Mecklenburg Medicine March 2015

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

March 2015 • Vol. 45, No. 3

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

Not all wear capes ...heroes

but all doctors are heroes.Happy Doctors’ Day on March 30

2 | March 2015 • Mecklenburg Medicine

NovantHealth.org/secondopinion

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Mecklenburg Medicine • March 2015 | 3

March 2015Vol. 45 No. 3

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: Roll Over Beethoven By Simon V. Ward III, MD

5 Feature: Type 2 Diabetes: A Public Health Epidemic By Lee McCracken

7 Feature: Will the SGR Be Repealed in 2015? Stay Tuned ... By Elaine Ellis, North Carolina Medical Society

7 National Health & Wellness Observances for March

8 Member News

8 Upcoming Meetings & Events

9 MCMS Annual Meeting

11 MMAE Feature: Improving Lives – One Dog at a Time By Bill O’Brien

12 Advertising Acknowledgement

13 Mecklenburg Area Partnership for Primary Care Research (MAPPR)

13 Charlotte AHEC Course Offerings for Spring 2015

14 At the Hospitals

16 Independent Physicians of the Carolinas


Roll Over BeethovenBy Simon V. Ward III, MD

A wise man once said, “If you are going to spoil anyone, spoil your dog, not your kids.” He said a lot of other wise things, and if I had listened, I would have been better off. Isn’t it interesting

how many things we hear and later realize they really ring true? That same wise person was wrong only once. That was when, at the height of their popularity, he said, “In five years no one will remember the Beatles.”

Sunday afternoons were spent listening to Mozart and Tchaikovsky, while reading medical journals or working on projects. He did not recognize the talent of these Brits with the long hair. Not yet being at an age to appreciate the classics, I could not understand why he would not rather listen to Jimi Hendrix or The Doors.

Years later, I looked forward with glib self-satisfaction to the day I would introduce my kids to all of the great rock music. I would be a cool dad, because this wasn’t stuffy classical music, but music with a beat. My kids did listen and gracefully admitted that some of it was really good, but “Dad, it’s…old.” My kids were right. Whether it is Beethoven or the Beach Boys, this was music from a previous century. Bread is something one should limit eating or eliminate altogether if gluten intolerant. Woodstock sounds like an environmentally conscious mutual fund. Mick Jagger is a great-grandfather, which gives a whole new meaning to the term “rocker.” It became apparent that the last train to Clarksville was not my ticket to ride on the Grand Funk Railroad to being a with-it dad. I decided to try listening and appreciating some more current music. It did not go well. One Saturday afternoon, I found myself in the den saying, “In five years no one will remember these artists.”

If anyone is spoiled, it is us — we live in America. The events of recent months have shown us the randomness and brutality of terrorism, but unless we are on call, we go to sleep each night knowing rockets will not rain down on our hospitals and homes. Our physician colleagues in other countries do not have the same reassurance. The last time our mainland was attacked by a foreign power was the last REAL British invasion of 1812. (Technically, not exactly true. Columbus, New Mexico was invaded and occupied by a force led by Pancho Villa in 1916. Eighteen Americans died in the battle. If CNN had been around, it would have received 24-hour coverage. With no Situation Room, instead of being breaking news, this sentinel event almost is forgotten.)

We also are spoiled because we live in North Carolina. We have the highest mountains east of the Black Hills and the most unique and beautiful coast north of the Keys. We also have a very benign malpractice climate. Anyone who has experienced it knows the pain and embarrassment when the deputy sheriff arrives to deliver a malpractice lawsuit. Then there are the decisions: Should I fight? Should I settle? Will my carrier let me fight? Should I cancel my office for a court date that probably will be moved? This state also

has had one of the most effective plaintiff attorneys in the country. He won an astronomical judgment right here in Mecklenburg County. In spite of that, in 2012, North Carolina had the seventh lowest per capita malpractice payout in the nation. That is unusual for a highly populated state on the east coast. Part of that may be due to physicians and our Medical Societies rallying in July 2011 to encourage the North Carolina General Assembly to override the governor’s veto of a bill to cap non-economic damages. The main reason our climate is so good, is that our patients don’t want to sue us. We really are not any smarter than docs in other states. Our patients, most of the time, just give us the benefit of the doubt. Do we deserve it?

We are spoiled, too, because we live in Charlotte. This is the Cambridge, Mass. of the medical world. Cambridge is the home of Harvard and MIT. Harvard consistently ranks in the top three universities in the country. MIT, except on the west coast, is considered the finest technical school. The main campuses are 1.3 miles apart. Folks in California would have an argument, as they have an extraordinary school. Both of my general chemistry professors were graduates of that university. From their hairstyles, it was obvious neither owned a bottle of shampoo. They both wore black shoes, and their white socks clearly were visible as their “long pants” ended two inches above the ankle. They were brilliant chemists, good teachers and 100-percent geek.

Charlotte has the best two medical centers of any city our size, and no city in the country has two that are better. The main campuses are 1.3 miles apart. Our ORs have the equipment we need to do our jobs. The ERs are well-staffed with capable personnel. When we give orders in the OR, the ICU, or on the floor, they are carried out. The call rooms have TVs that work, and the doctor’s lounges have more food choices than they should. Very few other cities have the medical environments we enjoy. We are spoiled.

Okay. It is not our fault. But, since we are spoiled, let’s do something good with it. Let us all be nice to those around us, treating nurses, OR personnel and other employees with the respect they show us. Most of all, let’s be good to one another. Get to know another practitioner. Help others when we can. No one ever said practicing medicine would be a cake walk, but by helping one another, we can enjoy some sweets along the way.

P.S . I say the dog is not spoiled. My wife thinks otherwise. It is just those big, brown eyes.

President’s Letter


Type 2 Diabetes: A Public Health Epidemic By Lee McCracken, Contributing Writer

B ring on the armchair and online shopping, the weekend movie marathon and the double-stacked, bacon-topped cheeseburger. We are living the American dream.

Statistics suggest otherwise, however, revealing that we are dying from the indulgence of an unhealthy American lifestyle. Diabetes mellitus type 2 has become an epidemic in the United States, despite growing awareness and risk-reduction education. It is increasingly diagnosed in youth and accounts for 20-50 percent of new-onset diabetes case patients, as obesity in children and adolescents continues to climb. And it’s projected the number of youth with diabetes type 2 will quadruple by 2050.1

The number of adults with diabetes type 2 also is increasing. According to the Centers for Disease Control and Prevention, a total of 1.7 million new diabetes cases were reported in 2012 among middle-aged and older adults. Sedentary and overweight adults ages 45-64 are developing diabetes at a faster rate, edging out those 65 and older.

America is in dire straits. Local endocrinology specialists predict the complications of obesity and diabetes type 2 — high blood pressure, stroke, kidney failure and blindness — will be presenting in patients in their 20s and 30s in the very near future. Two questions remain: Is screening and prevention going to help put the brakes on this chronic disease? Can scientific advancements keep up with demand?

Younger Than Ever“The rise of blood glucose levels in America is a public

health crisis,” says Adam Spitz, MD, an endocrinologist with Novant Health and the medical director of diabetes education at Presbyterian Medical Center. “Type 2 diabetes in children and teens is more rapidly progressive, and family practitioners and pediatricians now have to know how to treat it,” explains Spitz. “That wasn’t the case 20 years ago.”

Physicians now are not only educators about diet and exercise, they also are cheerleaders — spending time getting children and families to buy into the importance of taking care of themselves. “We have a lot more weapons, but there’s no drug that takes the place of a healthy lifestyle,” says Spitz.

Spitz also notes that many of the best oral medications are not working quite as well in younger patients as they do in middle-aged and older men and women. “The risk of complications earlier in life is a real threat,” he says.

Family physicians and internists report disease is striking younger

and younger. Scott Furney, MD, chair of Carolinas Medical Center’s Department of Internal Medicine, says he already is seeing many more patients in their 30s and 40s who are obese and disabled due to advanced joint degeneration and sleep apnea. “The likelihood of adolescents aging into young adulthood with kidney disease and high blood pressure is serious,” says Furney.

Part of the reason for the rise of type 2 diabetes in children is more babies being born predisposed to glucose intolerance. Edith Miller, MD, says pregnant women are passing diabetes onto their infants. “There are definite intrauterine

programming effects of maternal hyperglycemia on babies,” says Miller, medical director of CHS’s Carolinas Diabetes Center.

Specializing in diabetes in pregnancy, Miller explains this as “diabetes begetting diabetes,” and says she is seeing an ever-increasing number of patients coming in with type 2 diabetes, as well as more women are

developing gestational diabetes during their pregnancies. Studies have shown that babies exposed to high levels of blood sugar in the womb are six times more likely to grow into overweight

children and develop diabetes or prediabetes than those not exposed.

Miller adds that a significant number of her patients who develop gestational diabetes are not able to return to a healthy lifestyle. “While some women are highly motivated to eat well and exercise to lose the weight they gained, about 50-70 percent of mothers with gestational diabetes develop type 2 within 10 years of delivery.”

Furney says physicians are fighting an uphill battle. “By the time patients are in their 30s, they’re very set in their habits and patterns,” he explains. As a lifestyle disease, type 2 diabetes is increasing healthcare costs, impacting the productivity of the American workforce and draining the economy.

Feature

Call-to-Action AlertThe annual American Diabetes

Association Alert Day® (Tuesday, March 24) is a one-day “wake-up call” urging Americans to take the Diabetes Risk Test to find out if developing diabetes type 2 is a likelihood in their future if they don’t change their lifestyle. While diabetes type 2 affects one in 11 people, another one in three American adults has prediabetes.

Scott Furney, MD

Adam Spitz, MD

Edith Miller, MD


Feature

Treatment, Management

In seven years, the world will recognize the centenary of insulin, which was discovered in 1922 at the University of Toronto in Canada. Even though diabetes is not the devastating diagnosis it was nearly 100 years ago, it is significantly affecting overall life expectancy in the United States, according to some researchers. The life span of American adults is on the decline due to obesity and diabetes, and “child obesity will influence early-age mortality.”2

Furney, Spitz and Miller agree that, with technology enticing adults and children to sit still for longer periods of time and the food industry tempting appetites with supersized, calorie- and fat-laden meals, the diabetes type 2 epidemic is gaining momentum.

Shortened life span looms large, but poor quality of life over 10-20 plus years is a more present reality. Children and teens with diabetes will enter adulthood with years of chronic disease ahead of them.

“With diabetes type 2 presenting in individuals in their 20s and 30s, the number of years they may live as diabetics are going to be tough,” says Furney. Life span is one thing, but living with hypertension, being tied to dialysis or going blind, is another.

Miller affirms that today’s Gen Xs and Ys, who have an invincible mentality and who think illness and disability happens to “older people,” are at great risk. Habits are hard to break, and shortsighted living can be harmful. “I believe patients understand the risks, but they don’t want to change,” says Miller.

Access to information and fun devices to boost motivation are increasing, however. Participation in corporate wellness programs is on the rise, and many fitness centers have safe, 24/7 admittance. The YMCA of Greater Charlotte has numerous classes and programs for families, too, and both CHS and Novant have weight-management programs. There are tons of apps and wristband bracelets that help track diet and exercise.

“These tech tools are powerful,” says Miller. “Tracking and seeing their progress is very helpful for patients.”

Hope for the FutureOver the long-term, Furney and Spitz say policy must change

at the federal level. “Low-income individuals and families in the United States can’t afford to eat healthy,” says Furney. “The federal government subsidizes the production of grain and meat, but not fresh fruit and vegetables.” In fact, the Department of Agriculture refers to fresh fruits and vegetables as “specialty crops,” and farmers who participate in subsidy programs generally are prohibited from growing fruits and vegetables on the land for which they receive assistance.

Within laboratories, hospitals and physicians’ offices, scientific advances are making headway. Technologically, some of the advances in treatment for type 2 are a result of research in the management of diabetes type 1: a sensor to detect blood glucose readings, a computer to calculate insulin requirements and a pump to automatically deliver insulin. And, “smart tattoo” biosensors are being tested on animals that continuously detect glucose levels and provide results in real time. Research into replacing damaged beta cells, or replacing the entire pancreas with an artificial one, may also translate in the future into therapies for type 2.

“We also have a lot of new weapons in terms of new drug classes,” says Spitz. “There’s been significant pharmacological development with four new drug classes to help treat diabetes type 2, and this research seems to hold the most promise.”

Certainly bariatric surgery is a tool to help obese patients in improving weight loss and diabetes, as well as prevent diabetes type 2. And, more drugs for appetite suppression and weight loss are in the early stage of development. In terms of therapy that might cure, or even prevent diabetes type 2, research continues in the area of the connection between the gut and the brain — creating that feeling of fullness, regulating stomach emptying and suppressing glucose.

Overall, the management of this chronic disease depends on a well-controlled diet and medication (including patient compliance), lifestyle modifications and prevention and/or treatment of complications. Physicians and patients can expect more technology that assists patients with blood sugar monitoring and medication control between office visits, as well as additional therapies that aid in weight loss.

“This is, and will continue to grow as, a public health crisis,” says Furney. “Screening and treatment are essential, but we aren’t winning the battle there. We need to focus on prevention.”

1 “Prevalence of Type 1 and Type 2 Diabetes Among Children and Adolescents From 2001 to 2009” (JAMA, May 7, 2014) by Dana Dabelea, MD, PhD, Department of Epidemiology, Colorado School of Public Health, and Elizabeth J. Mayer-Davis, PhD, Department of Nutrition, University of North Carolina-Chapel Hill.

2 “A Potential Decline in Life Expectancy in the United States in the 21st Century,” (New England Journal of Medicine, March 18, 2005) by S. Jay Olshansky, PhD, Division of Epidemiology and Biostatistics at the University of Illinois-Chicago.

Screening Is EssentialBoth Carolinas HealthCare System and Novant Health have

programs in place to help catch prediabetes in overweight children and adults; medical personnel are taking their expertise out into the community to make screening more accessible. In addition, the number of undiagnosed type 2 patients is coming down, as the non-fasting hemoglobin A1c test can be done at any time of day, making it more convenient for people to get tested.

Novant Health and Central Piedmont Community College have offered free 15-minute appointments for diabetes screening, blood pressure and BMI, with follow-up consultations included.

In November, CHS concluded a “Pre-D Challenge: Reverse the Risk” initiative, with more than 53,000 people screened and more than 18,000 given the A1c test. Some 27,000 were identified as at-risk for prediabetes or diabetes, and more than 200 were enrolled in the CDC-developed diabetes prevention program with the YMCA of Greater Charlotte.


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Will the SGR Be Repealed in 2015? Stay Tuned …By Elaine Ellis, North Carolina Medical Society

Last year, the 113th Congress came closer than any previous Congress to repealing the Sustainable Growth Rate and presenting viable payment reforms. After a year of work, the relevant congressional committees had unanimous support for an SGR repeal bill that not only repealed the SGR and provided for a period of positive updates, but also set the stage for a new generation of physician payment arrangements that promote quality and value while maintaining a viable fee-for-service system. This was a significant accomplishment made possible by strong advocates within the Congress and a united front by organized medicine.

Unfortunately, this bipartisan, bicameral agreement failed to become law due to Congress’ persistent inability to agree on whether or how to offset additional costs to the current fictional budget baseline. In March, Congress forced through a 17th SGR patch bill despite significant opposition. Despite declarations from leaders on both sides of the aisle that work would proceed, there is no evidence any serious efforts were made to resolve the budget issue.

There are only 37 days the new Congress will be in session before the current SGR patch expires on April 1. Fortunately, the 113th Congress left a blueprint for reform. The AMA hopes legislators will build on the progress made last year so medicine can focus on addressing other important healthcare policy issues.

NATIONAL HEALTH& WELLNESS

OBSERVANCESMARCH 2015

Brain Injury Awareness MonthHemophilia Awareness Month

National MS Education and Awareness MonthNational Nutrition Month

Red Cross Month

March 19: Kick Butts Day

March 24: American Diabetes Alert Day

March 24: World TB Day

March 1-6: National Aplastic Anemia and MDS Awareness Week

March 2-9: National Sleep Awareness Week

March 3-9: Endometriosis Awareness Week

March 16-22: National Poison Prevention Week

Feature


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

MARCHn Tuesday, March 3

Charlotte Dental Society Board meeting.6 p.m.

n Wednesday, March 4Fighting for Women With Fashion Planning meeting.601 E. 5th St. (Safe Alliance).6 p.m.

n Tuesday, March 10MedLink meeting.Mecklenburg County Health Department.8:30 a.m.

n Tuesday, March 10MedLink of Mecklenburg 4th Annual Community Forum —Exploring Medicaid Expansion in North Carolina.Harris Conference Center.Noon-4 p.m.

n Monday, March 16MCMS Executive Committee meeting.5:45 p.m.

n Wednesday, March 18MMAE Finance Committee meeting./Board meeting.9 a.m./10 a.m.

n Wednesday, March 18MCMS Annual Meeting.Speaker: Jeanne Robertson.Myers Park Country Club.6 p.m.

n Thursday, March 19CAMGMA.Myers Park Baptist Church Cornwell Center.Noon.

n Friday, March 20Child Health Committee meeting.7:30 a.m.

n Monday, March 23May magazine deadline.

n Monday, March 23MCMS Board meeting.5:15 p.m.

n Wednesday, March 25David G. Welton, MD, Society Spring Luncheon.Speaker: Lawrence W. Raymond, MD, ScMTopic: “Navy Sealab Secrets: What Diving Doctors Didn’t Suspect.”Charlotte Country Club.11:30 a.m.

Member News

New Members Jennifer C. Baxley, PA-CCharlotte Pediatric Clinic13640 Steelecroft Parkway #210, Charlotte, NC 28278704-512-6100Wingate University Physician Assistant Program, 2010

Shannon N. Chadha, MDAllergy and ImmunologyCarolina Asthma & Allergy Center2630 E. 7th St. #100, Charlotte, NC 28204704-372-7900Georgia Health Sciences University, 2008

Marc A. Darst, MDDermatologyDarst Dermatology11301 Golf Links Drive N. #203, Charlotte, NC 28277704-321-3376Indiana University School of Medicine, 1990

Sonia J. Mabout, PA-CCharlotte Radiology1705 East Blvd., Charlotte, NC 28203704-362-7071University of Florida Physician Assistant Program, 2004

Elizabeth J. Maupin, PA-CCarolina Asthma & Allergy Center2630 E. 7th St. #100, Charlotte, NC 28204704-372-7900Wake Forest University School of Medicine Physician Assistant Program, 2009

Obinna C. Oriaku, MDFamily MedicineCrown Clinic4500 Tryon St., Charlotte, NC 28217University of Benin College of Medicine, 1990

Kaitlin C. Osbourn, PA-CCharlotte Radiology1705 East Blvd., Charlotte, NC 28203704-362-7071Duquesne University Physician Assistant Program, 2011

David A. Pearson, MDEmergency MedicineCarolinas Medical Center, Dept. of Emergency Medicine1000 Blythe Blvd., Charlotte, NC 28203Vanderbilt University School of Medicine, 2002

Ana-Maria M. Temple, MDPediatricsCharlotte Pediatric Clinic6235 Blakeney Park Drive #100, Charlotte, NC 28277University of North Carolina-Chapel Hill School of Medicine, 1999

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Medical Office Personnel Needed. Call 704-796-9672.

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Member News

RSVP to [email protected] or call 704-376-3688.

You are invited to attend theMECKLENBURG COUNTY MEDICAL SOCIETY

ANNUAL MEETINGWednesday, March 18, 2015

Myers Park Country Club

6 – 6:45 p.m. – Reception7 p.m. – Dinner & Speaker

8 p.m. – Dessert, Coffees and Wine Tasting

$35 ea. Members and guest / $50 ea. Non-Members and guest / $10 ea. Fellows & Residents and guest

Jeanne Robertson Jeanne Robertson is an American humorist

and professional speaker. At age 19, she

was named Miss North Carolina and went

on to be named “Miss Congeniality” in that

year’s Miss America competition.


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Improving Lives – One Dog at a TimeBy Bill O’Brien, Board Chair of Project 2 Heal

C harlie Petrizzo, co-founder of Project 2 Heal, was working a successful corporate job when he felt the need to do something more; he felt discontented with life in the financial world. His experiences had given him a

perspective on money and materialism that didn’t fit his life’s calling.When Charlie was a boy, he almost died – twice. With the help of

the family Labrador retriever, Charlie was able to heal. His intimate personal awareness of the healing power of dogs and the increasing news and recognition of the medical and scientific community related to the use of dogs as therapeutic modalities — ranging from helping children with autism and wounded veterans with PTSD to diabetic alert and canines detecting cancer — drove him to find a way to help others, using dogs.

He made a decision to follow the purpose that was borne into him as a boy: he would breed dogs. Not just any dogs, but Labrador retrievers, carefully selected for their intuitive intelligence, temperament and conformation. He would provide early training to the pups in each litter to give them a head start. Then he would donate them to service organizations that would train and place them with people he understood: those who were wounded or disabled.

As news about Project 2 Heal spread, Charlie and his wife, Sandy, Project 2 Heal co-founder, received an increasing amount of inquiries about their dogs. They began doing even more for the community that included training the dogs for local children and welcoming families with special needs children for animal-assisted therapy.

For the first five years, all the work of Project 2 Heal was funded personally by the Petrizzos, but the success of their dogs led to increasing calls for their services. Project 2 Heal became a 501(c)(3) nonprofit in January 2011, driven by the hope that the original dream could become a reality.

Charlie’s vision always had included what he referred to as the creation of a “Disneyland for dog lovers,” where children with special needs and wounded warriors and their families could come for peace and serenity, and, hopefully, a smile caused by the magic of one of the Project 2 Heal puppies.

The hope of that dream becoming reality was furthered when Charlie and Sandy acquired a 54-acre tract of land. Now, their hope is to create awareness and gain support in the region that will allow Project 2 Heal to begin land planning and construction of the envisioned facility.

Once complete, the Carolinas will become home to the country’s first multi-faceted complex focused on helping our wounded veterans, children with special needs and their families, with some very special dogs in an inviting environment dotted with ponds, hiking trails and cabins for overnight visits. It will be a place where our community can work together to become the paradigm for other communities. It will become a “destination” sought out by visitors to the Carolinas, all in the name of using man’s best friend to serve others.

Mecklenburg Medicine • March 2015 | 11Charlie Petrizzo

MMAE Feature


Advertising Acknowledgements

The following patrons made Mecklenburg Medicine possible.

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Cory Surridge, Au.D, FAAA741 Kenilworth Avenue, Suite 100, Charlotte NC 28204

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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) 3/6 Obesity Summit (IPE)

3/13 Robiscek Symposium 2015

3/18-20 39th Annual Internal Medicine Conference

3/28 Spring Cactus Cancer Conference

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.

Mecklenburg Area Partnership for Primary Care Research (MAPPR)

The Charlotte-Mecklenburg Community Relations Committee, Community Building Initiative and the Mecklenburg Area Partnership for Primary Care Research (MAPPR) at Carolinas HealthCare System have joined together to create a free online database of healthcare resources and social service providers in an effort to help those who are underserved. The database, called the Mecklenburg Access Portal (the MAP), is now live and available to use.

If you would like to learn more about the MAP and how to post information about your organization, or arrange a training session, contact Brant Aycock at [email protected]. The training normally takes less than an hour, and because the project is grant-funded, participation is free of charge. The MAP currently is

available in English, with a goal to have the content translated into Spanish within the next calendar year. The link to the portal is www.the-map.net.

Charlotte Gastroenterology & Hepatology Welcomes New Physician

Charlotte Gastroenterology & Hepatology welcomes Nicole R. Cullen, MD, to the Huntersville office. A graduate of Boston University, Cullen earned her medical degree from the University of Pittsburgh. She completed her residency at UNC Hospitals in Chapel Hill and made her way back to the Carolinas to join Charlotte Gastroenterology & Hepatology after finishing her fellowship at the University of Maryland Medical Center. She is board-certified in gastroenterology and internal medicine. Cullen’s professional interests include celiac disease, esophageal disorders and hepatology.

National Doctor’s Day is March 30.

Thank you for all you do!


At the Hospitals

n Novant Health Heart & VascularInstitute Introduces CardioMEMSPatient Monitoring In September 2014, certain heart

failure patients at Novant Health Heart & Vascular Institute began using a CardioMEMS monitoring system implanted in the pulmonary artery to monitor pressure in the chest cavity. The device can pick up on arrhythmias and increased fluid levels 10-14 days before a heart failure patient shows symptoms.

Implanted during a right heart catheterization procedure, the device takes pressure measurements from the sensor wirelessly and then transmits the information to the patient’s physician. Patients can take a daily reading from home or other non-clinical locations. Frequent access to patient pressure data provides physicians with a way to better manage a patient’s heart failure and potentially reduce heart failure-related hospitalizations.

Edward McMillian, MD, leads the CardioMEMS program. To refer a patient to the Novant Health Heart & Vascular Institute, call 704-343-9800 or fax 704-347-2011.

n Novant Health Performed Its FirstPercutaneous Mitral Valve Repair In December 2014, Novant Health

Heart & Vascular Institute performed its first percutaneous mitral valve repair using the MitraClip device.

This percutaneous mitral valve repair is available for patients who have severe mitral regurgitation and may not otherwise be candidates for surgical mitral valve intervention. To be eligible for the procedure, patients first must meet strict echocardiographic criteria and be deemed non-surgical after an evaluation by one cardiovascular surgeon.

Other structural heart and valve intervention offerings include:• Patent foramen ovale (PFO) closure• Atrial septal defect (ASD) closure• TAVR (non-surgical aortic valve

replacement)

• Percutaneous plugging of prosthetic aortic valve

• Mitral valve regurgitation• Percutaneous mitral valve repair

To refer your patient, contact the valve clinic at Novant Health Heart & Vascular Institute at 704-316-8287.

n Novant Health Hemby Children’sHospital Receives $20,000 Donationfrom Novant Health Thunder RoadMarathonNovant Health Hemby Children’s

Hospital was a beneficiary of the Novant Health Thunder Road Marathon. Hemby Children’s Hospital received a check for $20,000, which will be used to support the programming of the Child Life Team.

Hemby Children’s Hospital’s Certified Child Life Specialists are trained in child development and the effects of hospitalization on children. They are experts at helping children and their families maintain a sense of normal living patterns and minimizing psychological trauma during hospitalization. They do this through education and medical play, supporting families, coordinating events, assisting during medical tests and serving as a resource for questions regarding child development and parenting. Programs funded include, but are not limited to:• Art and music therapy• Holiday and birthday parties• Movie nights• Friday ice cream parties• Pizza parties• Support group dinners• Care items for patient families• Distraction tools, including puzzles,

books, games, DVDs and other toys.

n Physicians’ Fund Donates $335,000to Community OrganizationsThe Physicians’ Impact Fund recently

presented grants totaling $335,000 to seven nonprofit organizations in the Charlotte area. The presentation took place at the Belk House, located on the Novant Health Presbyterian Medical Center campus.

The Physicians’ Impact Fund was

created by physicians and friends in the greater Charlotte region to strengthen the health of the community through comprehensive health initiatives for the underserved. Since its inception in 2010, it has raised more than $1 million for area nonprofits focused on health care.

“The Physicians’ Impact Fund is one of the most rewarding things I’ve ever been involved in,” says co-chair Thomas Hayes Woollen, MD, of Novant Health Hallmark Care.

Through the power of collective giving, Physicians’ Impact Fund awards high-impact grants to organizations whose missions seek to improve the health of the local community.

“Our friends in the community believe this is one of the best places they can give, because we hold our recipients accountable for every dollar they receive,” says Woollen. “Grant recipients must be established in the community and able to make a measurable impact in the populations they serve.”

The HeartBright Foundation will receive its third grant from the fund to support its comprehensive program focused on identifying and treating cardiovascular disease, diabetes and hypertension for the underserved. First-time recipient Urban Ministry Center’s HousingWorks will use its $50,000 grant to hire a benefits specialist to help the chronically homeless population in Charlotte connect to healthcare resources.

The other recipients included:• Anuvia Prevention and Recovery Center• Care Ring/Physicians Reach Out• NC MedAssist• Lake Norman Community Health Clinic• The Relatives/NeighborCare

Daylight Saving TimeSet your

clocks ahead on Sunday,

March 8!


At the Hospitals

n Diabetes Prevention Effort Engages50,000 PeopleCarolinas HealthCare System has

concluded the first year of its large-scale effort to tackle Type 2 diabetes during its Pre-D Challenge: Reverse the Risk campaign. Launched with the System’s partner, the YMCA of Greater Charlotte, the aim of the Pre-D Challenge is to reduce the region’s rate of type 2 diabetes by preventing the dangerous disease before it is diagnosed.

In its first year, the Pre-D Challenge has achieved notable results:• More than 53,000 people have

completed a diabetes risk assessment.• More than 27,000 people have been

identified as at-risk for prediabetes or diabetes.

• More than 18,000 A1c blood sugar tests have been delivered.

• More than 200 people have enrolled in the diabetes prevention program (DPP).DPP participants have lost an average

of four percent of their body weight and achieved more than two hours of physical activity per week.

“This is one of the rare circumstances where you can easily intervene and prevent a disease,” says Zeev Neuwirth, MD, president and chief clinical executive of Carolinas HealthCare System Medical Group. “Our first-year results showcase the meaningful health impact we can make through large-scale proactive preventive efforts. The scale and success of this effort is something to be very proud of. It’s a great example of Carolinas Healthcare System’s commitment to our community.”

n Antimicrobial Team Keeps aWatchful Eye on PatientPrescriptionsWhen used properly, antibiotics are effective

medicines that can be used to save lives. However, when not used appropriately, antibiotics can lose effectiveness and contribute to the emergence of multidrug-resistant infections.

To provide the best possible clinical outcomes to patients while minimizing adverse events and antimicrobial resistance, Carolinas HealthCare System has implemented the Antimicrobial Support Network (ASN), led by Lisa Davidson, MD.

“Every day we have pharmacists who review inpatient antibiotic orders and determine if those orders are appropriate based on the patient’s clinical status and work-up of infection,” says Davidson. “If they think a change in antimicrobials would be appropriate, those recommendations are discussed with an infectious disease physician. The ASN team then contacts the patient’s clinician to make a recommendation.”

Launched in August 2013, the ASN has shown:• A systemwide decrease of antimicrobial

days of therapy of 9.4 percent.• A systemwide decrease in antimicrobial

purchasing of 11 percent.• An intervention acceptance rate of

85 percent.An ASN recommendation can include: stopping a patient’s antibiotics based on culture results or clinical findings, completion of a patient’s antibiotic course based on indication, decreasing the number of antibiotics a patient is prescribed, switching a patient to a more targeted or effective antimicrobial, or expanding the patient’s antimicrobial coverage to cover potentially multidrug-resistant organisms.

n Approach to Hand Hygiene Enhancedat Levine Children’sHospitalCarolinas HealthCare System’s Levine

Children’s Hospital recently became one of a few hospitals in the country to install advanced hand-washing machines outside its neonatal intensive care unit (NICU) and neonatal progressive care nursery (NPCN) to continue to protect patients from infections.

Levine is one of only two hospitals in North Carolina and one of only 300 in the nation with a touch-free, fully automated system for washing bare hands. This system kills up to 99.98 percent of harmful germs found on the skin. All visitors are required to use the machines prior to entering the NICU or NPCN.

These machines clean and rinse hands in 15 seconds, removing the same amount of bacteria from the hands as a 60-second manual wash and rinse process. It uses a solution stronger than soap and water with moisturizers that keep hands from drying out.

n Carolinas HealthCare SystemIncreasing Access to BehavioralHealth TreatmentCarolinas HealthCare System is working to

give people better access to behavioral health services by developing a program to provide those services using telemedicine in its primary care doctors’ offices. Lincoln Family Practice is one of three System practices in the region currently offering this service.

“One of the reasons people with behavioral health conditions do not get help is they have to wait too long to get an appointment,” says John Santopietro, MD, chief clinical officer for behavioral health at Carolinas HealthCare System. “No one would accept waiting months for cancer treatment. Waiting months for mental health treatment should not be acceptable either.”

Through the telemedicine program, the patient speaks with a behavioral health professional over a computer screen. The professional – a psychiatrist, counselor, or licensed clinical social worker – assesses the patient and coordinates care, including helping with medication issues and making referrals to outside services.

The program also includes a health coach, who calls the patient to follow up with medication changes and physician visits. The patient’s primary care doctor also is able to complete consults via the electronic medical record with a psychiatrist or pharmacist with expertise in behavioral health. In the near future, the team will be offering access to online therapy.

A patient receives an A1c blood sugar test during the Pre-D Challenge co-sponsored by Carolinas HealthCare System and the YMCA of Greater Charlotte.


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.

Elizabeth Rostan, MD, Charlotte Skin & Laser, announced Diana Roetting, PA-C, has joined the practice.

Congratulations to physician member Maeve O’Connor, MD, Allergy Asthma & Immunology Relief with offices in Charlotte and Salisbury, on her graduation on January 22 from the University of Arizona’s Integrative Medicine Program.

WELCOME New Members for 2015:

Todd Adams, MD, Lakeshore Women’s Specialists in MooresvilleJames Altizer, MD, Vein Center of Charlotte in the Pineville areaWilliam Ashe, Jr., MD, Asthma & Allergy Specialists in Charlotte, Matthews and MonroeHugh Black II, MD, Asthma & Allergy Specialists in Charlotte, Matthews and MonroeBilly Branner, MD, Charlotte Ophthalmology in Charlotte and HuntersvilleRick Gillespie, MD, CornerStone Ear, Nose & Throat Associates in Charlotte and MonroeGregory Glass, MD, Luke Medical Clinic in Mount HollyDouglas Johnston, DO, Asthma & Allergy Specialists in Charlotte, Matthews and MonroeBill McClelland, MD, CornerStone Ear, Nose & Throat Associates in Charlotte and MonroeVandana Patel, MD, Asthma & Allergy Specialists in Charlotte, Matthews and MonroeBoyd Vaziri, MD, Charlotte Ophthalmology in Charlotte and HuntersvilleBrandon Whiteside, MD, Charlotte Ophthalmology in Charlotte and HuntersvilleJason Wilson, MD, Charlotte Gastroenterology & Hepatology in Charlotte James Zolzer, MD, Lakeshore Women’s Specialists in Mooresville

WELCOME BACK Renewed Members for 2015:

Maher Agha, MD, Carolina Medical Associates in CharlotteJames Antezana, MD, South Charlotte General & Vascular Surgery in Charlotte in the Pineville areaJane Box, MD, Box Arthritis & Rheumatology in Charlotte in the Pineville areaPatrick Box, MD, Box Arthritis & Rheumatology in Charlotte in the Pineville areaJames Boyd, MD, Oncology Specialists of Charlotte in central Charlotte and Pineville areaRochelle Brandon, MD, Brandon Gynecology in Charlotte in the University City areaJohn Brendese, MD, Joint & Muscle Medical Care in CharlotteGeoffrey Chapman, MD, Oncology Specialists of Charlotte in Charlotte and PinevilleNelsa Ciapponi, MD, Optimal Health Medicine Center in south CharlotteMarc Darst, MD, Darst Dermatology in Charlotte, Monroe and Indian Land, S.C.Susan Echterling, MD, Carolina Medical Associates in CharlotteJustin Favaro, MD, Oncology Specialists of Charlotte in central Charlotte and PinevilleThomas Humphries, MD, MBA, Asthma & Allergy Specialists in Charlotte, Matthews and MonroeSatya Jammalamadaka, MD, “Dr. Jamma,” Pineville Pediatrics in Charlotte in the Pineville areaDino Kanelos, MD, Carolina Family Healthcare in south CharlotteSanjay Khiani, MD, Family Allergy Asthma & Sinus Care in Charlotte in the Pineville areaBill Larsen, MD, Northwest Family Physicians in Charlotte Lindsey Mashburn, MD, Lakeshore Women’s Specialists in MooresvilleDipika Misra, MD, Oncology Specialists of Charlotte in Charlotte and PinevilleCatherine Moore, MD, Oncology Specialists of Charlotte in Charlotte and PinevillePaola Natale, MD, Cabarrus Endocrinology in ConcordCatherine Norton, MD, Northwest Family Physicians in CharlotteBen Ogunwale, MD, Queen City Gastroenterology & Hepatology in CharlotteElizabeth Rostan, MD, Charlotte Skin & LaserEliza Sangmuah, MD, Matthews Internal MedicineEugene Sangmuah, MD, Matthews Internal MedicineJohn Sensenbrenner, MD, Sensenbrenner Primary Care in south CharlotteAvi Shah, MD, Carolina Medical Associates in CharlotteJason Shultz, MD, Oncology Specialists of Charlotte in Charlotte and PinevilleRatko Vujicic, MD, V Pain Clinic in Charlotte and Rock Hill, S.C.Steven Weston, MD, Weston MedSurg Center/Weston Veins Clinic in Charlotte and Gastonia

Independent Physicians of the Carolinas

Diana Roetting, PA-C

Maeve O’Connor, MD


1. NIH. Overweight and Obesity Statistics. Oct 2012. 2. The State of Obesity. http://healthyamericans.org/reports/obesity2014/?stateid=NC Visited 01-29-2015. 3. The State of Obesity. http://stateofobesity.org/states/nc/#print Visited 01-29-2015.Time to Act on Obesity is an educational initiative sponsored by Ethicon US, LLC.Please be advised that information such as your name and the value and purpose of any educational item, meal or other items of value you receive may be publicly disclosed. This information may be shared with Ethicon US, LLC., its affiliates, and a third party as required by law. If you are licensed in any state or other jurisdiction, or are an employee or contractor of any organization or governmental entity, that limits or prohibits meals from pharmaceutical and medical device companies, please identify yourself so that you (and we) are able to comply with such requirements. Thank you for your cooperation and understanding. These events are for healthcare professionals that have an interest in treating obesity. Ethicon respects the policies of federal, state, and local government facilities, as well as academic medical centers and other institutions that may restrict their employees from accepting any form of gift, meal, or gratuity. These promotional educational activities are brought to you by Ethicon US, LLC., and is not certified for continuing medical education. Presenters are compensated by and presenting on behalf of Ethicon US, LLC. and must present information in accordance with applicable FDA requirements.

© 2015 Ethicon US, LLC. 028679-150128

To learn more, or to register for an event, visit: http://www.ethicon.com/time-to-act-on-obesity/education/live-kick-off-events

One in three Americans has the disease of obesity.1 The number of adults with severe obesity has quadrupled over the past 30 years.2 In North Carolina, the diabetes rate of 11.4% is 8th highest in the nation, the hypertension rate is 35.5%, 11th highest in the nation and other obesity-related diseases like heart disease are on the rise.3 Healthcare professionals (HCPs) recognize the importance of addressing obesity, but the most recent advances in the field have yet to be translated into medical education.

In the Time to Act on Obesity program, sponsored by Ethicon, Charlotte HCPs will have the opportunity to develop their knowledge, skills, and tools to treat the source – not just the consequences – of this devastating disease.

The program is designed to advance understanding of the disease including:

• the causes • the body’s fight to defend a “set point” • the role of hormones • what treatments work and why

The Time to Act on Obesity education programs will deliver a high impact learning experience with a mixture of both in-person and online learning opportunities. Working with key Charlotte providers, there will be two kick-off events to choose from, open to all healthcare professionals with an interest in obesity, followed by webinars, Google+ Hangouts On Air, and online HCP Video Seminars.

It’s time to act on obesity.

Time to Act on Obesity Kick-Off Event

Thursday, March 5th, 2015Duke Mansion

400 Hermitage Road, Charlotte, NC6:30 PM - 9:30 PM

Time to Act on Obesity Kick-Off Event

Wednesday, March 4th, 2015Duke Mansion

400 Hermitage Road, Charlotte, NC6:30 PM - 9:30 PM

For Charlotte Healthcare Professionals


More than 25 locations across the Carolinas704-512-3963

Levine CanCer instituteWorld-class cancer care close to home.

see Dr. Kim’s full story at CarolinasHealthCare.org/CancerCare

every patient is unique. i learned this early in my careerfrom a patient wearing a silly hat and a determined smile.Her odds were not good; all the data pointed to badnews. But her spirit and attitude showed me so muchmore than her statistical odds. What she taught me hasstayed with me through every patient interaction since.she is strong today. and i am a better doctor for knowingher. at Levine Cancer institute, we always remember thatevery patient has her own story.

She walked into my office wearinga huge Dr. Seuss hat and saidshe was going to beat cancer.

LCI_Awareness_DrKim_MeckMedicine.indd 1 10/3/2014 7:15:56 AM

More than 25 locations across the Carolinas 704-512-3963

Levine CanCer instituteWorld-class cancer care close to home.

see Dr. Kim’s full story at CarolinasHealthCare.org/CancerCare

every patient is unique. i learned this early in my career from a patient wearing a silly hat and a determined smile. Her odds were not good; all the data pointed to bad news. But her spirit and attitude showed me so much more than her statistical odds. What she taught me has stayed with me through every patient interaction since. she is strong today. and i am a better doctor for knowing her. at Levine Cancer institute, we always remember that every patient has her own story.

She walked into my office wearing a huge Dr. Seuss hat and said she was going to beat cancer.

LCI_Awareness_DrKim_MeckMedicine.indd 1 10/3/2014 7:15:56 AM


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

CHANGE SERVICE REQUESTED

MCMS Mission:To unite, serve and represent ourmembers as advocates for our patients,for the health of the community andfor the profession of medicine.

PRSRT STDU.S. POSTAGE

PAIDCHARLOTTE, N.C.PERMIT NO. 1494

PATIENT SERVICE CENTERS… for all of your laboratory testing needs

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 612 Mocksville Avenue Salisbury, NC 704-637-1987Salisbury* 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

*Drug Screens only **Blood Draws only

LabCorpLaboratory Corporation of America

Mecklenburg Medicine March 2015

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