Peter Bernard and Tonya Mallory On the Road to Wellness 

"Two widely known area health care executives are taking another stab at a new business," reports the Times-Dispatch.

 

	Peter Bernard

Peter Bernard, former CEO of Bon Secours Health System and Bon Secours Richmond Health System, is partnering with Tonya Mallory, the founder and now ex-CEO of Health Diagnostic Laboratory in Richmond. They've "co-founded a health care venture - Creo Wellness LLC - that is in the midst of a national launch."

 

Creo's business plan hinges on working with corporate clients "to implement health wellness programs that encourage employees to adopt healthier lifestyles," including technology-based ways to create personalized plans for each employee.

 

"So far Creo has brought in $2.7 million in private investments," the TD reports, citing company executives and regulatory filings.

Bernard predicts further "exponential" growth following an agreement reached in July with the Brentwood, Tenn.-based health care consulting firm HealthTrust Purchasing Group that's affiliated with nearly 1,500 hospitals nationwide. Other big names mentioned as potential customers: Geisinger Health System, the Cleveland Clinic, UCLA and the University of Virginia.

 

This follows the return of both executives to "active roles in Richmond's business world," the TD writes. Bernard retired last year after four years leading Bon Secours Virginia and 15 years more leading Bon Secours Richmond. "I didn't really retire," Bernard said. "I just reinvented myself."

 

	Tonya Mallory

Mallory didn't talk to the TD, which described her resignation two years ago "after HDL confirmed that it was cooperating in a federal government investigation of reimbursement practices in the clinical laboratory industry."

 

The federal government later sued Mallory for allegedly participating in an $80 million kickback scheme - a case that's still pending, the TD reports.

 

Mallory has denied the charges, telling the TD last year, "I am not a criminal. This process feels like a witch hunt. I was not trying to take advantage of the health care system. I never thought any of my business strategies were fraudulent."

 

Click here to read more about Creo, which currently has 15 employees at its headquarters in western Henrico County. "They range from technologists and sales staff members to nutritionists and health coaches.

Don't Demonize Suboxone!

 

Writing in the TD this week, three family physicians who specialize in addiction treatment said they're worried that "the use of medication-assisted treatment continues to be questioned by drug courts, treatment centers, the media (see item below) and the general public."

 

	Dr. Neuhausen

This column is written by two RAM members - Dr. Sebastian Tong, a family physician at the VCU Health System and Dr. Katherine Neuhausen, a family physician and CMO at the Virginia Department of Medical Assistance Services - along with Dr. Hughes Melton, a board certified addiction medicine specialist who is chief deputy commissioner at the Virginia Department of Health.

 

They caution against the dangers of "demonizing" Suboxone. "With the growing overdose death rate from opioids in Virginia, these negative attitudes toward medication-assisted treatment are misinformed at best and dangerous at worst.

 

"As doctors who have practiced in Richmond and in Southwest Virginia, we can attest firsthand to the benefits of medications like methadone and Suboxone when they are used properly."

 

The challenge of using these drugs "is that they are being prescribed by clinicians without the necessary counseling and peer supports."

Click here to read more about their proper use and about a new program - Addiction Recovery Treatment and Services (ARTS) - which expands coverage for short-term inpatient detox and residential treatment to Virginia's 1.1 million Medicaid and CHIP recipients. And learn more about other community-based efforts that - along with training for doctors, counselors and others - can help "address the substance use crisis and reverse the opioid epidemic."

Suboxone Abuse Creates Twilight Zone in Southwest Va.

 

This in-depth TD article set in Wise, Virginia explores the sneaky ways that Suboxone is abused in Southwest Virginia.

"Buprenorophine, most often prescribed as Suboxone, is prescribed in this corner of the state at nine times the state average," the TD reports. "The region was hit worst by the painkiller epidemic, and now local officials say Suboxone has replaced oxycodone as the most popular street drug."

 

Virginia Secretary of Health Bill Hazel said this month that he wants the state to start requiring counseling alongside medication. "Suboxone by itself is not adequate treatment for substance abuse," he told the TD. "We're going to have to need to be careful with this."

What one writer has called "Epi-Rage" continues to poke patients and physicians alike, not to mention members of Congress and presidential candidates.

Consumers and politicians have accused the company of price-gouging, since the list price for a pair of EpiPens has climbed repeatedly from around $94 in 2007, when Mylan acquired the product, to today's list price of $608.

"The price hike, which hit just as parents and students were preparing for a new school year, has led to an election-year uproar amid widespread concerns about high drug prices," reports the Associated Press today.

Mylan CEO Heather Bresch defended the price hikes last week, saying the company only received $274 of the total price for a twin-package while insurers, pharmacies and other parties divvy up the rest. But her congressional testimony only threw more EpiPen onto the fire and - given the prospect of schoolchildren unable to afford the price of the protective drug device - made Mylan the latest poster child for a 21st century version of robber barons (remember "Pharma Bro" Martin Shkreli?)

"The raging debate over EpiPen pricing has offered a surprisingly wide window into the complicated world of prescription drug pricing, in which powerful drug companies, pharmacy benefit managers, insurers and federal health programs all play major roles," reports The New York Times, noting that "the system remains opaque."

Click here to see why Bresch recently had the "worst week in Washington."

The protests against EpiPen's pricing actually started because of a concerted effort by a New York woman on Facebook. Click here to read how she got things started.

And click here to learn how the National Association of Free & Charitable Clinics (NAFC) is helping in the effort to secure lower prices or a donated supply of EpiPens for clinics. And click here for another resource to help patients get reduced-price EpiPens.

Tropical Smoothie and Va. Dept. of Health Face Lawsuits as Hepatitis A Cases Top 60 in Va.

 

The number of Tropical Smoothie Café customers testing positive for Hepatitis A has risen to at least 81 confirmed cases, with 66 in Virginia and 15 in other states, the Times-Dispatch reports.

 

After citing the Virginia Department of Health's most recent alert,  the TD earlier reported on a growing number of questions -- and lawsuits --  "about whether the restaurant chain and state health officials acted rapidly enough in removing contaminated strawberries and notifying the public of the danger."

 

"After Tropical Smoothie was informed of an investigation into its potentially contaminated strawberries from Egypt, it took as many as four days to get all of the Egyptian strawberries out of use from all 96 of its restaurants in Virginia, according to a top health department official," the TD says.

 

It took two more weeks before the company or the health department informed the public about the potential contamination, the paper says.

 

This time lag is part of the case being made by a Seattle-based food safety law firm, Marler Clark, which reportedly has been in touch with more than 100 potential clients (more than the reported number of cases) considering filing lawsuits against Tropical Smoothie Café, the paper says. By last week, at least two such civil suits had been filed. 

 

Attorneys for the sickened customers said they could have avoided the food-based ailment if they'd received a shot to stop Hepatitis A in time, since "vaccines are typically effective within two weeks of exposure" to the virus.

 

Diane Woolard, director of the state health department's Division of Surveillance and Investigation, told the TD that the delayed announcement stemmed from a lack of firm evidence that the strawberries actually caused the Hepatitis A outbreak.

 

After talking with the café, and consulting the CDC and FDA, state health investigators worked fast to determine what people ate and whether they only consumed strawberries through Tropical Smoothie's drinks, she told the TD.

 

"You need some level of scientific certainty," Woolard said, "and it was lacking."

 

She praised Tropical Smoothie Café for acting "really quickly" in voluntarily pulling all of the Egyptian strawberries from its restaurants.

"They put the word out across the state, and the managers withdrew the product," most by Aug. 6 when they received the first notice from the company.

 

Yet, a lawyer for Marler Clark told the TD that the health department's account doesn't pass his "smell test." He said he plans to "put a lot of people under oath over the next several months."

Academy's Legislative Summit

 

The Academy's Legislative Committee recently met o discuss radiation safety for patients, transparency in healthcare costs, and Maintenance of Certification. Their proposals will be forwarded to the Medical Society of Virginia for consideration by MSV's House of Delegates at their annual meeting in October.

 

We still need delegates for the October meeting. Interested? Please contact Lara Knowles by clicking here or call her at 622-8137.

FIT's a Hit with Access Now & Friends! 

 

Access Now was thrilled earlier this summer to host a dozen friends from Richmond's health care community to learn more about a new testing procedure - FIT (fecal immunochemical test) made by Polymedco that's been proven to be a cost-effective way to screen for colorectal cancer.

Click here to learn more in our latest edition of "The Patient's Navigator!" Thanks to everyone who works so hard and volunteers their services to help those in need of specialty care through Access Now!

 

Petersburg Struggles to Stay Afloat

 

	Angry residents and employees at Tuesday's City Council Meeting

If you practice medicine in or around Petersburg, this week's in-depth Washington Post article about the hard times gripping the small city is a must read. It focuses on the interim city manager, Dironna Moore Belton, who has made the city's leaders face the music on their shaky financial situation and a $12 million budget shortfall.

 

Virginia Finance Secretary Ric Brown - who Belton called in to give an independent critique - said he's never seen anything like it in nearly 50 years of working in state public finance.

 

"What's more," the Post reports, "there is nothing in state law to help Petersburg - no provision for bankruptcy, no set way for the General Assembly to step in."

 

Read more about the Draconian measures an outside consultant recommended - what the Post called "a litany of municipal horrors" including raising taxes, closing a fire station, reducing school funding to a bare minimum, and closing city-owned museums.

 

Yesterday, Petersburg City Council approved several measures to close the city's $12 million budget gap, including a number of tax increases and the closing of three museums and two tourism centers. But in a tumultuous, marathon session filled with charges from angry residents, the council decided against the proposed closure of one of the city's four fire stations, the Times-Dispatch reports. 

U.S. Senate Sits on Zika Funds - Again

 

Even after a seven-week recess, the U.S. Senate could not summon the strength to pass a $1.1 billion spending bill to fight the Zika virus, reports The New York Times. Democrats are demanding the Republicans drop a provision that would block Planned Parenthood from getting any of the money to combat the mosquito-borne disease.

 

Dr. Tom Frieden, head of the CDC, warned that his agency has used almost all of the $222 million it was allocated to fight the virus. He warned that some key plans - such as help for Zika-plagued Puerto Rico - would have to be axed without more money soon.

 

The Potomac paralysis defies the wishes of most Americans, a recent study showed. Click here to read about Zika found in mosquitoes in the Miami area, and here to read about a controversy over spraying for the mosquitoes in South Carolina where bee farmers complain millions of their bees have been "nuked."

 

In other Zika news, fears about Zika are expected to increase global demand for condoms, reports The Wall Street Journal, as health agencies such as the CDC counsel men to use condoms to avoid passing the virus to their partners. Click here to read the most likely countries Zika's expected to break out. 

 

Click here for a new study that adds to "substantial evidence that Zika infections - even asymptomatic ones - may cause the temporary paralysis of Guillain-Barré syndrome.

Peds' Group Urging Flu Shots - not Spray

 

Concern about the effectiveness of an easy-to-use (and easy to sell to kids) nasal spray has led to new plans for pediatricians to only give flu vaccine through shots, reports The New York Times.

 

On Tuesday, the American Academy of Pediatrics agreed with the CDC that FluMist shouldn't be used this year because it hasn't protected kids against certain strains of influenza as well as regular flu shots. "Baffled scientists can't explain why," the Times reports.

 

One pediatrician gave this advice to parents: Don't tell your kids the shots won't hurt. Instead, tell them "it might hurt a bit but it doesn't last and you can do this."

RAM Docs on Southwest Va.'s "RAM"

 

Congrats to RAM members Ike Koziol, MD, Kenneth Olshansky, MD, and David F. Gardner, MD for their thought-provoking column in a recent Sunday Times-Dispatch Commentary, "Pride and Anger in Southwest Virginia." Click here! 

 

Describing the free medical and dental services given to more than 2,000 people at the annual Remote Area Medical Clinical - also known as RAM - they shared the mixed emotions it stirred up, from pride to anger. The four-day event is one of the largest free medical clinics in the nation, they wrote, but they argued that it could be averted by expanding Medicaid in Virginia.

 

"Tens of thousands of people have no health insurance and limited access to health care," the doctors said of those who drive hundreds of miles from as far away as Tennessee and Kentucky.

"Many of these proud folks worked in or had family members in the mines. Now, they work in fast food and have no health insurance. They make too much for Medicaid eligibility and too little to pay for coverage through the Affordable Care Act."

 

Click here to read more about the "overworked system" in Southwest Virginia, and the impact on its people who come to the annual free clinic in Wise, which is 146 miles southwest of Roanoke.

 

The health care is "provided by hundreds of selfless, dedicated and compassionate volunteers who come from Florida to Maine," spending "four days in the hot sun doing for these people what our society has not done."

 

Calling for Medicaid expansion, they asked, "Do we all know that much of this suffering can be prevented? Do we even appreciate how much suffering there is in areas like Wise?"

 

Some 40,000 citizens in southwest Virginia and an estimated 400,000 people statewide would benefit from new Medicaid services, they write. 

"We appeal to our leaders to do the right thing: Expand Medicaid."

Even as the national presidential race continues to find new lows,  Richmond's own mayoral race seems be swirling down the same political drain.

	Say it aint so, Joe!

Despite warnings to be civil at a mayoral debate sponsored by the city Democratic Committee yesterday, the TD reports, "Former Del. Joseph D. Morrissey lashed out at former Secretary of the Commonwealth Levar Stoney for calling for a Richmond mayor who shows 'good judgment, good character' and doesn't show up in unflattering stories on newspaper front pages and television screens."

"It takes us 10 to 20 steps back and we can't afford it," Stoney said.

Morrissey lashed back, telling Stoney -- a former chairman of the state Democratic Party and pals with Gov. Terry McAuliffe -- "You've got to come into the job with some experience other than being just a political operative."

The nastiness overshadowed any discussion among the six of eight Democratic mayoral candidates of the many tough issues facing the city of Richmond, from murky finances to ongoing efforts to improve its schools. The city Democratic Committee is expected to endorse one of the candidates later this week.

Last week's news reported that even as he faces new charges from the Virginia State Bar, former state Del. Joe Morrissey leads an eight-person pack of Richmond mayoral candidates with 28 percent of the vote, according to a poll released  by Christopher Newport University's Wason Center for Public Policy.

 

At the no. 2 spot: Jack Berry, the former director of Venture Richmond, who found support among 16 percent of 600 voters polled. Nearly a quarter of voters polled said they had not yet decided for whom they will vote, reports the Times-Dispatch.

 

	Leader of the pack

"With a little over two months to go, Joe Morrissey is in a very strong position," said Quentin Kidd, who oversaw the poll and directs the Wason Center.

 

"If he is unable to win the election outright, he will almost certainly be one of the two candidates in a runoff," Kidd told the TD. "The real contest at this point might be over whether any of the other candidates can bump Jack Berry out of second place."

 

To win the race, a candidate must get the most votes in at least five of the city's nine voter districts. If no candidate does that, a runoff election will be held Dec. 20 between the top two vote-getters.

The race has worried "members of Richmond's heavily white business class" who want "to stop enfant terrible Joe Morrissey from becoming mayor." This requires forcing out one or more of their candidates, possibly Jon Baliles, Bruce Tyler or Levar Stoney, opines TD political commentator Jeff E. Schapiro, noting that Democrats have been fretting for some time about Morrissey's growing lead. "But who to throw under the bus? And who among the other candidates is prepared to put the city ahead of themselves?"

Morrissey, meanwhile, appears to be enjoying himself abroad, Schapiro notes, as "he and Myrna, his alleged sexting partner-turned-wife and the mother of two of his five children by four women are traveling abroad. They were spotted earlier this week by a vacationing Virginia lobbyist at the Scottish golf mecca, St. Andrews."

Said political commentator Bob Holsworth: "The election is becoming, at least in part, a referendum on Joe Morrissey. The poll indicates that the strength of his support is stronger and deeper than many of his detractors had believed."

 

Last week, the TD reported that Virginia State Bar investigators "say they can prove" that Morrissey presented a "knowingly false" defense in 2014 against charges that he had sex with a 17-year-old receptionist working in his law office.

 

As a result, Morrissey once again faces the suspension of his law license." He lost it in 2003 after a disciplinary panel disbarred him at the federal level, citing, in part, Morrissey's "chronic disregard for truthfulness."

 

The Supreme Court of Virginia reinstated his law license in 2012, against the recommendation of the State Bar's disciplinary board, the TD reports.

Thinking of Replacing Sen. Tim Kaine? Get in Line!

 

Even before the November presidential election results are in, "Virginia Democrats are lining up to replace Tim Kaine in the Senate if he moves to the vice presidency," notes this Times-Dispatch editorial.

"Gov. Terry McAuliffe reports that about 20 wannabes have contacted him about being appointed to the vacancy that would occur if the Clinton-Kaine ticket prevails in November."

 

At the front of the line is 3^rd District Congressman Bobby Scott.

"McAuliffe says a 2017 special election could determine partisan control" of the Senate. "Larry Sabato's Crystal Ball predicts Democrats will take the Senate in 2016, perhaps in a 50-50 split with a Democratic vice president - Kaine - breaking the tie."

 

That reminds us of the recent even split in Virginia's Senate, where Democratic Lt. Gov. Ralph Northam has cast the tie vote. More food for thought ahead of next Tuesday's appearance at RAM by Mr. Crystal Ball himself -- Dr. Larry Sabato! 

CMS Pays Nearly $1.5 billion in Medicare Billing Settlement

 

A year after paying nearly $1.5 billion to more than a third of U.S. hospitals - with a number in the Richmond area - the Obama administration has disclosed who paid what. Click here for the Kaiser report on the payouts, and here for the entire list (which, alas, is not in alphabetical order).

 

More than 2,000 hospitals shared in the government payouts which represented "a compromise to reduce a swollen backlog of disputes over what hospitals argued they were owed."

Reach Out!  

We draw from a wide range of print, online and medical journals to bring you information we hope is relevant to your practice of medicine.

 

	Seeking inspiration at the Temple of Confucius in Beijing

But as a former journalist and nonfiction author, I recognize that mistakes do happen. So please contact me if you have any concerns, complaints, or ideas/articles you'd like to share by clicking here or calling 622-8136.

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Chip Jones
RAM Communications & Marketing Director