East TN Medical News Nov 2013

Robert M. Overholt, MD

PAGE 3

PHYSICIAN SPOTLIGHT

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LEGAL MATTERS: WHAT? ME WORRY? Physician Reporting Obligations Under the Tennessee Healthcare Consumer Right-To Know ActRecently, the Tennessee Board of Medical Licensure and other healthcare related boards around the state have been cracking down on failure of physicians or other providers to report payments made as a result of malpractice actions ... 7

CLINICALLY SPEAKING: Something to celebrate: Bariatric surgery leads to healthier lives

In December, my partner, Dr. Jonathan Ray, and I have the opportunity to take part in something special – the Foothills Weight Loss Specialists and Blount Memorial Weight Management Center fashion show ... 8

(CONTINUED ON PAGE 6)

By CINDy SANDERS

To see something in a different light often requires a shift in perspective. David A. Williams, CPA, MPH, FHFMA, leader of healthcare reimbursement and advisory services for HORNE

LLP, believes this certainly holds true for practices and facilities facing ever-increasing budget pressures.

Glass Half EmptyWilliams, a partner in HORNE’s Ridgeland, Miss. offi ce, noted for many health-

care providers, any incremental increase in revenue is eaten up by rising costs — from increased wages to higher prices for supplies to hikes in rent and utilities.

He pointed out that for hospitals, the largest revenue stream is for inpatient stays, and the largest single payer is Medicare, which can represent from the low 40s to the high 60s in terms of percentage of patients. “There has been a mar-

Gaining Perspective on the Reimbursement Landscape: Glass Half Empty … or Half Full


By CINDy SANDERS

What if a simple blood test could provide information that your patient had a signifi cantly elevated risk of developing diabetes within the next decade? What might that mean from the standpoint of early intervention and prevention? While it’s much too soon for this type of clinical application, researchers at the Vanderbilt Heart and Vascular Institute (VHVI) and Mas-sachusetts General Hospital have identifi ed a novel biomarker that lends itself to such intriguing questions.

Led by Thomas J. Wang, MD, director of the Division of Cardiovascular Medicine at Vanderbilt and physician-in-chief for VHVI, the team recently published results of their discovery of elevated 2-aminoadipic acid (2-AAA) as a precursor to diabetes in The Journal of Clinical Investigation. Tapping into the rich data source of the Framingham Heart Study,

Early Warning System: Researchers Identify Diabetes Risk Biomarker

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PhysicianSpotlight

By BRIDGET GARLAND

A familiar face to many East Ten-nesseans, Robert Overholt, MD, or “Dr. Bob” as he is more familiarly known, says he never imagined over 15 years ago how popular “The Dr. Bob Show”—his edu-cational health and wellness show—would become. “People will recognize my voice and face, and to me, it’s a nice thing. I enjoy people,” Overholt said. “I try to take time for people if I see them in a public place….Many, many times I have people say, ‘I’ve never met you, but you’re my doctor,’ or ‘I hate to bother you, but I want you to know, you have changed my life.’”

Overholt’s television show, however, is only a portion of what he has given back to his community. A life-long resident of Knoxville, Overholt has practiced medi-cine in the region since 1970. Specializing in adult and adolescent allergy, asthma, and clinical immunology, Overholt boasts having the career he always wanted. “My father was a physician, and the kindest, most wonderful man in the world. He got up at 4:30 a.m. to work and came home at 9 p.m.; he was extremely hard working. But when he took a vacation, he always took it with his children because we were very important to him. We had a won-derful childhood, and I enjoyed watch-ing him take care of people,” he recalled. “So, as early as junior high school, I knew I wanted to go into medicine like my fa-ther.”

Although born in Battlecreek, Michi-gan, Overholt came to Knoxville with his family when he was only six months old. But on the day Pearl Harbor was bombed, his father immediately left his practice and signed up with the United States Army. The family traveled with the military a few years, living in both Texas and Flor-ida, but soon came back to Knoxville when the war ended in 1944. “My father bought a house in Sequoyah Hills, ...and I attended local schools and graduated from West High School,” he shared. “I was a football All-American in elementary school, we were Pop Warner champions. I was All-State in football and basketball, I played baseball. Nobody knew it, but I had an offer from the Brooklyn Dodgers to sign.”

On top of all his accolades in sports, Overholt also received attention for his perfect academic record in high school, being offered a scholarship from Yale even. “But I wanted to play football, so I attended the University of Tennessee on a scholarship, under Coach Bowden Wyatt,” he said. Recruited as a tailback, Overholt inspired to be the next Bobby Dodd, but after his freshman year, the coach called him aside. “He told me, ‘You’d be a good tailback, except for three things: you can’t kick, you can’t pass, and you can’t run. I want you to play left end.’ And so I played left end,” chuckled Over-

holt, recalling the humbling experience. “We beat Texas A&M in the Gator Bowl that year, but after my second knee opera-tion, I told my coach it was time to go to medical school.”

Overholt headed to Memphis in 1959, where he went to the University of Tennessee Medical School. Finishing up in 1962, he and his wife Carole Campbell, who he married during his last quarter of school, moved to Pennsylvania for Over-holt’s internship at Philadelphia General Hospital, one of the leading rotating internships in the country. “My intern-ship was extremely hard. For almost six months of the year, I almost didn’t sleep. Of the 90 interns in the program, nine of them cracked mentally. It was just too much,” he recalled. “I worked very hard for six months. I made $88 a month, our rent was $110 month, so Carole worked in West Philadelphia as a dental hygienist.”

Surviving the program, Overholt went to Ann Arbor, Michigan, for his Internal Medical residency, greatly ap-preciative of the education he received from the full-time professors, at a much more relaxed pace. “I got lots of hands-on training in Philadelphia—I delivered over 40 babies, preformed appendectomies, lumbar punctures, everything, you name it, so I loved the three-years of teaching following that,” he said.

But like many other physicians at the time, Overholt was drafted during the Vietnam War and sent to Fort Myer in Virginia, where he lived on post. “I lived in temporary World War 2 housing, the Arlington graves were 75 yards from my house, the Pentagon was 500 yards away. I was a mile from the Lincoln Memorial, and 700 yards from the Iwo Jima Memo-rial,” Overholt shared. “But our housing was free, I was making $700 a month, and I was the richest I ever was. It was great! I bought a Volkswagen and a washer and dryer.”

After serving, Overholt returned to Ann Arbor to complete a two-year allergy fellowship from 1968-70, which he de-scribed as a wonderful training program. After finishing, he brought that training back to Knoxville, where he immedi-ately began practicing. “I grew up here, played football here, and my father and brother were here,” he explained. “My older brother is also a physician, Gene Overholt, who invented the fiber optic sig-moidoscope, which diagnosed Reagan’s cancer,” he boasted. “I tell everybody my father is my hero in private practice, and my brother Gene is also my hero. He is a wonderful man, a wonderful physician; we are very close and have a great love for each other.”

Overholt also has two other sib-lings—sisters, and all four of the Overholts still live in Knoxville. “We all love it. It’s the greatest place in the United States to live....We’ve got everything—recreation, a small college town, good transportation and education; it’s a wonderful place to live,” he enthused.

Overholt moved from his original practice location (located at the soon-to-be World’s Fair site) to the Weisgarber area in 1979 and where he continues to practice today. However, as Overholt ex-plained, in 1990, a big change transpired as physicians were faced with what to do about managed care. “You had to decide if you were going to put your head in the sand and not participate, or be proactive with managed care,” he said. “We decided to be proactive and go geographically and womb to tomb. That’s where we started, me and eight people.”

Remarkably, over the years, The Al-lergy, Asthma & Sinus Center has grown exponentially, with approximately 18 providers and 26 locations, reaching into Kentucky and recently into Middle Ten-nessee. “We are a big practice, but our purpose remains the same—to serve the people and be the best allergy practice in the United States,” Overholt said.

Around the same time the practice started its expansion, Overholt began another venture in a slightly different direction—to the television screen. Ap-proached by WBIR Channel 10 News, Overholt was asked to appear on their new weekend program. He started on Sunday mornings, and “I liked the cam-era and the camera liked me,” he shared. “Remember, I played football in front of people, I liked to teach, I liked medicine,

Robert M. Overholt, MD

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HealthcareLeader

Cathy KerbyBy JENNIFER CULP

When considering the driving forces behind Cathy Kerby’s 33-year career at The University of Tennessee Medical Center, two words come to mind: com-mitment and quality.

Born in the Knoxville area and raised in Jefferson City, Kerby has lived in Ten-nessee all her life. After graduating from Jefferson City High School, she earned a Bachelor of Science in Nursing from The University of Tennessee and then went to work at UT Medical Center. “When I came here right out of college as a young person, I never intended on staying,” Kerby said. “I thought, ‘I’ll come here and work for a few years and then move on,’ but I ended up staying, ended up lov-ing the place, and it’s just been a great, great career.”

Kerby’s decision to stay has also been a boon to her organization. For the ma-jority of her career at UT Medical Cen-ter, she has worked in management. As a young nurse, she quickly transitioned into working as a charge nurse, then assistant nurse manager, and eventually became nurse manager. When she went back to graduate school for a Master’s of Science in Nursing (which she earned in 2004), she became interested in the American Nurses Credentialing Center’s Magnet Recognition Program, which was devel-oped to motivate and show appreciation for healthcare organizations that achieve quality patient care, nursing excellence, and innovation in professional nursing practice. While researching the Magnet program for her graduate work, Kerby became convinced that it would be ben-eficial to her own workplace, all the while unknowing that the hospital’s leadership was interested in seeking Magnet recogni-

tion as well. “In 2006, I went to my first Magnet

conference in Denver, and from that ex-perience, I was more convinced than ever that it would be the right thing to do for our organization,” she recalled. In 2007, a position for Magnet coordinator was posted, and Kerby applied and was cho-sen for the job. “It’s been wonderful,” she said of the years since.

UT Medical Center is one of only three hospitals in Tennessee to receive Magnet recognition, along with John-son City Medical Center and Vanderbilt University Medical Center. Magnet rec-ognition is not an award, but rather a per-formance-driven measurement of quality nursing and patient outcomes. The des-ignation is good for four years, at which time it must be renewed. “You don’t just get it and rest,” Kerby explained. “You have to keep the momentum going.”

Kerby submits annual reports each

October in order to meet Magnet require-ments, and continues to monitor current data and work to achieve constant im-provement and innovation in all criteria. The recognition is a source of pride for the nurses of UT Medical Center, Kerby said. “It’s about the nurses! They take care of the patients. They are here 24 hours a day providing patient care, and it’s about recognizing them and wanting them to be proud of their work,” she said.

The honor of Magnet recognition attracts employees who want to work at a Magnet-recognized organization, mo-tivates nurses in their work, promotes a safe environment for nurses and patients, and ultimately results in high quality pa-tient care. Kerby is currently involved in planning a nursing leadership retreat for Magnet re-designation kick-off, and anticipates that UT Medical Center will successfully renew its Magnet-recognized status in 2016. “So, we’re busy! We can’t stop,” she concluded.

Kerby’s commitment to ensuring and improving quality in the place she lives isn’t limited to her work with the Magnet program. Recently, she was reappointed to the 2013 Board of Examiners for the Tennessee Center for Performance Excel-lence. TNCPE is modeled after the Bal-drige Performance Excellence Program, which recognizes excellence in various or-ganizations across the nation. “It’s a way for organizations to measure their progress and improve their performance. It’s a way to create alignment. There are all kinds of different organizations in TNCPE; it’s not just for healthcare,” Kerby explained.

Examiners must reapply and be ac-cepted each year, and undergo annual training prior to beginning each year’s review process. Kerby is currently in her second year volunteering as an examiner

for TNCPE. The program serves to up-lift and improve the entire community, Kerby said, recognizing various organi-zations in many fields. “My experience with Magnet has definitely influenced my work with TNCPE,” she said. “It’s just on a much broader scale. Both Magnet and TNCPE are about excellence for your or-ganization. They’re both about making us better.” Feedback from the examiners, who conduct site visits, review applica-tions independently, and participate in a consensus evaluation, allows a panel of judges to determine each applicant’s level of recognition. Kerby’s positive mindset of constantly moving forward and striving for improvement is evident even in the lan-guage she uses when discussing about the examination process; she speaks of identi-fying each applicant’s “strengths and op-portunities,” never weaknesses or failings.

Kerby’s enthusiasm for the Magnet Recognition Program, TNCPE, and es-pecially UT Medical Center is palpable. “I’m just proud of who we are and the accomplishments that we’ve achieved. Knowing that healthcare is such a rapidly changing environment, we have to strive for efficiency to be successful. Being in-volved in these programs keeps us moving forward. We want to be a top organiza-tion, and we’re certainly striving to do that,” she said.

Kerby’s work allows her to interact with “all kinds of different people,” which she enjoys, and her pride in her home-town and the people with whom she works is evident. She raised her three children in the Knoxville area, and avidly supports the UT football team. “I love the Knox-ville area; I love the East Tennessee area,” she said. In her contributions to her work-place and community, Kerby’s love and dedication shows.

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By BRIDGET GARLAND

It happens all too often. A law enforcement offi cer pulls over

a vehicle, suspicious that the driver is im-paired, but rather than being under the infl uence of alcohol or drugs, the driver is having a glycemic event.

It’s no surprise that police offi cers would make such a mistake because all of the signs and symptoms of a hyper- or hypo- event mimic those of substance im-pairment.

Recognizing a need to help law en-forcement offi cers identify diabetic drivers, Wellmont Health System, in collaboration with Mountain States Health Alliance, began an initiative in November 2009 to provide Diabetes Alert window stickers to persons on the road or in an accident that may be having a diabetic emergency.

“Anyone who has diabetes, and es-pecially Type 1, is subject to a hyper- or hypo- event, … and law enforcement is seeing this almost daily,” shared Jim Perkins, System Di-rector of the Wellmont Diabetes Centers. “It happens all the time, and people get put in jail and then sue the police de-

partment. The thought that law enforce-ment should have a heads up, that it might be something else, created this program.

“One of things that law enforcement wanted, though, was to make sure that ev-eryone who has a sticker truly has diabe-tes,” he said. This assurance is provided to offi cers through a prescription sheet that must accompany the sticker. Only patients who are given an order from their physician or a diabetes representative can receive the sticker.

Another request from law enforce-ment which the program has imple-mented is the distribution of pocket cards to offi cers so that they can identify the signs and symptoms of a diabetic event. “Every patrol offi cer in the state has ac-cess to them,” said Perkins. “Initially, we listed the signs and symptoms and went to the Kingsport Police Department to ask which ones mimicked impaired driving. ‘Each and every one of them’ was the re-sponse we got.”

The cards not only help the offi cers identify the signs and symptoms of a gly-cemic event, but also list treatment options for the offi cer to follow until EMS arrives.

“In most cases, EMS will come right away, but we do offer a 2-hour, POST-accredited program for training of law enforcement on diabetes,” Perkins ex-

plained. “Diabetes is so prevalent, though, that some places already teach diabetes awareness.”

Since implementing the program in the Tri Cities, interest and participation in the program has grown statewide, pres-ently totaling 27 hospitals across the state.

“As part of the State Diabetes Advisory Counsel, I meet every quarter with them and I report what we are doing here in the Tri Cities,” Perkins said. “When I brought up the sticker program, it was liked so much that it was implemented into the state plan. We received grant money to take it across the state.”

The statewide distributed stickers look almost identical, except for the par-ticipating hospital’s logo, allowing the

Keeping Tennessee Roads SafeDiabetes Alert Sticker Assists Diabetic Drivers, Law Enforcement Offi cers

Hypoglycemia (Low Blood Sugar) less than 70 mg/dL on meter.

Offi cer Observed Signs/Symptoms Include: Shaky, Blurry Vision, Nervous or Upset, Fast Heartbeat, Sweaty, Dizzy or Confused, Anxious, Hungry, Headache, Weak or Tired (Sleepy)

If possible, have person to do blood sugar check.

Treatment (Choose One): • 3 to 4 glucose tablets • 3 to 5 hard candies (chewed quickly) • 4 ounces of fruit juice • ½ can (6 ounces) regular soda pop • 7 Life Savers (chewed quickly)

Wait 15 minutes and recheck blood sugar, if still below 70 mg/dL treat again.

Hyperglycemic Event (Diabetic Ketoacidosis – DKA) can occur with blood glucose levels as low as 250 mg/dL.

Offi cer Observed Signs/Symptoms Include: Strong Fruity Breath Odor (similar to alcoholic breath); Confusion; Rapid, Deep Breathing; Drowsiness; Flushed, Hot, Dry Skin; Diffi culty Waking Up; Blurry Vision; Vomiting; Abdominal Pain

If possible, have person do a blood sugar check.

Treatment: CALL EMS

(CONTINUED ON PAGE 6)Jim Perkins


which is now following its third generation of participants, the Wang research team studied blood samples gathered more than a decade ago from 188 individuals who ultimately developed type 2 diabetes and 188 who did not develop diabetes.

Using these blood samples, the in-vestigators were able to compare levels of metabolites to see if there were any differ-

ences between the group that went on to develop diabetes and the group who did not. Wang noted newer technology now makes it possible to profile hundreds of metabolites at one time.

“One of the things that really lit up when we looked at the people who devel-oped diabetes was 2-aminoadipic acid,” he said. “Having elevated levels of 2-AAA

predicted risk above and beyond their blood sugar at baseline, their body weight, or other characteristics that put them at risk.” Wang added there doesn’t appear to be a specific threshold of risk at this point … the higher the levels of 2-AAA, the higher the risk of developing diabetes. In fact, those in the top quartile of 2-AAA concentrations had up to a fourfold risk of developing diabetes during the 12-year follow-up period compared to those in the lowest quartile.

Interestingly, the researchers found 2-AAA might not be just a passive marker. As part of the same study, the team con-ducted mouse model testing and discov-ered giving 2-AAA to the mice actually altered the way the animals metabolized glucose.

“It suggests the molecules might be playing a direct role in how the body pro-cesses glucose rather than being an inno-cent bystander in the process,” Wang said. He added that elevated levels of 2-AAA don’t necessarily mean the molecule is bad for the body. Instead, it could be a defense mechanism where the body is producing higher levels to fight risk from another, as yet unknown, source.

Figuring out the metabolite’s exact role in the functioning of pancreatic cells is one area for future research. If, indeed, 2-AAA turns out to be a defense mecha-nism to stave off diabetes, the good news is that the metabolite could be given to humans in the form of nutritional supple-ments. On the other hand, if 2-AAA turns out to be harmful to the body’s glucose regulation system, further research could reveal methods to lower the metabolite’s presence.

Wang was quick to say the next step

is to conduct additional research to mea-sure 2-AAA in other human populations outside of the Framingham study through both retrospective and prospective stud-ies. More in depth animal model studies are also in the pipeline. “A lot of the effort will be focused on trying to understand the biologic effect of 2-AAA in developing dia-betes,” he said of the work going forward.

However, Wang said the current re-search results at least raise the possibility that somewhere in the future knowing how high a person’s circulating 2-AAA levels are could impact clinical practice by allowing providers to adopt a more ag-gressive intervention posture among those at highest risk, whether that be through exercise, weight loss or pharmacologic measures. It is conceivable that 2-AAA might be the type of red flag for diabetes that high cholesterol is for heart disease.

“Understanding why diabetes occurs and how it might be prevented is a very intense area of investigation because of the serious consequences of having the disease,” Wang said. “Down the road, this might be one part of the armamen-tarium of tests that could be considered. If this were proven useful in further studies and could be used clinically, it would be an easy test to administer.”

As for the impact of the findings right now, Wang added, “In 2013, it highlights a specific pathway that might be related to diabetes risk that we previously didn’t know about.”

Considering the prevalence of type 2 diabetes and growing obesity epidemic in the United States, that is an important lead for researchers working to develop strategies to interrupt the disease progres-sion and stop risk from becoming a reality.

Early Warning System: Researchers Identify Diabetes Risk, continued from page 1

organization to promote their individual program. Any patient with diabetes can participate by calling the Diabetes Center for that particular health system or hos-pital. In West Tennessee, participating organizations include McKenzie Medical Center, Bruceton Clinic, Dresden Specialty Clinic, Jackson Madi-son County General Hospital, LeBonheur Children’s Hospital, Methodist Health-care – University Hos-pital, and Methodist LeBonheur Healthcare – Germantown Hospital; In Middle Tennessee, Baptist Diabetes Center, Macon County General Hospital, MTMC Diabetes Cen-ter, Gateway Medical Center, and Stones River Hospital; In East Tennessee, Well-ness Place at Methodist Medical Center (MMC), Fort Sanders Diabetes Center (FSDC), Erlanger Health System, and Chattanooga Lifestyle Center; In North-east Tennessee, Holston Valley Medical Center-Diabetes Treatment Center, Bris-tol Regional Medical Center-Diabetes Treatment Center, Wellmont Urgent

Care, Hawkins County Memorial Hos-pital, Takoma Regional Hospital, and Mountain States Health Alliance: Health Resource Center in the Mall at Johnson City.

For providers wanting to find out more about the program,

they can visit the website mydiabetesalert.com or locally, call in King-sport (423) 224-3575 or in Bristol (423) 844-2950.

Perkins empha-sized the benefits of the

program. “Physicians re-alize this is a real problem,

but the people who really un-derstand how much the program is

helping are the law enforcement people out on the street. These events happen all the time,” said Perkins. “I talked to one officer who had recently pulled over six people with the sticker, and they all were having glycemic problems. The police department sees it every day….And it doesn’t stop in the home or in the work-place. Every sticker we distribute identifies another driver driving with diabetes who may need help one day.”

Keeping Tennessee, continued from page 5

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LegalMatters

WHAT? ME WORRY? Physician Reporting Obligations Under the Tennessee Healthcare Consumer Right-To Know Act

BY JASON H. LONG

Recently, the Tennessee Board of Medical Licensure and other healthcare related boards around the state have been cracking down on failure of physicians or other providers to report payments made as a result of malpractice actions. Many physicians have been caught by surprise regarding their duties, in particular under the Tennessee Healthcare Consumer Right-to-Know Act, with respect to their reporting obligations. Often, a physician assumes that once a malpractice matter is resolved, either through litigation or settlement, his or her duties are over and it is time to move on. However, that is not always the case. Following are important questions to which every Tennessee provider should know the answer.

Q. Who is required to maintain a profi le with the Department of Health pursuant to the Tennessee Healthcare Consumer Right-to-Know Act?

A. The list is long and specifi c, but comprehensive. According to the Tennessee Healthcare Consumer Right-to-Know Act, the following individuals must establish a profi le with the Department of Health:

Physicians, osteopathic physicians, chiropractors, dentists, podiatrists, optometrists, dietitians, nutritionists, physician assistants, respiratory care practitioners, pharmacists, audiologists, speech pathology therapists, certifi ed nurse practitioners, registered nurse anesthetists, social workers, psychologists, professional counselors, marital and family therapists, clinical pastoral therapists, massage therapists, medical laboratory personnel, alcohol and drug abuse counselors, occupational therapists, physical therapists, dispensing opticians, electrologists, veterinarians, and nursing home administrators.

Q. Once I have a profi le established, do I ever need to revisit it?

A. Yes. The statute requires that providers update their profi le with the Department of Health within 30 days of any information changing event. For example, a change of practice or address would warrant an update. That notifi cation should be in writing to the Department of Health.

Q. If I am involved in litigation and there is a settlement, isn’t it enough that I am reported to the National Practitioner Data Bank?

A. No. The reporting requirements of the National Practitioner Data Bank (NPDB) and the Tennessee Department of Health pursuant to the Tennessee Healthcare Consumer Right-to-Know Act fall under separate and distinct statutory schemes and require independent reporting.

The NPDB is a confi dential clearinghouse created by Congress with the goal of improving healthcare quality and reducing fraud and abuse. Access to the database is generally limited to hospitals, other healthcare entities and professional societies with formal peer review, state medical and dental boards and healthcare practitioners performing a self-query. Typically, where a settlement or

judgment in a medical malpractice action against a provider has occurred, the provider’s insurance carrier will report the matter to the NPDB.

The Tennessee Healthcare Consumer Right-to-Know Act is a state statutory scheme. It requires reporting of all court judgments or arbitration awards where a payment is made to a complaining party. In addition, any settlements of healthcare liability claims in which a payment is made to a complaining party must be reported as well. There are statutory thresholds which defi ne a reportable event. Providers are only required to report where the judgment, arbitration award, or settlement is in excess of: $75,000 for physicians, $50,000 for chiropractors, $25,000 for dentists, and $10,000 for all others.

Q. Isn’t it my attorney or insurer’s responsibility to make sure that a report is made?

A. No. The statute makes clear that it is the provider’s responsibility to update their profi le with the Department and is silent as to whether anyone can make that report on their behalf. Hopefully, a provider’s attorney will counsel them regarding the need to update the provider’s

profi le at the conclusion of the case and assist in that regard. However, the responsibility lies upon the physician’s shoulder to assure that has occurred.

Q. How long do I have to make a report?

A. Updates must be made within thirty (30) days of a reportable event (settlement or judgment).

Q. What are the penalties for failure to report?

A. Failure to report can result in a Board complaint and disciplinary action.

It is essential, at the conclusion of any malpractice litigation, whether by judgment, arbitration, settlement, or otherwise, that a provider assess whether he or she is obligated to report any action to the Tennessee Department of Health. Failure to do so may result in a new and frustrating set of obstacles for the provider down the road.

Jason H. Long is an attorney practicing at London & Amburn, P.C. The focus of Mr. Long’s practice is medical malpractice defense, long-term care, general civil litigation, healthcare regulatory compliance, and appellate practice. He chairs the fi rm’s Civil Trial Practice. For more information, you may contact Mr. Long by visiting www.londonamburn.com.


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ClinicallySpeakingBY MARK A. COLQUITT, MD, FACS, FASMBS

Something to celebrate: Bariatric surgery leads to healthier livesIn December, my

partner, Dr. Jonathan Ray, and I have the opportunity to take part in something special – the Foothills Weight Loss Specialists and Blount Memorial Weight Management Center fashion show featuring bariatric surgery patients. The annual event provides an opportunity for participants to show off a bit – walk the catwalk and talk about what a difference their weight loss has made in their health and lifestyles.

This year’s celebration will mark the 11th annual fashion show. How has the event reached the 10-year mark and beyond? The secret to its success is simple, really.

First, it is remarkable to see the models’ change in appearance and to consider the amount of weight lost. Seeing patients with their former “fat” clothes or viewing before and after photos is always stunning. The 26 patients who participated in the 2012

fashion show represented a combined weight loss of 2,600 pounds. To put it in perspective, Ferrari is pioneering its next hybrid supercar, expected to come in at just under 2,500 pounds.

Second, the patient testimonials are compelling. The positive energy

and gratitude are palpable in the air as participants share stories of newfound confi dence, improved health, and the ability to wear fashionable clothes.

Often emotional and uplifting, testimonials also do a good job of conveying the signifi cant benefi ts of having surgery. Below are a few examples from past events:

Carson Lynn lost 250 pounds in 18 months following

his gastric bypass and said the surgery saved his life. “I was on oxygen, had high blood pressure, and my heart was out of rhythm. If I hadn’t had the surgery, I’d probably be in the ground tonight.”

“I didn’t realize how tired I was,” said patient Tami Hargis. “Now I’m ready to go every day!” Hargis lost 114 pounds following her gastric band procedure.

“I was taking three shots of insulin a day. Now I’m taking none,” said patient Larry Webb, who lost 125 pounds following surgery.

James Lawson lost 215 pounds in 15 months following his surgery. “I went from taking 17 pills a day to nothing. My diabetes is gone. This is the best thing you can ever do, and it can save your life,” said Lawson.

Diana Parton lost 66 pounds from August through December. “I came back from the hospital and got off my diabetes medicine, which I had to take twice a day. I took a handful of pills every morning, and now I only take three.”

While the fashion show is a “feel good” event that provides an excellent congratulatory platform for patients who have lost tremendous amounts of weight, Dr. Ray and I hope that it can also be an impetus for change.

Each year, among the crowd of patients, friends and family members are individuals trying to decide if bariatric surgery is right for them. The fashion show affords these individuals the opportunity to hear real stories from real people and see what is possible if they are willing to commit to change.

And, while far too many people still consider bariatric surgery a purely cosmetic procedure, its health

benefi ts are far too signifi cant to ignore. Consider the statistics for the 26 models from 2012 (see chart).

The link between bariatric surgery and resolution of diabetes is further confi rmed by STAMPEDE, a study published in the March 26, 2012, issue of the New England Journal of Medicine. The study concluded that bariatric surgery resulted in better glucose control than medical therapy in severely obese patients with Type 2 diabetes. The results of the study were signifi cant. At two years, diabetes remission had occurred in no patients in the medical therapy group versus 75 percent in the gastric-bypass group and 95 percent in the biliopancreatic diversion group. The results also showed that remission was independent of weight loss, suggesting that the positive outcomes are a result of metabolic changes achieved through surgery.

Do you have morbidly obese patients who have repeatedly failed at all efforts to lose weight? If they seem truly ready for and committed to change, I encourage you to consider recommending bariatric surgery. I’d love to see them on the catwalk in a year or two.

Mark A. Colquitt, MD, FACS, FASMBS, is Director of Metabolic and Bariatric Surgery at Blount Memorial Hospital in Maryville, Tenn., and is a bariatric surgeon with Foothills Weight Loss Specialists, a division of Premier Surgical Associates. Colquitt is board certifi ed by the American Board of Surgery. He is a fellow of the American College of Surgeons and of the American Society of Metabolic and Bariatric Surgery and is a member of the Society of American Gastrointestinal and Endoscopic Surgeons. For more information, visit http://www.foothillsweightloss.com.

Comorbidity Of 26 bariatric surgery patients, number to reach resolution of chronic health condition

Sleep apnea 6

Depression 2

Anxiety 1

Joint Pain 12

Hypertension 8

GERD (Gastroesophageal

refl ux disease) 7

Diabetes 8

High Cholesterol 5

Polysistic Ovarian Syndrome 1

Congestive Heart Failure 1

Foothills Weight Loss Specialists surgeon Dr. Mark Colquitt, right, praised the success of patient/models during the 10th Annual Bariatric Fashion Show in December 2012. With him is Blount Memorial Weight Management Center’s bariatric coordinator Dana Bradley, who is also a patient who lost 100 pounds within 10 months of her laparoscopic sleeve gastrectomy.

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By CINDy SANDERS

Established in 1938, the Tennessee Hospital Association has adopted the ta-gline “reinventing tomorrow’s healthcare every day for 75 years” as an ongoing theme for 2013.

Over the years, the staff of the THA might have had many days … often stretching into many months … to help members prepare for and implement change. However, in the face of industry-wide transformation, being nimble enough to reinvent the hospital’s role in healthcare delivery on a daily … if not hourly … basis has become the norm. Helping its mem-bership navigate the challenges that come with sweeping reform was central to the programming at the THA Annual Meet-ing, held Oct. 31-Nov. 1 at Gaylord Opry-land Resort and Convention Center.

“I’ve always said healthcare moves glacially, but we’re getting up to lighten-ing speed now,” THA President Craig Becker said with a rueful laugh. “It has been a tough road to hoe right now for our members.” Yet, Becker continued, he ulti-mately views the transformation process as ‘constructive deconstruction.’

Going into 2014, he continued, “Our number one issue is the Affordable Care Act and trying to get people enrolled …

not only the ones that are eligible through the fed-eral exchange but to try to convince the governor and Legislature to expand TennCare to include the poorest of the poor.”

Becker added there are approximately 500,000 Tennesseans who should be eli-gible for enrollment through the federal exchange. However, there are another 400,000 currently left out of coverage opportunities unless Gov. Haslam and the Centers for Medicare and Medicaid Services can come to an agreement about expanding TennCare rolls, and the Ten-nessee Legislature approves the plan.

“We’re having a hard time getting the Legislature to separate this from Obam-acare,” Becker said. However, he noted negotiations with CMS are ongoing, which he said was an encouraging sign.

“We’ve got $5.4 billion worth of cuts over 10 years under the Affordable Care Act,” Becker pointed out. Those cuts were more palatable when hospitals thought Medicaid rolls would be expanded. When the individual mandate was upheld but not the Medicaid expansion, anticipated coverage for large chunks of the popula-tion evaporated.

“I’m really concerned about my rural hospitals. They don’t have the reserves some of the bigger hospitals do,” Becker said. However, he added no facility is im-mune to the looming financial stressors. Addressing the key point of coverage for the 400,000 left out, Becker stated, “If we don’t get it, some of our hospitals cannot make it. I guarantee that.”

Three hospitals have recently shut down operations in Tennessee. While two in West Tennessee probably had more to do with the number of facilities in comparison to the population, one in East Tennessee simply couldn’t make it in healthcare’s new financial reality. Scott County residents now have to go else-where for care. “The hospital was strug-gling. When the (ACA) cuts came, it was the death nail for them,” Becker said.

The Tennessee Hospital Association is also focused on the Tennessee Payment Reform Initiative, which is initially slated to be rolled out for the TennCare and state employee populations. Tennessee has received a CMS grant to transform the state’s healthcare payment system. While details are still being ironed out, the governor’s vision is to incentivize ‘quarter-backs’ (typically physicians) to provide the highest quality, least costly care. As part of that plan, the quarterbacks would receive

a bonus for sending patients to facilities with the best quality and lowest prices.

However, Becker said there are con-cerns arising from geographic location and from skewed price comparisons. He pointed out large academic medical cen-ters with high-cost service lines including trauma centers and burn units and other unusual expenses such as graduate medi-cal education cannot fairly be compared to community hospitals without those same factors. In areas with only one nearby hos-pital, referring patients to a facility farther away that has a better cost structure might not be feasible … or desirable … depend-ing on the urgency of the situation.

Becker noted, “Seventy-five percent of physicians admit to one hospital only so I’m not sure it makes a lot of sense. I’m not sure that this will change physician admitting patterns.” However, he contin-ued, the general consensus is that the plan will move forward so THA staff is prepar-ing for implementation while addressing their issues with government and provider stakeholders in an effort to design a work-able plan.

Despite any reservations about the plan’s mechanics, Becker applauded the general concept of shared information. “I think the more transparent and the more

Tennessee Hospital AssociationReinventing Tomorrow’s Healthcare Every Day for 75 Years


Craig Becker


Leigh Anne W. Hoover is a native of South Carolina and a graduate of Clemson University. She has worked for over 25 years in the media with published articles encompassing personality and home profiles, arts and entertainment reviews, medical topics, and weekend escape pieces. Hoover currently serves as immediate president of the Literacy Council of Kingsport. Contact her at [email protected].

‘‘We have to make sure that patient care

is foremost. ’’

By LEIGH ANNE W. HOOVER

Just over the mountains in Ashe-ville, North Carolina, visitors to Bilt-more Estate can truly step back in time, and there is no better time to visit than during the holidays. The ex-perience is outstanding any time of the year, but dressed up for the holidays, Biltmore is simply spectacular.

My late mother, Corrie M. Whit-lock’s, life’s work was beautification. As a past president of the Garden Club of South Carolina, South At-lantic Regional Director for the Na-tional Garden Club, landscape critic, master flower show judge, master gar-dener, and the list goes on and on, my mother would have loved being able to interview Cathy Barnhardt, floral displays manager and holiday décor expert for the Biltmore Estate. She would have enjoyed Barnhardt and been truly fascinated with her gift.

Beautification was Mama’s gift, and everything she touched through her service in South Carolina and elsewhere was sim-ply magnificent. In fact, once in an inter-view prior to Mama’s passing, I remember explaining this to a journalist.

“If there’s a garden club in heaven, she will be in it. If not, she will organize one and make us all join!”

Barnhardt shares this same gift, and her talents have been featured on Today, CBS This Morning, HGTV, and in many national magazines. With a Bachelor of Science degree in ornamental horticulture and landscape design and a minor in art history from the University of Tennessee, the woman is amazing!

“My degree from UT is horticulture and landscape design, so when I came to Biltmore, I was hired to work in the green-house,” explained Barnhardt.

After a year of managing the green-house, Barnhardt was faced with a chal-lenge. She was asked whether she wanted

to stay in the greenhouse or move full time to the estate house, arranging flowers and “doing Christmas.” According to Barn-hardt, prior to her arrival and agreeing to take on the monumental assignment, Christmas at Biltmore had been done on a much smaller scale.

For over 36 years, Barnhardt’s talents have been on display at the grandest show house in the world. During Christmas, her expertise truly takes center stage.

“When I was at UT, I also loved his-tory, and I loved art,” continued Barn-hardt. “I think that when you combine a love of flowers, design, history, and art, Biltmore’s my perfect job, and that’s why I have been here for 36 years.”

Growing up just beyond Biltmore’s gates in Kenilworth, Barnhardt always knew that she wanted to come back to the mountains of western North Carolina to work at Biltmore, one of the reasons she feels this is her “perfect job.”

Although she decorates her own home, Barnhardt attests the Cape Cod style home is nothing like decorating the estate. How-

ever, she does incorporate a theme in her home, too.

Years ago, Barnhardt’s daughter sep-arated their personal ornaments by color, and this has helped her alternate colors like her team does at Biltmore. In fact, sorting by theme and color is a tip Barnhardt al-ways gives others for their homes.

Christmas begins early at Biltmore, and the annual “umbrella” themes are de-cided years in advance. Teams, including marketing, events, museum services, and horticulture, gather to map out themes for upcoming years. Barnhardt says they con-sider events both past and current to decide on the overall, umbrella theme.

Dressed in its holiday best, the estate, known as “America’s largest home,” offi-cially ushers in the season on November 2, 2013. For a 250 room chateau, it is only befitting that the holiday décor remains through January 12, 2014, and this year’s theme is “The Nature of Christmas.”

According to history, George Vander-bilt actually opened Biltmore House to family and friends for the very first time on Christmas Eve in 1895. Over the years, it has remained a truly festive and special time of celebration for the estate.

This year, the large banquet hall, which exhibits the infamous 35-foot tall decorated Fraser fir from Newland, North Carolina, will be in a whimsical fashion celebrating children and the festive spirit of Christmas.

“We want the Christmas tree to be fresh throughout the season. We want the guests that come in December to enjoy it just as much as those who come during the first week of November,” explained Barn-hardt.

In order to ensure this, two signature trees are used in the banquet hall. The “great switch” of the 35-foot tree occurs on December 11th this year. Barnhardt explained the switch begins at 4:00 in the morning with laundry bins on wheels for storing 500 ornaments, 500 lights, and 500 gift boxes for redecorating.

“500 is our number,” said

Barnhardt.”And, the reason is in some old, old periodicals, there is reference to 500 gifts, and that just seemed like a good number for the banquet hall. We have descriptions of that 35-foot tree, electric lights, or-naments that were hung on the tree, evergreen garlands, holly berries, and shining green leaves that tell us a little about what the decorations might have looked like here, but a lot of it is also our interpretation. We are in-spired by what was here.”

With essentially every employee, and some on reserve, the holiday transition occurs.

The tree is dismantled with a chainsaw in sections onto tarps, which are draped across the banquet room floor. According to modern-day tradition, the engineers even hide a used light bulb ornament somewhere

on the tree.“Guests love seeing the process,” said

Barnhardt. “Each year, we pick out two trees. The first tree usually is a little slim-mer. The second tree is a little bigger, and the reason is we can change that first tree out quickly and put that bigger tree in throughout Christmas.”

According to Barnhardt, these trees are grown specifically for the estate at a tree farm in Avery County. After they are re-moved, they are ground into mulch, which is later used in the gardens. The first tree raising day has become an annual tradition for many.

Beginning in November, visitors to Biltmore can come early in the season to obtain all kinds of ideas that can be used in their own homes.

“We love to get feedback from guests when they ask, ‘How did you do that? I want to do that at my house,’” said Barn-hardt. “It will be fun to see what the main interest is this year because last year, it was two little topiary trees that were on the breakfast room table made out of kumquats and oranges.”

Barnhardt notes that even though themes are changed, to always add a little something different and to keep everyone inspired, her decorators are “masters at re-purposing” and reusing items. Once they are too worn, items are denoted to Habitat for Humanity for their retail shop.

“We have a lot of freedom in deciding decorations based on the historical frame-work,” said Barnhardt. “And, I think we’ve been able to do that successfully through the years.”

For additional information about holi-day happenings, visit www.biltmore.com .

Enjoying East TennesseeBiltmore Estate - Deck the Halls!

I liked crowds, I liked people, and I was camera friendly. So within a week, they asked me if I wanted to go on Live at 5 on Thursday afternoons.”

Eventually, Overholt was plugged into a 30-minute program, what is now “The Dr. Bob Show” produced by PBS. The show broadcasts 26 shows a year, the purpose of which is to educate the public about health, wellness, and fitness. “I think the reason the show has been so popular is that we speak on a level that people can understand rather than pretend we are smart doctors and use big doctor words,” Overholt said. “If you are my guest, and you say something medical, I always ask what particular words mean. I want to make sure that people understand. For instance, if you say, ‘a catheter is inserted

into the coronary artery,’ what does that mean?”

Overholt says he picks topics that people want to know about and talks very little on allergy. “I have about two shows a year on allergy, the rest are anything from OB/GYN, to cardiology, to ortho-pedics, to general surgery, to neurology and Alzheimer’s, all sorts of topics,” he explained.

Overholt recalled that the nicest comment he has received about the show came from Lynn Massingale, Executive Chairman of TeamHealth. “He said, ‘You portray to the public the image that we as physicians want to portray to the public—as kind, happy, positive people who are here to help,’” Overholt repeated. “I will always cherish that compliment.”

Physician Spotlight: Robert M. Overholt, MD, continued from page 3


By BRAD LIFFORD

Dr. Jeffrey O. Carlsen has demonstrated that he doesn’t mind traveling thousands of miles to bring the best in eye care to patients in other parts of the world. Carlsen went far afield earlier this year to deliver eye care – he saw patients on a medical mission trip to a small town in Guatemala – but he doesn’t want his patients to have to travel far to re-ceive care. When he can bring very specialized eye care to children close to home, it gives him a particular sense of fulfillment.

In the case of those who have pediat-ric cataracts, although there is only a small population locally, it is one that Carlsen and his colleagues do feel a sense of commitment to, nonetheless.

“Everyone will develop cataracts as we grow older, as part of the normal aging process,” Carlsen said, “but pediatric cataracts are congenital; they are hereditary. You’re not talking a large number of cases here – it might be a dozen a year. But they still need our help, and it’s a service we feel like we should pro-vide to the community.”

Fortunately, with the recent purchase of a highly specialized surgical device at Niswonger Children’s Hospital, Carlsen and the pediatric care team at Johnson City Eye Clinic are able to offer pediatric cataract surgeries locally; he had his first cases in September.

“We really needed this,” Carlsen said, “because kids who did need this procedure were required to travel to Nashville or Knoxville.

“Traveling for eye care takes a toll on the children and their families because for kids who have cataract surgery, it’s a lifelong commitment to regular eye care and a particularly big commitment during that first year or so. That first year could mean six to ten trips to Nashville for check-ups. That’s a lot on a child and the child’s family.”

The physicians of Johnson City Eye offer a wide scope of services in their clinic in Med Tech Park, as well as a surgery center that is a compo-nent of delivering comprehensive care that includes the treatment of glaucoma, macular degeneration, pediatric ophthalmology, retinal disease, and cosmetic and reconstructive surgeries. In the coming weeks, patients will also see availability of a new facet at the Johnson City Eye Surgery Cen-ter: femtosecond laser surgery for cataracts. Carlsen said installation of this new, cutting-edge device could happen around the beginning of 2014. Unlike traditional cataract procedures performed with a surgical blade, a femtosecond laser uses tightly focused laser energy to allow for incredibly precise incisions. “It’s exciting, and I think we will be the first in the region

to offer femtosecond cataract surgery,” Carlsen said. “It’ll be appropriate for many patients, especially those with astigmatism.”

The surgery center in Med Tech Park en-ables patients to undergo same-day procedures in a facility that has earned the status as an Ac-creditation Association for Ambulatory Health Care, Inc., a distinction that is awarded only after a center has shown it meets the highest standards of quality care.

In addition to practicing pediatric and gen-eral ophthalmology, Carlsen’s clinical interests include cosmetic and reconstructive plastic surgery, as well as strabismus surgery. He com-pleted fellowships in pediatric ophthalmology and strabismus, as well as an ophthalmic plastic and facial surgery fellowship.

Carlsen is one of eight physicians who serve a wide spectrum of the ophthalmic needs not only of Tennesseans but also of patients in Virginia, North Carolina, and Kentucky, with a heritage of excellence that spans more than 70 years. In addition to Carlsen, the medical staff currently includes Drs. John C. Johnson Jr., Michael F. Shahbazi, Amy B. Young, Alan N.

McCartt, James W. Battle, Randal J. Rabon, Calvin L. Miller, and Peter Lemkin, a doctor of optometry. Dr. Carlsen is also very pleased to announce that Bristol native, Dr. Jennifer L. Oakley, a glaucoma specialist, will be joining the practice next month.

More than 100 healthcare professionals make up the team at Johnson City Eye Clinic. Another feature of the practice, located adjacent to the clinic, is Cosmetic Laser Skin Care, an extension of the physicians’ interest in plastic surgery for upper and lower eyelids and full face laser resurfacing, plastic, cosmetic, and reconstructive surgeries. In addition to the cosmetic surgeries and services available there – which includes Botox Cosmetic, Juvederm, and Restalyn, the skin care clinic offers a large variety of day spa services.

InSights

Johnson City Eye Clinic & Johnson City Eye Surgery Center110 Med Tech Park • Johnson City, TN 37604

225 Medical Park Drive, BristolPhone: (423) 929-2111 • Fax: (423) 929-0497

Email: [email protected]

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This concert is funded under an agreement with the Tennessee Arts Commission and the National Endowment for the Arts.

Free bus service: 6:15 (Colonial Hill); 6:30 (Maplecrest & Appalachian Christian Village); 6:45 (City Hall)

Tickets: $35; Seniors (65+) $30; Students $10For more information: 92-MUSIC (926-8742) or

visit www.jcsymphony.com

Winter Wonderlandfeaturing City Youth Ballet of Johnson City

Saturday, December 14, 7:30 p.m.Mary B. Martin Auditorium at Seeger Chapel, Milligan College

sponsored byFerguson Enterprises and Roadrunner Markets

The City Youth Ballet is a chartered, not-for-profit per-formance organization offering an extensive repertoire of classical and contemporary ballet performances for the general public and school groups throughout the year. The CYB provides high quality performances of classi-cal ballets and contemporary and lesser known ballets. Original, commissioned works are also part of the CYB’s repertoire. Under the direction of Susan Pace-White, the City Youth Ballet will join the Johnson City Symphony Orchestra in performance of excerpts from Pytor Illych Tchaikovsky’s “Nutcracker Suite.” The program will also include holiday-related music from Gabriel Pierne, Wolf-gang Amadeus Mozart, Anatol Liadov, Irving Berlin, Georges Bizet, Frederick Delius, and Leroy Anderson.

ket basket update, but for the last couple of years, it’s been less than 2 percent,” he said.

Williams noted the government puts in the full market basket update but then begins reducing the rate by looking at ad-justments tied to value-based purchasing, readmission rates and acquired conditions, in addition to other factors. “Normally you’re seeing very minimal increases. It’s caused a flattening of revenue per patient,” he said. Then, Williams continued, after payment increases are netted out, “Medi-care is subject to a 2 percent reduction to fulfill the sequestration order.”

He added that Medicaid, which typi-cally covers anywhere from 5-15 percent of patients … or higher depending on loca-tion and a hospital’s safety net status, is not currently subjected to sequestration. Yet, he said, hospitals are faced with mounting concerns about Medicaid expansion, un-compensated care, and cuts to dispropor-tionate share hospital payments.

For hospitals in states that didn’t opt to expand Medicaid rolls, administrators are worried about rising levels of uncom-pensated care for those that fall into the gap in the Affordable Care Act between traditional Medicaid eligibility and qualify-ing for federal subsidies on the healthcare exchange. Even for providers who are in states that did expand Medicaid, Williams said uncertainty still exists about how reim-bursement will actually net out.

Traditionally, Medicaid has reim-bursed providers at a set match rate for di-rect patient services and a 50 percent rate for the administrative portion of the epi-sode of care. Although the ACA Medicaid expansion plan covers 100 percent of pa-tient services for three years and then rolls down incrementally to 90 percent over sub-sequent years, the administrative match re-mains at 50 percent so the state does incur additional cost by expanding rolls. Addi-tionally, Williams said certain provisions of the ACA require mandatory changes for states regardless of expansion, includ-ing: welcome mat population or those who were eligible for Medicaid but had not en-rolled previously, foster children expansion to age 26, expanded eligibility for children, primary care physician fee increase, and health insurer fee. In Mississippi, a non-expansion state, the estimated amount of the mandatory changes is between a $272 - $436 million increase in spending. With this amount of growth, the state is not ex-pected to increase the reimbursement rate for a full episode of care.

Medicare DSH payments also are causing administrators to lose sleep at night. Initially, the ACA plan called for a 75 percent reduction in Medicare DSH payments. However, Williams said part of the final regulation that went into effect Oct. 1 of this year moderated that number a bit by moving to an empirical DSH pay-ment for uncompensated costs … a com-plex, calculated cut that softens the blow some by looking at a hospital’s relative share of Medicaid inpatient utilization as a proxy for uncompensated patients.

Williams said that for one hospital in the Mississippi Delta, the original Medi-care DSH reduction would have meant a loss of $5.6 million. “But,” he continued, “because of the additional payment to fund the uncompensated cost, it was actually a

reduction of $2 million.” While that is still a significant loss, “It could have been worse,” Williams noted.

Still, he continued, “You’re faced with the fact your revenue isn’t growing as fast as your expenses. It’s very concerning to most every healthcare organization around.”

Glass Half FullSo if revenue isn’t going up, the logi-

cal place to increase margins is to decrease costs. Yet, healthcare providers want to make sure they provide the best care possi-ble without sacrificing a patient’s well being simply to save a few dollars.

“A lot of people equate higher quality with higher cost, but that’s not necessar-ily true,” Williams pointed out. In fact, he said, doing the right thing in the right way is often significantly more cost efficient.

“A major cost in providing care to pa-tients is variation in the clinical process of care,” Williams said. He added it is easy to find real world examples of this type of variation where one hospital’s cost for an average hip replacement is $45,000, yet another one might have an average cost of $22,000. “What’s the disconnect?” he asked of the two cost scenarios. “A lack of standardization of using evidence-based protocols,” he answered.

By using data available through elec-tronic health records coupled with a part-nership with technology company Health Catalyst, Williams said HORNE is able to mine the available information to look at clinical pathways and search out deviation from standard protocols that adds to the cost of care. He was quick to add that the technology doesn’t seek to stop physicians from exercising their medical judgment but does highlight where there are outliers when it comes to following clinical proto-cols. “Best practices and evidence-based medicine say that these are the best proto-cols out there,” he pointed out.

Following those protocols not only saves money, but also should optimize qual-ity. With increased transparency, payers and patients will have access to information re-garding those positive outcomes and lower costs, which could ultimately drive volume.

A Foot in Both BoatsAdministrators and chief financial offi-

cers are caught between the fee-for-service and value-based payment worlds right now. Williams said they are trying to keep their heads above water in the current payment system … and now reimbursement experts want them to shift their focus to population management. Although making the move is understandably frustrating, Williams be-lieves it is also the best option to ultimately improve the bottom line.

“There has to be a change in culture from what it’s been in the past,” he noted. “We tell them, ‘Let’s prepare for it by being the most efficient, effective deliverer of care and eliminating patient waste.’ That puts you in a competitive advantage over those providers that have a higher cost structure.”

It is a different mindset, Williams con-tinued, to stop attacking reimbursement from the top and instead improve revenue by cutting costs. “If you deliver high qual-ity at a lower cost, then your margins are going to be greater. We see opportunities,” he concluded.

Gaining Perspective, continued from page 1


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By HEATHER RIPLEy

What strategies and tactics does your healthcare business use to promote its products or services to other businesses?

The usual, right? A mix of print ad-vertising, email marketing, social media posts and promotions, online ads and pay-per-click, press release distribution, web-site promotion, white papers and reports and, well, you get the picture. Or maybe you want to, but you don’t have the time or staff to manage all the above.

All of those marketing tactics depend on content. And, all that “content” takes time and effort to research, write, and pro-duce. The fact is, creating and distributing your content is probably taking a lot more time than you thought it would. When you hear the term “content marketing,” it not only means getting the content you write to the correct targets in a consistent manner, it means writing it correctly, too.

In my industry, healthcare public re-lations and marketing, content is not only “king,” it’s everything. And according to the recent B2B Content Marketing Report authored by Holger Schulze, manager of the B2B Technology Marketing Commu-nity on LinkedIn, more than 82 percent of the business respondents plan to increase

their content production next year. This means the trend toward businesses be-coming, in essence, their own publishers is not far off the mark.

One of the challenges for healthcare businesses in the coming year will be in finding a definitive way to answer the question: “Where is that content going to come from?” In the past, content came from various sources: your website, your marketing department (if your business had one), staffers who could write well, CEOs, other executives, freelance writers, or even staff members’ friends and family.

These sources may have been ad-equate in the past, but as more and more B2B companies plan on adopting some form of content marketing for the future, depending on staffers who are not trained or experienced in content marketing can end up costing your business more than you think. A content marketing plan is something businesses are going to need. And not just any plan, one that includes integrating content across multiple chan-nels and platforms for branding, continu-ity, purpose, identity, promotion, and for Internet search rankings (SEO).

Last year one of the biggest problems businesses had was creating engaging content, and that is still a major problem

going forward. According to the LinkedIn survey, the content challenges for B2B marketing in 2014 will be:

• Finding the staff time/bandwidth to create content (55 percent)

• Creating engaging content (49 per-cent)

• Producing enough varied content to capture interest across multiple channels (39 percent)

The key to good content though is not in the quantity, rather, it’s in the quality, and that’s where some businesses feel they lack the needed expertise to really engage and inform their audiences. It’s no secret that telling a compelling story is one of the most effective ways to create interest, but not every business is able to (or even wants to) employ a staff of experienced content marketers to write stories. And across multiple channels with the neces-sary keywords and search engine optimi-zation techniques tailored to each channel of communication.

Creating a cohesive and directed content marketing plan is even more chal-lenging when you consider the increas-ing number of channels content needs to fill. According to Marketing Profs and the Content Marketing Institute’s recent B2B Marketing Content report for 2013,

“B2B marketers are spending more, using more tactics, and distributing their con-tent on more social networks than they have in years past. Unfortunately, there is also more uncertainty. B2B market-ers are more uncertain whether they are using various content marketing tactics effectively.”

Rather than create an in-house pub-lishing department to handle the content needs of your B2B organization, firms of-fering content marketing services to this industry can be a worthwhile alternative. Before you make a decision on how to handle your B2B content marketing efforts, consider your staff’s time, your businesses’ ability to hire and manage content mar-keting staff, and how you will determine whether the return on investment (ROI) of your marketing efforts is successful or not. I think about it this way: content may be king but ROI is the master of the universe. Until you know which efforts are successful and why, it’s almost impossible to chart your future content marketing path.

Putting Content to Work for your Healthcare Business

Heather Ripley is the president and founder of Ripley PR, a business-to-business (B2B) public relations agency specializing in Healthcare IT. For more information, visit www.ripleypr.com or email [email protected].


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Knocking on Heaven’s Door: The Path to a Better Way of Death

by Katy Butler; c.2013, Scribner; $25.00 / $28.99 Canada, 322 pages

Indeed, the worst part about making a decision can be the regret that’s pos-sible at the end of the choice. And in the new book Knocking on Heaven’s Door by Katy Butler, a seemingly no-brainer decision tears a family apart.

Jeff Butler cheated death many times.

As a child, he narrowly missed dying in a car accident. In World War II, he lost an arm, but not his life. And in Novem-ber 2001, at age 79, he suffered a stroke that nearly killed him. A year later, he re-ceived a pacemaker.

And that, says his daughter Katy, kept him alive but didn’t “prevent his slide into dementia, incontinence, near-muteness, misery, and helplessness.”

Jeff and his wife Val were forward thinkers. He was a college professor. She was a perfectionist with fierce drive. They had been “in control of their lives, and they did not expect to lose control of their deaths.”

But that’s exactly what happened: as Jeff’s health continued to decline, his abilities dwindled and his cognizance weakened – all of which he was aware. He indicated dismay at his diminished life and said that he’d “unfortunately” lived too long.

On the other side of the country, Katy Butler worried. She’d always been closer to her father than to her mother, but arguments and old hurts continued

to sting. Still, she flew home to Connecti-cut to help because she was, after all, their daughter – statistically, the one who bore the brunt of parenting a parent.

But as Jeff’s dementia worsened, so did Val’s tolerance and her health. She was “stoic,” but impatient, snappish, and exhausted, and only accepted outside help when she became overwhelmed. Butler says she knew her mother “clout-ed” her father, and shouted at him in frustrated anger.

By this time, Butler was convinced that the pacemaker her father had wasn’t the medical miracle it was meant to be. And she learned that pacemakers could be turned off…

So much went through my mind as I read this beautiful, emotionally brutal book.

With sorrow, grace, and growing exasperation, author Katy Butler writes of her father’s long, messy death; her mother’s quiet, dignified passing; and the parallel story of how modern medi-cine, drug companies, and government rules promoted the former.

That’s a lot of hard reading, made gentler with Butler’s Buddhist values and serenity. And yet, it’s not easy to avoid outrage as she points out the unfairness of aging, the cruelty of physical decline, and the knowledge that those – and the surety of caretaking – are somewhat in-evitable for many Baby Boomers today.

This is a stunning book, truthful and its dignified, and it could be a conversa-tion-starter. If there’s a need for that in your family – or if you only want to know what could await you – then read Knock-ing on Heaven’s Door.

One Doctor: Close Calls, Cold Cases, and the Mysteries of Medicine

by Brendan Reilly, MD; c.2013, Atria Books; $28.00 / $32.00 Canada, 464 pages

In the new book One Doctor by Brendan Reilly, MD, you’ll see that moth-eaten testing methods may beat modern.

“New York doctors don’t work week-ends.”

That’s what one of Brendan Reilly’s patients claimed, surprised to see Reilly at her bedside on an early Saturday morning at New York’s Presbyterian Hos-pital. He was there because he believes that the doctor who “knows you best” is the one who should assume the majority of the caregiving. That’s not the way most medical centers work these days, but it’s the way he prefers to practice medicine.

For Reilly, doing things the old-fash-ioned way is often better than technol-ogy, when making a proper diagnosis. Machines, he points out, can miss the smallest of symptoms: a non-dilated pu-pil, an errant reflex, a hidden blood clot, rare bacteria that mimics something else.

“Diagnosing disease,” he says, “has something to do with patterns.” Good doctors – “grandmasters,” he calls them – know how to recognize those patterns without “wasteful, redundant, or ineffec-tive” medical intercession. Such recogni-tion, near-intuition, and the ability to deal with a day when “doctoring feels like pin-ball” are talents he cultivates in his resi-dents and students.

Even so, there are times when a doctor is stumped by a medical mystery that requires rapt attention and sleuthing skills. That’s when it’s mandatory to listen to a patient, the patients’ ailing body, and one’s own subconscious, as well as medi-cal knowledge new and old. Such myster-ies may result in instinctual reaction, and a cure. Other times, they might end with the surety that it’s time to stop.

And on that, says Reilly, doctors “know about regret. But we don’t talk about it. Ever.”

Broken up into thirds, One Doctor is a mixed (medical) bag.

Author Brendan Reilly, M.D. starts his book in the wee hours of a typical on-ser-vice day in a busy New York hospital, and we’re treated to a whirlwind of intriguing medical cases, AHA! moments, and solu-tions worthy of a Sherlockian novel. The end of that long day, and the cases of his own parents, are where Reilly wraps up.

I would have been more enthusiastic about this book, had that been the sum of it.

No, instead, the middle third here is taken up by the story of a couple that Reilly knew some 30 years ago, the care of which still resonates in his career. That was interesting at first, but I thought it be-came overly long.

And yet, I did enjoy this book, over-all, and I think lovers of medical dramas will, too. If that’s you, and you’re maybe willing to skip bits that lose your interest, then One Doctor tests out well.

theLiteraryExaminerBY TERRI SCHLICHENMEYER

Terri Schlichenmeyer has been reading since she was 3 years old, and she never goes anywhere without a book. She lives on a hill in Wisconsin with two dogs and 11,000 books.

information you get in the hands of our physicians and hospitals, the better off we are,” he said.

While the immediate future brings many challenges, Becker said the message of the annual meeting was a hopeful one. “This is the constructive destruction of the health system as we knew it. It will be very different going forward.”

As for the THA’s role in helping hospitals shift to population manage-ment models, Becker succinctly noted, “It’s coming, and we’re here to help you do it.” He continued, “We’ve really put an increased emphasis on quality. We’ve put an increased emphasis on education and on sharing best practices and process improvement data. Our data is all geared toward giving transparent information to our members so they understand how they stack up against others.”

He added the THA has also been hands-on in helping hospitals help their patients. In a move unique among hospi-tal associations, Becker said, “We actually took $3 million out of reserves and put it aside for grants for hospitals to enroll peo-ple in the exchange.”

He continued, “We touch 350,000 uninsured people every year in our emergency rooms.” Becker noted iden-tifying those who qualify for the federal exchanges and getting them covered is a win/win for families and facilities. Hos-pitals have until the end of November to apply for the grants.

“We’re excited to have a good oppor-tunity to give back to our members and hopefully help our hospitals get ahead of the curve in signing people up,” he said.

Despite the obvious pain points that come with transformational change, Becker and his staff are keeping an eye on the prize. “We’ll have a far better health-care system once we get to the other side,” he concluded.

Tennessee Hospital, continued from page 9


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MONTH CLINICAL FOCUS BUSINESS FOCUS

January Public Health Financial/Tax PlanningFebruary Cardiology Mergers & AcquisitionsMarch Stroke Healthcare Design/ConstructionApril Diabetes/Wound Care ICD-10May Women’s Health Health Information TechnologyJune Rural Health Practice ManagementJuly Pediatrics Health ExchangesAugust Ortho/Sports Med. Physician/Hospital AllianceSeptember Oncology Medicare/MedicaidOctober Senior Health ReimbursementNovember Radiology/Imaging Health Education

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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.

Daniel Branham, MD, Joins Tennessee Orthopaedic Clinics

KNOXVILLE, TN – Dr. Daniel Bran-ham has joined Tennessee Orthopaedic Clinics specializing and board-certified in hand and upper extremity pro-cedures.

Originally from the Clinton area, he has re-turned to his East Tennes-see roots after practicing at a Level II trauma cen-ter in Melbourne, Florida, for the last six years. Following the obtainment of his medical degree from the University of Tennessee Memphis, he completed his residency at the Medical College of Vir-ginia. A fellowship in Orthopaedic Hand

and Upper Extremity Surgery at the Uni-versity of Florida in Gainesville further de-veloped his expertise in patient care.

Branham is a member of the Ameri-can Academy of Orthopaedic Surgeons as well as the University of Florida Hand Fellows.

Parkridge Health System Welcomes Bement as Executive Director of Surgical Services

CHATTANOOGA, TN – Jared Be-ment has been selected as the Executive Director of Surgical Services for Parkridge Health System.

Bement has many years of experi-ence in nursing leadership. He comes to Parkridge from a position as Director of Perioperative Services at Baylor University

Medical Center in Dallas. Bement holds a Bachelor of Sci-

ence degree in nursing from the Baptist College of Health Sciences in Memphis, Tenn. He also holds a Master of Business Administration degree from East Tennes-see State University. Bement is a mem-ber of the American Nurses Association (ANA), the American College of Health-care Executives (ACHE), and the Associa-tion of PeriOperative Registered Nurses (AORN) Top 25 Surgical Services Summit.

St. Barnabas Multi-Sensory Room Opens Tennessee’s first multi-sensory room in a healthcare facility promotes patient well-being

CHATTANOOGA, TN – St. Barnabas announces the addition of a multi-sensory room to its program offerings.

St. Barnabas’s multi-sensory room is state-funded by UnitedHealthcare Com-munity and State Plan, and can be set to either relaxation mode or stimulation mode. The room can be staged to pro-vide a multi-sensory experience or single sensory focus, simply by adapting the lighting, atmosphere, sounds, and tex-tures to the specific needs of the individu-al at the time of use. Specific therapeutic outcomes aren’t expected – instead, the focus is to help users gain the maximum pleasure possible from the multi-sensory activity. Because it does not rely on ver-bal communication, it may be beneficial for people with dementia and those who would otherwise be almost impossible to reach. Sensory stimulation can decrease behavioral issues arising from mental health and dementia diagnoses, accord-ing to researchers.

The CHOICES program, part of TennCare, requires managed-care orga-nizations to participate in a quality of life project, and St. Barnabas was selected to pilot Tennessee’s first multi-sensory room in a health care facility.

LMU-DCOM’S Wieting Among Mentor of the Year Finalists at Annual Osteopathic Medical Conference and Exposition

HARROGATE, TN - Dr. Michael Wiet-ing, senior associate dean at Lincoln Me-morial University-DeBusk College of Osteopathic Medicine (LMU-DCOM) in Harrogate, Tenn., was recently named as a final-ist in the American Osteo-pathic Association’s (AOA) Mentor of the Year recog-nition program. The recognition program was conducted by the AOA in association with Pfizer Inc.

Wieting was selected as one of five finalists for the Mentor of the Year award from more than 175 nominated mentors.

Wieting was honored during a break-fast reception on Sept. 30 at the AOA’s OMED 2013, the Osteopathic Medical Conference & Exposition in Las Vegas.

Wieting is board certified in physical medicine and rehabilitation and is a fel-low in the American Osteopathic College of Physical Medicine and Rehabilitation as well as the American Academy of Physical Medicine and Rehabilitation.

McNabb Center welcomes board members and officers for 2013-2014

KNOXVILLE, TN –Andy Black, Helen Ross McNabb Center CEO, welcomes board members and officers to the Cen-ter’s board of directors.

2013-2014 Helen Ross McNabb Center Board of Directors with elected officers: Dr. Harold Black; Ms. Linda Gay Blanc; Mrs. Susan Conway, Chair; Mr. Joe Connell, Past Chair; Mr. Wade Davies, Chair Elect; Mr. Joe Fielden; Mr. Charles Finn, Secretary; Ms. Mai Bell Hurley; Mrs. Debbie Jones, Treasurer; Mrs. Ellie Kas-sem; Mr. Ford Little; Mr. Richard Maples; Mrs. Della Morrow; Mr. Joe Petre; Mr. James Schaad; Mr. Ross Schram, III; Dr. Karen Sowers; Mrs. Nikitia Thompson; Mrs. Traci Topham; Mrs. Linda Vaughn; Mrs. Dedra Whitaker; Mr. Chris Kittrell.

Award Recognizes New App for Smart Phones to Help Smokers Kick Habit

KNOXVILLE, TN – In 2012 Covenant Health and the Will Rogers Institute be-gan offering a new app for smart phones to help smokers make the smart choice to kick the habit. Now the Stop Smoking App has received a special honor for that mission.

The Dr. Peter Carter Award recog-nizes contributions to tobacco prevention in Knox County and surrounding commu-nities. During a recent award ceremony, Jon Dalton received the Dr. Peter Carter Award for the stop smoking app on be-half of Covenant Health. Dalton is manag-er of Parkwest cardiopulmonary wellness and rehabilitation, and was instrumental in creating the app.

To download the Stop Smoking app for a phone or other mobile device, go to www.covenanthealth.com/stopsmoking.

GrandRounds

Children’s Hospital Foundation welcomes New Board Members

CHATTANOOGA, TN – Children’s Hospital Foundation at Erlanger is proud to announce the appointment of five new board members to its team of supporters.

Jeff Eversole, Wal-Mart Market Manager, has been a supporter of Children’s Hospital through Wal-Mart’s campaigns with the Chil-dren’s Miracle Network Hos-pitals. Lisa Lowry-Smith, M.D., a Neonatologist at Children’s Hospital at Er-langer, has treated patients and worked with the hos-pital staff since 2011. Nita Shumaker, MD, pediatrician at Galen Medical Group, also serves on Chattanooga-Hamilton County Hospital Authority Board of Trustees. She was nominated to serve as the Authority Board’s representative on the foundation council. Amber Watten-barger is an independent consultant who is experienced in demand and supply planning. Christie Kizer Burbank, member of Miller & Martin PLLC, concentrates her legal practice exclusively in health care regulatory and transactional law and has served as a member and ambassador in other healthcare organizations in the community.

(Left to right) Amber Wattenbarger, Children’s Hospital Founda-tion Co-Chair Carrie Kennedy, Christie Kizer Burbank, and Jeff Eversole. (Not pictured: Dr. Lisa Lowery-Smith and Dr. Nita Shumaker.)

Dr. Daniel Branham Dr. Michael

Wieting


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Watkin named Director of Privacy for Covenant Health

KNOXVILLE, TN – Janice Watkin, for-mer health information management di-rector and privacy officer at Parkwest, has been named director of privacy for Cov-enant Health’s centralized privacy office. The office is part of the health system’s integrity compliance pro-gram, and Watkin works closely with Tish Breeding, corporate in-tegrity and privacy officer, to ensure ap-propriate protections and processes for HIPAA (Health Insurance Portability and Accountability Act) compliance, as well as other federal and state privacy require-ments.

Covenant Health Renews Sponsorship of Knoxville Marathon, Celebrates Ten-Year Anniversary

KNOXVILLE, TN — The Covenant Health Knoxville Marathon celebrates its 10th anniversary in 2014, and Covenant Health, which has sponsored the event for the past nine years, recently commit-ted to keep the marathon (and the mara-thoners!) running for three more years.

Proceeds from the marathon benefit the Knoxville Track Club’s scholarship and community fitness programs. In addition, a portion of the proceeds benefit the Pa-tricia Neal Rehabilitation Center’s Innova-tive Recreation Cooperative.

The 2014 marathon is set for Sunday, March 30, with the Covenant Kids Run scheduled for Saturday, March 29. Reg-istration and information is available at www.knoxvillemarathon.com..

Covenant Health Names Jenny Hanson to Succeed Ellen Wilhoit as LeConte CAO

SEVIERVILLE, TN — Covenant Health has announced that Jennifer (Jenny) Han-son, vice president and chief nursing officer at Fort Sanders Regional Medi-cal Center, will be the new president and chief admin-istrative officer at LeConte Medical Center in Sevier-ville. She will succeed Ellen Wilhoit, who will retire in early 2014.

Hanson has been CNO at Fort Sand-ers Regional since 2007. During her ten-ure, Fort Sanders Regional Medical Cen-ter has received multiple awards for qual-ity and patient care excellence, and has been named by U.S. News and World Re-port as one of the region’s top hospitals. The medical center and the Patricia Neal Rehabilitation Center have received certi-fication as a comprehensive stroke center of excellence by The Joint Commission.

Prior to joining Fort Sanders Region-al, Hanson was vice president of patient care services and system nurse executive for Baptist Health System of East Tennes-see. She also served as nurse executive, chief operations officer and interim CEO

at McLaren Health Care Corporation’s Lapeer Regional Hospital, in Lapeer, Mich. Her leadership experience includes achievements in quality improvement, staff development, physician partnering, financial turnarounds, and technology in-novation.

Ellen Wilhoit was named president and CAO of then-Fort Sanders Sevier Medical Center in 1999. Prior to that time, she served as the hospital’s chief oper-ating officer and chief nurse executive. With a focus on quality, strategic plan-

ning, physician recruitment and relations, financial management and nurs-ing administration, Wil-hoit helped the hospital achieve national recogni-tion for patient satisfaction and customer service. She helped lead the development, construc-tion, staff transition and opening of the new LeConte Medical Center in 2010. Named the most beautiful hospital in the U.S. in 2013, LeConte recently received a

5-star award from PRC for outpatient sat-isfaction.

Hanson assumed her new duties on Oct. 14. Wilhoit will continue in a tran-sitional leadership role, working along-side Hanson at LeConte Medical Center through the first quarter of 2014. Janice McKinley, Covenant Health senior vice president and CNO, will assume respon-sibilities as interim chief nursing officer at Fort Sanders Regional Medical Center.

GrandRounds

Janice Watkin

Jenny Hanson

Ellen Wilhoit


Covenant Receives Excellence in Healthcare Awards

KNOXVILLE, TN — Covenant Health organizations recently received numer-ous Excellence in Healthcare awards from Professional Research Consultants (PRC), a Nebraska-based organization which measures patient satisfaction among its database of 300 hospitals nationwide. Among the award winners were:

4-Star Awards (Top 25 Percent of National Database, 75th-89th percen-tile)

Overall Quality of Care:Fort Loudoun Medical Center – Out-

patientParkwest Medical Center – Inpatient,

Emergency DepartmentLeConte Medical Center – InpatientMethodist Medical Center – Inpa-

tientFort Sanders Regional Medical Cen-

ter – Inpatient 5-Star Awards (Top 10 Percent of

National Database, at or above 90th percentile)

Overall Quality of Care: Fort Sanders Regional - Outpatient,

3 North Surgery, 7 North Complex Medi-cal Unit, 3 West Nephrology Unit, 8 North Oncology Unit

Patricia Neal Rehabilitation Center – Overall Inpatient Rehab, TBI/SCI Rehab, Ortho/Neuro Rehab

Methodist Medical Center – Outpa-tient, Outpatient Surgery, 3 East Joint Re-placement Center, 4 West Oncology Unit, TCSC – Oak Ridge, Outpatient Radiation

Parkwest Medical Center – Outpa-


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GrandRounds

Name: Steve Shaffer

Position:Volunteer, J.D. and Lorraine Nicewonder Cancer Center in Bristol and the Bristol Regional Medical Center Emergency Department

At a Glance: January will mark three years that Steve Shaffer has been volunteering at the J.D. and Lorraine Nicewonder Cancer Center, as well as at the Emergency Department at Bristol Regional Medical Center. Every Monday and Wednesday, Shaffer devotes his time to helping patients at these facilities who may not have anyone else to accompany them to their visit. While patients at both facilities range in age, for Shaffer, his decision to volunteer came out of his love for one particular group. “I guess I’ve always had a soft spot for older folks; I like to sit down and talk about past experiences,” he said. “Some of them who have no one else come in by themselves, so I really like to socialize with them and try to understand what they are going through because we might go through the same thing one day. I like to give them as much of my time as I can.”

Shaffer starts his shift by preparing snacks, coffee, and other refreshments, and then makes his rounds to ensure that everyone feels at ease, that breakfast and dinner orders have been put in, and that the patients are tolerating their meals, as some persons cannot tolerate food while receiving chemotherapy.

“I really care for them, and sometimes you get attached to them. The other volunteers and I realize that the patients are coming in to get better, but the therapy has to work on them first,” he shared. “Patients can get to a point where they are down, depressed, and just want somebody, even hunger for somebody, to sit down with them and just listen to what they are saying. I pride myself on being a good listener.”

Shaffer says that for him, all the reward or recognition that he needs comes from the very satisfying feeling that he has helped someone get through their troubling time because “they are in a lot of pain, and I love them all. On Wednesdays and Mondays, that’s what I get up for,” he said. “I guess you can say that I crave that interaction, too.”

Of course, Shaffer says he couldn’t do what he does without the support of the other volunteers. “We have a great group of volunteers,” he said. “They care, and they try so hard. There are days they come in and don’t feel so good, but they still give all they can, and we just make each other laugh.”

tient, Childbirth Center, Cardiopulmonary Unit, Cardiac Specialty Unit

LeConte Medical Center – Outpa-tient

Thompson Cancer Survival Center - Outpatient, Thompson Breast Center, Thompson PET, Thompson Outpatient Radiation Oncology

Crystal Overall Top Performer Award (at or above 100th percentile)

Thompson Cancer Survival Center Breast Center

Leading Gastrointestinal Society Names Colleen M. Schmitt, MD, to President-Elect

DOWNERS GROVE, IL — The Ameri-can Society for Gastrointestinal Endosco-py (ASGE) announces the appointment of Colleen M. Schmitt, MD, MHS, FACG, FASGE, of the Galen Medical Group, Chattanooga, TN., to president-elect.

Schmitt assumed her duties in May during Digestive Disease Week in Or-lando, FL. Her term will continue through May 2014 at which time she will become president. She became a member of ASGE in 1994 and has served on a num-ber of committees. From 2005-2009 she served as chair of the Health and Public Policy Committee and was a member of the Research Committee for several years. Since 1994, Dr. Schmitt has been a reviewer for ASGE’s peer-reviewed scien-tific journal GIE: Gastrointestinal Endos-copy and was a member of the Editorial Review Board from 1999 to 2004. She is also a Fellow of the ASGE.

Schmitt practices at the gastrointesti-nal specialty arm of Galen Medical Group which has expanded to include six adult GI specialists, one pediatric GI specialist and one hepatologist. She is also Medi-cal Director at Memorial Research Center and was chief of the Division of Gastro-enterology at the University of Tennessee College of Medicine, Chattanooga Unit.

Ridgeview Behavioral Health Services Names Buuck C.E.O.

OAK RIDGE, TN – Ridgeview Behav-ioral Health Services recently announced the appointment of Brian D. Buuck to the position of Chief Executive Officer, effec-tive January 1, 2014. Buuck will replace Bob Benning who retires at the end of December this year, after 27 years of ser-vice to Ridgeview.

In his former position at Ridgeview as Chief Operating Officer for the past 10 years, Buuck was responsible for the day-to-day operations of Ridgeview’s clinical and support programs and was instru-mental in expanding Ridgeview’s services through grants and networking with other area providers.

Buuck holds a B.S. degree from the University of Louisiana, Lafayette, and a MSSW degree from the University of Ten-nessee. He is certified as a Licensed Clini-cal Social Worker.


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Boyd Promoted to Manager of Volunteer Services

KNOXVILLE, TN — Parkwest Medi-cal Center announces that Becky Boyd has been named manager of Volunteer Services. She will also serve as co-admin-istrator of the Patient Call Center and will be supervising the Guest Services de-partment. In addition, she will act as Cov-enant Health’s “Journey to Excellence” coordinator for Parkwest.

In her previous role, Boyd was Volun-teer Services coordinator at Parkwest for more than six years. During this time, she was instrumental in significantly growing the number of active volunteers from 80 to more than 150.

Boyd is a graduate of East Tennes-see State University, holding a Bachelor of Science degree in business manage-ment. Prior to working at Parkwest, she was the Community Relations Manager for Tellico Village Property Owners’ As-sociation and Executive Director of the Loudon County Visitors Bureau. Boyd is a member of DVS (Director of Volunteer Services) Tennessee Healthcare Volunteer Professionals.

New Memorial Vice Presidents Strengthen Care, Fiscal Responsibility

CHATTANOOGA, TN –Memorial Health Care System is proud to announce the addition of two new vice presidents to its award-winning staff. Danine Wat-son, MSN, RN assumes the newly created position of Vice President of nursing/as-sociate chief nursing officer, and Michael Sutton has been named vice president of finance.

Danine Watson joins the Memorial Health Care team in the role of vice president of nursing/associate chief nursing officer, having previously served as chief nursing officer (CNO) at Citizens Baptist Medical Center in Talladega, Ala-bama. She holds a Mas-ter’s Degree in Nursing and boasts more than 20 years of nursing in both clinical and leadership roles. As associate chief nursing officer, Watson is responsible for providing clinical leadership through the implementation of key strategic and op-erational initiatives, facilitating optimal care delivery, quality care, financial suc-cess, risk management and customer service.

Michael Sutton has been promoted to vice president of fi-nance of Memorial Health System. Since joining Me-morial in 2001, Sutton has served in several capaci-ties, including executive director of financial op-erations/performance im-provement/revenue cycle for nearly five years. Sutton earned both his Bachelor of Science in Accounting and MBA from University of Tennessee at Chattanooga.

GrandRounds

Michael Sutton

Hope is close to home.

www.msha.com/cancer

We know you want the best cancer care as close to home as possible. That’s why Mountain States Cancer Care is here for you with locations throughout Northeast Tennessee and Southwest Virginia. However, if you need a more advanced level of care that is not available at your community hospital, that’s no problem. Advanced cancer care services are available through our cancer care network. Our physicians at Mountain States Medical Group will make sure you get the care you need at the most convenient location possible.

No matter where you are in your fight against cancer – whether you’ve been recently diagnosed, are recovering from surgery, in the middle of radiation treatment or five years out – we are here for you and your cancer care needs.

Our Cancer Care Network:• Indian Path Medical Center• Johnson City Medical Center• Johnston Memorial Hospital• Smyth County Community Hospital• Sycamore Shoals Hospital

Hope is close to home.

www.msha.com/cancer

We know you want the best cancer care as close to home as possible. That’s why Mountain States Cancer Care is here for you with locations throughout Northeast Tennessee and Southwest Virginia. However, if you need a more advanced level of care that is not available at your community hospital, that’s no problem. Advanced cancer care services are available through our cancer care network. Our physicians at Mountain States Medical Group will make sure you get the care you need at the most convenient location possible.

No matter where you are in your fight against cancer – whether you’ve been recently diagnosed, are recovering from surgery, in the middle of radiation treatment or five years out – we are here for you and your cancer care needs.

Our Cancer Care Network:• Indian Path Medical Center• Johnson City Medical Center• Johnston Memorial Hospital• Smyth County Community Hospital• Sycamore Shoals Hospital

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East TN Medical News Nov 2013

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