november
2 012
Duke’s Retinal Specialists Provide Convenient, Best-in-Class Patient Care in Three Wake County Area Centers
T H E M A G A Z I N E F O R H E A LT H C A R E P R O F E S S I O N A L S
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Contents
COVER STORY
6 november
Duke’s Retinal Specialists
Provide World-Class Retinal Care Available in Convenient, Comfortable Wake County Area Eye Centers 2012
Vol. 3, Issue 10
FEATURES
13
Practice Management
Mobile Technology Boosts Efficiency
DEPARTMENTS 16 Women’s Health
21 News
Newest Robotic Treatment for Endometriosis Is Available in Smithfield
Single Fathers Due to Cancer Program Offers Support Group, Online Resource
17 Duke News
22 Durham Regional News
Maryan Binkley suggests apps for physicians that simplify office tasks, such as dictation, allowing more focus on patient care.
14
Women’s Health
Endometriosis and Pelvic Pain: Understanding Causes and Management
19 UNC News
associated pain.
Hospitals Earn Joint Platinum Performance Award for Heart Care Standards
23 News
Two Elected to Institute of Medicine
Rex Ear, Nose and Throat Specialists in Cary Is Led by Dr. Garside
20 News
24 News
Welcome to the Area and upcoming events
Dr. Andrea Lukes discusses conditions that may underlie pelvic pain and reviews the medical treatment of endometriosis-
- American College of Surgeons Awards Top Bariatric Surgery Accreditation - Anti-Cancer Drug Fights Immune Reaction in Some with Pompe Disease
- WakeMed Wins Top Honors for Commitment to Employee Learning - Hospital Is Recertified Stroke Center
COVER PHOTO: Retinal specialists with Duke Eye Center include those pictured, (from left) Tamer Mahmoud, M.D., Ph.D.; Stephanie Schuman, M.D.; Eric Postel, M.D.; Paul Hahn, M.D., Ph.D.; and Priyatham Mettu, M.D.; and Prithvi Mruthyunjaya, M.D.; and Eleonora Lad, M.D., Ph.D., not pictured.
2
The Triangle Physician
JOHNSTON MEDIC AL CENTER
Smithfield
A H e a lt h i e r tom or r o w b e g i n s today
From the Editor
From the Editor
Seeing Clearly It’s hard to imagine losing the ability to experience through sight the wonders of
T H E M A G A Z I N E F O R H E A LT H C A R E P R O F E S S I O N A L S
fall and spring every year, no less the emotion reflected in a loved one’s eyes. Today, much can be done to save sight from once vision-destroying diseases. It is possible with the appropriate level of urgency, expertise and technology, all available through Duke Eye Center, this month’s cover story. Also in this month’s issue of The Triangle Physician, Dr. Andrea Lukes addresses the importance of identifying the underlying condition causing pelvic pain and the need for lifelong management in some endometriosis patients. She also
Editor Heidi Ketler, APR
heidi@trianglephysician.com
Contributing Editors Maryan Binkley Andrea Lukes, M.D., M.H.Sc., F.A.C.O.G. Siamak Marzbani, M.D. Photography Mark Jacoby
invites referrals to her study on the safety and efficacy of elagolix in patients with
Creative Director Joseph Dally
endometriosis-related pain. Dr. Siamak Marzbani emphasizes the prevalence of
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jdally@newdallydesign.com
endometriosis and the benefits of advanced robotic technology in its diagnosis and
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treatment.
News and Columns Please send to info@trianglephysician.com
Maryan Binkley offers suggestions on smartphone applications that can maximize physician productivity. We all know the power of practice visibility for long-term growth and success. It is effectively achieved through well-crafted marketing messages and the effective mix of communication channels – print, broadcast, social media. The more targeted the reach, the more cost effective. Consider, then the reach of The Triangle Physician. Our magazine is delivered to more than 9,000 physicians, physician assistants, nurse practitioners, office administrators and staff throughout the Triangle. For those seeking visibility among those who can provide valuable referrals, the benefits of this
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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. Opinions expressed or facts supplied by its authors are not the responsibility of The Triangle Physician. The Triangle Physician makes no warrant to the accuracy or reliability of this information.
communication channel are clear to see.
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The Triangle Physician
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Cover
World Class Retinal Care Available in Convenient, Comfortable Wake County Area Eye Centers Duke Eye Center Now Has Wake County Retina Coverage Five Days a Week. Known for its award-winning excellence in patient care regionally and nationally, Duke Eye Center is the first choice of many patients in need of specialty diagnosis and treatment. Even though the Eye Center on the Duke University campus is in the backyard of many Triangle communities, patients can be intimidated when trying to navigate Duke’s campus, parking garages, and full waiting rooms. With that in mind, the Duke Eye Center has brought its expert retinal care to patients in Raleigh and Wake County by providing three satellite offices that make specialty eye care accessible and patient friendly five days a week. With the incidence of retinal diseases growing
Eric Postel, M.D., is the most senior Duke retina specialist in Duke Eye Center’s Wake County area offices. He sees patients at the Duke Eye Center of Raleigh.
almost as fast as the population of Wake County, making access to “best-in-class”
According to a study by the American
number of North Carolinians over age 55
retinal care easier and more convenient
Diabetes Association, the number of
grew 40 percent from 2000 to 2010. Bob
is crucial to providing the highest quality
Americans diagnosed with diabetes is
Garner, an AARP spokesman in North
care in diagnosing and treating diseases
expected to increase 165 percent, from
Carolina, says the state is a magnet for
such as age-related macular degeneration
11 million in 2000 to 29 million in 2050.
retirees moving in from other areas. With
(AMD) and diabetic retinopathy.
One of the complications of this disease
this surge in retirees and baby boomers,
is diabetic retinopathy, now the leading
the need for excellent care for age-related
Retinal Disease on the Rise
cause of new blindness in persons ages
eye diseases is increasing rapidly as well.
In the United States, AMD is the leading
25 to 74. Approximately 700,000 people
cause of severe central visual acuity loss
in the U.S. have proliferative diabetic
in persons over age 50. Approximately 15
retinopathy, with an annual incidence of
million people in the U.S. have AMD, and
65,000. A recent estimate of the prevalence
Duke Eye Satellite Offices Offer the Best in Private and Academic Retinal Care
more than 1.7 million Americans have
of diabetic retinopathy in the U.S. showed
“What is offered at the main office is also
the advanced form of the disease. The
an incidence of 28.5 percent among those
offered at our satellite offices: We provide
National Eye Institute estimates that the
with diabetes age 40 and older.
all the advantages of a large academic institution without the hustle and bustle
prevalence of advanced AMD will grow to nearly three million by 2020. Since
Wake County’s population grew faster than
of a congested environment,” says Tamer
the risk of AMD increases with age, the
any other county in the Triangle this past
Mahmoud, M.D., Ph.D., associate professor
need for retinal specialty care is growing.
decade, increasing by 43.5 percent. The
of ophthalmology, who practices at the
6
The Triangle Physician
“With our increased presence in Wake County (including seven retinal specialists, along with numerous other ophthalmologic specialists), we can manage the full spectrum of retinal diseases through our expertise, state-of-the-art testing and diagnostics, clinical trial access, and advanced surgical care,” says Prithvi Mruthyunjaya, M.D., director of ocular oncology and assistant professor of ophthalmology, who practices at the main Duke Eye Center and the Duke Eye Center of Cary. The Duke Eye Center at Page Road is conveniently located on the edge of Wake County at the new Duke Medical Plaza Paul Hahn, M.D., Ph.D., joined the Duke Eye Center after completing his fellowship in 2012. He is currently accepting new patients at the Duke Eye Center of Raleigh.
main Duke Eye Center on Erwin Road and
for low-vision patients. Large computer
the Duke Eye Center at Page Road. “At our
screens enable patients to see images of
satellite offices, it’s easier for patients to get
their eyes during their consultations. Pa-
appointments with the same doctors who
tients also can get their workups in one
practice at the main center. For example,
place—including imaging, ultrasound, la-
someone may need to wait a month or
ser treatment, injections, cryotherapy, and
more to see me at the main eye center, but
blood work—with a minimum of steps.
he or she can get an appointment with me within a week at the Page Road office.” The three satellite offices—designed to provide the most patient-centric care— are strategically located near and in Wake County for easy access, which helps to erase the logistical stress patients sometimes experience at the central Duke Eye Center. With ample, free parking,
in Research Triangle Park, which is in the heart of North Carolina’s Triangle region, anchored by the cities of Raleigh and Durham and the town of Chapel Hill. Just minutes from Raleigh-Durham International
Airport,
the
spacious,
multispecialty facility is designed with the vision-impaired patient in mind, with room to meet the growing demand for specialized eye care.
North Carolina Retina Club Creates Collaborative, Enriching Community When Tamer Mahmoud, M.D., founded the North Carolina Retina Club this year, he was eager to create an organization where retinal specialists from across the state could build relationships, enhance interactions and communications, and openly discuss issues. “At the Duke Eye Center, our retinal specialist community can share experiences and voice concerns and ideas. I wanted to extend this same collaboration with the entire North Carolina retinal specialist community,” says Dr. Mahmoud.
accommodating facilities (for low-vision patients and those using wheelchairs) and short wait times, Duke retinal specialists provide the best elements of a private practice—personalization, continuity of care, and a spacious, calm office—with the best elements of an academic institution —state-of-the-art
technology,
Duke’s
subspecialists on site, surgery, and access to clinical trials. Each satellite facility is furnished with the best equipment available and enhanced by examination rooms featuring accommodations for wheelchairs and special lighting
The society recently launched a two-way communication vehicle (a special email) to enable members to share experiences with new drugs, reimbursements, Medicare issues, insurance and other topics. “It’s a great cross-pollination between practitioners in academia and private practice,” Dr. Mahmoud adds. His experience as the program director for retina fellows at the Kresge Eye Institute in Michigan sets the standard for a thoroughly enriching affiliation. The society’s first meeting took place in early fall at the Duke Eye Center at Page Road. Retinal specialists from Duke, the University of North Carolina at Chapel Hill and Wake Forest University and dozens of private practitioners from across the state participated. The group plans to meet four or five times each year, rotating venues across North Carolina. The next meeting will be in January 2013, with the location to be determined.
novemBER 2012
7
treat condition. She had been told that nothing else could be done, but the Duke team came up with a more satisfactory approach. The patient said she would not have been able to receive Duke Eye Center care if it had not been for the easy-access satellite office because the main office was too intimidating.
Clinical Trial Access Available at the Satellite Offices The Page Road facility is a hub for clinical trials where drugs and devices are tested for safety and efficacy, although the other area satellite centers also are involved. There are more than 120 clinical trials bePrithvi Mruthyunjaya, M.D., provides retinal services at the Duke Eye Center of Cary, in Regency Park.
ing conducted at the Duke Eye Center in various therapeutic divisions, including
Patients here and at the other satellite
ally impaired people,” says Dr. Mahmoud,
offices stay with one technician for their
founder of the newly formed North Caro-
entire visit, ensuring a continuity of care. “I
lina Retina Club. (See sidebar.) “People
enjoy spending more time with each of my
are coming in from small communities in
patients and following them all they way
North Carolina, Virginia and South Caro-
through their process,” says Eric Kindall,
lina. At Page Road and the other satellite
ophthalmology technician at the Page
offices, we make scheduling and access
Road facility.
very easy and provide a one-stop-shop visit for our patients. From parking to checkout,
“Many referring physicians only think
the experience is smooth.”
of the Erwin Road facility when they refer patients to Duke. This can be very in-
Recently, a patient was referred to the
timidating and even scary for older, visu-
Page Road office with a difficult-to-
cornea, glaucoma, oculoplastics, retina, pediatric ophthalmology, and neuro-ophthalmology. Clinical trial participants can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. Many of these trials last three years and require monthly appointments, so a convenient location and ease of patientcentric care make participation more attractive. Patients are being recruited continuously for a number of retina-related clinical trials.
The North Carolina Retina Club, founded in 2012 by Tamer Mahmoud, M.D., will have several meetings throughout the state in 2013.
8
The Triangle Physician
Eleonora
(Nora)
Lad, M.D., Ph.D.,
assistant professor of ophthalmology, is at the Page Road office weekly. She specializes in the diagnosis and treatment of macular disease, especially AMD, diabetic retinopathy and retinal vascular disease. Her primary research interest is developing strategies for early diagnosis and treatment of AMD with a secondary interest in diagnosis of neurodegenerative disease, such as Alzheimer’s disease, by using retinal imaging. She was awarded the Clinical Scientist Development Award from the National Eye Institute for her proposal on dry AMD,
Eleonora (Nora) Lad, M.D., Ph.D., joined the Duke Eye Center in 2012 after finishing her fellowship. She is currently accepting new patients at the Duke Eye Center at Page Road.
and is the recipient of the prestigious Heed let’s get started. We’re here to help.”
Foundation award. “Macular degeneration
diseases as a medi-
is a devastating disease,” she says. “When it
cal retina special-
reaches certain stages, it is too late or is un-
ist.
treatable. My dream is to develop strategies
include the care of
M.D.,
for early diagnosis and treatment.”
patients with dia-
the patients at Page
betic
Road enjoy quick,
His
interests
retinopathy
Stefanie Schuman,
notes
streamlined
that
care:
Tamer Mahmoud,
and wet macular
M.D., Ph.D., is one
degeneration, particularly those who are
“We get a good
of five physicians
not responding to conventional therapies.
number of patients
nationwide serving
Dr. Mettu utilizes available retinal imaging
coming in from the coast, and they like
on an expert panel
technologies to customize treatment strat-
how easy this office is to drive to, to park
from the American
egies for individual patients and to coun-
at and to receive care.” Her research is in
Society of Retina
sel them on what to expect over the long
retinal imaging, where she uses spectral
Specialists’ Therapeutic Surveillance Com-
term. As a clinician-scientist, he is actively
domain optical coherence tomography
mittee—in collaboration with the U.S.
involved in laboratory and clinical research
(OCT) to view all the layers of the retina
Food and Drug Association, MedWatch,
to characterize novel mechanisms of mac-
in high resolution, as well as autofluores-
and the Centers for Disease Control and
ular diseases and to evaluate new therapies.
cence. “This can detect changes seen in
Prevention—to handle investigations relat-
“Our research is focused on understanding
macular degeneration and diabetes at the
ed to drugs and devices. When a new drug
more about what causes these diseases at a
earliest level as well as determine toxic-
or treatment comes to the market, physi-
molecular level,” Dr. Mettu says. “We hope
ity of medications within an individual’s
cians may notice an unforeseen outcome or
to use this knowledge to identify new tar-
eyes,” she says. “By using information from
symptom. This team of physicians collabo-
gets for treatment or to find new and better
this kind of imaging, the best and newest
rates to communicate and attend to these
ways of using existing treatments and tech-
treatments can be determined.” She is also
unexpected issues. The Focus is on diabetic
nologies for better care.”
working on a genetic sequencing clinical trial to track retinal degeneration.
retinopathy, complex retinal detachment, macular holes, epiretinal membrane and
His message to referring physicians is this:
small-gauge vitrectomy. He’s been chosen
“Please don’t hesitate to refer patients if
Duke Eye Center of Cary has served this
among best doctors in America since 2009,
you think we can be of help, particularly in
growing Wake County community for 10
and by the U.S. News & World Report.
challenging cases or if there is concern for
years and was the first multiophthalmol-
vision loss. Whether it’s monitoring closely
ogy specialty office treating vitreoretinal
Priyatham Mettu, M.D., focuses on
or starting treatment, we’re here to help
diseases. The office was renovated and
macular degeneration and retinal vascular
however we can. If we need to start treatment,
expanded last year to provide more per-
novemBER 2012
9
Priyatham (Prithu) Mettu, M.D., joined the Duke Eye Center in 2012 after finishing his retina fellowship. He is currently accepting new patients at the Duke Eye Center at Page Road.
sonalized and efficient care for the grow-
“When I refer my patients to the Eye Center
retinal diseases, including retinal detach-
ing number of retinal patients. The center
at Cary, I know they are going to see a top-
ment, epiretinal membranes, macular holes,
provides computer imaging, such as state-
caliber physician and receive a quality of
diabetic retinopathy, and AMD. He came to
of-the-art spectral-domain optical coher-
care only available at a teaching hospital,
North Carolina from upstate New York 15
ence tomography (SDOCT), angiograms,
with the comforts of a private-office
years ago. “The Triangle is so fertile for new
ultrasound, and eye injections.
setting,” says Robert Rosenstein, O.D.,
people and ideas,” he says. “It’s a great place
F.A.A.O., a third generation of Rosensteins
to live and practice. Wake County is full of
practicing optometry in Durham.
very well-educated people who stay updated
Like the other satellite eye centers, the Cary
on technology and are wonderfully engaged.
facility enjoys “down-the-hall” expertise by having a team of multispecialists
“Duke Eye Center physicians are excep-
They want to know what’s new, and they
available on site. “Our patients aren’t one-
tionally well-trained. In addition to their
want to be a part of cutting-edge treatments.
dimensional. When they are in our office
clinical work, they teach, conduct research,
I enjoy the conversations, and our patients
and need to see another specialist, they are
and work with residents and fellows. They
are great at following through on our recom-
just steps away,” says Dr. Mruthyunjaya.
are a different breed,” says Dr. Rosenstein.
mendations. This makes it fun because with
“It’s so rewarding to be able to provide
“The collaboration offered by the Duke Eye
this kind of patient engagement we really can
more people with superior retinal care.”
Centers is outstanding. We’re all working
provide best-in-class care.”
for the highest good of the patient.” Patients not only come to Duke for
Duke Eye Center of Raleigh at Duke
advanced retinal care and for end-stage
Prithvi Mruthyun-
Medicine Plaza, located in North Raleigh,
treatment, but they also come to Duke
jaya, M.D., who at-
has cared for and delivered world-class
for primary retinal care. With a point of
tends at the Cary
eye care from the most basic to the most
care close to people’s work and homes and
facility, sees patients
complex conditions for several years.
conducive to busy lives, Duke’s increase in
from many states
The newly refreshed facility provides
expertise in Wake County can meet this
who seek his exper-
broad-based care, serving a majority
growing need.
tise in ocular tumors.
of patients with macular degeneration
His clinical interests include care of advanced
and diabetic retinopathy and every type
10
The Triangle Physician
of macular surgical disease. Five days
operates at Duke Raleigh Hospital, which
work in the field to understand why cells
a week, Duke retinal specialists are in
he has equipped with absolutely state-of-
die in retinal degenerations, particularly
Raleigh to ensure that a growing number
the-art diagnostic and surgical equipment.
AMD.
of patients can receive the same best-in-
He is also currently conducting research
programs, Dr. Hahn’s primary interest is
the-country quality of care without the
developing methods to improve patient
in patient care. “If you suspect your patient
hassle of the congested home office. Since
care in a surgical, clinical and scientific set-
has a complicated eye issue, don’t wait
they encounter a wide range of diseases,
ting. He is part of a multidisciplinary team
to send him or her to us,” he says. “The
enabling them to know how these diseases
developing microscope-integrated OCT
longer you wait, the more complicated or
can present their symptoms, the retinal
imaging during surgical procedures. This
untreatable it can become. We have the
specialists can deal with the most complex
device is currently being used in a research
expertise, experience and equipment of
to the most ordinary issues.
capacity in the operating room to relay un-
a Duke service, with the ease of patient
precedented three-dimensional informa-
access in our Wake County satellite offices,
It is extremely helpful that this center is 50
tion during surgery, possibly resulting in
to diagnose and treat everything from
yards from Duke Raleigh Hospital, espe-
previously unidentified prognostic infor-
retinal detachment, flashes and floaters,
cially if urgent issues arise during a proce-
mation for postsurgical outcomes. To Dr.
retinal detachments, all diabetes-related
dure. This Duke Eye Center has the most
Hahn’s knowledge, Duke is the only facil-
issues, epiretinal membranes, and macular
senior retinal surgeons in Wake County.
ity in the country currently able to get this
degeneration.”
Despite
these
active-research
kind of imaging during surgery. Eric Postel, M.D., as-
Paul Hahn, M.D., Ph.D., joined as the
Dr. Hahn is also developing a novel
sociate professor of
first Wake County-
microfluidics platform toward point-of-
ophthalmology
based vitreoretinal
care testing of intraocular fluids, which
director of periopera-
surgeon for Duke
could be important in personalizing
tive services and CSU
in North Raleigh.
treatment of multifactorial diseases like
at the Duke Eye Cen-
He sees patients and
AMD. This research complements other
ter, provides a broad
and
Stefanie Schuman, M.D., specializes in macular degeneration and diseases of the retina. She is currently accepting new patients at the Duke Eye Center at Page Road.
novemBER 2012
11
Tamer Mahmoud, M.D., Ph.D., a Duke Eye Center fellow, returned to the Duke Eye Center in 2011 after practicing several years at the Kresge Eye Institute in Michigan. Dr. Mahmoud is currently accepting new patients at the Duke Eye Center at Page Road.
Satellite Eye Centers Support Duke’s Core Mission
and discoveries. For decades, Duke Eye
cal retinal care, including the surgical treatment of retinal detachment, proliferative
The Duke Eye Center is dedicated to
famous advanced microsurgery and OCT
vitreoretinopathy, diabetes, trauma, and
excellent patient care and has a strong
courses. The centers continue to provide
macular disorders including AMD. His
commitment to support research to find
educational opportunities and do outreach
research interests include the genetics of
a cure for blinding eye disease. It seeks to
locally, nationally and internationally.
AMD, diabetic retinopathy, ocular trauma,
preserve and restore the sight of present
patient safety and care delivery models. “I
and future generations by continuing to
have an open clinic—meaning people don’t
provide the highest and most complete
need to be referred, they can just call and
health care to patients, by developing
make an appointment to see me to evalu-
new knowledge and skills, and by passing
ate their retinal disease,” Dr. Postel says. “I
on this knowledge to other health care
am also happy to accept referrals for evalu-
providers and patients.
spectrum of state-of-the art medical surgi-
ation of retinal disease from all variety of physicians, including endocrinologists,
Each of the retinal specialists serving pa-
internists, cardiologists, ophthalmologists
tients at the Duke Eye Centers are involved
and more. As a group, we also get referrals
in national organizations and are teaching
of complex patients from other retina and
physicians. With a stronger presence in
glaucoma specialists across this region.”
and near Wake County, they are enhancing
The patients he sees in Raleigh appreciate
education among ophthalmologists, retinal
the modern, friendly and comfortable at-
specialists, and non-ophthalmologists in
mosphere, he notes.
the community so that everyone can benefit from the new technologies, techniques,
12
The Triangle Physician
Centers have conducted one of the most
Duke Eye Center of Cary 2000 Regency Parkway Suite 100 Cary, NC 27518 (919) 297-0900 Duke Eye Center of Raleigh Duke Medicine Plaza 3480 Wake Forest Road, Suite 300 Raleigh, NC 27609 (919) 681-3937 Duke Eye Center at Page Road 4709 Creekstone Drive Durham, NC 27703 (919) 660-5071
Practice Management
Mobile Technology Boosts Efficiency By Maryan Binkley
The health care industry has often been
The best dictation apps allow the provider
criticized for its slow transition into the
to fully document patient encounters using
digital world, but when it comes to mobile
a mobile device – viewing their schedule,
technology, doctors appear to be at the
recording dictations and both editing and
head of the pack. According to a recent
authenticating a transcribed note from
Manhattan Research survey, as many as 85
virtually any location. Software providers
percent of physicians own a smartphone,
with a strong integration capability can
while 62 percent use an iPad or other tablet.
upload the documentation directly into the hospital or clinic’s electronic health record,
Given the continual pressure to curb costs
delivering timely updates to the system.
and deliver care more efficiently, it’s only
Maryan Binkley is the owner and president of WebChart Inc. WebChart specializes in providing web-based, total medical data documentation solutions for physician practices, surgery centers and hospitals. Ms. Binkley graduated from nursing school in 1968 and began her career in a physician practice in the Washington, D.C., area. In 1974 she earned a bachelor’s degree in business administration. Ms. Binkley has worked in health care since 1968 in both clinical and administrative positions, providing her working knowledge of the challenges facing physicians and staff in today’s rapidly changing environment. For more information or to contact her: O: 336-463-4198 , C: 336-408-4209 or online at www.webchart.biz.
natural that doctors would embrace a tech-
Given the workload of a typical clinician
nology so adept at simplifying tasks. The
today, staying on top of these functions in-
health care app market has flourished, re-
between exams or even at home can make
sulting in some truly astounding innova-
a dramatic impact on productivity. Some
tions. Today, looking up a specialty drug,
practitioners are finding it’s faster to dictate
visually demonstrating a procedure – even
on a smartphone than calling in dictations
taking a basic echocardiogram – requires
using a traditional phone when they’re in
little more than reaching for one’s pocket.
the office.
Handheld devices can be just as effective
Of course, not all mobile documentation
when it comes to tackling the intrinsic
software is created equal. Look for solutions
Any time personal information is involved,
“back-office”
that are available on both Android and
security has to be a top priority. Make sure
physicians see themselves first and foremost
Apple
maximum
the app you are using stores patient data on a
as medical practitioners, they often spend
user flexibility, and offer a user-friendly
secure server, not on a device that can easily
almost as much of their day performing
experience. The ability to sort patient visits
be lost or stolen. Another key safety feature
ancillary tasks like documenting patient
by the status of their dictation is especially
is the option to deactivate password storage
information. Finding a good app to
useful.
on the phone or tablet, ensuring that only
functions.
While
most
iOS
platforms
for
streamline these duties can not only help
authorized personnel can log-in successfully.
alleviate a clinician’s workload, but also improve workplace morale.
Empowering health care providers to work smarter and
One area that particularly
more efficiently only enhances
benefits from mobile technol-
patient care and clinician sat-
ogy is dictation. The most in-
isfaction. Making better use of
tuitive method for physicians
technology will be a large part
to chronicle patient encoun-
of this movement. In the case
ters, it also promotes quality
of documentation apps, doctors
of care by allowing the doctor
are freed up to do the part of the
to focus on the patient rather
job that makes the most of both
than a computer screen during
their qualifications and their
a visit.
concern: patient care.
NovemBER 2012
13
Women’s Health
Endometriosis and Pelvic Pain:
Understanding Causes and Management By Andrea Lukes, M.D., M.H.Sc., F.A.C.O.G.
There are exciting developments in the
Once diagnosed, the management of endo-
treatment of endometriosis, a common
metriosis can be challenging. Surgical in-
gynecological problem.
terventions with the most effectiveness include ablation (laser) of the disease. At six
Endometriosis is defined as the presence
months after surgery, pain is significantly
of endometrium (lining of the uterus) that
improved in those receiving laser com-
occurs outside of the uterus. The most
pared to those within a control group, 62.5
common symptoms associated with endo-
percent versus 22.6 percent2. Other surgi-
metriosis are painful menses (dysmenor-
cal options, such as laparoscopic uterosac-
rhea), pain with sexual intercourse (dys-
ral nerve ablation (LUNA) and presacral
pareunia) and non-menstrual pelvic pain.
neurectomy, are technically challenging and not as commonly performed.
Approximately 70 percent of women with chronic pelvic pain have endometriosis1.
Most treatments of pain associated with
Diagnostic laparoscopy provides a defini-
endometriosis are medical. These treat-
tive diagnosis.
ments range from NSAIDs (nonsteroidal anti-inflammatory drugs), hormones (progestogens only or combined oral contraceptives), danazol (synthetic testosterone), GnRH (gonadotropin-releasing hormone) agonists, or more recently, the levonorgestrel intrauterine system. At Women’s
After earning her bachelor’s degree in religion from Duke University (1988), Dr. Andrea Lukes pursued a combined medical degree and master’s degree in statistics from Duke (1994). Then, she completed her ob/gyn residency at the University of North Carolina (1998). During her 10 years on faculty at Duke University, she cofounded and served as the director of gynecology for the Women’s Hemostasis and Thrombosis Clinic. She left her academic position (2007) to begin Carolina Women’s Research and Wellness Center, and to become founder and chair of the Ob/Gyn Alliance. She and partner Amy Stanfield, M.D., F.A.C.O.G., head Women’s Wellness Clinic, the private practice associated with Carolina Women’s Research and Wellness Clinic. Women’s Wellness Clinic welcomes referrals for management of heavy menstrual bleeding. Call (919) 251-9223 or visit www.cwrwc.com.
Wellness Clinic, we have experience with each of these medications and review all of
productive tract and ovarian and/or tubal
them in our management of endometriosis
masses. In addition, it is not always due to
and pain.
gynecological conditions. Pelvic pain can be due to gastrointestinal, urinary, neuro-
See if you may qualify for the Violet Petal Study — a medical research study for women with moderate to severe pain caused by endometriosis.
Our team is conducting an on-going study
logic, psychological, as well as psychiatric,
called “A Clinical Study to Evaluate the
disorders. We encourage a thorough work-
Safety and Efficacy of Elagolix in Subjects
up of all etiologies relating to pelvic pain.
with Moderate to Severe Endometriosis-
It is also important to understand that en-
Associated Pain.” We welcome calls about
dometriosis is a chronic disease that often
this study to our office at (919) 251-9223 or
requires a lifelong management plan.
by e-mail to janet@cwrwc.com or atiya@ cwrwc.com. Lastly, pelvic pain can be caused by a number of conditions, not only endometriosis: pelvic adhesions, pelvic inflammatory disease, congenital anomalies of the re-
14
The Triangle Physician
1) Spaczynski RZ, Duleba AJ. Diagnosis of endometriosis. Semin Reprod Med 2003; 21:193-208. 2) Sutton CJ, Ewen SP, Whitelaw N, Haines P. Prospective randomized double-blind controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal, mild, and moderate endometriosis. Fertil Steril 1994; 62:696-700.
Cancer Centers of North Carolina Physicians Bring 114 Years of Oncology Experience to Treatment of Patients in the Dunn Community Battling cancer is difficult enough; getting quality treatment shouldn’t be. Through evidence-based medicine and innovative research, patients in Harnett County now have access to advanced treatment options closer to where they live. With five leading physicians treating patients in a state of the art treatment center right in Dunn, Cancer Centers of North Carolina offers advanced, comprehensive and compassionate cancer care in a setting close to patients’ homes. Drs. Elizabeth Campbell, Neeraj Agrawal, Stephen Tremont, Mark Yoffe, and Roy Cromartie have more than 114 years of experience in medical oncology. Together with their team of caring oncology nurses, Cancer Centers of North Carolina physicians support the needs of Harnett County cancer patients and their families throughout the spectrum of illness, recovery and survivorship. From the moment you step into their newly remodeled office, you can feel the warmth of the practice’s patient-focused culture. In addition to a modern and comfortable treatment setting, the recent office remodel also brings a convenient new in-house lab and state of the art cancer diagnostic and treatment technology. “We’re determined to
provide
patients
throughout
the
community with access to the most
Shown L to R: Mark Yoffe, MD, Stephen J. Tremont, MD, Elizabeth E. Campbell, MD, Roy Cromartie, MD, and Neeraj Agrawal, MD
advanced cancer care available and we’re
Research, which has helped to develop 43
proud to serve the needs of families in
FDA approved cancer therapies.
Harnett County,” said Dr. Neeraj Agrawal. “We were the first practice to offer Cancer Centers of North Carolina is also
community-based outpatient cancer care
united in healing with The US Oncology
in the Triangle area more than 33 years
Network, one of the nation’s largest
ago,” said Dr. Mark Yofee. “We have deep
community-based cancer treatment and
roots in this community and are committed
research networks focused on advancing
to providing patients in our area with
cancer care in America. As an affiliate
the most advanced, compassionate and
of The US Oncology Network, Cancer
affordable care as they battle cancer.”
Centers of North Carolina is united with approximately 1,000 physicians and 10,000
For more information about Cancer
cancer professionals nationwide. Cancer
Centers of North Carolina and its Dunn
Centers of North Carolina participates
office visit www.cancercentersofnc.com or
in clinical trials through US Oncology
call 910.892.0070.
Raleigh (919) 781-7070 • North raleigh (919) 431-9201 • Cary (919) 854-6900 Cary (radiatioN) (919) 854- 4588 • ClaytoN (919) 781-7070 • duNN (910) 892-0070
novemBER 2012
15
Women’s Health
Newest Robotic Treatment for Endometriosis Is Available in Smithfield By Siamak Marzbani, M.D.
Millions of women in their childbearing years suffer from chronic pelvic pain associated with endometriosis, a condition in which endometrial tissue forms outside of the uterus. It is estimated that endometriosis occurs in 10 percent of women during the reproductive years. Endometriosis is the number one cause of infertility in the United States. Clinical data continues to demonstrate recurrence rates of 40-80 percent within two years. That is a problem! These women are actively seeking care; however, many providers are challenged in managing these
Dr. Siamak Marzbani of Johnston OBGYN in Smithfield offers the newest treatment advancement for endometriosis resection using the da Vinci Surgical System.
patients. Needless to say, this disease re-
while viewing a high-definition, three-di-
mains a serious health care problem.
mensional image inside the patient’s body. The surgeon’s fingers grasp the master
Biopsy is the only way to confirm a diag-
controls below the display with hands and
nosis of endometriosis. The da Vinci Surgi-
wrists naturally positioned relative to his
cal System makes obtaining such biopsies
or her eyes. The system seamlessly trans-
much easier when working around sensi-
lates the surgeon’s hand, wrist and finger
tive structures, such as the bowel or ure-
movements into precise, real-time move-
ters. Additionally, the three-dimensional
ments of surgical instruments.
vision, dexterity and control provided by the da Vinci robot offer the potential for
While the robot has been used for other
complete resection of lesions, regardless of
gynecologic surgeries, such as hysterecto-
location in the pelvic cavity.
my, fibroids and prolapse, its application to treat endometriosis is fairly new. Through
Using the da Vinci system, the surgeon
robotic surgery, patients can benefit from
operates seated comfortably at a console,
a less painful procedure, shorter hospital
stay, faster recovery time and often a better clinical outcome. This procedure requires only a few small incisions, so patients can get back to life faster, without the usual recovery following major open surgery.
The Robotic Surgery Team at Johnston Medical Center in Smithfield.
16
The Triangle Physician
Dr. Siamak Marzbani is the founder of Johnston OB/GYN Associates and has been providing health care for women in Johnston County for more than 25 years. He has extensive experience in delivering low- and high-risk obstetrics, gynecology, urogynecology and minimally invasive surgery with the da Vinci Surgical System. Johnston OB/GYN Associates is located at 520 North St., Smithfield 27577. Dr. Marzbani can be reached by phone at (919) 934-3015, by fax at (919) 934-0958 and online at www.jobgyn.com.
Duke News
American College of Surgeons Awards Top Bariatric Surgery Accreditation Duke Raleigh Hospital’s bariatric surgery
bariatric surgeons serving two clinic sites
The ACS accreditation is designed to assist
center has earned accreditation as a Level
and two hospitals, according to Jin Yoo,
the public in identifying those facilities that
1 facility by the Bariatric Surgery Center
M.D.,
provide optimal surgical care for patients
Network Accreditation Program of the
director of Duke Metabolic and Weight
American College of Surgeons, the highest
Loss Surgery of Raleigh. “Our program
accreditation possible.
is the second-largest academic bariatric
Established by the American College of
F.A.C.S.,
F.A.S.M.B.S.,
medical
who undergo this surgical procedure.
program in the U.S., which means that
Surgeons in 2005 to extend established
“To earn this designation, Duke Raleigh
patients are not only getting the best
quality improvement practices to all disci-
Hospital underwent a rigorous process
quality of care from (our) staff members
plines of surgical care, the BSCN accredita-
during which all aspects of the program’s
and physicians, but also all the latest
tion program provides confirmation that a
surgical processes were closely examined
advances, technology and research that can
bariatric surgery center has a demonstrat-
and data on health outcomes was collected,”
only be obtained from an academic center,”
ed commitment to the highest quality care
said Alfonso Torquati, M.D., M.Sci.,
Dr. Yoo said.
for its patients. To achieve the designation, each hospital undergoes onsite veri-
medical director of the Duke Center for Metabolic and Weight Loss Surgery. “This
In the United States, more than 11
fication by experienced bariatric surgeons,
outstanding achievement demonstrates
million people suffer from severe obesity,
who review the center’s structure, process
a commitment by both surgeons and
and the numbers continue to increase.
and quality of data using the ACS Bariat-
hospital to build and maintain the best
Obesity increases the risks of morbidity
ric Surgery Center Network Accreditation
bariatric surgery program in Wake and
and mortality because of diseases and
Program Manual as a guideline.
surrounding counties.”
conditions commonly associated with it, such as type II diabetes, hypertension
For more information, visit
The Duke Metabolic and Weight Loss
and
www.dukeraleighhospital.org
Surgery program is the largest bariatric
loss surgery currently provides the only
program in North Carolina, with six
effective, lasting relief from severe obesity.
cardiovascular
disease.
Weight-
or call (919) 954-3293.
Anti-Cancer Drug Fights Immune Reaction in Some with Pompe Disease damage caused by the absence of the enzyme.
In a January 2012 publication in Genetics
uted to dramatic improvement in three in-
In the new study, appearing online in the
cess in preventing the immune rejection in
fants with the most severe form of Pompe
Oct. 11 edition of the journal Genetics in
Pompe infants who were just beginning ERT.
disease – a rare, often-fatal genetic disorder
Medicine, the Duke team added a new step
They treated them with a drug cocktail that
characterized by low or no production of an
to the therapeutic regimen to address com-
included low doses of the cancer chemo-
enzyme crucial to survival.
plications suffered by a subset of infants with
therapy drugs rituximab and methotrexate,
Pompe disease who are treated with ERT.
plus the immune booster gammaglobulin to
Adding a third anti-cancer agent to a current drug cocktail appears to have contrib-
in Medicine, the researchers reported suc-
Duke researchers previously pioneered the
prevent the immune response to the ERT.
development of the first effective treatment
Some infants with Pompe disease who have
for Pompe disease via enzyme replacement
certain combinations of genetic mutations
The three cases described in the new paper
therapy (ERT). ERT relies on a manufactured
develop a severe immune response to ERT.
had already received the ERT for a pro-
enzyme/protein to act as a substitute for the
Very high levels of antibodies become di-
longed period of time and, despite initial
enzyme known to be lacking in patients with
rected against the enzyme and greatly re-
improvements, declined rapidly as their
a particular disease. In Pompe disease, ERT
duce its therapeutic effect, leading to rapid
bodies developed high levels of antibodies
has been found to reduce heart and muscle
clinical decline and death.
that blocked the effect of the enzyme re
novemBER 2012
17
Duke News placement. In these youngsters, plasma cells, which are the ultimate
University of Utah; Renuka Gera and Robert L. Conway of Michigan
source of antibody production, were left untouched by the immune-
State University; Joyce A. Kobori of Kaiser Permanente, San Jose, Ca-
suppressing drug cocktails.
lif.; and Amy S. Rosenberg of the U.S. Food and Drug Administration, Bethesda, Md.
“These plasma cells form rapidly after exposure to ERT, and some of them are what we call long-lived plasma cells that survive for years,
Dr. Kishnani reports receiving research support, honoraria and
continuing to spew out antibodies,” explained senior author Priya
consulting fees from Genzyme, which markets an ERT for Pompe
Kishnani, M.D., professor of pediatrics and medical genetics at Duke.
disease. Duke University and the inventors of the method of treatment and precursors of the cell lines used to generate the enzyme
After testing their ideas in mouse models of Pompe disease, the Duke
(rhGAA) used commercially have received royalties pursuant to the
researchers added a proteasome inhibitor called bortezomib to the
university’s policy on inventions, patents, and technology transfer.
regimen. Bortezomib, which is approved by the United States Food
This potential conflict has been resolved through monetization. Full
and Drug Administration to treat multiple myeloma and mantle cell
dislosures of conflicts are listed in the manuscript.
lymphoma, targets the plasma cells and inhibits the production of antibodies, reversing the established immune response. In all three cases the antibodies decreased rapidly. Just as rapidly, each of the babies’ conditions dramatically improved and the babies have continued to do well. “I’m absolutely delighted, because to me this has become life saving for these fragile babies,” Dr. Kishnani said. “This is what I truly think is translational research, where you learn about a problem in patients, address it in an animal model and take it back into the patients to make a difference.” “We were encouraged with the positive results from preclinical studies using bortezomib. We quickly developed a clinical protocol using
A simplified, conceptual diagram of a humoral immune response to a therapeutic protein and targets of various immunomodulatory agents.
bortezomib for infantile Pompe patients that had failed conventional treatment. It was truly a satisfying experience,” said first author Suhrad Banugaria, M.B.B.S., postdoctoral associate in pediatrics medical genetics at Duke. Next, the group is working to develop treatments that more specifically target antigens eliciting immune responses to ERT. Dr. Kishnani and colleagues hope that such a targeted approach might minimize the impact on the immune system generally. Dr. Kishnani said the insights her team has gained treating Pompe
YOU DON’T HAVE TO STOP DICTATING TO USE YOUR EMR.
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disease could be applied to other diseases in which an immune response has also been shown to reduce the impact of enzyme replacement therapy. “We’re already getting calls for other conditions such as mucopolysaccharidosis and Fabry disease, where physicians are facing the same issues: patients who have developed a significant antibody response and are not doing as well or have started to show a clinical decline,” Dr. Kishnani said. In addition to Dr. Kishnani and Ms. Banugaria, authors include Sean N. Prater of the Duke Department of Pediatrics; Judeth K. McGann, Jonathan D. Feldman and Jesse A. Tannenbaum of Kaiser Permanente, Santa Clara, Calif.; Carrie Bailey and David Viskochil of the
18
The Triangle Physician
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UNC News
Two Elected to Institute of Medicine Two University of North Carolina School
nationally, especially in Malawi and China,
group. He currently serves as vice chair of
of Medicine professors have been elected to
and in 2007 he was named founding direc-
an Institute of Medicine committee con-
the Institute of Medicine, considered one of
tor of the new Institute for Global Health &
ducting an evaluation of the California
the nation’s highest honors for those in the
Infectious Diseases. In 2005 he received the
Stem Cell Initiative. He was elected to the
fields of health and medicine.
Thomas Parran Award for lifetime achieve-
American Academy of Sciences in 2007 and
ment in sexually transmitted diseases from
the American Association for the Advance-
Myron S. Cohen, M.D., J. Herbert Bate
the American Sexually Transmitted Diseases
ment of Science in 2009. Dr. Magnuson was
distinguished professor of medicine, micro-
Association. Dr. Cohen was the 2008 recipi-
appointed as the School of Medicine’s vice
biology and immunology and epidemiol-
ent of the O. Max Gardner Award, the high-
dean for research in July 2010.
ogy and associate vice chancellor for global
est honor in the UNC 16-campus system.
health; and Terry R. Magnuson, Ph.D.,
The work in the Magnuson lab focuses on
Sarah Graham Kenan professor, chair of
Dr. Magnuson was recruited to UNC in 2000
the role of mammalian genes in unique epi-
the department of genetics and vice dean
as founding chair of the department of ge-
genetic phenomena, such as genomic im-
for research in the School of Medicine, are
netics and director of the newly established
printing and X-chromosome inactivation.
among the 70 new members announced by
Carolina Center for Genome Sciences. He
The lab also studies the tumor suppressor
the institute Oct. 15.
also created the Cancer Genetics Program
role of the BAF/PBAF chromatin remodel-
in the UNC Lineberger Comprehensive
ing complexes and has developed a novel
Dr. Cohen arrived at UNC in 1980, and
Cancer Center. A founding member of the
genome-wide mutagenesis strategy. The
in 1981 UNC Hospitals admitted its first
International Mammalian Genome Society,
Magnuson lab has published more than 150
AIDS patient, a man with hemophilia. For
Dr. Magnuson also served on the external
papers in these research areas
the next 30 years, Dr. Cohen’s research has
advisory committee for the Mouse Genome
focused on the transmission and prevention
Database at the Jackson Laboratory and was
The Institute of Medicine, part of the Nation-
of transmission of HIV, the virus that causes
chair of the Jackson Laboratory Board of
al Academies, has 1,928 members, including
AIDS. With a team of investigators at UNC,
Scientific Overseers.
21 from UNC with the addition of Drs. Cohen and Magnuson. Current members elect
he helped to develop laboratory methods to measure HIV in genital secretions, as well as
He served on the board of directors of the
new members from among candidates nom-
methods to detect the best antiviral agents
Society for Developmental Biology and also
inated for their accomplishments and con-
to reduce replication of the HIV virus.
for the Genetics Society of America and is
tributions to the advancement of the medi-
currently a senior editor of the journal Ge-
cal sciences, health care and public health.
Dr. Cohen is the architect and principal
netics. He was appointed by the National
Members commit to volunteer on institute
investigator of the multinational HIV Pre-
Academy of Sciences and the Institute of
committees, which carry out a broad range
vention Trials Network (HPTN) 052 trial,
Medicine to help establish guidelines for
of studies on health policy issues.
which demonstrated that antiretroviral
work with human embryonic stem cells and
treatment prevents the sexual transmis-
is a member of the NIH stem cell working
For more information go to www.iom.edu.
sion of HIV. This work was recognized by Science Magazine as the “Breakthrough of the Year” in 2011. Dr. Cohen serves on the National Institutes of Health (NIH) Office of AIDS Research Advisory Board, the NIH AIDS Research Advisory Council, and the Presidential Emergency Plan for AIDS Relief (PEFAR) Scientific Advisory Board. Dr. Cohen is the co-principal investigator of the NIH HIV Prevention Trials Network. At UNC, he has served as chief of the division of infectious diseases since 1990. Much of his research has been conducted inter-
The Triangle Physician 2013 Editorial Calendar January Glaucoma Wound Management Accounting
May Arthritis Women’s Health Medical Billing
September Atrial Fibrillation Urology Web Design
February Asthma and Allergies Heart Disease Consulting for your Practice
June Men’s Health Vascular Diseases Medical Collections
October Cancer in Women COPD - Lung Health Medical Software - EMR
March Nutrition Sleep Disorders Legal
July Imaging Technologies Psoriasis Medical Insurance
November Alzheimer’s Disease Diabetes Financial Planning
April Autism Irritable Bowel Syndrome IT Services
August Orthopedics Gastroenterology Medical Real Estate
December Pain Management Spine Disorders Practice Management
novemBER 2012
19
News
WakeMed Wins Top Honors for Commitment to Employee Learning WakeMed Health & Hospitals was ranked
training programs include an integrated
In 2007, WakeMed was number 31 out of
fifth among 30 organizations across the
nursing education program to help student
40 winners and in 2008 jumped 21 spots
globe in the American Society for Train-
nurses move through the system with the
to number 10. More information about the
ing & Development’s (ASTD) 2012 BEST
proper support, guidance and education,
2012 ASTD BEST Award winners may be
Awards program, an exclusive global rec-
and a tiered program for leadership devel-
found in the October 2012 issue of T+D
ognition in the training industry.
opment to ensure there is a full pipeline of
magazine.
prepared leaders within WakeMed. WakeMed’s education team, which in-
man resources. “We are very proud to be
Hospital Is Recertified Stroke Center
Organizations from Bahrain, Canada, India
recognized and ranked among the top five
WakeMed Cary Hospital has been recerti-
and the United States won the prestigious
in the world by a national organization for
fied as a primary stroke center by the Joint
ASTD BEST Award, which recognizes those
our efforts. We continue to focus on offer-
Commission.
that demonstrate enterprise-wide success
ing best-practices programming to educate
through employee learning and develop-
employees, develop leaders and ultimately
As a certified stroke center, WakeMed has
ment. Winners range from health care sys-
impact WakeMed’s retention rates, which
proven that it provides quality care to stroke
tems to financial services companies to hos-
are some of the highest in the region.”
patients and follows national standards and
cludes staff development and training, the
“Education and employee development
Center for Innovative Learning and nurs-
are priorities at WakeMed, and we are in-
ing education, competed against 84 orga-
vested in this growth at all levels,” said Jea-
nizations in 13 countries.
nene Martin, senior vice president of hu-
pitality organizations.
guidelines that can significantly improve Members from all three of WakeMed’s
outcomes for stroke patients.
WakeMed was specifically recognized for
education departments were honored with
its recruitment efforts, overall staff satisfac-
the ASTD BEST Award during a ceremony
The WakeMed stroke team is made up of
tion, breadth and depth of its training pro-
held in Washington, D.C. in early October.
specially trained physicians, nurses and
grams and support of employee learning
This award marks the third time in just five
therapists who are dedicated to the care of
programs at the C-level. Examples of these
years WakeMed has received this honor.
stroke patients.
Cary Endocrine & Diabetes Center, P.A.
CEDC provides diagnosis and treatment for patients with hormonal and metabolic disorders including: diabetes, lipid disorders, PCOS, thyroid disorders, osteoporosis and other bone disorders, pituitary disorders, adrenal disorders, and sex hormone disorders.
Celebrating our first year in Cary!
Sung-Eun Yoo, MD
Endocrinologist Diplomat, American Board of Endocrinology, Diabetes and Metabolism Diplomat, American Board of Internal Medicine Endocrine Certification in Neck Ultrasound (ECNU) Certification in the International Society for Clinical Densitometry (ISCD)
On-Site Services: • Thyroid, parathyroid and neck ultrasound • Ultrasound guided FNA • DEXA bone density scans and interpretation • Osteoporosis therapy • Comprehensive diabetes management including diabetes education, insulin pump therapy, and continuous glucose monitoring • LabCorp in-house Introducing Jeanne Hutson, NP-C Board Certified in Advanced Diabetes Management
Cary Endocrine & Diabetes Center, P.A. • 103 Parkway Office Court, Suite 202 • Cary, NC 27518 • 919-378-2332 • www.caryendocrine.com
20
The Triangle Physician
UNC News
Single Fathers Due to Cancer Program Offers Support Group, Online Resource The University of North Carolina at Chapel Hill Comprehensive
needs of fathers and their children and develop interventions to
Cancer Support Program has launched a new website for Single
lessen the burden on future generations of fathers and their chil-
Fathers Due to Cancer – www.singlefathersduetocancer.org – as a
dren, according to Dr. Yopp.
way to help fathers more easily find resources and support. The Single Fathers Due to Cancer Program includes a monthly supCCSP is a program of UNC Lineberger Comprehensive Cancer
port group for fathers and their children.
Center led by Donald L. Rosenstein, M.D., professor of psychiatry. Dr. Rosenstein joins Justin Yopp, Ph.D. and Eliza M. Park, M.D., on
For more information, visit www.singlefathersduetocancer.org or
the Single Fathers Due to Cancer team.
send an e-mail to singlefathersduetcancer@unc.edu. The
website
in-
cludes common experiences of single fatherhood,
re-
sources to support children and helpful organizations resource
and
informa-
tion. Team members of the Single Fathers Due to Cancer initiative are on the faculty of the Department of Psychiatry at the University of North Carolina at Chapel Hill and provide clinical services to patients diagnosed with cancer and their families. They are (from left) Justin Yopp, Ph.D.; Eliza M. Park, M.D.; and Donald L. Rosenstein, M.D.
“Each year, thousands
of
men
mourn the loss of their wives to cancer while adjusting
to their new role as single parents. Remarkably, there are very few resources available for these men,” said Justin Yopp, Ph.D., Single Fathers Due to Cancer coordinator. “We launched the website to help with a common but virtually ignored challenge for families affected by cancer.” The website also invites fathers to complete a research survey. Results of the UNC Institutional Review Board-approved study will help program faculty better understand the coping and adjustment
novemBER 2012
21
Durham Regional News
Hospitals Earn Platinum Performance Award for Heart Care Standards Several hospitals within the Triangle
FirstHealth Moore Regional Hospital,
reached the goal of treating these patients
region are among the 164 nationwide
Pinehurst;
Raleigh;
to standard levels of care as outlined by
to be awarded the American College of
University of North Carolina Hospitals,
the American College of Cardiology/
Cardiology Foundation’s NCDR ACTION
Chapel Hill; WakeMed Cary Hospital,
American Heart Association.
Registry – Get With The Guidelines
Cary; and WakeMed Raleigh Campus,
Platinum
Raleigh.
Performance
Achievement
Rex
Hospital,
To receive this award, a hospital must consistently
Award for 2012.
follow
the
treatment
winners’
guidelines in the ACTION Registry–
They are: Duke Raleigh Hospital, Raleigh;
commitment and success in implementing
GWTG Premier for eight consecutive
Duke
Durham;
a higher standard of care for heart attack
quarters and meet a performance standard
Durham Regional Hospital, Durham;
patients, and signifies the hospital has
of 90 percent for specific performance
The University
Hospital,
award
recognizes
the
measures. Implementation of the treatment guidelines is a critical step in saving the lives and improving outcomes of heart attack patients. “The fact that we are nationally recognized every year, but continue to work on ways we can improve, shows how committed we are to delivering the absolute best possible outcomes for our patients,” said Michael Komada, M.D., a board-certified interventional cardiologist at Durham Regional Hospital. ACTION Registry–GWTG is a partnership between the American College of Cardiology Foundation and the American Heart Association with support from the American College of Emergency Physicians, Society of Chest Pain Centers and the Society of Hospital Medicine. ACTION
Registry-GWTG
empowers
health care provider teams to consistently treat heart attack patients according to the most current, science-based guidelines. It also establishes a national standard for understanding and improving the quality, safety and outcomes of care provided for patients with coronary artery disease, specifically high-risk STEMI (ST elevation myocardial infarction) and NSTEMI (Non-ST elevation myocardial infarction) patients. Womens Wellness half vertical.indd 1
22
The Triangle Physician
12/21/2009 4:29:23 PM
News
Rex Ear, Nose and Throat Specialists in Cary Is Led by Dr. Garside
Partnering with patients and providers for a healthier community.
Rex Ear, Nose and Throat Specialists opened Oct. 3, with John Garside, M.D., who began practicing in Cary 10 years
Meet Alison...
ago and has a long partnership with Rex
Lost: 100 lbs Found: A New Beginning
Surgery Center of Cary. The new practice will provide a wide range of advanced medical and surgical
Joseph C. Moran, MD, FASMBS 2801 Blue Ridge Road, Suite 101 Raleigh, NC 27607
services for diseases and disorders that affect the ears, nose, sinuses, throat, voice
P: 919.781.0815 F: 919.781.0816
box, face and neck. The comprehensive audiology services include hearing aids, as well as speech, voice and swallowing therapy.
www.alasurgery.com NEWSOURCE-JUN10:Heidi
8/5/10
12:57 PM
Page 1
“Dr. Garside’s practice is an excellent addition to our team because of his strong track record of providing compassionate
Do They Like What They See?
and quality care for Cary patients,” said Steve Burriss, Rex Healthcare’s chief operating officer.
Make sure you connect with your key audiences using strategic, cost-effective advertising, marketing and public relations.
For patient convenience, Dr. Garside also will be able to provide more inoffice procedures, including sinus treatments. As part of UNC Health Care, the
Our services range from consultation, to design, to creation and implementation of strategic plans.
practice will give patients more access to research on new therapies and clinical trials at one of the world’s top academic medical centers. Rex Ear, Nose and Throat Specialists is located at 790 S.E. Cary Parkway, Suite 110 in Cary, 27511. It is open Monday to
newsource & Associates
Friday, 8 a.m. to 5 p.m. To schedule an appointment, call (919) 784-7400 or visit rexhealth.com/ent-specialists for more information.
Call (540) 650-3686 or send inquiries to hketler@verizon.net.
Our network of smart, creative, award-winning specialists serves the health care industry throughout the Mid-Atlantic.
Maybe it’s happiness in a child’s eyes. Whatever the desired outcomes, count on us to ensure your key messages have the 20/20 clarity to deliver.
novemBER 2012
23
News Welcome to the Area
Physicians Terrence Carter Bethea, MD Child Psychiatry; Nutrition; Psychiatry
ASPIRE Research Program Chapel Hill
Megan Shive Cifuni, MD Emergency Medicine
Upcoming Events
Physician Assistants
Tara Beth Hanaway-Quinlan, PA
Cardiology; Family Practice; Hospitalist; Internal Medicine; Urgent Care; Diabetes; General Preventive Medicine; Orthopedic Sports Medicine
Blue Ridge Family Physicians Raleigh
Community Family Medicine Sanford
Stephanie Jeanine Foley, MD
Lindsey Lee Brun, PA
Blue Ridge Family Physicians Raleigh
Katarzyna Joanna Jamieson, MD Hematology and Oncology, Internal Medicine
UNC Div of Hematology & Oncology Chapel Hill
Ryan Andrew Macke, MD Surgery; Thoracic Surgery
Duke University Medical Center Durham
Frank Richard Mihlon IV, MD Radiology; Radiology, Neuradiology
Duke University Hospitals Durham
Oluwole Ademola Odunusi, MD Internal Medicine
Duke University Hospitals Durham
Jack Kevin Sharp, MD
Morrisville
Leah Marie Beynon, PA
University of North Carolina Hospitals Chapel Hill Family Medicine
John Arthur Gantt, PA
Emergency Medicine; Family Medicine; Internal Medicine; Radiology
Family Medicine; Family Practice
Elena Hierseman, PA Family Medicine
Benson
Ryan Lloyd Hoover, PA Urgent Care
Duke University Hospital Durham
A Plus Urgent Care Youngsville
Gordon Lee Castleberry, PA
Jan Rae Lowery, PA
Emergency Medicine; Family Medicine; Orthopedic Sports Medicine
Whispering Pines
Weight Loss Surgery Support Group
Duke University Medical Center Durham
Wilson Community Health Center Wilson
Jordan Nicole Christiansen, PA
Jennifer Louise Steele, PA
Stroke Support Group
30108 Folklore Way, Cary
Tyler William Chavez, PA Abdominal Surgery; Cardiovascular Surgery; Colon and Rectal Surgery; Facial Plastic Surgery; General Surgery; Neurological Surgery; Pediatric Surgery; Thoracic Cardiovascular Surgery; Critical Care Surgery; Orthopedic Surgery; Vascular Surgery
Family Medicine; Gynecology; Pediatrics
Gibbons Family Medicine Cary
Chapel Hill
Ashley Gray Messina, PA Family Medicine; Urgent Care
Wake Forest
Natalia Salom Sorensen, PA Family Practice
Orthopedic Sports Medicine; Orthopedic Surgery
Cary Orthopaedic & Sports Medicine Specialists, PA Cary
Kathryn Patricia Fernandez, PA
Duke University Department of Pediatrics Durham
Emergency Medicine
Hospital Physician Partners Smithfield
Dianna Lynn Tercan, PA
Rebecca Devonne Silver, MD
Erin Marie Gallagher, PA
Alena Angel Thomas, PA
Family Practice; Internal Medicine; Cardiac Electrophysiology; Cardiology; Cardiovascular Disease
WakeMed Health & Hospitals Raleigh
University of North Carolina Hospitals Chapel Hill
Dec. 3, 5:30-7:30 p.m. Look Good Feel Better is a free American Cancer Society program that teaches women beauty techniques while they undergo chemotherapy and radiation treatments. Participants receive a free cosmetics kit and instruction by beauty professionals. Location: North Conference Room, Durham Regional Hospital Registration: Call (919) 470-7168
Dec. 4, 6-7:30 p.m. Durham Regional Hospital hosts a weight loss surgery support group to facilitate discussion on topics related to adjustment before and after weight loss surgery. December’s topic will be “Ask Veteran Patients your Questions.” Location: Duke Center for Metabolic and Weight Loss Surgery Durham Clinic, 407 Crutchfield St.
Ben-Jiang Ma, PA
Pediatric Pulmonology
Psychiatry
Look Good Feel Better
Durham
Critical Care Surgery; Surgery
305 Swans Mill Crossing, Raleigh
However much you value wildlife conservation in North Carolina,
Dec. 10, 1-2:30 p.m. The mission of this support group is to help educate the stroke survivor, caregiver and community about stroke prevention and stroke disabilities. This group meets the second Monday of each month. Location: Private Dining Room C, Durham Regional Hospital. Register for these events online at www. durhamregional.org/events or by calling (919) 403-4374, unless otherwise noted.
DEC NC
11
1234
quadruple it.
That’s right! Your conservation effort is increased by a 3-to-1 matching gift. So, when you are one of the first to display the new North Carolina Wildlife Habitat Foundation NCDMV license tag, your $10 tag contribution to the organization becomes $40 in lands preserved. The all-volunteer North Carolina Wildlife fe Habitat Foundation assists in acquisition, on, management, and protection of land in North Carolina for the conservation of habitats needed to preserve wildlife
24
The Triangle Physician
right here in the Old North State. Conservation education efforts are preparing future generations to sustain your concern for the lands we protect today. At www.ncwhf.org, download the license tag application and see the good works in process. pp Your new tag shows your support and your n contribution is put to work…times four. co
www.ncwhf.org w
“More than a doctor. Like a friend.”
We know it by heart.
Trust. WHV is an independent group of heart specialists with locations throughout Eastern North Carolina - ready to provide the care for your patient’s heart when and where they need it. We’ve been pioneering and delivering innovative cardiovascular care for over 25 years. Through our affiliation with UNC Health Care, our physicians can also tap into the latest research and expertise associated with a world-class academic institution. And this in turn allows all our patients to have more access to clinical trials and new therapies, resulting in the best cardiovascular care available in the area.
Cardiovascular Professionals in Johnston, Wayne and Wilson Counties Mateen Akhtar, MD, FACC Benjamin G. Atkeson, MD, FACC Kevin R. Campbell, MD, FACC Randy A.S. Cooper, MD, FACC Christian Gring, MD, FACC
Matthew A. Hook, MD, FACC Eric M. Janis, MD, FACC Diane E. Morris, ACNP Ravish Sachar, MD, FACC Nyla Thompson, PA-C
Waheed Akhtar, MD, FACC Malay Agrawal, MD, FACC Sunil Chand, MD, FACC Paul Perez-Navarro, MD, FACC Joel Schneider, MD, FACC
Cardiovascular Services Echocardiography Nuclear Cardiology Interventional Cardiology Carotid Artery Interventions Cardiac Catheterization Cardiac CT Angiography and Calcium Scoring Electrophysiology and Cardiac Arrhythmias Peripheral Vascular Interventions Pacemakers / Defibrillators Stress Tests Holter Monitoring Lipid and Anti-Coagulation Clinics Vascular Ultrasounds / AAA Screening
WHV Locations in Johnston, Wayne and Wilson Counties 910 Berkshire Road Smithfield, NC 27577
2076 NC Hwy 42 West, Suite 100 Clayton, NC 27520
2605 Forest Hills Road South West Wilson, NC 27893
2400 Wayne Memorial Drive, Suite A Goldsboro, NC 27534
Phone: 919-989-7909 Fax: 919-989-3147
Phone: 919-359-0322 Fax: 919-359-0326
Phone: 252-243-7049
Phone: (919) 736-8655 Fax: (919) 734-6999
When it comes to your cardiovascular care – We know it by heart. To learn more, visit our website www.WHVheart.com or call us at 1-800-WHV-2889 (800-948-2889).
Advanced Medical Imaging for Your Patients 19 Convenient Triangle Area Locations
Established in 1953, Wake Radiology is the leading provider of outpatient medical imaging for families in the Triangle. Our 54 radiologists are recognized experts, subspecialty trained and certified by the American Board of Radiology. A longtime leader in low-dose imaging, we are committed to minimize patients’ radiation exposure while maintaining the highest quality. We are proud to be the only multi-site freestanding outpatient imaging provider in the Triangle to earn the American College of Radiology’s prestigious Breast Imaging Center of Excellence (BICOE) designation. Our group is also the only one to earn certification from the International Society for Clinical Densitometry (ISCD) for bone density screenings and the first in Wake County to offer dedicated pediatric imaging services. Our 19 outpatient offices provide easy access to a full range of imaging procedures including: • Screening and diagnostic mammography • PET-CT and nuclear medicine • Interventional radiology and vein care • Orthopedic and sports imaging • Low-dose CT and MRI • Pediatric imaging So the next time imaging is necessary for your patients, choose Wake Radiology. We are in-network with most insurance plans and offer financial assistance or payment plans to patients who need it.
Wake Radiology. Excellence in medical imaging.
Express Scheduling: 919-232-4700 Mon-Fri 7:30am-6:30pm Chapel Hill Scheduling: 919-942-3196 Mon-Fri 8:00am-5:00pm wakerad.com Wake Radiology has 19 convenient outpatient imaging locations in Raleigh | Cary | Garner | Wake Forest | Morrisville Fuquay-Varina | Chapel Hill
Comprehensive Outpatient Imaging Services