Tampa Bay Medical News January 2013

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PHYSICIAN SPOTLIGHT PAGE 3

John A. Ferlita, MD ON ROUNDS

Pivotal 2012 Sets Stage for Promising 2013 at USF

The challenge is to move from implementation to sustainability

By JEFF WEBB

ManagingRisks The Art of Mediation – Part 3

Let the negotiations begin! ... 9

Finding Wellness: This Editor’s Journey After 25 years of writing about healthcare issues, with only caesarian sections, a 1995 laparoscopic hysterectomy, and occasional sinus challenges on my medical chart, my health took a nosedive last summer ... 4

TAMPA - For Stephen Klasko, the greatest accomplishments of 2012 also have created the greatest challenges for 2013.

“The challenge for 2013 is to make all the things we implemented in 2012 work,” said Klasko, CEO of USF Health and Dean of the Morsani College of Medicine at the University of South Florida.

“Last year was a year we will never be able to replicate. When we look at what we were able to do, it was an amazing year for a state medical school during the worst state

funding crisis we’ve ever had,” he said, noting that state funding to the USF College of Medicine has dropped 46 percent since he came on board in 2004.

Klasko said USF President Judy Genshaft and the board of trustees guided him and his leadership team “in the right direction, creating the framework for success, and allowed us to take calculated risks toward a much greater reward.”

What resulted was “what we now call USF 3.0,” Klasko said.

“That means we want to be where tomorrow’s healthcare happens today. We want Tampa Bay to be a national leader in that regard.”

Klasko cited several initiatives, most started years earlier, that came to fruition in (CONTINUED ON PAGE 8)

Details of BayCare and SMH Alliance Slowly Emerging

By MARK WEISENMILLER

The coming year should mark the start of a new coalition between BayCare, of the Tampa Bay area, and Sarasota Memorial Hospital (SMH).

For months, negotiators for BayCare and SMH have been trying to hammer out details for the alliance – not to be confused as a merger. Ellen Simon, senior communications editor with Sarasota Memorial Health Care System (SMHCS), which is working with SMH administrators regarding the alliance, will be quick to correct any such error.

“We are looking at a strategic alliance, which has yet to be finalized, but it will not involve the merger, sale, or lease (CONTINUED ON PAGE 6)

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PhysicianSpotlight

John A. Ferlita, MD Gynecological surgeon

By JEFF WEBB

ZEPHYRHILLS - In more ways than one, John Ferlita owes his success as an OB/ GYN and surgeon to his wife Alina.

“Alina is the COE - Chief of Everything,” said Ferlita. “She is the blood and guts of this practice,” said Ferlita of his companion of 41 years who has managed his office in Pasco County for 28 years. “Managing the nuts and bolts of a practice like this is quite a job. I don’t have a clue what happens in the office. Thank goodness I have a very intelligent wife and business partner who is exceptionally capable. If it wasn’t for her, I’d be broke,” he laughed.

But Alina’s role in Ferlita’s professional life has even deeper roots; her father is the one who persuaded Ferlita to become a physician.

It all started in Ybor City, perhaps the most historic neighborhood in Tampa.

Ferlita’s grandfather first visited Ybor in 1885. He returned to his home in Sicily, but came back in 1890. In 1895, he started a bakery business in the city of Cuban, Spanish and Italian immigrants. “He did very well, but he made his real money as a speculator,” said Ferlita. “As World War I approached, he anticipated there would be a shortage of flour. He hocked everything he owned and bought 50 train cars full of flour and he quadrupled his money because there was a flour shortage. With that money he built a small building and added another oven. It’s a nice immigrant story,” Ferlita explained.

Ferlita’s father, born in 1913, became the master baker, and through innovation and determination with his wife Rose, successfully managed the Ferlita Bakery, which is now home to the Ybor City Museum, and raised Ferlita and his older sister Deanna.

His father and mother were the most important influence of his early life, Felita said. “Lots of love, good values, strong work ethic. They taught us that all people are the same, no matter what race, creed or status in life. We all should be treated with respect and dignity.”

Ferlita met Alina when they were teenagers, just before he got his job at the U.S. Post Office and began his undergraduate work at Hillsborough Community College and the University of South Florida. His plan was to maybe get his masters or doctorate and become a biology or science teacher.

Alina’s father, Francisco Rodriguez, was a urologist in Tampa, “a Cuban fellow with an office near St. Joseph’s Hospital,” Ferlita said. “I was hanging out with him and his cronies, drinking scotch, smoking cigars and conversing. They took me in and I was ‘one of the boys.’ One day my fatherin-law invited me to observe on a case. Then his buddies did the same. Soon, I found out I had good hands.”

Because he was “making more money medicalnews

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at the Post Office than both my parents put together,” Ferlita did not qualify for financial aid, so he had to fend for himself. He traveled to the Dominican Republic to get his MD at the Universidad Central Del Este.

That was followed by internship and residency in the Department of Obstetrics and Gynecology at the University of Medicine & Dentistry of New Jersey in Newark, which he completed in 1985.

Wishing to return to Florida, Felita partnered with Dominick Caselnova, MD, in an OB/GYN practice in Dade City.

“It was a decent opportunity, but I never thought I would stay in the area because I was from Tampa and I had a lot of family connections and friends there,” Ferlita recalled. “I thought I’d just get my feet wet for a year in Pasco County, but it turned out to be a wonderful place to live and work,” he said. The group of “30-or-so physicians in the area were like family, and exceptionally talented. We took care of one another and I learned a lot from them,” Ferlita said.

“Then one year turned into two, then two into three, and then I started my own shop,” he said. “I liked the patient mix.

People were so nice. And the location was the best of both worlds, only 40 minutes away” from their parents in Tampa, which was a big help for a couple who were raising three children.

Ferlita has treated generations of pa-

tients. “I’ve delivered many babies from women in the same room where they were delivered. That makes you feel really old!” said Ferlita, who discontinued his obstetrics practice in 2011. “I got too old for being on call for that. I’m almost 60 and it’s physically tiring to do day in and day out” as a sole practitioner, he said.

But his gynecology, urogynecology and surgery practice is “very busy,” Ferlita said.

“That is what I am known for. I do procedures that are relatively cutting edge,” he said, including being one of the most prolific and in-demand gynecological robotics surgeons in Pasco County. “I’m a pioneer in laparoscopic surgery and minimally invasive surgery,” said Ferlita, who said he and he and his partner did as many of those cases as anyone in the southeastern U.S. during the 1990s.

Today, Ferlita’s urogynecological surgeries include treatment of urinary and fecal incontinence, overactive bladder, genital prolapse, interstital cystitis, prolapse and sacropexies. “You have to be jack of all trades and master of all. You can’t do just one or two procedures and

manage the patients’ necessities,” he said.

Ferlita sees 30-32 patients per day in his office, sometimes more because “I never refuse patients. If they are sick, that’s when you need to see them,” he said. Tuesdays, however, are reserved for surgeries, mostly at Pasco Regional Medical Center in Dade City, an institution he holds in high regard for being “innovative and progressive,” especially for its purchase of the DaVinci Robotic Surgical system that he uses so often.

“It’s pretty amazing that a 120-bed hospital puts up that kind of investment,” said Ferlita, who has been chief of staff and chief of surgery at Pasco Regional. “In 28 years, you do a lot of stuff,” he said.

Ferlita does find time for “stuff” outside his practice. “My hobbies are boating, fishing, kids and wife,” he said. The family has had a getaway residence in Englewood where he and his children, now aged 30, 27 and 26, spend as much time as possible. “I enjoy backwater fishing there, as well as upper Tampa Bay,” Ferlita said, adding that his wife is key in that endeavor, too. “If you want to catch fish, put Alina in the boat,” he said.

Another talent is gardening. “Plants always perform for me,” he said. “Anything I touch grows. Plants have souls and you have to connect with them. We’re all living things and we’re all connected one way or another.

Some people look at me funny when I say that, but it’s true.”

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Finding Wellness: This Editor’s Journey Obesity’s Cascading Effect on Health

By LYNNE JETER

After 25 years of writing about healthcare issues, with only caesarian sections, a 1995 laparoscopic hysterectomy, and occasional sinus challenges on my medical chart, my health took a nosedive last summer and I became fully entrenched in the patient experience.

At age 50, I was in doctor’s offices on a weekly basis after a mild AFib sent me to a cardiologist. Even though the episode appears to have been isolated, which EKG results, a cardiac ultrasound, and a 30-day heart monitor confirmed, it began a chain reaction that’s just now stabilizing. I remember thinking: I feel broken, but don’t know why.

Finding a primary care provider (PCP) was first priority. I was lucky and found a brilliant gem: Gus Vickery, MD. He diagnosed my hypothyroidism and Vitamin D deficiency and sent me to a gastroenterologist, who ordered my first colonoscopy. The procedure netted two polyps and a mandate to repeat the process in three years instead of five, and resulted in an IBS diagnosis.

That summer, I was midway through an intensive 3-year immunotherapy program for allergies to all sorts of trees, grasses, and molds when I needed ENT surgery to zap a highly infectious air bubble that was growing in my right sinus cavity, inflamed turbinates, and a deviated septum.

An August visit to an arthritis specialist resulted in diagnoses of osteoarthritis and fibromyalgia. Under the umbrella of fibromyalgia: IBS, hypothyroidism, Vitamin D deficiency, anxiety and depression! The domino effect was beginning to make sense.

I was certainly depressed about it all.

Nine months later, with improvements being made in all ailments, I asked my PCP about green lighting a weight loss program.

He recommended a relatively new clinic, Blue Sky MD. But he couldn’t give me the go-ahead until my thyroid levels were normal. With my thyroid levels climbing higher than before I began taking thyroid medicine, he doubled my dosage. With little improvement, he doubled it again. We waited.

In late July, a debilitating back injury knocked me further off the path to wellness, requiring weeks of intensive and painful physical therapy. By the time my thyroid levels were in the normal range, six weeks of inactivity had contributed to a lifetime high of 216 pounds.

Even though I was hopeful of a successful outcome at Blue Sky, I was skeptical.

I’d tried Weight Watchers, where I lost the 6-pound average, temporarily; a program focusing on abstinence from sugar, wheat and flour that had a weird cult aura; and other programs “guaranteeing” success.

Two years spent at a bariatric clinic focusing on a low-fat diet had resulted in minimal net weight loss, months of frustration, and more money spent than I’d like to admit.

In hindsight, I recall that none of the bariatric clinic staffers were slim, not even the doctors. They didn’t practice what they preached. A clear picture that showed more than basic blood panels wasn’t needed; it was a cash cow business and the waiting room was always full. An RN there told me I was wasting my time. A doctor there told 4

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me I’d never see 150 on the scales again.

But hope springs eternal. And crying uncle had gone unnoticed.

My inaugural Blue Sky visit involved an in-depth consultation. Dave LaMond, MD, CEO of Blue Sky, recommended bioidentical hormone replacement therapy after deep-level labs showed a negative 3 testosterone level. He recommended Niacin and baby aspirin after my heart ultrasound revealed the arteries equivalent to a 68-year-old woman. I followed all their recommendations and noticing an immediate improvement in my quality of life.

For 12 weeks, I was restricted to 900 calories and 90 carbs daily with supplemental vitamins and phentermine or natural appetite suppressants. The routine included weekly weigh-ins with a nutritionist, who deciphered the print-out data –water retention fluctuation, body fat percentage changes – and offered practical tips and recipes. During each visit, I also met with a doctor or PA

and opted for B-6 and B-1/12 shots.

A diet heavy on green vegetables, light on fruit, and protein consumed five times a day seemed extreme, but it worked. When I lost nearly 7 pounds the first week, I almost wept. At the end of 12 weeks, I’d lost 33 pounds and at least a dozen inches from my waist and hips. More importantly, I understand the relationship of food for fuel much better. I feel great!

I’ve graduated to a 1,200-calorie, 120carb daily diet, and was glad to have dodged the 600-calorie, 60-carb daily starter option.

Twelve hundred calories doesn’t sound like much, but I eat well. Yesterday, I had lowfat cottage cheese, strawberries and walnuts; string cheese and a hard-boiled egg; chicken, Kashi crackers and an apple; yogurt and Fiber 1 cereal; and lean beef with mushrooms, reduced-fat cheese, along with sweet potatoes and a tablespoon of butter and shake of cinnamon. Total calories: 1,175. Carbs: 112. Portion control is man-

datory; variety makes it easy.

Experiences in the healthcare field over the last 18 months have given me a much deeper understanding and greater respect of the challenges that hinder healthcare providers from doing what they love – healing people.

I’m healing, and eternally grateful.

With a goal of 150, which I’m confident I’ll see in early 2013, the journey isn’t over. On the last day of November, I was in the 170s! Will keep you posted.

Happy New Year & God Bless, Lynne Jeter P.S. Full disclosure: Blue Sky MD didn’t solicit or pay for publicity. It’s a good story, period. My instinct tells me PCPs will appreciate knowing about this reliable patient referral option and a career option with the “next big thing.” Read more about it in “Taking Flight.”

Taking Flight

A PCP’s best pal – and possible outlet – Blue Sky MD helps patients lose weight fast, keep it off

By LYNNE JETER

HENDERSONVILLE, NC — Medical entrepreneur Dave LaMond, DO, has incorporated an innovative clinical model of care for obese and overweight Dave patients that’s garnered LaMond, DO such positive results that he’s expanding quickly while also retaining a hands-on personal touch that’s gained a loyal and appreciative clientele.

After seeing the frustration shared by many primary care physicians (PCPs), LaMond blended two business concepts – a traditional fee-for-service medical spa and a weight loss clinic – to establish Blue Sky MD in 2009.

Founded on the principle of providing comprehensive care, with systems in place to meet all of a patient’s needs, Blue Sky has a culture of customer service and patient-centric care that’s a cornerstone for the practice.

“My mantra is ‘take care of the patient and everything else will take care of itself,’” he said. “The practice was based on providing cutting-edge care, with the primary goal of true primary prevention, or prevention of disease before complications.”

The practice has evolved into what LaMond described an “age-management” practice, focusing on nutrition, hormone optimization and non-surgical aesthetic offerings.

“We’re focused on producing clinical data to provide payors with cost savings and to validate our protocols,” he said. “We’re developing simplified protocols to provide ‘turn-key’ solutions to other providers in an ancillary service model. In other words, we’ll deliver the care for other providers. This solution will focus on weight control services.”

Finding the right clinical care model and

organizational structure proved the greatest challenge developing the business, said LaMond, who follows Medicare and National Institutes of Health (NIH) guidelines for the care of patients who need weight control services, and “metabolically” manage weight and bill under medical co-morbidities. “Without a proper, scalable solution in place, you’re destined to fail,” he admitted.

“Also, I have an incredible team with a cando attitude. They love this business and the culture. They’re adaptable and flexible and able to troubleshoot. The patient care piece is my passion, so that was easy! I love developing protocols. I’m constantly in the ‘lab’ refining and improving the program.”

Core Curriculum

The core curriculum of the program has remained relatively stable; LaMond continues adding tools to motivate patients while also measuring and screening for disease. An incentive for weight loss patients: they receive a $25 credit toward products and services for every 10 percent of weight lost, and also for every referral.

“Our process starts with an extensive intake, which takes 60 minutes,” explained LaMond. “We assume the role of clinical detective, with our objective to create an outline based on a series of clinical events. The underlying theme is often ‘abnormal weight gain,’ which was either a lifelong struggle or triggered by an event, either physiologic/medical or life change. We then use various tools to treat the underlying cause, often with a multi-pronged approach.”

LaMond’s goal is to measure metabolism.

“We compare our measured metabolism value with a calculated/predicted value,” he said. “The bottom line, if someone’s metabolism is off by 20 percent or

more of what we predict it should be, the patient has underlying metabolic issues/ metabolic syndrome. We work to correct these issues with diet and nutrition, exercise, nutraceuticals, medications and hormone replacement therapy.”

When done properly, hormone therapy is a game changer, said LaMond.

“This will become standard of care,” he said, “and already is in certain cases, such as male hormone replacement therapy.”

Low testosterone is a marker for metabolic syndrome, he noted.

“It’s standard of care to screen for this post myocardial infarction (MI) and in primary care settings,” he said.

Inside Out

The aesthetic portion of the practice typically comes into play once a patient is feeling better, often within weeks to months of the start of the weight loss program, LaMond said.

“Our patients want to be beautiful inside and out,” he said. “We offer everything from natural skin care, custom compounded skin care, mineral make-up, peels, neurotoxins, fillers and laser/lightbased technology for hair removal, wrinkles, skin laxity, and sun damage. We’re experts in this space … and we’re developing a natural skin care line.”

Staffing Blue Sky MD is an artform, said LaMond, who has a very simple rule: all personnel must walk the walk to talk the talk. Every employee follows the food plan outlined for patients; each one is healthy and slim, including LaMond. All dressed in black, the female staff adds scarves and boots to add spark while allowing the patient to stand out.

“We have a culture of excellence, and (CONTINUED ON PAGE 6)

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Taking Flight,

Details of BayCare, continued from page 1 of our organization. Sarasota Memorial will remain an independent public hospital governed by our elected hospital board,” Simon explained.

She went on to report that “patients wouldn’t notice much of a difference, since there would be no change in our name, identity, mission or ownership, but the proposed collaboration with BayCare would give Sarasota Memorial Hospital access to the extra resources, size, and scale of a large health system, the potential for joint venture and growth opportunities to improve patients access to care, and the opporGwen tunity for both organiza- MacKenzie tions to share our quality practices.”

SMH, an 806 bed facility which boasts almost one doctor for every bed – the hospital has 802 physicians – has, like many organizations in the past two or three years, been a victim of the lethargic recovery of the U.S. economy. SMH, in its last fiscal year, recorded a deficit of over 19 million dollars. One of the aftereffects of this is that 33 employees jobs were eliminated.

The main executives at SMH will at least partially fall under the aegis of BayCare. Chief Executive Officer Gwen MacKenzie’s job would remain the responsibility of the SMH Board of Directors. The responsibilities of COO David

Verinder and CFO William Woeltjen would fall under BayCare’s watch.

BayCare would set the salaries of the executives but the hospital board would have to give approval and Sarasota Memorial Hospital would pay those salaries.

As many, directly or indirectly, involved in the healthcare industry in southwest Florida know, SMH administrators have been looking for ways of cutting costs at the hospital.

One such interested spectator to all of this is Manatee County Commissioner Carol Whitmore. When she is not attending county commissioner duties, Whitmore, a registered nurse, works eight hours a week in the office of her husband, Andre Renard, MD, a plastic surgeon for over 40 years.

How would this proposed alliance between BayCare and SMH affect the competitive medical healthcare business between Manatee and Sarasota counties?

“It will affect it tremendously, and it will affect it drastically,” opined Whitmore.

“The (healthcare services) that used to be offered by a local, sole company, and the philosophy of hospitals always working with local healthcare companies, is a thing of the past. They (the SMH Board of Directors) are looking long distance to remain profitable. It’s disappointing that they don’t want to use local, or community healthcare services.”

Lisa Cresswell, a spokeswoman for BayCare, passed along all questions re-

garding the BayCare-SMH confederation to Kim Savage, senior communications editor for SMHCS. Savage said that “details (of the agreement) won’t be available to the public until they are first presented to the hospital board.”

Yet she did note that “both our staff and BayCare’s staff will have opportunities to learn from each other through training, educational programs, and quality summits, among other collaborative quality initiatives. By sharing clinical outcomes and quality data, both organizations can benchmark to identify strengths and opportunities for improvement.”

In 2011, BayCare HomeCare and Sarasota Memorial Hospital’s home care program merged. This merger included specialists and professionals from a wide variety of vocations, from dietitians to occupational and physical therapists.

However, Savage wanted to emphasize the fact that “it’s important to note that the home care merger is far different than the strategic alliance we are currently considering with BayCare. The home care service is wholly owned and operated by BayCare HomeCare. As part of the deal, Sarasota Memorial became a partner in BayCare HomeCare. Simon stressed that the strategic alliance is not a merger, lease, or sale. It is an agreement to collaborate on joint projects developed to meet joint strategic goals – but Sarasota Memorial will not become part of the BayCare network.”

continued from page 4

if this isn’t what my staff wants, we’re not afraid to make a change,” he emphasized.

“It’s best for the patients and the individual who’s not working out. We take time and understand someone’s skill sets ... promote from within when able and take time to identify needs … understand when staff is spread too thin (and) create channels of clear communication and expectations.”

In 2009, LaMond opened offices in North Carolina (Arden and Hendersonville) and Tennessee (Brentwood and Chattanooga), primarily in office building suites. Now his practice is so robust, he’s leasing office buildings.

“Our plans for 2013 are to open six ancillary service model clinics within existing practices,” said LaMond. “We’ll provide a turnkey solution to provide weight control and/or hormone therapy services within a practice. We already have commitments from two offices.”

LaMond frequently fields calls from overworked PCPs interested in opening a Blue Sky office, thus eliminating on-call requirements, overtime and other energydraining issues.

“Blue Sky MD is far superior to any program I’ve studied,” said PCP Gus Vickery, MD, of Vickery Family Medicine in Asheville, NC. “When I saw the program Dave had in place, I dropped my inhouse weight loss program and outsourced it. I’d send patients to Dave and they’d come back months later, 40 to 50 pounds lighter and much healthier and happier.”

Dr. Dipali Patel has a new office and hos ANNOUNCES

Dipali Patel, MD is an experienced and caring primary care physician that has moved into a new, convenient office near Westchase on Countryway Blvd. Dr. Patel is excited to help the area’s families with their health care needs as well as promoting preventative care and

Dipali Patel, MD Primar y Care

healthy lifestyles. She is a member of the American Academy of Family Physicians and the Glenda F. Parker, MD American College of Obstetricians and Gynecologists.

Internal Medicine

Joining Dr. Patel is Glenda F. Parker, MD Internal Medicine Dr. Glenda Parker is a board-certified physician in internal medicine. After completion of her training at Emory University and residency at Johns Hopkins Bayview Medical Center, she served as an attending physician with Johns Hopkins University and is also a former V.A. health care provider.

20043.indd Dr. Dipali Patel is1 a primary care physician. She completed 6 JANUARYstudies 2013 > her undergraduate in chemistry at the Florida Atlantic University, Boca Raton. She received her medical degree from the Ross University School of Medicine in Dominica. She completed a residency in family medicine

Glenda F. Parker, MD, completed her undergraduate studies at Washington University in St. Louis, MO. Dr. Parker then earned her medical degree from Emory University School of Medicine in Atlanta, GA. She completed her internal medicine residency at Johns

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Concussion Blood Test?

ORMC researchers identify protein marker to detect concussions and more severe traumatic brain injuries The discovery of a brain damage protein marker in the bloodstream by Orlando Regional Medical Center (ORMC) researchers may lead to a simple blood test to help doctors diagnose and treat concussions sooner.

“Preliminary research shows the protein is detectable within an hour of injury,” said Linda Papa, MD, an emergency medicine physician, director of academic clinical Dr. Linda research at ORMC, and Papa principal investigator of the study. “Also shown is the ability of the protein to determine how severe the injury.

While the results so far are promising, more research is needed before direct patient application.”

In a national multicenter study published in the May 2012 edition of Journal of Trauma, investigators tested the ability to identify the protein – ubiquitin C-terminal hydrolase (UCH-L1) – in the bloodstream after a head injury. The higher the level of protein in the blood, the more severe the brain injury was, which indicated a risk of bleeding in the brain and of the need for

urgent surgery. The ability to detect the elevated protein levels in the bloodstream may lead to the development of a blood test to diagnose concussions, a mild traumatic brain injury (TBI), and more serious TBIs. “Knowing whether there’s an injury to the brain, including a concussion, is critical to directing the path of treatment for patients,” said Papa. “It can make the difference in whether a patient is discharged to home or remains in the hospital for surgery or other treatment followed by the appropriate inpatient and/or outpatient rehabilitation.”

The same protein discovered in the bloodstream is also found in a patient’s cerebrospinal fluid following a TBI. “We’ve known the protein is present in the cerebrospinal fluid after injury,” said Papa. “Because it’s not practical or safe to remove this fluid from every patient, developing a blood test is important.”

In the ongoing study, patients with TBI are compared to two control groups – normal adult volunteers without any acute injuries; non-head injured patients treated in the emergency department with either a single broken arm or leg or after a motor vehicle crash, but without blunt head trauma.

“The brain is such an important organ,” said Papa. “Even after years of brain-related research, there are no blood tests available to diagnose concussions or more severe forms of TBI as there are with

other common conditions like heart disease, diabetes, liver problems and thyroid disorders.”

Instead, doctors rely heavily on CT imaging to assess the level of severity of TBI. “While CT imaging has proven to be an effective measurement tool, the technology doesn’t capture all injuries and raises concerns over exposure to radiation,” said Papa. “A blood test may also be able to detect protein markers that indicate a problem, but may not show up on a scan. We hope this test is the first step toward being able to provide a more complete and accurate diagnosis sooner.”

Nearly 1,500 TBI cases of all severities are treated annually at the ORMC Level 1 Trauma Center, Central Florida’s only Level 1 Trauma Center. The National Institutes of Health awarded a $2.25 million grant to ORMC to study TBI, which began in 2009 and will end in 2014.

ospital where she will be providing care.

As members of the Town & Country Hospital network of providers, these two talented and passionate doctors have access to a leading local hospital location, advanced technological equipment and a large staff of specialists. You can count on these doctors for the care your family needs, and should you need more specialized attention, Town & Country Hospital will provide them with the support they require.

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Pivotal 2012, continued from page 1 2012. Each, he said, had a fundamental question as its premise: “What’s going to be obvious 10 years from now?”

The USF Health System was established with the addition of its first hospital partner Lakeland Regional Medical Center. The partnership will create 200 to 250 new residency slots in West Central Florida, making USF’s residency program the largest in the state.

“It was clear that as healthcare systems and hospitals consolidated and everybody started talking to everybody else, us not having a health system as a medical school with different affiliates, Stephen wasn’t necessarily going Klasko, MD to put us on the cutting edge or in a leadership position,” said Klasko. “We believed Tampa Bay needed an academic medical center, so we created the USF Health System,” he said. Partnering with Tampa General Hospital and Moffitt Cancer Research Center “really creates the one thing we’ve been missing, a coordinated academic medical center in Tampa Bay that can compete with a Pittsburgh, Birmingham, San Diego or Philadelphia. When people talk about Tampa Bay academic medicine they will talk about Tampa General, Moffitt and USF as coordinated entity. It doesn’t mean that anybody has to own anybody,” he said.

The USF Health Center for Advanced Medical Simulation and Learning, or CAMLS, which opened in downtown Tampa in March, is the largest facility for the assessment of technical and teamwork competence in the world, according to USF. “It was clear to us that (medicine) is not going to be the only profession that never gets competency tested,” said Klasko. “It was equally obvious that we needed a USF presence in downtown Tampa. So, the ability to get that industry investment started is going to be a long-term opportunity for us and Tampa,” he said. More than 30,000 health professionals – doctors, nurses, surgery technicians, combat medics – from all over the world are expected to come to CAMLS to train and have their skills evaluated, making it a significant economic development component for Tampa Bay. USF Health is midway through its first full year of the SELECT program, which chooses medical students based on emotional intelligence rather than relying solely on their academic records. USF Health has partnered with the Lehigh Valley Health Network in Allentown, Pa., to create what they hope will be a model for the nation. In 2013, the charter class of SELECT students will transition from the first two years of medical school at USF to their final two years of medical school clinical training in Allentown.

We’ve been wanting to get our medical school named ever since I got here,” said Klasko, and that finally happened in 2012.

A $37 million gift from Frank and Carol Morsani established the Morsani College of Medicine at USF. “At that level, philanthropists ask themselves ‘Is this is a good investment’ and ‘Do I believe in the people?’”

Klasko said. The Morsanis’ financial commitment, Klasko said, was an endorsement

of USF Health’s leadership and plans to move forward.

In the spring of 2012, the USF Heart Institute was awarded $8.98 million in state and county funding, and hopes to get upwards of $20 million more approved by the Florida Legislature this spring. The institute, which focuses on regenerative medicine for cardiovascular disease, using the latest in gene and stem cell therapy, as well as personalized medicine based on an individual patient’s DNA. Directing the Heart Institute is Les Miller, MD, who previously was chair of the Department of Cardiovascular Science. That position is now held

by Arthur Labovitz, MD. “These are two of the top people in the country,” Klasko said, and in 2013 they will expand the institute’s clinical studies and put USF at the center of some of the most advanced research in cardiovascular care.

Another key person who joined USF Health in 2012 was Stephen Liggett, MD. Liggett heads the USF Health’s interdisciplinary Center for Personalized Medicine and Genomics, which targets the discovery of genetic variations to predict who will get a disease, how fast it will progress and the best drug to use for treatment.

“He is one of the top people in the world to combine the clinical and research elements of molecular genomics,” Klasko said. Bringing Liggett here from the University of Maryland was “one of the biggest coups of the year,” he said.

USF significantly raised its information technology profile by transforming its Paper Free Florida project from one of the worstperforming in the nation to one of the best.

The progressive effort to make electronic health records the communal norm saw USF Health’s ranking as a federally funded Regional Extension Center go from 57th in the nation to 6th. (See November Tampa Bay Medical News http://tinyurl.com/ c2s7a2w.)

Even with all those achievements in 2012, Klasko said there are still “plenty of things that will keep me up at night” in 2013. “People don’t have a clue how crazy this is going to get with the Affordability Act and decreases in Medicare reimbursements, bundled payments and things like that,” he said. “So, the whole issue of being high quality and high cost is going to be a killer. Insurance companies are going to start making decisions based on value-based purchasing. The concept of a diabetic patient who has seven different docs who don’t talk to each other is going to go away.

You’re going to have to get together with folks you’ve never gotten together with,” said Klasko. “The future is happening at a dizzying pace and we all have to make sure we are not over- or under-reacting.

But Klasko is single-minded about his top priority: “Implementing the things we have started and make sure they are sustainable,” he said. “A Tampa Bay-based medical academic center” is key to that success, he said. “We want to have people around the country say ‘Hey, Tampa Bay is really getting its act together from an academic medicine perspective.’ We’re going to be the next big thing.”

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Managing Risks

The Art of Mediation – Part 3 Let the negotiations begin!

out of the mediation at this point, but the mediator will The encourage you to “engage.”

You should do so.

Recap of Parts 1 and 2: best preparation Over the next few Having been ordered by the court to attend mediation in your pend- for tomorrow is to hours, each party will parry and thrust with demands ing medical malpractice lawsuit, do today’s work and offers, with each one atyou’ve left your busy practice and superbly well. tempting to drive the other entered into a foreign world filled toward their goal. Plaintiff’s with lawyers, mediators, risk – Sir William Osler attorney will want to receive managers and claims managers, as much money as possible otherwise known as the land of for the plaintiff; your defense suits – with briefcases. attorney will want to pay out as little as posYou know you did nothing wrong in treating sible on your behalf. this patient, yet you also have to acknowledge the realInterwoven with a continuing discussion ity: you didn’t document the record as completely as of the facts and the expert testimony, various possible. And the defense experts, though supportive of methods of negotiation will be used, dependyour care, have also admitted they would’ve ordered ing on what actually works with this particuthe additional test; which “more likely than not,” lar group of people. Some behave like used would’ve resulted in an earlier diagnosis and possibly car salesmen and simply jockey back and a better patient outcome. forth. Others give a hard and fast number The mediation begins. You sit with arms firmly and say “That’s it!” Some use “brackets.” crossed next to your attorney, while glaring at the For example, plaintiff’s attorney may say plaintiff’s attorney, and listen as each lawyer sumsomething like, “I’ll agree to decrease my marizes their client’s case. You resist correcting their demand to $250,000 if you agree to increase presentation of the medical facts and envision your your offer to $150,000.” In so doing, he’s day in court. Yet, as this lengthy discussion unfolds, clearly signaling that he wants to settle the you realize that rather than have a jury of six people case for $200,000. So the defense then of– whose only clinical qualifications are that they posfers another bracket, with a midpoint that’s sess a valid driver’s license – decide your fate, you lower than $200,000. An infinite number of conclude in your own mind that this matter needs to possibilities exist on how to best negotiate be resolved. The allegations of negligence supported resolution of a medical malpractice claim; by the plaintiff’s “expert” – an assistant professor what’s used on a given day is that which is from an academic institution on the other side of the best suited to the facts of the case and the continent – will get this case to a jury. And when people involved. you then consider your own time, stress, and financial At the end of the process, the mediator exposure, you conclude it is best to compromise today. will finally announce that all parties relucNow is the time to make sure your defense team tantly agree to a final settlement number. understands the medicine involved to counter the often The mediator then prepares a document absurd clinical allegations of the plaintiff’s attorney. formalizing this agreement, which will conTake a deep breath, exhale slowly, and survive. Let tain a clause stating you haven’t admitted to the negotiations begin! any negligence.

The mediation has concluded. There’s Once the attorneys have completed no fanfare, no shaking of hands between their presentation, the mediator will keep the plaintiff and defendant. By the time you largest group of people – usually all defenthank the mediator and move toward the dants and their representatives – in the main lobby, the plaintiff and plaintiff’s attorney conference room while the plaintiff’s attorwill have already departed. ney and plaintiff disappear to a smaller conIn the parking lot, you thank your attorference area. When there’s criticism among ney and your claims manager for applying defendants, they will also separate, but this their skills on your behalf today. And with isn’t usually the case as open, public criticism your mind absolutely numb, you walk to of one defendant against another only inures your car. It’s over. You survived. It’s now to the advantage of one party: the plaintiff. time to remember to take that big breath of During the next half hour, you’ll discuss fresh air, exhale slowly and then drive careall possible ramifications of this mediation fully to spend the evening with your family with your attorney in one room, while the and friends. Relax. Chill. You deserve it. mediator meets with the plaintiff and plainAnd when you return the next day to the tiff’s attorney in another space. This is where practice of the most honorable profession in the mediator begins to display incredible the world, remember the words of Sir Wilskills of diplomacy by cajoling and badgerliam Osler: “The best preparation for tomoring each side to expose their weaknesses, in row is to do today’s work superbly well.” an attempt to drive them to the center of the argument. After meeting with the mediator, Timothy R. Bone, president of Floridathe plaintiff attorney’s initial outrageous debased MedMal Direct Insurance, may be reached via Tim@MyMedMal.com. mand will be brought to your defense team by the mediator, along with insightful comments concerning the mediator’s take on the case. You’ll be tempted to simply walk

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Hillsborough County Medical Association

By DEBBIE ZORIAN

Tuesday, January 29

HCMA office, 606 S. Boulevard, Tampa, Tools & Tips for Marketing Your Practice HCMA Benefit Provider, Full Circle PR, is hosting a seminar to assist HCMA members in gaining more patients for their practice on January 29th, 5:45 pm at the HCMA office. There is no charge for members to attend. Call 813.253.0471 for more information.

Tuesday, February 5

InterContinental Hotel, Kennedy & Westshore Blvds.

HCMA General Membership Dinner Meeting The HCMA’s next general membership dinner meeting has been scheduled. Social hour will begin at 6 pm, the dinner and program will commence at 7 pm. Program details forthcoming. HCMA members are invited to call 813.253.0471, with any questions or to RSVP.

New Benefit for HCMA Members

The Florida Healthcare Law Firm, an HCMA Benefit Provider, invites members to celebrate the grand opening of their new online store. Free legal documents are available for instant download covering topics from Confidentiality Agreements to Space Leases!

Audio/visual presentations are also available for purchase (HCMA members receive a 25 percent discount by using a discount code).

Topics include: buying a medical practice, how to hire a physician, Florida’s prompt payment laws, and more! Call 813.253.0471 for more information.

New HCMA Focus Groups

Newly formed HCMA focus groups, the Young Physician Section (YPS) and the Women in Medicine Section (WMS), are looking for members. It is the goal of the HCMA’s YPS and WMS to reach out to these physician member groups of the HCMA, and in our county, who have been inconspicuous, albeit very important segments of our medical community. The goal of these focus groups is to promote a forum for networking and continuing education, and solicit ideas and energy from these members to make the HCMA relevant and useful to them, their practices, and their families.

Young Physician Section (YPS): Created for all HCMA members 40 years old or younger. Women in Medicine Section (WMS): Created for all HCMA female physicians. HCMA members are encouraged to contact the HCMA office if interested in participating in either of the new focus groups at 813.253.0471.

HCMA Health Plan

The HCMA continues to offer health insurance through Florida Blue. The plan is available to HCMA members, their families, and their staff. The purpose of the plan is to keep annual premium increases to a minimum while providing physicians with a great membership benefit. Members who enrolled last year will see no increase in their premiums!

HCMA members can call 800.622.9124 for details or visit: www.trusthcma.com. Mark Thompson, an agent for the HCMA Health Plan, can be reached by calling 813.639.3066.

HCMA Has Gone Social

Follow the HCMA on Twitter – http:// twitter.com/HCMADocs – and like us on FaceBook– www.facebook.com/HCMADocs. Keep updated on HCMA events and important notices!

HCMA’s Photo Site

The HCMA has created a website of photos taken during HCMA events. Please visit http://hcmaphotos.shutterfly.com and check back often for updates. A link to this site is also posted on the HCMA website: www.HCMA.net.

HCMA.NET – Always Changing

Visit the HCMA website to find a host of information, including new advertisers, the latest issue of The Bulletin, the HCMA Benefit Providers, a list of the HCMA officers, or a list of upcoming CMEs. You can also check out the photos from the FMA Annual Meeting, the HCMA Foundation Charity Golf Classic, and recent dinner meetings, or look up an HCMA member’s contact information! Visit the site at www.HCMA.net.

To learn more about the Hillsborough County Medical Association, or to find out how to become a member, please visit our website at www.HCMA.net.

Speaking of Women’s Health Conference Attracts Large Crowd in Bradenton

By MARK WEISENMILLER

Speaking of Women’s Health Conferences have been successful events since 1996 and the latest conference held in southwest Florida was no exception.

The theme of the all day conference, held in mid-November at the Bradenton Area Convention Center, was “Share Good Health.” Through a variety of speeches and symposiums, that is precisely what happened. This was the 10th annual Speaking of Women’s Health Conference held in southwest Florida.

The over 500 people who attended the conference, who paid five dollars apiece for general admission tickets, had access to speeches given by a wide variety of health and medical professionals, a dozen complimentary screenings, and even a gift bazaar.

At the latter, people browsed, shopped, and bought, jewelry, makeup, and other various knick-knacks.

Already, organizers have the date for the 2013 Speaking of Women’s Conference to be held in our area. It’s set for Sunday, November, 16, 2013 at the Bradenton Area Convention Center. “The event benefits the Manatee Memorial Foundation, 10

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Inc. The foundation’s major emphasis is on healthcare needs within our community and scholarships for medical education,” explained Betty Chambliss, director of advertising and community relations at Manatee Memorial Hospital.

This year’s keynote speaker was Maureen Whelihan, MD, OB/GYN, whose presentation was the attentiongrabbing “No Sex in the City: Love Life Boot Camp.”

At the recent conference wives brought their husbands and girlfriends brought their boyfriends. “Men are not prevented from coming to this event. We have worked with the Manatee County School Board on a men’s event during the year. This event is designed to be a fun and educational day for women, one they can share with mothers, daughters, sisters, and friends. Women often put their family above themselves.

This is a once-a-year time for them to think about themselves and their health and wellbeing,” noted Chambliss.

She has her own views on why these conferences, celebrating the many benefits of women’s health, are both well regarded and also well attended: “Speaking of Women’s Health is popular because it is

the perfect mix of education and entertainment. Some have called it ‘edu-tainment.’

Attendees are pampered with complimentary health screenings and samples of food and gifts. They also have the opportunity to hear from a team of experts on a variety of important health and well-being issues. It is a high energy atmosphere full of learning and laughter and a special time to spend with other women and the opportunity to form some new relationships.”

The Speaking of Women’s Health website – www.speakingofwomenshealth.com – reveals the group as a strong social and health movement whose goal is presenting women the most health and safety information as possible to help them make wise decisions for themselves and their family.

Speaking of Women’s Health was the brain-child of Dianne Dunkleman, who began just wanting to produce a one-day health event in Cincinnati in 1996. It has since grown to a national foundation with more than 50 events in 40 cities nationwide.

PUBLISHED BY: SouthComm, Inc. PUBLISHER Jackson Vahaly jvahaly@southcomm.com FLORIDA MARKET PUBLISHER John Kelly johnkelly@orlandomedicalnews.com ADVERTISING John Kelly 407-701-7424 Jkelly@tampabaymedicalnews.com Brenda Loyal 813-323-1037 bloyal@tampabaymedicalnews.com Harvey Zorfas 727-420-4283 HZorfas@tampabaymedicalnews.com NATIONAL EDITOR Pepper Jeter editor@medicalnewsinc.com LOCAL EDITOR Lynne Jeter lynne@medicalnewsinc.com CREATIVE DIRECTOR Susan Graham susan@medicalnewsinc.com GRAPHIC DESIGNERS Katy Barrett-Alley, Amy Gomoljak Christie Passarello ACCOUNTANT Kim Stangenberg kstangenberg@southcomm.com CIRCULATION subscriptions@southcomm.com CONTRIBUTING WRITERS Lynne Jeter, Cindy Sanders, Jeff Webb —— All editorial submissions and press releases should be emailed to: editor@medicalnewsinc.com —— Subscription requests or address changes should be mailed to: Medical News, Inc. 210 12th Ave S. • Suite 100 Nashville, TN 37203 615.244.7989 • (FAX) 615.244.8578 or e-mailed to: subscriptions@southcomm.com Subscriptions: One year $48 • Two years $78 SOUTHCOMM Chief Executive Officer: Chris Ferrell Chief Operating Officer: Rob Jiranek Director of Accounting: Todd Patton Director of Operations: Susan Torregrossa Creative Director: Heather Pierce Director of Content / Online Development: Patrick Rains Chief Technology Officer: Matt Locke Director of Digital Products: Andy Sperry Business Manager: Eric Norwood

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FOCUS ON CANCER RESEARCH, TREATMENT UPDATES, SCREENING AND DIAGNOSIS

Moffitt Cancer Center will present several conferences in 2013 for a variety of healthcare professionals.

JANUARY 19, 2013 9th Annual Clinical Breakthroughs & Challenges in Hematologic Malignancies Disney’s Grand Floridian Resort, Lake Buena Vista The 9th Annual Clinical Breakthroughs and Challenges in Hematologic Malignancies Conference is designed to present the most recent diagnostic and therapeutic advances in hematologic malignancies to practicing hematologists, oncologists, pharmacists, physician assistants and oncology nurses. Join us to hear national experts discuss the most recent treatment options and emerging therapies in these topics: myeloid malignancies, MDS, AML, NHL, ALL, CLL and multiple myeloma. Ample time will be available for case presentations and discussion.

For more information visit the conference website at: www.MOFFITT.org/ Hematology2013or contact Melissa Pearson at 813-745-1247.

It was the first note I ever got in crayon. “Thank you for making my daddy feel better.”

I keep it on my desk, where I pore over patient records and cash flow statements. Because even if the medical field seems to be changing by the day, the reasons I practice never do.

FEBRUARY 28 – MARCH 1, 2013 13th Annual Current Perspectives in Oncology Nursing Conference Moffitt Cancer Center, Tampa The goal of this annual nursing conference is to provide information pertinent to the practice of oncology nurses at all stages of their careers. Topics are chosen to educate the novice, update the proficient and challenge the expert oncology nurse. Call for abstract is available and nursing continuing education contact hours are offered. Special Event included: 9th Annual Rhinehart Reception and Lecture on February 27, 2013.

For more information visit the conference website at: www.MOFFITT. org/Nursing2013 or contact Chrystyna Pospolyta at 813-745-4918.

MARCH 9, 2013 State-of-The-Art NeuroOncology Conference Sheraton Sand Key, Clearwater Beach This conference will present the most recent diagnostic and treatment information and advances in neurooncology and neurosurgery. A variety of topics on neurological abnormalities will be presented.

Moffitt is the only brain cancer center in Florida and one of only 15 in the U.S. recognized by the National Cancer Institute as a founding and active member of the Adult Brain Tumor Consortium, which aims to develop more effective therapies for these tumors.

For more information visit the conference website at:www.MOFFITT.org/ NeuroOncology2013 or contact Melissa Pearson at 813-745-1247.

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