SMJ : March 2020 Issue

March 3, 2020 // Randy Glick

The Southern Medical Journal is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists, including medicine; surgery; women’s and children’s 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.

Southern Medical Journal, Vol. 113, No. 03, March  2020

Bioethics & Medical Education

Worldviews Matter in Medical Practice
Scott McAninch, MD

CME Article: Sleep Patterns and Health Behaviors in Healthcare Students
Kenneth Nugent MD, Rishi Raj MD, Rebecca Nugent PhD

Women's and Children's Health

High Prevalence of Buprenorphine in Prenatal Drug Screens in an Appalachian City
Charlotte Alexander, MD, Kevin Breuel, PhD, Martin Olsen, MD

Characterization of Young Children Presenting to the Emergency Department for Mental Health Complaints
Keri Read, MD, Justin Schwartz, MD, Jesse Martinez, MD, Susan Bennett Smith, LICSW, PIP, Kathy Monroe, MD

Medicine and Medical Specialties

Utilization of Acid Suppression Medication in an Underserved Population
Simon Akhnoukh, MD Candidate, Ariel Croker, MD, Gabriel Soliman, BA, Jennifer Acevedo-Giron, BA, Damaris Viera, ARNP, Jose Barboza, PharmD, Karim Hanna, MD

Are Salt Tablets Effective in the Treatment of Euvolemic Hyponatremia?
Ittikorn Spanuchart, MD, Hideaki Watanabe, MD, Thomas Aldan, MD, Dominic Chow, MD, PhD, Roland C.K. Ng, MD

Quality Care and Patient Safety

Improving Critical Value Read-Back Failure Rate by Modifying the Notification Procedure
Shauna Harris, MD, William Leech, BS, Daniel Matienzo, BS, Sonia Berrios Villanueva, MPA, Joshua Fogel, PhD, Maggie Tetrokalashvili, MD, John Riggs, MD

Check-in Kiosks in the Outpatient Clinical Setting: Fad or the Future?
Zachary A. Mosher, MD, Parke W. Hudson, MD, Sung R. Lee, MD, Jorge L. Perez, MD, Alexandra M. Arguello, BS, Gerald McGwin, MS, PhD, Steven M. Theiss, MD, Brent A. Ponce, MD

Public Health and Environmental Medicine

Temporal Trends and Geographic Variations in Mortality Rates from Prescription Opioids: Lessons from Florida and West Virginia
Sarah A. Palumbo, BS, Charles H. Hennekens, MD, DrPH, Janet D. Robishaw, PhD, Robert S. Levine, MD

Vaping: Safer Than Smoking?
Paola Galan Villar, MD, Faysal Alhasan, MD, Steven Lippmann, MD

Posted in: SMJ

Meet the SMA Past President: Philip Hartman, MD

February 24, 2020 // Randy Glick

Meet Dr. Philip Hartman — Family Practice Physician at St. Elizabeth. Dr. Hartman was the President of SMA for the 2019-2020 year. Recently, Dr. Hartman was interviewed by St. Elizabeths for an insider of the life of a physician and SMA is pleased to share that insight with its members and viewers.

Originally from Southwest Ohio, Dr. Hartman received his bachelors of science in Biology at Wheeling Jesuit University in West Virginia and returned to the Cincinnati area for medical school at the University Of Cincinnati College of Medicine.  After medical school, he became a board certified Family Physician through training with St Elizabeth Healthcare of Northern Kentucky. He practices broad-based, integrative family medicine in an outpatient setting for infants through the elderly, performing numerous procedures, acupuncture for the treatment of pain and traditional Western medicine for other chronic disease states and ailments such as obesity, diabetes, hypertension, and drug addiction. He is passionate about providing for his patients' needs with high quality, evidence-based care.

He regularly teaches medical students from his own alma mater as well as the University of Louisville, holding a gratis associate faculty positions at each. Taking his mission abroad, he has left the country numerous times to see patients in Belize and Haiti.

In his spare time, he enjoys reading suspense novels and participating in outdoor activities with his wife, three children and two dogs. He also enjoys farming and attempts to play an active role in the production of as much of his family's food as possible through raising fruit trees, crops, chickens, fish and bees.

Video made by St. Elizabeth Healthcare

American Heart Month: SMA’s Hypertension Resources

February 10, 2020 // Randy Glick

Modalities to Achieve Hypertension Control in Clinical Practice: A Call to Action

Price: $10 | Credits: 1

Cardiovascular disease continues to be the leading cause of morbidity and mortality in the U.S. and now globally. Hypertension also remains one of the major risk factors for cardio disease including heart disease (coronary heart disease, congestive heart failure, left ventricular hypertrophy, and arrhythmia), cerebrovascular disease (stroke), and renal disease (renal insufficiency and failure). Despite safe and effective treatment for hypertension, the awareness, treatment, and control rates for hypertension are disappointing, including in the United States (hypertension control rates of approximately 50-60 percent).
Take this Course

Competing Hypertension Guidelines: Where Are We Now?

Price: $10 | Credits: 1

Despite safe and effective non-pharmacologic and pharmacologic treatment for hypertension, the cardiovascular disease burden attributed to partially or untreated hypertension continues to be a major public health crisis. To address this disease burden in the United States, and now globally, hypertension guidelines have been periodically developed to aid in the clinical diagnosis, management, and treatment of the individual with hypertension. Recently in 2018, the American College of Cardiology and the American Heart Association (ACC-AHA) released new hypertension guidelines. These guidelines differed greatly from previous guidelines in the United States as well as other countries. Given the magnitude of the changes in these guidelines, there is a need to review these guidelines and the evidence-based medicine that led to the changes proposed and to determine the clinical applicability of the guidelines.
Take this Course

Hypertension: Still a Significant Health Concern

Price: FREE | Credits: .5


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Other Heart Health Resources

February is known as American Heart Month: Heart disease is the leading cause of death for both men and women in the United States. This month, educate yourself on symptoms, treatment and prevention. Here is playlist of all former CME courses featuring heart disease/heart health topics.

To learn more about American Heart Month, click the button to visit the American Heart Association's website.
Learn more about American Heart Month

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SMJ : February 2020 Issue

February 4, 2020 // Randy Glick

The Southern Medical Journal is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists, including medicine; surgery; women’s and children’s 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.

Southern Medical Journal • Vol. 113 • No. 02 • February 2020

Emergency Medicine & Disaster Preparedness
Changes in Proportions of Emergency Department Patients with Mental Illness Noted in the National Hospital Ambulatory Medical Care Survey, 2012–2015
La Vonne A. Downey, PhD, Amanda Hong MBA, Karina Herrera, BA

Assessment of the Need for Immediate Trauma Team Presence for Infants Presenting in Cardiac Arrest
Emily C. Alberto, MD, Lauren J. Waterhouse, BS, Jennifer L. Fritzeen, MSN, RN, Constance R. DiAngelo, MD, Victoria H. Scheidt, , Randall S. Burd, MD, PhD

Increasing Comfort with Sensory Processing Difficulties in the Prehospital Setting: Pre-Post Study of Education and Sensory Tools in EMS Providers
Nipam Shah, MBBS, MPH, Katherine Hert, BS, Ann E. Klasner, MD, MPH

Quality Care & Patient Safety
Sex Differences in the Association between Local Government Spending and Mortality: Evidence from Tennessee
Courtnee Melton-Fant, PhD, Scott Howard, MD, MSc, Xueyuan Cao, PhD

Bioethics & Medical Education
Changes in Health and Well-Being during Residents’ Training
Christopher E. Wee MD, Jacob Petrosky MD, Lauren Mientkiewicz DO, Xiaobo Liu PhD, Krishna K. Patel MD, Michael B. Rothberg MD, MPH

Public Health & Environmental Medicine
Utilization of Healthcare Resources by HIV-Positive Children in the United States: A National Perspective
Brook T. Alemu, PhD, MPH, David W. Brock, PhD, Sara N. Abate, BS, Brian C. Martin, PhD

Medicine & Medical Specialties
Epilepsy and Physical Activity in US Adults
James R. Churilla, PhD, MPH, Adrian J. Boltz, MSH, Tammie M. Johnson, DrPH, MPH, Michael R. Richardson, MSH

Same-Admission Cholecystectomy Compared with Delayed Cholecystectomy in Acute Gallstone Pancreatitis: Outcomes and Predictors in a Safety Net Hospital Cohort
Stephen Berger, MD, Cesar A. Taborda Vidarte, MD, Shani Woolard, MD, Bryan Morse, MD, Saurabh Chawla, MD

Prevalence and Clinical Impact of Atrial Fibrillation in Patients with Pulmonary Embolism
Yifeng Yang, MD, Baoqiong Liu, MD, PhD, John Taylor, DO, ZhiHua Huang, MD, Sonali Gupta, MD, Soumya Thumma, MD, LingLing Wu, MD, Shuai Wang, MD, George Everett, MD

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Things To Do in and around Erlanger, Kentucky

January 23, 2020 // Randy Glick

The Ark Encounter

Ark Encounter features a full-size Noah’s Ark, built according to the dimensions given in the Bible. Spanning 510 feet long, 85 feet wide, and 51 feet high, this modern engineering marvel amazes visitors young and old. Ark Encounter is situated in beautiful Grant County in Williamstown, Kentucky, halfway between Cincinnati and Lexington and right off I-75.

Cincinnati Zoo & Botanical Garden

The Zoological Society of Cincinnati was founded in 1873 and officially opened its doors in 1875, making the Cincinnati Zoo & Botanical Garden the second oldest Zoo in the United States. The Zoo’s original animal collection was very small, originally consisting of just eight monkeys, two grizzly bears, three deer, six raccoons, two elk, a buffalo, a hyena, a tiger, an alligator, a circus elephant, and over four hundred birds, including a talking crow. The Zoo was founded on 65 acres in the middle of the city, and since then has acquired some of the surrounding blocks and several reserves in Cincinnati’s suburbs.

Newport Aquarium

Newport Aquarium showcases thousands of animals from around the world in a million gallons of water, including the enormously popular “Sweet Pea” and “Scooter,” the stars of the first shark ray breeding program in the world.

This state-of-the-art facility was named the No. 1 aquarium in the 2012 Readers’ Choice Travel Awards from 10Best.com; the Best Rainy Day Outing in 2006 in Cincinnati Family Magazine; and the Best Aquarium in the Midwest in the Zagat Survey’s U.S. Family Travel Guide in 2004.

The National Underground Railroad Freedom Center

The National Underground Railroad Freedom Center celebrates the heroes who created the secret network through which the enslaved could escape to freedom, the Underground Railroad.

From this historical vantage point of courage, cooperation and perseverance, we relate this uniquely American story to the contemporary efforts of Modern Abolition, inspiring everyone to take steps for freedom today.

Kings Island

With more than 100 rides, shows and attractions, Kings Island offers the perfect combination of world-class thrills and family attractions. Guests can experience the park’s 15 roller coasters, including the world’s longest wooden (The Beast) and steel inverted (Banshee) roller coasters, Diamondback and Mystic Timbers, voted “Best New Ride” in 2017 by Amusement Today. Families can spend the day together in the 18-time, award-winning Planet Snoopy kids’ area. Admission to Kings Island includes Soak City Water Park, which features more than 50 water activities, including 36 water slides.

These are just some of the many attractions that Erlanger and the surrounding areas have to offer.

Check out the links below for more options.

Things To Do Around Erlanger
Southern Regional Assembly
Trip Advisor

Update on the Focus on Women’s Health

January 7, 2020 // Randy Glick

SMA is sad to announce we are no longer hosting our Focus on Women's Health Conference in Kiawah held in July.

We have however found a few excellent choices for you to consider:

28th Annual Primary Care Conference
Kiawah Island, SC
Session I: June 29-July 3, 2020
Session II: July 6-10, 2020
https://www.cmemeeting.org/cme-conferences/kiawah-island-south-carolina-cme

2nd Annual Women’s Health Conference
The Biltmore Estate
Ashville, NC
September 14-16, 2020
https://www.cmemeeting.org/cme-conferences/asheville-north-carolina-cme

For more information on these conferences, please contact:

Continuing Education Company
(800) 327-4502
www.CMEmeeting.org  

Women's Health Resources

Oncofertility: Fertility Preservation and Gynecologic Considerations in Oncology Patients
Endocrine Causes of Menstrual Dysfunction: More Common Than You Think
Competing Hypertension Guidelines: Where Are We Now?
Clinician Burnout
Diabetes in Pregnancy - Screening and Maternal-Fetal Implications
Management of Gestational Diabetes, Type 1 Diabetes, and Type 2 Diabetes in Pregnancy
Contraception Controversies Panel Discussion
Osteoporosis: What is Happening?
Sexually Transmitted Infections: I've Got an APP, What Else Do I Need?
Behavioral Change for the Office-based Clinician
Preconception Care - The Gateway to a Healthy Pregnancy
Cases in Diabetes & Thyroid Disease (New Thoughts)
Concussions and Gender Variations
Newer Orthopedic Modalities & Therapies 2019
Healthy Living: What's New? Guiding Your Patients in 2019
Modalities to Achieve Hypertension Control in Clinical Practice: A Call to Action
Challenging Case Presentations in Women’s Health
Clinical Dilemmas: Vulvovaginitis and Vulvodynia
Substance Use Disorders in Women

Online CME
Women's & Children's Health SMJ Articles
SMA's Women's Health Youtube Playlist

SMJ : January 2020 Issue

January 5, 2020 // Randy Glick

The Southern Medical Journal is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists, including medicine; surgery; women’s and children’s 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.

Southern Medical Journal • Vol. 113 • No. 01 • January 2020

Public Health & Environmental Medicine
Poverty and Health in Tennessee
Kate Beatty, PhD, MPH, Olivia Egen, MPH, John Dreyzehner, MD, MPH, Randy Wykoff, MD, MPH&TM

Medicine & Medical Specialties
Procedural Anxiety, Pain Catastrophizing, and Procedure-Related Pain during EGD and Colonoscopy
Marco Lauriola, PhD, Manuela Tomai, PhD, Rossella Palma, MD, Gaia La Spina, MA, Anastasia Foglia, MA, Cristina Panetta, MD, Marilena Raniolo, MD, Stefano Pontone, MD, PhD

Single-Institution Experience of Synovial Sarcoma
Amy Farkas, MD, Seth T. Lirette, PhD, Youssef Al Hmada, MD, Anderson B. Collier, MD, Jennifer Barr, MD, Srinivasan Vijayakumar, MD, Vani Vijayakumar, MD

Single-Institution Experience of Synovial Sarcoma
Amy Farkas, MD, Seth T. Lirette, PhD, Youssef Al Hmada, MD, Anderson B. Collier, MD, Jennifer Barr, MD, Srinivasan Vijayakumar, MD, Vani Vijayakumar, MD

Chest Radiography Should Be Requested Only on Admission Based on Clinical Grounds
Zvi Shimoni, MD, Michal Rosenberg, MD, Leeor Amit, MD, Paul Froom, MD

Women's & Children's Health
Characteristics of Pediatric Patients With Retained Bullet Fragments and Need for Follow-Up Blood Lead Monitoring
Todd Fleenor, MD, Joshua Haupt, MD, Kathleen Richard, MD, Michele Nichols, MD, Nipam Shah, MBBS, MPH

Uterine Corpus Malignancies in Appalachia Kentucky: Incidence, Survival, and Related Health Disparities
Marian Symmes Johnson, MD, Thomas C. Tucker, PhD, Quan Chen, PhD, Bin Huang, PhD, Christopher P. DeSimone, MD, Rachel W. Miller, MD, Lauren A. Baldwin, MD, Tricia I. Fredericks, MD, Brian T. Burgess, MD, Frederick R. Ueland, MD

CME Article: Epidemiology, Clinical Presentation, and Seasonal Variation in the Diagnosis of Children with Eosinophilic Esophagitis in Oklahoma
Kinjal Suryawala, MD, Sirish Palle, MD, Muhammad A. Altaf, MD

Bioethics & Medical Education
Statewide Regional Campus Development: Academic Medicine’s Response to US Physician Shortages
Elena A. Wood, MD, PhD, Kathryn R. Martin, PhD, Paul M. Wallach, MD

Wellness Programs in an Academic Practice: Lessons Learned
Julie M. Marshall, MD, Quinn L. Johnson, MD

Commentary on “Wellness Programs in an Academic Practice: Lessons Learned”
Benjamin N. Hunter, MD, G. Richard Holt, MD, MSE, MPH, MABE, DBioethics

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Abstract Award Winners from the 2019 Southern Region Burn Conference

December 7, 2019 // Randy Glick

Poster Abstract Winners

1st Place: P53 Correlating Burn Wound Depth and Scar Depth After Contact Burns: A Histological Assessment in Porcine Models
Maria Batchinsky, BS,
United States Army Institute of Surgical Research, Burn Center, Ft. Sam Houston, TX

2nd Place: P22 Post Operative Wound Care Using Silver-Based Dressing with Autologous Skin Cell Suspension
Anna Stilinovic, PA-C, University Medical Center, New Orleans, LA

3rd Place: P10 A Plasma-Alginate Composite Gel Provides Improved Mechanical Support for Stem Cell Growth and Delivery
Nicholas E. Clay, PhD,
United States Army Institute of Surgical Research, Burn Center, Ft. Sam Houston, TX

Resident/Fellow Podium Presentation Awards

1st Place: Population-based One-year Mortality for Stevens-Johnson/Toxic Epidermal Necrolysis Spectrum Disorders is Greater at Burn Facilities than Other Facilities in New York: Expected Based on Treated Disease Severity or Sobering Wake-up Call?
Philip D. Hewes, MD, MPH, Resident, University of Rochester, Kessler Burn Center, Rochester, NY

2nd Place: Indocyanine Green Fluorescence Angiography to Determine Adequacy of Burn Wound Excision
Paul F. Sauer, Jr., MD, PGY-4, University of Kentucky, Burn Unit, Lexington, KY

3rd Place: Post Resuscitative Cerebral Edema Mortalities in Severe Burns: Case Reviews
Ana R. Segura, MD, Orlando Health, Orlando, FL

Non-Physician Podium Presentation Awards

1st Place: Reducing Burnout Related to Night Shift Calls to Physicians – A Process Improvement Project
Kristy D. Hemingway, MS, BSN, RN, NE-BC, Orlando Regional Medical Center, Orlando, FL 

2nd Place: Evaluation of Pain Management Practices in Adults with Small Burns Admitted to a Large, ABA Verified Burn Center
Rita Gayed, PharmD, BCCCP, Grady Burn Center, Grady Health System, Atlanta, GA

3rd Place: Burn Sepsis: Does the Initial Vitamin C Level Matter
Jeffrey W. Williams, PA-C, Wake Forest Baptist Health Burn Center, Winston-Salem, NC

Student Podium Presentation Awards

1st Place: Tube Feeding Through Surgery, Impact on Glucose Control in Burn Patients
Andrea L. Hess, Medical Student, Timothy J. Harnar Burn Center, Texas Tech University Health Sciences Center, Lubbock, TX

2nd Place: Burn Disaster Preparedness - How It Changes for a Hurricane
Roshanara Diaz, Medical Student, The Burn Center at HIMA – San Pablo, Caguas, San Juan, PR

3rd Place: The Impact of Financial Reward on Opioid Consumption in the Treatment of Thermal Injury to the Upper Extremity
Kathryn Schubauer, BS, Ohio State University, Columbus, OH

Congratulations to the winners and thank you to all who presented!

SMJ : December 2019 Issue

December 4, 2019 // Randy Glick

The Southern Medical Journal is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists, including medicine; surgery; women’s and children’s 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.

Southern Medical Journal • Vol. 112 • No. 12 • December 2019

Quality Care & Patient Safety
CME Article: A Hospitalist-Led Team to Manage Patient Boarding in the Emergency Department: Impact on Hospital Length of Stay and Cost
Alexander Hrycko, MD, Vishal Tiwari, MD, Michael Vemula, MD, Ashley Donovan, BS, Christine Scibelli, RN, Kirti Joshi, MD, Paul Visintainer, PhD, and Mihaela S. Stefan, MD, PhD

Commentary on “A Hospitalist-Led Team to Manage Patient Boarding in the Emergency Department: Impact on Hospital Length of Stay and Cost”
Amy A. Ernst, MD

Emergency Medicine & Disaster Preparedness
Emergency Medicine Resident–Driven Point of Care Ultrasound for Suspected Shoulder Dislocation
Benjamin Boswell, DO, Robert Farrow, DO, Michael Rosselli, MD, David A. Farcy, MD, Luanna Santana, RN, Carlos Dos Santos, BA, and Luigi X. Cubeddu, MD, PhD

Bioethics & Medical Education
How Postbaccalaureate Career Changer and Traditional Medical Students Differ Academically
I. Cori Baill, MD, Bertha Ben Khallouq, MA, Oloruntomi Joledo, PhD, Anna Jacobs, BA, Robert Larkin, BA, and Nyla Dil, DVM, PhD

Commentary on “How Postbaccalaureate Career Changer and Traditional Medical Students Differ Academically”
Lewis L. Hsu, MD, PhD

Spirituality of Physicians
Duraiyah Thangathurai, MD, PhD, Sarah Vitug, MD, MPhil, and Vikas Ravi, MD

Editor’s Response
G. Richard Holt, MD, MSE, MPH MABE, DBioethics

Medicine & Medical Specialties
Dietary Supplement Use is High among Individuals with Parkinson Disease
Christine C. Ferguson, MS, RD, Linda L. Knol, PhD, RD, Anne Halli-Tierney, MD, and Amy C. Ellis, PhD, RD

Public Health & Environmental Medicine
Social Support for Physical Activity for High Schoolers in Rural Southern Appalachia
Pooja Shah, BSPH, Jodi L. Southerland, DrPH, and Deborah L. Slawson, PhD, RD, LDN

Women’s & Children’s Health
When to Worry about Cancer: Concurrent Carcinoma and Recurrence in Borderline Ovarian Tumors
Mackenzie W. Sullivan, MD, and Susan C. Modesitt, MD

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Did You Miss Out on the 2019 Southern Regional Assembly?

November 7, 2019 // Randy Glick

Did you miss SMA's Southern Regional Assembly?

Review some of the highlights from this year's Assembly

SMA Presidential Installation

Philip Hartman, MD
SMA 2019-20 President

"While respecting the one hundred and thirteen year old organization we represent, we must continually evolve to draw in new members and provide value to our current members. While once upon a time, physicians joined organizations because “This is my specialty,” or “This is my region” or even “I believe in this mission,” Today's young physicians look more for return on investment. We also place a high value on work-life balance."

Click Here to Learn More about Dr. Hartman

Installation of New Leadership

Along with the installation of the new SMA President Dr. Philip Hartman, SMA also installed new leadership -- Dr. Christopher Morris is the new President-Elect and Dr. Donna Breen assumed the role of the President-Elect Designate. New committee members were also recognized. We would like to say thank you to all the newly installed members of our SMA Membership for your commitment to serve and lead SMA.

Click Here to See SMA's New Leadership
Click Here to See All of the New Committee Members

Young Physicians' Day

On the Saturday session of the Assembly, SMA hosted a Young Physicians' Day Abstract Competition. We started off the morning with Poster Presentations. It was a great morning of SMA Leadership and other Physicians walking around learning about the research done by Residents and Medical Students. Following the Poster Presentations, we had Residents/Medical Students/and Fellows presenting Oral Abstracts in front of the audience of the Assembly.  

Click Here to See the Results of the Abstract Competition

2020 Southern Regional Assembly

SMA Installs New Committee Members

November 7, 2019 // Randy Glick

AT THIS TIME, SMA WOULD LIKE TO RECOGNIZE OUR NEW COMMITTEE APPOINTMENTS.

NEW MEMBERSHIP COMMITTEE MEMBERS

Karan Pastora, BS

Dantwan Smith, MD, MBA

NEW EDUCATION COMMITTEE MEMBERS

David S. H. Bell, MD

Christopher Jackson, MD

Errington Thompson, MD

Natalie Weiss, BA, BS, MS

NEW BUDGET AND FINANCE COMMITTEE MEMBER

Karan Pastora, BS

NEW ALLIANCE COMMITTEE MEMBERS

Stella Brown, BA

Dr. Alicia Hodge

THANK YOU ALL FOR YOUR COMMITMENT TO SERVE AND TO LEAD SMA.

SMA Installs Philip Hartman as the 2019-20 President
SMA Installs New Leadership

SMA Installs New Leadership

November 7, 2019 // Randy Glick

Christopher Morris, MD
President Elect 2019-20

Christopher R. Morris, MD, a board certified rheumatologist with more than 25 years’ experience, is in private practice in Kingsport, Tennessee at Arthritis Associates. Additionally, he has served as a clinical educator for internal medicine residents at East Tennessee State University in Johnson City, Norton Community Hospital in Norton, Virginia, and Johnston Memorial Hospital, in Abingdon, Virginia.

A native of Springfield, Illinois, Dr. Morris received his undergraduate degree from Tulane University in New Orleans, Louisiana, and received his medical degree from the Universidad Autonoma de Guadalajara, Guadalajara, Jalisco, Mexico. He completed his Internship and Residency at the University of Tennessee Medical Center in Knoxville, and Rheumatology fellowship at the Medical College of Georgia in Augusta.

Dr. Morris is an active member of the Southern Medical Association (SMA) and currently serves as the Chair of the Education Committee. He previously has served as an SMA Councilor for the state of Tennessee, as well as a member of several of the Association's Education Design Groups. Additionally, Dr. Morris has served on 5 Committees for the American College of Rheumatology, currently serving on the Government Affairs Committee, which advocates for the specialty of Rheumatology, as well asfor the patients with arthritic diseases.

In her own words,

I am an Otolaryngologist practicing general ENT and allergy for the past 30 years in Marksville, Louisiana after finishing my residency at Tulane Medical Center in 1988. I graduated from University of Alabama Medical School cum laude in 1983. Also, I completed a fellowship in Otolaryngic Allergy in 1992. I am proud to serve the needs of a semirural small town community and take care of adults and children with ear, nose, and throat problems who would have to travel many miles for their care.

Practicing in a small community was very new to me when I first came here. I grew up in New Orleans, Louisiana and was educated in the public and parochial schools there. Living in a smaller community remained a challenge for me in adjustment, but I have come to realize that this environment is perfect for me. I get to know my patients and their families, and their extended families, and relatives, which engages me in their lives, both as a medical doctor, friend and mentor. It is truly the best of both worlds and I have come to treasure my practice as a small town doctor in this community.

I joined the SMA in 1984, while I was a resident and I have been a member ever since. I enjoyed the collegiality as well as the learning experience. It is a big organization with a small town atmosphere in that we are emboldened to learn from the experts in a spirit of congeniality and relaxed learning experience. It is an organization where everyone has equal time, every question has equal value, and everyone has the right to understand the concepts that are being presented. No question or thirst for knowledge is too little and everyone is included in the quest for medical knowledge and skills in the healing arts.

Donna Breen, MD
President Elect Designate 2019-20

SMA Installs New Committee Members
SMA Installs Philip Hartman as the 2019-20 President

SMA Installs Philip Hartman as the 2019-20 President

November 7, 2019 // Randy Glick

Philip Hartman, MD
SMA President 2019-20

Click Here to Read Dr. Hartman's Speech

Originally from Southwest Ohio, Dr. Hartman received his bachelors of science in Biology at Wheeling Jesuit University in West Virginia and returned to the Cincinnati area for medical school at the University Of Cincinnati College of Medicine.  After medical school, he became a board certified Family Physician through training with St Elizabeth Healthcare of Northern Kentucky. He practices broad-based, integrative family medicine in an outpatient setting for infants through the elderly, performing numerous procedures, acupuncture for the treatment of pain and traditional Western medicine for other chronic disease states and ailments such as obesity, diabetes, hypertension, and drug addiction. He is passionate about providing for his patients' needs with high quality, evidence-based care.

He regularly teaches medical students from his own alma mater as well as the University of Louisville, holding a gratis associate faculty positions at each. Taking his mission abroad, he has left the country numerous times to see patients in Belize and Haiti.

While serving as the Councilor to the State of Kentucky for the Southern Medical Association, he strove to bring other physicians the tools they needed to enjoy practicing excellent medicine. He continues that through his leadership as President of SMA.

In his spare time, he enjoys reading suspense novels and participating in outdoor activities with his wife, three children and two dogs. He also enjoys farming and attempts to play an active role in the production of as much of his family's food as possible through raising fruit trees, crops, chickens, fish and bees.

SMA Installs New Committee Members
SMA Installs New Leadership

SMA Recognizes Young Physicians and Physicians-in-Training at the Regional Assembly

November 7, 2019 // Randy Glick

The work of talented medical students and residents was on display Saturday, November 2, during SMA’s Southern Regional Assembly in Birmingham, Alabama. With more than 40 poster and oral abstract presentations, meeting attendees had the opportunity to interact with the presenters while hearing interesting case studies and learning about various fields of research. Prizes were awarded for the best posters and oral abstracts and SMA would like to recognize the winners:

Oral Abstract Winners

1st Place: An Analysis of Proton Pump Inhibitor Therapy and Glycemic Control in Patients with Type 2 Diabetes Mellitus
Mark Daniel Cromer, BS

2nd Place: Impella Device Success: Walking Home after Cardiogenic Shock from Ventricular Fibrillation
Christopher Taylor Smith, DO

3rd Place: When Negative Imaging And Cultures Fool The clinical Picture Of A Brain Abscess And What to Trust
Jared B. Mullins, DO

Poster Winners

1st Place: P02: An Unusual Case of Disseminated Nocardial Infection Resulting in Brain  Abscess in an Immunocompetent Patient
Talha Perwez, MD

2nd Place: P17: Knowledge, Attitudes, and Beliefs Regarding HIV Post-Exposure  Prophylaxis
Katie O'Connell, MS

3rd Place: P04 Paradoxic septic emboli in a setting of tricuspid valve infective endocarditis  and atrial septal defect: A case report
Catherine Ann Adams, BS, MD

Travel Award Winner

Given in Recognition of the Highest Submission Score Received for the Abstract
Marshall University Surgery Resident Radiation Safety
Ruth Pula Gerola, BSN, MD

Congratulations to all of our presenters! Each of you helped make SMA’s Southern Regional Assembly a success! For a complete listing of all posters and oral abstracts presented at the Assembly, please visit https://sma.org/presentations.

New Courses from the Business of Medicine

November 7, 2019 // Randy Glick

Presented by:
Stanley (Stan) G. Harris, PhD

Ethics and Motivating Change in a Millennial Workforce

Credits: 1 | ABIM MOC Points: 1

As healthcare leaders and practitioners, you are expected to change to meet demands or capitalize on opportunities. Sometimes you get to guide the change from the beginning and other times you are expected to implement a change determined by someone else. Regardless of the impetus, how do you help change efforts succeed particularly given the historical odds of success? Only about a third of change efforts accomplish their designed purposes, another third fall woefully short, and a third fail. In this presentation, and drawing from over 25 years of research on the “Building Readiness for Change” model by Achilles Armenakis and Stan Harris, you will explore the five key concerns that underlie individuals’ decisions to resist, comply with, or support changes and examine them in your own context. You will also gain insight into the six leadership behaviors that can shape these concerns to build change support and enthusiasm.

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Presented by:
Joni Wyatt

Opportunities in Value Based Reimbursement

Credits: 1 | ABIM MOC Points: 1

As the healthcare industry moves to value based reimbursement, providers and health systems are often caught in the crossfire of new regulations, new reimbursement models and the potential for government incentives or penalties. Thriving in this new environment requires an understanding of new regulations, knowledge of the available reimbursement models and the ability to access risk and reward associated with each opportunity. The goal of this activity is to present information on new types of reimbursement models, the infrastructure needed to make them successful and how they may impact current revenue and patient care. Concepts around the integration of value based care as part of a long term strategy will also be discussed, along with processes to ensure successful implementation.

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Presented by:
Nneka Unachuwku, MD, FAAP

Career Development: Lifelong Learning - Don’t Stop at MD, Think Like an Entrepreneur

Credits: .50 | ABIM MOC Points: .50

The health care industry is in the middle of a disruption. For the first time in decades, less than 50% of practices are physician owned. This is despite the fact that the research shows better patient outcomes with physician led systems. While there are many reasons for this, one of the major reasons is because physicians lack business skills and so avoid the business of medicine altogether. Physicians need to add business skills to their clinical skills in order to not only take great care of their patients but to also build the thriving systems needed.

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Presented by:
Robert Martin

Marketing and Promoting Your Medical Practice

Credits: .75

Approximately 1 out of 5 of healthcare professionals do not have a website, making it harder for new patients to find them. SMA's Business of Medicine Simplified Conference will provide information to improve communication skills, develop relationships, and better engage patients through the use of tools and techniques available via internet marketing.

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Presented by:
Kayla Blakely, DPN, CRNP, NP-C

State of Rural Health in the South

Credits: 1 | ABIM MOC Points: 1

The primary care workforce across the United States has significantly aged. In Alabama alone, predictions forecast Alabama will require a 23% increase in primary care providers within the next 10 years to meet the demands of the growing and aging population. The decline in primary care providers available and the lack of access to healthcare in rural areas creates a challenge. Overcoming the provider and access shortage can be accomplished through implementing interprofessional teams, philanthropic partnerships and academic-practice partnerships. The goal of this activity is to introduce the concepts needed to help a clinician become proactive in improving rural health and identify ways to implement new partnerships.

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Presented by:
Teddy Gillen

MedMal 101: Contracts, Claims, and Risk Management

Credits: .75

The past 5-10 years have been a 'buyers market' for independent physicians in search of medical malpractice insurance coverage. Pricing has been going down year over year and more carriers are entering the market. In the last year, we have seen 7 insurance companies go insolvent. Underpriced coverage, large judgements, reinsurance availability and carriers operating at an underwriting loss are factors pointing towards a hardening malpractice marketplace. It is important that independent physicians understand their options. Malpractice contracts can be complicated, and sometimes even confusing for a provider who is navigating the selection of the best possible contract, at the best possible rate, or to meet a specific need. The goal of this activity is share insights on claims trends and the other forces that determine pricing; examine the basics of medical malpractice insurance terms, and the various contracts available to the independent physician; and provide tips on risk management strategies to mitigate risk to malpractice claims.

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Presented by:
Teddy Gillen

MedMal 101: Contracts, Claims, and Risk Management

Credits: 1 | ABIM MOC Points: 1

Technology in every industry in business has been able to make things more efficient, automate processes, and reduce costs. However, in healthcare thus far, things have been the absolute opposite or extremely stagnant. Technology has yet to gain the same the traction and in some ways has taken a few steps backward. It has not done what we have all expected would occur; improve the quality of care for patients and improve the quality of life for providers, reduce healthcare costs, improve throughput, and make things so much easier. Why?

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Presented by:
G. Richard Holt, MD, MSE, MPH, MABE, DBE

Publishing a Manuscript

Credits: .50

Medical research, clinical studies, and knowledge sharing through scientific publications are all foundational to the profession of medicine. Preparing scientific manuscripts properly is a foundational capability for medical students, resident physicians, and practicing physicians. In particular, the Southern Medical Journal is a multidisciplinary journal which strives to provide a format for sharing of clinical information across specialties with the goal of excellence in patient care. Properly preparing a manuscript for submission to a medical journal is both an art and a science, and many manuscripts fail to meet the standards set forward by a specific journal. The goal of this activity is to enhance the knowledge of the attendees in manuscript preparation, and to provide resources for that goal.

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SMA Online CME Courses make it easy to obtain AMA PRA Category 1 Credits™.

Courses are available to anyone and are free to SMA Members.

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SMJ : November 2019 Issue

November 4, 2019 // Randy Glick

The Southern Medical Journal is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists, including medicine; surgery; women’s and children’s 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.

Southern Medical Journal • Vol. 112 • No. 11 • November 2019

Women’s & Children’s Health
Provider Practice and Perceptions of Pediatric Obesity in Appalachian Kentucky
Timothy S. Thornberry, Jr, PhD, Valery R. Bodziony, MS, and David A. Gross, MPA

Commentary on “Provider Practice and Perceptions of Pediatric Obesity in Appalachian Kentucky”
Inés María Anchondo, DrPH, RD

Teen Driving Education in a Pediatric Emergency Department: Effectiveness of a Toolkit
Zoza Grace Spears, MD, Brittany Schoen, BSN, RN, Tiffany Thompson, RN, BSN, Michele Nichols, MD, William King, MPH, DrPH, and Kathy Monroe, MD

Role of Physician Gender in the Modern Practice of Obstetrics and Gynecology: Do Obstetrician-Gynecologists Perceive Discrimination from their Sex?
Mark Turrentine, MD, Mildred Ramirez, MD, Lauren Stark, MPP, Carrie Snead, MA, and Jay Schulkin, PhD

Bioethics & Medical Education
Curriculum Enrichment Across the Medical Education Continuum Using e-Delphi and the Community Priority Index
Hamisu M. Salihu, MD, PhD, Deepa Dongarwar, MS, Erik D. Malmberg, PhD, JD, Toi B. Harris, MD, Jennifer G. Christner, MD, and William A. Thomson, PhD

Public Health & Environmental Medicine
Patients and Guns: Florida Physicians Are Not Asking
Melanie G. Hagen, MD, Babatunde Carew, BS, Marie Crandall, MD, MPH, and Zareen Zaidi, MD, PhD

Medicine & Medical Specialties
Frequency of β-Blocker Use Following Exacerbations of COPD in Patients with Compelling Indication for Use
Nathan Pinner, PharmD, Wesley Oliver, PharmD, MS, Tara Veasey, PharmD, Jessica Starr, PharmD, Sarah Eudaley, PharmD, Amber Hutchison, PharmD, and Kurt Wargo, PharmD

CME Article: Impact of β-Lactam Allergies on Antimicrobial Selection in an Outpatient Setting
Rachel A. Ness, PharmD, BCPS, Jessica G. Bennett, PharmD, Whitney V. Elliott, PharmD, BCPS, BCGP, Amanda R. Gillion, PharmD, BCPS, and Debendra N. Pattanaik, MD, MBBS, FACR, FAAAI

Scratching the Surface of the Antivaccination Phenomenon
Faysal Alhasan, MD, Leen Makki, MD, and Steven Lippmann, MD

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A Qualitative Assessment of Healthcare Experiences and Perceptions Among Pregnant and Postpartum Women with a History of Drug Use

October 21, 2019 // Randy Glick

A Qualitative Assessment of Healthcare Experiences and Perceptions Among Pregnant
and Postpartum Women with a History of Drug Use

Author: Alexandra Ranucci, BS, MS4, Department of Obstetrics and Gynecology, Tulane School of Medicine, New Orleans, LA
Co-Authors: Alexandra Ranucci, Jinnesse Taylor, Clara Wynn,
Department of Obstetrics and Gynecology, Tulane University School of Medicine

Knowledge Gap: Women who use illicit drugs during pregnancy are often faced with the difficult decision  whether or  not to seek prenatal care that will likely include drug screening and subsequently reveal illegal  substance use. We believe clinician actions and implicit biases during initial encounters with pregnant  women who use drugs have the ability to greatly impact this decision. Our study aims to better  understand the factors that encourage or dissuade these women from seeking prenatal care and  ultimately disclosing their substance use. Additionally, we aim to elicit women’s perceptions of  clinician actions after learning of their drug use, with suggestions for clinician improvement when  treating this population.

Design: We recruited 11 women from two Louisiana drug rehabilitation centers who were pregnant or gave  birth within the past two years and reported drug use during that pregnancy. We utilized semi‐ structured qualitative interviews, and collected lifetime drug use and pregnancy histories and basic  demographics. Using NVivo software, three independent research team members have begun to  conduct in‐depth analysis to identify interview themes using an exploratory approach. Consensus  building rounds will occur to resolve discordant coding.

Findings: Based on preliminary interview coding, a variety of factors were identified as contributing to a  woman’s reluctance to seek prenatal care, including: perception of judgement from clinicians, fear of  DCFS intervention and child separation, and drug addiction and the need to use superseding other  priorities like accessing healthcare. Recommendations for providers included the need for clinicians to  address drug use more directly, explicitly asking if treatment was desired as well as any other social  factors impacting their drug use and pregnancy.

Implications: In response to these themes, our preliminary recommendations include: improved training to  mitigate clinician implicit bias specifically when providing prenatal care to women using drugs, and  education regarding the full scope of substance use treatment options available to patients in order to improve clinician comfort in directly addressing substance use with evidence based treatment.

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A student-led interactive campaign day teaching UME trainees to Choose Wisely

October 21, 2019 // Randy Glick

A student-led interactive campaign day teaching UME trainees to Choose Wisely

Author: Sudarshan J Mohan, Bachelor of Science in Public Health in Biostatistics and Quantitative Biology (UNC‐Chapel Hill), Master of Science in Biomedical Sciences (EVMS), Medical Student (second year), School of Medicine, EVMS, Eastern Virginia Medical School, Norfolk, Virginia
Co-Authors: Lauren Keenan/B.S. Cell Biology and Biochemistry, Bucknell Univ. (2017), Medical Student, Eastern Virginia Medical School/Norfolk, VA

Background: The negative implications of wasteful healthcare spending are well‐documented in literature; yet, the  physician’s responsibility in reducing healthcare costs is not effectively taught during medical training.  Recently, many have advocated for the addition of a high‐value care (HVC) competency to modern  medical curriculum in an effort to pre‐emptively educate students on resource stewardship and  counteract high‐ordering practice habits often developed in residency. Eastern Virginia Medical  School has taken steps to establish a high‐value care thread within our Care Forward Curriculum. The  inaugural year (2018‐2019) of incorporating Choosing Wisely into the curriculum included an  interactive learning day for the entire community that is described here.

Intervention: The inaugural Choosing Wisely Day took place on November 16, 2018. The event was open to  students of all‐disciplines and levels, residents, attendings, and faculty. Events included a keynote  with a well‐known high‐value care expert, a poster session with “Top 5” Choosing Wisely  recommendations, and an innovation challenge, modeled after the popular television show Shark  Tank. We also hosted the American College of Radiology, who prepared several Choosing Wisely‐ based cases and taught students to use their Clinical Decision Support Tool to aid in providing high‐ value care.

Outcomes: Over 100 students representing each of our medical school classes and numerous faculty attended  and/or participated in at least one of the events during the day. The most notable outcome of the day  was establishing a value‐added role for students to engage residents, attendings, and other faculty by  using recommendations supported by medical specialty societies to advocate for patients. Following  the intervention, attendees were administered a pre‐/post‐evaluation, designed to survey students'  prior knowledge about high‐value care, willingness to seek out Choosing Wisely resources, and  comfort in applying HVC concepts in the clinical setting. Results indicated that students largely  recognized low‐value care as an issue at baseline, even though statistically significant increases  (p<.01) were observed in students' agreement with statements establishing the presence and ill effect  of low‐value care. A key finding was students' markedly increased reported likelihood to seek out  Choosing Wisely recommendations to guide their clinical decision making (p<.0001). This suggests  that Choosing Wisely Day may have provided students with the knowledge and resources to  incorporate value into their medical education and practice prior to entry into residency. However, we  also observed that students reported relatively low comfort levels in identifying overuse and advising  patients accordingly in the clinical setting. We thus have recognized skills involved in practicing high‐ value care as a target area for improving subsequent Choosing Wisely events.

Future Directions: We will continue to host a Choosing Wisely campaign day annually, while ensuring to modify event  content to address students’ self‐reported areas of weakness in applying HVC in clinical practice. In  future years, we will continue to engage students in both the planning and execution of the event, increase attendance through improved marketing, and further increase awareness of Choosing Wisely  and the importance of High‐Value Care.

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SMA Connect

October 9, 2019 // Randy Glick

With SMA Connect, a new member benefit, Southern Medical Association (SMA) members gain a powerful resource by which members can connect, exchange knowledge and share solutions.

SMA Connect, is a cloud-based, private member-only online community. The community includes an open forum for general member discussion, as well as Board of Directors and Committee forums for facilitating communications and document sharing. Other communities planned for launch include Medical Student and Residents forums.

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SMJ : October 2019 Issue

October 3, 2019 // Randy Glick

The Southern Medical Journal is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists, including medicine; surgery; women’s and children’s 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.

Southern Medical Journal • Vol. 112 • No. 10 • October 2019

Women’s & Children’s Health
Improving Transitions of Care for Healthy Adolescents and Young Adults
Shannon Leung, MD, MPH, Mason Walgrave, MD, and Sarah Mennito, MD, MSCR

Enhanced vs Standard Parents as Teacher Curriculum on Factors Related to Infant Feeding among African American Women
Lisa Tussing-Humphreys, PhD, MS, RD, Jessica L. Thomson, PhD, Melissa Goodman, PhD, and Alicia Landry, PhD, RD

Bioethics & Medical Education
Implementation of Case Conferences to Improve Interprofessional Collaboration in Resident Continuity Clinic
Tanya Nikiforova, MD, MS, Carla L. Spagnoletti, MD, MS, Scott D. Rothenberger, PhD, Kwonho Jeong, MS, and Peggy B. Hasley, MD, MHS

Teaching Medical Students in the Rural Setting Long Term: Physicians’ Attitudes and Perceptions
John Wheat, MD, MPH, John Brandon, MD, Melissa Cox, PhD, Scott Thomas, MD, Susan Guin, MSN, and James Leeper, PhD

CME Article: A More Directive Living Will for Older Adult Patients with End-Stage Medical Conditions?
Jack DePriest, MD, MACM, Priyanka Jagannath, MD, Michael Iannetti, MD, and Suzanne Kemper, MPH

Medicine & Medical Specialties
Use of Rheumatologic Testing in Patients Who Eventually Receive a Diagnosis of Rheumatoid Arthritis
Dilpreet K. Singh, MD, Jasdeep Badwal, MD, Ritika Vankina, MD, Santhi Gokaraju, MD, Jennifer Friderici, MS, Scott Halista, MD, and Tara Lagu, MD, MPH

Commentary on “Use of Rheumatologic Testing in Patients Who Eventually Receive a Diagnosis of Rheumatoid Arthritis”
Kam A. Newman, MD, and MohamadOmid Edrissian, MD

Intravascular Iodinated Contrast Is an Independent Cause of Acute Kidney Injury Following Coronary Angiography
Srijan Tandukar, MD, Helbert Rondon-Berrios, MD, MS, and Steven D. Weisbord, MD, MSc

Sports-Injury Encephalopathy
Angeline Prabhu, MD, Bilal Abaid, MD, Samreen Fathima, MD, Shivani Naik, MD, and Steven Lippmann, MD

Venous Thromboembolism: Are NOACs the Right Initial Drug of Choice for Unprovoked Venous Thromboembolism?
Ahmed K. Pasha, MD, Anupa Baral, MD, and Ahmed K. Pasha, MD Anupa Baral, MD

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