West Michigan | November/December 2009 | ■ A Business & PrActice MAnAgeMent MAgAzine | about PhysiciAns | froM PhysiciAns | for PhysiciAns ■ Bronson Methodist Special Feature Hospital’s Advanced Radiology Offers Rapidly Growing Robotic Hope for Patients With Surgery Program Uses Previously Untreatable Tumors State-of-the-Art Technology Money Matters Patients Are Customers, Not Case Numbers contents VOl. 12, NO. 6 NOVeMBeR/DECeMBeR 2009 4 4 COVeR sTORY DEPARTMENTS Bronson Methodist hosPitAl’s Rapidly 2 from the publisher growing roBotic 3 issues in public health surgery Program uses stAte-of-the- 7 med beat Art technology hy ap At Bronson Methodist Hospital, 3-D, 8 law matters l Photogr high-definition technology has been in A place since 2008, and surgeons have 15 kudos been using it to perform minimally 16 insurance matters invasive surgery with the assistance Photo by Anthony Dug of a robotic device called the da Vinci ON THe CoveR 19 legal ease Bronson Methodist Hospital’s Rapidly Surgical System. Twelve surgeons growing Robotic surgery Program Uses who practice at Bronson Methodist 20 money matters state-of-the-Art Technology Hospital currently use the robot. 12 sPeCiAl feature Advanced RAdiOlOgY OffeRs Hope for Patients With PReViouslY Untreatable Tumors Radiofrequency ablation (RFA) offers promise to cancer patients who were previously untreatable. The minimally invasive procedure delivers a good prognosis for many smaller primary site lesions in the lung, kidney, liver and bone. For more advanced cancers that are not at the primary site, RFA can 12 provide palliative care that extends life beyond what was previously possible. West Michigan Md NeWs noveMber/deceMber 2009 | 1 from the publisher Welcome to the first issue of MD News West Michigan incorporating many of the planned enhancements mentioned in my earlier columns. We hope you like what you see. There’s Publisher: Tom McKenna more to come. Photographer: Anthony Dugal Photography, Ann Telicean With its new fresh look, feel and content flow we believe future issues of MD News will provide our readership with the Contributing Writers: Martha Rabaut Boonstra, Alan G. Gilchrist, Pierre L. Hulsebus, Gretchen Johnson, same outstanding local content incorporated within our new Richard M. Tooker, Robert G. Wilson design for better readability and an enhanced presentation of the materials, submitted by our clients, whom contribute valuable information and services to the health care community. We will continue to enhance our Web presence at westmichigan.mdnews.com and, Chief Executive Officer: David McDonald if you have not already visited, I invite you to do so and give us some feedback on our President: Tony Young efforts thus far. As always we appreciate your input as to how we may improve the Chief Operating Officer: Ann Farmer Chief Financial Officer: Webster Andrews usefulness of our Internet presence. 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Although every precaution is taken to ensure accuracy of published materials, M.D. News cannot be held responsible for opinions expressed or facts supplied by its authors. Copyright 2009, Sunshine Media, Inc. All rights reserved. Reproduction in whole or in part without written permission is prohibited. Advertise in MD News Contact information For more information on advertising in the Send press releases and all other information MD News West Michigan edition, related to this local edition of MD News call Publisher Tom McKenna at 1-877-900-3505 c/o: P.O. Box 48 or e-mail [email protected]. Oshtemo, MI 49077 Printed on post-consumer recycled paper using soy-based inks. 05-739 2 | West Michigan Md NeWs noveMber/deceMber 2009 issues in public health Health disparities in Kalamazoo County Sexually Transmitted Infections By Richard M. Tooker, M.D., Chief Medical Officer Health disparities between African- 10,000 Caucasian males. These num- to afford treatment of these infections Americans and Caucasians are a bers are for 2008 and represent a sharp and their medical complications. well-recognized problem in most increase in just a few years. These measures of disparity are evi- communities, with Kalamazoo being Further, Kalamazoo rates for gon- dent in the fact that the Kalamazoo no exception. The African-American orrhea and Chlamydia have jumped County HCS Sexually Transmitted infant mortality rate continues to be above the statewide rates for the Infection clinic treats more than 70% three times that of Caucasians. Several last two to three years driven by the of these reportable infections. initiatives and programs are addressing significant disparity in infections Other communities with urban the issue. Another health disparity of among African-Americans. The hid- centers experience these disparities in striking proportions, however, remains den epidemic of sexually transmitted sexually transmitted infections. Some a silent epidemic among African- infections is driven not by racial of these communities have taken sig- American teens and young adults. This disparity alone. It is also due to the nificant steps to end the silence and hidden health threat is also a problem fact that these infections are primar- address the problems resulting in this for most Michigan and U.S. communi- ily among individuals between 15 very serious public health problem. ties, but gets little attention or sense and 30 years of age. Especially hard Kalamazoo County has a great deal of urgency. The problem is high hit are 15-19 year olds, making the to learn from these communities and rates of reportable sexually transmitted issue difficult for our communities the time for action has never been infections. to acknowledge. more critical. ■ Among the reportable sexually African-American residents in transmitted infections, racial dispar- Kalamazoo are, on average, less able Source: Kalamazoo County Health ity is especially striking with respect to access care for these infections or Surveillance Data Book to gonorrhea, Chlamydia and HIV/ AIDS. HIV infection rates for African- Americans in Kalamazoo are five times the rate for Caucasians. With respect to Chlamydia, African- American/ Caucasian disparity is very significant. The African-American female rate is 412 cases per 10,000 individuals versus 37 cases per 10,000 for Caucasian females. For African- American males, the rate is 288 cases per 10,000 individuals versus 10 cases per 10,000 Caucasian males. The profile for gonorrhea infections is equal- ly disturbing. The African-American female rate is 217 per 10,000 versus eight per 10,000 Caucasian females. The rate for African-American males is 228 per 10,000 versus just two per West Michigan Md NeWs noveMber/deceMber 2009 | 3 cover story Bronson Methodist Hospital’s Rapidly Growing Robotic Surgery Program Uses State-of-the-Art Technology By Gretchen Johnson Three-D HD was touted as the “next gen immersive TV robotic surgery. experience” at the Consumer Electronics Show in Las Vegas in “The da Vinci system uses traditional laparoscopic in- January. At Bronson Methodist Hospital, 3-D, high-definition struments, held by robotic arms, under the direction of the technology has been in place since 2008, and surgeons have surgeon who is at a console across the room,” explains Anna been using it to perform minimally invasive surgery with Hoekstra, M.D., M.P.H., gynecologic oncologist of the West the assistance of a robotic device called the da Vinci® S HD Michigan Cancer Center. “It works with a 3-D visualization Surgical System. Twelve surgeons who practice at Bronson system, and it mimics the movements of the physicians’ hands currently use the robot. and arms. It has seven degrees of freedom of movement for a The da Vinci Surgical System, from Intuitive Surgical, is more natural operating experience for the surgeon.” part of a rapidly growing robotic surgery program at Bronson Relatively new technology, the da Vinci Surgical System that combines the benefits of laparoscopic surgery with en- was the first robotic surgery system in its class when the hanced graphics and motion capabilities. Its most common FDA approved it for general laparoscopic surgery in the U.S. uses include hysterectomy, colon surgery, the treatment of just nine years ago. For this reason, long-term studies on the gynecological cancers, prostatectomies for the treatment device are not yet available and early research is limited.