East Tn Medical News August 2014

Dr. Michael Casey

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Emerging & Reemerging Infectious DiseasesChikungunya and new strains of infl uenza are among a list of emerging infectious diseases that have grabbed recent headlines, but reemerging diseases including measles and pertussis are also causing epidemiologists concern across the nation ... 6

Taking Your Breath Away How Do Cities Fare In The Latest Annual Asthma Report? ... 7

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By CINDy SANDERS

There’s no question healthcare delivery is in the middle of a transformational period highlighted by un-precedented consolidation. While there are a number of factors impacting alignment decisions, Paul Keckley, PhD, boiled the equation down to its simplest terms, “Economics drives behavior.”

Keckley, managing director for Navigant’s Center for Healthcare Research & Policy Analysis, said physi-cians are having to assess their practices in light of a new reality that requires effi ciency, effectiveness and contracting clout to survive.

“If you’re of a view that the economics favors you being inde-pendent for the rest of your practice, you go that route,” he stated.

However, the noted healthcare expert who has pub-lished three books and more than 250 articles on the industry and health reform, said that practice model is becoming increasingly rare.

For many, Keckley said practice decisions take a step-wise progression. Option A fi nds two small prac-tices within a specialty banding together. Option B brings multiple specialties together to form a large group. Option C has physicians or practices joining forces with a hospital or payer under some type of em-ployment, joint venture, or managed services organiza-tion (MSO) agreement.

“I think most doctors are past Option A. I think most doctors realize circling the wagons around a single specialty isn’t realistic,”

Partnering in a New Paradigm

(CONTINUED ON PAGE 15)

NASS Takes a Proactive Approach to Evidence-Based Coverage Decisions

By CINDy SANDERS

In an effort to improve patient access to appropriate, evidence-based care, the North American Spine Society (NASS) recently released detailed policy recommenda-tions for coverage of 13 common spine care treatments, procedures and diagnostics.

The fi rst-of-their-kind reference documents outline when it is … and when it is not … appropriate to utilize each of the options based on an extensive review of cur-rent literature by a multidisciplinary team of experts.

William Watters, MD, president of NASS, said, “Maintaining patient access to high-quality, evidence-based and ethical spine care is the single most important part of NASS’ mission. It is our hope that payers, spine specialists and their patients will use these evidence-based coverage recommendations as a reference to advocate for appropriate care for patients.”

Watters added the society was uniquely positioned to take the lead on such an ex-tensive project because of the multispecialty nature of the organization, which includes the expertise of surgeons and allied health professionals. “We cover the full spectrum of spine care,” he noted.

Watters, who is a board certifi ed orthopaedic surgeon in private practice at the Bone & Joint Clinic of Houston and a clinical associate professor at both the Uni-versity of Texas Medical Branch in Galveston and Baylor College of Medicine, said


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Dr. Paul Keckley

2 > AUGUST 2014 e a s t t n m e d i c a l n e w s . c o m

PhysicianSpotlight

By JOE MORRIS

Most physicians will tell you they always wanted to be a doctor, but finding a specialty … that was the tricky part. Not so for Dr. Michael Casey, who knew early on that he wanted to be in sports medicine, and do knee work in particular.

“I always wanted to play sports, even though I was short and slow,” Casey said. “I also was aware that the NFL wasn’t look-ing for short, slow tailbacks, so I knew I needed to do something with my brain. I gravitated to the sports side of medicine even before I was in medical school.” After earning a biology degree at (and playing football for) Cen-tre College in Kentucky, Casey graduated from the University of Tennessee College of Medicine in Memphis and then completed a residency at Parkland Memo-rial Hospital in Dallas. Barry Tietjens, a renowned orthopedic consultant in Auckland, New Zealand, then chose him for a sports medicine and knee fellowship at his Unisports Sports Medicine Clinic.

“He only asks one fellow a year, and I was lucky enough to get it,” said Casey, who now practices at Tennessee Ortho-paedic Clinics.

The world of orthopedics in gen-eral, and knee surgery in particular, has evolved at a rapid pace. Like full and par-tial hip replacement work, the options for

knees continue to expand, which makes for unique challenges.

“The whole concept has changed,” Casey said. “In the past, relatively young people, active individuals, would have in-juries to their knees, or abnormalities on the joint surfaces, and we would have no answer. They were just destined to con-tinue to have symptoms and eventually progress into arthritis. Then new tech-niques came about in Europe in the late 1980s, and eventually in the United States

in the 1990s, that have been able to allow us to treat those patients very differently.”

As an example, he points to a recent procedure performed on a 30-year-old woman who’d been a college basketball player and led a very active life. She’d been told there was nothing to be done ex-cept wait until such time as she needed a total knee replacement, but Casey gave her another option. He is accredited by Carticel, and uses the company’s treatment to retrieve cells from an area of defect in order to grow new cartilage. He did some repair work on the joint, and removed cartilage cells. Then after a two-week period for new cells to be grown in the lab from that sample, he went back into her knee to implant them.

“The result of this treatment is a real reduction of pain and in-creasing of function, and hope-fully the delay of any progression of arthritis,” Casey said. “We are seeing a lot of new advancements

coming out of Europe. They are leading the United States right now because we are behind getting things approved by the FDA, and approved by the payors, but companies here and over there are still working on new technology. Sooner or later all the approvals here will catch up, and a lot of new technology will come onto the market.”

Waiting for insurance companies and regulators to catch up to technology is nothing new, but adapting to ongoing

and expanding Meaningful Use criteria and the many components of the Afford-able Care Act is. To that end, Casey says he and his practice are working to adjust to the “new normal” by ensuring strong patient education in their practice every day.

“We know we have to do things more efficiently now, and limit things that can slow the process of the patient’s recovery,” Casey said. “But tied into that is patient education because a lot of things are really starting to fall on their shoulders. We are the ones telling them that they can’t stay in the hospital for three days after a knee replacement, but it’s their insurance that’s not going to pay for it. It can be a real battle with the payors because sometimes they don’t have a good home environ-ment and need that extra day. We fight for them, but increasingly they are having to fight for themselves as well.”

That means setting realistic expecta-tions for procedures, recovery times, and more.

“The patient is going to have to work on their own recuperation instead of com-ing to the hospital and going to a rehab center,” Casey said. “They are having to learn to manage their own recovery, which can be hard. The ACOs that are being set up are providing some tools to help, but it’s too early to see how all of that is going to play out. Like everything else, cost is going to be the driving factor of how, and when, follow-up procedures like rehab and recovery are paid for.”

For instance, he says, “soon there probably will be total knee replacements done on an outpatient basis. The tech-nology is pretty much here for that, but I don’t think the patient expectation is.”

While he applauds efforts to reduce inefficiencies in the healthcare system, Casey also notes that in areas like Mean-ingful Use, the approach has sometimes been too much geared towards standard-ization.

“Electronic medical records have re-ally slowed us down, and I think they are making the cost of care higher,” he said. “There are a lot of complexities there because we are having to input a lot of data that can be completely irrelevant. It would better if I were only inputting what is relevant to what’s being treated, rather than information that has nothing to do with what’s going on during that particu-lar visit. If we could get more physicians’ input from all the different fields, perhaps we could stop lumping things that apply to a family practice into what a cardiolo-gist or someone in sports medicine needs. We’re not all in the same boat, and so hopefully we can work towards everyone having electronic records, but a more spe-cialized approach to how they are used and collected.”

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LegalMatters

Profit and Loss: The Top Ten Things Providers Need to KnowPart IV: The Stark Reality –Your Physician Group may not be a “Group Practice”

BY PATTI T. COTTEN, LONDON & AMBURN, P.C.

This article is the fourth installment in a series which explores the top ten health law issues and their potential financial consequences on a provider’s practice.

The “Stark Law” is the healthcare

industry’s common name for the federal law which prohibits physicians from making referrals of certain “designated health services” (DHS) payable by Medicare to an entity with which the the physician (or an immediate family member of the physician) has a financial relationship (1). “Stark” is often correctly cited by healthcare providers with a basic understanding that there is something inherently wrong with financially rewarding a physician for referring DHS to outside entities such as hospitals, laboratories, and other diagnostic facility. But, what many physicians do not realize is that the Stark law may directly impact the

compensation arrangements inside their own group practices.

How do the Stark laws/regulations apply to a physician group practice?

Any group practice which performs its own DHS (e.g., radiology services, laboratory and pathology services, physical therapy services, etc.) for Medicare patients must be concerned about compliance with the Stark law. When a group physician orders an x-ray on one of his/her Medicare patients and that x-ray is performed by the group’s rad tech on the group’s radiology equipment, then that physician has made a Stark “self-referral” to an entity with which he has a financial arrangement (i.e., his/her own group). To be Stark-compliant, that referral has to fall within an enumerated exception to Stark’s self-referral prohibition.

Isn’t there a Stark “group

practice” exception? The Stark “in-office ancillary

services” exception (the “IOAS exception”) allows a physician to refer within his/her own group practice, so long as each element of the IOAS exception is fulfilled. Contrary to popular belief, there is no “group practice” exception under Stark. However, in order to apply the IOAS exception to the ancillary services performed by the group, the practice must meet Stark’s definition of a “group practice.”

Our group of physicians has been practicing together for 15 years. How could we not qualify as a “group practice” under the Stark law?

If asked to define a “group practice,” most physicians would cite the traditional business model. Under common perceptions, “XYZ Medical Group, PLLC” (which might have 4 physician members, 2 physician employees, plus a couple of mid-level practitioners, practicing in the same office and billing under the same group name) surely qualifies under Stark as a “group practice,” right? Well, it depends.

Other than shared office space, equipment, personnel, and billing numbers, what other factors determine whether a group qualifies as a Stark “group practice”?

Many physicians who routinely order lab work or x-rays performed by their own group practice do not realize that the group’s compensation model will determine whether or not that Stark “referral” falls within the IOAS exception. Yet, for a group to be considered a “group practice” under the Stark law (so that it may qualify for the IOAS exception), its must ensure that its allocations of overhead and expenses and its calculation of physician compensation, productivity bonuses and profit-sharing are “not determined in any manner which is directly related to the volume or value of referrals” (2).

Why does Congress care how my group allocates its overhead expenses?

Actually, Congress does not

really care how a group allocates its expenses, but it does require that overhead expenses be “distributed in accordance with methods previously determined.” So, the group must determine, in advance, how it is going to allocate expenses. The allocation may be changed any number of times so long as it is applied prospectively, but the group may not wait until those expenses are incurred and then take into account each physician’s volume of DHS referrals when allocating those expenses.

May a group physician be compensated for ordering DHS?

Yes, but only indirectly. Stark says that a group may pay its physicians using methods that either recognize their “hands on” productivity or allocates to them a share of overall profits derived from DHS performed by others in the group. Whether a profit or productivity approach is selected, the key is that the physician’s allocation may not be determined in a manner that is directly related to the physician’s volume or value of DHS referrals.

So, our group must split all

ancillary revenues equally?That’s only one Stark-compliant

compensation methodology – and it may be highly unsatisfactory, especially when the group’s physicians have significantly varying use of the group’s ancillary services. Moreover, it is a common misconception that all ancillary revenues of the group practice have to be allocated in the same way. The Stark law only applies to Medicare DHS revenues, so revenues derived from ancillary services billed to commercial payers may be allocated directly to the ordering physician.

If the group focuses on productivity, then it might pay bonuses based on total patient encounters or relative value units (“RVU”). Or, it might look at physician referral patterns for non-DHS revenues and allocate the DHS revenues along those same patterns under a profit-sharing arrangement. While the Stark regulations actually enumerate three approved compensation methods


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Many healthcare IT businesses create white papers in hopes of gaining more in-terest in their products, processes or data. And, hopefully, getting more business leads and attention as a result. The best white papers are factual and informative, rather than promotional or pushy, and a well-written, authoritative white paper can elevate your business in the eyes of your peers, other businesses and potential cli-ents by presenting an image of expertise and knowledge.

Sometimes white paper development is overlooked by businesses in the health-care industry, misjudged as a verbose and boring document no one really reads. However, I have found that white papers written in an educational and practical style can be effective and powerful mar-keting tools. In a recent blog by content marketing expert Lee Oden, he listed the top content marketing tools from the up-dated 100+ B2B Content Marketing Sta-tistics report. Out of all the various content strategies used by the businesses studied, white papers made the top ten, coming in at number nine on the list.

While a white paper may not be as “sexy” as a fl ashy, glossy advertisement, businesses can benefi t from a great white paper in many ways:

Your peers will think of your business

as an authorityA white paper need not be a lengthy,

100-page tome, but it does need to be fac-tual, offer useful information, and appeal to the audience your business is trying to reach. Presenting useful research or re-vealing a solution to a common business problem will make your readers and peers look to you as the expert in your industry.

You can collect email addresses from individuals downloading your paper

This is probably one of the main ad-vantages to offering a free white paper to your target audience. If you ask for an email address before allowing your white paper to be viewed in its entirety, you have an easy way to follow up with potential cus-tomers who have already shown an interest in your business. You can also use this as a way to track the white paper’s success.

By offering case studies, you elevate your business without selling it

People love a good case study, and a white paper is the ideal medium to high-light your best ones without too much horn-tooting. Just like reviews on TripAd-visor, the case studies in your white papers promote your product with real user infor-mation, not sales talk. Your white papers will be more successful without overt plug-ging, and your audience will come back to read your other papers.

You can repurpose your white papers for multiple platforms

White papers can be great content marketing tools for social posts, blog posts, press releases, website teasers, articles, and as information pieces for media. Use the information in your white papers on other platforms to help build an audi-ence and gain more traction. By sharing and promoting your valuable information via social, you can create additional buzz and funnel readers directly to your white paper.

When creating a white paper for your healthcare business, always keep in mind your audience. What can your white paper offer that will help your audience or solve a problem? Try to offer statistics and diagrams to create visual interest. And remember not to be too technical, unless your paper is specifi cally geared to expert IT professionals or engineers. If you do not have writers on staff, professional writers or agencies who employ seasoned writers can develop a structure and style for your white papers, while targeting your audi-ence for maximum impact.

There are also free tools and resources online where you can investigate the proper steps needed to write a successful white paper.

Heather Ripley is the founder and CEO of Ripley PR, a national B2B public relations agency specializing in Healthcare IT. For more information, visit www.ripleypr.com or email [email protected].

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By CINDy SANDERS

Chikungunya and new strains of influenza are among a list of emerging infectious diseases that have grabbed recent headlines, but reemerging diseases including measles and pertussis are also causing epidemiologists concern across the nation.

“There are newly emerging diseases and reemerging diseases … and both are disturb-ing,” stated Tim Jones, MD, state epidemiolo-gist for the Tennessee Department of Health (TDH). Jones, whose past experience includes working in the Centers for Disease Control and Prevention’s Epidemic Intelligence Ser-vices, recently provided insight into the old and new. He also shared his thoughts on why we’re seeing a resurgence of some diseases, such as polio, that the medical community thought would be a distant memory at this point in history.

“Internationally, we had hoped that polio would be eradicated by the turn of the century, but here we are in 2014 with it expanding into additional countries,” he said.

Jones, who is the immediate past president of the Council of State and Ter-

ritorial Epidemiologists, noted the spread of new diseases and return of some of the older ones is multifactorial with global mobility and increasing refusals to be vac-cinated contributing to the problem.

Emerging Infectious Disease“The majority of these new diseases

are what we call zoonotic. As the name suggests, they are diseases that have jumped from the animal world into hu-mans,” Jones explained, adding exam-ples include SARS, West Nile Virus and H1N1.

The most recent mosquito-borne dis-ease to make its way to the United States is chikungunya. “We just started seeing it in the last few months,” Jones noted of the disease’s migration primarily from the Ca-ribbean where there have been large out-breaks. “Our first cases in Tennessee were in May. We’d never seen it before. As of today, there are 37 suspected cases, and all of them are people who have recently returned from the Caribbean.”

Jones added, “This new one, chikun-gunya, luckily does not have a reservoir out in the wild.” He explained the viral disease doesn’t live in birds or other ani-mals and only transmits between mosqui-tos and humans. “For me to get it, the mosquito would have to bite an infected person and then me. So far we haven’t seen any jump from infected travelers

to someone local, but that’s what we’re afraid of.”

(Editor’s Note: At the time of the interview in early July, there had not been any cases of chikun-gunya originating in the United States. However, the CDC has since confirmed the first cases of the virus being locally acquired. The virus is transmit-ted through two species of mosquitoes, Aedes ae-gypti and Aedes albopictus, which are found in a number of regions across the country including the Southeast.)

Primary symptoms include joint pain and fever. Although there is no vaccine, Jones noted, “It’s rarely fatal, but it makes you feel terrible for about a week, and 10 to 15 percent of people will have very bad arthralgias for up to a year.”

Dengue is another mosquito-borne virus that epidemiologists are closely mon-itoring. “Generally, it’s pretty endemic in the Caribbean and South and Cen-tral America, but it seems to be moving north,” Jones said. “As these vector-borne diseases move into new areas, it raises con-cerns as to whether it could be related to climate change.”

With no vaccine or treatment, den-gue is a leading cause of illness and death in the tropics and subtropics and is caused by any of four related viruses transmitted by mosquitos. “Unfortunately, dengue you can get more than once, and if you get it a second time, it’s usually much more severe,” Jones said, adding it’s nickname is ‘breakbone fever’ because the intense joint and muscle pain can cause those with den-gue to have contortions.

The first 2014 human case of yet an-other mosquito-borne disease, West Nile Virus, was confirmed in Tennessee in late June. WNV has been present in the state since 2001.

The common thread with all three of these viruses is that there is no vaccine so prevention remains the best way to con-tain the spread of the virus. The TDH lists a number of recommendations on their website for individuals to prevent mos-quito bites including the use of insect re-pellants and elimination of standing water near homes.

Reemerging DiseasesAlthough ‘officially’ eradicated from

the United States in 2000, measles is still present in other regions of the world and has begun to reappear in this country. In fact, the CDC recently announced they have confirmed more cases of measles in the United States so far in 2014 than in any other year in the past two decades.

This spring, the TDH identified the first case of measles in the state in three years. As with most cases now seen in this country, the virus was traced to an inter-national traveler and then spread to those who weren’t immune to the disease.

“We had one person who returned from overseas from an area that was hav-ing an outbreak, and we ended up hav-ing five people infected before we got it under control,” Jones said. Transmittable through the air, he added, “Measles is very serious and really, really easy to spread.”

Although the state has a very high rate of compliance for the measles vaccine, Jones pointed out that the vaccine was re-ally only recommended for those born after 1957 since many older citizens were exposed to measles in childhood. A two-part vaccine, Jones said the state probably only has 2-3 percent of the population that isn’t fully immunized.

Pertussis, or whooping cough, is an-other disease spreading throughout the country. Although Jones said Tennessee has only had light activity with 100-200 cases per year, other parts of the country have been much more heavily affected. “There are some states in the Midwest and now California that have had many hundreds and thousands.”

The problem, Jones continued is a combination of under-immunization and the fact that it isn’t a perfect vac-cine. Because of some concern about the immunization wearing off, a booster is now recommended. “In the last couple of years, we began recommending all adults that haven’t had this new Tdap (tetanus, diphtheria and acellular pertussis) vaccine get a dose no matter when the last time they had a tetanus shot,” Jones said.

In Tennessee, the continuing concern over tuberculosis comes with some good news and some bad news. “For the first time this year, Tennessee is below the na-tional average, which is exciting … but as the numbers go down, the complexity of each case is going up,” Jones said.

He added, “While we’re having a real impact on domestic TB, now nationally the majority of TB cases are in the foreign-born population. We’re seeing much more imported TB.”

Although contagious, Jones said it takes close, prolonged contact rather than casual proximity to spread the disease. In the absence of a good vaccine for TB, test-ing becomes important … particularly for healthcare workers.

A major issue with reemerging dis-eases is a lack of recognition by healthcare providers since they are so rare. “There are very few physicians in the U.S. who have ever seen a true case of measles,” Jones said. “Likewise for TB … most physicians are never going to have seen a real case, and that makes it challenging.” He added, “With TB, for example, we’re increasingly seeing people who went to a healthcare professional and were treated for bronchitis, smoker’s cough, etc. We’ve got to keep these diseases in the back of our minds as possibilities.”

Jones said education and awareness are key to catching infectious diseases early. The CDC has extensive information on both emerging and reemerging public health threats. Likewise, the TDH pro-vides resources and local updates about diseases present in Tennessee. For more information, go online to cdc.gov and to the TDH section on communicable and environmental diseases and emergency preparedness (CEDS) at health.state.tn.us/ceds.

Emerging & Reemerging Infectious Diseases

Dr. Tim Jones


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A thriving city rich in history, perched on the brow of the picturesque James River, has once again captured the uncov-eted title as the most challenging place to live with asthma.

For the second consecutive year, and four of the last fi ve years, Richmond, Va., took the title perch, with worse than aver-age ratings for prevalence factors (crude death rate for asthma), risk factors (annual pollen score, poverty rate, the uninsured, and public smoking laws), and medical factors (emergency room visits for asthma).

Medical News markets located across the South and Midwest were represented in “Asthma Capitals 2014,” the 11th an-nual research project released by the Asthma & Allergy Foundation of America (AAFA). Boston Scientifi c Corporation (NYSE: BSX) sponsored this year’s report.

Medical News market rankings, with 2013 rankings in parentheses:

No. 2: Memphis, Tenn. (3)No. 6: Chattanooga, Tenn. (2)No. 22: New Orleans, La. (24)No. 26: St. Louis, Mo. (55)No. 27: Little Rock, Ark. (31)No. 38: Nashville, Tenn. (32)No. 41: Knoxville, Tenn. (10)No. 42: Jackson, Miss. (47)

No. 48: Birmingham, Ala. (23)No. 49: Orlando, Fla. (62)No. 50: Tampa, Fla. (57)No. 55: Lakeland, Fla. (60)No. 64: Daytona Beach, Fla. (76)No. 65: Baton Rouge, La. (79)No. 75: Sarasota, Fla. (87)No. 81: Raleigh, NC (91)No. 87: Charlotte, NC (86)Most Metropolitan Statistical Areas

(MSAs) in Medical News markets im-proved over 2013, collectively dropping 45 spots. The St. Louis market showed the least improvement, moving up 29 spots among the most challenging places to live with asthma. The most improved MSAs for easier asthma living: Knox-ville, Tenn., sliding down 31 spots, fol-lowed closely by Birmingham, Ala., which dropped 25 spots.

MethodologyAnalytical data from the 100 most-

populated MSAs in the United States de-termined the ranking system. Researchers and medical specialists focused on three primary areas – prevalence, risk, and medical factors – that include 13 unique factors, with non-equal weights applied to each data set in individual factor groups. Total scores were calculated as a compos-ite of all factors, refl ecting each factor’s

relative impact on exposure to asthma triggers, quality of life, costs and access to care.

Prevalence factors included the predicted population with asthma, self-reported population with asthma, and re-corded death rates for adults and children from asthma. Risk factors included com-prehensive annual pollen measurements, average length of peak pollen seasons, out-door air quality, poverty and uninsured rates, state school inhaler access laws, and smoke-free public laws.

Medical factors included ER visits for asthma, rescue medication use, controller medication use, and the number per pa-

tient of board-certifi ed adult and pediatric allergists and immunologists, and pulmo-nologists.

ER visits represent a signifi cant chunk of asthma care-related costs.

“Many ER visits are from people with severe asthma, but not all of them,” said Mario Castro, MD, professor of medicine and pediatrics at Washington University School of Medicine in St. Louis, discuss-ing the average of more than 2,300 visits to ERs for asthma in each U.S. city, with one in four admitted to a hospital. “Many people with less severe asthma show up to the ER, too. But much of this is avoidable with new treatments for severe patients and better prevention and care for those with less severe disease.”

Making StridesEarlier this year, the Supreme Court

upheld the U.S. Environmental Protection Agency’s (EPA) Cross-State Air Pollution Rule, which aims to reduce the amount of pollution drift from certain states into oth-ers, prompting health issues for residents in those states. The Supreme Court also noted the rule is an effective way to con-trol emissions, and melds with the EPA’s mission under the Clean Air Act.

The AAFA is collaborating with state

Taking Your Breath Away How do cities fare in the latest annual asthma report?

The national burden of 25 million Americans with asthma costs more than $50 billion annually in healthcare expenses, missed school and work days, and deaths. Yet, asthma rates have continued to climb since the late 1980s across age, gender and racial lines, now affecting nearly 10 percent of the U.S. population.



HealthcareLeader

Linda SnodgrassBy JENNIFER CULP

“I have been in the healthcare indus-try for 24 years, and I’ve enjoyed every step of the way, but I absolutely love Ur-gent Care!” said Linda Snodgrass, Prac-tice Administrator for First Assist Urgent Care of Mountain States Medical Group. “Patient service is my passion,” she con-tinued, “and at First Assist, I have the op-portunity to meet patients from all over the region, help meet their healthcare needs, and hopefully make a positive dif-ference in their lives.”

The roots of Snodgrass’s career ex-tend back to her childhood in Salisbury, North Carolina. Her mother worked as a nurse at the VA Medical Center in Salis-bury, and watching her work to care for patients and improve their lives made Snodgrass interested in pursuing a health-care career of her own. “My first job in healthcare was a summer position as a patient service representative in a local radiological office in Salisbury,” Snod-grass remembered. “I fell in love with the elderly patients I helped there, so I felt that I was definitely on the right career path.”

Snodgrass’s ambition led her to enroll at East Tennessee State University, which she chose for its Healthcare Administra-tion program. While working to earn her degree, she spent evenings and weekends as a medical transcriptionist in the Radi-ology Department of Takoma Hospital in Greenville, Tennessee, and later as a med-ical transcriptionist and office assistant in the Occupational Medicine Department of the same hospital. Upon earning her Bachelor’s degree in Healthcare Admin-istration, Snodgrass took on a full-time position as a medical transcriptionist for Medical Center OB/GYN in Johnson City. “That position was a blessing for me

because it allowed me to work full time to support myself and attend graduate school at night. The physicians and office manager there were very supportive of my school schedule and career goals, which made completing graduate school much easier for me. Even though many of them have now retired, I will be forever thankful for their support,” she said.

After completing her Master’s degree in Public Health in 1997, Snodgrass ex-panded the scope of her responsibilities, becoming the practice manager for John-son City OB/GYN Associates. In 2004, she took a position as practice administra-tor at the Center for Integrative Medicine, where she developed her skills and expe-rience until moving to her current job at

First Assist Urgent Care in 2007.“I am currently responsible for the

First Assist Urgent Care/MedWorks Occupational Medicine service line for Mountain States Medical Group, which consists of eight clinics, 47 providers, and 87 team members located in Tennessee and Virginia,” she explained. “Much of my time is spent on day-to-day opera-tions, traveling from site to site. I may be in Jonesborough in the morning, Colonial Heights after lunch, and Abingdon in the afternoon!”

Navigating the healthcare industry, as Snodgrass pointed out, can be a con-fusing experience for the layperson, who may not know where to go or who to call in order to find appropriate care for their medical problems. At First Assist, provid-ers and staff work not only to address pa-tients’ immediate needs, but also to help them secure establishment with primary care providers, pediatricians, and special-ists. First Assist is open 364 days a year, on weekends and evenings, as well as holi-days for the convenience of patients suf-fering from non-life threatening injuries and illnesses. The practice offers on-site x-rays and lab services for convenience of patients, as well as sports and school physi-cals and occupational medicine services at each of its eight locations. Snodgrass is personally invested in providing the best possible experience for each and every patient; her phone number is listed on the practice’s website for patients who have any questions or concerns about seeking care at any of First Assist’s locations. In addition to treating patients’ physical ail-ments, the First Assist team makes a pri-ority of engaging with and improving the local community.

“The First Assist team members, pro-viders, and I enjoy community outreach,

and make it a priority to get out into the community and participate in numerous outreach events quarterly,” Snodgrass ex-plained. “You may see us in the clinic on Monday, at the Health Resource Center in the Johnson City Mall on Thursday, and in the First Assist First Aid Tent on the football field on Saturday! We just want to make a positive difference in the community and let our patients know that we’re here for them when they need us.”

Snodgrass and her husband Roger, a pharmaceutical specialist, recently cele-brated their 10-year wedding anniversary. The couple have two children, William (age 6) and Morgan Elizabeth (age 3). When she’s not working, Snodgrass likes to relax with reading, landscaping, and interior design.

“My husband and I love antiquing and traveling, but our favorite time of day is evening when we get to just relax and spend time outdoors with the children,” she said. Snodgrass and her family love their Elizabethton home and community. “Even though I’m not from East Tennes-see originally, it’s home now, and I can’t imagine living anywhere else,” she said. “It’s a beautiful place to live and raise a family!”

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Take good care of your money.


East Tennessee Children’s Hospital Gastroenterology and Nutrition ServicesGI for Kids, PLLC

Every Child Is Special.

www.giforkids.com (865) 546-3998

Bee Fit 4 KidsOur physicians are well aware of the obe-sity crisis in the United States, especially among children. That’s why

we have developed Bee Fit 4 Kids, a family-based, multidisciplinary pediatric weight management program. Bee Fit 4 Kids brings together a physician extender, behavioral health clinician and registered dietician to cre-ate a team for each child in the pro-gram. Working with the children, his or her parents and other family members where appropriate, the team builds rapport with the child through one-on-one meetings, and then begins to create an individualized treatment plan around nutrition, fi tness and psycho-logical concerns. How does it work? Healthy lifestyle changes at every step of every day. Weight loss doesn’t happen overnight, and good eating habits don’t form in a weekend. We work with the child to teach him or her about healthy and fun food choices, as well as starting on physical activities. The emotional side of weight loss is covered as well, so the child learns how to live healthier both physically and mentally. Bee Fit 4 Kids is for children and adolescents with a Body Mass Index, or BMI, greater than the 95th percentile, or the 85th percentile if there is an over-weight parent, medical complication or family history of specifi c health risks.

The Developmental Feeding ClinicChildren born prematurely often have diffi culty eating as they grow and develop. Partnering and collaborat-ing with Dr. Nadine Trainer at East

Tennessee Children’s Hospital, GI For Kids’ Medical Director, Dr. Youhanna Al-Tawil, working with dietician Ashley Treadway, has developed The Develop-mental Feeding Clinic of the Children’s Hospital Rehab Center to address their special needs. At its core, The Feeding Clinic focuses on the needs of children with feeding issues due to neonatal ab-stinence syndrome, premature birth, neurodevelopmental delay and sensory integration disorder.

Liver Disease Specialty TreatmentGI For Kids has launched a new liver program that will treat the entire range of liver issues, from elevated liver en-zymes to diseases such as hyperbiliru-bemia, autoimmune hepatitis, infectious hepatitis and chronic liver conditions.

Celi-ACT GI For Kids has many patients who deal with the ongoing issues

surrounding celiac disease and gluten intolerance. Our goal is not only to pro-vide medical treatment, but also care and support. Celi-ACT is a support group that gives children and their families the education and information to deal with a diagnosis of Celiac disease. From life-style changes to what to expect medi-cally, the group is there to calm fears and provide hope.

KidsFACTKidsFACT (Kids Fight-ing against Crohn’s and Colitis Together) is a nonprofi t sup-

port group founded by GI For Kids to

help those with pediatric Infl ammatory Bowel Disease, or IBD. In addition to providing information and support, KidsFACT also gives college scholar-ships to children with IBD, Crohn’s Disease and ulcerative colitis.

Transitions Behav-ioral Health ClinicAll of our work at GI For Kids is patient-centered, but that doesn’t mean just treating the physical

ailments. We also focus on the mind, because whether it’s dealing with a Crohn’s diagnosis or the emotional issues surrounding weight loss, whole-body health is key to success. Our Transitions Behavioral Health Clinic works with pediatric patients and their families as they tackle the big changes that have come their way. We offer support and behavioral modifi ca-tions, and also receive outside referrals from other pediatrics practices to treat behavioral issues both related and unre-lated to GI issues.

From intake to diagnosis and beyond, GI For Kids works with patients and their families to treat GI illnesses, weight issues, mental-health challenges and much more. We work with the en-tire East Tennessee Children’s Hospital medical family on community outreach events and educational seminars/work-shops throughout the year, because we believe an informed community is a healthy community. If you would like any information about our practice, support groups or upcoming events, please contact us at (865) 546-3998, or visit us at www.giforkids.com.

Celi-ActKnoxville area celiac patients helping each other.

www.celi-act.com Established by GI for Kids, PLLC

GI FOR KIDS DOESN’T FOLLOW THE TRENDS, IT SETS THEM.

When a child says “my tummy hurts,” it can be a lot of di� er-ent things. That’s why GI For Kids is ready to treat children with a variety of GI issues, o� ering pediatric gastrointestinal, hepatology and nutritional services.

We are an a liate of East Tennessee Children’s Hospital, and our highly trained, award-winning sta� includes four board-certifi ed pediatric gastroenterologists, three nurse practitio-ners, a physician assistant, two behavioral health clinicians, three registered dieticians and a research coordinator.

Their healthcare should be, too. At GI for Kids, that’s the way we do things all day, every day.

TREATING THE WHOLE CHILD ISN’T A CONCEPT. IT’S WHAT WE DO.At GI For Kids, we treat our patients when they come to us, but we also keep up with what’s going on outside our walls. From attending (and often presenting at) seminars and workshops to writing for medical journals, we take the advanced concepts of pediatric medicine and create programs tailored to help our patients, and their families, live better lives.

2100 Clinch Avenue, Suite 510 | Children's Hospital Medical Offi ce Building | Knoxville, TN 37916


East Tennessee Children’s Hospital Gastroenterology and Nutrition ServicesGI for Kids, PLLC

Every Child Is Special.

www.giforkids.com (865) 546-3998

Bee Fit 4 KidsOur physicians are well aware of the obe-sity crisis in the United States, especially among children. That’s why

we have developed Bee Fit 4 Kids, a family-based, multidisciplinary pediatric weight management program. Bee Fit 4 Kids brings together a physician extender, behavioral health clinician and registered dietician to cre-ate a team for each child in the pro-gram. Working with the children, his or her parents and other family members where appropriate, the team builds rapport with the child through one-on-one meetings, and then begins to create an individualized treatment plan around nutrition, fi tness and psycho-logical concerns. How does it work? Healthy lifestyle changes at every step of every day. Weight loss doesn’t happen overnight, and good eating habits don’t form in a weekend. We work with the child to teach him or her about healthy and fun food choices, as well as starting on physical activities. The emotional side of weight loss is covered as well, so the child learns how to live healthier both physically and mentally. Bee Fit 4 Kids is for children and adolescents with a Body Mass Index, or BMI, greater than the 95th percentile, or the 85th percentile if there is an over-weight parent, medical complication or family history of specifi c health risks.

The Developmental Feeding ClinicChildren born prematurely often have diffi culty eating as they grow and develop. Partnering and collaborat-ing with Dr. Nadine Trainer at East

Tennessee Children’s Hospital, GI For Kids’ Medical Director, Dr. Youhanna Al-Tawil, working with dietician Ashley Treadway, has developed The Develop-mental Feeding Clinic of the Children’s Hospital Rehab Center to address their special needs. At its core, The Feeding Clinic focuses on the needs of children with feeding issues due to neonatal ab-stinence syndrome, premature birth, neurodevelopmental delay and sensory integration disorder.

Liver Disease Specialty TreatmentGI For Kids has launched a new liver program that will treat the entire range of liver issues, from elevated liver en-zymes to diseases such as hyperbiliru-bemia, autoimmune hepatitis, infectious hepatitis and chronic liver conditions.

Celi-ACT GI For Kids has many patients who deal with the ongoing issues

surrounding celiac disease and gluten intolerance. Our goal is not only to pro-vide medical treatment, but also care and support. Celi-ACT is a support group that gives children and their families the education and information to deal with a diagnosis of Celiac disease. From life-style changes to what to expect medi-cally, the group is there to calm fears and provide hope.

KidsFACTKidsFACT (Kids Fight-ing against Crohn’s and Colitis Together) is a nonprofi t sup-

port group founded by GI For Kids to

help those with pediatric Infl ammatory Bowel Disease, or IBD. In addition to providing information and support, KidsFACT also gives college scholar-ships to children with IBD, Crohn’s Disease and ulcerative colitis.

Transitions Behav-ioral Health ClinicAll of our work at GI For Kids is patient-centered, but that doesn’t mean just treating the physical

ailments. We also focus on the mind, because whether it’s dealing with a Crohn’s diagnosis or the emotional issues surrounding weight loss, whole-body health is key to success. Our Transitions Behavioral Health Clinic works with pediatric patients and their families as they tackle the big changes that have come their way. We offer support and behavioral modifi ca-tions, and also receive outside referrals from other pediatrics practices to treat behavioral issues both related and unre-lated to GI issues.

From intake to diagnosis and beyond, GI For Kids works with patients and their families to treat GI illnesses, weight issues, mental-health challenges and much more. We work with the en-tire East Tennessee Children’s Hospital medical family on community outreach events and educational seminars/work-shops throughout the year, because we believe an informed community is a healthy community. If you would like any information about our practice, support groups or upcoming events, please contact us at (865) 546-3998, or visit us at www.giforkids.com.

Celi-ActKnoxville area celiac patients helping each other.

www.celi-act.com Established by GI for Kids, PLLC

GI FOR KIDS DOESN’T FOLLOW THE TRENDS, IT SETS THEM.

When a child says “my tummy hurts,” it can be a lot of di� er-ent things. That’s why GI For Kids is ready to treat children with a variety of GI issues, o� ering pediatric gastrointestinal, hepatology and nutritional services.

We are an a liate of East Tennessee Children’s Hospital, and our highly trained, award-winning sta� includes four board-certifi ed pediatric gastroenterologists, three nurse practitio-ners, a physician assistant, two behavioral health clinicians, three registered dieticians and a research coordinator.

Their healthcare should be, too. At GI for Kids, that’s the way we do things all day, every day.

TREATING THE WHOLE CHILD ISN’T A CONCEPT. IT’S WHAT WE DO.At GI For Kids, we treat our patients when they come to us, but we also keep up with what’s going on outside our walls. From attending (and often presenting at) seminars and workshops to writing for medical journals, we take the advanced concepts of pediatric medicine and create programs tailored to help our patients, and their families, live better lives.



EAST TN MEDICAL NEWS

Become a Fan on Facebook.Follow us on Twitter.Follow us on

Knoxville MGMA Monthly MeetingDate: 3rd Thursday of each month

Time: 11:30 AM until 1:00 PMLocation: Bearden Banquet Hall, 5806 Kingston Pike,

Knoxville, TN 37919Lunch is $10 for regular members.

Come learn and network with peers at our monthly meetings. Topics are available on the website.

Registration is required. Visit www.kamgma.com.

Chattanooga MGMA Monthly MeetingDate: 2nd Wednesday of each month

Time: 11:30 AMLocation: The monthly meetings are held in Meeting Room A of the Diagnostic Center building, Parkridge Medical Center, 2205

McCallie Avenue, Chattanooga, TN 37404 Lunch is provided at no cost for members, and there is currently no cost to a visitor who is the guest of a current member. Each member is limited to one unpaid guest per meeting, additional guests will be $20 per guest. All guests must be confi rmed on

the Friday prior to the meeting.RSVP to Irene Gruter, e-mail: [email protected] or call

622.2872. For more information, visit www.cmgma.net.

3RD THURSDAY 2ND WEDNESDAY

Mark Your CalendarYour local Medical Group Managers Association is Connecting Members and

Building Partnerships. All area Healthcare Managers are invited to attend.

the society already had experience weighing the evidence at the request of physicians, patients and payers. “NASS began a number of years ago be-coming involved in third party payer coverage de-cisions,” he noted. How-ever, he continued, the turnaround time was often tight and the number of studies to consider extensive.

“We decided to proactively create our own coverage decisions based on the best evidence available … and where evi-dence was lacking, based on the expertise in this group,” he explained. “We came up with what we feel is the most sound group of recommendations based on the best evidence available at this point and time.”

Watters continued, “One of the hopes that we have is that we bring a bit of uniformity to the whole process of spi-nal care.”

Christopher Kauffman, MD, health policy council director for NASS, con-curred. He said allowed treatments and diagnos-tics vary by state and by payer. These recommen-dations outline the scope and clinical indications for a therapeutic measure when a patient meets ap-propriate inclusion cri-teria. They also clearly state scenarios in which employing the measure is not indicated.

While not recommending payers re-imburse for every procedure under every circumstance might be controversial among some providers, Kauffman said, “People who understand where medicine is going with outcome measures get it. So far, the re-sponse has been overwhelmingly positive.”

He added, “People may confuse cov-erage with medical appropriateness. The two are not equal. People assume pay-

ment equals medical appropriateness. I can’t stress enough this isn’t true. Payment equals treatments where the literature has reached a certain bar of evidence.”

Kauffman, a board certifi ed ortho-paedic surgeon in practice at Premier Orthopaedics in Nashville, said, “For everything we recommend, we think the evidence does reach the bar for coverage. This is what we think should be covered by any payer.”

However, he continued, it doesn’t mean other treatments being employed don’t have therapeutic benefits. “You can’t ever throw out the art of medicine.” Yet, Kauffman noted, “If you’re falling outside the clinical guidelines, you have to expect that you’re going to do a peer-to-peer review, or it might not be a covered service.” He added the recommendations would be routinely revisited to incorporate new evidence.

In addition to the 13 coverage pol-icy recommendations published in May, Watters said NASS is already in process or planning to create documents for 14 additional diagnostic and therapeutic mo-dalities including annular repair, cervical and lumbar radiofrequency neurotomy, cervical fusion, cervical laminectomy and laminoplasty, minimally invasive lumbar fusion, SI joint fusion and injec-tions, DNA-based scoliosis test and elec-trical stimulation for bone healing, among others. “The remainder will be released within a year,” he said.

“The plan is to reassess the literature at least every two years,” he continued, emphasizing the need to stay current as new studies are published and new treat-ment options become available. “This has to be a living document.”

He added it’s a nearly impossible task to ask physicians, surgeons, nurses, therapists and other providers to wade through all the literature required to prac-tice evidence-based, contemporary medi-cine. Having the committee go through the best, most soundly crafted studies to

create each of the 5-30 page recommen-dations, which include supporting details behind the rationale and a thorough list of references, simplifi es the process for prac-titioners and their patients. “These turned out to be remarkably educational docu-ments,” Watters stated.

Both Kauffman and Watters stressed at the end of the day, the coverage rec-ommendations are an effort to ensure patients have equal access to the best pos-sible treatments.

“It’s making sure that good spine care is available for patients across the U.S.,” Kauffman concluded.

NASS Takes a Proactive Approach, continued from page 1

Dr. William Watters

Dr. Christopher Kauffman

Coverage Policy RecommendationsTo access the documents for each of the procedures listed below, go online to www.spine.org and click on the “Policy & Practice” heading.

Cervical artifi cial disk replacement

Endoscopic discectomy

Epidural cervical spinal injections

Interspinous device without fusion

Interspinous fi xation with fusion

Laser spine surgery

Lumbar artifi cial dis replacement

Lumbar discectomy

Lumbar fusion

Lumbar laminotomy

Lumbar spinal injections

Percutaneous thoracolumbar stabilization

Recombinant human bone morphogenetic protein (rhBMP-2)

each for distributing profi ts and for paying productivity bonuses, group practices may also devise their own indirect allocation method, as long has it is appropriately documented and, essentially, “makes sense.” So, while groups may not give a physician dollar-for-dollar credit for each ancillary service he/she orders, it may be able to use the Stark-sanctioned methods which virtually mirror a direct allocation.

Should our group practice really be worried about our compensation methodology?

Consider this chain of events: A group does not qualify as a “group practice” because it wrongly allocates DHS revenues based on physician referrals, but nevertheless bills the Medicare program for DHS ordered by its physicians, violating the Stark law. That means that monies received for those DHS services are actually overpayments, which the Affordable Care Act (ACA) says must be reported and refunded within sixty (60) days of their identifi cation (3). If the group does not so report and refund, then it now has retained overpayments. Under the ACA, those overpayments become “false claims” that may be prosecuted under the False Claims Act (4). Most cases under the False Claims Act are initiated by whistleblowers.

Would it not be better then for your group practice to review its compensation methodology and ensure Stark compliance than to have a disgruntled former employee convince the government to do it for you?

Patti T. Cotten is an attorney at London & Amburn, P.C. in Knoxville, Tennessee, focusing her practice on healthcare regulatory compliance matters, including Stark law. She co-chairs the fi rm’s Healthcare Compliance, Regulatory Matters, HIPAA, Peer Review, and Managed Care practice group. Disclaimer: The information contained herein is strictly informational; it is not to be construed as legal advice.

Notes142 U.S.C. § 1395n242 C.F.R. §411.352342 U.S.C. § 18001431 U.S.C § 3729

Profi t and Loss: The Top Ten Things Providers Need to Know, continued from page 4


EAST TN MEDICAL NEWS

Whether it’s staffing, billing and collections, or help with insurance claims, Mountain Management offers a full range of services to meet the business needs of physicians wanting to improve their practices and betters serve patient needs.

Our customized strategic business and management plans and patient satisfaction programs ensure your practice is in compliance with Medicare, Medicaid, OSHA, laboratory rules, human resources, and payroll regulations. We also offer help with purchasing, medical records, education and more.

To learn more about how your practice can benefit froma relationship with Mountain Management, please call

(423) 495-6889

Do what you do best:Care for your patients.

Leave therest to us.

5425 MtnMngmnt_EastTNMedNews_HfPg_Hor_FINAL.indd 1 6/13/14 3:56 PM

The Literary ExaminerBY TERRI SCHLICHENMEYER

Getting Waisted: A Survival Guide to Being Fat in a Society That Loves Thinby Monica Parker; c.2014, HCI; $15.95 / $19.95 Canada, 278 pages

Up and down. Up and down.

You’re up and down while cleaning, work-ing, exercising, and weighing yourself – and on that note, if the latest diet doesn’t work, maybe the next one will.

Or, maybe, as you’ll see in the new book Getting Waisted by Monica Parker, it’s time to break this yo-yo string.

Born in Glasgow, Scotland, Monica Parker was six-and-a-half pounds at birth but an hour later, “I weighted sixty-two pounds.” That’s a slight exaggeration, she admits, but the point is that, for as far back

as she remembers, Parker was overweight.Her mother, whom Parker calls

Queen Elizabeth (resemblance in attitude only), was a Viennese refugee from Hit-ler’s regime who’d been forced to leave her two eldest children behind during the war. The family was reunited when Parker was a small child, but the damage had already been done: she grew up lonely, picked-on, self-conscious, and believing that her mother barely noticed her. Subconsciously thinking that being larger would mean being seen, Parker ate.

She was chubby when the family – which now included Parker’s estranged father – immigrated to Toronto. She was chunky as a teen when she learned that her size gave her “power” - but not enough to keep her from being raped. She tried to fl irt, tried to date, hoped to fi nd a boy-friend, and ended up being little more than a sidekick to her two svelte roommates as a young adult.

Men didn’t like Parker’s body. She didn’t like it, either.

Parker tried every diet that sounded workable. She starved herself, then binged; rewarded and punished herself; and almost ruined the relationship she always wanted.

And then, in one of those only-in-Holly-wood moments, Hollywood called and Parker was offered a job she dreamed of. It meant moving to Beverly Hills, though, an atmosphere that didn’t exactly nurture Parker’s body image…

Getting Waisted is a nice surprise. It’s funny in the right places, sad where sad be-longs, and supportive in a Sisterhood kind of way. However, there’s a big but…

In this memoir, author Monica Parker takes us through her personal ups and downs – a lot. Reminiscent of yo-yo diet-ing, we read about highs and lows that hap-pen repeatedly, details that start to seem like more of the same. I didn’t mind that at fi rst – or fourth, or fi fth – but I quickly lost my appetite for it. It just made the book feel padded.

But then – literally on the penultimate page – we get the nugget we’ve waited for, the raison d’être, the thing every woman needs to know. I wish it had come sooner, but angels sang when I read it and that’s good enough for me.

Watch for copious amounts of (justi-fi ed) (and charming) name-dropping when you read this book – and if you’re a mirror-avoiding, diet-trying woman who hates her

thighs-arms-stomach-chin, you should. For you, Getting Waisted is one to pick up.

Over Our Dead Bodies: Undertakers Lift the Lid by Kenneth McKenzie and Todd Harra; c.2014, Citadel Press; $15.95/$17.95 Canada, 256 pages

The End.And then

what? What happens to your mortal remains when that’s all that remains? Take a peek at Over Our Dead Bodies by Ken-neth McKenzie and Todd Harra, and you’ll get a general idea.

In your job, you basically know what to expect from day to day. Not so, if you’re an undertaker. When you care for the dead and their families, anything can happen – and McKenzie and Harra prove that well.



To learn more, visit healthcare.goarmy.com/y941 or call 1-888-550-ARMY.

Terri Schlichenmeyer. Terri is a professional book reviewer who has been reading since she was 3 years old and she never goes anywhere without a book.

Name: Jayma Jeffers-Branam

Position: Practice Manager, GI for Kids, Knoxville

At a Glance: Although Jayma Jeffers-Branam has only been with GI for Kids for 18 months, she brings more than 26 years’ worth of healthcare experience with her — and everyone benefi ts.

“I’ve worked in basic cardiology, internal medicine, pediatrics, behavioral health, OB-GYN, and even family dentistry,” Jeffers-Branam said. “But wherever I’ve been, the focus has always been on the patient. That’s very true of GI for Kids, where everything we do, all the healthcare we provide, is about working toward that.”

A native Tennessean, Jeffers-Branam spent more than 20 years in neighboring Lexington, Ken., before returning home. Her work as a practice manager has carried her to different patient demographics over the years, but she says that working in the South, and Kentucky and Tennessee in particular, have a lot of common elements.

“Our patient bases are very similar in this region, even though we may be treating women at one practice, and children at another,” she said. “The needs differ, but the patients all have a lot in common just because they are from the area around the practice.”

One thing that has changed is how practices operate, and so as a practice manager Jeffers-Branam says she has to work constantly to keep up.

“Major changes over the years always have revolved around insurance, and managing it for patients,” she said. “It’s about all the different types of coverage, and the different authorizations for a patient’s treatments. We have to be on top of all those requirements in order to give the very best care we can give. That can be a real juggling act sometimes, and very diffi cult, but the goal is always to provide the very best care for that patient, regardless of what’s going on with their insurance. We always treat the patient fi rst.”

Technology has also been a boon, especially as electronic medical records have taken hold.“It’s a great tool, and getting even better,” Jeffers-Branam said. “As a healthcare provider, you want something

that’s going to make you more effi cient in your workfl ow, but doesn’t change the way you treat patients. Having all a patient’s information at your fi ngertips is amazing.”

Parents and even children are getting into the tech arena as well, which helps create partnerships for the practice that wouldn’t have been possible before, she added.

“They are all very tech savvy, and doing research on the conditions they have and the types of questions to ask,” she said. “People want to learn what they can do at home to live a better life, and that really raises the bar for us. We have to understand not just the technology that’s coming out for our offi ce work, but also what the community is working with, and how we can work with them. Healthcare providers are defi nitely having to change with the times.”That’s not a problem at GI for Kids, Jeffers-Branam notes.“Children’s Hospital has been a staple in this area for years, and when I came home I was thrilled to get the opportunity to come to GI for Kids,” she said. “I love being affi liated with the hospital network, and the work that GI for Kids does is amazing. Dr. Al-Tawil has a incredible reputation across the country for being a pioneer in pediatric GI and nutrition treatment, and we are doing amazing things here.”

HealthcareServiceSnapshotBut fi rst – a little history.Take the label “undertaker,” for ex-

ample. It initially had to do with the un-dertaking of proper burial but some 130 years ago, the National Funeral Directors Association offi cially changed the title to “funeral director.”

Back then, funeral directors and cabi-net makers went hand-in-hand; someone had to make the coffi ns, so why not some-one with woodworking skills? The business was then passed down through the family, with many an undertaker getting his (or her) start as a child, sweeping the parking lot, pulling weeds, or helping out inside.

But getting back to the main point: “no day is the same” for a funeral direc-tor. You can’t ever prepare yourself for a “Goat” to appear on someone’s last wishes. You can’t fail to be impressed at the timing of a husband and wife who die within hours of one another. You can’t re-main unfazed by any coincidence, really, and you’ll never get over the death of your own mother, no matter how many moth-ers you’ve buried.

Still, funerals aren’t “doom and gloom and death and dying and tears and crying every day, all day.” Funny things happen – like a hearse caught in a snowstorm and a funeral rescued by a beat-up pickup. Like a jazz funeral that ended with a second chorus. Like superstitions, accidental love-matches, funeral crashers, and life stories that start with a piece of furniture and go full circle.

And speaking of life, the authors say, enjoy yours to the fullest “because you too will one day be pushing daisies.”

No pun intended, but my fi rst impres-sion of “Over Our Dead Bodies” was that it was a little stiff.

There’s quite a bit off-topic in the fi rst few pages here – extraneous info that felt like a commercial – and because of that, it seems to take awhile for authors Ken-neth McKenzie and Todd Harra to get to the body of their book. Once they do, however, we’re treated to the kinds of tales we’d normally beg to hear when we’d meet an undertaker at a cocktail party, as well as personal stories and a rambling (and quite fascinating) social history of death and fu-nerals.

But fear not: this isn’t macabre stuff; it’s funny and poignant and, as you dig in, it’s very, very addicting. Once you’ve started Over our Dead Bodies, in fact, you’ll like it to The End.

The Literary Examiner, continued from page 13


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chapters to mandate or improve on the requirement of stocking epinephrine in schools for severe allergic reactions. For example, California is considering legisla-tion to strengthen its existing epinephrine-stocking law to require schools to stock the medication and train a volunteer to administer it. Illinois is considering legis-lation to require, rather than simply allow, schools to stock epinephrine. All states in Medical News markets have epinephrine-stocking school policies in place, with the exception of North Carolina, which at press time had pending legislation.

The AAFA has banded with other national health advocacy groups to sup-port increased research funding, which in-cludes lobbying against proposed budget cuts for the National Institutes of Health, Centers for Disease Control and Preven-tion (CDC), Agency for Health Resources and Quality, and other agencies with research relevant to asthma and allergic diseases.

For example, the CDC’s National Asthma Control Program has helped decrease asthma mortality rates by more

than 45 percent since its inception in 1999.

“There are many things that we can improve now to make life better for people with asthma,” says AAFA spokes-person and asthma patient, Talisa White. “Our Asthma Capitals report helps to shed light on the asthma burden in each city, but it also provides a roadmap for improvements.”

Taking Your Breath Away, continued from page 7

Fast Facts about Asthma

Every day in the United States,

44,000 people have an asthma attack;

36,000 kids miss school due to asthma;

27,000 adults miss work due to asthma; and

9 people die from asthma.

SOURCE: AAFA.

said Keckley. “Two out of three primary care doctors have already cast their lot,” he continued of aligning with hospitals, payers or very large groups.

“Frontline specialists have already gone to bigger groups. Now they are mov-ing to the next option … most look like they’re going to hospitals,” he added of orthopedists, ENTs and OB/GYNs. As for other specialists, he said the decision to remain independent, merge or consoli-date is all over the board and is specialty dependent.

Going forward, Keckley said, “I think we’re going to end up with a very few private doctors in practice indepen-dently.” He predicts seeing a few more very large, multispecialty practices. “I think the majority end up employed in the hospitals because of these new payment mechanisms.”

In fact, he noted, “It’s been incentiv-ized for the hospitals to hire physicians.” Clinical integration, outcomes-based re-imbursement and bundled payments have created an environment where hospitals and doctors are increasingly co-depen-dent.

Although hospital administrators and clinicians have always had to work together, Keckley said this new closeness highlights areas that must be addressed to maximize effectiveness. Three key stress-ors are administrative decisions, clinical performance, and … of course … alloca-tion of money.

“There’s always going to be tension around operations,” he said of admin-istrative decisions. “Each presumes the other’s operating is simpler than it really is,” he continued of the chasm between blue suits and white coats.

With reimbursement tied to out-comes, he said physicians and hospitals face tougher decisions around strategy.

One issue is how to address physicians not practicing effectively. “The hospital suits don’t do a very good job of changing the behavior of doctors. It takes peers,” he noted.

The biggest cause of tension is ex-pected to be around allotting payments to each of the partners in a vertically inte-grated delivery system. “And then you get down to money, and that’s where it gets ugly,” Keckley stated. However, he con-tinued, too often the perception among administrators is that it’s all about the money when it comes to physicians. “If it was just about money, there are a lot of better ways to make money … and easier, by the way. Most doctors don’t go into it to be wealthy. It’s hard work. The aver-age medical career is 30 years, and it’s a hard 30 years.”

That said, he added physicians do want to be successful, have a sense of satisfaction around their career choice and be well compensated for their work. However, Keckley noted, “There’s such a difference between the way doctors think things should be and the way they are.”

Keckley said too many physicians tend to dismiss data as unreliable or be-lieve their patient is an outlier. Yet, he added, “The table stakes are you’ve got to have data. You can’t just have a bunch of opinions.” To bridge that gap, Keckley said he believes it is going to take physi-cians willing to step into the hot seat and take criticism from their colleagues as the profession adapts to new economic reali-ties.

“I think physician leadership is prob-ably going to be a theme over the next 10 years,” Keckley said. “The medical profession is well respected and well com-pensated … that doesn’t change … but how that profession plays in the delivery system is very much a work in progress.”

Partnering, continued from page 1 GrandRoundsParkridge Medical Center Earns Mission: Lifeline Quality Achievement Award

CHATTANOOGA — Parkridge Medical Center has received the Mission: Lifeline® Bronze Receiving Quality Achievement Award for implementing specifi c quality im-provement measures outlined by the Amer-ican Heart Association for the treatment of patients who suffer severe heart attacks.

The American Heart Association’s Mission: Lifeline program helps hospitals, emergency medical services and commu-nities improve response times so people who suffer from a STEMI get prompt, ap-propriate treatment. The program’s goal is to streamline systems of care to quickly get heart attack patients from the fi rst 9-1-1 call to hospital treatment.

Parkridge Medical Center earned the award by meeting specifi c criteria and stan-dards of performance for the quick and ap-propriate treatment of STEMI patients to open the blocked artery. Before patients are discharged, they are started on aggressive risk reduction therapies such as cholesterol-lowering drugs, aspirin, ACE inhibitors and beta-blockers, and they receive smoking cessation counseling if needed. Eligible hospitals must adhere to these measures at a set level for a designated period to receive the awards.

Dr. Bill Stacy to Chair Memorial Foundation’s Board of Directors

CHATTANOOGA – The Memorial Health Care System Foundation, the fun-draising arm of Memorial Health Care Sys-tem, is pleased to announce offi cers and new members of the Foundation’s Board of Directors.

Bill Stacy, PhD, Emeritus Chancellor of UTC and retired Headmaster of Baylor School, will serve as chair of the Memorial Foundation Board of Directors. He previ-ously served as the secretary and vice chair, and was co-chairman of the Inspired Heroes capital campaign.

MaryStewart Lewis, of AT&T, will serve as vice chair.

Holly Harwell, of Keller Williams Realty, will serve as the immediate past chair.

Hodgen Mainda, of MDP Manage-ment, will serve as secretary.

James Woods, of the Trust Company, will serve as treasurer, and Lee Jackson, M.D. of Memorial Robotics and Urologic Cancer, will hold the member-at-large post. Dr. Jackson is a board certifi ed urologist and prostate cancer surgeon at the Memorial Health Care System.

Medical News is pleased to provide space for press releases by providers in our Grand Rounds section. Content and accuracy of the releases is the sole responsibility of the issuer.


Mark Your CalendarYour local Medical Group Managers Association is Connecting Members and Building

Partnerships. All area Healthcare Managers (including non-members) are invited to attend.

JOHNSON CITY MGMA MONTHLY MEETING

Date: The 2nd Thursday of Each MonthTime: 11:30 AM – 1:00 PM

Location: Summit Leadership Foundation3104 Hanover Rd.

Johnson City

KINGSPORT MGMA MONTHLY MEETING

Date: The 3rd Thursday of Each Month Time: 11:30 AM – 1:00 PM

Location: Indian Path Medical Center Conference Room, Building 2002,

Second Floor, Kingsport

2ND THURSDAY 3RD THURSDAY

GrandRoundsMemorial Announces Board of Directors for 2014-2015

CHATTANOOGA – Memorial Health Care System is pleased to announce new members of the board of directors.

Charles L. Arant, president of the Ten-nessee Aquarium, will remain as chair of the board of directors. Sister Judith Raley, Sisters of Charity of Nazareth, will serve as secretary.

New members of the board include Christopher St. Charles, MD, president of the medical staff and a partner in the Associ-ates in ENT/Head and Neck Surgery; Jeffrey T. Wilson, pastor of the New United Mis-sionary Baptist Church and a former Ham-ilton County School Board member; Sister Dorothy Jackson, SCN, a member of the Sisters of Charity of Nazareth congregation and resident manager of the SCN apart-ments in Louisville, KY.

Board members continuing their ser-vice are as follows: Corinne A. Allen, former executive director of The Benwood Foun-dation; Christopher P. Crimmins, co-founder of The Chattanooga Land Company; Sister Gertrude Foster, Sisters of Charity of Naza-reth; Mary P. Tanner, PhD., retired senior vice chancellor for academic affairs, University of Tennessee at Chattanooga. John F. Boxell, MD, retired head and neck surgeon; Leo M. Brown, CLU, ChFC, AEP, partner, Davis, Smith & Brown; David B. Dodson, MD, in-ternal medicine specialist; Robert C. Grev-ing, retired executive vice-president, Unum Group; James L.E. Hill, retired chief execu-tive, Lupton Company; Sister Earline Hobbs, Sisters of Charity of Nazareth; James M. Hobson, chief executive officer, Memorial Health Care System; Christopher T. McKee, vice president, McKee Foods; John P. Nash, MD, orthopedic surgeon, Center of Sports Medicine and Orthopaedics; Cynthia Nes-son, retired senior vice president, Grady Health System; James H. Pesnell, retired se-nior vice president, Cigna Insurance; Kath-leen Sanford, senior vice president/chief

nursing officer, Catholic Health Initiatives; Wayne T. Scott, MD, internal medicine spe-cialist, Carolyn H. Smeltzer, EdD, RN, owner, Consulting Healthcare Services; and William P. Warren, MD, cardiologist.

Memorial Named Top 100 Great Community Hospital

CHATTANOOGA – Memorial Hospital has been named to the 2014 edition of “100 Great Community Hospitals,” a list based on community hospitals’ accolades, quality and service to their communities by Becker’s Hospital Review.

According to the Becker’s Hospital Re-view article, the hospitals that made the list have fewer than 550 beds and have continu-ally worked to provide the quality of care and the experience patients deserve and expect.

The Becker’s Hospital Review editorial team selected hospitals for inclusion based on rankings and awards from iVantage Health Analytics, Truven Health Analytics, CareChex, and the American Hospital As-sociation. iVantage recognitions considered include Healthstrong Hospitals, which are organizations in the top tier of iVantage’s Hospital Strength Index rankings, and the Top 100 Critical Access Hospital list, which indicates the critical access hospital per-forms as well or better at the median overall than all U.S. general acute-care hospitals in clinical and operational performance and financial outcomes. Inclusion on Truven Health Analytics’ 100 Top Hospitals list was also factored in.

Tennessee’s New Breast Density Law Effective July 1, 2014Memorial Health Care System’s new technology improves lesions and mass detection in women with dense breast.

CHATTANOOGA – Dense breast tis-sue can make cancer harder to detect on a traditional mammogram, which increases

the risk of a late-stage diagnosis in many women, according to the American Cancer Society. The new Tennessee state law effec-tive Tuesday, July 1, 2014, will require mam-mography radiologists to notify women of their breast density and offer other screen-ing options in addition to their routine mammograms.

Memorial offers tomosynthesis (also known as 3D mammography) which is dif-ferent from traditional mammogram in the same way a CT scan of the chest is different from a standard chest X-ray. A digital mam-mogram takes a two-dimensional photo of the breast. With tomosynthesis, a series of images from multiple angles are taken and converted to a three-dimensional image.

These images are constructed into slic-es and the series can be viewed individually or as a whole breast. This allows Memorial radiologists to obtain a more comprehen-sive picture of the breast tissue, where it improves visibility of lesions, increased abil-ity to size and stage masses and improve visualization and detection of women with dense breasts, reducing call backs, and pro-viding women with a greater piece of mind.

Breast tomosynthesis clinic research has shown:

* A reduction in patient call backs for tradition mammography.

* Improves lesion visualization over traditional mammography.

* Increased ability to identify size and stage of masses

* Improved visualization and detec-tion of masses and lesions in women with dense breasts.

Researchers believe that this new breast imaging technique will make breast cancers easier to see in dense breast tissue and will make breast screening more com-fortable.

To learn more about breast cancer or to schedule a screening mammogram call 423-495-4040 or visit www.maryellenlocher.com.

New members of the Foundation Board include:

Leo Brown – Leo Brown’s affiliation with Memorial dates back to 1996 when he be-gan his first term as a member of the Devel-opment Council, predecessor to the Foun-dation Board. Mr. Brown was instrumental in the creation of the Memorial Health Care System Foundation in 2000 and served two terms as Chair of the Board before becom-ing a member of the Memorial Health Care System Board of Directors where he has also served as Board Chair. Leo is a partner with Davis, Smith & Brown, a financial services company.

Sue Culpepper – Sue Culpepper is the Director for Student Success for the College of Business at the University of Tennessee at Chattanooga. A dedicated civic leader, Sue is a Rotarian, a member of the University of Tennessee Alumni Association’s Women’s Council, University of Tennessee at Chat-tanooga Alumni Association, and currently serves on the boards of the Chattanooga Women’s Leadership Institute, Rotary Club of Downtown Chattanooga, the Dean’s Ad-visory Board for the University of Tennessee at Chattanooga College of Business, and Friends of Memorial Council.

Susan Maclellan – Susan Maclellan currently serves on the boards of The Beth-lehem Center, Young Life, and the Baylor School Parent Alliance. She also serves as a Parent Representative at Baylor, and is involved in fundraising for The Bethlehem Center and The Howard School.

Dan Norton – Dan Norton is a gradu-ate of The McCallie School and received his Undergraduate and Master’s Degrees from Rhodes College. He is a financial advisor with Lawson Winchester Wealth Manage-ment. In addition to his fundraising efforts for United Way, McCallie and March of Dimes, Mr. Norton also serves as the Vice Chairman of the Board of Directors for the River Valley March of Dimes.

David Wendt, M.D. – Dr. David Wendt received his medical degree from Wayne State University. Dr. Wendt completed his internship and residency at Henry Ford Hospital where he served as Chief Medi-cal Resident before going on the complete fellowships in cardiology at the University of Iowa and electrophysiology at Duke. He has practiced with the Chattanooga Heart Institute since 1994. He is a board certified in cardiac electrophysiology and certified with The North American Society of Pacing and Eligible Electrophysiology. Dr. Wendt has been published in numerous medical journals and is frequently involved as an in-vestigator in research efforts.

Other board members include Carlos Baleeiro, MD, Alexis Bogo, Sophia Bridger, Morgan Everett, Deborah Everhart, War-ren Logan, Sanford Sharp, MD, Dawn Shea, Paula Shuford, and Father Jim Vick. Ex-offi-cio members are Jennifer Nicely, Memorial Foundation President and James M. Hob-son, FACHE, Memorial Health Care System CEO.


Online Event

Calendar


GrandRounds

Bee Fit 4 Kids is a family oriented pediatric weight management program using evidenced based research to help overweight children & their families. We are now accepting insurance.

KidsFACT is a nonprofi t support group created by GI for Kids, PLLC for those diagnosed with pediatric Infl ammatory Bowel Disease (IBD) & their family members.

Our behavior clinicians are experienced in helping a variety of disorders.

Support group helping the Knoxville region with celiac disease & gluten intolerance. www.celi-act.comwww.giforkids.com (865) 546-3998


…welcomes Dr. David DeVoid, who joins the group as a Pediatric Gastroenterologist specializing in diagnosing and treating infants, children and teens with digestive, liver and nutritional problems. He graduated from the University of Maryland and received initial medical training at Baylor College of Medicine while serving in the U.S. Air Force. He completed his Pediatric Residency at Wilford Hall USAF Medical Center in San Antonio, Texas and postgraduate Fellow in Pediatric Gastroenterology at Walter Reed Army Medical Center in Washington, DC. serving in the U.S. Air Force for a total of nine years. He most recently cared for pediatric gastroenterology patients in Chattanooga, Tennessee for 16 years. His Gastroenterology interests include Irritable Bowel and Liver diseases as well as encouraging a healthy lifestyle as an important part of any treatment plan.

East Tennessee Children’s Hospital Gastroenterology and Nutrition Services

ACCEPTING NEW PATIENTS

GI for Kids, PLLC

Allen Thompson Sherwood, MD, joins Memorial Family Medicine Ooltewah

CHATTANOOGA – Memorial Health Partners Foundation announces a new physician at Memorial Family Medicine Ooltewah. Allen Thompson Sherwood, MD, is board certifi ed in family medicine. Dr. Sherwood earned his doctorate at Uni-versity of Tennessee Center for the Health Sciences, Memphis, TN and completed an internship in general surgery at Rutgers Uni-versity, New Brunswick, NJ. Dr. Sherwood completed his residency at University of Tennessee College of Medicine, Chatta-nooga, TN where he specialized in Family Medicine.

Memorial Family Medicine Ooltewah is a primary care practice with seven board-certifi ed physicians. The practice treats chil-dren, adults and seniors and is currently ac-cepting new patients.

Connie S. Wagner Appointed to 2014 TNCPE Board of Examiners

KNOXVILLE — Connie S. Wagner, Di-rector of Radiology for Parkwest Medical Center, has been appointed by the Board of Directors of the Tennessee Center for Per-formance Excellence (TNCPE) to the 2014 Board of Examiners. Each year, the TNCPE award program recognizes local, regional, and statewide organizations that demon-strate excellence in business operations and results.

As an examiner, Wagner is responsible for reviewing and evaluating organizations that apply for the TNCPE Award. The Board of Examiners comprises experts from all sectors of the regional economy, includ-ing health care, service, nonprofi t, manu-facturing, education and government. All members of the Board of Examiners must complete extensive training in the Baldrige Criteria for Performance Excellence. Exam-iners take the skills and expertise developed during training and the assessment process back to their own jobs, benefi ting and im-proving their own organizations in the pro-cess.

Summit Welcomes Pediatrician Jessica Albright to Tennessee Valley Primary Care

KNOXVILLE—Dr. Jessica Albright, a primary care physician specializing in pe-diatrics, has joined Tennes-see Valley Primary Care in Jefferson City. A native of the community, Dr. Albright earned her bachelor’s de-gree from Carson-Newman and her medical degree from the James H. Quil-len College of Medicine in Johnson City.

She recently completed her residency at East Tennessee State University Pediat-rics where she was the chief resident. Dr. Albright is now accepting new patients and will be primarily located at 120 Hospi-tal Drive in Jefferson City. She will also see patients on select days at Summit Medical Group at Newport, 610 Cosby Highway. Both practices accept most insurance plans.

Erlanger receives $1 million Innovation Award from BlueCrossPayment aims to enhance, promote health care quality

CHATTANOOGA — BlueCross BlueShield of Tennessee has awarded the Erlanger Health System $1 million for inno-vation initiatives designed to enhance and promote healthcare quality in the commu-nity.

The Innovation Award payment is part of a fi ve-year strategic partnership between Erlanger and BlueCross announced last April, making Erlanger the exclusive Chatta-nooga health system in the BlueCross’ Blue Network ESM.

One key initiative funded by the BlueCross award was the creation of a Care Transition Team targeting high-risk patients, age 65 and older, with no primary care phy-sician and with repeated visits to Erlanger’s

Emergency Room (ER) within six months. High risk conditions include conges-tive heart failure, COPD and pneumonia, among others. Within one week of every ER visit to Erlanger, a designated navigator on the Care Transition Team follows up with a phone call to ensure the patient is taking medications, to see if further assistance is needed, and to encourage a primary care visit.

During the joint announcement of their strategic partnership last April, offi cials with both organizations stressed that their agree-ment would signifi cantly benefi t the com-munity, particularly after the new health care law went into effect this year. The agree-ment, which made Erlanger the exclusive Chattanooga health system in the new Blue Network E, covered many of those enrolling in the health care Marketplace. .

LMU Nurse Anesthesia Concentration Receives Continued Accreditation through 2024

HARROGATE - The Caylor School of Nursing (CSON) at Lincoln Memorial Uni-versity (LMU) nurse anesthesia concentra-tion has received continued accreditation from the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). The nurse anesthesia concentration’s ac-creditation has been continued for 10 years, the maximum period allowed by the COA. The concentration’s next accreditation re-view will take place in Spring 2024.

This is the latest in a series of acco-lades for the nurse anesthesia concentra-tion. The members of the 2013 graduating class, which received their Master of Science in nursing degrees in the nurse anesthesia concentration in December 2013, achieved a fi rst-time pass rate of 100% on the national certifying exam. Within two months of grad-uating, the class had a 100% employment rate.

The nurse anesthesia concentration

is one of three Master of Science in Nurs-ing degree concentrations offered by the CSON, along with family nurse practitioner and family psychiatric mental health nurse practitioner. Associate of Science in Nurs-ing, Bachelor of Science in Nursing and RN-Bachelor of Science in Nursing degree programs are also available. Enrollment in the CSON has quadrupled over the last fi ve years as new programs and concentrations have been added. 2014 marks the 40th an-niversary of the CSON at LMU.

LMU-DCOM Faculty Member Elected President of TOMA

HARROGATE - Dr. Gina DeFranco, associate professor of family medicine at Lincoln Memorial Universi-ty-DeBusk College of Os-teopathic Medicine (LMU-DCOM) in Harrogate, Ten-nessee, has been elected president of the Tennessee Osteopathic Medical Asso-ciation (TOMA). DeFranco took offi ce in May 2014 dur-ing TOMA’s Annual Convention and Scien-tifi c Seminar in Gatlinburg, Tennessee.

DeFranco earned a Bachelor of Sci-ence degree in biology at the University of North Carolina at Chapel Hill and her doctor of osteopathic medicine degree from the University of Health Sciences College of Os-teopathic Medicine in Kansas City, Missouri. DeFranco completed her family medicine residency and was assistant professor of family medicine at the University of Tennes-see College of Medicine in Chattanooga before joining the faculty of LMU-DCOM in 2009. She is board certifi ed in family medi-cine by both the American Board of Family Medicine and the American Osteopathic Board of Family Physicians. In addition to her teaching duties at LMU-DCOM, De-Franco also practices family medicine at the University Medical Clinic in New Tazewell, Tennessee.

Dr. Jessica Albright

Dr. Gina DeFranco


GrandRounds


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Physician Assistant Program at LMU-DCOM Holds White Coat Ceremony

HARROGATE – Lincoln Memorial University-DeBusk College of Osteopathic Medicine (LMU-DCOM) held the White Coat Ceremony for the Physician Assistant Program Class of 2015 on Saturday, June 28. Dr. Anthony Wayne, chairman of pediatrics at Griffin Hospital in Derby, Connecticut, was the keynote speaker. The White Coat Ceremony is an important, public demonstration of a student’s commitment to patient care and professionalism. The Ceremony is considered to be a rite of passage, in that an individual has demonstrated the qualities and abilities to provide competent care and can move on to the next phase of his or her training.

During the ceremony the Alisha Jane Hicks Memorial Scholarship was presented to PA Class of 2015 member Ellie Leonard of Chattanooga, Tennessee. The scholarship was es-tablished to honor the memory of Alisha Hicks, a member of the PA Program Class of 2013 who passed away following a car accident in June 2013. In choosing the recipient, factors considered include program GPA and community service, as well as the characteristics which Alisha Hicks embodied, such as passion for the LMU-DCOM PA Program and the PA profes-sion, a selfless nature, compassion for others, a desire to care for the underserved and faith in the greater good.

The DeBusk College of Osteopathic Medicine is located on the campus of Lincoln Me-morial University in Harrogate, Tennessee. LMU-DCOM is an integral part of LMU’s values-based learning community, and is dedicated to preparing the next generation of health care professionals to provide health care in the often underserved region of Appalachia and be-yond. For more information about LMU-DCOM, call 1-800-325-0900, ext. 7108, email [email protected], or visit us online at www.lmunet.edu/dcom.

LMU White Coat Caption: PA Class of 2015 members recite the Physician Assistant Oath after receiving their white coats.

McNabb Center welcomes new board members and officers for 2014-2015

KNOXVILLE – Jerry Vagnier, Helen Ross McNabb Center CEO and President, welcomes new board members and officers to the Center’s board of directors.

2014-2015 Helen Ross McNabb Cen-

ter Board of Directors with elected officers:Dr. Harold BlackMs. Nancy Cain*Mrs. Susan Conway, ChairMr. Wade Davies, Chair ElectMr. Joe FieldenMr. Charles Finn, SecretaryMr. Mike Fishman*

Mr. Ted Flickinger*Ms. Mai Bell HurleyMrs. Debbie Jones, TreasurerMrs. Ellie KassemMr. Chris KittrellMr. Ford LittleMr. Richard MaplesMs. Della MorrowMr. Joe PetreMr. James SchaadMr. Ross Schram, IIIDr. Karen SowersDr. Mary Kay Sullivan*Mrs. Nikitia ThompsonMrs. Traci Topham*Newly appointed board members

Erlanger wins eight ADDY Awards

CHATTANOOGA – The Erlanger Health System won eight ADDY awards at the annual advertising awards ceremony hosted by the Chattanooga Advertising Foundation.

ADDY’s are the world’s largest advertis-ing competition and are considered the Os-cars of the advertising industry. The Chat-tanooga ADDY’s were judged by advertis-ing executives and previous national ADDY award winners from other states.

Working in collaboration with local advertising agency, The Johnson Group, Erlanger was honored with a Gold ADDY award this year for Elements of Advertising, Visual and Cinematography for “Norman.” The commercial featured Norman Blake, bluegrass artist and former Erlanger neu-rology patient. Erlanger’s Gold ADDY now qualifies for regional and national awards.

Erlanger also received six silver AD-DY’s. Two were for cancer treatment services in “Upside Down” magazine ad and Can-cer TV campaign for “Upside Down” and “Eraser.” Others included orthopedic sur-gery services campaigns with two magazine ads, enhanced photography and a silver in cinematography for “X-ray/Bone,” “Bike,” and “Sean.”


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Dr. Sheryl Hunter-Griffi th Kids Healthy Teeth Get the whole story at regions.com/kidshealthyteeth

Support Niswonger Children’s Hospital!

The toy room in the surgery center at Niswonger Children’s Hospital is full of toys ready to help cheer up young patients, thanks to funds raised by

Niswonger Children’s Hospital license plate sales.

But the hospital needs help if the program is to continue another year. When it’s time to renew your license plate, please help by

purchasing a Niswonger Children’s Hospital license plate.

www.msha.com/childrenLocated in Johnson City, Tennessee • Serving children and families of Southern Appalachia

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East Tn Medical News August 2014

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