16
December 2009 >> $5 Richard Klein, MD, MPH PAGE 3 PHYSICIAN SPOTLIGHT PRSRT STD U.S. POSTAGE PAID FRANKLIN, TN PERMIT NO.357 EDITOR’S LETTER November 2014 >> $5 PRINTED ON RECYCLED PAPER PROUDLY SERVING CENTRAL FLORIDA ONLINE: ORLANDO MEDICAL NEWS.COM BY LYNNE JETER Earlier this year, to breathe life into the medi- cal society, the Orange County Medical Society (OCMS) hired Fraser Cobbe, president of Cobbe Consulting & Management, an award-winning as- sociation management firm focusing on specialty societies, and executive director of the Florida Or- thopaedic Society. “I was very attracted to this role because of the proud tradition of the Orange County Medical So- ciety, and I was very interested in getting involved with leading and building the community physician organization,” said Cobbe, OCMS executive direc- tor. “When you walk into our building, you can’t deny the medical society’s rich history. To see the original minutes from the first meeting, and the legacy of physician leadership, the impact has been huge.” A Florida State University (FSU) political sci- ence graduate, Cobbe interned for the Florida Medical Association’s political action committee, headed the Manatee County Medical Society more than a decade ago, and also represents Bones Soci- ety of Florida, Florida Orthopaedic Risk Purchas- ing Group, Florida Society of Nephrology, and the South Carolina Orthopaedic Association. Medical Society Renews Mission New leadership at Orange County Medical Society attracts members, redefines value of organization to community physicians (CONTINUED ON PAGE 10) BY LYNNE JETER WINTER PARK – As Floridians morph into holi- day mode, a very important meeting will take place con- cerning a critical aspect of futuristic medicine Dec. 4-5 at The Alfond Inn in Winter Park. The Southeastern Telehealth Resource Center (SETRC), Florida State University (FSU) College of Medi- cine, and the Florida Partnership for TeleHealth will host the inaugural annual Florida TeleHealth Summit – Trans- forming the Delivery of Healthcare – for healthcare providers, hos- pital and health system administrators, policy makers, elected local and state officials, university administrators, IT experts, and telehealth industry leaders. “This will be the Florida’s first focused statewide Advancing TeleHealth in Florida Southeastern Telehealth Resource Center to host first annual Florida TeleHealth Summit Dec. 4-5 in Winter Park (CONTINUED ON PAGE 8) We’re thrilled to be crafting the third edition of the Orlando Medical News’ signature annual InCharge magazine, which will debut in December in lieu of a regular monthly edition. Compiling this compendium of healthcare leaders in Central Florida has been a labor of love, and we appreciate the collaboration of healthcare organizations in a region rich in healthcare resources and untapped potential. In next month’s special publication, Jeff Webb, our very talented Physician Spotlight writer, will provide insightful behind-the-scenes information on leaders of the Florida Medical Association (FMA) and Florida Hospital Association. I’ll focus on legislative advocacy issues impacting statewide and local organizations. Lobbying Fraser Cobbe (CONTINUED ON PAGE 12) InCharge Healthcare ‘15 WHO IS LEADING THE INDUSTRY THROUGH AN ERA OF CHANGE? WHO IS TRANSFORMING THE WAY CARE IS DELIVERED? [email protected] 407-701-7424 We have made it easy to keep you in contact with the key decision makers across the broad platform of the city’s healthcare industry. COMING DECEMBER 2014

Orlando Medical News November 2014

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Page 1: Orlando Medical News November 2014

December 2009 >> $5

Richard Klein, MD, MPH

PAGE 3

PHYSICIAN SPOTLIGHT

PRSRT STDU.S.POSTAGE

PAIDFRANKLIN, TN

PERMIT NO.357

EDITOR’S LETTER

November 2014 >> $5

PRINTED ON RECYCLED PAPER

PROUDLY SERVING CENTRAL FLORIDA

ONLINE:ORLANDOMEDICALNEWS.COM

By LyNNE JETER

Earlier this year, to breathe life into the medi-cal society, the Orange County Medical Society (OCMS) hired Fraser Cobbe, president of Cobbe Consulting & Management, an award-winning as-sociation management fi rm focusing on specialty societies, and executive director of the Florida Or-thopaedic Society.

“I was very attracted to this role because of the proud tradition of the Orange County Medical So-ciety, and I was very interested in getting involved with leading and building the community physician organization,” said Cobbe, OCMS executive direc-

tor. “When you walk into our building, you can’t deny the medical society’s rich history. To see the original minutes from the fi rst meeting, and the legacy of physician leadership, the impact has been huge.”

A Florida State University (FSU) political sci-ence graduate, Cobbe interned for the Florida Medical Association’s political action committee, headed the Manatee County Medical Society more than a decade ago, and also represents Bones Soci-ety of Florida, Florida Orthopaedic Risk Purchas-ing Group, Florida Society of Nephrology, and the South Carolina Orthopaedic Association.

Medical Society Renews Mission New leadership at Orange County Medical Society attracts members, redefi nes value of organization to community physicians

(CONTINUED ON PAGE 10)

By LyNNE JETER

WINTER PARK – As Floridians morph into holi-day mode, a very important meeting will take place con-cerning a critical aspect of futuristic medicine Dec. 4-5 at The Alfond Inn in Winter Park.

The Southeastern Telehealth Resource Center (SETRC), Florida State University (FSU) College of Medi-cine, and the Florida Partnership for TeleHealth will host the inaugural annual Florida TeleHealth Summit – Trans-forming the Delivery of Healthcare – for healthcare providers, hos-pital and health system administrators, policy makers, elected local and state offi cials, university administrators, IT experts, and telehealth industry leaders.

“This will be the Florida’s fi rst focused statewide

Advancing TeleHealth in FloridaSoutheastern Telehealth Resource Center to host fi rst annual Florida TeleHealth Summit Dec. 4-5 in Winter Park

(CONTINUED ON PAGE 8)

We’re thrilled to be crafting the third edition of the Orlando Medical News’ signature annual InCharge magazine, which will debut in December in lieu of a regular monthly edition. Compiling this compendium of healthcare leaders in Central Florida has been a labor of love, and we appreciate the collaboration of healthcare organizations in a region rich in healthcare resources and untapped potential.

In next month’s special publication, Jeff Webb, our very talented Physician Spotlight writer, will provide insightful behind-the-scenes information on leaders of the Florida Medical Association (FMA) and Florida Hospital Association. I’ll focus on legislative advocacy issues impacting statewide and local organizations. Lobbying

Fraser Cobbe

(CONTINUED ON PAGE 12)

InCharge Healthcare ‘15WHO IS LEADING THE INDUSTRY THROUGH AN ERA OF CHANGE?

WHO IS TRANSFORMING THE WAY CARE IS DELIVERED? [email protected]

407-701-7424

We have made it easy to keep you in contact with the key decision makers across the broad platform of the city’s

healthcare industry.

COMING DECEMBER 2014

Page 2: Orlando Medical News November 2014

2 > NOVEMBER 2014 o r l a n d o m e d i c a l n e w s . c o m

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PhysicianSpotlight

By JEFF WEBB

ORLANDO - Richard Klein was a bit of a globetrotter as a child, so perhaps it is not surprising that two of the most important events in his adult life, profes-sionally and personally, required him to traverse two oceans.

Before learning more about those pivotal journeys, it is instructive to know that as a youngster Klein, now 47 and the section chief of the Plastic and Re-constructive Surgery Center at the UF Health Cancer Center Orlando Health, had a family history that might be worthy of a textbook about mid-20th-century im-migration geography.

Klein’s father’s family were Hungar-ian Jews who settled in Chile after escap-ing the Nazis just before World War II. Klein’s mother was born in China to a Chinese mother and a Dutch father. As World War II ended, they fled Shanghai to avoid the Communist takeover. After a couple of nomadic years, the family settled in the newly created state of Israel. That is where Klein’s father, who was visiting the Mideast, met his mom. They married and moved to Santiago, which is where Klein and his two older sisters were born.

But, once again, the family chose to relocate when socialists took over Chile in 1968. They moved to Switzerland, but it was an uneasy time in Europe. “There was a lot of political intrigue there in the 1970s,” said Klein. “That’s when terror-ism really began, with hijacking of planes and killing Olympic athletes. When we traveled we were very careful to never fly over a hostile country because my mother had an Israeli passport and we did not want to have to land in the wrong country and just disappear,” he remembered.

The family made yet another new start when they moved to northern Cali-fornia in 1980. Klein was only 14 and he already had lived on three continents. But no matter where he called home, his dream to become a physician, specifically a surgeon, never dimmed. “I always had an interest in medicine and I was always busy building things with my hands,” he said.

After graduating from Santa Clara University, Klein spent a year in Swit-zerland doing medical research and developed an interest in international healthcare. He returned to the U.S. and earned his MD and a Masters of Public Health concurrently at Tufts University in Boston.

Klein completed his internship and general surgery residency at the Univer-sity of Pittsburgh School of Medicine. It was then that plastic surgery began to fas-cinate him, Klein said, “because it is just so different than other surgeries. There’s creativity and lots of three-dimensional

thinking. No two problems are the same.” Klein headed farther north to accept

a four-year research fellowship in trauma/burn surgery at the University of Michi-gan. A three-year residency in plastic and reconstructive surgery followed.

Klein was in private practice in McLean, Va., for a couple of years when he got a call from his former department chairman at the University of Michigan,

David Smith, MD, who was now chair-man of surgery at the University of South Florida School of Medicine in Tampa. After three years in that academic setting, Klein was invited in 2008 by former USF colleague Kenneth Lee, MD, to join him at what was then MD Anderson Cancer Center in Orlando. “(Lee) wanted to do complex reconstruction, and for that type of surgery you really need to have a partner because if things go wrong, you need to have a backup and no one else here knew how to do microsurgery,” said Klein.

Atlantic Turning PointIt was a trip across the Atlantic two

years ago that was a professional turning point for the well-traveled Klein. He went to Paris to study with Corrine Becker, MD, who is world-renowned for pioneer-ing Vascularized Lymph Node Trans-plant (VLNT) surgery. The microsurgical technique gives sufferers of lymphedema, a chronic condition that causes massive swelling of the extremities, an option to relieve their pain and discomfort, which often follows treatment and surgery for breast cancer. It involves removing healthy lymph nodes from another part of the body and inserting them into the area that has lymphedema.

Klein returned to Orlando from Paris

and trained his partners, Lee, and Jeffrey Feiner, MD, and now they are among a handful of surgeons in the U.S., and the only ones in Florida, he said, who regu-larly perform this delicate, ground-break-ing microsurgery.

Before he did the first VLNT 18 months ago, Klein said about 20 percent of his breast reconstruction patients had lymphedema, and “there wasn’t much we could do for them other than a dramatic surgery that could be pretty disfiguring.” Today, Klein said, more than half of the approximately 500 patients who come to his practice every month are seeking con-sultation or treatment for lymphedema, and almost 20 percent of those are travel-ing here from states as far away as Califor-nia, Texas and New York.

The impact Klein and his partners have created at UF Health Cancer Cen-ter Orlando Health is not lost on Presi-dent Mark Roh, MD. “One of the things I respect most about Richard is that he is a brilliant surgeon, but he’s always inter-ested in learning and trying new things to help his patients,” Roh said. “(Regarding) lymphedema … he saw that his patients had very few options for relief and he took it upon himself to learn a cutting-edge pro-cedure, to go to Europe and bring VLNT back to Florida. What he has done since

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Page 4: Orlando Medical News November 2014

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KISSIMMEE—Osceola Re-gional Medical Center is ramping up its first-ever Graduate Medical Education (GME) program, sub-stantiating a new chapter of becom-ing a prominent teaching facility and once again proving its dedication to investing in the local community.

In July, the HCA West Division hospital launched two very different residency programs at the Kissim-mee campus via the University of Central Florida (UCF) and Nova Southeastern University, aimed at capturing the pipeline of doctors through residency programs and re-taining them in Central Florida.

Trailblazing ProgramWith the advent of Osceola Region-

al’s new OB-GYN residency program, approved by the American Osteopathic Association and sponsored by Nova South-eastern University, comes the first-of-its-kind in Florida – and the southeastern United States.

The program began with such de-mand that Osceola Regional OB-GYN residency director Mark Palazzolo, DO, received 120 applications for three open-ings in 2014.

“We were initially approved for eight total residency slots, but because it’s such a popular program and the volume is there, we’ve moved our accreditation to 12 slots, accepting three first-year residents every

year to the four-year program,” explained Palazzolo, who completed medical school at Michigan State University and residency at St. John Health System in Detroit. Even though studies show that nearly two of three residents practice medicine where they complete their residency, Palazzolo relocated to Central Florida in 2007 to pursue the opportu-nity to grow and develop the hospital’s women’s health department. It’s now the largest of its kind in Osceola County, with three offices and seven OB-GYNs affiliated with the hospi-tal.

“We have such an intense need for OB-GYNs in Central Florida,” he said. “And while there’s no contract, agreement or understanding in place that a position will be available for residents when they complete the program, we look favorably on their desire to stay in Florida, more spe-cifically the Central Florida region, when we go through our screening process for residency applicants.”

The residency program follows a na-tionally-recognized curriculum that includes rotations in obstetrics, gynecology, maternal-fetal medicine, and ultrasonography.

“All subspecialties have been catching the residents’ interest,” said Palazzolo. “It’s a nice balance.”

Every week, residents work a half day

in continuity clinic, a practice that continues throughout the four-year program. The trio also has protected educational time through morning didactics.

The residency program has an unexpected bonus – spiritual medi-cine training – via a small grant that Palazzolo secured. “It was im-portant to me for residents to have exposure to as many different facets of the specialty as possible,” he said.

New Health Economy Class

In July, Osceola Regional also launched a three-year internal med-icine residency program approved for 60 residents through a partner-

ship with the hospital, the UCF College of Medicine, and Orlando VA Medical Cen-ter.

“It’s a big program with 20 new resi-dents a year,” explained Ejaz Ghaffar, MD, director of the internal medicine residency program at Osceola Regional. “By choice, we decided to take 16 this first year, to make sure we’re doing everything exactly right, and it’s all going great. So far, no major hurdles. We’ve very happy with the results and we’re looking forward to the next batch of residents.”

Osceola Regional Adds 72 GME SpotsUCF and Nova Southeastern host two diverse residency programs at HCA Kissimmee campus

(CONTINUED ON PAGE 6)Dr. Mark Palazzolo

Internal Medicine and OB/GYN GME residents with faculty and administrators

Page 5: Orlando Medical News November 2014

o r l a n d o m e d i c a l n e w s . c o m NOVEMBER 2014 > 5

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then is absolutely amazing. He’s changed the lives of so many of his patients because of his commitment to being the best sur-geon he can be,” said Roh.

In addition to VLNT, Klein is sought after for other breast reconstruction sur-geries, including an advanced technique called DIEP flaps. (DIEP stands for the deep inferior epigastric perforator artery, which runs through the abdomen.) “We use microsurgery to reconstruct the breast using the patient’s own tissues,” said Klein.

Pacific Turning PointA few years before, a turning point in

Klein’s personal life took him across the Pacific to the Republic of Vietnam. That is where he and his wife went – twice in 18 months – to adopt their sons. They were

6 months old when they brought them home, and now they are 7 and 6 years old. “We wanted to give an opportunity to children who wouldn’t have one oth-erwise,” Klein said. “It was a wonderful experience. The Vietnamese people were extremely friendly. We felt very welcome.”

Klein, a former private pilot with a fascination about air travel, shares with his sons his 30-year hobby of using balsa wood to build remote control airplanes. The family also enjoys going to air shows.

Klein’s wife is a nurse anesthetist at Florida Hospital Orlando. Klein met her at the University of Michigan and she, too, has an international history. She grew up in the Czech Republic. Between them, they speak five languages: English, Span-ish, French, Czech and Russian.

Ghaffar also bucked the trend by not remaining where he completed residency training. After graduat-ing from Khyber Medi-cal College in Pakistan, and completing his in-ternship and residency at LaGuardia Hospital-Cornell University in New York, Ghaffar en-tered private practice in the upper Midwest, where he also led the Department of Medicine at Dakota Medical Center and served as clinical assistant professor at the University of South Dakota. A warmer climate and the opportunity to grow Central Florida’s internal medicine practice helped the Win-ter Park-based HIMS Hospitalist Group recruit Ghaffar to Central Florida in 1998. In addition to his role as site director of Osceola Regional’s internal medicine resi-dency program, he also serves as medical director for Keystone Rehabilitation and Health Center in Kissimmee and assistant professor at the UCF College of Medicine.

“One aspect of this program that I re-ally like is … instead of noon conferences, which traditional residency programs have, we’ve set up an academic half-day for di-dactics,” he said. “When I was completing my residency program, we had noon con-ferences that were constantly interrupted. We (residents) still had patient duties and were often paged to leave the conference, go out, and come back again, only to get paged again. Every Thursday, residents here are free of their ward duties – the fac-ulty takes over those duties – so they can focus entirely on what’s being discussed.”

Internal medicine training, by nature, makes it more difficult to accurately deter-mine the number of residents who may re-main in the area, said Ghaffar.

“Some residents may choose internal medicine in practice, while others will go on to specialties such as oncology or cardi-ology, which require further training,” he said. “Certainly, some will stick around and we’re pleased with the potential.”

The internal residency program fol-lows the 4 + 1 Block Schedule model. Every resident alternates a week of conti-nuity clinic with four weeks of an inpatient

rotation, outpatient rotation or elective. “The 4 + 1 schedule minimizes con-

flicting inpatient and outpatient duties, and allows residents to focus fully on one educational aspect at a time,” said Ghaf-far. “It optimizes each learning experi-ence, and enhances the continuity clinic experience by allowing for better familiar-ization with the clinic setting, which be-comes an educational home throughout the program.”

Ghaffar pointed out the residency program’s “tremendous support” from Osceola Regional faculty. “They’re all eager to teach residents,” he said. “Because Osceola Regional has grown steadily with new services and programs, it was obvious we needed to bring everything to the top of the line. We’re no longer the small com-munity hospital.”

Full CircleEven though the internal medicine

residency program is based from UCF, it’s open to all successful MD graduates, noted Deborah German, MD, founding dean of the UCF College of Medicine, while also pointing out that not all interns are based or will be based from UCF.

The second year of interviews began last month for the next cohort, which in-cludes several hundred possible candidates from all over the nation and the world, in-cluding UCF, she noted.

“We’re delighted with our first resi-dents and their dedication to caring for our community,” said German, also vice president for medical affairs at UCF. “This new program is a testament to the power of partnership. Osceola Regional and the Orlando VA Medical Center are working with the UCF College of Medicine to create an outstanding in-ternal medicine residency program that will bring more qualified physicians to our community. This new partnership provides residents with a diverse group of patients, including military veterans and residents of Osceola County, one of Florida’s most diverse and fastest-grow-ing counties. Our residents are gain-ing experience in caring for everyone. This experience is vital for tomorrow’s healthcare leaders.”

Osceola Regional, continued from page 4

Dr. Ejaz Ghaffar

Richard Klein, continued from page 3

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By ROSEMARy ANTONELLI

Historically, children diagnosed with the genetic multi-system disorder cystic fi-brosis rarely lived beyond their teens. But with the development of increasingly ef-fective treatments, patients today not only are living longer, some of them are being identified with the disease when they are well into adulthood.

At Central Florida Pulmonary Group, the only accredited adult cystic fibrosis care center in the Greater Orlando region, a surprisingly large number of grown-ups – 147 in August – are being treated for the hereditary disease.

“This is more than the number of childhood cases that are being treated at either Arnold Palmer Medical Cen-ter or Nemours Children’s Hospital in Orlando,” reports Tamika Williams, the cystic fibrosis nurse coordinator at Central Florida Pulmonary Group. “The average life expectancy now is 39 years.”

One glowing example of patients at the Orlando-based medical practice who have triumphed over even that statistic is 74-year-old Nancy Stone of Kissimmee. She maintains an active, full life despite her daily regimen of various lung medi-cations, oxygen, and bronchodilators for

mechanically breaking up the mucous that thickens in lungs affected by cystic fibro-sis. She flies to Wisconsin and Colorado without traveling companions to visit her daughters, and she recently enjoyed a va-cation on a cruise ship.

“I feel fortunate to live close to Or-lando and have these doctors who are will-ing to work with me,” says Stone, who was diagnosed with cystic fibrosis, along with her two brothers, when they all were in their 20s.

She participates in the ongoing clini-cal research trials conducted at Central Florida Pulmonary Group, whose 18 physicians specialize in chronic lung con-ditions and sleep disorders. The purpose of the trials is to test promising new drug therapies to further improve survival rates, relieve symptoms and promote normal liv-ing for patients.

“The most innovative thing right now,” said Daniel T. Layish, MD, a pul-monary specialist who is a principal clini-cal research investigator at the practice, “is a new medication called Kalydeco, which is the first drug to target a specific genetic defect that causes cystic fibrosis.

“It’s a pill that right now is the only specific therapy for cystic fibrosis ap-proved by the Food and Drug Administra-

tion, and trial results so far have included improved lung function, weight gain and a slowing of the progression of the disease in patients who have taken it.

“The downside,” adds Layish, “is that it has only helped about three per cent of cystic fibrosis sufferers, because to qualify for this therapy a patient must have certain gene mutations. However, other studies are being done on potential new treatments for the other 97 per cent of patients.”

Clinical trials at Central Florida Pul-monary Group tend to be on a par with the level of trials conducted in sophisti-cated labs at university hospitals and re-search centers.

An editorial published in August in Annals of Internal Medicine stated that if improvements in care and survival of patients “continue at the rate observed between 2000 and 2010, the median pro-jected survival of children born with the disease in 2010 exceeds 50 years.”

It cautioned, however, that successful new treatments also pose new challenges, and that “continuing to ensure the kind of care that has resulted in growing numbers of patients with CF living far into adult-hood will not be simple or inexpensive…Caring for adults with CF requires a vil-

lage.” People with the disease are at in-creased risk for diabetes, osteoporosis and liver failure.

The bottom line, though, is that for patients such as 74-year-old Stone, receiv-ing cutting-edge medications and indi-vidualized care through participation in drug research trials is worth the risks or side effects.

“Patients such as Nancy Stone, who has done five or six trials I’ve conducted,” notes Bert Kesser, RRT, a clinical re-search coordinator at Central Florida Pulmonary Group, “have a passion for finding a cure for the disease. Many of the participants also realize the drugs being tested may not come to market for de-cades, and that they are often helping a next generation of patients.”

“You never know which one will be the drug that helps,” said Stone, who feels she has benefited, “and if I can help others by being in research trials, that’s good.”

At the same time, she stays engaged in the support network and empathy she has discovered on a cystic fibrosis Face-book page.

“It’s where young people diagnosed with the disease are sharing their experi-ences and suggestions and ideas,” she re-lates. “It’s really neat.”

Diagnosis and Treatment of Cystic Fibrosis Expanding

Page 8: Orlando Medical News November 2014

8 > NOVEMBER 2014 o r l a n d o m e d i c a l n e w s . c o m

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telehealth summit,” said SETRC director Rena Brewer, RN, MA. “We have folks from across the state contributing to this im-portant agenda. There’s a lot of telemedicine going on in Florida right now, despite the lack of telehealth supporting policy.”

In less than a year, Waycross, Ga.-based SETRC, which also serves Georgia, Alabama and South Carolina, has provided a platform for tele-health stakeholders from across the state to come together in three regional work-groups to improve collaboration, address barriers, and overall, advance telehealth in Florida. Healthcare industry advocates have lobbied state lawmakers to pass tele-health legislation that includes, among other points, reimbursement for telehealth at the same rate as an in-clinic visit. Bills introduced in the 2014 session didn’t gain sufficient traction.

A priority agenda item for the sum-mit, which will begin and end with poli-cymakers, will include gearing up for

comprehensive tele-health legislation in the 2015 legislative session.

“Florida’s been chewing on it for a cou-ple of years at the capi-tol,” said Brewer. “We’re hopeful 2015 is the year for meaningful telehealth policy for Florida.”

Healthcare ReformTelemedicine is the key to reforming

healthcare, emphasized Paula Guy, CEO of Global Partnership for TeleHealth and the Florida Partnership for TeleHealth.

“Access to care is becoming more of a problem and telemedicine is the answer, especially as fewer primary doctors are coming out of residency … and more new physicians are moving into specialties,” she explained. “Technology is allowing the physician to go to the patient instead of vice versa, and there are truly no limits with telemedicine.”

Guy quashed a misperception about telemedicine by pointing out that “the right telemedicine can be extremely high

quality, very efficient and quite cost-effec-tive.”

SETRC is also working with hospitals on readmission issues, an area in which telemedicine can make a tremendous dif-ference and also allay fiscal penalties.

“One of the leading reasons for re-admission is chronic disease,” said Guy. “When patients are sent home, it’s typi-cally not with the kind of follow-up needed to keep them out of hospitals. Heart fail-ure is a great example. Telemedicine al-lows the necessary follow-up and patient education opportunities for those who have been recently discharged. Patients can use simple technology to record heart rhythms and submit other patient biomet-rics.”

Agenda HighlightsMeeting agenda highlights slated for

the first annual Florida TeleHealth Sum-mit:

David Christian, vice president of government affairs for the Florida Cham-ber of Commerce, will moderate a Day 1 early morning session on Florida TeleHealth Policy.

Anne Burdick, MD, MPH, associate dean of telemedicine and clinical outreach for the University of Miami Miller School of Medicine, will lead a discussion on Tele-Health: Enhancing Healthcare for Floridians.

Mark Stavros, MD, FACEP, associ-ate professor of clinical sciences and edu-cation director of emergency medicine for the FSU College of Medicine; Kim M. Landry, MD, FACEP, associate profes-sor of the FSU College of Medicine and CEO of Excalibur Telemedical Services Inc.; and Antonio Carlos de Cunha Mart-

tos, MD, assistant professor of surgery and director of Global e-Health for the Uni-versity of Miami Miller School of Medi-cine, will serve on the pre-lunch Emergency Telehealth Panel.

Jay H. Sanders, MD, CEO of The Global Telemedicine Group and founding board member and president emeritus of the American Telemedicine Association (ATA), will present the luncheon keynote address. (Florida has approached the ATA about becoming its first state chapter.)

Florida telehealth initiatives to be discussed cover ALS patients, behavioral health, cardiac patients, e-ICU, school-based teleheath, telegenetics, telestroke, and how telemedicine can increase effi-ciencies and patient access.

Ken Peach, executive director of the Health Council of East Central Florida,

Advancing TeleHealth in Florida, continued from page 1

Rena Brewer

Paula Guy

The Southeastern Telehealth Resource Center (SETRC) is one of 14 regional and national HRSA-funded TeleHealth Resource Centers. The non-profit Georgia Partner-ship for TeleHealth Inc. operates Atlanta-based SETRC, which serves as a resource to organizations, networks, and practitioners interested in providing, supporting and promoting telehealth services for the rural and underserved in Alabama, Florida, Georgia and South Carolina. Its primary mission: to increase the use of telehealth ser-vices throughout the region, especially to underserved populations.

For more information, visit www.setrc.us or contact SETRC director Rena Brewer, RN, MA, via [email protected] or (229) 291-0494.

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Page 9: Orlando Medical News November 2014

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On Wednesday, Jan. 14, 2015, the OCMS will host its annual meeting at the Grand Bohemian Hotel Orlando, beginning at noon. Maria Noll, MD, president of the Florida Medical Association, will present the keynote address.

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Cobbe’s forte: Diving into the eco-nomic side of physician practices, advanc-ing medical education and lobbying for legislative advocacy.

“The real trick to having success-ful medical societies is finding real value to members,” he said, noting that of ap-proximately 3,500 licensed physicians in Orange County, OCMS membership is roughly 500. “We’ve got a great oppor-tunity to build membership in Orange County and reconnect with many mem-bers.”

Another major challenge that medical societies face: membership in general for organized medicine has dropped in part be-cause of the dynamics of consolidation, as hospitals and health systems have gobbled up physician practices.

“Many of the resources that indepen-dent physicians needed are often available through the organizations that acquired them,” Cobbe pointed out. “We must re-

define our mission and reorganize benefits to better define our value to physicians,” he said, noting an environmental scan of member needs is being analyzed by the Orlando-based staff he brought to the OCMS: Tania Jones, COO and practice management consultant; Lencie Gradis-har, operations manager; and Diane Berg, communications specialist.

“Since membership is competitive, we have to find our niche of unique value as a county medical society,” he said. “Just one example, county medical societies are uniquely positioned to unite physicians within a community and provide them the platform to collaborate and coordinate care and interact with each other in an ef-fective way to keep them profitable and sustainable as they deal with marketplace changes.”

At the board level, OCMS leaders have discussed various industry challenges to address, such as the growing gap between

medical graduates and residency slots. The OCMS Board includes two key community leaders: Deborah German, MD, vice presi-dent for medical affairs and founding dean of the University of Central Florida School of Medicine, and Michael Muszynski, MD, dean of the Orlando regional campus for the FSU College of Medicine.

“The issues facing medicine and the ability of physicians to deliver quality care to our patients is of great interest to me,” said German. “I’m pleased to serve on the Orange County Medical Society Board. The young doctors we train today will inherit the world of practice we leave behind.”

Up next: strategic planning sessions for OCMS board members.

“We’re reaching out to the various players that make up the medical infra-structure in Orange County, including FSU and UCF, to see how collectively we improve the practice environment and ex-pand opportunities for medical graduates because once medical graduates of Florida schools leave the state to take residency slots elsewhere, it’s difficult to get them back,” he said. “We’re also seeking an audience with the health systems to chat about ways we can more effectively work together to help address our individual missions. That’ll be a continual work in progress.”

Cobbe is also focusing on outside events, such as quarterly conferences with payors and members, and networking events linking medical students and resi-dents with society members.

Another priority agenda item: pro-viding physician leadership development programming and training for society members. Earlier this year, to encourage activism throughout their careers, Cobbe took a few medical students as alternate delegates to the annual FMA meeting to shadow OCMS leaders as resolutions were adopted. A medical student serves on the board every year, Cobbe noted.

“Orlando’s such a huge center for leg-islative leadership,” he said. “We need to focus on developing physician leaders to represent our community.”

An important program that Cobbe says the community has well in hand in-volves primary and specialty services for in-digent care in Orange County. At Manatee County Medical Society, he initiated and secured county funding for the specialty care program for the community, which has grown tremendously.

“The parallel to Orange County is it has one of the best-run, most comprehen-sive safety net programs for communities around the country, Special Care Central Florida and the PCAN Network,” he said. “Since my brief time of working with them, there appears to be a well-coordinated, ef-ficient network of community players and stakeholders who meet monthly through this network to discuss the utilization of their limited resources. Everything appears to run like a well-oiled machine. We cer-tainly have our challenges as the need is significant but they’ve brought everyone to the table and everyone seems to be play-ing from the same game sheet in Orange County. It’s something the community can be very proud of.”

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Medical Society Renews Mission, continued from page 1

On May 26, 1908, a small group of physicians from Orlando and Sanford met in the home of John S. McEwan, MD, to establish the Orange County Medical Society (OCMS). As part of the initial work, the medical society board passed a fee bill that included, among other interesting tidbits, rates of $2 to $5 for house visits in the city, with a premium rate of $3 to $10 for house calls between the hours of 10 pm and 6 am. Advice? Anywhere from a buck to $10.

In 1926, to better serve its members as Central Florida experienced significant growth, OCMS spun off Seminole County Medical Society as an independent society.

John LoVoi, Tyler Caton, Joseph Snavely and Drew Walters won first place at the inaugural Medical Matchplay Golf Event.

Page 11: Orlando Medical News November 2014

o r l a n d o m e d i c a l n e w s . c o m NOVEMBER 2014 > 11

By JESSICA SOLÁ-ACEVEDO, MD

In 2013, there were over 10 million patient visits to doctors’ offices due to knee injuries and knee pain. This number is ex-pected to rise as the population ages and obesity increases. Carrying extra weight increases the pressure on your knees, it also increases the production of the hormone leptin, and studies show this may promote the early development of osteoarthritis. Smokers with osteoarthritis sustain greater cartilage loss and have more severe knee pain than nonsmokers. Certain structural problems, such as having one leg shorter than the other or flat feet, may increase the risk for developing knee pain.

Simply stated, the knee is a very com-plex joint. It is involved in just about every lower body activity. How does it do this? The knee has what is called “six degrees of freedom.” This means it can move in six different directions. This allows for many different movements and maneuvers; how-ever, it also presents many ways for poten-tial injury.

What makes up the knee? Four bones work in unison to allow the

knee to perform all of its activities: the femur, fibula, tibia and the patella. Ligaments allow these bones to attach to one another and ten-dons help muscles attach to the bones. Bursa help cushion the joint, and the menisci are tough fibrocartilage structures that transfer the load from the upper leg to the lower leg and stabilize the knee during flexion, exten-sion and during circular movements. Any one of these structures can be pain sources due to injury or wear and tear.

Injuries: Anterior Cruciate Liga-ment (ACL) injuries are the most common sports injury. Athletes who participate in high demand sports such as football, soccer and basketball are most likely to injure their ACL. Rapid direction changes or landing from a jump incorrectly can tear the ACL; this injury is frequently accompanied by damage to other structures in the knee such as menisci or other ligaments. Collateral Ligaments (CL) can be injured by direct blunt forces that push the knee sideways. Meniscal tears are often seen in sports, these can occur with twisting and pivoting. At times, a sudden awkward twisting motion of the knee can cause injury to the meniscus. At the time of injury one should perform RICE: rest, ice, elevation and compression. Anti-inflammatory medications such as as-pirin and ibuprofen will help relieve inflam-mation. Topical ointments such as volatren gel, pennsaid or compounding creams can be an alternative treatment option if oral NSAID’s are not well tolerated. Subsequent treatment will depend on the severity of the injury.

Arthritis: Rheumatoid arthritis (RA)

is an auto immune disease, where the mem-branes covering the knee are affected. The course of RA varies from mild disease to se-vere joint destructive variant that progresses rapidly, eventually leading to unremitting pain and joint deformity. Treatment for RA related pain is targeted on decreasing the body’s immune response with disease-modifying anti rheumatic drugs (DMARDs) and biological drugs such as enbrel, humira, methotrexate and Sulfasalazine. Anti-in-flammatory medications and opioids may be necessary when there is significant joint destruction. Despite recent improvement in biological agents and treatment modali-ties in the field of rheumatology, progres-sive joint destruction continues to occur in a subgroup of RA patients, who eventually require joint surgery.

Osteoarthritis (OA) affects over 20 million Americans, with roughly half of those affected experiencing knee pain. This makes OA the most common cause of knee pain in America. It is a degenera-tive “wear and tear” type of arthritis caused by degeneration of cartilage in the knee. In its extreme form, the femur will rub on the tibia, bone on bone causing debilitat-ing pain and difficulty ambulating. OA is commonly seen after age 50, however the increasing incidence of obesity and smok-ing can lead to early development of OA. The reported cases of knee OA in as early as in the 20’s are steadily increasing. Treat-ment options may vary based on severity. Activity modifications such as participating of low impact activities such as cycling and swimming, instead of running can help re-duce additional wear and tear of the knee. Weight loss is key; for every pound you are overweight there are 5 extra pounds of pres-sure on the knee cap, with time this leads to significant damage. Acetaminophen or anti-inflammatory medications are proven to decrease pain associated with knee pain from OA.

The patient should seek medical at-tention if activity modifications and over the counter medications are not providing relief. The optimal medical team should in-clude the primary care physician, an ortho-pedic surgeon, pain management specialist and a physical therapist. Knee x-rays and frequently MRIs are required to make a di-agnosis and to determine the best course of treatment. Intra-articular steroid injections may be necessary; these provide localized relief of inflammation. Viscosupplements

Knee Pain: Risks Factors, Causes and Solutions

(CONTINUED ON PAGE 12)

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such as Hyalgan, Synvisc and Euflexxa in-jections may also ease the pain and stiffness of osteoarthritis. These substances mimic naturally occurring synovial fluid that sur-rounds the knee and may provide pain relief for several months. Advanced osteo-arthritis may require surgical intervention; arthroscopic surgery or total knee replace-ment may be indicated for severe disease. For patients who suffer from debilitating knee pain and are not surgical candidates or for those who would rather try a less in-vasive approach; Genicular nerve blocks and radiofrequency ablation present a new and exciting treatment option. This proce-dure is done in an outpatient setting under local anesthesia or moderate IV sedation if desired. It takes 10-15 minutes to complete with no down time. It is done with fluo-roscopic guidance, nerve stimulation and radiofrequency heat to target the superior medial, superior lateral and inferior medial

genicular nerves that are directly involved in transmitting pain signals from the knee. There is a growing amount of data that sug-gests genicular nerve radiofrequency has also been significantly helpful for patients who have persistent knee pain after total knee replacement. Ultimately, treatment goals should be to decrease pain and allow the patient to adopt a healthier, more active lifestyle that will help prevent further injury.

state lawmakers to pass comprehensive and meaningful telemedicine legislation is at the forefront of the 2015 agenda. Robert Wah, MD, president of the American Medical Association (AMA), an IT guru, will share details of the resolution on telemedicine passed earlier this year by AMA delegates and how it relates to local efforts of telehealth advancement.

Much appreciation goes to this year’s Editorial Advisory Committee for their tireless participation: Sami Bay, executive director of the Volusia County Medical Society; Fraser Cobbe, executive director of the Orange County Medical Society; Celia Myers, president of MGMA Central Florida; Carrie Pope, executive director of the Seminole County Medical Society; Lisa Sanchez, president of Orlando PAHCOM (Professional Association of Health Care Office Management); and Cindy Tyler, who recently shifted from FMA vice president of membership development to senior development officer at the Florida State University College of Medicine’s Foundation.

The 2015 InCharge is our gift to readers – all licensed MDs and DOs, and hospital and healthcare administrators in Central Florida – as the only compendium that doesn’t require “pay to play.” The special publication highlights our mission as advocates for issues impacting the local medical community. As editor of Orlando Medical News since its inception in 2006 alongside market publisher John Kelly, thank you for allowing us the continued opportunity to provide substantial information aimed at enhancing the quality of your life’s work.

Best always,Lynne JeterEditor, Orlando Medical News

Knee Pain, continued from page 11will moderate discussion about strategies for moving telehealth forward in Florida.

Day 2 begins with a look at improv-ing access to care for rural patients with multiple sclerosis, featuring Paul Hoffman, MD, and Sean McCoy, PhD, both with VA Telehealth. McCoy recently reported the VA model allows for healthcare provid-ers to “practice anywhere in system,” and discussed how 11 state consortiums in the Northeast have reciprocity for nursing licen-sure; a current congressional bill proposes licensure requirement for the state of resi-dency only.

Christopher Sullivan, PhD, of Image Research LLC, will moderate a discussion on health information exchanges (HIEs) concerning telemedicine and public health.

Deborah Randall, a health law at-torney and telehealth consultant, will moderate a panel discussion on telehealth legal considerations. Also on the panel:

healthcare attorneys Michael R. Lowe of Michael R. Lowe PA, and Lance Leider of The Health Law Firm.

Chris Pittman, MD, president-elect of the Florida Medical Association’s politi-cal action committee, will participate in a panel discussion on The Politics of Telehealth.

The summit will close with a sum-mary discussion of the unlimited potential of telehealth in Florida.

“If you’re not doing telemedicine today, you will within a couple of years,” said Guy. “That’s why healthcare provid-ers need to attend this conference. Tele-medicine is changing people’s lives for the better.”

Advancing Telehealth, continued from page 8

To register for the Florida TeleHealth Summit, visit: http://

www.fltelehealth.org/florida/conference/fpt-conference-2014/

Dr. Jessica Solá-Acevedo is Board Certified by the American Board of Anesthesiology. She earned her medical degree at the University of Puerto Rico. She completed a fellowship in Pain Management at the Carolina’s Pain Institute, Wake Forest Baptist Health and her residency in Anesthesiology at Wake Forest Baptist Health.

She is a member of the American Society of Anesthesiologist, the American Society of Regional Anesthesia and American Academy of Pain Management.

She can be reached at [email protected]

Editor’s Letter,continued from page 1

Page 13: Orlando Medical News November 2014

o r l a n d o m e d i c a l n e w s . c o m NOVEMBER 2014 > 13

By DAWN RIVERA

A lot of medical facilities and local practices have started getting busier, so they’re using temporary workers as a means to feel out staffing levels, and as they see it’s sustainable, they’re convert-ing those people over to permanent hires.

“Test the Water First” is the old adage for moving forward with caution. With the rising cost of hiring healthcare workers, why would you take the plunge without first testing the waters? Healthcare industry observers say the recent temp hir-ing upswing could reflect an improving economy. With the popularity and stay-ing power of flexible work arrangements, employers need to stay current with the needs of today’s work force.

While bringing in a new hire on a Temp-to-Perm contract is foreign to a lot of practices, the benefits are numerous. Liability insurance during the term of the contract is covered by the staffing source along with Workers Compensation. This elevates your liability during the train-ing process, while you are still evaluating whether or not you hired a Chatty Kathy or perfect fit. Most Temp-to Perm con-tracts are thirteen weeks. In thirteen weeks

you have an abundance of time to critique personal habits, ability to learn, job per-formance skills and actual fit into the office environment.

Testing the waters is not nearly as costly as making a poor decision and choosing hastily the wrong candidate because you need to cover a position im-mediately. The Sink or Swim, Fight or Flight theory can be observed here as well. Every manager has made a poor hiring decision that may have cost the company thousands in wages, benefits and lost pro-ductivity.

A well-seasoned employee takes time to generate and train to your needs, but why spend time training someone that may not have the personality that will work with your office dynamics. I’ve al-ways said “give me someone that has great people skills and I will create an excellent employee, but give me someone that has great work skills and lacks in people skills and it will be a struggle.”

Consider your options in building an efficient team. Using a staffing source and a little help from a business profes-sional that only hires highly skilled, tested, trained and drug tested medical profes-sionals should be high on your list of

“must do’s.” Change is always risky and it’s not

something we do well under pressure. The current “I got this” seems to dwindle as the healthcare industry changes almost daily. The size of your business does not matter when it comes to staffing needs. Every small company can benefit from an agency’s expertise and ability to do in depth interviewing and critiquing. What this means to you is the ability to make the right hire the first time.

A family-owned business has a lot in-vested in their company and reputation, too much in fact to risk all of the time it takes to place a bad hire. Using a staffing source gives you that assurance that you have done everything you can to protect your business.

One of the biggest issues that compa-nies face today is that of unemployment claims, which can range in the thousands of dollars for even one employee let go. Another benefit of using a staffing resource is your lack of liability for unemployment until you have had time to thoroughly evaluate.

The common response when discuss-ing Staffing Resourcing within the Medi-cal Industry is “We do that ourselves.”

That comment is generally made without the knowledge of the cost it takes to screen and hire someone new. Then pen and pencil method of jotting down the hourly cost of the process, testing, screening and interviewing is never really done by the person that relays that message with a well versed etiquette.

Ask yourself these things; Is the job you need to fill seasonal? Can you provide an exact date of the end of the employ-ment if it is? What if that seasonal person finds full time employment after you have trained them and leaves? Do you have a backup plan? Do you need someone with specialized skills that you won’t need or can’t afford once the project is completed? Is this an emergency caused by someone who is absent unexpectedly and is plan-ning to return? Do you really know when they will return?

There are many reasons to consider local staffing options. Don’t be caught knee deep in the pond unless you have tested the waters first. You have nothing to lose but dry britches.

Testing the Waters

Dawn M Rivera is Building and Development Specialist at Arbor Medical Staffing. She can be reached at [email protected].

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By SHONAK PATEL, MD Aortic aneurysms. Carotid artery dis-

ease. Peripheral vascular disease. When asymptomatic all these conditions pose little danger and in most cases cause no serious harm to a patient. But somewhere along the patient’s journey they associate those words with: life, death, or somewhere in between. So what do I do as a consumer, as someone who wants to live and be fully functional, as someone who doesn’t want to have a stroke, have a “ticking time bomb” waiting to explode, or someone who could lose their leg if they don’t have their blockage fixed. To me, the answer is simple – be informed, do your research, see the appropriate specialist. Unfortu-nately, there are many “specialists” out there who confidently do the wrong thing.

Primum non nocere, which in Latin means “first, do no harm” is what we are initially taught in medical school and even repeat as part of the Hippocratic Oath. Another way to state this is, given an ex-isting problem, it may be better not to do something, or even to do nothing, than to risk causing more harm than good.” For example: a 65 year-old hypertensive, hy-perlipidemic smoker who had a coronary bypass graft in the past now complains of pain when walking two blocks. He rou-tinely sees two physicians, his primary care doctor and his cardiologist. The patient then has two endovascular procedures by his “vascular” doctor for a long superficial femoral artery occlusion. All the interven-tions failed, and a bypass was suggested

by the same doctor. The second-opinion work-up reveals that the patient was not started on statins, nor advised to stop smoking, and was not fully treated for his hypertension. But the biggest revelation was that the patient was never told that his uncorrected femoral artery occlusion posed little risk to his life or limb. Simply stated, the patient underwent two proce-dures, all with their own risks, when he never needed one to begin with.

Other examples include abdomi-nal aortic aneurysms and carotid artery disease. How many patients have family members who have had strokes or rup-tured aneurysms? These same patients may get a carotid duplex for a bruit or MRI for chronic back pain, but now what. Say the ultrasound shows 50-60 per-centxxxxx carotid stenosis bilaterally and the patient is asymptomatic. She asks her doctor – “Am I going to have a stroke,” “Do I need surgery,” “Who should I see for this?” Well, depending on whom she does see will impact her and maybe even change her life. The same scenario can be seen with abdominal aortic aneurysms. An ultrasound may show a 4.2cm aneu-rysm in a 65 year-old otherwise healthy male. All this patient really wants to know is, “when is it going to rupture?” Based on that question the patient is advised to have an EVAR (endovascular aortic repair) procedure “as soon as possible.” Wisely, he seeks a second opinion and was advised to have his aneurysm observed periodically. Eight years later the patient is well and the aneurysm has a maximum

diameter of 4.5cm. So what if these patients had had an

urgent carotid revascularization or urgent EVAR for asymptomatic disease? And what if they had a complication – a stroke, bleeding, MI, or even death? Many self-appointed vascular “specialists” are not fully aware of the benign natural history of non-coronary vascular disease; others, it seems, choose to ignore it. What is clear – no matter what the specialty – is that non-coronary vascular diseases have been studied well and have a known natural history. Thus, the true vascular specialist who is trained in arterial disease, venous disease, and lymphatic disease can help medically manage and routinely survey

specific disease entities. And more impor-tantly, know when not to do surgery, ulti-mately helping in doing no harm to the patient. As we all know, every procedure comes with its own inherent set of risks and complications, so why would you put someone in jeopardy if they never needed to be there in the first place.

Life, Death…Or Somewhere In Between

Shonak Patel, MD, of Vascular Specialists of Central Florida is board certified in general surgery and board certified in vascular surgery. He earned his MD from Ross University in 2006 with high honors. He completed his two year vascular surgery and endovascular therapy training at the University of Alabama in Birmingham, AL. He completed his fellowship in June 2013.

Page 14: Orlando Medical News November 2014

14 > NOVEMBER 2014 o r l a n d o m e d i c a l n e w s . c o m

IMPOWER Doctors Receive Waiver from Florida Board of Medicine to Prescribe Controlled Substances via Telepsychiatry

Three Florida licensed medical doc-tors on staff at IMPOWER, a leading non-profit mental health & child well-being organization in Central Florida, have been granted a waiver from the Florida Board of Medicine regarding Rule 64B8.90.141(4) Florida Administrative Code which prohibits the prescribing of controlled substances through the use of telemedicine. M. Branch, M.D., J. Reed, M.D. and N. Kirmani, M.D. are the only mental health practitioners in the state to receive the waiver therefore making IM-POWER the only current Florida provider of telepsychiatry that can prescribe con-trolled substances for psychiatric care.

Statistics indicate that 1 in every 4 adults, and 1 in 5 youth ages 13 to 18 experiences a mental health illness every year. The most successful medications for these diagnoses and others are primar-ily stimulants which are non-narcotic con-trolled substances that were impacted by Rule 64B8.90.141(4) F.A.C.

In Florida and the country are facing a shortage of psychiatrists, particularly child and adolescent psychiatrists…. which is creating an accessibility crisis, says Anna Baznik, IMPOWER President & CEO. To fully address the mental health needs of

the community, this shortage must be ad-dressed and treatment and medication management accessible, especially for clients who reside in rural areas, Baznik added.

The use of telepsychiatry is widely accepted and endorsed in other states further stated Baznik. The program of-fers mental health and psychiatric care through a real-time, live, face-to-face, HIPPA compliant, secured video plat-form via the internet and successfully ad-dresses these barriers to care. To date, the alternative virtual care option has resulted in increased patient access to services, more consistent patient services, reduction in time/costs/transportation for patients, reduction in stigma of seeing a psychiatrist and reduced absences from school/personal time.

Currently, an approximate 4,000 cli-ents are receiving mental health services and 1,900 clients are receiving psychiat-ric services from IMPOWER in Orange, Osceola, Seminole, Brevard, Volusia and Polk Counties.

In September, Dr. Branch, Dr. Reed, Dr. Kirmani and IMPOWER petitioned the Florida Board of Medicine for a waiver from Rule 64B8.90.141(4) Florida Admin-istrative Code. On October 10, 2014, Anna Baznik and Dr. Branch (IMPOWER’s Medical Director) appeared with their counsel, Anthony Iannacio, Esquire of

Bush Graziano Rice & Platter, P.A., before the Florida Board of Medicine to present their Petition.

The Board granted the parties a one-year wavier from Rule 64B8.90.141(4) Flor-ida Administrative Code and requested Ms. Baznik and Dr. Branch return in De-cember of 2015 to report on the success of IMPOWER’s tele-medication manage-ment program, as well as to seek a per-manent waiver from the Rule.

MedMal Direct Insurance Ranked on 2014 Florida Fast 100 List

Jacksonville-based MedMal Direct Insurance Company (MedMal Direct) was recognized as one of Florida’s fastest growing companies and was named to the 2014 Florida Fast 100 List as the 19th fastest growing company in the State of Florida.

MedMal Direct debuted on the 2014 Florida Fast 100 List after realizing more than 344 percent revenue growth be-tween 2011 and 2013. The list recognizes the 100 fastest growing companies in Florida each year and is compiled using data obtained by research directors of the four Florida Business Journal markets including Jacksonville, Orlando, South Florida and Tampa Bay.

South Lake Hospital Board Chairman Susan McLean honored by Florida Hospital Association

South Lake Hospital’s longtime Board of Director Chairman Susan McLean received the 2014 Trustee of the Year Award from the Florida Hospital Association (FHA) at the Annual FHA Celebration of Achievement in Qual-ity and Service Awards in Orlando.

The Trustee of the Year Award honors a board member of a hospital or health system who has contributed significantly to the health of the community by provid-ing leadership and guidance to the hospi-tal or system board. McLean was recog-nized for helping to shape healthcare in south Lake County for more than 30 years.

McLean joined the South Lake Hos-pital District Board of Trustees in March of 1988.

Recognizing her tireless efforts to support the South Lake Hospital mission, the hospital district board of trustees ap-pointed McLean to the operating board in 2003. She immediately became the lead support in establishing and co-chaired the philanthropic campaign to build the hospital’s Centre for Women’s Health, al-lowing obstetrical services to return to the south Lake County community after a 20-year absence. The Centre for Women’s Health opened in 2004 and continues to provide women’s services including labor and delivery, diagnostic imaging, child-birth and breastfeed education and a new mother’s support group.

In 2007, McLean was appointed chair of the South Lake Hospital Board of Di-rectors and retains that role today.

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Page 15: Orlando Medical News November 2014

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