West TN Medical News May 2015

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PHYSICIAN SPOTLIGHT PAGE 2

Brad Adkins, MD

ON ROUNDS Physician Suggesting Options To Lower Costs Related to Breast Cancer A new report has fueled the debate over rising medical costs linked to routine breast cancer screenings during the past five years. The latest report estimates those costs are much higher than previously documented ... 3

PHiiT: Statewide Initiative Addresses Pressing Pediatric Issues

By CINDy SANDERS

In the fall of 2013, the Tennessee Chapter of the American Academy of Pediatrics (TNAPP) launched a bold new initiative to address pediatric quality issues in primary care through the formation of the Pediatric Healthcare Improvement Initiative for Tennessee (PHiiT). Following a successful first pilot program in East Tennessee, PHiiT is now expanding its education and quality improvement efforts across the state.

The collaborative – which is inclusive of all Tennessee parties utilizing pediatric care, delivering pediatric care, measuring outcomes or structuring payment systems – came about as a result of conversations with key stakeholders over the course of several years. Allen Coffman, Jr., MD, FAAP, who serves as medical director of PHiiT, said many practices were struggling in the wake of the recession. At the same time, practices were being asked to revamp many of their processes.

“All of this was coming at one time,” said Coffman, a practicing pediatrician with Highland Pediatrics in Chattanooga and past president of TNAPP. “Providers were overwhelmed with the financial changes, care delivery changes, and changes on how our (CONTINUED ON PAGE 8)

HealthcareLeader HIT: Optimization Through Integration You can love it, hate it, fear it or revere it … but technology has become an integral part of healthcare processes on both a clinical and operational level.

Therefore, you might as well learn to optimize it ... 5

ONLINE: WESTTN MEDICAL NEWS.COM

Reba Celsor CEO, Dyersburg Regional Hospital

By SUZANNE BOyD

Bringing her belief that healthcare is a calling, a passion for improving the quality of life of those she serves and more than 30 years of experience, Reba Celsor is settling into her new role as CEO of Dyersburg Regional Hospital.

For Celsor, nursing was her initial calling but when the opportunity arose for her to move

into management, she saw it as an extension of that calling. After three months of settling in at Dyersburg, Celsor is excited at finding what she calls the best-kept secret in the community, and is ready for this secret to get out.

As a young child, Celsor found herself hospitalized at the age of nine; an experience that led her to decide she wanted to be a nurse. “It (CONTINUED ON PAGE 4)

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PhysicianSpotlight

Brad Adkins, MD for me and my growing family. I could not have Faith and family are asked for better mentors at the core of what drives than Drs. Lewis, Swindle Brad Adkins, MD, which and Webb,” said Adkins. may be a good thing since Shortly after joining they fit nicely with his The Woman’s Clinic in career as an OB/GYN August 1996, the Adkins at The Woman’s Clinic welcomed their second in Jackson. Being able child, a son named Jonato witness the miracle of than. Their family would birth and be a part of one expand again to include of the most important a daughter Catherine times for a family are just and then one more son, a part of what makes him Jacob. All four kids are love his job. Developing roughly two years apart lasting relationships with in age. Family is a prihis patients also makes ority for Adkins. “When OB/GYN the perfect fit I am not working, I put for Adkins. family first,” said Adkins.

The Memphis na“I love to spend time with tive attributes his decimy kids. We enjoy sports sion to pursue medicine be it watching them or to a friend’s father and participating in them. I to his older sister. “It was have been lucky enough probably not until high to get to coach each one school that I really got to in basketball.” thinking about medicine An avid sports enas a career and had the thusiast, Adkins admits aspiration to pursue it,” he has a competitive said Adkins. “My friend’s side that he has to feed dad was an OB/GYN, of as much as he can. “I all things, and he had alplayed football and basways been such a great ketball in high school. I role model for me. I reused to play basketball ally admired him and three days a week as an what he was doing. My adult at 5:30 a.m.,” he sister Beth went to nurs- Brad Adkins, M.D. embraces his wife Carol after completing the 5-day 500 mile bike adventure said. “As I got older I ing school so that also Wings Ride to Rosemary Beach. had injuries and surgerhelped get me consideries so I had to find someing medical school.” thing else to get exercise.

After graduating from Memphis said Adkins. “I looked at a lot of different About ten years ago I started swimming Prep, Adkins headed to Ole Miss where programs. The program in San Antonio, again just to get back in shape. That led he majored in English with minors in biolTexas really stood out for me in terms of me to venturing into triathlon. I took a ogy and chemistry. “At the time that was a the faculty and location. We were blessed break from those last year but hope to get pretty unconventional path to get to medithat I matched there.” back into it again.” cal school,” said Adkins. “Today it is not With his match with the OB/GYN In addition to pushing himself physithat uncommon for an English Major to residency program at the University of cally, Adkins likes to also continually grow get in, so maybe I was at the forefront of Texas at San Antonio, Adkins and his new his faith. For three years he has found a that trend.” bride embarked on a four-year journey. unique way to do both while also helping Adkins returned to Memphis, where “It was a wonderful opportunity for us to cancer patients through Wings Ride to he earned his medical degree at the Unigrow and mature together as a couple. We Rosemary benefiting the Wings Cancer versity of Tennessee Center for Health knew no one there when we moved and Foundation. “The ride was started by some Sciences. While it was an OB/GYN that had no family nearby,” said Adkins. “As guys in Memphis and a friend of mine told influenced his decision to pursue medimuch as we loved it there, as my residency me about it. I thought it sounded awesome. cine as a career, it was not until medical came to an end, we realized we wanted to A 500 mile ride over five days from Memschool rotations that Adkins even thought be closer to family. Our son Conner had phis to Rosemary Beach that raised money about OB/GYN as a possible specialty. been born and both our fathers were facto help cancer survivors,” said Adkins. “I “I realized some specialties did not fit my ing health issues so we knew it was time to decided to ask our clinic administrator, Jon personality,” said Adkins. “But OB/GYN come home.”

Ewing, to join me and help me train for it. was fun and exciting. Being there to watch As Adkins started interviewing with He said yes and we have done it the past one of God’s miracles take place in addiclinics in his search to find a permanent three years in October.” tion to the surgical side of things, it was the home, his first interview was with The Initially Adkins says he thought the specialty for me.”

Woman’s Clinic in Jackson, TN. Since it ride, which he knew would push him Marrying his college sweetheart, was close to Memphis, Adkins thought he physically, would be quite an accomplishCarol, at the end of medical school meant would check it out along with other clinment. “The impact this has had on me exAdkins was embarking on a whole other ics and get in a visit with family. What tends far beyond physical,” he said. “The adventure with his residency. “Carol and he found was a clinic with great mentors guys on this ride are strong men of faith I were both born and raised in the South, who he wanted to be in practice with in a that have really impacted me. It recharges so we saw my residency as a chance to extown that was a great size to raise a fammy batteries and encourages me to be a perience a different part of the country,” ily. “The Woman’s Clinic was the right fit better husband, father and doctor.”

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Physician Suggesting Options To Lower Costs Related to Breast Cancer

By BETH SIMKANIN

A new report has fueled the debate over rising medical costs linked to routine breast cancer screenings during the past five years. The latest report estimates those costs are much higher than previously documented.

A Memphis physician says the reasons for the high costs are readily apparent, as are the ways to reduce the costs.

The study published in Health Affairs, a national, peer-reviewed healthcare journal, reported last month that the U.S. spends $4 billion annually on tests that produce false-positive mammograms and the over-diagnosis of breast cancer.

The increased use of digital mammograms, insufficient professional experience and subjectivity are the potential causes, according to breast-care specialist Christine Mroz, MD. She says doctors and patients can do several things to lower medical Dr. Christine Mroz costs and the chances of receiving a false-positive reading from a mammogram.

The study, performed by a research fellow at Boston’s Children’s Hospital and a Harvard Medical School professor, concluded that among the surveyed women, 11 percent received a false-positive result from a mammogram. That means about 3.2 million women nationally would get a false-positive result each year, resulting in $2.8 billion in spending, according to the study.

“There has been an increase in the number of false positives in the last five years or so because they are being viewed digitally,” Mroz said. “When the mammogram is magnified four times its actual size, something may look abnormal when it isn’t. If you don’t know what you are specifically looking for, it can result in a positive reading to be on the safe side.”

Mroz is a breast surgeon with over 45 years of experience in breast care and is the founding physician of the Mroz-Baier Breast Care Clinic, which opened in 1994. Since then the clinic has seen more than 45,000 patients. Mroz and another breast surgeon, Ron Mattison, MD, see 25 to 30 patients per day. The clinic is one of the few that still performs film screen mammograms, which use X-ray film.

“Digital screenings, where the results are viewed on a computer, are now the preferred method because an office doesn’t have to store film, so the cost is lower,” Mroz said.

According to Mroz, there is a learning curve associated with reading digital mammograms. Doctors must relearn how to view them.

“Clinics have used film screening since the 1970s, so digital mammography is relatively new,” she said. “All systems westtnmedicalnews

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will be digital in the future, and I think professionals will get up to speed in reading them. My advice for the people reading them is to view them at actual size instead of magnifying them.”

Another factor that can generate false-positive results is that the radiologist viewing the screen may not be specialized in reading mammograms.

“Some clinics have rotating radiologists who are reading the mammograms, and they aren’t as up to speed on knowing what abnormalities to look for,” Mroz said. “You want the same mammography radiologist looking at the patient’s mammograms and ultrasound if possible.”

According to Mroz, mammography radiologists receive additional training and must be board-certified according to the 1992 Mammography Standards Act. These radiologists must view a certain number of mammograms per year and take continuing education credits to stay certified.

“Experienced interpreting physicians are viewing mammograms at the larger breast clinics in the Memphis area,” Mroz said.

She takes this one step further at her clinic.

“Each physician personally views the patient’s mammogram, ultrasound and biopsy results,” she said. “We also exam the patient and perform the surgery. We are a part of the entire process from day one.”

Mroz recommends that patients seeking a mammogram can decrease the chance of receiving a false-positive result by going to a clinic that specializes in mammography and inquire if a mammography radiologist reads the results.

“Patients need to make sure they are going to a place where the physician is experienced in reading mammograms,” she said. “Also, it’s best if the patient goes to the same office each year to receive a mammogram. That office has the patient’s previous mammograms on file for comparison. If a patient switches doctors, she should pick up her previous X-rays and take them to her new doctor.

“False positives can generate additional tests and in some cases surgeries, which can be expensive. That is another reason you want someone experienced viewing the results. An experienced In-

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terpreting Physician would know by the shape and distribution of a calcification if it looks cancerous. The person would be able to determine whether to biopsy it immediately or wait six months to see if it changes.”

Mroz stresses that in many cases it is safe for doctors to monitor a calcification for six months before performing a biopsy.

“Eighty percent of calcifications are not cancerous,” she said. “Things do not progress that quickly, especially in micro calcifications. A patient does not go from stage zero to stage three in six months. Six months is a perfectly safe time period to wait, and a patient’s life is not in danger during that time frame. The treatment for the patient is exactly the same.”

The American Cancer Society recommends yearly mammograms for women beginning at age 40, while the U.S. Preventive Services Task Force, an independent group of national experts in prevention and evidence-based medicine, recommends a biennial screening to be done at age 50. The study found that women 40 to 49 were more likely to have a false-positive mammogram compared to women over 50.

“There is a trend in some states, such as California, where professionals are re-

evaluating whether to recommend a yearly mammogram at age 40,” Mroz said. “My professional opinion is that women ages 40 to 70 should still get a mammogram screen annually, but also perform a selfexam in the shower once a month. Selfexam is still the best way for women under age 40 to know something is abnormal.”

A mammogram is the best method to catch cancer in its early stages, Mroz said.

More than 62 percent of women ages 40 to 49 get an annual mammogram, and more than 72 percent of women 50 to 59 get a regular screening, according to the National Center for Health Statistics.

“My hope is that in 10 years we won’t have to perform mammograms,” she said.

“There is work being done with genes that hopefully will be able to predict a patient’s risk, so that mammograms are done selectively for only high-risk patients.”

Mroz suspects something as simple as a saliva specimen or a blood test might be able to detect whether a patient is prone to having breast cancer.

“We could experience a new treatment in breast cancer in the next decade,” she said. “Pin-pointing cancer genes means more targeted medicines, less surgery and less scared patients.”

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Letter to the Editor

Telemedicine May Improve Healthcare Access in Tennessee As the U.S. healthcare industry strives toward the apex of delivering the highest quality care at the lowest possible cost, we are adopting new ways to do things better, faster and cheaper.

Developing technologies that support telemedicine (also known as telehealth) could be one example.

Telemedicine is delivered by physicians, nurses and other care providers using various forms of web-based technology to interact with patients on screen versus in person. It typically involves videoconferencing, photo transmissions, remote monitoring of vital signs and other clinical services.

Telemedicine is a relatively new mode of healthcare delivery in Tennessee and in the U.S., though the number of patients worldwide using telemedicine services is estimated to rise from less than 350,000 in 2013 to about seven million in 2018, according to a 2014 report published by

IHS Technology.

Healthcare organizations are also getting on board. According to a survey released by Becker’s Hospital Review last November, 84 percent of hospitals and health systems believe the development of telemedicine services is important to their organizations.

There are obvious advantages to a telemedicine encounter. For patients, it eliminates the time spent traveling and waiting, especially for people in rural areas where access to brick-and-mortar healthcare services may be scarce. More frequent physician-patient interaction and in-home monitoring solutions have the potential to speed up the delivery of care, help make sure patients adhere to treatment plans, better manage chronic diseases, and ultimately improve patient outcomes.

It also gives physicians who practice in rural parts of our state the ability to

consult with specialists when patients are unable to travel to a referral appointment.

Critics raise valid questions about the quality, safety and effectiveness of a telemedicine encounter, including liability factors and appropriate access to and use of patients’ protected health information.

Some physicians buy in to the concept.

Others do not. Rules and regulations vary from state to state, with no federal legislation addressing the practice.

The Tennessee General Assembly in 1998 created a telemedicine license for physicians located outside of the state who used information transmitted electronically to diagnose or treat patients located within Tennessee. The “telemedicine license” is an alternative to a full Tennessee physician’s license. Last year, the Board of Medical Examiners proposed to eliminate the telemedicine license and require a “full” Tennessee license to practice tele-

medicine. It also seeks to define telemedicine, and place parameters and restrictions on its practice. The Tennessee Medical Association and others are actively participating in these ongoing discussions, advocating for rules that promote safety and accountability for each patient encounter, without being so restrictive that they stifle the technology’s potential.

To be clear, a telemedicine encounter is not the same as a face-to-face encounter with a doctor. Technology cannot replace that.

We should be open, however, to new technologies that can improve access to quality healthcare in Tennessee and, if used and regulated appropriately, contribute to better patient health and help reduce overall healthcare costs.

John W. Hale, Jr., MD President, Tennessee Medical Association

Healthcare Leader: Reba Celsor, continued from page 1 was a positive experience. Everyone was so kind to me and I just knew nursing was what I wanted to pursue,” said Celsor, who grew up in Russellville, Kentucky.

“I earned my Associate Degree in Nursing through the University of Kentucky at Hopkinsville Community College. I eventually got my Bachelor Degree in management from Trevecca Nazarene University in Nashville several years later. My first job out of college was in a small community hospital in Logan County. After working there a couple of years, I moved to Springfield, Tennessee and began working for an HCA affiliated hospital, then I continued to work for HCA for the next 18 years.”

After nearly 20 years in nursing, Cel-

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sor moved to the executive side in 2006 when she joined the corporate administrative staff of LifePoint Hospitals, Inc. as the director of clinical operations for the American division and their perinatal subject matter expert. While she was involved with leading quality improvement in perinatal programs at 40 facilities, she also was the director for clinical and quality operations of 12 hospitals in five states. “While I traveled about 75 percent of the time, it was an invaluable experience that allowed me to see all aspects of hospital operations,” said Celsor. “I got to see first-hand many types of hospital management, learn best practices as well as things to look for that may not lead to success.”

From 2010-2012, Celsor served as both COO and CNO of LifePoint’s Putnam Community Medical Center in North Florida. She then moved to Beckley, WV to serve as COO and interim CEO at Raleigh General Hospital for three years. Celsor spent nine years with LifePoint Hospitals, during which time she not only completed their CEO Leadership Development program she also earned a Master of Business Administration in Health Care Management from Colorado Technical University.

When the CEO position with Community Health Systems’ Dyersburg Regional Hospital opened in early 2015, Celsor jumped on it. “I had spent the bulk of my career in Tennessee and wanted to get back there,” said Ceslor. “Family is very important to my husband and me. Moving to Dyersburg meant we were about three hours from my daughter, three grandchildren as well as my son who all live in Southern Kentucky and the farm we still own. I

also have step sons in South Carolina.”

While she only took over as CEO in February, Celsor says she is very pleased at what she has found at the 225 bed acute care facility which offers a complete range of services with the exclusion of open heart, spine and neurological surgeries.

“This hospital has been ranked by the Joint Commission as a top performer for four years on key quality measures. We have a Leap Frog Safety Rating of A. Our patient satisfaction scores are good, as well as our quality matrix,” she said. “I am a very data driven person and have looked at the stats for this hospital. We have come a long way but we can improve. My goal now is to move them from good to great.”

Over the course of her career, Celsor has developed the philosophy of the CEO being the number one driver of quality, which is one of the reasons she wanted to pursue a CEO position. “I am passionate about safe quality care,” said Celsor.

“When you have a CEO who is engaged and believes in high quality care, that can be a game changer in that environment.

We need to deliver a high standard of care to our patients that is shrouded in warmth, kindness and compassion.”

As with many rural hospitals, Celsor faces a familiar challenge. “We have a large Medicare and Medicaid population which means we have to manage our resources very well so that we can balance the budget and provide the level of care our patients need,” said Celsor. “Being affiliated with a large organization such as Community Health Systems eliminates the duplication of resources. Support services are centralized so I have them available when we need them. We also have a

built-in network of hospitals from which we can draw. This not only helps us manage resources more efficiently but also delivers best practices to the community.”

Celsor sees plenty of opportunity for growth in Dyersburg. The hospital is on track to start offering interventional cardiology in the third quarter of this year. She also sees room for growth in the already busy Emergency Department as well as in the hospital’s Ambulatory Surgery Center.

“We can absorb more of the area’s healthcare needs,” said Celsor. “We are working to have more primary care physicians on staff as well as expanding our imaging and surgical services.”

Community Hospitals can be one of the best-kept secrets in Celsor’s book.

“If you look at the incidence of errors in healthcare, I would rather be with people that know me than where you may not get the same level of attention by people you do not know,” said Ceslor. “One thing that can help us grow, is to market our hospital and share our success stories. We want people to know that they can receive excellent care right here at home.”

Celsor has drawn on her faith over the course of her career and feels blessed to have been able to move from a clinical role into an executive leadership role especially as a woman in a male dominated field. “Healthcare is a calling, my calling,” she said. “I want to be a part of a community and stay until I can see a difference being made. I want to be proud to call it home and proud to say I am the CEO of the community hospital. I also want all of our physicians and employees to be proud to say that they work at Dyersburg Regional Medical Center.” westtnmedicalnews

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HIT: Optimization Through Integration

By CINDY SANDERS

You can love it, hate it, fear it or revere it … but technology has become an integral part of healthcare processes on both a clinical and operational level. Therefore, you might as well learn to optimize it.

That was a key part of the message Chris Miller, principal with Nashvillebased Cumberland Consulting Group, and Deb Dulac, director of PRISM and business systems for the University of Vermont Medical Center, shared with audiences at the recent HIMSS15 Annual Conference & Exhibition. More than 38,000 Chris Miller professionals flocked to Chicago last month to attend the premier health information technology conference, which included more than 300 peer-reviewed education sessions, vendor exhibits touting the latest technology options, updates on government regulations impacting the industry and keynote speakers ranging from Bruce Broussard, president and CEO of Humana, to George W. Bush, 43rd president of the United States of America.

“Over the past five years, there has been a huge shift towards technology largely because of the HITECH Act of

2009 and government programs like Meaningful Use that have helped drive the technology in healthcare,” Miller said.

Although slower to adopt technology into daily operations – particularly in a clinical setting – than many other industries, healthcare has increasingly been pressed to take an ‘all in’ stance.

Miller noted that over the last few years, technology has fundamentally changed the way providers … both large and small … operate. He added the challenge is balancing the adoption of technology with everything that brings.

“Today anything a healthcare organization wants to change in a business or clinical process requires a change in their technology, and likewise, any change in their technology has an impact on the care they provide or their revenue,” he said.

“I think healthcare entities were used to thinking of technology as a separate entity, but now it’s so intertwined,” added the Atlanta-based HIT expert.

In their HIMSS presentation, Miller said he and Dulac focused on how to manage and optimize technology now that it has become so pervasive, while at the same time accounting for all the other changes happening in healthcare including a switchover to ICD-10, meeting ongoing and new Meaningful Use requirements, actively engaging patients, supporting accountable care models, and the myriad

other programs that require attention.

The bottom line is that thinking of each of these mandates or initiatives as individual tasks to conquer leads to madness … or at least extreme frustration. Instead, Miller said the question should be, “How can organizations effectively manage all of those together with a higher degree of efficiency and lower overall cost?”

He continued, “When I think implementation, somewhere between 25-30 percent of the time spent on these changes is spent on testing so if you can group – effectively overlap testing on these programs – you can significantly save time.”

More than just testing, though, Miller said very deliberately grouping initiatives under a single governance project structure helps with a range of other issues from interoperability to simplification for end users. “Being able to group things together almost makes it irrelevant as to what changes were made,” he said of the finished product in the minds of those actually using the technology.

The ‘ripping off the bandage’ approach means one educational update for those end users as opposed to having to create an educational module for each individual initiative. Not only does a rolling schedule of changes often feel more overwhelming, but also the time away from desks learning the new processes would typically be less under a grouping struc-

ture than to have 10 separate trainings for 10 separate initiatives.

Miller was quick to admit that creating overarching technology structures could be difficult without staff or contracted expertise, which makes it more problematic for small practices.

“Whether you see it as a good or bad thing, there’s certainly a lot of consolidation in the market. Small private practices are becoming more and more rare,’ he said. “I think one of the reasons is it’s becoming increasingly difficult for groups like that to manage all these changes.”

Miller added larger practices or health systems enjoy the economies of scale that make it easier to incorporate the rapid number of changes taking place.

However, he added that in addition to HIT consultants, software vendors typically also offer at least some assistance in helping clients assimilate new processes into their workflow.

“Managing technology is only getting more complex,” he concluded. “Organizations need to be intentional and strategic in how they do that … whether that’s implementing analytics platforms, system upgrades, system optimization, Meaningful Use programs, or ICD-10. They need to be looking at ways they can consolidate those initiatives to be more effective with their resources and increase the return on their technology investment.”

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MedicalEconomics

BY BILL APPLING

A couple of weeks ago I found myself talking with three school teachers. They were young – 22 and 23 years old. Two were finishing their first year of teaching and one was finishing her second year.

I enjoyed listening to their excitement and consistent theme of caring about their students and wanting them to succeed in life, whatever they decided to do.

But, there was another consistent theme in this conversation: Frustration.

They didn’t want their enthusiasm to slowly drift away. They felt that their ideas and ways of teaching were not getting attention, or worse, being ignored, and they were being excluded in the education process for current and future educational needs and development.

According to these young teachers, burnout among new young educators usually comes within their fifth year of teaching because of the reasons mentioned. Keep in mind, these are adults.

By 2020, they will represent more than one out of every three adults (36 percent).

They are ethnically diverse, socially tolerant, and technology savvy. This generation’s unique blend of civic idealism and astute pragmatism will hopefully enable them to overcome the internal culture wars and institutional malaise.

Executives, managers, teachers, healthcare providers sometimes experienced bad luck or poor timing, but a large body of research suggests

Zoo of Biases… that may be by cognitive and behavioral biases. While techniques to “debias” decision making do exist, it’s often difficult for these individuals, whose own biases may be part of the problem.

There are tools and techniques that can help flag times when the decision making process may have gone awry and interventions are necessary.

Early researches suggest this is the case roughly 75 percent of the time.

(McKensey Quarterly, April, 2015, Phillip Meissner, Oliver Sibony and Torsten Wulf.)

Sibony says, “We have looked at this zoo of biases and tried to sort out what really matters. When people ask me what will make a difference as they build decision processes, I emphasize three things: “First, recognize that very few decisions are one of a kind. Lots of projects happened before, and you can learn many things from these experiences.

“Second, recognize uncertaintyhave alternatives, prepare to be wrong, and have a range of outcomes where the worst case is real and not ‘best case minus 5 percent,’ which is very common.

Creating a setting where it’s ok to admit uncertainty is very difficult. But if you can achieve that, you can make headway.

“Third, create a debate where people speak up. It’s the most obvious but also the most difficult. If you’re the decision maker, when you get to the debate you’ve already got an idea of

where you want it to lead. And if you’re an experienced executive, you’ve already influenced your people, consciously or unconsciously. A good intervention point is to ask subordinates if anyone disagreed with you about a recommendation they bring to you. If everybody agreed, that’s a sign that many may have been ‘groupthink.’”

Soras Sarasvathy, a professor at the Darden School at the University of Virginia, has researched the difference between how entrepreneurs and very good senior managers at Fortune 500 firms think. She gives them a scenario about a new-product introduction. The typical Fortune 500 manager will run projections from the market data. But the entrepreneur’s reaction is, “I don’t trust the data. I’d find a customer and try to see the product.” The entrepreneur’s reaction is, “I’m gonna experiment. I’ll find my way into it.” The entrepreneurs’ impulse to experiment is right. We need to breed more of this type of thinking into decision making.

Two particular types of bias weigh heavily on the decisions-confirmation bias and overconfidence bias. The former describes unconscious tendency to attach more weight than we should to information that is consistent with our beliefs, hypotheses, and recent experiences and to discount information that contradicts them. Overconfidence or bias frequently makes executives

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misjudge their own abilities, as well as the competencies of the organization. It leads them to take risks they should not take, in the mistaken belief they will be able to control outcomes.

The combination of misreading the environment and overestimating skill and control can lead to dire consequences.

Consider a decision made by Blockbuster, the video-rental giant, in the spring of 2000. A promising start-up approached Blockbuster’s management with an offer to sell itself for $50 million and join forces to create a “click-and-motor” video rental model. Its name? Netflix. As a former Netflix executive recalled, Blockbuster “just about laughed [us] out of their office.” Netflix is now worth over $25 billion. Blockbuster filed for bankruptcy in 2010 and has since been liquidated.

In retrospect, it is easy to ascribe this decision to a lack of vision by Blockbuster’s leadership. But at the time, things must have looked very differently.

Netflix was not the the video-on-demand business it has since become. There were practically no high-speed broadband connections of the kind we now take for granted, and widespread use of video streaming would have seemed like a futuristic idea. In Blockbuster’s eyes, Netflix, with its trademark red envelope, was merely one of several players occupying a small land thus far unprofitable mail-order niche in the video business. Kind of like the Sears, Roebuck & Company catalogue of the past vs. online ordering now.

In an environment of change and disruption, many leaders fear – correctly – that their organizations do not take enough risks or will fall prey to “analysis paralysis” and let opportunities slip away.

Hence the popularity of start-ups as role models of fast, iterative decision making.

As Reid Hoffmann’s often said, “If you are not embarrassed by the first version of your product, you’ve launched too late.”

While this “better safe than sorry” mindset characterizes many successful startups, it may not be the best inspiration for the strategic decisions of mature organizations. Some risks are worth taking, such as those taken knowingly, in pursuit of commensurate rewards. But some risks are taken recklessly because the risk takers are blind to their own overconfidence or have failed to consider alternative viewpoints.

As the founder and president of J William Appling LLC, healthcare and management and consulting firm, I have greatly tweaked my business model.

Have you?

Bill Appling, FACMPE, ACHE, is founder and president of J William Appling, LLC. He is a national speaker, presenter and a published author. He serves as an adjunct professor at the University of Memphis and is on the boards of Hope House and Life Blood. For more information contact Bill at j.william.appling@ outlook.com.

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Population Health Advances Physicians are buzzing about the new healthcare paradigm

By JULIE PARKER

America’s independent physicians met mid-March in San Antonio, Texas, for the 20th annual national meeting of TIPAAA – The IPA Association of America, the largest trade association serving independent and integrated physicians in the United States.

The focal point: population health, a relatively new front burner issue unfamiliar to many practitioners. Congress included the model as a component of mandates in the Patient Protection and Affordable Care Act (ACA) (See box).

“We covered a lot of ground at our annual meeting to educate independent physicians about population health,” said Al Holloway, founder and president of TIPAAA. “Once we fully understand what it is, then we’ll find tools, products and services that can assist independent physicians in their daily practice.”

One question that repeatedly popped up: What’s the difference between population health and public health?

“Some view population health as a more modern version of public health, which itself – improving the health of the public – may be a goal, a measurement system, and a conceptual framework that undergirds a profession and a scientific

field,” wrote Michael A. Stoto, PhD, in “Population Health in the Affordable Care Act Era,” published by Academy Health (Feb. 21, 2013).

“Population health differs from public health, at least perceptually, in at least two respects,” Stoto explained. “First, it’s less directly tied to governmental health departments. Second, it explicitly includes the healthcare delivery system, which is sometimes seen as separate from or even in opposition to governmental public health.”

David B. Nash, MD, MBA, founding dean of the Thomas Jefferson University School of Population Health, pointed out that population health “builds on public health foundaDavid Nash tions.”

Among the building blocks, according to Nash: • Connecting prevention, wellness and behavioral health science with healthcare delivery, quality and safety, disease prevention/management and economic issues of value and risk – all in the service of a specific population. Examples: a city, provider’s practice, employee

group, hospital’s primary service area or pre-school children.

• Identifying socioeconomic and cultural factors that determine the health of populations, and developing policies that address the impact of these determinants.

• Applying epidemiology and biostatistics in new ways to model disease states, map their incidence and predict their impact.

• Using data analysis to design social and community interventions and new models of healthcare delivery that emphasize care coordination and ease of accessibility.

“When applied to healthcare delivery, population health differs from conventional healthcare by emphasizing value rather than volume of services rendered,” said Nash.

How will population health affect physicians?

Monumentally, said Kathy Jordan, president of Jordan Search Consultants.

“The primary care practice of the future will look much different than it does today,” she said. “Instead of one-on-one encounters between the patient and their provider, the patient interaction process will include phone visits, email consultations, group visits, education programs

and encounters with a variety of care team members. Out-of-office contact will become the new norm as patient health improves. Additionally, primary care physicians of the future must exhibit leadership and interpersonal skills, as well as a passion for top-tier service delivery. How well they manage the team will directly translate to how well the health of their patient population is being managed, which will directly impact future compensation models.”

Important financially: To be eligible for incentivized government funding, organizations must prove their commitment to, and implementation of, population health, said Jordan.

“They’ll be required to improve the patient care experience, the overall health of populations, and lower per capita costs of case,” she said. “As a more comprehensively integrated system focused on population health begins to dominate, the healthcare industry, healthcare experience and provider recruitment initiatives must also evolve.”

Enter population health management.

Regina Levison, vice president of client development for Jordan Search Consultants, said that “while population (CONTINUED ON PAGE 9)

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PHiiT: Statewide Initiative Addresses Pressing Pediatric Issues, continued from page 1 board certification processes were happening … so we asked, ‘How can we do this better?’”

As discussions became more formalized, Coffman said TNAPP realized it would take a broad coalition to address the changes providers faced and drive quality to improve the health of the state’s youngest citizens. PHiiT’s main goals are: • to educate providers about high value process changes for practices to impact serious population health concerns, • to bring together stakeholders to organize and prioritize what those population health priorities are and develop measures to assess outcomes, and • to ensure providers and patients have the tools they need to be successful.

“We’re really focusing on that patientprovider space and making sure the patient and provider have the Dr. Allen tools they need to make Coffman, Jr. that a better working relationship,” Coffman said. After all, he continued, “The only ones who can really change healthcare delivery are providers in concert with patients.”

Working with the National Improvement Partnership Network out of the University of Vermont, PHiiT set about to develop and implement quality improvement projects around pediatric health concerns that are high cost, consistent with state and federal priorities, have poor outcomes, are difficult for patients, and/or cause frustration for practitioners.

Coffman said each quality improvement project also includes a Continuing Medical Education component and standardization of metrics and outcomes reporting so the collaborative could analyze data and broadly share information and best practices.

The first initiative – Breastfeeding Sustainment and Smoking Cessation Project – was piloted through practices in Chattanooga, Knoxville and Oak Ridge with funding from the Tennessee Department of Health and data support from the Tennessee Initiative for Perinatal Quality Care (TIPQC). Coffman said the project kicked off in the summer of 2014 and winds up this month. An educational program was hosted over two weekends to get providers – which included physicians, nurses, nurse practitioners, and medical students – up to speed on ways to extend breastfeeding and discourage tobacco use around infants, and preliminary data has been very encouraging.

“When you look at breastfeeding, one-third will breastfeed no matter what you do, one-third won’t no matter what, and one-third in the middle are undecided, ambivalent,” Coffman said.

“There is a high value window during 8

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the newborn period. We know the sooner you get them (mothers) in and the better you engage them that first two weeks, you maximize the chance they will continue to breastfeed,” he explained, adding this newborn period is also the most motivated time for caregivers to quit smoking.

“We have been able to improve the frequency of patients seen within 72 hours of hospital discharge from 76 percent at baseline to 85 percent at our first followup,” Coffman said. “Our two-month breastfeeding rate has increased from 56 percent at baseline, which was better than anyone expected, to 62 percent at our first follow-up,” he continued. Coffman did note the higher-than-normal baseline breastfeeding rate could be attributed to the type of practices that participated in in the pilot, which were already working to engage parents around the importance of breastfeeding.

As for the second part of the project, Coffman noted, “Only 60 percent of newborns were being screened for tobacco exposure at baseline. We were able to increase that to three-quarters, 76 percent, at our first follow-up.” He added that instead of just asking if the child was exposed to tobacco, which Coffman said could feel judgmental and garner a biased response, PHiiT trained providers to reframe the conversation. “What we tried to teach was to positively engage the family around their care network and then go back and ask if each of those persons used tobacco.”

Ultimately, Coffman noted, providers need effective tools they can use to engage with patients. “We know there is a finite amount of time that the provider and patient have so we look for the high value propositions … what really works.”

He continued, “We really push our education faculty to choose what are high value changes and then communicate that to providers and patients in a way that is useful.”

Coffman said an important part of the equation that has been missing is feedback as to what is sustainable and then using that feedback to help develop payment structures that incentivize continued process improvement. While the information is critical to inform practice and impact outcomes, Coffman was quick to say that PHiiT provides tools and data but allows providers the freedom to be innovative in how they address issues with patients.

With the first pilot successfully drawing to a close, PHiiT is looking to expand that project and others across the state.

The collaborative recently announced an

award of a $1.49 million, three-year contract with the Bureau of TennCare to take PHiiT’s efforts statewide.

The next project is to develop a pediatric metric dashboard with the assistance of all four pediatric residency programs in Tennessee. PHiiT’s quality coach will assist participating practices in gathering data pertaining to the measurement of the metrics. “That will give practices ongoing feedback as to what their practice is doing compared to the state aggregate,” Coffman said of the dashboard, known as the Provider Best Practice Resource.

From there, specific quality improvement projects will be added. Coffman said asthma would be among the first

initiatives with obesity, behavioral health and developmental screening modules as other likely candidates to roll out in the near future.

“What we’re hoping is to give practices real data to make business decisions around investing in quality improvement,” he said. “I think providers are going to learn a lot about the way they deliver care.”

PHiiT has begun enrolling additional practices to participate in the expanded programming. Coffman said pediatric, family and general practices that see children are all welcome to participate. In addition, school-based clinics, health department clinics and federally qualified health centers are also encouraged to enroll. For more information, contact Becky Brumley via email at becky.brumley@ tnaap.org.

TPCA, United Health Foundation Connect for Quality Last month United Health Foundation awarded $900,000 to the Tennessee Primary Care Association to help support “Tennessee Quality Connect,” a clinical initiative connecting healthcare professionals and patients through Community Health Centers (CHCs) in person or by utilizing telehealth technology.

CHCs, which are often located in communities where primary healthcare providers and hospitals are not easily accessible, serve as a primary source of care for one in 17 Tennesseans. However, when a patient’s condition requires the attention of a physician not on staff at a CHC, a range of barriers from a lack of transportation to not having adequate childcare to not being able to take time off work can stand in the way of seeing the specialist. The United Health Foundation grant is focused specifically on providing access to behavioral health and nutritional counseling services for individuals with hypertension, diabetes and depression to help combat these chronic issues.

The ability to leverage telehealth technology extends the reach of urban-based specialty care providers, improving access to critical health services in remote and underserved areas. More than 10 million people nationwide directly benefited from using telemedicine last year, according to the American Telemedicine Association.

“The Tennessee Primary Care Association’s work in the community has shown significant success in connecting people with quality healthcare services, and we are grateful for the opportunity to support its efforts to bring new, innovative approaches to healthcare,” said Rita Johnson-Mills, CEO of UnitedHealthcare Community Plan of Tennessee.

Announced at Neighborhood Health in Nashville, the grant is part of United Health Foundation’s “Helping Build Healthier Communities.” The funds will be awarded over three years and will support the Tennessee Quality Connect initiative at 17 CHCs, which collectively represent 104 health center sites serving more than 300,000 residents across 44 counties.

Officials gathered to celebrate the United Health Foundation grant to the Tennessee Primary Care Association last month. Pictured (L-R): UnitedHealthcare Community Plan of Tennessee COO Richard Reeves, Tennessee Primary Care Association CEO Kathy Wood-Dobbins, State Rep. Harold Love, State Rep. John Ray Clemmons, Neighborhood Health CEO Mary Bufwack, and UnitedHealthcare Community Plan of Tennessee CEO Rita Johnson-Mills. westtnmedicalnews

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Mastering Population Health Thomas Jefferson University offers nation’s first MS-PopH program

By JULIE PARKER

The hottest new advanced degree in healthcare, beyond medical school, focuses on a game changer for the nation’s healthcare delivery system: population health.

Thomas Jefferson University (TJU), home of the nation’s only School of Population Health, received approval March 5 to become the only institution of higher learning in the United States to offer a new graduate-level degree program: Master of Science in Population Health (MS-PopH).

The program is accepting applications for this fall.

“Population health is catching fire.

It’s a raging inferno at the moment,” said David B. Nash, MD, MBA, founding dean of the Jefferson School of Population Health and the Dr. Raymond C. and Doris N. Grandon professor of health policy at Thomas Jefferson University.

Nash, a board-certified internist, became involved in promoting quality improvement and lobbying for healthcare policy change in the 1980s. He joined the university in 1990 as a faculty member; the former university president asked him to build the School of Population Health

For additional information on the Jefferson School of Population Health degrees – program content, admissions requirements, deadlines, and tuition and fees – visit http://www.jefferson.edu/university/population-health/degreesprograms/population-health/about.html.

for the campus, which opened in 2008 as the first U.S. academic institution focused on population health. Already, 25 students have completed the graduate certificate online program, which takes 12 to 20 months to complete. Its focus: to help current and emerging healthcare leaders understand the new population health paradigm. More than 100 students have completed the onsite Population Health Academy, a 40-hour continuing education program, providing an overview of basic concepts in population health.

“Healthcare inside a medical facility is only 15 percent of the story; 85 percent of healthcare happens outside the hospital,” noted Nash. “We have to reach outside the four walls of our hospitals to coordinate with community pharmacies, nursing homes, extended care facilities and the like, and link all of these care providers – from the hospital’s board of

Population Health, continued from page 7 health is defined as the health outcomes of a group of individuals comprising a specific demographic population, population health management is a business model centered on the delivery of comprehensive care and management of total risk.”

The foundational shift in the healthcare experience will morph from an industry driven by reactivity to an industry driven by proactive measures, said Levison.

“The goal of population health is to keep a patient population as healthy as possible and minimize the need for costly interventions, procedures, emergency room visits, and hospitalizations,” she said.

As an increasing number of healthcare organizations move to models of

accountable care, the overall healthcare experience will be reconstructed, said Jordan.

“Within this transformation, we’ll see an altered patient and physician experience,” she said. “With an emphasis on proactive preventative care, evidencebased protocols, managed care teams, care coordination, and multidisciplinary teams, population health management will reward value in care, versus volume of patients seen.

“Although the results of these initiatives won’t manifest for a decade or more, population health management will almost certainly improve the quality of lives for millions of individuals throughout the country.”

The ACA and Population Health The Patient Protection and Affordable Care Act (ACA) addresses population health in four significant ways: •

Provisions to expand insurance coverage target the advancement of population health by improving access to the healthcare delivery system.

•

Other provisions seek to enhance the quality of care delivered.

•

Lesser known provisions aim to improve prevention and health promotion measures within the healthcare delivery system.

•

The final set promotes community- and population-health based activities, including the establishment of the National Prevention, Health Promotion and Public Health Council, which has already produced the mandated National Prevention Strategy and Prevention and Public Health Fund for monetizing Community Transformation Grants.

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trustees to the folks delivering home infusion medication. It’s a big operational challenge. We’re going to have to become a well-oiled, organized, value-generating team.”

Kathy Jordan, president of Jordan Search Consultants, said the new degree program is well-timed.

“The healthcare landscape is shifting more dramatically right now than it has since its inception,” she said. “As an increasing number of healthcare organizations move to models of accountable care, the overall healthcare experience will transform. With an emphasis on proactive preventative care, evidence-based protocols, managed care teams, care coordination, and multidisciplinary teams, population health management will reward value in care, versus volume of patients seen. In some cases, this may require new types of training.”

The comprehensive MS-PopH online graduate degree program will help students develop competencies in five key public health areas – behavioral and social sciences, biostatistics, environmental health sciences, epidemiology and health policy. Students will also develop proficiency in the application of population health skills and principles, culminating in a Capstone project applying theory and lesson in real-world situations.

Already in place at Thomas Jefferson University: a doctoral degree program – PhD in Population Health Sciences –that started four years ago and has 14 students.

The first two graduates will receive their degrees this month.

The doctoral degree is studied onsite, with the goal of preparing leaders with global vision to analyze the determinants of health. Doctoral candidates specialize in one of four areas: health policy, healthcare quality and safety, applied health economics/outcomes research and behavioral/health sciences.

“The PhD in Population Health Sciences isn’t intended for those new to the discipline,” noted Nash. “Preference is given to applicants who’ve completed a master’s degree or master’s level coursework in appropriate fields of study, such as public health, social work, health policy and behavioral sciences.”

The addition of the MS-PopH program came soon after Stephen K. Klasko, MD, MBA, relocated from the University of South Florida (USF) Morsani College of Medicine and USF Health, where his transformative ideas took the Tampa medical school to unprecedented heights.

Klasko is in his first year as president of Thomas Jefferson University and presi-

dent/CEO of the Thomas Jefferson University Hospital System, now the largest healthcare system in Philadelphia, Pa., the nation’s sixth largest city.

“We’re moving healthcare from a Blockbuster mentality to a Netflix mentality,” said Klasko, pointing out the university began offering population health “before anybody put population health in the same sentence.”

“At Thomas Jefferson University, we created a whole new mission and vision, where health is all we do,” he explained.

“Our vision is to reimagine healthcare education discovery to create unparalleled value. Jobs will be needed in healthcare in 10 years that aren’t even yet imagined, and a good many will be in population health.”

Nash, who also serves as a government and private-sector consultant, chairs the Technical Advisory Group of the Pennsylvania Health Care Cost Containment Council and is a board member of various healthcare organizations, including Humana.

“The great thing about Dr. Nash’s school, it’s not a Johnny-come-lately. He’s devoted his life to population health,” said Klasko. “In most universities, population health is part of another school and lacks the panache … that puts us at the forefront.”

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Help Wanted: Population Health Physician Leaders Filling positions may be a tall order; job-getters will enjoy top-of-license roles

By JULIE PARKER

Finding presentable candidates for population health physician leaders is a tall order, especially since many doctors remain unfamiliar with the new paradigm in post-healthcare reform.

Personnel represents one of three key ingredients to implementing population health management. It’s the glue to connecting data and the changing nature of the overall healthcare experience. The hard shift in practice management has healthcare organizations scrambling to secure top-notch population health physician leaders, a move that keeps physician recruiters like those at Jordan Search Consultants quite busy.

“Our clients know the organizations able to most effectively aggregate and distribute data—to collaborators, team members, and even patients themselves—will succeed,” said Kathy Jordan, president of Jordan Search Consultants.

“Healthcare systems are now implementing robust software systems and population health management programs that help automate data integration, analysis, reporting, and communications so that real-time evaluations—and adjustments in patient care plans—can be made instantaneously. Having the right IT systems – and IT personnel – in place is critical to advance clinical outcomes, improve care, and lower costs. Organizations with the ability to master data control and predictive analytics to generate decision-driving insights will succeed in population health management.”

Unfortunately, the shortage of primary care physicians (PCPs) – the leaders of population health management – continues to escalate. As population health management becomes the dominant healthcare model, the demand for their roles will be unprecedented.

“As physicians continue to leave the private practice model in favor of employed physician models, cultural fit

within an organization will become a key recruitment parameter,” said Regina Levison, vice president of client development for Jordan Search Consultants. “In addition, PCPs will be recruited based on their ability to build consensus, manage teams, and lead a diverse care team to better patient health. Organizations must understand what physicians are looking for clinically, financially, and administratively to ensure a fit with the organization. Physicians who embrace the care team model, understand how to utilize advanced practice providers, and enjoy leadership opportunities will be in high demand. In addition, recruits must understand new incentive and reimbursement structures.

Physicians will be rewarded for meeting care management needs of patients; reimbursement will be tied to quality as opposed to quantity.”

Characteristics of a potential population health physician leader, according to Jordan Search Consultants, include: • A minimum of five to 10 years of practice experience.

• Board certification.

• A good understanding of the way Electronic Medical Records (EMRs) work.

• A plan to help move the population health management team to the next level.

• Mentoring ability.

• Advanced education.

“We’ve changed how we evaluate

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physician candidates and physician leaders so we can provide a better slate of candidates to our clients,” said Jordan. “We want to assess their ability to embrace population health, their understanding of population health, and their attitude and ability to treat patients under a population health model. We have to dig more deeply. The physician leader of the population health management team will be working at the highest end of their license.

We evaluate their ability to give direction and make assignments to the team and to educate their colleagues. They’ll need to assess where the team is strong, and where it needs additional education, training and support. It’ll be dictated not only by geography, but also by the socioeconomic element of the population being served.”

Clients are thrilled, said Jordan, when the consulting firm finds a candidate who already knows the EMR system they’ve implemented.

“That’s one less bridge to cross,” she said.

One of the most pleasant surprises Jordan Search Consultants’ recruiters have discovered in physician leader candidate pools is the growing number of physician candidates who have, or are pursuing, advanced business degrees, such as an MBA, perhaps with a concentration in healthcare management, MHA (masters of healthcare administration), MPH (masters of public health), MHI (masters of healthcare informatics), MMM (masters of medical management), or MS-PopH (masters of population health).

“The MMM is a relatively new degree,” Jordan said, adding the MS-PopH degree program is a brand new offering at Thomas Jefferson University, the nation’s only school to offer that particular advanced degree. “They’re educating themselves to lead the charge.”

On the flip side, PCPs who otherwise might be excellent candidates for those positions simply lack time to pursue higher education.

“The rank-and-file practicing physician in a community doesn’t need a degree in population health to see his patients,” said Al Holloway, founder and president of TIPAAA (The Independent Physicians Association of America). “No, that doesn’t make sense. Having an understanding of population health will impact his practice, but he doesn’t need a degree in it.”

The need for these type of leaders is unprecedented, said Jordan.

“As the demand increases, and we continue to have a very limited supply of physician professionals for these leadership positions, automatically the compensation goes up,” she said. “That’s something I hope potential candidates will strongly consider.”

PUBLISHED BY: SouthComm, Inc. CHIEF EXECUTIVE OFFICER Chris Ferrell MARKET PUBLISHER Pamela Harris pamela@memphismedicalnews.com Ad Sales: 501.247.9189 LOCAL EDITOR pharris@medicalnewsinc.com NATIONAL EDITOR Pepper Jeter editor@medicalnewsinc.com CREATIVE DIRECTOR Susan Graham susan@medicalnewsinc.com 931.438.8771 GRAPHIC DESIGNERS Katy Barrett-Alley Amy Gomoljak James Osborne Christie Passarello CONTRIBUTING WRITERS Suzanne Boyd, Julie Parker, Cindy Sanders, Beth Simkanin CIRCULATION subscriptions@southcomm.com —— All editorial submissions and press releases should be emailed to: westtneditor@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 Paul Bonaiuto President Chris Ferrell Chief Financial Officer Ed Tearman Executive Vice President Of Digital And Support Services Blair Johnson Director Of Financial Planning And Analysis Carla Simon Vice President Of Human Resources Ed Wood Vice President of Content Curt Cordes Vice President Of Production Operations Curt Pordes Group Publisher Eric Norwood Chief Revenue Officer Dave Carter Director Of Digital Sales & Marketing David Walker Controller Todd Patton Creative Director Heather Pierce West TN Medical News is published monthly by Medical News, Inc., a wholly-owned subsidiary of SouthComm, Inc. ©2015 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.

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GrandRounds West Tennessee Regional Forensic Center Reaccredited

Community Celebrates Career of Dr. Eugene P. Reese, Jr.

The West Tennessee Regional Forensic Center (WTRFC), which has been managed by the University of Tennessee Health Science Center (UTHSC) since July 1, 2014, has been reaccredited by The National Association of Medical Examiners (NAME). The association is the premier organization of physician medical examiners, coroners, medical death investigators and medicolegal system administrators in the United States.

According to NAME, accreditation is an endorsement that policies and procedures of the office meet prescribed standards for medicolegal systems. Accreditation, which involves an onsite, peer-review process and is conferred for a period of five years, signifies that the office performs with a high degree of competence and attention to public service. The review looks at administration and procedures, but does not apply to individual practitioners or the work produced by the office.

The WTRFC houses the Shelby County Medical Examiner’s Office, and oversees medicolegal death investigation services for 20 counties west of the Tennessee River. The Shelby County Commission last year awarded UTHSC a one-year, $3.1 million contract to operate the facility, with an option to renew for three additional oneyear periods.

After 35 years of service to the community, oncologist Eugene P. Reese Jr., MD, has retired. The Kirkland Center held a celebration for him in April.

Dr. Reese was the first board certified sub-specialist in Hematology and Oncology to join JacksonDr. Eugene Madison County General Reese Jr. Hospital and the Jackson Clinic and is recognized as one of two physicians who helped develop the Oncology program in Jackson. He made the decision to retire from his full time practice at the hospital in April 2010 but continued to follow his patients at the Jackson Clinic, PA. The Kirkland Cancer Center was privileged to have Dr. Reese and his partners integrate their practice in February 2014.

Dr. Reese has had several medical staff appointments through his career and his work has been recognized locally and nationally including being selected as one of America’s Top Physicians and one of America’s Top Oncologists several times.

He was most recently honored as the West Tennessee Healthcare Foundation’s-Jackson Award Recipient for Health Care 2013.

When asked about his service as a physician, Dr. Reese said that he always thought that the patient’s fight with cancer was his fight too.

West Tennessee Healthcare and BlueCross BlueShield of Tennessee Reach New Agreement West Tennessee Healthcare (WTH) and BlueCross BlueShield of Tennessee have reached a new multi-year agreement.

The new contract allows BlueCross’ Blue Network S℠ and Blue Network P℠ members to use services at West Tennessee Healthcare facilities on an in-network basis.

Bobby Arnold, President and CEO of West Tennessee Healthcare said that WTH is committed to its patients and communities, and they are pleased to finalize the new network agreement that will allow continued service for BlueCross members.

Hospice Of West Tennessee Sponsors Charity Golf Tournament A four man charity golf scramble tournament, “Hittin’ for Hospice,” an annual fundraiser benefiting Camp WINGS Hospice of West Tennessee was held in April at Woodland Hills Golf Course. “WINGS” stands for wisdom, insight, knowledge, and guidance through sorrow.

The camp is for children ages 7-14 years of age who are grieving the loss of a loved one. The camp is designed to offer these children the opportunity to express their grief through art, music, and play while in the company of caring volunteers

and other children who are experiencing loss. The camp is staffed by trained counselors and volunteers and there is no charge for children to attend.

For more information about Camp WINGS call Pat Bard at Hospice of West Tennessee at 1-800-286-5717.

Tennessee Medical Association Welcomes New President John W. Hale, Jr., MD, a family physician in Union City, has been installed as 2015-2016 President of the Tennessee Medical Association, the state’s largest professional organization for physicians.

Dr. Hale’s term officially began during TMA’s annual convention in Nashville.

Dr. Hale is the 161st President of the TMA. He succeeds Douglas J. Springer, MD, FACP FACG, a gastroenterologist in Kingsport.

Dr. Hale is originally from Halls, Tenn.

He graduated from the Quillen College of Medicine at East Tennessee State University and has practiced family medicine at the Doctor’s Clinic in Union City for 24 years. He is board certified in family medicine and has been an active TMA member, serving on the TMA House of Delegates for 23 consecutive years. He has also been a TMA Judicial Councilor and served on the Board of Trustees and as Speaker and Vice Speaker of the House, a past Young Physicians Chair, and as a delegate to the American Medical Association House of Delegates.

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Jackson-Madison County General Hospital Nationally Recognized for Hip Replacement Surgery Jackson-Madison County General Hospital ranks among the top hospitals in the nation for its lower than expected complications related to hip replacement surgery. It is also one of only 3 hospitals in Tennessee to receive a 5-star rating for hip replacement surgery from Healthgrades©, a leading source of hospital, nursing home, and physician quality ratings and profiles.

Another reason to choose us for your joint replacement surgery.

The Jackson-Madison County General Hospital orthopedic program includes highly trained and experienced orthopedic surgeons, state of the art surgical and therapy technology, including the use of Exparel© to speed recovery by controlling pain following surgery, a dedicated orthopedic nursing unit, high patient satisfaction, the area’s only CARF accredited inpatient rehabilitation center, a Joint Effort education class and the convenience of 14 Sports Plus outpatient therapy locations.

For more information, visit www.wth.org/orthopedics or call 731-541-HEAL (4325)

Congratulations to our Physicians and Staff