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 LOUISIANA ARCHIVES

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Acadiana Hospitals Launch New Imaging Centers
With small specialty imaging centers pop-ping up all over Acadiana, local hosp-tals are jumping head-on into the fray. In February, Opelousas General Health System broke ground on its stand-alone facility in Sunset. Following close behind was Lafayette General Medical Center, which began demolition of the second floor of the Burdin Riehl Center to accommodate its own diagnostic headquarters in May. The Outpatient Diagnostic Center in Sunset is a joint venture between Opelousas General Health System and OGH Imaging, L.L.C. OGHS staff radiologist, Dr. Richard Lastrapes, says that this physician/hospital partnership currently has about 37 physician investors, but more shares are in the offering. He explains that St. Landry Parish-based doctors saw a need for full-service diagnostic imaging in this area. "We have come together to create this outpatient imaging facility in Sunset, which we all know is an underserved community medically," he says. "We thought that it would be a great place to start, especially as the growth is occurring from Lafayette to Carencro and towards Opelousas from Eunice, and capture a certain market of patients who may have more difficulty finding medical imaging or traveling further distances to get quality imaging studies."
by Lisa Hanchey

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Dawn Starns
Venture Capitalists May Receive Boost With Tax Breaks
While Louisiana and the South still lag be-hind other parts of the country when it comes to raising venture capital, public and private efforts to encourage these types of investments have begun to make their presence felt. The Louisiana Angel Network, designed to provide early-stage funding for viable start-up companies, opened at the beginning of the year. None of its members have made any investments through the network yet, but that's not bad news, executive director Dawn Starns said. "There has never been any type of network formalized that does this, ever, in the state," Starns said. "It's important to note that because we finally have one, people are interested in it ... and we've started the conversation about venture capital." Angel-round funding typically ranges from $50,000 to around $2 million. Entrepreneurs can use that money to do everything from finishing their product development to entering the marketplace.
by Ted Griggs

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Michael J. Culotta
Louisiana Hospitals Quietly Make Transition to LifePoint
Patients will notice little change at the four Louisiana hospitals LifePoint Hospitals Inc. acquired in its $1.7 billion acquisition of Province Healthcare Co. "As I tell people all the time, they still start IV's the same way they always have. They still put stitches in the same way. They still put on bandages the same way. There's not a whole lot of difference at the local level," said Sarah Branton, a spokeswoman for Doctors' Hospital in Opelousas. The major change at Doctors' Hospital, as well as Eunice Community Medical Center, Teche Regional Medical Center in Morgan City and Minden Medical Center, is taking place behind the scenes. These former Province properties and 17 others are switching to HCA Inc. health and business management systems. LifePoint already owned River Parishes Hospital in LaPlace and Ville Platte Medical Center. Michael J. Culotta, chief financial officer of LifePoint Hospitals, has said it will take two and a half to three years to convert the Province hospitals to the HCA system. Just the clinical side takes 12,000 to 15,000 man-hours to convert to the Meditech software, Culotta said during presentations to investors and brokers. In addition, converting the accounting systems will consume about 3,000 man-hours.
by Ted Griggs

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Physician's Spotlight: Dr. Joan Wojak
Few people are able to combine their passion with their work, particularly when that job is highly specialized. But, Lafayette physician Joan Wojak has managed to do just that - by finding a niche which merges her love of horses with her practice in interventional neuroradiology. In her precious spare time, this busy doctor volunteers for the Acadiana Therapeutic Riding Association (ATRO), which provides equine-assisted therapy and therapeutic riding for patients with disabilities. With her Cossack heritage, Wojak was destined to become a rider. Both of her grandfathers were horseman. "Behind the Mongolians, the Cossacks are probably the second best natural native horsemen in the world," she explains. Dr. Wojak, who hails from Long Island, New York, sought greener pastures after finishing her neurosurgery residency at NYU. Tired of the fast pace of Manhattan, she jumped at the opportunity to complete a radiology residency at LSU in New Orleans. After completing a fellowship in interventional neuroradiology, Wojak was offered a job in Lafayette.
by Lisa Hanchey

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Louisiana Psychologists Start Pioneering Program For Mental Health Drugs
A new law took effect in January that allows psychologists in Louisiana to prescribe medications for their mental health patients. And some here see it as a model for expanding the right to another 48 states that still force most patients to see a psychiatrist to get a prescription for the many drugs designed to help them. Psychologists insist that the new law isn't an open invitation to quick certification. In order to prescribe drugs for mental health patients, psychologists have to first complete 450 hours of classroom work taught over two years. "The training is post-doctoral," says Linda Upton, Ph.D., president of the Louisiana Psychological Association and a practicing psychologist in Baton Rouge. "Only psychologists who have a particular interest in pharma-psychology and are willing to get the extra training will be certified." The coursework runs the gamut from anatomy to biochemistry, neuroscience, pharmacology, right through pathophysiology and lab assessments.
by John Carroll

Genentech Touts Major Gains in Cancer Fight
Every year, tens of thousands of the world's top cancer experts are brought together by the American Society of Clinical Oncologists to delve into the nitty-gritty world of clinical trial data and the never-ending search to find a better tool to fight the world's toughest killer. And each year, one of the drug developers touting their new pharmaceuticals walks away with the unofficial title of cancer drug champion as the reporters who cover the scene shine their spotlight on the greatest triumphs of the past 12 months. This year, virtually everyone at the annual meeting in Orlando in mid-May was willing to hand the crown to Genentech as this year's easy winner. It's not hard to see why.In the months leading up to the gathering, Genentech had sealed its dominant status with news on three major cancer drugs: Herceptin, Avastin and Tarceva. In several studies, Avastin - which works by starving tumors of blood - was linked to longer survival times for colon and breast cancer. And Genentech wowed researchers in Orlando with the news that Avastin also extended the lives of patients with advanced lung cancer by more than two months, a significant response in a field with extremely high mortality rates.
by John Carroll

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Donna F. Landry
Physician-owned Hospitals Wield Economic Influence On Doctors, Community Hospitals
Owning a piece of a limited-service, or specialty hospital, can change the way doctors practice medicine, resulting in a dramatic rise in high-cost surgeries and procedures, according to a recent Georgetown University study. The study's results came as little surprise to community, or full-service, hospitals in the Acadiana area. Lafayette is home to four specialty hospitals, two of which opened in 2004. "Our Lady of Lourdes has experienced a decrease in patient volume over the past two years. Some of it undoubtedly can be attributed to the limited service hospitals," said Berch Stelly, a spokesman for Our Lady of Lourdes Regional Medical Center. Stelly said the hospital is also doing fewer surgical procedures because of the limited-service hospitals. But move over to the Lafayette General Medical Center campus and the picture is quite different. Chief Operating Officer Donna F. Landry said specialty hospitals have had little impact on the community hospital, and Lafayette General Surgical Hospital, the hospital's joint venture with 11 surgeons, is proving the benefits of a collaborative approach.
by Ted Griggs

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Radiology and Imaging: Focusing on The Newest Technologies and Techniques
Radiology is not just about plain x-rays anymore. Today's radiologists use the latest technology to analyze not only still pictures, but moving organs. Modern equipment has evolved far beyond two-dimensional to 3D and even 4D views. Currently, radiology involves not only interpreting films, but also preventing and treating disease. Interventional radiologists are constantly finding less invasive methods to cure conditions through technology, rather than surgery. This month, Acadiana Medical News surveys some of the latest diagnostic advances, as well as the newest interventional and radiology techniques. Cutting-edge Diagnostic Technology Area radiologists agree that the most exciting diagnostic advances are in multi-slice computed tomography, positron emission tomography and short-bore magnetic resonance imaging. Of course, CT, PET and MRI have been around for a while, but constantly evolving technology is taking these scans to a whole new level. For CT, the current trend in radiology is moving from four-slice to 16- and 64-slice scanners. A decade ago, the CT was a tedious process, scanning one cross-section of the body at a time. "For example, you would take a scan slice, the table would move, you would take another scan slice, the table would move," explains radiologist Charles Brdlik, who practices with the Radiology Associates of Southwest Louisiana. "Nowadays, what we're doing is using the helical multi-slice scanners to basically obtain a volume of information on the patient at one time."
by Lisa Hanchey

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The Charité Artificial Disc consist of a moveable high-density plastic center sandwiched between two medal endplates.
Lafayette Neurosurgeon Performs First Artificial Disc Implant
On May 5, Lafayette neurosurgeon Alan Appley became the first Acadiana physician to perform spine surgery using an artificial disc. He proudly reports that the procedure "went very well," then modestly adds, "it's kind of a beginner's luck thing." Dr. Appley used the Charité artificial disc, which was just approved by the FDA in October, to execute this breakthrough procedure. Similar to the implant used for hip and knee replacement, this device consists of two metal endplates encasing a sliding core. The endplates are fabricated from medical grade cobalt chromium alloy, while the core consists of a movable plastic. Small external "teeth" affix to the vertebrae above and below the disc space to secure the implant. Traditionally, surgeons perform fusions to relieve symptoms from a degenerated or herniated disc. However, this procedure leaves the surrounding vertebrae immobilized, limiting movement in the spine. By contrast, the artificial disc design maintains spine flexibility and range of motion. "The idea with the artificial disc is to both reestablish the height of the disc space to relieve the pressure on the nerves, and also to get back to the normal motion of that disc space," Appley explains.
by Lisa Hanchey

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Meghan Gerety, M.D.
Study Shows Seniors Often Shun Prescription Drugs
America's seniors often avoid taking the drugs that are prescribed for them, either because they can't afford it or they don't feel they need to, according to a detailed analysis of the feedback gathered by Medicare. And those seniors who do take drugs as their doctor suggests often take a complex variety of pharmaceuticals that are often prescribed by more than one doctor and are frequently filled in different pharmacies. The researchers paint a complex picture of seniors who often appear deeply confused by the drugs that they're on, the potential for harmful interactions as well as anxiety over who picks up the tab. And the three groups that conducted the analysis - the Kaiser Family Foundation, the Commonwealth Fund and Tufts-New England Medical Center - say that the data also presents some clear challenges to Medicare as it rolls out a new prescription benefit plan in January. Altogether, four out of 10 seniors said that they failed to fill a prescription either because they couldn't afford it, didn't think they needed it or simply didn't want to. At the same time, almost half of the 89 percent of seniors who said that they had filled a prescription said they paid for five or more drugs. More than half of seniors taking drugs said they received a prescription from more than one doctor and a third used more than one pharmacy. And of those elderly Americans with three or more chronic illnesses, nearly 75 percent took five or more drugs while more than half had failed to fill all their prescriptions.
by Tracy Staton

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Gregg Gothreaux
Businesses Must Plan For Success Or Fail To Achieve It
You're an aspiring healthcare entrepreneur and believe your idea can be turned into a money-making machine. What's the first step to making the dream a reality? Do you approach the banks? Private investors? Venture capital funds? The patent office? "The No. 1 thing is to get a business plan together," said Roy Holleman, executive director of the Enterprise Center of Louisiana. People new to running a company don't want to spend their time working on a business plan, but it's the most important thing they can do," Holleman said. Developing a plan isn't something you can hire a company to put together, Holleman said, although lots of people are tempted to do so. A business plan is often highly personal. It provides a road map to where the company is going and how it will get there, Holleman said. Putting the plan together makes the businessperson answer all kinds of questions he or she may not have thought about, from finding start-up capital and hiring employees to finding office space and calculating overhead costs. "You have to be prepared for the bank, and you have to be prepared to go into business," Holleman said.
by Ted Griggs

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Nancy-Ann DeParle
Healthcare Stocks on the Rise, Lure Investors
Medical devices and instruments. Healthcare information technology. Hospitals and other facilities. Managed care. Biotechnology innovations. Administrative outsourcing. All these business sectors and more combine to lure investors of all stripes to the healthcare arena. Yet if you thought healthcare was hot last year, it's on fire now. "I've been on this side of healthcare - the business of healthcare as opposed to the regulation or the legal aspects of healthcare - for about four years. I think there's more going on right now than I've seen since I've started," says Nancy-Ann DeParle, a senior adviser with JPMorgan Partners in New York. DeParle is former administrator of the federal Health Care Financing Administration (now the Centers for Medicare and Medicaid Services) and past commissioner of the Tennessee Department of Human Services. DeParle says she examined potential deals in three cities during one week in May. "We don't usually take a trip just to see something. It usually has to be somewhat compelling to even make that step, and all of these were compelling on paper and compelling in person," she says. "We'll see what happens. There's a lot going on." JPMorgan Partners has been investing in healthcare for two decades and raised a $6.5 billion fund for the purpose in 2000-2001.
by Sharon H. Fitzgerald

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Ralph J. Ibson
Advocating for the Mentally Ill
Last month, Ralph J. Ibson, vice president for government affairs for the National Mental Health Association (NMHA), listened as Dr. Larke Huang, PhD, outlined key issues and findings on the state of mental health in America during a Congressional Briefing (see sidebar on page 18). Huang, who had served as one of the commissioners appointed by President George W. Bush to the New Freedom Commission on Mental Health, rolled out disturbing statistic after disturbing statistic on the number of Americans who suffer from a mental or emotional disorder and the nation's response to these individuals. "I was struck by an observation," said Ibson. "The data she was citing made it very clear we have a crisis in mental health among juveniles in America. For any other disease, it would warrant a national campaign ... sadly that's not the case for mental disorders." Ibson said Dr. Huang noted there are 30,000 suicides each year in the United States, but he added that number occurs against a backdrop of 650,000 attempted suicides serious enough to warrant an emergency room visit. Factoring in the fiscal, physical and emotional toll of mental illness, Ibson said, "Our failure to make mental health a priority is in itself a national tragedy." Despite a better understanding of causes and treatment protocols, Ibson said the stigma attached to mental illness remains pervasive and is something he battles regularly in his work on Capitol Hill.
by Cindy Sanders

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Dr. Cheryll Bowers-Stephens
Rehabilitating the State's Mental Health Rehab Program
Responding to rumblings about provider abuse, Louisiana's Department of Health and Hospitals is making sweeping changes to its Mental Health Rehabilitation Program. About 121 agencies currently participate in this project, which services adult Medicaid recipients with serious mental illness and children with emotional/behavioral disorders. But, this number could dwindle as providers struggle to comply with the stringent new requirements. Effective June 1, private participants will no longer be reimbursed on a capitated basis. Under the former system, mental health providers were paid a set rate per month for each patient. Now, agencies will be compensated using a fee-for-service approach. "What we're going to be moving to is called fee-for-service, meaning that each person that was being served by the program will have an individualized service plan developed," explains Dr. Cheryll Bowers-Stephens, assistant secretary for DHH's Office of Mental Health. "The agencies will get reimbursed for each and every service they provide, rather than getting one flat fee for providing everything." According to DHH's Communications Director, Bob Johannssen, the rates were developed by Louisiana's Medicaid program through conducting surveys of other states. Medicaid compared fees for comparable services, then adjusted them for this state's economic factors, such as cost of living, median household income and salaries in selected service professions.
by Lisa Hanchey

Mental Health Office Finds Itself in Familiar Territory, Under Budget Pressure
Another fiscal year, another state budget shortfall, another good chance that the funding for mental health services will be cut. Louisiana's mental health professionals and advocates are all too familiar with the picture. With the state Department of Health and Hospitals facing a $295 million deficit, DHH announced a plan to shutter 17 mental healthcare clinics and cut 100 psychiatric beds, 20 of them at University Medical Center in Lafayette. The proposal includes cutting 140 jobs and $9.4 million and 244 jobs from the department's Office of Mental Health. "It's going to be a disaster if the cuts are as draconian as it looks like they will be right now," said Lois Simpson, executive director of the Advocacy Center. The nonprofit agency helps indigent Louisiana residents with mental illnesses and physical disabilities. The proposed cuts to the Office of Mental Health will push more mentally ill people into prisons "because that becomes the modality of treatment for them" and onto the streets, Simpson said. The rural mental health clinics facing closure include centers in Crowley, Opelousas, New Iberia, and Ville Platte. However, Dr. Cheryll Bowers-Stephens, assistant secretary for the Office of Mental Health, said she's hopeful that some of the additional $360 million recognized by the Revenue Estimating Conference funds will find its way to mental health.
by Ted Griggs

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New InnerVue System Offers An Inside Look At Body Damage
Dr. Kenneth Bramlett has had years of experience trying to gauge the severity of a child's knee injury or an adult's arthritis through an MRI or by using his fingers in a probing clinical examination. But in many cases Dr. Bramlett never got all the information he really wanted for his diagnosis. Now, though, he can look right at the damage. About six months ago, Dr. Bramlett - an orthopaedic surgeon and clinical director of a Southeast orthopedics clinic - began to use Arthrotek's InnerVue Diagnostic Scope System. A 1.9 mm fiberoptic tube - about the size of a surgical needle - can be inserted directly into a knee or shoulder. A tiny camera gives the doctor a crystal clear, digital image of the tissue or bone injury, making it possible to make a visual examination of the damaged area inside the body. "We can stick this in there and three minutes later make a diagnosis," says Dr. Bramlett. Patients only require a quick shot of Lidocaine to dull any pain in the region of the examination and they're able to leave the physician's office after the examination under their own speed. "It's a very efficient, very quick and easy device to use." And it's designed to give patients the information in a way that they can understand exactly what needs to be repaired - and share that information with their family and friends, if they like. "You can make a CD, so when the patient gets through he has a CD of his condition," says Dr. Bramlett, which includes the voice-over of his examination as he is looking at the image.
by John Carroll