Carilion MedicineSPRING 2017 In partnership with the Virginia Tech Carilion School of Medicine and Research Institute A DECADE OF TRANSFORMatION A regional health system in Virginia has reinvented itself as a national leader with forward-thinking health care, education, and research contents CARILION MEDICINE SPRING 2017 Departments 2 FROM THE CMO 3 IN BRIEF Medical school integration with Virginia Tech; national humanism award; leadership in research 6 GRAND ROUNDS Education initiatives both classic and with a twist 36 THE ART OF MEDICINE: THE COMFORTER As Caroline Osborne was fighting for her life, her friends found new meaning in their white coats. 38 CHEERS FOR PEERS Carilion clinicians achieve recognition 32 40 BACKSTORY: PHYSICIAN, A KEEN EYE AND A LEAD THYSELF LISTENING HEART: Increasingly, physicians are expected to lead, Thomas Kerkering, M.D., govern, and manage. delights in the life stories of his patients. BY HUGH J. HAGAN III, M.D. Features COVER STORY 16 22 26 30 32 8 THE FIX STORM CALL OF BACK ON A DAY IN THE A DECADE OF More Virginians now die from opioid overdoses CHASERS THE WILD TRACK LIFE OF THOMAS TRANSFORMATION than from car accidents. Carilion doctors are Carilion has launched Medical students joined Carilion and its partners offering new surgical a wilderness medicine with clinicians and KERKERING In celebrating 10 years as an The globally renowned integrated care delivery system, are offering a range of approaches for patients fellowship in response to engineering students to approaches to the opioid whose epilepsy has failed the region’s popularity as develop a technique to infectious disease expert Carilion offers a model for follows clues worldwide. revolutionizing patient care. addiction epidemic. to respond to treatment. an outdoor destination. enhance spinal fusion. BY CHARLES SLACK BY JESSICA CERRETANI BY VERONICA MEADe-KellY BY PAULA BYRON BY ALISON MAtthiESSEN BY DAVID HUNGATE SHUTTERSTOCK (COVER); DAVID HUNGATE (aboVe) ten years ago, we began a transformation at Carilion, turning a collection of hospitals into Carilion Medicine an integrated care delivery system emphasizing President and Chief Executive Officer exceptional clinical care, education, and research. Nancy Howell Agee On the pulse of the That transformation meant taking risks. Chief Medical Officer and Carilion Clinic community We took a risk when we changed the way we Executive Vice President organized, becoming a physician-led clinic. We Patrice M. Weiss, M.D. took a risk by partnering with Virginia Tech to Editorial Advisory Panel in brief Nathaniel L. Bishop, D.Min.; Cesar Bravo, M.D.; start a medical school and research institute. We John Burton, M.D.; Kimberly Carter, Ph.D., R.N.; took a risk when we embraced population health, Mahtab Foroozesh, M.D.; Evelyn Garcia, M.D.; THE FUTURE IS NOW: Nancy focusing our work on the community as well as Mark Greenawald, M.D.; Daniel Harrington, M.D.; Howell Agee, president and Cynda Johnson, M.D., M.B.A; Donald Kees, M.D.; chief executive officer of Carilion our own patients. STRONGER TOGETHER Wilton Kennedy, D.H.Sc., P.A.-C.; Claudia Kroker- Clinic, speaks at the Virginia Tech We surrounded ourselves with innovative and tenacious people, and we Bode, M.D., Ph.D.; Eduardo Lara-Torre, M.D.; Bruce In August, the Virginia Tech Board of Board of Visitors meeting. kept pushing to build the future of health care all around us. We expanded Long, M.D.; John Pastor; William Rea, M.D.; David Visitors voted to integrate the academic Sane, M.D.; Gary Simonds, M.D.; Jon Sweet, M.D. our academic programs, services, and research. Along the way, we received and research missions of the Virginia Tech Chief Administrative Officer attention for our approach to national problems, such as physician burnout Carilion School of Medicine fully into Jeanne Armentrout Virginia Tech. and opioid addiction. Vice President The medical school will notify and We continue to take risks and to look at problems from new angles. We’re Mike Dame review milestones with several accrediting finding new ways to bring care to people where they are, realizing they may and regulatory bodies, including the Executive Editor not always be able to come to us. We’re working with community partners to Linda Staley Liaison Committee on Medical Education, improve our regional economy and the social determinants of health. We’re before becoming the university’s ninth Editor college in July 2018. The medical school taking a page from colleagues in other industries to use data and process Paula Byron is now an independent institution, improvement toward clinical advancement. Art Director affiliated with both Carilion Clinic and We keep working to find solutions not for the sake of innovation itself, but Laura McFadden Virginia Tech. The school, along with the for the people. We’re working for the mother who hasn’t visited the doctor Special Thanks closely aligned Virginia Tech Carilion because it’s too difficult to coordinate child care and public transportation. Neely Conner, Catherine Doss, Laura Mitchell, Research Institute, will form the core Anne Shaver, Ashley WennersHerron We’re working for the father who needs mental health services but doesn’t of the expanded Virginia Tech Carilion work together to attract and hire expert growing, and dynamic research university know where to find them, or what questions to ask. We’re working for the CARILION CLINIC Health Sciences and Technology Campus clinicians to fill future appointments. with world-class expertise in the biomedical 1906 Belleview Avenue in Roanoke. “For more than a decade, the relation- sciences is a natural next step for both grandmother who needs surgery, to ensure her hospital stay is a safe one and P.O. Box 13367 “The integration will create new oppor- ship between Virginia Tech and Carilion Virginia Tech and Carilion Clinic.” that she doesn’t acquire additional infections. We’re also working to care for Roanoke, VA 24033 tunities to access external research has grown stronger as we both focus on In 2016, Virginia’s General Assembly CarilionClinic.org each other, because physician burnout is a serious problem and clinicians who funding that is available to institutions supporting our region,” said Virginia Tech approved a bond package to build a $66- 800-422-4842 have support are better able to care for others. with medical schools,” said Nancy Howell President Tim Sands. “The integration million facility to expand the Health Our patients and our communities continue to face many health problems. So Agee, president and chief executive of the school of medicine into a vibrant, Sciences and Technology Campus. we continue to work, and we will continue to evolve. officer of Carilion Clinic. “That builds on our already strong program and This edition of Carilion Medicine highlights our past ten years, our present, and conference Carilion Medicine is published twice a year at: will be good for the students, Virginia our vision for the future. 213 McClanahan Street, Suite 200 Tech, and Carilion because it will lead Muhammad Ali once said: “If your dreams don’t scare you, maybe they’re not Roanoke, VA 24014 to increased growth in translational Precision in Neuroscience big enough.” Phone: 540-266-6586 Fax: 540-266-6608 research, connecting the theoretical to In October, the Virginia Tech Carilion hospitalizations than any other disease Our dreams are big. Medicine is constantly evolving, and each advancement Email: [email protected] our patients’ bedside. It will also help Web: CarilionClinic.org/carilionmedicine Research Institute became the capital of the group, including heart disease and cancer. has the potential to save lives and make our patients healthier. us to continue to attract the very best clinical researchers and their teams.” precision neuroscience world, as it hosted “By understanding an individual’s I can’t wait to see what the future holds. Carilion Clinic is a nationally ranked integrated health the Virginia-Nordic Precision Neuroscience genetics, behavior, education, habits, Many of the major connections between care system headquartered in Roanoke, Virginia. Its Conference, the first international scientific and life experiences, such as physical and flagship, Carilion Roanoke Memorial Hospital, is the Carilion and the medical school will clinical affiliate of the VirginiaT ech Carilion School of continue after the integration. Students meeting to explore an ultra-personal psychological trauma—all the things Medicine and Jefferson College of Health Sciences. will continue to train at Carilion Roanoke approach to brain health. that make people who they are—the © Copyright 2017 by Carilion Clinic. No part of this Memorial Hospital and elsewhere within Michael Friedlander, Ph.D., executive neuroscientific community may be able to publication may be reproduced or transmitted director of the institute, pointed out develop individually tailored plans that allow in any form or by any means without written the Carilion system. About 300 clinicians Patrice M. Weiss, M.D. permission from Carilion Clinic. All editorial rights at Carilion Clinic will continue to hold that more than 1,000 disorders of the people to thrive cognitively, socially, and Chief Medical Officer and Executive Vice President reserved. Opinions expressed herein may or may not dual appointments as professors at the brain and nervous system result in more physically,” he said. reflect the views of Carilion Clinic. Carilion Clinic medical school, and the two entities will 2 CARILION MEDICINE | SPRING 2017 PHOTO: JARED LADIA PHOTO: LOGAN WALLACE CARILION MEDICINE | SPRING 2017 3 honors Carol Gilbert Wins Prestigious A NEW MODEL OF COMMUNITY HEALTH OUTREACH briefings Humanism in Medicine Award In partnership with the Bradley Free Clinic, Supporting the community health Leadership Honor Carol Gilbert, M.D., an associate professor of countered a larger hurdle when she decided New Horizons Healthcare, and United Way workers is a Community Hub, an Tracey Criss, M.D., surgery at the Virginia Tech Carilion School to pursue surgery because she was a woman of Roanoke Valley, Carilion has received a infrastructure that provides tools and co-interim chair of of Medicine, has won the Arnold P.