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Author Dr. Jay Faber and Enduring Hearts

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Ankur Chatterjee

Ankur Chatterjee

Author Dr. Jay Faber and Enduring Hearts

Founded as a nonprofit organization in 2013, the mission of Enduring Hearts is to fund research that both increases the longevity of pediatric heart transplants and improves the quality of life for transplant recipients. The results of funded research projects contribute to the clinical and scientific knowledge about many important aspects of organ transplantation, e.g. the mechanisms of long-term organ deterioration, the consequences of tissue injury, and opportunities to intervene, postpone, and eliminate these rejection processes.

Executive Director for Enduring Hearts, Ankur Chatterjee joined me to talk about how the organization got its start and what it hopes to achieve by supporting research that will help extend the life

Dr. Faber is a veteran children’s and adult psychiatrist on staff at the Amen Clinic in Atlanta and in Costa Mesa, California.  He has written a book entitled “Escape: Rehab Your Brain to Stay out of the Legal System,” so he’ll be talking about this publication and how he believes this will be a game-changer for those who find themselves constantly getting into trouble with the law, often to the point of incarceration.

I was surprised to hear that as many as 85% of incarcerated Americans suffer from some form of substance abuse/addiction and many also face mental illness.  Dr. Faber’s book shares a road map for people who are dealing with substance abuse/addiction to be able to have a greater chance of recovery.

Summertime Pregnancies

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summertime pregnancies

Dr. Winnie Soufi

 

summertime pregnancies

Dr. Rama Rao

Summertime Pregnancies

CW sat down with Dr. Winnie Soufi and Dr. Rama Rao, of Womens Health Associates.  Dr. Soufi is a board certified OB/GYN, and Dr. Rao is a board certified gynecologic surgeon, and they are part of a 7 member practice on the Northside Hospital campus here in Atlanta.

We got into summertime pregnancies and what expectant mothers should think about, from dealing with heat, hydration, nutrition, and more, as well as advances in gynecologic surgery that benefit patients with problems that warrant a surgical approach.

Check back soon for more info!

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Manners Matter

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Manners Matter

Dr. Silverman is a cardiologist with Northside Hospital. He also teaches at the cardiac clinic at Grady Memorial Hospital – where he has been a volunteer since 1973. Dr. Silverman received his medical degree from Ohio State University. He completed his internship and residency at Vanderbilt University, while he received his cardiology training at Johns Hopkins Hospital in Baltimore.

He was an officer with the U.S. Public Health Service at the CDC. Dr. Silverman started the cardiology teaching program at Emory for Northside Hospital. He also developed Northside’s cardiology program. He served as the editor of Atlanta Medicine magazine for 15 years, and he is a long-time member of the MAG Journal editorial board.
After retiring as the founder of the pediatric ICU of the Scottish Rite Campus of Children’s Healthcare of Atlanta and founding and directing Atlanta’s busiest special care nursery, Dr. Saul Adler completed a Master of Arts degree in Professional Writing from Kennesaw State University. He currently writes short stories and novels and screenplays.

Dr. Barry Silverman and Dr. Saul Adler wrote the book ‘Your Doctor’s Manners Matter: Better Health Through Civility in the Doctor’s Office and in the Hospital.’ The book helps patients understand what qualities they should look for in their doctors. Good manners are about respect, communication, being dutiful, caring, benevolence, and understanding.

These are all critical values in an accomplished doctor. The book describes what common courtesies and manners patients should expect from their health care providers – and how failing to meet these expectations can result in lower quality and more costly care.

Their book addresses a number of important issues, including the origins of poor behavior in the medical office; why manners matter; how doctors communicate; how rude and uncivil behavior can lead to bad outcomes; what a patient should expect in terms of civility and good manners; how ordering a lots of tests does not necessarily
translate into quality care; what a patient should expect in the doctor’s office; how to navigate a hospital setting (emergency room, admitting office, surgical suite, and hospital ward); how to interact with multiple physicians at the same time; understanding who is in charge; and how to interact with the nurses, PAs, and consulting and attending physicians.

The book is available on Amazon.com.

 

Pre-pregnancy and Prenatal Genetic Testing

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genetic testing

Tanya Mack of Women’s Telehealth

Pre-pregnancy and Prenatal Genetic Testing

We continue our twice-monthly series with Women’s Telehealth’s Tanya Mack.  She caught up with Certified Genetic Counselor, Rachel Klein, of GenPath Diagnostics.  The topic of discussion was focused on pre-pregnancy and prenatal genetic testing, when it makes sense, the difference between screening and diagnostic tests, how to deal with results, and more.

Women are routinely offered a variety of genetic tests during the first three months of pregnancy in the US.  Every woman wants to believe their baby is normal and uncomplicated. However, the CDC reports that 1:33 babies born in the US will have a birth defect. Genetic tests, both screening and diagnostic, show the likelihood that a developing baby has a genetic condition that may cause problems with growth, development and bodily functions.

Information from genetic testing plus the mother’s age, the couple’s ethnic background and a family history of a genetic disorder can help calculate the odds that the fetus might have a defect such as Cystic Fibrosis, Tay-Sach’s Disease, Sickle Cell Anemia, Down’s Syndrome or neural tube defects. Joining us for this segment of Top Docs is Rachel Klein, a Certified Genetic Counselor from one of the nation’s leading prenatal genetic testing labs, GenPath.

Special Guest:

Rachel Klein, Genetic Counseling Program Manager, GenPath Diagnostics  linkedin_small1  twitter_logo_small-e1403698475314  facebook_logo_small3  

genetic testing

 

Health Care Fraud and False Claims

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false claims

Scott Grubman, CW Hall, and James Marcus talk healthcare fraud.

Health Care Fraud and False Claims

I hosted 2 False Claims Act legal experts on this week’s MAG edition of Top Docs Radio.  You’re going to want to check out what they have to say, as it could mean the difference between practicing medicine or not, in the end.

Scott Grubman is a partner with the law firm of Chilivis Cochran Larkins & Bever in Atlanta. He represents health care providers of all types and sizes with government investigations and audits, False Claims Act, and other complex litigation and various regulatory and compliance matters.  Prior to joining private practice, Scott served as a trial attorney with the U.S. Department of Justice in Washington, D.C., and as an assistant U.S. attorney in Savannah – where he served on a district health care fraud taskforce.  Scott also serves as an adjunct professor at Georgia State University’s College of Law, where he teaches a course in health care fraud and abuse.

Jason Marcus is among a select group of lawyers who devote their practice to qui tam and related retaliation claims under federal and state False Claims Acts. He has practiced FCA law exclusively since 2008, and he formed the firm of Bracker & Marcus in January of 2015 with partner Julie Bracker, who is dedicated to representing whistleblowers nationwide. Jason is a 2006 graduate of the University of Georgia School of Law, a former clerk to the honorable Magistrate Judge G.R. Smith of the Southern District of Georgia, and a member of Taxpayers Against Fraud Education Fund and the Georgia affiliate of the National Employment Lawyers Association.

Health care is one of the fastest growing and most heavily-regulated industries in the United States.  Given that government payers (Medicare, Medicaid, etc.) finance a significant portion of the system, regulators and law enforcement have dedicated tremendous resources to rooting out and punishing fraud and abuse in health care.  In fiscal year 2015 alone, the federal government recovered nearly $2 billion in settlements and judgments from health care providers under the federal False Claims Act, which does not include recoveries through audits and other administrative avenues.

Moreover, not only are the actions of healthcare providers constantly scrutinized by federal and state auditors

and law enforcement, but also by competitors, commercial insurance companies, private whistle blowers, and the public. Big hospitals and health care entities with “deep pockets” have historically carried the bulk of the liability in government enforcement actions.  But beginning in 2015, the federal government announced a new policy which focuses on holding individuals – particularly individual health care providers – responsible and liable for unlawful conduct. A lot of the laws governing health care fraud and abuse do not require a specific intent to defraud or even actual knowledge of the unlawful nature of the conduct. In fact, one of the major laws governing health care fraud and abuse (the physician self-referral law or “Stark law”) requires no culpable mindset whatsoever.  Accordingly, it is crucial for health care professionals of all types to be aware of the various statutory and regulatory schemes that govern health care billing and to act accordingly.

MORE INFO SOON!

Special Guests:

Scott Grubman

false claims

Jason Marcus

false claims

Dr. Scott Beach

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Heart & Vascular Care

Dr. Scott Beach talks vascular disease.

Dr. Scott Beach

On this week’s show I sat down with interventional cardiologist, Dr. Scott Beach, of Heart & Vascular Care, with offices in Johns Creek, Cumming, and Canton, GA.  I’ve known Dr. Beach for several years through the practice I was working for (Hyperbaric Physicians of Georgia).  Our physicians have worked with him on numerous patients’ cases, both sending him folks who needed to have their blood flow to their lower extremities evaluated, as well as providing specialized wound care for patients he and his colleagues occasionally see in their practice.

Dr. Beach share how he enjoys the fact that his relationship with his patients and their loved ones tends to extend over years rather than being short and limited to a procedure or two.  We talked about vascular disease and some things both patients and doctors need to think about to get problems identified and treated early.

Scott explained how often, symptoms of developing vascular disease are mild and gradually reduce the patient’s tolerance to activity.  In many instances, the patient and their family merely chalk the changes up to “getting older”.  That’s dangerous, because it means the blockage of blood flow that’s causing the symptoms continues to grow until a major event occurs such as a heart attack, stroke, or possibly a limb amputation.

We discussed the fact that there are simple, non-invasive studies that can reveal early vascular disease when it’s easier and more-likely-successful to treat with more options to choose from.  Additionally, we talked about the fact that having pulses that can be felt on a patient’s foot is NOT an accurate means of determining whether a patient has vascular disease that needs attention in many patients.

Additionally, when patients have a wound on their foot or leg that is healing slowly or not at all, it is very important to know whether blockage of blood flow is contributing to the inability to heal.  Too often, these patients go for amputation that could have been readily prevented with one of those non-invasive or minimally-invasive studies he described.  For patients with a wound that’s not healing, it is important for them to have a multiple-specialty team of doctors who help with different facets of the non-healing wound.  Scott and his colleagues certainly subscribe to this approach and get their patients with limb threatening wounds access to all available experts who can help save their foot/leg.

The value in this multi-specialty approach cannot be overstated when you consider that in diabetics (one of the largest groups who experience vascular disease), the 5 year mortality rate for patients undergoing a below-the-knee amputation is just under 50%.  Most patients and many doctors are not fully aware of this risk.

Special Guest:

Dr. Scott Beach, MD, Heart & Vascular Care  facebook_logo_small3  linkedin_small1

Heart & Vascular Care

 

Telemedicine

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Sidney Welch

Healthcare attorney, Sidney Welch

Telemedicine

We sat down with legal expert on healthcare matters, attorney, Sidney Welch, of the Polsinelli law firm on our monthly episode with Medical Association of Georgia.  What is it?  How is it utilized?  And, what are the licensing, regulatory, and legal concerns around it?

Georgia Composite Medical Board (GCMB) has stressed that it is essential for telemedicine patients in the state to receive the same high standard of care they would in a traditional office setting.  GCMB adopted a number of telemedicine rules in 2014 that “allow the Composite Board to take disciplinary action against licensed physicians and allied health professionals who practice telemedicine if they do not provide the minimum standard of care.”

Georgia’s rules require physicians and other allied health care professionals who deliver care by way of telemedicine to…

  • Be the ones who provide all of the treatment and/or consultations via telehealth.
  • Have access to the patient’s medical history if they are providing the services.
  • Have personally seen and examined the patient if they are referring the patient to a telehealth provider.
  • Maintain records on the patient’s evaluation and treatment if they are providing a service via telehealth and to provide a copy of those records to the referring physician.
  • Provide telehealth services only within their specialty.
  • Give their name, credentials and emergency contact information to the patient when they provide a telehealth treatment or consultation.
  • Provide the patient with “clear, appropriate, accurate instructions” on follow-up care.

Controlled substances for pain or chronic pain treatment cannot be prescribed through telehealth – but a physician or a nurse practitioner or a physician assistant can order appropriate labs or other diagnostic tests.

The physician who provides the care via telemedicine must make a “diligent” effort to ensure that the patient is seen and examined in person at least once a year by a Georgia-licensed physician or other appropriate health care professional.

Special Guest:

Sidney Welch, JD, of Polsinelli  linkedin_small1  twitter_logo_small-e1403698475314  facebook_logo_small3  

Sidney Welch

Clostridium Difficile

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Clostridium Difficile

Dr. David Dickensheets, CW Hall talk Clostridium Difficile

Clostridium Difficile

On this week’s episode we talked about one of the leading causes of hospital-acquired infections: Clostridium Difficile, or “C. Diff.”  I sat down with Dr. David Dickensheets, infectious disease specialist with Infectious Disease Services of Georgia in his Cumming, GA office.

According to the CDC nearly half a million persons experienced a Clostridium difficile infection last year.  Their website explains:

“Approximately 29,000 patients died within 30 days of the initial diagnosis of C. difficile.  Of those, about 15,000 deaths were estimated to be directly attributable to C. difficileinfections, making C. difficile a very important cause of infectious disease death in the United States.  More than 80 percent of the deaths associated with C. difficile occurred among Americans aged 65 years or older. C. difficile causes an inflammation of the colon and deadly diarrhea.

Previous studies indicate that C. difficile has become the most common microbial cause of healthcare-associated infections in U.S. hospitals and costs up to $4.8 billion each year in excess health care costs for acute care facilities alone.  The new study found that 1 out of every 5 patients with a healthcare-associated C. difficile infection experienced a recurrence of the infection and 1 out of every 9 patients aged 65 or older with a healthcare-associated C. difficile infection died within 30 days of diagnosis.”

Clearly it’s a big problem.  Dr. Dickensheets shared some great information on how the infection is diagnosed and why it’s so hard to eradicate from a hospital environment.  He also talked about an interesting treatment approach–the fecal transplant.

That’s right, in some instances, patients have been able to resolve the infection by having fecal material from a healthy human instilled into their bowel, allowing a repopulation of normal flora bacteria that compete with the C. Diff., helping to eliminate the infection.

Special Guest:

Dr. David Dickensheets, MD, of Infectious Disease Services of Georgia

Clostridium Difficile

  • Doctor of Medicine, Thomas Jefferson University
  • Residency, Roger Williams Medical Center
  • Fellowshp, Brown University
  • Board Certified in Infectious Disease

Pre-diabetes

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Dr. Ellie Campbell

Dr. Ellie Campbell talks pre-diabetes

Pre-diabetes

This week I featured a long-time friend of the show, Dr. Ellie Campbell, of Campbell Family Medicine, located in Cumming, GA.  We talked about a topic I am hopeful many of our followers will both listen to and share:  Pre-diabetes.

How many times have you gone for your annual check-up and been told, “Your labs are normal,” when your fasting blood glucose is >80mg/dl?  Those “normal” results could actually be a red flag that you have Pre-diabetes.

During this phase it’s actually possible to reverse the condition through diet and exercise.  But, as Ellie described, many physicians haven’t yet been educated that they need to be concerned with glucose levels that don’t exceed “normal” limits.  This means that we, as patients, need to be advocates for ourselves and our loved ones.

It is well-known that diabetes leads to a range of chronic and often, deadly, diseases such as heart disease, kidney disease, blindness, stroke, and more.  While we also know it is often challenging to make life-style changes, when you are aware of the risks, it can become more easy to do so.

I am pleased Ellie sat down with us to talk about pre-diabetes, a problem many people can actually do something about if they’re willing to make some of the simple changes she recommends.

Special guest:

Dr. Ellie Campbell, DO, Family Practice & Integrative Medicine at Campbell Family Medicine

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Campbell Family Medicine

  • Doctor of Osteopathic Medicine, Kirksville College of Osteopathic Medicine
  • Family Medicine Residency, Medical College of Georgia
  • Board Certified Family Medicine

Medical Malpractice Lawsuits

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Huff Powell & Bailey

Dan Huff talks medical malpractice

Medical Malpractice Lawsuits

The phrase medical malpractice causes most people’s pulse to quicken. For a physician being named in a medical malpractice case is one of the worst events in their life. This week we discussed medical malpractice in Georgia and how physicians can avoid it.

For the past 23 years, Dan has specialized in representing physicians and hospitals in medical malpractice lawsuits.  As one of the founding partners in the Atlanta law firm of Huff, Powell & Bailey, LLC, he has represented defendants in more than 90 jury trials.

Dan has defended and successfully tried cases for every specialty of medicine and numerous hospitals throughout Georgia. His trial record would be a proud career for any defense lawyer and is remarkable because Dan has tried and won this many cases before turning 50.  Many of those cases have been against the best plaintiffs’ attorneys in the state. Dan is also a regular contributor to MAG’s quarterly Journal.

Huff shared what malpractice is, and why he chose this area of focus for his legal career.  He offered some advice on how healthcare practitioners can avoid a malpractice lawsuit.  We discussed his professional advice for how to handle conversations with patient and/or family after a sentinel event has occurred.  And we talked about how health professionals need to handle patient records and what to do if served with a lawsuit.

Dan explained how defendants in a suit should behave during the proceedings of the case to reduce the likelihood a jury will rule against them.

Special Guest:

Dan Huff, JD, and co-founder, Huff, Powell, and Bailey

Huff, Powell, & Bailey

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