january/february 2018
The Triangle Physician T H E
M A G A Z I N E
F O R
H E A L T H
C A R E
P R O F E S S I O N A L S
Johnston Health Therapeutic Wound Center Caring and Experienced Staff and Physicians Go Above and Beyond to Save Limbs
“After losing my right foot to an infection fueled by diabetes that I didn’t even know I had - I needed physical and emotional healing. I found both at Johnston Health’s Therapeutic Wound Center! Now, at last, I’m back customizing show vehicles - and riding my bike again!”
Joshua Bailey Kenly, NC
For Joshua’s complete story, visit “Patient Stories” at: johnstonhealth.org. For more information on our Therapeutic Wound Center visit: johnstonhealth.org/woundcare
Expert Care - Close To Home! SMITHFIELD
www.johnstonhealth.org www.johnstonhealth.org
CLAYTON
From the Publisher
Healing Power This month’s cover story on the Johnston
broader community preparedness and the
Health Therapeutic Wound Center explores
laws that govern disaster planning.
the expertise needed to harness the healing power of state-of-the-art hyperbaric oxygen
Here’s wishing you a successful 2018. Are
therapy and treat stubborn wounds. The
you prepared with a well-devised plan
well-written feature article conveys the
for promoting your services and unique
practice’s high degree of quality of care
qualities?
and professionalism, as well as a culture of genuine patient care.
We invite you to consider the costeffective use of The Triangle Physician as
Also in this issue, physician advocate
a communication vehicle that reaches a
Marni Jameson Carney reports that the
key market, the more than 9,000 directors,
Association of Independent Doctors has
administrators and managers within the
added two more state chapters. AID is
Triangle medical community. We welcome
working to reverse the trend of economic
your medical news that runs free of charge,
pressures that cause independent
and we offer competitive ad rates for
physicians to join hospitals, which AID
increasing awareness of your healing power.
members believe is not good for patients,
Contact us at info@trianglephysician.com
doctors or communities.
for details.
The question is not if a disaster will strike
With great appreciation,
one’s medical practice, it’s when, according
Publisher
to practice management consultant Margie
John Teague
Satinsky. In the first of her two-part series on disaster planning, Satinsky addresses potential risk, and takes into consideration
The Triangle Physician T H E
M A G A Z I N E
F O R
H E A L T H C A R E
P R O F E S S I O N A L S
Copy Editor John@TTP2LC.com
Creative Director - Joseph Dally jdally13@gmail.com
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The Triangle Physician
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Every precaution is taken to insure the accuracy of the articles published. The Triangle Physician can not be held responsible for the opinions expressed or facts supplied by its authors. The Triangle 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 Triangle Physician.
Table of Contents january/february 2018
Vol. 9, Issue 1
DEPARTMENTS 8 Physician Advocacy Independent Doctors Group Forms Chapters in Pennsylvania and Texas This update on the Association of Independent Doctors reports a growing number of members and chapters
10 Practice Management
4
Disaster Planning, Part1: Understanding Practice Risk
12 Research News Cancer drug discover methods used to identify new lyme disease therapy
COVER STORY
Johnston Health Therapeutic Wound Center Caring, Experienced Staff, Physicians Go Above and Beyond to Save Limbs On the Cover: Since opening in 2003, Johnston Health Therapeutic Wound Center has saved limbs and improved the lives of hundreds of patients. Members of the staff are, from left to right, standing: Naomi Parker, CNA II; Judy Williams, certified hyperbaric technologist; Teri Smith, RN; Dr. Manmohan Singh, medical director; Angela Fortson, RN, director; Kris Popilek, RN; Carol Parker, RN; and David McCoy, RN; and seated: Rebecca Evans, RN; Mary Lena Canupp, RN; Paige Gregg, RN; Stephanie Keene, RN; and Danielle Bass, registrar.
enduring gratitude February 3, 2018
The 9th annual Enduring Gratitude event honoring veterans and active members of the finest forces of The United States Military. For more information regarding military registration, voluntering, or donations, please visit
www.enduringgratitude.org
january/february 2018
3
Category
Johnston Health Therapeutic Wound Center
Caring, Experienced Staff, Physicians Go Above and Beyond to Save Limbs Although it’s been 14 years, Manmohan Singh,
There had been local demand, too, for
care at the wound clinic on opening day at
wound care. At his practice, the surgeon had
Johnston Medical Mall in Smithfield. He was a
been seeing bedsores on neglected patients
Raleigh educator who had seen the new service
who had nowhere else to go for treatment.
advertised on TV.
trators added a wound care clinic to the plans
Therapeutic Wound Center, grabbed attention
for the medical mall, which required an exten-
because it offered, among other things, hyper-
sive renovation of the shuttered Burlington In-
baric oxygen (HBO) therapy. Back then, such
dustries textile mill across the street.
was in Durham.
The Triangle Physician
Responding to the need, hospital adminis-
The clinic, now called Johnston Health
clinics were few and far between. The closest
4
eral surgeon.
M.D., remembers the first patient who sought
For that first patient, Singh prescribed HBO therapy to stop internal bleeding, which had
“We knew there was great demand for
been caused by radiation therapy to treat pros-
wound care because the clinic at Duke Hospital
tate cancer. The patient had been seeing his urol-
was overflowing,” says Singh, medical director
ogist, who had done everything he could to help.
of the Johnston Health clinic and a retired gen-
“After several sessions in the HBO chamber,
Johnnie Dupree shares a light moment with registered nurse David McCoy, as he examines the healed wound on Dupree’s foot. The staff prides itself on personalized, compassionate care.
the patient healed completely,” Singh
Typically, sores or wounds that
says. “Since then, I’ve seen him out and
don’t heal from conventional treatment in
about, and he’s doing great.”
about 30 days are considered non-healing, or chronic. The clinic sees a variety
Treating Wounds Is a Science
of chronic wounds, from diabetic, pres-
Although HBO chambers have been
sure, venous and arterial, to burns, spi-
used to treat chronic wounds since the
der bites and traumatic injury wounds.
1960s, few physicians back then knew about HBO therapy or understood the
Wound Detectives
complexity of wounds, Singh says.
Investigate Causes
So how does hyperbaric oxygen
Angela Fortson, director of Johnston
promote healing? As patients relax inside
Health Therapeutic Wound Care, says
the transparent, cylindrical chamber,
the first step in treating a wound is find-
they breathe in pure oxygen at an air
ing out why it hasn’t healed. At their
pressure two to three times higher than
initial visit, patients can expect tests,
normal. This increased flow of oxygen
health-related questions and, sometimes,
reduces swelling and helps form new
a procedure.
blood vessels.
“If patients have diabetes, we’re
“Treating wounds has become a
looking at how well it’s under control,”
science,” says Singh, who is certified in
she says. “If they have pressure ulcers,
wound care. “There are so many meth-
we’re looking at how to relieve that pres-
ods of therapy, from debridement to neg-
sure. What kind of bed are they lying on?
ative-pressure wound therapy to biologi-
What kind of shoes are they wearing?
cal grafts using the frozen cells of animal
We’re looking at all factors.”
and human tissue.”
january/february 2018
5
Registered nurse Stephanie Keene has worked at Johnston Health Therapeutic Wound Center since it opened in 2003. For continuity of care, patients see the same nurse and physician at every visit.
Depending on their needs, patients may be assigned to a particular physician on the medical staff. If they have problems with blood flow, they may see Thomas Powell, M.D., a vascular surgeon. If they have a wound caused by MRSA and need IV therapy, they may see Octavio Cieza, M.D., an infectious disease specialist. Rounding out the medical staff are Mark Bowling, M.D., and Marie-Luise Zaldivar, M.D., both primary care physicians. All have training in wound care and hyperbaric therapy. A culture or tissue biopsy, an X-ray or
By the time Johnnie Dupree, 77, a
there’s infection in the tissue or bone.
former truck driver, got to the wound
Arterial studies may be needed to find out
center, his foot ulcer was the size of a
if there’s enough blood flow to deliver oxygen,
quarter and deep enough to see bone.
nutrients and medications to the wound. If
“I couldn’t feel it so I didn’t realize
blood flow is poor, then the patient may need a
it was that bad,” he says. “It had gotten
surgical intervention.
to the point that I could hardly walk. I
A venous Doppler ultrasound may be ordered to check for blood clots.
6
The Triangle Physician
A Patient’s Story
magnetic resonance imaging can determine if
was afraid I was going to lose my foot.” For the next 12 weeks, Dupree
During the first visit, the physician may de-
spent two and a half hours every week-
bride or remove tissue that may be hindering
day in the HBO chamber. At home, his
the wound from healing. A topical anesthetic is
granddaughter, a certified nursing as-
applied, if needed, Fortson says.
sistant, administered a daily regimen
Before the patient leaves, a case manager
of antibiotics through a peripherally
may be asked to place orders for supplies,
inserted central catheter (PICC) to
equipment or visits from home health – any-
fight an infection that had spread to
thing the patient needs to start healing.
the bone in his foot.
Patients return to the clinic weekly until
“After my treatment started, I be-
their wounds are at least 50 percent healed.
gan to feel stronger and better every
Afterward, they’re seen as needed until they’re
day,” he says. “I have more energy.”
completely healed, she adds.
His foot has since healed, and he will
“Our patients see the same doctor and
return to the clinic for one last visit. Dupree says he’ll always remember the kindness of the staff. Because he is blind, they
walking, Fortson says. “Her turnaround was
nurse, so they get
remarkable.”
to know each other
Fortson, a nurse certified
take him to and from the bus when it arrives at
in wound care, thinks the
the medical mall. If he has to wait, they bring
clinic stands out because of
him coffee, fixed the way he likes it.
its personalized care. “Our
Turns out his ulcer was caused by a
patients see the same doc-
poor-fitting shoe. At the medical mall, two or-
tor and nurse, so they get
thotics companies set up two days a week to
to know each other well,”
see patients. The staff scheduled an appoint-
she says. “We truly care and
ment for Dupree to get inserts and the special
worry about our patients.”
diabetic shoes that he now wears.
very well.
We truly
care and worry about our patients.”
- Angela Fortson
Fortson says patients also receive counseling on
“Saving Limbs Is What Makes Our Job
health factors, such as smoking ces-
So Rewarding”
sation, proper diet and taking medications
Fortson says many patients come to the clin-
as directed.
ic for second opinions after being told they
“More and more often, we’re finding that
need amputation. “They’re upset and feeling
many patients don’t have a family doctor,”
hopeless,” she says. “Saving limbs is what
she adds. “They may know they have diabe-
makes our job so rewarding.”
tes, but they don’t have anyone to help them.
Her favorite story is about the patient who arrived on a stretcher, the flesh on her
We do all we can to connect the dots, and get them the care they need.”
foot rotting and dotted with maggots. But with
To schedule an appointment or to get
every visit for debridement, HBO therapy and
more information about Johnston Health
skin grafts, her foot got better.
Therapeutic Wound Center, call (919) 938-
At first, the patient was so despondent that she didn’t speak. But as she started to
7716. Hours are 8 a.m. to 4:30 p.m., Monday through Friday.
heal, she started talking, and then began
Judy Williams, a certified hyperbaric technologist, operates the two HBO chambers at the wound clinic. It’s been proven that oxygen heals wounds.
january/february 2018
7
Physician Advocacy
Independent Doctors Group Forms Chapters in Pennsylvania and Texas Frustrated by the increasing pressures on in-
said Carey. The four-year-old association has
dependent doctors to sell out to hospitals and
nearly 1,000 members in 33 states. In forming a
health systems, doctors in Pennsylvania and
state chapter, which requires a minimum of 15
Texas have banded together to form the two
members, the independent doctors recognized
newest state chapters of the Association of In-
that they would be stronger together.
dependent Doctors.
Marni Jameson Carey is the executive director of the Association of Independent Doctors. You may reach her at (407) 571-9316 or marni@aid-us.org. Visit www.aid-us.org for more information.
8
The Triangle Physician
Nationwide, large hospital systems have
The Pennsylvania and Texas chapters
been aggressively acquiring independent doc-
bring the total number of AID state chapters
tors and turning them into employed physi-
to six. With this addition, the fast-growing na-
cians, Carey said. Studies show that is one of
tional nonprofit, which also has chapters in
the leading drivers of higher health care costs.
California, Florida, New England (Vermont and
“AID is working to reverse that trend,
Maine) and South Carolina, gives local inde-
which is not good for patients, doctors or com-
pendent doctors a voice on the national stage,
munities,” said Carey.
and a vehicle through which they can be ac-
“By joining forces with AID, we can bring
tive locally, said AID Executive Director Marni
greater attention to the issues facing indepen-
Jameson Carey.
dent doctors and their patients,” said Cristin
“When doctors from one area join the as-
Dickerson, M.D., a radiologist and partner of
sociation, their collective voice gets louder,
Green Imaging in Texas. “We must do all we
and they can better protect their professions,”
can to protect patients’ access to the person-
Physician Advocacy
alized care offered by independent doctors.” While consolidation in health care is a national problem that all independent doctors should protect against, states also have regional issues that a concentrated group of local doctors can influence, said Carey. “Forming a chapter of AID will help us ensure that consolidation doesn’t completely wipe out independent doctors, which have been proven to offer the most cost-effective care to patients,” said Dr. Anthony Dippolito, M.D., a surgeon in Bethlehem, Penn. The doctors also will benefit from AID’s infrastructure, national reach and resources. Members who opt to make their names public will become part of AID’s online directory of independent doctors, a growing database
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january/february 2018
9
Practice Management
Disaster Planning, Part I:
Understanding Practice Risk By Margie Satinsky, M.B.A.
Disasters that interrupt a practice’s ability to provide
well beyond the practice’s four walls. Disaster plan-
care for patients can happen at any time and in any
ning, therefore, necessitates looking beyond your
place, not just Texas, Florida, Puerto Rico or Cali-
immediate environment and developing a good un-
fornia. It’s likely that both large and small disasters
derstanding of preparations that are made in your
will impact you at some point during your medical
community, in your state, and at the national level.
career. In this first of a two part-series, we address the potential risk to your practice, your practice’s fit into Margie Satinsky is president of Satinsky Consulting LLC, a Durham, North Carolina, consulting firm that specializes in medical practice management. She is the author of numerous books (e.g. Medical Practice Management in the 21st Century), and articles for The Triangle Physician, and other publications. Satinsky’s 2017 White Paper on Disaster Planning is available at: http://www. satinskyconsulting. com/documents/ DisasterPlanning WhitePaper2017.pdf. To request other practice management services, contact margie@ satinskyconsulting.com.
We recommend communicating in advance with at least the following private and public health care providers, agencies, and organizations:
the larger context and state law. In our second arti-
•H ealth care providers: local hospital; regional
cle, we’ll recommend helpful suggestions for restor-
hospital or academic medical center; ambula-
ing your business to normal operations as quickly
tory surgery center; nursing homes; rehabili-
as possible.
tation facilities; medical colleagues in your specialty; other providers
Potential Risk of Disaster to Your Practice The risk of disaster in your practice is broad. It in-
•P ublic health departments (local, county, state)
cludes both natural and human-made disasters.
•P ublic safety departments (local, county, state)
Natural disasters include hurricanes, tornadoes,
•F ire departments (local)
flooding, and other major weather events that often
• S tate medical board
but not always are predictable in advance of their
• S tate medical society
occurrence. Unpredictable natural disasters include
•F ederal Emergency Management Agency
fire, bioterrorism and contagious diseases. They may occur suddenly, spread over a widespread geographical area and require a more complicated
(FEMA) • Department of Homeland Security (National Incident Management System [NIMS] program)
response than that needed for forecasted disasters. Given the heavy dependence on technology
North Carolina Law
of most medical practices, the potential for human-
North Carolina has many laws and regulations that
made disasters is also great. Problems with tele-
govern disaster planning for medical practices.
communications, computer operating systems and
Here’s a partial list of common questions and an-
applications, heating and air conditioning systems
swers.
and equipment malfunctions also qualify as disasters that can both interrupt your business and have
Laws and Regulations that Govern
a devastating impact on your practice.
Disaster Planning for North Carolina Medical Practices
Your Practice’s Fit Fit into the
disasters? Chapter 166A of the North Carolina
Most medical practices focus on the day-to-day
General Statutes and Article 36A of Chapter 14
care of patients and on those organizations with
of the North Carolina General Statutes (Chapter
which they frequently collaborate (e.g., medical
The Triangle Physician
166A has 4 articles).
colleagues, hospitals, laboratories, vendors and
2. Is the statute that deals with natural disas-
suppliers). Although unanticipated failures in com-
ter broad enough to cover emergencies that
puter or telecommunications systems are restricted
would arise out of a pandemic flu? Yes
to the practice itself, many other disasters extend
10
1. What state laws govern emergencies and
Larger Context
3. How does North Carolina define a disaster?
acquisition and relocation for supple-
have during a disaster or emer-
widespread or severe damage, injury,
mental repair and replacement hous-
gency?
or loss of life or property resulting from
ing to individuals and families, and for
health director is related to quaran-
any natural or man-made accidental,
any programs authorized by the Gen-
tine and isolation.
military, or paramilitary cause (G.S.
The authority of the state
16. If there is an imminent threat of
eral Assembly. 9. During a disaster or emergency in
contagious animal disease, what
4. How does North Carolina define a
North Carolina, who in the state
powers does the State Veterinar-
state of emergency? The condition
has the power to protect the pub-
ian have? The state veterinarian can
that exists whenever, during times of
lic? The governor has broad author-
implement emergency measures and
public crisis, disaster, rioting, catas-
ity. He/she can delegate certain duties
procedures, including quarantine and
trophe, or similar public emergency,
to the secretary of the Department of
public safety authorities are unable
Crime Control & Public Safety.
N.C.G.S. 166A-4(1)).
warranted inspections. 17. During a disaster or emergency,
to maintain public order or afford
10. During a crisis, can the governor
is there protection from potential
adequate protection for lives or prop-
require public workers to work?
malpractice liability? NCGS 166A-
Yes
14(a) classifies those working in emer-
erty, or whenever the occurrence of such condition is imminent (NCGS 14-
11. During a disaster or emergency,
gency management as working in
what authority does the governor
government functions and therefore
5. Who in North Carolina can declare
have over local governmental au-
protected from liability for the death
a state of disaster? The governor can
thorities? If the governor finds that
or injury to persons or property dam-
make a proclamation or the General
local control of the disaster or emer-
age resulting from their activity. The
Assembly can pass a resolution.
gency is insufficient to adequately
exceptions to this important protec-
6. What types of disasters can be de-
protect lives and property, s/he can
tion is willful misconduct, gross neg-
clared? Type I disaster – provided
exercise his/her powers (Article 36A
ligence, or bad faith.
288.1(10)).
three criteria are met. This is not a
18. How does the protection from mal-
of Chapter 14).
federal disaster. Type II and Type III
12. What are some of the ways in
practice liability apply to health
disasters – can be declared only when
which the governor can act during
professionals during a disaster or
the United States president declares a
a disaster or emergency? He/she
emergency? Providers have immu-
major federal disaster that triggers as-
can procure by purchase, condemna-
nity protection if they are operating
sistance from Federal Emergency Man-
tion, seizure, or other means to con-
as emergency management workers
agement Agency (FEMA) and Small
struct, lease, transport, store, main-
at the request of the state or other
Business Administration (SBA).
tain, renovate, or distribute materials
level of government. If they are pro-
and facilities for emergency manage-
viding care to patients on their own
ment (NCGS 166A-6(c)).
initiative but are not considered emer-
7. What do we need to know about a Type I disaster? Type I disaster lasts for 30 days after the declaration and
13. If our practice offers to allow the
gency management workers, they do
can be renewed for up to three addi-
state to use our property, can we
not receive special protection. (NCGS
tional months. State financial aid avail-
expect compensation? No
166A-14(d).
able mirrors the federal FEMA and SBA
14. If our property is used during an
19. Does the North Carolina Medical
help that would be available in Type II
emergency to shelter and protect
Board have special powers dur-
and III disasters.
people other than our own pa-
ing a disaster or emergency? Yes.
8. What do we need to know about
tients, can we be held civilly liable
The North Carolina Medical Board
Type II and III disasters? Type II di-
for the death of injury of any per-
can issue a limited physician assistant
sasters last for six months and can be
son or the loss or damage to prop-
volunteer limited license allowing
extended for up to one year. State funds
erty where these losses and inju-
physician assistants to perform medi-
may be made available for acquisition
ries resulted from the use of the
cal acts, tasks, and functions without
and relocation and for supplemental
property for the above purposes.
compensation, provided certain con-
repair, and replacement housing to in-
There is a waiver of private civil liabil-
ditions are met (NCGS 90-12.1).
dividuals or families. Type III disasters
20. If a physician or other health care
ity (166A-15).
last for 12 months and can be renewed.
15. What authority does the North
provider volunteers to provide
State funds may be made available for
Carolina State Health Director
care in the community, is there
january/february 2018
11
Practice Management
An occurrence or imminent threat of
immunity from malpractice li-
place of employment to people
health care provider licensed or certi-
ability? Yes. North Carolina grants
referred by a local health depart-
fied in North Carolina who provides
immunity to volunteer health care
ment or nonprofit community
services within the scope of his/her
health center (NCGS 90-21.16).
license or certification at a free clinic
professionals as follows:
is immune.
( 1) A volunteer medical or health
There is also immunity for a volun-
care provider who provides care
teer medical or healthcare provider
21. Can the governor waive health
at a facility of a local health de-
who serves as medical director of an
professional licensure laws dur-
partment or nonprofit community
emergency medical service (EMS)
ing a pandemic or disaster? Yes.
health center, and (2) A volunteer
agency. A retired physician who
The governor can waive professional
medical or health care provider
holds a “limited volunteer license” is
licensure laws for authorized emer-
who provides care at his/her
immune. Any volunteer medical or
gency workers (NCGS 166A-14 (c).
Research News
Cancer Drug Discovery Methods Used to Identify New Lyme Disease Therapy Antibiotics are currently the only treat-
department of Pharmacology and Cancer
Duke researchers have begun screen-
ments available for Lyme disease and
Biology at Duke, are collaborating with sci-
ing a library of thousands of compounds
other tick-borne illnesses, but research-
entists at Johns Hopkins School of Medi-
looking for potential drugs that target a spe-
ers at Duke Health are working to expand
cine and Tulane Medical Center to perform
cific Borrelia burgdorferi protein, which
the medical toolkit by identifying vulner-
distinct functions of the study.
plays a key role in promoting the survival
able areas of disease-causing bacteria that
The Duke team will use technology
of the bacteria.
Haystead’s lab has pioneered for cancer
The research project represents a
The research project, which recently
drug discovery, which will identify protein
new exploration for Spector, a leading can-
received a $3.8 million grant from the Ste-
targets for the development of a completely
cer researcher who was instrumental in
ven & Alexandra Cohen Foundation, relies
new class of molecularly targeted therapies
the development of lapatinib, the first oral
on drug discovery methods that have prov-
for Borrelia burgdorferi and Bartonella.
inhibitor of the HER2/neu cancer promot-
could lead to innovative therapies.
en successful in identifying treatments for
The team at Duke will then screen
ing protein approved by the United States
thousands of new compounds to identify
Food and Drug Administration for the treat-
“Our goal is to find alternatives to
those that target the desired proteins. The
ment of a subset of breast cancers.
antibiotics to treat Lyme disease, which is
new compounds identified at Duke will
Spector’s interest in Lyme disease re-
caused by the Borrelia burgdorferi bacteri-
then be tested at Johns Hopkins in a high-
search stems from his personal experience
um, and illnesses that arise from the Barton-
throughput assay to evaluate their effects
with the infection, which he battled for
ella pathogen,” said Neil Spector, M.D., the
on the viability of Borrelia burgdorferi and
years without a clear diagnosis. After suf-
Sandra Coates Associate Professor Breast
Bartonella.
fering near-fatal heart failure, he underwent
cancer and viral diseases.
Cancer Research at Duke Cancer Institute and the study’s co-principal investigator.
The most promising drug candidates
a heart transplant in 2009.
will then be sent to Tulane, where research-
Spector said many features of cancer
“We’re hoping to move from isolat-
ers will determine their efficacy in animal
are also true of Lyme. For example, how
ing targets to identifying potential drugs to
models of Bartonella illnesses and Lyme
and where tumors spread is not random.
testing in animal models within three years
diseases, including in primates.
Similarly, Lyme affects different people in different ways, and Spector asserts that
– so a very aggressive timeline,” said Spec-
The Spector and Haystead labs have
tor, who was a Lyme patient himself and
already identified more than 20 bacterial
nearly died from complications of disease.
proteins that represent attractive targets
“I think there’s a way to capitalize on
“Our goal is to identify drugs that will target
for drug development. The protein targets
the lessons we’ve learned in cancer biol-
the Achilles’ heel of these pathogens while
are selected in part for their specificity to
ogy and basic research over the past 20
sparing the normal gut microbiome.”
Borrelia burgdorferi, which would reduce
years and apply them to Lyme research,”
the risk of adverse side effects, such as the
Spector said. “We don’t have to reinvent
destruction of normal, healthy gut flora.
the wheel.”
Spector and co-principal investigator Timothy Haystead, Ph.D., professor in the
12
The Triangle Physician
there are likely biological factors at play.
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