East TN Medical News August 2015

FROM THE EDITOR:

The Times They Are a-Changin’

Undergoing transforma-tive change, this industry has been tasked with fundamen-tally altering delivery methods and asked to meet height-ened consumer expectations and increased demands for interaction and engagement.

While the above state-ment is certainly representa-tive of the healthcare industry … in this case, we are actually referencing the media’s role in the dissemination of informa-tion.

The way we consume news has dramatically changed over the past de-cade. Yet, how, when and where we receive information is often a matter of personal choice. Some people love the feel of newsprint between their fi ngers. Others like to get information on their tablet. Still others want the highlights in 140 characters or less, giv-ing them control of whether or not the topic is worthy of a click through to more informa-tion.

Recognizing our read-ers embody these varied preferences, East Tennessee Medical News is excited to announce major changes

continued on page 6

Dr. Gregory Sutton

PAGE 3

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By CiNdy SANdERS

Frequently viewed by parents and young athletes as more annoy-ance than necessity, it’s easy for the sports physical to devolve into automatic answers to a list of questions, a quick check of vital signs and then out the door with a signed permission slip for another year of organized activity.

But it doesn’t have to be … and really shouldn’t be … this way, stressed Chris Koutures, MD, FAAP, a board certifi ed pediatrician and sports medicine specialist who sits on the American Academy of Pediatrics (AAP) Council on Sports Medicine & Fitness.

Instead, he continued, providers should look at the sports physical as a prime opportunity to address important issues with children, teens and parents. “There are a host of things we can look at … both sports specifi c and medically in general,” he said. “Every opportunity we get

(CONTINUED ON PAGE 4)

Why a Sports Physical Should Take More than 10 Minutes

A Word to the WiseOIG Cues Areas of Interest with Recent Alert, Guidance

By CiNdy SANdERS

A word to the wise should be suffi cient.In recent weeks, the Offi ce of the Inspector

General has released a fraud alert on physician compensation arrangements and updated guid-ance for healthcare governing boards.

Michelle B. Marsh, partner at nationally ranked healthcare fi rm Waller Lansden Dortch & Davis, said all such communiqués from the OIG deserve special attention. Marsh, who is the practice leader for Waller’s Healthcare Compliance & Operations group, said the June 9 alert reiterated the need to make sure physicians are being paid only for work they

are actually doing and at a rate that refl ects fair market value.

Red fl ags, Marsh noted, include “pay-ing physicians as medical directors when they

didn’t really provide the services, or when ser-vices weren’t necessary, or where payment was

not related to the value of their services but to the volume of referrals.”

She continued, “Not that this is breaking news … these arrangements were always wrong.”

However, Marsh added, the difference is that the OIG has previously appeared to focus most of their

attention on the non-physician partner in these cases. It hasn’t been unusual, for example, for a lab com-


FOCUS TOPICS ORTHOPAEDICS & SPORTS MEDICINE COMPLIANCE

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PUTTING THE

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In recent weeks, the Offi ce of the Inspector General has released a fraud alert on physician compensation arrangements and updated guid-

Michelle B. Marsh, partner at nationally

are actually doing and at a rate that refl ects fair

ing physicians as medical directors when they didn’t really provide the services, or when ser-

vices weren’t necessary, or where payment was not related to the value of their services but to

the volume of referrals.”

news … these arrangements were always wrong.” However, Marsh added, the difference is that the

OIG has previously appeared to focus most of their attention on the non-physician partner in these cases.

It hasn’t been unusual, for example, for a lab com-

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Regardless of the specialty, healthcare professionals often say they got into medicine in order to take care of people. But when it comes to something like cancer, which varies in every patient, hav-ing the ability to research and study alongside that care is a defi nite bonus. That “triple play” of options is what brought Dr. Gregory Sut-ton to Tennessee Oncology’s Chat-tanooga location, where he hopes to bring his expertise to the many services provided to patients.

“When I was younger, I saw a lot of cancer in my immediate fam-ily,” Dr. Sutton said. “Almost all of my grandparents had some form of malignancy at some point in their lives, and some of them were taken when I was very young. That af-fected me in many ways that I didn’t real-ize until I was in college.”

He initially was studying in mathe-matics and engineering, but soon realized that he wanted to work with people. He kept recalling experiences with doctors — good and bad — that he’d had growing up.

“Some of them would sit down and talk with us, tell us what was going on with our family member who was ill, but oth-ers would hustle in and out of the room and leave us confused,” he recalled. “I re-member being angry and scared, all the feelings that come when someone you love is dying of cancer. I realized that I never wanted anybody to feel like that, to not know what’s going on, and that was my main motivator to get into medicine, and then to pursue oncology.”

Prior to joining Tennessee Oncology, he was with The West Clinic and Bos-ton Baskin Cancer Foundation, both in Memphis. He received his medical degree from the University of Tennessee, and completed an internal medicine residency at the University of Tennessee at Chat-tanooga. Sutton also has completed a fel-lowship in The West Clinic/University of Tennessee hematology and oncology program.

In addition to having family in Chat-tanooga, he says he was drawn to Tennes-see Oncology because of all the activity in and around the physician-owned prac-tice and its multiple clinics and locations across Tennessee.

“It’s a larger group, which means that I can focus on patients and taking care of people, doing the clinical work versus hav-

ing to be tied up in administrative tasks and paperwork,” he said. “We have a great support system to do that, and to do it well. I’m freed up to talk with patients and the families, to build those relation-ships as we provide treatment.”

By meeting with his fellow physicians in the practice’s other offi ces, he was able to develop an even greater appreciation for an infrastructure that provides a place for clinical research, drug trials, and more.

“There are a lot of opportunities because we’re not curing cancer until we make progress on discovering what’s going on as it metastasizes, and trying new treatments in people to see how specifi c cases react,” he said. “Some of the trials we’re participating in are amazing; there are so many more options now. And be-fore, people who have had to travel a long way to participate in some of these trials, and we’re able to offer them right here in Chattanooga. That’s a really big thing, be-cause if someone can’t travel to where the treatment is, then it’s not going to him or her any good. There are a lot of barriers, and that’s one we can remove.”

Going forward, he says that he and his fellow physicians and researchers hope to do more in that regard.

“We want to take some of the mystery out of cancer,” he explained. “You can look at cancer under a microscope. You can sit down and show scans and photos to the patient and his or her family members. You can explain a lot of what is going on. And then when you start looking at treat-ment options, everyone is much more aware of the issues, and there’s a lot less confusion and apprehension.”

In the end, Sutton says quality oncology treatment comes down to two things: access and care.

“If you can’t great treatment for a patient, then it doesn’t do any good,” he said. “The new drugs coming out are very expensive. We have patient advocates and support systems in place, assistance pro-grams for people who don’t have in-surance, so that we can get out there and work with the drug companies to provide a treatment for a patient. That has been a lifesaver.”

Access also comes into play with regard to research and devel-opment because government fund-ing and other revenue streams are a fraction of what they were a decade ago.

“Private pharmaceuticals are doing a lot of the research now; there’s also a lot of investigator-

led research that our group participates in with organizations such as the Sarah Cannon Research Institute,” Sutton said.

“There are world-class trials going on, and therapies being developed, and we are get-ting involved in those as much as we can.”

For him, it will always come down to those one-on-one patient meetings, help-ing someone who’s dealing with a caner diagnosis come to grips with what is hap-pening — and then know that a trusted partner will be with him or her every step of the way.

“The fi eld of oncology is growing rap-idly, which is a good thing in terms of re-search and development, but at the same time is daunting for the patients,” Sutton said. “Until we’re able to cure cancer, we’ll need those trials to push the enve-lope. It’s a reportable disease; everyone who is diagnosed with it is tracked, and so we can really see where we are going. But aside from that, I want to be ale to work with our patients, to develop the right course of action for them, so that they can benefi t from all the treatments and tech-nologies. They are the ones we are doing all this work for, and we want to make sure they know that.”

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pany incorrectly paying a physician to be the target of an OIG fraud investigation. This latest alert highlights the agency’s willingness also to go after the physician.

“Physicians should keep in mind it’s a violation of anti-kickback laws to receive a payment for referrals, as well as to make a pay-ment for referrals, so it’s both the payer and the recipient,” Marsh said. “Both sides of a transac-tion subject to kickback scrutiny are at risk … not just one side. The alert shows nobody is getting a free pass.”

Inappropriate arrangements extend past the major red flags, Marsh added, of other, more subtle infractions. The June alert noted the agency “recently reached settlements with 12 individual physicians who entered into questionable medical di-rectorship and office staff arrangements.”

Continuing with the example of a physician-lab agreement, Marsh said it is perfectly appropriate for the lab company to have someone at a physician office to draw or pick up samples. However, that lab employee cannot answer phones at the practice or provide general office work at no charge to the physician. When an affili-ated healthcare entity pays salaries for the physician’s front office staff, the OIG said it relieves that physician of the financial burden they would normally incur and therefore constitutes improper remunera-tion to the physician.

If deemed guilty of committing fraud, both the physician and affiliated health entity are subject to possible civil, crimi-nal and administrative sanctions. How-ever, Marsh added, “The other thing the OIG highlighted in that fraud alert is the resources the OIG and others are making available to help with compliance.”

Marsh said the OIG does a good job of providing compliance education on this

and other issues through their site at oig.hhs.gov. Specific to this issue, the fraud alert directed physicians to their “Com-pliance Program Guidance for Individual and Small Group Physician Practices,” which is available at oig.hhs.gov/authori-ties/docs/physician.pdf.

Finally, Marsh underscored the need to document actions in any type of com-pensation arrangement. A physician and partner could be found guilty of fraud de-spite appropriate compensation if actions performed were not supported by written data. “The rule in healthcare is if it wasn’t documented, it wasn’t done,” stated Marsh. “It’s important to accurately docu-ment any arrangement and then act in ac-cordance. You can appear to be crossing the line if you don’t document … even if the services were provided.”

The OIG released another piece of news earlier this spring providing updated guidance for healthcare governing boards on compliance oversight.

“If you’re accepting a board position, we would certainly recommend you look at this guidance and that you are comfort-able with all the responsibilities,” Marsh said of her firm’s advice.

It’s a mistake, she explained, to think of a board appointment as an honorary title rather than as an executive leadership position. “In particular,” she continued of the guidance document, “it discusses the expectations that the board be involved in identifying and monitoring risk areas and that the board is expected to pull together many different functions within the orga-nization including quality, compliance, audits, legal and human resources.

“It’s clear the OIG’s expectations for the board is that it is responsible for mak-ing sure all the pieces come together and that the compliance program, as a whole, addresses those risk areas at an appropri-ate level for the organization. Ultimately, the compliance of the organization all rolls up to the board,” Marsh concluded.

A Word to the Wise, continued from page 1

Addressing Common Questions & ConcernsPediatric sports medicine specialist Chis Koutures, MD, FAAP, shared

insights and advice on several common questions and concerns parents might have regarding their active offspring.

How Much is Too Much?“The minimum the American Academy of Pediatrics

recommends is one day off a week from organized activity,” Koutures said.

Furthermore, he continued, there are additional time limits on adult-directed activity that should be considered. “If you take the age of a child, that’s the number of hours of organized activity they should not exceed in a week,” he said of recommendations based on new data. Therefore, a 12-year-old shouldn’t participate in more than 12 hours of organized sports and practices in a week. However, Koutures stressed, this time limit doesn’t apply to additional free play with friends.

Overuse“I think we’re seeing more overuse injuries,” Koutures said. In part, he

thinks the increase is due to more children becoming one-sport athletes, which leads to repetitive motion. He added that when a child plays a number of sports, different muscle groups are engaged, and children mentally learn different movement patterns.

While physicians might not be able to change a child’s activity preferences, they can help mitigate overuse injuries through evaluation and education. “With my throwing athletes, I look at the shoulder range of motion. There are great studies that show if we can make sure they have appropriate follow through, we can reduce the risk of injury,” he pointed out.

Hydration & NutritionKoutures noted the AAP released a statement on sports drinks several

years ago. “The belief is that for most times, water is sufficient,” he said. Koutures added that a sports drink might be appropriate when exercising for over an hour, particularly if it is hot and humid, or right after an activity to replace salt and sugar.

“We like to think of hydration as being a full time job,” he continued, noting proper hydration doesn’t occur during the small window of practice or playing. Instead, children should be drinking water regularly to prepare for … and recover from … activity.

He also tells young athletes to look at their urine to gauge their level of hydration. “If it’s really dark, that’s a sign of dehydration,” Koutures reminds them.

As for pre-activity nutrition, he said that somewhat depends on the child, time of day and personal preference or tolerance. Recognizing some kids really can’t eat much shortly before competition, he suggested trying fruit because of the liquids and quick energy it provides.

“The most important meal of the day isn’t breakfast, lunch or dinner,” he continued, “It’s what you eat right after you exercise. Getting some sort of protein mixed with carbohydrates in that first half hour after you exercise is essential for recovery.” Koutures added chocolate milk has a great protein-to-carb balance. Greek yogurt and peanut butter are also good options.

Michelle Marsh

to sit down with a family is a chance to educate … whether with a sports physical or routine physical.”

Koutures, who is based in Anaheim Hills, Calif., is co-author of “Pediatric Sports Medicine: Essentials for Office Eval-uation” and served as medical team physi-cian for USA Volleyball and Table Tennis at the 2008 Beijing Summer Olympics. He pointed out providers have the opportunity to not only identify and fix current prob-lems but to delve deeper to discover and address underlying issues that could pre-vent or reduce the impact of future injuries or illness. “One thing that pediatricians and primary care providers do so well is antici-patory guidance,” he said.

Koutures said there are a host of reasons families rely on retail clinics for a sports physical ranging from convenience to cost to the drop-in nature of such fa-cilities. However, he pointed out, seeing your regular provider has a value-added proposition that shouldn’t be ignored. “If

we do our job right, we are providing such a higher level of care,” he said. “If you have a relationship with that family, you can look at past history. We can see a his-tory of asthma. We can look at a growth scale and see if there’s been a tremendous amount of growth. We can see immuniza-tion records,” Koutures enumerated.

He added the long checklist of issues, ailments and conditions on sports medi-cine forms makes it easy to simply answer ‘no, no, no’ to everything. However, those answers aren’t always accurate … whether by accident, oversight, or fear of being sidelined.

“You look at the sheet, and it says ‘no history of asthma.’ Really? There was an episode two years ago,” Koutures out-lined an example of the benefit of going to a provider who knows a child’s history. “If you know the child has asthma, they can actually have a better sports experience because you are addressing and control-ling the issue.”

Why a Sports Physical Should Take More, continued from page 1

Dr. Chris Koutures

He added, “Having that background knowledge is one more checkpoint to making sure we’re giving the best care we can.”

As important as it is to use the time to educate young athletes and their fami-lies about issues ranging from nutrition and hydration to concussion and overuse, Koutures said a sports physical is also a great time to listen. Particularly with older adolescents where part of the appointment is without the parent, Koutures said it’s a great time to open dialogue about alcohol, drugs and supplements and to allow kids to ask questions. “We need to take the

time to educate ourselves,” he added of hearing a patient’s thoughts and concerns.

Listening, he continued, also plays an important role in an area where he believes providers could do a better job – assessing and addressing mental health issues. “It’s a silent epidemic,” Koutures noted of the number of adolescents feeling overwhelmed, anxious or depressed.

“If you get that one time a year to sit down with a family and address these things, you can make a big impact,” Kou-tures concluded of the sports physical. But, he added, “That’s not going to happen in 10 minutes.”


It was full steam ahead this year when the 109th Tennessee General Assembly convened for the first time in January. Indeed, a whole host of measures passed this session, including a law that significantly increased fines for seat-belt violations and a statute that decriminalizes the taking, possessing, or transporta-tion of Coragyps atratus—more commonly known in these parts of the State as “a buzzard.” Vultures aside, when the Legislature adjourned on April 22, 2015, it placed on the books a number of health-related laws that may substantially impact you, your practice, and your bottom line. Summarized below are a few of the highlights.

Pain Management ClinicsYet again, Tennessee’s pain

management clinics were a focus this legislative session. Public Chapter 475 now requires that all medical directors of pain clinics be board certified in pain medicine by July 1, 2016. Further, the same Act coined a new term called a “certificate holder,” which it defines as a medical doctor, osteopath, advanced practice nurse, or physician assistant. Going forward, any person with “an ownership interest” in a pain manage-ment clinic must meet the eligibility standards of a “certificate holder.”

Aside from the new certification and ownership requirements, the General Assembly has also honed the law requiring the Department of Health to identify the top 50 prescribers in the State. In its prior form, the statute permitted the Department of Health to demand that each prescriber and his or her supervising physician (if the pre-scriber is an advanced practice nurse or physician assistant) who appears on the top fifty prescribers list justify the amount of controlled substances that had been prescribed. The new itera-tion of the statute, on the other hand, keeps in place the top fifty list but also imposes the same justification require-ments on “the top ten prescribers of controlled substances in all of the coun-ties . . . having a population of less than fifty thousand.”

TelehealthAfter last year’s legislation leveling

the reimbursement rates between Tele-health and traditional brickandmortar practices, most everyone anticipated

an uptick in the number of Telehealth services provided within the Volun-teer State’s borders. What we did not know, however, was the extent to which the legal standard of care would differ between Telehealth services and the traditional, in-person patient encounter. This question was answered this session when the General Assem-bly enacted a law that states telehealth providers “shall be held to the same standard of professional practice as a similar licensee of the same practice area or specialty that is providing the same healthcare services through in-person encounters, and nothing in this section is intended to create any new standards of care.” Further, this legisla-tion precludes the licensing boards from “establish[ing] a more restrictive standard of professional practice for the practice of telehealth . . . .” These are certainly words of encouragement to those of you who wish to incorpo-rate a telehealth component to your practice.

Medical SpasBeginning next year, the Board

of Medical Examiners will maintain an online registry for all medical spas in the State. The registry will provide the following information for each medical spa: 1) its name and address; 2) the name of its medical director or supervising physician (including license number and designation as a medical doctor or doctor of osteopathy); and 3) the certification information of the medical director or supervising physi-cian. In addition to medical spas, the registry will provide the same, identify-ing information for physician’s offices or practices that provide cosmetic medical services.

CredentialingHistorically, when a practice group

hired a new provider, billing the new provider’s treatment during the creden-tialing period was a nightmarish task that often exposed the group’s patients to a heightened risk of paying higher “out-of-network” charges. Realizing the unfairness of this phenomenon, the Legislature established a framework for new providers to become credentialed with private health insurers while still seeing patients. The new law, which

becomes effective January 1, 2016, requires insurers to provide any

medical group with whom they have an existing contract “a list of all information and supporting documentation

required for a credentialing application of a new provider applicant to be considered complete.” After the new provider submits a completed application, the insurer has 90 days in which to approve it. During that 90-day period, the practice group may

hold all claims for the new provider and submit them for reimbursement once the provider’s application is approved. If the provider’s application is denied, however, insurers are not required to reimburse at the negotiated rates for the group’s credentialed providers.

ConclusionThis past legislative session was

an active one. This article provides but a glimpse of that activity and is by no means an exhaustive list of the health-related measures that passed this session. What’s in store for next year remains a mystery, but if this year is any indication, rest assured that more changes are on the horizon.

Mitchell Panter is an attorney with London Amburn, a law firm based in Knoxville, Tennessee, which represents providers in the area of healthcare law, including regulatory, compliance, HIPAA, malpractice and nursing home defense, employment, mergers and acquisitions, corporate and business matters. For more information, you may contact Mr. Panter, visit www.londonamburn.com. Disclaimer: The information contained herein is strictly informational; it is not to be construed as legal advice.

LegalMattersBY T. MITCHELL PANTER, LONDON & AMBURN, P.C.

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When Andy Laverghetta started his role as CEO for Southeastern Retina Associates in March, he was fulfilling a dream he and his wife had shared for more than 10 years. They finally got to move their family closer to the mountains.

“For years, my wife and I had talked about moving towards the moun-tains,” Laverghetta said. “We had looked at North Carolina, but at the end of 2013, we went to Gatlinburg on vacation. We stayed in a chalet, the kids got to see snow for the first time. It was great. On the drive home, my wife started saying that we had to get north, and I agreed.”

At the time, the Laverghetta family lived in Orlando, Florida, where Andy was the CEO of the Florida Heart Group. He enjoyed the job and truly liked and respected the physicians he worked with there, but when he learned about the opportunity to become CEO for Southeastern Retina As-sociates, he had to know more.

“I met Dr. Hoskins through another opportunity, and we had stayed in touch. I was excited when I learned about the oppor-tunity here,” he said. “I committed to the role around Christmas 2014, moved from Florida in February, and started in March. We sold our house in Florida, bought a home here and we are fully entrenched in the commu-nity.”

Laverghetta’s decision to join Southeastern Ret-ina Associates was about more than just the mountains. He saw a unique in-dependent practice with a great work-ing environment and a lot of oppor-tunities.

“I really like the environment here,” he said. “It’s a private practice where we aren’t burdened by lay-ers of bureaucracy, so we can be much

more efficient and effective. We have a vi-sion to execute and we feel like we can make an impact every day we show up to work.”

Southeastern Retina Associates’ impact has breadth and depth, with 19 offices and 14

physicians. “We have a unique practice here,” Laverghetta said. “It took me a while to wrap my head around how they have so many offices.”

Ultimately, Laverghetta joined South-eastern Retina Associates because he was drawn to the people and to the field of retina surgery. But his favorite part of the job so far has, hands down, been the people.

“My favorite thing about Southeastern Retina Associates so far has been the per-sonal relationships with physicians and the management team here,” he said. “That was important to me when I made the decision to come here. I genuinely like all of these people and I felt that way about the practice I came from as well.

“There’s a unique atmosphere here,” he continued. “The physicians have created a friendly, laid back atmosphere, but there is a lot of intensity as well. We all feel like we’re here to accomplish something big.”

His management philosophy is simple: he wants to learn as much as he can in order to provide a strong support structure. “The management team is great. There is a lot of talent here,” he said.

“They are smart folks who are welcom-ing and excited about what they’re doing. We’re all excited to learn together.

“I want to set an environment where people feel empowered and challenged, where they can grow and learn new things every day,” He continued. “I have gotten a lot of great opportunities at early ages and I want to pay that forward.”

Laverghetta is quick to acknowledge that he can learn a lot from the people he works with each day. “I am deliberate about coming in and learning all I can,” he said. “There’s a saying that we have two ears and one mouth and that we should use each in proportion. Right now I am listening and paying attention so I can learn more and pick up institutional knowledge. There are experts all around. I am learning from them. I’ve found that action takes care of itself when you listen.”

Andy and his wife Jennifer have four children—three daughters, ages 4, 7, and 10, and one son, who will turn two in July. He has played in bands since he was 12 years old and even considered a career in music in his 20s. “I had fantastic opportunities, but also learned that it isn’t how I wanted to make a living,” he said. “I still try to write and record and play as much as I can. I look at music as therapy. It keeps me balanced. Most people are surprised to learn about that side of me, but music is a passion that doesn’t go away.”

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The Times They Are a-Changin’, continued from page 1

to our product. If you love the monthly paper (and we certainly hope you do), no worries … you’ll still receive it faithfully each month in the mailbox.

However, we’ve long realized the static nature of our websites left much to be desired from both an aesthetic standpoint and the ability to adequately offer information between print cycles. Additionally, the editorial and publishing teams have looked at various solutions to quickly alert our readers to major break-ing news stories and to have a platform to put important information in your hands in the immediate fashion audi-ences have come to require.

To achieve these goals and meet your personal expectations, we are de-buting our new website this month and offering you the flexibility of following us on social media platforms to receive updates. Knowing how many journals, magazines and e-mails you receive on a daily basis, we promise not to flood your devices with a constant stream of data. Instead, we will format key information into brief updates and breaking news alerts as warranted.

For many of you, we already have your email addresses on file so you will automatically receive an e-blast. If you aren’t currently receiving electronic noti-fications from us, feel free to contact me at [email protected] with your email address, and I’ll make sure you are added. You can also make such a request online at www.easttnmedical-news.com.

Our mission … as it has always been … is to make sure we get the latest clinical, business, research and regulatory news in your hands, in addition to updat-ing you on industry events and happen-ings among colleagues. The new format of the website makes it easier than ever for you to see the latest information in each of these categories, find related content, and share articles on your own social media platforms. Additionally, the design was created to be scalable to desktop, tablet and smartphone formats.

As Bob Dylan aptly noted – The Times They Are a-Changin’ – and we’re excited to embrace that change with enhanced capabilities to deliver the best possible product to you in a manner that suits your busy life. We hope you enjoy the new look, flexible formats, and ability to receive industry updates in between print cycles. Please feel free to share your thoughts and comments with us. As al-ways, we’re open to suggestions on how to continue to improve our publication and our performance.

Sincerely,

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BY JOHSON CITY EYE CLINIC

Johnson City Eye Clinic

and Surgery Center

provides the iStent

Trabecular Micro-Bypass

Stent as a treatment option

to reduce eye pressure for

patients with both cataracts

and glaucoma.

The iStent is FDA-approved

for use in conjunction with

cataract surgery to reduce

eye pressure in adult patients

with mild to moderate open

angle glaucoma currently

being treated with glaucoma

medicine. In clinical trials,

iStent has been shown to safely reduce eye pressure, with is the

primary cause of open-angle glaucoma.

“This is great news for people who have both a cataract and

glaucoma,” says Dr. James Battle, III. The eye drops used to treat glaucoma

can be difficult to administer and expensive. With iStent, many patients

will need less medicine to control their eye pressure and some may not

need prescription eye drops at all.”

iStent is the smallest medical device ever approved by the FDA and

is placed in a patient’s eye during cataract surgery. Dr. Battle went on

to say, “It is so small you are unable to see or feel it after the procedure is

done. Although you won’t even know iStent is there, it will be working to

help reduce your eye pressure.”

Implanting the itStent does

not significantly extend the

length of time the patient

spends in surgery and has a

similar safety profile to cataract

surgery alone. Proven safe and

effective, the iStent Trabecular

Micro-Bypass:

• Is safely implanted during

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Studies have shown

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Johnson City Eye Clinic was the first to bring iStent to the region and

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ClinicallySpeakingBY JOEL “TREY” BRADLEY, III, MD AND KRISTOPHER WILLIAMS, MS, MD

Over the past several years, the complexity of patients and difficulty of hernia repair has dramatically increased. We saw this during our fellowships at Carolinas Medical Center in Charlotte, North Carolina. We each spent two years of intense research and care of complex hernia patients. While we were there, we identified a need for specialized complex hernia expertise in East Tennessee, as several of our patients were referred to Carolinas Medical Center from this area. Having family ties to East Tennessee, we were both determined to return to the area and help provide care for these com-plex patients.

One example of the type of complex cases we are seeing is pa-tient Tonia Brock of Knox County. The 71-year old had been battling a large, multiply recurrent hernia bulge in her abdomen for more than a dozen years. She developed her first hernia several years after having an ileostomy at age 29, which was surgically repaired for the first time in 1998, but because of infection the hernia eventually reoc-

curred. It was the beginning of a long string of recurrences and subsequent attempted repairs for her. By 2014 she had undergone at least nine hernia operations without a permanent resolution.

In recent years Mrs. Brock’s hernia grew uncomfortably large and had such a negative effect on her quality of life that she seldom left her home. In describing how this hernia was strongly impact-ing her life, she stated, “It was like my whole stomach was a hernia. It looked like I was carrying a big watermelon around.”

We take a comprehensive ap-proach to complex hernia repair, work-ing with patients before surgery to ad-dress medical, diet, and lifestyle factors such as infection, diabetes manage-ment, obesity and proper nutrition in order to prepare them for a successful, lifelong result. Preoperative prepara-tion is key for patients like Tonia Brock

who have had multiple failed hernia repairs and are severely limited in their daily life due to a massive abdominal wall hernia.

We successfully repaired Ms. Brock’s complex abdominal hernia at Fort Sanders Regional this past fall. Her daily quality of life has improved dramatically since undergoing surgery. Although these types of hernia repairs are major abdominal surgeries, the restored abdominal wall functionality and resultant improved mobility often allow patients to return to a completely normal life without limitation following adequate post-operative recovery.

We are excited to offer complex hernia repair to patients in East Ten-nessee. We are passionate about offering hope and permanent solutions for patients with complex hernias and those that have failed previous surgical repairs.

Joel F. “Trey” Bradley, III, MD and Kristopher Williams, MS, MD are fellowship trained minimally invasive general surgeons, specializing in hernia repair with Premier Surgical Associates in Knoxville. They perform procedures at Fort Sanders Regional and Parkwest Medical Centers.

Pair Of Premier Surgical Surgeons Team Up For Complex Hernia Repair

Tonia Brock

Travis Estes

By AmANdA ShEll JENNiNgS

Before student-athletes hit the foot-ball field, EMS professionals, school of-ficials and emergency departments have been working for weeks to ensure all safety protocols are in place for players and fans.

Priority Ambulance provides emer-gency standby ambulance service for every home football game at Loudon, Lenoir City and Greenback high schools. Providing full coverage for high school athletics involves a high level of behind-the-scenes interagency cooperation.

The ambulance service met last month with Loudon County Schools coaching staffs, athletic trainers and Fort Loudoun Medical Center emergency de-partment staff to review and update pro-tocols for treating sports-related injuries. The ambulance agency reviews proper technique for patient immobilization and splinting; proper hydration; and recogniz-ing the signs of heat stroke and concussion symptoms.

According to Travis Estes, director of emergency medical services for Priority Ambulance in Loudon County, preven-tion education and consistent response across all parties are critical safety factors.

“Our number one goal is prevention, and pretty much everything we do is striving to pre-vent or lessen the im-pact of injuries,” Estes said. “The other thing we strive for is continu-ity and communication among our personnel, athletic trainers, coaches and emergency department per-sonnel.

“When these students experience an emergency, they are going to be in a tough situation and scared. We have a seamless plan in place so they understand immediately that we are going to provide the best care as a team and that we have their best interest at heart.”

Tennessee Secondary School Athletic Association (TSSAA) requires an ambu-lance to be on standby at every football game, but Priority Ambulance goes above and beyond that requirement. As part of its mission to serve the community, the company has created a network of shared information and agency coordination in case of an emergency on the field or in the stands.

For home football games in Loudon

County, the ambulance service places on the sideline a state-of-the-art advanced life support ambulance, licensed paramed-ics and EMTS and equipment to treat any sports medical emergency, includ-ing advanced cardiac monitors and defi-brillators, ventilators, other devices and medication.

The most common emergencies that they prepare for are bone fractures, spinal and neck injuries, heat-related illness and concussions. Personnel provide training to school athletic trainers to review steps for prevention, common signs of these inju-ries, and actions to take if they occur.

Concussions are one of the most com-mon and serious injuries for high school athletes, and in the past, head injuries too often have gone unnoticed and untreated.

“Comprehensive planning is es-pecially important with the emerging research about the long-range and sig-nificant effects of concussions on student-athletes,” Estes said.

According to the U.S. Centers for Disease Control and Prevention (CDC), emergency departments treat more than 248,000 sports-related traumatic brain injuries (TBI), including concussions, in youth and adolescents up to age 19. These

visits have increased by approximately 60 percent over the past decade.

“In years past, if an athlete took a hit, the coaching staff would put them back on the field if they said they were ready,” Estes said. “With current research, we’ve realized that’s not the best thing. We work with coaches to recognize the signs of a concussion so kids won’t be returned to the field until they have been medically cleared. If there are any questions about it, we won’t let kids play.”

The effects of a TBI can last a few days, months or years. Additionally, suf-fering one concussion makes an athlete more susceptible to successive ones. The effects of TBI can include impaired vision, thinking or memory issues, personality changes or depression.

To identify concussions, Estes says EMTs and paramedics apply some sim-ple tests on the field. Delayed eye pupil reaction, inability to focus vision or ask-ing repetitive questions all are signs of a concussion. They also will test a student-athlete’s short- and long-term memory through a series of questions.

“New technology in sports is going to be helpful in identifying and treating these injuries in the near future,” Estes said. “Technology, like helmets with impact sensors, already help us dig a little deeper into what’s happening on the field. The sensor will register if there’s been a signifi-cant hit or change in speed.”

Greenback High School recently added six new helmets with Riddell In-Site Response System sensors. The data is monitored by the athletic trainers and when a significant hit is registered, the athlete is pulled for evaluation. Estes noted as more information is gathered from the sensors, Priority Ambulance and Loudon County trainers will be able to build treatment plans and processes based on empirical data.

Each season, the ambulance service personnel also meet with coaching staffs and trainers to review any new equipment and the proper ways to remove face masks and helmets. They also meet with the Fort Loudoun Medical Center emergency de-partment staff to ensure they are aware of any changes to equipment. According to Estes, the intent is to be 100 percent prepared in the unfortunate event of an emergency.

“We work closely with our partners to make sure we are providing the best care,” Estes said. “The athletic trainers and coaching staff are with the athletes every day and provide us with invaluable knowledge of students’ health history. Coordination with the emergency depart-ment is key to ensure that a player will re-ceive seamless healthcare from the field to treatment by physicians in the hospital.”

Through extensive preparation and planning, Loudon County is prepared to safely kick off its football season.

Friday Night FrightsOff-Field Emergency Personnel Prepare For Football Season


The Literary ExaminerBY TERRI SCHLICHENMEYER

A Sky of Diamonds: A Story for Children about Loss, Grief and Hope by Camille Gibbs; c.2015, Jessica Kingsley Publishers; $19.95 U.S. & Canada, 48 pages

You wear your feelings on your face: happy, and you smile. Sad, and you frown. Surprised, and your mouth says “Oh!” while your eyes open wide. You don’t even have to think about it; everybody in the world knows how you feel. But in the new book A Sky of Diamonds by Camille Gibbs, there’s just no way to know what to do next.

In the middle of school one day, Mia’s daddy came to take Mia home.

She knew it was an unusual day because Daddy looked sad. That was because Mia’s Mum had been in an accident at work, and her heart stopped. Mia’s Mum died. Mia would remember that day forever.

“I couldn’t speak,” she said, “and my head swirled.” She felt like all the color had been sucked out of every-thing. At fi rst, she couldn’t believe it, and she dreamed about her Mum. Waking up was hard.

Sometimes, she even thought it was all her fault. It wasn’t - her Dad explained that she was grieving and that it might feel like a rollercoaster, with up days and down days. Still, Mia was “angry at everything.” Her friends still had their mothers, and that wasn’t fair! They were happy, and that wasn’t fair, either! What would she do if her Dad died, too? Mia wondered what would happen if she died.

Finally, her dad decided that they needed a memory box, a place to put all the good things and the good days they could remember. She and her fa-ther also crawled under the bed and screamed, they slammed doors (which felt really good!) and Mia punched holes in the newspaper. She then wrote her mother some letters, one of which was about the stars in the sky and what her Mum had said about them: she’d chosen the shiniest one, to whisper goodnight when she wasn’t with Mia.

And that made Mia feel better.I have two very defi nite thoughts

about “A Sky of Diamonds,” the fi rst of which was that I loved the mes-sage. In explaining the basic grieving process through the eyes of a little girl who’s suffered a big loss, author Camille Gibbs tells kids that their thoughts and feelings are completely normal. Through the story, she also subtly offers coping methods for kids who are really struggling, and a nice introduction guide for parents and pros who have never had to comfort a child who’s dealing with loss.

On the other hand, I was not im-pressed at all with the illustrations that accompany this story. I would have far preferred to see professional work in a book with this importance; what’s here feels uncomfortably unappealing.

Still, this is one of those things you hope you never need, but you’ll be glad to know is out there. Despite the illustrations, it may be perfect for 5-to-10-year-olds who’ve suffered loss, as well as for parents or caregivers. They might fi nd what’s inside A Sky of Diamonds feels just right.

The Nurses by Alexandra Rob-bins; c.2015, Workman; $24.95 / $33.95 Canada, 360 pages

Imagine a job where lifting “approximately 1.8 tons” in an 8-hour shift is a requirement, where squabbles and sexual ha-rassment are common, and appreciation is of-ten rare, as you’ll see in The Nurses by Alex-

andra Robbins. You might work all day without eating and without rest-room breaks, and your life could be in some degree of danger at all times.

Welcome to nursing.With this description in mind

and wanting to know more about the medical personnel who know you bet-ter than your doctor does, Alexandra Robbins “interviewed hundreds of nurses” in North America and over-seas. She also shadowed four nurses working at various hospitals in an un-named “major American city.”

There was soft-spoken Molly, who understood that nurses some-times get the short shrift in hospital budgets, an issue that irked her at a time when she had more important things on her mind. Sam, a fi rst-year nurse, needed every ounce of self-confi dence to fi ght undeserved gossip from peers who didn’t un-derstand her quiet personality or her focus. Juliette hated the lack of support and acceptance within her workplace, and when she learned of a supervisor’s unprofessionalism, she

realized that it was time to make a move. And there was Lara, who gave

in to workplace temptation and s u b s e q u e n t l y battled drug ad-diction. Few col-leagues knew of her past or of her recovery, but when an injury required

surgery and pain-killers, Lara wasn’t sure she had the strength to fi ght her

demons again.In following these four women at

work, Robbins learned of “egotism,” violence, and bullying they endure from patients and co-workers. She also examines why nurses get “crisp.” Yes, her interviewees admitted, medi-cal personnel talk about patients, but it’s not personal. Yes, there are things that nurses wish they could tell you. And no, it’s not easy work but most “’truly love nursing.’”

Those of you who are (or are relat-ed to) nurses are nodding your heads, aren’t you? Yep, you know the truth. Author Alexandra Robbins’ subjects don’t gloss over anything here; in fact, The Nurses is exciting and honest, from admission to release.

But personal stories aren’t the entire reason to read this book: Rob-bins also busts myths, shows the inner workings of Emergency Rooms, of-fers golden advice, and she explains behind-the-scenes events and why nurses deserve way more kudos than they get. That nicely balances the inherent drama in the four personal stories, though it might make patients outraged.

I can see this book for nurses, defi -nitely, but it’s also something to read if you’re thinking of nursing school or if you might need medical care any-time soon. The Nurses contains good stories, but it’s also helpful. In short, it’s a reader’s McDream.

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

THE STRENGTH TO HEAL and learn lessons in courage.

©2011. Paid for by the United States Army. All rights reserved.

The pride you’ll feel in being a doctor increases dramatically when you care for our Soldiers and their families. Courage is contagious. Our Health Professions Scholarship Program helps you reach your goal by providing full tuition, money towards books and lab fees, a $20,000 sign-on bonus, plus a monthly stipend of more than $2,000.

To learn more about the U.S. Army health careteam, healthcare.goarmy.com/mednewsor call 615-874-5002.

$24.95 / $33.95 Canada,

diction. Few col-leagues knew of her past or of her recovery, but when an injury required

surgery and pain-killers, Lara wasn’t sure she had the strength to fi ght her



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GrandRounds

PYA Announces Integration of Antibiotic Stewardship Program ExpertsPershing Yoakley & Associates (PYA) announces the integration of antibiotic stewardship industry leaders.

KNOXVILLE – Pershing Yoakley & Associates (PYA), a national manage-ment consulting and accounting firm, has added the esteemed Dr. James Mi-chael Keegan and his consulting team to its organization and now offers compre-hensive antibiotic stewardship program (ASP) solutions to healthcare providers across the U.S. This dynamic addition further expands PYA’s role in providing value-added professional and clinical services for clients. The implementation of fully integrated ASPs has the effect of optimizing patient treatment regimens, improving patient safety and care, re-ducing costs, and positively affecting broader population health outcomes.

Keegan’s clinical healthcare con-sulting team has contributed to the development and refinement of single facility and system-wide community-based execution protocols of antibi-otic stewardship initiatives for the last 20 years. Keegan, an infectious disease specialist, has been a driving force in antibiotic stewardship. Currently, this team is finalizing arrangements to be-gin the nation’s first statewide antibiotic stewardship initiative to improve the use of antibiotics.

Together with Keegan and his team, PYA combines a broad diversity of ex-perience and a national reputation and scale in the healthcare industry to afford further advances in the patient experi-ence while at the same time lowering costs. “We are beyond pleased to unite with PYA,” said Keegan. “Our dedica-tion to patient safety and quality of care finds its match at PYA. We expect great advances in antibiotic stewardship to result from this union.”

Erlanger Ranked 7th Largest Public Hospital System In Nation

CHATTANOOGA – Erlanger Health System is now the nation’s seventh largest public hospital system, according to Modern Healthcare’s 2015 Hospital Systems Survey.

Rankings for the survey were based on net patient revenue for 2014. Among all public hospital systems in the nation, Erlanger ranked seventh based on net patient revenue of $582.5 million for 2014. The Chattanooga-based health system placed tenth in the rankings last year with $537.5 million in net patient revenue for 2013.

“Very few public hospital systems in the United States can match the extent and quality of services that Erlanger of-fers,” said Kevin M. Spiegel, FACHE, President and CEO of Erlanger Health System. “As we continue to expand our services and facilities, I anticipate that

our ranking will continue to climb in fu-ture surveys.”

Increases in patient revenue and facility growth have also boosted Er-langer’s payroll, with the employment count swelling to more than 5,300, as of June 30, 2015.

In addition to Erlanger employees, the health system also employs hun-dreds of contract workers from such industries as nutrition, technology and construction services. The $50 million expansion of Erlanger East Hospital, for example, will employ between 800 to 1,000 construction workers over the next 18 months.

Joseph M. Winick, FACHE, Erlanger Senior Vice President for Planning, Analytics, and Business Development, predicts that “Erlanger will employ an additional 150 full and part-time team members when the current construction project expands Erlanger East’s inpa-tient capacity to 107 beds.” This expan-sion is being financed by $70 million in bonds issued by Erlanger and sold to Wall Street investors in late 2014 for the purpose of financing capital projects like the Erlanger East Hospital expan-sion.

Modern Healthcare, the hospital industry’s leading publication, also ranks Erlanger Health System in the 2015 Hospital Systems Survey as 118th in the nation among all US healthcare systems in terms of net patient revenue for 2014.

Asbury Place Names Kim Golly Regional Sales Director Asbury Place retirement communities in Maryville and Kingsport recently named Kim Golly regional sales director.

KNOXVILLE, KINGSPORT – In the newly created role, Kim Golly will pro-vide sales/marketing support and coaching to the sales teams at the Maryville and Kingsport campuses while continu-ing her direct sales and marketing activities at the Maryville campus.

“With her knowledge and passion for our industry and upbeat personal-ity, Kim is a tremendous asset to Asbury Place,” said Marjorie Shonnard, chief operating officer for Asbury, Inc. “As we communicate the benefits to residents of continuing care retirement commu-nities and work to meet the growing needs of seniors in Maryville and King-sport, this new position brings greater strength and focus to our overall inde-pendent living and assisted living mar-keting and sales efforts.”

Golly has been with Asbury Place for four years, previously serving as di-rector of sales and community relations for the Maryville campus.

Before joining Asbury Place, Golly had a 20-year career in the banking in-dustry. She describes the career move as a happy accident. “I came to Asbury Place when I was looking for a place for

my father-in-law to live. Going to work there was not in the plan, but it’s the best thing that could have happened,” said Golly.

Golly volunteers with a variety of senior-related special events in the community and LeadingAge, the pro-fessional association for 6,000 not-for-profit, aging services organizations. LeadingAge recently recognized Golly as a leader in the field by naming her a coach for HackFest, a two-day event that challenges teams to “Engage with Age” by creating a technology-driven tool aimed at improving the lives of old-er adults and their families.

Golly and her husband, John, have three sons, a daughter and two grand-sons.

McCarthy Building Companies Awarded Surgery Expansion and Patient Tower Project at Erlanger East Hospital in Chattanooga$31 million project recently broke ground in Chattanooga.

CHATTANOOGA – McCarthy Building Companies recently broke ground on a new patient tower and an expansion of the surgical center at the Erlanger East Hospital in Chattanooga, Tenn. Site work on the $31 million proj-ect began in May and comes on the heels of McCarthy winning a master plan contract for Erlanger›s main cam-pus in 2014.

The 99,000-square-foot expansion project, which will transform the exist-ing facility into a full-service hospital, includes four new operating rooms, a PACU expansion, a Prep/Post op ex-pansion, a new cardiac catheterization suite, and renovations to the reception and administrative areas. This project also includes a new 58-bed patient tower with a food court, pharmacy and laboratory areas.

“McCarthy has proven to be a great partner to Erlanger,” said Erlanger Health System President and CEO Kev-in M. Spiegel, FACHE. “We are pleased to work with this outstanding organiza-tion as we expand our facilities to meet the growing needs of our community today and in the coming years.”

In 2013, the Erlanger Health System opened its fifth emergency department at Erlanger East Hospital. One of five Erlanger campuses located throughout the region, it served more than 22,000 area residents during its first year of op-erations.

“We are honored to build a facility that will provide such an important func-tion for the Chattanooga community,” said Project Director Gary McGrath.

Throughout the project, McCarthy will work closely with adjacent property owners and Erlanger employees to en-sure a safe and productive environment during construction. The project is de-signed by HKS Architects, Inc. and is slated to be completed by December 2016.

Kim Golly


CHI Memorial Receives American College Of Cardiology Award For Cardiac CareNCDR ACTION Registry–GWTG Platinum award recognizes high standards.

CHATTANOOGA – CHI Memorial has received the American College of Cardiology’s NCDR ACTION Registry–GWTG Platinum Performance Achieve-ment Award for 2015. CHI Memorial is one of only 319 hospitals nationwide to receive the honor.

The award recognizes CHI Memo-rial’s commitment and success in imple-menting a higher standard of care for heart attack patients and signifies that CHI Memorial has reached an aggres-sive goal of treating these patients to standard levels of care as outlined by the American College of Cardiology/Ameri-can Heart Association clinical guidelines and recommendations.

Fritsch Named Medical Director Of Hospital Medicine

CHATTANOOGA – William J. Frit-sch, Jr., MD, has joined CHI Memorial’s leadership team as medi-cal director of hospital medicine. Fritsch leads a clinical staff of thirty-eight physicians and five mid-level providers.

Fritsch served as the lead hospitalist at St. Fran-cis Medical Center in Cape Girardeau, MO, for more than thirteen years where he provided administration of all aspects of the hospitalist program including clini-cal performance, strategic planning and recruiting. While at Saint Francis, he served on the medical executive com-mittee and led quality, cost containment and compliance initiatives. As a member of the board of directors of Saint Fran-cis Physician Partners, a health-system based practice with more than 130 mem-bers, Dr. Fritsch provided long-term plan-ning guidance.

Fritsch received his medical degree from University of Missouri Columbia School of Medicine, Columbia, MO, where he also completed his residency in internal medicine.

Becker’s Recognizes CHI Memorial As A Great Community Hospital

CHATTANOOGA — Becker’s Hospital Review has released its 2015 list of “100 great community hospitals” which includes CHI Memorial.

“We are honored to be named to this prestigious list,” says Rick Napper,

CHI Memorial Interim CEO. “CHI Memo-rial’s achievements are made possible through the partnership of our physi-cians, staff and volunteers who work in tandem to provide exceptional care while creating a nurturing environment that promotes healing.”

“CHI Memorial continually strives to provide high-quality clinical care,” says Kevin Lewis, MD, CHI Memorial Chief Medical Officer. “Our medical and clinical staff implement and evaluate quality initia-tives to ensure that people in our commu-nity receive the best possible outcomes.”

For the purposes of this list, Becker›s defines community hospital as a hospital with fewer than 550 beds and that have minimal teaching programs. Some are located in suburban areas near major cities, while others are found in ru-ral towns that serve as the only hospitals in their communities. Whether indepen-dent or part of a larger health system, the hospitals on this list have continually worked to provide high-quality care. The Becker’s editorial team selected hospi-tals based on awards and rankings from a number of well-known industry ratings agencies.

LMU-DCOM Launches International Medicine Scholars Program

HARROGATE - Lincoln Memo-rial University-DeBusk College of Os-teopathic Medicine (LMU-DCOM) has selected four students from the Class of 2016, Branden Moore, Razik Oumeddour,

Kristin Baker and Rachel Grisham, for its inaugural LMU-DCOM International Medicine Scholars Program.

«This is a once in a lifetime opportu-nity for our students to gain experience in an international health care setting, and we are confident they will represent us well,» said John Williamson, MD, director of International Medicine at LMU-DCOM.

Branden Moore and Razik Oumed-dour will represent LMU-DCOM at Gannnan Medical University in Ganzhou City, China. With a population of nine million, Ganzhou City, located in south-ern China, is the second largest city in the Jiangxi Provence. Founded in 1941, Gan-nan Medical University is the only medi-cal university in the area and has 17,000 students and 2400 university hospital staff. Moore and Oumeddour will work at First University Hospital, a 2,200 bed hospital in the heart of the city. While at Gannan Medical University, the students will do weekly internships in internal medicine, surgery, pediatrics and ICU, and emergency medicine. They will also take weekly Chinese culture courses and have the opportunity to tour Shangyou Lake, Jingang Mountain and the City of Beijing.

While Moore and Oumeddour will be gaining experience in a large urban setting, students Kristin Baker and Rachel Grisham will be headed to Australia for a rural experience. Baker and Grisham will represent LMU-DCOM at James Cook University (JCU) in Queensland, Australia. JCU is a teaching and research institution

with a focus on tropical environments including tropical medicine and pub-lic health care in under-served popula-tions. Similarly, LMU-DCOM›s mission is to serve the health and wellness needs of people within both the Appalachian region and beyond, and enhance access to comprehensive health care for under-served communities

LMU-DCOM›s long-standing re-lationship with James Cook University (JCU) began in 2012 when Rex Hobbs, associate director of the Physician As-sistant Program, visited JCU and worked to create an agreement allowing both PA and DO students to do clinical rotations in Queensland, Australia. This winter, two students from JCU spent a month in Harrogate, Tennessee doing clinical rota-tions with local doctors.

«We›ve had a wonderful long-time relationship with James Cook University and are thrilled to now be partnering with Gannan Medical University in China,» said Williamson.

The students were selected based upon academic performance and a writ-ten essay. They will be embarking on their 4-week international rotations trip in September 2015. LMU-DCOM has established relationships with physicians across the globe and LMU-DCOM stu-dents have participated in global health opportunities in several international lo-cations such as Cambodia, China, Costa Rica, England, Egypt, Ghana, Guatemala, Guinea, India, New Zealand, Sri Lanka, and Vietnam.

GrandRounds

LaFollette Eye Clinic Honored As A Top U.S. Eye Care BusinessLAFOLLETTE – INVISION, a national magazine for American eye care professionals, recently announced that LaFollette Eye

Clinic has been named one of “America’s Finest Optical Retailers” for 2015. This distinction comes less than a year after the clinic’s move to a new facility and location.

A panel of judges selected the winners from around the country based on interior design, indi-viduality, exterior design and website.

The design theme of LaFollette Eye Clinic’s new 10,000 square foot facility was a “Celebration of Vi-sion,” and the judges certainly celebrated the look and feel of the vibrant color scheme found through-out the building, comparing it to some of the most well-known brands in the world.

“One of our judges complimented LaFollette Eye Clinic as ‘the Target of optical retailing,’ and another said ‘it may just give Disney a run for its money as the happiest place on Earth’,” says INVI-SION editor-in-chief Julie Fanselow. “We all got a sense of energy from the colors and the building’s spacious, open feeling.”

Drs. Andy and Elizabeth Howard, owners of the practice since 2002, wanted to create a place that would keep local residents in the area and save them from traveling for their vision care and eye-wear. As the new location gains more prominence and notoriety, more visitors from around the region are making the trip to LaFollette.

“We wanted to create a true destination for East Tennesseans who value not only their vision, but also their overall health,” says Dr. Andy Howard. “We’re truly grateful for everyone that played a role in helping us achieve our ‘vision’ and this dream.”

Other 2015 honorees include practices and stores in Oakland, Calif., Westlake, Ohio, Las Vegas, Nev., Wayzata, Minn., Cam-bridge, Mass., Paris, Texas, Rockville, Md., Madison, Wis. and San Diego, Calif.

Howard added, “To receive this national recognition alongside so many wonderful practices from around the country is tre-mendous and it’s an honor that we share with our entire community that has supported us for so many years.”

All of the winners will be featured in the July-August print edition of INVISION. Read more about the winners at invmag.us/2015finest.

Dr. William Fritsch

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East TN Medical News August 2015