College faculty present at annual Alabama family physicians meeting

Presentations were made at the annual Alabama Academy of Family Physicians meeting by College of Community Health Sciences faculty. The meeting, held June 26 – 29, 2014, in  Sandestin, Fla., provides networking opportunities and Continuing Medical Education to family physicians, physicians assistants, residents and medical students from across Alabama.

An entire day of lectures was presented by the College on Saturday, June 27, the third day of the conference. Faculty presented new information respective to their specialties.

Presenting on autism screenings and the role played by family medicine physicians in early detection and intervention were Lea Yerby, PhD, assistant professor in Community and Rural Medicine and the Institute for Rural Health Research; and Angela Barber, PhD, assistant professor in communicative disorders at The University of Alabama.

The prevalence of autism in Alabama per thousand is 5.7, while the national prevalence per thousand is 14.7, they said. The reason for the discrepancy is a screening issue, Yerby said. And the key to more screenings and early intervention is for family medicine physicians and autism specialists to work together.

Ninety two percent of parents of a child with autism first expressed concern to their primary care provider, Yerby said.

“It takes two—screeners and family physicians. Neither of them can do it alone. But those two combined are really where we move forward, where more children are less likely to fall through the cracks.”

Scott Arnold, MD, associate professor and chair of the Department of Internal Medicine, presented new findings in adult medicine literature from 2013 to 2014. Some areas Arnold covered included diabetes prevention and care, treatment of heart disease, blood clotting, intracranial stenting, sepsis, hepatitis C screening and treatment, low testosterone treatment, and lung, colon and cancer screenings.

Jerry McKnight, MD, a professor of Family Medicine, presented a clinical case study of 10 patients with one common etiology: hereditary hemochromatosis. The case study was presented in a typical grand rounds fashion, presenting the symptoms to the attendees of the patients and leading into the diagnosis.

Following McKnight was Richard Friend, MD, director of the The University of Alabama Family Medicine Residency • Tuscaloosa (operated by the College), who wrapped up the day with a presentation on critical care and emergency room medicine for family physicians. Many physicians present during his presentation indicated they work in some sort of emergency medicine capacity.

Friend discussed the role of family physicians in the ICU, common trends and diagnoses in an emergency setting and various procedures such as intubating, performing a lumbar puncture and atrial fibrillation.

“You have to have a heightened sense of awareness to [practice emergency medicine] and do it well,” he said. “The key is to really be aware of common procedures and to always practice evidence-based medicine.”

College to host Patient-Centered Medical Home conference

Among the keynote speakers is Paul Grundy, MD, MPH, director of Global Healthcare Transformation for IBM and founding president of the Patient Centered Primary Care Collaborative.

Among the keynote speakers is Paul Grundy, MD, MPH, director of Global Healthcare Transformation for IBM and founding president of the Patient Centered Primary Care Collaborative.

The College will host a conference in July that focuses on the Patient-Centered Medical Home (PCMH) and ways that physicians and other health care providers can incorporate this model of care into their medical practices.

The conference, “Building the Patient-Centered Medical Home: Inspiration and Tools to Help Transform Your Practice,” will be held July 25-26 at Hotel Capstone on The University of Alabama campus.

Among the keynote speakers is Paul Grundy, MD, MPH, director of Global Healthcare Transformation for IBM and founding president of the Patient Centered Primary Care Collaborative.

In his role at IBM, Grundy (known as the “Godfather of the PCMH) develops strategies to shift health-care delivery toward consumer-focused, primary-care based systems through the adoption of new philosophies, primary-care pilot programs, new incentive systems and the information technology required to implement such changes.

The Patient Centered Primary Care Collaborative works to advance an effective and efficient health-care system built on a foundation of primary care and the PCMH.

“As a College, we are interested in not only transforming our own practice into this PCMH approach, but also helping to move the bar and further the transformation of medical care in our area,” says Richard Streiffer, MD, dean of the College. “That is part of our mission and that is really the motivation for the conference. It is a tool for us internally as well as at the community level to increase awareness, create dialogue and learn from experts with experience in this transformative process.”

According to the Agency for Healthcare Research and Quality, the PCMH is best described as a model of primary care delivery that is patient-centered, comprehensive, coordinated, accessible, and that focuses on quality and safety.

The name PCMH can be confusing because in this case a medical home is not a place but rather a philosophy of providing care. All the attention to patients is not an extravagance. Heading off problems in the doctor’s office often keeps patients out of the emergency room or from being readmitted to the hospital, both costly forms of health care. The PCMH has also been shown to help patients manage chronic health conditions, which account for an estimated 75 percent of all U.S. health care spending.

In addition to Grundy, other keynote speakers at the conference will include: Beverley Johnson, president and CEO of the Institute for Patient- and Family-Centered Care in Bethesda, Maryland; Melly Goodell, MD, chair of the Department of Family Medicine at MedStar Franklin Square in Baltimore, Maryland, a state that is three years into a PCMH pilot project; and Michael Canfield, MD, associate chief of staff of Ambulatory Care for the Central Alabama Veterans Health Care System.

CME, as well as CEUs for nursing and social work, will be provided at the conference. For more information, visit the conference website at http://cchs.ua.edu/pcmh.

New family medicine physicians, fellows recognized at graduation

Twelve physicians graduated from The University of Alabama Family Medicine Residency on June 22 and will soon start practices in Alabama, Georgia and Tennessee.

The residency, which is operated by the College, provides physicians with three years of specialty training in family medicine. Founded in 1974, the residency is one of the oldest and largest in the United States. With the current class, the residency has graduated a total of 435 physicians who are practicing in 29 states.

Fellows were also recognized at the graduation ceremony, which was held at the South Zone in Bryant-Denny Stadium. The College offers one-year fellowships in sports medicine, hospitalist medicine, obstetrics, behavioral health and rural public psychiatry. The fellowships provides additional training for family medicine physicians in other specialty areas.

“This will be an exciting time for you, and there will be some anxiety as you enter the new world of practice,” Richard Streiffer, MD, dean of the College and a family physician, told the graduates. “In five or 10 years our discipline is going to be very different than it’s been during your residency, and I think it will be better. We’re seeing how we are being asked to be players in the healthcare system. At last the country is waking up to the fact that what we do as family medicine physicians is essential.”

Robert Ireland, MD, who recently retired from the College’s Department of Family Medicine after 22 years, was the graduation keynote speaker. He said connecting and building trust with patients is key.

“Over the last three years, we’ve given these young doctors an opportunity to develop their medical skills, but after the science, it’s all about how we treat people,” Ireland said. “Even with all the advances in medicine, it’s still pretty much observational in primary care and connecting with patients as only we in primary care can do.”

He told the graduates: “You are unequivocally ready for practice. Be confident that you are prepared for that responsibility.”

2014 residency graduates and where they will practice

Megan Bullard, MD – Muscle Shoals, Ala.

Mark Christensen, MD – Marshall County, Ala.

William Clifford, MDNATO peace-keeping mission in Kosovo

Jeffrey Colburn, MD – Dalton, Ga.

Alisha Congress, DO – Hueytown, Ala.

Tamer Elsayed, MD – Tuscaloosa, Ala.

J.D. Engelbrecht, MD – Buchanan, Ga.

Danielle Henson, DO – Columbia, Tenn.

Maury Minton, MDGadsen, Ala.

Cynthia Mouton, MD – Demopolis, Ala.

Jonathan Parker, DO – Muscle Shoals, Ala.

Saman Razzak, MD – N/A

Fellowship graduates recognized

Scott Boyken, MD – Sports Medicine

Friederike Fischer, MD – Hospitalist Medicine

Bruce Lovins, MD – Hospitalist Medicine

Bhavik Patel, MD – Hospitalist Medicine

Shelley Waits, MD Obstetrics

College welcomes new fellows

In July, the College of Community Health Sciences welcomes five new fellows to three of the College’s fellowship programs: Lauren Linken, MD, will join the Obstetrics Fellowship; Shazia Malik, MD, and David Aymond, MD, will join the Hospitalist Fellowship; and Blake Perry, MD, and Jeremy Coleman, MD, will join the Sports Medicine Fellowship.

These fellowships, along with a Behavioral Health Fellowship in Family Medicine and a Rural Public Psychiatry Fellowship, make up the College’s post-residency training programs and provide family medicine residency graduates with training and expertise in a selected sub-specialty.

“While a fellowship is not for everyone, a significant number of family physicians today are seeking additional training in order to gain specialized expertise in a subset of the broad field of family medicine,” says Richard Streiffer, MD, dean of the College.

The Obstetric Fellowship, a 12-month training program, is aimed at addressing the overwhelming need for obstetric care in rural and remote areas. As the attrition of OB/GYNs in the United States exceeds the number of physicians completing OB/GYN residency programs and entering general OB/GYN practice, programs training family physicians to provide quality obstetrical care will continue to grow in importance.

“Family medicine physicians trained in obstetrical and newborn care is the answer to reducing perinatal morbidity and mortality, not only in Alabama, but throughout the United States,” says Daniel Avery, MD, professor and chair of Obstetrics and Gynecology at the College.

Linken is a graduate of the University of Alabama School of Medicine and recently completed a residency in Family Medicine and Community Health at the University of Massachusetts Medical School.

A program of both the Department of Internal Medicine and the Department of Family Medicine at the College, the Hospitalist Fellowship is designed to assist family physicians in obtaining the skills necessary to provide inpatient care appropriate to the existing and future needs of urban, rural and underserved areas.

This 12-month training program will be joined by Malik, a graduate of the Medical School of the Americas in Nevis, West Indies, who completed a family medicine residency at Western Michigan School of Medicine in Kalamazoo, and Aymond who received his medical degree from Ross University School of Medicine and completed a family medicine residency at Rapides Regional Medical Center in Alexandria, La., where he was appointed chief resident in 2013.

Perry, a graduate of the University of Alabama School of Medicine who gained his clinical training at the College, recently completed the Wake Forest Baptist Family Medicine Residency.

Coleman completed his medical degree at Duke University School of Medicine in Durham, N.C., and his residency in family medicine at Louisiana State University in New Orleans.

Both Perry and Coleman come to the Sports Medicine Fellowship with significant experience in sports medicine that will benefit them as they work through the 12-month training program under the supervision of James Robinson, MD, professor and endowed chair of Sports Medicine at the College.

Robinson also serves as the team physician for The University of Alabama football team.

“Fellowships are an important component of our graduate medical education offerings, and something we hope to expand in future years, for example in geriatrics, and perhaps women’s health,” says Streiffer. “These fellowships will prepare family physicians to better serve a need in their community or practice, to provide leadership in that area or to prepare them for a future academic role.”

Scarbrough selected to prestigious fellowship

Cathie Scarbrough, MD, an assistant professor in the College’s Department of Family Medicine and assistant director of The University of Alabama Family Medicine Residency, was selected to the University of North Carolina Faculty Development Fellowship in Chapel Hill.

This mid-career program for medical educators has a history of developing graduates for careers as leaders in family medicine education. The program is a one-year commitment, including six weeks in the Family Medicine Residency at Chapel Hill, and includes training and experiential projects in medical education, teaching, management and scholarship.

Scarbrough started the program in June, joining the 36th fellowship class, which consists of a diverse group of educators coming from a variety of community, university and military family medicine programs.

Jared Ellis, MD, an assistant professor in the College’s Department of Family Medicine and associate director of The University of Alabama Family Medicine Residency, recently completed the fellowship.

“The opportunity to interact with and learn with leading peers from around the nation has been an incredible opportunity,” Ellis says.

Community and Rural Medicine offers week-long Agricultural Medicine course

In an effort to train health and safety professionals to provide care and prevention services to agricultural producers and their families, as well as those who work in processing of raw agricultural products, the College of Community Health Sciences’ Department of Community and Rural Medicine offered a comprehensive week-long training course on Agricultural Medicine. The course, held May 12-16 at the College, focused on Occupational and Environmental Health for Rural Health Professionals.

The target audience of the course included physicians, nurses and other health and safety professionals, such as extension agents, rehabilitation counselors, emergency medicine personnel, health professions students and others interested in the health and safety of agricultural community. Approximately 30 people were in attendance including students of The University of Alabama Rural Scholars Program, College faculty and staff and others from various backgrounds around the Southeast.

A similar course was first held by the University of Iowa in 1974 in response to an epidemic of occupational disease and traumatic death and injury in the face of diminishing local and federal resources. Over the last 40 years, more than 400 health care and safety professionals have been equipped with the information and skills necessary to provide clinical and preventive services to the agricultural sector.

The University of Alabama was selected to participate in the University of Iowa’s Center for Agricultural Safety and Health (ICASH) Building Capacity Grant which provides $8,000 per state to plan and implement an Agricultural Medicine Training Course like the one offered by the University of Iowa. The grant is funded by the National Institute of Occupational Safety and Health.

Susan Guin, MSN, CRNP, an assistant professor in the College’s Department of Community and Rural Medicine and the coordinator of the training course, reached out to the Alabama Cooperative Extension System and the Tuskegee University Cooperative Extension Program to review and revise the course materials supplied by ICASH to reflect the agricultural environment in Alabama and the Southeast.

“For this program to be successful,” Guin said, “the differences in climate, culture, commodity, etc. must be addressed.”

The curriculum included presentations from College faculty and other UA faculty as well as guest lecturers from Auburn University, Tuskegee University, the University of Iowa and Purdue University.

Hammond completes Nurse Leadership Program

Angela Hammond, CRNP, a nurse practitioner in the University Medical Center Faculty-Staff Clinic and an inaugural fellow in the Duke-Johnson & Johnson Nurse Leadership Program, successfully completed the one year program in May 2014. Program components included three leadership retreats as well as distance-based learning activities and a transformative health leadership project.

The Duke-Johnson & Johnson Nurse Leadership Program is a partnership between Duke University School of Medicine, Duke University School of Nursing and Johnson & Johnson.

The program provides leadership development for advanced practice nurses to enable them to effectively address the health needs of their communities, especially underserved populations. Program Fellows are expected to be change agents within their practice settings and the evolving health care environment.

University Medical Center, operated by The University of Alabama College of Community Health Sciences, is the largest multi-specialty clinic in West Alabama. It provides primary care to University faculty and staff and the West Alabama community.

UA Matters: Ways to Avoid Heat Stroke

Having some fun in the sun is typically a popular summer activity, but it can also be dangerous. The University of Alabama College of Community Health Sciences’s Dr. Anne Halli-Tierney offers a few tips on how to enjoy the summer sun and stay safe.