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The Scalpel Thoughts From the Chairman As the academic year ends, it is again time to celebrate the transition of young, bright physicians that will progress to the next year of training or graduate from our programs by successfully completing their residency or fellowship. Despite the wonderful time for celebration, there is a growing awareness that our healthcare system as we know it is failing. Clearly the financial situation of increased healthcare costs for patients and employers, decreased reimbursement and increased documentation requirements for physicians and hospitals is not sustainable. With growing transparency, we see greater Dr. Ramshaw concerns about the fragments of our healthcare system functioning as businesses focused on revenue growth more than accountability for providing value to the patient. We also see an increasingly complex patient population with patients taking more medications, having had more prior operations and a 1/3 of our population in the US in chronic pain. As a surgery department in an academic medical center, I believe we will need to address the challenge of figuring out how to deliver patient care in a way where costs are lowered, and outcomes are improved at the same time. This is a great challenge but also a great opportunity. This past year was a challenging year financially for our hospital partner, UTMC, resulting in a negative margin. Fortunately, we have a very collegial organization with excellent leadership. With the collaborative leadership of Joe Landsman, many people contributed to apply solutions to our financial downturn. Things are already looking brighter and through the hard work of our leadership, we recently received the news that we will be a provider again within the Blue Cross Blue Shield Network S.
Inside this Issue Summer 2018 ● Physicians Executive MBA ● Resident Research Day Visiting Lecturer
● 2018 Health Innovation Symposium ● New Residents and Fellows ● Faculty News ● Alumni Spotlight ● ACGME Diversity Outlook
● Academics
During these times of financial constraint, a growing issue has surfaced concerning the culture of our department and our organization. We have been blessed with a strong group of physician leaders who have been here for many decades, including our past Chair, Dr. Goldman. These physician leaders have promoted a culture that is focused on patient care and educating trainees over any practice or individual physician priority. In speaking with one of our faculty members, who came to us from a medical center with a much more competitive environment, he expressed an interest endocrine surgery, particularly thyroid procedures. He met with Dr. Nelson (another of those physician leaders responsible for our positive culture) who at that time was doing most of the thyroid procedures. Dr. Nelson was welcoming and supportive to help this young surgeon grow his practice, even though he was in a different physician practice group. This is not what would normally happen at most other organizations where competition breeds a poor culture. Continued...
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...Chairman’s Thoughts Continued
We are at risk for devolving into a more negative culture if we do not continue to work together to address the challenge of figuring out how to transform our healthcare system into one that sustainably lowers cost and improves outcomes. There is no way to do that without having access to accurate patient data. This includes the financial data that will allow us to measure the value of care we provide in the context of each definable patient care process. With access to this data, we can learn to work in teams to figure out how to lower costs at the same time we improve outcomes. During this past academic year, we have built a data and analytics infrastructure that will facilitate our ability to do this. We also have an agreement with the hospital that will allow our infrastructure partner, CQ Insights, to begin automated data pulls from the many data repositories within our organization. With the data in one place, we can begin to use the data appropriately to improve the value of care. Working collaboratively within and across care teams and not focusing only on individual and practice financial (RVU) goals will be critical to maintain our collegial culture and to successfully transform our healthcare system from one based on the volume of care we provide to one based on measuring and improving the value we provide for our patients.
Surgery Resident Lauren Grimsley, MD, Experiences Physician Executive MBA
Dr. Grimsley
Einstein once said “the definition of insanity was doing the same thing over again and expecting different results." I felt like under this definition, in italicized print would read "See: Healthcare." I decided to pursue an MBA after realizing that healthcare was failing on multiple levels. And despite being a healthcare provider, I knew relatively little regarding the business side of medicine. I did not take any business classes in college and the seminars that were offered in medical school were relatively surface level understanding of a very complex problem. I wanted to be able to speak intelligently on issues surrounding the business side of medicine so I could better understand the system for my and my patient's benefit. After speaking with Kate Atchley regarding my desire to better understand the business of medicine, I applied and was accepted to the program for the Class of 2017.
Our first residence period started on a snowy January day and I got to know the rest of my class who had similar feelings about the changing healthcare sphere. Classes, homework and assignments ramped up quickly and before I realized it, April had arrived with our second residence period. The second residence period was by far the most grueling in my mind. I had lost my stamina for sitting in class from 7AM to 7PM. The third residence period flew by and finally we reached December. Long nights of catching up on homework and working on my Organizational Action Plan had paid off and graduation was before me. It was amazing to review my classmates' projects and see their insightful and creative Organization Action Plans. In truth, healthcare can seem like a big machine, with physicians feeling like they are just a simple cog in a complex process. The PEMBA program not only educated me about the business aspects of medicine that are so vital to our practice, but also taught me vital leadership skills to succeed. Most importantly, PEMBA connected me to a rich network of change leaders that reinvigorated my enthusiasm for improving healthcare. The Physicians Executive MBA is offered by the Haslam College of Businesses at the University of Tennessee. Graduates of the program include faculty: Dr. Keith Gray, Dr. Brian Daley, and Dr. Blaine Enderson. Critical Care Fellow Dr. Jessica Taylor and faculty Dr. Todd Nickloes are currently completing the program. More information about PEMBA can be found at: https://haslam.utk.edu/pemba
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Resident Research Day Features Notable Figure in Surgery
Dr. Valentine
As part of the annual Resident Research Day, Dr. James Valentine, M.D. will be lecturing as the Kimball I. Maull Visiting Professor speaker. A renowned vascular surgeon, Dr. Valentine is Professor of Surgery at the University of Minnesota. He previously worked at Vanderbilt University Medical Center until 2015. He completed his undergraduate degree at Vanderbilt and his medical degree at Emory University. He completed residency training at Parkland Hospital in Dallas, Texas and was Previously the Director of the Division of Vascular Surgery at University of Texas Southwestern Medical School in Dallas. Dr.. Valentine also served the U.S. Navy for four years. Currently he specializes in treatment of arterial, venous, and lymphatic disease.
Whittington Lecture Series—Health Innovation Symposium 2018 On June 14 this exciting event will bring together the Knoxville healthcare community to discuss how to best transform healthcare into a sustainable system based on measurable value for the patient through entrepreneurship, innovation, and data analytics. The goal of this year’s symposium is to identify and drive a more holistic approach toward opportunities for collaboration, discovery, and innovation throughout the Knoxville healthcare community. UTGSM seeks to truly transform healthcare relationships between care providers and patients in order to drive down costs, increase efficiency, and elevate UTGSM’s core competencies both regionally and nationally. This symposium will also serve as the Whittington Lecture Series for the Department of Surgery. This year's keynote will feature David A. Kessler, M.D. Dr. Kessler is an American pediatrician, lawyer, author, and administrator. He was Commissioner of the Food and Drug Administration from 1990 to 1997. He currently serves as a Medical Advisor of Keas Inc., an Advisor at TPG Growth, as well as a Member of the Advisory Board at Opiant Pharmaceuticals, Inc. and has served as its Strategic Advisor since September 24, 2012. He has published numerous articles in The New England Journal of Medicine, JAMA, and other major medical journals and is a New York Times bestselling author. The symposium will also feature the work of Bruce Ramshaw, M.D., Professor and Chair, Department of Surgery at UTGSM in applying continuous quality improvement (CQI) toward patient care at UTMC; demonstrate what others across the industry are doing; and highlight how to best utilize data from real patient care to measure value of care and drive sustainability. This will be followed by a special panel dedicated to the entrepreneurship — the future of CQI and how start-ups in the space can best achieve success. Finally, the symposium will also feature a special message from Steve Case. Mr. Case is an entrepreneur, investor, and businessman best known as the co-founder and former chief executive officer and chairman of America Online. Since his retirement as chairman of AOL Time Warner in 2003, he has gone on to invest in early and growth-stage startups through his Washington, D.C. based venture capital firm Revolution LLC. To register for this event: https://www.eventbrite.com/e/the-university-of-tennessee-graduate-school-of-medicineinnovation-symposium-tickets-46148458281
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NEW RESIDENTS AND FELLOWS 2018-2019
Winston Crute, MD PGY1 Prelim. Urology University of South Alabama
Joseph Hlopak, MD PGY1 Prelim. Edward Via College of Osteopathic Medicine
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Alan Good, MD
Brandon Hays, MD
PGY1
PGY1 Prelim.
Saint Louis University
University of Tennessee
Amy Howk, MD PGY1 University of Tennessee
Eric Johnson, MD PGY1 Prelim. University of Texas— San Antonio
Kasey Helmlinger, MD PGY1 Prelim. Radiology American University of The Caribbean
Justin Jong, MD PGY1 University of South Alabama
Callie McAdams, MD
PGY 1 West Virginia University
Keith Zoeller, MD PGY1 Prelim. University of Louisville
Chris Porter, MD
Kevin Reed, MD
PGY1
PGY1 Prelim.
Katherine Yared, MD
Texas A & M Health Science Center College of Medicine
Urology
PGY1
University of Tennessee
University of Louisville
Phillip P. Rideout, MD
Lars R. Webb, MD
Danilo A. Martins, MD Critical Care Fellow
Vascular Fellow Dell Medical School at the University of Texas at Austin
Mercer University School of Medicine
Instructor, Advanced GI MIS Fellow University of New Mexico Hospital
Resident Research Day June 16, 2018 Morrison’s Conference Room University of Tennessee Medical Center
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New Faculty
The Department of Surgery welcomes Dr. McKeown as Professor with the Division of Cardiothoracic Surgery.
Peter McKeown, MB, BS, MBA, MPH
Dr. McKeown is a graduate of University of Queensland, Brisbane, Australia where he received a Bachelor of Medicine and Bachelor of Surgery. He also holds a Bachelor of Arts from University of Queensland, Brisbane, Australia Psychology Postgraduate Studies. He is a Fellow of the Royal College of Physicians and Surgeons of Canada, Fellow of Royal Australasian College of Surgeons, Fellow of the American College of Surgeons and Fellow of American College Healthcare Executives. Dr. McKeown is also a graduate of the MBA program at the University of South Florida, and MPA and MPH graduate of Harvard University.
Dr. Blaine Enderson Takes on Role as Vice President of the Emergency and Trauma Center From David Hall, Senior Vice President and Chief Operating Officer of the University of Tennessee Medical Center:
Dr. Enderson
As we continue to strive to improve all areas of our organization, we’ve named Dr. Blaine Enderson as vice president of the Emergency and Trauma Center. Dr. Enderson has been with the medical center since 1987. Throughout his 30 years as a physician leader, Dr. Enderson has been a tremendous asset to our Emergency, Trauma and Critical Care team and to our full organization. He moves to the vice president role after spending the past several years as medical advisor of Trauma and Emergency Services as well as medical director of Critical Care Services. Karen Pryor will continue in her role as Director of Emergency, Trauma and Critical Care services, reporting to Dr. Enderson. Meanwhile, we’re making a shift in the reporting structure for one our areas, as Radiology Services will now fall under the leadership of Garlena Lee and become part of Clinical and Sleep Services. We believe the changes we’re making will help us bolster the individual service lines and enhance our overall operations at the medical center. We’re very appreciative for all the great contributions of our team members and physicians in Emergency, Trauma, Critical Care, and Radiology, and are confident this new structure will best allow us to continue to improve on behalf of our patients.
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Alumni Spotlight: Jeffrey D. Hollis, MD, FACS
Class of 2004
Dr. Hollis
Dr. Hollis graduated residency from UTMCK in June 2004. After residency he chose Gallatin, Tennessee, located northeast of Nashville. That same year, he began his solo private practice, General Surgery at Sumner Regional Medical Center (140 beds). Dr. Hollis is going on 15 years now in his practice involving all aspects of general surgery including robotics. He remained solo until 2014 at which time he joined Sumner Medical Group as a partner. His group is comprised of 18 physicians and 6 nurse practitioners. Specialties include internal medicine, family practice, GI, pulmonology, neurology, endocrinology, and general surgery.
Dr. Hollis has held many professional appointments. He served as hospital Vice Chief of Staff from 2007— 2009, Chief of Staff from 2009—2011, and Chair of the Department of Surgery several times – 2005, 2006, 2013, and 2014. Currently he is the Trauma and Critical Care Medical Director (2016—current). Sumner Regional Medical Center is currently seeking new level 3 trauma designation with the State of Tennessee. For the past 14 years he has been the Acting Physician Liason for the ACS accredited Cancer Program. He is ABS Board certified and a Fellow of the American College of Surgeons. Following graduation in 2004 he married Ashley, whom he met at UTMCK. They have two girls, Evelyn (10) and Anabel (8). He enjoys golfing, relic hunting, and has a Facebook page dedicated to his finds called “Middle TN Civil War Relic Hunters.” Speaking on his role in medicine, Dr. Hollis says: “I have a passion for educating and financial planning. Two years ago, I partnered with a financial group in Nashville to begin a type of “educational outreach” regarding retirement planning from a physician’s perspective. I have long realized this was an area not commonly presented to young medical professionals. I took some of my life lessons (and hard knocks) and with these professional relationships, developed a seminar geared to this topic. The goal: to give an overview of “what I wish someone would have told me back then”. Then, about 6 months ago, I was very fortunate to be introduced to some of the AMA representatives in charge of medical education. By coincidence, they were in the early stages of developing a nationwide pilot program to address this very topic. Through a lot of teamwork and coordination with the AMA, I was asked to be a part of the launch of their new financial education pilot program as a speaker. We are very excited and know this is a much needed topic to accent the medical education already being provided. We look forward to speaking to the surgery department and sharing some of this information.” Dr. Hollis will be returning to UTMCK as Visiting Professor in September 2018 to present Surgery Grand Rounds on behalf of the AMA.
Clinical Quality Improvement Update As part of his initiative to improve patient quality, Chairman Dr. Bruce Ramshaw has recently been granted permission by the UT Medical Center to use his patients data for CQI. A first of its kind, this data collection will examine gender, age, emotional and mental state, and the immune system of patients to better understand patient needs and outcomes. The process in total will take 2—4 years and will also consider variables such as the type of surgery the patient will receive. The ultimate goal is to introduce a pre-habilitation climate to decrease patient pain, required post-op rehabilitation, and future hernia repair surgeries.
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Diversity in the Department of Surgery The latest version of the Common Program Requirements have added a new focus on diversity. The language “The program, in partnership with its Sponsoring Institution, must engage in practices that focus on mission -driven, ongoing, systematic recruitment and retention of a diverse workforce inclusive of residents, fellows (if present), faculty members, senior administrative staff members, and other relevant members of its academic community.” Although the ACGME does not define what diversity entails, how to measure it under the department’s current system driven by applicant choice rather than institutional or department decisions, it is a Core requirement. The Department of Surgery has always demonstrated adherence to cultural core values rather than gender, ethnicity or religion. Enclosed are tables of the applicants and the residents for review. This diversity requirement is viewed as a potential discussion point for the upcoming site visit. 2017-2018
2016-2017
2015-2016
2014-2015
Total # of Applicants Male
1060 670 (63%)
1144 756 (66%)
1262 823 (65%)
1172 781 (67%)
Female
390 (37%)
386 (34%)
435 (34%)
388 (33%)
No Response
0
2 (<1%)
4 (<1%)
3 (<1%)
American Indian or Alaskan Native
8 (1%)
7 (1%)
9 (1%)
11 (1%)
Asian
227 (21%)
257 (22%)
325 (26%)
283 (24%)
Black, African-American, African
81 (8%)
85 (7%)
85 (7%)
97 (8%)
Hispanic, Latino or of Spanish Origin
117 (11%)
101 (9%)
103 (8%)
104 (9%)
Native Hawaiian
2 (<1%)
1 (<1%)
0
2 (<1%)
White & White Other
578 (55%)
574 (50%)
576 (46%)
552 (47%)
Other
43 (4%)
35 (3%)
43 (3%)
52 (4%)
Prefer Not to Say
4 (<1%)
84 (7%)
121 (10%)
71 (6%)
Total # of Applicants Interviewed
127
97
110
95
Male
74 (58%)
52 (54%)
64 (58%)
59 (62%)
Female
53 (42%)
45 (46%)
46 (42%)
36 (38%)
Black, African-American, African Applicants Interviewed
5 (4%)
2 (2%)
1 (1%)
4 (4%)
Asian Applicants Interviewed
11 (9%)
13 (13%)
11 (10%)
10 (11%)
Total # of Categorical Match Positions
6
6
6
5
Total # of Matched Females
3 (50%)
1 (17%)
2 (33%)
2 (40%)
Total # of Matched Black-African American, Africans
0
0
0
0
Total # of Matched Asians
1 (17%)
1 (17%)
0
1 (20%)
Applicant Self-Identification:
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Publications
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Presentations
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Summer 2018
The University of Tennessee Medical Center Department of Surgery - 827 1924 Alcoa Highway Knoxville, TN 37920-6999 Phone: 865-305-9294 RETURN SERVICE REQUESTED
The University of Tennessee Medical Center comprises the University Memorial Hospital and the Graduate School of Medicine. Together, these entities embody the medical centerâ&#x20AC;&#x2122;s philosophy and mission through the spirit of exploration, the passion for teaching, and the compassion to restore. The University of Tennessee is an EEO/AA/Title IV/Section 504/ADA/ADEA employer. E20-6358-00-0002-08
Department of Surgery Faculty Division of Cardiothoracic Surgery Division of Physical Medicine and Rehabilitation Raymond A. Dieter, III, M.D.* Jeffery S. Hecht, M.D.* Thomas E. Gaines, M.D. Miriam Weinstein, MD John Mack, M.D. Peter McKeown, M.B.B.S. Division of Ophthalmology David J. Harris, Jr., M.D.* Division of General Surgery Nicholas G. Anderson, M.D. Matthew L. Mancini, M.D.* Charles G. Ange, M.D. Mariah Beasley, M.D. Paul D. Froula, M.D. Terry Bingham, M.D. David G. Girkin, M.D. Mark Casillas, M.D. Gary N. Gitschlag, M.D. Paul Crawford, M.D. Herbert J. Glatt, M.D. Daniel Drinnen, M.D. Joseph M. Googe, Jr., M.D. Melissa LaPinska, M.D. John c. Hoskins, M.D. Gregory J. Mancini, M.D. D. Lee McDaniel, M.D. Henry S. Nelson, Jr., M.D. T. McMillan, M.D. Jeffrey Nix, M.D. James H. Miller, M.D. Bruce Ramshaw, M.D. Bradley L. Pearman, M.D. Andrew Russ, M.D. Stephen Perkins, M.D. Tom Thompson, M.D. James Rouse, M.D. Keith Shuler, M.D. Division of Neurosurgery Jonathan W. Sowell, M.D. Todd Abel, M.D. Richard Boxer, M.D. Division of Orthopedic Surgery Lewis W. Harris, Jr., M.D. Scott T. Smith, M.D.* Frederick Killeffer, M.D. George R. Baddour, M.D. James A. Killeffer, M.D.+ Michael S. Eilerman, M.D. Joshua A. Miller, M.D. Edwin M. Holt, M.D. William E. Snyder, Jr., M.D. Glenn Ed Jeffries, M.D. William A. Tyler, Jr., M.D. G. Mathien, M.D. William Oros, M.D. Richard S. Smith, M.D. Division of Surgical Oncology Kostas Triantafillou, M.D. Keith D. Gray, M.D.* John L. Bell, M.D. Division of Plastic and Reconstructive Surgery James Lewis, M.D. Joseph T. Chun, M.D.* Jillian Lloyd, M.D. Kathleen S. Herbig, M.D. James McLoughlin, M.D. David B Reath, M.D. Stacy Stephenson, M.D. Division of Pediatric Surgery Glaze Vaughan, M.D.* Division of Surgical Research Carlos Angel, M.D. Michael Karlstad, Ph.D. Eric R. Jensen, M.D. Eric Heidel, Ph.D. Oscar H. Grandas, M.D. *Division Chief Deidra Mountain, Ph.D. + Academic Chief
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Division of Vascular Surgery Michael B. Freeman, M.D.* Joshua Arnold, M.D. Ryan Buckley, M.D. Oscar Grandas, M.D. Michael McNally, M.D. Scott L. Stevens, M.D. Division of Transplant Surgery Oscar H. Grandas, M.D.* Alex Cantafio, M.D. Mitchell H. Goldman, M.D. Division of Otolaryngology Richard J. DePersio, M.D.* Leslie L. Baker, M.D. Michael J. Belmont, M.D. Robert A. Crawley, M.D. William D. Horton, M.D. John Little, M.D. Allen M. Rosenbaum, M.D. Ronald K. Sandberg, M.D. S. Soss, M.D. Division of Trauma/Critical Care Brian J. Daley, M.D.* Reagan Bollig, M.D. Marc Campbell, M.D. Blaine L. Enderson, M.D. James Goodin, M.D. Lindsay McKnight, M.D. Todd A. Nickloes, D.O. Frank Roberts, M.D. Lou M. Smith, M.D. Dana A. Taylor, M.D. The Department of Surgeryâ&#x20AC;&#x2122;s mission at the University of Tennessee Graduate School of Medicine is to provide surgical education by delivering the highest quality patient care, teaching and research.