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FirstHealth of the Carolinas
Inside the Orthopaedic Service Line By Brenda Bouser
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It is a few minutes before 7 a.m. on a Wednesday morning in February, almost time for the monthly meeting of the Orthopaedic Service Line at FirstHealth Moore Regional Hospital.

Ward S. Oakley, M.D., a veteran orthopaedic surgeon and the service line chair, is conferring with Cindy McNeill-McDonald, FirstHealth’s vice president, Quality, about a couple of matters that she wants to bring before the group. As Dr. Oakley and McNeill-McDonald talk, others enter the 2C Orthopaedics Conference Room and take their seats.

Once assembled, the gathering will include representatives from Pharmacy, Infection Control, Performance Improvement, Inpatient Rehab, Physical Therapy, Food & Nutrition, Outpatient Therapy, Outcomes Management and Home Care as well as most (sometimes all) of the 10 orthopaedic surgeons who have hospital privileges, their physician assistants and members of the nursing staff. Each will have the chance to speak.

This particular service line meeting is known for the variety in its membership as well as for its lively exchange of ideas. That’s exactly what Dr. Oakley wants.

“We talk about issues that are of concern to all of these people who deliver care,” he says. “I want everyone to feel like they have value, because trying to improve the quality of care is what it’s all about.”

The February meeting begins with a report from Judy Finlan, the hospital’s director of Clinical Data Management, about a mandate from the Centers for Medicare & Medicaid Services (CMS) about pre-operative antibiotics. It then moves on to other medical issues and then to patient satisfaction scores. Everyone in the room gets the chance to weigh in.

“We look at the total patient in every department,” says Evelyn Dimps-Williams,R.N., assistant director for the 2C Orthopaedics nursing unit. “The goal is a seamless stay for the patient.”

Each year, FirstHealth’s orthopaedic surgeons perform about 1,000 joint replacement surgeries alone, making the service line one of the organization’s busiest. (In addition to their work at Moore Regional, some of the physicians also see patients at Richmond Memorial and Montgomery Memorial. A number of surgical procedures are also provided at Richmond Memorial.)

Dr. Oakley has been the service line’s chair since 2001, when he took the reins from the retiring John Ellis, M.D., a pioneer in FirstHealth’s orthopaedics program. (See the related story on page 16.) Dr. Oakley encourages the lively discussion, describing it as a “forum” for presenting new techniques and new devices with the ultimate goal of quality patient care.

“Doctors don’t always do the same thing,” he says. “But if they have a treatment that is a better way to do something, it should be passed on for the patient’s benefit.”

Dr. Oakley is also a fan of the pre-surgical program that Dimps-Williams and her staff offer for patients who are scheduled for total joint replacement. These “classes” offer not only an overview of the surgery but also a tour of the nursing unit—which “eases that aspect of the patient’s anxiety,” according to Dr. Oakley—as well as information on what patients can expect upon discharge.

“Doing these things before the actual surgery is all to the benefit of the patient,” Dr. Oakley says. “Anything we can do to help that, that’s a positive thing. The service line helps create that kind of environment.”


In addition to their practices in Pinehurst, five orthopaedic surgeons see patients at a Pinehurst Surgical office at 109 Physicians Park in Rockingham that is staffed five days a week by Kevin Slater, P.A. Those surgeons, Drs. Casey, Conti, Moore, Oakley and Strom, also perform orthopaedic surgeries—from fracture repair to total joint replacement—at First Health Richmond Memorial Hospital in Rockingham. In addition, Drs. Fedder and Casey see patients two days a week and one day a week respectively at offices in the Medical Arts Building adjacent to FirstHealth Montgomery Memorial Hospital in Troy. That office is staffed five days a week by Joleen Moore, C-FNP. For more information on these services, call (800) 213-3284.

Mark E. Brenner, M.D.
Board certified
Pinehurst Surgical
(910) 295-0222
John R. Moore IV, M.D.
Board certified
Pinehurst Surgical
(910) 295-0224
Hospital affiliations: Moore Regional, Richmond Memorial Medical education: University of Buffalo, N.Y., M.D.; internship: Buffalo General Hospital, surgical; residency: Montefiore Hospital & Medical Center, Bronx, N.Y., orthopaedic surgery; fellowship: Jewish Hospital, Louisville, Ky., hand/microsurgery Hospital affiliations: Moore Regional, Richmond Memorial Medical education: University of Mississippi School of Medicine, Jackson, M.D.; internship: Mayo Clinic, Rochester, Minn., surgery; residency: University of Oklahoma Health Sciences Center, Oklahoma City, orthopaedic surgery; fellowship: New Mexico Center for Joint Replacement, Albuquerque, adult reconstruction
   
David J. Casey, M.D.
Board certified
Pinehurst Surgical
(910) 235-9767
Ward S. Oakley Jr., M.D.
Board certified
Pinehurst Surgical
(910) 295-0209
Hospital affiliations: Moore Regional, Richmond Memorial, Montgomery Memorial Medical education: Boston (Mass.) University of Medicine, M.D.; internship: Walter Reed Army Medical Center, Washington, D.C.; residency: Boston University, orthopaedic surgery; fellowship: Weill Cornell Medical Center, New York, N.Y., adult reconstruction Hospital affiliations: Moore Regional, Richmond Memorial Medical education: University of Tennessee Center for Health Sciences, M.D.; internship: Baptist Memorial Hospital, Memphis, Tenn.; residency: Baptist Memorial Hospital, general surgery & Campbell Foundation, Memphis, orthopaedic surgery
       
Neil A. Conti, M.D.
Board certified
Pinehurst Surgical
(910) 295-0230
James E. Rice, M.D.
Board certified
Sandhills Orthopaedic & Spine Clinic (910) 692-3144
Hospital affiliations: Moore Regional, Richmond Memorial Medical education: UNC-Chapel Hill, M.D.; internship: Greenville (S.C.) Hospital Systems; residency: University of Cincinnati, Ohio, orthopaedic surgery; fellowship: University of Iowa, Iowa City (research fellowship) Hospital affiliations: Moore Regional Medical education: Ohio State University College of Medicine, Columbus, M.D.; internship: Brooke Army Medical Center, Fort Sam Houston, Texas, surgery; residency: Brooke Army Medical Center, orthopaedic surgery; fellowship: North Carolina Spine Center
       
David P. Fedder, M.D.
Board certified
Pinehurst Surgical
(910) 295-0881
David E. Strom, M.D.
Board certified
Pinehurst Surgical
(910) 295-0226
Hospital affiliations: Moore Regional, Montgomery
Memorial Medical education: University of Illinois, M.D.; internship: Rush-Presbyterian St. Luke’s Medical Center, Chicago, surgical; residency: Rush-Presbyterian, orthopaedic surgery; fellowship: Cincinnati Sports Medicine and Orthopaedic Center, sports medicine
Hospital affiliations: Moore Regional, Richmond
Memorial Medical education: Wayne State University, Detroit, Mich., M.D.; internship: Wayne State University, general surgery; residency: Wayne State University, orthopaedic surgery; fellowship: Mayo Clinic, Scottsdale, Ariz., foot and ankle
       
Jason E. Guevara, M.D.
Board certified
Pinehurst Hip & Knee Center
(910) 295-7070
Glen D. Subin, M.D.
Board certified
Mid-South Orthopaedic Clinic
(910) 295-4500
Hospital affiliations: Moore Regional Medical education: University of California, San
Francisco, M.D.; internship: University of California, San Francisco, surgical; residency: University of California, San Francisco, orthopaedic surgery; fellowship: University of Pittsburgh (Pa.), adult reconstruction
Hospital affiliations: Moore Regional Medical education: Downstate Medical Center, Brooklyn, N.Y., M.D.; internship: New York University Medical Center, New York, N.Y., general surgery; residency: New York University Medical Center, orthopaedics; fellowship: Duke University Medical Center, Durham, hand surgery