tri cities medical news july 2013

David Hecht, MD

PAGE 2

PHYSICIAN SPOTLIGHT

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HEALTHCARE LEADER: Troy Sybert, MD As a young resident in Louisiana, Troy Sybert, MD, was given a gift—a jar of Mayhaw jelly—from one of his patients. Made from the berries of Hawthorne trees, this jelly is considered a rare, special treat ... 4

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The Move to DNPNurses embrace advanced degree program to address the increasingly complex healthcare practice environment

(CONTINUED ON PAGE 10)

By cINDy sANDERs

In October 2004, member schools of the American Asso-ciation of Colleges of Nursing (AACN) voted to endorse the organization’s position state-ment calling for the transition of the level of preparation needed for advance practice nursing from the mas-ter’s degree to the doctorate level by 2015 through the addition of the DNP — Doctor of Nursing Practice.

“Will we have all of our APRN programs transition to DNP by the 2015 deadline? Probably not … but we will have a critical mass that are,” said Jane Kirschling, PhD, RN, FAAN, dean of the School of Nursing for the University of Maryland who serves

as 2012-2014 board president for AACN. “I feel like we’ve reached the tipping point,” she

added.Indeed , the

growth of DNP programs nation-

wide has been remarkable. By spring 2013, programs ex-

isted in 40 states and the District

of Columbia. “We are extremely pleased that

we currently have 217 Doctor of Nurs-ing Practice programs up and running in

the United States. If you go back to 2004, we only had seven pro-grams,” Kirschling noted. “In addition, we have 97 new programs under development.” She added enrollment has jumped from 170 DNP students in 2004 to 11,575 last year.

By cINDy sANDERs

As healthcare continues to transform and evolve, the skill sets needed to be an effective leader and provider are changing, too. From HIPAA and HITECH to the Affordable Care Act, the regula-tory and reimbursement envi-ronments have impacted the recruiting process by demand-ing that physicians, nurses and management teams be able to provide the best outcomes in the most effi cient manner possible.

“The hospital model is changing so those leaders don’t look the same anymore,” said Brian Kelley, a partner with The

Buffkin Group, LLC. “You better have a deep bench,” he continued of the need to have an executive team with different areas of expertise.

Just as the ideal applicant is changing, the most effective way to recruit that candidate is also undergoing a transformation. “We’re

doing a lot of things differently than we did fi ve or six years ago,” noted Susan Masterson, national vice president of provider recruitment for TeamHealth. “The day of placing an ad and waiting for the right candidate to appear is long gone.”

As for the true impact of health reform on job recruitment, the experts all agreed that has yet to fully play out. “We’re building


2 > JULY 2013 e a s t t n m e d i c a l n e w s . c o m

PhysicianSpotlight

By BRIDGET GARLAND

For most physicians, moon-

lighting wouldn’t be a possibility,

with demanding, on-call sched-

ules, but David S. Hecht, MD,

MBA, doesn’t have a choice.

As dad to two young daugh-

ters, he jokingly calls transport-

ing them to soccer practice and

horseback lessons his second job.

“That’s what takes most of my

time outside of work,” shared

Hecht, Chief of Staff at Moun-

tain Home VA Medical Center.

“Every weekend it’s something;

we are always traveling, even

recently as far as Chattanooga,

Nashville, and Memphis.”

But as the doting father of

Emma and Caroline, Hecht doesn’t seem

to mind the extra responsibility, as do

most proud fathers, and is thankful that

his schedule affords him the opportunity.

Come Monday mornings, however,

Hecht is back to his primary job, either

at his desk, in clinic, or in the operating

room, as his position of Chief of Staff has

him wearing several different hats. Ap-

pointed to the position in July 2012, Hecht

is responsible for all clinical issues that af-

fect the medical staff and for overseeing

the clinical, teaching, and research ser-

vices provided by it. In addition, he serves

as Clinical Associate Professor of Surgery

at East Tennessee State University’s James

H. Quillen College of Medicine.

“The chief of staff position here is

very unique, as compared to the private

sector,” he explained. “It’s part of an ex-

ecutive leadership team that decides the

course of the facility and its outlying loca-

tions, which consists of the director, the as-

sociate director, the chief of staff, and the

director of nursing services. Then we must

report to a regional office in Nashville,

and they then report to Washington.”

Although he is grateful for the op-

portunity to serve, he admitted that the

position isn’t without its challenges. “It is

very challenging to coordinate the goals of

Washington with the goals of the facility

level,” he said.

In addition to his administrative

tasks, Hecht continues to operate one day

a week and to see patients in clinic one

day a week.

“I really like problem solving,” re-

sponded Hecht, when asked what

he likes most about his job. “I also

enjoy being able to affect many vet-

erans care, as opposed to just indi-

vidual care.”

Hecht grew up in Cranford,

New Jersey, but moved to the South

when he attended the University

of Virginia, receiving a Bachelor’s

degree in Psychology in 1992. As

a student, he had always loved sci-

ence, so he knew for a long time that

a physician was what he wanted to

be. So after graduating, Hecht at-

tended the University of Medicine

and Dentistry of New Jersey/Rob-

ert Wood Johnson Medical School

and completed a general surgery

residency at the University of Flor-

ida and Shands Hospital in Jack-

sonville, finishing in 2001. He was Chief

Resident and received the Emmett F. Fer-

guson, Jr., Award for Outstanding Surgi-

cal Resident. “I choose surgery because

of its very hands-on approach,” he said.

“And for the more immediate gratification

in terms of healing patients of the prob-

lems for which they present.”

It was while he was in medical school

that Hecht met his wife Rachel, who is

now a pediatrician in Elizabethton. The

couple trained together in Jacksonville,

and when it came time to find a place to

settle, they looked to compromise. “My

wife is from New Orleans, and I am origi-

nally from New Jersey, and there were

not many general surgery opportunities

when I graduated, so we decided to go

geographically between the two families,”

recalled Hecht. “I took care of a surgeon’s

daughter from Elizabethton while I was in

Jacksonville; she was in a bad car accident.

So he invited me to take a look up here.”

Hecht entered private practice for

almost 8 years, as a solo general surgeon

at first, but eventually created a multispe-

cialty group—Mountain Empire Medical

and Surgical Associates, PLLC. When an

opening for the Chief of General Surgery

at Mountain Home VA became available,

he applied and was selected for the posi-

tion. He served in that capacity for two

years, and then became Chief of Surgery,

until being appointed to his current posi-

tion of Chief of Staff.

While serving as Surgery Chief,

Hecht assisted with significant process im-

provements in the OR and surgical wards,

as well as worked on quality improvement

initiatives as measured by the National

Surgical Quality Improvement Program.

“I really couldn’t have done what I’ve

done without my family’s support,” he ac-

knowledged.

“I am very excited about the VA’s

role in guiding the future of healthcare,”

shared Hecht. “At our facility, we per-

form many types of general and vascular

surgery, but what we can’t provide at our

facilities, such as cardiothoracic surgery,

we work closely with our partners to co-

ordinate care.

“Surgery’s movement toward more

minimally invasive surgeries and robotic

surgery is also very exciting,” he contin-

ued. “It allows us to get patients back on

their feet a lot sooner.”

David Hecht, MD

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e a s t t n m e d i c a l n e w s . c o m JULY 2013 > 3

By LEIGH ANNE W. HOOVER

Facing picturesque Bays Mountain, Allandale Mansion in Kingsport, Tennessee, sits beneath a canopy of trees hugged by box-woods on 500 acres of grandeur. Reflecting the exquisite opulence of a bygone era, the Allandale am-bience is quite simply unrivaled.

Originally the home of Har-vey and Ruth Brooks, Allandale Mansion was gifted to the City of Kingsport upon his death in 1969. One of the conditions of Brooks’ will was that Allandale “shall be open to the public and held for public use and benefit.”

In 1983, the city government sup-ported a group of citizens in their ef-forts to renovate the facilities and develop the usage of the facil-ity. The organization is Friends of Allan-dale (FOA).

In addition to on-going efforts support-ing Allandale, FOA is now proudly celebrat-ing the long-awaited inaugural opening of the Amphitheater at Allandale Mansion with “Music at the Mansion” by the Sym-phony of the Mountains on Sunday, July 28, 2013. This regional celebration, high-lighted by a ribbon cutting, promises to be an extraordinary concert event.

The Kingsport Area Chamber of Commerce, City of Kingsport and FOA are joining together to open the Allandale Amphitheater for the region, and follow-ing the official opening, the facility may be booked by professional musical groups, rented by the public for weddings, family celebrations, school performances, gradu-ations, and church events.

“Music at the Mansion” on Sunday, July 28, 2013, is a first time event mark-ing the culmination of a five-year project initiated by the late Dr. Harry W. Coover, the founding benefactor of the facility. The FOA is hosting the Symphony of the Mountains (SOTM) in a full-length, pops/light classical concert with an inter-mission for the community and the entire surrounding region.

The stage sits behind historic Allan-dale Mansion at the base of a gentle hill, and patrons are invited to bring folding chairs or blankets to sit on in a relaxed, family friendly atmosphere for an early evening of entertainment, which is sched-uled to begin at 6:00 p.m. Patrons are also encouraged to bring picnic suppers and beverages to the event.

“Year-round seasonal beauty has al-ways beckoned visitors to Allandale Man-sion and its scenic campus,” said Curator

Rod Gemayel. “From mansion events, like parties and weddings, to intimate re-ceptions in the elegant courtyard gardens, Allandale offers a host of available ame-nities, and we are so proud of the new-est state-of-the art venue—our Allandale Amphitheater.”

While many cities are losing sym-phonies, SOTM, the region’s only fully-professional orchestra, continues blessing

Northeast Tennessee and Southwest Virginia with a musical heritage that began as a dream in 1946.

Led by conductor Cor-nelia Laemmli Orth, the Allandale Amphitheater opening concert is an impor-tant stop on the symphony’s summer schedule. “Music at the Mansion,” in the Allan-dale Amphitheater, is one of three performances in a touring symphony series be-ginning at Chetola in Blow-ing Rock, North Carolina, traveling to Wise, Virginia,

for a performance at University of Vir-ginia—Wise and ending with the finale in Kingsport, Tennessee.

“I strongly believe that music can touch our souls and make a difference in people’s lives,” explained Laemmli Orth. “I am excited about this wonderful col-laboration, and I hope that we will reach people of all ages and show them that or-chestra music is fun.”

Media partners include Charter, Kingsport Times-News and VIP SEEN Tri-Cit-ies Magazine. Tickets will be available on-line through Ven-dini, at the SOTM office, or at the amphitheater on the day of the event.

The concert will happen rain or shine, and in case of rain, the venue will be moved to the Robinson Middle School auditorium in Kingsport.

Ticket prices are: Adults - $20; Children/Students - $5; and Seniors (55+) - $15. Groups of 10 or more will be: Adults - $15 and Children/Stu-

dents - $3.Free parking is available in front of

the mansion, barn or in the field behind the venue. Guests are also invited to bring picnic dinners and beverages. The lower level of Allandale Mansion will also be open to visitors. Guests can also glimpse the surrounding grounds.

“Because ‘Music at the Mansion’ is part of a touring concert event, we are ex-pecting patrons from neighboring states,” said Gemayel. “Opening the Allandale Amphitheater is such an exciting celebra-tion, and ‘Music at the Mansion’ promises to be a highlight of the summer!”

For additional information visit www.symphonyofthemountains.org or www.allandalemansion.com

Enjoying East TennesseeMusic at the Mansion - Allandale Amphitheater and Symphony of the Mountains

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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].


HealthcareLeader

Troy Sybert, MDBy BRIDGET GARLAND

As a young resident in Louisiana, Troy Sybert, MD, was given a gift—a jar of Mayhaw jelly—from one of his patients. Made from the berries of Hawthorne trees, this jelly is considered a rare, special treat because of the short harvest season and the enormous effort it takes to gather the fruit. Perhaps not an uncommon ges-ture deep in the land of Southern hospital-ity, but for Sybert, the gift has stood out as a revealing moment throughout his years in healthcare.

“It’s that component that drives my love of medicine,” shared Sybert, “That individual patient interaction and their appreciation of our time and service.”

In his current position, however, Sybert isn’t afforded that interaction with patients. Instead, he is equipping other physicians with the ability to maintain that personal relationship with the patient, in an era of healthcare where the computer often takes a seat between the patient and the provider—and when productivity tends to be more of a priority than qual-ity.

Named Chief Quality and Medical Information Officer for Wellmont Health Systems last year, Sybert works system wide to improve performance and patient

safety operations. He also oversees clini-cal informatics personnel, at a time when Wellmont is developing a new electronic medical record system through a contract with Epic Systems, a software developer for mid-size and large medical groups, hospitals, and integrated healthcare orga-nizations.

Sybert’s vision is to match the medi-cal information workflow with patient flow. “A patient’s journey is chronicled in the electronic medical record [EMR], and the medical information should match the

journey the patient is taking. And if it isn’t documented, it never happened, right?” he posed. “My skill set is efficient process design. I have a knack for redesigning workflow to produce better outcomes. It’s one of my strengths. It’s my contribution to healthcare now.”

Publicly health trained, Sybert is now looking at the health of many rather than the individual. “My skill sets lend them-selves to public health—system process thinking. I ask, ‘what are the problems?’” he explained.

But asking that question can have its challenges. The introduction of new tech-nology, or at least “undesirable” new tech-nology like an EMR, Sybert clarified, can be intrusive to workflow. “Whereas a big new robot is new technology, that’s desir-able technology; everybody wants a new robot,” he said. “But EMR is different. It’s undesirable. So balancing workflow engineering with the EMR implementa-tion becomes trying to help everybody be as happy as possible.

“We are all people, human, and we resist change,” he continued. “And this kind of change effects everyone in the hos-pital or clinic—all providers, clinical staff, office staff, everyone.”

Sybert shared a poignant example from the book Who Moved My Cheese? by Spencer Johnson, a business parable that describes four typical reactions to change.

“We are no different than the book’s examples of response to change,” he said. “We may ‘sniff and scurry’ or maybe ‘hem and haw’ but we adapt in different ways.”

Although Wellmont has been well onboard the health information trek, cur-rently, the health system has four differ-ent EMRs being used in its facilities. “The implementation of Epic will solve several problems at several levels,” Sybert said. “We will move forward with a single re-cord—it should be ‘one patient, one re-cord.’ All Wellmont clinics will be in line with each other, which will improve pa-tient care.”

Added Sybert, “One way we are look-ing at it is that it’s the patient’s record, and all Wellmont facilities are the steward of

that record.” Citing John Kotter’s change man-

agement strategies, Sybert believes “the momentum of the movement” will carry people throughout the new Epic integra-tion, set for this December. Although most Wellmont providers are already using an EMR system, switching to a new system will require several hours of training, a big time commitment for everyone in the office.

When asked about strategies he would recommend to others looking at implementing new information technol-ogy, Sybert explained that getting users to understand the bigger picture of EMR implementation is essential for any group moving from paper to electronic. “There are some sacrifices, but there are also tre-mendous gains,” he said. “You don’t have to hunt down the paper record, for exam-ple. It’s immediate now, wherever you are. People tend to focus on the cons, but for their overall goals—the best patient care possible—the pros will outweigh the cons. EMR is good for the patient.”

Sybert joined Wellmont in March 2010 and was promoted to his new posi-tion last October. Before making the move to Tennessee, he served as chief medical officer for the University of Texas Medical Branch in Galveston, Texas. He received his medical degree from the University of Texas Southwestern in Dallas, and re-ceived a Master’s degree in public health from the University of Texas Medical Branch Graduate School of Biomedical Sciences in Galveston. Board-certified in public health and general preventive medi-cine, he completed a fellowship in hospital medicine at the Mayo Clinic in Rochester, Minn. In addition to his position at Well-mont, Sybert is an adjunct faculty member for East Tennessee State University, where he lectures on informatics related to public health. He is a member of the American College of Preventive Medicine, the Ameri-can Society for Quality, and the American College of Physician Executives.

Sybert is married and lives in the Piney Flats/ Johnson City area, where you might find him spending time with his three young children… or perhaps enjoy-ing a jar of Mayhaw jelly.

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By HEATHER RIpLEy

While many industries have em-braced the use of social media to grow and promote their businesses, healthcare organizations have remained cautious. This is changing swiftly, and if you are not using social media for your B2B or consumer-oriented healthcare businesses now, you will be soon. The shift in social media adoption by healthcare organiza-tions offers an enormous opportunity.

Still not convinced? Some of the nation’s top medical facilities are social champions and employ various social media platforms with great success.

Take the prestigious Mayo Clinic - this well-known medical facility has de-veloped a successful social media program and has been using and tweaking social media strategies since its first foray into the “social” world in 2007. The facility’s social strategies have been used as an ex-ample for other hospitals and healthcare providers to follow.

The clinic’s social successes include:• Identifying and signing up recruits

for new medical studies, something that had been a challenge before the use of so-cial media

• Creating a Social Media Health Network, encouraging candid discussions online between medical practitioners and healthcare providers worldwide

• Developing a YouTube channel in

2008 that is currently the most popular medical channel on the service, with more than 10,600 subscribers and 9,266,000 video views

• Building a Facebook presence - going from zero to more than 418,955 “likes” since 2007

The 2012 release of a book for other healthcare organizations to use as a social media guidebook called, Bringing the So-cial Media Revolution to Healthcare

The Cleveland Clinic is another hos-pital group with a strong social media pres-ence, believing in direct communication with patients and providers via social media.

According to Content Marketing World, Clevelandclinic.org is believed to be the number one, most-visited, multi-specialty hospital website in the country. The clinic’s senior director of multi-chan-nel marketing, Scott Linabarger, also manages its social media channels and developed a new blog site in 2012.

Linabarger was quoted recently say-ing the new site, Health Hub, “is about furthering or enhancing the Cleveland Clinic brand. We want this content to be seen or interacted with and engaged with and liked by as many people as possible.”

I have long been a proponent of on-line social interaction as an integral com-ponent of a public relations strategy for B2B and B2C businesses. I’ve created and implemented fully-integrated social media initiatives for small businesses, nonprofits,

and national healthcare IT businesses.Part of that experience has led me to

offer social media training sessions for my clients’ employees, from in-depth social instruction to managing entire corporate social programs.

If you cannot partner with a social media/public relations expert to help you start off on the right foot, here are some basic social “Dos & Don’ts” for healthcare businesses:

Social Media in Healthcare Dos

Do start slowly. If you are just starting out, think small and pick one platform to begin with. Stick to it and do it well.

Do it regularly. This means if you decide to start a Facebook page, make a commitment to post to it every day or every other day. Many businesses lose Facebook inertia after the first few months by simply not posting or responding to comments.

Do offer relevant, quality information. Find a way to present helpful information without offering actual medical advice.

Do have your legal advisors help you create and post a legal disclaimer for the information you disseminate on your so-cial channel. You’ll be glad you did.

Do listen and respond to feedback. One of the problems with healthcare-re-lated social media efforts is the lack of fol-low-through. If you have a social channel,

you need to regularly monitor and reply to comments, questions, and feedback.

Do create a social media policy. Many companies fail to do this step, and with healthcare, it’s even more important to have one in place before you write your first post.

Social Media in Healthcare Don’ts

Don’t deliver medical advice. This is a big one, and it’s difficult to maintain your objectivity. Defer to your legal ad-visors about what constitutes medical ad-vice, and keep your posts informative but generic, if possible.

Don’t use social media as an advertis-ing tool. Remember your audience wants information and news, not a sales pitch.

Don’t forget to maintain profession-alism no matter what. It can be hard to read critical comments or posts, but take a breath and respond to them with kind-ness and compassion. If necessary, take the conversation offline.

Don’t use social media as a personal platform. Remember, your social efforts are to improve your brand’s social pres-ence, not yours.

How Social Media is Reshaping Healthcare

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


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Youth Leadership Forum Praised by Students

Twenty-four outstanding Hamilton County high school students participated in the eighth annual Youth Leadership Forum on Medicine, which was held June 3-6. The program is sponsored by the Chattanooga-Hamilton County Medical Society, Medical Foundation of Chat-tanooga, and University of Tennessee College of Medicine. More than 80 nomi-nations of rising high school juniors and seniors were considered.

The four-day program is designed to encourage rising juniors and seniors to learn more about life as a physician. Dur-ing the course of the week, students spend time shadowing a variety of physicians and enjoy daily lectures and roundtable discussions with physicians.

Former Medical Society President Mark Brzezienski established the program in 2006.

“I decided to pursue a career in medi-cine after participating in a program like this,” Brzezienski said. “We hope this experience will encourage and inspire talented students to enter the field of med-icine.”

Based on evaluation comments, the students seem to think it is working.

“The information and experiences shared by different doctors is invaluable,” one student commented. “I have never

gotten the chance to have doctors talk and lecture to us like I have through this. Shadowing and actually getting a feel for the (medical) field is invaluable.”

Local Physicians Honored during Doctors’ Day Salute

The Chattanooga-Hamilton County Medical Society, Medical Foundation of Chattanooga, Medical Alliance, and Proj-ect Access are recognizing local physicians by saluting ten honorees for Doctors’ Day Appreciation. The honorees were selected from nominations submitted by local resi-dents.

The ten honorees are:Tracy Dozier, MD, Academic Inter-

nal MedicineAnnesofie Dubeck, MD, Diagnostic

CenterHunter Jennings, MD, Chattanooga

Surgical OncologyTodd Levin, MD, Chattanooga Al-

lergy ClinicVicente Mejia, University Surgical

AssociatesMelissa Phillips, MD, TCFPA Family

Medical CenterPhillip Pollock, MD, Diagnostic Pa-

thology AssociatesMarty Scheinberg, MD, Plaza Urol-

ogyMark Thel, MD, Chattanooga Heart

InstituteStephen Thomas, MD, Ophthal-

mologistPatients submitted almost 100 nomi-

nations of Chattanooga-area physicians this year.

National Doctors’ Day provides a time for people to show appreciation to the doctors who care for them or their loved ones. The first Doctors’ Day obser-vance was March 30, 1933, in Winder, Georgia, on the anniversary of the first use of general anesthetic in surgery. The U.S. House of Representatives adopted a resolution commemorating Doctors’ Day on March 30, 1958. In 1990, Congress es-tablished March 30 each year as the Na-tional Doctors’ Day.

This year’s observance also salutes the 625 volunteer physicians who care for low-income uninsured residents of our community through Project Access.

The event was held in coopera-tion with News 12 This Morning and BlueCross BlueShield Community Trust.

OSHA SEMINAR OFFERED FOR MEDICAL OFFICES

The Medical Society and Doctor’s Management are offering the 2013 OSGA Seminar: Annual Compliance Training for Health Care Workers. Separate ses-sions will be held on Wednesday, July 31, from 10 a.m.-noon or from 1:30-3:30 p.m. at Diagnostic Center Conference Room in Chattanooga. Advance registration is required. The cost is $50 per person for offices in which at least half of physicians are Medical Society members, and $75 for nonmembers. For information and a registration form, contact Kevin Lusk at 423-622-2872

Project Kickball Tournament Coming in September

Prepare for a fun day of running the bases, fellowshipping with friends, and, well kicking a ball. What better way to have fun, and raise money for Hamilton County Project Access, than bring back a favorite childhood game and play it as adults?

Medical practices are encouraged to put together a team for the first Project Kickball tournament on September 28 at Warner Park in Chattanooga. A limit of 20 teams will be allowed to participate in the tournament. The teams will consist of 7-15 players in a double elimination tour-nament, guaranteeing at least two games per team.

Trophies will be awards to the win-ner, but also award prizes for special cat-egories like “Best Costumes,” “Best Team Name,” etc. There will be a registration fee of $250 to participate. This would be a great way for practices to get involved by sponsoring a team and encouraging employees to participate. For information and a registration form, contact Kevin Lusk at 423-622-2872.

The Chattanooga-Hamilton County Medical Society, established in 1883, is an advocate for physicians and for the continual improvement of community health. The Society protects and pro-motes the patient-physician relationship. The Medical Foundation is an affiliated nonprofit organization that provides ac-cess to healthcare for low-income unin-sured residents and works to promote community health.

What’s Happening in Chattanooga?

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Area doctors were recently recognized for Doctor’s Day Appreciation. Honorees were nominated by local residents and were presented the award by The Chattanooga-Hamilton County Medical Society, Medical Foundation of Chattanooga, Medical Alliance, and Project Access.

e a s t t n m e d i c a l n e w s . c o m JANUARY 2013 > 7

Shatita Daniels Katie GrahamGreg Gilbert Brooke ThurmanAndrew McDonald

LBMC has assembled a uniquely

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40 healthcare professionals

that clearly differentiate us

from other service providers

– all with deep financial

experience as well as practical

experience working in

the field of healthcare.

Accounting - consulting - HR - tecHnology

KNOXVILLE | NASHVILLE | CHATTANOOGA

ph: 865.691.9000 | www.lbmc.com

Meet Some of the Faces Behind Our Healthcare Experience.

Meet Stacy Schuettler 865.862.3037 (direct) / [email protected] President - LBMC Technologies

Stacy has an extensive and diverse background in developing and managing IT consulting businesses. Her IT career started at IBM Corporation where she was responsible for selling computer hardware and software. Since that time she has focused on assisting clients in defining technology solutions that support their business functions and objectives. Under Stacy’s leadership, LBMC Technologies is continually recognized nationally in various rankings related to software and IT service offerings. She has a passion for helping businesses succeed and is involved in community and industry organizations focused on entrepreneurial initiatives.

Where Great Companies Come to Grow.

Wine 201Sparkling Summertime Rosé

Rick Jelovsek is a retired physician, a Certified Specialist of Wine, and a member of the Society of Wine Educators. He is also author of a book available from Amazon on Wine Service for Wait Staff and Wine Lovers. You may contact him with wine questions at [email protected] or visit his website at www.winetasteathome.com.

By RIck JELOVsEk, csW

I wrote about rosé wines last summer, but cannot resist expounding their virtues again. This time, however, I want to con-centrate on sparkling rosé wines—those bubbly, effervescent wines that refresh. They are an ideal summer porch sipping drink. Pink sparklers are usually light in alco-hol (less than 13%), served refrigerator cold, and have that special tingle on the tongue and mouth.

In general, sparkling wines are all pur-pose. They are great for meditation, celebra-tion, sipping with appetizers or desserts, or just for a general mood lifter. Madame Lily Bollinger, of the French Champagne house of the same name, has a quote that I think applies to all sparkling wines:

I only drink champagne when I’m happy and when I’m sad. Sometimes I drink it when I’m alone. When I have company I consider it obligatory. I trifle with it if I’m not in a hurry and drink it when I am, oth-erwise I never touch the stuff, unless I am thirsty.

Rosé Champagnes and sparkling wines vary from white styles in that they are pink to pale orange in color. This comes from pigment in the skins of red grapes. Either a small amount of red wine is added to the white wine to make a rosé or a small amount of red grapes are fermented with a major-ity of white grapes to result in the light red color. The taste of rosé sparkling wines is

altered only slightly from white styles by the added flavor of the red grapes or red wine used, and also by the slight amount of tan-nins from red grape skin pigment. These tannins contribute a minor astringent mouth feel that helps clear the palate and hints of red or black fruit aromas and flavors.

Most sparkling wines are moderately acidic as are white wines. A winemaker can counterbalance the tartness by how much residual sugar is left in the finished wine. The sugar decreases tartness. Sweetness levels can range from dry (extra brut, brut) to slightly sweet (extra dry, sec, demi sec) to sweet (doux). I favor the slightly sweet ver-sions as a general rule-of-thumb.

Almost every winemaking region in the world makes a sparkling rosé wine. They all use grapes that flourish in their areas. Basically, there are several methods of transforming still wine into a carbonated, sparkling wine. The traditional method is used in France for Champagne and Cré-mant. Other regions who use the traditional method will indicate that on the bottle label. In the traditional method style, a precisely measured, additional dose of unfermented grape juice or sugar solution with yeast is added to the bottle which is then recapped. As that additional sugar ferments, the car-bon dioxide bubbles are trapped in the bottle, carbonating the wine. Some of the top California sparkling wines are made this way as well as all of the Cava from Spain. The wine remains with yeast in the bottle for

a long time, often one to three years before the yeast plug is disgorged. Disintegrated yeast cells (lies) are what impart a toasty, bready aroma and taste to the Champagne style wine.

A second method of sparkling wine production is called the Charmat, or closed tank method. This is commonly used for Prosecco and Spumante production in Italy. The still wine is placed in a tank and the dosage of grape juice or sugar solution is added to the entire tank. Fermentation takes place in the tank under pressure and the finished wine is also bottled under pres-sure to keep the carbon dioxide dissolved in the wine. Since the wine does not sit on the yeast lees for long, there is no toasty, yeasty taste. The pure fruit flavor of the grape dominates.

Another method to carbonate spar-kling wines is simply to bubble carbon di-oxide through the wine just as you might for the production of drinking soda. While this method produces coarser bubbles, it still produces an exciting beverage with the dominant fruit taste of the grape variety.

The best known French sparkling rosé wines include pink Champagnes such as those from Charles Heidsieck, Duval Leroy, Moet & Chandon, and the sommelier›s fa-vorite, Billecart-Salmon Brut Rosé. Out-side of France›s Champagne region, rosé sparkling wines made by the traditional method in France are called Crémants. Examples might include Lucien Albrecht

Cremant d›Alsace Brut Rose, Domaine des Baumard Cremant de Loire Rosé, Cré-mant d›Bordeaux (Reserve de Sours Spar-kling Rosé), and Crémant d›Burgundy (Le Grand Courtâge Brut Rosé).

Italian examples include Banfi Rosa Regale, Canella Rosé Spumante, and Ber-lucchi Franciacorta Rosé. Spain boasts several rosé Cavas such as Jaume Serra Cristalino Brut Rosé Cava, Freixenet Brut Rosé Cava, and Segura Viudas Brut Rosé. Australia has Jansz Brut Rosé and Jacob›s Creek Sparkling Rose among many others.

In the U.S., examples might include Treveri Cellars Sparkling Rose from Wash-ington State and from California, J Vine-yards NV Brut Rose Russian River Valley, Domaine Carneros Brut Rosé Cuvée de la Pompadour, Schramsberg Mirabelle Brut Rosé, Roederer Estate Brut Rosé, and Glo-ria Ferrer Brut Rosé.

When the hot weather comes, you will want to savor this wonderful beverage. Chill up a few bottles of any sparkling rosé wine this summer, put on Neil Diamond›s 1970 song «Cracklin› Rosie,» sip away and enjoy!


The Trust Company: Founded to service retirement plan needs of physicians

In 1987, The Trust Company’s founder, Sharon Miller Pryse, recognized a need for an independent trust company specifically to focus on retirement plan needs for physicians. “We have a long and successful history with medical groups,” said Pryse. “My late

husband was a physician, and it was at his suggestion, and with his support, that The Trust Company was founded.” Over the years, The Trust Company has expanded the industries and individuals it serves, but it still maintains a high concentration of medical focus -- of more than 200 corporate retirement plans with more than 28,000 participants in 16 states, almost 70 (35%) are for physician groups in East Tennessee. Why is The Trust Company a great financial resource for medical clients? Because of their depth of experience with medical clients, they can offer plan design with flexibility, taking on the responsibility of retirement programs and removing the liability from physicians. A single-source provider, The Trust Company assumes full fiduciary oversight of its clients’ retirement plans. Without the administrative burden or legal exposure of serving as plan trustee, clients can focus on what they do best—ensuring the success of their own businesses. The Trust Company’s top notch team of trust professionals includes specialists in qualified retirement plans, investment management, wealth management, trust administration, and estate planning. That expertise is put to work to develop personalized strategies for each client and determine portfolio managers that match each client’s investment needs and circumstances. Busy physicians especially enjoy having immediate access to professionals across the financial landscape. Because The Trust Company is independent of any large bank or corporation, its professionals have the flexibility and customer focus to be problem solvers who often are able to offer considerable savings because there is no need for outsourcing to multiple providers. One interesting solution for medical groups is cash balance plans. “Cash balance plans are one of the fastest growing segments of the qualified retirement plan arena due to their ability to significantly increase contributions in tax-deferred accounts,” said Daniel Carter, EVP, and chief administration officer. “These types of ‘hybrid’ plans can be extremely beneficial to physicians when used properly.”

Expansion Throughout East Tennessee Unlike other regional and super-regional banks, The Trust Company is privately owned and independent, allowing it to respond quickly to market changes. This agility allowed it to quickly expand with new offices in Johnson City and Chattanooga (opened in 2011 and 2012, respectively), and the company presently has more than $2.1 billion in assets under management. Its Knoxville headquarters office includes a staff of 35 in its retirement services division alone to provide the highest level of service to plan administrators and plan participants alike, with a 95% historical retention rate for retirement plan clients. The Trust Company has carried its commitment to being a role model in its support of the community—organizationally as well as individually—to the newer locations in Johnson City and Chattanooga. The company supports more than 60 East Tennessee non-profit organizations, and its Trust Officers collectively sit on more than 25 boards of directors. In addition to these ongoing commitments, the company prides itself in being a quick responder to needs in East Tennessee and beyond. Off the clock, staff members average 2 hours per week of volunteer work with

more than 40 organizations. To help clients make informed financial decisions, the company provides a full complement of wealth management services. Its investment consulting and wealth management service is driven by one overriding objective: to simplify the complexities of clients’ financial lives through sound investment advice and responsible wealth management, committed to providing impartial counsel, exceptional service, and measurable results. Whether it’s securing funds for a fulfilling retirement, tax-efficient stock option planning, deciphering a complex benefits package, or ensuring that cash flow meets a client’s daily needs, the Trust Company is a trusted resource for sound advice.

KNOXVILLE4823 Old Kingston Pike, Suite 100Knoxville, TN 37919P.865.971.1902 | F. 865.971.1020

JOHNSON CITY862 MedTech Parkway, Suite 205Johnson City, TN 37604P.423.232.0280 | F. 865.971.1020

CHATTANOOGAThe Volunteer Building832 Georgia Avenue, Suite 505Chattanooga, TN 37402P. 423.308.0374 | F. 423.971.1020

Our Johnson City office provides full service to clients in the Tri-Cities. Left to right: Nathan Woods, Steve Alexander, Shawn Weems, Susanne Hauk.

The Chattanooga team serves clients from its offices in The Volunteer Building. Standing left to right: Fred Speakman, Stacy Roettger, Daniel Carter, Susanne Hauk. Seated left to right: Pam Dietrich, James Woods.

www.thetrust.com

- Paid Advertorial -


As the oldest independent trust company headquartered in Tennessee, The Trust Company has specialized in helping

individuals, businesses, and foundations reach their financial goals for more than 25 years, with $2.1 billion in assets

under management. You deserve the benefits of world-class expertise and the personalized service of a local firm.

We offer both, and we’d like to be a part of your success story.

Knoxville4823 Old Kingston Pike, Suite 100, Knoxville, TN 37919 | P. 865.971.1902

Johnson City862 MedTech Parkway, Suite 205, Johnson City, TN 37604 | P. 423.232.0280

ChattanoogaThe Volunteer Building, 832 Georgia Ave., Suite 505, Chattanooga, TN 37402

P. 423.308.0374

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Trust for Generations

Investment Management | IRAs | Personal Trust401(k)s | Retirement Plan Administration | Endowments & Foundations

Financial Planning | Estate Planning & Administration

ClinicallySpeakingBY JAMA STINNETT, LPN, CPHQ

New Nursing Specialty is Improving Care for Bariatric PatientsMorbid obesity affects an esti-

mated 1 in every 50 American adults. An individual is considered morbidly obese if he or she has a Body Mass In-dex (BMI) of 40 or more. Normal BMI ranges from 20-25. Severe obesity not only interferes with basic physical func-tions like breathing and walking, but it is also associated with more than 30 other diseases and conditions includ-ing diabetes, high blood pressure, heart disease, sleep apnea, asthma, gastroesophageal reflux disease, os-teoarthritis, cancer, and infertility.

The need for effective and long lasting treatment has led to an explo-sion in the field of bariatric surgery in the past two decades. The number of weight loss surgeries performed in the United States has grown to roughly more than 250,000 procedures each year. Many bariatric centers, such as New Life Center for Bariatric Surgery in Knoxville, Tennessee, recognize the unique challenges of morbidly obese patients and have embraced the need for specialized bariatric nursing care-givers.

Both Nursing Coordinators on New Life’s staff, Sarah Grimes, RN, CBN, and Robin Saunders, RN, BSN, CBN, have received the prestigious designation of Certified Bariatric Nurse (CBN) from the American Soci-ety for Metabolic and Bariatric Surgery (ASMBS). Nurse Coordinator Sarah Grimes was one of the first nurses in the country to earn this distinction.

“I was in the first group of peo-ple to take the bariatric nursing exam when it was first offered in 2007,” ex-plained Grimes. “I felt it was an impor-tant step to staying current in my field, and being able to take my dedication to bariatric care to the next level.”

Before joining New Life Center for Bariatric Surgery in 2004, Grimes spent several years caring for bariatric

patients as a nurse on a hospital sur-gery unit.

“I started taking care of bariatric patients on the floor and loved having patients who were so educated about their surgery and engaged in the whole process,” remembered Grimes. “It was amazing to see the beginning of their weight loss journey. I really wanted to be able to follow up with them past that point and work with them through the entire process.”

Nurse Coordinator Robin Saun-ders was a labor and delivery nurse for 25 years before turning to bariatric care.

“I like working with patients who need special one-on-one care,” she said. “Bariatric patients are sometimes fragile emotionally and really appreci-ate care that’s attentive and respect-ful.”

Saunders says becoming a Certi-fied Bariatric Nurse was another way she could connect with her patients. “Bariatric patients are often well edu-

cated about the surgery and it puts them at ease to know that you have that extra clinical training that’s tailored precisely to their unique needs.”

The American Society for Metabol-ic and Bariatric Surgery (ASMBS) de-veloped the Certified Bariatric Nurse (CBN) program to access the skills and

knowledge of bariatric nursing practi-tioners. Candidates must hold an RN license, have at least two years expe-rience caring for morbidly obese and bariatric surgery patients, and pass the extensive CBN examination. The exam encompasses different aspects of care including patient education, safety and emotional support.

“Certification requires a height-ened level of knowledge and cultural awareness of the obese patient’s spe-cial needs,” said Grimes.

Bariatric surgeon Dr. Stephen Boyce says ensuring that heightened awareness is an important benefit for New Life’s patients. “Part of being a comprehensive weight loss center is having nurses and staff who are unique-ly dedicated and qualified to guide people through their surgical journey. Our patients’ lives and health are truly transformed , and we feel so proud and privileged to be a part of that.”

Jama Stinnett, LPN, CPHQ, is the Office Manager for New Life Center for Bariatric Surgery located at Turkey Creek Medical Center in Knoxville, Tennessee. The Tennova Center for Surgical Weight Loss is the only Level One facility in Knoxville accredited by the Bariatric Surgery Center Network (BCN) Accreditation Program of the American College of Surgeons (ACS).

Many programs like New Life Center for Bariatric Surgery in Knoxville are employing advanced practice nurses. New Life has two designated Certified Bariatric Nurses (CBN) on staff. Pictured from left to right are: Robin Saunders, RN, BSN, CBN; New Life Office Manager Jama Stinnett, LPN, CPHQ; and Sarah Grimes, RN, CBN.

to be the last. A workgroup from the Board of Pharmacy is collaborating with staff at the TDH to identify additional measures and improvements to address the manu-facturing and distribution process. Items under consideration include more proac-tive inspection with additional emphasis on critical reviews of maintenance and qual-ity control records, interim self-assessment and applicable reporting by the licensed entities, and adoption of applicable U.S. Pharmacopeia Standards. Additionally, three more licensed pharmacists are being recruited by the Board of Pharmacy to serve as inspectors and another adminis-trative staff person will be added to facili-tate the new self-assessment and reporting responsibilities.

“It’s a great challenge to strike a

thoughtful, protective balance between addressing the daily drug shortages faced by patients and healthcare providers across Tennessee with the absolute need to assure safety and ef-fectiveness in the com-pounded product,” said TDH Commissioner John Dreyzehner, MD, MPH. “While we wish the current situation asso-ciated with a Tennessee pharmacy had not hap-pened and that patients had not been affected, the actions taken by the board, along with legislation passed recently, are moving us forward in assur-ing the safety and availability of important medications.”

State Pharmacy, continued from page 7

Dr. John Dreyzehner


the plane engine as we fly it,” Masterson said wryly.

So how are recruiting and manage-ment firms attracting and retaining the right people in a period of great transi-tion, and what skills should candidates hone to answer new challenges posed by the nation’s complex healthcare sys-tem? Medical News asked a number of recruiters to share their insights.

PhysiciansIn addition to her

national provider re-cruitment duties with TeamHealth, Masterson is a past board member and committee chair for the National Association of Physician Recruiters and a current committee member for the Association of Staff Physi-cian Recruiters.

On the national front, she said the need for primary care physicians is antici-pated to rise dramatically. Yet, she contin-ued, only about a quarter of the applicants coming out of training are headed that direction. “We need more family practice and internal medicine physicians,” she said.

“The government is going to have to make more slots for internship and residency, and they’re going to have to incentivize physicians to be primary care doctors,” Masterson added of anticipated demand in the wake of ACA.

“Regardless of the specialty,” she con-tinued, “I think there are different compe-tencies for doctors that are a ‘must have’ today than (were necessary) years ago.” A focus on quality, prevention and evidence-based medicine were included on her list. Masterson also noted the need to be com-fortable with technology and said two of the biggest skills were to be team-oriented and effective in mentoring and working along-side advanced practice clinicians (APCs).

“Another thing I think we’ll see is there will be a lot of physicians that are in small, private practices that will choose to join larger companies or hospitals,” Mas-terson said. She added that her company is recruiting many physicians who are ready to hang up their shingle because of heavy workload, decreasing reimbursements, in-creased regulation and uncertainty over how healthcare reform will impact their practice. Another factor driving this trend, she added, is that the ‘new millennials’ (born between the early 1980s and 2000s) are very focused on a work-life balance and value personal time as much as career … which often translates into a willingness to be hospital employees rather than taking on the stress of owning their own practices.

In her own company, Masterson said they have taken a much more proactive strategy to recruit residents for their key focus areas of emergency medicine, anes-thesiology, urgent care and the ‘ists’ — hos-pitalists, laborists, surgicalists. TeamHealth has created a number of support services … from online resources to shadowing

opportunities to hosting discipline-specific boot camps … to help the young recruits settle into their new roles.

“We’re also signing many more APCs … probably three or four times more than we did just four or five years ago,” she noted of the increased demand for physi-cian assistants, nurse practitioners, nurse anesthetists and other mid-level providers.

As demand increases for providers, it has become increasingly competitive to fill open spots. Locum tenens companies have been springing up, said Masterson. Where those temporary providers had been filling in for short periods during vacation or ma-ternity leave, Masterson said it is increas-ingly common to see them in place for months at a time while the search contin-ues for a permanent hire. TeamHealth has their own internal group known as Special Ops physicians to answer this need.

Hiring, however, is only one part of the puzzle. “It’s one thing to recruit the doctors, but then we have to retain them so there is a tremendous focus on retention,” Masterson said.

Advanced Practice Providers

MedPlacer, a national recruitment and operational process improvement firm, places healthcare providers and executives in a variety of positions. However, said Jeff E. Mc-Cracken, founder and managing director, the company’s core business is on emergency, surgical and cardiovascular ser-vice placement. “When we originally founded our company, we had a broader approach,” he noted. Over time, he continued, “We’ve really focused in more on a couple of key niche areas, and it’s really driven by the market.” Mc-Cracken added, “About 90 percent of the professionals we place have a nursing back-ground of some sort.”

The company, he explained, has three main divisions — permanent nursing lead-ership recruitment, staff nursing recruit-ment, and interim departmental leadership. Although MedPlacer doesn’t always put an interim director on site, when the company does have a leader on the ground, that per-son helps clients assess operations, identify weaknesses, outline process improvements, set departmental objectives and align staff appropriately to achieve those goals.

McCracken said the strategy has been to not only glean the technical needs of a department but to understand the culture to recruit the right person. “The retention rate has been much higher because we’ve had an on-the-ground experience within the hospital,” he noted.

Like physicians, McCracken said nurses are now recruited nationally. As the housing market has improved, he has found an increased willingness among nurses to consider positions in other parts of the country. An area of rapid growth has been placing staff level nurses in departments to help alleviate dependence on travel nurses. He was quick to add that travel nurses play

an important role in helping a facility staff up for seasonal peaks or to meet the needs of increased patient populations for short periods of time. However, he added, hospi-tals ultimately want staff members who are engrained in their community.

Kipper Latham, RN, chief clinical of-ficer for MedPlacer, is the person on the inside. “It helps the nurse understand that hospital before they pick up and move from Pittsburgh to Texas,” he said of being em-bedded in the hospital while assessing a department’s operations, staffing and pro-cesses.

Additionally, he spends his time learn-ing about the area … schools, activities, the housing market, and quality of life … to best match a job candidate with both the hospi-tal and community. He added finding the right match is more than just aligning skill sets. “You have to look not only on paper but also understand that professional’s long-range goals and motivation,” he said.

Like McCracken, Latham said travel nurses play an important role in staffing solutions but likened them to renters vs. owners. “Travelers are needed, but it’s not the same as if 80-90 percent of your nurses are part of the community,” he explained.

During a seven-month stint in the emergency department at a Texas hospital, Latham saw the number of travel nurses decrease from 25 to two, and the Press Ganey hospital scores rise from the bot-tom 25th percentile to the top 15 percent. “Patient satisfaction scores went through the roof because now you had ownership in the community,” Latham noted.

As with physician recruitment, reten-tion is a key to success. McCracken reiter-ated turnover not only hurts the bottom line, but it takes a heavy toll on key areas impacting quality and efficiency including morale, institutional knowledge, cultural sensitivity, and patient and employee sat-isfaction.

He added there is no crystal ball to know exactly how ACA will impact hos-pital staffing, but McCracken pointed out increased volumes are often seen in the Emergency Department first and then have a domino effect in other areas of op-eration. He said MedPlacer is working col-laboratively with colleagues in other firms to try to prepare for increased demand. “We’re continuing our strategic alliance with other recruitment companies nation-ally. That way we can scale appropriately,” he concluded.

The Executive SuiteThe Buffkin Group focuses primar-

ily on placements at the C-suite level for service providers and end payers. The landscape … and the skills needed to suc-cessfully navigate the new terrain … are definitely changing.

“When you’re in the heat of your business, it’s sometimes difficult to take a strategic look at your ex-ecutive team and ask, ‘Do we have the team in place to meet the regulatory demands that take place in 2014?’” said Craig Buffkin, man-

aging partner and founder of the firm.For non-profit hospitals, he added,

that could mean a shift in attention. Pre-viously, these facilities were much more focused on outcomes than on cost factors. Now, both must be equally weighed. “It’s put a lot of pressure on having a different type of leader in different parts of their or-ganizations that didn’t exist five years ago because not only do they have to worry about outcomes but also on driving costs and efficiencies,” Buffkin said.

The new regulatory environment and shifts in reimbursement models have brought about some consolidation of acute care facilities and hospitals taking over physician practices. In the short run, said Buffkin, consolidation shrinks the leader-ship market. However, he continued, “In the long term, it typically increases the need as companies get bigger.”

In fact, he continued, “We’ve doubled the number of searches we’ve been com-pleting on an annual basis in the last several years, and the majority of that demand has come from our healthcare clients because of regulatory pressures.”

Brian Kelley, a partner based in the firm’s Connecticut office, added the com-plex delivery and regulatory environment has made it nearly impossible for one per-son to have all the skills necessary to meet the hospital’s or practice’s needs. Three areas he identified as ‘critical in any man-agement setting’ are knowledge and experi-ence of healthcare services, profit and loss expertise to understand reimbursement challenges and a robust understanding of IT from both a quality and efficiency per-spective.

“You have to have a team … it’s not one person,” he said. “For one person to have all three of those skill sets is few and far between.” That, however, has opened the door for others to break into healthcare. In hospitals, Kelley said, “The old world was to build from within … not so much anymore. They are willing to recruit from outside the hospital’s four walls,” he contin-ued, noting this is particularly true in terms of technology positions.

Buffkin added it has also opened a greater need for marketing profession-als … both to draw patients and to reach healthcare professionals as demand begins to exceed supply. “We work with academic medical centers, and one of the areas we’re seeing an increase is in chief marketing of-ficers. They are increasing their marketing departments as they try to attract more applicants to medical school and nursing school to meet the rising demand.”

On the flip side, the push for quality has also opened the door for more physi-cians to take on leadership roles. Kelley said he is seeing more doctors return to school to get a graduate degree in business. Ultimately, he noted, you have to look at the leadership in place at any given facility and fill in the gaps.

“We all are seeing more candidates who are taking the time to be better edu-cated,” he added. “Healthcare has a lot of complexities, and I think people are pre-paring themselves better for the changes.”

Recruiting in an Era of Reform, continued from page 1

Jeff McCracken

Brian Kelley

Craig Buffkin

Susan Masterson


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

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

JOHNSON CITY MGMA MONTHLY MEETING

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

Location: Quillen ETSU Physicians Clinical Education Building,

325 N. State of Franklin Rd., Johnson City

Save the Date: Don’t miss the September meeting, comedian Matt Fore will be performing.

July’s Topic: Workplace Violence and Active Shooter Situations presented by Offi cer Joe Hartman, JCPD.

KINGSPORT MGMA MONTHLY MEETING

Date: The 3rd Thursday of Each Month

Time: 11:30 AM – 1:00 PM

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

Second Floor, Kingsport

July’s topic: Intro and Info of An ACO presented by Amanda Hall, BCTI

2ND THURSDAY 3RD THURSDAY

A Dog Walks into a Nursing Home

by Sue Halpern; c.2013, Riverhead Books; $26.95 / $28.50 Canada, 320 pages

They say it can’t be done.

You can’t teach an old dog new tricks, they say, but you’ve spent a good amount of time doing it successfully anyhow. Sit, stay, down, you’ve taught ‘em all. It just took patience and love.

And in the new book A Dog Walks into a Nursing Home by Sue Halpern, it takes patients and love – and sometimes, the teaching role is reversed.

Sue Halpern had her work cut out for her.

When she decided to train her sev-en-year-old Labradoodle, Pransky, to be a therapy dog, Halpern knew it would be a challenge. For most of her life, Pransky was a country dog, unaccustomed to leash, used to wide-open romps in the Vermont woods. She understood all kinds of words (including every synonym for “walk”), but teaching her the tasks she needed to know to formally visit the local nursing home wouldn’t be easy.

The requirements were overwhelming, but Halpern “soldiered on.” Six weeks after they began, she called County Nursing and Rehabilitation Home. Not long afterward, she went through orientation, agreed to several stipulations and a criminal back-ground check, and Pransky passed the Therapy Dog test.

It was official: the Halpern-and-Pran-sky team was approved to visit County’s dementia unit… but Halpern felt uneasy. Nothing she’d ever done had prepared her for what they were about to do.

She needn’t have worried: her dog had it covered.

Theologians, Halpern says, recognize seven virtues: love, faith, hope, prudence, fortitude, justice, and restraint. Once Pran-sky started “working,” she taught Halpern to see those virtues in herself, staff, and the residents they visited.

There was faith for Clyde, a “big flirt” who told everyone that he was leaving County on the arm of a beautiful woman; love for Dottie and Iris, dear friends who couldn’t live without one another; restraint for Scotty, who’d been a teacher before dementia set in; prudence for Stella with a “beautiful singing voice;” and fortitude for Lizzie, suffering from a rare disease.

And through it all, “Hope was the thing with wispy, tan tail feathers, that was forty-three pounds, that came when called.”

Though Mom warned me not to, I have to admit that I judged this book by its cover. A Dog Walks into a Nursing Home looks, at first blush, like it might consist of humorous, rompish anecdotes of nursing home life.

Nope. While you will find a few unintentional

nursing home chuckles here, author Sue Halpern spends most of her pages filling readers with goodness and stories of the near-miraculous relationship between pups and people. Hers is a quiet, Zen-like book packed with philosophy, theology, and a dog. It’s more reflective, more spiritual than other dog books, and it will make you look at your canine kids with a little more won-der.

Definitely, dog lovers and TDI teams will want to read this book, but I also think there’s plenty in here for Eldercare workers, too. If that’s you, then fetch this book be-cause missing A Dog Walks into a Nursing Home just can’t be done.

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.

Rooted in the desire to deliver the highest quality of care in the practice set-ting, Kirschling said the addition of the DNP was consistent with what is happen-ing in other healthcare disciplines includ-ing pharmacy, audiology and physical therapy. Grounded in evidence-based

practice, she said the hope is that these doctoral-prepared nurses will take exist-ing discoveries and more rapidly drive that knowledge to the bedside. Addition-ally, she said the degree is anticipated to prepare these nurses to provide leadership in an increasingly multifaceted healthcare environment.

“What I project we’ll see with time as we graduate more from the DNP pro-gram is they will actually partner with PhD nurses to create some really interest-ing synergy to solve really difficult clinical issues and to solve them in a quicker time-line that directly impacts patient care,” stated Kirschling.

The reason for the DNP movement is multifactorial. In addition to aligning with other health profession disciplines that offer a clinical doctorate, Kirschling said the degree also recognizes the complexity of the nation’s evolving healthcare deliv-ery system.

The number of hours and amount of academic work required to become an ad-vanced practice registered nurse provided another impetus behind the DNP move-ment, Kirschling noted. Nursing had al-ready moved to increase and expand practical knowledge in APRN master’s programming. Where many master’s de-grees in other fields require 30-36 credit hours, the four recognized APRN master’s programs — Nurse Practitioner, Clinical Nurse Specialist, Nurse Anesthetist, and Nurse Midwife — already required a minimum of 40-55 credit hours. With the newer doctoral degree, students need, on average, 80 credit hours in the baccalaure-ate to DNP program and an additional 39 credits in the master’s to DNP path.

“Healthcare in the county has changed dramatically,” Kirschling con-cluded. “The depths of knowledge and the skill set any provider needs have just in-creased over time. We, as a discipline, felt it was critical that our graduates be pre-pared to meet the demands of the future.”

The Move to DNP, continued from page 1

PhD vs. DNP

Jane Kirschling, PhD, RN, FAAN, president of the American Association of Colleges of Nursing, said the addition of the Doctor of Nursing Practice (DNP) degree was the clinical complement to the long-standing Doctor of Philosophy (PhD) or Doctor of Nursing Science (DNSc) degrees, which prepare students for scientific research.

The PhD, she noted, “is really intended to prepare the next generation of scientists for new discovery so they are generating new knowledge for the discipline.” In addition to an interest in a nursing faculty career with a research component, Kirschling said it was fairly common for nurse executives to obtain a PhD as they sought to increase leadership roles. With the addition of the DNP, nurses now have two terminal degree tracks from which to choose — research and practice.

The newer DNP quickly overtook PhD and DNSc programs in terms of the number being offered across the country. Currently, there are 131 research-focused programs in the U.S. The number of research doctoral programs grew from 103 to 131 between 2006 and 2012. During that same time period, DNP programs grew from 20 to 217.

As the field looks to increase the number of doctoral-prepared nurses, the good news is enrollment is up in both research-based and practice-based doctorate programs, although the newer DNP degree has seen much more rapid growth as more academic institutions have begun offering the option. Between 2004 and 2012, the number of students enrolled in DNP programs increased from 170 to 11,575. The number of students seeking a PhD in nursing grew from 3,439 to 5,110 during the same timeframe.


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GrandRounds

MSHA named one of AARP’s 50 best U.S. employers

JOHNSON CITY – Mountain States Health Alliance (MSHA) has been recog-nized by AARP as one of the 50 best em-ployers in the nation for workers over 50. MSHA is the only company in Tennessee to receive the honor this year.

Any U.S.-based employer with at least 50 employees is eligible to apply for the Best Employers award. Candidates are vetted to ensure that practices meet the needs of mature workers, and appli-cations are reviewed by an independent panel of judges composed of private sector, nonprofit and government labor experts.

Areas of consideration include re-cruiting practices; opportunities for train-ing, education and career development; workplace accommodations; alternative work options, such a flexible scheduling, job sharing and phased retirement; em-ployee health and pension benefits; and benefits for retirees.

In 2011, MSHA created a committee made up of several dozen team mem-bers over the age of 50, and asked them to come up with suggestions for making the health system an attractive employer for mature workers. At the recommen-dation of the committee, MSHA leaders made several changes, including the ad-dition of a Retiree Relationship Manager

who is available to advise team members on retirement plans, benefit questions, and other issues.

The health system also created a job sharing program for team members who are nearing retirement. The program al-lows workers to ease into retirement by reducing their hours without losing ben-efits.

For a full list and for more informa-tion on the 2013 Best Employers, visit www.aarp.org/bestemployers, which in-cludes background on employers’ work-force practices and a description of the selection process.

Robot Gives Alzheimer’s Caregivers Peace of Mind

JOHNSON CTY—According to the Alzheimer’s Association, there are more than 15 million caregivers of people with Alzheimer’s or Dementia, providing 17 billion hours of unpaid work a year. Is it possible for a therapeutic robot to give these caregivers a break and their loved ones some peace of mind? Yes, it is.

PARO, a robotic baby harp seal, has been shown to improve the emotional and physical well-being of patients of all sorts by simulating the mental therapeu-tic methods of animal-assisted therapy. PARO is programmed to behave as much like a real animal as possible, and offers all the benefits of pet therapy 24 hours a

day, 7 days a week. Sheba, Appalachian Christian Vil-

lage’s (ACV) PARO seal, provides thera-peutic comfort and companionship whenever needed. He enjoys cuddling, responds by name, understands audio cues, such as praise, and even nuzzles your hand when you pet him. Just like a regular animal, Sheba uses its five senses to connect with the patient, and assists in bringing the patient back to society.

ACV, a senior living community lo-cated in Johnson City, TN, is one of 31 companies in the United States and cur-rently the only community in Tennessee that has the privilege of owning a PARO robot. ACV has been using Sheba as a part of their Memory Care unit since Feb-ruary 2013, and has been incorporated into the daily routine of many Memory Care residents at ACV, as well as used at impromptu times to calm an upset resi-dent by offering companionship.

Frontier Health Nets Silver, Merit Healthcare Advertising Awards

JOHNSON CITY—Frontier Health received Silver and Merit 30th Annual Healthcare Advertising awards spon-sored by Healthcare Marketing Report. The agency’s 2012 annual report, “Re-covery, Success & Independence” net-ted one of only 241 silver awards granted

among more than 4,000 entries. The Healthcare Advertising Awards is

the largest healthcare advertising awards competition; and one of the 10th largest of all advertising awards. It is the oldest, largest, and most widely respected health-care advertising awards competition.

Frontier Health’s newly redesigned external website, www.frontierhealth.org, received a merit award based on creativ-ity, quality, message effectiveness, con-sumer appeal, graphic design and overall impact.

Frontier Health’s external newsletter, Impressions in Behavioral Health Care, also received a merit award based on the same criteria. The Impressions newsletter is mailed to nearly 2,400 area businesses, industries, regional and state leaders. The newsletter includes information on the organizations commitment to the highest standards of excellence, behav-ioral health news, public health aware-ness campaigns, and information on the agency’s anti-stigma effort, StoptheWhis-pering.org and the facebook.com/Fron-tierHealth page. The StoptheWhispering mini-site is nearing completion.

Overall, only nine silver awards were presented for annual reports. Within the specialty category, there were only three merit awards presented for publications and only three merit awards presented for websites.


Name: Cindy Luttrell

Position: Director of Social Services at Takoma Regional Hospital

At a Glance: Honored with Takoma’s prestigious “Crystal Dove” award, Cindy Luttrell received the award at the hospital’s annual Service Awards Banquet held at the General Morgan Inn.

Luttrell was described by Daniel Wolcott, Takoma’s president and CEO as “creative; loved by patients, families and staff alike; appreciated for tenacity; a problem solver; talented; involved in the community; cares about youth; lives our values; is trusted by physicians; knows how to help patients in difficult situations; understands her job and excels in her field; can have difficult conversations well; isn’t afraid to stand up for what she believes in; is fun; and is a leader.”

Luttrell’s job is to help patients transition to the right place after receiving care at Takoma. “That means she deals with patients who want to go home, but can’t; and patients who don’t want to go home, but have to,” Wolcott said. “She deals with patients who can’t take their babies home yet. She deals with families who have just lost loved ones. She helps doctors find placement for patients whose conditions can’t be treated here because they need long-term care. These are important and difficult conversations, and Cindy does them all day long with grace and compassion.”

She also teaches the hospital’s corporate-wide “SHARE” orientation class for new associates.

Luttrell is an elected member of the Greeneville City School Board and was recently recognized for her community contribution in that role. She is married to Alan and they have two daughters, Rachael and Chelsea.

GrandRounds

AHS, Takoma Win Gallup Great Workplace Award for Third Year

GREENEVILLE – Adventist Health System, which is comprised of 44 hospi-tal campuses including Takoma Regional Hospital, has received the prestigious 2013 Gallup Great Workplace Award for the third consecutive year.

AHS received the award at the 2013 Gallup Summit in Omaha, Nebraska, May 7-9.

Jack Lister, Takoma’s human re-source director, said that the prestigious award demonstrates that AHS – and Ta-koma – has one of the best-performing and most-productive and engaged workforces in the world. “Takoma’s vision is to be the best place to work, practice medicine and receive care,” Lister said. We are on a journey to provide world-class healthcare right here in Greeneville. This Gallup award, along with the other awards we have received lately, shows the excellent progress we are making to-ward achieving that goal.”

Wiles receives 2013 Hope Award

JOHNSON CITY –Dr. David Wiles was presented with the 2013 Hope Award on May 4, 2013, at the Spine Health Foundation annual fundraiser. The Hope Award symbolizes excellence in accom-plishing the mission of the Spine Health Foundation. This annual award is offered to an individual who has selflessly provid-ed his or her time to help fulfill our goals of helping others get back to life.

Wiles is a neurosurgeon with East Tennessee Brain and Spine Center, P.C. in Johnson City, TN. He received his Bachelor of Science degree from Auburn University, and his doctor of medicine degree from Tulane University. He then completed his General Surgery intern-ship and Neurosurgical residency at the University of Tennessee-Memphis.

Mountain Home VA Medical Center Selects Mental Health Leader

MOUNTAIN HOME –Heidi Ver-mette, MD, was selected as the new Associate Chief of Staff (ACOS) for Mental Health. The ACOS for Mental Health is responsible for development of strategies to meet the mental health goals of the facility, VISN, and VA.

Vermette started her VA career as a staff psychiatrist in the Dallas Veterans Af-fairs Medical Center in 2004. She moved to Tennessee in 2008 after being select-ed as the Assistant Chief for Psychiatry. She graduated from Tarleton State Uni-versity in 1989 with a BS in Biology and Texas Tech University in 1993 with an MD. She completed a residency in Psychiatry and fellowship in Law and Psychiatry at the University of Massachusetts.

Vermette has published and pre-

sented nationally in the area of police and correctional officer training and has developed a number of telehealth pro-grams.

ETSU Family Medicine’s education series in Bristol focuses on breast cancer

BRISTOL – Dr. Sue Prill, a Bristol can-cer specialist with the Wellmont Cancer Institute, provided information and an-swered questions about breast cancer on June 13, as part of a series of public lectures at the Bristol Public Library that is being co-sponsored by the medical residency program at ETSU Family Physi-cians of Bristol.

The series will continue through-out the year on the second Thursday of each month with a wide range of health issues, including such specific diseases as cancer and diabetes, as well as public health concerns. Dr. Raymond “Robin” Feierabend, an ETSU professor of Family Medicine and director of graduate medi-cal education, is the series moderator.

The July discussion will feature Dr. Tim Urbin, a clinical psychologist at ETSU Family Physicians of Bristol and an assis-tant professor with East Tennessee State University’s James H. Quillen College of Medicine. Urbin will lead a discussion on the topic “Dementia: Myth and Reality.”

ETSU faculty members among gathering of statewide ex-perts to address infant and maternal concerns

JOHNSON CITY – Two faculty mem-bers from the East Tennessee State Uni-versity Department of Pediatrics helped highlight the progress being made to im-prove infant and maternal health in Ten-nessee at a statewide conference.

A wide-ranging group of more than 350 stakeholders – including physicians, nurses and hospital administrators – at-tended the annual meeting of the Ten-nessee Initiative for Perinatal Quality Care (TIPQC) in Franklin. TIPQC is fund-ed by a grant from the State of Tennessee through the Department of Health.

Dr. Mike DeVoe, director of Neo-natology and interim chair of the ETSU Department of Pediatrics, and Dr. Karen Schetzina, an associate professor of Pedi-atrics and director of Community Pediat-rics Research at ETSU’s James H. Quillen College of Medicine, have led the devel-opment of TIPQC initiatives and partici-pated in the conference. Devoe is on the state oversight committee for TIPQC and Schetzina is a statewide leader for the TIPQC Breastfeeding Promotion in the Hospital project.

The three-day program featured ses-sions on maternal and child health issues and quality improvement projects. The attendees, including leaders from the Vermont Oxford Network State Collab-orative – an organization with members from 10 states – were able to sharpen their projects and objectives through col-laborative sharing, benchmarking and learning from national and state experts. New statewide TIPQC projects were also

Dr. Heidi Vermette

selected.Danielle Moze, neonatal dietitian

with the Northeast Tennessee Regional Perinatal Center, shared a report on ef-forts to increase the amount of breast milk consumption by infants in the Neo-natal Intensive Care Unit (NICU) at Nis-wonger Children’s Hospital.

The Neonatalogy Division at Quillen partners with Niswonger Children’s Hos-pital, which treats over 400 patients each year in its NICU.

Neonatal abstinence syndrome is a group of problems that may occur in babies born to mothers who take narcot-ics or other addictive drugs during preg-nancy. Prior to the conference, TIPQC unveiled a new program, the Neonatal Abstinence Syndrome Project, to address issues related to infants who are born with drug addiction.

Schetzina said that although North-

east Tennessee has made strides in im-proving infant health through the TIPQC Breastfeeding Promotion project, there is more to be gained.

The Johnson City Medical Center (JCMC) Family Birth Center has recently joined the TIPQC Breastfeeding Promo-tion project to share its experience and expertise in improving hospital breast-feeding support. Chasta Hite, manager of lactation services for Mountain States Health Alliance, said the hospital system has been working on several perfor-mance improvement projects to increase breastfeeding rates since 2010.

Dr. John Dreyzehner, Tennessee’s commissioner of health, attended and recognized TIPQC with the Commis-sioner’s Outstanding Service Award. Ten-nessee has gone from 47th in the nation in infant mortality rate to 39th since the inception of TIPQC.


GrandRounds


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American Cancer Society Announces Upcoming Research Study and Celebrates 100th Birthday at Recent Kickoff Rally

TRI CITIES, TN – The American Cancer Society recently celebrated its 100th birthday with a kickoff rally to announce its upcoming Cancer Prevention Study-3 coming to five locations across Northeast Tennessee and Southwest Virginia August 6-9, 2013. In partner-ship with Wellmont Cancer Institute and YWCA of Bristol, the organization is look-ing to enroll 600 participants across the region in the free research study.

The Society is looking for local men and women between the ages of 30 and 65 from various racial/ethnic back-grounds with no personal history of can-cer to help reach full enrollment of at least 300,000 people nationwide.

Enrollment will take place at various locations across Northeast Tennessee and Southwest Virginia:

• YWCA of Bristol, 106 East State Street, Tuesday, August 6, 2:00 pm – 6:30 pm

• Bristol Regional Medical Center, 1 Medical Park Boulevard, Wednesday, Au-gust 7, 9 am – 1:30 pm

• Holston Valley Medical Center, 130 West Ravine Road, Thursday, Aug 8, 8 am – 12:30 pm

• Southwest Virginia Cancer Center, 671 Highway 58 East, Friday, August 9, 7 am – 11:30 am

• Wellmont Medical Associates On-cology & Hematology at Allandale, 4485 West Stone Drive, Friday, August 9, 1 pm - 5:30 pm

Signing up requires a one-time in-person visit to read and sign a consent form, complete a survey, have your waist measured, and give a small non-fasting blood sample like what you’d do during a routine doctor visit. Participants will also complete a more detailed survey at home and will continue to receive periodic follow-up surveys in the future that researchers will use to look for more clues to cancer’s causes.

CPS-3 is the latest addition to the Society’s groundbreaking cancer prevention studies, which have been instrumental in helping identify major factors that can affect cancer risk. For more information or to learn how to become involved with CPS-3, visit cps3north-easttn.org (TN) or cps3swva.org (VA), email [email protected], or call toll-free 1-888-604-5888.

Left to Right: Kathy Waugh, Executive Director of the YWCA of Bristol, Suzanne Rollins, Survivor, Karen Heaton, Health Initiatives Representative with the American Cancer Society, and Sue Lindenbusch, Vice President of the Wellmont Cancer Institute


A diagnosis of breast cancer is one of the scariest experiences a woman or man can have. We aim to ease patients’ fears by providing a brand new comprehensive breast center in a healing environment with cutting-edge medical equipment and the care of compassionate physicians, nurses and other highly trained staff .A new collaborative model for breast cancer care

We recognize that every breast cancer is diff erent, and no two patients are the same. With this in mind, we have created a breast cancer clinic that features radiologists, medical oncologists, radiation oncologists, pathologists, lymphedema specialists, nurse navigators and other integrated caregivers working together to plan your patients’ treatment options in a new collaborative care model.During cancer conference meetings, each diagnosed case is discussed among the team. We then arrive at a care plan tailored to each patient’s case and circumstances. Th is model streamlines treatment and empowers our patients to make better-informed decisions regarding their breast cancer treatments.

The highest-quality breast care in the region

Th e Leonard Family Comprehensive Breast Center off ers convenient access to expert physicians, advanced technology and unmatched support for any breast health need.Our staff works together to provide the best, most comprehensive care for patients diagnosed with breast cancer. By following and exceeding national standards for breast care, the Leonard Family Comprehensive Breast Center is one of only two facilities in the state of Tennessee to earn accreditation from the National Accreditation Program for Breast Centers. Th e center is also accredited by the American College of Radiation and has been awarded its Breast Imaging Center of Excellence Award.CareChex, a national health-quality ratings organization, ranked Bristol Regional in the top

10 percent of the nation in women’s health and cancer care in 2013, making the comprehensive breast center the perfect addition to our state-of-the-art facility.

A unique approach to breast health

Th e Leonard Family Comprehensive Breast Center off ers a full spectrum of breast cancer care – from prevention and screening to detection, diagnosis, treatment and survivorship – in one convenient facility.Services and amenities off ered by the breast center include:

• Multidisciplinary team approach to breast care• Dedicated radiologists with sub-specialized

training in breast health• Oncology nurse navigators who off er one-on-

one education and guidance• Screening and diagnostic digital mammography• Breast ultrasounds• Bone densitometry• Ultrasound guided biopsies and stereotactic

biopsies• Designated patient parking outside the new

breast center entrance• A comforting, spa-like atmosphere

Giving guidance to your patients

We believe patients shouldn’t have to navigate the care process alone. And we also recognize the value of comfort and convenience to help match your patients’ busy schedules. Patients shouldn’t have to worry about scheduling their own appointments, waiting inordinate amounts of time to see their physicians or deciphering the next steps of their treatments. Th at’s why nurse navigators strive to ensure no patient gets lost in the system.

A nurse navigator will stay in contact with the patient from the beginning to coordinate appointments, ensure adequate case presentation and communicate with our team. Th e navigator will ensure each patient moves through the care process quickly and knowledgeably. In addition, the navigator will introduce the patient to supportive care information and resources, such as social workers, nutritionists or lymphedema specialists.At the Leonard Family Comprehensive Breast Center, we want to be there for our patients. Th at is why we are creating a lifelong bond with them and their families, and that is what we want for your patients. By combining premier technology with a well-respected, compassionate staff , we are delivering the best possible breast care to the region.

Help your patients get the care and support they need.

If you would like to schedule an appointment for your patients or tour our facility, please call 423-844-4584. To learn more about our breast care services, visit wellmont.org.

Leonard Family Comprehensive Breast Center

Bristol Regional Medical Center1 Medical Park Blvd., Suite 100wPhone: 423-844-5600 • Fax: 423-844-5609

The new Leonard Family Comprehensive Breast Center offers a full spectrum of breast care in one convenient location.

From discovery to recovery, we are dedicated to your patients.

Dr. Sue Prill, medical oncologistBristol Regional Medical CenterLeonard Family Comprehensive Breast Center

Wellmont Physician Connection

- Paid Advertorial -

www.msha.com/bcbsT

Important information for people with BlueCross BlueShield of Tennessee Insurance Coverage

8At t e n t i o n

MSHA & BCBSReach Agreement.

We are pleased to announce that Mountain States Health Alliance and BlueCross BlueShield of Tennessee have reached a new multi-year agreement. The new contract allows you, your family and other BlueCross members to continue to use services at MSHA on an in-network basis. There will be no disruption to patients who have BlueCross commercial insurance plans with P, S or V networks, Federal Employee Program (FEP) plans or BlueCross plans from outside of Tennessee.

Your health is our number one priority, and that’s why in our talks with BlueCross we worked diligently to protect your access to MSHA facilities and services. We know you have a choice as to where you receive your care. That’s why we are so focused on providing you high-quality care and access to a wide range of primary care and specialty services in convenient settings — from numerous outpatient care sites to our family of hospitals, including Niswonger Children’s Hospital.

Thank You.MSHA is grateful to be able to continue providing care to you and your family. We especially

appreciate your patience and support as we worked through negotiations with BlueCross.

If you have any questions, please feel free to call us at 423-431-6647 or e-mail [email protected].

tri cities medical news july 2013

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