Feb 252014
 

The news has been filled with reports of new guidelines to prevent and treat heart disease, hypertension and obesity.  My patients have pointed out that none of these new guidelines discuss diet. Reports about the new heart guidelines focus on a controversial new risk assessment tool and also the potential for many more people taking statin drugs.  Working toward achieving and maintaining a healthy weight and consuming a health promoting diet is still an important part of taking care of your heart.  If you don’t know your daily caloric needs, it’s time for you to go to SuperTracker (www.supertracker.usda.gov) and create a personal heart healthy diet and physical activity plan. If you know your calorie needs, you might want to track your intake using a Smartphone App like myfitnesspal.com.  Use the Nutrition Facts label on foods to identify foods that are lower in fat and saturated fat.  It’s recommended that you eat as little Trans-fat as possible and less than 6 percent of your calories from saturated fat. If a Nutrition Facts label shows a food having less than 5 percent of the Daily Value from saturated fat that is a low saturated fat food.  Avoid those foods that meet more than 18 percent of the Daily Value. Many people enjoy following a Mediterranean eating approach to protect their heart.  You can find a nice handout on the ECU Family Medicine website (http://www.ecu.edu/cs-dhs/fammed/resources/upload/RC_Med_diet-2.pdf) that allows you to assess your current diet and see what changes you might need to make.  And if you are on the Brody-Vidant Medical Center campus, stop in at the ECHI Heart Café (first floor of the ECHI hospital).  You can try affordable, delicious heart healthy food.  Are you confused about how to protect your heart?  Ask for a referral to a registered dietitian who can help you discover a healthy, affordable, fad-free way of eating for heart health.

 Kathryn M Kolasa Kelly PhD, RD, LDN
Professor Emeritus and Affiliate Professor.  Master Educator.
Vidant Health Nutrition Consultant

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Feb 072014
 

To commemorate African-American History Month, the Brody School of Medicine’s Office of Diversity Affairs and the Student National Medical Association will sponsor an illustrated talk entitled, “Entering a ‘White’ Profession: Black Physicians and Racial Exclusion, 1865-1920.” Todd L. Savitt, PhD, assistant dean of diversity and professor in the Department of Bioethics and Interdisciplinary Studies, will speak noon-1p.m. on Thursday, Feb. 20 in Brody 2N-86.

Black physicians in the highly race-conscious turn-of-the-century South were gaining recognition and achieving a measure of success.  Like other physicians, they faced the problems of gaining patients’ confidence and establishing collegial relationships with other local doctors.  They had to earn their status among patients and practitioners.  But black physicians of the period lived always with another issue that affected their careers and personal lives—race.  For example, they had to overcome black patients’ reluctance to use their services, low remuneration from a generally poorer, predominantly black clientele, and an unfriendly reception and professional exclusion from many white physicians. The sorts of situations Southern black physicians encountered and the ways they coped with them in their dealings with black patients, white physicians, white patients, and fellow black doctors as they entered the previously white medical profession are the subject of this article.

Race added an extra measure of uncertainty to the arrival of a black practitioner in town.  Few blacks and even fewer whites had ever met and dealt with, personally or professionally, a black person with a medical degree.  So the same black citizens who accorded black physicians high status in the community also treated warily someone so different from themselves who took on a role (“doctoring”) usually reserved for whites.

Southern white doctors took advantage of black practitioners’ vulnerable positions to isolate them professionally.  In addition to refusing to consult with or assist blacks, they barred their black colleagues from joining local and state medical societies, refused them admitting privileges to local hospitals, and overtly and subtly tried to reduce their competitiveness for patients who could afford to pay.  This gulf of isolation based on race appeared almost immediately after blacks entered the medical profession in the 1860s.  Such exclusionary policies extended to all Southern medical societies through the 1940s.

Black physicians fought against professional isolation in several ways.  Personal contact with white physicians sometimes helped.  More fruitful were activities that sought to circumvent the formal racial isolation imposed by whites.  Though these methods simply established parallel segregated institutions for black physicians, they did provide professional opportunities that were otherwise unavailable.  Occasionally black physicians in a city established a local medical society and met regularly for professional or social purposes.  Others simply recognized common needs and acted to assist one another, even in rural areas.

In general, black physicians adapted to medical practice in the segregated South despite the variety of racial problems and barriers they faced.

Savitt, Todd

Jan 212014
 

The REACH (Redesigning Education and Accelerating Change in Healthcare) Initiative, at the Brody School of Medicine, is thrilled to welcome its inaugural class of the Teachers of Quality Academy professional development program.

Health systems today need clinicians skilled in patient safety, quality improvement and systems-based practice. Additionally, this expertise must be developed in graduates who embody the highest values of professionalism and can thrive in an environment of interprofessional, team-based care.

The REACH program at the Brody School of Medicine is designed to close this substantial gap between today’s trainees and tomorrow’s health care practitioners.

A kick off banquet was held Jan. 16 for the 37 new TQA faculty, their sponsors, and medical school and health system leaders. TQA faculty represent all clinical departments in the BSOM, as well as faculty from the College of Nursing and College of Allied Health Sciences.

The TQA curriculum, focused on patient safety, quality improvement, team-based care and population health, as well as educational development for teaching these competencies, will begin online modules and independent reading in January. Our first of six two-day learning sessions begins in March, at which time we anticipate having thought leaders from the American Medical Association on site to champion this work and educate our faculty. During the summer, the TQA cohort will begin work on a Credential in Medical Education with ECU’s College of Education, which is where the real curriculum development for our students will begin.

We are excited to collaborate with the Institute of Healthcare Improvement in the development and administration of a pre-test/post-test for both our TQA faculty and students, based on the 16 online modules to complete the Open School Certificate, which all TQA faculty and students will complete. Student curricular pieces are being designed, implemented, and refined with current students with plans for full implementation of innovative educational strategies to be offered throughout the four years of the medical school curriculum beginning with our 2014 matriculants.

While this project was not originally designed as an interprofessional cohort of faculty and students, we are excited that leaders from the Division of Health Sciences have supported the transformation of this project into an interprofessional program, which will model the transformation needed in health care. Our health system is engaged, at the level of the Vidant Health CEO, Vidant Medical Center President, Chief Medical Officers from both Vidant Health and Vidant Medical Center and the Vidant Health Chief Quality Officer. Visit http://www.ecu.edu/reach to find out more about this exciting initiative!

luan lawsonLuan Lawson, MD, MAEd
Assistant Dean of Curriculum,
Assessment and Clinical Affairs
Brody School of Medicine

Jan 032014
 
kidneys dec. 2013

Dr. Robert Harland of the Brody School of Medicine, center, poses with participants in the kidney donor exchange, left to right, Sherrie Hoopes of Jacksonville, Leslie Smith of Bevinsville, Ky., Jamaal Peele and his mother, Brenda Peele, both of Greenville, during a press event Dec. 30 at Vidant Medical Center. Photo by Jeannine Manning Hutson

The new year often brings resolutions for better health. Losing weight or eating healthy foods may be No. 1 on many lists, but organ donation can be another way to make a difference.

A four-person kidney transplant in Greenville has given two people hope in the new year and two more the satisfaction of knowing they helped save a life.

Physicians from the Brody School of Medicine at East Carolina University and a local private practice participated in the transplants, which took place Dec. 16 at Vidant Medical Center.

Dr. Robert Harland, professor and chief of surgical immunology and transplantation at ECU and chief of transplant surgery at VMC, said the procedures were successful and allowed two of the hospital’s wait list patients to receive living donor kidneys instead of potentially waiting years for a kidney from a deceased donor.

Jamal Peele of Greenville and Leslie Smith of Bevinsville, Ky., each had planned to donate one of their healthy kidneys to relatives, but were not good matches. They were good matches, however, for each other’s relatives.

Thus, Peele donated to Smith’s aunt, Sherrie Hoopes of Jacksonville. Smith donated to Peele’s mother, Brenda Peele of Greenville.

The donors met the recipients for the first time Dec. 30 and all are doing well. Both donors underwent their procedures laparoscopically, which requires smaller incisions and often results in a quicker recovery and shorter hospital stay. The recipients are off dialysis and have normal kidney function.

The kidney exchange was the second performed by the transplant program at ECU and VMC, following a six-person exchange in 2011. Harland estimates that about 500 paired exchange kidney transplants were performed in the United States in 2013, representing fewer than 10 percent of the approximately 6,000 living donor kidney transplants performed. However, this transplant option has seen rapid growth over the past five years. The first paired kidney exchanges were performed in the United States in 2000.

In addition to maintaining an internal paired exchange list, patients listed at VMC have the option of being listed for a nationwide exchange list.

More than 434 eastern North Carolinians are awaiting a kidney transplant at VMC, according to according to Jennifer Thompson, transplant coordinator with Vidant Health. In 2013, doctors performed 94 kidney transplants, up from 88 in 2012.

The typical length of time between joining the Vidant/ECU waiting list and receiving a transplant is between 36 and 60 months, Thompson said.

Thompson estimated more than 3,000 people are on dialysis in the 29-county area served by Vidant Health.

Clearly there is a need for more organ donors. Several observances related to organ donation kick off next month. Feb. 14 is National Donor Day, March is National Kidney Month and March 14 is World Kidney Day. April is Donate Life Month. Click the links to learn more.

In addition to Harland, the following experts were involved in the kidney transplant last month:

–Dr. Claire Morgan (ECU Physicians)

–Dr. Carl Haisch (ECU Physicians)

–Dr. Reginald Obi (ECU Physicians)

–Dr. Heather Jones (Eastern Nephrology Associates)

–Dr. Kristel McLawhorn (Eastern Nephrology Associates)

–Dr. Scott Kendrick (Eastern Nephrology Associates)

–Dr. Lorita Rebellato (ECU associate professor of pathology and laboratory medicine director of histocompatibility lab)

For more information about kidney transplants at ECU and VMC, call 252-744-2620.

Dec 182013
 

Forty-nine physicians from the Brody School of Medicine at East Carolina University have been chosen by their peers for inclusion in the 2014 “Best Doctors in America” list.

The annual list is compiled by Best Doctors Inc., a Boston-based group that surveys more than 45,000 physicians across the United States who previously have been included in the listing asking whom they would choose to treat themselves or their families.

Approximately 5 percent of the physicians who practice in the United States make the annual list. A partial list of the state’s best doctors is in the December issue of “Business North Carolina” magazine. The full list is online at http://www.businessnc.com/special-reports-publications/special-report/north-carolina-s-best-doctors/?back=special.

The ECU physicians on the list are Dr. William A. Burke, dermatology; Drs. Jon Firnhaber, Susan Keen, Greg W. Knapp, Lars C. Larsen, Tae Joon Lee, Gary I. Levine, Kenneth Steinweg and Ricky Watson, family medicine; Drs. Paul P. Cook and Keith M. Ramsey, infectious diseases; Dr. Nathan Brinn, pediatrics and internal medicine; Drs. Mary Jane Barchman and Paul Bolin, nephrology; Drs. Raymond Dombroski and Edward R. Newton, obstetrics and gynecology; Drs. David Hannon and Charlie J. Sang Jr., pediatric cardiology; Dr. Glenn Harris, pediatric diabetologist; and Dr. William E. Novotny and Ronald M. Perkin, pediatric critical care; Dr. Susan Boutilier, pediatric neurology and sleep medicine; and Dr. John Gibbs, neurology.

Also listed are Dr. Michael Reichel, pediatric developmental and behavioral problems; Dr. David N. Collier, pediatric obesity; Dr. Daniel P. Moore, physical medicine and rehabilitation; Dr. Elaine Cabinum-Foeller, pediatric abuse; Dr. Diana J. Antonacci, John Diamond and Kaye L. McGinty, child and adolescent psychiatry; Dr. Scott S. MacGilvray, neonatal medicine; Drs. Lorraine Basnight, Karin Marie Hillenbrand, Thomas G. Irons, Suzanne Lazorick, Dale A. Newton, John Olsson, Kathleen V. Previll and Charles Willson, general pediatrics; Drs. Robert A. Shaw, Yash Kataria and Mark Bowling, pulmonary medicine; Drs. Robert Harland and Eric Toschlog, surgery; Dr. Emmanuel Zervos, surgical oncology; Dr. Danielle Walsh, pediatric surgery; Dr. W. Randolph Chitwood Jr., cardiothoracic surgery; Dr. Eleanor Harris, radiation oncology; and Dr. Charles S. Powell, vascular surgery.