Louisiana Medical News May 2013

By TED GRIGGS

A few of the National Commission on Physician Pay-ment Reform’s recommendations, such as paying the same rates for the same services regardless of setting, merit con-sideration, according to the Louisiana State Medical So-ciety’s president.

But the commission misses on a number of other pro-posed changes, Dr. Van Culotta said, including the group’s major premise: that fee-for-service payments to physicians are a chief driver of healthcare costs and uneven quality of care.

“Doctors are the least of the problem,” Culotta said. “Most doctors are working under a 20-year-old fee schedule.”

The never-ending increases in healthcare costs have far more to do with the amounts spent on new technologies and prescription drugs, Culotta said. If the United States focuses on cutting physician payments and doesn’t do something to control the spiraling price tags of prescription drugs and technology, the only reductions achieved will be in the number of doctors.

The Affordable Care Act, also known as ObamaCare, will bring 32 million newly insured people into the healthcare system in 2014, Culotta said. The problem is there aren’t enough doctors practicing today to handle those 32 million people.

And cutting physician payments isn’t going to help with the doctor shortage, he added. The

By LISA HANCHEy

In December, a man in his 40s was admitted to Ochsner Medical Center in New Orleans with biventricular heart failure. He had been surviving on two IV medications and an intra-aortic bal-loon pump. “Because of his biventricular heart failure, there was not really much we could offer him, other than medical therapy, which he already was on and was not doing well,” recalled Dr. Aditya Bansal, a cardiothoracic surgeon at John

Ochsner Heart & Vascular Institute. “Patients like this were basically relegated to go to hospice.”

That all changed in February when Ochsner became the fi rst site in the Gulf South region to perform the Total Artifi cial Heart (TAH) implant. The SynCardia

TAH, the world’s fi rst and only FDA-approved device, is indicated for patients with end-stage biventricular heart failure. Consisting of two biocompatible pumping chambers

with four valves, this mechanical heart is operated by an external power supply connected by two drivelines below the rib cage. This device provides blood fl ow of up to 9.5 liters per minute through

each ventricle. “With the presence of total artifi cial heart, you actually remove the right and left ventricles, and

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Medical Society Says Pay Reform Group Misses Mark

Dr. Ralph ChessonWhile stationed in the U.S. Navy as an engineering offi cer, Ralph Chesson had a conversation with the ship’s doctor on a Polaris submarine that changed his life. “I’d always kind of wanted to be a doctor,” he revealed ... page 3

ObamaCare May Generate Medical TourismThe power of the Internet and greater price transparency have helped give patients more care options, with millions of U.S. residents traveling abroad each year to seek treatment. But more and more U.S. physicians are trying to tap into the multibillion-dollar business ... page 4

2013 Legislative Session to be Busy with HealthcareThe 2013 Regular Session of the Louisiana Legislature convened on Monday April 8, 2013 ... page 9

Physician Spotlight

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(CONTINUED ON PAGE 12)


Heart to HeartOch sner implants fi rst total artifi cial heart in Gulf South

Dr. Aditya Bansal

2 • MAY 2013 Louisiana Medical News

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Louisiana Medical News MAY 2013 • 3

By LISA HANCHEy

While stationed in the U.S. Navy as an engineering offi cer, Ralph Chesson had a conversation with the ship’s doc-tor on a Polaris submarine that changed his life. “I’d always kind of wanted to be a doctor,” he revealed. “But when I talked to my ship’s doctor, I told him that I didn’t try to apply because I did so badly in for-eign language. He said, ‘Oh, you don’t need that anymore.’ And, at that point, I knew that that was what I was going to do.”

A graduate of the Naval Academy, Chesson served on nuclear submarines from the time he entered the Navy in 1962. After that fateful conversation with the ship’s doc, he took a hiatus from mili-tary service in 1968 to attend Virginia Commonwealth University for pre-med. Next, he earned his doctorate at the Medi-cal College of Virginia. “While I was in medical school, I came back in the Navy on a scholarship program, which paid my way nicely,” he said.

After completing medical school a year early, Chesson performed an intern-ship and residency in obstetrics and gyne-cology at Naval Regional Medical Center in Portsmouth, Va. Why OB/GYN? “It was just a natural thought process for me when I was fi rst did it as a medical stu-dent,” he said matter-of-factly. “It became obvious to me that that was what I wanted to do.”

Following his residency, Chesson was sent to Camp LeJeune for three years. Afterwards, he returned to Portsmouth to teach. In 1979, one of his mentors told him about urogynecology. “My mentor told me I needed to do this and, he was correct,” he said. “I’ve been working in urogynecology since before it had that name.”

After serving in the Navy for 20 years, Chesson retired from military service. He continued to teach in Portsmouth until two of his residency students recruited

him to LSU in New Orleans. In 1995, he left his home state for Louisiana. Since then, he has served as a clinical professor of gynecology for the LSU Health Sci-ences Center, section of Urologynecology and Pelvic Floor Reconstruction. “Uro-gynecology has actually become an offi -cial subspecialty this year,” he reported. “Finally. It’s been a long time coming. It’s hard to establish a new subspecialty. I didn’t think it was going to happen before I retired, but it has.”

From 1995 until today, Chesson has

practiced urogynecology with various groups in New Orleans and at Women’s & Children’s Hospital in Lafayette, La. as part of its Women’s Multi-Specialty Group. “I spend part of my time in La-fayette, part of my time in New Orleans,” he explained. The board certifi ed OB/GYN, urogynecologist and reconstruc-tive surgeon specializes in diagnosis and treatment of pelvic conditions including stress and urge continence, uterine pro-lapse and other pelvic problems resulting from childbirth. He serves as a member

of the American College of Obstetrics and Gynecology, American Urogynecology Society and the So ciety of Gynecologic Surgeons.

On a personal note, Chesson just celebrated his 50th wedding anniversary with his wife, Dianne. Their daughter, Meredith, has a PhD in archeology and teaches at the University of Notre Dame. Son Ralph, III works as a stockbroker in Norfolk, Va.

In his free time, Chesson enjoys play-ing duplicate bridge with Dianne. “My wife plays a lot more bridge than I do; I work for a living still,” he said. “It keeps you going.”

Each year, Chesson participates in medical mission trips to third-world countries. At press time, he was planning a journey to Rwanda, Africa to perform obstetrical fi stula surgeries and teach. “Teaching is very important to me,” he revealed. He also travels annually with a group to Nicaragua to help with different procedures.

While Chesson enjoys exercising, particularly walking, he has a pastime that his colleagues might be surprised to know. “I do ballroom dancing,” he said. “I’ve done that for a long time, since the early 1990s. Dianne and I like to dance. We did it competitively a long time ago. But that’s stupid. We enjoy it.”

Physician Spotlight

Dr. Ralph ChessonSea Story

CONNECTED?Are You


By TED GRIGGS

The power of the Internet and greater price transparency have helped give pa-tients more care options, with millions of U.S. residents traveling abroad each year to seek treatment. But more and more U.S. physicians are trying to tap into the multi-billion-dollar business.

Dr. Arnold Feld-man, a Baton Rouge-based pain management specialist, is one of them. Feldman has established a full-service concierge program, The Feldman Institute Travel Program, that offers patients, no

matter where they’re from, a sort of one-stop shopping experience.

“Our goal is to develop a travel pro-gram where you can say, ‘Doctor, I want to come and see you.’ And we just basically say, ‘Would you like us to take care of the arrangements?’”

Feldman has three employees out of a 40-person staff who handle the travel ser-vices. The staff will do whatever the patient prefers, including making airline reserva-tions, picking patients up at the airport, arranging hotels and rental cars, and rec-ommending restaurants, attractions and events.

These tasks are not overly difficult, Feldman said.

Feldman’s practice has also made ar-

rangements with hotels near his practice to make sure his patients can always get a room.

Marcy Rogers, CEO of SpineMark Corp., is building a global network of spine centers and work-ing with Feldman to boost his medical tourism busi-ness.

In 1998, The Wall Street Journal published a story about Apollo Hospitals Group in India and how it was attracting patients from the United States and Europe for joint and cardiac stent replacements, Rog-ers said. At the time, people thought medi-cal tourism might generate $200,000 in revenue a year.

Those estimates were obviously too low, Rogers said.

Medical tourism is now one of the fast-est-growing segments of the healthcare in-dustry, she said. There are now companies whose sole purpose is to manage medical benefits for patients and help them travel outside their home city, state or country.

A Google search of medical tourism and concierge generates more than 1.1 million results.

Medical tourism used to mean leav-ing the United States for the lower prices offered in less developed countries, Rogers said. But that is no longer the case.

Germany, Spain and other so-called Tier One countries, which are every bit as developed as the United States, are recruit-ing patients from abroad for surgery, she said.

An April story by Reuters says around 270,000 of the 37 million tourists who visited Turkey in 2012 came for surgical procedures, which generated $1 billion in

revenue. Turkish Airlines has standing dis-counts for medical tourists.

Those sorts of business opportunities aren’t limited to foreign countries, Rogers said.

Feldman said medical tourism now accounts for 1 percent to 2 percent of his practice’s revenue, but he hopes to boost that percentage into double digits within the next year or so.

The tremendous changes being brought about by the Affordable Care Act – the majority of requirements kick in next year – will mean even greater numbers of people traveling to seek care, Feldman said, and more personal service.

Over the past several years, insurance companies and employers began looking at physicians as interchangeable, Feldman said. They seemed to think that doctors were all the same, and it didn’t really mat-ter who a patient saw.

Feldman said this opinion is totally wrong. But this attitude, along with a num-ber of other contributing factors, helped create a more impersonal approach to medicine.

It also helped spawn the practice of concierge medicine, he said, and concierge travel service is just the next step.

The physician entrepreneurs involved in medical tourism, whether in the United States, China, Germany, etc., are like the pioneers who settled the West, Feldman said.

“I think you couple the pioneer spirit with the Internet, and you’re going to find a growing, burgeoning part of medicine. And I think it’s going to be a great thing,” Feldman said. “Because I got news for you. What we have in this country is about to implode. I don’t know what’s going to hap-pen, but it ain’t going to be good.”

Feldman said that in 2014, the Af-fordable Care Act is going to scramble the healthcare industry’s eggs.

Within a year, everybody is going to be clamoring for some reasonable change, he said. And that may mean getting on an air-plane to seek care in a different city or state.

Feldman doesn’t have a primary care physician. Like a lot of other people, Feld-man said, he is too busy to sit in a doctor’s office for eight hours.

But the U.S. healthcare system in its current incarnation makes zero accom-modations for people who cannot afford to spend time away from work, Feldman said. Unless a person has some sort of inside con-nection, he or she must place their life on hold – even for a trivial matter – in order to seek treatment.

Feldman said his goal is to provide patients with “an oasis” from that sort of experience.

The idea behind the travel center is to give people the highest quality medical care without disrupting their lives too much, he said.

Dr. Arnold Feldman

ObamaCare May Generate Medical Tourism

This year, we’re celebrating BIG!

Happy 100th Birthday American Cancer Society!

Help us finish the fight by participating in Relay For Life where we DREAM BIG,

HOPE BIG and RELAY BIG!

To find a Relay For Life in your community please call 1-800-227-2345 or visit relayforlife.org.

Marcy Rogers

MARKETING


The heart surgeons and cardiologists at The Regional Medical Center of Acadiana’s new Heart Institute are operating with the latest life-saving, valve replacement technology in their hands. We are the first and only facility in Acadiana and third in Louisiana chosen by Edwards Lifesciences as a transcatheter aortic valve replacement (TAVR) hospital.

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TAVR Team: (L to R) Dr. Raghotham Patlola, Cardiovascular Institute of the South (CIS); Dr. Wade May, CIS; Dr. Charles Wyatt, Regional Medical Center of Acadiana; Dr. Mitchell Lirtz-man, Regional Medical Center of Acadiana; Dr. John Patterson, CIS; Dr. Louis Salvaggio, CIS


By CINDy SANDERS

Earlier this year, Andrew Dixon, senior vice president of marketing and operations with Igloo Software and the former chief marketing officer for Micro-soft Canada, was invited to Dallas to share in-sights on how healthcare organizations can make the move from social media marketing to an integrated social business strategy during the CIO Healthcare Summit.

At the core of a social business strat-egy is the desire to deepen connections, engagement and collaboration within various communities touched by the com-pany or industry. For healthcare provid-ers, those communities might be other practitioners, researchers, payers, staff, and … of course … patients.

“Social business is no longer just for early adopters,” said Dixon. “It really is a modern way to help connect members together.”

One of the first steps, however, is to understand the difference in social media and social business. “Social media is about analyzing how your brand is being received in the marketplace,” Dixon ex-plained. “Social business is modern com-munications brought into the business for the purpose of end-user productivity, col-laboration and engagement.”

He continued, “The most popular tool being used today to do that is email, but email was never intended to be a col-laborative tool.”

In a typical scenario, he continued, one person would email an attached document to 10 people for comments and input, which leads to 10 different docu-ments with notes that might be conflicting to compile into one master file … which is then sent back out for further review. Ultimately, businesses need to connect three key elements together — processes, information and people. Dixon noted that while large investments have been made in processes, the chief tools of email and a word processor have been fairly stagnant for the last 20 years.

To address this issue, social business software designers have taken a cue from technologies like Facebook and Twitter, which started in the consumer realm.

Dixon said the beauty of these tools is that they are lightweight, easy to navigate, simple and very effective in keeping indi-viduals connected to their social network, which is a sophisticated online commu-nity.

The concept of online communities, he continued, isn’t new to healthcare. “Even back in the 1990s, people would have early dos-based discussion boards. Around 2000 … 2002 … we started to see the emergence of heath information repositories like WebMD. For consumers, it was the first time they could easily get information outside of a doctor’s visit,” Dixon said. He added that by mid-2005, those repositories had become more like communities where people with a similar interest could connect with each other.

“Fast forward to where we are today, and what we really have are health net-works. They really are communities, but they’ve introduced much richer commu-nication and collaboration tools,” Dixon continued. He noted tools like microblog-ging, wikis and forums open the path to allow discussion around content within a community setting. “The reason social business tools are so popular is not only do they work they way you do, but you can choose the one that’s most appropriate for the task at hand,” he added.

Creating Engaged CommunitiesDixon said the ability to engage and

connect in a community setting is one of the most powerful aspects of a social busi-ness model. Today, patients with similar ailments can tap into a network to share experiences, information and support. That said, he added the communities could be built with parameters to allow providers to monitor and moderate dis-cussions.

“It’s open communication, but at the same time, you introduce controls,” he ex-plained. Although it does take some time to manage, Dixon added, “The scale and the reach you get with an online commu-nity far exceeds what you could ever get from an in-person visit.” That element also allows physicians to disseminate mes-sages about wellness and disease manage-ment to large, targeted populations, which will be increasingly important in new ac-countable care delivery models.

For physicians, the community setting

The Move from Social Media Marketing to Social Business Strategies

Andrew Dixon

(CONTINUED ON PAGE13)

MARKETING

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» Better care coordination and patient management

» Timely access to patient records

» Improved patient safety/reduced medical errors

» Enhanced patient/physician communication

» Increased security of records

» Improved public health reporting

» Reduced medical costs

» Improved access to information in emergencies and disasters

» Streamlined connectivity with eHealth Exchange

Benefits include

More than 130 hospitals, clinics, physician practices and health care companies throughout Louisiana are now participating in LaHIE. For more information or to schedule an on-site demonstration, contact [email protected] or call (225) 334-9299.

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InitiativeEnabling authorized providers to electronically share health information through a secure and confidential network.

In partnership with the Office of the National Coordinator for Health Information Technology (ONC), U.S. Department of Health and Human Services, Grant #90HT0050/01. lhcqf.org


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By LyNNE JETER

LITTLE ROCK – When Bill Hefley, MD, was a junior partner at a Little Rock orthopedic practice more than two decades ago, he was tasked with choosing a new infor-mation technology (IT) system to replace an an-tiquated one. After com-pleting due diligence on various options, he played it safe and purchased a new system from the na-tion’s largest vendor.

“It was a complete disaster,” recalled Hefley, noting the software was different than the demonstration version, the trainer was “preoccupied and disinterested,” and customer support was practically non-ex-istent. “Our practice collections soon ap-proached zero. I knew there had to be a better way.”

A hobbyist computer programmer, Hefley devoted his energies to filling the void in the marketplace. From it, he estab-lished MedEvolve as a truly collaborative industry partner to solidify the IT back-bone of medical practices. The success of MedEvolve’s practice management (PM) software – it not only organizes patient databases, scheduling and billing, but also allows extensive data reporting – led to the launch of its revenue cycle management (RCM) division. In a fairly crowded field of practice management software companies, MedEvolve stands out not only in software performance, but especially in a vital yet often overlooked area – customer service.

The Drawing BoardIn searching for a better solution in

the early 1990s, Hefley connected with Pat Cline, president of Clinitec International Inc., then a startup company based in Hor-sham, Pa., and a pioneer in the emerging field of electronic medical records (EMR).

“Intrigued, I became an early inves-tor and a development partner focused on orthopedic clinical content,” he said, not-ing that a small public company acquired Clinitec, which became known as NextGen Healthcare, now one of the world’s lead-ing healthcare IT companies. Hefley, an orthopedic specialist in minimally invasive surgeries for the knee, hip and shoulder using arthroscopic and joint replacement procedures, became a development part-ner with NextGen in 1994, working on the development of clinical content for ortho-pedists. “By 1997, I felt opportunities still existed in the physician PM software indus-try. While most physician practices were utilizing computerized billing and sched-uling, the available systems were DOS- or Unix-based and not taking advantage of the Windows GUI interface, much less the Internet. More importantly, healthcare IT vendors in the physician sector remained notoriously atrocious in delivering sup-port and customer service. I frequently heard my physician friends and colleagues recount horror stories of flawed software systems with dismal support that were mak-

ing it impossible to run their practices suc-cessfully. I remembered my personal bad experience with the large national vendor and the stellar reputation of a small local firm, MBS (Medical Business Services Inc.), which I’d also checked out.”

In 1998, Hefley and Steve Pierce of MBS, a 9-year-old IT firm with a mature DOS-based PM software product, founded MedEvolve with the vision of becoming the first Windows-based physician PM system that employed the Internet and delivered impeccable support and customer service.

“My practice became the beta site for the first version of our new Windows-based PM system,” recalled Hefley, MedEvolve’s president and CEO. “We began to sell our product regionally initially and eventually throughout the United States. We inte-grated our PM product with several spe-cialty-specific EMR systems to reach more physician practices. We continually worked to upgrade the software and deliver new, innovative functionality. By our tenth year, we had several thousand users nationwide.”

With the success of MedEvolve’s PM product, Hefley recognized a growing need among physician clients for expertise in RCM.

“Physicians were struggling with in-creasingly complex third-party payor systems, growing documentation require-ments, mounting government regulations, and threats of audits, fines and imprison-ment,” said Hefley. “Practices were search-ing for a partner with expertise in these areas that could relieve them of the burden of constantly attempting to stay abreast of the ever-changing rules and regulations. Physicians wanted to focus on the practice of medicine and leave the headaches to people that specialized in those matters.”

MedEvolve developed an RCM divi-sion, acquired three small RCM compa-nies, and now has a division that includes experienced practice administrators and dozens of billing and coding specialists.

“With specialization, scale, and great software, we’ve been able to produce some of the best results in the industry – 97 per-cent first-pass claims success, 27 percent average increase in practice revenue, and a 38 percent average reduction in accounts receivable days through MedEvolve RCM services,” he said. “By switching to MedE-volve’s RCM service, providers imme-diately experience less hassle, lower costs and increased revenue that result in an improved bottom line and peace of mind.”

Health Reform Impact The 2009 American Recovery and

Reinvestment Act (ARRA) authorized the Centers for Medicare & Medicaid Services (CMS) to award incentive payments to eligible professionals who demonstrated Meaningful Use of a certified electronic health record (EHR) system.

“With the new criteria defined, MedE-volve saw a need for a modern EHR prod-uct designed from the ground up to meet Meaningful Use mandates and finally de-liver on the industry’s promise of a cutting edge, customized solution that helps prac-

tices save time and money and improve the quality of patient care,” said Hefley. “The resulting MedEvolve EHR is fully integrated with the MedEvolve PM system and is de-signed for the high volume practice with an emphasis on fewer clicks, fewer screens, faster data input and faster data retrieval.”

Hefley has placed a strong emphasis on customer service as the bedrock prin-ciple of MedEvolve. It’s not just a catchy slogan; he rewards employees for “outra-geously excellent customer service” with WE (Whatever, whenever, Exceed expec-tations) awards. The WE Award comes with a cash bonus and a new title on the employee’s email signature. As a result, employees strive to achieve the distinction of a “Four-time Recipient of the MedE-volve WE Award.”

“In the software business, that means several operators are at the ready for pe-riods of peak call volume,” he said. “We maintain support-to-client ratios above the industry norm. We design our soft-ware to be intuitive with online help so that less support is necessary. In the RCM division, we work claims as much as neces-sary to ensure our providers are fully paid for the services they’ve performed. We’re not some detached, impersonal entity; we partner with the practice in achieving their goals.”

Today, MedEvolve offers PM and EMR software and RCM services to phy-sician partners, and also electronic pre-scribing, data analytics and other ancillary products and services. With four offices, the company covers all specialties and the entire United States, from solo practitio-ners to practices with more than 50 physi-cians. Commitment to service has garnered MedEvolve a reputation of trust among physician partners, allowing the company to rise above the scores of small physician IT companies nationwide.

By year’s end, MedEvolve will out-grow its new corporate headquarters in downtown Little Rock, a refurbished red brick bakery built circa 1919, necessitating yet another expansion.

“We’re now in that sweet spot where we have the expertise and resources to meet our clients’ every need, and yet we re-main nimble and able to move quickly in a rapidly changing healthcare environment,” he said. “We’re proud to be privately held so that we aren’t a slave to our stock price and quarterly reports, but rather free to do what’s right for our client. Our fore-most concern remains the principles upon which the company was founded – elegant, user-friendly software and unparalleled customer service.”

IT AccelerationMedEvolve finds ‘sweet spot’ niche providing PM and EMR software and RCM services to physician practices nationwide

Dr. Bill Hefley


By CINDy SANDERS

What if the standard treatment ap-proach was the wrong one? In the case of several autoimmune disorders, it’s a theory that is gaining traction bolstered by recent research findings.

Stephen A. Paget, MD, FACP, FACR, MACR, physician-in-chief emeritus at the Hospital for Special Sur-gery in New York City, has spent his career re-searching and treating a range of inflammatory and autoimmune disor-ders. The rheumatologist, who is also a professor of Medicine and Rheumatic Disease at the Weill Med-ical College of Cornell University, said the potential exists for a paradigm shift in how clinicians view and treat some disorders in-cluding reactive arthritis, Whipple’s disease and persistent Lyme disease.

Paget said the accepted concept has been “that in a genetically predisposed per-son, with some type of environmental trig-ger … probably virus or bacteria … they develop disease.” Although the initiation was from a microorganism, he continued, the conventional wisdom has been that the self-perpetuation of symptoms is due to the body’s subsequent response. “What you

were left with was an inflammatory prob-lem that was no longer tied to the previous organism,” Paget explained.

A good example would be persistent Lyme disease. The infectious trigger is the Borrelia burdorferi, a bacterial species of the spirochete class, which is transmitted to humans through a tick bite. Skin rash in a bull’s-eye pattern (erythema migrans), fever, fatigue, chills and headaches are among early symptoms. Later symptoms could in-volve the joints, heart or central nervous sys-tem. For most, a prescribed course of oral or intravenous antibiotics takes care of the infection and symptoms. However, in some patients, synovial inflammation persists even after the bacteria have been nearly or totally eradicated. This has given rise to the belief that in predisposed patients, the initial Lyme disease triggers an ongoing autoim-mune disorder.

In his 2012 paper, “The Microbiome, Autoimmunity and Arthritis: Cause and Ef-fect: An Historical Perspective,” which was published in Transactions of the American Clinical and Climatological Association, Paget noted that for more than 100 years, there has been “tantalizing but often incon-clusive evidence” about the role of microor-ganisms in autoimmune diseases. He wrote, “Current therapy focuses on the pathogen-esis rather than the etiology of these dis-orders. In order to rein in the overactive

immune system we believe to be causing the disease, we employ immunosuppressive drugs, an act that would be counterintui-tive if infection were the root cause of the problem.”

A small but intriguing study out of the Division of Rheumatology at the Univer-sity of South Florida College of Medicine published in the journal Arthritis Rheum in May 2010, found a six-month combination antibiotic regimen was effective in treating patients with the autoimmune condition Chlamydia-induced reactive arthritis. In the nine-month, prospective, double-blind, triple-placebo trial, researchers assessed a six-month course of combination antibiot-ics with a primary end point of the number of patients who improved by 20 percent or more in at least four of six variables without worsening in any variable.

At month six, the authors found significantly more patients in the active treatment group became negative for C trachomatis or C pneumonia. The pri-mary end point was achieved in 63 per-cent of patients in the active arm of the trial, with 22 percent of those patients believing their disease had gone into com-plete remission. No patient in the placebo group achieved remission.

Pointing to this study, Paget noted that one of the failures of antibiotic regimens in the past in treating autoimmune disorders

might be the duration of the therapy. “If you give long courses of antibodies, you may very well calm the problem down,” he said. However, he noted, physicians cur-rently switch to steroids, T-cell inhibitors, and other immunosuppressive drugs to ameliorate the ongoing inflammatory issue after treating the triggering microorganism with antibiotics or antivirals for a relatively short course,

“It may very well be we have to im-prove the immune system response instead of suppress it, and that’s the interesting twist,” Paget continued. If the root cause of an autoimmune condition is infection, “You’d want the army active,” he said of augmenting the immune system.

While much more research must be done, Paget said mounting evidence of the important connection between microor-ganisms and a number of autoimmune dis-orders provides ‘food for thought’ when it comes to the best course of action for treat-ing these conditions and could ultimately portend a paradigm shift in the delivery of care.

“In some of these, the organism is slow, smoldering … but still there in a low-grade way that is triggering the inflammatory re-sponse. We have to be appreciative of the fact that we want to do the best thing for our patients … but what we’re doing (now) may be the worst thing,” he concluded.

Unconventional WisdomRethinking the approach to some autoimmune disorders

Dr. Stephen A. Paget


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The 2013 Regular Session of the Louisiana Legislature convened on Mon-day April 8, 2013. State lawmakers will meet until June 6, 2013. Below is the list of pre-fi led bills that are related to healthcare and/or social services. If you would like to view a particular bill, visit the Louisiana Leg-islature’s website at www.legis.la.gov Feel free to email me at [email protected] if you have questions about any of these measures. For regular legislative up-dates, like Checkmate Strategies facebook page or sign up for tweets @capitolbabe

HB 1, FanninProvides for the ordinary operating ex-penses of state government for Fiscal Year 2013-2014

HB 6, SchroderProvides that the crime of carrying a fi rearm or dangerous weapon on school property shall not apply to off-duty law enforcement offi cers HB 10, PearsonAdds certain hallucinogenic substances to the list of Schedule I controlled dangerous substances

HB 15, MackAdds certain compounds to the Schedule I classifi cation of controlled dangerous substances HB 35, BarrowProvides for retirement eligibility of em-ployees of state hospitals under certain conditions

HB 79, HensgensProvides relative to school crisis manage-ment and response plans

HB 82, HillLimits the sale and purchase of products containing dextromethorphan

HB 89, HoffmannProvides relative to the use of seclusion and physical restraint to address the be-havior of certain students

HB 90, MackAuthorizes DPS&C to sell bulletproof vests to other law enforcement agencies

HB 95, DixonProvides relative to eligibility criteria for admission or readmission to a public school and prohibits the denial of admis-sion or readmission based on certain stu-dent characteristics

HB 103, BadonProvides relative to criminal penalties for possession of marijuana or synthetic can-nabinoids and the applicability of the Ha-bitual Offender Law relative to possession

of marijuana or synthetic cannabinoid of-fenses

HB 110, NortonRequires that La. Medicaid eligibility standards conform to those established by the Affordable Care Act HB 111, HoffmannProhibits outdoor smoking within 25 feet of certain exterior locations of state build-ings

HB 115, JamesProvides for parent petitions relative to the transfer of certain schools from the Recov-ery School District back to the local school system HB 116, HoffmannProvides relative to textbooks and other instructional materials for elementary and secondary schools

HB 120, PughAuthorizes the La. State Board of Nursing and the La. State Board of Practical Nurse Examiners to accept certain accreditations for nurses HB 121, MontoucetProvides with respect to the membership of the Workers’ Compensation Advisory Council

2013 Legislative Session to be Busy with Healthcare

Legislative Affairs

Cindy Bishop



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HB 129, PierreProhibits giving a teacher or administrator a performance rating until completion of his full evaluation

HB 150, GreeneRequires recognition of assignment of health insurance benefi ts to health care providers

HB 153, FoilExpands the income tax checkoff applica-ble to prostate cancer to include all types of cancer

HB 155, CoxProvides relative to school safety, security, and crisis

HB 160, ReynoldsDelays implementation of certain teacher evaluation program requirements and requires legislative approval of the value-added teacher assessment model prior to implementation of the requirements

HB 173, HazelAmends Louisiana’s safe haven law to pro-vide that a child 12 months old or younger may be relinquished to a designated emer-gency care facility

HB 206, ReynoldsRemoves geographic limitations on the legislature’s authority to create new school boards and on provisions relative to fi -nancing education

HB 212, BrossettProvides relative to the creation of a state-wide mapping and planning system for certain schools

HB 214, JeffersonProvides relative to parental involvement in public schools

HB 216, ShadoinProvides relative to the ability of the Pa-tient’s Compensation Fund Oversight Board to invest certain funds

HB 224, HollisProvides for the removal of a school bus driver convicted for certain offenses rela-tive to operating a vehicle while intoxi-cated

HB 226, RichardCreates the crime of prohibited sexual contact between a psychotherapist and a client or patient

HB 228, FanninProvides relative to balance billing by and reimbursement of noncontracted facility-based physicians for covered health care services rendered in an in-network health care facility HB 230, PopeProvides relative to the defi nition of “eli-gible student” for participation in the Student Scholarships for Educational Ex-cellence (voucher) Program HB 233, SmithProvides that eligibility standards for the La. Medicaid program shall conform to those established by the Affordable Care Act and requires reporting of program outcomes HB 234, Williams, P.Requires that owner identifi cation infor-mation be marked on every removable dental prosthesis fabricated by a dentist or pursuant to a dentist’s order

HB 251, TalbotRequires DHH to institute Medicaid cost containment measures to the extent al-lowed by federal regulations

HB 273, LorussoProvides relative to reports, records, and adjudicatory functions of the La. State Board of Medical Examiners

HB 275, WillmottAuthorizes podiatrists to obtain patient histories and perform physical examina-tions under certain conditions

HB 281, SimonCreates a single license for behavioral health services providers

HB 291, PriceChanges composition and requirements relative to Advisory Committee on Equal Opportunity

HB 294, RitchieProvides relative to regulation of long-term care insurance policies

HB 322, ThierryRequires birthing facilities to perform pulse oximetric screening for certain heart defects on each newborn in the care of those facilities HB 342, HuvalProvides relative to balance billing by and reimbursement of noncontracted health

care providers of emergency medical ser-vices

HB 374, StokesProvides relative to timing of payment of insurance premium taxes to the commis-sioner of insurance

HB 543, PierreProvides relative to regulation of surplus lines insurance

HB 592, ThibautProvides for the adequacy, accessibility, and quality of health care services offered by a health insurance issuer in its health benefi t plan networks

HB 645, CromerProvides relative to an internal claims and appeals process and external review pro-cedures for health insurance issuers

HCR 7, BarrowSuspends laws authorizing DHH to im-plement resource allocation models for Medicaid-covered home- and commu-nity-based long-term care services

HCR 8, EdwardsAmends administrative rules to provide that La. Medicaid eligibility standards conform to those established in the Afford-able Care Act

SB 18, WardProvides for cake and cookie products and preparation of cakes and cookies in home for public consumption

SB 21, MillsLimits liability for a nonprofi t corpora-tion entering into a cooperative endeavor agreement with the Department of Health and Hospitals to operate a supports and services center

SB 26, PetersonRepeals the Louisiana Science Education Act

SB 33, BrownProvides relative to a minority hiring sur-vey by the division of minority affairs in the Department of Insurance

SB 35, HeitmeierProvides for health action plans by the De-partment of Health and Hospitals

SB 55, JohnsProvides for Medicaid transparency

SB 57, Dorsey-ColombCreates the Louisiana Sickle Cell Com-mission

SB 67, PetersonCreates the Louisiana Statewide Educa-tion Facilities Authority

SB 73, WhiteConstitutional amendment to grant the Southeast Baton Rouge community school system in East Baton Rouge Parish the same authority granted parishes rela-tive to MFP funding and raising revenue for schools

SB 75, Buffi ngtonProvides with respect to monies deposited into the Medicaid Trust Fund for the El-derly

SB 76, Buffi ngtonProvides for use of monies in the Louisi-ana Medical Assistance Trust Fund

SB 86, MorrellProvides relative to the Louisiana Mental Health Counselor Licensing Act

SB 101, JohnsProvides with respect to life insurance re-serves SB 125, PetersonProvides that eligibility standards for the La. Medicaid program shall conform to those established by the Affordable Care Act and requires reporting of program outcomes

SB 126, Smith, G.Provides relative to health insurance rate review and approval SB 134, MorrellProvides for licensure of behavior analysts

SB 150, AdleyProvides for authorized agents for pur-poses of criminal history checks on non-licensed persons and licensed ambulance personnel

SB 180, ErdeyProvides relative to the division of insur-ance fraud in the Department of Insur-ance SB 185, MurrayProvides relative to Medicaid and certain managed health care organizations pro-viding health care services to Medicaid benefi ciaries SB 199, WhiteCreates and provides for the Southeast Baton Rouge Community School Board and school system in East Baton Rouge Parish

SB 205, LaFleurProvides for the establishment of foreign language immersion programs in local public school districts

SB 206, LaFleurProvides for empowered community schools SB 220, WalsworthProvides for the “Louisiana Has Faith in Families” Act SB 221, WardEnacts the Louisiana Has Faith in Fami-lies Act

SB 222, WalsworthRevises licensure procedures for child day care centers and facilities

2013 Legislative Session to be Busy with Healthcare, continued from page 9

Legislative Affairs content is provided by Checkmate Strategies, publisher of Health Care Information Services. All content ©

Checkmate Strategies and Louisiana Medical News, LLC. For more information, readers

may contact Cindy Bishop at 225.923.1599 or P.O. Box 80053, BR, LA 70598, or send email to [email protected]. Our website is www.

checkmate-strategies.com


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end result could be more patients in hospi-tal Emergency Rooms, the most expensive form of care anywhere.

The National Commission on Physi-cian Payment Reform was convened in 2012 by the Society of General Internal Medicine. Dr. Bill Frist, former Senate Majority leader, served as the honorary chair. Dr. Steven Schroeder, a health professor at the University of California, chaired the group.

The commission says that each year, U.S. spending on healthcare amounts to $8,000 per person. Despite this enormous investment, Ameri-cans’ health “pales” in comparison to people in other countries, ac-cording to the commis-sion. A large portion of the blame for this is the fee-for-service payment system, and the “skewed fi nancial incen-tives” that encourage doctors to provide more care, and more costly care, regard-less of whether patients benefi t.

The long-term solution? Moving to a payment system based on value through bundled payments, capitation and in-creased fi nancial risk sharing, according to the commission.

The commission’s recommendations include:

• Increasing reimbursement for eval-uation and management services. The payments for technical services are much higher than those for preventive care or for offi ce visits to help patients manage their diabetes. The average radiologist earned $315,000 in 2011, roughly double the average for a family doctor.

• Pay equal rates for the same phy-sician services, regardless of whether the services are done at an outpatient clinic or in a hospital.

• Abolish Medicare’s Sustainable Growth Rate. The Congressional Budget Offi ce has estimated doing that will cost

$138 billion, but reducing the overutiliza-tion of medical services within Medicare would easily cover that amount.

• Where fee-for-service contracts exist, they should always include a compo-nent of quality or outcome-based perfor-mance reimbursement at a level suffi cient to motivate substantial behavioral change.

Culotta agreed that evaluation and management are the most undervalued healthcare services and the reimburse-ments for both should be fi xed.

The commission’s solution is annual updates for evaluation and management codes while freezing payments for proce-dures for three years.

Culotta said Louisiana’s Medicaid program has tried something along a similar line, cutting reimbursements for specialists in an attempt to control costs.

The problem with that approach is that it has become almost impossible for a primary care doctor to refer a Medicaid patient to a specialist, such as an orthope-dic surgeon, Culotta said.

“What specialist is going to take a Medicaid patient if he is being paid less and less?” Culotta said.

Culotta also said the payments for outpatient services should be equalized.

One idea the commission didn’t ad-dress is tort reform, which Culotta said could reduce healthcare costs.

Physicians are still practicing defen-sive medicine because they fear being sued, Cultta said.

The commission report says major studies have shown malpractice is not a signifi cant driver of healthcare costs, but the threat of lawsuits means physicians order unnecessary tests and providing un-necessary medical services.

Culotta said including quality standards in fee-for-service contracts is a good idea, but those standards must be detailed, he said.

“We need to do that up front, and we want that to happen,” Culotta said.

He said while fee-for-service gets criti-cized, there is a limit to what physicians

can make patients do.For example, the doctor can make

a recommendation, a referral and even schedule the appointment with a special-ist, Culotta said. But the physician can’t force the patient to go to the appointment.

“We can’t be policemen,” he said.If the patient doesn’t go to the ap-

pointment, a few weeks or months later, he or she ends up in the Emergency Room, and the quality of care measures go out the window, Culotta said.

Medical Society Says Pay Reform Group Misses Mark, continued from page 1

implant these artifi cial ventricles, which are connected to your main blood vessels and basically take over the complete functioning of the heart,” Bansal ex-plained. “By this, you remove a lot of medica-tions that are still needed in the left ventricular assist device group, arrhythmia problems are resolved and you have an excellent car-diac output, which is actually needed for organ recovery. So, for suitable candidates, I think it would be one of the best devices that we have at this current stage.”

To be a candidate for TAH, pa-tients must have Class III/IV heart fail-ure symptoms, left ventricular ejection fracture of less than 35 percent, early end-stage organ dysfunction, ventricular arrhythmias and hospitalization for heart failure in the past six months. “The device is also suitable for a patient who has had a heart transplant but is failing and needs some support,” Bansal added. “Also, it is indicated for patients with clots in the left side of the heart where left ventricular as-sist device would not be a good option.”

Ochsner’s patient met these criteria and had the proper chest cavity dimensions for TAH implantation. After 48 hours of advanced training, the multidisciplinary team of anesthesiologists, perfusionists, surgeons and residents was ready for the eight-hour procedure. After connecting the patient to a heart-lung bypass machine, lead surgeon Bansal resected the failing heart. Then, he sewed the new ventricles

and attached them to the main blood ves-sels. “There’s a long, tedious process with these connections – making sure that there is no leak, making sure that they are ex-tremely hemostatic,” Bansal explained. “Once that is done, then we have to get these individuals off the bypass machine and make sure that the new heart takes over. So, it’s quite an involved process.”

Following the procedure, the patient adapted well to his new artifi cial heart. “He is doing fantastic,” Bansal reported. “He is eating, he has started to walk, which he had not done since December, he is talking to his family. He is doing ev-erything that you and I do at this stage. We are gradually increasing his activity levels and, very soon, he is going to the fl oor.” If all goes as planned, the patient will eventually return home with a Free-dom portable driver.

Once patients receive TAH, they are placed back on the heart transplant list. Nationwide, about 3,500 patients are cur-rently waiting for a donor heart. “Total artifi cial heart is a bridge to heart trans-plant,” Bansal explained. “There is actu-ally a person in Europe who was fi ve years out with an artifi cial heart before he got a heart transplant.”

Ochsner is one of only 40 sites in the U.S. certifi ed for TAH implantation. “There are probably 1100 done in the whole world,” said Dr. Hector Ventura, section head, Heart Failure and Trans-plantation at Ochsner. “Ochsner has been at the forefront in the development of advanced heart failure treatments. The Total Artifi cial Heart is another milestone in the history of Ochsner in serving pa-tients with innovative technologies.”

Bansal believes that patients should be considered for TAH as soon as they are confi rmed as candidates. “Whenever we think that the patients are failing medical therapy, that is the time that we should consider advanced options,” he said. “Be-cause, the longer you wait, the more end organ damage happens. Once that hap-pens, then it becomes very critical for these devices and advanced therapies to start to turn patients around.”

Heart to Heart, continued from page 1

Dr. Van Culotta

Dr. Hector Ventura

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lets providers who might not be geograph-ically connected engage each other. One of Igloo’s clients is the American Academy of Family Physicians. The organization launched the Delta Exchange as a way for physicians from across the country to become more aligned. “They were able to coordinate all the different best practices and overall learning that various physi-cians had and bring each other along. It was a great way to be able to coordinate a geographically diverse set of practitio-ners,” Dixon said.

Similarly, community settings that encourage discussion and idea exchange could work equally well for other groups including researchers, mid-level provid-ers and practice managers. Internally, an intranet community allows for easy com-munication and collaboration. Using the same types of business tools employed in external communities, staff members can easily review documents, communicate information broadly across geographic locations, vote on policy, and share ideas.

Security“Security has to be built in as a core

set of requirements in any social busi-ness tool,” said Dixon. “The technology is there,” he continued. “It’s one of the central things you look at when deciding which social business tool provider makes sense.”

He added, “Any enterprise-class so-

cial business software fi rm can not only lock down the individual permissions but also has the ability to audit everything that has happened in that community.”

Avoiding Information OverloadDixon said email is in danger of be-

coming less and less useful because of in-formation overload. The same caveat also applies to information imparted through social business tools. “If you don’t imple-ment properly, you risk making that prob-lem worse,” he said.

However, social business tools can be offered in a very targeted manner through channels. Individuals choose which chan-nels are of interest to them and subscribe. Drilling down even further, there are gen-erally options within the channel to refi ne what information the subscriber receives and how.

The Bottom LineWith accountable care organizations

and patient-centered models, support-ing patients and colleagues by providing timely, pertinent information in an easily-accessible manner has become even more critical, Dixon pointed out. “That means you need to be able to collaborate and communicate internally and externally. From a common sense perspective, those that do that best will attract the most pa-tients and keep the most patients … those who don’t will fi nd the opposite.”

The Move from Social Media Marketing, continued from page 6

Three Trends Driving ChangeThree trends are driving change in the workplace – social, mobile

and cloud. People want to be connected; they want to be able to access their information on the move; and they want access on a variety of devices so information can no longer be stored in one physical space.

“It’s incredible how powerful each of these trends are alone, and they are all converging,” said Andrew Dixon of Igloo Software. “By the end of 2013, 20 percent of all U.S. businesses will possess no IT assets whatsoever,” he said, quoting recent statistics. “All of their IT requirements will be outsourced and provided to them by the cloud.”

Citing recent research from business and technology research fi rms McKinsey & Company and Gartner Inc., Dixon underscored just how pervasive these three trends are. “Seventy-two percent of all organizations have already adopted at least one social tool,” he said, adding, “Your phone will outpace your PC as the most popular device to access the Internet this year.”

Although healthcare is sometimes criticized for being slow to adopt business technology, Manhattan Research’s annual Taking the Pulse® study of U.S. physicians’ digital use revealed 85 percent of physicians in 2012 own or use a smartphone professionally (up from 30 percent in 2001). Between 2011 and 2012 the number of physicians who own a tablet nearly doubled from 35 percent to 62 percent. Furthermore, half of the tablet-owning doctors have used their device at the point of care.

variety of devices so information can no longer be stored in one

powerful each of these trends

the end of 2013, 20 percent of all U.S. businesses will possess no IT assets whatsoever,” he said,

of their IT requirements will be outsourced and provided to them

Citing recent research from business and technology research fi rms McKinsey & Company and Gartner Inc., Dixon underscored just

Why Senate Bill 55 Must Passby LSMS Vice President of Governmental Affairs Jennifer Marusak

Vice President, Governmental Affairs Jennifer Marusak

LSMS Making Louisiana a Better Place to Practice Medicine Since 1878

There are many im-portant bills on the table this legislative session, but none moreso than Sen-ate Bill 55, which provides transpar-ency in the Medicaid program by requiring the Louisiana De-partment of Health and Hospitals to re-port certain informa-tion about the Bayou Health and Louisiana Behavioral Health Partnership programs to the Louisiana Legislature.

Why is this legislation needed?

Louisiana expends approximately $2.5 billion a year in these two programs. Currently, there is no reporting or over-sight required for either. Therefore, it is imperative that meaningful oversight and reporting are required to ensure our tax dollars are being spent in the most efficient and effective manner possible.

The Bayou Health and Louisiana Behav-ioral Health Partnership programs were both touted to provide better quality care at a lower cost. As stewards of taxpayer dollars, it is imperative that the legislature ensures these goals are being achieved. Without meaningful reporting to the legislature, this obligation cannot be met.

Furthermore, according to a Voter Consumer Research poll conducted in January of this year, 82% of Louisiana voters said they favor a law requiring greater transparency in the Medicaid program.

What is required to be reported?

1. Measures which speak to the viability of each plan, including total number of healthcare providers in each plan, total number of enrolled recipients in each plan, amount of the total payments, and average per member per month pay-ment for each plan.

2. Metrics centered around claims payments to providers in the program,

including percentage of clean claims paid, average time to pay all claims, and number of claims denied or reduced for certain reasons.

3. Measures that speak to how prescrip-tion drug benefits are being managed. This includes the total number of prescriptions subject to prior authoriza-tion and prescription claims subject to step-therapy or fail first protocols.

4. Measures that speak to health outcomes, including the Medical Loss Ratio of each plan and a comparison of specific health outcomes.

5. Measures of provider and recipient satisfaction through recipient satisfac-tion survey reports and the number of grievances and requests for state fair hearings filed by recipients.

In addition to appropriate measures, the initial report filed by DHH shall include measures from the legacy Medicaid pro-gram so that a comparison can be made between Bayou Health, the Louisiana Behavioral Health Partnership, and the traditional Medicaid programs.

Guidance and bulletins for Bayou Health

DHH will be required to make public all guidance documents it issues which relate to Bayou Health. All of this guid-ance is not public today.

Plan amendments and correspondence

DHH will be required to make public all state plan amendments and related correspondence with the Centers for Medicare and Medicaid Services within 24 hours of submission or receipt.

Stay up-to-date on the latest information

You can keep abreast of all LSMS legis-lative efforts by visiting www.lsms.org/advocacy or by becom-ing a member of the Society, which, in addition to great benefits, allows your voice to be heard on these and other topics in the legislature. Join today by calling 800-375-9508 or emailing [email protected].


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In the News

Bergeron Elected Delegate to the National Conference of the Association of Surgical Technologies

Jay Bergeron, CSFA has, recently, been elected as Delegate to the National Conference of the Association of Surgical Technologies, scheduled for May 21 – 25, 2013 in New Orleans, Louisiana. He is also serving on the Governmental Affairs Committee of the Louisiana State Assem-bly of the Association of Surgical Tech-nologies. Jay works at Surgery Center, Inc. in Lafayette as a Scrub Tech in the Operating Room, as well as in the Pur-chasing Dept. of Materials Management.

Cajun Invasion Donates $2,000 To The Louisiana Foundation For Cancer Care

LAFAYETTE - Cajun Invasion, the fi rst dragon boat racing team in Louisiana, recently made a $2,000 donation to the Louisiana Foundation for Cancer Care. The funds will help cancer patients in Louisiana receive much needed treatment and support services, such as trans-portation to and from radiation therapy ap-pointments. Nancy Duhon, Ann Roberts, and Delores Blaire of Cajun Invasion pre-sented this check to the Foundation and its partner, Oncolog-ics, on March 13, 2013.

These funds are only available for donation because of the fundraising efforts of Cajun Invasion and the generous donations of their many supporters. The organization’s primary fundraiser is the Annual Pink Ribbon Jam – the 4th annual event was held in October 2012 at Blue Moon Saloon.

Louisiana Heart Hospital Physicians Group Signs Agreements

LACOMBE-The Louisiana Heart Hospital (LHH) announced that it has re-cently completed agreements for clinical integration with seven Northshore area physicians.

“These agreements represent an im-portant step in the growth of the Louisi-ana Heart Hospital integrated delivery system, and we are proud to have these experienced physicians join our group,” “ said Steve Blades, CEO of LHH and Sr. Vice President for Physician Services for Cardiovascular Care Group, the parent company of LHH.

The physicians who have signed clini-cal integration agreements include:

Michael C. Finn, IV, M.D., F.A.C.C.Dr. Finn has maintained a private

practice in Louisiana since 1976 with Board Certifi cation in In-ternal Medicine and Car-diovascular Disease. He completed his medical education at Tulane Medi-cal School; Internship at Baltimore City Hospital; Residency at U.S. Public Health Service Hospital, New Orleans; and Cardiology Fellowship at Ochsner Foundation Hospital, New Orleans. He is Clinical Assistant Profes-sor at Tulane University Medical School; Member of the Tulane Vascular and Heart Institute; and Staff Cardiologist, University Hospital, New Orleans. Finn won the American Medical Association’s Physician Recognition Award in 2010.

Cary F. Gray, M.DDr. Gray has maintained a pri-

vate practice in Slidell since 1980 with Board Certifi cation from the American Board of Surgery. He received his medical doctorate from Louisiana State Univer-sity School of Medicine, New Orleans and also completed his residency in general surgery at LSU Medical Center. He is a Fellow of the American College of Surgeons and a member of the Louisiana State Medical Society, the St. Tammany Parish Medical Society, the Rives Society, and the Surgical Association of Louisiana.

Walter E. Gipson, IV, M.D.

Dr. Gipson has maintained a pri-vate practice in Picayune, MS since 1996 with Board Certification in Family Practice. He completed his medical education at University of Mississippi School of Med-icine. Dr. Gipson holds certifications as a Medi-cal Review Offi cer and in Advanced Cardiac Life Support and Advanced Life Support Pe-diatrics. Gipson serves as Medical Direc-tor of St. Joseph’s Hospice and preceptor

at Tulane University Medical Center and University of Mississippi Medical Center. He is a member of the Mississippi State Medical Association and the American Academy of Family Physicians.

Waseem Muhammad Jaffrani, M.D.

Dr. Jaffrani has been practicing in Louisiana for 15 years and holds Board Certification in Internal Medicine and Cardiovas-cular Disease. He has ex-tensive clinical experience including a Research Fel-lowship in Heart Failure and Transplantation at Ochsner Medical Foun-dation; Internal Medicine Internship, Internal Medicine Residency, Advanced Imaging Fellowship – Cardiol-ogy, and Clinical Fellowship – General Cardiology at Tulane University Health Sciences Center; and an Interventional Cardiology Fellowship at Thomas Jeffer-son Hospital, Philadelphia, PA.

David Kaplan, MD

Dr. Kaplan has maintained a private practice in Slidell since 1999 with Board Certification from the American Board of Sur-gery in general and vas-cular surgery. Dr. Kaplan completed his medical doctorate and residency at Louisiana State University School of Medicine, New Orleans and completed a vascular surgery fellowship at Mt. Sinai Hospital in New York. He is certifi ed by the Louisiana and Mississippi State Board of Medical Exam-iners, and the National Board of Medi-cal Examiners and is a Diplomate of the American College of Surgeons. Dr. Ka-plan also serves as a clinical instructor of vascular surgery at LSU Medical Center in New Orleans.Richard J. Sanders, Jr., M.D.

Dr. Sanders has maintained a private Family Practice on the Northshore since 1986. Dr. Sanders completed his medical

education at Louisiana State University School of Medicine, New Orleans and performed his residency at Washington-St. Tammany Regional Medical Center in Boga-lusa. He serves as a pre-ceptor for both Tulane Medical Center and LSU Medical School. Sanders also holds U.S. Patents for the treatment of acne and for the treatment of hair loss.

James Emerson Smith, III, M.D.

Dr. Smith has been practicing in Louisiana for over 30 years with Board Certifi cation in Internal Medicine and Cardiovascular Diseases. He completed his medical education at University of Nebraska Medical School, interned in the Tulane Affi liated Resi-dency Program, and com-pleted residencies at the Cook County Hospital in Chicago and Tulane Affi li-ated Residency Program. Dr. Smith’s Cardiology Fellowship was completed at Tulane Medical School – Touro Infi rmary Hospital and he holds a license in Nuclear Cardiology. Smith is an American College or Cardiology Fel-low and a member of the Louisiana State Medical Society and the St. Tammany Parish Medical Society.

Dr. Michael C. Finn

Dr. Cary F. Gray

Dr. Walter E. Gipson

Dr. Waseem Muhammad

Jaffrani

Dr. David Kaplan

Dr. Richard J. Sanders, Jr.

Dr. James Emerson Smith,

III


In the News

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Fifty-six Percent of LSUHSC New Orleans Medical Graduates Chose To Remain In LA

NEW ORLEANS-–Fifty-six percent, or 104 of 187 LSUHSC New Orleans graduating medical students participating in the National Resident Match Program this year chose to remain in Louisiana to complete their medical training. The LSU Health Sciences Center New Orleans res-idency programs accepted 138 new resi-dents, and 51 percent of the 65 percent of 4th year medical students entering LSU residency programs will enter LSU Health Sciences Center New Orleans residency programs.

The residency programs at Earl K. Long Medical Center in Baton Rouge have accepted 32 new residents in Emer-gency Medicine, Internal Medicine-Cate-gorical, Internal Medicine- Preliminary, and OB/GYN.

The residency programs at Univer-sity Medical Center in Lafayette have accepted 16 new residents in Family Med-icine, Internal Medicine-Categorical, and Internal Medicine Preliminary.

The Match, conducted annually by the National Resident Matching Pro-gram (NRMP), is the primary system that matches applicants to residency pro-grams with available positions at U.S. teaching hospitals and academic health centers. The choices of the students are entered into a software program as are the choices of the institutions with residency programs. All U.S. graduating medical students found out at the same time today where they “matched” and where they will spend their years of residency train-ing.

The percentage of LSUHSC New Orleans medical graduates going into pri-mary care is 43 percent this year. Primary Care specialties included are Family Prac-tice, Internal Medicine, Medicine-Prelim-inary, Obstetrics-Gynecology, Pediatrics, and Medicine-Pediatrics. OB/GYN is not always included in primary care data; however, in some Louisiana communities the only physician is an OB/GYN.

Of the 52 accredited residency and fellowship programs sponsored by LSU Health Sciences Center New Orleans, 25 participated in the Main NRMP Match whose results were released today. They are Anesthesiology, Child Neurology, Derma-tology, Emergency Medicine, Family Prac-tice (Kenner, Bogalusa and Lake Charles), Internal Medicine, Medicine-Preliminary, Neurological Surgery, Neurology, Obstet-rics-Gynecology, Orthopedic Surgery, Oto-laryngology, Pathology, Pediatrics, Physical Medicine and Rehabilitation, Psychiatry (Baton Rouge and New Orleans), Radiol-ogy, General Surgery, Surgery-Preliminary, Vascular Surgery, Medicine-Pediatrics, and Medicine-Emergency Medicine.

LSUHSC medical graduates training in other states will be going to such pres-tigious programs as Mayo, Barnes Jewish Hospital, UCLA, Beth Israel Deaconess, Baylor, Duke, Emory, Georgetown, and Vanderbilt, among others.

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Documents

Louisiana Medical News May 2013