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RoundsThe laTesT news foR pRimaRy caRe physicians fRom cleveland clinicseptember/october 2010
inside
Cleveland Clinic Offers Acupuncture for Athletes and Active Individuals
Rheumatology and Orthopaedic Consults Available Across the Region
Cleveland Clinic Urologists Studying New Prostate Cancer Test
B-Aware: Brain Tumor and Neuro-Oncology Center Launches New Brain Metastasis Initiative
New Hernia Center Streamlines Care
Staff Notes
Coming Events
Thyroid center offers comprehensive patient Guide
cleveland clinic’s endocrinology & metabolism institute has a rich history of innova-
tion dating back to the organization’s founding, when George crile sr., md, earned
national acclaim for achieving the lowest mortality rates for thyroidectomies. Today,
the Thyroid center is internationally recognized for expertise in thyroid ultrasound,
novel diagnostic markers and genetic evaluations of thyroid cancer patients. it is one
of the only centers in the country offering radiofrequency ablation of liver metastases
from thyroid cancer, and several team members have expertise in robotic surgery.
our endocrine services are consistently ranked in the Top 10 in the nation by
U.S.News & World Report and are no. 1 in ohio.
collaboration among specialists is a hallmark of the Thyroid center. experts from a
variety of cleveland clinic specialties, including endocrinologists, endocrine surgeons,
pathologists, radiologists, genomic medicine experts, oncologists from Taussig cancer
institute and others, work hand-in-hand with referring physicians to offer seamless
care to patients with a wide variety of thyroid conditions.
patients benefit not only from the center’s clinical experience, but also from an
active research program that plays a leading role in the development and testing
of new treatments.
The Thyroid center recently produced a comprehensive guide to the treatment of
thyroid disease. if you are interested in obtaining free copies to offer to your patients
with thyroid conditions, please contact natalie weigl at 216.448.1055.
to schedule a referral to the thyroid center, call 216.445.5800 or toll-free
888.851.5232. n
services for physicians
referring physician center
for help with service-related issues, information about our clinical
specialists and services, details about cme opportunities and
more, contact us at [email protected], or 216.448.0900 or toll-free
888.637.0568.
critical care transport WorldWide
cleveland clinic’s critical care transport team and fleet of mobile icU
vehicles, helicopters and fixed-wing aircraft serve critically ill and highly
complex patients across the globe.
To arrange a transfer for sTemi (sT elevated myocardial infarction), acute
stroke, ich (intracerebral hemorrhage), sah (subarachnoid hemorrhage)
or aortic syndromes, call 877.379.code (2633). for all other critical
care transfers, call 216.444.8302 or 800.553.5056.
request for medical records
216.444.2640 or toll-free 800.225.2273, ext. 42640
track your patient’s care online
drconnect offers referring physicians secure access to their patient’s
treatment progress while at cleveland clinic. To establish a drconnect
account, visit clevelandclinic.org/drconnect or email [email protected].
remote consults
online medical second opinions from cleveland clinic’s myconsult
are particularly valuable for patients who wish to avoid the time
and expense of travel. visit clevelandclinic.org/myconsult, email
[email protected] or call 800.223.2273, ext. 43223.
outcomes data
view the latest clinical outcomes book from many cleveland clinic
institutes at clevelandclinic.org/quality/outcomes.
services for patients
medical concierge
complimentary assistance for
out-of-state patients and families
800.223.2273, ext. 55580, or
email [email protected]
global patient services
complimentary assistance
for national and international
patients and families
001.216.444.8184 or visit
clevelandclinic.org/gps
General patient Referral
24/7 hospital transfers or
physician consults
800.553.5056
on the web at clevelandclinic.org
Stay connected to Cleveland Clinic:
cleveland clinic offers acupuncture for athletes and active individuals
cleveland clinic sports health now offers acupuncture as one
component of multidisciplinary care for patients with athletic
injuries or orthopaedic disorders.
acupuncture may be combined with standard therapy for overuse
injuries, such as plantar fasciitis in runners, for example.
frank caruso, lac, a licensed acupuncturist who focuses on
athletic and orthopaedic disorders, explains that acupuncture can:
• speed recovery from acute sports injuries
• enhance athletic conditioning
• prevent reinjury
acupuncture may also assist in managing conditions that inter-
fere with athletic performance, such as allergies, headaches,
neck pain, anxiety and irritable bowel syndrome, he says.
colonic stenting now at select Regional hospitals
colonic stenting, a unique procedure used to preserve large
bowel function despite blockage from cancer, is available at
two convenient locations on the east and west sides of town,
at cleveland clinic fairview and hillcrest hospitals.
diya alaedeen, md, general surgeon at fairview hospital,
and Joel anderson, md, general surgeon at hillcrest
hospital, are among the few cleveland clinic physicians
outside of main campus who offer the procedure.
The management of colon cancers involves several special-
ists. colonic stenting is an option for patients with advanced
colon cancers who cannot tolerate a major surgical resection
without allowing for immediate alternative therapies.
a colonic stent is a self-expanding wire mesh tube inserted
via the rectum to hold open a blockage in the bowel. once
implanted, the stent can remain in place permanently. it is
effective in relieving the discomfort associated with large
bowel blockage without interfering with daily activities.
to refer a patient for colonic stenting at hillcrest, call
440.449.1101; at fairview, call 440.673.0100. n
pain management services expand to fairview hospital
cleveland clinic’s pain management centers now provide
care at fairview hospital.
Treating more than 10,000 patients a year, the centers
offer some of the nation’s most integrated pain management
programs, including psychiatry, physical therapy, medication
management, surgical intervention and more.
patients have access to the latest innovative treatments and
leading specialists, including emad daoud, md, George
Girgis, do, and fady nageeb, md, who are seeing patients
at fairview hospital.
drs. daoud, Girgis and nageeb specialize in interventional
pain management for back and neck pain as well as, spinal
cord stimulation and neuromodulation for neuropathic
pain, and they are board-certified in pain management and
anesthesiology.
the cleveland clinic fairview pain management center is
located in the fairview medical office building, suite 404,
18099 lorain avenue, at fairview hospital. to arrange a
patient referral or consult, please call 216.476.7331. n
caruso trained at pacific college in san diego. he interned at
the University of california, san diego sports center, and also
at chengdu and nanjing universities in china.
to refer a patient for acupuncture at the cleveland clinic
sports health center, please call 216.986.heal (4325). n
clevelandclinic.org/rounds 3
Rheumatology and Orthopaedic Consults Available Across the Region
Cleveland Clinic’s orthopaedic specialists and rheumatologists can now see
your patients at three new community locations, in Canfield, Middleburg Heights
and Medina.
The orthopaedic specialists available at these locations are experts in:
• shoulder, knee and hip arthroscopy
• hip, knee and ankle joint replacement
• hip and knee resurfacing
• arthroscopy and reconstructive surgery for sports injuries
The rheumatologists who have joined orthopaedic specialists at our
Canfield location offer:
• expertise in lupus, vasculitis and other systemic illnesses
• advanced therapies for osteoporosis and immunologic disorders
• comprehensive care for rheumatoid and psoriatic arthritis, and gout
canfield. In Canfield, telemedicine capabilities streamline consults with
rheumatology subspecialists at our main campus, and minimize preoperative
and postoperative visits for orthopaedic surgery patients. Full physical therapy
services are offered on-site. We are located at 3736 Boardman Canfield Rd.
in Canfield.
middleburg heights. Our new Middleburg Heights location gives
your patients convenient access to Cleveland Clinic specialists in upper
extremity disorders, foot and ankle conditions and sports medicine, and
to our general orthopaedists and podiatrists. Full-service rehabilitation
is also offered on-site. We are located at 7010 Engle Rd., Suite 105, at
Jefferson Park.
medina. At our new Medina location, your patients can see Cleveland
Clinic orthopaedic specialists in joint replacement, knee and shoulder
arthroscopy and osteoarthritis management. Kenneth Greene, MD, and
Joseph Scarcella, MD, are located in the Medina Hospital Medical Office
Building at 970 E. Washington St., Suite 6D.
In addition, our orthopaedic specialists and rheumatologists can see your
patients at our Twinsburg Medical Offices (2365 Edison Blvd., Suite 100).
Our rheumatologists are also available for consults at South Pointe Medical
Office Building (20500 Harvard Rd., Suite 207, Warrensville Heights) and at
Cleveland Clinic Sports Health (34500 Chardon Rd., Willoughby Hills).
to refer patients to any of our locations, please call 216.445.0096 or
800.223.2273, ext. 50096. n
cleveland clinic RoUnds4
The Beachwood family health & surgery center recently installed a maGneTom®
espree, a revolutionary open-bore mRi that combines outstanding image quality
with greater patient comfort. The new unit brings a new dimension to the family
health and surgery center’s expansive imaging capabilities.
open-Bore mRi is at the forefront of imaging technology. The unit has a 70-cm
internal bore, short 125-cm system length, 1.5T field strength and Tim™ (total
imaging matrix) technology. Tim, one of the world’s leading advances in mRi, uses
the most innovative Rf-technology integrated with a radically different matrix coil
design for superior image quality.
and because of the unit’s open bore and short length, it provides a more comfort-
able exam for anxious or claustrophobic patients. when the scan requires that the
patient’s head be in the unit, there are 30 cm of space above the patient’s face,
about twice that of traditional vertical-field open magnets. The new design can
accommodate patients weighing up to 550 pounds.
to refer a patient to beachwood for imaging, please call 216.839.3000. n
imaging institute adds advanced prostate mR
The cleveland clinic imaging institute’s section of
abdominal imaging is now performing and interpreting pros-
tate mR at cleveland clinic’s main campus. prostate mR is
advanced imaging technology that provides accurate, clear
images of the prostate, which helps physicians accurately
diagnose prostate cancer and determine the most effective
treatment plan for patients.
The prostate mR examination is performed without and with
iv gadolinium contrast to diagnose and stage patients with
prostate cancer. Utilizing high-field strength 3T magnets,
a combination of high-resolution T2-weighted imaging,
diffusion-weighted imaging, mR spectroscopy and dynamic
contrast-enhanced (dce) T1-weighted imaging, prostate mR
allows radiologists to assess patients with biopsy-proven or
suspected prostate cancer. patients who are able will have an
endorectal coil placed to obtain the best possible signal-to-
noise ratio.
for more information or to schedule a prostate mr scan
for your patient, please call 216.445.7050. n
Cleveland Clinic Urologists Studying New Prostate Cancer Test
Cleveland Clinic urologists now offer a new screen-
ing test for prostate cancer called PCA3. Compared
to PSA, which is not specific for cancer, PCA3 is a
prostate cancer-specific marker that has been shown
in clinical trials to provide improved sensitivity and
specificity for detection of prostate cancer, and to help
specialists decide on the need for rebiopsy in men
with an elevated PSA and prior negative biopsy.
PCA3 also is being tested in a clinical trial in patients
undergoing radical prostatectomy to test its predictive
value for pathologic outcomes. PCA3 is measured in
urine following a digital rectal exam (DRE).
to schedule a pca3 test for your patients,
please call 216.444.5600. n
open-Bore mRi enhances imaging capabilities in Beachwood
clevelandclinic.org/rounds 5
“for many years, oncologists considered brain metastasis as a
uniformly fatal condition, and treatments were limited to pal-
liative brain radiation,” says Gene Barnett, md, director of the
Brain Tumor and neuro-oncology center at cleveland clinic’s
neurological institute. “over the last two decades, however,
approaches that are more aggressive and accurate have been
developed that may lead to a local cure or sustained control of
the disease in some patients.”
nevertheless, dr. Barnett believes cancer patients with
systemic cancers are poorly informed about the risks of devel-
oping brain metastasis, its early warning signs and modern
therapeutic options available beyond the traditional treatment
of whole-brain radiation.
b-aware program launches
To address this issue, the Brain Tumor and neuro-oncology
center has launched B-aware, a program to educate and
empower patients with information on the risks, symptoms
and treatment options that may increase their life spans and
improve quality of life.
“at the same time, we are actively engaged in developing physi-
cian awareness,” says dr. Barnett. “To that end, we officially
announced the B-aware initiative before physicians who
attended the international symposium on long-Term control
of secondary central nervous system malignancies held last
spring in cleveland.”
The Brain Tumor and neuro-oncology center is collaborating
with the american cancer society to promote the B-aware
program on its website.
To learn more about the B-aware program, please visit
clevelandclinic.org/b-aware.
to refer patients, please call 216.445.8971 or
800.556.5056, ext. 58971, weekdays, 8 a.m. to 5 p.m.;
or 216.444.2000 on nights and weekends and ask for
neuro-oncology staff or the chief neurosurgical or neurologi-
cal resident on call. for pediatric patients, ask for the chief
pediatric neurological resident on call. n
B-aware: Brain Tumor and neuro-oncology center launches new Brain metastasis initiative
an estimated 140,000 to 170,000 patients with common systemic cancers are diagnosed with brain metastasis every year in the United states, particularly patients with breast, lung and kidney cancers, and melanoma.
cleveland clinic RoUnds6
pediatric care expands in western suburbs
cleveland clinic children’s hospital pediatric specialists are
increasing coverage in family health centers in avon and
westlake to improve access for referring physicians and
parents on the west side of cleveland. patients who previously
may have had to travel to cleveland clinic’s main campus can
be seen closer to home by:
• sudeshna mitra, md, pediatric neurology
• steven spaulding, md, pediatric rheumatology
• Kenneth Zahka, md, pediatric cardiology
• meghan Barlow, phd, pediatric psychology
for more information about cleveland clinic children’s
hospital pediatric specialty care throughout the region, visit
clevelandclinic.org/kids.
cleveland clinic children’s hospital provides several
options for healthcare professionals seeking to refer
a pediatric patient:
for consultation: 216.444.3627 (docs) or 800.553.5056
24 hours a day, seven days a week
for emergency referral: 866.ccf.tots (223.8687)
24 hours a day, seven days a week n
cleveland clinic recently established a hernia
center, which formally combines the expertise
of its surgeons who see patients at 15 conve-
nient locations in northeast ohio. part of the
digestive disease institute, the center’s more
than 30 general surgeons perform 1,700
hernia repairs each year, from the routine to
the most complex cases.
The new hernia center is designed so that patients
have easy access to individualized care: comprehensive
evaluations with a board-certified surgeon determine the
best surgical procedure for their specific type of hernia,
which helps avoid repeat hernias and complications.
hernia center locations:
• cleveland clinic main campus
• Beachwood family health & surgery center
• euclid hospital
• fairview hospital
• hillcrest hospital
• independence family health center
• lakewood hospital
• lorain family health & surgery center
• marymount hospital
• solon family health center
• strongsville family health & surgery center
• Twinsburg medical offices
• westlake family health center
• wooster specialty center
• willoughby hills family health center
to make a referral to cleveland clinic’s hernia center,
call 216.444.6644. n
new hernia center streamlines care
clevelandclinic.org/rounds 7
staff notes
new staff
mark Berkowitz, mddepartment of orthopaedic surgery
specialty interests:
all conditions of the foot and ankle including lower extremity trauma
dr. Berkowitz sees patients at cleveland clinic main campus and in middleburg heights.
phone:
216.445.0096
email:
laurence Bilfield, mddepartment of orthopaedic surgery
specialty interests:
general orthopaedic surgery including total joint replacement, arthroscopy, trauma and blood management
dr. Bilfield sees patients at lutheran hospital and the westlake medical office on columbia Road.
phone:
216.445.0096
email:
scott R. Burg, dodepartment of Rheumatic and immunologic diseases
specialty interests:
rheumatoid arthritis, osteoarthritis, systemic lupus and golf-related injuries
dr. Burg sees patients at cleveland clinic main campus, south pointe hospital medical office Building and cleveland clinic sports health on chardon Road.
phone:
216.445.0096
George e. Girgis, dopain management center
specialty interests:
interventional pain management for back and neck pain, neuromodulation for neuropathic pain, osteoporosis, cRps, degenerative joint disease, verte-bral compression fractures and cancer pain management
phone:
216.444.pain (7246) or 800.392.3353 (main campus); 216.476.7331 (fairview hospital); 440.204.7400 (lorain family heath & surgery center)
cleveland clinic RoUnds8
Thomas Graham, mddepartment of orthopaedic surgery chairman, department of innovations vice chairman, department of orthopaedic surgery
specialty interests:
complex reconstructive challenges of the hand and wrist, sophisticated elbow surgery (instability, stiffness, replace-ment), surgical care of the child with congenital hand differences, and care of the professional athlete’s hand and wrist
dr. Graham sees patients at cleveland clinic main campus.
phone:
216.445.0096
John w. hill, mdpain management
specialty interests:
interventional pain management for back and neck pain, spinal cord stimu-lation, intrathecal pump management and medical management of pain
dr. hill sees patients at ashtabula county medical center.
phone:
440.997.6700
sumit Katyal, mdpain management
specialty interests:
interventional pain management for back and neck pain, neuropathic pain, spinal cord stimulation, headache and cRps
phone:
216.444.pain (7246) or 800.392.3353
martin a. markowitz, mdophthalmology — cole eye institute, hillcrest
specialty interests:
comprehensive ophthalmology, cataracts, glaucoma and external diseases of the eye
dr. markowitz sees patients at the hillcrest atrium medical Building.
phone:
440.461.4733
manu mathews, mdpain management
specialty interests:
neuropathic pain, pelvic pain, peripheral vascular disease, chronic chest pain, central pain, post stroke pain, mood disorders associated with pain and neuromodulation (spinal cord and deep brain stimulation)
phone:
216.444.pain (7246) or 800.392.3353
Guy mulligan, mddepartment of endocrinology
specialty interests:
general endocrinology, diabetes and thyroid disorders
dr. mulligan sees patients at cleveland clinic main campus, Twinsburg medical offices and south pointe hospital.
phone:
216.444.6568 (main campus), 330.888.4000 (Twinsburg), 216.295.1010 (south pointe)
clevelandclinic.org/rounds 9
staff notes
sheldon m. oberfeld, mdophthalmology — cole eye institute, hillcrest
specialty interests:
comprehensive ophthalmology, cata-racts, corneal and external diseases of the eye
dr. oberfeld sees patients at the hillcrest atrium medical Building.
phone:
440.461.4733
vernon patterson, dodepartment of orthopaedic surgery
specialty interests:
non-operative sports medicine and overuse injuries in the endurance athlete
dr. patterson sees patients in avon and middleburg heights.
phone:
216.445.0096
paul c. shin, mdpain management
specialty interests:
interventional pain management for back and neck pain, neuromodulation for chronic pain, vertebral compression fractures, osteoporosis, percutane-ous disc decompression, spinal cord stimulation, minimally invasive lumbar decompression, myofascial pain and neuropathic pain
phone:
216.444.pain (7246) or 800.392.3353 (main campus); 216.491.6433 (south pointe hospital)
michael shlonsky, dpmdepartment of orthopaedic surgery
specialty interests:
general podiatry, forefoot surgery, mus-culoskeletal and dermatologic conditions of the foot, diabetic foot care, wound management, screening and education, sports injuries of the foot and ankle, and joint replacement of the toes
dr. shlonsky sees patients at the westlake family health center and the westlake medical office on columbia Road.
phone:
216.445.0096
email:
Ramon Tiu, mdTranslational hematology and oncology Research
specialty interests:
aplastic anemia, leukemia, cytopenia, myelodysplastic syndrome, myelopro-liferative disorders, pancytopenia and paroxysmal nocturnal hemoglobinuria
phone:
216.444.6833
scott a. wagenberg, mdophthalmology — cole eye institute, hillcrest
specialty interests:
comprehensive ophthalmology, cata-racts, glaucoma, corneal and external diseases of the eye and dsaeK
dr. wagenberg sees patients at the hillcrest atrium medical Building.
phone:
440.461.4733
new staff (continued)
cleveland clinic RoUnds10
september 2010
3 8thAnnualPediatricNeurologyUpdateSeminar executive caterers at landerhaven, mayfield heights, oh
10-11 RheumatologyHighlightsReportLIVE, featuringAdvancesinBCellBiology Renaissance hotel, cleveland, oh
11 38thAnnualDermatopathology Self-AssessmentWorkshop
13-14 2010DiabetesandtheHeart— joint-sponsoredwithJoslinDiabetesCenter sheraton hotel, Boston, ma
13-17 2010–2011Preceptorshipin CarotidUltrasoundInterpretation
14 LeadershipDevelopmentforWomenin HealthcareProfessions corporate college east, warrensville heights, oh
17-24 CardiovascularCTTrainingProgram
23-24 Heart-BrainSummit2010 cleveland clinic lou Ruvo center for Brain health, las vegas, nv
24 2010Women’sHealthUpdate cleveland clinic administrative campus, Beachwood, oh
24-25 HotTopicsinHealthcare—AlumniReunion cleveland clinic lou Ruvo center for Brain health, las vegas, nv
28-10/1 2010DigestiveDiseaseInstituteWeek
• InternationalSummitonFibrosisin IntestinalInflammation:Mechanisms andBiologicalTherapies
• 46thGastroenterologyUpdate
• 31stTurnbullSymposium
• 2ndHepatic-Pancreatic-BiliaryCourse LaparoscopicColorectalSurgery
coming events — www.clevelandclinicmeded.com
cme opportunities: live and online Cleveland Clinic’s Center for Continuing Education’s website, clevelandclinicmeded.com, offers convenient, complimentary learning opportunities, from a virtual textbook of medicine (Disease Management Project) and a medical newsfeed refreshed daily to myCME, a system for physicians to manage their CME portfolios. Many live CME courses are hosted in Cleveland, an economical option for business travel.
note: All courses are at the spectacular state-of-the-art InterContinental Hotel & Conference Center on the Cleveland Clinic campus in Cleveland, OH, unless otherwise noted.
october 2010
1 UrologyforthePrimaryCareProvider cleveland clinic administrative campus, Beachwood, oh
1-3 NewEraInternationalMultidisciplinarySharing (NEIMS):AFocusonAcuteIschemicStroke wynn hotel, las vegas, nv
1-6 2010ClevelandClinicEpilepsySymposia This event consists of two events: epileptology: comprehensive Review and practical exercises; and epilepsy surgery: invasive evaluation
7-9 NephrologyUpdate2010 Renaissance cleveland hotel, cleveland, oh
8 CancerSurvivorship
14-16 BestinPractice:ImprovingMRandCTImaging caesar’s palace, las vegas, nv
15-17 13thAnnualEndocrinologyand MetabolismBoardReview
18-19 NanomedicineSummit
21-22 21stCenturyTreatmentofHeartFailure
22-23 RheumatologyHighlightsReportLIVE,featuring AdvancesinBCellBiology westin Times square, new york, ny
22-23 2ndInternationalSymposiumonRoboticKidney andAdrenalSurgery
23 PainManagementforYourPractice cleveland clinic administrative campus, Beachwood, oh
29 24thAnnualClinicSeminarsDermatology
30 EssentialsfortheSpineCareClinician lutheran hospital, cleveland, oh
november 2010
3-4 ObesitySummit2010
On July 13, 2010, U.S. Department of Health and Human
Services Secretary Kathleen Sebelius announced the final
rules regarding the “meaningful use” of electronic health
records (EHR) for the first two years (2011 and 2012) of
what is intended to be a multiyear incentive program. The
rules comprise the guidelines for how healthcare providers
will achieve the meaningful use of health information technol-
ogy and thereby qualify for Medicare and Medicaid incentive
payments under the 2009 American Reinvestment and
Recovery Act.
Simply stated, providers must use a certified EHR system to
achieve a set of practice-related objectives, which, for physi-
cians, include 15 “Core” and any five of 10 “Menu” tasks.
Other regulations issued by the Department of Health and
Human Services (DHHS) describe EHR certification criteria
and standards, as well as new safety and security protec-
tions. As organizations, neither DHHS nor CMS will be
responsible for directly certifying an EHR product as mean-
ingful use compliant. Instead, a number of certifying entities
will be authorized to authenticate EHR systems according to
meaningful use objectives and system requirements.
The Cleveland Clinic Foundation 9500 Euclid Ave. / AC311 Cleveland, OH 44195
The Journey BeginsMoving forward to an electronically connected, information-driven healthcare mode
RoUnds | sepTemBeR/ocToBeR 2010 | The laTesT news foR pRimaRy caRe physicians fRom cleveland clinic
10-CCR-007
Taken together, these announcements resemble a journey’s
itinerary. The ultimate destination, as envisioned by medical
and technology professionals and policymakers, includes
integrated health information technology systems that will
help improve healthcare quality, lower costs, and better
connect physicians and their patients.
As you consider which health information technology system
would be right for you and your practice, please remember
to include the Mypractice community electronic medical
record system among your choices.
to find out more about myPractice Community, call
216.738.4617 or visit clevelandclinic.org/transform. n