July/August 2014 • Vol. 44, No. 7
Mecklenburg Medicine A Publication of the Mecklenburg County Medical Society | www.meckmed.org
Mecklenburg County Medical Society • Mecklenburg Medical Alliance and Endowment Founders of: Bioethics Resource Group, Ltd., Hospitality House of Charlotte, Teen Health Connection, N.C. MedAssist, Physicians Reach Out
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July/August 2014 Vol. 44 No. 7
Table of Contents 6
President’s Letter: Patient Satisfaction ... Is It Possible?
By James B. Hall, MD
OFFICERS President James B. Hall, MD
President-Elect Simon V. Ward III, MD
8 Feature: TranscendED: A First for Eating Disorder Treatment in Charlotte
By Rebecca Glavin, MBA
8
National Health & Wellness Observances for July and August
9
Feature: Non-Traditional Medical Modalities – A Growing Trend By Babak Mokari, DO
10 Feature: River Jam Fiesta at the U.S. National Whitewater Center
Secretary Stephen J. Ezzo, MD Treasurer JP McBryde, MD
Immediate Past President Janice E. Huff, MD
BOARD MEMBERS Lloyd L. Bridges, MD Raymond E. Brown, PA Scott L. Furney, MD W. Frank Ingram III, MD Scott L. Lindblom, MD Shivani P. Mehta, MD Elizabeth B. Moran, MD Cheryl L. Walker-McGill, MD Thomas N. Zweng, MD
EX-OFFICIO BOARD MEMBERS Sherry Ward, President Mecklenburg Medical Alliance & Endowment Sandi D. Buchanan, Executive Director Mecklenburg County Medical Society
12 MMAE News
Keia V. R. Hewitt, MD, President Charlotte Medical Society
13 Member News
Docia E. Hickey, MD NCMS Speaker of the House
14 At the Hospitals
Darlyne Menscer, MD NCMS Delegate to the AMA
16 Independent Physicians of the Carolinas
Marcus G. Plescia, MD, Health Director Mecklenburg County Health Department Douglas R. Swanson, MD, FACEP, Medical Director Mecklenburg EMS Agency
16 Advertising Acknowledgement
EXECUTIVE STAFF Executive Director Sandi D. Buchanan
1112 Harding Place, #200, Charlotte, NC 28204 704-376-3688 • FAX 704-376-3173 meckmed@meckmed.org Copyright 2014 Mecklenburg County Medical Society
Director, Meetings & Special Events Trisha G. Herndon Executive Assistant Stephanie D. Smith
MECKLENBURG MEDICINE STAFF
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. Non-members may subscribe to Mecklenburg Medicine at a cost of $30 per year, or $3.50 per issue, if extra copies are available. 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.
Editor Mark E. Romanoff, MD Managing Editor Sandi D. Buchanan Copy Editor Lee McCracken
Advertising Mark Ethridge mecklenburgmedicine@gmail.com Editorial Board N. Neil Howell, MD James B. Hall, MD Jessica Schorr Saxe, MD
Graphic Design — Wade Baker
Mecklenburg Medicine • July/August 2014 | 5
President’s Letter
Patient Satisfaction ... Is it Possible?
By James B. Hall, MD, President
I
n 2001, the Institute of Medicine designated “patient centeredness” as one of six goals for a 21st-century health care system, and now, in fulfillment of that pronouncement, “Patient Satisfaction Scores” have become the sine qua non of quality patient care. Hospitals give primary abeyance to it because of the relationship engendered by provisions in the Patient Protection and Affordable Care Act (ACA) that directly impact hospital reimbursements via the Hospital Consumer Assessment of Healthcare Providers and System scores (HCAHPS). Under the federal health reform law, hospitals are looking at about $1 billion in Medicare reimbursements as a function of these scores. There is a provision for patients to “report and rate their hospital experiences” online at RateHospitals.com. The idea is that this will provide valuable feedback to future patients and hospitals, so that the institutions can identify their strengths and weaknesses. Thus, in the ideal world, objective and learned input will result in overall improvement in the delivery of quality health care for all of our patients, resulting in, dare I say, improvement in our patient satisfaction scores. Putting this into perspective, this thought process was summarized in one article I read (now here’s a scary thought), that “patient satisfaction will significantly define the future of health care in the United States.” This brought to mind an article from Forbes Magazine on patient satisfaction, in which they quoted an ER physician from South Carolina who noted that he gave Dilaudid to all the patients who came in with chronic pain complaints, so he got great patient satisfaction scores. We are fortunate in Charlotte to have two excellent acute care hospital systems that are staffed by well-trained physicians, who demonstrate on a daily basis a desire to provide excellent care that is patient/family focused and who seek to have their patients leave feeling a real sense of satisfaction, knowing that they and their loved ones have received the best care possible. But when I went online to “RateHospitals.com,” the first two institutions listed were the Marina Del Rey Hospital in California (a 90-bed short-term acute care hospital) and the Memorial Hermann Katy Hospital (a 140-bed short-term acute care hospital), which also was described as an “urban” hospital in the metropolis of Katy, Texas. So, when patients rate us, please recognize that it is often an “apples and oranges” comparison. These are issues of “real dollars” for our hospitals as based on a 27-question government survey developed by the Agency for Healthcare Research and Quality (AHRQ) for the Centers for Medicare & Medicaid Services (CMS) which will be given to our patients, the government will use it to dole out the Medicare payments. There will be a rate cut of 1 percent this fiscal year, which will then increase to 2 percent
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by 2017. These hold-backs will be redistributed as a “bonus” to high-performing/scoring hospitals, and conversely, those that score low will lose money. The areas measured include reasonable metrics, like how quickly interventions are given for heart attacks or how soon antibiotics were started for pneumonia, but also for “how often did doctors treat you with courtesy and respect” or “how often were your room and bathroom kept clean,” which may be very subjective. Conceptually, this is a worthy effort as we all want to improve the quality of the care and ambiance that we offer our patients. Certainly, the development and identification of metrics of quality are important, and by definition demands that we objectively collect data and document whether we are achieving those metrics. And therein lies the problem. It is difficult for most people to step outside of themselves and be objective about what we do and how we do things. We see the reality of this with North Carolina Medical Board newsletters that list in black and white the shortcomings that some of our colleagues have gotten entangled with by making bad decisions; we see it when some of us should have retired a year or two earlier; we see it in medical decisions that are made, and we think, “There but for the grace of God go I!” We all remember the imperative, “Primum non nocere.” Where the rubber meets the road is who chooses the metrics, and what determines quality. Is a hospital in the urban city of Katy, Texas fraught with the same issues of patient care as are our hospitals in Charlotte? The medical quality metrics are something we as physicians and hospitals can control. When used appropriately to actually measure something as opposed to “checking off a box” to prove that you did it, this can improve the care we give our patients. What we can’t do is control patients’ perceptions. This then raises the question of just who are these “companies” that are doing the surveys which impact hospitals and physicianemployees financially. We have seen a proliferation, dare I suggest metastatic growth, of this new industry which has
“... patient satisfaction will significantly define the future of health care in the United States.”
nothing to do with medicine, but simply is a new business that has seen a vacuum and filled it with regulations. Companies like Press-Gainey somehow have become the end-all in the establishment of what they perceive as the benchmark of quality and the administering of patient satisfaction surveys. While the statistical validity of the various instruments used are assumed to be a given, I would suggest we all need to look at these. The structure of the questions, the number of questions, the “n” of the sample, etc., are issues that even on a superficial glance, call into question the validity of the reports they generate, and yet, upon which we are judged. To offer just one example, a fellow oncologist had a patient respond to a questionnaire, “that Dr. ‘X’ has saved my life twice, BUT I just wish he would spend more time with me in the office.” There are a couple of different ways the patient’s comment could be interpreted. In spite of my cancer and because of Dr. “X”s expertise, thank God I’m still alive; or, conversely, Dr. “X” just doesn’t spend enough time with me when I’m in the office. Which way would you guess the patient’s statement was interpreted on her survey? Wrong. The evaluation noted he didn’t spend enough time with the patient. This begs the question, how much is enough? What about the patient who wants (as opposed to needs) pain medicine? What about the patient who had to wait so the patient before her “had enough time” during her office visit?
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I guess my problem is that I’m left with the question, “Are we still a profession or are we a hotel?” Personally, I resent that most of the recent expenditure of healthcare dollars has nothing to do with the advancement of our ability in the treatment of disease, but has everything to do with the burgeoning growth of ancillaries that serve only to support the support. I would love to know just how much money has been spent by all of the hospitals in the United States on the infrastructure (hardware and software) and the supporting IT folks for our conversion to EMR? How much has been spent on the governmental bureaucratic infrastructure and adherence to regulations that support the ACA? How much has been spent and is being spent on patient satisfaction surveys? How much of our unfunded fellow citizens’ direct health care expenses could be covered by all of these? My bet is that there would be money left over. Bottom line: As I tell residents, when it comes to patients, “just do what’s right.” But, when it comes to us doctors, to maintain the music philosopher theme, are we getting to the point that we just “can’t get no satisfaction?”
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Mecklenburg Medicine • July/August 2014 | 7
Feature
TranscendED: A First for Eating Disorder Treatment in Charlotte By Rebecca Glavin, MBA, Client Care Coordinator
L
ast fall, TranscendED (Transcend E.D.), an outpatient treatment center for adolescent and adult females struggling with eating disorders, opened its doors in Matthews. TranscendED offers a partial hospitalization program, an intensive outpatient program and outpatient services, as well as support groups. Earlier this year, TranscendED expanded its continuum of care to include the first-ever residential facility for eating disorders in Charlotte and the surrounding area. Charlotte now is home to a six-bed residential eating disorder program. This is a first for the community and a service that medical and mental health professionals in the Charlotte area can rely on. In the past, patients needing this level of care were referred out of town, and sometimes out of state, to receive necessary treatment. Leaving the area often meant leaving family and support systems — a critical component of lasting recovery. With a residential facility in Charlotte, patients now can obtain the level of treatment necessary without sacrificing their family support and involvement in the therapeutic process. TranscendED is the vision and creation of Rose LeDay, PhD, a board-certified psychologist, who spent the majority of her professional career specializing in eating disorders. LeDay has opened, managed and led a number of eating disorder programs and centers across the country. Her dream has been to offer a holistic, truly recovery-oriented approach to eating disorder treatment with an emphasis on connection and relationships. LeDay stresses that an eating disorder keeps the
NATIONAL HEALTH & WELLNESS OBSERVANCES JULY 2014 Eye Injury Prevention Month Fireworks Safety Month UV Safety Month July 6-12: National Therapeutic Recreation Week July 13-19: Every Body Deserves a Massage Week
AUGUST 2014
individual isolated and feeling alone, so a major first step to healing is creating trusting relationships with treatment providers. TranscendED’s multi-disciplinary staff (general practitioners, psychiatrists, psychologists, nurses, dietitians, therapists, counselors, admission coordinators and case managers) are committed to uncovering and addressing each individual’s unique emotional needs and providing a safe and nurturing environment for recovery. According to the National Eating Disorder Association (2014), in the United States, 20 million women suffer from an eating disorder at some time in their lives. Furthermore, weight and shape concerns are expressed by females ages 6 and older, and 40 to 60 percent of elementary school girls (ages 6–12) report preoccupation with becoming fat (Smolak, 2011, as cited in National Eating Disorder, 2014). These statistics emphasize the need for the growth and development of additional eating disorder treatment centers. TranscendED is proud to be providing the Charlotte community with expert comprehensive services across the full continuum of care. For more information about TranscendED’s programs, or to make a referral, call 704-708-4605. References: National Eating Disorder Association, 2014. Get the facts on eating disorders. Retrieved at http://www.nationaleatingdisorders.org/ get-facts-eating-disorders.
Save the Date! Managers Healthcare Symposium Thursday, Aug. 21, 2014 8 a.m.-4 p.m.
Cataract Awareness Month Medic Alert Awareness Month National Breastfeeding Month National Immunization Awareness Month Children’s Eye Health and Safety Month
Harris Conference Center 3216 CPCC Harris Campus Drive, Charlotte
August 1-7: World Breastfeeding Week August 5-9: National Health Center Week August 6: National Night Out (America’s National Night Out Against Crime)
Open to CAMGM members, medical practice administrators, managers and staff.
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Feature
Non-Traditional Medical Modalities – A Growing Trend By Babak Mokari, DO
I
was moonlighting at an urgent care center a few weeks ago, when I saw a 52-year-old female patient with the chief complaint of headache and nasal congestion for 10 days. She had a history of seasonal sinusitis. While reviewing her history, I saw her medication list. She was on a thyroid and a antihypertensive prescription medication. Additionally, she was taking a number of herbs and supplements, including a multivitamin, fish oil, ginseng and black cohosh. She also had been taking vitamin C and Echinacea during her illness. A few years ago, this would have surprised me, but these days I see more and more patients who are taking vitamins, herbs and supplements. All these patients have at least two things in common: They prefer nontraditional routes in attempts to improve their health, and they are essentially unguided in their quest (unless you count Dr. Oz and the clerk at GNC). According to the 2007 National Health Interview Survey (NHIS), U.S. adults spent an estimated $33.9 billion out of pocket on complementary health approaches in the previous 12 months. They spent about twothirds ($22 billion) on self-care costs (i.e., products, classes and materials), and the remaining one-third ($11.9 billion) on visits to complementary health practitioners. The $33.9 billion represented about 1.5 percent of total healthcare spending, but 11.2 percent of total out-of-pocket healthcare spending in the United States. The trend is not only driven by media, but because patients often feel better without the side effects of most prescription medications. What does this mean for medical practitioners? Well, for starters, we need to accept the reality of this trend and make sure we inquire about it during the intake process. I also
It is already challenging to manage the aspects of our patients’ health, even with our training, in the seven to 10 minutes allotted. Nonetheless, we should inquire and advise about the plethora of herbs, supplements and treatment modalities.
would encourage all practitioners to open their minds about the potential use of these products and modalities, as well as the potential harms and interactions. Now, that sounds all well and good, but we know that in the reality in which we practice medicine, this is a challenge. It already is challenging to manage the aspects of our patients’ health, even with our training, in the seven to 10 minutes allotted. Nonetheless, we should inquire and advise about the plethora of herbs, supplements and treatment modalities. When a new class of medication is introduced to the market, we are equally uncomfortable. However, the pharmaceutical companies try to curb our discomfort by repetitive media campaigns, office visits and luncheons. Well, this campaign is being waged by the patients. If you haven’t seen it in your practice, then you likely are not asking the question. As a medical community, we cannot afford to ignore this trend. We need to empower ourselves and our patients with a basic level of knowledge about these products, and familiarize ourselves with practitioners in the community who have embraced this trend. Integrative medical practices are emerging throughout the country, often led by physicians and a team of traditional and nontraditional practitioners. Integrative pharmacists slowly are emerging to help patients manage their prescription and over-the-counter herbs and supplements. Medical schools and residency programs have been incorporating it into their curriculum, as well. The changes we are facing in health care are coming from all directions. This is a challenging, but exciting, time to be a healthcare practitioner. Regardless of the direction of the change, it is the prepared practitioner who will persevere and prosper.
Save the Date! David G. Welton, MD, Annual Fall Luncheon Wednesday, Sept. 24, 2014 Charlotte Country Club
Speaker: DAVID E. PRICE, MD Topic: “What’s a Head for Football? Update on Concussions” 11:30 a.m.–1 p.m. Open to MCMS Emeritus members and their guests Cost: $40 per person Registration forms will be e-mailed and mailed.
Mecklenburg Medicine • July/August 2014 | 9
Thank you, Spaugh Dameron Tenny, for co-sponsoring our River Jam event at the Whitewater Center in June!
10 | July/August 2014 • Mecklenburg Medicine
Mecklenburg Medicine • July/August 2014 | 11
MMAE News
Our MMAE Year Dear friends in MMAE, We completed our MMAE year with a stellar Annual Meeting on Thursday, May 22. Becky Williford, Joan Scharf and their program committee planned a lovely affair at Myers Park Country Club. The event was very demonstrative of the kind of year we have had in MMAE — informative, cooperative, supportive and fun. Gail van der Veer has been working for more than a year on the requirements for the Cannon Award and reviving this prestigious award after a short hiatus. Through her diligence, an outstanding civic leader was identified and suggested by a MMAE member. Roslyn Greenspon, who founded the Juvenile Diabetes Foundation in 1974 and shepherded it to an effective voice and advocacy, is our Cannon Award recipient for 2014. Gail’s introduction highlighting the accomplishments of some past recipients, as well as Ms. Greenspon, gives honor to MMAE and future recipients for their contributions to the health and wellbeing of our community. Linda Kramer, as chair of Grants and Disbursements, awarded 12 deserving agencies with grants totaling $81,000 — the most MMAE has ever given in a year. And I must tell you, our speaker, Amy Pasquini, development director from Our State magazine, was so much fun. We should have taped it and put it on YouTube! She DID sing the Butter Bean Song! Every organization should have such a spokesperson. We are more than fortunate to look forward to the leadership of Sherry Ward as our president and her very capable Board for the next year. Sherry was a president-elect for me — a true pillar; always there to help. My gratitude to her is endless. Plans for the coming year already are moving forward as we look toward the November Holiday House under the chairmanship of Paula Reutlinger and Karen Chandler. Memberships are now up for renewal — don’t forget to do it! And don’t forget our Friends category, if you have a friend who shares your interest in advocating for a healthier community. This year we changed financial advisors and moved our Endowment account to Wells Fargo under the direction of Lorayne Fiorillo Financial Advisors. This motion was passed by the Board in May 2013, at which time the Endowment was $1,732,000. The Endowment as of May 2014 is $1,832,000. Through our very capable treasurer, Dana Colee, we have achieved a high level of financial responsibility of being good stewards of our money, and are now able to say our membership support levels are adequate for our administrative expenses, allowing us to be assured all monies donated go completely to our mission. We have been given a legacy, and all are working hard to preserve it to advocate for a healthier Charlotte-Mecklenburg community. Our programs this year through our Program Committee have been wide ranging: Williams-Sonoma cooking demo to kick off the year; an expert explanation of the Affordable Care Act; a magical, amazing and exhausting trip through decorating the White House for Christmas; hearing the story of how St. Jude’s gave a child with only a 1-percent chance of survival a life of fulfillment as an adult; the inside story of soup making; a Community Health Luncheon focused on patient advocacy; and a talk about aging with dignity and the outlook for dementia in our population. Linda Kramer and the by-laws committee have completed a review of our by-laws and the recommended changes were approved by the Board in May. You, as members, will be receiving a copy of them for your review and a vote. We believe they reflect our present practices with more clarity. Thanks to Linda and the committee. It was a huge job and well done. I have had a most rewarding year as your president. MMAE makes a difference in our community and you make a difference by being a member ... something for us to always take pride in.
Save the Date! MMAE 2014 Holiday House
With best regards, Gretchen Allen Outgoing President, MMAE
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November 14-16 Home of Drs. Sid and Amy Fletcher 2148 Selwyn Avenue
Member News
Upcoming Meetings & Events Meetings are at the MCMS office unless otherwise noted.
JULY
No MMAE Board meeting. No CAMGM meeting.
Friday, July 4 Independence Day - MCMS office closed. n Tuesday, July 8 MedLink meeting. Mecklenburg County Health Department. 8:30 a.m. n Tuesday, July 8 Charlotte Dental Society Board meeting. 6 p.m. n Tuesday, July 15 WPS Fighting for Women with Fashion Planning meeting. Safe Alliance office. 6 p.m. n
AUGUST
No MCMS Board meeting. Friday, July 18 Child Health Committee meeting. 7:30 a.m. n Monday, July 21 MCMS Executive Committee meeting. 5:45 p.m. n Tuesday, July 22 September magazine deadline. n Monday, July 28 MCMS Board meeting. 5:15 dinner. 5:45 meeting. n Wednesday-Saturday, July 30-August 2 AAMSE Annual Conference Louisville, Kentucky. n
Tuesday, August 5 Charlotte Dental Society Board meeting. 6 p.m. n Tuesday, August 5 WPS Fighting for Women with Fashion Planning meeting. Safe Alliance office. 6 p.m. n Tuesday, August 12 MedLink meeting. Mecklenburg County Health Department. 8:30 a.m. n Sunday-Friday, August 17-22 NCAPA Summer Conference. Kingston Plantation, Myrtle Beach. n Monday, August 18 MCMS Executive Committee meeting. 5:45 p.m. n
Tuesday, August 19 WPS Fighting for Women with Fashion Planning meeting. Safe Alliance office. 6 p.m. n Thursday, August 21 Managers Healthcare Symposium. Harris Conference Center. 8 a.m.-4 p.m. n Thursday, August 21 CAMGM meeting. Harris Conference Center. Noon. n Friday, August 22 October magazine deadline. n
Coming in early 2015 …
Hawthorne Medical Plaza New 30,000 SF Class “A” Medical Office Building on Hawthorne Lane • Across from main entrance to Novant Health Presbyterian Medical Center • Excellent location just a short walk to the hospital • Ownership options available For more information, please contact:
Reed Griffith 2701 Coltsgate Road | Suite 300 | Charlotte, NC 28211
reed@brackettflagship.com
704.971.8908
www.brackettflagship.com
Mecklenburg Medicine • July/August 2014 | 13
At the Hospitals Association and the American Stroke Association, as well as the commitment to improving patient outcomes. Novant Health Blume Pediatric Hematology & Oncology Receives Research Grant Blume Pediatric Hematology & Oncology was the proud recipient of a $20,000 grant from CureSearch for Children’s Cancer’s Clinical Trial Advancements Award Program. This grant will support staff efforts toward discovering new approaches for the prevention, diagnosis and treatment of pediatric tumors at Novant Health Hemby Children’s Hospital and Novant Health Presbyterian Medical Center. “Cancer — particularly pediatric cancer — is a family disease,” says Paulette Bryant, MD, Blume Pediatric Hematology & Oncology. “To be able to offer patients and families the latest in cancer care, while remaining close to home, makes what is already a difficult journey a little bit easier. That’s what this grant will further enable us to do.” n
Novant Health Hospitals Receive AHA Get With The Guidelines® Awards for Stroke Care Novant Health has received three Get With The Guidelines® quality achievement awards from the American Heart Association (AHA) for implementing specific quality measures from the AHA for the treatment of stroke patients. Novant Health Presbyterian Medical Center has won the Gold-Plus Quality Achievement Award, and both Novant Health Matthews Medical Center and Novant Health Huntersville Medical center won the Silver-Plus Quality Achievement Award. Get With The Guidelines® helps Novant Health provide the most up-todate, research-based guidelines so stroke patients can receive rapid diagnosis and treatment and can recover quickly, while reducing the possibility of disability. These awards demonstrate a commitment to providing high-quality care that is aligned with the latest evidence-based guidelines from the American Heart n
First Robotic Surgery for Lung Cancer Performed at Novant Health Presbyterian Medical Center On May 9, Charles Harr, MD, a thoracic surgeon with Novant Health Heart & Vascular Institute, performed the first robot-assisted lobe removal in Charlotte to treat lung cancer at Novant Health Presbyterian Medical Center. An alternative to traditional open lobectomy, the da Vinci® Surgical System is a far less invasive and painful option for thoracic surgery. With the da Vinci® Surgical System, patients receive three 1-centimeter incisions and a slightly larger fourth incision, compared to the traditional 5- to 6-inch thoracotomy incision. Patients can generally avoid having their ribs spread and are offered a more precise resection of the lung and clearance of lymph nodes. Unlike open thoracotomies, epidurals or catheters are not needed. Patients experience lower rates of complication, less blood loss and less pain. Surgery for lung cancer typically is performed on patients diagnosed in early stages of cancer. n
Free Wellness Screenings at Target Clinics Target Clinic locations are offering free health screenings from 11:30 a.m. to 3:30 p.m. on the second Saturday of every month. The Novant Health community wellness initiative team will be screening for diabetes, high blood pressure and obesity at these Target Clinic locations: • Northlake, 9841 Northlake Centre Parkway • Concord, 6150 Bayfield Parkway • Steele Creek, 12830 Walker Branch Drive n
Novant Health Recognized Nationally for Diversity Program Novant Health has been named one of the 2014 Top 10 Hospitals and Health Systems in the nation by DiversityInc, the country’s leading source for advancing and recognizing excellence in diversity management. Novant Health is third on n
14 | July/August 2014 • Mecklenburg Medicine
this year’s list, surpassing some of the country’s most prestigious healthcare systems including Cleveland Clinic (fifth) and Mayo Clinic (eighth). “This honor recognizes the exceptional work being accomplished across Novant Health,” says Carl Armato, president and CEO of Novant Health. “As a core value, diversity permeates our organization. Its influence is felt in the very fiber of who we are and why we exist.” Novant Health Introduces Ready at Home Program Novant Health introduced a new Ready at Home program to simplify the transition from hospital to home. “Ready At Home improves a patient’s recovery by ensuring they leave a Novant Health medical center with the medications and knowledge they need to adhere to their physician’s care plan,” explains Michael Nnadi, vice president of pharmacy services for Novant Health. “Better compliance can lead directly to a faster, healthier recovery and reduce the possibility of patient readmission.” The Ready At Home team coordinates important details around a patient’s discharge and at-home medications, so the patient can focus on what really matters — getting better and staying healthy. If patients need medications or other healthcare supplies, pharmacy transition specialists will consult with them to provide affordable solutions. These can then be delivered directly to patients in their rooms so they don’t have to make a stop on the way home. Because discharge medications and supplies are separate from the hospital bill, Ready At Home helps make sure they are properly processed by the insurer. Ready at Home is available at Novant Health Presbyterian Medical Center, Novant Health Rowan Medical Center and Novant Health Forsyth Medical Center, and eventually will expand throughout the Novant Health footprint. The Ready At Home team consists of a director of engagement and a group of pharmacy transition specialists, who coordinate with the patient’s physician and other providers to determine discharge needs. n
At the Hospitals
Efforts Reduce Patient Safety Events Carolinas HealthCare System has prevented more than 4,400 patient safety events in two years, a 30 percent drop, and equivalent to savings of more than $17 million in related care costs. These outcomes are the result of strong work by hospitals in a collaboration known as the Carolinas HealthCare System Hospital Engagement Network (HEN), developed to catch errors at the point of care and prevent patient harm. The Carolinas HealthCare System HEN is part of the prestigious national Partnership for Patients HEN initiative led by the Centers for Medicare & Medicaid Services. The national HEN is a public-private partnership of 26 health organizations aimed at reducing preventable patient harm by 40 percent and 30-day hospital readmissions by 20 percent by the end of 2014. In 2013, Carolinas HealthCare System hospitals saw as much as a 22-percent decrease in 30-day readmissions for all-cause heart attack, heart failure and pneumonia diagnoses, and 14-percent decreases for alldiagnoses. The System also has seen decreases of 14 percent and 23 percent in the number of patients with harmful levels of bloodclotting factors and glucose. Other notable improvements include: • 73-percent reduction in early elective deliveries between 2012 and 2013, exceeding national benchmarks in 2013. • 51-percent reduction in pressure ulcer rates between 2012 and 2013, exceeding national benchmarks. • 53-percent reduction in number of patients who developed ventilator-associated pneumonia in 2012, exceeding national benchmarks for the same year. n
Reproductive Medicine and Infertility Center Outcomes Exceed National Average Since opening in November 2013, the newly expanded Carolinas HealthCare System Reproductive Medicine and Infertility (RMI) Center has achieved remarkable outcomes. n
Early pregnancy outcomes are significantly above the national average, highlighted by an ongoing pregnancy rate of over 50 percent for IVF in couples with women 35 years and younger and over 60 percent for frozen embryo transfers. Single embryo transfer has become the procedure of choice for many patients, as it reduces the incidence of twins, which poses a much higher infant and maternal risk and costs 10 times more than a single birth. As a result, the RMI now is recognized nationally as a provider with the ability to deliver these excellent live birth rates and low multiple birth rates. RMI’s board-certified reproductive endocrinology and infertility specialists include Bradley Hurst, MD; Paul Marshburn, MD; Michelle Matthews, MD; and Rebecca Usadi, MD. This team performed a record 145 procedures in the first three months of 2014. The new laboratory facilities include a rigorously controlled environment with highly purified air, a relaxing spa-like environment for patients, and a devoted and experienced team of professionals, including embryologists, physicians and nurses. To learn more about the center, visit www.carolinashealthcare.org/ womens-services-infertility-and-reproduction. Advice for Physicians Addressing Patient Substance Abuse With abuse of alcohol, marijuana, opiates, prescription medications and cocaine on the rise in Charlotte and nationwide, Alan W. Bozman, PhD, assistant vice president of behavioral health at Carolinas HealthCare System, has some recommendations for physicians faced with substance-abusing patients: • Physicians should understand they are respected by their patients and the physician’s thoughts and concerns matter to the patient. Instead of “Have you been drinking much?” ask “How many drinks containing alcohol do you consume a day, a week, a month? Do you have days that you drink five or more drinks in one setting? How often? Do you take your medications exactly as prescribed? Do you use any other drugs recreationally or regularly?” • The Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a solid tool to use. Substance abuse professionals at Carolinas HealthCare System are willing n
to provide brief training to primary care physicians and other professionals on how to use this tool. • Any time the physician feels a patient’s substance abuse is negatively impacting the patient’s physical health, mental health, relationships or functioning, the physician should refer to an expert in substance abuse. Dealing with substance abuse issues before they become major problems often is easier and less disruptive to the patient’s life. • Carolinas HealthCare System has a call center staffed 24/7 by professionals to assist physicians and their patients in getting the help they need. The number is 704-444-2400. “The primary care physician is on the front line and has the opportunity to help patients get the care they need before substance abuse takes over their lives,” says Dr. Bozman. “The substance abuse and behavioral health treatment programs at Carolinas HealthCare System are ready to aid primary care physicians and their patients.” Joshua Patt, MD, MPH, Earns AAOS Fellowship Joshua Patt, MD, MPH, an orthopedic surgeon specializing in musculoskeletal oncology and spine surgery at Carolinas Medical Center, is one of 10 surgeons named to the American Academy of Orthopedic Surgeons (AAOS) 20142015 Leadership Fellows Program. The prestigious one-year program helps to empower and create future AAOS leaders who have previous leadership Joshua Patt, MD, MPH or volunteer experience in the orthopedic field. Carolinas Medical Center is one of only five centers in the nation with an orthopedic surgeon who is trained in complex spinal and musculoskeletal oncology. In addition to being a leader in his clinical field, Patt also serves as the residency program director for the orthopedic surgery residency program. His primary research interests are clinical outcomes in oncology, spinal tumors and geriatric hip fracture outcomes. He has published 11 peer-reviewed journal articles and multiple book chapters, in addition to giving scientific presentations at both regional and national meetings. n
Mecklenburg Medicine • July/August 2014 | 15
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 conglomerate and to provide educational programs and resources to physician members and their administration. Find them online at IndependentPhysicians.org. Kenneth Ashkin, MD with Mecklenburg Neurological Associates in Charlotte recently passed the newly created American Board of Psychiatry and Neurology added Kenneth Ashkin, MD certification exam in Epilepsy. He is now certified in Neurology, Sleep Medicine, Clinical Neurophysiology and Epilepsy. Metrolina Eye Associates is pleased to announce the opening of its Indian Land,
South Carolina office in July. Located at 6237 Carolina Commons Drive, Suite 300, this office serves the growing community of Indian Land and greater Lancaster County with fullservice ophthalmic and optometric Sean Pitale, OD care for patients of all ages. The practice also welcomes its newest provider, Sean Pitale, OD, who practiced optometry in Hilton Head prior to joining Metrolina Eye Associates. Pitale is a Captain in the United States Air Force and a member of the South Carolina Air National Guard. Before his career change to optometry, Pitale was a television reporter in Charlotte. V Pain Clinic has begun using cooled radio frequency neuroablation for low back pain (with results lasting up to two years). Medical Director Ratko Vujicic, MD is excited about geniculate nerve radio frequency ablation for chronic knee pain. It is performed on an outpatient basis and is a perfect solution for patients who are not surgical candidates. For details, visit www.mycoolief.com. Physician members gathered for a meeting in May to hear John Walker, MD, speak on “Transformative Care — Flipping Reimbursement Models … Charting a
Course Towards Pay for Value.” He spoke about models based around patient needs in various areas, such as a Heart Function Clinic, Cancer Services and Personalized Primary Care. Other topics Dr. Walker addressed were patient-centered resources, pay for performance and John Walker, MD bundled pricing and shared savings. Walker is the chief medical officer at Cornerstone Health Care, a multi-specialty medical group in the Triad area with more than 300 providers, 1,800 employees, 80 practices and 15 hospitals. He has been instrumental in the group for PatientCentered Medical Home (PCMH) processes, a Patient Care Advocacy Program, and he has led a team seeking improvement in Press Ganey Patient Satisfaction Scores. Thank you for your continued patronage! 2014 Renewed Members: Kenneth Ashkin, MD, Mecklenburg Neurological Associates Ivan Mac, MD, Metrolina Eye Associates Alireza Nami, MD, Joint & Muscle Medical Care Kathryn Stephens, MD, Laurel OB-GYN Associates
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CarolinasHealthCare.org Mecklenburg Medicine • July/August 2014 | 19
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