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FirstHealth of the Carolinas
Specialty clinics division offers patients one stop for treatment By Annette Dunlap
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The Bariatric Center
Pinehurst Surgical began offering bariatric surgery in March 1999. Candidates for the surgery now benefit from the multidisciplinary approach offered at the Bariatric Center at Moore Regional Hospital.

Priscilla Godfrey, R.N., is the program coordinator. Julie Walenta, a registered dietitian, provides nutrition counseling that is specific to bariatrics.

Bariatric surgery is the last resort procedure for people who have tried everything else to address their morbid obesity. A successful outcome for bariatric surgery depends on many factors, including a lifestyle change. The involvement of so many specialists in the care of these patients makes the Bariatric Center a good fit for a multidisciplinary approach.

“The hospital understood that a good bariatric program cannot be done through the physician’s office alone,” says the program’s medical director, Kenneth Mitchell Jr., M.D. “The best pre-, peri- and post-operative models throughout the country use a campus-based program.”

According to Dr. Mitchell, the multidisciplinary approach means that bariatric patients will get the highest quality care. After visiting programs across the country, he concluded that the team-based model works best for bariatric patients. Through this approach, representatives from every specialty that works with bariatric patients participate in the development of a care plan.


Kenneth Mitchell Jr., M.D.


Raymond Washington, M.D.

Kenneth Mitchell Jr., M.D., and Raymond G. Washington, M.D., are the physicians affiliated with FirstHealth’s Bariatric Center.

Specialties include behavioral medicine, cardiology, pulmonology, physical therapy and exercise physiology, nursing, nutrition, support groups and, of course, surgery.

The hospital’s commitment to the bariatric program has created a comfort zone for its patients. “Bariatric patients already experience discrimination because of their obesity,” Dr. Mitchell says. “They are sensitive to every aspect of the way they are treated. If you don’t have a gown that’s large enough to fit them, or a bed that they can lie in, or a chair that they can sit in, then patients are extremely uncomfortable.

“When a hospital, such as Moore Regional, takes steps to identify the details that are important to bariatric patients, that creates a comfort zone for them. This comfort zone instills confidence, and then those patients tell others about their positive experiences.”

Patient responses on questionnaires helped drive the move toward the multidisciplinary approach. “We are responding to the needs of our patients to create a program that can be designated as a Center of Excellence,” Dr. Mitchell says. “That means that we are taking the steps to ensure the high likelihood of a good outcome for each person who participates in our program.”

Goals of the Specialty Division
While each specialty is a stand-alone center within the Specialty Division, each program has the same goal.”

“We are bringing the physicians to the patient, rather than asking the patient to make visits to many different physicians to receive treatment,” says Mooney.

Family members as well as patients benefit from this convenience. Most importantly, delays in starting a treatment plan are reduced. Providing the best possible outcome for every patient is the ultimate goal of each program within the Specialty Clinics Division.

To contact the Chest Center of the Carolinas, call (866) 263-3229. To contact the Bariatric Center, call (866) 603-9191. To contact the Esophageal Center, call (866) 603-8472. All are information and referral numbers, and all are toll-free.

 

A day in the life of the Chest Center team

It is 11:30 on a Tuesday morning when Moore Regional Hospital‘s Chest Center team gathers for its weekly meeting after having seen patients since early morning. Andy Kiser, M.D., the center’s medical director, opens the meeting by calling the team’s attention to a set of CT scans illuminated on the light board.

After he identifies the patient, Dr. Kiser gives the diagnosis and his suggested course of treatment. Then he asks, “I’d like input from Radiology. What do we do here? If I operate, the patient will lose some ribs.”

Radiology is not the only service represented at this meeting. With its multidisciplinary approach to care, the Chest Center brings together physicians from several different specialties, including radiation oncology, medical oncology and pulmonology. Nursing is also a part of the team.

Dr. Kiser’s question is typical of what takes place throughout the team’s meeting. Over the course of the next hour, the team will review the diagnosis and treatment for each of a dozen patients who are receiving Chest Center care.

While many of the patients have been diagnosed with cancer, there is no onesize-fits-all treatment. Each case is discussed individually, and each team member contributes his or her thoughts regarding the best way to care for the patient.

Conversation is lively, but the objective of each team member is clear: How do we track a patient’s progress and provide him or her with the best treatment?

Physicians do not agree with every initial diagnosis, but that is to be expected in this highly collaborative atmosphere. The team is dedicated to excellence in patient care, and that commitment occasionally expresses itself in differing views about a patient’s condition.

When the physicians differ, each one explains how he or she interprets the CT or lab results. The physician supports the interpretation with a recommendation for additional testing to confirm the diagnosis. The team arrives at a consensus, and the next steps of the patient’s care plan are outlined.

Calling the team’s attention to the next patient, Dr. Kiser points to a PET scan. He reviews the patient’s medical history, age and recommendations for treatment.

“I treated that patient for another form of cancer three years ago,” says medical oncologist Ellen Willard, M.D. She discusses the medications used to treat the patient previously, and reviews how that may affect the patient’s response to the cancer treatments now under consideration.

Once again, the physicians discuss the patient’s prognosis. They take a comprehensive, holistic approach to patient care. Their goal is to identify the best way to help a patient, without creating additional, unnecessary medical complications.

The team completes its review of the patients on its list, and adjourns at 12:40 p.m. Members of the team ate lunch during their meeting, and they are ready to return to their offices to see patients—and to implement the plans developed for their patients’ care.

It is 11:30 on a Tuesday morning when Moore Regional Hospital‘s Chest Center team gathers for its weekly meeting after having seen patients since early morning. Andy Kiser, M.D., the center’s medical director, opens the meeting by calling the team’s attention to a set of CT scans illuminated on the light board.

After he identifies the patient, Dr. Kiser gives the diagnosis and his suggested course of treatment. Then he asks, “I’d like input from Radiology. What do we do here? If I operate, the patient will lose some ribs.”

Radiology is not the only service represented at this meeting. With its multidisciplinary approach to care, the Chest Center brings together physicians from several different specialties, including radiation oncology, medical oncology and pulmonology. Nursing is also a part of the team.

Dr. Kiser’s question is typical of what takes place throughout the team’s meeting. Over the course of the next hour, the team will review the diagnosis and treatment for each of a dozen patients who are receiving Chest Center care.

While many of the patients have been diagnosed with cancer, there is no onesize-fits-all treatment. Each case is discussed individually, and each team member contributes his or her thoughts regarding the best way to care for the patient.

Conversation is lively, but the objective of each team member is clear: How do we track a patient’s progress and provide him or her with the best treatment?

Physicians do not agree with every initial diagnosis, but that is to be expected in this highly collaborative atmosphere. The team is dedicated to excellence in patient care, and that commitment occasionally expresses itself in differing views about a patient’s condition.

When the physicians differ, each one explains how he or she interprets the CT or lab results. The physician supports the interpretation with a recommendation for additional testing to confirm the diagnosis. The team arrives at a consensus, and the next steps of the patient’s care plan are outlined.

Calling the team’s attention to the next patient, Dr. Kiser points to a PET scan. He reviews the patient’s medical history, age and recommendations for treatment.

“I treated that patient for another form of cancer three years ago,” says medical oncologist Ellen Willard, M.D. She discusses the medications used to treat the patient previously, and reviews how that may affect the patient’s response to the cancer treatments now under consideration.

Once again, the physicians discuss the patient’s prognosis. They take a comprehensive, holistic approach to patient care. Their goal is to identify the best way to help a patient, without creating additional, unnecessary medical complications.

The team completes its review of the patients on its list, and adjourns at 12:40 p.m. Members of the team ate lunch during their meeting, and they are ready to return to their offices to see patients—and to implement the plans developed for their patients’ care.

To contact the Chest Center of the Carolinas, call (866) 263-3229.

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