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Margie A. Scott, MD Veterans Health System

the future of general acute care hospitals Arkansas Mental Health Counselors Association

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Contents + /5

May / June 2018 I Vol. 5, No. 4

10

fe atures Serving Those Who Have Served Us........................... 10 One on One with Margie A. Scott, MD

The Future of Acute Care Hospitals..................... 17 Arkansas Mental Health Counselors Assocation........ 24 Q&A with Board Members

Depa rt m ent s Editor’s Desk.............................................................8 Healthcare Briefs............................................... 27

17

Hospital Rounds..................................................57 Ad Index................................................................... 66

Corr es po nd ent s Policy.......................................................................... 42 Director’s Desk.................................................... 44 Mental Health....................................................... 46 Medicaid................................................................... 48 Acupuncture.......................................................... 50 Wealth Management....................................... 52 Orthopedics........................................................... 54

Editor’s Desk

A team with a focused, uplifting attitude can reach far beyond individual capabilities to accomplish great things. A team with talented, but harsh individuals can fail at even the simplest task. Attitude is everything. my office crying, and begging to return. She expressed a kind of humility I never expected to see in her. She was remorseful. She had seen Healthcare organiza-

the grass wasn’t greener. She understood what she did to our group

tions succeed by building

practice. I believed her, against conventional wisdom. I went to bat for

teams the right way. These orga-

her—convinced the others that she should come back. After all, I was

nizations are often one big team,

told, a tiger doesn’t change its stripes. It was beautiful. She was hired

supported by many small teams

back. She became our organization’s greatest advocate. She was a joy

with a unified vision. All individ-

to have around. She remained as a nurse at this practice for at least

uals work together, from nursing,

ten more years. That’s one of the greatest things about attitude; it can

to accounting, to doctoring, to

change on a dime. It is a decision. Attitude is everything.

building maintenance staff, striv-

I’m not talking about the Pollyannaism to the point of not recogniz-

ing to provide important, valuable services to our community

ing opportunities to improve. We should always look for, and be aware

and our health.

of organizational opportunities to improve. But, it’s all in the way you

Education and skill are the foundation. We hire those with skill

do it. Know the difference. Attitude is everything.

sets and talents to bring the orchestra together, and we always

When you are working in a healthcare team environment, seek to

find out, attitude is everything. Individuals will come into a

improve by using good words, and intentions. Seek to improve in all the

healthcare organization with skills. They will learn the system,

ways you can. Smart leaders will tune into passive-aggressive defeat-

the culture, the accountability, and the way. But, deep within this

ism. I’ve always thought one of the downsides of political correctness

individual is a huge asset to positive results, or a force intent on

is creating a culture of passive-aggressiveness. Passive-aggressiveness

working against collective progress, or somewhere in between.

basically means being destructive and cowardly at the same time. We

Call it street smarts. Call it whatever you like. Smart organiza-

shouldn’t encourage this behavior. Let people speak. Let people say

tions don’t keep destructive forces for very long. Smart organi-

what’s on their minds. Give people an opportunity to communicate

zations recognize the good ones. Smart organizations have keen

their visceral selves. This is how we understand each other. This is

discernment.

how we best construct a team. Teams will change people. People will

Managers study the value of systems from such organiza-

change teams. Build the system and watch them shine. If they’re intent

tional design leaders as Deming, Juran, and Crosby, etc. Quality

on destruction, let them go. This isn’t just management. This is leader-

organizations understand the science and importance of design

ship. Real leaders see the twisted angles. Real leaders understand the

to achieve consistent outcomes with human assets. In addition,

value of attitude. Leaders are at all levels of the organization. Just in

we’ve all seen those exceptional people throughout all lines of

case it hasn’t been said, once you have the skillset, attitude is every-

an organization. Those people who have a great attitude, avoid

thing. Ultimately, the patient succeeds.

slanderous gossip, lead through example, and focus on the entire patient experience, while being respectful to their teammates. These are the people you want. These are the people to hold onto. About twenty-five years ago, while running a group practice in Houston, we had a talented, skilled nurse who was becoming quite destructive to our organization. She was basically bad mouthing

Smith Hartley

all of us quite often. We decided to terminate her employment.

Chief Editor

Things improved. Then, almost a year later, this nurse came into

8 MAY / JUN 2018 I Healthcare Journal of little rock

[email protected]

dialogue

Serving Those Who Have Served Us

One on ONe with Margie A. Scott, MD Medical Center Director Central Arkansas Veterans Healthcare System


M

argie A. Scott, MD, was appointed Medical Center Director of Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, Arkansas, effective May 1, 2016. As the Medical Center Director, Dr. Scott has direct line responsibility and full accountability for managing all activities in a healthcare delivery system, which includes a two-campus medical center with 280 operating hospital beds, a 152-bed Nursing Home Care Unit and a 119-bed Domiciliary. CAVHS also manages eight Community Based Outpatient Clinics. She sets policy for the overall budget of the medical center that totals more than $573 million and more than 3,000 employees. Dr. Scott graduated from Meharry Medical College in Nashville, Tennessee, and received a Medical Degree in 1988. She completed Anatomic and Clinical Pathology residency; fellowship training in Surgical Pathology; and fellowship training in Molecular Pathology at Vanderbilt University, Nashville, Tennessee. After serving as faculty and clinical laboratory director at Vanderbilt for five years, she accepted a full time appointment at CAVHS where she has served as Laboratory Director, Assistant Chief of Pathology & Laboratory Medicine Service, Chief of Pathology & Laboratory Medicine Service, Deputy Chief of Staff, Chief of Staff, Interim Medical Center Director, and VISN 16 Interim Chief Medical Officer. Dr. Scott is a graduate of the Health Care Leadership Institute (HCLI) Class of 2007. Dr. Scott is a tenured Professor of Pathology at University of Arkansas Medical Sciences and is active in resident education. Healthcare Journal of LITTLE ROCK I MAY / JUN 2018 11

dialogue

70,000

Central Arkansas Veterans Healthcare System (CAVHS) serves approximately 70,000 veterans each year, and is one of the largest, most complex VA healthcare systems in the country.

Chief Editor Smith W. Hartley What are some

of the specific challenges and opportunities facing Central Arkansas Veterans Healthcare System? Dr. Scott Central Arkansas Veterans Health-

care System (CAVHS) serves approximately 70,000 veterans each year, and is one of the largest, most complex VA healthcare systems in the country. We are composed of two hospitals, John L. McClellan Hospital in Little Rock, and Eugene J. Towbin Hospital in North Little Rock, eight community based outpatient clinics (Mountain Home, Russellville, Conway, Searcy, Pine Bluff, El Dorado, Hot Springs, and Mena), the Veterans Day Treatment Center for veterans without homes, and two home based


primary care facilities in West Little Rock and Hot Springs. It is a challenging mission to provide comprehensive healthcare across such a geographically large area. We provide our veterans with comprehensive outpatient services, inpatient care, long-term care, rehabilitation services, mental health care, and multiple intensive outpatient programs, in which veterans live on our North Little Rock campus for 8-12 weeks during specific types of therapy. Another challenge is ongoing recruitment and retention of clinical providers, nurses, and other allied healthcare professionals in a very competitive healthcare market. We have a unique mission and opportunity to continuously expand service to Arkansas veterans, and to impact care across the South-Central VA Network, and sometimes across the entire VA system. CAVHS offers outstanding federal benefits and a mission that is second to none—serving Arkansas heroes. Editor How does a hospital for veterans

operate differently than a traditional hospital? Dr. Scott Central Arkansas Veterans Health-

care System has a unique mission to provide healthcare to America’s heroes, and we take that mission very seriously. Veterans have earned their healthcare by risking their lives so that we may enjoy the freedom we have today. Eligibility for services is determined by legislation, as well as executive orders of the President of the United States. Congress, who

“CAVHS is leading the country in the whole health and wellness journey for veterans.”

serves as our Board of Directors, appropriates our budget. The VA has a unique understanding of the service-con-

Editor Can you describe

model, mental health services, and whole

the medical issues most

health prevention/wellness services. CAVHS is leading the country in the whole health

commonly treated?

nected illnesses facing our veterans, such

and wellness journey for veterans. We have

as Post Traumatic Stress Disorder (PTSD),

Dr. Scott Many of the medical conditions we

been charged with rolling this out across the

Traumatic Brain Injury (TBI), and Military

treat at CAVHS are common to all health-

entire South-Central Network of VA facili-

Sexual Trauma (MST). Our mental health

care systems across this part of the coun-

ties. We also have specialized expertise in

services are more focused on those treat-

try; these include hypertension, diabetes,

providing care that is often seen in combat

ments, as opposed to the private sector.

cardiovascular illness, chronic obstruc-

veterans, such as Post Traumatic Stress Dis-

Many of our employees are also veterans

tive pulmonary disease, and renal disease.

order (PTSD), Traumatic Brain Injury (TBI),

themselves, so we understand and support

CAVHS provides comprehensive primary

poly-trauma rehabilitation, Military Sexual

a culture of service that is veteran centered.

care using the Patient Aligned Care Team

Trauma (MST), accelerated degenerative

Healthcare Journal of LITTLE ROCK I MAY / JUN 2018 13

dialogue

joint disease, and a host of unusual chemical exposures (agent orange, nerve gas, tar pits, and aerosolized munitions particles). Many chemical exposure illnesses take months to years to develop, and we are continuously learning of new conditions and syndromes as we follow veterans through exposure related health registries each year. Editor Throughout the country, veterans’

hospitals have received some attention for access issues. Will you explain what Cen-

“Timely access to care is step one in ensuring we meet our mission of providing healthcare to Arkansas veterans.”

tral Arkansas Veterans Healthcare System is doing to improve timeliness of appointments and coordination of care? Dr. Scott Timely access to care is step one in

ensuring we meet our mission of providing quality healthcare to Arkansas veterans. We have designed our outpatient clinic management system to focus on clinic organization structure, scheduling practices, and access. We have two full-time Group Practice Managers that focus entirely on clinic operations with standardized processes, training, and education that ultimately streamlines access to care. We are contin-

wellness, and prevention. We strive to

is dedicated, compassionate, and talented

uously working on improving our access to

intervene early to prevent acute events,

employees. Through the servant leadership

care at CAVHS. Our wait times are openly

and prevent or delay progression of

management style, we make our organiza-

published on the Access to Care website,

chronic illness. Our approach is centered

tion stronger, encourage innovation, and

www.accesstocare.va.gov.

on the veteran and what is important to

focus on our mission of serving Arkansas

CAVHS wait times as of March 7, 2018: Average Time for Primary Care Visit New Patient: 26.3 days Established Patient: 3.5 days Average Time for Specialty Care Visit New Patient: 17.8 days Established Patient: 4.3 days Average Time for Mental Health Visit New Patient: 13.8 days Established Patient: 1.8 days

them. What are the veterans’ personal

veterans. Along with the CAVHS leadership

goals? What do they want their life to

team, I dedicate time every week to meeting

look like? We are one of eighteen whole

with front line staff to discuss their concerns

health centers in the VA system, and have

and suggestions for improvement. This is

an Integrative Medicine service that

one of my favorite weekly activities.

Editor Can you give some examples of

how a modern veterans’ healthcare system operates differently from past VA systems, regarding care options and operations? Dr. Scott One very important and mean-

ingful change is our focus on health,

utilizes alternative treatment modalities to improve overall health and wellbeing such

Editor How much local autonomy is Cen-

as acupuncture, biofeedback, yoga, and

tral Arkansas afforded for Arkansans? Or,

chiropractic medicine. We want our veter-

is this mostly a centrally run system?

ans to reach the goals that are important to them and their families.

Dr. Scott While operating within the reg-

ulatory and overall strategic direction of Editor Please describe your leadership

the Department of Veterans Affairs, we can

style.

meet the local needs of Arkansas veterans. At Central Arkansas Veterans Healthcare

Dr. Scott I strive to be a servant leader and

System we focus on our local and state-

use the team-building approach of manage-

wide mission by partnering with UAMS, our

ment and performance improvement. The

Academic Affiliate, Arkansas Department

greatest resource of our healthcare system

of Veterans Affairs, and Veterans Service


which is helpful for veterans living in rural

Dr. Scott We have a solid process of stra-

areas of the state. CAVHS has a 28 bed PTSD

tegic and business planning at CAVHS that

domiciliary program, with an 8-week inten-

focuses on the foundational services we

sive specialized outpatient program pro-

provide Arkansas veterans. Each opera-

vided by the PTSD clinical team. The Men-

tional department chief involves employees

tal Health Clinic providers address military

at all levels within their service, to develop

and non-military PTSD. The clinical team

an operational plan that is rolled-up into the

uses initial treatment selection sessions

overall operations plan each year. We are

and a joint decision making process, so that

doing quite well with our budget this year,

selected treatments are a good fit for veter-

and have successfully expanded staffing in

ans. CAVHS has been nationally recognized

several areas, such as nursing, community

for best practice in PTSD therapy, and veter-

care, whole health, mental health, logistics,

ans from across the country come to CAVHS

and tele-primary care. We are an organi-

for this specialized care.

“We are an organization that embraces continuous quality improvement.”

zation that embraces continuous quality improvement. We have areas in which we

Editor Please explain how

excel, such as length of stay, Oryx inpa-

Central Arkansas Veter-

tient quality metrics, mental health conti-

ans Healthcare System

nuity of care, and avoiding hospitalizations

can work to operate

in primary care patients with ambulatory

efficiently within its

care sensitive conditions. While we are very

budget, and also pro-

proud of these quality metrics, we continue

vide quality care. How

to work towards improvement in all areas

is quality manifested

of care for our veterans.

throughout the system? Editor Going forward, what does the future

look like for veteran care and Central

Organizations across the state. We have

Arkansas Veterans Healthcare System?

taken the initiative to be a leader in advancing healthcare for our veterans by becoming

Dr. Scott The future for CAVHS and Arkan-

an Innovation site for VHA, and currently

sas veterans is very bright. We take our mis-

have six nationally funded projects focused

sion seriously, and our goal is to be inno-

on improving healthcare delivery. We have

vative and creative, always pushing the

also developed multiple programs in Little

envelope a little further to ensure our veter-

Rock that have been rolled out across the

ans are given as many healthcare and well-

VA, such as the Medical Foster Home Pro-

ness options as possible. The VA is undergo-

gram and the Group Advanced Care Plan-

ing an exciting transformation to enhance

ning Program.

services for our veterans in more ways than ever. We are modernizing our system,

Editor Can you describe some of the treat-

enhancing timeliness of services, and pro-

ment modalities for PTSD?

viding more community care connections than ever before. We have joined forces in

Dr. Scott At CAVHS, many modalities for

working with our Veterans Service Organi-

treatment of PTSD are utilized. We have

zations and community partners across the

learned that there is no single modality

state to prevent veteran suicide. Providing

that works for all veterans; having multiple

healthcare to our veterans is an honor and

options for them to choose from is critical

a privilege. We are here to serve those who

to their success. We offer Evidence Based

have served us. n

Therapy (EBT) for veterans with PTSD, on both an individual and group basis. Therapy is offered face-to-face and via telemedicine, Healthcare Journal of LITTLE ROCK I MAY / JUN 2018 15

By William T. Marshall, CPA (Inactive), MBA, JD

The Future of General Acute Care Hospitals Healthcare Journal of little rock I MAY / JUN 2018 17

Hospital Finances

I

n my article that appeared in the last March/April 2018 edition of Healthcare Journal of Little Rock, entitled “Hospitals Operating Through Finan-

cial Pressures”, I discussed how both the non-profit hospitals and for-profit general acute care hospitals (hospitals which offer the full area of medical services as opposed to specialty hospital facilities) were losing money due to the declining margins. Since the passing of the Patient Protection and Affordable Care Act of 2010, there has been an effort by commercial healthcare insurers to control what is often referred to as the “healthcare continuum of care”. All gen-

William T. Marshall, CPA (Inactive), MBA, JD

“Each of the participants in the healthcare delivery chain is trying to maximize its percent of the profit dollars that flow through the health care delivery system.”

eral acute care hospitals in this country are feeling the pressure of declining margins as Medicare, Medicaid, and commercial health insurers are pursuing more vertical integration. The vertical integration of payers and providers will persist to place more and

according to a study by Health View Ser-

Based on my over 40 years of experi-

more pressure on general acute care hos-

vices. A survey by Nationwide Retirement

ence representing the various entities which

pitals, which will continue to cause falling

Institute found that 64% of pre-retirees,

make up those participating in the contin-

inpatient volumes and reimbursement lev-

including those who are affluent, are “terri-

uum of care in the healthcare industry, it is

els, along with rising drug costs and labor

fied” by the healthcare costs on their retire-

my opinion that the patient will eventually

expenses. In addition, regulatory changes

ment plans.

become an informed decision maker in the

to policies such as “disproportionate share”

Each of the participants in the health-

healthcare industry, as he or she is in other

and the “340B drug discount program” exac-

care delivery chain is trying to maximize

industries, and as a result of the patient’s

erbate the situation. In a report to Congress

its percent of the profit dollars that flow

knowledge, and the fact that the patient is

from the Medicare Advisory Commission

through the health care delivery system.

required to pay a larger amount for his or

(MEdpac), entitled “Medicare and Health

The healthcare continuum of care, like any

her healthcare through increased deduct-

Care Delivery System from the Medicare

other industry, begins with the consumer

ibles and premiums, the healthcare com-

Payment Advisory Commission”, dated

(patient) and ends with the seller (service

mercial insurance companies will no longer

March 2018, MEdpac estimated that hospi-

provider). Just like the U.S. consumer in

have the consumer’s de facto proxy. Whether

tal margins sank to negative 10% in 2017, a

other industries, such as retail goods, there

the healthcare commercial insurance com-

drop from negative 7.1% in 2015.

are many other parties in that industry’s

panies (payers) or the consumer (patient)

The healthcare industry and its costs

delivery system which are responsible for

wins their inconsistent goals of control-

are approaching 18% of the Gross National

various functions in delivering the money

ling the continuum of care in the health-

Product and meanwhile, this country’s pop-

from the ultimate payer to the seller. How-

care industry in the future will determine

ulation is aging, and non-communicable

ever, unlike other industries, such as our cur-

the future of the general acute care hospital.

diseases are increasing around the world.

rent healthcare delivery system as it is cur-

This article will first describe the efforts

According to an article in the March, 2018

rently structured, the ultimate consumer is

of the commercial health insurance payer

Journal of Accountancy, published by the

not truly aware, nor has had an incentive to

and Medicare payer system to control the

American Institute of CPAs, entitled “Clients

know, the amount of dollars that those in

continuum of healthcare, while still acting as

Are Living Longer-How Will Your Practice

the continuum of care are being paid and

the de facto proxy of the ultimate consumer.

Adapt?”, written by Ilan Polyak, healthcare

why these entities are being paid. As a result

Second, it will describe if a knowledgeable

costs for the next decade are expected to

of this consumer unawareness, commercial

patient would ultimately shift the control of

rise at more than twice the rate of the Con-

health insurers have been allowed to have

the continuum of healthcare from the pay-

sumer Price Index, the rate that Social Secu-

the consumer’s de facto proxy in the con-

ers to the consumers.

rity cost-of-living adjustments are pegged,

tinuum of care in the healthcare industry.


THE FUTURE OF THE GENERAL ACUTE

to their insured customers at a lower cost,

“Collaborative”. Pursuant to these sharing

CARE HOSPITAL IN THE EVENT THAT

the margins of general acute care hospitals

agreements, Arkansas BlueCross BlueShield

THE COMMERCIAL HEALTH INSURANCE

will continue to decline. In order for com-

and the Clinically Integrated Network will

PAYER AND THE MEDICARE PAYER SYS-

mercial health insurance companies to ver-

agree on a dollar target to be paid per mem-

TEM OF PAYMENT CONTINUE TO RETAIN

tically integrate, they have often entered into

ber per month, and quality standards for

THE DE FACTO PROXY OF THE ULTIMATE

network agreements with certain hospitals,

patient care wherein the Clinically Inte-

CONSUMER—THE PATIENT.

primary care physicians, specialty care phy-

grated Network entity may share in any

Commercial health insurance companies

sicians, and other providers of healthcare

profits that the Clinically Integrated Network

have had to become creative since regula-

services. Some of these network agreements

may make by providing healthcare services

tors blocked recent attempts for them to

are between commercial health insurance

for less than the dollar target, to the degree

grow horizontally, including thwarted merg-

companies and Physician Hospital Orga-

that the Clinically Integrated Network meets

ers between Aetna and Humana, and Anthem

nizations (PHOs), Independent Practice

certain quality standards. Soon these sharing

and Cigna Corp. Commercial health insurers

Associations (IPAs), Clinically Integrated

agreements may require the Clinically Inte-

are aligning with providers (hospitals, pri-

Networks (CINs), and Financially Inte-

grated Networks to share in any loss if the

mary care physicians, and specialty physi-

grated Networks (FINs). Arkansas BlueCross

Clinically Integrated Network provides the

cians). In Arkansas, Arkansas BlueCross

BlueShield has entered into share savings

services at a cost that is more than the dollar

BlueShield has approximately 80% of the

agreements with several Arkansas Clinically

target, which is adjusted based on the Clin-

commercial health insurance marketplace.

Integrated Networks (CINs). CINs are orga-

ically Integrated Network’s ability to meet

The Arkansas Department of Insurance has

nizations typically formed by a hospital and/

the quality standards contained in the shar-

determined that it is not equipped to regu-

or a group of physicians wherein the CIN

ing agreement between the Clinically Inte-

late the payments that commercial health

enters into participation agreements with

grated Networks and Arkansas BlueCross

insurers pay healthcare providers, so the

the hospital that formed the CIN, and some-

BlueShield.

payments that commercial health insur-

times other hospitals outside of their ser-

As commercial healthcare insurance

ance companies pay various providers of

vice area, and physicians, allied providers,

companies grow their networks, they will

healthcare services in Arkansas may vary

and other providers of healthcare services

be able to carve out “high-cost” hospitals or

depending upon the bargaining power of

that a commercial health insurance com-

certain services from contracts, which will

the provider.

pany must have to offer the full array of

mean lower volume and revenues for hos-

Since commercial health insurance com-

healthcare services covered in an insured

pitals, according to Moody’s in its February

panies do not have to carry the hefty over-

patient’s health insurance policy. In Arkan-

21, 2018 Report, “In-Depth: Not-for-profit

head of full-service general acute care

sas, the largest commercial healthcare

and Public Healthcare-U.S.: Hospitals Face

hospitals, and as the commercial health

insurer, Arkansas BlueCross BlueShield has

New Threat from Health Insurers’ Disrup-

insurance companies vertically inte-

entered into sharing agreements with sev-

tive Growth Strategies Report”. Investors

grate and pursue an objective of preven-

eral Clinically Integrated Networks, which

at McGuireWoods Healthcare and Life Sci-

tive care, outpatient, and post-acute care

Arkansas BlueCross BlueShield refers to as

ences Private Equity & Finance Conference in Chicago in February of this year said they are steering investments away from large general acute care hospital systems and focusing on urgent, home health, micro-hos-

“General acute care hospitals participating in the continuum of the healthcare system must require physicians and various hospitalbased physicians to work together to drive best practices and ensure communication with their patients.”

pitals, and other specialty inpatient facilities. General acute care hospitals participating in the continuum of the healthcare system must require physicians and various hospital-based physicians to work together to drive best practices and ensure communication with their patients. While this may sound simple, hospital politics can sometimes get in the way. Nate Kaufman, Managing Director of Kaufman Strategic Advisory, has seen how challenging general acute care hospital coordination can be in his work

Hospital Finances

with clients across the country. “Professional

data, PAI and Avalere found the percent-

practices. Their business models depend on

staff is probably one of the most underman-

age of hospital-employed physicians grew

the eventual disaggregation of the health-

aged groups at general acute care hospital

5 percent and 22 percent in every region of

care continuum of care. The General Acute

systems.”

the United States from 2015 to July, 2016.

Care hospital systems cannot afford to

In an effort to gain bargaining power in

According to a comment editorial in the

ignore those threats. “The time to generate

the current healthcare continuum of care,

March 5, 2018 edition of Modern Health-

value from the past decade’s physician prac-

general acute care hospitals have been employing physicians. According to Becker’s

care, entitled “Physician Acquisition Indi-

tice binge acquisition is growing shorter.”

gestion”, authored by Merrill Goozner, Edi-

UnitedHealth Group CEO, Stephen Hems-

Hospital Review’s “Hospitals Employ 42% of

tor Emeritus, based on Modern Healthcare’s

ley made $17.8 million in total compensation

Physicians in 2016: 5 Study Findings”, writ-

Physician Compensation Database, which

for running the nation’s largest Commer-

ten by Morgan Haefner in the March 15, 2018

tracks average salaries based on the survey

cial Health Insurance company. Hemsley’s

edition. From July 2015 to July 2016, 5,000

of a dozen compensation consulting firms

compensation grew by 22.4% over 2015,

physician practices were acquired by hos-

and organizations, the average pay for 22

according to documents filed with the U.S.

pitals, according to an updated study from

specialists, including the relatively low-

Securities and Exchange Commission. Unit-

the nonprofit Physician Advocacy Institute

paying fields of family practice, pediatrics,

edHealth’s 2016 revenue totaled $184.8 bil-

and Advocacy. The five findings of this study

and internal medicine, rose 10.8% between

lion, up 17.6% year over year. Net income

are: (i) hospitals employed 42% of physicians

2012 and 2017. Average physician pay is now

was $7.3 billion, up 23.3% over 2015. (www.

in July, 2016, up from 1 in 4 physicians in

$386,000 annually, up 10.9% from $348,000

modernhealthcare.com/article/20170421/

July, 2012; (ii) from July, 2012 to July, 2016,

in 2012. In percentage terms, that pay hike

NEWS/170429946). UnitedHealthcare is the

the number of hospital-employed practices

is 4% more than the national inflation rate

largest Medicare Advantage Insurer.

increased by 36,000 purchases, reflecting

over the same period. In other words, despite

According to “The Profitability of Health

a 100 percent incline; (iii) as of July, 2016,

consolidation, doctors in recent years have

Insurance Companies from the Execu-

nearly a third (29%) of physician practices

consistently pulled down steady, inflation-

tive Office of the President of the United

were hospital-owned; (iv) between July, 2015

adjusted pay increases. The goal of these

States”, by the Council of Economic Advi-

and July, 2016, the number of physicians

hospital systems is to become an integrated

sors in March, 2018, the Executive Sum-

employed by hospitals increased by 14,000

delivery system that can be centrally man-

mary states that despite the significant ini-

nationwide. The percentage of employed

aged with a fixed budget. But the centrif-

tial financial losses in the individual market

physicians grew by almost 11% during the

ugal forces that could disrupt those plans

after the key provisions of the Affordable

same time, and (v) physician employment

are gathering speed. Outside capital is being

Care Act (ACA) took effect, commercial

and hospital ownership of practice climbed

poured into stand-alone imaging and pro-

health insurance companies’ profitabil-

for the fourth consecutive year nationwide

cedure centers, storefront and workplace

ity in the individual market has risen due

when, including July, 2015, to July, 2016

clinics, and concierge-style primary-care

to substantial premium increases, government premium tax credits that pay for those premium increases, and the large, government-funded, Medicaid expansion. Since ACA’s implementation, health insurance stocks outperformed the S&P 500 by

“Commercial health insurers remaining in the individual and small group markets seem to have actually accounted for ACA regulations, and older, more costly risk pools than expected, by charging higher premiums that have largely been covered by federal government premium subsidies.”

106 percent. Commercial health insurers remaining in the individual and small group markets seem to have actually accounted for ACA regulations, and older, more costly risk pools than expected, by charging higher premiums that have largely been covered by federal government premium subsidies. Stable year over year enrollment, despite larger premium increases, suggest a distorted market that involves large transfers from taxpayers to commercial health insurers. Large commercial health insurers, many of whom left the individual market, are profiting from


Healthcare Journal of little rock I MAY / JUN 2018 21

Hospital Finances

the Medicaid expansion, which is largely provided through private managed care and paid for by the Federal government. In addition, this report stated that in 2017, most Blue Cross Blue Shield regional insur-

“Consumers today are more demanding than ever before. Not only do they want to be in control, they want options tailored specifically to their needs.”

ers that are the main insurers in ACA compliant individual and small group markets have also returned to pre-ACA profitability. All commercial health insurers can expect to become more profitable this coming year

few of their questions.

information ecosystem that allows and

due to recent tax reform. The charts below

Thankfully, her husband survived, and

compare the Health Insurance Stock Index

after a week in the hospital, he was dis-

v. Benchmarks (Figure 1) to the Individual

charged. Before leaving, Verma asked for

Consumers today are more demanding

Market Monthly Premiums and Claims Per

his medical records so that her husband’s

than ever before. Not only do they want to

Enrollee (Figure 2).

doctors in Indiana could have all of his infor-

be in control, they want options tailored spe-

mation. The following is a quote from Verma,

cifically to their needs.

In summary, the charts above illustrate that the future of the general acute care hospital will result in a continual decrease in their margins if the commercial health

who is now CMS’s Administrator: “It’s our data. It’s our personal health information, and we should control it.”

encourages the healthcare market to tailor products and services for patients.”

According to an article in the March 23, 2018 Harvard Business Review entitled “Apple’s Pact with 13 Health Systems Might

insurers continue to be the de facto proxy

Verma then announced a federal initiative

Actually Disrupt the Industry”, authored

for the patient in the healthcare contin-

amed “My HealthE-Data” that would bring

by David Blumeathal and Aneesa Chopra,

uum of care. According to an analysis from

the patient to the center of the healthcare

Apple and 13 prominent centers like John

Moody’s Investor Services, general acute

system. While the plan was short in detail,

Hopkins and the University of Pennsylva-

care hospitals that do not adapt to the cur-

Verma went on to say, “Imagine a world in

nia disclosed an agreement that would allow

rent evolving continuum of healthcare could

which your health data follows you wher-

Apple to download onto its various devices

get squeezed out as commercial healthcare

ever you can share it with your doctor, all at

the electronic health data of those systems

insurers merge and become larger and direct

the push of a button.”

with a patient’s permission. “It could truly

more patient care to lower cost entities.

In this world, patients could track lives at

disrupt change in the U.S. healthcare sys-

each touch point and combine it with data

tem. The reason—it could liberate health care

WHERE A KNOWLEDGEABLE CONSUMER

claims and even wearables. That data could

data for game-changing new uses, includ-

(PATIENT) COULD ULTIMATELY CHANGE

“cure diseases and provide more evidence-

ing patients, as never before”. This article

THE FUTURE OF THE HEALTHCARE CON-

based treatment guidelines that ultimately

states, “[g]ive patients their data, and let

TINUUM OF CARE

will drive down costs and improve health

them control their destiny, let them share it

outcomes,” Verma said.

with whomever they wish in the course of

The Centers for Medicare and Medicaid Services’ (CMS) Administrator, Seema

Seema Verma also announced an over-

their own health care journey.” All 13 of these

Verma, attended the Health Information

haul of the government Electronic Medical

health institutions are listed on the Apple 24,

and Management System Society Trade

Records System (EMR) incentive programs.

2018 Apple news release discussed below.

show. She revealed that her husband suf-

White House advisor Jared Kushner spoke

On January 24, 2018, Apple’s website

fered a heart attack on his way home from

prior to Verma, calling for greater interoper-

stated, “Apple announces effortless solution

a weekend trip. Verma expressed the frus-

ability. The Trump administration is push-

bringing health records to iPhone, Health

tration millions of families feel when they

ing for greater patient control of health data.

Records Brings Together Hospitals, Clinics

try to explain complex medical histories to

“Medical data belongs to the patient,” Kush-

and the Existing Health App to Give A Fuller

doctors who have never before seen them

ner said.

Snapshot of Health”. This announcement

or their loved ones. Speaking remotely to the

It’s interesting to note that the Pennsyl-

stated in part, “[a]pple today introduced a

family’s doctors in Indiana from her office

vania Medical Center announced in Febru-

significant update to the Health App with

in Washington, D.C., Verma tried to get them

ary 2018, it would be one of the few pro-

IOS 11.3 beta, debuting a feature for custom-

to share medical records with the University

viders joining Apple’s move to allow health

ers to see their medical records right to the

of Pennsylvania Medical Center clinicians

records to live on patients’ iPhones. Accord-

iPhone. The updated Health Records section

treating her husband. She recollected feel-

ing to Seema Verma, “This Administration

within the Health App brings together hos-

ing helpless when she could not answer a

will pull every lever to create a healthcare

pitals, clinics, and the existing Health App to


make it easy for the consumers to see their

Healthcare Drive via email. “The continued

care and unpaid bills, increased from $35.7

available medical data from multiple medi-

liberation of data in healthcare is impera-

billion in 2015 to $38.3 billion in 2016 (AHA,

cal records held in multiple locations when-

tive; we must move beyond the islands of

Uncompensated Hospital Fact Sheet, Decem-

ever they choose. In the past, patients’ medi-

automation to fully connect patients, provid-

ber 2017). Second, new technology-savvy

cal records were held in multiple locations,

ers, payers, and the ecosystem at large, but

players will enter the market to meet the

requiring patients to log into each care pro-

this is one of many ways we are seeing [a]

demands for transparency in the face of ris-

vider’s website and piece together the infor-

true network effect take hold.” This emailed

ing deductibles. General acute care hospitals

mation manually. Apple worked with the

newsletter from Health Drive lists all 40 of

can use this opportunity to position them-

healthcare community to take consumer−

the health systems that were linking medical

selves to show value to their community

friendly approach, creating Health Records

records to Apple’s Health App. (www.health-

by analyzing the current level of transpar-

based on Fast Healthcare Interoperability

drive.com-April 2, 2018 email newsletter).

ency and consumer engagement, and they

Resources (FHIR), a standard for trans-

In a March 2018 article of the Healthcare

can utilize the toolkits available to improve

ferring electronic medical records.” (www.

Financial Management Association (HFMA)

their operational processes and offer trans-

apple.com/newsroom/2018) On March

magazine entitled “Increasing Consumer

parency to increasingly engage their con-

29, 2018, Apple made IOS 11.3 available to

Engagement and Drive Value”, authored by

sumer base.

download.

Lisa Winfield, PhD, J.P Morgan’s CEO, Jami

Digital transformation stands to save

According to Health Drive’s, April 2, 2018,

Dimon stated, “[our] people want transpar-

the healthcare industry 300 billion dol-

emailed newsletter topic entitled “Apple’s

ency, knowledge, and control when it comes

lars, but historically, healthcare organiza-

PHR Health System Partnerships Up Three-

to managing their healthcare.” The continu-

tions have fallen behind other B2C industries

fold”, now nearly 40 health systems have

ing trend towards increased consumer-cost-

like retail or financial services. As a result,

partnered with Apple to contribute medi-

sharing, consumer engagement, and calls for

they have lost opportunities to not only

cal records to the tech company’s updated

transparency have implications for the gen-

deepen engagement with their customers

Health Records section for iPhone. The new

eral acute care hospital. This article states

and patients, but also lower cost and drive

records section, which is still in beta mode,

that first, as deductibles continue to rise,

outcomes.

allows customers to view their medical

consumers may be less likely to seek elective

Today’s patients must be viewed in the

records with the Health App. Twelve health

procedures, which could cause some decline

same way other industries learned a decade

systems, including heavy hitters like Geis-

in hospital volume. Foregoing or delay-

ago to see their core customers—as device-

inger, Johns Hopkins Medicine, and Med-

ing elective procedures may also, in some

hopping, empowered customers who

Star Health, were name-dropped as partners

cases, contribute to more acute and even

demand what they want, when and where

in the original January 2018 release. Apple

higher-cost needs later. Moreover, HDHP’s

they want it. Patients move throughout a

has now made the feature available to any-

may also contribute to higher uncompen-

customer life cycle much like other types

one who updates their phone’s IOS software

sated care costs, as consumers increasingly

of customers do, and they want tools that

to the latest version. “We’re seeing strong,

struggle to afford care. According to a recent

help them make smarter choices and stay

early excitement from our client base tap-

fact sheet issued by the American Hospital

informed about treatment follow-ups. Fur-

ping into Apple Health Record”, said Jona-

Association (AHA), hospitals’ total uncom-

thermore, they demand that this be easily

than Bush, Athena Health’s CEO, who told

pensated care, including fee and discounted

accessible and part of a cohesive digital experience from start to finish. In summary, the general acute care hospital must adopt a perspective of being

“Today’s patients must be viewed in the same way other industries learned a decade ago to see their core customers—as device-hopping, empowered customers who demand what they want, when and where they want it. ”

obsessed with patient success and satisfaction, and will require a review of tools and processes in order to satisfy that obsession. Otherwise, they will be replaced with microhospitals, specialty hospitals, (much like the Arkansas Heart Hospital in Little Rock and the Arkansas Surgical Hospital in North Little Rock), outpatient facilities, walk-in clinics, independent laboratories, and other specialty low cost providers of hospital care. n

Arkansas Mental Health Counselsors Association

Q & A with ArMHCA Board Members: President Wendy Blackwood, LPC-S NCC, DCC Legislative Chairperson Jessica Costaldi, LPC President-Elect Laura Brinker, LPC

Chief Editor Smith W. Hartley What are some

the Darkness walks to bring awareness to

Editor Please describe the regulatory issues

things ARMCHA is working on?

suicide prevention and survival, adopting

facing mental health providers.

individuals and families from Dorcas House ArMHCA Our purpose is to provide quality

to provide Christmas gifts, supporting uni-

ArMHCA Although mental health and sub-

training to Arkansas mental health provid-

versity chapters with donations, and serv-

stance abuse treatments were mandated as

ers, advocating for positive changes in the

ing as speakers in educational workshops.

“essential benefits” in health insurance plans

mental health system, educating the public

under the Affordable Care Act (2010), many

on mental health issues, mentoring gradu-

Editor What do your membership numbers

people in need of services still face substan-

ate students who will be future counseling

look like? How often do you folks get together,

tial barriers to treatment in the form of high

professionals, and supporting mental health

and where?

deductibles and/or copay costs. Individual insurance plans vary widely on what types

providers’ needs, so that they can provide quality and accessible services to the public.

ArMHCA We have approximately 200 to 250

of services, and even how many sessions

active members, many who participate in

are covered, which unfortunately impacts

Editor Are ARMCHA’s goals unique to the

our annual conference, attend our annual

both clients and counseling providers. Ther-

national chapter in any way? If so, please

board retreat and monthly board meetings

apists are not free to diagnose, due to certain

describe.

typically hosted by the board president. We

insurance companies or Medicaid not pay-

also have regional and university chapters

ing for diagnoses they feel are less impor-

that meet monthly or bi-monthly.

tant. Additionally, the extensive paperwork

ArMHCA The Arkansas Mental Health Coun-

selors Association (ArMHCA) is a state

required by Medicaid takes time away from

chapter of The American Mental Health

Editor How has the mental health world

Counselors Association (AMHCA). The

changed over the years?

actual therapy. Editor What are some other non-regulatory

goal of ArMHCA is to recruit, unify, organize, advocate, and advance the profession

ArMHCA In the past few decades the focus

challenges facing mental health providers and

and practice of mental health counseling

of mental health has become more broad

organizations?

in Arkansas. Our members include coun-

and inclusive of many populations. There

selors, psychologists, and social work-

are more children, elderly, and rural com-

ArMHCA Although the stigma of seeking

ers, as well as students enrolled in gradu-

munities receiving counseling services than

mental health services has eased some over

ate counseling programs. ArMHCA serves

ever. People are more comfortable seeking

time, it does still exist. The goal of ArMH-

their counseling colleagues by presenting

services, which indicates a decrease in the

CA’s community outreach committee is to

an annual two-day conference, an annual

stigma of mental health. Social media has

help low income clients find resources such

board retreat, and by offering continuing

provided a platform for people to speak out

as childcare and transportation, as well as

education programs through its regional

about their challenges and needs, which

resources to refer clients specifically for sub-

chapters. ArMHCA members also partici-

increases awareness and decreases feel-

stance abuse and supportive living for clients

pate in community events such as Out of

ings of isolation.

that are severely mentally ill.

24 MAY / JUN 2018 I Healthcare Journal of Little Rock

Editor What is the future of mental health,

and experience equivalent to clinical social

specifically in Arkansas?

workers, and if approved to provide Medi-

Arkansas mental health providers will

care services, we could help reduce long wait

lead the way in innovative treatments, spe-

ArMHCA ArMHCA has joined with our

lists and improve the overall well-being of

cifically in treating trauma through Eye

national organization to support legislation

our country’s expanding senior population.

Movement Desensitization Reprocessing

(S. 1879/H.R. 3032) that would allow men-

In support of this legislation, ArMHCA’s Leg-

(EMDR), Trauma Focused Cognitive Behav-

tal health counselors to provide reimburs-

islative Chair, Jessica Costaldi, joined more

ioral Therapy (TF-CBT), and mental health

able therapy services to Medicare beneficia-

than 70 counselors from across the country

first aid crisis response to natural disas-

ries. Currently, psychiatrists, psychologists,

in Washington DC last summer to meet with

ters or community crises. We want to advo-

mental health clinical nurse specialists, and

members of Congress and advocate for this

cate for the citizens of Arkansas by engag-

clinical social workers are the only approved

important legislation. Although still pending,

ing legislators and lobbyists to encourage

mental health providers within the Medi-

the House and Senate bills continue to gain

better dialogue with clinicians, learn about

care system. The need for services is already

bipartisan momentum, and most recently,

the specific needs of mental health ser-

outstripping the availability of approved

AARP announced its endorsement of the

vices consumers, and appropriately allo-

providers, especially in rural areas. Mental

measure, noting the growing mental health

cate funding to support those services. n

health counselors have education, training,

and substance abuse needs of older adults

in the United States.

N e w s / p e o p l e / i n f o r m at i o n

Healthcare Briefs Breast Cancer Survivors Benefit from Exercise Story next page


Healthcare Briefs Breast Cancer Survivors May Benefit Cognitively from Acute Exercise A study of breast cancer survivors has shown that moderate intensity exercise for short periods, such as walking 20-30 minutes, may improve a women’s ability to carry out cognitive tasks, com-

The research team presented their findings during a paper session at the SBM Annual Meeting, held in New Orleans at the Hilton Riverside New Orleans. Salerno is an SBM member.

Surgeon General Adams Visits Arkansas Department of Health

pared to when the same tasks are done after rest-

United States Surgeon General Honorable

ing, according to research presented at the Soci-

Vice Admiral Jerome M. Adams, MD, MPH, was

ety of Behavioral Medicine (SBM) Annual Meeting

the featured presenter for Public Health Grand

& Scientific Sessions.

Rounds held at the Arkansas Department of

“Cancer survivors tend to score worse on a wide

Health (ADH).

variety of cognitive functioning tasks compared

In his talk, entitled “Better Health through Bet-

to people without cancer,” explained Elizabeth

ter Partnerships,” Dr. Adams discussed the impor-

Salerno, PhD, lead investigator for this project.

tance of partnerships in public health. He also

“We still don’t fully understand the mechanisms

talked about his recent public health advisory that

by which this occurs, and it may be either the

urges more Americans to carry naloxone, a life-

cancer, the treatments, or both that contribute to

saving medication that can reverse the effects of

memory and concentration problems.”

an opioid overdose.

Cancer survivors, including breast cancer survi-

Naloxone is already carried by many first

vors, often experience cognitive problems, such

responders, such as EMTs and police officers. The

as poor memory, loss of concentration, slower

surgeon general is now recommending that more

processing of information, and reduced execu-

individuals, including family, friends, and those

tive function (thinking that involves organizing,

who are personally at risk for an opioid overdose,

scheduling, and coordinating tasks).

also keep the drug on hand.

Surgeon General Vice Admiral Jerome M. Adams, MD, MPH

In this study, conducted at the University of Illi-

“We were honored to host Dr. Adams today

nois at Urbana-Champaign, 48 breast cancer sur-

and to hear from him about opioid abuse, an

vivors with a mean age of 56 years completed a

issue that affects numerous Arkansans and

battery of cognitive tasks before and after dif-

their families,” said Nathaniel Smith, MD, MPH,

strong relationships with the public health com-

ferent durations of exercise or rest. On all these

State Health Officer and Director of the Arkan-

munity and forging new partnerships with non-

tests, the women either maintained or improved

sas Department of Health. “This issue, like many

traditional partners, including business and law

their performance after some level of exercise

public health issues, must be addressed through

enforcement. He was the key speaker at the

compared to when they did the cognitive tasks

multiple partnerships on the local, state, and

annual AMHC conference.

after resting.

national levels.”

The ADH, the Fay Boozman College of Pub-

“These findings suggest that walking for

Adams oversees the operations of the U.S. Pub-

lic Health at the University of Arkansas for Medi-

20-30 minutes may help breast cancer survivors

lic Health Service Commissioned Corps, which

cal Sciences, and the Arkansas Center for Health

maintain or improve their cognitive function,”

has 6,500 uniformed health officers who serve in

Improvement jointly sponsor the Public Health

explained Salerno. “We know that exercise pro-

nearly 600 locations around the world.

Grand Rounds each week to provide continu-

tects against a host of diseases already, and mod-

He is a board-certified anesthesiologist. Adams

erate exercise may also help breast cancer survi-

served as the Indiana State Health Commissioner

vors protect their cognitive functioning.”

from 2014 to 2017. He was also an associate pro-

While more work is needed to understand

fessor of clinical anesthesia at the Indiana Univer-

the specific domains of cognition most heavily

sity School of Medicine and a staff anesthesiolo-

impaired by cancer and its treatment, exercise

gist at Eskenazi Health, where he was chair of the

may still be a better alternative than rest in this

Pharmacy and Therapeutics Committee.

ing education to medical professionals across the state.

UAMS’ Teresa Kramer, PhD, Honored for Work with Child Abuse Victims Teresa Kramer, PhD, a professor in the University

sample of cancer survivors. The next step in this

A guest of the ADH, The University of Arkan-

of Arkansas for Medical Sciences (UAMS) Depart-

research would be to test a wider variety of cog-

sas for the Medical Sciences (UAMS), and the

ment of Psychiatry, has been named the recipient

nitive tasks and look at physiologic and psycho-

Arkansas Minority Health Commission (AMHC),

of the 2018 Senator Percy Malone Child Protec-

logic measures to better understand the mech-

Adams, whose motto is “better health through

tion Award by the Children’s Advocacy Centers

anisms of cancer-related cognitive impairment.

better partnerships,” is committed to maintaining

of Arkansas (CACA).


For weekly eNews updates and to read the journal online, visit HealthcareJournalLR.com

Kramer received the award at a luncheon at the William Jefferson Clinton Presidential Center.

and return-to-play decisions regarding adoles-

research findings, and funds to hire a research

cents with concussions.

assistant and statistical assistance,” Yates said.

The award recognizes Kramer’s contributions as

“Our study aims to investigate a number of

“We are honored and excited to potentially

director of Arkansas Building Effective Services

questions related to [the] assessment of high

contribute to a better understanding of concus-

for Trauma (ARBEST), a program in the UAMS

school athletes who have had a concussion,”

sion in this adolescent population,” Lowe said.

Psychiatric Research Institute and supported by

Lowe said. “We are examining a number of

The NIGMS supports research that contributes

the Arkansas Legislature. Under her leadership,

dynamic movement tests as well as a variety of

to the understanding of biological processes

ARBEST has provided training in evidence-based

tests of reaction time to uncover potential gaps

and strives toward advances in diagnosis, treat-

trauma treatments to mental health profession-

in the current recommended assessment practice

ment, and prevention. Its IDeA program supports

als and child advocates across the state. The pro-

for this population following a concussion. We are

research in states that typically have experienced

gram also provides clinical services and follow-up

also examining the frequency of neurocognitive

low levels of National Institutes of Health funding

care at UAMS for children who have experienced

testing in this population.”

and addresses research needs of communities

trauma.

According to the Center for Disease Con-

The Malone award was established in 2010 to

trol and Prevention, between 1.6 and 3.8 mil-

honor the achievements of the senator and his

lion sports and recreation-related traumatic brain

wife, Donna, who have worked for years to create

injuries occur every year in the United States.

legislation to combat sexual and physical abuse

Yates and Lowe found adolescent high school

of children and adolescents.

athletes to be an understudied population at risk

Kramer has more than 30 years of experience in

for concussions.

that are medically underserved. For more information, visit www.nigms.nih.gov.

Deanne L. King, MD, PhD, Joins UAMS Department of Otolaryngology as Director of Clinical Research

research involving young trauma victims, begin-

“We hope that our findings can ultimately

Deanne L. King, MD, PhD, has joined the Uni-

ning with her work as a graduate student at the

impact not only assessment procedures but also

versity of Arkansas for Medical Sciences (UAMS)

University of Cincinnati. The chief psychologist at

clinical rehabilitation and return-to-play decision-

as director of clinical research for the Department

UAMS, Kramer has been director of ARBEST since

making,” Yates said.

of Otolaryngology-Head and Neck Surgery in the

its inception in 2009.

Yates and Lowe are currently in their second

College of Medicine.

“It is an honor to be recognized for this award.

year of receiving grant funding from the IDeA

King will facilitate collaborations on otolaryn-

Through the ARBEST program, we have trained

program for this study. The third grant year,

gology topics between researchers on campus,

more than 2,000 mental health professionals to

which includes the latest grant, begins May 1.

assist residents and medical students with pub-

provide effective treatments for children exposed

They have received $50,000 a year from the pro-

lishing their research, increase the number of clin-

to trauma, and reached more than 5,000 other

gram and will seek additional grants during the

ical trials in the department, and pursue grant

professionals working in this field,” said Kramer.

next school year.

funding. She is also an assistant professor in the

“I am extremely proud of the ARBEST team and

Several students pursuing a doctoral degree

the commitment of our entire state to serve these

in physical therapy and one pediatric resident

“This is a new position for the department and

children and their families.”

assisted Yates and Lowe with data collection at

is part of our overall effort to expand our research

Arkansas Children’s Hospital and various schools.

program,” said John Dornhoffer, MD, depart-

Yates said that UCA’s physical therapy department

ment chair. “The department is already nationally

has been flexible and supportive of their travel

known in clinical and academic circles. Research

needs for data collection.

is a key area where we have the opportunity to

UCA Physical Therapy Faculty Members Receive $50K Grant to Study Concussions in Adolescent Athletes Two faculty members in the University of Central Arkansas College of Health and Behavioral

College of Medicine.

In the first two years of the study, they col-

provide an even more academically comprehen-

lected data from 275 healthy athletes, whose data

sive and rich learning environment for our faculty,

served as a reference range.

students, residents, and fellows.”

Sciences have been awarded a $50,000 grant to

“We are now in the process of collecting data

King has a Bachelor of Science in biochemistry

support an ongoing study on concussions in ado-

on subjects [in] the Arkansas Children’s Hospital

from the Texas A&M University in College Sta-

lescent athletes.

Concussion Clinic. We will be able to compare

tion. She has an MD/PhD in molecular and cel-

Dr. Leah Lowe, assistant professor in the

data from these concussed athletes to the values

lular biology and pathobiology from the Medical

Department of Physical Therapy, and Dr. Char-

obtained in our normative samples,” Lowe said.

University of South Carolina in Charleston. She

lotte Yates, associate professor in the depart-

The NIGMS IDeA program grant will allow Yates

completed an internship in general surgery and

ment, were awarded the grant from the National

a surgery residency in otolaryngology-head and

and Lowe to expand their reach.

Institute of General Medical Sciences’ (NIGMS)

“The grant has provided us with funds to travel

Institutional Development Award (IDeA) program.

to schools and assistance to attend the physi-

Their research focuses on assessment, treatment,

cal therapy national conference to disseminate

neck surgery, both at UAMS. King said she enjoys helping researchers make connections.


Healthcare Briefs

Deanne L. King, MD, PhD

Havelka to its Jacksonville team of healthcare

With the ExactVu system, the urologists at Arkan-

providers.

sas Urology will now be able to actually visual-

Havelka earned her Doctor of Nursing Prac-

ize areas of interest in the prostate and specif-

tice (DNP) degree from the University of Tennes-

ically target biopsies at those suspicious areas

see Health Center in Memphis and most recently

in addition to performing systematic ultrasound

served as nurse practitioner with Access Medical

biopsy protocols.

Clinic, managing the care for more than 200 sub-

“Our strategy of investing in and providing the

acute rehab and long-term care patients in five

latest technologies is essential to enable Arkan-

nursing homes. Formerly, she was a registered

sas Urology and our urologists to provide the

nurse at Baptist Health-Little Rock in the intensive

highest standards of care for our patients,” said

care unit. She also served as an adjunct nursing

E. Scot Davis, CEO of Arkansas Urology. “The

faculty member for the nursing program at the

prostate biopsy is the key technique by which

University of Central Arkansas in Conway.

prostate cancer is diagnosed and we believe this

“Research can sometimes be an isolating pur-

“We are proud to welcome Chelsea to our

suit, but collaboration and idea-sharing is so

team,” said Mike Dupuis, division vice president,

important to the overall process,” King said. “I’m

Baptist Health Urgent Care. “Her experience with

“Arkansas Urology invested in the ExactVu

also looking forward to helping our students and

Baptist Health and in various areas of nursing will

technology to allow us to better serve Arkan-

residents. Otolaryngology-head and neck surgery

make her a valuable addition to our team.”

sans. We wanted to give men with the diagnosis

new high resolution micro-ultrasound imaging platform is a significant breakthrough.”

is a highly competitive field. Having published

The center treats a variety of urgent care and

of an elevated PSA another option to the tradi-

research to your name early in your career is not

family health needs, including allergies, skin con-

tional transrectal ultrasound (TRUS) biopsy,” said

only a valuable experience, but, increasingly, a

ditions, stings/bug bites, to broken bones, child-

Edwin Diaz, MD. “The ExactVu micro-ultrasound

necessity for medical students to successfully

hood illnesses, and vaccinations. No appoint-

imaging platform gives us the unprecedented

match into an otolaryngology residency.”

ment is needed and walk-ins are welcome. New

ability to visually detect prostate tissue abnor-

Dornhoffer has held the privately funded Sam-

patients can register online prior to visit to save

malities and, thus, perform lesion directed tis-

uel D. McGill Jr. Endowed Chair in Otolaryngol-

time with paperwork. For more information

sue sampling in addition to template directed

ogy Research since 2002. There are a total of six

visit UrgentCareBaptistHealth.com.

biopsies. By utilizing high-resolution imaging,

endowed chairs within the department to assist

Located at 1813 T.P. White Drive across 167 from

we aim to detect more aggressive cancers and

Wal-Mart, the Jacksonville center is open Mon-

offer appropriate treatments to these men.”

Faculty in the Department of Otolaryngology-

day through Friday, 8 a.m. to 8 p.m.; Saturday, 8

“We are thrilled to be working with and support-

Head and Neck Surgery are fellowship-trained

a.m. to 6 p.m.; and Sunday, 1 p.m. to 6 p.m. Bap-

ing the progressive team at Arkansas Urology in

in their specialty and cover all the sub-special-

tist Health Urgent Care also has centers located

their introduction of the ExactVu micro-ultra-

ties in the field (otology, endocrine, head and

in Benton, Bryant, Cabot, and North Little Rock.

sound into their practice so that their patients can

with research funding.

neck, rhinology, laryngology, pediatric, and vascular anomalies). The faculty consistently receives high scores on patient satisfaction, and six faculty members are listed in “Best Doctors in America.” They practice at UAMS Medical Center, Arkansas Children’s Hospital, and the Central Arkansas Vet-

Arkansas Urology Acquires ExactVu™ Micro-Ultrasound System for Prostate Imaging and Biopsy

benefit from the near microscopic resolution of this imaging system,” said Randy AuCoin, Exact Imaging’s President and CEO. “This is the first acquisition of this technology in the state and shows Arkansas Urology’s strong commitment to

Arkansas Urology announced that it is the first

investing in the latest state-of-the-art technolo-

customer in the state of Arkansas to acquire Exact

gies so as to provide the best patient-centered

Department faculty members also publish their

Imaging’s ExactVu™ high resolution micro-ultra-

standard-of-care.”

research at a high level, with several textbooks

sound system for targeted prostate biopsies. The

The ExactVu high resolution micro-ultrasound

and dozens of peer-reviewed manuscripts pub-

ultrasound-guided prostate biopsy is the stan-

system is in operation at the Arkansas Urology’s

lished each year. Faculty members present their

dard-of-care procedure that allows urologists to

main campus at 1300 Centerview Drive in Little

research at numerous national and international

sample a man’s prostate and gather biopsy tis-

Rock.

events and invited lectureships.

sue that can be analyzed pathologically to deter-

erans Health Care System.

Nurse Practitioner Chelsea Havelka Joins Baptist Health Urgent Care-Jacksonville Baptist Health Urgent Care welcomed Chelsea

mine the presence of prostate cancer. With a 300 percent improvement of resolution over conventional ultrasound, the ExactVu™ micro-ultrasound platform provides the urologist with a new level of resolution by which to examine the prostate.


Doctors Sheffield, Kent, Daniel, Judkins Form Conway’s Baptist Health Comprehensive Spine and Pain Management Center It’s hard to find highly skilled doctors disciplined


in both pain medicine and anesthesiology in

in osteoporosis and bone density testing. He

Arkansas. Because specialists with these com-

received his medical degree from the University

bined skills are sorely needed, Drs. Sheffield Kent

of Arkansas for Medical Sciences.

and Daniel Judkins recently returned to their home state to set up practice. The two are the founding physicians of the Baptist Health Comprehensive Spine and Pain Management Center in Conway.

ophthalmic medical technology students. “The completion of the ninth floor is the capstone of the Jones Eye Institute,” said Christo-

Henson received his medical degree and com-

pher T. Westfall, MD, Jones Eye Institute direc-

pleted his residency in internal medicine at

tor, interim UAMS College of Medicine dean and

UAMS. He has practiced medicine for more than

director of its Department of Ophthalmology. “It’s

20 years.

fitting this was accomplished through the contin-

A life-long resident of Arkansas, Stanley

ued generosity of the Walker family.”

Kent and Judkins met while in medical school

received his medical degree with a specialty in

The ninth-floor revamp moves all simulation-

and worked together during their anesthesiol-

internal medicine from UAMS and has practiced

related tools and equipment that were once scat-

ogy residency at the University of Arkansas for

medicine since 1992.

tered across multiple floors in the institute to a

Medical Sciences. Both went on to become fel-

Fendley, Henson, and Stanley joined the exist-

centralized, modern space where residents can

lowship-trained in pain management: Judkins at

ing staff of two advanced practice clinicians –

review surgeries on television screens and prac-

Emory University in Atlanta and Kent at Wake For-

Amanda Rogers, APRN, and Jessica Strack, PA-C.

tice procedures.

est University in Winston-Salem, North Carolina.

Baptist Health Comprehensive Care Clinic is

“We are thankful for the many contributions the

With more than 12 years of experience com-

located at 3500 Spring Hill Drive, Suite 100, across

Walker family has made to UAMS through the

bined, Kent and Judkins have expertise in man-

the street from Baptist Health Medical Center-

years,” said interim UAMS Chancellor Stepha-

aging pain associated with the sciatica, herniated

North Little Rock. The clinic is open Monday

nie Gardner, PharmD EdD. “UAMS would not be

discs, arthritis, fibromyalgia, and post-surgery.

through Friday from 8 a.m. to 5 p.m.

what it is today without the Walkers.”

UAMS Jones Eye Institute Opens Walker Eye Surgical Simulation & Education Center

ing director, lauded the Walker family’s charitable

Their services include joint injections, nerve blocks, ketamine infusions, spinal cord stimulation, epidural steroid injection, radiofrequency rhizotomy, kyphosplasty, and many others.

John P. Shock, MD, Jones Eye Institute foundgiving and commended Johnny Mike Walker and Mandy Macke for carrying on the Walker Founda-

The Baptist Health Comprehensive Spine

A portion of the ninth floor at the University

and Pain Management Center is located at 650

of Arkansas for Medical Sciences’ (UAMS) Har-

The center will be led by Ahmed Sallam, M.D.,

United Drive, Suite 340, in the Conway Medical

vey & Bernice Jones Eye Institute has been trans-

PhD, JEI ophthalmologist and assistant professor

Park behind Baptist Health’s Conway hospital.

formed into an instructive, collaborative center

in the Department of Ophthalmology.

The center is open Monday through Friday from

where ophthalmology residents and UAMS stu-

“There’s real evidence this will improve our res-

8 a.m. to 4:30 p.m.

dents can learn surgical techniques and proce-

idents’ competency levels, so the benefit of this

dures outside the confines of an operating room,

simulation center is two-fold,” said Sallam. “It

thanks to a $600,000 donation from the Willard &

increases the comfort level and proficiency of our

Pat Walker Charitable Foundation.

residents, which in turn, improves patient safety

Baptist Health’s Comprehensive Care Clinic Welcomes Three Physicians

UAMS faculty, staff, and supporters celebrated

tion’s philanthropic spirit.

and satisfaction.”

Drs. Jack Fendley, Greg Henson, and Robert

the opening of the Walker Eye Surgical Simula-

Stanley began practicing medicine at the Baptist

tion & Education Center with a dedication cere-

Health Comprehensive Care Clinic in North Little

mony, complete with tours of the simulation cen-

Rock on April 2. All three are established inter-

ter, classrooms, and clinical space that comprises

nal medicine physicians who will be using their

the renovated floor. Johnny Mike Walker, Walker

Kayla Harrison, a two-time Olympic gold med-

expertise to treat seniors, provide adult primary

Foundation trustee and son of Willard and Pat

alist in judo and childhood sexual abuse survivor,

care, and facilitate transition of care from hospi-

Walker, and Mandy Macke, foundation associate

recently spoke at the University of Arkansas Clin-

tal discharges.

director, were in attendance.

ton School of Public Service.

2012 Olympic Gold Medalist, Childhood Sex Abuse Survivor Speaks at Clinton School

The providers at Baptist Health Comprehensive

The Walker Center features simulation

The free lecture was hosted by the University of

Care Clinic work closely with pharmacists, dieti-

machines, microscopes, and other equipment

Arkansas for Medical Science’s ARBEST (Arkan-

tians, and other specialists to provide compre-

to help the next generation of ophthalmologists

sas Building Effective Services for Trauma) pro-

hensive holistic care to patients 55 and older. In

hone their skills. Under new curriculum require-

gram and the Clinton School of Public Service in

addition, the clinic has an on-site lab and digital

ments, ophthalmology resident physicians will

connection with National Child Abuse Preven-

X-ray equipment for their patients’ convenience.

have to show proficiency in certain surgical tech-

tion Month.

Fendley has practiced internal medicine for

niques and procedures, including suturing, cat-

Harrison, who became the first American gold

more than 35 years in central Arkansas. Board-

aract surgery, and glaucoma surgery. The cen-

medalist in judo at the Summer Olympics in Lon-

certified in internal medicine, Fendley specializes

ter will also be open to medical students and

don in 2012, was sexually abused by her coach


Healthcare Briefs from the time she was 12 to 16. The coach was sentenced to 10 years in prison in 2007. Harrison is now an advocate for children and adolescents, speaking out about her struggles and how she overcame them to reach the pinnacle of her sport. Her book, Fighting Back: What an Olympic Champion’s Story Can Teach Us about Recognizing and Preventing Child Sexual Abuse - and Helping Kids Recover, will be available for purchase at the event and will be released nationally on April 20. “Kayla has become a symbol of success and encouragement for survivors of childhood sexual abuse,” said Teresa Kramer, PhD, director of the ARBEST program. “She has a remarkable message that will undoubtedly inspire us in our ongoing efforts to eliminate child maltreatment.” Begun in 2009, the ARBEST program was developed to treat children who have been traumatized as well as to educate mental health professionals on the best interventions. For more

March Man-ness

information, visit http://arbest.uams.edu.

UAMS 12th Street Center Hosts March Man-ness at Saint Mark Baptist

Saint Mark is the main sponsor and has been

in the College of Medicine at the University of

since this UAMS event began in 2014. The Arkan-

Arkansas for Medical Sciences (UAMS) and direc-

The University of Arkansas for Medical Sciences

sas Cancer Society was among those organiza-

tor of the UAMS Harvey & Bernice Jones Eye

(UAMS) 12th St. Health & Wellness Center pro-

tions providing educational materials. ARcare and

Institute, has been appointed interim dean of

vided free healthcare services at its recent March

Linq for Life also sponsored and provided sup-

the College of Medicine.

Man-ness men’s health event at Saint Mark Bap-

plies and services for March Man-ness.

tist Church in Little Rock.

Westfall will lead the college during a national

The 12th Street Health & Wellness Center is a

search for a new dean. He was appointed by

While this event focuses on men’s health,

free interprofessional clinic run by students under

UAMS Interim Chancellor Stephanie Gardner,

women were also invited to receive free blood

the supervision of faculty and other licensed vol-

PharmD, EdD, after former dean Pope L. Mose-

pressure checks, glucose and cholesterol screen-

unteers. It provides students from the UAMS col-

ley, MD, stepped down from the position on Feb.

ings, lipid testing, and physical examinations.

leges of health professions, medicine, nursing,

23 to pursue his research.

Males also had blood drawn to check prostate

pharmacy, and public health and the graduate

“Dr. Westfall brings extensive leadership

sensitive antigen (PSA) for prostate cancer screen-

school an avenue to learn in an interprofessional

experience to his post as interim dean as well

ings. A panel of healthcare professionals, pharma-

center. The center focuses on education, preven-

as strong dedication to our mission and a colle-

cists, and physicians were on hand to answer per-

tion, and management of chronic diseases such

gial approach to management,” Gardner said.

sonal health questions.

as hypertension and diabetes. It also provides

“He will ensure continuity and continuing growth

“Serving the community’s health needs is our

information about healthy living, preventive care,

in the college’s education, clinical, and research

mission, and March Man-ness is a big part of ful-

consultations, and screenings for residents of the

programs.”

filling it,” said Lanita White, PharmD, director of

Little Rock Promise Neighborhood and surround-

the UAMS 12th Street Health and Wellness Cen-

ing areas.

ter. “Strong public participation every year has demonstrated there is a continuing need in the community for these screenings and health education. March 24 will mark our fifth annual March Man-ness men’s health event, and each spring we have witnessed its growing popularity.”

Christopher Westfall, MD, Appointed UAMS Interim Dean of College of Medicine

As a member of UAMS’ senior leadership, Westfall will work closely with Gardner and incoming Chancellor Cam Patterson, MD, who will begin serving full time at UAMS on June 1. While serving as interim dean, Westfall will continue his roles in ophthalmology and clinical services.

Christopher T. Westfall, MD, FACS, professor

“I am honored to serve our college and Arkan-

and chair of the Department of Ophthalmology

sas as interim dean,” Westfall said. “In the 21


Healthcare Briefs


2016, she chaired the first American Heart Association Scientific Statement fully devoted to cardiovascular disease in women. The statement concluded more research, improved diagnostic equipment, and early recognition of symptoms is needed to identify and treat women with cardiovascular disease in order to improve outcomes. This professorship supports McSweeney’s continued efforts to enacting the Christopher T. Westfall, MD, FACS

statement’s suggestions.

Jean C. McSweeney, PhD, RN

“This means this research can go on forever and that’s what we need,” said McSweeney. She was presented the professorship medallion by interim UAMS Chancellor Stephanie Gardner,

years I have been at UAMS, I have seen how hard

in ophthalmic plastic and reconstructive surgery

PharmD, EdD, and College of Nursing Dean Patri-

my colleagues work to educate exceptional phy-

at the Massachusetts Eye and Ear Infirmary and

cia Cowan, PhD, RN.

sicians, advance research that transforms health

Harvard Medical School in Boston. He is certi-

care and improves health, and ensure that Arkan-

fied by the American Board of Ophthalmology.

“I can say, personally, I’ve greatly admired Dr. McSweeney,” said Gardner. “She’s one of the

sans receive the very best medical care. In this

Westfall served as department chair and resi-

new leadership role, my appreciation for our ded-

dency program director in ophthalmology at Wil-

icated faculty has grown even stronger.”

ford Hall U.S. Air Force Medical Center. He retired

Cornelia Beck, PhD, RN, a retired UAMS Col-

Westfall joined the faculty in 1997 and served

as chief consultant in ophthalmology to the U.S.

lege of Medicine and Nursing faculty mem-

in numerous leadership positions prior to his

Air Force Surgeon General, at the rank of Colonel.

ber, renowned researcher, and close friend of

appointment as chair of ophthalmology and director of the Jones Eye Institute in 2009. These included vice chairman and medical practice leader; chief of the oculoplastic surgical services at UAMS Medical Center, the John L. McClellan

foremost female leaders at this institution and is a personal hero and great friend to me.”

McSweeney, said that being a compassionate

Jean C. McSweeney, PhD, RN, Invested in Women’s Cardiovascular Health Professorship

listener is what enabled McSweeney to identify women’s different symptoms and to use this research for the benefit of others. Caring about women’s difficulty getting diagnosed with heart

Memorial Veterans Hospital, and Arkansas Chil-

Jean C. McSweeney, PhD, RN, professor and

disease is what drove McSweeney to many

dren’s; chief of service at Arkansas Children’s; and

associate dean for research in the University of

accomplishments throughout her nursing career,

chairman and medical director of the Ophthal-

Arkansas for Medical Sciences (UAMS) College of

Beck said.

mic Medical Technology Program in the UAMS

Nursing and co-director of its PhD program, was

“Dr. McSweeney has affected the lives of

College of Health Professions. Westfall served

invested in the Women’s Cardiovascular Health

patients across the world,” she said. “The knowl-

as UAMS chief of medical staff in 2014-2016. In

Professorship.

edge she’s generated has changed the ways

2008, he was invested as the inaugural holder of

According to the U.S. Centers for Disease

women recognize the symptoms of a heart attack

the Pat Walker Endowed Chair in Ophthalmol-

Control and Prevention, heart disease is the

and the way clinicians listen to women and their

ogy. He has led UAMS’ surgical specialties ser-

No. 1 cause of death for women in Arkansas.

symptoms. She is, indeed, the queen of hearts,

vice line since 2015.

The professorship will support UAMS’s recruit-

women’s hearts.”

Westfall received his undergraduate degree

ment of more cardiovascular researchers, stud-

McSweeney has received continuous fund-

from the U.S. Military Academy at West Point,

ies to improve treatment and health outcomes

ing from the National Institutes of Health’s (NIH)

New York, and earned his medical degree at

for women with cardiovascular disease, and edu-

National Institute of Nursing Research since 1999,

the Ohio State University in Columbus, Ohio.

cational opportunities to inform women of the

and has previously served on its advisory coun-

He completed a residency in general surgery

risk factors and symptoms associated with car-

cil. She’s also received numerous grants from the

at Keesler U.S. Air Force Medical Center in Mis-

diovascular disease.

American Heart Association, Sigma Theta Tau

sissippi, was certified by the American Board of

McSweeney is an internationally known

International, and the American Nurses Founda-

Surgery, and awarded fellowship in the American

researcher with more than 20 years of experience

tion. She was the second nurse, and first Arkan-

College of Surgeons (FACS). He went on to com-

in women’s cardiovascular disease. She was the

san, appointed to the NIH’s Council of Councils,

plete a residency in ophthalmology at Wilford

first to identify different heart attack symptoms for

which advises the NIH director. She is also the

Hall U.S. Air Force Medical Center at Lackland

women in a 2003 study published in the American

former director of an NIH-funded Center for Bio-

Air Force Base in Texas, and a two-year fellowship

Heart Association’s premier journal, Circulation. In

behavioral Interventions.


Healthcare Briefs


It is the correspondence and personal stories

together a diverse group of investigators who can

opportunities in several ways: from senior UAMS

from hundreds of research participants, McSwee-

work as a team that is more than the sum of the

faculty, from each other during periodic work-

ney said, that continues to push her to do more in

parts,” said O’Brien, a professor in the Depart-

group sessions, and from distinguished outside

women’s cardiovascular research and treatment.

ment of Internal Medicine-Endocrinology in the

speakers invited to UAMS.

“It was their stories that made me know I was

College of Medicine. “The COBRE approach is a

They also receive detailed help applying for

going to do this for the rest of my career,” she

proven model. Its participants are more likely to

their own research funding. Once they secure a

said. “I never could have done it without all those

obtain independent federal funding, and it serves

certain level of funding – an NIH Research Proj-

women who were willing to participate.”

as a springboard for innovative, quality research.”

ect Grant (R01) or similar level – they are con-

She is a Fellow in the American Heart Associa-

The $11.3 million represents phase one of the

sidered “graduated” from the COBRE and their

tion and the American Academy of Nursing, and

COBRE grant in direct and indirect costs. It will

spot is opened to make room for another junior

a member of several professional organizations.

support the research of four UAMS faculty who

researcher.

McSweeney is past president of the Southern

are early in their careers and have yet to secure

“The NIH believes in this approach, and so do

Nursing Research Society and serves as chair of

independent research funding. With approval,

we,” said Lawrence E. Cornett, PhD, vice chancel-

the Central Arkansas American Heart Association

COBRE grants can be renewed for up to three

lor for research. “With each graduate, the cycle

Board of Directors. .

phases, representing up to $30 million in funding

continues, and over time it helps an institution

and support for numerous junior investigators.

develop a critical mass of investigators focused

McSweeney has presented her findings across the United States in such venues as the National

Each COBRE center is organized around a

Heart Attack Alert Coordinating Board. She has

theme; in this case, musculoskeletal disease.

served as a discussant for the National Heart,

Although the participants in Phase I of O’Brien’s

Ambrogini, one of the junior faculty that is ben-

Lung, and Blood Institute’s Women’s Isch-

COBRE come from different disciplines, they are

efitting from the grant, said she could not have

emia task force, and was a featured speaker

all interested in bone health.

dreamed of a better scenario.

at the National Institute of Nursing Research’s 20th Anniversary Symposium.

on a theme and supported by the necessary technology to do cutting-edge research.”

Elena Ambrogini, MD, PhD, of the Department

“This is the perfect setup for me,” Ambrogini

of Internal Medicine-Endocrinology, is studying

said. “Not only do I have the funding, I have the

She has been at UAMS for more than 20 years

the association between atherosclerosis and

mentoring and expertise of seasoned investiga-

and served as the College of Nursing’s interim

osteoporosis and a therapy that could target both

tors, and I have this environment – the resources,

dean for most of 2015, prior to Cowan’s appoint-

diseases; Jinhu Xiong, MD, PhD, of the Depart-

technology, and collaborators with the technical

ment in November of that year. McSweeney

ment of Orthopaedic Surgery, is studying the

skillsets needed to make my research possible.

helped develop the doctoral program of the Col-

mechanics behind how exercise improves bone

It’s the ideal combination of factors to help me

lege of Nursing.

health; Niels Weinhold, PhD, of the Myeloma

reach the next stage in my career.”

“She’s an outstanding educator, mentor, and

Institute, is studying why some forms of myeloma

O’Brien said that existing synergy and colle-

researcher,” said Cowan. “She’s the ideal person

(cancer that develops in the bone marrow) are

giality at UAMS built the strong foundation that

to serve as the inaugural holder of this endowed

more aggressive than others; and Srividhya Iyer,

made the success of the Center for Musculoskel-

professorship.”

PhD, of the Department of Orthopaedic Surgery,

etal Disease Research COBRE application possi-

is studying how different cellular stress pathways

ble. Aiding in the success of his application, he

are important for issues like low bone mass.

cited support for research at UAMS, specifically

NIH Awards $11.3 Million to Establish Bone Research Center at UAMS

Support for the investigators comes in many

among leadership of the College of Medicine;

forms. They receive funding for their research.

existing COBRE’s at UAMS; and the Center for

University of Arkansas for Medical Sciences

They are supported by existing technology at

Osteoporosis and Metabolic Bone Diseases at

(UAMS) Professor Charles O’Brien, PhD, has been

UAMS, and the grant can fund additional tech-

UAMS, led by Stavros Manolagas, MD, PhD.

awarded $11.3 million in federal funds over five

nology purchases, if needed.

years to launch the Center for Musculoskeletal Disease Research.

“Dedicated research funding is indispensable to support projects for young investigators and

The center is one of the largest and longestfunded osteoporosis research centers in the world and is based in the Endocrinology Division.

The Centers of Biomedical Research Excel-

their path to independence,” said Associate Pro-

“Dr. Manolagas led a Program Project grant

lence (COBRE) grant comes from the National

fessor Maria Almeida, PhD, associate director of

for 20 years, which really allowed us to develop

Institute of General Medical Sciences branch of

the Center for Musculoskeletal Disease Research.

true synergy within the Endocrinology Division.

the National Institutes of Health (NIH). The pro-

“The investigators also receive structured support

We’ve seen the success that consistent funding

gram aims to create multidisciplinary, collabora-

in other aspects needed to develop their careers,

can bring, so we want to build on that success

tive, and synergistic research centers in states with

such as budget and personnel management and

and take the lessons we’ve learned in the divi-

lower rates of federal research funding.

professional development.”

sion and share them with others,” O’Brien said.

“What this funding will allow us to do is bring

They are exposed to mentoring and networking


COBRE grants are only available for Institutional


Development Award (IDeA) states where NIH

has an ability to speak to a wide spectrum of pro-

for local public health. “We are pleased to be

funding has been historically low. They include

fessions and backgrounds, making biomedical

able to offer same-day service for these records

23 states and Puerto Rico.

informatics understandable and engaging.”

requests in all of our counties in the near future.”

UAMS faculty lead five other COBRE centers

Butte has authored more than 200 pub-

at UAMS and the Arkansas Children’s Research

lications, with his research repeatedly fea-

ing vital records, visit https://www.healthy.

For

more

information

about

order-

Institute. They include the Center for Transla-

tured in The New York Times, The Wall Street

arkansas.gov/programs-services/program/

tional Neuroscience, Edgar Garcia-Rill, PhD,

Journal, and Wired magazine. In 2013, he was

certificates-and-records.

$22.5 million, third and final phase; the Center

recognized by the Obama administration as an

For more information about local health unit

for Microbial Pathogenesis and Host Inflamma-

Open Science Champion of Change for promot-

locations and services, visit https://www.healthy.

tory Responses, Mark Smeltzer, PhD, $21 million,

ing science through publicly available data. Butte

arkansas.gov/health-units.

Phase II; the Center for Studies of Host Response

was elected into the National Academy of Med-

to Cancer Therapy, Martin Hauer-Jensen, MD,

icine in 2015.

History of Medicine Society Holds Annual Dinner

PhD, $10.5 million, Phase I; the Center for Child-

The Winthrop Rockefeller Distinguished Lec-

hood Obesity Prevention; Judith Weber, Ph.D.,

tures were established in 1972 and endowed by

The public was invited to the Society for the His-

$9.4 million; Phase I; and the Center for Transla-

friends of former Arkansas Gov. Winthrop Rock-

tory of Medicine and Health Professions’ annual

tional Pediatric Research, Alan Tackett, PhD, $11.5

efeller. The endowment that funds the lecture

dinner and lecture held recently at the University

million, Phase I.

program allows five universities in the Univer-

of Arkansas for Medical Sciences (UAMS).

UAMS Hosts Biomedical Informatics Expert for Rockefeller Distinguished Lecture

sity of Arkansas system to offer free public lec-

Abby Burnett, an independent researcher and

tures that communicate ideas to stimulate pub-

journalist, presented the lecture, “Gone to the

lic discussion, intellectual debate, and cultural

Grave: Burial Customs of the Arkansas Ozarks,

advancement.

1850-1950.”

The University of Arkansas for Medical Sciences

Past speakers at UAMS include Donald Ber-

The annual dinner and lecture is co-sponsored

(UAMS) hosted a free lecture by Atul Butte, MD,

wick, MD, former administrator for the Centers for

by the UAMS Library’s Historical Research Center.

PhD, a leading voice in biomedical informatics, as

Medicare and Medicaid Services, and Rebecca

The society provides support for the Historical

part of the Winthrop P. Rockefeller Distinguished

Skloot, author of The Immortal Life of Henrietta

Research Center in the UAMS Library. It awards

Lecture series.

Lacks.

an annual research grant to encourage research

Butte presented “Translating a Trillion Points of Data into Therapies, Diagnostics, and New Insights into Disease.” The lecture was held in the Fred W. Smith Auditorium on the 12th floor of the Jackson T. Stephens Spine & Neurosciences Institute.

into the history of the health sciences in Arkan-

ADH: Birth, Death Certificate Services Rolling Out to All Counties

sas. Other projects include the conservation of rare and classic books in the center. Membership is open to anyone with an interest in preserving

The Arkansas Department of Health (ADH) is rolling out vital records services to all local health

Butte is the inaugural director of the Institute

units in all counties. By the end of this year, all

for Computational Health Sciences at the Univer-

health units should be able to process same-day,

sity of California, San Francisco, and he holds the

in-person requests for birth certificates and death

Priscilla Chan and Mark Zuckerberg Distinguished

certificates, in most cases.

the history of UAMS and medicine in Arkansas.

Emotions Run High as COM Learn Residency ‘Match’ Locations, Specialties Tears came in all shapes and sizes at Match Day

professorship. He is also the executive director

Currently, these services are available in Pulaski-

for Clinical Informatics across the six University of

Central, Washington, Benton, Jefferson, Sebas-

California Medical Schools and Medical Centers.

tian, Crawford, Craighead, Crittenden, Hemp-

College of Medicine senior class President

“The Winthrop P. Rockefeller Distinguished

stead, Grant, Union, St. Francis, Boone, Drew,

Grant Cagle ripped open a sealed envelope

and Bradley county local health units.

to reveal the location and specialty for his resi-

Lecture offers UAMS a wonderful opportunity to

2018 – tears of joy, tears of relief, and tears from proud families.

invite innovative scientists and thought makers

Records requests will still be processed at the

dency: internal medicine at Rhode Island Hospi-

to our campus to speak to our employees and

central ADH office in Little Rock. Online and mail-

tal/Brown University in Providence. Almost inau-

students, as well as our community,” said Interim

in requests will also still be available. Any requests

dible through tears, he assured the crowd that it

Chancellor Stephanie Gardner, PharmD, EdD. D.

to change or correct information on existing birth

was his dream match, and the audience erupted

Micah Hester, PhD, chairman of the UAMS com-

or death certificates must still be handled in the

to share his joy.

mittee organizing the presentation, agreed.

Little Rock office, located at 4815 W. Markham St.

Student after student came to the podium, each

“Bioinformatics is central to medical care, pub-

“Arkansans need access to their vital records for

with their own version of Cagle’s story, including

lic health, and disease prevention in the 21st cen-

a variety of reasons, some of which can be time-

the years of work, high expectations, and support

tury, he said. “Dr. Butte is a dynamic speaker who

sensitive,” said Don Adams, ADH center director

from others along the way. Many used their time


Healthcare Briefs at the mic to give thanks. “It takes a team just for one medical student to graduate,” Cagle said. Each year Match Day starts at 11 a.m. Central Time, with senior medical students all over the nation simultaneously opening envelopes to reveal their match – or where they have been accepted to continue their training in a residency program for the next three to seven years. For some, the tears came later, maybe as they hugged their proud mothers and fathers waiting on the sidelines, or while hugging other members of their class – peers who can truly understand everything that has led up to this day. Tess Coker and Alex Croft got a little misty-eyed as they looked back to that first day of school when they met. Soon after, they started dating. They had each other to lean on throughout the highs and lows of med school, and the match process for couples is especially daunting.

UAMS Match Day

Match Day is conducted by the National Resident Matching Program (NRMP). Students in their fourth year apply to programs, interview and then

mic, he announced his match – orthopaedic sur-

Similarly, Julie Sherrill, who grew up in Dumas

send a ranked list to the NRMP. Residency pro-

gery at UAMS – with a bit of punch in his voice,

and attended the University of Arkansas at Fay-

grams also submit a list of preferred candidates,

and the crowd cheered in response. McLeod’s

etteville for her undergraduate degree, matched

and an NRMP computer, using an algorithm, rec-

father is an orthopaedic surgeon in Arkadelphia

in pediatrics at UAMS just as she hoped.

onciles the lists as best as possible.

and he envisions a similar future for himself.

“I grew up in rural southeast Arkansas, where

Couples face the additional challenge of try-

“I’ve had so many great mentors in the ortho

health care is limited and doctors are hard to

ing to match in the same geographical area,

department,” McLeod said. “It was a no-brainer

find,” Sherrill said. “I want to be a primary care

while considering each other’s career goals with

for me to stay in that program. They’re doing

provider for children and adults in a small, rural

regard to specialty and the prestige of the pro-

exciting things right now, and I’m glad I’m going

community. Arkansas is my home state and I really

gram. There is a couple match option through

to get to be a part of it.”

would like to use my training to care for the people here.”

the NRMP that tries to factor in geography, but

McLeod said that in addition to his mentors,

still, it’s tough. One of the students who didn’t

support from his wife has been key in the pro-

This year, 51 percent of the UAMS students

match this year was a member of a couple who

cess, and he’s glad he will have the support of

matched in primary care – internal medicine,

was not looking for alternatives in order to stay

some familiar faces as part of his residency. Der-

pediatrics, family medicine, or obstetrics/gyne-

close to a partner.

rick Henry, Timothy Hereford, and Sean Parham

cology. With an in-state tuition and fees for the

also matched in the department.

2017-2018 academic year of $32,378, many Arkan-

“We both knew on Monday that we had matched somewhere, but you don’t know exactly

Several students also matched in family medi-

sans pursuing careers in medicine see the value

where, and even with couple matching you still

cine at the UAMS Regional Center in Pine Bluff,

in a quality education at that price and chose to

have to list some apart, and couple matching in

including Robert Ferguson of Booneville, who

complete medical school at UAMS close to home.

general just limits your options,” Croft said. “We

said he hopes the program will take him one step

One of UAMS’ goals is to inspire doctors to stay

were both super nervous coming into this.”

closer to his goal of becoming the rural Arkansas

in Arkansas for their careers, particularly those in

family doctor he aims to be.

family medicine.

Coker’s envelope revealed she had matched in pediatrics; Croft matched in emergency medi-

“It’s what I’ve always wanted to be,” Ferguson

cine – both at Indiana University School of Medi-

said. “When I was growing up, the doctor you saw

cine in Indianapolis.

in the doctor’s office was the same one you saw

Arkansas Department of Health Celebrates Public Health Week

“We couldn’t be more happy,” Croft said.

in the hospital, it was the same person providing

The Arkansas Department of Health (ADH) cel-

Cody McLeod of Arkadelphia, on the other

you with almost all of your care. That was my idea

ebrated National Public Health Week (NPHW)

of what a doctor was.”

April 2-6.

hand, said selecting his top rank was easy. At the



critical care and infectious diseases clerkships. The ACCM is a part of the larger Society of Critical Care Medicine. In addition to bestowing honors and fellowship status on clinicians, the college is responsible for developing about 25 of the guidelines for best practices used nationwide in intensive care units. The guidelines cover everything from managing sepsis, sedation-pain-analgesia-delirium and how to use mechanical venKeith Olsen, PharmD, FCCM

tilation for a patient.

James D. Marsh, MD

James D. Marsh, MD, Honored by American Heart Association James D. Marsh, MD, chair of the Department NPHW is observed during the first full week of

Health Week 2018 in Arkansas, Healthy Active

of Internal Medicine in the College of Medicine

April each year. During the week, health profes-

Arkansas, and the services that ADH provides,

at the University of Arkansas for Medical Sci-

sionals connect with individuals and communi-

visit www.healthy.arkansas.gov.

ences (UAMS), has been honored by the Ameri-

ties to show how public health helps Arkansans improve their own health, protects them from epidemics, and provides preventive health services in their communities. This year’s national theme, Healthiest Nation

UAMS Dean Keith Olsen First Pharmacist to Become Chancellor of American College of Critical Care Medicine

can Heart Association for his three-decade career fighting cardiovascular disease and stroke. Marsh received the Worthen-Cornett Award at the Little Rock Heart Ball at the Statehouse Convention Center.

2030, Changing our Future Together, focused on

Keith Olsen, PharmD, FCCM, dean of the Col-

Named in memory of the philanthropy and ded-

the steps it will take to make the United States

lege of Pharmacy at the University of Arkansas for

ication shown by the late George Worthen and

the healthiest nation in one generation – by 2030.

Medical Sciences (UAMS), was recently named

the late James K. Cornett, MD, the Worthen-Cor-

ADH, along with statewide health and pub-

chancellor of the American College of Critical

nett Awarded is presented to an individual each

lic health partners, honored this theme through

Care Medicine (ACCM), becoming the first phar-

year at the Heart Ball for excellence in volun-

events and social media. To celebrate this theme,

macist to lead the national organization.

teerism. Recipients demonstrate an outstanding

ADH partnered with the Cabot School District to

Olsen has served on the Board of Regents of

commitment to working with the American Heart

highlight second-grade through fourth-grade stu-

the ACCM for six years. As the most senior per-

Association’s mission to build healthier lives, free

dent drawings in ADH’s yearly Public Health Week

son on the board, he ran for secretary-general

of cardiovascular diseases and stroke.

poster. These drawings, part of an annual contest

in 2016 and was elected. He next served as its

Marsh has received numerous grants from the

in Lonoke County, show students’ ideas about

vice chancellor, and as that term expired, Olsen

American Heart Association for a total of more

what it means to make healthy choices.

assumed the office of chancellor at the recent

than $500,000 during his career. It has funded

Society of Critical Care Medicine Congress held

research into using gene therapy to improve the

in San Antonio, Texas

function of a failing heart, stroke prevention, and

Stephanie Williams, ADH deputy director for programs, met with students whose work was featured in the poster in an event on April 2.

In 1977, Olsen earned his bachelor’s degree in

other topics.

“It’s important that Arkansas is a healthy place

chemistry from Wayne State College in Wayne,

“I am proud to receive this recognition,” Marsh

for our children to learn and grow,” Williams said.

Nebraska, and in 1980 his doctor of pharmacy

said. “AHA research funding has touched the

“ADH is pleased to support our children’s vision

degree from University of Nebraska Medical

lives of every heart and stroke patient treated

of what a healthy state looks like.”

Center (UNMC). After receiving his doctorate,

in the United States, no matter if the hospital is

NPHW is also the perfect time to learn about

he completed a residency in clinical pharmacy at

a research institution or not. This research has

the services that ADH has available for Arkansans.

UNMC. He was a member of the UAMS College

led to gold standard treatments and guidelines

There is at least one Local Health Unit (LHU) in

of Pharmacy faculty from 1989 to 1993.

used by healthcare providers in every corner of

each county in Arkansas. LHUs offer many ser-

From 2007 to 2015, Olsen served as chair of the

the nation and around the world. Not only does

vices, including immunizations; the Women,

Department of Pharmacy Practice at the UNMC

every heart and stroke patient benefit from our

Infants, and Children (WIC) program; HIV and

College of Pharmacy. He specializes in critical

research, but so do the millions of people who

STD testing; women’s health services; tuberculo-

care and infectious diseases, teaching and serv-

want to live healthier lives and prevent these dis-

sis treatment; and environmental health services.

ing as the Infectious Disease Section coordinator

eases from every happening.”

For more information about National Public

for pharmacotherapy II and is a preceptor for the

“My family, like the majority of families in


Healthcare Briefs Arkansas, has been affected by heart disease

those. This is particularly important in a primarily

and stroke, with lives disrupted or ending too

rural state like Arkansas, as many radiation oncol-

soon,” Marsh said. “It is a privilege to commit

ogists choose to practice in larger, more metro-

my career to developing preventive measures

politan areas.

and new treatments for cardiovascular disease,

“It’s important for our patients, for UAMS, and

and to caring for patients who are already bearing

for all of Arkansas that we are active in educating

the burden of heart disease and stroke.”

and training radiation oncologists who we hope

A nationally prominent internist, cardiologist,

will remain in Arkansas for their careers,” said Xia.

and cardiology researcher, Marsh served on the

The program, which is accredited by the

faculties at Harvard Medical School and Wayne

Accreditation Council for Graduate Medical

State University before being recruited to UAMS

Education (ACGME), holds four residency slots.

in 2004 where he is also the Nolan Professor.

The first resident will arrive in July of 2018, fol-

Niki C. Carter, DMD

Marsh received his medical degree from Har-

lowed by one additional resident each year for

vard Medical School in 1974. He trained in inter-

the following three years. In subsequent years,

nal medicine at Brigham and Women’s Hospital

as one resident graduates, an additional one will

individuals at UAMS took an active role in mak-

in Boston, where he went on to complete clini-

be added, keeping the program’s participation

ing the residency program a reality, including Jim

cal and research fellowships in cardiovascular dis-

at a total of four.

Clardy, MD, associate dean, and Molly Gathright,

eases. He served on the faculty at Harvard for 13

Xia hopes to see that number increase in the

MD, assistant dean of the Graduate Medical Edu-

years while also directing the cardiology fellow-

future. “The UAMS Radiation Oncology Cen-

cation office and the College of Medicine admin-

ship program at Brigham and Women’s Hospital.

ter sees about 900 patients each year. As that

istration. Xia also expressed gratitude to Peter

In 1993, he moved to Wayne State University in

number grows, we have the potential to increase

Emanuel, MD, director of the UAMS Winthrop

Detroit, where he later was appointed director of

our residency numbers as well,” she said, adding

P. Rockefeller Cancer Institute, for his support

cardiology, and in 2001, became associate chair of

that there are only 193 radiation oncology resi-

and encouragement throughout the rigorous

the Department of Internal Medicine.

dency slots available in all programs across the

application process and to Highlands Oncology

United States.

Group in northwest Arkansas for its partnership

UAMS to Offer Arkansas’ First-ever Radiation Oncology Residency Program

Residents for the 2018 and 2019 slots have already been selected through a highly compet-

in providing additional training opportunities for residents.

itive application process. Physicians interested in

“We received approval from the ACGME our

Radiation oncology is a complex and competi-

pursuing radiation oncology must have already

first application attempt, with no conditions

tive field, attracting some of the brightest medical

completed a one-year internship, and many also

attached. This is a rare accomplishment and

students from across the country. Until now, how-

have earned doctoral degrees in addition to med-

could not have happened without the support

ever, anyone in Arkansas interested in pursuing

ical degrees.

of the entire Department of Radiation Oncology

a career in radiation oncology had to leave the state for advanced training.

“This field draws an impressive caliber of medical students, many who have already published

This summer, that will change when Arkansas’

academic papers and conducted important

first-ever radiation oncology residency program

research,” said Thomas Kim, MD, assistant pro-

welcomes its inaugural resident at UAMS.

fessor in the Department of Radiation Oncology

and many others at UAMS,” said Xia.

UAMS’ Niki C. Carter, DMD, Named a Regent for International College of Dentists

“UAMS has recognized the need for a resi-

and assistant director of the residency program.

The International College of Dentists USA Sec-

dency program for many years, and establish-

Kim, who joined UAMS in 2017, was recruited

tion Board of Regents has named Niki C. Carter,

ing it has been high priority since I arrived in July

not only to treat patients, but also to help

DMD, director of the General Practice Residency

2016. Many people and groups at UAMS came

advance the department’s educational standing.

(GPR) program at the University of Arkansas for

together to support this dream and make it a real-

He and others in the department took an active

Medical Sciences (UAMS), the new Regent for

ity,” said Fen Xia, MD, PhD, chair of the Depart-

role in the accreditation application and site visit,

District 12.

ment of Radiation Oncology in the UAMS Col-

as well as in interviewing and selecting the pro-

lege of Medicine and director of the Radiation

gram’s first residents.

Oncology Residency Program. The goal of the four-year program is to educate the next generation of radiation oncologists,

“I look forward to developing the curriculum and ensuring we meet our educational goals moving forward,” said Kim.

Her four-year term began Jan. 1, 2018. Region 12 includes Arkansas, Kansas, Louisiana, and Oklahoma. In addition to overseeing the GPR program, the first such dental residency program in Arkansas,

whether they choose to treat patients, conduct

In addition to the Department of Radiation

Carter is also an associate professor in UAMS’

research, teach, or practice any combination of

Oncology faculty and staff, other groups and

Center for Dental Education, which is part of the



appreciate you.’ We appreciate your leadership

well-deserved, not just because of what you’ve

“It is such an honor to be named a regent,” said

at UAMS of our clinical, academic, and research

accomplished, but because of the promise for

Carter. “I look forward to representing the den-

activities that support our overall mission, and we

the future.”

tists of District 12 and bringing their concerns to

appreciate everyone who has helped make this

the International College of Dentists leadership.”

chair a reality.”

College of Health Professions.

During the ceremony, McDonald was presented with a commemorative medallion by Gardner and

Carter is a member of the American Dental

The chair is named in honor of Ferris, who

Association and has held various leadership roles,

chaired the Department of Radiology for 31 years,

including president of the Arkansas State Dental

helping bring comprehensive subspecialty train-

“It goes without saying that receiving the Ernest

Association’s (ASDA) Central District Dental Soci-

ing and highly specialized radiological care to

J. Ferris Chair in Radiology is the highest honor

ety, ASDA District Executive Council representa-

Arkansas. He trained more than 350 fellows and

of what’s now a pretty long career, and I’ll be for-

tive, and ASDA New Dentist Chair of Arkansas.

residents at UAMS, six of whom have gone on

ever grateful,” McDonald said. “Our more than

She has served as chair of the Arkansas chapter

to become department chairs at various medical

100 years of history in radiology at UAMS and the

of the American College of Dentists, president of

schools. Ferris ultimately expanded the depart-

contributions of our founders, faculty, residents,

the Pulaski County Dental Society, and president

ment to include 50 radiologists with diverse sub-

and alumni constitute a powerful legacy. It’s our

of the Arkansas Chapter of National Association

specialties before he stepped down as chair in

privilege now to continue to build on those rela-

of Women Business Owners, as well as deputy

2008.

tionships that have made us so strong as we move

regent and vice regent of the International College of Dentists.

Ferris, who attended Boston University School

Christopher Westfall, MD, interim dean of the College of Medicine.

into our second century.”

of Medicine, held faculty positions at Harvard Uni-

McDonald recognized nearly every person in

The International College of Dentists describes

versity and Tufts University, and served as chief

the room with thanks, from department heads

itself as an “honorary organization that recognizes

of radiology at Boston University Medical Center

and faculty to technologists, staff, and residents.

outstanding and meritorious service to dentistry

for eight years before being recruited to UAMS

He also thanked his wife, Donna, and his family

and communities throughout the world.” The

in 1977.

for their support.

organization’s core values are integrity, leadership, and service.

James E. McDonald, MD, Invested in Ernest J. Ferris, MD, Chair in Diagnostic Radiology

Known nationally and internationally for his con-

“The Ferris chair is primarily for our residents

tributions to the field of radiology, Ferris received

and their education, and the strengthening of

the American Board of Radiology’s Distinguished

the faculty who have the sacred responsibility to

Service Award in 2000 and was presented with

help our residents become radiologists,” McDon-

the Radiological Society of North America’s high-

ald said.

est honor, the Gold Medal, in 2001. At UAMS, he

McDonald received his medical degree summa

James E. McDonald, MD, FACR, chair of the

received the Caduceus Club’s Distinguished Fac-

cum laude from the University of Mississippi

Department of Radiology in the College of

ulty Award in 1996 and the Dean’s Distinguished

School of Medicine and completed an internship

Medicine at the University of Arkansas for Medi-

Faculty Scholar Award in 2007. College of Medi-

in surgery and pathology at the Louisiana State

cal Sciences (UAMS), was invested as the holder

cine students recognized him four times with the

University School of Medicine in New Orleans.

of the Ernest J. Ferris, MD, Chair in Diagnostic

Red Sash Award.

He completed his residency in diagnostic radiol-

A ceremony, held in the Diner Learning Cen-

ogy at the Mallinckrodt Institute of Radiology at

McDonald, who joined UAMS in 2010, was

ter at UAMS’ main Little Rock campus, served

Washington University in St. Louis, serving as co-

appointed department chair in November of

as a celebration of the department, with radiol-

chief resident in his final year, and continued his

2016. An endowed chair is among the highest

ogy staff, technologists, residents, alumni, and

training with a fellowship in nuclear medicine at

academic honors a university can bestow on a

faculty members participating. Ferris attended,

UAMS and Mallinckrodt.

faculty member and is established with gifts of

along with Phillip Kenney, MD, who served as

He joined the College of Medicine full time as

at least $1 million. The funds are invested and

department chair from 2008-2012. With McDon-

an assistant professor and director of the Divi-

the proceeds are used to support the educa-

ald, the three men represent more than 40 years

sion of Nuclear Medicine in 2010, and has served

tional, research, and clinical activities of the chair

of department history.

as director of the Nuclear Medicine Residency

Radiology.

holder. Those named to a chair are among the

“Jim is an incredibly important leader on this

Program since 2013. He served as interim co-vice

most highly regarded scientists, physicians, and

campus, and hence in this state,” said Richard

chair of the department from 2012 to 2014 and

professors in their fields.

Turnage, MD, senior vice chancellor for clinical

was promoted to interim chair in May of 2014.

“I congratulate Dr. McDonald for the many

programs and chief executive officer of UAMS

He was promoted to associate professor in July

accomplishments that have merited this

Medical Center. “The department has thrived

2016 and was named chair in November of 2016.

honor,” said UAMS Interim Chancellor Stepha-

under his leadership, and we look forward to

McDonald was a partner in Radiology Associ-

nie Gardner, PharmD, EdD. “From one South-

even greater success for the department and

ates P.A. in Little Rock from 1983 to 2010, where

erner to another, the best way to say this is, ‘We

the university. This important honor is incredibly

he served on its governing board, including a


Healthcare Briefs status after serving with distinction, said Larry

the University of Arkansas for Medical Sci-

Alman, board chair. They retain all the rights and

ences (UAMS), recently will held a public

privileges of regular board members. Grundfest

forum, NASA Spinoffs in Arkansas. Panelists dis-

is the fifth member of the board to be honored

cussed the advanced engineering, medical, and

as a lifetime member. The other four are Sissy

educational benefits of NASA and the space

Clinton, Jo Ellen Ford, Martha Murphy, and Judy

exploration program.

Snowden.

Judy Grundfest

A panel included Antino Allen, PhD, assistant

“We are deeply grateful to Judy for all the

professor, department of pharmaceutical sciences

encouragement and wisdom that she has given

in the UAMS College of Pharmacy, Little Rock;

to so many,” said Jeanne Wei, MD, PhD, direc-

Darrell Heath, solar system ambassador, Central

tor of the Reynolds Institute. “She is a remarkably

Arkansas Astronomical Society, Little Rock; and

resilient and amazing role model for all of us”

Andy Chouinard, PhD, manager, Optical Engi-

Grundfest was an active volunteer in the early

neering, BEI Precision Systems and Space Co.,

term as chair. He was active on the medical staff at

years of the institute’s 20-year history, especially

St. Vincent Infirmary, now CHI St. Vincent, where

in the effort to raise funds to build the Reynolds

Science Café Director Linda Williams, MS, who

he was chief of nuclear medicine from 2003 to

Institute’s building on the UAMS main campus.

is also a research liaison with the UAMS Division

2010 and led a fundraising campaign for nurs-

She worked diligently with other board members

of Research, moderated the event.

ing education. At Southwest Regional Medical

on a campaign that raised a total of $24 million

Center, his leadership posts included chief of

in two fund-raising campaigns. The result is the

the Department of Radiology, chief of staff, and

eight-story building that houses clinics, research,

chair of the advisory board. He also served as an

and administrative offices.

adjunct clinical assistant professor in the UAMS Department of Radiology from 2003 to 2006. In addition to leading the Department of Radiology, McDonald has championed implement-

Maumelle.

UAMS Sponsors Free Smoking Cessation Program Smokers ready to kick the habit were invited to

She was the second person to lead the Commu-

participate in a free seven-week program spon-

nity Advisory Board as its chair from 2001-2002,

sored by the University of Arkansas for Medical

and has been a board member for a total of more

Sciences (UAMS).

than 12 years.

The small-group Freedom from Smoking pro-

ing imaging decision support algorithms into the

In 2005, Grundfest was awarded the Jo Ellen

gram met from 5-6:30 p.m. for seven Tuesdays

Epic electronic medical records system at UAMS

Ford Distinguished Service Award by the Advisory

and led an effort to ensure appropriate use of

Board. The board noted at the time her important

Participants received a one-on-one support,

mobile chest radiography. He was named both

contributions and volunteer work in establishing

heard first-hand stories from former smokers,

director and medical director of the Imaging Ser-

the Ottenheimer Therapy and Fitness Center at

and received information on nicotine replace-

vice Line in 2015. He is the director of Nuclear

the Reynolds Institute. She also serves as chair of

ment therapies, healthy eating habits, and stress

Medicine and PET and an expert on the molecu-

the Ottenheimer Brothers Foundation.

management.

starting April 24 at 900 John Barrow Road.

lar imaging of multiple myeloma, and serves as

“She has served with great dignity, enthusi-

Since it was introduced by the American Lung

McDonald a consultant to the UAMS Myeloma

asm, and is widely admired, not only for her work

Association (ALA) almost 30 years ago, the Free-

Institute. He assists in the integration of quanti-

ethic and the volunteer hours she puts in, but also

dom from Smoking program has helped more

tative imaging and radiomics into research initia-

for her generosity,” Alman said. “Judy is some-

than 1 million Americans end their addiction to

tives for the Department of Biomedical Informat-

one who is dependable, sincere, and always fol-

nicotine. The program was offered by the UAMS

ics and chairs the Radiation Safety Committee.

lows through. She is very deserving of a lifetime

Winthrop P. Rockefeller Cancer Institute and used

membership.”

materials provided by the ALA.

McDonald was named a Fellow of the American College of Radiology in 2016.

Judy Grundfest Named Lifetime Member of UAMS Reynolds Institute on Aging Community Advisory Board Judy Grundfest recently was made a lifetime member of the UAMS Donald W. Reynolds Institute on Aging Community Advisory Board by the board’s executive committee. A member of the board is eligible for lifetime

The Reynolds Institute on Aging Advisory Board members serve as ambassadors to support and publicize the Reynold’s Institute on Aging’s mission, which includes eight Centers on Aging

AMA Applauds Surgeon General’s Call for Expanded Availability of Naloxone

located throughout the state where the needs

The following statement is attributed to Patrice

of an aging generation are met with the highest

A. Harris, MD, MA, chair of the AMA Opioid Task

standards of service, research, and care.

Force.

Science Café Focuses on NASA Spinoffs in Arkansas

endorses the Surgeon General’s advisory on nal-

Science Café Little Rock, co-sponsored by


“The American Medical Association strongly oxone. The AMA Opioid Task Force has encouraged physicians to co-prescribe naloxone for all


patients at risk of overdose. Surgeon General

one-on-one consulting, commercialization sup-

Adams, physicians, first responders, and public

port, talent development, and collaboration.

Diego School of Medicine. “To be able to reduce the reliance upon opi-

health advocates all recognize that naloxone is a

The Boot Camp is an intensive, weeklong pro-

oids and other medications with side effects, it is

literal lifesaver and a vital tool in our fight against

gram during which students identify problems

crucial to establish evidence showing mind-body

the opioid epidemic. Patients, family members

or opportunities in healthcare, and then work in

practices like yoga provide cost-effective benefits

and friends should not hesitate to ask their physi-

interdisciplinary student teams to formulate new

in both veterans and non-veterans with chronic

cians to prescribe naloxone so they can save their

venture ideas, talk to potential customers, meet

pain,” Groessl said.

own or their loved one’s lives. Many states have

with influential faculty, and work closely with men-

“The study results suggest that yoga, which is

made naloxone available without a prescription.

tors from the healthcare industry. The boot camp

typically delivered in a group format, is a relatively

All forms of naloxone should be readily available

coaches the teams through everything from entity

low-cost intervention and has a favorable cost-

and covered by insurance plans with minimal or

filing and intellectual property to creating a sus-

effectiveness ratio. Using intent-to-treat data,

no cost-sharing. The AMA looks forward to work-

tainable entrepreneurial team.

yoga was delivered for about $23 per session/

ing closely with the Surgeon General’s Office to

“This camp is emblematic of the Conductor’s

help bring an end to the epidemic of opioid over-

mission to foster and nourish entrepreneurial tal-

dose deaths.”

ent within our state,” said Jeff Standridge, chief

In the United States, chronic low back pain is

catalyst for the Conductor. “This camp creates

the leading cause of lost productivity and the sec-

opportunities to show students that there are

ond most common cause for physician visits. Bil-

viable career paths to entrepreneurship, and to

lions of dollars are spent each year in the United

introduce them to the vast experts and resources

States on healthcare related to back pain. Mili-

in the state’s health sciences.”

tary veterans and active duty military personnel

Health Sciences Entrepreneurship Boot Camp Arkansas undergraduate and graduate college students will learn the fundamentals of entrepre-

participant, considerably less than the average cost of physical therapy,” Groessl said.

neurship and forming new health science ven-

In 2017, the camp’s inaugural class had rep-

have higher rates of chronic pain than the gen-

tures at a residential boot camp at the University

resentation from 10 colleges and universities,

eral population, and the back is the area of the

of Central Arkansas (UCA) in Conway.

empowering students from around the state with

body that is most commonly affected. In addi-

The Health Sciences Entrepreneurship Boot

the knowledge and tools they need to think criti-

tion to pain, those with the condition also report

Camp will be held May 20-25. It is a joint initiative

cally, learn entrepreneurial principles, and launch

increased disability, psychological symptoms, and

of the University of Arkansas for Medical Sciences

innovative ventures. Additionally, the camp offers

reduced quality of life.

(UAMS), Arkansas INBRE, BioVentures, and The

leadership, team building, and other recreational

Conductor, a public-private partnership with UCA

experiences in Conway.

In the study, veterans were randomly assigned to either yoga or to receive care as usual. Veter-

and Startup Junkie. Arkansas IMBRE (IDeA Net-

BioVentures is a technology commercialization

ans in the yoga group attended yoga two times

works of Biomedical Research Excellence) helps

organization and startup incubator focused on

a week for 12 weeks, whereas comparison partici-

build research infrastructure across the state.

promoting a biomedical technology industry for

pants were invited to attend the same yoga pro-

Arkansas and translating research into products

gram only after six months. The 12-week yoga

that benefit human health.

intervention consisted of two 60-minute instruc-

The residential camp is all-expenses-paid, and is funded through UAMS, Arkansas INBRE, BioVentures and the Conductor. Eligible students must have completed their sophomore year of college. Space permitting, there will be spots available for immediate graduates and graduate students.

tor-led yoga sessions per week, with home prac-

Yoga Shown to be CostEffective for Chronic Back Pain Management

tice sessions encouraged. The main results of this study were published in July 2017, and showed that yoga participants

Yoga is a low-cost strategy for treating veter-

had larger improvements on measures of pain,

For more information about the Health Sciences

ans with chronic lower back pain, according to a

disability, fatigue, physical function, and quality

Entrepreneurship Boot Camp, visit www.arcon-

new Veterans Affairs (VA) San Diego Healthcare

of life. Prior research produced similar finding in

ductor.org/bootcamp.

System study recently presented at the Society of

non-Veterans samples, but the current study is

Behavioral Medicine’s Annual Meeting & Scien-

one of the first to document the costs and cost-

tific Sessions in New Orleans.

effectiveness of yoga. n

“We’re thrilled to partner with the Conductor to offer this camp again this year,” said Nancy Gray, PhD, director of BioVentures. “This camp is inte-

In a study including 150 military veterans

gral in creating a statewide, biomedical research

with chronic lower back pain, researcher Erik

infrastructure in Arkansas, and expands the state’s

J. Groessl, PhD, and his VA San Diego team

health sciences entrepreneurial network.”

found that when compared to care as usual,

The Conductor drives innovation, entrepre-

yoga improved function and reduced pain, and

neurship, and economic development in central

was inexpensive to provide. Groessl is also a

Arkansas through high-impact programming,

researcher with the University of California San


column policy

In a special session called by Gov. Asa Hutchinson in March, the Arkansas General Assembly adopted legislation that will make Arkansas the first state in the nation to shed light on a part of the pharmaceutical pricing

Increasing Transparency Around Drug Costs

process that until now has taken place largely in the shadows.

The legislation authorizes Arkansas

pharmacies for filling a prescription. Both

to license and regulate pharmacy benefit

public and private payers have turned to

managers, or PBMs. Its passage was in part

PBMs for help in holding down drug costs

a response to a lack of transparency in how

through their ability to negotiate rebates

healthcare dollars are flowing for critical

from drug manufacturers. But the role of

needs such as prescription drugs.

PBMs in the drug pricing process has largely

PBMs, which negotiate contracts with prescription drug makers and pharmacies

been shielded from outside eyes and has become increasingly controversial.

on behalf of health plans, play a significant

Two years ago, the state—through its Em-

role in determining the amounts paid to

ployee Benefits Division that manages the


Joseph W. Thompson, MD, MPH Director, Arkansas Center for Health Improvement

Arkansas State and Public School Life and Health Insurance Plan, the largest self-insured plan in the state—terminated its relationship with its PBM for failure to dis-

“The newly enacted law prohibits a PBM from paying a pharmacy an amount lower than the wholesale cost of a drug.”

close financial distributions as required in the PBM’s contract. The state subsequently contracted for network and claims management through a new PBM but is negotiat-

Department. The law also requires a PBM

to justify increasing prices above a certain

ing rebates through the Evidence-Based

to contract with a sufficient number of phar-

threshold, for example.

Prescription Drug Program (EBRx), which

macies, not including mail-order services, to

In 2015, the Arkansas General Assembly

operates within the University of Arkansas

provide “convenient patient access to phar-

and Gov. Hutchinson approved the Arkan-

for Medical Sciences College of Pharmacy.

macies within a reasonable distance from a

sas Healthcare Transparency Initiative Act,

patient’s residence.”

which states that “greater transparency of

Earlier this year, pharmacists in the state complained that a PBM had lowered the

The newly enacted law prohibits a PBM

healthcare utilization, quality, and price

reimbursement paid to pharmacies to rates

from paying a pharmacy an amount lower

information leads to more informed, en-

that were often less than the amounts the

than the wholesale cost of a drug. It also

gaged, activated consumers.” The initia-

pharmacies paid for the pharmaceuticals,

prohibits a PBM from including in a con-

tive is powered by the All-Payer Claims

forcing pharmacists to choose between

tract a gag clause to bar a pharmacist from

Database (APCD), administered by the

selling the drugs at a loss or turning away

providing information to state or federal of-

Arkansas Center for Health Improvement

patients. Pharmacists also protested that

ficials or telling customers about the total

(ACHI) with oversight by the state Insur-

PBMs were providing differentially higher

cost of a drug or a less expensive alterna-

ance Department.

rates to chain-owned/operated pharmacies

tive drug.

The APCD contains medical, pharmacy,

than independent pharmacies. The uproar

Also, the new law authorizes the Insur-

and dental claims and enrollment data from

led the governor to call a special session

ance Department to enforce Act 900 of 2015,

public and private payers dating back to

that resulted in passage of The Arkansas

which prohibits a PBM from reimbursing a

2013. ACHI is currently conducting a study to

Pharmacy Benefits Manager Licensure Act.

pharmacy with which it is not affiliated less

determine what data elements in the APCD

The new law requires a pharmacy ben-

than it reimburses a pharmacy with which

may assist the Insurance Department in the

efit manager in Arkansas to obtain a license

the PBM is affiliated for the same drug. A

development of regulations under The Ar-

from the Arkansas Insurance Department.

violation of Act 900 is a misdemeanor and

kansas Pharmacy Benefits Manager Licen-

The Insurance Department must propose

can be the basis of a lawsuit by the Arkansas

sure Act. As Arkansas is the first state with

licensing rules and submit them to the Ar-

Attorney General.

PBM oversight, the results of this study will

kansas Legislative Council in time for the

The 2018 law does not apply to companies

council to consider approving them before

that fund their own insurance plans. Those

Sept. 1, when the rules go into effect.

plans are regulated by the U.S. Department

The Arkansas Insurance Commissioner is

of Labor.

be of interest to other states as they address similar issues. Transparency is an important tool in the effort to lower healthcare costs and improve

authorized under the law to review and ap-

No other state has taken an oversight

the quality and efficiency of the healthcare

prove a PBM’s compensation plan to ensure

role of PBMs as aggressive as Arkansas’s,

system. The governor’s call and the legisla-

that the reimbursement rate paid to phar-

but some states are promoting transpar-

tors’ actions regarding PBMs are the latest

macies is “fair and reasonable to provide

ency in other ways as they seek to hold down

steps toward better understanding and un-

an adequate pharmacy benefits manager

prescription drug costs. Several, including

locking information about how almost one

network for a health benefit plan under the

Vermont, Nevada, Maryland and California,

out of every five dollars changes hands in

standards issued” by the state Insurance

have passed laws that require drug makers

the state of Arkansas. n


dialogue

column

Director’s Desk

ADH Programs to Address Heart

attack and stroke deaths

There are a multitude of costly illnesses and diseases that affect Arkansans; however, time and again, heart attack and stroke rise to the top of the list for both fatality and expense. Arkansas has the highest rate of heart attack, or Acute Myocardial Infarction (AMI), in the country, with over 2,500 deaths reported annually. ST-segment elevated myocardial infarction (STEMI) is a deadly form of AMI with out-of-hospital mortality up to 50 percent. The national average health care cost

and diagnosis and treatment can significant- to work with other regions in the state later

to treat a heart attack victim in the first 90

ly improve outcomes. Second, promoting

this year. For EMS, this includes following

days is $39,000—not including lost wages or

healthy behaviors can prevent strokes and

patient care guidelines, such as performing a

any other associated costs. Stroke deaths are

STEMIs from happening in the first place.

pre-hospital stroke screen, applying a stroke

not far behind heart attack in the rankings:

To reduce the time lapse between onset

patient wristband, pre-notifying the receiving

Arkansas ranks fifth in the nation for stroke

of symptoms, diagnosis and treatment for

hospital that a suspected stroke patient is en

deaths, with 1,500 people dying annually.

Stroke/STEMI, the ADH is taking a regional

route, and meeting appropriate destination

Strokes in Arkansas occur at a rate of 9,600

approach with extensive collaboration be- and transfer protocols. The stroke wristbands

per year, or 27 per day. It is the leading cause

tween Emergency Medical Services (EMS)

of disability and long-term care admissions

providers and hospitals, as well as com- the quality improvement process and have

among Arkansans. Nationally, stroke care

munity education. This approach is based

costs are $34 billion annually, with life-time

on the model for the state’s trauma system.

care after a stroke estimated at $103,000.

The ADH has begun by focusing on the

are a particularly important component of been a cornerstone of the trauma system’s success. The identification numbers printed on the bands are used to connect the pre-

Statistics this grim call for a proactive ap-

southwest region of the state. This area was

hospital and in-hospital data systems to

proach to address both stroke and STEMI.

chosen due to the existing infrastructure

track the patient from first medical contact

In 2016, the Arkansas Department of Health

and readiness of the partners in the region.

through discharge in order to drive perfor-

(ADH) Stroke/STEMI Section was created to

The Stroke/STEMI Section is working with

mance improvement.

reduce the impact of these diagnoses among

providers to ensure a common standard

Hospitals that demonstrate they meet

Arkansans by focusing on two things. First,

of care is followed by pre-hospital (EMS)

evidence-based standards in acute stroke

reducing the time between a stroke or STEMI

and in-hospital providers and is planning

performance are able to qualify as designated

44 MAY / JUN 2018 I Healthcare Journal of LITTLE ROCK

Nathaniel Smith, MD, MPH Director and State Health Officer, Arkansas Department of Health

“To evaluate the success of the system, accurate and complete data are critical. The Stroke/ STEMI Section has recruited 13 hospitals in the region to participate in the Arkansas Stroke Registry, which is vital to allowing the program to identify and close gaps in patient care.”

(ASLS®) curriculum to increase application of

(STAC) that consists of healthcare profes-

the latest evidence-based stroke guidelines

sionals from across the state including car-

(seven hospitals across the state are now

diologists, pre-hospital providers, nurses

certified ASLS training centers).

and public health officials. This group was

The work ADH is doing to address stroke

formed to coordinate efforts to optimize

is being guided by the Arkansas State Leg-

STEMI patient care. The group is working to

islature-appointed Arkansas Acute Stroke

ensure Arkansas healthcare providers apply

Task Force. This task force consists of

the latest evidence-based STEMI guidelines

healthcare professionals from different

through a web-based STEMI education pro-

agencies across the state such as neurolo-

gram available to all healthcare providers

gists, pre-hospital providers, nurses, and

across the state who manage acute STEMI

public health officials.

patients. In addition, the STAC and ADH

Arkansas Stroke Ready Hospitals (ArSRHs).

The ADH is also taking a regional ap-

have launched a Dial, Don’t Drive public

At this time, two of the hospitals in the re-

proach to STEMI care to put in place stan-

awareness campaign for both stroke and

gion are designated as Primary Stroke Cen-

dards of care to optimize patient outcomes.

STEMI to educate the public about heart at-

ters by The Joint Commission, while two

This includes implementing a pilot program

tack and stroke signs and the importance of

of the hospitals are designated by ADH as

in three Arkansas regions (northeast, north

calling 911 right away if either is suspected.

ArSRHs. Three additional sites are provision-

central and southwest) to improve care

Finally, the ADH recognizes the important

ally designated as ArSRHs (official designa-

coordination between EMS and hospital

role that lifestyle changes play in reducing

tion is expected shortly).

emergency departments and to reduce pa-

risk of heart attack or stroke. These include

To evaluate the success of the system,

tient treatment times. There are a total of

quitting smoking, moving more, and eating

accurate and complete data are critical.

18 EMS services and 14 hospitals partici-

healthy foods. By quitting smoking, people

The Stroke/STEMI Section has recruited

pating in this program. The pilot includes

can lower their blood pressure and reduce

13 hospitals in the region to participate in

various components, such as providing 12-

their risk of heart disease. Arkansans can get

the Arkansas Stroke Registry, which is vi-

lead EKG equipment to EMS services, uti-

help quitting by contacting the Arkansas To-

tal to allowing the program to identify and

lizing a cellphone application platform to

bacco Quitline at 1-800-QUIT-NOW. In ad-

close gaps in patient care. In addition, the

enable efficient data transfer between EMS

dition, efforts such as Healthy Active Arkan-

program is working on additional quality

and hospitals, and web-based education to

sas provide a menu of available resources

improvement efforts and trainings in the

increase application of the latest STEMI pa-

to Arkansans to help them be more physi-

region. Forty-five new instructors have been

tient care guidelines.

cally active and choose nutritious healthy

certified and more than 300 providers have

The STEMI pilot is being guided by the

trained in the Advanced Stroke Life Support

recently-formed STEMI Advisory Council

food. Information on HAA can be found at healthyactive.org. n


column Mental Health

I wonder what would happen if you received the following message from a friend, co-worker, or family member:

Last year I was reading an article—on my phone, of course—and I was shocked to learn that the typical cell phone user touches their phone 2,617 times a day. A heavy user touches their phone up to 5,400 times a day. I remember feeling a bit odd to learn I was considered a heavy user. I was thinking about this again recently when I realized how much more I now do on my phone. In fact, it is hard for many of us to do anything without our cell phones. We surf, read, chat, post, argue, and snap; we check them when they alert us, which is often. We want to be alerted about everything because we are so involved, and frequently tell others how busy and involved we are. It is almost a matter of pride. We seem to believe this is a great communication tool for people. But are we really involved with people?

Hey, Can I tell you something?

…

Would you answer? If so, how quickly would you respond? Does this question cause you fear or worry about what you might learn? More importantly, are you sure you would respond properly? How will you know if you have done the right thing? When it comes to mental health, I think the reason many may not know how to respond

Responding to Mental Health: It Doesn’t Have to Be Complicated

to someone reaching out for help is because they have never been faced with it. Take a moment to consider these statistics gathered from The National Institute of Mental Health. 1 in 5 adults experience mental illness in a given year; one-half of all lifetime cases of mental illness begin by age 14, and threequarters by age 24; the average delay of onset of symptoms and treatment is 8 – 10 years. These staggering numbers indicate that, statistically speaking, everyone knows someone suffering from mental illness. While we post, chat, argue, and snap about the latest symptoms of allergies or physical illnesses, or even a cancer diagnosis and treatment, we rarely see this for mental illness. Unfortunately, mental illness is still plagued by shame and social stigma. Misperceptions are rampant. Your response to someone reaching out for help is critical. The proper response may seem complicated, but it doesn’t have to be. If someone has made that difficult and brave


Kim Arnold Executive Director NAMI Arkansas

• Feeling very sad or withdrawn for more

“Your response to someone reaching out for help is critical.”

than 2 weeks (crying regularly, feeling fatigued, feeling unmotivated) • Trying to harm or kill oneself, or making plans to do so • Out-of-control, risk-taking behaviors that can cause harm to self or others • Sudden overwhelming fear for no reason, sometimes with a racing heart, physical discomfort, or fast breathing • Not eating, throwing up, or using laxatives to lose weight; significant weight loss or gain • Severe mood swings that cause problems in relationships • Repeated use of drugs or alcohol • Drastic changes in behavior, personality, or sleeping habits (waking up early, acting agitated) • Intense worries or fears that interfere with daily activities If this describes you or someone you know, follow the steps. Be brave. Say it out loud. Tell someone. Someone will listen. Educate yourself. It is not complicated. n

first move, whether by text, email, phone call,

Sometimes a person just wants to tell some-

or even a personal conversation in a trem- one else about a loved one’s diagnosis. Or, it may be about their own mental health con- Kim Arnold was born and raised in South Carolina. Relocating from Topeka, Kansas to Arkansas in May 2005, she joined NAMI and it only takes a few steps to be on your assistance in finding help for themselves or Arkansas as Executive Director in November that same year. Ms. Arnold has 30 a loved one. way to helping someone in need. years of experience in the mental health First, you must respond. Let them know This may guide you to the third step—edu- area, including the for-profit arena of psyyou will listen, and that you are there for cate yourself about local mental health re- chiatric inpatient hospitalization, the notthem. That is the first thing they need to sources in your area. You may also need to for-profit sector of community mental health and advocacy. Before coming to know. They need to hear, “Yes, you can tell educate yourself about the warning signs of Arkansas she spent 15 ½ years with a notme something. You can tell me anything. I mental health conditions, and find out how for-profit Community Mental Health Center as a member of Senior Management, am listening.” Reassure the person that it is you can be an advocate for your friend, family overseeing the day to day operations of safe to talk to you. member, or co-worker. several clinical and administrative proThe second thing you need to do is listen, The last step is to encourage the individual. grams, focusing on community based services. Ms. Arnold has expanded and reand listen without judging. As a colleague of Encourage them to continue their journey, established the support, advocacy, and mine says, “You can walk a mile in someone because it is an important one. Let them education efforts of NAMI Arkansas to include children and senior citizens, along else’s shoes, but you can’t know what it’s re- know you will be there. with the adult population. She served as ally like until you have removed your shoes The following are signs of possible mental Commissioner on the Children’s Behavioral Health Care Commission for 11 years. first.” Listening guides you to the next step. illness: bling voice, they trust you. Now all you need

to know is what to do. That is the easy part,

dition. Sometimes the person may just need


column medicaid

WHO WANTS TO BE A TYPE 2 DIABETIC?

No one, of course, wants to be a type 2 diabetic. Nevertheless, 86 million Americans — one third of the adult population — are prediabetic and nearly 90 percent are unaware of their risk to become a type 2 diabetic. Prediabetes is defined differently by different organizations, but a fasting glucose over 100 (American Diabetes Association) or a hemoglobin A1c greater than 5.7 are common definitions. Without intervention, 5-10 percent of people who are prediabetic will develop diabetes (fasting glucose > 125) every year. Who is at risk for prediabetes? The American Diabetes Association and the Centers for Disease Control indicates that individuals with a BMI>25 or a history of gestational diabetes should be screened for elevated fasting blood sugars. African Americans and patients with Asian heritage could be screened

William Golden, MD Arkansas Medicaid Medical Director

if their BMI>23. High blood pressure, high cholesterol, and other metabolic problems also increase risk. Given those parameters, the majority of Americans are at risk of being prediabetic. In light of the health consequences of developing type 2 diabetes, what should individuals do to manage their risks and likewise, what should the health system do in response to this large scale challenge?

“Patients who can reduce body weight by 5 percent and sustain that change have 50 percent less chance of developing type 2 diabetes as compared to individuals who do not embark on personal change.”

Lifestyle always wins the day Obesity is the major driver for developing type two diabetes. Fortunately, studies have

program, a DDP site must document that

drop out by week 16 of the program. Good

documented that structured weight loss, ex-

greater than 60 percent of enrollees attend at

coaches do make a difference. Statistics indi-

ercise, and lifestyle modification programs

least nine sessions in the first six months and

cate that retention is high if enrollees make it

can make a difference. Patients who can re-

three sessions during the second six months.

to at least four DPP group visits. Different de-

duce body weight by 5 percent and sustain

Certified programs can get over 35 percent of

mographic groups show variation in program

that change have 50 percent less chance of

their participants achieving 5 percent weight

participation. Data on DPP effectiveness for

developing type 2 diabetes as compared to

loss or greater, as well as provide substantial

Medicaid beneficiaries is limited but slowly

individuals who do not embark on personal

documentation of ongoing monitoring of the

emerging. Arkansas Medicaid is working with

change. Initiation of the drug metformin, an

weight and physical activity.

the Arkansas Department of Health on a pilot

inexpensive medicine that facilitates up-

Increasingly, insurance entities, even

take of glucose by muscle cells, can reduce

Medicare, have begun to pay for participation

program to assess the structure and impact of

conversion of prediabetic patients to type 2

in these recognized programs. Costs can vary

So, who wants to be a type 2 diabetic? No

diabetes by a third, but is less effective than

substantially. DPP advocates study coaching

one; but too few are ready to commit to the

weight loss and lifestyle change, especially

composition that can reduce costs but still

changes necessary to lessen their long term

in older patients.

DPP for its population under coverage.

attain results. Small group teaching is more

risk for diabetes. Community health services

Achieving weight loss is never easy. The

efficient than individual coaching; commu-

are evolving to support lifestyle change, but

clinical literature has produced numerous

nity health workers are less expensive than

individual patients must decide that such

negative studies regarding routine counsel-

pharmacists and dieticians. Televideo, online

change is a priority for their own futures. n

ing and dietary advice. The CDC, in concert

support systems, and other virtual experi-

with the YMCA system, has pioneered a year-

ences are under development as well. Many

long program Diabetes Prevention Program

structured programs can now deliver DPP

(DPP) of counseling and reinforcement that

for under $500 a participant for the year-

can reliably achieve 5 percent weight loss in

long intervention.

participants. Participants attend at least 16

Substantial barriers remain. Community

small group classes offered every week for

capacity to deliver effective services is lim-

six months and then a monthly follow up

ited, but growing. Insurance coverage of

session for an additional six months.

screening and treatment is expanding. But

The CDC now organizes a certification

access and financing is just the start.

process to identify community sites that will

Ultimately, individuals must decide to

produce consistent outcomes. Recognized

commit to the program. Even after screen-

centers have effective lifestyle coaches and

ing and referral by a health professional, 2/3

supply data that confirm engagement of en-

of patients do not follow through with signing

rolled participants. To remain as a certified

up for DPP. Fifty percent or more of enrollees

Bill Golden, MD, Professor of Medicine at UAMS, holds a secondary appointment in the COPH Department of Health Policy and Management and has been appointed to serve as a member of the guiding committee for the national Health Care Payment Learning and Action Network. The network, which is under the federal Centers for Medicare & Medicaid Services (CMS), was convened to identify payment models and reforms that will lead to better care at lower costs – primarily by tying health care payments not to services but to value and quality of patient outcomes. Dr. Golden, who has been a leader in state and national efforts to move towards payment models that emphasize value over volume, also serves as Medicaid Medical Director for the Arkansas Department of Human Services.


column Acupuncture

By now, everyone is aware of the opioid epidemic that is leading to more heroin addictions and overdoses. I personally know several families who have suffered the loss of a loved one due to this crisis. Theories abound. The New Yorker reported on how pharmaceutical companies, lobbyists, and doctors have fueled the problem in, “The Family That Built an Empire of Pain”. U. S. Senator Claire McCaskill’s, “Fueling an Epidemic: Exposing the Financial Ties Between Opioid Manufacturers and Third Party Advocacy Groups,” describes how manufacturers of opioids have made significant financial investments into third party organizations. Regardless of how we view the origin of the epidemic, the focus now is on how to fix the problem.

Masking the Problem

Politicians are joining the battle, at least in name. President Trump declared the situation a health emergency. “How We Will Win the War on Opioids” stated on www.whitehouse.gov, “On October 26, 2017, President Trump issued a Presidential Memorandum for the Heads of Executive Departments and Agencies to use all lawful means to combat the drug demand and opioid crisis. He also directed the Secretary of the Department of Health and Human Services to declare the crisis a Public Health Emergency.” Yet, there are complaints about lack of funding to combat such an emergency. In September, 2017, the National Association of Attorneys General sent a letter signed by thirty-five state attorneys general, including Arkansas, to the president and CEO of America’s Health Insurance Plans, urging that, “When patients seek treatment for any of the myriad conditions that cause chronic pain, doctors should be encouraged to explore and prescribe effective non-opioid alternatives, ranging from non-opioid medications…to physical therapy, acupuncture, massage, and chiropractic care.” It goes on to point out the important role insurance companies play in giving access to alternative methods of pain management, and make a positive impact in the way providers treat patients with chronic pain. Basically, it asks insurers


Martin Eisele, LAc Evergreen Acupuncture

to cover alternative medicine. The U.S. Sur-

these approaches focus on the front end—

shingles.

geon General spoke in Little Rock in early

There are plenty of research articles

reducing the problem by controlling the

April, saying doctors should be educated

going back decades that demonstrate the

flow of opiates, and monitoring prescrip-

about alternative treatment methods, and

effectiveness of acupuncture for treating

tions. Our own Department of Health says

that these methods should be reimbursed

both chronic and acute pain. For nearly

it is partnering with others, but does not

appropriately. It would be nice if the Ar-

thirty years, the World Health Organiza-

mention acupuncturists, or even massage

kansas Insurance Commission would be

tion and the National Institute of Health

therapists, whose own board is a part of

open to promoting acupuncture.

have listed numerous pain syndromes

the ADH. The Medicaid column referenced

Here in Arkansas, physical therapy,

for which they recommend acupuncture.

a weak evidence base for interventions,

chiropractic, and counseling are already

Acupuncture has also been used as a

and a need to evaluate policy effectiveness,

included in most plans, but acupuncture

complementary treatment for addictions.

still never mentioning alternative treat-

and massage are not. I get regular calls

The National Acupuncture Detoxification

ment methods. The evidence base for acu-

asking whether or not I take insurance.

Association has a protocol for treating

puncture is massive, and the only column

The question is, does their insurance cov-

addictions, using five needles in each ear.

I have seen mention alternative methods

er acupuncture? Arkansas insurers are

This method has been adjusted slightly to

is by the CEO of Bridgeway. It seems that

only required to cover what Medicare

create another protocol called, Battlefield

the CEO of Bridgeway would know more

covers, which does not include acupunc-

Acupuncture, to treat PTSD and anxiety. I

about treating addictions than most of us.

ture. Some plans go beyond that, and will

use these protocols on a regular basis. The

UAMS is even advertising a study using

cover acupuncture, but not many. Howev-

NIH page on this treatment method con-

various other drugs to treat opioid drug

er, many federal and out of state plans do

cludes, “The NADA protocol developed in

dependence. Perhaps they should do more

cover acupuncture. When callers learn the

an era of rampant opiate use has always

studies on acupuncture. Maybe it is time

cost of acupuncture is not covered under

maintained a community and creativity

for the medical community to embrace

their Arkansas plan, they look elsewhere

focus as it has evolved into a tool for mod-

complementary and alternative methods

for relief. Acupuncture is usually the last

ern times with potential for broad applica-

relative to this crisis.

resort because they’ve tried everything

tion in behavioral health, criminal justice,

One of the ways I promote my business

else covered by insurance—drugs, PT, chi-

trauma/disaster responses, and humani-

is to offer doctors a free treatment, so they

ropractic, even surgery. One vital way to

tarian aid. It may be that the appropriate

can see how acupuncture feels, and what

help reduce opioid addiction is to provide

evidence base for the NADA protocol is

their patients would experience if they

coverage for more alternative methods for

this very amassing of small, elegant tri-

were prescribed acupuncture. Sadly, out of

treatment. It makes no sense to limit treat-

als that illuminate the various types of

over three hundred of these generous of-

ment options if we truly want a solution to

applications and outcomes. This review

fers, I have had less than ten accept.

the opioid epidemic.

demonstrates the mounting evidence that

We know opiates only mask the pain,

Acupuncture has been used for centu-

the NADA protocol has positive effects on

and can lead to worse problems, when

ries to treat pain, both chronic and acute.

a host of measures, populations, and treat-

abused. Ignoring proven alternative pain

In the twenty years I have been practicing

ment modalities. It is striking that many

and addiction treatment methods is mask-

acupuncture, I have successfully treated

of the studies reveal NADA’s effectiveness

ing the problem. Now that we are facing a

patients’ heads (migraines, sinus pain, ear

with populations often considered to be

true opioid epidemic, it seems logical that

aches, tooth aches, and Bell’s Palsy), feet

the most difficult to treat.”

doctors and insurers should recommend

(plantar fasciitis, sprained ankles, foot

Why wouldn’t doctors and insurers

acupuncture, chiropractic, massage, coun-

neuropathy, and Achilles pain), and every-

want to use all available non-addictive

seling, physical therapy, and other proven

where in between. Acupuncture is effective

methods for treatment?

methods for pain treatment that focus on

for acute musculo-skeletal pain, and is es-

In this very magazine, the past three

pecially good at treating nerve pain, such

issues have included articles about ap-

as neuropathy, trigeminal neuralgia, and

proaches to alleviate the problem. Usually,

the problem, rather than masking it. n


column Wealth

Four Social Security Mistakes That Could Cost You a Small Fortune Maximizing Social Security is an integral part of a reliable retirement income game plan, yet more than 90% of claimants do not maximize their benefits. There are over 2,728 rules in the Social Security Administration’s handbook and thousands more regulations about those rules in the Program Operating Manual System. It is no wonder there is a lot of confusion about when to claim Social Security. Here are the four Social Security mistakes that could cost you tens of thousands, if not hundreds of thousands of dollars over a lifetime. Mistake #1 Assuming Social Security Administration employees are experts about the rules for claiming your benefits Never assume you will receive reliable advice from the Social Security Administration. Consider a recent report released by the Government accountability office. The Senate Special Committee on Aging held a hearing on the findings, and the commission’s conclusion was a scathing criticism aimed at the Social Security Administration for providing misinformation online and in its offices. Simply put, the conclusion of the COA report and the Senate hearing is that claimants routinely receive inconsistent advice, misinformation, and are often not informed about the options available to them. I recently met with a nurse practitioner that vis-


David Lukas David Lukas Financial

she visited the local Social Security office, she was told not to worry because returning to work would only temporarily reduce or eliminate her Social Security payments, and that her benefits would resume after she turns age 66. She was told no further action on her part was needed. I informed her that following the advice given to her by the Social Security representative would result in a permanent 25% reduction of her lifetime benefits. I advised her to file form SSA-521 and pay back the $3,000 she had already received. This $3,000 investment yielded a 25% higher lifetime payout in just a few short years. Mistake #4 Not Taking into Consideration Survivor’s Benefits When one spouse dies, the surviving ited the local Social Security office to in-

benefits already taken. If it has been less

spouse receives the higher of the two ben-

quire about her claiming options. She was

than one year since you turned on your

efits. If the higher income earner thinks

informed that her only option was to claim

Social Security payments, contact a Social

they want to claim early, be aware that

her own benefits, which is incorrect. She

Security expert to be sure you’ve made the

this could result in a 56% lower survivor

was qualified to file what is called a “re-

right decision, as you have a short window

benefit. It’s a fact that people are living

stricted application”, allowing her to col-

of opportunity to correct any mistakes you

longer due to medical advances. My own

lect over $60,000 in spousal benefits for

have made.

grandmother is about to turn 103. If you

the next four years, and her own benefits to earn a guaranteed 8% annual increase. She then has the option to turn on her own monthly payment at age 70 and receive a

are married, don’t overlook maximizing survivor’s benefits. If married, you do not

Mistake #3 Not understanding how working can

want to make a claiming decision based on your benefit alone.

affect your Social Security benefits

32% higher lifetime payout just four years

Full Retirement age is when you are first

Throughout your career, if you earned

from now. Thankfully we caught this mis-

eligible to receive full or unreduced bene-

a modest income, you’ve likely contribut-

take before it was too late. Through her life

fits. Full retirement is age 65 to 67, depend-

ed six figures to Social Security. For some

expectancy, this could provide well over

ing on when you were born. There is a lot of

people, it could be multiple six figures. This

$100,000 in additional retirement income.

confusion surrounding the “earnings test”.

is a benefit you have rightfully earned.

Mistake #2

If you decide to claim your benefits before

Claiming your Social Security benefits

you reach Full Retirement Age (FRA) and

can be complicated and confusing. There

Believing you can change your claim-

continue to work, there is a high probabil-

are hundreds of different options for

ing strategy after making an initial choice

ity you will see a complete elimination of

claiming your benefits. If you don’t have

your Social Security benefits.

a well thought out claiming strategy, you

If you discover you have made a costly claiming mistake, you have one year to no-

I recently met with a retired registered

tify the Social Security Administration that

nurse who chose to claim her benefits as

you wish to retract your filing. There is one

soon as possible (age 62). Shortly thereaf-

caveat. The SSA requires you pay back any

ter, she decided to go back to work. When

could lose tens of thousands, if not hundreds of thousands of dollars. Get competent advice; not doing so could cost you a small fortune. n


column Orthopedics

Jimmy Tucker, MD Arkansas Specialty Orthopaedics

This is the fifth of six articles detailing the merger of OrthoArkansas Orthopedics & Sports Medicine, and Arkansas Specialty Orthopedics. Our goal is to share, from a physician leader’s perspective, the issues and industry trends that lead to a merger decision, the strategic, legal, and cultural process of merging, our candid experiences along the way, and our results. In this article we discuss the process of merging the cultures of both groups, at the physician and staff level, and creating a new, unique culture for the merged entity.

(or doesn’t), develops, and influences. Culture is what is ultimately important to the organization and those it serves, and what is important to the people of the organization. It is what makes them tick, what motivates them, and what brings them contentment and joy. For many organizations, culture happens by accident. It evolves over time, sometimes in a good direction, and some-

Merging Cultures

times not. The healthiest organizations vigorously pursue a specific articulated culture. Time and again, most organizations like to show sustainability and influence that weathers the storms of economic changes, industry shifts, and market variations. A merger creates a rebooted, new, or

In our first article, we reviewed our

and governance structures that solve past

renewed culture. As physician leaders and

overarching desire to bring the golden age

problems, and formalize organizational

organizational heads, we can either get out

of medicine—that time when we can help

practices.

in front of it and lead towards a particular

our patients improve their health and

Our third article examined issues relat-

function more than any time before—to

ed to going public with the merger. This

change it after it evolves.

our patients and partners. We believe the

step is not about publicity or market-

COMPONENTS OF CULTURE

golden age of medicine can be now, if it is

ing, but about assuring acceptance of the

While there are many different formula-

steered by those closest to patients—phy-

merger process by parties with a stake in

tions and terms, most of the time organiza-

sician leaders who want their organiza-

its outcome, both internal and external to

tional culture gets broken down into a few

tions to be essential partners to patients,

the practice. This is the beginning, not the

common categories. Several of these are

other providers, and society in general.

end, of communication about the merger,

familiar, and we will comment on each as

We noted a combination of the national,

and signals that it really is going to happen,

it applies to physician groups.

local, and group factors creating an inflec-

and will be a good thing for all involved.

Mission

culture, or we can play catch up, and try to

tion point, such as health care consolida-

The last article reviewed the various le-

Mission is the highest purpose of the

tion, costs and accountability, EMR and

gal decisions, issues, and documents that

group, or why it exists, in one pithy sen-

IT infrastructure, value-based healthcare

formally create, govern, and guide the legal

tence. This is generally easy to nail down,

purchasing, and the needs of our commu-

operations of the merged entity, and the

but very difficult to devise and articulate

nity and state, which led us to consider

need for non-lawyer docs to have a thor-

specifically and distinctively, in a way that

the notion that we should combine our

ough understanding of that arena, in order

inspires and empowers. It is reasonable to

groups to meet these challenges together.

to be sure the big ideas of the merger are

get the general purpose down on paper at

worked out legally and properly.

first, but as time goes on, clarifying and

In the second article, we reviewed the

Now, let’s talk about a merged culture,

categories of issues key to the cultural,

verbalizing, with mantra-like repetition,

operational, and legal decision to merge.

and how it comes about.

an organization’s distinctive and particular

We reviewed the need for financial and

ALL GROUPS HAVE A CULTURE

purpose, energizes investment and perfor-

legal advisors with merger expertise, and

Every human organization has a cul-

we considered the importance of arriv-

ture. Culture is the big idea behind why

ing at mutual strategic goals, operational

an organization exists, and what purpose

If mission is why we exist, vision is what

and financial principles, and leadership

it serves. Culture is also how it functions

we want to achieve, and the impact it will


mance at all levels. Vision

Tad Pruitt, MD OrthoArkansas Orthopedics & Sports Medicine

have. Ideally, in a merger situation vision

ture. This means that strategy will either be

organization can serve them all equally.

for the merged group will have been artic-

the way the mission is accomplished and

Priorities must exist, either by declaration

ulated at length during merger discussions,

the vision is achieved, or it won’t. Strate-

or default. It is worth thinking about the

and is fairly easy to condense and refine.

gy will either be in sync with the values of

real and aspirational beneficiaries of your

Values

an organization and its people, or it won’t.

culture. Among the various potential values for

An organization’s values are the atti-

Strategy must be congruent with the oth-

tudes, actions, and priorities that it most

er parts of the culture, or else the cultural

a group medical practice:

prizes. Values are what we believe makes

statements need to change.

• Financial Efficiency/Sustainability • Financial Profit

us who and what we are, or who and what

One more thing: Don’t forget that the

we want to be. For physicians and medical

merger is your biggest strategic priority.

groups, it can be hard to separate out what

The merger itself is a huge project, and its

• Health Care True Quality

we ought to value (like quality or ethics),

successful execution must be the prima-

• Customer (Patient) Service

from what we truly, functionally and op-

ry strategy for the initial phase of action.

• Provider (Physician) Service

erationally, value (say, efficiency). Under-

It is tempting to assume that operations

• Physician Practice Lifestyle

standing and naming both sides of that

will take care of themselves while leaders

• Innovation

equation can be very helpful in assessing

chase higher goals, but physician leaders

• Research

where merging cultures are coming from,

have a fiduciary and ethical responsibil-

• Compassion

and what it will take to get to a new value

ity to be sure that all internal aspects of

• Exclusivity

destination.

the merger don’t lose out to the grander

• Transparency

People

vision driving the reason to merge in the

• Performance/Excellence

first place.

• Education

One of the most overlooked aspects of culture is people. The people who com-

ACTUAL VS. ASPIRATIONAL CULTURE

• Operational Efficiency

Since your group can never equally val-

prise your organization will deeply affect

It is worth noting that, any time an or-

ue all of the above, or other cultural as-

the culture you have. Those people, es-

ganization begins discussing, dreaming

pects you determine, being honest about

pecially doctors, but also key staff lead-

about, and coming to a consensus on any

the priorities, and creating cultural prac-

ers, will inevitably have particular, and

aspect of culture, there is always tension

tices that reinforce them, is critical for a

sometimes unique aptitudes, attitudes,

between what we are, versus what we wish

culture that enables your mission.

ambitions, experiences, interests, talents,

we were. There is a pull between the actual

EXECUTING ON CULTURE: CHAMPIONS

interests, and priorities. This milieu of

and the aspirational. That is a natural and

AND REWARDS

personalities and personnel, when added

good thing. As leaders, part of our job is to

Finally, there are at least two vital com-

together, play a huge part in the culture

cast vision—to describe the way things are

ponents of a congruent and sustainable

of a group. In essence, every key leader or

(actual), and the way they ought to be (as-

culture. First, every culture needs a cham-

stakeholder is a mini-culture to himself

pirational). We have to be honest about the

pion. Someone in leadership, especially on

or herself. All those mini-cultures amal-

culture (helpful or not) that actually exists

the physician side, must carry the banner

gamate into a larger one. The who drives

in our groups before a merger, and ambi-

of culture, and be the one to fight for it at

the what and the why. The best physician

tious about the culture we want to have.

every turn. It is true that culture is the re-

and staff leaders help individuals discover

Addressing culture in the merged entity

sponsibility of all leaders, and that a healthy

and articulate all those qualities, and then

requires acknowledging the former and

organization will multiply the champions

incorporate and employ them into the

inspiring the latter.

of culture internally, as the organization

creation of a powerful group culture and

CULTURE AIMS AT A TARGET

matures. However, one leader must own

overall impact.

Another aspect of culture for honest

the culture portfolio, and have the author-

assessment and intention is whom the cul-

ity and influence to act on it, or intentional

The strategic priorities of an organi-

ture serves. Who is the target of the mis-

culture will never be established. Second,

zation—what its goals are, how it will ac-

sion? Who benefits most from the values?

any culture worth writing down and aspir-

complish them, and the order in which it

Most health care organizations will serve

ing to is also worth rewarding, significantly

pursues them—are key components of cul-

a number of values at some level, but no

and repetitively. Ideally, embracing the in-

Strategy/Priorities


Orthopedics

tended culture through personal success

treatment or facility, and beyond any leader

in the mission and vision, exemplifying

or achievement. Culture is the instrument

the values, achieving the strategy, and

that brings satisfaction and contentment in

employing one’s unique skill set, should

the midst of long days, and at the close of a

be compensated. In culture, as in many

long professional life.

other things, you get what you pay for. Rewarding culture, especially around stated values, shows that a leader’s words count, and a leader’s actions serve a greater goal. The creation of a merged group’s culture

“A person can do nothing better than to find satisfaction in their own toil.” —Ecclesiastes 2:24

should be just as intentional as the cre-

Culture Questions for Leaders

ation of its merged operations, legal and

Mission: What is our general purpose? What is our highest purpose?

governance structure, and service. At the end of the day, or at the end of a career, it is an organization’s culture that makes the difference. Surely, the delivery of care is large part of that culture, but so is the way it is delivered, the character of the organization that delivers it, the people who work there, and those impacted by it. That cumulative impact is culture. A healthy, intentional culture is larger than any

Vision: What do we want to achieve or accomplish? What will be our impact? Values: What words best describe the character, attitudes, actions, and priorities that are most important in the work life of our physicians and employees, in order to achieve our mission and vision? What are the current values we would like to keep or

eliminate? What are the values to which we aspire? People: What are the skill sets, aptitudes, and talents of the members of our team? How can we best empower and employ those? Who is best at which roles in our organization? How do our unique people shape our unique culture? Strategy: What are the key actions or endeavors that can accomplish our mission and vision? What is most important to do next? Target: Whom does our culture serve? How do we measure that? Champions: Who will carry the banner of culture for our group? How will we empower that leader? Rewards: How will we reward and incentivize the culture we desire? n

H o s p i ta l n e w s a n d i n f o r m at i o n

Hospital Rounds

UAMS Comprehensive Epilepsy Center Earns Highest Accreditation Level Story next page

Healthcare Journal of Little rock I MAY / JUN 2018 57

Hospital Rounds UAMS Comprehensive Epilepsy Center Earns Highest Accreditation Level

months should request a referral to an epilepsy center with an epileptologist. Palys received his medical degree from Kaunas Medical University in Lithuania, followed by gen-

The Comprehensive Epilepsy Center at the University of Arkansas for Medical Sciences (UAMS)

eral surgery residency training at Lithuanian Uni-

has been accredited with the highest designa-

versity of Health Sciences in Kaunas. He com-

tion available from the National Association of

pleted his general surgery internship at the

Epilepsy Centers.

University of Illinois at Chicago, Metropolitan

The Level 4 accreditation means that UAMS is capable of performing the most complex surgeries for the treatment of epilepsy. The accreditation

Group Hospitals, and his neurosurgery residency Michele Diedrich, MD

is valid through December of 2019. The nearest

at a Virginia Commonwealth University fellowship percent of patients referred to the center for

UAMS has hired fellowship-trained neurosur-

treatment actually turn out to be non-epileptic.

geon Viktoras Palys, MD, who is capable of per-

For many others, accurate diagnosis of a spe-

forming complex epilepsy surgeries including

cific epilepsy syndrome might lead to changes

placing temporary recording electrodes on the

to anti-seizure medications that can result in vast

surface of the brain or implanting them within the

improvements.

brain tissue. The center offers a broad range of surgical procedures for epilepsy.

Richmond, Virginia. He also obtained additional functional and stereotactic neurosurgery training

adult Level 4 epilepsy programs are in Jackson, Miss., and in Dallas.

training at Virginia Commonwealth University in

The center can provide minimally invasive procedures for the treatment of epilepsy, such as

directed by Kathryn L. Holloway, MD.

Named Chief Nursing Officer, VP of Patient Care for Baptist Health Medical Center- Little Rock Michele Diedrich has been named as chief nursing officer and vice president of Patient Care for Baptist Health Medical Center-Little Rock.

In addition to the spectrum of brain surgeries, it

implanting stimulation devices like responsive

Diedrich comes to BHMC-Little Rock after serv-

offers MRI-guided laser ablation for the diseased

neurostimulators or vagus nerve stimulators. The

ing as the chief nursing officer at Integris Baptist

brain tissue along with placement of responsive

center also offers Video-EEG monitoring technol-

Medical Center, a magnet recognized, 629-bed,

brain stimulation (RNS, Neuropace) and vagus

ogy, neuropsychological assessment, MRI scans,

level 3 Trauma Center in Oklahoma. She received

nerve stimulation (VNS) devices. For the minimally

PET scans, and Ictal SPECT scans that are tailored

her Bachelor of Science in Nursing from the Uni-

invasive diagnostic and/or treatment procedures,

specifically for epilepsy.

versity of Arkansas for Medical Sciences and her

the robotic stereotactic assistance (ROSA) is avail-

Epilepsy is a common and serious neurological

Master of Arts in Health Services Management

able to supplement the traditional surgical navi-

condition that is characterized by repeated unpro-

from Webster University. She also received her

gation tools.

voked seizures. Seizures are caused by abnormal

Doctor of Nursing Practice, Administrative Focus

Palys joins epileptologists Bashir Sami Shi-

bursts of electrical activity in the brain. They cause

from Oklahoma City University.

habuddin, MD, and Ikram Khan, MD, as well as a

spells of altered behavior, consciousness, emo-

“Michele is a compassionate leader whose

multidisciplinary team dedicated to the treatment

tions, or sensations. They might be mild with brief

broad spectrum of clinical expertise and sound

of epilepsy, including neuroradiologists, neuro-

experiences like changes in vision, unusual tastes

financial management ensure quality patient

psychologists, pharmacists, and social workers.

or smells, tingling, or a sense of déjà vu. They can

care,” said Greg Crain, administrator and senior

also be severe, such as convulsive seizures with

vice president of BHMC-Little Rock. “With more

violent muscle stiffening and contractions.

than 10 years of delivering effective leadership

Shihabuddin, medical director of the Comprehensive Epilepsy Center and a professor in the Department of Neurology in the UAMS College

There are several types of epileptic seizures

and breakthrough initiatives at acute-care hos-

of Medicine, said that in addition to highlighting

and epilepsy disorders. Epilepsy can result from

pitals, Michele is a big picture thinker and deci-

programs with advanced surgical capabilities, the

multiple causes, such as head trauma, abnormal-

sive leader known for reaching across department

Level 4 designation signals a dedication to a team

ities in brain structure, and genetic predisposi-

lines to forge alliances to advance organizational

approach and comprehensive care.

tion. In many cases, the cause of seizures remains

goals.”

“Many patients with epilepsy will not need these

unknown.

CHI St. Vincent Names Shawn Barnett as Senior Vice President and CFO

advanced surgeries, but they benefit from being

Early treatment is important. The National Asso-

treated at a comprehensive epilepsy center, where

ciation of Epilepsy Centers recommends that

we can offer patients the whole scope of treat-

patients whose seizures are not under control after

ments available, backed up by the technology and

three months of treatment by a primary care phy-

CHI St. Vincent announced that it has named

expertise necessary,” Shihabuddin said.

sician should seek treatment from a neurologist.

Shawn Barnett as its senior vice president and

Epilepsy can be difficult to diagnose and com-

Patients who have been seeing a general neurol-

chief financial officer. Barnett has an extensive

plex to manage. Shihabuddin said about 30

ogist and are still experiencing seizures after 12

background in healthcare administration, working



for both for-profit and nonprofit healthcare sys-

also be able to communicate via the portal with

hunt planned for Jan. of 2019. The event will have

tems. He most recently was president and chief

the surgical office, check test results, schedule

teams of four hunters competing for an elaborate

operating officer of CHI St. Luke’s Health-Memo-

appointments, and pay their bills.”

grand prize that can be equally divided among

rial in Lufkin, Texas. Before that, he was regional

The physicians will remain in their current office

the team members, as well as the landowner

CFO for CHRISTUS Santa Rosa Health System in

in the Medical Building, Suite 502, on the CHI St.

donating property for the hunt. Organizers of the

San Antonio, and he has served as regional CFO

Vincent campus at 1 Mercy Lane in Hot Springs.

derby have secured private land in and around

for CHRISTUS St. Michael’s Health System in Tex-

To request an appointment, call (501) 321-1329

arkana, Texas. A Jonesboro native, he was controller for what was then Methodist Hospital in Jonesboro from 1988 to 1995 and was CFO of that hospital, then called Regional Medical Center of NEA, from 1995 to 1999. He also served as CFO at Triad’s Northwest Health System in Springdale and at Woodland Heights Medical Center in Lufkin.

To learn more about the team, visit chistvincent.

the Conway area and continue to pursue participation from area landowners who are interested in hosting a hunt the day of the derby.

com/neurosurgery-hs.

Hunters will be awarded points assigned to dif-

CHI St. Vincent Heart Institute Expands with Electrophysiology Services

ferent species of ducks that are brought in the day of the derby. Point values for different ducks will be kept confidential until all teams have returned

CHI St. Vincent Heart Institute electrophysiologists are now seeing patients in Hot Springs. Drs.

from the hunt. The team with the most points wins the grand prize.

Barnett has a bachelor’s degree in Accounting

Tom Wallace, Mangaraju (Raj) Chakka, and Prab-

Teams will be assigned their specific hunting

from Arkansas State University, and he earned

hat Hebbar will be consulting with patients who

locations through a random drawing held the eve

an MBA with an emphasis in healthcare manage-

otherwise would have to travel to a Little Rock

of the hunt.

ment from Regis University in Denver.

clinic to receive care from an electrophysiologist.

“Nothing pulls guys together like a great hunt,

This expansion of care to CHI St. Vincent Hot

and this also is an opportunity for us to focus on

Springs makes it easier for patients with heart

men taking care of their health, a topic that men

arrhythmias, like atrial fibrillation (AFib), to be

rarely discuss,” said Thad Hardin, MD, a family

diagnosed and treated close to home.

practice physician at Conway Regional Medical

Barnett lives in Little Rock and has three adult sons.

Hot Springs Neurosurgery Clinic Joins CHI St. Vincent Medical Group

“Atrial fibrillation, or AFib, is an epidemic in this

Center and one of the organizers of the derby.

country,” said Dr. Tom Wallace. “Left untreated,

“We are fortunate to provide comprehensive

Neurosurgeons James M. Arthur, MD, and Jus-

it can lead to life-threatening conditions, such

men’s health services to our community, but they

tin Dowdy, MD, with the Hot Springs Neurosur-

as heart failure and stroke. Many of our patients

do us no good if men don’t take a proactive role

gery Clinic have joined the CHI St. Vincent med-

live in Hot Springs. I am glad that we will be able

in taking care of themselves. So, our goals are

ical group.

to see them in a location that is convenient and

two-fold with this event.” Hardin joins physicians

closer.”

Andrew Cole, MD, and Lew McColgan, MD, in

The clinic specializes in treatment of surgical diseases of the brain, spinal cord, peripheral nerves,

The physicians will see patients in the Hot

planning the derby. Also working with the plan-

and spine. This includes degenerative diseases,

Springs Heart Center on the CHI St. Vincent cam-

ning are executive leaders from Nabholz Con-

trauma, benign and malignant tumors, infectious

pus at 200 Heartcenter Lane. Drs. Yuba Acharya,

struction, Conway Corporation, the University

processes, and congenital abnormalities. Nurses

Michael Frais, Oyidie Igbokidi, Nazneen Tata, and

of Central Arkansas, First Security Bank, Trinity

Darlene Abernathy, APRN, and Kay Lynn Harris,

Srinivas Vengala serve as full-time cardiologists at

Development, JSI Partners LTD, American Safe-

APRN, will also join the CHI St. Vincent Medical

this location. They consult closely with the EP spe-

guard Insurance, Crain Automotive, C2 Power

Group as a part of the clinic’s medical team.

cialists, and look forward to having Drs. Wallace,

Sports & Deboard Electronics, and Simmons

Chakka, and Hebbar in the Hot Springs office.

Bank.

Conway Influencers Plan Central Arkansas’ First Arkansas Duck Derby

date and is expected to begin in the fall. Har-

Arthur has more than 40 years of experience in neurosurgery. He established his practice, Hot Springs Neurosurgery Clinic P.A., in 1981. Dowdy joined the practice in 2016 after serving as chief resident in the department of neurological surgery at the University of Arkansas for Medical

Team registration will be announced at a later din said the initiative is open to non-hunters as well. The community is invited to attend a ban-

A group of Conway influencers hopes to take

quet the evening prior to the hunt, whether or

advantage of Arkansans’ passion for duck hunt-

not those individuals are participating on a team.

“We are thrilled to welcome this neurosurgi-

ing, while also supporting men’s health programs

The banquet will include dinner, a silent auction,

cal team to our growing medical group,” said

at Conway Regional Health System. Proceeds also

and big ticket raffle items. One of the raffle items

Anthony Houston, president of CHI St. Vincent

benefit the Lodging Assistance and Guest House

will be a Duck Truck, a mechanically-enhanced,

Hot Springs. “One of the many advantages for

program for patient families who live out of town

wrapped truck that is popular among duck hunt-

patients is that their medical information will

and need short-term lodging.

ers. A limited number of raffle tickets will be

Sciences.

be available on our patient portal. Patients will

The inaugural Arkansas Duck Derby is a one-day

sold at $100 each for a chance to win the duck


Hospital Rounds truck. Other big ticket raffle items and items up for bid as part of the silent auction will be available to anyone who attends the banquet. Sponsorships for the Arkansas Duck Derby are still available. Sponsors who wish to register a team receive the benefit of early registration; however, registration fees are not included in the sponsorship. A sponsorship of $20,000 includes two early bird registration opportunities; a sponsorship of $10,000 includes one early bird registration. Landowners who would like to donate their property for the one-day hunt and prospective sponsors may contact Marla Hambuchen at [email protected].

UCA, Conway Regional Announce $390K in Grants to Address State’s Nursing Shortage The University of Central Arkansas and Conway Regional Health System announced their latest partnership, which is aimed at addressing shortages in the numbers of registered nurses in Arkansas. The Conway Regional Health Foundation is providing a total of $390,000, with $240,000 for student scholarships and $150,000 for faculty development and School of Nursing initiatives. The Partnership for Clinical Excellence, or

Conway regional UCA scholarships. Pictured L-R: College of Health and Behavioral Sciences Dean Jimmy Ishee; Conway Regional CEO Matt Troup; Conway Regional Chief Nursing Officer Angie Longing; UCA School of Nursing Director Susan Gatto; Cornell Malbia, member of the UCA Board of Trustees and chairman of the Conway Regional Board of Directors; and UCA President Houston Davis.

PCE, will award a $2,500 scholarship to an average of eight students in the UCA School of Nursing. Funds will be granted per semester for four

care for years to come,” Conway Regional CEO

a local approach to the national issue of the nurs-

semesters for students pursuing a Bachelor of Sci-

Matt Troup said. “Healthcare providers across the

ing shortage. Together, we can begin to address

ence in Nursing.

country are looking for ways to tackle this criti-

this issue.”

“UCA continues to be a leader in producing

cal nursing shortage, and we see this investment

Nursing students will be admitted with the stan-

exceptional clinical professionals for the health-

in education as an important step along with the

dard admissions requirements in the UCA School

care industry in Arkansas, and we recognize the

added benefit of a focus on clinical best prac-

of Nursing. The university and Conway Regional

growing need for quality nursing graduates. We

tice and other areas such as research and staff

will jointly select students for the PCE scholar-

are uniquely positioned to meet the growing

development.”

ships. PCE students must commit to working for

demand in our state and region,” said UCA Pres-

The January 2012 issue of the American Journal

ident Houston Davis. “Our leadership role in nurs-

of Medical Quality includes a report titled, “United

Conway Regional for a minimum of two years after

ing will only increase as we partner in growth and

States Registered Nurse Workforce Report Card

UCA will also receive support for nursing fac-

development with the industry.”

and Shortage Forecast.” This report indicated a

ulty development and School of Nursing initia-

graduation and passing licensure requirements.

“As longtime neighbors and partners working

projected nursing shortage between 2009 and

tives through the Nursing Enhancement Fund, a

together to positively impact this community and

2030, with the most acute shortages in the South

$150,000 grant with $50,000 paid annually over

state, Conway Regional is proud to be a part of

and West.

three years.

the solution to the growing demand for quality

Susan Gatto, director of the UCA School of

“This is a unique approach to providing afford-

nurses. This partnership with UCA will ensure that

Nursing, said, “UCA and Conway Regional have

able access to a nursing degree. As a UCA nurs-

we can continue to provide the community and

a long history of partnering. This latest initiative

ing graduate myself, I understand the challenges

our patients with excellent and compassionate

not only strengthens our partnership, but it is also

faced not only by the healthcare provider in great



need of nurses, but also by the educational institu-

Kentucky Derby-inspired dinner and libations, live

“I am proud to say that both years outstanding

tions striving to produce more graduates to meet

and silent auctions, a hat contest, and much more.

nurses on our staff have achieved Great 100 rec-

the demand of the market. Our hope is that this

Southern Silks benefits Methodist Family Health,

ognition. Last year, there were four. This year, nine

new program can help more students pursue

a 119-year-old organization that provides psychi-

of the Great 100 work alongside us at Conway

their dream of becoming a nurse,” said Conway

atric, behavioral, emotional, and spiritual health-

Regional Health System. Some give direct care

Regional Chief Nursing Officer Angie Longing.

care to Arkansas children and families.

for our patients; others provide support behind

“Nationally, and here in the Southern region, the

For more information about Southern Silks, the

the scenes or leadership in management roles.

nursing shortage is augmented by the shortage

rules of the game, or Methodist Family Health,

They all share some common traits: the compas-

of nursing faculty. In fact, the shortage of nursing

visit MethodistFamily.org/Southern-Silks or con-

sion they have for our patients and the dedication

faculty is just as critical as the shortage of nurses,

tact Cathey Henry, associate director of develop-

and professionalism they contribute to the nurs-

if not more so,” Gatto said. “This initiative will

ment, at [email protected] or by call-

ing profession,” said Matt Troup, Conway Region-

help support the retention of current faculty and

ing (501) 906-4209.

al’s president and CEO. “I am honored to count

recruitment of other faculty here at UCA.” Since its establishment in 1967, the UCA School of Nursing has played a leadership role in nursing education. Programs offered include the Bach-

myself among those who get to work with these

Bon Jovi Tribute Band Headlines UAMS Cancer Institute’s RockStar Lounge

and many other outstanding nurses at Conway Regional every day.” He added, “I know our honorees would be quick

elor of Science in Nursing, Masters of Science

Guests relived their favorite hits when Slippery

to point out that their recognition could only be

in Nursing, and the Doctor of Nursing Practice.

When Wet – The Ultimate Bon Jovi Tribute head-

possible through the great team they work with

Consistently responding to the needs of students,

lined the recently held RockStar Lounge.

every day in areas such as pharmacy, environmen-

changes in healthcare, and education standards,

Proceeds from the fundraising event will benefit

tal services, food and nutrition, respiratory therapy,

UCA’s nursing degree programs ensure that stu-

cancer research programs at the Winthrop P. Rock-

information technology, admissions, and count-

dents are prepared for a quickly evolving health-

efeller Cancer Institute at the University of Arkan-

less others.”

care environment.

sas of Medical Sciences (UAMS).

UAMS Winthrop P. Rockefeller Cancer Institute Benefits from Day at the Races

An awards program honoring Great 100 Nurses

Formed in 2003, Slippery When Wet is officially authorized by Bon Jovi and has performed in venues across the country and aboard Royal Caribbean Cruises.

from throughout Arkansas was held on April 10 at the Embassy Suites in Little Rock. Recipients of the award at Conway Regional live throughout north central Arkansas, and include:

Day at the Races offered guests the chance to

Presenting sponsors for the event were Arkan-

Gloria M. Dickson of Morrilton, RN, Conway

enjoy a day at Arkansas’ only thoroughbred race

sas Federal Credit Union, FIS, and Win and Nat-

Regional Rehabilitation Hospital. She has been

track while supporting cancer patients at the Win-

alie Rockefeller. RockStar Lounge is an annual

a nurse since 2008, and began working weekend

throp P. Rockefeller Cancer Institute at the Uni-

event hosted by the Envoys, an advocacy group

option at the Rehabilitation Hospital in May of

versity of Arkansas for Medical Sciences (UAMS).

of the Winthrop P. Rockefeller Cancer Institute

2016. “I like to get my patients up and moving,”

The event was held at Oaklawn Jockey Club in

Foundation.

said Dickson. “You get to know your patients.

Hot Springs. Honorary chairs for the event are

The Envoys’ mission is to advance the outreach

Mary Beth Bridges and Andrea Bridges in mem-

efforts of the Cancer Institute by promoting its

ory of their husband and father, Don Bridges.

physicians, scientists, programs, and vision. Mem-

Sarah E. Duck of Vilonia, RN, labor & delivery.

bership is free, and volunteering hours are flexible.

“I have known since I was young that I wanted to

For information or to become an Envoy, visit can-

take care of people,” said Duck. “I believe that

cer.uams.edu/envoys.

nursing is the career that allows me to live out my

5th Annual Southern Silks Benefits Methodist Family Health Methodist Family Health saddles up its stable of stick ponies in May to help raise funds to rebuild the lives of Arkansas children and families. South-

Nine at Conway Regional Among State’s Great 100 Nurses

ern Silks, the organization’s signature fundraiser,

Nine registered nurses with Conway Regional

was held May 5 at 6 p.m. at the Metroplex Event

Health System have been selected for statewide

Center at 10800 Col. Glenn Rd. in Little Rock.

2018 Great 100 Nursing recognition.

They are not defined by the surgery they have had.”

faith and gives me the ability and flexibility to be home with my family as much as possible.” Sarah has been with Conway Regional since 1999 and has 20 years of nursing experience. Nancy R. Embry of Conway, RN, lactation services in Women’s and Infant’s Services. “I have

Arkansans helped Methodist Family Health cele-

The Great 100 Nurses Celebration was founded

been drawn to nurturing and helping since I was

brate the 144th running of the Kentucky Derby with

in New Orleans 31 years ago and has since hon-

a young girl. I cannot imagine doing much else,”

this post-race, Derby Day soiree that included faux

ored thousands of nurses in Louisiana, Oklahoma,

said Embry. She has been at Conway Regional for

horse races where guests were the jockeys. Prizes

North Carolina, and Texas. This is the second year

11 years.

were awarded for each race, and guests enjoyed a

the recognition has been given in Arkansas.

Ruth Ann Fisher of Conway, RN, director of


Hospital Rounds Department. Sindee has been a nurse since 1983 and recently celebrated 10 years at Conway Regional. She realized she wanted to be a nurse while in college at the University of Arkansas Community College at Morrilton (Petit Jean Vo-Tech). “I knew the first week of school it was going to be hard, but the rewards would last a lifetime,” she said. Sindee has worked in Information Services since 2015. In her position, Sindee focusses on project management and assuring processes and workflow are coordinated and in line. For more information about Great 100 Nursing, visit www.g100nurses.org

CHI St. Vincent Hot Springs Joins Arkansas Children’s Hospital Nursery Alliance CHI St. Vincent Hot Springs announced that it is joining Arkansas Children’s Hospital Nursery Alliance, which coordinates care between neonatologists at ACH’s Neonatal Intensive Care Unit (NICU) Nine registered nurses with Conway Regional Health System have been selected for statewide 2018 Great 100 Nursing recognition. They are, pictured left to right, Andrea Harrison, Sarah Duck, Suzanne Harris, Marilyn Minor, Nancy Embry, Angie Longing, and Sindee Morse. Not shown are Ruth Ann Fisher and Gloria Dickson.

and physicians in CHI St. Vincent Hot Springs’ Anthony Childbirth Center, further improving the quality of newborn care. CHI St. Vincent Hot Springs is the newest hospital member of the ACH Nursery Alliance, which

HomeCare Services. Ruth Ann has been a nurse

Angie E. Longing of Conway, RN, chief nurs-

was established in 2016. Neonatologists at ACH

for 22 years, including 16 years with Conway

ing officer and vice president of Patient Care Ser-

will provide immediate consults to physicians at

Regional. “I always wanted to do what I could to

vices. “I am so humbled to be recognized along-

CHI St. Vincent Hot Springs, educational sup-

help others. Home care became my passion when

side many other caregivers in the great state of

port, quality data review, implementation of best

I was in nursing school. That’s when I realized that

Arkansas. In my 24 years of nursing, I have had

practices in collaboration with ACH, and training

is where I can make a difference,” said Fisher. “I

the opportunity to work with many nurses and I

through telemedicine for the purpose of improv-

could help patients’ manage their illnesses by

am still in awe of the dedication and compassion

ing neonatal care close to home. They will also

educating them on how to make lifestyle changes

that I witness every day. Nursing is a gift and a

provide support as needed to help the babies at

to allow them to live a full and happy life.”

calling and I am proud to be a nurse,” said Long-

CHI St. Vincent Hot Springs or at ACH get the

Suzanne Harris of Conway, RN, director of Med-

ing. Longing has worked as a nurse or in manage-

best care possible.

ical/Surgical and Specialty Services at Conway

ment at CHI-St. Vincent Morrilton, CHI-St. Vincent

In addition, the alliance offers development of

Regional. “Nursing is a calling; it’s a calling to take

Infirmary/North, and at Conway Regional Health

opportunities to track and monitor outcomes and

care of others and to use the talents and gifts one

System.

participation in ongoing research. Another ben-

has been given so that people have the care that

Marilyn B. Minor of Conway, RN, 2 North/Oncol-

efit is post discharge follow-up by monitoring

they need,” said Harris. “I wanted to make a dif-

ogy. Marilyn became a nurse because her mother

and measuring other health conditions through

ference in people’s lives – my patients, my fami-

had polio at the age of 20 and was wheelchair

an expanded High Risk Newborn Clinic network.

lies, and my employees. Nursing gives me that

bound for the remainder of her life. “She taught

“Arkansas Children’s is creating a statewide net-

opportunity every day in multiple ways.” She has

me to be empathetic and sympathetic to others

work of care in order to deliver the right care at the

been a nurse for 13 years, all at Conway Regional.

needs,” said Minor. “My aunt was a registered

right time close to home for the children of this

Andrea L. Harrison of Vilonia, RN, Quality and

nurse as well, and influenced my life greatly.” She

state,” said Marcy Doderer, president and CEO of

Regulatory Officer for the health system, and has

been a nurse at Conway Regional for 18 years and

Arkansas Children’s. “Today, we’re excited to wel-

responsibility for quality resources and case man-

been in nursing since 1982.

come CHI St. Vincent Hot Springs to the Arkansas

agement. Andrea has been a nurse for 12 years, including 11 years at Conway Regional.

Sindee S. Morse of Clinton, RN, informat-

Children’s Hospital Nursery Alliance, the first nurs-

ics nurse analyst in the Information Services

ery alliance in Arkansas that focuses specifically



on neonatal care by partnering with local hospi-

the Great 100 Nurses Foundation’s annual list of

tals. Together, Arkansas Children’s Hospital and

the state’s superb nurses.

and an on-site survey. “We had to train 350 physicians and nurses and

CHI St. Vincent Hot Springs will ensure Arkansas’

The list honors nurses from numerous back-

had to build training modules going forward,”

newborns get better today and can be healthier

grounds and specialties for their concern for

said Smith. “I am very proud because I know all

tomorrow.”

humanity, their contributions to the profession,

the hard work people put into this.”

Doderer shared her enthusiasm for the alliance

and their mentorship of others. UAMS nurses on

Breastfeeding is one of nine priority areas

and the bright future for Arkansas’ tiniest patients.

the list come from research, administration, and

of Healthy Active Arkansas, a 10-year plan

“The alliance is bigger than our two hospitals with

clinical practice.

announced in 2015 by Gov. Asa Hutchinson to

Conway Regional, Jefferson Regional, and more

The Great 100 Nurses Foundation was founded

provide community-based efforts to reduce obe-

to come. When we collaborate as the full alliance,

by P.K. Scheerle more than 30 years ago in Loui-

sity. UAMS co-chairs the plan’s breastfeeding com-

we will share our data and talk about quality over-

siana. It advocates for nursing through scholar-

mittee with Baptist Health.

all within the alliance. Each of these community

ships and research. The foundation has honored

Hospitals provide a unique and critical link

hospitals brings their own level of expertise, expe-

nurses in Louisiana, North Carolina, Texas, and

between the breastfeeding support provided

rience, and data to the table so that together we

Oklahoma. This is the second year it has honored

before and after delivery. Mothers who give birth

elevate the care for all of the infants being cared

Arkansas nurses.

at baby-friendly hospitals and birthing centers are

for in the alliance. Together we can change the trajectory for neonates in our state.”

Among the UAMS nurses named to the list

more likely to initiate exclusive breastfeeding and

included 15 from the UAMS College of Nursing.

more likely to sustain breastfeeding at six months

Arkansas Children’s Hospital operates the state’s

“The faculty and staff in the College of Nurs-

only designated Level IV NICU (100 beds) and has

ing are indispensable when it comes to prepar-

and one year of age. The Baby-friendly Hospital Initiative encourages

access to pediatric specialists from all disciplines.

ing the next generation of nurses,” said Patricia

maternity facilities throughout the world to adhere

CHI St. Vincent Hot Springs manages the largest

A. Cowan, PhD, RN, dean of the College of Nurs-

to the Ten Steps to Successful Breastfeeding. The

birthing center in the region it serves, with physi-

ing. “Having that work validated with an honor

steps are:

cians delivering nearly 1,000 newborns every year.

such as this reminds us that others recognize their

• Have a written breastfeeding policy that is rou-

The Anthony Childbirth Center has capacity for 15

efforts and how important they are to Arkansas.”

newborns. The nursing staff is made up entirely

The UAMS nurses honored by the Great 100

of registered nurses, and CHI St. Vincent’s Level II

Nurses Foundation are Claudia P. Barone, Eliz-

nursery can provide care for most infants.

abeth E. Beazley, Gina L. Boshears, Jan Bowen,

tinely communicated to all healthcare staff. • Train all healthcare staff in the skills necessary to implement this policy. • Inform all pregnant women about the benefits and management of breastfeeding.

“At CHI St. Vincent Hot Springs, we have pro-

Christina M. Bricker, Terry L. Brown, Wendy G.

vided quality and compassionate care to the

Burgener, Catherine B. Buzbee, Kristen N. Carter,

next generation of Arkansans for decades. With

Christina M. Davis, Leonie C. DeClerk, Deena D.

this new nursery alliance, the newborns and new

Garner, Donna Gullette, Rhianna M. Harberson

• Show mothers how to breastfeed and how to

mothers of southwest Arkansas will be the most

Baribeau, Seongkum Heo, Terri L. Imus, Souraya

maintain lactation, even if they are separated

important beneficiaries of our partnership,” said

J. Irani, C. Renee Joiner, Sandra A. Lubin, Ellyn

Anthony Houston, president of CHI St. Vincent

E. Matthews, Donna J. Middaugh, Jeannette R.

Hot Springs. “This is a wonderful opportunity to

Minyard, Heather Moseby, Larronda M. Rainey,

work with Arkansas Children’s to share resources

Ginny Smith, Barbara L. Smith, Sharon B. Steven-

and expertise, and to offer to our newborns and

son, James Mark Tanner, Devin K. Terry, Nicole

patients a new, collaborative approach to elevat-

Ward, Teresa M. Whited, and Patricia B. Wright.

ing the wellness of Arkansans.” CHI St. Vincent Hot Springs is the largest hospital in southwest Arkansas, and it has a 130-year legacy of providing excellent and compassionate care to residents of Garland County and the region. The Anthony Childbirth Center had 991 deliveries in 2017.

2018 Great 100 Nurses List Includes 32 from UAMS

• Help mothers initiate breastfeeding within one hour of birth.

from their infants. • Give infants no food or drink other than breast milk, unless medically indicated. • Practice rooming in by allowing mothers and infants to remain together, 24 hours a day. • Encourage breastfeeding on demand. • Give no pacifiers or artificial nipples to breast-

UAMS Medical Center Joins Five Other Hospitals Across the State in Obtaining the Baby-friendly Designation

feeding infants. • Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.

The Baby-friendly designation was awarded

Adhering to the Ten Steps is associated with

UAMS Medical Center by Baby-Friendly USA

increased rates of breastfeeding around the

Inc., the accrediting body for the hospital initiative.

world. n

The designation requires verification of policies, curriculum, action plans, quality improve-

Thirty-two nurses from the University of Arkan-

ment projects, and staff training. Also included

sas for Medical Sciences (UAMS) were named to

are competency verification, a readiness interview,


Reviews by the bookworm

You only have two hands. That’s all and when they’re full, you’re done. You can’t hold more items, pick up more work, or take on additional anything. Two hands, that’s all you have to offer but in the new book “Tears of Salt” by Pietro Bartolo and Lidia Tilotta, you can also offer your heart. Lampedusa, a tiny island just off the coast of Italy, has always been where Pietro Bartolo feels the most at home. It is, after all, where his parents came when they married. It’s where Bartolo brought his own bride, where his three children were born – and it’s the current site of his clinic and the first port of call for refugees fleeing terrorism in Somalia, Lebanon, Tunisia, Syria, and Nigeria. There’s an odd inconsistency between a beautiful island surrounded by crystal seas and the misery of those who wash ashore. Long before the refugee crisis began, Lampedusa was quietly idyllic; today, it’s still a place frequented by wealthy vacationers, Popes, and statesmen but also by corpses and people who are gravely injured. Bartolo is proud of the former, dismayed and overwhelmed by the latter. He gets constant calls to come to work, to meet rescue boats on the pier, to deal with refugee trauma in both mind and body. His wife runs a laboratory, and she’s often called, too. Like fellow villagers, they’ve taken in refugees who required extra care. Even that, he indicates, can break his heart. So many things do. He knows why some female refugees beg him to abort the babies they carry, fathered by soldiers of war. He’s seen the bravery of mothers who hand their children to strangers to save. He’s observed families torn apart, and some reunited. A paralyzed mother begged for a job, so that she might bring her family to Europe. Women are preyed upon by traffickers. Toddlers die. A ten-year-old boy refused to cry over his father, who was killed by Boko Haram. Says Bartolo: “You can wear all the protective gear you like, but you cannot protect your soul.” Have we become inured to tragedy? Author Pietro Bartolo (with Lidia Tilotta) is afraid we have, so when offered the opportunity to become the subject of a short movie, he seized upon it to call

“…be prepared to get pretty darned uncomfortable.”


By Pietro Bartolo & Lidia Tilotta c.2018, W.W. Norton

attention to the plight of the refugees. That story, and more, are inside “Tears of Salt.” But before you start, be prepared to get pretty darned uncomfortable. Although he might often temper his tales with lovely barefoot-childhood memories of a village filled with people who care for one another, Bartolo doesn’t hold back from the horror he’s seen, or the things his patients have endured to find a better life. Beware that some anecdotes are downright gruesome. He tells… and tells… and tells stories that beg to be shouted from the cliffs, making this a book that may never become a bestseller but for compassionate readers concerned with current events, it’s a must-read. If that’s you, find “Tears of Salt.” Get it in your hands. n

You need a shave. It’s been awhile and, though you’ve been grooming and growing, you’re long overdue – so, maybe just a little off the top. You’ll feel a lot better when you do, and in the new book “Endure” by Alex Hutchinson, you’ll see how your body will adapt on track, path, ocean, drift, and desert. Prior to 1954, it was believed that the human body was physically incapable of running a mile in less than four minutes – until the late Roger Bannister put that notion to rest quite handily. As for today, the belief that a marathon of 26.2 miles can’t be finished in under two hours still holds – but barely. When it comes to endurance, effort, and the human body, we’ve long been fascinated with possibilities; the questions, in fact, go back centuries and countless tests and studies have been (and are being) done to determine answers when a hundredthof- a-second means something. Still, one thing’s for sure: says Hutchinson, “the will to endure can’t be reliably tied to any single physiological variable.” Much of the matter of endurance has to do with “the need to override what your instincts are telling you to do…” Perhaps not surprisingly, it very much has to do with the brain, “but not in the simple it’sall-in-your-head manner of self-help books.” The science of it all is “complex,” made even more so by outliers who, for any number of reasons, can and do achieve beyond preconceived limits – which is to say that we still don’t know where the “ultimate limits” lie. The stories, even so, are tantalizing. Hutchinson writes of Henry Worsley who, at age forty-eight, tackled a South Pole trek that “demanded every ounce of his reserves.” Hutchinson shows how early scientists helped save the lives of the men who built Hoover Dam. He examines how we pace ourselves, sometimes sub-consciously; why we do better after we’ve suffered; and how hypnosis may increase strength. He explains how deep diving and high climbing pose the same questions; why marathon runners are shrinking; why thirst shouldn’t matter; what diet can do; and how none of this may matter in the future. We’ve all known that can’t-go-another-inch feeling, when a surprising well of reserve is suddenly present. Where did that come from? And can you utilize it at will? In “Endure,” you’ll

“This is not just a book for athletes.”

By Alex Hutchinson Foreward by Malcolm Gladwell c.2018, Wm. Morrow

see, but first: this is not just a book for athletes. While it’s true that author Alex Hutchinson writes extensively about men and women who participate in extreme, even elite, sports, the lipbiting anecdotes inside “Endure” prove that this is a book for anyone who might find themselves in inclement weather or unusual situations. Yes, it’s mostly about athletic endurance, but its everyday relevance lies in the science Hutchinson brings which, though sometimes a bit too deep for the casual reader, is applicable whether you run to finish line or fridge. Athletes and trainers, of course, will soak this book up, and adventurers will jump for it. Even couch potatoes should enjoy it because “Endure” is razor sharp. n


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