PRSRT STD U.S. POSTAGE PAID FRANKLIN, TN PERMIT NO.357 ON ROUNDS PRINTED ON RECYCLED PAPER Understanding the Power Shift in the New Health Economy HRI shows why the industry is ripe for picking; players compete to be healthcare’s new Amazon.com In 2010, CellScope was birthed in tech-savvy San Francisco with the mission of creating a home medical kit of smartphone-friendly devices. Its debut offering – Oto, an otoscope that takes digital images of the ear canal – was promoted as a way to reduce up to 30 million office visits annually for ear infections in the United States ... 7 Partnering in a New Paradigm There’s no question healthcare delivery is in the middle of a transformational period highlighted by unprecedented consolidation ... 9 August 2014 >> $5 PROUDLY SERVING THE MAGNOLIA STATE Brian Condit, MD PAGE 2 PHYSICIAN SPOTLIGHT ONLINE: MISSISSIPPI MEDICAL NEWS.COM Controlling Asthma Mississippi part of CDC’s National Asthma Control Program; takes other measures to improve outcomes Pairing Technology for Better Access to Lung Cancer Baptist Medical Center is Mississippi’s only hospital combining superDimension TM technology with CyberKnife radiosurgery for treatment and diagnosis BY LYNNE JETER When cardiothoracic surgeon Michael Koury, MD, joined Baptist Medical Center in Jackson as director of thoracic surgery in 2010, his mission was to improve outcomes for lung cancer patients. Updating the bronchoscopy lab and equipment became one of his top priorities. Last year, the program got a boost when Baptist obtained the EBUS (endobronchial ul- trasound) system. Recently, the hospital invested in the superDimension TM System, Covidien’s Electromagnetic Navigational Bronchoscopy, a diagnostic and therapeutic tool that uses GPS- like technology to locate, biopsy and prepare to treat lesions deep within the lung. “The navigational bronchoscopy marries (CONTINUED ON PAGE 10) BY LYNNE JETER This year, Metro Jackson was elevated slightly in “The Top 100 Most Challenging Places to Live with Asthma in 2014,” sliding five spots to No. 42, according to “Asthma Capitals 2014,” the 11 th an- nual research project released by the Asthma & Allergy Foundation of America (AAFA). Of the 100-point sys- tem, Metro Jackson re- ceived a total score of 75.54, with worse-than- average ratings for prev- alence factors (crude death rate for asthma), risk factors (annual pollen score, poverty rate, and the uninsured), and medical factors (emergency room visits for asthma and use of control medications). Despite the dismal report, it’s important to note how closely the Metropolitan Statistical Areas (MSAs) ranked. For example, six cities also had total scores of 75, with only tenths of points separating them in the rankings. With Metro Jackson as Mis- sissippi’s only MSA in the rank- ings, the report shines a light on the challenges of treating asthma (CONTINUED ON PAGE 4) Increase web traffic Powerful branding opportunity Any metro market in the U.S. Preferred, certified brand-safe networks only Retargeting, landing pages, SEM services available [email protected]GUARANTEED CLICK-THROUGHS Get verified results (impressions and/or clicks) for (LOCAL) online advertising. (pictured left to right): superDimension Sales Rep Brady Hamilton, Pulmonologist Maria Rappai, MD, and Baptist Cardiothoracic Surgeon Michael Koury, MD.
Transcript
PRSRT STDU.S.POSTAGE
PAIDFRANKLIN, TN
PERMIT NO.357
ON ROUNDS
PRINTED ON RECYCLED PAPER
Understanding the Power Shift in the New Health EconomyHRI shows why the industry is ripe for picking; players compete to be healthcare’s new Amazon.comIn 2010, CellScope was birthed in tech-savvy San Francisco with the mission of creating a home medical kit of smartphone-friendly devices. Its debut offering – Oto, an otoscope that takes digital images of the ear canal – was promoted as a way to reduce up to 30 million offi ce visits annually for ear infections in the United States ... 7
Partnering in a New ParadigmThere’s no question healthcare delivery is in the middle of a transformational period highlighted by unprecedented consolidation ... 9
August 2014 >> $5
PROUDLY SERVING THE MAGNOLIA STATE
Brian Condit, MD
PAGE 2
PHYSICIAN SPOTLIGHT
ONLINE:MISSISSIPPIMEDICALNEWS.COMNEWS.COM
Controlling AsthmaMississippi part of CDC’s National Asthma Control Program; takes other measures to improve outcomes
Pairing Technology for Better Access to Lung CancerBaptist Medical Center is Mississippi’s only hospital combining superDimensionTM technology with CyberKnife radiosurgery for treatment and diagnosis
By LyNNE JETER
When cardiothoracic surgeon Michael Koury, MD, joined Baptist Medical Center in Jackson as director of thoracic surgery in 2010, his mission was to improve outcomes for lung cancer patients. Updating the bronchoscopy lab and equipment became one of his top priorities.
Last year, the program got a boost when Baptist obtained the EBUS (endobronchial ul-trasound) system. Recently, the hospital invested in the superDimensionTM System, Covidien’s Electromagnetic Navigational Bronchoscopy, a diagnostic and therapeutic tool that uses GPS-like technology to locate, biopsy and prepare to treat lesions deep within the lung.
“The navigational bronchoscopy marries (CONTINUED ON PAGE 10)
By LyNNE JETER
This year, Metro Jackson was elevated slightly in “The Top 100 Most Challenging Places to Live with Asthma in 2014,” sliding fi ve spots to No. 42, according to “Asthma Capitals 2014,” the 11th an-nual research project released by the Asthma & Allergy Foundation of America (AAFA).
Of the 100-point sys-tem, Metro Jackson re-ceived a total score of 75.54, with worse-than-average ratings for prev-
alence factors (crude death rate for asthma), risk factors (annual pollen score, poverty rate, and the uninsured), and medical factors (emergency room visits for asthma and use of control medications).
Despite the dismal report, it’s important to note how closely the Metropolitan Statistical Areas (MSAs) ranked. For example, six cities also had total scores of 75, with only tenths of points
separating them in the rankings.With Metro Jackson as Mis-
sissippi’s only MSA in the rank-ings, the report shines a light on the challenges of treating asthma
(CONTINUED ON PAGE 4)
Increase web traffi c Powerful branding opportunity Any metro market in the U.S. Preferred, certifi ed brand-safe networks only Retargeting, landing pages, SEM services available
GUARANTEED CLICK-THROUGHSGet verifi ed results (impressions and/or clicks) for (LOCAL) online advertising.
(pictured left to right): superDimension Sales Rep Brady Hamilton, Pulmonologist Maria Rappai, MD, and Baptist Cardiothoracic Surgeon Michael Koury, MD.
2 > AUGUST 2014 m i s s i s s i p p i m e d i c a l n e w s . c o m
By LUCy SCHULTZE
This year, Tupelo physician Brian Condit, MD, will be learn-ing customer-service concepts from the Ritz-Carlton hotel company and gleaning efficiency ideas from a food-processing business in Min-nesota.
As a 2014-15 fellow of the Baldridge Performance Excellence Program, Condit is among 14 ex-ecutives from across the country who’ll seek to gain a greater un-derstanding of leadership and how it can help any organization better fulfill its mission.
“The idea is to bring back good ideas to our own organization,” said Condit, a physical medicine and re-habilitation specialist who directs the Physician Leadership Institute at North Mississippi Health Ser-vices.
The task of improving health-care for people in North Mississippi Medical Center’s service region has become a central aspect of Condit’s career since he joined NMMC in 2004. The challenge includes both re-sponding to the changes currently affect-ing the healthcare system and introducing innovative ideas to take the organization forward.
“It’s clear the healthcare world is changing, and if physicians want to be heard, they have to be involved,” he said. “We need to be able to step up and to speak the language — to help things move forward in a positive direction.”
For Condit, that awareness came through the influence of Kenneth Davis, MD, former chief medical officer at
NMMC. Inspired by his mentorship, Condit enrolled in the master of health ad-ministration program at the University of Alabama at Birmingham. He then worked with Davis’s successor, Mark Williams, MD, to establish the hospital’s Physician Leadership Institute in 2010.
That initiative was an important piece of North Mississippi Health Services’ suc-cess in winning the 2012 Baldridge Award in the healthcare category.
“Even more important than the award is the process that you go through in looking at your organization and how
we optimize and balance what we do,” Condit said.
“As a physician, what it really boils down to for me is the quality of care we are delivering at the bed-side. I call it the ‘Mom Test’: Are we delivering care at the level we would want for somebody in our own family?
“We must insist on that level of care and compassion and engage-ment, because ultimately we will all be there.”
A native of Tucson, Ariz., Condit came to a career in medi-cine through a fascination with biology. He received a bachelor’s degree in biology from the Uni-versity of Arizona in Tucson and worked in search-and-rescue, where he received first-aid train-ing. After volunteering in the emergency room at the University of Arizona and working in medical research, he opted to enroll in the UA College of Medicine.
His interest in rehabilitation medicine drew from his own ex-perience playing sports and being
active outdoors, as well as from its connec-tion to neurology.
He completed his internship and resi-dencies in internal medicine and physical medicine and rehabilitation at St. Francis Medical Center in Pittsburg, Pa.
Condit is board certified in internal medicine and physical medicine and re-habilitation. He is a fellow of the Ameri-can Academy of Physical Medicine and Rehabilitation and has special training in electro-diagnostic nerve studies.
He spent four years practicing in southern Texas before he was recruited to
join North Mississippi Health Systems. He completed a master of health administra-tion degree from UAB in 2010.
Today, he serves as medical director of the Rehabilitation Institute at North Mississippi Medical Center and prac-tices as part of North Mississippi Physical Medicine and Rehabilitation. His group includes two fellow physicians and two nurse practitioners.
Condit’s role is primarily focused in the hospital’s acute rehabilitation unit, where approximately 50 percent of pa-tients are recovering from a stroke. Pa-tients also include those recovering from injuries to the spinal cord or head, or from amputations.
As part of his term as a Baldridge Fel-low, Condit is currently developing as a capstone project a leadership program for nurse practitioners in North Mississippi Health Systems’ service area.
“If you look at the changing dynamic of primary care, the balance is shifting toward advanced practice practitioners or nurse practitioners within the com-munity,” he said. “Since our mission is to promote the health of everyone in the community, the goal of this project is to help those nurse practitioners be success-ful both in terms of their practices and in terms of providing excellent care.”
That effort has a direct connection to North Mississippi Health Systems’ ability to improve the health of its community, he said.
“If there’s not really good primary care out there, then a lot of the chronic diseases we’re having to deal with won’t be well treated, and people will come in sicker with problems that are harder to address,” he said. “It’s not that I have all the answers. Our goal is that we want to support them.”
Outside of his practice and leadership activities, Condit enjoys spending time with his family, including wife Ruth and their three grown children. Among the family’s efforts is gathering for the honey harvest of their 34-hive beekeeping opera-tion.
“It just seemed like a neat thing to do,” said Condit, who was inspired by the fleeting sight of a Swiss beekeeper during a visit to the Alps. When he returned home, Condit took an introductory class through the Mississippi State University Extension Service and got started.
“Unlike cows or chickens, where you’re having to deal with them every day, bees are basically wild organisms in a box,” he said. “You try to set them up in the best possible situation so that they can be productive, and if you do, you can get a wonderful product from them.”
The raw, unfiltered honey produced by the bees Condit keeps is sold under the brand Shire Hearth LLC and sold at a local health food store.
Brian Condit, MDPhysicianSpotlight
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Our healthcare specialists have solutions to most every situation you mayencounter in your practice - and more importantly, can help you avoid manypitfalls that often occur in the complex world of today’s medicine.
Every day we partner with hospitals, physicians and other healthcare providerswith issues regarding reimbursement, Stark & Anti-kickback, Licensure, HIPAA,and Certificates of Need - as well as everyday needs such as practice structure,employment guidance and liability defense.
We’re the perfect partner for your healthcare practice. Give us a call to reviewyour challenges - we’ll make a prescription for a trouble-free path.
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By DAVID JOFFE
The Affordable Care Act (ACA) brings about significant healthcare reform changes, as well as opportunities for small employers in 2014. Many of the reforms affect all employers who sponsor group health plans; however, the effect of some of the reforms is limited for smaller em-ployers. Also, small employers will benefit from changes affecting tax credits and new coverage provided through the Small Business Health Options Program.
2014 ReformsFor plan years beginning on or after
Jan. 1, 2014, certain existing reforms will be enhanced, and new reforms will apply to most plans. Annual limits will be pro-hibited on essential health benefits; pre-viously, restricted limits were allowed. Waiting periods may not exceed 90 days. Plans may also not discriminate against a healthcare provider acting within the scope of his or her license; however, this provision does not require plans or insur-ers to contract with “any willing provider” or prohibit varying reimbursement rates. Preexisting condition exclusions will no longer be permitted; this is true regardless of the age of the participant. Non-grandfa-
thered plans will be required to cover costs associated with certain approved clinical trials.
Insurance ChangesAs a related matter, new limitations
on premium rate setting will apply for in-surers in the small group market (generally, 2 to 50 employees). New guaranteed-avail-ability and guaranteed-renewability rules also apply. ACA provides for an overall limitation on out-of-pocket maximums and deductible limits for non-grandfa-thered plans. Although these require-ments apply to all group health plans, the agencies interpret the deductible limit (in 2014, $2,000 for individuals or $4,000 for other plans) as applying only to plans and insurers in the small group market. With respect to out-of-pocket maximums (in 2014, $6,350 for self-only coverage and $12,700 for family coverage), although the requirement applies under ACA to all group health plans, the agencies have added a one-year safe harbor if a plan or insurer utilizes more than one service provider to administer benefits, subject to certain requirements.
Tax CreditSince 2010, eligible small employers
that offer health insurance coverage to their employees have been entitled to a tax credit of up to 35 percent of the nonelec-tive (employer) contributions they make toward the premium cost (and up to 25 percent for tax-exempt eligible small em-ployers). Some important changes become effective beginning with 2014 taxable years. First, the maximum credit amount increases from 35 percent to 50 percent of premiums paid (and from 25 percent to 35 percent for tax-exempt eligible small employers). Second, the coverage must be offered through a SHOP exchange (see below). Third, the credit can be claimed for only two consecutive years beginning on or after 2014.
Automatic EnrollmentACA amends the Fair Labor Stan-
dards Act to require certain large employ-ers to enroll automatically new full-time employees in one of the employer’s health benefit plans (subject to any waiting period authorized by law) and continue the en-rollment of current employees. However, the requirement only applies to employers that have more than 200 full-time employ-ees. Also, the Department of Labor (DOL) has indicated that employers are not re-quired to comply with this requirement
until final regulations are issued and ap-plicable. As of March 15, 2014, the DOL had not issued the regulations.
ExchangesOne of the key features of ACA
was the establishment by Jan. 1, 2014, of American Health Benefit Exchanges, which are now sometimes referred to as Marketplaces. The Exchanges perform a variety of functions required by ACA in-cluding certifying qualified health plans (QHPs), determining eligibility for enroll-ments in QHPs and for insurance afford-ability programs (e.g., advance payment of premium tax credits), and responding to customer requests for assistance.
One type of Exchange is the Small Business Health Options Program (SHOP). SHOPs are designed to allow small employers to offer their employ-ees a choice of QHPs. The Department of Health and Human Services has pro-vided for a federally facilitated SHOP in states, like Tennessee, that do not estab-lish a state-based Exchange. Participation in SHOP is strictly voluntary for small employers. Beginning in 2014, however, purchasing employer-provided health cov-erage for employees through SHOP will
Changes & Opportunities for Small Employers under ACA
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4 > AUGUST 2014 m i s s i s s i p p i m e d i c a l n e w s . c o m
Belhaven Building1200 North State Street, Suite 300, Jackson, Mississippi 39202
601-981-4091 • www.msretina.com
Committed to your visual health.
Missisippi Retina Associates is Pleased to Welcome
Dr. Brown is a Board Certifi ed Ophthalmologist who graduated from and did his residency at the University of Mississippi Medical Center Department of Ophthalmology. Brown also underwent extensive training at Massachusetts Eye and Ear Infi rmary in Boston, MS in addition training in Ophthalmic Pathology for Ophthalmologist at the Armed Forces Institute of Pathology
Jay Brown, M.D.Ophthalmology
Diseases and Surgery Of The Retina And Vitreous
patients in a rural state of nearly 3 million. Roughly 165,000 Mississippians live with asthma; one in 10 children has it. In 2008, nearly 12,000 emergency room discharges listed asthma as the primary diagnosis. Asthma hospitalization rates are highest among children age 4 and younger.
Roadmap to ImprovementMississippi is taking strides to improve
asthma outcomes. For example, Missis-sippi is one of 36 states in the Centers for Disease Control and Prevention’s (CDC’s) National Asthma Control Program, which has helped decrease asthma mortality rates by more than 45 percent since its in-ception in 1999.
The Mississippi State Department of Health’s Asthma Program partnered with nine regional asthma coalitions to imple-ment the FLARE program in hospitals statewide. FLARE represents five key mes-sages: Follow up with a primary doctor; Learn about asthma medicines; Asthma is a lifelong disease; Respond to warning signs that asthma is getting worse; and Emergency care may be needed if certain symptoms occur.
The coalitions are also involved in the “2011-2015 Mississippi State Asthma Plan” that addresses prevalence, risk, and medical factors, with the overall goals of reducing asthma deaths and the burden of asthma on Mississippians; decreasing asthma disparities in all Public Health Districts; reducing asthma-related ER vis-its and hospitalization rates, and activity limitations among asthma sufferers; and increasing provider and patient education and care according to National Asthma Education and Prevention Program (NAEPP) guidelines.
The nine participating coalitions across the state are:
• Coast Asthma Coalition of Missis-sippi
• Delta Asthma Coalition of Missis-sippi
• East Central Asthma Coalition of Mississippi
• Northeast Asthma Coalition of Mis-sissippi
• Northwest Asthma Coalition of Mississippi
• Southeast Asthma Coalition of Mis-sissippi
• Southwest Asthma Coalition of Mississippi
• Tombigbee Asthma Coalition of Mississippi
• West Central Asthma Coalition of Mississippi
In 2010, Mississippi lawmakers en-acted comprehensive policy on the pre-vention and management of childhood asthma. “It’s now required for all school employees and nurses to receive asthma education, actions to be taken by schools to reduce asthma triggers in the school setting, and most importantly, individual asthma action plans must be submitted to school personnel for those students with asthma in grades K-12,” said Gov. Haley Barbour, upon signing the bill into law.
In 2011, more than 200 child care professionals attended 11 asthma care
training sessions across the state. The Mississippi Asthma Program also trains volunteers to provide assessments to edu-cate citizens about low-cost ways to reduce asthma triggers and prevent asthma com-plications, and raises awareness of the dis-ease through the Breathe Well program. It also collaborates with Live Well, a support group for adults with asthma that helps them self-manage the disease.
Last November, President Obama signed the School Access to Emergency Epinephrine Act into law, which encour-ages states to implement policies requiring schools to stock undesignated epinephrine auto-injectors (epi-pens) for use in emer-gencies. He pointed out that states devel-oping such policies will be given additional preference for federal grants.
On March 31, Gov. Phil Bryant signed “Mississippi Asthma and Anaphy-laxis Child Safety Act” (Senate Bill 2218) into law, stating that “each public, pri-vate and parochial school may maintain a supply of auto-injectable epinephrine at the school in a locked, secure, and easily accessible location.” The law became ef-fective on July 1, in time for the 2014-15 school year.
The “Asthma Capitals 2014” report noted that Jackson has a better-than-aver-age state school inhaler access law, though improvements could be made to require a supply of epi-pens and assign a volunteer to learn how to administer it, in the absence of a school nurse.
Other areas in which the AAFA re-port gave Metro Jackson better-than-av-erage scores: public smoke-free laws and, despite the overall physician and special-ist shortage, the number of specialists per asthma patient. In the needs-work catego-ries: estimated asthma prevalence, self-reported asthma prevalence, and the use of quick-relief medications.
Editor’s note: For an overview of the Asthma & Allergy Foundation of America’s report, “The Top 100 Most Challenging Places to Live with Asthma in 2014,” please read “Taking Your Breath Away” in this edition.
Controlling Asthma, continued from page 1
be the only way for qualified employers to obtain the small business healthcare tax credit (described above).
Although ACA brings about signifi-cant changes for 2014 for most employers, small employers are generally less affected and will have some positive opportunities in 2014.
David Joffe is a partner with Bradley Arant Boult Cummings, LLP. He practices primarily in the areas of employee benefits, executive compensation and employment law and is chair of the Employee Benefits and Executive Compensation Group. A graduate of the University of Texas School of Law, he is admitted to the bar in Alabama, Tennessee, Texas and the District of Columbia. For more information, go to babc.com.
Changes & Opportunities, continued from page 3
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m i s s i s s i p p i m e d i c a l n e w s . c o m AUGUST 2014 > 5
Building on Excellence
James W. Woodall, M.D.Neck and Back Specialist
William B. Bell, M.D.Hand and Wrist Specialist
Mississippi Sports Medicine and Orthopaedic Center is pleased to announce the additions of Dr. James Woodall and Dr. William Bell.
Dr. Woodall is an orthopaedic neck and back specialist, and Dr. Bell specializes in hand and wrist injuries. To schedule an appointment, call Toll Free (800) 624.9168 or (601) 354.4488.
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By LyNNE JETER
A thriving city rich in history, perched on the brow of the picturesque James River, has once again captured the uncov-eted title as the most challenging place to live with asthma.
For the second consecutive year, and four of the last fi ve years, Richmond, Va., took the title perch, with worse than aver-age ratings for prevalence factors (crude death rate for asthma), risk factors (annual pollen score, poverty rate, the uninsured, and public smoking laws), and medical factors (emergency room visits for asthma).
Medical News markets located across the South and Midwest were represented in “Asthma Capitals 2014,” the 11th an-nual research project released by the Asthma & Allergy Foundation of America (AAFA). Boston Scientifi c Corporation (NYSE: BSX) sponsored this year’s report.
Medical News market rankings, with 2013 rankings in parentheses:
No. 2: Memphis, Tenn. (3)No. 6: Chattanooga, Tenn. (2)No. 22: New Orleans, La. (24)No. 26: St. Louis, Mo. (55)No. 27: Little Rock, Ark. (31)No. 38: Nashville, Tenn. (32)No. 41: Knoxville, Tenn. (10)No. 42: Jackson, Miss. (47)
(MSAs) in Medical News markets im-proved over 2013, collectively dropping 45 spots. The St. Louis market showed the least improvement, moving up 29 spots among the most challenging places to live with asthma. The most improved MSAs for easier asthma living: Knox-ville, Tenn., sliding down 31 spots, fol-lowed closely by Birmingham, Ala., which dropped 25 spots.
MethodologyAnalytical data from the 100 most-
populated MSAs in the United States de-termined the ranking system. Researchers and medical specialists focused on three primary areas – prevalence, risk, and medical factors – that include 13 unique factors, with non-equal weights applied to each data set in individual factor groups. Total scores were calculated as a compos-ite of all factors, refl ecting each factor’s
relative impact on exposure to asthma triggers, quality of life, costs and access to care.
Prevalence factors included the predicted population with asthma, self-reported population with asthma, and re-corded death rates for adults and children from asthma. Risk factors included com-prehensive annual pollen measurements, average length of peak pollen seasons, out-door air quality, poverty and uninsured rates, state school inhaler access laws, and smoke-free public laws.
Medical factors included ER visits for asthma, rescue medication use, control-
ler medication use, and the number per patient of board-certifi ed adult and pe-diatric allergists and immunologists, and pulmonologists.
ER visits represent a significant chunk of asthma care-related costs.
“Many ER visits are from people with severe asthma, but not all of them,” said Mario Castro, MD, professor of medicine and pediatrics at Washington University School of Medicine in St. Louis, discussing the average of more than 2,300 visits to ERs for asthma in each U.S. city, with one in four admit-ted to a hospital. “Many people with less severe asthma show up to the ER, too. But much of this is avoidable with new treatments for severe patients and better
prevention and care for those with less se-vere disease.”
Making StridesEarlier this year, the Supreme Court
upheld the U.S. Environmental Protection Agency’s (EPA) Cross-State Air Pollution Rule, which aims to reduce the amount of pollution drift from certain states into oth-ers, prompting health issues for residents in those states. The Supreme Court also noted the rule is an effective way to con-trol emissions, and melds with the EPA’s
Taking Your Breath Away How do cities fare in the latest annual asthma report?
The national burden of 25 million Americans with asthma costs more than $50 billion annually in healthcare expenses, missed school and work days, and deaths. Yet, asthma rates have continued to climb since the late 1980s across age, gender and racial lines, now affecting nearly 10 percent of the U.S. population.
(CONTINUED ON PAGE 9)
6 > AUGUST 2014 m i s s i s s i p p i m e d i c a l n e w s . c o m
Abraham Lincoln said, “Nearly all men can stand adversity, but if you want to test a man’s character, give him power.”
You’ve seen it in: • The medically-talented physician
who has the bedside manner of a hungry, disgruntled badger;
• The narcissistic attitude in the phy-sician who believes the rules don’t apply;
• The doctor ranting to a hospital staff member in front of patients or other staff;
• The verbal explosions when a nurse telephones the physician on call with a legitimate question about a patient; and
• The lack of empathy and disrespect of patients’ feelings (word of mouth prevails).
Even though such physicians com-prise only about 3 – 6 percent of their practicing peers, these few pack a power-ful wallop. As you’ll see in this series, their negative attitudes and behaviors produce turbulent waves and even destructive tsu-namis on the measures that matter.
Medical competence and emotional/social intelligence are far from synony-mous. According to an impressive body of research, it’s the latter that has the greatest impact on the most important measures—patient outcomes, patient satisfaction, pa-tient loyalty, customer word-of-mouth and willingness to recommend, mistakes and safety concerns, liability and lawsuits, and in a clear and startling way, the bottom line. You’ll hear more specifics about these in a future column.
Epstein and Hundert defined “profes-sional competence” as “the habitual and judicious use of communication, knowl-edge, technical skills, clinical reasoning, emotions, values, and reflections in daily practice for the benefit of the individual and community being served.”
On the flip side, medical profes-sionals who have commonly been called “disruptive physicians” exhibit behaviors that belie professional competence. They exhibit “abusive behavior that interferes with patient care or could reasonably be expected to interfere with the process of delivering quality care,” according to the Federation of State Medical Boards of the United States. Such inappropriate behav-iors may range from verbal abuse to ha-rassment.
A physician lacking in emotional and social competence engages in behaviors, such as:
• disrespectful or profane language; • demeaning words, manner, or be-
havior toward staff;• inappropriate sexual comments, in-
nuendo, and even physical touch;• angry outbursts; • public criticism of staff;• throwing of charts or instruments; • bad-mouthing other physicians ver-
bally or in chart notes; • dishonesty; and• unethical behavior.In other words, disruptive behav-
iors involve any inappropriate behavior, confrontation, or conflict – ranging from verbal abuse to sexual harassment – that harms or intimidates others to the extent that quality of care or patient safety could be compromised.
Are these isolated occurrences? Not according to the research of Hickson, et.al. He and his colleagues found that the best estimates based on a body of studies are that 3 – 5 percent of physicians consis-tently create problems through disruptive behaviors. Further, these researchers indi-cated that 6 percent of physicians received 25 or more complaints from patients over a 6-year period. In the data to follow, it will become apparent that patient com-plaints and satisfaction are tied to a host of other important outcomes in healthcare.
Word-of-mouth “advertising” – ei-ther positive or negative – is the most powerful kind. Interestingly, a large-scale study of customer behavior across service industries found that for every customer who complains to the organization about a problem, there are approximately 24 more who have experienced a distress-ing experience but who have chosen not to complain to the company either ver-bally or in writing. Instead, they com-plain to their neighbors and their friends in person, in social media, and on various “feedback sites.” Further, they indicate their displeasure by changing healthcare
providers. More specifically, according to Service America in the New Economy, an usually incisive, but older set of studies on consumer complaint behavior conducted by TARP, now known as e-Satisfy, found the following:
The average business never hears from 96 percent of its unhappy customers. For every complaint received, the aver-age company has 24 other customers with problems, 6 of which are serious problems.
Complainers are more likely than non-complainers to do business again with the company that upset them, even if the problem isn’t satisfactorily resolved.
Of customers who register a com-plaint, between 54 and 70 percent will do business again with the organization if their complaint is resolved. That figure goes up to a staggering 95 percent if the customer feels that the complaint was re-solved quickly.
Well, that preliminary news is alarm-ing enough. Now here’s where it be-comes apparent that these data are older data, for they predate the advent of social media. These findings only indicate what customers do “in person” or on the phone.
The average customer who has ex-perienced a problem with an organiza-tion tells nine or ten other people about it. Thirteen percent of people who have a problem with an organization relate the incident to more than 20 people.
Customers who have complained to an organization and had their complaints satisfactorily resolved tell a median of five to eight people about the treatment they received, depending on the industry.
Customers who have a bad experi-ence trying to resolve a problem will tell 8 to 16 other people about their negative experience.
True, these data are startling. How-ever, consider now the fact that these stud-ies were conducted before the explosion of social media, the game-changer! People now tell hundreds and even thousands about their experiences with the click of the mouse! The over-arching power – either positive or negative - of “word-of-mouth advertising” is among the most incontrovertible principles of marketing.
So given these potential disastrous consequences to the healthcare organiza-tion, why do these negative actions among certain physicians occur, and why are they sometimes allowed to continue and create harm throughout the system? We’ll talk about that in the next edition of this series.
Beverly Smallwood, PhD, is a psychologist with more than 30 years of experience coaching physicians and executives, and developing healthcare leadership teams. Contact via [email protected].
Editor’s note: This column is part of a four-part series on “The Price of Not Nice,” by Beverly Smallwood, PhD.
The Price of Not NiceHow negative physician behaviors impact the bottom line
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IT’S GOODTO BEBLUE
By LyNNE JETER
In 2010, CellScope was birthed in tech-savvy San Francisco with the mission of creating a home medical kit of smart-phone-friendly devices. Its debut offering – Oto, an otoscope that takes digital im-ages of the ear canal – was promoted as a way to reduce up to 30 million office visits annually for ear infections in the United States. Oto represents an early wave of players threatening to bulldoze the healthcare landscape in the $2.8 trillion, consumer-slanting New Health Economy.
“We’re our own construction workers and we can do our own contracting jobs. We’re our own travel agents. We’re our own movie producers. We’re accepting all of these technologies to do things for our-selves and … healthcare is the next fron-tier,” CellScope CEO Erik Douglas told the Health Research Institute (HRI) for the recently released report, “Healthcare’s New Entrants: Who will be the industry’s Amazon.com?”
“Dramatic change has been predicted for the healthcare industry many times
over,” wrote HRI. “This time, the envi-ronment is finally ripe for that transfor-mation. Revenue will circulate differently, and to many new players. Consumers, spending more of their own money, are exerting greater influence and going be-yond the traditional industry to find what they want and need. In the New Health Economy, purchasers increasingly will reward organizations providing the best value, whether it’s an academic medical center, a tech company with a great app, or a healthcare shopping network.”
At play: Sharp new recruits versus healthcare incumbents. Potentially disrup-tive entrants to the playing field include
well-established companies outside the industry expanding to the medical field, and non-traditional companies creating new modes of care.
Case in point: At the JP Morgan Healthcare Conference in January, Wal-green CEO Gregory Wasson, a Purdue-trained pharmacist, reminded investors that “hardly anyone went to a drugstore for a flu shot” five years ago. Now it’s a mini-healthcare center.
Another example of the ripple effects of slight shifts in the $2.8 trillion pie: If half of all patients choose new alternatives for some dozen medical procedures, such
as an at-home strep test, it could impact roughly $64 billion of traditional provider revenue, according to a December 2013 HRI-commissioned consumer survey.
Here’s the rub: Even though the U.S. healthcare system is known for pi-loting life-saving medical interventions, it’s failed in attempts to produce efficient business models to deliver outcomes pro-portionate to cost. The trend leaves an opening for power players traditionally outside the medical sector. For example, of the 38 Fortune 50 companies listed in 2013 with a major stake in healthcare, 24 are new entrants. Of those, 14 are tradi-tional healthcare organizations, seven are retailers, five are technology companies, four are financial firms, three are tele-communications companies, and two are automakers. One of those is developing services such as chronic condition man-agement while driving.
Companies that already possess im-peccable consumer credentials, such as Walgreen, with its active customer base of 74 million, are poised to upend the health
Understanding the Power Shift in the New Health EconomyHRI shows why the industry is ripe for picking; players compete to be healthcare’s new Amazon.com
(CONTINUED ON PAGE 8)
8 > AUGUST 2014 m i s s i s s i p p i m e d i c a l n e w s . c o m
sector via cost-saving products and ser-vices:
Apple was issued a U.S. patent in 2013 for a “seamlessly embedded heart rate monitor” for iPhone and other devices.
AT&T opened its mHealth platform to developers in 2012, hoping to become the essential component in healthcare’s game-changing apps. Nasrin Dayani, executive director for AT&T ForHealth Solutions, told HRI, “We believe the ulti-mate jury … is the consumers themselves. It won’t be decided by the providers or payers.”
CVS Caremark, a 7,600-store chain, made a splash in February with a revised strategy to brand itself a healthcare com-pany that includes having tobacco-free pharmacies by year’s end.
Google last year rolled out Calico, a company with expertise in both healthcare and consumer-oriented technology that focuses on aging and associated illnesses.
Samsung unveiled its new Galaxy S5 smartphone earlier this year, with a built-in heart rate monitor.
Time Warner Cable recently re-vealed a “virtual visit” pilot project with Cleveland Clinic caregivers to interact with patients via telemedicine.
Who’s going to grab the biggest slice of the lucrative market?
“Is it going to be some random startup or … your doctors?” Target CMO Joshua Riff, MD, questioned. “You have the infrastructure. You have the knowl-edge. You have the experts. You need to be leveraging these technologies.”
By LyNNE JETER
The New Health Economy poses a major dilemma for traditional providers: compete or partner?
In its recently released report, “Healthcare’s New Entrants,” the Health Research Institute (HRI) discussed ways to move healthcare entities to the forefront of this labyrinth and highly-regulated new ecosystem, with the as-yet-undefined third-party payment system as a significant barrier.
In a nutshell: Understanding mar-ket needs, consumer desires, regulatory requirements, and reimbursement com-plexities are required to succeed. Perhaps a hospital with a value-based care contract may find it cost-effective to dispatch pa-tients to local retail clinic partners instead of surgeons to have post-operative stitches removed.
The New Health Economy is spinning off innovative collaborations with some-times unlikely players. The Health Council of East Central Florida (HCECF) is work-ing with the Viera VA Outpatient Clinic to secure pilot funding for Chronic Care Brevard, a model built around the Poly-Chronic Care Network (PCCN). It pro-vides communities with a safety net boost for residents with multiple or poly-chronic
diseases and represents only one of various HCECF-initiated programs to help com-munities in its four-county service area – Brevard, Orange, Osceola, and Seminole – adapt to the New Health Economy.
“We’re exploring innovative ways to improve the health of populations and the patient experience of care, all at a reduced per-capita cost as we move along the eco-system journey,” said HCECF executive director Ken Peach. “For example, we’re working on another program, predicated on one underway at the Satellite Beach Fire De-partment, where they’ve successfully reduced hip fractures by up to 50 per-cent. In their community of 12,000, paramedics on the fire department staff follow up with recently hospitalized residents and, with their permission, survey their homes to as-sess fall risks inside and out. Most women fall inside a home; the majority of men fall outdoors. It’s important to take the entire property into account. Their program has been successful for a number of years.”
HCECF, Osceola County Health Department, Florida Hospital, and Com-munity Vision are developing a promis-ing, new “Phone to Home” program for
Osceola County. “When appropriate, every time the
EMS responds to a call, the paramedics give the person a healthcare guide link-ing all Osceola County support services,” explained Peach, noting the health coun-cil picked that area because of the higher number of incomplete runs. “If a person re-fuses transport, there’s no reimbursement, so hopefully this can reduce those incom-plete runs, and therefore reduce costs.”
Among the overall suggestions from the study:
Start with the consumer and work back-wards. When health organizations fully comprehend patient needs, they might require an overhaul of operating hours, clinician availability via digital devices, and pricing and quality transparency. For example, one-third of Walgreen’s immu-nization traffic takes place outside tradi-tional office hours.
Focus on the business model. Base it on value-generation in the New Health Econ-omy.
Understand that not all innovation is cre-ated equal. “Aspire for disruptive leaps as patients reward truly transformative ser-vices and products. Embrace a fast, frugal, frequent, failure model to quickly develop and test ideas,” noted HRI.
Be flexible. Healthcare organizations should develop strategies for production-based and value-based models.
Engage risk management early. Tradi-tional rules of healthcare still apply. In-volve regulatory, legal and compliance counsel early in the process. For example, Airbnb took a calculated risk by launch-ing its travel rental business in 2008 be-fore many communities had determined whether it fit local ordinances; today, the company serves more than 11 million guests in 192 countries.
Collaborate. Blend the best of emerging ventures and incumbents, filling skill and asset gaps.
Think bigger than a website. Healthcare’s
next-generation consumer is mobile and thrives online. “It will take more than a website and a grip on social media services to thrive in the New Health Economy,” noted HRI.
Don’t go solo. Success in the new reign will require intrinsic knowledge of the complex and fragmented healthcare sys-tem, technological expertise and strong consumer ties. “Few organizations possess all of these,” according to HRI.
Integrate. Consumers haven’t em-braced electronic health records, perhaps because of privacy and security concerns. Integration and accessibility of data will be pivotal in the design of a seamless, coordi-nated health system.
Compete in cyberspace. Even though half of American adults own a smartphone, 80 percent of young adults (aged 18 to 34) do! Developing efficient, affordable solutions for healthcare delivery to consumers’ de-vices will be a critical step in the overhaul.
For traditional healthcare organiza-tions, the industry transformation necessi-tates the consumer at its core, and requires evaluating all processes from operating hours to clinician availability via digital devices to transparency of pricing and quality. It also requires them to “figure out what matters most,” such as commod-ity revenue versus new revenue models rooted in core capabilities while also in-vesting in new ones, noted HRI.
New entrants should focus on two primary goals: getting paid, and know-ing the stakeholders. The industry trans-formation also requires them to develop a new consumer-focused value equation, and emphasize quality via innovative ap-proaches like virtual networks of second opinion experts.
“Within a decade, healthcare will feel very different,” concluded the HRI report. “The players will be different, with part-nerships between new entrants and tradi-tional organizations. And this New Health Economy will have … its Amazon.com.”
Compete or Partner?The New Health Economy poses major dilemma for traditional providers
Ken Peach
Understanding the Power Shift,continued from page 7
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By CINDy SANDERS
There’s no question healthcare deliv-ery is in the middle of a transformational period highlighted by unprecedented consolidation. While there are a number of factors impacting alignment decisions, Paul Keckley, PhD, boiled the equa-tion down to its sim-plest terms, “Economics drives behavior.”
Keckley, managing director for Navigant’s Center for Healthcare Research & Policy Anal-ysis, said physicians are having to assess their practices in light of a new reality that requires effi ciency, effectiveness and contracting clout to survive.
“If you’re of a view that the econom-ics favors you being independent for the rest of your practice, you go that route,” he stated. However, the noted healthcare expert who has published three books and more than 250 articles on the industry and health reform, said that practice model is becoming increasingly rare.
For many, Keckley said practice deci-sions take a step-wise progression. Option A fi nds two small practices within a spe-cialty banding together. Option B brings multiple specialties together to form a large group. Option C has physicians or practices joining forces with a hospital or payer under some type of employment, joint venture, or managed services orga-nization (MSO) agreement.
“I think most doctors are past Option A. I think most doctors realize circling the wagons around a single specialty isn’t re-alistic,” said Keckley. “Two out of three primary care doctors have already cast their lot,” he continued of aligning with hospitals, payers or very large groups.
“Frontline specialists have already gone to bigger groups. Now they are mov-ing to the next option … most look like they’re going to hospitals,” he added of orthopedists, ENTs and OB/GYNs. As
for other specialists, he said the decision to remain independent, merge or consoli-date is all over the board and is specialty dependent.
Going forward, Keckley said, “I think we’re going to end up with a very few pri-vate doctors in practice independently.” He predicts seeing a few more very large, multispecialty practices. “I think the ma-jority end up employed in the hospitals be-cause of these new payment mechanisms.”
In fact, he noted, “It’s been incentiv-ized for the hospitals to hire physicians.” Clinical integration, outcomes-based re-imbursement and bundled payments have created an environment where hospitals and doctors are increasingly co-depen-dent.
Although hospital administrators and clinicians have always had to work together, Keckley said this new closeness highlights areas that must be addressed to maximize effectiveness. Three key stress-ors are administrative decisions, clinical performance, and … of course … alloca-tion of money.
“There’s always going to be tension around operations,” he said of administra-tive decisions. “Each presumes the other’s operating is simpler than it really is,” he continued of the chasm between blue suits and white coats.
With reimbursement tied to out-comes, he said physicians and hospitals face tougher decisions around strategy. One issue is how to address physicians not practicing effectively. “The hospital suits don’t do a very good job of changing the behavior of doctors. It takes peers,” he noted.
The biggest cause of tension is ex-pected to be around allotting payments to each of the partners in a vertically inte-grated delivery system. “And then you get down to money, and that’s where it gets ugly,” Keckley stated. However, he con-tinued, too often the perception among administrators is that it’s all about the money when it comes to physicians. “If it was just about money, there are a lot of better ways to make money … and easier, by the way. Most doctors don’t go into it to be wealthy. It’s hard work. The average medical career is 30 years, and it’s a hard 30 years.”
That said, he added physicians do want to be successful, have a sense of satisfaction around their career choice and be well compensated for their work. However, Keckley noted, “There’s such a difference between the way doctors think things should be and the way they are.”
Keckley said too many physicians tend to dismiss data as unreliable or be-lieve their patient is an outlier. Yet, he added, “The table stakes are you’ve got to have data. You can’t just have a bunch of opinions.” To bridge that gap, Keckley said he believes it is going to take physi-cians willing to step into the hot seat and take criticism from their colleagues as the profession adapts to new economic reali-ties.
“I think physician leadership is prob-ably going to be a theme over the next 10 years,” Keckley said. “The medical pro-fession is well respected and well compen-sated … that doesn’t change … but how that profession plays in the delivery system is very much a work in progress.”
Partnering in a New Paradigm
Dr. Paul Keckley
mission under the Clean Air Act. The AAFA is collaborating with state
chapters to mandate or improve on the requirement of stocking epinephrine in schools for severe allergic reactions. For example, California is considering legisla-tion to strengthen its existing epinephrine-stocking law to require schools to stock the medication and train a volunteer to ad-minister it. Illinois is considering legisla-tion to require, rather than simply allow, schools to stock epinephrine. All states in Medical News markets have epinephrine-stocking school policies in place, with the exception of North Carolina, which at press time had pending legislation.
The AAFA has banded with other na-tional health advocacy groups to support increased research funding, which includes lobbying against proposed budget cuts for the National Institutes of Health, Centers for Disease Control and Prevention (CDC), Agency for Health Resources and Quality, and other agencies with research relevant to asthma and allergic diseases.
For example, the CDC’s National Asthma Control Program has helped decrease asthma mortality rates by more than 45 percent since its inception in 1999.
“There are many things that we can improve now to make life better for people with asthma,” says AAFA spokesperson and asthma patient, Talisa White. “Our Asthma Capitals report helps to shed light on the asthma burden in each city, but it also provides a roadmap for improve-ments.”
Taking Your Breath Away,continued from ptage 5
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the CT scan of the patient to the patient’s anatomy to provide a GPS driving-type picture on a computer screen so that physicians can reach lesions in the lungs further out than previously possible,” ex-plained Koury.
When a patient is being prepped for anesthesia for the outpatient procedure, physicians map their diagnostic plan. “With multiple areas, you can plan path-ways to the lesion within the left lung, for example, and then within the right lung if necessary,” he said.
Once a nodule is reached the ex-tended working channel then parks itself in front of the mass. Then physicians use various tools for biopsies or other manipu-lations.
During the procedure, pathologists provide feedback through Baptist’s rapid on-site evaluation (ROSE) of cytological material.
“It usually takes only a few minutes for pathologists to give us an idea of what direction to take, so patients often have an update when they wake up,” he said. “If pathologists need to evaluate the biopsy more, it may take one to three days for the results.”
Navigational bronchoscopy is also designed for more accurate placement of fi ducials for patients that are candidates for CyberKnife treatment, which could be done as early as a week later. “We need a certain amount of time to make sure fi du-cials don’t move,” he explained. “An x-ray
may be done that day; and then a few days later. If everything’s good, the patient may go straight to CyperKnife radiation.”
CyperKnife is a mode of radiation therapy that allows automatic, computer aided tracking of a lung nodule with beams coming from multiple directions on a robotic chassis so that only the tumor gets maximum radiation doses and pre-serves surrounding tissue.
The placement of tiny gold seeds (fi -ducials) around the tumor with Naviga-tional Bronchoscopy allows very precise CyperKnife localization of the tumor.
Importantly, Koury emphasized, the navigational approach carries a sig-nifi cantly lower risk to patients, roughly 1 percent versus 20 percent risk of collaps-ing the lung as compared to when radiol-ogy performs a needle biopsy through the chest wall.
“Especially for patients with signifi -cant emphysema,” he said, “we can get to lesions with less risk than by traditional methods.”
The ability to detect lung cancer ear-lier is vital to reducing lung cancer deaths. By implementing all the technologies available at Baptist including Low Dose CT scanning, EBUS and Navigational Bronchoscopy lung cancer mortality may be decreased by 20 percent.
“That’s been proven,” said Koury. “This is an additional tool with less mor-bidity to help make a diagnosis early. The only thing that’ll change people dying
from lung cancer is fi nding the lesions earlier, making the diagnosis earlier, and then treating them appropriately. It will help people know what their diagnosis is and whether they need to go to surgery, radiation therapy, chemotherapy, or an-other treatment option.”
Lung cancer kills more Americans than breast, colon, and prostate cancer combined, primarily because 85 percent of lung cancer is discovered late-stage; only 15 percent is diagnosed in early stages.
“The number of people that die in a year in the U.S. is like a 747 crashing every day,” said Koury. “The problem with lung cancer is that up to 90 percent is brought on by bad habits like smoking. Because of that, it doesn’t get the media attention of breast or colon cancer.”
At full capacity, the approximately 10 active physicians on Baptist’s staff trained in this procedure could easily perform a dozen or more a month, Koury noted.
Baptist has taken another step to boost early lung cancer detection through CT screenings provided for $125.
“We’re fi nding more small nodules from these screenings,” he said. “Many times, people will have a small lesion that the radiologist can’t stick, but they’re nervous about it if they have a history of smoking,” he said, noting that most pa-tients don’t realize that not all lung lesions are cancerous. “It more accurately helps us make a diagnosis and alleviate the pa-tient’s anxiety and concerns.”
This screening exam for lung cancer is much more sensitive than regular chest x-ray, he said.
“In high risk patients, it only takes 325 CT scans of patients to save one life from lung cancer,” said Koury. “By com-parison, breast cancer takes 900 to 1,900 screening mammograms and it takes 500 screening colonoscopies to save one life.”
With electromagnetic navigational bronchoscopy, suddenly the entire periph-ery of the lung becomes available to physi-cians, noted Kyle Hogarth, MD, assistant director of medicine, and director of bron-choscope at the University of Chicago.
“Even a minor shift in fi nding people at stage 1 or stage 2 is going to dramati-cally change the entire structure of lung cancer,” he said.
Pairing Technology for Better Access, continued from page 1
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GrandRounds
Medical News is pleased to provide space for press releases by providers in our Grand Rounds section. Content and accuracy of the releases is the sole responsibility of the issuer.
Dr. Edward Bryant of Kosciusko has been named the recipient of the A. A. Derrick Quality Award given each year by the state’s Medicare Quality Improvement Organiza-tion, Information & Qual-ity Healthcare (IQH), ac-cording to Dr. James S. McIlwain, IQH president of medical affairs. Dr. Bry-ant’s has been active in supporting the quality program and has served as a member and chairman of the IQH board of directors.
He earned degrees from the Uni-versity of Mississippi and Louisiana State University and the Ph.D. degree from the University of Mississippi Medical School, where he also earned the M. D. degree. His internship and residency in family practice were completed at the USAF Medical Center, Wright-Patterson AFB, Ohio. His service included serving at the American Embassy in Moscow, USSR, in 1980. In 1983, he was named “Outstanding Family Physician in the service and received the USAF Meritori-ous Service Award. He served as direc-tor of the Family Practice Residency in Carswell Air Force Base, TX. His service with the United States Air Force encom-passed the years from 1966 through 1991. His rank is Lieutenant Colonel Medical CORPS (Retired Reserve). Dr. Bryant returned to Kosciusko in 1983 to private practice, founding the Family Medicine Clinic.
HORNE’s Healthcare Delivery Institute Adds Brown to Leadership Team
HORNE LLP announced the hir-ing of Alexandra Brown, M.D., as the associate director of its Healthcare Delivery Insti-tute. Brown joins Direc-tor Thomas Prewitt, M.D., on the leadership team of the institute where she will focus on the develop-ment and instruction of the Advanced Training Program.
The Advanced Training Program in Healthcare Delivery Improvement is a cornerstone of HORNE’s Healthcare De-livery Institute and has graduated three classes since its inception in 2013. The ATP trains students, who fill roles in their health care organization ranging from clinicians to CFOs, in both the theory and methodology of continuous quality improvement in the health care environ-ment. The program is a sister-program to Dr. Brent James’ internationally rec-ognized Advanced Training Program at Intermountain Healthcare.
Madison River Oaks Medical Center Receives Safe Sleep Seal
Madison River Oaks recently re-ceived the “Safe Sleep Seal”, awarded by The Mississippi SIDS (Sudden Infant Death Syndrome) and Infant Safety Al-liance. Madison River Oaks is the first hospital in the State of Mississippi to re-ceive this special designation.
Cathy Files, Executive Director for the Mississippi SIDS and Infant Safety Alliance, presented Madison River Oaks with the award.
To achieve the designation, all of Women’s Services nursing team partici-pated in training on Safe Sleep Principals and Risk Reduction for SIDS. Nurses will teach families these principles prior to their leaving the hospital. Another key element is that Halo Sleepsacks (rather than blankets) will be utilized when ba-bies are placed in their crib. The nursery staff will encourage parents/families to follow this practice when going home. Use of blankets and bedding are one of key factors that contribute to an in-creased risk for Sudden Infant Death Syndrome. Staff will be required to par-ticipate in annual education related to the reduction of SIDS.
Although the overall rate of SIDS in the United States has declined by more than 50% since 1990, reducing the risk of SIDS remains an important public health priority. SIDS and suffocation deaths are a significant part of Mississippi’s infant mortality rate – which is the highest in the country. .
Memorial Hospital at Gulfport Serves as Academic Center and Teaching Facility
Memorial served as an Academic Center and Teaching Facility for 18 of the first 100 graduates from William Carey University College of Osteopathic Medicine.
Through an agreement between Memorial and William Carey, over 50 members of the Memorial Medical Staff served as Preceptors to third and fourth-year medical students. In August 2014, another 20 third and fourth-year stu-dents will participate in the program at Memorial.
The William Carey University Col-lege of Osteopathic Medicine is the sec-ond medical school in Mississippi and the first in the region to focus on osteo-pathic medicine. The curriculum is disci-pline-based and is structured around the Core Competencies of the osteopathic profession in order to maximize the stu-dents’ opportunity to train for a career in Osteopathic Primary Care.
David Northington, DO, Chief of Memorial Medical Staff, serves as the Medical Director of the Preceptor pro-gram. The physicians that serve as Pre-ceptors were placed on the adjunct fac-ulty of William Carey University.
Dr. Edward Bryant
Dr. Alexandra Brown
Alabama Flor ida Georg ia Miss i ss ipp i Washington, DC
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EVERY COMPANY FACES CHALLENGES.
WORKING WITH YOUR LAW FIRM SHOULDN’T BE CHALLENGING.YOUR LAW FIRM SHOULD BE OUT IN FRONT, REMOVING CHALLENGES.
THIS IS WHAT WE DO FOR SOME OF THE MOST RESPECTED COMPANIES IN HIGHLY REGULATED INDUSTRIES — AND WE HAVE TAKEN BOLD STEPS TO ENSURE A CLIENT EXPERIENCE AS FREE FROM CHALLENGES AS POSSIBLE.
WORKING WITH YOUR LAW FIRM SHOULDN’T BE CHALLENGING.
FACES CHALLENGES.
YOUR LAW FIRM SHOULD BE OUT IN FRONT, REMOVING CHALLENGES.
A CLIENT EXPERIENCE AS FREE FROM CHALLENGES AS POSSIBLE.
FREE BACKGROUND INFORMATION AVAILABLE UPON REQUEST. No representation is made that the quality of legal services to be performed is greater than the quality of legal services performed by other lawyers. Contacts: Scott E. Andress, Managing Partner, Jackson, MS (601) 961-9900; Ricky J. Cox, Managing Partner, Gulfport, MS (228) 864-9900.
Balch_MSMedNews_FullPG_Challenges_TM.indd 1 5/29/14 10:49 AM
