Tampa Bay Medical News 2015

By J.B. BITAR, MD, FACC, AND SUSAN BITAR, MSN, RN

It’s reasonable to say the outlook for physician providers is grim.

As pressure keeps mounting on phy-sicians, some will seek early retirement, administrative positions or similar non-patient care employment, or change ca-

reers. Already, many physicians in private practices are being acquired by hospitals as employees. Their hopes are to avoid a reduction in pay and administrative bur-dens brought by Meaningful Use (MU) mandates. Most hospital-employed physi-cians now realize they cannot escape ei-ther problem.

For doctors to focus solely on patient in post-ACA era,

collective bargaining is needed

Exodus from Private Practice?

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PHYSICIAN SPOTLIGHT

Murray L. Shames, MD

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(CONTINUED ON PAGE 4)

By LUCy SCHULTZE

A new kidney transplant program serving the Tampa Bay area is on track for launch this spring, with a renowned transplant surgeon at the helm fa-cilitating the program’s development.

Hussein Osman-Mohamed, MD, PhD, joined the staff of Largo Medical Center in December as medical director of its new Transplant Institute of Flor-ida (TIF). Since then, he has been putting the necessary staff in place to begin providing transplant services, while also overseeing the recent opening of Largo’s Hepatobiliary


Largo Medical Center to Debut Kidney Transplant ProgramTransplant Institute of Florida provides new service in Pinellas County

Practicing Medicine without PoliticsVolunteer physicians enjoy camaraderie at free clinics, made possible by state’s strong sovereign immunity law ... 5

What Does UnitedHealth’s Latest Move on Hysterectomies Mean?Nation’s largest health insurer stiffens rules on hysterectomy coverage ... 7

Exodus from Private Practice?Exodus from Private Practice?

A new kidney transplant program serving the Tampa Bay area is on track for launch this spring, with a renowned transplant surgeon at the helm fa-

Hussein Osman-Mohamed, MD, PhD, joined the staff of Largo Medical Center in December as medical director of its new Transplant Institute of Flor-ida (TIF). Since then, he has been putting the necessary staff in place to begin providing transplant services, while also overseeing the recent opening of Largo’s Hepatobiliary


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By JEFF WEBB

TAMPA - Ask Murray Shames about his goal, and there is not a trace of un-certainty in his answer: “Build the best vascular surgery residency program in the country.”

Now in his ninth year as director of the program, Shames is making sure his peers throughout the country are aware of his plans, and that the profile of the Uni-versity of South Florida’s Division of Vas-cular Surgery remains dominant.

“We were one of the first integrated vascular programs in the country,” said Shames, 47. “Our program consistently attracts top-notch applicants. We have grown to 10 residents and fellows (and) I would like us to be recognized nationally as the best academic and clinical training program in the country,” he said.

To that end, Shames, has become a well-traveled ambassador as he builds the program’s brand. “I’ve always traveled a fair amount, but this past year has been absolutely brutal,” said Shames. For ex-ample, during a recent week in March he was in Chicago on Sunday, then New Orleans on Thursday and Friday, and back to Tampa on Saturday. After taking a short family vacation in Colorado, he then trekked to California, Miami, Chi-cago and London.

“A lot of it is national and regional meetings and invited speaking. A lot is education-based. I work with a group of people who are program directors inter-ested in simulation and education. We’ve developed training courses. We run a course in Houston, in New Orleans, one here in Tampa,” he said. “I have been an architect of the program (here) and the whole national program.”

“It’s a way to build the program name, or as my boss (Karl Illig, MD and director of the Division of Vascular Sur-gery) says, ‘to wave the USF flag.’ It builds the reputation of the program to have fac-ulty at these meetings,” Shames said. The number of invites Shames receives has increased his opportunity to spread the word “now that I have pretty significant national recognition. Building relation-ships with other facilities and faculty peo-ple helps a lot in recruiting residents,” said Shames, a full professor of both surgery and radiology at USF.

“We have outstanding clinical talent” in the residency program, which, along with the rest of the Division of Vascular Surgery operates from Tampa General Hospital. “We have lots of opportunity and our volume of cases is really top-notch, so we attract good people, Shames explained. “We have had residents who have gone on to become chiefs of divi-

sions and program directors at other in-stitutions.”

Shames said research will become an even bigger component for his residency program. “We are going to institute a mandatory research year for our inte-grated residents, which will make them stronger candidates to remain in academic

surgery, attend more national meetings, and get more reputation for themselves as well as the division. The use of the re-sources over at CAMLS for simulation and education are clearly one of our great-est assets,” said Shames, referring to the USF owned-and-operated Center for Ad-vanced Learning and Simulation, where

students from all over the world come to train before operating on real patients. “We hope to become a training and test-ing center for the fundamentals of vascular surgery,” he said.

In addition, Shames is focused on continuing to develop the Center for Aortic Disease, which is “a multidisci-plinary team of surgeons, radiologists and Tampa General Hospital leadership to make TGH a center of excellence in the treatment of aortic diseases,” he said, and where he can combine his “research in-terest in aortic aneurysm pathophysiology and clinical interest in endovascular aortic surgery.”

Shames’ administrative, teaching and research responsibilities are in addition to his work as a vascular surgeon who spe-cializes in complex aortic cases. The Divi-sion of Vascular Surgery logs about 2,000 surgeries a year and Shames handles about 600 of those, including “a signifi-cant number of peripheral endovascular and vein procedures,” he said.

His combined efforts earned him praise from his colleagues, including Deana Nelson, executive vice president & COO at Tampa General, who described Shames as “one of the hardest-working and most

PhysicianSpotlight

Murray L. Shames, MDProgram Director, Vascular Surgery Residency Fellowship, University of South Florida at Tampa General Hospital


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Center within the TIF.“Ours will be the only transplant cen-

ter in Pinellas County, as well as the only hepatobiliary center with a multidisci-plinary approach,” Mohamed said. “This is a huge county, with many physicians in related specialties and a wide variety of patients who previously had to travel across the bay to access services like this.”

Mohamed joined Largo Medical Center from Tampa General Hospital, where he was an abdominal organ (liver, kidney and pancreas) transplant and hep-atobiliary surgeon who also performed minimally invasive surgeries. Additionally, he is an affiliated assistant professor with University of South Florida.

Mohamed holds a medical degree from Ain Shams University Faculty of Medicine in Cairo, Egypt. He completed his training at the Medical University of South Carolina in Charleston and at the University of Pitts-burgh Transplantation Institute.

Mohamed was attracted to Largo for the opportunity to build a transplant pro-gram from the ground up.

“We’re working to build this program the right way from the start, in terms of the personnel we need and the way they’re

able to work together as a team,” he said. “Teamwork is very important in transplant surgery, and it’s also a value I’ve seen here at Largo beyond our program. Everybody is so excited about having this program, they’re eager to help in any way they can.”

Teamwork is also a key aspect of care at Largo Medical Center’s new Hepatobi-liary Center, which began seeing patients in January. Its multidisciplinary approach enlists a range of specialists – from hepa-tologists and oncologists to interventional radiologists and pathologists – to provide a customized treatment plan for each in-dividual patient.

“A part of our design is for all of these specialists to sit down together and talk about every single patient, to determine what ap-proach to take in treating, for example, a pa-tient’s liver tumor,” Mohamed said. “That’s the kind of program we are building.”

The Hepatobiliary Center treats con-ditions of the liver, pancreas and gall blad-der. Services include resection procedures, surgical management and advanced diag-nostic and therapeutic endoscopy. Liver cancer treatments provided through the center include Yttrium-90 microsphere therapy (SIRT); chemotherapy and tar-

geted therapy for hepatocellular car-cinoma (HCC) including transarterial chemoembolism (TACE).

Procedures through the Hepatobili-ary Center are being performed at Largo Medical Center’s main campus at 14th Street in Largo. That is also where kidney transplants will take place once TIF se-cures approval from the United Network for Organ Sharing (UNOS), the final step in the approval process.

The establishment of the Transplant Institute of Florida culminates a long-term effort for Largo Medical Center. The hos-pital filed a kidney transplant program letter of intent and application during the fourth quarter of 2013. Florida’s Agency for Health Care Administration granted its certificate of need in March 2014, au-thorizing the hospital to serve the state’s Transplantation Area 2 comprised of 13 counties. Largo’s will be one of eight pro-grams in the state approved to provide kidney transplants.

The Transplant Institute’s clinic space will be housed in a diagnostic build-ing adjacent to the hospital.

For living donors, the transplant pro-gram will provide minimally invasive lapa-

roscopic kidney removal, Mohamed said.“The statistic in general for any trans-

plant center is that 25 to 30 percent of do-nors are living donors,” he said. “These are healthy people, and we’re able to offer them an easier recovery and less scarring through minimally invasive techniques.”

For patients for whom a living kidney donor has volunteered but has been found not to be a match, a new registry through the National Kidney Registry (NKR) as well as paired kidney donation now helps in-crease the chance that a good match can be found. The Kidney Paired Donation Pilot Program provides a database that allows pa-tients in need of a kidney to exchange their donors in order to find a compatible match.

“The pool includes donors from all over the country,” Mohamed said “The registry is helping to provide more donor matches than ever, giving us another re-source to help restore kidney function to our transplant patients.”

To follow the development of Largo Medical’s Transplant Institute of Florida, visit largomedical.com.

Largo Medical Center, continued from page 1

talented doctors at Tampa General.”One of Shames’ mentors is Dennis

Bandyk, MD, who was USF Vascular Surgery Division director for 20 years until 2011. Bandyk is now chief of vascu-lar surgery at the University of California San Diego, but remains in contact with the protege-turned-prodigy he first met as a general surgery resident in Tampa.

“We were really lucky to get him back at USF after his fellowships,” said Ban-dyk, 67. “He’s a very good surgeon and cares a lot about his patients. But he also cares a great deal about educating others to become vascular surgeons. Murray has

always been a leader and he has excelled to become one of the most respected edu-cators in the nation,” said Bandyk. “His career hasn’t plateaued yet.”

Considering how much time Shames spends delivering speeches and lectures, it is inspiring to note that he “hates public speaking.” Shames said he has “embraced it as a way to conquer the fear, sort of an immersion therapy. … Rather than shy away from it, I accepted every opportu-nity. I don’t get as nervous and sweaty as I once did, but it still kind of freaks me out a little,” he laughed, adding that he used to practice with and seek advice from his

wife, Francie Linsky Shames.Shames is a native of South Africa

who moved to the U.S. in 1985, about two years before he enrolled at the University of Pennsylvania. That is where he met Fran-cie, who grew up in Tampa, in 1988. The couple moved to Bronx, N.Y., where he earned his MD at Albert Einstein College of Medicine in 1994. He got matched to USF for his general surgical residency and after that he continued his training for a year in Australia, and then completed his vascular surgery fellowship at Washington University School of Medicine in St. Louis.

Shames and Francie, an architect who

consults mostly as an interior designer, de-cided that Tampa would provide the qual-ity of life they wanted for the family they planned, so they moved back to Tampa. The couple now has daughters, ages 12 and 8.

Tampa also feeds Shames’ love of the water. “I grew up sailing. … My family and I spend a vacation every summer sailing around the British Virgin Islands on a cata-maran. I truly love the peace and quiet, and the time with my family without the distrac-tions of work, electronics, TV,” he said.

Murray L. Shames, MD, continued from page 3

PhysicianSpotlight

As the physician shortage worsens, the gap is being filled by the growing employ-ment of allied health extenders. The cost of medical education is quite high, and post-graduate medical education requires years of residency and fellowship training – a huge time and financial commitment in higher medical education that may not yield a return on investment.

Two solutions may help solve this di-lemma:

1. Physicians need to be represented by a group that addresses the following non-medical issues: restrictions imposed by regulations, insurance plan interference with care, and unfair compensation that’s out of line with the commitment of medical education. The Association of Independent Doctors could represent these issues on be-half of physicians.

2. Physicians may accomplish the same goal by tapping into the already existing

American Medical Association (AMA) via local, state, and national branches. By hav-ing thousands of solo physicians as members, the shared discontent with heavy-handed regulations and dwindling fees may be ex-pressed to garner a more favorable outcome.

Membership would demand expedit-ing these pressing issues to the forefront of the legislative agenda in Washington, DC. This would redirect the AMA to deal with real obstacles facing local physicians. By joining forces, a momentum would be created by the physician manpower in this country – and also capture attention at the local, state, and federal level.

By lobbying on Capitol Hill, physician voices may be heard in unison. The control over how to treat patients would shift from insurance plans back to providers, where it belongs. Payment should be proportionate with the medical service provided – not with what CMS or private insurance plans deem

appropriate. The focus should shift from MU measures to a true and simple mean-ingful healthcare relationship between two people: the physician and the patient.

Actions the AMA could take to grab the attention of the politicians in Washing-ton, DC:

Request that members collectively be-come non-participants in the Medicare/ Medicaid program. Certain specialties are already non-participants.

Call for members collectively to not accept Medicare HMOs or private insur-ance contracts unless the reimbursement is higher than 100 percent of the local geo-graphic Medicare fee schedule.

Recommend implementing an admin-istrative service fee for processing or obtain-ing authorizations on insurance claims, and also charging insurance plans a set fee for unnecessary denials that cost a practice time and money. This may stop the game of deni-

als played by the insurance industry to avoid or delay reimbursement for services.

After all, at the heart of the matter is the physician-patient relationship. The pa-tient and the provider may disagree with what the payer may deem quality care. The quality of care exists when the doctor provides safe and effective care for the pa-tient, and the patient is satisfied with the care rendered by the doctor. It’s not quality care when the doctor cannot control when or how to treat a patient, or when the pro-vider has to play by the payer’s rules to re-ceive a payment on behalf of the patient.

Personalization and the professional relationship between a physician and pa-tient is a quality that cannot always be cap-tured by mandates.

J.B. Bitar, MD, FACC, and his wife, Susan Bitar, MSN, RN, practice at Cardiology Care Center in Lake Mary.

Exodus from Private Practice, continued from page 1


By JULIE PARKER

Every Monday afternoon, retired Clearwater cardiologist Paul Kudelko, DO, FACC, heads to the Clearwater Free Clinic in Clearwater to volunteer with third-year residents from Nova Southeastern Univer-sity near Fort Lauderdale. He’ll return on Thursday morning to see patients.

In Orlando, internal medicine spe-cialist Doris Cameron, MD, spends eight hours a week volunteering at Shepherd’s Hope, and a half-day on Friday at Grace Medical Home.

Besides being motivated by the pure enjoyment of practicing medicine without

the politics while also giving back to their local communities, both physicians say volunteering in the free clinic arena is only possible because of Florida’s strong sover-eign immunity laws.

“Many physicians shy away from vol-unteering at free clinics because they don’t understand how sovereign immunity cov-ers them completely,” said Cameron. “If physicians were better educated about

how sovereign immunity works in Florida, more would volunteer. Until then, their concern about liability remains a signifi-cant barrier.”

Cameron began volunteering in 2009, three years before Florida lawmakers strengthened the sovereign immunity law. Initially, she volunteered at Shepherd’s Hope a few hours a week. The mother of

three added Grace Medical Home to the rotation when it opened in 2010.

“I was so concerned about the liabil-ity that I kept my medical malpractice in-surance for a year while I researched the state’s sovereign immunity law to see if it really worked,” she said. “After I looked into it and saw the law had held up to chal-

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Practicing Medicine without Politics

‘‘Many physicians shy away from volunteering at free clinics because they don’t understand how sovereign immunity covers them completely ... If physicians were better educated about how sovereign immunity works in Florida, more would volunteer. Until then, their concern about liability remains a significant barrier.’’ – Doris Cameron, MD

Volunteer physicians enjoy camaraderie at free clinics, made possible by state’s strong sovereign immunity law



By JULIE PARKER

A vital piece of legislation that many physicians remain unaware of makes it easier for them to volunteer at the state’s free and charitable clinics: Florida’s robust sovereign immunity (SI) law, considered the strongest of its kind in the nation.

“When physicians practice and vol-unteer in our free and charitable clinics, they get to practice the pure art of medi-cine,” said Mark Cruise, executive direc-tor of the St. Petersburg-based Florida Association of Free and Charitable Clin-ics (FAFCC).

“They don’t have to worry about medical malpractice,” said Cruise. “There’s no insurance billing. They get to spend as much time as they need with pa-tients. Also, they get to see other colleagues in the community who are volunteering with them and share this rewarding expe-rience outside their daily practice lives.”

Cruise said the state’s 100-plus free and charitable clinics, the most of any state in the nation, are operating in part because of the strength of the SI law. It’s also a contributing factor to the opening of six new free and charitable clinics antici-pated in 2015.

Stephanie Garris, JD, executive di-rector of Grace Medical Home in Or-lando and chair of FAFCC’s Public Policy Committee, spends a significant amount of time monitoring legislative and regula-tory issues, including keeping a keen eye on potential changes to the SI law.

“That law makes it possible for us to recruit and retain physicians as volun-teers,” she said. “It’s vital to our sector.”

FAFCC’s policy agenda for the 2015 legislative session includes three changes to the SI law:

• Removing language that prohibits SI-covered clinics from receiving state funds to pay for services. Presently, funds form the state appropriation may not be used to help clinics employ or expand the hours of a paid healthcare provider, which repeatedly has been proven to augment volunteer provider recruitment and retention, and to en-hance overall volume, quality and con-tinuity of care.

• Amending the law to clarify that em-ployed and volunteer healthcare pro-viders practicing in SI-covered clinics will be granted sovereign immunity. This change would simply codify Flor-ida’s Department of Health policy and practice.

• Amending the law to permit SI-covered clinics to charge patients a nominal fee, not exceed $10, for administrative costs, if necessary. This change would bring the law up to date with the continuing development of the free and charitable clinic sector in Florida. At press time, two identical bills with

proposed changes were moving through both chambers: Senate Bill 1146, introduced by Sen. David Simmons (R-Altamonte

Springs), had moved to the judiciary com-mittee, and House Bill 965, introduced by Rep. Fred Costello (R–Port Orange ), had been referred to the Health Quality Sub-committee; Appropriations Committee; Health and Human Services Committee.

“We’re optimistic that we can get this passed,” said Cruise.

Retired doctors represent a grow-ing segment of the physician population volunteering at free and charitable clin-

ics. In fact, nearly 15 percent of Florida’s licensed physicians plan to retire in the next five years. Their ability to serve pa-tients who will continue to fall through the cracks is vital as the physician workforce continues to decline. “Physicians typically don’t retire well,” noted Garris. “These brilliant doctors want to serve. The sover-eign immunity law gives them freedom to do so without having to purchase medical malpractice policies.”

Jeannie Shapiro, executive director of the Clearwater Free Clinic in Clearwater, shared that 70 percent of the clinic’s 150 physician volunteers are retired from pri-vate practice.

“They love medicine, and want to give back and provide care,” she said. “Unfortunately, many physicians don’t know about Florida’s sovereign immunity law or we’d have more volunteers!”

That sentiment is echoed by Shep-herd’s Hope CEO Marni Stahlman in Orlando, whose free clinic network allows patients to see doctors in a private practice setting with the agreement that patients will not be charged for a clinic visit.

“It’s a way for them to participate with us without leaving their office, which is sometimes very difficult,” said Stahlman.

In 2012, state lawmakers updated Florida’s SI law, initially enacted in 1992, to protect licensed medical provid-ers through the Volunteer Healthcare Provider Program under Florida’s De-partment of Health (Florida S.S. 766.28 Sovereign Immunity Law).

Any licensed medical provider, while practicing within the scope of their license at a free clinic in Florida, is granted ex-tended SI as long as the patient is living at or below 200 percent of the federal poverty level and is not insured. The law

Protecting Volunteer PhysiciansFlorida’s Sovereign Immunity Law strongest in nation

lenges, I relaxed.”In Clearwater, Kudelko retired in

2010 and spent a year establishing a new lifestyle that included a couple of extended vacations with his wife, Debbie, and read-ing “more books in a year than my entire lifetime,” he said.

“When you’re a physician, you read for educational purposes, which is impor-tant in the field of cardiology that changes so much,” said Kudelko.

But Kudelko yearned to return to the practice of medicine in some aspect. In December 2011, he joined the volunteer staff at Clearwater Free Clinic. When the sovereign immunity laws were improved in 2012, it gave him the peace of mind to add more hours.

“As a retired physician, I do what’s needed to maintain my license, which in-cludes 50 hours of post-graduate or CME credits every two years,” he said. “That’s a financial responsibility of my own. If I wasn’t able to have sovereign immunity, I’d also have to pay quite high fees for medical malpractice insurance. It would be unfeasible to volunteer.”

Cameron had been in private practice for decades and was growing frustrated with the changes in the practice of medi-cine that were, she said, “getting in the way of practicing medicine.”

“I was given five or 10 minutes to see a

patient. I had to be careful about referrals,” she said. “When I volunteer, it’s pretty much my time. We don’t have a lot of spe-cialists, so I can use the knowledge I have to treat the whole patient. I love doing that.”

Recently, Cameron diagnosed a male patient with ALS. He had been to the emergency room several times, didn’t have access to routine medical care, and his symptoms had grown progressively worse.

“Basically, nobody was able to diag-nose him,” she said. “It was a bad diagnosis to give, but it was necessary for him to have an answer and find ways to improve the quality of his life.”

Kudelko also sees patients with symp-toms he normally doesn’t find in cardiol-ogy work, and appreciates the teamwork environment at the free clinic.

“I like the challenge and the fact that we help each other a lot,” he said. “Hav-ing politics as an eliminated part of the equation makes a substantial difference. There are no petty jealousies. Patients sense that. On the flip side, every doctor knows you might get patients who are cranky when they come into the clinic. They’re hurting and don’t really want to be there. By the time they leave, their spirits are much improved. They feel sup-ported by a group of medical providers who really want to be there. That in itself is extremely rewarding.”

Kudelko, a board member of the Clearwater Free Clinic since 2012, was surprised to learn that 70 percent of pa-tients at the free clinic hold a job but don’t qualify for medical care.

“It seemed the intent of the Affordable Care Act was to close the gap, but instead it’s widened the cracks,” he said. “The pa-tient population is very appreciative that someone’s there to help.”

Kudelko was familiar with the Clearwater Free Clinic when he was in private practice. He was also in charge of the internal medicine residency program at Suncoast Hospital, now Largo Medical Center in Largo.

“At that time, we used the free clinic for outpatient training of our residents,” he explained. “Then the hospital developed its own outpatient clinic and our residents no longer went to the free clinic, unfortu-nately. But for quite a few years when we were involved, I was there once a week re-viewing charts.”

Returning to the free clinic in a volun-teer capacity to mentor residents “is such a pleasure,” said Kudelko.

“Even though it’s a learning experi-ence for these young people coming up as I mentor them, they give back to me in more ways than they could imagine,” he said. “The sovereign immunity law makes it all possible.”

Practicing Medicine without Politics, continued from page 5



2629 McCormick Dr. , Sui te 101 | ClEARWATER, FL 337592629 McCormick Dr., Suite 101 | Clearwater, FL 33759

By JULIE PARKER

UnitedHealth Group, the nation’s big-gest player in the health insurance market, recently announced a policy change to nar-row the rules on hysterectomy coverage.

Even though the insurer’s plan to impose tighter restrictions on the use of the morcellator has garnered the most at-tention – many hospitals ceased using the laparoscopic surgical device after the FDA reported in April 2014 the fast-spinning blade can actually spread uterine sarcoma in some women undergoing hysterecto-mies – the squeeze is also being felt on the performance of hysterectomies in general.

UnitedHealth (NYSE: UNH), the insurer of 40 million patients based in Minneapolis, Minn., now requires spe-cific authorization before most types of hysterectomies are performed. Only vaginal hysterectomies – the least inva-sive and inexpensive option – done on an outpatient basis are exempt. The policy doesn’t affect hysterectomies performed in cancer treatment. Approximately half a million hysterectomies are performed annually in the United States.

Before UnitedHealth announced its policy decision, Anthem was the only major commercial insurer requiring pre-authorization for hysterectomies. Cigna and Aetna haven’t indicated they will fol-low suit. An Aetna spokesperson said the decision is “best left up to the physician and patient based on clinical circum-stances,” a position also adopted by the American College of Obstetricians and Gynecologists (ACOG).

Days after UnitedHealth’s an-nouncement, ACOG members buzzed about the issue at an ACOG national leadership conference.

“It’s been good fodder for discussion, though we’re taking it very seriously,” said Ravi Johar, MD, an OB/GYN from St. Louis, Mo., past president of the St. Louis Metropolitan Medical Society. “For Unit-edHealth to reverse course, no one knows exactly what it means.”

Johar, council chair of the Missouri State Medical Association, said OB/GYNs are certainly accustomed to the pre-certifi-cation process.

“We’ll do what we’ve always done,” he said. “We’ll discuss with patients all of the options and go from there. The decision is between the patient and physician. My job is to provide the best medical care possible. How that affects them financially is a big impact, but it’s not my area of expertise.”

UnitedHealth is a good weathervane in the post Affordable Care Act era, with its combination of market power, community support, and access to exceptional data, said Jay Wolfson, DrPH, JD, Distinguished Professor of Public Health, Medicine and Pharmacy at the University of South Flor-

ida (USF) Morsani College of Medicine. “In this case in particular, it’s impor-

tant to recognize that UnitedHealth, over the past couple of years, has been the most aggressive of the health insurers in tighten-ing up their markets,” he said. “They began eliminating a lot of physicians and hospitals from their panels in many communities.”

For example, said Wolfson, cancer and children’s hospitals were removed from Unit-edHealth’s list of risk providers, based on the argument of cost being significantly higher at those healthcare facilities than others.

“Procedures in hospitals like MD Ander-son, Sloan Kettering and Moffitt may cost 50 percent more than non-specialty, community facilities,” he said. “That’s to be expected be-cause they’re teaching hospitals.”

Wolfson also pointed out that United-Health acquired Optum, a healthcare tech-nology firm established in 2010, which he considers one of the “best staffed analytic division of third parties.”

“Optum focuses on quality, outcome and cost-effective analyses of United’s (and other available) databases” said Wolfson. “Their research translates into what, to whom and how much United will pay.”

That influence has infiltrated the health-care industry in many ways. In January 2013, while outsourcing work with Optum before bringing the firm in-house, UnitedHealth Group’s Center for Health Reform and

Modernization proposed the use of predictive mod-eling software, particularly in Medicare and Medicaid programs, as tools for care management and informa-tion security as a possible solution to both healthcare fraud and preventable hos-pitalizations.

“As part of the ACA, they’ll continue to drill down and drive down costs and utili-zation and attempt to be as directive as they can to their patients, physicians, hospitals … to optimize cost, utilization and safety while also reducing liability,” said Wolfson.

Some hospital systems are adopting a tough stance against UnitedHealth’s cull-ing process and policy changes they view as unfavorable.

“Three years ago, BayCare (Health Sys-tem, Tampa Bay’s dominant non-profit hos-pital chain), went up against UnitedHealth over reimbursement issues,” noted Wolfson. “Unlike most standoffs, there was no last minute negotiation and 450,000 members in Tampa Bay had to change hospitals and physicians because BayCare stood its ground against this healthcare delivery powerhouse.”

Wolfson also sees a trend of separate policy issues, in part led by UnitedHealth, that are shaking up the medical device manufacturing industry and the pharma-

ceutical sector.“Until recently, pharmaceutical com-

panies have had a tremendous influence in medical schools and communities concern-ing what medications physicians prescribe,” he said. “Now some medical schools across the country like ours have gone ‘drug-free’ and no longer allow pharmaceutical reps to teach in our classrooms or offer ‘educational’ program lunches.”

The same cycle holds true for manu-facturers of medical devices, Wolfson said.

“The device manufacturing industry has also heavily affected medical practice,” he said. “Their significant influence is waning.”

In response to UnitedHealth’s policy change on hysterectomies, medical schools will place a stronger emphasis on technical skills to perform vaginal hysterectomies.

“We’ve developed a generation of sur-geons who don’t know how to do vaginal surgery, quite frankly,” said Neil Finkler, MD, an OB/GYN in Orlando and CMO at Florida Hospital Orlando.

“So many physicians stopped using vaginal hysterectomies and it’s not being taught very much,” Wolfson added. “Our younger medical students don’t have the skills. It’s easier to use a device, which gener-ates more revenue and becomes a standard. Most clinicians interviewed say it’s safer, less complications, but it’s not done because it’s just not being done. That’ll change.”

What Does UnitedHealth’s Latest Move on Hysterectomies Mean?Nation’s largest health insurer stiffens rules on hysterectomy coverage

Dr. Jay Wolfson


Marijuana, Medicine & AddictionA conversation with ASAM President Dr. Stuart Gitlow

Dr. Stuart Gitlow

also applies to private medical practices, where licensed medical providers often see qualifying patients voluntarily and at no charge.

As a precaution, if a volunteer phy-sician sees an existing patient who is determined to be ineligible for SI – for example, having new insurance or being over-income – the physician would have 30 days of extended SI.

If a volunteer physician is affiliated with a Professional Association (PA) prac-tice, the Florida Department of Health recommends establishing a SI contract to protect the corporation.

Under the SI program, if a patient

served by a volunteer healthcare pro-vider under contract files a lawsuit, the patient may only file it against the state, not the individual provider. In that case, the Department of Insurance will provide legal services, and if the court decides the patient suffered damages as a result, the patient may be awarded damages up to $100,000, paid by the state.

“In the 18 years we’ve been operat-ing, nobody has had a challenge,” said Stahlman. “Shepherd’s Hope and other free and charitable clinics are in need of additional volunteer health professionals and it’s important for those considering it to realize this protection benefit.”

Protecting Volunteer Physicians, continued from page 8

By CINDy SANDERS

With three states plus the District of Columbia sanctioning recreational use of marijuana and virtually all other states either allowing for or considering de-criminalization and/or medical use of the drug, the great marijuana debate has become a leg-islative hot topic over the last three years. For Stu-art Gitlow, MD, MPH, DFAPA, however, talk of medical benefits asso-ciated with inhaling the plant is just smoke and mirrors.

Gitlow, who concludes his term as president of the American Society of Ad-diction Medicine this month, said there are two major issues with the drug … ad-diction and toxicity. The double board-certified psychiatrist, who has a private practice in Rhode Island, is concerned by the possibility of adding marijuana to the mix of alcohol and tobacco as yet another substance with the potential to do more harm than good.

The DrugMarijuana refers to the dried leaves,

flowers, stems and seeds from the hemp plant Cannabis sativa, which contains the mind-altering chemical delta-9-tet-rahydrocannabinol (THC), along with other compounds. The National Institute on Drug Abuse (NIDA) has found mari-juana to be the most common illicit drug in America and one for which usage is on the rise. The national organization stated marijuana’s popularity, particularly since 2007, has coincided with a diminishing public perception of the drug’s risks.

However, at the same time risk per-ception has been declining, the drug’s potency has actually been on the rise. In looking at the amount of THC in mari-juana samples confiscated by the police, the THC concentration averaged close to 15 percent in 2012 as compared to around 4 percent in the 1980s, according to the NIDA fact sheet on marijuana.

Gitlow agreed, saying, “The mari-juana that is available today is much different, much more potent, than the marijuana that was available in the ‘60s. More research needs to be done to see if there are even more long-term issues with this more potent form.”

AddictionGitlow noted marijuana works like

any other addictive drug. “There’s not debate at all within the medical commu-nity that it’s addictive … that’s a given,” he said. “It’s like any other psychoactive drug … it’s not addictive to the majority of those using it once or twice.” However, he continued, “There’s no way of knowing if a person is going to have a problem with the drug until they try it … and then they

are playing Russian roulette.”Gitlow explained, “Ad-

dictive disease is not about the drug, it’s about a brain abnormality. It exists be-fore somebody picks up the drug.” The three fac-tors required for addic-tion, he said, are a genetic abnormality, environmen-tal trigger and the drug. “Addictive disease is in only, give or take, 15 per-cent of the population.”

He added popular consensus is that about 9 percent of adults and 17 percent of adolescents who use marijuana become addicted. In addition, NIDA’s marijuana fact sheet noted addiction rates jump in daily users, with as many as 25-50 percent becoming addicted.

Toxicity“There’s a second issue with mari-

juana, and it’s independent of addiction. Marijuana has toxic ramifications,” Git-low said. “Marijuana makes you stupid,” he stated bluntly. “It lowers IQ. It causes slowing of the processing speed. It causes abnormalities of attention and focus. It ba-sically dumbs you down, and it does that more or less universally.”

When marijuana is smoked, the THC passes quickly from the lungs into the bloodstream and to the brain. THC tar-gets cannabinoid receptors, which have a higher density in areas of the brain that influence pleasure, memory, con-centration, coordination, thinking and time perception. Additionally, THC’s chemical makeup is similar to a naturally occurring brain chemical called anan-damide. That similar structure lets THC be ‘recognized’ by the brain, allowing the outside compound to alter normal brain communication.

Of major concern is the affect mari-juana has on brain development when used heavily among adolescents. A recent study showed marijuana users who began in adolescence had fewer connections in the areas of the brain that control mem-ory and learning. A large, long-term New Zealand study found those who began heavily smoking marijuana in their teens lost an average of eight IQ points between ages 13 and 38. However, that impact on IQ wasn’t replicated in the study among those who didn’t begin smoking until adulthood.

NIDA also cited issues with cardiopul-monary and mental health. Gitlow said, “There’s a five-fold increase in psychotic disorders among those who use marijuana as compared to those who don’t.”

Alcohol vs. Tobacco, MarijuanaLast month, results of a new study

stating marijuana is 114 times less lethal

than alcohol made the media rounds and became fodder for late night comics.

Gitlow said comparing the two is like comparing apples and oranges. “They affect different parts of the brain,” he said.

Gitlow also noted it is possible to ingest enough alcohol in one sitting to kill you, which isn’t really true of mari-juana or tobacco. “So I could make the argument that cigarettes are safer than

alcohol,” he said. However, there aren’t many physicians recommending a patient give up the occasional glass of wine and take up smoking tobacco instead.

“We’re not prohibitionists,” Gitlow continued. “No one at the American So-ciety of Addiction Medicine says alcohol should be banned, but all these drugs col-lectively are an enormous burden on the American public from an economic and health-related standpoint.”

Considering the dangers of tobacco and alcohol, Gitlow said he couldn’t fathom why, as a country, we would want to add marijuana to the mix. “Why would we want to make our burden worse?” he questioned.

Possible BenefitsGitlow reiterated his frustration at

claims of marijuana being a medical mar-vel. “There is no medical purpose. No one has ever proven through a double-blinded trial a medical benefit of marijuana.” He

continued, “That’s not to say there aren’t components within the plant that might not have medical application.”

However, Gitlow said breaking down the more than 100 components in mari-juana would require scientific investiga-tion just like any other drug in this country seeking approval from the Food and Drug Administration. He added marijuana lobbyists bringing anecdotal evidence to legislators interested in the bottom line

doesn’t constitute a thorough re-search endeavor.

NIDA’s viewpoint is similar, noting that so far

clinical evidence does not show the therapeutic benefits of marijuana outweigh the health

risk. In it’s assessment of the drug, the national organiza-

tion stated, “To be considered a legitimate medicine by the FDA, a substance must have well-defined and measurable ingre-dients that are consistent from one unit (such as a pill or injection) to the next. As the marijuana plant contains hundreds of chemical compounds that may have dif-ferent effects and that vary from plant to plant, and because the plant is typically ingested via smoking, its use as a medicine is difficult to evaluate.

“However, THC-based drugs to treat pain and nausea are already FDA approved and prescribed, and scientists continue to investigate the medicinal properties of other chemicals found in the cannabis plant – such as cannabidiol, a non-psychoactive cannabinoid com-pound that is being studied for its effects at treating pain, pediatric epilepsy, and other disorders.”

With the increased attention being given to marijuana around the country, it’s a safe assumption that opponents and proponents will continue the debate.


By CINDy SANDERS

Patients increasingly want to access online services to enhance convenience and communication with providers, ac-cording to a recent national survey con-ducted by TechnologyAdvice Research. Yet, the majority of respondents in the “2015 Trends in Patient Engagement” survey said a number of digital solutions that would be helpful are not offered by their primary care practices.

“Only 19 percent said their physician of-fered online appoint-ment scheduling,” noted Cameron Graham, survey author and man-aging editor for Technol-ogyAdvice, a company that conducts research and analysis of IT prod-ucts in a number of industries including healthcare. “Only 17 percent said their physician offered online bill pay.”

In addition to scheduling and pay-ment functions, Graham said viewing test results or diagnoses online also ranked high among survey participants. However, only 27.8 percent said their physician pro-vided that option. Graham pointed out all three of the most desired digital services are fundamental patient portal features. With that in mind, he continued, “There’s a big discrepancy between what patients report having access to and the EHR adoption rate among physicians.”

Graham said electronic health re-cord adoption rates are in the “high 70s, low 80s” by office-based physicians in the United States. “A lot of those systems should have online appointment and bill pay capabilities,” he said, adding some of the older systems might not have those op-tions but virtually all newer products offer robust patient portal resources.

“I think one of the big takeaways is that the patients don’t seem to be aware of the tools their physicians probably have,” he said. The other option, Graham con-tinued, is that offices have these capabili-ties but are not using them. Either answer could spell trouble for practices.

“When we asked how important these services were when people were choosing a physician, 60.8 percent said it was ‘important’ or ‘somewhat important,’’ Graham said. “If physicians are offering these in-demand digital services, a more proactive approach to promoting them is needed and could create an advantage in attracting and retaining patients.”

Graham added he also believes physi-cians need to more fully embrace digital services. “Patients value them a lot. Phy-sicians think of them as an extra or add-on.” With meaningful use requirements staged to increase health information ex-change and promote patient engagement, Graham noted the effective use of patient

portals could help practices hit the neces-sary benchmarks to access incentives.

However, he noted, there probably won’t be a ‘one size fits all’ solution when it comes to patient engagement. “We did find age played a role in which services patients wanted their physicians to offer,” he said. Not surprisingly, the demand was much higher by younger adults than in the senior population. “Among the 25- to 34-year-old demographic, almost 40 per-cent said they would like to have a smart phone app for scheduling appointments; but among the 65 and older demographic, only 3.8 percent said that would be some-thing they’d want.”

Similarly, 35.3 percent of patients ages 25-34 would like for their physician practice to offer secure messaging outside of office hours compared to just 11.5 per-cent of those ages 65 and older. Of the six digital services listed on the survey (online appointment scheduling, smartphone app for scheduling, online test results/diagno-ses, online bill pay, secure messaging, and health resources/educational material),

23.5 percent of those ages 25-34 reported they didn’t want their physician to offer any of the services, while 44.2 percent of partici-pants 65 and older had that same response.

Graham continued, “I think it’s im-portant for physicians to be aware of what these different demographic groups want.” He added such information could help providers tailor their message accord-ingly when discussing the different ways patients could access the practice and en-gage with providers.

Another disconnect highlighted by the survey was provider follow-up. While 68.6 percent of respondents said it was ei-ther ‘very important’ or ‘somewhat impor-tant’ that a physician follow up with them, only 30 percent reported receiving any follow-up from the practice that wasn’t tied to bill pay. “They’re very good about following up related to money,” Graham pointed out, but patients want more than that. In addition to building rapport with a patient, Graham said digital communi-cation offers an easy way to make sure in-structions were understood and are being

followed, check on medication adherence, share prevention tips, and remind patients about the need to schedule routine screen-ings and services.

The “Trends in Patient Engagement” survey included responses from more than 400 adults across the United States re-garding their digital experience at primary care practices. The survey was conducted Jan. 5-7, 2015. A download of the survey whitepaper is available at technologyad-vice.com/research.

TechnologyAdvice, which is head-quartered in Brentwood, Tenn., offers free, neutral research and analysis of IT prod-ucts to connect businesses with technology options that best address each company’s specific needs. The company works with businesses and practices looking for the right software for just a few people up to large enterprises in need of solutions for thousands and has assisted Apple, Oracle and HP in selecting new technology. Last year, TechnologyAdvice was named to the top half of the Inc. 5000 list of America’s fastest-growing private companies.

Survey Says … A Digital Disconnect Exists Between Patients, Practices

Cameron Graham

TechnologyAdvice helps educate, advise, and connect businesses of all sizes. We are a market leader in business technology recommendations, and help our clients better navigate emerging industries through original, unbiased research. Find additional studies and product analysis at TechnologyAdvice.com.

Talk to an expert! 877.917.7644 ext. 133

Download the full report at:research.technologyadvice.com/trends-in-patient-engagement/

What Digital ServicesDo Patients Value the Most? Online services play an increasingly

strong role in physician choice


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HCMA Foundation Awards Grants to Local Organizations & A Scholarship

The HCMA Foundation is a 501 (c) (3) charitable organization which provides cash grants to non-profit organizations in the Tampa Bay area for programs de-signed to promote awareness and support of health related issues in Hillsborough County, Florida and surrounding areas. The Foundation’s primary fundraiser is the annual HCMA Foundation Charity Golf Classic.

This year’s grant recipients are:Cherry Bekeart/HCMA Foun-

dation Medical Student scholar-ship. Scholarship applications will be processed and a chosen candidate will be presented with a scholarship at the May 5, 2015 HCMA Installation Dinner Meeting.

Frameworks of Tampa Bay to support their PATHS project which promotes alternative thinking strategies for disadvantaged youth at the Sulphur Springs YMCA.

The Judeo Christian Health Clinic to assist in replenishing the phar-macy shelves in order to provide medicine for uninsured patients, free of charge.

MORE HEALTH to support the “Scrubba Bubba” program which teaches second graders how germs and bacte-ria spread and how they can prevent the spread of disease.

Voices for Children to assist in providing psychological and psychiatric examinations for the benefit of abused and neglected children in Hillsborough County.

For more information about the HCMA Foundation, please contact Elke Lubin at the HCMA office: 813.253.0471 or [email protected].

HCMA Has Gone SocialLike the HCMA on FaceBook (http://

www.facebook.com/HCMADocs). Keep updated on HCMA events and important notices!

HCMA.NET – ALWAYS CHANGINGVisit www.HCMA.net to find a host

of information, including new advertisers, the latest issue of The Bulletin, the HCMA Benefit Providers, a list of the HCMA of-ficers, or a list of upcoming CMEs. You can also peruse the photos from the FMA Annual Meeting, the HCMA Foundation Charity Golf Classic, and recent dinner meetings, or look up an HCMA member’s contact information!

To learn more about the Hillsbor-ough County Medical Association, or to find out how to become a member, please contact the HCMA at 813.253.0471 or visit our website at www.HCMA.net.

Hillsborough County Medical Association News

Thursday, October 29, 2015Tournament Players Club – Tampa BayHCMA Foundation Charity Golf ClassicWe don’t care HOW you play – JUST PLAY!

Golfer registration is $150 (Includes cart, greens fee, goodie bag, lunch, and dinner), raffle item donations are appreciated and sponsorship opportunities (ranging from $300 to $7,500) are available.

For more information contact Elke Lubin or Kay Mills at the HCMA office: 813.253.0471.

Dr. Jose Jimenez

Dr. Danielle Ofri

Dr. Jose Jimenez, a Pediatrician, will be in-stalled as the 2015-2016 HCMA President, suc-ceeding Dr. Devanand Mangar. In addition to Dr. Jimenez’s installa-tion, the 2015 HCMA Election results will be announced, and the Cherry Bekeart/HCMA Foundation Medical Student scholarship will be awarded.

The featured speaker for the dinner meeting, Danielle Ofri, MD, PhD, is the Associate Professor of Medicine, NYU

School of Medicine, Ed-itor-in-Chief, Bellevue Literary Review, and author of “What Doctors Feel: How Emotions Affect the Practice of Medicine.” Dr. Ofri will present, “Surviving Medicine in the 21st Century.”

The event begins at 6:30PM for HCMA members and their guests only. Call Kay Mills at the HCMA: 813-253-0471 for information, including sponsorship and exhibit opportunities.

Tuesday, May 5, 2015InterContinental Hotel, Kennedy & Westshore Blvds.HCMA Presidential Installation Dinner Meeting

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GrandRoundsUSF Health and Florida Orthopaedic Institute Sign Agreement

USF Health, the region only aca-demic health center, and Florida Ortho-paedic Institute (FOI), Florida’s largest private orthopaedic group, have forged a new academic affiliation with the aim of creating a pre-eminent department of orthopaedic surgery at the University of South Florida over the next decade.

As part of this bold new alliance, FOI President Roy W. Sanders, MD has been named chair of the USF Health Morsani College of Medicine fsDepartment of Or-thopaedics and Sports Medicine. Dr. Sand-ers, also director of the FOI Orthopaedic Trauma Service, will continue his executive leadership and clinical roles at FOI while helping advance the USF orthopaedics de-partment to the next level of clinical educa-tion and research excellence as chair.

This new affiliation occurs as David Leffers, MD, the department’s chair since 2009, plans to step down from this post, but he will remain as a full-time associ-ate professor of orthopaedics and sports medicine in the Morsani College of Medi-cine and team physician for the USF Bulls.

Building upon the critical core USF-FOI relationship at Tampa General, the new alliance will expand the array of out-patient sites available to aspiring ortho-paedic surgeons for subspecialty train-ing experiences – a major recruitment advantage in such a highly competitive discipline. It will also offer USF medical and other health science students more opportunities for clinical experiences in orthopaedics and sports medicine.

The agreement allows FOI physi-cians obtaining USF voluntary or part-time faculty appointments to oversee and provide the clinical education and training of all USF orthopaedic resi-dents and postgraduate fellows at Tam-pa General, Florida Hospital Tampa and Florida Hospital Carrollwood, as well as FOI’s ambulatory surgery centers and outpatient offices.

Manatee Memorial Hospital First in Region with Head, Neck Robotic Surgery

Bradenton - Manatee Memorial Hos-pital is the first hospital in the region to of-fer the latest technology in head and neck surgery using the da Vinci® Transoral Ro-botic Surgery (TORS) for treatment of tu-mors of the oropharynx (throat, base of the tongue and tonsils) and for sleep apnea.

Axay S. Kalathia, M.D., an otolaryn-gologist, (ears, nose and throat physi-cian) recently performed the first sur-

gery at the hospital.The da Vinci® Transoral Robotic Sur-

gery (TORS) allows surgeons to operate through the mouth. The system features a magnified 3D high-definition vision sys-tem and special wristed instruments that bend and rotate with far greater range than the human wrist, enabling surgeons to operate with enhanced vision, preci-sion, dexterity and control.

The benefits of treating patients with tumors of the oropharynx with TORS in-clude: reduced operative time with im-proved swallowing function compared with traditional surgery; more rapid recov-ery with shorter hospitalization compared with traditional surgery; better identifica-tion of which patients will benefit from chemotherapy and radiation therapy (rather than giving these treatments with their side effects to all patients routinely); and potentially reduced doses and areas of radiation needed, thus further lowering the risk of swallowing dysfunction.

For patients with sleep apnea, the robotic technology is able to reduce the obstruction at the base of the tongue.

Moffitt Cancer Center Achieves Prestigious Nursing Magnet® Recognition

Moffitt Cancer Center has earned the prestigious Magnet® designation in recognition of its nursing excellence. Magnet recognition is granted by the American Nurses Credentialing Center (ANCC), the credentialing body of the American Nurses Association, to honor outstanding health care organizations for nursing professionalism, teamwork, quality patient care and innovations in nursing practices. Only 7 percent of na-tional and international health care orga-nizations are recognized by the ANCC Magnet Recognition Program®.

Magnet designation is achieved af-ter successfully completing a process in which a team of professionals with experi-ence in quality indicators, nursing admin-istration and nursing care appraises a hos-pital’s nursing services, clinical outcomes and patient care. Research data and ex-tensive interviews help evaluate the nurs-ing practice with respect to the patient, family, community and nursing services.

The Magnet Model is designed to provide a framework for nursing prac-tice, research and measurement of out-comes. Through this framework, ANCC can assess applicants across a number of components and dimensions to gauge an organization’s nursing excellence. The foundation of this model is composed of various elements deemed essential to delivering superior patient care. These include the quality of nursing leader-ship and coordination and collaboration across specialties, as well as processes for measuring and improving the quality and delivery of care.

Medical News is pleased to provide space for press releases by providers in our Grand Rounds section. Content and accuracy of the releases is the sole responsibility of the issuer.

March of Dimes 2015 national ambassador Elijah Jackson, 12, left, and Tampa General Hospital vice president of women’s and children’s services Pam Sanders visit Valeria Chavez and her daughter Amelia as they tour the TGH neonatal intensive care unit on Thursday, March 19, 2015. Elijah was born prematurely at 25 weeks, just over 11 inches long and weighing one pound and 1.5 ounces. He spent seven months in intensive care and had heart surgery, along with respiratory and digestive problems and other issues.

Amelia Chavez, who is being cared for in the Tampa General Hospital neonatal intensive care unit, was born on Valentine’s Day at Tampa General Hospital.

Morton Plant Hospital Hosts Cornerstone Celebration for Doyle Tower

Morton Plant Hospital has advanced to the next phase of its master facility plan with a groundbreaking ceremony in which a cornerstone will be set for the Doyle pa-tient and surgical tower. The new tower is the centerpiece of a transformation to help the hospital meet the community’s health care needs for the future.

The new four-story Doyle Tower, located on the east side of the main hospital building, will feature private rooms, an additional main entrance to the hospital, and new surgical, women’s orthopedic platforms. The new tower is named in honor of Roz Doyle for her support of the hospital’s commitment to improving the health of the community.

Additionally, Kate Tiedemann has made a major gift to fund an Intraoperative MRI that will be part of the new surgical platform in the Doyle Tower expected to open next year.

Morton Plant’s $200 million campus transformation project is planned to take ap-proximately four years and be completed in 2016, the hospital’s 100th anniversary. It will add over 200,000 square feet to the hospital’s patient care and ancillary services space. Begun in 2012, the project initially focused on preparing the hospital’s infra-structure and utilities for the campus transformation.

Roz Doyle (left) on hand with Kate Tiedemann to celebrate cornerstone celebration.

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Tampa Bay Medical News 2015