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PHYSICIAN SPOTLIGHT PAGE 3
Patrick MacMillan, MD ON ROUNDS CLINICALLY SPEAKING: New breast cancer treatment options boost survival, offer new hope As a surgical oncologist focused on treating breast cancer, I see daily how devastating a breast cancer diagnosis can be. But I also see daily how new and often cutting-edge treatments give women the hope and courage they need to help manage ... 4
LEGAL MATTERS: Healthcare Surrogates Get Increased Powers – Including Admission for Mental Health Treatment Effective July 1, 2013, those individuals designated as healthcare surrogates for others have additional powers in areas concerning mental health treatment, medical records access, or consent to disclosure of protected health ... 5
ONLINE: EASTTN MEDICAL NEWS.COM
Research Uncovers New Clues to the Causes of Schizophrenia By CINDy SANDERS
An insidious condition, schizophrenia is estimated to occur in about 1 percent of the population worldwide. Characterized by a breakdown in thought processes, the mental illness has been described for centuries through accounts of individuals suffering from delusions, paranoia and hallucinations. The chronic, debilitating disorder takes a heavy toll not only on affected individuals but also on their families and society as a whole. An early onset disorder, many patients are first diagnosed during the late teens or early adult years and struggle throughout their lifetime to manage symptoms. “It’s a horrible disorder,” stated Patrick Sullivan, MD, director of the Center for Psychiatric Genomics at the University of North Carolina School of Medicine. “It’s a huge, huge public health problem, and it’s one where the scientific discussion has been
dominated on partial information.” He added, “People have done the best they can with what information they have. We’ve been debating the cause of schizophrenia for the better part of a century now.” On Aug. 25, Sullivan and colleagues helped move that conversation forward with the online publication of a new genome-wide association study (GWAS) in the journal Nature Genetics. “This is the largest published study we’ve done in the field,” noted the lead author who also serves as a professor in the departments of Genetics and Psychiatry and UNC. Collaborators in the study include co-authors from the Karolinska Institutet in Sweden, the Stanley Center for Psychiatric Research at the Broad Institute of MIT (CONTINUED ON PAGE 10)
Happy, Safe Workforce Prerequisite for Patient Safety Report Emphasizes Impact of Workplace Culture on Patient Outcomes By CINDy SANDERS
If the workforce ain’t happy … ain’t nobody happy. This spring the Lucian Leape Institute at the National Patient Safety Foundation (NPSF) released a report, Through the Eyes of the Workforce: Creating Joy, Meaning and Safer Health Care, that underscored the fundamental importance the workplace environment plays on patient safety. The result of two roundtables on the topic, the report contends patient safety is inextricably linked to healthcare workers’ own sense of safety and well being since providers who feel disrespected or threatened are more likely (CONTINUED ON PAGE 10)
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PhysicianSpotlight
Patrick MacMillan, MD By BRIDGET GARLAND
Doctor by day, musician by night may not be a totally accurate description of Patrick MacMillan, MD, but it comes pretty close. While most of his time is spent seeing patients. MacMillan can be spotted, on occasion, wielding a microphone at local Tri-Cities venues. A member of the Under the Table Band, MacMillan enjoys writing, singing, and playing music, which he started doing in 2006 with Dr. Tom Roy, another local physician. Four years ago, however, he started performing with Under the Table, and hasn’t stopped since. He, along with the other band members, has the crowd dancing and singing along by the end of the night, demonstrating another one of his unique qualities—connecting with people. That’s one of the main reasons MacMillan pursued medicine as a career in the first place—he wanted to help people. “It [becoming a doctor] wasn’t something I always wanted to do,” he shared. “I was about 26 or 27, studying at that time to be a social worker, but decided to change. I guess you could say I was a late bloomer. “I became fascinated with science, biology in particular, so I decided to look into medicine as a career and maybe put some social work into medicine,” he said. “As a social worker, you can’t practice medicine, but as a medical doctor, I could hold on to that idea of helping people, which is one of the reasons why I chose psychiatry.” Originally from Evansville, Indiana, MacMillan attended the University of Southern Indiana for his undergraduate degree, where he majored in history. He obtained his medical degree from Ross University and completed his residency in
internal medicine and psychiatry at East Tennessee State University’s Quillen College of Medicine in 2004. MacMillan heard about the dual med/psych track while he was in medical school during his third-year clerkship. He had already finished his psychiatry clerkship but fell in love with internal medicine. The dual track seemed to be the perfect answer for combining his two interests. “My preceptor told me that when those departments teamed up, the result was great patient care.… As you may know, there is a stigma associated with mental illness, so med/psych allows me to get people seen for mental health issues through the backdoor by treating them for primary care,” he explained. “On the flip side, I see a lot of people with chronic mental illness, especially schizophrenia, who have chronic medical problems. It’s an interesting way to treat people, which fits my personality and my philosophy; it made sense.”
MacMillan is actually board certified in three specialties—psychiatry, internal medicine, and hospice & palliative medicine. These multiple certifications work together to support MacMillan’s philosophy of care, that patients can’t be treated one-dimensionally, the entire person must be treated—body, mind, and spirit. “You can’t separate the mind from the body, so the med/psych track becomes a way to treat the entire person,” he said. “There are certain things that really enable me to bring medicine and psychiatry together, and that’s hospice and palliative care. It’s a big passion for me and something I want to develop my skills in, particularly hospice. “When you are dealing with someone’s chronic illness or a life-limiting illness, such as cancer, end-stage lung disease or end-stage heart disease, the psychiatric component really comes into play,” he continued. “Hospice and palliative medicine is probably where these two fields have come together for me into one field, and that’s where I really get to use my medicine skills and my psychiatric skills.” MacMillan also shared that another
benefit to working in hospice care is the people with whom he has the opportunity to work—the patients, nurses, social workers, chaplains, and many more. “I really get to work with a lot of different, talented folks,” he said. “And when people are at the end of their lives—in a particularly vulnerable state—they tend to let down their guard, put down their defenses, and you can really make an impact on people and their family’s lives, as far as their spiritual health, their physical health, or their emotional and mental health. I think hospice meshes together all the training that I’ve had in a very a succinct way.” After finishing his residency, MacMillan stayed at Quillen, where he currently holds a dual appointment in internal medicine and psychiatry. Recently, he was appointed as course director in internal medicine, a role which requires working with medical students in their 3rd year while on hospital wards. “I really enjoy medical education, whether it’s residency education or medical student education. I like being around students, hungry to learn, and it also keeps me current.” MacMillan, as previously mentioned, also likes to be around his family, which includes his wife of 21 years and their three children—two daughters, one who lives in Memphis and teaches for Teach for America and the other who is in her 1st year of medical school, and a son, who lives in Evansville and is a musician, artist, and, surprisingly, a butcher. Writing and playing music, as well as poetry, isn’t MacMillan’s only recreational interest; in fact, he keeps active and enjoys being on the lake, camping, anything that gets him outdoors. Most recently, he became a certified diver. Although his career and hobbies keep him busy, the most important thing to him, MacMillan said, are the people in his life. “I really like to be around family; I even moved my mom here five years ago. I like being with family and good friends, spending time with people.”
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Italian Inspiration featuring Members of the East Tennessee State University Symphonic Wind Ensemble and Concert Band Saturday, November 16, 7:30 p.m.
Johnson City Symphony Orchestra
Mary B. Martin Auditorium at Seeger Chapel, Milligan College
A wind ensemble made up of local brass musicians, coordinated by Christian Zembower, joins with the Johnson City Symphony Orchestra for an evening of music composed by Gioacchino Rossini, Felix Mendelssohn, and Ottorino Respighi.
Evening Program
Gioacchino Rossini: Overture to “La Gazza Ladra” Felix Mendelssohn: Symphony No. 4 in A Major, Op. 90 “Italian” Ottorino Respighi: The Pines of Rome
Tickets: $35; Seniors (65+) $30; Students $10 For more information: 92-MUSIC (926-8742) or visit www.jcsymphony.com Free bus service: 6:15 (Colonial Hill); 6:30 (Maplecrest & Appalachian Christian Village); 6:45 (City Hall) This concert is funded under an agreement with the Tennessee Arts Commission and the National Endowment for the Arts.
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ClinicallySpeaking BY ANITA JOHNSON, MD
New breast cancer treatment options boost survival, offer new hope As a surgical oncologist focused on treating breast cancer, I see daily how devastating a breast cancer diagnosis can be. But I also see daily how new and often cutting-edge treatments give women the hope and courage they need to help manage or overcome the physical, mental and emotional challenges of breast cancer, and in many cases, beat the disease altogether. One in eight women will develop breast cancer in her lifetime. While the leading risk factors are well known – older age, family history, mutations in certain genes – the most important risk factor for breast cancer is simply being a woman. The fact that any woman can develop breast cancer is one reason annual mammograms and clinical breast exams are so important; regular screening helps detect cancer early. As with every type of cancer, when breast cancer is discovered early there are more treatment options available, survival rates are longer and the cure rate is higher. In the U.S., trends in breast cancer are encouraging. Data from the National Cancer Institute show consistent declines in both new cases and deaths from breast cancer since 1990. Further, the U.S. Centers for Disease Control and Prevention (CDC) reports that from 2000 to 2009 the incidence of breast cancer in the U.S. decreased by 0.9 percent per year, while mortality decreased 2.1 percent annually. What’s most notable about these data is that breast cancer mortality is decreasing at more than twice the rate of incidence – meaning that women with breast cancer are living longer. That trend also is borne out by CDC data: although less than 75 percent of women with breast cancer survived more than five years in the 1970s, in 2005 more than 90 percent did. There may be several reasons behind the decline in breast cancer deaths. However, new technologies and improvements in existing treatments are very likely contributing to higher survival rates and improved quality of life for women with breast cancer. In addition to continued refinements in breast-conserving and reconstructive oncoplastic surgery techniques, there is an array of advanced treatment technologies available today. For example, genomic testing is an innovative new diagnostic tool that allows tumors to be examined on a
genetic level. By identifying mutations that occur in a cancer cell’s genome, doctors can better understand what caused the tumor and tailor treatment based on these findings. Genomic testing might suggest a drug normally used for another type of cancer could be an appropriate treatment for breast cancer based on the genetic properties of the tumor. Another example is intraoperative radiation therapy (IORT), one of many new technologies that deliver radiation more precisely, helping minimize damage to healthy tissue and treatment times. With IORT, radiation is delivered directly to the tumor site after a surgeon has removed the tumor. A 30-minute dose of IORT can often replace weeks of traditional radiation. In addition to radiation, there have been numerous advances in chemotherapy treatments for breast cancer. Targeted therapy blocks specific molecules involved in tumor growth by directing drugs or other specially-created compounds (e.g., man-made immune system proteins) to attack cancer cells. A targeted therapy called chemoembolization delivers medication through a catheter directly into a tumor using image guidance. The chemotherapy drugs are mixed with particles, called microspheres, which block blood flow to the tumor. With so many options available to treat breast cancer today, treatments can almost be tailored to the individual based on factors such as her genetic profile, location of the tumor, the type of tumor and whether the cancer has spread, among others. However, which treatment a woman ultimately chooses is a very personal decision best made in collaboration with her family, personal physician and oncologist. The specter of breast cancer can be frightening, but it is important to remember that most women will not develop the disease. Women who are at an increased risk should talk to their doctors about how often they should receive mammograms and what other screenings, such as genetic testing, might be beneficial. Although breast cancer continues to claim too many lives – more than 35,000 each year – advanced treatment options are having a significant impact on survivability and quality of life. Anita Johnson, MD, FACS, is medical director of breast surgical oncology at Cancer Treatment Centers of America at Southeastern Regional Medical Center in Newnan, Ga.
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LegalMatters BY JENNIFER PEARSON TAYLOR
Healthcare Surrogates Get Increased Powers – Including Admission for Mental Health Treatment Effective July 1, 2013, those individuals designated as healthcare surrogates for others have additional powers in areas concerning mental health treatment, medical records access, or consent to disclosure of protected health information. What is a healthcare surrogate? Tennessee law allows any adult or emancipated minor to designate any individual to act as surrogate decision maker for the patient. In order to make such a designation, the patient need only inform his or her healthcare provider, either orally or in writing, of his or her decision (1). A surrogate then has the ability to make a healthcare decision for the patient when the designated physician deems that the patient lacks capacity to make his or her own decisions and no other agent or guardian has been appointed or is reasonably available. Can a healthcare provider designate a healthcare surrogate for a patient? Yes. If a patient lacks capacity and has not designated a surrogate or agent, and does not have a guardian or other legal agent, then the supervising healthcare provider must identify the patient’s surrogate and document the designation in the patient’s medical records. Tenn. Code Ann. § 68-11-1806 describes the hierarchy of individuals to whom the healthcare provider should look when designating a patient’s surrogate: • the patient’s spouse (unless legally separated) • the patient’s adult child • the patient’s parent • the patient’s adult sibling • any other adult relative of the patient who has exhibited special care and concern for the patient, who is familiar with the patient’s personal values, who is reasonably available, and who is willing to serve. Can a healthcare provider act as a surrogate for a patient? Yes, but only under a very narrow set of circumstances. If there are no eligible persons reasonably available to act as the patient’s surrogate, then the physician may make health care decisions for the patient, but only after physician either one, consults with and obtains the recommendations of an institution’s ethics mechanism or two, obtains concurrence from a second physician who is not directly involved easttnmedicalnews
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in the patient’s healthcare, does not serve in a capacity of decision-making, influence, or responsibility over the designated physician, and is not under the designated physician’s decisionmaking, influence, or responsibility (2). Does the physician designated surrogate have the same powers as the patient designated surrogate? No. A surrogate who has been designated by the healthcare provider, rather than the patient, may make all healthcare decisions for the patient that the patient could have made on his or her own behalf, except that artificial nutrition and hydration may be withheld or withdrawn only by a patient-designated surrogate, or by physician-designated surrogate when the designated physician and a second independent physician certify in the patient’s medical records that the continuation of artificial hydration or nutrition is merely prolonging the act of dying. What new powers do healthcare surrogates have? Previously, designating a healthcare surrogate allowed the surrogate to make healthcare decisions for a patient but did not allow for the surrogate to admit or request release of a patient from voluntary inpatient mental health treatment or to authorize the disclosure of mental health or substance abuse records of a patient. Changes in Tennessee law effective July 1, 2013, now allow a healthcare surrogate, both patient-designated and physician-designated, to • apply for admission to a public or private hospital or treatment facility for a patient to receive diagnosis, observation, and treatment of a mental illness or serious emotional disturbance (3); • request the release of the patient from voluntary inpatient treatment (4); • consent to the disclosure of confidential mental health and substance abuse treatment information concerning the patient (5). What does this mean for my practice? Careful attention should be paid to the documentation in a patient’s medical record when the patient lacks capacity and another person is making healthcare decisions for the patient. The medical record should
clearly document whether the patient designated the surrogate while the patient still had capacity. A copy of any written designation of healthcare surrogate should be kept in the patient’s medical record. If the healthcare provider determines that a patient lacks capacity and must designate a surrogate for the patient, the medical record should include documentation regarding: • the healthcare provider’s determination that the patient lacks capacity; • the relationship between the physician-designated surrogate and the patient; • whether the physician believes the surrogate can and will act in the best interests of the patient; • the surrogate’s demonstrated care and concern; and • the surrogate’s availability to visit the patient and engage in face-toface contact with healthcare providers
concerning the patient. Healthcare surrogates are a vital part of the care provided to patients who lack capacity to make their own healthcare decisions. Providers may rely on the decisions of a surrogate, but must ensure that sufficient documentation of the surrogate’s authority to act exists in the medical record. Disclaimer: The information contained herein is strictly informational; it is not to be construed as legal advice. Jennifer Pearson Taylor is an attorney practicing at London & Amburn, P.C. Her practice focuses on health law, with concentrations in healthcare employment and board investigation matters, along with the defense of long term care and medical malpractice claims. For more information, you may contact Ms. Taylor by visiting www.londonamburn. com.
Notes 1. T.C.A. § 68-11-1806. 2. T.C.A. §68-11-1806(c)(3). 3. T.C.A. § 33-6-201. 4. T.C.A. § 33-6-206. 5. T.C.A. § 33-3-104.
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From the Editor:
Paddles Up for Community, Comradery, Cancer Care I’ve read about the Mountain States Dragon Boat Festival every year since I moved to Johnson City in 2006. Just completing its 8th year on September 7th, the Dragon Boat Race, hosted by the Mountain States Foundation, has become an event many people in the community look forward to participating in. I, on the other hand, have always been a bit leery, considering my lack of any athletic talent—until recently. I wanted to know what all the hype was about. I would hear many of my colleagues and friends go on and on about all the fun they had at the race. I couldn’t imagine that paddling a boat could be all that enjoyable. So, when the invitation was given, how could I turn it down? I’m inquisitive by nature. Good thing I’m a quick learner. The same week I accepted the invitation was the week I learned to paddle—the Dragon Boat way. I didn’t realize that paddling a canoe or kayak is different from paddling a Dragon Boat. Paddles should be up (vertical, not horizontal), and the speed comes from digging in deep and pulling back, using my abs (do I even have abs?) to power the motion, not my arms. And one more thing…you have to stay in-sync; otherwise, the paddler behind you gets out of rhythm, too, affecting the whole team. Our quick lessons paid off. Our team—the Yottabytes (a name
The Yottabyte Team, captained by Bill Steck, Corporate Director of the MSHA IT Customer Service Center, won the IPC, The Hospitalist Co., Challenge Cup only computer geeks could come up with)—was scheduled in the first race in the first heat. Our twenty-one member crew probably had some first race jitters, finishing second in our race with a time of 62.72 seconds, but with some helpful advice from our steersmen, our time in the second race in the next heat was much improved. We shaved off four seconds
and ended up among the top 18 teams who were placed in the Challenge Cup heats. Although none of our team members expected to be competitive in the race (almost all of us were first time paddlers), the thrill of moving on to a Cup Challenge had us riled up and prepared to win—and we did. We walked away winners of the IPC, The Hospitalist Co., Challenge Cup.
While winning the cup was definitely thrilling, what impressed me the most about the Dragon Boat Festival was the sense of community and comradery fostered by the event. Local healthcare providers, businesses, and organizations, even the Science Hill High School Marching Band, came out to work together for a common cause. This year, the annual fundraiser benefited Mountain States Health Alliance Oncology Services, and at the opening remarks, area cancer patients addressed the crowd, expressing gratitude for the paddlers’ fundraising efforts. Remarkably, every face in the crowd appeared to have a smile, with the realization that so many lives would be touched with the dollars earned—as of this writing, $152,909.17. I am so grateful I had the opportunity to participate, so let me say thank you to the Mountain States IT Department for allowing me to paddle with them as a Yottabyte. For more information or to see photos from this year’s festival, visit http://www.mshafoundation.org/. All the best, Bridget Garland Editor, East Tennessee Medical News
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Enjoying East Tennessee Cades Cove
By LEIGH ANNE W. HOOVER
As legend goes, the picturesque cove, which is part of the Great Smoky Mountains National Park, was once call “Kate’s Cove” and named for the wife of an Indian chief. Some say it was named after Chief “Kade” or “Cade” or possibly even the Cades Family. Others even say it was originally called “Caged Cove” because settlers felt “caged in.” Regardless, today, Cades Cove still posses the peacefulness and tranquility of wildlife and natural beauty on a landscape canvas created by God. The Great Smokey Mountains National Park is over 500,000 acres of land, and Cades Cove is within this acreage. When the area was turned into a national park, the open fields were maintained, offering views for great distances and prolific wildlife. “It isn’t a traditional forest area like much of the park,” said National Park Spokesperson, Molly Schroer. “So, you can see a great distance, and there are no trees obstructing your view of wildlife in the open fields where they roam.” According to Schroer, black bears are a popular sight in the fall, and they are usually out eating acorns and nuts around the
trees. “We ask people not to feed the bears,” explained Schroer. “People need to keep a safe distance of 50 yards…, and if you find a bear is getting closer, make a lot of noise and be loud to scare it off. Don’t give them food or a reason to want to approach you.” Visitors can glimpse breathtaking vistas ripe with all of the glorious colors of the season. Whether it’s from the car enjoying the
11-mile loop around the Cades Cove, hiking to Abram Falls, or enjoying a picnic, Cades Cove is truly a treasure—especially in October. “Cades Cove is located in the western part of the park near the Townsend entrance,” explained Schroer. “It’s a great place to see wildlife, historic cabins, and the fall views.” In fact, Cades Cove has been referred to as “the largest open air museum in the
entire Great Smoky Mountains National Park.” Structural remains are reminiscent of life dating back to the 1800s. “Cades Cove is such a particularly beautiful area of the park because you’ve got these great views, where you can see the mountains from a distance, but you can also see this historic past with the cabins, mill, churches and barns…,” said Schroer. “It’s a great place to explore and see what it was like for the people who settled and lived in the park many years ago.” Some structures are visible from the loop and just short walks from the paved parking pullover areas. Often, park rangers assist visitors by answering questions and conducting programs. Topics and times vary, and these can be referenced on the park website. There is also a Cades Cove tour/map book with some history about each. The oldest structure in Cades Cove, John Oliver Cabin, is a favorite for Schroer because she enjoyed walking to it and sharing this piece of history with her mother. Such structures are connections to the past and reminders of life in a “simple time” without the stress of life today. Although the loop is closed occasionally to motor traffic in the summer, the loop is open daily during the fall from sunup to (CONTINUED ON PAGE 8)
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Enjoying East Tennessee, continued from page 7
sundown. Due to the park’s popularity, Schroer suggests visiting on a weekday when possible or beginning early in the morning. Also, make sure that you have a full tank of gas, snacks, and plenty of water. “Be prepared to spend the day. It can take three to four hours just to get around the 11 mile loop,” said Schroer. “Just be patient and come out and enjoy it. People love this, and they come back every year.” The head of the loop offers picnic areas and restrooms. There is a small campground store to rent bicycles, and there are also riding stables. Halfway around the loop at the Cable Mill historic area, you will also find a visitor’s center and restrooms. Beautiful water areas and creeks are also throughout Cades Cove. If you are adventurous, you can pack hiking shoes and explore Abram Falls. Named for a Cherokee chief, Abram Falls has its own trail leading to it. However, it is important to plan for this hike and bring appropriate gear. “Many people go out in the Cades Cove loop not quite knowing what to expect,” explained Schroer. “But after driving through a tunnel of trees in the park in order to get there and then coming up on this beautiful, open area—running an 11 mile loop—it’s such a great part of history and the perfect place for wildlife.” For additional information, visit www. nps.gov/grsm or http://www.nps.gov/ grsm/planyourvisit/cadescove.htm for the specific site on Cades Cove. Leigh Anne W. Hoover is a native of South Carolina and a graduate of Clemson University. She has worked for over 25 years in the media with published articles encompassing personality and home profiles, arts and entertainment reviews, medical topics, and weekend escape pieces. Hoover currently serves as immediate president of the Literacy Council of Kingsport. Contact her at hoover@chartertn.net.
A Butterfly Called Hope As a gifted storyteller, New York Times bestselling author Mary Alice Monroe beautifully parallels human relationships with nature. Now, “Monroe’s Monarch,” better-known as A Butterfly Called Hope, arrives, as the monarch butterfly population is declining, to entrance, educate, and capture future conservationists. Once this little book becomes part of your home or classroom collection, you will also want to be on the lookout for milkweed and caterpillars to house and watch your own monarch arrive from its chrysalis, and Monroe tells you how. Just as she beautifully writes, while also teaching in her adult novel The Butterfly’s Daughter, Monroe emerges with the same inner spirit and passion in her latest children’s book, A Butterfly Called Hope from Sylvan Dell Publishing. Teaming with award-winning photographer Barbara Bergwerf and co-author Linda Love, Monroe’s second children’s book displays the miracle of transformation in a book that can be shared with children and adults alike—milkweed required! From actively raising her own monarch butterflies, researching, and following them to their wintering sanctuaries in the mountains of Mexico, Monroe shares additional, educational details “for the creative minds” in the back of the book for more indepth study. Even vocabulary words from the life cycle are included. “My adult reading student, Ralph, from Reading with Ralph—A Journey in Christian Compassion, Jan-Carol Publishing, Inc., learned all about the loggerhead sea turtle
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in Monroe’s first children’s book, Turtle Summer which is the comSummer, panion to her adult novels Swimming Lessons and The Beach House,” said author Leigh Anne W. Hoover. “I know A Butterfly Called Hope will also provide shared lessons on the monarch to read, enjoy, and to treasure.” The monarch butterfly actually travels through Tennessee during October winging its way to Mexico for the winter. In addition to this new book, readers can experience the grandeur through the IMAX Theater’s Flight of the Butterflies 3D at the Tennessee Aquarium in Chattanooga.
“Obviously, this is a great time to see the film as the “Supergeneration” of monarchs will be migrating through our region in late September and October,” explained Thom Benson, senior marketing and communications manager for the Tennessee Aquarium & IMAX Theater. “Last year we had quite a few stop by the butterfly garden between River Journey and Ocean Journey and in the IMAX garden.” Flight of the Butterflies 3D will be showing at IMAX Theater at the Tennessee Aquarium in Chattanooga through Thanksgiving. The film description can be found at: http://tnaqua.org/IMAX/ IMAX.aspx To learn more about this great flight, be sure to visit! Both A Butterfly Called Hope and Reading with Ralph—A Journey in Christian Compassion are available from major book sellers.
Reading with Ralph— A Journey in Christian Compassion Medical News columnist Leigh Anne W. Hoover is author of the well-known children’s book The Santa Train Tradition and awardwinning Festus and His Fun Fest Favorites. Recently, Hoover has ventured into a new genre publishing her first adult, non-fiction novel Reading with Ralph— A Journey in Christian Compassion with JanCarol Publishing, Inc. “Ralph is my adult reading student at the Literacy Council of Kingsport, Inc.,” said Hoover. “We are in our seventh year working together weekly, and Bee Fit 4 Kids is a family oriented pediatric weight management program using evidenced based research to help overweight children & their families. We are now accepting insurance. KidsFACT is a nonprofit support group created by GI for Kids, PLLC for those diagnosed with pediatric Inflammatory Bowel Disease (IBD) & their family members. Our behavior clinicians are experienced in helping a variety of disorders. Support group helping the Knoxville region with celiac disease & gluten intolerance. www.celi-act.com
Ralph is also a member of our church and Sunday school class at First Broad Street United Methodist Church in Kingsport. Without a doubt, I believe that Ralph was put in my path. In fact, when Ralph learned that I was writing a book about him, he replied, ‘This book is not about me. It’s about God.’” While the story of Ralph shows God’s strength and His prevailing love and grace, it also sheds a light on illiteracy, a cause near and dear to Hoover. When Ralph came to the Literacy Council of Kingsport, he was at a first grade reading level. Today, with the help of tutors, he is now above a sixth grade level and continues to improve. Over the past seven years, Ralph has gained a sense of freedom, independence, and confidence. Hoover is a native of South Carolina and graduate of Clemson University. Reading with Ralph— A Journey of Christian Compassion is endorsed by the President of Clemson University James F. Barker and Clemson Head Football Coach Dabo Swinney. Additional endorsements include New York Times bestselling authors Mary Alice Monroe and Patti Callahan Henry, former Clemson and NFL Titans Football player (CONTINUED ON PAGE 10)
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theLiteraryExaminer BY TERRI SCHLICHENMEYER
Five Days at Memorial: Life and Death in a StormRavaged Hospital by Sheri Fink; c.2013, Crown; $27.00 / $32.00 Canada 558 pages You know what you’d do in a crisis – or do you? Could you ignore your inner voice and do something wrongly right? That’s what allegedly happens in the new book Five Days at Memorial by Sheri Fink: one of our country’s worst disasters may’ve led to one of medicine’s most questionable acts. When Southern Baptist Hospital opened in New Orleans in 1926, its founders hoped it would be “the greatest hospital in all the Southland.” Indeed, it had the sturdiest of buildings: when Hurricane Betsy hit in 1965, the campus barely blinked. There was no reason, therefore, to believe that the hospital (renamed Memorial Medical Center the mid-1990s) couldn’t withstand Hurricane Katrina. As Katrina approached land on August 28, 2005, there were as many as 2,000 people at Memorial, including staff and families, 183 Memorial patients, and 55 patients belonging to LifeCare, a “hospital within a hospital” that rented facilities at Memorial. There were also hundreds of staff-owned pets inside, for safety’s sake. At first, the atmosphere was lighthearted. It was obvious by the “little shimmy shake” of the floor-to-ceiling windows and the devastation outside that the storm was dangerous, but staff was optimistic. And then the levee broke. Water poured into the building, the hospital’s generators became waterlogged, air conditioning failed, and the temperature skyrocketed inside. Plumbing shut down, and fetid odors wafted through each floor. Evacuations were denied (or sporadic), whispers of “martial law” circulated, and optimism waned as the sickest patients became dehydrated, overheated, delirious. Nurses scrambled to keep people alive in conditions that deteriorated almost by the minute. When it became obvious that pets mightn’t be evacuated, some staff tearfully requested that beloved companions be euthanized. A few nurses wondered if they would ever leave Memorial alive. And then someone asked a quiet question: “Why should we treat the dogs better than we treat the people?” Inflammatory? You bet. And the subject of a months-long, post-Katrina investigation, all of which author and Pulitzer Prize-winning author Sheri Fink details in this huge, totally absorbing book. Five Days at Memorial begins with tip-of-a-shark-fin anxiety and quickly de-
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scends into chaos, which perfectly displays a mere taste of what happened to the survivors you’ll meet here. That’s the first half of this book, before Fink’s story turns into something conversation-worthy, something that (admit it) everyone’s reluctantly thought about. From there, and during the legalities that Fink recounts, readers have a front-seat view of finger-pointing, trackscovering and fact-finding that also became policy-changing. Once you start it, it’s hard to let go of a book like this because the memory of what happened is still awfully fresh.
High Price: A Neuroscientist’s Journey of SelfDiscovery That Challenges Everything You Know About Drugs and Society by Dr. Carl Hart; c.2013, HarperCollins; $26.99 / $28.99 Canada, 340 pages In the new book High Price by Dr. Carl Hart, you’ll be surprised at recent revelations about drugs, and the causes of addiction. Growing up on “one of the roughest neighborhoods of Miami,” Carl Hart had all kinds of temptations at his fingertips. Still, he managed to resist many of them. That doesn’t mean, however, that Hart was a complete angel. Guns were easy to get where he lived, and there was once a time when he wanted one for revenge-making. He and his friends shoplifted, dine-and-dashed, and once held a gun on a white man for fun. And he experimented with drugs – marijuana, cocaine, tobacco, and alcohol - even though he knew that those substances would poorly affect the basketball career he badly wanted. When he didn’t get a basketball scholarship, Hart knew that his best option was to join the military, so he entered the Air Force and discovered that basic training was easy for an athlete from Miami who was used to hot-weather activity. He used that ease to challenge his fellow airmen, and he found his leadership abilities. And because he was trying to stay out of trouble – which meant avoiding the brothers who wanted to smoke marijuana – he took his first college class. Today, Hart’s career lies in the study of the effects of drugs on behavior, and because of his research, he has learned some surprising things about addiction; for instance, the vast majority of cocaine use is outside the black community, and 80-90 percent of cocaine users “do not develop problems with the drug.” Furthermore, Hart believes that the solution to the drug problem – and, by extension,
many of the other societal ills that befall inner cities – isn’t through a racially-motivated “war on drugs.” What’s needed, he says, is for people – especially young adults - to have a “stake in our society.” Though it tends to take a while to get to the point, High Price isn’t bad. Author and neuropsychopharmacologist Dr. Carl Hart uses his own life experiences and plenty of up-front truth to show how general perceptions of drug use and abuse is wrong, particularly when it comes to drugs and the Black community. This mixing of personal story and hard research is interesting and appealing, in part because Hart isn’t preachy and partly due to his unique history as someone who actually lived that which he’s trying to help others avoid. It took some effort for me to stay with this book at first, but I was ultimately glad I stuck around. And if you’re a reader who questions assumptions, is tired of “experts” who don’t walk the walk, and you love a good biography, then High Price is a book I believe you’ll like, too. Terri Schlichenmeyer has been reading since she was 3 years old, and she never goes anywhere without a book. She lives on a hill in Wisconsin with two dogs and 11,000 books.
Online Event Calendar To submit or view local events visit the East Tennessee Medical News website.
A user name and password are required to submit an event. Under Member Options, go to “free sign up” to register.
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...Welcomes Jennifer Oakley, MD. She is a glaucoma specialist (our third) and a Bristol native, attended UT and ETSU’s Quillen College of Medicine, completed an Ophthalmology Residency at University of MS Medical Center and a Glaucoma Fellowship at the University of South Florida.
Accepting new patients!
110 Med Tech Park • Johnson City, TN
423-929-2111 Find us on Facebook
JANUARY 2013
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Happy, Safe Workforce Prerequisite for Patient Safety, continued from page 1 to make errors and less likely to follow institutional protocols. Julianne Morath, RN, MS, president and CEO of the Hospital Quality Institute based in Sacramento, Calif., co-led the roundtables with former U.S. Treasury Secretary Paul O’Neill, now CEO of Alcoa. A founding member of the Lucian Leape Institute, Morath was the inaugural recipient of the John M. Eisenberg Award for Lifetime Achievement in Patient Safety from NPSF and is a noted author and speaker on the topic of safety and workforce improvement. Going into the roundtables, Morath said the working hypothesis was, “A workforce, no matter how committed and skilled, cannot create a culture of safety unless they themselves are free from harm and disrespect.” This hypothesis was borne out during the discussions that included the experiences and opinions of frontline practitioners, leaders of healthcare organizations, scholars, and representatives of government agencies and healthcare professional societies. Morath said, “It became very evident through the course of the roundtables that we have a long way to go in healthcare workforce safety.” When workers live in a constant state of risk, they become blind to that risk and resigned to their situation, Morath said. “It’s a dangerous place to be if you think this is as good as it’s going to get no matter what you do,” she noted. When a workforce reaches this state, Morath continued, the workers won’t speak up or speak out. Yet, the evidence clearly shows having a culture that allows for effective assertion … or a ‘stop-the-line conversation’ … is a prerequisite for patient safety. Morath, who served as chief quality and patient safety officer at Vanderbilt University Medical Center at the time of the roundtables, said her co-leader O’Neill has often made the statement that every person in a workforce should be able to answer affirmatively to three essential questions: 1. Am I treated with respect and dignity by everyone? 2. Do I have the support and training tools to do my job? 3. Am I recognized and thanked for my contributions? Unfortunately, ‘no’ is too often the answer to those questions. “It was jarring to
find not only was there a lack of respect … but even worse, there was a culture of disrespect in many of our healthcare organizations that was tolerated,” she said of the group’s findings. “We have a somewhat historic and toxic culture where the hierarchy has to do with positional titles and the number of degrees,” Morath added. Vulnerabilities in the system include accepting emotional abuse, bullying and learning by humiliation as ‘normal,’ performing demanding tasks under severe time constraints due to the production and cost pressures that dominate today’s healthcare landscape, and having a higher rate of physical harm than such high-risk industries as mining, manufacturing and construction. This culture of fear and intimidation takes away the joy and meaning from work that most healthcare employees chose for the very purpose of helping others and making a difference. “While this report is concerning, it’s also hopeful,” said Morath, noting there were also examples of healthcare workplaces that are getting it right … at least most of the time. New healthcare models that rely heavily on teamwork are also helping make cooperation part of the landscape. “It really requires an appreciation and respect for everyone’s contribution in a team to deliver high quality, safe care in this complex environment in which we work today,” she noted. The report asserts joy and meaning are created when the workforce feels valued, safe from harm and part of the solutions for change. The Mayo Clinic and Virginia Mason Medical Center are two examples that Morath said stood out for their culture of respect. She also said Hospital Corporation of America (HCA) has an exemplary employee safety and security initiative. To create safe, supportive work environments, healthcare facilities must become high-reliability organizations with a fundamental precondition that employees are their most valuable assets and that the health and well being of those employees is a non-negotiable priority. The report outlined seven strategies to move the needle toward becoming this type of an effective organization. 1. Develop and embody shared core values of mutual respect and civility; transparency and truth telling; safety of all
Reading with Ralph, continued from page 8 Coty Sensabaugh, and several others. Reading with Ralph— A Journey of Christian Compassion contains a foreword written by Dr. Robert Laubach. Laubach is well into his 90s, and his father, Dr. Frank Laubach, created the “Laubach Way to Reading” when he was a missionary in the Philippines. Dr. Frank Laubach was referred to as the “Apostle to the Illiterates,” and he coined the phrase “Each One Teach One.” Literacy organizations throughout the country utilize the Laubach 10
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Way to Reading. A portion of the proceeds from Reading with Ralph— A Journey of Christian Compassion will go towards the Literacy Council of Kingsport, Inc. located in Kingsport, Tennessee. The book is available on Amazon and Barnes & Noble, as well as other major outlets, and it is also in e-book format. Visit Leigh Anne W. Hoover on Facebook or www.thesantatraintradition.com.
workers and patients; and alignment and accountability from the boardroom through the front lines. 2. Adopt the explicit aim to eliminate harm to the workforce and to patients. 3. Commit to creating a high-reliability organization and demonstrate the discipline to achieve highly reliable performance. 4. Create a learning and improvement system. 5. Establish data capture, database and performance metrics for accountability and improvement. 6. Recognize and celebrate the work and accomplishments of the workforce regularly and with high visibility. 7. Support industry-wide research to design and conduct studies that will explore issues and conditions in healthcare that are harming the workforce and patients.
“It sounds deceptively simple, but it’s about and individual and collective commitment to continual learning, continual improvement, and continual engagement,” said Morath. “When you start, you’re never finished. This is a commitment … a long term commitment.”
Through the Eyes of the Workforce To download the full report and related materials, go online to www. npsf.org. Click on “About Us” and select the Lucian Leape Institute at NPSF. From there, choose the LLI Reports and Statements link under “Related Pages.”
Research Uncovers Clues, continued from page 1 and Harvard, and the Mount Sinai School of Medicine in New York. “We discovered there were 22 places in the genome, 13 of which to our knowledge had never been described before, and each is a clue about the cause of schizophrenia,” Sullivan said of identifying nearly two dozen locations in the human genome that are involved in the disorder, including one that has previously been implicated in bipolar disorder. Dr. Patrick “If finding the causes Sullivan of schizophrenia is like solving a jigsaw puzzle, then these new results give us the corners and some of the pieces on the edges,” he stated, adding the number of genetic variants probably numbers in the thousands. “These 22 are the tip of the iceberg.” The study was based on a multi-stage analysis that began with a Swedish national sample of 5,000 schizophrenia cases and 6,200 controls followed by a meta analysis of previous GWAS studies and then a replication of single nucleotide polymorphisms (SNPs) in 168 genomic regions in independent samples for a total of more than 59,000 people included in the research. The results underscored two takeaways for Sullivan. The first, “We need to do more studies urgently. We’re actually quite encouraged and believe larger studies of this type will lead to more knowledge,” he said. The second, “The early results we have here certainly indicate two different biological processes are involved.” The research uncovered two distinct pathways that might be associated with the disorder — a calcium channel and microRNA 137. Calling the calcium channel, which includes the genes CACNA1C and CACNB2, the ‘queen of the channels,’ Sullivan explained there are a number of FDAapproved calcium channel blockers on the market today that are used for a variety of conditions ranging from hypertension and angina to migraines. Stressing that it was much too early to draw conclusions, Sullivan said the findings
at least indicate the calcium channel might be an area that deserves further attention from those studying schizophrenia. Hypothetically, he continued, calcium channel blockers might be found to have unexpected efficacy in schizophrenics. “That’s something that needs to be evaluated in a careful, rigorous way,” he said, again cautioning against jumping too far ahead. The second pathway includes its namesake gene MIR137, which is a known regulator of neuronal development. Sullivan noted more than a dozen other genes are also known to be regulated by MIR137, as well. Schizophrenia has long been known to have a strong genetic component. While it occurs in about 1 percent of the general population, the disorder is found in about 10 percent of people with a first-degree relative diagnosed with schizophrenia. The National Institute of Mental Health notes the highest risk for developing the illness — 40 to 65 percent — occurs in an identical twin of an individual with schizophrenia. Yet, most scientists believe genetics is only one component in developing the disorder, which probably has environmental triggers, as well. While Sullivan said each different approach to solving the enigma of schizophrenia is important, he noted the genetic approach offers a strong foundation for discovery. “We can measure the DNA part of people particularly well these days,” he said. “Our study is a step forward in understanding the genetic basis of the disorder. This is really, truly nice progress.” He added the new findings provide “a couple of good strides forward” even though an endpoint isn’t yet in sight. “But for researchers and scientists, it shows us a bunch of things we’ve never seen before … and that’s pretty cool.” And Sullivan expects more information to be forthcoming. “What’s really exciting about this is that now we can use standard, off-the-shelf genomic technologies to help us fill in the missing pieces,” he said. “We now have a clear and obvious path to get a fairly complete understanding of the genetic part of schizophrenia. That wouldn’t have been possible five years ago.” easttnmedicalnews
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Wellmont Physician Connection
The best defense is a great offense. Especially when it comes to breast cancer. Thanks to remarkable strides in early detection, genetic testing and medical intervention, breast cancer fatality has seen a marked decline in recent years. And with the advanced breast imaging capabilities at the Wellmont Cancer Institute’s accredited breast centers, we can identify and start treating cancer almost as soon as it starts.
Finding invisible threats Most people can’t find a pea-sized lump in a breast on their own. But our advanced imaging services can find many that size – and even smaller.
Dr. James Phillips
Digital mammography
For younger women, or those with dense breast tissue, digital mammography can be particularly effective at detecting cancer. Just a 15-minute mammogram can be the impetus for early treatment or muchneeded peace of mind.
Digital mammography is available at the comprehensive breast centers of Holston Valley Medical Center and Bristol Regional Medical Center, as well as the Wellmont Breast Center in Johnson City. We also offer it in the radiology departments of Hawkins County Memorial Hospital in Rogersville, Lonesome Pine Hospital in Big Stone Gap, Va. and Takoma Regional Hospital in Greeneville. Breast MRI
For more advanced imaging options, the imaging services at Holston Valley and Bristol Regional also offer magnetic resonance imaging – mri – breast scans. Breast mris are more sensitive than mammograms and allow for better
early detection. The American Cancer Society’s new screening guidelines support what Wellmont’s been doing for several years – combining breast mris with annual mammograms for high-risk women. Breast-specific gamma imaging
Holston Valley was the first hospital in Tennessee to offer breast-specific gamma imaging – bsgi – which is also sometimes called molecular breast imaging. This is a procedure that helps show the metabolic activity of lesions in the breast, offering an important advantage to women with: • Dense breast tissue • Multiple suspicious lesions or clusters of microcalcifications • Lesions that can be felt but cannot be detected using other scans • Post-surgical or post-therapeutic densities • Implants • Hormone replacement therapy
Not only are we proficient with the most recent cancer-detecting technologies, but our breast centers were among the first in Tennessee to be accredited by the American College of Surgeons’ National Accrediting Program for Breast Centers. We’re currently the only two facilities in Northeast Tennessee to hold that distinction.
Fighting alongside our patients – every step of the way Receiving a breast cancer diagnosis can be one of the most overwhelming moments in a woman’s life. That’s why all of us with the cancer institute take extraordinary measures to guide our patients through treatment, giving them strength for today and hope for tomorrow.
helping patients find their way through visits, treatments and questions. Wellmont’ s breast centers, along with the Wellmont Cancer Institute, provide a complete range of services for the diagnosis and treatment of breast disorders and cancers, including: • High-risk clinic • Genetic testing and counseling • Clinical trials • Multidisciplinary care, including social workers and dietitians • Surgery, including treatment for breast conservation • Plastic surgery, including reconstructive breast surgery • Chemotherapy and targeted therapy • Radiation therapy, including breast brachytherapy • Support groups • Survivorship Our multidisciplinary team delivers holistic, compassionate care in a healing environment. And with locations in Kingsport, Johnson City, Bristol and Dr. Randall Barker Southwest Virginia, no matter where your patients live, you can rest assured they are getting the very best cancer care, close to home. Written by Dr. Randall Barker and Dr. James Phillips, diagnostic radiologists, Blue Ridge Radiology
From the moment a woman is diagnosed, she works with a nurse navigator who guides her through treatment and recovery. Our navigators are invaluable resources for
Learn more about our state-of-the-art breast imaging services – visit wellmont.org and click the Our Services tab. Patients may be referred by calling 1-855-878-8550.
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GrandRounds Blood Assurance begins serving Johnson City area JOHNSON CITY – Blood Assurance, a non-profit regional blood center, will expand its service region to include the Johnson City, Tennessee area. Effective Sept. 1, Blood Assurance and its network of volunteer blood donors will be the exclusive source of blood donations for three hospitals in the Mountain States Health Alliance, including Johnson City Medical Center, Johnson County Community Hospital and Franklin Woods Community Hospital. Donors in Washington and Sullivan Counties can support the needs of these local hospitals by donating blood with Blood Assurance, who will process and test the blood donations then fulfill the orders from the hospitals based on blood type and specific patient needs. “Blood Assurance is looking forward to working with donors, civic groups and businesses as we reach a common purpose of impacting lives in Johnson City and the surrounding area,” said Rick Youngblood, president and CEO of Blood Assurance. “Blood Assurance plans to provide blood for all the Mountain States Health Alliance hospitals over the coming months, allowing us more opportunity to serve the Tri-Cities area.” Youngblood invites the area’s blood donors to donate with Blood Assurance and encourages first-time donors to begin a life-saving habit of giving blood every 56 days. When separated into components of platelets, plasma and red cells, each blood donation can benefit up to three patients in need. Founded in 1972 in Chattanooga, Tennessee, Blood Assurance is a nonprofit regional blood center supplying blood components to more than 70 hospitals and healthcare facilities throughout five states, including Ala-
bama, Georgia, North Carolina, Tennessee and Virginia. For more information on donating blood or hosting a blood drive, please visit www.bloodassurance.org.
Orthopedic Surgeon Todd Christensen Joins TMA GREENEVILLE – Dr. Todd Christensen, a board-certified orthopedic surgeon, has joined Takoma Medical Associates. Christensen’s office is located on the third floor of the TMA building at 438 E. Vann Road. Christensen specialDr. Todd izes in total shoulder, hip Christensen and knee replacement, as well as arthroscopic knee and shoulder surgery. Christensen received his medical degree Loma Linda University Medical Center in California, where he was class valedictorian. He also completed his orthopedic residency at Loma Linda University Medical Center. Christensen served in the U.S. Air Force from 19951999 as an orthopedic surgeon and retired as a major. He is a member of the American Board of Orthopedic Surgeons and the American Academy of Orthopaedic Surgeons.
Starnes Joins Family Medicine Practice at TMA GREENEVILLE – Dr. Georganna Starnes has joined the family medicine practice at Takoma Medical Associates. Starnes’ office is located on the first floor of the TMA building at 438 E. Vann Road. Starnes graduated from East Ten- Dr. Georganna Starnes nessee State University’s
Quillen College of Medicine. She completed her residency with ETSU Family Medicine in Bristol.
Christina Miller, Michael Franklin Join Greeneville Urgent Care/Industricare as PAs GREENEVILLE – Christina Miller and Michael Franklin have joined Greeneville Urgent Care and Industricare as physician assistants. Miller graduated from Kettering College of Medical Arts in Ohio with Christina Miller a Bachelor of Science degree in physician assistant studies. She is board certified and lives in Greeneville with her husband, Michael, and their daughter. Franklin received his physician assistant certification from Wake Forest University School of Medicine. He is nationally certified with more than 20 years of experience in primary, urgent and emergency care. Franklin lives in Greeneville with his wife, Cathy. They have four children. They attend Greeneville Cumberland Presbyterian Church. Greeneville Urgent Care/Industricare is located at 1021 Coolidge St., Suite 4.
Wellmont Cardiothoracic Surgeon Receives Paul Harris Fellow Award from Local Rotary Club BRISTOL – Dr. Bill Messerschmidt, a cardiothoracic surgeon with the Wellmont CVA Heart Institute, was recently awarded the Paul Harris Fellow award by the Bristol Virginia-Tennessee Rotary Club. Each year, the club has a longstanding tradition of recognizing two Paul Harris Fellows in memory of the
Mark Your Calendar
Your local Medical Group Managers Association is Connecting Members and Building Partnerships. All area Healthcare Managers (including non-members) are invited to attend.
2ND THURSDAY
3RD THURSDAY
JOHNSON CITY MGMA MONTHLY MEETING
KINGSPORT MGMA MONTHLY MEETING
Date: The 2nd Thursday of Each Month Time: 11:30 AM – 1:00 PM
Date: The 3rd Thursday of Each Month Time: 11:30 AM – 1:00 PM
Location: Quillen ETSU Physicians Clinical Education Building, 325 N. State of Franklin Rd., Johnson City
Location: Indian Path Medical Center Conference Room, Building 2002, Second Floor, Kingsport
KGMA October Meeting Speaker is Pam Slemp, TMA • Topic: “New Laws Affecting You and Your Practice” 12
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lives and works of Dr. Kermit Lowry Sr. and Dr. Kermit Lowry Jr., both past club presidents. The Paul Harris Fellow honorees are handselected by a commitDr. Bill tee and given each year Messerschmidt to two people it believes have made outstanding contributions to the community and exuded Rotary’s motto of “Service Above Self” in their personal and work lives. Dr. Claude Crockett, a retired physician who practiced at Bristol Regional Medical Center, presented Dr. Messerschmidt with the award at the club’s annual banquet. He highlighted the surgeon’s integrity and his exceptional contributions to the region’s high-quality cardiovascular care. A former president of the Bristol Regional medical staff, Messerschmidt is a leader in developing innovative ways to provide the best care possible for his patients. For years, he and other heart institute physicians have been at the forefront in the region of performing beating-heart bypass surgery, which carries multiple health benefits. He has also extensively used da Vinci Surgical System to perform a number of procedures, including removal of the mammary artery inside the chest for use in coronary artery bypass surgeries and a single-vessel bypass without splitting the breast bone. He also uses this piece of medical equipment to perform lobectomies on lung cancer patients.
Nancy Merritt Named Chief Compliance Officer for Wellmont Health System KINGSPORT – A highly respected healthcare leader with more than a dozen years experience with compliance matters has brought her expertise to Wellmont Health System. Nancy Merritt has been named Wellmont’s chief compliance officer. She comes to the region after serving as vice president and compliance officer for Scott & White Health Care in Temple, Texas, Nancy Merritt since 2011. Merritt is responsible for overseeing programs that make certain Wellmont and its co-workers comply with all provisions of Medicaid and Medicare. She also implements safeguards so Wellmont has appropriate relationships with healthcare providers who refer patients to the health system. Plus, she ensures Wellmont is following federal regulations that mandate privacy of patient health information. Prior to her position at Scott & White, Merritt was vice president and compliance officer at Parkland Health & Hospital System in Dallas from 20072011. She was also chief compliance officer from 2000-2007 and internal audit director from 2000-2006 at Valley Health easttnmedicalnews
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GrandRounds System in Winchester, Va. A Lewiston, Maine, native, Merritt has ties to the region, with her mother and a sister living in Kingsport. That family connection, along with Wellmont’s sterling reputation, was a key factor in her decision to accept the position. Merritt obtained a Bachelor’s degree in Business Administration, with an emphasis on accounting, from the University of Maine. She is certified in healthcare compliance and healthcare research compliance by the Health Care Compliance Association and in internal audit by the Institute of Internal Auditors.
Quillen Medical Student receives award to support Leukemia Research JOHNSON CITY – A medical student at East Tennessee State University’s James H. Quillen College of Medicine has received an award from the American Society of Hematology to support his research aimed at finding better treatments for leukemia. Ko Maung is one of only 19 medical students chosen for the 2013 Hematology Opportunities for the Next Generation of Research Scientists (HONORS) Award. A fourth-year student at Quillen, Maung is collaborating with his faculty mentor, Dr. K. Krishnan, on a new treatment for leukemia that marries a specific type of vitamin E with a drug typically used to treat heart conditions. Krishnan, the holder of
the Paul Dishner Chair of Excellence in Medicine, is chief of the Division of Hematology and Oncology in the ETSU Department of Internal Medicine. Maung is investigating a treatment combining tocotrienol – a form of vitamin E – with statins, a class of drugs often used to lower cholesterol levels, especially in people with cardiovascular disease. The work by Maung, a native of Myanmar, a country in Southeast Asia also known as Burma, will build on previous studies by Krishnan. Maung will continue his research project while also fulfilling his obligations as a student, which will undoubtedly mean frequent nights spent in Krishnan’s lab. Fortunately, perseverance is one of Maung’s attributes. Were it not for the political instability of his native country, Maung might have completed his medical education in the mid2000s. He was set to start medical school for the first time in 2000, in Myanmar. Maung moved to the United States and enrolled at Lafayette College in Pennsylvania, where he earned a bachelor’s degree with a double major in mathematics and economics. He then moved to Tennessee and, not having forgotten his goal of becoming a doctor, took basic science courses at Tennessee State University and earned a Master’s degree at Middle Tennessee State University. His path came full circle when he was accepted at Quillen.
Bristol Regional, Holston Valley Recognized by American Heart Association for Heart Care KINGSPORT – Superior cardiovascular care from the Wellmont CVA Heart Institute, which bolsters quality of life for the region’s patients, is achieving special recognition from the American Heart Association for prompt and effective heart attack treatment. Bristol Regional Medical Center earned the Gold award in the Mission: Lifeline program administered by the national organization. The hospital is the only one in Tennessee and Virginia to attain this remarkable status, reinforcing the quality of care it delivers at the Alpha Natural Resources Center for Interventional Cardiology. Holston Valley Medical Center received the Silver award, demonstrating again that the heart institute is the go-to organization for the best cardiovascular Physicians with the Wellmont CVA Heart Institute accept care in Northeast Tennessee and the American Heart Association’s Mission: Lifeline Gold and Silver awards for prompt and effective heart attack Southwest Virginia. treatment. Pictured, left to right, Dr. Herb Ladley, intervenThe heart institute celebrat- tional cardiologist and medical director of the Level One ed the honors the two hospitals Heart Attack Network; Belinda Whitten, vice president of achieved at a ceremony Tuesday, Chattanooga field operations and development for the American Heart Association; and Dr. Pierre Istfan, interSept. 10, at MeadowView Con- ventional cardiologist and medical director of the cardiac ference Resort & Convention catheterization lab at Bristol Regional Medical Center. Center. At the event, the two hospitals received their awards from the American Heart Association, and physicians noted that their commitment to continuous improvement would continue. Bristol Regional collected the Gold award for compiling a composite score of 85 percent or greater on Mission: Lifeline quality achievement indicators for heart attack patients for two consecutive calendar years. Holston Valley received the Silver award for meeting this standard for one calendar year. easttnmedicalnews
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Maung is already planning a career in oncology when he graduates from medical school.
Samples chosen presidentelect of committee for Sleep Science Programs JOHNSON CITY – Dr. Donald Samples, interim dean of the East Tennessee State University College of Clinical and Rehabilitative Health Sciences, has been elected to serve as president-elect of the national committee that accredits academic programs for the study of polysomnography technology, the science of evaluating sleep disorders. Samples will serve one year in his current appointment with the Commit-
tee on Accreditation for Polysomnography Technologist Education and become president of the organization in the fall of 2015. Prior to becoming interim dean of the college, Samples served as associate dean for Academic Affairs and as professor and chair of the Department of Allied Health Sciences. The department collaborates with the ETSU School of Continuing Studies and Academic Outreach to offer a certificate program in polysomnography technology. Samples also holds committee appointments to the Commission on Accreditation for Respiratory Care and the Commission on Accreditation of Allied Health Education Programs.
WellmontOne Obtains New Helicopter with Additional Safety, Speed, and Efficiency to Enhance Care BRISTOL – WellmontOne Air Transport has acquired a faster and more fuel-efficient helicopter that will provide additional safety measures and amenities to enhance the high-quality emergency care for which it has always received widespread respect. The snazzy Bell 407 went into service earlier this month and enables pilots and crew members to continue serving the region with distinction through new technology. It will make flying the aircraft even better for those who play a valuable role in rescuing patients facing some of the most traumatic and life-endangering injuries and illnesses. This aircraft, built by the same company that owns a facility in Piney Flats, can fly about 10 miles per hour faster than its predecessor and has a quicker lift off the ground with one less engine. The new helicopter, which operates with an engine built by Rolls-Royce, burns much less fuel, reducing environmental impact and creating valuable cost savings that can be applied to patient care. Additional features include a traffic collision avoidance system that alerts the pilot to other traffic in the vicinity and a radar altimeter that measures the altitude of an aircraft above the terrain over which it is flying. The helicopter also has improved rear visibility that enables flight nurses and paramedics to assist the pilot in looking for obstructions. Plus, the helicopter has an improved navigational system and a computerized start system that has simplified the process for the pilot. As was the case with the previous aircraft, the Bell 407 is equipped with nightvision goggles. PHI Air Medical provides the helicopter, pilots and mechanics, while Wellmont supplies the medical equipment and medical providers. Wellmont also supports the medical operations of the Med-Flight II program, which is run by the Virginia State Police. Anita Ashby, Wellmont’s system director of flight services, who supervises the flight team, is thrilled with the many attributes this helicopter will bring to the region. But she is just as proud that the delivery of care onboard and at the scene will remain at the same high level. Paramedics and nurses can complete and transmit 12-lead electrocardiograms and have the same cardiac monitors and defibrillators that are used in the emergency departments at Wellmont hospitals. Some of the other pieces of equipment include a ventilator, respiratory equipment, core temperature monitoring equipment, advanced and surgical airway supplies and an abundance of critical care medications.
Jessica Antonino, a flight nurse on WellmontOne Air Transport, shows a 12-lead electrocardiogram machine aboard the helicopter. OCTOBER 2013
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GrandRounds American Heart Association honors Indian Path Medical Center for Outstanding Heart Attack Care KINGSPORT – Indian Path Medical Center has been recognized by the American Heart Association for the second year in a row for meeting a set of crucial achievement measures in its cardiac care for STEMI patients. IPMC was recognized at the Silver Level for meeting STEMI Referral Center Achievement Measures as part of the AHA’s “The Mission: Lifeline Recognition Program.”
American Hospital Association honors Franklin Woods Community Hospital
Franklin Woods one of four in the nation recognized for quality JOHNSON CITY – Representatives from the American Hospital Association (AHA) visited Franklin Woods Community Hospital (FWCH) to present a prestigious award to the three-year-old facility. Franklin Woods was one of four hospitals in the nation recognized this year by the AHA for leadership and innovation in quality improvement and patient safety. The hospital received the second-highest honor from the AHAMcKesson Quest for Quality program. The American Hospital Association McKesson Quest for Quality Prize is
presented annually to honor leadership and innovation in quality improvement and safety. The prize is supported by a grant from the McKesson Corporation. The criteria for the 2013 award include demonstration of an organizational commitment to and progress in achieving the Institute of Medicine’s (IOM) six quality aims: safety, patient-centeredness, effectiveness, efficiency, timeliness and equity. One goal of the award is to honor hospitals that are making progress in quality improvement with models that can be replicated by others in the hospital field. In recognition of Franklin Woods’ selection as the 2013 McKesson Quest for Quality Finalist, the hospital will receive a $12,500 monetary reward and will be featured in various AHA publications throughout the year.
Mountain States Foundation launches capital campaign for radiation oncology JOHNSON CITY – The Mountain States Foundation announced plans for a new capital campaign that will have a significant impact on cancer care in the Tri-Cities region. The Foundation has made a commitment to support a construction and renovation project at Johnson City Medical Center (JCMC) for the radiation oncology department. JCMC’s new radiation oncology
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center will be housed in the lower level of the hospital’s new surgery tower, which is still under construction. The radiation oncology center will expand from 16,700 square feet to 35,700, and will go from five exam rooms to 12. The expansion will not only provide greater convenience for patients, but improved technology as well. With funds provided by the Foundation, the hospital plans to purchase a new linear accelerator, the Varian TrueBeam radiation system. The highly focused beams from this piece of technology allow physicians to target cancer cells with pinpoint accuracy while minimizing damage to healthy tissue. This allows some patients to be treated in a shorter length of time with fewer side effects. The construction and renovation project will also add a medical library for patients, a chapel, and a separate waiting area and entrance for children. The total cost of the project is $15 million, and the Foundation has committed to raising $7 million toward that goal. For more information about the campaign or to make a donation, visit www.mshafoundation.org.
Status Solutions’ Personal Situational Awareness Technology Implemented by Appalachian Christian Village East Tennessee retirement community deploys the MIMI mobile health monitoring solution
CHARLOTTESVILLE, Va. — Status Solutions has announced that Appalachian Christian Village, one of the first established Continuing Care Retirement Communities in East Tennessee, has introduced the Motion into Meaningful Information (MIMI) mobile health monitoring solution to residents in its Personal Care Plus program. This real-time, nonintrusive system provides health alerts to family members and community staff to proactively monitor residents’ healthcare needs. Powered by AFrame Digital, MIMI tracks vitals and daily activities via a wristwatch device to create personalized care models and trend reports. If a change in any baseline occurs, a notification automatically goes to caregivers to assist them in determining if modifications to a resident’s health care are needed. Appalachian Christian Village’s Personal Care Plus program is comprised of Independent Living residents who need some health care assistance. With MIMI’s implementation, the senior living community will log blood pressure, capture sleeping patterns, and track glucose levels. MIMI also is being integrated with Status Solutions’ Situational Awareness and Response Assistant (SARA) to provide fall-detection alerts. SARA has been used for automated alerting and response management across Appalachian Christian Village’s spectrum of care since January 2008.
PUBLISHED BY: SouthComm, Inc. CHIEF EXECUTIVE OFFICER Chris Ferrell PUBLISHER Jackson Vahaly jvahaly@southcomm.com 615.844.9237 ASSOCIATE PUBLISHER Cindy DeVane ceedevane@gmail.com 423.426.1142 EDITOR Bridget Garland bridget@easttnmedicalnews.com 423.523.4729 CREATIVE DIRECTOR Susan Graham susan@medicalnewsinc.com GRAPHIC DESIGNERS Katy Barrett-Alley Amy Gomoljak Christie Passarello CONTRIBUTING WRITERS Sharon Fitzgerald, Cindy Sanders, Lynne Jeter, Terri Schlichenmeyer, Bridget Garland, Leigh Anne W. Hoover, Rick Jelovsek, Brad Lifford, Joe Morris ACCOUNTANT Kim Stangenberg kstangenberg@southcomm.com CIRCULATION subscriptions@southcomm.com —— All editorial submissions and press releases should be emailed to: editor@easttnmedicalnews.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 Become a fan on Facebook, and Follow us on Twitter@EastTNMedNews SOUTHCOMM Chief Executive Officer Chris Ferrell Chief Financial Officer Patrick Min Chief Marketing Officer Susan Torregrossa Chief Technology Officer Matt Locke Business Manager Eric Norwood Director of Digital Sales & Marketing David Walker Controller Todd Patton Creative Director Heather Pierce Director of Content / Online Development Patrick Rains East Tennessee Medical News is published monthly by Medical News, Inc., a wholly-owned subsidiary of SouthComm, Inc. ©2013 Medical News Communications.All rights reserved. Reproduction in whole or in part without written permission is prohibited. Medical News will assume no responsibilities for unsolicited materials. All letters sent to Medical News will be considered Medical News property and therefore unconditionally assigned to Medical News for publication and copyright purposes.
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