June/July/August 2010 - Holy Name Medical Center

News from and for
Holy Name Medical Center’s
Medical Staff
Also available online at:
www.holyname.org/md360
June/July/August 2010
Medical Staff Officers
President: Patricia Burke, M.D.
Vice President: Thomas Birch, M.D.
Secretary: Mihran Seferian, M.D.
Treasurer: Ronald White, M.D.
Members-At-Large:
Medical Chiefs Representative: Joel Goldfarb, M.D.
Surgical Chiefs Representative: Harris Sterman, M.D.
Member At Large: Giuseppe Condemi, M.D.
Member At Large: Rosanna Modesto, M.D.
Medical Staff Department
Directors and Division Chiefs
Dept. of Anesthesiology: Alan Gwertzman, M.D.
Dept. of Emergency Medicine: Richard Schwab, M.D.
Dept. of Family Practice: Joseph Cassotta, M.D.
Dept. of Interventional Radiology: John Rundback, M.D.
Dept. of Medicine: Joseph Schuster, M.D.
Allergy: Patrick Perin, M.D.
Cardiology: Stephen Angeli, M.D.
Dermatology: Jeffrey Rapaport, M.D.
Endocrinology: Mark Wiesen, M.D.
Gastroenterology: Joel Goldfarb, M.D.
Infectious Disease: Thomas Birch, M.D.
Internal Medicine: Lewis Attas, M.D.
Nephrology: David Levin, M.D.
Neurology: David VanSlooten, M.D.
Oncology: Beata Pieczara, M.D.
Psychiatry: Sharad Wagle, M.D. Pulmonary Medicine: Stuart Silberstein, M.D.
Radiation Oncology: Charles Vialotti, M.D.
Rehabilitative Medicine: George Gombas, M.D.
Rheumatology: Ralph Marcus, M.D.
Dept. of Obstetrics & Gynecology: Christopher Englert, M.D.
Dept. of Pathology: Drew Olsen, M.D.
Dept. of Pediatrics: Harry Banschick, M.D.
Dept. of Radiology: Jacqueline Brunetti, M.D.
Dept. of Surgery: John Poole, M.D.
Dentistry: Steven Haber, D.D.S.
General Surgery: Joseph Manno, M.D.
Neurosurgery: Patrick Roth, M.D.
Ophthalmology: Christopher Brown, M.D.
Orthopedics: Jeffrey Steuer, M.D.
Otolaryngology: John Poole, M.D.
Podiatry: Ritchard Rosen, D.P.M.
Plastic Surgery: Harris Sterman, M.D.
Thoracic Surgery: Ignatios Zairis, M.D.
Urology: George Klafter, M.D.
Vascular Surgery: Kenneth Fried, M.D.
MD360º
from the president/CEO
Welcome New Chief Medical Officer
Please join me in welcoming Adam D.
Jarrett, MD to Holy Name Medical Center
as our new Executive Vice President and
Chief Medical Officer. Dr. Jarrett brings a
distinguished background as both clinician
and administrator, having practiced internal
medicine in Bergen County for 13 years
before pursuing hospital leadership opportunities in upstate New York. We’re pleased
that he has returned to this area and joined
our Medical Center.
As CMO, Dr. Jarrett will be an essential
member of our team, a physician/adminis-
trator whose experience will help us address
the challenges we face in today’s dynamic
healthcare environment, while acting as
a liaison between the medical staff and
administration. His role entails formulating
policies, procedures and practices that are
aligned with our organization’s long-range
planning and development, as well as with
newly emerging national healthcare initiatives. He will oversee medical staff services
to ensure delivery of the highest standard
of patient care, with a focus on clinical effectiveness, patient safety and quality.
718 Teaneck Road • Teaneck, NJ 07666
Michael Maron is
President/CEO of
Holy Name Medical Center.
Adam D. Jarrett, MD, MS, FACHE
Adam D. Jarrett, MD, MS, FACHE has
been named Executive Vice President
and Chief Medical Officer of Holy Name
Medical Center. Dr. Jarrett, an internal
medicine physician, possesses a broad and
valuable skill set that encompasses hospital
leadership experience, clinical expertise,
practice management experience and
formal management education. He has
demonstrated proficiency in performance
and quality improvement, medical
education, conflict management and
negotiation, managed care contracting and
corporate compliance.
He comes to HNMC from ClaxtonHepburn Medical Center in Ogdensburg,
NY, where he has been Chief Medical
Officer since 2005. Dr. Jarrett is also
President of Claxton Medical P.C., and
Medical Director of Cardiopulmonary
Rehabilitation at Claxton-Hepburn Medical
Center. He is a peer reviewer for the New
York State Department of Health Office
of Professional Medical Conduct and,
until recently, also served as the Medical
Director of United Helpers Nursing Home
for United Helpers in Ogdensburg.
Storms-a-Comin’
As I sit basking in the early morning
warmth of the sun on this Labor Day
weekend, my dog sits companionably by
my side. Despite all predictions to the
contrary, “Earl” has not harmed us, except
for our peace of mind and our finances.
Pool parties, barbeques and vacations
were summarily cancelled with the
announcement of the potential force
of hurricane “Earl.” Along the Eastern
Seaboard, propane tanks and grills were
battened down, patio furniture stacked
or moved to shelter, and large glass doors
and window panes protected. Jones Beach
officials, anticipating the worst, closed
the beaches, toppled lifeguard stands
and dragged them to high ground fearing
their loss, awash at sea. Even the Outer
Banks vacationers and residents alike were
evacuated. Fortunately, and unfortunately,
all these preparations and evacuations
came to naught.
The unfortunate “naught” was, of
course, the vacation industry. Up and
down the East Coast, in an economy thin
Prior to his work with Claxton-Hepburn,
Dr. Jarrett was Managing Physician of
Prospect Medical Offices in Midland
Park, NJ and a Collaborating Physician for
Valley Community Care in Hawthorne, NJ.
During that period, Dr. Jarrett was affiliated
with The Valley Hospital in Ridgewood,
where he was a member of the Department
of Medicine. Prior to that, he was a member
of the voluntary teaching staff of New York
Hospital-Cornell Medical College, where
he had completed his residency in internal
medicine/primary care and won the award
for top primary care physician.
Dr. Jarrett earned his medical degree
from George Washington University School
of Medicine and his master’s of science in
health care management from New York
University’s Robert F. Wagner School of
Public Service.
Save These Dates
from the president of the medical staff
Indicia
or
Postage Here
US Postage
PAID
Over the next several months, Dr. Jarrett
will be getting to know Holy Name better.
It would be helpful for him to meet as many
of our physicians as possible, so I encourage you to stop by his office and introduce
yourself.
with discretionary spending monies, the
owners of hotels, motels (oh, that great
portmanteau word), restaurants and
boardwalk auctioneers, were looking
forward to this last hurrah of summer.
Having this last wave of vacationers,
who scrimped and planned for this final
summer weekend, could have buoyed their
final balance sheets.
And so another opportunity for a small,
but important part of our economic
recovery has not come to fruition. The fall
season abounds with hurricanes—Earl and
fabled Fiona have wrought no havoc. But
remember, and with any luck, storms-acomin’, perhaps in early November!
Annual Physicians’
Cocktail Party
Honoring Physician Leadership
Saturday, October 2, 7-10 p.m.
Marian Hall Conference Center
Cocktails, hors d’oeuvres and music
RSVP by Sept. 28 to 201-833-7220
Founders Ball
Honoring David Butler, MD,
Timothy Finley, DO, & Alan Gwertzman, MD
for their relief efforts in Haiti
Patricia A. Burke, M.D.,
Ph.D., is President of the
Medical Staff and an
ophthalmologist on staff at
Holy Name Medical Center.
Saturday, November 13
Cocktails at 6:30; dinner & dancing to follow
Cipriani Wall Street, NY, NY
RSVP by Nov. 8 to 201-833-7143
New Medical Student Program Trains
Tomorrow’s Doctors at HNMC
Physician/Teacher Benefits
• D.O. faculty are afforded Category 1 credits for teaching the students
• M.D. faculty are given Category 2 credits.
• All teaching faculty are given an academic title through the medical school.
Medical students from the Touro College
of Osteopathic Medicine (TouroCOM) began
rotations at Holy Name Medical Center on
July 1. Located in Harlem, New York, this
brand-new medical school admitted its
first class of students in September 2007.
TouroCOM is the nation’s 24th college of
osteopathic medicine and Touro’s third. With
over 400 students currently enrolled at Touro,
the school has set a goal of training primary
care physicians to fill the nationwide shortage.
Holy Name will train approximately 20 to 30
medical students a month.
“To partner with Holy Name Medical
Center provides an exceptional opportunity
for our medical students,” says Robert
B. Goldberg, DO, Dean, Touro College
of Osteopathic Medicine. “Holy Name’s
commitment to medical excellence, patient
safety, and quality care sets it apart from its
peers. We are thrilled to offer Holy Name as
an affiliate training site for the students at the
Touro College of Osteopathic Medicine.”
A Well-Rounded Education
Third- and fourth-year medical students rotate
through all the medical and surgical subspecialty
areas at Holy Name for one or two months,
depending upon the rotation. Some of the
students will spend their entire year here, while
others will undertake only specific rotations.
The students are assigned to attendings or other
department staff, and spend time both in the
Medical Center and in outpatient offices.
I meet weekly with all the students for an
academic conference, in which we review
any issues with the rotations and the students
learn how to present. Several Holy Name
staff members have volunteered to lecture
to the medical students on their areas of
expertise. At the completion of each rotation,
students take a standardized exam and
undergo an exit interview.
Over 50 Holy Name medical staff members
are involved in the Touro Program and
mentor the medical students. Attendings find
that teaching medical students “keeps them
fresh” and up-to-date on medical topics and
is a way to give back to the next generation of
physicians. D.O. faculty are afforded Category
1 credits for teaching the students and M.D.
faculty are given Category 2 credits. All
teaching faculty are given an academic title
through the medical school.
Positive Feedback
The initial feedback from students and
supervising medical staff has been excellent.
Students find Holy Name to be a wonderful
learning environment and, to my delight, the
medical and nursing staffs have welcomed
the students with open arms. The program
has been received positively by patients, as
well, as they often find that medical students
are able to spend quality time with them, as
well as their families, when busy attendings
are sometimes not able to do so.
“We are delighted and thrilled to have the
medical students from Touro at Holy Name
Medical Center,” says Craig Hersh, MD, Assistant
Vice President of Medical Affairs. “Thus far, it
has been a rewarding experience for our doctors
and nurses, and has only served to improve the
overall patient experience. An environment of
continuous learning is a benefit to all.”
My hope is to eventually develop
residency training programs at Holy Name
Medical Center as a natural progression in
medical education. The expectation is not
only to train excellent future physicians, but
to ensure the next generation of Holy Name
physicians. We have found that a significant
number of medical students and residents
will practice in the area where they train.
It’s A Different World
Medical education is in a constant state
of evolution. The traditional approach of
teaching at large academic institutions with
multiple residency programs and specialty
fellowships is, in some cases, being replaced
by smaller community-based programs,
which are more akin to the environment in
which most graduating students will practice.
This new model will, hopefully, produce
primary care physicians, rather than the
“super-specialists” who may not satisfy the
needs of future generations. Our students will
use their electives to gain exposure to these
larger clinical settings but, based on overall
experience and objective markers such as
board scores, the different approaches appear
to deliver an equivalent experience overall.
While prior generations of physicians
trained with large textbooks and spent hours
reading in the library, this new generation of
medical students utilizes their cell phones,
laptops and PDAs to review anatomy, look
up medication dosages, investigate topics,
and formulate differential diagnoses. The
students don’t carry beepers; they simply
text their attendings and fellow students.
Lectures and notes are streamed to their
computers. It’s quite a different world.
I would like to thank Dr. Craig Hersh for
helping me develop the program and Dr. Judith
Kutzleb for her invaluable, ongoing assistance.
If any medical staff member is interested
in precepting the medical students or giving
lectures, please email me at maurizio.
[email protected].
Maurizio Miglietta, DO,
is Director of Medical
Education for the TouroCOM
Program and a general
surgeon on staff at Holy Name
Medical Center.
Broken System
More than 25 years ago, I walked through the
doors of Holy Name Hospital (now renamed Holy
Name Medical Center). I was immediately amazed
by the warmth, professionalism and compassion
of the entire staff of this hospital. I continue to be
amazed. It is a special place founded 85 years ago by
the Sisters of St. Joseph of Peace to provide a level
of care to the sick which placed the patient first and
foremost, the type of care surprisingly lacking in
many medical facilities even today. I know that many
of the physicians who come to Holy Name feel this
way. This year, I joined the Founders Circle to give
something back to the hospital that helped me to
be a better physician. I believe in the mission of our
founding sponsors and am committed to ensuring
that their vision stays the course for another 85 years.
The Founders Circle supports Holy Name
Medical Center’s pursuit of excellence and helps
to ensure that programs and services continue
to meet the diverse needs of our community. We
as physicians are often not acknowledged by the
media or the public, for the charity we provide in
the form of free services. Many of us think that this
is giving enough. However, I would encourage all
members of the medical staff to donate to the Holy
Name Health Care Foundation. Please put them on
your charity list, maybe at the top of the list. Please
join me in the Founders Circle.
For more information about the Founders
Circle and its member benefits, visit www.
holyname.org/founderscircle or contact Kathy
Minarik at 201-833-3014 or email: minarik@
holyname.org.
2
Joel Goldfarb, MD, is a
gastroenterologist on staff at Holy
Name Medical Center and a
member of the Holy Name Health
Care Foundation’s Founders Circle.
I had heard before the sentiment of a heart falling into a
stomach, of the giving way of what held them apart, distinct from,
each other. I had heard of this before. But I wondered when it
happened to me why no one had elaborated on the phenomenon.
Why no one ever mentioned that it wasn’t a sinking feeling, akin
to losing your stomach on a roller coaster, but that it was a hot
iron mallet pounding your heart, decimating it until it melted into
the lower recesses of your abdomen. And just like on the roller
coaster, when you start to head back upward on the track and
find your stomach suddenly in your throat—it wasn’t like that
either. My heart stayed on the floor.
My first year of medical school was the hardest year of my life
for more reasons than simply that it was my first year of medical
school. A good portion of my pain during that year came from
watching my very best friend in the world, Amy, become more
and more ill. Worse, I watched her become less and less her.
We were nine when she was diagnosed with Type I diabetes
mellitus, and after the ravaging effects took over her body, the
sickness began to creep into her soul. Her kidneys were the first
to begin to fail, but more organs began throwing in the white
towel as her body and spirit became exhausted.
I remember the last meal I had when the world was still
normal and not broken. After finishing our last final on the last
day of our first year, my friends and I went to eat cheese and
drink wine to celebrate. We left there full of the richness of the
meal and of the communion with friends who had survived so
much together. As I walked down the street, I listened to the
voice mails that had accumulated during the meal. My best friend had gone to the hospital again. Nothing new;
she was probably vomiting again, and only the hospital had
drugs strong enough to calm her stomach and soothe the pain.
She had to be resuscitated. This was different. But, I had sat
beside her during dialysis a few times and watched her erratic
blood pressure and respiratory rate. Once, as the number
continued to fall as I stared at it, I looked at her alarmingly and
called out, “Amy! Are you breathing?” She suddenly sat up and
said she was trying.
She was in a coma.
And everything stood still. It was as if the wind quit ripping
around the buildings of Manhattan. My friend’s voices became
blurry murmuring in the background. And my heart fell into
my stomach.
I boarded a plane. I laid my head in my own lap during the
long flight home and seeped soft and continual tears into my
pillow. I knew I was going home to say goodbye, and it wasn’t
the way it was supposed to be. I needed answers to what had suddenly happened to my friend,
why she had lost this fight, why no one seemed to have been able
to help her win this battle. The truth rolled out, just as the CT
scan print-out did so I could read the words that said my friend
might be lying in that bed and her heart might be beating and her
lungs might be expanding, but she wasn’t really there anymore.
Amy was alone at the emergency room, and although she was a
“repeat offender,” and her ejection fraction was recently as low as
6%, she was not hooked up to any kind monitoring system. They
couldn’t say why her heart had failed, or how long it had been
since it had done so by the time they looked in and noticed she
was unresponsive. They just knew that she had not taken a breath
on her own since, and this was over.
My heart still pummeled, numbness gave way to a staggering
rage, coming all the way up from my toes and threatening to
explode out my ears. My questions went unanswered, partly
because there was no record of the actual event that ended her
consciousness and partly because only a devoted nurse was
there to offer support. I never saw a doctor, either while Amy
was on life-support nor after her heart slowly stopped beating
again and she slipped away. I don’t know if her blood sugar was
checked initially; I don’t know her potassium level; I don’t know
if she was scared, if she sat up suddenly, trying to catch her
breath or if she simply nodded off to sleep on the pain medicine.
And sadly, no one else does either.
My friend died alone. No one was sitting beside her in the
emergency room watching her numbers because no numbers
were being monitored. Amy’s heart was only this sick because
when she told her family doctor that she was having problems
breathing when supine, her doctor told her it was just panic
attacks, ignoring the obvious sign of congestive heart failure.
This proceeded for months before a routine heart test for being
on the kidney transplant list found the severely depressed heart
function. Although she had more doctors than most people
have keys on a keychain, there was no cohesiveness to her care,
and her health suffered.
Just as she slipped away with the ED unaware, Amy slipped
through the cracks of medical care in the grander scheme.
My broken friend was treated by a broken system and failure
transpired. A heart stopped, and hearts broke. And it’s time for
the breakage to stop. The holes must be tended and the cracks
mended. We must repair this system and find a way to grasp
tighter to our patients and hang on for dear life.
Holly Foote is a third-year medical student at TouroCOM-NY,
with a pediatric rotation at Holy Name Medical Center.
report from the Chief nursing officer
Effective Case Management for Better Outcomes
How do we help our patients navigate
an increasingly complicated continuum of
care? How can we change our processes
to accommodate physicians’ needs for
communication with various members of
the case management team? How do we
all ensure that patient interventions are
timely and appropriate? How do we make
best use of our resources and, at the same
time, maintain a high level of satisfaction
among patients, families and healthcare
professionals alike?
While there are many paths we might
take to answer these questions, effective
case management might be the single most
important avenue to success.
A Patient Advocacy Model for
Outcomes Management
To address our institutional and patient
care priorities, Holy Name Medical Center
has redesigned our case management
program using the “patient advocacy
model.” This model emphasizes the
coordination of services on the continuum
of care from the patient’s perspective
by focusing on quality and increased
satisfaction.
We’ve renamed the Medical Management
Department—it is now known as the
Outcomes Management Department,
which better reflects our goals. Maritza
Gonzalez, RN, MA, who has been Quality
Manager and Utilization Review Specialist
at Holy Name for the last five years, is the
department’s new Administrative Director.
Outcomes Management will address all
aspects of the patient care continuum by
combining quality, utilization and discharge
planning tasks. Rather than unit-based, the
new expanded program is team-based and
hospital-wide, tapping the broad skill sets
of social workers, discharge planners, and
nurse clinical coordinators to individualize
care according to each patient’s condition,
rather than having a single staff member
attempt to address all the patient’s case
management needs.
Look forward to extended coverage by
the clinical care coordinator/social worker
team, including more evening hours
and weekends, in an effort to enhance
communication between our staff and
the physicians, and between the staff and
patients/families. We’re also conducting
daily discharge planning rounds by case
managers, along with the unit director and
clinical coordinator, to ensure that all the
needs of all the patients are addressed in a
timely, quality-driven, cost-efficient manner.
Benefits All Around
Better role definition and extended
coverage will allow all tasks along the
continuum of care to be performed
more thoughtfully and thoroughly. Team
members will ask, What do we really need
to do to help this patient? They will consider
the need for psychosocial intervention,
whether tests necessitate an overnight
stay or can be performed on an outpatient
basis, how we can keep this health event
from recurring in this patient, and what
information the family needs to help
smooth the transition to home or another
level of care. They will continue to work
with insurance companies, coordinate
necessary tests and procedures, review
complete chart documentation, which will
maximize reimbursement and the patient’s
understanding of the discharge instructions,
and address any number of issues to
produce the best outcome possible. That’s
going to elevate quality, and from there,
flows everything else—patient satisfaction,
sound financial performance, and so forth.
What can we expect from this fresh
perspective on Outcomes Management?
Decreased payer denial rates, shorter
Medicare length-of-stay, a reduction
in 30-day readmission rates, maximum
reimbursement, a decrease in avoidable
delays and wait times when transitioning
between facilities or to home, and increased
patient and staff satisfaction.
The staff of our Outcomes Management
Department looks forward to working with
you and your patients toward our mutual
goals of quality and satisfaction. Please don’t
hesitate to contact me or Maritza Gonzalez
at ext. 6053 with your questions and
feedback.
Sheryl Slonim, DNP, RN-BC,
NEA-BC is Executive Vice
President for Patient Care
Services and Chief Nursing
Officer at Holy Name
Medical Center.
The Doctors’ Dilemma (One of Them, Anyway)
The medical profession was toppled from
its pedestal when healthcare reformers
succeeded in entrenching the concepts
of “healthcare provider,” healthcare
industry,” and “medical-industrial complex”
into our cultural vocabulary. This newspeak effectively cast medical practice
into the realm of big business, on a par
with ExxonMobil, BOA and Enron. The
“industry’s” will and intent was no longer
to heal patients, but to make money at
their expense, driven by the profit motive.
Perceived as such, it has become a system
subject to ever-increasing oversight and
regulation.
We in the profession can only arch our
backs and hiss at this cultural sea change.
Alas, our collective teeth and claws, the
AMA, opts to follow the political piper.
But enmeshed within this odious cultural
fabric runs a thread of truth we cannot
avoid. The elitist reformers were motivated
by a major factor—escalating cost. Cost
containment has traditionally not been a
factor in the healing arts equation. It is not
taught in medical school. After all, money
is no object when someone’s health is at
stake. Not long ago, cost control was not
a consideration for practicing doctors or
hospitals. Third party carriers simply paid,
and ratcheted up their rates. This scenario
is obviously no longer sustainable.
Hospital administration now works
diligently at cost containment. It operates
under a prospective payment system
in which prolonged hospital stays
and expensive inpatient testing and
procedures are financially damaging.
Your administration strives constantly to
provide maximum patient satisfaction
and to expedite and simplify your hospital
activities in a congenial and efficient work
environment.
You can help it meet these goals and
enhance its financial position without
sacrificing your own financial objectives.
Try to optimize hospital stays beginning
on day one with a proactive care plan.
Focus on the acute issue and limit inpatient
testing to evaluation of the immediate
clinical problem. Secondary, non-acute
issues are often better handled postdischarge as an outpatient. Your patient
with uncomplicated community-acquired
pneumonia and a stable BUN of 25mgm%
probably doesn’t need inpatient nephrology
consultation with associated daily
chemistries, renal ultrasound, renal MRA,
and three additional days in the hospital.
Start thinking “lean”—and if physician
capitation is on the horizon, you’ll be better
positioned to deal with it!
Joseph A. Frascino, M.D.
is Vice Chairman of the
Holy Name Medical Center
Board of Trustees and a
retired nephrologist.
My Doctor and His Diagnosis
Less than a decade ago, Dr. A sought out an
insightful colleague in psychiatry. “Rich, I
feel so bad. (sic) I’m depressed all the time.
I took the leading selling antidepressant, in
escalating dose according to the package
insert. I don’t feel any benefit,” he reported.
His new doctor got right down to business,
taking a careful history of his life, his health,
family, career, hopes and dreams. Adam told
about the four medical malpractice lawsuits
pending and his looming un-insurability. He
talked about his kids who wanted to go to
college and the lifestyle that he thought that
he would enjoy as “a Doctor.”
At the end, the psychiatrist said: “Adam,
you’re not depressed. You need to leave your
medical group practice and go it on your
own. Otherwise you will never be happy.”
This was not at all what Adam had expected.
He thought he would have his diagnosis
confirmed, receive some insight-based
therapy and a fresh prescription.
“My partners are my mentors, my
recruits and my dear colleagues. Besides, I
have a restrictive covenant. I can’t leave,” Dr.
A protested.
Dr. Richard’s eyes narrowed, his voice
deepened and he directed: “Adam, you
think about it. In addition, I am going to
waive professional courtesy and charge you
$200; otherwise, you will not take my advice
seriously.”
Adam stopped the medication and after a
moderate amount of consternation and delay,
he went out on his own. The lawsuits were
dropped after the depositions, the constriction
was released and in time, he felt better.
Less than a month ago, the same colleague
in psychiatry visited Dr. A in the office.
“Adam, I feel so bad. I have FUO (fever of
unknown origin). Every night I have sweats.
I’ve measured fevers to 100.8, I’m down
four or five pounds and now my blood work
shows a normocytic anemia with elevated
CRP and a sedimentation rate of 108. My
shoulders ache, though I do have a history
of cervical radiculopathies. I took the most
popular antibacterial, a 5-day pack usually
used for non-bacterial afflictions and some
amoxicillin that we had in the house, but I
didn’t get any benefit.”
FUO is a classic challenge to the mettle
of any diagnostician with a differential
diagnosis running over 100 possibilities
in the Principles and Practice of Infectious
Diseases. Dr. A felt that this was a particular
challenge to deliver the professional benefit
that he had received years earlier.
He got right down to business by taking a
careful history of exposures, travel, hobbies,
dental work and all of the usual questions.
The physical came next. No fever now,
temporal arteries OK, a little gingivitis, no:
cardiac murmur, adenopathy, splenomegally,
etcetera. Undeterred, they went on to more
blood tests, serologies, CT scans from top to
bottom, bone marrow biopsy and a transesophageal echocardiogram. Dr. A was
contemplating blind temporal artery biopsy
and/or an empiric course of steroids.
Finally, he said: “Rich, I think that your
teeth are bad.”
“My dentist says my teeth are fine.”
Adam’s eyes narrowed, his voice deepened
and he said: “You need a new dentist. In
addition, I am going to waive professional
courtesy and charge you $200; otherwise you
will not take my advice seriously.”
Out of a sense of duty or to justify his
expenditure, his colleague found a new
dentist. He had an extraction and a root
canal and all of the signs and symptoms
resolved, including the anemia and the
inflammatory markers.
Dental abscess is a very satisfying FUO
diagnosis because it is obscure, benign and
easily treatable.
Physician, Heal thyself?
I am trying to remember the source of that
quote: “The doctor who treats himself has
a………..for a patient.”
At least we can take care of each other.
Thomas Birch, MD is Chief
of Infectious Disease at Holy
Name Medical Center
3
Report from The Infection Prevention Team
Grand
Rounds
M e d i c a l S ta f f
Location: Marian Hall
Time: 9:00 - 10:00 a.m.
September 21: “Treatment Advances in
Colorectal Cancer”
Dr. Marwan Fakih
September 28: “Obama Care and You;
Perfect Together”
John Poole, MD
October 5: “Skin Cancer and Cutaneous
Signs of Systemic Disease”
Chang Son, MD
October 12: “Update on Clinical
Research, Infection Control and Antibiotic
Management”
Thomas Birch, MD
October 19: “Smoking Cessation”
Jill Williams, MD
October 26: “Robotic Thyroidectomy”
Emad Kandil, MD
November 2: “Optimum Diabetes
Management: From the Intensive Care Unit
to Home”
Mark Wiesen, MD, Randy Cole, MD and
Maria Soper, RN
November 9: Host
“Patient Blood Management: Proactive
Approaches to Reduce Transfusions”
Areyh Shander, MD
November 16: “Infection in Total Joint
Arthroplast”
Ari Seidenstein, MD
November 30: “From Clinical Use to
Meaningful Use”
Deb Ross, RN and Mike Skvarenina
December 7: “Wound Healing”
Felix Raymond Ortega, MD
December 14: Host
“AFIB”
James Reiffel, MD
SAVE THE DATE
HNMC Medical Grand Rounds
October 26, 2010, 9 a.m.
Marian Hall
“Robotic Thyroidectomy”
presented by
Emad Kandil, MD
Assistant Professor of Surgery
Clinical Assistant Professor of Medicine
Chief, Endocrine Surgery
Tulane University School of Medicine
SAVE THE DATE
2010 General Medical Staff Meeting
Wednesday, December 8, 12 noon
Marian Hall Conference Center
Find out what’s happening at Holy Name
and in the medical community.
Enjoy lunch.
4
The Role of Metronidazole in Preventing
Clostridium Difficile Infections
Clostridium difficile (C.diff) is a
major cause of nosocomial infections
and diarrhea. It is caused by the use of
broad spectrum antibiotics, especially
penicillins, clindamycin, fluoroquinolones
and cephalosporins, which can eradicate
the normal flora in the gut. Under such
conditions, C. diff can grow freely without
any restrictions, releasing toxins that
can damage intestinal mucosa and cause
inflammation, which then leads to frequent
diarrhea. The standard treatment of choice
for C. diff infection is metronidazole (Flagyl),
along with oral vancomycin, which is usually
reserved for severe cases or non-response to
metronidazole therapy.
A study was conducted at Holy Name
Medical Center to examine the hypothesis
that the presence of metronidazole in an
antibiotic regimen can protect the patient
against C. diff infection.
This study is a retrospective case controlled
study identifying two groups of patients who
received anti-bacterials within a selected time
period. Patients were enrolled consecutively
and then separated into two groups: patients
who got C. diff infection and patients who
did not get the infection. From there, patients
who received metronidazole were identified.
Inclusion
• Total of 173 patients
• 140 patients who did not get C. diff infection
• 33 patients who got C. diff infection
Exclusion
• Patients with a prior history of C. diff infection
• Patients who came to the hospital with C. diff infection
Results
Out of 172 patients total, 89 patients
received metronidazole, along with other
antibiotic treatment and 83 patients received
antibiotics other than metronidazole.
• Among the 139 patients who did not
get the infection, 82 patients (59%)
received metronidazole and 57 patients
did not receive metronidazole.
• Among the 33 patients who got
the infection, 7 patients (21%) received
metronidazole and 26 patients did not
receive metronidazole.
These results show very high statistical
significance with a p value less than 0.0001
and support the hypothesis that patients
who receive metronidazole in an antibiotic
regimen may be protected against C. diff
infection. Further prospective studies are
needed to support prescribing of empiric
metronidazole. In the interim, it may be
worthwhile to include metronidazole in
most antibiotic regimens which otherwise
require anaerobic therapy in an attempt to
gain a dual benefit. Issues of tolerability and
resistance remain a concern.
Jae Jo-Cho, Ernest Mario School of Pharmacy
2010 PharmD. Candidate; Lori-Ann Iacovino,
MS, RPh and Thomas Birch, MD, Chief of
Infectious Disease
Cryoablation of the Prostate
Being diagnosed with prostate cancer may
be one of the most difficult and frightening
experiences of a man’s life. Prostate cancer
is one of the most common cancers in men
and traditional forms of treatment with
surgery or high dose radiation can result in
serious side effects.
Fortunately, an advanced treatment
called cryoablation offers new hope for a
cancer-free future. Best of all, it is minimally
invasive and virtually free of side effects
that can occur with surgery or radiation.
Cryoablation requires no radiation beams
or six-week time commitment. When
compared with radical prostatectomy,
cryoablation is equally effective in select
patients, without risk of major surgery or
blood loss and allows a faster, easier recovery.
Cryoablation is a Medicare-approved
minimally invasive procedure that kills
prostate cancer by freezing the cancer
cells. Suitable candidates are patients with
tumors localized to the prostate. Even
patients with high-risk tumors or those more
likely to fail radiation can be cured with
cryoablation. Recent advances have made
cryoablation extremely patient-friendly
and highly effective. Ultrasound images
allow precise positioning of the cryoprobes.
Temperature monitors continuously record
the freezing process, determining when the
target temperatures have been reached and
protecting vital structures.
The benefits include a choice of general or
regional anesthetic, a shorter hospital stay
(usually overnight) and a fast recovery and
return to normal activities. Incontinence is
rare, and many patients can be treated with
a nerve-sparing approach that also preserves
erectile function. Focal Therapy has allowed
a smaller volume of tissue to be targeted,
and would permit maintaining all urinary
and sexual functions with a rapid return to
normal activities.
Cryoablation is not major surgery. It is truly
minimally invasive. Laparoscopic surgery, by
contrast, is minimal access and is not minimally
invasive. There are risks of incontinence and
impotence, as well as tumor recurrence.
Most patients who undergo cryosurgical
ablation of the prostate can return to
normal activities within days to weeks.
Blood transfusions, incisional pains or
stress incontinence are just not seen with
cryoablation. Erectile function can be
preserved in selected instances.
Contact or visit our office and get the
facts.
Gene S. Rosenberg, MD
Kevin R. Basralian, MD
Gene S. Rosenberg, MD, FACS,
Kevin R. Basralian, MD,
FACS and Daniel R. Lowe,
MD are on staff at Holy Name
Medical Center and practice
with University Urology
Associates PA, 20 Prospect
Ave., Suite 719, Hackensack,
NJ 07601. They can be reached
at 201-343-0082. Website:
hifumedicalcenter.com.
Daniel R. Lowe, MD
Medical Library Database Services
• BMJ Case Reports and Clinical
Evidence (on-campus access only)
The Medical Staff Library is located in
the Marian Conference Center and is open
with badge-swipe access 24-7-365. The
library offers a selection of print journals,
on-line journals and numerous electronic
databases, most of which can be accessed
from your off-site location.
HNMC’s medical staff members find the
following references especially helpful:
• Two databases geared to the physician
at the point-of-care:
• BMJ Point of Care (on-campus access only)
BMJ Point of Care was developed
jointly by BMJ Group and Epocrates.
It features clear, concise expert opinion,
as well as embedded, context-specific
links to the most authoritative medical
evidence to provide fast, credible
answers to the most pressing patient
care questions.
• DynaMed
DynaMed is a clinical reference tool
containing clinically-organized
summaries for more than 3,000 topics.
It was created by physicians for
physicians and other healthcare
professionals. DynaMed may also be
utilized on mobile devices.
• Case Reports delivers a focused,
peer-reviewed, valuable collection of
cases in all disciplines, so that
healthcare professionals, researchers
and others can easily find clinically
important information on common
and rare conditions.
• Clinical Evidence website summarizes
the current state of knowledge about
interventions used for prevention and
treatment of important clinical
conditions.
Keydi Boss O’Hagan is HNMC’s Medical
Librarian. Contact her for username and
password, and for more information:
201-833-3395 or [email protected]
or [email protected].
Percutaneous Discectomy Using the SpineView™
Interventional Discectomy System
Introduction
Percutaneous discectomy has long been
accepted as a minimally invasive treatment
alternative to open surgical procedures. The
enSpire™ Interventional Discectomy System is
a modern device indicated for use in disectomy
procedures. It is typically used in the treatment
of non-sequestered disc herniations.
Lumbar disc herniation background
Intervertebral disc herniation (bulging with
nerve root compression) occurs as the result
of degenerative and/or traumatic weakening
in the fibrous outer wall of the disc (annulus
pulposus). Most frequently seen in the lumbar
spine, herniation can occur in escalating
degrees of severity. In more severe cases, disc
material can become “sequestered,” meaning
that the disc bulge has advanced to the point
of being fully displaced with no continuity
with the parent disc. When disc herniation
causes nerve root irritation or compression,
patients require treatment due to back
pain often associated with discomfort and
neuropathy in the lower extremities.
Management of disc herniation
The management of disc herniation
ranges from conservative, non-invasive
rehabilitative therapy to open surgical
intervention to achieve nerve root
decompression. Conservative therapy
consists of medication such as non-steroidal
anti-inflammatory drugs (NSAIDS), oral
steroids, and analgesics including opioids.
In addition, bed rest and/or various forms
of physical therapy are utilized. Benefits of
conservative therapy are commonly seen in
conjunction with epidural steroid injections,
often resulting in only temporary pain relief,
generally extending up to three months.
Lumbar discectomy, a surgical procedure,
is indicated when conservative measures
do not offer relief and when sensory and/or
motor deterioration is experienced. Lumbar
discectomy is a surgical procedure that can
be performed using various methodologies
of escalating intervention. The most invasive
method is the open, complete discectomy,
which can be accompanied by fusion of the
cephalad and caudal vertebral structures.
These procedures, though effective in reducing
pressure within the intervertebral disc and
adjacent nerve root, often lead to significant
morbidity and persistent pain. In addition,
because the biomechanical integration of the
spine is altered by these procedures, further
vertebral deterioration can occur.
Percutaneous lumbar discectomy
Percutaneous lumbar discectomy
(PLD) is a less invasive surgical procedure
when compared to open procedures, and
involves the removal of only part of the disc
responsible for nerve impingement, and
has been an effective treatment for disc
herniation for more than 30 years. In its
evolution, the procedure has been modified
from the use of manual cutting forceps, to
automated devices in which a mechanized
cutting and sometimes suction apparatus is
used to remove disc material.
Several clinical articles over the last 20
years have been published supporting the
clinical benefits of these devices. These
studies indicate a 75-90% improvement in
functional status. In addition, the studies
indicate significant reduction in pain levels
and consumption of pain killers.
enSpire™ Interventional Discectomy
System: Device and Intended Use
SpineView’s enSpire™ Interventional
Discectomy System is a modern percutaneous
discectomy device granted clearance by
the Food and Drug Administration (FDA)
Your Patients
After Hospitalization
Take full advantage of Medicare
reimbursement while your patient is
receiving home health or hospice care.
Once again, a Medicare regulation has
put Holy Name Home Care into a quick
compliance mode. This time, we are totally
dependent on physician support. The
PECOS (Provider Enrollment Chain &
Ownership System) requires physicians
referring their patients to home health
services to be enrolled before the Medicare
certified home health agency can be
reimbursed for their services. We are,
therefore, asking your help with this issue,
which is so important to providing needed
home care services to your patients.
Are you enrolled?
If you have not done so, please enroll
on the website, www.cms.hhs.gov/
MedicareProviderSupEnroll, so your
patients can receive home care services.
Are you taking advantage of all
Medicare reimbursement?
There are two ways physicians can be
reimbursed for their services while their
patients are receiving home health and
hospice services:
1.Care Plan oversight: Physicians who
oversee complex care needs of Medicare
home health and hospice patients can be
reimbursed for these services. To receive payment, the physician must:
• provide service to the Medicare beneficiary
receiving home health services
• have had a face-to-face encounter with
the patient within the six months
prior to billing
2.Certification and recertification: This
includes contacts with the Home Health or
Hospice staff, and review and signature of
the Plan of Care and other documentation
sent by the home care staff.
Need more information?
The National Association for Home
Care & Hospice (NAHC) has recently
updated a short guide, which includes the
documentation requirements and billing
codes for reimbursement of physician
services. Copies of this publication are
available by calling Holy Name Home
Care at 201-833-3740.
A more detailed publication, Physician
Payment for Home Care & Hospice Services,
includes specific definitions, documentation
requirements, physician home visits, and
coverage rules and is available on the NAHC
website, www.nahc.org .
Patricia M. Hunt, MS, RN is
Executive Director of Home
Care and DayAway at Holy
Name Medical Center.
AP view
Lat. view
enSpireTM device
Enlarged enSpireTM tip
in 2009. It is a single-use, non-thermal
discectomy device using a 16g. cannula
typically used in the lumbar spine. The
enSpire™ device is introduced into the disc
under fluoroscopic guidance, very similar to
a diagnostic test called a discogram. It has a
deployable wire with a 7mm sweep diameter
to cut and grind disc material, and an auger
mechanism to remove the disc material to a
collection chamber (see figures above). This
ability to collect excised material provides
the physician with direct information about
the amount of disc material removed. To
date, there have been no reports of serious
or unexpected patient adverse events
attributable to the enSpire™ system.
The author’s experience with this device
has been very encouraging. I have used
it on multiple patients and have had very
encouraging results. The response has been
from 30-40% relief to 100% relief. Only one
patient has had no response.
Samyadav Datta, MD
is a pain management
specialist on staff at Holy
Name Medical Center
and Director of the Center
of Pain Management in
Hackensack. He can be
reached at 201-488-7246.
Fraxel re:pair® Laser
for Skin Rejuvenation
Fraxel re:pair® is the new gold
standard for fractional CO2 laser
ablation, deep dermal coagulation and
skin rejuvenation. The Fraxel re:pair®
laser is the third generation of Fraxel
lasers and accomplishes in one 30minute session what formerly required
three or more treatments, several
weeks apart.
The device provides a laser facelift
for patients with moderate to severe
photo-damage and other age- and
environmental-related damage, by
shrinking the skin and dermis threedimensionally, as the treatment head
is rolled over the face, neck and
décolletage.
Indications for use include fine
rhytids or wrinkles, freckles or
lentigenes, and general skin laxity.
Ablation of textural irregularities,
dyschromia, and acne scars are
additional benefits derived. The device
has also been approved for use on
stretch marks and on the hands and
extremities.
The procedures are performed
under IV sedation or topical
anesthesia. Most patients are healed
in three days, and they can resume
their normal activities and social
The Fraxel re:pair® laser is the third
generation of Fraxel lasers and
accomplishes in one 30-minute session
what formerly required three or more
treatments, several weeks apart.
engagements several days later.
I am the first plastic surgeon in
both Bergen and Passaic counties to
offer this skin rejuvenating modality.
Both I and those patients I’ve
treated are quite impressed with the
results. I continue to offer Botox®,
Juvederm® and Radiesse®, as well as
face- and brow-lifting procedures,
and breast and body contour surgery.
Additionally, I am doing laser hair
removal and treating acute acne with
the Isōlaz IPL.
Robert S. Fischer,
MD is a plastic and
reconstructive surgeon
on staff at Holy Name
Medical Center, with
a private practice at
19-21 Fair Lawn Ave.,
Fair Lawn, NJ 07410.
He can be reached at
201-796-4100 and
RobertSFischerMD.com.
5
Service
Anniversaries
Welcome to the Medical Staff
The Holy Name family extends its
congratulations and gratitude to the following
members of the medical staff for their
association with our Medical Center. This list
recognizes anniversaries during May, June,
July and August, 2010.
Appointments to the Medical Staff during May, June, July
and August 2010
40 Years
Richard J. Kossman, MD, Neurology
Joseph Musa, MD, General Surgery
Medical School: Columbia University School of Dental & Oral Surgery
Internship and Residency: Columbia University – Pediatric Dentistry
Practice: 23-00 Route 208 South, Suite 2-5, Fair Lawn, NJ 07610
Phone: 201-796-4111
35 Years
Jacinto Fernandez, MD, Obstetrics & Gynecology
30 Years
Robert Malovany, MD, Pulmonary Medicine
Vincent Lanteri, MD, Urology
25 Years
Josef Weisgras, MD, Internal Medicine
20 Years
Lewis Attas, MD, Oncology
Francis Forte, MD, Oncology
Stephen Kamin, MD, Neurology
Zvi S. Marans, MD, Pediatrics
Michael Schleider, MD, Oncology
Jeffrey Steuer, MD, Orthopedics
Albert Tartini, MD, Nephrology
15 Years
Raymond B. Andronaco, MD, Urology
Sheila A. Bond, MD, Plastic Surgery
Gerard T. Eichman, MD, Cardiology
Steven D. Gillon, DO, Gastroenterology
Anne J. Miller, MD, Orthopedics
Raphael Novogrodsky, MD, Urology
Austin M. Pattner, MD, Nephrology
Gary D. Wasserman, MD, Urology
10 Years
Kristin A. Concepcion, MD, Pediatrics
Marc M. Egazarian, MD, General Surgery
Amina Elkassir, MD, Pediatrics
Stuart B. From, MD, Allergy
Ziv Harish, MD, Pediatrics
Jennifer L. Kmieczah, DPM, Podiatry
Omana R. Mathew, MD, Pediatrics
5 Years
Ananea Adamidis, MD, Nephrology
Fang Chin Chiang, DO, Emergency Medicine
Amy Fisch, DO, Anesthesia
Tonel Leibu, MD, Internal Medicine
Anne M. Shaftic, NP, Internal Medicine
Dorene Soo-Hoo, DPM, Podiatry
Zalmen L. Suldan, MD, Nephrology
Daniel Walzman, MD, Neurosurgery
Peter Ilowite, DO,
Awarded “Teacher
of the Year”
Peter G. Ilowite, DO,
dermatologist, was
recently awarded
“Teacher of the Year”
by the dermatology
residency program at
Mount Sinai Hospital and
Medical School in New York City, where he
is an assistant professor of medicine. It is
the second year in a row that Dr. Ilowite has
received the honor. He has practiced in Saddle
Brook, NJ for 15 years, and is also a consulting
dermatologist for the Kessler Institute for
Rehabilitation in Saddle Brook. Dr. Ilowite can
be reached at 201-843-7177.
6
Purnima Hernandez, DDS
Surgery/Pediatric Dentistry
Nicholas Bevilacqua, DPM
Surgery/Podiatry
Medical School: New York College of Podiatric Medicine
Internship: St. Vincent’s Catholic Medical Centers
of NY – Podiatry
Residency: St. Vincent’s Catholic Medical Centers
of NY – Podiatry
Practice: 730 Palisade Ave., 1st floor, Teaneck,
NJ 07666
Phone: 201-353-9000
Jay Chun, MD
Surgery/Neurosurgery
Medical School: Columbia University College of Physicians and Surgeons
Residency: University of California, San Francisco – Neurosurgery
Fellowship: Emory Clinic – Neurosurgery/Spine
Practice: 310 Madison Ave., Morris Township,
NJ 07960
Phone: 973-285-7800
Janna Cohen-Lehman, DO
Medicine/Endocrinology
Medical School: New York College of Osteopathic Medicine
Internship: North Shore University Hospital – Medicine
Residency: North Shore University Hospital – Medicine
Fellowship: North Short University Hospital – Endocrinology
Practice: 229 Engle Street, Englewood, NJ 07631
Phone: 201-567-3674
Clenton Coleman, MD
Medicine/Nephrology
Medical School: University of Medicine & Dentistry
Internship: St. Luke’s-Roosevelt Hospital – Medicine
Residency: St. Luke’s-Roosevelt Hospital – Medicine
Fellowship: Lenox Hill Hospital – Nephrology
Practice: 177 North Dean St., Englewood, NJ 07631
Phone: 201-567-0446
Marina Cozort, MD
Medicine/Psychiatry
Medical School: Rostov State Medical University
Internship: Rostove Regional Clinic Hospital – Ob/Gyn
Internship: Bergen Regional Medical Center – Psychiatry
Residency: Bergen Regional Medical Center – Psychiatry
Practice: 111 Dean Drive, Tenafly, NJ 07670
Phone: 201-568-8288
Elizabeth Eapen, MD
Pathology
Medical School: University of Kerala, Medical College
Internship and Residency: St. Luke’s-Roosevelt Hospital – Pathology
Fellowship: Montefiore Medical Center – Gynecologic Pathology
Fellowship: Westchester County Medical Center – Cytopathology
Practice: Pathology Dept., Holy Name Medical Center, Teaneck, NJ 07666
Phone: 201-833-3246
Enrique Feoli, MD
Medicine/Neurology
Medical School: National University of Cordoba, School of Medicine
Internship: Bronx-Lebanon Hospital
Residency: New York University Medical Center - Neurology
Fellowship: New York University Medical Center – Neurophysiology
Fellowship: Presbyterian Hospital – Epilepsy
Practice: 20 Prospect Ave., Suite 800, Hackensack, NJ 07601
Phone: 201-343-6676
Warren Glick, NP
Family Practice
Education: Fairleigh Dickinson University
Practice: HNMC Clinic, 718 Teaneck Rd., Teaneck, NJ 07666
Phone: 201-833-7183
Edmund Kwan, MD
Surgery/Plastic Surgery
Medical School: Georgetown University School of Medicine
Internship: St. Vincent’s Hospital & Medical Center
Residency: New York Hospital – Surgery
Fellowship: Flowers Clinic – Plastic Surgery
Practice: 302 East 72 St., NY, NY 10021
Phone: 212-734-4488
William Ko, MD
Radiology
Medical School: Boston University School of Medicine
Internship: Framingham Union Hospital
Residency: St. Vincent’s Hospital & Medical Center – Radiology
Fellowship: Thomas Jefferson University Hospital – Radiology
Fellowship: Brigham and Women’s Hospital –
Breast Imaging
Practice: HNMC Breast Center, 718 Teaneck Rd., Teaneck, NJ 07666
Phone: 201-833-7100
Steve Kwak, MD
Surgery/Orthopedics
Medical School: University of Medicine and Dentistry
Internship: Tuft’s – New England Medical Center – Surgery
Residency: Tuft’s – New England Medical Center – Orthopedic Surgery
Fellowship: Southern California Orthopedic Institute – Sports Medicine
Practice: 730 Palisade Ave., Teaneck, NJ 07666
Phone: 201-353-9000
Francis Lee, MD
Surgery/Orthopedics
Medical School: Seoul National University, School of Medicine
Residency: Jersey City Medical Center – Orthopedics
Fellowship: University of Toronto – Pediatric Orthopedics
Fellowship: Massachusetts General Hospital – Musculoskeletal Tumor
Practice: 3959 Broadway, 8 North, New York, NY 10032
Phone: 212-305-3293
James Lee, MD
Surgery/Otolaryngology
Medical School: New York University School of Medicine
Internship: Beth Israel Medical Center
Residency: New York University Medical Center – Otolaryngology
Practice: 219 Old Hook Rd., Westwood, NJ 07675
Phone: 201-666-8787
James Lim, MD
Radiology
Medical School: University of Medicine & Dentistry
Internship: St. Vincent’s Hospital & Medical Center – Medicine
Residency: St. Barnabas Medical Center – Radiology
Fellowship: New York Presbyterian Hospital-
Columbia Campus – Radiology/Nuclear Medicine
Practice: 718 Teaneck Rd., Teaneck, NJ 07666
Phone: 201-833-7023
Daniel Lowe, MD
Surgery/Urology
Medical School: Albert Einstein College of Medicine
Internship: Montefiore Medical Center – Surgery
Residency: Montefiore Medical Center – Urology
Practice: 20 Prospect Ave., Suite 719, Hackensack, NJ 07601
Phone: 201-343-0082
Mindy Nestampower, MD
Anesthesia
Medical School: Albany Medical College/Union University
Internship: Staten Island University Hospital – Medicine
Residency: New York Hospital – Anesthesia
Fellowship: Memorial Sloan-Kettering Cancer Center – Pain Management
Practice: 350 Ramapo Valley Rd., Suite 18-282, Oakland, NJ 07436
Phone: 201-644-7700
Steven Novak, MD
Anesthesia
Medical School: Ohio State University School of Medicine
Internship: Dartmouth Hitchcock Medical Center – Pediatrics
Residency: New York Presbyterian Hospital – Columbia Campus – Anesthesia
Fellowship: Cleveland Clinic – Clinical Research
Practice: Bergen Anesthesia, 718 Teaneck Rd., Teaneck, NJ 07666
Phone: 201-833-7149
Nitin Patel, MD
Surgery/Urology
Medical School: University of Medicine and Dentistry
Internship: University of Medicine and Dentistry – Surgery
Residency: University of Medicine and Dentistry – Urology
Practice: 255 W. Spring Valley Ave., Suite 101, Maywood, NJ 07607
Phone: 201-487-8866
Ari Seidenstein, MD
Surgery/Orthopedics
Medical School: UMDNJ-Robert Wood Johnson Medical School
Internship: Montefiore Medical Center – Orthopedic Surgery
Residency: Montefiore Medical Center – Orthopedic Surgery
Fellowship: Insall Scott Kelly Institute – Adult Reconstruction & Sports Medicine
Practice: 10 Forest Ave., Paramus, NJ 07652
Phone: 201-291-4040
Mathew Silverman, DO
Internal Medicine
Medical School: Philadelphia College of Osteopathic Medicine
Internship: Maimonides Medical Center – Medicine
Residency: Maimonides Medical Center – Medicine
Practice: 480 Market Street, Saddle Brook, NJ 07663
Phone: 201-845-4048
David Singh, MD
Radiology
Medical School: State University of New York, Syracuse
Internship: Albany Medical Center – Medicine
Residency: Albany Medical Center – Radiology
Fellowship: Albany Medical Center – Vascular and Interventional Radiology
Practice: 718 Teaneck Rd., Teaneck, NJ 07666
Phone: 201-833-3310
Chang Son, MD
Medicine/Dermatology
Medical School: McGill University
Internship: Brigham and Women’s Hospital
Residency: Yale New Haven Hospital – Dermatology
Practice: 2083 Center Ave., Suite 3A, Fort Lee, NJ 07024
Phone: 201-944-3800
Edward Strauss, RNFA
Surgery/General Surgery
Education: Bergen Community College – RN
Practice: 24 Summit Ave., Butler, NJ 07405
Phone: 201-207-9487
Timothy White, PA
Emergency Medicine
Education: University of Medicine & Dentistry – PA
Practice: HNMC Emergency Department, 718 Teaneck Rd., Teaneck, NJ 07666
Phone: 201-833-3210
Walk for Hope Connects
with Hispanic Population
Led by FOX News journalist/author
Geraldo Rivera, 400 people hoofed their
way through James J. Braddock North
Hudson Park in North Bergen to raise
funds for needy cancer patients on May 22.
Conducted by the Medical Center’s Hispanic
Outreach Program in association with the
Celia Cruz Foundation, the event featured
complimentary blood pressure screenings,
cancer information and education, and the
opportunity for informal consultations with
bilingual physicians.
Dr. Fernandez-Cos, Medical Director
of the Hispanic Outreach Program, was
on hand to answer participants’ medical
questions, as were colleagues Dr. Juan
Gonzalez, general surgeon; Dr. Gilberto
Gastell, internal medicine; Dr. Yadyra Rivera,
hematology/oncology; Dr. Mauricio Zapiach,
gastroenterology; Dr. Octavio MelendezCabrera, ob/gyn; and Dr. Jorge Verea,
internal medicine.
The Hispanic Outreach Program is a
culturally-sensitive initiative offering health
information, referrals, educational programs,
seminars, and screenings at Holy Name and
off-campus locations for residents of Bergen,
Hudson and Passaic counties in New Jersey.
Destination Honduras for KMP Physicians
A surgical team composed of physicians
from Holy Name Medical Center’s Korean
Medical Program conducted its annual
medical mission to Progreso Hospital in
Honduras in July, performing 45 surgeries
over the course of four days.
HNMC’s Hee K. Yang, MD, general
surgeon, Tae Won Moon, MD,
otolaryngologist, Edmund Kwan, MD,
plastic surgeon, Sung K. Yun, MD,
obstetrician/gynecologist, and Kenneth
Park, MD, anesthesiologist, worked with
their sponsoring organization, Kingdom
Pioneering Mission, which provides
physician expertise to third-world healthcare
facilities that lack adequate staff. Honduras is
the group’s first project, having commenced
two years ago with the distribution of
over-the-counter analgesics. After the team
established their credibility with the staff
at Progreso Hospital, “we passed the test,”
says Dr. Yang, and they were invited back to
operate on patients.
Dr. Yang explains that the team undertakes
procedures not routinely performed at
Progreso, either because of their complexity
or the lack of surgical supplies and materials.
He says that while the government-run
hospital charges an affordable fee for an open
Dr. Kwan (standing) and Dr. Moon perform a facial
reconstruction as a medical student looks on.
Dr. Edmund Kwan (third from left), Dr. Yang (fifth from left) and Dr. Tae Won Moon (far right) join a medical student and staff
members at Progreso Hospital.
cholecystectomy, it charges $250 for the
laparoscopic approach. “The people’s average
monthly income is around $250,” points out Dr.
Yang, “making a lap chole—which is easier on
the patient—prohibitive.” In response to this
need, the team performed the operation for
only $25 per patient. Dr. Yang also performed
complex hernia repairs that required the use of
mesh which, because of its expense, is difficult
to obtain at Progeso Hospital.
Dr. Kwan performed many skin grafts and
skin reconstructions on patients with nonhealing ulcers due to wound complications.
Dr. Moon assisted with facial reconstructions,
including cleft lips and palates, an otoplasty
for severely protruding ears, and a corrective
surgery for a young woman who had been
partially scalped in a car accident and whose
initial surgery had left her with a displaced
eyebrow. Dr. Park administered anesthesia for
all the surgical patients.
The surgical team was accompanied by
a youth group, composed of young people
who are interested in pursuing medical
school. When members of the youth group
weren’t observing the surgeons in action,
they were helping to teach English to the
local school children and building classroom
furniture, such as bookcases and desks.
Are Hospitalists the Marcus Welbys of Today?
Marcus Welby, MD, which aired on ABC
from late September 1969 through midMay 1976, was one of the most popular
doctor shows in U.S. television history.
The program, starring Robert Young, was
centered on the basic doctor show formula—
the older physician-mentor tutoring the
young man—and transferred it from the
standard hospital setting to the suburban
office of a general practitioner. According to
the Museum of Broadcast Communications,
the sicknesses that Dr. Welby dealt with—
everything from drug addition, rape, tumors
and autism—ran the same wide gamut
that hospital-based medical shows did. In
fact, many of the patients ended up in the
hospital, and Dr. Welby ultimately moved his
practice to a hospital toward the end of the
show’s run.
Fast forward to healthcare in Bergen
County as a microcosm of our nation’s
healthcare and one may see that Dr.
Welby’s decision to move his practice to the
hospital was, in fact, a harbinger of how
medicine is now practiced. Unfortunately,
healthcare today is beset by a shortage
of primary care physicians, reduced
physician reimbursements by the insurance
companies, an aging boomer generation
and the ever-increasing cost of patient
care. So what is the answer to these thorny
public health issues that we have all been
hearing about, and how does this relate to
our Bergen County community, which also
happens to be the most populous county in
the state of New Jersey?
A partial healthcare solution for our
community and its primary care physicians
and specialists who need additional clinical
support and relief is hospitalist medicine.
That’s right, “hospitalist” medicine. So what
is a hospitalist? A hospitalist is a physician
who specializes in caring for patients during
their stay in the hospital. In fact, hospitalists
have been admitting patients at Holy Name
Medical Center for the past year.
Holy Name Medical Center readily
recognized the value that hospitalists
bring to its patients and their primary care
physicians. Today, there are five hospitalists
at Holy Name. These board-certified internal
medicine specialists are available 24/7 to
support area physicians and their patients
who require inpatient hospital care.
Mohammad Tehranirad, MD, the Lead
Hospitalist of Teaneck Hospitalists at Holy
Name, comments, “Our doctors are fullytrained physicians, board-certified in internal
medicine, and work in close consultation
with the patient’s primary care physician.
We also work closely with other involved
specialty physicians during their patient’s
hospital stay. Our patients are culturally
diverse and I not only love the patient
interaction, but also the opportunity to work
with the patient’s primary care physician.”
According to Ronald Rigolosi, MD of
Riverside Family Care in Lodi, “I have
worked successfully with hospitalists since
2001 when I was in Kansas City. I am back
home now in New Jersey and the hospitalists
at Holy Name allow me to concentrate
on my patients in the office, knowing that
my patients in the hospital are receiving
the level of care that I would provide and
expect. The Holy Name hospitalists are
there day and night, seven-days-a-week and
that means a lot to me as a physician and
of course, my patients.” Of course, the use
of Teaneck Hospitalists is at the discretion
of the primary care physician, and they are
available to all Holy Name Medical Center
physicians. They are invaluable members of
the patient care team.
Visitors to our Bergen County area,
people who do not have a local physician
or those whose physician does not have
privileges at Holy Name also receive care
from the hospitalist service. As in any
medical situation, continuity of care from the
time of admission to discharge is ensured by
the hospitalist. What’s more, the hospitalists’
familiarity with the many specialists at Holy
Name Medical Center and its departments
allows them to efficiently coordinate
care and monitor patient progress while
continuing the consultant referral patterns
for each patient. Since Teaneck Hospitalists
do not have outside practices, they are at
Holy Name throughout the day and are
better able to follow up on tests and make
necessary adjustments in a timely manner,
based on clinical test results.
Richard Joo, MD, an internal medicine
practitioner with offices in Englewood
Cliffs and Palisades Park, adds, “Hospitalist
medicine is the only way to go. The
hospitalists help streamline care for my
patients and they give excellent care. There is
never a time that a hospitalist is not at Holy
Name for my patients and me. The fact is,
my patients need me in the office. When
they are at Holy Name Medical Center for
whatever medical reason, we simply pick
up where the hospitalists at Holy Name
left off. It is that simple. Discharges happen
when they are supposed to happen, and
communication between hospitalists and
myself is great. Patient bounce backs or
readmissions are not a problem at Holy
Name and that is important to me.”
With our nation’s healthcare reform effort
still being played out, at least here in Bergen
County, there is no argument about the
merits of the Hospitalist Program at Holy
Name Medical Center. We think Marcus
Welby, MD would be proud of this medical
service in our community!
Paul White is Vice President of Physicians’
Practice Enhancement, provider of Teaneck
Hospitalists at Holy Name Medical Center.
7
Foundation Golf Outing Raises $245,000
The Holy Name Health Care Foundation held its 16th Annual Holy Name Classic Golf Tournament on June 14 at the Hackensack Golf
Club, Oradell, and at the Arcola Country Club, Paramus. More than 200 golfers and other participants turned out, raising over $245,000
for the benefit of the Medical Center’s programs and services.
“Each year, our Holy Name Golf Classic gathers new supporters and longtime friends for a wonderful day of golf and to raise significant
funds for Holy Name Medical Center,” said Kevin McCarthy, Vice President of Development and Executive Director of the Holy Name
Health Care Foundation. “This year was no exception. Golfers enjoyed a beautiful day thanks to a good forecast and a terrific awards
program and dinner. All proceeds from this year’s Golf Classic will go directly to benefit the healing mission of the Medical Center.”
Magnet Recognition
From the American Nurses
Credentialing Center. Places us
among the top 5% of hospitals
nationwide for excellence in
patient care.
Beacon Award
From the American Association
of Critical Care Nurses for
exceptional acute and critical
care nursing.
J.D. Power and Associates
Distinguished Hospital
Awards
For Emergency, Inpatient,
Outpatient
and Maternity Service Excellence.
Accredited Chest Pain
Center
From the Society of Chest
Pain Centers for our ability to
diagnose chest pain
and acute coronary symptoms.
Primary Stroke Care Center
Certification
From The Joint Commission,
the nation’s leading health care
evaluation and accreditation
organization.
June/July/August 2010
MD360º is published bimonthly by Holy
Name Medical Center’s Department of
Marketing/Public Relations and is intended
for use by the medical staff of Holy Name
Medical Center.
8
HealthGrades® Specialty
Excellence Award for
Stroke Care™
Ranked in the top 10% of
hospitals nationally for stroke
services.
HealthGrades®
Distinguished Hospital
Awards for Clinical
Excellence™ Among the top
5% of hospitals in the nation for
clinical excellence.
Modern Healthcare
magazine
Ranked fourth in the nation on
the “100 Best Places to Work in
Healthcare” list.
NJBIZ magazine
Cited Holy Name among the
“Best Places to Work in
New Jersey.”
Data Advantage, LLC
Awarded for quality, affordability,
efficiency, patient safety and
overall experience.
Patricia A. Burke, M.D., Ph.D., President of the Medical Staff
Jane F. Ellis, Vice President, Marketing and Public Relations
editor:
Barbara Franzese Cron, Manager, Marketing Communications
Please e-mail all comments and contributions to: editor [email protected]
or call Jane Ellis, 201-833-3129 or Barbara Cron, 201-530-7904.