April 2018 • Vol. 48, No. 4
Mecklenburg Medicine A Publication of the Mecklenburg County Medical Society | www.meckmed.org
Leading the Way for Healthier Air
Mecklenburg County Medical Society
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Mecklenburg County Medical Society Foundation @meckmedsociety
Need a referral for Parkinson’s or movement disorders? Know when it’s time to make the referral Fellowship-trained at Icahn School of Medicine at Mount Sinai, James Battista, MD, specializes in providing fast diagnoses and treatments for movement disorders, including Parkinson’s and Huntington’s diseases, spasticity, tremors, dystonia, restless leg syndrome and tic syndrome. Here’s when to refer your patient to Dr. Battista: • Symptoms persist despite compliant medication use. • Surgical evaluation for deep brain stimulation placement. • Condition impacts daily activities. • Patient requires multidisciplinary care, including physical therapy, occupational therapy, speech therapy, behavioral health and home health.
To refer a patient, call 704-384-9437 or email NHNeurosciences@NovantHealth.org.
Novant Health Neurology Specialists 1918 Randolph Road, Suite 400 Charlotte, NC 28207
NHNeurologySpecialists.org © Novant Health, Inc. 2018 2/18 • GCM-267860
James Battista, MD Movement disorder specialist
AOCC is excited to welcome the following providers and their patients to our practice. These rheumatologists have been active in the Charlotte Medical Community for many years. Dr. Diane George
Dr. Firas Kassab
Dr. Cheryl Robertson
Dr. Alison Johnson
Dr. Victoria Lackey
Dr. Jill Zouzoulas
They join the existing providers at AOCC: Dr. Shabnam Ali
Dr. Robert Kipnis
Dr. Charles Seehorn
Meagan Lambert FNP
Dr. Heather Gladue
Dr. Andrew Laster
Dr. Ashley Toci
Heather Perkins FNP
Dr. Ahmad Kashif
Dr. Gary Maniloff
Ashton Chamblee PA
Erin Siceloff PA
Founded in 2000, AOCC is an independent specialty practice committed to providing compassionate and stellar care to patients with rheumatic diseases. We are experienced in treating patients with a variety of autoimmune and connective tissue diseases including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus, scleroderma, gout, vasculitis, osteoporosis and osteoarthritis. We offer infusion services, physical therapy, diagnostic imaging including ultrasound, X-ray and DXA, as well as a full service lab. Please visit our web site at www.aocc.md for more information. We are now able to serve new and existing patients in a timely manner at our two convenient locations. PIPER GLEN (across from Stonecrest)
7810 Ballantyne Commons Parkway, Suite 300 Charlotte, N. C. 28277 Phone: 704-926-5558 or 704-926-5559 Fax: 704-342-0835
MIDTOWN
1918 Randolph Road, Suite 600 Charlotte, N.C. 28207 Phone: 704-342-0252 Fax: 704-342-0835
HOURS: 8:00 AM-5:00 PM Monday-Friday | www.aocc.md Mecklenburg Medicine • April 2018 | 3
Table of Contents 5 President’s Letter: Is There A Conflict? By Scott L. Furney, MD, President, MCMS
5 Charlotte AHEC Course Offerings for April 6 Feature: Denial By Jessica Schorr Saxe, MD
7 Feature: n Charlotte Physicians Lead the Way for Healthier Air at Hospital Construction Sites n Idle-Free Schools Campaign Clears the Air for Kids Reprinted with permission from Clean Air Carolina.
8 Feature: A Novel Muscle Transfer for Independent Digital Control of a Myoelectric Prosthesis: The Starfish Procedure By R. Glenn Gaston, MD, and Bryan J. Loeffler, MD
9 9 10 10 12 12
New Members Upcoming Meetings & Events At the Hospitals National Health & Wellness Observances for April Independent Physicians of the Carolinas Advertising Acknowledgements
On the Cover:
April 2-8 is Public Health Week. See articles relating to public health on page 7. 1112 Harding Place, #200, Charlotte, NC 28204 704-376-3688 • FAX 704-376-3173 meckmed@meckmed.org Copyright 2018 Mecklenburg County Medical Society Mecklenburg Medicine is published 10 times per year by the Mecklenburg County Medical Society, 1112 Harding Place, Suite 200, Charlotte, NC 28204. Opinions expressed by authors are their own, and not necessarily those of Mecklenburg Medicine or the Mecklenburg County Medical Society. Mecklenburg Medicine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. Mecklenburg Medicine is not responsible for unsolicited manuscripts. Classified Ads: Open to members, nonprofits and non-member individuals only; advance approval of the Managing Editor and advance payment required. Member rate is 0, non-members $20 for the first 30 words; $.75 each additional word. Display Ads: Open to professional entities or commercial businesses. For specifications and rate information, contact Mark Ethridge at mecklenburgmedicine@gmail.com. Acceptance of advertising for this publication in no way constitutes professional approval or endorsement of products or services advertised herein. We welcome your comments and suggestions: Call 704-376-3688 or write Mecklenburg Medicine, c/o Mecklenburg County Medical Society, 1112 Harding Place, Suite 200, Charlotte, NC 28204.
4 | April 2018 • Mecklenburg Medicine
April 2018 Vol. 48 No. 4 OFFICERS
President Scott L. Furney, MD
President-Elect Elizabeth B. Moran, MD Secretary Babak Mokari, DO
Treasurer John R. Allbert, MD
Immediate Past-President Stephen J. Ezzo, MD
BOARD MEMBERS
Raymond E. Brown, PA Sarah M. Edwards, MD E. Carl Fisher, Jr., MD Donald D. Fraser, MD Vishal Goyal, MD, MPH Jane S. Harrell, MD Stephen R. Keener, MD, MPH B. Lauren Paton, MD Anna T. Schmelzer, MD Rachel L. Storey, DO Andrew I. Sumich, MD G. Bernard Taylor, MD
EX-OFFICIO BOARD MEMBERS Tracei Ball, MD, President-Elect Charlotte Medical Dental & Pharmaceutical Society Sandi D. Buchanan, Executive Director Mecklenburg County Medical Society Darlyne Menscer, MD NCMS Delegate to the AMA
Douglas R. Swanson, MD, FACEP, Medical Director Mecklenburg EMS Agency
EXECUTIVE STAFF Executive Director Sandi D. Buchanan
Finance & Membership Director Stephanie D. Smith
Meetings & Special Events Coordinator Jenny H. Otto
MECKLENBURG MEDICINE STAFF Editor Scott L. Furney, MD Managing Editor Sandi D. Buchanan Copy Editors Lee McCracken Stephanie Smith
Advertising Mark Ethridge mecklenburgmedicine@gmail.com Editorial Board Stephen J. Ezzo, MD N. Neil Howell, MD Jessica Schorr Saxe, MD Graphic Design Wade Baker
President’s Letter
Is There a Conflict? By Scott L. Furney, MD
M
y father passed away four years ago. The lessons I learned from that experience are profound, and more than I can share in one article. Part of that journey included learning skepticism of our profession, which can have a dark side. My father initially was hospitalized with shingles and an abnormal CBC. I flew up to Michigan a few days later, as his workup was unfolding. Only after significant prodding did his hematologist tell me he thought my dad had chronic lymphatic leukemia and a bone marrow biopsy would confirm it. I did not know the physician, but was told by the hospital team that we were lucky to have him assigned to my father’s case. Fast forward a week; his bone marrow confirmed CLL, and it appeared to be stage 0, which was good news. Then things got weird. I received his records from his less-than-forthcoming hematologist. My father had adequate bone marrow iron stores, but his treatment included an additional set of office-based iron infusions. I called the physician, asking politely, “Why are you giving him iron infusions when his bone marrow iron stores are normal?” The shocking answer from an eminent board-certified hematologist was, “Because he is anemic.” Let that sink in … I returned to Charlotte, and a few days later my sister called, informing me my father was scheduled for “urgent” chemotherapy. Given that he had stage 0 disease and was recovering from shingles, this made no sense to me at all. I am not a hematologist, but I know some really smart ones. A quick collegial consultation later, I called my father’s physician and told him his service no longer was needed. My father was mortified; not with his physician, but with me. As a trusting baby boomer, he could not fathom how a physician might not have his best interest at heart. Imagine how hard it was for me to tell my father that his physician was less interested in his health than his insurance payment. In case you are wondering if I over-reacted, his physician has since lost his license and is in federal prison for Medicare fraud. The link to the article is at the end of this letter. Why do I tell this story? Having been sensitized, I now see conflicts of interest in almost any place I look. The literature is full of articles describing how compensation systems can drive overuse when physicians benefit. Stark Law, among others, is there to ensure we minimize the risks associated with physician self-referral. The problem still exists. Atul Gawande wrote a great piece in “The New Yorker” called “The Cost Conundrum” in 2009. I highly recommend you read it. Two lines distill the essence of the conundrum: “Somewhere in the United States at this moment, a patient with chest pain, or a tumor, or a cough is seeing a doctor. And the damning question we have to ask is whether the doctor is set up to meet the needs of the patient, first and foremost, or to maximize revenue.” The lack of insight we have into our own potential conflicts is best highlighted by surveys of physician attitudes toward pharmaceutical sales events. About 20 percent of physicians
believe they could be influenced by a marketing event, but they think 80 percent of their colleagues could be. We are capable of turning a blind eye to the things we justify. I have been on the soap box long enough. While 99 percent of us provide high-quality care with no apparent conflicts, I suspect there are conflicts below the surface we need to examine critically. There are a handful of our colleagues we have an obligation to uncover and report, for the sake of our patients and profession. The only thing I regret in managing my father’s care team is that his physician practiced for another year before he was indicted and removed from his practice. How many patients did he treat after I recognized the problem? In humble service,
Link to the news coverage of the hematologist: https://www.cnn.com/2015/07/10/us/michigan-cancer-doctorsentenced/index.html
CHARLOTTE AHEC COURSE OFFERINGS Charlotte AHEC is part of the N.C. Area Health Education Centers (AHEC) Program and Carolinas HealthCare System.
APRIL 2018
Continuing Medical Education (CME) 4/6 4/28-29 Online Online Online Online Online Online Online
Online
Partners Health Summit: Solutions to North Carolina’s Opioid Epidemic 32nd Annual Meeting of the GDCN Protecting Your Patients From Air Pollution Risk Management: Patient Identification Social Media: Risks and Benefits for Physicians Prevention and Management of Concussion/Mild Traumatic Brain Injury Motor Vehicle Crash Victims MTAC Trauma Modules Get the 4-1-1: Everything Primary Care Providers Should Know About Parent Training in Behavior Therapy While Working With Families With Young Children With ADHD Electronic Medical Record on Trial (Risk Management)
For more information or to register for these courses, call 704-512-6523 or visit www.charlotteahec.org.
Mecklenburg Medicine • April 2018 | 5
Feature
Denial By Jessica Schorr Saxe, MD
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hen I started practice, I had never experienced a serious illness. My family members, even the aged, were healthy. I considered myself an exceptionally compassionate family physician. I was the healer, and illness was for others. I secretly felt my healthy lifestyle and general virtue were an amulet against misfortune. My stethoscope and white coat served as accoutrements of invincibility. Then my mother got lost. I had called to tell her I was going to stop by. “I’m some place,” she answered, her voice low, rough, panicky. “I don’t know where.” “Inside?” I asked. “Outside?” She couldn’t say. I kept her on the line, probing for clues. Finally, in the background, I heard a kind neighbor offering to help. When I arrived, they were seated on my mother’s favorite earth-toned sofa, her friend soothing her; my mother staring ahead, stunned that she had gotten lost one floor below her own apartment. Although she had been diagnosed with Alzheimer’s disease a year earlier, this was the first time I absorbed how terrifying it could be. Not only for her, but for me as I contemplated this unfamiliar person in my mother’s body, so lost, so childlike. In 34 years of family practice, I had many patients with cognitive impairment. I had friends whose parents had dementia. How had I not realized how much pain it caused? Or that I someday would know that pain? Once orderly, my mother now scatters clothes across her room as she compulsively “organizes.” My siblings and I have watched our mother be transformed into a fragile, bewildered old woman, adrift in a vast sea without landmarks or time pieces. Where is the mother we knew, who rose through pure grit from dire poverty in the hinterlands of Argentina after her family escaped Eastern Europe? The mother who could do everything — cook, clean, garden, knit, coordinate her children’s activities and work full time? The mother who even recently was an indomitable force, insisting on directing my father’s care and resisting help for herself? As I busy myself making sure her needs are met, sometimes simmering beneath the surface, sometimes screaming its way into my consciousness, is a searing pain. How did all this come as such a surprise? My grandmother had Alzheimer’s disease in her early 80s, but my mother passed that age intact. In their mid 80s, my parents had rich intellectual and social lives. Dementia, I thought, happened to other people’s parents. No longer able to hide from the dual realities that dementia has struck
my family and that it begets suffering, I see now that denial has been a stubborn undercurrent in my life. At 54, when called to follow up on a mammogram, I ignored the first two messages. My diagnosis of breast cancer shocked me. In the right demographic and without risk factors for heart disease, I had figured cancer was probably in my future — but my distant future. I knew that no one is ever ready, but I did not find this consoling. My head told me I should ponder my confrontation with mortality but by the third early-morning radiation treatment, I could focus only on getting out to get to work. After weathering surgery and radiation, I resumed my roles as mother, wife and doctor as if serious illness were a mere ripple in my identity as the healer.
Where is the mother we knew… who could do everything — cook, clean, garden, knit, coordinate her children’s activities and work full time?
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Five years later I had bladder cancer, discovered incidentally at the end of pelvic reconstruction surgery. I was in the entirely wrong demographic for this one — wrong gender, wrong age, wrong smoking status, no occupational hazards. “Why?” I asked. “You’re an outlier,” my doctor said. It was a doctor kind of reply that, as a patient, I found neither enlightening nor comforting. At times, I felt intensely vulnerable. I agonized while waiting for biopsy results that would determine my fate. Results often were excruciatingly late, and I realized they did not have the same urgency for those who controlled them as they did for me. A doctor’s casual aside, which barely hinted of some ominous possibility, could leave me fretting for days. With both cancers, I experienced profound fatigue that rest did not relieve. I started taking walks immediately after my pelvic reconstruction and
Feature cystoscopies. When I returned home, I crawled back into bed, completely spent. If I tried to power through, I was punished by a headache and exhaustion that lasted the entire day. I now see I had maintained a barrier to the recognition that such illnesses could afflict my own family. And, instead of peeking over it, I stood resolutely behind, expending considerable effort to maintain my experiences. And embarrassed, as I reflect on all the patients to whom I may have spoken casually without realizing the impact of my words, whose profound fatigue I did not appreciate, who endured illnesses without the support and resources I had. How many times I wondered, had I dismissed my patients’ questions with bromides masquerading as answers? I think of the parents whom I nonchalantly reassured without realizing how their concerns about their children shook their cores. In my earlier life and career, denial had its uses. It prevented the paralysis that might have ensued had I realized how fraught with challenge and sadness the road ahead might be. More recently, my personal entanglements with suffering have changed me. Where once I tried to help people with issues I thought I never would encounter, I now realize their circumstances could be mine. Seeing difficult situations that have not befallen my family — substance abuse, estrangement, domestic violence — I now am less likely to judge and more able to be attuned to the pain.
When my dignified, gentle octogenarian patient came with her granddaughter, and they complained of her memory loss, the anguish beneath their calm demeanors touched the anguish about my mother in my own heart. I felt their fear of her loss of her cherished autonomy. I listened carefully to their concerns. Referring her for further evaluation, I reassured them I would continue to be her primary care doctor. And then there was my longstanding patient with cocaine-related cardiomyopathy, who glowed with pride at her progress in literacy. I had seen her through years of cocaine abuse, treatment and then recovery. Though fond of her, I had felt a chasm separated her problems from mine. Now, as I rejoiced with her, I felt only a fine line of luck and fate divided us. Knowing fear, vulnerability, and helplessness has opened me to empathy and connection with others. Denial has its place. But having life shatter the protective walls of denial and free the energy required to maintain them has proved strangely liberating.
Charlotte Physicians Lead the Way for Healthier Air at Hospital Construction Sites
(PM2.5) can have lethal effects. Dr. Raymond noted that one of the most dangerous sources of PM2.5 comes from diesel engines, even when they are idling. He concluded North Carolina should join the other 35 states that have enacted mandatory idling limits to improve air quality.
Lawrence Raymond, MD, Thomas Zweng, MD, and Stephen Keener, MD, MPH, recently celebrated a major clean air victory with leaders of Novant Health, Atrium Health and Clean Air Carolina, a Charlotte-based statewide advocacy group. Drs. Raymond and Keener serve on the advisory board for Medical Advocates for Healthy Air (MAHA), a Clean Air Carolina initiative. At a meeting several years ago, as part of the Mecklenburg County Raymond Medical Society Public Health Committee, they proposed the use of new construction equipment and anti-idling practices to reduce toxic diesel emissions at hospital construction sites. The two healthcare systems worked together in 2017 to develop a facilities standard requiring the use of lowemission equipment and anti-idling signage. These measures Zweng will help protect the health of patients, hospital visitors, staff, construction workers and neighbors. The commitment to prioritize clean construction practices by Novant Health and Atrium Health serves as a model for other healthcare systems in North Carolina and the Southeast. According to the EPA, Keener every dollar spent on reducing diesel pollution results in $13 in public health benefits. Email MAHA Manager Rachel McIntoshKastrinsky to learn more about the Clean Construction Partnership at rachel@cleanaircarolina.org.
Lawrence Raymond, MD, Encourages State Mandatory Idling Limits for Diesel Engines
On October 12, Lawrence Raymond, MD, published a letter to the editor in the “New England Journal of Medicine” discussing the recent study by Di et al., 2017, that showed that even at levels below the National Ambient Air Quality Standard, fine particulate matter
Reprinted version of an essay published in “On Being A Patient” in Annals of Internal Medicine, December 5, 2017. Access essay at http://annals.org/aim/article-abstract/2664839/denial.
Idle-Free Schools Campaign Clears the Air for Kids
Clean Air Carolina’s Clear the Air for Kids Program is providing educational signage and other air quality resources to public schools in Mecklenburg, Gaston, Union, Cabarrus, Lincoln and Rowan counties to discourage unnecessary idling from cars and buses on school grounds. Signs will be placed near school bus lots and along the drop-off/pick-up line. More than 800 signs are being provided to 391 schools. Unnecessary idling is a chronic community problem that impacts public health. Most people don’t realize their vehicles are a source of air pollution. When buses and cars are idling at the same time on school campuses they create a plume of pollution that is hard to escape. Children’s lungs are still developing and they have a faster breathing rate than adults, making them more vulnerable to the impacts of pollution. Research has shown that reducing air pollution leads to improved lung function in children ages 11-15, a critical period in lung development. Help our children breathe easier by turning your engine off if you expect to be idling for less than 30 seconds. Reprinted with permission from Clean Air Carolina.
Mecklenburg Medicine • April 2018 | 7
Feature A Novel Muscle Transfer for Independent Digital Control of a Myoelectric Prosthesis:Â
The Starfish Procedure By R. Glenn Gaston, MD, Chief of Hand Surgery Atrium Health, OrthoCarolina Hand and Upper Extremity Fellowship Director Bryan J. Loeffler, MD, Clinical Faculty, OrthoCarolina Hand & Upper Extremity Fellowship, Atrium Health Department of Orthopaedic Surgery
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ignificant technical advancements have occurred with upper extremity prosthetics in recent years, yet the goal of achieving independent finger control has remained elusive given the limitations of the human-prosthesis interface. Muscle contractions must generate a sufficient amplitude of electric current to be detected by the surface electrodes which power these prosthetics. However, in patients with partial or total hand amputations, the requisite number of functioning, detectable muscles is lacking. As a result, control of current myoelectric hand prosthetics is very unnatural and non-intuitive and thus often abandoned by patients.
The Starfish Hypothesis
In patients with partial hand amputations, the interosseous muscles often are still present and innervated, yet their deep position in the hand prevents surface electrodes from detecting the signals generated by their contractions. If these muscles could be transposed to the dorsum of the hand without injuring the associated neurovascular pedicles, could they serve as myoelectric signals for a patient with a partial hand amputation? If so, could this lead to the
8 | April 2018 • Mecklenburg Medicine
development of a highly intuitive prosthesis since the interossei naturally initiate finger flexion? Could this concept be applied at an even more proximal level?
The Starfish Naming
First, a cadaveric study was undertaken to validate the proposed surgical technique of transposing the interossei while preserving the neurovascular bundles. When all interossei, along with the thenar and hypothenar musculature, were raised simultaneously with the pedicles the resultant appearance was that of a starfish. This appearance, coupled with the starfish’s unique ability to regenerate lost limbs, led us to term this surgery the Starfish procedure. In this cadaveric study, all the hand intrinsic muscles were able to be mobilized as a group while maintaining neurovascular pedicles up to the mid-forearm level.
The Starfish Procedure
Prior to embarking on this surgery, the viability and functionality of the interosseous muscles must be confirmed either in the operating room at the time of initial injury or by EMG preoperatively.
Once confirmed, the terminal portion of each metacarpal is resected to allow sufficient room for the prosthetic componentry and to make the prosthetic digits match the natural finger lengths. The desired interossei are then mobilized from the metacarpals while maintaining nerve and blood supply. These muscles then are transferred to a subcutaneous location on the dorsum of the hand. Soft tissue interpositions then are created and placed between the transferred interossei to create a buffer between the individual interosseous muscles. This minimizes myoelectric cross-talk between the transferred muscles and allows cleaner signal detection by The opportunity to the surface electrodes. salvage muscles that With this technique, each preserved interosseous muscle will contract when the retain their nerve and patient attempts to initiate digital flexion of the corresponding finger. The muscle contraction blood supply and transfer generates a myoelectric signal that can be them proximally into the detected by a surface electrode, which transmits the signal to the prosthetic digit. When the residual limb to allow prosthetic digit receives that signal it flexes thus producing the patient’s desired function. Because increased highly intuitive each transferred muscle corresponds to a single myoelectric signals finger and each muscle has its own sensor and prosthetic finger, individual digital control is has broad potential possible. (Figures 2 &3)
Results
NEW MEMBERS Ingrid S. Bullard, MD Obstetrics and Gynecology Novant Health Rankin OB/GYN 1918 Randolph Road #670 Charlotte, NC 28207 704-384-1620 East Carolina University, 2000
Charles Edwin Stoddard III, MD Nephrology Metrolina Nephrology Associates 433 Copperfield Boulevard NE Concord, NC 28025 704-786-7770 Medical University of South Carolina, 2001 Nady Hamid, MD Orthopaedic Surgery OrthoCarolina 1915 Randolph Road Charlotte, NC 28207 704-323-3190 University of Alabama, 2005
applications for improved prosthetic function.
At the OrthoCarolina Reconstructive Center for Lost Limbs, we now have performed seven Starfish procedures for partial hand amputees, ranging from two to four fingers lost. In all cases, robust palpable and detectable signals were detected immediately following surgery. Patients demonstrated the ability to naturally control each prosthetic finger in a highly intuitive manner even at the two-week post-op visit. The index patient now is over two years from surgery and is capable of natural independent finger motion. He can both pick a flower and lift a 20lb dumbbell. He is the first-ever patient with individual digital control of a prosthetic following a partial hand amputation.
The Future
Following the Starfish procedure, the transferred muscles provide independent signals to power individual digital control of a myoelectric hand prosthesis. This concept of salvaging muscles with remaining nerve and blood supply from a mangled extremity and transferring them into a more proximal location during amputation has the potential to markedly enhance available signals for myoelectric detection and hence function. This technique has the potential to create similar individual digital control for even more proximal level amputations. Our cadaveric study demonstrates the potential for applying this concept to more proximal level amputations including the potential for a myoelectric hand with all five digits capable of independent control. This could potentially be performed even at the level of the distal forearm amputation. The opportunity to salvage muscles that retain their nerve and blood supply and transfer them proximally into the residual limb to allow increased highly intuitive myoelectric signals has broad potential applications for improved prosthetic function.
Enhancing Care for Patients With Upper Extremity Amputations An increasing volume of patients with upper extremity amputations, coupled with innovative surgical and technological advancements, as well as a passion for the care of these patients led Drs. Gaston and Loeffler to found the OrthoCarolina Reconstructive Center for Lost Limbs (www.orthocarolina.com/RCLL). This monthly clinic provides multidisciplinary care and an opportunity for social support to amputees from the region and across the nation with surgeons, prosthetists, and therapists collaborating to maximize quality and efficiency of care.
Upcoming Meetings APRIL
Meetings are at the MCMS office unless otherwise noted. n
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Tuesday, April 10 MedLink meeting Community Care Partners of Greater Mecklenburg 4701 Hedgemore Drive, Charlotte 8:30 a.m. Friday, April 13 Child Health Committee meeting 7:30 a.m. Monday, April 16 Executive Committee meeting 6 p.m. Thursday, April 19 CAMGMA Social Time and Location TBD Monday, April 23 June magazine deadline
Mecklenburg Medicine • April 2018 | 9
At the Hospitals Novant Health Opens New Congestive Heart Failure Clinic Novant Health Heart & Vascular Institute continues to grow and expand to increase access for patients. A satellite office for the congestive heart failure clinic recently opened at 1718 E. 4th St., suite 604, in the Presbyterian Medical Tower. This clinic provides a new and updated space for cardiology patients who have been diagnosed with heart failure. Patients can be referred at 704-343-4424. n
Novant Health Rehabilitation Center and Novant Health Sports & Performance Medicine Powered By EXOS Opens in Arboretum Area Novant Health Rehabilitation Center and the Novant Health Sports & Performance Medicine powered by EXOS performance facility has opened in the Arboretum. This combined specialty location at 8045 Providence Road, Suite 100, offers outpatient physical therapy, sports medicine services, performance training and performance nutrition. To learn more or schedule an appointment, call 704-316-1222. n
Novant Health Rehabilitation Center Arboretum Rehabilitation hours: Monday-Thursday, 7 a.m.-6 p.m., and Friday, 7 a.m.-4 p.m. The Rehabilitation Center provides outpatient physical therapy services for all orthopedic conditions, including treatment for spine disorders, sports medicine, balance disorders, as well as rehabilitation for post-surgical patients. Novant Health Sports & Performance Medicine powered by EXOS Performance training hours: MondayThursday, 5 a.m.-7 p.m., Friday, 5 a.m.-6 p.m., and Saturday, 9-10 a.m. The performance facility is a state-of-theart space dedicated to providing youth, high school and adult athletes of any fitness level with comprehensive performance training. In addition to performance training, the facility offers performance nutrition consultations with a registered dietitian and sports medicine services, including manual therapy, soft tissue work and sports injury care. Novant Health Matthews Medical Center Opens New Breast Center Novant Health Matthews Medical Center recently held a grand opening for its new breast care center. The state-of-the art center located inside the hospital has doubled in size and offers the most comprehensive imaging services available. The center offers patients a spa-like environment complete with infused water in the waiting room, a check-in kiosk, cell phone charging stations, massage chairs and aromatherapy. To learn more or schedule an appointment, call 704-384-SCAN. n
New Physician Joins Novant Health Thoracic Surgery Jonathan D. Kraut, MD, has joined Novant Health Thoracic Surgery at 301 Hawthorne Lane, suite 200. Dr. Kraut specializes in minimally-invasive thoracic surgery and is boardcertified in thoracic surgery. He is a fellow in the American College Kraut of Surgeons and is a member of the Society of Thoracic Surgeons and the Southern Thoracic Surgical Association. Kraut earned a medical degree from St. George’s University School of Medicine in Grenada, West Indies. He completed a general surgery residency at Christiana Care Hospital in Newark, Del., and a cardiothoracic surgery fellowship at Saint Luke’s Hospital in Kansas City, Mo. For more information or to refer a patient, call 704-316-5100. n
Joe Gibbs Racing and Novant Health Expand Partnership Novant Health is now the official sports medicine provider for Joe Gibbs Racing, providing specialized orthopedic care, rehabilitation, athletic training, wellness services and consultants for performance potential. With this partnership, Novant Health is the exclusive healthcare provider of sports medicine to Joe Gibbs Racing’s four Monster Energy NASCAR Cup Series teams and three NASCAR XFINITY Series teams. n
Psychiatric Clinic Opens in Concord Novant Health continues to grow and expand its behavioral health services with the opening of Novant Health Psychiatry in Concord. The new clinic is at 845 Church St. N., suite 203. The clinic is staffed by Sumana Gadde, MD, who completed her Gadde internship and residency in general psychiatry at the University of Louisville n
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School of Medicine and her fellowship in child and adolescent psychiatry at Vanderbilt Medical Center. Dr. Gadde offers clinical assessments and referrals, individual therapy to children, adolescents, adults, geriatric, group therapy, psychiatric assessments and treatment and medication management. For more information or to refer a patient, call 704-316-5027. Novant Health Mint Hill Medical Center Accepting Applications When Novant Health Mint Hill Medical Center opens in October, the Mint Hill area will have a comprehensive, state-of-the-art hospital to call its own — with expert emergency, inpatient and outpatient care, and specialized care close to home. The new hospital currently is accepting applications for the following opportunities: nursing and inpatient care; emergency services; laboratory services; radiology; respiratory therapy; pharmacy; rehabilitation; and operating room. For employment information or to view all available positions, visit NovantHealth.org/ MintHillTeam.
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NATIONAL HEALTH & WELLNESS OBSERVANCES APRIL 2018 Alcohol Awareness Month Autism Awareness Month Cancer Control Month Child Abuse Prevention Month Counseling Awareness Month Donate Life Month Humor Month Minority Health & Health Disparities Month Occupational Therapy Month Sexual Assault Awareness Month Stress Awareness Month Testicular Cancer Awareness Month Women’s Eye Health and Safety Month April 2-8: Public Health Week April 4: Day of Hope April 6-8: Alcohol-Free Weekend April 7: Alcohol Screening Day April 7: World Health Day April 16: Healthcare Decisions Day April 21-27: Infant Immunization Week April 22: Earth Day April 22-28: Environmental Education Week April 23-29: Medical Fitness Week April 26: Take Your Daughters and Sons to Work Day
At the Hospitals
New Tool Offers Charlotte-Area Community Members the Ability to Search Available Free or ReducedCost Social Services Atrium Health has launched its Community Resource Hub, which is serving as a search, referral and application tool to help the Charlotte community locate free or reduced-cost social service programs. With this new tool, Atrium Health aims to extend care outside of doctors’ offices and provide better access to services that reduce healthcare barriers. The Community Resource Hub connects Atrium Health providers, social workers and individuals in the Charlotte area to organizations that offer key social services, including legal assistance, transportation, housing and food. It allows users to choose from thousands of available resources anyone can access — local and national. The Community Resource Hub quickly populates facilities and programs that meet individualized needs to help users make more informed decisions without needing to search multiple websites. Individuals may search the hub on their own and can easily navigate the platform by category or keyword to identify programs that meet their needs. For example, users can select “transportation” to see available programs that provide transportation to schools or hospitals, or those that help pay for transit depending on their need. Users also may narrow results by eligibility criteria, such as income, age or family size. Once a program has been selected, the Community Resource Hub provides the next steps to take, as well as a detailed description of the program, hours of operation, location details and contact information. For the launch of the Community Resource Hub, Atrium Health initially is partnering with 15 Charlotte-area organizations, allowing partners and providers to refer users to facilities and programs that meet individualized needs. Once a referral is
made, information automatically is sent to the user and the selected agency to proactively connect the user in need. For more information and to search available programs, visit the Community Resource Hub at CarolinasHealthCare.org/ CommunityResourceHub.
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Mental Health Emergencies Happen — Learn How to Help Millions of people each year take a CPR or first aid class to learn how to recognize and care for a variety of medical emergencies. But what about someone experiencing a mental health emergency? That’s where Mental Health First Aid (MHFA) comes in, educating our community on how to reach out and help those around us who may be struggling with suicide, mental illness or a substance use disorder. MHFA is a free, eight-hour course that teaches how to identify, understand and respond to signs of addictions and mental illness — from the beginning stages all the way through crises. As part of a national effort, Atrium Health has been offering free MHFA training to individuals and groups across the community for three years and has trained more than 10,000 people. Interested? Anyone can sign-up for a course, just email MHFA@CarolinasHealthCare.org or call 704-631-1028. Wondering how you can help someone in need? MHFA follows a five-step action plan called ALGEE to help those who may be dealing with suicide, mental illness or substance use disorders. Here are the steps: 1. Assess for risk of suicide or harm. Some warning signs include threatening to hurt or kill oneself, seeking access to means to hurt or kill oneself, talking or writing about death and feeling hopeless. 2. Listen nonjudgmentally. MHFA teaches you to use verbal and nonverbal skills such as open body posture, comfortable eye contact and other strategies to take part in appropriate conversation. 3. Give reassurance and information. MHFA provides information and resources you can offer to someone to offer emotional support and practical help. n
4. Encourage appropriate professional help. Types of professionals include primary care physicians, psychiatrists, social workers, counselors and certified peer specialists. Types of professional help include talk therapies, medication and other professional supports. 5. Encourage self-help and other support strategies. People with mental illness can support their own recovery and wellness through exercise, relaxation, meditation, participating in peer support groups and using self-help books. If you or someone you know is experiencing a mental illness or substance use disorder, call the Behavioral Health Help Line at 704-444-2400 or 800-4182065 for 24/7 crisis assistance or text CONNECT to 741741. Sanger Heart & Vascular Institute Performs First-in-World Stent Implantation Atrium Health Sanger Heart & Vascular Institute’s clinical team has enrolled and treated the first patient in the investigational device exemption study for a venous selfexpanding stent system. Erin Murphy, MD, FACS, director of Sanger Heart & Vascular Institute’s venous and lymphatic program, and Gregory Stanley, MD, FACS, vascular surgery fellowship director, performed the venous procedure on the first patient in the world in December 2017 at Atrium Health’s Carolinas Medical Center. The patient, who has nonthrombotic iliac vein lesion (NIVL), is doing well post-treatment. The implantation is part of a multicenter international trial, with Murphy leading clinical research efforts as the lead principal investigator for the ABRE IDE trial in the United States. “Deep venous obstruction impacts more than 27 million people worldwide and can result in limited mobility and poor quality of life,” says Dr. Murphy. “By investigating a new form of iliac vein stenting, we are committed to exploring the latest treatment options for patients.” Sanger Heart & Vascular Institute teams perform more than 2,500 vascular procedures annually, with comprehensive vein treatment for a variety of vein complications. n
Mecklenburg Medicine • April 2018 | 11
Independent Physicians of the Carolinas
Independent Physicians of the Carolinas is a nonprofit 501(c)(6) membership organization whose mission is to create public awareness of medical doctors not employed by a network or hospital system and to provide educational programs and resources to physician members and their administration. Visit us at IndependentPhysicians.org. Oncology Specialists of Charlotte has a new Head & Neck clinical trial in the Javelin solid tumor studies: A Randomized, Double-Blind, Phase 3 Study of Avelumab in Combination with Standard of Care Chemoradiotherapy (Cisplatin Plus Definitive Radiation Therapy) Versus Standard of Care Chemoradiotherapy in the Front-line Treatment of Patients with Locally Advanced Squamous Cell Carcinoma of the Head and Neck. To learn more about the study or to inquire on patient enrollment, email lauren. jordan@djlresearch.com or call 704-247-9179, ext. 202.
now comprises 22 board-certified physicians and nine advancedlevel practitioners who have been serving the Charlotte area for more than 40 years. The practice offers diagnostic and therapeutic endoscopy, clinical research trials, infusion therapy, web-based care management tools and professional nutritional counseling. Charlotte Gastro stays committed to its patients by providing the highest quality, state-of-the-art care. The National Committee for Quality Assurance (NCQA) has awarded Carolina Family Healthcare the level 3 (highest level) recognition for Patient Centered Medical Home. PCMH is a team-based healthcare delivery model led by a healthcare provider to provide comprehensive and continuous medical care to patients with a goal to obtain maximal health outcomes. The provision of PCMH is intended to allow better access to health care, increase satisfaction with care and improve health. To learn more about the Patient Centered Medical Home, visit https://pcmh.ahrq. gov/page/defining-pcmh.
Advertising Acknowledgements The following patrons made Mecklenburg Medicine possible.
Arthritis & Osteoporosis Consultants of the Carolinas........................3 The 5th Annual “Fore The Cure” golf tournament to benefit Susan G. Komen Charlotte will take place May 21 at Raintree Country Club. Joanne Monaco, chemo nurse at Oncology Specialists of Charlotte, spearheads this event to support breast cancer patients and the detection and prevention of breast cancer in our community. To join the golf team, sponsor, or donate items for the event, email joannetmonaco@gmail.com. Queen City Plastic Surgery is the first in Charlotte to offer Bodytite, the latest minimally-invasive body contouring and lipolysis option. This treatment is for the face and body and can be performed in office. For more information, call the office at 704-372-5685. Happy 20th anniversary to Charlotte Gastroenterology & Hepatology. April 1, 1998 may seem like an odd day to start a business, however, this venture was no April Fool’s joke! In the past 20 years, CGH has grown from one location to five offices and four endoscopy centers. The healthcare provider team
12 | April 2018 • Mecklenburg Medicine
Atrium Health.........................................................................................15 Carolina Asthma & Allergy Center......................................................14 Charlotte Eye Ear Nose & Throat Associates.....................................14 Charlotte Radiology...............................................................................13 Flagship Healthcare Properties............................................................ 13 LabCorp..................................................................................Back Cover Novant Health...........................................................................................2
LAKE NORMAN MEDICAL PLAZA 134, 146, & 170-A Medical Park Road | Mooresville, North Carolina
PROPERTY HIGHLIGHTS • Three (3) Class “A” medical office buildings • 134 Medical Park Rd: ± 21,576 SF available • 146 Medical Park Rd: ± 1,880 to ± 7,390 SF available • 170-A Medical Park Rd: ± 3,432 to ± 9,534 SF available • Walk to Lake Norman Regional Medical Center • Proximate to Lowe’s Home Improvement Headquarters • Excellent accessibility and parking with close proximity to I-77, I-40, and I-85. WILL ROBERTSON d. 704-971-8904 will@FlagshipHP.com
GREG McINTOSH
d. 704-749-7248 greg@FlagshipHP.com
Flagship Healthcare Properties (FHP) is a full-service real estate firm providing comprehensive solutions for our healthcare system and physician clients, including: capital, development, leasing, asset and property management, accounting, marketing, and investment expertise to a diverse, growing, and healthcare-centric portfolio of properties.
2701 Coltsgate Road, Suite 300 | Charlotte, North Carolina 28211 | 704-442-0222 | www.flagshiphp.com
Mecklenburg Medicine • April 2018 | 13
Ah...Ah...Ah...SPRING!
IT’S THAT TIME OF YEAR AGAIN. WE CAN HELP YOUR PATIENTS BREAK THE SEASONAL ALLERGY CYCLE. If you have patients who suffer from seasonal allergies year after year, it’s tempting for them to try over-the-counter remedies that may help ease their symptoms, but can leave them groggy or drowsy. Our board-certified allergists can test to discover exactly what your patients are allergic to, create a customized treatment plan that over time can lessen the severity of symptoms, and, in many cases, cure their allergies altogether! Call 704.372.7900 today to refer your patients to any of our 12 convenient office locations.
breathe » live » thrive | www.carolinaasthma.com
GOLFING FORE A HEALTHY CHARLOTTE
Patients with hearing loss?
BENEFITING CARE RING
April 23, 2018 | Carolina Golf Club
Help them hear clearly again with a referral to CEENTA. ceenta.com | 704.295.3300
For more information, visit www.careringnc.com/golfing
14 | April 2018 • Mecklenburg Medicine
A PLACE…
filled with light
where each and every heartbeat begins
A GATHERING GROUND…
Where diverse thinkers come together And connections are made
AN AMBITION…
Working with partners to build something new To better more lives
Bringing health, hope and healing
FOR ALL
Carolinas HealthCare System is Mecklenburg Medicine • April 2018 | 15
Mecklenburg County Medical Society
PRSRT STD U.S. POSTAGE PAID CHARLOTTE, N.C. PERMIT NO. 1494
1112 Harding Place, #200 Charlotte, NC 28204 CHANGE SERVICE REQUESTED MCMS Mission: To unite, serve and represent our members as advocates for our patients, for the health of the community and for the profession of medicine. Founders of: Bioethics Resource Group, Ltd., Hospitality House of Charlotte, Teen Health Connection, N.C. MedAssist, Physicians Reach Out
LabCorp Laboratory Corporation of America
PATIENT SERVICE CENTERS
Ballantyne Billingsley** Carmel** Cabarrus Charlotte Charlotte** Gastonia Stat Lab Huntersville Huntersville** Lake Norman Matthews Northridge* Pineville Rock Hill Salisbury** Shelby Statesville** University**
… for all of your laboratory testing needs
15830 John Delaney Drive 300 Billingsley Road, Suite 200A 5633 Blakeney Park Drive, Suite 100 478 Copperfield Blvd. 8401 Medical Plaza Dr, Ste 140 1718 E. 4th Street 660 Summitt Crossing, Suite 206 16525 Holly Crest Lane, Suite 250 10030 Gilead Road, Suite B100 134 Medical Park Drive, Suite 102 1500 Matthews Township Parkway, Suite 1147 5031-G West W.T. Harris Blvd. 10410 Park Road, Suite 450 2460 India Hook Road, Suite 101 601 Mocksville Avenue 809 N. Lafayette Street 1710-A Davie Avenue 10320 Mallard Creek Road
*Drug Screens only **Blood Draws only
16 | April 2018 • Mecklenburg Medicine
Charlotte, NC Charlotte, NC Charlotte, NC Concord, NC Charlotte, NC Charlotte, NC Gastonia, NC Huntersville, NC Huntersville, NC Mooresville, NC Matthews, NC Charlotte, NC Pineville, NC Rock Hill, SC Salisbury, NC Shelby, NC Statesville, NC Charlotte, NC
704-540-0251 704-332-6904 704-542-7061 704-795-2710 704-372-6609 704-372-6609 704-854-9497 704-948-8101 704-875-9130 704-799-6230 704-849-0154 704-598-6266 704-341-1145 803-328-1724 704-637-1676 704-480-7004 704-878-0948 704-549-8647