Mecklenburg Medicine April 2015

Mecklenburg MedicineA Publication of the Mecklenburg County Medical Society | www.meckmed.org

April 2015 • Vol. 45, No. 4

Mecklenburg County Medical Society • Mecklenburg Medical Alliance and EndowmentFounders of: Bioethics Resource Group, Ltd., Hospitality House of Charlotte, Teen Health Connection, N.C. MedAssist, Physicians Reach Out

2 | April 2015 • Mecklenburg Medicine

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Mecklenburg Medicine • April 2015 | 3

April 2015Vol. 45 No. 4

OFFICERS

PresidentSimon V. Ward III, MD

President-ElectStephen J. Ezzo, MD

SecretaryElizabeth B. Moran, MD

TreasurerScott L. Furney, MD

Immediate Past President James B. Hall, MD

BOARD MEMBERS

John R. Allbert, MDRaymond E. Brown, PAW. Frank Ingram III, MD

Stephen R. Keener, MD, MPHScott S. Lindblom, MDJohn P. McBryde, MD

Shivani P. Mehta, MD, MPHRobert L. Mittl, Jr., MD

Pulak D. Patel, MDCheryl L. Walker-McGill, MD, MBA

EX-OFFICIO BOARD MEMBERS

Sherry Ward, PresidentMecklenburg Medical Alliance & Endowment

Sandi D. Buchanan, Executive DirectorMecklenburg County Medical Society

Michelle Conner, DDS, PresidentCharlotte Medical Society

Docia E. Hickey, MDNCMS President-Elect

Darlyne Menscer, MDNCMS Delegate to the AMA

Marcus G. Plescia, MD, Health DirectorMecklenburg County Health Department

Douglas R. Swanson, MD, FACEP, Medical DirectorMecklenburg EMS Agency

EXECUTIVE STAFF

Executive DirectorSandi D. Buchanan

Meetings & Special EventsTrisha G. Herndon

Finance & Database Specialist Stephanie D. Smith

MECKLENBURG MEDICINE STAFF

Managing EditorSandi D. Buchanan

Copy EditorsLee McCrackenStephanie Smith

AdvertisingMark Ethridge

[email protected]

Editorial BoardStephen J. Ezzo, MDN. Neil Howell, MD

Scott S. Lindblom, MDJessica Schorr Saxe, MDSimon V. Ward III, MD

Graphic Design — Wade Baker

Mecklenburg Medicine is published 10 times per year by the Mecklenburg County Medical Society, 1112 Harding Place, Suite 200, Charlotte, NC 28204. Opinions expressed by authors are their own, and not necessarily those of Mecklenburg Medicine or the Mecklenburg County Medical Society. Mecklenburg Medicine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. Mecklenburg Medicine is not responsible for unsolicited manuscripts.

Non-members may subscribe to Mecklenburg Medicine at a cost of $30 per year, or $3.50 per issue, if extra copies are available.

Classified Ads: Open to members, nonprofits and non-member individuals only; advance approval of the Managing Editor and advance payment required. Member rate is 0, non-members $20 for the first 30 words; $.75 each additional word.

Display Ads: Open to professional entities or commercial businesses. For specifications and rate information, contact Mark Ethridge at [email protected]. Acceptance of advertising for this publication in no way constitutes professional approval or endorsement of products or services advertised herein.

We welcome your comments and suggestions:Call 704-376-3688 or write Mecklenburg Medicine, c/o Mecklenburg County Medical Society, 1112 Harding Place, Suite 200, Charlotte, NC 28204.

1112 Harding Place, #200, Charlotte, NC 28204704-376-3688 • FAX [email protected] 2015 Mecklenburg County Medical Society

Table of Contents 4 President’s Letter: Mirror, Mirror on the Wall By Simon V. Ward III, MD

5 Feature: 7 Tax Discussions You May Want to Have With Your CPA By Shane Tenny, CFP®

6 Feature: All Signs Point to a Healthier Mecklenburg County By Marcus Plescia, MD

8 Feature: Mecklenburg County’s Progress in Public Health

8 Charlotte AHEC Course Offerings for Spring 2015

10 Member News

10 Upcoming Meetings & Events

11 National Health & Wellness Observances for April 2015

11 Advertising Acknowledgement

13 MMAE Feature: MMAE Health Classroom Gets High Marks By Kathleen Klimas

14 At the Hospitals

16 Independent Physicians of the Carolinas


Mirror, Mirror on the WallBy Simon V. Ward III, MD

I n many ways, the extremes are the easiest — all good, such as apple pie, or all bad, such as Adolph Hitler. If life were lived in the extremes, the best path would be easy to identify, and we could all follow it. As we learn somewhere around

the second grade, very little in life is all good or all bad. We spend the majority of time working and playing in the gray zone. Automobiles can give us the ability to travel almost anywhere we want to go, but motor vehicle accidents are the leading cause of death among teenagers. Surgery is a wonderful tool physicians use to cure disease, but when complications occur, surgery can cause death in an otherwise healthy patient.

Everyone knows heroin is bad. Cocaine only has narrow clinical uses by otolaryngologists for nasal bleeding. Tobacco belongs in this group. The inherent health risks of smoking are well-described. Smokers have a greatly increased risk of lung cancer, heart disease and obstructive pulmonary disease. It is very easy and straightforward for us to advise patients against using these substances. They do not enhance the quality of life. The potential for significant health problems is high. We, as parents, also should talk to our children about the dangers of heroin, cocaine and tobacco, and warn them never to touch them.

Then comes a gray zone: alcohol. It’s complicated. Many people who drink in moderation live long and healthy lives. There is literature that suggests very modest alcohol intake reduces the risk for stroke.

Campus consumption of alcohol increasingly has become a concern. Eighty percent of college students say they drink alcohol. The number of binge drinkers, defined as having four to five drinks in a two-hour period, is between 25 percent and 50 percent. The National Institutes of Health reports 1,825 deaths of college students per year related to alcohol. Some 600,000 injuries per year are alcohol-related.

College administrators are actively working to reduce these numbers. My alma mater recently passed a ban on hard liquor on campus that will take affect this month. The administration knows what is occurring on campus and is making its best decision on how to rectify the problem. I trust they know what they are doing, but the majority of problems with alcohol on campuses around the country involve beer. Other colleges have instituted rules about actively managing keg parties — when the keg is tapped, and when it is shut down.

If alcohol were the same as cocaine, then banning all alcohol from every campus in the country would be the answer. That would be straightforward. The problem is, alcohol does not go away. When students graduate and work for an advertising agency in Chicago or an investment firm in Boston, they then would have to make their decision about how they use alcohol. The “real” world may only be a great classroom for how NOT to use alcohol. Any NFL stadium in the country on a hot Sunday afternoon provides many bad examples.

The best long-term solution will be one that changes the attitudes of young people toward alcohol — making it the norm to use it wisely, or not at all. It would also be easy for us to look at this problem as a bunch of immature kids who have not learned to live responsibly, except ... when we look in the mirror. As we do that, we see an intelligent, highly-educated person who has satisfied strict requirements to be certified by the state and other licensing authorities as capable of providing care to the citizens of this county. And, we face our own gray zone problem: prescription opioid analgesics.

It was relatively simple in the days when our patients faced the problems of overdose with heroin and cocaine. In 2012, there were 17,000 deaths due to opioid analgesics. More people died due to prescription medications than heroin, cocaine and methamphetamine combined. Between 1991 and 2007, the death rate from prescription medications tripled. A few of these meds were obtained from pharmacy break-ins. The vast majority were obtained from a prescription written by a healthcare provider — prescriptions WE wrote.

If opioid analgesics were cocaine, we simply would ban them. Again, this is a gray zone. Opioid and similar analgesics serve a real purpose. If patients have had major abdominal, thoracic or orthopedic surgery, they deserve relief from the pain. Certain medical conditions are associated with pain that only prescription analgesics can control. Adequate pain control can increase a patient’s mobility so they are at less risk for deep vein thrombosis or pneumonia.

We have not been good stewards of the privilege to administer these medications. This past October, the DEA changed the classification of hydrocodone to Schedule II. That means we no longer can call in hydrocodone-containing analgesics. The North Carolina Medical Board this past June initiated more comprehensive safeguards against inappropriate prescribing, which all licensed practitioners are expected to follow.

The worst part is that these regulations even are necessary. We are not a bunch of 18-year-olds away from home for the first time at an Alpha Beta Gamma keg party. We are in our offices, surgery centers or hospitals doing the work we do every day. We need to remember the importance of prescribing these medications at the appropriate time and in the appropriate amounts. There is no easy solution, but we can and will do better. Let us also talk to our kids. We all need to navigate up this complicated river known as life.

President’s Letter


Feature

7 Tax Discussions You May Want to Have With Your CPABy Shane Tenny, CFP®, Spaugh Dameron Tenny

W ith the pain of filing fresh in your mind, we thought it’d be a good time to mention a few ideas that may help lessen your tax burden in future years. These come straight from our

experience in helping physicians notice the details in their financial lives. Obviously, they may not all apply to you, but hopefully you can put this article in your tax folder to spark a helpful conversation with your CPA or financial planner.

1. Roth IRAs – Roth IRAs are a possibility for everyone. Contrary to popular belief, even physicians can get $5,500 into a Roth IRA ($6,500 if over age 50). You simply make a non-deductible contribution to an IRA and then file a form to convert (technical term) the balance to a Roth IRA. From that point, it all grows income tax free. (Note: You should carefully discuss this with your CPA if you have an IRA, as there can be some additional factors to consider.)

2. Health Savings Accounts – HSAs offer the perfect trifecta of tax benefits: contributions are tax deductible, growth is tax deferred and qualifying withdrawals are income tax free. Many people are confused on the difference between an HSA and an FSA (Flexible Spending Accounts) and have avoided both. While an FSA has a “use it or lose it” restriction, the balance in an HSA is fully vested and available at any time for qualifying withdrawals.

3. Receipts – Too many people don’t keep track of their receipts from Goodwill after they drop off closet purgings. These tax receipts are like cash in your pocket. Although the Goodwill employee won’t value your items, you can do so easily using an online giving guide, and reduce your taxable income dollar for dollar with your donations value.

4. Give Investments, Not Cash – If you typically make cash gifts to churches, charities or other nonprofits during the year, you may be missing out on a wonderful tax savings. With most investment accounts showing positive returns in recent years, you may have some stocks or mutual funds that have long-term gains but have not yet been sold. Rather than paying 20 percent capital gains tax when you sell the appreciated investment, most charities will provide you the details to give the investment to them, which they can then sell with no tax obligation. Although your portfolio is now a bit smaller, you can use the cash previously earmarked for charity to replenish your account. At the end of the day, you get the same charitable deduction and avoid paying capital gains tax on your investments.

5. Roth 401k – Most employers now allow your 401(k) contribution to be treated as either pre-tax deferral or a Roth deferral. This is different than a Roth IRA account, but does have the same tax-free treatment of earnings. Imagine for a minute your 401(k) contribution as a seed and the future withdrawals in retirement as the harvest. Would you rather take a tax

deduction on the seed and pay tax on the harvest in retirement? Or would you rather pay tax on the seed and receive the harvest free of income taxes? This isn’t a simple calculation, I know, but one that many folks would benefit from making.

6. Investment Advisory Fees – Many professionally managed investment accounts are assessed quarterly management fees. Although you may have to look around for the fees, make sure to give this information to your CPA. Advisory fees for non-retirement accounts may add to your itemized deductions.

7. Solo 401k – Physicians with income outside their practice, like consulting or moonlighting, often wish to defer taxation on these additional earnings. While the traditional suggestion has been the use of a SEP IRA, you may wish to explore setting up a Solo 401(k). This type of account sometimes can facilitate much higher contribution amounts for the same level of earnings. Furthermore, the strategy can be really enhanced by employing your spouse to assist with this side business and making a deferral of his or her income, as well.

This information is being provided with the understanding that it is not intended to be interpreted as specific legal or tax advice. The author is not authorized to give tax advice. Individuals are encouraged to seek the guidance of their own personal tax counsel.

Securities, investment advisory and financial planning services offered through qualified registered representatives of MML Investors Services, LLC Member SIPC, 6000 Fairview Road, Suite 400, Charlotte, NC 28210, 704-557-9750. Spaugh Dameron Tenny is not a subsidiary or affiliate of MML Investors Services, LLC or its affiliated companies. CRN201702-189145

Would you rather take a tax deduction on the

seed and pay tax on the harvest in retirement? Or would you rather

pay tax on the seed and receive the harvest free

of income taxes?


All Signs Point to a Healthier Mecklenburg County By Marcus Plescia, MD, MPH, Mecklenburg County Health Director

T obacco use remains the leading preventable cause of death, disease and disability in our community, contributing significantly to incidence of heart disease, stroke, at least 13 cancers, diabetes and is linked to

diseases of almost every organ of the body. Despite the well-known dangers of smoking, one in five adults in Mecklenburg County still smoke, not to mention the number who continue to be exposed to secondhand smoke. This population-health crisis is real and is a priority for intervention to prevent chronic diseases.

The good news is that Mecklenburg County now has more smoke-free or tobacco-free public spaces. Through the leadership of the Mecklenburg County Health Department, a bold step was

taken by the County last fall. The Mecklenburg County Board of Commissioners passed two tobacco regulations (laws) which became effective March 18, 2015. This county-wide wellness initiative provides the public and employees who work for the county, City of Charlotte and six townships, protection from secondhand smoke and support for quitting tobacco. It also will role model a tobacco-free

norm for kids on government property and in county-owned parks.The first regulation is a Board of Health Rule for smoke-free

government grounds, which means all government buildings, vehicles and property in the county, city of Charlotte and the towns of Cornelius, Davidson, Huntersville, Matthews, Mint Hill and Pineville will be smoke-free. No smoking will be allowed anywhere on the property. Smoking is defined as all lit smoking products, such as cigarettes, cigars, pipes, hookahs and cigarillos.

The second regulation is a County Ordinance for tobacco-free parks. This means all parks, greenways and property owned by

the Mecklenburg County park system are tobacco-free. Two areas exempted from the parks ordinance include county-owned golf courses and some of the regional parks, except during special events. Tobacco includes all smoking products, as well as smokeless tobacco (chew, dip, snuff) and electronic cigarettes or electronic nicotine delivery devices.

Enforcement of the regulations occurs through strategic signage, public education and communication with key stakeholders. Over time it becomes the social norm, much like smoke-free restaurants and bars have over the past five years in North Carolina.

Why Include Electronic Cigarettes? Although 2013 N.C. state legislation made the sale of e-cigs to

minors illegal, recent data (N.C. Youth Tobacco Survey, 2013) indicates the use of e-cigs increased by 352 percent among high school teens during the past two years. And, it’s not just teens. Many adults report they recently quit smoking, but often have replaced the behavior with this electronic counterpart. E-cigs maintain nicotine addiction and are not yet proven to be a “safe” product, although some claim they may be “safer” than combustible cigarettes. Although the North Carolina youth smoking rate is at an all-time low (15.5 percent), the concern is that

Feature

Despite the well-known dangers of smoking, one in five adults in

Mecklenburg County still smoke, not to

mention the number who continue to be exposed to

secondhand smoke.


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use of other tobacco products among our North Carolina teens (up from 25.8 percent in 2011 to 29.7 percent in 2013) is on the rise, in large part due to use of these electronic devices.

FDA ruling on regulating nicotine delivery devices is pending, and more studies are identifying harmful chemicals in these often candy and fruity-flavored products. Electronic cigarettes are not an FDA-approved cessation method. The use of nicotine replacement therapy (nicotine patch, gum, lozenge, nasal spray and inhaler) are FDA-approved quit methods with proven results and clearly labeled nicotine levels without the other harmful chemicals.

Community as Patient — Physicians and other healthcare providers are in an influential position to support community-

wide strategies proven to reduce tobacco use. According to CDC’s Best Practices for Comprehensive Tobacco Control Programs, supporting and implementing programs and policies to influence organizations, systems and networks that encourage and support individuals to make behavior choices consistent with tobacco-free norms, are most effective. The social norm change model presumes that lasting

change occurs through shifts in the social environment — initially or ultimately — at the grassroots level across local communities. Population-wide interventions that change societal environments and norms related to tobacco use — including increases in the unit

price of tobacco products, comprehensive smokefree policies, and hard-hitting media campaigns — increase tobacco cessation by motivating tobacco users to quit and making it easier for them to do so (CDC, Best Practice, 2014).

Physicians play a powerful role in promoting cessation to patients and families, through using the “5-A’s method” or a shortened 3-A’s approach: ask about tobacco use, advise tobacco users to quit,

assess readiness to quit, assist patients in accessing quit help, and arrange for follow-up. QuitlineNC is an evidence-based cessation resource free to anyone in North Carolina who is ready to quit in the next 30 days, and can be accessed by calling 1-800-Quit-Now or by health professionals using the fax referral option. Patients who are uninsured, on Medicaid or Medicare, can receive two weeks of

free nicotine patches when they register with the quitline. Effective community interventions to reduce tobacco’s

toll involve and influence people in their daily environment. Mecklenburg County has taken a bold step in promoting smoke-free and tobacco-free environments; however, the work is not done. Partner with us to broaden support for smoke-free worksites and tobacco-free public places, and to help patients and families access quit support. For details, visit www.tobaccofreemeck.org or call 980-314-9064. For health practice resources to promote cessation, visit www.quitlinenc.com.


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National Public Health Week is April 6-12, with the theme

Take a look at progress in public health from the 2014 State of the County Health Report (SOTCH), Mecklenburg County Health Department:

Chronic Disease PreventionObjective: Reduce rate of overweight and obesity by 5 percent; reduce tobacco use rate by 10 percent.

Reducing Overweight and Obesity• Village Heart BEAT (Building Education and

Accountability Together) designed to promote heart healththrough improved diet, increased physical activity andbiometric screenings.

Reducing Tobacco Use• Mecklenburg Board of County Commissioners approved

a County Ordinance for tobacco-free parks and a Board ofHealth Rule creating smoke-free government grounds forthe county, City of Charlotte and six towns in the county.

Mental HealthObjective: Reduce suicide rate by 5 percent.

Reducing Suicide Rate• Mental health first-aid training targeting staff and

volunteers working with homeless populations.• Youth suicide task force formed under Child Fatality

Prevention and Protection.

Access to CareObjective: Provide access care to all, regardless of ability to pay.

Increase Number of Insured Individuals and Families• “Get Covered Mecklenburg” hosts mass enrollment events.• Navigators throughout Mecklenburg County to provide free

enrollment assistance.• 44, 597 residents obtained coverage during first open

enrollment period.

Injury and ViolenceObjective: Reduce homicide rate by 5 percent.

Reducing Homicide Rate• Charlotte-Mecklenburg Police promote Crime Stopper

program through Project Safe Neighborhoods.• Community Support Services, Charlotte-Mecklenburg

Police, Teen Health Connection, Charlotte-MecklenburgSchools and other partners complete “Seeking to Heal andReclaim” needs assessment.

• Community Support Services-Women’s CommissionDivision hosts middle school leadership conference, as partof “Do the Write Thing” program.

New Initiatives and Emerging TrendsHealth Impact Assessment (HIA) of Lynx Light Rail Extension• Mecklenburg County Health Department awarded grant to

conduct HIA to improve consideration of public health incommunity design and built environment projects.

Charlotte Chamber’s Healthy Charlotte Council• Using the American Fitness Index as a benchmark, the Council

hopes to help Charlotte achieve a top 10 ranking in the nextfive years.

Preparedness and Ebola Response• Various health department protocols were modified to facilitate

the most effective Ebola response, including after-hours contact,quarantine and isolation, and traveler monitoring procedure. Thedepartment also has reached out to Mecklenburg residents fromWest Africa to educate them about the spread of the disease.

For a copy of the report, go to: http://charmeck.org/mecklenburg/county/HealthDepartment/

HealthStatistics/Pages/default.aspx

Charlotte AHEC Course OfferingsCharlotte AHEC is part of the N.C. Area Health Education Centers

(AHEC) Program and Carolinas HealthCare System.

SPRING 2015Continuing Medical Education (CME) 4/11-12 29th Annual Meeting of the Glomerular Disease

Collaboration Network (GDCN)

4/20-22 National Council Conference

4/23 SGEA Regional Conference

4/25 2nd Annual Clinical Updates in Neurology

5/2 UNC Pathology Conference

5/15 Reach Out & Read

For more information or to register for these courses,call 704-512-6523 or visit www.charlotteahec.org.

Healthiest Nation 2030


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Upcoming Meetings & EventsMeetings are at the MCMS office unless otherwise noted.

APRILWednesday, April 1

Fighting for Women With Fashion Planning meeting.

Safe Alliance office.6 p.m.

n Friday, April 3Good Friday – MCMS office

closed.

n Tuesday, April 7Charlotte Dental Society Board

meeting.6 p.m.

n Tuesday, April 14MedLink meeting.Mecklenburg County Health

Department.8:30 a.m.

n Wednesday, April 15MMAE Finance Committee

meeting.9 a.m.

n Wednesday, April 15MMAE Board meeting.10 a.m.

n Thursday, April 16CAMGMA.Myers Park Baptist Church

Cornwell Center.Noon.

n Monday, April 20Executive Committee meeting.5:45 p.m.

n Wednesday, April 22June magazine deadline.

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Member News

THE 10TH ANNUALGOLF TOURNAMENTA DECADE DEDICATED TO

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For more information, contact Merrill Mills at [email protected] or 704-355-4048.

Sponsored by Carolinas HealthCare Foundation.

SAVE THE DATE!SAVE THE DATE!


Advertising Acknowledgements

The following patrons made Mecklenburg Medicine possible.

Alexander Youth Network .................................... Insert

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NATIONAL HEALTH & WELLNESS

OBSERVANCESAPRIL 2014IBS Awareness Month

National Autism Awareness Month

Primary immunodeficiency Awareness Month

Sarcoidosis Awareness Month

April 7: World Health Day

April 10: National Alcohol Screening Day

April 6-12: National Public Health Week

April 26-May 3: National Infant Immunization Week

SAVE THE DATE!SAVE THE DATE!


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MMAE Health Classroom Gets High MarksBy Kathleen Klimas

A n important aspect of the mission of the Medical Alliance is education, and judging by the response to MMAE’s Annual Health Classroom, it is mission accomplished for 2015. About 135 individuals

attended the Alliance-sponsored program on food allergies held at Myers Park Country Club on Thursday, Feb. 19.

Attendees at MMAE’s ninth annual health education event began the day with a delicious breakfast buffet followed by a comprehensive program entitled “Food Allergies: Hype or Hypersensitivity.” Speakers included three board-certified allergists from Carolina Asthma and Allergy Center, who donated their time to help an eager audience understand the facts about food allergy.

According to MMAE President Sherry Ward, “We felt food allergy is a health area that is often misrepresented in the media, and we wanted to make accurate medical information available to the general public.”

John Klimas, MD, gave an overview of food allergies, which included audience participation and a grocery bag containing the “Big Eight” foods that most frequently cause an allergic reaction. He talked about symptoms and management of food allergies and food intolerance, and warned attendees about bogus tests that are expensive, but unreliable.

Gray Norris, MD, tackled the subject of peanut allergy, a topic he’s familiar with on a personal level as his 4-year-old son has peanut allergy. He talked about a number of theories on the causes of peanut allergy and detailed some of the most current research about providing immunity to peanut allergy.

This topic made national news a few days later, when the New England Journal of Medicine published a study conducted in England. It showed that children who were considered high-risk candidates for peanut allergy and who ingested a small

amount of peanut butter weekly before their first birthday, were less likely to develop peanut allergy.

Emily Langley, MD, led the discussion on wheat and gluten allergy. She explained that while wheat allergy is seen most commonly in children, they frequently outgrow it. Celiac disease, which requires a patient to adopt a gluten-free diet, is an inflammatory reaction to gliadin, a protein found in wheat, barley and rye. It is not an allergy. Under some debate is gluten intolerance, in which non-Celiac patients react with a variety of symptoms to gluten. Eliminating gluten appears to improve general health but a gluten-free diet may put an individual at risk for deficiencies in iron, folic acid, calcium, Vitamin D and Vitamin B12.

Representatives from Parents of Allergic Kids (PAK) participated with a display and educational materials. Park Road Books brought a selection of books about food allergies. Enjoy Life donated gluten-free snacks for sampling. And, representatives from Sanofi Pharmaceuticals demonstrated the use of the Auvi-Q epinephrine auto-injector. Four lucky individuals took home raffle prizes: one nut-free and one gluten-free gift basket donated by First Source; an Italian foods basket contributed by Fresh Market; and a gift certificate donated by Earth Fare.

Save the Date!Save the Date!Family Love Letters

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Speaker from Neuberger Berman

Help with preserving that which is most important for you to leave your family ...

getting your affairs in order.

Thursday, April 23 • Lumiere French KitchenPresented by SunTrust

Annual Meeting and Presentationof Grant RecipientsSpeaker: Mary Tribble

“Doing Well and Doing Good”

Tuesday, May 19 • Carmel Country Club

Gray Norris, MD, Emily Langley, MD and John Klimas, MD.Gray Norris, MD, Emily Langley, MD and John Klimas, MD.Gray Norris, MD, Emily Langley, MD and John Klimas, MD.


At the Hospitals

n Novant Health Presbyterian MedicalCenter Recognized As ‘Baby-Friendly’On January 28, Novant Health

Presbyterian Medical Center received international recognition as a Baby-Friendly Designated birth facility. One of only seven facilities to be so designated in North Carolina, Presbyterian Medical Center is the first hospital in the Charlotte area to receive this recognition.

The Baby-Friendly Hospital Initiative (BFHI), a global initiative of the World Health Organization and the United Nations Children’s Fund (UNICEF), was first launched in 1991. The initiative’s goal is to improve health outcomes for mothers and babies through breastfeeding and immediate skin-to-skin bonding by recognizing birthing facilities that successfully implement the “Ten Steps to Successful Breastfeeding” and the “International Code of Marketing of Breast-milk Substitutes.”

“We are thrilled to be recognized as a Baby-Friendly facility,” says Pat Campbell, vice president of Women’s Services at Novant Health Presbyterian Medical Center. “We recognize that women who choose to breastfeed may need extra support during their hospital stay. The evidence-based guidelines reinforced by the Baby-Friendly program help us provide that support to mothers and their growing families.”

As a Baby-Friendly hospital, Novant Health Presbyterian Medical Center is staffed with lactation consultants who assist mothers in gaining the skills and confidence they need to breastfeed once the baby arrives. Other important practices of Baby-Friendly hospitals include encouraging skin-to-skin contact between mothers and newborns and rooming in, allowing the baby to stay in the mother’s room during their time in the hospital. Both practices encourage bonding and improve the newborn’s ability to breastfeed. Studies also show that immediate skin-to-skin contact helps newborns maintain their temperatures,

normalize heart and breathing rates, and reduce their likeliness of crying.

“One of the most highly effective preventive measures a mother can take to protect the health of her infant and her health, is to breastfeed,” says T. Christopher Morris, MD, chair of the OB/GYN department at Novant Health Presbyterian Medical Center. “Research shows that a mother’s decision to breastfeed can be greatly influenced by the opinion and support of her healthcare providers, so we want to ensure that mothers are connected to the resources they need to make an informed decision at every stage of their pregnancy.”

Research shows that breastfed babies have lower risk of asthma, childhood leukemia, childhood obesity, ear infections, eczema (atopic dermatitis), diarrhea and vomiting, lower respiratory infections, sudden infant death syndrome (SIDS), type 2 diabetes and necrotizing enterocolitis, a disease that affects the gastrointestinal tract in pre-term infants. Breastfeeding also is linked to a lower risk of type 2 diabetes, certain types of breast cancer, and ovarian cancer in mothers.

“Many of the health benefits babies get from breastfeeding early in life can carry on through adulthood, as well,” says Erin Washburn, DO, chair of the Pediatrics Department at Novant Health Presbyterian Medical Center. She adds that for optimum growth and development, the American Association of Pediatrics recommends moms breastfeed exclusively until babies are six months old, and continue until at least their first birthday.

n Dr. Eric Warren Contributes toConcussion White Paper in NatureReviews Neurology In February, Eric Warren, MD,

Novant Health Waxhaw Family Physicians and Sports Medicine, was published in Nature Reviews Neurology as a contributing author to “Mind the gaps – advancing research into short-term and long-term neuropsychological outcomes following youth sports-related concussions.”

Warren has been involved in concussion care for many years, and in November 2013, he was invited to speak about genetic testing in concussions at a think tank hosted by Safe Kids Worldwide in Washington, D.C. As a result of the think tank, Dr. Warren was asked to assist in writing the paper now published in Nature Reviews Neurology.

The paper highlights critically-needed research in the areas of concussion science, dementia, genetics, diagnostic and prognostic biomarkers, neuroimaging, sports injury surveillance and information sharing. In each area, the authors proposed clear and achievable paths to improve the understanding, treatment and prevention of youth sport-related concussions.

The primary care sports medicine physicians of Novant Health have advanced training in treating concussions and minimizing the risk of more serious complications. Using a cognitive test called ImPACT™ and vestibular balance testing, physicians are able to measure the effects of a concussion and determine when it is safe for patients to return to play. For more information about sports medicine and the ImPACT™ test, visit NovantHealth.org/sports. To refer a patient, call 704-316-SPRT (7778).

n Novant Health Pulmonary and CriticalCare Partners with UNC-Chapel HillLung Transplant ProgramIn October 2013, Novant Health and

UNC-Chapel Hill partnered together in a lung transplant outreach program. This is the first outreach transplant program in North Carolina and is available to all patients.

The program is designed to be convenient for those in the Charlotte area to get a lung transplant in Chapel Hill and then continue their follow-up care close to home. The lung transplant team from UNC-Chapel Hill comes to Novant Health Pulmonary and Critical Care every other month to meet with lung transplant patients, as well as offer consultations for potential lung transplant candidates. Since the program’s inception, seven patients have gone through the program, and one patient has received a lung transplant at UNC.

If you would like to speak directly with a transplant physician or surgeon, call 800-862-6264. To make a referral, call 984-974-7589.


At the Hospitals

n Institute Offers Novel Technologyfor Brain Cancer PatientsPatients with a deadly type of brain

cancer may now receive an innovative treatment at Carolinas HealthCare System’s Levine Cancer Institute.

The institute is one of only 150 cancer centers in the nation to offer NovoTTF to treat glioblastoma. NovoTTF is a wearable device that delivers electric fields to a patient’s brain via ceramic disks, which are attached to the scalp. The technology recently became FDA-approved for its success in reducing the size of brain tumors and prolonging survival in patients with glioblastoma.

“This is a very personalized type of medicine, which truly could be a game-changer for patients who think they have exhausted all other options,” says Ashley Sumrall, MD, neuro-oncologist at the Institute.

Dr. Sumrall, along with Stuart Burri, MD, radiation oncologist, are principal investigator and co-principal investigator on a clinical trial testing NovoTTF patients with unresectable glioblastoma, in which chemotherapy and radiation treatment mechanisms are not sufficient. The Institute is the only site in the nation enrolling patients in the trial, which is available in Charlotte and at Roper St. Francis in Charleston, S.C.

n Alzheimer’s Patients Sought forNew TrialCarolinas HealthCare System’s

Department of Neurology and the Department of Behavioral Health are collaborating on an innovative new trial for patients with mild Alzheimer’s disease (AD). The study is called EXPEDITION3. Effect of Passive Immunization on the Progression of Alzheimer’s Disease: Solanezumab (LY2062430 vs. Placebo). EXPEDITION3 is studying if an investigational drug can slow the progression of the disease in patients with mild Alzheimer’s.

This is a phase III multicenter and groundbreaking study comparing solanezumab with placebo in approximately 2,100 patients with mild Alzheimer’s disease. The primary objective of this study is to test the hypothesis that solanezumab, administered as an intravenous infusion at a dose of 400 mg every four weeks for 76 weeks, will slow the cognitive and functional decline of AD as compared with placebo in patients with mild AD.

The study also requires a PET scan and MRI scan to be done at screening and at the end of the study. The medication, along with the PET and MRI scanning, is free of charge to the patient.

The trial is seeking the following patients:• Men and women ages 55-90.• Meets the NINCDS/ADRDA criteria

for probable Alzheimer’s disease.• Must have a reliable caregiver (defined

as at least 10 hours per week ofcontact with patient).

• If receiving concurrent treatment with anAChEI and/or memantine, has been onmedication for at least four months witha stable dose for at least two months.

Excluded patients include: • Meets the NINCDS/ADRDA criteria

for vascular dementia. • Has a current serious or unstable illness.• History within the last five years of

malignant disease (except for BasalCell CA or in situ prostate CA).

• History within the last five years ofserious infectious disease of the brainor head trauma resulting in protractedloss of consciousness.Physicians with patients who may

benefit from this trial should contact Megan Kramer, BSN, RN CRC, at 704-446-0803.

n Ortho Residency Program AgainRecognized As One of the Top inthe CountryU.S. News and World Report

ranked Carolinas HealthCare System’s Orthopaedic Surgery Residency Program in the top 20 percent in the

country and third in the Southeast this year. The program has maintained a board-pass rate of 100 percent for more than 15 years.

Medical students are taking notice, as well. While the program only accepts five residents each year, this year more than 850 applications were submitted. To put this in perspective, orthopaedic residency programs in the United States receive an average of 518 applications. Seventy-five percent of all applicants in the country applied to Carolinas HealthCare System’s Orthopaedic Surgery Residency Program.

The program provides a rare diversity of training in different medical environments – both in a university-style setting and a private practice setting.

“One of the highlights of our residency is that our residents receive a hybrid educational model and a hybrid practice model,” says Joshua C. Patt, MD, MPH, residency program director. “They get to work in a more standard health system-based academic practice and then they also spend 40-50 percent of their time working in a large private practice setting.”

This year, the program introduced an intern surgical simulation curriculum. Under the direction of Brian Scannell, MD, and supervising faculty from every orthopaedic subspecialty, a broad spectrum of orthopaedic concepts and basic surgical skills were covered.

Another aspect that differentiates the program is the one-on-one teaching environment. This unique residency model provides high-volume exposure to all subspecialty areas of orthopaedics, with between two and seven fellowship-trained faculty members in each area.

“When you are a resident on certain subspecialty services, you are working primarily with one doctor,” says Dr. Patt. “This gives our residents a direct working relationship with individual patients and an individual doctor. The benefit is that our residents receive truly individualized teaching that helps them be at the front line of the educational process.”


Independent Physicians of the Carolinas is a nonprofit 501(c)(6) membership organization whose mission is to create public awareness of medical doctors not employed by a network or hospital system and to provide educational programs and resources to physician members and their administration. Visit us at IndependentPhysicians.org.

Queen City Plastic Surgery has opened an office in the Arboretum shopping center and is accepting new patients. Enam Haque, MD, FACS, is a board-certified plastic surgeon who is fellowship trained in both hand and plastic surgery. The practice offers a full range of services, including cosmetic procedures, reconstructive surgery, hand surgery and surgical treatment of migraines. Queen City Plastic Surgery is in the Belle Grove Office Park at 3025 Springbank Lane, Suite 240. Call 704-372-5685 or visit www.qcplasticsurgeons.com.

Charlotte Gastroenterology & Hepatology is pleased to announce the addition of Nicole R. Cullen, MD. A graduate of Boston University, Dr. Cullen received her medical degree from the University of Pittsburgh. She and her husband fell in love with the Carolinas while he was at Duke and she was completing her residency at the University of North Carolina Hospitals in Chapel

Hill. This made for an easy decision to move to Charlotte after Dr. Cullen completed her gastroenterology fellowship at the University of Maryland Medical Center. She is accepting new patients at the Huntersville office.

Pineville Pediatrics announces the addition of provider Tori Welch, PA-C, who joins Satya Jammalamadaka, MD (Dr. Jamma), seeing patients at their office at 10700 Kettering Drive, Suite D, Charlotte, in the Pineville area. Office hours have been extended and are now 8 a.m.-8 p.m., Monday through Friday, and 9 a.m.-2 p.m. on Saturdays.

Peter Ford, MD, has joined Vascular Solutions PC, Vein and Vascular Center in South Charlotte at 7800 Providence Road, Suite 209. Learn more about Dr. Ford at www.veinscharlotte.com.

Tarun Narang, MD, with Carolina Digestive Health Associates has begun seeing patients at the Pineville area office at 10620 Park Road, Suite 102, Charlotte. Dr. Narang specializes in general and advanced gastroenterology and therapeutic endoscopy.

Asthma & Allergy Specialists, P.A. is excited to announce its newest division — the Food Allergy Institute of Charlotte. The Food Allergy Institute offers comprehensive and personalized care for patients with food allergies. Its team of board-certified allergists, Vandana Patel, MD, and Douglas Johnston, DO, provide expert evaluation for adverse food reactions. Patients of the Food Allergy Institute of Charlotte also will have access to consultations with the onsite board-certified pediatric registered dietitian, Raquel Durban. For more information, visit www.foodallergycharlotte.com or call 980-213-2148.

M. Reza Bolouri, MD, is enthusiastic about the relocation of his practice Alzheimer’s Memory Care to 7809 Sardis Road, Charlotte, early this summer. The phone number will remain the same at 704-364-4000.

Dermatology Specialists is pleased to welcome Justin Haught, MD, to its practice in Blakeney. Dr. Haught is trained in medical, surgical and cosmetic dermatology, and treats both adults and

children. Haught graduated from the West Virginia University School of Medicine before completing his internship at Virginia Commonwealth University in Richmond. He then finished his residency in dermatology at the University of Pittsburgh Medical Center. He is board-certified by the American Board

of Dermatology and is a fellow of the American Academy of Dermatology. He has authored articles in numerous peer-reviewed journals, including the Journal of the American Academy of Dermatology, the Archives of Dermatology, Cutis and the American Journal of Clinical Dermatology.

Funds were raised in March for Colon Cancer Awareness Month, where local gastroenterology practices were hard at work at promoting colonoscopy screenings. Carolina Digestive Health Associates sponsored the Survivors Tent and rallied a team in the Colon Cancer Coalition’s 2015 Get Your Rear in Gear 5k Run/Walk on March 7; and Charlotte Gastroenterology & Hepatology (CGH) co-sponsored the 5k event with Novant Health. The event raised money to increase awareness about colon cancer and provide free screenings. Team CGH consisted of more than 75 physicians and staff members.

Allergy Asthma & Immunology Relief (AAIR) has opened a fourth location in Steele Creek at 13557 Steelecroft Parkway, Charlotte, 28278. AAIR founder and physician Maeve O’Connor, MD, recently graduated from a two-year fellowship in Integrative Medicine from the University of Arizona, which included more than 1,000 clinical hours. Dr. O’Connor looks forward to using these additional tools to give AAIR patients relief. To find out more about The Integrative Health and Lifestyle Program, visit www.azcim.org. AAIR physician Jennifer Caicedo, MD, is now the President of the Charlotte Pediatric Society. AAIR staff and clinicians welcome new team member, Christine Delaney, LCSW, ACSW. Delaney has worked in the mental health field for 15 years and has a unique understanding of the challenges of managing allergies that lead to frustration in families.

Independent Physicians of the Carolinas

Nicole R. Cullen, MD

Tori Welch, PA-C

Peter Ford, MD

Tarun Narang, MD

Vandana Patel, MD

Douglas Johnston, DO

Justin Haught, MD


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LEVINE CANCER INSTITUTEWorld-class cancer care close to home.

See Christopher’s full story at CarolinasHealthCare.org/CancerStory

Christopher was diagnosedwith stage 4 kidney cancer, andoncologists at Levine CancerInstitute treated him with anexperimental drug not availableanywhere else in the region.It’s been three years since hisdiagnosis and he has his life back.

“My work in the arts ismy passion. I rarely calledin sick to my job at themuseum. And then I wastold I had terminal cancer.”

LCI_Awareness_Christopher_Mecklenburg_Medicine.indd 1 3/4/2015 11:03:35 AM


LEVINE CANCER INSTITUTEWorld-class cancer care close to home.

See Christopher’s full story at CarolinasHealthCare.org/CancerStory

Christopher was diagnosed with stage 4 kidney cancer, and oncologists at Levine Cancer Institute treated him with an experimental drug not available anywhere else in the region. It’s been three years since his diagnosis and he has his life back.

“My work in the arts is my passion. I rarely called in sick to my job at the museum. And then I was told I had terminal cancer.”

LCI_Awareness_Christopher_Mecklenburg_Medicine.indd 1 3/4/2015 11:03:35 AM


Mecklenburg CountyMedical Society1112 Harding Place, #200Charlotte, NC 28204

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Ballantyne 15830 John Delaney Drive Charlotte, NC 704-540-0251Billingsley** 300 Billingsley Road, Suite 200A Charlotte, NC 704-332-6904Carmel** 5633 Blakeney Park Drive, Suite 100 Charlotte, NC 704-542-7061Cabarrus 478 Copperfield Blvd. Concord, NC 704-795-2710Charlotte** 1718 E. 4th Street Charlotte, NC 704-372-6609Gastonia Stat Lab 660 Summitt Crossing, Suite 206 Gastonia, NC 704-854-9497Huntersville 14330 Oakhill Park Lane Huntersville, NC 704-948-8101Huntersville** 10030 Gilead Road, Suite B100 Huntersville, NC 704-875-9130Lake Norman 134 Medical Park Drive, Suite 102 Mooresville, NC 704-799-6230Matthews 1500 Matthews Township Parkway, Suite 1147 Matthews, NC 704-849-0154Northridge* 5031-G West W.T. Harris Blvd. Charlotte, NC 704-598-6266Pineville 10410 Park Road, Suite 450 Pineville, NC 704-341-1145Randolph** 1928 Randolph Road, Suite 109 Charlotte, NC 704-334-2629Rock Hill 2460 India Hook Road, Suite 101 Rock Hill, SC 803-328-1724Salisbury** 611 Mocksville Avenue Salisbury, NC 704-637-1676Salisbury* 514 Corporate Road Salisbury, NC 704-221-4407Shelby 809 N. Lafayette Street Shelby, NC 704-480-7004Statesville** 1710-A Davie Avenue Statesville, NC 704-878-0948University** 10320 Mallard Creek Road Charlotte, NC 704-549-8647

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Documents

Mecklenburg Medicine April 2015