About the SMJ


For the Integrated Multidisciplinary Approach to Patient Care

About the Southern Medical Journal

As the official journal of the Birmingham, Alabama-based Southern Medical Association (SMA), the Southern Medical Journal (SMJ) has for more than 100 years provided the latest clinical information in areas that affect patients' daily lives. Now delivered to individuals exclusively online, the SMJ has a multidisciplinary focus that covers a broad range of topics relevant to physicians and other healthcare specialists in all relevant aspects of the profession, including medicine and medical specialties, surgery and surgery specialties; child and maternal health; mental health; emergency and disaster medicine; public health and environmental medicine; bioethics and medical education; and quality health care, patient safety, and best practices. Each month, articles span the spectrum of medical topics, providing timely, up-to-the-minute information for both primary care physicians and specialists. Contributors include leaders in the healthcare field from across the country and around the world. The SMJ enables physicians to provide the best possible care to patients in this age of rapidly changing modern medicine.

As an accredited provider of CME by the Accreditation Council for Continuing Medical Education and in accordance with the ACCME’s Standards for Commercial Support, Southern Medical Association requires that all individuals in a position to affect the content of a CME activity disclose to the learners relevant financial relationships with commercial interests. Further, any relationship determined to be a conflict of interest will be resolved prior to the activity. For Journal CME articles, author disclosures are published in the footer section of each article. The editor, editorial staff, reviewers and planners for Journal CME articles have no relevant financial relationships to disclose and no conflicts of interest to be resolved.

Editorial Board

G. Richard Holt, MD, MSE, MPH, MABE, D BE
University of Texas Health Science Center
San Antonio, Texas

Associate Editors
Amy Ernst, MD, Emergency Medicine
University of New Mexico School of Medicine
Albuquerque, NM
December 2015

Colonel Joseph Brennan, MD, Head and Neck Surgery
San Antonio Military Medical Center
San Antonio, Texas
December 2016

Philip F. Stahel, MD, FACS, Orthopedics
Denver Health Medical Center
Denver, Colorado
December 2017

Editorial Board
Steven T. Baldwin, MD, Pediatric Emergency Medicine
University of Alabama at Birmingham/Children's Hospital of Alabama
December 2017

Frederick E. (Rick) Barr, MD MSc, Pediatrics
Assistant Editor for Child Health
Batson Children's Hospital, University of Mississippi Medical Center
Jackson, Mississippi
December 2017

Robert Brooks, MD, MA, MBA, MPH, Internal Medicine & Infectious Diseases
Assistant Editor for Medicine and Medical Specialties
University of South Florida, Tampa
December 2017

Rachel Brown, MD, M Phil, Psychiatry
Assistant Editor for Medical Education
University of Missouri School of Medicine
Columbia, Missouri
December 2016

Mary Jane Burton, MD, PhD, Infectious Diseases
University of Mississippi School of Medicine
Jackson, Mississippi
December 2018

Jason Collins, MD, FACEP, Emergency Medicine
Assistant Editor for Emergency and Disaster Medicine
Texas A&M HSC College of Medicine|
Temple, Texas
December 2015

Vanessa Diaz, MD, MS, Family Medicine
Medical University of South Carolina
Charleston, South Carolina
December 2015

David A. Fleming, MD, MA, FACP, Internal Medicine, Bioethics
Assistant Editor for Bioethics
University of Missouri School of Medicine
Columbia, Missouri
December 2016

Lawrence Frisch, MD, MPH, Population Health
Vancouver Coastal Health Research Institute
Vancouver, Canada
December 2018

John Hardt, PhD, Bioethics, Health Policy
Neiswanger Institute for Bioethics and Health Policy
Loyola University-Chicago’s Stritch School of Medicine
December 2016

James H. Holmes, IV, MD, Surgery
Assistant Editor for Surgery & Surgical Specialties
Wake Forest Burn Center
Winston-Salem, North Carolina
December 2018

Kyle J. Kalkwarf, MD, General Surgery Resident
University of Arkansas for Medical Sciences
Little Rock, Arkansas
December 2017

Robert Oldham, MD, MS, Psychiatry
Assistant Editor for Mental Health
Fresno County, CA Department of Behavioral Health
University of California at San Francisco School of Medicine
December 2015

Kristen Plastino, MD, Obstetrics & Gynecology
Assistant Editor for Women’s Health
University of Texas Health Science Center at San Antonio
December 2015

Joann Schulte, DO, MPH
Assistant Editor for Public Health and Environmental Medicine
University of Texas Southwestern Medical School
Dallas, Texas
December 2016

Michael A. Thomas, MD,
Reproductive Endocrinology and Infertility
University of Cincinnati School of Medicine
Cincinnati, Ohio
December 2018

International Editorial Board Members
Florian Bruns, MD, Medical Ethics
Charite Center for Humanities and Health Sciences
Berlin, Germany
December 2017

Andrew Elder, MBChB, FRCP, Geriatric Medicine
Royal Infirmary of Edinburgh
Edinburgh, Scotland
December 2018

Paul Froom, MD, MOccH, Epidemiology and Preventive Medicine
Sackler School of Medicine
Tel Aviv, Israel
December 2018

Martin Kreis, MD, Surgery
Department of Surgery
Benjamin Franklin Hospital
Berlin, Germany
December 2017

Olivia Kreze, MD, PhD, FRCPath, Hematology
Newham University Hospital
London, England
December 2017

Rowan Parks, MD, FRCS, General Surgery
Royal Infirmary of Edinburgh
Edinburgh, Scotland
December 2018

Ramon Parsa-Parsi, MD, Hematology-Oncology, International Affairs
German Medical Association
Berlin, Germany
December 2017

Julia Tainijoki-Seyer, MD, Public and International Health
World Medical Association
Ferney-Voltaire, France
December 2017

SMA Officers, 2014-2015
Mark S. Williams, MD, MBA, JD, CPE
Indian Springs, AL

Benjamin M. Carmichael, MD
Hattiesburg, MS

Immediate Past President
Stuart Goodman, MD, MBA
Clinton, MD

Executive Director
Randall E. Glick, BSB/PM, MCP
Birmingham, AL

Each member of the Southern Medical Journal Editorial Board, if not a current member of the Southern Medical Association, is supplied with a complimentary SMA membership for the term of his or her Board service. Association membership includes a complimentary subscription to the Southern Medical Journal. There is no other compensation

Publishing & Editorial Staff

Celia Braithwait
[email protected]

Production Editor
Anita McCabe
[email protected]

Translation, Rights & Licensing
Silvia Serra
[email protected]

LWW Business Offices 
Two Commerce Square, 2001 Market Street
Philadelphia, PA 19103
Phone: 215-521-8300

G. Richard Holt, MD, MSE, MPH, MABE, D.Bioethics
325 E Sonterra Blvd, Suite 210
San Antonio, TX 78258
[email protected]

Managing Editor
Jennifer Price, MA
[email protected]

Author/Submission Questions
[email protected]

Association Headquarters
Southern Medical Association
35 Lakeshore Drive
Suite 201
Birmingham, Alabama 35209
Phone: 800-423-4992 or 205-945-1840

Disclaimer: Opinions expressed by the authors and advertisers are their own and not necessarily those of the Southern Medical Association, the Publisher, the Editor, or the Editorial Staff. The Association, the Publisher, the Editor, and the Editorial Staff are not responsible for the authenticity of the opinions or statements made by the authors in communications submitted to the Journal for publication. The author or communicant shall be held entirely responsible. The Association, the Publisher, the Editor, and the Editorial Staff do not guarantee, warrant, or endorse any product, service, or claim made or advertised in this publication.