Lisa Kohler, MD - AkronCantonMDNews

Greater Akron/Canton Edition | January-February 2008 VOL. 12, NO. 1 

www.akroncantonmdnews.com 

Lisa Kohler, MD 

Dealing with Death Daily 

Bariatric Surgery and 

Type 2 Diabetes 

Special Sections 

Cardiology 

Obesity 

2008 Annual Directory 

of Services

from the publisher 

Affiliation. That was the buzzword throughout the greater Akron/Canton medical community, 

as 2007 came to a close. Akron General Health System formed an affiliation with 

Cleveland Clinic; Medina General Hospital, with University Hospitals; and Summa Health 

System, with WRH Health System and Robinson Memorial Hospital. In addition, Summa 

acquired Barberton Citizens Hospital, bringing its total number of hospital affiliations and 

acquisitions (which includes Akron City Hospital, St. Thomas Hospital and Cuyahoga Falls 

General) to six. 

These affiliations and acquisitions were expected and, most would agree, necessary — especially 

in the light of continuously increasing costs and decreasing reimbursements. Most hope 

the new partnerships will improve operational efficiencies for all concerned. Other benefits, 

such as enhanced healthcare services, new research collaborations, assistance with physician 

recruitment, and expanded opportunities for staff education, are anticipated, as well. 

Anticipation. Hopeful anticipation. That may well be the buzz word/phrase for 2008. May 

we all anticipate a healthier, happier and more prosperous new year. 

Here’s to 2008! 

Jan Raabe, Publisher 

Greater Akron/Canton M.D. News 

jan@akroncantonmdnews.com 

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Stacy Brethauer, MD, Tomasz Rogula, MD, PhD, 

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contents VOL. 

12, NO. 1 

JANUARY-FEBRUARY 2008 

4 COVER STORY 

LISA KOHLER, MD 

Dealing with death on a daily basis 

— that’s Dr. Lisa Kohler’s job as the chief 

medical examiner of Summit County. 

11 SPECIAL SECTION 

OBESITY 

11 SURGERY FEATURE 

BARIATRIC SURGERY 

AND TYPE 2 DIABETES 

Of all the benefits of bariatric surgery, the 

most dramatic appear to be related to type 2 

diabetes. Is it a treatment? Is it a cure? Read 

what the medical literature says about this. 

hospital spotlight 

27 

2008 Annual 

Directory of Services 

38 SPECIAL SECTION 

DEPARTMENTS 

50 the sporting life 

51 the sommelier 

59 hospital rounds 

4 

Akron General’s Chest Pain Center 

Acute myocardial infarction (AMI) is the single leading 

cause of death in America, accounting for 1 in 5 deaths 

in 2003, according to statistics from the American Heart 

Association. Ongoing advancements in the treatment 

of AMI result in reduced mortality and morbidity, but 

successful CARDIOLOGY 

treatments are time dependent and necessitate 

rapid initiation. For good outcome, the patient must quickly 

recognize the signs and symptoms of an AMI and seek 

medical care, and the physician must quickly diagnose the 

AMI and initiate treatment. 

In 2003, Akron General Medical Center introduced to 

38 

George Litman, chief of Cardiology at Akron General Medical Center 

Summit County the concept of a chest pain center as a 

strategy to significantly reduce heart attack deaths through 

the rapid treatment of patients with AMI. One year later, 

this Center was accredited by The Society of Chest Pain 

Centers. The Society promotes protocol based medicine 

to address the diagnosis and treatment of acute coronary 

syndromes and heart failure, and to promote the adoption 

of process improvement science by healthcare providers. To 

date, less than 400 hospitals have earned Chest Pain Center 

accreditation from the Society. 

“To earn accreditation status, healthcare facilities must 

meet or exceed a wide set of stringent criteria and 

then allow an on-site evaluation by a review team 

from the Society of Chest Pain Centers,” said George 

Litman, MD, chief of Cardiology at the Akron 

General Heart & Vascular Center. “We were the first, 

and still are the only, hospital in Summit County to 

have an accredited Chest Pain Center.” 

To achieve accreditation by the Society of Chest 

Pain Centers Akron General demonstrated expertise 

in the following eight areas: 

Emergency Department Integration with the 

Emergency Medical System. A formal relationship 

between the ED and the local EMS links the care 

processes for patients with symptoms of possible 

acute coronary syndrome (ACS). 

Emergency Assessment of Patients with Symptoms 

of ACS / Timely Diagnosis and Treatment of ACS. 

An ED program minimizes delays in institution 

of therapy for an ACS (nitrates, heparin, aspirin, 

percutaneous intervention, thrombolytics, etc.). 

Patients with Low Risk for ACS and No Assignable 

Cause for their Symptoms. An ED or hospital 

observation program monitors and evaluates lowrisk 

patients to avoid the inadvertent release home 

of patients with ACS or unstable angina. 

Functional Facility Design. The ED CPU has 

a functional design for chest pain evaluation 

to accomplish optimal patient care. It includes 

appropriate cardiovascular monitoring equipment. 

Personnel, Competencies, and Training. Physicians 

ON THE COVER 

Lisa Kohler, MD, Summit County Chief 

Medical Examiner 

11 

PHOTO © SMITHBERGER PHOTOGRAPHY, NORTH CANTON 

2 | GREATER AKRON/CANTON M.D. NEWS JANUARY-FEBRUARY 2008

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cover 

story 

Lisa Kohler, MD 

Dealing with Death Daily 

By Alex Strauss 

When Dr. Lisa Kohler was a Norton High School student, she 

was interested in two things: Law enforcement and science. She was 

fascinated by the idea of reconstructing a crime from puzzle-pieces of 

evidence as she knew crime scene investigators did. But she also loved 

her science classes and excelled at working with her hands. When she 

had the opportunity to visit both the local crime lab and the Summit 

County Coroner’s Office, she jumped at the chance. 

“I was trying to figure out what I was going to do with my life and 

was deciding between these two areas. I went to the crime lab and 

found it interesting. I also came to the coroner’s office and had a chance 

to speak with the coroner at the time. I immediately found forensics 

so fascinating,” Dr. Kohler recalled. 

In the wake of that pivotal meeting, Kohler went on to pursue two 

summer internships at what was then the coroner’s office while she 

was an undergraduate at the University of Toledo. There was no doubt 

— she was hooked. 

“My internships were really what made me decide that this is what 

I wanted to do. Forensic pathology combined my interest in law 

enforcement with my interest in science and my desire to really be 

hands-on in my work,” said Dr. Kohler. She enrolled in the Medical 

College of Ohio where she studied forensic pathology and attended 

local forensics conferences whenever possible to meet and talk with 

other pathologists. The more she learned, the more convinced she 

became that she was on the right career path. 

Dr. Lisa Kohler is a board-certified forensic pathologist and the chief medical examiner of Summit County. As such, she oversees a staff of 22 who 

perform more than 600 autopsies annually. 



After mornings of case evaluation and autopsies, a medical examiner’s afternoons are normally spent reviewing paperwork, communicating with 

families and law enforcement personnel, and performing various microscopic studies. Dr. George Sterbenz is shown here reviewing a case with Dr. 

Kohler. 


“Not all pathologists enjoy doing autopsies, but I really do. I like 

being able to hold that heart in my hands and see the damage that was 

caused by that heart attack,” she said. “I enjoy the mental challenge 

but I also really enjoy the physical challenge of being able to feel and 

touch what was going on inside that person’s body.” 

THE ROAD LESS TRAVELED 

Dr.Kohler received her medical degree from the Medical College 

of Ohio in Toledo. After completing her pathology residency at the 

University of Pittsburgh, she went on to fellowship training at the 

Office of the Chief Medical Examiner in Richmond, Virginia. It was 

there that she took supplemental training in several specialized areas 

including forensic dentistry and forensic anthropology. Armed with 

her education and a true passion for her field, Dr. Kohler returned to 

her home state in 1998 to join the office that had so inspired her as a 

student. Colleagues who had come to know her and her work during 

her summer internships were glad to welcome her back. 

“It was really a very easy transition when I started as a Deputy 

Medical Examiner in the Summit County Medical Examiner’s Office,” 

said Dr. Kohler. “People in the office knew me and they knew what 

to expect.” 

Dr. Kohler hit the ground running and quickly moved up the ranks 

in her office. By 2000, she was promoted to Chief Deputy Medical 

Examiner and a year later became the Acting Chief. In April 2001, 

Dr. Kohler became Summit County’s Chief Medical Examiner, 

simultaneously fulfilling a lifetime dream and becoming the only 

Chief Medical Examiner in a state where all other top county forensic 

experts are coroners. 

“To be a coroner you have to have a medical degree but, according to 

our charter, to be a medical examiner, you have to be a board-certified 

forensic pathologist,” explained Dr. Kohler, who pointed out another 

difference. Medical Examiners are appointed by the county; coroners 

are elected by popular vote. “I don’t have to step away from my duties 

every four years and do the things required to maintain a position as 

an elected official. I can just continue to concentrate on my work.” 

HEAVY WORKLOAD 

And there is plenty on which to concentrate. As Chief Medical 

Examiner, Dr. Kohler oversees a staff of 22, who perform more than 

600 autopsies annually. She spends her days handling cases that range 

from the mundane to the sensational. 

“Any sudden or unexpected death when the person was in good 

GREATER AKRON/CANTON M.D. NEWS JANUARY-FEBRUARY 2008 | 5


health gets referred to our office. Of course, violent deaths and also 

death by accidental injury are referred here. Likewise, any child under 

the age of two who was not under the continuous care of a physician 

and anyone who was mentally handicapped are referred.” 

It is up to Dr. Kohler and her staff to review each case, decide whether 

an autopsy is in fact warranted, perform the autopsy, and communicate 

the resulting findings to the family or law enforcement officials. 

“Sometimes it’s an elderly person who hasn’t seen a physician in 

many years,” Dr. Kohler explained. “Sometimes we just do an external 

evaluation to rule on the probable cause of death when the family 

does not want an autopsy.” 

But other cases, such as homicides and suicides, are not so straightforward. 

Occasionally, a case will make local or national headlines, such 

as the high-profile Jessica Davis murder investigation in which Kohler 

will soon testify. These types of cases can present an exciting challenge 

to Dr. Kohler and her team, but they also create a lot of extra work. 

“One of the toughest and most time-consuming aspects of handling 

a case like that is just making sure that the media has access to the 

information they need. We end up answering a lot of extra phone 

calls,” she said. “The other aspect is that we often need to bring in 

other experts, such as a dentist or fingerprint expert or a forensic anthropologist 

if there is a high degree of decomposition. So, from that 

standpoint, it can be more taxing as well as more challenging.” 

After mornings of case evaluation and autopsies, Dr. Kohler’s afternoons 

are spent reviewing paperwork, communicating with families 

and law enforcement personnel, performing various microscopic 

studies, and sometimes providing expert testimony in court cases. 

While a daily routine devoted to death might weigh heavily on some, 

Kohler continues to love her work, especially performing autopsies. 

The key to staying positive, she explained, is maintaining an objective 

view and having her family’s support. 

“There is always a degree of separation. You have to be able to really 

disassociate from the person you are working on and view it as a set 

of clues, the answers to a puzzle as to why he or she died. Sometimes 

there will be something that hits more close to home, such as a young 

child or someone close to your own age. But, for the most part, you 

have to concentrate on the fact that you are providing those family 

members with some kind of closure.” 

FROM MEDICINE TO MANAGEMENT 

In fact, it is not the daily face of death that Kohler finds most 

challenging in her job. It is her managerial and administrative duties. 

Her staff includes three board certified forensic pathologists, three 

morgue attendants, nine forensic death investigators, a computer 

specialist, three secretaries, a toxicologist, a histotechnologist and 

an administrator. Keeping the busy office running smoothly is a 

constant effort. 

“I am a physician. I never really received 

formal training on how to be an administrator,” 

said Dr. Kohler. “I have had to really 

learn how to deal with managerial things.” 

But, as in the other areas of her professional 

life, Kohler has risen to the challenge. Under 

her leadership, the Summit County Medical 

Examiner’s Office was awarded a five-year 

accreditation by the National Association of 

Medical Examiners in 2006. The designation 

required written policies and procedures in 

compliance with strict NAME guidelines. 

And there was an additional hitch. 

“I was actually in the hospital having my 

third child at the time the on-site inspection 

took place,” recalled Dr. Kohler. “So the 

people in the office really had to step up to the 

challenge. It was very much a team effort.” 

Just as she thrives on the challenges of 

leadership and the efforts of piecing together 

complex cases, Dr. Kohler also enjoys the 

never-ending variety of her job. 

“Sometimes we’re figuring out medical 

problems. Sometimes we’re dealing with 

legal issues. Sometimes we’re helping to solve 

crimes. Every day is different and every day 

presents a new set of challenges.” ■ 


Summa Health System forms Affiliation 

with WRH, acquires BCH 

In November, Summa Health System announced 

an affiliation agreement with WRH 

Health System and acquired Barberton Citizens 

Hospital (BCH). Under terms of the agreements, 

Summa has already begun working with 

both hospitals to enhance the scope of healthcare 

services provided to the communities served. 

WRH HEALTH SYSTEM 

The affiliation with WRH was formed to 

provide greater access to healthcare services, 

including enhanced emergency and after hours 

care, intensive care and cardiology for the residents 

of Medina and Wayne Counties and the 

surrounding communities. It also was formed to 

increase operational efficiencies for both Summa 

and WRH. As part of the affiliation agreement, 

Summa will provide support to WRH in the areas 

of finance, materials management and other 

general operating and administrative services. 

The agreement will include oversight through 

the creation of an affiliation council consisting 

of members of the senior leadership teams from 

both Summa Health System and Wadsworth 

Rittman Hospital. 

Under terms of the agreement, WRH is an 

affiliated member of Summa Health System. 

However, the affiliation agreement makes no 

change in the ownership status of either organization. 

In addition, the Wadsworth Rittman Area 

Hospital Association Board of Directors will 

continue to be responsible for the operation of the 

facility. Summa and WRH also are examining 

ways in which they can work together to create 

a more fully integrated future model that benefits 

both organizations and the community. 

BARBERTON 

CITIZENS HOSPITAL 

Summa Health System acquired Barberton 

Citizens Hospital from a subsidiary of Tennesseebased 

Community Health Systems. Driven 

by its desire to enhance care for the people of 

Barberton and the surrounding communities, 

Summa entered into negotiations to purchase 

Barberton Citizens Hospital in September. 

There are no plans to make any changes to 

hospital leadership or to eliminate employees. 

The search for a successor to Barberton Citizens 

Hospital president & CEO Willard Roderick, 

who recently announced plans to retire effective 

May 31, 2008, will begin in the near future. 

Barberton Citizens Hospital and WRH 

Health System are the second and third additions 

to Summa Health System in 2007. In January, 

Summa formed an affiliation agreement with 

Robinson Memorial Hospital in Ravenna, Ohio. 

Other Summa hospitals include Akron City, St. 

Thomas and Cuyahoga Falls General. ■ 


Akron General 

Health System 

and Cleveland 

Clinic Form 

Clinical 

Affiliation 

Akron General Health System and 

Cleveland Clinic have agreed to form a 

clinical affiliation, effective immediately. 

This affiliation will provide opportunities 

for Akron General and Cleveland 

Clinic to work together in areas that 

may include an expansion of clinical 

services at Akron General, collaboration 

on research, assistance with physician 

recruitment and improving educational 

opportunities for medical staff at 

Akron General. 

As clinical affiliate of the Cleveland 

Clinic, Akron General will be able to enhance 

clinical care capabilities currently 

offered, while retaining self-governance 

and independence. In addition, the affiliation 

will serve as a catalyst to develop 

new and innovative programs in areas 

such as health and wellness. 

Both sides began due diligence discussions 

during the summer aimed at 

developing a working relationship. Those 

in-depth discussions resulted in the announcement 

of this clinical affiliation. 

Currently, Akron General and the 

Cleveland Clinic are working together 

in an innovative program that brings 

Cleveland Clinic physicians, who are 

world-renowned specialists in cardiac 

rhythm disorders, to Akron General 

to treat patients at its Heart & Vascular 

Center. The new agreement provides 

potential to replicate this model in other 

clinical areas at Akron General. ■ 


RateMDs.com: 

Physicians Beware 

By Corbin Moore 

The internet is a valuable tool for 

physicians both for research and communication. 

However, recently it has 

become dangerous ground. This is because 

the trend of anonymous consumer 

ratings has finally spread to healthcare. 

The reputations of all physicians are now 

vulnerable to damage by anonymous 

postings on internet sites. 

One of the most popular of these 

sites is www. RateMDs.com. RateMDs 

encourage patients to anonymously 

evaluate their doctors and post whatever 

they choose about their experience. The 

lack of checks or any kind of authenticity 

requirements mean that essentially, 

anyone can write anything about 

any physician. 

Angry patients, competitors, and 

others who would seek to harm your 

reputation now have a free and easy 

global platform in which to do so. A 

company out of North Carolina founded 

to protect physicians from frivolous 

lawsuits has been conducting research 

on RateMDs.com and other sites and 

what they have discovered is unsettling 

to say the least. 

Until now, there has been little that physicians 

could do about libel on the internet. 

However, there is at least one organization 

which is gearing up to combat web defamation 

(see www.medicaljustice.com). They 

have crafted a proactive, innovative solution 

that can help you prevent unwanted 

comments and take action if and when you 

find them. 

We encourage all physicians to look 

themselves up on www.RateMDs.com, 

www.healthgrades.com, and other sites. 

It is also a good idea to “Google” yourself 

and your practice regularly to see what’s 

out there on websites and blogs. 

Corbin Moore is president of Sirak-Moore 

Insurance Agency in Canton and Akron. ■ 

1 0 | GREATER AKRON/CANTON M.D. NEWS JANUARY-FEBRUARY 2008

surgery feature 

Bariatric Surgery and Type 2 Diabetes 

A Treatment? A Cure? 

By Philip R. Schauer, MD; Bipan Chand, MD; Stacy A. Brethauer, MD; Tomasz Rogula, MD, PhD 

Bariatric surgery cases, involving Roux-en-Y gastric bypass, 

gastric banding, and biliopancreatic diversion, have increased 

dramatically in the United States over the last decade from approximately 

10,000 cases per year to 200,000 annually in 2007. 

(See illustrations on next page.) This increase coincides with a 

dramatic increase in the incidence of obesity, as well as patient 

demand for surgery. 

The majority of bariatric procedures today are being performed 

with less invasive laparoscopic techniques, which have reduced 

complications, recovery time, and pain from the surgery, making 

it much more desirable for patients. Patients tend to lose anywhere 

from 40% of their excess body weight to 75-80% of their excess 

body weight. Many studies demonstrate that the majority of the 

weight lost from bariatric operations is maintained up to and beyond 

10 years, indicating a very durable effect. 

The major benefits of bariatric operations are primarily, but 

PHOTOS COURTESY OF CLEVELAND CLINIC 

not exclusively, derived from the amount of weight loss. Many 

medical conditions, including the following, have been shown to 

be dramatically improved or reduced after surgery: type 2 diabetes, 

hypertension, hyperlipidemia, osteo arthritis, gastro esophageal 

reflux, sleep apnea, fatty liver disease, urinary incontinence, coronary 

artery disease. All of these have been shown to dramatically 

improve or resolve following bariatric operations. (See illustration 

on third story page.) 

BENEFITS OF BARIATRIC SURGERY TO 

PATIENTS WITH TYPE 2 DIABETES 

Of all the benefits of bariatric surgery, the most dramatic appear 

to be related to type 2 diabetes. Type 2 diabetes is defined as severe 

insulin resistance leading to a chronic state of hyperglycemia. Until 

recently, therapy for type 2 diabetes has been restricted either to 

insulin or oral hypoglycemic agents, in addition to lifestyle changes 

and dietary therapy. 

In the early 1990s, reports regarding the effect of bariatric 

operations on type 2 diabetes began to appear in the medical literature. 

In five published studies examining a total of 3,568 people 

undergoing Roux-en-Y gastric bypass, diabetes was in complete 

remission in most cases. The majority of studies showed remission 

in approximately 83% of cases. Remission in diabetes means that 

patients are able to discontinue all diabetic medications, and have 

a normal fasting blood sugar and a hemoglobin A1C (HA1c) of 6.0 

or less. However, one study found the remission rate to be as high 

as 98%. 12345 Moreover, bariatric surgery may help prevent diabetes 

altogether. In a 5.5 year longitudinal study of obese people with 

impaired glucose tolerance, those who underwent bariatric surgery 

had a 30-fold lower risk of developing diabetes. 6 

Lowering the risk of diabetes and its long-term health effects 

clearly saves lives. Given the close association between obesity and 

diabetes, it is not surprising that in one 2004 observational study, 

Christou et al found that the 5-year mortality rate in patients who 

had undergone bariatric surgery was 0.68% compared with 16.2% 

in the medically managed patients— an 89% relative risk reduction. 

7 That same year, Flum and Dellinger reported the findings of 

a retrospective study of mortality in morbidly obese patients who 

had undergone gastric bypass. They found a 27% lower mortality 

rate over 15 years in the patient population as opposed to obese 

patients who had not had surgery. 8 


Since that time, over 20 studies have been conducted, including 

a recent medical analysis that shows a significant improvement 

and/or remission of Type 2 diabetes that is quite durable. In 

their meta-analysis, Buchwald et al calculated that diabetes improved 

or resolved in 86% of bariatric surgery patients, although 

diabetic outcomes varied according to operative procedure. 

Diabetes resolved completely in 84% of gastric bypass patients. 

Biliopancreatic diversion and gastric bypass patients had the most 

improvements in hyperlipidemia postoperatively (99% and 97% 

resolution, respectively). 9 

The improvement appears to be dependent on a number of factors, 

including type of procedure. Gastric banding generally results 

in a remission rate of approximately 40-50%. For gastric bypass 

the resolution rate is approximately 83% and for biliopancreatic 

diversion, the resolution rate is 80-100%. A mechanism of resolution 

appears to be related to weight loss and perhaps to other 

factors. The fact that approximately 30% of patients who have 

gastric bypass have an immediate remission (prior to discharge 

from the hospital) suggests that factors other than weight loss may 

play a very important role. 

Recent work by leading investigators suggests that many gut 

hormones positively affect insulin resistance and insulin production 

including GLP1, GIP, PYY, and Ghrelin. Investigators have 

suggested that the bypass of the stomach and duodenum may be 

a key factor in altering the secretions of 

these hormones. 

The durability of this effect has been 

shown to be sustained up to and beyond 10 

years. A recent study, the Swedish Obesity 

Subject Study, compared approximately 

2,000 patients who had bariatric procedures 

with a matched cohort who did not 

have surgery and found the surgical group 

had dramatically reduced incidence of 

type 2 diabetes and a high remission rate 

that was sustained out to 10 years. 10 Other 

studies support this durable effect on type 

2 diabetes. A 2003 study published in the 

Annals of Surgery found that diabetes patients 

who received laparoscopic gastric bypass 

surgery experienced a mean weight loss of 

60%, resulting in resolution of their diabetes 

in 83% of cases. 2 The remaining 17% of 

patients involved in the study saw marked 

improvement in their type 2 diabetes following 

surgery. The group most likely to 

see complete resolution of their diabetes 

included patients who had diabetes for fewer 

than five years, were able to control it with 

diet alone, and saw the greatest weight loss 

after surgery. The study further concluded 

that the earlier the surgical intervention, 

the more likely it is to have a lasting effect 

on type 2 diabetes. 

Two recent landmark studies in The New 

England Journal of Medicine demonstrate that 

bariatric operations reduce long-term mortality 

associated with obesity. One study by 

Dr. Ted Adams from the University of Utah 

compared two cohorts of severely obese 

patients, approximately 4,000 patients 

each. 11 One group had Roux-en-Y gastric 

ILLUSTRATION COURTESY OF CLEVELAND CLINIC 

1 2 | | GREATER AKRON/CANTON M.D. NEWS JANUARY-FEBRUARY 2008

ypass; the other group was a community 

control group who were matched for age, 

body mass index % (BMI), and gender. At 

7 years follow-up, after gastric bypass there 

was a 40% reduction in overall mortality in 

the surgical group compared to the control 

group. Most of this mortality benefit was 

realized in reduction of cardiovascular 

mortality, cancer mortality and mortality 

specific to diabetes. In fact, there was a 

92% reduction in diabetic-related mortality 

in this study in the surgical group. 

The Swedish Obesity Study also published 

mortality data with a mean follow-up 

of 11 years and 99.9% follow-up rate. 10 They 

reported a 30% reduction rate in mortality 

in the surgical group, which included gastric 

banding, vertical banding gastroplasty, and 

gastric bypass, compared to control patients 

who were treated with standard medical 

therapy. The greatest reduction in mortality 

was seen from cardiac-related mortality 

and cancer. Both of these studies, along 

with several other studies, clearly show a 

strong reduction in mortality associated 

with bariatric surgery. 

BARIATRIC SURGERY AS A 

TREATMENT FOR TYPE 2 

DIABETES? 

Endocrinologists, surgeons and clinical 

investigators are now seriously beginning 

to think of bariatric operations as a direct 

treatment for type 2 diabetes. In fact, in 

March of 2007, an international meeting 

convened in Rome that included leading 

endocrinologists and bariatric surgeons to evaluate the role of 

bariatric procedures in treating type 2 diabetes. There appeared to 

be a very strong consensus that bariatric operations are effective for 

treating type 2 diabetes in patients with severe obesity, and patients 

with mild to moderate obesity may benefit as well. 

Currently, several clinical trials are being conducted to evaluate 

bariatric surgery as a treatment for patients with type 2 diabetes 

in patients with a BMI of less than 35 to as low as 30. At the 

Cleveland Clinic we are currently conducting a study known as 

STAMPEDE or Surgical Therapy and Medications Potentially 

Eradicating Diabetes Efficiently (http://clinicaltrials.gov/ct/ 

show/NCT00432809?order=2). This is a five-year, randomized 

control trial evaluating advanced medical therapy for diabetes 

compared to Roux-en-Y gastric bypass and sleeve gastrectomy 

in patients with diabetes and a hemoglobin A1c greater than 7.5 

and a BMI of between 30 and up to 40. The primary endpoint of 

success is to achieve hemoglobin A1c less than 6. Secondary endpoints 

include measuring changes not only in diabetes, but also in 

co-morbid conditions such as hypertension, hyperlipidemia and 

cardiovascular disease. To refer patients to this trial please call 

216-445-8461 or 216-445-3983. 

Considering the fact that Type 2 diabetes is an extremely debilitating, 

chronic disease that often leads to severe complications 

such as blindness, renal failure, neuropathy, and premature death 

due to cardiovascular complications such as myocardial infarction 

and stroke, any therapy that delivers consistent remission 

with reasonable risk is a major advance and treatment. Although 

surgery does carry significant perioperative risk including a 

ILLUSTRATION COURTESY OF CLEVELAND CLINIC 

GREATER AKRON/CANTON M.D. NEWS JANUARY-FEBRUARY 2008 | | 13

Bariatric & Metabolic Institute. He is also 

the past president of the American Society 

of Metabolic and Bariatric Surgery. 

Dr. Bipan Chand is the director 

of Surgical Endoscopy, Advanced 

Laparoscopic and Bariatric Surgery, and 

staff surgeon at the Cleveland Clinic 

Bariatric & Metabolic Institute. 

Dr. Stacy Brethauer is the assistant 

Laparoscopic Fellowship director and associate 

staff surgeon at the Cleveland Clinic 

Bariatric & Metabolic Institute. 

Dr. Tomasz Rogula is an associate staff 

surgeon at the Cleveland Clinic Bariatric 

& Metabolic Institute. 

PHOTO COURTESY OF CLEVELAND CLINIC 

mortality rate of approximately 0.3 % and a major complication 

rate of 5%, the strong potential for diabetes remission and 

even improvement in longterm survival does suggest that the 

perioperative risks are justified. 

Perhaps in the very near future, bariatric operations will be integrated 

into standard clinical pathways for treating type 2 diabetes 

in obese and severely obese patients. 

For more information, call 216-444-4794. ■ 

About the authors of this article: 

Dr. Philip Schauer is professor of Surgery, Cleveland Clinic 

Lerner College of Medicine, and director of the Cleveland Clinic 

References 

1. Pories WJ, Swanson MS, MacDonald KG, 

et al. Who would have thought it? An operation 

proves to be the most effective therapy for adult-onset 

diabetes mellitus. Ann Surg. 1995; 222:339-352 

2. Schauer PR, Burguera B, Ikramuddin S, 

Cottam D, Gourash W. Hamad G, Eid GM, 

Mattar S, Ramanathan R, Barinas-Mitchel 

E, Rao RH, Kuller L, Kelley D. Effect of 

laparoscopic Roux-en-Y gastric bypass on type 2 

diabetes mellitus. Ann Surg 2003 238:467-484; 

discussion 84-85 

3. Sugarman HJ, Wofe LG, Sica DA, Clore JN. 

Diabetes and hypertension in severe obesity and effects 

of gastric bypass-induced weight loss. Ann Srg 

237: 751-756; discussion 2003 757-758 

4. Wittgrove AC, Clark GW. Laparoscopic 

gastric bypass, Roux-en-Y-500 patients: technique 

and results, with 3-60 month follow-up. Obes Surg 

2000 10:233-239 

5. Schauer PR, Ikramuddin S, Gourash W, et 

al. Outcomes after laparoscopic Roux-en-Y gastric 

bypass for morbid obesity. Ann Surg. 2000; 232: 

515-529 

6. Long SD, O’Brien K, MacDonald Jr. KG, 

Leggett-Frazier N, Swanson MS, Pories WJ, 

Caro JF. Weight loss in severely obese subjects prevents the progression of impaired 

glucose tolerance to type 2 diabetes. A longitudinal interventional study. 

Diabetes Care 1994 17:372-375 

7. Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases longterm 

mortality, morbidity, and health care use in morbidly obese patients. Ann 

Surg 2004; 240_416-423; discussion 423-424. 

8. Flum DR, Dellinger EP. Impact of gastric bypass operation on survival: a 

population-based analysis. J Am coll surg 2004; 199: 543-551. 

9. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic 

review and meta-analysis. JAMA 2004; 292: 1724-1737. 

10. Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on 

mortality in Swedish obese subjects. N Engl J Med. 2007 Aug 23; 357(8): 741-52. 

11. Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric 

bypass surgery. N Engl J Med. 2007 Aug 23; 357(8): 753-61. 

1 4 | GREATER AKRON/CANTON M.D. NEWS JANUARY-FEBRUARY 2008 


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special section: obesity 

Bariatric Surgery 

Increases Longevity 

By Adrian G. Dan, MD 

The field of bariatric surgery has grown 

considerably since operative procedures were 

first performed with the intent of weight loss 

in 1956. The next fifty years have witnessed 

an obesity epidemic that has reached global 

proportions and is threatening to decrease the 

average life expectancy of future generations. 

This growing demand and the explosion 

of new technologies brought about by the 

laparoscopic revolution have resulted in the 

perpetual improvement of surgical techniques, 

leading to an exponential increase 

in the volume of patients undergoing such 

weight loss procedures. Bariatric surgeons 

have observed first hand the direct impact 

that bariatric surgery has on the quality of 

life of morbidly obese patients. In addition, 

the health benefits became evident as resolution 

of medical co-morbidities associated 

with the metabolic syndrome consistently 

followed weight loss. Researchers around the 

world reported improvement and resolution 

of type 2 diabetes, hypertension, hyperlipidemia, 

obstructive sleep apnea, and GERD, 

amongst many other conditions. Surgical 

weight loss has distinguished itself as the only 

dependable long-term weight loss solution for 

patients with morbid obesity. Despite these 

significant benefits, there had been little hard 

scientific evidence thus far demonstrating any 

survival advantages. 

Recently, however, several studies have 

begun to clarify the impact that weight loss 

surgery has on the survival and longevity 

of morbidly obese patients. Studies from 

Canada, Sweden, Australia and Italy have 

shown a significant survival benefit for 

patients undergoing weight loss operation, 

when compared to non-surgical control 

groups. These patients underwent a variety 

of procedures, including gastric bypass and 

laparoscopic adjustable gastric banding. The 

most recent evidence, published in the New 

Studies from Canada, Sweden, Australia and Italy 

have shown a significant survival benefit for patients 

undergoing weight loss operation, when compared to 

non-surgical control groups. 

England Journal of Medicine, is an elaborate 

study from the University of Utah spanning 

a 19-year period. This large retrospective 

cohort study, investigating the effects of 

Roux-en-Y gastric bypass, found that the 

long-term mortality after just seven years 

of mean follow-up was lower by 40% 

in the surgically-treated patient group. 

Specifically, mortality was reduced by 56% 

from coronary artery disease, by 92% from 

diabetes-related causes and by 60% from 

cancer-related causes. 

This avalanche of scientific data substantiates 

the survival advantage that bariatric surgeons 

have observed in patients who have chosen 

weight loss surgery as a means to improve 

their overall health. As more evidence is 

gathered regarding the safety, health benefits 

and survival advantages provided by weight 

loss surgery, more patients are likely to pursue 

the health benefits and increased longevity 

conferred by bariatric surgical procedures. 

Dr. Adrian Dan is with Summa Physicians, 

Advanced Laparoscopy Surgery of Northeast 

Ohio. He is also an assistant professor of Surgery 

at Northeastern Ohio Universities College of 

Medicine and serves as Associate Medical Director 

of the Bariatric Care Center – Summa Health 

System. ■ 


feature 

Obesity: The Continued Battle 

By Liz Meszaros 

Approximately 15 million people in the United States — that’s one in 

50 adults — are morbidly obese, according to data from the American 

Society for Metabolic and Bariatric Surgery (ASMBS). Morbid obesity 

is defined as a body mass index (BMI) of 40 or more, or a BMI of 35 or 

more with an obesity-related condition, such as type 2 diabetes. Morbid 

obesity is considered by the American Society for Metabolic and Bariatric 

Surgery as a life-threatening disease. 

The comorbidities and illnesses associated with morbid obesity are 

numerous, and include type 2 diabetes, coronary heart disease, stroke, 

hypertension and almost all types of cancer. They also include asthma, 

osteoarthritis, joint degeneration, gastroesophageal reflux disease, 

chronic headache, liver disease, sleep apnea, lower back pain and urinary 

incontinence. 

Professional medical institutions are well aware of the costs and effects 

of obesity and morbid obesity. For example, according to research from 

the National Institute of Diabetes and Digestive and Kidney Diseases 

(NIDDK), the conditions of overweight and obesity run the United 

States an estimated $117 billion annually. According to researchers from 

the Centers for Disease Control and Prevention (CDC) and the National 

Institutes of Health (NIH), obesity is related to 112,000 deaths annually 

in this country. 

It is surprising then, with the increased awareness and improved 

efforts at maintaining healthy diets and lifestyles in the United States 

by both individuals and medical professions, that most obese patients 

do not receive a diagnosis from their primary care physicians. This 

was the finding of a recent study done by researchers at the Mayo 

Clinic, Rochester, MN. 1 

They used the Mayo Clinic primary care database to identify obese 

patients who had undergone general medical exams from November 

1, 2004, to October 31, 2005, 

The comorbidities and illnesses 

associated with morbid obesity 

are numerous, and include type 2 

diabetes, coronary heart disease, 

stroke, hypertension and almost 

all types of cancer. 

in a primary care clinic. Obese 

patients were considered to be 

those with a BMI of 30 or greater. 

In all, 9,827 patients were seen for 

a general medical exam. Of these, 

2,543 were obese. Only 19.9% of 

these obese patients actually had a 

diagnosis of obesity documented, 

and only 22.6% had a documented 

obesity management plan. 

Staff physicians were also less 

likely than residents to document 

obesity as a diagnosis. 

“ M a k e a d i a g n o s i s o f 

obesity because making a diagnosis 

increases the chances 

that a management plan will 

be put into place,” said Warren 

Thompson, M.D. 

Clinicians have not traditionally tended to make a diagnosis of obesity 

in the past. The reasons are many, said Dr. Thompson, who is an associate 

professor of medicine at the Mayo Clinic. 

“It can be a difficult issue to discuss with patients. Patients do not like 

to be told that they are obese. There’s a bit of discomfort on the part 

of the patient as well as the clinician. Another problem is that obesity 

had not been regarded as a disease. Until 2004, Medicare did not cover 

obesity. This has contributed as well to the tendency for clinicians not 

to make this diagnosis,” explained Dr. Thompson. 

Clinicians must take a proactive role in the diagnosis and management 

of obesity, he continued. “I think that both clinicians and patients are 

well aware of the burden of obesity. What we’d like to stress to clinicians 

is that it’s important to make a diagnosis and discuss it with your 

patients. If you don’t discuss it, there’s no plan that will be formulated 

to deal with it.” 

Patients with a diagnosis of obesity were 2.5 times more likely to 

formulate a weight-loss management plan than those who had not been 

diagnosed. So simply being diagnosed as obese made it more likely that 

patients took the crucial step of improving their health by establishing a 

treatment plan with their physician. 

Dr. Thompson and his colleagues also found that older patients and 

men were significantly less likely to be diagnosed as obese, while those 

with a BMI of greater than 35, diabetes and obstructive sleep apnea were 

significantly more likely to be diagnosed. 

“In people with diabetes or obstructive apnea or those who are more 

obese (BMI over 35), physicians were more likely to make the diagnosis,” 

said Dr. Thompson. “So look out for cases where people are healthy, but 

just a little bit overweight but not significantly obese (BMI of 30-35). 

These are the people who are often missed. Those are the people we want 

to make sure the doctors reach,” he told M.D. News. 

“If someone walks into the office weighing 400 pounds, obviously, 

the physician and patient are considering obesity. But say, for instance, 

someone comes in weighing 220 pounds (this depends on their height, 

too). This person may well be obese, but neither the physician nor the 

patient may feel it’s a problem because the patient is healthy. These are 

the people we don’t want to miss because it is a problem for that patient, 

and losing weight will improve their health,” he stressed. 

THE BARIATRIC OPTION 

Currently, surgery for morbid obesity is considered by many to be the 

most effective treatment for obesity. Bariatric surgery has been proven 

to have significant benefits in obese individuals who have tried dieting, 

exercise and other options to lose weight, but have failed to do so. 

Research has shown that bariatric surgery is an effective long-term 

treatment of morbidly obese patients. Bariatric surgery includes laparoscopic 

and open gastric bypass surgery, laparoscopic adjustable gastric 

banding and duodenal switch. The number of bariatric surgeries performed 

in the morbidly obese population of the United States reached 

an estimated 205,000 surgeries in 2007, according to figures from 


Recommendations to Combat Childhood and Adolescent Obesity 

This past summer, recommendations for the management of 

overweight and obese children were released by the Expert Committee 

on the Assessment, Prevention and Treatment of Child and Adolescent 

Overweight and Obesity. The writing committee was comprised of 

representatives from 15 health professional organizations, including: 

• American Academy of Child and Adolescent Psychiatry 

• American Academy of Pediatrics 

• American Association of Family Physicians 

• American College of Preventive Medicine 

• American College of Sports Medicine 

• American Dietetic Association 

• American Pediatric Surgical Association 

• American Psychological Association 

• Association of American Indian Physicians 

• The Endocrine Society 

• National Association of Pediatric Nurse Practitioners 

• National Association of School Nurses 

• National Hispanic Medical Association 

• National Medical Association 

• The Obesity Society 

“Childhood obesity is a major public health problem,” said Cecil B. 

Wilson, M.D., board chairman of the American Medical Association. 

“Overweight children tend to have health problems more commonly 

found in adults, like diabetes, high cholesterol and high blood pressure.” 

In early 2005, the expert committee began meeting to review 

scientific data regarding the assessment, prevention and treatment of 

children who are overweight and obese. The 22 recommendations they 

agreed upon are designed to help health care professionals provide 

obesity care to the children in their practices. 

The following are some of the committee’s recommendations for the 

assessment of children who are overweight or obese: 

1. Yearly assessment of weight status in all children, to include height, 

weight and body mass index (BMI) measurements for age. The 

measures should then be plotted on standard growth charts. 

2. Classification of children into two groups: 

• Obese: Children aged 2-18 years, with a BMI greater than or equal 

to the 95th percentile for age and sex and those with a BMI over 30 

• Overweight: children with a BMI equal to or greater than the 85th 

percentile, but less than the 95th percentile for age and sex 

3. Skin-fold thickness assessment for obesity is no longer recommended 

4. Waist circumference measurements are not recommended 

5. Qualitative assessments of dietary patterns in all pediatric patients 

at each visit, including assessment of dietary practices outside 

the home (at restaurants or fast-food establishments, excessive 

consumption of sweetened beverages, excessive portion sizes) 

6. Assessment of child’s level of physical activity and sedentary activity 

7. A focused family history for obesity, type 2 diabetes, cardiovascular 

disease and early death due to heart disease or stroke 

8. A thorough physical examination 

In children who are classified as overweight or obese, the guidelines 

recommend laboratory testing to include fasting lipid profiles (85th 

to 94th percentile with no risk factors), aspartate aminotransferase 

(AST) and alanine aminotransferase (ALT), fasting glucose (85th to 

94th percentile with risk factors in history or upon physical exam), and 

all of these test plus blood urea nitrogen (BUN) and creatinine (greater 

than the 95th percentile). 

“Our committee worked diligently to identify new treatment and 

prevention options to address the growing problem of overweight and 

obese children,” said Reginald Washington, M.D., spokesperson for the 

Expert committee. “We hope that health care professionals will apply 

these recommendations to their practice, so we can continue working to 

preserve the health of our children.” 

the ASMBS. Yet of the approximately 15 million Americans who are 

morbidly obese, only 1% of those who are clinically eligible are treated 

with bariatric surgery. 

These procedures, which include gastric bypass surgery, vertical-banded 

gastroplasty and gastric banding, are recommended by 

physicians for patients with a body mass index (BMI) of 40 or greater, 

or for those patients who have a BMI of 35 or more who have serious, 

obesity-related medical conditions including type 2 diabetes or severe 

sleep apnea. 

Much research has been directed at assessing the factors, outcomes 

and efficacy of bariatric surgery in obese patients. For example, the 

entire October issue of the Archives of Surgery was dedicated to bariatric 

surgery. 

Researchers of one of the studies in that issue found that a loss of 5% 

to 10% of excess body weight before gastric bypass surgery in highrisk, 

morbidly obese patients may make for a shorter hospital stay and 

quicker postoperative weight loss. 

For this study, researchers at the Geisinger Health System in Danville, 

PA, studied 884 patients (average age: 45 years) who underwent open 

or laparoscopic gastric bypass surgery from 2002 to 2006. 2 

In all, 19% of these patients lost 5% to 10% of their excess body 

weight prior to the procedure, and 48% lost 10% or more. Patients 

who lost more than 5% were less likely to stay in the hospital for more 

than four days. Patient who lost more than 10% of their excess weight 

before the surgery were twice as likely to have lost 70% of their excess 

weight one year after the procedure, compared with those who lost no 

weight or only 5% of their excess weight preoperatively. 

Researchers of yet another study in the same issue of the Archives 

of Surgery found that obese patients on Medicaid who had Roux-en-Y 

gastric bypass surgery may return to work earlier than obese patients 

on Medicaid who do not undergo this procedure. 3 

For this study, conducted by researchers at the Virginia Mason 

Medical Center in Seattle, WA, 38 medically disabled patients who 

receive Medicaid and underwent Roux-en-Y gastric bypass (average 

age: 48 years; average BMI: 58) were compared with 16 Medicaid 

patients (average age: 51 years; average BMI: 54) who did not have 

the procedure. 

“The patients who underwent Roux-en-Y gastric bypass were more 

likely to return to work, with 14 (37%) working, compared with 1 

(6%) of the nonoperative control patients,” the authors wrote. “Return 

to work was more likely in patients who had resolution of comorbid 

conditions [co-occurring illnesses] after surgery.” Those who returned 

to work no longer required Medicaid funding. 

“Surgical treatment of morbid obesity has a profound effect on patients’ 

quality of life, as evidenced by the sustained long-term weight 

loss, reversal of comorbidities, improved rating of quality of life and the 

patients’ ability to return to the workforce,” they concluded. ■ 

References: 

1. Bardia A, Holtan SG, Slezak JM, Thompson WG. “Diagnosis of Obesity by 

Primary Care Physicians and Impact on Obesity Management.” Mayo Clin Proc 2007 

Aug;82(8):927-32 

2. Still CD, Benotti P, Wood GC, Gerhard GS, Petrick A, Reed M, Strodel W. 

“Outcomes of Preoperative Weight Loss in High-Risk Patients Undergoing Gastric 

Bypass Surgery.” Arch Surg 2007 Oct;142(10):994-8 

3. Wagner AJ, Fabry JM Jr, Thirlby RC. “Return to Work after Gastric Bypass in 

Medicaid-Funded Morbidly Obese Patients.” Arch Surg 2007 Oct;142(10):935-40 


esearch 

NEW STUDY EXAMINES 

BRAIN-GUT RELATIONSHIP 

IN THOSE SUFFERING 

WITH STOMACH PAIN OR 

DISCOMFORT 

A new clinical study will explore 

the brain-gut interaction in patients 

with functional dyspepsia and whether 

certain drugs can effectively relieve 

symptoms of this disorder. Functional 

dyspepsia is a costly and chronic disorder 

that can cause severe stomach pain often 

reported as cramping, bloating and gas, 

or great discomfort or fullness after eating. 

The study is funded by the National 

Institutes of Health (NIH) at six medical 

centers in the U.S. 

The Functional Dyspepsia Treatment 

Trial (FDTT) will determine if either 

of two FDA-approved drugs that act on 

both the brain and the gut are better 

than placebo in relieving stomach pain 

or discomfort after meals in patients 

with functional dyspepsia. The study 

will also determine whether certain 

genes can predict who will best respond 

or not respond to the medicines. 

Finally, the trial will determine whether 

participants have a continued response 

for six months after the medicines are 

stopped. 

Functional dyspepsia is a commonly 

diagnosed disorder. The symptoms are 

thought to be the result of abnormal muscle 

activity within the stomach, which 

may be caused by abnormal sensitivity 

of the nerves in the stomach or irregular 

signals from the brain to the muscles in 

the gut. “While we do not know the exact 

cause of functional dyspepsia, we do 

know that the disorder can cause chronic 

and sometimes debilitating symptoms 

that can have a dramatic effect on the 

quality of life for functional dyspepsia 

suffers,” said Patricia Robuck, Ph.D., 

MPH, project scientist for FDTT and 

Director of the Clinical Trials Program 

of the Division of Digestive Diseases and 

Nutrition, National Institute of Diabetes 

and Digestive and Kidney Diseases 

(NIDDK), the sponsor of the FDTT 

at NIH. “We are interested in learning 

more about the brain-gut interaction 

and physiological effects of these two 

similar but different classes of drugs on 

the symptoms associated with functional 

dyspepsia.” 

Currently, the treatment of functional 

dyspepsia is considered limited. Standard 

treatment includes food restriction, antisecretory 

drugs (H2 blockers, proton 

pump inhibitors) and prokinetics, which 

help make the stomach empty faster. 

Patients with dyspepsia sometimes also 

try alternative medicines and non-drug 

measures such as hypnotherapy. The effectiveness 

of these alternative measures 

remains unproven. 

Results from small studies using 

medications like amitriptyline and escitalopram 

for adults with functional 

dyspepsia suggest that the abdominal 

pain and motility may get better. “We 

are excited by these early findings,” says 

Nicholas J. Talley, M.D., Ph.D., Chair 

of the trial and Chair of the Department 

of Internal Medicine at the Mayo Clinic, 

Jacksonville, FL. “If it turns out that 

these drugs correct stomach emptying, 

stomach retention and overall motility, 

we could help improve the quality of 

health and life for the millions of people 

with functional dyspepsia.” 

Over the next five years, researchers 

will enroll 400 men and women, 

ages 18-75 years old, with functional 

dyspepsia who have failed to respond 

to antisecretory treatments for the 

disorder. The participants will receive 

amitriptyline or escitalopram or placebo. 

Patients with peptic ulcer disease, 

a history of drug or alcohol abuse and 

past abdominal surgeries will be excluded 

from the trial. Women who are 

pregnant and patients whose reading 

skills are insufficient to complete self 

report questionnaires will also be excluded. 

Recruitment for the trial began 

in January 2007. 

The following principal investigators 

and clinical centers are conducting the 

study: 

• Dr. Nicholas J. Talley, Mayo Clinic, 

Jacksonville, FL (Study Chair) 

• Dr. John K. Dibaise, Mayo Clinic, 

Scottsdale, AZ 

• Dr. Earnest P. Bouras, Mayo Clinic, 

Jacksonville, FL 

• Dr. G. Richard Locke, Mayo Clinic, 

Rochester, MN 

• Dr. Michael P. Jones, Northwestern 

University, Chicago, IL 

• Dr. Charlene M. Prather, Saint Louis 

University School of Medicine, Saint 

Louis, MO 

• Dr. Brian E. Lacy, Dartmouth- 

Hitchcock Medical Center, Lebanon, 

NH 

For information about participating in the 

trial, contact the central study coordinator, 

Vickie Silvernail, at (507) 284-2812 or 

dyspepsia@mayo.edu. 

For general information about digestive 

diseases, see http://digestive.niddk.nih. 

gov/ddiseases/a-z.asp. 

The NIDDK, a component of the NIH, 

conducts and supports research in diabetes 

and other endocrine and metabolic diseases, 

digestive diseases, nutrition and obesity, and 

kidney, urologic and hematologic diseases. 

For more information about NIDDK and its 

programs, see www.niddk.nih.gov. 

The National Institutes of Health (NIH), 

the nation’s medical research agency, includes 

27 institutes and centers and is a component 

of the U.S. Department of Health and Human 

Services. It is the primary federal agency for 

conducting and supporting basic, clinical 

and translational medical research, and it 

investigates the causes, treatments and cures 

for both common and rare diseases. For more 

information about NIH and its programs, visit 

www.nih.gov. ■ 

Source: The National Institutes of Health 


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AFFINITY MEDICAL CENTER 

APPOINTS INTERIM CEO 

Barry Michael is Affinity Medical Center’s 

interim CEO. In this role, he will be responsible 

for all hospital operations and will work closely 

with the board, medical staff and senior leadership 

team. 

Prior to accepting this position, Michael 

held various healthcare leadership positions in 

Pennsylvania, Kentucky, Alabama, Georgia and 

Tennessee. He is known for his outstanding leadership 

in hospital operations, physician relations 

and recruitment and for leading organizations to 

achieve high levels of patient satisfaction scores. 

Michael received his master’s degree in 

healthcare administration from Duke University 

and his bachelor’s degree from Pennsylvania 

State University. 

BCH CEO ANNOUNCES 

RETIREMENT 

Willard Roderick, chief executive officer of 

Barberton Citizens Hospital, announces his retirement 

after 25 years of services. This decision 

will be effective May 31, 2008. Mr. Roderick 

considered retirement in 2007, but has agreed 

Willard 

Roderick 

to remain in his current role 

as CEO at Barberton Citizens 

Hospital to assist with the 

transition to the Summa 

Health System. 

Mr. Roderick began his 

career at Barberton Citizens 

Hospital 25 years ago as the 

Director of Plant Operations 

and was named President and CEO on August 

1, 2000. Over the last 5 years, Mr. Roderick 

implemented the Getting to Excellence initiative 

which focused on five pillars of excellence that 

served as a foundation at the hospital for clinical, 

financial and quality excellence. 

During his 25 years of service, he has always 

been involved in many community initiatives and 

plans to continue to do so after he retires. 

CFGH PRESIDENT ELECTED 

TO NATIONAL POSITION 

Cuyahoga Falls General Hospital (CFGH) 

president Kathleen A. Rice, RPh, MBA, was recently 

elected chair of the American Osteopathic 

Association’s (AOA) Bureau of Hospitals 

for 2008. 

Kathleen A. 

Rice 

ceo info 

Rice was elected to her oneyear 

term by members of the 

AOA’s Executive Committee 

at the organization’s recent 

annual conference. The AOA 

seeks to advance the practice 

of osteopathic medicine 

by promoting excellence 

in education, research 

and the delivery of quality, cost-effective 

healthcare within a distinct, unified 

profession. There are more than 38,000 

members nationally. 

Rice has been actively involved in osteopathic 

education since 1984, most recently serving as 

Vice Chair of the Bureau of Hospital’s executive 

committee. In her new role, she will represent 

the 85 osteopathic teaching hospitals as a member 

of the AOA’s Board of Trustees. 

In addition to her involvement with the 

AOA, Rice also serves on the Ohio Osteopathic 

Association’s Board of Trustees. Rice has served as 

president and chief operating officer of Cuyahoga 

Falls General Hospital since 2004, holds a Master 

of Business degree and is a licensed pharmacist. 

She resides in Lyndhurst, Ohio. ■ 


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Northeast Ohio Quality 

Improvement Collaborative 

by Marianne Lorini 

from the arha 

In 2007, the Akron Regional Hospital 

Association and the Ohio Hospital 

Association worked together to create 

the Northeast Ohio Quality Improvement 

Collaborative. All hospitals in Northeast 

Ohio were invited to participate. Currently 

there are 34 hospitals that are part of this 

collaborative. This is a voluntary project 

that brings together, in a non-competitive 

setting, hospital chief executive officers, 

hospital quality management professionals 

and hospital medical directors. This locally 

designed, collaborative effort provides performance 

measures and tools for hospitals 

to use to improve the quality of care in 

their respective facilities as well as the 

This locally designed, collaborative effort provides 

performance measures and tools for hospitals to 

use to improve the quality of care in their respective 

facilities as well as the community’s quality of services 

as a whole. 

community’s quality of services as a whole. 

OHA has worked on similar projects in 

Dayton, Cincinnati and Columbus. 

Over the past eight years the Ohio 

Hospital Association has been able to 

work with Dayton hospitals to achieve 

important improvements in the quality of 

care. Because of this work, the number of 

deaths for patients with acute myocardial 

infarction (heart attack) decreased in 

Dayton. Dayton hospitals won the 2002 

Ernest Codman Award, a national honor, for 

their efforts. Over the past couple of years, 

OHA has also been working with the hospitals 

in the Cincinnati and Columbus areas 

with the goal of achieving similar results, and 

is now pleased to work with the Northeast 

Ohio area hospitals in the same manner. 

STAND UP 

& TAKE YOUR LIFE BACK 

For more than FOUR DECADES, the SPECIALISTS at the 

COMMUNITY CARE CENTER at ALLIANCE COMMUNITY HOSPITAL 

have been offering residents of Alliance and its surrounding 

communities the ultimate in skilled nursing and therapy services/ 

rehabilitative care. 

CCC is an ODH compliant, 78-bed skilled-nursing facility offering 

state-of-the-art therapy in a fully functional, home-like setting. 

Patients of the CCC are given PRACTICAL, HANDS-ON TRANSITION 

TRAINING in a space offering replica bathroom, bedroom, living room, 

kitchen, and laundry room models for improved rehabilitation techniques. 

The center even houses a Cadillac, so that patients can practice 

entering and exiting a car, among other realistic skill methods that help 

make the hospital-to-home transfer a smooth one. 

For the most comprehensive therapy and rehabilitative care 

anywhere – come see the professionals at the Community 

Care Center at Alliance Community Hospital. 

A Planetree Affiliate 

Tours are available upon request and most major insurances accepted. 

CALL FOR MORE INFORMATION, 330-596-7600.

from the arha 

Hospitals participating in this collaborative 

are: Akron Children’s Hospital, 

Akron General Medical Center, Aultman 

Hospital, Barberton Citizens Hospital, 

Cleveland Clinic, Cuyahoga Falls General 

Hospital, Euclid Hospital, Fairview Hospital, 

Hillcrest Hospital, Huron Hospital, Lake 

Hospital System, Lakewood Hospital, 

Lutheran Hospital, Marymount Hospital, 

MedCentral Health System Mansfield 

Hospital, Medina General Hospital, Mercy 

Medical Center, Robinson Memorial 

Hospital, Salem Community Hospital, 

Samaritan Hospital, Southwest General 

Health Center, South Pointe Hospital, St. 

John West Shore Hospital, St. Vincent 

Charity Hospital, Summa Health System, 

Trumbull Memorial Hospital, Union 

Hospital, University Hospitals Bedford 

Medical Center, University Hospitals 

Case Medical Center, University Hospitals 

Conneaut Medical Center, University 

Hospitals Geauga Medical Center, University 

Hospitals Geneva Medical Center, University 

Hospitals Richmond Medical Center, and 

WRH Health System. 

There are three committees which meet 

on a regular basis regarding this health 

quality improvement collaborative. The 

Steering Committee consists of quality 

improvement personnel from each of the 

participating hospitals and is responsible for 

data analysis and validating the data. The 

Medical Directors Committee is comprised 

of Chiefs of Staff, Medical Directors and 

Vice Presidents of Medical Affairs and is 

responsible for the design, executive and 

evaluation of the project’s various quality 

improvement initiates. The Medical 

Directors have recently chosen the issue 

of Congestive Heart Failure as their first 

focus area. The Quality Council is made 

up of CEOs and vice presidents of Medical 

Affairs from hospitals participating in the 

project, and serves as the governing board. 

They provide oversight and leadership and 

serve as the “stewards” of the initiative. 

The Ohio Hospital Association is planning 

to hold a meeting in Columbus this 

summer where all of Ohio’s regional quality 

improvement collaboratives will share 

regional best practices and successes that 

each has had to date. 

Marianne Lorini is president/CEO of the 

Akron Regional Hospital Association (ARHA). 

Member hospitals include Affinity Health System 

- Doctors Campus; Affinity Health System - 

Massillon Campus; Akron Children’s Hospital, 

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FDA Approves 

Second-Generation Smallpox Vaccine 

The U.S. Food and Drug Administration 

has licensed a new vaccine to protect against 

smallpox, a highly contagious disease with 

the potential to be used as a deadly bioterror 

weapon. 

The vaccine, ACAM2000, is intended 

for the inoculation of people at high risk of 

exposure to smallpox and could be used to 

protect individuals and populations during 

a bioterrorist attack. It will be included 

in the Centers for Disease Control and 

Prevention’s (CDC) Strategic National 

Stockpile of medical supplies. 

A worldwide vaccination program eradicated 

smallpox in the population. The last 

case of naturally occurring smallpox in the 

U.S. was in 1949 and the last case in the 

world was reported in Somalia in 1977. 

Known stockpiles of the virus are kept 

in only two approved labs in the United 

States and Russia. The CDC considers it a 

category A agent, meaning it presents one 

of the greatest potential threats for harming 

public health. 

Smallpox is caused by the variola virus, 

a virus that emerged in human populations 

thousands of years ago. It spreads through 

close contact with infected individuals or 

contaminated objects, such as bedding or 

clothing. There is no FDA-approved treatment 

for smallpox and the only prevention 

is vaccination. 

“The licensure of ACAM2000 supplements 

our current supply of smallpox 

vaccine, meaning we are more prepared 

to protect the population should the virus 

ever be used as a weapon,” said Jesse 

L. Goodman, M.D., MPH, Director of 

FDA’s Center for Biologics Evaluation and 

Research. “This vaccine is manufactured 

using modern cell-culture technology, allowing 

rapid and large-scale production of a 

vaccine with consistent product quality.” 

The symptoms of smallpox typically 

began with high fever, headaches and body 

aches. A rash followed that spread and 

progressed to raised bumps and pus-filled 

blisters that crusted, scabbed and fell off 

after about three weeks, leaving a pitted 

scar. The fatality rate historically was about 

30%, according to the CDC. 

ACAM2000 is made using a poxvirus 

called vaccinia, which is related to but different 

from the virus that causes smallpox. 

The vaccine contains live vaccinia virus 

and works by causing a mild infection that 

stimulates an immune response that effectively 

protects against smallpox without 

actually causing the disease. 

The vaccine is derived from the only 

other smallpox vaccine licensed by FDA, 

Dryvax, approved in 1931 and now in 

limited supply because it is no longer 

manufactured. 

Although smallpox vaccination ended in 

the United States in 1972 because it was 

no longer needed for prevention, the U.S. 

military resumed vaccination of at-risk 

personnel in 1999 after concluding that 

the disease posed a potential bioterrorism 

threat. 

“Smallpox could be a particularly dangerous 

biological threat to us that would 

kill or debilitate a high percentage of the 

population,” said Rear Adm. W. Craig 

Vanderwagen, M.D., Assistant Secretary 

for Preparedness and Response, U.S. 

Department of Health & Human Services. 

“The licensing of ACAM2000 will make 

us better prepared as a nation because it 

provides an important, effective tool for 

protecting first responders and individuals 

with a high risk of exposure from this 

potentially lethal disease.” 

ACAM2000 was studied in two populations: 

those who had never been vaccinated 

for smallpox and those who had received 

smallpox vaccination many years earlier. 

current topics 

The percentage of unvaccinated persons 

who developed a successful immunization 

reaction was similar to that of Dryvax. 

ACAM2000 also was found to be acceptable 

as a booster in those previously 

vaccinated for smallpox. 

Because ACAM2000 contains live vaccinia 

virus, care must be taken to prevent 

the virus from spreading from the inoculation 

site to other parts of the body and to 

other individuals. 

To minimize known risks, the vaccine 

licensing is subject to a risk minimization 

action plan (RiskMAP). The RiskMAP requires 

providers of the vaccine and patients 

to be educated about these and other risks. 

The RiskMAP also requires patient education 

through an FDA-approved medication 

guide for those who receive the vaccine. 

The medication guide explains the 

proper care of the vaccination site and 

provides information about serious side 

effects that can occur with ACAM2000. 

In studies, about one in 175 healthy adults 

who received smallpox vaccine for the first 

time developed inflammation and swelling 

of the heart and/or surrounding tissues 

(myocarditis and/or pericarditis). Of the 

10 affected adults, four had no symptoms 

and at the end of the study, all but one had 

their symptoms resolve. 

ACA M20 0 0 is manufactured by 

Acambis Inc. of Cambridge, England, 

and Cambridge, MA. Dryvax was made 

by Wyeth Laboratories Inc. based in 

Madison, NJ. 

See Also: 

IDSA Bioterrorism Information and 

Resources: 

www.idsociety.org/bt/toc.htm 

www.cidrap.umn.edu/idsa/bt/smallpox/biofacts/smllpx-summary.html 

■ 

Source: Infectious Disease Society of America 


M.D. NEWS 

2008 ANNUAL DIRECTORY FOR PHYSICIANS 

Greater Akron/Canton Edition 

Directory Index 

Business & Lifestyle 

Products/Services 

Accounting Services 

Advertising/Public Relations 

Architects 

Banking Services 

Billing & Collection 

Building/Renovating 

 

 

 

Continuing Medical Education 

Financial Planning 

Insurance 

 

Legal Services 

 

 

 

 

 

 

Printing Services 

 

 

 

Healthcare 

& Related Services 

 

Behavioral/Mental Health Care 

Cancer Centers 

Cardiac Care 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Laboratory Services 

 

 

 

Neurology/Neurosurgery 

 

 

 

Orthotics & Prosthetics 

 

 

 

Physician Referral Lines 

 

 

 

 

Senior Healthcare Services 

 

 

 

Stroke Care 

Vascular Surgery 

Weight Loss Surgery 

 

Wound Care Centers 

www.akroncantonmdnews.com

Business & Lifestyle 

ACCOUNTING SERVICES 

CBIZ/ Mayer Hoffman McCann 

4040 Embassy Pky, Akron 

1-888-668-6501 

www.cbiz.com 

Weidrick Livesay Mitchell & 

Burge 

2150 N Cleveland-Massillon Rd, Akron 

330-659-5985 

www.wlmcpa.com 

ADVERTISING/PUBLIC RELATIONS 

Akron/Canton M.D. NEWS 

6864 Mapleridge NW, Canton 

330-499-5332 

www.AkronCantonMDNEWS.com 

Covey & Koons, Ltd. 

931 N Main St # 202, North Canton 

330-244-8515 

www.covey-koons.com 

Jerry Moody Advertising & Design 

28790 Chagrin Blvd, Cleveland 

216-831-6250 

Marcus Thomas, LLC 

24865 Emery Rd, Cleveland 

216-292-4700 

ST&P Communications 

320 Springside Dr, Fairlawn 

330-668-1932 

ARCHITECTS 

Dwight Yoder Builders 

1267 Southeast Ave #8, Tallmadge 

330-633-7300 

BANKING SERVICES 

National City 

Private Client Group 

330-375-8383 

wealth.nationalcity.com/ 

BILLING & COLLECTION SERVICES 

CompuData, Inc. 

771 N. Freedom St, Ravenna 

330-296-6000 

www.medicalbillingthatpays.com 

BUILDING/RENOVATING - 

COMMERCIAL 



330-633-7300 

Testa Companies 

2335 Second St, Cuyahoga Falls 

330-928-1988 

www.testacompanies.com 


RESIDENTIAL 


RESIDENTIAL cont. 



330-928-1988 


COMMERCIAL DEVELOPERS 



330-633-7300 



330-928-1988 


CONTINUING EDUCATION 

Akron General Medical Center 

Department of Medical Education 

400 Wabash Ave, Akron 

330-344-6050 

www.akrongeneral.org 

Cuyahoga Falls General Hospital 

1900 Twenty-Third St, Cuyahoga Falls 

330-971-7225 

www.summahealth.org 

Robinson Memorial Hospital 

Dept of Medical Education 

6847 N Chestnut St, Ravenna 

330-297-2540 

www.robinsonmemorial.org 

Summa Health System 

Akron City and St. Thomas 

Hospitals 

525 E Market St, Akron 

330-375-3107 


University of New Mexico 

Department of Emergency Medicine 

Albuquerque, NM 

505-272-0444 

http://hsc.unm.edu/emermed/ 

FINANCIAL PLANNING 

Brookshire Financial Group 

116 Cleveland Ave NW #425, Canton 

330-453-3991 

www.brookshirefinancial.com 

National City 

Private Client Group 

330-375-8383 

wealth.nationalcity.com/ 

Weidrick, Livesay Mitchell & 

Burge 


330-659-5985 


INSURANCE - BUSINESS/EMPLOY- 

MENT PRACTICES LIABILITY 

INSURANCE - HEALTH 

SummaCare 

P.O. Box 3620, Akron 

1-800-821-9322 

www.summacare.com 

INSURANCE - HOME, AUTO, 

EXCESS LIABILITY 

Sirak-Moore Insurance Agency Inc 

4700 Dressler Rd NW, Canton 

 

INVESTMENT MANAGEMENT 

Brookshire Financial Group 

116 Cleveland Ave NW #425, Canton 

330-453-3991 

www.brookshirefinancial.com 

LEGAL SERVICES 

Brouse McDowell 

388 South Main St #500, Akron 

330-535-5711 

www.brouse.com 

Buckingham Doolittle & 

Burroughs LLP 

4518 Fulton Dr NW, Canton 

330-492-8717 

www.bdblaw.com 

Krugliak Wilkins Griffiths & 

Dougherty Co, LPA 

4775 Munson St NW, Canton 

330-497-0700 

www. kwgd.com 

MEDICAL MALPRACTICE 

INSURANCE/BILLING FRAUD 


4700 Dressler Rd NW, Canton 

 

MEDICAL OFFICE SPACE 



330-928-1988 


PHOTOGRAPHERS 

Smithberger Photography 

3990 Fulton NW, Canton 

330-499-0411 

www.smithbergerphoto.com 

PHYSICIANS HOSPITAL ORGANIZATION 

Summa Health Network 

10 N Main St, Akron 

330-996-8687 

www.summahealthnetwork.org 



330-633-7300 



4700 Dressler Rd NW, Canton

PHYSICIAN MULTI- 

SPECIALTY GROUP 

Summa Physicians, Inc. 


222.spi.summahealth.org 

PRACTICE MANAGEMENT 

Brouse McDowell 

388 South Main St #500, Akron 

330-535-5711 

www.brouse.com 

Buckingham Doolittle & 

Burroughs LLP 

4518 Fulton Dr NW, Canton 

330-492-8717 

www.bdblaw.com 



1-888-668-6501 

www.cbiz.com 

PRACTICE MANAGEMENT cont. 

Krugliak, Wilkins, Griffiths & 

Dougherty Co, LPA 

4775 Munson St NW, Canton 

330-497-0700 

www. kwgd.com 

Premiere Medical Resources 

3033 State Rd, Cuyahoga Falls 

330-923-5899 

Weidrick, Livesay Mitchell & Burge 


330-659-5985 


REAL ESTATE - COMMERCIAL 



330-928-1988 


RETIREMENT PLANNING 



1-888-668-6501 

www.cbiz.com 

Weidrick, Livesay Mitchell & 

Burge 


330-659-5985 


WEBSITE DESIGN & HOSTING 

The Karcher Group 

5590 Lauby Rd Suite B, North Canton 

330 493-6141 

www.thekarchergroup.com 

Health Care 

ALCOHOL/DRUG REHAB 

CANCER CENTERS cont. 

CARDIAC CARE cont. 

Edwin Shaw Hospital 

for Rehabilitation 

1621 Flickinger Rd, Akron 

330-784-1271, ext 5404 

www.edwinshaw.com 

Summa’s Ignatia Hall/Chemical 

Dependency Program 

St. Thomas Hospital 


 

BEHAVIORAL HEALTH CARE/ 

MENTAL HEALTH CARE 


Department of Psychiatry & 

Behavioral Sciences 


330-344-6525 

Akron General Health & Wellness 

Center – West 

4125 Medina Road, Suite 214, Akron 

330-665-8171 


Summa Center for Behavioral 

Health 



30-379-9841 


CANCER CENTERS 

Akron Children’s Hospital Showers 

Family Center for Childhood Cancer 

and Blood Disorders 

One Perkins Square, Akron 

330-543-8580 

www.akronchildrens.org 


McDowell Cancer Center 

224 W. Exchange St, Akron 

330-344-HOPE 




330-297-2899 


Summa Center for Cancer Care 

75 Arch St #206, Akron 

330-375-6101 

www.summahealth.org/cancer 

Opening Fall 2008: Jean B. & Milton N. Cooper 

Cancer Center 

University Hospitals 

Ireland Cancer Center 

11100 Euclid Ave, Cleveland 

800.641.2422 

www.UHhospitals.org/irelandcancer 

CARDIAC CARE 

Akron Children’s Hospital 

Heart Center 


330-543-8521 



Heart & Vascular Center 


330-344-3278 


Cleveland Clinic Cardiac Rhythm 

Program at Akron General 

Physician Office Building 

224 W Exchange St, #220, Akron 

330-344-4377 


1900 23rd St, Cuyahoga Falls 

330-971-7426 



330-297-2406 


Summa Cardiovascular Institute 

Akron City Hospital 


330-375-7990 

www.summahealth.org/heart 

Summa Heart and Lung Center 

95 Arch St, Akron 

1-800-23-SUMMA 



Heart & Vascular Institute 


216-844-8448 

www.UHhospitals.org 

DIABETES EDUCATION 

Summa Center for Diabetes 


444 N. Main Street, Akron 

330-379-5680 

DRIVER EVALUATION/TRAINING 

Edwin Shaw Hospital for 

Rehabilitation 


330-784-1271, ext 5344 


EMERGENCY DEPARTMENTS 

HOME HEALTH CARE cont. 

HOSPITALS - ACUTE CARE cont. 



330-344-6611 



Center – North 

4300 Allen Rd, Stow 

330-945-3111 


GENERAL SURGERY 



330-375-3000 


Department of Surgery 


330-344-6000 




330-971-7333 

Lodi Community Hospital 

Ambulatory Surgery 

225 Elyria St, Lodi 

 

Robinson Surgery Center 

411 Devon Place, Kent 

330-678-4100 


The Surgery Center at Akron 

General Health & Wellness West 

4125 Medina Rd, Akron 

330-665-8120 


Department of Surgery 


Patient Scheduling: 

216-844-SURG (7874) 


HOME CARE 


Home Care Group 


330-543-5000 


Summa’s HomeCare 



330-996-8773 


HOME HEALTH CARE 


Home Care Group 


330-543-5000 

Robinson Visiting Nurse & Hospice 


330-297-8899 



Summa’s HomeCare 



330-996-8773 


Visiting Nurse Service and 

Affiliates 

#1 Home Care Place, Akron 

 

www.vnsa.com 

Visiting Nurse Service Personal 

Care Services 

3600 W Market St #70, Fairlawn 

330-745-1601 · 1-800-362-0031 

www.vnsa.com 


Affiliates 


 

www.vnsa.com 

HOME INFUSION SERVICES 

Advanced Infusion Services 

160 Opportunity Pkwy #102, Akron 

330-745-1601 · 1-800-362-0031 

www.vnsa.com 

Summa Home Infusion Center 



330-376-1325 


HOSPICE CARE 

Alliance Visiting Nurse 

Association & Hospice 

885 S Sawburg Rd #106, Alliance 

330-821-7055 

www.achosp.org 

Hospice and Palliative Care 

of Visiting Nurse Service 

3358 Ridgewood Rd, Akron 

 

www.vnsa.com 

Robinson Visiting Nurse & Hospice 


330-297-8899 


Summa’s Palliative Care 

and Hospice Services 



330-996-8773 · www.summahealth.org 

HOSPITALS - ACUTE CARE 

Affinity Medical Center 

www.affinitymedicalcenter.com 

·Massillon Campus 

875 Eighth St NE, Massillon 

·Doctors Campus 

400 Austin Ave NW, Massillon 





(see Summa Health System) 




Alliance Community Hospital 

200 E State St, Alliance 


Aultman Hospital 

2600 Sixth St SW, Canton 

www.aultman.org 

Barberton Citizens Hospital 

155 Fifth St NE, Barberton 

www.barbertonhospital.com 

Cleveland Clinic 


www.clevelandclinic.org 

Cleveland Clinic Children’s 

Hospital 


www.clevelandclinic.org/ 

childrenshospital 



Edwin Shaw Rehab 





www.lodihospital.com 

Medina General Hospital 

1000 E Washington St, Medina 

www.medinahospital.org 

Mercy Medical Center 

1320 Mercy Dr NW, Canton 

www.cantonmercy.com 


6847 Chestnut St, Ravenna 






 


 


 


Union Hospital 

659 Boulevard, Dover 

www.unionhospital.org 

University Hospitals Case Medical 

Center 


www.uhhospitals.org 

WRH Health System 

195 Wadsworth Rd, Wadsworth 

www.wrhhs.org

HOSPITALS - LONG TERM ACUTE CARE 

Regency Hospital Akron 

155 Fifth St NE, Barberton 

330-615-3800 

www.regencyhospital.com 

Regency Hospital Cleveland West 

6990 Engle Rd, Middleburg Hts 

440-202-4300 


Regency Hospital Cleveland East 

4200 Interchange Corporate Ctr Rd, 

Warrensville Hts 

216-910-3900 


Regency Hospital Ravenna 


330-615-3800 


HYPERBARIC OXYGEN THERAPY 



330-344-6823 


Hyperbaric Medicine & Wound 

Healing Ctr 

Wooster Community Hospital 

1799 Beall Ave annex, Wooster 

330-263-8750 

www.woosterhospital.org 

IMAGING SERVICES - COMPREHENSIVE 



330-996-5760 


Akron General Outpatient 

Facilities 

Health & Wellness Center – North, Stow 

Health & Wellness Center – West, West Akron 

Green Health Center 

Tallmadge Health Center 

330-996-5760 



Radiology Department 


 




Information: 330-297-2795 

Scheduling: 330-297-2338 



The Imaging Center of Kent 






330-996-8881 


IMAGING SERVICES - MAMMOGRAPHY 



330-344-6450 





 


Reflections Breast Health Center 

2603 W. Market St #200, Akron 

1587 Boettler Rd, Uniontown 

1310 Corporate Dr, #600, Hudson 

33 North Ave, Tallmadge 

330-864-1571 



also Kent & Aurora 








Summa Breast and Imaging Center 


330-375-7575 


Summa Health Centers 

at White Pond, Cuyahoga Falls, Green, 

and Western Reserve 

330-375-7575 


IMAGING SERVICES - 

MRI/OPEN MRI 



330-996-8881 




330-996-5760 


Akron General Outpatient 

Facilities 

Health & Wellness Center – North, Stow 

Health & Wellness Center – West, West Akron 

Green Health Center 

Tallmadge Health Center 

330-996-5760 


Belden Village Open MRI Center 

5005 Whipple Ave NW, Canton 

 


Open MRI 

1900 Twenty Third St, Cuyahoga Falls 

330-971-7496 

Drs. Hill & Thomas Co 

2131 Lake Rd, Ashtabula 

440-998-2222 

www.hillandthomas.com 

IMAGING SERVICES - 

MRI/OPEN MRI cont. 

Drs. Hill & Thomas Co. 

Westside Imaging Center 

5260 Smith Rd, Brook Park 

216-267-8080 



Southside Imaging Center 

3443 Medina Rd #175, Medina 

800-332-8454 



Eastside Imaging Center 

2785 SOM Center Rd, Willoughby Hills 

440-944-8887 





 














330-996-8881 





330-996-8881 


IMAGING SERVICES - P.E.T. 



330-996-5760 







LABORATORY SERVICES 



330-996-8881 


Akron General Lab Services 

Health & Wellness Center – North 


330-945-3117 


LABORATORY SERVICES 

MINIMALLY INVASIVE SURGERY 

ORTHOPAEDIC CENTERS 


Center – West 


330-665-8125 

Akron General Green Health 

Center 

1587 Boettler Road, Uniontown 

330-896-2966 

Akron Health Center 

676 S Broadway, Akron 

330-344-4080 



1900 23d St, Cuyahoga Falls 

330-971-7430 




330-996-8881 



Outpatient Lab 


also Kent & Aurora 

330-297-2875 




Walk-ins welcome 


MEDICAL EQUIPMENT 

LEASING/SALES 

Klein’s Orthopedic & Medical 

Equipment 


330-928-3720 

Klein’s Medical West 

One Park West Blvd #140, Akron 

330-865-9000 

Visiting Nurse Service Equipment 

& Supplies 

Akron and Massillon locations 

 

www.vnsa.com 

MEDICAL TRANSPORTATION 

SERVICES 


Physician Transfer Line 

 


LifeCare 

3755 Boettler Oaks Dr E-2 

Uniontown 

330 899-0022 

www.lifecare-ems.com 

MENTAL HEALTH CARE (See 

BEHAVIORAL HEALTH CARE) 




330-297-2740 


Robinson Surgery Center 

411 Devon. Place, Kent 

330-678-4100 


Summa’s Minimally Invasive 

Surgery Institute 

 

Surgery scheduling 330-375-7000 


NEUROLOGY 

Neurology & Neuroscience 

Associates, Inc. 

Akron, Green, Hudson, Medina, 

Belden Village, West Akron, Ravenna 

330-376-1902 


Neurological Institute 


866-UH4-CARE 


NURSING HOMES 


Community Care Center 

200 E State St, Alliance 

330-596-7600 


Rose Lane Health Center 

5425 High Mill Ave NW, Massillon 

 

OCCUPATIONAL MEDICINE 


Working Parnters 


330-297-2876 


The Summa Center for Corporate 

Health 



330-379-5959 


The Summa Center for Corporate 

Health 

Summa Health Center at Green 

3838 Massillon Rd #350, Uniontown 

330-899-5540 

ORTHOPAEDIC CENTERS 


Center for Orthopedics and Sports Medicine 


330-543-3500 



Orthopaedic Center 


330-344-1980 

Summa Orthopaedics 



330-379-5661 



Department of Orthopaedics 


216-844-7200 


ORTHOTICS & PROSTHETICS 

Hanger Orthotics & Prosthetics 

 

330-670-8263 

 

330-479-0020 

 

330-633-9807 

 

330-821-4918 

 

330-833-9411 

OUTPATIENT HEALTHCARE CENTERS 

Akron General Health & 

Wellness Center-North 


330-945-9300 


Wellness Center-West 


330-665-8000 


Akron General Akron Health Center 

676 S. Broadway St, Akron 

330-344-2462 


Akron General Green Health Ctr 

1587 Boettler Rd, Uniontown 

330-344-2462 


Akron General Tallmadge Health Ctr 

33 North Ave, Tallmadge 

330-344-2462 


Children’s at Hudson 

5655 Hudson Dr, Hudson 

330-542-5437 


Cleveland Clinic Family Health Centers 

www.clevelandclinic.org/fhc 


Healing Ctr Wooster Community 

Hospital 


330-263-8750 

www.woosterhospital.org

OUTPATIENT HEALTHCARE CENTERS 

Summa Health Center at Green 

3838 Massillon Rd, Green 

330-899-5500 

Summa Health Center at Cuyahoga 

Falls 


330-375-7575 

Summa Health Center at Western 

Reserve 

5655 Hudson Dr #200, Hudson 

330-650-6710 

Summa Health Center at White Pond 

One Park West Blvd #130, Akron 

330-873-1518 

Summa Specialty Health Center 


330-375-7575 


Summa Wellness Center at the 

Natatorium 

2345 4th St, Cuyahoga Falls 

330-926-0384 

Summa Wellness Institute at 

Western Reserve 

5625 Hudson Dr, Hudson 

330-650-6710 

PAIN MANAGEMENT CENTERS 

Falls Pain Management Center 



330-971-7246 


Summa’s Pelvic Pain Specialty Ctr 

Professional Center North Building 


330-762-0954 


PHARMACIES 


New Choice Pharmacy 


330-971-7393 

Klein’s Pharmacy 


330-929-9183 


676 S. Broadway, Akron 

330-253-0963 


4125 Medina Rd #105, Akron 

330-665-8145 

PHYSICIAN REFERRAL LINES 


Need-A-Physician 

330-344-AGMC 

PHYSICIAN REFERRAL LINES cont. 


Case Medical Center 


 


PRIMARY CARE PHYSICIANS 


Need-A-Physician 

330-344-AGMC 


Pioneer Physicians Network 


 

Tallmadge 330-633-6601 

 

Barberton 330-745-3151 

 

Portage Lakes/Akron 330-644-2700 

 

Norton 330-825-7371 

 

Cuyahoga Falls 330-923-4500 

 

Green 330-896-6111 

 

Akron/Green 330-899-9070 

 

Barberton 330-848-9104 

 

Akron 330-835-9056 

 

Tallmadge 330-633-3817 

 

Akron 330-644-1672 

Ravenna Primary Care 

330-296-9606 

RADIATION THERAPY 


Department of Radiation Oncology 


330-344-6448 




For information: 330-297-2795 

To schedule: 330-297-2338 


Summa Health System Department of 

Radiation Therapy Akron City Hospital 


330-375-7948 

REHAB - INPATIENT 



330-344-6530 


Rehabiliation and Transitional 

Care Services 

200 E. State St, Alliance 

330-596-7607 

REHAB - INPATIENT 



330-784-1271 



Rehabilitation Services 


 


Summa Rehabilitation Services 

·Akron City Hospital, Akron 

330-375-3367 

·St. Thomas Hospital, Akron 

330-379-5200 

·Cuyahoga Falls General Hospital 


REHAB - OUTPATIENT 


Physician Office Building 

224 W Exchange St, Akron 

330-344-6530 


Akron General Outpatient Facilities 

·Health & Wellness Center – North, Stow 

·Health & Wellness Center – West, West Akron 

·Green Health Center 

·Tallmadge Health Center 

·Wadsworth 

330-665-8200 




1345 Corporate Dr, Hudson 

585 White Pond Dr, Akron 

577 Grant St, Akron 

330-784-1271 



Rehabilitation Services 


 



Cardiac & Pulmonary Rehab 


330-297-2394 



The Rehab Center/Sports Clinic 


330-297-2770 


Summa Rehabilitation Services 

·St. Thomas Hospital, Akron 

330-379-5200 

·Cuyahoga Falls General Hospital 


·Summa Specialty Health Center 

Akron 330-379-5200 

·Summa Health Center at White Pond 

Akron 330-836-9023 


REHAB - OUTPATIENT cont. 

SPORTS MEDICINE 

VASCULAR SURGERY cont. 

Summa Rehabilitation Services cont. 

·Summa Health Center at Green 

Uniontown 330-899-5599 

·Summa Health Center at Western Reserve, 

Hudson 330-379-5200 

·Natatorium and Wellness Center, 


SENIOR HEALTH SERVICES 


Geriatric Assessment Clinic 

330-344-6382 


Summa Center for Senior Health 



330-375-4100 


Summa’s New Horizons 

Adult Day Services 


Nordonia Hills 330-650-2440 



Affiliates 


 

www.vnsa.com 

SLEEP DISORDERS CENTERS 


Sleep Disorders Center 


330-344-6751 



Sleep lab Services 


330-948-5532 or 

1-888-520-6000 ext 85532 

Montrose Sleep Center 


Wellness Center-West 


330-665-8211 

Ohio Sleep Disorders Centers 

Green, Hudson, Medina, West Akron 

1-866-445-6653 

www.nnadoc.com 

The Robinson Memorial Hospital 

Sleep Disorders Center 


330-297-8080 


Streetsboro Sleep Center 

9150 Market Square Dr, # 101, Streetsboro 

330-626-7771 


 


330-379-5161 

 


330-971-7222 



Center for Orthopedics and 

Sports Medicine 


330-543-3500 


Akron General Sports Medicine 

Downtown Akron, Munroe Falls, 

Green, Wadsworth, West Akron 

330-344-4115 



The SportsClinic 


Also Kent, Streetsboro & Aurora 

330-297-2770 

Summa Center for Sports Health 


20 Olive St #201, Akron 

330-379-5051 


Summa Center for Sports Health 

Summa Health Center at Western 

Reserve 

5655 Hudson Dr #200, Hudson 

330-342-4612 


STROKE CARE 



330-344-6000 




330-784-1271 


Neurology & Neuroscience 

Associates, Inc. 

Stroke Prevention Ctr, Neuro Rehabilitation Ctr 

and TIA Clinic, Akron 

330-376-1902 

www.nnadoc.com 

Summa Center for Stroke Care 



330-375-6214 


VASCULAR SURGERY 


Heart & Vascular Center 


330-344-3278 




330-971-7333 

Summa Cardiovascular Institute 



330-375-7990 


WEIGHT LOSS SURGERY 


Bariatric Center 

400 Wabash Ave., Akron 

330-344-1100 


WEIGHT LOSS SURGERY 

Summa’s Advanced Bariatric 

Care Center 


330-375-6590 


WOMEN’S HEALTH CARE 


Women’s Center 


330-344-6868 


Akron General Women’s Health 

Clinic Akron General Akron 

Health Center 

676 S Broadway St, Akron 

330-344-6800 

Summa’s Pelvic Pain Specialty Ctr 

Professional Center North Building 


330-762-0954 


Northeast Ohio OB/GYN 


also Kent and Streetsboro 

330-296-4165 

Summa’s Joan H. Michelson 

Women’s Resource Center 


330-375-3493 


WOUND CARE CENTERS 


Wound Center 


330-376-HEAL (4325) 



Healing Ctr Wooster 

Community Hospital 


330-263-8750 


Summa Wound Care Center 

Ostomy and Hyperbaric Services 


444 N Main St, Akron

legal ease 

Expecting Inspection 

By Cathy A. Sloane, Esq. 

The physician’s day in the office was 

going fairly smoothly until the practice 

manager announced an unexpected visitor; 

a Medicare auditor was seated in the 

conference room. When asked if there was 

a problem, the auditor gave no specific reason 

prompting this surprise visit. Rather, 

she explained that she would be auditing 

patient charts for adequacy of documentation 

on claims billed to Medicare. The 

on-site inspection of records would 

begin today. 

This is a fictional story, but it illustrates 

the discomfort that physicians face when 

surprised with an audit from an insurance 

carrier. The questions are many. Is 

this a routine inspection? Have there 

been patient complaints? Has the medical 

practice been flagged by irregular billing 

patterns? Worse yet, could this be a 

whistle-blower investigation? 

Although an external audit can certainly 

be random and routine, physicians are 

acutely aware that Medicare and other 

insurance carriers often conduct audits to 

investigate suspected fraud or abusive billing 

practices. Physicians cannot avoid all audits 

like this one, but there are actions that you 

can take to decrease that probability. 

AUDIT PREVENTION 

The Department of Health and Human 

Service and the Office of Inspector General 

(OIG) have asked physicians to voluntarily 

develop and implement compliance programs. 

A compliance program integrates 

the various complex laws and regulations 

into your claims-processing procedures. 

Ideally, the goal is to prevent fraud and other 

wrongful behavior. 

A comprehensive compliance program 

will include a coding compliance policy. 

Although an external audit can certainly be random 

and routine, physicians are acutely aware that 

Medicare and other insurance carriers often conduct 

audits to investigate suspected fraud or abusive billing 

practices. 

This policy is a “meeting of the minds” 

between the physicians, billing staff, and 

insurance carriers that claims will be 

processed with agreed values (codes). 

Importantly, the coding compliance policy 

should establish a plan for both the internal 

monitoring and independent reviews of 

your coding and billing functions. 

Internal monitoring is your day-today 

assessment of operations to ensure that 

processes are working as they are intended. 

For example, internal staff with coding 

expertise might routinely monitor a sample 

of records for “evaluation & management” 

(E&M) coding accuracy. The frequency and 

type of internal monitoring will vary based 

on the dynamics and specialty of the practice. 

Staff should not forget to document their 

monitoring activities according to policy. 

Independent reviews are chart audits 

conducted by a certified coder at the 

request of the physician. Too often overlooked, 

independent reviews are vital to 

your compliance program in that they are 

non-biased, external controls for assessing 

any weaknesses in your coding and billing 

processes. Should an investigative audit by 

an insurance carrier later reveal inaccurate 

coding, the independent review by a certified 

coder can demonstrate your reasonable 

efforts to comply with ethical and legal 

business practices and thus avoid a fraud 

claim basis. 

Physicians are advised to schedule an independent 

review with a certified coder at 

least annually. Independent reviews should 

be scheduled more frequently if there have 

been significant additions to the medical 

staff, changes in documentation methods, 

or increase in rejected claims. 

CONCLUSION 

Insurance carriers have become stricter 

in enforcing accurate coding and billing 

as substantiated by documentation in the 

patient record. Random audits are not 

uncommon. However, physicians can take 

steps to minimize the likelihood of a payer 

audit, and mitigate possible sanctions, by 

establishing a compliance program. 

An effective compliance program will 

lessen the risk of fraud and abuse by identifying 

and addressing high risk areas. 

Self-monitoring and scheduling an independent 

review by a certified coder are 

compliance efforts deserving of your special 

attention. Your healthcare attorney can 

locate a coding specialist familiar with your 

practice needs. 

NOTE: This general summary of the law 

should not be used to solve individual problems 

since slight changes in the fact situation may 

require a material variance in the applicable 

legal advice. 

Cathy A. Sloane is a Nurse Attorney 

and Certified Coding Specialist Physicianbased 

with the law firm, K rugliak, 

Wilkins, Griffiths & Dougherty Co., LPA 

in Canton. ■ 


Kiddie Tax Changes in 2008 

By Michael T. Livesay, CPA/PFS 

A while back Congress came up with the 

concept known as the “Kiddie Tax.” This 

law was intended to discourage parents in 

high tax brackets from shifting income to 

their lower tax bracket children in order to 

reduce the family’s federal income tax bill. 

The law closes this potential loophole by 

taxing at the parent’s higher federal income 

tax rate the children’s unearned income 

(i.e., interest, dividends, and capital gains) 

in excess of a threshold amount. Earned 

income from jobs or self-employment is 

always exempt from the Kiddie Tax. 

Before 2006, the Kiddie Tax only affected 

children under the age of 14 with 

unearned income above the threshold. In 

Consider a gift to a §529 college savings plan. The 

Kiddie Tax rules make these accounts more attractive 

because assets are removed from the parent’s estate, 

contributions may qualify for a state tax deduction 

and children pay no tax when funds are withdrawn for 

education. 

2006 and 2007, the age limit was changed 

so that the tax applied to children under the 

age of 18. Starting in 2008, the Kiddie Tax 

can potentially affect your children until 

they turn 24 years old and the Kiddie Tax 

rules are not affected by whether the child 

is claimed as a dependent or not. 

Specifically, the Kiddie Tax rules affect 

a child when all of the following requirements 

are met. 

1. At least one of the child’s parents is 

alive at year-end and is in a higher marginal 

federal income tax bracket than 

the child. 

2. The child does not file a joint return for 

the year (i.e., they are not married). 

We Can Keep 

Your Practice Healthy 

Grow your business your way with Physician-based accounting. 

Weidrick, Livesay, Mitchell & Burge’s is staffed with experienced accounting 

professionals with a focus on physician practices. We specialize in physician-based 

business accounting to help doctors achieve their potential and remain successful. 

Controlling overhead, managing collections, personal taxes and retirement planning 

for our clients means you are free to concentrate on your specialties... 

your patients, your practice, your family. 

Call us today to find out what we can do for you! 

WEIDRICK, LIVESAY, 

MITCHELL & BURGE, LLC 

C E R T I F I E D P U B L I C A C C O U N T A N T S 

2150 North Cleveland-Massillon Road • Akron, Ohio Akron: 330-659-5985 Medina: 330-722-5249 


3. The child has unearned income in excess 

of the threshold ($1,800 for 2008). 

4. The child falls under one of the following 

three age rules. 

• Rule 1 (under Age 18). The child is not 

age 18 at year-end. 

• Rule 2 (Age 18). The child is age 18 at 

year-end and does not have earned in 

come in excess of one-half of his or her 

support. 

• Rule 3 (Age 19-23 and Student). The child 

is age 19 through 23 at year-end and: (1) 

is a student and (2) does not have earned 

income in excess of one-half of his or 

her support. A child who attends school 

full-time for at least five months during 

the year is considered to be a student. 

Despite the new rules starting in 2008, 

there are several things that can be done 

to mitigate the effect of the Kiddie Tax. 

First, once a child’s investment income 

exceeds $1,80 0, avoid giving them 

anymore income-producing property 

until the year the child reaches age 24 

or has completed his or her education, 

whichever is earlier. Second, do not sell 

appreciated investments until after the 

child has reached the point when they 

are no longer subject to the kiddie tax. 

Third, choose investments that generate 

tax-free or tax-deferred income (i.e., 

municipal bonds, U.S. Savings Bonds, 

CDs, insurance policies and growth 

stocks). Finally, consider a gift to a §529 

college savings plan. The Kiddie Tax 

rules make these accounts more attractive 

because assets are removed from the 

parent’s estate, contributions may qualify 

for a state tax deduction and children 

pay no tax when funds are withdrawn 

for education. 

Even if you do everything you can, but 

still get hit with the Kiddie Tax and your 

children are forced to pay more federal 

tax, the silver lining is that the Ohio taxes 

are unaffected. 

Mike Livesay is a CPA and principal with 

Weidrick, Livesay, Mitchell & Burge, LLP, in 

Bath. ■ 

NOW 

HEAL THIS 

The first wound treatment 

center of its kind near you. 

A wound that hasn’t healed in 30 days threatens your 

health and lifestyle. At the Hyperbaric Medicine & 

Wound Healing Center at Wooster Community Hospital, 

our proven treatment heals chronic wounds. You’ll get 

the latest in equipment and technology, supervised by 

a panel of local, skilled physicians. Our specialized 

care is covered by most insurance plans and Medicare. 

Talk to your doctor or call the Hyperbaric Medicine & 

Wound Healing Center at Wooster Community Hospital. 

There’s new hope for healing your wound. 

Call for a free evaluation. 

330-263-8750 

Hyperbaric Medicine & Wound Healing Center 

Wooster Community Hospital 

1761 Beall Avenue, Annex 

330-263-8750 Phone ~ 330-263-8752 Fax 



hospital spotlight 

Akron General’s Chest Pain Center 

Acute myocardial infarction (AMI) is the single leading 

cause of death in America, accounting for 1 in 5 deaths 

in 2003, according to statistics from the American Heart 

Association. Ongoing advancements in the treatment 

of AMI result in reduced mortality and morbidity, but 

successful treatments are time dependent and necessitate 

rapid initiation. For good outcome, the patient must quickly 

recognize the signs and symptoms of an AMI and seek 

medical care, and the physician must quickly diagnose the 

AMI and initiate treatment. 

In 2003, Akron General Medical Center introduced to 

George Litman, chief of Cardiology at Akron General Medical Center 

Summit County the concept of a chest pain center as a 

strategy to significantly reduce heart attack deaths through 

the rapid treatment of patients with AMI. One year later, 

this Center was accredited by The Society of Chest Pain 

Centers. The Society promotes protocol based medicine 

to address the diagnosis and treatment of acute coronary 

syndromes and heart failure, and to promote the adoption 

of process improvement science by healthcare providers. To 

date, less than 400 hospitals have earned Chest Pain Center 

accreditation from the Society. 

“To earn accreditation status, healthcare facilities must 

meet or exceed a wide set of stringent criteria and 

then allow an on-site evaluation by a review team 

from the Society of Chest Pain Centers,” said George 

Litman, MD, chief of Cardiology at the Akron 

General Heart & Vascular Center. “We were the first, 

and still are the only, hospital in Summit County to 

have an accredited Chest Pain Center.” 

To achieve accreditation by the Society of Chest 

Pain Centers Akron General demonstrated expertise 

in the following eight areas: 

Emergency Department Integration with the 

Emergency Medical System. A formal relationship 

between the ED and the local EMS links the care 

processes for patients with symptoms of possible 

acute coronary syndrome (ACS). 

Emergency Assessment of Patients with Symptoms 

of ACS / Timely Diagnosis and Treatment of ACS. 

An ED program minimizes delays in institution 

of therapy for an ACS (nitrates, heparin, aspirin, 

percutaneous intervention, thrombolytics, etc.). 

Patients with Low Risk for ACS and No Assignable 

Cause for their Symptoms. An ED or hospital 

observation program monitors and evaluates lowrisk 

patients to avoid the inadvertent release home 

of patients with ACS or unstable angina. 

Functional Facility Design. The ED CPU has 

a functional design for chest pain evaluation 

to accomplish optimal patient care. It includes 

appropriate cardiovascular monitoring equipment. 

Personnel, Competencies, and Training. Physicians 


and nursing staff in contact with patients with symptoms 

of ACS have certain core competencies and training. 

Leadership and management may require additional core 

competencies and training. 

Process Improvement Orientation. CPU management 

structure is based on continuous quality improvement 

program principles to ensure quality patient care and 

proper utilization of ED resources. 

Organizational Structure and Commitment. The facility’s 

administration, medical staff, and multidisciplinary 

committee must make a commitment to the establishment 

and support of a Chest Pain Center. 

Community Outreach Program. An ED- or hospitalbased 

community outreach program educates the public 

to promptly seek medical care if they have symptoms of 

an AMI, such as chest pain, chest discomfort, shortness of 

breath, diaphoresis, syncope, and risk factors for coronary 

artery disease, particularly smoking. 

“The Society of Chest Pain Centers carefully evaluated 

all of these things over a period of several months,” said Dr. 

Litman. “In 2004 we received our initial accreditation. In 

2007 we were re-accredited with a new designation as a chest 

pain center with PCI (percutaneous intervention). This means 

that Akron General is capable of acute interventions, such as 

angioplasty and surgery, to open blocked arteries in patients 

experiencing heart attacks. 

Unlike traditional compliance-based models, the Chest Pain 

Center accreditation process is based on a process improvement 

methodology. The Society gives healthcare facilities the tools 

to understand what their care processes are, to measure them, 

to communicate about them across departments, and to make 

strategic plans for their improvement. 

“We constantly try to improve our process to improve 

our treatment time,” said Thomas Lloyd, DO, medical 

director of Akron General’s Chest Pain Center. “The goal 

recommendations, from the American Heart Association 

and from the American College of Cardiology, are to 

effectively treat the heart attack in 90 minutes or less from 

the time the patient comes through our door. We call this 

‘door-to-balloon’ (D2B) time.” 

Dr. Lloyd explained that only 35% of hospitals nationwide 

have been able to achieve a D2B time of 90 minutes patients 

presenting with AMI. In the past 6 months, however, 

Akron General’s average has been 71 minutes. We are now 

routinely treating many patients in less than 40 minutes. 

“Every minute saved is heart muscle saved, and that makes 

a difference in the patient’s quality of life,” he said. “If all 

hospitals met these guidelines it would save an additional 

1000 heart attack patients a year”. 

Thomas Lloyd, DO, medical director of Akron General’s Chest 

Pain Center 

Both Dr. Litman and Dr. Lloyd credit teamwork and a 

collaborative spirit for these impressive statistics. 

“It takes a big team effort from the Emergency Department 

which must be keyed into patients with chest pain, a 

paramedic rescue service that works with the hospital, 

interventional cardiologists and a cath lab team all of which 

are willing to be on call and available within 20-30 minutes 

of being called, technologists, nursing personnel . . . all are 

important in making this work,” said Dr. Litman. 

“We have really made great strides,” said Dr. Lloyd. 

“Initially, I thought the 90-minute guideline was excessive 

and too difficult to meet. But now that we’ve exceeded that, 

I think that the guidelines can be reduced further. If you put 

a system in effect to challenge that, you will meet it.” 

For more information about the Society of Chest Pain 

Centers and its accreditation process, visit the Society’s 

website at www.scpcp.org. For more information about 

Akron General Medical Center’s Chest Pain Center, call 

1-800-362-2462 or visit www.akrongeneral.org. 




■ 

 

 

 

 

 

 

 


R E G E N C Y H O S P I T A L C O M P A N Y 

Giving People Their Lives Back 

Regency Hospitals of North Central Ohio are intensive critical care hospitals 

serving the needs of medically complex patients that require acute level care for 

a longer period of time than traditional hospitals are set up to provide. We are 

a national network of hospitals with a different way of thinking, a different way 

of caring, and a different way of treating, and it shows in everything we do. 

R E G E N C Y PRO G R A M S A N D S E RV I C E S 

Pulmonary/ventilator program 

Medically complex/multi-system failure program 

Wound care program (stage III and IV decubitus) 

Low-tolerance rehabilitation services 

Regency Hospital of Akron 

155 Fifth Street NE • Barberton, Ohio 44203 

Main: 330.615.3792 • Referral: 330.615.3800 

Regency Hospital of Ravenna 

6847 North Chestnut Street • Ravenna, Ohio 44266 

Main: 330.296.2350 • Referral: 330.615.3800 

Regency Hospital Cleveland East 

4200 Interchange Corporate Center Rd. • Warrensville Heights, Ohio 44128 

Main: 216.910.3800 • Referral: 216.910.3900 

Regency Hospital Cleveland West 

6990 Engle Road • Middleburg Heights, Ohio 44130 

Main: 440.202.4200 • Referral: 440.202.4300

cardiology 

Doctors Report Rare Heart 

Attacks in Adolescents 

By John Lane, MD and Giora Ben-Shachar, MD 

Chest pain in otherwise healthy children 

and adolescents is a frequent cause 

for emergency room visits. In the vast 

majority of these patients, the cause of 

this pain is non-cardiac in origin – often 

a result of muscle strains or stress. 

However, based on our study of nine 

pediatric patients over an 11-year period, 

it seems wise to take these complaints 

seriously. While it is uncommon, myocardial 

infarction can occur in adolescents 

with normal coronary arterial anatomy. 

Emergency medicine physicians assessing 

children and adolescents with acute chest 

pain should not assume the pain is noncardiac 

in nature just because they are, 

in fact, pediatric patients. Such patients 

need a protocol work-up and, even hospital 

admission, if myocardial enzymes are 

abnormal. Further work-up, dysrhythmia 

monitoring, possible coronary angiography 

and treatment would then also 

be warranted. 

We examined the clinical history, 

electrocardiographic (ECG) tracing, 

echocardiography, and cardiac enzymes of 

nine patients presenting in the emergency 

department of Akron Children’s Hospital 

or Rainbow Babies and Children’s Hospital 

in Cleveland between June 1995 and May 

2006. The patients reported acute chest 

pain, especially a crushing-type pain that 

radiates to the arm or jaw or neck, similar 

to the symptoms of adults experiencing 

heart attacks. 

Patients in whom findings were suggestive 

of acute myocardial infarction, 

in addition, underwent drug screening, 

serum lipid profile, and hypercoagulability 

work-up. Where myocardial infarction 

was definitely diagnosed, the patients 

underwent heart catheterization with 

coronary angiography. All of these 

patients lacked common risk factors for 

heart problems, such as high blood pressure, 

unhealthy cholesterol levels, and 

drug abuse. 

All nine patients (eight of them male), 

between the ages of 12 and 20 years 

(mean age of 15.5 years), met established 

criteria for myocardial infarction. 

Eight had abnormal ECG findings. 

All nine patients had abnormal cardiac 

enzymes. Three presented with 

echocardiographic abnormalities. 

Four patients had cardiac dysrhythmias, 

three with nonsustained ventricular 

tachycardia. Drug abuse, lipid profiles 

and hypercoagulability (done on the last 

seven patients) studies were negative 

in all. Five patients had left ventricular 

focal hypokinesia, as seen by echo 

or angiography. None had abnormal 

coronary anatomy. 

Cardiac function normalized in eight 

patients. One patient had a persistent focal 

inferior hypokinetic wall segment. 

Acute treatment for all patients included 

Nitroglycerin and aspirin or intravenous 

Heparin. Thrombolytic therapy was not 

administered in any patient. Diltiazem 

was started post infarction and continued 

post-discharge. 

Cardiac catheterization with coronary 

angiography was performed in all patients 

to assess for congenital heart disease, myocardial 

wall motion abnormality, and to 

define coronary arterial anatomy. Patients 

were assessed post-hospitalization by 

clinical history, ECG, echocardiography 

and exercise stress testing. 

Calcium channel blocker therapy was 

initiated in all patients with no recurrence 

of anginal chest pain on follow-up. One 

patient complained of chest pain distinct 

from anginal pain on follow-up. 

The patients in the study did not have 

any permanent, long-term injury in 

heart function. The necessary duration 

of therapy with calcium channel blockers 

is unknown. 

The etiology of infarction in the patients 

in the study is presumed due to coronary 

spasm given the lack of fixed anatomic 

stenosis or occlusion. The spasm was apparently 

of sufficient duration to result 

in myocardial necrosis and enzyme leak. 

The vasoactive nature of their ischemia 

was also suggested by effective response 

to Nitroglycerin. 

Ruling out myocard ial i n farction 

cannot solely depend on the 

absence of typical electrocardiographic 

changes. Obtaining cardiac 

enzymes is critical to exclude myocardial 

infarction when chest pain suggests 

myocardial ischemia. 

No precipitating event could be identified 

as a cause for coronary spasm and it 

is unclear, at this time, which adolescents 

are at risk. One patient in the study had 

been treated with Ritalin, but it was not 

deemed to have played a causative role. 

The implication of acute myocardial 

infarction in otherwise healthy adolescents 

for future cardiac events, activities 

and lifestyle, as well as for long-term 

management, is, as of yet, unknown. It, 

therefore, makes it important to identify 

and establish long-term follow-up into 

the adult years. 

Drs. John Lane and Giora Ben-Shachar are 

pediatric cardiologists in Akron Children’s 

Hospital’s Heart Center. In addition, Dr. 

Lane is director of Akron Children’s Adult 

Congenital Heart Service. Their study, entitled, 

“Myocardial Infarction in Healthy 

Adolescents” was published in the October 2007 

issue of Pediatrics. ■ 


Free AED Program for State Schools 

Completed, National Effort Begins 

The Ohio School AED Project, which 

placed automated external defibrillators 

(AEDs) in Ohio schools, is now complete. 

The five-million-dollar project, administered 

by Akron General Medical Center in partnership 

with Cardiac Science and the American 

Heart Association, resulted in the placement 

of 4,544 AEDs in schools throughout Ohio. 

Terry A. Gordon, DO, a cardiologist with 

Northeast Ohio Cardiovascular Specialists 

and a member of the medical staff at Akron 

General, spearheaded the project. 

“Defibrillation from an AED is the single 

most effective treatment for starting the heart 

after a sudden cardiac arrest, the leading 

killer in the United States,” said Dr. Gordon, 

who pointed out that every year in America, 

over 330,000 people collapse from sudden 

Defibrillation from an AED is the single most effective 

treatment for starting the heart after a sudden 

cardiac arrest, the leading killer in the United States. 

Dr. Terry A. Gordon 

cardiac arrest. “Already, twelve lives have 

been saved in Ohio with these devices.” 

Earlier this month, a 13 year-old boy from 

Vernon, Ohio, who collapsed at school was 

revived through the use of an AED that was 

obtained through the project, and similar 

cases have been reported by schools across 

the state. Schools receiving an AED through 

the project were required to form a team of 

five people who were trained on the use of 

the device. Ohio Senate Bill 321 provided 

qualified immunity from civil and criminal 

liability of people who provide defibrillation 

from one of the AEDs. The AED program 

also included CPR training as well as alignment 

with local EMS. 

Plans are now being made to obtain funding 

and expand the program nationally. Dr. 

Gordon is working to enlist the aid of state 

and congressional leaders to help champion 

this most urgent cause and put an AED device 

in every school in America. ■ 


Key Elements in Developing a Website 

We’ll be the first to admit it: It’s really 

easy to build a website these days. 

You can rely on an ad agency, your 

web-savvy nephew, or even a one-sizefits-all 

template. We’ll also be the first 

to warn you: these options often lead to 

frustration, wasted time and money, and 

poor results. 

Effective Web sites, those that actually 

help grow a medical practice or business, 

have a unique balance of form and function 

and adhere to industry standards of 

design and programming. 

I n t h is second i nst a l l ment i n 

a six-part series on eMarketing for 

physicians, we’ll look at three key elements 

to consider when developing 

your website: Industry Best Practices, 

Content Management and Accessibility/ 

Usability Standards. 

INDUSTRY BEST PRACTICES 

Your website should have more than 

just aesthetic value. It should effectively 

communicate your practice’s mission and 

services, illustrate your brand/feel, and 

engage potential patients. Your website’s 

programming (its nuts and bolts, if you 

will) should also adhere to the following 

industry best practices: 

• Optimized graphics for faster loading 

times. Visitors rarely wait more than 

ten seconds for pages to load; 

• Hand-coded pages that don’t rely on 

automated software and minimize 

loading times; 

• Browser compatibility, so your site 

works on a variety of browsers and 

operating systems; 

• Open-spaced design and legible fonts; 

• Search engine-friendly design, so that 

search engines can follow the architecture 

of the site; 

• Persuasive conversion points to get patients 

to call, make appointments, ask 

for referrals, etc; 

• Easy integ rat ion w it h existing 

databases. 

CONTENT MANAGEMENT 

The premise of a Content Management 

System (CMS) is simple. It allows 

you the ability to add, edit, and delete 

information in real-time. One 

of the most versatile features of this 

system is that anyone can use it, no 

matter the level of their programming 

or design skills. Here are some 

of t he adva nt ages of a qualit y- 

built CMS: 

• Page content editing on-the-fly; 

• Faster and less costly updates, since your 

staff can update at anytime; 

• Additional pages that can be added to 

your site at anytime; 

• Preformatted titles and text to create 

consistency across the Web site; 

• Search-friendly programming, allowing 

content to be open to the search 

engines; 

• More cost savings as more pages 

are added; 

• Custom built to fit the needs of 

your site. 

Effective Web sites, those that actually help grow a 

medical practice or business, have a unique balance 

of form and function and adhere to industry standards 

of design and programming. 

emarketing 

Don’t risk a poorly built site. You should never have to 

decide between form OR function. A well-built site 

should be easy to maintain, easy to update, and easy for 

all visitors to browse. 

ACCESSIBILITY/USABILITY 

STANDARDS 

When visitors enter your site, they 

should be able to define two things 

right off the bat: your site’s purpose 

and whether or not your site offers 

relevant information. 

Your site should also be programmed 

properly so that it is accessible to visitors 

who are disabled. You may have read 

that Target was recently sued because 

their site was inaccessible to people 

with disabilities. Accessibility includes 

features like font size options and text 

descriptions of images for vision-impaired 

individuals. This is especially 

important in the medical profession, 

since you are more likely to have visitors 

using assistive technology when browsing 

the internet. 

So how do you know if your site is accessible? 

Easy – your site should be built 

in compliance with W3C guidelines. 

W3C is a group that sets standards on the 

web, and a good developer will know how 

to build a site to their specifications. 

Don’t risk a poorly built site. You 

should never have to decide between form 

OR function. A well-built site should be 

easy to maintain, easy to update, and easy 

for all visitors to browse. 

The Karcher Group is an award-winning 

Web Development, Marketing and Hosting 

firm located in North Canton. Their clients, 

which number over 500, include small 

businesses and Fortune 500 companies. For 

more information, contact Patrick Quicci at 

patq@thekarchergroup.com or 330-493- 

6141, or visit www.thekarchergroup.com. ■ 


The Enforceability 

of Physician Non-Competes 

By Hans A. Nilges, Esq. 

Imagine that, upon coming into the 

office one Monday morning, you find the 

following sitting on your desk: 

Dear Dr. Smith, 

This is to let you know that, effective immediately, 

I am leaving to go work for the physician 

group across the street. I know you hate those 

guys, but they do the exact same type of work 

you do, and they are paying me more money. 

I’m sure you won’t have trouble replacing me 

because hundreds of other docs in the county 

can do anything I can do. 

Thanks for all of the money and training 

you have given me over the past few years. I 

especially appreciated meeting and getting to 

know your patients and referral sources. Don’t 

worry — I have all of their names and phone 

numbers so we can keep in touch. Also, all of 

those meetings I attended where we discussed 

growth strategy for your practice were really 

interesting and have given me a lot of good 

ideas for the future. 

Sincerely, 

Dr. Jane 

P.S. I know I have a non-compete that prohibits 

me from working for a competitor within 

10 miles for 1 year, but a friend of mine told 

me those things aren’t enforceable, so don’t try 

anything funny. 

You then promptly call your attorney 

T: 7 in 

and ask: 

Are Physician Non-Compete’s 

Enforceable? The answer is, “It depends.” 

Generally, non-competes, 

non-solicitation provisions, and other 

forms of employment restrictive covenants, 

because they act as a restraint 

on trade, are viewed with disfavor by 

courts. Among many courts, that disfavor 

is especially acute when the restrictive 

covenant involves a physician. Indeed, 

several courts have given at least lip-service 

to the idea that physician restrictive 

covenants must be strictly construed in 

favor of physician mobility. 

The American Medical Association has 

likewise expressed its disfavor of physician 

restrictive covenants and have decried 

the doctor will 

hear you now 

T: 4.875 in 

want better health care? start asking more questions. to your doctor. to your pharmacist. 

to your nurse. what are the test results? what about side effects? don’t fully understand your 

prescriptions? don’t leave confused. because the most important question is the one you should 

have asked. go to www.ahrq.gov/questionsaretheanswer or call 1-800-931-AHRQ (2477) 

for the 10 questions every patient should ask. questions are the answer. 


them as tending to “disrupt continuity of 

care, and potentially deprive the public 

of medical services.” AMA Code of Ethics, 

E-9.02. It has even gone so far as to declare 

restrictive covenants “unethical if 

they are excessive in geographic scope or 

duration … or if they fail to make reasonable 

accommodation of patients’ choice of 

physician.” Id. 

It would be ill-advised, however, for 

a physician to find excessive comfort 

from such precatory statements. Neither 

Ohio courts nor the AMA, despite their 

substantial hand-wringing, have ever 

found that physician non-competes are 

per se unenforceable. Indeed, unless a 

physician has a fairly unique subspecialty 

or skill (e.g., a kidney stone specialist 

accomplished in lithotripsy), or serves a 

geographic area with few available medical 

resources, most courts will treat a 

physician’s non-compete the same as any 

other non-compete. 

That is, courts will enforce the noncompete 

if the employer can prove that 

doing so will protect some legitimate 

interest. Primary among the interests 

that courts will determine worthy of 

protection include: 1.) relationships with 

patients and patient referral sources; 2.) 

access by the physician to trade secret or 

confidential business information; and 

3.) the provision of some unique training 

that will enable the departing employee to 

compete unfairly. If the existence of such a 

legitimate interest is established, the court 

will then examine whether the scope of 

the covenant is reasonable. Generally 

speaking, the more narrowly tailored 

the restriction, the more likely it will be 

enforced as written by the court. 

So Is Dr. Jane’s Non-compete 

Enforceable? Most likely. Here, Dr. 

Jane, who does not have any unique skills 

or training, violated the express terms of 

her restriction by going to work across the 

street. She has admitted that she developed 

relationships with Dr. Smith’s patients and 

referral sources. And, the tone of her letter 

gives the clear implication that she plans on 

utilizing those relationships to Dr. Smith’s 

detriment. Additionally, it appears that Dr. 

Jane was given access to confidential, if not 

trade secret, information that would enable 

her to compete unfairly. 

Thus, it is likely Dr. Smith has a legitimate 

protectable interest, even if the 

training Dr. Jane received was not unique. 

So, if Dr. Smith can prove that he needs 

at least 1 year to secure his relationships 

and adequately modify or implement his 

business plans, and that he attracts patients 

within a 10 mile radius, a court will likely 

enforce Dr. Jane’s restriction. 

Hans A. Nilges is a member of the Employment 

& Workers Compensation Practice Group at 

Buckingham, Doolittle and Burroughs, LLP, in 

Canton, where he assists employers with their 

employment law needs. ■ 

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Sandboarding: Doin’ the Dunes 

By Tom Gotzy 

the sporting life 

Look — it’s a skier, a snowboarder, a 

skateboarder, no — it’s a sandboarder! Yes, 

a sandboarder. 

Sandboarding is possibly one of the oldest 

sports, according to the Chinese. At festivals 

in ancient times, the Chinese took to swooshing 

down sand dunes on slats of flat wood 

planks. This was in the eighth century. But, 

throughout the centuries, sandboarding lost 

its place in the annals of adventure to skiing 

and 20th-century snowboarding. 

As a sport, sandboarding has experienced 

a recent revival. After all, the white stuff 

melts away in the spring but the sand dunes 

stand year round. It’s a great way to satisfy 

that yearning for carving snow during winter, 

all year round, spring, summer, fall 

and winter. 

Sandboarding made a mild comeback as an 

offshoot of the 1960s surfing craze. Although 

sandboarding was treated more like a fad, 

enthusiasts strapped anything to their feet: 

car hoods, surfboards, skateboards with the 

trucks taken off, even scraps of cardboard 

just to name a few of the creative constructions. 

However, over the years sandboarders 

have adopted many technologies from snowboarding 

to make this a sport everybody 

could enjoy. 

Sandboard “pilots” strap on a board anywhere 

from 100-cm to 160-cm long (think 

long skateboard). The construction is a 

wood laminate encased in fiberglass with a 

Formica-like-material base coated in wax 

(different waxes for different sand, sounds 

a lot like snowboarding, huh?). Then the 

sandboarder proceeds to walk up the sand 

dune or hitch a ride on a dune buggy to get to 

the top. Sorry, no ski lifts — the sand won’t 

support the heavy weight! 

They strap their bare feet or boots into 

binders and make the fast descent back down 

to the bottom. 

Throughout the world, sandboarder 

pilots can board in just about any country, 

including China, Egypt, Saudi Arabia, Africa 

and Peru. 

Here in the U.S., Florence, OR, is one of 

the great sandboarding havens. As a former 

logging community and voted the best place 

to retire, Florence has what the some other 

locales lack: soft, clean sand that acts like tiny 

ball bearings under your board. Three rivers 

contribute to the sand playground: the Coos, 

the Umpqua and the Siuslaw. All three dump 

stream sediment into the ocean off a gently 

sloping sand stone terrace that stretches 

about 40 miles, from Coos Bay all the way 

to the iconic Heceta Head Lighthouse. 

Ocean currents and offshore winds toss the 

grains back onto the shelf, where it piles up 

in waves, bowls and flat plains. The winds, 

tides and currents that wash and rewash the 

sediment grind out what may be the cleanest 

and softest sand on the coast and maybe 

in the world. Let’s just say you want to try 

sandboarding if you’re in Oregon. 

GIVE IT A TRY 

If you have experience snowboarding, 

sandboarding is quite similar, but there 

are some things you need to know. First of 

all, you don’t need to go to Florence. Any 

good-size dune will do anywhere you can 

find one. There are sandboarding “parks” 

throughout the country in places like 

California, Arizona, Colorado, Idaho, 

Indiana, and even New York, New Jersey, 

Michigan and Massachusetts. 

Be sure you’re qualified to do this sport. 

Brush up on the rules of the dunes and make 

sure you’re fit. Being in good physical shape 

helps, as does indifference to falling and/or 

crashing. 

Remember, in sandboarding, there is no 

lift to take you back to the top. This means 

that you will have to be in great shape to 

trek back up the dune for your next run and 

every run — unless you have a buddy that 

owns a dune buggy or ATV and gives you a 

ride back up. Also, keep in mind that sand 

is very abrasive and if you happen to take a 

spill you may feel a little pain. Last thing to 

know is that after every run you take, the 

sandboard needs to be waxed. Again, sand 

is very abrasive and will quickly wear off the 

last coat of wax you put on. 

OK, now you have a place to go, a board 

that’s designed for sand and the nerve to try 

it, strap your board on and head to the top 

of the dune. Just like snowboarding, you 

strap the board to your feet, scoot over to 

the edge and launch yourself down the dune. 


the sommelier 

Some Like It Hot 

By Natalie MacLean 

I enjoy skiing, sledding and skating best 

from my kitchen window. From here, warm 

and dry, I can watch my more active friends 

and family participating in those chilly activities. 

When they come in to sit by the fire, I 

offer them hot toddies, mulled wine and hot 

buttered rum cider. These winter warmers 

are what make my cheeks rosy and they also 

infuse the whole house with the heady aromas 

of steaming spices. They make me embrace 

the great indoors as I pour the top-ups into a 

thermos for the hardiest souls to take outside 

with them again. 

HOT TODDY 

The word “toddy,” from the Hindu tári 

tádi, originally meant a drink of fermented 

sap or coconut milk. The British picked up 

the idea in the 19th century, though their 

toddies, usually made from scotch, were 

the sporting life 

As a beginner, remember to bend your knees 

slightly and point your lead arm forward, this 

keeps your balance and helps carve the sand 

while you turn with your board. 

Don’t just buzz down the dune in a straight 

line, you can really pick up a lot of speed and 

if you happen to fall it also increases the “rug 

burns” that you get. Just take it easy for the 

first couple of runs and, after a while, you’ll 

really get the hang of it. 

So grab your board shorts, board and wax, 

and hit the dunes! 

FOR MORE INFORMATION 

Vi s it t hese websites for more 

information: 

Planet Sandboard: 

www.geocities.com/pipeline/9766/. 

Sandboard Magazine: 

www.sandboard.com. ■ 

more often consumed for medicinal purposes. 

Today we usually use dark spirits as a 

base, such as rum, scotch, Irish or Canadian 

whiskey or bourbon, as the base for this classic 

and simplest hot cocktail. For a modern 

twist, use hard cider or apple brandy for a 

lovely baked apple pie flavor. 

In a heat-proof bowl, mix 4 tablespoons 

of sugar with a few dashes of cloves and cinnamon 

in 16 ounces of boiling water. Then 

add 8 ounces of your preferred dark spirit. 

Pour into four coffee mugs and add a splash of 

lemon juice if desired. Stir with a cinnamon 

stick, which you can leave in for decoration 

and flavor. Grate fresh nutmeg over the top 

if you like. For an extra kick, use spicy tea 

instead of hot water. In fact, if you’re looking 

for some inventive updates on the traditional 

toddy, check out DiscCookery (Whitecap, 

$18), by CBC radio host Jurgen Goethe. 

MULLED WINE 

This Dickensian classic was created before 

vintners learned how to preserve wine with 

corks and sulfites. Back in Victorian times, 

wine was kept in oak barrels until consumed, 

and it often spoiled. So wine merchants created 

“mulled wine,” masking the bad odors 

with spices and liqueurs. Mulled means 

heated, not boiled, which is important to 

keep in mind as you make this cocktail. 

To make mulled wine for four, choose a 

full-bodied red wine, such as an Australian 

shiraz or a Chilean cabernet. The wine 

needn’t be expensive, but don’t use anything 

you wouldn’t drink by itself as cooking it 

concentrates flavors for good or bad. Heat 

the contents of a 750-ml bottle in a large, 

nonreactive saucepan. Keep in mind that 

“mulled” means just warmed, not boiled. 

Simmer gently, stirring occasionally, for 

about 10 minutes. Then add 3 to 4 ounces 

of either port or orange liqueur, two whole 

cloves, a tablespoon of sugar and a dash of 

cinnamon. Simmer for another five minutes. 

Pour through a sieve to strain the solids 

from the liquid. Pour into heat-proof mugs 

or glasses. Stir with a stick of cinnamon and 

garnish with orange slices. 

HOT BUTTER RUM CIDER 

This ought to be the Canadian national 

drink given all the rum we ran to the 

United States during Prohibition, as well as 

our heritage in making first-class cider. To 

make hot buttered rum cider for four, heat 

four cups of cider in a small saucepan over 

low heat, along with two cinnamon sticks, 

2 tablespoons of honey and 1 tablespoon of 

lemon juice. Simmer uncovered, stirring 

occasionally, for about 10 minutes. Strain the 

mixture to remove the solids. Next, combine 

4 teaspoons of butter with 4 tablespoons 

of brown sugar and add it the cider and hot 

water. This prevents the butter from floating 

on top of the liquid like an oil slick. Pour 

the cider mixture into four heat-resistant 

mugs and then top up with a quarter cup of 

rum. For extra decadence, add a dollop of 

whipped cream on top. Not only is this festive, 

but it is symbolically hopeful: Beneath 

the snowcaps of winter lies the promise of 

summer warmth. 

All these hot drinks warm the parts of 

us that other drinks just don’t reach. As we 

sit by the fire with our feet up, our hands 

wrapped around the toasty mug, letting the 

steam brush our cheeks and the spices tickle 

our noses, we feel that we’ve been warmed 

from the inside out. 

Natalie MacLean is the author of Red, White 

and Drunk All Over: A Wine-Soaked 

Journey from Grape to Glass. She was named 

the World’s Best Drink Writer for the articles and 

wine picks in her free wine newsletter available at 

www.nataliemaclean.com. ■ 




Beware of Online Phishing Scams 

By Paul D. Guerra, AIF 

Among e-mails from friends, family, 

and colleagues, you may have seen something 

like this: 

“Dear valued Bank X customer, we’ve reviewed 

your account and discovered an inaccuracy in 

your information. Please follow the link below 

to verify your account …” 

Sound legitimate? It probably isn’t. 

Chances are you’ve just been hit by a 

phishing scam. These scam artists try 

to con you to hand over your sensitive 

personal data via spam e-mails or pop-up 

windows. Phishing scams are designed to 

deceive unsuspecting people into disclosing 

valuable personal information, such as 

credit card numbers, account data, social 

security numbers, and passwords. Most 

often, they appear to be a genuine notice 

from a trusted source. 

If you get such a message, know that 

there is nothing personal behind it. You 

are not being specifically targeted. You are 

one of thousands who likely get the same 

message. That’s why it’s called “phishing”; 

the scammers are putting out their nets, 

in a sense, to see who bites. 

You may think you won’t get caught, but 

scams are becoming increasingly more professional 

and target more and more people. 

Many are now taking the actual logos of the 

sites they pretend to be from, while they 

brazenly put in a disclaimer claiming that 

fraudulent use of the Internet is a crime! 

There are simple precautions you can 

take to make sure that you do not become 

a victim. If you notice any of these 

“red flags,” think twice before handing 

out information: 

• The e-mail contains urgent requests 

for personal financial information, or 

to reconfirm existing information, and 

either asks you to follow a link or to fill 

out a form in the e-mail. 

• The message uses scare tactics to 

convince you that your security is 

being threatened. 

• The message is addressed “Dear customer,” 

or some other impersonal 

greeting. 

• The message is from a bank or Web site 

you do not do business with. 

• The message appears to be from somewhere 

you do transact business with. 

Scammers often use well-known entities, 

such as leading Web sites or big 

credit card issuers, assuming there 

is a high probability that the owner 

of a random e-mail account uses that 

particular company. 

• The message has misspelled words and 

punctuation errors, or does not use correct 

English. (Many phishers operate 

outside the U.S.) 

If you suspect the site is not secure, 

do not enter any credit card numbers or 

account information. You can identify a 

secure Web site by its address. A secure 

source will begin “https” rather than just 

“http.” Please note: This is not a fail-safe 

method. Some hackers have learned to 

forge the security “s.” 

So what if you get a message and it still 

looks genuine? Continue to exercise caution. 

Some ways to avoid being lured in: 

• Never click on the link in the e-mail. Go 

to the site in question yourself and log 

into your account from there. 

• Mouse over the link in the e-mail; some 

Internet browsers show you at the bottom 

of the screen where the link goes 

to. Again, this is not a foolproof method 

either. Scammers are getting more sophisticated 

in “spoofing” legitimate Web 

sites’ addresses. 

• Review credit card and bank statements 

regularly. Look for any suspicious 

transactions. 

• Be cautious of attachments, regardless 

of who sent them. 

• Don’t give out personal financial information 

unless you’re on a secure 

Web site. 

• Install anti-virus software and keep it 

up-to-date. 

• Avoid e-mailing personal financial information. 

E-mail is not a secure method of 

communication. Most banks will never 

ask you to submit personal information 

this way. 

• Call your bank or credit card company to 

double-check that the message is legit. 

• Alternately, forward the message on 

to the Web site in question for their 

opinion. Many, such as Amazon, eBay, 

and numerous banks, have phishing or 

“spoofing” departments to determine 

legitimate e-mails from fake ones. 

• Don’t fall for warnings that you must 

respond within 24 hours, or some other 

accelerated time frame, in order to keep 

your account open. 

If you are unsure if the message is valid, 

contact the company it was sent from 

(use the phone number listed on their 

official Web site — never what the e-mail 

provides). If you suspect you’ve been 

scammed, notify the bank or credit card 

company that you think you provided 

account information for, as well as the 

company targeted in the e-mail. This is 

to prevent your information from being 

used maliciously. To prevent this scammer 

from striking others, contact the 

Federal Trade Commission at www.ftc. 

gov and file a complaint. Your next step 

is to visit the FTC’s Identity Theft Web 

site at www.consumer.gov/idtheft—victims 

of phishing may be especially vulnerable 

to identity theft. 

It’s much easier to prevent yourself from 

becoming a phishing victim, than it is to 

resolve the problems once they occur. Use 

caution when forging your way through 

the Web, and you may not be caught 

by phishers. 

Paul D. Guerra is an Accredited Investment 

Fiduciary (AIF) and the president of Brookshire 

Financial Group, Inc. in Canton. ■ 


PQRI: You Can Pry 

a Few More Bucks Out of Medicare 

Internists Need Only Report on Three Measures to Qualify 

By William Rogers, MD, FCEP, Director, CMS Physicians Regulatory Issues Team 


I dare say that every physician in the 

United States is aware that the Medicare 

program pays doctors in 2007 less than 

it did in 2001. Physician expenses have 

been increasing annually — office rent, 

staff salaries and malpractice insurance 

premiums increase every year. What in 

the world are the bureaucrats who run 

Medicare thinking? 

When the Medicare program was 

established in 1965, spending on physician 

services was modest, and local fee 

schedules were the rule. As the figure 

shows, Medicare spending grew dramatically 

over the next decade and in 1975, 

Congress intervened, limiting physician 

fee schedule increases to the rate of 

growth of the Medicare Economic Index. 

Spending continued to increase and by 

1984, Congress actually froze physician 

fee increases. 

In 1987, 1992 and 1997, Congress imposed 

mathematical formulas that were 

intended to rein in physician spending. 

The last of those formulas, called the 

sustainable growth rate (SGR), has determined 

the physician fee schedule since 

1997. The SGR formula prevents spending 

on physician services from growing much 

faster than real per capita gross domestic 

product (GDP). Because of the very rapid 

growth in spending on chemotherapeutic 

drugs and on imaging studies, as well as a 

more modest but very real growth in volume 

of other physician office services, the 

amount of money in the Medicare Part B 

pie available to pay physicians for an office 

visit has shrunk considerably. 

The SGR formula has dictated a reduction 

in the physician fee schedule every 

year since 2001. Congress has intervened 

every year, except in 2002, to prevent the 

negative update, but the formula remains 

on the law books, and the Centers for 

Medicare & Medicaid Services (CMS) 

has predicted that in 2008, physician payments 

will have to be reduced by 9.9%. 

Congress is exploring alternatives to the 

SGR, but the budgetary implications are 

sobering. Just to freeze physician fees for 

the next 10 years would increase Medicare 

spending by $171 billion. Allowing physician 

spending to increase at the rate of the 

Medicare Economic Index for the next 10 

years would cause Medicare spending to 

increase by $252 billion. 

There is an opportunity for physicians 

to pry a few more dollars out of 

the Medicare program without worrying 

about spending time in the local 

pokey. This opportunity is known as the 

Physician Quality Reporting Initiative 

(PQRI). Congress has allocated money to 

be awarded to physicians who participate 

in this program, by reporting on quality 

measures to CMS. 

Physicians should think about participating 

in the PQRI. Measure reporting 

begins on July 1, 2007, and the measures 

are reported on the Medicare claim 

form that the office generates already. 

Physicians who participate will get a check 

from Medicare, as well as a confidential 

report, which will give the reporting 

physicians a sense of their personal performance. 

Unlike the hospital quality measures, 

physician measures will not be disseminated 

to the public. There are currently 

74 measures, but internists will only need 

to report on three measures to qualify for 

the payment. 

We hope to have the detailed specifications 

of the measures on the PQRI 

website by the end of March. As soon as 

the specifications are available, it will be 

a simple matter for a practice to develop 

a simple worksheet that will list just the 

measures that the practice has elected to 

report. 

If, for example, the practice decided 

to report on hemoglobin HbA1c measurement 

in their diabetic patients, the 

worksheet would list the CPT II code 

for that measure, and the doctor would 

check the box if she or he had measured 

the HbA1c. 

When the chart is processed by the billing 

staff, they need merely add that CPT 

II code to the claim form on line 24. 

Further information on the PQRI 

is available online at http://cms.hhs. 

gov/pqri. 

We would encourage physicians with 

questions to call in on the next physician 

open-door forum. 

Medicare spending and projected growth, 

1967-2016. Medicare expenditures, in billions 

of dollars. 

William Rogers, M.D., FACEP, is the 

Director of the Centers for Medicare & Medicaid 

Services’ Physicians Regulatory Issues Team and 

a practicing emergency room physician. 


SCREEN FOR VASCULAR 

DISEASE IN ELDERLY 

Screening for vascular disease appears 

to be beneficial for people 55 years of age 

or older with cardiovascular risk factors, 

according to the Society for Vascular 

Surgery (SVS). Vascular disease is a 

leading cause of stroke, death and limb 

amputation in the United States, and is 

particularly dangerous because in many 

people the disorder is entirely asymptomatic 

until a life-changing medical 

event occurs. 

“It is unfortunate that most often people 

who have a stroke or abdominal aortic 

aneurysm are unaware of their condition 

before it is too late. With baby boomers 

entering this age group, it is important the 

public becomes aware of vascular disease 

and the benefit of screening,” said K. 

Craig Kent, M.D., vascular surgeon and 

President of the SVS. “Members of SVS 

want people to know that when diagnosed 

early, these diseases can be managed and 

treated to prevent catastrophic results.” 

Noninvasive vascular ultrasound screenings 

have been proven to accurately detect 

evidence of these diseases; and, when 

evidence is found, vascular surgeons can 

successfully treat the diseases to prevent 

stroke or loss of life. People who should 

consider being screened are those 55 years 

or older with cardiovascular risk factors 

including a history of hypertension, diabetes 

mellitus, smoking, high cholesterol, 

known cardiovascular disease or a family 

history of abdominal aortic aneurysm. 

The SVS recommends the following 

screenings in high-risk individuals: an 

ultrasound scan of the aorta to identify 

aortic aneurysms; an ultrasound scan of 

the carotid arteries to assess stroke risk; 

and blood pressure measurements in 

the legs to identify peripheral arterial 

disease and risk of heart disease. The entire 

statement on vascular screening is 

available at: http://www.vascularweb. 

org/_CONTRIBUTION_PAGES /Media/ 

svs_positions/svs_positions.html. 

“Vascular surgeons treat those at risk 

for stroke, people with abdominal aortic 

aneurysm and individuals with peripheral 

arterial disease using lifestyle changes, 

medication, noninvasive procedures and, 

in the most advanced cases, open surgery,” 

said Dr. Kent. 

Source: The Society for Vascular Surgery 

ALZHEIMER’S FOUNDATION 

OF AMERICA AWARDS 

GRANT TO NJF CENTER FOR 

CAREGIVERS 

The Alzheimer’s Foundation of America 

(AFA) recently awarded the NJF Center 

for Caregivers, Scottsdale, AZ, with 

a $5,000 grant to train its staff to 

evaluate dementia care settings to see 

if they meet AFA’s national standards of 

optimal care. 

The grant is one of 19 grants totaling 

nearly $100,000 that AFA presented to 

community organizations across the U.S. 

this spring. 

The AFA grant will help the NJF 

Center for Caregivers offset the costs 

of training its staff to become specialists 

for AFA’s Excellence in Care 

Dementia Program of Distinction. 

Excellence in Care specialists evaluate 

a setting’s physical environment, safety 

procedures, program activities, staffclient 

interaction and training of staff 

and families to see if they comply with 

AFA’s standards, as well as work with a 

facility toward continual performance 

improvement. The voluntary standards 

reflect what AFA believes to be essential 

components of any quality dementia 

care program. 

In addition, the center, a member 

organization of AFA, will use the grant 

to increase its marketing efforts to 

inform caregivers about its services. 

Its services include counseling, client 

assessments, crisis prevention, counseling 

on long-term care placement and 

referrals to other community resources 

in Scottsdale. 


“The NJF Center is grateful to the 

AFA for its support and commitment 

to our mission of providing support to 

informal caregivers,” said Rebecka Feola, 

Executive Director of the NJF Center for 

Caregivers. “This grant will assist the 

NJF Center in not only working alongside 

the AFA in promoting qualified care to 

those with Alzheimer’s disease and other 

dementias, but also providing our other 

charitable services to a population often 

overlooked and underserved.” 

It is estimated that there are nearly 30 

million informal caregivers in the United 

States, with more than half a million of 

them in the state of Arizona. 

AFA, a national nonprofit organization 

that focuses on the care needs of those with 

dementia, has been awarding grants twice a 

year, in the spring and fall, to its nonprofit 

members since 2004. In the current cycle, 

AFA gave out $5,000 grants to 19 member 

organizations in 14 states. The member 

organizations provide support and services 

to individuals with Alzheimer’s disease and 

their family caregivers. 

In addition to its biannual grant process, 

AFA also awards an annual grant, 

called The Brodsky Grant, to a member 

organization for a program that is judged 

to be innovative and has the potential to 

be replicated. 

“As a foundation, AFA is committed 

to driving funds back into local communities,” 

said Eric J. Hall, AFA’s Chief 

Executive Officer. “We know these funds 

are ultimately making a difference in people’s 

lives, especially as organizations face 

increasing demand for their services.” 

Currently, it is estimated that more than 

5 million Americans have Alzheimer’s 

disease, including one in 10 aged 65 or 

older, and nearly one in two aged 85 or 

older. The incidence is expected to triple 

by mid-century. Alzheimer’s disease is 

now the seventh leading cause of death 

in the U.S. ■ 

Source: The Alzheimer’s Foundation of 

America 


PEER-REVIEWED, ONLINE 

DATABASE SHOWCASES LOCAL, 

COUNTY AND STATE PANDEMIC 

PLANNING 

Public health planners have a new tool to 

help them prepare for one of the most daunting 

public health emergencies: an influenza pandemic. 

PandemicPractices.org, launched by the 

Center for Infectious Disease Research & Policy 

(CIDRAP) at the University of Minnesota and 

the Pew Center on the States (PCS), a division 

of The Pew Charitable Trusts, brings together 

more than 130 peer-reviewed promising 

practices from four countries, 22 states and 

33 counties. Compiled as a resource to save 

communities and states time and resources, 

the database enables public health professionals 

to learn from each other and to build on their 

own pandemic plans. 

“The federal government has a national plan in 

place for a flu epidemic. But that plan will be useless 

unless states and local communities are ready 

and able to handle a public health emergency 

on the ground,” said Jim O’Hara, Managing 

Director of Health and Human Services Policy 

at The Pew Charitable Trusts. “Communities 

across the country are facing the challenge of 

translating broad requirements into local action, 

often with limited resources. This database is 

an excellent tool to help public health officials 

inform their own pandemic planning and may 

save valuable time and resources that would be 

spent crafting strategies from scratch.” 

Every winter, seasonal flu kills approximately 

36,000 Americans and hospitalizes more than 

200,000. Occasionally, a new flu virus emerges 

for which people have little or no immunity. 

Such a virus will spread worldwide, causing 

illnesses and deaths far beyond the impact of 

seasonal flu, in an event known as a pandemic. A 

severe flu pandemic will last longer, sicken more 

people and cause more death and disruption 

than any other health crisis. In addition to the 

human toll, a flu pandemic will take a serious 

financial toll. One report predicts a range from 

a global cost of approximately $330 billion in a 

mild pandemic scenario to $4.4 trillion worldwide 

under a 1918-like scenario. 

Planning for a flu pandemic represents a challenge 

in public health. No one can predict the 

severity of the next pandemic and there is a shortage 

of data from past pandemics to help guide 

planning. Despite the hard work of professionals 

across the public health community, America is 

unprepared for even a moderate pandemic. For 

example, the public health research and advocacy 

group Trust for America’s Health noted in its 

2006 report card — supported in part by The 

Pew Charitable Trusts — that 25 states would 

run out of hospital beds within the first two 

weeks of a moderate flu pandemic. 

“It is crucial that states, counties and cities 

continually enhance their preparedness for 

pandemic influenza,” said Michael Osterholm, 

Ph.D., MPH, CIDRAP Director. “This online 

database represents an important step by providing 

concrete, peer-reviewed materials to 

further public health preparedness.” 

PandemicPractices.org highlights approaches 

that communities across America have developed 

to address three key areas: altering 

standards of clinical care, communicating effectively 

about pandemic flu, and delaying and 

diminishing the impact of a pandemic. Users 

can easily find practices applicable to their communities. 

The database can be searched by state 

or topic, as well as by area of special interest, 

such as materials translated into multiple languages, 

materials for vulnerable populations or 

toolkits for schools. 

“Communities across America are looking for 

information and resources to help them plan for 

a flu pandemic. This database will be a vital contribution 

to those efforts,” said Isaac Weisfuse, 

M.D., MPH, Deputy Commissioner, New York 

City Department of Health and Mental Hygiene, 

who served as an Advisory Committee member 

and reviewer on this project. 

Planners can examine and download pandemic 

flu planning materials and use or adapt 

them to fit local needs. The database allows 

cities, counties, states, hospitals, clinics and 

community organizations to find materials 

that may enhance their pandemic preparedness. 

Even agencies whose work is included can 

benefit from the work of others. For example, 

communities that have developed strong risk 

communications practices can learn from their 

peers who have focused on expanding the health 

care workforce to meet the needs of an influx 

of patients. 

“There are strong examples throughout the 

database of innovative practices developed 

in one part of the country that would be applicable 

elsewhere. Big cities can learn from 

rural towns, and this project highlights that,” 

said Sue Urahn, Managing Director, The Pew 

Center on the States. “By sharing practices, 

we strengthen the likelihood that as a nation 

we will be able to effectively manage a public 

national news 

health crisis, while saving lives and protecting 

the viability of communities.” 

Source: Pew Charitable Trusts. 

‘GREENECHIP’ SYSTEM: FIRST 

DIAGNOSTIC TOOL TO RAPIDLY 

DETECT AND IDENTIFY ANY 

VIRUS, BACTERIUM, FUNGUS OR 

PARASITE 

Researchers in the Mailman School’s 

Jerome L. and Dawn Greene Infectious 

Disease Laboratory have developed a new 

tool for pathogen surveillance and discovery 

— the GreeneChip system. The GreeneChip 

is the first tool to provide comprehensive, 

differential diagnosis of infectious diseases, 

including those caused by viruses, bacteria, 

fungi or parasites. In addition, it is the first 

tool that can be used on a wide variety of 

samples, including tissue, blood, urine and 

stool, allowing for the rapid identification 

of pathogens in a variety of laboratory and 

clinical settings. 

“Because clinical syndromes are rarely specific 

for single pathogens, methods that simultaneously 

screen for multiple agents are important, 

particularly when early accurate diagnosis can 

alter treatment or assist in containment of an 

outbreak,” said W. Ian Lipkin, M.D., Director 

of the Greene Infectious Disease Laboratory 

and professor of epidemiology, neurology and 

pathology. He added, “To address the challenges 

of emerging infectious diseases and biodefense, 

public health practitioners and diagnosticians 

need a comprehensive set of tools for pathogen 

surveillance and detection.” 

GreeneChip features include a comprehensive 

microbial sequence database that integrates 

previously distinct reserves of information about 

pathogens; for every entry of a pathogen and its 

properties, the GreeneChip contains a correlate 

of its genetic makeup. 

GreeneChip performance was initially tested 

by using samples obtained from patients with 

respiratory disease, hemorrhagic fever, tuberculosis 

and urinary tract infections. In all cases, 

GreeneChip analysis detected an agent that was 

consistent with the diagnosis obtained by more 

traditional and slower methods, such as culture 

or polymerase chain reaction (PCR). 

This research was supported by the National 

Institute of Allergy and Infectious Diseases and the 

Ellison Foundation. ■ 

Source: Columbia University Mailman School of 

Public Health 


usiness spotlight 

Hanger Prosthetics & Orthotics 

According to the National Center for Health Statistics, 

more than 1.5 million people in the United States have lost 

an extremity due to disease or injury. This equates to almost 

6 in 1,000 people. In most cases, appropriate prosthetic devices 

can restore their lifestyles. 

Hanger Prosthetics & Orthotics offers state-of-the-art 

technology, clinically differentiated programs and unsurpassed 

customer service from a team of certified clinicians. 

Offices are conveniently located in Akron, Canton, Massillon, 

Alliance and Tallmadge. Beth Orzell is the Area Practice 

Manager. 

“Excellent service—to our patients and to our 

referring physicians and other referral sources—is really 

our hallmark,” said Orzell. “We provide whatever our 

patients need, from compression hose all the way up to 

prosthetic limbs, and we provide it in a timely and very 

professional manner.” 

Hanger orthotics include 

 

 

 

 

 

 

 

 

 

 

 

 

Prosthetics include 

 

below-elbow, above-elbow, and shoulder 

 

 

the foot, below-knee and above-knee, hip disarticulation 

and hemi-pelvectomy amputations. 

All orthotics and prosthetics for Hanger’s Akron/Canton 

area offices are custom-made in Hanger’s new 5,000-squarefoot 

Fairlawn facility which houses a full-service lab, patient 

exam rooms and a complete gait analysis room lined with 

mirrors and parallel bars. Here prosthetists and therapists 

can literally “see” how a patient adapts to a new device. 

“We have 16 allied health professionals with over 170 

years of combined experience in our Akron/Canton offices,” 

said Orzell. “Everyone is on board with serving the 

patient, whether it’s in one of our offices or in a hospital. 

We even make house calls—to nursing homes or private 

homes, wherever the patient lives. This is especially advantageous 

for elderly patients who have trouble getting out 

into the community to obtain the care they need.” 

For pediatric patients, Hanger will open in 2008 an office 

in the Considine Building in downtown Akron, where 

Akron Children’s Sports Medicine and Orthopaedics is 

located. Hanger is the preferred provider for Akron Children’s 

Hospital. 

Clinical hours at all of Hanger’s locations are 9 am to 5 

pm, Monday through Friday. Whenever needed, arrangements 

are made to see patients after hours. An oncall service 

is also available for Hanger’s referral sources. 

For more information about Hanger Prosthetics & Orthotics, or to 

refer a patient, call 330-670-8263. 


What’s New at Area Hospitals 

hospital rounds 

Affinity Medical Center’s Cardiology 

Rehabilitation Department has received accreditation 

from the American Association of 

Cardiovascular and Pulmonary Rehabilitation 

(AACVPR). The AACVPR’s mission is to 

improve the quality of life for the patient and 

their families. 

Akron Children’s Hospital’s sports 

medicine center and orthopedics center are 

merging to form the new Center for 

Orthopedics and Sports Medicine at Akron 

Children’s Hospital. The new office is located 

on the seventh floor of the William H. 

Considine Professional Building, on Bowery 

Street across from the hospital. 

Akron General Medical Center has 

been selected by the Orthopaedic Research 

and Education Foundation (OREF) to be 

the host organization for the 2008 Resident 

Research Symposium and Competition on 

April 24th. This symposium will provide 

residents from orthopaedic programs across 

the state with exposure to new orthopaedic 

knowledge and provides an opportunity for 

a better understanding of research design 

through participation in presentations and 

listening to judges’ critiques and questions. 

Alliance Community Hospital (ACH) 

received three “above average” ratings — the 

highest possible — from Employers Health 

Coalition of Ohio, Inc for excellent clinical 

care in orthopedic surgery (specifically, hip 

replacement and knee replacement) and 

in chronic obstructive pulmonary disease. 

The ratings, which resulted from data 

gathered by WedMD Quality Services, 

were reported in the 2008 Consumer Guide 

to Ohio Hospital Quality. They were based 

on comparative statewide performance using 

two quality indicators: mortality and 

major complications. 

Aultman Hospital recently held its 

fourth annual Nursing Research Day for 

the hospital’s nearly 1,600 nurses to educate 

each other about their evidence-based 

nursing practices. More than 40 independent 

and unit-based projects were shared. 

Topics included improving customer and 

staff satisfaction, smoking cessation initiatives, 

electronic medication administration, 

pneumonia and family-centered care. 

61 N. Cleveland Massillon Rd, Suite C 

Akron 330-670-8263 

33 North Ave, Suite 201 

Tallmadge 330-633-9807 

7981 Hills & Dales Rd. 

Massillon 330-833-9411 

Employees from all areas of care, including 

nursing students, viewed and learned from 

the projects. 

Barberton Citizens Hospital recently 

opened the Summit Regional Hernia Center. 

3812 W. Tuscarawas St. 

Canton 330-479-0020 

1220 W. State Rd. 

Alliance 330-821-4918 

215 West Bowery St, Suite 7300 

Akron 330-543-2160 

** temp location until 2008 


hospital rounds 

The center specializes in minimally invasive 

laparoscopic techniques and traditional open 

techniques for surgical repair of hernias. The 

Center is located in the medical office building 

adjacent to the hospital. 

Medina General Hospital now provides 

complimentary wireless Internet access 

for patients and visitors who bring laptops, 

PDAs or other wireless-enabled devices to 

the hospital. The wireless network is available 

throughout the hospital on every floor 

and is available 24 hours a day, seven days a 

week. It is not available in the medical office 

buildings adjacent to the hospital. 

Mercy Medical Center has earned 

the Gold Seal of Approval from the Joint 

Commission for Primary Stroke Centers following 

a recent, unannounced on-site review. 

The Joint Commission’s one-year certification 

means that Mercy has demonstrated compliance 

with three key requirements: compliance 

with consensus-based national standards, 

effective use of primary stroke center recommendations 

and clinical practice guidelines to 

manage and optimize care, and performance 

measurement and improvement activities. 

Robinson Memorial Hospital’s new 

Professional Center is scheduled to open in 

Ovarian Cancer 

January. The 52,000-square-foot Center, 

which is attached to the hospital via a covered 

walkway near the Emergency Department, 

will bring together two centers of excellence: 

Cardiology and Outpatient Endoscopy. In 

addition, the Center will include physician 

office suites, a blood lab, x-ray and other diagnostic 

testing services, disease management 

clinics, a gourmet coffee shop and outdoor 

healing garden. 

Summa Health System’s Akron City 

Hospital has been named a “Leapfrog Top 

Hospital” for 2007. The only facility in 

Northeast Ohio and one of just 33 adult hospitals 

in the nation to make the list, Summa 

received this designation based on results 

from The Leapfrog Group’s Hospital 

Quality and Safety Survey, a rating system 

that assesses hospital quality and safety. 

Union Hospital has new digital mammography 

technology which can help 

radiologists interpret mammograms more 

accurately. Digital x-ray images are displayed 

on a large, high-resolution computer screen. 

A Computer Aided Detection (CAD) system 

draws attention to an area of concern by placing 

a circle or rectangle around that portion 

of the breast image. The radiologist then 

takes a second look at those highlighted areas 

MANY WOMEN WITH OVARIAN CANCER 

HAVE SYMPTOMS BEFORE THEIR DIAGNOSIS* 

Help your patients know the symptoms of ovarian cancer 

(one or several of these for three or more weeks): 

Abdominal pressure, bloating or 

discomfort 

Increased abdominal size or clothes 

fitting tighter 

Increased or urgent need to urinate 

Pelvic pain 

Constipation or diarrhea 

Nausea, indigestion or gas 

Abnormal vaginal bleeding 

Unusual fatigue 

Unexplained weight loss or gain 

Shortness of breath 

Low back pain 

Loss of appetite 

National Alliance 

*Recent studies in medical journals show that between 47 and 95 percent of women have symptoms several 

months before their diagnosis, even with early-stage disease. 

www.ovariancancer.org 202-331-1332 

and either confirms or amends the original 

interpretation. Further testing is then recommended 

if indicated. 

WRH Health System has received the 

prestigious 2007 Commitment to Quality 

award from Ohio KePRO for outstanding 

clinical performance in patient care. WRH 

Health System earned this statewide recognition 

following a yearlong collaboration in the 

Appropriate Care Measures (ACM) project 

with Ohio KePRO, Medicare’s Quality 

Improvement Organization for Ohio. All 

participating hospitals focused voluntary 

efforts on increasing the percentage of patients 

receiving appropriate care for acute 

myocardial infarction (heart attack), heart 

failure and pneumonia. 

Special thanks to the hospital public relations 

administrators who submitted information for this 

column. To include your hospital’s news, add us 

to your press release list or e-mail information to 

jraabe@akroncantonmdnews.com. The editorial 

deadline for the March-April issue of Akron/Canton 

M.D. News is February 4th. ■ 

advertisers’ index 

Akron Children’s .............. Inside Back Cover 

Akron General Medical Center ................. 19 

Alliance Community Hospital ...................24 

Belden Village Open MRI .........................49 

Brookshire Financial Group .....................10 

Brouse McDowell .....................................46 

Buckingham Doolittle & Burroughs, LLP ...7 

CBIZ .........................................................9 

CompuData .............................................16 

Drs. Hill & Thomas Co. ............................45 

Dwight Yoder Builders .............................23 

Hanger Orthotics & Prosthetics ...............59 

Hyperbaric Medicine 

& Wound Healing Center .....................37 

Klein’s .....................................................15 

Krugliak Wilkins 

Giffiths & Dougherty, Co., L.P.A. ........22 

Mercy Medical Center .... Inside Front Cover 

National City Private Banking Services ...25 

Premiere Medical Resources ...................10 

Regency Hospitals ...................................43 

Sirak-Moore Insurance, Inc. ......................8 

Summa Health System ............... Back Cover 

Testa Companies .......................................3 

University of New Mexico ........................49 

Weidrick, Livesay, Mitchell & Burge ........36 


The new and expanded Center for Orthopedics and Sports Medicine 

offers a personalized, all-in-one approach to care for: 

+ Orthopedic evaluation and surgical and nonsurgical treatment 

+ Sports Medicine evaluation and treatment 

+ Fully-equipped, sports-oriented rehabilitation and therapy services 

+ Diagnostic testing, including fast, high-resolution, digital X-ray 

+ Orthotic and prosthetic services 

+ Research and education 

We also offer timely appointments and quick results. 

Refer a patient at 330-543-3500. 

*Based on a recent survey of Northeast Ohio parents 


Considine Professional Building | 7th Floor

Get to Know 

Summa Physicians Inc. 

Summa Physicians Inc. (SPI) is a Summa Health System entity of multi-specialty physicians and practices. 

Currently SPI employs nearly 100 physicians in 19 specialties, including cardiology, colorectal surgery, 

dermatology, endocrinology, family medicine, gastroenterology, general surgery, hematology/oncology, 

infectious disease, internal medicine, obstetrics and gynecology, ophthalmology, orthopaedics and sports 

medicine, palliative care, plastic surgery, psychiatry, sleep medicine, transplant surgery and trauma 

surgery. The mission of SPI is to promote stronger affiliation and employment of physicians in order 

to ensure that the health system meets community and hospital needs for physician services now 

and in the future, as well as to develop physician coverage in new markets. 

As a SPI physician, the benefits include: 

• A more predictable and stable compensation plan, regardless of the status of a patient. 

Physicians are compensated for all clinical activity, compensation is not based on profit/loss. 

• Stabilization of malpractice expenses 

• Management of physician office expenses and corporate overhead 

• Professional management team skilled in practice operations, 

management and marketing 

To learn more about Summa Physicians Inc., 

visit www.spi.summahealth.org.

Lisa Kohler, MD - AkronCantonMDNews

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