007 (10-9-2007 to 3-9-2009) Cisco lost 59 percent, Intel lost 51 percent, Microsoft lost 50 percent and the world’s largest company, GE lost 82 percent, 40 percent worse than in the Crash of 2000.

orlandomedicalnews

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Do you remember the gut-wrenching feeling when the world’s largest stock market, the S&P 500 plunged 57 percent in the Crash of 2007? How much of your portfolio did you lose?

Many investor we have met with own stocks and funds that dropped, plunged 50 percent to 70 percent, or more, in the last crash.

Since the stock market peak (3/24/2000), how well have the largest and most widely held stocks done? As of January 16, 2015 Cisco is still down 65 percent, Intel is down 48 percent, Microsoft is down 17 percent, and the largest market cap company in the world in 2000, GE, is still down 56 percent. Let’s not forget WorldCom and Enron, which along with GM no longer exist.

Many investors pulled out during the crash at, or near the bottom - afraid to ever get back in the markets. They missed out on one of the biggest rallies of all time, about a 205 percent rally. After the S&P 500 losing 57 percent in the Crash of 2007 the first 232 percent increase was a recovery – not a rally. Too many investors forget to “Buy Low – Sell High.”

S&P 500 Growth Not Great?

Most investors are surprised to learn that the S&P 500 has only grown a total of 34.8 percent since its high of March 24, 2000. The S&P 500 has only grown 4.3 percent annually over the past 15 years (with dividends,).

Are you doing anything different this time? Probably not.

The definition of “crazy” is doing the same thing over and over again, expecting different results.

It is important to periodically have an in-depth Portfolio Review and Risk Analysis.

Most portfolios we review contain 97 to 99 percent stocks and equity funds. Many are much riskier than the S&P 500, even while underperforming the index. Many investors had not realized they were far out-of-balance from their Risk Profile so we suggested some rebalancing.

Expanding Economy?

Oil and copper show a contracting, not expanding U.S. economy. We can see that oil and copper move lock-step with the S&P 500 stock market index – until now. Oil and copper, two major measures of growth have headed sharply down, while somehow the stock markets have been pushed higher. Can this happen?

(CONTINUED ON PAGE 12)

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UnitedHealth’s Latest Move, continued from page 10

surgery, quite frankly,” said Neil Finkler, MD, an OB/GYN in Orlando and CMO at Florida Hospital Orlando.

“So many physicians stopped using vaginal hysterectomies and it’s not being taught very much,” Wolfson added. “Our younger medical students don’t have the skills. It’s easier to use a device, which generates more revenue and becomes a standard.

Most clinicians interviewed say it’s safer, less complications, but it’s not done because it’s just not being done. That’ll change.”

Stock Market Jitters, continued from page 11

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APRIL 2015

Not too likely.

How can we protect our profits (this time)? We suggest diversifying. While diversification alone is no guarantee of future performance, doing the same thing we did in the last two crashes is likely to offer substantial losses, just like the last crashes.

One option is investments which guarantee your income for life (regardless of the stock markets, interest rates, etc), and guarantee to increase in your future income, which then locks-in a minimum income for life (which can ratchet higher).

They may also lock-in a guaranteed death benefit for your family, and this death benefit may also ratchet higher with investment performance. These are, of course, annuities. Only annuities offer guaranteed income for life and guaranteed death benefits, which are backed 100 percent by the issuing companies.

Then there are alternative investments which do not “correlate” or fluctuate with the stock markets, bond markets, or interest rates. Alternative investments are used in the “endowment” style investment model popularized by Yale and Harvard. These endowments use non-traditional, non-correlated, and many times non-liquid assets to protect their endowment when stock markets fall.

This information is for educational purposes only and NOT an offer to sell any security or insurance product and is NOT an endorsement of any specific Alternative Asset.

Securities offered through Financial West Group (FWG) - member FINRA/SIPC. Atlantic Financial Advisors, LLC, Registered Investment Advisor not FWG affiliated.

Scott L. Olson is president of Atlantic Financial Advisors, LLC, and is a Registered Investment Advisor. With 36 years’ experience in Financial and Estate-Planning, Wealth Preservation and Wealth Transfer, Scott has been a popular speaker across the U.S. to groups of Attorneys, CPAs, Financial and Estate Planning professionals. He provides Continuing Education courses to Attorneys, and CPAs. Scott’s expertise includes, not just Roth-Conversion, but tax-free, or “Substantially Discounted Roth-Conversion©” and the Annuity Arbitrage, a tax-favored income and estate-tax free wealth transfer technique. He can be reached at scott@atlanticfinancialadvisors.com

orlandomedicalnews

.com

Team Web Design: More Bang for Your Buck

By KRISTEN SCOTT

Think hard about your practice’s web site. Is it performing well, or have you experienced a slump in your business, and your bottom line? Consider the following questions: • Is your website not HIPAA compliant?

• Was it designed before 2013?

• Does it not respond to, and function on, all devices and browsers correctly?

• Do you rank after the first page on Google search?

If you have answered yes to any of these questions, it’s past time your website was redesigned. Your website is an important asset in today’s economy, but the technology has never been so confusing. So many businesses know that they need an update, but end up settling for new layouts of websites built with the same level of technology. Like a brick and mortar facility, it requires maintenance and care. Taking your practice to the next level today means carefully scouting out a web design company and doing your research. One of the largest considerations for most practices is the price, but that should not be your deciding factor. Remember, just as in the medical field, you often get what you pay for.

If you are considering making the leap onto the Internet, the price tag can be daunting, and the services offered confusing. We all know a presence on the internet is a valuable asset and an investment so careful consideration is required.

Where should you start? Here are some quick tips on how to choose your future web design company: Staffing Every office is staffed by individuals with different specialties – you have an office manager, your MD, your PA, nurses and assistants… all with specialized tasks, all carefully chosen to work well together. No one person can be a specialist in everything, so only consider purchasing from a company who has a team at your disposal. The right company for you will include specialists in graphic design, coding, content development and SEO (search engine optimization).

If you want your website to attract your customers, you need to make sure that your site is both informational and inviting. A web design team can handle multiple angles at once, while providing personalized experience. This will lead to a better web experience for not only you, but your current and prospective patients as well.

Portfolio Medical websites have very unique design and security requirements, so the right web design company for you will not only have a strong portfolio in the medical field, but also the knowledge to assist you with finding the right server for your HIPAA compliance needs. Take the time to look through their portfolio for designs that appeal to you, as well as testing a sampling of their websites to ensure that they are able to be navigated on all devices. I know your time is at a premium so orlandomedicalnews

.com

the easiest way to do this is to shrink the browser window size on your computer to see how the website responds to change.

A website that adapts to your window size (without shrinking to an unreadable font size) is called a responsive website, and these are typically preferred by users to the extremely ‘simple’ mobile websites of the early 21st century. Having a website that is completely responsive on all devices and browsers means that you won’t miss out on prospective clients simply because they aren’t on a desktop computer.

SEO The medical field is highly competitive - so it is important that your potential web design firm operates up to Google’s standard. All the SEO work in the world may not be able to make up for a poorly designed website. In the long run, spending a little more up front may save you thousands. When asking for a proposal from a firm, make certain to have them outline what is included as a part of their SEO work and don’t forget to ask if it includes content development by a professional copywriter. This is an extremely crucial part of the process as (in Google’s world) content is king and over 90 percent

of search engine traffic never goes past the first page on Google search.

Company policies Regardless of your practice’s beliefs, it is always important to place high value on integrity and the honesty of the vendors you wish to contract. Look for a company that willingly provides references in your field, has a history of standing behind their work, and is always easy to reach. If it takes you weeks to get in touch with someone for a proposal, then odds are good it will not be any easier to reach them when you have made a payment. Oftentimes, it

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is worth paying a little extra for a company that fulfills these requirements, and if you take the time to contact the companies they provide as references, you will often be able to find out the truth about a company’s work. Ask not only about their attitude and the experience, but whether the price changed after the work started, if the site was completed on time, and if they have ever had issues with reaching the company. This will help ensure a great (and timely) web design experience for your practice.

Just as I spent time researching doctors and reading reviews when I needed knee surgery, you need to do the same for your website. In the end, you need to weigh the benefits against the cost, and often that means paying a little extra for the best you can find.

You have 5-7 seconds to make that first impression online and impress your prospective clients… So take a good look at your current website and ask yourself Have you?

Kristen Scott is Google & Inbound Certified and works as a Strategy Consultant with the highly creative marketing & web design firm Designzillas.

She is a specialist in marketing needs for the medical professional and excels in helping businesses interact with their customers. She can be reached at kristen@ designzillas.com

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Protect Seniors from Financial Abuse sures. Suggest to your parents that they take several common-sense steps to avoid financial scams. For example, urge them to never give personal information over the phone or in response to emails.

Since these types of requests are the most common methods used to perpetrate scams, encourage your parents to put all such solicitations – as well as requests for money – in the “trash” folder. Also, ask your parents to remove paper mail promptly from their mailbox – resourceful identity thieves have been known to steal mail and extract key pieces of personal information from financial statements or correspondence from Social Security. And if your parents don’t already have a paper shredder, present one to them as a gift – and show them how to use it to delete old statements, credit card offers and similar documents.

• Check for legal documents. Your parents, like everyone, should have a will and a durable power of attorney. These documents will enable someone they trust implicitly to handle their finances if they can’t. Discussing these types of issues with your parents may not be easy – but it’s certainly important.

• Review parents’ situation regularly.

Many parents are not comfortable

By JAMES FAUST

It’s unfortunate but true: The elderly population is targeted for financial abuse or exploitation. In fact, by some estimates, this type of targeted abuse results in billions of dollars in losses each year. If you have elderly parents, what signs should you watch for to determine their vulnerability? And what can you do to help protect your parents from being victimized?

In regard to the first question – signs of vulnerability – the most important thing to watch for is your parents’ mental state. As you know, many people go through their entire lives with their faculties intact – but even if this is the case with your parents, you still may want to be on guard against them falling prey to unscrupulous operators. And if you have noticed your parents becoming forgetful, confused, overly agitated or showing any other signs of possibly diminished mental capacity, you may want to be particularly vigilant for the appearance of financial irregularities.

If you don’t think your parents are, as yet, victims of fraud or abuse, you can take steps to help protect them. Most importantly, maintain constant communication with them and be aware of what’s going on in their lives.

Also, consider the following actions: • Advise parents on precautionary mea-

sharing the specifics of their financial situation with their adult children. Yet, as much as you can, try to periodically review your parents’ insurance, banking and investment statements. These meetings give you good opportunities to look for irregularities or suspicious activities, such as significant changes in their spending patterns, unusual cash withdrawals or transfers from their bank accounts, or sudden transfers of assets to a relative or someone outside the family.

• Know the professionals. Your parents may not be totally at ease involving you with their financial and tax advisors.

However, using your discretion, see if you can accompany your parents when they meet with their advisors. If these people are legitimate professionals, they will not object to your interest in your parents’ affairs — in fact, they should welcome it.

• Your parents have done a lot for you.

You can help repay them by doing your part to help protect them from threats to their financial security.

James M Faust is a financial advisor with Edward Jones. He is a graduate of the University of Florida, and holds a bachelor’s degree in business administration with a focus on marketing and a minor in economics.

He can be reached at the Edward Jones Curry Ford Rd. location.

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GrandRounds John Millwater Jr. Passes John Mangum Millwater Jr., husband of 45 years to Carol Bishoff Millwater, executive director of the Lake Sumter Medical Society in Tavares, died March 1. He was 64. Of his many accomplishments, Millwater was honored with the Jerry Mauldin Humanitarian Award for his philanthropic role in the growth and development of a youth ministry program at First United Methodist Church in Houma, La., when he worked for Entergy Corporation in the nuclear engineering field. In his immediate family, in addition to his wife, Carol, Millwater is also survived by his son, John Millwater, and daughter, Karen Dawn Millwater McGowan, their spouses, and four granddaughters. The family has requested donations to We Care of Lake County, a nonprofit organization established by Lake Sumter Medical Society in 1994 to provide case management services via volunteer specialty physicians for the community’s uninsured population.

UF Health Cancer Center – Orlando Health Receives 2015 Women’s Choice Award UF Health Cancer Center – Orlando Health earns the 2015 Women’s Choice Award as one of America’s Best Breast Centers, acknowledging its dedication to providing exceptional patient care and treatment. Breast cancer is the second most common form of cancer among American women according to the American Cancer Society, and one in eight women in the U.S. will develop invasive breast cancer during their lifetime.

By carrying the evidence-based designation of the Women’s Choice Award seal, UF Health Cancer Center – Orlando Health has signified its commitment to a global mission to elevate the patient

experience for women and all patients as one of more than 315 America’s Best Breast Centers.

UF Health Cancer Center – Orlando Health earned the award by having met the National Accreditation Program for Breast Centers (NAPBC) standards from the American College of Surgeons. The NAPBC is a consortium of national, professional organizations focused on breast health and dedicated to the improvement of quality care and outcomes of patients with diseases of the breast through evidence-based standards and patient and professional education. As one of America’s Best Breast Centers, UF Health Can-

cer Center – Orlando Health also carries the Seal of the American College of Radiologists as a Breast Imaging Center of Excellence, and scored above-average on the Centers for Medicare and Medicaid Services patient satisfaction measures.

The Women’s Choice Award helps women and their families by providing recommendations they can trust and use when making healthcare choices.

As the collective voice of female consumers, the Women’s Choice Award provides women with recommendations from other women that they can rely upon.

has been named the new Chief Executive Officer effective April 1, 2014.

Burish comes with nearly a decade of healthcare management experience, most recently serving as chief executive officer of Shands Starke Regional Medical Center in Starke, Fla. During his tenure, the hospital provided high quality care as demonstrated by recognition from the Joint Commission as a Top Performer on Key Quality Measures based on Core Measure outcomes. He oversaw renovations to the Med/Surg floor and pharmacy, expanded surgical services, and successfully recruited specialty physicians to the community, including establishing fulltime Cardiology in collaboration with UF Health.

Burish previously served as Chief Operating Officer at Heart of Florida Regional Medical Center in Haines City, Fla. and Chief Operating Officer at Barrow Regional Medical Center in Winder, Ga. Active in the community, Burish served on the Boards of CareerSource North Florida, Haines City Economic Development Council and Barrow County Family Connections/Communities in Schools as well as participating membership in Rotary and Kiwanis. He holds a Master of Busi-

ness Administration and a Bachelor of Science in Biological Science from University of Notre Dame.

institutions and their students.

CORcare helps healthcare profes­sionals consider all possible conditions associated with any single or combination of clinical features for rapid assistance in differential diagnosis and narrowing down to the final diagnosis. CORcare is the first system to embed ACCF/AHA Guidelines specific to data points within each condition, providing instant graded opinions of leading authorities. This fea­ture fully supports and uses the “Guide­line Directed Medical Therapy (GDMT)” initiative of the AHA and ACC. Also based on ACCF/AHA Guidelines, CORcare provides order sets for many of the common conditions, a feature proven to reduce physician ordering time by up to 50 percent. After diagnoses and manage­ ment strategies are in place, CORcare pro­ vides a secure platform for patient followup – called MyCOR™ – which includes tools to improve medication adherence and other telemedicine functions.

Details available at www.cormedtec.com

UFHCC Named Cancer Center of Excellence Gov. Rick Scott and the Florida Department of Health have recognized the University of Florida Health Cancer Center, with locations in Gainesville and Orlando, as a state-designated Cancer Center of Excellence.

The designation by the Florida Legislature recognizes hospitals and treatment centers that demonstrate excellence in patient-centered coordinated care for people undergoing cancer treatment and chemotherapy. The hope is that the designation will encourage excellence in cancer care, attract and retain the best cancer care providers in the state and help Florida be recognized nationally as a preferred destination for quality cancer care, according to the Department of Health website.

The Department of Health based the designation on a “systems approach” to improving the quality of cancer care, focused on three areas: the health care organization, the health care team members and patients and family members.

UF Health and Orlando Health launched a joint oncology program early last year.

The joint program has resulted in one of the state’s largest, most comprehensive cancer programs, staffed by some of the nation’s top oncology experts. With facilities throughout central Florida, the physicians and staff at the UF Health Cancer Center serve more than 10,000 new cancer patients annually.

By combining the knowledge, experience and expertise at both organizations, the UF Health Cancer Center at Orlando Health offers patients expanded clinical care and treatment options provided by highly subspecialized physicians, oncologists, surgeons and staff who collaborate to provide comprehensive interdisciplinary care. The approach also benefits patients with expanded access to additional UF Health experts, new drugs, clinical trials and shared resources.

St. Cloud Regional Medical Center Names New Chief Executive Officer St. Cloud Regional Medical Center (SCRMC) has announced that Brent Burish orlandomedicalnews

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System Launched to Improve Cardiovascular Outcomes

COR Medical Technologies (COR) has introduced CORcare™, a comprehensive instant outcome support system for rapid and accurate diagnosis, treatment, and follow-up management of patients with acute and chronic, common and rare dis­ eases involving the cardiovascular system.

It was developed by Vincent Friedewald, M.D., F.A.C.C., with the support of an internationally-acclaimed Senior Editorial Board. COR is a vast, one-of-a-kind rela­ tional database comprising thousands of signs and symptoms, imaging findings, laboratory abnormalities, electrocardio­ graphic results, body area networking (BAN) measures, and genomics, as well as drugs and devices used for treatment.

CORcare is available to healthcare professionals on a variety of technology platforms including mobile devices. Tar­geted users of CORcare include physi­ cians, emergency medical technicians, nurse practitioners, physician assistants, nurses, physician groups, hospitals, and academic

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