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TOLEDOMEDICINEThe Journal of The Academy of Medicine of Toledo & Lucas County

Winter 2017 Volume 108/Number 1

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er from an iatrogenic infection. UTMC is proud of the collaborative efforts of all stakeholders without whose dedi-cation this effort would not have been possible. We are honored and proud of the recognition for our staff’s efforts to improve the patient experience.

(from page 19)

Foundation Chair in Gastrointestinal and Personalized Surgery. His clinical inter-ests include endocrine surgery, islet cell transplant, liver surgery, neuroendocrine tumors, oncology, pancreatic cancer and translation genomic medicine and surgery. His research focuses on translational pre-cision medicine and surgery, specifically pertaining to pancreatic cancer.

Dr. James Van Hook will join the College of Medicine in March as chair of the De-partment of Obstetrics and Gynecology. He has served as professor and director of the Division of Maternal-Fetal Medicine at the University of Cincinnati College of Medicine and Cincinnati Children’s Hos-pital since 2008. His clinical and research interests include hypertensive disorders of pregnancy, women’s health and rehabili-tation, physician health, and critical care obstetrics and gynecology.

In addition, Dr. Thomas Papadimos has joined the University as a professor and chief of the Division of Critical Care Medi-cine. He serves as the medical education director for the Jacobs Interprofessional Im-mersive Simulation Center. Dr. Papadimos comes to Toledo following service as vice chair of academic affairs in the department of anesthesiology at The Ohio State Uni-versity and director of critical care services at the Ross Heart Hospital.

Please join me in welcoming these health care leaders to our community.

— Christopher J. Cooper, MD

(Dean’s Report continued from page 16)

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Winter 2017 TOLEDOMEDICINE 1

EditorialIn My Opinion

President’s Page4th District Councilor’s Report

Alliance Activities UTCOM Report

Hospital Reports

Send information to: TOLEDOMEDICINE The Academy of Medicine, 4428 Secor Road Toledo, Ohio 43623 Ph. 419.473.3200 Fx. 419.475.6744 [email protected]

www.toledoacademyofmedicine.org

Officers

PresidentJoDee E. Ahrens, MD

[email protected]

President-ElectChristopher A. Bates, MD

[email protected]

Vice PresidentRichard L. Munk, [email protected]

SecretaryTimothy M. Husted, [email protected]

TreasurerWilliam C. Sternfeld, MD

[email protected]

Immediate Past PresidentBennett S. Romanoff, MD

[email protected]

Editorial Board

EditorS. Amjad Hussain, MD

[email protected]

Ted E. Barber, MD, [email protected]

Stephen P. Bazeley, [email protected]

Gerald W. Marsa, [email protected]

James G. Ravin, [email protected]

J. Gregory Rosenthal, [email protected]

Stephen J. Rubin, [email protected]

StaffExecutive DirectorLee F. Wealton, MPH

[email protected]

Managing EditorJohanna D. Begeman, JD

[email protected]

Advertising ManagerJanice M. Schutt

[email protected]

C O V E R S T O R Y

Academy of Medicine 2017 Annual Meeting

TOLEDOMEDICINE is an official publication of The Academy of Medicine of Toledo and Lucas County

All statements or comments in TOLEDOMEDICINE are the statements or opinions of the writers and not necessarily the opinion of The Academy of Medicine of Toledo and Lucas County. The Academy of Medicine does not necessarily endorse the advertisements in TOLEDOMEDICINE.

Published quarterly during February, May, August and November. Subscription rate $20 per year. Contributions to TOLEDOMEDICINE are due before the first of the month preceding publication.

Winter 2017

Volume 108

No. 1TOLEDOMEDICINE10

F E A T U R E S

D E P A R T M E N T S02030405081616

06

On the cover:

Character in MedicineJ. Gregory Rosenthal, MD

JoDee E. Ahrens, MD, President

09Valentine Mural: Billie Burke James G. Ravin, MD

14In Memoriam: A Compendium Stephen P. Bazeley, MD

2 TOLEDOMEDICINE www.toledoacademyofmedicine.org Winter 2017

Fifteen years ago, I was told that if I voluntarily attended a one hour seminar on risk manage-

ment sponsored by my malpractice insurer, I would enjoy a substantial reduction in my malpractice insur-ance premium. Well sure, why not?

A couple of years later, it was a two hour quasi-voluntary seminar. The past two years it has become a man-datory 3 hour on line tutorial with a mandatory must pass quiz at the end of each hour segment to ensure you didn’t watch the game instead of the slides or listen to the stereo instead of the talking heads.

For the past several years, I have had to watch a mandatory OSHA brief-ing on hazardous materials, blood, and infective materials; again with a must pass quiz at the end. And let us not forget the mandatory HIPPA briefing with requisite quiz at the end.

And now before I can see a patient in my office, there are reams of forms and government mandated paperwork that must be completed before I can legally see the patient. Then of course, there is the paper-work demanded by the insurer that must be completed if I expect to be paid for my services.

The demands upon physicians have grown exponentially in the past de-cade. And we are not alone. Esti-mates are that government regula-tions have drained some 3.6 billion USD’s from our economy in the past decade.

Now I’m not talking about restric-tions and regulations that make sense. Licensure ensures that the unsuspecting public is not mali-ciously or dangerously fleeced or harmed by the nefarious or the un-trained. And some demonstration of the maintenance of those skills makes sense.

However, physicians are being dic-tated to increasingly by those who neither understand nor necessar-ily appreciate what we do. And it isn’t always by those with an ax to grind against a group regarded as “privileged” and therefore a target. Sometimes it is regulation to justify the life and times of those adminis-tering the regulations. A great gig for some.

As physicians, we are used to shoul-dering great responsibility and it rankles to have someone who doesn’t understand what it takes to be in a position to wield the au-thority to meet the demands of that responsibility, steam roll with their mandates.

Unfortunately, we must take a large portion of the blame for the man-dates. As usual, a few bad actors spoil it for the rest of us, and we need to ensure our peer review and state medical authorities do the job of rooting out the dangerous and incompetent. But that surely is a miniscule fraction of our collective body.

The reason we are being pushed around with impunity is our loss of cohesion. Multiple authors on these pages have decried the decline in or-ganized medicine. The price we pay is lack of the ability to say “shove off” to intrusive mandates and the authorities administering them.

If we could ever get our act together and behave as a cohesive force, we would be able to inject some sanity into the world of mandates. I cite as the most successful example the case of the medical malpractice en-vironment in the state of Ohio. I can count substantial dollars in my pocket thanks to the efforts of the Ohio State Medical Association and their successes in reining in the ex-cesses of the medical malpractice world. The gains are always just an

Ohio Supreme Court election from going away, however, and we can never forget that.

But if we ever expect to push back with any real effect, then we need to remember that together we are stronger than we are apart. I am reminded of Ben Franklin’s admon-ishment to the Continental Congress that “We must, indeed, all hang to-gether, or most assuredly we shall all hang separately”.

— Ted E. Barber, MD, MBA

Mandates

Editorial

18 TOLEDOMEDICINE www.toledoacademyofmedicine.org Winter 2017 Winter 2017 TOLEDOMEDICINE 19

tion’s 50 Top Cardiovascular Hospitals by Truven Health Analytics,TM an IBM company. More than 1,000 hospitals across the country were independently evaluated on their inpatient cardiovas-cular programs and Toledo Hospital placed in the top 5% for achieving superior clinical outcomes.

The Truven Health 50 Top Cardiovas-cular Hospitals study uses data col-lected by the Centers for Medicare and Medicaid Services to measure hospital performance. Areas evaluated include hospital readmission rates, the average length of stay, mortality rates and cost of care. According to the data, the 50 Top Hospitals had fewer readmissions and patient complications, higher inpatient survival rates, shorter hospital stays and lower cost procedures.

Also in November, Toledo Hospital along with three other ProMedica hos-pitals and 90 ProMedica Physicians’ offices made the switch to Epic for their electronic health records. This launch, which has been the largest one to date for ProMedica, was no small feat. Over 5,000 employees and providers were trained on the new system. More than 130 people were involved in manag-ing the patient registration, order and medication backload process before the launch. And, approximately 800 internal super users received advanced training to provide on the ground support.

Timothy J. Mattison, MDSt. Luke’s Hospital

It has now been a mere 6 months since the effective date of our divestiture

from ProMedica. It has been a busy time for the Administration and the Medical Staff. We continue to be the only hospital in the area which takes every major insurance. We continue all of us to strive to give the best care to our patients while the administration remains committed to providing the best quality at the lowest cost. We also remain committed to maintaining all the services we have been providing our community and look for more op-

portunities to serve our community and our patients.

ProMedica has graciously agreed to help us through our transition back to being an independent health care provider by continuing to temporarily support us with services ranging from IT to HR and payroll.

As we all know, EHR is the infrastruc-ture that can make or break a good healthcare facility. It is also one of the biggest expenses, after payroll, that a hospital faces. We have begun a major overhaul of our IT infrastructure. We are looking at upgrading most of our soft-ware. We have started to transition the first of our WellCare Physician practices from Allscripts to eClinical Works. We are working on converting our hospital EHR from McKessen to Cerner and hope to have that completed before the end of this year.

I, of course, have been working with our usual team to plan for the St. Luke’s Hospital Annual Medical Staff dinner to be held at the Hilton Garden Inn at Levis Commons on Saturday March 4th.

I want to take the time to acknowledge one of my predecessors on whose shoulders I have been standing. Dr. Dan Williams was a Past Chief of Staff, SLH Board Member, who has actively helped guide me with his 10 years of experi-ence on the Credentials Committee. He has taken a well-deserved retirement. In addition to his love and support of St. Luke’s Hospital, “Dr. Dan” will be best remembered for his great sense of humor and sack full of jokes he always carried with him.

Thomas A Schwann, MDThe University of Toledo Medical Center

The University of Toledo Medical Center has earned a high ranking

by Consumer Reports as one of the country’s safest teaching hospitals with the lowest rate of central line associ-ated blood stream infection (CLABSI) rates.

UTMC is proud to have been named one of America’s 32 best teaching hospitals at preventing central-line infections in intensive care units (ICUs). Consumer Reports studied federal data from 2011 to 2015 that showed UTMC had just between one and five central line infec-tions in each of the years studied. Patient safety is our top priority and this report reflects the emphasis that institutional leadership has placed on eliminating hospital-acquired infections and the hard work that our physicians, nurses and entire staff have put in to reduce the number of these infections.

Each year there are approximately 250,000 CLABSI nationwide and up to 100,000 deaths are attributed each year to hospital-acquired infections with CLABSI accounting for a third of these deaths. The Center for Disease Control estimates that the annual cost of CLABSI is upwards of $1 billion or roughly around $16,000 per each event. Given the University’s mission “to improve the human condition,” it is vital for UTMC as a teaching hospital to focus on safety as we prepare the next generation of physicians to serve our community.

The recognition reflects our increased focus on infection prevention protocols, including strict hand hygiene, standard-ization of procedures and forming a specially trained vascular access team of nurses who are the only ones that handle central lines and dressings. Such meticulous dedication to evidence-based protocols that have been shown to de-crease CLABSI has led to the hospital experiencing a 55 percent reduction in the infection rate associated with central lines since 2012, as well as a significant decrease in all hospital-acquired infec-tions.

Preventing hospital-acquired infections is essential to optimizing outcomes of patients who are increasingly older, have more morbidities and have complex health problems, which contribute to them frequently not being able to recov-

(continued on page 20)


Institute and the Mercy Health – Heart and Vascular Institute.

The process results in improved access to St. Vincent’s specialists and interven-tions, while simultaneously improving patient outcomes through decreased duration of cerebral and myocardial ischemia, and improved results for national quality benchmark standards such as door-to-balloon times and door-to-drug times.

Manish M. Thusay, MDProMedica Bay Park Hospital

As we wrap up 2016, it has been a busy and collaborative year at

ProMedica Bay Park Hospital.

Recent accomplishments at ProMedica Bay Park Hospital provide a reminder of the importance of our Mission to im-prove the health and well-being of those we serve. These successes highlight the ways that great strides are being made to ensure that patient care remains our number one priority.

The team at ProMedica Bay Park Hos-pital is on a journey to become a highly reliable organization that focuses on patient safety and high quality outcomes for our patients. Our staff believes in focusing on a personal commitment to safety, communicating clearly and pay-ing attention to detail in order to prevent patient harm. The team works daily to create a culture of safety that fosters a healthy environment for our patients, physicians and staff. For example, sur-gery can be a dangerous area of care due to the fact that scalpels, sutures and in-jection needles are typically present for all surgical procedures. The ProMedica Bay Park Hospital operating room staff has gone more than 700 days without a sharps injury. This great achievement is attributed to the operating room staff focusing on a culture of safety. Our dedicated and caring staff takes great pride in creating a safe environment for all patients and employees.

(from page 17)

In closing, the entire staff at ProMedica Bay Park Hospital contributed a tremen-dous amount of effort and dedication to seamlessly launch our new electronic health record system on November 1. Thank you to everyone for being as help-ful as possible to fellow staff and physi-cians during our successful go-live.

Here’s to continuing to be Well Con-nected with each other and our patients into 2017 and beyond!

Henry H. Naddaf, MDProMedica Flower Hospital

The Cancer Genetics Program at Pro-Medica Flower Hospital’s Hickman

Cancer Center recently won $50,000 worth of genetic testing vouchers to help patients who are unable to afford genetic testing. The vouchers will ben-efit patients seen system-wide through the program. Female professional surfer, Dimity Stoyle, represented Flower Hospital in a surfing competition known as the “Battle for the Breasts” and won the online vote, earning the prize of $50,000 in genetic testing vouchers from Ambry Genetics. Genetic testing can help indi-viduals who have had family members with a history of cancer learn more about their own risks. Those with a history of cancer can also learn the chances of their children having a similar diagnosis. Flower Hospital is expanding imaging capabilities by adding a new 64-slice CT scanner on the ground floor. A second 64-slice CT scanner is also planned in 2017. The scanners will provide enhanced image quality for providers and create efficient service for patients. The Breast Care Center has moved to the ground floor of the hospital and a 3D breast tomosynthesis unit is now installed to improve breast cancer detection. The Flower Hospital Medical Staff Dinner is scheduled for Friday, March 10 at 6 p.m. at Sylvania Country Club. The theme is “All Aboard”, a riverboat

casino night. Enjoy refreshments, din-ner and games while celebrating the achievements of colleagues. Flower Hospital medical staff, please save the date!

Howard M. Stein, MDProMedica Toledo Children’s Hospital

ProMedica Toledo Children’s Hos-pital is pleased to welcome Loyal

Coshway, MD, and Kathleen Moltz, MD, pediatric endocrinologists, to its medical staff. Drs. Coshway and Moltz join the team of Mark Watkins, DO, Lisa Richards, CPNP, and Sheri Luke, CNP, at the Endocrine and Diabetes Care Center.

Dr. Coshway completed her fellowship in pediatric endocrinology at Nation-wide Children’s Hospital, Columbus, Ohio and her residency in pediatrics at William Beaumont Hospital, Royal Oak, Michigan. She received her medical de-gree from The University of Toledo Col-lege of Medicine. Her special interests include diabetes, adrenal insufficiency, thyroid disorders, hypopituitarism and hypocalcemia.

Dr. Moltz completed her fellowship in pediatric endocrinology at Yale Uni-versity, New Haven, Connecticut and her residency in pediatrics at Wayne State University, Detroit, Michigan. She received her medical degree from Michigan State University, East Lansing, Michigan. Her special interests include diabetes as well as other pediatric endo-crine disorders. She enjoys lecturing and has received several teaching awards. The expansion of Toledo Children’s Hospital endocrinology and diabetes care team improves access for children and families struggling with diabetes, growth and hormone issues and thyroid issues.

Peter F. Klein, MDProMedica Toledo Hospital

In November 2016, ProMedica Toledo Hospital was named one of the na-


The Community Health Com-mission of The Academy of Medicine of Toledo and Lucas

County has named the ‘Opioid Cri-sis’ a primary area of concern for the 2016-2017 year.

Heroin and opiate use in our com-munity is an epidemic, and in many cases fueled by the abuse of prescrip-tion opioid medications. Fatal drug overdoses are the leading cause of accidental death in Ohio, and statis-tics are rising aggressively as opiates such as Fentanyl are cut with hero-in. The Lucas County Coroner’s of-fice, which tracks heroin and opioid deaths in 19 Northwest Ohio coun-ties and 2 counties in Southeastern Michigan, has reported an increase from 8 deaths in 2010 to 215 deaths in 2015. In response, organizations such as the Governor’s Cabinet Opiate Ac-tion Team (GCOAT) and the Mental Health and Recovery Services Board of Lucas County have developed ini-tiatives to fight the Opioid Crisis.

GCOAT was established in 2011 to as-sist in the fight against opioid abuse and targets law enforcement, pub-lic health, addiction and treatment professionals, healthcare providers, educators, and parents. The Lucas County Heroin and Opiate Initiative, funded by the Mental Health and Recovery Services Board of Lucas County, is a collaborative initiative that focuses on community outreach. Their staff provides resources and presentations to assist with the pre-vention of prescription drug abuse and to those who are suffering from addiction.

What do we need to know as part of the medical community? What can we do in our daily practice?

• Address the rise in deaths from opioids

o Support the use of Naloxone by first responders and fam-ily members of opiate addicts, realizing that it does not address the root cause of addiction, but it does save lives

• Be aware of the established path-ways for treatment and recovery

o GCOATo Lucas County Heroin and Opi-ate Initiative

• Focus on Prevention

o Education in schools and public awareness campaignso Support and advertise drug takeback days in our offices

• Emphasize Safe Prescribing

o Utilize non-opioid therapies whenever possibleo Utilize OARRS (Ohio Automat-ed Rx Reporting System) for all prescriptions of opioidso Be aware of the expanded Ohio Opioid Prescribing Guidelineso Develop processes in our own practices that make the prescrip-tion of opioids safe with the im-plementation of controlled sub-stance contracts

• Have your “go to” resources

o Start Talking! tips from http://starttalking.ohio.gov

o The Addiction Hotline through the United Way of Greater Toledo 211 serviceo www.aplaceformaryhbh.org is an on line resource for assistance to families with loved ones who have addiction problemso OPI-RESCUE APP https://opirescue.com/ o Project Dawn Website http://www.healthy.ohio.gov/vipp/drug/ProjectDAWN.aspxo Ohio Substance Abuse and Monitoring Network Reports (quarterly by year, by county) http://mha.ohio.gov/Default.aspx?tabid=514o The Ohio Academy of Fam-ily Physicians online prescribing guidelines and tools

Today’s heroin addict is your next-door neighbor. They defy socio-eco-nomic definition and are found in all zip codes. Unfortunately, prescribed opioids are highly addictive and thus legally written prescriptions for pain management have become a gate-way to heroin addiction. The heroin that is available is often mixed with more potent opioids, like fentanyl, resulting in the growing number of opioid deaths. Naloxone simply saves lives—we must also manage the flow of prescription opioids. For-tunately, with the use of OARRS, the serious attempt to close “pill mills”, and the establishment of opioid pre-scribing guidelines, the number of opioid doses dispensed in Ohio has significantly decreased over the last several years. We can only hope that, by further efforts and greater aware-ness by all those involved, we will turn the tide of the Opioid Crisis.

Opioid Crisisby Jeanine S. Huttner, MD

In My Opinion


JoDee E. Ahrens, MD

President’s Page

Thoughts on Our Academy of Medicine

Something happened with the new millennium doctors stopped joining The Academy and they have left in large numbers. It speaks to the changes in our society. Membership in all organizations is declining. Social media serves as our sad substitute.

“Never doubt that a small group of thoughtful, committed

citizens can change the world; indeed it is the only thing that

ever has.”

— Margaret Mead

In 1851 eight physicians in Toledo met to form the Toledo Medical Asso-ciation, which has now become The Academy of Medicine of Toledo and Lucas County. We are their legacy.

In 1903 they joined forces with the Lucas County Medical Society, which was formed in 1894, to officially be-come The Academy of Medicine of Toledo and Lucas County. They re-mained on the forefront of the com-munity and its many health related troubles throughout the twentieth century. You can read the time line on the link in our web site or obtain a copy of The First 150 Years – A History of The Academy of Medicine of Toledo and Lucas County 1851-2001, authored by Barbara Floyd and Vicki L. Kroll in collaboration with S. Amjad Hus-sain, MD.

Something happened with the new millennium: doctors stopped join-ing The Academy and they have left in large numbers. It speaks to the changes in our society. Membership in all organizations is declining. So-cial media serves as our sad substi-tute.

Dr. Romanoff wrote an eloquent se-ries of essays detailing the benefits of organized medicine which were re-cently published in our magazine, To-ledo Medicine. The UTCOM medical

students have a very large presence at the AMA in their student section. They already seem to grasp that unit-ed we can make a difference, more so than if we stand alone.

No longer do we know our colleagues personally or professionally. And unlike physician assistants and nurse

practitioners, we are fragmented as a profession. We practice only in hos-pitals or our offices. Gone are the groups meeting in doctors’ lounges at hospitals or attending staff dinners together. We get home later because of the EHR. We struggle to see more patients to cope with the ever rising overhead in our offices. We are not allowed to simply have a bad day be-cause we are graded on how person-able we seem at any given moment. We cannot do a prescription refill be-cause the computer stops, we cannot

get into the operating room because the smoking history will not enter into the computer. The heart cath-eterization cannot proceed because the history and physical has not shown up on the data yet. On and on the problems come… Who “gets” it besides your fellow physicians?

The Academy of Medicine seems to be more important because our phy-sician colleagues are the only ones who know our lives, our struggles and our frustrations. Repeatedly, I have heard physicians say they hate the computer, the regulations, the intrusions in their physician/patient relationships and they want to just quit. Yet to a person they pause and say but I still love the patient care and that keeps me doing this job. The Academy is a small forum, but to take back our professions we must start somewhere.

We want and need our members to return to the fold and help to trans-form ourselves into a united group serving Toledo and Lucas County. It matters not where you draw your paycheck from in our medical com-munity.

Remember why you went into medi-cine. Surely it was to advocate for your patients, to promote health and wellness and to be a leader. Join us and help us leave that legacy for your families as our forefathers once dared to dream.

Please be that thoughtful group of concerned citizens who change our world.

:


Reportsmaintaining consistently high levels of excellence in patient experience, em-ployee and physician engagement and/or clinical quality performance.

Also on the way to all Mercy Health facilities is PerfectServe – a customiz-able clinical communications system designed for physicians. PerfectServe was first introduced at Mercy Health – St. Vincent Medical Center in late 2014. It will give physicians more control and improved patient care and improve their collaborative efforts with colleagues. PerfectServe enables users to selectively filter and control their contacts based on criteria like patient condition and origi-nating facility; then decide the method and appropriate time for contact based on personal preference.

Rajender K. Ahuja, MDMercy Health — St. Charles Hospital

Mercy Health is proud to be part-nering with Unison Behavioral

Health Group with the creation of a treatment facility to address the grow-ing opioid addiction issue in Toledo. Unison announced that, with Mercy Health and support from the Mental Health & Recovery Services Board, it will open a subacute detoxification unit to provide needed medically supervised detoxification services. In doing so, Unison will enhance its clinical part-nership with Mercy Health to develop clinical programs and services to serve adult, chemically dependent men and women. Mercy Health has committed to the community’s behavioral health through the opening of the Behavioral Health Institute on the Mercy Health – St. Charles Hospital campus. Together, we continue to work for the betterment of our community.

Due to the growing demand for cardiac rehab services and congestive heart fail-ure services, St. Charles has expanded our current cardiac space to create capac-ity for these services. The construction and redesign has created more space for cardiac rehab patients and heart failure patients seeking services in the community. Post-acute care is a critical component for continued recovery of patients suffering with these diseases.

Another addition is a new infusion center for patients in need of infusion services in the community. The recently opened center will do all infusions with the exception of chemotherapy infusions.

Also new to St. Charles is John Roost, DO, an obstetrician and gynecologist, who has an interest in robotic surgery. Dr. Roost recently completed his train-ing to start performing robotic surgery at St. Charles, closing a gap on a much needed service in the area.

And although the holidays are over, I’d be remiss not to mention the hos-pital’s annual support of the holiday family adoption program through the East Toledo Family Center. In 2016, the team at St. Charles adopted 24 families. Departments throughout the hospital were very generous in providing a merry Christmas to those in our community in need.

Randall W. King, MDMercy Health — St. Vincent Medical Center

Mercy Health has elevated the fight against cancer with the opening of

the Mercy Health – Perrysburg Cancer Center, which is a department of Mercy Health – St. Vincent Medical Center. Now serving patients from throughout

the region, the freestanding cancer cen-ter offers diagnostics, radiation therapy, clinical trials and more. Born of a unique partnership between Mercy Health, The Toledo Clinic’s medical oncologists and Toledo Radiation Oncology, the cancer center provides a single, coordinated care pathway for all patients, providing improved integration and coordination of care.

St. Vincent is also proud to share that The Neuroscience Institute at Mercy Health - St. Vincent Medical Center has earned The Joint Commission’s Gold Seal of Approval® and the American Heart Association/American Stroke As-sociation’s Heart-Check mark for their achievement in earning the Advanced Certification for Comprehensive Stroke Center accreditation. This is the highest level of accreditation for stroke care with only 110 comprehensive stroke centers in the country.

Congratulations to all physicians and staff who worked hard to secure this cer-tification. The designation will further the region’s vision to deliver world class experiences and care as well as improve the community health and wellbeing for patients needing stroke care.

In a continued focus to make access easier for our patients, Mercy Health – Life Flight Network has developed an auto-launch algorithm to immedi-ately launch transportation for all acute stroke and STEMI heart attack patients being transferred to St. Vincent from area hospitals. The auto-launch system will streamline inter-facility transfers in ultra-time-sensitive situations. The program was a collaboration of Life Flight and the physicians and members of the Mercy Health – Neuroscience



UTCOM Report

Dean’s

ReportThe University of Toledo College Of Medicine

Area Hospitals

ReportsChiefs of Staff

Hospital Reports

R. W. Mills, MD Mercy Health — Children’s Hospital

In our continued effort to make ac-cess easier for those we serve, Mercy

Health – Children’s Hospital now has a diagnostic center specially designed for our youngest patients. Located near our team of pediatric sub-specialists on the Mercy Health – St. Vincent Medical Center campus, the pediatric-friendly space offers diagnostic services such as lab, X-ray, and ultrasound in one convenient location.

I am proud and humbled by the amazing support recently shown from the com-munity by way of two major financial contributions. Throughout the month of December, the community helped secure $20,000 for Mercy Health – Children’s through a national Children’s Miracle Network campaign sponsored by federal credit unions. By voting for our hospital – nearly 37,500 times – supporters have helped us continue to deliver world-class care.

Additionally, organizers of the Mercy Health – Glass City Marathon recently announced that all money raised at the 2017 kids’ race will go to Mercy Health – Children’s Hospital to help fund lifesaving technology. Children’s has supported the kids’ portion of the marathon and is committed to growing participation in the event, which intro-duces children ages 2-12 to running. The goal is to have 1,000 children sign up. Mercy Health – Children’s once again is pleased to be offering educational opportunities for the pediatric com-munity. The 20th Annual Perinatal Conference will be held on a new date and in a new location. This year, the conference will be on Friday, March 24 at the Hilton Garden Inn. Also, the Dr. John T. Schaeufele Pediatric Summit

will be held on Friday, April 28 in the Mercy Health – St. Vincent Medical Center auditorium. This full day CME activity will focus on a variety of top-ics including gastroenterology, sports medicine, intensive care, hematology, and neurology.

Shakil A. Khan, MDMercy Health — St. Anne Hospital

For a third consecutive quarter, Mercy Health - St. Anne Hospital

received the Toledo area’s only 5-star rating for overall quality by the Centers for Medicare and Medicaid, placing St. Anne once again among a select few of the top hospitals in the country for this rating.

This 5-star rating is a testament to the level of quality care provided by the team at St. Anne and the work being done to deliver an amazing patient ex-perience. St. Anne previously achieved another quality award distinction this past year in patient safety recognizing how well a hospital prevents infections, medical errors and other preventable complications, and St. Anne was rec-ognized in Press Ganey’s top decile for inpatient experience. I’m proud to be a part of a team that consistently is recog-nized as a leader in quality care.

Patient experience and making access easier also continue to remain a top priority at Mercy Health – St. Anne Hospital. A key example is the Mercy Health – Sylvania Medical Center, which celebrated its one year anniversary in October. The full-service emergency department continues to garner top percentile in patient satisfaction scores. In fact, both the Perrysburg and Sylvania emergency departments were recently recognized with the Guardian of Excel-lence Award and the Pinnacle Award for

Recruiting nationally recognized clini-cal and research faculty to northwest

Ohio, as well as recruiting and retaining top students, residents and fellows in the health sciences, are among the goals of The University of Toledo College of Medicine and Life Science’s Academic Affiliation with ProMedica.

We are excited to see that begin to material-ize. The level of talent recently recruited to our region will have a positive effect on our efforts to enhance the training and education of medical students, residents and fellows in our region. Importantly, the leaders and physicians of ProMedica have been very involved in these efforts and each new chair understands how impor-tant it is to both organizations, and to our community, that the Academic Affiliation succeeds expectations.

Dr. Lance Dworkin has joined our team as the chair of the Department of Medicine. He comes to Toledo from Brown University where he was professor of medicine and vice chairman of medicine for research, academic affairs and ethics. He specializes in hypertension and his research interests include the mechanisms of progressive kidney failure and prevention.

Dr. Puneet Sindhwani is the new chair of the Department of Urology. He joins UT from the University of Oklahoma Health Sciences Center where he served as an as-sociate professor of urology and was the university’s chief of male infertility and andrology section and started the male reproductive health program.

Dr. Charles Brunicardi recently joined the college as chair of the Department of Sur-gery. He comes to Toledo from the David Geffen School of Medicine at UCLA where he has served as the professor-in-residence and vice chair for surgery and the Moss

(Dean’s Report continued on Page 20)


Fourth District Councilor’s Report

Longtime Leader of the Ohio State Medical Association Retires

Anthony J. Armstrong, MD

D. Brent Mulgrew, the longtime executive director of the Ohio State Medical Association

(OSMA), retired in January after a 42-year career at the state’s largest physi-cian-led organization. Mulgrew joined the OSMA in 1974 and assumed the top leadership post in 1992 where he remained until his retirement. “I want to thank the OSMA for giving me the opportunity to make a small difference in the world of health care during the last 40 plus years,” Mulgrew said. “I will retire leaving with four decades of memories that offer a mixture of pride-ful accomplishments and yet a yearn-ing wish to have done more. Working for the OSMA has been the best job I could have imagined.”

Todd Baker has been named the new CEO of the OSMA. Baker had served as director of professional relations for the OSMA and was selected by a group of OSMA physician leaders fol-lowing a national search for Mulgrew’s replacement.

OARRS Compliance Letters to Continue with Modifications

The State Medical Board of Ohio (Board) has no plans to stop sending OARRS compliance letters to Ohio physicians it says have committed at least one violation of the state’s opi-oid prescribing guidelines. The letters, which started in September, have been a concern for the OSMA and physi-cians across Ohio because of confu-sion over why many individuals who believe they are in compliance or are exempt from checking OARRS are re-ceiving the communication.

The OSMA met with the Board’s ex-ecutive director, A.J. Groeber, State of Ohio Board of Pharmacy executive di-rector Steve Schierholt and members

of their staffs in November. The meet-ing was arranged in response to the OSMA’s response to the letters. The OSMA sought clarification on why some physicians were being targeted with the letters and to encourage the Board to refine and increase specific information provided to each doctor so they can better assess any changes they might need to make.

The OSMA noted the Board must im-prove its messaging to physicians. The Board said it is committed to assuring its licensees understand OARRS and added that it would continue to hone in on clearer data that will help it pro-vide physicians with more definitive information for why they might be receiving the letters and how they can go about improving their compliance. The Board praised the response from physicians to the letters saying that thousands have contacted the Board to update their OARRS information or make other corrections that bring them into full compliance with the state rules. The Board noted, however, that the vast majority of physicians being contacted are not suspected of egre-gious errors but of occasional missed patient checks or incorrect registry in-formation needing to be updated.

Remembering Dr. Walter A. Reiling, Jr. and Dr. Thomas W. Morgan

Two renowned past-presidents of the OSMA recently died. Dr. Walter A. Reiling, Jr., who this past April was awarded the association’s Dis-tinguished Service Citation during the OSMA’s Annual Meeting, passed away on October 25. A week later Dr. Thomas W. Morgan, a trailblazer in the medical community, died on Novem-ber 2.

Dr. Reiling served as OSMA president from 1993-1994 but remained a highly-visible leader within the association long after he completed his one-year term. Dr. Reiling served as the Chief of Staff at Good Samaritan Hospital in Dayton for many years and was known as a transformative physician leader, noted for his medical research work. He also served as a member of Ohio’s Board of Regents. Throughout his ca-reer, Dr. Reiling was extremely active and volunteered with numerous other health care leadership organizations. He was the first Chairman of the Hos-pital Medical Staff Section in Ohio. He was also a chair of the Hospital Medi-cal Staff Section of the American Medi-cal Association (AMA) and Chairman of the Ohio Delegation and the Great Lakes Coalition at the AMA.

Dr. Morgan, who led the OSMA from 1979 to 1980, was noted for leading a project to build a new modern, multi-specialty medical facility in South-east Ohio. Holzer Hospital and Clinic opened in the late 1960s. A Diplomate of the American Board of Surgery, Dr. Morgan was the first surgeon to per-form carotid endarterectomy for stroke, aneurysm repair and bypass surgery for blocked leg arteries at Holzer. He also served as a member of the Board of Trustees and chair of the depart-ment of Surgery at Holzer. Dr. Mor-gan was a powerful and hardworking physician advocate at the OSMA. He spent many years interacting and en-gaging in work at the OSMA as well as other professional medical organiza-tions. Dr. Morgan served for 10 years as a member of the Ohio delegation to the AMA as well as a member of the American Association for Surgery of Trauma, the Board of Governors of the American College of Surgeons and the Ohio Chapter of the American College of Surgeons.


Character in MedicineBy J. Gregory Rosenthal, MD

I had the pleasure of seeing a new patient in the office, a truck driver who relied on bilateral vision for his

profession. He had seen another special-ist who had told him that there was no treatment, but that a new study of an expensive new medicine would soon be available. He was not told of the options nor was he told that the doctor would be paid handsomely for enrolling him in this study. After months off work, he became frustrated and sought a second opinion.

One month after treating him, his vision was improved enough to renew his CDL and resume driving.

Is that what we’ve come to, making pa-tients pawns to make more money? As in all professions, there will always be doc-tors who are primarily financially moti-vated. This used to be the exception. The physician as patient advocate used to be the clear norm. Is it still? Some now con-sider this to be naïve and sentimental.

After all, “Modern” medicine is now big business. Aren’t doctors to do as they are told by health systems and medical busi-nesses, who know this business better than them? Doctors see surreal incomes among executives in the business world, just as their own compensation decreases and the cost and risks of practicing soar. This is especially true in the pharmaceu-tical industry, the very industry most accessible to physician involvement. It is tempting to ask, ‘Why not me?” After all, if physicians drive health care, why not be paid by the industry that fuels so much of it? If doctors diagnose and treat illness, why not get paid to implement the plans of an industry that works to “de-fine” new illnesses and new “needs” for its products. If doctors do research and if industry is rapidly taking over control of that process, why not become a paid

mercenary? If industry is so eager and fi-nancially capable of funding healthcare, why not just give in? It’s convenient and rewarding and, hey, you can’t fight it anyway, right?

The problem is that with each step, the patient becomes more of a commodity, less of a person.

Giving in betrays that which defines the character of the physician. We simply cannot do that and continue to be first a healer, teacher, advocate and caregiver to our patients.

Giving in to profitable complicity with the pharmaceutical industry, or any other industry, betrays the fundamental ethical difference between the practice of medi-cine and the practice of business. This is not to suggest that one is right and the other wrong, only that they have fun-damentally different ethical constructs. The business ethic accepts that the busi-ness person will act so as to promote their business. The business person is ex-pected to be honest but not so altruistic as to prevent making a profit. The rela-tionship with the client is an adversarial negotiation in which a product or service is provided for the highest price that the market will bear and the consumer’s ob-ligation is to beware lest the transaction not be ideal.

The physician’s ethic is fundamentally different. His or her relationship with the patient is not adversarial, but one of ad-vocacy wherein the physician is expected to serve the patient’s best interests at all times. The defining role of the physician is to be an advocate on behalf of the patient and not to be that of which the patient must beware. The physician is to make the patient healthy and less reliant on therapy, not more so as is the goal of any

pharmaceutical marketing department. The patient expects not to be taken ad-vantage of physically or financially by a physician or any industry agent.

The pharmaceutical industry is a hybrid, as are the hospital and insurance indus-tries. Pharma is a business entity and can be expected to behave like one. Unlike non-medical industries though, it traf-fics in the health of its consumers and therefore has a responsibility to the pub-lic trust. This industry used to be faith-ful to that trust, but now increasingly only pays lip service to it. On the whole, the industry has run amok and betrays its responsibility to the public when it is financially expedient to do so. Such a charge may seem extreme, but there are countless examples of drug companies justifying outrageous pricing or mar-keting and research practices as being consistent with their “responsibility to shareholders”. Why sell an Epipen for $10 if you can sell it for $600? Well, be-cause you can. I once had a debate with a senior Vice President at Genentech about why they increased the price of a me-too drug by over 1000-fold. He explained to me that they were “taking the moral high road” because they had a “moral obli-gation to their shareholders to make as much money as possible”. The physician researcher sitting with us explained that he was “only a scientist and didn’t have to worry about ethics”.

Although physicians have a right to make a comfortable living, they are obligated to refuse profiteering and even racketeer-ing at the patient’s expense. The majority do, but even the well intentioned can fol-low an insidious slide into the hands of corporate and especially pharmaceutical interests. It starts innocently enough. A T-shirt at the Academy booth for listen-ing to the pitch. Later, maybe the compa-

Feature


learned to play complex arrange-ments - he also played guitar and had an excellent singing voice. In 1999 the Ohio Academy of Family Physicians awarded him the presti-gious Family Physician of the Year award, a testimony to his passion for medicine, his passion for teach-ing, his passion for people and his passion for his family. He was an educator at the Medical College of Ohio and later became the director of the Mercy Hospital Family Prac-tice residency where I encountered him as one of his trainees. For 63 years he loved and adored his wife Joan and always showed deep ten-derness for his children. Unfortu-nately, his youngest son David died in 1977. Never one to stay idle, John joined his daughter’s practice in 2003 where he worked until the time of his death. He leaves behind his beloved wife Joan, 3 children, and 8 grandchildren. John - back then I called him “Dr. Coleman” - was a superb teacher, always ready to listen, always ready to give good advice to lead us on our paths to knowledge. He was truly a won-derful role model as a family physi-cian and I’m not at all surprised he was still practicing at the age of 88! A true legacy from the old Mercy Hospital, he will be sorely missed by all of us. A quote: “Tobacco has historically been a product and a crop that has been attached to the black community for years. It drove the slave trade at a greater pace and more ruthlessly than did cotton. African-Americans have been a culture of tobacco users and we need to change that.” Peace,

Dr. Coleman, and to Joan and your lovely family.

William G. Bruggemann, MD, died peacefully on December 9, 2016 at the Franciscan Care Center. He was born in Fostoria, did his undergrad-uate and graduate studies at The Ohio State University and did his internship and residency at the To-ledo Hospital. Bill was a captain in the United States Army during the Vietnam War. He enjoyed skiing, boating and spending time with his family. His obstetrics-gynecology practice had a wonderful reputa-tion in the Toledo community and his group delivered many, many babies and performed many, many operations. During occasional en-counters during my early years of practice, I never saw him without a smile. He is lovingly survived by his wife of 60 years Audrey, 3 chil-dren and 2 grandchildren.

So, my fellow physicians and their loving families, as we were in-structed by the now famous phi-losophers Crosby, Stills, Nash and Young: please “love the one you’re with” and who you are married to … Carpe diem.

— Stephen P. Bazeley, MD


Winter Leaves Us a Little Bit Colder than Before

In Memoriam: A Compendium

John L. Culberson, MD, went to meet his maker on September 15, 2016, spending his last years cop-ing with Parkinson’s disease. A family physician for over 40 years, he practiced in Sylvania and many of his patients became friends. A “throw back” to the good old days, John even made house calls! Ex-celling at sports, he graduated from Capital University and then attended the University of Cincin-nati School of Medicine, graduat-ing in 1962. He did a rotating in-ternship at St. Vincent’s Hospital, then joined the United States Air Force and was a flight surgeon. Continuing his lifelong interest in aviation, he was certified as an Aviation Medical Examiner for the FAA for years. He was quite active at both Toledo Hospital and Flower Hospital, served as Family Prac-tice Chairman at both hospitals as well as serving on numerous com-mittees, and was one of the first Toledo area doctors to be certified by the AAFP. Active in the com-munity, John was a member of the Rotary Club of Sylvania, served as President 1975-1976, and was also a member of the First United Meth-odist Church of Sylvania. Fulfill-ing his mission to be active and not just an observer, John had many interests including team physician for Northview High School, tennis, photography, and rafting/ boating with his wife and daughters and family. During his earlier years he delivered many babies and was al-ways there in his office, taking the extra time if the patients needed to talk. He leaves behind his wife of 28 years, Carol, 3 daughters and 3

stepchildren - also many grandchil-dren and step grandchildren, who can relish the memories he spent performing magic tricks, flying kites, or consuming root beer floats at Grandpa’s house. His reputation in our area was outstanding, a true credit to his profession as a caring family doctor.

Frank O. Horton III, MD, died at home on October 10, 2016 from lung cancer. He was a member of the charter class at MCOT (Medical College of Ohio at Toledo,) contin-ued his training at Hurley Medical Center in Flint, Michigan, Denver General Hospital, the Cleveland Clinic, and did fellowships at the University of Oklahoma. He start-ed a pulmonary practice in Toledo Hospital in 1979 and later added the specialty of sleep medicine. He was a very active clinician and was quite involved in the expansion of ProMedica’s sleep labs in our area from one to seven! He was a cru-sader trying to convince his pa-tients to stop smoking and when appropriate to be assessed for sleep apnea issues (and to wear their masks!) His gentle sense of hu-mor, sometimes a little bit off-color, endeared him to all patients of all ages and sexes (yes, even the little old ladies.) Born in the Cincinnati area, Frank led his Loveland High School basketball team to the city championship his senior year. His politics were conservative, and he took pride in playing golf once with Newt Gingrich. He met his wife Susan playing tennis and they were married in 1988. He leaves behind his wife Susan, two sons and two

grandchildren. I remember seeing Frank in his white outfit as I began my time on the floors of the old Maumee Valley Hospital and I still remember him with a smirky smile, always a kind word and often a joke. Many of my patients saw him over the years and he truly helped them have better days as the fields of pulmonary medicine and sleep medicine were evolving.

John H. Coleman, MD, died on November 26, 2016 in his Virginia home at the age of 88. John moved to Virginia with his wife Joan in 2003, where he joined the medical practice of his daughter, Dr. Linda Coleman. He was born the grand-son of slaves in Madison, Indiana, and was valedictorian at the age of 15 of his high school class. He en-tered Indiana University at the age of 16, and graduated from the Indi-ana University School of Medicine in 1953. While in medical school, he met the love of his life, the lovely Joan Hughes of Gary, Indiana. After spending a few years as a Captain in the Medical Corps of the United States Army in Indiana and later Texas, John and his family moved to Toledo where he practiced medi-cine for nearly 50 years. He was quite involved in the community, serving on numerous boards and commissions including the Board of Directors of Mercy Hospital, the Cordelia Martin Health Center, and Lucas County Children Services Board. John was known for his bril-liant mind, quick wit and fantastic smile. An avid golfer, he was a vo-racious reader, a writer and without ever taking a single piano lesson


ny sponsors a dinner for your referrals, some nice CME, and of course you pick a complimentary topic. Later they ask you to give a talk for which they supply your lecture slides, an honorarium and travel expenses. Again, the talk expresses your gratitude. Then maybe a trip to be on the advisory board (read “shill training”), and finally the big time: you are asked to be on the “research team”, but of course they own and control the analysis and presentation of the data. You don’t like that, but what the heck. It’s great for the practice and “everyone is doing it any-way”. It all seems okay, you guess. The only trouble is, it’s not.

It leads insidiously to full complicity with the marketing efforts of industry at the cost of the patient. This complic-ity comes at many levels. The most self-evident is through the promotion of new, more expensive “me-too” drugs of dubi-ous value, through direct-to-consumer marketing, and many other gambits. A more egregious example of complicity is industry manipulation of the research process, spinning the statistics, and inte-grating the research process with the mar-keting plan.

What is the alternative for someone who wants to be a doctor first and foremost?

Simple: be a doctor. Why? Because it is the right thing for the patient. The questions remain unchanged since the beginning of medical practice: What defines the phy-sician’s ethical imperative? What defines the physician’s character? Is the doctor’s primary responsibility like the business-man’s, to maximize profits, or is it to be an advocate/activist for patients regard-less of the prospect of personal gain?

Clearly, the ethical practice of medicine demands this. This is not to say that med-

ical care must be free, but it does mean that the doctor must:

• Act on analysis of all available data, not just what companies sponsor and promote.

• Weed out company bias rather than promote or benefit from it.

• Stand up for the patient in the face of business imperatives that use pa-tients to maximize profits by push-ing more expensive me-too drugs and self-serving research and mar-keting plans.

• Resist the mindset that Big Pharma and big-business medicine should dictate how medical care is done.

Listing innumerable examples is beyond the scope of a short essay, but the reader can consult the books “Doctoring Data”, “Dangerous Medicines and Organized Crime”, or “On The Take”, all authorita-tive books by well-respected medical re-search leaders. There are many others.

The doctor’s calling is a “higher calling”. The physician’s calling is antithetical to the business calling without denying the legitimacy of business practice. This is true whether the business is pharmaceu-ticals, health systems, insurance, or any-thing else. Businesses appropriately seek profit, but this is kept in check through competition, government regulation, leg-islation, public advocacy and transpar-ency in the media. At least it used to be.

Physicians need to maintain a higher eth-ic. The physician’s imperative is to be the most knowledgeable and therefore most powerful protector of the patient’s inter-ests, even in the face of business’ quest for profit. It is not to use his or her knowl-edge and power to assist business in the exploitation of patients. It is just that simple, and every priority of the physi-

cian must follow from that, whether in patient care, medical education, research, or public advocacy.

Pharma has made cosmetic steps to de-crease influence on physicians, but it is not enough to refuse free lunches and pens. Real independence requires physi-cian abstention from corporate complic-ity in practice, education, research and administration. Medical practice means patient advocacy. Period.

Doctors in research or education should also serve the public interest. They must serve the medical and lay public. They should also lead their corporate partners in matters of medical integrity, not be led by them. With full disclosure, doctors can work for industry, but they are still accountable to their medical oath and to their charge as physicians to serve the public interest.

Corporate and independent research can coexist productively if both are presented and understood for what they are. The public’s interests cannot be served if bias or marketing trickery is concealed in any way.

The system has been gamed. Big business would have physicians, once the leaders of the medical profession, become idiot stepchildren led around by profit seek-ers, or worse, partners in full complicity. We can retake the high ground by simply dissembling that system and demanding that physicians and healthcare workers control medicine and not industries that have no ethical framework to answer the medical calling. We need to do this now, before the healthcare economy has be-come completely funneled into industry coffers and before we lose all credibility with the public.


Starting 2017 Strong!

Alliance Activities

Jan Colville & Lela Rashid

The holidays are over and like many people, the Alliance has great goals for the New Year!

As always we are trying to increase our membership, be of good ser-vice to our community, as well as support our hard working doctors!

In December, we were all set with a new member yoga night, fol-lowed by some fellowship at a lo-cal eatery. Chelsea Gupta worked hard on organizing this activity and asked that every person bring some toiletries/beauty products to the event to support Mom’s House. Unfortunately, Mother Nature had other ideas and we were forced to cancel, due to a snowstorm. Even though the event was cancelled, Chelsea teamed the effort to collect and still distribute many needed items to Mom’s House. We are so

grateful to be able to help out, and so many generous women contrib-uted. Hopefully the yoga can be re-scheduled, but our efforts were still very productive, thanks to Chelsea and her team of helpers.

Our gourmet-cooking group had their holiday party at Element 112 on January 6, 2017. Usually they all prepare the holiday meal, but this year decided to celebrate together and take a break from the prepara-tion.

Lela attended the annual Acad-emy of Medicine Annual Meeting on January 12, 2017 at the Premier Banquet Complex. Jan was at-tending a medical conference with her husband and was unable to be there.

On February 15, we will have our annual general membership meet-ing at Element 112 in Sylvania. We are looking forward to hearing Mr. Bill Geha speak to us regarding the heroin epidemic in our community. Mr. Geha works with local schools and is a source of knowledge and care in this area. We are hoping for good attendance, as this is a topic that is of concern to all of us.

Coming up on March 30 is our an-nual Doctors' Day. For a small do-nation, doctors can be recognized on this special day. They receive a card and a thank you for all of their hard work throughout the year.

The New Year has begun and our plans for expanding our member-ship, supporting our causes, edu-cating ourselves and supporting our hardworking physicians are underway. Happy New Year!

— Lela and Jan

Packing up supplies for Mom’s House.


and most involved members at the stu-dent level of organized medicine than at any other medical school in Ohio. 74% of M1 students are student mem-bers of the AMA and UTCOM has ex-ceeded the national goal for member-ship. UTCOM has the most students on national standing committees and for the past three conferences their stu-dents have had the best attendance at the national meetings. The Academy Council has had a student representa-tive for many years giving input at the monthly meetings. The Academy of Medicine in turn serves as a mentor to the UTCOM students. We really need to show our gratitude and thankful-ness to Dr. Donna Woodson who has worked closely with these students. We know that these students will be-come involved in organized medicine and most likely will be leaders in their ultimate medical communities.

Dr. Romanoff thanked everybody for having the faith and trust in having him as Academy president this past year. He knows that we will be in excel-lent hands with our new president, Dr. JoDee Ahrens. He sincerely thanked our Executive Director, Mr. Lee Weal-ton, who over the past 46 years has been

the backbone of The Academy. He said Mr. Wealton’s help this past year and over the years has been invaluable and Lee is very much valued and appreci-ated. Last, but not least, Dr. Romanoff thanked his wife, and best friend, Hed-va, who he said has had to put up with countless evening meetings that he attends. He also serves on four other boards which did not help out with the number of meetings. She palpably helped his presidency as his personal editor with her superior English skills

when he wrote his editorials. He said after 45 years of marriage “we’re a pret-ty good team”.

Dr. Romanoff introduced Dr. JoDee E. Ahrens as the 160th president of The Academy of Medicine of Toledo and Lucas County and its predecessors, the Toledo Medical Association and the Lucas County Medical Society. Dr. Ahrens said Dr. Romanoff has been a great person to work with and thanked him for being a great role model over the past year. Dr. Ahrens presented Dr. Romanoff with a presidential shadow box and gavel to commemorate his ex-cellent year as Academy President. The meeting concluded with Dr. Ahrens announcing the 2017 Academy election results. Officers elected include Dr. Christopher A. Bates, President-Elect; Dr. Richard L. Munk, Vice President; and Dr. Timothy M. Husted, Secretary. Councilors elected to a two-year term include Drs. Dennis R. Assenmacher, Thomas J. Colturi, Darlene S. Fairch-ild, Rex N. Figy, Mark D. Gallagher and Brian F. Hoeflinger. Newly elected members of the Nominating Commit-tee include Drs. Karl S. Fernandes and Henry H. Naddaf.

Dr. Bennett Romanoff presents a plaque to Dr. Richard Wiseley for his many years of dedicated service.

Dr. Carson Oostra, Resident Representative to Council and his wife, Caitlin.


America led by faculty members from UTMC. The third component of the Global Health Program involves disas-ter response missions where disaster relief teams have been sent to Nepal, Philippines and Haiti after recent in-ternational disasters. Currently they have 17 international academic affili-ates throughout the world representing opportunities in China, India, Lebanon, Jordan, Israel, Philippines and Nepal.

Dr. Romanoff thanked Dr. Brickman for his excellent presentation and present-ed him with a copy of The First 150 Years -- A History of The Academy of Medicine of Toledo and Lucas County 1851-2001.

In his Presidential address, Dr. Ro-manoff said it was amazing how fast this past year had flown by and it liter-ally seemed that it was just a few short months ago when he accepted the pres-idency of The Academy of Medicine. The focus of his term in office was to reach out to most unaffiliated physi-cians who are not members of orga-nized medicine in order to boost our membership, which will be an ongoing work in progress. Two of his editorials,

The Role of Organized Medicine – Is It For You and Volunteerism directly engaged the issues of the importance of belong-ing and being involved in organized medicine.

Dr. Romanoff thanked Mercy Health Toledo for their continuing corporate contributions to The Academy of Medi-cine, St. Luke’s Hospital for their corpo-rate contribution in 2017 and ProMedi-ca for their past corporate contributions

and said it has allowed The Academy to remain an important entity and to have a voice along with the AMA and OSMA. (If you did not read his article on Volunteerism in the autumn issue of Toledo Medicine, please take the time to go back and read it. It can be found on The Academy website.) Getting in-volved is very gratifying and the right thing to do. He realizes that everybody is very busy and that we often feel that we just do not have enough time. There is an old Chinese saying that goes; "To say, 'I don't have the time' is like saying, 'I don't want to' ". Please consider that giving just a little of your time does not really affect your life that much and take a moment to reflect on your lives, your practices and your time. Dr. Ro-manoff challenges you who are not al-ready involved to become involved in our community and The Academy of Medicine. Please encourage your col-leagues and friends to join The Acad-emy and to become involved. Together we can all make a difference as it just takes a phone call to The Academy or to one of the officers.

Dr. Romanoff said it gives him great pride and pleasure that our UTCOM medical students have the most active

Dr. Bennett Romanoff thanks guest speaker Dr. Kris Brickman for an excellent presentation on the Global Health Program.

Dr. Bennett Romanoff presents a plaque to Dr. Donald Marshall for his many years of dedicated service.

(from page 11)


Editor’s Note: A long and colorful history of the Valentine The-atre is celebrated in a beautiful mural gracing the lobby of the the-atre. Dr. Ravin has written about some of the famous artists who have appeared at the Valentine in the last 80 years. This article is one in a series accasionally published in Toledo Medicine.

The American actress Billie Burke (1884-1970) is best known for her role as Glinda, the Good Witch of

the North, in the 1939 film, The Wizard of Oz. In one of her two autobiogra-phies, in considering her roughly forty movies, she wrote this was her favorite role.1

She was married to the famous Broad-way producer Florenz Ziegfeld, Jr, (1867-1932) from 1914 until his death in 1932. Ziegfeld is remembered for his series of theatrical reviews, the Ziegfeld Follies, which took place from 1907-1931, and Billie Burke appeared in several. Paul Block (1877-1941), pub-lisher of the Toledo Blade, and Ziegfeld were good friends. In 1929, just before the great crash, Ziegfeld was getting anxious about the stock market, but Block’s financial advisor advised him not to sell. Block passed that advice on to Ziegfeld, who soon regretted taking that advice from his friend.2

The Wizard of Oz is a Metro-Goldwyn-Mayer Technicolor fantasy-adventure film based on The Wonderful Wizard of Oz by L. Frank Baum. Stars in the cast besides Burke include Judy Garland as Dorothy, Jack Haley as the Tin Man, Ray Bolger as the Scarecrow, Burt Lahr as the Cowardly Lion, and Margaret Hamilton as the Wicked Witch of the West.

Mary William Ethelbert Appleton (“Billie”) Burke was born in Washing-ton, DC, the only child of Blanche and William (“Billy”) Burke. As a child she toured the US and Europe with her parents. Her father was a singer and clown who worked for the Barnum &

Valentine Mural: Billie BurkeBy James G. Ravin, MD

Bailey Circus. The day she was born he was on tour with the circus and wired home, “I don’t care whether it’s a boy or a girl, but does it have red hair?”3 At nearly the same time, Bailey, who was almost as excited as his chief

clown, telegrammed, “I will make you a firm offer of one million dollars cash for the baby.” After eight years in the US, career prospects looked better in England. The family moved to London and she began acting on stage there in 1903. By age 18 she was a successful musical comedienne. She invented the Billie Burke Type, a comic who doesn’t know she is funny. Four years later she returned to America and starred in Broadway musicals and cinema. She was a great hit and became the high-est paid motion picture actress. She was charming, girlish, and dressed fashionably with a wardrobe designed by Lady Duff Gordon.4 In the 1933 cinematic comedy Dinner at Eight, di-rected by George Cukor, she played the role of Millicent Jordan. She was type cast as a lightweight, a spoiled society woman who had a high-pitched voice. The movie was a great success and the cast included many well-known indi-viduals, including Lionel Barrymore,

Marie Dressler, John Barrymore, Jean Harlow, and Wallace Beery.

In 1936 MGM released the film The Great Ziegfeld about her future hus-band and it received several Academy Awards. Burke did not appear in the movie since MGM thought she was too old for the part. Instead, Myrna Loy played her role. In 1937 Burke appeared in the first of several Topper movies. The following year (1938) she appeared in Merrily We Live, and this movie earned her the first and only Oscar nomination she ever received, as best supporting actress.

From 1943-1946 CBS Radio broadcast The Billie Burke Show, a situation com-edy sponsored by Listerine. In 1951-1952 she had a television talk show, At Home with Billie Burke. Her last movie appearance was in 1960. That same year she was given a star on the Hol-lywood Walk of Fame. Her legacy in-cludes a very long list of credits. She played alongside many well-known actors and actresses of her era. Just her role in The Wizard of Oz was enough for cinema immortality.

1. Burke B, Shipp C. With a Feather on my Nose. New York: Appleton-Century-Crofts, 1949, p 258.2. Ziegfeld R, Ziegfeld P. The Ziegfeld Touch. The Life and Times of Florenz Ziegfeld, Jr. New York: H. N. Abrams, 1993, p. 154.3. Burke, Shipp, op. cit. p. 9.4. Majer M. Staging Fashion, 1890-1920. Jane Hading, Lily Elsie, Billie Burke. New Haven, CT: Yale University Press, 2012, pp. 153-173.


2017 Academy of Medicine Annual Meeting

Cover Story

The Academy of Medicine of To-ledo and Lucas County's 115th Annual Meeting was held on

January 12. Dr. Christopher A. Bates, Academy Vice President, began the evening with the invocation followed by Academy President Dr. Bennett S. Romanoff welcoming the attendees and making a number of introductions.

Following dinner Dr. Romanoff invited Dr. Richard J. Wiseley to join him at the podium and announced that Council elected him to Meritorious Fellow sta-tus in recognition of his many years of exemplary services to The Academy of Medicine. Dr. Wiseley served on the OSMA Delegation from 1972 until he re-tired from the Delegation in September. He served as chair of the Delegation from 1983 until 1987 and again from 2008 until 2016. He also served on The Academy of Medicine Council, Judicial & Internal Affairs Commission and the Membership Services Commission. Dr.

Romanoff presented Dr. Wiseley with a plaque in thanks for his many years of service. Dr. Romanoff then asked Dr. Donald B. Marshall to join him at

the podium. Dr. Marshall served on the OSMA Delegation from 1988 until he retired from the Delegation in De-cember. He served on the Judicial & Internal Affairs Commission and the Membership Services Commission prior to being elected Councilor, Secre-tary, Vice President and President-Elect of The Academy of Medicine, serving as President in 1998. He was elected to Meritorious Fellow status in 2007. Dr. Romanoff presented Dr. Marshall with a plaque in thanks for his many years of service. Dr. Richard L. Munk, Academy Secre-tary, led a moment of silence in tribute to those Academy members who passed away since the last Annual Meeting, in-cluding Drs. William G. Bruggemann, John H. Coleman, John L. Culberson, Michael B. Gordon, Frank O. Horton, III, Pablo A. Pons, David K. Scheer, Kenneth W. Seo, Daniel R. Sullivan and Ayyaswamy Thambuswamy.

From left, 50 Year Award recipients Dr. Arthur Mancini and Dr. Shaheda Ahmed with Dr. Anthony Armstrong, OSMA 4th District Councilor, who presented the awards.

From left, 2016 officers Dr. Henry Naddaf, Immediate Past President, Dr. Christopher Bates, Vice President, Dr. JoDee Ahrens, President-Elect, Dr. Bennett Romanoff, President, Dr. William Sternfeld, Treasurer, and Dr. Richard Munk, Secretary.


One of the evening’s events was pre-sentations to the OSMA 50-Year Award recipients acknowledging the 50th an-niversary of graduation from medical school. OSMA Fourth District Coun-cilor Dr. Anthony J. Armstrong pre-sented 50-Year Awards to Drs. Shahe-da B. Ahmed and A. Arthur Mancini. Other 50-Year Award recipients who could not attend the meeting include Drs. Ziya Celik, Martha E. Early, Jules J. Isaacson, Vijay K. Mahajan, Roger A. Miller, Sukhjit S. Purewal, Divya M. Shah, Madhukar D. Shah and Ursula F. Xanthakos.

Each year one of the highlights of the evening is the formal induction of the new members who were approved dur-ing the year. The 2016 new members include Drs. David B. Da Rocha-Afodu, Arthur P. Delos Reyes, Anil K. Gupta, Mark A. Guzzo, Sreekanth V. Indurti, Sarath K. Palakodeti and Marsha S.

Paul. Dr. Romanoff welcomed the new members and also recognized the As-sociate Members who were elevated to Fellow Membership status in 2016. The new Fellows include Drs. Salil Av-

asthi, Mirza M. Baig, Lindsey J. Bostel-man, Stephanie J. Cole, Christopher J. Cooper, John V. Houghtaling, Nicole A. Hubbard, Nadine C. Kassis, David M. Lewis, Wael M. Otaibi, Dino Santacroce and Siva R. Yechoor.

Dr. Kris Brickman was the guest speak-er and discussed the Global Health Pro-gram, which outlines the integration of Global Health Education at The Uni-versity of Toledo Medical Center with students and residents from The Uni-versity of Toledo College of Medicine and Life Sciences, along with Pharma-cy and Nursing students on the Health Science Campus. The Global Health Program represents three primary com-ponents, the first being one month aca-demic elective rotations, primarily for fourth year medical students, but can also involve residents in various train-ing programs. Mission activity makes up a significant portion of the Global Health Program, primarily in Central


Dr. Donna Woodson with medical students, from left, Hannah Kissel-Smith, Medical Student Representa-tive to Council, Kara Richardson, Kevin Stephenoff, Kevin Qin and Jared Friedman.

Dr. Bennett Romanoff presents the presidential gavel to Dr. JoDee Ahrens, 2017 President.


America led by faculty members from UTMC. The third component of the Global Health Program involves disas-ter response missions where disaster relief teams have been sent to Nepal, Philippines and Haiti after recent in-ternational disasters. Currently they have 17 international academic affili-ates throughout the world representing opportunities in China, India, Lebanon, Jordan, Israel, Philippines and Nepal.

Dr. Romanoff thanked Dr. Brickman for his excellent presentation and present-ed him with a copy of The First 150 Years -- A History of The Academy of Medicine of Toledo and Lucas County 1851-2001.

In his Presidential address, Dr. Ro-manoff said it was amazing how fast this past year had flown by and it liter-ally seemed that it was just a few short months ago when he accepted the pres-idency of The Academy of Medicine. The focus of his term in office was to reach out to most unaffiliated physi-cians who are not members of orga-nized medicine in order to boost our membership, which will be an ongoing work in progress. Two of his editorials,

The Role of Organized Medicine – Is It For You and Volunteerism directly engaged the issues of the importance of belong-ing and being involved in organized medicine.

Dr. Romanoff thanked Mercy Health Toledo for their continuing corporate contributions to The Academy of Medi-cine, St. Luke’s Hospital for their corpo-rate contribution in 2017 and ProMedi-ca for their past corporate contributions

and said it has allowed The Academy to remain an important entity and to have a voice along with the AMA and OSMA. (If you did not read his article on Volunteerism in the autumn issue of Toledo Medicine, please take the time to go back and read it. It can be found on The Academy website.) Getting in-volved is very gratifying and the right thing to do. He realizes that everybody is very busy and that we often feel that we just do not have enough time. There is an old Chinese saying that goes; "To say, 'I don't have the time' is like saying, 'I don't want to' ". Please consider that giving just a little of your time does not really affect your life that much and take a moment to reflect on your lives, your practices and your time. Dr. Ro-manoff challenges you who are not al-ready involved to become involved in our community and The Academy of Medicine. Please encourage your col-leagues and friends to join The Acad-emy and to become involved. Together we can all make a difference as it just takes a phone call to The Academy or to one of the officers.

Dr. Romanoff said it gives him great pride and pleasure that our UTCOM medical students have the most active

Dr. Bennett Romanoff thanks guest speaker Dr. Kris Brickman for an excellent presentation on the Global Health Program.

Dr. Bennett Romanoff presents a plaque to Dr. Donald Marshall for his many years of dedicated service.

(from page 11)


Editor’s Note: A long and colorful history of the Valentine The-atre is celebrated in a beautiful mural gracing the lobby of the the-atre. Dr. Ravin has written about some of the famous artists who have appeared at the Valentine in the last 80 years. This article is one in a series accasionally published in Toledo Medicine.

The American actress Billie Burke (1884-1970) is best known for her role as Glinda, the Good Witch of

the North, in the 1939 film, The Wizard of Oz. In one of her two autobiogra-phies, in considering her roughly forty movies, she wrote this was her favorite role.1

She was married to the famous Broad-way producer Florenz Ziegfeld, Jr, (1867-1932) from 1914 until his death in 1932. Ziegfeld is remembered for his series of theatrical reviews, the Ziegfeld Follies, which took place from 1907-1931, and Billie Burke appeared in several. Paul Block (1877-1941), pub-lisher of the Toledo Blade, and Ziegfeld were good friends. In 1929, just before the great crash, Ziegfeld was getting anxious about the stock market, but Block’s financial advisor advised him not to sell. Block passed that advice on to Ziegfeld, who soon regretted taking that advice from his friend.2

The Wizard of Oz is a Metro-Goldwyn-Mayer Technicolor fantasy-adventure film based on The Wonderful Wizard of Oz by L. Frank Baum. Stars in the cast besides Burke include Judy Garland as Dorothy, Jack Haley as the Tin Man, Ray Bolger as the Scarecrow, Burt Lahr as the Cowardly Lion, and Margaret Hamilton as the Wicked Witch of the West.

Mary William Ethelbert Appleton (“Billie”) Burke was born in Washing-ton, DC, the only child of Blanche and William (“Billy”) Burke. As a child she toured the US and Europe with her parents. Her father was a singer and clown who worked for the Barnum &

Valentine Mural: Billie BurkeBy James G. Ravin, MD

Bailey Circus. The day she was born he was on tour with the circus and wired home, “I don’t care whether it’s a boy or a girl, but does it have red hair?”3 At nearly the same time, Bailey, who was almost as excited as his chief

clown, telegrammed, “I will make you a firm offer of one million dollars cash for the baby.” After eight years in the US, career prospects looked better in England. The family moved to London and she began acting on stage there in 1903. By age 18 she was a successful musical comedienne. She invented the Billie Burke Type, a comic who doesn’t know she is funny. Four years later she returned to America and starred in Broadway musicals and cinema. She was a great hit and became the high-est paid motion picture actress. She was charming, girlish, and dressed fashionably with a wardrobe designed by Lady Duff Gordon.4 In the 1933 cinematic comedy Dinner at Eight, di-rected by George Cukor, she played the role of Millicent Jordan. She was type cast as a lightweight, a spoiled society woman who had a high-pitched voice. The movie was a great success and the cast included many well-known indi-viduals, including Lionel Barrymore,

Marie Dressler, John Barrymore, Jean Harlow, and Wallace Beery.

In 1936 MGM released the film The Great Ziegfeld about her future hus-band and it received several Academy Awards. Burke did not appear in the movie since MGM thought she was too old for the part. Instead, Myrna Loy played her role. In 1937 Burke appeared in the first of several Topper movies. The following year (1938) she appeared in Merrily We Live, and this movie earned her the first and only Oscar nomination she ever received, as best supporting actress.

From 1943-1946 CBS Radio broadcast The Billie Burke Show, a situation com-edy sponsored by Listerine. In 1951-1952 she had a television talk show, At Home with Billie Burke. Her last movie appearance was in 1960. That same year she was given a star on the Hol-lywood Walk of Fame. Her legacy in-cludes a very long list of credits. She played alongside many well-known actors and actresses of her era. Just her role in The Wizard of Oz was enough for cinema immortality.

1. Burke B, Shipp C. With a Feather on my Nose. New York: Appleton-Century-Crofts, 1949, p 258.2. Ziegfeld R, Ziegfeld P. The Ziegfeld Touch. The Life and Times of Florenz Ziegfeld, Jr. New York: H. N. Abrams, 1993, p. 154.3. Burke, Shipp, op. cit. p. 9.4. Majer M. Staging Fashion, 1890-1920. Jane Hading, Lily Elsie, Billie Burke. New Haven, CT: Yale University Press, 2012, pp. 153-173.


Starting 2017 Strong!

Alliance Activities

Jan Colville & Lela Rashid

The holidays are over and like many people, the Alliance has great goals for the New Year!

As always we are trying to increase our membership, be of good ser-vice to our community, as well as support our hard working doctors!

In December, we were all set with a new member yoga night, fol-lowed by some fellowship at a lo-cal eatery. Chelsea Gupta worked hard on organizing this activity and asked that every person bring some toiletries/beauty products to the event to support Mom’s House. Unfortunately, Mother Nature had other ideas and we were forced to cancel, due to a snowstorm. Even though the event was cancelled, Chelsea teamed the effort to collect and still distribute many needed items to Mom’s House. We are so

grateful to be able to help out, and so many generous women contrib-uted. Hopefully the yoga can be re-scheduled, but our efforts were still very productive, thanks to Chelsea and her team of helpers.

Our gourmet-cooking group had their holiday party at Element 112 on January 6, 2017. Usually they all prepare the holiday meal, but this year decided to celebrate together and take a break from the prepara-tion.

Lela attended the annual Acad-emy of Medicine Annual Meeting on January 12, 2017 at the Premier Banquet Complex. Jan was at-tending a medical conference with her husband and was unable to be there.

On February 15, we will have our annual general membership meet-ing at Element 112 in Sylvania. We are looking forward to hearing Mr. Bill Geha speak to us regarding the heroin epidemic in our community. Mr. Geha works with local schools and is a source of knowledge and care in this area. We are hoping for good attendance, as this is a topic that is of concern to all of us.

Coming up on March 30 is our an-nual Doctors' Day. For a small do-nation, doctors can be recognized on this special day. They receive a card and a thank you for all of their hard work throughout the year.

The New Year has begun and our plans for expanding our member-ship, supporting our causes, edu-cating ourselves and supporting our hardworking physicians are underway. Happy New Year!

— Lela and Jan

Packing up supplies for Mom’s House.


and most involved members at the stu-dent level of organized medicine than at any other medical school in Ohio. 74% of M1 students are student mem-bers of the AMA and UTCOM has ex-ceeded the national goal for member-ship. UTCOM has the most students on national standing committees and for the past three conferences their stu-dents have had the best attendance at the national meetings. The Academy Council has had a student representa-tive for many years giving input at the monthly meetings. The Academy of Medicine in turn serves as a mentor to the UTCOM students. We really need to show our gratitude and thankful-ness to Dr. Donna Woodson who has worked closely with these students. We know that these students will be-come involved in organized medicine and most likely will be leaders in their ultimate medical communities.

Dr. Romanoff thanked everybody for having the faith and trust in having him as Academy president this past year. He knows that we will be in excel-lent hands with our new president, Dr. JoDee Ahrens. He sincerely thanked our Executive Director, Mr. Lee Weal-ton, who over the past 46 years has been

the backbone of The Academy. He said Mr. Wealton’s help this past year and over the years has been invaluable and Lee is very much valued and appreci-ated. Last, but not least, Dr. Romanoff thanked his wife, and best friend, Hed-va, who he said has had to put up with countless evening meetings that he attends. He also serves on four other boards which did not help out with the number of meetings. She palpably helped his presidency as his personal editor with her superior English skills

when he wrote his editorials. He said after 45 years of marriage “we’re a pret-ty good team”.

Dr. Romanoff introduced Dr. JoDee E. Ahrens as the 160th president of The Academy of Medicine of Toledo and Lucas County and its predecessors, the Toledo Medical Association and the Lucas County Medical Society. Dr. Ahrens said Dr. Romanoff has been a great person to work with and thanked him for being a great role model over the past year. Dr. Ahrens presented Dr. Romanoff with a presidential shadow box and gavel to commemorate his ex-cellent year as Academy President. The meeting concluded with Dr. Ahrens announcing the 2017 Academy election results. Officers elected include Dr. Christopher A. Bates, President-Elect; Dr. Richard L. Munk, Vice President; and Dr. Timothy M. Husted, Secretary. Councilors elected to a two-year term include Drs. Dennis R. Assenmacher, Thomas J. Colturi, Darlene S. Fairch-ild, Rex N. Figy, Mark D. Gallagher and Brian F. Hoeflinger. Newly elected members of the Nominating Commit-tee include Drs. Karl S. Fernandes and Henry H. Naddaf.

Dr. Bennett Romanoff presents a plaque to Dr. Richard Wiseley for his many years of dedicated service.

Dr. Carson Oostra, Resident Representative to Council and his wife, Caitlin.


Winter Leaves Us a Little Bit Colder than Before

In Memoriam: A Compendium

John L. Culberson, MD, went to meet his maker on September 15, 2016, spending his last years cop-ing with Parkinson’s disease. A family physician for over 40 years, he practiced in Sylvania and many of his patients became friends. A “throw back” to the good old days, John even made house calls! Ex-celling at sports, he graduated from Capital University and then attended the University of Cincin-nati School of Medicine, graduat-ing in 1962. He did a rotating in-ternship at St. Vincent’s Hospital, then joined the United States Air Force and was a flight surgeon. Continuing his lifelong interest in aviation, he was certified as an Aviation Medical Examiner for the FAA for years. He was quite active at both Toledo Hospital and Flower Hospital, served as Family Prac-tice Chairman at both hospitals as well as serving on numerous com-mittees, and was one of the first Toledo area doctors to be certified by the AAFP. Active in the com-munity, John was a member of the Rotary Club of Sylvania, served as President 1975-1976, and was also a member of the First United Meth-odist Church of Sylvania. Fulfill-ing his mission to be active and not just an observer, John had many interests including team physician for Northview High School, tennis, photography, and rafting/ boating with his wife and daughters and family. During his earlier years he delivered many babies and was al-ways there in his office, taking the extra time if the patients needed to talk. He leaves behind his wife of 28 years, Carol, 3 daughters and 3

stepchildren - also many grandchil-dren and step grandchildren, who can relish the memories he spent performing magic tricks, flying kites, or consuming root beer floats at Grandpa’s house. His reputation in our area was outstanding, a true credit to his profession as a caring family doctor.

Frank O. Horton III, MD, died at home on October 10, 2016 from lung cancer. He was a member of the charter class at MCOT (Medical College of Ohio at Toledo,) contin-ued his training at Hurley Medical Center in Flint, Michigan, Denver General Hospital, the Cleveland Clinic, and did fellowships at the University of Oklahoma. He start-ed a pulmonary practice in Toledo Hospital in 1979 and later added the specialty of sleep medicine. He was a very active clinician and was quite involved in the expansion of ProMedica’s sleep labs in our area from one to seven! He was a cru-sader trying to convince his pa-tients to stop smoking and when appropriate to be assessed for sleep apnea issues (and to wear their masks!) His gentle sense of hu-mor, sometimes a little bit off-color, endeared him to all patients of all ages and sexes (yes, even the little old ladies.) Born in the Cincinnati area, Frank led his Loveland High School basketball team to the city championship his senior year. His politics were conservative, and he took pride in playing golf once with Newt Gingrich. He met his wife Susan playing tennis and they were married in 1988. He leaves behind his wife Susan, two sons and two

grandchildren. I remember seeing Frank in his white outfit as I began my time on the floors of the old Maumee Valley Hospital and I still remember him with a smirky smile, always a kind word and often a joke. Many of my patients saw him over the years and he truly helped them have better days as the fields of pulmonary medicine and sleep medicine were evolving.

John H. Coleman, MD, died on November 26, 2016 in his Virginia home at the age of 88. John moved to Virginia with his wife Joan in 2003, where he joined the medical practice of his daughter, Dr. Linda Coleman. He was born the grand-son of slaves in Madison, Indiana, and was valedictorian at the age of 15 of his high school class. He en-tered Indiana University at the age of 16, and graduated from the Indi-ana University School of Medicine in 1953. While in medical school, he met the love of his life, the lovely Joan Hughes of Gary, Indiana. After spending a few years as a Captain in the Medical Corps of the United States Army in Indiana and later Texas, John and his family moved to Toledo where he practiced medi-cine for nearly 50 years. He was quite involved in the community, serving on numerous boards and commissions including the Board of Directors of Mercy Hospital, the Cordelia Martin Health Center, and Lucas County Children Services Board. John was known for his bril-liant mind, quick wit and fantastic smile. An avid golfer, he was a vo-racious reader, a writer and without ever taking a single piano lesson


ny sponsors a dinner for your referrals, some nice CME, and of course you pick a complimentary topic. Later they ask you to give a talk for which they supply your lecture slides, an honorarium and travel expenses. Again, the talk expresses your gratitude. Then maybe a trip to be on the advisory board (read “shill training”), and finally the big time: you are asked to be on the “research team”, but of course they own and control the analysis and presentation of the data. You don’t like that, but what the heck. It’s great for the practice and “everyone is doing it any-way”. It all seems okay, you guess. The only trouble is, it’s not.

It leads insidiously to full complicity with the marketing efforts of industry at the cost of the patient. This complic-ity comes at many levels. The most self-evident is through the promotion of new, more expensive “me-too” drugs of dubi-ous value, through direct-to-consumer marketing, and many other gambits. A more egregious example of complicity is industry manipulation of the research process, spinning the statistics, and inte-grating the research process with the mar-keting plan.

What is the alternative for someone who wants to be a doctor first and foremost?

Simple: be a doctor. Why? Because it is the right thing for the patient. The questions remain unchanged since the beginning of medical practice: What defines the phy-sician’s ethical imperative? What defines the physician’s character? Is the doctor’s primary responsibility like the business-man’s, to maximize profits, or is it to be an advocate/activist for patients regard-less of the prospect of personal gain?

Clearly, the ethical practice of medicine demands this. This is not to say that med-

ical care must be free, but it does mean that the doctor must:

• Act on analysis of all available data, not just what companies sponsor and promote.

• Weed out company bias rather than promote or benefit from it.

• Stand up for the patient in the face of business imperatives that use pa-tients to maximize profits by push-ing more expensive me-too drugs and self-serving research and mar-keting plans.

• Resist the mindset that Big Pharma and big-business medicine should dictate how medical care is done.

Listing innumerable examples is beyond the scope of a short essay, but the reader can consult the books “Doctoring Data”, “Dangerous Medicines and Organized Crime”, or “On The Take”, all authorita-tive books by well-respected medical re-search leaders. There are many others.

The doctor’s calling is a “higher calling”. The physician’s calling is antithetical to the business calling without denying the legitimacy of business practice. This is true whether the business is pharmaceu-ticals, health systems, insurance, or any-thing else. Businesses appropriately seek profit, but this is kept in check through competition, government regulation, leg-islation, public advocacy and transpar-ency in the media. At least it used to be.

Physicians need to maintain a higher eth-ic. The physician’s imperative is to be the most knowledgeable and therefore most powerful protector of the patient’s inter-ests, even in the face of business’ quest for profit. It is not to use his or her knowl-edge and power to assist business in the exploitation of patients. It is just that simple, and every priority of the physi-

cian must follow from that, whether in patient care, medical education, research, or public advocacy.

Pharma has made cosmetic steps to de-crease influence on physicians, but it is not enough to refuse free lunches and pens. Real independence requires physi-cian abstention from corporate complic-ity in practice, education, research and administration. Medical practice means patient advocacy. Period.

Doctors in research or education should also serve the public interest. They must serve the medical and lay public. They should also lead their corporate partners in matters of medical integrity, not be led by them. With full disclosure, doctors can work for industry, but they are still accountable to their medical oath and to their charge as physicians to serve the public interest.

Corporate and independent research can coexist productively if both are presented and understood for what they are. The public’s interests cannot be served if bias or marketing trickery is concealed in any way.

The system has been gamed. Big business would have physicians, once the leaders of the medical profession, become idiot stepchildren led around by profit seek-ers, or worse, partners in full complicity. We can retake the high ground by simply dissembling that system and demanding that physicians and healthcare workers control medicine and not industries that have no ethical framework to answer the medical calling. We need to do this now, before the healthcare economy has be-come completely funneled into industry coffers and before we lose all credibility with the public.


Character in MedicineBy J. Gregory Rosenthal, MD

I had the pleasure of seeing a new patient in the office, a truck driver who relied on bilateral vision for his

profession. He had seen another special-ist who had told him that there was no treatment, but that a new study of an expensive new medicine would soon be available. He was not told of the options nor was he told that the doctor would be paid handsomely for enrolling him in this study. After months off work, he became frustrated and sought a second opinion.

One month after treating him, his vision was improved enough to renew his CDL and resume driving.

Is that what we’ve come to, making pa-tients pawns to make more money? As in all professions, there will always be doc-tors who are primarily financially moti-vated. This used to be the exception. The physician as patient advocate used to be the clear norm. Is it still? Some now con-sider this to be naïve and sentimental.

After all, “Modern” medicine is now big business. Aren’t doctors to do as they are told by health systems and medical busi-nesses, who know this business better than them? Doctors see surreal incomes among executives in the business world, just as their own compensation decreases and the cost and risks of practicing soar. This is especially true in the pharmaceu-tical industry, the very industry most accessible to physician involvement. It is tempting to ask, ‘Why not me?” After all, if physicians drive health care, why not be paid by the industry that fuels so much of it? If doctors diagnose and treat illness, why not get paid to implement the plans of an industry that works to “de-fine” new illnesses and new “needs” for its products. If doctors do research and if industry is rapidly taking over control of that process, why not become a paid

mercenary? If industry is so eager and fi-nancially capable of funding healthcare, why not just give in? It’s convenient and rewarding and, hey, you can’t fight it anyway, right?

The problem is that with each step, the patient becomes more of a commodity, less of a person.

Giving in betrays that which defines the character of the physician. We simply cannot do that and continue to be first a healer, teacher, advocate and caregiver to our patients.

Giving in to profitable complicity with the pharmaceutical industry, or any other industry, betrays the fundamental ethical difference between the practice of medi-cine and the practice of business. This is not to suggest that one is right and the other wrong, only that they have fun-damentally different ethical constructs. The business ethic accepts that the busi-ness person will act so as to promote their business. The business person is ex-pected to be honest but not so altruistic as to prevent making a profit. The rela-tionship with the client is an adversarial negotiation in which a product or service is provided for the highest price that the market will bear and the consumer’s ob-ligation is to beware lest the transaction not be ideal.

The physician’s ethic is fundamentally different. His or her relationship with the patient is not adversarial, but one of ad-vocacy wherein the physician is expected to serve the patient’s best interests at all times. The defining role of the physician is to be an advocate on behalf of the patient and not to be that of which the patient must beware. The physician is to make the patient healthy and less reliant on therapy, not more so as is the goal of any

pharmaceutical marketing department. The patient expects not to be taken ad-vantage of physically or financially by a physician or any industry agent.

The pharmaceutical industry is a hybrid, as are the hospital and insurance indus-tries. Pharma is a business entity and can be expected to behave like one. Unlike non-medical industries though, it traf-fics in the health of its consumers and therefore has a responsibility to the pub-lic trust. This industry used to be faith-ful to that trust, but now increasingly only pays lip service to it. On the whole, the industry has run amok and betrays its responsibility to the public when it is financially expedient to do so. Such a charge may seem extreme, but there are countless examples of drug companies justifying outrageous pricing or mar-keting and research practices as being consistent with their “responsibility to shareholders”. Why sell an Epipen for $10 if you can sell it for $600? Well, be-cause you can. I once had a debate with a senior Vice President at Genentech about why they increased the price of a me-too drug by over 1000-fold. He explained to me that they were “taking the moral high road” because they had a “moral obli-gation to their shareholders to make as much money as possible”. The physician researcher sitting with us explained that he was “only a scientist and didn’t have to worry about ethics”.

Although physicians have a right to make a comfortable living, they are obligated to refuse profiteering and even racketeer-ing at the patient’s expense. The majority do, but even the well intentioned can fol-low an insidious slide into the hands of corporate and especially pharmaceutical interests. It starts innocently enough. A T-shirt at the Academy booth for listen-ing to the pitch. Later, maybe the compa-

Feature


learned to play complex arrange-ments - he also played guitar and had an excellent singing voice. In 1999 the Ohio Academy of Family Physicians awarded him the presti-gious Family Physician of the Year award, a testimony to his passion for medicine, his passion for teach-ing, his passion for people and his passion for his family. He was an educator at the Medical College of Ohio and later became the director of the Mercy Hospital Family Prac-tice residency where I encountered him as one of his trainees. For 63 years he loved and adored his wife Joan and always showed deep ten-derness for his children. Unfortu-nately, his youngest son David died in 1977. Never one to stay idle, John joined his daughter’s practice in 2003 where he worked until the time of his death. He leaves behind his beloved wife Joan, 3 children, and 8 grandchildren. John - back then I called him “Dr. Coleman” - was a superb teacher, always ready to listen, always ready to give good advice to lead us on our paths to knowledge. He was truly a won-derful role model as a family physi-cian and I’m not at all surprised he was still practicing at the age of 88! A true legacy from the old Mercy Hospital, he will be sorely missed by all of us. A quote: “Tobacco has historically been a product and a crop that has been attached to the black community for years. It drove the slave trade at a greater pace and more ruthlessly than did cotton. African-Americans have been a culture of tobacco users and we need to change that.” Peace,

Dr. Coleman, and to Joan and your lovely family.

William G. Bruggemann, MD, died peacefully on December 9, 2016 at the Franciscan Care Center. He was born in Fostoria, did his undergrad-uate and graduate studies at The Ohio State University and did his internship and residency at the To-ledo Hospital. Bill was a captain in the United States Army during the Vietnam War. He enjoyed skiing, boating and spending time with his family. His obstetrics-gynecology practice had a wonderful reputa-tion in the Toledo community and his group delivered many, many babies and performed many, many operations. During occasional en-counters during my early years of practice, I never saw him without a smile. He is lovingly survived by his wife of 60 years Audrey, 3 chil-dren and 2 grandchildren.

So, my fellow physicians and their loving families, as we were in-structed by the now famous phi-losophers Crosby, Stills, Nash and Young: please “love the one you’re with” and who you are married to … Carpe diem.

— Stephen P. Bazeley, MD


UTCOM Report

Dean’s

ReportThe University of Toledo College Of Medicine

Area Hospitals

ReportsChiefs of Staff

Hospital Reports

R. W. Mills, MD Mercy Health — Children’s Hospital

In our continued effort to make ac-cess easier for those we serve, Mercy

Health – Children’s Hospital now has a diagnostic center specially designed for our youngest patients. Located near our team of pediatric sub-specialists on the Mercy Health – St. Vincent Medical Center campus, the pediatric-friendly space offers diagnostic services such as lab, X-ray, and ultrasound in one convenient location.

I am proud and humbled by the amazing support recently shown from the com-munity by way of two major financial contributions. Throughout the month of December, the community helped secure $20,000 for Mercy Health – Children’s through a national Children’s Miracle Network campaign sponsored by federal credit unions. By voting for our hospital – nearly 37,500 times – supporters have helped us continue to deliver world-class care.

Additionally, organizers of the Mercy Health – Glass City Marathon recently announced that all money raised at the 2017 kids’ race will go to Mercy Health – Children’s Hospital to help fund lifesaving technology. Children’s has supported the kids’ portion of the marathon and is committed to growing participation in the event, which intro-duces children ages 2-12 to running. The goal is to have 1,000 children sign up. Mercy Health – Children’s once again is pleased to be offering educational opportunities for the pediatric com-munity. The 20th Annual Perinatal Conference will be held on a new date and in a new location. This year, the conference will be on Friday, March 24 at the Hilton Garden Inn. Also, the Dr. John T. Schaeufele Pediatric Summit

will be held on Friday, April 28 in the Mercy Health – St. Vincent Medical Center auditorium. This full day CME activity will focus on a variety of top-ics including gastroenterology, sports medicine, intensive care, hematology, and neurology.

Shakil A. Khan, MDMercy Health — St. Anne Hospital

For a third consecutive quarter, Mercy Health - St. Anne Hospital

received the Toledo area’s only 5-star rating for overall quality by the Centers for Medicare and Medicaid, placing St. Anne once again among a select few of the top hospitals in the country for this rating.

This 5-star rating is a testament to the level of quality care provided by the team at St. Anne and the work being done to deliver an amazing patient ex-perience. St. Anne previously achieved another quality award distinction this past year in patient safety recognizing how well a hospital prevents infections, medical errors and other preventable complications, and St. Anne was rec-ognized in Press Ganey’s top decile for inpatient experience. I’m proud to be a part of a team that consistently is recog-nized as a leader in quality care.

Patient experience and making access easier also continue to remain a top priority at Mercy Health – St. Anne Hospital. A key example is the Mercy Health – Sylvania Medical Center, which celebrated its one year anniversary in October. The full-service emergency department continues to garner top percentile in patient satisfaction scores. In fact, both the Perrysburg and Sylvania emergency departments were recently recognized with the Guardian of Excel-lence Award and the Pinnacle Award for

Recruiting nationally recognized clini-cal and research faculty to northwest

Ohio, as well as recruiting and retaining top students, residents and fellows in the health sciences, are among the goals of The University of Toledo College of Medicine and Life Science’s Academic Affiliation with ProMedica.

We are excited to see that begin to material-ize. The level of talent recently recruited to our region will have a positive effect on our efforts to enhance the training and education of medical students, residents and fellows in our region. Importantly, the leaders and physicians of ProMedica have been very involved in these efforts and each new chair understands how impor-tant it is to both organizations, and to our community, that the Academic Affiliation succeeds expectations.

Dr. Lance Dworkin has joined our team as the chair of the Department of Medicine. He comes to Toledo from Brown University where he was professor of medicine and vice chairman of medicine for research, academic affairs and ethics. He specializes in hypertension and his research interests include the mechanisms of progressive kidney failure and prevention.

Dr. Puneet Sindhwani is the new chair of the Department of Urology. He joins UT from the University of Oklahoma Health Sciences Center where he served as an as-sociate professor of urology and was the university’s chief of male infertility and andrology section and started the male reproductive health program.

Dr. Charles Brunicardi recently joined the college as chair of the Department of Sur-gery. He comes to Toledo from the David Geffen School of Medicine at UCLA where he has served as the professor-in-residence and vice chair for surgery and the Moss

(Dean’s Report continued on Page 20)


Fourth District Councilor’s Report

Longtime Leader of the Ohio State Medical Association Retires

Anthony J. Armstrong, MD

D. Brent Mulgrew, the longtime executive director of the Ohio State Medical Association

(OSMA), retired in January after a 42-year career at the state’s largest physi-cian-led organization. Mulgrew joined the OSMA in 1974 and assumed the top leadership post in 1992 where he remained until his retirement. “I want to thank the OSMA for giving me the opportunity to make a small difference in the world of health care during the last 40 plus years,” Mulgrew said. “I will retire leaving with four decades of memories that offer a mixture of pride-ful accomplishments and yet a yearn-ing wish to have done more. Working for the OSMA has been the best job I could have imagined.”

Todd Baker has been named the new CEO of the OSMA. Baker had served as director of professional relations for the OSMA and was selected by a group of OSMA physician leaders fol-lowing a national search for Mulgrew’s replacement.

OARRS Compliance Letters to Continue with Modifications

The State Medical Board of Ohio (Board) has no plans to stop sending OARRS compliance letters to Ohio physicians it says have committed at least one violation of the state’s opi-oid prescribing guidelines. The letters, which started in September, have been a concern for the OSMA and physi-cians across Ohio because of confu-sion over why many individuals who believe they are in compliance or are exempt from checking OARRS are re-ceiving the communication.

The OSMA met with the Board’s ex-ecutive director, A.J. Groeber, State of Ohio Board of Pharmacy executive di-rector Steve Schierholt and members

of their staffs in November. The meet-ing was arranged in response to the OSMA’s response to the letters. The OSMA sought clarification on why some physicians were being targeted with the letters and to encourage the Board to refine and increase specific information provided to each doctor so they can better assess any changes they might need to make.

The OSMA noted the Board must im-prove its messaging to physicians. The Board said it is committed to assuring its licensees understand OARRS and added that it would continue to hone in on clearer data that will help it pro-vide physicians with more definitive information for why they might be receiving the letters and how they can go about improving their compliance. The Board praised the response from physicians to the letters saying that thousands have contacted the Board to update their OARRS information or make other corrections that bring them into full compliance with the state rules. The Board noted, however, that the vast majority of physicians being contacted are not suspected of egre-gious errors but of occasional missed patient checks or incorrect registry in-formation needing to be updated.

Remembering Dr. Walter A. Reiling, Jr. and Dr. Thomas W. Morgan

Two renowned past-presidents of the OSMA recently died. Dr. Walter A. Reiling, Jr., who this past April was awarded the association’s Dis-tinguished Service Citation during the OSMA’s Annual Meeting, passed away on October 25. A week later Dr. Thomas W. Morgan, a trailblazer in the medical community, died on Novem-ber 2.

Dr. Reiling served as OSMA president from 1993-1994 but remained a highly-visible leader within the association long after he completed his one-year term. Dr. Reiling served as the Chief of Staff at Good Samaritan Hospital in Dayton for many years and was known as a transformative physician leader, noted for his medical research work. He also served as a member of Ohio’s Board of Regents. Throughout his ca-reer, Dr. Reiling was extremely active and volunteered with numerous other health care leadership organizations. He was the first Chairman of the Hos-pital Medical Staff Section in Ohio. He was also a chair of the Hospital Medi-cal Staff Section of the American Medi-cal Association (AMA) and Chairman of the Ohio Delegation and the Great Lakes Coalition at the AMA.

Dr. Morgan, who led the OSMA from 1979 to 1980, was noted for leading a project to build a new modern, multi-specialty medical facility in South-east Ohio. Holzer Hospital and Clinic opened in the late 1960s. A Diplomate of the American Board of Surgery, Dr. Morgan was the first surgeon to per-form carotid endarterectomy for stroke, aneurysm repair and bypass surgery for blocked leg arteries at Holzer. He also served as a member of the Board of Trustees and chair of the depart-ment of Surgery at Holzer. Dr. Mor-gan was a powerful and hardworking physician advocate at the OSMA. He spent many years interacting and en-gaging in work at the OSMA as well as other professional medical organiza-tions. Dr. Morgan served for 10 years as a member of the Ohio delegation to the AMA as well as a member of the American Association for Surgery of Trauma, the Board of Governors of the American College of Surgeons and the Ohio Chapter of the American College of Surgeons.


JoDee E. Ahrens, MD

President’s Page

Thoughts on Our Academy of Medicine

Something happened with the new millennium doctors stopped joining The Academy and they have left in large numbers. It speaks to the changes in our society. Membership in all organizations is declining. Social media serves as our sad substitute.

“Never doubt that a small group of thoughtful, committed

citizens can change the world; indeed it is the only thing that

ever has.”

— Margaret Mead

In 1851 eight physicians in Toledo met to form the Toledo Medical Asso-ciation, which has now become The Academy of Medicine of Toledo and Lucas County. We are their legacy.

In 1903 they joined forces with the Lucas County Medical Society, which was formed in 1894, to officially be-come The Academy of Medicine of Toledo and Lucas County. They re-mained on the forefront of the com-munity and its many health related troubles throughout the twentieth century. You can read the time line on the link in our web site or obtain a copy of The First 150 Years – A History of The Academy of Medicine of Toledo and Lucas County 1851-2001, authored by Barbara Floyd and Vicki L. Kroll in collaboration with S. Amjad Hus-sain, MD.

Something happened with the new millennium: doctors stopped join-ing The Academy and they have left in large numbers. It speaks to the changes in our society. Membership in all organizations is declining. So-cial media serves as our sad substi-tute.

Dr. Romanoff wrote an eloquent se-ries of essays detailing the benefits of organized medicine which were re-cently published in our magazine, To-ledo Medicine. The UTCOM medical

students have a very large presence at the AMA in their student section. They already seem to grasp that unit-ed we can make a difference, more so than if we stand alone.

No longer do we know our colleagues personally or professionally. And unlike physician assistants and nurse

practitioners, we are fragmented as a profession. We practice only in hos-pitals or our offices. Gone are the groups meeting in doctors’ lounges at hospitals or attending staff dinners together. We get home later because of the EHR. We struggle to see more patients to cope with the ever rising overhead in our offices. We are not allowed to simply have a bad day be-cause we are graded on how person-able we seem at any given moment. We cannot do a prescription refill be-cause the computer stops, we cannot

get into the operating room because the smoking history will not enter into the computer. The heart cath-eterization cannot proceed because the history and physical has not shown up on the data yet. On and on the problems come… Who “gets” it besides your fellow physicians?

The Academy of Medicine seems to be more important because our phy-sician colleagues are the only ones who know our lives, our struggles and our frustrations. Repeatedly, I have heard physicians say they hate the computer, the regulations, the intrusions in their physician/patient relationships and they want to just quit. Yet to a person they pause and say but I still love the patient care and that keeps me doing this job. The Academy is a small forum, but to take back our professions we must start somewhere.

We want and need our members to return to the fold and help to trans-form ourselves into a united group serving Toledo and Lucas County. It matters not where you draw your paycheck from in our medical com-munity.

Remember why you went into medi-cine. Surely it was to advocate for your patients, to promote health and wellness and to be a leader. Join us and help us leave that legacy for your families as our forefathers once dared to dream.

Please be that thoughtful group of concerned citizens who change our world.

:


Reportsmaintaining consistently high levels of excellence in patient experience, em-ployee and physician engagement and/or clinical quality performance.

Also on the way to all Mercy Health facilities is PerfectServe – a customiz-able clinical communications system designed for physicians. PerfectServe was first introduced at Mercy Health – St. Vincent Medical Center in late 2014. It will give physicians more control and improved patient care and improve their collaborative efforts with colleagues. PerfectServe enables users to selectively filter and control their contacts based on criteria like patient condition and origi-nating facility; then decide the method and appropriate time for contact based on personal preference.

Rajender K. Ahuja, MDMercy Health — St. Charles Hospital

Mercy Health is proud to be part-nering with Unison Behavioral

Health Group with the creation of a treatment facility to address the grow-ing opioid addiction issue in Toledo. Unison announced that, with Mercy Health and support from the Mental Health & Recovery Services Board, it will open a subacute detoxification unit to provide needed medically supervised detoxification services. In doing so, Unison will enhance its clinical part-nership with Mercy Health to develop clinical programs and services to serve adult, chemically dependent men and women. Mercy Health has committed to the community’s behavioral health through the opening of the Behavioral Health Institute on the Mercy Health – St. Charles Hospital campus. Together, we continue to work for the betterment of our community.

Due to the growing demand for cardiac rehab services and congestive heart fail-ure services, St. Charles has expanded our current cardiac space to create capac-ity for these services. The construction and redesign has created more space for cardiac rehab patients and heart failure patients seeking services in the community. Post-acute care is a critical component for continued recovery of patients suffering with these diseases.

Another addition is a new infusion center for patients in need of infusion services in the community. The recently opened center will do all infusions with the exception of chemotherapy infusions.

Also new to St. Charles is John Roost, DO, an obstetrician and gynecologist, who has an interest in robotic surgery. Dr. Roost recently completed his train-ing to start performing robotic surgery at St. Charles, closing a gap on a much needed service in the area.

And although the holidays are over, I’d be remiss not to mention the hos-pital’s annual support of the holiday family adoption program through the East Toledo Family Center. In 2016, the team at St. Charles adopted 24 families. Departments throughout the hospital were very generous in providing a merry Christmas to those in our community in need.

Randall W. King, MDMercy Health — St. Vincent Medical Center

Mercy Health has elevated the fight against cancer with the opening of

the Mercy Health – Perrysburg Cancer Center, which is a department of Mercy Health – St. Vincent Medical Center. Now serving patients from throughout

the region, the freestanding cancer cen-ter offers diagnostics, radiation therapy, clinical trials and more. Born of a unique partnership between Mercy Health, The Toledo Clinic’s medical oncologists and Toledo Radiation Oncology, the cancer center provides a single, coordinated care pathway for all patients, providing improved integration and coordination of care.

St. Vincent is also proud to share that The Neuroscience Institute at Mercy Health - St. Vincent Medical Center has earned The Joint Commission’s Gold Seal of Approval® and the American Heart Association/American Stroke As-sociation’s Heart-Check mark for their achievement in earning the Advanced Certification for Comprehensive Stroke Center accreditation. This is the highest level of accreditation for stroke care with only 110 comprehensive stroke centers in the country.

Congratulations to all physicians and staff who worked hard to secure this cer-tification. The designation will further the region’s vision to deliver world class experiences and care as well as improve the community health and wellbeing for patients needing stroke care.

In a continued focus to make access easier for our patients, Mercy Health – Life Flight Network has developed an auto-launch algorithm to immedi-ately launch transportation for all acute stroke and STEMI heart attack patients being transferred to St. Vincent from area hospitals. The auto-launch system will streamline inter-facility transfers in ultra-time-sensitive situations. The program was a collaboration of Life Flight and the physicians and members of the Mercy Health – Neuroscience



Institute and the Mercy Health – Heart and Vascular Institute.

The process results in improved access to St. Vincent’s specialists and interven-tions, while simultaneously improving patient outcomes through decreased duration of cerebral and myocardial ischemia, and improved results for national quality benchmark standards such as door-to-balloon times and door-to-drug times.

Manish M. Thusay, MDProMedica Bay Park Hospital

As we wrap up 2016, it has been a busy and collaborative year at

ProMedica Bay Park Hospital.

Recent accomplishments at ProMedica Bay Park Hospital provide a reminder of the importance of our Mission to im-prove the health and well-being of those we serve. These successes highlight the ways that great strides are being made to ensure that patient care remains our number one priority.

The team at ProMedica Bay Park Hos-pital is on a journey to become a highly reliable organization that focuses on patient safety and high quality outcomes for our patients. Our staff believes in focusing on a personal commitment to safety, communicating clearly and pay-ing attention to detail in order to prevent patient harm. The team works daily to create a culture of safety that fosters a healthy environment for our patients, physicians and staff. For example, sur-gery can be a dangerous area of care due to the fact that scalpels, sutures and in-jection needles are typically present for all surgical procedures. The ProMedica Bay Park Hospital operating room staff has gone more than 700 days without a sharps injury. This great achievement is attributed to the operating room staff focusing on a culture of safety. Our dedicated and caring staff takes great pride in creating a safe environment for all patients and employees.

(from page 17)

In closing, the entire staff at ProMedica Bay Park Hospital contributed a tremen-dous amount of effort and dedication to seamlessly launch our new electronic health record system on November 1. Thank you to everyone for being as help-ful as possible to fellow staff and physi-cians during our successful go-live.

Here’s to continuing to be Well Con-nected with each other and our patients into 2017 and beyond!

Henry H. Naddaf, MDProMedica Flower Hospital

The Cancer Genetics Program at Pro-Medica Flower Hospital’s Hickman

Cancer Center recently won $50,000 worth of genetic testing vouchers to help patients who are unable to afford genetic testing. The vouchers will ben-efit patients seen system-wide through the program. Female professional surfer, Dimity Stoyle, represented Flower Hospital in a surfing competition known as the “Battle for the Breasts” and won the online vote, earning the prize of $50,000 in genetic testing vouchers from Ambry Genetics. Genetic testing can help indi-viduals who have had family members with a history of cancer learn more about their own risks. Those with a history of cancer can also learn the chances of their children having a similar diagnosis. Flower Hospital is expanding imaging capabilities by adding a new 64-slice CT scanner on the ground floor. A second 64-slice CT scanner is also planned in 2017. The scanners will provide enhanced image quality for providers and create efficient service for patients. The Breast Care Center has moved to the ground floor of the hospital and a 3D breast tomosynthesis unit is now installed to improve breast cancer detection. The Flower Hospital Medical Staff Dinner is scheduled for Friday, March 10 at 6 p.m. at Sylvania Country Club. The theme is “All Aboard”, a riverboat

casino night. Enjoy refreshments, din-ner and games while celebrating the achievements of colleagues. Flower Hospital medical staff, please save the date!

Howard M. Stein, MDProMedica Toledo Children’s Hospital

ProMedica Toledo Children’s Hos-pital is pleased to welcome Loyal

Coshway, MD, and Kathleen Moltz, MD, pediatric endocrinologists, to its medical staff. Drs. Coshway and Moltz join the team of Mark Watkins, DO, Lisa Richards, CPNP, and Sheri Luke, CNP, at the Endocrine and Diabetes Care Center.

Dr. Coshway completed her fellowship in pediatric endocrinology at Nation-wide Children’s Hospital, Columbus, Ohio and her residency in pediatrics at William Beaumont Hospital, Royal Oak, Michigan. She received her medical de-gree from The University of Toledo Col-lege of Medicine. Her special interests include diabetes, adrenal insufficiency, thyroid disorders, hypopituitarism and hypocalcemia.

Dr. Moltz completed her fellowship in pediatric endocrinology at Yale Uni-versity, New Haven, Connecticut and her residency in pediatrics at Wayne State University, Detroit, Michigan. She received her medical degree from Michigan State University, East Lansing, Michigan. Her special interests include diabetes as well as other pediatric endo-crine disorders. She enjoys lecturing and has received several teaching awards. The expansion of Toledo Children’s Hospital endocrinology and diabetes care team improves access for children and families struggling with diabetes, growth and hormone issues and thyroid issues.

Peter F. Klein, MDProMedica Toledo Hospital

In November 2016, ProMedica Toledo Hospital was named one of the na-


The Community Health Com-mission of The Academy of Medicine of Toledo and Lucas

County has named the ‘Opioid Cri-sis’ a primary area of concern for the 2016-2017 year.

Heroin and opiate use in our com-munity is an epidemic, and in many cases fueled by the abuse of prescrip-tion opioid medications. Fatal drug overdoses are the leading cause of accidental death in Ohio, and statis-tics are rising aggressively as opiates such as Fentanyl are cut with hero-in. The Lucas County Coroner’s of-fice, which tracks heroin and opioid deaths in 19 Northwest Ohio coun-ties and 2 counties in Southeastern Michigan, has reported an increase from 8 deaths in 2010 to 215 deaths in 2015. In response, organizations such as the Governor’s Cabinet Opiate Ac-tion Team (GCOAT) and the Mental Health and Recovery Services Board of Lucas County have developed ini-tiatives to fight the Opioid Crisis.

GCOAT was established in 2011 to as-sist in the fight against opioid abuse and targets law enforcement, pub-lic health, addiction and treatment professionals, healthcare providers, educators, and parents. The Lucas County Heroin and Opiate Initiative, funded by the Mental Health and Recovery Services Board of Lucas County, is a collaborative initiative that focuses on community outreach. Their staff provides resources and presentations to assist with the pre-vention of prescription drug abuse and to those who are suffering from addiction.

What do we need to know as part of the medical community? What can we do in our daily practice?

• Address the rise in deaths from opioids

o Support the use of Naloxone by first responders and fam-ily members of opiate addicts, realizing that it does not address the root cause of addiction, but it does save lives

• Be aware of the established path-ways for treatment and recovery

o GCOATo Lucas County Heroin and Opi-ate Initiative

• Focus on Prevention

o Education in schools and public awareness campaignso Support and advertise drug takeback days in our offices

• Emphasize Safe Prescribing

o Utilize non-opioid therapies whenever possibleo Utilize OARRS (Ohio Automat-ed Rx Reporting System) for all prescriptions of opioidso Be aware of the expanded Ohio Opioid Prescribing Guidelineso Develop processes in our own practices that make the prescrip-tion of opioids safe with the im-plementation of controlled sub-stance contracts

• Have your “go to” resources

o Start Talking! tips from http://starttalking.ohio.gov

o The Addiction Hotline through the United Way of Greater Toledo 211 serviceo www.aplaceformaryhbh.org is an on line resource for assistance to families with loved ones who have addiction problemso OPI-RESCUE APP https://opirescue.com/ o Project Dawn Website http://www.healthy.ohio.gov/vipp/drug/ProjectDAWN.aspxo Ohio Substance Abuse and Monitoring Network Reports (quarterly by year, by county) http://mha.ohio.gov/Default.aspx?tabid=514o The Ohio Academy of Fam-ily Physicians online prescribing guidelines and tools

Today’s heroin addict is your next-door neighbor. They defy socio-eco-nomic definition and are found in all zip codes. Unfortunately, prescribed opioids are highly addictive and thus legally written prescriptions for pain management have become a gate-way to heroin addiction. The heroin that is available is often mixed with more potent opioids, like fentanyl, resulting in the growing number of opioid deaths. Naloxone simply saves lives—we must also manage the flow of prescription opioids. For-tunately, with the use of OARRS, the serious attempt to close “pill mills”, and the establishment of opioid pre-scribing guidelines, the number of opioid doses dispensed in Ohio has significantly decreased over the last several years. We can only hope that, by further efforts and greater aware-ness by all those involved, we will turn the tide of the Opioid Crisis.

Opioid Crisisby Jeanine S. Huttner, MD

In My Opinion


Fifteen years ago, I was told that if I voluntarily attended a one hour seminar on risk manage-

ment sponsored by my malpractice insurer, I would enjoy a substantial reduction in my malpractice insur-ance premium. Well sure, why not?

A couple of years later, it was a two hour quasi-voluntary seminar. The past two years it has become a man-datory 3 hour on line tutorial with a mandatory must pass quiz at the end of each hour segment to ensure you didn’t watch the game instead of the slides or listen to the stereo instead of the talking heads.

For the past several years, I have had to watch a mandatory OSHA brief-ing on hazardous materials, blood, and infective materials; again with a must pass quiz at the end. And let us not forget the mandatory HIPPA briefing with requisite quiz at the end.

And now before I can see a patient in my office, there are reams of forms and government mandated paperwork that must be completed before I can legally see the patient. Then of course, there is the paper-work demanded by the insurer that must be completed if I expect to be paid for my services.

The demands upon physicians have grown exponentially in the past de-cade. And we are not alone. Esti-mates are that government regula-tions have drained some 3.6 billion USD’s from our economy in the past decade.

Now I’m not talking about restric-tions and regulations that make sense. Licensure ensures that the unsuspecting public is not mali-ciously or dangerously fleeced or harmed by the nefarious or the un-trained. And some demonstration of the maintenance of those skills makes sense.

However, physicians are being dic-tated to increasingly by those who neither understand nor necessar-ily appreciate what we do. And it isn’t always by those with an ax to grind against a group regarded as “privileged” and therefore a target. Sometimes it is regulation to justify the life and times of those adminis-tering the regulations. A great gig for some.

As physicians, we are used to shoul-dering great responsibility and it rankles to have someone who doesn’t understand what it takes to be in a position to wield the au-thority to meet the demands of that responsibility, steam roll with their mandates.

Unfortunately, we must take a large portion of the blame for the man-dates. As usual, a few bad actors spoil it for the rest of us, and we need to ensure our peer review and state medical authorities do the job of rooting out the dangerous and incompetent. But that surely is a miniscule fraction of our collective body.

The reason we are being pushed around with impunity is our loss of cohesion. Multiple authors on these pages have decried the decline in or-ganized medicine. The price we pay is lack of the ability to say “shove off” to intrusive mandates and the authorities administering them.

If we could ever get our act together and behave as a cohesive force, we would be able to inject some sanity into the world of mandates. I cite as the most successful example the case of the medical malpractice en-vironment in the state of Ohio. I can count substantial dollars in my pocket thanks to the efforts of the Ohio State Medical Association and their successes in reining in the ex-cesses of the medical malpractice world. The gains are always just an

Ohio Supreme Court election from going away, however, and we can never forget that.

But if we ever expect to push back with any real effect, then we need to remember that together we are stronger than we are apart. I am reminded of Ben Franklin’s admon-ishment to the Continental Congress that “We must, indeed, all hang to-gether, or most assuredly we shall all hang separately”.

— Ted E. Barber, MD, MBA

Mandates

Editorial


tion’s 50 Top Cardiovascular Hospitals by Truven Health Analytics,TM an IBM company. More than 1,000 hospitals across the country were independently evaluated on their inpatient cardiovas-cular programs and Toledo Hospital placed in the top 5% for achieving superior clinical outcomes.

The Truven Health 50 Top Cardiovas-cular Hospitals study uses data col-lected by the Centers for Medicare and Medicaid Services to measure hospital performance. Areas evaluated include hospital readmission rates, the average length of stay, mortality rates and cost of care. According to the data, the 50 Top Hospitals had fewer readmissions and patient complications, higher inpatient survival rates, shorter hospital stays and lower cost procedures.

Also in November, Toledo Hospital along with three other ProMedica hos-pitals and 90 ProMedica Physicians’ offices made the switch to Epic for their electronic health records. This launch, which has been the largest one to date for ProMedica, was no small feat. Over 5,000 employees and providers were trained on the new system. More than 130 people were involved in manag-ing the patient registration, order and medication backload process before the launch. And, approximately 800 internal super users received advanced training to provide on the ground support.

Timothy J. Mattison, MDSt. Luke’s Hospital

It has now been a mere 6 months since the effective date of our divestiture

from ProMedica. It has been a busy time for the Administration and the Medical Staff. We continue to be the only hospital in the area which takes every major insurance. We continue all of us to strive to give the best care to our patients while the administration remains committed to providing the best quality at the lowest cost. We also remain committed to maintaining all the services we have been providing our community and look for more op-

portunities to serve our community and our patients.

ProMedica has graciously agreed to help us through our transition back to being an independent health care provider by continuing to temporarily support us with services ranging from IT to HR and payroll.

As we all know, EHR is the infrastruc-ture that can make or break a good healthcare facility. It is also one of the biggest expenses, after payroll, that a hospital faces. We have begun a major overhaul of our IT infrastructure. We are looking at upgrading most of our soft-ware. We have started to transition the first of our WellCare Physician practices from Allscripts to eClinical Works. We are working on converting our hospital EHR from McKessen to Cerner and hope to have that completed before the end of this year.

I, of course, have been working with our usual team to plan for the St. Luke’s Hospital Annual Medical Staff dinner to be held at the Hilton Garden Inn at Levis Commons on Saturday March 4th.

I want to take the time to acknowledge one of my predecessors on whose shoulders I have been standing. Dr. Dan Williams was a Past Chief of Staff, SLH Board Member, who has actively helped guide me with his 10 years of experi-ence on the Credentials Committee. He has taken a well-deserved retirement. In addition to his love and support of St. Luke’s Hospital, “Dr. Dan” will be best remembered for his great sense of humor and sack full of jokes he always carried with him.

Thomas A Schwann, MDThe University of Toledo Medical Center

The University of Toledo Medical Center has earned a high ranking

by Consumer Reports as one of the country’s safest teaching hospitals with the lowest rate of central line associ-ated blood stream infection (CLABSI) rates.

UTMC is proud to have been named one of America’s 32 best teaching hospitals at preventing central-line infections in intensive care units (ICUs). Consumer Reports studied federal data from 2011 to 2015 that showed UTMC had just between one and five central line infec-tions in each of the years studied. Patient safety is our top priority and this report reflects the emphasis that institutional leadership has placed on eliminating hospital-acquired infections and the hard work that our physicians, nurses and entire staff have put in to reduce the number of these infections.

Each year there are approximately 250,000 CLABSI nationwide and up to 100,000 deaths are attributed each year to hospital-acquired infections with CLABSI accounting for a third of these deaths. The Center for Disease Control estimates that the annual cost of CLABSI is upwards of $1 billion or roughly around $16,000 per each event. Given the University’s mission “to improve the human condition,” it is vital for UTMC as a teaching hospital to focus on safety as we prepare the next generation of physicians to serve our community.

The recognition reflects our increased focus on infection prevention protocols, including strict hand hygiene, standard-ization of procedures and forming a specially trained vascular access team of nurses who are the only ones that handle central lines and dressings. Such meticulous dedication to evidence-based protocols that have been shown to de-crease CLABSI has led to the hospital experiencing a 55 percent reduction in the infection rate associated with central lines since 2012, as well as a significant decrease in all hospital-acquired infec-tions.

Preventing hospital-acquired infections is essential to optimizing outcomes of patients who are increasingly older, have more morbidities and have complex health problems, which contribute to them frequently not being able to recov-



er from an iatrogenic infection. UTMC is proud of the collaborative efforts of all stakeholders without whose dedi-cation this effort would not have been possible. We are honored and proud of the recognition for our staff’s efforts to improve the patient experience.

(from page 19)

Foundation Chair in Gastrointestinal and Personalized Surgery. His clinical inter-ests include endocrine surgery, islet cell transplant, liver surgery, neuroendocrine tumors, oncology, pancreatic cancer and translation genomic medicine and surgery. His research focuses on translational pre-cision medicine and surgery, specifically pertaining to pancreatic cancer.

Dr. James Van Hook will join the College of Medicine in March as chair of the De-partment of Obstetrics and Gynecology. He has served as professor and director of the Division of Maternal-Fetal Medicine at the University of Cincinnati College of Medicine and Cincinnati Children’s Hos-pital since 2008. His clinical and research interests include hypertensive disorders of pregnancy, women’s health and rehabili-tation, physician health, and critical care obstetrics and gynecology.

In addition, Dr. Thomas Papadimos has joined the University as a professor and chief of the Division of Critical Care Medi-cine. He serves as the medical education director for the Jacobs Interprofessional Im-mersive Simulation Center. Dr. Papadimos comes to Toledo following service as vice chair of academic affairs in the department of anesthesiology at The Ohio State Uni-versity and director of critical care services at the Ross Heart Hospital.

Please join me in welcoming these health care leaders to our community.

— Christopher J. Cooper, MD

(Dean’s Report continued from page 16)

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Winter 2017 TOLEDOMEDICINE 1

EditorialIn My Opinion

President’s Page4th District Councilor’s Report

Alliance Activities UTCOM Report

Hospital Reports

Send information to: TOLEDOMEDICINE The Academy of Medicine, 4428 Secor Road Toledo, Ohio 43623 Ph. 419.473.3200 Fx. 419.475.6744 [email protected]

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President-ElectChristopher A. Bates, MD

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Editorial Board

EditorS. Amjad Hussain, MD

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Ted E. Barber, MD, [email protected]

Stephen P. Bazeley, [email protected]

Gerald W. Marsa, [email protected]

James G. Ravin, [email protected]

J. Gregory Rosenthal, [email protected]

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C O V E R S T O R Y

Academy of Medicine 2017 Annual Meeting

TOLEDOMEDICINE is an official publication of The Academy of Medicine of Toledo and Lucas County

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Winter 2017

Volume 108

No. 1TOLEDOMEDICINE10

F E A T U R E S

D E P A R T M E N T S02030405081616

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On the cover:

Character in MedicineJ. Gregory Rosenthal, MD

JoDee E. Ahrens, MD, President

09Valentine Mural: Billie Burke James G. Ravin, MD

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