F e b rua ry / M a rc h 2 013
Wake Forest Baptist Medical Center Experts in Heart Disease
Also in This Issue
Tort Reform Local Commerce
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Editor’s Note
Safety Net This month’s cover story showcases cardiac care and acute care (trauma/burn) at Wake Forest Baptist Medical Center – two dedicated specialty areas that strengthen the region’s safety net by elevating capability and improving outcomes for the most critically ill. The cover story also gives readers an overview of the Wake Forest Baptist trauma and burn centers. The Wake Forest Baptist Advanced Cardiac Care and Transplant Program attends to all those with cardiac problems, from the straightforward to the most complex, including advanced congestive heart failure. A leading center for heart failure care, Wake Forest Baptist provides a dedicated team of cardiac experts and the range of treatment options, from conservative to the most advanced. In this article, a transplant patient from Lewisville shares her remarkable treatment story.
Editor Heidi Ketler, APR Contributing Editors Richard V. Bennett June DeLugas Amanda Kanaan Photography - Kendal Murphy Creative Director - Joseph Dally
The acute care surgery subspecialty at Wake Forest Baptist offers expanded emergency surgery capability for treating everything from general emergencies to trauma and burn to unexpected inpatient intervention. A team of acute care surgeons is devoted to the needs of all of these patients and assures timely assessment and surgical intervention.
Contact Information for Marketing, Media & News: Faye Tuttle Email: Faye@TriadPhysician.com Phone: 336.399.1140
The acute care program also encompasses two-year fellowship training and evidencebased research centered on improving patient outcomes.
News and Columns Please send to info@triadphysician.com
Also in this issue of The Triad Physician, attorney Richard Bennett returns to explore the limitations of tort reform. Interior designer June DeLugas reminds us of the quality furniture being handcrafted here in our region and the value of shopping locally. And Amanda Kanaan offers five tips for maintaining a patient-friendly website.
Subscription Rates: $48.00 per year/$6.95 per issue Advertising rates on request Bulk rate postage paid Greensboro, NC 27401
We all know the importance of referrals for practice health and the need to reinforce community awareness. The Triad Physician can help you do that. Send us your practice news and columns sharing your professional insight for publication at no cost to you. Consider advertising to reach our readership – more than 6,000 physicians, doctors of osteopathic medicine, physician assistants, nurse practitioners, administrators and hospital staff. Think of The Triad Physician as an integral part of your marketing-communications safety net. With deepest respect and gratitude for all you do,
Heidi Ketler Editor
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The Triad Physician
Every precaution is taken to insure the accuracy of the articles published. The Triad Physician can not be held responsible for the opinions expressed or facts supplied by its authors. Opinion expressed or facts supplied by its authors are not the responsibility of The Tirad Physician. However, The Triad Physician makes no warrant to the accuracy or reliability of this information. All advertiser and manufacturer supplied photography will receive no compensation for the use of submitted photography. Any copyrights are waived by the advertiser. No part of this publication can be reproduced or transmitted in any form or by any means without the written permission from The Triad Physician.
Category
COVER STORY
4
Wake Forest Baptist Medical Center Experts in Heart Disease
February/March 2013
7
Vol. 2, Issue 1
FEATURES
15
Legal
Interior Design
Shop Locally: Quality and Service Are Closer Than You Think
Tort Reform Playing Field Not Level Enough Attorney Richard Bennett argues that the medical malpractice
Designer June DeLugas offers tips on buying furniture and
tort reform of October 2011 didn’t go far enough.
reminds us of the local furniture manufacturing industry.
DEPARTMENTS 8 Practice Marketing
18 News
How to Avoid the Pitfalls of Bad Medical Websites
System Unification to Strengthen Novant Health Brand
16 News
19 News
Triad HealthCare Launches Secure Health Information Exchange
- High Point Regional Hosts Project SEARCH Students - Alamance Regional Tests Ultraviolet Disinfection to Reduce Infections
17 News Wake Forest Baptist Urologist Awarded a Physician of the Year
20 News
- New physician and physician assistant listing - 2013 editorial calendar
On the cover: Vinay Thohan, M.D., medical director, Wake Forest Baptist Medical Center’s Advanced Cardiac Care and Transplant Program
February/March 2013
3
Category Cover Story
Wake Forest Baptist Experts in Heart Disease Each year, heart disease tops the list of the
Medicare cost-driver among all diagnoses.
There is reason to be optimistic, but for
country’s most serious health problems.
According
Heart
the 150,000 to 200,000 patients diagnosed
Wake Forest Baptist Medical Center’s Heart
Association, the direct and indirect annual
with very advanced CHF, the prognosis
Center has demonstrated its expertise and
costs of treating heart failure in the United
continues to be devastating. Fifty percent
commitment to provide comprehensive,
States approach $40 billion.
of them die within a year after diagnosis.
those with the most straightforward cardiac
With an aging population and improved
A Dedicated Team of Experts
problems to the most complex, including
survival after myocardial infarction, heart
As one of the area’s leading centers for
advanced congestive heart failure.
failure prevalence is likely to continue to
heart failure care, the Advanced Cardiac
climb. At the same time, medical science
Care and Transplant Program at Wake
Congestive Heart Failure
is offering major advances in diagnosis
Forest Baptist provides comprehensive
Congestive heart failure (CHF) affects more
and treatment, which have the potential
evaluation, management and treatment of
than six million adults in the United States.
to convert a heart failure diagnosis from
patients with advanced CHF.
Unlike many other kinds of heart disease,
that of an extremely high mortality rate to
the incidence of CHF is increasing; about
a more guarded prognosis. Today patients
“We determine the most effective treatment
600,000 new cases are diagnosed each
diagnosed with CHF have an opportunity
for an individual at each specific phase of
year. Heart failure represents the largest
for an improved quality of life.
the disease,” says Vinay Thohan, M.D.,
to
the
American
individualized care to all heart patients, from
Vinay Thohan, M.D., medical director, Advanced Cardiac Care and Transplant Program, and Carol Jackson, a heart transplant patient.
4
The Triad Physician
medical director of the Advanced Cardiac Care and Transplant Program. Evidence shows that programs that specifically
focus
management
have
on
heart
failure
the
best
patient
outcomes, and the Wake Forest Baptist program is staffed with cardiologists who are board certified in advanced heart failure/transplant
cardiology,
cardiac
surgeons, nurse specialists, dieticians and social workers.
Advanced Treatment Options “Patients who benefit most from treatment at the Wake Forest Baptist Heart Center include those who have a new onset of heart failure, do not respond to medication therapy, have two or more hospitalizations for heart failure within six months or who have a recent deterioration in their cardiac
Edward Kincaid, M.D., heart transplant surgeon.
function,” says Dr. Thohan. For the most severely affected patients,
cases, LVADs have resulted in such an
The goals of the program are to reduce
LVADs – either as a bridge to transplant
improvement
the rate of hospital readmissions, decrease
or as a destination therapy – or heart
that the patients become eligible for
symptoms and improve functioning and
transplantation may be the best option. In
transplant consideration. “Ninety percent
overall quality of life for each patient.
2011, Wake Forest Baptist was designated
of our patients implanted with LVADs are
Wake Forest Baptist’s CHF services range
as one of fewer than 100 medical centers
either currently supported or have gone
from the least-invasive drug therapies
in the nation to receive certification from
on to have a heart transplant within six
and lifestyle consultation to state-of-the-
The Joint Commission to implant LVADs in
months. More importantly, they are alive
art surgery, including implantation of left
patients with end-stage heart failure. The
and well and are out of the hospital,” says
ventricular assist devices (LVADs) and
LVAD, which performs the pumping for
Dr. Thohan.
heart transplants.
the heart, is implanted into the abdomen,
in
patients’
conditions
allowing patients to pursue their regular
Heart
daily activities.
definitive therapy for severe CHF.
their lives, but how successfully patients
“This certification allows us to have
Wake Forest Baptist has performed 55
manage their disease when they return
a tremendous impact on the lives of
heart transplants in the last five years
home from the hospital is key to slow the
patients with advanced heart failure who
with outstanding results. “Unlike many
progression of disease,” says Dr. Thohan.
have no other viable options,” says Dr.
transplant programs, we cast a wide net
“We provide education and support in
Thohan. “Without LVAD therapy, the two-
for patients who can benefit from this
heart failure and medication management,
year survival rate for these patients is less
lifesaving intervention,” says Dr. Thohan.
and we encourage all of our CHF patients
than 10 percent, a prognosis worse than
“Many programs exclude patients over
to take an active role in the management of
almost every cancer. With support from
age 65. In our program, age is not a
their medical condition.”
the new generation of LVADs, survival has
contraindication and if those over age
improved seven-fold.”
65 are otherwise acceptable candidates,
“We have many effective treatment options
transplantation
remains
the
for patients that prolong and enhance
we will list them for transplantation. In
Treatment of CHF often begins with treating underlying conditions such as
In the last few years, 35 Wake Forest
our program 1:4 patients who received a
kidney disease, anemia, diabetes and lung
Baptist patients, ranging in age from
heart transplant are over the age of 65. I
disease, which can improve CHF for some
17 to 68, have been implanted with
consider them walking miracles.”
patients.
Heartmate II® (LVAD) devices. In some
February/March 2013
5
transplant surgery. “They had me out of bed sitting in a chair the next day,” says Ms. Jackson. “Everyone was so kind to me, and I was confident everything was going to be all right. I went home two weeks later. I still needed help getting around, but my physical therapist worked hard to get me back on my feet. “I feel wonderful now. I didn’t realize how badly I had felt all those years. Now I can do what I want. My husband, Henry and I went to the shore recently. I hadn’t been able to walk in the sand before. It was just too difficult, so I’ve added that to the list of life’s pleasures that have been given back to me.” The LVAD device is used as a bridge to transplant or as a destination therapy.
I’m so happy to be able to do the things I love,” Ms. Jackson says. “My husband, my
Carol Jackson’s Story
Dr.
Thohan
adjusted
Ms.
Jackson’s
friends and the wonderful people at Wake
One of these walking miracles is 71-year-
medication, put her on a salt-free diet and
Forest Baptist have been with me every
old Carol Jackson of Lewisville, N.C. Ms.
prescribed cardiac rehab. “But my heart
step of the way. They tell me that twinkle in
Jackson was diagnosed with a rare form of
kept getting sicker, and finally I had all
my eye is back, and my hands aren’t always
restrictive cardiomyopathy when she was
the tests necessary to be put on a list for
freezing. My husband’s happy to have a
39. With time, this condition developed
a heart transplant,” she says. “The good
wife who doesn’t feel like an icicle.”
into heart failure as the heart lost its ability
news was that even though my heart
to pump blood properly.
was getting sicker, my other organs were
Brighter Future for CHF Patients
healthy.” Ms. Jackson had an implantable
“I am optimistic that our ability to care
“I had been having some chest pain,”
cardioverter defibrillator (ICD) inserted in
for severely ill CHF patients will continue
says Ms. Jackson. “My doctor put me
the fall of 2011 to control her arrhythmia.
to improve as our arsenal of treatments
in the hospital, did tests and started me
In July, Ms. Jackson underwent a cardiac
expand to include even smaller, more
on medications. I returned home with
catheterization and was told she’d need
patient-friendly
instructions not to bike or run or lift
to spend some time in the hospital’s ICU.
research
anything over 10 pounds. It was hard. I
“My heart was getting weaker. My ejection
approaches,” says Dr. Thohan.
love doing things for my family, friends and
fraction was down to 15-20 percent
church, but I always had to think about
(compared to a normal range of 55-70
“Over the last 10 to 15 years, there has been
how what I wanted to do might stress my
percent),” she says.
a leap in our understanding of cellular and
heart.”
technologies
uncovers
new
and
as
therapeutic
molecular alterations that take place in CHF The wait for a transplant began. “People
patients,” says Dr. Thohan. “We have been
For 30 years she accepted the limitations
kept asking me if I was afraid of the idea of
participating in several research projects
her condition placed on her and restricted
a transplant, but I never was,” Ms. Jackson
focused on unraveling the complex genetic
her exercise to walking. When her health
says. “I said I’d try anything to get my old
underpinnings of heart failure that bode
worsened, her cardiologist referred her to
life back.”
well for more satisfying and better and
Dr. Thohan. “He was the most caring man,
longer lives for our patients.”
and I could tell he was sincerely interested
On Aug. 8, 2012, Ms. Jackson got the call
in me and how my illness affected my life,”
confirming that a heart was available for
says Ms. Jackson. “I swear that every inch
her.
of me inside and outside was checked during that initial appointment.”
The next morning cardiovascular surgeon Edward Kincaid, M.D., performed the
6
The Triad Physician
For more information, call Wake Forest Baptist Medical Center’s Heart Center 24-hour Physician Assistance Line (PAL®) at (866) 996-7370.
Legal
Tort Reform Playing Field Not Level Enough By Richard V. Bennett
particularly tort reform for medical
Legalized Misrepresentation to the Jury
malpractice lawsuits. Those tort reform
This one is an example of how the General
statutes, which went into effect in October
Assembly changed the law for the good
2011, did level the playing field for medical
but fell way short of going far enough.
You’ve probably heard about tort reform,
malpractice to some extent. However, in my opinion, that field is still somewhat
Before tort reform last year, the law
slanted in favor of plaintiff patients who
allowed the plaintiff’s attorney, in cases
sue those in the medical profession. Here
where Medicare paid the medical bills,
are few examples:
to stand up before the jury and tell them his client had a certain amount of medical
Richard Bennett is a founding partner of the Winston-Salem law firm of Bennett & Guthrie P.L.L.C. For more than 30 years, Mr. Bennett has practiced in the field of civil litigation, with an emphasis on medical malpractice defense. For more information, visit www.bennett-guthrie.com or call (336) 765-3121.
“The Cap”
expenses – even when no one paid or was
There is the $500,000 cap (“the cap”) on
even responsible to pay for a significant
non-economic damages that caught the
part of the bill. That attorney was not
left the collateral source rule – another
press’ attention. That’s the one that puts
breaking the law or violating legal ethics.
legalized misrepresentation to the jury
the cap on subjective damages, like pain
– alive and well. This old common law
and suffering, which has caused some
Rather, it was a legalized misrepresenta-
principle applies outside of the Medicare
juries to get carried away, particularly in
tion to the jury. It worked like this:
context.
sympathetic cases. The malpractice plaintiff had a physician’s
As a result of its existence, the plaintiff’s
Nevertheless, a half million dollars is still
bill for $30,000, all of which was covered
attorney can tell the jury that the plaintiff
a lot of money. And the cap will be raised
by Medicare. However, Medicare paid
patient’s medical expenses are $12,000,
every year, based on a formula using the
only about $12,000 of the bill and the
even when the patient did not pay a
Consumer Price Index.
physician was forbidden from collecting
penny of that amount and it was all paid
the rest from the patient. Nevertheless, the
by Medicare.
Significantly, the cap does not apply, and
plaintiff’s attorney could still imply to the
there is no limit to damages, in cases
jury that the patient had a $30,000 medical
If, for example, a patient’s medical bills are
where both:
bill and to seek recovery for that amount.
all paid by the patient’s health insurance
• Damages suffered are disfigurement,
carrier and the patient pays none of the
loss of use of part of the body,
The General Assembly changed that.
bill, the plaintiff’s attorney is allowed to
permanent injury or death; and,
Now a plaintiff may only claim as medical
lead the jury to believe that the patient is
• The jury should believe that the
expenses bills that have actually been
the one who paid the bill. That’s still the
defendant medical care provider’s
paid (as by Medicare) or represent
law.
act or failure to act were committed
amounts that are actually necessary to
in reckless disregard of the rights of
satisfy the bill (which Medicare hasn’t
Conclusion
others, grossly negligent, fraudulent,
paid yet). So now, under that scenario,
The tort reform provisions, which went
intentional or with malice.
the plaintiff’s attorney must tell the jury
into effect Oct. 1, 2011, should reduce
that the plaintiff patient’s medical bills are
some of the legal inequities that the
$12,000, not $30,000.
medical profession has faced in defending
Consequently, there will be a number of medical malpractice lawsuits in which the
itself. However, there is still plenty of legal
defendant will not have the benefit of the
The Collateral Source Rule
room for patients to sue their physicians
“the cap.”
Unfortunately, the General Assembly
and hospital.
February/March 2013
7
Practice Marketing
How to Avoid the Pitfalls of
Bad Medical Websites By Amanda Kanaan
So your practice has a website. That’s a good start. But if it’s no more than an online brochure, than you may not be reaping much of a return on your investment. According to a study by MedCity News of several hundred urologists, orthopedic surgeons and other practices: • 69 percent of physicians have websites but only 33 percent of them have anything more than biographical and practice information on it; • Only 4 percent made at least one blog post in the past 12 months to inform patients of trends and research. This means too many medical practices are ignoring the well-documented fact that most prospective patients search online for health care information – including provider resources. Some even chose their doctors online by forming an impression about their practice merely based on the quality of their website. The online brochure approach is grossly inadequate for today’s educated, involved
and computer-centric health care consumer. Even worse, the “set-it-and-forgetit” mentality of practices that rarely update their website content means their site is likely to appear low on search engine results, which certainly doesn’t compel the reader to trust or even contact the provider. Here are five ways for you to avoid the pitfalls of an outdated website: 1. U pdate your website regularly
The easiest way to keep your website up to date is to write regular blogs (weekly or monthly). The word “blog” may conjure up ideas of online posts about life experiences. Don’t worry, in this case I mean brief (400 word) educational articles that keep patients up to date with the latest trends or advances in your specialty. It’s the same information you share with patients every day but just in written form. Implementing the blog (or a “News” section) directly on your website gives you the most benefit for your search engine rankings.
Amanda Kanaan is the president and founder of WhiteCoat Designs, a North Carolina-based marketing agency catering specifically to physicians. WhiteCoat Designs offers doctors affordable marketing solutions to help them grow their practices. Services include website design, search engine optimization (SEO), social media management, online reputation monitoring, brochure and collateral design, branding makeovers and physician liaison services to build patient referrals. Ms. Kanaan can be reached at amanda@whitecoat-designs.com or (919) 714-9885. To learn more, visit www. whitecoat-designs.com.
2. Present an attractive, updated design
Your website doesn’t have to be overdone with flashing images and music playing in the background, it just needs to look updated (i.e., not like it was designed during the start of the online revolution in the early ’90s). An attractive, yet simple design is most effective because it gives patients the sense that the site is updated yet keeps the navigation user-friendly. 3. Include patient education
You’ve probably had a patient ask you about health information they read on WebMD. There’s no denying that patients search for health information online. And who better to give it to them than their own doctor? Including patient education on your website will not only keep prospective patients on your website longer but it also positions you as the expert in your specialty. At the end of the day, you want patients and even referring physicians looking to you for advice, not WebMD.
8
The Physician The Triangle Triad Physician
4. Offer online tools
Online tools such as patient portals, online bill pay and the ability to download forms have become more than convenient patient perks. They are now the expectation. These tools are simple ways to increase patient satisfaction and set your website apart from your competitors. 5. Participate in social media
Legal Expertise, Health Care Knowledge Principal Karen McKeithen Schaede, a registered nurse for 10 years, brings in-depth understanding of health care to the practice of law.
Physicians still have mixed reactions when it comes to social media. Most practices agree that patient-to-patient referrals are one of their largest sources of referrals, and social media is essentially an online megaphone for these interactions. The use of social media logos (e.g. a logo on your website that links to your Facebook page) also makes your website look more up to date, since this is still a relatively new trend that patients view as progressive. Social media is also a great way to share blogs, patient education and practice news with current patients, prospective patients and referring practices alike.
Our staff can assist you with: • Medical Practice Formation • Physician Employment • Medical Practice Sale, Acquisition or Consolidation • Medical Joint Ventures • Medical Staff Disputes • HIPAA Issues • Corporate Compliance • Contract Disputes • Employment and Labor Law 1175 Revolution Mill Drive Studio 7A Greensboro, NC 27405 Fax: (888) 392-2707 karen@shadylaw.net www.shadylaw.net
If you want to set your practice apart online and really use your website to its full benefit then make sure your website is more than a stagnant source of simple contact information. Websites can be a powerful marketing tool that can attract patients and boost patient satisfaction when utilized to their full benefit.
336-288-4055
North Carolina’s Premier Interior Design Firm Thank You for Voting Us Best Interior Designers Two Years in a Row!
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“You Dream It, We Design It!” 2575 Old Glory Rd. Clemmons • 336.778.1030 • www.junedelugasinteriors.com
February/March 2013
9
Feature Story
Wake Forest Baptist Medical Center
Acute Care Surgery Hits Full Stride
James Holmes IV, M.D., director, Burn Center; Michael Chang, M.D., director, Trauma Services; Wayne Meredith, M.D., chair, general surgery, Wake Forest Baptist Medical Center Acute Care Surgical Team.
10
The Triad Physician
H
ealth care is in a constant state of
of accessibility provides an increased
service is comprised of eight physicians
evolution, and a new subspecialty,
safety net to critically ill patients,” says Dr.
board certified in both general surgery
Chang.
and surgical critical care. Because acute
acute care surgery, has emerged that fo-
care surgeons face tremendous variety
cuses on providing the highest quality of care to patients with critical surgical
While these initial benefits are clear, a
in the patients they treat, they draw from
needs.
mature, dedicated acute care surgery
many disciplines and are adept at a great
program, such as Wake Forest Baptist’s,
range of surgical procedures. They treat
The new subspecialty has deep roots in
also includes surgeons with a focused
approximately 4,500 patients each year in
trauma surgery. “Late in the 20th century
academic
four main areas of care:
we recognized that surgeons who focused
patients with surgical emergencies, a
on trauma care experienced better out-
fellowship-training program specific to
comes for their critically ill patients,” says
this subspecialty and evidence-based
wide range of acute problems, such
Michael Chang, M.D., director of Trauma
research centered on improving outcomes
as appendicitis, cholecystitis, intes-
Services at Wake Forest Baptist Medical
in patients with surgical emergencies.
tinal obstructions and hernias, are
and
clinical
interest
in
• Emergency General Surgery. A
treated. Advanced monitoring and di-
Center. “Trauma surgery evolved as a separate body of medical knowledge under
Dr. Meredith was instrumental in creating
agnostic technology allow the surgery
the umbrella of general surgery.”
a two-year fellowship program to train
team to perform bedside procedures
acute care surgeons at Wake Forest
for critically ill patients.
Forward-thinking physicians, including
Baptist. The medical center was one
Wake Forest Baptist’s Wayne Meredith,
of the first 15 in the country to offer a
Wake Forest Baptist cares for more
M.D., chair of General Surgery, advanced
program to prepare general surgeons
than 3,000 adult patients with
the evolutionary trend by creating a spe-
with broad training in emergency general
serious injuries to the neck, chest,
cialty devoted exclusively to meet the
surgery, trauma and burn surgery, and
abdomen and extremities. Care is
needs of trauma patients and other sur-
surgical critical care.
coordinated with other surgical
• Trauma Surgery. Each year
specialists, including neurosurgeons,
gical emergency patients who require timely assessment and the availability
Four Main Areas of Surgical Care
orthopaedic surgeons, plastic
of surgical intervention 24-7. “This level
Wake Forest Baptist’s acute care surgery
surgeons and interventional
The Wake Forest Baptist acute care surgical team engages in mock operating room training for surgical emergencies.
February/March 2013
11
Wayne Meredith, M.D., chair, General Surgery
Michael Chang, M.D., director, Trauma Services
James Holmes IV, M.D., director, Burn Center
As an ACS-verified Level I trauma center, a
high risk of shock. We attend to imme-
tertiary care referral center and a regional
diate life threats, such as bleeding and
patients are treated each year in Wake
resource center, Wake Forest Baptist has
airway problems. Patients then spend a
Forest Baptist’s Burn Center, one of
the capability of providing total care in ev-
24-hour ‘time out’ in the ICU, so we can
only two specialized burn centers
ery aspect of injury, including prevention.
restore some physiologic balance before
in North Carolina. The center has
“A trauma center is more than a building,”
returning them to the operating room for
eight beds in the burn intensive care
says Dr. Chang. “It’s a collection of individ-
more surgery. Research confirms better
unit and 16 beds in the acute care
uals dedicated to the care of trauma pa-
survival rates for these patients,” says Dr.
unit, with two hydrotherapy areas for
tients, from the moment of injury through
Chang.
wound care and a gym for therapy.
rehabilitation.” The trauma team includes
• Surgical Critical Care. This service
radiologists. • Burn Surgery. More than 250
trauma surgeons, nurses, respiratory
The medical center has two operating
provides unexpected or supplemental
therapists, social workers, rehabilitation
rooms devoted to acute care surgery,
surgical intervention for critically ill
specialists, dieticians, a chaplain and an
one specially equipped for orthopaedic
hospital patients. For such patients,
outreach coordinator.
cases; an 11-bed trauma ICU equipped with hemodynamic and intracranial pressure
acute care surgeons provide continuous monitoring and consultation with
“We treat more than 3,000 patients each
monitoring and mechanical ventilation; a
other specialists.
year in the trauma center,” says Dr. Chang.
40-bed step-down unit for trauma patient
“Our patient service area covers eastern
care and a 27-bed inpatient rehabilitation
Tennessee, southern Virginia and all of
unit.
Skilled Care and Resources: The Trauma Center and Burn Center
North Carolina.” AirCare provides 24-hour critical care
Wake Forest Baptist has all the resources needed to provide comprehensive acute
Research is an integral part of the trauma
transport services, by helicopter and
care surgery.
team’s efforts. The trauma center was the
ground ambulance, dedicated to trans-
first to publish an acute care surgery pa-
porting trauma patients from referring
The Trauma Center. The medical cen-
tient registry, an essential database that
hospitals or directly from an accident
ter’s Level I trauma center, one of six in
serves as a foundation for clinical re-
scene to the trauma center.
North Carolina, has been designated by
search. The Burn Center. Wake Forest Baptist’s
the state since 1982. In 2001, the American College of Surgeons (ACS) verified the
“We are also known internationally for
Burn Center, the oldest in North Carolina,
medical center as a Level I adult trauma
our research in damage-control surgery,”
has been in continuous operation since
center. In 2011, it verified the medical cen-
says Dr. Chang. “Some patients who come
1978. It is the only center in the area and
ter as a Level I pediatric trauma center, the
to us are physiologically exhausted from
one of only two centers in the state to be
only one in the state.
their injuries because of blood loss and
verified by the American Burn Associa-
other traumatic conditions. They are at
tion (ABA), which ensures that the center
12
The Triad Physician
includes all the surgical, medical and psy-
“Their personal understanding of the
tients each year, and we never turn any-
chological support expertise needed to
complexity of suffering from a serious
one away. We are open 24 hours a day,
provide gold standard burn care.
burn adds immeasurably to our patients’
every day of the year,” says Dr. Holmes.
healing.”
The center cares for burn patients from the central Piedmont and western North
“Verification of our burn center by the ABA puts an official stamp of approval on
Dr.
necessary
Carolina, southwestern Virginia, south-
what we do here to treat burn patients,”
surgical interventions such as excisions
ern West Virginia, eastern Tennessee and
says James Holmes IV, M.D., director of
and grafting. Plastic surgeon Joseph
north central South Carolina. “Many times
the burn center. “I am proud of our team
Molnar, M.D., associate director of the
we’re the closest burn center for patients
of direct caregivers – physicians, psy-
burn center, performs surgery on faces
in neighboring states.”
chologists, nurses, pharmacists, nursing
and hands, as well as long-term scar
assistants, therapists, social workers and
revisions and reconstruction.
Holmes
provides
all
The Wake Forest Baptist Burn Center is an active participant in research that prom-
chaplains.” “We are very proficient at removing
ises to result in improvements in patient
“Caring for burns requires more than
burned skin quickly and getting our pa-
care. “In the near future, we expect to
medical attention. It is the most traumatic
tients off ventilators,” says Dr. Holmes.
hear very promising results from a study
and painful injury people can survive,”
“Our length-of-stay performance exceeds
that marks the first significant operative
says Dr. Holmes. There is a monthly sup-
the ABA goal of one day per percent of
advancement in skin grafting in decades,”
port group to help burn survivors and
total body surface area burned. Most
says Dr. Holmes.
their families cope with the long-term
centers report 1.5 days or more: Our pa-
effects of serious burn injuries, as well
tients experience an average of .9 days.
For more information about acute
as inpatient survivor support via the Sur-
Our outcomes data is also outstanding.
care surgery services at Wake Forest
vivors Offering Assistance in Recovery
We haven’t had a central line infection in
Baptist Medical Center is available by
(SOAR) peer support program. “Our vol-
nearly two years.”
calling (336) 716-7021 and selecting option 2.
unteer group is among the largest and most active anywhere,” says Dr. Holmes.
“We treat between 250 and 275 burn pa-
Wake Forest Baptist’s Brenner Children’s Hospital has the only Level I pediatric trauma center in North Carolina.
February/March 2013
13
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Interior Design
Shop Locally
Quality and Service Are Closer Than You Think By June DeLugas
When considering purchasing furniture
All of these companies manufacture their
for your home or office, there are
furniture within a 100-mile radius. Hickory
countless options. Simply do a Google
Chair has been lauded nationally as a
search for “office furniture,” and you will
company that proves you can still achieve
see a host of online retailers selling their
fiscal success while providing healthy
goods. Before selecting one, I urge you
benefit packages to all employees without
to consider the value of shopping locally.
outsourcing jobs.
Just think about what a shot in the arm you will be giving that locally owned
When dealing with the pricing of a sofa,
company.
oftentimes the old adage “if it seems too good to be true, it usually is too good to
Buying locally is one of the most
be true” is apropos. The manufacturers
important things we can all do to support
listed above all use eight-way, hand-tied
the economy and stabilize the housing
cushions and kiln-dried wood. Both are
and job market in our area. For every $100
essential to the durability of the furniture.
spent in locally owned stores, $68 returns
Another consideration is the content and
to the community through taxes, payroll
durability of the fabric.
June DeLugas, an interior designer in Clemmons, is known for creating awardwinning homes that reflect the special relationships she develops with each client. Her retail showroom and design firm is open Monday through Friday from 10 a.m. to 5:30 p.m. and on Saturdays by appointment. You also can visit her website and blog online at junedelugasinteriors.com.
provide an answer within 24 hours. Look for a company that provides delivery
and other expenditures. Where furniture is concerned, your dollars also can have a
As you price furniture, be aware of
major impact in neighboring communities,
the services provided by the company
like High Point and Lexington. Believe it
where you make your purchase. Make
or not, there are wonderful companies
sure you purchase from a company
that still manufacture their furniture in
with experienced and qualified interior
North Carolina.
designers who can help in the selection of your piece. The staff should attend
In our retail store and design center, we
seminars on the furniture they sell and
carry lines such as Pearson, Hickory
if they do not know the answer to your
Chair, Miles Talbott and Michael Thomas.
questions, they should usually be able to
for all of your furniture and a staff member to be at your home during the delivery to ensure your satisfaction and answer your questions. Should a problem arise, local staff should begin seeking a solution to the problem immediately. We invite you to visit a local store or showroom and view some of the beautiful items that are handcrafted in your own backyard. Shop locally. February/March 2013
15
News
High Point Regional Hosts Project SEARCH Students Guilford County School students are
through internships in local businesses.
the right thing every time for our patients.
gaining work experience at High Point
The goal is to help the students
These students have demonstrated that
Regional Health System during their senior
obtain
community-based
determination since the first moments of
year of high school as part of the National
employment. The High Point Regional
their interviews. We are thrilled to have
Project SEARCH program.
Health System Project SEARCH Program is
them as a part of our team,” said Bobbie
the first autism-specific program in North
Comer, career services liaison.
This is a collaborative community part-
competitive
Carolina. Project SEARCH was founded by Erin
nership that includes High Point Regional Health System, Guilford County Schools,
Four students were selected for the first-
Riehle, nurse administrator, and Susie
UNC TEACCH-Greensboro and The Guil-
year program. They will experience three
Rutkowski, education administrator, in
ford Center, which is providing start-up
10-week internship rotations within various
1995 at Cincinnati Children’s Hospital
funds for the first year. Lincoln Financial
departments at High Point Regional
Medical Center in Ohio. The program has
also awarded a $20,000 grant to assist with
through June 28. Students are instructed by
been implemented successfully in 206
program costs during the first year.
a Guilford County Schools instructor, and
sites in 39 states and four other countries
the job coaches provide onsite training at
including Australia, Canada, Scotland and
Project SEARCH is an unpaid internship
the student internship sites through UNC
the United Kingdom.
program for students with intellectual and
TEACCH-Greensboro at the hospital. For information about Project SEARCH,
developmental disabilities that focuses on building employability skills provided
“Success begins with determination to do
visit www.projectsearch.us.
Alamance Regional Tests Ultraviolet Disinfection to Reduce Infections Center
study because its automated dose-delivery
cleaners and antibiotic therapies.
has joined a select group of hospitals
system has been shown to overcome the
“For the past three years, hospital-
participating in an infection-reduction
inaccurate, human-based cycle timing and
study funded by the Centers of Disease
poor device placement common to newer
Control and Prevention. The two-year
UV devices lacking third-party efficacy
study is measuring the effectiveness of
studies essential in delivery of a standard
using advanced, no-touch environmental
of care. Tru-D SmartUVC also eliminates
ultraviolet
human
Alamance
Regional
disinfection
Medical
technology
to
error
to
provide
consistent,
reduce infections.
repeatable disinfection outcomes.
The nine-hospital CDC study looks at
According to an Alamance Regional
four specific pathogens that persist in
Medical
the hospital environment: MRSA, VRE, C.
elimination
difficile and acinetobacter. Patients that
within patient rooms is a critical and
present symptoms for these pathogens are
essential practice in the reduction of
traditionally placed on contact precautions,
hospital-acquired infection (HAIs). It also
and special chemical cleaning procedures
is an important target for hospitals, as
are used to disinfect the environmental
associated costs are often non-reimbursed.
surfaces after the patient is discharged.
Yet, facilities are faced with the challenge
Center of
press surface
advisory,
the
contamination
of eliminating infection-causing germs Tru-D SmartUVC was selected for the
16
The Triad Physician
that are increasingly resistant to chemical
News acquired infection (HAI) rates have been
line-of-sight
surfaces
According to the advisory, Alamance
dropping at Alamance Regional,” said
from a single placement within a room,
Regional’s participation in the study
Sara Wall, R.N., infection preventionist at
“overcoming human error such as missed
supports its commitment “to improving
Alamance Regional. “This study will help
and difficult-to-reach surfaces, improper
the health of the citizens it serves” and
us determine if UV light can help us obtain
chemical applications and unreliable
vision “to set the statewide standard for
even lower infection rates.”
‘blind-dose guessing’ associated with
excellence and responsiveness.”
and
shadowed
questionable outcomes of lesser advanced Tru-D’s automated SmartUVC cleaning
and disruptive strobe light offerings.”
Other hospitals involved in the study include Duke University Hospital, North
system accurately measures and delivers the lethal UV dose required to break apart
The SmartUVC technology is reportedly
Carolina Memorial Hospital at UNC, Rex
the DNA of bacteria, virus and spores
the only ultraviolet disinfection device
Healthcare, High Point Regional Hospital,
and render them harmless, according to
supported by multiple, independent peer-
Durham Regional Hospital, Duke Raleigh
the advisory. Clinical research has shown
reviewed
advanced,
Hospital, Durham Veterans Administration
more than a 99.9 percent reduction of C.
environmentally
germicidal
Medical Center and Chesapeake Regional
difficile spores using Tru-D’s Sensor360
disinfection system has moved disinfection
Medical Center in Virginia. Alamance
technology.
of rooms and equipment to a much
Regional and the other participating
higher level than can be achieved through
hospitals are members of the Duke
manual, chemical cleaning alone,” said
Infection Control Outreach Network.
According
to
the
advisory,
Tru-D’s
engineering enables it to silently disinfect
studies.
“Tru-D’s friendly
Tru-D spokesman Chuck Dunn.
Wake Forest Baptist Urologist Awarded a Physician of the Year Gopal H. Badlani,
Dr. Badlani is recognized as an expert in
in Niger and other underserved areas. In
M.D., professor and
the field of urinary incontinence and has
another international project, he brought
vice chair for clinical
been invited nationally and internationally
together two organizations, International
affairs in the Depart-
as a visiting professor. He currently serves
Volunteers in Urology and Jeev Sewa
ment of Urology at
as secretary general of the American
Sansthan, in a project to care for the
Wake Forest Baptist
Urological Association and was recently
underserved in India. As a result, more
Medical Center, was one of three physi-
appointed to the Advisory Council of
than 6,000 people have received urologic
cians nationwide to be awarded a Physi-
the National Institute of Diabetes and
care during the past 15 years.
cian of the Year Award for Clinical Excel-
Digestive and Kidney Diseases. Dr. Badlani also volunteers in Winston-
lence from Castle Connolly Medical Ltd. Dr. Badlani was a leader in establishing
Salem at the community care center.
The Clinical Excellence Award recognizes
the scientific basis for use of grafts in a
physicians who exemplify excellence in
minimally invasive approach to repair
Upon completing his urological training
clinical medical practice. This is the eighth
pelvic organ prolapse using a mesh sling.
at Long Island Jewish Health System,
year the organization has sponsored the
He also has led research on minimally
Dr. Badlani went on to a fellowship in
awards.
invasive treatments for benign prostate
neurourology at Baylor University in
obstruction.
Houston. He is the editor of several textbooks and has authored more than
“Dr. Badlani has made significant contri-
200 publications and book chapters.
butions to the field of urology during his
Dr. Badlani’s special interest is volunteer
30-year career,” said Anthony Atala, M.D.,
work
W.H. Boyce professor and chair of urol-
and he previously served on the board
Castle Connolly Medical Ltd., which is
ogy. “He is committed to the very best in
of International Volunteers in Urology.
based in New York, has a mission to
patient care and we are proud that he is
He has worked with the International
help consumers find the best health care
part of our practice.”
Organization of Women’s Disorders for
through guides such as America’s Top
surgical care of obstetric complications
Doctors.
in
underdeveloped
countries,
February/March 2013
17
News
System Unification to Strengthen Novant Health Brand Novant Health is uniting its four-state
“In 2013, we will formally join our system
According to a corporate press advisory,
footprint by executing a strategic branding
under one brand to better serve our
Novant Health’s strategic brand process
plan to tie together its multiple points of
communities and bring efficiencies to our
began with the Codman Award-winning
care across the region.
operations. Together, our employees and
hand-washing campaign in 2005, which
physician partners will unify to create an
focused on the safety of patients and
The brand rollout, which is set to begin
unmatched health care experience for
invited them to have a voice in their care.
April 17, will be marked by the use of a
our patients.”
Three years later, MRSA infections were down 63 percent, and more than 3,000
new logo and facility name changes. “We
brand name, Novant Health, along with a
communities to know that when they see
facility locator. Novant Health’s facilities
this brand, they can expect to receive
in the Triad will become: Novant Health
something unique – the highest quality
Since then, Novant Health has focused
Forsyth Medical Center, Novant Health
of care coupled with an experience
on transforming health care to create an
Kernersville Medical Center and Novant
that meets their needs on their terms
experience that allows patients to focus
Health
– when, where and how they want to
on getting better and staying healthy. The
receive that care,” said Jeff Lindsay,
advisory cited as an example Novant’s
Clemmons
Medical
Center
(opening in April).
want
the
people
across
our
hospitals around the world had emulated
All 13 hospital facilities will adopt the
the program.
policy of screening all admitted patients for type 2 diabetes. Since launching the program throughout its facilities in September 2010, the “search and rescue” program has diagnosed nearly 5,000 people with previously undiagnosed diabetes. Another component of the unified system strategy is open access for patients. For patients, that will be experienced through real-time online appointment scheduling, E-visits and collaborative patient-clinician care. “We have made significant progress to transform health care, but the next, logical step in our journey is to tie our system together,” said Mr. Armato. “By unifying under the Novant Health brand, we are signaling to our patients and our Formed in 1997, Novant Health has grown
president of Forsyth Medical Center and
communities that whether you seek
from four to 13 acute care facilities, more
chief executive officer of the greater
care at a Novant Health facility in North
than 100 outpatient facilities and 350
Winston-Salem and eastern markets for
or South Carolina – or Northern Virginia
physician practice facilities in four states.
Novant Health. “We’re building a health
or Georgia – you should expect an
care experience that’s simpler, more
unmatched experience including access
“Over the past 15 years, Novant Health
convenient and more affordable, and
when and where our patients want it at an
has grown into a sizeable regional health
that’s what we mean when we promise to
affordable price. We want to make health
system,” said Carl Armato, president and
provide a remarkable patient experience.”
care remarkable. That is our promise.”
chief executive officer of Novant Health.
18
The Triad Physician
News The organization also has implemented
nearly 1,000 Novant Health leaders met
For more information on the strategic
employee-engagement strategies as a
in Charlotte, N.C., to be trained on the
changes, visit www.NovantHealth.org/
part of the branding plan. In February,
strategic plan.
remarkable.
Triad HealthCare Launches Secure Health Information Exchange Area doctors will see a more complete record of their patients when Triad HealthCare Network rolls out a health information exchange over the next 18-24 months. The health information exchange (HIE) is a computerized system for sorting patient information from Triad HealthCare Network members and creating a single medical record for each patient.
providers can come together to achieve their common goal of improving care for members of the community,” said Sumit Nagpal, chief executive officer of Alere Accountable Care Solutions, the company responsible for creating the HIE solution
used by Triad HealthCare Network. “This is a transformational moment that will bring Triad HealthCare and its members one step closer to the long-awaited information revolution in health care.”
“This produces a huge change in the way medicine is practiced,” said Steve Neorr, vice president and executive director of Triad HealthCare Network. “Our goal is to ensure that all aspects of your health are managed at each medical visit – not just the concern that brought you in that day.” The single chart should also help avoid duplicate tests and paperwork. Keeping medical records safe and secure is an important feature of the Triad HealthCare Network HIE. “Security features alerting us to potentially unauthorized searches of medical records (are) only part of the system,” said Mr. Neorr. “Highly sensitive portions of medical records, such as mental health, substance abuse and HIV status, are locked to everyone without patient approval,” he said. While all 700-plus members of Triad HealthCare Network will have access to the HIE, it will be used first by primary care doctors. The system works with nearly all medical records programs, including the Cone HealthLink electronic medical record.
Expertise
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February/March 2013
19
News Welcome to the Area
Physicians
Julisa Margarita Patel, MD
Emergency Medicine Wake Forest Univ Baptist Medical Center Winston-Salem
Reshma Manhar Patel, MD
Internal Medicine Wake Forest University Baptist Medical Center
Thoracic Cardiovascular Surgery Triad Cardiac and Thoracic Surgery Greensboro
Adaorah Elizabeth Okafor, DO
Rishi Pawa, MD
Roger David Gomez, PA
Aaron Alan Guess, DO
Christopher Bradley Watkins, DO
Pediatric - Emergency Medicine Wake Forest Univ Baptist Medical Center Winston-Salem
Cynthia Cowan Bennett, MD Elon
Physician Assistants
Pediatric Rheumatology
Erin Renae Barrett, PA
Gastroenterology; Internal Medicine Wake Forest University Baptist Medical Center Winston-Salem
Martha Fairbanks Perry, MD
Neurology
Emergency Medicine Wake Forest Univ Baptist Medical Center Winston-Salem
Roy Dewayne Book, MD
Troy Pope, MD
Addiction Medicine; Addiction Psychiatry; Psychiatry Gateway Health, Inc. Greensboro
Dawn Scotton Caviness, MD Family Medicine Cone Health Family Practice Greensboro
Imran Khalid Choudhry, MD
Orthopedic Surgery; Orthopedic, Hand Surgery; Orthopedic - Surgery of the Hand Wake Forest University Baptist Medical Center Winston-Salem
Family Medicine; Family Medicine Western Rockingham Family Medicine Madison
Jody Jeppson, PA John Rolland Laisure, PA
Family Medicine; Nephrology, Internal Medicine; Pediatric Nephrology; Rheumatology Greensboro
Emergency Medicine Winston-Salem
Joshua Graham Porter, MD
Scott David Long, PA
Dermatology
Psychiatry
Family Medicine; Geriatric Medicine; Internal Medicine; Occupational Medicine; Pediatrics; Preventive Medicine/Occupational; Emergency Medicine; Urgent Care NextCare Urgent Care Burlington
Michael Edward Schinlever, MD
Amy Patel, PA
Jeffrey Allan Puette, MD
Wake Forest University Baptist Medical Center
Mariam Rabya Qureshi, MD
Evan Schaller Corey, MD
Critical Care-Internal Medicine; Emergency Medicine Wake Forest Univ Baptist Medical Center Winston-Salem
Casey Jae Davis, MD
Jacob Alan Sepmeyer, MD
Emergency Medicine
Toral Shah Desai, MD
Diagnostic Radiology Wake Forest University Baptist Medical Center
Internal Medicine
Basharat Alam Shah, MD
Kayla Faith Griffith, MD
Jasmeet Singh, MD
Surgery; General Surgery Wake Forest University Baptist Medical Center Winston-Salem
Quan Terrelle Johnson, MD Pediatrics
Vineet Korrapati, MD
Gastroenterology; Internal Medicine Rowan Diagnostic Clinic, PA Salisbury
Payman Kosari, MD
MOHS-Micrographic Surgery; Pediatric - Dermatology Wake Forest University Baptist Medical Center Winston-Salem
Ervin Lee Lowther Jr., MD
Wake Forest Univ Baptist Medical Center Winston-Salem
Iskra Magick Myers, MD Ramanathan Nagappan, MD
Cardiovascular Disease; Internal Medicine Greensboro
Michael Monroe Ogden, MD Administrative Medicine; Pediatrics
James Timothy O’Neil Jr., MD
Otolaryngology; Otorhinolaryngology Wake Forest Univ Baptist Medical Center Winston-Salem
Vipul Vrajalal Parekh, MD
Neurology/Psychiatry; Neurology Wake Forest University Baptist Medical Center Winston-Salem
20
The Triad Physician
Wake Forest Baptist Medical Center Winston-Salem
Carrie Jean Hall, PA
Adolescent Medicine; Pediatrics
Nicholas Rice Phillips, MD
David Bezov, MD
Whitney Graham, PA
Interventional and Vascular Radiology; Neuroradiology; Pediatric Radiology Wake Forest Univ Baptist Medical Center Winston-Salem
Emergency Medicine
David Sanders, PA
Family Medicine; Pediatrics; Urgent Care Pioneer Family Medical Danbury
Shannon Shumate Sparks, PA
Cardiology; Diabetes; Emergency Medicine; Family Medicine; General Preventive Medicine; Hospitalist; Internal Medicine; Obstetrics and Gynecology; Urgent Care
Patrik Erik Stridh, PA
Radiology
Orthopedic Sports Medicine; Orthopedic Surgery; Orthopedic Surgery, Adult Reconstructive Orthopedics Specialist of the Carolinas Winston-Salem
Jeffrey Howard Walden, MD
Emma Veigh Weavil, PA
Family Medicine; Family Practice
Family Medicine
David Paul Yelverton, MD
Allison Nicole Williams, PA
Timothy Aaron VanHoose, MD
Emergency Medicine Wake Forest Univ Health Sciences Winston-Salem
Neurological Surgery Morehead Memorial Hospital Eden
The Triad Physician 2013 Editorial Calendar April Autism Irritable Bowel Syndrome IT Services
July Imaging Technologies Psoriasis Medical Insurance
October Cancer in Women COPD - Lung Health Medical Software - EMR
May Arthritis Women’s Health Medical Billing
August Orthopedics Gastroenterology Medical Real Estate
November Alzheimer’s Disease Diabetes Financial Planning
June Men’s Health Vascular Diseases Medical Collections
September Atrial Fibrillation Urology Web Design
December Pain Management Spine Disorders Practice Management
The Magazine for Health Care Professionals
The Triad Physician
Did You Know? We mail to over 6,000 MDs, PAs, administrators, and Hospital staff in 41 counties in the Eastern NC – Not to each practice but to each MD or PA personally
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Counties: Alamance, Allegany, Ashe, Caswell, Davidson, Davie, Forsyth, Guilford, Randolph, Rockingham, Stokes, Surry, Watagua, Wilkes, and Yadkin Counties Cities: Greensboro, Winston Salem, High Point, Burlington, Reidsville, Boone, Wilkesboro, Mount Airy, Lexington, Thomasville, Kernersville, Asheboro, Eden, and Statesville
Local physician specialists and other professionals, affiliated with local businesses and organizations, contribute all editorials or columns about their respective specialty or profession.
Every issue includes the latest listing of: MDs and PAs who are newly licensed by the NC Medical Board and New MDs and PAs to the area.
We also publish free of charge: • Practice, hospital and other medical facility news, including: • New MDs and PAs; • New facilities, expansions and relocations;
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CLEVELAND CLINIC
FORSYTH MEDICAL CENTER
Forsyth Medical Center is now affiliated with #1 ranked Cleveland Clinic. Forsyth Medical Center has been selected as the Triad region’s only affiliate heart hospital for the Cleveland Clinic — ranked #1 in the nation by U.S. News & World Report, 17 years in a row. This transforms our healthcare landscape forever. With Forsyth Medical Center and Cleveland Clinic working together, you have the best of the best on your side, with access to the most advanced research, programs, technologies and techniques in the world of cardiovascular medicine and surgery. Now there’s no need for you or your loved ones to travel for most cardiac care. Or to compromise. The #1 choice in cardiovascular care is right here for you.
www.forsythmedicalcenter.org/heart www.clevelandclinic.org/heart