Resident physician receives scholarship to care for patients in Haiti

Dr. Natalie Kuijpers, a chief resident of The University of Alabama Family Medicine Residency, has received a scholarship to provide patient care in Haiti. The residency is operated by the College of Community Health Sciences.

Kuijpers is one of only two family medicine residents in the US to receive the scholarship, which is awarded by the American Academy of Family Physicians Foundation. The foundation’s Family Medicine Cares International Program provides patient care, family medicine education and school and orphanage support to Haiti.

“Dr. Kuijpers will be part of the program’s Patient Care Team and will be providing direct patient care for the people of Haiti,” says Dr. Jane Weida, associate director of the residency.

Haiti, one of the poorest countries in the Western Hemisphere, was devastated in 2010 by a 7.0 magnitude earthquake. More than 100,000 perished in the first 60 seconds of the earthquake, and some 250,000 homes and 30,000 commercial buildings were destroyed or severely damaged. As many as 150,000 Haitians were still homeless as late as 2014.

The scholarship will cover all expenses for Kuijpers trip to Haiti. In addition, the scholarship will cover travel costs to the AAFP’s national conference in Kansas City in August 2018, where she will present highlights of her work in Haiti.

University Medical Center recognized as a Patient-Centered Medical Home

University Medical Center was nationally recognized in December as a Patient-Centered Medical Home for its patient-centered, quality and coordinated care.

“Your practice is among the elite group that has demonstrated its commitment to advancing quality in health care,” the National Committee for Quality Assurance wrote in announcing the PCM certification of UMC, which is operated by the College of Community Health Sciences.

NCQA recognition means medical practices have made a commitment to providing care that is patient-centered, accessible, continuous, comprehensive and focuses on quality. The PCMH model uses a care delivery team, led by a primary care physician, that delivers coordinated and integrated care and is proactive in providing preventive, wellness and chronic illness care – all with the patient at the center of the health care experience.

Research shows that the PCMH model builds better relationships between patients and their clinical care teams, improves quality of care, as well as the patient experience and staff satisfaction, and reduces health care costs. The PCMH has also been shown to help patients be more compliant and able to successfully manage chronic health conditions.

“This was a long time coming and a lot of work, and it matters because NCQA PCMH recognition improves patient care and reduces costs,” says Dr. Richard Streiffer, dean of CCHS. “In addition, the PCMH model is associated with happier staff and patients.”

UMC is the largest community practice in West Alabama, with locations in Tuscaloosa, Northport and Demopolis. UMC provides primary care-focused health services in family medicine, internal medicine, pediatrics, women’s health, psychiatry, geriatrics, neurology and sports medicine. The PCM certification was received by UMC’s Tuscaloosa location on the UA campus for its family medicine and pediatric clinics.

NCQA recognition ranges from Level 1 to Level 3, which is the highest. UMC family medicine clinics received Level 3 PCMH recognition and its pediatric clinic received Level 2 recognition. The levels require meeting such benchmarks as: enhancing access to care and continuity of care; identifying and managing patient populations; planning and managing care; providing self-care support and community resources; tracking and coordinating care; and measuring and improving performance.

These efforts translate to providing patients with reminders about chronic and preventive care needs, more regular health screenings, after-hours care, use of electronic health records to improve quality and efficiency of care and to monitor chronic diseases, and use of multiple communication channels, including web-based portals through which patients can request appointments and prescription refills.

“There are not many PCMHs in Alabama. We are one of only a small handful that I know of in the state,” Streiffer says.

Dr. Jane Weida, an associate professor in the College’s Department of Family, Internal, and Rural Medicine who led efforts to obtain PCMH recognition for UMC, believes the small number of recognized practices in Alabama stems from a lack of financial resources, especially for small and rural practices.

“It is very difficult for a small practice to achieve PCMH certification. We had a committee of about nine (people) that met every other week for two years,” Weida says. “It took thousands … of hours to do this. A small practice that is working full time on patient care simply doesn’t have the time to do it.”

Getting off Electronics and Outdoors

“Think of a special memory of being outside that impacted you growing up.”

That’s how Dr. Caroline Boxmeyer, a professor in the Department of Psychiatry and Behavioral Medicine at the College of Community Health Sciences, began her lecture for the Mini Medical School Program on January 29. The program is a lecture series the College provides in collaboration with The University of Alabama’s Osher Lifelong Learning institute, or OLLI.

While her lecture was titled “Getting your Grandchild off Electronics and Outside,” the advice shared was not just for children.

Getting off electronics is often difficult for many reasons, including that technology is a useful tool that has become part of everyday life. But screens are addictive and work on the same addiction pathways as drugs, Boxmeyer said.

“Be mindful of children,” she noted. “Their brains are still developing their foundational stretchers and connections. We want to be mindful about how they are spending their time when that is happening.”

Taking a break from electronics has many benefits, Boxmeyer said. It can help reduce anxiety and stress, increase positive thinking, and improve overall health and wellness. The American Academy of Pediatrics suggests children need to spend 15 to 60 minutes outside each day to experience a positive impact on the human body.

Ways to get outside include:

  • Outdoor camps/organizations
  • Family trips
  • Outdoor playtime
  • Sports
  • Hobbies (gardening, fishing, etc.)

Health Matters Honored for Excellence

The weekly television segment Health Matters, a collaboration of WVUA-23 and the College of Community Health Sciences, received an award of Special Merit from the Council for Advancement and Support of Education, earning recognition as one of the best media relations programs in the Southeast last year.

Health Matters provides important and timely health information to WVUA viewers throughout West Alabama and parts of the Southeast. CCHS provides content for the weekly series via interviews with its dean, Dr. Richard Streiffer, a family medicine physician, and members of the CCHS faculty – physicians with specialties in family medicine, internal medicine, pediatrics, obstetrics and gynecology, sports medicine, geriatrics, neurology, psychiatry and psychology.

The interviews are conducted by WVUA’s managing editor, Mike Royer, and are filmed at CCHS. The segments, about a minute and half in length, air twice a week – during the 5 pm newscast on Wednesdays and again during the 10 pm newscast on Sundays.

Health Matters was launched in spring 2017, and topics have included high cholesterol, the importance of prenatal care, diabetes, depression and anxiety, sinusitis, childhood vaccinations and adult immunizations, low-back pain, Alzheimer’s disease, stress relief and attention deficit hyperactivity disorder.

The full interviews are approximately five to six minutes in length. Both the segment aired and the full interviews are posted to the WVUA website. Television viewers are directed to the website for more in-depth information about the health topic.

Health Matters is a key component of the College’s media and public relations efforts.

CASE is an international professional association serving educational institutions and the professionals who work on their behalf in communications, alumni relations, development, marketing, advertising and related areas.

Higginbotham steps into UA’s interim VP for Research position

Dr. John C. Higginbotham, who leads research efforts for the College of Community Health Sciences, was tapped by University of Alabama President Stuart Bell to serve as UA’s interim vice president for Research and Economic Development while the search for a new vice president is underway.

Higginbotham has served as UA’s associate vice president for Research and Economic Development for the past several years. He also serves as associate dean for Research and Health Policy for the College, and as chair of the College’s Department of Community Medicine and Population Health and director of its Institute for Rural Health Research (IRHR).

“We are fortunate Dr. Higginbotham is available to serve during this interim time,” says UA Provost and Executive Vice President Kevin Whitaker. “His extensive academic and research background, intimate knowledge of our existing research and economic develop operations, and strong relationships with faculty and researchers across campus and around the country will serve the University well as we begin the important national search for a new vice president.”

Says Higginbotham: “Serving in this leadership capacity is an honor. I appreciate the trust Dr. Bell and Dr. Whitaker have placed in me to continue the important work of this office during this critical time.”

Meanwhile, faculty in the College’s Department of Community Medicine and Population Health and IRHR will take on additional administrative responsibilities during Higginbotham’s interim time. Dr. Martha Crowther will serve as interim associate dean of Research and Health Policy for the College, and Dr. Lea Yerby will serve as vice chair of the department.

In addition, Dr. Louanne Friend will serve as acting deputy director of IRHR. Dr. Pamela Payne-Foster, deputy director of IRHR, was granted a special sabbatical this semester to work with Stillman College’s senior administration in efforts to strengthen the Tuscaloosa institution’s academic mission.

CCHS Partners with the Alabama Statewide Area Health Education Centers

The College of Community Health Sciences has partnered with Alabama Statewide Area Health Education Centers to extend educational and training opportunities to high school students in rural areas of Alabama who are interested in pursuing health care careers.

The partnership “serves the mission of the College for CCHS to continue to support the region in terms of leadership in medical education and scholarship through its assistance to our area partners,” says Dr. Richard Streiffer, dean of CCHS. “Alabama Statewide Area Health Education Centers (AHEC)has become established nationwide, in the majority of our states, and this is a historic role in which they have deep experience and success. We are pleased to help Alabama AHEC assume this role for the benefit of our state and its communities.”

For the past 25 years, the College’s Rural Programs have operated as a pipeline system that starts in high school, for junior and seniors, to prepare students for opportunities in health care following graduation and before they begin higher education and training. In recognition of the positive impact that AHEC has had throughout the state, the College has determined that the opportunities for advancement to provide for these students would be exponentially higher with the network that AHEC has in place statewide, beyond medical school and including other health care professions.

CCHS will continue to be an active partner as the high school programs transition to AHEC’s lead role with continued support and involvement from the College in the future.

“We are so appreciative of the opportunity to assume responsibility for the CCHS rural high school programs. AHECs have a long history of working with high school students, to recruit them into health careers. It’s an area where AHEC really shines, and we thank CCHS for their confidence in us to continue to move these programs forward,” says Dr. Cynthia Selleck, Director of the Alabama Statewide AHEC Program.

To date, the College’s rural scholastic year programs have already transferred to AHEC implementation and include the after-school Health Profession Academy and the in-school Health Careers 101. During the next year, it is anticipated the summer programs for Rural Health Scholars and Rural Minority Health Scholars—11th and 12th grades, respectively—will transition to AHEC’s lead, though they are currently being managed by the College with AHEC’s assistance. Following the final transition of all high school programs to AHEC’s management, the College will continue developing a future workforce of medical professionals through the Rural Medical Scholars, Rural Community Health Scholars, and Family Medicine Residency programs, while providing oversight to the new AHEC high school programs as they do the same.

About the Partners

The University of Alabama College of Community Health Sciences is dedicated to improving and promoting the health of individuals and communities in Alabama and the region through leadership in medical education and primary care; the provision of high quality, accessible health care services; and scholarship.

Alabama Area Health Education Centers (AHEC) are committed to expanding the health care workforce, maximizing diversity and facilitating distribution, especially in underserved communities. AHECs were created by Congress in 1971 to increase the quantity, diversity and distribution of health care professionals, especially in rural and underserved areas. Research has shown that positive changes to these three areas increase access to care and improve the overall health of communities.

 

CCHS-led UA United Way fundraising goal smashed

The 2017 University of Alabama United Way of West Alabama fundraising campaign, led by CCHS, has exceeded its goal. Final pledges and donations totaled $454,929, the University announced Nov. 30.

UA set a goal of raising $375,000 this year, just a little more than last year’s goal, which was also exceeded.

“It’s our pleasure to be able to share that we have once again not only met – but exceeded – our annual goal,” the University announced in an email. “It means lives changes for the better for so many in our area.”

United Way of West Alabama covers nine counties and has 26 partner agencies, including Good Samaritan Clinic, Big Brothers Big Sisters, the Phoenix House and Temporary Emergency Services.

Addiction, performance-enhancing substances topic of CCHS endowed lectures Alice McLean Stewart Endowed Lecture for Addiction Education

Whether it’s drugs, alcohol, smoking, food, gambling, working or shopping, addiction is costly to individuals and society, said Dr. H.E. Logue, a psychiatrist, who presented the CCHS Alice McLean Stewart Endowed Lecture on Addiction Nov. 10.

In Alabama last year, addiction cost the criminal justice system $436 million and the healthcare system $300 million, he said.

Addiction can also contribute to such co-morbid illnesses as borderline personality disorder, bipolar disorder, schizophrenia and general anxiety disorder, said Logue, founder and president of Affiliated Mental Health Services Inc. in Birmingham. His presentation was titled Understanding Addiction: Yours, Mine, Ours.

Logue said the “big three” of addiction are smoking, alcohol and opiates. In 2016, there were 51,000 opioid deaths in the US and that number is expected to be repeated this year. “That’s 102,000 deaths in the last two years, Logue said.

He said there are three stages of addiction: exhilaration, withdrawal and anticipation for more. “It’s an ongoing problem that never really goes away. The body never forgets’ it’s always there.”

Logue noted the difference between addiction and dependence. He said addiction is an insatiable desire for a substance that overpowers and neutralizes judgement and behavior in a way that is detrimental. Dependence is use of a substance or behavior to alleviate pain.

There are treatment options for addiction, he said, including Alcoholics Anonymous, 12-step programs, outpatient and inpatient programs and pharmacological treatments.

The Alice McLean Stewart Endowed Fund for Addiction Education was established in 1994 by Alice McLean Stewart to promote addiction education at CCHS through the creation of a lecture series. Stewart received a bachelor’s degree in home economics from The University of Alabama in 1941 and a master’s degree from the University of Chicago in 1942. She taught in the Tuscaloosa City School System and Partlow State School from 1960 to 1988.

The Ernest Cole Brock III Endowment for Continuing Medical Education

Performance-enhancing substances can improve athletic strength and speed, but they carry significant risk to health and sports, said Dr. John Lombardo, the NFL’s drug advisory for anabolic steroids and other performance enhancing drugs.

“That’s why they’re banned – because of the adverse health effects, and to create a level playing field and protect the integrity of the game,” Lombardo said.

Lombardo provided the CCHS Ernest Cole Brock III Endowment for Continuing Medical Education lecture on Nov. 17. His talk was titled Performance Enhancing Substances.

Lombardo listed some of the more common performance-enhancing substances. There are anabolic steroids, which are synthetic substances related to testosterone that promote the growth of skeletal muscle.

Stimulants are another, and can include amphetamine, ephedrine and pseudoephedrine. Lombardo described stimulants as “effective and dangerous,” explaining that they work to stimulate the central nervous system, giving athletes enhanced reaction time and the ability to fight fatigue. But they can also cause seizures, cardiac arrest, gastrointestinal problems and dependency.

Supplements, often consisting of herbs and plant derivatives and extracts, are another performance-enhancing substance used in sports. The US Food and Drug Administration does not have the authority to review dietary supplement products for safety and effectiveness before they are marketed.

“No independent agency is verifying the ingredients so you’re taking something no one has tested,” Lombardo said. He said up to 20 percent of supplements contain non-labeled substances that could cause a positive drug test. “We tell athletes to beware of supplements and don’t take them, but they will take these, they always do. There’s a fear factor. They’re so intent on getting better they’ll try anything.”

Lombardo said there are times when substances that enhance performance are used for therapeutic reasons and exemptions are granted “recognizing that there are medical conditions for which they might be needed,” treating injuries and ADHD being a few. Most exemption are granted prior to use, not retroactively, “like after a positive test,” he said.

The Ernest Cole Brock III Endowment for Continuing Medical Education lecture series was established by Ernest Cole Brock Jr., MD, and his wife, Hannah Brock, with the goal of educating health professionals about the treatment of concussions and other sports injuries. They created the fund to honor the memory of their son, Ernest Cole Brock III, who died in 1999 at the age of 36. The late Dr. Ernest Cole Brock Jr. was an orthopedic surgeon who practiced for many years in Tuscaloosa and a longtime physician for the Alabama Crimson Tide.

Event highlights College’s research and scholarly activity

Research and scholarly efforts of CCHS faculty, staff, residents, medical students and graduate students were highlighted during the College’s 9th Annual Research and Scholarly Activity Day.

Thirty-nine poster presentations were displayed at the Nov. 9 event, held at the Northeast Medical Building. Judges were: Dr. Alan Blum, professor of Family Medicine at CCHS; Dr. Cassandra Ford, associate professor of Nursing at UA’s Capstone College of Nursing; Dr. Michele Montgomery, assistant professor of Nursing at UA’s Capstone College of Nursing; and Dr. Raheem Paxton, associate professor of Community Medicine and Population Health at CCHS.

 

Winners were named in three categories:

Student Division

First Place – Paul Strickland, William Riley, Jared Willis, Dr. Dan Avery, Glenn Davis, ET-P, Travis Parker, EMT-P, and Jared Halstrom, for Developing a Comprehensive Obstetrics Training Program for Alabama Emergency Medical Service Providers.

Second Place – Hillary Dorman, Amy Albright, Kaleb Murry, Deanna Dragan, Dr. Jermaine Mitchell, Dr. Pamela Payne-Foster, Dr. JoAnn Oliver, Chris Spencer, and Dr. Rebecca Allen, for The Holt Potted Plant Project: Older Adult Wellness & Community Engagement.

Third Place – Caroline Whittington, and Dr. Patricia Parmelee, for Effects of Activity Levels on Emotional Well-Being in Osteoarthritis: Global vs. Momentary Effects.

 

Resident Division

First Place – Dr. Paul Manhas, Dr. Richard Giovane, Paul Strickland, Dr. Jennifer Clem, Dr. Catherine Skinner, and Dr. Drake Lavender, for Basics of Clinical Medicine Lecture Series: A Novel Student-/Resident-directed Learning Initiative.

Second Place (tie) – Dr. Brittany McArthur, Dr. Dakota Acton Jones, Dr. Jackie Luker, Dr. Anne Halli, Dr. Clifton Scott, and Dr. Sam Lee, for Identifying Barriers Associated with the Discussion and Completion of Advanced Directives.

Second Place (tie) – Dr. Lisa Tsugios, Dr. Alan Blum, and Dr. Louanne Friend for Pet Therapy.

Third Place – Dr. Blake DeWitt, Dr. Catherine Skinner, and Dr. Louanne Friend, for The Effects of an Advanced Life Support Obstetrical Interprofessional Class on Participant Interprofessional Socialization and Readiness to Function in Interprofessional Teams.

 

Faculty Division

First Place – Dr. Martha Crowther, Dr. Cassandra Ford, Dr. Latrice Vinson, Dr. Chao-Hui Huang, Dr. Ernest Wayde, and Susan Guin, MSN, CRNP, for Recruitment of Mid-life and Older Adults for Mental Health and Physiological Measures.

Second Place – Dr. Abbey Gregg, and Shreya Roy, for Exploring the Impact of Medicaid Expansion for Former Foster Youth: Associations between Health Insurance and Adult Outcomes.

Third Place (tie) – Dr. Mercedes Morales-Aleman for Sexual Healthcare Access among Adolescent Latinas in Alabama.

Third Place (tie) – Dr. Drake Lavender for Melanosis Coli: A Case Report.

 

Of the posters, 14 were presented in the Student Division, 12 in the Resident Division and 13 in the Faculty Division.

CCHS brings Mini Medical School to Capstone Village

The CCHS Mini Medical School presentations are now offered at Capstone Village, a residential retirement community on The University of Alabama Campus.

The Mini Medical School series was created several years ago by the College in collaboration with UA’s OLLI program and lets adults and community learners explore trends in medicine and health. Lectures are provided by CCHS faculty and resident physicians who also care for patients at University Medical Center.

The first Mini Medical School presentation at Capstone Village was provided Nov. 16 by Robert McKinney, MSW, LCSW, PIP, ACSW, an assistant professor of Social Work at CCHS and director of UMC’s Department of Social Services. The topic was anxiety.

McKinney said anxiety is normal and most people experience anxiety at some point in their lives. “The difference between regular anxiety and anxiety that we need to pay attention to has to do with the way those feelings affect our lives – if the same thing is bothering you for more than six months, and if you change your life because of the anxiety.”

He explained that common anxiety disorders are generalized anxiety disorder, panic disorder, social anxiety disorder and phobias, and symptoms include uncontrollable feelings of panic and fear, sleep disturbances, shortness of breath, increased heart rate, inability to sit still, nausea and dizziness.

McKinney said 40 million Americans suffer from anxiety disorders, but only one-third receive treatment, and that takes a toll on health. “Chronic stress has negative effects on the body and can create disease.”

So, how do you know if you have an anxiety disorder? “It’s about intrusive feelings that cause us to change something in our lives – going out of our way to avoid a perceived stressor, avoiding social situations, feelings of being watched or judged, panic attacks, sleeping less, or more, due to intrusive thoughts,” McKinney said.

The good news is that anxiety disorders respond well to treatment, he said, including therapy, medication, meditation, yoga and exercise.

“Anxiety is real, not imagined, and it should be treated like any other medical condition,” McKinney said.