Physicians Practice, brought to you by Upstate Medical University

Syracuse, NY | January 2013

William Darko PharmD, director of the pharmacy residency program, with pharmacy resident Christina Phelan.

PHARMACY RESIDENCY PROGRAM GROWS ecognizing the value that pharmacists add in managing drug therapies, especially in academic medical centers like Upstate Medical University, has led to changes in pharmacy education and highlighted the need for advanced patient care training.

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“The development of clinical specialty programs for pharmacists helps us meet highly specified needs in patient care and nurtures expertise in drug therapy management skills required of a specialized pharmacist,” explains Luke Probst PharmD, pharmacy residency coordinator.

Upstate University Hospital serves as a training site for students from more than 10 pharmacy schools. Residency programs, which provide intensive postgraduate training in hospital pharmacy and various subspecialties, have experienced an uptick in recent years.

Upstate has six pharmacy residents in their first postgraduate year, the largest class since the program began in 1998.

Residents at Upstate not only contribute to patient care, but are also active in quality improvement efforts, medication-related research projects, multidisciplinary team rounds and the education of peers through presentations and patientspecific interventions. Management and administrative skills are also honed, creating opportunities for residents to take their careers in multiple directions. ■

Upstate Connect: 800-544-1605 for Physician-To-Physician Service

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U P S TAT E U N I V E R S I T Y H E A LT H S Y S T E M N E W S

Mary Ellen Greco MD and Kristine Keeney MD, two well-known Central New York breast surgeons, have opened the Upstate Breast Care Center at the Community Campus.

BREAST SURGEONS OPEN BREAST CARE CENTER ary Ellen Greco MD and Kristine Keeney MD are now seeing patients in their new breast care office in the Physician Office Building South on the Community Campus, 4900 Broad Road, Syracuse.

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Both surgeons got their medical degrees from Upstate Medical University. They are boardcertified and fellowship-trained and have been well established in the Syracuse community for more than a decade. They treat a wide range of breast conditions from cancer to fibroceptic breast disease.

Upstate University Hospital’s Community Campus.

breast surgical oncology at Northwestern Memorial Hospital in Chicago, Ill. She is board certified by the American Board of Surgery.

Greco is a graduate of LeMoyne College. She completed a residency in general surgery at Upstate and then completed a fellowship in trauma and surgical critical care at the University of Maryland Medical System/R. Adams Cowley Shock Trauma Center in Baltimore, Md. Greco is a diplomate of the American Board of Surgery.

“Women’s breast health has always been a pillar of the care we provide at the Community campus,” said Meredith Price, chief administrative officer of Upstate University Hospital’s Community Campus. “The addition of these two highly trained breast surgeons makes our complement of breast care that much more comprehensive and easily accessible for patients.”

Keeney is a graduate of Boston University. At Upstate, she completed a residency in general surgery, serving as chief resident of general surgery. She was a Susan G. Komen fellow of

Greco and Keeney are accepting referrals.

Call Upstate Connect at 800-544-1605 for appointments. ■

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Upstate Connect: 800-544-1605 for Physician-To-Physician Service

U P S TAT E M E D I C A L U N I V E R S I T Y N E W S

CENTER FOR VISION RESEARCH MARKS 15 YEARS ith a clear vision and a good action plan, much can be accomplished in 15 years. This is evidenced by Upstate’s Center for Vision Research, which has grown from a threeperson enterprise to a group attracting world-class researchers and creating significant collaborations that have garnered millions of dollars in research funding.

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Since its inception in 1997, the Center has brought more than $21 million to Upstate from governmental agencies, private foundations and grateful patients, and the District 20-Y1 Lions.

As the funding has grown, so has the number of members, now totaling more than 40. Administrative director John Hoepner MD said the center has distinguished itself as the largest clinically focused research group at Upstate, and its members have made important breakthroughs into the causes of eye disease.

“Our primary goal is to enhance the research and training efforts of vision scientists in our region,” said Hoepner, who is also professor and chair of Upstate’s Department of Ophthalmology. He said the center’s long-term goal is to provide cures for conditions that cause blindness. “This can only be achieved by providing an environment that fosters scientific collaborations and attracts the best, brightest, and most innovative scientists who either use, or create, new technologies to achieve those goals.”

John Hoepner MD

To help foster these collaborations, the Center moved from its Weiskotten Hall location to Upstate’s newly expanded Neuroscience Research building, formerly the Institute for Human Performance. ■

Upstate Connect: 800-544-1605 for Physician-To-Physician Service

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U P S TAT E M E D I C A L U N I V E R S I T Y N E W S

CLINICAL TOXICOLOGIST ALEXANDER GARRARD e’s not a physician, and he’s not a detective, but a large part of Alexander Garrard’s job is to stay ahead of the drug dealers so he can help save their customers from bad reactions and overdoses. Garrard, 28, and his colleagues from Upstate’s Poison Center lecture throughout the 54-county coverage area, teach and supervise residents and medical students at Upstate Medical University, consult on patients at Upstate University Hospital, and — on occasion — answer calls from the media.

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How was it, being interviewed on CNN about the dangers of bath salts?

“It still boggles my mind. You look at some of the people who are on CNN, and wow, I was there too.

You’re just sitting at this desk looking into a camera, so you can’t really see them on the other side.

There’s a 7- or 8-second delay, so it can get very confusing.”

Did you want to be a clinical toxicologist when you were little?

“For the longest time, my dream job was to be a commercial airline pilot because my mom works for Lufthansa German Airlines. That kind of fizzled. And I ended up speaking to one of the pharmacists at a grocery store where I was a bag boy. I became really intrigued.

“I did a pre-pharmacy curriculum at the University of Georgia in Athens. I got my Doctor of Pharmacy degree at Mercer University in Atlanta.

Most people who graduate with a PharmD usually go into a community pharmacy. To do something like this, you have to pursue more post-graduate education. So that’s where the fellowship came in.

I did a two-year fellowship in clinical toxicology and emergency medicine in Jacksonville with the Florida Poison Information Center.

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Alexander Garrard displays dangerous synthetic drugs known as “bath salts.”

What is your day like?

“Jeanna Maraffa, Christine Stork-Medicis and I are the only pharmD toxicologists here, so we rotate. Every third week, we’re on hospital service. Anybody who comes into Upstate with an overdose, a poisoning, or an envenomation, we automatically get consulted on those patients and give recommendations on what’s the best way to care for those patients.

“We also have administrative responsibilities. I’m in charge of continuous quality improvement.

That means reviewing the cases and seeing —Were they managed appropriately? Could something have been done differently? What did we do well?

“I’m also in charge of death reports for our coverage area. Anybody who dies (from poisonings or overdose), I write up his or her death report for the American Association of Poison Control Centers.

That can get kind of depressing. In 2011 we had 55.

That’s a hard part of the job. As health care providers, it’s ingrained in us to save people and to help people. And unfortunately there’s some people who overdose on so much drug that despite your most valiant efforts, there’s too much drug on board, and you can’t counteract it.” continued on page A5

Upstate Connect: 800-544-1605 for Physician-To-Physician Service

U P S TAT E M E D I C A L U N I V E R S I T Y N E W S

Psychologist Richard O’Neill PhD, host and veteran broadcaster Linda Cohen and producer Steve Marks on the set of Upstate’s radio show, HealthLink On Air.

UPSTATE EXPERTS SHARE INFORMATION IN WEEKLY TALK RADIO SHOW variety of physicians, researchers, students and other health care professionals have appeared on Upstate’s weekly talk radio show, HealthLink on Air, over the last 7 1/2 years. The show airs from 9 to 10 a.m. Sundays on NewsRadio FM 106.9 FM or AM 570 WSYR. If you miss it, catch it anytime at www.upstate.edu/healthlinkonair by typing the subject or guest’s name in the search field.

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Six recent shows of interest: • Urologist Dmitriy Nikolavsky MD addresses female pelvic reconstruction.

• Geriatrician Sharon Brangman MD talks about memory loss and feeding tubes.

• Trauma surgeon Joan Dolinak MD speaks about the dangers of the salt and ice ‘game’ that teens are playing.

• Physical therapist Cassi Terpening explains how Upstate’s fatigue management program is used in cancer rehabilitation.

• Richard Cantor MD gives a rundown of advances in pediatric emergency medicine.

• Rich O’Neill PhD answers “How do parents cope with an teen’s ‘Jekyll and Hyde’ behavior?” ■

Clinical Toxicologist continued from page A4

How do you know so much about street drugs?

“A unique part of our job is really trying to stay ahead of the curve, or at least be as knowledgeable as possible about these substances. That means looking through the drug blogs and really kind of getting dirty and getting into that community and finding out — What are people using? How are they using it? What are people saying? What are the effects?

“There is no study out there, no release from the FDA. A lot of it is word of mouth, talking to the patients. A lot of what we know about these drugs comes from patients who have presented to the emergency room. It’s a little bit like ‘CSI’ mixed with ‘House,’ where you have all these weird presentations: Why is this person so aggressive and agitated, with high blood pressure? What drugs out there do we know that can cause this?”

Reach the Upstate Poison Center at 800-222-1222. ■

Upstate Connect: 800-544-1605 for Physician-To-Physician Service

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U P S TAT E G O L I S A N O C H I L D R E N ’ S H O S P I TA L N E W S

CHILDREN’S HOSPITAL MARKS THREE YEARS

he Upstate Golisano Children’s Hospital has a patient satisfaction rate of 93 percent among inpatients and outpatients, with 96 percent of patients rating their care at nine or 10 on a 10-point scale. The hospital within a hospital occupies the top two floors of a “treehouse” addition to Upstate University Hospital which opened in 2009.

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Golisano is state-certified as a pediatric trauma center and has one of only two poison control centers in the state. The children’s hospital has 71 beds — 23 in surgery, 12 in hematology/oncology, 21 in general pediatrics (including 11 for adolescents) and 15 in intensive care.

Fifty-eight percent of patients are admitted to Golisano through Upstate’s pediatric emergency room. For the fiscal year from July 2011 to June 2012, 4,303 pediatric patients were discharged from Golisano, 2,636 had inpatient surgery and 3,187 had outpatient surgery.

The Upstate Golisano After Hours Care center opened in February 2012 on the Community campus, providing care from 4 to 11 p.m. weeknights

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and noon to 11 p.m. weekends. In the first six months of operation, 2,893 children were treated, with 4 percent being transferred to Upstate’s pediatric emergency room downtown and/or admitted to the Golisano Children’s Hospital.

Golisano is staffed by 80 attending physicians, including 10 pediatric specialists hired this year: three hospitalists and one each in anesthesiology, general surgery, neurology, hematology/ oncology, nephrology, pulmonology and radiology. Golisano doctors work with 39 residents and two fellows.

Ninety-one percent of Golisano patients come from the counties of Broome, Cayuga, Cortland, Herkimer, Jefferson, Madison, Oneida, Onondaga, Oswego and St. Lawrence.

Among Golisano patients, 51 percent are age 5 or younger and 22 percent are younger than 1 year. The top diagnoses include appendicitis, asthma, bronchiolitis, cancer, cellulitis, diabetes, pneumonia, respiratory syncytial virus and seizure/epilepsy.

Upstate Connect: 800-544-1605 for Physician-To-Physician Service

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HEMATOLOGIST/ONCOLOGIST AJEET GAJRA WINS HOSPICE AWARD

MEDICAL SOCIETY BESTOWS SERVICE AWARD UPON EVA GREGORY

ematologist/oncologist Ajeet Gajra MD received the Anita Award from Hospice of Central New York.

He was recognized for his compassion and commitment to his patients, along with his efforts to teach fellow physicians, Ajeet Gajra MD healthcare professionals and students about the importance of patient understanding and support when facing a life-limiting illness.

va Gregory MD received an award for physician service from the Onondaga County Medical Society. The honor recognizes her work as onsite clinical director at the Onondaga Nation, south of Syracuse.

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Ava Gregory MD

Gajra is an associate professor of medicine at Upstate who directs the fellowship in hematology/oncology.

Gregory, a member of the executive committee in Upstate’s Department of Family Medicine, has worked on the Nation since 1993. Gregory also leads teams to underserved countries twice a year to work in mobile medical clinics. For six years she served on the Syracuse Rescue Mission Board of Directors.

The Hospice award, established in memory of Anita Stockman, is given annually to a physician who communicates honestly and sensitively, who respects patient decisions and remains actively involved with patients in their final journey. ■

Gregory says she is honored to receive the society award, “although my biggest reward is the privilege to work at the Onondaga Nation and with people serving in our rural upstate communities.” ■

CAMPUS HONORED FOR WORK-LIFE BALANCE PRACTICES pstate Medical University received a $25,000 award from the American Council on Education and the Alfred P. Sloan Foundation for its promising practices in career flexibility for academic physicians.

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Upstate was one of only seven national medical schools recognized through a competitive process for its innovative “trackless” promotion system for full- and part-time College of Medicine faculty.

With this trackless system, faculty members choose an area of excellence in patient care and service, research, or education, in which they can be promoted, based on their leadership,

innovation and national reputation. The system promotes career flexibility and faculty satisfaction within clearly defined expectations and allows individuals to follow their passions.

Paula Trief PhD

“The criteria for advancement through promotion and tenure are clear, ” said Paula Trief PhD, senior associate dean for faculty affairs and faculty development and a professor of psychiatry and medicine. “This system opens the path to promotion for part-time faculty, and helps retain faculty members and attract future physicians.” ■

Upstate Connect: 800-544-1605 for Physician-To-Physician Service

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