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Brad Adkins, MD

PAGE 2

PHYSICIAN SPOTLIGHT

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PHiiT: Statewide Initiative Addresses Pressing Pediatric Issues

By CINDy SANDERS

In the fall of 2013, the Tennessee Chapter of the American Academy of Pediatrics (TNAPP) launched a bold new initiative to address pediatric quality issues in primary care through the formation of the Pediatric Healthcare Improvement Initiative for Tennessee (PHiiT). Following a successful fi rst pilot program in East Tennessee, PHiiT is now expanding its education and quality improvement efforts across the state.

The collaborative – which is inclusive of all Tennessee par-ties utilizing pediatric care, delivering pediatric care, measuring outcomes or structuring payment systems – came about as a result of conversations with key stakeholders over the course of several years. Allen Coffman, Jr., MD, FAAP, who serves as medical di-rector of PHiiT, said many practices were struggling in the wake of the recession. At the same time, practices were being asked to revamp many of their processes.

“All of this was coming at one time,” said Coffman, a prac-ticing pediatrician with Highland Pediatrics in Chattanooga and past president of TNAPP. “Providers were overwhelmed with the fi nancial changes, care delivery changes, and changes on how our

(CONTINUED ON PAGE 8)

By SUZANNE BOyD

Bringing her belief that healthcare is a call-ing, a passion for improving the quality of life of those she serves and more than 30 years of experience, Reba Celsor is settling into her new role as CEO of Dyersburg Regional Hospital. For Celsor, nursing was her initial calling but when the opportunity arose for her to move

into management, she saw it as an extension of that calling. After three months of settling in at Dyersburg, Celsor is excited at fi nding what she calls the best-kept secret in the community, and is ready for this secret to get out.

As a young child, Celsor found herself hos-pitalized at the age of nine; an experience that led her to decide she wanted to be a nurse. “It


HealthcareLeader

Reba CelsorCEO, Dyersburg Regional Hospital

FOCUS TOPICS WOMEN’S HEALTH HIT NURSES

Physician Suggesting Options To Lower Costs Related to Breast Cancer

A new report has fueled the debate over rising medical costs linked to routine breast cancer screenings during the past fi ve years. The latest report estimates those costs are much higher than previously documented ... 3

HIT: Optimization Through Integration

You can love it, hate it, fear it or revere it … but technology has become an integral part of healthcare processes on both a clinical and operational level. Therefore, you might as well learn to optimize it ... 5

2 > MAY 2015 w e s t t n m e d i c a l n e w s . c o m

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By SUZANNE BOyD

Faith and family are at the core of what drives Brad Adkins, MD, which may be a good thing since they fi t nicely with his career as an OB/GYN at The Woman’s Clinic in Jackson. Being able to witness the miracle of birth and be a part of one of the most important times for a family are just a part of what makes him love his job. Developing lasting relationships with his patients also makes OB/GYN the perfect fi t for Adkins.

The Memphis na-tive attributes his deci-sion to pursue medicine to a friend’s father and to his older sister. “It was probably not until high school that I really got to thinking about medicine as a career and had the aspiration to pursue it,” said Adkins. “My friend’s dad was an OB/GYN, of all things, and he had al-ways been such a great role model for me. I re-ally admired him and what he was doing. My sister Beth went to nurs-ing school so that also helped get me consider-ing medical school.”

After graduating from Memphis Prep, Adkins headed to Ole Miss where he majored in English with minors in biol-ogy and chemistry. “At the time that was a pretty unconventional path to get to medi-cal school,” said Adkins. “Today it is not that uncommon for an English Major to get in, so maybe I was at the forefront of that trend.”

Adkins returned to Memphis, where he earned his medical degree at the Uni-versity of Tennessee Center for Health Sciences. While it was an OB/GYN that infl uenced his decision to pursue medi-cine as a career, it was not until medical school rotations that Adkins even thought about OB/GYN as a possible specialty. “I realized some specialties did not fi t my personality,” said Adkins. “But OB/GYN was fun and exciting. Being there to watch one of God’s miracles take place in addi-tion to the surgical side of things, it was the specialty for me.”

Marrying his college sweetheart, Carol, at the end of medical school meant Adkins was embarking on a whole other adventure with his residency. “Carol and I were both born and raised in the South, so we saw my residency as a chance to ex-perience a different part of the country,”

said Adkins. “I looked at a lot of different programs. The program in San Antonio, Texas really stood out for me in terms of the faculty and location. We were blessed that I matched there.”

With his match with the OB/GYN residency program at the University of Texas at San Antonio, Adkins and his new bride embarked on a four-year journey. “It was a wonderful opportunity for us to grow and mature together as a couple. We knew no one there when we moved and had no family nearby,” said Adkins. “As much as we loved it there, as my residency came to an end, we realized we wanted to be closer to family. Our son Conner had been born and both our fathers were fac-ing health issues so we knew it was time to come home.”

As Adkins started interviewing with clinics in his search to fi nd a permanent home, his fi rst interview was with The Woman’s Clinic in Jackson, TN. Since it was close to Memphis, Adkins thought he would check it out along with other clin-ics and get in a visit with family. What he found was a clinic with great mentors who he wanted to be in practice with in a town that was a great size to raise a fam-ily. “The Woman’s Clinic was the right fi t

for me and my growing family. I could not have asked for better mentors than Drs. Lewis, Swindle and Webb,” said Adkins.

Shortly after joining The Woman’s Clinic in August 1996, the Adkins welcomed their second child, a son named Jona-than. Their family would expand again to include a daughter Catherine and then one more son, Jacob. All four kids are roughly two years apart in age. Family is a pri-ority for Adkins. “When I am not working, I put family fi rst,” said Adkins. “I love to spend time with my kids. We enjoy sports be it watching them or participating in them. I have been lucky enough to get to coach each one in basketball.”

An avid sports en-thusiast, Adkins admits he has a competitive side that he has to feed as much as he can. “I played football and bas-ketball in high school. I used to play basketball three days a week as an adult at 5:30 a.m.,” he said. “As I got older I had injuries and surger-ies so I had to fi nd some-thing else to get exercise.

About ten years ago I started swimming again just to get back in shape. That led me to venturing into triathlon. I took a break from those last year but hope to get back into it again.”

In addition to pushing himself physi-cally, Adkins likes to also continually grow his faith. For three years he has found a unique way to do both while also helping cancer patients through Wings Ride to Rosemary benefi ting the Wings Cancer Foundation. “The ride was started by some guys in Memphis and a friend of mine told me about it. I thought it sounded awesome. A 500 mile ride over fi ve days from Mem-phis to Rosemary Beach that raised money to help cancer survivors,” said Adkins. “I decided to ask our clinic administrator, Jon Ewing, to join me and help me train for it. He said yes and we have done it the past three years in October.”

Initially Adkins says he thought the ride, which he knew would push him physically, would be quite an accomplish-ment. “The impact this has had on me ex-tends far beyond physical,” he said. “The guys on this ride are strong men of faith that have really impacted me. It recharges my batteries and encourages me to be a better husband, father and doctor.”

Brad Adkins, MD

PhysicianSpotlight

Brad Adkins, M.D. embraces his wife Carol after completing the 5-day 500 mile bike adventure Wings Ride to Rosemary Beach.

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Brad Adkins, MD

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By BETH SIMKANIN

A new report has fueled the de-bate over rising medical costs linked to routine breast cancer screenings during the past fi ve years. The latest report es-timates those costs are much higher than previously documented.

A Memphis physician says the rea-sons for the high costs are readily appar-ent, as are the ways to reduce the costs.

The study published in Health Af-fairs, a national, peer-reviewed healthcare journal, reported last month that the U.S. spends $4 billion annually on tests that produce false-positive mammograms and the over-diagnosis of breast cancer.

The increased use of digital mam-mograms, insufficient professional experience and subjectivity are the potential causes, accord-ing to breast-care special-ist Christine Mroz, MD. She says doctors and patients can do several things to lower medical costs and the chances of receiving a false-positive reading from a mammogram.

The study, performed by a research fellow at Boston’s Children’s Hospital and a Harvard Medical School professor, con-cluded that among the surveyed women, 11 percent received a false-positive result from a mammogram. That means about 3.2 million women nationally would get a false-positive result each year, resulting in $2.8 billion in spending, according to the study.

“There has been an increase in the number of false positives in the last fi ve years or so because they are being viewed digitally,” Mroz said. “When the mam-mogram is magnifi ed four times its actual size, something may look abnormal when it isn’t. If you don’t know what you are specifi cally looking for, it can result in a positive reading to be on the safe side.”

Mroz is a breast surgeon with over 45 years of experience in breast care and is the founding physician of the Mroz-Baier Breast Care Clinic, which opened in 1994. Since then the clinic has seen more than 45,000 patients. Mroz and another breast surgeon, Ron Mattison, MD, see 25 to 30 patients per day. The clinic is one of the few that still performs fi lm screen mammograms, which use X-ray fi lm.

“Digital screenings, where the re-sults are viewed on a computer, are now the preferred method because an offi ce doesn’t have to store fi lm, so the cost is lower,” Mroz said.

According to Mroz, there is a learn-ing curve associated with reading digital mammograms. Doctors must relearn how to view them.

“Clinics have used fi lm screening since the 1970s, so digital mammography is relatively new,” she said. “All systems

will be digital in the future, and I think professionals will get up to speed in read-ing them. My advice for the people read-ing them is to view them at actual size instead of magnifying them.”

Another factor that can generate false-positive results is that the radiologist viewing the screen may not be specialized in reading mammograms.

“Some clinics have rotating radiolo-gists who are reading the mammograms, and they aren’t as up to speed on know-ing what abnormalities to look for,” Mroz said. “You want the same mammography radiologist looking at the patient’s mam-mograms and ultrasound if possible.”

According to Mroz, mammography radiologists receive additional training and must be board-certifi ed according to the 1992 Mammography Standards Act. These radiologists must view a certain number of mammograms per year and take continuing education credits to stay certifi ed.

“Experienced interpreting physi cians are viewing mammograms at the larger breast clinics in the Memphis area,” Mroz said.

She takes this one step further at her clinic.

“Each physician personally views the patient’s mammogram, ultrasound and bi-opsy results,” she said. “We also exam the patient and perform the surgery. We are a part of the entire process from day one.”

Mroz recommends that patients seeking a mammogram can decrease the chance of receiving a false-positive result by going to a clinic that specializes in mammography and inquire if a mammog-raphy radiologist reads the results.

“Patients need to make sure they are going to a place where the physician is experienced in reading mammograms,” she said. “Also, it’s best if the patient goes to the same offi ce each year to receive a mammogram. That offi ce has the patient’s previous mammograms on fi le for com-parison. If a patient switches doctors, she should pick up her previous X-rays and take them to her new doctor.

“False positives can generate addi-tional tests and in some cases surgeries, which can be expensive. That is another reason you want someone experienced viewing the results. An experienced In-

terpreting Physician would know by the shape and distribution of a calcifi cation if it looks cancerous. The person would be able to determine whether to biopsy it im-mediately or wait six months to see if it changes.”

Mroz stresses that in many cases it is safe for doctors to monitor a calcifi cation for six months before performing a biopsy.

“Eighty percent of calcifi cations are not cancerous,” she said. “Things do not progress that quickly, especially in micro calcifi cations. A patient does not go from stage zero to stage three in six months. Six months is a perfectly safe time period to wait, and a patient’s life is not in danger during that time frame. The treatment for the patient is exactly the same.”

The American Cancer Society rec-ommends yearly mammograms for women beginning at age 40, while the U.S. Preventive Services Task Force, an independent group of national experts in prevention and evidence-based medi-cine, recommends a biennial screening to be done at age 50. The study found that women 40 to 49 were more likely to have a false-positive mammogram compared to women over 50.

“There is a trend in some states, such as California, where professionals are re-

evaluating whether to recommend a yearly mammogram at age 40,” Mroz said. “My professional opinion is that women ages 40 to 70 should still get a mammogram screen annually, but also perform a self-exam in the shower once a month. Self-exam is still the best way for women under age 40 to know something is abnormal.”

A mammogram is the best method to catch cancer in its early stages, Mroz said. More than 62 percent of women ages 40 to 49 get an annual mammogram, and more than 72 percent of women 50 to 59 get a regular screening, according to the National Center for Health Statistics.

“My hope is that in 10 years we won’t have to perform mammograms,” she said. “There is work being done with genes that hopefully will be able to predict a patient’s risk, so that mammograms are done selec-tively for only high-risk patients.”

Mroz suspects something as simple as a saliva specimen or a blood test might be able to detect whether a patient is prone to having breast cancer.

“We could experience a new treat-ment in breast cancer in the next decade,” she said. “Pin-pointing cancer genes means more targeted medicines, less sur-gery and less scared patients.”

Physician Suggesting Options To Lower Costs Related to Breast Cancer

Dr. Christine Mroz

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As the U.S. healthcare industry strives toward the apex of delivering the highest quality care at the lowest possible cost, we are adopting new ways to do things better, faster and cheaper.

Developing technologies that support telemedicine (also known as telehealth) could be one example.

Telemedicine is delivered by physi-cians, nurses and other care providers using various forms of web-based tech-nology to interact with patients on screen versus in person. It typically involves vid-eoconferencing, photo transmissions, re-mote monitoring of vital signs and other clinical services.

Telemedicine is a relatively new mode of healthcare delivery in Tennessee and in the U.S., though the number of patients worldwide using telemedicine services is estimated to rise from less than 350,000 in 2013 to about seven million in 2018, according to a 2014 report published by

IHS Technology.Healthcare organizations are also

getting on board. According to a survey released by Becker’s Hospital Review last November, 84 percent of hospitals and health systems believe the development of telemedicine services is important to their organizations.

There are obvious advantages to a telemedicine encounter. For patients, it eliminates the time spent traveling and waiting, especially for people in rural areas where access to brick-and-mortar healthcare services may be scarce. More frequent physician-patient interaction and in-home monitoring solutions have the potential to speed up the delivery of care, help make sure patients adhere to treatment plans, better manage chronic diseases, and ultimately improve patient outcomes.

It also gives physicians who practice in rural parts of our state the ability to

consult with specialists when patients are unable to travel to a referral appoint-ment.

Critics raise valid questions about the quality, safety and effectiveness of a tele-medicine encounter, including liability factors and appropriate access to and use of patients’ protected health information. Some physicians buy in to the concept. Others do not. Rules and regulations vary from state to state, with no federal legisla-tion addressing the practice.

The Tennessee General Assembly in 1998 created a telemedicine license for physicians located outside of the state who used information transmitted electroni-cally to diagnose or treat patients located within Tennessee. The “telemedicine li-cense” is an alternative to a full Tennessee physician’s license. Last year, the Board of Medical Examiners proposed to elimi-nate the telemedicine license and require a “full” Tennessee license to practice tele-

medicine. It also seeks to define telemedi-cine, and place parameters and restrictions on its practice. The Tennessee Medical Association and others are actively partic-ipating in these ongoing discussions, ad-vocating for rules that promote safety and accountability for each patient encounter, without being so restrictive that they stifle the technology’s potential.

To be clear, a telemedicine encounter is not the same as a face-to-face encounter with a doctor. Technology cannot replace that.

We should be open, however, to new technologies that can improve access to quality healthcare in Tennessee and, if used and regulated appropriately, con-tribute to better patient health and help reduce overall healthcare costs.

John W. Hale, Jr., MDPresident, Tennessee Medical Association

Telemedicine May Improve Healthcare Access in Tennessee

Letter to the Editor

was a positive experience. Everyone was so kind to me and I just knew nursing was what I wanted to pursue,” said Celsor, who grew up in Russellville, Kentucky. “I earned my Associate Degree in Nurs-ing through the University of Kentucky at Hopkinsville Community College. I even-tually got my Bachelor Degree in manage-ment from Trevecca Nazarene University in Nashville several years later. My first job out of college was in a small community hospital in Logan County. After working there a couple of years, I moved to Spring-field, Tennessee and began working for an HCA affiliated hospital, then I continued to work for HCA for the next 18 years.”

After nearly 20 years in nursing, Cel-

sor moved to the executive side in 2006 when she joined the corporate adminis-trative staff of LifePoint Hospitals, Inc. as the director of clinical operations for the American division and their perinatal sub-ject matter expert. While she was involved with leading quality improvement in peri-natal programs at 40 facilities, she also was the director for clinical and quality opera-tions of 12 hospitals in five states. “While I traveled about 75 percent of the time, it was an invaluable experience that allowed me to see all aspects of hospital opera-tions,” said Celsor. “I got to see first-hand many types of hospital management, learn best practices as well as things to look for that may not lead to success.”

From 2010-2012, Celsor served as both COO and CNO of LifePoint’s Putnam Community Medical Center in North Florida. She then moved to Beck-ley, WV to serve as COO and interim CEO at Raleigh General Hospital for three years. Celsor spent nine years with LifePoint Hospitals, during which time she not only completed their CEO Lead-ership Development program she also earned a Master of Business Administra-tion in Health Care Management from Colorado Technical University.

When the CEO position with Com-munity Health Systems’ Dyersburg Re-gional Hospital opened in early 2015, Celsor jumped on it. “I had spent the bulk of my career in Tennessee and wanted to get back there,” said Ceslor. “Family is very important to my husband and me. Moving to Dyersburg meant we were about three hours from my daughter, three grandchil-dren as well as my son who all live in South-ern Kentucky and the farm we still own. I

also have step sons in South Carolina.” While she only took over as CEO in

February, Celsor says she is very pleased at what she has found at the 225 bed acute care facility which offers a complete range of services with the exclusion of open heart, spine and neurological surgeries. “This hospital has been ranked by the Joint Commission as a top performer for four years on key quality measures. We have a Leap Frog Safety Rating of A. Our patient satisfaction scores are good, as well as our quality matrix,” she said. “I am a very data driven person and have looked at the stats for this hospital. We have come a long way but we can improve. My goal now is to move them from good to great.”

Over the course of her career, Celsor has developed the philosophy of the CEO being the number one driver of quality, which is one of the reasons she wanted to pursue a CEO position. “I am passion-ate about safe quality care,” said Celsor. “When you have a CEO who is engaged and believes in high quality care, that can be a game changer in that environment. We need to deliver a high standard of care to our patients that is shrouded in warmth, kindness and compassion.”

As with many rural hospitals, Cel-sor faces a familiar challenge. “We have a large Medicare and Medicaid popula-tion which means we have to manage our resources very well so that we can balance the budget and provide the level of care our patients need,” said Celsor. “Being af-filiated with a large organization such as Community Health Systems eliminates the duplication of resources. Support ser-vices are centralized so I have them avail-able when we need them. We also have a

built-in network of hospitals from which we can draw. This not only helps us man-age resources more efficiently but also delivers best practices to the community.”

Celsor sees plenty of opportunity for growth in Dyersburg. The hospital is on track to start offering interventional cardi-ology in the third quarter of this year. She also sees room for growth in the already busy Emergency Department as well as in the hospital’s Ambulatory Surgery Center. “We can absorb more of the area’s health-care needs,” said Celsor. “We are working to have more primary care physicians on staff as well as expanding our imaging and surgical services.”

Community Hospitals can be one of the best-kept secrets in Celsor’s book. “If you look at the incidence of errors in healthcare, I would rather be with people that know me than where you may not get the same level of attention by people you do not know,” said Ceslor. “One thing that can help us grow, is to market our hospital and share our success stories. We want people to know that they can receive excellent care right here at home.”

Celsor has drawn on her faith over the course of her career and feels blessed to have been able to move from a clinical role into an executive leadership role es-pecially as a woman in a male dominated field. “Healthcare is a calling, my calling,” she said. “I want to be a part of a commu-nity and stay until I can see a difference being made. I want to be proud to call it home and proud to say I am the CEO of the community hospital. I also want all of our physicians and employees to be proud to say that they work at Dyersburg Re-gional Medical Center.”

Healthcare Leader: Reba Celsor, continued from page 1


By CINDy SANDERS

You can love it, hate it, fear it or re-vere it … but technology has become an in-tegral part of healthcare processes on both a clinical and operational level. Therefore, you might as well learn to optimize it.

That was a key part of the message Chris Miller, principal with Nashville-based Cumberland Consulting Group, and Deb Dulac, di-rector of PRISM and business systems for the University of Vermont Medical Center, shared with audiences at the re-cent HIMSS15 Annual Conference & Exhibi-tion. More than 38,000 professionals flocked to Chicago last month to attend the premier health information technology conference, which included more than 300 peer-reviewed education sessions, vendor exhibits touting the latest technology options, updates on govern-ment regulations impacting the industry and keynote speakers ranging from Bruce Broussard, president and CEO of Hu-mana, to George W. Bush, 43rd president of the United States of America.

“Over the past five years, there has been a huge shift towards technology largely because of the HITECH Act of

2009 and government programs like Meaningful Use that have helped drive the technology in healthcare,” Miller said. Although slower to adopt technology into daily operations – particularly in a clini-cal setting – than many other industries, healthcare has increasingly been pressed to take an ‘all in’ stance.

Miller noted that over the last few years, technology has fundamentally changed the way providers … both large and small … operate. He added the chal-lenge is balancing the adoption of technol-ogy with everything that brings.

“Today anything a healthcare orga-nization wants to change in a business or clinical process requires a change in their technology, and likewise, any change in their technology has an impact on the care they provide or their revenue,” he said. “I think healthcare entities were used to thinking of technology as a separate en-tity, but now it’s so intertwined,” added the Atlanta-based HIT expert.

In their HIMSS presentation, Miller said he and Dulac focused on how to man-age and optimize technology now that it has become so pervasive, while at the same time accounting for all the other changes happening in healthcare including a swi-tchover to ICD-10, meeting ongoing and new Meaningful Use requirements, ac-tively engaging patients, supporting ac-countable care models, and the myriad

other programs that require attention.The bottom line is that thinking of

each of these mandates or initiatives as in-dividual tasks to conquer leads to madness … or at least extreme frustration. Instead, Miller said the question should be, “How can organizations effectively manage all of those together with a higher degree of ef-ficiency and lower overall cost?”

He continued, “When I think imple-mentation, somewhere between 25-30 percent of the time spent on these changes is spent on testing so if you can group – ef-fectively overlap testing on these programs – you can significantly save time.”

More than just testing, though, Miller said very deliberately grouping initiatives under a single governance project struc-ture helps with a range of other issues from interoperability to simplification for end users. “Being able to group things together almost makes it irrelevant as to what changes were made,” he said of the finished product in the minds of those ac-tually using the technology.

The ‘ripping off the bandage’ ap-proach means one educational update for those end users as opposed to having to create an educational module for each in-dividual initiative. Not only does a rolling schedule of changes often feel more over-whelming, but also the time away from desks learning the new processes would typically be less under a grouping struc-

ture than to have 10 separate trainings for 10 separate initiatives.

Miller was quick to admit that cre-ating overarching technology structures could be difficult without staff or con-tracted expertise, which makes it more problematic for small practices.

“Whether you see it as a good or bad thing, there’s certainly a lot of consolida-tion in the market. Small private prac-tices are becoming more and more rare,’ he said. “I think one of the reasons is it’s becoming increasingly difficult for groups like that to manage all these changes.”

Miller added larger practices or health systems enjoy the economies of scale that make it easier to incorporate the rapid number of changes taking place. However, he added that in addition to HIT consultants, software vendors typi-cally also offer at least some assistance in helping clients assimilate new processes into their workflow.

“Managing technology is only getting more complex,” he concluded. “Organi-zations need to be intentional and strate-gic in how they do that … whether that’s implementing analytics platforms, system upgrades, system optimization, Meaning-ful Use programs, or ICD-10. They need to be looking at ways they can consolidate those initiatives to be more effective with their resources and increase the return on their technology investment.”

HIT: Optimization Through Integration

Chris Miller

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Never before have physicians and other healthcare professionals been so strapped for time. And never before has so much information been vital for them to be in the loop on. Medical News, America’s largest network of healthcare newspapers, plays a role in providing important information on national topics and showcasing local trends – all written specifically for healthcare professionals.

GET IT.Don’t fight for their attention.

Zoo of Biases…BY BILL APPLING

MedicalEconomics

Bill Appling, FACMPE, ACHE, is founder and president of J William Appling, LLC. He is a national speaker, presenter and a published author. He serves as an adjunct professor at the University of Memphis and is on the boards of Hope House and Life Blood. For more information contact Bill at [email protected].

A couple of weeks ago I found myself talking with three school teachers. They were young – 22 and 23 years old. Two were finishing their first year of teaching and one was finishing her second year.

I enjoyed listening to their excitement and consistent theme of caring about their students and wanting them to succeed in life, whatever they decided to do.

But, there was another consistent theme in this conversation: Frustration.

They didn’t want their enthusiasm to slowly drift away. They felt that their ideas and ways of teaching were not getting attention, or worse, being ignored, and they were being excluded in the education process for current and future educational needs and development.

According to these young teachers, burnout among new young educators usually comes within their fifth year of teaching because of the reasons mentioned. Keep in mind, these are adults. By 2020, they will represent more than one out of every three adults (36 percent). They are ethnically diverse, socially tolerant, and technology savvy. This generation’s unique blend of civic idealism and astute pragmatism will hopefully enable them to overcome the internal culture wars and institutional malaise.

Executives, managers, teachers, healthcare providers sometimes experienced bad luck or poor timing, but a large body of research suggests

that may be by cognitive and behavioral biases. While techniques to “debias” decision making do exist, it’s often difficult for these individuals, whose own biases may be part of the problem.

There are tools and techniques that can help flag times when the decision making process may have gone awry and interventions are necessary.

Early researches suggest this is the case roughly 75 percent of the time. (McKensey Quarterly, April, 2015, Phillip Meissner, Oliver Sibony and Torsten Wulf.)

Sibony says, “We have looked at this zoo of biases and tried to sort out what really matters. When people ask me what will make a difference as they build decision processes, I emphasize three things:

“First, recognize that very few decisions are one of a kind. Lots of projects happened before, and you can learn many things from these experiences.

“Second, recognize uncertainty-have alternatives, prepare to be wrong, and have a range of outcomes where the worst case is real and not ‘best case minus 5 percent,’ which is very common. Creating a setting where it’s ok to admit uncertainty is very difficult. But if you can achieve that, you can make headway.

“Third, create a debate where people speak up. It’s the most obvious but also the most difficult. If you’re the decision maker, when you get to the debate you’ve already got an idea of

where you want it to lead. And if you’re an experienced executive, you’ve already influenced your people, consciously or unconsciously. A good intervention point is to ask subordinates if anyone disagreed with you about a recommendation they bring to you. If everybody agreed, that’s a sign that many may have been ‘groupthink.’”

Soras Sarasvathy, a professor at the Darden School at the University of Virginia, has researched the difference between how entrepreneurs and very good senior managers at Fortune 500 firms think. She gives them a scenario about a new-product introduction. The typical Fortune 500 manager will run projections from the market data. But the entrepreneur’s reaction is, “I don’t trust the data. I’d find a customer and try to see the product.” The entrepreneur’s reaction is, “I’m gonna experiment. I’ll find my way into it.” The entrepreneurs’ impulse to experiment is right. We need to breed more of this type of thinking into decision making.

Two particular types of bias weigh heavily on the decisions-confirmation bias and overconfidence bias. The former describes unconscious tendency to attach more weight than we should to information that is consistent with our beliefs, hypotheses, and recent experiences and to discount information that contradicts them. Overconfidence or bias frequently makes executives

misjudge their own abilities, as well as the competencies of the organization. It leads them to take risks they should not take, in the mistaken belief they will be able to control outcomes.

The combination of misreading the environment and overestimating skill and control can lead to dire consequences. Consider a decision made by Blockbuster, the video-rental giant, in the spring of 2000. A promising start-up approached Blockbuster’s management with an offer to sell itself for $50 million and join forces to create a “click-and-motor” video rental model. Its name? Netflix. As a former Netflix executive recalled, Blockbuster “just about laughed [us] out of their office.” Netflix is now worth over $25 billion. Blockbuster filed for bankruptcy in 2010 and has since been liquidated.

In retrospect, it is easy to ascribe this decision to a lack of vision by Blockbuster’s leadership. But at the time, things must have looked very differently. Netflix was not the the video-on-demand business it has since become. There were practically no high-speed broadband connections of the kind we now take for granted, and widespread use of video streaming would have seemed like a futuristic idea. In Blockbuster’s eyes, Netflix, with its trademark red envelope, was merely one of several players occupying a small land thus far unprofitable mail-order niche in the video business. Kind of like the Sears, Roebuck & Company catalogue of the past vs. online ordering now.

In an environment of change and disruption, many leaders fear – correctly – that their organizations do not take enough risks or will fall prey to “analysis paralysis” and let opportunities slip away. Hence the popularity of start-ups as role models of fast, iterative decision making. As Reid Hoffmann’s often said, “If you are not embarrassed by the first version of your product, you’ve launched too late.”

While this “better safe than sorry” mindset characterizes many successful startups, it may not be the best inspiration for the strategic decisions of mature organizations. Some risks are worth taking, such as those taken knowingly, in pursuit of commensurate rewards. But some risks are taken recklessly because the risk takers are blind to their own overconfidence or have failed to consider alternative viewpoints.

As the founder and president of J William Appling LLC, healthcare and management and consulting firm, I have greatly tweaked my business model. Have you?


By JULIE PARKER

America’s independent physicians met mid-March in San Antonio, Texas, for the 20th annual national meeting of TIPAAA – The IPA Association of Amer-ica, the largest trade association serving independent and integrated physicians in the United States.

The focal point: population health, a relatively new front burner issue unfa-miliar to many practitioners. Congress included the model as a component of mandates in the Patient Protection and Affordable Care Act (ACA) (See box).

“We covered a lot of ground at our annual meeting to educate independent physicians about population health,” said Al Holloway, founder and president of TIPAAA. “Once we fully understand what it is, then we’ll find tools, products and services that can assist independent physicians in their daily practice.”

One question that repeatedly popped up: What’s the difference between popu-lation health and public health?

“Some view population health as a more modern version of public health, which itself – improving the health of the public – may be a goal, a measurement system, and a conceptual framework that undergirds a profession and a scientific

field,” wrote Michael A. Stoto, PhD, in “Population Health in the Affordable Care Act Era,” published by Academy Health (Feb. 21, 2013).

“Population health differs from pub-lic health, at least perceptually, in at least two respects,” Stoto explained. “First, it’s less directly tied to governmental health departments. Second, it explicitly includes the healthcare delivery system, which is sometimes seen as separate from or even in opposition to governmental public health.”

David B. Nash, MD, MBA, founding dean of the Thomas Jef-ferson University School of Population Health, pointed out that popu-lation health “builds on public health founda-tions.”

Among the building blocks, accord-ing to Nash:

• Connecting prevention, wellness and behavioral health science with healthcare delivery, quality and safety, disease prevention/man-agement and economic issues of value and risk – all in the service of a specific population. Examples: a city, provider’s practice, employee

group, hospital’s primary service area or pre-school children.

• Identifying socioeconomic and cultural factors that determine the health of populations, and develop-ing policies that address the impact of these determinants.

• Applying epidemiology and biosta-tistics in new ways to model disease states, map their incidence and pre-dict their impact.

• Using data analysis to design social and community interventions and new models of healthcare delivery that emphasize care coordination and ease of accessibility.

“When applied to healthcare deliv-ery, population health differs from con-ventional healthcare by emphasizing value rather than volume of services rendered,” said Nash.

How will population health affect physicians?

Monumentally, said Kathy Jordan, president of Jordan Search Consultants.

“The primary care practice of the fu-ture will look much different than it does today,” she said. “Instead of one-on-one encounters between the patient and their provider, the patient interaction process will include phone visits, email consulta-tions, group visits, education programs

and encounters with a variety of care team members. Out-of-office contact will become the new norm as patient health improves. Additionally, primary care physicians of the future must exhibit lead-ership and interpersonal skills, as well as a passion for top-tier service delivery. How well they manage the team will directly translate to how well the health of their patient population is being managed, which will directly impact future compen-sation models.”

Important financially: To be eligible for incentivized government funding, or-ganizations must prove their commitment to, and implementation of, population health, said Jordan.

“They’ll be required to improve the patient care experience, the overall health of populations, and lower per capita costs of case,” she said. “As a more compre-hensively integrated system focused on population health begins to dominate, the healthcare industry, healthcare experi-ence and provider recruitment initiatives must also evolve.”

Enter population health manage-ment.

Regina Levison, vice president of client development for Jordan Search Consultants, said that “while population

Population Health AdvancesPhysicians are buzzing about the new healthcare paradigm

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TPCA, United Health Foundation Connect for Quality

Last month United Health Foundation awarded $900,000 to the Tennessee Primary Care Association to help support “Tennessee Quality Connect,” a clinical initiative connecting healthcare professionals and patients through Community Health Centers (CHCs) in person or by utilizing telehealth technology.

CHCs, which are often located in communities where primary healthcare providers and hospitals are not easily accessible, serve as a primary source of care for one in 17 Tennesseans. However, when a patient’s condition requires the attention of a physician not on staff at a CHC, a range of barriers from a lack of transportation to not having adequate childcare to not being able to take time off work can stand in the way of seeing the specialist. The United Health Foundation grant is focused specifically on providing access to behavioral health and nutritional counseling services for individuals with hypertension, diabetes and depression to help combat these chronic issues.

The ability to leverage telehealth technology extends the reach of urban-based specialty care providers, improving access to critical health services in remote and underserved areas. More than 10 million people nationwide directly benefited from using telemedicine last year, according to the American Telemedicine Association.

“The Tennessee Primary Care Association’s work in the community has shown significant success in connecting people with quality healthcare services, and we are grateful for the opportunity to support its efforts to bring new, innovative approaches to healthcare,” said Rita Johnson-Mills, CEO of UnitedHealthcare Community Plan of Tennessee.

Announced at Neighborhood Health in Nashville, the grant is part of United Health Foundation’s “Helping Build Healthier Communities.” The funds will be awarded over three years and will support the Tennessee Quality Connect initiative at 17 CHCs, which collectively represent 104 health center sites serving more than 300,000 residents across 44 counties.

Officials gathered to celebrate the United Health Foundation grant to the Tennessee Primary Care Association last month. Pictured (L-R): UnitedHealthcare Community Plan of Tennessee COO Richard Reeves, Tennessee Primary Care Association CEO Kathy Wood-Dobbins, State Rep. Harold Love,State Rep. John Ray Clemmons, Neighborhood Health CEO Mary Bufwack, and UnitedHealthcareCommunity Plan of Tennessee CEO Rita Johnson-Mills.

PHiiT: Statewide Initiative Addresses Pressing Pediatric Issues, continued from page 1board certification processes were happening … so we asked, ‘How can we do this better?’”

As discussions became more formalized, Coff-man said TNAPP real-ized it would take a broad coalition to address the changes providers faced and drive quality to improve the health of the state’s youngest citi-zens. PHiiT’s main goals are:

• to educate providers about high value process changes for practices to impact serious population health concerns,

• to bring together stakeholders to organize and prioritize what those population health priorities are and develop measures to assess out-comes, and

• to ensure providers and patients have the tools they need to be success-ful.

“We’re really fo-cusing on that patient-provider space and making sure the patient and provider have the tools they need to make that a better working re-lationship,” Coffman said. After all, he continued, “The only ones who can really change healthcare delivery are providers in concert with patients.”

Working with the National Im-provement Partnership Network out of the University of Vermont, PHiiT set about to develop and implement quality improvement projects around pediatric health concerns that are high cost, consis-tent with state and federal priorities, have poor outcomes, are difficult for patients, and/or cause frustration for practitioners. Coffman said each quality improvement project also includes a Continuing Medi-cal Education component and standard-ization of metrics and outcomes reporting so the collaborative could analyze data and broadly share information and best practices.

The first initiative – Breastfeeding Sustainment and Smoking Cessation Project – was piloted through practices in Chattanooga, Knoxville and Oak Ridge with funding from the Tennessee Depart-ment of Health and data support from the Tennessee Initiative for Perinatal Quality Care (TIPQC). Coffman said the project kicked off in the summer of 2014 and winds up this month. An educational program was hosted over two weekends to get providers – which included physicians, nurses, nurse practitioners, and medical students – up to speed on ways to extend breastfeeding and discourage tobacco use around infants, and preliminary data has been very encouraging.

“When you look at breastfeed-ing, one-third will breastfeed no matter what you do, one-third won’t no matter what, and one-third in the middle are undecided, ambivalent,” Coffman said. “There is a high value window during

the newborn period. We know the sooner you get them (mothers) in and the better you engage them that first two weeks, you maximize the chance they will continue to breastfeed,” he explained, adding this newborn period is also the most motivated time for caregivers to quit smoking.

“We have been able to improve the frequency of patients seen within 72 hours of hospital discharge from 76 percent at baseline to 85 percent at our first follow-up,” Coffman said. “Our two-month breastfeeding rate has increased from 56 percent at baseline, which was better than anyone expected, to 62 percent at our first follow-up,” he continued. Coffman did note the higher-than-normal baseline breastfeeding rate could be attributed to the type of practices that participated in in the pilot, which were already working to engage parents around the importance of breastfeeding.

As for the second part of the project, Coffman noted, “Only 60 percent of new-borns were being screened for tobacco exposure at baseline. We were able to increase that to three-quarters, 76 per-cent, at our first follow-up.” He added that instead of just asking if the child was exposed to tobacco, which Coffman said could feel judgmental and garner a biased response, PHiiT trained providers to re-frame the conversation. “What we tried to teach was to positively engage the fam-ily around their care network and then go back and ask if each of those persons used tobacco.”

Ultimately, Coffman noted, provid-ers need effective tools they can use to engage with patients. “We know there is a finite amount of time that the provider and patient have so we look for the high value propositions … what really works.” He continued, “We really push our educa-tion faculty to choose what are high value changes and then communicate that to providers and patients in a way that is useful.”

Coffman said an important part of the equation that has been missing is feedback as to what is sustainable and then using that feedback to help develop payment structures that incentivize con-tinued process improvement. While the information is critical to inform practice and impact outcomes, Coffman was quick to say that PHiiT provides tools and data but allows providers the freedom to be in-novative in how they address issues with patients.

With the first pilot successfully draw-ing to a close, PHiiT is looking to expand that project and others across the state. The collaborative recently announced an

award of a $1.49 mil-lion, three-year con-

tract with the Bureau of TennCare to take

PHiiT’s efforts state-wide. The next project is to

develop a pediatric metric dash-board with the assistance of all four pediatric residency programs

in Tennessee. PHiiT’s quality coach will assist participating practices in gather-ing data pertaining to the measurement of the metrics. “That will give practices on-going feedback as to what their practice is doing compared to the state aggregate,” Coffman said of the dashboard, known as the Provider Best Practice Resource.

From there, specific quality improve-ment projects will be added. Coffman said asthma would be among the first

initiatives with obesity, behavioral health and developmental screening modules as other likely candidates to roll out in the near future.

“What we’re hoping is to give prac-tices real data to make business decisions around investing in quality improve-ment,” he said. “I think providers are going to learn a lot about the way they deliver care.”

PHiiT has begun enrolling additional practices to participate in the expanded programming. Coffman said pediatric, family and general practices that see chil-dren are all welcome to participate. In addition, school-based clinics, health de-partment clinics and federally qualified health centers are also encouraged to en-roll. For more information, contact Becky Brumley via email at [email protected].

Dr. Allen Coffman, Jr.


By JULIE PARKER

The hottest new advanced degree in healthcare, beyond medical school, fo-cuses on a game changer for the nation’s healthcare delivery system: population health.

Thomas Jefferson University (TJU), home of the nation’s only School of Popu-lation Health, received approval March 5 to become the only institution of higher learning in the United States to offer a new graduate-level degree program: Master of Science in Population Health (MS-PopH). The program is accepting applications for this fall.

“Population health is catching fire. It’s a raging inferno at the moment,” said David B. Nash, MD, MBA, founding dean of the Jefferson School of Popula-tion Health and the Dr. Raymond C. and Doris N. Grandon professor of health pol-icy at Thomas Jefferson University.

Nash, a board-certified internist, be-came involved in promoting quality im-provement and lobbying for healthcare policy change in the 1980s. He joined the university in 1990 as a faculty member; the former university president asked him to build the School of Population Health

for the campus, which opened in 2008 as the first U.S. academic institution fo-cused on population health. Already, 25 students have completed the graduate cer-tificate online program, which takes 12 to 20 months to complete. Its focus: to help current and emerging healthcare leaders understand the new population health paradigm. More than 100 students have completed the onsite Population Health Academy, a 40-hour continuing education program, providing an overview of basic concepts in population health.

“Healthcare inside a medical facility is only 15 percent of the story; 85 percent of healthcare happens outside the hos-pital,” noted Nash. “We have to reach outside the four walls of our hospitals to coordinate with community pharmacies, nursing homes, extended care facilities and the like, and link all of these care providers – from the hospital’s board of

trustees to the folks delivering home in-fusion medication. It’s a big operational challenge. We’re going to have to become a well-oiled, organized, value-generating team.”

Kathy Jordan, president of Jordan Search Consultants, said the new degree program is well-timed.

“The healthcare landscape is shift-ing more dramatically right now than it has since its inception,” she said. “As an increasing number of healthcare organi-zations move to models of accountable care, the overall healthcare experience will transform. With an emphasis on pro-active preventative care, evidence-based protocols, managed care teams, care co-ordination, and multidisciplinary teams, population health management will re-ward value in care, versus volume of pa-tients seen. In some cases, this may require new types of training.”

The comprehensive MS-PopH on-line graduate degree program will help students develop competencies in five key public health areas – behavioral and so-cial sciences, biostatistics, environmental health sciences, epidemiology and health policy. Students will also develop profi-ciency in the application of population health skills and principles, culminating in a Capstone project applying theory and lesson in real-world situations.

Already in place at Thomas Jefferson University: a doctoral degree program – PhD in Population Health Sciences –that started four years ago and has 14 students. The first two graduates will receive their degrees this month.

The doctoral degree is studied onsite, with the goal of preparing leaders with global vision to analyze the determinants of health. Doctoral candidates specialize in one of four areas: health policy, health-care quality and safety, applied health economics/outcomes research and behav-ioral/health sciences.

“The PhD in Population Health Sci-ences isn’t intended for those new to the discipline,” noted Nash. “Preference is given to applicants who’ve completed a master’s degree or master’s level course-work in appropriate fields of study, such as public health, social work, health policy and behavioral sciences.”

The addition of the MS-PopH pro-gram came soon after Stephen K. Klasko, MD, MBA, relocated from the University of South Florida (USF) Morsani College of Medicine and USF Health, where his transformative ideas took the Tampa medical school to unprecedented heights.

Klasko is in his first year as president of Thomas Jefferson University and presi-

dent/CEO of the Thomas Jefferson Uni-versity Hospital System, now the largest healthcare system in Philadelphia, Pa., the nation’s sixth largest city.

“We’re moving healthcare from a Blockbuster mentality to a Netflix men-tality,” said Klasko, pointing out the uni-versity began offering population health “before anybody put population health in the same sentence.”

“At Thomas Jefferson University, we created a whole new mission and vision, where health is all we do,” he explained. “Our vision is to reimagine healthcare education discovery to create unparalleled value. Jobs will be needed in healthcare in 10 years that aren’t even yet imagined, and a good many will be in population health.”

Nash, who also serves as a govern-ment and private-sector consultant, chairs the Technical Advisory Group of the Pennsylvania Health Care Cost Contain-ment Council and is a board member of various healthcare organizations, includ-ing Humana.

“The great thing about Dr. Nash’s school, it’s not a Johnny-come-lately. He’s devoted his life to population health,” said Klasko. “In most universities, population health is part of another school and lacks the panache … that puts us at the fore-front.”

Mastering Population HealthThomas Jefferson University offers nation’s first MS-PopH program

For additional information on the Jefferson School of Population Health degrees – program content, admissions requirements, deadlines, and tuition and fees – visit http://www.jefferson.edu/university/population-health/degrees-programs/population-health/about.html.

The ACA and Population Health

The Patient Protection and Affordable Care Act (ACA) addresses population health in four significant ways:

• Provisions to expand insurance coverage target the advancement of population health by improving access to the healthcare delivery system.

• Other provisions seek to enhance the quality of care delivered.

• Lesser known provisions aim to improve prevention and health promotion measures within the healthcare delivery system.

• The final set promotes community- and population-health based activities, including the establishment of the National Prevention, Health Promotion and Public Health Council, which has already produced the mandated National Prevention Strategy and Prevention and Public Health Fund for monetizing Community Transformation Grants.

health is defined as the health outcomes of a group of individuals comprising a spe-cific demographic population, population health management is a business model centered on the delivery of comprehen-sive care and management of total risk.”

The foundational shift in the health-care experience will morph from an in-dustry driven by reactivity to an industry driven by proactive measures, said Levison.

“The goal of population health is to keep a patient population as healthy as possible and minimize the need for costly interventions, procedures, emergency room visits, and hospitalizations,” she said.

As an increasing number of health-care organizations move to models of

accountable care, the overall healthcare experience will be reconstructed, said Jor-dan.

“Within this transformation, we’ll see an altered patient and physician ex-perience,” she said. “With an emphasis on proactive preventative care, evidence-based protocols, managed care teams, care coordination, and multidisciplinary teams, population health management will reward value in care, versus volume of patients seen.

“Although the results of these initia-tives won’t manifest for a decade or more, population health management will al-most certainly improve the quality of lives for millions of individuals throughout the country.”

Population Health, continued from page 7

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By JULIE PARKER

Finding presentable candidates for population health physician leaders is a tall order, especially since many doc-tors remain unfamiliar with the new paradigm in post-healthcare reform.

Personnel represents one of three key ingredients to imple-menting population health man-agement. It’s the glue to connecting data and the changing nature of the overall healthcare experience. The hard shift in practice management has healthcare organizations scrambling to secure top-notch population health phy-sician leaders, a move that keeps physi-cian recruiters like those at Jordan Search Consultants quite busy.

“Our clients know the organiza-tions able to most effectively aggregate and distribute data—to collaborators, team members, and even patients them-selves—will succeed,” said Kathy Jordan, president of Jordan Search Consultants. “Healthcare systems are now implement-ing robust software systems and popula-tion health management programs that help automate data integration, analysis, reporting, and communications so that real-time evaluations—and adjustments in patient care plans—can be made instan-taneously. Having the right IT systems – and IT personnel – in place is critical to advance clinical outcomes, improve care, and lower costs. Organizations with the ability to master data control and predic-tive analytics to generate decision-driving insights will succeed in population health management.”

Unfortunately, the shortage of pri-mary care physicians (PCPs) – the leaders of population health management – con-tinues to escalate. As population health management becomes the dominant healthcare model, the demand for their roles will be unprecedented.

“As physicians continue to leave the private practice model in favor of employed physician models, cultural fi t

within an organization will become a key recruitment parameter,” said Regina Le-vison, vice president of client development for Jordan Search Consultants. “In addi-tion, PCPs will be recruited based on their ability to build consensus, manage teams, and lead a diverse care team to better patient health. Organizations must un-derstand what physicians are looking for clinically, fi nancially, and administratively to ensure a fi t with the organization. Phy-sicians who embrace the care team model, understand how to utilize advanced prac-tice providers, and enjoy leadership op-portunities will be in high demand. In addition, recruits must understand new incentive and reimbursement structures. Physicians will be rewarded for meeting care management needs of patients; re-imbursement will be tied to quality as op-posed to quantity.”

Characteristics of a potential popula-tion health physician leader, according to Jordan Search Consultants, include:

• A minimum of fi ve to 10 years of practice experience.

• Board certifi cation.• A good understanding of the

way Electronic Medical Records (EMRs) work.

• A plan to help move the population health management team to the next level.

• Mentoring ability.• Advanced education.“We’ve changed how we evaluate

physician candidates and physician lead-ers so we can provide a better slate of can-didates to our clients,” said Jordan. “We want to assess their ability to embrace population health, their understanding of population health, and their attitude and ability to treat patients under a popula-tion health model. We have to dig more deeply. The physician leader of the popu-lation health management team will be working at the highest end of their license. We evaluate their ability to give direction and make assignments to the team and to educate their colleagues. They’ll need to assess where the team is strong, and where it needs additional education, training and support. It’ll be dictated not only by ge-ography, but also by the socioeconomic element of the population being served.”

Clients are thrilled, said Jordan, when the consulting fi rm fi nds a candidate who already knows the EMR system they’ve implemented.

“That’s one less bridge to cross,” she said.

One of the most pleasant surprises Jordan Search Consultants’ recruiters have discovered in physician leader can-didate pools is the growing number of physician candidates who have, or are pursuing, advanced business degrees, such as an MBA, perhaps with a concentration in healthcare management, MHA (mas-ters of healthcare administration), MPH (masters of public health), MHI (masters of healthcare informatics), MMM (masters of medical management), or MS-PopH (masters of population health).

“The MMM is a relatively new de-gree,” Jordan said, adding the MS-PopH degree program is a brand new offering at Thomas Jefferson University, the na-tion’s only school to offer that particular advanced degree. “They’re educating themselves to lead the charge.”

On the fl ip side, PCPs who otherwise might be excellent candidates for those positions simply lack time to pursue higher education.

“The rank-and-fi le practicing physi-cian in a community doesn’t need a degree in population health to see his patients,” said Al Holloway, founder and president of TIPAAA (The Independent Physicians Association of America). “No, that doesn’t make sense. Having an understanding of population health will impact his practice, but he doesn’t need a degree in it.”

The need for these type of leaders is unprecedented, said Jordan.

“As the demand increases, and we continue to have a very limited supply of physician professionals for these lead-ership positions, automatically the com-pensation goes up,” she said. “That’s something I hope potential candidates will strongly consider.”

Help Wanted: Population Health Physician LeadersFilling positions may be a tall order; job-getters will enjoy top-of-license roles

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GrandRounds

West Tennessee Regional Forensic Center Reaccredited

The West Tennessee Regional Fo-rensic Center (WTRFC), which has been managed by the University of Tennessee Health Science Center (UTHSC) since July 1, 2014, has been reaccredited by The Na-tional Association of Medical Examiners (NAME). The association is the premier organization of physician medical examin-ers, coroners, medical death investigators and medicolegal system administrators in the United States.

According to NAME, accreditation is an endorsement that policies and proce-dures of the office meet prescribed stan-dards for medicolegal systems. Accredita-tion, which involves an onsite, peer-review process and is conferred for a period of five years, signifies that the office performs with a high degree of competence and at-tention to public service. The review looks at administration and procedures, but does not apply to individual practitioners or the work produced by the office.

The WTRFC houses the Shelby Coun-ty Medical Examiner’s Office, and oversees medicolegal death investigation services for 20 counties west of the Tennessee River. The Shelby County Commission last year awarded UTHSC a one-year, $3.1 mil-lion contract to operate the facility, with an option to renew for three additional one-year periods.

Community Celebrates Career of Dr. Eugene P. Reese, Jr.

After 35 years of service to the com-munity, oncologist Eugene P. Reese Jr., MD, has retired. The Kirk-land Center held a celebra-tion for him in April.

Dr. Reese was the first board certified sub-spe-cialist in Hematology and Oncology to join Jackson-Madison County General Hospital and the Jackson Clinic and is recognized as one of two physicians who helped develop the On-cology program in Jackson. He made the decision to retire from his full time practice at the hospital in April 2010 but continued to follow his patients at the Jackson Clinic, PA. The Kirkland Cancer Center was privi-leged to have Dr. Reese and his partners integrate their practice in February 2014.

Dr. Reese has had several medical staff appointments through his career and his work has been recognized locally and nationally including being selected as one of America’s Top Physicians and one of America’s Top Oncologists several times. He was most recently honored as the West Tennessee Healthcare Foundation’s-Jack-son Award Recipient for Health Care 2013.

When asked about his service as a physician, Dr. Reese said that he always thought that the patient’s fight with cancer was his fight too.

West Tennessee Healthcare and BlueCross BlueShield of Tennessee Reach New Agreement

West Tennessee Healthcare (WTH) and BlueCross BlueShield of Tennessee have reached a new multi-year agreement.

The new contract allows BlueCross’ Blue Network S℠ and Blue Network P℠ members to use services at West Tennessee Healthcare facilities on an in-network basis.

Bobby Arnold, President and CEO of West Tennessee Healthcare said that WTH is committed to its patients and commu-nities, and they are pleased to finalize the new network agreement that will allow continued service for BlueCross members.

Hospice Of West Tennessee Sponsors Charity Golf Tournament

A four man charity golf scramble tour-nament, “Hittin’ for Hospice,” an annual fundraiser benefiting Camp WINGS Hos-pice of West Tennessee was held in April at Woodland Hills Golf Course. “WINGS” stands for wisdom, insight, knowledge, and guidance through sorrow.

The camp is for children ages 7-14 years of age who are grieving the loss of a loved one. The camp is designed to offer these children the opportunity to express their grief through art, music, and play while in the company of caring volunteers

and other children who are experienc-ing loss. The camp is staffed by trained counselors and volunteers and there is no charge for children to attend.

For more information about Camp WINGS call Pat Bard at Hospice of West Tennessee at 1-800-286-5717.

Tennessee Medical Association Welcomes New President

John W. Hale, Jr., MD, a family phy-sician in Union City, has been installed as 2015-2016 President of the Tennessee Medical Association, the state’s largest professional organization for physicians. Dr. Hale’s term officially began during TMA’s annual convention in Nashville.

Dr. Hale is the 161st President of the TMA. He succeeds Douglas J. Springer, MD, FACP FACG, a gastroenterologist in Kingsport.

Dr. Hale is originally from Halls, Tenn. He graduated from the Quillen College of Medicine at East Tennessee State Univer-sity and has practiced family medicine at the Doctor’s Clinic in Union City for 24 years. He is board certified in family medicine and has been an active TMA member, serving on the TMA House of Delegates for 23 consecu-tive years. He has also been a TMA Judicial Councilor and served on the Board of Trust-ees and as Speaker and Vice Speaker of the House, a past Young Physicians Chair, and as a delegate to the American Medical As-sociation House of Delegates.

Dr. Eugene Reese Jr.

Does your bladder control your life?Reclaim control NOW!

Feel like you’re always searching for the restroom?

Embarrassed about having to go so frequently that you find yourself

canceling plans?UNACCEPTABLE!

As you age, bladder and bowel control problems may seem unavoidable, but you don’t have to live with them. We want you to know there is help and we are here to serve you! Dr. Paul Gray at Woman’s Clinic, P.A. offers InterStim therapy, a minimally invasive, advanced therapy for overactive bladder and incontinence.

Susan, Dr. Gray’s nurse, can be reached at 731-422-4642 to schedule an appointment to discuss the treatment options available for you. Let this therapy help you get back to enjoying life the way you used to.

“I’m excited to be offering this procedure to my patients. Nothing can better describe this process for patients who suffer, than life changing”. - Paul Gray, M.D.

Millions of people suffer from bladder control issues such as overactive bladder and retention. The effects can be devastating and seem to steal your quality of life. At the Woman’s Clinic, we want to help improve your quality of life by offering the treatment of InterStim therapy.

“I thank God every day for Dr. Gray and the staff at the Woman’s Clinic. I had no quality of life and the pain was bad. With InterStim therapy, I got my life back. I was the guinea pig for Dr. Gray and I am so glad he and I chose this for my care. It has truly saved my life. I would definitely recommend this to anyone who suffers”. -Kelly

Jackson-Madison County General Hospital Nationally Recognized for Hip Replacement Surgery

Jackson-Madison County General Hospital ranks among the top hospitals in the nation for its lower than expected complications related to hip replacement surgery. It is also one of only 3 hospitals in Tennessee to receive a 5-star rating for hip replacement surgery from

Healthgrades©, a leading source of hospital, nursing home, and physician quality ratings and profiles.

Another reason to choose us for your joint replacement surgery.

The Jackson-Madison County General Hospital orthopedic program includes highly trained and experienced orthopedic surgeons, state of the art surgical and therapy technology, including the use of Exparel© to speed recovery by controlling pain following surgery, a dedicated orthopedic nursing unit, high patient satisfaction, the area’s only CARF accredited inpatient rehabilitation center, a Joint Effort education class and the convenience of 14 Sports Plus outpatient therapy locations.

For more information, visit www.wth.org/orthopedicsor call 731-541-HEAL (4325)

Congratulations to our Physicians and Staff

west tn medical news may 2015

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