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Archive for October, 2010

CME Event – How to Handle Difficult Patient Encounters

Thursday, October 21st, 2010

October 21, 2010 at the W Atlanta-Midtown. For more information visit the Medical Association of Atlanta.

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Medical Association of Georgia – House of Delegates

Saturday, October 16th, 2010

October 16-17, 2010 in Savannah.  For more information, contact MAG at www.mag.org

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17th Annual Immunize Georgia Conference

Tuesday, October 12th, 2010

October 12, 2010 at the Macon Marriott City Center in Macon, Ga. To register, e-mail ImmunizeGeorgia@golinharris.com

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Nancy Collop, M.D., Director of Emory Sleep Center

Monday, October 4th, 2010

Nancy Collop, MD, a nationally recognized expert in sleep medicine, has been named director of the Emory Sleep Center. She also will have a primary appointment in the Emory School of Medicine as professor of medicine in the Division of Pulmonary, Allergy and Critical Care Medicine, and a secondary appointment as professor of neurology.

Collop comes to Emory from Johns Hopkins University, where she served as a professor of medicine in the Division of Pulmonary and Critical Care Medicine and as the medical director of The Johns Hopkins Hospital Sleep Disorders Laboratory.

Collop will work in close partnership with experts from all disciplines of medicine to further the Emory Sleep Center’s interdisciplinary approach to treating patients with a variety of sleep disorders.

“Sleep medicine spans the spectrum of all medicine,” says Collop. “You can look at any part of medicine and find that sleep has an effect. I look forward to leading the collaborative work and research we will be doing with our colleagues in neurology, pediatrics, nursing, otolaryngology, oral and maxillofacial surgery, and other areas to provide a comprehensive diagnosis and treatment plan for our patients.”

Collop graduated summa cum laude from Edinboro State University in Edinboro, Pennsylvania and earned her medical degree at Pennsylvania State University College of Medicine, where she was awarded the Roche Clinical Psychiatry Research Award and was elected to the Alpha Omega Alpha Honor Society. Collop completed her internal medicine internship and residency at the Medical College of Virginia and a pulmonary/critical care fellowship at the University of Florida. She was a recipient of the Research Fellowship Award from the American Lung Association of Florida.

She has been awarded several prestigious honors including “Best Doctors in America,” Baltimore’s “Top Doctor” in pulmonary and critical care medicine and sleep medicine, the Al Soffer Award for Editorial Excellence and the College Medalist by the American College of Chest Physicians, Distinguished Alumna for Natural Sciences (Edinboro University), and the Helmut S. Schmidt Award (American Board of Sleep Medicine).

Collop has served on the Board of Directors for the American Board of Sleep Medicine since 1998 and was the president from 2002-2009. She is on the Board of Directors of the American Academy of Sleep Medicine and is currently the president elect; she is also on the Board of Directors for the American Sleep Medicine Foundation. She was on the founding committee of the American Board of Internal Medicine (ABIM) Sleep Medicine Examination Committee and also serves on the ABIM Pulmonary Self Evaluation Process committee. Collop is an associate editor of the journal Chest and serves on the editorial board of Pulmonary Reviews. Her research interests include diagnostic testing for sleep-disordered breathing and standards for polysomnography.

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Andrew Golde, M.D., ENT Surgeon, Performs First Two Robotic TORS Cases

Monday, October 4th, 2010

Northside Hospital has expanded its robotic surgery program to include Transoral Surgery (TORS), performing its first two cases – tongue base cancer resection and lingual tonsillectomy – on Sept. 10.

Used in a growing range of specialties including ENT, thoracic, urology and gynecology, da Vinci computer-assisted robotics technology enables surgeons to perform minimally invasive procedures, while preserving and improving the visualization techniques of open surgery.

“This translates into less pain and discomfort, faster recovery and a better quality of life for patients with tumors and airway abnormalities that require surgery,” said Andrew Golde, M.D., ENT surgeon, who performed the first two robotic TORS cases at Northside.  In addition, patients benefit from minimal scaring, shorter hospital stays and a quicker return to normal speech and swallowing.

Robotic TORS is perhaps the most effective minimally invasive surgical treatment for diseases of the head and neck available today.  The da Vinci Surgical System allows the surgeon to provide the patient with procedures equivalent to traditional transoral surgery, but with the advantage of 3D high-definition visualization of the surgical site, and the precision and versatility afforded by robotic instrumentation.

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Transplant Specialists Join Piedmont Transplant Institute

Monday, October 4th, 2010

Erica Hartmann, M.D. joined Piedmont Transplant Institute from Wake Forest University Health Sciences in Winston-Salem, N.C., Erica Hartmann, M.D. received both her bachelor of arts and medical degree from the University of Missouri at Kansas City. She completed her internship and residency at Tulane University in New Orleans. Dr. Hartmann completed a fellowship in nephrology and an accredited fellowship in transplant nephrology, both at the University of Michigan.

Dr. Hartmann’s impressive career includes serving as associate professor of medicine and as medical director of the abdominal organ transplant program at Wake Forest University Health Sciences.

Chakri Panjala, M.D., a transplant hepatologist, joined the Piedmont Transplant Institute following the completion of two fellowships at the Mayo Clinic Florida: gastroenterology and hepatology, and liver transplantation. Dr. Panjala completed his internal medicine internship and residency at the University of Rochester, Rochester, New York. He is a medical graduate from the Gandhi Medical College and Hospital in Hyderabad, India, with additional qualification of masters in health systems management from George Mason University in Falls Church, Virginia.

Dr. Panjala, upon completing his residency, served as an attending physician in the department of internal medicine at Rochester General Hospital. He also served as an associate consultant in liver diseases and transplantation at the Mayo Clinic Florida after completing his training in the same. Dr. Panjala has a keen interest in clinical research pertaining to liver transplantation with emphasis on liver and biliary cancers and presented his research work both nationally and internationally at various reputable meetings.

He received three national awards and two Mayo Clinic Institutional awards within the last two years. Dr. Panjala is one of the twenty-five leading fellows from around the world who received the American Society of Clinical Oncology and Cancer Foundation merit award in 2010 in recognition of his contributions to clinical research in gastrointestinal malignancies.

Lance L. Stein, M.D., a transplant hepatologist, joined Piedmont from Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital – Columbia and Cornell, where he recently completed a fellowship in advanced transplant hepatology (ACGME). He received his bachelor of science from Pennsylvania State University and his medical degree from Temple University School of Medicine. He did his internship and residency at Emory University School of medicine and completed a fellowship in gastroenterology and hepatology, as well as a research fellowship, at the University of California – San Diego School of Medicine.

Dr. Stein is experienced in clinical research and teaching and has received numerous honors and awards for his work. He is a member of several academic and professional societies, including the American Association for the Study of Liver Diseases, American Gastroenterological Association, American Society of Gastrointestinal Endoscopy and the American College of Gastroenterology.

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Resurgens Charitable Foundation’s 2010 Golf Event

Monday, October 4th, 2010

October 4, 2010 at Hawk’s Ridge.  For more information, email Mary O’Flaherty at oflahertyml@resurgens.com.

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Children’s Healthcare of Atlanta First Pediatric Facility in U.S. to Offer Robot-Assisted Scoliosis Surgery

Monday, October 4th, 2010

Children’s Healthcare of Atlanta is the first pediatric facility in the U.S. to offer robot-guided scoliosis surgery.

The SpineAssist surgical guidance system allows a surgeon to pre-plan a procedure in a CT-based 3D simulation of the patient’s spine.  During the surgery a robotic extension arm guides the surgeon to the pre-planned location.  While only four health care facilities in the U.S. currently use the system, it is widely used in Europe.

Dennis Devito, M.D., an orthopaedic surgeon at Children’s, pioneered the use of the device in pediatric scoliosis patients.  In a study performed by Devito, he found improved accuracy when using the robotic guidance system for screw implantation in scoliosis patients.

“Worldwide, Children’s has the largest volume of experience using robotic guidance in pediatric patients,” said Devito. “We’re excited to offer scoliosis patients this leading-edge device.”

At Children’s, pediatric orthopaedic surgeons care for thousands of patients who require specialized surgical treatment for a variety of conditions, throughout Georgia, the Southeast and internationally.

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Study Finds More Americans Bypassing Their Personal Physician When Immediate Treatment Required

Monday, October 4th, 2010

Only 45 percent of the 354 million annual visits for acute care in the United States are made to patients’ personal physicians, as Americans increasingly make busy emergency departments, specialists or outpatient care departments their first point of contact for treatment of new health problems or a flare up of a chronic condition like asthma or diabetes.

The findings, which appear in the September edition of Health Affairs, do not bode well for the nation’s already busy and frequently undermanned emergency rooms. While fewer than five percent of doctors across the U.S. are emergency physicians, they handle more than 28 percent of all acute care encounters – and more than half of acute care visits by the under-and uninsured.

According to co-authors including Steven Pitts, MD, associate professor of medicine in the Emory School of Medicine and a staff physician at Emory University Hospital Midtown, and Arthur Kellermann, MD, the Paul O’Neill Alcoa Chair in Policy Analysis at the RAND Corporation and previous associate dean for health policy at Emory University, health reform provisions in the Patient Protection and Affordable Care Act that advance patient-centered medical homes and accountable care organizations are intended to improve access to acute care. However, the challenge for reform, according to study authors, will be to succeed in the complex acute care landscape that already exists.

“Timely access to care is important, especially for those who are acutely ill. First-contact care has been a central tenet of primary care. But over the past few decades, the focus of primary care has shifted as a result of a growing elderly population, the growing burden of chronic disease and the challenge of coordinating care across multiple physicians,” says Pitts. “Low rates of reimbursement have accelerated this trend by forcing many primary care physicians to pack their daily schedules with 15-minute office visits – leaving little time for patients with acute health problems.”

The study, which took place between 2001 and 2004, shows that Americans made an average of 1.09 billion outpatient visits per year to physicians, averaging 321 visits per 1,000 people each month. Slightly more than a third of all encounters, or 354 million per year, were for acute care — treatment of new problems or a flare-up of a chronic health condition.

Twenty-two percent of acute care visits were managed by general/family practitioners, 10 percent by general internists and 13 percent by general pediatricians. Many involved treatment of minor upper respiratory problems, such as cough and sore throat. Office-based specialists handled 20 percent of acute care visits, generally for conditions in their respective areas of expertise (e.g., skin, eye and orthopedic problems). Twenty-eight percent of acute care visits were managed by hospital emergency departments, typically for more complex and potentially dangerous conditions such as stomach and abdominal pain, chest pain and fever.

“One of the biggest barriers to providing acute care in primary care practice is that many primary care doctors have packed schedules. This makes ”same day” scheduling, much less treatment of walk-in patients, extremely difficult,” says Kellermann.

“Busy schedules also discourage primary care physicians from taking the time they need to treat patients with complex, undifferentiated complaints. It is faster and simpler to refer them to a specialist or the nearest emergency department. Ensuring timely access to primary care is a desirable goal, because it increases a person’s odds of finding a “medical home”. Unfortunately, for many years now, primary care in the U.S. has been in decline,” Kellermann says. “Patients have adapted by seeking care elsewhere when they get sick.”

Our data indicate that more than half of acute visits today involve a doctor other than the patient’s personal physician. Dr. Pitts adds, “More than a quarter of all acute care visits, including virtually all weekend and “after hours” encounters, occur in hospital emergency departments. Heavy use of emergency departments for problems that a primary care provider could treat, if their patients could get in to see them, is not desirable from a societal perspective,” says Pitts. “Too often, emergency care is disconnected from patients’ ongoing health care needs.”

“Hospital emergency departments are vital, particularly when your life is on the line.” Kellermann says. “Americans know that when they can’t get care elsewhere, the ER is the one place in our nation’s healthcare system where the doctor is always “in”. Strengthening primary care is a major goal of healthcare reform. If successful, it will be a win for everybody.”

In addition to Pitts and Kellermann, other study authors included Emily R. Carrier, a senior health researcher at the Center for Studying Health System Change in Washington, D.C., and Eugene C. Rich, a senior fellow at Mathematica Policy Research, also in Washington, D.C.

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CIGNA and Piedmont Physicians Group Launch Accountable Care Organization Pilot Program

Monday, October 4th, 2010

CIGNA and Piedmont Physicians Group, part of Piedmont Healthcare, have launched an accountable care organization (ACO) pilot program. With a comprehensive, accountable and collaborative approach to medical care, the ACO pilot is expected to improve access to and quality of patient care, and provide better care coordination while lowering medical costs.

An ACO is a variation on the patient-centered medical home model of health care that rewards primary care doctors for improved outcomes and lower medical costs. CIGNA’s program with Piedmont is one of the first patient-centered pilot programs in the Atlanta area involving a medical practice and a single private payer and is the first accountable care organization in Georgia.

The program, which began July 1, is focused on approximately 10,000 individuals covered by a CIGNA health plan who receive care from one of Piedmont’s more than 100 primary care physicians who are members of the Piedmont Physicians Group.

During the ACO pilot, a Piedmont Physicians Group practice will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current Piedmont physician and will not need to do anything to receive the benefits of the ACO pilot. There also is no change in any plan requirements regarding referrals to specialists.

Key to the CIGNA/Piedmont program is a registered nurse, funded by CIGNA and employed by Piedmont, who serves as a clinical care coordinator to help patients with chronic conditions or other health challenges navigate their health care system. The care coordinator will enhance patient care by coordinating CIGNA data and clinical programs of the Piedmont Physicians Group, as well as communications, appointment availability and education around those clinical programs. Using CIGNA data to help drive improved outcomes is one of the core strengths of the program.

“We believe that we can achieve better clinical outcomes by adopting a patient-centered model of primary care,” said Dr. David Epstein, CIGNA’s senior medical director for Georgia. “Health care in the United States has shifted away from prevention and primary care, which has resulted in a ‘disease care’ system that relies more on specialist intervention and rescue procedures rather than improving health and providing greater value to patients. The patient-centered model places the focus back where it belongs – on improving the health of individuals through comprehensive primary care services and delivering better outcomes through enhanced care coordination.”

CIGNA will pay the primary care physicians of the Piedmont Physicians Group as usual for the medical services they provide, plus an additional fee for care coordination and other medical home services. The physicians also will be rewarded through a “pay for performance” structure if they meet targets for improving quality and lowering medical costs. According to CIGNA’s Epstein, emphasizing the value of the primary care physician will help increase the professional satisfaction and financial rewards for doctors who practice in primary care.

CIGNA will evaluate results after the program has been operational for at least 12 months. The pilot is one of many that CIGNA participates in nationally and is intended to help the company gather data about the effectiveness of the patient-centered model.

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